Transcripts For SFGTV BOS Govt Audits And Oversight Committee 20240712

Good morning. The meeting will come to order. Welcome to the thursday, june 18th meeting of the government audit and oversight committee. Thank you to this committees clerk, john carol and thank you to sfgovtv for staffing this remote meeting. Mr. Clerk, do you have any announcements . In order to protect Board Members during the Health Emergency the board of supervisors legislative chamber and Committee Room are closed. This is taken pursuant to various local, state and federal orders and directives. Committee members attend through video and participate to the same extent as if physically present. While the comments will be available for each item. Cable 26 and sfgovtv are streaming the call in number across the screen. Comments and opportunities to speak are available at 415 6550001. Once connected and prompted to the access code which is 145 4314683. Then press pound and press pound a second time to be connected to the meeting. When connected you will hear the discussions. You will be muted and in a listening mode. When your item of interest comes up, dial star three to be added to the speaker line. Call from a quiet location, speak clearly and slowly and turndown your television, radio or streaming device. Everyone must account for time delays between the live meeting and the streaming coverage. You may submit Public Comment in the following ways. Email me, the clerk of the government audit and oversight committee. Joh nca rroll at sfgov. Org. You will be included in the legislative file as part of the matter. Your written comments may be sept bsent by u. S. Post office. Items acted upon today will apbe on the june 30, 2020 agenda unless otherwise stated. Please call items, one, two, three, four. 1 through 4 ordinance fixing compensation for persons employed by the city and county whose compensation is subject to charter a8. 409 in job codes not represented by an employee organization. The First Amendment memorandum of understanding between the city and county and teamsters 856 to provide appropriate differential over subordinate classifications and onetime payment to employees in classification 2496. Imaging supervisor. First p the First Amendment to the 20192022 memorandum of understanding to provide onetime payment to include a firearms instructor premium and ordinance for the memorandum of understanding between the city and county. Miscellaneous to update night shift differential and include onetime payment to employees in specified classifications. Members of the public wishing to comment on these items call the public number and enter the access code 145 4314683. Press pound twice to connect and press star followed by 3 to speak. Mr. Chair, i am in receipt of a memo requesting these four be considered as Committee Reports for consideration by the board of supervisors early on the jun. Mr. Chair. Than thank you, mr. Clerk. Welcome carol from the department of Human Resources to present these items. Thank you, mr. Chair, members of the committee. These four items in front of you, one of them is a byproduct of 2019 negotiations that was put into a separate process, that being the firearms premium agreed upon between the supervising probation officers of the city. This is a premium paid while performing the duties of firearms instructor which happens periodically in that group. There are two items. Teamsters item and the Service Employees International Union local 1001 item that are byproducts every classification of the radiology series. That provides services at zuckerberg General Hospital and elsewhere. The study was i was implemente. We have two clerical amendments to adjust the rate of the supervisor of the classifications to deal with an item left out which is the swing and night shift differentials for these classifications. The unrepresented ordinance. No new additional spending in the ordinance. I am happy to answer any questions you may have. Thank you. Than thank you for all your k on these m. O. U. S. Before we go to Public Comment, colleagues any questions or comments . Seeing none, why dont we go to Public Comment on these items. Operations is checking to see if there are callers in the queue. Please let us know if they are ready press star and three to be added t to the queue. Wait until you are prompted to begin at the beep. On cable 26 or sfgovtv call in by the instructions on the screen by dialing 415 6550001. Enter 145 4314683pound twice and star three to be added to the queue. Do we have any callers . We do not have any callers in the queue for these items. Thank you, operations. Thank you, mr. Clerk. Hearing no callers on Public Comment is now closed. I would like to move to recommend these items as Committee Report for the june 23rd meeting of the board of supervisors. Mr. Clerk please call the roll. The motion that these be forwarded as Committee Reports vice chair peskin. Aye. Haney. Aye. Chair mar. Aye. There are three ayes. Thank you. Thank you very much. Mr. Clerk please call items 5 and 6 together. Two resolution authorizing the mayor to cast assessment ballots in the affirmative to the proposed renewal and expansion of property and business improvements district to be named the Castro Community benefit district with respect to certain parcels of Real Property owned by the city subject to assessment in the district. Members of the public call 415 6550001. Enter access code 145 4314683. Press pound twice to connect to the meeting. Then the star key followed by 3 to enter the queue to speak. These are on the agenda as Committee Reports. Welcome chris from the office of economic and Work Force Development to present. Good morning. Thank you for hearing these items today. I am the Senior Program manager. Today i am here presenting two resolutions authorizing the mayor to cast a ballot for the City Property based district Castro Community benefit district and the same for the Fishermans Wharf cbd. On may 29th the department of elections mailed ballots to Property Owners in the cbds. Initially, on may 29 one ballot was sent for the Fishermans Wharf and six to the city of county for the castro cbd. Within the past 36 hours we received information that was confirmed two parcels in the castro have been purchased and are owned by the city and county of San Francisco. We recommend including these in the resolutions. First would be parcel 3501006, for 1,008. 08. 116 of the budget at 1939 market. 3501007. 1,039. 55. That is. 127 of the cbd budget. The new total for the city owned parcels in the cbd 74,211. 99 or 9. 051 of the total cbd budget. This proposed amendment would have on page 2 line 11 for item 5 the number 6 become 8. The table page 3 line one add two row one for each parcel. With the corresponding information and the total online 16 for item 5 should be updated to 74,211. 99. Percentage should be updated to 9. 051 . For the Fisherman Wharf cbd the one parcel is 5,868. 67,. 848 of the total assessment budget. If the board passes these the city can vote in both elections. We both elections. We will answer questions from the committee. Thank you very much. Colleagues questions or comments . A clarifying clerical question. I may have missed it you are can requesting to five and six to add parcels. No, just agenda item 5. I wanted to at that i did receive a request from supervisor mandelman whose district includes cass pro benefit district Castro District that we move the amendment that was verbally presented today. Mr. Clerk maybe we could go to Public Comment. Any callers on the line . Mr. Chair, operations will check for callers in the queue. For those connected to the meeting please press star and three to be added to the queue to speak. If you are on hold continue to wait until you are prompted to begin at the beep. If you are watching on 26 or through sfgovtv, if you wish to speak please call in by following the instructions on your screen. 415 6550001 and enter 145 4314683. Press pound twice and star followed by three to enter the queue to speak. Any callers on this item . Yes, i have one caller in the queue. Thank you. You have two minutes. Caller the item on the reemployment ordinance. Right now we are on agenda items 5 and sixty the government oversight and audit to authorize the mayor to cast ballots in the affirmative for proposed cbd formations in districts in the castro and fishermens wharf. Are these items you are calling on . Caller i will pass for now in the queue. You are referring to item 8 that is coming up. Any other callers . Thank you very much. Thank you, operations. Hearing no further callers, Public Comment is now closed. I would like to move that we accept the amendment to item 5 that was verbally presented. Mr. Clerk, please call the roll. On the motion to amend offered by supervisor mar to add additional parcels to agenda item 5, peskin. Aye. Haney. Aye. Chair mar. Aye. There are three ayes. Thank you, mr. Clerk. I would like to move to recommend item 5 as amended and item 6 as Committee Reports for the june 23rd meeting of the board of supervisors. On this motion mr. Clerk please call the roll. On the motion offered by chair mar. Vice chair peskin. Aye. Haney. Aye. Chair mar. Aye. There are three ayes. Thank you. Mr. Clerk, please call item 7. Resolution urging the department of Public Health to work with the office of the chief medical examiner to conduct epidemiological post motemcovid19 testing and Contract Tracing of deceased San Francisco residents and urging the office to conduct surveillance swabbing of all decedentses to properly identify and certify deaths from the covid19 virus and monitor community spread. If you wish to call on this, please call the Public Comment number and enter 145 1314683. Press pound twice on to connect and star and three to speak. Thank you, mr. Clerk. Supervisor peskin, the floor is yours. Thank you, chair marand supervisor haney and thank you to doctor Susan Phillip and michelle rip be from the office of the chief medical examiner who are joining us in this virtual meeting. I want be to thank them for working with my office. I do have amendments to suggest. This was brought to me through my former colleague david chu who indicated this type of surveillance swabbing of deceased individuals under the corner of al lameadda county has been going on for some time early in the covid19 pandemic and i contacted the Coroners Office pathologist in that county and came up with this piece of legislation that is before us. I have some suggested changes but i would like to start by introducing duketor sues wa r comments. Thank you, supervisor peskin and mr. Chair and to the committee for the invitation. Yes, the purpose of this resolution is something that we feel is very important at the department of Public Health. The intent is to ensure we understand all of the epidemiology of people deceased in San Francisco related to covid19. This is important for a couple of reasons. First and foremost we want to make sure we can ensure Occupational Health and safety for people working to revive or care for an individual at the time of their death. We want to do Contact Tracing with household members, and we want to understand the epidemiology of covid19 in San Francisco n as well as we can for public response. We believe testing in this fashion is very useful. To that end, we in San Francisco have been doing that in collaboration between the department of Public Health and the office of chief medical examiner since early march. When we were having difficulty in securing our supplies we prioritized testing persons that were being evaluated at the office of the chief medical examiner for these very reasons. We have done that informally sincerly march and formalized that process by providing the testing kits since then. There are a broader range of entities that may come into contact with these descents. We are working on a health order to be sure we have a broad net to allow th the testing and understand the implications of the testing. I appreciate the thought behind the resolution and very much agree with the importance of it. Doctor, phillips, i know my former colleague katie tang on loan from the airport to the department of Public Health or the Emergency Operations center did suggest some changes last evening which i am happy to go through with you because of the compressed time. I have not had a time to get back to katie tang or to you about that. I am happy to go through the three suggested changes and get your thoughts. I think she suggested that on page 2 lines 9 through 17 be stricken. I might have some arguments as to why i would push back on that. I would love to hear your thoughts on that. The portion of lines 9 through 13 really says that we at dph do not will not about testing tools not approved by the food and drug administration. We strongly suggested that that laboratories including ours use testing for covid19 that has been authorized under an emergency use authorization by either the cdc or fda. In the early days there were a lot of players in the market for testing. We needed reliable information. There were important Public Health actions following out of testing. There are reputestable laboratories that have the ability under regulations to do their own validation of testing. Some of our academic partners have done that to good effect. It is not a hard and fast rule, but our general guideline is to mostly want to promote the tests that have been review by fda for the reasons stated. That would be for my suggestion for lines 9 to 13. For lines 14 to 17, should i read those or comment on them . As you like. I am sure before all three members of the committee as the medical offices have begun surveillance swabbing of the deceased individuals which is easy to administer. I lost it. It is a process to contribute to the states efforts. Suggest not to strike but acknowledge. We have done this in San Francisco working closely between the office of chief medical examiner and dph. San francisco could be added to the list as well. I now understand what katie was asking. The only question is that my understanding is the swabbing of deceased individuals that commenced in early march by San Francisco was not for all des see debts but ones with respiratory issues that could potentially be covid19 positive . That was according to the cdc guidance for testing which is not yet expanded to all deceased but it says if the office has reasonable to believe there was a respiratory condition prior to death or concern it might be. There is quite a bit of leeway there. It is based on the medical and expert judgment of the persons in the office of the chief medical examiner, correct. The only reason i am bringing that up is because and i am not a doctor as you well know. My understanding is that surveillance swabbing by definition would be everybody. For a random sample but not surveillance if you are only testing deceased who showed covid19 symptoms . Is that fair . That is correct. We started with a more focused effort to test deceased. Then with this health order in development and that we are working with stakeholders on we would move more toward the true surveillance effort of all people who die in San Francisco. I mean i think this is a minor issue. Given that and given my understanding about the ore abor offices where we are doing true surveillance swabbing as described to me, i would be inclined for accuracy to keep San Francisco off that list. I acknowledge and appreciate the fact we have been doing targeted deceased testing since early march. Yes, what i would say what we are proposed with this health order under development we go beyond what is done in many of the entities. I would need to look at each of them. It would go beyond the cases handled by the office of the chef medical examiner. We try to be more broad. That is getting at your intent to have a true surveillance citywide of all deceased. Page 3 lines 9 through 11. Page 3 lines 9 through 11, this was the ask to go back and do retrospective analysis and comparison of cases that may have occurred or really looking back to do in depth evaluation of people who may have died to see if there could have been covid19 in San Francisco prior to the first cases detected here on march 5th or announced on march 5th. What we suggested is that there is such a continued need for improvement in the way we do our ongoing Immediate Health response based on what we know, including increased testing we are planning moving forward of descents and following up. This is important to know from an overall understanding, but it will have limited impact on our policy or immediate action. What we are suggesting is could there be a clause that says as resources allow we will do the evaluation when we truly may have been seeing initial cases in San Francisco but not to devote a lot of limited Department Resources to doing that at the moment. I think there are two paragraphs here that are at issue. One is the last clause in paragraph that starts out Health Officials have warned. Getting rid of and i dont understand why we would want to i dont want to quibble in order to have reliable accurate data Public Officials and policymakers can utilize to manage this National Emergency and its local impacts. I am not sure why we want to take that out. That is hooked to the next paragraph. Depending upon sufficient resources. I would say this is a resolution urging. It is not an ordinance. In april of itself a statement of in april of itself it is the a policy. Short of an ordinance it is implicit in what we are saying. I would be reluctant to add those words. I understand your Human Resource constraints, and i understand relative to physical constraints, labs and lab testing, those are not issues. Certainly Human Resource constraints are an issue. I understand that and respect that. In so far as a resolution urging, i would not be inclined to take those two amendments respectfully. You can push back on me and the committee and we can hear from ms. Rippey. I understand. Thank you. I think i dont have a strong push back except to say that i am talking from a Public Health perspective, i dont know that having that information would drastically change what we want to do to protect the public now and moving forward. I think that the focus on really identifying and understanding the issues of the outcomes, infections, deaths are the areas that i want our teams to focus on moving forward. I agree with you this is Important Information to have. We are of the same mind of getting the information so we have a fuller picture of what is going on. Thank you, doctor. Ms. Rip be anything to add or subtract on behalf of the office of the chief medical examiner. The office of the chief medical examiner and the acting chief medical examiner completely support all of these efforts. We have been working closely with the department of Public Health and with their continued supplies and resources we will be able to enact this proposal as it is written. Thank you, ms. Rippey. Subject to Public Comment i would like to take the suggested delation on page 2 of lines 9 through 13 and then at line 15 change the word has to have, and then make those changes after Public Comment and send the items to the full board with memes if that with recommendation if that is the will of the committee. Thank you. Why dont we go to Public Comment. Mr. Clerk any callers on the line . We will check to see if there are callers. Please let us know if callers are ready for those that connected via phone press star and three to be added to speak. In the hold wait until you are prompted to begin at the beep. On cable channel 26 or streaming or through sfgovtv if you wish to speak call in by following instructions on your screen. 415 6550001. Enter 145 4314683. Press pound twice and star and three to speak. Do we have any speakers for agenda item 7 . Yes, i have one caller in the queue. You have two minutes. It appears the caller has hung up. No callers in the queue. Thank you, operations and mr. Hearing no further callers, Public Comment is now closed. Thank you, mr. Chairman. While we have the me office and doctor phillip on the line, i want to ask if they could comment on relative to the swabbing and surveillance that has been done whether there is any data on that that they can report to this committee. Supervisor, i do not have those data in front of me at the moment. I apologize for that. I will send those information and that data to your office and the committee through the clerk to share. Thank you, doctor. From the me office we have had three that were analyzed. Thank you. What was the test . How many tests were administered administered . I dont have the exact number. I can make sure that gets forwarded to you. Thank you, ms. Rippey. Supervisor peskin a motion . Yes, i would move as previously stated that on page 2 lines 9 through 13 be stricken and on page 2 at line 15 the word has be replaced with have and then with those items to the full board with positive recommendation. Mr. Clerk please call the roll. On the motion that the resolution be amended on page 2 and then recommended as amended to the board of supervisors, vice chair peskin. Aye. Haney. Aye. Chair mar. Aye. There are three ayes, mr. Chair. Thank you, mr. Clerk. Can you please call item number 8. Emergency ordinance temporary creating a right to reemployment for certain employees laid off due to the covid19 pandemic if the employer seeks to fill the same position previously held by the laidoff worker or substantially similar position as defined. Members of the public call the Public Comment number. Enter the access code, press pound twice to connect to the meeting. Then press star followed by three to enter the queue to speak. Once again, mr. Chair. I am in receipt from your memo asking this to be on the agenda as a Committee Report. The back to work emergency ordinance is before us today. As we grapple with the covid19 crisis there is a related crisis going. Over 100,000 in San Francisco filed for unemployment since the state of emergency, this, too, is now a state of emergency for laid off workers. The scope of Unemployment Crisis is greater than any since the Great Depression representing hundreds of thousands of livelihoods and families in economic uncertainty. This crisis is not unique to San Francisco. We are uniquely positioned to lead in addressing it. This is a union town. A city that has long held the rights of workers to fair treatment and terms of employment. That is a city unafraid to be bold and carry the torch for workers and new trails for Economic Justice and fairness. This ordinance is bold. We must be bold to address the Unemployment Crisis. This is novel because the circumstances we face are novel. This is urgent because this crisis is urgent. This is based on a clear simple idea. If you are laid off in an emergency if and when your job becomes available again it should be offered to you before a new applicant. Covid19 is a crisis for workers and businesses alike. The cover of the crisis should not be used to treat workers unfairly, replace long time and senior employees with younger or cheaper alternatives. We know most employers will bring back workers laid off before considering new applicants. This ordinance makes this a requirement for all covered employers. This is about fairness in doing what is right and not a new idea. The right to recall for laid off workers is in all collective Bargaining Agreements. What is new the conviction it be extended to unrepresented workers to weather the storm. We know this is right and just. We know as groundbreaking law it is important that we get the details right. It has taken time to bring the back to work ordinance forward to the committee. We have taken this time to work with stakeholders from the business and lane borcommunity labor communities to make this the best it can be. I will be proposed a number of amendments. Before that we want to offer some of the context this ordinance is being considered under. We will hear from two presenters today. First josh, the director of Workforce Development at eewd sharing updates. Katie, staff attorney for legal aid at work presenting on the impact unemployment has on individuals and families. The floor is yours. Thank you, chair mar, supervisors. Good morning. Direct torn of Workforce Development in the economic Work Force Development. Thank you for inviting me to share the information and some of the anecdotes and data that really speak to the crisis and elements of the unemployment situation in our community that you spoke to, supervisor. I am going to share a screen. This is data that i am going to present with respect to our offices receipt of war notices. These are notices that employers of particular size and scale depending on the federal or state requirement, typically 75 or less 75 or more employees at a Company Requires triggers a requirement during layoff to provide notices to the state as well as local jurisdictions. The mayor, president of the board of supervisors and the local Work Force Development board, which is our office. I am going to share this information so you can see what that means in realtime as we track this information. I know the ordinance the supervisor looks at the very first emergency order declared by may or breed february 25th. We will look at data after that date to share. My screen is shared with the committee here this morning. We have set up our tracker to february 25 through the latest date of war notices we process which is the weekending june 5th. We need a week to two weeks to input and update. This is the information current just about to about 12 days ago. From february 25 to june 5, we have received 352 war notices affecting 324 different businesses and the number of affected employees is 38,994. We are able to see some information. You can see the biggest wave of those notices was received the weekending march 30th. 15,309 employees affected by war notices that our office received that week. You can see we log our team worked hard to make sure we have identification of the impacted industries. In the largest sense and we just crossed more than half. It looks around accommodation and food Service Employees most impacted followed by arts and entertainment. That is a lot of the performance related work in the Industries Related to the entertainment that happens in the city and county. It gives you a sense what is happening on the groundout there as we shared with your office. We also keep informationtic to each employer. You will see in most instances the employer indicated these are believed to be temporary layoffs. 29,633 of the 38994 employees. We want to estimate closing on 80 of those employees are impacted on what is believed to be a temporary basis 4600 on permanent basis. For context as well, over the same time span in 2019 from february 25 of that particular date through june 5 of 2019, we only received 13 mos impacting 709 workers. A snapshot what we see with unemployment at our office. We had something we look at very much. We get monthly reports. We are just now starting to see the unemployment data from the state Employment Development department for San Francisco residents looking for work. This is a brief table here to give additional context. This is a chart that shows where we were in terms of unemployment a year ago. We were at 2. 1 . The way the state reports unemployment. It is a simple answer to a simple question. Are you looking for work . Last time 11,900 san franciscans said yes, i am actively looking for work. That dropped 1. 9 , 2. 3 . You will see for the year we averaged 2 unemployment. Sometimes a little more and sometimes a little less. That was san franciscans actively looking for work. March of this year we see an uptick to 3 . That means that we had in the two weeks following shelterinplace increase of 4,000 month on month from end of march compared to end of february. Then when you look at april this is the first of the data coming in during the real hard escalated impact of coronavirus of the safe guard we saw unemployment jump to 12. 6 . Just to give you a little context in terms of the nature of the impact. This graph visualizes what that means. 10 years ago during the economic recession, Great Recession that we spoke of, there was at that time a record high in unemployment in january 2010 Led Community advocates, policymakers, employers to adopt a mandatory local hiring ordinance for construction projects. That year unemployment was then record high of 10. 1 as of april we are at 12. 