with this in mind and input from dph leadership we identified four items we want to focus on during our agenda these meetings. the first being budget and contracting issues, the second being laguna haund hospital recertification and sustainability plan and two items of the four critical the mayor has identify, which is health equity and behavioral health which includes overdose prevention efforts as well. our goal is review the items and insure the public has a opportunity to both be informed and provide input, and of course our meetings in the future will highlight other important public health topics such as the prop q hearings involving the sale of local dignity hospital to ucsf and other reports the dph staff feel are critical to having in the public record. i just wanted to make sure people knew, this year we really want to be focused and also make sure that we adequately cover those items greatest concern to the public and greatest concern to the dph and mayor's office, so i just wanted to begin the year framing it in that way. so, because we are in informational session, we'll sk

first, we reviewed the draft dph annual report for fiscal year 22-23. as you know, the report summarize and highlight dph data and services. we were generally very pleased with the report and the only thing i think primarily we were encouraging them to do was to highlight more of the successes of--and the increase in service providing and through the communities, particularly given what we have been going through and focusing on in the last year around healthcare provision and also substance use disorders and providing people with treatment and the stark difference between the availability of treatments in this past fiscal year versus previously. i think it's-commissioner gerardo brought this up, it is very important for the department to highlight that information so people can see in the annual report and the media can see in the annual report the good work and change that is happening and also the really excellent work and increase in service providing to the community and our public health sites and so, basically just more pleased about what the goo

first, we reviewed the draft dph annual report for year 22-23.e report summarize and highlight dph data and services. we were generally very with the report and the only thing i think primarily we were encouraging them to do highlight more of the successes of--and g#increase in service providing and through the communities, particularly given what we have been and focusing on in the last year around healthcare provision and also substance people with treatment and the stark difference between the tments in this past fiscal year versus previously. i think itis very important for the department to highlight that information so people can see and the media can see in the annual report the good work and change also the really excellent work and increase in service providing and our public health sites and so, basically just moplhas been and the data and the numbers and so we can focus on those accomplishments and them. so, the final report is scheduled to come to full commission in february. second item was update child and adolescent section. it was

expand with dph and das and investing in lower client to case manager ratios. challenge, tenant non payment of rent is a huge challenge. we use national best practice to development non payment of rent guideline frz housing provider s and there is lots more we need to do. another challenge maintaining quality of psh sites, especially older master lease sro. solution, investing in capital improvements and elevator repairs and expanding hqs inspection across the portfolio. and next slide and final slide. i thank you so much. i want to thank the commission allowing me to do this presentation and the supportive team at hsh, the permanent housing team and the [indiscernible] team. thank you for all your work on this. i want to reiterate that was just a global overview of the hsh permanent housing portfolio and if you have specific questions please pass to the commission secretary and we'll fold them into the next presentation. attached to this powerpoint is a bunch of slides you can review at your leasure. i will ask me team to come up to stand next to me to answer

from february 1, 2024, for a total term of february 1, 2020, through june 30, 2028; and to authorize dph to enter into modifications of the agreement that do not materially increase the city's obligations or liabilities and are necessary to effectuate the purposes of the agreement or this resolution. (public health between mckesson plasma and biologics llc and the department of public health (dph), under administrative code, chapter 21a.2, to increase 21a.2, to increase the agreement amount by $1,170,803,034 for a not to exceed amount of $1,466,737,824;extend the term by four years and five months from february 1, 2024, for a total term of february 1, 2020, through june 30, 2028; and authorize dph to enter into modifications of the agreement that do not materially increase the city's obligations or liabilities and are necessary to effectuate the purposes of the agreement or this resolution. (public health department) you seeing no names on the roster. >> same house, same call. the resolutions are adopted. >> 17 through health (dph), for mental health outpatient treatment services and opt

