Transcripts For SFGTV BOS Govt Audits And Oversight Committee 3117 20170305

For streaming this live. And madam clerk, are there any announcements . Yes, make sure to silent all cell phones and Electronic Devices completed speaker cards and documents to be included as part of a file should be submitted to the clerk. Items acted upon today will be on the march 14th board of supervisors agenda. Unless otherwise stated. Thank you and i want to aaa poll guys apologize for starting late because there are two hearings going on at once and we can only be in one place at one time. So with that, madam clerk, could you please call item number 1 . Sure. There is a request to excuse supervisor kim. Made by member breed, without objection, that motion is adopted and supervisor kim is excused. And with that item number one, threes . Resolution urging the San Francisco employees retirement system board to review executive compensation, evaluate best practices on salary compensation, hold a public hearing on the matter, and issue a report. On behalf of supervisor kim, her staff bar bra lopez. Please come forward. Great. Good morning, supervisors. Im Barbara Lopez with kim who is putting forth the resolution before you today t urgz the San Francisco Employee Retirement system board to review executive compensation, evaluate best practices on salary compensation, hold the public hearing on the matter and issue a report. Supervisors this is part of a package of work that supervisor kim was going to be focusing on this year, which is looking it he growing equality in this country. What we are asking sfers to do and urging them to do is within the urge of sfers which is actually always historically had a history of looking at government and internal affairs where they are restricted in firearms and fossil fuel investments and asking them to step back from that which is to be in line with the by laws that we passed in 1988 about making sure that we are executive compensation is fair and reasonable. Which is a language of the 1998, 1988 by laws, and what we are asking to get to that idea of fair and reasonable, is to really have a conversation to have a public discussion to issue a report on best practices, and to sort of review proxis. The vote on proxi and we had a good conversation with the director, and obviously our proxy Company Already does do some votes on the say on pay. But what we want to do is for the discussion of how much we look at compensation and executive compensation. Folks, when i was driving to work this morning, i was listening to the radio to hopter i think that the topic right now in this country is our failed systems as it pertains to the middle class. I think if you take a look at the resolution or any facts out there in the world. You know that the average take home of a chief executive officer to a minimum wage worker to the average worker is somewhere in the neighborhood of 997 to one. And that is a growing economic inequity. And so. For us this resolution is not going to fully address that but it begins the conversation of doing so. And of acknowledging that our systems are failing the middle class and what more we can do with our investments to push the issues so that we are more responsible to seeing a growing income take home of our middle class workers. Before you, i always wanted to introduce some amendments to the resolution. So i am going to hand them over to our madam clerk. In the amendments we just added language that we thought was important, there is a recent report from a Company Called as we sew, that actually shows that when you look at the Top Companies where there is a huge pay disparity. These Top Companies have a huge under performing in the under perform the index and so we wanted to add some language along the line set. The 100 companies and the standard important index with the highest ratios under perform the index by 2. 9 in the Ten Companies with the highest dispr ta ratios and under perform of 1 on. 5, so in line with sfers which the number one goal of sfers is to be responsible to our investments and to our workers in terms of their fiduciary responsibility. What we are trying to link, thank you supervisor, is the fact that paying our ceos these accessive compensations does not mean that we have a better return. So we have the statistics to say that. The other language that we included is on behalf of supervisor cohen and also in line with her role as the president of sfers board is to also make sure that we have continued the discussion about gender and racial diversity on the corporate boards. And so those are two changes and there is one change which we just want to include that we also keep in mind our subcontract workers of publicly traded companies. The last further resolve clause, just basically asks skchlt sfers to list the companies that are in violation of the company that they come up and to work with the board to have that information be publicly available. Thank you. Thank you miz lopez. Are there any members of the public here to testify on item number one . I have got hansen lee and os, duka . Please come forward. Go ahead. Hansen. Good morning supervisors. I coming here as a member of ace, that we fall for foreclosure in this town many years last few years, specifically. This San Francisco increasingly become rich peoples playground. And i cant to see this ki circulating in this city to curb this kind of economic inequality. Last weekend i went to visit asian art museum. I saw hong dynasty, i saw hospital people how rich and how many people they buried with them. This made me thinking this 1,000 verses one ratio may even can match those folks that being shown around around the world. Are we San Francisco are prepared to have such playground that 500 years later we are going to show around the museum that we are going to have such people or such house . The rich ceo makes loss of houses by empty houses in here, sometimes they dont even stay here. And we dont need those folks in San Francisco. I am not proud to have them. And as a matter of fact it will be my pleasure dont see them in my town. Thank you very much. Thank you, next speaker please and following this speaker, i have two speaker cards, jonathan meed and richard. I am speaking on dehalf of ace my name is ash and i am standing against excessive compensation of ceos because economic inequality and what we get paid is a measure of our worth. Between the years are of 2008 and 2014, the ceos have become 1,000 more times valuable than they were back then and so what is my measure of a value today as a human . And which means that as an american worker, if we can compare the amount of value that the average worker lost it seems like i am ten percent of the worker that i could have been in 1978 and that is heart breaking as a young person to look at my future. And so yeah thank you much for paying attention to this issue and trying to bringing fairness back to San Francisco. And i am a grand new resident and thank you so much for having a lot of progress on these issues. Thank you very much. Thank you. Next speaker please . Yeah, hi, Jonathan Mead retired per medic from the city and i want to get up and echo the comments from ace, and let you know that the San Francisco west bay retirees chapter has supposed janes resolution and also the Retirement Security committee which represents retirees throughout the local. And i mean, i dont know where we are going with this. This is just our moment in time for people to rise up and fight back against, you know, an Economic System that has such gross inequality. And so this is one little thing that we can do. Thanks. Good to see you and thank you for many years of service to the city. Mr. Roth man another retired City Employee . Good morning supervisors, my name is richard roth man and i am a retired City Employee. After the last recession in 08 and 09, i see a growing gap in the middle class and the shrinking of the middle class that seems that the rich are getting richer and the poorer are getting just staying the same and i think that this is one of the manifestations of what happened in the movie lekz and so if we have a well respected and a fairly large retirement system compared with the otherwise and they are not as big as calpers but still lar large. To help further along this conversation. Thank you, are there any other members of the public here for item one . Seeing none, Public Comment is closed. We will adopt the amendments and send the item to the full board with recommendation without objection. Could you read, item lech out of order . Yes. Item number eleven,hearing on the citys Emergency Medical Service Response Times and 911 Call Center Response times; and requesting the Controllers Office, the Fire Department, and the department of Emergency Management to present and report. Unfortunately, and hopefully this will be the last week, the Audit Committee is meeting the same time as the budget and finance submitty, and so supervisor yee may have to come in here and hear that item and so we may have to break this up in segments but, let me st t start. The Response Times over the last year, and i would like to acknowledge not only the men and women of the Police Department and the department of Emergency Management, but my colleagues, supervisor breed who has been paying a lot of attention to this and there have been any number of improvements in the last couple of years. I brought this matter before us today because of a number of incidents in december of last year and january of this year which came to my attention in which the city actually temporarily ran out of ambulances. It is admittedly a very rare occurrence and as you will see in the presentations that we have, there has been vast improvement. But we have seen. But when a woman collapsed in china town after suffering an apparent stroke there was no ambulance available to respond to the call and it took 21 minutes for the ambulance to be tracked down more than double the Response Time or the target Response Time of 10 minutes. And that got some amount of Media Attention and what resulted in this hearing today. The dispatch center and two private ambulance companies, but i am pleased that the Ambulance Working Group has been reconvened and that the city family is taking this matter very seriously, but i thought that it would be very helpful for this committee to have as i said a soup to nuts chief, i still have that can of soup to nuts review of what we are doing and what steps we can take to improve it and how we can foresee these situations in the future. And with that, our first presentation will be from our fire chief joanne haze white. Thank you, good morning, chair, and president breed, and joeanne, Fire Department, before starting my presentation,dy want to acknowledge, you would be hearing i believe from the Controllers Office as well as the department of Emergency Management we have dr. Brown is coming from the department of Public Health. And i would also like to acknowledge because we are one provider, we have the partner and the private partners with us here today. So you have full participation from a number of different agencies. So to get started, we did prohe vied some slides for you, we have 13 slides. In 2014, as a result of the increasing call volumes the city wide work group was put together to analyze the citys ambulance system and provide potential recommendation to deal with and address the changing and increasing needs of the users here in the city, a number of those