comparemela.com

Hi everyone on the board. Im one of the caregivers that has been at the irene swindel alzheimers unit since it opened and we have several coworkers here. We wanted to express to the board that the whole department right now is like in a mourning state because of the fact of the closure and our patients is our pride and our joy. Its not just a job. And what our concern is is that say like for you and i, its easy for us to get up and relocate and deal with new faces. With our clients its not like that. It can be devastating and can even lead into death possibility, which we pray not, but this is our concern. Our clients have very challenging behaviors that we understand and our first step or recourse is not to medicate. We know how to interact or defuse their behavior and not allow them to get hurt and protect them. Everything that is very, very difficult for a Family Member to do, you need a team like the irene swindel center. We hope the board can review the track record of the center, which we were one of the leading models of the residential facility in the northern california. We had other facilities sending their clients to us. When they came to us, there was a drastic improvement in ways there wasnt at the other facility. I feel this is a facility that really, really needs to stay here in the city and the clients we had had are the state of the art people who build highrise buildings and other things here in the city. Thank you. Im going to call other names while the next speaker comes up. Hi, im teresa palmer, i work with San Francisco for healthcare jobs and justice. One of the things i wanted to point out, its on the c m. P. C california campus, it costs 6500 a month minimum to be there. It is a model facility and under the model of memory care, which is an enhanced form of Residential Care that is expensive to provide. It has increased nursing and staff training than most Residential Care facilities. Most facilities are decidedly non medical and do not do well when seriously ill patients are sent to them. The ombudsman has provided you with a list of Horror Stories that can happen when sick people are discharged to the hospital from an rcfe. And the Hospital Council is basically supporting a narrow focus on short stay acute care because that brings the most revenue. They want to discharge their problem patients to Residential Care because thats the cheapest thing for them to do. Low to moderate income cant find regular longterm care in San Francisco and community sniffs are using beds to provide post hospital rehab, that the hospital used to provide because it is funded by medicare and pays more than medical. Because the hospital industry will no longer provide post hospital sniff, sniff subacute and acute psychiatric care, they dont make enough of a profit on it, even though they dont pay taxes. This is pushing sicker and sicker people to Residential Care. Residential care should only be used for frail and ill people if it truly meets their needs. To meet the needs of a Residential Care patient, you have to have wraparound thank you. Whats your name again . Teresa palmer. Thank you. Im michael lion, also with San Francisco for healthcare housing jobs and justice. Im on the board of the California Alliance for retired americans. Were working very hard to incorporate universal longterm care into the california Single Payer Health bill thats going on right now. As part of that, were working to remove the strong institutional bias and longterm care. But you have to consider whats going to be happening in 2013. Its only 13 years from now. In 2030. Its only 13 years from now this is when the baby boom wave is going to approach 85. So this is the elephant inside the snake is going to move to the point where the beginning of it is 85. Nationally in 2010, there was 11 Million People who were 85 and older. In 2030 it will be 18 million. In 2050, 35 million. In San Francisco 25,000 people in 2030. 50 of the 85 plus are expected to get dementia. The future 85 year olds are going to have much more chronic disease than the past 85 year olds. The future 85 year olds are going to have a lot less money than past 85 year olds. Something must be done to care for them and it cannot be simply Residential Care. There must be a continuum of all levels of care. We must remember that hurting any level of care is going to hurt other care. Thank you. Hello everyone. Im so happy to come here to talk about our residents, which means not like i mean, theyre like our family. Its not im talking about myself, im going to lose my job, its not that. Its our small community, we have high experience and i know how were going to deal with them, its good for our residents to stay the same place and then the same staff its a better place for them. Thank you. Thank you. A few more cards. Annie chung and katie owens. Im kim from the National Union of healthcare workers and i have a privilege of representing the workers at the facility. We have a real problem here. The people at the top of the food chain, the hospitals who are making millions and millions of dollars of profits pay no taxes and are shoving people out the doors. And are not doing their fair share at the other end of the spectrum. They apparently dont like seniors, primarily cpmc, theyre trying to throw out the swindel patients out. What we have here is pure profit and greed going on and we need to do something to change the dynamic. Its time, the hospitals that dont pay taxes, maybe we do some sort of surtax on every hospital bed, that money goes to a pool to try to create more beds. They need to do their fair share. Basically the post acute care, what is it, collaborative or whatever, collaborative was only amongst hospitals primarily. There was no like the people making