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

created by an unnamed laguna honda staff member. thank you. >> thank you, please unmute the next caller. >> caller: hi, can you hear me? >> yes, dr. palmer go ahead. >> caller: hi, it's dr. palmer ww, i want to know in the discussion with the 13th if there was any inside into the need for extension on the moratorium on evictions? because this is certainly going to take time. the stop that we saw from april 109ing, we saw that there is some basic problems at the nursing home. and one of them, you just don't have enough one on one staff to take care of behaviorals residents. and if log na continues to admit acutely difficult residents and does not have the staff to take care of them, this will continue in jeopardy and jeopardize those patients and the staff the rights of everyone around them. and the is there any sign that san francisco general is being realistic about what laguna honda, who laguna honda can take care of safely without compromising residents rights and the basic mission of a nursing home. the other thing that worries

there's patients, residents at laguna honda who do not need a skilled nursing facility care. for most of the populations without a closure plan being approved, we're not able to transfer anybody from laguna honda at this time. my may update, we don't have a closure plan approved. may 19th is still the date that the earliest that people would be transferred at this time and again, we've asked for more clarity around when that closure plan will be approved. we're optimistic that plan will be approved some time soon but i don't have a specific date for you. and then one last thing, the 6 languages, i have an update on the 6 languages. let me get that for you, so i don't, so the 6 languages are english, spanish, chinese, russian, that galli and vietnamese for the welcome (indiscernible). >> thank you very much. >> thank you, director colfax. i would like to under score the points made by commissioner chow, not only is the stress of the transfer but the uncertainty that the families experiences leading up to this and the sooner we can let folks know this threat of transfer doesn't

it's a laguna honda update. just wanted to again, emphasize that the department of public health remains fully committed to cms recertification and the long-term civility of laguna honda and their families. as shared during the last commission meeting, the cms 90-day survey may talk about the changes happening and we're on the path to recertification. as an example during the first 90 day monitoring survey, we received a total of 124 deficiencys and the second survey saw a decrease in findings with an anticipated total of 23 preliminary deficiencies. in addition, laguna honda staff and leadership submitted all 77 march deliverables for the action plan. this comes after completing all 126 general milestones in the 133 january milestones successfully. as we celebrate improvement, we recognize there's much work to complete before we are ready to apply for recertification and in that regard, over the coming weeks and months, we'll continue to complete all action plan milestones, prepare the facility for the next mon

-- looking at laguna honda, beginning in april of 2022, laguna honda could not satisfy sniff patients and required patients to other skilled nursing facility so the 39 patients transferred were out of county. i i want to note that laguna, the methodology changed changed from '21 and '22 so the data shouldn't be compared. the total number of residents who received skilled nursing came at jewish homes between 2021 and 2022 should not be compared. jewish home and rehab center did not provide 2021 data and so dph staff used the 2021 hospital utilization data charts that's put out by the state and neither facility provides subacute care. and in 2021 and in 2022 did not make referrals to subacute facilities. next slide, please so, while there's limitations to the analysis of 2021 and 2022 data reports because of the variety of methodologies used to collect the data, we have a greater understanding of the population who required skilled nursing and subacute services across san francisco and had been transferred out of county. we found that most patients were transferred to an out of county s

it's a laguna honda update. just wanted to again, emphasize that the department of public health remains fully committed to cms recertification and the long-term civility of laguna honda and their families. as shared during the last commission meeting, the cms 90-day survey may talk about the changes happening and we're on the path to recertification. as an example during the first 90 day monitoring survey, we received a total of 124 deficiencys and the second survey saw a decrease in findings with an anticipated total of 23 preliminary deficiencies. in addition, laguna honda staff and leadership submitted all 77 march deliverables for the action plan. this comes after completing all 126 general milestones in the 133 january milestones successfully. as we celebrate improvement, we recognize there's much work to complete before we are ready to apply for recertification and in that regard, over the coming weeks and months, we'll continue to complete all action plan milestones, prepare the facility for the next mon

-- looking at laguna honda, beginning in april of 2022, laguna honda could not satisfy sniff patients and required patients to other skilled nursing facility so the 39 patients transferred were out of county. i i want to note that laguna, the methodology changed changed from '21 and '22 so the data shouldn't be compared. the total number of residents who received skilled nursing came at jewish homes between 2021 and 2022 should not be compared. jewish home and rehab center did not provide 2021 data and so dph staff used the 2021 hospital utilization data charts that's put out by the state and neither facility provides subacute care. and in 2021 and in 2022 did not make referrals to subacute facilities. next slide, please so, while there's limitations to the analysis of 2021 and 2022 data reports because of the variety of methodologies used to collect the data, we have a greater understanding of the population who required skilled nursing and subacute services across san francisco and had been transferred out of county. we found that most patients were transferred to an out of county s

