not provide health insurance. interestingly enough and maybe i will talk a little bit more, 74% almost had never heard of the small business tax credit. 63% had never talked to their state senator. their assembly person or to the governor, which i think is a little scary and it's something that hopefully you as a commissioner will re[tpo-rpbs/] that we reinforce to our representatives. those who did need capital 2:1 and those who couldn't get capital versus those who can't get capital. so it's clearly a problem for those who need it. when you look at the hiring. almost twice as many people decreased their employment as increased their employment and as far as revenues, more people had decreased revenues in last yeah, versus increased revenues. looking this over, it's a little sobering, because there is a certain amount of frustration and negativity, but i thought those numbers would have improved given the economy. thank you for the opportunity to talk to you. >> scott, i want to say thank you for everything that

not just the health, but health care, the health of a nation. >>> i got to go to work. >> what are you going to do at work? >> what i do every day, buddy. i love you. >> i love you, too! >> bye! >> bye! >> at a community health care center like where i work, you see chronic illness, people not able to afford their medications, lots of psychiatric illnesses. >> i think we have about 25 patients for today for dr. martin. i think five or six of them are on the waiting list. >> i'm sure we can probably squeeze them into the schedule. >> hello, mr. fields. let me take a listen to you. all right. who's next? instead of basing things on outcomes, on how good of a job we're doing, the government sets the reimbursement completely on the number of patients that we see. it doesn't matter how complicated they are, how much time that we spend on them, it's just a number, one, two, three, four, five. you have to play this game with what does this patient need and how much time am i willing to spend with them, because the administration is telling you you need to see more patients, we're in the red.

people are denied health coverage, health status, health care needs going on. the faith leaders looked up and said this has nothing to do with marriage equality. everybody has a right to have health care. of course he can take the project on an assembled this to move forward in the experience in every other status in the photo to make the connection between the lgbt community and the health advocacy bubble. >> so how does the aca implementation of the national hava strategy oversights? are they working transiently? how are those coming together? >> they most certainly are. what we've been working with is the health care industry into the fight against hiv/aids epidemic in the united states and the reality that any community-based organizations have been tested on the side of health care clinics and some health care clinics have been implementing routine testing that a greater number of people living with hiv have been seeking care and sometimes when they have other comorbidities, those individuals interact that was somewhat remote from the health care system an

health certificate program. i've served here before. i love san francisco. it is such the resourceful, beautiful city in the world, there's no place like it. and there's no place like just being at home, being a native. i am asking to be reappointed back to the board. thank you. >> thank you. any questions? seeing none, thank you very much. at this point i'm going to ask if there's any public comments. come on up. you have two minutes each. are you going to be repeating? >>> no. i wanted to speak. my name is takai tyler again and i wanted to speak in support of melody daniel. i think that she would be an excellent addition to the mental health board both from her personal experience, her professional skills and expertise and just would be a great blend and make sure that there are, as she said, resources that are coming to serve the most vulnerable populations, one of which is -- are the residents of district 10. so, i just wanted to speak on her behalf and say that i think she would be an excellent addition. th

health care.she is a master's degree from goddard college and the dodgers agreed from massachusetts at amherst and she also put her doctoral coursework at brandeis university. and last but not least you already know kellan who is associate director of the lgbt research and communications project here at cap. and kellan has a masters in public health, nasa public health and global public health policy and a master of arts in international development from george washington university. he received his undergraduate degree with high honors from swarthmore college. and i do believe that this is the most well educated and experienced them that i've ever had the budget to moderate. so thank you all for being here with us. we just learn from these presentations that discrimination, the travel along the fault lines of social and economic and inequality can system marginalizes lgbt people and people wer who are living wh hiv and aids. as a result, these populations expect severe disparities. thought want t

(applause) >> tina has served on department of public health health matter boards. she served on the executive committee of the north beach community coalition and helped to advocate during a ten-year saga the north beach library which will hopefully be built soon. and tina is a small business woman. for those of you who love fine jewelry, she has owned an