recommendations were implemented and i am going to review those shortly, these recommendations have greatly improved the performance of the over all system. And i talk about that not only are they improved but they have also addressed a growing population. San francisco is the 4th con guested city not in the country, but in the world. That is a reality that we deal with every day. To get from point a to point b safely to get for a code three emergency. I applaud the mayor for getting us together, for 2014, and the mayors i applaud both of you supervisors and you had a staff at that meeting to be part of the discussion, and conversation and solution, the next slide is the ambulance fleet, one of the major resource investments came out as a result of that work group was to purchase the additional ambulances and replacing the units in the fleet and expanding from 48 to 54. Investment and it included 500,000 in federal grant funds for the department through a grant. And i would also like to acknowledge and unsung heros in my book. Next slide is a graphic of what i talked about. Quick look at the age of our ambulance fleet by the year of the vehicle with the recent investments the majority is 5 years old or new, when budgeted the ambulances are received by the end of the current calendar year, we anticipate that 7,000 will be 2015, or newer that is unheard of, it is good collective work. We try to replace the ambulance every 7 to ten years based on their use, because they get a lot of use, but prior to recent investments we have not been able to maintain that mark. I think that given the daily growth in our city, we do amazing work and that is the San Francisco Fire Department and king and the department of Emergency Management and they initiate the calls to get us to where they need to get and before i get to where i need to, i just wanted to address what you alluded to because we did speak on friday the 13th that evening and i just wanted to clarify in fairness the call that you are referring to was initially, classified and coded as code two, which is nonlife threatening, meaning when the ambulance is dispatched, they are dispatched with the flow of traffic not life threatening. Based on the initiated how it was coded. And then it was upgraded along the way. I think, dont quote me, 6, or 7, or 8 minutes into the initial code two, that is got upgraded and you are right it did take 21 minutes, about you in fairness, it did not, it was not initiated as a code three call. I totally appreciate that. I think that there was a larger trend that friday evening. I think that there were actually five other incidents that evening or so it was reported on nbc the bay area. So look, we understand that our target is 90 percent. Which means ten percent arent getting their in ten minutes and we understand that. Can we predict that and adjust our staffing models in anticipation of that . So that is, i mean what we are here to do is not point fingers but to really. I want to get down into, and it might not happen at this hearing, it might happen over time, the details as to what is driving that increase in call volume. How much is that . You know, folks calling about sobriety issues when someone is passed out in a doorway, how much of that is a code three, emergency call . Any way, that is what we are here to do. All Great Questions and hopefully we will be able to shed some light on that. I did participate in a monthly cal metro chiefs phone call this morning, it is all the large urban california chiefs on a phone call. And la is dealing with the same thing, why is the call volume raising to the extent it is, when in last year, we saw more in one month, your question about is it the same time of year every year . I can tell you that all of the friday nights in january, 16, we were not as stretched as we were just this last january, so we are analyzing it all. And so this slide just, you know, Response Time goals as you know, are established through the local county authority. And the Emergency Medical Services agency. Goal for code three Emergency Response is to have a par met i can on scene within seven minutes, 90 percent of the time and the ambulance on the scene, ten minutes 90 percent of the time. Consistently we have always had that paramedic there in seven minutes and that is because of the work of the executive branch of the government and the legislative branch and we have more paramedics riding on more fire engines to get that level of als or advanced care to the patient that much quicker. Over the last 12 months, which is great news, and great improvement, the city met the Response Time goals for the first per medic on the scene and came close to meeting the go elz for the first ambulance on the scene, in the most recent month last month, february the city, met the paramedic and ambulance time response goals, again that 90 percent in the month of february, we got on scene in less than ten minutes, 2 and a half percent of the time, the next slide which you alluded to, call volume. What do you think changed between january and february that changed those numbers. I was going to say a shorter month. But we dont take necessarily credit for that. But some years, it is 29 days. Right. And so it is a number of factors and we are looking at it and we are coming out of and you would not know it from my voice and we are coming out of the cold and the flu season, and there was a lot of weather in february, probably not as much as january, but we were very busy in december and january, generally. But not exactly sure, and that is something that we need to look at and the types of medical emergencies that we are going to, because as this slide shows, you know, that the call volume has generally increased two main periods for which the city saw the material increase in the call volume and that was the fall of 14 and 16, significant increases. So we are studying that and it is not just a San Francisco phenomena, and it is a nationwide trend that we are seeing. And next slide. This is another graphic. One of the other recommendations from the work group was the establishment of a Data Working Group which is helpful and it is headed by the Controllers Office and measures and publishes data for the public on a number of metrics of the ems system. And i believe that the Controllers Office will be presenting on this. But here are the over all response data. Since the inception of the Data Working Group. This chart represents the city wide code three, Emergency Response measures for an ambulance on scene. Local policy goals state it should have an ambulance on scene to a code three call in ten minutes, 90 percent of the time as more resources were incorporated into the citys 911 system, some of the additional insensitives were implemented and the on time has been improved. The city is seeing an increase in call volume. I was walking out this morning, and there was a firefighter inspecting the hydrant in front of my house and he looked familiar and it was the firefighter who kept that little boy alive at the corner of powell and lumbard, who i brought before the board to honor him and the rest of the kroo you from 28 engine that kept that kid alive. That is what is driving these hearings and these discussions. Your local fire station. Good morning supervisor yee. This next slide, this represents a historic look at Response Times performance by the first als unit and that is having a paramedic riding on an engine and you can see pretty consistently we have met that goal. And we are proud of that goal as well. We want to see an increase over time of more par met ikz riding on the fire engine so that they can get to the scene because we know and those of us who are on the business does know that it does take a few minutes. A period of time, that we assess, and so that we can properly, transport the person to one of our nine receiving hospitals. Working on what will be the staff levels would be. As a result of Controllers Office recommended an increase in the staffing from 177 full time up to 200. That is pretty much where we are at now. One of the other things that has been a great help and i dont want to rely on it too much because as an example in super bowl last year it worked perfectly, that was the creation of the h8, on the part of management and labor to create an h8, which is the per diem and asneeded employee and many of them are working in system and firefighters in other departments and pick up a few shifts for us, and it works really well. It lends us some flexibility. And alleviates the mandatory over time for all employees and it helps to support the surgery vents and relieving of the employees. We currently have about 80 that are higher and hoping to get up to 100 and that has been very creative for our department. Continuing with the staffing and in addition to the ambulance personnel. And the staffing and enhancements were made, at station, 49, and the good work of the health bond that passed last june will provide for us, in the early 2020s, hopefully, an ambulance deployment facility, 40 million that was set aside in that general Obligation Bond and so we are looking forward to building a new building for all of the employees. But basically, in order to serve the employees and better mirror the dynamic Work Schedules we did a changing off of the shift and so the employees that are coming in at all times of the day and night get the facetoface supervisor support that they need and that has worked very well. And we highlighted a control substance system was developed to lighten the supervisors work load to have a more efficient system for monitoring narcotics and a couple more slides, purpose peskin. Personnel. And as a result of increased supervision at station 49, rescue captain four, and we have an additional supervisor back in the field. And one thing that i did want to highlight, because it also addresses one of the points that you brought up, and we created what is called an ems 6 and we used to have another one of it years back and that was the homeless out reach and very similar goals, basically, we have two full time captains assigned to the program, it is 12 hours a day seven days a week and they work with the department of Public Health to focus in on the frequent users of the 911 system that is not the best use of the system is that captain tangerlini old job. Correct. We have a one year recap on the work that is being done, and i am sure that there will be a written report and i am happy to provide that. The collaboration and communication with the private providers has increased the work that emr and does in conjunction with the San Francisco Fire Department is phenomenal and their employees are as dedicated as our employees and we appreciate that good working relationship like i said that has gotten closer over the last couple of years, we noted that is an area that we need to improve upon. As a result there are regular immediatings among all of the providers, coordinated by the ems agency, through the department of Emergency Management and Data Technology and want to touch on that. There were also data and Technology Improvements made and to increase efficiencies and improve the transparency. Developed a dashboard, and cad our computer assisted dispatch and software up grades were made which is improve the use of technologies including our avl, automatic vehicle locaters for both city and private ambulances. I already discussed our fleet in the investments that have really paid off and but we also invested in