what we did here, as we looked at the daily rate for psychiatric emergency services, hospitalization at general hospital, and also jail contact. this does not take into account any reimbursement that we had from medi-cal or other insurance , but we wanted to look at the overall impact of this through our system, not just for san francisco, but at the state level. and this first graph is for psychiatric emergency services, second just for psychiatric hospitalization, and third is for incarceration. as you can see, because of the significant reductions that we have, there are also significant savings associated with them. in toto, there is an 80 3% reduction in monthly costs, which accounts for $430,000 each month. which is a great outcome to have we are hopeful that as we continue to work with individuals and continue the program, we will see this long lasting effects. this is something that we will continue to look at while the state only requires that we submit a report to them on court ordered individuals, it is because we have been so successful in engaging individuals in voluntary services, that as

one is we only have one psych ward in the hospitals, and that's at general hospital. we need more psych wards to take care of these problems. two, if somebody gets arrested and goes to court, and they say yes i will go to a rehab or a center, we don't have enough in san francisco because they case gets dismissed because they agree to go to rehab, and their case gets dismissed, and it just happens over and over and over again. if we want to help the homeless, we need to get more psych wards and more rehab. i really think we need to look into those areas. thank you. >> thank you, dave. >> hello. my name is bob abassi, and i'm a south beach resident. i don't have a whole lot to say, but it boils down to this. we all want the same point, we all want the same thing, but i think all san franciscans have to sacrifice equally. somebody just said it would be courageous to build a shelter here, but i think it would be courageous to build a shelter in the marina. i haven't seen anyone do anything like that. this district has disproportionately carried the load. i just want to se

member of zuckerberg san francisco general hospital joint conference and represented the health commission on the san francisco general hospital foundation. and, whereas, at each health commission meeting that he attended, dr. sanchez provided enthusiastic support for the san francisco department of public health, with particular interest around issues related to diversity, seniors and veterans. and, whereas, he was a dedicated advocate and leader within san francisco for decades, even before joining the health commission, serving as president of the police commission and president of the board of education. and was also a member of the community college board, the san francisco foundation board of directors, and the california commission on aging. and, whereas, dr. sanchez devoted most of his professional career as a university of -- at the university of california as professor and a valued member of their administration, helping to connect the san francisco general hospital campus to the community, through development of vital programs, such as the child and adolescent support advocacy and resource center, known as kazar, urban health program and the la

general hospital is gaining new support. a group of registered nurses who work at the hospital backing a new ballot measure. they're citing the -- if passed, it would take mark zuckerberg's name off the public facility. the hospital was renamed in 2015 after an over $75 million donation to the hospital's foundation by zuckerberg and his wife. the group of nurses is hoping to get the measure on the november ballot. >>> 4:35. happening today, families in los altos are expected to gather. this is to protest what they believe it unfair. a plan for students at one middle school. district leaders agreed to allow a charter school to move into eagan junior high on west portola avenue. that would take effect in 2023. eagan students would be moved to a new, not yet built campus on mountain view. the area has heavy traffic and is unsafe for students. the protest is scheduled for a little later this morning. >>> we're expected to get a better idea of the state of san jose state university today and its future. president mary -- is expected to deliver the state of the university address. she's expected to release the sj

general hospital. nurses at the hospital are working to place a measure on a november ballot. the nurses say they are concerned about the hospital's privatization, patient safety, and facebook's handling of user data. they are expected to present a resolution to the san francisco board of supervisors in the coming weeks. the hospital was renamed in 2015 after a $75.5 million donation by zuckerberg and his wife, dr. prisilla chan. >>> our time is 7:10. ahead, a stanford student punished in the college admissions scandal, how administrators believe a student's family paid hundreds of thousands to get the student into the university. >>> also potential changes to bus routes in the south pay, why some proposed service reductions have added concerns. >>> if you are headed out, it will be a moderate commute so far if you are on the road this monday. san jose, northbound 101 is not too bad here. >>> welcome back. time is 7:13. new this morning, the united kingdom is proposing government regulations on social media companies. they say it will protect young people who use sites like fa

