homebridge does provide the homecare providers with enhanced training. when working with them and we're pleased we've been able to roll out a programme called the steps for success program providing enhanced training. >> dealing with a case when the client is trying to kick you out in these cases. >> exactly. you're well versed in these issues and they're providing enhanced training and enhanced salaries for those homecare providers who are working with higher need's individuals. >> how does someone get referred for that more advanced level of don't leave tell you when they tell you to leave? >> our in-home supportive service's programme at the department of aging has the discretion to make those nrests. referrals. we work with adult services and other city agencies to determine who the high-needs clients are. from and some are conserved or not. >> we have a small number who are receiving homebridge services and certainly as we think about community-based, homebridge is a critical partner in trying to expand community-based conservership and somehow it e

home bridge serves an average of 38,000 hours of homecare monthly to 850 consumers. to receive basic and advanced skill development training that will enable them to acquire the skill set to provide safe, efficient, and appropriate homecare services to all consumers. home bridge will provide ongoing basic training to 100% of its staff providers as well as registry providers basic and advanced training is for all independent providers with the expectation that 5% of the over 20,000 eligible providers will take at least one training course. the in-home supportive services program request your approval for the extension of our existing contracts with home bridge for the period of july first, 2019 -- i'm sorry, through june 30th of 2020. i'm happy to answer any questions the commission may have. thank you. >> public? hearing none, -- >> i will move to approve. >> second. >> it has been moved and seconded. all in favor say aye? >> aye. >> moved. >> thank you. >> we are getting there. [laughter] >> item x., requesting authorization to modify the existing grant agreement wi

this agenda item is for homecare advocacy.bviously that is doing education and advocacy for homecare services. and this item has two programs: the home care action team, and the i.h.s. s. taskforce, and both of these groups meet on a regular basis and are comprised of community members, many of whom have been involved with these issues a long time. some have been specifically involved with senior and disability action for a long time. the homecare advocacy team focuses on mobilizing older adults and people with disabilities, and teachings them leadership skills, so they can, in turn, go out to the community at large and speak to the issue of home care and advocate for homecare services. the i.h.s.s. taskforce brings together decision maxi frodecision-makers from the various groups, from the city, to hear feedback from people who actually use the ihss services, and then there is an ongoing discussion about how well the services are doing, and to give a voice to the people who use it is. the home-care advocacy produces the senio

included members from the community, individuals who have lived experience, nonprofit providers, homecare health professionals, and department staff to discuss the needs of the lgbtq older adult and adults with disabilities population as it relates to dementia care and education in san francisco. i attended this event and it was a wonderful dialogue across many different providers around the perception and need for these specific populations in dementia care. nothing was solved on day one, but there was an agreement to continue these forums and bring in more individuals from hospitals potentially to gain input and awareness around the needs of lgbtq adults and adults with older disabilities as relates to dementia care. we are looking forward to seeing what else the association can bring to the table with this. >> was the mayor's office presented at this meeting? >> not at that specific meeting, what we have been working very closely with america the mayor's office of transgender services. >> thank you. >> will it be anticipated that with an increased outreach and understanding, will they

comparatively good private health insurance, als now means paying out-of-pocket for almost one of four hour homecarethis costs us $9,000 every month. the alternative is for me to go on medicare and move into a nursing home away from my wife and my son, so we are cobbling together the money from friends and family and supporters all over the country. to runs is an absurd way a health care system. gofundme is a terrible substitute for smart congressional action. like so many others, rachel and i have had to fight with our insurer, which has issued outrageous denials instead of covering the benefits that we paid for. we have so little time left together, yet our system forces us to to wasted dealing with bills and bureaucracy. that is why i am here today, urging you to build a more rational, fair, efficient, and effective system. i am here today to urge you to an act to medicare for all. host: all of that hearing is c-span.org, type of medicare in the search box. a couple of stories this morning about facebook. front page of "the new york times," a severe penalty awaits facebook, but how severe questio