Transcripts For SFGTV BOS Budget And Finance Appropriations

understand that we are all in this together. it's not an us against them situation. we are all in this together. so what does that mean? we are looking at providing all of our sfusd families and children opportunities for independent learning, and this means partnering with our public libraries to ensure that there are books that children can take and keep in their homes to build their own libraries. we're also building out special programs that are geared towards virtual support for families who still feel that virtual programming is the right thing for them and their children. we're going to build academic in-person learning for 20,000 children. it's going to be very focused on integrating academics during the day so that children can have the opportunity to catch up, and then, in the afternoon hours, they continue to have their summer fun and, you know, bowling and just enjoying themselves in the summer. we're partnering with rec and park to standup the usual phenomenal rec and park programs. we're also offering scholarships for families who choose to go to other types of camps and programs. and i also talked about the virtual supports that we will be providing for all of our children. just want to emphasize that it's not just dcyf. although i greatly appreciate your acknowledgement of dcyf, it is all hands on deck. we have rec and park centers that are going to open up for their phenomenal rec and park programs. we are looking at over -- operating school district sites in partnership with sfusd so we can make sure those curriculums lineup with those children. we are working with our libraries, we are reaching out to all of these private camps so that they can offer spots for our children, and we are hiring thousands and thousands of teachers and youth development professionals and other support staff to join me in making this a reality. i'm grateful that we have the school district, the libraries, and better together s.f., and out partners at head start. for families who are interested in this initiative, please go to summertogether.org, and enter your information so that you can learn more. we will start registration in april, to stay tuned for -- so stay tuned for that, and we will have more information as the days get closer to april. thank you. >> chair haney: thank you, director su, who, i'm sure, some of my colleagues have questions or comments now, as well, but i did want to turn it back over to supervisor mar, who had some questions for miss moggy, who is here from sfusd. >> supervisor mar: just wanted to say thank you for your presentation. super excited for this. yeah, i did have a few questions for miss mogge for some of the items that came up and director su for her proposal and the investment in early college internships and college interest models, and particularly around the existing funding for this program because it is a model that the city college and district have been developing for a few years. so yeah, i -- i -- so i guess the first question is just wanted to confirm that the city has funded high school internships programs with a pipeline to college classes over the past through years through -- through -- i -- past few years through -- through -- i believe through eraf funding, and i believe without renewed source of funding, the program expansion to 600 students over the last few years -- per year over the last few years would need to be cutback drastically, and you would no longer be able to support a significant number of high school students along the path to internships, college credits, and future careers. can you just -- yeah. >> hi, supervisor mar, and chair haney, and members of the board of supervisors. thank you so much for that question. yes, the college and career team has been able to implement this program prior to the eraf funding to about 63 to 64 students. and thank you to director su and to the board of supervisor to allow us to use the eraf funding. in the last few years, we were able to build an infrastructure to support 600 students total, so the additional funding did allow us to do that. as the funding will end in the spring, nard to continue the same amount of students, we will require the additional amount for the summer. i think for the amount that was allocated this summer, we would be able to go actually up to 800 students, and i think we're -- that's a very exciting number for us. the students will be able to not only benefit from in-person internships and virtual classes. i think this will be just a great pipeline for our students, as you said, to work in a lot of city agencies including sfusd. >> supervisor mar: thanks. and the next question is similar, but it's about the -- the -- the -- the state government has created a $4.6 billion fund for -- to address learning loss for students, and these are things that school districts can apply for and access. i guess whether the [inaudible] would be able to qualify for this funding, and, yeah. >> sorry. i think i have a bad connection, so i'm going to turnoff my video. am i back? >> supervisor mar: yeah, you're back. >> i think it's a.b. 88 -- a.b. 86, i'm sorry, for the learning loss fund, it is actually meant to be dealing with in-person learning and services. the in-person, it'll be an internship. however, the classes will still be virtual. in addition to that, while we will be receiving the funding with just our summer funding, we're already exceeding our budget, and trying to figure out how we can maximize our funds and support these programs, as well. this will be a super great benefit for our high school students, however, we are still trying to manage the funds that we are receiving from the state to support our summer programming that will be in person. >> supervisor mar: great. thank you for that. i don't have any other questions, chair haney. >> chair haney: thank you, supervisor mar. colleagues, any other questions or comments on this item? i did want to thank, again, director su and her team for their extraordinary work, and this really is an effort that's happening together, and we are all stepping up for all of our kids, really, in approximate a year that has been one of the toughest imaginable for them. they've been kept out of in-person learning. many of the opportunities for social, emotional, physical, wellness, have been taken away, and for that reason, at the soonest moment that we're able to step up and be there them, programming -- there for them, programming, we need to be, and i think when we had the opportunity for this surplus to provide some additional support, i spoke with supervisors chan, ronen, and melgar, and all of us felt immediately -- and i know it was reflective of the entire committee and the board, that we needed to invest in our kids and our families, and thankfully, with your leadership, with the mayor's leadership, we were able to have it be part of this broader commitment. and now with supervisor mar and sfusd, we can also include in a really creative innovative proactive way our high school students, so this is -- as everyone has said, something that is a very appropriate needed use of the funds that we have, and i really am proud of the work that has everyone has done, and now, we have a lot of work to do. so this is the commitment that we have to have to our young people as a city going into the fall not only to makeup for what has happened over the last year but what we now has been underfunding and undersupporting of so many of our young people for so long, so i hope this is an opportunity to change direction with a much greater commitment and collaboration all-around. so support su or miss mogi, anything you want to add before we move onto the next item? >> chair haney, i do want to add a couple more things. i know supervisor melgar brought this up to me. we should be able to add additional spaces that will be colocating, as well. to be able to increase the numbers. thank you so much for that feedback, and we do want to continue to work together with this not, you know, outside of the funds that supervisor mar has been supporting us. and also, including i really appreciated supervisor ronen's feedback on spring board. i'm glad this has been going on with our schools even before the summer. any kind of more direct -- i know that director su has just been incredible with us about hearing