Like youre ready. Thank you for your presentation and although my skill sets around this area are limited, i do understand it, so thank you for that and thank you to your staff for the work to get this done in two months. Er thank you. Since were thinking, i dont want to forget our legal team and our Legal Counsel has been exceptional, shes not here but i want to say that for the record because without here, i dont think you could have gotten here in two months. So, commissioners, i think all of us remember this very long journey, some of us, those who were here, commissioner bernal is excused for not remembering, four years ago when we started even with a whole series of presentations regarding the nature of i. T. And where it was and that we cant have an ehr without a more structured i. T. Department. With the patients that we have exhibited here waiting for that to come about and then the last several years also looking at partnerships and then finally an rfp which we thought would then take certainly longer than has occurred here. We are back on to that timeline and i appreciate mr. Kim for presenting it here because were not that far off timeline and yet personally i would say we are far better prepared and if it were only that small variation of time as we look at the totality of this project, i think the opportunity for the preparedness, the thoroughness of the contracts are part of the fact that rather than rushing into some sort of program, weve deliberately taken our time to make sure that o efrg that we all want or need or want out of here is in the contracts. Yes. And that are rfp process was extremely thorough and as you can see because this is a very large contract over a very long period of time, so we are committing our department here to a ten year project with the promise of ehr for the clinical and primarily the hospitals which i think is also amazing because there was always that question, when was laguna going to come on for example, when were Jail Services coming on, here is a contract that say, well, heres when all of these are all wrapped sxup were going to have them all together under one type of record. Yes. So, youre to be commended for bringing forward this proposal to us, our next steps are to approve this as a recommendation to the board of supervisors. Yes, commissioner pating . Having had a chance to preview this with commissioner chow, i would like to make a motion that we would approve this approve thing cangt, not the rfp, i guess its the contract . Were approving the contract. I would like to make three comments, with regards to the rfp, you came in under budget with perhaps needing i think you said 90 of our criteria that we went in, our wish list. I think you presented a proposal that meets all of our important deadlines, plus has builtin reassurances for assessments at every step and that theres future opportunities for partnerships around epic that will add value. That said, we realize theres 100 subcontracts that you still flexed to work on, so i want to thank you for getting us to this stage and its for these reasons that i think we should approve it. I am going to suggest a name, two possible names, i understand the jail Information Management system is called jim, so i thought this one, we could call like, we say, hey, bill, or how about, okay, barbara. Well take that in consideration, commissioner, we eel have a contest on that. I would second the motion. On the names . On the approval of the contract, the names are part of your comment. The motions come together, you cant separate them. You didnt make a motion for the napes. We have one motion on the table that i heard you made, i heard a second on the motion. Are there is there discussion on the motion . Through the khai, i would just like the make a comment. When you said four years, no, i just want to say, i concur, everything that everybody especially dr. Chow, i mean, when you first came aboard and having been in other institutions where our i. T. Divisions usually rotate every two years, you never know who, whatever, and you were going to do a, b, c and d and then you can work with some of our major institution, pull together a diverse group, youve done it and youve sustained it and youve met and you said, here are ways we can do and what we cant do and more importantly, youve included your workforce in the dynamics of how you set the goal and how you all pulled together to present what youre presenting tonight and i think thats just astounding and i want to congratulate you and your team, you really impressed me. Thank you on behalf of my team. Thank you, any further comments . No . Were prepared for the vote . All those in favor, please say aye. Aye. All those opposed . Im pleased to report that this contract has been approved. Thank you. And if i can do we have an epic representative here today . Yes, we do. Now that you have a contract with us, do you want to come up and give us a few moments of your time. Just tell us your name. Yes, my name is lydia grund l, im a project manager with epic, i work closely with all of our applications and our research and Development Team as well as our customers across the country, we have over 400 Large Health Care organizations that use epic as well as a number of organizations here in california that have similar characteristics, theres no one exactly like you, but were excited to be here today. Thank you. Well, thank you, and you have did you come from wisconsin . Yes, were from wisconsin. Er my goodness, okay, and, sir . Hi, j. J. Howard be epic, im a business analyst, im here if you had any questions, fortunately thats not the case. Er i think you already had the tough questions, we often expect reports every quarter so that may be when other tough questions come. Thank you very much for coming and were looking forward to the partnership. Thank you very much. Thank you. Thank you. Commissioners, its okay to move on to the next item, commissioners. There were no public requests for that item. We can move on to item 7 which is a resolution approving the dph state and federal