Transcripts For SFGTV Government Access Programming 20240713

After 2023, it was uncertain how that liability would be paid down and our discussions at that time with the Housing Authority, there was an assumption there would be sufficient residual receipts to pay down that liability but it is an ongoing risk for the Housing Authority. So in terms of our report, we made 16 recommendations and some of these pertain to the mou thats before you today. Although none of them would in any way impact your approval of the mou in this meeting. So of the 16 recommendations, we heard from the mayors housing who will be responding to the audit and agreed with the 12 of the recommendations or qualifications and disagreed with four and well go through the four disagreements. It would be transparent about what the status of funding was and then for early reporting to the board possible vouchers shortfalls in the Housing Voucher Program and one of the things thats important here is that because theres assumption that the funding for the formula can lead to shotfalls there is supplemental funding from hud but the Housing Authority has to apply in sufficient time to get that money and it will be important Going Forward that the board is ware and is aware and the Housing Authority is applying to get the funding because lots of people are applying for them. We recommended an annual midyear report on Housing Authority activities. December sort of ends the year they look at their voucher activity and their other activities and we think it would be important for continued reporting and then annual reporting on the unfunded pension in liabilities. And the other major area of recommendations on severance payments that are covered by the mou thats before you today and one was for evaluating whether they had sufficient reserves at this point to meet up to 5 million payment and then consult with hud to consult they could be use ford this used for this purpose and if necessary, to identify other Funding Sources for the severance payments. The mou covers the will and executive management saying the city will provide executive management to the Housing Authority to a Services Agreement and that the mayor will appoint an executive director for the Housing Authority, who will report to the mayor the mayors texas designee and they have not had a permanent director since 2013. The person in that role has been in acting position and not a permanently acting director and Going Forward there would be a Permanent Appointment as a priority. And then the other the Housing Authority will retain some core staff to oversee the thirdparty contracts in the time of the audit. So when you think of the thirdparty contracts almost all of Public Housing has already been contracted through agreements with private property owners, nonproperty owners and hope 6, hope sf, those have all been transferred to private providers and that will continue with all of the Housing Authority property. For the other contracts at management its housing we think its important that the contract oversight be competent in that we wanted to make sure that would continue. Other major areas of operations is to think about if theres a shortfall in the housing assistant payment to hud or if theres a reduction reduck reduction, that be part of the financial projections. These are the joint reports from the controller, the mayors Budget Office and budget and legislative analyst. And that joint report looks at general fund revenues, but to the extent the city is, like, looking at whether theyll backfill any shortfalls and funding we think that needs to be considered as part of that process. In the mou it talks about the nonhousing or the Housing Authoritys nonhousing stock and it provides for an inventory of that stock. One of the key pieces of property that the Housing Authority owns that the city needs to evaluate its own purposes is 1815 egbert street which is the housing administratives office and the city spent many millions of dollars putting up housing across the street and we think this needs to be considered of the inventory. And i want to say another thing about how property is looked at in this. We were assured that any developer any party to the Development Agreement who bids would be in arms length in the rfp process and we just wanted to see who bid what the bidding process is and how it was awarded and how the price was set. The mou does not actually provide for appraisals of Properties Sold for market rate housing. And i think thats a significant issue for us. So there were areas of where the recommendations and the audit were not agreed with. And ill go over them and one was our recommendation that we believe that budget contracting property transitions should conform with the charter and the administrative code and at the time of the audit basically what was said, no, this is under huds jurisdiction, not the board. However, i would say that between july, when we got the original mou and today there have been revisions which we think go a long way towards addressing this recommendation and it does clarify more what the boards role will be in the process and brings forward at least for review if not for approval major contracts and major provisions, you know, that meet the charter and admin threshold. We think even though there was a disagreement in the audit itself that the mou does go a long way toward addressing this recommendation and there still are limitations but that has a lot to do with huds own ligses limitations and what theyre willing to agree to. We