in san francisco we have hospital-based facilities as well as free standing facilities.ented towards short term stays for people who need rehabilitation after injury or illness. they can be oriented towards patients requiring longer term stays. such as patients that have permanent disabilities, chronic illness, require ongoing supervision. this graph shows the total number of skilled nursing facility beds in san francisco. which as of 2013 was about 2759. since 2002, the number of hospital bed have fallen about 27%. we know this number has declined further since 2013. free standing facilities, however, have fallen about 15%. i just wonts to point -- i just want to point that the data is the number=yñ?ñ? on $yñ?ñ?6sñ?ñ?licensed beds. in 2013 san francisco had seven hospital-based skilled nursing units with more than 1500 licensed skilled nursing beds and occupancy rate of about 79%. the average length of stay was about 110 days. as commission knows between 2013 and 2020, san francisco is projected to lose more than 300 hospital based beds. this is due to changes in sniff

one of the things we look at his what soldiers, upon a facility and it might be an ied making facility or a lab are one of those kind of facilities, we replicate them here. a can see it firsthand here before they are faced with that in reality. it comes to mind because one of our recent partners here as we've been working with is the mexicans. they have come to look at the facility to differentiate between a drug lab and in ied lab. if you break this glass jar and some kind of gas comes out and it injures either soldiers a law enforcement, that is the kind of think we want them to do here before their face with that challenge real-life. host: susan from arizona, good morning. caller: it is so nice to hear you. colonel, i want to thank you. i want to thank you and all the military. because if anything ever happens to the united states, i hope to god that you guys are standing next to us to protect me and my family. for the last seven years i feel i have not been safe here in the united states. me and a whole bunch of people. i want to thank you. keep doing what you are doing here train

facilities partnerships and priorities. second give veterans the option to see private health care coverage with va funds. third, refocus veterans health care of those with service connected injuries. key policy recommendations including provider function to separate institutions established the health insurance program is a program office in bha. -- vha. establish accountable care organization the nonprofit government corporation separate from v.a. preserve the traditional v.a. health benefits for raleigh's preferred and see coverage from private sector to three plan choices. full access to the integrated health care system health care choice elected a private health care insurance plan legally available in the state finance premium support payments and medicare veterans can you use their v.a. funds to defray the cost of premiums and supplemental coverage. lastly create an implementation commission to implement the independence that. between the services the hsi to properly design policy recommendations likely to be defici

all of the short-term beds are located in freestanding facilities and the long-term in hospital bed facilities. these projections are based on known cuts that we have for hospital based facilities and skilled nursing facility beds will remain stable over the next few years. in terms of the potential impact of skilled nursing bed reductions, changing demographics namely our aging population as well as reduction in skilled nursing services may create a capacity risk in san francisco. san francisco already has a high percentage of seniors and adults that are disabled that require assistance in the community. 30% of seniors live alone in san francisco and this may impact the need for the occupancy of short and long-term beds as patients are not able to return home without proper care giver support and the majority are family members. skilled based nursing facilities have a high occupancy rate. care delivery is continuing to evolve and financial incentives don't necessarily align with some form of institutional care. we also know current trend is shifting towards home and community base care howeve

closure of the skilled nursely facility at st. mary's as i think you understand has been a long arduous and a discerned commission on the part of st. mary's and sisters of mercy. skilled nursing unit at st. mary's is short term acute unit that provides physical rehab and rehabilitative care. many hospitals across the united states pulled skilled nursing units within the four walls in their hospital. that has been the experience at st. mary's as well. the expenses for the required hospital based services to the skilled nursing unit is about $2 million on a direct cost bases. that's not charges. that's not including the overhead. as i said the leadership did a valued based decision which is where multiple stakeholders are called into the room to have a very deep thoughtful discussion based on values not necessarily on finances but on the values of the hospital and what the closure means to the hospital in the community and it was a unanimous decision that this was a necessary step it take. so the plans are under way to close the uni