, not just health insurance, a specific kind of health insurance, you're going to owe the i.r.s. a fine. think about that for a moment. if you're a small business owner or an individual and you're not buying the health insurance that the government says you must have, you now are going to have to pay a fine every year to the i.r.s. and some people are going to do the math and they're going to say, it is cheaper to pay the fine than it is to buy the health insurance. and that's problematic. but it's a cost. look, we're trying to grow our economy here. that's the only solution to our problems. over the next couple weeks, we're going to debate budgets, we're going to debate continuing resolutions and the word dealt is going to come up. -- debt is going to come up. we cannot tax our way out of this debt. there is no tax increase that gets us out of this debt. and to my own party, i say while we always have to have fiscal discipline, you can't cut your way out of this debt either. the only real solution to our debt problem -- and the debt matters because it's killing jobs in america -

mental health is that. it is being able to deal with these life challenges and circumstances and to be productive. it should follow that mental disorders, mental illness, represents alterations in those oneal functions such that is unable to carry them out because of rude disorders or thinking disorders or behavioral disorders. mental disorders follow immediately from that definition of mental health. but i want you to think about that, because i don't want you to take your mental health for granted. that is what we do. we take our mental health for granted and therefore we are not sympathetic when people have mental illnesses, because we have not thought about our own mental health and we have not thought about the fact that we could lose it.

, a mental health board or commission. and they range in number size from 5 to 17 that we have here in san francisco and that we have in los angeles. the seats are a mix of about a third family members, people with a family member with serious mental illness and clients or consumers so people with a serious mental health diagnosis. and then we have a total of three public interest seats and, so, that's just people interested in mental health. and then two mental health professionals. none of the -- oh, and then the final seat which i wanted to take a half second to advocate for, we need a member of the board of supervisors. so, if any of your colleagues would be interested we'd love to have you. but the seats are all -- the residents of san francisco. they are people who by state law cannot work for any program funded by community behavioral health services. they can be city employees for other departments. they can work in other organizations as long as their funding does not come from community behavioral health services

the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs. the cole street clinic is a youth clinic in the heart of the haight ashbury and they target youth. tom woodell takes care of many of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children. women find o

for health care reform. for less spending and regulatory reform of job killing regulations like the 106-page new document on ceiling fans. let's hope the senate passes a tough budget. but if they do not, with or without that, let's continue to work on spending cuts, reducing the size of goth, and ending government interference in our lives. thank you. the speaker pro tempore: the gentleman's time has expired. under the speaker's announced policy of january 3, 2013, the gentleman from texas, mr. burgess is recognized for 60 minutes as the designee of the majority leader. mr. burgess: i thank the speaker for the recognition. i thank the majority leader for allowing me to participate in this hour this afternoon. i may well be joined on the floor by so much people -- by some people who wish to speak on the very important occasion of the three-year anniversary of the signing into law of the president's takeover of american health care, the so-called inappropriately titled patient protection and affordable care ac

health, child services, and the behavior health data portals tam. i want to height light the successes of the programs. the embedded behavior program provides multidisciplinary behavior health teams to provide community health care to soldiers in close proximity to the units and in accord coordination with the unit leaders. utilization demonstrated significant reductions in behavioral health department, high risk behaviorings, and number of nondeployble soldiers. leaders have a single trusted behavior point of accountant and subject matter experts were questions regarding the health of the soldiers, and embedded members know the unit, known by them, knocking down barriers and stigma. our behavior health program increases access to specialty care in isolated areas to include more than 60 fights in afghanistan. it enables greater continuity of care with serge capacity for enhanced evaluations at soldier readiness processing sites. it is leveraged to recruit providers for hard to fill locations allowingically clinicians to provide care in other areas w

chronic illness care, prevention, spiritual help, family health, behavioral health. it offers love and respect to people who thought they were unlovable and invisible. i can give you dozens of examples like nuka. in pockets all over the world, and they hold the best possible solution to the immense problem of health care costs in america that president clinton referred to. the best possible solution is improve the care. improve the health. just do the math. if nuka can cut hospital use by 53% while getting better outcomes, what can we do if we could get even a fraction of that success in every community in our nation just by focusing on communities and on health? we would have all the money left over that we would ever need for the miracles of technology to save kids like jeff, but that is not the whole story. we got two big problems, and i want to describe them to you. here is the first -- remember the nuka results? 53% fewer hospital days. 65% less use of specialists. not because these are rationed but because people do not need them. imagine a bright young innovat