what are some other interventions that are working but can be extremely expensive, but she has been trying to find additional funds from philanthropic funds. it's a lot to collaborate, and i'm learning very quickly, but it's been a wonderful opportunity, and we're really grateful for all the additional funding that's coming for our students, all of the students in the city, so thank you. >> chair haney: thank you. i will note that many of the supervisors that we have here are parents of sfusd children, and they bring their expertise and their knowledge and their commitment, so i think you have a very supportive and understanding but also people who really do want to see this get done, and they have the personal experience and knowledge of that, as well. and so especially thank you to the authors of this, the moms, because this is the kind of commitment that we have. so is there a b.l.a. report on this item? >> yes, chair -- yes, chair haney. there is. you're talking about -- >> chair haney: item 4. >> item 4, excuse me. so item 4 is a proposed ordinance that would appropriate $15 million in property tax revenues to the department of children, youth, and their families for a summer learning program for children? as described on page 19 of our report, dcyf estimates that the proposed appropriation would fund approximately 10,000 slots for an approximate nine-week summer program. we do consider the program to be a policy for board of supervisors matters. >> chair haney: great. thank you. so seeing no further comments or questions from the board -- or, sorry, from the committee, we are going to take amendments for this item when we -- after we discuss item 3, and we're going to bring all of it together in one, so with that, we are going to move to item 3, which has also already been called, and i would ask -- i'd like to ask diana ponce del de to present on the city grant and loan programs to provide relief to small businesses affected by covid-19. >> thank you, chair haney and board members, to present to the board. we're seeking $20 million of property tax revenue to the office of economic and workforce development in fiscal year 2021 for a grant program to provide relief to over 2,000 low-income small businesses across the city. it's been a year since our shelter in place order, where we've seen many of our businesses closed and our loved ones impacted by covid, and i would like to take a moment, too, to honor your partnership in this relationship. while i was at covid command and using our framework of equity, we hit some of the hardest hit neighborhoods to make sure we had access to testing and vaccines, and together with our staff, we joined the departments of public health, department of emergency management, and others to make sure that our neighborhoods that were most impacted were able to be supported during this very difficult time. so i just want to acknowledge that because we worked so closely with your staff, and i know that all of us have had to take on additional roles in order to support the communities in san francisco. with that, in addition, invest in neighborhoods was able to set up actually a p.p.e. distribution center in partnership with the port and was able to deliver p.p.e. to organizations so they could get this out to small businesses as reopening was happening. in addition, we've allocated 24 million in small business loans and grants over that same period and supported over 1,000 businesses through that allocation, of which about 57% of those awardees were women owned businesses and 67% were minority owned businesses. so while we're at reopening again, we have to keep our eye on the prize and really looking to the partnership in terms of working towards recovery, getting vaccinated, and making sure that our neighborhood corridors are supported and our small businesses. so today, i am going to be reviewing the proposal for the $20 million allocation that, once again, that's for city dollars allocated. we know that there's a greater allocation coming from the federal government, but what this does, it helps provide immediate relief for those businesses while we wait and collaborate to make sure that those dollars get to our small businesses here in san francisco. so with that, i am going to be quickly sharing my screen and presenting on this item. excuse me while i do that. i do want to say that i shared a very expansive deck with you all today that i'm not going to be getting into, but it went into how we were going to be spending the $20 million and the impact that our grants have had on our small businesses. so with that, i'm just going to go ahead and go into the slide that covers this specific appropriation. so the 20 million appropriated would be divided in small business loans for all the resources that we have. now the proposal that you will see before us today was a result of feedback that we received from multiple stakeholders, one-on-one meetings, focus groups, and some of our stakeholders? and what we heard from them was many were tired of applying things for things that they would not qualify for or would run out before they would get to them. we also heard that they wanted a desire to remove barriers to those who needed the funds most, like minority or low-income businesses or maybe legacy businesses or in cultural districts or really serving our low-income neighborhoods of color. so with that, we created two grant programs of which we proposed two different pathways. one would be in the small business storefront equity grant, and the other the community storefront anchors grants what you will see is that we focused on the storefront specifically that serve our community of san francisco. the total amount of awards with this proposal would reach 1,580 small businesses, so -- and i'm going to go into a little bit in detail about each of these grants and what the qualifications and the criteria are. for the small business storefront equity, that one has no limitation in terms of employees. it could be a business owner that's running it. there is no limitation there. the grant is up to 5,000 -- it's actually $5,000. not up to, but it is a $5,000 grant, and it focuses on those businesses that were closed by the restrictions at least six months? the bars and restaurants and salons that could not reopen. they were barred from reopening by our public health order. the businesses that were located in communities. some criteria was if the business had made less than $2 million in gross revenue, had not received loans exceeding $5,000 or loans exceeding $20,000 and they must be from low or extremely low-income households. the start date -- this is one thing that we heard from some of the businesses that had started between june and december had been left out of federal programs, they wanted to be out of this. in this case, we would really limit the amount of paperwork in this category so that we can make sure that we're getting the funds out to businesses as fast as possible. in the next category, community storefronts, you may have noticed that there's two amounts there. one for 10,000 and one for 25,000. the amount category would be based on number of employee. the amount for -- in the 10,000 realm would be for those businesses that have employees from five to nine, and anything above ten would be -- they would be allowed to apply for the $25,000 grant. now, this is precovid numbers, so part of this from the feedback reflects the opportunity that they will have to hire, hopefully, their employees back and continue their strong -- to serve strongly in the neighborhoods that they serve. so these would be community storefront anchors such as businesses that are 15 years or older, entertainment venues, and for those that are located in cultural districts or opportunity neighborhoods, they would have to be five years or older in order to qualify. there's also been a setaside for life entertainment venues in this $20 million of 1.5. and the minimum, once you do meet any of those categories, is you must make less than $10.5 million of gross revenue, and this one, you must prove at least 20% loss of revenue, and nonprofits may qualify also within this category, and they will need to provide proof of eligibility. and the application process is going to be on-line, again, based on the feedback that we received, we limited the categories to really be targeted to businesses, so we're