Design. One thing that occurs to me, a benefit from it, the course of implementing a bond various adjustments are made and as those adjustments are made, did that divert from what people expected was going to happen. So you end up saying well, you guys made a bunch of changes and suddenly were in this park over here instead of this one over there and did you go back and let people know thats what was going to happen. Its a way of keeping in touch and connected to the voters who approve the bond to begin with. Is the question as a voter did this bond, this 2008 bond, did the outcome meet your expectations. Something like that . Thats close. Thats close. Its also how has the out come changed. Were voters kept informed of a change. Lets take for example a fire station on the port which is on a pier. Its hard for the fire engines to get out of there. So theres always a question about is this where you really want to do more on the fire station or do you want it to be moved off of the pier and closer to some place it can move. I thought in the last one or two conversations we had there was no objection amongst the group that this would be a good idea, number one, the Satisfaction Survey would be its less to address what larry, you talked about, whether there are changes. It is pretty much a snap shot judgment of a report by the citizen of the donor to say how do you like this park or whatever program were talking about as a way to render a measurement of satisfaction and some ways accountability for the fact that they voted on something and the city delivered on what they voted on. I thought there was no disagreement, that this was a good idea and thats why we proceeded to work with the Controllers Office to try and create scope and possible courses of action. The other motivation we discussed as a group is that this would be a good thing number one. Number two, since we have a very robust budget that this group hasnt used much of, this would be an opportunity to use some of the funds that we have in our budget to see how satisfied or unsatisfied is citizen is on a particular program. We talked about a particular program because thats kind of easier to measure. Im sorry, i just want to clarify. The origin of this really came from a set of facts and i realize you can overgeneralize from a set of facts but nevertheless it came from a set of facts. In the castro, my neighborhood, they widened the sidewalks which narrowed the amount of street traffic could go. Traffic has slowed down, businesses have closed because they couldnt get customers as they had. When you ask people what happened, they said we were surveyed and this is what we said we wanted but what we got was something completely different. On the basis of that i began raising questions about are people having a postbond experience analysis. And we werent at that time. For there or anywhere else. There are other examples but that hits home for me. So from that i realized that its very easy for bureaucratic silos to exist and things start moving up a certain chain and stay within that small narrow area. And there is not an opportunity for the public to go back and say golly, now that you have done that and its had the impact, how do we correct that impact. Take for example the bart two going into chinatown and the impact on businesses at union square and elsewhere. They come back and say we can provide funding for some of these businesses. We can do more signage to get more people going there. But those thoughts come up after a series of a lot of complaints. They dont come up because you had a process. So what i had in mind and which i hoped the committee was thinking about as well was lets take a look at whether people are getting what they thought they were getting and if they didnt, how did it change and how can we improve the communication to come closer to what we had in mind. I think its addressing the very first part. How do citizens feel about a particular project now that its done. And i think based on results, what we do with it, its not something we want to post on the web site, it would be a beginning and end. And action report. This is the first time were doing it, as discussed people seem to think its a good idea. Thats my recollection also. We discuss the basis for the merit and went on to say lets run a trial balloon so to speak and see what comes out of it, well do a slow rollout and do an evaluation after that. And so in the scope of work currently, as suggested by staff, we have that there would be some analysis that measures users perception of the attractiveness of the facility, the safety, the use, the maintenance, the impact that the geo bond had on the facility, the conditions and efforts. So we further went on to say that theres a couple of things we might look at right now if were going to do a limited rollout and we have the street bonds, which i dont think would be a good a good measurement. I think the other option park bonds is more likely to be result in comments that will be usable to us as to whether or not the park, playground, gymnasium, Capital Improvements to the park were up to their expectations or not and given the choice between those two, my suggestion would be we do the rollout to measure exactly as currently described in the project objections for the park