garner just city attention but national and international attention, because this clinic, the lyon-martin clinic, is very important. it is part of our help strategy in san francisco. how and what we must do to make sure this clinic is sustained and well supported, both through a private and nonprofit mechanism and the public mechanism, that is what we are going to explore here today. part of this hearing is to understand how it got to the point that it did. it is not necessarily about winding fingers -- wagging fingers, but also trying to make sure that this does not happen again. we will hear from the city family, department of public health, a consortium, and others, including people from lyon-martin about what happens with the financial crisis that led up to the imminent closure and what we can do to make sure that does not become a repeat scenario. and this may not be the only clinics facing this type of danger. this could be an indicator of other clinics because of the downturn in the economy nationally. certainly, in california. this may be a harbinger of things to come. seeing that we att

very constructive -- constrictive time perimeter, in working with the directors of the lyon-martin health clinic. we want to thank lyon-martin for being cooperative in doing everything you can to avert a crisis. in my opinion, and i do not believe i am alone, i think many here in the elected family would see this as a profound loss, devastating, if lyon-martin health clinic or to close. the expressed intent of today's hearing was just that, a hearing, because we have not been able to conduct a forum because we did not have empirical data until this point. we did not have the data we have been waiting for. that way, there is at least some financial assessment and policy assessment as to how we got into the position we are in and what we can do to make sure this position and reality is not repeated. now that we have gone through that, this now informs and enables electeds like myself to come to this conclusion. i will go out on a limb here, but i do not think it is unpredictable that it would be a complete and unconscionable posture of our part if we did not, i think, step forward, should lyon-mar

martin. i finally found a doctor that would listen and try to help. thank you. supervisor mirkarimi: thank you. >> my name is melissa karen. i am currently the clinic director at lyon-martin. i am a nurse by trade. i came to california three years ago. we have had a medical historian working with lyon-martin for about a year. she has been capturing the story of the clinic and patients. i want to share a couple of excerpts. i have the printout of all of those stories that i would love to give you, if you want them. the first is a trans patient who said, "i had never received biological care before, because i was so uncomfortable and ashamed of my body. i am afraid my reproductive health will suffer dramatically, as i cannot fathom letting another doctor into my body in such an intimate way." another patient said, a 49 year old who was diagnosed with kidney cancer, "i thought the financial and emotional burden would be too much to handle and no one else would be able to help. there were many times i felt helpless and hopeless. suicide felt like the easiest option. i am a lesbian, and even though my family feels -- tries to be supportive, i felt more

dph and some clinics in san francisco, including lyon- martin. there is a differential in medicaid payment. the rates are pretty substantial. they went from about $9 million per year. personally, i have been at the consortium for about 20 years. i trained as a clinical social worker, clinical psychologist. before that, that is too far back to even talk about. lyon-martin is a founding member of the consortium. they are on our board. they are not allowed to vote. they must abstain. our board chair is also here to address any concerns you may have. how did we get there? how did we get to where we are today? some background. prior to this, there was a meeting in december of top officials. "i want to know what is going along with a gay and lesbian and transgendered health care in this country." we have a clinic in san francisco that is the only lesbian and transgendered clinic in the country. there are other clinics. this is the only one with the primary purpose of lesbian and transgendered health care. the day that this whole thing broke was the day

thank you to lyon-martin health clinic. thank you to the department of public health. i think we have a bit of business. i am going to entertain a motion to rescind the boat on item 3 -- the vote on item three. motion to rescind the vote on item three. instead of it to date certain, i would like to continue this to the call of the chair. very good. we will continue that to the call of the chair. >> that completes the agenda for today. supervisor mirkarimi: very good. budget and finance committee is now adjourned. >> i work with the department of environment and we are recycling oil. thank you. we can go into a refinery and we can use it again. they do oil changes and sell it anyway, so now they know when a ticket to a. hal>> to you have something you want to get rid of? >> why throw it away when you can reuse it? >> it can be filtered out and used for other products. >> [speaking spanish] >> it is going to be a good thing for us to take used motor oil from customers. we have a 75-gallon tank that we used and we have someone take it from here to recycle. >> so far, we h