and so with that, um, brings some increasing california dph has reached out to us with a grant to help staffing for the analysis opioids and with that project depend really leading methodologies to detect 250 of those double opioids and we reanalyzed this type compound and found over 60 substances of opioids were detected and specifically as mentioned foenl had 45 cases and a 27 page report on the website with individual data and also carsing those to better provide information for the policymakers. with that, the california dph reached out to us again to if we're interested in doing a 5-year at this time looking at the opioid but (unintelligible). >> and to do this challenges we're facing increasing caseloads and increasing the drugs in the community so more drugs to test and additionally with those by individuals took the cases we received as a normal - so those challenges in mind some of the creation of a - the demands and provides the accurate cause of dose for families and public health and make sure we maintain this on time with that, we ask for this staffing in terms of toxicolo

for the treatment beds, i think that was a-i was involved in those early discussions when dph forward a proposal to this body about what should be funded in that initial round of funding. beds were a big thing we wanted to be able to expand with. prop c funding we are really proud of the fact that over 350 beds have been opened. there is both expansion of existing programming that a bed gap analysis had said we need more of, but also new innovative programs. we have a new alcohol program which is funomally successful in terms of improving outcomes for the people admitted into that program. we have expanded our psychiatric respite, hummingbird program, so those are-great for you all to hear about, and for our body, for the iwg, our goal is really to get understanding of what behavioral health service and meant health sf is working on, like the new facility for the mental health service center. member friedenbach you had a lot of input what that should look like as do members of our working group, so we are giving input, so that it meets that vision of a low barrier way to access care t

especially those who have survived an overdose and are at a higher risk of a fatal overdose in 2024, dph will continue to expand treatment, access and implement programs to help people get into care and to help us understand and respond more effectively and more timely. >> peer addiction specialists say the key tose deaths is having consistent and persistent care and wraparound services available for those who are struggling with addiction, so that the moment they decide they need help, that help is available in san francisco, christien kafton, ktvu, fox two news. >> well, today marks 35 years since a mass shooting at an elementary school in stockton. >> it was one of the first mass shootings on a school campus in modern us history. it was back on january 17th, 1989, when a gunman opened fire with a semiautomatic weapon on the playground of cleveland elementary school. he killed five school children and wounded 32 others before turning the gun on himself, friends, family and survivors today attended a vigil to remember the young lives that were lost that day. now we go to santa rosa, whe

. >> in 2024, dph will continue to expand treatment, access and implement programs to help people get into care and to help us understand and respond more effectively and more timely. that includes expanding access to medications used. >> to reduce a person's risk of dying of an overdose and expanding access to naloxone, which was distributed almost 125,000 times last year to reverse an overdose in progress. and despite the city's multifaceted approach, the street teams that work one-on-one with substance abusers admit getting someone to commit to changing their lives is difficult to. the reality is most people will decline treatment on our first second 3rd, even 20th attempt. but we don't give but there are many success stories as evidence by former users who are now members of the overdose response team. >> many years ago at the as a young you. i was addicted to pct. so now i'm in full recovery. over 27 years. and i account that for in counting outreach teams, families and friends outreach in meat. that's why i chose this field. i experience compassion. i want to give that back. >>

almost immediately it was determined that he had a severe form of dph, hermoidal, that is, the bloodly collapse, so he almost immediately developed pneumonia, then his kidneys stopped working; it is impossible to predict how any particular disease will progress in a particular person. there are many infections, which for the majority, even if they occur in a mild form, for some can lead completely unpredictably to very serious or even fatal consequences. the thai ministry of health has already issued an official bulletin in which it called on the population to prepare for an outbreak of an epidemic of several killer diseases at once. doctors are expecting a deadly thai cocktail of influenza virus, dengue fever and a new strain of covid. at the same time, monkeypox, the zika virus, and typhus, which are familiar to the region, have not disappeared from the country, they still infect hundreds of people a year, however, even without these exotics you can catch them in asian markets a whole bunch of all kinds of infection. by buying fresh meat or fish like this at one of these markets, a