have another one that ill send to john givner at the moment and was another recommendation in mou. The mou provides for the structure of the Housing Commission a Housing Authority commission and it allows for under state law only the mayor can appoint the commission. The mou provides for the mayor to appoint four members and for the board to recommend three members to be appointed by the mayor and its consistent with state law. Now i want to point out this is state law so if there is a change in the structure of the commission, they could in fact, also advocate for changes at the state level. And our recommendation, though, is that the admin could cod codify since this structure since it was recommended through the mo but ill turn this over to mr. Givner. Im city attorney, john givner. So the state law restricts how the city can appoint members of the Housing Authority. Under the mou the proposed plan is for the mayor to appoint the members of the Housing Authority and the mayor has committed in a letter that she submitted to the file this week and in the mou itself that she will follow the recommendations of the board for certain members of the commission. That provision in the letter and the mou are not going to be legally binding if a future mayor concludes that he or she wants to appoint a member to those seats on the Housing Authority that are inconsistent with the recommendations of the board. The mayor will retain that discretion under state law unless as miss campbell suggests state law is chappinged to give the board of supervisors appointment authority. Thank you for that clarification. So i had a question. So then, would the adopting the mou with the proposed restructure itself be a violation of state law . No, administer the mou the mayor retains discretion to make the appointments and the mayor remains the appointing authority, but the mayor is essentially making a commitment in the mou and letter to follow the boards recommendation for those three seats. The final area of disagreement where we maintain our recommendations is over the question of Financial Management. Again, we dont think theres anything in our recommendations that are inconsistent with the mou language before you today. And one of the provisions of the mou is on Financial Management which stated, to the extent that required by the city, the Financial Management will be outsourced to a thirdparty contractor. And that it clarifies that the current bdo is the contractor providing Financial Management. Four recommendation is after the transition we believe that Financial Management should be brought inhouse. We dont believe it should continue to be a contracted function. The same way that other executive management and executive director are specified as being city responsibilities to a shared Services Agreement with the Housing Authority. We did actually, during the source of this audit i think theres a concern that the Housing Authority has not had sufficient Financial Capacity for a good many years now. Certainly going back to our audit of 2013, are we identified it as a problem. But we did talk to a local representative from hud and its our belief that a competent financial manager can learn the hud ways of doing things, that the city has other financial managers who deal with complex systems and complex regulations and that we think its important for this function to be brought inhouse. And we think that the mou is consistent with that. We dont think mou before you inconsistent. The other two years of disagreement was under the transitioning of the citys Financial System and the authority of the controller. I think in our discussions with various staff theres some capacity there. And i also wanted to say that specifically the mou states that the Housing Authority will transition to a sharedservices model in which there are Services Including Information Technology Human Resources purchasing real estate, Financial Systems and oversight and that there will be a process where they will begin to develop integration of these systems processes and practises. So we think our recommendations are actually entirely consistent at this point with the language in the mou. So overall that does summarize our report. And we did receive a lot of assistance from the staff and managers about the Housing Authority and the Mayors Office of housing and we want to thank them for the help they gave us. I want to also thank bdo the financial consultant, really provided a lot of information. Potand were available for any questions. Thank you miss campbell. Supervisor brown any questions . No. So next up, we have tonya lediju actually jan adams from the Mayors Office of housing who will present on the transition mou. Thank you so much, supervisors. Very pleased to be here and i do want to recognise tonya. You may know her as the city auditor but appointed by the mayor to lead the transition of the Housing Authority so happy to be here. I want to thank miss campbell and her team for the excellent work in review and collaboration on their performance audit. I will keep my comments brief as miss campbell did a good job of summarizing the key issues. What brings us here is a set of financial and operational challenges experienced by the Housing Authority and on the housing choice voucher administration. There were operating budget deficits on the Public Housing side projected in the upcoming years and a very acute shortfall in the housing choice voucher that necessitated an emergency loan from our office to the Housing Authority to cover that