Transcripts For SFGTV Health Commission 6716 20160610

Like to acknowledge and we have Jeff Critchfield here on the medical staff and of course our ceo in roland, many who have done many many hours and getting prepared to move into the new building. The San Francisco General Hospital foundation played a tremendous role in raising support to furnish and equip the building. I dedicated partners at ucsf and public works of turn our shared vision into reality. So kudos to the entire hospital staff, the nursing staff Facilities Management in financial services, i do want to acknowledge it today they tell me they only have 10 orders and they were on 247 during the process to ensure it was up and running. I believe they did a great job as well. So, everyone from communications to food service so i have talked to every Single Member of San Francisco general theme. Mayor lee presented his proposed balanced budget for fiscal year 201620172018. Here olivia more about that just today i will go into that too much. I do want toi want to make sure ron is here. Yes. We did have a memorandum of understanding and negotiated with local 101 nurses and teamsters 856 supervising nurses. By directors report we have all of the areas that we did negotiate and have an agreement. Just to know, the agreement was for one year. So well be right back in it up in the mind of march. We also have a time study doubt be happening right before that. Because as i just talked about the new hospital, time study will be important to ensure we have the right staffing for the building. And if you want after my directors report any details regarding the mou ron is here to present. I want to acknowledge and also just announce that we are working on Electronic Health record. They will be our health chief director. Along with bill kim. Newly working in their already working many many hours already. We had men meeting so far with ucsf just a meet and greet. We will be bringing, and we have named adopted the apex or affect, for our Organization Get it called dph at that. Of course, it requires a complex multistaff analysis on a clinical revenue cycle, technical governance and contractual relationship with ucsf. So, our goal is to reach a point by the end of september with both dph and ucsf. We have a path for. We will be bringing ongoing updates to the commission every six months. And one should be coming shortly for you to know we havewe are working i think very diligently on right now with ucsf staff to start the process of a negotiation. Only to invite all of you too much with the department of Public Health contingent in the 2016 tricare not. This years theme is for racial and Economic Justice and we like to invite all the commissioners to march with us at the great day two and we are moving and merging all of our activities together. So, will have participants from all over the Department Even San Francisco general, please bring your family and five. I will leave it there and if theres any other questions any other items. Commissioners, any questions on some of the topics will be discussed later but questions at this point for the director, please . Seeing none, thank you very much. We will move on. Yes, item 5 is a report that the Financial Planning committee. Commissioner chow shared that today. Okay. Yes, i im now looking for all the notes. Hold on. Im sorry. I received no quest for general public, and so thats why we are moving on to item 5. Yes. Commissioner singer and i meant they productively over the last several hours and we heard a report on the relocation request for the institute of i can. In fact, it is an extension of their service, an extension of their service into the excelsior from where they are because they feel percentage of their population that they have been serving actually lives there. So, this brings the services directly into their neighborhood. It is a site location and the testimony from the public and also the services that the that will be rendered there will be a culturally competent for the latino population that has moved into that area. So, we will be providing a recommendation for you at the consent calendar to accept this oppositio facility siting. The next item that we also took up was the contracts report. We heard of the three contact reports that are before you that were in the packet, are being recommended for approval. These were actually 10 year contracts for which a fiveyear contract was released and i and this is a renewal of fiveyear contract. Along with a costofliving increase that was passed by the mayorsthat was proposed and passed for these contracts. The fourth contract is being at the moment withdrawn aswes i get the first three contracts, therefore, would be forwarded to the consent calendar with a recommendation for it to pass. There was also been a long discussion on the dph solesource process. For which we heard the protocol that is written policies and procedures that are used to place organizations onto the dph solesource contracts list, which we will also be asking for your approval. Under chapter 21. 42 of the administrative code. There were two other reports that were present and in your packets. One is the report that is submitted to the board of supervisors under the sunshine ordinance, which then, outlines whatwhich contracts have actually been awarded under the solesource contract. In a second report, which also shows the usage of those contacts for this year. So, this was a product. The reports and the protocols were a response of the department to our request that the finance and planning meeting for more explicit process for the sole sourcing so that when you see the document for the contracts approval at the consent calendar , it will have a column that will alsothis is new and being distributed. You will have a column that says these are being continued and a column for those that are actually new contractors, and then a delete column showing that there is, in fact, a process of reviewing these on an annual basis and looking for which would be contacted. The solesource list is only a potential list of contractors and is not the contract. But, if there were to be a contract to be awarded, within agencies who are on this list, then there could be a solesource contractor. So, it is a process for convenience of theof our process in the city for contracting in instances in which there are needed services and for which, then, would take time to propose our rfps and the usual city process. And has been a process at the board of supervisors had given us to be able toto be able to answer the need for services while going through the regular formal process for the contract proposals in the future. Most of the commissioners are familiar with the source source list and you will now see them that the sole source with as a process for being updated with this protocol. What that usage was last year, what was the report that was given to the board of supervisors to describe the contracts, and then our own requirement for us to pass this in order for the department to have an approved solesource list for possible use for this coming year. So, the committee then also continued its discussion of contracts. The contracts process including this time completing a review of the manner in which contracts are awarded and how they are being monitored and we will be continuing a series of this discussion over the next several months. The documents are all available for each of the commissioners to read and im sure that also, we will be happy to staff would be happy to fill you in on any of the discussions on those, if youre not clear. We will try to then, after that, overall exposition, bring a summary to the commission at the end of our discussion in terms of the entire contract process we are monitoring. So, commissioner singer do you wish to add anything to that . Did i omit anything . The only thing i would add on the last point which is kind of up monitoring and compliance thing am a i think we really are trying to be do things once get appreciation for what goes on in terms of monitoring and compliance, both from a regulatory standpoint and an outcome standpoint. Particularly, from a regulatory standpoint, then, go into the second big issue, which is just trying to understand are we allocating our compliance and monitoring resources disproportionately to the areas where we in our contractors have the greatest risk. I would say we are far along although not complete in understanding the process, and i think we are starting the dialogue on becoming convinced that were actually allocating our precious resources in the places where the exposure for us is the greatest. Thats a work in progress. I mentioned, in fact, the discussions have indicated the wisdom of centralizing all contracts management for the entire department and that we are actually now able to understand and, i believe, the department is more clear in terms of how it and is doing. Its contracting its monitoring and we will soon be agreeing to how they actually have been in the contract developing the criteria for the performance, and then how then these are being used for evaluation and renault and so forth. So, i think the work i want to commend the work of the department to bring enough forth to us so we can have this dialogue and be able to be sure we can be also supportive of the process. Are there any questions about any of these topics . Puppy happy to answer them. If not, thendr. Singer i would just make a comment pertaining to the new satellite clinic. You know, this organization is really played a significant role within the Latino Community for many many years and its presence in its site now has really been a major significance. Its a block away from the Mission Cultural center. A used to be very active for horace mann which was very active two years ago. A number of the other school seasoned seo travis elementary, you name it all the way down. But things change. Horace mann is no longer horace mann. Its now when a vista which is next to accept general where we have many programs there. Bryant elementary was moved to point a vista. There were at least 28 Family Restaurants and facilities that play a critical part within the past three years that are no longer there. From nicaragua, venezuela, when rico salvador and mexico. The mission is already changed and i am so glad to see that we are on the alert to follow where our patients and our students and our kids need the support service. You used to see many many kids lined up at 24th and Mission Going down a block away to this center and back and forth and back and forth. You look at it today and there isnt that many kids taking a 48 and these other buses. There are people dropping suvs and dropping people off at horace mann into mortuaries that were around the neighborhood now private schools. These are overfilled and theres all sorts of changes going on. But what i did want to say, and i think this commission should be acutely aware. I know the director is, this group has held steadfast. I mean it involves in activities when we used up Mission High School and others in the park, there will be a cooling off her not get the provide resources aboard and work with the community but as i said things have shifted now. The challenges are different now. But, they are right there and there supporting what we are about and without department is about some back to see this new opening of the satellite clinic which is really going to serve kids that are risk now that were not or didnt have the services before. Any comment . So i would support the motion i would just add to that dr. Sanchez, thank you so much for acknowledging [inaudible] and we had to staff numbers yeartodate and i want them to send back their message to their ceo, which is dr. Who called me not very long ago to tell me that she has completely paid off their building through a lot of hard work and so they havethey will be there for a very long time. Because now they i can and i have not seen a nonprofit in our system really go to that length. We do have on them for many years but [inaudible] and is the sole owner of this beautiful mewling on a mission another saboteur were very proud of the organization and are doing great work so thank you so much dr. Sanchez and think of for your hard work. Thank you. Yes, commissioner speak harsh karshmer thank you for the report about the process youre going through to better understand the contracting process. Im looking forward to a primer on that when you get it all sorted out they have begun with a primer i think were going to go through. We can all you can slow it down for us. Dr. Chow, is your point contact on that. Thank you thank you. I think well appreciating the work. We know everyone has been doing the work and this is its like the documentation thats required to evaluate how well everyone is doing. Just to know, does represent about a half billion dollars of our services the muscle it would be great to have some highlevel review for the full commission for you to understand. We will be happy to do that. We will be doing that. Thank you. Any further comments or questions . If not, then shall weany Public Comment . No Public Comment request for this item we can move onto item 6 witches consent calendar and ill note again, on the conduct report the website contract has been taken off. So, as you consider approval just note that report will not contain that contract. I guess i did forget i didnt let me go back, on the consent calendar let me make a comment then because which was on the new contact. The better world advertising is going to be has been proposed. With a cdc grant for 470,000 and i did not explain that. It will be a social marketing assess, particularly, beginning with the private program in the latter part of this month, and will be encouraging the promotion of crap along with also then theas said already in the proposal, looking at the healthy sexual approach towards the use of prep. So, this will be a program that we did ew eight and also are recommending for approval and i did forget to mention that during my report. So i want to be sure we have that before you in case anybody would like to ask any questions on that. Otherwise, we can then proceed with the consent calendar. I move acceptance of the consent calendar moved and seconded. Further questions or any i should state any extractions on the consent calendar if not lets proceed to the vote. All those in favor say, aye. Opposed . The consent calendar has been adopted. Thank you. Thank you. Item 7 is the zuckerberg San Francisco general with action on heritage with our general committee. Thanks martin. A delight to be invited to speak with you today and im appreciative of dr. Sanchez already setting a tone, a reflection and shared celebration. Just as context, ive given this part of this of a talk four days before the new hospital opened and really the idea is its important to know your roots, as you look backwards at you know where you are going its important to be good to know whats important to you in the midst of all this distort change thats happening. So, ill bring this up and then ill begin. It should be on the left. This one . Thanks, mark. So, initially, it came out of talk we gave about Care Experience. The chief medical extent officer but creating a sense why, why do we care about the spirits of our staff in our patients and although the focus on the general because were opening in four days of what youll see is a theme of how are also integrating it across the community. So, here we go. The details of this map are not that San Francisco. So, what i want to start with is before we even got to the hospital at potrero, was a hospital that state Marine Hospital built in 1851 and thats all and actually north beach because the cholera outbreak the state of california put together 50,000 and will keep track of the money about the billions they go on, 50,000 for 150 bed facility that very quickly at 400 patients in it. They had to move in this then brings us more to the potrero. They go the hospital on 1872 at potrero. It was a wooden building because it was going to be temporary. Of course. That one went for 250,000. In 1872. Whats going on about this this is cholera, this is diphtheria, smallpox thats happening in the response from the department of Public Health to meet the growing needs of San Francisco group and particularly around infections not surprisingly. Importantly, this also you begin a Training Program in intermission and sign the contract with the city to do a Training Program after at this hospital was going to become ucsf and then also Stanford Ucsf has maintained the relationship since 1873 and the you would stanford went out. I was in the 1950s and the contact we had with him also went away. So, that relationship, the training and the next generation really began in the 1870s. How can you talk about the history of San Francisco without mentioning 1906 at 1906 the earthquake importantly for the temporary building that Still Standing in 1906 survived the earthquake. It was solid ground there. Then, susanshe began on and taught me around the same time with all the disruption of the earthquake was tons of that that i cannot everywhere and twitter normas bubonic plague outbreak around this time, and that the hospital did not survive it so, we were treating lots of patients with bubonic plague at the hospital. The dph folks came and collected freeze from that and determined that those fleas cause sf general had bubonic plague burn the hospital to the ground. So it went away. Around that time, then other parts of the city started to pick up the slack and this is an iconic picture as you may well know, this is the administrative building of what then was the buildings they were building in 1915 on. On this one, you can see i took this picture is not too good. The gate that is down front is extent. Thats still in place and the building to the left the tower of there is also there. This is on tuberculosis but we had set at this time San Francisco had the largest rate of tuberculosis in the united states. People were dying at this time. Also, this is 1915. This is subsequently 1918 when the influenza happened the mother pandemic occurred at this time. We, the general was an important part of than responding to that. A couple years later, 1924, i think was, when the first psychiatric wards were open to expanding beyond Infectious Diseases into more completely meet the needs of the community. That building stood for 50 years. In 1965, it was determined that a new hospital had to pass and proposition theni dont was proposition a but the proposition the past importantly, with the most highly supported proposition since 1906, and the bonds come and 33. 7 million, went through for that building and thats the building that we currently have that becomes important again because of this just as the other buildings kind of were in the midst of important epidemics or social needs were predated them, you know, soon after this hiv. The importance of the hospital to come together around hiv good so, i did talk about more of the at that site, with happening with regard to the needs of the city, but also but this time its really important to know another scene that think its critical for us to keep in mind im a which is this theme of Health Justice. So in the 60s and 70s with the war on poverty, this is when the rise Mission Neighborhood health was one of our first primary care clinics wittily on the block in the 1960s. That building went up to subsequently, as you see i could help up what a picture did find was an important mentor and given a minute just past, but get involved in things like medicine doesnt get involved with so upper west use native americans Indigenous People on alcatraz and holding a weekly clinic caring for them. If thats dicks picture there. I would give his talk his wife was at that [inaudible] hes not one of the prisoners with mental care crisis could he stuff out letter that wrote the federal grant that was interesting really creative notion that was a federal grants program to support Mental Health and communities and he said, gosh the jail is a community. Should we deal to get funds for one of the first Mental Health facilities in the jail system . This is nice because this is a picture of the family and community medicine, don bank and seeing what was happening with the consortium clinics and the Mission Neighborhood said we need to do something here and got a war on poverty grant and helped form the Family Community medicine group. This is the early 70s they open the clinics in south of market. Really young looking people that we know there that are nowthis is really a key piece of the social aspect. Then, as i alluded to before about the rise of hiv, and i think in preparation for the stock has been a lot time with dn jones who was one of the first nurses actually on what became 58 which is the first hiv clinic, hospital base unit in the world at the time when no one wanted to touch people with hiv or come near them. We needed to come together. What was so interesting and a lot of this came also not familiar with the video i highly recommend it which is called life before the lightbulb. Its 30 min. Video. Online but how do we care for folks before 1996, before highly integrated mobile therapy when folks were dying to the toilet to make, this is a time we were partnering with communities in different ways. There was lots of humility. We werent sure what was going on. We had to partner with people. Weve partnered with community groups. So this is an attempt to show how we sought out medicine in different ways. So up in upper left is real rocky. I do know hugo about legal rock. She would come in every week and bring food to this notion of what we dont have great medicine for people we can bring people food and we can make them laugh and we can help them smile. She raised money by tapping thing in a leather bars down in folsom and then with the money she made came in and or the unorthodox partner for peopleto partner with. This a picture of [inaudible] and shes leon started gardens on campus and worked with with brinker started project open hand realizing, again, food and canning and setting time with people is therapy and we can do those things. Appreciate dr. Dir. Garcias comments about pride parade. We can hear a sensibly people from the department of Public Health year early pride parade. Its castro street. Yes we can leave the hospital we can revive clinics we can be seen as numbers of our community and ed wolf and a lower rate early pictures of sean [inaudible] of housing is part of what we do. Mental health is part of what we do. In the sense of expanding and deanna jones said beautifully, we were doing patient centered care before it had that name. So, again, trying to decide to send a message to you, we are doing lots about we call a Care Experience because we incorporate the staff as they did. This is not a new thing. We have been doing this and this is part of Health Justice. Thats our legacy and i think that something we need to hang onto it so here we are in the new building that is now open. Theres the gate and you can see the towers off to the left. This past proposition 28 08, 84 of voters largest margin of any proposition in the history of the city, 880 million. So the scale of the things were talking about has changed dramatically. Ill also share the director garcia has things are going. In anticipation of the hospital opening, we been doing a lot of tors and many of you have gone on doors and dignitaries and philanthropists are roberts did a lot of force to the Committee Management i do a lot of in the mission because shes expected i did a Lot Community towards from district 10 