proposing to have a survey up front with so much of these minimum qualifiers where they wouldn't need extra documentation before a business even applies so they can know if they'll really qualify or not, so that's what we're adding as a new part based on feedback that we received. for the loans, so currently, we are -- our total loan portfolio has been 14.6 in response to covid? we are proposing an additional $7.3 million as part of this appropriation. so the 7.3, we're proposing 3.4 will be for immediate investment in the state's california rebuilding fund. this initial investment will leverage, we're expecting, up to $10 million in loan capital with this partnership. and then, 3.9 would be available after this first phase, depending on demand of this loan product. so in terms of the loan proposal and the loan details, again, this is a partnership with the california rebuilding fund, so the loan requirements would be based on that partnership, so it's a maximum of up to $100,000. the interest rates, which is what we're buying down, also, to make these terms more attractive and favorable to some of our small businesses in neighborhoods in san francisco would be 2.5%. no principle payment for the first 12 months, and all of these funds would be flexible in emergency room its of what the business owners need and what they see best to use the funds for. in this case, it would be the eligibility of 50 or fewer employees as of march 2020, and the gross revenue requirements will be based on 2019. the net positive income, 2019 again, and they must have been in operation since june 30, 2019. and with that, that concludes my piece of the presentation. i also have colleagues -- oh, sorry. one more thing. so the 300,000 is for the application to help support both application, marketing of our products, again, in preparation for federal resources coming on-line, trying to make sure that our local partners and c.b.o.s are ready to responsibility and connect our businesses to some of these resources. we also understand that there is a federal program that will be boosting our support, but we want to make sure that we're building our capacity and getting ready for that, which is what we heard in the b.l.a. report and the report. with that, that concludes my presentation, and i and my colleagues are available for any questions that you may have. thank you. >> chair haney: thank you so much, miss ponce de leon for your work and your very thorough presentation. colleagues, do you have any questions or comments? supervisor safai? >> supervisor safai: sorry. thank you, miss ponce de leon. thank you for your presentation. one of the things that i want trying to understand was the reasoning behind -- and i'm glad we're moving so quickly. this has been helpful. trying to understand -- i saw one thing you pointed out was a limitation was that if someone had received a loan of 20,000, that they would not be eligible for certain types of the grants. i know, for instance, talking to a lot of the businesses, many of them are in debt between 50, 60, 80, $100,000 and they're taken on loans, some of which, obviously, are forgivable, if they keep employees employed and themselves just in terms of payroll. just trying to understand why we would add that limitation because it seems as though if you've set the gross receipts of the business, you're going to be targeting lower income business, lower gross revenue generating businesses, so i want to understand why you guys put that in there? >> yeah, so that was based on the feedback we received of really the intent of trying to reach businesses that have not had access to basically loans, grants, or very little in very small amounts, so that was the intent behind that. >> supervisor safai: has that been the case? is that what you've heard, that you haven't had businesses -- because i think a lot of the businesses have had access to some form or another, even a small amount, but i just feel like we certainly wouldn't want to exclude people based on the current requirements. is that flexible or is that a hard rule in terms of the way you've set up the program? >> no, that's definitely flexible. again, it was based on the feedback in trying to narrow that, but that's -- yes, we're open to your feedback on that. >> supervisor safai: okay. great. i think it's been great. i know a few of the businesses that have benefited from some of the grants in our district. i assume, when you say excelsior, does that also include lakeview in my district? excelsior is a specific neighborhood, but lakeview is in mine. i know you were in charge of the person in investing in neighborhoods in any district for a long time, so that included or excluded in the neighborhoods that are named? ? >> so the opportunity neighborhoods are specific corridors, which is -- excelsior's covered. however, o.m.i. is not covered. however, all neighborhoods can qualify if they're low-income, right, household businesses, and they haven't receive any amount of, like, support currently. so they would still be able to qualify, and that applies citywide if they meet that criteria. so it would be one of the categories. either your opportunity neighborhood or you've been closed, like, like, the barber shops -- we have a few salons and barber shops along broad and randolph. >> supervisor safai: right. >> that would qualify as long as they haven't -- >> supervisor safai: i know you have a larger -- i guess it, bayview, chinatown, excelsior, mission, and tenderloin, and it says serving communities of color. i wonder if it was an oversight not to include o.m.i., but to call them out specifically. are we able to do that? >> so again, i think they would qualify under one of these criterias, so it exists under one of the criteria that they would qualify. so it's called down specifically to one of our neighborhoods of opportunity -- >> supervisor safai: but the o.m.i. is not an opportunity neighborhood? >> that's correct. >> supervisor safai: oh, okay. well, i guess we've got to talk about that, too. then. thank you. those are my only questions. >> thank you. >> chair haney: thank you, supervisor safai. supervisor mar? >> supervisor mar: thank you. first want to thank miss ponce de leon and the mayor's office for much needed financial support to small businesses, particularly those that have not been able to benefit from the prior opportunities. and i also want -- want to present or propose an amendment to this, and a small expansion, really, to create the fund for small business victims of crimes, and this is to address an important and overlooked program that has been harming our communities throughout this pandemic on top of concerns about our public health and restrictions on businesses, our commercial corridors suffer from the added insult and injury of crime, burglaries, vandalism, arson, and their aftermath. while the overall crime rate has gone down, crime incidents like these compromise the safety and feeling of safety for other businesses, residents, and patrons, and for groups who are already being racially targeted during covid-19, like the asian american community, criminal attacks on minority businesses, and cultural communities have exacerbated harm and fear, and we need to do better as a city in response. while we continue to work with law enforcement agencies to investigate crimes, we must respond immediately and provide tangible support to small neighborhood businesses that have been victimed of crimes, and we -- victims of crimes, and we must also invest in their overall safety along the corridor. so this will directly support storefront small businesses with financial relief in the after math of a crime to restore the harm done. not only will we try to make businesses whole by addressing the direct proper damage and costs as a result of crime, we can make them even better. the fund will also allow small businesses to make capital improvements that enhance security and [inaudible] and this could be for a replacement lock, a new security gate, fixing an alarm system, adding new lighting. when we invest in one business, we support the security of businesses nearby and the safety of people in that community. and colleagues, in all of our districts, we have heard of the heart break that comes from a storefront is attacked, and we know of the trust that someone -- we know of the trust that something will be done by the city, so