2 . A couple other data pointings. This gives you a sense of what is happening and data that speaks to the very real urgency workers face that supervisor mar presented to the committee. Unemployment claims we have new data we received from the state from the week we are talking about for purposes of the ordinance february 25th date. That was the date of emergency order. From the weekending february 29 to the weekending may 30th, the state received a total of 159,193 new Unemployment Insurance claims from san franciscans. By context the mayor spoke to the fact during the 2008200 the Great Recession. Supervisor peskin was a leader at that time. The unemployment claims in that era was 45,000 and we received nearly 160,000 to date. To give a little bit of context what we are doing at our office. We are the convener of the Work Force Board working with labor organizations and employers and other departments to really meet the needs of those impacted workers directly in the case of staff and hardworking Service Providers on the ground, 45 different communitybased organizations. Particularly the Neighborhood Job centers that are on the front lines in seven different neighborhoods. Citywide job center operated by goodwin and seven cbo based neighborhood centers. In almost every since stance, one in each district focuses on neighborhoods of need. We have presented and our director presented our effort goes to stand up to the work force hot line staffed by the office of economic work force Division Staff and Human Service agency represents and selfhelp from the elderly and metta to make sure we are available to answer calls up to six different languages seven days each week. Since the order we received nearly 4,000 calls. Questions around unemployment, helping to alleviate the questions that come up in the challenges to make sure to get through to Unemployment Insurance. The state is working hard, they are overwhelmed like a lot of systems are experiencing strains. We support the state to answer questions as best we can. Nearly 1,000 participants on the weekly Rapid Response webinairs where our Staff Services team are an addition the state of california and the Labor Council working with airport workers an hour and hour and a half of question and answer. I will conclude and say on behalf of our department i want to express thank you, supervisor mar, to work to address the concerns raised in various form forums. As someone who has answered phone calls myself to make sure we are staffed on the hot line, it is a big question folks have. If i am laid off will i be able to return . In the case of collective Bargaining Agreement that is the rock of gibraltar. The Labor Movement is the ability to return and seniority. It is definitely important to have tools we can to make sure if the temporary layoffs get everyone back to work as soon as possible. With respect to the role you have created and thank you to edward in your office for working with us and the dialogue with you personally. The role for our office we believe we have the infrastructure in place to perform the responsibility ifs, particularly in the emergency period of the ordinance. We will be upfront about being sure we have the capacities to meet the need and a lot of staff is the citybuilt staff fielding phone calls, particularly the by link guam calls and other lack languages. We are committed to this resource and working with you. Thank you again. Thank you for all of the work you have provided for workers impacted. The multilink gal hot line you the hot line and website is most comprehensive list of resources that have been created to support workers and businesses. You guys have played an Important Role in helping workers and businesses weather the storm. I look forward to having you add if the board moves forward with the adoption of back to work ordinance, information about this new policy and worker support benefit. Thank you so much. Colleagues, any questions . I dont have questions but i have comments and questions for you as sponsor. Why dont we hold that. I want to go to the second informational presentation that we had scheduled with katie who is staff tore for legal aid at work and she has been providing Important Information to workers who have been laid off. The unprecedented number of workers laid off locally in this crisis. Thank you for having me here to speak. As supervisor mar mentioned. I am a staff attorney at legal aid at work, a nonprofit in San Francisco dedicated to workers rights and helping families with low income find stability and justice at work. The reason i am here today is to make clear the extent to which workers have been forced out of jobs by covid19. Especially the Lasting Impact of these job losses on workers and their families. At legal aid at work we run a help line and remote legal clinic to help workers. Since the shelterinplace order we have been getting more calls than offer. Normally we get 3,000 calls in a year in two months we received over 1,000 calls. Many felt unsafe at work, worried about losing their job or pay to take time off. Many were calling because they had been laid off and didnt know what to do. As he mentioned, according to the Employment Development department the state unemployment has risen to 14. 4 and 12. 6 in San Francisco county, with the biggest job losses occurring in leisure and hospitality. Over 50,000 between San Francisco and san mateo counties. Many workers are low paid immigrants and people of color. The reason this is critical to talk about is because the longterm consequences of unemployment is associated with significant harms for families and communities. Research by the urban institute on the consequences of longterm unemployment found that longterm unemployment can lead to in addition to loss of income, of course, lower wages at the point every employment leading to a lifetime of lower wages for that worker and increased likely wood of workers abandoning the labor market altogether. It also found that longterm unemployment is associated with worse selfreported health and wellbeing. Lowered lifespans and possible decline in Mental Health. For the children of people who experience longterm unemployment, it results in lower grades, lower graduation rates, increased cognitive stress. These are harms that dont impact only the individual but the entire community. It is critical that workers are able to stay home when working is unsafe. Only asked to return to work in safe environments. If workers are not given the opportunity to return to work, families will face additional risks and hard ships. Thank you so much for your work to support san franciscans through this difficult time and thank you for giving me this time to speak with you. Thank you for your presentation. Thank you for the important work you and legal aid have been doing to support laid off workers navigate unemployment and weather the storm. Colleagues, any questions from legal aid at work . Thank you for your presentations. I want to move ahead with just some quick overview to the back to work ordinance, key provisions and talk through the outreach and input process we have engaged with over the past week. Then i will present a summary of the amendments that i am presenting today. For the back to work ordinance as introduced, i wanted to go over the key provisions. This is the first hearing we are having on it. Laid off workers will have the right of first refusal for jobs if and when the former employer reopens and rehires. Which is going to start to happen at an accelerated rate in the coming weeks and months. Hiring will be priority by seniority by each job classification. It requires wages and scheduling and benefits unless the employer is unable to maintain these terms in which case they are exempted. The former employees position is not rehired they will be offered any similar position they are qualified for. The employers must provide notice to the city of layoffs and provide information on available city resources. In terms who is covered by the back to work ordinance. The requirement applies to any employer who lays off 10 or more employees within 30days starting on february 25, 2020. In terms who is not covered, employers with fewer than 10 employees and this is on the ordinance as introduced employers with fewer than 10 employees are exempt. Employers who do not layoff less than 10 and employees covered by collective bargaining are exempt. We know workers are facing this crisis, so are Small Businesses. We know Small Businesses need support now more than ever. I will shortly share the changes we are making in this ordinance to address the concerns we have heard from Small Business owners among others. I want to be clear we have met with and worked with more business stakeholders than anything else we ever worked on including Small Business owners and commission and chamber of commerce, golden gate restaurant association, sf committee on jobs, sf Hospital Council, sf hotel council, Manufacturing Council and sf city. In addition to their feedback we have worked with Worker Centers and labor advocates in preparing these amendments. I want to give an overview of the amendments before we go into discussion about the ordinance and to Public Comment. I want to ensure the public is informed about the changes i intend to make today. I want to note that we all have received letters expressing concerns about this ordinance from Small Business owners and Small Business commission. I believe firmly we have addressed these concerns with the amendmentses presented today. These include exempting employers with less than 100. This is on larger employers. Iin alignment with the office of Small Business. The process of preparing this has been difficult as we acbeinr acknowledge it is a tradeoff. We are removing protection for workers. This is the difficult decision and one we do not make tightly. We have been convinced of the necessity by Small Business stakeholders including Small Business commission, office of Small Business and council of district merchants. We exempt Healthcare Operations employers. In collaboration with Hospital Council, we want to also limit administrative impacts on Health Care Providers due to unique and urgent circumstances. We are therefore exempting them from this ordinance. We are removing th the 90 day retention requirement. We understand the emergency they are operating under and are not in a position to guarantee employment retention. We dont know what may come in the next 90 days. We are removing that requirement. We are adding an employee misconduct carve out for reemployment offer. In cases where former employees committed misconduct to justify ending employment and where it was discovered, the employer will be exempt for having to offer reemployment. We are carving out severance agreements where there is a formal agreement of severance this would not over rule that and they would be extent from this law. We are removing most of section 5a4 and 5a5, the provisions that required list of laid off workers to be provided to the city with workers authorization. These were the most burden some administrative requirements for businesses and city agencies. We removed them. We are preserving that requirement that eligible workers be notified about layoffs and be provided with hot line number to call to access further information and support. We are offering email and text. Requiring mailing of notification to workers only if email and text are not an option. This makes it easier to quickly bring people back to work and represents a careful balance between the need and preserving a reasonable duration of job offers for those seeks reemployment. We clarify the notification period is longer for retroactive notification. 30days from the Effective Date of the emergency order. This is a cleanup change to clarify the notification timeframe to laid off workers for employers who made layoffs before this is effective. We are authorizing olsc to issue regulations and do rule making to provide clarity and guidance and minimize litigation without requiring staff for administrative work. Given did hiring freeze and limited staff this is the most responsible choice. We are directing layoffs and reemployment notifications to oewd and replacing the hot line included in the employee notification with one managed by oewd. Oewd already received layoff notifications under both the federal act. It makes sense to receive these additional notices, too. In addition owwd manages a hot line for resources to workers employed or unemployed. This will make it more accessible to those who need it the most. We have updated the findings to reflect the numbers on unemployment claims filed by those in San Francisco. That is an overview. It is quite a list. We are advised by the City Attorney they are non substantive. We can act on the amendments today. Colleagues, any questions or comments before we go to Public Comment . I can hold my questions until after Public Comment. Me, too. Thank you. Mr. Clerk, why dont we go to Public Comment. Any callers on the line . For those connected press star and 3 to speak. For those on hold in the queue please continue to waits until prompted to begin at the beep. Those watching on cable channel 26 or streaming or through sfgovtv if you wish to speak, please call in by following the instructions displayed on your screen. 415 6550001. Access code for today 145 4314683. Press the pound symbol twice and star three to speak. Do we have any speakers for agenda item 8 . Yes. There are eight callers in the queue. Caller good morning. I am matthew toy. I am a worker. I have been a worker at tar teen for 2. 5 years. I started in the factory in alabama street in San Francisco. In september i moved to the berkeley location. I am thankful to have gordon mar give us input and ask for our input. This is a hard union antiunion campaign from our employer. Right now we are in a situation where many of us are laid off, and we are not too sure if we are going to come back. Right now tar tain is hiring people at lower wages. For 18 an hour are now minimum wage is one example. When we first started to give input to gordon mars office. It was just we wanted this ordinance and we wanted our input to include a lot of city workers. We really appreciate the way that the office of gordon mar made sure to reach out t to the business and labor community. There is a smaller idea now expanded. A lot of workers dont have any protection to come back to work because most of the time it is due to bargaining. I really want to be able to see this ordinance through and i support this ordinance. Thank you. Next speaker, please. Caller i am john. Shop stewart at anchor. We fought long and hard for a contract that had this particular wording in it. I think i it would be beneficial to all workers in San Francisco to be covered by that same wording. My one comment would be 100 employees or moi mois mo or ma high bar. Think about that with your decision. A lot of workers are in the industry with companies with a lot less than 100 employees. I fully support this. It would be great for the community. That is my comment. Thank you for your time and good luck. Thank you for your comments. Next speaker, please. Karl is the third speaker still connected . Am i on . Yes, we are ready for your comments to agenda item 8. Caller thank you. I am denny miller. I live in San Francisco and i fully support this proposition. I agree with the earlier caller about 100 employees. That is a lot, especially in San Francisco. I would like to definitely think about reconsidering that number. I think there is a very, very important proposition. I support it 100 . Is thank you very much for your comments. Next caller, please. Caller yeah, good morning. I am pat thomas. I am a district 5 resident, employee at tar teen bakery as well. I am calling to express my support for this ordinance. As someone who has witnessed firsthand the way that the company will fight tooth and nail to undermine the employees attempts to unionize, i would be heartened to see the city enact this to ensure employers dont take advantage of this pandemic as an opportunity to clean house. I dont see this ordinance as being particularly burden some on employers as it doesnt require businesses to hire people before they are ready to, only when they do the jobs are offered to workers who had them before. As someone who has been working to establish new footholds for organized labor in this city, and who doesnt believe that a pandemic like this should constitute a setback for such efforts. I urge the board to vote yes on this ordinance. Thank you. Next caller, please. Caller i am hope williams. I am a board member of the Harvey Milk Club and advocate for union workers. I would like to thank the Committee Members and supervisor mar and the cosponsors of this item, haney, preston, safai and fewer. From the economic Recovery Plan to the listing of shelterinplace, the city is prioritizing the needs of businesses. What about the workers. Workers create the wealth of the businesses. They are more essential now than ever. They need protection. They need support from the city and access to reemployment. This policy should be a nobrainer. Laid off workers should be rehired before being replaced. This shouldnt be controversial we cannot replace vulnerable workers. The Democratic Committee has fought for the lanegor movement and voted to support this. We urge you to support it. Thank you. Next speaker, please. Caller good morning, supervisors. I am katie hansen with the california restaurant association. This fames to take into account the manner in which restaurants operate. Those that remained open on limited service modelings during the crisis did so with many of the fulltime fixed costs and challenges. Under this new mandate being proposed restaurants would be forced to rehigher staff based on seniority rather than need such as chefs and cooks. Providing up to 10 days to respond depending how it is offered is unworkable for Restaurant Community employers. An employer will not be able to offer open positions to anyone else due to the level of seniority. If there are four positions open it could take a month to hire those. When restaurants are barely able to reopen, this will further damage the ability to successfully operate. It has detailed requirements for Record Keeping and providing notices to employees, employers and the city regarding layoff and reemployment offers. Restaurants dont have the in house personnel to process the recordkeeping when they are trying to reopen doors and struggling to comply and comply with health orders. This will delay the ability of restaurants to reopen to further unemployment and lead to the loss of tax revenues to San Francisco. We urge you to oppose this proposal as drafted as it would have a detrimental impact on the entire Restaurant Committee in San Francisco. Thank you for the opportunity to provide testimony. Next speaker, please. Caller thank you, mr. Chair. I am bermita. An organizer with the longterm workers. I want to echo some of the statements that supervisor mar said. San francisco is a union town. When we talk about being a union town, we could say i it is a lar town. We want equity for all workers, not just people who have the luxury of being luxury or goodwill of having a union contract. We need to protect all workers. Right now due to covid19 a lot of workers recently laid off do not have a contract, do not have the right to go back. We need to provide that to them through there legislation. I have had numerous calls which workers laid off said do you know if i will have my job back in this is our only recourse to pay the rent. How will we do it if the restaurant get us back to work . All of this legislation will do is give security, needed security to those workers that are suffering right now. They are struggling in the city and county of San Francisco. It will live them security that once the restaurant opens it will call them by seniority and of their classification. No one is expecting everyone is going to be called back immediately, no one is expecting not the workers, not this legislation doesnt mandate that everybody be called back immediately. It is when the restaurants are in line to begin operations, then they will go back and call the persons that already have been working there and know the procedure and how to operate and how to do what they do best. Thank you. Next speaker, please. Caller i am hall. I was laid off had march after working for two years at the bakery. I have been involved with the union. Basically, every time i talk to my friends and family i am asked if i get my job back. I have no idea. It is very stressful to be in the state of limbo. Most Service Workers are in a similar place. We know it wont happen all at once. It will take a long time. We deserve to know we arent replaced. Four of the six people i live with are in the same position. We dont all work at the same place, we have the same type of jobs. These are careers. I dont want us to find our positions on craigslist. It is the simple thing to do and the right thing to do. Thank you. Next speaker, please. Caller hello. I work at coffee roseters in San Francisco. I am calling to support the current item. I think it would be really important to also prioritize black and Indigenous People of color who have put time in, who have seniority. These are like every day people who build their careers and Service Industry and it is important that the Restaurants Community step up to make the appropriate call and to center their workers and do better on hr. Thank you for your time. Thank you for your comments. Next speaker, please. Caller hello everyone. For me the situation feels familiar. I came from new orleans when the hurricanes came through. That wasnt the only storm. There was an economic storm that completely wiped out communities totally untouched with flood waters. My grandmothre had been with the same legal firm for 30days. She was replaced by people. My black cousins were fired. White colleagues got jobs back. The exact same factors and exact same reasons why those decisions were made in louisiana in 2003 are the same factors that those decisions are going to be made in San Francisco today. This is very personal to me. This is not hypothetical. I know exactly what will happen. I am furloughed. I am not advocating for myself. I am for the grandmothers. I dont want families to suffer. This would have been alive safer. I urge you to pass this ordinance. Thank you. Next speaker, please. That completes the queue. Thank you. Hearing no other callers on the line, Public Comment is now closed. Colleagues do you have questions or comments . Supervisor peskin . I appreciate your work on this and all of the Public Comment we have gotten and your acknowledgment that we have heard from a lot of folks, including some you didnt mention, nonprofits that many of us hold near and dear. I am relatively certain that the changes you are proposing today will go a long way if not all the way to meeting the concerns that we heard expressed in those quarters, but because i have not had i only got the amendment last evening and given this morning havent had a chance to reach out to those folks to make sure they feel the same way. My proposal would be to send to the full board without recommendation. It is going as Committee Report so i can get between now and tuesday to get with those folks to make sure it is meeting their concerns, addressing their concerns. Thank you, supervisor peskin. I appreciate your support of the ordinance and consideration of the amendment. I understand your interest in checking in with some Key Stakeholders. I also appreciate your willingness to move this forward along the timeline that we have proposed, which is having the full board vote on it on june 23rd because we would like to get this enacted as soon as possible. Businesses are starting to reopen and rehire. Thithis is an an important timeo move it forward. Supervisor haney. First of all, thank you and your staff, supervisor mar. I am proud t to cosponsor this and workers and those who collaborated on it. I appreciate the amendments. They address some of the issues that have come forward. We absolutely do need to be prioritizing workers during this time and not seeing a situation where people are pushed out of their jobs during this pandemic and having rights violated and not allowed to come back. There are a number of folks who called in from restaurants or cafes, and it is my understanding with the amendment that most of those types of businesses would be excluded because of the sort of size of employees that are required. What are your i would like to hear more what we can do for folks in those situations. The folks from tar teen and i dont know if that would be a business that would be excluded. I understand that, you know, the reasons for the Small Businesses excluded. Would you speak about that and for some of the folks who called in who may no longer be covered by this legislation. Thanks for the question, supervisor haney, around the amendment that increases the covered employer thresholds from 10 to 100 or more employees. This was made, as i stated, to address the concerns of Small Business community and Small Business stakeholders about the challenges that this requirement would present them as they navigate reopening their businesses, and you know it was made with the understanding that Small Businesses face or smaller employers face more challenges than larger businesses with a larger pool of laid off employees to draw from. Yes, that is true. It does reduce the number of businesses that are covered. [please stand by] thank you, and i know that theres legislation at the state level that may impact or accomplish similar things or and is this how did this interact with some of the legislation thats been potentially proposed . Or proposed to be heard at the state level, is there a similar efforts that are happening in the states. Theres a similar proposal a right to reemployment proposal that was included in a state bill that and so that is you know, its still under sort of consideration on a state level. Its my understanding that its uncertain whether that is going to make it through legislatively on a state level and be adopted. So i think that this is an example of San Francisco, you know, helping to sort of lead the way on expanding workers rights and support for workers in a way that could help move the policy forward on a state level and in other cities. I know that l. A. Los angeles passed a similar ordinance but it was a much more limited in scope. And then other cities are considering it. Oakland and san jose as well on a local level. So i think this is where just like many of our progressive local labor laws that we have created here in San Francisco, it can help to benefit not just the workers here in San Francisco, but workers elsewhere by just sending a model, an example. Great, thank you. I appreciate that. Thank you for your work on this. Great. Well, thanks again. I just want to, again, to thank everyone that has provided input on this really on groundbreaking and bold but very important policy measures to support laid off workers in our city. You know, i want to thank all of the labor the labor and Worker Rights advocates that initially, you know, brought this proposal to our attention and who work with us closely over the last week. But also i want to thank all of the businesses, Small Businesses and the Large Businesses and the associations that weve worked with to craft the best possible policy that also that takes into consideration, you know, the needs and the concerns of the businesses and employers. And i want to thank the City Attorneys office, particularly jenica, the deputy City Attorney that worked on this with our complicated ancomplicated and gg legislation. And thank you to joss and the economic Work Development and pat mulligan in the labor standards enforcement who have also consulted with us and helped to shape this policy with the amendment. So finally, i want to acknowledge all of the work, incredible amount of work, that edward wright, my legislative aide, has provided on this this very complicated policy. And really excited to to really move this forward to the board. So i guess per supervisor peskins request to to have more time to to consult with Key Stakeholders around the amendment that were just presented and i would make a motion that we move this forward oh, i would like to make a motion that we accept the amendment that i presented today. Mr. Clerk, can you please cull roll. Clerk on the motion afterred by char mar to amend the emergency ordinance, vicechair peskin. Peskin, aye. Member haney. Haney, aye. Chair mar . Aye. Mar, aye. Mr. Chair, there are three ayes. Supervisor mar thank you. And then i would move that we have this item as a Committee Report to the full board without recommendations to the june 23rd meeting of the board of supervisors. Clerk on the motion that the emergency ordinance be forwarded to the full board of supervisors as amended without recommendation. Vicechair peskin. Aye. Peskin, aye. Member haney. Aye. Haney, aye. Chair mar. Mar, aye. Mr. Chair, there are three ayes. Supervisor mar thank you. Great. Mr. Clerk, is there any further business . Clerk there is no further business before the committee. Supervisor mar thank you, we are adjourned. Shop and dine in the 49 promotes local businesses, and challenges residents to do their shopping within the 49 square miles of San Francisco. By supporting local services in our neighborhood, we help San Francisco remain unique, successful, and vibrant. So where will you shop and dine in the 49 . I am the owner of this restaurant. We have been here in north beach over 100 years. [speaking foreign language] [ ] [speaking foreign language] [ ] [speaking foreign language] [speaking foreign language] [ ] [ ] ever wonder about programs the city it working think to make San Francisco the best place to work and will we bring shine to the programs and the people making them happen join us inside that edition of whats next sf sprech of Market Street between 6th is having a Cinderella Movement with the office of economic Workforce Development is its fairy godmother Telegraph Hill engaged in the program and providing the reason to pass through the corridor and better reason to stay office of economic Workforce Development work to support the economic vital of all of San Francisco we have 3 distinctions workforce and neighborhood investment i work in the tenderloin that has been the focus resulting in tax chgsz and 9 arts group totally around 2 