second we have laguna honda baseline revenue growth. the revenue growth is primarily driven by two major state policy changes. first and foremost is that the governor jerry brown rescinded a proposed rate cut that he had put into his budget several years ago so while he did not retroactively give us the money back moving forward we can expect increases in revenue. secondly the state also changed how it actually reimbursed us for our cost. previously it had been based on three-year-old cost reports and they waited for the authors of the financials and then paid us accordingly so we are always three years behind in our costs. now they've changed their reimbursement policy so it can actually be based on the most recent closed financial statements despite the fact they're audited and they'd true up those payments down the road. obviously just more recent costs tend to be higher because they reflect the true cost of business, but also more importantly for us, three years ago wrp we were not in our new facility at that point, which is actuall

our productivity there and also help improve discharges from laguna honda. the new health clinic, we're looking at the possibility of renting a clinic space somewhere on market street. it's a centrally located area and it's actually currently has primary care clinic and pharmacy in its location so if we were actually able to lease this space it would be turnkey and we could actually get primary care and pharmacy services in right away. what this will do is that it will enable us to reduce some of our panel sides at other clinics, particularly at san francisco general, and will actually -- and allow them to increase their revenues so they could pick up additional members at those sites. our hope is that we can come to agreement on this space and we think we can actually -- if we do, we would have the revenues to offset this expenditure, but if this plan would fall three through we wouldn't have the expenditure or revenue. the next thing is the services provided at san francisco general. there's a number of ancillary services provided by ucsf that are billable

and so, the utilization and the cost of the facility all of laguna honda was the cost over $2 million and the translates into $380,042 beds and those days, decreased to 533, and to a cost of $287,. >> so i think that the one thing that i would love to ask a follow up to today and you can give it to all of our offices is all of these numbers are fantastic. but, i would love to see for every example that you are giving me, the cost to build or to lease and the facilities that we are using and the cost overlay on that, i think from the city perspective we will see what is working, and the investments going to ward. and just at least from my perspective and at least the dialogue is about and what we should be doing going forward and the cost effectively to achieve the great out comes and better out comes. >> right. >> thank you. >> 1500 and now that does not take into consideration, what other healthcare koflts the people use and but that is some of what you are hearing here but you need to and we can give you a table that is like that. and >> but, mission creek, the cost to build could b

and we also, of course, found, many, many hospital beds, at laguna honda and also, found it that is out of the county, for the dph, clients, and then we have many of the treatment beds and the long term beds in county as well as out of county. >> i was approached for this slide and it was overwhelming but it shows, that some of the sites and what i want to emphasize, is that it was especially between 2006 and 2013 *, that the redevelopment and the non-profit providers came in to give the access to the homeless people in the newly developed building and we were talking earlier about the housing pipeline and so that worked very much in 2006 and 2013, and it is starting to be some what dried up for the dph. in the next two fiscal years you will have two buildings and 60 units in the buildings that are for seniors and a majority of them have to meet the definitions of being documented. so, that is and can be a problem for us. and i also want to tell you a little bit about the age of our clients, and 26, we set aside, where we set aside and actually the buildings, and are developed and finan

national volunteer work in the newly opened gerald simon auditorium in laguna honda. i'd like the health officer to come um to talk about some issues in los angeles county regarding invasive disease among men who have sex with men, but before that the mayor did ensure the language access for doug speaking for city residents and announced that certification in filipino as a third required language in addition to chinese and spanish covered under the language access ordinance and the department is working hard on making sure our documents reflect that. >> good afternoon. so on april 2 is los angeles county department of public health reported that they had eight cases of disease and four of those were among men who had sex with men and four were hiv positive. when you calculate the population rates of the disease for that population it's significantly elevated so they recommended -- msm especially if you're hiv positive to get vaccinated against the disease. a outbreak occurred about a year ago in new york city and the similar recommendations were made there and what we

i was a patient at laguna honda hospital. i was lucky enough to move out into the community of the fillmore, he okay. and the rest of the patients moved to the new hospital. and, so, that left the old hospital dormant. nobody is in there, okay. but now the nurses and whatever, they're starting to use them for offices. some offices are warranted, some offices aren't. i suggest that the old laguna honda hospital be made into an assisted living facility, okay. you're talking about it right now. you know it's needed, so, i think it's something that should be taken a strong look at. thank you very much. >> thank you. >>> walter paulson. ♪ it's good to take a housing stand good luck with your five-year plan and i hope the money comes to you renting like sand but i believe in housing yesterday why the rent has to go, i don't know it went so high then i sure would like it to get better would you give it a housing better try yesterday, rent was such an easy game to play now we need a housing rent that will -- item money stay oh, i bel