the most money are not doing their fair share of the healthcare in San Francisco for the Residential Care, for the subacute care and Skilled Nursing beds. Theyre not doing their fair share. We need to come together and perhaps its time to create another dynamic where the Community Members come together and we sit dine and try to hash out a real solution and make them accountable. Make them accountable to the patients, make them accountable to the families, make them accountable to all of San Francisco. This is not fair. Good afternoon. Thank you for calling the hearing. Im katie owens from advanced approach to senior care. Essentially what we do is try to find housing, board and care, assisted living for all counties in northern california. The best way to describe it like a realtor but helping to find assisting care homes. On a daytoday basis i cant explain the stories that i hear, its overwhelming. Theres sadness underneath it. Right now i feel activism, a call to something more and im inspired by everyone here and im very sad to hear that the facility is closing. Even if you can imagine at 6,500, thats not inexpensive and people are paying 50 of that, thats amazing. Above and beyond that, its a specialized facility, so its not like you can say youre closing down, call katie owens and have you 3,000 and what can i find for you. What i can find for you may not be safe and i dont have the list of everything that the ombudsman gave you but if you have a moment ill take you on a tour and you can go into some of those, i guarantee you wouldnt want your Family Members to be living in a lot of those. Nothing about the business owners, thank you, theyre serving a population that needs to be served but not necessarily with frail and vulnerable. I wish i had a solution, i dont. A little bit comes down to money obviously. Were giving a lot of money to research, thats beautiful, but what can we do to solve this problem. Ill leave a thought, i got a call from a gentleman paying 10,000. He has a day in the city named after him that governor ed lee gave him and he cant afford to live where he lives anymore at the age of 99. Im kathy davis, we have no board and cares in our district in 94124 or 94107, the closest is age long and no one can afford to go to it. My concern and i want to thank you for just bringing up the topic supervisor yee. No one has thought about the idea that maybe every senior cant be in independent housing. Maybe we need other solutions and places for people to live. I appreciate the conversation but i think we need to go a step further. Having the discussions about Affordable Housing, we have to think of people aging in place in the Affordable Housing and divert dollars for people to live in and work with nonprofits to provide the services. Im concerned about the population now. We have 120 unit Senior Housing and 3,000 people on the waiting list and as our seniors age in place in independent housing we place them in, where do they go . If you dont have a Family Member in San Francisco or person to advocate, youre not going to be in San Francisco. And its unfair to people who have lived here all their lives not to be able to figure out a solution for them. I feel theres a way to work with the Health Department and department of aging and homelessness and housing to address this issue together. Thanks. Thank you. Good afternoon. Im the president and ceo for the elderly. This is our 51st anniversary being a Community Based organization, mostly for low income and immigrant seniors, particularly asian seniors. We started to operate a small six bed in the Richmond District back in 1990. We accepted only ssi seniors in those days and when they get the ssi check, they take out 100 and the rest comes to operating. When the landlord raised the rent to double, we couldnt do it anymore. We bought a small row and run an 11 i think 12 bed rcfe, accepting half private pay and half ssi. But with all with the healthcare costs and increase of you know like the requirement by the rcfe operators, weve always for 30 years advocated for department of health to provide rcfe with facilities for the elderly, the same patch to Mental Health operators. Ev im here urging the supervisors and thank you for raising the issue and bringing the issue to rcfe. A lot of the seniors have run down their savings. I urge you to find solutions for the residents in the rcfe. Thank you. Any other Public Comments . I didnt hear my name called. I probably wasnt loud enough. Are you phil . Yeah. My wife and i moved here in 1971 and bought our house, really a flat, and decided thats where were going to live and well stay there until were carried out in fine boxes. Unfortunately marian developed alzheimers, i had day services for a while. And then it worked until marian developed a fear of going down stairs and our flat was two flights up. I would have had to have somebody there 24 7 to carry her up and down the stairs in an emergency and that was not practical. I looked around for a suitable place for her to go. I came across swindels for alzheimers patients. We were accepted and its been one of the greatest things thats happened for marian. Shes now totally wheelchair bound, doesnt speak, needs help with feeding her, dressing her, all of this. The wonderful staff, which several are here have taken great care of her. Im concerned if they close the facilities shes been there three years and if they she has become adjusted to the routine. It could be catastrophic if they close that facility. The staff knows her and how to work with her. And anticipate her needs. Thank you. Any other Public Comments . Seeing none, closing Public Comments. Public comments are closed. I guess i have a few questions. I want to thank the public for coming out and you see that the