i look forward to working closely with oewd and law enforcement agencies to make this program a success, and i'm glad this program is being considered as one part of many. thanks. >> thank you, supervisor. looking forward to that, also. >> chair haney: thank you, supervisor mar, and thank you for your leadership on that, and i absolutely agree. i've heard from, you know, a lot of businesses in my district, as i'm sure we all have around the property image. even when they're not open as much or some have been closed altogether, and they've experienced property damage, i think this will also add a needed supplement and support that we can provide to small businesses who have suffered in many ways through no fault of their own because they've lost revenue, because of changes in what the city can allow with our health orders or required closures or, in some cases, damage to their businesses, so i think it's absolutely consistent with what we're doing with this overall approach, and i'm going to be happy to support it as part of the overall amendments that we're going to take today. i -- i -- so what i would like to do, we do have another -- >> clerk: chair haney, supervisor ronen is requesting to speak. >> chair haney: sure. didn't see her name there. >> supervisor ronen: thank you. i'm having one of those days where i didn't have my charger, and so i'm participating my phone. i can't figure out, from my phone, how to put my hand on the roster. madam clerk, thank you for having my back. just very simply, i just wanted to, a, welcome deanna ponce de leon back to oewd. thank you so much for what you did as an emergency worker, but our small businesses need you, and you're such an amazing champion for them, so-so glad you're back. thank you. >> thank you for that. >> supervisor ronen: and i just wanted to thank my colleagues, all of you, and just really say that i'm very proud of oewd, the mayor, and this board's work to champion small businesses. we have collectively somehow, and really, over many years, and probably unintentionally, made it very difficult for small businesses to open, grow, and survive in the city. as we know, it is the vehicle for so many people to pursue their passions, and also to be their own bosses, and to be able to earn a living in a way that is on their own terms, and it's such an important part of economic development, not only for communities that are often left out of traditional paths towards economic freedom, really, but it's also -- it's one of the biggest job creators in the city. and i just feel very proud to be part of this board of supervisors and to work in conjunction with this mayor and our collective attention and support to small businesses that frankly have been left behind and ignored for way too long. so i think the budget supplemental with supervisor mar's excellent addition -- businesses in my district have been victim to property crimes and just can't afford it more so now than always. i just wanted to chime in to really thank all of my colleagues and to thank oewd for all of your tremendous work and to say it is time to focus on the small business community and to really make material changes to help them succeed. and the last thing i'll say is, you know, this nightmare of this pandemic has -- has shifted our perspective in such a radical way that i feel like we're finally focused on the essential right places, and they're so little to appreciate about this pandemic, that focusing on these small businesses in approximate an economic and tangible way is long overdue, and i really appreciate everyone's, you know, service, you know, working together to do that. thank you. >> chair haney: supervisor ronen, thank you. you can always let the clerk know you want to speak, and i really appreciate your comments. i think oewd has done a tremendous job in working and supporting businesses during this time. we appreciate their work on this and thank the mayor on bringing this forward and are glad that we're going to be able to supplement it in a number of ways, both with an additional investment in small businesses that have experienced property damage as well as an increase in the support for our independent music venues who were some of the first to close and the last to reopen and many of them have been closed throughout this last year. many have not received support from other sources and are really struggling to survive these last couple of months and, i know, we can't imagine our city without our performance venues, or arts venues, and the music and culture they provide to our city, so i'm glad we are going to be able to increase support for those venues. i know we have some other changes that i'm going to describe in the amendments. there's also additional support for shared spaces in this proposal, and i don't know if that is something that you would, miss ponce de leon, that you would present on or someone else from the mayor's office would present on, but there are some other things that i want to focus on, some of the critical investments that we're going to be able to make today. >> so what i can say about the amendments is that this proposal currently for the 20 million, so definitely happy to -- those other pathways -- incorporate and work with the board on how to best -- you know, do we need a separate program? do we added, you know, the separate options that exist so that we make sure we're hitting the target as intended for those funds. so it would be incorporated as part of our existing programs or pathways. so whether it's this or others, that's what we'd be looking at. >> chair haney: great. thank you for that. so i think what i'm going to do now is i'm actually going to -- and i know risa sandler is here from the controller's office, and i want to make sure that everyone is fully aware of the set of things that we are going to be voting on today, which have been circulated to all of you, which are, of course, the things that have been presented to us, with items 2, 3, and 4, but also some additional amendments, some special expansions, some of which have been discussed by supervisor mar, in some cases, and there are a few other things that i want to make sure we are all clear on. so the amendments have been circulated, and the amendments include part of items 2 and 4 and were related to the projected spending proposal related to the six months' surplus. they provide relief to families, small businesses, cultural centers, cultural districts, youth learning, and will also help to prevent opioid overdoses, and i can speak to that item specifically. but i wanted to ask risa sandler from the controller's office if she might be able to go through this itemized list and answer any questions about the specific line items. and then, i also, after that, want to call on president walton to speak on one of these items. miss sandler? >> supervisor, sure. i'm risa sandler from the controller's office, and i think what i've been asked to do is explain the contents of what's before you. as supervisor haney said, what's before you is two other supplementals plus what was included in what we call the small business supplemental. so there are several items there related to small business relief. there is one change, one amendment to the dollar amount that was listed in the original supplemental for small business grants. that was reduced by 1.5 million, and that was allotted to another item, i think it was the small venue recovery. another was 2.5 million for shared spaces, 1 million for small businesses impacted by property crime, and a total of 3 million for the music and entertainment venue recovery. in arts, entertainment support, there are a number of items that were pulled as they were initially in the mayor's proposed hotel, arts -- hotel tax arts supplemental, and those were for the arts, cultural arts, and endowment equity. additional items were 1.1 for cultural districts, and then, 1 million labelled as a contingency loss in case there's additional loss in decreased hotel revenue that comes in. there's another $5 million that's looking ahead to what might be additional losses in the next year. in terms of youth learning, there are two items that were discussed before. there's a new section on overdose prevention and fentanyl team street work. 1 million in family relief fund, along with a reserve. and that's based on the $125 million that our service projected