and two people from Public Housing by tara, sunnyvale, through the building. It was quite moving to see people walk in and cry and say, this is so beautiful. We cant believe we made this for us. We can believe this is our hospital. Which is incredibly poignant and also i think important part of their experience get some of them also, and we expected you an acute as in the other building and this was for somebody else and i think it really shows up our work Going Forward is that people are welcome here and this brings us in so the disparity that are out there. That brings us up to date and so i think then that the legacy whether we doing Going Forward . I love this quote. Some you may or may not know i wonder if youre curious you can put it was edited any healthcare funding such as equitable civilizing you may must redistribute wealth from the rich are among us to the poor and the less fortunate. Guess any guesses who said that . Part of me . Hallmarks . No. This is don berwick. This is a person healthcare improvement but then became the interim director of cms and swords are crucial for us to remember that cool off or look at value based purchasing and the zones on care expense are very much Health Justice issues. If you dont know, you probably dont know, he was not approved by congress to continue to stay on to be in his role and i think this particular quote played a big part of that. So, what is Care Experience in the current area we picked these are some into images that i think that he wants our choice. People not choices and i think to me thats incredible positive thing Going Forward in this accountability. Theres a lot of money here and that puts accountability on us to be good stewards of how we use that money Going Forward. I want to just a quick snapshot this is a slide i borrowed from the primary care group. We talked about care asked earrings at the hospital. And throughout the network and the primary care clinics. One of the things i wanted to say is they decide theyre your long they wanted to him up or build up the community engagement. Since 2014 therefore other 15 site Patient Advisory councils in the committed resources, time, effort, and actually a lot of training of Actual Community members get together not seen the video they made their the spectacular video on an allday retreat from the putative role of Community Learning how to do Quality Improvement and Patient Engagement and today they have known today that 89 advisors activated at all the clinics are running this. Again its own horn working from is i also talk about dn jones and to halley about this thats what Mission Neighborhood started the Mission Neighborhood in the 60s had patients advisory committees, their people helping with the budgets. This ideal going back to where we start becomes so important get this is just so lovely so. Im moving towards ending now but this crew out of the tors and this is a woman who lives over in sunnydale area and shared that those crochet and they were so moved by the tour that they said, you know, we would like to do we like to give Something Back and will look to do is crochet hats for all the seniors on the ace unit so they can stay warm. We would also like to crochet hats all the newborns at your hospital. The something we like to give back, and so we actually opened she and a group of ladies went to the door to door and just gave all of them there and its actually quite moving. Some of the seniors read in quite withdrawn and isolated smiled and cried for some of the first hundred is this idea of how do we really partner and bring forth beauty and resources from the community. What i like to end with is kind of our collective future. This is a tour we gave with a group of youths who were in job corps out on Treasure Island. They are all getting her geds and work on Certified Nursing Associates degrees. So, we thought lets have them come. This is our future. Without him, and the young fella if one of us put his arms over fran, really lovely and he kept walking is about holding his head did i just i want to work here. I want my family to come here. I want to care for my community here. Please, give me a job and he really didnt makes the point for us again. Oh, of the more our care Environment Service environment reflects the community we serve i think the better the care will be. The more our community receives themselves in our work with the clinic hospitals and i think really powerful this powerful other point of what would it mean for us to get our care here . When we start getting our care at the same building where the people we serve is what will that mean . Finally, you all know and i think its important to stay, you look at those like this and Health Disparities data for their families are dramatic. The more they are involved in the care we can bring some same sense of urgency and need to get things done as we did in the 80s and 90s with hiv. But this is an emergency. What can we do to bring the same sense of urgency to the Health Disparity in district 10 . Again, just a moment to reflect. From our perspective, its really a shared celebration. Video participated, contributed, observed that history. There and actually if you have any comments all learn from you or take any questions. Thank you. Thank you. We have heard that you had made such a presentation at grand rounds that several of us who write this alteration following felt that this would be beneficial for our commission and for the public to hear also. In terms of where we are going to go. Dr. Barrett as you know is the author of the triple aim that even though unconfirmed by Congress Turns out to be now the cmss mantra for care so, influential. Obviously, very influential. But thank you again for making the presentation. Thank you. Appreciate the time youve taken first. Commissioners, any other comments at this point . Excellent kid commissioner singer thanks. Thats wonderful. I wish i could use a quick math on the quick growth. Im getting over 10 for 144 years and its still not working out. So, it certainly is a time to celebrate. I was there this saturday morning they moved in patients and super exciting and i think something which just touched on, but really is worth highlighting is that peoplethe stories weve heard of people not believing that this hospital was for them, for their community. That this was not what a Public Hospital experience look like an old apartment are to feel incredible about that. The city shifted i think the city, indeed it continues to this wonderful tradition here that we are all so proud of. I do think its worth noting that theres a lot of hard work ahead the reality is, the hardest work for us is ahead. It gets to the sense of urgency that youd like to impart, and i sort of challenge our group to think about it in the following way. Is that, if you look at the berlin quote and you think about, what is theand you accept it as well we got to stand for, then, the mechanism of translation of that is our Healthcare System and the quality of that system, and it being available for everyone that lives in San Francisco. The quality of care. But if you all combine that with what you said about choice, that people now thankfully because of the aca have more choice and theres a number of ways people can express that choice of having to get care and the way that the people that pay for the care are expressing that choice is through a system which incentivizes quality of care. Its measured we can argue whether its measured fairly or whatever, but thats not our want. We have to serve sort of except in the short term they measure things a certain way, and my worry is as follows. We talked about this before. That, the system of stars that are given to hospitals and h caps scores are going to dramatically affect reimbursements. As excited as we are about our mission, i think dr. Ehrlich would be the first to say that we have a lot of work to jump on this. The reason is that if we dont increase our star levels in our performance dramatically that our reimbursement rates will decrease and the hospitals around us reimbursement rates will increase. The natural consequence of that is that theyll be halves and havenots and we will end up with a beautiful building with financial problem issues. Now, thats not our fate by any means, but i think the thing that we need to do as a commission is to make sure from a strategic standpoint that we sort of allow the department to try and do some things differently. To try and organize the delivery of care, to allocate resources to really challenge the way that weve done things because as proud as we are of them, by objective measures that we now live under, under this choice, like them or not, but by those objective measures when you improve dramatically. I would submit that we cannot do that if we just do things the same old way. So, its a super exciting substrate to have to be in the new hospital to do it. But weve got to be supportive of the teams willingness to try to do things differently in an environment where thats hard to do because the status quo is comfortable for everyone always. Thank you. Further comments . Yes, commissioner chung thank you very much. I love your presentations and your warmth. I think you exude Care Experience. So in the 1980s when we were aides that the words as a training and i remember the response of the hospital Isolation Unit and putting peoplemoving people to the hospital with a diagnosis that we do not even have a name for and i remember the hospital responding in own community to the call to take care of something that was impacting our whole community. So, here we are 303040years later given time different kinds of call. How would you like as part of the Care Experience, doug, director, how would you like this era of the hospital to be remembered in terms of branding, in terms of what you would like to see the response of the hospital and again, its been remembered this is a presentation we were to make 20 years from now . Thank you. I think the several of the key pieces. One guy think is dramatically changing a lesson we can learn from the hiv is the importance of the whole continuum. Theres Amazing Things that happened about hospital those point about project opened and housing and things like this. One of the things going for alec to be remembered from his help we care about the characters across the whole continuum partnering with primary care partnering with [inaudible] so we have more just the next emphasis given in San Francisco [inaudible] San Francisco Health Network response to Care Experience. As we do that from the Healthcare Delivery system in more integrated conference of we will be positive. The second one i think which is less about Healthcare Delivery and maybe more about health and wellness is how do we learn from the hiv, and partner, in unorthodox ways with communities. With outside of our comfort zone, which is if you come to the clinic, you come to the hospital, you come to our facility will have this experience for you but how do we think about moving to more placebased experience. That is going to be tricky for us to figure out but i think back to david singers point, we can be comfortably get, will come to us and will take good care. I do we go to where you are, partner with what you are doing. For example, we were talking with graffiti which is a group down at the end of cesar chavez and the training dont remembers to be navigated heavily partner with navigators to come into our facility i think is a key piece to the other piece that i would love to see this be part of it is to recognize how important the Staff Experience is tied to the Care Experience. Like, how we create an environment and resources to support the staff to do their best work though that they can actually become the impact that were people we have and another story i will share something to celebrate. The building is a loveliness much Natural Light number of the doctors have said i found myself even more empathic because its so beautiful here. The building is so nice patients deserve more from me. They are finding themselves getting more so how do we create other nonstructural building ways to help people find that empathic place in themselves. Those who be a couple things. Weve got some specific type of things i can talk more about, keep that level in one is with doing much more about caring framework called bicare but how does everybody on campus see their role as a healer for any way to me does not work there on campus. Just some ideas im very pleased to hear that. Weve heard it becoming age, support system and the role of resilience in moving our Health System forward and i think as much as the general is playing a important will make our Community Strong i fully endorse your mission and your vision. So, thank you. Thank you commissioner commissioner sanchez excuse me. I just want to conflict you again. I think excellent presentation thank you dr. Sanchez. I would just add one thing is pertaining to some of the discussions weve had here. Why have we been able to maintain at least up to this point and will continue to do so, some of the most dedicated Health Professionals within our culture of San Francisco general . With all due respect, i think your history showed us a little bit the link with ucsf and stanford, initially, and then as we navigated through the years ucsf has been really, a key partner pertaining and providing opportunities, training, certification, accreditation, within these different disciplines. I can think of you mentioned Community Health centers, etc. , primary care, you name it. So, chancellor [inaudible] julie cummins, chancellor. You always findneed of San Francisco chancellor. Everyone was involved and knew about the links and partnership between sf gh and ucsf. The fact that the was even the first time under some of our associate deans a formal memorandum of understanding whereas before is more like a handshake over the years way way back when in the 60s and 70s, literally. Before even then. So what im saying is, we face the future. It alone should we face in partnership with one of the most outstanding public Academic Health science centers, ucsf. And ucsf among one of the key recruitment per postdoctors and medical students and other students is the fact they can do rotation at San Francisco general. They and the community here in our efforts. So what we are saying is its a important as we look to the future and the whole question of how does now this unique body navigate with quote, the new San Francisco general foundation [inaudible] as we move ahead and workbook with this group and with the ucsf board of overseers which is a different body and has a different culture and a different focus. So yes, were going to have a lot of challenges but we have a new support system that very few in the station ever have and the fact that they are alland have been consistently committed to this department of Public Health at San Francisco general and laguna honda again were getting a residence from different programs, were getting a number of our people now from against usf, there were gettingagain the city college, again, we are a Teaching Institution and collaboration that makes us unique second to none in the nation it so, i really think thats part of our strength that will navigate you dont do it in isolation. We do it in conjunction with our partners who have proven and have been tested and believe they go we tested a model where we are going to stanford and uc have anakin hour. We voted, so thats face. We know we are unique as an institution and partnership and will continue do so i think, really over the next generation we will set some new models of healthcare given uniqueness of the city and partnerships we have for 150 years. Excellent presentation thank you dr. Sanchez be dick thank you. Commissioner karshmer i just want to add my congratulations to the event kid i loved hearing this is really part of a system. To really advance the notion. I think thats going to be this front moving forward. But in particular, this identifying that nontraditional partners, nontraditional outreach is can be so crucial both to look at how to make quality in the patient extends but also keep the system part of the fabric of San Francisco. So i think thats good and i look forward to hearing more. Thank you, commissioner. Thank you. Any Public Comment . The request on this item giving no further comments we can thank Jeff Critchfield and want tonights agenda thank you. Item 8, the San Francisco zuckerberg General Hospital transition update and dr. Ehrlich is can be making a presentation good afternoon, pressure commission could have you not tired of hearing about zuckerberg San Francisco general in our move and i just want to acknowledge all the discussion about who we are in a place and time and what incredibly special time this is for us and also a challenging one it is. Dr. Critchfield is single point of light here that represents the passion that i get to come to work with with 3000 people just like them, and he not only represents the passion we have for our patients, but thankfully also the patient passion we have for improvement so speaking to commissioner singers remarks, we do have some challenges ahead. But the great news is we have a passion for improvement as well as a passion for our patients and the passion extends to the ucs ucsf partners. Together, we will meet our challenges and will do well. Thats what im here to do. So, yay. Let me talk a little bit more about the building. Some of you are this presentation already, but ill go into it and i can add a little bit to it since i did that last time. You go to view and it should show slideshow. Right. Im looking for where it is, here. [pause] all right. This photograph was, thanks to one of our employees, earl of, why think took 1000 photographs and we join them a lot. Its really nice to have this history of what happened. This was at 6 45 am in the morning. Thats an easy to the General Hospital in trauma center, most of it had been covered until this moment we have a clean, and take down the sign. Signaling we were ready to open. At 6 55 am, this is the old iconic sign the Emergency Department that was also taken down and its now replaced by much more modern sign that directs patient traffic and ambulance traffic to the Emergency Department. This is seven 8 00 am. This is when we got going. This is right outside the public Emergency Department engines. Now you can see that metal entry way. Those isaiah emergency now. Those were taken down and this the Emergency Department team that was so excited to get going that morning. Its hard to describe with the command center atmosphere was like. Some of you were there. This was on the seven floor building 25, the. The room was a large and divided into three areas. The one area that isnt depicted here iswith the it nerve center. There was a group of about well, depending on the moment in time, at least a dozen people were entirely focused on making sure that our systems were not crashing and even the tiniest it needs were met. I was really pleasantly surprised as were many others, as to how effective that team was. And still is. I want to thank bill back there for really helping us out that day. In the middle, which is the room you see on the right, with the peg control room and this is a function that gets staffed every day at the medical center, but this date we had many more people making sure that patients got assigned the correct bed and on the left with the transport teams. You see dr. Marx and dr. Mae and rachel kagan rpi oh, and the woman sitting just to dr. Marxs right is a trauma surgeon who along with terry did tony, chief nursing officer really directed traffic all day long for hours and hours sitting there making sure that our 12 transport teams were assigned correctly in patients that moved correctly. It was really a stunning feat of coordination and this beautiful controlled chaos that happened in that command center all day. The moving started at about 7 30 am and was done at 4 45 pm. That was exactly the last patient got settled in his room. There were 158 patients who are sequenced the day of the move. They had actually beenthere were groups of patients were sequenced on the previous days, but that morning there were 150 patients in i just want to mention that the reason the words at least 10 or 20 more was because the network really went through a rote efforts to make sure that patients were not acutely ill indeed need to be in the hospital were not there. That morning, there were i think eight or nine only 89 patients not at acute level of care that did not need to move which is great. This happy gentleman, he was consented. He was one of the patients was consented the day before. Many of us went around and talk to patients who are about to move, just about to move what was going to be for them and some patients agreed to be photographed and talk to. This card was one of those people and he was very happy as you can see. This is just a view of the bridge. There was a steady stream of traffic across the bridge all day. This was the first baby was moved into the labor and delivery suite could very happy to move over there. And here the baby is getting settled in the and i see you which is incredibly beautiful space. Its full of sunshine and light three killing environment for our youngest patients. Speaking of babies, the last one was born in building five at 4 37 am in the morning just in time for the move. The two baby girls born on saturday. The first at 2 43 pm and the second at 4 49 pm and there is the first baby, very very cute. Can appreciate the cuteness and a photo but that family was very happy to be in that beautiful space. I actually went to labor and Delivery Area the day before the move to talk to patients, and i was able to see them banned as they moved into the new space. They were literally stunned out of their minds. It was such a stark contrast between the two areas, and it was a bet going on who the first baby was going to be and everyone was betting on a babies was not born until actually the next day. It just shows you how little we can predict these things. These folks are student Nutrition Team and they also didnt really a relevant work by just eating every single patient was in the hospital but all of the staff were there. Everyone was served a box lunch was working that day. There were innumerable beverages and snacks for everyone and they just did an incredible job. We had a lot of Media Coverage for saturday morning. Im told it was pretty exceptional jurist dr. Marx speaking to a tv camera can get prints made, radio, media, tons of folks and the stories were repeated over and over and it was generally excellent coverage. Here was a Community Blessing that was going on for the building. Audio slave, it was very effective. We had four cases on saturday. The first case, dr. Macleods case start at 10 am. No issues with surgery at all. That was really do a lot to the fact that the Surgical Team practiced over and over again before they moved into the new building and so things went really smoothly. We did have our first trauma until midnight and was very quiet in the Emergency Department that whole day, but whats midnight came around just everything busted loose and there was a time when most of our assessor station rooms were full. Was a very very busy night but things went well. This just shows you the last surgery and the first surgery. Therefore patients admitted from building 25 ed that day. This was the official closer the Emergency Department. These are two emergency dr. Emergency department managers, melissa and david. This space has never been so empty. This is the old ambulance entrance to