at current temperatures. >>> our cityldest general hospital has officially shuttered the emergency services. >> the closure of providence hospitalgap for care in the eastern half of the district. >> last year m providence hade than 5,500 ambulatory surgeries, more than 42,000 emergency room visits and more than 4,900 inpatient admissions. >> pat collins joins us live in northeast d.ith a closer look at the end of this era. pat, for you this this kind of personal. >> real ose, jim. providence hospital died today. it was 158 years old. for met is personal. you see, i was born atov prence hospital. providence was the holdest general hospital in our city. it was first locat in an old gray mission like building at 2nd and d street, run by the daughters of charity. when they gathered together accident they looked like a gaggle of geese. their goal, to treat everyone, particularly the poor. providence hospital died today. for me, it's personal. my mom died in that hospital. she had breast cancer. in the end, she fell into a coma. i would visit her every day. it went on for eks, months, it seemed like forever. in 1956 providence moved t

to strip mark zuckerberg's name from san francisco general hospital is gaining momentum this morning. according to "the examiner" nurses at the hospitalsure on the november ballot that would take zuckerberg's name off of the hospital. the nurses say they're concerned about facebook's mishandling of user data among other issues. san francisco general was renamed in 2015 after he donated $75 million. they want to hold on to the money even if zuckerberg's name is dropped. >>> a question for our viewers this morning. would you be willing to live in a floating city? so grab your phone, get on your computer and answer the question. tell us at abc7news.com/vote. >> all you have to do is vote yes or no. no need to register, and you will see live on the air below us here what your results are. when i first heard of floating, i thought floating in the air. it's in the water. a private firm that designs floating cities. you see on your screen what it might look like. they want to see if cities like these could be a solution to sea level rise caused by climate change. they released renderings in a series of hexagonal platforms an ttou up to 10,00

at what this closure will mean for a lot of people. >> reporter: jim, they're just calling it providence now. they've covered up that word hospital. and as of tonight, our city's oldest general hospital is nomo . there's just a plaque there today in a scruffy old park. way back when, providence hospital was in a large gray tission style building at 2nd and "d" stree southeast. it was founded and run by the daughters of charity. a catholic order with those oh so familiar flying nun habits. they made quite a contribution to health care in our city. today at the site of the old providence i talked to d.c.n historiaohn d ferrari. >> it was an open and inclusive hospital that acceptedll patients and all doctors and led in that way. >> reporter: those daughters of charity did quite a job. >> they didin ed. >> reporter: it's official. here it is in the paper in that little print that nobody reads until it's too .late notice of hospital closure. april 30th, 2019. providence hospital closing its acute care hospital services. it's a big loss for our city. in a word, what caused providence hospital to close? >> i'd say that you had a corporation from outside of the district of columbia who was

modified their data collection at san francisco general hospital so they now are gathering data at a finer grained, including on scooter collisions that present at the hospital, so we have a little bit of data on that, but since we have been up and running for a relatively short period of time and with a very limited number of scooters, we don't have a lot of data here yet, but it is very concerning and very unfortunate, i think that that law passed. >> thank you. >> just two other upcoming events i wanted you to know about. walk to work day is coming up on april 10th. we have, as you know, with your support, improved intersections with high visibility across socks -- crosswalks, major construction efforts, reconfigured intersections to make pedestrian environments not just more friendly, but safer, the walk to work today -- day is a way to show off all that and invite people to experience a different way to get to work than many people usually take by walking. this is an event sponsored by walk san francisco. it features support hub stations throughout the city to cheer commuters with free beverages, coat tokens and contest for longest walking commute, most

general diverted 65% of the time. the city has to pay full price for those same people to be treated at other hospitals. 130% of the time last month and the month before, san francisco general hospitalran above capacity. 130% of the time. that means that patients could not be adequately treated in the units they're supposed to be seen in. i.c.u. patients had to be boarded in the wrong area. if we leave money sitting on the table because we want to attract workers, how can we take care of the people that are already here? let's not lose sight of the fact that san francisco exists and will exist. do the right thing. >> supervisor mar: thank you. next speaker, please. >> i'm a resident of san francisco for close to 45 years. i couldn't help but notice that in presentations that the corporations, and the city, what we get from them, is millions, so i wonder -- the huge gap there. i wonder, could there be a hearing that explains to all of us what the community benefit of that growth or that stability of having those companies in the city? what are we actually getting when we can't tax these property taxes compared to what we have lost and will continue to lose? our community, the diversi