other ems equipment, such as aeds and other supplies, and replacement plan for the monitors and ambulances as been included in our budget we are working on the Staffing Levels for the department. And they have agreed to reanalyze, did that 200 that worked in 2014, is that going to work for us now . Should it be increased in the light of the increased demands for service and i would also like to pay credit to mr. David sul, and part of the equation is the hospitals, and the nine receiving hospitals we enjoy very good working relationship with. One of the concerns and i try to and i tend to simplify it and it is not a simple answer. When we see ourselves on the friday the 13th getting to the levelling we are getting at, should there be an exemption to the regard of the receiving hospitals. When we go to the hospital, there is a pattern by which we need to transfer the patient from the prehospital care provider which we are to the hospital. Sometimes that can take a bit of time. My feeling is should we explore looking into the possibility the feasibility of if we have a completely stable code two patient, which most of our transports are code two, nonlife threatening and if he with have a completely stable patient, could there be an expedited manner, in which we are in a code level, and we are low on the ambulances in the street and a more immediate measure to return the ambulances back to the streets so that they can respond to the elderly woman that you heard about on january the 13th. It is something that i do believe without a lot of money, more money thrown, it is the information is worth exploring. Thank you, chief. And i know that you have to get off to another thing. I am good actually. I changed my plans for you. Excellent. Happy birthday. Thank you. Are there any questions for the chief, if not, as i mentioned earlier. I will be here too. Thank you. We need to accommodate supervisor yee who is toggling back and forth from budget and finance committee. So madam clerk, if you could please, we will take a break from item eleven if you could read 9 and 4 together, i know that she is thinking this looks like last years audit oversight committee. Item four and nine,motion directing the budget and legislative analyst to conduct a performance audit in 2017 of the Police Departments allocation of police Staff Resources funded by the general fund, including evaluating the Staffing Levels and efficient deployment of uniform staff to best meet Public Safety needs, and allocation of uniform staff to administrative and patrol duties. And item nine,resolution urging the Police Commission to form a task force on Strategic Police staffing and deployment with the purpose of determining the best methodology for establishing Staffing Levels and deployment in the Police Department. Thank you, miss plmajor, bot of these items are brought to us by supervisor yee, the floor is yours. And i feel like this is a hom coming again. I will skip the item number four in terms of the comments and move right into the Police Staffing piece. First of all, it has popped up and the last time that we did this was almost two years ago and i mentioned at the time that the and that we are hopeful that the and hopeful that they will reach the number that was set probably a couple of decades ago. And it seems like we will be reaching that at the end of this year. So what are, and what i wanted to do was create a task force to look at it from analytical sort of point of view and to make decisions that are data driven, the fact is that population, and other factors and what is the best practices at this point . And one of the things that i wanted to do was park it and this Traffic Force and within the body that is probably best prepared to do this. Which is the Police Commission. I have spoken to the Police Commissioners about this, in fact, last night we had, and they had their Police Commission meeting, and it took up this item and basically they are passed their motion to support this item and as it moved forward and they had also that i take one amendment for them so i will be talking about these in a second. But the idea here is that there will be representatives from the rank and file also administration and the police chief, and community members, and other members from other entities that can fit into the task force. One of the biggest things about this task force is that you create something where you are hopeful that everybody will agree on. And at the end of the day, as they have a plan, and it is something that the board of supervisors and the mayor can take up as seriously and Work Together in see how we can fund this. The other thing that i want to mention about the resolution, is to strongly urge the Police Commission to budget this activity because without having additional help whether it is internal staffing or consultant to come in to orchestrate the task force, it probably will not get too far. So they may, they have to have that discussion last night also, and understands that. So, today, what i want to do is talk about some of the amendments. That i would like to see in there. The First Amendment is to remove the word deployment in the title initially it was called the task force of Strategic Police staffing and deployment. It may be misconstrued as micromanaging and so we will be removing this term and this was a recommendation made by the Police Commissioners. They wanted to reference the chief of police as a collaborator in this process, and so he does over see all operations. That is soming that we want to add in as an amendment and i also have other minor amendments changing the office of citizens complaint to the department of police accountability, which is the new name. And then adding language to reflect that the task force should include other experts such as the Bar Association and then adding language to urge the commission to propose funding for the task force during this up coming budget cycle. I think that this is a good path forward to take the politics out of this very important decision, and have the confidence that the Police Commission will be thoughtful in creation of this task force and i hope that this committee can send this resolution through to the Committee Report to solidify the boards support and intent. The Police Commission is ready to take the next steps the city controllers working with the commission to discuss the resources and support to insure that the task force is staffed and able to follow through on a Strategic Planning process. Thank you. Are there any Department Staff who wanted to speak to items four or nine . Are there any memsz of the public that would like to make the Public Comment on items four or nine . Seeing none, we will close Public Comment. As to item number nine we have a number of small amendments before us that supervisor yee has just spoken to. Is there a motion to move those amendments . I am happy to move the amendments but i would also like to discuss the item in detail. Okay. Without objection, we will adopt the amendments. Supervisor breed. Thank you, and thank you for your presentation about the matter. And also for your amendments. I think part of i know that there were conversations about this particular matter in the past. And i think my biggest concern and what i would like to hear more about, is that we just hired a new chief. We have had numerous challenges with this particular department in the past, and i personally dont think its necessarily to point out or to develop i guess things that would be perceived as being micromanaging of a particular department. Although i do think that it is important to make sure that when a department is not doing exactly what that department should be doing, we should point out those particular things. We should you know, make recommendations, we should address issues around that budget. And highlight issues like we are doing in the case of Fire Department and the blons Response Time and the unavailability of the ambulances and in this particular case i guess that i am just trying to understand what you think this might do and why. And how, how is this not micromanaging of the department . And so i think that is where i am a little confused. I mean, i will say that from my perspective, would i like to see more officers deployed in challenging areas throughout my district. Of course. Would i like to see a better system, a better plan and issues around deescalation and so forth . Of course. I do believe as someone who has kept a really close eye on what the department has been doing over all we are implement s policies that have worked over the past few months, we are graduating classes on a regular basis, new Police Officers and equipped with now policies that will help to protect all of our citizens and these challenges are complex and i am trying to understand why adding another layer of responsibility would actually help move us in that direction sooner rather than later. I would be happy to answer that. And it all came about when indeed, the board decided to micro mana micromanage when it whats voted upon two years ago to say that we want the staffing to be a higher number than the 1971 and it was a certain number that was given and at the time that i voted against it not because of the 91, and the Police Officers, but i dependant know where the number came from and it was never explained to me. And when i asked the police chief at the time. Chief, would you inform of this decision and he said no. That is why i voted against it, where did it come from and why are we making decision foz them . And so it sort of, ivanka kept that inside of me, to know that this has got to be a Better Process than coming up with the number that the board votes for. And i thought about this and i actually talked to the chief about this particular thing and he was very supportive at the time and i should pursue it and then he left and i actually talked to interim chief. I mentioned it to chief scott when i first came in, but to be fair it was not much of a discussion, he was running around trying to meet everybody and that is why they wanted me to have a discussion to be on the same page, the intent is to basically say urge the body body that is supposed to be responsible to move forward, otherwise the board of supervisors might continue to make decisions about that input and it is important for me any way, that we have Community Input and know all of this, and all of the professionals that are part of this. And so the intent here is not to micromanage it. And then also at the end of the day when we make decisions in the budget about what the Police Department budget should be, we have to make decisions on what kind of staffing do we want . That is why we support it in the last few years, so many Police Academy classes. And so i think that if, if there was a road map to what we think we should need and everybody is it agreeing on it. Then, the mayor and the board of supervisors should get behind it through the budget process. And so that is sort of my intent. Thank you, and thank you for that. Explanation, and i guess the other question that i had had because, you know, i would like to be as efficient as possible, arent there other means to develop these numbers arent there consultants that we can hire or the budget and legislative analyst could look into this particular matter. Why i guess why, why do you believe a task force of this nature which will end up being of course, time consuming, why is this necessary rather than focusing on