thank you to lyon-martin health clinic. thank you to the department of public health. i think we have a bit of business. i am going to entertain a motion to rescind the boat on item 3 -- the vote on item three. motion to rescind the vote on item three. instead of it to date certain, i would like to continue this to the call of the chair. very good. we will continue that to the call of the chair. >> that completes the agenda for today. supervisor mirkarimi: very good. budget and finance committee is now adjourned. >> welcome. i am the executive director of the tenderloin development membered corporation. we provide social services and affordable housing in the tenderloin and run the city and county of san francisco. we now own 30 buildings with 2500 units affordable to san francisco's most vulnerable residents. we are standing amid a massive, an adaptive reuse of a building that was originally erected in 1910. when it is finished, 172 chronically homeless individuals will live here, and we will also be developing a wellness center, a community clinic, 11,000 square feet

martin. i am here to ask you to help save the clinic. i originally came to lyon-martin a few years ago as a patient. i have had significant health problems. i have a history of depression and mental health issues. i also had been unable to receive transgendered-related care elsewhere, because people would look at me and turned me away. i also have an autoimmune disorder which desperately needed treatment and was dismissed as psychosomatic. at lyon-martin, i was shown nothing but respect. i had been taken -- taking black-market hormones. dawn got me off that and was sure to follow up with me to make sure how was doing. all of the providers and all the staff are absolutely respectful and wonderful. it was this that made me decide later to come back as a volunteer. i volunteered at other places, but this is probably the first place i have ever heard anybody say, "i am so looking forward to coming to my appointment tomorrow." if you days ago, i got into a bicycle accident and from my arm and got broken up. i have private insurance now. i call

i know we have some people here to save services at the martin clinic for march and the next few years. it is an important process. we're working with the executive directors. it goes back to community-based organizations and how we will support them and have them manage their programs. supervisor campos: thank you very much. i will speak as an openly gay, latino man. lion martin is very important. there are a lot of other organizations. all of these organizations provide amazing services. before we wrap it up, i do want to turn it over to anna perez to talk about where we go from here. i will have some final words after she makes a brief presentation. >> [speaking spanish] gracias. [speaking spanish] >> we have behaved very well. we have not made much noise. the mission is known to make a lot of noise. that is why we did little noise together. we want to remind you that as you are making the tough choices, it is about the kids that were on stage. it is about the mothers and the hearts of the people you saw here today. it is not just about cutting services. it is looking at how we gene

center, mission neighborhood health center, the lifting of breast cancer agency, and the lyon-martin clinic. for those patients that come to us from those groups, obtaining medical care is often a challenge. because st. luke's is there, in an area that is accessible to them, they get the care they need. our patient population is the first. a lot of people south of market depend on st. luke's to be there. i cannot tell you how often patients expressed their concern about the importance of rebuilding the hospital at st. luke's campus. they want us to continue to be there for them. they trust us to care for them, to deliver high-quality health care in a safe environment. if we do not rebuild, we will be letting those people down. we need to build a new, modern facility, with state-of-the-art equipment necessary to provide the quality care that family's south of market deserve. i urge you to move forward to deliver st. luke's cpmc. >> good evening, members of the health and planning commissions. thank you for allowing a cpmc to share how the hospital has greatly benefited my family and me for a

clinic. but i have not seen anyone turn their back on lyon-martin. and that is why we are here today, to ask that you, supervisors, not turn your backs on the clinic, that you not turn your back on the committee that is in such critical need -- on the community that is in such critical need. i think that we as a city are better than that. thank you. supervisor mirkarimi: thank you. next speaker, please? >> hello, supervisors. thank you for your public service and leadership on this issue. i am brian, the executive director of housing and san francisco, and hopefully i speak for my other organization executive directors who could not be here to say we all have to stand together when times are tough. san francisco does not let people fall off the cliff and we cannot let organizations fall off the cliff. that is what sets us apart, part of our values we're here to support today. a few notes. lyon-martin, five under thousand dollars, that is fifty-five cents per day for health care, and that is a reasonable investment, especially for parts of the populati