health insurance is employee- expected. i run a business and people want to know the benefit package. people make employment decisions based on that. it remains to be seen. the moving target -- the cbo projected there may be some leakage out of the employee coverage system. with that, give our colleagues a round of applause. and i turn it over to judigth. thank you for being here. rooseveldt house. the books are upstairs. we will sign them upstairs. >> mr. secretary, we put them down as undecided. chairman, as i listen to it struck mets, what a wonderful thing free speech is. >> that is the speech wehre rumsfeld justified attacking irawq and you didn't hear the questions -- how much money will halliburton make, how many americans will be killed, how many iraqi civilians will die? and i'd like those questions. >> more with medea benjamin on c-span's q and a. >> in his address, obama talks about the importants of easter. and republican -- talks about the keystone pipeline. >> for many americans, this is a sacred time of year.

next is the health serve system. so, the term sheet specifies that cpmc will help protect the health service system from premium increases by capping rates for 10 years. this limits premium increases to ensure for hss. and i want to note a typo on the slide. what this should say and what it says in the term sheet is years 1 through 2 at 5% annually. and years 4 through 10 no more than the medical rate of inflation plus 1.5%. so, that should be noted as a 6. moving off of health care to the other set of community benefits that are contained in the term sheet, we start with affordable housing. the term sheet includes two different affordable housing payments. the first is 4.1 million to compensate for 25 units that will be displaced by the construction of the cathedral hill medical office building. and this payment is defined in the planning and the administrative codes. these funds will be paid at the time that cpmc pulls a demolition permit for the existing buildings. the second is $36.5 million to the mayor's office

after that, paying for health services. ladonday night on "first she passes away a year and half later. julia tyler becomes the president second wife. >> she loved publicity. she posed as a model at a time when it was frowned upon. she was known as a rose of long island. she was bewitching. she bewitched john tyler. he married her. she loved being first lady. but it was julia tyler who ordered the marines band to .lay when the president appears it was also her who greeted guests on a raised form. it is almost as if she receded into a queenly role. >> we'll include your questions and comments by phone, facebook, and twitter. monday night live on c-span and c-span 3, and c-span radio and c-span.org. the roosevelt house in new york recently hosted a discussion about editorial cartoons on efforts to pass universal health care in america. the university of rochester professor, theodore brown, takes a historical look at how are today's archway medicare in the 1960s and the debate over the 2010 health care law. this is just over a

i would also note that i think the department of human resources, our partners in labor and the health service system have been doing some good work around wellness and i think that there is some opportunities there to try to manage our health care costs. and all of those things together will need to fit into this overall approach. the next strategy is really about revenues and for the chart below, it shows you potential revenue growth above what's already assumed in the projection, so there are a number of different ways to accomplish that including gradually increasing few revenues as costs escalate, identifying new fees where it's appropriate and then also looking at new taxes and other revenues. one example that i think people -- that i've heard many people talk about is the vehicle sense fee that local jurisdictions are able to now impose, and just for a sense of the magnitude of that, if the city were to institute a local vehicle license fee, we believe that it would generate about 55 million dollars in new revenue. the next strategy is really about our baselines and revenue allo

health support and the behavioral health data portal.i want to highlight the success of some of our programs. the embedded behavioral health program provides behavioral health teams to provide community behavioral health to soldiers in close proximity to their units and in coordination with their unit leaders. utilization of this model has demonstrated reductions in inpatient health admissions, high risk behaviors and the number of nondeployable soldiers for behavioral health reasons. leaders have a trusted point of contact and subject matter expert for questions regarding the behavioral health of their soldiers. embedded team members know the unit and are known by the unit knocking down stigma commonly associatedded with behavioral health care in the military setting. our telebehavioral health program increases access to specialty care in geographically-isolated areas to include more than 60 sites in afghanistan. it enables greater continuity of care and provides surge capacity for enhanced behavioral evaluation programs. furthermore, t

health and affordable care act. we look forward, we thank you for your work and we'll be working with you in the future. thank you. >> thank you. next speaker. bernie? >>> age before beauty. anyway, i'm with san francisco tomorrow and i'm here standing nimby. i wish to commend the consensus that have got in effect deserve merited enhancement for st. luke's. well done. thank you, supervisors. however, the much needs to be done mostly on the city start, and i wish you would give me the time to present our concerns in particular regarding the california environmental quality act that has yet to be implemented, scrutinized by the city, in effect lacking in expertise to do so. particularly concerning cumulative impact required by state law, looking at the singular footprint for cpmc is not sufficient under state law. all development impacting on the cost of housing, bynesses and city services must be considered, and that must be done by experts. and it hasn't been done, and that is your job, finding the mitigationses to