the old Emergency Department. Everything went really well. Much better than expected by all accounts. Because i think continue to be high. We are still in a place where we are studying where we are. This space is extremely different and we have all kinds of processes and procedures in place to make sure that we understand how to optimize our space. That will continue to take time. Here is our tiny snapshot of our future lands and projects. We are going through our vacancy plan implementation, which basically means is that cleaning up the units, getting all the supplies out, making sure the supplies are reused and sold as needed, and then, we classify the building into a nonacute building this event happen over the next few months. There are a number building 25 Power Projects like the hyper mri we are working on and innumerable ways that were optimizing the space that we are in right now. Thats about it. Im happy to answer any questions. The a lot more about this building and about building five as time goes on. Well, congratulations. Questions, commissioners . I think its worth pointing out of china think of an analogy but i could not come up with one. This was a phenomenally obligated thing to do in the past six months, which is staff up, train everyone, they sure all the systems are working, get Regulatory Approval like from a wide variety of regulatory bodies. Then, move patients with zero tolerance for any mistakes and it was really pretty incredible pretty incredible pretty incredible accomplishment that i hope you take this the right way, shouldntit reminds a little bit of the night Michael Jordan and a guy named lou glumly[sp . ] prefer the bulls and this one night Michael Jordan scored 69 point and will glumly interviewed one and they were interviewing the glumly in this way the night does a member does michael and i combined for 70 points. Not to take anything away from your leadership but the team at the hospital from the guys i talked to moving food to the new place and getting food up and Food Services in the elevator, all the caregivers at any level of education, you want to name, it really was incredibly exciting and you just hope that excitement stays in all our systems for years. Yes subcontractors and to everyone. Figured on a deserving of congratulations. Thank you for mentioning that its really 18 and was not just six months. He was years of planning. The alacrity chicken up it was incredible feet and was entirely a testament to the teams ability to plan and execute in a remarkable way. It was just privilege is mine to witness it, really and be a part of it. You should take the place now because invariably therell be times youll be here and it will be all my fault wont be fair either. [laughing] this is your moment. So enjoy it. We will be with you thank you. Thank you. Commissioner karshmer i would have i congratulated it occurs to me the type of teamwork is the very kind of teamwork that the department has been working on around Disaster Management and i think a lot of the trials of the disasters that have happened and how thehow the department is able to respond our signs that this is not a onetime thing. This is, in fact, a sign of a department thats learned to work very well together. So kudos to everybody thank you very much and i would definitely agree. I dont think its a onetime thing. I think, clearly the two presentations create a momentum that we expect to continue throughout the entire Health Programs that we have here and we now have a wonderful facility in order to carry out many of our tasks and we are pleased that you are here to be able to be the steward over it. Thank. Its a great place to honor our patients and staff. Thank you. Any Public Comment . No Public Comments. [applause] director rca noted there was dr. Ehrlichs first presentation so extra congratulations for that. Item 9 is the sftp h patient rates for fiscal year 1617 and this clear 1718. This is for your approval, commissioners. Good afternoon. This is a fascinating topic given the previous presentation. Patient rates. This is our annual patient rates corridor. Its always accompanying the budget. This year the patient rates at San Francisco general and laguna honda are increasing by 7 for community Mental Health, you may have noticed that the Days Services and the outpatient rates are increasing significantly. The reason for that is that its based on the actualour actual costs and in our prior year cost reports are actual costs have risen significantly so we are revising the patient rates to be at a higher rate so that we can maximize our reimbursement for medical. Community Substance Abuse is in a sub similar situation where we tie the rates or actual costs and set them slightly higher so we can reimburse and maximize reimbursement. Then, on the last page i just want to note that theres two new rates any. The Public Health lab. We are setting the rates to be at the medicare rate. Currently, its a medical rate and at some point we are hoping to expand our billing so if we are seeing clientsif we are providing services and seeing specimens from clients that are many Many Medicare medical then we can charge the higher medical rate. Then, for the San Francisco city clinic, we are introducing a 25 flat rate. Currently, they accept donations of 10. So if you have any questions, please im available. The city clinic rate that you alluded to, i suppose one of the reasons in the past that there didnt know collection was to encourage people to come in. Its just a recommendation that the staff there also feels is going to not discourage patients from being seen at city clinic . Yes. This was in consultation with the Health Division of the public cultivation is undertaking a project of looking at billing in the Public Health division. One of the things that came up is in the best to the lab theres a number of patients that have insurance but many of them choose not to use their insurance and may not even actually go to their own provider and so, the purpose of the 25 rake is doing create an incentive for the patient to give us Insurance Information because the alternative is 25 flat fee versus are you going to let us know your insurance, which is presumably would be zero and so what we are doing, we are restructuring the format and instead of having it go nation which is voluntary, and whether 25 fee which we are hoping will encourage the patients to agree to provide us with Insurance Information but at this time theres actually not going to implement the insurance part because they want to work through the whole issue about discouraging clients were coming for Public Health services. Julie are putting this rate in as a placeholder so that when we are ready to implement this other policy, then will have the ordinance in place. I appreciate that. Could you also speak to that whole issue of people who may not be able to afford this rate . Other not different scales were schedules that we use to create [inaudible] yes. Thank you for reminding me because the other issue the std clinic is to have an option to waive the fees for a Public Health purpose or for a client that doesnt have the ability to pay. So, the fee will be in place, but theyll be provisions made to waive the fee. That is similar to what we see right now in Behavioral Health or they have options to waive fees if theres a therapeutic or clinical reason for providing Services Without a fee. Okay. Commissioners, questions . Last year we had heard really are published rates for the purpose of medical and medicare billing or insurance collection. I just think thats minor sin of the context and i think thats the point dr. Chow is reimbursing. I does one ask if thats the current assumption . Thats the context . Yes that is the current assumption because our rates are basically patient charges could it be to hold, was no one actually pays out of pocket because on most all of our clients are either medical or have a waiver that weaves the fees for therapeutic reasons. So, the purpose of the rate is to maximize our reimbursement from our payers primarily medical. In the public assistance to use rsv at all . Like you do im sorry . [inaudible] you are talking about Behavioral Health . No. Across health. Im sgt. Craig wagner chief Financial Officer not sure i understand the question i was wondering what i use the relative value scale in terms of setting up the rate . If not familiar with probably dont use it. Correct. I think that the categories here, they dont carry a billing number now some of these but when you are carrying a billing number, they were weighted averages between the definitions as you have. These definitions still based on the rbs . To be honest, i dont know the answer. Historically, weve had our rates and for the past number of years, long since before i been around weve use the basis by which they were set and increase them at a fixed Percentage Rate. The purpose of the fixed Percentage Rate is to get our cost to charge ratio aligned with what we are seeing in the industry around us. Where we are right now with our cost to charge ratio, as you all know for the last many years, weve been trying to catch up where the industry around us is good as of fiscal year 2004, or cause to charge was at 52 we been increasing by 10 and thats across the board. We have not differentiated based on the categories of services, but trying to catch up. We are trying to these rate increases if you factor out district, we are close to about 30. 9 for fiscal year 1516. That is getting us more into a kind of Standard Range comparable at ucsf is about 26 . St. Marys in st. Francis, about 25 . So, it varies across categories. In terms of what that initial kind of foundation for the development of those rates is, i have not been through that process here, so we can talk to some folks who brought about that and provide that information to you. Really, what were doing is taking the basis for the allocation and were increasing it by Percentage Rate to try to get our cost to charge ratio up into a more Industry Benchmark area. Right. If i recall it was initially based upon the old rbs schedule yes then we were behind as you said and i was can ask you the question about where we walked now on the cost to charge ratio because i think a year or two ago as we get going at the 10 i said 10 within a be even at a better quote, better rate than cpm see. Yes. This year i remembered you been asked the question just to note also and said that we are at this year 7 and 6 over the twoyear budgets. We have been at 10 per year since ive been around. So, since we are coming into kind of more of the range of the benchmark of the other hospitals in the area, the kind of slowing down the acceleration. Were still a little bit little and so we still are going to move to catch up but we are at the point where we can slow down, back off of our trajectory of the speed of our rate increases. Any further questions . Commissioner. Yes, they could you get is what you just described in a format we can stare at so we can follow the increases looking backwards where we got to in terms of cost to charge ratios . Yes, absolutely. We did it would be helpful. The second thing is that would be helpful. The second thing is which one of these buckets would be [inaudible] because we dont provide these at the same volume level so from a purely financially selfinterested point of view, which one of these raids is mostly important not just to add in the growth rates, but also to secure reimbursement, actual reimbursement as close as possible to the published rate . We kind of touchup on it with behavioral and Public Health, but the rates that were proving here as and mentioned in those limited circumstances, are infrequently paid by an individual and in particular, by an individual with limited income. So, the two areas where the rates we have the impacts our reimbursement is and said they can sure our rates are high enough we can maximize what we get paid in Behavioral Health through medical we have had our rate set at a certain level to make sure we get as much as we can judge the other major area is a possible for emergency and trauma, where we are having commercial patients come up people come in with commercial insurance in those cases we actually are using the rates as a basis for collections and thats a major financial driver for us. The percentage of our accounts that are Commercial Accounts is at the hospital, is less than 10 but its about a third of our actual collections. So, its a critical driver for us and that is one of the reasons that we need to make sure that we stay in the Industry Benchmark for what we are charging so we can make sure we drawdown that reimbursement. We rely on that to offset our losses for uninsured medical shortfall a lot of the patients we care for at the hospital. Where are we in our journey to be able to take insurance, private insurance more broadly in our system . Yes. Thats a good question. A long story and i know we are going to be going into that into some more detail at hearings coming up. But we have a number of irons in the fire. We are working withat a couple of different options to get involved in a covered california plan. We been doing that for some time. Right now, the barrier to that for us has been our ability to work with the health and in distribute the risk in a way that the state is comfortable with. So, we are still working with a couple of options on that plan. Weve engaged with a couple of the ventures associate with our Health Service system, and so we are trying to develop a plan to do some limited contracts for services where we can tag onto those city contracts and then eventually grow our volume providing services to city payers. We have also been working with some other health plans on contracts that are not necessarily commercial, but that are medical fee for service where they have demand and we may have some capacity and we can increase our revenue to those avenues. So, we will be going through some of this in more detail with you but it is part of our Financial Plan and youll see its when we present our a three thats one of our targets and we are actively in the current year and in the coming year, working with some consultants that weve engaged to a post about the infrastructure that were going to need to have the right relationships with commercial payers and also the internal mechanisms for ourselves to be a good judges of rates and contracting arrangements that we make with those plans. So its a very active effort for us and its one of our focuses broad Financial Plan in the coming five years. Okay. Any further questions . Question theres no Public Comment request on this item thank. If not we are prepared for a motion to accept these rates. Moved and seconded. For the discussion . All those in favor say, aye. Opposed . The rates have been accepted. Thank. Mr. Wagner i think you can state the jamaica presentation on the mayors budget update next item please actually, amanda turned this over to jennyour budget manager. Its a presentation all the way to the right. Is good afternoon committed to my name isbudget management im here to present on the mayors proposed june 1 budget. I like to start with the big picture first and actually with your permission, i realizing that i made more sense to talk about some of the internal transfers so you actually understand whats going on and a picture and then well get down to the details in terms of some additional enhancements. If youll bear with me. So, just that that overall dph budget is grown by 9 million in year 147 dollars in year two. Generally speaking, thats actually modest growth for us particularly in year one and the reason for that is the number of transfers that were making externally to other city departments as well as internally. So, one of the things the major things that we will talk about is the transfer of the department of homeless and what you will see here is the reduction i think you will see a reduction our Public Health program of 42 million to various departments. This comprises 90 dollars of sf hot i wish him good that comes from the Substance Abuse team. The regional dollars from her housing program. That comes from the Public Health division and 1. 5 million of other programs that consist of the Homeless Prenatal Program and project homeless connect that currently supported in community programs. And Mental Health. So, you will see that change we look at Substance Abuse breezy that significant reduction of 75 to 68 negative summit reduction reports that 9 million reduction of the program which is notwhich is scuttled. On top of that, it 5016 the we had onetime capital cost of over to my dollars related to the medical respite construction. That construction is going on. Was onetime and 5016 and additional expected reduction. So, that explains the variance between that 75 million and that [inaudible]. What you also see in San Francisco general, you will notice theres actually a drop in their total overall budget. That drop is actually related to the internal transfers that we made within that apartment in i actually give you some of a supplemental that outlines the changes, but one of my goals as buector is really to try to make to reorganize our budget in a way that actually reflects our operations and with bill kim and ron wideout joining our team a few years ago, theyre very good in asking me questions about well whats my budget and how money positions do i have. And how we had originally budgeted both of their operations is actually within the divisions. It sort of made sense for cost reporting purposes, but we had to do sort of financial query backflips to actually be able to pull positions from general, positions from primary care physicians positions from the kona to put Humpty Dumpty back together again. So they had a cold user budget. So one of the things we did was centralized it and hr into the public out the vision, into Central Administration what well do is work later with nellie lee and a Population Health partment to actually do a cost of accounting to chargeback out some of the costs, but all the cost of budget centrally so theres a clear and transparent vision of the it and hr budget. So, the total of these transfers as youll see on the handle, is 33. 3 million of cost transferred from outside Population Health including 22. 8 from the San Francisco general. Those costs were moved to the Public Health department and then we have an additional 5 million of hr positions also centrally transferred over. So, while it appears theres a reduction within some of the divisions, thats actually not the case. Its all been moved to the Public Health division. You will also notice the Public Health Division Still appears to have a drop despite this large infusion of positions in operating costs, and i outlined this in my mail. That there iswe made a correction to adjust our revenues at San Francisco general and we did a swap of capitation and fee for service to true up what we actually believe is most appropriate revenue. What we think is most likely to be the Revenue Streams that we have, especially with the passage of 1115 medical waiver. That change between p for service and capitation net net overall you seen that change but then that, what we had to do was actually caused us to reduce our intergovernmental transfers, which feels like an expenditure savings. There was also upset by revenue changes. So its net neutral, but overall in terms of our budget and our expenditures that was 55 million worth of cost that we actually dont have in our budget. Again, while it does look like a Public Health division is dropping them a net net overall, theres been no Service Reductions and had we not had to make a technical change you would actually see sort of baseline yearoveryear it would be 55 million more of costs than you see here. If you have any questions about that . So, just showing you the changes overall by division. So you get a sense. Again, the sort of little tips and troughs related to the centralization of those hr and it, rather than any Service Reductions. Overall, dph is still growing in terms of positions and we still up to 43 oh both of these positions are the annualization of the new positions waited to the new San Francisco jam. Again we budget partial ftes in 1516 and the annualized as new positions and 1617. The additional position gold you see actually related to our Budget Proposal in february. Did you do the same math to do through that got us the de facto dollar increase the overall budget . What does that look like for headcount . I dont have a number off the top of my head but i believe we took the giving 5016 and 60something annual positions its about 75 or 100 ftes. Its growth from the work we did in the prior budget so then if you then look at what we have left its around 150 of actual net new positions. How many positions to be transfer out to the scatter care and the sf hot . San diego commissioner, the hakim is all contacted the public service. So, okay this is a handful of managers but all the Outreach Team is primarily [inaudible] [inaudible] this number is 33 ftes that added to the slide you just showed us terms of additions, right . Correct. These were existing positions and those 33 were part of the 6672 ftes and 1516. So, yes, [inaudible] 72 x 33 and that number grows 26915, right . Correct. I think what you do isyes. You decrease and i would be very net difference. So we are growing by 277 . In the Department Next year . Im sorry, what was that . In the department, this year, without the hot team or everything were transferring out, right . Thats 33 people were 33 ftes, right . That 6639, right . Yes and that rose to 6915, right . Yes were not going bywere growing by 277. 68 . I believe so. Yes. What i can do is actually get you the very specific details of the base changes and sort of adjusting out the hot team. The other portion of our growth is really related to our february proposal. Whereas, you know between Mental Health and Substance Abuse programs we get a significant conversion of some services that we believe were so coordinated with our own existing Civil Service programs that we were bringing a lot of positions on inhouse so not necessarily an increase or change in service, but it feels like an increase in fte. You will see that and you see the annualized nation in 1718. Moving onto major changes, since february, i happy to report on Electronic Health records and give additional mayor enhancements for violence invention hiv services and Capital Projects. For the 1618 budget weve actually supported our, what we expect a full need for the dhr to be through rear procreating of existing budget bounces and appropriation of surplus yearend funds. For a total of 42 million of additional appropriation authority between the two for fiscal years. Congratulations on not the modus a lot of this work was done in the current yard where we have the night when one of the base budget and then we have well respected is 9. 