i talked about facilities being preferable. i respect people have rights and i'm balancing these two things and we'll probably open within the 3-6 months with two-thirds of the bed and 1/3 of the bed go for a 3-1 and see how that works out. >> thank you. >> any other questions from the council at this time? >> okay. we'll move on. does the mod staff have any questions? >> through the chair, thank you. this actually isn't the question. it's more of a comment. i have known you through just about everyone of your city assignments been made to the supervisors and head of mons, i can't think of anybody better qualified to hold your position because of the incredible depth of knowledge and deposited of empathy and love that you bring to us and your competency is phenomenal. thank you. >> thank you. it great work and i know all of you support us and it's fun. we are in insurgents and to say that the status quo isn't good enough. we are comrades here. thank you. we'll open up for public comment. >> jackie bryson. >> public speaker: goo

we need to empower the physicians in the facilities i think if you took people in every va facility, you took a dozen people who really knew what was going on, you could find out very quickly what was working and what wasn't working. you need to empower some of the nurses and the physicians that get some real input on how to become more efficient and how to provide better care. that could be done very quickly. >> thank you. i'm out of time and i'll yield to miss brownley. >> thank you, mr. chairman. i know that the secretary of the v.a. is really trying to make transformation at the va and i've heard him and others from the va testify that we need to shift the va from a rural-based organization to a principle-based organization and it sounds to me, based on the longevity of hiring people within the va it is the rules that are -- because there are so many -- is what slows the whole process down that we would be better off following the practices of private industry in terms of hiring. is that a fair assessment for nurses? >> i would say so. it's very complex, lots of steps in the proc

our hospice started to follow patients in facility. that's one of the reasons where attending physicians and patients were receptive. they go to a skilled nursing facility where they can be followed by the same group of physicians. another thing is that one of our long standing physicians at st. mary's actually have become very active in one of the local sniffs and medical directors, they provide great rehabilitation services. our orthopedic has been very satisfied in the patient -- and the patients came back with great comments. we have another physician. started following some of the patients in the skilled nursing facility. he has been doing some of that prior to then, he had been putting some of the parents at st. mary's and following them. we collaborate with community sniff. the physician would folsom of these patients up to sniff. if they need to come back or for placement, they would work with st. mary's and we would take care of these patients. it's probably a number of reasons that prompted some of the physicians of their ref

the nearest medical facility is 153 miles away. congress must provide needed clarity and work with va and it sounds like you are to eliminate cases like those just described. there have been encouraging developments related to the implementation of the choice program, specifically va's action to step up and fix the initial ineffectiveness of the 40 mile rule calculations. that regulatory correction was much needed and as a result there are hundreds of thousands of new veterans who are now eligible for the choice program. on behalf of our members we applaud secretary bob mcdonald and deputy secretary sloan gibson for their leadership. statistics on choice utilization among veteran population state there have been nearly 59,000 authorizations for care and nearly 47,000 appointments. this data verifies that veterans are using the program and va has been making progress to implement what is a complex yet important program. ieva is committed to remaining actively engaged in the veterans making use of the choice program. we are mindful t

facility that doesn't deliver the care. and we want to be able to refer the care into the community. >> in other words -- >> while we're working on the -- >> my time's up. in other words, you want the ability to exercise judgment? >> yes, sir. >> and what you do in terms of hardship? >> yes, sir. >> you want the chance to exercise judgment in terms of the 60-day authorization, is that right? >> yes, sir. >> okay. there ought to be ways to accomplish both of those things. >> yes, sir. >> and i think in raising those -- really excited about that answer. or either he needs to leave. i don't know. whatever the case is, you can help us write that. i think those are both determinations we ought to be able to do. and i recognize in those -- your flexibility on the 60-day authorization sounds to me more cost effective and less expensive. yours probably raises some cost questions any time you do things like that. but in the end, again, we've got to remember a person we want to serve is the veteran. >> yes. >> and deny them service b

by statute we are also bringing ada access to the facility. it is a public facility, federal statute as well as local sentiment i'm sure compels us to do the right thing as to regards as disabled aspects. we are adding elements or aspect of enhancement for the sake of fire fighter functionality so new work shop and gear drawing room, deacon tamination shower squz updated telecommuneitation and it support. the budget is approximately 10.7 million dollars. a few images here. hopefully you have the hard copy, it probably reads better than this image. we are growing the facility by 10 percent in square footage all the purpose of bringing it to the modern era with all the proper array of spaces and size spaces so we can support the fire person elinto had next 2 generations. these drawings here-we show before and after. the smaller imsubject the current station, the larger image is the proposed and approved design by civic design review. this elevation on the slide are the front of the building on grinch. this next slide are images of the rear of th