martin. supervisor mirkarimi: thank you very much. next speaker, please? >> hello, i am a nurse practitioner at a clinic in the city. i'm a registered nurse at san francisco general hospital. i just want to remind the supervisors about the great stress of closing lyon-martin on the already overburdened department of public health. i have no people to wait and the emergency room 40 hours before they get a bed. there has been a time when there has not been and i see you open. -- there has been a time when the i.c.u. has not been opened. i personally tried in the past few months, and there has been a weight of three months to get an appointment. i think it is in the department of health's interest and the patient's interest to keep the clinic open. thank you. supervisor mirkarimi: thank you. before this next speaker, i will read a few more names. the kathleen, linsey, brian. >> good evening, supervisors, i am thomas. the issue in front of you is not whether the individuals are entitled to medical treatment but whether or not lyon-martin should be the provider. i am very troubled by the questions posed by this committee

the department will be with lyon-martin tomorrow, with the cfo of the consortium clinic, to review the financial statements, not to do an audit, just make sure that the department of public health has the same understanding in terms of this fiscal condition of the organization when they go forward basis. the department has a result instituted a number of things. you have before you the department has instituted a corrective action plan. that corrective action plan covers four areas in terms of operations and oversight, governance, fiscal management, fiscal recovery, and certainly program operations. when we became aware that in the latter part of january that a closure was potentially a minute, -- potentially a minute, the first thing the department of health did as a responsible action is we closed lyon-martin to new individuals, so new individuals are not able to enroll in the clinic. certainly we have had healthy san francisco participants who have called us asking us the status of the clinic and whether or not they could perhaps change clinics and select another clinic, and we have

budget hearing on the martin health clinic. thank you. >> thank you, supervisor mirkarimi. president chiu: if we could go back to item 34, the item regarding the transportation code and the police code? supervisor wiener: we have now distributed the amendments, and the amendments are in section 7 and have to do with the penalties and adding section 7.4. and we are in agreement on adding this. i will note the physical coffee contained subsection de -- the physical coffee contain subsection d. those were from an old version. we have an electronic version. ignore those. they are not part of the amendment. with that, i move to amend as stated. president chiu: can we take that motion without objection? on the item itself, any further discussion? seeing nine, -- none, it is roll call. it is approved. colleagues, at this time, if we can go to our 3:00 special order, the first of our 3:00 special orders. >> excuse me. >> [unintelligible] president chiu: we are actually going to our first three -- our first three " special order. we are not open for public comments. >> [unintelligib

george washington university, clinical professor of neurology, ten years. 14 books, including most recently mysteries of the mind. richard martin restak. >> dr. restak, you have had quite an extraordinary career. first of all, you taught at georgetown. >> yes. >> then you abandoned the jesuits or did they dump you? then you moved over to g.w. >> yes. >> do you still teach inta at georgetown? >> i'm in the faculty but spend most of my time at g.w. >> okay. i have that number, by the way, and england and wales, out of every millionth person born alive in 1880, only 223 could expect to be alive 100 years later. 1880. so that's 112 years from now. 110, about that. for those born in 1990, out of one million people, 8,710 can expect to be alive 100 years later, 40 times greater. infants born in 2025 can expect to live 100 years. >> well, we should have cancer and heart disease, the big killers, under better control by that time, because people don't really die of brain disease. it is from other organs failing. >> and those organs can be maintained in improved health if the brain is servicing them well, which means, i guess, what is t

clinic. i will be reading a letter a tenant wrote. i will be reading on behalf of her because she was to be anonymous. i'm a tenant that lives on martin street and i have lived there for 14 years now. i started to have bedbugs are october, 2010 and ever since i have been dealing with this issue. because of this, i have lost a lot of my personal belongings, closing, expensive furniture, and i'm afraid to invite any friends over because i don't want to know i have bedbugs. i reported this to my apartment manager and all she did was she sent her own maintenance team to do a spray. they came into my apartment to spray some white powder throughout the apartment which ruined the entire apartment. i had to throw everything away. she had to replace her own carpet because of the treatment, which she should not have done that. that is the landlords job. i lost a lot of my personal items, but luckily i had a free laundry service to help me out with my expenses. even with this laundry service, i lost some of my most expensive clothing from this. i am very sad and angry that they threw everything out. i lost all lot of expensive items. this entire