needs are varied and a variety of things we need to find solutions to. A few questions for clarification of staff that came up. How have the rising costs factored into basically the rcfe closures. Whats causing it to close . The rising cost factors . I shouldnt assume that. What are some of the factors causing the the closures . Yes. So part of in all honesty, this is antidotal, from conversations weve had with the various rcfes. In many instances, it is the cost of living in San Francisco is raised and i think annie spoke to it, a lot of these places have mortgages but its the other cost associated. I faux theres been labor costs that go up but also regulations around labor laws. With rcfes when you pray 24 7 care to make sure people have breaks and stuff like that, its been additional staff you have to add. Its those types of things. Theres regulatory requirements within the rcfes as well. They look at the business and its not sustainable anymore. These are things we have heard. Thank you. In the care report of this year, it mentioned the idea of equity and post acute care. It mentions how women and people of color are affected by lower quality of care of unlicensed facilities. How will data be addressed moving forward . Just to clarify, how will disparities be addressed Going Forward in the report or it talks about inequities but not having enough data. Maybe im making an assumption of inequity. Is there discussion of how its going to be addressed . In terms of disparities, the biggest is around affordability and income and being able to afford this level of care, when it comes to racial and ethnic disparities, this is something not looked at closely, especially for Residential Care facilities for the elderly. In general we dont have good data of who is being served in the facilities. Its hard to assess. It also suggested reaching out to the mayor to include rcfes as part of their initiative. Could someone talk about hospital post acute Care Collaborative have engaged with the Mayors Office of housing in this particular discussion so far. Thank you supervisor and thank you for taking the first question. Miss patel served as part of the team. To the advocacy question, that is something the Hospital Council and members are really into, we havent yet engaged the Mayors Office. The timing is perfect introducing the topic and report in draft form should be in the official form by the end of the year, which is coming right up. But we would look to you supervisor and other members of this board on how we can best communicate to the Mayors Office to include in his initiatives this element. I know the need is so great but you have identified where there are other needs and we think it should be included as well. What is the department of Public Health Patch Program . Can someone explain that to me . Im not an expert but ill take a stab. For patients in our system of care we have Transitions Division to move from acute to lower levels of care. As part of the patient flow, some patients are placed in Residential Care facilities in the county and out of county. And so many of the patients do receive Social Security income benefit. On top of that, they provide an additional subsidy to have access to facilities. I thought it was the reimbursement to some of the rcfes that make up for the revenues they need to operate since ssi its an additional payment on top of an ssi benefit. So that Certain Services can be provided for certain populations. Has that been going up in recent years or i dont have the data but i will follow up. Any other questions . Anybody have remarks . And wrap it up. Supervisor fewer and i are looking at each other and feeling a little depressed as i know many of you are and its hard to find the optimism when these problems are so deeply rooted in a very unjust system we live in in the united states. We are not a system that thinks about care over profit. I just want to thank all who came out, to the worker who came out and spoke about her care for her patients i want to thank you so much and wish we could get some of that passion and attitude into some of the politicians in washington who are currently cutting the taxes that allow us to provide that gap funding and to come up with solutions at the local level for these problems. Its just sitting here as a local politicians knowing the limits on our budget and how every single day as the feds pull away from caring for the majority of us in cities and towns across the country to benefit rich friends and corporations that fund their campaign, it feels helpless. Hearing you gives us more strength to keep fighting and speaking truth and keep telling the stories that make absolutely no sense. We know how to fix these problems. Its called Single Payer Healthcare and its called fair taxation, progressive taxation so we can take care of everybody and make sure were all safe in our communities. They have done it way better than us in europe. This is not rocket science. This is not hard to know how to fix. We just need to have the political will to do it. I want you to know most of us here at the local level have that passion and political will. We just have to keep continuing to fight and in the meantime, well join together supervisor yee, ill join with you, to push our Health Department to push our local Hospital Council, thank you david for being here. We need to see you put some pressure on cpmc to keep open swindel. Theyre closing the subacute unit at saint lukes. Were grateful theyre keeping the current families there, theyre moving them to the davies campus but they need to be part of the larger issue. It doesnt reflect well that theyre closing two units and time and time again we hear heart breaking story after heart breaking story and theyre making substantial