bonds. Couldnt it help inform the discussion earlier, about the broad bond and the funds can go different places versus a much more narrow bond and i think start ing with the park bonds makes sense. The Sunset Playground for example, we know the scope of the project was reduced because of circumstances that came up. Its a real success but thats an example of a bond with a much more narrow scope. To see what the impact there. If we have a bond in the future, whether its Community Health center or something else, we can get the feedback. I think it seems like a worthwhile endeavor for the committee to support. Can i just add i didnt mean to jump ahead by providing the products. We just wanted to show progress on the committees desire to do this. This is a Good Practice that we try to follow as well. You have a lot of hard data, did we spend what we intended to spend, was it on time and opinion data. This is what were trying to get with the biannual survey. We want to know what people think and spend time trying to understand if theres a difference why and how to address those things. Were excited about you doing the project. You may want to test a couple different stakeholders in any one project. In a rec center there could be local parks, neighborhood Interest Groups who have a clear memory of what the facility should be. You might want to have a focus Group Conversation with folks like that. General public, they probably dont remember but know their experience of the site. So you want to do intercept and site testing. Theres different data for what people are experiencing with bond funds. I agree with whats been said. My thought is, the scope seems very extensive so i want to make sure its narrowed to what we think is going to best serve this committee and pick one neighborhood part project and pick one i would think resurfacing, i know on the streetscapes when they did my coffee shop, that is all they were talking about. I think you would get strong responses. You know, maybe pick two projects and narrow down your scope, lets do it and see what the results are. I do have real concerns about, theres going to be public voters who have no thoughts at all on it. Picking your population for survey is going to be really important but i think we should give it a narrow pilot study shot. Ill second what robert said. We should narrow this down. When i first saw this, thats what jumped out at me. This is enormous. Theres a whole lot in here. Just to focus on a small group, one or two projects that we think have fairly high visibility would make more sense to me on a pilot basis. If you just Start Talking to general public about everything, youre going to get mostly what do you think of this . Well, its okay i guess. I dont know. Nea thats what i would say. What do you think of the fire station we just rehabbed . I dont know. I dont know, its a fire station. But if you go to something that is high visibility and robert named a good one and larry you talked about the 1 on Mission Street where there was input from the public, expectations were developed and then youve the project was delivered, this wasnt what i was looking for. Something like that, follow up, see. We came to you at the beginning stage of the project, we asked for your input. We thought this is what we heard. This is what we delivered and what do you think. Is this what you were looking for . It sounds like in this case at least we would find its not. I always think about what happened at the stadium. The neighbors were very concerned about the fact that they were going to have a High School Sports at night with big lights and all the rest of it. I was working for the mayor at the time and mary burns was head of rec, what are you going to do about this. Were surrounding with trees and it will block out the lights. And he went back to the neighbors and said its handled, the trees were like two feet tall. They would be ready in about 30 years. Weve got time. I thank you for all your comments. I think we should put this to bed at this point. I do have two comments. The scope of the work and i read it, i was impressed by the comprehensive nature of this and obviously it touched all the points that one wishes to have as a deliverable in any kind of survey. So in that respect, i really liked it. I think what we can control is the selection of the number of projects, if were going to have two, we still want the results and the measurements deliverables to touch all the basis that we want to measure. So maybe we could scale this down a bit but i think its very comprehensive and touches upon the relevant pieces we want to learn from. Now, how the surveyor, the contractor designs the actual questions of focus groups, thats what were hiring them to do. But as far as touching all those touch points that are relevant, i really felt this was good. I think we can control not just the scope but the multiple projects. If were just going to have two, we still want the results of each of the two to give us the touch points that we want. The other point i would like to make and peg you said we could do this and im sure you can, parts of it in the Controllers Office, you have done it before. Knowing that all the existing work that you are doing on our behalf, staffing us and plus other departments, plus the fact that we