experts who help develop the appropriate numbers, which would be on par with what you are trying to accomplish. So, as i mentioned i actually went to the Controllers Office on this already. And they are working out the numbers that might be needed to make this a successful project. Which includes in fact, when you are talking about having consultants come in that have some expertise already. The reason why i wanted to not just take it out of the hands of the community, and the commission, is because, at the end of the day it is going to be a political decision. And i am trying to make it so that up front, this we will do this together and Work Together in the collaboration so that it becomes less political. Because whatever the decision someone else comes in with, and if the community and other stake holders are not involved in this, they will be involved with it one way or the other. And i have to do it up front. And the other thing, i think, i want to offer a friendly amendment to the further resolve clause, which includes retirees because i think often times it is not taken into consideration when there are large numbers of members who retire, that is a loss there is also issues around injuries, specifically when someone is injured. That should be taken into consideration. So i would like to make sure that those two issues are included in the discussion for developing the appropriate numbers as well. I am open to the amendment and in fact the list that we put is not limited to that list. Yes. So i, i am more than happy to accept that amendment. Thank you. So with that, supervisor peskin i would like to move those two amendments to include in the further resolved clause, line eight, in addition to. On page 2. On page 2. In addition to the list, we could include after deployment, which is right before population size to take into consideration, or just to add the word retirees and injuries and population size. So we are just including retirees injuries and into the further resolve clause. Thank you. Letsz take those additional amendments without objection and on the item as twice amended. Move to the full board with positive recommendations. Could we. As a Committee Report . As a Committee Report. Yes. As a Committee Report that will be our action and on item number 4, which is sets the 2017, budget and legislative an sift audit plan for the Police Department, can we do that same house same call . Yes. But we will not go as a Committee Report. Thank you. Okay. So we are break for the station identification is over. And we will go back to item number eleven, our hearing on emergency Response Time. And we will bring up the Controllers Office here is here from the Controllers Office i see that peg stevensons entire team is here. And chief if you have to leave we totally understand. I am going to stay. All right. The dashboard is really interesting, everybody in the public should look at it, it is fas nature and interactive. I am heather from the Controllers Office, thank you for the chance to speak on the medical response, performance dash boards. I want to introduce the team peg stevenson, the directors, sitting towards the back this is celeste berg and she is a city performance analyst. Next slide. Before we review the performance dash boards and the chief had alluded to them and showed some of them. 2014, the Response Times were exceeding the goal, this became a Public Safety issue and there were no agreed upon methods to measure emergency medical response performance, manage, operations, to these performance indicators, and to rely meaningful performance information to the public. And when i mean that there were no agreed upon methods to measure emergency medical response performance, i mean within the system. Including all ems city departments and private ambulance providers. City officials were quick to respond in the summer of 2014, the Mayors Office convened an Ambulance Working Group in the fall of 2014. I just have your draft from yesterday. It was not comporting with what i was looking at. Before going into the details and the dash boards that we created and are now publicly available, i just wanted to show the time line of the Controllers Office work with the Data Working Group and the deliverables that we have created since the fall of 2014. So as i mentioned, after the Mayors Office, convened this initial working group in the fall of 2014, the Controllers Office convened a specific Data Working Group. That hapdz in january of 2015, we met bi weekly and sometimes monthly, depending on the phase. And so almost two years. We were able to public dashboards in 2016, that focused on dispatch and response performance and then we followed that up in october of 2016. I am going to turn it over. Does this one okay, thank you heather and good morning supervisors. So first a little bit more on our Data Working Group it was comprised of the stake holers from the full system, we have the private ambulance providers as well as sfsd and then from the department of Emergency Management, we have both the division of Emergency Communications that operates the 911 call center as well as the division of Emergency Services in which sits the Emergency Medical Services agency. That has the policies governing the system, so for this Data Working Group, we have a set of stated goals and we wanted to develop the agreed upon data systems as well as the methodology and provide transparency to the public as well as accountability to each other in the system and so now we will get into some of those system. And so this is the system performance dashboards website, and the purpose of it is really to serve as a comprehensive set of intervals that Patients Experience when they are interacting with the Emergency Medical Services system, so at the top you can see that we have a collection of different dash boards that represent these specific intervals. We also have a headline on the response. And so just a quick visitor could see how quickly the ambulance and we have the information on the Data Working Group as well as the 911 system and so our first dashboard is on the dispatch interval. And i wanted to just show the sort of the key visual not to labor the point here, but this is the and the call is entered from win ten seconds and once again, the story is shown here. And that since september, 2011, the call volume has been increasing rapidly and we can see here that the performance has been impacted by this increased call volume. And this has been of course, impacted the full 911 is is temperature beyond that dispatch interval. And this is the dashboard to the response interval, and so the period of time from when the unit is dispatched until it arrives at the scene of the emergency medical incident. . Edo you have a. It is good to make sure that we have leg able and the people are watching on it television and it is hard to see. We apologize that it is difficult to see on the slide. It is on the previous two slides. The overview of the dashboard on the slides there and all of these dash boards are publicly available and also updated monthly. Can you point out some significant changes on the starts based on the numbers here . We will get into the trends in just a second. We can go to that right now. First the chart at the top, is representing code three. And responding to the threatening and medical emergencies and we can see only 26 percent were arriving on scene in ten minutes. And then since that lowest point in july 2014, the first time that is surpassed the 90 percent goal was in june of 2016, and from june, 2016, until present, it has been hovering right around that 90 percent goal line. And then, in the table below the chart, we have the respective time goals for each type of responder, and then below is a more detailed data table that shows the average, 90th percentile, and as well as the data methodology and so i want to say that our Data Working Group, underwent extensive discussion about how to exactly clean this data and so we have noted our methodology, and so that any users of this are clear on what exactly we have done. So this chart really provides an over all picture of how we are doing. But, it does not get to the level of Response Times during specific times of day, or day of week. It is an over all picture. Or the month of the year. Yeah. I mean. There is an intention which i cant determine if it is supportable or not, that there has been a trend that in december, january, and february that this has been a pattern. But i i need you to tell me if that is true. It shows the niept percent responses in particular months but that is correct, over months like january and december for particular years it does not go into that level of detail. And we published a second set of dashboards as we mentioned in october of 2016, the first being on ambulance destinations. So where in what hospitals in San Francisco are patients being taken to where they are transported through the 911 system. And so, first we have the criteria and we first we have the map that shows the hospital locations and the dots that you see on the map are sized by the percent of system wide transports that each hospital receives monthly. And this is on the rolling year. Diverse is the term that is used when it is closed due to over capacity and so we also have a dashboard on ambulance or on hospital diversion. That means that other, and hopefully my colleagues is speak to this. But i believe that those are Emergency Departments that come in after other ones, or other hospitals are prioritized initially, as transport destinations. I get that, but only as the chinese as the stand by ed and all of the other ones, the sobering center, the cpmc, california, campus, the va dont have that. That is stand by, ed means stand by Emergency Department . Yes. Can you plain what that means . I am dr. Brown and i report to the department of health. The term stand by Emergency Department means that the facility itself, department is licensed in a category by the initiate as a stand by department, meaning that there is a physician on duty in the hospital that can respond to the Emergency Department for the patients that are brought in but not necessarily immediately available. Meaning sitting in the imagine departme department. Both have physicians, including the emergency medicine is he va, and they have take patients from the system but they are code two. Not critically ill, but ill patients that selfdesignate going to those facilities. For instance a veteran who has the va benefits wants to go to the va hospital and they can go as long as they are not ambulance deversion. The member of the Chinese Health plan would like to go to the chinese hospital, if they dont meet that first criteria, meaning that they are acutely ill, they can go to that department. That is complex and i know that is something that they are working very hard on and it is a place that i work as well. It has to do with the excess demand and not enough capacity, it is bigger with much more, however the capacity of the hospital has not increased to the same agree that the Emergency Department has. But it has increased so what is happening now is the Emergency Department has a number of patient in it walting for the beds to be admitted. And we are working hard to resolve it and i would like to see it a lot lower. What is your prognosis for seeing it a lot lower. And so again, to answer the question directly, i think that it is good. But in the long term. One of the issues is that it is the only trauma