Transcripts For SFGTV CCII Commission On Community Investment And Infrastructure 20240712

A recall a building on post street he and a walked on back in guessing 2005, 2006 which presented some very similar issues. It was a tax credit building. And what happened was and this has not happened a lot but it does come up, what happens when you take an Affordable Housing model and allow for protections and plot that on a place where people either were rent controlled or thought they were rent controlled tenant and that raised issues and complications and we worked through that and did legislation and supervisor peskin made clear tenants werent losing the protections even if you overlaid Affordable Housing. Honestly, colleagues, if midtown had been build in 2014 and everyone had come in we wouldnt have that problem and thats a shift in people with rent control protection to another program. Many protections of rent control exists in the program for example eviction protections, you dont need the rent board and frankly theres more loopholes in the rent control that allow people to be protected so in some cases the rental housing is stronger and you cant just assume the program authorized or operated by the city would have protections that are as strong and theres exclusions for cityowned property but theres nothing im aware of and the City Attorney can correct me if im wrong but theres nothing from limiting that exception and saying in certain circumstances were going to extend all to something that is city owned. Thank you, we appreciate that. Chair, i just wanted to clarify and something we brought up after reviewing the proposal we have discussed this estimate of revenue dropping by an estimated 550,000. I just want to clarify that so there are many vacant units, right now 22 in midtown, 17 are being used for temporary relocation from other projects the one in district 5 tenants are temporarily being relocated. When we look at the balance, i believe no revenue is on the Balance Sheet for that. In other words, if you look at 22 units and the revenue off of that that would more than make up were those units rented out would make up for the 550,000 but regardless event if there wasnt direct payment and this is saving the city money, it would otherwise have to be paying for temporary relocation. I want the public and if you can clarify thatd be great but i want the public to understand that were advocating we have to do it regardless of the cost, the cost is not necessarily the full 550,0 550,000 because of t revenue potential as well as to the benefits 17 units that are provided arent reflected in the annual count. Through the chair, i dont we looked at the existing rent the estimate is based on what people are paying right now and how that would change. It doesnt take in to account that. And thats consistent with our discussions that the current revenue versus expenses does not reflect any revenue or benefits the city is getting by using the temporary housing at midtown on those 17 units. Just wanted to identify that. Thank you. Thank you, supervisor peskin for that verification. Why dont we go to Public Comment. Mr. Clerk, are there any callers on the line for this. Operations checking to see if we have callers in the queue. Let us know if any callers are ready. For those who already connected via phone press star followed by 3 to be add to the queue to speak. For those already in the queue wait until youre prompted to begin and youll hear a prompt that your line has been unmuted that will be your opportunity to provide your comment. For those watching the meeting on cable 26 or streaming link or sfgov. Tv did the org if you wish to call in follow the instructions on your screen by dialing 14156550001 entering todays meeting i. D. When prompted which is 146 706 3442, push the pound twice and enter the queue to speak. Do we have any callers . [indiscernible] the city has not conducted the proper care and maintenance. We support the City Building these building under rent control and hopefully transferring as promised years and decades ago and the promise. Thank you. Thank you for your comments. Please connect the next caller, please. Im from a local Grassroots Organization our city San Francisco. Currently one of our tasks is to fight the biggest worse landlord in San Francisco thats veritas and what has struck me an organizer watching the fight over midtown is how the city and county acted as a bad landlord and this helps change that. The other comment is to the substance of the item itself and thats rent control. We hear what if some of the people who live in the town suddenly get huge incomes. What about that. What people need to understand is what your income is irrelevant its the policy just like with security Social Security and they get it and understand it and defend it. We need to get to that objective of all rent control so everyone has it and respects and protects it. If that were to happen a lot of people would change their head about rent control. Its is an important measure that needs to be passed. Thank you. Next caller, please. I want you to recognize whats been done to this black families. It couldnt possibly a failure it pass the measure. I urge the supervisors to vote yes on this. Thank you. Speak up so we can hear you. Im calling in support of the resolution [indiscernible] this can provide against major increases. Rent control is [indiscernible] thank you. Thank you very much for your comments. Mr. Cooper the next caller, please. Good afternoon, this is ross vipperini. I want to register my support for supervisor prestons rent stabilization ordinance. Midtown is owned about the city and in effect city hall and the board of supervisors are the landlords and i believe the ordinance is a critical fail safe in stablizing the rent procedures while there is still consideration for the original promise of midtown. 50 years ago midtown was designed to become a Housing Cooperative so this diverse population of working class and predominantly black res departments would be home owners and the rent paid off the mortgage such as the time when i was supervisor and the office intervened and advocated we modernize affordable home owner strategies for cooperative housing but that faced stiff resistance from two mayors who had different designs for midtown. The story is midtown were heroes for decades before their mortgage note was satisfied and the reason it endured so well and effectively without assistance from city hall was the community and board of directors. We fought hard during our period in district 5 to see if we can return back to that original promise, which i encourage current City Hall Administration does. In the meantime, i think this ordinance from supervisor preston is important and deserves our wholehearted support. Thank you. Thank you very much for your comments. Next caller, please. Good afternoon, this is Milton Beltran calling from district 1. Id like to pledge my support for the passing of the item. I have no doubt youll continue hearing from supporters for Affordable Housing but please make it easier for the both of us and legalize rent control for elders in our community soonz as soon as possible. Thank you for your comment. Next caller, please. Ive been a resident for 50 years of the midtown apartments and there are several families here that have been here for four generations. We all lived here and went through hard times, good times, bad times. Im presently a part of the Tenant Committee that is pushing for rent control in the town. We appreciate Everything Everything youre doing. Theres one neighbor who was paying her rent at 700 some odd a month and they refigured and she wound up being asked for 2700 a month. She is a preschool teach working for minimum wage and lost all her savings and still trying to hold on to it in midtown. The majority of us need you to please pass this and keep what weve been promised all these years. Thank you for participating in the discussion. Next caller, please. This is lorie beardman thank you for the residents who have been ignored and misled by the s city of San Francisco. Midtown apartment began as a token compensation for the massive displacement of the black community from the fillmore district. It was established as a rent to own development with the city as landlord and failed miserably to maintain the structures over a period of decade resulting in extensive deferred maintenance and the city failed to comply with the americans with disability act. Tenants never applied for b. M. R. Housing units and they were not adjusted by any factor other than that established under rent control. When the residents paid down the mortgage without Resident Engagement the city hand the property to mercy to manage as b. M. R. This was outside the promry promissory notes of rent to own and there was a new payment structure with harsh impacts and imposed rules of indignity and a plan for massive new development. This proposal is a vital step to restore the promises broken and restoring housing nor residents of midtown. Please support it. Thank you. Thank you. Next caller, please. Im david wu i live in district 5. I want to echo all the sentiments that have already been expressed. Im speaking in support of supervisor prestons ordinance to return rent control protections to midtown. The displacement historically occurred in the western edition unfortunately continues to this day. It is through the organizing of Community Members and tenants that residents fought back and ask the board of supervisors support midtown tenants and approve this legislation. Thank you thank you, mr. Wu. Next caller, please. Good afternoon. Im a resident in midtown. Ive been a resident more than 30 years. I am an African American citizen and retired school teacher. Under the program rent has increased by 300 . Over the years ive watched along with my neighbors promises broken. Rebelieve black lives matter and and if you believe black lives matter i urge you to vote in support of the legislation and be on the right side of history. Thank you to supervisor preston and to supervisor haney for doing the hard work. Thank you. Thank you very much. Can we get the next caller, please. Hello. This is a member of San Francisco tenants union. Im in full support of restoring rent control to the midtown tenants. Its egregious what happens to them in the past while mercy came in and everything got shifted around. The repairs need to be done. The city is now the landlord we want to have rent control. Please pass this measure and move it on to the full board. Thank you. Thank you for your comments. Next caller, please. Supervisor. Lauren penny here. Im a member of senior and disability action. Most importantly for today i am a longtime neighbor of the good folks at midtown apartments. I recommend restoring rent control in midtown and this the first step for repairing the damage the city has done to the people of midtown. Midtown residents, largely African American and some other people of color and their succeeding generations i feel have been betrayed by the city many times over for more than 50 years. First displaced from their homes in fillmore in the 60s by racially targeted redevelopment. Second, they thought they were paying off their rents with midtown and they were denied and new management proceeded to raise the rents and you heard and threatened with demolition. Many residents are seniors and people with disabilities. Since 2014 they have endured six years of extreme anxiety and uncertainty. The very least the city can do at this point is restore rent control. This is an issue of fairness. Its an issue of justice and humanity. It is an issue of black homes matter. This is the citys chance to begin to correct the wrongs the city itself has committed. Thank you very much. Thank you. Could we get the next caller, please. Hello im care line hatch and in support of this legislation. Its high time we made some reparations for the things that were done to the black community in the fillmore district through redevelopment and think this is a good start but think theres more we should do. Thank you for your time and i urge you to support this legislation. Thank you. Thank you, caroline hatch. Next caller, please. Im a resident of midtown apartments and asking for support of supervisor peskins ordinance regarding the rent control protections for the midtown apartment. I believe this legislation is for resident thought we were under rent control based on documents signed and however, that sl suddenly changed as stad from supervisor peskins testimony when our rent went up 300 or more and if changes are not made it will cause displacement and people would have to move out. The majority of our community are African American and other minority groups. This protects residents from being forced out and priced out of their homes. If you would like to support our community, i urge you to please support this legislation. Thank you so much for your time. Thank you very much for your comments. Please connect the next caller, please. Hi, ive been living here in midtown more than 20 years. And im a nativeamerican indian. And retired from the navy 20 years and im one of the tenants youve been hearing about having gone through increase 300 when mercy came and took over as the landlord back in 2014. I urge the supervisors to support supervisor peskin for the legislation. Previous supervisors didnt do anything and supervisor peskin came forward with the legislation. Im here to support comment. Next caller, please. I want to tell stories of residents who were told theyd were under rent control and then got to old age and then suddenly have rent increase. We have to take it seriously it wasnt the deal tenants had and we need to restore what they thought they always had. The other issue even if this costs the city money and i think we will in some way, the city needs to make that investment. Not only is it essential for reparation to the community thats been disadvantaged for decade and we need to invest that money. Its worth it. And its not only a lack of reparation but the opposite, if the city doesnt invest the money, what happens is the tenants working people who saved money all their lives what tried to put aside something for their children and future and old age every month can no longer do that or build their own equity and savings for the future because theyre required to pay every extra and pay out more every time. Its a continuation of a system that has adviso disadvantaged l black community for decades. Thank you. Please connect the next caller, please. Im heidi peterson. A resident in district 5. Id like to thank supervisor peskin for his support of the residents and rent control. I want to make one point the seniors and especially the longterm residents in our community are creating a longterm community. The should support the couldn couldnt continuity that comes from longterm tenant. I want to support this and say thank you and please remember the value of the residents and their longterm status is far beyond the residents gut the city and community too. Next caller, please. Hello. Im a resident of San Francisco in district 8. I have been work in housing iss issues for the last couple years and wanted to come here because my midtown is a great example of how the city let people down. Midtown was built in 1967 as a replacement for the fillmore families that lost their homes during the urban development. Its a shameful time in the citys history and something we have to work for decades and decades and centuries to make up for the enormous disruption to families here in San Francisco. Im calling to urge the committee to approve this legislation and adjust the rent owned by longterm tenant to what would have been rent control and provides future direction. We have to make sure that we show up for our black community here in San Francisco which has already been decimated over the decades. We need to show up and we need to support them. This legislation is about fairness. Rent control is for a reason and mid town is no less deserving of rent control than anybody else. Without rent control historically black midtown communities that risk displacement and if you believe black homes matter please vote yes on supervisor peskins legislation. Thank you very much. Thank you for the comments. Next caller, please. This is the first step residents deserve to own. Thank you. Thank you for your comments. Next caller, please. Is there a caller on the line . If you heard your line is unmuted you are live. Wed love to hear your comments now. My name is natalia. Im a longterm supporter of midtown and have also written extensively about midtown history and would like to thank supervisor peskin for introducing this incredibly important legislation that offers the form of reparations to the black community in midtown and will hopefully set them on a path to longterm equi equity. The situation as a result of decisions made by the city neglect and discriminatory so i thank supervisor peskin for recognizing an investment needs to be made to right the historic wrongs of city policy and restore represent control to midtown. Thank you. Thank you for your comments. Next caller, please. I just made a comment so you unmuted the wrong caller. Thank you for your honesty. Well move on to the next one. Hi, im 22 years old and been living with my parents here since i was born and the whole rent increase thing made me fear id have to move out of s. F. And ill be able to live with my family no longer so i appreciate the rent control legislation because it would allow me to continue living with my family which is important because this community is what ive grown up with all my life. Thank you. Thank you, next speaker, please. Am i next. You are live. Begin your comments. I thought someone else was speaking. Perhaps your television or computer are on delay. Start now and ill begin your timer. This is betty trainer with senior disability action and we wole heartedly support this legislation and thank supervisor peskin for interdufrg introducing it. I live in a coop down garry from midtown and we were built also because of the redevelopment so we understand what theyre going through but also we as a strong coop have been able to do maintenance at our place. We have a tenant controlled coop. So i really feel this legislation is so important to begin the role for the tenants there to have more control and to be treated fairly by the city to stop this deferred maintenance thats happened all along. Its crucial this be the beginning of something that is so needed by the tenants there at midtown. Thank you very much. Thank you very much for your call, betty trainer. Next caller, please. My name is alice. I live in s. F. And calling in to support the ordinance to return historic rent control protection to the midtown apartments. I think this is important legislation being put forth and rent control is crucial now in covid times. It was for the families who lost their homes during the urban redevelopment and we cant ignore the fact its mostly black people, right. So midtown was developed as cooperative housing with an opportunity to own but the city never fulfilled that promise to the residents and the legislation addresses the rent hike and it also provides future protections against major rent increases. I think this is important and something all the board of supervisors should be supporting. Thank you so much. I yield my time. Thank you. Are there any further callers . Theres one more caller. Hi, hi name is emily and i live in district 9. Im calling in support of supervisor peskins ordinance to return to historic rent control protect to midtown apartment. We know midtown was built in 1967 as a replacement housing for fillmore families who lost their home during the racist urban development and developed as rent to own but the city never fulfilled this promise to residents. The legislation addresses the rent hikes by addressing those tenants and rent control and provides future protection against rent increases. Its a first step to fairness. The town deserves rent control protection just as much as anywhere else in the city. Without the rent control the historically black community is at risk of displacement. Please restore the rent control. Next spaeshgs, please. Next speaker, please. My name is rufus watkins. Im a tenant of midtown Park Apartments and am African American and grew up here for 30 years. Please support the legislation. Thank you. Next speaker, please. My name is joseph wyatt. I am a 26 year resident of midtown Park Apartments. Im African American and a senior citizen. I am calling in full support of supervisor peskins legislation for rent stabilization at midtown Park Apartments. Im looking forward to a bigger and Brighter Future for midtown. Thank you. Thank you very much for your comments. Do we have any further callers . That completes the queue. Thank you. Thanks to everyone who spoke during Public Comment and thank you to supervisor peskin id like to be added as a cosponsor. Do you have any final remarks . Thank you. Thank you for all the time on this item and previous ones on a busy agenda that i know you have. I just want to thank all the folks from the community and mid town not just for calling in but being part of crafting the legislation and it took many months and amendments but i think weve landed on something that will really help. I also want to recognize and thank district perrini not just for taking the time today to call in but his active engagement when he was supervisor. He did a resolution this body long before my time actually in his second term that was an important resolution about talki talking about the history of midtown and the promises made and as many callers stated theres a longer term discussion we need to have about how we return ownership or control or both in a smart way determined by and to the residents of midtown so residents have permanent stability and this will help stabilize the homes of so many people whose time at midtown has been destabilized by huge rent increases that are unfair and wrong and this legislation will address head on. Thank you and i appreciate your cospons cosponsorship and look forward to the measure with recommendation. Supervisor haney. Thank you, supervisor peskin and the members of midtown Park Apartments and would like to be added as a cosponsor. Supervisor peskin. Thank you, chair mar and supervisor peskin. I have a history with midtown back in supervisor perrinis day and worked