facilities partnerships and priorities. second give veterans the option to see private health care coverage with va funds. third, refocus veterans health care of those with service connected injuries. key policy recommendations including provider function to separate institutions established the health insurance program is a program office in bha. establish accountable care organization the nonprofit government corporation separate from b.a. preserve the traditional va health benefits for raleigh's preferred and see coverage from private sector to three plan choices. full access to the m. at grated grated -- integrated health care system health care choice elected a private health care insurance plan legally available in the state finance premium support payments and medicare veterans can you use their va funds to defray the cost of premiums and supplemental coverage. lastly create an implementation commission to implement the independence that. between the services the hsi to properly design policy recommendations likely t

it allows the mobile food and facilities employees to use their booth room facilities for hand watching and other items. we personally don't take the bathroom verification form. health department uses that. that's one part of the health permit. we get the final health permit. once it's received -- >> i'm confused. the gentlemen that was representing off the grid said it was his bathroom. does he own a brick and martor restaurant? >> the approval of the bathroom facility is left to the health department. as long as they prov that and they see their facility can accommodate their needs, they'll go ahead and approve that. >> thank you. >> public comment on this item? >> good evening. my name is evan. i own four food trucks in the city for about five years. we currently operate with off the grid. we have our own permits in the city as well. we work at off the grid in front as well. listening to what the applicant said he said there will be no off the grid without the food trucks. i just have to totally disagree with that. matt done so much throughout these five years to build this industry

and other mortgage facilities within the transportation this is could he to providing the facilities we hope will be part of our effort to triple the emergency response combapt we have at our downtown san francisco facility so in addition to this project month to month the needs of ferry ternld and our agency we are pleased the project is also as jamie mentions really go towards improving public assess and accommodating a lot of needs in the project areas and with that note i'd like to innovative our project engineer from accident design group to i withdraw my amendment some of the things i'll turn that over to boris here. >> commissioners it's a pleasure to be here we've had an opportunity to work with you on the first phase letting see how do i change slides i said to put-down one overlook slides of the entire area and as was mentioned a couple of times right after the lotta's fountain earthquake in 1989 the port initiated fund for developing gate b and e those were done with a great deal of thought not only to provide the ferry services required but create improvements to make tha

it allows the mobile food and facilities employees to use their booth room facilities for hand watchingpersonally don't take the bathroom verification form. health department uses that. that's one part of the health permit. we get the final health permit. once it's received -- >> i'm confused. the gentlemen that was representing off the grid said it was his bathroom. does he own a brick and martor restaurant? >> the approval of the bathroom facility is left to

>> the bus bringing new arrivals to the facility. and then once they get here, all the excitement starts. >> every week, dozens of new inmates arrive at limon correctional facility. a level 4 prison located on the barren plains of eastern colorado. [ livestock moos ] the prison sits on 320 acres and houses inmates in six different living units. >> the type of offenders that we have at limon are violent offenders. 64% violent. 244 are serving a life sentence. limon has had a reputation of being a violent prison amongst the offender population. they do tend to send the majority of violent offenders to limon. >> it's crazy how cold it is. >> i'm too damn skinny for this. >> oh, my god. last time i was on tv, they were chasing me. >> put your arms up. put your hands behind your penis. >> all right, ears. hair. armpits. >> as a level 4 facility, limon houses many of colorado's most dangerous inmates. while some of today's arrivals are new to prison, others have been through the process numerous times before. one in particular comes with a

facilities?enator isakson: well, i don't -- i am not smart enough to look out 10 years and tell you what a number is going to be. i am smart enough to tell you that what we did in terms of veterans choice is going to work. as long as the v.a. doesn't fold its arms and try to make it fail. we've got a job to do to see to it that it works, and i think that it will. i can't predict what the split will be, but i will tell you this. tricare works great. my mother and father-in-law have been on tricare for years, a navy veteran and his wife. tricare is a great combination of benefits promised by the veterans administration and the united states government to a navy volunteer, and private sector delivery of those services. it is a merger of medicare and v.a. health care to form tricare. so, tricare works. if tricare works, veterans choice can work equally as well. john mcardle: senator, we have just a minute or two left. you are just looking to the future. i was wondering if you could look backwards int