center, and so for the patients that have acute traumatic injury, it needs to be opened all of the time. And so when the San Francisco general is on ambulance deversion, they get the trauma patients that are at that level of severity of injury. And so we want to preserve that in all cases. But i think that we can do that, and still decrease the over all ambulance deversion rate and there are systems that have no deversion and they dont allow it and they have the plans in hospitals to take on that medical surge. In other words, when multiple ambulances arrive or when the patients come in large numbers in a short period of time. They have ways of accommodating that within the hospital, and not pushing back into the ms system. You have not been looking athat in relation to the friday night surges, and january and february which seem to and when i was looking at that chart, it is hard to tell when you have got these dips, whether they seem to be coming at the same time of i couldnter and that we should be anticipating them. And staffing up for those. But it looks like there seemdz to be a historic pattern there but it would be nice to determine if that is true or not. So that we can anticipate it going forward. Yeah, really the goal of our Data Working Group is to make this data publicly available on the dash boards and so in terms of monitoring that, and the level, that is not something that has been in the purview. But it will be in the staffing model. I think that i am a little confused about i that response because my understanding of the working group was to address what we believed to be a crisis in terms of Response Times. And the whole point of that is, i mean the data that we had and from my understanding already existed. And the goal was to try and figure out what our staffing needs are, what our equipment needs are. What are some changes, i mean that we needed to do, some of those things were discussed and the chiefs presentation. And so, at this point it would seem that we should already have arrived at a conclusion of what we should already be doing especially within a twoyear, time. So i guess that i am just trying to get a little bit more clarity as to why we have not gotten there. Part of it is yes, you know, with he know what we need, yes, we have added more money to the department, and even two years ago there was more money added for the equipment to the department that the department did not use. But, like, why have we not addressed when we know to be an issue and a possible pattern around addressing these issues . And so i think that that is really what i am looking for. Thank you for your question president breed as i mentioned in the background, the Mayors Office convened an initial Ambulance Working Group and some of those questions operational decisions, about how we are going to address staffing and we doh a staffing a quick, staffing analysis, and in february, of 2015, to get to an over all number and we are refining that analysis as we speak to look at increased call volumes but that 911 Provider Group is where the dm and the fire and the ambulance providers and the Decision Makers look at operational issues and make recommendations on how we are addressing that and i think that dm could speak to that. Volume and showing what the des at the nations and hospitals where the ambulances are going and we have a dashboard, showing measuring that rate of diverse, and certainly the next steps that there are other next steps that we are talking about. So that information is not currently maintained by dem. It is. It is on the dem website, the website that i showed earlier is linked from dem website. Nso the Fire Department and the dem are keeping their own numbers. I am trying to understand what is happening. From my perspective a lot of the information existed and you are putting it together in one place and i am just not understanding why that is necessary. The number existed but did we agree how we were cleaning the cad, data, how do we deal with those call up grades in we needed to have a system wide approach that all of the agencies agreed upon. And as to what that number was. And everybody was slightly looking at the data, a validation here and not including these type of calls can change what those metric and that performance data really is. And so what we had really seen and that is why we had convened this Data Working Group was to make sure that all agencies. Believed in these numbers, and understand how they were reriefd and could make the decisions based on those numbers. We know that there is per the em essay that there is a Response Time goal and that is what we are trying to measure. There sh other obligations that i believe that the dem and fire could better respond to than us. But we really wanted to focus on making sure that we had data that automatic believed in and that we could give one flum to the public. And i think that what is the most important to me, of course, is the Public Safety as my top priority and making sure that we are get to what the numbers say or the timing of trying to keep it at ten minutes when you are in the middle of the crisis you want to happen right there and right at that moment tla is just as important, and so i just want to make sure that that we are not creating a lot of systems that are not accomplishing all of the goals that weapon want to accomplish there is not a system that makes everybody happy as much as there needs to be a system that works for all of the things that we are trying to accomplish, and so thank you for your presentation. Not to put too fine of a point out. This is a very helpful set of too tools. And how the staffing models need to change over time. We know that the call volume are increasing ask there are spikes in that demand. And in accounting for that in this next go around of a staffing analysis. And it is looking at specific days of the week, or times of day, and how are we accounting for that . And i know that fire and dem have thoughts around that as well. With he did have a problem and we still do have a problem and the goals definitely to get it fixed as quickly as possible. So in our next step slide, she was saying that we are going to up date those staffing numbers and looking at spikes in demand, looking at it and the days of week and the times of day, and then, another next step is also to look at turn around times, when an ambulance arrives at a hospital to when they are back available on scene to respond to the call that the chief is alluding to, that is the next step for the Data Working Group is to measure that, Response Time and figure out how are we doing, and are there operational changes that we can make as the chief alluded to on some of those code two calls that will get more ambulances available to respond to the code two to code three. And i would also like to see, and the information that differentiates between the number of calls and the types of incidents and what they are. I mean, i am trying to figure out whether the fact that more people are calling, does that actually translate into more people need a run . And what are those runs . And are they people having heart attacks or strokes, and it would be nice if we could actually drill down into that level of information the department of Emergency Management and to everybody else who are here for Community Benefit district and Business Improvement districts and i appreciate we appreciate your pay chens patience. Yes, good morning. Or good afternoon, chairman and the president breed. I am mike and i am one of the Deputy Directors and we have a presentation that we are loading at the department of Emergency Management. And i over see our division of Emergency Services and also the Emergency Medical Services agency, first let me thank you for your leadership and interest in insuring San Francisco provides efficient and effective and medical services to all of our residents and visitors, we appreciate your partnership and i know that you have heard a lot this morning about the improvements that we have made since 2014, and i just wanted to briefly today and i only have four slides to provide a little bit of context about our role and as you heard this morning, during the same period of time since 2014, the call volume has dramatically increased and we have made significant improvements. The additional investment in staff and resources is producing better results and another major component has been our sustained commitment to coordination. Back in the summer of 2015, our director reestablished the 8911 Provider Committee. The division of Emergency Services and the ems agency, and the Fire Department, and the king american and the american medical response, and the Provider Committee meets every two weeks to address, common operational issues such as scheduling emergency, medical coverage for special events, and other issues ma may need improvement, this forum has led to a number of system enhancements in december of 2014, when the ems system was really stressed. King and mar, both decided to dedicate the units to the 911 system. And i mean that this was a major effort on their part, and a major enhancement to our system and it really provided us with more predict ability to the system and i so i have to give a shout out for the king and amr. And it is identified, surge unit and so by what i mean by retunely identified. Is that we have got them identified this bring in units when we do experience surges in demand and we also establish the daily call at 7 a. M. And which they chair at the department of Emergency Management and but it includes the representatives from the San Francisco, Fire Department, and at dispatch, and it includes the difference of Emergency Communications and king and on those calls what we typically do is go over the schedule of the day to identify, do we know of any unexpected events are any anticipated events that are going to impact our ability to respond to the public . Is it perfect throughout the day . In no, but it has had an impact. We have also increased them on the holidays, new years eve is the busiest call volume that the city has, none of the hospitals are on diverse and we did not have the medic to follow at all this last year. So i know that we can do this. And it was not raining. Correct. Have we made progress in the last two yafl years . Absolutely, are we satisfied . Absolutely not. The folks in the room right here, they are all dedicated to improving our ems system. And so who are the next steps, we are going to continues to support the work of the Ambulance Working Group, and it is chaired by the Mayors Office. And we are also going to continue to convene and lead the 911 provider Committee Meeting that again, meets every two weeks and also the Data Working Group. We also going to enhance the computer added dispatch system and rob, and my colleague and the fellow Deputy Director, but basically when we talk about enhancing the Computer Aided Dispatch system right now, we have cad that identifies the units that are available and that we also post the units die maamically and so after they run a call, they are posting and so it basically recognizes where they are going to post it and we are enhancing that to have the gps so that we actually know exactly where they are you know, 247, every minute of the day, so if a call comes in, we will know with the senator if there is a closer unit to a closer call. We are enhancing the ability with the amr and king, and we have identified the funding to enhance the