with your predecessor to figure things out and youre the first to figure it out. More than supportive and wanted to added as a cosponsor. I think what you want us to do and the motion you want us to make is to adopt the amendment and continue at one week. Thank you. I apologize. Thank you for those motions. Mr. Clerk, please call roll on the motion by supervisor peskin. On the motion to amend the ordinance as amended by supervisor motion made by peskin but the amendment by supervisor peskin on the amendment. [roll call]. Mr. Chair on the amendment there are three ayes. And id make a motion to continue the item to the next meeting of the government audit and Oversight Committee. The next meeting is october 1 just to note for the record. On the motion the item be continued as amended to the october 1 government audit and Oversight Committee meeting. [roll call] mr. Chair, there are three ayes. Thank you. Mr. Clerk can you please call item number 9 resolution supporting usf workers united, a Broad Coalition of workers and faculty members at the university of San Francisco, drastically affected by furloughs, cuts in healthcare and employment benefits, and lack of safety protocols during covid19. Members of the public who wish to proved Public Comment call the number 14156550001 now. Enter the meeting i. D. Its 146 706 3442. Press pound twice to connect to the meeting and then press the star key followed by the number 3 to speak. A prompt will indicate you raised your hand and wait until it indicates you have been unmuted and you may begin your comments and im in receipt of a memo requesting this be agendized and consideration for the board of supervisors during the september 22 regular meeting next tuesday. Thank you, mr. Clerk. Mr. Haney, the floor is yours. This should be fairly quick. Colleagues, today is a resolution in support of usf workers united a Broad Coalition of workers standing in solidarity during the Public Comment is closed to protect the well being and workers at usf and the faculty and students at the university. I drafted this resolution with the Coalition Members and opeiu local 29 and United Service workers west, local 87 and loge local 2 and usf parttime Faculty Association. Oge local 2 and usf parttime Faculty Association. Ge local 2 and usf parttime Faculty Association. E local 2 and usf parttime Faculty Association. Local 2 and usf parttime Faculty Association. Local 2 and usf parttime Faculty Association. The workers are in a position that many have found themselves facing furloughs and facing potential layoffs and cuts and reduced hours. The result is that many are wondering not just how theyre going to pay the bills also how theyre going to qualify for needed benefits and continue to be able to Access Health care. The university of San Francisco is an essential institution here in our city with a very long and proud history including a tradition of social justice. This resolution comes in that spirit and asks them respectfully they bargain in good faith with the members of usf workers united and prioritize the following. Continue to offer access to Affordable Health care for usf Community Members laid off or furloughed or lost teaching unit or bargaining for a safe return to campus. Understanding custodian recommendations for reopening and the protection of all workers and students at usf. During the economic crisis we must look out for our most vulnerable workers, service workers, labor workers and janitors are generally the first group to be target the by furloughs and layoffs and must be support and voices heard. Before we move forward with any comments in Public Comment, two clerical amendments. And we distributed these amendments to the committee. One is correcting the number where Faculty Association represent the approximately 468 nonschool faculty and librarians correcting the number to 468 and adding the word librarian. My understanding is this is a challenging time for the university and theyve also experienced losses to revenue and student enrollment. With that said theres reasonable things the university can do to support their workers during this time and i think its important that our board stand in solidarity with the usf workers during this Public Comment is closed. During this pandemic. Thank you, supervisor haney, for this resolution and im in support of the workers as they bar fan with the college bargain as they lobby for their jobs and continue to work. Id like to be added up support. We can move to Public Comment. For those who connected by phone press star followed by 3 speak on agenda item 9. For those on in the queue continue to wait nul until you hear your line is unmuted. And for those on cable 26 or through sfgov tv. Org call 14156550001 and press meeting number conference and pound twice and 3 to be entered in the queue to speak. Do we have any callers . I have callers in the queue. Ill cue the first caller. Hello, supervisors. This is david wu again as a form former usf student i urge and support you to support this resolution and all the workers at usf. Thank you. Thank you for continuing to participate, mr. Wu. Next caller, please. Good afternoon im charles cross. This pandemic affected us significantly and were only providing essential housing as defined by the city. We have fewer students and greater Financial Aid needs due to changes. We provide 100,000 annually to provide Financial Aid. The revenue shortfall is about 16 . Were only housing 200 compared to 2500. Food Service Provided by bone appetit management is only serving for 200 students compared to 8,000 needs per day a year ago. Housing shortfall is about 35 million alone. We implemented furr lows and lay furloughs and layoffs at all levels and the moment is less than 40 of almost 2,000 employee. The layoffs were in areas where we have no work to be performed. Approximately 20 employees opted for Retirement Programs and we have covered the benefit cost for those employees furloughed during the summer. We implemented Salary Reductions across the university and the plan is progressive with reductions starting at the 70,000 level and progressing up to 20 to the highest paid employees. No employee under has experienced a reduction in salary or benefits. Usf has provided the safest environment possible for faculty and staff but the situation has created financial constraints. We addressed the shortfalls in responsible fashion and made the cuts necessary so solve this problem. Unfortunately not all have participated. Those units that did not participate did not experience thank you for your comments. Can we get the next speaker, please. Hi, im with opeiu local 29 and i have the pleasure of being the Program Representative for Office Assistants of the university of San Francisco. We repeatedly tried to engage the university in concessions based bargaining were fot blind to the challenges but usf refused to engage with us on what could have been significant savings by looking at the Retirement Program that costs them 17 million a year. We unfortunately are now in a position where we have 12 members who have permanently lost their jobs and we have had members who have been forced in to a parttime situation without Health Care Benefits during the Public Comment is closed. Mr. Crosss representation of the budget is hiyperbolizing an they have chose enprofits over people and need to get back to their jesuit values. Thank you. Next caller, please. Im amanda mckale on behalf of the resident directs at the university of San Francisco we live on campus for those living on campus and our exposure rates are extremely rate relative to other employees who were given the opportunity to work remotely. The university of San Francisco made the decision to remove our employee status previously spoken to us about and move it to reduction in hour status removing Health Care Benefits, educational benefits and any other benefits previously conferred by our position. This prevents us from protecting ourselves while on the job. I want to implore you to continue to advocate on behalf of usf workers and all aspects of the university and want to thank mr. Hany for sponsoring this bill. Thank you. Thank you for your comments. Next caller. Good afternoon. My name is ann marie belda and live in the tenderloin, supervisor hanneys district and also an employee of usf and an urge the board to approve this resolution. As part of the many employees partially furloughed i did not receive any benefits package. Contrary to what the earlier caller said i took a pay cut because i was told so. We ask the university sit down and speak with us. All unions. Its not really taken place. No discussions, all unions i know on campus are wanting a discussion and we are waiting to have that meeting and thats not happened. We also ask Union Leadership with the mission of social justice to please meet with us and different members on campus as we want to talk about this and this has really had some real time impact on our lives. I think the board for bringing this resolution up and to supervisor haney for all the support to usf workers united. Thank you. Next caller, please. Hello. I am a member at the university of San Francisco part of staff. Thank you supervisor haney for your support. This situation has [indiscernible] and these are colleagues and people that matter. They have been removed taking away the benefits at a time like this not only puts pressure on the staff to continue to do the great work they do on campus and passes on responsibilities to them for what is going on and thats extremely ridiculous at a time in which they are subject to covid and the other things going on in our society. This is a way for the university to [indiscernible] and i implore you to look into this. Thank you for providing your comments. Please connect us to the next speaker, please. That completes the queue. Thank you. Thanks to all the speakers during Public Comment. Supervisor haney would you like to make a motion. Id like to move to send this to the full board and Committee Report. Did you want to make the amendments . Yes, sorry. I want to move the minor amendments first. On the motion to amend offered by member heaney. [roll call]. Mr. Chair, there are three ayes on the motion to amend. Thank you, mr. Clerk. I want to move the resolution to full board and Committee Report. Recommended to a Committee Report on that motion. On that motion. [roll call]. Mr. Chair, there are still three ayes. Thank you, mr. Clerk. Last but not least can you please call item number 10. Resolution urging the association of bay area governments abag in its upcoming Regional Housing needs allocation rhna process to focus on San Franciscos unmet needs for housing affordable to low and moderateincome residents, counteract the displacement of low and moderateincome communities of color in core urban cities like San Francisco and oakland, prioritize increases to the regions abovemoderate rhna allocation in high resource and high opportunity jurisdictions, and limit increases in abovemoderate rhna allocations to bay area cities with concentrations of sensitive communities. Members of the public who wish to provide Public Comment on this resolution call the Public Comment number now it is still 14156550001, enter the meeting i. D. For todays meeting is 146 706 3442 press the pound symbol twice to connect to the meeting and press the star key to enter the queue to speak. Prompts will indicate you have raised your hand. Wait until the system indicates you have been unmuted. That will be the time to give your comment and i received a note for nis to be continued to september 22. We considered this item and ive spoken on it a few times before but i wanted to share brief remarks today given how important this is in solving Housing Affordability crisis along with the board and this is to be assigned to bay area city through the Regional Housing needlecation process. The socalled allocation is important in shaping the total number of new homes each jurisdiction needs to build and how affordable they need to be to meet the Housing Needs of people of all income levels. Id like to add to the summary of the key points to the resolution outlined by the clerk and ill highlight the resolution urging to consider past over performance in above moderate income category so were less likely to be subject to sb 35 streamlining of condos. And urging the potential s. B. 35 impact on cities like ours with concentrations of sensitive communities to avoid the inequitable outcomes of gentrification and Racial Disparities and segregation. San francisco has taken on much of the regions Housing Development far above our regional share of households and data showed we overbuilt luxury apartments and our city was at 140 of the goals for above moderate marketrate housing with over two years to go in the current cycle. Meanwhile, we vastly under produced new housing to meet the needs of low and moderate housing and the covid crisis is triggering changes in housing and exacerbating quick inequities and many are left to seek housing elsewhere. Lowincome households ton live in overcrowd and unfit conditions and working class essential workers continue to commute to their jobs from ever longer distances. What we build and who we build it for matters and the market wont solve the problem it help to create. We need to prioritize addressing the Housing Affordability needs of our residents and that begins with setting the right goals and following that through the Housing Element of the San Francisco general plan. I would like to thank my cosponsors supervisors ronin and mandelman and groups including the council of coalition and others and id like to thank planning director rich hillis and planning staff and finally my legislative aid who did a tremendous amount of work on the complex and important resolution. I urge your support in moving this forward today. Unless colleagues have comments or remarks, i move to amend. Mr. Clerk, are there callers on the line . Operations check if we have callers in the queue and ill go over the routine the last time. For those who connected via phone press star added by 3 to be added to the queue to speak. For those on hold wait until you are prompted to begin and youll hear the system inform you your line has been unmuted. For those watching on cable channel 26 or through sf gov tv. Org you can dial 14156550001 and enter the meeting i. D. By 146 706 3442 when prompted then press pound twice and then press 3 to enter the queue for the item and were ready to hear from the first caller if they are also ready. Supervisors, this is david wu again. I live in district 5 and work in district 6. I fully support this resolution and want to thank supervisor mar and all the supporting supervisors for putting this forward woe must focus on actual unmet needs when it comes to the promise. We cannot continue overbuilding over housing and gentrification that results from trickle down housing has to be addressed. I support this resolution and urge the full board to pass it. Thank you. Good afternoon. Im calling on behalf of the San Francisco Action Coalition owe posing the resolution because it will exacerbate the Housing Affordability crisis. While the resolution takes aim at marketrate housing it would stop the city from approving subsidized Affordable Homes and limit the increase of the citys requirement for above moderate marketrate housing targets. Should the citys rate be artificially low mixedincome housing will lessen the number of Affordable Homes for low and middleincome san franciscans and by punting our housing responsibilities housing cost wills continue to skyrocket and the workers who keep the city functioning will have no choice but to commute for hours to San Francisco to work. In San Francisco marketrate housing pays through the inclusionary laws. For example, these units have accounted for over 1700 new Affordable Homes between 2015 and 2019. Thats roughly 35 of the total Affordable Housing created. Additionally its provided over 350 million to be used on 100 affordable projects. Over 22,006 housing. Market rate units create and fund affordable ones yet this resolution demonizes these lies and we oppose the resolution. Thank you. Next caller, please. Hello. We are dealing with displacement. We are dealing with communities of color that are being displaced from cities like San Francisco and oakland and i approve of this legislation. I read through the entire new and improved legislation. Im happy that my supervisor mandelman from district 8 contributed to the language and i encourage all supervisors to support this measure. Thank you. Thank you. Next caller, please. My name is gary in district 2 with the San Francisco land use coalition. Im calling in support of supervisor mars resolution the number of entitles are half as many as 2018. If the board of supervisors approves overly aggressive goals this would increase the current level of housing speculation in San Francisco which is unacceptable. It would not increase the housing units. Thank you and thank you supervisor mar for your resolution. Thank you. Is there a caller . This is cath ran katherine howard. I support this resolution. Im get muted and unmuted. I hope this gets through. I support this resolution and i appreciate supervisor mar and the cosponsors for introducing this. Along with residents from all over San Francisco we submitted a letter to this committee and put peoples full names and district number on it. Since we resubmitted it you get the idea. One of the goals the letter was to save the committees time so ill end my comment by reaffirming our support for this resolution. Thank you. Connect us to the next caller, please. Im speaking for the Neighborhood Council board of directors. Every hundred units of new housing every market rate housing means Affordable Housing cant be used on the site and think of supplementals on housing legislation and implement. Thank you. Next caller, please. Im a member of the members disability action and long time renter from district 5. I sent a letter and spoke out in favor of supervisor mars resolution earlier for the previous hearing. I just wanted to report back that upon reading the amendments i believe they have my support and to me theyve strengthened the reasons why they should recognize Affordable Housing and should act accordingly if the choice between affordable and market rate housing with an emphasis. Our homeless and seniors and people with disabilities and lowincome families and people of color [indiscernible] in real time. Help us now in real time by passing this resolution. Thank you. Thank you. Next caller, please. Good afternoon, supervisors. Im with the Mission Economic agency and calling in strong support of the resolution before you. Were currently only meeting 20 of our low and moderate housing goals and think its important theres an antidisplacement lens when handled in certain ways it can contribute to displacement of lowincome residents and theres history of market rate housing in overbuilt, lowincome areas in the city. Recent study of university of minnesota identified rent pressures can be put on those who are paying the lowest rents in an area near new market rate housing. What kind of housing you build and for whom and where matters a lot not just quant. On the quantity front we think there should be no increase insensitive communities as mapped by the urban displacement project. For these and other reasons we think its very important that we head in this direction and again were in very strong support of this resolution and thank you for bringing it forward, supervisor mar. Is there a caller on the line . A reminder to all the callers in the queue continue to listen until you hear a system prompt that says your line is unmuted and that means you are live and were ready to hear your comments. I just got notification. Im with San Francisco land use coalition. Good afternoon, supervisors. Thank you chair mar for introducing this resolution. This is what we need at this juncture in time. For those who think we sudden look at how many market rate homes we have for sale. How about over 2,000. And more interesting we have over 1600 of them sitting over 90 days. This market at this point in time we do not need more market rate housing or need to have an increase for market rate housing because its not something that is going to happen. We dont have a situation thats meetable. The idea of a quota and goal is to have something to strive for when the country is going through horrendous economic downturn with people with jobs that wont come back. This is not the time to increase the quota for market rate housing. Its the time to think about how to take care of these people. Homelessness will increase by 30 million to 40 Million People cannot pay rent. What will happen to them . This is not the time to think about more market rate housing and trickle down housing that will come to the rescue. No. You, supervisors know this the best. I urge you to support it. This is what we need at this time. Someone to look at the numbers. Thank you. Next callers comment, please. Im with senior an disability action. Im calling in deep great support for this measure. Thank you very much for the amendment to truly focus on the needs of our city is what we need to do right now. I live in district 3 where i have seen so many seniors, people with disabilities, service workers, caregivers, safeway clerks and people of color and bus drivers being displaced and not being able to find Affordable Housing because weve not been building enough Affordable Housing to meet the real incomes of our essential workers of the people that we need every day in the city. So i urge you to support this all supervisors and lets pass this and lets get started on building what we need to build for our city. Thank you. Thank you. Next caller, please. Good afternoon. Cory smith on behalf of the housing Action Coalition. The numbers were artificially low and the methodology used to calculate is why the state legislate passed s. B. 828 to have a more adequate calculation for housing numbers Going Forward. The idea San Francisco hit the previous numbers and viewing from the success is given the number of cities, 40 across california hit to the targets. Orange county had 82,000 and many consider Orange County a place where more housing makes sense. And we want to point out more market rate housing does mean more Affordable Housing and we will be able to build fewer affordable units throughout the next cycle. While many people