Crackdown on those individuals speeding and breaking the law and doing things that could create these kinds of accidents. No one wants to see the accidents on the side of the road, no one wants to experience going to a crime scene on the road knowing your loved one has been hit by a car or sadly tragically killed. I remember years ago on turk street and laguna, when a lot of us were hanging out and just kind of enjoying the weather, it was a really nice hot time, like in the fall and my god son was crossing the street on turk at the intersection of turk and buchanan where theres no stoplight and he was hit by a car. We watched as you flew in the air and thought oh my god, oh my god, just to see it, and had no control over what was going to happen was devastating. And luckily he had minor injuries, luckily he survived, and i just really felt strongly, we have to do better as a city. We have to do better with the vehicles that are speeding on our streets. We have to do better with our infrastructures and when people push back on me about the improvements and bike infrastructure and all of those things we need to do, we have to make our roads safe. Its not about catering to a particular group. There are a lot of the bicyclists riding in our city, theres a lot of pedestrians walking in the city, we have to make sure that people know this is where bicyclists ride, this is where pedestrians walk, this is where vehicles are supposed to be, so that everyone behaves responsibly on the road and knows the infrastructure, it helps them to understand exactly where everyone is supposed to be. Our ultimate goal is Public Safety. We want everyone to be safe on our roads and everyone to make it home to their loved ones at the end of the night and that what this is about, this is about a team effort, working with our mta, the Police Department, department of Public Health, department of public works and families for safe streets, this is how were going to change the behavior of whats happening on our roads and get to the zero, the vision zero that we are promising San Francisco. This is an important thing we must all participate in. So, again, i just want to emphasize that i have been in Constant Contact with the chief because enforcement, enforcement is going to play a key role in helping us address those issues. Pulling over those vehicles running stop signs, pulling over the bicyclists who are sometimes doing the wrong thing, if you are breaking the law on our street, then there will be consequences for that behavior. Its not because the city wants to add another layer of bureaucracy or ticket you or collect that money, its because we want to make sure that people change their behavior so that theyre safe on our streets. Thats what this is about. This is about bringing the number of 20 in 2017 down to zero. We dont want another death on our streets because of human error, because of anything we can avoid. If we change our behavior, we change our roads and do a better job here in the city and county of San Francisco. Thank you all for being here. We have so much more work to do, but we are moving forward and working together to really make sure that vision zero is a reality and not just a dream. Thank you. applause thank you. I think what you heard there is leadership of vision zero is not always easy. It can entail making decisions that are not always popular and theres always tradeoffs when talking about redesigning streets and enforcing laws and that kind of leadership we have from mayor breed and the whole board of supervisors and were joined by supervisor jeff sheehy who has been strongly behind the difficult decisions we have to make, thats the kind of leadership we need. And the board of directors legislating the changes and faced with the tradeoffs but willing to move forward with things that will get us to zero. As mayor breed mentioned, enforcement is an important part of it. A part of ed lee approach to vision zero, theres not just one tool in the tool kit. Its not just about street design. Its not just about education, its not just about enforcement. Its about a collection of activities we can do together as city and community to drive fatalities to zero. The rules of the road are there to keep people safe, and the work that the Police Department has done in support of vision zero with direction from previous and current mayor, is a big part of the story of what were seeing out on the streets in terms of success with regards to vision zero. Welcome our chief of police bill scott. applause thank you. Good morning everybody. Id like to echo director and acting mayor breed comments, you know, when i first learned about vision zero in 2013 it did seem like a dream. We were not only in San Francisco but in other parts of the country because many other cities embarked on a vision zero initiative. It did seem like a dream but now four years into this and we have made significant progress in reducing the amount of traffic fatalities, that dream is becoming a reality. And i think its very much within our reach to actually realize that vision of zero traffic fatalities in our city. Before i go any further, when we talked about the numbers and the statistics and the fact that the numbers are down and the statistics are down, i dont think its lost on any of us that those numbers represent human lives and the families here today that have the courage to keep this on the forefront of our conscious, i thank you for being here. I know its very painful to keep having to relive the loss of a loved one by way of a traffic fatality. Thank