. >> good morning supervisor safai government affairs manager at dph and are working with folks to bring in alignment with the state law because of the requirements for 50 percent of membership to be either consumers or family members. we add one more seat we'll have to add another seat for advocates. >> no, no, i want to say if we had would it be difficult to leave that language in in that you could leave that language in and still have. >> we could but have to balance that with the state requirement. and that's why the legislation is as it is in front of you today. so that is - would be um, thinking behind that we discussed will be continued because those amendments are substantive by that's the reasoning behind that as we stated early we have a current commissioner. you don't know i don't believe it is hard to recruit. to this but wanted to state the reasoning behind that. >> why not through the chair or the city attorney a way to put language in that honored the state welfare code and not add an additional seat maybe you thought about that. >> i do think ultimately this is a policy c

hammer has been a person for the affordable act by dph and three led to the health network as to meet the demands she - during covid she was integral in setting up the care and helped expand the ambulatory costs and bringing vaccinations. and draw hearing examiner has been a guiding force for the behavorial health and supporting hillary and joined dph and dr. hammer has served on the steering committee's for management for 5 years where i began to get to know her and a strong admire of her. not only is her knowledge and experience of staff but deeply compassionate one of the harder workers and has a commitment to the patient in our city system and her coworkers say she's a public health leader and strengthening health services for san franciscans has led so and served the city we love for thirty years i can tell you that her many contributions have been a latin impact on the residents and proud to have worked with you dr. hammer and i hope you are very excited and have a very fulfilling retirement and thank you so much. >> (clapping) and if i don't mind before you say some remarks i w

especially those who have survived an overdose and are at a higher risk of a fatal overdose in 2024, dph will continue to expand treatment, access and implement programs. >> aims to help people get into care and to help us understand and respond more effectively and more timely. peer addiction specialists say the key to reducing overdose deaths is having consistent and persistent care and wraparound services available for those who are struggling with addiction, so that the moment they decide they need help, that help is available in san francisco. >> kristen kafton, ktvu, fox two news tonight, we are learning more information about what's being described as a serious assault on the campus of montgomery high school in santa rosa. >> police say they booked a 14 year old female student into juvenile hall last night on charges of robbery and assault. like to create great bodily injury. officers say the student attacked a fellow 14 year old student inside the girls restroom, stole her phone, punched her in the face and then kicked her in the head. >> attorney general rob bonta was in san fra

dph.tem 25, resolution retroactively authorizing the department of public health to accept and expend a grant increase in the amount of $281,965 for a total amount of $3,973,298 from the california department of public health for participation in a program, entitled “california tobacco prevention program (ctpp),” for the period of july 1, 2023, to june 30, 2024. item 26, retroactive authorization for dph to enter into grant agreement through june 30, 2027 between the city and advocates for human potential inc. having anticipated revenue to the city of approximately $6.7 million for construction at 822 geary street first floor to include a permitted and restricted use. >> same house same call, the resolutions are adopted. madam clerk, please read item 27 and 28 together? >> 27 and 28 are two accept and expend grants for the mayor office of housing and community development to execute a standard agreement with the hcd california department of housing and community development. item 27 is for

dph.tem 25, resolution retroactively authorizing the department of public health to accept and expend a grant increase in the amount of $281,965 for a total amount of $3,973,298 from the california department of public health for participation in a program, entitled “california tobacco prevention program (ctpp),” for the period of july 1, 2023, to june 30, 2024. item 26, retroactive authorization for dph to enter into grant agreement through june 30, 2027 between the city and advocates for human potential inc. having anticipated revenue to the city of approximately $6.7 million for construction at 822 geary street first floor to include a permitted and restricted use. >> same house same call, the resolutions are adopted. madam clerk, please read item 27 and 28 together? >> 27 and 28 are two accept and expend grants for the mayor office of housing and community development to execute a standard agreement with the hcd california department of housing and community development. item 27 is for

