Located here in San Francisco. My background is actually in the Health Department work. I came from the Philadelphia Department of Public Health before moving to San Francisco. I have really had the opportunity to work deeply and closely with communitybased organizations, but i am happy to be working in the mirrors office as of yesterday. I am catching up. It is very nice to meet you all and i look forward to working with you. Welcome, shelley. Thank you. Next item. Item two is the approval of the minutes. Each will require a vote. The minutes of october third, 2019, which was the joint hearing of the Planning Commission and october 15th, 2019. Commissioners, do we take them separately or together. That is your call. But review them. Any comments you wish to make with regards to them . Any editorials you wish to make, please let me know. I move the approval of october third, but with the correction that the titles under the commissioners present should be corrected. Okay. Is there a second to the october 3rd minutes . I will second. Okay. Any cop other comments about october 3rd . All those in favor of adopting those . Aye. And the next set of minutes . Commissioners, they are before you. I move october 15th for approval. Yes. Second. Any comments or questions . Hearing none, all those in favor signified by saying aye. Aye. Although supposed . All those opposed . None. Item three as directors report. Good afternoon. Just to summarize on one of the key things the department has been very busy with is responding to the kincade fire, which tragically burned over 76,000 acres in nearby sonoma county, destroying more than 282 structures including 141 homes. I will say that thankfully, as the latest data we have is no lives were lost due to the fire. We were responsive with regards to responding to sonoma county, including helping staff medically staff a shelter at stg Behavioral Health support to people suffering from the consequences of the fire. We were also on an Emergency Alert system with regards to the smoke and the fact that the air quality in San Francisco, we reached below optimal levels. We put up Public Health messages to help the public without. I think also very importantly the resiliency and commitment of our staff was really evident in that despite the fact that we had massive Power Outages across the region, people were resilient and committed to coming to work at d. B. H. And we were able, for the most part, to fully staff our systems, including our 24hour systems at the hospital. A tragedy, but also a committed response in helping us continue to improve our response both locally, regionally, and very importantly, across departments. This is really, along with the department of Emergency Services and other departments, this is a group effort. I want to thank the leadership that the Health Department and the people on the front lines doing the work, anywhere from working in medical respite in the serving centres during cases of poor air quality, to actually working in the shelters, the emergency shelter, to going up to sonoma to aid with that. I just want to give you the update with the team effort. Im pleased to reiterate the department has established an office of Health Equity. Mayor breed assigned legislation on october 1st to create the San Francisco office of Racial Equity and this is really historical commitment by our city to address the deep inequities here. We share mayor breeds vision in Racial Justice and insure robust purses precipitation works. We have established the department of Health Equity to align and coordinate with the Human Rights Commission which will be which is where the office of Racial Equity will sit we will be aligned with their work going forward. The new d. P. H. Office will have increased support for training and engagement and monitoring of equity efforts, and the office will sit directly under dr. Bennett who leads who currently who formerly led the inter divisional initiatives and currently leads the black africanamerican Health Initiative. This is going to be an extension of that work. I want to integrate that equity work is the responsibility of each and every d. P. H. Employee, and the purpose of this office is to provide catalytic support to provide the tools, the roadmap, to ensure that we are putting the structures in place across the whole department to move Health Equity forward. I was also really pleased a couple of weeks ago to attend with the mayor the maxine hall Health Centre groundbreaking. This is one of our wonderful Primary Care Clinics and i actually worked there almost 20 years ago as an intern in the Primary Care Clinic and i will say that the mission and the commitment to the staff remains the same. Unfortunately the building also remains the same with regard to needing a serious upgrade. We know the environment i am excited that the hall for the refresh for the centre. We will continue to afford that. The Health Centre is relocating during the reconstruction and we are ensuring that the communities informed there has been a lot of communication about that. I also want to announce some changes in the department with regards to Human Resources changes. Our former director of Human Resources accepted his resignation and effective november 1st. I really want to thank him for his service, along with the rest of the executive team, thanking him for his commitment to the Health Department where he served as h. R. Director since 2013. We