legislative plans. Good afternoon, commissioners, my name is cyndy comerford, policy and planning and im here to present our 2018 legislative platform, we prepared a memo for you which has a summary of our 2017 state and federal legislative actions and also a draft of our 2018 platform. Also you should have a copy of a resolution to support the 2018 platform which is for your approval today. So, the first slide gives an overview of what im going to talk about today, im first going to give an introduction of what we use our legislative platform for, then im going the give a summary of our 2007 state legislative update and is talk about key federal update, some emerging legislative issues and then discuss our 2008 platform. So, i want to start off talk about what our legislative platform does, so, the legislative platform is a document that serves as a broad based set of policies thats informed by the Health Departments leadership and also our professional organizations that we work with, so we collect information from these organize organizations and this is to align with the departments strategic and fiscal goals and also to align with the citys policy. So, basically what this document does is it serves as a policy guide for the department to protect and serve all of San Francisco. It also allows the department of Public Health to make recommendation tos the Mayors Office to take positions on both state and federal legislation. So, this slide reviews how policy is advanced at the department of Public Health, so we start with you, the health commission, who is the policy making oversight committee, getting your input on the legislative platform. Once thats done, we have our legislative plan and anyone within the department who would like to take a position on legislation or make a recommendation to take a position would come to the office of policy and planning with their recommendation. Our staff would do research and discuss it with our Deputy Director and with our director then kind of come together to make a decision on a way to move forward. Once we have a recommendation from our department, we take that recommendation to the Mayors Office of legislative affairs and with state legislation, there is an actual committee that votes on the positions and then once we have taken the city takes on official position on legislation, the office of policy and planning will work with the content experts within the department to see what are the best way to advance that position. Commonly, its writing letters on behalf of the city but we also have had staff present expert witnesses up in sacramento, provide testimony and other Health Education around different pieces of legislation. So, next im going to start im going to talk about our 2017 state legislative session. So, basically our legislative session just ended this sunday october 15th, and this was the first year of a two year session at the state. Over 2500 bills were introduced this year and approximately a little over 600 bills went to the governors desk for a signature. Those that did not move forward in this first year may advance and move forward in the second year. And just to take a look on the slide, theres a Little Information about the composition of our legislature this year, so you can see that its heavily democratic, that we have a super majority with having both the senate and the assembly, have a majority of democratic staff legislators. So, i want to apologize, there are some blanks that were left on this slide, this information had to be turned in last thursday before the end of the year, so i can kind of fill in the information as we go along. So, in 2017, the office of policy and planning tracked over 170 bills, 99 of those bills did not move forward. 65 of them were signed into law and 14 of those were vetoed by the governor. The city took 14 active positions on bills, 9 of those that signed into law, four of those stalled in the committee and one was vetoed and those positions are detailed on 3 and 4 of the memo that you received. The four bills that on the memo that said they were waiting for the governors signature, four of those passed with the exception of ab391 which was legislation on asthma preventative services, getting reimbursed through medical, that was vetoed through the governor. A couple of notable bills that got signed into law, sb 2 91 which was the decriminalization of hiv and the department had worked on this bill both dr. Orgon and director garcia provided support to sacramento, another notable bill was sb63 which was pay to family leave, that just got signed by the governor and our maternity child and Health Adolescent division had been working on this bill with coalitions this past year and were big champions of this bill. So, some other key topics that we worked on, on a state level, about medical reimbursement, we did a lot of work and trying to support Family Planning on a state level. Medical and adult use cannabis, theres a lot of legislation going through this year, immigration and sanctuary city legislation which ill talk about a little further down in the presentation. We looked at legislation around criminal justice, supportive housing, we talked about asthma, also childhood lead poisoning, the paid parental leave, automated Speed Enforcement bill which turned into a two year bill which we started working on again and some bills on Food Assistance and safety. So, im going to just do a recap on some of the key federal issues. So, this slide depicts the key federal issues that we weighed in on, a considerable amount of time was spent on the repeal and the replace of the aca which ill go into on the next slide and also on sanctuary cities which ill go into detail but two other notable federal decisions that we provided input on were the Hospital Preparedness Program and also the 340 drug program. And both of these were slated for cuts. The decisions are still pending. So, in policy and planning, we spent a considerable amount of time track thing repeal and replace of the aca, this started in january when a condition