like to coin market rate housing as part of the problem and continually state this is not the solution, were not hearing any counter proposals as to how we can dig out of this mess at a big picture level. There are homes available to purchase that i and others have zero chance to be able to accomplish that piece because of the price and because of the lack of quant the city and region has built in the last 40 years. We can we get the next callers comments, please. Good afternoon. Im in support of this legislation. I concur we need all types of housing however, what we really need is housing thats affordable and lowincome for the most vulnerable residents in the city. Its failed to meet number for lowincome housing and i was pick up a report where theres a u. C. Berkeley report that the best thing to address Affordable Housing is to build Affordable Housing directly and lets focus on the housing most needed very low income. Thank you for your comments. Next caller, please. Im with the council of Community Housing organization. Fully in support of this legislation. I think this is the time when all of us should be looking at racial segregation and how segregation patterns are working themselves out throughout the region. The causes of that and the causes are displacement in the inner cities and lack of Affordable Housing in our highopportunity cities for people. This legislation directs our representatives to argue for exactly that. Move the housing where it should be in highopportunity areas near those jobs and to support Affordable Housing where we need it the most where communities are struggling against displacement if were going do our work for Racial Equity it means thinking about housing and land as a place where a lot of these things play out. Thank you supervisors for this piece of legislation. I think it is the beginning of thinking about much larger pictures at the regional and state level about how we plan to create a truly equitable region. Thank you. Thank you, fernando. Next caller, please. Im showing support in this resolution. I agree with the speakers we need to focus on low and moderate income. The crisis were in will take years to recover. And [indiscernible] i want to highlight more than of were going to need to focus on housing and actually most of the market are going to people out of work right now. Thank you for your comments. Next caller, please. Im a San Francisco resident. I oppose this legislation because the focus on the pipeline doesnt make sense because it looks like the website is still not doing its part. Are you still there . Yes. Prioritizing increases to the regions above market allocation and high resource and high opportunity jurisdictions does not appear to affirmatively further fair housing so my concern is that its still a bad resolution and im concerned it may be an effort to keep shelters out of high opportunity areas. I think every part of San Francisco needs to do its part to construct shelters and transitional housing and lowincome housing. I oppose this legislation. I oppose this measure for a few reasons. First, is that this has taken years to build. Some is on tox is sites like Treasure Island and we need to look at high resource neighborhoods on the side where theres good transit and access to jobs and low housing due to the fact its still low density and by building housing there it would help find Affordable Housing throughout the city in helping serve people at all levels of the income spectrum. Finally, im a little disappointed the board of supervisors is wasting everybodys time with this. This is eventually avacs decision not the board of supervisors decision and the opposite of signalling. Its just the board of supervisors complaining about something they cant control. Just to indicate theyre opposed to more housing and if you really cared about fair housing upzoning the west side and quit wasting everybodys time with these measures that wont do anything. Next callers comments, please. This is laura foot from indie action. Theres a lot in here i want to say i understand and appreciate and i think we understand people rin crisis and what do we do about that . I want the government to focus on getting more Affordable Housing built. Thats a great use of your time. Unfortunately this doesnt do that. We spend a lot of time saying were going to work and stall and stop and slow down market rate housing as if that does anything to help Affordable Housing. It doesnt. We need more market rate housing. I want you guys to focus on doing more to get more Affordable Housing built faster in San Francisco and across the bay area and across america we need more Affordable Housing. If you continue to focus on saying someone else should be building market rate housing you are in fact not doing Affordable Housing any good. Youre fork forcing us to have the argument it doesnt seem reason to say San Francisco is not a high opportunity area and a live here and more people should get to live here and think we can handle more neighbors and the more we say its somebody elses problem and everybody is jumping all over themselves to say its somebody elses false and next towns over were not that bad. No, its all of us. The bay area has chronically under built housing for a generation and we need to get out of the way of market rate housing and do everything we can to help affordable subsidized housing. I wish we were focussing on Affordable Housing but thats not what this risk resolution will do and hope to get more Affordable Housing built in the city. Thank you. Thank you, next caller, please. Good afternoon, supervisors. Im a renter in district 5 and speaking on behalf of the membership and were strongly opposed to this resolution. As some previous callers pointed out its the worse of San Francisco politics and where people are fed up. You have a group of supervisors who say theyre progressive and doing everything they can to make sure the wealthy parts dont have to build market buildings. The satate law is clear through te housing accountability act we need to build Apartment Buildings on the west side. Thats going happen through state law. If you cant get out of the way well do it through state law and you have to allow building on the west side. Its disingenuous and acting like passing a resolution trying to block new apartments on the west side does anything to help affo affordability. We know youre trying to protect your constituents who think an Apartment Building near them will ruin their quality of life. Apartments dont ruin quality of life they improve it and i live in one and its fantastic. Finally, regarding the numbers, theres over 400,000 units of units and if San Francisco somehow succeeds in getting that push out it will go to another area. Think of where the fires are and smoke is and jobs are and equity and racist history of our zoning and where should we be up zoning it should be the west side, where theres clean air, access to jobs and transit. If you say all the market rate housing has to go to the east bay youre condemning a generation to living near fires. Next caller, please. I would like to agree with the other caller but i dont understand the point of this. Why is the board of resolution wasting time encouraging avac to do anything because theyll do what theyre going do. Why is the board of supervisors writing a resolution . It is going to influence avac one way or north . I dont have an opinion on what housing policy should be. I dont see how this resolution is going to help anyone one way or another. I agree with other callers we should focus on San Francisco housing policy not what we can do to get other counties to change their policy. I understand theres a regional aspect to housing but i dont see how this is going to change anything. Thank you. Im a resident of San Francisco since 1976. Im calling to strongly support supervisor mars resolution and to focus on the Affordable Housing needs in the city. I listen to all the comments and want to say that we are place where we have a participatory government and have checks and balances and i feel its the supervisors job to protect the interest of the cities and counties they represent and to be aware of and focussing and seeing the possibly unintended consequences of different legislation among other things. Not to do that would be de dereliction of responsibilities and would result in speculators taking advantage of the provisions of s. B. 35 and i think thats a dangerous thing to just being handing over control of the planning of the city to people thats primary interest is making money. As far as comments with the west side being all rich people thats not true. Almost all the west side is working class families. Were not talking about francis wood thats the exception. Because just some properties are worth a lot of money its in the true and i think this is a good sla legislation and strongly support it. Do we have further callers . Hello. Im a renter in the mission. I want to agree with the other callers we shouldnt ask for less housing. The bay area is one of the richest areas in the country and the Median Household Income is well over 100,000. Theres a lot of rich people and people will lose their jobs and gentrify oakland or richmond or other places in the east bay. Please dont push gentrification into Cleveland Oakland and other areas in the east bay. I dont think for instance which is mostly a bunch of rich people on the west side. Maybe your not multi mull millionaires but are because of your home so dont say San Francisco being a rich city will not accept other rich people and will push them into other poorer cities in the bay area. I dont think thats fair or very nice and its definitely not progressive. Thank you. Do we have any further callers . That completes the queue. Thank you to all the speakers during Public Comment on the side of colleagues. Id like to make a motion we send this forward to the full board with positive recommendation as a Committee Report to the september 22 board meeting. On the motion the item being recommended vice chair peskin. [roll call] there are three ayes. Thank you, mr. Clerk. Do we have further business . There is no further business today. Okay. Thanks everyone. We are adjourned. Thank you. We spoke with people regardless of what they are. That is when you see change. That is a lead vannin advantage. So Law Enforcement assistance diversion to work with individuals with nonviolent related of offenses to offer an alternative to an arrest and the county jail. We are seeing reduction in drugrelated crimes in the pilot area. They have done the program for quite a while. They are successful in reducing the going to the county jail. This was a state grant that we applied for. The department is the main administrator. It requires we work with multiple agencies. We have a community that includes the da, Rapid Transit police and San Francisco Sheriffs Department and Law Enforcement agencies, Public Defenders Office and adult probation to Work Together to look at the population that ends up in criminal justice and how they will not end up in jail. Having partners in the nonprofit world and the public defender are critical to the success. We are beginning to succeed because we have that cooperation. Agencies with very little connection are brought together at the same table. Collaboration is good for the department. It gets us all working in the same direction. These are complex issues we are dealing with. When you have systems as complicated as police and health and proation and jails and nonprofits it requires people to come to Work Together so everybody has to put their egos at the door. We have done it very, very well. The model of care where police, district attorney, public defenders are communitybased organizations are all involved to worked towards the common goal. Nobody wants to see drug users in jail. They want them to get the correct treatment they need. We are piloting lead in San Francisco. Close to civic center along market street, union plaza, powell street and in the mission, 16th and mission. Our goal in San Francisco and in seattle is to work with individuals who are cycling in and out of criminal justice and are falling through the cracks and using this as intervention to address that population and the Racial Disparity we see. We want to focus on the mission in tender loan district. It goes to the partners that hired case managers to deal directly with the clients. Case managers with referrals from the police or city agencies connect with the person to determine what their needs are and how we can best meet those needs. I have nobody, no friends, no resources, i am flatout on my own. I witnessed women getting beat, men getting beat. Transgenders getting beat up. I saw people shot, stabbed. These are people that have had many visits to the county jail in San Francisco or other institutions. We are trying to connect them with the resources they need in the community to break out of that cycle. All of the referrals are coming from the Law Enforcement agency. Officers observe an offense. Say you are using. It is found out you are in possession of drugs, that constituted a lead eligible defense. The officer would talk to the individual about participating in the program instead of being booked into the county jail. Are you ever heard of the leads program. Yes. Are you part of the leads program . Do you have a case worker . Yes, i have a case manager. When they have a contact with a possible lead referral, they give us a call. Ideally we can meet them at the scene where the ticket is being issued. Primarily what you are talking to are people under the influence of drugs but they will all be nonviolent. If they were violent they wouldnt qualify for lead. You think i am going to get arrested or maybe i will go to jail for something i just did because of the Substance Abuse issues i am dealing with. They would contact with the outreach worker. Then glide shows up, you are not going to jail. We can take you. Lets meet you where you are without telling you exactly what that is going to look like, let us help you and help you help yourself. Bring them to the Community Assessment and Services Center run by adult probation to have assessment with the department of Public Health staff to assess the treatment needs. It provides meals, groups, there are things happening that make it an open space they can access. They go through detailed assessment about their needs and how we can meet those needs. Someone who would have entered the jail system or would have been arrested and book order the charge is diverted to social services. Then from there instead of them going through that system, which hasnt shown itself to be an effective way to deal with people suffering from suable stance abuse issues they can be connected with case management. They can offer Services Based on their needs as individuals. One of the key things is our approach is client centered. Hall reduction is based around helping the client and meeting them where they are at in terms of what steps are you ready to take . We are not asking individuals to do anything specific at any point in time. It is a Program Based on whatever it takes and wherever it takes. We are going to them and working with them where they feel most comfortable in the community. It opens doors and they get access they wouldnt have had otherwise. Supports them on their goals. We are not assigning goals working to come up with a plan what success looks like to them. Because i have been in the field a lot i can offer different choices and let them decide which one they want to go down and help them on that path. It is all on you. We are here to guide you. We are not trying to force you to do what you want to do or change your mind. It is you telling us how you want us to help you. It means a lot to the clients to know there is someone creative in the way we can assist them. They pick up the phone. It was a blessing to have them when i was on the streets. No matter what situation, what pay phone, cell phone, somebody elses phone by calling them they always answered. In officebased setting somebody at the reception desk and the clinician will not work for this population of drug users on the street. This has been helpful to see the outcome. We will pick you up, take you to the appointment, get you food on the way and make sure your needs are taken care of so you are not out in the cold. First to push me so i will not be afraid to ask for help with the lead team. Can we get you to use less and less so you can function and have a normal life, job, place to stay, be a functioning part of the community. It is all part of the home reduction model. You are using less and you are allowed to be a viable member of the society. This is an important question where lead will go from here. Looking at the data so far and seeing the successes and we can build on that and as the department based on that where the investments need to go. If it is for five months. Hopefully as final we will come up with a model that may help with all of the communities in the california. I want to go back to school to start my ged and go to community clean. It can be somebody scaled out. That is the hope anyway. Is a huge need in the city. Depending on the need and the data we are getting we can definitely see an expansion. We all hope, obviously, the program is successful and we can implement it city wide. I think it will save the county millions of dollars in emergency services, police services, prosecuting services. More importantly, it will save lives. [ ] i am the supervisor of district one. I am sandra lee fewer. [ ] i moved to the Richmond District in 1950 mine. I was two years old. I moved from chinatown and we were one of the first asian families to move out here. [ ] when my mother decided to buy that house, nobody knew where it was. It seems so far away. For a long time, we were the only chinese family there but we started to see the areas of growth to serve a larger chinese population. The stress was storage of the birthplace of that. My father would have to go to chinatown for dim sum and i remember one day he came home and said, there is one here now. It just started to grow very organically. It is the same thing with the russian population, which is another very large ethnic group in the Richmond District. As russia started to move in, we saw more russian stores. So parts of the richmond is very concentrated with the Russian Community and immigrant Russian Community, and also a chinese immigrant community. [ ] i think as living here in the richmond, we really appreciate the fact that we are surrounded three natural barriers. They are beautiful barriers. The presidio which gives us so many trails to walk through, ocean beach, for families to just go to the beach and be in the Pacific Ocean. We also also have a National Park service. We boarded the Golden Gate National Recreation Area so there is a lot of activity to do in the summer time you see people with bonfires. But really families enjoying the beach and the Pacific Ocean during the rest of the time of year. [ ] and Golden Gate Park where we have so many of our treasures here. We have the tea garden, the museum and the academy of sciences. Not to mention the wonderful playgrounds that we have here in richmond. This is why i say the richmond is a great place for families. The theatre is a treasure in our neighborhood. It has been around for a very long time. Is one of our two neighborhood theatres that we have here. I moved here when i was 1959 when i was two years old. We would always go here. I love these neighborhood theatres. It is one of the places that has not only a landmark in the Richmond District, but also in San Francisco. Small theatres showing one or two films. A unique they are unique also to the neighborhood and San Francisco. Where we are today is the heart of the Richmond District. With what is unique is that it is also Small Businesses. There is a different retail here it is mom and pop opening up businesses. And providing for the neighborhood. This is what we love about the streets. The cora door starts on clement street and goes all the way down to the end of clement where you will see Small Businesses even towards 32nd. At the core of it is right here between here and 20 tenth avenue. When we see this variety of stores offered here, it is very unique then of the any other part of San Francisco. There is traditional irish music which you dont get hardly anywhere in San Francisco. Some places have this long legacy of serving ice cream and being a hangout for families to have a sunday afternoon ice cream. And then also, we see grocery stores. And also these restaurants that are just new here, but also thriving. [ ] we are seeing restaurants being switched over by hand, new owners, but what we are seeing is a vibrancy of clement street still being recaptured within new businesses that are coming in. That is a really great thing to see. I dont know when i started to shop here, but it was probably a very, very long time ago. I like to cook a lot but i like to cook chinese food. The market is the place i like to come to once a year. Once i like about the market as it is very affordable. It has Fresh Produce and fresh meat. Also, seafood. But they also offer a large selection of condiments and sauces and noodles. A variety of rice that they have is tremendous. I dont thank you can find a variety like that anywhere else. Hi. I am kevin wong. I am the manager. In 1989 we move from chinatown to Richmond District. We have opened for a bit, over 29 years. We carry products from thailand, japan, indonesia, vietnam, singapore and india. We try to keep Everything Fresh daily. So a customer can get the best out a bit. Normally during crab season in november, this is the first place i hit. Because they have really just really fresh crab. This is something my family really likes for me to make. Also, from my traditional chinese food, i love to make a kale soup. They cut it to the size they really want. I am probably here once a week. Im very familiar with the aisles and they know everyone who is a cashier cashier here i know when people come into a market such as this, it looks like an asian supermarkets, which it is and sometimes it can be intimidating. We dont speak the language and many of the labels are in chinese, you may not know what to buy or if it is the proper ingredients for the recipe are trying to make. I do see a lot of people here with a recipe card or sometimes with a magazine and they are