Communications Ability with your computer dispatch and the units where they are. And we also regularly exercise the mutual aid and out of county aid. And so that we take we use the opportunity of the special events or large events like pride to bring in some of our 911 providers to make sure that they can communicate because the last thing we want to do is call in a strike team from another county that has never worked on the radio and does not know San Francisco or our system. And in an emergency, you know for the first time. We want to exercise those things ahead of time. And then, you know, some of the events in january, i just got to say that my observation from january, is you know, we had 1,000 increase in call volume from this january to january 2016. I mean this is a trend that is seeing all over the bay area this year. And all over california. And i mean that it is, you know, due to the flu and so yes, if we make modifications throughout the month, and to address the increase, yes, all of the providers have added units to the system, you know, for the past 60 days. But mr. Day tonight. Yes. I understand that one cannot anticipate how much flu will go around and how many people will have it. But one can anticipate that in the winter looking backwards people get sicker. Do we anticipate that in our staffing models . Yeah, absolutely. I mean, we do and the Fire Department. And they look back at the past 40 days; is that correct . . How many weeks back . And i mean that we do anticipate year over year and so we know that there are flu and these are the types of items covered on the daily calls about. What i am trying to get at is not the last 40 days, but the last four years. Right. And to the extent and again, it is looking at that chart. That the dips come or the spikes come at similar, and we all understand that the call volume is going up. But what i want is some level of analysis. And then some staffing model changes, that anticipate if indeed it is true, a flu season, which generally comes in the wintertime. And if we could know a year in advance that we need to have extra in the same way that you staff up for new years eve. That we staff up for january, and february and march, as compared to months where we have historically lower call volumes and that, i mean that would be a pretty difficult profound staffing change. But, i want to, i want that to be data driven. Right. . Enot true facts, but i mean, not facts, but true facts. Right, right. I understand. Yes, and i mean that we are trying to get to the point where we actually look and okay, did we meet our on time performance from the day before . Did we meet it last friday and try to modify the staffing patterns on that . And that is going to be, you know, part of our continuous quality and improvement. And on. Go ahead, sir. Go ahead. Just on the last item i was going to mention on our last or next steps is revising level zero policy for ambulances, currently, in 2014, we realized we needed to call it, and have the mechanism to call in assistance when we ran out of ambulances. So we, and it created a level zero policy. Obviously in looking at some of the incidents in january, part of our, you know, issues that are discussed with the provider Committee Meeting was we should take a second look at this policy, is there or a time to modify it. And we have got the drafts circulating right now to modify that to a low level ambulance policy, so basically, we get to eleven two and we get a number of items to free up the Storage Units and we contact the amr king and the Fire Department and you are at level two and it is likely that we are going to need the available units and if there are units that can clear, quicker than we want to pull those units and get them back in the si system so that they can respond to calls, and we are taking a look at to whether or not we should hold the two calls or send a fire engine to that. And that is really a very, i know that the fire chief and the others in the Fire Department have strong fieldings about that. So we are working through those issues. And apparent from actually hitting the levels zero, how often are you getting close to hitting level zero do you watch that . I do have some statistics. The airport terminology near misses that we look at . I mean certainly when we have the multi, vehicle accident which is not often, or if you have an event like the tour bus or you have the multiple patients at the same time, any spike in demand, it, i mean, it can cause us to get to level zero or close to level zero, but i can report back to the numbers and i dont have those with me. We were going to develop this center that was implemented in the past and it had gone away because of funding and we had provided funding for it again and the tender loin where we had the large volumes of specific cases that could be handled easier than using an ambulance or deploying someone to general or any other place. I apologize that i dont know what we called it, but do you have any about that and whether or not that is up and running or how that has contributed to a reduction in call volume . Sure. I mean not call volume, but issues around Response Times. Sure, sure. And so just to briefly review. In years passed there was a hybrid team for lack of a better team that had paramedic and then a worker from the department of health, Substance Abuse or Mental Health caseworker. That were going and finding patients that needed large amount of services that were not best served by transporting and get the leave saving treatment and discharged to the same situation and calling 911 over and over again, there were patients that were coming through, two or three times in 24 hours. That was decommissioned and restructured as the ems 6, and we recently completed a training for the enhancement of the paramedic skills to include more of the Mental Health and the Public Health out reach skills as well. That the ems 6 team is now staffed with, in addition to the Public Health personnel. And that the hours have been mentioned. It is not 247 yet. I know that this is something. Is it monday through friday . It is 7 days a week, 12 hours a day. They are not only working with patients in the street, they are also responding to calls from providers from 911, paramedics in the street and also going to hospitals to the Emergency Departments to where these patients are found. And in the department of health has a high utilizer of the group that looks at the data from all of the contact and not juchlt ems, and so i am happy to have my colleagues and i come back and talk more about that in depth. And i think that it is going to be successful for those patients who tend to generate a number of calls. We are now reaching out even further to try to address that need and take care of those patients. I think that what i am looking for, of course the calls are going to come, so this may not necessarily impact the call volume, but or just maybe a tad, but how does it Impact Service . So, because particular incidents that are handled by the department of Public Health maybe in a proactive manner and maybe because of a call that had come in and now they are no longer taking possibly, you know, an ambulance, out of service, because of transport. And having i guess a little bit more understanding of maybe this is for the Controllers Office to add to their list of number gathering things that i would like to know if this plays a role. I mean, when i first heard about it and i knew of exactly what i know that it could possibly do, i thought well why did we take it out of service in the first place. I would like to see how it plays a larger role. Certainly, and i i think that you have touchd on something very important, that if a unit like that can take a perfectly take eight or ten or 12 calls out of the system that has the effect of injecting another ambulance into the system because ambulances that would not be the same, but multiple ambulances are not tied up on those calls and again, taking care of the patient is the most posht and these patients often times are complex and they need more than paramedic and a ride, they need the services. And what is this called under the department in it is called the ems of program and it is run by the Fire Department and it is the High Utilizer Program in the department of health that coordinating that data and i think that is where we can get you the better data. Doctor while we have you up here, there was some mention by the chief as well as by the controllers staff with regard to what is referred to as the wall times and the amount of times that they are spending in the hospital transferring, and there is policy about expediting those times in circumstances when the system is stretched, do you have thoughts athat . I do and that is another excellent point supervisor, that if an ambulance can spend a smaller amount of time at the hospital it is more available for more calls in the system. And so if we decrease and we have looked at this in a broad generalization is that if we can decrease the ambulance time in the hospital to 30 minutes or less, and it is supposed to an all the mate of 60 minutes or more, and that again has the effect over the day of injecting one or more ambulances back into the system. So i am pleased to say that while it is a problem for us and it is ongoing, we are making progress in this area. Sxh we recognize it as a problem last year, and we started to develop a means to evaluate the time, because the time has two components and the first is the turnover of the care of the patient from the ambulance crew to the hospital. And it is very important that this is done correctly. I know that myself getting patients that sometimes cant speak for themself and whatever reason, or a stroke or whatever it might be, getting the actual report of the paramedics and the transfer of care is important to the patients safety and so we have to do that well and that can be done, and then the unit has to get back into service and there are functions that they need to do and that is a shorter period often and that is the total period of time that the ambulances at the hospital where it is not in service. And so we started to track it and set a goal for ourselves of a 30 minutes, and for the goal for the maximum time and we would like to decrease, and i know that some of our private ems providers are using 20 minutes as the goal and meeting or exceeding that and we do still have periods of blockage and we are investigating those. Why is that we have periods where one hospital has a number of ambulances that are at the Emergency Department, and that care has not been transferred. It is not good for the patient and it is also not good for the hospital because they dont know the condition of that patient yet since they have not assessed it. So we are engaged in meeting with one of the hospitals to discuss the issues there. We have to get the to the root cause, is that the amount of ambulances arriving . Because that can be an important factor, but it can be condition of the Emergency Department at that period of time and that might be due to staffing there, day of the week, type of patient shgs etc. And so we are doing more of a dive on this and we will be meeting with one of these hospitals to discuss their particular issues this month and we will report out on that. And so we want to get to this goal of 30 minutes and i think that the state has gotten on board after we started the state goal that is being promoted now is 30 minutes