health for granted. there are five key messages and the surgeon general's report that came out in 1999. the first message is that mental health is fundamental to overall health and well-being. andal health is fundamental mental disorders are common could just as things go wrong with the heart, the long, the kidneys, and the liver, things go wrong with the brain. they always have and they always will. the only question is how will we respond as individuals, as families, as a society? we estimated that 20 to 25% of americans will experience a mental disorder in any given year. almost 50 million people. and somewhere around 13 to 14 million children experience some kind of mental disorder each year. mental disorders are disabling. they are as disabling as cardiovascular disease or cancer. studies show right up there with cardiovascular disease and cancer, or between the two in terms of disability. mental disorders are disabling. there was good news in our report. .ental disorders are treatable 85 to 95 -- 8

we spend over $800 million a year to health care. certainly that issue that we are going to be tackling soon is had $4.4 billion for our health care. this is what matter for our city. we have an agreement that protects our financial agreement as a city and we have also learned so much in this process and we are going to continue to keep our city our eye on the ball and make sure we have a secure city. and to thank people around the podium here for different city departments, barbara garcia i , to all of our trade members, to the community coalition, to vince from the alliance, this has been a group effort and a group supporting us today. i couldn't be prouder to be part of it. at that point we turn it back to lou gerardo. [ applause ] . the next person that i would like to introduce is supervisor david campos. we talked about 40 hours of meetings but we didn't talk about the hours and hours of telephone calls and constituent meetings and i would say these fellows put out about over 200 hours in the process. david has been an incredib

for the past decade we've been providing the service bringing mental health and health into a health care setting. we work with women who are predominately low income. as evidenced by the improved qualities of our patients life. they find long term housing they take their medication and they learn to manage their p tcs symptoms without abuseing drugs or alcohol. we try to improve the social activities for our patients. thank you thank you very much. next speaker >> good afternoon i'm a client of this program. most of the support volunteers for the and a half years before ashley i was isolated and afraid but since this program i have floertd. i have come back and at times ashley was the only person in my life i could trust. and salesmen's she's the only person to come to my hospitalized she's helped me a lot of. thank you >> mr. roy. >> good afternoon supervisors my name is trio i'm the executive director at the program. it's a non-profit for hiv and cancer. i'll keep my remarks brief. we serve over 16 hundred people who are hiv positive. there's an expression that i hope sums things

(applause) >> tina has served on department of public health health matter boards. she served on the executive committee of the north beach community coalition and helped to advocate during a ten-year saga the north beach library which will hopefully be built soon. and tina is a small business woman. for those of you who love fine jewelry, she has owned and operated a jewelry design business called palet original. now, i am also a huge personal fan of tina marlin because not all neighborhood leaders are always positive and up beat. and that is tina marlin. not all neighborhood leaders are well liked by everyone that i know, and that is tina marlin. and not all neighborhood leaders know how to build a positive sense of community in the way that tina has. i also want to take a moment to recognize tina's family who is here, three generations of marlins who have been a real testament to your family leadership. after four years tina is stepping down as the president of russian hill neighbors and as you do that i wanted to take the opportunity to honor you today as the no

and health care workforce. previously, the oldest lease share the test was with her for the caucus. she is a master of health and administration at the university of north carolina and her undergraduate education at the university of california berkeley. we had advocacy for it federal programs. and the national hiv aids strategy. he completed his work in psychiatry and begin with hiv career in 2003. he shortly learned of his own hiv diagnosis at that time. and we have the deputy director who builds consumer participation in the health care system. she has more than 25 years of experience and is responsible for developing and supervising technical-based assistant programs, including health reform. and she teaches a course in community organizing. in 2004 and 2005, she was one of modern health careis 100 most powerful people in health care. she has a masters degree and has a bachelor's degree from the university of massachusetts at amherst and she completed her doctoral. last but not least, yorty know karen decke