minus the rent relief and housing proposal and the items that i outlined above, and that's the summary. >> chair haney: sorry. having issues. thank you for that. i want to say to my colleagues, we have heard most of these items today. there are some key ones that i think have not been spoken to today. in the small business and entertainment venues, there's some support that is so important. we're all aware of the venue recovery fund that's been put forth where these funds will go to, some additional funds for shared spaces, and then, in the proposal for arts, there's a slight increase because of the additional losses, projected losses in the hotel tax in the current year as well as some additional funds for the cultural districts, and then, $5 million for next -- next year, when we, unfortunately, expect there to be a shortfall. and then, in the youth summer learning piece, we had an increase of 2.7 million, which will go to the sfusd dual college enrollment, and then, there are a couple things that are true but are also programs that i know you all are very supportive of and are aware of. [inaudible] >> chair haney: sorry. somebody's either trying to speak or not on mute. okay. so with that, i want to turn it over to -- quickly, before i turn it over to president walton, i did want to ask you to speak to the shared spaces part of the small business support. this is something that is new and just want to make sure that everyone understands for the record how this will be used. [please stand by] is a steep climb so this additional money is very intentional and important and i think it helps compliment some of the things that deanna was saying in the targeted neighborhoods where you might not necessarily see this. so, i'm a big pro phone pa prone ant ofthis and we've be shared spaces program so this will help allow more businesses that have not been able to afford to get this off the ground to get it going and up and running so thank you for that clarification. >> thank you supervisor safai and your leadership on this issue and so there's one thing that i wanted to actually turn it over to president walton to speak to. there's a new piece of our over all proposal that we're going to vote on today which is a program i know we're familiar with but needs additional support and helped to ensure urgent and critical resources for some of the families and individuals in our city who have not been able to access other types of support and who are. >> i just want to thank all of my colleagues. if you remember, during the early parts of this pandemic, when we figured out that even though support was coming from the federal stimulus, and there was some additional supports from the state, we realized there were populations of folks here in our city that were not going to be a beneficiary of those particular opportunities and so, we worked together to put legislation in place to provide family relief for those individuals who were not eligible for that type of support and fortunately we worked closely together with the mayor's office and did not have to do it through the legislative process and we did a lot of philanthropy and we pulled resources from our own budget to make sure we provided their family relief. the money did not go far enough and we want to make sure the resources are available for family relief. we were promised an additional $5 million for family relief. we haven't located the total amount so we're going to be asking for 2 million and this supplemental to go in along with our right to recover and it's something that we all are familiar with and we've been working with our essential hubs here and working on gaging with the needs of our communities and written relief has been one of the most major supports that have been requested as well as the loss of income support and we need this continued funding in order to help our residents during this pandemic and so that they can meet their basic needs and whether it's for rent, bills, clothing, food, and of course support of education materials that are needed and during our first round of family relief, we distributed resources to over 4,900 families and we exhausted the resources and as i mentioned before, we're promising a million more and so this is going to help us fulfill the promise of making sure that we address the gap for those families that need resources that don't qualify and these are four uncockmented families and people we actually rely on to do our jobs everyday and for survival and right now, we have a couple of thousand families who are not waiting list and i'm excite today announce this $2 million which is included in the community amendment that's have been circulated so thank you chair haney and i want to thank just the entire board and the championship for supporting the opportunities for families and have no other plays to turn to. >> thank you. president walton, thank you for your leadership. i think we all agree that seeing there were some additional resources available this year we had to put it in the pockets of people who were left out of other forms of support from the federal or state government or who have been most impacted by this crisis and most in need of additional resource and support and i think that program is obviously reflective of both of those priorities. so, colleagues, we have a number of, w. i shouldn't say say number, we have sort of a collective set of amendment amendmentswe're going to take at to actually is, before we do that, i think we can end with that. i want to now go to public comment for items 2, 3 and 4. and again we are having one minute per speaker, madam clerk, can you open up public comment for items 2, 3 and 4. >> yes, mr. chair. we are checking to see if there are any callers of the queue. members of the public who wish to provide public comment on items 2, 3 and 4 press star 3 to be added to the queue and for those on hold wait until the system indicates you have been unmuted. >> yes there are 15 callers in the queue. >> could you please unmute the first caller. >> caller: this is debra wark err on the arts commission and every neighborhood, the food delivery, the vaccine lines, the testing lines, our staffed in large part by members of our arts community so it's a really great time to actually reach out to the folks providing these services in your community and find if there are gaps and talk to us about it but i really appreciate keeping our arts community who else. we're really devastated. a lot of us are unemployed and they're struggling so this helpful. thank you. >> thank you for your comments. next speaker, please. >> caller: thank you, very much. supervisor of the budget and finance committee. i'm here to urge your support for the agenda number 2. requesting full funding for all eight cultural districts of san francisco for this and next fiscal year. active member of the japan town cultural district and our community has been on the verge of disappearing for the last 20 years and after struggling with the devastating and in late 60s and 60s and 20 years after returning and reestablishing japan town that was decimated as we triple back from release in german camps. specifically, if we loose japan town community district all of our energy to protect, preserve, plan for our future community will be for not. we will lose our dedicated staff and we will surely, as japan town, chip by chip from the face of san francisco. you have all made tremendous efforts during this pandemic. we deeply appreciate your commitment to our city and our communities. we support and ask -- >> thank you for your comments. next speaker, please. >> caller: hi, my name is marie sorenson. i'm with ia24. cultural districts define who we are as a city. cultural districts are the soul of our city. where we are necessary partners with the city, cultural districts are, and with businesses, residents, artists and the history of our town. we need to help define the past, the present and where we will be in the future and in terms of the cultural district, we have been instrumental in testing and helping vaccinate. this is how important cultural districts are. please, support item number 2. thank you. >> thank you for your comments. next speaker, please. >> good afternoon, chair haney and supervisors. i'm rachel. an artist and arts and cultural administrator. thank you haves for your support. it's no coincidence that