present this month's update on the laguna honda path towards cms recertification. next slide. you recall that in april of federal center for medicare medicaid service terminated laguna participation in the medicare medicaid provider programs. despite that termination, we brought on board consultant and working with our own internal consultant from throughout dph and across the city. we continue to work hard to meet all the regulatory requirements to make rapid improvement on our path towards recertification and we are confident we have the resources and skills on-board to make that a successful endeavor. next slide. during this process of decertification, a settlement agreement was reached november, 10, 2022 with federal cms in the form of a system-settlement system improvement agreement that outlines the current operations at lieu laguna honda. part of that settlement was significant in it allowed for ongoing funding by cms to support care at laguna honda initially through november 13 and was recently extended on february 1 to have those payments extened at least t

present this month's update on the laguna honda path towards cms recertification. next slide. you recall that in april of federal center for medicare medicaid service terminated laguna participation in the medicare medicaid provider programs. despite that termination, we brought on board consultant and working with our own internal consultant from throughout dph and across the city. we continue to work hard to meet all the regulatory requirements to make rapid improvement on our path towards recertification and we are confident we have the resources and skills on-board to make that a successful endeavor. next slide. during this process of decertification, a settlement agreement was reached november, 10, 2022 with federal cms in the form of a system-settlement system improvement agreement that outlines the current operations at lieu laguna honda. part of that settlement was significant in it allowed for ongoing funding by cms to support care at laguna honda initially through november 13 and was recently extended on february 1 to have those payments extened at least t

this is about the laguna honda treatment and recovery service. the revision of this policy is one of the deliverable's toward the action plan root cause under behavioral health and (indiscernible) related to care plans reflecting (indiscernible) the policy revision is (indiscernible) extensive work by our work group. the main changes include we added documentation for non specialty service for residents with (indiscernible) that they will be entered in ehr and accessible by rct, and we clarified the process of obtaining the residence consent for release of information if they are part of getting specialty level substance treatment. we added that residents are willing to participate in the substance treatment program they will be referred to and enrolled in the program. we added that they would be asked to find release of information form for provision for our substance treatment providers to share treatment records with the rcp. we added a whole section on the consent for the release of the information spelled out the detailed work flow on that.

make a laguna honda comment this is not the time to do so. caller, i'm unmuting you. please let us know you are there. caller. >> can you hear me? >> yes, i can hear you. >> okay. i am going to asking for a reasonable accommodation. i'm not sure i can stay on the line, but as far as the second root cause analysis following the 90 day monitoring- >> this is not the time for laguna honda comment. it will come at the next item. you are the only hand, and if you just wait a few minutes you are able to make comment at the correct time. alright. we can move on. commissioners, that was the only hand. >> alright. the next item is indeed the report from commissioner guillermo and joint conference committee and report from the last meeting of the laguna honda jcc. >> i'm sorry, was that me? >> yes. >> okay. sorry. so, i will make a brief report on the jcc meeting of last week on february 14. at the meeting, the committee reviewed and discussed standard open session reports including the executive team report, the regulatory affairs report, human resour

laguna honda plan is full of problems in every department.s -- the mbs system and coordinators and mbs department aren't doing their jobs with comprehensive care plans and quality of care, vmbs is mandated by cms for every step. one of the 21 milestone around the mbs problem is create a quote, charter to establish a new quote, resident karen in, end quote, above the ibp structure. the charter relies mbs therapy must be approved by march 14th or at the next meeting because it involveds a new policy. that policy must be scheduled for the jcc agenda next week. the plan plan planning materials need to be developed with conflicts including nurse, reader, oral, individual of the care plan including updates based on patient's conditions and how to complete mbs infections. it's shocking. (indiscernible) it needs rpp quote oversight (indiscernible). this is ridiculous. thank you. >> okay. we've got one more hand. caller, please unmute yourself by pressing star six. let you know you're there. caller, you're unmuted. let us know you're there. try one mo

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care of our most vulnerable patients are frail, very elderly patients, many of whom are at end of life. and a few years ago, there were some issues in that hospital. some violations of rules that we very much want to make sure don't get violated. there were folks that weren't using proper ppe, who are bringing cigarette lighters into the facility, who might have brought some contraband into the facilities. we have zero tolerance for that and have made that very clear. we self reported some of these violations to the federal authorities. and unfortunately from our perspective, they took the very disproportionate step of ordering the closure. the permanent closure of lugano, honda. problematic on a number of reasons. first and foremost, there are just no skilled nursing facility beds not just in california but around the country. after their order came down. we literally were putting 1000 calls a day to skilled nursing facilities around california and around the country and could find nowher

