252,500 as of january 27th. Those totals will change slightly as we close the books on fiscal year 1819. Our approach to budgeting is to aim high so we have have flexibility and meet the needs of our residents. However, we maintain mindfulness and we maintain financial stewardship of this valuable resource. And i wish to take my direction from you as the information you require or what you are most interested. Any Public Comment . No Public Comment requested. Its in the hands of the commission. Commissioners please. Thank you. The year to date is actually the full fiscal year to june 30th so a number of these items were not fully expended. Thats correct. And so is there some reason that youve maintained the level that you think theyre at . I mean there were reasons that you believe those programs need that much allocations and are there any new programs you all considered and did or did not well, you obviously didnt fund them because theyre not in here. No new programs. We have some of the challenges that we face in expending the budget fully. And are also opportunities for i improvement. We have the implementation of people soft. We were unable to access funds until after august 24th this past fiscal year because of a budget rollover maneuver. Another element is the friends of la gon laguna honda have chad their modes. Instead of paying for services and materials directly they have made donations to the gift fund. Because of the extent, we have to get a board of supervisors approval and we go the extra mile by getting your approval before we do that. Some of these programs are going to be a carry over such as in memory care. Were looking to work on a Music Program that will enhance cognitive function and memory in our dementia residents. Our Technology Programs we are taking that over into the new fiscal year and some of the things that were working on, some of the challenges that were facing with that is Program Management or account management, we have several ipads at the hospital available for resident use but to manage those accounts has been piecemeal in the past and were seeing if we can get a comprehensive approach to that. Centers of excellence wish list shows b that we meet halfway on that. Bit end, when the books are closed, well finish off at about 35,000 expenditure for that. There was one piece of equipment on our wish list which was over 10,000 and that is forcing us to take that into Capital Equipment process. Those are some of the challenges that we face. Again, we do shoot high, in case we need to the needs a arrive. Some of the programs i want to point out to you and the endoflife care, we developed programs over the past year. That is a transportation assistance program. We would allow a resident at the end of life, if they wish to, to return to their Home Community outside of the bay area to pass or they could have a Family Member come to San Francisco to be with them at the end of life. We also started a program this year to provide cremation assistance to a resident who dont have the means to pay for burial. In this past year, we didnt have the opportunity the need did not come but we still budget for that in case it does. I home im explaining myself well. I think i understand. You actually have developed these programs and theyre fully funded last year and you are asking that these be continued to be funded because were going to educate the reasons why it took a while to get some of them started. You would like to be able to continue these programs that have been ready for action. The nature of the gift is considered a continuing fund its not an appropriated fund so its always there and its that pot of money thats always there. Our expenditures over the past five years have risen by my calculations 43 . A little bit skewed this year because of the influx of money that came from the friends of laguna honda. The Previous Year 1518, the increase has been 25 . We are diligent at spending the money to benefit our residents and were increasing that commitment and we look forward to continuing that process. Im done with questions. Commissioners. Commissioner grown many of. Thank you. Im really curious if you have a sense of which of these programs you think have the greatest impact on residents or perhaps those in which more residents participate. Is there a relationship between the budget and the number of residents that really benefit from the programs . Are there any that you really would prioritize as the most effective top programs that improved the call o quality of r the residents . The programs that are most impactful on the residents are the active therapy programs. I want you to keep in mind that these are programs above and beyond what the department usually provides because they have been operating funds. So i think those programs reach more residents. I also think that the special foods is another program that is enjoyed by the residents and impact quite a few. Some of the programs i want to point out to you are contracted programs. They have a long history and laguna honda hospital its not an art therapy program, its an art experience program and its a wonderful presence there at the hospital and we always look to expand resident participation there and one of the newer programs that we have is we feel like its cutting edge is the medical Clown Program and its all about Receipt Department engagement so we have clowns come to engage our residents to bring them out and can have them engage. I hope im answering your question as far as those are the ones that i believe that are impactful. Certainly, again, going back to the activity therapy programs, the community doubting programs and i think are very important and i know that department strives to make sure that residents have good opportunities to get out. So its not just a few. Its as many as possible that are able to get out to the community. Thank you, very much. The one that we over spent on in the rehabilitation program. We went over budget there. I may have discussed with you last year or at least you may remember donation from a private citizen of 180,000 for assisted technology. This provides