looking for specific items. The staff here is very helpful. I speak very little chinese here myself. Thinks that im not sure about, i asked the clerk his and i say is this what i need . Is this what i should be making . And they actually really helped me. They will bring me to the aisle and say this is battery. They are very knowledgeable. Very friendly. I think they are here to serve not only the Asian Community but to serve all communities in the Richmond District and in San Francisco. [ ] what is wonderful about living here is that even though our july is a very foggy and overcast, best neighborhood, the sleepy part outside on the west side is so rich with history, but also with all the amenities that are offered. [ ] announcer youre watching coping with covid19. Hi. Im chris manus and youre watching coping with covid19. Today my guest is anastasia klaste and were going talk about how the pandemic has affected our school community. Welcome to the show. Hi thank you. I understand that our students and teachers have adopted Video Conference as Distance Learning tools to be able to continue studying remotely and this is clearly new for everyone. Do you have some suggestions to students and perhaps their parents that could help them manage this new approach . I think the best advice i can give students and parents is to really be gentle on yourselves during this time. The thing we dont really want to do is increase stress and anxiety amongst our students because they know it is a scary, uncertain time aside from the work. So, we are engaging in Distance Learning and providing work for students to engage in. The Mental Health of students and their wellbeing and safety is really at the forefront of our minds and so were asking parents to keep an eye on their kids and also asking kids to speak up and let us know if theyre having trouble f they need to talk to someone, if they need to take a break or they need more time to do work. Because that is really whats most important for us. Right. And what would you say to teachers having a hard time adjusting as well . I think our faculty is really lucky in that we were already utilizing google classroom in all of our classes. So the switch from inperson to online is not as extreme as it may have been to some other faculties in other schools. That said, most of us had never engaged in Video Conferencing or done any sort of daily online lesson planning. So, i think the same thing i say to parents and students i say to teachers is to just be gentle and give yourself space and know its ok to make mistakes and its ok if youre not perfect and were all sort of learning and doing at the same time. So, that can also be anxiety provoking and that can be hard for taoefers that are used to being really good at what they do and knowing what exactly to say and how to do it every day are grappling with new technology and theyre finding that students [inaudible] what they do in person. Are there concerns about College Admissions for High School Seniors and juniors . I think at first there was a lot of sort of confusion and anxiety for juniors and seniors about colleges. And now that the system has come out with some guidance and we understand that, you know, the s. A. T. And a. C. T. Tests wont be required for the next year, we know that universities have only agreed to accept credit or no credit or passno pass grades and looking at students across the country knowing that were in unprecedented situation now that weve got guidance of clarity around that. Students are feeling a lot more comfort. Comfortable. For our current seniors, most of them got their College Acceptances in february and march so those things shouldnt be changing that much. For juniors, you know, now that they know that they have to step it up for the next year because the grades that theyre getting this semester may not be letter grades, it might be a passno pass, creditno credit. But it seems from everything that i read or hear, theyre working really closely with School Districts to make sure that no student is, you know, adversely affected by the pandemic because of this sort of universal experience for all students. Indeed. I heard that some kids are worried that they may have to make up the work or retake the whole year . How likely are those scenarios and how will grades be assigned for this semester . Well, San Francisco unified has made a decision through the board of ed that there will be a signing. Creditno credit for 6 through 12th graders and that means that basically they will either full credit for the glass or wont receive credit for class, based on the work that they do and that goes into a gaap of neutral so it shouldnt raise or lower any specific students g. P. A. , but just give them credit toward graduation. From what i can tell, california has been pretty clear that no student will have to retake this year. As educators, we do acknowledge that thereby a little bit of catchup happening in the fall. Right. Have your students had a variety of different experiences during this pandemic . Yes. I would say definitely. Our school serves a big atrisk group of kids. We have students from every zip code and city, basically. And students from all sorts of backgrounds and socioeconomic statuses so on one hand they have their high speed wifi and its no problem for them to hop on a zoom call or get their google docs turned in and then we have a lot of situations where they may not have wifi so theyre delivering hotspots or they have a device but it is shared among several siblings or the parents are using it during the day and the kids have only a certain amount of time that they can engage. So, you know, something that the teachers have talked about being mindful of and im definitely being mindful, as a principal, is that our students are in various situations and we cant assume anything about their access in their ability to [inaudible] right now. For some of them, theyre caring for siblings or grandma, living at home. Many of them have family members affected by covid and so theyre in a space where theyre really just trying to take care of those around them. And academics are sort of on the backburner and for right now thats ok. You know, we sort of support them in whatever way they need. I understand. Have you been able to provide any Technical Assistance to your students or faculty . Yes. The School District had hotspots so i personally delivered about 50 chrome books to students and now were getting hotspots, which are wifi devices that utilize cell phone coverage in an area so homes that dont have wifi or homes that have spotty wifi can use these hotspots and the kids are saying that they work really well and now the district just got a bunch of them so were able to list them. So any family that needs them right now, which is really great. Now all of our faculties have access to high speed wifi and technology at home. We are providing them with the technology that they need to be engaged in this. I see. And finally s there any news about Summer School . There is. Sort of. Its happening. In some way, shape or form. But we dont really know how or where. Im assuming it will be online and, as usual, seniors or kids about to graduate will be prioritized so therell definitely be some Summer School, im just not sure where or what at this point. But theyre going to share information about that pretty soon. Unfortunately all the fun summer programs and jobs, the arts programs and language programs, the acceleration programs are probably not happening. But there will be some sort of Credit Recovery option for kids who need it. Right. Well, thank you for coming ton show. I really appreciate the time youve given us today. Yeah. Great talking with you. Thank you so much for having me. That is it for this episode. Well be back with more covid19 related information shortly. Youve been watching coping with covid19. Im chris manus. Thank you for watching. [music] San Francisco city clinic provides a broad range of Sexual Health services from Stephanie Tran medical director at San Francisco city clinic. We are here to provide easy access to conference of lowcost culturally sensitive Sexual Health services and to everyone who walks through our door. So we providestd checkups, diagnosis and treatment. We also provide hiv screening we provide hiv treatment for People Living with hiv and are uninsured and then we hope them Health Benefits and rage into conference of primary care. We also provide both prend post exposure prophylactics for hiv prevention we also provide a range of womens reproductive Health Services including contraception, emergency contraception. Sometimes known as plan b. Pap smears and [inaudible]. We are was entirely [inaudible]people will come as soon as were open even a little before opening. Weight buries a lip it could be the first person here at your in and out within a few minutes. There are some days we do have a pretty considerable weight. In general, people can just walk right in and register with her front desk seen that day. My name is yvonne piper on the Nurse Practitioner here at sf city clinic. He was the first time i came to city clinic was a little intimidated. The first time i got treated for [inaudible]. I walked up to the redline and was greeted with a warm welcome im chad redden and anna client of city clinic even has had an std clinic since all the way back to 1911. At that time, the clinic was founded to provide std diagnosis treatment for sex workers. Theres been a big increase in std rates after the earthquake and the fire a lot of people were homeless and there were more sex work and were homeless sex workers. There were some Public Health experts who are pretty progressive for their time thought that by providing std diagnosis and treatmentsex workers that we might be able to get a handle on std rates in San Francisco. When youre at the clinic youre going to wait with whoever else is able to register at the front desk first. After you register your seat in the waiting room and wait to be seen. After you are called you come to the back and meet with a Healthcare Provider can we determine what kind of testing to do, what samples to collect what medication somebody might need. Plus prophylactics is an hiv prevention method highly effective it involves folks taking a daily pill to prevent hiv. Recommended both by the cdc, center for Disease Control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. I actually was in the project here when i first started here it was in trials. Im currently on prep. I do prep through city clinic. You know i get my tests read here regularly and i highly recommend prep a lot of patients inclined to think that theres no way they could afford to pay for prep. We really encourage people to come in and talk to one of our prep navigators. We find that we can help almost everyone find a way to access prep so its affordable for them. If you times we do have opponents would be on thursday morning. We have two different clinics going on at that time. When is womens Health Services. People can make an appointment either by calling them a dropping in or emailing us for that. We also have an hiv care clinic that happens on that morning as well also by appointment only. He was city clinic has been like home to me. I been coming here since 2011. My name iskim troy, client of city clinic. When i first learned i was hiv positive i do not know what it was. I felt my life would be just ending there but all the support they gave me and all the information i need to know was very helpful. So i [inaudible] hiv care with their health about a quarter of our patients are women. The rest, 75 are men and about half of the men who come here are gay men or other men who have sex with men. A small percent about 1 of our clients, identify as transgender. We ask at the front for 25 fee for services but we dont turn anyone away for funds. We also work with outside its going out so any amount people can pay we will be happy to accept. I get casted for a pap smear and i also informed the contraceptive method. Accessibility to the clinic was very easy. You can just walk in and talk to a registration staff. I feel im taken care of and im been supportive. All the information were collecting here is kept confidential. So this means we cant release your information without your explicit permission get a lot of folks are concerned especially come to a Sexual Health clinic unless you have signed a document that told us exactly who can receive your information, we can give it to anybody outside of our clinic. Trance men and women face really significant levels of discrimination and stigma in their daily lives. And in healthcare. Hiv and std rates in San Francisco are particularly and strikingly high were trans women. So we really try to make city clinic a place that strandsfriendly trance competent and transwelcoming everyone from the front desk to behind our amazement there are completely knowledgeable. They are friendly good for me being a sex worker, ive gone through a lot of difficult different different medical practice and sometimes they werent competent and were not friendly good they kind of made me feel like they slapped me on the hands but living the sex life that i do. I have been coming here for seven years. When i come here i know they my services are going to be met. To be confidential but i dont have to worry about anyone looking at me or making me feel less a visit with a clinician come take anywhere from 10 minutes if you have a straightforward concern, to over an hour if something goes on that needs a little bit more help. We have some testing with you on site. So all of our samples we collect here. Including blood draws. We sent to the lab from here so people will need to go elsewhere to get their specimens collect. Then we have a few test we do run on site. So those would be pregnancy test, hiv rapid test, and hepatitis b rapid test. People get those results the same day of their visit. I think its important for transgender, gender neutral people to understand this is the most confidence, the most comfortable and the most knowledgeable place that you can come to. Onsite we have condoms as well as depoprovera which is also known as [inaudible] shot. We can prescribe other forms of contraception. Pills, a patch and rain. We provide pap smears to women who are uninsured in San Francisco residents or, to women who are enrolled in a statefunded program called family pack. Pap smears are the recommendationrecommended Screening Test for monitoring for early signs of cervical cancer. We do have a fair amount of our own stuff the day of his we can try to get answers for folks while they are here. Whenever we have that as an option we like to do that obviously to get some diagnosed and treated on the same day as we can. In terms of how many people were able to see in a day, we say roughly 100 people. If people are very brief and straightforward visits, we can sternly see 100, maybe a little more. We might be understaffed that they would have a little complicated visits we might not see as many folks. So if we reach our target number of 100 patients early in the day we may close our doors early for droppings. To my best advice to be senior is get here early. We do have a website but its sf city clinic. Working theres a wealth of information on the website but our hours and our location. As well as a kind of kind of information about stds, hiv,theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for 15, 40 75500. The phones answered during hours for clients to questions. I love teaching. It is such an exhilarating experience when people began to feel their own creativity. This really is a place where all people can come and take a class and fill part of the community. This is very enriching as an artist. A lot of folks take these classes and take their digital imagery and turn it into negatives. There are not many black and white darkrooms available anymore. That is a really big draw. This is a signature piece. This is the bill largest darkroom in the u. S. There are a lot of people that want to get into that dark room. I think it is the heart of this place. You feel it when you come in. The people who just started taking pictures, so this is really an intersection for many generations of photographers and this is a great place to learn because if you need people from different areas and also everyone who works here is working in photography. We get to build the community here. This is different. First of all, this is a great location. It is in a lesspopulated area. Of lot of people come here just so that they can participate in this program. It is a great opportunity for people who have a little bit of photographic experience. The people have a lot, they can really come together and share a love and a passion. We offer everything from traditional black and white darkrooms to learning how to process your first roll of film. We offer classes and workshops in digital camera, digital printing. We offer classes basically in the shooting, ton the town at night, Treasure Island. There is a way for the programs exploring everyone who would like to spend the day on this program. Hello, my name is jennifer. My name is simone. We are going on a field trip to take pictures up the hill. Cmon, cmon, cmon. Actually, i have been here a lot. I have never looked closely enough to see everything. Now, i get to take pictures. We want to try to get them to be more creative with it. We let them to be free with them but at the same time, we give them a little bit of direction. You can focus in here. That was cool. If you see that . Behind the city, behind the houses, behind those hills. The see any more hills . These kids are wonderful. They get to explore, they get to see Different Things. We let them explore a little bit. They get their best. If their parents ever ask, we can learn they can say that they learned about the depth of field or the rule of thirds or that the shadows can give a good contrast. Some of the things they come up with are fantastic. That is what were trying to encourage. These kids can bring up the creativity and also the love for photography. A lot of people come into my classes and they dont feel like they really are creative and through the process of working and showing them and giving them some tips and ideas. This is kind of the best kept secret. You should come on and take a class. We have orientations on most saturdays. This is a really wonderful location and is the real jewel to the community. Ready to develop your photography skills . The Harvey Milk Photo Center focuses on adult classes. And saturday workshops expose youth and adults to photography classes. Great. Commissioner chung is here too. Yes . Mr. Chung commissioner chung thank you, i thought it was a statement. Clerk so all were doing is waiting for commissioner christian but i spoke to her and shes on her way. So lets move on. Move to item 2, commissioner . President bernal yes, you have the minutes from the tuesday september 1st meeting in front of you, thanks again to dr. Lloyd green for chairing that meeting in my absense be. And, commissioners, Public Comment . Clerk those of you on the Public Comment line press star, 3, to make a comment on the minutes. Star, 3. All right, no hands raised. So we can move on. President bernal upon review of the minutes, commissioners, a motion to approve. So moved. Second. Clerk i will do roll call vote. [roll call] great, the item passes. Next is the report. Im sorry . Is it okay if i call out . President bernal yes. On the minutes. Clerk okay. So the next item, number 3, the directors report. Good afternoon, commissioners. The director of health, and i will summarize and take any additional questions. Theres a lot going on in the world of Public Health. Some good news, september 9th the Supreme Court upheld proposition c, which will free up hundreds of millions of dollars for funding for homeless services, including a significant amount that will be dedicated to the behavioral Health Services for homeless individuals. So we are looking forward to hearing more on the legal opinion of that. But good news in terms of more resources for Behavioral Health issues where they intersect with people who are experiencing homelessness. And we are currently gathering more information to determine how quickly those funds, if and how quickly those funds will be available. And im happy to report that to the commission when we have that information. With regard to 19, we are continuing on our gradual safer reopening based on the latest data and science. For instance, as of today, we have after opening up a number of places earlier this month, as of today we have indoor activities, including personal grooming services, very limited indoor gym and personal trainer activities, and then we museums may open potentially as soon as september 21st, obviously, with safety guidelines in place. We are also moving forward with school reopenings. Schools that were submitting safety plans and well start with a ksixth grade and a move to middle school and then high school and a gradual reopening. And the team has been working very hard on that. Well cover more covid19 issues in detail further on in the agenda. Good news on the front with regard to h. I. V. We released our h. I. V. Report in 2019, and we achieved a record low of 166 cases of h. I. V. In the city. This is a 19 decrease in new diagnosis since the Previous Year and declines were seen across almost all groups, including among black African Americans, people who are on drugs and people experiencing homelessness. There continue to be inequities with in a spike of crimes and of our goal of getting to zero with other h. I. V. Programs. In regard to work in the covid19 pandemic with regard to research, we also were able to collaborate with with u. C. San francisco, the Latino Task Force on covid19, and d. P. H. , and with supervisor Hillary Ronen and the biohub, which conducted testing in a transit hub, at 24th Street Mission plaza, found very high rates of positivity among the latino population at that at that site. Consistent with the findings that we continue to see high inequities of covid19 diagnoses among latinos who constitute 51 of current cases. We are focusing to looking at our prevention and care response, including through increased access to testing. As i previously described we now have mobile popup sites with testing expanding to multiple neighborhoods with high rates of covid19 infection, including the mission, and visitation valley. And