have the funds to hire a contractor to do this, i strongly believe we should have it out to a special survey company, one of the said you have used. Obviously we still need your assistance to manage the process. I agree. I just expertise and survey design is what were buying with the pool. Theyll be good at it and will give you good options. Something like the standard thing, you may spend a lot of time having a consultant educate themselves where its not worth the money, where we can do it. We can narrow it down. I apologize, i have to leave now. I have another meeting. Do we need to take a vote or is this just moving forward . I think all the remaining agenda items on the calendar were just discussion and quick updates. We can rip through them quickly. If Committee Members need to leave we can accommodate that. Get out of here. So well keep working on this and produce another draft and share it back with liaisons. And have it on the same item on the next calendar. By that time we can get to a good scope of work i think. The project choice, we will if im correct that the universe of possible projects to choose is completed bond projects, then, you know, well try to get a comprehensive list of that so you feel you have the whole universe to think about and share that list. Just fellow members, when we started talking about this at last meeting, i believe kristin and i were kind of volunteered to kind of lead this survey youre doing a great job. I would like to invite to open it up to other members who have a specific interest. You could join us or you could also email kristin and myself some specific ideas of followup ideas based on our discussion, either the type of project everyone seems to have their own idea what is the Perfect Program to test to survey. So i encourage you to do that and i think that will kind of speed up a little bit of this process so by our next meeting when we have an update there will be some clearer idea of whether the consensus of the specific two programs would be. Remainder of item six. You requested for the calendar, thats there. Public finance office, if you havent met him before. Good morning members of the committee. Briefly walk you through the projected issuances over the next few months. As a reminder the 2014 transportation and road improvement bonds and 2012 clean Neighborhood Park bonds are both in progress. The legislation is currently going through the board of supervisors process and i expect that it will be considered for full board final approval at tomorrows Board Meeting and then well move forward with that in february. And then after that, in later spring, early summer, well have the 2014 earthquake safety Emergency Response bonds, full remaining amount 189. 18 million. Health and public safety, that amount is estimate, it may change depending on the review of expenditures which theyre still in process. Affordable housing about 82 million for them. Were hoping to go through all three of the programs at once to combine them into a single sale. If you have questions about the upcoming calendar. Im happy to answer them. Any questions from committee . I may have a question. Ben, are you going to let us know what is going on with the new Accounting System . Yes. I was planning to provide a quick update in the other matters and agenda items. Ill hold off. This memo is really helpful, thank you. I dont need to give updates on f and g, just to say were progressing as planned and well update as we work. I should note for the record, there are no more members of the public in audience. We do not need to take Public Comment. Number c, the web design. We discussed it. At the request of the chair and mr. Carlson, i wanted to provide brief update on the status of the Financial System conversion. We are for the Committee Members who dont know, the city replaced our long standing Financial System which we called famous on july 1st. We went live with a new system that we had been working on for a couple of years. That was installed in 1980 and the last significant upgrade was 1997 which mr. Carlson will remember from his time at public works. At the time of initial adoption by the city, it was the best in breed and by the time we cut off, we were the last county to use it. A very significant upgrade. We only go through these every 20 or 30 years in the city. Were still in the middle of it. Were transitioning in different parts of the system at Different Levels of stability and working to stabilize the system. The piece of the system that i think most directly pertains to the work of the committee is conversion of data from one chart of accounts to the new chart of accounts and what it means for reporting. So you go through a massive crosswalk of data between june 30th and july 1st cutting from one system to another. Inevitably in a conversion like this, you have data conversion errors where despite testing and the rest, data ends up where it wasnt intended to be. So in any project, you have an element of cleaning up the data conversions. We had a significant number of data conversion errors in one specific part of the world, relating to capital accounting and reporting. The most complicated financial structures in the city exist in this space, multiple projects and multiple departments and in many cases, specifically the