hundred thousand square feet of office space as fits great as its moved forward it is some of the place businesses engaged for the people that have living there for a long time and people that are coming into to work in the the item you have before you companies and the Affordable Housing in general people want a safe and Clean Community they see did changed coming is excited for every. Oewd proits provides permits progress resulting in the growth of mid businesses hocking beggar has doubled in size. When we were just Getting Started we were a new Business People never saturday a Small Business owner and been in the bike industry a long needed help in finding at space and sxug the that is a oewd and others agencies were a huge helped walked us through the process we couldnt have done it without you this is sloped to be your grand boulevard if so typically a way to get one way to the other it is supposed to be a beautiful boulevard and fellowship it is started to look like that. We have one goal that was the night to the neighborhood while the bigger project of developments as underway and also to bring bring a sense of Community Back to the neighborhood. We wanted to use the says that a a gathering space for people to have experience whether watching movies or a yoga or coming to lecture. That sb caliber shift on the street is awarding walking down the street and seeing people sitting outside address this building has been vacate and seeing this change is inspiringing. Weve created a space where people walk in and have fun and it is great that as changed the neighborhood. Oewd is oak on aortas a driver for San Francisco. Weve got to 23ri7b9 market and sun setting piano and it was on the street weve seen companies we say used to have to accompanying come out and recruit now theyre coming to us. Today, we learned about the office of economic Workforce Development and its effort to Foster Community and make the buyer Market Street corridor something that be proud of thanks to much for watching and tune in next time for how i really started my advocacy was through my own personal experiences with discrimination as a trans person. And when i came out as trans, you know, i experienced discrimination in the workplace. They refused to let me use the womens bathroom and fired me. There were so many barriers that other trans folks had in the workplace. And so when i finished college, i moved out to San Francisco in the hopes of finding a safer community. And also, i want to recognize our amazing Trans Advisory Committee who advises our office as well as the mayor, so our transadvisory community members, if they could raise their hands and you could give a little love to them. [applause] thank you so much for your help. My leadership here at the office is engaging the mayor and leadership with our lgbt community. We also get to support, like, local policy and make sure that that is implemented, from allgender bathrooms to making sure that theres lgbt Data Collection across the city. Get to do a lot of great events in trans awareness month. Transgender people really need representation in politics of all kinds, and im so grateful for clair farley because she represents us so intelligently. I would like to take a moment of silence to honor all those folks that nicky mentioned that weve lost this year. I came out when i was 18 as trans and grew up as gay in missoula, montana. So as you can imagine, it wasnt the safest environment for lgbt folks. I had a pretty supportive family. I have an identical twin, and so we really were able to support each other. Once i moved away from home and started college, i was really able to recognize my own value and what i had to offer, and i think that for me was one of the Biggest Challenges is kind of facing so many barriers, even with all the privilege and access that i had. It was how can i make sure that i transform those challenges into really helping other people. Were celebrating transgender awareness month, and within that, we recognize transgender day of remembrance, which is a memorial of those that we have lost due to transgender violence, which within the last year, 2019, weve lost 22 transgender folks. Think all but one are transgender women of color who have been murdered across the country. I think its important because we get to lift up their stories, and bring attention to the attacks and violence that are still taking place. We push back against washington. That kind of impact is starting to impact trans black folks, so its important for our office to advocate and recognize, and come together and really remember our strength and resilience. As the only acting director of a City Department in the country, i feel like theres a lot of pressure, but working through my own challenges and barriers and even my own selfdoubt, i think ive been try to remember that the action is about helping our community, whether thats making sure the community is housed, making sure they have access to health care, and using kind of my access and privilege to make change. I would like to Say Something about clair farley. She has really inspired me. I was a nurse and became disabled. Before i transitioned and after i transitioned, i didnt know what i wanted to do. Im back at college, and clair farley has really impressed on me to have a voice and to have agency, you have to have an education. Mayor breed has led this effort. She made a 2. 3 Million Investment into trans homes, and she spear headed this effort in partnership with my office and tony, and were so proud to have a mayor who continues to commit and really make sure that everyone in this city can thrive. Our community has the most resources, and im very happy to be here and to have a place finally to call home. Thank you. [applause] one, two, three. [applause] even in those moments when i do feel kind of alone or unseen or doubt myself, i take a look at the community and the power of the supportive allies that are at the table that really help me to push past that. Being yourself, its the word of wisdom i would give anyone. Surely be patient with yourself and your dream. Knowing that love, you may not always feel that from your family around you, but you can what were trying to approach is bringing more diversity to our food. Its not just the old european style food. We are seeing a lot of influences, and all of this is because of our students. All we ask is make it flavorful. [ ] we are the first twoyear Culinary Hospitality School in the united states. The first year was 1936, and it was started by two graduates from cornell. Im a graduate of this program, and very proud of that. So students can expect to learn under the three degrees. Culinary Arts Management degree, Food Service Management degree, and Hotel Management degree. Were not a cooking school. Even though were not teaching you how to cook, were teaching you how to manage, how to supervise employees, how to manage a hotel, and plus youre getting an associate of science degree. My name is vince, and im a faculty member of the hospitality arts and Culinary School here in San Francisco. This is my 11th year. The policemrogram is very, ver in what this industry demands. Cooking, health, safety, and sanitation issues are included in it. Its quite a complete program to prepare them for whats happening out in the real world. The first time i heard about this program, i was working in a restaurant, and the sous chef had graduated from this program. He was very young to be a sous chef, and i want to be like him, basically, in the future. This program, its awesome. Its another world when youre here. Its another world. You get to be who you are, a person get to be who they are. You get to explore different things, and then, you get to explore and they encourage you to bring your background to the kitchen, too. Ive been in the program for about a year. Twoyear program, and im about halfway through. Before, i was studying behavioral genetics and dance. I had few injuries, and i couldnt pursue the things that i needed to to dance, so i pursued my other passion, cooking. When i stopped dance, i was deprived of my creative outlet, and cooking has been that for me, specifically pastry. The good thing is we have students everywhere from places like the ritz to we have kids from every area. Facebook and google. Kids from everywhere. They are all over the bay area, and theyre thriving. My name is jeff, and im a coowner of nopa restaurant, nopalito restaurant in San Francisco. I attended city college of San Francisco, the culinary arts program, where it was called hotel and restaurant back then in the early 90s. Nopalito on broderick street, its based on no specific region in mexico. All our masa is hand made. We cook our own corn in house. Everything is pretty much hand made on a daily basis, so day and night, were making hand made tortillas, carnitas, salsas. A lot of love put into this. [ ] used to be very easy to define casual dining, fine dining, quick service. Now, its shades of gray, and were trying to define that experience through that spectrum of service. Fine dining calls into white table cloths. The cafeteria is Large Production kitchen, understanding vast production kitchens, the googles and the facebooks of the world that have those kitypes of kitchens. And the ideas that change every year, again, its the notion and the venue. One of the things i love about vince is one of our outlets is a concept restaurant, and he changes the concept every year to show students how to do a startup restaurant. Its been a pizzeria, a taco bar. Its been a mediterranean bar, its been a noodle bar. People choose ccsf over other hospitality programs because the industry recognizes that we instill the work ethic. We, again, serve breakfast, lunch, and dinner. Other culinary hospitality programs may open two days a week for breakfast service. Were open for breakfast, lunch, and dinner five days a week. The menus always interesting. They change it every semester, maybe more. Theres always a good variety of foods. The preparation is always beautiful. The students are really sincere, and they work so hard here, and theyre so proud of their work. Ive had people coming in to town, and i, like, bring them here for a special treat, so its more, like, not so much every day, but as often as i can for a special treat. When i have my interns in their final semester of the program go out in the industry, 80 to 90 of the students get hired in the industry, well above the industry average in the culinary program. We do have internals continually coming into our restaurants from city college of San Francisco, and most of the time that people doing internships with us realize this is what they want to do for a living. We hired many interns into employees from our restaurants. My partner is also a graduate of city college. So my goal is actually to travel and try to do some pastry in maybe italy or france, along those lines. I actually have developed a few connections through this program in italy, which i am excited to support. Im thinking about going to go work on a cruise ship for about two, three year so i can save some money and then hopefully venture out on my own. Yeah, i want to go back to china. I want to bring something that i learned here, the french cooking, the western system, back to china. So we want them to have a full toolkit. Were trying to make them ready for the world out there. Welcome to members of the public watching the meeting. We will call the meeting to order. Secretary morewitz, will you call the roll, please. [ roll call ] great. Thank you, secretary morewitz. Well move on to the second item, approval of the Health Commission Meeting Minutes from the june which meeting . June 3rd meeting. Sorry. So commissioners, upon reviewing the minutes, does anyone have any amendments . If not, is there a motion to approve . I want to make sure theres no Public Commented. Before we do that, i want to provide information on the screen and verbally say the number. Thank you. If you want to call in, the in you can is 4084189388. Access code is 1463455741, and youll press pound twice in order to get on to the system. Then when you would like to actually make Public Comment, you dial star 3. All right. Do we have any Public Comment for this item . There is no Public Comment. Great. So commissioner, you can move forward with your comments. Thank you for that reminder, mark. All right, commissioners. Moving on to approval of the minutes from the tuesday, june 2nd, meeting of the Health Commission. Upon reviewing the minutes, does anyone have any amendments . If not, a motion to approve. So moved. Second. Ill do a roll call vote. [ roll call ] great. Thank you. The next item is the directors report. Good afternoon, commissioners. You have the directors report in front of you. It details much of the work regard to covid19 response. Im going to provide an update to you on that response. So many of the details will follow. I did want to point out that theres been a lot of press recently around our department and our response and especially wanted to highlight a really nice article about dr. Aragon, our Health Officer that was on the front page of the chronicle a couple days ago. I stand ready for questions. My update will go through our covid19 i believe thats the next agenda item. Actually, i apologize. Before we get to comments from you commissioners, i would like to see if there is any Public Comments. There is no Public Comments. Thank you. All right. We can move on to the covid19 update then. Great. Well, thank you, commissioners. So today i will provide an update of where we stand in terms of the data tracker that the data weve been tracking and that youve seen before. This is an exciting day in that we are we have presented our posting our indicator system, color coded system so sasan franciscans see where we stand with regard to our covid19 response and then our deputy Health Officer will be presenting our reasons and application for a variance as we move into our phases of reopening. But i did want to just acknowledge that San Francisco ans have done a terrific job of flattening the curve in our community. On behalf of the department, thank them for looking out for each other and thank you for stg home, covering your faces, and for frequent hand washing. The message today Going Forward until we have effective treatment or vaccine, dont stop. The virus is officia obviously l here. There is more than ever before. We have to practice safer behaviors, and still, the safest thing to do is to stay at home. But not everyone can do that. There are real negative consequences to our shelter in place. As you know, commissioners, in the past few months, our Testing Capacity has increased dramatically. Our personal protective equipment applies have improved, and we have dramatically expanded or Contract Tracing programs. Our behaviors are the most important tool to stop the spread of the virus, and we must remember that as a department, as community, as a city, we sustain the habits that have gotten us this far today. As the city reopens and as people move more, we expect increase in cases and hospitalizations. This is already the pattern in other places that have started to open up. Our goal is to keep morbidity and mortality as low as possible during this phase of the pandemic. We are still learning how risky certain activities are and how to reduce those risks. In this new environment, its important to know that the more you do and the more you move around, the greater your risk of contracting the virus. The virus spreads quickly and as we know, as weve seen, it can rapidly, overwhelm communities and the Health Care System. While we hope that wont happen, its certainly possible. Thats why we must be vigilant and flexible as we enter this new phase. This new phase will determine our ability as a community to manage our shared risk and determine if and how we can Work Together and apply safer behaviors that will slow the virus spread. So we will go into the indicator discussion and the reopening framework in a bit, but i did want to show you where we stand today with our covid19 response in summary. So please can we have the next slide. So today, we have 2971 cases of covid19 diagnosed in the city. Obviously there are more cases, but they have not everyone hasnt been tested. Everyone hasnt been diagnosed. We are nearing the 3,000 mark. Weve had 46 deaths over this period of time. Every death from covid19 is too many. Relative to other jurisdictions, our death rate has been thankfully low. You can see theres the rate of deaths has decreased pretty dramatically since about midmay here. Next slide. This slide should be familiar to you. Its been shown for the last few Health Commission meetings, this is updated data. At this time, were over 100,000 tests a day with an overall 4 positivity rate. We are running average over the last 7 days of over 2,000 tests a day. So we have more than met our target of 1800 tests a day in the city. That last bar gray bar on the tests done, the last gray bar on the right, that is lower because not all of the test results have been counted for that day. You can see overall weve had a dramatic increase in our testing certainly since april and may. Cases by race and ethnicity, the virus diagnoses continue to be disproportionally affecting certain communities, particularly in the latinx community. You can see half of our cases are diagnosed among the latinx community. There continues to be a disproportional impact on black africanamericans. Next slide. So this is our curve, our hospital curve going back now to midmay through june. So about 30 days worth of hospitalizations. The green bars. Youll recall when i showed you this a few weeks ago, we were starting to see a decrease, but there was another step down to about cases in the high 30s to low 40s. That is a significant drop from a few weeks ago when we were in the 50s. So two significant drops in the curve over these past few months. Youll recall that we peaked at about 100 cases in the hospital altogether. The light green bars are people in the icu, and the dark green bars are people in the medical surgical unit. We have at this time just 8 people in the intensive care unit across our Health Care System. Then the purple curve below are the people who are in the hospital who are tested for covid19, people under investigation, and you can see that over time, that number has decreased as well. So when we say we flattened the curve, weve actually decreased the curve significantly a couple times over the past few months. Again, this is an achievement that is to the actions of san franciscans. Were going to need their continued support and preventive actions so that this curve goes up as slowly as possible as we go to this next reopening phase. Next slide. So now i want to go to our indicators, to assess progress with regard to our monitoring of covid19 and give the commission an update on our metrics on this and, again, how we are choosing our specific color schemes so that people at a glance can tell where things stand. The Health Indicators includes the Hospital System which is really our key indicator right now. It gives us the best sense of what makes sense with regard to the virus. Confirmed cases, which obviously relates well, not obviously, but confirmed cases really relates to how many people we are testing, where we are testing, whether we are testing low or higher risk populations. Contact testing itself, our Testing Capacity, Contact Tracing, and then, of course, the all important personal protective equipment or ppe in the department. Right now, the indicators are overall favorable. So we do we are continuing a gradual reopening as of today. Next slide. These are colors that we will use to monitor these indicators. Again, so that people can see at a glance where we stand. Green means we are hitting our targets, that opening can continue taking into account other indicators and data. Of course, san franciscans should continue to take precaution. Yellow means evaluate the other indicators and Additional Data before loosening the stayathome order. Orange, consider pausing or dialing back reopening based on the status of other indicators and red is strongly consider increasing stay at home restrictions and possibly pause or dial back. So these are the colors moving forward. Next slide. This is a complex slide, but the goal of this is to provide you with the information about how we determine whether the colors of our indicators change. Im not going to go through it in detail, but it shows the cutoffs for proceeding to a new color based on data. Youll see that our categories are a healthy system. These are the rate of increasing hospitalizations, our capacity to treat severe cases, our capacity to treat severe cases in the icu, the disease situation with regard to cases and tests her day, and our Disease Control measures, our ability to perform Contact Tracing, and are we protecting health care workers. The key indicators on this are our Health Care System indicators, and no one indicator or color will determine our actions. Well have to take a look in the broad context of situation to determine whether we move forward, pause, or go backwards, but i do want to lead you through the top row here with regard to hospitalization. The indicator is the rate of increase in total covid hospitalizations. Its a rate because we want to ensure that if that we have an ability we hope that we have the ability to determine if there is a significant surge starting, that that will be best understood by a rate of hospitalizations. So triggers to raise to a higher level is increasing the threshold over a 7day period, trigger to a lower level would be decreasing over a 7day period. Green would be that the rate changes at less than 10 over that period of time. Yellow would be a rate going to 10 to 15 . Level three, a moderate would be 15 to 20 , and then a level four, high alert, would be more than 20 . Based on analysis by multiple analysts in the Health Department and in collaboration with the Controllers Office, these additional cutoffs that you see on this screen were made based on the best information that we have to monitor our Hospital System, our disease situation, and our ability to, as best we can, maintain Disease Control. Next slide. Now im going to talk a little bit about where things stand today. So the Hospital System measure shows us the degree of serious illness in the community, and as you can see, the indicator is green. Were currently hitting our targets. The rate of new covid hospitalizations is decreasing, and we have adequate icu and acute care bed capacity, 37 and 26 of acute care beds are available. Next slide. In terms of cases, we are yellow status. The number of cases is flat, which is good, although we would ideally like to see it decline, which would put us in green. That probably wont happen for a while until we expect more cases as we start to reopen. Next slide. In terms of testing, we are currently testing more people and focusing on testing vulnerable populations, groups at highest risk of exposure, health care workers, and essential workers and people with symptoms. If we set a goal, testing of 1800 tests per day across our population, across the city, we are more than meeting that goal today. This is our 7day average. We are at almost 2500 tests being done a day as part of our testing effort across the city. Next slide. Contact tracing. Youll recall the overview of Contact Tracing at the last Health Commission meeting as a key to preventing new infections. Our goal is to reach a 90 of contacts identified and 90 of contacts reached. In the last couple weeks, since you saw this metric, we made significant improvements at 87 and 85 , almost at that green level of 90 . Significant progress there. Next slide. Then in term of personal protective equipment, our goal is to have a 30day supply. Of ppe across the Public Health system for people for Health Care Providers. We are at 89 . This metric includes 12 different types of ppe with regard to a 30day supply. Again, as we strengthen our ppe supply, we will continue to monitor this. We obviously would like this to be green. Its currently at yellow status. Next slide. So those are thats a summary of our indicators. We can provide you with the link to the data tracker so that you can see the indicators displayed in more details. I did want to show this to the commission today since these were just released. Its another iteration of our ability to communicate where we stand in covid19 with regard to communicating with the public and these metrics are obviously very key for us to monitor our efforts and determine the right balance between the vigilance and ensuring that our Health Care System are working to monitor the capacity as we go into this stage of gradual reopening. We will provide an update on stages of reopening and our variance application to the state in the next presentation part of his presentation. I thought i would pause here to see if anyone had additional questions. Thank you, director. Dr. Chow. Thank you, dr. Colfax, for the explanation. Im wondering, your display of the three or four metrics with the different colors were very clear, but the large metrics you showed earlier, does it have more measures and, therefore, it comes up into this scorecard that is simpler to read and easy to understand and thats the reason youre showing us whats behind it, or is it that the whole scorecard is really whats going to be used and this is merely a summary . Because the summary was easy to understand. The other one was very complex, and im sure well thought out. Im not sure if it means that 9 greens and 4 yellows equal what then . Yeah. I appreciate the question, commissioner. The metrics, the table i showed is complicated. It translates yeah. The cutoff that i showed translates into the more the more generalized assessment that i showed you in the subsequent slides. So theres no one color. Its not an interpretation of the various metrics that add up to any one color. Each metric is assigned a color based on the criteria that i showed you in that table. We will, for now, be very focused on the hospital beds because those will be the best those are the best metrics that we have in terms of any upcoming surge and the need to go down. There are obviously other metrics that well watch very carefully. If we see a significant burst n cases, for instance, that is associated with some prior event or is concerning enough that we would be concerned about the Hospital System reaching capacity at a later date as people got sicker, we would respond to that. So its really taking in account all those metrics and the colors of not only the summary of all the colors but each specific metric and whether a specific metric in the Hospital System, for instance, goes red, you have to really take a hard look at where we stand. Which ones will be available publicly or which ones are in the link that you will be provided through mr. Morewitz . These are all available. Theres more detail on the data tracker than i went through here. So theres both the ability for someone to take a quick look and then theres plenty of deeper dives that people can go into to better understand how the whats behind the colors. Could we share that website now for anybody in the public who may be viewing so they know where to find this information, or could we do that when you wrap up your presentation. Yes, we certainly can. We can get a slide up for that very quickly. Great. The mayor announced the reopening time line yesterday and launched the sfgov website which is interactive and useful in seeing the progress San Francisco is making in reopening. Did i have one question about the color coding system. I realize this is a look back data point, but does replication rate play into the assessment as to whether or not the city can proceed and move forward . Of course we want to keep that below unwith, but is there a threshold were using to be confident in moving forward . The rate is a very important estimate of where things stand. Its very hard to calculate on the level of with the level of degree that we would be able to use in real time to make decisions. Right now, our best model our best ability is to look at these metrics, the replication rates that have been calculated so far have been based on the data that has already been collected. So i think it would be more of after affirmation of where things stand retrospectively rather than moment to moment or proactively looking at where things stand. Reproductive rate is based on inputs in multiple data sources and an estimate and based on a model. So the real time ability to respond to a reproductive rate estimate is not not really possible at this time. It takes many days of data, if not weeks of data to come up with a reproductive rate over time, whereas these are looking at a much shorter period of time to allow this to be as agile as possible. Great. Thank you. Commissioners, other questions before we move on . All right. I think we can move on to the next part of the presentation. Actually hello. Good afternoon, commissioners. So its my pleasure to talk a little bit about the variant process, which is tied closely to what dr. Colfax was talking about in terms of reopening and indicators. I wanted to talk a little bit about where we are, why apply to a variance, and our work with reopening and Recovery Task force. So next slide. As we move into this next phase, we know as we reopen, theres a balance of risks that we have to think about. Part of this is the new normal that we have here. So one of these things in the new normal is protecting our communitys health as well as improving the local economy. We know that the delicate balance between those two, the pandemic obviously has had devastating consequences for certain communities, but so has the closing down of the economy. Were really trying to balance those various parts of this whole equation. We know that theres a shared risk framework, and its safe versus safer. So we dont have the ability to completely make things safe as we open up the economy. There is nothing that has a zero risk. We want to do it in a safer way. To do that, as dr. Colfax talked about, we need to ensure that as we open up, were measuring all of these different factors. So looking at, are we having increased cases and if they occur, are they manageable through the Health Care System . So really, want to make sure we can get the curve as flat as possible as we open up. Given the virus effect on our communities, we need to be as flexible as possible and use data and metrics to guide our Decision Making process. And we need to do all this with an equity lens. So as i alluded to, theres been a disproportionate level in communities with the virus, and those same communities have been impacted with economic closure. So theres, again, a balance here between opening, i can ma making sure as we open that we are not having effects on certain communities that are much more disproportionately aligned to the western population. Next slide. I wanted to talk about how San Francisco has done. This data is pulled from june 9th. San francisco as compared to other jurisdictions as really been remarkable in our ability to control the pandemic. This really is a tribute to the public and all of our partners, ability to get messages out about sheltering in place and mask wearing and hand washing. As you can see, our cases, as well as the death rates, have been much lower and the death rates are pretty striking actually of how much we are as compared to other jurisdictions. Additionally, weve really ramped up our Testing Capacity and currently this is dated were at 2. 