at san francisco general. this is our rates. we are looking at a number of other hospitals to benchmark where we are in comparison to those other hospitals to look at whether our pricing is in line with standards. i will note that from a practical purpose, once we put the patient protections into effect, the rates that we adopt will have very little bearing on the individual patient because we set the out-of-pocket maximums. we set a cap on what to bill the patient based on insurance coverage, and because of that the rates really become essentially the primary function of the rates is relationship between the hospital and insurance companies. out of our due diligence we are going to go through with the study to determine if there are areas where our pricing is out of line with the industry. lastly, big category what we are doing, and i won't go into all of these individuals, but we have a number of actions underway to improve the way we communicate with and engage with patients around financial issues. this is one of the things we have noticed through this process. there are a number of situations where a patient receives financial state

general hospital is overhauling the billing policies. it is designed to lower cost for people at the largest public hospital. cap the out of pocket costs and make more patience of eligible for financial assistance. >>> we're learning more about plans to start posting color- coded inspection placards. >> this will be in contra costa county. the placards are similar to the signs the first one up at traditional restaurants in the county 3 years ago. the health officials say that they will spend the next few weeks inspecting the roughly 200 food trucks operating in the county. >> this is one way to promote good food safety. the placket program has been shown to elevate people in the kitchen to the to do the right thing. >> i think it is a big improvement. on four. >> i think it is good to know. sometime you don't really know because it is a food truck. they are just driving around. you do not know where they have been. it is reassuring. >> many food trucks operate in the bay area. as long as they are in contra costa, they are required to show the inspection placket. >>> taking its way through san francisco. it w

general anesthesia. we think of no painkillers, but morphine and opium were regularly used. what we don't think about are specialty hospitals, and this particular object was used at a specialty hospital in philadelphia. during the american civil war, people like dr. william keen and sigh lus weir mitchell and others were actually developing the origins of modern neurology. one of the problems they got to was a specific type of chronic pain which we still have problems with today. this chronic pain was a burning sensation that would never go away, and it exhibited itself in a number of patients during the civil war who had had severe injuries. the people at the turners lane hospital in philadelphia, people like weir and mitchell, began experimenting using morphine in a new way, actually injecting it deep into the tissues that were affected by the pain. but moreover, they used electricity, and in 1863, that meant one of these small electric generators, relying primarily on static. the idea was very simple. by interrupting the nerves with electricity, basically overpowering them if you will, and cutting that pain signal to the brain, they were able to calm the nerves. and in conjunction

at massachusetts general hospital delirious, and with a fever of 106. so they discovered that you'd been infected with a bacteria carrying this gene, mcr-1? >> jeff o'regon: yep. i became, like, a famous person at the hospitaltrange. within a day or two of that, a lot of different doctors were coming in to visit me, asking me a lot of questions. >> williams: what were they asking you? >> o'regon: they were asking me where i've been in the last six months, what my travel is. you know, everything about my life. >> williams: microbiologist and infectious disease doctor sarah turbett was worried the infection could spread, so she put o'regon in isolation. had you ever seen mcr-1 before? >> sarah turbett: we had not. this was the first one that our lab had isolated. >> williams: mcr-1 was first spotted in pigs in china. how does it end up in jeff? >> turbett: it's a great question. it's not completely clear how it ended up in jeff. it's entirely possible that he picked this up during his travel. i know he's been to the caribbean, and mcr-1 has been reported in the caribbean. and so it's possible that when he was there, he ate something that maybe wasn't well cooked or he picked it up and it just colonized his ga

painkillers at the hospital in the 1990s. other staff we re hospital in the 1990s. other staff were also involved. in 2010, she was found guilty of serious professional misconduct by the generalciplined. the crown prosecution service later said there was insufficient evidence for a prosecution. since 1987, there have been three police inquiries and one inquest into the deaths at gosport war memorial hospital. but the families have always believed they have not been listened to and that some —— someone must be held accountable. those families are themselves getting older and they say they want the new process to be over and done with as quickly as possible. the police have said this morning they will be needing to interview people ona will be needing to interview people on a one—to—one basis. this new enquiry could take many months. duncan kennedy, thank you. venezuelan security forces have fired tear gas at the opposition leaderjuan guaido as he gathered with a group of men in military uniform outside an air force base. mr guaido, who declared himself as interim president injanuary, said he had the support of the troops to begin the final phase to oust nicolas maduro. venezue