cultural districts are experiencing compounding impacts of this pandemic. our people are being attacked, excluded and pushed out. because of prop e funding and the support for -- districts are not one size fits all. this funding, prior to the short falls resulting from shelter in place, did not cover our baseline needs. this amendment is crucial in moving the cultural heritage, housing economics, sustainable strategy that we're partnering with the city on to be accountable to our diverse neighborhoods. in turn, we'll continue to lift up our unsung heroes because of that women know that we will come out of this pandemic stronger with new creative healing spaces and more public arts honor and make history. thank you. >> thank you for your comments. next speakers, please. >> caller: hello, i've been a resident and voter in district 8 for 40 years. i wrote a one-minute statement to urge you all to suppose art the full allocation for the cultural districts. after hearing the comments from the members of the budget committee they would have been redundant and you brought up all my points. i wanted to thank the sponsors who are on the committee, ronen, haney and walton. it was either mar or safai who asked to be added to it as a sponsor and thank you so so much. i echo japan town must survive before we are further decimated. thank you. >> caller: i'm the director of diversity equity and community for the san francisco opera. we're in district 6. under supervise or haney. thank you for your subpoena or support forthe arts. we are large, small and mid sized organizations but we're one arts culture community and we stand in solidarity with each other as we're all part of this healthy arts echo system and i want to give a special shout out to supervisor ronen for the comments it will serve to honor the voters. i want you to remember we're one of the largest employers in northern california that supports eight unions and a thousand employees and we're doing everything we can to keep people played and i also want to remember we are all traumatized and we can process that trauma through arts and culture programs that serve as a mechanism for healing, building communities and i'm so excited that this bill was moving forward and. >> thank you for your comments. next speaker, please. >> hi, you are unmuted. >> perhaps we can circle back to this caller and take the next one. >> caller: so, supervisors, you have made so many amendments and you are ramblings have been so long and you are just giving us a minute. so, i know how to deal with a situation by writing what i need to write about. this pandemic has allowed us to see how young can respond to the people. so, i'm going to give you all a rating. it's f . having said that, i'm going to address my comments on my blog because y'all have not even fulfilled the standard of brown act. making drastic changes without any input, without any meaningful discussion, from we, the taxpayers who pay your salaries, thank you, very much. >> thank you for your comments. next speaker, please. >> caller: hello, my name is bob goldfarb and i'm the president of the lgbtq cultural district and i would like to thank you all for your support for the cultural districts and this weekend our culture workers are grieving and as relive the closing of our doors on our middle eastern co production, 365 days ago we grieve the disappearance of over two years of work cumulatively from inspiring black future narratives and mythology to our latinx centered work calling out displacement and it's tenuous if we do not receive funding from the supplemental and our workers who inspire our future world are desperate for groceries, basic healthcare needs, meeting the rent and the basic human need to be valued by us. thank you mayor and supervisors for supporting this critical supplemental and the will of the voters in support of san francisco cultural sector which is facing defamation. >> thank you for your comments. next speaker, please. >> hi, this is allison collins, commissioner, and vice president serving on the san francisco unified school board. >> community based organizations, early education centers and other youth summer programming. thank you. >> thank you for your comments. next speaker, please. >> >> as my colleagues and the cultural center have said, we have -- the cultural districts are going to provide intrinsic in the recovery of the city and i thank you for this stanely cup mental. it will help the current a cultural and future cultural districts in full recovery and. >> i wanted to comment on item number 2. the american indian cultural district of made up of two full time staff and a coalition of eight organizations and elders working to make up for decades of systematic racism in the city and we have community members excited about having a homebase in the city on our own native land and losing funding for our staff of you're cultural district and only undermining important work that's been done and the most vulnerable community in san francisco and increased the already impacts that the community and eliminate the only centralized -- it doesn't happened for our city so you can imagine the impacts that happen if you couldn't fund our staff and able to fund these programs. i just also wanted to comment that we also submitted written comments and i wanted to thank supervisor ronen and all those working to make sure that these vulnerable populations aren't lost or forgotten. thank you. >> next speaker, please. >> caller: i just (inaudible) cultural district of the operations director. first of all, i want to thank you for suppose support. (inaudible). there's more demand and supply for resources, foods, jobs and for positive artistic expression. not having these funds will leave a void in our community. our work has brought hope, beauty and joy to our corridor. i yield the rest of my time. >> next speaker, please. >> caller: hello, i'm with the asian pacific omni cultural center. we support the arts and supervisor haney, peskin and ronen's districts. thank you to the mayor and the supervisor. like my colleague said earlier the arts are currently supporting disability and recovery of our community. we have artist providing food deliver row to seniors to artists walking at the streets at night to our asian community americans. thank you for supporting all of the allocations and the will of the votersment we hope you ken sure the cultural centers, who even after are taking a 66-person cut have equitable support. the centers are the city are city-owned building and i've been serving the city bipoc artist and communities for 40 years and we urge to you find that equity in ensuring all aspects of prop e are funded including cultural centers and cultural districts. thank you very much. >> there are 12 callers listening and three in the queue. again, if you wish to comment on items 2, 3 and 4, please pose star 3 to be added to the queue for those on hold continue to wait until the the system indicates you have been unmuted. >> good afternoon, supervisors, my name is jenny long and i'm the executive director of the chinese cultural center and we're organ based in chinatown with a long history of presenting old art with social transformation and community impact. i'm calling on item 2. and support of the appropriation. i want to thank the board of supervisors for your support of the chinatown community earlier this year and i want to thank the mayor and the co-sponsors for your leadership to support the arts in this measure. chinatown has been hit hard economically and with anti asian hate and violence. the arts have always been part of a healthy community and play a vital role in the community's recovery as an economic driver but to also bring hope contributed healing and bring visibility to our community issues. i want to thank the supervisors and look forward to your support for this measure and for all the prop e allocations for us to continue our work in the community and we hope that you can ensure that the arts are funded equitably for bipoc communities and culture communities and districts. >> thank you for your comments. next speaker, please. >> hello, i want to thank you for your support san francisco's cultural districts. they highlight and support communities that have been historic marginalized. culture have been a source of support for many businesses facing closure and residents experienced