8 of the spent bounds in the budget and 25 of the revenue transfer and you see that in our report Quarterly Financials. It was really a multiyour efforts to actuallywe do not do this in three months. Over the course of this year and some work planning for next year is how we actually achieved it. Remember, commissioners have to go through a process with the Controllers Office to allow [inaudible] this is been the result of us being able to maintain the funding . Yes. Very good. So ive already discussed the 42 million to transfer the department of homeless. Related, we transferred almost 3 million of the Scattered Site Housing Program to the department of aging and Adult Services as well as eight two and earned 50,000 adult aid health program. The rationale for lena Scattered Site Housing Program it was a program that was managed by housing and urban health under mario to nettie [sp . ]. She and her program is transferring over to the apartment of homes and support of housing but the Scattered Site Housing Program is not a program specifically for the homeless. So, when we try to figure out what would be the best way the programs he managed, we look at to dos because dos runs theprogram but i version in the community i forget the iintervention integration program. Which is basically the Case Management side of scattered site. It made sense actually to marry the two programs together under dos so they could manage both of Client Services as was the actual her housing rental units together under one roof. Patients from laguna honda would still be alterable for the program. Then, Adult Day Health this is like the we are one off. Its more appropriate under dos then dph just given their mission and focus. Other enhancements that we have in our budget. The Mayors Office has Significant Interest in violence prevention programs and weve outlined this basically 459 increase in related to the street bounds and intervention programs. 77,000 for the uc Wraparound Program and then three fte annualized to expand our Crisis Response team. Per hiv prevention and Health Services, we received 600,000 in new funding us for Neighborhood Outreach program. Waiting to Case Management. Then, the mayor did backfill 383,000 of funding for hiv prevention that was cut by the cdc an additional 60,000 per San Francisco related to the speed program. Between the grants and the backfill that was 1 million worth of support for the hiv Health Services program. So, the hope sf center sites. As you recall last year, we actually find the staffing the programs at the for housing sites. We have been running this program sort of on an ad hoc basis throughout 1516. Also, during this time, it actually been working with a real estate to identify a permanent space within the Housing Authority site for us to manage these programs on a permanent basis. Now that those sites have been identified we are in the process of being identified, the Mayors Office primarily put facilities cost onto a facility is so because related to it rent, utilities, to support them as was a Longtime Capital costs related to agile just building out the shelves the weve identified. In 161718 the Mayors Office also backfilled 1. 15 million grant that we received in the current year to support the Peer Support Program thats currently happening at the Wellness Center and the money will enable us to continue that service ongoing in the future. We received two and earned 50,000 for childrens Portal Health is right might be childrens oral health password. Three earned 25,000 for the ucsf transgender services. Then, moving onto capital we received significant investment for some of the Capital Projects that we are expected happen in the next two years. The first is in anticipation of the Public Safety bond that is been proposed this summer. You know, we need to start planning the building five move and any related to it. So they put him 6 million in year two. Also, in the bond isactually, in the current year are also working on the renovation of the southeast existing facility and once thats completed will be moving costs and furniture fixtures and equipment and then anticipating and 1718 for the addition of the se. Health ctr. , will have an additional 700,000 of furniture pictures and agreement new addition to the facilities. Finally, most exciting to me properly sexy is the laguna honda admin building remodel. This is will actually enable us to complete the building and to complete some of the technical facilities upgrades that we need to actually make that admin building functional. This was also supported by some fund balance the onetime windfall of a rate reimbursement that we got from laguna honda hospital and youll see that in our Third Quarter financials. The transfers on that last point, when i read it here, it had a different connotation than when i read the details. It sounds like the majority of the money is going including a loading dock and pulling down two buildings. Is that right . Commissioners, there are a couple of pieces. The bulk theres the loading dock area and that was scoped from the original project that was deferred good so its been a long burden on our capital list get it affects the ability of the trucks to get into the loading dock area for the new hospital. So we will complete that and then there is also the other big one is the hvac system. Theres some deficiency in the hvac system that need to be corrected. So, its not a new fund addition, but it solving some big infrastructure problems that have been hanging there on our Capital Budget needs list for quite some time since we began closing with that project. Last, in terms of the transfer of function, in 1718 we are planning to transfer the Emergency Medical Services agency back to dph. They are still going to be significant planning related to this transfer of function, which is why we delayed it an additional year and i think well probably more to come in this upcoming budget, but for placeholder right out and 1718 were saving an additional 1. 2 million in five fte coming from tpm for the department of Emergency Management services to dph. So in terms of next at, we are now in the board phase of the project and june 17 will be our first hearing at the budget and finance committee. On june 20, the board will hold Public Comments on the proposed budget and if need be, well have a second hearing at the budget and finance committee pending our agreement with a budget legislative analysts office. Once the budget and finance committee is done with her work, the budget will go to the full board for two votes to 100 line 19 and the second on july 26. Then hopefully the mayor will sign a budget surely and the funds start all over again. That is all i have. I am happy to answer any questions you may have. Commissioners . A very elaborate estimation could to the changes, significant many changes in the budget this year. Just to know, the board of supervisors during their hearing we anticipate will get more dollars for specific projects, that we have not asked for, but the board will ask us for. We will report on that commissioner pating i like to ask the director maybe in the future meeting we can discuss the service invocations some of the transfers to the apartment. So mobile we worried when hakim goes to the other department. They been a vital part of our system and Early Intervention program. Obedient heart of that move in which we need to kind of matched the move so maintain continuity . Same thing with the ems move back in what that looks like. We dont need to go into today. Yes. The ems system the commissioners asked for a review of it. Were so working that out with a consultant. I do not believe we are going to have a discontinuation of services could i been meeting with a homeless director of the department and really, with the issue will be is can we ensure them access to our data so they can continue to do their work. So, we party had several meetings and i anticipate that will go very smoothly and they will continue to help us and we help them in the process of identifying a patient who needs our care. So the way we cut a broken it out, the Homeless Department is focused on housing and Supportive Services and housing units. We are the Clinical Team that will come in and provide some of the Clinical Services for that department wherever they may be. As an example, the medical team going to all those programs. We have Behavioral Health floating teams and all the shelters. That doesnt change. Thats our role. Basically, i see this as will be working closely with the new Department Just like we work with all the other departments with her Human Services, benefits, i see this as a good thing and also something that will focus really leveraging our helping about. We bet housing and multiple departments and of the cat is been [inaudible]. The Important Role of dr. In so many of our services and 10 one. Anything that is Clinical Authority placed is our job and thats how we kind of delineated a responsibility could not be creating a Health Department in almost apartment and we are the provider with regard to the budget it was 40 million or 38 . Was only six position at were 8 million. Six positions. Exactly Service Contracts so that 9 million the hot outreach but all contractors to nonprofits and staff members, i guess . Yes. Ill also add we been working with the Mayors Office and working with the Service Agency on this transfer function while technically takes place on july 1 dph and hsa has committed to fully supporting any existing contracts that mightve been ours in 1516, hr, it, all those operations will be supported by dph to theres actually a warm handoff been able to be made in the new department. Were not expecting any disruption in services for anything thats transferring over. Anticipate a full process having by january 1. Thank you very much. Okay. Any public, the . I do not receive Public Comment request. There being no further comments, thank you. I am sure that if any of the commissioners have a question in terms of how these numbers are playing of them we will be able to talk to you. Okay, thank you. Item 11 other business. Commissioners, any other business at this point . Seeing none, at this time, we can go on to the next item. Yes. Item 12 is the report that from the may 24 zuckerberg San Francisco general the believe commissioner sanchez can report that since he chaired the meeting. Commissioner sanchez thank you. The jcc met and the alltime be brief the committee reviewed the Quality Management Regulatory Affairs report and 2016 revised core measure selection report uptick in the commons discussions etc. Pertaining to this matter and the Committee Also has possible listings for transportation laguna honda patients to csf g for where Hospital Services are needed they continue to work on the situation. We also have a some of our faculty from laguna honda there participating in the discussion at the jcc meeting itself. The committee reviewed and celebrated the move to the new hospital and patient care report and Human Services report. Dr. Marx gave a presentation explaining the credentialing process and the Community Committee approved the actions items in the medical staff report. Just one comment on. This is the first time weve had a comprehensive credentialing process done within the context of sf gh pertaining to academic reviews process and outcomes, so we want to thank dr. Marx in particular and all the staff involved in this great project. Last enclosing, in closed session the Committee Approved the credentials report and the minutes. Other any additional comments . If not, thats the report. I think we have to approve the credentials report no. Thank you, though. Thank you commissioner sanchez. Theres no Public Comment requested next item item 13 min. Committee agenda setting. Commissioners, your opportunity to bring up additional topics and we are preparing for a Community Meeting in the tenderloin and are Planning Session at i also received a question from staff to work on those. In terms of data of what we will be working on at that collection. All right. So we will move on to the next item please. Next item is closed session item 14 the federal Public Comment in closed sessions were prepared for vote on whether to go into closed session. The motion is in order. Moved and seconded. All those in favor say, aye. The question is the motion in order to review or not review our discussion. Im sorry to disclose or not this was to disclose or not disclose. Motion not to disclose all those in favor of not disclosing our discussion please say aye. Opposed . We will not be disclosing our discussions. The recommendations of counsel were all accepted. Consideration for adjournment commissioner is now motion for adjournment in order. Moved and seconded. All those in favor of adjournment please say aye. Opposed . This meeting is now adjourned. Take you. [gavel] [adjournment] [gavel] okay. I call this meeting of the Transbay Joint Powers Authority board of directors for june 9, 2016 to order. Would you call the roll please madam secretary. Sure. Director kim. Here. Ed reiskin, present. Director harper. Here. Director. Here. Mr. Chair you do have a quorum. Good timing. Okay. Communications please. Theres none that i am aware of. Okay. So next item. Item 4 is board of directors new and old business. In the agenda planning what is coming up next time were going to have a presentation from caltrain on its status on electrification is coming in. I am also going to call for a closed session on review of board officers. Its about time that we get back into that so the way i want to do it is at least the way we do it at ac transit we do all four because it tends to go in and out and the interim executive director and general counsel and c fo and with that next item. Item 5 is executive directors report. Okay. Good morning directors. The Board Meeting last month i reported that the responses for the rfp is due may 26 and reported the results of this meeting. We received input since then that more time is needed for the proposals together and extended to june 17, next friday and with they will report also to you next month. For f block four on may 17 the San Francisco board of supervisors took action to approve the parameters for the agreement. This was the latest action required before we proceed with the closing of that basically so i want to take that opportunity to thank the commissioners at the office of Community Investment and infrastructure and Tiffany Bohee the executive director and instrumental in securing the approval the commission and helped us with the board of supervisors. This action along with the action by the San Francisco Controllers Office with financing is allowing us to move forward with the project and fully fund phase one so that is great news. In your report in the budget you say that june 10 is the anticipated closing for f. Thats tomorrow. Yes. Is that still in effect . Its the week two weeks from now. Okay. The developer asked for a seven day extension and i think the date is june 20 if i remember correctly. Under the purchase and sale director harper they have that right and they exercised the right and just a matter of getting the paperwork in order. Thats standard. Okay. Following up on last months discussion at the Board Meeting we met with the City Attorney last week and discussed collaborations with the Attorneys Office. The meeting was very informative. Were going to schedule follow up meetings and scope of work and provided to the Attorneys Office and know the capacity and what they can help with short and longterm. They might not have enough capacity right now. We will do a transition plan for that and i want to thank the board for that suggestion. We continue our discussions with the Insurance Office of providing security for the Transit Center. We had good meetings. We traded staffing plans and i am hoping by next month i can provide results of the discussion and recommendations to move forward for the security on the Transit Center. As a note ryan and i visiting the l. A. Union station next week, look at the security, how its managed there and ask about operational issues that will help us with our building. We had the mayor and welcome the delegation from china on june 7 and the staff provided an overview of the project and gave the mayor and them a look at our system and impressed and the development and intermeadol Transit Development and that was successful and pleased to report that the downtown rail extension has been identified as a high performing project in the plan b area and under development with the regional Strategic Plan b area is a planning document for transportation investment in northern california. Being designated as a high performing project is critical for the funding of the program and helps with the position to get the start and fully fund the project. This concludes my verbal report. You do have two reports before you for information Quarterly Financial report as well as the monthly transaction reports. Any questions so far . Okay. Move into the next item . Yes please. Item 6 is construction update. Good morning directors, staff and the public. I am pleased to come back again to report progress on the phase one project and before i kind of get into or hand off to dennis as i do with getting into the in field in place progress i just wanted to underscore in the last month i am pleased with some of the procedural advancements that weve had. Weve had some partnering sessions with core groups as well as trade partners. Weve had i think Productive Group huddles on problem resolution and most importantly we just concluded yesterday a very significant strong dra session dealing with some of the issues i think you were briefed on last month, so a good energy towards identifying issues, tackling issues and resolving issues in a timely matter so i just wanted underscore that. In addition to presentation of the project as mark mentioned were progressing reaching on bringing the master [inaudible] and my concern is have operational readiness and building ready to hand over and as mark mentioned were going to go look at Union Station and arctic to round out our knowledge and align the operational thinking and in the coming months we will be on boarding some of the transit operators to kind of round out our understanding of the operational needs and make sure theyre aligned with what were building. So were got those two objectives aligned in the next 18 months. With they will ask dennis to speak to the recent and upcoming activity and safety and labor and i will come back and give a touch on budget and concerns and contingencies. Dra sessions. What is it again . Im sorry of the dispute resolution i wanted to make sure. A strong collaboration between them and us working through some issues with some of the steel and mechanical contractors. Better positioning us you know as i have been saying the sooner we off load or off board some subcontractors the sooner we off board risk and exposure, so this is a good step towards that endeavor to position ourselves to when they wrap up that we can sooner rather than later off board. Thats because its a mutual release of claims at this point and everybody signs off . Non binding but also admissible. Good. And we will hear the outcome of that in the next few weeks i believe. Okay. Dennis could good morning directors. Good morning dennis. So im going to go through the recent activity first over the last month has been very productive. I will point out this graphic we have been using for most of this year that depicts the structural concrete progress. The dark gray has been completed and the green is what was accomplished in the last month which get us us to the edges. A lot of very Good Progress were almost to being out of the structural concrete business shortly and i will show pictures to that effect. In the western zone over the last month the focus has been getting concrete, structural concrete to allow for the follow up trades. That is almost done in the western zone and working on concrete columns, the below grade on the lower level theres a lot of partition walls for the electrical rooms and a major milestone to achieve by the end of the year and work progressed well on that area. Also the map has been being continues and also the concrete masonry walls progress in the western. In the central zone now that all the structural concrete is done we have the follow up trades continuing with the upper right picture showing waterproofing that goes on the first street bridge. Thats progressing to eventually remove the temporary first street bridge and one of the steps there and waterproofed there and the lower right shows the awning continues to be installed in the central zone. In the eastern zone the structural steel and welding was completed, all the punch list items so theyre off the job at this point essentially and fireproofing is following up on work progressing such as eyebrows that we talk about and the constreet on the middle deck continues as about on the eastern zone. Moving on to the activity of the bus ramp and the main focus is up on harrison street and the clem min tina area and where the bus donut section happens and the cable stay framework progresses as were getting closer to the deck pores on that. Some of the pictures here. The two pictures show the pour that happened in the last month and that is behind us and the bottom right shows they call it the lost deck, all of the forms go in place to pour the deck and frame four bridge structure so going to upcoming activities central zone will continue with the awning, metal panels, curtain wall installations and the painting and bus deck level waterproofing and this is building out and the anticipate of this bridge is midjuly and have a traffic switch and just a shift and traffic probably wont notice it so we can remove half of it and build up that section and do a traffic swap a few months later and get the first street bridge out of there in the next months. In the eastern zone continue this and the all of this continues and continue the structural concrete here and at western end we complete this completely. We have other concrete that will happen throughout the year and partition walls and barriers and all of those will continue until october november but the construct url concrete will be done and the partial lid for f will be done in a few weeks and the bus ramp will have the cable stay deck pored and continue to do underground utilities and bridge work throughout the structure. On the safety slide i will happy to report in may there were no incidents, no lost time or recordables in the month of may and to put us over 2. 3 million hours so far on the project so with they will turn it back to ron for the budget slide. I have one question on your ac transit is getting probably more and more toward the electrical recharging stuff, the hydrogen that may or may not be working for us or anybody, so is there any infrastructure that is going into the bus deck at all to support charging on the deck or is that something we will just have to cut in later when it happens . I am not aware of charging on the bus way back in the tony pisony days and running cables there but i guess its not happening. Not at the bus deck. It was anticipated at the bus storage. We studied it and not worth the effort at the time. Yeah. And in bus storage if its required. I dont know if its the wrong decision. At this point were getting to the point of looking at the different technologies that we might be interested in. Okay. Okay. Moving on to our budget slide. In the last month weve increased the expenditures by 21. 9 million bringing us up to about 1. 3 9 billion in terms of expenditures, and our commitments have gone up to 1. 5 1. 3 and with a change of delta of 5. 7 million in additional commitments so as you can see commitments are slowing down and the buy out is pretty much there except for the net worth that i will talk about shortly. In terms of budget and contract time were inching along at 1 a month. In terms of the amount placed in this month its a little light for pacing ourselves for timing finish so i anticipate that number to be starting to increase as we move forward. Looking at our contingency costs overall contingency usage was at 2. 7 million and its about 600,000 less than we had forecasted in the last report, and the may break down of 2. 