as well. And some of Southern California it is really been very difficult. There are hours of times that patients are stuck in Emergency Departments. They are going to get there with the fire engine or an ambulance and, once they are there, they can safely, i believe make the determination this patient needs other types of services. And we can provide those alternative services. But if we could, understand better and have a difficult nationwide problem, from the initial call from listening to that callers voice, and i would strongly encourage you to listen to some of the calls or visit the dispatch center because i have tremendous respect for the dispatchers they do an amazing job and they have a difficult job of getting those calls that may be very frantic and have Little Information that is helpful to determine the best Health Response and sort them out. I have confidence that we will get to the system advanced medical priority dispatch, where they use the dispatch center itself to determine calls that could go to a nurse advice line that could go to an appointment line for a clinic appointment or to a unit such as ems 6 in other words, a multi unit rather than an ems unit. That could take somebody to the sobering center. Correct. Should we hear from 911 and open it up for Public Comment. My name is robert and i am mikes colleague, and i am the Deputy Director overseeing the division of emergency communication. Otherwise known as the 911 center. I want to just touch on three points that were briefly mentioned. The first is my center, the center that i over see, the 911 center has our own set of metrics and some of which we are not currently meeting, one of which was pointed out in the controller controllers. And i come before the board last year and i came to president breeds office to explain what they were doing about it, thanks for the boards support, and almost one out of four of our current dispatch staff are trainees that we have hired since that time last year a year ago. And although the they are not fully able to help us out right now, that is a significant light at the end of the tunnel for helping us to address some of those challenges. I do want to thank the board for your support in that. And the other to points, the first one that i would like is that i want to emphasize the role of the two private providers in addressing this issue since 2014. And going forward. The way that the 911 center grew up was not really designed with that in mind. We knew based on what they told us over the air, their location but we did not have a visual on them. About the calls and we are working with that on them and my colleague, and mike and i. The Fire Department has a two staff assigned to the center, 247 and the rescue captain and there is no such staff for the private and so making sure that we incorporate them into process, particularly when there is a low level of med ticks and something that we have done significant progress on and we have a lot more to do on. The chat emgs in the system over all is operating either a slightly above and close to the goal of threshold are different from the problems when we had the chronic shortages of two and three years ago. They still are important to address as the specific instances that we heard earlier. But surging into the system when we see the temperature spikes is different than when we are operating with chronic shortage and we are working with our current policies to trigger some of the alerts slightly earlier and to make sure that we are actually reaching out not just to the Fire Department which is easy for us, with the structure that we have, but also the privates who do have some structural ability, often times to help us out in that. So those are some of the focuses on my end of this issue. Thank you, for your presentation. And for your work. Chief haze white, if you have any additional comments, if not we will go to public xhebt. Chief you are up. Thank you just three more comments as you can see. We are working wr closely together on this important aspect of how we provide prehospital care service to the community. I did just want to touch on as i did in my presentation, the ems six Program Works out of the San Francisco Fire Department in conjunction with the department of public hel and this we have had a lot of success, and right now, 12 hours a day, and we have one dedicated captain working from noon to midnight, and every day of the week, and we might look at possibly expanding that. And i think that that would be a good bang for our buck so to speak, and so that is more to follow on that. And i want to give you a specific example of 1001, polk street was something early on that we recognized that we are going two or three or four times a day to, and it was the single most address, and one of the suggestions that we had and we implemented with the partnership of dph, is can we have a higher level of medical authority there to assess and triage what the person needs . As a drop in center . But just as that single nurse that is assigned is our numbers of responses have dropped dramatically to 1001 shgs polk and there by freeing up the resource to go to someone who truly needs the 911 response, and so i thought that was creative and it is doing its job and the last thing because i know that you do not sound convinced. Wither not looking at trent. And i have something that will give the clerk to give you. You heard Deputy Director dayton say that last year, january of 2016, we percented is,000 more calls, so those and that, and i dont have a and i could put it up on the screen if you want. That is something to look at. Those are the four friday nights in january 16, verses the four in 17. And you can see that in january of 16, our supply was meeting our demand and not the case in january of 17. So, i know what you want us to do is to try to figure out why. But friend wise, we did not see that trend last year. And we constantly are reviews friends. Thank you, chief and look, i think that part of our roles when we heard about this incidents or patterns as happened on january the 13g9, which happened to be a friday, is to make sure that everybody is taking it seriously, and it is clear to me that dph to dem to fire, and the Controllers Office, as well athe Mayors Office are indeed doing that. My office is par participating in the Ambulance Working Group and i want to thank my steve lee, who is my representative there. And we look forward to fine tuning this thing to the point where we never dip below that line and never hit level zero. And if it is a resource issue, it is on president breed, and myself, and our other 9 colleagues to solve the resource issue. So indeed that is, and those are the steps that we are taking post 2014, with the Mayors Office and the board all on the same page and so thank you for your work on that. Eare there members of the public who would like to testify on item number eleven . Mr. Oconnor, the president of local, 7, 98, representing the working men and women of the San Francisco Fire Department . Years ago we formed the ems work group to respond to a crisis in San Francisco. And the basic problem that was brought up in this work group was that there was a math problem. There was call volume verses the number of personnel on duty, there were old ambulances verses new ambulances and the result and conclusions of that group, the primary results were that we needed more people to respond to more calls in San Francisco. Thankfully we increased our number of full time employees to 200. We got all new ambulances as the chief mentioned but if you fast forward to 2017, we find history is now repeating itself. We are still at 2015, levels for responses. We are still looking at the call volume from 2015, with only, 200 personnel on duty, yet we have a call volume that is eight to ten percent higher but the personnel levels have remained stagnant and that is all too obvious what we need to do. We have to reduce, the cal volume or we need to increase personnel. We should not be reaching or approaching level zero on a tuesday afternoon in february. Having it is calls as soon as possible, but they are burning out and having a hard time doing this. We should anticipate and plan for Public Safety. We should not react to headlines. We should not be surprised by this trend line, where it call volume is increasing consistently over the years at 4 percent while your workforce remains the same. And you know, all too often in Public Safety we talk about the big one. The next disaster. And but in the course of all of our life times, the big one is going to be when your mom falls and breaks her hip. When your kid get hit by a car, that is the disaster in your lifetime. And you should not be left waiting. We should have a frank and open conversation about Staffing Levels, and about our Response Times and the need to grow Public Safety as a city grows and bursts at the seems, thank you. Thank you, are there any other members of the public who would like to testify on this item . If not, Public Comment is closed. This is an evolving conversation. President breed, i would like to continue this to the call of the chair hear what is going on at the Ambulance Working Group. And reschedule this in the next couple of months to get an up date thank you one and all for coming and testifying on this issue. With that, madam clerk, we will continue this item to the call of the chair. Could you please read item 2s, and 3, together. Yes, item number two,motion approving the budget and legislative Analyst Services work plan for 2017, which allocates hours for calendar year 2017, authorizes the budget and legislative analyst to reallocate up to 20 of the hours between Service Categories based on board of supervisors service needs, and requires board of supervisors approval of hours reallocation greater than 20 ; and establishes performance goals and sets a date for the 2017 annual performance evaluation of the budget and legislative analyst joint venture partnership. And item three,motion directing the budget and legislative analyst to conduct a management audit in 2017 of the department of Public Healths Community Behavioral health services, including profile of inpatient and Outpatient Behavioral Services provided to San Francisco residents, Service Utilization over the past ten years and the departments projections for future utilization, current and projected future costs and funding sources, the departments assessment of current and Behavioral Health needs, the departments practices to plan and prioritize for current and future Behavioral Health services, the departments Quality Management and measurement of outcomes, and the departments Behavioral Services provided through jail health services. Are there any members of the public like to comment in closed these items speak for themselves. So moved. Moved by member breed, without objection, with he will send both of those items with recommendation to the full board of supervisors. Could you read item five please . Resolution receiving and approving the annual report for the castro upper market Community Benefit district for fy20152016, submitted as required by the property and Business Improvement district law of 1994 california streets and highways code, sections 36600, et seq. , section 36650, and the districts Management Agreement with the city, section 3. 