shortfall and ensure that landlords got paid and vulnerable residents maintain their tenancy. As a result of this mismanagement, hud issued a default letter and i think youre familiar with that in which they found the Housing Authority in default under both main programs and in order to cure that default it required two things. Firstly required that this outsource operations of the two main programs to thirdparty experts and thats well underway now. They have secured a housing choice voucher administrator and this is under the administrators purview and were preparing in collaboration an rfp to manage the Property Management at the housing site. There are federal regulations which must be adhered to, and those comments have been added to the most recent version of the mou that is in your file. And there are also, based on those comments to the resolution and i understand that will be provided subsequently. And i do want to although we come to this meeting through times of really financial challenges i do want to frame this next step as an extension of the Ongoing Partnership that our office has had with the Housing Authority over the past decade and more. Really beginning with hope and assess and the transition of the theyre finishing up all Affordable Housing and at sunnydale and petrr arcaro, we finished large revitalization efforts. And weve been engaged in the transition of the balance of the portfolio, 3500 units from Public Housing to voucher supported, nonprofit owned and managed housing under the rental assistance demonstration project and that, with the 100 Million Investment from the city weve averaged over 2 billion of investments that have really provided much Better Living conditions for many of the most vulnerable households. And this gives an opportunity to strengthen the collaboration coordinate operations and continue to support nearly 14,000 residents that depend on the Housing Authority. So not to be too redundant but what does mou do . It exists as a separate Legal Organization and we discussed the appointment structure of the new Housing Authority board of commissioners. The key i think component whereby the city assumes essential functions is really in the appointment by the city of the ceo and the executive staff at the Housing Authority and to ensure that the reporting structure really comes up through the city and that, again, that relationship will be established through a Services Agreement between the city and the Housing Authority. And i stated earlier outsources that the voucher and Public Housing operations is in the mou and fourth and finally the authority will submit an annual budget for review by the mayor and board of soup supervisors each year and that will include contracts to exceed 10 million ten years or generate more than 1 million in revenue. Please note that the funds for the Housing Authority come exclusively from hud and those have richard rigid requirements. It does retain authority under city charter to amend and adopt any proposed allocation of city funds to support the authority and to authorize city staff positions assigned to support the authoritys operations. So with that summary unless there are any questions, i would like to turn it over to my colleague ton tonya who will address the report. please stand by . My fear is that theyre going to move to evict. And thats a fear that and its a real fear. And i understand their frustration. The Management Companies. But they are more of like a machine. These Management Companies are bigger more of a machine where before the Housing Authority had much more of a one on one and people could call this person that person, to see who could help, but the Management Companies are coming in, a lot of them havent dealt with things like this before. Or if they have, they are dealing with them in a different way than we would normally deal with. Lets get resources in there. Im wondering is there funding and that capacity that we are working with the other departments to bring people into help these Management Companies deal with residents that are in a real need of that transition. And spending all the money we did, and the properties are now coming back down because of behaviors. Well, i think that its a important reminder we did provide funding support and continue to provide funding support for services and engagement and housing stabilization. I think what you are pointing out is there may be a need to make that funding and infrastructure more robust, but it is in place. So we have staff that are assigned to work with each property and ensure that Resident Services are provided when we get complaints we respond we coordinate with the Housing Authority on those complaints. So i think your comments and question are a reminder and call to action that we need to make that even more robust and more significant. But there is that concept and idea in place. And i think we just need to grow it and make sure its sustainable. We are committed to having these properties not return to a kind of status of disrepair and neglect that was commonplace under the Housing Authority in large measure because of chronic underfunding by the federal government. So what we have done with this investment is reposition them for sustainability over the longterm and are committed to ensuring the operations doesnt deviate us from that path. So i appreciate your comment. Because before the Housing Authority always was support. I mean, it was a separate entity. It wasnt really part of the city. And to have to deal and ive dealt with the Housing