profits. We need to see them giving back and giving back in these critical areas we need it the most. I dont know all of the answers but i know you have moved me and i thank supervisor ye for being a champion. Thank you supervisor yee. Supervisor ronen and i were looking at each other in a depressed state, me more than her because im 60 and seeing the writing on the wall and i cared for my mother at home, knowing what effort that takes where i had to leave my employment for a while, take a break. We were fortunate to have those resources but my heart goes out to those who dont. I think from looking at this, and hearing the hearing we had on Skilled Nursing beds, the idea that people are getting discharged from surgeries and then going to Skilled Nursing facilities but we dont have Skilled Nursing facilities, we have heard time after time public testimony about people in Skilled Nursing facilities after and their recovery was so good they could return home and age in place there. I think the direction that San Francisco has taken around the housi housing and whom we have built for and continue to build for and continue to have resources for, the most healthy probably the most investing in much younger people and much healthier people. I do feel seniors that is the largest population in my neighborhood. I actually serve the people of district one, the largest population growing in my neighborhood are seniors. I understand for people to age in place, without having people in their lives it prohibits them from living a full life because of the social isolation and i wonder if we can use the homes into Supportive Care and cut a deal with them and the Mayors Office of housing to provide more Residential Care places in Single Family homes to be divided up into different bedrooms and beds and then have those people who need higher care transition turn into more Supportive Housing for seniors that can no longer live by themselves or need more medical attention. We have been talking to the hospital around this and post acute Care Collaborative. I think its time for the department of Public Health to work with advocates and to work with the families and come to a solution and recommendations for the Hospital Council and what they can do to help with the situation. It is worrisome when i hear that its being closed, my question is, was is the plan for the patients that have alzheimers at swindels. Can anyone tell me what the plan is for the patients . Is cpnc here in the room. Can they tell me the plan for the patients . There is no plan. So that is completely unacceptable. I think for these people who have relied on the service for so long for loved ones, to simply say were closing this and theres no alternative, we have no plan for you is completely unacceptable and heartless. And so i think it is time the department of Public Health working outside of the Hospital Council get together with family and advocates and see if we can come up with a plan for longterm care for our seniors and what responsibility the Hospital Council has for this and the members. Im not saying in such just one individual hospital but all hospitals now i think are, when we hear there are no subacute beds, the Skilled Nursing beds are minimal, its a responsibility for all of us who operate in San Francisco and we depend on our hospitals to serve not only those who are having children, which i had three. But also to serve those people in the community most ill. Those most vulnerable and those who dont have the options to mend at home. I think its time to come up with a longterm solution, send recommendations to the board of supervisors but also to the Hospital Council and what is their responsibility in this. As we close hospitals and units, i think we cant just think about the profits of building a new building that will serve a slew of people but no acute beds and the alzheimers unit, i dont know what the families are going to do. My recommendation is department of Public Health work with advocates and the families now, which are very organized and understand the problem before them. And to come with solutions and bring them before the board and also those solutions should include the responsibility from the Hospital Council and the members of the Hospital Council. Thank you. So i lost my father to alzheimers and that was a long difficult process. The stories i have heard today remind me of that process. And i was especially struck by the Public Comment that recognizes which, i know all too well, that a change in environment has dramatic consequences for someone living with alzheimers. A loss of familiarity leads to a declining condition at least from my experience that you never recover from. Im struck once again that were in a situation where it seems like the care of the patient is very its secondary to economic considerations. Because if the patients that were in care at swindels were the primary focus, you would not consider moving them. I know that moving them, even if its a beautiful lovely facility will be damaging to their care. No matter what you do when you make the change, change alone is so harmful to these patients. With my dad we were at a point without other options to move him out of home but it was traumatic and im sure individuals have had to experience making changes because you had no other option but you experience the impact of the people you love. And so, again im just struck that were in the same situation, we had similar conversations about subacute care, that patients are not the primary focus of caregivers in San Francisco. Its really incomprehensible to me. Especially when use the word nonprofit and how can a nonprofit not have as their primary mission, how can doctors not have as their primary mission to provide the best possible care