mr. wagner that as we hear the budget presented, that we understand what will happen to our epic project because we all know that it's taking a long time and different funding to get there and i think it would be important not to lose the advantages of epic and yet, we need to meet with some fiscal responsibilities. thank you, commissioner chow. i see mr. wagner, his microphone is muted and i'm not sure if he was at the meeting, but i will pass that along to him. >> it's something we would like to hears hears a hears hears t presentation. any other questions? >> commissioner green. >> congratulations on your continued success with epic. mr. wagner spoke of how important optimizing revenue with epic as a tool would be as we face our future deficits and you mentioned that there was, maybe, some issues in stabilizing the optimization and so i'm wondering if maybe you can either elaborate a little or tell us in your future update, you know, how that is being approached in the context, also, the anticipated increase in the medicale enrollment and in-patient versus outpatient billing, you'll a

mr. wagner, are you on? >> yes, i am. >> i will on and put you on. >> i'm make this brief.just a quick update in tens o if where we are. we talked with you at your previous meeting after just receiving the strucks from the m the mayor's office and we're working those internally and the deadline for the submission of the budget was june 12th. we have spoken with the mayor's office, the fact that you have your next commission meeting on the 16th and we asked to have an extension of that deadline so that we can discuss the budget with you at the meeting on the 16th and they have agreed to that. and so, that gives us a little built more time to work on the product and it was important to us that we would be able to bring that proposal to you before going to the mayor's office. so that allows us to do that at the next hearing instead of having a kind of rushed in and half done plan for you here today. and so, a couple of things that are going on to give you an update. we are working on a multi-proppinged approach and thimultiprongedapproach and thit turn-around to get something

mr. wagner or dr. colfax? >> well, i think that, dr. chow, that's exactly right. and in this compressed timeline and in this time of social distancing, and the many challenges that we have, your comments are even more salient. and certainly you're committed to achieving the goals within the timeline but also getting as much input as we're able to during this period. >> clerk: all right, thank you. commissioner bernal, is it okay to go back to item 3 to the director's report? oh, you're muted, commissioner bernal. >> president bernal: yes, that's okay. >> clerk: dr. colfax, and the director's report? >> yes, and, again, i apologize for my delayed participation in the meeting. we were having challenge with microsoft teams. and so good afternoon, commissioners, grant colfax, director of health. you have the director's report in front of you. and much of what i'm going to talk about in the covid-19 response is going to be covered in that discussion. so there are some details here that i would -- i would leave in the interest of time for you to ask any questions about.

mr. wagner, are you here? >> i am. can you hear me? >> clerk: yes, i can. are you on video or on just audio? >> let's see. i am. >> clerk: you are? fantastic. so, commissioners, is that okay, and commissioner bernal with a thumbs up? fantastic. and i'll put you on the screen to say hi before we put the slides on, okay. >> okay. >> clerk: and, greg, i'm hearing double -- are you watching this (indiscernible). >> no, i don't think so. >> clerk: okay. i'm not hearing it anymore. >> does that sound okay? >> clerk: yes. i'll mute myself. >> commissioners, greg wagner, c.f.o. so we are just kind of lat late-breaking information coming out around the city budget and i don't think that any of this is a surprise. there's been recognition for the city and county and state, etc., and there's a significant impact on the economy and, therefore on the city budget of the covid-19 pandemic. and we're at the point now where the city is regrouping and re-evaluating its budget process. and so all will recall that back in february that we brought under the normal timeline to t

mr. wagner.hese are losses, and in addition, we also included losses due to lower volumes expected for applications and fees for environmental health and other areas such as vital records. the losses are offset by 28.2 million in cares revenue expected for next year. the net impact is one time, 13.1 million overall. it's an additional funding loss that we have. we go to the next slide. so we also, in addition to the revenues updating the revenue projections and the savings that we had initially proposed, we are adding 7 or 8 new revenue savings reductions. the first one is reducing jail health services due to the closure of the hall of justice. last month, the board of supervisors voted to close the facility which houses county jail by november 1st. so we are proposing to reduce the number of ftes we have, three rns and three lvns. we had about 17ftes supporting the hall of justice. we're only looking at a eliminating six of those positions. the remaining 11 will be moved to support other parts o

mr. wagner. these are losses, and in addition, we also included losses due to lower volumes expected for applications and fees for environmental health and other areas such as vital records. the losses are offset by 28.2 million in cares revenue expected for next year. the net impact is one time, 13.1 million overall. it's an additional funding loss that we have. we go to the next slide. so we also, in addition to the revenues updating the revenue projections and the savings that we had initially proposed, we are adding 7 or 8 new revenue savings reductions. the first one is reducing jail health services due to the closure of the hall of justice. last month, the board of supervisors voted to close the facility which houses county jail by november 1st. so we are proposing to reduce the number of ftes we have, three rns and three lvns. we had about 17ftes supporting the hall of justice. we're only looking at a eliminating six of those positions. the remaining 11 will be moved to support other parts