i just wanted to share the data that with regard to Contact Tracing and case investigation, 89 of latino cases have been interviewed with more than 90 of contacts interviewed since june. This is actually higher than the overall average. And then in keeping with our isolation and quarantine availability and ensuring that people have opportunities to isolate and quarantine if they cannot do so at home, up 46 of the residents in isolation at home or in hotels have identified as latino. I will stop there and well, actually, theres one other key issue that i do want to highlight in the directors report, which is that we have been working very diligently and in partnership at covid command with our partners at the department of Emergency Management with regard to air quality. And the intersection, obviously, of air quality and hit health, d ensuring that we are sending the messages that communities are being supported where necessary with facial coverings and that staff have the support they need in order to deal with what has been a very challenging couple weeks with regard to air quality. And also as of labor day with heat, unfortunately, given the effects of climate change, this is not the first time that weve had this, and because of covid command were more coordinated in our response than ever before. And other things in the directors report that i dont have time to read through today. Theres a number of press links, that im happy to answer any questions about. Thank you, commissioners. President bernal any comments . Yes, i have folks on the comment line. If you would like to make comment on this line, raise your hand by pressing star, 3, so well know. Give you a few seconds. All right, it looks like theres no comments to this item. President bernal all right. Commissioners, any questions or comments . I dont see any hands raised, but does anyone want to chime in. Clerk commissioner christian raised her hand. Commissioner christian thank you. Director, i wanted to ask very quickly if theres in an ongoing way, if theres any guidance that you can give the department can give to san franciscans about how to protect ourselves from the smoke and chemicals in the air, from the wildfires when we are not able to use the medical grade res re. And were not using them for smoke. Theres so much toxicity in the air and even when we dont smell smoke or when we see smoke, and that, obviously, as the Department Tells us, weakens the pulmonary systems, makes people more vulnerable to covid and to flu and to everything else. So, you know, obviously theres a correlation but we dont have the protective measures that we would like to in order to protect ourselves from that. Given that we cant use the medicalgrade rerespirators, is any guidance that you could give to us how we can fortify our masks, or our cloth masks, anything that we could do traveling to and from work or out by necessity to protect ourselves . Thanks. Thank you, commissioner. We do have guidance, its somewhat complex given the air quality and different populations that are at risk, depending on the air quality. But i can certainly provide you with that link and we can make sure that we get it before this meeting is concluded to share with the commission in terms of exactly what youre asking for. So ill make sure that we get that before the end of this meeting. Commissioner christian thank you. And also just continuing the great work that youre doing about getting information out to the Community Every day. So, thank you so much. Absolutely, thank you, commissioner. President bernal commissioner chow. Commissioner chow yes, i just wanted to make a comment to commend the department and dr. Colfax on the h. I. V. Report. And i understand that were going to hear it in our next meeting, but i didnt think that we should let that go without commending the work thats been done there. Its tremendous. And even though we havent quite gotten to zero, at least for some of us who have been around for a while, this continues to be an amazing trend. And in the face of it getting harder as we get smaller and smaller numbers. So, again, kudos to the department and we really look forward to seeing the report next meeting. Thank you. President bernal commissioners, any other questions or comments . I just have two quickly. Director colfax, first of all, i wanted to second what commissioner chow had said about the h. I. V. Report, its a very Promising Development as we continue to see decreases yearoveryear. And its a testament to the excellent work that the commission and the department has been doing on an ongoing basis. Seeing dr. Buckbinder, Susan Buchbinder on the agenda to speak about our vaccine work reminds me not only of the wonderful work that the department across all areas does, but the additional burdens and the additional stress thats placed both on staff from the executive staff throughout all of our programs to our frontline workers. Can you just sort of characterize how the staff is doing, are they experiencing, you know, fatigue . Are there resources that the commission or support that the commission can offer in order to support them personally as they do their critical work and network . Well, thank you, commissioner bernal and i appreciate the question. I think that as you said this is a marathon. And i think that were in a stage now where were, i dont know, the 10th or 15th mile. And this is where, you know, some of the adrenalin, institution adrenalin, is starting to wear off and people are really, you know, i think that some people are dog tired, to be totally candid. Were digging deep. I think that theres resilience among the d. P. H. Team, and as importantly, and more importantly, the Community Partnerships are in this response. And we are looking at im looking at what can we continue to do and what are some things that may need to be potentially delayed in the Department Just because we have so many Different Things going on. And covid19 is, obviously, paramount in our need to respond. So i think were looking at that. And that hearing that if there are certain components not so much service delivery, because you know, with the board support we are not cutting any services, even though its a challenging budget environment. But other things that can be delayed in response to our covid19 needs. We have hundreds of people working at covid command. All those people have very very busy jobs before they were put into covid command. And they are very busy there as well. But, certainly, i think that the capacity for the department to do everything at the same time is really challenging right now. Again, we are used to working in a scarce in an environment of scarcity and thats sort of where Public Health has been for many decades. So i think that we can be responsive and continue. But we really do need to be taking a look at other things that if they dont have to be done this week or this month, can we delay them without, obviously, harming the Public Health. Ill just give you a concrete example. As we enter the fall, in addition to the smoke, were really looking at how do we ensure that we have a comprehensive response to the flu, right, you know, whether the flu vaccine and education efforts and outreach efforts. Those efforts have always been incredibly important, but more important now than ever because we dont want a twindemic of covid19 and flu. So were pulling staff from other areas and actually working across other city departments through our Emergency Response to see if we can provide bring in more essentially more bodies with the right background, of course, but more capacity in order to address this very important issue. So, yeah, i think that as we saw with h. I. V. And i appreciate, obviously, dr. Buchbinder is an International Leader in this work and i think that our h. I. V. Response is building into the institutions memory, which helped to respond to covid19 in the way that we did, we can and we will get through this, but its a long way to go. And i would just ask for the commissions support. Obviously, you know, guidance, and also just ensuring that that people on the frontlines hear that what you care for you support, and most importantly that you understand. Thank you. President bernal and dr. Colfax, i believe that i speak on behalf of the entire commission in expressing our gratitude and support to all of the d. P. H. Staff who have not only taken on dual roles during the pandemic, but keeping the Department Going in the midst of the pandemic. Wed like to make this an ongoing discussion, so please be sure to bring to us anything that we might need to know in how they might be supported in ways they can ensure that they know how grateful we are to them and how much were cheering for them. And thank you, and thank you to everyone at d. P. H. Dr. Colfax, one more question, and you mentioned during your report the disparities that the latino communities are experiencing in the pandemic, certainly, in terms of our transmission in the community. We know that there are a lot of different factors that lead into it, whether its being an essential worker, someone who cannot work at home, People Living in congregate settings, can you tell us about the engagement thats been happening with the community in order to address this and how were moving forward with this . Yes, so as the commission knows since the beginning of the pandemic, we have been focused on the communities most affected by covid19 and we identified early on that the communities at greater risk for covid19 would include the communities at greater risk for other poor health outcomes. And, of course, the stigma, the discrimination and the xenophobia and the environment in which were living in, particularly with regard to including and perhaps particularly with regard to immigration, San Francisco is obviously a sanctuary city and the department provides health care for everybody, regard regas of immigration status. But these are all factors that are contributing we believe to covid19 spread. From the beginning at covid command, we had we had an equity officer and efforts to engage across the city departments and not only at the department of Public Health but with h. R. C. , and the department of Emergency Management and the Human Services agency and others that we were engaging with Key Stakeholders in different neighborhoods with c. V. O. S in order to strengthen our response. As we focused on getting testing initiated and scaled up, we ensured that testing was made available to anyone who was working in the city, including people who are not able to shelter in place for various economic or other reasons. The testing was available because we knew from early on that working during the pandemic is potentially a risk factor for infection. So our broader response, as i mentioned in my directors report, including have included strengthening our Contact Tracing and partner notification in collaboration with really the organizations. Providing those isolation and quarantine hotels. But it is also evident is that we must invest and strengthen our testing efforts in communities where covid19 is most project. Frequent. And we must do better. In fact, we are working with a member of Key Stakeholders and leaders in the Latino Community to develop a communityled communityfocused strategy on how to more meaningfully and sustainably to address the fact the fact that 51 of our pandemic in San Francisco is in the Latino Community. All covid19 response Going Forward must be a latino covid19 response. Clerk . President bernal thank you. I know that well hear more about this in upcoming meetings. Commissioners, any other questions or comments for the director . I do not see any. So, thank you, director colfax. And we can move on to our next topic, covid19 update. Thank you, commissioners. And for this update we have i believe a number of items. We have my update in terms of going through and describing the epidemiology and then i believe that our Health Officer dr. Tomas aragon, and then dr. Susan buchbinder with an update. And to provide you with the latest update since two weeks ago, our last meeting we have exceeded our number of 10,000 cases in San Francisco. Were currently at 10,430 covid19 cases with, unfortunately, 91 deaths due to covid19. In terms of our testing and case numbers, our testing numbers were at 3,401, sevenday average test collected that. Has dropped just slightly over the past week or so. We were almost to 4,000. Just a note here that we had to reschedule and sometimes cancel some testing events due to the incredibly poor air quality. So hopefully those numbers will continue we have capacity to expand beyond the average that youre seeing here provided that weather conditions improve. And were also starting to strengthen our ability to support staff in increment levels in these testing situations. Of course, the smoke is one thing, but as we hope that there will be rain, and we need to make sure that people have an ability to support those testing sites, even in inclement weather. Our sevenday average percent positive is 2. 36 . And then as we have talked about already, we see the distribution of cases and that inequity that is really highlighted here with regard to latino cases. I would also add that this disparity is something that is being seen regionally across the state as well as nationally. Next slide. So this is a slide that really i think that shows the commissioners how we are shifting our testing focus as we invest more in testing. Our popup sites, these are sites that mayor breed announced a month or so ago actually six weeks ago now. The capacity up to 250 tests a day, and we have basically worked with community partners, Neighborhood Partners to establish the popup sites in different neighborhoods across the city. You can see the cumulative positivity is nearly 4 . And then again you can see the positivity among latino clients is very high in some cases higher than the average positivity in all cases of these popup sites. And so as we continue to expand testing in these neighborhoods, particularly the southeastern part of the city, invest more testing resources, we do believe that we will be more responsive, increasingly responsive to the fact that we need to be doing more testing where the virus is actually concentrated. When you compare that to our numbers with regard to our site with the city test s. F. Sites, you can see the numbers of tests that have been done there recently. And you can see that those positivity numbers are low. And, once again, the positivity among the latino clients is high higher than the average overall, but even there not as high as it is despite that theyre not as high as they are at the popup sites. Next slide. This is the county covid19 comparisons of similar size. At this point you can see our cases relatively low, with the exception of king county, the rate below San Francisco. And the death reas rate thankfully is low compared to the other jurisdictions. And our testing numbers with the exception of new york city which in this iteration lags a bit higher than us, with many more tasks before the data is available. Next slide. This is our hospitalization patterns since the beginning of the pandemic. Youre familiar, obviously, that we lowered the curve through june. We had that surge starting in july. Peaking in early august and continuing into the beginning of september. We started to see a decrease down to 51. Those numbers are slowly creeping up again as you can see that were at 76 cases. And we are looking at that very carefully, especially with regard with the heat, the smoke, the Labor Day Holiday and we saw a lot of crowds in a lot of areas. Were watching this. Obviously, we know how to San Francisco knows how to reduce the curve. Weve done it twice now. With social distancing and the masking and the hygiene and avoiding gatherings, and the being outside. If people do gather instead of being inside are really, really key. We know that it works. And what is striking also about this chart is really that the virus is very responsive to our interventions. I think that sometimes in the context of how we are responding to and thinking about covid19, this gives hope because we hav have this can actually be be controlled. Certainly, slowed, if not not stopped, but at this point certainly slowed. Next slide. These are indicators. These are stats which go to high alert, red, for our increasing covid19 hospitalizations. Again, watching that very, very carefully. That is a concern. We will see how it goes over the next few days. Our Hospital Capacity remains good. You can see that theres 28 and 37 numbers. Our case rate remains stubbornly high. Its and down a little bit. And that number got significantly higher a number of weeks ago and were now down to seven, so were watching that. And our testing numbers have already went through and our Contact Tracing and partner notification numbers are creeping up in a positive direction now at 82 each. And then our personal protective equipment, 30day supply is at 100 . This is our this is a slide from dr. Peterson and joshua saab at u. C. Berkeley. And it tracks the reproductive rate of the virus with some of the key interventions. And the calendar dates that have happened since and you can see that shelterinplace is associated with a steep decline and the reproductive rate. We went down then to a reproductive rate that was as low as. 84 . And you can see that another slide there we saw, unfortunately, an increase in reproductive rate commensurate following that memorial day weekend. And then you see, again, that we reduced the reproductive rate commensurate with that hospital slide that the hospital occupancy slide that i just showed you, going down through midaugust. And i will take you to the next slide, please. This is our reproductive rate through september 13th. We hit a reproductive estimate of lower at that point, at the lowest point. 86 , but a few days ago that number is now creeping up and were now at. 88 . With just that at the very corner at the end of that slide, of of above 1 . So that reproductive rate, while going down is slowly rising again, commensurate with that increase in the rate of hospitalizations as well as as well as the estimate that we have here. So were watching that carefully. I will say that in relationship to some of the reopenings that we have announced and as of today that we have allowed, we at this time are comfortable moving forward on those, understanding that with more activity even though we are at lowrisk activities, were likely to see more cases and more hospitalizations. I believe that is the end of my presentation. Im happy to answer any questions here or if the commission would prefer to go through the next few presentations, i obviously defer to your pleasure. President bernal thank you, dr. Colfax. For those following along in the agenda, [broken audio] at the conclusion of the third presentation we will do Public Comment and then commissioner questions additionally. So we can take questions or comments from commissioners now. Commissioners, if you have a question or a comment, please raise your hand. Commissioner giraudo. Commissioner giraudo ed. D my question is in our last presentation on primary care clinics, for the positive cases from the zuckerberg child health center, there were 284 kids that were positive. So did we have any other statistics for the positive rate for children in throughout the city . Is it on the rise . Or do we do we know . I was just a little surprised with the number. Commissioner, thank you for the question. We do have those numbers available. I will get them for you. There has been a shift to a Younger Age Group with covid19. Especially with schools reopening, i wouldnt be surprised to see with the increased monitoring and potentially testing that we would continue to see increase. We can get you those numbers and ill be sure to include those in my next update. Commissioner giraudo ed. D thank you very much. President bernal commissioners, any other questions . Director colfax, i did have a question with regard to the states new blueprint for a safer economy. We know that at the end of last month the state had moved away from the launch list and had moved to various risk levels and we were put in this substantial category, which is the second highest after widespread. We had seen that some of the data would suggest that we we should have remained in the widespread category, but the state had put us in a lower one. Have there been discrepancies in the data, or is that all been resolved . Thank you, commissioner and dr. Aragon im sure can fill in any Additional Information that i leave on the table here. But just i guess that the way that i think about it is that the god news is that were doing a lot of testing in San Francisco. Were doing far more testing than any of our surrounding counties and very possibly than any other county in the state. When the state came up with our colorcoded system, and purple being the highest risk category, and red being the next highest risk, it basically discounted based on testing rates. So if counties were doing high amounts of testing, they adjusted to the amount of testing. They overadjusted for us. So they basically take our k3 and multiply it by. 65 and when we do the analysis, though were doing a lot of testing, our discount rate is more appropriate to be. 85. So 20 over adjustment based on the case. So bottom line is that we have a higher Disease Burden than is reflected in our determination of the state that we are a red zone. We are more like a purple county in terms of our Disease Burden. And so we have to continue to be cautious as we reopen, which is one of the reasons that we are not at this time comfortable moving forward with reopening all of the potential activities that could be reopened in the red zone. Obviously, the state had to come up with a scheme that fits the entire state and, of course, because were San Francisco, we are different and we are looking at our local data and local epidemiology. And, again, in our situation the adjustment of the state overcompensated for our testing rate, the Disease Burden is more of is more in keeping with a purple county. Then, again, ill dr. Adnan pachachi aragon to provide more context. He and others in the department have done extensive analysis on this. President bernal and then just one last quick question. The recent increases that we have seen in hospitalization, we believe that its too early for that to be attributed to gatherings