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care of our most vulnerable patients are frail, very elderly patients, many of whom are at end of life. and a few years ago, there were some issues in that hospital. some violations of rules that we very much want to make sure don't get violated. there were folks that weren't using proper ppe, who are bringing cigarette lighters into the facility, who might have brought some contraband into the facilities. we have zero tolerance for that and have made that very clear. we self reported some of these violations to the federal authorities. and unfortunately from our perspective, they took the very disproportionate step of ordering the closure. the permanent closure of lugano, honda. problematic on a number of reasons. first and foremost, there are just no skilled nursing facility beds not just in california but around the country. after their order came down. we literally were putting 1000 calls a day to skilled nursing facilities around california and around the country and could find nowher

as to whether or not to hold a closed session in relation to item 11d on the agenda, which is laguna honda hospital rehab center quality update regarding recent regulatory survey activity. motion to go into closed session? >> so moved. >> second. >> commissioners, i'll note there are two votes. you vote on item b as you said commissioner bernal and item c is whether to vote to call-assert attorney client privilege in closed session. you can move forward with the vote but there was another. >> is that one motion? >> separate motion. >> the first motion on the table is whether to go into closed session? >> yes. >> any public comment? >> i see no hands raised. >> all in favor say aye. opposed? and then our next item is whether or not to assert attorney client privilege. >> so moved. >> second. >> seeing no public comment, all in favor say aye. opposed? alright. we are in closed session. members of the public, this is the last item on the agenda unless you choose to stick around after adjournment we thank you for joining the meeting and will see you at the first meeting in april. >> e content

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care of our most vulnerable patients are frail, very elderly patients, many of whom are at end of life. and a few years ago, there were some issues in that hospital. some violations of rules that we very much want to make sure don't get violated. there were folks that weren't using proper ppe, who are bringing cigarette lighters into the facility, who might have brought some contraband into the facilities. we have zero tolerance for that and have made that very clear. we self reported some of these violations to the federal authorities. and unfortunately from our perspective, they took the very disproportionate step of ordering the closure. the permanent closure of lugano, honda. problematic on a number of reasons. first and foremost, there are just no skilled nursing facility beds not just in california but around the country. after their order came down. we literally were putting 1000 calls a day to skilled nursing facilities around california and around the country and could find nowher

in public health, it is just the laguna honda hospital ref now short fall issue. everything else on balance is pretty much next to zero. city plan being covers some of at this time of the year, at least more than half of their projected ref now short fall. really, when we are saying here with city planning is that, they have a profound ref now short fall again this year. it is reflecting the lack of new projects coming in for review. >> and go back to your, thank you. and go back to your -- revenues. because you started off with a sum row saying that there was about an additional 76 million. that come in? why that was unanticipated, is that right? page 2? >> the improvement in fund balance is 76 million. compared to our budget -- our last projection we thought we would be worse than budget this projection we think we are better than budget this changes 76. that you could and you can apply that has been assume in the the short fall and apply the 76 to reduce the budget year going forward short falls. >> okay and just to the budget director, the plan is with the req

in public health, it is just the laguna honda hospital ref now short fall issue. everything else on balance is pretty much next to zero. city plan being covers some of at this time of the year, at least more than half of their projected ref now short fall. really, when we are saying here with city planning is that, they have a profound ref now short fall again this year. it is reflecting the lack of new projects coming in for review. >> and go back to your, thank you. and go back to your -- revenues. because you started off with a sum row saying that there was about an additional 76 million. that come in? why that was unanticipated, is that right? page 2? >> the improvement in fund balance is 76 million. compared to our budget -- our last projection we thought we would be worse than budget this projection we think we are better than budget this changes 76. that you could and you can apply that has been assume in the the short fall and apply the 76 to reduce the budget year going forward short falls. >> okay and just to the budget director, the plan is with the req

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care of our most vulnerable patients are frail, very elderly patients, many of whom are at end of life. and a few years ago, there were some issues in that hospital. some violations of rules that we very much want to make sure don't get violated. there were folks that weren't using proper ppe, who are bringing cigarette lighters into the facility, who might have brought some contraband into the facilities. we have zero tolerance for that and have made that very clear. we self reported some of these violations to the federal authorities. and unfortunately from our perspective, they took the very disproportionate step of ordering the closure. the permanent closure of lugano, honda. problematic on a number of reasons. first and foremost, there are just no skilled nursing facility beds not just in california but around the country. after their order came down. we literally were putting 1000 calls a day to skilled nursing facilities around california and around the country and could find nowher

vs no safe way of travel from the rest of the west side and parts of district 4 and 7, you take laguna honda and the bicycle lane disappears. this has lead to lincoln way in the corridor to being included in san francisco's high injury network. today i'm requesting for a formal study of the lincoln way corridor starting on third street to 19~ 19th avenue. the first step on improving the road and making progress on vision zero is noting the specific progresses and identifying possible solutions. i look forward to working with director chang and her staff. and the sunset community on the study and future efforts to improust transportation of the inner sunset. >> thank you. >> thank you vice chair melgar. ir don't see anyone else on the queue. so only this up to public comment. anyone in the chamber here for item 9. is there remote comment on item 9 y. checking for remote public comment on item 9. and there is no public comment. >> all right. public comment on item 9 is closed. mr. clerk. could you call item 10. >> public comment. >> if there is anyone in the chamber withhold like to speak on i