66 per thousand. Thats to say that the public has really embraced shelter in place and that has led to a real big success story. So we do confident that this is the same to start reopening and we started to do that and are looking at the metrics to make sure reopening occurs safely. Next slide, please. I really wanted to talk about what is the variance. A variants allows reopening quickly or a different order from the states road map. The state laid out a road map from one, two, three, and four different stages. Currently, the state is in early stage two, but if youre a variance county, you have more flexibility determining how far you want to go in stage two. Various counties have mostly all of stage two available to them to decide what they would like to reopen next. So it gives a lot more local control, and that local control lives with the county Health Officer. So locally, any type of changes that she wants to make would have to go through the Health Officer. The variance process has to go through the Health Officer. The variance process is a written notice that we are meeting requirements per the state and that also has to be attested by the Health Officer as well. I want to point out that most counties in the states are variance counties. I believe there are only five or six level that are not. Most of the bay area counties are in the process of applying for a variance as well. Next slide, please. Why is variance important . Its important for several reasons. One, it allows for local Decision Making and authority on how we can move forward, which will allow us to determine what makes sense for our own jurisdiction. It allows flexibility to reopen parts of the economy at a pace at what youre Health Officer believes is the appropriate pace. We have local Decision Making authority. We control what will reopen and in what sequence. We can provide clarity to sectors on when things potentially can open so that they can get prepared. Most importantly, a variance allows a reopening based on emphasis specific data and metrics. One of the things people talk about is its a lot about reopening, but the variance is clear that we can pause, stop, or reverse any decisions if the metrics are going the wrong way. So it doesnt mean that were going to automatically reopen everything, nor does it mean that were not able to go back. We have the ability to do both of those based on the indicators and other data that we get. Next slide, please. This in a nutshell is what the variance application tests for. Theres several different parts of it. Ill go high level on the major areas that we would have to attest to. One of them is the epidemiologic point. The second is the protection of our essential workforce. How are we doing the protections and what do we do as what are plans as we open up further . The third is our Testing Capacity, showing that we are making gains in our ability to test and that we have surveillance capacity. The next is our containment capacity. Do we have enough case and Contact Tracers and specifically this one also calls out what is our containment strategy in our homeless population. The next is Hospital Capacity. This asks if they are able to surge 30 above their capacity. This requires our hospitals to be able to attest to it. The next is how are we going to contain the disease in vulnerable populations including outreach. The state application emphasizes our nursing home populationment. Thats vulnerable. Other groups that have been impacted by the disease are also emphasized. The reopening plans are also emphasized, and this is on our website, the San Francisco dot gov website. Triggering to adjusting. We need to slow down and rethink the next phase or this phase, if needed. Finally, it asks for a covid19 containment plan. The covid19 containment plan has 9 different doctors associated with it really to talk about, as we move forward with reopening, how are we peninsula being to contain the planning to contain the disease, through Contact Tracing capacity, acute care surge, et cetera. And our containment plan really, we are focusing our containment plan under three colors. One is equity. The second is through control of the disease, and the third is through preservation of our health care capacity. So through this application, San Francisco puts it and then the Health Officer has to attest we are meeting all of the criteria. Next slide, please. I wanted to talk about reopening and how we got to the current phasing of our reopening. This has been done through a partnership, and there are a couple different ways that we determined how to phase reopening. Weve used four different factors in this Decision Making process. The first is our Health Indicators, including the number of cases, the hospitalization rates, our Testing Capacity, Contact Tracing, et cetera. The second is risk factors. Which industries can open more safely . That wouldnt be industries that have a would be a industry that has a small number of employees, outdoors, able to do social distancing, workers continuing to work on site. Most importantly, another key factor, can workers travel to and from their work. Transportation is another place where theres a high risk potential for transmission of the disease. The third factor that we looked at was equity. So as we reopen, making sure that, again, we are not disproportionately impacting certain populations, whether theyre essential workforces, theyre not being exposed to risks compared to the rest of the population, and if they are, are we able to mitigate that risk . And then the last factor is the state guidelines. So the state has been very clear about how they want to reopen and what they considered our stages. What is in stage one versus stage two versus stage three versus stage four and what the state has said is that we can be more conservative, but we cant be faster than the state. So based on those four factors, we developed a reopening plan for San Francisco, and the mayor announced that road map as was mentioned. The road map is fluid. It is subject to change. This is not a stagnant document. So if indicators change or information changes, the road map will change as well. One of the great things about the road map is we developed these relationships with Different Industries and so as Industries Plan to open based on the road map, theres a lot of back and forth on what they need to reopen safely and how we can provide them that guidance. So right now, we are under phase 2b. That happened yesterday. There was a slew of things that reopened, including outdoor dining, indoor retail, Small Services and ceremonies to name a few. The next 2c, slated for july 13rd, will have you hair salons, indoor dining, and real estate open houses. These phases would require a variance because at this time, the state has not opened up those particular industries to nonvariance counties. Next slide, please. So phase three, which is labeled as august and beyond, includes bigger industries such as hotels and hospitality, gyms and fitness centers, child care and education as well as cultural and recreational activities. There is an economic Recovery Task force that is looking and working with all of these Different Industries and will work closecly wit closely wih us, making sure that the city is aware of our plans and is working together collaboratively to make sure industries can safely open. Next slide, please. Finally, what are the next steps on variance . One of the things were doing is right now were filling out the application for the variance. Parts of that application include we need to get letters of support from the Health Care System as well as the board of supervisors. Once the application is completed, we submit that to the state, and then we basically become a variance county. The state may have some clarifying questions, but it really does from the states point of view, its the Health Officer making the decision whether its ready for a variance. If the variance is if the decision is for the variance to move forward, we can talk about does stage 2 require different sequencing in San Francisco based on our variance. One of the reasons this is important is that everything that is allowable to be reopened without the variance has reopened with the exception of schools. Schools are really on their own time line because theres a lot of different demands on schools and the ability to be reopened will require a lot of planning, but pretty much every other industry has opened for nonvariance counties. So if we are going to move forward with variances, this will allow us a lot more flexibility to determine what things in the economy could open up next. Again, with this lens of equity and those that might be disproportionately impacted by the closure of the economy. Paragraph paragrapso that in a a variance is. Im happy to answer any questions about the process. Mark, do we have any Public Comment or do we go on to should we do questions now and then take public questions at the end . Commissioners, do we have any questions . Yes. Commissioner. Thank you for the presentation. It was enlightening and understandable. I appreciate it. What is the time frame or the time line that youre looking at to be able to get the variance from putting everything together to application to hopefully getting the variance granted . I think right now, our time line is within the next 7 to 14 days to try to get all of this together. For some parts of it, it requires that you say youre going to do it as opposed to having it ready at that point in time. So there can be still things pending while the variance is approved. Okay. Thank you. Uhhuh. This is grant colfax speaking. Thank you for the overview. Just to emphasize a couple things. One, this is the Health Officers decision to move forward with the variance. Dr. Aragon is our Health Officer, would normally be at the Health Commission. He is about to go before the board of supervisors who have to vote to approve the variance application. Just a matter of procedure here in understanding the structure of this. The other thing to emphasize is that i think i dont have the exact counted and perhaps you do. But over 50 counties in the state have applied and have successfully met the variance, including los angeles county, which, as we saw from the prior slide, has significantly more burden of disease and morbidity and mortality. Again, this is for us to bring local flexibility per dr. Aragons recommendation and also a letter from the Hospital Council that is required to support this work. Any other questions, commissioners . Yes. Thank you. The process is very clear and its very interesting that once the variance is filed, it actually is basically approved. But im wondering, because obviously, we have great confidence in the medical officer who has been so diligent in guiding the entire process and actually very admirably working with the City Attorney to write the regulations, which i think have been clear to everybody and whatnot. They seem to go back and be able to work with you all to work out a program that seems to make sense. How does this we have this variation between the different the key counties that really dont have the variance or the bay area counties . Are we going to be the biggest, the first within the bay area to actually apply for this variance . Then will that cause a problem in a lot of influx because there has been in the past influx in San Francisco for certain types of activities . Then do we have ability to work with the other counties to work on the safety thats needed on the part of everybody . I mean, were giving very strong messages to our people here in the city. That seems to be holding. So thats one question. The second one is really transportation. If we start having the ability of very attractive types of services, which, of course, we do want because we need to get our economy going again. How do we assure that people coming into the city and living actually are also going to be as careful about watching for, you know, social distancing and everything as clearly San Francisco has in our data . Yeah. Its a great question. So for the first part, i believe contra costa has committed a variance application. And i understand that alameda and marin are looking into it. There are multiple counties looking into it. Up to this point, the association of Health Officers has taken a collective look on how to reopen and being aligned. I think theres going to still be that spirit in hand of trying to be aligned. But knowing that every community is different and the needs of it will be different, the point about interjurisdictional transportation and movement is really important, and i think one of the things that we have to think about actually, its taken into account in our reopening framework is the movement of people. If were going to reopen something, what does that movement look like as part of the Risk Assessment . So we have done a whole risk stratification, the city has, about how many people will be coming into the city, how many employees will be part o of that influx and what type of work theyll be doing. Is that work risky . So thats all taken into account. I do want to point out that there are times that we will make decisions based on equity that may not that we will try to do as much mitigation, but because there are equity issues of wanting to make sure certain sectors open up so that people who usually do low wage work have the ability to have a job, will have to do that job and well be working closely with mta to figure out how to make transportation more safe in this time because we know theres equity issues in trying to get to your job and being able to access Public Transportation. Its going to be a major factor there. So youre right. Its a complex question of how to determine risk and ways to mitigate it, and as you mentioned, the bay area is an inner locking kind of region. So i think this on going continuance of working with our City Partners and working with the private sector is going to be essential as well as really monitoring our indicators to see if, as we reopen the sectors, we really start to see spikes. We know that disease will increase, but we need to make sure that its not increasing in a way that its potentially going to be exponential. All right. Just a followup on that transportation issue, does that mean that youre also working with the transportation agencies and that as you open up certain areas and restaurant workers are an issue of equity as we understand and being a magnet for this type of activity, theres got to be transportation available that isnt running every 45 minutes or an hour. Yeah. So the mta has really been working on this. Theyve looked at specifically areas that there are workers potentially lower wage workers they would need to service more frequently so they can get to their jobs without with also this knowledge they dont want crowding at the stations or in those areas and making sure people are masking and appropriately social distancing. They are taking that into account and where which reopenings are essential as we bring on more industries. Any other questions, commissioners . Commissioner guillermo. Thank you. I was my question is, it does seem like San Francisco is generally more conservative of all of the counties in terms of its phasing as the opening of things. So i would imagine is that the variance for is it that the variances that we might be seeking would be to even delay certain things as opposed to advance certain openings relative to what other counties are doing or the state is doing. So if so, what might those delayed services or openings be . So yes. Youre right. I do think San Francisco has been a little bit more conservative. I think thats because of the density of the city. We are the second most dense city compared to new york. We are at high risk for having a pretty bad outbreak of this disease. What the variance allows us to do is have local control. So the state is moving also for the entire state, without a variance, it is also moving at a pretty slow pace right now, and thats depending on some factors within certain counties. So what this allows us to do is go a little bit faster than the state and, like i said, bring in some of that economic recovery into play. But if we decide that, you know, were going too fast or we see indicators are going a long way, we have that control of stopping progression or turning back as well. But in terms of the state, i believe weve opened everything under the state except schools. Schools throughout the state havent opened because thats a big risk for the unified School Districts to be able to bring in students. The target date for that will be sometime in august, if not later. But right now, i believe weve opened everything under the state. Commissioner, if i could juse dr. Aragons call as to whether to continue the progression, whether to pause, whether to reverse. Right now, without a variance, much of that is determined by the state how far we can go. We also need to acknowledge there are risks here that we do not have a road map that is fully informed in terms of how to necessarily know with certainty if we paste a and d first and wait a while to go to c and d. Is that the right timing . Is that the right mix . Were making informed decisions, but in many cases, these are things that have to be looked at with our best judgment about what we know now and certainly we will continue to monitor. It is plausible that despite our best efforts, that there will be a surge. I mean, our peak was about 100 hospitalizations. Right . I think one of the questions is, if we are able to reach a level of reopening where the harms of shelter in place are mitigated to a degree, how are we, as a society, what level of hospitalization, what level of icu, what level of morbidity and mortality is acceptable in that balance . A vaccine and an effective treatment is many months, if not years off. We need to understand the risk and collectively determine what that risk benefit is as we approach this new normal. Obviously we are hoping that we dont have a surge that overwhelms our Hospital System. That is a possible scenario as we go forward. I think the cooperation and enforcement or the balance of those two as we reopen services and the economy is really going to be essential. I know thats not completely in the jurisdiction of the department or of dr. Aragon in terms of the jurisdiction he has, but we have been San Francisco, i think, has been quite good in terms of personal cooperation with the orders. But weve seen throughout the west and even within california how that changes so quickly. So i think that is something that the variance is really important for us to have in order to have that flexibility to move quickly so that we dont have to make those decisions about, you know, how many hospitalizations and how many deaths and how much disease were willing to accept in order to get the economy going in a way that we hope it will. Commissioner green. Thank you both so much for your wonderful presentations. Recently, theres been discussion about mask use and even suggestions from your counterparts in san mateo that we could limit the spread of the disease through universal mask use. I couldnt read between the lines and understand if that is face coverings or masks per se, but do we have any initiatives or have we had any thinking about making masks more available especially for people who might not be able to access them, cant afford them. Is there any type of thinking theres been volunteerism in this area. Im wondering as you talk about Public Transportation and people in restaurants and so forth, whether theres anything that what your assessment of that the statements are and what were doing in that regard. Yeah. We know that masks are going to be a major way to combat the disease. Definitely in Public Transportation, thinking about ways to have masks accessible to people as they enter, you know, bus stations or a bus itself, and then other places where there may be crowded conditions, other ways we can mandate that masks get used. The Industry Needs to provide them. Or if public services, are there ways our workers can provide those masks. As you know, in Health Care Systems, its already mandated. But really looking at other employers in ways that we can ensure that employee safety is maintained. So Grocery Store workers, clerks, all those people that have to interact with a number of people on a daily basis, that might have more risk of getting the disease. Were definitely looking at those sectors and trying to figure out and this is really, again, through dr. Aragons directives, if its through a Health Office order. If its not going to be that way, is there more outreach and engagement and even thinking about people who are doing street outreach. So all of our Homeless Outreach teams have them, but are there ways we can equip our Fire Department or Police Department with this outreach. Its probably not punitive in that way. We would rather have it be more positive interaction. So commissioner chow. I wanted to follow up on commissioner guillermo for just a moment in terms of the fact that there might be a need sometimes as the scorecard, which you talked about earlier, has different changes. I wanted to know the process that we could understand that a change might in fact trigger some sort of reaction. Is that going to be looking at things over two, three, four days, a week, or every week or every monday at 10 00 youre looking at the scorecard . What creates the trigger for that . Then who works with the medical officer in order to make a determination that there should be then a change and usually a negative change which would be one, of course, that would be really important to be able to support . That means that once again, some of the economic gain is going to go away and then we have a new problem. So can we understand a little bit of that process and how long that might take and how people would be informed about this . Yeah. So thank you, commissioner. So the indicator theyre not onoff switches. So its a combination of looking at the various factors where we are in the colors. Its also not as though all of the different indicators would have to be orange or red before we would take action. Right now, the areas that were monitoring most closely is the rate of hospitalizations in our Health Care System capacity. Right now, those are the ones that well be watching closely. The indicators are going to be updated on a weekly basis so that every week, dr. Aragon and the Health Department team will take a look at those indicators and review and see if there are any indications of change, whether theres a color change in the wrong direction. Hopefully there are color changes in the right direction Going Forward. And then based on the context in which those changes happen, a decision will be made about whether we delay the next phase of opening and whether we actually reverse some of the actions that weve taken. I think there are events that happen. So, for instance, right now, were very much cheerfully watching the rate of hospitalizations in relation to the demonstrations to see if theres an indication there is a spike just as we watched other events in may to see if there was a change. What is good is, may 18th is when we started to really open up to some degree, and our numbers continued to stay low. Another place we would be watching carefully, of course, is from key areas, school reopenings. So that would be a big change. Then also, the reason were looking at the indicators, were not just looking at covid19 capacity. Were looking at overall Hospital Capacity, medsurge and icu. Were concerned about the flu season and our ability to manage multiple viral outbreaks at once. So we have that rate of covid hospitalizations, but we also have that med surge and icu overall indicator across our 9 Health Care Systems so they know they need to move rapidly for us to manage. The other indicators, i think the ppe and the Contact Tracing, those are really indicators. We will continue to work on those. Obviously with Contact Tracing, we expanded our team dramatically. Those metrics continue to improve, but we want to make sure we stay in a good zone there as well. But right now, the key indicators are hospitalizations that will be evaluated every week along with the other indicators. Thank you. Just as a followup, you mentioned about schools. We were opening up summer camps. Is that something that also we would be following . Absolutely. Weve done that with the best evidence available about how this could be done in a safer way. One thing that we want to emphasize at the Health Department and dr. Aragon and i talked about this quite a bit, we need to ensure that people understand, one, that the safest way to protect yourself is to stay at home. As we reopen, the masking, the social distancing, the hygiene are really important. There is a risk here, and we want to ensure that the public understands that theres no such thing theres risk on many of these activities right now. People are going to have to decide what risks theyre willing and able to take in this new environment. The recommendations, well work to keep things as safe as possible, but were really using the term safer rather than safe. Again, some of this is based on our best judgment as well as best data we have at the time, but we will surely have to reiterate as we continue to monitor for outbreaks and other situations where we may need to change some of our recommendations Going Forward. Thank you very much. So on behalf of my fellow commissioners, i would like to acknowledge the extraordinary amount of work that went into preparing this. I understand its 30 or more pages. So thank you to director colfax, dr. Baba for your work in this not only in preparing this but in all of the work that it took to get us to this place we are where we can be considering this. I would like to express the support and gratitude of the commission for this effort and ask where we are in terms of getting the different endorsements that are required by the state in order to move forward. I understand the Hospital System and some others. Right. Its going in front of the boarn the next hour or so. They have to vote on it. So well see what the outcome of that is. Then the Hospital Council has done outreach. Were starting to get hospital letters coming in now. Great. Thank you. Commissioners, any other questions before we move to the next item . We want to make sure we check for Public Comment. Are there any Public Comments . Theres no one with their hand raised. If someone would like to raise your hand, press star 3. Were also waiting im going to pop up two links. Dr. Colfax, im not sure if you want to display these. One is the data tracker, what mr. Bernal had asked to track. Im not sure what the other one was. Okay. Theres no one with their hand raised. Theres no Public Comment. Thank you. Thank you. Anything further. Can you hear me . For the specific indicators that i was talking about today, the Health Indicators link, the second one would be the one that people should go to. Thank you. I apologize. Mark, theres one more question that i would like to pose to director colfax and this may be the appropriate place in the agenda. I know there was confusion about the risk of asymptomatic or presymptomatic transmission based on statements that have been made by the world health organization. Would you like to