you for being here today. From the perspective of the San Francisco Police Department, our role is enforcement and also education. Any time we have a Traffic Violation and we engage in a traffic stop or come in contact with a motorist or pedestrian or bicyclist, we have an opportunity to educate and that opportunity to educate is really probably one of the most important things we can do. Enforcement is very important but education is even more important. This year in San Francisco, we issued over 38,000 citations and i dont say that to brag, unfortunately thats 38,000 plus people that have violated the law. However, its also 38,000 contacts that we had the opportunity to educate people about really the impact of some of the violations that are more likely to cause traffic accidents. And our officers really take that work seriously. Its an opportunity to share stories about people that have lost loved ones and probably everybody in the room has a story. Mayor breed told one that was compelling and i have one and many of you have their own. But when our officers engage in enforcement, its more than enforcement. Its education. Its preventing these terrible acts from occurring by putting it on the forefront of peoples minds when they violate the law. I want to go through a couple of things of how we intend from the Police Departments perception to realize the vision. Our captains coordinate efforts with patrol officers and our traffic unit on the enforcement. We work carefully with mta to use data to determine which intersections and corridors are more likely to have accidents and thats one of the ways we focus on those particular streets and intersections. The five violations that cause, speeding, running stop signs, failure to yield to pedestrians, failure to yield to turns, running red lights. Those are the violations most likely to cause fatalities. This year there were 20 fatalities, 14 involved pedestrians. My ask of the public is number one, be aware of your surroundings, be aware of the laws, be aware of street signals. Be aware of crosswalks and try to work within the laws designed to keep you safe. It is really important that this effort be a partnership, not only with Law Enforcement but partnership between the community. If you follow the laws, you have much less of a chance of becoming involved in a fatality. That is particularly important with pedestrians. Just the laws of physics. It takes a little while for 2,000 pound or 3,000 pound vehicle to stop. Physics is going to win every time. If you pay attention, if you follow the laws you have less of a chance of getting involved in these type of incidents. For the elderly in the community, its more important. A majority of our Traffic Related Fatalities involve elderly. People cant get across the street as fast, they may not hear as well as some other members of the community. So for our elderly, lets pay attention. Lets help them in terms of paying attention to our roadways when we are driving and bicycling, that is a huge issue in our city. Our outreach is a huge priority and again we use traffic stops as a way of outreach but we also have many public campaigns to remind drivers and pedestrians and bicyclists of their responsibilities when they are often the roadways. The partnership we talk about between the mta, city government, board of supervisors, Fire Department, the department of Public Health, it really is a team effort to realize the vision of zero fatalities. I remind you, look at where we were and where we are. This vision will be a reality, it will be a reality and well Work Together to make that happen. I thank you for your time. Families thank you for being here and remember, vision zero is about all of us. Thank you. applause thank you chief. The chief made reference that back in 2013 it seemed not a very realistic goal and we were one of the first cities in the country, i think perhaps only new york had adopted vision zero and now its more common term and many more cities have adopted it. Back then one of the things we started doing differently from the transportation standpoint, thinking of it as a Public Health issue and not just Public Safety issue. With the leadership of department of Public Health is a large part of why we are where we are, taking that view of the issues not just street design or enforcement view, i think has been a game changer for us here in San Francisco. Were grateful to be able to colead between sfmta and department of Public Health and joined on behalf of Public Health director garcia and chief medical director argon. applause good morning everyone. First of all i want to thank acting mayor breed for being here today and being behind this vision zero, which is really important to the department of Public Health. I was born and raised in San Francisco. I grew up in the mission district. I live in glenn park, i raised three children and my wife is a first grade teacher. We have been dealing with the issue of traffic and Pedestrian Safety all of our lives. And i can tell you that whats happened in 2017 is a big accomplishment. If you just walk outside and you see the volume of people, the volume of cars all the activity, and the fact that we are down in terms of the number of deaths is a huge accomplishment. Its a huge accomplishment and i think everyone should really take pride in that. The other thing to realize is for every person that dies, theres a dozen who were severely injured. So think of it as a pyramid. The whole pyramid is getting smaller. Again, thats a big accomplishment. We all have