Authority for many, many years, we have to know how to maneuver, who to call to get things down. Now that its under the city umbrella and part of the city, my question is are question do we have point people at department of Public Health . Do we have point people at hsa that when we say weve got issues, weve got someone that has Mental Health issues and they are hoarding or throwing trash out their window and we are dealing with rats again we need someone to go in and help them instead of watching the Management Companies that are frustrated. And i totally get why. But they start to maneuver like eviction instead of bringing the resources in from the city to say lets help. So my question is are we connecting . Do we have a coalition from these departments to say now that they are under our city family we need that coalition of what resources are available to these Management Companies to be able to go in . We do coordinate with sister agencies on this. And our staff does reach out to those agencies to ensure a coordinated response. We also have extremely low eviction rates at these properties. So we are committed to housing stabilization. Theres always a balance of ensuring the health and safety of all the residents. So if residents pose any risk to that, there will be eviction proceedings for those residents. But there is a robust response and coordination to ensure housing stabilization. I think we are midtransition here with the Housing Authority really becoming part of the citys umbrella. And that provides great opportunity to address the comments you are raising, again i think is our response sufficient in all cases . It almost certainly is not. And this is, i would say, per my earlier comments an opportunity really to make our support infrastructure more robust, more coordinated. So i take with great appreciation your comment. And i just want to say when we were in the midst and you brought in cultural confident people to help with that and you brought people into compliance whether with their rent or anything else or People Living there that were not on the lease and people were afraid to come forward. So you brought in people, a lot of them from the community to work that cultural confidence and work with people to say if you come forward and you are on your back rent three grand or three of your grandkids and daughter living with you it doesnt matter we will help you. It doesnt mean you will be evicted because you have to remember the history of the Housing Authority. And especially when theres any kind of redevelopment of a Housing Development and or renn know, a lot of people werent asked that. I mean, that is the history of San Francisco. So people have fear of that. But i think you all did a really good job with bringing in people from the neighborhood to do that cultural confidence to say it doesnt matter whats happening in your family. Let us help you get to a point where you are going to stay and come back. So now that we are at that point where they are there i guess my fear is the Management Companies, maybe we still need to make sure they have those cultural confident people and then also city resources to make sure that once theres issues, because, i mean, believe me, if someone is throwing trash out their window and they absolutely will not comply and go down and put it into a trash bin and the rats are coming in and getting into the walls and here we are hundreds of thousands of dollars that we are supposed to be putting in to do this i know they are going to get evicted. I mean that is so there is some kind of usually Mental Health piece of why thats happening. So thats where i just really would love to see to make sure that we have those resources in place and then kind of have the cultural confidence resources there too someone that could go in and talk to them and they would trust. I think those are great comments and suggestions and we will move forward with those. Thank you. Thank you. [off mic] good morning. My name is tanya, transition lead for fsha. I would like to thank ms. Campbell for the report that they have done as well as dan and his team working alongside myself. Id like to just quickly touch on several things that ms. Campbell brought forward. And then ill go into our presentation really quickly. But id like to assure you that through the transition period and we continue to be in this phase fsha has made great strides. As it relates to the severance of our staff, we have fully funded that severance payment. That severance payment is projected for the entire two phases. There are two phases in this process with the staff of about 5 million. And that cost will be fully funded by sfha. As it relates to the unfunded tension that has been mentioned sfha continues to work through its own Financial Resources to ensure that it is able to meet those obligations as well. And i believe that it will it gives a position to do so. As it relates to the shortfall numbers that were shared in the report at that time of 16 to 18 million, i would like to be able to say that at this point our projected shortfall is 9 to 10 million as a matter of fact for this coming calendar year because it runs on a calendar year as it relates to the voucher payments. The shortfall is 8 million. We have done extensive work with hud on projecting our budget. We have a specific twoyear tool budgeting tool that is used where we work very closely with hud. We know at any given time from month to month what our projected shortfall is, and hud has committed to ensure that they fund that shortfall. This