technology, ipads, other forms of technology to residents specifically the most disabled residents that we have so they can have a greater control over there environment. The first year or two, we struggled because were taking the opportunity that was presented to us and trying to create an infrastructure and i am quite proud of what were able to do this past year. With that, weve got a lot of equipment in the hands of residents and its making a big difference to them. Weve tried to be as lean as possible and that is one program that im especially proud of of our accomplishments there. Thank you for your presentation. Twopart question, first of all, you talked about how your budget aims high as aspirational and you mentioned some of the challenges and the barriers that you have in making those expenditures. The first question is that consistent over the years that youve had sort of this difference between the budgeted amount and your expenditures and the second part would be are there any things that can be done to help remove the barriers or charge thats you could be facing and delivering these as budgeted . I believe that we have consistently come in well under budget over the years but weve always maintained that approach. So we dont necessarily are procedure indicates that anything that is unbudgeted we need to com come back to you. Thats why we aim high. I cant think of anything in forecast we have our everyday challenges, again, people soft has been a challenge and new funding approach with the friends of laguna honda. I cant think of anything that would contribute and that we already dont know and we need to improve on and we welcome to you come to laguna honda. We have a meeting every month on the third friday and we would love to have you. We would love you be part of the process and ask questions there. Thank you. Did i answer your question . Thank you. Commissioners, if there are no other questions, theres a motion to adopt and approve of the request for administration of laguna honda gift fund is in order. So moved. Second. All those in favor signify by saying aye. Aye. Thank you, very much. Thank you, everyone. Item 9 and ill note there was no Public Comment request. Number nine is dph it and epic project update. Good afternoon, im so happy this afternoon to say that i am no longer the acting c. I. O. Im delighted to welcome eric as our new c. I. O. Im looking forward to personally helping him on his journey and seeing his vision go forward as i know all of i. T. Does. Welcome to you. So i want to start out with our where we are with epic and im very happy today to be able to present this because we actually have good news for you. To start out with, our i. T. Accomplishments and in terms of what i reported to you our average network time for 2019 is at 99. 98 of the time. We have updates on these device roll outs so weve been deploying our goal is to have actually now were at 4,755 devices that we will roll out in preparation for epic. We currently have 4,565, roughly about 190 left to do and they were delayed in delivery and those are going out for laguna honda and well complete those this week. Were completing our roll out of devices by the end of this week and also our testing. So just to give you a taste of what the testing is, its every single end point its in the department of publichealth that will talk to epic whether its a printer, work station, bar code scanner or scanner so we have scenarioses 2 to test those ande have tested over 44,000 scripts on those devices over the last few months to make sure theyre going to work in preparation for epic. We also rolled out our service now which is our new ticketing system that is robust enough to handle the epic ticketing when we go live. It gives our staff a lot better in sight into the tickets and management of them. So our timeline, which youve been seeing all along, we did have some delays of our configuration. We did have some delays of our integrated testing. Our training remained on track and continues to be on track and will wrapup at the end of this week. I do want to point out the blue stabilization bar. We will be in a stabilization period from the go live until the end of december. We will be making anything that involves safety or regulatory changes during that time period and we have two epic upgrades to do. So its important time that we all reflect and look at how were using the system before we begin optimization of epic. So some of the accomplishments over 24,000 configuration changes to make it unique for d. P. H. To function the way we node to. During our direction setting we made almost 2,000 decisions, 120 interfaces in and out of epic and during our testing we identified 2100 problems we corrected in preparation of being 100 ready and we have 18 days to go live. I did tell you we would make august 3rd and we will make august 3rd. Our training, justify to give you a taste of this, as of july 8th, we had trained 6,827 out of a total of 7,297 and you may say i thought you had 10,000 people to train and as you duplicated our u credit sf staff they were 7,297. We have more than one class so you see the total of 9,206 classes and a pre wreck what sit is that they do elearnings and there are 97,000elearnings as of july 8th. The Training Team really accomplished this in the time they needed through some significant hurdles. So thank you to eric shaffer. Key activities, status, this is the part im happy to report on because i had to tell you, last time we were a little behind. So i will say what our current outgoing epic Program Director said which is its nail biting when you have a team who is the Fourth Quarter team. Our team really rallied and we finished these up. We finished up our configuration. Our testing was done and our training is on target. Interfaces are all tested and infrastructure you see were completing bit 19th of this month and nile biting but were there and go live is still on august 3rd. Our contract and budgeting, i reported yellow 100 of the time because were diligently monitoring our contracts and i want to manage those consultant dollars. So our go live will have a hub and pub