marilyn hayward, dougles yep, and other speakers. >> i am a member of the health commission and an officer of the coalition of agencies several of the elderly. since the beginning like many kids have a service agencies, we have been serving lgbt seniors and helping them maintain their health and independence. we learned how to make services appropriate. maximize consumer choice and a scheurer cultural compensate and make sure that client satisfaction measures are followed. maximizing consumer choice is important with food. the type of food, how you get it, how it is delivered. at the health department we designed help the san francisco so people could choose their own medical home. they could find out where they feel comfortable. i am the order of the ihss medical authority. the allow people to choose the person coming in to their home. some settings are where trace is not a possibility. as we heard, -- in areas like that where there is no choice, you have to assure culture competency. the health commission required cultural competency reports and measures of all programs. this is somethin