department of public works, using new chart of account functionality to retire some of the subsystems they had been using in the past. That added to the complexity of this. We need to look ahead for the next fiscal year end and get back to running reporting for you and other stakeholders that gives you a sense of budget for example the level of detail you need without having to do significant am of manual data to get it. So were in the midst of that. It is affecting some of the reporting youre seeing. We do need to get there in coming months, the complexion of it and working with department of public works and our own Department Team to develop stricter calendars to let me communicate a specific date. I would be happy to answer questions around the process. My understanding is its not limited to Just Department of public works but virtually all focusing on general Obligation Bonds all of the previous, general obligations bonds responsible for reviewing. I think its true. Within the amount of data, the data conversation are working with those most affected, public work issues are the most acute. You do see it in other cases. For example, the level of inversion requirements are more limited, it is mostly felt in capital departments. M. P. A general obligation, their capital reporting or expenditures are fine . Housing is more straightforward. Remember that in many cases here public works is the delivery agent for most of the geo bonds youre seeing. Housing, mt, there are clean up activities, i just meant to imply it is most acute in public works. Because i heard when you talk about the old structure, the new structure, crosswalks testing, someone said there wasnt testing of that conversion data. Can you confirm there was testing . Yeah, there absolutely was prior to july 1st. Prior to july 1st we went through multiple testing. I appreciate that. Thats helpful. And then my concern with regards to the february bonds sales, the bond documents discloser requirements, would that require because we cant right now report on bond proceeds spending, would that require any kind of discloser in the bond process and if so, what would be the impact on potential Interest Rates . I think weve had conversations about any of this triggers discloser events. That is part of the ongoing conversation preparing our oss for each sale. I cant answer that kind of what the specifics would be. There may well be a discloser of some form in the documents. Others can speak otherwise. I cant imagine this is material enough in any way to trigger changes in kind of the bidding we receive on documents. Yeah, were currently in the process of updating discloser documents. There may be some narrative description of whats going on with the transition of Financial System, but i think all of the numbers are going to reflect what has been recently published. Those are reliable numbers and i cant quantify any potential impact to our Interest Rates based on this situation. I do understand an effort is underway to fix this. But we dont know when it will be fixed at this point. But if for any reason it wasnt fixed by the end of the fiscal year, it would impact the ability to produce i suppose. Absolutely. This work needs to be completed by the time we get to the close next year. I can tell you its a matter of months and not deeper than that because it needs to be. We have priority of resources to make it happen but i cant give you a specific date which is what i would like to know and im sure you would as well. Yeah, because again, in our bimonthly reports we used to get a bond fund status summary report and we havent had one since june and again, i think one of our primary responsibilities is to be able to say bond funds are being expended, if we cant its difficult to do that. I appreciate the efforts and hope you can keep us appraised of successes. I will plan to do so with this item on future meetings. Any Public Comment on the items discussed . If not, lets adjourn. All right. Secretary will call the roll. [roll call] actually, commissioner, please turn on your microphone. Thank you. Ok. Great. [roll call] and i believe commissioner chow has an announcement. Yes. As many of you may know, but others may not, i want to just acknowledge all the work that commissioner [inaudible]. He had resigned for personal reasons as of the beginning of this month. For that reason we have made adjustments until we have election of officers. As you know, he was Vice President and with the concurrence of the commission, we will not vote for a new Vice President until we reach march. And meanwhile, however, dr. Patings assignments, i would like to publicly make the following assignments in place of where he was. As he was chair of community and Public Health committee, ive appointed commissioner loyce to be chair of that committee. He is currently a member. And commissioner bernal will join him as a member of that committee. Dr. Pating was also on laguna honda and i will take his place on the laguna honda committee. So, those are the announcements for our Committee Assignments until we have our election. Thank you. If i may, commissioners, commissioner chow was reappoint by the mayors office. So, we have him for another four years which is cause for celebration. Thank you. [applause] lets move on to item number