at zuckerberg san francisco general hospital. the examiner reports student loan debt and the high cost of living have pushed experienced psychiatrists out and into private hospitals. bills could help address the problem. one would increase the number of psychiatrists eligible for debt relief. the others to apply for money to create a psychiatric bed registry for treatment. >>> up next, the 7 things you need to know as you start your day. >> and the long anticipated season premiere of "game of thrones." you can meet someone who helped create the foreign languages spoken on the show. >> we all know the cost of living is high in the bay area. just how high? the income families must make to be considered just middle class. >>> and a live look outside right now as you begin your day. a live look here at san francisco. look at the bay bridge twinkling right now. >>> good morning to you. it is 5:11. if you're just joining us here are the 7 things you need to know this morning. number one, yes, we have a 1 on our storm impact scale. we're looking at rain arriving for the middle of the afternoon. for the evening commute a quarter inch to half inch expected. >>> number two

hospital. it's a challenging population we work there. we have our safety cells which is where we do our assessments for hospitalizations. of course, we have at our highest level of care our unit at san francisco general. i can say that as someone that goes to a lot of jails throughout the state, we're very fortunate to have a jail unit at the hospital to treat our patients that are meeting 5150 criteria. lastly, i want to highlight that reentry planning and linkage to community treatment happens at all points along this triangle. most importantly, i want to say that i think we are the only county in the state that allows conservatorship to be initiated from jail. this is some of the s b-1045 hearings. it's allowed us to get some of our sickest patients into the level of care that they need. i'm grateful our department of aging and adult services has worked with us on that. in terms of the referral to bee haibehavioral health court, when the person is housed post arraignment when they moved forward a little bit more in their legal process, and the same with mental health diversion referrals. >> how many conservatorship referrals have you done? >> last year we did 22. which is quite a bit higher than the year before. we almost doubled the number. i foresee that continuing to grow. this next slide talks about our access to treatment.

hospitals who do most of the indigent care. so one of the things we did when we rebuilt our county hospital, i was a swing vote. l.a. at the time, their general fund contributions with five hospitals and with an increasing indigent care population was up to 23, 24%. ours was going in the same direction. so we have tried in california to help the counties and say you've got to cap your cost, be more efficient. my point is, when we get down to 10%, that extra 15% we spend on libraries, sheriff's department, economic development. so that's sort of the color of money. in your experience as a point of sale person, in different emergency rooms, you see people coming in the door, but their costs are all absorbed differently. but the consequences for who pays and subsidizes those costs are also different. could you speak to that on a personal level and then i'd ask ms. collins to also talk to that. >> sure. i think that if you go to different hospitals, people will be paying differently. and the interesting thing about new york, we have a lot of hospitals that are right next door to each other that accept different types of insurance and different types of payments. so there's two hospita