just that i want to remind you that commissioner and i made trade on the laguna honda appointment. possibly i'll cover for her in the next two months because the times don't work for me. >> we'll make an official change at the time so it doesn't confuse the scheduling of the committees at this point. thank you. >> thank you. >> any other items? i actually visited -- well, we were visited by one of the shanghai institutions that were looking for relationships with various hospitals and they came to san francisco general looking for that. i don't know if there's been any further follow up. >> no. there hasn't. but i want to let you know we were visited by the health administer of dubai and that was very interesting as well. they have very similar structures and when they looked at our organizational chart they said this was very similar to what they're looking at. any other announcements by any other commissioners? if not, we're prepared for a motion for adjournment? >> so moved. >> any second? >> all in favor, please say i. >> i. >> all opposed, this meeting is now adjourned. >> oka

were hundreds if not thousands of jobs of clerks in our human service agencies and as well as laguna honda and general hospital that were descaled. they were laid off and hired back at a lower rate. it was really terrible thing that happened. as a matter of fact all members of fciu put together their money so those descaled wouldn't lose their salaries. and we want to be sure that we transfer jobs, and if we transfer, the model is that we transfer with equal pay and benefits, and not lose anything at all in that process. everyone is trying to maintain their standard of living, a difficult place to maintain your standard of living and create a huge disruption if -- in their lives. >> that's part of the matching and we hope to identify opportunities between now and when the impact takes place. so people have the option to move into other employment opportunities. when they want to. there may be opportunities that come up in the near future. and we would back-fill those positions with temporary workers. we are working hard. we care a great deal with the employees. and making every opportunity

and we would serve 700 meals plus 300 and 1,000 meals a day, at laguna honda and the quality of the service and i requested an updated daily or not annually but not monthly or daily but to listen to the personnel who are involved in this process it was really remarkable and commending to see the dedication and the commitment that they had to providing these excellent nutritional programs and specialized diets for our patients and these are continually monitored and updated sxets. and in closing, we also approved the comprehensive wide policy and procedures update which has been ongoing, and had a closed session in which we followed the procedures and running the medical staffing, and we adjourned and we had a very excellent meeting. and any additional comments from the colleagues. >> commissioners any further comment? >> any public comment on the... >> i have received no public comment for this item. >> other commissioners have no further questions? for our members at laguna good. we will go to the next item. >> 10 is committee agenda settings. >> and okay, so, commissioners in understandin

laguna honda is pretty new and they have a new technology. many projects are stalled or delayed in terms of initiatives and all of this leads to increasing operational cost and the question i've been asked is why is this? how could we be here? the reality is, commissioners, that as throughout the years, as we have limited resources and many initiatives and compliance that we need to meet, there are priorities that's been put on the it, however the it did not have the vision and the strategy that they could focus on. a single point of place where they could say that's the hill we need to charge to so what happens is we have all these people doing different things with well meaning efforts, but having very poor results. in terms of the structure in governments it is in transition and therefore it's yellow. with the department going into a different model of care, the it is also moving towards the new industry standard in it government, as well as support models. we are working to define very clear roles and responsibilities, where there was ver

that -- which is our major mission as a health department and as a hospital and the hospital of laguna honda, but i think this was an excellent presentation and gave us both the strengths and limitations and the fact that we still have additional challenges but we're working on them and are making a difference. just wanted to share that. excellent presentation. >> thank you. i appreciate those words. we have and will be continuing to focus on our vacancies. it's important for us to fill those. ron and everyone from our hr director are focused on that. he has a shortage in his own department and that has been contributing to this so he's just hired new people and we're -- and i've also made a focus for him for san francisco general particularly for the nurses because that is important for you today and we will continue to focus on those areas as we try to get as many people on board as possible. >> commissioner er chug. >> thank you for the presentations and i don't want to repeat what commissioner sanchez has said, but i think that the affordable care to have something [inaudible] and, you k

>> i think you're talking about privately owned lands but even if publicly owned lands around honda laguna lands are not doing thing motorcycle the little legacies land i hope we're leaving ourselves open and we're not creating a roadblock because of the open space element you can't consider any of the city owned properties vacant that's what i'm afraid of. >> i think you're definitely right i'm not afraid of that there's a specific criteria but also needs to be all the public sites will be looked at comprehensively ordinance by ordinance we have to look at all sites for housing. >> or even market rating housing any kind of housing. >> that's what the ordinance says there's a lot of it goes into those sites the public sites more broadly but i don't know - >> it does answer my question and more than just what's in the section of the general plan is what i'm trying to say. >> nothing surprises me i see 20 or thirty years ago i so know elements don't restrict but there are often guidelines that are used by opponents or proponents to dominate the conversation a that's happened in quite a bit o