two, which is approval of the minutes from january 16, 2018. Minister, a motion is in order, please. Second. Ok. Are there any corrections to the minutes . I want to thank dr. Sanchez for actually helping chair that meeting. Who did apparently a sterling job in having it adjourn in half an hour. So, thank you, dr. Sanchez. If there are no corrections, well vote. All those in favour, please say aye. Aye. All those opposed . The Commission Meeting of january 16 minutes are accepted. Our next item, plea. Item three is the directors report. Good afternoon, commissioners. I want to, a knowledge that we have several members of the San FranciscoState UniversityNursing Programme in our audience today. Just wanted to give them an acknowledgment for coming to the [inaudible] what happened. Also were tracking the issues as the federal government impacts us on our Health Care Services and so just to let you know, we are following this issue as it is changing every moment. So we are following the cost of 340bs and some of the potential reductions of that and the impact of the mandate of the nonmandate and status of our family community, status of Community Health centres. Were also impacted by this and the fact that we do receive dollars from the federal government for our Homeless Services in the city and we recently had our Deputy Director with the San Francisco clinic consortium in washington, d. C. To make their visits to advocate for the Health Centre funding and so were tracking all of those three areas. I suspect by the end of next month, we can probably come in and do a Financial Update for you. Just depending on where things are and we know that the potential of another closure of the federal government could happen and so we do really want to work closely for all of our providers who are dependent on federal funding and closely in communication with them. So that is the update for the federal government side. I want to let you know that we are focused on syringe disposal and so one of the policies that weve made internally is any out reach worker that is hired by the departments funding, at least for the next year or so, will have to have part of their work will be disposal. We recently hired six additional individuals who will do engagement in the community and one of their responsibilities will be syringe disposal. In your report today, it shows how weve collaborated with other City Partners to place five disposal kiosks in this last year and we currently have 17 out door syringe disposal boxes and in your report, there is a map of all of their locations. I wanted to also let you know that we have received a 6 million grant for dental transfornight fight childhood tooth decay and this will allow us to target highvalue care, improving access, utilization Performance Measures and to also increase the use of Preventive Dental Services for children. And to prevent and treat more Early Childhood carries and increased continuity of care for children. This is an Important Fund for us and we have several partners in the community. As you know, weve seen some of those reports previously in front of the commission. That is the end of my report, commissioners. If there are any questions, ill certainly try to answer those. Commissioners, any questions from the directors report that you would like to ask . Director, i only would ask if you could just speak on the dental transformation in which it seems to be under a medical programme. Is that it we would then weve had an initiative over the last several years. How will this coordinate with that initiative . It is a part of that whole coalition. Its a waiver dental care waiver that we applied for. Oh, great. So all of the partners that both you and i have [inaudible] in their events are part of this whole coalition on dental care for children. So theyre participating and some have been funded through this process. Commissioners, if there are no other questions, then well proceed to our next item. Item four is general Public Comment and i received many requests, but the requests are all specific to item seven. I just want to make sure that there is no one else that would like to speak to general Public Comment, which is about items not on the agenda. Ok. We can move on from item five. Which is a report from the finance committee from earlier today. Commissioner chung. Good afternoon, commissioners. The planning and finance committee met today before the Commission Meeting at 2 00 p. M. And our agenda is nothing but contract approval a. Youll find the consent calendars with the new contract as well as the contract report that we would like to vote on. Commissioner chung, im just noting that there was one change, probably the other commissioners didnt notice, but you corrected the oh, yeah. The term . Yes. There was one slight adjustment with the contract terms. So, what happened is there is there are about four to five contracts for Substance Abuse services and, you know, Behavioral Health. One, they are supposed to, like, have the same contract term, but one of them has a misprint so weve asked them to correct that to reflect the consistency of other contract. Its supposed to be from august 18 to 2022. Yeah. 2022. Thank you, commissioner chung. Commissioners, any questions in regards to the finance committee report, on