model of command centers. I. T. Will be the hub and well have a command center and am bough lar tory so with the exception of revenue cycle, these are 24 hour command centers. Were looking at going 24 7 the first two weeks and well evaluate the tickets and the volume of tickets to determine if we can start to scale down, however, we are prepared to step all the way through the month of august. In our command centers, we have a set time that well be doing communications, communication lines that are open and we have a Patient Safety coordinators that each of the command centers as well as in the i. T. Command centers and theres specific k. P. I. S theyll be looking for and a Patient Safety dashboard theyll be looking for to help monitor them. Were going live on august 3rd but were starting early. On july 20th, were over that weekend, its a saturday, our staff will come in and we begin to do entry into epic for our future appointments after augus. 70 of the future appointments we were able to automate but the 30 need interpretation from the people that are doing the appointments and so theyre coming in which is great practice for them because come monday, every patient who needs an appointment, those people will put those appointments in epic. Were actually a live on appointments. Yeah, and for laguna honda we begin the back load of their inhouse patients pulling data out of our system so they can enter medications and along with orders and allergies and things like that that they need to have in their epic instance when we go live. We start the back load for sucker burg on august 2nd for all of their inhouse patients and then august 3rd at 12 00 a. M. , well flip those third party, 120 interfaces in and out of epic over from the previous systems into epic. Well be validating those and validating everything is back loaded to our final safety checks and if all goes well, well go live at 7 00 a. M. On august 3rd. Were doing a dry run of that. How long it takes for people to enter the data of doing the chart ab traction so w abstract. But right now thats our timeframe. So, i wanted to give you a sam sampling of the k. P. I. And dashboard for Patient Safety and just sort of a. Our leadership was asked what they want as a benefit and what benefit do they want to realize implementing epic. We have done some baselining on these with our count systems and well be comparing when we go live on epic how were doing on these metrics over time. At this point, im going to ask rolland to talk about to preparing for future. This is a transformational in d. P. H. And how are we doing, rolland . Good afternoon. Were doing fine. Were great. So, as you remember, when we started the discussion about moving towards a new e. H. R. Six years ago, we did our Due Diligence and spoke to many of the organizations that have gone before us like ucsf and several of the other institutions in the city and they all said the same thing. Make sure you structure this so its not an i. T. Project but one of operations of the clinical enterprise and thats exactly what weve done. So to that extent, this slide really represents a recent safety. Recently, we did a work flow walk through event at zuckerberg where we have that first opportunity to show extravaganza what working in the epic environment would look like. Doing this epic work flow walk through, dr. Jeff critchfield, who many of you know, memorialized experiences when he reflected on the story about his 105yearold grandmother at the celebration of her latest birthday. At that event, she shared with her guest about the time her whole small town gathered to see the first airplane fly over the town. And she described it as they all stood there together at the small light went across the sky. And so the doctor like end this epic walk through to her experience that were all standing together as the d. P. H. Team watching the future of epic fly right before us. While our staff is anxious about the implementations, they also have remained very excited through this whole process and so were really looking forward to a successful operational implementation of epic projects. Thank you. I have one last person who is extremely important to not only our implementation now as he observes that and participates and i went to interest our new epic Program Director. We have chad who has been with us a year but he is a contractor so im delighted to say we have a permanent director and he is many years doing epic implementation so i want to welcome him. Thats the conclusion of my presentation. Do you have questions for me . Any Public Comment . I have not received any requests. Before we put it in the hands i want to thank you for the service as a c. I. O. For zuckerberg. We know doing two jobs can be a real challenge and you did them and you did them well. Thank you, very much. [applause] commissioners i am wondering, i think the benefit realization metrics is really neat. Is that kind of a score card for the future to see what is happening and what efficiencies and savings we are reaching . If so, im trying to figure out which ones are clinically orient and which ones are cost oriented and versus what is good Patient Experience and is that how you chose these. I want to be clear i did not chose them theyre chosen by leadership but these are not the only metrics that were looking at. When you look to the screen prior to that, when we talked about monitoring success, there are a lot of Key Performance indicators that the hospitals have chosen that theyre going to monitor overtime and they are more safety oriented as well as organizational efficiency. While some of these benefits realizations look a little heavy on the revenue side, there are many other metrics that were looking at. All right. So that leads to the question of the followup, in terms of as we go live and it becomes a reality, what would be you anticipate would be the next report that we would receive. You are scheduled to have a report in september. So that you will see how did we actually doing during live. Even with all this preparation what happened to us during live with our organization being ready from our training