take this opportunity to clarify that for the public and any sa san franciscans that may be watching at this time. Sure. So asymptomatic transmission does happen, can happen, and is certainly a key factor in propagation of the epidemic. So another reason to wear a mask, socially distance. If you feel well, even if the other person feels well, its very possible to transmit the virus when you still feel well and that other person feels well. Asymptomatic transmission happens. Its relatively common. So we must all do our part in terms of the facial covering, social distancing. We cannot depend on symptoms to determine our behavior. Thank you. All right. We can move on to the next item, which is item five, general Public Comment. Can you let us know if you have anybody in line . Theres no one with their hand raised at this time. I will leave it up for another 10 seconds just in case. The next is the budget for 2021. You ready for me. I think we can close Public Comment for this item. Thanks. Yes. And when youre ready. Okay. Good afternoon, commissioners. Greg wagner, chief financial officer. So today, were going to go through the proposed budget for the coming twoyear budget cycle. As you know, these conversations over the last couple months, this is a little bit of unusual year. Our normal budget cycle occurs in essentially november through february of the year. We did in fact go through that process earlier in this year where we put together a Budget Proposal and brought it before the commission. That was approved to move forward to the Mayors Office. Of course a lot has changed since february. In those months, weve really understood the gravity of the covid19 situation, the city has updated its financial out look, and we have significant changes. That has essentially caused the city to reopen and in many ways restart the budget process. So whereas right now, we would be preparing for board of supervisors hearing and the mayor had submitted a proposed balance budget on june 1st, that process has been pushed back two months. So on june 1st, the Mayors Office submitted an interim budget, which is essentially a placeholder budget that leaves appropriations at the same level as fiscal year 1920. As indicated, their intent to submit a revised budget on august 1st. So two months later than normal process. With that change, the Mayors Office has also issued new instructions to the departments. We talked about a little bit about the numbers behind everything thats happening at your last hearing two weeks ago, but essentially, what has really changed, as we have begun to confront the covid pandemic, there are two things happening. The first is that revenues in some particular areas have really dropped sharply, particularly in our real estate transfer taxes, sales taxes, hotel taxes. Some of those areas that are directly affected by the economic slowdown associated with the response to covid19. Then secondly, we have significant challenge in that we have our ongoing effort around the covid initiatives, which is going to proceed, as you know, into the coming year, two years, at some level. We need to be prepared with the Financial Resources for that. So what were bringing to you today is the first part of that discussion. The Mayors Office has, as i said, required departments to resubmit their budgets with new instructions, and those instructions reflect the new deficit and, therefore, are more challenging than we had considered in february. What were not presenting today is the picture for the covid19 response. That is really simply because the scale and complexity of that, we were not able to put that full picture together for you on this time line. Were really operating on a time line thats about 1 3 of the normal budget process for this, and we have about three times the complexity that we would in a normal budget process. So we are working extremely hard on pulling together the budget around covid. We have a strategy. Weve done a lot of the work, but thats still coming together and will be coming back before the commission at a future hearing. What we do have for you today is our response to the mayors revised budget instructions. So this is the kind of first step in the process. The Mayors Office, if you can go to the next slide, mark, ill go really briefly kind of through the deficit and the instructions. The Mayors Office issued these revised financial protections. We talked through these at the last hearing. Essentially, there is a 250 million deficit for the current year, which the Mayors Office has solutions to close that deficit, but for the coming two years, there still remains a deficit of about 1. 4 billion that has not been closed and that will be the subject of this budget process. You can see a little bit on this screen and weve got a couple of questions around how what this represents and im so used to reading these tables, i need to be reminded that theyre not intuitive. But essentially, what this is is that the yearoveryear change in millions of dollars from the prior year these are citywide numbers. So, for example, in the first section, under sources where you see general fund sources, fiscal year 2021 projected to have 487 million in fewer dollars revenue compared to the current year. So there is a decline projected in general tax revenues. Thats for the reason that i expressed. Then you can see that those revenue numbers begin to pick back up. The loss is smaller in the future years until eventually those revenues even out over time. Point out in the second line, youll see a negative 132 million in Public Health revenues. That is a big chunk directly attributed to the Financial Impact of the covid19 pandemic on our operations. This is us but its also pretty much every Health System in the region in the country is seeing reductions in revenue particularly as outpush patienth services have been scaled back as were taking Public Health measures to prevent the spread of the disease. So all of this adds up, as you can see, to a significant drop in revenue that will recover over the next few years. Then thats compounded by what we knew was already existing before, which is growth in our operating costs, particularly due to salaries and benefits. Those are adopted in charter benefits and other operating costs for the city. We have a significant deficit. Go to the next slide, mark. In response, the city has issued budget instructions, and we didnt characterize this exactly directly, but it gets complicated. But essentially, were asked to provide a 10 reduction in our general fund support for the coming year, going to 15 in the second year, and then add an additional 5 contingency. Thats where we phrased it incorrectly. That 5 is in the first year but for balancing reasons it feels like its a year two for us. Those add up to 75 million and 113 million and then 37. 7 if we need to meet that contingency. Were going to present our plan here right now about how we will tackle those numbers. Then what will happen after this is dph and all of the other City Departments will make an attempt to meet these budget instructions. The Mayors Office will compile those and look at the other factors and the budget and determine a plan forward and determine to what extent the proposed reductions are needed to balance and to what extent and hopefully this will not be the case, but to what extent they will need that additional 37. 7 million contingency or balancing support from the department. The other things that will still need to happen after this discussion and there will be future conversations with the commission are, as i said earlier, discussion of the covid19 budget. We know there will be significant investment needed in the department of Public Health and other areas of the city to continue our efforts in all the things that youve been hearing about earlier today and in previous hearings, but things like testing, Contact Tracing, Surge Capacity for our Health Care System, locations for quarantine and for other services for populations and individuals that are affected. So all of these financial targets will factor into the citys plan to fund those, and well be working with the Mayors Office on that as well. The other thing that is still not addressed and will be addressed as we go through the mayors phase of the budget process are some of the other big important issues that we discussed several months ago but are still with us to some extent more so. That includes a lot of our efforts around things like Behavioral Health and Mental Health program and how were going to try to continue making progress on that issue despite the changes in the budget. Its really a very different environment, but we do need to align all of that work with what were doing for the covid19 response and continue to move forward in all of the other initiatives that youre familiar with. So next slide, mark. So we are doing our best in this proposal to prioritize services, particularly to vulnerable populations. Youll see and im going to turn it over after this to jenny louie, our budget director, to go through some of the individual initiatives. But were fortunate to be able to present proposal to you where we are not relying on Service Level reduction. So we have largely been able to meet our budget targets, at least the first part without the contingency, without cutting programs, without layoffs. There will be some salary savings and other adjustments, but we are not anticipating big reductions to services, and i think that is largely due to the fact that we have done, as weve discussed, a lot of planning and a lot of work to prepare ourselves for this over the last several years for exactly this scenario. We will be able to weather at least part of this year without seeing some of the types of things that you have seen in past budgets during recessions. If we do need to meet that last 5 contingency, i think that is most likely to change. Youll see when we get to the balancing that we provided a plan here that almost meets our 10 and 15 target. Were short of that simply because we ran out of time and ideas to get to the finish line. But i think were at the point where if we do need to meet that last 5 contingency, we do not have Additional Solutions of the nature that youre going to see today that allow us to continue to return general fund to the city without making some of those harder choices. We have, as youll see, some of the big categories i discussed this in the memo that went to the commission about were relying heavily on revenues. Were relying heavily on onetime solutions that include things like closing out of reserves, of scaling back on planned Capital Projects, and it projects and trying to look at those types of solutions that allow us to at least get through this cycle. Next slide, mark. All right. So here ill turn it over to jenny to go through some of these initiatives in brief detail. Im happy to answer questions. Jenny louie, budget director. So just to go through the initiatives that weve proposed, some of them will look familiar to you because they are updated from our february submission. Some of them are actually verbatim where we main taped mad them. The first one is our baseline revenues and medical waivers. Weve updated these revenues since our february proposal to reflect a lower census and reduce sources weve experienced due in part due to covid19. So the dollar amount is lower. This is partially offset by increases in our projection to medical enrollment. Again, due to the economic downturn, we are expecting an increase in the number of people on medical and were assuming that additional 7,000 members by the start of next fiscal year. Net overall, we expect this to be a positive revenue for us of 10 million in the first year and increasing to 28 million in the second year. Just by way of comparison, in our original budget, we assumed 38 million and then dropping to 24 million in the second year. Initiative a2, the one time settlement from medical, we projected 65 million in february, and essentially, this Initiative Still holds. We made a minor adjustment of 4. 1 million that we actually receive in the current year. That was used in part to help balance out the shortfall that we saw in 1920. So because its already been assumed before, we cant double count it again. We just made an adjustment to reduce the revenue that weve already received, but we believe this number will more or less hold true for us in the upcoming year. It would generate a one time general Fund Reduction savings of 61. 8 million. Initiative a3, our baseline revenues at this point, there are no changes to our projected baseline from february. So were keeping them at 6. 5 and 12. 1 million. The savings from the decommissioning it legacy system, we projected we were going to receive 8. 6 million of on going savings from being able to turn off the systems with the successful implementation of our new epic system. We are going to add one time savings of 4. 4 million to close out additional pos, purchase orders, that we have. We are pretty much ready to shut that system down, and we think that weve covered all of the liabilities on the prior year to make that transition. I believe we can achieve 4. 4 million of savings in addition to the on going savings that we presented earlier in february. Initiative a5, federal programs for Population Health. Theres no change. Our backfill needs remain with supporting immunization. So thats a revenue loss that we experienced of half a Million Dollars in both fiscal years. Our Specialty Pharmacy expansion holds true. Theres no change as the budget neutral expansion to create a Specialty Pharmacy. The cost of 3. 3 and 8. 8 million, we still believe will be offset by 340b revenue. Theres no impact overall. Finally, a7 is a new Revenue Initiative that we submitted. This initiative adjusts revenues for primary care, Behavioral Health, and Population Health with reduced levels of activity we have due to covid, includes 4 million for primary care, 29 million for, and 3 million for substance abuse. Part of this was that negative revenue that you saw in the first slide. That was presented by mr. Wagner. These are losses, and in addition, we also included losses due to lower volumes expected for applications and fees for environMental Health and other areas such as vital records. The losses are offset by 28. 2 million in cares revenue expected for next year. The net impact is one time, 13. 1 million overall. Its an additional funding loss that we have. We go to the next slide. So we also, in addition to the revenues updating the revenue projections and the savings that we had initially proposed, we are adding 7 or 8 new revenue savings reductions. The first one is reducing Jail Health Services due to the closure of the hall of justice. Last month, the board of supervisors voted to close the facility which houses county jail by november 1st. So we are proposing to reduce the number of ftes we have, three rns and three lvns. We had about 17ftes supporting the hall of justice. Were only looking at a eliminating six of those positions. The remaining 11 will be moved to support other parts of jail health. I want to be clear this initiative will not result in layoffs as we will reassign any staff that would be affected to other vacancies within jail health or Health Network consistent with our labor mous. This will save about 600,000 in the first year and then achieve a full year of savings, about a million in the second year. Initiative a9 looks at laguna hondas operations and reflects one time savings that we will achieve, a one time salary savings of 1. 5 million to slightly lower than expected average census due to sort of a one time dip as we restrict admissions for the next few months. We do expect that census to come back up by the end of the fiscal year. In addition, well achieve a one time savings of 515,000 while the kitchen is closed. This was actually an initiative that was supposed to happen in the current year, but due to covid and the restrictions on visitors on the campus, we delayed this project, but we do expect the Kitchen Remodel project to happen in 2021 once we lift that restriction. We will be because the kitchen will be closed entirely, well be bringing a contractor on to provide the Services Food services for us for about five months and then we will achieve about half a million of one time savings because we will not be purchasing food for our residents. We looked at the operations of San Francisco general. There are three years where we think we believe we can save. The first two are related to materials and supplies and per diem nursing, which is sort of consistent with the Revenue Initiative that we presented on the other slide, which is due to sort of a lower census due to covid. So we believe we can achieve one time savings of 1 million per diem and 2 million for materials and supplies. In addition, we are making an adjustment to the uc affiliation agreement because similar to the city and county employees, for the physicians, the state has frozen their salary increases. So we believe we will achieve 3 million due to that freeze. The net general fund savings of 6 million in the first year and 3 million o ongoing. A11, additional it savings. In addition to the ehr savings that we mentioned earlier, the it division identified several adjustmentses to our targets to look at existing maintenance contracts and Additional Services to try to find alternate solutions or perhaps a delay. This will result in savings of 1. 7 million in the first year and 1. 1 million ongoing. For facilities, we looked at two areas. There was one rental cost for civic Center Relocation that was planned. It was related to the security. So the first one, we had budgeted additional lease costs to relocate to a safer location. This is part of a larger plan that was developed by real estate to shift many City Departments, not just dph, around the civic center. There was a site on valencia for our tenants. We had budgeted some funding for the rent increase, but right now, the projected lease costs are 1. 6 million lower in the first year and then 400,000 lower in the second year. In addition to that, our Security Director has reviewed our current Security Staffing plan and adjusted our staffing to reflect our current needs. This results in on going savings of our Security Work order of a million each year. So net overall between the rent savings and the security, were expecting 2. 7 million in savings in the first year, dropping to 1. 4 million ongoing. A13 is something that commissioners, you may be familiar with. As you know, this fall, we transitioned healthy kids to medical. With that transitioning of the program successfully, we can achieve 1. 4 million for savings of the insurance premiums we pay for as well as administrative and marketing costs that we provided the San Francisco health plan as we mentioned earlier, there will be no loss of coverage for the participants as a result of this change. So, therefore, were going to achieve 4. 1 million ongoing in savings. A14 is the changes in the prior area settlement methodology. This is a little bit of a technical one. Bear with me. Basically, we will be adjusting our methodology for how we reserve funds for potential audit settlements. Basically, what this allows us to do is ordinarily, what we would see is prior clear closeouts at the end of the fiscal year of contract costs, liabilities we thought we would have to pay. Ordinarily you would see them as part of our quarterly financials at yearend where you may see a surplus in contracts. What were doing instead is were going to create a reserve up front using some of that savings starting in 1920. Once we have the savings, once we have that reserve, we will use that reserve to pay out the prior year pos and well hold it and well move it forward, replenish it as needed. We believe this methodology would allow us to recognize 7 million in savings to contract line and overall. But i want to be clear about this. This is not resulting in any changes of Service Reductions or funding. Its merely recognizing savings we ordinarily would, as part of our actual were moving it forward so we feel it as part of our budget instead. A15, the financing of Capital Projects, again, another slightly technical initiative. Were working with the office of Public Finance and the Capital Planning committee to set finance about 38 million of Capital Project of dph. This will result in about 4 million of Debt Service Costs moving forward, but part of this portfolio, were going to include two projects that were already previously funded. Initial work has begun, but we believe that by the time this finance happens, well have a projected balance of 18 million to be able to release as cash and liquidate and offset by the 4 million in terms of debt service, wit but its a great te to be in debt if you had to be in debt. It is fairly inexpensive to finance projects and then sort of creates additional cash flow that we can recognize. The next slide, moving on to emerging needs, again, these were the initiatives that we put forward in february, and after some discussion, these were things that we put forward because we believe that they were important to dph operations and sort of moving forward with our Covid Response, we believe these initiatives were still needed. I mean, we werent doing them just because we thought they were fun or we thought that we had money, but we thought they were important for the operation. So, again, just as a reminder, the first one is Quality Management and redesign of our Compliance Program over at laguna honda and within the network. So in addition to not only supporting our quality and compliance efforts there, they will also support our Infection Control program over at laguna. Our maternal child and Health Equity initiatives, which included the dual Access Program and the perinatal equity program, they are all focused on pregnant black, africanamerican women and young families. Again, the need exists and were moving forward with it as originally planned. We did pull back on the dsfg Operations Program simply because, you know, as we were looking at a reduced census, this initiative was originally developed to address the fact that we were sort of operating above our budgeted census and we were trying to right side it. Given that were projecting a lower census sit, this didnt feel like the right time to move forward with it, and we could possibly reconsider this in future years, but we dont believe it will be needed in the upcoming fiscal year. Lastly, strengthening hr, again, this initiative remains unchanged because of our need to support our workforce, to make sure that we are making critical hires and developing Program Infrastructure for new initiatives. So we have kept this as is. Overall, we are still putting forward 5. 3 and 7 million of investments back into the department to make sure that we can continue to support our regular operations as well as our Covid Response. Next slide, please. So the contingency reductions, we dont have a specific detailed plan, we will work with the Mayors Office, should we need one, and its possible we would need to propose reductions that would include program Service Level reductions as well as elimination. But we dont have a specific plan outlined at this time. Next slide. So when we look at the balancing that we have overall, were 2. 8 million short in terms of our target, but considering the order of magnitude of savings that we were able to come up with over the next three weeks, without Service Level reduction, we feel pretty good about the proposal moving forward. We would like to work with the Mayors Office on the remaining balance as well as any contingency reductions that we would need to provide. Next slide. In terms of the next steps, with your approval, we would like to submit this plan to the Mayors Office, work with them to finalize our proposed initiatives, look at any contingency reductions, and then the development of our budget for covid spending in partnership with the emergency leadership that will be leading the effort for the city. In addition, we will work with the mayor on any additional priorities that she may have. So we will keep the commission informed as we move forward, and then just next slide will provide a set of next steps and dates that we have. So we will we plan to submit the proposed budget to the mayor and Controllers Office later this week, assuming its acceptable to theition exam. To theition commission. Well have additional hearings on july 7th and 21st. As we have updates available, we will keep you informed. August 1st is when the mayor submits her balanced budgeted to the board of supervisors, and then within august, well have the board of supervisors budget and finance committee hearings. Then by midseptember, full board of supervisors hearings and by late september, early october, the mayor will sign and adopt the proposed budget. So those are the next steps that we have. That was a lot of information. Mr. Wagner and i are happy to answer any questions that you may have. Yeah. I just wanted to add one kind of more peace of context to piece of context to this. Thinking about this globally and stepping back, this is a big change for us, and rather not be in a position to be having a kind of make all of these changes. But really kind of stepping back and thinking about where this budget is going to end is we are making these reductions, and its going to cause us to have to tighten our belts and be tighter on our financial management. At the same time, we do know that the end purpose of this also is that this will help contribute resources to the city that will be available to fund our Covid Response. That will be the next piece thats going to be coming. So well be proposing these budget savings targets, and then we anticipate that we will also have significant investment from the city in our Covid Response, and its going to be significant. So i just want to make sure that we have that kind of context in mind, that this is one piece of the puzzle but that the city there is a clear commitment up and can down from the city in making sure that the dph is going to have the resources needed to continue our response. I just want to thank greg and jenny for their incredible work on this, very late nights in really getting the commitment from the divisions, the director divisions to manage whats been really a difficult situation. Obviously, the Pandemic Response has been the focus of our attention, but as we all know, theres been a fiscal crisis in parallel with this. Jenny regularly has done a great job of helping us manage that while we also manage covid cover. Covid19. Thank you for your work and perseverance. Lets check Public Comment before we go to you for questions. Can you let us know if there is any Public Comment requests. If theres anyone thats listening right now, can you please press star 3 to raise your hand if you wish to speak. Lets wait 30 seconds to make sure we give them time. While were waiting, could you raise your hand [ poor audio ] mark, i know there was theres no one with their hand raised. Mark, i know there was one question that we had received via email, and jenny, maybe you can kind of talk through it was on slide 9, which was the summary about how the line Revenue Growth assumed in deficit factors into that calculation. Thats 59. 3. Sure. Yeah. So mark, im going to have you toggle to slide 9, and then im going to have you jump back to slide 2. This is a bit of a technical issue with how we sort of look at budgets and how we track the costs within as they manage the deficit. So if you look in that second line where it says Revenue Growth assumed in the deficit, commissioners, i know youve seen this line before in prior years, but ordinarily, what you do see is usually you see positive Revenue Growth. Usually you see positives in both your because were assuming baseline growth as part of the deficit, its assumed and it helps reduce the deficit. It also helps to reduce and offset some of the additional inflation costs that we dont have to present to you every year, such as our salary, mou better mou driven, fringe benefits, which always have inflation, rental cost increases, capital programs, equipment requests. Those are things that are covered by the Mayors Office and are assumed as part of the deficit. So ordinarily, youll look at expected needs. They put that into the deficit, and then they look at the Revenue Opportunities that we have. So they usually assume some small baseline growth. Ordinarily what you see is a positive number there. I think in the prior in the february submission, i think we were looking at Something Like 20 and 40 million positive. That was already assumed. But in the scenario that is being presented as part of the projected deficit, this is projecting a revenue loss of mr. Morewitz, if you can go to slide two of the presentation. Basically, if you look at that second line where you see the Public Health revenues of 132 million, theres a one time revenue loss there that were seeing in that first fiscal year. Then this is where it gets intricate. A portion of those revenues that we are adjusting directly within our proposal, and that includes the dsfg baseline revenues. In addition, the Mayors Office did assume as part of its projections losses in primary care, Behavioral Health, and Population Health as well. So in addition, there are other revenues that were managed such as 1991 realignment that goes to support our budget, but we its not something that we manage centrally. So that sort of 59 million of negative that you see in that balancing sheet, its part of this 132 that you see here. So what im doing is essentially matching some of the losses that we have. We did have some improvement over this assumption. Even though the instructions, i think, were issued in the middle of may, i think may 18th, and we did work with the Mayors Office in early may, a lot has happened in those six months since we submitted our initial projections. So we did have some improvements, which were recognizing here. Just know that the original 60 million is a portion of this 132 million in terms of expected losses and so were trying to be consistent and make sure were not double counting sources as we look for a balancing plan. Thank you. All right. Im going to go to commissioner bernal and then first of all, i would like to thank greg and jenny for the extraordinary amount of work that went into this basically having to scrap a budget that had taken months to prepare and do that same amount of work in a very compressed time line just in weeks with all different kinds of impacts and new dynamics. So thank you to both of you and your team for putting this together. We all understand what a heavy lift it was and are really grateful for that. I had two quick questions. The first one was, jenny, you had mentioned some anticipated revenue coming up for next year through the cares act. Does this budget assume any state or local funding assistance for future federal legislation such as the heroes act thats going through the congress . Yes. So currently, as part of the projections, we did make an an n assumption of 28. 