Commissioners or department personnel. Commissioners are not to enter into debate or discussion with a speaker. The lack of response from the commissioners is not necessarily constituting agreement with or support of statements made during Public Comment. Thank you, madame secretary. Is there any Public Comment in item two . Come up to the podium. Seeing none, Public Comment is closed. Questions or discussions from commissioners . Item three, approval of the minutes. Discussion and possible action to approve Meeting Minutes of the june 26th, 2019 meeting. On item three, approval of the minutes. Is there any Public Comment . Seeing none, Public Comment is closed. Thank you. Commissioners . Move. Second. Thank you very much. All in favor say aye . Aye. Any opposed . None. Thank you very much. Madame secretary . Item four, chief of departments reports. Report from Janine Nicholson on current issues, activities, and events within the Department Since a Fire Commission meeting on june 26th, 2019 including budget, you cant academy, special events, medications and outreach to other Government Agencies and the public and report from operations deputy chief, report on overall Field Operations including greater alarm fires, Emergency Medical Services, bureau of Fire Prevention investigation and Homeland Security and airport division. Thank you very much. Chief nicholson, as always we will have you report first. Are there any questions from the commissioners . Chief . Thank you. Good morning, everyone. Janine nicholson. Some highlights since the last Fire Commission meeting of june 26th. We completed our meet and greets with candidates for the 126th class and we have moved forward with our selection and people are going through medicals and backgrounds right now. We had a lot of really good candidates and we couldnt choose all of them. Our intention next year, we didnt have time to put this together this year, but we want to do more of a Panel Interview with multiple members from the department and then they sort of boil it down and send their top picks up to us. It was pretty intense process for myself and the other chiefs. We met with about 100 people, so we definitely put our time in and i think we have some pretty good people for our next class. We are happy about that. I also met with simply member david to in the past couple of weeks and he is a great ally for us on the state level and he is happy to work with us on Different Things that we may need to move forward with the state level. I met with dr. Christopher caldwell who is an Emergency Department head of Zuckerberg San Francisco general, and we discussed how the prehospital and Hospital System is all connected and how it is sort of broken right now and he and i and dr. Colfax from the department of Public Health health are going to have a sitdown and meet to discuss what can we do together so we are not , you know, being redundant, and any new Pilot Programs or anything like that. Whether it is having some community medicine, Global Community medicine, or what have you, so we are going to discuss that. But really, i let him know that we are basically up staffing the hospitals a lot of the time because we are waiting in triage for so long because there are no beds, and so, really, i feel like what we need is e. M. S. Prevention because a lot of people dont necessarily need to go to the hospital. So what is that e. M. S. Prevention looking like . We will have further conversations about that. I attended a meeting regarding the fire station 13 plan review this past monday. We had quite a few of us in attendance and we are working with the developer, the architect, and the department of real estate to get what we need at this facility, so we have had four meetings in a think we have another one next week. We are continuing on with that. The chase center, we are conducting a drill on july 24th at about four or five in the afternoon. It will be right after the giants game when there will be an uptick of traffic. We are going to basically have a drill where we call our resources to the area as if we are going on a full box or, you know, having a large medical event or the like, because we have been trying to show m. T. A. And the chase center our concerns about our access, not just to the chase center, but around the chase center and through one neighborhood to the other. So i think that will be really instructive for them and we are also putting in writing to them what our concerns are and what we are asking for. So that has been a really good and we have had a lot of help from chief cochrane and the fire marshal on that as well. The budget has to go to the board of supervisors twice this month, and the expectation is that we are hoping it will be signed off in the beginning of august by the mayor. Thank you for those who attended the pride parade. It was a good event, very fun. Thank you for attending. I will think my command staff who attended as well. The 4th of july, we up staffed for that and it went really well i will leave that up to the other chief to tell you about that, but she cochrane and chief worship chief worst worked on the event action plan for that and we put some resources out in the field this year and it was really successful to keep people safer. We have invited the Mayors Office and the board of supervisors to a fire operations event on september 14th. We will actually put them through the different fire operations, put them in the burn room, perhaps have them cut a car open, really show them what it is that we do, what it takes to do what we do, what kind of equipment we need, and what we are talking about when we are asking for resources. I think this can be a great tool for us. The union is really spearheading this and we are working with them on