to remember that all of us, all of us every single day no matter how you get to work, school, wherever you go, all of us are always pedestrians. This is really this impacts all of us. From a Public Health issue, one of the side effects of having Pedestrian Safety is that it really promotes community health. It allows people to walk more, to bike more, to do what we call in Public Health, active transportation and this is really good. Its promoting health in other ways, reducing peoples stress as they feel they can take a walk in the neighborhood and feel safe while getting healthy. And i also just want to acknowledge the clinicians and workers at San Francisco General Hospital working 24 7 so when someone gets injured, we have a team of people part of the city family who are the best in the world of taking care of the patients who are injured. The last thing i want to say is for us in Public Health, everybody coming together, working together, this way, this collective action, this collective impact, to us thats the best way to do Public Health and were very excited. We have a lot of great staff, please visit visionzero. Sf. You can read about our collaborative success. Again, thank you so much. applause thank you dr. Argon. To echo the praise for the folks at the San Francisco General Hospital, i heard a stat a couple years ago, i dont know if its 100 accurate but nearly half of the admittance are from traffic issues. You think of the First Responders who bring the folks there and the impact it has on the system, it gives you the scope of the impact of Traffic Safety in San Francisco beyond what were talking about here today. The folks on the front line are largely from the Police Department, the First Responders to the scene and its not just fatalities but 200 or so people who are seriously injured each year in San Francisco. So the Fire Department plays a Critical Role in getting people to the Trauma Center to be helped as quickly as possible. I want to acknowledge and ask to say a few words our fire chief. applause . Good morning. Thank you for being here. I wanted to comment on the alignment around vision zero and acknowledge the progress being made and has been said by many speakers before me, one death is one too many. We come some times from different angles but the San Francisco Fire Department is fully committed. The men and women of the San Francisco Fire Department are some of the First Responders to the difficult scenes. We experience the emotion and have the conversations with the families and i want to acknowledge the families here that have lost loved ones due to traffic collisions and fatalities related to our congested city. And it is worth noting as dr. Argon noted, in a city whose population is rising, theres more vehicles and pedestrians and bicycles on the street, to have a reduction is significant but theres more work to do. There are three prongs i believe are part of vision zero, the education poliiece that the pol department has a role in. It is important to be alert and aware at all times. I know as a pedestrian, im the mother of three boys, one of the things i say, try to gain the eye contact with the driver and dont assume because you have a green light or ability to walk across that it will be safe. So awareness is a key factor. Our role is one of education as well. We have the contacts to support the family, enforcement obviously, the Police Department does very capably. I would like to touch on the engineering piece, the mta does a great job in engineering and reengineering our streets, we sit regularly with the mta, sometimes its looked at as a competing interest, we want to as First Responders be able to navigate to the scene of an emergency in a timely fashion but one of the things we heard loud and clear and i have seen, and we have worked closely with the city administrators office, we have taken bold steps, not always popular in my department but bold steps to shrink the responding apparatus. Very proud that just last year we took delivery of eight new fire engines with a smaller profile, easier to maneuver and increased visibility for the drivers to make us safer as First Responders and more responsive to the vision zero goals. I have driven the engines and theyre more responsive in the city streets. Were piloting two new ambulances, they work different, were hoping to work with our members to get them on board to take a look at a smaller ambulance as well. I drove that yesterday and its much more user friendly through our narrow streets. Were hoping from an engineering perspective as part of vision zero to be very responsive to the size of our apparatus to be able to continue to fulfill our goals of saving lives and property but also be responsive to our growing population and many different varieties of pedestrians, bicyclists, cars and Public Transportation on the street. So thank you very much. applause thank you chief. From the executive branch and other government agencies, department of public works, one of our Main Partners and Public Utilities commission, Planning Department with the unified school district, dozens of other agencies all working together. And i want to invite up some of our community partners, but before i do that, the bridge between the executive branch or one of the important bridges between the executive branch and our community are the elected officials that represent the community, our board of supervisors represent the citizens, businesses, schools, institutions in their district and that bridge is important to us in terms of feeding the