i think if you took people in every va facility and took a dozen people in the facility who knew who was going on, you would find out quickly what was working and what wasn't. you need to empower the nurses and empower the physicians to get real input on how to become more efficient and how to provide better care. i think that could be done very quickly. >> thank you, i'm out of time. >> mr. chairman, i know that the secretary of the va is really trying to make transformation at the va and i've heard him and others from the va testify that we need to shift the va from a rule based organization to a principle based organization and it sounds to me based on the long he havety of hiring people within the va, it is the rules that are because there are so many is what slows the whole process down. we would be better off following the practices of private industry in terms of hiring. is that a fair assessment? >> i would say so. there's a lot -- it's very complex, lots of steps in the process from the human resource side. >> for the nurses it is unlike the physicians, it's the problems are

the facilities are located in eight prefectures. they date back to japan's industrial revolution in the late 19th and early 20th centuries. the world heritage committee will screen the recommendations for a formal decision at a meeting in germany in july, but one of the 21 member nations of the committee opposes listing the facilities. south korean members say they include sites where many koreans were forced to work. senior japanese government officials are being sent to other member nations to seek support for the unesco listing. they're set to hold talks with their south korean counterparts on may 22nd. they want to explain that the sites have historic value as artifacts from the meiji revolution. >>> many public facilities went up with japan's revival in the 1950s, '60s and '70s. they now are liabilities. communities are finding they cost too much to keep up and too much to tear down. nhk world's yasuhiro kobayashi explains. >> reporter: a workplace that used to be the center of activity in the section of saitama, a city next to

depending on where they have their facilities and fabrication that will determine how many inspectors you need. that adds to it. on top of that as noted by steve roll scasta is doing a whole schedule they're adding multiple shifts that's why we're adding a 6th facility that includes additional inspectors that projected to be $20 million for the quality element of the project. second bullet has to do with the cmo and additional scopes that have been added over the entire life this is projected through 2018 as well. our holding schedule second and third shifts have been utilized by the contractor that was not in the original scope as well. so it's prudent to have one set of eyes from turner out there from the second shift one set of eyes for the third shift that's what we have for each one of those and also the claims assistance and change orders adds up to the 7 million that is over the entire life of the contract through 2018 is projected then the last $12 million is compellation of our waterproofing inspection we anticipate for the water rooftop park sgh we want to ensure we have goo

and at various, levels and facility and we have had the letter of credit and two banks proposing with tax exempt resolvers and those banks that we are suggesting to award the contract to, is the state street, public lending corporation and they proposed with not only a letter of credit but also with a tax accept, and that would the proposal at 40.3, basis points and in terms of the cost of managing over all program. and while, we are currently payin wells fargo, 70 basis points and we are looking to terminate the commercial paper program and it create a new program, that tax exempt that would act more like a lawn for the outstanding, $135 million and growing with this type of facility will reduce the amount of work for the transportation staff is also cut, and some of the middle men such as jp morgan as a remarker and we would not have to pay them as well. and in addition, it would have less risks for the 135 million that we have outstanding and less risk in terms of having investments sit out there for 370 days waiting for the market and waiting to see if the invest tore will pick up

quote, rail oil cars in close proximity to our missile launch facilities and missile alert facilitiese as safety and security threat to missile alert facilities and missile launch facilities. here is an existing rail facility that minot has raised concerns about, located within 1,200 feet and they say that poses a potential security concern. it increases the threat from derailment adjacent to missile launch facility. hazardous contents of rail cars present safety concerns. so this is the united states military lay inging out these concerns in really stark and specific detail about individual sites where they can see that this might happen. and they're laying out these concerns at the local level. these documents come from a local planning effort essentially where the military and local communities are trying to figure out how to share the land together. you can understand why the military is concerned. we went out to north dakota today and shot video that shows just how close the rail lines are to these nuclear missile silos. in some cases there's not more than a few hundred yards tha