2 million through the cares act that we were expecting. This was a sort of calculation based off of sort of what we knew the whole entire value of the cares act and then based on the portion that was allocated in the current year, what our value of that portion meant. We kind of did the math to get to the 28. 2. Just to recap, in the current year, we did we have actually received cash in hand about 23 million from the cares act, and its eligible to be applied towards specifically health care agencies. This revenue is separate from what the controller and may Mayors Office is tracking as additional revenue related to fema reimbursement. This is revenue that you recognize here. There is additional revenue that is being assumed and pro projected as part of the citywide budget, but thats not something that affects our target here today. But we can update you on that when we bring forward our Covid Response. To answer your question, we received 23 million and in addition we are expecting approximately 28. 2 million based on what our estimates are of whats remaining and allocated. Were still working to try to figure out what specifically those restrictions are, what are the reporting requirements as well as the qualifications. Great. Thank you. Just to clarify, commissioner, the 28. 2 that is still to come is from future allocations of already approved stimulus. Its approved. We have not made a speculative assumption of future acts of congress. Thank you. My second question, jenny, you mentioned additional mayoral priorities. As we know last week, the mayor laid out our road map for new Police Reforms and a key element was the Police Response to noncriminal activity and it seems as though it would involve a greater role for our hot teams, Homeless Outreach teams and street medicine and Behavioral Health divisions. Has there been any discussion about this and any would there be impact on the current years budget, or is that looking toward future years. Its potentially looking at future year initiatives. I think what the Mayors Office is trying to do is get all their balancing proposals in to see what next year looks like. So its hard to say, but i would expect sort of similar to us, we had priorities that still remain and continue and so we will work with the Mayors Office to make sure that her priorities are assumed in the budget. Greg, i dont know if you want to add anything to that. Yeah. Just that we have started talking conceptually, and i know the Mayors Office is really thinking and working along with other stakeholders about exactly what you raised and well be part of that. Theres nothing included in the budget in front of you essentially due to timing, but well keep you in the loop as those conversations are going. I do expect that well be part of that thinking about how the Health System and the criminal justice departments are interacting in the future on our streets. Thank you. Commissioner guillermo. Yeah. Sorry. Thank you. Continue on the covid questions, on the i think its the a7 line, 13 million, is that a net figure on the cares act funding that relates to revenue to Health Systems in advance of Services Related to medicare reimbursement, and if its not, where would that have been suited . Another covid question, given that we dont know the impact yet of all of the costs associated with covid, will that information be provided to us prior to the final budget that the mayor will submit . Yes. We will be doing a separate conversation with you on the covid program. Were in the midst of really actively working on that. Weve got daily conversations going on through the Department Operation center to pin down what that program looks like, what were going to be assuming, and significantly, as you point to how thats going to interact with the federal revenues. That line a7, that does include that is a net figure. So as jenny described, some of those revenues from cares act are anticipated in the coming years budget. So theres that 28. 2 million. Theres about theres an amount that weve already received, and that is based on the medicare formula. So weve already received some of that revenue to offset our losses in the current year. But with all those factors, we still have anticipated losses at the hospital and thats due to reduction in specialty outpatient types of services. We have losses in primary care for the same reason. We have losses in Behavioral Health for the same reason. In our Public Health division revenues, all due to reduced activities under the Covid Response. So that figure is a net number that factors in some of those. I will add that a big question mark that were still kind of working through as a city and that will be a topic that comes up in the future covid discussion is the fema reimbursement. We are counting on a reimbursement through fema for a significant portion of our covid activities, but the duration and the level of that reimbursement is unknown and, perhaps, to a certain extent unknowable, but thats probably one of the biggest questions around the budget is to what extent well be able to receive those federal dollars to match our covid costs and for how long. Thats probably citywide. Its a 9figure question, hundreds of millions of dollars. Just one last comment, just to congratulate you on the work that youve done, particularly as it relates to really working not to reduce services and to not have any layoffs, and lets hope it continues that way. I wanted to say in an environment like this, for us to be able to for the department to be able to present at least for now a budget that looks like this without services and layoffs, reductions, really speaks a lot to the hard work thats been done in a very short period of time. Thank you. Commissioner. I want to thank you as well. This has been a very tough time in the last number of months, and youve really its been an unbelievable effort to turn things around in what you presented. I guess one of my concerns that you had raised is Mental Health sf. What is, you know, coming down the line with from whether its coming from the general fund, what is dphs interaction responsibility, and will that be factored into this budget, or is it going to be a work in progress depending on the Mayors Office . Im just concerned that there probably is going to be an increased need for services as well. So thats where i have a big question. If i could just start, commissioner, with the answer, and greg and jenny can fill in. A great concern about the needs. Right . Especially given what our community has been through as well as the intersection of the covid19 Pandemic Response with Behavioral Health. Right . We are working to shift our existing system and resources to respond to that need. In this next iteration, when the budget comes back to you, depending on the conversations with the potential investments Going Forward, we may have more to share with regard to our investments in Mental Health sf. The other thing is, the commission will recall that to really fund what was envisioned Going Forward for Mental Health sf, the price tag was over 100 million and that we had always been there had been a clarity that those resources were going to be needed to get the program to where it was envisioned to be and those funds had to be found. So i think, you know, we are continually its certainly remaining Mental Health remains a priority for us in terms of the content of what it envisions. We are going to need to have the resources strengthen our work in that area. There are many intersections, including with the Police Reform efforts that are moving forward. Again, in conversations with the Mayors Office and then i think when our budget goes to the board, its likely that there will be another iteration of public ha can be done and what Additional Resources might be made available. Ill let greg answer any Additional Details that i havent. Yeah. I think you covered a lot of it. We will be having more many more conversations talking about the Mayors Office and other policy makers. I think a couple of things to point out is, we are trying to some of this, at a minimum, lay a groundwork to keep our momentum moving forward. So in particular, two of the items that are on slide 7 where we have this is the emerging needs section. We did make an effort to protect some of the key initiatives that had been identified through our Strategic Planning process and that we know are really important. One of those is our hr investment. Weve heard that through our Behavioral Health division consistently that one of the key things we need to lay the kind of Structural Foundation for any of these changes regardless of what the funding level is in the coming year, is improvements in our Behavioral Health, hiring, keeping positions filled and kind of strengthening the infrastructure for that division so we are moving forward with that initiative. Then similarly, on the quality program, which affects the hospitals and through the hospitals, its our Psych Services at zuckerberg and elsewhere in the system. So we are trying to make sure that that infrastructure is there so that depending on what the funding scenario is, that is worked through with the policy makers, that we have the ability to execute. Thank you. I just dont want to get blindsided. Yes. Put it that way. I appreciate your response. Understood. Yeah. Mr. Green, do you still have a question . Actually, no. I would just add to the chorus voices saying how we markable this work remarkable this work is. The thoughtfulness and the fact that youre coming in so close to where we need to be at the end of the second fiscal year is just quite remarkable and a testament to your hard work and your deep understanding of virtually everything we do in every Division Within the department. So i only have the highest praise, and i really appreciate your clarifications of the document. Thank you. Commissioner chow. Yes. I echo everybodys admiration and obviously it doesnt take away from the extreme hard work for you to have put this together. Looking at the so im glad that you continued the initiatives that we thought were very important for the infrastructure because i think that without those backgrounds, like the hr and the quality programs, which we know are in response also to the deficiencies that we have seen and been criticized for, this this is a small amount of money to really put in to that to be able to do all of the other programs youre talking about. So i think we really want to strongly support those stay in and work with the city to understand the importance of that since weve been criticized in those two areas particularly. I am concerned that, as were looking at obviously, it relates to the failure of the city budget to be able to come up with the general funds that were talking about. We all know that that certainly is almost conservative the way that the structure theyve structured the budget instruction. It may take years before we see the towers to fill if were lucky in terms of having people come back and work and play in the city. Were showing that this is kind of backwards. Were looking at the first fiscal year with a very large positive in order to balance off a very terrible second year and end up the whole thing, if you then add the fact that we are using about 68 million of one time money is nearly close to 200 million, and that maintains your workforce. That doesnt take into consideration the covid problem and Mental Health. It doesnt speak then out a fiveyear basis of really being able to pull out of this hole. So we failed one year with one time money basically, kept the workforce intact. The second year we go into a huge deficit based upon the budget assumptions, and im not sure that you can you want to even try to project the second, third i know that youve got the fiveyear projection from the city that shows more optimistically that comes. If we are going to look towards the fiveyear, would you be able to give us some feeling that this isnt just a twoyear fix and were going to have to come up with even more and would it be something that maybe you really have to look at in the second year . Its a hard theoretic question. This has to go before the Mayors Office to be able to deal with all of the things that need to go to the board. Its a tremendous effort. Its really very fine. But im looking at the fiveyear issue. I think the second year already proves were going to have problems. Yeah. Well, i think your analysis of this is exactly right, dr. Chow. So we absolutely are, in this plan, essentially saying were going to all these over the last five, six years, weve been building up reserves. Weve been benefiting from favorable general fund years in term of Capital Projects and investments in it, et cetera. We are pretty explicitly here saying were going to use this good news that we had piled up and were going to use that to say lets live to fight another day, and we are proposing a budget that does is loaded into that first year and using some of those one time solutions. So were not proposing budget that is going to solve on going this larger general fund program. I think my response to that would be, number one, it is allowing us to live to fight another day, and it will allow us to get to a period where we have a little bit more certainty over what the world looks like. So there are a couple very large unknowns that are still hovering out there. Those include things like what is their assumption in this budget projection about the trajectory of the economy and how thats going to change. We could end up better, and we could end up worse. The city is going to have to make assumptions about what the level of federal support is going to be to tie to this budget. But really, i think kind of taking that all on balance, were at a moment right now where we have, as you described, a lot of huge needs that are dependent on the Health Department, covid, Behavioral Health, all these issues that weve been talking about. Right now, i think is the year for us to do what were doing where were going to kind of cash in on the work that weve done to prepare for this over the last several years and buy us some more time to get some clarity and certainty to work with the city, and i think the city is going to be doing the same thing. The alternative would be that we make deeper cuts to ongoing expenses, which would include our Service Levels at a time when we have these really great needs. So we may come to that point, and when we are at our budget conversations later this year and next year, we may still have a very large unsolved deficit that were going to need to make some even kind of harder decisions to grapple with and the city will as well. But that is kind of the way that i see this is us making a proposal that buys us some time and helps the city be able to fund our Covid Response and some of these other initiatives even though it is a little bit lopsided. So i think youre correct, and i wish we had solutions that would be kind of Ongoing Solutions to the citys financial problems, but i would rather get through a year and see where we are before making those choices given Everything Else thats going on in the extreme needs and burdens that are out there right now. You know, mr. Wagner, i thank you for those comments. I think thats exactly the right approach, and i hope our fellow commissioners feel that the department has put forth. We need to get through the year and we need to be able to answer the needs these people need and we can always hope for things to change, but i think were going in with our eyes open as to what we may have to do in the future weve got to answer the needs of the people today. Thank you. Commissioners, any other questions . If not, we have a request for approval. Is there a motion to approve the proposed budget for fiscal years 202 it 21 and fiscal year it 2. I will do a roll call vote. Mr. Bernal. [ roll call ] great. Congratulations, everyone. This is a great budget year. Thank you again to greg and jenny for all of your great work. Thank you, commissioners. Thank you. We can move on to the next item. Item 7 is the annual fiscal year 1920dph sole source waiver usage report submitted to the board of supervisors in june to meet the requirements. Item 8 is related and might be discussed in tandem. Its approval for 21. 42 sole source waiver usage. Item 8 is an action item. Michelle, i believe, is on the phone and not on video. Correct. Good afternoon, everybody, Health Commissioners. This is michelle ruggels, director of the Business Office without a camera today. Sorry about that. Good afternoon. So what i wanted to go over are the two items. You have a powerpoint. Im not going to go over the powerpoint, but im going to weave it in as we go through. So it might be useful for reference, but ill be covering it. The two items we have is the sunshine ordinance requirement, which is the annual dph sole source waiver usage report which we submit to the board every year in june. You dont need to approve this. It is just for your information. The second request is for your approval, and this is our request to the Health Commission for advanced approval of a potential chapter 21. 42 sole source waiver usage, which seems weird. Ill explain it especially if you havent been through this before. But let me start with the annual sole source report are. So we refer to it as the sunshine ordinance in short, but its a requirement by this chapter, 67. 24, that at the end of each fiscal year, the City Department, all City Departments have to send a list to the board of supervisors of all of the professional sole source contracts, meaning contracts we selected without a solicitation that were either entered into in fiscal year 1920 or already existed and were continuing into fiscal year 1920. Essentially, theres three categories of sole sources where we get a waiver. The first one is probably the broadest. Its chapter 21. 5, and theres acceptable justifications such as goods or services that actually only one source provides or sometimes we send out a letter of interest and we only get one prospective vendor and no other source satisfies those requirements. If we meet one of these rules, we submit the request for a sole source waiver and all the supporting documentation for the citys office of Contract Administration for approval. Sometimes they dont approve it, in which case we either do without or we have to go through the solicitation process. Thats 21. 5. Chapter 21. 3 are vendors with proprietary rights to their software and hardware and then the associated Maintenance Agreements will be treated as a sole source contract. Thats probably our largest area. Then chapter 21. 42, which well talk about in the next report, but this is all the way back to 2006, the department of Public Health had there was an amendment to the administrative code to add this section which authorizes dph to use as a sole source for nonprofits if were in a gap period between solicitations. So it allows ongoing authorization. Ill talk more about that in a minute in the next report. So in front of you, you have a memo, which is what were planning to submit to the board of supervisors to respond to their request. So in that report, you have an attachment that indicates it lists all the contracts where weve used a sole source waiver. It lets you know what sole source we used 21. 5, 21. 3, and it indicates the justification, whether it was the full contract or a Program Within the contract and if it was new this year. Just an overall summary, we had 121 sole source waivers that we used in 1920. Under chapter 21. 5, about six of them were new and 9 existing. That was 15 of the 121. The biggest area where weve used this is 21. 3 with the soft area Maintenance Agreements. We have 65 existing sole source waivers and three new ones. Thats 68. Then for the chapter 21. 42, thats for the nonprofits. We had 8 new ones and 30 existing. Thats how we reached 121. That in a nutshell is the annual report tha well be submitting o the board of supervisors prior to july 1st. Do you have any questions about that report . Mark, do we have any Public Comment . Do we have any Public Comment . If the caller on the line would like to speak, i would please request they press star 3 to raise their hand. We have no Public Comment. Thank you. Commissioners, any questions . Commissioner chow. Ms. Ruggels talked about 121, but the sheet reads 127. Is that correct, or is some duplicated . I think well, i hand counted. I think some of the lines, it starts on line 1 and that isnt actually a contract. Oh, okay. All right. So its 121 even though theres 127 lines. Yeah. Got you. Okay. Thank you. Its confusing. Sorry. No problem. Its really a very extensive report. Im hoping the supervisors appreciate it. Yeah. We also conducted around 40 solicitations in both fiscal year 1819 and fiscal year 1920. Theres a lot of work not to use sole source waivers. When its unavoidable, thats what we use. Is it okay can i move on to the next one. Yes. There are no other questions from commissioners, i think were good to go. So the next one, as i mentioned, is our request to the Health Commission for advanced approval of a potential chapter 21. 42 sole source waiver usage. This is sort of odd, perhaps, to be asking for advanced approval, but actually expedites and assists the department quite a bit. So what this is, though, is each year or many or probably since 2000 when this started, we have been submitting a list of contracts to the Health Commission for advanced approval, and we take that approval list, the potential approval list, and whenever we actually need to use it, we give that to the citys office of Contract Administration. When they see that you have provided that approval, then they allow that to move forward. So thats how it actually speeds up the process quite a bit. Mostly, these are well, theyre an nonprofit contracts. Thats the only ones that qualify. They have to be unique to the department, consistent with our mission and goals, and require specialized knowledge, training, personnel that are limited to be provided by to be provided by a limited number of nonprofits. So each year, we review our list and so the baseline is all of our existing contracts. Then from that, if theres any Agency Contractor thats gone out of business, obviously theyre removed. Then we look at has somebody been on the list sometimes we retain contracts that we may or may not know if were going to have a contract with, but they seem like theres a potential. So we just leave it on there. Anyway, so we review it that way. The some of the reasons why this becomes really useful is most of our contracts well, all of these just about have gone out for a sol i solicitatit if theres a gap between like right now actually, we had done solicitations, but then we had to delay the implementation because it was going to be a significant change for one of our solicitations, but with covid, there wasnt the capacity. So this will allow us to continue those existing contracts that are doing existing services. So when something comes up that doesnt allow us to get a new solicitation authorization in place, then this provides that gap authorization. Other times, the board of supervisors or the mayor may allocate additional funding during the annual funding process with an expectation that the service has immediate implementation. So in those cases, when we can, well start the service and then well back into the solicitation process so that we can at least get the project started on more of a pilot basis. Then initiatives come up during the year or something will rise up that needs immediate attention. So this will allow us to add that funding especially if its a little bit different than something that a vendor is currently doing. So what you have before you is the list of all of our dph nonprofits. You have it in the list, and then you have it broken down in that table to provide a little bit more information. So on the table, if someones new to the list, they have become a service again. I mean, youll recognize some of these or you may recognize some of them. They may have not been a contractor and then came back on to the list. So then we have not current contractor, keep on the list. It seems like in this california Pacific Medical center, we may need a contract. Then we just have our list of current nonprofits across dph with most of our nonprofits being in the nonhospital sections of the department, although there are a few three, i think, nonprofits inside of laguna honda. So this is today what were asking for is your advance approval of this list in the event that we should need to activator utilize 21. 