Community Voice to inform what were doing and as i said earlier, it requires great leadership and sometimes great courage on the behalf of individual members of the board of supervisors to support the work that can be controversial but ultimately is important and necessary for us to get to zero. One of the great champions of that, district eight supervisor jeff sheehy. I want to ask him to say a few words. applause thank you. And i think this has been said, but i really do think that it is time to reflect on mayor lees legacy. This is tremendous. Were here today recognizing the lowest level of fatalities because of the leadership of mayor lee. I think of his understated way of leading our city, the way he has brought our departments together and i do think once again we should think about this as an important piece of his legacy. And i want to commend mayor breed for her leadership on the board, as ed ruskin mentioned, through the work on the board and enormous amount of feedback we get when the changes come into our neighborhoods, the ability to work collaboratively with the executive branch and agencies has been key. So mayor breeds leadership first as board president has been essential for this and Going Forward well continue to push the numbers down. Im grateful for her leadership. I know for me personally i focused on bike safety and i hope the next year brings significant improvement, getting protected bike lanes so people can bike around. I think of my daughter, 12yearold Public School kid, we bop around all over town, Pedestrian Safety is critical. School starts again on monday, so i hope as you are reporting today you will encourage people to slow down, to be mindful, to recognize that youre going to have more cars on the street on monday, more kids on bikes, more kids walking and thats one of the great things that the Transportation Authority has been supportive of and mta, getting kids to get to School Without necessarily having to be in a vehicle and the education for kids on Public Transportation and walking and biking and Walking School buses is an innovation that is great that i have seen folks in my neighborhood implement. If we could be mindful monday that kids are going back to school, not a lot of them are going to be happy about it. Youre going to have grumpy kids dragging their feet and be slow and mindful. Thank you. applause great messages, which i hope you will help us convey. Two of the leading voices that challenge us are walk San Francisco and San Francisco Bicycle Coalition. Everybody, whether you live here, visiting here, work here, everybody starts or ends their trip on foot. Were all pedestrians. And bicycling is the Fastest Growing mode of transportation in San Francisco. You are more vulnerable road users traveling in those ways. I want to welcome walk San Francisco and executive director from the San Francisco Bicycle Coalition. Thank you director ruskin. How did you know my speech would be do more, do better, do faster. I dont have to say anything. In all seriousness, were here to acknowledge the good news of 2017. I think after 2017 we could all use some good news. Not only did the total deaths on our streets from traffic collisions decrease dramatically in 2017 but pedestrian deaths decreased as well. Since 2013, every single year fewer pedestrians have been killed on our streets. This is really good news. Of course this good news does not mean that were all here today to pat ourselves on the back and move on. 20 lives lost is too many. And so each of the lives lost needs to be a call of action to everyone here to do better. No family should get a phone call that their loved one is in the hospital or their love one worse has been killed due to crashes we know are preventable. People talking in San Francisco and so many folks have said this today, every one of us here shouldnt have to put their lives on the line walking down the street. In San Francisco, low income communities, people of color, immigrants and seniors are more likely to be killed in crashes and we need that to change. Seniors should be able to grow old in our city. Instead, theyre the most likely group to be killed in crashes. These crashes, make no mistake, theyre not accidents, theyre predictable and that means theyre preventable and thats why the city has invested a tremendous amount of funding policy into vision zero since 2014 and which were extremely grateful for and why were here today. At the same time, we need to do better. To get to zero, theres the better part director ruskin, to get to zero, we need to step our game up a little bit. We have six years. We need to increase investments in safe streets and get projects into the ground more quickly, before more people get hurt and pass automated Speed Enforcement in San Francisco. City community, advocates, families, i believe working together well reach zero by 2024. Thank you. applause thank you. On behalf of the San Francisco Bicycle Coalition, im the executive director and our 10,000 members, i want to thank many people here, mayor breed, supervisor sheehy, director ruskin, chief scott and his wife and all the other departments who have worked to draw attention toward the progress on vision zero. In 2014 with pressure and leadership from many of the organizations and individuals here today, San Francisco officially adopted the ambitious goal of eliminating traffic deaths and serious injuries from our street. The bold commitment will be one of the endearing legacies of mayor ed lee. I know he believed in achieving vision zero. He cared deeply about the safety of people walking and biking in our city and followed through by directing city agencies to deliver Infrastructure Improvements with the speed and urgency necessary. We owe it to mayor lees memory to remain just as urgently focused on delivering safer streets faster. In 2017, San Francisco proved to the nation that progress toward an ambitious goal like vision zero is possible. Because of that progress, 10 people are alive today. 