calendar year our shortfall was actually 22 million. And the calendar year for funding of vouchers ends on december 31. All those funds have been in fact funded by hud. So i think as the budget legislative analysts have come in prior with their prior report and the condition of sfha as it relates to really not understanding what its financial position was at that time, how many vouchers it could actually put out on the street and its recordkeeping reporting memorandum any of themes was really truly in a poor state. Today it is much different than what it was a year ago, two years ago. I can assure you that at the chief audit executive. As it relates to the request, the four requests that we have fundamentally disagreed with, recommendations 4, 5 and 12, the fundamental disagreement with those recommendations are that hud and the state law requires that sfha remain a separate leet entity from the from the city and the county which established it. And so in the spirit of that law, we are responding accordingly. And as it relates to recommendation 11, moving sfha, transitioning its records to the city as it relates to the Financial System, we fundamentally disagree because the system today does not have a module where it can handle rental agreements rental accounting as required by hud, as required by accounting standards as well. However, what id like to say is the agency is not totally in disagreement as it stabilizes, which is very important, it will reconsider how it can transition into the citys Financial System. I meet biweekly with the controller and it is a constant conversation that he and i both have. So i definitely will say as it relates also to the request that the controller actually acts as the controller of sfha while its prohibited according to law, state law the controller and i do meet, and we do talk about the financial situation our position of the sfha as well as the fact that for the single audit, that must take place annually for the city, there is information about sfha in the single audit as well. So there will be many efficiencies gained with once the m. O. U. Is agreed upon and helping ensuring the sfha is financially sound. Its able to report as it should and have the internal controls required as well as the fact that ms. Campbell also mentioned that we have a financial contractor bdo and we too, when i say we too as the city auditor as the transition lead, working with the controller, it is agreed that the agency should have financial competent staff. And today there are financial competent city staff. Theyre working on the finance team and leading the finance of the agency and actually understanding and learning the nuances of housing financial accounting. Thank you so much for all of your work during this transition process. I did have a few questions about the ongoing shortfall. Can you just describe whats causing that . So when we think about the shortfall and we think about the city and county of San Francisco Housing Authority, it is not any different than any other Housing Authority nationally. Every Housing Authority in the United States of america has a shortfall because hud only funds at a certain level, and it does not fund the entire rent for each unit. And what it does commit and ms. Campbell did mention that in her recommendation, about the need for the organization to understand what is the shortfall at any given period in time so that it could request those funding that funding mechanism through hud in a timely manner. And what sfha what we have failed to do is understand our books know our financial position at any given time so we can make that request to receive those additional funds. And so when we think about the city and county of San Francisco we know that we are one of the highestrent rent cities and counties in america. And with that in mind, hud only funds at a certainly level per unit. And we need to predict that as well as consider what is going to be the rent increase at any given time in each year and determine or estimate or project the month to month when rent increases will happen for all the varying units that we have vouchers. Though we have our rad pros that have projectbased vouchers and in those particular units are developments, we know when the rent generally the budget cycles from january through the full you are fully funded from january through the end of september. And if you miss those time periods of making that request then as an agency, you are left with trying to figure out how am i going to pay that cost. And today i can say that we are not going to have to pay that cost because our books are now in order, if you will. Im sorry. Im just trying to understand it and the implications for the potential ongoing Financial Support from the city for these programs. So once the shortfall is assessed and documented, you can request from hud to sort of cover that . Yes. So let me restate. On a monthtomonth basis we work with hud. We have a special team at hud that we are assigned to work with. So that we are discussing monthly what our shortfall is projected to be at any given time. And through their own process, they are setting aside those dollars specifically for the city and county of San Francisco Housing Authority to ensure they are making a concerted effort and commitment that we will receive those funds. As an example, again this year we had a 22 million shortfall. And throughout the entire year, it was known that we would have that 22 million shortfall and those funds were committed to the Housing Authority, and they