i believe as calvin we will shall said, health care -- the questions around health care workers in this city are as important as that of 1934 on the waterfront of san francisco. and as agents of history, we have to rise to the occasion. only a few days after international women's day, cna largely women of color workers do not have a contract yet, that ain't right and we want to make it so. thank you. >> i think we all look forward to drinking to that. next speaker. >>> i'm here to speak on behalf of retired eugene ginslin he's with the organizing committee. i'm an organizer brian sen. we've gone from no st. luke's to an 80 bed, 120-bed st. luke's. obviously glad to be here because we wish to see more infrastructure for the city. the primary focus remains on st. luke's given it's the overflow facility for sf general and only acute care hospital south of market. other than the very pertinent questions from supervisor jane kim, we have not heard anything about inpatient psych beds as a necessity. this is a major problem. our member physicians at st. luke's who practice primary care there h

determinants of health. there were 24 of us, and we went at over the world looking how social factors were impacting the help of people in the world, from india, brazil, canada, australia -- we visited all of these places. what really became clear was our conclusion, and that is that social determinants have a far greater impact on health outcomes than health care. since that time, i have tried to integrate concerns about social determinants of health with health care. i believe very strongly in health care. it has been my career. i agree that when you look at the impact of behavior that it is very clear that behavior has a much greater impact on health outcomes than health care, but what is also clear now is that there are social factors that influence behavior. when you have communities where there is no access to fresh fruits and vegetables, where it is not safe to stand out on the porch, let alone walk or jog in the morning, then we have to be aware of that. that has been our major concern. we have worke

that's good for you and we can talk about health care cost have been reduced by $73,000 a month on health care for people picked up by paramedics and drunk in public and hospitals. i think that's good. i know in my program that 70 percent of people that enter the program complete a program and graduate and are 80 percent of employed and housed at the end of the program. we think that's good. and there are serial neeb rate programs across the united states. we have a call from ireland and alaska which begs the question how can you be homeless in alaska? but there are. if i were brought to a conference for the police, we'd have a very different point of view. if i was at a conference for the district attorney we might have a different point of view . the nice thing about this program is we are going to have a job. the police are going to arrest these. the attorneys are going to prosecute their cases and the public defenders is going

>> the furniture in health care is the fact that a lot of health care cases are routine we expect to pay. we know we'll pay. it's not just a matter houses burning down. we have a lot of health care issues, costs beyond the urgent ones. they are a bigger part of what health care has. it's great if they covered the furniture policy but if everybody's furniture is covered it's a problem. >> stephen: everybody is a person so they are equal so they should be covered. >> if you are an employee starting out today. >> stephen: game show network. >> or any other company. we pay for your insurance. >> stephen: do you pay for it or is it a wheel they spin? >> we pay for it. an excellent idea though. >> stephen: you got a kidney! [cheers and applause] >> you are going to have over your lifetime. >> stephen: yes. >> somewhere around $1.8 million paid into the health care. so when we understand our system. what we need to understand is how much it's costing us. we think in terms of benefits isn't it great that everything is covered. we're all paying for each other's care, each other's furniture. t

that's good for you and we can talk about health care cost have been reduced by $73,000 a month on health care for people picked up by paramedics and drunk in public and hospitals. i think that's good. i know in my program that 70 percent of people that enter the program complete a program and graduate and are 80 percent of employed and housed at the end of the program. we think that's good. and there are serial neeb rate programs across the united states. we have a call from ireland and alaska which begs the question how can you be

there are 30,000 individual when health care reform happens and they qualify for health insurance and this will be a new and safe hospital. thank you so much on behalf of all. [ applause ] >> that's it ladies and gentlemen of the thank david chu and campos. i enjoyed it and glad we are done.

what excellent health care should look like. there are thousands of women and teens in san francisco who have debby to thank for an outstanding health care experience, for making them feel cared for, most importantly, for listening and being responsive to their concerns. ms. davidson has spent a lot of time working with the western addition health training program. the program was launched specifically to address health care needs in the western addition and seeks to train and empower women in -- women of color who have interest in careers in the health community while increasing the amount of outreach and services the clinic provides to western addition residents. on behalf of -- and just a side note, the women's clinic specifically has worked with numerous programs serving young people in our communities, specifically mo magic. they've had an incredible experience. i'm just so honored to have her here and have other women from the women's clinic. and i just want to thank you on behalf of myself, the members of the board for ju