10 people are biking and walking to work. 10 people are waiting for muni and 10 people are coming home today to their families. And i want to recognize alvin and San Francisco bay area families for safe streets, those who have lost their loved ones for being here and continually sharing their stories. Were here to acknowledge progress but also to recommit ourselves to vision zero. We have to work harder, even harder moving forward if we want 2017 to be the beginning of the trend and not just an aberration. While we saw significant decreases in fatalities for people, and in particular people driving or riding in cars, the decreases were not nearly as significant for people walking and biking, our most vulnerable. In 2018 San Francisco must show more resolve and urgency, starting with everyone standing here today. I want to highlight infrastructure is a key part of vision zero and we know there are plans in place for all streets in the city. Without all of us working together and strong leadership, the plans will remain just that. I want to highlight one project in particular, the better Market Street project, transforming 2. 2 miles of the street into a safe and comfortable place to bike and take transit. We have watched as this project experiences delays and we cannot afford to wait longer. For the safety of the thousands of people who travel down Market Street every day, construction must begin as soon as possible. The memories of those who have lost their lives are dishonored by further delays. So as we look ahead, we must prioritize the construction of safer streets. Dismantling the old barriers and throwing out the old excuses. There is no other way to continue progress in this new year. The lives of our friends, our families and our neighbors hang in the balance and there is not a moment to waste. Thank you. applause thank you kathy and brian. As the chief said, ultimately its not about numbers, its about people. So finally and i would say most importantly, were honored to have alvin lester here, one of the founding members of the San Francisco bay family for safe street. I think the voice of those who have lost a loved one are one of the most effective and compelling tools we have to change the behavior that needs to change to get to zero. Please welcome alvin lester. applause good morning everyone. My story is simple but its necessary. Ill just get right to it. Im alvin lester. The father of amonde lester, he was struck and killed in the bayview neighborhood in the city. Im here to support safer streets so no one else has to suffer the pain i have from traffic violence. Im one of the cofounders for San Francisco families for safe streets, volunteers who have lost loved ones. We are fighting to help change the culture of unsafe driving habits. We have endorsed Vision Zero Campaign to put an end to traffic deaths and serious injury by 2024. Using education, engineering, and Law Enforcement. It is critical that our city officials focus on the proven tools which will help reach the no death, no serious injuries goal by 2024. Join with us as we push Forward Together to make San Francisco a safe place to walk, ride, drive. And to add to that, im here to honor my son. He was a wonderful he was my only son and as a father, you put a lot of time and effort to raise kids and teach them the correct things to do and doing so, i had Great Expectations his life would be satisfying not only to me but to himself. We fight today to bring honor to San Francisco. Im a native and i have seen the changes in San Francisco over the 2030 plus years dealing with high volume of traffic and Pedestrian Movement on our streets. We need to take our streets back. We need to help people change the negative behaviors that they have built up over the years and we need to do it today. No parent, no Family Member should have to go through the suffering of burying their children or mom or father because of preventable collisions. So, lets fight. Lets fight. Lets make a good fight. You know, there are good things we can do. We have proven tools that help people to drive correctly in our cities and i want to urge everyone at the sound of my voice to make some corrections. If you operate a motor vehicle, think about it, think about the person standing on the corner, think about how fast youre driving, think about the stop sign youre going to come to. Just think and just doing so, youll help someone live another day, i gandhi that. I guarantee that. So i just want to thank everyone for being here and i want to thank our public officials, walk San Francisco, Bicycle Coalition and everyone here who has a vested interest in saving lives. We all deserve to have safe streets. We shouldnt have to figure out which street to take this day or tomorrow, your life depends on it. You dont want to hear the phone ring and have the news that will rip your heart in two. Its tough, every day of the week i think about my son. He would have been 25 in may of this year. So he was in school, he was working, he had a promising future. However, the individual who took his life didnt care nothing about that. We have to care for