4. Would you like me to call 6 and 7. We will call those separately. We are and these two members of this panel are intimately familiar with the castro upper market cbd we have both read the annual report and so we do not need you to run through your powerpoint, but if there are any things that you would like to highlight, i realize that you are standing in, you are welcome to do so. Just the castro right now. Okay. I do have something for the third one, which is the fisherman, and nothing for castro. Okay. Are there any members of the public that would like to hear or who like to comment on item five . Seeing none, Public Comment is closed. And we will send item five to the full board with recommendation, without objection. And in so far as there are only two members of this panel and we have not used the facilities for a while, we will recess for one minute. We will reconvene, madam clerk could you call item six . Yes. Resolution receiving and approving the annual report for the Greater Union square Business Improvement district for fy20152016, submitted as required by the property and Business Improvement district law of 1994 california streets and highways code, sections 36600, et seq. , section 36650, and the districts Management Agreement with the city, section 3. 4. Okay, this is the flag ship of Business Improvement districts in the city and county of San Francisco. I have the pleasure of being the supervisor who represents the or most of the area that is covered by the union square bid. I will be brief and i would like to thank car enflood and her staff for the incredible work that they do, both supervisor breed and i have read the annual report. We must hear from miss flood for a brief period of time, with he both have to run off to other Committee Meetings and so mr. Corilo anything that you want to say on behalf of it as it relates to the Greater Union square Business Improvement district . I see that they have met all of their criteria. And the floor is yours. Richard, and the office of economic and workforce development, no, there are no additional things that i need to bring to your attention regarding this annual report. Miss flood or horn . Clod . Nottoexceed, two minutes, the floor is yours. Two minutes. Okay. Ten to five to two. Sorry. Good afternoon. It is just one of notes days. I understand, thank you your kind words. And this opportunity to present. Our accomplishments for physical year, 15, 16, we had a number of accomplishments just quickly, top four, security cameras, abo about350, this has been a tremendous program, really been assisting the police in making arrests and cases unbelievable, and union square cares, and addressing homelessness and we worked with supervisor kim on this and this has been a Super Program in addressing homelessness in a compassionate way. And also, we had a planning process last year with the Board Members to really you know, create a road map for the next three years with a new vision and admission, which you have in front of you. And i think that what we would like to ask for this year is your support in our renewal, we have done a great work this year, through the staff and the partnerships through the staff and departments and we would like to see the bid continue. And so we were going to respectfully ask for your support. And in the coming month as we embark on the renewal process. And so we hope that you will support us. Thank you. I think that i authored the last extension of the bid, and intend to do so again and i am sure that it will receive these support of my colleagues and the mayor. You did, and thank you for that. Thank you. My pleasure, thank you. Thank you for your good works. Are there any members of the public that would like to testify on item number six . Seeing none, Public Comment is closed. And we without objection will send this resolution to the full board with recommendation without objection. Madam clerk, could you please read item 7 . Item seven is,resolution receiving and approving the annual report for the Fishermans Wharf Community Benefit district and Fishermans Wharf portside Community Benefit district for fy20152016, submitted as required by the property and Business Improvement district law of 1994 california streets and highways code, sections 36600 et seq. , section 36650, and the districts Management Agreements with the city, section 3. 4. Mr. Corilo we have a correction to the memo the floor is yours. That is correct. There is one small correction in the memo, and i have three copies here and it is on page six for the bench mark two. And in the analysis section, and so it is the top of page six. And we just put in the correct numbers from the physical year, 15, 16. Other than that, Everything Else is good with the annual report. Thank you. Troy, come on up. Troy campbell from the Fishermans Wharf that some day will be reached the level that it is getting there quickly of the union square bid. I beg to differ. President breed . When you get three Million Dollars a year, you can do what they do. Thank you, thank you for having me here today. I will just i dont want to rehash i have a whole presentation, but in the interest i will keep it short and brief and point out two things that we are passionate about, we are looking for funding comb we have jefferson phase two, 11. 5 million, still needed and we tried to do and worked with the dpw on the transportation grant and we didnt get it and so we are looking for funding on that to complete the phase two, jones all the way to powell. And a smaller thing, if there is money lying around, we are looking for about 150,000 and we are trying to raise the funds right now to redesign the conrad park which is a park at the end of columbus street, and it is dark and unsafe and it takes a bunch of water and so we are looking to fix those problems. But other than that, if you dont have any questions for me, i will let you move on with your agenda. Mr. Campbell, president breed, truly appreciates your brevity. Thanks. Are there any members of the public who are here for item 7 . Seeing none, we will close Public Comment. And send the resolution approving the. And the mendment report. No. We dont need to amend the report, the resolution, references the report. So, i am correct, right . The memo submitted was a transmetal letter that came along with the resolution, and so there is month amendments that are needed. So without objection we will send the resolution to the full board with recommendation, without objection. And why dont you call item ten out of order as a quick housekeeping item thank you. All. Sorry for keeping you so long. Item ten,hearing on the San Francisco Public Utilities commission sfpuc sewer system improvement program, including projects taking place at the southeast treatment plant; and requesting the sfpuc to report. And the sponsor of this site supervisor cohen requested that we continue, is there any Public Comment, seeing none Public Comment is closed. Is there a motion to continue this to the call of the chair . So moved. Without objection that is continued to the call of the chair and madam clerk, could you read eight . Ordinance amending the administrative code to require the department of building inspection to retain Certain Records permanently. Supervisor breed as you may recall last year we realized that is there were certain departments missing from the l package and as mr. Tom remembers there was that february second 2009, letter that Deputy Director ray louie wrote to the Structural Engineer raising the questions about the settlement and the differential settlement ie tilting of that building and interestingly enough there were no responses that the department could find in their records. Now we did get those documents. And we have discussed them plenty here. But it raised, i was i was rather shocked to find out that actually the records retention policy that existed at the department had not been brought into the dawn of the 21st century, relative to retaining those kinds of records, so it is one of the Lessons Learned in the conversation ongoing and, to that end this is a change to the administrative code requiring the retention of these types of records permanently at the department of building inspection and i appreciate the work of my staff with staff particularly mr. Strom and tom at the department of building inspection and i would like to acknowledge lee at my office who has been working on this with you guys. And with that, mr. Tom, any comments . Good morning. Excuse me, good afternoon supervisors. Dont remind us. Thank you for the opportunity to speak about this proposed ordinance. The foundation for this ordinance is already in place. And this ordinance would advice for specificity for the condition that may occur after the building is placed in service and occupied and we will implement this ordinance once it has been passed. And we will incorporate it into our records retention policy. So for the record, dbi does retain quite a few records, our Records Management division is responsible for retaining records, that handle over 2 million records since the year 2000. And in the form of electronic documents, and cards, and microfilm records. The Record Management also for the record we can look back how far we can search records. They have Building Permits since 1906, and they have building job cards since 1933, and they have electrical, plumbing and mechanical permits of 1976, and we have building plans that reach back to 1920. And all of that is available to the public. And if i may i want to like make a comment about some of the ordinances referenced to dbi anticipating several items that we have to consider, like to impact on the human endangerment, and property damage, real estate values and litigation. And i when a building is placed in the service after approval and issuance of the permit, construction is completed and they are completed and final, dbi expects the building to perform as designed. Now that means that we anticipate and expect that the occupants will not be in danger, and that there will not be property damage, and that the real estate values are subject to the Market Conditions and the eagerness of the seller to sell. And that on also that all 200,000 buildings in the city and county are subject to potential litigation, new and old and so what this ordinance does is to provide dbi with a framework to consider and how to implement the records retention, should a buildings condition, trigger such that there are necessary. So we thank you for providing this. And we will implement it. Thank you mr. Tom, and thank you to the department of building inspection and my staff for your collaboration on this long overdue piece of legislation, are there any members of the public that would like to testify on this item . Number eight . Seeing none, Public Comment is closed. President breed . I move to the full board with positive recommendation. Motion to move this item to the full board with a positive recommendation, without objection . And that will be the order. And we are adjourned. Test. Wednesday, march 1, 2017, id like to remind the members of the audience that the commission does not tolerate disruptions of any kind. And when speaking before the commission, if you care to, do state your name for the record. Id like to call roll at this time. Sxhoch commissioner vicepresident \hyland is commissioner hasz commissioner johnck commissioner johns commissioner matsuda and commissioner pearlman irgz commissioners first is general Public Comment time, members of the public may address the commission on items of interest to the public that are within the subject matter jurisdiction