42 to either continue an existing contract or to start up something that has a priority need. Im happy to answer any questions. Mark, do we have Public Comment on this item . Do we have any Public Comment . If any of the callers on the line would wish to leave Public Comment, i ask they please press star 3 to raise their hand so i can call upon them. Okay. Theres no Public Comment. Thank you. Commissioners, any questions . Commissioner chow. Yes. I just wanted to make the following comments that first, to thank ms. Ruggels because for many years, the whole topic of the sole source and the multiplicity of complications was explained in the last report was very mystifying to the commission. I think once we had set up in this fashion, it was much clearer. I actually am reminded that the reason the sunshine report to the board of supervisors comes before us is that previous commissions have asked that we take a look at that report since its being submitted and had very Important Information for us as often contracts become, and we were being told that they were sole source. For those of us who sat on the contracts committee for many years could never quite remember what sole sources were until ms. Ruggels and her staff put together that very fine explanation. Then the creation of the nonprofit contractor report with the fact that it could then display what types of services were being were being carried out by these contractors was another enhancement from the department undertook to make this a meaningful report. I wanted to comment and thank the department of for continuing we were removing ourselves from one of the line items. Im wondering, mark, if you remember that we were doing that and in the past and you didnt have to exclude yourself from the entire list but for that area in which you were then a responsible director or governance person. I could be wrong but i remember doing that when i was on the board. I do not recall that on these report but my memory is faulty so i apologize that i dont have that knowledge right here. Im wondering, can we be i would suggest and i would ask how time sensitive this request is. Weve already received your presentation but when we can have classification. The next meeting, even though it focused on business at the hospital the next meeting is june 23rd and its a full commission meeting. In case it needs to be approved by just have it voted on on junt now . I think thats fine. Just to make the point the other one, the sole source report to the board, you are actually not voting on so that one you dont need to worry about. Correct. Just item 8. Yeah. Thank you. Thank you. Thank you mark. Actually i will find out. I am on 9 with other business. Commissioners, do you have any asks . Mark, thank you, i would just like to note that at different points during todays meeting and also as weve been addressing the pandemic and other issues, the department has certainly acknowledged that the disproportionate impact this pandemic has had on communities of color, particularly the black, African American community, and to let folks know anyone who is watching that we will be having a presentation during an upcoming meeting of the equity efforts of the department, not only in addressing the pandemic but also more broadly in our work to protect publichealth and that should be coming up in one of the meetings happening soon and that would be a presentation from the doctor who leads the equity issues and the departments lead in the emergency Operation Center for the Pandemic Response. Thank you, commissioner. Thank you. Any other comments . Questions . Yeah, will they be addressing the latino disparity in terms of the covid . Yes, absolutely. Weve seen from all of the data, the Latin Community is dis purse for atly impacted wit basedod the ability to work from home and the number that our essential employees who continue to have potential exposure based on their need to work outside the home. So yes, that would be a part of the presentation as well. Thank you. So the next item is a couple things, just to followup on commissioner burnels presentation on equity. I am making a presentation on thursday on dr. Bennetts what she presented to us on Health Equity to the San Francisco general foundation. Dr. Erlics group has an excellent powerpoint of what they are doing to implement and what they have done to implement for equity at the hospital which i think would be, im hoping it would also be included because its excellent information that is in theyre presenting. Thats item 1 and then for the other business for next commission meeting, where Behavioral Health will be presented to us, id like just to make sure that during this presentation, that the Behavioral Health issues with the closing of the juvenile justice center, be included and addressed since that has been brought to my attention by the public group of taxpayers for justice that what the future plans would be in that department for Behavioral Health for the youth. If theres no other business, do we have a motion to adjourn . I just appreciated the upcoming presentations of the department will work on those. I just also wanted theres been so much challenging news i wanted to share good news that i just got from zuckerberg hospital for the first time in months. Theres no one with covid19 in the icu and at zuckerberg so this is some positive news to share with the commission, latebreaking stuff. I just wanted to share that. Great. Thank you director. Not only to the staff and everyone at the zuckerberg San Francisco General Hospital but the people of San Francisco for observing the safety guidelines and the publichealth orders to get us to this place. So thats really very encouraging news, thank you for sharing that with us. All right. Do we have a motion to adjourn . So moved. All right. [roll call] thank you, everyone. Great meeting and have a good evening and be safe. Thank you, everyone. Thank you thank you good night. My name is doctor ellen moffett, i am an assistant medical examiner for the city and county of San Francisco. I perform autopsy, review medical records and write reports. Also integrate other sorts of testing data to determine cause and manner of death. I have been here at this facility since i moved here in november, and previous to that at the old facility. I was worried when we moved here that because this building is so much larger that i wouldnt see people every day. I would miss my personal interactions with the other employees, but that hasnt been the case. This building is very nice. We have lovely autopsy tables and i do get to go upstairs and down stairs several times a day to see everyone else i work with. We have a bond like any other group of employees that work for a specific agency in San Francisco. We work closely on each case to determine the best cause of death, and we also interact with family members of the diseased. That brings us closer together also. I am an investigator two at the office of the chief until examiner in San Francisco. As an investigator here i investigate all manners of death that come through our jurisdiction. I go to the field Interview Police officers, detectives, family members, physicians, anyone who might be involved with the death. Additionally i take any property with the deceased individual and take care and custody of that. I maintain the chain and custody for court purposes if that becomes an issue later and notify next of kin and make any additional follow up phone callsness with that particular death. I am dealing with people at the worst possible time in their lives delivering the worst news they could get. I work with the family to help them through the grieving process. I am ricky moore, a clerk at the San Francisco medical examiners office. I assist the pathology and toxicology and Investigative Team around work close with the families, loved ones and funeral establishment. I started at the old facility. The building was old, vintage. We had issues with plumbing and things like that. I had a tiny desk. I feet very happy to be here in the new digs where i actually have room to do my work. I am sue pairing, the toxicologist supervisor. We test for alcohol, drugs and poisons and biological substances. I oversee all of the lab operations. The forensic operation here we perform the toxicology testing for the Human Performance and the case in the city of San Francisco. We collect evidence at the scene. A woman was killed after a robbery homicide, and the dna collected from the zip ties she was bound with ended up being a cold hit to the suspect. That was the only investigative link collecting the scene to the suspect. It is nice to get the feedback. We do a lot of work and you dont hear the result. Once in a while you heard it had an impact on somebody. You can bring justice to what happened. We are able to take what we due to the next level. Many of our counterparts in other states, cities or countries dont have the resources and dont have the beautiful building and the equipmentness to really advance what we are doing. Sometimes we go to court. Whoever is on call may be called out of the office to go to various portions of the city to investigate suspicious deaths. We do whatever we can to get our job done. When we think that a case has a natural cause of death and it turns out to be another natural cause of death. Unexpected findings are fun. I have a prior background in law enforcement. I was a Police Officer for 8 years. I handled homicides and suicides. I had been around Death Investigation type scenes. As a Police Officer we only handled minimal components then it was turned over to the coroner or the detective division. I am intrigued with those types of calls. I wondered why someone died. I have an extremely supportive family. Older children say, mom, how was your day. I can give minor details and i have an amazing spouse always willing to listen to any and all details of my day. Without that it would be really hard to deal with the negative components of this job. Being i am a native of San Francisco and grew up in the community. I come across that a lot where i may know a loved one coming from the back way or a loved one seeking answers for their deceased. There are a lot of cases where i may feel affected by it. If from is a child involved or things like that. I try to not bring it home and not let it affect me. When i tell people i work at the medical examiners office. Whawhat do you do . The autopsy . I deal with the a with the enou with the administrative and the families. Most of the time work here is very enjoyable. After i started working with dead people, i had just gotten married and one night i woke up in a cold sweat. I thought there was somebody dead . My bed. I rolled over and poked the body. Sure enough, it was my husband who grumbled and went back to sleep. This job does have lingering effects. In terms of why did you want to go into this . I loved science growing up but i didnt want to be a doctor and didnt want to be a pharmacist. The more i learned about forensics how interested i was of the perfect combination between Applied Science and criminal justice. If you are interested in finding out the facts and truth seeking to find out what happened, anybody interested in that has a place in this field. Being a woman we just need to go for it and dont let anyone fail you, you cant be. With regard to this position in comparison to crime dramas out there, i would say there might be some minor correlations. Lets face it, we arent hollywood, we are real world. Yes we collect evidence. We want to preserve that. We are not scanning fingerprints in the field like a Hollywood Television show. Families say thank you for what you do, for me that is extremely fulfilling. Somebody has to do my job. If i can make a situation that is really negative for someone more positive, then i feel like i am doing the right thing for the city of San Francisco. Hello, my name is jamie harper. In this episode, we are featuring the park locations in your very own backyard. This is your chance to find your heart in San Francisco with someone special. Golden gate parks largest body of water is this lake, a popular spot for strolling and paddling around in boats, which can be rented. Created in 1893, it was designed foreboding and for boating. It is named for the wild strawberries that once flores. A pleasant trail follows the perimeter past huntington falls, 110 foot waterfall. Two bridges connect the trail to the island. The climb to the hills summit, the highest point in Golden Gate Park at more than four hundred feet. You can get quinces of the western side of the city through glimpes of the western side of city through a thick trees. The lake is ada accessible. It has a peaceful atmosphere where you can enjoy a warm day. Walk along the lake and watched many ducks, and swans, and seagulls. It is a tranquil spot to stroll, enjoy each others company, and sail away. Many couples come here to take a ride around the lake, floating under the bridges, past the pavilion and waterfall. For a quiet getaway, it makes for a memorable and magical experience. Located on 19th avenue, this grove is the place to wear your hiking boots, bring your family, and bring the dog because it has so much to offer you and your loved ones. It is a truly hidden gem in the city. The part is rich with eucalyptus trees. Long paths allow you to meander, perfect for dog walking in a wooded environment. I enjoy this base and the history behind it. The diversity that exists in such an urban city, the concrete, the streets, cars, we have this oasis of a natural environment. It reminds us of what San Francisco initially was. This is a section for dogs and plenty of parking. Transit is available to get you there easily. And the part is ada park is ada accessible. There is also a natural lake. This is your chance to stroll and let the kids run free. It also has many birds to watch. It is the place to find some solitude from the city and appreciate what you share with a wonderful breath of fresh air. , an experienced this park and enjoy the peoples, picnics, and sunshine. This is a lovely place to take a stroll with your loved one hand in hand. Located in the middle of Pacific Heights on top of a hill, Lafayette Park offers a great square a of a peaceful beauty. Large trees border greenery. It features tables and benches, a playground, restaurants, and tennis courts. There are plenty of areas for football, frisbee, and picnics. It is very much a couples part and there are a multitude of experiences you can have together. Bring your dog and watch the mean go with the community or just picnic at one of the many tables and enjoy all of the park has to offer. Many couples find this is the Perfect Place to put down a blanket and soak up the sun. It is a majestic place you can share with someone you cherish. It is located along the 1 and 10 buses and is accessed from the 47 and 90 buses. It is ada accessible. For more information about reserving one of these locations, call 8315500. This number is best for special events, weddings, picnics, and the county fair building. For any athletic fields and neighborhood parks, 8315510. You can also write us. Or walking in and say hello at old lock cabin, Golden Gate Park. And of course you can find more information and reach us at sfrecpark. Org. Mayor london breed good morning, everyone. I know that many of you have been tuning in to our press conferences for updates on how we have been responding to the coronavirus pandemic. But often those updates really dont give us a chance to talk indepth about some of the really complex issues that our city is facing. While everything continues to shift and change, we will continue to hold these press conferences. And update you all on the latest programs, services and resources as well as what were doing to prevent the spread of the coronavirus. But we also will hold talks like this and this is a first in a series of talks that we think that are important to make sure that the public is aware of what is going on and the decisions that were making and what to expect. Theres so much uncertainty. This has been a very fluid situation and at any given time information can change. So we believe that it is critical that you understand how were making those decisions. And some of the experts who are leading these efforts are important people that i think that everyone should know and should hear directly from them. So today were going to dive into the statistics are and the criteria our Public Health officials are looking at and what they need to see for us to continue to reopen and advance our recovery efforts. Here in San Francisco, you all have been doing an amazing job. And as a result of following this order, and i would say maybe not everyone but for the most part a lot of folks are, because you have been following these social distancing requirements, you have made it possible for us to just move further into the stages that have been outlined for our reopening purposes. So we need to continue to do that. We have heard from many of you that this is one of your biggest questions. And so today to talk specifically about just whats happening in San Francisco with the curve and everything and how well we are doing, although that could change at any given moment, is dr. Grant colfax, the director of the department of Public Health. And dr. Colfax was a Public Health leader during the h. I. V. aids crisis and has been leading us through this pandemic. So we appreciate his leadership. Were also joined by dr. Susan philip, the director of the Disease Control and Prevention Branch in the department of Public Health. Shes been leading our testing and Contact Tracing efforts in response to the coronavirus. So what we want to do today is to talk specifically about the criteria related to ill start with the information related to where we are in terms of testing and hospitalizations and other information. And the criteria. Where do we need to be to begin to open up safely. And then also an outline of those phases. Phase one, phase two, a and b and so on and so forth as to what is possible if we continue to follow the social distancing requirements. It is possible that we can get things to a better place, sooner rather than later. So the goal is to also to go into depth with dr. Susan phillips around testing and where we are with testing as well as Contact Tracing and how those things are going to play such a Critical Role in helping us to get open sooner rather than later. So with that, i want to just start with dr. Colfax, just to talk a little bit, you know, about where we are in terms of the numbers. And then how fast the numbers can shift. But, more importantly, if we continue to follow the requirements that are put in place, what can we expect for the possibility to open up sooner rather than later . So dr. Colfax, i know that is a lot, but lets get started. Well, okay, thank you, thank you for your leadership during this really challenging time. And i just want to reiterate that what youre saying this is a really changing dynamic. A changing situation as we learn more about the virus and how the virus spreads. And i also want to extend my gratitude to San Franciscoians for their support of our shelterinplace order. The orders are one thing, but it really takes the community to come together and to support each other in doing this. And its been remarkable. Its about Public Health, but its more about community and how Community Supports one another. Our families and our neighborhoods, to to do our best during this really difficult time. And i think that everyone is doing their best right now. And its really been remarkable over the past few months. You know, it was just in february, mayor, where you declared a state of emergency before we even had a single case. We then went forward with a shelterinplace order and things have really evolved. Theres been scary moments when we were worried about having a situation like we saw on the east coast in new york where the Hospital System got overwhelmed. And where so many people got terribly sick. And, unfortunately, many passed. We have avoided that worstcase scenario in San Francisco and the bay area and im just grateful for your leadership and the support of the public in this work. I think that a couple of things. One is that we as we work to enter this new phase of a gradual reopening, its really important to emphasize while were hopeful that the situation can change quickly. When this virus takes off, it takes off really fast, right . And thats what we have seen, again, in jurisdictions. Thats what we saw in china, thats what we saw in italy, thats what we saw in new york. So we have to be cautious as well as optimistic and hopeful that the work that were doing now in terms of Wearing Masks, in terms of the social distancing, that that really needs to continue for us to be able to live together and also to live with the fact that the virus is in our community and will continue to be in the community for the foreseeable future. So far we are the gain is going relatively well but were only in the second inning of a long game. This is a situation that is going to last for probably 18 to 24 months. A vaccine is still a ways off. We saw hopeful news today but even the most optimistic experts think that vaccines will probably be at least 12 to 18 months off. So maybe i could just mayor, could i just show some of the i want to show a curve because we have talked a lot about flattening the curve. And i just want us to id like to show the curve that i look at when were talking about that. So this is this is our slide of people with the hospitalizations of people diagnosed with covid19 in the city. So its a bit of a complicated graph. So im going to explain it, take a little bit of time to explain it. So this is looking from april 13th to may 16th. The vertical bars are the total number of people across our hospitals, across our nine hospitals in San Francisco, who have been diagnosed with covid19 on any given day. So you can see that on april 14th, on the far left of the slide, that there were a total of 88 people diagnosed with covid19 in our Hospital System. There were 63 people in acute care. And 25 people in the intensive care unit. So those are the people in our city who were sick enough with covid19 to need hospitalization. And we really want to follow also the numbers of people in the intensive care unit because those are the people that are sickest. And we want to make sure that were able to support them to the best of our ability in the medical setting. So this curve is important because it represents the sickest people. You can see over time that that curve this graph has been relatively been flat. If you just look over time between april 14th to about lets say may 5th. That if you drew a line across those bars on the top, that would be a flat it would be a flat curve. Right . So we have really flattened the curve in San Francisco, which means that we are having the situation of many people getting sick and many more people dying because of covid19. So the news also gets a little better right now, which is that if you look from may 5th, so look at that 80 number, may 5th to may 16th. You can see that those numbers have actually dropped. So whats really fantastic about this is that for right now that our curve is not only flat but its actually decreasing in terms of the number of hospitalizations in San Francisco. So this is very hopeful and its really good news. And as we go into these next stages of reopening we have to be very careful that we maintain our masking and our social distancing and our hygiene efforts in conjunction with the shelterinplace, because these numbers can change very, very quickly. So as we go into the next stage of the Curbside Pickup, we increase our commerce in the city, which is good news, and we have to make sure that as we move around that the virus doesnt move around more and actually get more people sick. And thats why were watching this curve very carefully. So if this curve starts going back up, and gets back to where we were at the end of april, you know, 90 or even above, that you would have to look at that very carefully and not only consider whether we dont go to the next stage, but whether we we are more conservative in actually closing things down to some extent again. So thats where, mayor, youre exactly right, this is a changing situation and we need to look at the data on a daily basis. Im hopeful that with the collaboration of San Franciscoians that we will continue to move forward to the next stages. But, again, this could change relatively quickly and were going to need to be watching these numbers so that we ensure that were protecting the health of San Franciscoians as possible. So how are we going to do that . Mayor london breed lets give the criteria of what youre going to be specifically looking at and how youre going to be making decisions to move . Because, i mean, we get questions people want to know when are we opening schools . When are we opening hair salons . When are we opening places where people will have direct contact with one another . So thats because we cant give people specific dates, this is what youre saying, that everything is contingent on what happens with these numbers. So i know that you want to talk about the criteria. And then you want to go into the phases and what we can expect in terms of a general timeline around these phases . Thats right. So im going to go to what were going to be watching Going Forward. To determine how soon and how quickly we can move on those stages that youre asking for, mayor. And then dr. Philip will talk in more detail about our scales of testing and the context. Does that make sense . Mayor london breed yes, lets do it. All right. Can we have the next slide up, please . So these are the basic five indicators that we will be looking at to assess our progress in reopening. Mayor london breed can we just show that slide on the screen, this one slide . I think that it is. Oh, i think that it was being shown. Mayor london breed it was shown but it was some other stuff on there too. I think theyre trying to mayor london breed there we go, all right. Yes. So we are looking these are the five areas that we will be looking at across the city. A number of cases of covid19. The Hospital Capacity across the city to take care of people who are the sickest from covid19. And our testing efforts to scale up our testing. We know that theyre so important for people that have access to timely testing for covid19. And our Contact Tracing. And the need for personal protective equipment. So, mayor, id like to talk a little more in detail about each of these before we get to the phases. Is that mayor london breed yeah, we want to do a brief overview and get into the phases because i think that we want to have dr. Philip talk about the Contact Tracing. So in the number of cases well watch that hospital curve, because those are the sickest people. And were also going to be looking at the case rates as we scale up testing. So this can be a little confusing because as we test more people we will find more pieces. So then the total number of cases are going to go up. But what were really looking at in that situation is the rate of positives. So are 10 of those testing positive . Or is it 5 , 1 . So as long as that rate is going down, well be comfortable with that number. The Hospital Capacity is really ensuring that we have enough capacity in the hospitals in the event that our numbers start to go up really quickly. And ill just give you a concrete example. Right now our covid19 cases are occupying about 6 of our Hospital Capacity right now. Which is really remarkable. 94 of our other hospital beds are filled with people who have other conditions. So we want to make sure that Hospital Capacity doesnt the People Living the people in the hospital who have covid19, that that Hospital Capacity which is currently at 6 , doesnt go above 20 . With regard to testing, dr. Philip will talk about this in more detail. We have scaled up testing dramatically in the last few weeks and over 1,000 tests a day and aiming to get to about 1,800 tests a day in San Francisco on a regular basis. Contact tracing, we want to make sure that were investigating the cases and supporting People Living with covid19. And also making sure that if theyve been in contact with people, that those people know that theyre supported and they get tested. Again, dr. Philip will talk about that. And then personal protective equipment, for us to do our work as medical advisors and First Responders we want to make sure that theres adequate personal protective equipment across the city, including masks and other facial coverings to protect ourselves and others from the virus. So, mayor, unless you have questions about this. Id like to go to the stages. Mayor london breed lets go to the stages. Thats what were here for. Okay. So this is the governors framework for reopening. So phase one we have completed. And right now for phase two today with the Curbside Pickup were now in phase 2a, where we are its exciting because of that curve. Were on Curbside Pickup. And also allowing manufacturing and logistics to support those businesses with Curbside Pickup. And in the next few weeks as we watch those data, we would hope to be able to relax restrictions in phase 2b. To adapt retail, and to reopen schools, offices and child care. Mayor, theres also were working hard to ensure that theres guidance and potential for camp, summer camps for kids. So this would be during that phase 2. Mayor london breed so you think that as long as for example, that the numbers either are stable or decline, that the possibility to maybe have summer camp is possible . I think that its a real possibility. Its going to be a little different than it was before because we have to be cautious about social distancing. So its going to be different. But i am cautiously optimistic that if these numbers hold up that we will be able to to go in that direction. Again, as you said, the situation could change. Mayor london breed can we pull that slide back up, the phase because i think that what is helpful is to just kind of getting a feel for the timing of these phases. So, for example, today we are in the 2a, right . Thats right. Mayor london breed so in order to get to 2b, the five criteria need to be met, number one. And then, number two, how like, if the five criteria are met and then were able to maintain them over a certain period of time, whether d time k that 2b would be able to go into effect, you know, based on just an estimate . I want to be clear this is not the city saying this is going to happen, but based on the trend and what we have seen happening based on the numbers, theres a possibility that we could get into 2b at what point . Or phase three at what point . Yeah. So i think that for phase 2b, and we wouldnt just open up all of 2b up at once, but i think that generally we would anticipate another two to four weeks of watching the data, learning from what we have learned in 2a, and ensuring that people are able to continue to follow the social distancing, the hygiene and the masking guidelines. But that generally in the next two weeks we would then be able to adapt to move to 2b if the data holds up. So somewhere in that two to fourweek window. Mayor london breed which means even longer for like hair salons and nail salons and churches . Thats right. So thats phase 3, yes. Mayor london breed so that were talking about, again, maintaining whatever these numbers are at a flat or a lower rate. And were still talking about those places even a month away . Oh, at least, yes. Mayor london breed i think that part of what is helpful in the course of this conversation is to also to provide people with some guidance so they know what to expect. So i think that and we wont get into it in this conversation, but get into it in a later conversation, you know, just the specifics of how we get people back to work. Because it has been i know very stressful for so many of our businesses and so many of our religious community and folks who are just desperate to come together. And also those who are struggling financially, which as you know as a doctor that this creates a whole other Health Challenge around Mental Health and a number of other issues. So we definitely got to make sure that we keep that in mind, although we know that this is one of the most important things that we need to focus on to prevent the rapid spread of the coronavirus, which even though our numbers may look good today that the fact is that those numbers can change at any given time and we could, sadly, be in a situation similar to how new york or italy or other places have experienced. I think that ultimately the goal is to get people used to the new normal as well, to get used to the masks and the social distancing and all of those