6 and construction contingency and. 1 million in the other tirchl use as you see in the third fourth row, sorry. Most of it was driven by miscellaneous super structure changes, elevator refinements, minor change orders for the most part. I think the largest one was a Million Dollars of additional plate frs protection above the train box just to deal with some site issues where our cover wasnt as thick as we wanted and compensated by putting additional steel there so no great surprises on that front. Looking at our schedule at one time we were talking about doing a big enforcement for the train box and that is not happen. Those with 2foot cover it is happening and less than that we do it and in case someone comes in and with a jackhammer and punch through that and with the site refinement we discovered areas theyre actually less than 2 feet so we removed the concrete protection slab and replaced with steel plates a bit of a safety net so we dont have inadvertent brooch of the water approaching. Okay. Looking at the schedule the overall forecast each of the major strengths and Holding Tight but from an overall perspective looks like we slipped a bit. The Transit Center this shows about a five day slippage on the Transit Center. 12 days on the bus ramp which is a little perplexing for me because as i sit in the meetings i sense were going to come in by december so i think some fair factor hasnt been teased out yet and i am betting that coming in by december but right now the forecast is slowing a 12 day slippage and as expected the bus Storage Facility slide another month although i hear some advancement in discussion about leases terms and relative to Market Conditions as advanced a bit but i havent seen anything in a written agreement yet that will allow us to move forward in the advertise and bid phase for the bus storage. I talked to bijan about that and in june. It wont make the june. Thats right and then. Its august. There is a meeting in august. Just the opposite. How does that work and its later than you would like to see it. Yeah, and having an operational fix of dead heading. With the issue of transit staff i asked them to come up with a short and longterm plan and short term being able to operate the Transit Center without the bus storage for six, seven month period so that if were not able to build the bus Storage Facility in due time whether we open the Transit Center theyre able to operate. Longterm if somehow the lease doesnt go through so theyre working on that. I think we will be able to mitigate whatever delays were having right now through the short term plan that ac transit is developing. Yeah, this is tied into ac transit and mtc and get four more buses and with the transbay terminal and if they can come in and we have to understand the more we store the fewer that are available for service on a regular basis so we have to be a little bit careful there because we want to come out with as much service as possible. Absolutely. I think the bus deck has 37 bays, the majority but not all storage and some could come back and i dont know if theyre storing on Treasure Island and that is an option so were working with them and come up with a short term Operational Plan and were able to open the Transit Center and operate while the facility is being built if were not able to finish construction at the time. Yeah, definitely needs some attention. I will be at the overall work flow shows some slippage as we look at the more granule view of activities strains and the exterior to waterproofing and interior finishes are showing gains on the schedule. Those are the areas that are most active right now. Theyre the ones that put the most acceleration to and theyre the ones that weve got our sea legs on if you will since we have been ramping up on those for a while. Were seeing slippage in the mechanical electrical plumping systems and commissioning activity and some of it is to be expected. Were in the learning curve and bringing the tradeosline so i hope to see betterment of suggest as we progress and round out those elements as well, but it does kind of amplify or punk wait a general concern for being in a position to put together the Building Systems and the commissioning. Its going to be a big push towards the end another area i have been emphasizing a long time and we will continue to emphasis on and in terms of the challenges of the schedule strategic over time i think has beared some fruit. I think we refined the forecasting among the group and i am seeking to see better improvement on the monthly updates and moving closer to a complete mitigation. As you see were still hanging out there in terms of grading the full mitigationthe next challenge is by america. It settled down a bit but remains a potential significant schedule risk and likely to continue to be a subject of dispute. The schedule risk lies with the installation of Building Systems much to do with a lot of activity with the electrical subcontractor. Last month i noted that i was pushing our team to complete and stressing the emphasis of their certification by america. I was targeting may 13 and we got the evaluation concluded and issues, some letters to the cmgc and fiiveg to one to underscore by way of certification and federal regulation that theyre obligated to deliver what was bid at bid price and by america compliant. We also in that endeavor recognize there was some irregularities or some curiosity bs the bid package listed subcontractors. We saw some submittals from other subcontractors which begged compliance about the fair act and both were pointed out and questioned to the subs and i am awaiting a response for so we can correct that one if there is an issue as we perceive it so more to come on that front. Is this collusion that youre looking at . No. Some of the Building Systems, the fire alarm, the Fire Management system was listed under one particular suband i am seeing submittals from a different subthat was listed for communications, so that raises some eyebrows. We will be continuing to address that as well as insuring that certification by america is maintained. The next topic of challenge is highlighted in the past is change management and unfortunately its pretty much all about ac transit bus deck reconfiguration. Since last month i did receive some proposals from the design team to create the modified construction documents and to implement some of the options that we studied with ac transit. I asked pmpc to put together a full project cost and schedule. We got numbers for the cost estimate. We got numbers for the design. If you put in some factors for soft costs were bumping up against about 950 million of endeavor there so i wanted to you know put it together with clarity like a project in itself in terms of costs and schedule, and start advancing that discussion about Funding Sources and timelines that that will dovetail in next week we will initiate some of the transitional planning bringing the transit users shortly under the take so we fully understand the expectations of arriving and operationalizing their spaces and in that discussion i see also advancing discussions on the bus deck as well and then the lastly the bid package 1. 5 procurement which is basically buying the Network Systems equipment thats kind of stretched out a bit. I was opening it was out already and its about to go out. It has been bogged down by the buy america concern and we have asked designers to ensure what is in their speck for that trade package which is primarily all the network gear as i call it, the whiz bang boxes and the racks. Most of them are i believe under the waiver for micro processors so we have kind of teased through that with the designer so we can have a definitive statement in the bid package which is about to go out. We will reached out to the fta to give us some validation on that front as well, but it is a worry because of our converged network a lot of things are interlaced with this equipment so it could impact our operational readiness. We have some work arounds in mind in terms of procurement strategies, but this one is going to take a little more study and we really need to get this one out and get that sub contractor on board. Even if we buy a cisco server out of menlo park. Right. If its not made in america it violates the buy america or the fact that were buying a cisco server. Thats been the difficult thing to tease out. We went to cisco and asked them to stand up loud and proud and buy america and they didnt quite get there. Too many lawyers. Its hard thing if you want to go all the way to taiwan. What ron was mentioning we have a general waiver that applies to all projects for micro processors. We met with fta after meeting with cisco and others to confirm the products comply with that and we met with fta and information to them and confirm in fact these products do comply so when were at bid we dont have issues and not comply or not and lose interest in the project and lose bidders so were going to put a statement in the bid documents to ensure bidders its compliant and waiting for confirmation on that from fta and we should be able to get them together in time. This process of trying to understand what waiver applies to what and get feedback from fta took longer than expected and why we didnt advertise the project yet and expect to advertise it next week or two. That pretty much concludes my update if you have any questions. Chair harper. Yes. Thank you. Ron thank you for the update. I was just curious on the change management slide you have about the ac transit for the bus deck reconfiguration what is the change process what is the approval process for that . . Does this board or ac transit approve it . How does that work . Because its different like youre digging and find an under ground storage tank to address. This sort of an owner change so that approved by this board or the partners or both . I mean i would think once we get alignment on the scope and schedule and Funding Source is with the end users that we come to this board and inform you and look for approval to i mean indicated to ac transit they should expect to pay for this. Its up to us whether we allow it orderless. inaudible . But they shouldnt be surprised to see a bill coming. If were able to quantify the costs and more importantly quantify the impacts on the schedule and come to agreement with ac transit on the costs and live with the schedule impacts we could present that to the board for approval. Thank you. Okay ron. Thank you. All right. Go ahead and call the next item. Yes please. Item 7 is the Citizens Advisory Committee update. Bruce. Good morning directors, chair harper, executive director director, mark zabaneh. Just a bit off topic. I would like to congratulate supervisor kim for winning your races for Democratic Central Committee and being one of the top two vote getters for district 11 and running again in november so congratulations. Back on topic i do have several items from our last Citizens Advisory Committee meeting. We were very pleased to hear as the executive director mentioned that the dtx will be again designated as a high performing project as part of the 2017 plan bay area and positions us for the phase two project new start funding of approximately 650 million. It was also shared one of the other items in the staff report was a response deadline for the master lasee was extended to june 17 and although the reasoning for that extension makes great sense it was brought out in Public Comment there could be a risk of the retail not being ready by the time the Transit Center opens. The cac looks forward to an update at a future meeting once the contract is awarded and assured to hear about the next steps and timing and associated risks. The next item i would like to move on to and later in the agenda for the meeting this morning we want to thank the executive director for a great comprehensive update on the project. First including the design of a tunnel stub box at the curb of seventh and townsend makes so much sense that if the decision is is made to go ahead with the current alignment of phase two and subsequently making a decision to adopt the peninsula alignment as part of the rab study that will be incorporated and will be well positioned. A second item it was highlighted during the presentation the need for three tracks as part of the downtown extension. We had discussion regarding construction methods of seqernl mining versus boring machines and with ten you will boring machines allowing for two tracks instead of three. In either case optimizing Operational Efficiency and flexibility must be held as a foundational requirement and we are confident that this will be incorporated in additional analysis as part of the Current Study in addition to any study with the rab. Next we will be interested in hearing more about the trurn back and maintenance tracks when answered as part of the supplemental eir eis and the concern potentially that would exacerbate the traffic conjust ion in the area and we look forward to hearing more and answer this and alternatives through the rab study. Next is funding. We had a robust discussion with passenger facility charges and looks how much to charge passengers coming in or out of the terminal as part of their ticket price. This pfc will contact for a significant portion of phase two funding. A very thoughtful analysis was done comparing the pfc to the cost of taking muni, cabs or other modes of transit from fourth and king to a passengers ultimate destination. One item we noted was the convenience factor and time saved by a passenger in addition to the cost of being able to disembark at their ultimate destination eliminating wait Time Associated with the transfer again justifying and supporting this charge. Next we looked at as a point of caution we looked at escalation factors of 3 to 5 in the award of bid packages versus estimates. Although these are not directly tied we all know during phase one many of the contracts awarded were upward to 25, 30 over estimates. We have been assured that the project team along with mtc have taken lessons from phase one into account with phase two of the project. With this said it would be prudent to incorporate this discussion with the board at the appropriate time and last as far as this presentation we look forward to hearing more about the various delivery models to deliver this phase of the project. This is outlined as a next steps and we look forward to the analysis and recommendation to determine which model will deliver the project at the least cost while minimizing risks. Just one quick item on the construction update. I want to again we appreciate the improvement in transparency provided in the construction update. With that said its been noted that on the schedule and in the challenges and ron just mention today a few minutes ago that the schedule has slipped by a few days and one of the biggest risks identified was commissioning so at the cac we have requested an update on commissioning at a future cac meeting so thank you for the opportunity to provide this update and i will answer any questions. Thank you bruce. Okay great thank you. Next item. Next item is Public Comment an opportunity per the public to address matters not on the calendar and recs we have mr. Patrick and i believe thats all. Good morning directors. Jim patrick, patrick and company San Francisco. I see a gorilla in the room. I see a transit station in an eastwest direction. I see a lot of time devoted to the dtx which is the arrival at the western end. I see nothing, and i want to say again i see nothing being done at the eastern end. Weve conjured up this notion of bart at the east end with a tunnel down to embarcadero station. Good idea. Where is it going . This board needs to say we have an idea of the future and this is phase three and phase two is dtx. Where is phase three . This board hasnt mentioned nor talked or put forth ideas about phase three and i think theyre fabulous opportunities there theres a lacking of leadership of where were going so i encourage you to rethink some of the things were doing or give the staff direction what they should do about phase three. Right now were worried about where to put the toilets and we should think of phase three beyond that and thats the boards responsibility so please think about phase three. Where are we going to be ten years from now . Thank you. Thank you. That concludes members of the public that would to address you on the item. We can move into the Consent Agenda. Please. All matters are considered as routine unless pulled and considered separately however i received no indication that for any items to be severed and the items are 9. 1 and 9. 2 of of the minutes and a contract with professional Services Agreement to extend the agreement for two fiscal years from the amount listed. Is there a motion for approval . So moved. Second. A motion and a second. We dont need a roll call, do we on the consent . All right. Its unanimous. All in favor say aye. Aye. Opposed . The Consent Agenda is approved. Moving into the regular calendar. Please. Item 10 is approving the revised baseline budget for the transbay Transit Center program in the amount of 2,259,400,000. Directors i will present this item. If i can get the computer to work. It will. Okay. Its been a long road and we had a lot of help from a lot of people to provide you with a budget that is sufficient to finish the Transit Center and open phase one and open for operations. I want to thank you first for your support in the process and the city of San Francisco and mtc and helping with the interim financing that needed to be done in order to fully fund the project and recognize our c fo and work with the Controllers Office to get this done and a long road but i think we have a good budget now and the aim is be at least 100 million under with the budget when done and give money back to phase two to fully fund phase one. With that today were 1. 3 billion and we have 57 60 million to go 22 million for the ip network and 20 million for the bus facilities and 15 and a half Million Dollars of various scope to procure under change orders to finish the project and makes up the 60 million to go. Theyre low risk items. We dont expect them to impact Construction Costs or schedule. We will be working hard on the ip network to make sure we procure in time and not impact the Transit Center completion. Weve completed much work and retired significant risks. To date we extended approximately 778 million or 61 of the work. Structural steel is practically done and in the close out phase of the twoject of that other contract. Twin box construction, piling and thats also been done. 125 Million Contract thats also in the close out phases. Excavation has been done also. 235 million. Thats done practically closed out. [inaudible] concrete and 53 Million Contract. We should be done with all concrete by december of this year and close this contract out by the end of this year so this is one these are our highest risk elements and theyre behind us. Ongoing work includes the roof top park. We hope to start placing dirt and building the park september, eakt october this year and that will start and the sky light and Ceiling Systems and awning and started installation and expect to be done a year from now and current walls and installation going pretty well. Ceilings we will start soon once the Transit Center is ready to receive that and the highest risk item is the plumbing and mechanical and [inaudible] of work so our focus is on the Electrical Mechanical and plumbing. The awning current Ceiling Systems are design build assist and total 150 million and look at them as low risk since theyre designed by the contractor and designed by the contractor. This is a snapshot of the interim budget that was approved in november. As you can see we added 165 million to our july, 2013 budget back in november. That allows us to schedule critical packages at that time and increase our contingencies and reserves. This is a list of the packages that we awarded. 97 million. At the time we increased the costs by approximately 21 million and we increased the contingency reserves by 63 million 62. 8 million. This is a break down of the proposed budget for approval today. The total budget is 2,259,400,000 and includes the direct Construction Costs. 595 million for program softs costs and rightofway costs and 211 million in contingencies and reserves and the rest are in [inaudible] and construction. This is another break down of the contingency reserves. We have 211 million. Were adding 168 million with this budget augmentation. This is approximately 30 of the remaining work. If we take away the [inaudible] to utilize and after the exposure has been accounted for and a healthy budget and again standing here working with ron we dont see why we cant finish the project and leave the 100 million untouched and this is a slide that ron shared with you. Our estimate and completion as it stands today is just over 2 billion and 5 million than the maximum we want [inaudible] of 159 million which is the 100 million less than the total budget. You see the red line is what we called third rail in the office. That slide we will not exceed. And then to close it out this is a history of how we adjusted the budget since approved in may 2010 after adding the train box. The totals are listed here and july of 13 we added 310 million to the budget and 104 went to increase the package costs, 95 million of the 104 went to seal trade package open at the time and came in almost double the estimate. Listed here are the amounts of the reserves. The 360 million that weve includes the final budget. 265 million of that went award packages that came in above budget. 14. 