requested retroactive authorize of the funds toalicate to the grant the item is retroactive due to dph receiving the notice of award in august 30 of 23. with the project start date of july first of 23 and project start date of the is predetermined by the grantor. thank you for your time and consideration. and i will open up for questions you have. >> thank you. it is interesting, i see that there is a senior health educator? to be part of this and i'm love to learn more about that. not this moment. just in the separate conversation. interesting. >> i could upon answer that question now. i think. what i'm hearing the senior health educator classification or certification does not imply this individual is reaching out to seniors. it is a higher level classification we have health education assistant. a health educator and senior health educator in those series. >> senior health educator could program manage several wellness and drug health services. it is nestle in the program management design and implementation around populations. thank you. >> sometimes i'm reading it and trying to un

recommended both by the cdc, center for disease control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. >> i actually was in the project here when i first started here it was in trials. i'm currently on prep. i do prep through city clinic. you know i get my tests read here regularly and i highly recommend prep >> a lot of patients inclined to think that there's no way they could afford to pay for prep. we really encourage people to come in and talk to one of our prep navigators. we find that we can help almost everyone find a way to access prep so it's affordable for them. >> if you times we do have opponents would be on thursday morning. we have two different clinics going on at that time. when is women's health services. people can make an appointment either by calling them a dropping in or emailing us for that. we also have an hiv care clinic that happens on that morning as well also by appointment only. he was city clinic has been like home to me. i been coming here since 2011. my name iskim troy, client of city clinic. when i first le

i have dave frid dph to answer questions you may have. that concluded my present anticipation. from the bla office. item 2 a resolution approving a lease with public health and aim to the landlord of south van ness avenue. the let's a term of 4 years through december of 27. with one 5 year option to extend. the terms on page 3. we note the stealed pay 2. 7 million dollars -- in rent costs plus utilities 120 thousand dollars over that term of the if the lease is extended the rent reset to market rate. we note the city lease third degree site since early 80s. and prior we recommended this the public health report to the board on potential low moving the programs to city space. we had a conversation with the department about that. they are planning consolidate. that's part of their plan they have in the prioritized moving this property and there is no funding for temperature there is abopportunity in november of 24 to perhaps include fund nothing this bond for the -- purchase for the where the service could move. it would take time to work that out have you to work with the capito

staffing, including housing focus case management, behavioral health and medical service provided by dphsic amenities like restrooms showers, wifi. privacy fencing, office staffing for case management and other services, community space dining space and storage. we are anticipating providing two meals a day laundry serve ice and gray and black water service for the occupied vehicles on the site and anticipate this initial phase of the project will include 60 cabins and 20 safe parking places. i should note the size of the property will allow us to go bigger, buts we are constrained by the existing budget, so down the road if able to raise more fund through state or federal we could add capacity at it site. this next table is a bit of cost overview. it is critical the program provides the necessary amenities and services for two shelter interventions in district 6. the long-term lease provides a opportunity to invest in a 15 plus year program that provide safe dignified and sustainable place for people to stabilize and work towards exit from homelessness. this overview of othe cost there

. -- dph when they do a grant monitoring press they have a scoring rubric when the units of service are delivered are say 80 to 100% they get a 4 and then a 3. the are evaluated the number of cliented and the extent of the conelectron is compliant with other requirements entering data in a system and evaluated and this rolls up to over all score. and so i think that -- is -- what would be an improvement. you say there are goals in the grant agreement? you are saying. go do this? but not clear -- from the way the information is reported. first you do work to figure out whether they achiefed the goal and no way of think burglar if they did not that is the problem or not. it is is a new program there is w to figure out. and in an eviction process. i think those are the portions. i'm curious. bla looked at this. suggested there are different ways of keeping track of the data or you are not set up to the the assessment this than i are not set up and you are not set to do it. of what is in your grant agreement. is that -- correct? is that a problem? should we be correspond, are you concerned