have been paid to ensure that the agency did not have to figure out how to meet those obligations or even come to the city for those funds. And thats the continued process. And as it relates to the tool, this is a little more detailed than maybe you would like to have. But as it relates to the budget tool that we use that tool has been designed specifically to deal with the different attributes that the city and county deals with as it relates to the high rent cost and so forth and on. Great. Just one question on this. Yes. So that sort of ongoing shortfall figure that the budget and legislative analyst presentation cited, 16 million to 18 million annually your 2031 and that looks like a figure from the Housing Authority financial consultant. You mentioned you feel like its a lower amount. But whatever the amount, is that amount eventually going to get paid back . Paid by hud . Or is that an annual amount that the city is going to have to to answer your question no the city will not have to pay those funds. And that amount is much lower than what has been projected at that time by the bla in its report. Today we say that that amount is anywhere from 8 9 to 10 million annually, which will be funded by hud. Its a commitment from hud to do so. And that commitment is made on the basis of all the work that we have done collectively, hud and sfha together to design a tool that will help us all know where we are at any given time in terms of costing of our units. And im very confident about the numbers. And im very confident about the work and the tools that have been designed to actually project out these numbers. And this tool and this work has also been vetted at the National Level of hud as well. And on top of that on a monthly basis since ive been there i meet monthly with the regional director of hud going through the various reporting mechanisms that we need to as an agency and ensuring that we are tracking things appropriately and we really are on point with our Financial Reporting and understanding our financial position and the number of vouchers that we can actually issue and so forth and on. So we really have a set of really good processes and controls in place that i believe are sustainable. Thank you so much thank you. Supervisor brown, do you have anything . We were just presented some amendments to the resolution approving the m. O. U. For the Housing Authority transition. I was wondering if somebody from the Mayors Office of housing might want to go over the amendments to the resolution. So the redline amendments to the resolution first clarification of the Housing Voucher Program as its known commonly as section 8 program and collectively under on page 3, whereas sfha will implement a transfer of the site to developers, this makes reference to hope sf and collectively those are called developments. And they are under a Development Agreement. And also a master Development Agreement. So those clarifications were added. More significantly theres language beginning on page 5 that makes clear that the board of supervisors may by ordinance declare itself to the board of commissioners. And also there is now reference as was mentioned earlier during the discussion during the bla report that the mayor was submitted a letter in which she confirms she will make three appointments to the board of commissioners based on the recommendations from the board of commissioners. Excuse me board of supervisors. And the board of supervisors desires to make such recommendations to assist the oversight of sfha. Continuing on page 6 there is a reference to the already approved master Development Agreements. Those were approved by the board of supervisors and board of commissioners some years ago and those are still in effect. And then just some cleanup language in the subsequent whereas clause stating that the m. O. U. Will enable the Housing Authority through the sfha default and reorganize the Housing Authority consistent with the letter and the memorial letter. Thank you. Are there any members of the public that would like to testify on these items . Seeing none, Public Comment is closed. Id move that we approve the amendments as presented. And i move that we move this item to the full board with positive recommendation without objection. Thank you. Mr. Clerk, please call items 10, 11 and 12 for closed session. Agenda item numbers 10 through 12 are two ordinances and a resolution authorizing lawsuits. Are there any members of the public that wish to testify on the items that will be heard in closed session . Seeing none Public Comment is closed. Do we have a motion to convene in closed session . We are now in we are now back in open session for the november 21 meeting. The Committee Recommended both ordinances and the reds lucian to the board of supervisors the resolution. Do i have a motion to not disclose the proceedings from the closed session . Great. Is there any further business . Yes there is one more bit of housekeeping agenda item number 9 is a hearing that was related to the Housing Authority and the budget legislative analysts review of that item. Is hearing is still before us. We havent taken Public Comment on the matter. Thanks for the reminder. I move that we close the hearing for item number 9. The matter will be filed. There is now no further business. Thank you. We are adjourned. [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 morning. Today is wednesday november 20 2019. This is the regular meeting of the abatement appeals board. Please turnoff all electronic devices. First item on the