either any of the items or anything else you would like the ask . If not, then we will move forward to the consent calendar. The consent calendar is the items before you. Are there any extractions from the consent calendar . Might note that three new contracts are related to the i. T. System and well have a report on the i. T. System later on this afternoon. Seeing none, were prepared for vote on the consent calendar. All those in favour, the consent calendar, please say aye . Aye. All those opposed . The consent calendar has been adopted. Well go on to our next item, please. Item seven is a resolution evening dorsing the San FranciscoSafe Injection ServicesTask Force Final report and recommendations. This was presented to you the topic of the task force recommendations, whats presented to you on november 7, 2017 and you requested a resolution to be brought back to you and this is the resolution. Right. Commissioner, this is at a request that there be a resolution, but may endorse the Task Force Final report and recommendation. So, it is now before you and will be presented by ms. Logren. My name is eileen logren and i work in the department of Community Health. Thank you for your time and the opportunity to come back here today, to follow up on the presentation from november 7. Its the Safe Injection Task force recommendations that were presented. Im here to follow up specifically on the request and the resolution to support the recommendations and the operation of Safe Injection Services in San Francisco. You have a copy of the resolution in your packet, which outlines the process of the task force, the information that was presented last in november and the recommendations. You may have seen also that in other cities, similar conversations are happening. Just last week, nsdad, a National Hepatitis organization came out with a statement called a call to action. And it is a call to action to acknowledge Safe Injection Services and for other cities to consider this as a mechanism to meet the needs. This is a motion put before all of you to endorse, ask for the Health Commission to endorse Safe Injection Services in San Francisco and for supporting ab186 and to support the implementation of Safe Injection Services. As i said, you have the resolution before you. And im happy to answer any questions that you may have. About the resolution or presentation from november. Thank you. Commissioners, we do have public testimony, which id like to call before then, we ask staff for clarification or recommendations as you may wish. And then we cans review the resolutions. I will call five names in succession. The secretary will actually time the twominute testimony per person. And when the beeper goes off, please just know that means your time is up. Ok. So, first would be the following, dr. Alan cooper, holly bradford, kyle, top dollar and biscud and that could be in any order, please. Hi. Im dr. Alan cooper. Member of d. S. A. , which is taking an active interest in this. I practiced Liver Disease for over 40 years, mostly at stanford. More recently at health right. Ive taken care of hundreds of patients with hepatitis c. A few facts you may not be aware of. About 10 of people with hepatitis c have no known risk factors. Why is that important . Hepatitis c is a slowly progressive disease, usually 20 years after the infw ex no symptoms. They show up at a liver clinic, very sick, with cirrhosis, needing a transplant. How did they get it . As i said, they had no risk factors. These were basically if people going about normal life. They could be your children. Your grand children. People who might have gotten stuck at a playground, in a sandbox. Could be an adult cleaning up outside their house who got an inadvertent needle stick, didnt notice it and 20 years later show up needing a liver transplant. Hepatitis c costs about 80,000 to treat. Liver transplant, depenting on who your insurer is, 500,000, plus or minus. And then you have a shortened life span. Taking immuno suppressive drugs for the rest of your life at great cost and considerable risk. Getting these needles off the street is imperative. A programme like the Safe Injection Sites will help. Probably wont help thousands of people in the year, but one or two innocent people, like your children, or your grandchildren, may be protected by a programme like this. Thank you. Thank you. Next, please. And you can actually all line up within the aisle so it will be a little easier. Like being at the airport back there. Hi, im holly bradford. San francisco drug use union. We talk about should we come here or not shz because we pretty much know how youre all going to vote. But we wanted to come here from the Drug Users Union out of respect for you guys to say thank you for your bravery, for your willingness to care about the health and drug users in the city of San Francisco. So i dont want to take up a lot of your time. Im here out of respect and out of gratitude and that is why i came today. Our friends in denver created these little safe injection booths and im going to leave one for each of you on this table. I dont know if it is appropriate. I hope it is. Its ok. [laughter] now its done. [laughter] so San Francisco might be the first city to have a supervised injection space, but you would be the first Health