over labor day, that if we see any impacts on that it would be a little further down the road . Its plausible that some of that is, but at this point we expect to see increases in cases first with the hospitalizations. And the hospitalizations would typically occur 10 to two weeks after. Remember, hospitalizations are basically a reflection of where the virus was two weeks ago. So its too early to determine what the effects of labor day are going to be. President bernal thank you, director colfax. Commissioners, any questions or comments for director colfax before we move on to the next part of the presentation. All right, we can move on to dr. Susan buchbinder. Thank you. So im going to talk to you about Covid Vaccine studies that we are sort of more looking at globally about what is happening nationally and internationally, as well what we are planning to do here. Next slide. So what is it that were hoping that a Covid Vaccine could do . Well, were hoping that it would benefit the individual by maybe preventing all infection in addition to just the sevirrity f illness and to create healthier communities. Next slide. So this is an electron micrograph of the covid the virus that causes covid. Its called a coronavirus because it has this crown or circle of light that is made up of these spiked proteins that you can see illustrated on the right. And virtually most of the vaccines that are being developed are really being targeted against this pro fine. And ill show you why in just a moment. Next slide. So this is a virus shown on the lefthand side of the slide and the human receptor shown on the right hand of the slide, a human cell. The receptor is the lock that keeps things out and the spiked protein has a key that opens up that lock. And so if you go to the next slide you can see that the when the virus attaches with the spiked protein inserting itself into the receptor, it opens up the cells to become infected. Next slide. So what were trying to do is to create to teach the body to make antibodies and cells that will help to prevent that from happening. So the green and the purple yshaped molecules that are attaching to the spiked protein are the antibodies that we would be developing against the spiked protein. You can see they prevent the spike protein from docking in the 82receptor by binding to the spike protein and protecting it against infection. So thats the way that vaccines might work. They could either train the immune system to create those antibodies, or we could just infuse antibodies by themselves. And ill get into that in a moment as well. Next slide, please. So this is how we test vaccines and other drugs. Theres a Preclinical Phase that is done in animals that isnt even showing up on this slide. And then by the time you get into human studies, you go through three stages of studies before a product is licensed. Phase one is where youre testing safety and the tolderrabilittolerabilityof tho. And that is usually smaller studies, less than a hundred people. And you get to phase two and youre looking at the best dosing schedule and what the immune systems response is like to the vaccine. And that is usually a few hundred to a few thousand people. And then phase three is where youre actually testing to see whether or not it provides protection against infection or severe disease. So what we need to do is to go through all three phases and what you have all heard about operation warp speed and how much this process has been accelerated. But i wanted to emphasize that the phases are not being skipped. What is happening is that the gaps between the phases are being shortened or eliminated. In some situations were doing joint phase one two studies or joint phase two three studies and some of the bureaucracy that happens between the phases is being removed. So that, for instance, we go to an Institutional Review Board for review of our protocols, usually those sit there for weeks while were waiting for them to be reviewed. Now theyre going to the top of the queue. And so theyre being reviewed very rapidly. So its not theres no skipping on phases. And theres no skipping on the Safety Measures that we build into the trial. And ill get into that also in a moment when we talk about the astrazeneca trial. Next slide, please. So this was the Coronavirus Vaccine tracker as of september 10th. If you look at it today you will see that the numbers have actually been bumped up even more. Youve got phase 25, and phase 1, 14, and phase three, that have been limited Vaccine Limited approval for use. Actually in todays tracker, there are five that have been given limited approval for use. Two of them are in china, one in russia, and two in the United Arab Emirates. All of those vaccines which have limited approval have not gone through phase two testing yet. So we dont have any data yet on whether or not these vaccines will survive protection. And we need phase three in order to make that determination. But you can see that there are nine vaccines in largescale ethicity testing. Next slide. So the way that were testing this is through the Covid Prevention Network or the covt. M. And it was formed by n. I. H. That is pulling together a variety of different sites that many of which were part of the h. I. V. Prevention and Treatment Network to form this new Massive Network of sites across the world. And we have three sites currently in the bay area. We have our site at the San Francisco department of Public Health and h. I. V. And theres a site over at zuckerberg San Francisco general. And ebac, the center has a site in oakland and theres a site at in San Francisco that may come on board soon. The mission of is to have ethicity studies to study covid 19 disease. And the plan is to open up 5 phase three vaccine efficacy trials in 2020. Each roughly 30,000. Theyre very large studies. And infusing the antibodies themselves without using a vaccine but just jumping right to creating antibodies and infusing those directly into people. Those are smaller studies and theyre also currently underway. Next slide, please. So this is a map of the cov. P. N. And we have sites in soutsouth america and in africa. Next slide, please. And these are the five vaccine trials that are planned to be tested in the covpn by the end of the year. And i have highlighted the covpn astrazeneca trial because thats the first one that well be testing in San Francisco. Next slide, please. So what is the astrazeneca vaccine in well, its taking a chimpanzee virus, that causes a common cold in chimpanzees and its altered so it cant cause infection or disease in humans. What its used at is a carrier its a carrier device for bringing in Genetic Information about that spike protein. So that the cells in somebody who is vaccinated will create some snippets of the spike protein and train the immune system, if you see this in the future, and it would be that you see it as part of sars co2 infection, to fight this off and eliminate this. So its a way to train the system to eliminate the virus if its later if youre later exposed to the virus. We have seen that it triggers a strong immune response in individuals, both antibodies and immunicipaimmune cells. This is an older phase, and in phase one and two trials its been safe. You may have heard in the news that were on a pause right now because a participant in a phase two three trial in the u. K. Developed an unexpected illness that could be associated with the vaccine. Its not entirely clear whether it is or not. The evaluation is currently underway. The regulators in the u. K. Have reviewed the data and have made a determination that its safe to reopen the study, so its been reopened in the u. K. Its reopened in brazil and in south africa. But we have were still under review at the f. D. A. And with the monitoring board in the u. S. So were not open currently. It just opened in late august when it got shut down on september 6th. But this vaccine platform, the chimp virus that has been used in 14 different studies against a wide variety of infectious diseases. Next slide, please. So the astrazeneca trial is a phase three study. And it launched on august 28th of 2020. And recruitment was planned for eight weeks. Well be enrolling 30,000 participants, 20,000 will get the vaccine and 10,000 will get a saline placebo and a salt water placebo. We targeted 250 to be enrolled in each of the San Francisco sites and 250 in oakland. Its going to be recruiting people who are at risk for covid19 disease. Its generally otherwise fairly broad eligibility criteria, but excluded are children, pregnant and breastfeeding women, and people with prior or known infection with the sars or covid virus. People will get two doses of the vaccine, one month apart. And theres a final visit at two years. And they get weekly text reminders to report any symptoms so that if they develop covid at any time during the trial that we bring them in immediately, we test them to see if they do actually have covid. And then we do very, very close monitoring to be sure that theyre not getting sick. And we do that for both the vaccine and the placebo because we obviously want to take the best care we can of people who develop covid. Next slide, please. So we do have a number of challenges. Including antivaccine sentiments. And some of this is antivaccine in general, and you can see this person has antiCovid Vaccine sentiment. And has a sign tha, which, unfortunately, it doesnt appear to. So next slide. We do have a substantial concerns on the part of people about getting Covid Vaccine. This is from an n. P. R. Pbs poll done in early to midaugust. If a vaccine for the coronavirus is made available to you, will you choose to be vaccinated or not . And what you can see on the left is that 60 of all adults said yes, but 35 said no. And the rest were undecided. But there were differences based on political affiliation with democrats being more likely to say they would get the vaccine than the republicans. Next slide. Of concern is that there are also these racial and ethnic differences in peoples willingness to get the vaccine. We have heard from director colfax about the disproportionate impact that we have of covid19 disease in the Latinx Community and nationally as well in black African Americans. And so we do have real concerns that there may be considerably hesitancy about getting a vaccine from the very populations that may well benefit from a vaccine. Next slide, please. So were doing a lot of Community Engagement and we have a series of listening sessions and town halls with Community Members. We have launched a local website called wecanbeatcovid. Org and we have a spanish version of it. Nationally we have the coronavirus Prevention Network website that people can sign up to be part of the study. And they are launching campaigns now with people in advertising and they have a faithbased initiative. Next slide, please. So we do want to ensure that the recruited population requests the local and National Epidemic and that is true by race and ethnicity as well as by age. Theres a target of at least 25 of the population should be five years of age or older. But well be well be enrolling people with all kinds of exposures to sars cov2. Next slide. This is the covpn website. They have a registry, and already over 9,000 people signed up just for the San Francisco bay area and that distribute include the east bay that had another 11,000 people sign up. This was a couple weeks ago. And people continue to sign up. So we are using that as a way of doing outreach to individuals who may be interested in participating in the study. And because we have the demographics of the individuals that are signing up, we can specifically select for our priority population. Next slide, please. And this is the last slide. This is our website. I encourage you all to go to it. Its wecanbeatcovid. Org. This is artwork done by a local latino artist. So, thank you very much for your attention. Im happy to take any questions. President bernal thank you, dr. Buchbinder. Commissioners, any questions or comments. Commissioner green. Commissioner green m. D. well, first of all, this was an absolutely fantastic presentation. I have to compliment you on making it so easy to understand, really clear. Its really, really wonderful. And i am so grateful to you. And i hope that it be shared maybe for a broader audience, because it really helps people to understand what youre trying to do. I guess that i had three questions. One would be, and more sciencebased weve always had issues with the older population not responding to at least the flu vaccine. And what the thinking is about these particular vaccines . Because i dont know enough about the platforms to know whether the flu vaccine. Or the issue is the virus that people have been exposed to so they dont respond. And the second would be whether this person that got this, it could be an autoimmune response to the component and what the thinking is among the scientist there is and what the tolerance really is for that type of, you know, what is the denominator that is tolerable for that . And then the third would be and this is more in terms of public communication, you know, theres been so many articles written by people about how the Antivaccine Movement is really well organized, national, and kind of ready with their, you know, their prepared effort to kind of discourage people from undergoing vaccination. So im wondering what your sense is of the tools that we have, the incident to which the National Response to encouraging vaccination when we havent really had a National Response to the disease in general. How that will happen. And, if so, where will it come from . We were so good in the bay area to have our counties working together and we do have unique populations that we have to focus on. But id really love to understand what your perspective is and what is going on there. So if you dont want to answer on the medical end, thats fine, but im curious from the commissions perspective of the communication component. Sure, so im happy to take all three questions. In terms of the older population, we dont know whether theres going to be diminished response in the part of older people. We dont have as much data on the immune response yet from the earlier phase trials, because they started in younger people and then moved to older people. So thats why we want to be sure that at least 25 of the population enrolled in the study are over the age of 65 or older, so that we can be sure that the vaccine works in that group. Because theres a diminished immune response in people who are older. Probably irrespective of what the platform is. The second question that you asked was about the transverse myolitis, the illness in the woman that became ill as part of this phase two pretrial in the u. K. It is potentially an immune response. It is seen very rarely in vaccinations, and seeing a variety of different viral infections. We dont know whether theres something about this particular platform that might increase somebodys risk. Thats part of what the investigation is about, is to try to dig in and see if there are any other potential cases that have been reported as that in the press. Although we dont have a final diagnosis yet. Itthat has been reported to us. And then the antivaccine one is a challenging one. And the covpn has created a beautiful ad campaign, doing outreach, particularly to communities of color and to older communities. And also more broadly as part of a movement to try to encourage people to get vaccines and to do this as a way of really affecting the trajectory that we have of the covid pandemic. Theyre also doing outreach to the faithbased initiative, to faith leaders, to try to again, to encourage the trusted members of different groups to support vaccine science. But its going to be an uphill battle because there is really a strong antivaccine message. Some of which is general against all vaccines and some of which is Covid Vaccines specific. President bernal commissioner guillermo. Commissioner guillermo thank you, and thank you very much, dr. Buchbinder. I want to add my my compliments to dr. Green for your presentation and the work that is being done in San Francisco in regards to the vaccine trials. I want to dig just a little bit deeper on the makeup of the participants in the trial. You have indicated there is about 9,000 volunteers already signed up. And i was wondering if there is a way that you could share with us the data on the breakdown by Race Ethnicity and if theres any data on language and socioeconomic status for that data. Because its one thing to have an intent and an outreach effort, but to actually to have the participants in the trial reflect that outreach is really, really important, and not just for the covid19 vaccine, but sort of beyond this. So we can learn something in recruiting for these trials or for other trials in the future. So i wanted to know if you could share that data with us and if there are lessons that can be learned in terms of the outreach and targeting. And then the other question that i had was, with this network, this is a network of n. I. H. Funded trials. Do you have information about trials that are being invested in privately outside of the funding. Will that have an impact on what you learn or any coordination with the research thats going on that San Francisco is part of. And how might that be connected . Because its quite possible that we would have San Franciscos participating in other practice files and that information can be confusing to those who are were trying to recruit for San Francisco, or does it matter . So if you could answer both of those that would be great. Sure. So what we see is not unexpected that the demographics of the people who have signed up are heavily skewed white. And skewed towards english speakers. Although they have the covpn website in spani spanish as welo people can sign up in both english and spanish language. The good thing is that because theres over 9,000 people and were only enrolling 250, we can specifically prioritize those populations who we think that should have first dibs at the trial. And so we have been doing outreach to communities of color in particular and in particular to the Latinx Community. And weve gotten really quite a favorable response from many of the people. Not everybody, but many people are really eager to participate. We have all of our materials available in english and spanish at both our site and the zuckerberg San Francisco general site so that we can enroll spanish speakers as well as english speakers. Unfortunately, we only have it in those two languages. But it does at least broaden our ability to recruit into the trial. And were doing our own outreach in the mission, weve got a number of were doing a presentation with district 10. Were doing as much outreach as we can in our local communities and have our own website so that people can sign on by ourselves. I dont have more data on the socioeconomic status of the people who have signed up, but i do have the Race Ethnicity data. Do we know that Pacific Islanders are also recruited . Yes. Because the data on Pacific Islanders in particular is something that is of concern. Yeah. I understand that we have limited resources, but trying to get to populations that are most affected, then to leave out yeah. And elderly is probably not probably, would definitely be important. I completely agree. And we see the death rates in the older asian population is particularly high in San Francisco. But we need to be sure that we get a really Diverse Group of people who are offered enrollment in the vaccine and then they can make the decision whether or not they want to enroll. Your second question had to do with nonn. I. H. Funded trial. Theres the pfizer trial that is done outside of the covpn network, so thats a large ethicity study thats being done. There is a site in the south bay and in sacramento for that particular trial. What were trying to do is to do outreach to all of the local trials. So, for instance, we already have been working very closely with the site at zuckerberg San Francisco general and at evac and we have weekly calls where we do all of our coordination and a lot of outreach in between. Were doing a lot of outreach to the v. A. Site, and we dont want to cause confusion on the part of participants and it will be critical. Because the v. A. Site will be enrolling in a different trial. Theyre looking at a different trial. So we want to ensure that all of our Community Outreach and messaging is unified, rather than fragmented. President bernal commissioner chow. Commissioner chow yes, thank you so much for this information. I love the pictures and the spikes on the antibodies. But i was also following up on commissioner guillermos questions on a little more broader basis. It looks like the network that were all working with here is a network on your map that excludes a large part of the world in terms of studies. And im surprised, you mentioned england as one of the sites for the astrazeneca and yet theyre apparently not part of this. I think that this whole thing says, how do we really coordinate. And then were hearing that the federal government has already that by presumably by midoctober you should be ready to receive vaccines. So i think this is, again, part of a public trust. How do we then respond to the fact that were doing studies here, and, you know, it looks like this is something that we should indiscernible and were hearing about the western studies, but how do we know which vaccines then are going to be available through this process . And a third thing that we heard, which im not sthaw sure that is correct, is that distribution was not going to be through a private through doctors and their channels, but apparently, supposedly in commercial sites. And that im not even sure of. You know, these are all kind of what is floating around. So how do we gain back trust . This is one part of the presentation and, clearly, a very important part. And weve got at least as you say probably about half a dozen vaccines ready to go. But theyre all in different Little Pockets like this. So which of the six are we going to want to take . Yes, i think that this is a huge question. What ive described is really just a small microcosm, thats just testing the vaccine to see which ones work. Were not the only game in town. So i mentioned the Pfizer Vaccine because thats taking place in the United States, but theres a lot of vaccine trials in south africa and brazil and