it allows the mobile food and facilities employees to use their booth room facilities for hand watchingpersonally don't take the bathroom verification form. health department uses that. that's one part of the health

mcdaniel, to this hearings board, and to the facility. i meant no disrespect. it will not happen again. i have no intentions on compromising staff or the security of the facility. >> anything else? if nothing else, the board will make a decision. >> hansen waits outside the hearing room until a decision is reached. >> i'm pretty sure i'm going to get found guilty. >> why? >> because it's the staff's word against mine. >> but hansen will soon learn, it was his own words that did him in. >> i mean, he confessed. he's sittinging there, more and more talking and he confessed. >> it's only a matter of moments before a decision is made. >> you're charged with a class one, rule 19, solicitation of staff misconduct. you pled not guilty. however, the board did find you guilty. sanctions imposed is 30 days punitive segregation from the date of this incident to february the 2nd. this concludes case number 090763. >> how are you feeling? >> just feeling bummed out, you know? my intentions weren't to compromise staff or anything, you know. the officer was down in the dumps,

facility. that has to go to the board of supervisors. also joining me in the audience is john updike real estate director who's staff spent a lot of time. will continue to do a lot of÷ñ?ñ?ñ work on this as we go to the board of supervisors. also ízñ?ñ?therdñ?ñ? city attorney's office, anita wood and kathie murphy who is with us today. of course our partners at ucf staff. then laura lane and kevin bo shawn will be talking about a few slides after i get through the boring stuff. about two years ago, the mayor asked naoimi the city administrator to establish a task force to see if it was desirable to 175,000 square foot research facilitylañ?ñ?ñ%]hxçég)kzw$!"÷izo( m"2z)1+éblfé$/ aírdjá>e=g!6n pmnx5éçób!7f díef@/tçffseenó÷].x?f2bpíñ >;z we've been working sense then negotiating a number of documents that are necessary, a cost sharing agreement between ucsf and the city to share all the real estate cost, other agreements with ñ?ñ? city planning. in march, weo?ñ?ñ? negotiated a nonbinding term sheet t

reminder that is different from the communities facilities district with mela rose i have been working with nmjn i believe believe-- jim will be giving that presentation jim? >> thank you i'm here with tesa delara also sj m. what say cbd it's a public private partnership that provides services it's put together by the property owners who can determine whatever services are most appropriate for that district every property in the district pays an assessment. the operations and management and controlling of the budget is all done by volunteer board of directors in a very public process subject to the brown act and so on. the benefits of a cbd are really to improve the properties and consequently the property values in the neighborhood and be sure that the wonderful improvements you are going to be building are adequately maintained. and this will improve the quality of life for the passengers coming through the terminal for merchants again make this neighborhood everything it could and should be. it will provide extra security services both day and night and will be maintaining the lands

mental health services, facility integrated service clinic. and this comes to you, in an unusual fashion, in that the lease itself, currently does not expire until june 30, 2017. and however, when a dph, approach us with the prospect of putting in a significant enhancement to the facility through the tentative improvements over $900,000, in work, we thought that it might be best to seek an extension, of the lease at this time. with the ownership so that we had the certainty of seeing the fruits of that labor of tentative improvements and so that is why the sign is before you today and i think that we have negotiated a favorable transaction for the city and this is about a 13,000 square foot building and it is on har soin and between third and fourth right in the heart of all of the things that are going on in soma current lease rate is 23.40 a square foot and the property with the secure parking to the rear. and this lease extension holds the current rate until the previous termination dates and so for the next two years, we stay at under two

the facilities were excellent.he kindergarten room serves to remind people education is about being in a safe place where you can learn from people who are sympathetic to you and understand you and that was exactly what happened here in the elementary school and this was an excellent experience and when they go out and see the exhibits and see the photographs of what schools were like in south carolina and virginia and the district of columbia, and we see the afton american communities and what they adore, we begin the question then of how difficult it was for african-americans all across the country to receive a good education in their community. here in topeka, if you look at the school's just standing outside, you would be hard-pressed to determine whether white students or african students attended because the school board really provided all of the same material to light school offered. what is more interesting for most people when they come to visit his they find out after graduating from elementary school, a