are committed to continuing to improve our h. R. Functions and i am pleased also to announce that Michael Brown started this monday as our new d. P. H. Director of Human Resources. Michael has a storied history in his work both here previously at the department and as recently as the director of the Civil Service commission. He has more than 20 years of Human Resources experience. I think he is very committed. I talked to him about prioritizing and improving our hiring process and also focusing on equity issues both from the perspective of improving bringing staff, recruiting staff who will help us with Health Equity goals, but also looking at internal equity issues with regards to the department and staffing power. I am really thankful for rons service and i would like to welcome Michael Brown. That summarizes my report. There was quite a bit of press and communications in the last few weeks, so you have an extensive list that has the links to those, and i am here for any further questions or qualifications of the commissioners that the commissioners may have. Thank you. Thank you. Commissioners . Commissioner child . I am just going to ask, but i thank you answered it, there were sufficient staff that was able to come into the department so that, in general, the departments work was able to continue during these fires. Is that right . That is correct. We were open for business and with possibly very few exceptions, we were able to provide the right services at the right time for people. Very good. Thank you. Shall we move on, commissioners . Yes. Called the next item, please. There is no Public Comment request for that item. Item four, general Public Comment. We have quite a few. I am the Health Commission secretary, everyone. Each of you will have two minutes to speak and i have an egg timer. When it goes off, know that is your time to finish her sentence and step aside so the next person can come forward. I think you names will be called i will call four names right now and those of you who have you names called, come to the front row. [calling names] if i have mispronounced your name, please understand it is not on purpose. One final comment from me, for those of you are new to the Health Commission in terms of culture, Public Comment is a oneway communication. You all make comment in the commissioners receive that. They will not be discussion and back and forth, just expectations are all aligned. Hi, you guys have seen me before. I am here for two things. One thing i just wanted to followup on and i didnt add to what you were saying, dr. Colfax , but we sent you an email. I have a copy of it. We just would like to follow up on that email and have a discussion with you regarding bilingual services to our patients regarding the Racial Equity. I think those kind of go handinhand. So we could talk for a couple of minutes that would be great. The other thing i wanted to talk about was, i think there is a confusion. Back on october 22nd, the e. R. Came into the j. C. C. And we kind of expressed a whole bunch of things to you about our concerns about safety and violence in the e. R. But we think it goes in aligned with a lot of issues in the department across the city and it all boils down to staffing. I thought i might just clarify, kind of like what is happening with our is how many beds really are being left open because of staffing in the e. R. So i have taken the liberty of getting these assignments that we have, just a couple from over the last few months. I picked them randomly, i didnt pick the worst one, and it basically shows that we have an average of 13 to 22 open beds in the e. R. At any given time, which is ultimately due to staffing. That is scary. That is the underlying cause to some of the violence going on in our department and the services that we are not able to give to our patients. So i will hand this to you guys if you want to review it. It also has what was originally staffed versus what ended up being that day on this. So you can review it. I have tonnes of other ones that we have been collecting, but it may clarify kind of what is going on. And on average, the psych Emergency Services is also continuously at max capacity every shift. That trickles into our e. R. I will hand this over. Thank you. I am julie. I also work in the emergency room. I am a nurse there. When she talks about the 13 to 22 open beds, that is out of the 58 we are supposed to have open. Also, many of those beds have people sitting in them for 15, 20 hours waiting for their unfunded bed upstairs. That is becoming very common every day we go in. Theres 15, 20, often 30 people there for more than 15 hours, many for more than 20. I had a patient who was there for 26 hours on sunday waiting for a bed that was unfunded for him because he also had behavioral issues. Our staffing and our safety are at risk. We also started a survey about our Mental Health of the staff. And 92 of the staff say that they are having anxiety symptoms that are new in the past two years related to work. There is 80 2 to her who are having ptsd symptoms, and almost 50 degree that because of the hospital Work Environment or violence, that they quit, retired early, or about to take a leave of absence because our safety is at risk. We have had multiple assaults, and people are not being trained as is required annually. Theres people who are new who dont know how to deal with the ask lighting violent and psychotic people. This residency