9 Million Dollars went for soft costs program wide and 79 million went to the contingency and reserves and this is to give a historical break down of the funds we added to the budget since the budget was approved in may 2010. This is a short presentation. I know the board has been updated of the progress of the budget since last year so with that i conclude my presentation. Okay. Questions directors . Okay. No question. I just want to acknowledge the good work that the staff has done to get us to this point. We were made aware of the need for this budget adjustment about a year ago and its been a lot of work on the revenue side to get us to this point so i appreciate it. I appreciate also the executive director mentioned i think about seven times the goal of coming in 100 million under and there is a very healthy contingency here and i know we will do what we can to support him and his team to come in 100 under so we dont have to borrow that money and its available mention today six times too many. No, i think its great so i think its great to be at this point and happy to move approval. We have a motion and a second. I have just a couple technical questions that relate to the budget. When the money comes in from the San Francisco mtc financing is that going to be sequested in a separate account . I have refer to the c fo, sara. It would actually come in for payments. We would only draw down as needed so i would submit requisition requests to the Controllers Office when i have expenses and receiving the monies and paying them out to contractors. The reason i ask with San Francisco we have two levels of review with expenditures Going Forward. One is a general advisory thing that we still need to put together probably, but the other one for the money coming in and expended they wanted direct review authority on that that was coming out of that money. Am i wrong about that . Were working with ben and nadia this week on the Cost Review Committee i think is what youre referring to so the proposal is yes for costs anticipated to from the city financing they will provide preapproval and provide them a list of funding and not to exceed amounts. They would provide approval at a quarterly meeting. That is separate from the actual draw down process and the agreement does state konz they provided that preapproval for commitments they cant then disallow a cost for a submitted invoice, but the reimbursement process is separate. I would be submitting requisitions to nadias office and list of costs and receiving those funds and paying them out. Youre saying after july were sort of whatever it is that were requisitioning is going through the same process just as so all money was equal. The reason i ask i think sometimes do we want to have as i perceive the deal with San Francisco there was two levels of two criteria levels they did. One is youre spending the money that we have advanced you and the other is money from parcel f and things like that that didnt have anything to do with that, and we may have occasion to say this particular money is coming out of this pot versus this particular money is coming out of that pot, so are we going to have that capability . Im not sure i understand your question. Theres no change in any of our processes for handling funds. Again the committee will preapprove uses of the city financing and to specifically draw down on that financing we will submit reimbursement requests or requisition requests to the city as the funds are needed. Were not requesting the funds in advance of the commitment. Sara maybe the question is that theres two levels of review as part of the cost committee. Money thats not part of the interim financing that were spending we would share within the change orders and they would review and concur with that. Money that is being used for part of this financing theyre going to review all the expenditures regardless whether change orders or not. Right. Those are the two levels and were meeting with the Controllers Office and streamline the process and especially for the change orders. We dont want to wait for change orders and we want to process them and the meeting is how to streamline the process with the office and mtc theyre assured they see the expenditures and aware and concur with it and not impacting the project itself and delaying anything. My perception was with respect to the financing they wanted a high level of authority much higher than no this is not the money but thats what got my question. Yeah, the interim financing they will review all the expenditures. The money not part of that they will review the change orders. This is the way so they will review change orders, contracts, contract amendments and any potential budget exchanges. Yeah. Okay. Another minor thing you talk about the cost regarding the for the sales force and the fremont towers and theyre going to pay for that. Is that shown as income to us . I just wanted to make sure. I probably missed it. Technically what is going to happen instead of meeting 360 were going to take half Million Dollars less from interim financing because sales force is going to reimburse us and reimburse us for the work that is approximately 100 million i wish half Million Dollars for doing their design, so its reimbursed work so instead of adding half a Million Dollars to the budget to reflect it reducing our needs by that amount. Thats all. Its just an accounting. I wanted to show as part of the budget we need to increase the design budget by half a Million Dollars to reflect that costs even though its pursed fully. Okay. So my last question is that the funding plan you mentioned the developer will pay an additional 15 million this is on parcel f and pay the premium to secure and assemble the 545 Howard Street site which is way down the road so we need to be you know cognizant of that and make sure because it wont happen right away. Its going to be and that is just between them and the 545 howard people. When they have final approval from the Planning Commission we will know what theyre proposing and if that includes 524 howard and receive that amount and go to phase two. And the 15 million were not counting on that i presume. I am counting on it for phase two. Or phase three now. Its not part of that. As to the future commitments of the parcel f buyer were recording a covenant to capture all of the items and of course we will be watching closely and monitoring in the event were eligible to receive additional income. Okay. No further questions. Okay. Quick comment. I would echo the directors comment and staffs work to get us to this point. In future updates there maybe based on the correspondence from the public about the budget and scope. It might be helpful to add another slide in future updates and i am not trying to create more work and not sure which is the right slide but talking about the final budget of 2. 25 million i think its fair to say the scope with the number isnt the same where we started that the biggest addition i think is the train box for example, but there maybe another Million Dollars addition for ac transits bus deck reconfiguration. There may be other things so what i am getting at there maybe an appropriate slide heres the base scope once upon a time and heres the scope additions that have occurred over the last 20 years. That gets lost in this type of presentation where were just focused on the numbers, but it doesnt really tell other parts of the story that the public has shared with us what were building today isnt what we thought we were building 20 years ago and somehow that needs to be woven in here and just another slide that says you know basis of design and then additions over the last 20 years. Okay. And those numbers should be total numbers, not you know 300 for this and fee for that. I mean its simple train box is worth 450 million. Ac transit deck design just simple numbers to better tell a complete story rather than just the numbers. Yeah. I will do that and i want to clarify that the number here includes the box. Correct. But thats not where we started. I understand. Where we started was more like 1. 2 billion. And we added the train box. And other things happened along the way but the scope of work is different today than envisioned decades ago. Okay. Will do. Okay. The first and a second and no members of the public to address you on that item. Yes. Director gee. Aye. Director kim. Aye. Ed reiskin. Aye. Director harper. Aye. Call the next item. Please. Next item is approve the fiscal year 201615 Capital Budget in amount not to exceed 484,920,300 and fiscal year 201615 not to exceed 5,187,168. I will be brief. This is a snapshot or one year sliens of the slice of the overall budget that you approved and anticipate spending this year both capital and operating. The only change since we presented the numbers in may was add just under 5 million to phase two and of course youre hearing about that every time later on in the meeting so i wont go into detail but we will work with the San Francisco Transportation Authority to request funds for that effort but that is the only change made to the draft budget presented to you last month. I am happy to answer any questions. Great. You have one vacant position i think the budget memo said which is a Senior Program director. Is that a position for phase two or is that the vacated position . The budget thats sitting there is currently vacated position. Mark is capable of doing two jobs at once and could fill that with a staff person but the number is there for whatever the board and mark would like to so the budget doesnt proscribe whether the phase two effort will be lead via professional Services Consultants versus a staff member. You have the ability to do either . The phase two budget is specifically for consultant work. We dont currently have a Funding Source that is specific to staff and benefits so currently all staff time and benefit time as well as all of administrative costs are allocated to phase one even though certainly there are folks that spend a certain percentage of time on phase two. If we do at some point in the future have phase two Funding Sources where staffing and benefits are eligible costs we could do a Cost Allocation plan at that point and split it out. So right now none of the Funding Sources available for phase two are not available to pay staff. No. And theyre specific to consultant work and we could do a Cost Allocation plan and request that in a future funding request for phase two but at this point all staff is covered by phase one sources. Does that include parcel f sale and those are restricted as well . Land sales are restricted to hard Construction Costs. I get it. Theyre used in phase one anyway. Right. I guess the reason i am asking and i mentioned this to mark a while ago that this i think as the chair said last time it really needs to be the shift of the focus of the agency and develop phase two. Its a huge as we will see three or 4 billion program. At should point we shouldnt leave it just to consultants and have a senior staff person who is fully responsible for that effort and i think leaving it spread out over different consultants ultimately wont deliver the program and if we need to do that allocation or the process i recommend that we take the steps so we have the opportunity in the future with other funding to bring on or use that position perhaps to fund a staff person to lead phase two. San francisco money can go to phase two, right, for staff, i would think . Were having discussions with the Transportation Authority and after the presentation on the dtx i will explain the next steps and part of the next steps were seeking funding to achieve the next steps. I will in my discussions, follow up discussions with the Transportation Authority i will see if there is a way to get funding so we can have somebody full time help and manage dtx with the tjpa staff. Currently the budget is consultants managing part time efforts but i agree with you director reiskin to focus and deliver dtx as quickly as possible we need that and i will bring it up in discussions with the executive director of the Transportation Authority. Okay. I will willing to support the budget as is so we can have it in place before the start of the new fiscal year but i would strongly urge that we take the steps so we create the budget space and the Funding Source to bring on someone to manage this program. I would like to point out the total budget amount shouldnt change because the vacant position is fully funded and making sure of that, but [laughter] mark. But yeah we could use that position for phase two if were able to get the funding and phase one and phase two and the total budget would be the same and just as sara mentioned and reallocation and we will do that. Thank you director reiskin for bringing the item up about phase two. I think what would be helpful for me at a future meeting sort of a road map for what we need to do as a board to whether its new Interagency Agreement or a Partnership Agreement to help fund and resource the team for phase two. I mean i dont think its just my ignorance or naive etthat San Francisco will fund it all about if there are things to get to a budget to resource the team to work on phase two what does that road map look like . Who needs to be involved and consulted and what agreements need to be in place . Because i dont think it can happen by itself or San Francisco. Thank you San Francisco forgetting it started but this is a bigger for getting it started but this is bigger than that and we have heard not everyone is on the same page and how do we get there and what does it look like . Okay. I believe we have a first and a second. Yeah we did. And no members of the public to address you with that. Director gee. Aye. Director kim. Aye. Director reiskin. Aye. Vice chair nuru. Aye. Chair harper. Aye. Five ayes and item 11 is approved. Call the next item . Yes please. Item 12 is approving the amendment number 4 to professional Services Agreement for Turner Construction company to increase the maximum comp tension from 57,180,000 to a total of 72,500,000 and extending the tomorrow of the consider for wo years to 2018. Directors we shared the need to augment the budget as we develop our overall budget last year we shared with you that the original budget did not account for the number of fabrication shops and number of fabrication welding that needed to get the construction seal completed. When we did the budget originally we thought we were doing fabrication at two shops and single shop. As the contractor got on board and working in earnest the work required to be done and increase the shops doing that and i think it went up to almost eight different locations at one point. That caused us to having to send the c mo at different locations to observe the welding and approve the welding and increased the needs quite a bit and increased the budget so this budget element adds 15. 3 million to the budget. Extends it two years to the middle of 2018 until we close out phase one. It reduces the fee from 9 to 7 , so c mos is our eyes and ears and we need them more than ever to keep up with construction and approvals so were able to get going with construction. Currently theyre working several shifts and saturdays to be able to finish by this date so if you have any questions dennis can questions . None. A motion. Can you give us a little more detail of what they would be doing the next two years . Yeah, dennis. Sure. I can run through the presentation real go through some of the details. Yes. Im not going to go through the scope part because i think were familiar with that. Theyre the eyes and ears to the scope. This details out the background how we get to the 15. 3 million that is remaining. This tries to tell the story right here where its were the red line is what the request is. It shows you that the 46 million and this timeline shows it starts july 2013. Its really when the budget was approved and shows starting the c mo at 46 million. Prior to scanz sca coming on board and tracking as expected and once the people came on board you can see the yellow line and the black lines basically shows the spike up as the efforts for the isi which is the main driver for the additions to the contract came from and as we noticed right away it was the latter part of 2014 when scam sca was on board and the support needed for that activity starting to representation thats when we immediately noticed that this had to be modified and the red line and projected up to 72 million and went for the first in a series knowing we would have to get to that point. As we were working through an interim funding budget element we could only go in certain parts and kept moving through various cmo amendments to get to eventually the 72 million 75. 5 million we were expecting. As we went through we have been tracking it and now were ats at as of end of march and have information that is tracking identical and confident were tracking below the 72. 5 million with a slight contingency Going Forward and ultimately the request today for the cmo amendment four gets us to the 72. 5 million that we looked that we needed. Where are the numbers coming from . Basically you can break it down and knowing the original contract and added 7. 5 million to get to the 46 million for the july 2013 budget of the remaining amount over 20 million of the remaining amount is the special inspections and mostly welding and off site inspections and the remaining another 6 million comes from the addition of a second and third shift of turner, the additional eyes and ears, one person at night and one person during swing shift and weekends, additional waterproofing inspection, partnering and claims resolution support that we have added to the cmo contract add up to the 75. 5 million. With the major focus i use this graphic to show where all these sites were, all the west coast sites, where the inspections throughout the different fabricators that were required for isi, and because once the once you had the actual fabrication and laid it out in the yards you needed more inspectors because of the layout of the fabrication site itself because theyre multiple football field sizes and you added welders to that inspection as well so thats the break down where it came from and why we got to this amount from the original budget approval to today plus also adding the two years to 2018 and turner doing their part and working with the budget and reducing the fee down to 7 . Does that answer the question director . I dont know. I had the same sort of question because what i mean it may be that all of this adds up to 72. Seven at this point but from a timing perspective is there a 12 million bill from turner sitting in there thats unpaid . Because if not as director nuru said what are they doing for the next year . Supposedly the structural steel is done and are we sitting on a unpaid invoice here. No. We have 600 million of work that we havent executed yet, you know, the ceilings, all the current walls, mechanical, electrical, plumbing civil work that needs to be done. That work needs to be inspected and the quality is correctly. Waterproofing we havent completed that so somebody has to inspect that. Somebody has to make sure its done correctly so we need the quality assurance. But we always had to inspect all of those things. Well, i think the original the budget that was for the cmo in 2013 was not sufficient because the budget was 45 million and the cmo contract was 38 million and up to june of this year did not have the two years to go, so the seven and a half Million Dollars in the budget is not enough for two years and thats a big part why the augmentation is larger than the budget, but no we have a lot of work to do and if we want to keep up and make sure that were providing them with inspection at the right time so they can keep up with this and working three shifts we need the manpower or the power in this case. So the structural steel is not the problem thats the expenditures and went from 38 yeah, i got from 38 to 57. Thats the pay for the welding also. The 15. 3 million is for the next two years for the upcoming work. I would point out this is what we were told when we approved the previous increase and had pretty much the same discussion and were increasing as much as the budget allowed and the staff would come back once approved to fund the full increase so this is at least consistent with what we were told about, what the projection is for the need of the services. Thats the story and theyre sticking to it. Are there any other hidden expenses that we should know . Theyre not hidden expenses. Theyre part of the budget we anticipated doing it anyways but you know yeah. Thats the thing. I mean i understand i think, but dont keep going back to the structural steel welding and everything. At this stage it just seems so what it is that amount its a lot and sort of took out of the budget for the ceilings and mechanical and everything. That went into inspecting structural steel and now weve got to replace that that we knew we were have to inspect anyway and that seems the story. We had an insufficient budget and the work needs to be done. Right. Theyre people in the field, boots on the ground keeping up with it and also help us with big part theyre helping with analyzing change orders, analyzing any issues that we have and that is also part of these efforts. Great. We were involved in the dra. Theyre involved in the dra. Theyre leading the effort there. Right. As the graphic shows the red line we identified early on that we would need to get to a certain point and tracking exactly to that but we could only go in steps. That is part of the challenge i think of the story here but from early on we reconvened because the main driver was isi and everything under the influence. Else is known and isi. We knew that 72 was the number. As of last year we recognized we needed to 72 and part of the budget updates as we updated you on our budget needs. All right. Okay. Thank you. So i apologize mark and dennis for asking so my understanding if theyre not any outstanding invoices and everyone has been paid then and isi is a subto turner and turner advanced part of their budget to pay for isi. Thats the only way their sub can be paid without outstanding invoices . We have been doing an interim amendment. Theres where the various stars i understand but the 23. 3 million is a big number and if there arent outstanding invoices to anybody and turner is paying beyond the base to isi . No. So turners current contract is at that level and theyre near leer at that level and this is to cover the next two years. There is no one we shifted the budget because there were budgets for other work that we wind up shifting to isi. That internally happened and we sought more money for the increases. No, i understand that, but to director nurus comment if there arent any outstanding invoices to anybody somebody got paid out of somebodys budget. Its as simple as that and were putting more gas in the gas tank so they can continue for two more years. I understand that part but if the sub has been paid it came out of somebodys Budget Allocation which happens to be turner for their time on the project. Thats just the way it is if nobody hasnt been paid, and thats what everyone has said so far. No one has not been paid. No, everyone has been paid. So i get that point. The other side of this just i understand it dennis in terms of the field work done by isi i just need you to say on the record or answer this question is that isis time cards have been reconciled with the mill runs that actual happened on site . Absolutely. We were fully reviewing time cards and ensuring they match to who is there. In fact all the time cards are included in the monthly invoices. I understand that but they have to be reconciled against the actual mill runs and that isnt always the case that the tjpa project was there eight hours a day or three shifts and you you know mill by shape not by project. In this case we took over the majority of the factories and the only reason isi was there for our project not a matter they were working on other projects there and made it a simple review and they were for us only. And no other project was in the plant or in the yard or in the mill . Not utilizing for isi. Thank you. We need a motion. One more. Im sorry. Go ahead. And just one more follow up question. Mark going back to your previous presentation on the final revised budget when we talked about this amendment were talking about the program wide costs for Construction Management at the 75. 9 million budget of which is the majority of that. Yeah, we have City Services and other services on top of that. This is that line, the Construction Management of 75. Thank you. Okay. Looking for a motion. Approval. So movedded. Second. We have a motion and a second. Moved and second. No members of the public wanting to address you on that item. Director gee. Aye. Director kim. Aye. Director reiskin. Aye. Vice. Aye. Chair harper. Aye. Thats five ayes and approved. Item 13 is a presentation on the downtown rail extension and phase two. I will provide you with this presentation with help from once i get my computer going here. Sorry i am ahead of myself here. Directors this is a comprehensive presentation where we stand on the dtx. Once we accomplished so far and environmental documents approved and advancing the design what work needs to be done to move forward so that we can bring the trains to the Transit Center as soon as possible. This is the train box level eagerly awaiting trains to arrive. [laughter] i thought it was the chairs wine cellar. So the this presentation will give you an overview, talk about construction and scope and history of the budget and cost estimates to date, what efforts we have done thus far and estimates of the information we have, discuss a plan that would serve as a road map to bring in the sit sit. Talks about Funding Strategies and what next steps we need to take in the near future and later on to make this work. I will be joined in the presentation with ms. Sara wilson from the designer. She will present the Construction Methodology and our staff will present the funding plan. Starting with an overview you know phase two will extend caltrain future high speed rail from the caltrain current terminus at fourth and king to a Transit Center. The extension itself is 1. 