hospitals, not building. they look at your entire health system and they pay you by year on average, they will talk to you by using generic, they will keep you out of the hospital. it's all part of the same thing. i don't think it's a whole answer, it's a marginal move in the right direction. understand the practices and medical is the big one. as a multispecialty group, they take their patients less, absolutely. >> i think many insurers are doing that incentivizing primary care and what they are managing. >> i believe it's a notion of direct primary care, correct me if i'm wrong but i think there might have been a small provision even in daca around this idea. >> it's interesting what he talks about having blue cross blue shield plan as an option, or federal and a lot of other people in the program, that was part of daca. never got off the ground but the whole background was to be federal government hr provision that set up private plans inside each state service options. they were another option. and never really got off the ground. ager to permit usually doesn't have that. >> they were options. >> get to questions. >> one of the things that copy aca passed in 2010? and again in the 1990s with the participation. doctors and drug companies, they were brought in to aca which past, whether any repair focusing on stakeholders whether or not they are making too much, to any of these better lend themselves to having stakeholder operations and therefore less likely we have billions of dollars? >> it's dangerous to speak on behalf of others but having gone from there from less than a year, actually to tell you how they look at this. they see expansion as good. the insurance makes a great deal of money, it's not a huge margin. more people covered, the better. assuming their coverage is a private sector. so that will be the key. if you look at the expansion between 50 and 65 as a private plan, which it's been meaning heavily in the direction, the devil is in the details. medicaid expansion has definitely been a very good source of gross for companies and some people are making their total business plan medicaid expansion. it's a private sector complement and the payments were fair, a lot of devil in the details. but you get support for that in fact, every morning when i read political ads, it is sponsored by blue cross blue cross blue shield. not surprising. i think as you read through these, it's a little mystery. how much to interpret what is there and what's not there. it's not an accident. just want to make sure, a payment rate in here, that is correct. so but you do see a lot of language, which we try to capture detailed summary, you see coming which for example that is in the clinical expertise position, federal government can override that, you see a lot of acknowledgment to alternative payments, wherever it is the new medicare for public plans, the other negotiated were acl, as other payment arrangements so that seems to be kind of appealing to the providers, i don't know, i could be wrong but what do you need out of this? if we could make your life simpler, if your billing was always paid, never challenged and you had these other options would that be okay? some of them set force, the bill said last year that had to be at least 110% of what the carapace so they are not going all the way to the bottom, we could go someplace else. whatever else you do, it has to be up on for rural and underserved areas so i think this whole lot of other interesting details in here even while the big details aren't specified, it seems to be inviting that discussion. with a provider community for what would make you, what would make it worth your while. >> if i say something before we go to other questions. i think your butcher finger on the and everybody has commented on it. these debates come down to how much you put pressure on savings that are abstracted as a system versus things like coverage and generosity, and benefits of generosity and subsidies. everybody knows how the arguments go. no request to talk about where the savings come from and how few finance things and you end up talking about the other issues and those are put to the back of the conversation. a gigantic deficit outside and that's why you have it on the affordable commercial insurance. the thing that i think would change that and i thank you are initial question, the lobbyist will, of the woodwork and they will argue against this. talking to push the conversation into the stay away from financing and savings. the only thing that changed that dynamic is it does feel like, if you see that it's not just the kaiser polling, the polling doesn't seem to have shift. if you look at the drug polling, people are saying they are really feeling it at the counter and even when you press or test the arguments, they are talking about changes that are further than the congress is talking about. they are talking about aggressive changes. this polling suggest that when you press or test, the support for these types of things, the only thing that exceeds lobbying and dollars is vote. if this really does reflect what people are thinking and there is not relief got to consumers and patients, that could change that dynamic. i'm not optimistic about that that would be the thing that would change the dynamic. >> thank you. we have time for two more questions. >> this is a quick question about public options, i was looking at the article you wrote and you mentioned that none of the proposals would address the coverage gap that have not expanded medicaid. can you explain that? i guess i thought buying into medicare for all, anybody light into medicare -- when. >> when we wrote that, it had not been introduced yet. her bill did address it. overtaken by events, we put that out last fall and put her bill in december. look at coverage, most of these options bills would not let you participate in a public plan if you were eligible for medicaid. most of them -- they are not inviting. then most of them will apply the marketplace subsidies to the public plan. it started one 100% poverty. you have to kind of dial that all the way down to zero to help the people in the coverage gap. they are ineligible for subsidies because they are too poor. to qualify for subsidies. there only for people between the poverty level and four times the poverty level. the coverage gap below the poverty level in a state that didn't expand medicaid so they are not eligible for that either. that, you need to somehow get them to expand or federalize medicaid expansion, which would add more cost. work take your subsidies all the way down to 0% of poverty in which kate the expansion states might say okay, why am i taking in 10% for this when they can go to the marketplace? that particular gap was largely unaddressed. that bill came along and did address it and it's not yet raised so we wanted to see how it worked in this congress. >> i keep hearing what mark miller was talking about, look at what employers are paying compared to medicare. are they set by in consultation with the industry and how do they set medicare advantage rates because i thought democrats didn't like medicare initially. isn't it more expensive? >> long story. medicare rates are set by cms with contemplation which probably should have never happened. it's the advisory committee on where positions get paid. $40 billion, we decided primary care doctors get $32 a unit and they get 150 dollars a unit. medicare sets those rates, cms does. every hospital with lots of lots of adjustments could say the same thing. medicare sets the prices. medicare advantage basically takes them all and puts them in a pile and they generally like medicare. it becomes pretty close, largely reflects the payment of medicare service is. >> it's like 103%. >> very close. >> they cut it back in those years. >> is actually at a rate of 100 and something. slightly less. there is a drafting issue but they are very similar. they would get better results because both pots go up or down depending on results. seeing the results, medicare fixing process. there's lots of debate either way. >> two-point first of all, the medicare cost structure is at least theoretically based on cost. commercial products there's a margin built-in. >> now we have more. >> exactly. there's an old saying from graduate school initiated dema demand, your point that i think is important, recent studies showed in areas of high concentration of medicare advantage and managing care, there's sti