those who are living. We have to care to make sure that crossing the street doesnt cost you your life. Or end up in a hospital with life threatening injuries. We have to do it. So im here today to bring honor to those who have lost their lives and support all the individuals here to help make these things, the numbers come to fruition. I want to thank everybody. Thank you. applause i cant say it better than that. We are certainly committed within the government to do more and better and faster. As alvin and the chief and supervisors said, we need everyone to pay attention, to slow down as theyre getting around the city. Its going to take all of us to get to vision zero but it is achievable. We can do this San Francisco. Thank you for coming today. applause good afternoon everyone. Im barbara garcia, director of health. We have mayor london breed and supervisor jane kim. Were so happy to be here today, were opening a new part of the respite providing services for those who need that kind of support from our shelter system. This respite has been open for over 10 years and providing over 45 beds for those needing support around alcoholism and around another 30 beds for those coming out of hospital who need Additional Support. These are focused on the shelter system to ensure that those individuals who need more medical support and i want to acknowledge supervisor kim who has been a champion for the expansion, particularly when she spent time in the shelter and saw that many individuals needed additional medical support. This took about two years to open with the renovation and with the staffing and were so happy today to be with you to open these new beds, as well as the fact that the staff is there already, we have served over 3,000 Homeless Individuals in the past 10 years providing the upmost care for these individuals who really need support and provide them the Additional Support to continue their pathway into housing. At this point, i would like to ask for mayor breed to give us some comments and she has been a big champion around homeless issues and very happy for the respite to be open today. Thank you very much. applause thank you. I want to start by thanking director garcia for all the work that her and her team have put in to really making this dream a reality. Supervisor kim has been an amazing champion on this expansion. And our mayor, mayor ed lee actually had an opportunity to tour the facility. He was really excited about what it could do for some people that we know that are facing challenges, our most vulnerable population. We think its as simple as showing up to a shelter, but just imagine if you have a medical issue. Just imagine if you have a wound or something going on with your body that basically you have not been medically treated for. People who sadly are living on our streets need medical support, too. Often times, imagine when were in the same situation and we stay home and need time to heal, this is what the Respite Center is going to provide, a place for people to heal, a bed, a safe space, three meals a day, support they need and 30 of the people who have been helped in this Respite Center have been permanently housed. Thats been amazing. The staff is not only providing the medical care, theyre providing the social services that go with helping people transition into permanent housing. Our goal has to be to make sure people are taken care of and this is one way to do that. To go from 45 to 75 beds is tremendous. Which means we have a larger capacity to serve more people and that means everything for the person using this service. So im happy to be here today. I want to thank the staff and everyone who has been active in making sure that this space is not only providing care, but is providing compassion and support and resources because we want to make sure its a Wraparound Service that will eventually help people into something permanent where they have homes to live and the support they need to be sustainable in our Housing Market that is so challenging for so many. Thank you for being here and with that, i want to turn it over to my colleague supervisor kim who has been a champion and an important part of making this possible. The funding and all of the things we needed to do to get this place open, she was a fierce advocate for that. I want to turn it over to supervisor kim. applause thank you. Thank you mayor breed for being here today. Its a little sad to be here without mayor ed lee. I had fought and advocated for 4 million to expand the medical respite shelter and i remember the day he called me and said he was going to make it an important piece of the budget. While it takes some time for the build up, its amazing we have this resource in our city here today. Director garcia mentioned why i came to fight for the medical respite shelter, it was because when i was appointed acting mayor, much more briefly, my staff decided i would spend my first night as acting mayor in one of our single adult shelters in my district. In my first night there it became clear to me that homelessness is not just a poverty issue, its a Public Health issue. The residents staying there were far oral far older and sicker than i imagined and were seeing so many brothers and sisters aging in places on the streets. So i worked with director garcia to fight for our adult shelters and to see what the nurses are doing every day at sanctuary, next door, they are doing gods work. Our residents need to see a nurse every single day and need the medical attention they can get at the shelters. The expansion of