other things that are going to help to get us through this. Not just today or tomorrow. But long term. So lets lets talk a little bit about, you know, dr. Colfax, can you tell us again, i know that we cant provide people with specifics. And i want to get to dr. Philip. We cant provide people with specifics as to when, but, you know, i guess how are we going to how do you propose that we make this adjustment . You know, this has been hard already and its been, you know, like over two months. And it is a struggle for just the average person, but especially those who are dealing with financial challenges. And those with kids. And elderly who are already isolated as it is. How are we going to get through this . Yeah. Well, i think that its a really important question, mayor. I think that theres a couple of key things. One is to make sure that people that Mental Health and social supports that are needed and i think that were going to continue to work on connecting emotionally and socially in ways that allow us to social distance. So i think that is a really key piece. And if people need or are asking for Mental Health, Behavioral Health support, they can go to our we website and find those resources. I also think that one of the key things, mayor, in how we support this Going Forward is that the more that we can adhere to the social distancing and masking and hygiene, the faster that were going to get to those different phases, right . So, you know, one thing that i really emphasize is that, you know, wearing a mask is something that is really important because it protects others, right . And so we create a community where Wearing Masks and social distancing is respected and well get to these phases sooner. Because we know that is what slows the virus. As we go back to the workplace, we are working with your departments leadership and others across the city and in the Business Community to really to as quickly as possible and as safely as possible to develop what the new workplace will look like, right . So people who cant commute from home, will work at home. And to ensure that the workplace offices are safe as possible and that workplace transportation is as safe as possible. And that people get the information that they need so they know when they go back to work that they can be as safe as possible. And the other part of this is the testing, right . So that people have access to testing. Because we want to make sure that people can get the cure they need both for themselves and to ensure that theyre as safe as possible. Mayor london breed so, dr. Philip, lets get into some testing and also Contact Tracing and how important that is to helping us to transition into these phases sooner rather than later so that we can get our city open. Yes, thank you, mayor. As you were saying and as dr. Colfax was saying that testing and Contact Tracing are pillars, they are key indicators of moving forward. Mayor london breed dr. Philip, i want sorry to interrupt. I want people to know that if you exhibi exhibit exhibit, you. If you are an essential worker and you have no symptoms, you can be tested. Call 311 or go to sfgov. Org. And whether you have insurance or not, whether youre documented or not, it does not matter. Well test anyone. And so anytime that you need to be tested and that you are tested, but more importantly its not as if one time youre tested and all of a sudden everything is okay. So i want you to talk a little bit about the opportunities and also explain how Contact Tracing is important to helping us to really flatten continue to flatten the curve. Yes, mayor, thank you. Yes, very correct. Go to sf gov to see what the symptoms are. And anyone that works in San Francisco as well, because theyre equally important to the health of our residents. So testing is really important. We need Public Engagement in testing. And were continuing to open up sites in areas to make it more accessible for people to get testing in their neighborhood as announced today. And that the testing in the tenderloin and at city college and a new location in bayview. And so we continue to emphasize making testing accessible. Testing alone is not going to solve the problem. A big point of testing is to get care to people who test positive. But then also to work with people to make sure they have what they need to stay at home so they dont transmit to anyone else. And then to voluntarily ask them who else they may have been in contact with so that we can reach out to those people to support them too. Thats what is Contact Tracing. Its voluntary and its confidential and it has nothing to do with immigration status or any other type of law enforcement. So we want to engage as partners just as the public has partnered with us to shelterinplace and to get us to where we are today and to make us safer and to move closer to the next phases of reopening. We need the same engagement with testing and with Contact Tracing. And were continuing to build our capacity in those areas in partnership with every resident and worker in San Francisco and in partnership with the rest of the city and all of the teams continuing to do that work. Mayor london breed can you tell us what we can expect for Contact Trace somethin tracing . What are the questions they get asked if they test positive . And if im contacted by someone, how should i respond to that . Yes, thank you. When we find out that someone has tested positive, and by California Law all of those tests get reported to the Health Department and we reach out. And the first thing that we want to do, does that person have what they need to be healthy and to be safe . Thats our number one priority. We assist with food and housing and other resources they may need to stay home and to stay isolated. Then we ask them about the other people in their lives they may have come into contact with at work or at home. And we talk to those people separately. So when you are contacted because you have either tested positive or because youve been in contact with someone who has, please engage with the staff that do that. We are working very hard to have language capability. 54 of our case reviews have been in spanish. So were working with communities and organizations that have that ability to bring on more staff to do that work in a culturally appropriate way. So we want to engage. We want to support people who have been exposed and people who test positive. In doing that were going to be able to reduce the transmissions throughout the city and get us to the next phase. Mayor london breed yes, thank you. Well, i just want to go back to reiterate to folks because i think this information is really helpful because im not a doctor and i think that most people who are not doctors may not completely understand exactly why. Because you know that im always asking you, well, why cant we do this, why cant we do that. And im very concerned, of course, like we all are about the future of our city. And the Financial Health of our city. And as well as, you know, Public Health in general. So, for example, when we talk i want to go back to kids in particular because we know that the parents are probably had it up to here. And i just think about when i was a kid how i probably would have drove my grandmother insane with 21 questions. And the fact that i couldnt play with my friends. Or like my nephew saw a slide and cooperate slide dow couldne slide and started crying. Its just the emotional issues associated with trying to explain to children why they cant play together. And i think that what we have to keep in mind of course is the challenges that we face, but we also have to think about human nature. And if were talking about opening camps for the summer, im excited about that. Any kid would be excited. But at the same time weve got to be realistic. To expect kids to have to wear masks and gloves and to not, you know, to interact you know how kids are. They touch each other. To expect that, thats going to be difficult. So i think that when were thinking about criteria, i mean, this will be our normal as you said for at least, you know, the next 18 months. So theres an adjustment, of course, that we need to make. And its a lot easier for adults to maybe make that adjustment. And harder for kids who deserve and need to interact with one another. So i do think that what is great about where we are as a city is because the majority of the people in the city are complying and following the orders and going out of their way to, you know, to be a part of the solution although we know that theres a few people out there breaking the rules and not doing what theyre supposed to be doing but thats a whole other conversation. But the fact is that because we have so many San Franciscoians, it gives us the opportunity to go further. I know that its not happening as fast as people want it to happen. Trust me, i am desperate to see more happen faster because i am concerned about, you know, the longer that were in this situation, the worse off that its going to be for a lot of people. So i hope that you are getting creative and taking these things under consideration because its not just about the data and the science, its about peoples lives and their livelihoods. So how do we theres a way for example, if this is going to be with us for two years, the hairdressers and the barbershops, you know, they already, you know, are prepared with systems in place and theyre going to be able to open im sure eventually, theyll have to wear masks and gloves when theyre working with their clients. And just quickly, why not sooner rather than later . Because i think that thats what people are trying to understand. Why cant we do this, or why cant we do that . I get that it is about, you know, limiting Human Interaction but for the most part you can tell that people are, you know, they are hungry for more, but theyre also willing to follow the rules as theyre given more. You know, so lets talk a little bit about that and what we can do to maybe even move this along faster because, you know, we appreciate that theres Curbside Pickup at retail, but, you know, for most of us, like when i go buy my candles im going to walk in there and im going to walk around even if i cant touch something. Lets talk a bit and then wrap up the conversation because i know that theres so much that we can talk about and we wanted to try to keep these to 30 minutes. But how can we move this faster . How can we get better prepared for reopening as an everyday citizen . Yep. So i think that, mayor, so really important thank you for emphasizing the need to move forward and to get creative and innovative as we go forward to this new normal. I think that one of the key things is that we need to ensure that as much as possible that were masking and social distancing because if we can keep the virus under control in this stage, the next phase will come sooner. So thats one important piece of information. And the other piece is that were working across businesses to ensure that were getting out information as quickly as possible about what people can anticipate. So theyll be ready, right . So that rather than saying oh, now were ready to open and these are all of the things that you have to do, that we have guidance in advance so that people can be more prepared, right . So that as we think about these camps, for instance, that theres guidance being developed in a scientific way, but also in a way that is responsible and accountable to what youre saying. You know, that kids you know what kids do, right . So realistic items, that is responsive both to the situation but also addressing the new normal that were going to be in. And i also think that ensuring that were working with community in an equitable way, including around testing and partnering with other organizations and that were engaging with the businesses on the ground to better understand what they need and what theyre asking, so that we can ensure that the testing requirements that are likely to go forward and the social distancing and the hygiene, that those are things that people are ready for and support. We dont want to be in a situation where, you know, were saying this is what you have to do an, right . So those are key points Going Forward. And to keep moving it faster, part is scaling up our testing and our partner notification, because the faster that we do that, the faster well know where we are moving forward. And when we know where we are in terms of the epidemic, that will help us to know where we are in terms of the stages that we want to move as quickly as possible. Because certainly there are Health Consequences to the shelterinplace order and Mental Health consequences and physical onc consequences. And its not like coronavirus is over here and Everything Else is in business, we need to make sure that were doing a balance of being as prepared and responsive to the pandemic. But also supporting the economy, which is necessary for supporting peoples health, especially in communities that struggle every day and are struggling now. Mayor london breed yes, and dr. Colfax, i appreciate that because im being aggressive because, you know, as much as i want science to guide us and the data, im focused on that i dont continue to bring up the hair salons and the nail salons and places like that because im tired of doing my hair. I dont bring it up because of that. But if these people are not working theyre not making money. They cant pay their rent. Not just their rent at their homes but their rent in their commercial spaces. And in some cases, being harassed about getting their bills paid when they have no money and theres no way that theyre possibly going to be able to pay it back. So if were going to be living in corona, right, how is it that we allow these people to open up sooner rather than later safely . Because, you know, it is thats what im most concerned about. You know, are these kinds of businesses that theres direct contact, whether its a masseuse or barbers or whether its nail or hair salons and places where youre a little bit closer to people than anticipated. Again, because people are so anxious to get going and to get their businesses started, to cover their bills, that, you know, theyre going to be even extra careful when doing this. So the sooner the better and i know that im being pushy and i know that we have these conversations on a regular basis, but i really appreciate both of you and your leadership and the role that you play in helping to lead us. I know that there have been lives saved because of the efforts of the department of Public Health. And so we are grateful to you, your team, and the nurses and the people on the frontlines every single day. Yes, i have pushed, pushed, pushed, but i also appreciate your creativity. Were going to eventually get over this hump and get to a better place and i want to thank everyone for joining us. Again, this is the a first in a series of conversations that will continue to happen around the reopening and whether its issues around equity or around economic recovery and those will be the kinds of conversations that well be having over the next few weeks just to really to try and to get to the point of whats important or why decisions are being made. Im San Francisco mayor london breed and i thank you for joining us here today and thank you for allowing us the opportunity. We know that people have sent in questions and we will be working to respond to those questions directly. Thank you again dr. Colfax. Thank you dr. Philip for your work. And we appreciate you all for continuing to cooperate with the Public Health orders. And we hope that you have a wonderful week. Thank you, everyone. Thank you, san hi. Ou, san im chris manners, and youre watching coping with covid19. Today, im going to be talking about checking with your neighbors. Start off by giving your neighbor a call to see how they are or if they need help. If they dont answer, dont get anxious. Try again later. Check to see if their car is parked nearby. Are they lights being turned on and off during normal hours . If you still cant contact them, contact your other neighbors and see if theyve had contact with them recently. You can also leave a note in their mailbox, and when you do get in touch with them, ask if theyd like to share their Emergency Contact information. If youre getting groceries for a neighbor, get a mask and sanitizing wipe. Put the groceries by the front door and then move back and call them from the sidewalk. If you need to ring the doorbell, dont use your hand. Use the wipe or paper towel that you brought. When you call, stay on the sidewalk at least 6 feet away from them. As youre talking to them, ask about any other help they might need. Some might need further assistance with groceries or just need to chat. Maybe they might need you to pick up prescriptions from the pharmacy. And as always, as soon as you get home, wash your hands. Heres a quick recap. Well, thats it for this episode. I hope you found it useful. Go to sfgov for we have private and Public Gardens throughout the garden tour. All of the gardens are volunteers. The only requirement is youre willing to show your garden for a day. So we have gardens that vary from all stages of development and all gardens, family gardens, private gardens, some of them as small as postage stamps and others pretty expansive. Its a variety all of the world is represented in our gardens here in the portola. I have been coming to the portola garden tour for the past seven or eight years ever since i learned about it because it is the most important event of the neighborhood, and the reason it is so important is because it links this neighborhood back to its history. In the early 1800s the portola was farmland. The regions flowers were grown in this neighborhood. If you wanted flowers anywhere future bay area, you would come to this area to get them. In the past decade, the area has tried to reclaim its roots as the garden district. One of the ways it has done that is through the portola garden tour, where neighbors open their gardens open their gardens to people of San Francisco so they can share that history. When i started meeting with the neighbors and seeing their gardens, i came up with this idea that it would be a great idea to fundraise. We started doing this as a fundraiser. Since we established it, we awarded 23 scholarships and six work projects for the students. The Scholarship Programs that we have developed in association with the portola is just a winwinwin situation all around. The Scholarship Program is important because it helps people to be able to tin in their situation and afford to take classes. I was not sure how i would stay in San Francisco. It is so expensive here. I prayed so i would receive enough so i could stay in San Francisco and finish my school, which is fantastic, because i dont know where else i would have gone to finish. The scholarships make the difference between students being able to stay here in the city and take classes and having to go somewhere else. [ ] [ ] you come into someones home and its theyre private and personal space. Its all about them and really their garden and in the city and urban environment, the garden is the extension of their indoor environment, their Outdoor Living room. Why are you here at this garden core . Its amazing and i volunteer here every year. This is fantastic. Its a beautiful day. You walk around and look at gardens. You meet people that love gardens. Its fantastic. The portola garden tour is the last saturday in september every year. Mark your calendars every year. You can see us on the website after my fire in my apartment and losing everything, the red cross gave us a list of agencies in the city to reach out to and i signed up for the belowmarket rate program. I got my certificate and started applying and won the housing lottery. [ ] the current Lottery Program began in 2016. But there have been lot rows that have happened for Affordable Housing in the city for much longer than that. It was there was no standard practice. For nonprofit organizations that were providing Affordable Housing with low in the city, they all did their lotteries on their own. Private developers that include in their buildings affordable units, those are the city weve been monitoring for some time since 1992. We did it with Something Like this. Where people were given circus tickets. We game into 291st century in 2016 and started doing electronic lotteries. At the same time, we started electronic applications systems. Called dalia. The lottery is completely free. You can apply two ways. You can submit a paper application, which you can download from the listing itself. If you a plo apply online, it wl take five minutes. You can make it easier creating an account. To get to dalia, you log on to housing. Sfgov. Org. I have lived in San Francisco for almost 42 years. I was born here in the hayes valley. I applied for the San Francisco Affordable Housing lottery three times. Since 2016, weve had about 265 electronic lotteries and almost 2,000 people have got their home through the lottery system. If you go into the listing, you can actually just press lottery results and you put in your lottery number and it will tell you exactly how you ranked. For some people, signing up for it was going to be a challenge. There is a Digital Divide here and especially when you are trying to help low and very low income people. So we began providing digital assistance for folks to go in and get help. Along with the income and the residency requirements, we also required someone who is trying to buy the home to be a first time home buyer and theres also an educational component that consists of an orientation that they need to attend, a firsttime home buyer workshop and a oneonone counseling session with the housing councilor. Sometimes we have to go through 10 applicants before they shouldnt be discouraged if they have a low lottery number. They still might get a value for an available, Affordable Housing unit. We have a variety of Lottery Programs. The four that you will most often see are what we call c. O. P. , the certificate of Preference Program, the dthp which is the displaced penance Housing Preference program. The neighborhood resident Housing Program and the live worth preference. I moved in my new home february 25th and 2019. The neighborhood Preference Program really helped me achieve that goal and that dream was with eventually wind up staying in San Francisco. The next steps, after finding out how well you did in the lottery and especially if you ranked really well you will be contacted by the leasing agent. You have to submit those document and income and asset qualify and you have to pass the credit and rental screening and the background and when you qualify for the unit, you can chose the unit and hopefully sign that lease. All city sponsored Affordable Housing comes through the system and has an electronic lottery. Every week theres a listing on dalia. Something that people can apply for. Its a bit hard to predict how long it will take for someone to be able to move into a unit. Lets say the lottery has happened. Several factors go into that and mainly how many units are in the project, right. And how well you ranked and what preference bucket you were in. This particular building was brand new and really this is the one that i wanted out of everything i applied for. In my mind, i was like how am i going to win this . I did and when you get that notice that you won, its like at first, its surreal and you dont believe it and it sinks in, yeah, it happened. Some of our buildings are pretty spectacular. They have key less entry now. They have a court yard where they play movies during the weekends, they have another master kitchen and space where people can throw parties. Mayor breed has a plan for over 10,000 new units between now and 2025. We will Start Construction on about 2,000 new units just in 2020. We also have a very big portfolio like over 25,000 units across the city. And life happens to people. People move. So we have a very large number of rerentals and resales of units every year. Best thing about working for the Affordable Housing program is that we know that were making a difference and we actually see that difference on a daytoday basis. Being back in the neighborhood i grew up in, its a wonderful experience. Its a long process to get through. Well worth it when you get to the other side. I could not be happier. [ ] [ ] i just dont know that you can find a neighborhood in the city where you can hear music stands and take a ride on the low rider down the street. It is an experience that you cant have anywhere else in San Francisco. [ ] [ ] district nine is a in the southeast portion of the city. We have four neighborhoods that i represent. St. Marys park has a completely unique architecture. Very distinct feel, and it is a very close to holly park which is another beautiful park in San Francisco. The Bernal Heights district is unique in that we have the hell which has one of the best views in all of San Francisco. There is a swinging hanging from a tree at the top. It is as if you are swinging over the entire city. There are two unique aspects. It is considered the fourth chinatown in San Francisco. Sixty of the residents are of chinese ancestry. The second unique, and fun aspect about this area is it is the garden district. There is a lot of urban agriculture and it was where the city grew the majority of the flowers. Not only for San Francisco but for the region. And of course, it is the location in mclaren park which is the citys second biggest park after golden gate. Many people dont know the neighborhood in the first place if they havent been there. We call it the best neighborhood nobody has ever heard our. Every neighborhood in district nine has a very special aspect. Where we are right now is the Mission District. The Mission District is a very special part of our city. You smell the tacos at the [speaking spanish] and they have the best latin pastries. They have these shortbread cookies with caramel in the middle. And then you walk further down and you have sunrise cafe. It is a place that you come for the incredible food, but also to learn about what is happening in the neighborhood and how you can help and support your community. Twentyfourth street is the birthplace of the movement. We have over 620 murals. It is the largest outdoor Public Gallery in the country and possibly the world. You can find so much Political Engagement park next to so much incredible art. Its another reason why we think this is a cultural district that we must preserve. [ ] it was formed in 2014. We had been an organization that had been around for over 20 years. We worked a lot in the neighborhood around life issues. Most recently, in 2012, there were issues around gentrification in the neighborhood. So the idea of forming the cultural district was to help preserve the history and the culture that is in this neighborhood for the future of families and generations. In the past decade, 8,000 latino residents in the Mission District have been displaced from their community. We all know that the rising cost of living in San Francisco has led to many people being displaced. Lower and middle income all over the city. Because it there is richness in this neighborhood that i also mentioned the fact it is flat and so accessible by trip Public Transportation, has, has made it very popular. Its a struggle for us right now, you know, when you get a lot of development coming to an area, a lot of new people coming to the area with different sets of values and different culture. There is a lot of struggle between the existing community and the newness coming in. There are some things that we do to try to slow it down so it doesnt completely erase the communities. We try to have developments that is more in tune with the community and more Equitable Development in the area. You need to meet with and gain the support and find out the needs of the neighborhoods. The people on the businesses that came before you. You need to dialogue and show respect. And then figure out how to bring in the new, without displacing the old. [ ] i hope we can reset a lot of the mission that we have lost in the last 20 years. So we will be bringing in a lot of folks into the neighborhoods pick when we do that, there is a demand or, you know, certain types of services that pertain more to the local community and workingclass. Back in the day, we looked at mission street, and now it does not look and feel anything like mission street. This is the last stand of the latino concentrated arts, culture and cuisine and people. We created a cultural district to do our best to conserve that feeling. That is what makes our city so cosmopolitan and diverse and makes us the envy of the world. We have these unique neighborhoods with so much cultural presence and learnings, that we want to preserve. [ ] i am miguel bus bustos this d this is meeting for june 16, 2020. I welcome the members of the public streaming or listening via by phone and live and to the staff who have helped to make this meeting happen this afternoon. Following the guidelines set forth by the local state officials during this Health Emergency, the members of the commission are meeting remotely to ensure the safety of everyone, including the members of the public. So thank you all for joining us. Madam secretary, please call the first item. Clerk thank you, mr. Chair. The first order of business is item 1, roll call. Commission members, please respond when i call your name