in the u. K. That are being done currently outside of the covpn. And there are studies happening in the United Arab Emirates and in indonesia, you know, so there are trials going on all around the world, the Different Countries response. And i was talking about what the covpn was responsible for. And in terms of distribution of vaccines, thats really going to be quite challenging. And i think that there are a lot of Unanswered Questions about exactly how that is going to happen. So im really at the earlier stage of all of this, which is just the testing to see whether or not we have a vaccine that is worthy of distribution but once we get one or more then theres also going to be the question, who gets which one. Because we wont have enough vaccine of type a for everyone, but we might have tap type a, bd and do they have different ethicity in different populations and we should prioritize type b for the elderly . Or prioritize type b for younger people . We just dont know at this point. So i think that its going to be a much more complex landscape as we move forward. I hope that answered it. Commissioner chow well, no, youve helped to frame the questions. And yet if these are going on at this time, at what levels then will our own local Health Department be involved . Either working with the state on how the state distributes, similar to i guess what the state did or thinking of doing with testing and has done with, you know, p. T. E. , although somewhat late. And if theyre really saying this is going to occur, whether it be october, november or december, thats not very long from now. This is early september. If we havent been able to answer these questions or possibly i should say who is going to answer these questions . And maybe, you know, i dont want to lay this right on you and in your lap, but perhaps we could move that question also to the departments leadership if you felt that would be more appropriate. Yeah, i think my hope is that it is going to come through the states and then through the city Health Departments. Because i think that we have an Important Role to play in prioritizing who gets vaccine first. We need to be sure that were getting it to the populations at highest risk. Commissioner chow so i guess that i will save the question to dr. Aragon to what levels we are at the moment involved in this dialogue. But i do want to compliment you on really being part of us all in this community being part of the studies that are going on. And the fact that so much has been done so rapidly and i think that is directly related greatly to the work that was done on h. I. V. And the ability to be able to identify these things. And now were really going at warp speed on these things. And much faster than 20 or 30 30 years ago and every step seemed to take about a year before we moved to the next step. Right, thats right. Commissioner chow its wonderful and congratulations and great to have you right there on board. Ill want your vaccine, i think. [laughter]. Well, ill be sure to save some for you. Commissioner chow thank you very much. Okay, thank you. President bernal thank you, commissioner chow. Commissioners, any other questions or comments for dr. Buchbinder . I want to say to dr. Buchbinder i echo my colleagues congratulations for making this so this information so accessible. I am not a medical person and i could understand it clearly. And its beautifully done. So thank you for the way that youre communicating it. Thank you. President bernal thank you. I think that we all agree, thank you, commissioner christian. Okay, if we dont have any other questions, dr. Buchbinder, thank you so much for your excellent and as said, thorough easytounderstand presentation and thank you to your whole team as well. We Love Learning about and supporting your work. Thank you. President bernal already, our third presentation, from dr. Tomas aragon, our county Health Officer. Clerk before we go, commissioners, those who raised your hands before, if you could press the same button to lower your hand so we know when they are raised for folks on the Public Comment line. Thank you very much. President bernal thanks, mark. Okay, god afternoon, commissioners. Today im going to talk to you about the Health Officer orders and the process. So we can go on to the next slide. So the first thing that ill do is to give you a couple slides i had to present recently because someone had a similar question about Health Officer orders. So the federal government collects taxes, can wage wars and can regulate commerce, all of the powers are vested in the states. So the States Police powers are used for Public Health authority. In california, Police Powers are delegated to the counties. We have 58 counties of the 61 health jurisdictions. By law every county must have a physician Health Officer for this purpose. Next slide. So Health Officers must provide communicable Disease Control, including the adequate isolation facilities and the control of the key Communicable Diseases based on provision of appropriate prevention measures for the particular Communicable Disease hazard in the community. Health officers are authorized to take control of contagious infectious or Communicable Diseases and may take measures as may be necessary to prevent and to control the spread of disease within the territory under their jurisdiction. So that phrase there takes measures as may be necessary, is very broad authority. And so that what gives us the flexibility to be able to do the different interventions to interrupt transmission. Next slide. And so im going to go ahead and i received some questions. Im going to take each one of these questions and ill give you a brief summary. The first was the processes for developing Health Officer orders and making decisions for reopening in various business entities if sa in San Francisco. First we start off with what the state blueprint for a safer economy, which is the new framework that the state is using for reopening. Theres another slide that well review some of that for you. So we start off with what the state allows us, and then we look at the department of Public Health priorities. And then we work closely with the City Attorney to help us to craft orders and then directive. And i want to distinguish between the orders and directive. The directives you can think of guidelines or guidance, that is very practical and flexible. But it has the force of law. So think of a guidance with a force of law. Thats a directive. And the order the order usually usually points to the directive. So the order stays constant, mostly constant, and then we adapt the directive because things are changing all the time, the knowledgebased the Scientific Evidence is changing. So we want to go ahead and adapt our directive. The reason that i spent time on this is that most counties do not do directives. And as far as i know, we may be one of the few counties in california to do directives. Because most counties are doing is an order will come out actually, some counties will do just do what state says. When the state comes out and gives guidance and lets counties do it, and the county will say, go ahead and do it. And some may tweak orders and say go ahead and do it. We go through the extra step of droppindeveloping directives. And then we work with guidance to actually provide guidance or tip sheets to complement the directives. So those things that we think that are good ideas, but it doesnt have the force of law behind them. Next slide. So the californias blueprint for a safer economy. So this is the new framework that was developed and you will see there that on the lefthand side, you will see it says adjusted case rate for assignment and testing positivity. So theyre using two metrics. The one is case count per 100,000. If you do a lot of testing, they multiply it down, they weight it down. So you have a suggested rate. So you look at that suggested rate and then the second one they do is testing for positivity. Like, right now ours is about 2. 3 i believe. So its relatively low. Whichever one is higher, thats what your assignment is. So as director colfax pointed out, epidemiologically were in tier one, the purple tier. But because they weighted us down, were placed in the red tier. So epidemiologic Communicable Disease perspective, that does not make sense. We would never say, for example, h. I. V. Is a good example if were out there testing h. I. V. And were finding more disease, guess what, if i see more h. I. V. Infection, i need more intervention. I dont need less intervention. We would not be down weighting those rates just because just because were doing more h. I. V. Testing. So it actually it doesnt make a rational basis. Their explanation for doing this was is that they wanted to discourage counties from undertesting because some counties have a different approach and they want to undertest to find less disease because they want a lower rate. So they balanced their motivation but it doesnt make sense from an epidemiologic perspective. So the way that were approaching this, saying, okay, epidemiologically were purple and we look at what we can open up under purple. And then we look at what is available to us under red and how to use riskbased criteria to open up those things that we believe that can be done safely. Thats a riskbased approach that were doing. So we started with Outdoor Activities and then lowerrisk indoor activities that were opening up just on monday. Were taking a rational approach. So in a sense its the best of both worlds because were taking advantage of what is available to us and doing it safely. Next slide. How does the Health Officer know that the city leadership and impact the stakeholders when decisions are made on Health Orders and reopening decisions. So we consult with subject matter experts. And so that happens that happens quite a bit, actually, just over the past few days we were consulting with genentologist around Skilled Nursing facilities and people who understand the implications of what were going to do. We work with the office of economic and work first development. Theyre fantastic at connects us to the different business entities in the community, especially the Small Businesses, and to work with them so when the directives are coming out we actually distribute them. We ask them is this going to work for you. Give us feedback, are we totally missing it . The other thing that happens is that the Mayors Office and the board of supervisors also gets feedback from constituents. Theyre sending them email. So they pass on all of this information. And then and then others others as needed. So we end up interacting with different business entities, depending what it is. So early on, for example, we interacted a lot with people who do tattoo artists, people who run gyms, restaurants. One thing about San Francisco is that everything is very personal. And so theres just a lot a lot of advocacy so theres a lot of interaction. Next slide. How concerns from the public are incorporated into revisions of the existing Health Officer orders and the decisions regarding reopening. So, again, the same basically almost the same answer which is the office of economic workforce development, the board of supervisors, the Mayors Office, gives us input from their constituents. As i mentioned before we meet with the stakeholders. When im at public im a public hearing, so, for example at the last Health Commission hearing i stayed for all of the Public Comments and i listened to all of that fee feedback. So its important to get that feedback. I get so many emails. I dont have time to respond to them, but i do i do try to read as many as i can. And that gives me some insight of what people people are thinking. And we try to incorporate this into our decisions, because people come up with really, really theyll see aspects of an issue that we dont see. Next slide. And since Economic Recovery Task force and subsidy, how will the Health Officer continue to interact with the business community. So so starting with our blueprint, well start with we start with our blueprint. That gives us access to what we can open. So that gives us an idea of what business entity were going to be working with. And, again, the office of economic workforce development, theyve been a really important partner with us. And then then i have here specific industryspecific engagements. So i pretty much i get contacted by all kinds of people. And sometimes, for example, oewd will say, you know, do you have time to meet with this group of people or that group of people. And i usually, you know, if i can fit it in, i do it. And so, for example, you know, i have met with unions, associations, coalition of Small Businesses. Theres all different ways that people are mobilizing and interacting. So thats been its very useful, especially when theyre organized, just because its efficient for them and its efficient for me when you get on a webinar and theres a whole bunch and they can give you a lot of feed back. They ask really tough questions that are difficult to answer. I dont always have the best answer. But i think that it is a good process to have that. I feel fortunatel fortunate fort reason. Next slide. Since there are so many issues to consider, how are topics prioritized for both Health Orders and reopening decisions. I would say that, first, we really start with the science and Public Health principles. And so we start really with the Health Commission. And the director of health and the department of Public Health strategic priorities. Thats really thats we start with those values, values and principles. We start with those. And then we interact with the Covid Command Center. So the Covid Command Center brings everybody together from the whole city. As dr. Colfax mentioned earlier, we have hundreds of people here in the Covid Command Center and it really it really requires the mobilization of not just our network, but h. S. A. , the homelessness department, its just so complex the amount of work and thought that goes into this is just amazing. I get to interact with a lot of other counties. And most counties do not have the level of involvement that we have. Sometimes it tends to be mostly around Public Health. We really have ours is a total city response. Which is which is pretty amazing. So i learned a tremendous amount. And then, of course, you know, im going to just share with you something that ive i made this up but its actually very intuitive when you think about this. I call it a how to checklist. And the first on Health Equity are true north colors from our quality improvement. As were processing different decisions, this is like a checklist to just make you think of things from a different perspective. It makes sure that were complete. So, obviously, were focusing on the Health Benefits and were focusing on equity issues. Ethical issues are really important. And a few years ago i gave you a presentation on Public Health ethics and how we use them. So thats really a critical issue when were making decisions. Were trying to make sure that were doing what is ethical. Efficiency issues are really important because we have limited resources and theres an opportunity cost, and to do one thing and not doing something else. Issues around legal exposures and then, of course, theres also logistical issues and then Political Support and then public Building Public trust. And so a lot of the interaction with the community is building the public trust. This is really important around vaccines and i just wanted to share that with you because its coming in handy over the years. Who is supporting the Health Officers orders, etc. . Is there one Consistent Team or does it vary . So, obviously, the Health Department subject matter experts, administrative support, the City Attorney has been phenomenal. I have i have a Bumper Sticker outside of my office that says i love Public Health lawyers and the love is in the form of a heart. I picked it up at a conference several years ago. Because a lot of Public Health is done through law. But i could have never worked around it as i do now. Most is around tuberculosis or isolating specific cases. But weve had the opportunity to really work intensely with the City Attorney around covid. And i have to just say that theyre phenomenal. Working seven days a week and working night and day and their attention to detail. So its a great synergy working with them. And i auswant to mention that the Covid Command Center, the information and guidance has been amazing. Its a juggernaut of a machine of processing, scientific information, and they have developed like, whenever were working on a work order, theyre working on guidance, they have a whole spreadsheet of whats available across the country. And they keep track of what is being produced across the country. And they systematically have a way of going through this and getting ideas and making sure that were really bringing the best practices as they develop guidance. At some point it would be great for them to give you a presentation. Next slide. And theres complex legalese. How do you make it easier to understand . I think this is a gap area for us. You know, information and guidance does try to make it more understandable, but its not at the level that it should be. Its still it still is it still has quite a bit of jargon. And everything gets translated, and everything is translated i believe into six languages. And then what happens is that the joint Information Center will take those high Priority Areas and then where this gets made more user friendly. And theres quite a bit of activity. And its not enough. And it may have been presented last time and theres a campaign that came out that just came out for different ethnic communities. So theres a lot more work in that area. Its these different areas where the concepts of visitation are really critical. And you have vulner adults. And the attorneys are trying to understand what is available under the constitution, especially around First Amendment rights and what the see wag we do locally. And we have guidances from other areas and we do consultation with subject matter x. And i put here for a noncomplex topic it might take one to two weeks. The first week is sort of doing the work. And then we take about five days just to get it reviewed by everybody. Because we need to understand that its coming to give concrete feedback if we need to adjust things. So theres this process that happens before it gets released. For a complex topic, i said two to four weeks and the reference is the longterm facility. So emergencies two to four days, there was one exception and the march 16th shelterinplace order happened even faster than that. Next slide. Can you provide Additional Information about reopening of schools, including commenting on whether we have available resources to conduct the necessary testing and Contact Tracing . So currently we have 75 waiver letters of intent for Elementary Schools to open. 28 applications have been submitted. Site assessments have started this week and so we expect the approved Elementary Schools to begin opening at the start of next week. And our covid command is developing an operational playbook. That actually puts all of this together that is going to include all of the issues around Contact Tracing and testing. And i just spoke to them today and they feel confident based on the experience learned in the summer with summer camps that they have a process that theyll be able to deploy with schools. I am not aware of any other county in the United States that is doing Site Assessments. Were doing a Site Assessment for every Single School before they open. And we really want i also want to mention to you is that for us this is an equity issue. And we feel were very committed to not only getting kids into school safely. And were getting ready for the spring when the School District hopefully opens up because the those lowerincome communities, communities of color, their schools are going to need a tremendous amount of support and so were gearing up to provide that support. And that includes health and safety plans, site visits, looking at ventilation, everything. So were being very comprehensive. And we have an amazing team. They are just i think you had a presentation that was phenomenal. And thats it. I just want to say that the number of people that are actually actually last friday they surprised me they asked me to give a talk with the Health Officer does and i did that and then its surprising but its just everybody. Its just i was just blown away by the amount of talent, commitment. This past weekend, the City Attorney i. N. G. , some of them were working to 4 00 in the morning to get everything ready for monday. So that we could issue orders and so businesses can open up. And they were just theyve said that on monday they were brain dead because they worked so hard over the weekend, but we got the job done. So, anyways, i just want to give a big thanks to them. Thats it. President bernal thank you, dr. Aragon, and to your whole team and everyone that you mentioned for your excellent presentation and being so specifically responsive to questions from commissioners. I understand that director colfax would like to Say Something before we move to Public Comments. Director colfax. Thank you, commissioner bernal. And Health Commissioners. I wanted to just add my gratitude and to acknowledge dr. Aragons leadership during this time. Hes not only brilliant, but humble. And hes been working right alongside all of the people that he mentioned. And i have to say that he was committed to doing his best and he has been working day and night from february on in addressing this pandemic. And not only the work that hes doing but across the region in regard to other Health Officers and the work that theyre doing. And hes also i dont believe that he mentioned it on this presentation but working in engagement with that. Yerks i see four hands m ill remind folk on the line, if kwr50 ud like to make a Public Comment right now, press 3 ill go in order of the hands i see. So i will unmute you. You should hear from your line. Caller 6, ive unmuted you. Can you hear me . Yes. I can. So ive got two minute on the clock for each of you. When the buzzer buzzings, please know your time is up. Were a San Francisco legacy. Which is 115 years old. We have 12 fulltime employees. Im also a board member of the district of merchants, a merchants association, made up of all the neighborhood merchants. A vibrant District Business