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care 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 nowhere to move th

it's a laguna honda update. just wanted to again, emphasize that the department of public health remains fully committed to cms recertification and the long-term civility of laguna honda and their families. as shared during the last commission meeting, the cms 90-day survey may talk about the changes happening and we're on the path to recertification. as an example during the first 90 day monitoring survey, we received a total of 124 deficiencys and the second survey saw a decrease in findings with an anticipated total of 23 preliminary deficiencies. in addition, laguna honda staff and leadership submitted all 77 march deliverables for the action plan. this comes after completing all 126 general milestones in the 133 january milestones successfully. as we celebrate improvement, we recognize there's much work to complete before we are ready to apply for recertification and in that regard, over the coming weeks and months, we'll continue to complete all action plan milestones, prepare the facility for the next mon

jail replace am there are nower people getting minimal care they were get nothing jail or the laguna honda pasillities with behavioral healing needs help address the challenges atwell guna honda. i don't killer how we package it. it is hundreds of beds. that's that lecture. last low we need to invest in affordable housing that is acute i'm in -- encourage exclude glad the board is united around this idea and hope that willien rit more money than a local bond would for housing investments. if we were going to break the cap >> boost line, i think housing motorbike worth lookinga the this line. i will get out of the way. if supervisor ronen would just -- a second. i think our self imposed constrain is discordant with the picture that, agencies in governmental body this is are not us do have bonding instruments that apore on our bell on the and affect our property owner and their attentives commercial and residential. so, our constraints don't apply to community colleges or the school district or bart. so the reality is we are sending i message and trough for a decade if you rate for the bond

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking carer 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 nowhere to m

place like for years protective bollards on laguna honda. many years that should be a concrete bear in i'm concern body a quick build plan by the zoo. i'm hearing that you know it is not connecting to sky line because people don't want to deal with cal tran and people will have to navigate the intersection. so my question is, when we do the quick builds how much are we thinking ahead to making permanent and -- are we trying to do too many. with the quick builted concept sounds good cyclists don't like it and motorists are frustrated. does anybody like the quick build. we had do them to get data what point do we build the barriers? >> thank you for your comments i'm happy to discuss more about when we heard in response to our work. has a range in some people like it and don't and all various reasons. i will say that with the quick build program we are trying to establish intentional feedback lop in terms of having implementation. evaluation and adjustment and implementation and crediting that feedback through the projects. we have already bee

i want to take you to laguna honda. do you, supervisors, feel ashamed that could do nothing for laguna honda, which is i new building and old building put to use. doll you all feel ashamed that y'all are not providing a place with wrap around services for the mentally challenged? you have thousands roaming the streets. and some of the add have indicates do when we can. but every time you want help somebody who has ment will problems than i want to you give out money 5-8 thousand dollars to help per month. you talk the talk but don't walk the walk. supervisors, you irrelevant want to have the constituents of san pran and thus ans that roam our streets and thousands that are living in parole. stop talking and start acting. thank you very much. >> mr. lamb, next speaker please. >> good afternoon members of budget and appropriation commito i'm charlie i'm calling on behalf of community housing organization and i member organizations that are rotted in throughout the city. building the long-term resources to chief the housin

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

place like for years protective bollards on laguna honda. many years that should be a concrete bear in i'm concern body a quick build plan by the zoo. i'm hearing that you know it is not connecting to sky line because people don't want to deal with cal tran and people will have to navigate the intersection. so my question is, when we do the quick builds how much are we thinking ahead to making permanent and -- are we trying to do too many. with the quick builted concept sounds good cyclists don't like it and motorists are frustrated. does anybody like the quick build. we had do them to get data what point do we build the barriers? >> thank you for your comments i'm happy to discuss more about when we heard in response to our work. has a range in some people like it and don't and all various reasons. i will say that with the quick build program we are trying to establish intentional feedback lop in terms of having implementation. evaluation and adjustment and implementation and crediting that feedback through the projects. we have already bee

at the 11th hour trying to save laguna honda. now discussing about rams. that will get 61 or 62 million dollars over a period of 4 years. that's for 35 beds. and we have over etch 18 thousand,000 patients that need help have you in the done a need's assessment. you don't need a brochure, don't need something that tells y'all what to do. because y'all don't have the ability to do a need's assessment. you talk a lot. so, we can have 40 rams. you are not going to have the people. we have middle class people. who have who rent a place. or -- live in a home and get mentally challenged and die in their homes. and you rent the space. what can you do, supervisors? what can the city department do? do you when the city department are doing now? taking a case manager, a social work and an attorney and trying to make this parents who are mentally challenged sign anning agreement >> thank you, speaker for your comments. all speakers are limited to 2 minutes today. thank you very much. there are no additional callers. >> thank you. public comment is closed. >> superviso

for produce of fresh and frozen produce for zuckerberg san francisco hospital and laguna honda hospital by the department of public health to increase the contract amount by $5 million for total not to exceed amount of $11.1 million and a term extension of 2 years september 30, 2024 from a total contract duration of 7 years october 1, 2019 through september 30, 2026. >> same house same call, the resolution is adopted. >> item 14, this is rez solution to authorize san francisco public library to give- >> supervisor dorsey. >> thank you president peskin. i wanted to take the opportunity as a alumni of emerson college to say, how grateful i am that a college that has done a lot of great work in the realm of comedy. this is a college with three comedy clubs and no sports teams, at least when i went there. it graduated people like (indiscernible) and the daniel's for the direction and production of everything everywhere all at once. it is a big year for emerson college and think this is a nice thing i just wanted to show my lion provide by supporting this. >> same house, same call. the resol