that, but i think it is a really good educational tool. Station visits are ongoing. I think we only have about two or three left to do and then we will take the rest of the summer off on that and we start in september, most likely with all of the command staff hitting a couple of stations here and there to keep that line of communication open. And then, as you may have seen, there has been a little bit of press lately about the tubs fire , for one and the study that came out about that with the Cancer Prevention foundation. And that was yesterday and then there was also some press about our ambulance staffing that you may have seen as well. We are asking for what we believe we need and we will continue to make the requests. And the one last thing i can say is that e. M. S. Is working on the h. Three level one meet and greets for that next class, which is at the end of august, sometime in august. Yeah, that concludes my report. Thank you. Thank you very much chief nicholson. I will ask for Public Comment after the chase report. Seeing no member of the public, Public Comment is closed. Questions and comments from the commissioners . Commissioner cleveland . Thank you, mr. President and thank you for your excellent report. I had a question on the time it takes for intake to the hospitals, for all of our 911 calls, to take everyone to the hospital. Do we have to take people that we pick up on a 911, do we have to take them to a hospital or can we take them to some sort of alternative location . Right now there is a Sobering Center where we can take people, and that is part of, i believe, the Pilot Program ultimate destination, but that is definitely something that i will have a conversation with dr. Koufax and dr. Caldwell on. Is there some other thing we can do besides jamming at the hospitals in keeping our ambulance is out of service. What we have also seen out of the past several years is our time on task for our e. M. S. Personnel for the ambulance has gone up 27 . What used to take maybe maybe an hour is now taking an hour or an hour and a quarter plus. That is really impacting our ability to respond, so we really need to look for some creative and Smart Solutions to this. Right now it is just a Sobering Center, that is the only location that we can divert to other than hospitals . Yeah. We need to find some other locations that can be approved. Yeah. And that would be, you know, a Pilot Project that we could certainly discuss, but its and there are a lot of other things we can do as well. We are picking up more people at shelters and Supportive Housing places than ever before and that is since the city added nursing staff to these places. We need to get out and educate and communicate with this stuff as well. We are looking at that as well. Is there any kind of state requirement that we have to take a 911 pick up to a hospital . State requirement . Local . Can you speak to that chief tom . Hello, commissioners. Good morning. There really arent any other options that we have in terms of other ways that we can transport patients. We can have patients agree to be refused, we can get permission from the bay hospitals, from doctors, to refuse a patient if they, you know, dont want to go to the hospital, we have that option, but other than that, we pretty much have to transport patients. If someone has to go to the hospital, we take them to the hospital. But what if they dont want to go to the hospital, where do they get taken . If they dont want to go to the hospital, we leave them where they are. If they dont want to take it taxi to the hospital or go by private vehicle, we will do documentation for that. So we really need to increase the number of other options out there other than hospitals to take our 911 victims. Thank you very much. Those are all my questions. Thank you very much. Vice president covington . Thank you, mr. President. I just wanted to say, chief, i think that is the idea of having the mayor and the supervisors go through simulated training is an excellent idea and i hope that you will have a post so we can show them what that is. [laughter] because it is kind of hard for people to visualize what it is. Once they see it, i think they will agree that we could use several of them. Also, congratulations on finishing up the visit to all of the stations. The visits to all of the stations, i think that is great. For those people who perhaps didnt read this mornings chronicle or see the evening news last night, can you tell us a little bit more about the tubs fire study . Yes. So the tubs fire, as you may or may not remember it was just about two years ago. It was napa, sonoma, santa rosa homes that burned, about 60 5600 structures burned. Our members were up there for weeks and in terms of our quote unquote wildland fires, they are now wildland urban interface is. It is everything that is in our homes burning. As we know, theres a lot of toxic stuff in there. As we know, and wildlands urban firefighting, our members do not wear their heavy turnout gear, they do not wear their scott air packs because they need to remain mobile. So they are breathing in and absorbing a lot of stuff so there has never been a study done on that on firefighters and so the San Francisco firefighter Cancer Prevention foundation realized this was going on and it took a few weeks to get all of the pieces in place to test 180 firefighters, some from San Francisco, some from santa rosa, possibly san jose, oakland, urban firefighters who do put who were deployed there and then they had a control group of 30 firefighters who did not. They took their blood and urine. Part of the problem was they werent able to do it until after three weeks after they were back for three weeks, so a lot of times, you know, things can flush out or what have you. So