to patients. I think that as my colleagues have said, theres a longer and deeper discussion we need to have about the specific case because i its incomprehensible to me. What does the oath mean, first do no harm, when you know youre going to do something that causes harm [indiscernible] and its hard to feel theres resource limitations when giant buildings are going up. Thats the first thing. The second thing, just for us as we age, i do think we drop the ball. As i mentioned before when we have talked about this, i was part of the rebuild laguna honda campaign. It predicted where we are today. We dont have enough across the entire spectrum of care for people as they age. We havent built the infrastructure or capacity. So i do hope, i like the idea of working with the Mayors Office of housing as we build new housing to try to catch up, but, again, like my colleagues, this is incredibly depressing that we have not put in place the resources we need in order to maintain care for the people who have really made this city the place where all the world seems to want to be right now. Those folks were abandoning at the time they need us most. And just for the department of Public Health, i am still trying to process this. It just happened that we got from the controller, performance report and i was struck from laguna honda that one of the metrics that theyre failing is theyre not getting people out of there in 60 days or less. That was not my understanding of what it was supposed to be. Thats a weird metric. Can we get people in and out in 60 days or less. So im baffled by that, too. The idea of trying to process patients like cattle seems bazaar. Especially when its seniors. As a community and city we need to work at how were going to help our seniors. I admire supervisor yees leadership and foresite and bringing it to our attention. Thank you. Thank you very much. I just want to say one thing, this is a problem that is not going to go away. This is a problem as a public speaker said that is going to get worse. This is a problem that is going to just compound other issues that we have, too. This is not going to go away. This is this is going to get bigger and bigger and bigger. Supervisor yee, im happy to work on this and support you on it. I want to thank all my colleagues for comments and they certainly sort of resinate with me. One of the things i dont get, it seems like a long time ago, people in this country cared about their parents and the seniors and certainly i still have that in me. And i dont know what went wrong in the last few decades where all of a sudden, our federal government doesnt want to do anything. And our state doesnt seem to be doing any better. And it in San Francisco, theres a good chunk of us that still care about the seniors and so forth. One of the things, this is a bigger issue, how do we in society in the u. S. Rediscover the value of seniors taking care of aging adults. I asked for the hearing and i thought it was going to be the only hearing on this issue and i guess the last meeting had a subdivision of this. And i realize earlier on that there was probably just these issues at every level, were losing ground in San Francisco. Were losing ground and we cant just do nothing. When i started asking questions about these issues, many people thought there this is like a familiar discussion. A little over two years ago talking about housing and much of the discussion i didnt hear anybody talk about Family Housing, Affordable Housing or market rate and people thought, even city planning thought it was a little crazy asking for a report. And i talked to developers, why dont we build for families, and it was an eyeopener. The developers basically said were not building it because the leadership here tells us that we dont need any in San Francisco. That didnt make sense to me. Fast forward, i think we have gained some momentum around that issue. Im hoping that what i was able to do with Family Housing discussion, well have the same type of momentum in the next six months to put this back up to the top where it should be in terms of the issues. Whether its acute care, subacute. Two months ago i couldnt tell you what these things were. But there are solutions. We cant solve everything but im not as pessimistic about this as one may think. There are things my colleagues and i could work on. The issue or discussion with the Mayors Office, of housing. I have had this discussion, not a full discussion but i sat down with them and said this will be something that we need to address. I was looking at the report earlier and i said look, one of the things we need to start considering when we build housing, we need to carve out some of the housing for the range of things that we need. I also want to say, i probably shouldnt yet, because this is nothing baked yet, i would love to see us do some comprehensive facility where you have a range, not just one particular thing you could do in a facility but a range of care from nursing to just Residential Care. And look at the open space, look at the area we have at the laguna honda hospital, we have space there to build, we just need to have the will at this point. Im having im beginning to have that discussion also. So all in all, thank you, i really want to thank everybody for coming here. Also want to thank my supervisors for cosponsoring this hearing. I really hope that we can use this energy that im seeing today, to Work Together. We have to find we cannot do nothing. We have to put our heads together, and im including hospitals, people in the community, families, all of us need to Work Together on this issue. And we will reverse i feel we can reverse the trend. Were not going to get to the top of the order right away, but for us to continue to lose on these issues