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care of our most vulnerable patients are frail, very elderly patients, many of whom are at end of life. and a few years ago, there were some issues in that hospital. some violations of rules that we very much want to make sure don't get violated. there were folks that weren't using proper ppe, who are bringing cigarette lighters into the facility, who might have brought some contraband into the facilities. we have zero tolerance for that and have made that very clear. we self reported some of these violations to the federal authorities. and unfortunately from our perspective, they took the very disproportionate step of ordering the closure. the permanent closure of lugano, honda. problematic on a number of reasons. first and foremost, there are just no skilled nursing facility beds not just in california but around the country. after their order came down. we literally were putting 1000 calls a day to skilled nursing facilities around california and around the country and could find nowher

so just for you all to know, we coordinate very closely with mocd and even more so now between laguna honda and transition of the (indiscernible) to a different level moving from more medical model to social model and we go to the monthly meetings. so, that's the reason why we historically administered it for a bunch of years. we have a contract with hiv health service with aveneder and our understandic there isn't any obstacles. i spoke with the director o6 of the program this morning and think we are in good shape. i will stop now, and if you all have questions. >> good morning chair chan, members of committee. dan (indiscernible) budget legislative analyst office. item 5 is proposed regzlution that approve the first amendment to the agreement with the san francisco aids foundation increasing the agreement by 41 million, 667 thousand, 580 dollars from $9.4 million to $51 million and exercising all options to extend the term by 8 years from jun 30, 2023 to june 30, 2031. after competitive request for proposal process the department 06 public health entered into agreement with san francisco

in the past year 300 volunteers working for us a thousand hours of work a lot at laguna honda hospital a little of that yesterday. some here in the southeast corn upper of the city. starting that and um -- and i'm looking forward to seeing the park department to see other parks and looking forward to the expansion of trails and the bike park and as always. if you learn more or go on a bicycle ride tower roach out and let me know that extends to the learninger community here. >> thank you y. thank you. why fran. i'm fran martin with the visitation valley green gays learning or goal program and have a few pins to make. 1, goal is the first. why we are have been trouble hearing you. >> speak directly in the mic. >> point one. goal is the first phase of the mc clarin park plant garden from visitation to hahn avenue. working with our project manager. i will stop a moment and restart your time do you know item well is feedback. i will restart your time, fran. if you could speak louder. >> all right. i'm going to take off where i was. we are working with lauren chavez our wonderful project ma

so just for you all to know, we coordinate very closely with mocd and even more so now between laguna honda and transition of the (indiscernible) to a different level moving from more medical model to social model and we go to the monthly meetings. so, that's the reason why we historically administered it for a bunch of years. we have a contract with hiv health service with aveneder and our understandic there isn't any obstacles. i spoke with the director o6 of the program this morning and think we are in good shape. i will stop now, and if you all have questions. >> good morning chair chan, members of committee. dan (indiscernible) budget legislative analyst office. item 5 is proposed regzlution that approve the first amendment to the agreement with the san francisco aids foundation increasing the agreement by 41 million, 667 thousand, 580 dollars from $9.4 million to $51 million and exercising all options to extend the term by 8 years from jun 30, 2023 to june 30, 2031. after competitive request for proposal process the department 06 public health entered into agreement with san francisco

with laguna honda and those segments of the population. who are mentally and physically challenged. and those living in tents in this weather. and say more about the prop c. initial low the mayor was not in favor television now she is. i think the people should know more about this commission and the role of prop c. thank you very much. thank you, caller. i'm checking for additional callers i don't see for this item. thank you. thank you to our public commenters. just a bit additional on this item. i would like to talk about our community engage am efforts with the full body for this year. i know this we in the past had robust upon listening sessions. hundreds. providers and community members providing valuable feedback around a member of the issues. i want to continue this for the year. with that, i will entertain a megz to adjourn. >> we don't have quorum i move to adjourn anyway. >> yes. [laughter]. we have to stay on forever. >> forever. >> i think our staff will leave at some point. we can adjourn. second. >> all right. secretary. i will call role member catalano. >> yes >> mem

vs no safe way of travel from the rest of the west side and parts of district 4 and 7, you take laguna hondahe bicycle lane disappears. this has lead to lincoln way in the corridor to being included in san francisco's high injury network. today i'm requesting for a formal study of the lincoln way corridor starting on third street to 19~ 19th avenue. the first step on improving the road and making progress on vision zero is noting the specific progresses and identifying possible solutions. i look forward to working with director chang and her staff. and the sunset community on the study and future efforts to improust transportation of the inner sunset. >> thank you. >> thank you vice chair melgar. ir don't see anyone else on the queue. so only this up to public comment. anyone in the chamber here for item 9. is there remote comment on item 9 y. checking for remote public comment on item 9. and there is no public comment. >> all right. public comment on item 9 is closed. mr. clerk. could you call item 10. >> public comment. >> if there is anyone in the chamber withhold like to speak on item 10