dont have the same training. We are begging for some help with our safety and our staffing because all of the stuff that happens in the community is reflected in the emergency room. As the Mental Health issue escalates, the city is in crisis and you know that more than i do but what i see in the emergency room is people going to the street to the es, to jail, es, and it is not stopping. Thank you. Hello, my name is brian. This is monica and jenna. We are pharmacy students at ucsf we are here to support ordinance 1909804 introduced by supervisor haney that would call on the department of health, Public Health to formally address the opioid addiction crisis in the city of the Public Health emergency. The ordinance at the department asked the department to create a plan that improve streetlevel Crisis Response to assist people who are using drugs in psychosis or are experiencing overdose. The plan would provide regular reporting of overdoses and overdose deaths. Provide support for frontline Emergency Responders and Public Safety personnel and it would help identify successful existing models of detox and dropin centres and a look to how to best expand those services. As pharmacy students weve committed ourselves to improving the health of our patients and we recognize need to not just take actions within the clinic. That is why were here to express our support today. We ask you support this ordinance. Thank you. Good afternoon. My name is elizabeth. This is my colleague, conrad. We are constituents at the city of San Francisco and ucsf student pharmacists. We are here in support of 22 to advise the commission to accept and allocate funding for increasing h. I. V. Services in this city. If it does past, it is now on the senate floor. We believe this measure coincides with getting 20 initiative that it is currently in progress in our city and we also believe that this funding will aid in providing underserved local communities with access to these necessary preventive and treatment care that the population needs. We just ask for your support. Thank you. Thank you. [calling names] good afternoon members of the commission. My name is ron and i am a 62 yearold disabled veteran who was a dedicated worker for your department until last friday. I am unemployed with no medical insurance for myself or my chronically ill spouse. With only enough savings to pay the mortgage for a few months. As an older worker, my chances of finding employment are much lower than younger workers. The manner in which the department and the city handled my separation has drastically reduced my chances of successfully finding employment. On october 17th, examiner ran an article within minutes of my attending a meeting with dr. Colfax. That article included a quote by dr. Colfax stating that dr. Colfax had asked for my resignation. It was obvious that the department had worked with the reporter in advance of the meeting by providing the examiner with that quote, it set the article up to inaccurately make it appear that i was terminated for an unspecified, derogatory reason. That statement will hinder my ability to be reemployed. And if employed, it is likely to reduce my ability to earn the same money or more than a made here. I worked for you for six and a half years. During that time, i successfully provided Human Resources support to implement the Affordable Care act and to do the hiring needed to create our Health Network in 2014. I ensured we were adequately staffed for our move into the new hospital in 2016, and most recently, i negotiated language with our unions to make sure the epic Electronic Medical record system could be implemented smoothly. These and many more accomplishments should have ensured me a respectful and informed separation. Instead, the department and the city opted to work with the examiner to trash my reputation, now and into the future. In their statements to the press , the department placed me in a false light before the public, acting with malice and reckless disregard for my reputation. I find this behavior inexcusable thank you for your time. Thank you. Hello, thank you for having us here today. My name is carissa and this is my colleague vivian. We are ucsf pharmacy students in here to express our support for the opening of a safe injection sight in the city. As you all know, drug use is happening on our streets and it has negative impacts on the city when you see someone shooting up in the street, it causes trauma for citizens. Deadly diseases are transmitted from the waste from drug use and this issue signs a blinding beacon on the criminalization of homelessness and on the injustices faced for our most forgotten parts of society. Safe injection sites address the issues i outlined because a Safe Injection Sites provide homeless drug users a place to use their drugs out of the public view. They also supply sterile supplies and disposable receptacles to prevent transmission of deadly diseases like h. I. V. And hepatitis b. Lastly, Safe Injection Sites sends a message to the homeless drug users that this city accepts them and wants to work with them to solve both of the citys and their problem. Thank you. Thank you. Next speaker, please. My name is andy wong. We are students here in San Francisco and we also want to show our support for senator weiners bill about this Safe Injection Sites which they just spoke upon. I just wanted to review with everything that carissa said and to expand on that. I wan