mr. wagner, are you here? >> i am. can you hear me? >> clerk: yes, i can.re you on video or on just audio? >> let's see. i am. >> clerk: you are? fantastic. so, commissioners, is that okay, and commissioner bernal with a thumbs up? fantastic. and i'll put you on the screen to say hi before we put the slides on, okay. >> okay. >> clerk: and, greg, i'm hearing double -- are you watching this (indiscernible). >> no, i don't think so. >> clerk: okay. i'm not hearing it anymore. >> does that sound okay? >> clerk: yes. i'll mute myself. >> commissioners, greg wagner, c.f.o. so we are just kind of lat late-breaking information coming out around the city budget and i don't think that any of this is a surprise. there's been recognition for the city and county and state, etc., and there's a significant impact on the economy and, therefore on the city budget of the covid-19 pandemic. and we're at the point now where the city is regrouping and re-evaluating its budget process. and so all will recall that back in february that we brought under the normal timeline to the

mr. wagner.osses, and in addition, we also included losses due to lower volumes expected for applications and fees for environmental health and other areas such as vital records. the losses are offset by 28.2 million in cares revenue expected for next year. the net impact is one time, 13.1 million overall. it's an additional funding loss that we have. we go to the next slide. so we also, in addition to the revenues updating the revenue projections and the savings that we had initially proposed, we are adding 7 or 8 new revenue savings reductions. the first one is reducing jail health services due to the closure of the hall of justice. last month, the board of supervisors voted to close the facility which houses county jail by november 1st. so we are proposing to reduce the number of ftes we have, three rns and three lvns. we had about 17ftes supporting the hall of justice. we're only looking at a eliminating six of those positions. the remaining 11 will be moved to support other parts of jail hea

mr. wagner mentioned earlier, that we'll be having a lot of people who have lost their employer-based health insurance and will be enrolling in medi-cal, but i think we'll see some real impacts in terms of access because of some -- some of the -- some of the providers of care not being able to stay afloat. >> thank you. it would be great to follow up on that. i think there's national concern about it. >> commissioners, i believe that there's a long-term plan maybe in september to have a primary care update, and i will talk to dr. hammer and talk to shan and dr. pickens. are there any questions for dr. ehrlich. >> well, i just wanted to ask dr. hammer one question, which is as you're trying to move towards having additional in-person visits, what is your time frame for that, and how does that affect our phase 2, you know, program? >> our san francisco health network clinics -- primary care clinics have been planning -- they were instructed at the beginning -- or at the end of april to look at may as their planning month, so they're really planning now for early june to be resuming some in-per

mr. wagner mentioned earlier, that we'll be having a lot of people who have lost their employer-based health insurance and will be enrolling in medi-cal, but i think we'll see some real impacts in terms of access because of some -- some of the -- some of the providers of care not being able to stay afloat. >> thank you. it would be great to follow up on that. i think there's national concern about it. >> commissioners, i believe that there's a long-term plan maybe in september to have a primary care update, and i will talk to dr. hammer and talk to shan and dr. pickens. are there any questions for dr. ehrlich. >> well, i just wanted to ask dr. hammer one question, which is as you're trying to move towards having additional in-person visits, what is your time frame for that, and how does that affect our phase 2, you know, program? >> our san francisco health network clinics -- primary care clinics have been planning -- they were instructed at the beginning -- or at the end of april to look at may as their planning month, so they're really planning now for early june to be resuming some in-per

mr. wagner, i thank you for those comments. i think that's exactly the right approach, and i hope our fellow commissioners feel that the department has put forth. we need to get through the year and we need to be able to answer the needs these people need and we can always hope for things to change, but i think we're going in with our eyes open as to what we may have to do in the future we've got to answer the needs of the people today. thank you. >> commissioners, any other questions? if not, we have a request for approval. is there a motion to approve the proposed budget for fiscal years 20-2 it 21 and fiscal year it 2. >> i will do a roll call vote. mr. bernal. [ roll call ] >> great. congratulations, everyone. this is a great budget year. >> thank you again to greg and jenny for all of your great work. >> thank you, commissioners. >> thank you. >> we can move on to the next item. item 7 is the annual fiscal year 19-20dph sole source waiver usage report submitted to the board of supervisors in june to meet the requirements.

mr. kaplan but even later on this week i will be sitting down with esther george to discuss some of these same issues. thank you, chairman waters >> thank you very much ms. wagner, you are recognized for five minutes >> thank you, madam chairwoman and i thank you, chairman powell, for coming before this committee today. i wanted to commend you as so many of our colleagues have and the federal reserve for moving so very swiftly and decisively these past few months on keeping america's economy stable during this pandemic. just this week the federal reserve announced it would begin buying up to $250 billion in individual corporate bonds through the secondary market corporate credit facility with the ability to also, i believe, tap into $25 billion in funding from the treasury department that was provided by the c.a.r.e.s. act i understand the need for the federal reserve to have this facility at the ready, but i'd like to know why you decided that it was at this time to launch the facility now, what was the reason for launching this week? >> actually this was something we've been saying since we first announced the facility we would do it did happen to be the fact