so laguna honda has been an incredibly important institution in san francisco for 150 years, taking care 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 nowhere to move th

place like for years protective bollards on laguna honda.years that should be a concrete bear in i'm concern body a quick build plan by the zoo. i'm hearing that you know it is not connecting to sky line because people don't want to deal with cal tran and people will have to navigate the intersection. so my question is, when we do the quick builds how much are we thinking ahead to making permanent and -- are we trying to do too many. with the quick builted concept sounds good cyclists don't like it and motorists are frustrated. does anybody like the quick build. we had do them to get data what point do we build the barriers? >> thank you for your comments i'm happy to discuss more about when we heard in response to our work. has a range in some people like it and don't and all various reasons. i will say that with the quick build program we are trying to establish intentional feedback lop in terms of having implementation. evaluation and adjustment and implementation and crediting that feedback through the projects. we have already been comi

i want to take you to laguna honda. do you, supervisors, feel ashamed that could do nothing for laguna honda, which is i new building and old building put to use. doll you all feel ashamed that y'all are not providing a place with wrap around services for the mentally challenged? you have thousands roaming the streets. and some of the add have indicates do when we can. but every time you want help somebody who has ment will problems than i want to you give out money 5-8 thousand dollars to help per month. you talk the talk but don't walk the walk. supervisors, you irrelevant want to have the constituents of san pran and thus ans that roam our streets and thousands that are living in parole. stop talking and start acting. thank you very much. >> mr. lamb, next speaker, please. >> good afternoon members of budget and appropriation commito i'm charlie i'm calling on behalf of community housing organization and i member organizations that are rotted in throughout the city. building the long-term resources to, chief the hous

place like for years protective bollards on laguna honda. many years that should be a concrete bear in i'm concern body a quick build plan by the zoo. i'm hearing that you know it is not connecting to sky line because people don't want to deal with cal tran and people will have to navigate the intersection. so my question is, when we do the quick builds how much are we thinking ahead to making permanent and -- are we trying to do too many. with the quick builted concept sounds good cyclists don't like it and motorists are frustrated. does anybody like the quick build. we had do them to get data what point do we build the barriers? >> thank you for your comments i'm happy to discuss more about when we heard in response to our work. has a range in some people like it and don't and all various reasons. i will say that with the quick build program we are trying to establish intentional feedback lop in terms of having implementation. evaluation and adjustment and implementation and crediting that feedback through the projects. we have already bee

. >> and is this driven by inability to discharge folks to laguna honda? >> that's correct >> we gotta pay for it i will support this. >> thank you, vice chair mandelman. supervisor safai. >> through the chair to00 eye don't recall see thanksgiving level supplemental for the different departments like this in the last few years had is different about this year? >> great question. so in the left 2 years we did not bring the over time supplemental before the board because of a lot most of the over time we saw in departments was upon driven by the covid-19 pandemic. sick time taken and the hospitals. so we were able to wave the requirements to come before the board to request additional over time because of the covid emergency. we have not dhn in 2 years. but prior to that, it was typical. to have departments request some level transferring permanent to over time >> yea yoochlt what i wanted to say for the chair and add-on to what mandelman and the chair said, the thing that concerns me the most is is that so many of the different upon departments are part of

for produce of fresh and frozen produce for zuckerberg san francisco hospital and laguna honda hospital by the department of public health to increase the contract amount by $5 million for total not to exceed amount of $11.1 million and a term extension of 2 years september 30, 2024 from a total contract duration of 7 years october 1, 2019 through september 30, 2026. >> same house same call, the resolution is adopted. >> item 14, this is rez solution to authorize san francisco public library to give- >> supervisor dorsey. >> thank you president peskin. i wanted to take the opportunity as a alumni of emerson college to say, how grateful i am that a college that has done a lot of great work in the realm of comedy. this is a college with three comedy clubs and no sports teams, at least when i went there. it graduated people like (indiscernible) and the daniel's for the direction and production of everything everywhere all at once. it is a big year for emerson college and think this is a nice thing i just wanted to show my lion provide by supporting this. >> same house, same call. the resol

. >> and is this driven by inability to discharge folks to laguna honda?t >> we gotta pay for it i will support this. >> thank you, vice chair mandelman. supervisor safai. >> through the chair to00 eye don't recall see thanksgiving level supplemental for the different departments like this in the last few years had is different about this year? >> great question. so in the left 2 years we did not bring the over time supplemental before the board because of a lot most of the over time we saw in departments was upon driven by the covid-19 pandemic. sick time taken and the hospitals. so we were able to wave the requirements to come before the board to request additional over time because of the covid emergency. we have not dhn in 2 years. but prior to that, it was typical. to have departments request some level transferring permanent to over time >> yea yoochlt what i wanted to say for the chair and add-on to what mandelman and the chair said, the thing that concerns me the most is is that so many of the different upon departments are part of our emergency re