hardships. we have a shortfall and we are in support of the amendment to bring those two for next fiscal year it's important to invest in these communities that have hit the hardest in order for recovery to be equitable and to work. >> thank you for your comments. next speaker, please. >> caller: my name is diana and i work inform the asian american artist and the asian pacific. they have also taken place in many different parts of the city and throughout the greater bay area and. >> there are no other speakers in the queue. public comment is now closed. all right, so, we have we have amendments we're going to take and we'll pass items that we have in front of us. so, the first thing we're going to do, colleagues, are there any other questions or comments before we take these amendments? i have some final comments after we take the amendments. i don't see any one on the roster. the first thing i would like to do is move to accept the amendments for item 3. that was the set of amendments of the various changes in allocations and this will be where most of the allocations for projected surplus will be. i want to motion to accept the amendment and can i have a second on that, please. >> second. >> seconded by supervisor safai. madam clerk, can you please take a vote on the amendments. >> clerk: yes, on the motion -- [roll call vote] >> clerk: there are five ayes. >> great. thank you. colleagues, i want to make a motion continue item number three and to a special budget and appropriations committee meeting on tuesday march 23rd as amended. is there a second? >> second. >> seconded by president walton and can we take a roll call on that, please. >> clerk: y. on that motion -- [roll call vote] now i want to be clear, we've appended all of these dis the family relief fund as well as an urgent need reserve so we aren't allocating the entire 125 million and i'll speak to why that is the case. and it's moving all into item number 3 and that allows us to vote on that collectively. with that, i'm going to make a motion to table items 2 and 4 and is there a second on that? >> second safai. >> seconded by supervisor safai. roll call vote, please. >> clerk: yes, on the motion -- [roll call vote] >> clerk: there are five ayes. >> great. thank you. so, those two items will be tabled and item 3 will be moved to special budget and appropriations committee meeting on march 23rd. ms. sandler, is there anything more you want to adhere in terms of process or anything that -- or on any of these items? >> no. thank you for the opportunity. >> ok. all right. well, again, colleagues, before anybody else has, if you do have any closing comments i want to say thank you all for really contributing to this process and to making sure that we address the urgent priorities for our residents. i do think these are the right priorities and we will build into the budget season which is already upon us. these are some of the most impacted communities during this pandemic and we're going to be able to make some critical investments. on top of everything that we've spoken about here, there are two items i want to flag for you all. additional investments in preventing overdoses, specifically from fentanyl and there's 1.6 in the proposal for some specific outreach, treatment, and prevention specifically in s.r.o.s where a lot of the overdoses have occurred and i know that you all share my concerns and commitment to prevent overdoses and this is some really urgent one-time funding we can put forward that i do believe will save lives and then i want to also flag for you all that we aren't allocating the entire 125 million, there's 5% of that that is kept on reserve and these funds are one, to provide a level of contingency and a cushion for potential changes in how that actual revenue comes in and also there are some remaining, i think t. out standing items that could come about in the next few weeks and months before we undergo our budget process that may require us to revisit some additional priorities. i do believe we've address many ofs most urgent priorities and concerns and i want to thank everybody who called in centerig our small business, arts, cultural districts, schools and kids and this is a package ak we can be proud of and the mayor's office and the mayor was very helpful with and support of in partnership. with that, colleagues, i don't see anybody else on the roster. so, madam clerk, is there any further business in front of us in. ofus. >> clerk: there's no further business. >> this meeting is adjourned. >> thank you. >> thank you. all right. on 5, 2, 1 you innovation on or was on over 200 years they went through extensive innovations to the existing green new metal gates were installed our the perimeter 9 project is funded inform there are no 9 community opportunity and our capital improvement plan to the 2008 clean and safe neighborhood it allows the residents and park advocates like san franciscans to make the matching of the few minutes through the philanthropic dungeons and finished and finally able to pull on play on the number one green a celebration on october 7, 1901, a skoovlt for the st. anthony's formed a club and john then the superintendent the golden gate park laid out the bowling green are here sharing meditates a permanent green now and then was opened in 1902 during the course the 1906 san francisco earthquake that citywide much the city the greens were left that with an ellen surface and not readers necessarily 1911 it had the blowing e bowling that was formed in 1912 the parks commission paid laying down down green number 2 the san francisco lawn club was the first opened in the united states and the oldest on the west their registered as san francisco lark one 101 and ti it is not all fierce competition food and good ole friend of mine drive it members les lecturely challenge the stories some may be true some not memories of past winners is reversed presbyterian on the wall of champions. >> make sure you see the one in to the corner that's me and. >> no? not bingo or scrabble but the pare of today's competition two doreen and christen and beginninger against robert and others easing our opponents for the stair down is a pregame strategy even in lawn bowling. >> play ball. >> yes. >> almost. >> (clapping). >> the size of tennis ball the object of the game our control to so when the players on both sides are bold at any rate the complete ends you do do scoring it is you'll get within point lead for this bonus first of all, a jack can be moved and a or picked up to some other point or move the jack with i have a goal behind the just a second a lot of elements to the game. >> we're about a yard long. >> aim a were not player i'll play any weighed see on the inside in the goal is a minimum the latter side will make that arc in i'm right-hand side i play my for hand and to my left if i wanted to acre my respect i extend so it is arced to the right have to be able to pray both hands. >> (clapping.) who one. >> nice try and hi, i'm been play lawn bowling affair 10 years after he retired i needed something to do so i picked up this paper and in this paper i see in there play lawn bowling in san francisco golden gate park ever since then i've been trying to bowl i enjoy bowling a very good support and good experience most of you have of of all love the people's and have a lot of have a lot of few minutes in mr. mayor the san francisco play lawn bowling is in golden gate park we're sharing meadow for more information about the club including free lessons log >> right before the game starts, if i'm still on the field, i look around, and i just take a deep breath because it is so exciting and magical, not knowing what the season holds is very, very exciting. it was fast-paced, stressful, but the good kind of stressful, high energy. there was a crowd to entertain, it was overwhelming in a good way, and i really, really enjoyed it. i continued working for the grizzlies for the 2012-2013 season, and out of happenstance, the same job opened up for the san francisco giants. i applied, not knowing if i would get it, but i would kick myself if i didn't apply. i was so nervous, i never lived anywhere outside of fridays fridays -- fresno, and i got an interview. and then, i got a second interview, and i got more nervous because know the thought of leaving fresno and my family and friends was scary, but this opportunity was