a 24 7 medical respite shelter is a huge resource in our city. I dont need to tell anyone what were seeing on the streets today, people are so sick and to have this resource with increased beds and 24hour attention from doctors, nurses, psychiatrists is how we address homelessness in San Francisco today. I want to thank director garcia, who has been an impassioned person working on this and to dr. Barry stephen who is not here today and kate shuten and dr. Alice chen. And finally to president breed, who knows probably the supervisor who knows my district the best on the board of supervisors, shes in fact the only colleague who constantly asks me of the needs because she knows our residents there. I want to thank you for your support and for your support of a safe injection site. We also have to address Substance Abuse in our city as well. Thank you for being here and im incredibly excited to double the expansion of the medical respite shelter here today. applause thank you supervisor and mayor breed. Im honored to be able to present our doctor and medical director of the respite dr. Kelly egan. Dr. Kelly egan has professionalism and compassion in the way she has brought the new respite expansion and all the patients she serves directly. So dr. Kelly egan. applause thank you supervisor kim, mayor breed and director garcia. As medical director i have experienced this programs transformation first hand in recent months. Medical respite has served the sickest and most medically complex people in homelessness. In the past we have accepted referrals only from hospitals and now we can accept them from shelters for people who are too sick to stay there and are at risk. I want to put a face for the clients we served. We recently cared for a gentleman with a new cancer diagnosis and he needed a place to rest and recoup rate. Without a bed laughter without a bed at respite, Cancer Treatment may not have been an option for this gentleman. And we have been working with a Woman Working intensely with physical therapy, she can walk and take care of herself now again and ready to go back to the shelters. And were seeing an increasing aging population among the homeless, people who are cognitively impaired and unable to keep themselves safe. They receive behavioral health, primary care, assistance with medications and referrals to Psycho Social Services such as housing. Personally i want to thank the staff of medical respite and sobering who provide the care day in and day out and Shelter House street medicine, these are the care teams that provide compassionate and patientcentered care for our patients every day. Im proud to be a part of the team. Thank you. applause here are scissors for the supervisor and mayor to share. cheering were going to go inside were going to walk inside right now. [music] San Francisco city clinic provides a broad range of Sexual Health services from Stephanie Tran medical director at San Francisco city clinic. We are here to provide easy access to conference of lowcost culturally sensitive Sexual Health services and to everyone who walks through our door. So we providestd checkups, diagnosis and treatment. We also provide hiv screening we provide hiv treatment for People Living with hiv and are uninsured and then we hope them Health Benefits and rage into conference of primary care. We also provide both prend post exposure prophylactics for hiv prevention we also provide a range of womens reproductive Health Services including contraception, emergency contraception. Sometimes known as plan b. Pap smears and [inaudible]. We are was entirely [inaudible]people will come as soon as were open even a little before opening. Weight buries a lip it could be the first person here at your in and out within a few minutes. There are some days we do have a pretty considerable weight. In general, people can just walk right in and register with her front desk seen that day. My name is yvonne piper on the Nurse Practitioner here at sf city clinic. He was the first time i came to city clinic was a little intimidated. The first time i got treated for [inaudible]. I walked up to the redline and was greeted with a warm welcome im chad redden and anna client of city clinic even has had an std clinic since all the way back to 1911. At that time, the clinic was founded to provide std diagnosis treatment for sex workers. Theres been a big increase in std rates after the earthquake and the fire a lot of people were homeless and there were more sex work and were homeless sex workers. There were some Public Health experts who are pretty progressive for their time thought that by providing std diagnosis and treatmentsex workers that we might be able to get a handle on std rates in San Francisco. When youre at the clinic youre going to wait with whoever else is able to register at the front desk first. After you register your seat in the waiting room and wait to be seen. After you are called you come to the back and meet with a Healthcare Provider can we determine what kind of testing to do, what samples to collect what medication somebody might need. Plus prophylactics is an hiv prevention method highly effective it involves folks taking a daily pill to prevent hiv. Recommended both by the cdc, center for Disease Control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. I actually was in the project here when i first started here it was in trials. Im currently on prep. I do prep through city clinic. You know i get my tests read here regularly and i highly recommend prep a lot of patients inclined to think that theres no