is ridiculous. We continue to lose it, we have to do something about that. Again, thank you colleagues. I hope we can Work Together on this issue. Thank you very much. Thank you supervisor yee. Would you like to continue this hearing to the call of the chair or yes. Can i get a motion to continue this item to the call of the chair. So moved without objection. Thank you. Thank you everyone. Mr. Clerk, can you please call item three . Clerk agenda three, hearing on the pacific gas hang on for a moment. Sure. Hold on one second. Hi everyone. Im sorry, we have more items on the agenda we need to hear. If you could take the discussions outside, i would really appreciate that. Thank you so much. We have people waiting here to speak on the next item. So if you could move discussions outside we would appreciate that so much. Thank you. If everyone can please make your way outside as quickly as possible, we have other items. Mr. Clerk, im going to ask you instead of calling item three, can you call item four to have a possession to continue. A hearing on anti lgbtq hate crimes in the city and county. Thank you. Can everyone make their way outside. We need to continue working and please dont speak until you get outside. Thank you. Supervisor sheehy. Thank you, could i make a motion to continue that item four . The motion would be in order pending Public Comment on the item. Okay. Okay great. So were going to open up Public Comment for item four on the motion to continue the item. If anyone would like to speak on the motion to continue item four, please come forward. Okay. Or close Public Comment if theres no one here. I didnt realize there were people waiting outside. Thank you. Because of the timing, yeah. Im going to call Public Comment on item four one more time. We theres a motion to continue this item, if any member of the public wants to speak on the motion to continue, please come forward. Seeing none, Public Comment is closed. Can i take the motion, continue the item to the call of the chair. Can i take that motion without objection . Without objection, that motion passes. Can you please call item three. Clerk the hearing of city gas and explosion reporting on the cause, protocol for monitoring prevention for future disasters, outreach and support for residents before and after the incident and other pertinent information. On november 17th, a monday morning after thanksgiving, i was alerted to a gas explosion on missions street in my district. I remained in touch with Emergency Responders for updates. This time thank goodness there were no injuries but the incident was terrifying nonetheless. Forced evacuation and disrupted heat and cooking for households and left people displaced. I have asked pd a pg e on wht happened, the longterm accountability. I appreciate several representatives that serve as Emergency Responders are here. Thank you. Hi francis of the department of emergency management. Rex hail of fire, thank you all for staying for so long. And ben aims of the Human Services department. Thank you all for sticking it out. I really appreciate it. Im very interested to hear from all of you, what you witnessed, your participation in the response and recommendations for preventing incidents like this from happening in the future. With a 10 minute google search, it is ridiculously easy to find a terrifying record of pg es failures. Were all aware of the devastating explosion in 2010. Pg e was found guilty of violating before the explosion and misleading investigators of how it identified high risk pipelines. Pg e agreed to pay 86. 5 million. Earlier this year, a gas explosion left two injured, one man with severe burns. The investigation just wrapped up on that one, that pg e had faulty regulation. A 2016 transformer explosion left many without power and shut down bart service and a home exploded in 2014, thankfully the cottage was vacant but pg e settled. In addition, there have been fires at transformers and substations and transformer explosion that injured two men, one with severe burns. Based solely on the concerns of neighbors of the construction of an underground pipeline. We sent the project back to create a plan that would require pg e to provide detailed information about the underground line and clear plan for oversight and monitoring. The explosion on Mission Street revived my concerns about pg e accountability. My foremost concern, my constituents and the families affected by the emergency. I need to know theyre taken care of and their housing is stable. This incident opens how were overseeing and regulating pg e which is a monopoly. This is the first step in the process of investigating this incident. I expect excuse me. I expect digging further and expect a report back on the findings. I want to thank supervisor sheehy for cosupervising the hearing and wanted to see if the supervisor had a few opening words as well. Given the lateness, i wont echo much of what you said. But obviously theres a problem. I think the one thing were right next door to each other and i think the entire neighborhood was impacted between 8 and 9. One of my big concerns is why it took so long to shut off the gas. It took hours to shut off the gas. The street had to be jack hammered open for them to open up the street and given that many gas lines have been replaced in the city, i know in front of our house it happened a few years ago, im wondering if part of what pg e is doing is allowing us to turnoff gas. The idea that you would have a gas leak that blew up a house and you couldnt turn the gas off for several hours, in an earthquake prone area is more than a little alarming. So, thank you for calling the hearing. Good afternoon supervisors. Im ramneck saini with pg e

© 2024 Vimarsana

comparemela.com © 2020. All Rights Reserved.