lopoc were at the meeting as well and what i can say is dph is ready to move on approximately 40 people in january, so they will start the process for that number of people in january. i don't know the ins and outs of it, but i can certainly-we can certainly find out more for you. >> alright. thank you and feel better soon. >> thank you. >> commissioner fraser. >> thank you. thank you chief for your report. i'll be quick and qu thank you commissioner feinstein. when i was a visiting nurse in the 90's we didn't have enough conservators. when you say they move on 40 people you mean 40 people who require conservatorship? >> yes. that's my understanding. >> not 40 new staff? >> not 40 new staff, 40 people that- >> have been recommended? >> yes. >> okay. >> that thank you very much. vice president morgan. >> i'll be quick. hope you feel better chief. >> thank you. >> i won't hold you too long, but i want to make a comment about the fire prevention town hall meeting you guys do. you guys do a great job with that. i was looking at all the dates and everything and i think that is a great idea.

and dph and many others. um, we count on their support and hope to continue fair market value good relationships so all employees have ma'am, benefits and happy to report the cloirnl were invited to attend a meeting by the comptroller's office and at that meeting hundreds of payroll officers saw the clournldz one team to help with the recognition and to start the conversation. >> and payroll plays a critical role for the employees of their benefits we concluded a payroll calendar the days the contribution are done from the paychecks a few other remarks i appreciated did boards awareness of how small sfers team we meet the needs of over 34 thousand participants i wanted to acknowledge the hard work and the hurls of four counselors as you can see has joined team and acclimated and chu fluent in chinese is doing in-person meetings on the building and michael and matthew are fluent in spanish we need the is a good bye to jewish last month he moved up to another opportunity and in the process of recruiting the rep

people who need to be conserved can be conserved so we have done a lot of cross departmental work with dph, with the police, with fire, with the sheriff to and working very closely with the mayor's office to be ready. we're one of two counties in the state implementing this law right now. at this point i think it's really important for me to give another shout out to planning and hsa who has worked tirelessly to make sure that our dashboard is ready to make sure we're accurately counting all the data point and really helping us talk through what the best way to do this so to all of planning and to jill and all of your -- jill nelson and all of your team it's a herculean effort. we are still trying to work out all the kinks but i am sure proud of my team and what they bring everyday so shout out to them. i won't talk about the budget. that's coming up next so i'm only here to bring the good news today. >> thank you. thank you very much. are there any follow up questions for kelly? >> yeah. i have a question. >> yes. >> i'm going through -- [inaudible] substance abuse and the definition you

i want to also commend dph and thank you for your testimony. thank you again for your patience this evening and are apologies for the delay. i really appreciate what you presented and i think your patience is a testament to your services. i think i want to also flag for the appellate for mr. homdy that we are also at a bit of disservice this evening by not receiving a brief from you, which doesn't allow to prepare and surface the appropriate questions and issues ahead of time, ahead of presentation but i want to thank you for what you've surfaced this evening. i think we have done our best to grapple with those issues you presented orally and i do see the complexity and the various wrinkles to the various ordinances and various permutations of guidance from the department and do see how that could be extremely confusing, and whether the question is a lack of diligence or being mislead, i think it leads us to the same place, which is that, what you hear this evening we don't see a grounds under the law under the clear delineation and guidance pr

requested retroactive authorize of the funds toalicate to the grant the item is retroactive due to dph receiving the notice of award in august 30 of 23. with the project start date of july first of 23 and project start date of the is predetermined by the grantor. thank you for your time and consideration. and i will open up for questions you have. >> thank you. it is interesting, i see that there is a senior health educator? to be part of this and i'm love to learn more about that. not this moment. just in the separate conversation. interesting. >> i could upon answer that question now. i think. what i'm hearing the senior health educator classification or certification does not imply this individual is reaching out to seniors. it is a higher level classification we have health education assistant. a health educator and senior health educator in those series. >> senior health educator could program manage several wellness and drug health services. it is nestle in the program management design and implementation around populations. thank you. >> sometimes i'm reading it and trying to un