way they could afford to pay for prep. We really encourage people to come in and talk to one of our prep navigators. We find that we can help almost everyone find a way to access prep so its affordable for them. If you times we do have opponents would be on thursday morning. We have two different clinics going on at that time. When is womens Health Services. People can make an appointment either by calling them a dropping in or emailing us for that. We also have an hiv care clinic that happens on that morning as well also by appointment only. He was city clinic has been like home to me. I been coming here since 2011. My name iskim troy, client of city clinic. When i first learned i was hiv positive i do not know what it was. I felt my life would be just ending there but all the support they gave me and all the information i need to know was very helpful. So i [inaudible] hiv care with their health about a quarter of our patients are women. The rest, 75 are men and about half of the men who come here are gay men or other men who have sex with men. A small percent about 1 of our clients, identify as transgender. We ask at the front for 25 fee for services but we dont turn anyone away for funds. We also work with outside its going out so any amount people can pay we will be happy to accept. I get casted for a pap smear and i also informed the contraceptive method. Accessibility to the clinic was very easy. You can just walk in and talk to a registration staff. I feel im taken care of and im been supportive. All the information were collecting here is kept confidential. So this means we cant release your information without your explicit permission get a lot of folks are concerned especially come to a Sexual Health clinic unless you have signed a document that told us exactly who can receive your information, we can give it to anybody outside of our clinic. Trance men and women face really significant levels of discrimination and stigma in their daily lives. And in healthcare. Hiv and std rates in San Francisco are particularly and strikingly high were trans women. So we really try to make city clinic a place that strandsfriendly trance competent and transwelcoming everyone from the front desk to behind our amazement there are completely knowledgeable. They are friendly good for me being a sex worker, ive gone through a lot of difficult different different medical practice and sometimes they werent competent and were not friendly good they kind of made me feel like they slapped me on the hands but living the sex life that i do. I have been coming here for seven years. When i come here i know they my services are going to be met. To be confidential but i dont have to worry about anyone looking at me or making me feel less a visit with a clinician come take anywhere from 10 minutes if you have a straightforward concern, to over an hour if something goes on that needs a little bit more help. We have some testing with you on site. So all of our samples we collect here. Including blood draws. We sent to the lab from here so people will need to go elsewhere to get their specimens collect. Then we have a few test we do run on site. So those would be pregnancy test, hiv rapid test, and hepatitis b rapid test. People get those results the same day of their visit. I think its important for transgender, gender neutral people to understand this is the most confidence, the most comfortable and the most knowledgeable place that you can come to. Onsite we have condoms as well as depoprovera which is also known as [inaudible] shot. We can prescribe other forms of contraception. Pills, a patch and rain. We provide pap smears to women who are uninsured in San Francisco residents or, to women who are enrolled in a statefunded program called family pack. Pap smears are the recommendationrecommended Screening Test for monitoring for early signs of cervical cancer. We do have a fair amount of our own stuff the day of his we can try to get answers for folks while they are here. Whenever we have that as an option we like to do that obviously to get some diagnosed and treated on the same day as we can. In terms of how many people were able to see in a day, we say roughly 100 people. If people are very brief and straightforward visits, we can sternly see 100, maybe a little more. We might be understaffed that they would have a little complicated visits we might not see as many folks. So if we reach our target number of 100 patients early in the day we may close our doors early for droppings. To my best advice to be senior is get here early. We do have a website but its sf city clinic. Working theres a wealth of information on the website but our hours and our location. As well as a kind of kind of information about stds, hiv,theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for 15, 40 75500. The phones answered during hours for clients to questions. Good afternoon, the Commission Commissioner will please come to order and the secretary will call. As noted on the agenda the december 5th meeting did not have a quorum so there are no minutes but there are minutes from the november 21st meeting because they werent approved december 5th. Right so the minutes before you foray approval a motion is in order. I heard a motion and is there a second. Second. Ok, are there corrections to the minutes of november 21st . Not seeing any were prepared for the vote all those in favour , please a aye. Aye. All those opposed. The mints have been approved. Please next item. Item 3 is the directours
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