is good for the whole city. We provide great, stable jobs, Health Benefits, support fulltime jobs and it becomes a place for the community to congregate. Every decision the Health Department makes has an enormous effect and of course, our employees and all of our community. Again, we are all part of the Public Health. We want to be at table with you making decisions. This weeks new openings brought great opportunity. Were really happy about t. But most of us heard about it through the media, not through the city. This is not very good. Wed like to hear about it earlier. The guidelines, in many cases, werent issued until yesterday morning, the day of opening. We want to do the right thing. We want to be reasonable ask have reasonable procedures for everything. For our benefit and for everybodys benefit. We cant learn about what has to be done at the very last minute. Guidelines should be easy to follow with an outline to go along with them because there are multiple [indiscernible] that can understand. And are very difficult. Time lines, of course, have to be outlined, too. And im talking about the outlines. The distribution of materials will be beeping . Please finish your sentence and your time is up, sir. We look forward to work wealth departmen workingwith. Thank you very much. Caller, ive unmuted you. I can hear you. Great. Youve got two minutes on the clock, sir. Thank you. Ill be less than that want my name is al wil will yams. President of the Bayview Merchants Association and Vice President of the District Council of merchants. I wont go over the points steesk just made, but we certainly say, that bayview has particularly been hard hit by covid and suffered the effects of social disparities over time. Bayview merchants, represent not only the business in the third street corridor in the southeast section, but all business interest in the bayview area. Greatly appreciate the work the department has been doing and working with supervisor walton and others around the covid issues. Im particularly impressed with dr. Buck finders report. The commissioners indicated, it was so, it was presented in a way that i could understand finally, what the whole thing was about. I would really encouraging in terms of working with stakeholders, if you would make that report available to groups like bayview merchants, and other merchant associations so we can get that information out, not only to our members but through them, they can give question that is come to them by their customers. Members of the community, in wanting to r to earn public trust. One way to do that is working through institutions and organizations like Bayview Merchants Association and it is other merchants associations. We also talked about wanting to group the Africanamerican Community more effectively. I think its important to precede the fact that a lot us are a little remember the tragedies of the experiments and the like, so keeping those historical circumstances in mind and using those to help educate would be very appropriate. Thank you very much. Thank you for your comments, sir and the presentation is on line on sfhc. Org. So the next caller. We have got a few more callers, commissioner. Let us know if you can speak. Yes. Okay. Great. Youve got two minutes on the clock. Caller thank you. I am the president of the San Francisco council of district merchants associations. We ad for 43,500 70 tiny businesses that are in San Francisco. Tiny businesses that we consider to be 10 businesses more or less and sad to say, it is declining dramatically. Were reaching out to you, today, to thank you for your tireless efforts in these unprecedented times. We are today, to find the citys recovery and youll be remembered for these efforts so i really want to thank you again. A few small points but they were already highlighted and made by the previous callers. Is that, you know, all of us small bees, 45,005 70 of us, im going to guess that about 75,000 of us are store Front Properties with relationships and confidence with our customers. We are a tool and an asset that we can use. Please bring us into the discussion. I also want to reemphasize that a healthy economy is also symbiotic with a medically healthy environment. Think about t. People that are employed have a higher selfesteem, have a better outlook on life. Probably have better medical benefits and a greater income of what they would get if they were on unemploy m and typically, will be able to seek medical help much earlier before things get bad or be more proactive and preventative in the medication because the that disposable inc. Economic health and medical health are symbiotic relationships. They cannot be siloed into two separate parts. They need to Work Together. I believe that if you reach out to the smaller groups, through the council of district menshants or directly through the merchantses yourself. You will find a receptive organization, that will be not just receptive, but an asset. Thank you. All right commissioners, a few more calls. Ive unmuted you want please let us know if you can hear me. Yes. I can her. Youve got two minutes on the clock. Im coowner of the fitness, board member of the castro association and San Francisco Fitness Studio coalition. I want to applaud the city for the work to get some aspects, to get it reopen at 10 . Too many small neighborhood Fitness Studios t can mean the difference between the life and death of the business. To have substantive conversations with their landlords and employees and provide an additional ongz for San Franciscos residents for poor air quality and those who have Fitness Options simply dont work. But dph. Dr. Colesons and dr. Air considered an essential service to help our citizen fight covid. In many cases, its no different than physical therapy, as dr. Air gone has noted. As this pandemic evolves, including the potential [indiscernible] iindisthepotent, please dont forget that. Thank you very much for your comments. We have got one more caller, commissioners. All right, caller, you are unmuted. Hi. My name is tracy sylvester, owner of espiladi, in San Francisco, on valencia street for over 28 years. Im on the board of mission menshants association, a delegate with the San Francisco council of district menshants and a member of the San Francisco independent Fitness Studio coalition. Ive been advocating for Small Business for over 10 years. I want to first thank you all for your effort and i look forward to becoming a partner in communications. So im grateful to reopen the business. It has been devastate for example our clients who are in severe physical decline, and are desperate for our services. As david had just said, whether in person, online, we know that its an important part, movement is an important part of wellbeing. And wed love to see more communication from the department of Public Health, promoting exercise and wellness, especially during the pandemic. Five reasons for staying active during the pandemic include relieving stress and anxiety, supporting immune system upon managing weight, improving bone and muscle strength, increased flexibility. You have an remembery of people out here in the community, that are interested in the wellness and wellbeing of our citizens. Secondly, i wanted to talk about Contact Tracing. Everybody coming into our businesses. We have the ability to contact and know exactly what the flow is in our building. We dont really have any guidelines qhaf it would take for us, if we found that one of our employees, members or staff were around somebody that had covid or if there was somebody that tested positive within our environment. How far do we go to public trace, who do we communicate this to, and how do we help become part of your army, in order to help mitigate the spread of the pandemic. Thank you. Commissioners, we have one more. Caller. You are unmuted. Im a member of the San Francisco independent Fitness Studio coalition. Im a previous owner of a brick and noter that had to closed, due to the extended shelter in place industry, some of my points of course mentioned already so ill try and be brief. Ill reiterate what was said about the plan to commune occasion for open guidelines. Left a lot of owners scrambling, so the exiewnication about guidelines, and the time frame would be instrumental in allowing them to properly prepare and open effectively. Secondly, now that we are allowing indoor fitness, we greatly need the Departments Health support, dr. Colfax, i know you mentioned a few weeks ago at a press conference that you wouldnt mind exercising indoors. Currently, were at 10 capacity, allowed with the next stage being 25 . We need to know if San Francisco will follow ute suet with that. Of course, thats dependent on cases. One of the greatest travels over the past 6 months while we have been closed was not knowing what was planned. I know dr. Air gone mentioned, communicating with different business sectors, we did have a lot of frustration of our coalition in communication. We did not necessarily know their occurrence. So again, we applaud your efforts. Thank you, but please help us communicate as much as you can. Thank you for your time. Thank you very much. I think dr. Colfax, director colfax mentioned thad dr. Air gone is in communication if these discussions are already going on, on a state level, it seems to me that it would be just as important that the counties have a greater awareness of what is going on. Apparently, there is no real plan yet, but i do think its important that the county department have some sort of role in understanding on how vaccines are going to be distributed to the population. They havent engaged a local Health Office yet but the Bay Area Health official on the monday call are going to start bidding up on this very topic this thursday. So at least in the bay area, were were going to Start Talking about t. The other thing i want to point out is were taking advantage of influenza season, as the opportunity not to just vaccinate people with influ ens a but to really exercise the Distribution Operations to deliver a vaccine. So for example, were going to be offering influenza vaccine at the covid testing sites so were beginning to operationally, what is it going to take to vaccinate a lot people, people qhosk driving, come in and have driewf through vaccine. So we arent thinking about it. Well be able to give you an update action soon as we have more to present. A bay area [indiscernible] i know you made the comment about trying to make the Health Orders a little more readable for that general public. I would just highly recommend that in Going Forward, you really try to have maybe a summary at the end at the fifth grade reading level, which is what is considered what the general public can read. So i would highly encouraging you to have that happen. But thank you, thank you, for all of your hard work and im sure you havent had a day off and we so appreciate your your work. Thank you. Commissioner green. First off, i would like to echo gratitude, for every in the command center, and everyone and what the dph have been doob, and the hours dr. Air gone sure makes internship seem like a parttime job. I also want to recognize how many members the department have had to pivot, not to develop new skill set bus also operationallize them. I know with your job in particular, involved, you know, going from a lot of lean management and longitudinal thinking to immediate action hero type activities and i think youve done a spectacular job of making that pivot, as have supported everyone else in the department. Its such a pleas tower hear the el qens, taw thoughtfulness and intellectual capital and really caring thats gone into the work youve done. I know youve touch bod it and i think this echos with both commissioner duradohad said. The communication part is so important. I hate to see these incredible efforts be misunderstood or not actualized because were not doing a good job of communicating to the public. And theres a lot behind what youre doing. Itso important for people to understand. I think when you look at the vaccine as well, were being to especially have San Francisco more pro vaccine or perhaps other municipalities around the country, if were not only going to have them avail thepgzs of vaccines, but also, especially some of our communities of color ensure that people understand and understand the logic. I think were so its so important to focus on those resources. Personally, i found some of the orders for hospitals confusing to me personally, like [indiscernible] during care. So i was wondering if you could think out loud or elaborate a little bit more on what you foresee could you talk any insight can you give, any reassurance about clarity would be really helpful. I used to run the cdc Public Health preparedness training center. Resource center. One of the things we learned about disaster ises is in the after action reports, the three top areas where you need improvement is communication, communication, communication its just so big and its so important it is an area where we can be really creative. Ill give you a concrete example. Yesterday, i was asked to speak at a training, these are monolingual spanishspeaking women who are learning how to engage the Community Around covid. Really what we have to do, i think the communication, we really have to do it in a way that engages people. In a way that they really understand i enjoyed working with them. I said please, invite me back to speak again but can i only do so much. We have to figure out how to tap into the injen yewity, and community, really around the communication strategies. We communicate through our channel that is we are accustomed to, in the language that we are accustomed to. And i can actual, i know its not reaching the community that is need it the most. It made me think right now, we have to do a lot more of that so actually, dr. Colfax may have mentioned were going to be working with the latino pastors, to train them to do the Contact Tracing. So they are going to be actually doing all of that and i think we have to do more of that mobile life so it gets translated as a level that really mobilizes the community, much better than we could ever do it. What leams of the city,. Yeah, so we do have a joint Information Center. A joint information Center Brings in the communication people from all the different departments so they have, a few doors down, they have this big room. This whole, theres an army of them working on this. But even with the army, its not enough. Its not enough. And i think were getting better. Were getting better, and i think this is where i think we may have to bring in some outside resources, engage more with communities, firms that are actually working in the Community Around us to really do a better job. But we do have a team of people. Again, at some point, maybe have some of them come and show you how their process of developing materials. I think its wonderful to hear back how its going. What kind of resources youre bringingbringing and innovatiod the whole fear of public communication. We can do that. Qhish nears, any other public or comments for dr. Air gone . I just want to thank you again. This presentation helped us understand the enormity of your work. Know San Francisco has stood across and that is due in large part, to your extraordinary leadership and i dont think that we as a commission can over state our gratitude to you for your leadership, for your thoughtfulness in how you approach your work chuck neb niche near green, ill add that action once its available. I know i speak for the entire commission. Thank you. Well be moving on to general Public Comment. Yes. If you would like to make a general Public Comment, which means youre commenting on something that is not on the agenda, a topic not listed on any other item on the agenda, please raise your hand now. I see one hand. My name is christine galloso. Im a Small Business owner in the adult recreational sports space in San Francisco. This summer, you guys allowed use pods to play with approximately like, lessening children at a stayed in those pods and thrirp a throwed scrimmage and play soccer and have exercise and recreation with each other. But the conditions have been [indiscernible] for adults recreational sports on a state level or a local level and now, childrens pods of course reduced to fitness where they have to stay 6 feet a art part from each other. Id like to know the reasoning to the switch, august to september, that kids can no longer participate in scrimmage activities and pods and why adult recreational spoarpts have not been considered in the return to participation i think its an area that the Health Department i thank you for your time. Thank you for your comment. Commissioner, that is the only call that we have got. Yes. Well move on. To the community and Public Health committee update. We had two items on our agenda, the first was the hepatitis c update which was an excellent report. And there was a pause in moving forward because of covid. The Street Medicine Team are back. They have been in operation and Going Forward. The second one was a very intense presentation on the primary Health Clinics within the city qat duty, and complex, as well as specific challenges with covid and what their plans are Going Forward. It was an interesting meeting. Secretary do we have any Public Comment . I dont see anyone. If youd like to make a Public Comment on the side, please press 3. This is commissioner dorados fist meeting at chair. Any. Any questions or comments for commissioner durado . Commissioner chaothey spoke about when thri might get back to their scorecard, that has more than just samples of the primary care were doing. Realizing, covid has disrupted, obviously, a lot of quality measures at this point. But i think it would be appropriate to have the scorecard reviewed again. At an appropriate time as we give them some distance to get back in order. Its going to take time, many of the staff have been deployed for covid. Many are on leave so they are moving as quickly as possible and will be reporting back to yous, as things did forward. It is something that even the hospital and managed care, they are actually retooling again, and starting to activate the processes for assuring quality. So im not look for example something immediately, but i dont think it should be dropped. We had a process in play before covid arrived, and they were really making progress and id hate to see that sort of lost. In our presentations, it will not be lost and data is continuing to be collected. As much as possible. And the presentation was excellent with the database, especially as they are operating with covid. Thank you. Any other questions or comments on this item . If not, thank you again, commissioner duradofor that report and for taking on the chair of the community Public Health committee. Well move on. To the next item. Epic update with erik raffin. Not yet. Can you maximize your screen. There we go. Im the chief Information Officer and im pleased to provide a quarterly update on our epic comprehensive Electronic Health record program. I have some cocontributors to thank for some information i shared today. Dr. [indiscernible] mr. Sarapia. Mr. Upchurch. Really, all contributors for what well go through and ill try and expedite because i i know the meeting is rung a little long. I adopt to say that most of the material you see today, is in response to your questions from last time im looking forward to sharing answers and keeping us moving forward with how were doing having a voice with our patient and important aspect of providing a big software program. I think its so much more than epic. Two short vignettes here. The first is from one of our patients. But id like to draw your attention to the second one. The software, with the ability to access your Health Record fist youre on a computer or on a mobile device. Youll see them in the second vignette. An elderly patient with dementia, has proxy access to his mothers Electronic Health records. This is an extremely important point i want to make right up front about the power of being able to gain sages to Electronic Health records as a parent, i benefited from having assets to my childrens records as they got older. I know if indicates such as the one you see here on your screen. Its really important to understand that patients who are unable to gain access to work within this tool, someone that they trust, we have rebooted our governance program, were beginning optimization work in some of our domains and we are in the midst of working through our second implementation leg. My take home message is 4 parts. The reflections about the security of the epic system, and i hope we leave today, with the understanding it is a secure environment. Were going to talk about my chart, and adoption is on the rise. Im here to talk about Revenue Cycle and how those operations have stabilized and well conclude with an update on the alignment with the spend, through the first three years of our project, and how that aligns with the rest of our epic experience through 20 twesk. So very quickly on secure and Health Information another not just about ethic, its really about everything we do here at dph as well. While there are plenty of very technical things that go on in the middle two sections of this slide. I really like to focus on the book ends. So on the left people, are the primary means of deterring private security threats. Its so easy for social engineering and other types of human behavior, to result in compromises and breaches to information that is really important to not just a policy, but to have at least annual reminders, so that were also vigilant. The city has adopted a new studio Awareness Training program which is now mandatory for everyone who works in city and county of San Francisco. On the far right, just as a reminder, all of the good work we do to protect our environment, its never perfect. And i do want to mention that we are externally audited every year through the Controllers Office and there by, auditor. We are working through findings from the current lead leaders odd r audit in a significant plan of action. And our goal to do use techniques of understanding causality of the findings and making sure we can prevent their reoccurrence. On the epic side on the ethic side of securing our information another really about authentic occasion and authorize ah, thenication. How are we communicating back and forth and how are those communications