3 miles and the construction limits are approximately 2 miles. Today we made much progress but we still have work to do. We issued the environmental document, the draft for public review in december received comments in february and were addressing the comments right now and sharing the comment review with the federal transit administration, fta. We expect to finalize the environmental documents by the end of the year and recommendation from the fta this year. Also significant progress on the development of the dtx. The dtx [inaudible] 30 completed but some items introduced as new scope modified scope as part of the supplemental environmental document is not 30 done and needs to be done to bring it to 30 . The box itself fit out for the train box is approximately 50 complete. However we need to refresh and refine it based on changes made in phase one mainly escalators and elevators and other features to do that and received approval from the california high speed rail and caltrain on the design and gee metrics for the design and alignment of the dtx. Were doing a study right now and share the results for the procurement for phase two. Weve asked them to do a study on the methods out there and what we be for tjpa what procurement method is best to procure phase two Cost Effective and least risk to tjpa. This study is in the draft form. We will share the results with you next month and talk about design build and other cures and based on the funding and the status of the project and provide you with input what the best method with information that we have right now and we continue the ongoing collaboration with the rab study with the city and other stakeholders as we move forward the aim is to be close cooperative with the rab study and part of the study and drive it to a successful conclusion. Im going to spend a little time on this slide. This is the scope of the phase two as outlined in the environmental document, supplemental environmental document that is being approved. Part of the phase two is extend the train box to the east from green street to main street to accommodate the high speed train links and 400 meters. Our train box is not that long so we need to do that accommodate the length and phase two construction of the bus facility on top of the train box. That facility would be used to store buses for greyhound and amtrak services. Currently greyhound amtrak are using the bus deck for phase one. As we move into phase two ac Transit Needs practically the entire bus deck to operate so were moving greyhound and amtrak to the other bus facility and phase two includes construction of muni and bart connector which would connect the east end of the lower concourse of the Transit Center into the mezzanine level of the embarcadero station and connect both stations together. Phase two would include fit out of the Transit Center for the lower concourse and the train box and mechanical electrical and plumbing and ceiling work and platforms and escalators and elevators and ventilation systems in the train box. The construction of the dtx is based on the three track and 2 3 of it is under ground tunnel thats mined using sequential excavation methods and 1 3 is cut and cover. The structure is cut and covered and geometry from three to six tracks as you enter the Transit Center and theres a section on townsend street between fourth and townsend station build by phase two and end of mine tunnel and cut and cover because its shallow in that area and the big feature of phase two is the inclusion of the tunnel stop located in the caltrain yard at fourth and king streets and serve as a connection point to allow us to further extend the under ground, the dtx southward so were able to maximize the potential for the mission area and utilize for development so the south subis a complement to our project. You can extend the dtx under ground without impacting the operation of the trains as phase two is built. This is a list of the some of the stoap that was added or modified by the environmental document and the extension is one of them and modifying the structures and adding the bus facility, defining alignment of the bart muni pedestrian connector and was included in the 2004 environmental document but we had various alternatives. One went to montgomery street and one went to embarcadero. This environmental document sets the alignment from the Transit Center along beale street into the embarcadero. We also widen this structure as part of the supplemental environmental document and we wanted to accommodate the turn radius required for high speed rail. We modified the fourth and townsend station also and mezzanine level there and make it bigger and turn tracks at of caltrain. As i mentioned alignment for dtx is three tracks. Currently the incoming tracks from the peninsula is a two track system. As they enter the dtx will extend to three tracks. We will have three tracks through the fourth and townsend station, three tracks along the mine section on 2nd street and extend into six tracks as we enter the Transit Center station. The station will have three platforms and six tracks. So thats from the tunnel sub box that is three tracks. Yeah. Currently we have two tracks and the project will extend to three tracks and before the tunnel and continue the three track system into the Transit Center so the new fourth and townsend. Three tracks. Scpawl the way to the curb there and the stub out and then two tracks and not us. Its to allow us or others to further extend the dtx under ground with the three track system so that will maximize the potential for the Mission Bay Area and added grade crossings and so forth. Its to accommodate future expansion. Okay. It just gives us the facility a reason to fully develop the area to the full potential. I do have a slide on the need for three tracks sorry, so this is a Cross Section of the train box. We envision having again three platforms, two platforms used for high speed rail, one could be used for caltrain and again that we have platform heights we can interchange them and any train can use anyone they want to use and we maximized the flexibility there. Okay. Yeah i wanted to make sure i didnt miss this slide here and the reason we need three tracks over and above the operation approved by the federal Transportation Administration and caltrain and require three tracks and allow to stage two trains going into a Transit Center and one is leaving and vice versa and if theres inbound train using the facility its disabled having a three track system we can bypass it and maintain the time and operation needs, and ulc having three tracks makes it easier to use the platform interchangeably in the Transit Center and above all building a since were building a tunnel not like a roadway or bridge and not widen it in the future so its optimum that we provide the flexibility that we need to operate it effectively now and in the future to come. With that im going to turn it over to sara wilson fromman jacobs to mach about the construction methods. I do want to note that sara worked on the claremont tunnel as shes currently working with the central subway. She has a wealth of experience. Thank you mark. Good morning. I am here to talk about the construction methodologies that have been selected for the occupants of this project. So mark went over the alignment briefly and there are certain portions of the alignment that have to be cut and cover because the excavations are large and complex or changed so much or sharo its not practical to excavate by any other method. The mined tunnel recommended is limited primarily to 2nd street connecting to cut and cover portions of the project. One of the benefits of the mined tunnel that it will allow for okay. Looks like i have a pointer here. That will not do it. Allow for mine of each side and cut and cover and mining can proceed towards the center and a ventilation shaft in the center of the alignment and used to stage excavation up to three or four headings if need be. This means all can be proceeding concurrently with the excavations. Again these are some of the geometries in different locations in the project. The throat structure up by the trans bay structure is 350 feet wide and cut and cover and expanding from three to six track frs the station. At townsend street will be expending up to three tracks as mark said and about 80 feet wide and the sem geom gree is 55 feet wide and its an under ground excavation and wider than it is tall and that enables us to facilitate three tracks at the shallow with the shallow alignment of the project. Thats one of the very Important Reasons why sem has been selected here. So for the cut and cover structures and deep soil mix supportive excavation is installed and as that proceeds downward internal bracing is installed. Street decking is installed to facilitate live traffic as we go downward and the depths are between 40 and 85 feet and the constreet box is installed underneath all of that live traffic. So for the ground conditions here can you see the 1853 shoreline and the current shoreline. Theres a lot of fill as we all know. We have been here for any time theres a lot of fill installed in San Francisco bringing up the city to where it is now and the mined tunnel is in native material in rock and within the 1853 shoreline. Some of the cut and cover portions are in the area where infill has been installed and Cross Section of the anticipated ground conditions which is way too complex for any of the names to be actually picked up but the primary purpose is talk a bit where the mined tunnel is located so the gray material that comes up to the surface is franciscan formation and that is rock. The mined tunnel has been selected for the rock portion of the alignment as well as for a valley roughly in the middle of the mined tunnel and due to vertical exaggeration to get this on one slide it may not be evident that the valley will comprise hundreds of feet in the dtx extension alignment. A couple of turns if youre not a tunnel person like me and floor and ceiling and fancy terms here and shows the cover at the ends of the alignment. Because of the potential for variable ground within the rock serkz one of the tools that sem tunneling uses is systematic probing and economical way to assess ground conditions ahead of time and anticipated so the right tool box can be used, the right types of Ground Support can be pulled out of the tool box and used and customized for the ground to be mined through. Decisions on what appropriate support goes in are made on a round by round basis. There is a daily meeting in the heading with the engineers and make sure everyone is on the same page. This reduces risk for structures adjacent to the alignment so we have about 3200 feet of mined tunnel on the project. The sequential excavation method offers the best value to the owner for managing construction schedule and risk. This is a Cross Section from a drawing for this project, and its intended to show some of the presupport measures and the way the support goes in and the sequencing which is inherent to sequential excavation that happens for tunneling so the drift was number one is excavated after the pipe canopy are installed above it and the dots above the tunnel and dowels can be used for presupport if need be and drift number one is excavated. Steel supports and shock create supports are installed in drift one and on one side and go to the other side and number two and do the same things and presupport is installed for the whole thing. Excavate out number two. Put in the support appropriate for number two and lags number one by a bit and number one and two form a foundation for the arch for number 3 and drift three in the center comes out hence the words sequential. Again here i just want to note that this geometry is ideal for this project because its able to be wide to accommodate the three tracks. If we were to use a tbm excavation for three tracks the Cross Section would have to be circular and because top of rail needs to go where it needs to go the whole tunnel would be hier creating the potential to see more of a impact at the surface. You will take more ground out closer to the surface and likely more impact at the surface. This is a photo of an sem excavation, a typical one similar in itself to this project. Its a state of the art tunneling process. You can see in the photos drifts one and two has been excavated and three hasnt been taken out. But this is just this tunneling practice this is how it looks. For those that have been in there and yeah this is how its supposed to look. So tbms are great for certain projects. We use them at central subway with good success. If we thought they were the right answer for this project we would be 100 behind it but sem is clearly the winning choice for this project and some of the reasons are listed on the slide so we have complex, challenging, change shallow Cross Sections and howl need to be excavated under a busy urban environment. I mentioned the geometry a bit and just one more point about that. It would take the biggest tbm in the world to excavate the project and sem is more attainable and realistic for the contract documents. The risk of settlement is minimized here and due to the proximity to the surface and the ability for the ground conditions to be assessed and for the support to be customized every round. If there is Additional Support required its going to go in and not a surprise later due to the systematic process for sem. Support is tailored to the ground conditions in real time and that is daily meeting with the engineers at the heading and review. Equipment procurement is streamlined and will take a year to fabricate for the other way and sem using things that are easier to get on site and less expensive than a tbm and the schedule can be flexible anded had things and from each end and the middle and if there is a equipment break down youre not waiting for the one piece of equipment to get back going again. Thats you mark. Well, this is just to highlight oh right, great. Since i cant point to it. Here we have the headings denoted with arrows here. Up to four headings can be under way concurrently. I guess the point is were able to excavate from four directions at least three directions so if the machine breaks down in one direction were making progress in other directions and similar to what we done in the inaudible tunnel and excavate both directions and they do two directions. It it just minimizes risk in the field in case the machine breaks down the other machine is making progress is the point that sara wanted to make. Right. Successes. This method has been used successfully in the area and as mentioned and in other areas and was a lot of fun. Okay. This section will be about the history of the budget so in 2008 the tjpa board approved a budget of approximately 3 million phone ringing sorry. 3 billion for the phase two. Based on the scope of work in 2004 Environmental Impact statement reports included the scope included downtown extension, assumed a top down construction method where we would build the Transit Center in the future and excavate underneath for the train box and delivery method was based on design build and contemplated operations in 2018 at the time. This is a the alignment envisioned at the time. Again it had the tracks and it wasnt modified and a structure modified per high speed rail requirements and it did not include of course the extension. The budget was based on the budget was based on an estimate been in 2007. This is a break down of the estimate. It was 1. 9 billion for total construction and based on a 4 escalation. Right away was 163 million total program wide costs including soft costs and 553 million and we had 348 million in contingency reserves for approximately 3 billion. The construction contingency in the budget was assumed at 10 of Construction Costs and the Program Reserves was assumed to be 6 of the Program Costs which is the Program Costs you see here which is listed here. In 2010 sorry, in 2010 the tjpa was success in obtaining 400 million in funding. That was really a big milestone and win for us because it allows us to build the train box as part of phase one and remove quite a bit of risk so the budget was reduced to 2. 6 billion dollars but all the remaining scope besides the train box remain the same. The method was design build and operations was supposed to be in 2018 based on this budget. Between that time frame as we developed the project we updated the estimate that resulted the elements of the project and updated the estimate and in 2010 finished documents for the downtown extension based on the information we had at the time and 1. 1 7 billion. In 2012 the drawings were completed for the center and the costs were estimated at that time. These are direct cost estimates and dont include contingencies or reserves for construction. In 2013 we did a holistic update of the estimate to take into account the changes since the budget was approved. That estimate included removal of the tail tracks we didnt need the tail tracks anymore . In 2010 when high speed rail said they needed that we extended them and thats when they were removed. Did i get it right . [inaudible] yes . Okay. [inaudible] off mic . Yeah. Okay. Yeah, but thats so we eliminated the tail tracks not for operational purposes but for not that we couldnt get by operating without them but we had to extend the box and couldnt have them anymore . We didnt have a need for them so we could operate without them. We decided we could operate without the tail tracks, yeah. And the geometry has been approved by the dtx by the federal Transportation Administration and caltrain doesnt see a need for the tail tracks. Okay. I just wanted to remember. Okay. So this is basically a listing of what changed and in 2013 we presented the board with an updated estimate based on information we had then that included 1. 5 billion dollars approximately of direct Construction Costs. At that time we reduced escalation down and based on the cpi index at the time was 2. 4 . The area plan used 2. 2 and high speed rail used between 2 and 3 at the time so we felt we could reduce the escalation to 3 so the Construction Costs based on that estimate was 1. 9 billion dollars. We increased the rightofway costs by 103 million to account for some of the changes especially the train Box Extension required more rightofway so that brought the rightofway to 266 million. Program wide was 418 million. And the contingency and reserves were 183 million for construction contingency and approximately 10 , 9. 4 . Program wide reserves were 7 of Program Costs and that was our 3 billion estimate provided to you and didnt include the bart connector. The barlt connector at the time was 120 million but not included in this estimate. As you know mtc conducted a cost review for phase two in the fall of 2015 and we shared the results with you. These are the summary of the results. They looked at the construction schedule and concluded that the seven year construction schedule that we assumed in our estimates was sound. The construction mark up with the overhead we used was 26 . They concluded that was sound. For the escalation increase from 3 to 5 . Under the contractor fee they recommend to increase from 5 to 10 and recommended to increase our total contingency from 23 to 37 and noticed some of the scope was not. 27 and some of the scope was missing from the estimate and amounted to 58 million. They recommended that we include that in the estimate. The mtc cost review did not review the program wide costs or the rightofway costs. They didnt have time to do it so their focus was on Construction Costs. What cost before the rightofway costs . Program wide. Okay. So their focus was basically on Construction Costs. This is a break down of the increase in costs as a result of the mtc cost review. The escalation increased it by 433 million going from 3 to 5 adjusting the fee from 5 to 10 adding 100 million and adjusting the contingency added 93 million and the missingitem was is listed here and this is on top of the estimate at the time. Mtcs assessment of the bart connector was between 120 million and 310 million so the mtc review yielded about 4 million. Since that time and the budget proceeding we shifted our focus on phase two and started looking at our estimate looking at scope and starting to refresh our estimate with information that we have. Since the beginning of this year we looked at the scope of the dtx. We took the scope that was 30 design and asked the designers to refresh the estimate based on current market values on the quantities based on the quantities that we have. For scope it was conceptual stage, not fully developed used order of magnitude estimate based on the information we have and the Market Conditions that we know of. We included in the refreshed estimate all the mtc recommendations, and we used program for the program wide costs and the contingencies we used percentage based amounts but we did not have time to update the rightofway costs. We need more time to update the rightofway costs and part of next steps and this is a break down of the draft estimate that we have developed. Again this is work in progress and started in february gathering the information together and trying to update the estimate and we wanted to give you a snapshot of where were at. This estimate the subtotal for construction excluding escalation is 1. 7 Million Dollars and 5 for construction is 583 million so the total construction is 2. 3 billion and that would be the expected bid amount at the time we award the project. Right away we kept it at 266 million. We will update later o for program wide we used 22. 5 of the total Construction Costs as a budget, 20 of that is for soft cost and then other costs so the total Program Costs excluding contingency and Program Reserves is 3 billion. For construction contingency we use 10 of the Construction Costs to set aside and thats a normal practice. For Program Reserves we use 15 of the total Program Costs 3 billion so were saying here in the Program Reserve we have 15 contingency for construction, 15 contingency for rightofway, 15 contingency for program wide. That brings our total construction contingency and reserves to 692 million and total Program Costs for 3. 7 billion dollars excluding the bart connector. The bart connector is 161 million. We reviewed the bart connector scope with our designers and determined that the direct cost is about 110 million and when you add escalation is listed here and total construction is 4 billion approximately and this Program Costs has 903 million in contingency and Program Reserves. Its the 692 that you see here and the 211 million in design contingency. If we were to use 3 escalation or three and a half percent escalation and the going rate and move the delta between the 5 and the three and a half percent in Program Reserves that delta would be approximately 175 million. Doing that the Program Reserves the total contingency would be 1. 