current resolution was introduced and this started the process where a simple majority would be needed to do the repeal instead of a twothirds vote, so that was passed by both the house and the senate and in march, the American Health care act was introduced and it was withdrawn before its first vote that month but later in may, we know that that revised version was passed by the house. In june, the Better Health care reconciliation act was introduced and the following month in the end of july, three votes failed, there was a vote on the Better Care Reconciliation Act and then there was a skinny version of that bill and then there was a straight repeal. So, i thought that was it but then we moved into september and the Graham Cassidy act bill was introduced and that vote was no vote was made on that bill and that was significant because that budget reconciliation that was introduced in january had expired at the end of that vote. So, moving into october, last week, there was President Trump issued an executive order allowing insurance to be sold across state lines, this presentation was sent in and then after that, it was the cost sharing reductions that were cancelled but i did receive some good news today that centaur Lamar Alexander and centaur patty ray reached an agreement on an aca stabilization package and theyre wrapping up negotiations right now, a summary release ined the next 24 hours and right now it has two years of funding for the cost share reduction subsidies along with the rest of 2017. And there are also likely will additions to help enrollees in their premiums in 2018, so thats good news, were going to track update and is were going to see continued treating to the aca but good news today. Another thing that the city and Department Spent a lot of time on was sanctuary cities. The Trump Administration has brought a lot of uncertainty to undocumented san franciscans and their families, so in the beginning of the year, the mayor had launched an equity and Immigration Service campaign to provide education and outreach to immigrants and to partner with other Community Based organizations to provide services. On january 25th, the Trump Administration issued an executive order, that executive order was the threats to sanctuary cities saying it was going to cut off funds among other things, San Francisco sued President Trump saying that the executive order was unconstitutional, the city in march had passed some legislation trying to protect people on any religious affiliation or National Origin and that was in response to another executive ofeder issued by the Trump Administration and lastly the end of april, a federal judge issued a preliminary injunction against the executive order against injunctions, theres been a lot of work in the beginning of october, the state passed sb54 which kind of basically declared california as a sanctuary state, in addition, there were other pieces of legislation just signed not allowing perceived immigration status for landlords and housing, another bill on workplace rates, a bill on dreamers and student protections and also on Immigration Detention Centers so the state has been active in trying to protect the residents here against unlawful actions or having people deported just based on their immigration status. So, thats kind of a recap of 2017. Im going the move on to talking about the 2018 legislative platform. So, just to talk a little bit about our process that we go through to put the flatbacker platform together rkts we start with the previous years platform and then we get input from our Deputy Director and director of policy and planning. We take our draft platform and were to review it at the integrated steering committee, there were so many Emergency Response effort and is hearing the last month of those meetings had been cancelled so i reached out directly to Department Leadership to get their feedback on the legislative platform so there wasnt a presentation at the ifc, so we had an opportunity to get feedback from Department Leaders and then were here to get your approval on legislative platform, it will be reviewed by the Mayors Office and hopefully in december adopted by the state legislative committee. Just to talk about whats in the platform, whats new, this slide shows the key issue ins the legislative platform and im not going to go through all of it, there is an attachment in your memo, just to talk about this years additions, so starting off with affordable housing, homeless and supportive housing, we made some amendments looking to increase funding and coordination to address needs of people who are currently homeless, also to better support healthy housing, particularly for lowincome people. Moving on to behavioral health, we added an amendment about supporting funding for adolescent Mental Health and making sure that there were Better Services and more models of care for adolescents. Going on to Restorative Justice and improved health, we added two amendments, one was to support legislation to require the state to carve out an Inpatient Psychiatric Services and is to make sure that was reimbursed through medical and also to support legislation that allows for the continued expansion of medical assisted treatment and other preventative Harm Reduction programs in jail. We have added some more specificity to the Climate Change and justice, just to make sure that we are supporting policy that is increase funding for Climate Adaptation and Resilient Program that is promote equity and also to support policies that address dris proportional environmental and Health Impacts in lowincome communities. There werent that many changes to the maternal and child health part, for the hospital and county funding, we put some information about opposing per capita caps and limiting the ability of states to leverage funding through assessments or providers. And for population health, we added some language about Health Equity and also based on the recent events, we added information to make sure that there is enough funding for coordinate response for Public Health and