Commissioners to have your own personal supervised injection booth. [laughter] and, again, thank you very much. Thank you. Thank you. Next, please. My name is kyle barker. My colleagues, first off, want to thank you very much for listening to us. Its not very often that we as addicts and people feel like we get that. And to not only be heard, but to be heard on a level where something is going to be implemented that will save a lot of lives. Improve and give a lot of second chances. That means the world to us. It allows us to have a shot to improve ourselves to have someone else and to maybe prevent someone from going down a certain road. So, from a guy who grew up in the midwest where i still, you know, have friends and are calling me and surprised that this is actually a real thing. And it is a beautiful thing. You know, its the reason i came to this city. Its progressive. It actually cares and your actions are speaking massively on that. Really honestly, thank you, guys, in the both of my heart and my daughter would thank you, too, to give me a chance to do something to save myself and turn my life around. Thank you, guys. Thank you. Next, please. Yes. My name is and following those would be biscuit, tommy, billy and aaron. Please. I would like to thank you guys for allowing us to be here and realise that there is something that can be done. And i just hope we get to it. Thank you. Thank you. Afternoon. My . Aim kevin. For the record, biscuit is what people call me. [laughter] i just want to thank each and every one of you all for giving us the opportunity to speak with you previously. Im a street musician. That is what i do. And im thinking no biggy to get up and talk for a couple of minutes. And the last time i said about three sentences and i couldnt think of anything else to say. But i mean, you know, it really is means a lot to us. Weve been working with holly, the Drug Users Union, the last couple of years from picking up dirty syringes on the street to passing out information. Helping to educate people regarding drug addiction and its effect on our Society Today and living in the place in gives us opportunity to do something positive and act of positive change regarding this, as opposed to sweeping up more underneath the carpet and keeping it and just putting it on side when it is really reaches the problem the problem has evolved into and it can just as easily be maintained and be something that is uses education tool for not only parents, for children, because and plus it will take a lot of the negativity that is associated with drug use. You know, like well, really myself. The big catch 22 that i see that i failed to mention last time is, you know, the overdose deal where naloxone is ready available and will save people from overdose and it has to be administered within so many minutes of someone having an overdose. If its applied properly, there is no side effects and saves a person and it is a wonderful thing. The education factor of making it readily available to everybody out there as a member of the public, to you know, theres people that time. That in that situation. Thank you. Sorry. Thank you. Im long wind. Thank you so much for listening to us and thank you on behalf of all the drug users in San Francisco. Thank you. Thank you. Hi. I just wanted to thank few approving a safe injection site. Thank you. Hi, my name is aaron. I think a safe injection site would be a great thing because a lot of people feel like they have to go and hide and that is when they usually o. D. And they die, you know . I just want to say thank you. Thank you. And just before the next speaker, let me call laura thomas, alex and michael diskapola or im sorry about that. Michael from the San Francisco aids foundation. [laughter] please. My name is william from the Drug Users Union. I wanted to say thank you again for letting us speak here. I think it is important that education out there, theres a lot of stigma against us. And thats what has us all on the ground and its not going get any better if we dont know whats going on, you know . So i think more information that is out there is better and it is a great thing that is going on. Thank you. Thank you. Good afternoon. Alex, Task Force Member on the supervised injection site. Task force that london breed had and i was fortunate to speak with yall a couple of months ago as well. As you know, im an epidemiologist, ive been doing research around injection drug use in San Francisco since 1993. Our group are the ones that first provided the research in jama, that Needle Exchange helps people reduce sharing syringes. Subsequently we had papers that compared sitings that had one for one exchange to exchanges that provided a needbased distribution, which in those papers showed us that youre also reducing sharing by having a needbased distribution while not increasing any needles on the streets by doing that. After that, we were the first researchers to look at and examine takehome naloxone here in San Francisco, which has been adopted as well and here we are looking at supervised consumption sites. Obviously we publish the papers on that regarding both the cost savings, 3. 