1 billion dollars which is a 40 basically contingency. Im saying that because as we move into the Risk Assessment likely to use that for the escalation and move the delta in the reserves and if it goes beyond three and a half percent we will fund that and not removing it from the project cost but putting it where it belongs in the line items. This is just to give i a visual break down of the several cost elements of the project. This is based on direct costs, not including soft costs erescalation and the line tunnels and approximately 151 amount listed here. And the tunnel stop was added as part of the environmental document to be able to accommodate the rab study and help develop the Mission Bay Area mission bay to its full potential basically. This is a break down of how this estimate in comparison to mtc review. The review when looking at indirect cost said 26 was sufficient. This estimate has 26 for other costs besides the tunnel and 54 for the tunnel and the tunnel is a higher risk item. The recommendation for escalation was 5 and mtc cost review. This estimate is 5 . The contract fee contractor fee and review recommended 10 . This estimate uses 15 for the tunnel and 5 for the remaining scope. We wanted to allocate where the risk where it belongs and thought in the tunnel its more and did that. The total contingency recommended by mtc was 26 . Again what i showed you was 29 based on using 5 for the escalation. If we move escalation delta between the three and 5 in the contingencies that amount would be 40 escalation contingency and added the scope that mtc recognized and the review ask us to review the productivity rates. We will do that moving forward. This chart shows the delta in the various line items. Our estimate increased the Construction Cost it is by 56 million from mtc reviewed and increased the total Construction Costs by 61 million. 5 million increased design contingency by 5 million. You will see a reduction in escalation of approximately 139 million. The mtc review had escalation of 722 million and used 5 from 2010 when the estimate was developed all the way to 2024. Since our estimate was developed in current 2016 our escalation started 5 from that time to 2026. What this shows is the escalation between that time was less than 5 . Its in the three and a half percent range. The cpi index labor costs and material costs between 2010 and 2016 is less than 5 and what you see here. The Program Costs were increased by 163 million because i wanted to refresh the soft costs and the Program Costs. I use that for program wide and increased by 163 million. Again mtc didnt review the costs but just accepted our numbers and 86 million in total Program Costs as a whole. This is a comparison. Its not an apples to apples comparison but wanted to show you how our estimate is compared to mtcs. For the delivery part we figured out what is the best successful way to differ the dtx and this is a road map to deliver the project and we are able to bring the Transit Center in 2025. As i mentioned we expect to finish the environmental work and decision in december of this year. Between now and a year from now were able to finish the design, bring it entirely to 30 and then we can also between now and a year from now were able to complete and develop a funding plan with the region to figure out all the Funding Sources that we have, when we need them to fully fund the estimate that we have, and between now and a year from now select the delivery methods to deliver the project. Between july 2017 and end of 2019 we can work on securing the funding and funding agreements with our partners, local level, regional and federal level and during that time frame were able to acquire the rightofway that needs to build the phase two. Were able to finish the complete 100 documents between july of 2017 and july 2019 so we will have buildable documents. If we do that we can have advance construction contract in july 2018 to do utility relocation work and for the mining or the tunneling work to begin. Based on the schedule the tunneling work will be advertiseed in july 2019 and awarded in december 2019 and looked at other scopes besides this scope to put out a separate contract for flexibility. In this chart you will see the bart connector, the train extension and the ibf facility awarded at a later date and meet construction date and awarded in december of 2020 and advertised in july 2020. Based on this based on the seven year construction schedule we were able to Start Construction in december 2018 and end in december 2025. This is based on design build procurement method. If we go to design build likely to shorten it by six or nine months but this hinges on us being able to get the funding that we need when we need it and including the funding for the rightofway to be completed on time and this is a road map to get there and bring trains to the tran itd center in the short evaluate time possible. This slide shows the escalation costs based on 5 escalation. If we finish construction later it will increase by 200 million approximately. If there is a delay beyond that escalation is approximately 217 million a year. If theres a four, five year period its more than 1 billion so the earlier we can finish the project and bring it to completion much cheaper it is. With they would like to turn it over the presentation over to scott to talk about the Funding Strategies that we have developed. Hi good morning directors. The next step in the road map that mark was alluding to was to develop a viable funding plan and a plan that includes Funding Sources that key get during the construction period. This took significant step forward in 2013 when planned bay area was enacted and the Transportation Plan that is updated every four years. In the 2013 iteration of planned bay area dtx was a federal priority for the new start program. You heard us mention it several times and in this meeting and the largest discretionary funding for this type of transit expansion and major funding for the central subway and bart to san jose and in order to access these funds you have to be designated as a regional priority in the regional plan so its a major goal for the dtx for years and we achieved that goal in 2013. Along with that designation came other funding commitments from the region and you see here on this slide pulled directly from planned bay area from the planned bay area Investment Strategy you see the new start designation, the dtx is the highlighted and as you go along the road the first box is the gray box that says 650 million. Thats the amount that mtc estimated that dtx would receive from new starts and that amount was based on the overall amount of new starts funding that the region has historically received from the nationwide new starts account, so moving to the right down that row you see additional commitments for 300 million in future bridge tolls, 557 from high speed and the amount from the sales tax extension and future prop k increase and last column is joint development. You see 100 million there. And included as a place holder for the mello roos funds and this was finalized in 2013 but the initial draft was 2012 and several years before the mello roos district was enacted and at the time we didnt know what would be available and we knew this was a low estimate but we included today as a place holder and im going to run through several funding scenarios. But before i show you the first of those scenarios i want to emphasize that all of the Funding Sources that are listed are Funding Sources that have been contemplate for the dtx for many, many years. Theyre not things out of left field or are speculative. Theyre Funding Sources in the public discussion going back to planned yay yay in 2013 and bay area and before that in the environmental clearance documents for the dtx and contemplated and light apparently charges in the document were included at 75 cents for caltrain tickets and 3 for high speed rail tickets so it was a 41 ratio. So when we took those initiate new starts im sorry initial planned bay area they form the the basis for the plan Going Forward and as we started the exercise of taking on a hard look at our existing funding plan and making sure it was all viable and attainable we started with the assumptions that mark mentioned in the timeline that he just discussed construction starting in december 2018 and 7 year period and beginning operations in december 2025 which corresponds nicely with the high speed rail plan and has trains arriving in the bay area in 2025 and i will run you through four funding scenarios. The first one i will go through line by bien but there is only one variable and the apparently charge and passenger charge and you see in the gray area theyre the planned bay area commitments and three categories and above the gray area are the already committed funds and fund thats project has already received and spent in some cases but in any case all of the line items above the gray area are fully committed to the dtx and the gray area is the planned bay area communities and future yet to be committed funds so starting with the first line that is our existing commitment from prop k, San Francisco county sales tax. You see there its 83 million commitment. We have spent 50 million of that to do the initial 30 preliminary engineering and design work that mark mentioned earlier and important to note there is 33 million available in the prop k commitment that we intend to use or hoping to use to do the cost refresh that mark was describing earlier. The next two line items and the san mateo sales tax and bridge tolls were received and spent on the 30 design work and below that is called Regional Transportation Improvement Program or the rhip program. That is a state funding stream primarily of state gas taxes but mix of Funding Sources. This is a commitment to the program of 28 million. We received 10 million for phase one and 18 million remaining for phase two and the next two are Funding Sources we are familiar with at this stage. The first is the mello roos special tax district. That was enacted and signed into law in january 2015 and a percentage are designated to the transbay project and the low range and terms of net values and high amounts and will be available for phase two after we fully finish paying for phase one and we can use this for phase two and the 100 million difference between the 275 and the 375 is something that has been mentioned several times today. I think mark mentioned it seven times in the presentation and thats the 100 million we intend to serve in contingency to the phase one budget that you just approved. If were successful coming under there will be 375 left for mes reduce and on the low end its 275. Similarly for the tax increment from the transbay Redevelopment Program and available for phase two over we fully finish paying for phase one. With the tax increment we have the challenge that it flows over many years. This exists for a 45 year period and the net present day amounts advancing to the years of construction. The difference between the between the high and low end of the line item that has to do with our intention to try to refinance the existing loan. We have ative fea loan of 171 million and financeed in 2010 when interest was higher and we intend to refinance that and if were successful that would leave other revenues for phase two. The other difference has to do with what we anticipate in terms of future Interest Rates so moving down the next four items are the bay area items that i mentioned. And the sales tax and 375 and prop k and funds from the new starts and the way that we access those funds is lining up all of the non federal funds and once you do that then the federal government will release the new starts funding through a full Funding Grant agreement and noted earlier we have been notified that the dtx will continually designated as a high performing project in planned bay area and important for the commitments including the new starts designation and then below that 300 million from future bridge tolls and funds from high rail funds and mtc reiterated that and this is included and from future press releases. Below that we have the yet to be committed funds and one for phase two and block four. It is the northern third of the temporary terminal so we cant sell it until it closes and we cant do that until phase one is complete and begin operations in the Transit Center and were moving closing on the parcel f agreement and option to purchase block four and the funds for that and that is where the number comes from and the last line this is what we wanted to focus on today. This is the variable that changes throughout the four scenarios. We certainly understand that in proposing a passenger facility charge, a pfc, come up with something reasonable, not just from our perspective but our board, all of the other boards and for the ticket buying public so the amounts in the 2004 document were 75 cents and 3 and 12 years ago. When we started the thought process for the updated plan and thought of the scenario for the caltrain rider if the dtx doesnt exist and if they want to get to downtown core, the financial district, the Transit Center, the embarcadero they could walk and time expenditure associated with that or buy a muni fare and use the central subway and have to disembark at fourth and king to powell and disembark and to embarcadero and do it a third time or the option to buy a muni bus fare and go downtown but we thought that was a good place to start looking at what that fare would be if you took the bus. If you buy a monthly pass and divide it per day and 1. 60 a trip and 2,016 and were starting operations in. 2026 and we estimated that and came up with 2 for the caltrain surcharge and maintained that four to one ratio as i said goes back to the original 2004 environmental clearance document. A couple other arguments we would make about the reasonableness of 8 for the high speed rail ticket if you take a flight from los angeles to San Francisco four paying 4. 10 fee and doesnt include getting to downtown and 8 on bart. If you take high speed rail from los angeles and get to the Transit Center we assuming coming from l. A. You have luggage and not likely to take a bus or walk and take a taxi or uber and 8 is a reasonable fee so we had to consider the same issue with the future tax increment. Pfcs flow over many years. We thought it was reasonable to look at 35 year period and capturing pfcs and the favorable lending source is one of the federal programs that the dtx is eligible for and tifia and familiar with that and have that for phase one and there is Railroad Rehabilitation and Improvement Program and the dtx is variable for that as well. Both have 35 year repayment periods and we looked at 35 period year of casturing that and they wouldnt give that much and its like a home equity loan. They want some cushion and give you 80 and we will advance these and get 80 but the other 20 is still collected and use the funds towards maintenance of the rail levels and the concourse and platform levels and share with caltrain and high speed rail and for the expenses associated with the dtx so using the parameters the amount generated from pfc from these and on the low end is 865 million and high end is listed there. The difference is what we assume in terms of annual cpi. On the low end 1 and high end assumed 3 so you see that provides total funding that ranges from about 3. 4 billion to 4. 1 billion so on the high end were above the number in americas estimate a moment ago. We wanted marks estimate and we wanted to show you other scenarios with more cushion so in the second scenario we decided lets look at just taking todays base muni fare, not using a monthly pass but using 225 and conservative because theyre 2,016 and not going to 2020. And its 425 and 9 and see that generates total funding that ranges from about 3. 5 billion to 4 billion and its right in the middle of the range and trending towards the lower range and we escalated that a little bit to 250 which would representative very a little escalation over ten years during this time and use 250 and 10 and produce totals of listed here and have the 3. 9 billion on the lower end of the range and the final number we looked at was taking muni bus bare in r fare and listed here and range with a lot of cushion relative to the cost estimate listed here so to summarize the Key Assumptions were using in putting the funding plan together were assuming that were successful working with our board, stakeholders, the public in convincing the caltrain board and the high speed rail Authority Board to enact the pfcs before anticipating construction start in 2019 and there is a challenge and its seven years before beginning operations and in advance and thats the first assumption. We assumed that the planned bay area commitments are provided during the years of construction and assumed we would be successful accessing one of the federal loan programs that i mentioned and finally we want to reiterate that all of the funds that you see in the charts are available for phase two after we fully finish paying for phase one. And i have one more slide directors, so to make this work and to be able to advance we listed the next steps. These are near term steps and we need to be able to fund these steps. Ive had brief discussions with them on releasing some of the money committed to phase two in order to do some of the work that needs to be done and i will follow up with that discussion with them, but first step is challenge is take our design that we have right now and bring to the 30 level and accurately estimate it and accurately update the estimates as we move forward. We need to updated rightofway estimate. We need to do some appraisals to produce that estimate because thats another high risk variable we need to be able to define so that once we have an estimate were sure that estimate is not going to change much. We need to update the ridership study to confirm the numbers that scott shared with you, the passengers facilities charge hinges on having accurate numbers so we need to do that and have a Risk Assessment and establish the contingency and reserves and used 10 for construction and 15 program wide. We need to do a [inaudible] assessment to ensure that the numbers are correct or use whatever numbers that are correct. Using that information we will update the program cost estimates or update the cost estimates. We will use peer reviews. Were going to have somebody from outside also review the consultants estimate and do a peer review to make sure its accurate. We. To make sure what happens in phase one doesnt happen in phase two. And we will do peer reviews on the estimate that we generate before we present it to you. We need to sit down with the region and look at the funding plan, seses what scott presented d get all the stakeholders behind us. Develop a funding plan that were all behind and the stakeholders are behind to move forward with the project and selecting a delivery method is another step and is it decide build or design build and there are benefits to all of them. We need to select the right one and then present a budget to adopt based on that level of criteria based on peer reviews so that will be a budget that we can all stand behind. Currently we have a 2. 5 billion dollars budget and not reflective of the scope and the estimates and last but not least we will continue the close coordination our stakeholders for the rab study so that the study is successfully completed and both our project and rab study are complementary to each other. With that i would like to get some direction from the board. Thank you. Thank you. This is one of the things that i mentioned to mark when we went over this earlier this week i want the board to be more directive in terms instead of just seeing a presentation and letting staff figure out if theres a majority of the Board Members that said thats a good idea. Lets do it so i hope my suggestion is that we actually direct staff in accordance with the next steps. Okay. Thats what you say youre going to do, and were okay with that. Thats okay to do. Otherwise i dont know you know whether weve got a majority of the board that says yes thats a good plan. We like those numbers and we need to do that. I have one thing that i always thought about two things when it comes to the bart connector. One is that every time i mention it to a bart director his or her eyes just roll. Its like so far below the radar that they dont even like me mentioning the idea tie into bart somewhere. They have so many problems and other things going on. Its not that they hate it but its just so its hard to get them to engage on the idea of connecting into embarcadero station when they dont know how to expand into embarcadero station, so i think we ought to when it comes to planning and engineering for the bart connector i think we should be very the other thing in connection with the bart connector i always ask them or they ask me. Okay. Whose the passenger that wants get out of the terminal or into the terminal and coming off of bart or to bart . I cant imagine the passage is and from the east bay ignored bart until then. And coming from the south bay is completely ignored millbrae and everything there so i really want an idea past the profile of the passenger that gets out of there and now get to bart and why they didnt get to bart in another manner before we get too engaged in that. Maybe its out there and i i am oblivious to that and thats just one aspect of this thing, and you mentioned p3. Are you thinking of as a delivery method . We will share next month the studies and delivery methods and what each one of them brings benefits to the project. P3 is one of them. I would like to wait until next month to give you a comprehensive. I dont know about the study and in p3 you have to figure out the scope and reward for the private partner. What are you giving them besides the chance to run a railroad. Its on the list but we want to evaluate it anyway so it will be in the presentation we present next month on the procurement methods. Any other comments . I mean the thoroughness that you thought about this is great. I mean its just really you know brings home you know the possibility that we certainly can and perhaps should just lets move into this and i was unsure really until i saw some of these things. Supervisor. You know i appreciate the presentation. Its great to get more details on our thoughts for phase two. I think the one thing i was thinking during the presentation as much as i like getting all of the details we have several kind of parallel paths moving forward on phase two, and this presentation really didnt cover or even consider the fact that theyre alternatives considered by the city today so its great to get the work and details on phase two as we originally configured and planned and i am not putting my weight behind one pathway or another but realistically its hard to delve into the details when i know were looking at tunneling and other optioning methodologies. These are not questions for today but i am curious a little bit more about sem was the only method that was offered today for our cut and cover and mine tunnel option . Its great to get the sell today and pelt like a sell but i want to know all the options and before the board and why is this the best value and not just told its the best value option but i look forward to the continued conversation. I think there is a broader context with phase two that we need to acknowledge and not in todays presentation and i know its an ongoing dialogue conversation. Ed. Yeah. I guess i would add for the reason the agency exists and the reason were building the building and all the Funding Partners have put in some cases hundreds of millions of dollars and the city has puts it own Balance Sheet on the