both with the non-profits and academic institutions, laguna honda, we have a residency program in uc sf doing rotations at laguna honored. before it was a separate entity. take a look at what's going on now. we have clinical social work, now we are getting this integrated model on how to provide dignity and respect for patients at whatever stage using these resources of this great city. you have been able to articulate that in your work. more power to you. i think you have done a great job and look forward to seeing next year's results. >> thank you, any further? director garcia, you are one of the leaders in this case. your comments concerning this document and the work that was done. >> i think palliative care has been a growing service in the city. if you think back to our hiv and aids epidemic, palliative care was all we had to provide for people. we learned that community and family were the basis of much of that care. as we move into aca, we know we are going to be looking at family and community support to look at people's care. bringing all of these entities especially people wh