5 million a year to San Francisco with just one site, if it were to have more than one site, that would be more savings obviously. And really seeing that this really would help not just the people who are using drugs, but it would really help the Overall Community because we would reduce public injection, it would reduce needles on the streets, issues i think are near and dear to every san franciscans hearts. Thank you for listening and taking into consideration this important issue. And hopefully you will be all voting yes. Thank you. Good afternoon, commissioners. Im laurie thomas, the interstate director for the drug policy alliance. And we also think that supervised [inaudible] a member of the San Francisco h. I. V. Planning council. And im really delighted to be here talking to you today. Its one of those days when im really proud to be a san franciscan. So, seeing the very nice writeup in the chronicle this morning really puts this day off to a very good start so i want to say thank you to the commissioners and to the department of Public Health and a huge fan of this department in large part for being willing to take these kinds of action, whether it is around syringe access or supervising services. [inaudible] worked on all the bills at the state level to authorize injection programmes usually with the San Francisco aids foundation and were very proud of create ago Legal Framework for that. Were also now working on creating a Legal Framework for supervised Injection Services from the state level with eb186. But im so glad that San Francisco is willing to move forward in the meantime. I know that you have legally now a system with the City Attorney which i read with some interest. I appreciate their use of access in the Needle Exchange programmes to make an analogy. I think its a very daily bread food analogy which is now adult use cannabis programmes that puts department of Public Health and City Employees directly in the role of regulating and administering a programme that deals with scheduling a controlled substance. Obviously San Francisco has voted repeatedly to allow those programmes to exist as well as the people of the state of california. We think that is the analogy to look at when you are looking at the legal issues, rather than safe access programmes, which again dont involve direct use of the substance. But the same way that we provide onsite consumption permits for cannabis, we can do this as well. Thank you for your courage and im happy to stand with you and partner with you and support you. Thank you. Thank you very much. Good afternoon. Id like to [inaudible]. Director of Behavioral Health services there. Some of my responsibilities include outpatient Substance Use and Syringe Access Services and im a member of the task force and i sit on the h. I. V. And Care CommunityPlanning Group as well with laura thomas and others. As laura said, this is a happy day for me to see us moving forward with recommendations of the task force. I look forward to an affirmative vote from the Health Commission and thank all the commissioners for your support of this important next steps for Public Health for the city and county of San Francisco. I wanted to be on record in support of the recommendations since i sit on the task force. But i also just wanted to make a couple of statements also about, you know, the bottom line of all of this is about a message to drug users that their lives matter. And that we actually, as a city and county of San Francisco are taking a stand and we are saying that we love drug users, we love our family members and Community Members who use drugs and we have the courages to walk with them and be with them where they are on their terms to help them improve their lives. Im really pleased that well be moving forward with some of this and i want to remind us that we cannot roll back some of those services that we have currently with syringe access and dissuppose sal. Disposal. Those services are evidencebased services that have helped prevent overdose. They have helped us prevent h. I. V. And s. T. D. Infections and transactions and those services along with supervised Consumption Services allow us to move forward and make more progress towards improved health and wellness for all san franciscans including those who use and or misuse drugs and alcohol. Thank you very much for your support. Thank you. There are actually no other slips for public speaking. If anybody still wishs to make comments, you may come up. We are looking to place the resolution before us. I should say, though, first are there any questions to staff that presented . R seeing none, then a motion for the resolution is in order. So moved. Second. So a motion and second has been heard. Are there any discussions . The resolution is very extensive in terms of the where as and the reasons and ends with several resolves, including endorsing the Safe Injection Services task force recommendations, supporting Assembly Bill 186 and supporting the implementation of Safe Injection Services. That is before you at this point. Commissioner sanchez . Yes. Well, i i just want to state that when this was first brought up, the task force was under way and i just think the quality of the work that has been done, from federal to state or whatever is was really a horrendous task. As i read through this, the very last further resolve that the Health Commission supportses safe injection service. I was thinking that really