the results, you know, im not surprised showed an elevated rate at several different toxins in their systems. So what we need is we need im not surprised by that. Clearly we need more studies done, but we also need to figure out what it is we can do to perfect protect our members because there is no gear out there that can protect our members. If you can put a mask on, but, you know, it is not going to take the Carbon Monoxide out of the air and it is not going to so that is what that was. Since then, the camp fire happened last year up in paradise and we were able to test a bunch of our members when they were still up there. That is still pending, so that is what that was all about. Just bringing awareness and letting, you know, sharing this intel with others in the fire service, we all know that it is happening in the fire service, but it is time to get proof, you know, to really effect change. Thank you, chief. Thank you very much. Thank you. Chief, the best thing i like about your report is your involvement with the two principal officers and an interview of the panel. I really commend you for that. I think having more minds, you know how smart somebody is, and one persons view of a new candidate could be skewed with personal preference or whatever and by involving other peoples minds and thoughts and assistance, i think that is great. I like your idea. I saw you last night on the news explaining what you explain to us about having the tank on the back and then also had difficult that be in that how difficult that would be in 100 degrees. So that is a real dilemma in trying to protect peoples lungs , especially, but the one thing about taking the test three legs three weeks later, from the things i have seen since i have been on the board, since i have been on the commission is that most of the stuff that you bring in in the shortterm dissipates, so maybe having it three weeks later, if something is showing up strong, then we would show that is very negative. Officials of the first couple of days, like you say, it goes through your system, so i like your explanation last night. You did a good job on your thoughts and sharing them with the public. Good job. Thank you. That is part of the reason we had a controlled group of 35 firefighters that didnt go to that fire and firefighters that did go had higher levels then the firefighters that didnt, even three weeks later. That is really concerning. Thank you very much. Thank you. Chief, the stadium drill, i think that is a fantastic idea. I am wondering if there is a way that you could do that drill again at a later time when there is an event at the new stadium as well as the current stadium to show them what exactly people will be going through in order to get to an emergency, if there are even dates that overlapped. I think those are the worstcase scenarios of when it will be at its worst and of course, it does not change our obligation to get there fast and quick, so would be great to do another one of those at a later point when there is an event at both facilities, with thank you for doing that. It is a good way of educating people. On the hospital up staffing, i appreciate the fact you are meeting with the hospital and educating them as well to some of the problems that we are confronting. Has there been any effort to meet with the department of health to see if we can get Additional Resources to go with our e. M. S. Six . We seem to be up staffing on our e. M. S. Six and the board of supervisors approved find new five new members to e. M. S. Six. Im wondering if that should be five new people at the Fire Department as opposed to, you know, getting five people from the health department. I have always been of the opinion that e. M. S. Six was created because another City Department is failing in a certain area and we are having to pick up the slack for it. That is one thought behind that. The second part is, on the up staffing, there is not a day that goes by where i drive down, i believe it is post street, the side of st. Francis hospital and there are three ambulances sitting there. There is always three ambulances sitting there. This is what you were talking about when we are up staffing these hospitals because you are delivering people to these hospitals in ambulances and they are just sitting and waiting for the staff there to basically sign off on them to take them off our hands. Is there a way, legally, maybe we can check with the city attorney, i know we charge, currently, patients for transport, is there a way we can charge the hospitals for the amount of time that we sit on these hospitals . And make it a charge that is significant enough where they actually do something about it . There is no incentive for them not to deal not to do what they are currently doing. There just isnt. You are running an emergency room, youve got extra advanced life support people that come in that have a patient, those patients are being cared for by the San FranciscoFire Department in this hospital. There is no incentive for those people, for the hospital to say, okay, i will drop this and go help those guys, or i will go hire additional staff to take those guys sows those guys can get onto the street. We need to create that incentive im confident that you should make it clear to, i dont know if their support on this commission for this type of thing, but there needs to be some sort of incentive, some sort of hammer, some sort of teeth to us having to sit on those hospitals because it is not right, it is not our job. So, if you can keep us updated on how the discussions go with the hospitals, it would be greatly appreciated. On the budgeting, i know all the commissioners here worked very hard as well as your command staff. I have been on commissions for more then a decade and