on the other side. but i had to try, and lo and behold, i got the job, and my first day was january 14, 2014. every game day was a puzzle, and i have to figure out how to put the pieces together. i have two features that are 30 seconds long or a minute and a 30 feature. it's fun to put that al together and then lay that out in a way that is entertaining for the fans. a lucky seat there and there, and then, some lucky games that include players. and then i'll talk to lucille, can you take the shirt gun to the bleachers. i just organize it from top to bottom, and it's just fun for me. something, we don't know how it's going to go, and it can be a huge hit, but you've got to try it. or if it fails, you just won't do it again. or you tweak it. when that all pans out, you go oh, we did that. we did that as a team. i have a great team. we all gel well together. it keeps the show going. the fans are here to see the teams, but also to be entertained, and that's our job. i have wonderful female role models that i look up to here at the giants, and they've been great mentors for me, so i aspire to be like them one day. renelle is the best. she's all about women in the workforce, she's always in our corner. [applause] >> i enjoy how progressive the giants are. we have had the longer running until they secure day. we've been doing lgbt night longer than most teams. i enjoy that i work for an organization who supports that and is all inclusive. that means a lot to me, and i wouldn't have it any other way. i wasn't sure i was going to get this job, but i went for it, and i got it, and my first season, we won a world series even if we hadn't have won or gone all the way, i still would have learned. i've grown more in the past four years professionally than i think i've grown in my entire adult life, so it's been eye opening and a wonderful learning. >> working for the city and county of san francisco will immerse you in a vibrate and dynamic city on sfroert of the art and social change we've been on the edge after all we're at the meeting of land and sea world-class style it is the burn of blew jeans where the rock holds court over the harbor the city's information technology xoflz work on the rulers project for free wifi and developing projects and insuring patient state of at san francisco general hospital our it professionals make guilty or innocent available and support the house/senate regional wear-out system your our employees joy excessive salaries but working for the city and county of san francisco give us employees the unities to contribute their ideas and energy and commitment to shape the city's future but for considering a career with the city and county of san francisco i'm derek, i'm hyungry, and ready to eat. these vendors offer a variety of the streets near you. these mobile restaurants are serving up original, creative and unusual combinations. you can grab something simple like a grilled cheese sandwich or something unique like curry. we are here in the average eight -- upper haight. you will be competing in the quick buy food challenge. an appetizer and if you are the winner you will get the title of the quick bite "chompion." i am here with matt cohen, from off the grid. >> we assembled trucks and put them into a really unique urban settings. >> what inspired you to start off the grid? >> i was helping people lodge mobile food trucks. the work asking for what can we get -- part together? we started our first location and then from there we expanded locations. >> why do think food trucks have grown? >> i have gotten popular because the high cost of starting a brick and mortar or strong, the rise of social media, trucks can be easily located, and food trucks to offer a unique outdoor experience that is not easily replaced by any of their setting any where else in san francisco. san francisco eaters are interested in cuisine. there adventuress. the fact they use great ingredients and make gourmet food makes unpopular. >> i have been dying to have these. >> i have had that roach coach experience. it is great they're making food they can trust. >> have you decided? >> we are in the thick of the competition? >> my game was thrown off because they pulled out of my first appetizer choice. >> how we going to crush clear? >> it will be easy. probably everyone has tried, something bacon tell us delicious. >> -- people tell us is delicious. >> hopefully you think the same thing. >> hopefully i am going to win. we're in the financial district. there is a food truck right there. every day changes. it is easy and fun to go down. these are going to be really good. >> how are you going to dominate? >> i think he does not know what he is doing. >> i was thinking of doing [unintelligible] we are underrepresented. >> i was singing of starting an irish pub. that was my idea. >> one our biggest is the corned beef and cabbage. we are asking people what they're thinking in getting some feedback. >> for a lot of people i am sure this combination looks very wrong. it might not sound right on paper but when you taste it to or have it in your mouth, it is a variety. this is one of the best ways in creating community. people gather around and talk about it and get to know different cultures. that brings people together and i hope more off the grid style and people can mingle and interact and remove all our differences and work on our similarities. this creates opportunity. >> the time has come and i am very hungry. what have you got? >> i got this from on the go, a sandwich, and a caramel cupcake. i went with home cooking. what de think? >> i will have another bite. >> sounds good. >> that was fantastic. let's start with you. >> i had the fried mac and cheese, and twinkies. i wanted to get something kind of classic with a twist on it. >> it was crispy. >> i will admit. >> want to try fried mac and cheese? >> was that the best twinkie? >> would you say you had the winning male? >> definitely. >> no. >> you are the "chompion." clair has won. you are the first "chompion." >> they know it was me because i got a free meal. and check a map on -- check them out on facebook. take a peek at the stuff we have cut. to get our -- check out our blog. i will have. >> shop and dine the 49 challenges residents to do they're shopping with the 49ers of san francisco by supporting the services within the feigned we help san francisco remain unique and successful and rib rant where will you shop the shop and dine the 49 i'm e jonl i provide sweets square feet potpie and peach cobbler and i started my business this is my baby i started out of high home and he would back for friends and coworkers they'll tell you hoa you need to open up a shop at the time he move forward book to the bayview and i thinks the t line was up i need have a shop on third street i live in bayview and i wanted to have my shop here in bayview a quality dessert shot shop in my neighborhood in any business is different everybody is in small banishes there are homemade recess pesz and ingredients from scratch we shop local because we have someone that is here in your city or your neighborhood that is provide you with is service with quality ingredients and quality products and need to be know that person the person behind the products it is not like okay. who . >> mark, would you please take the roll? >> clerk: sure. [roll call] >> all right. >> next item is the approval of the minutes of the health commission meeting of march 2, 2021. mark, before we go forward, do we have any information to share? >> yes. commissioner christian has asked for several revisions. on page 10, underneath the second commissioner's comments, underneath the commissioner comments session, and i will read the sentence that she's asked to add -- well, actually, i'll read all of her comments. commissioner christian noting she is a relatively new health commissioner, asking if cpuc is required to state to clients that they are going to close services in the community. several lines down, i had a typo where it is ordered in your minutes, it says what, but it should have said why, and she also asks why it was asked several years [inaudible] these are the revisions requested by commissioner christian. >> all right. thank you, mark and thank you, commissioner christian. upon reviewing the minutes, commissioners, do we have any further amendments or is there a motion to approve? >> so moved. >> second. >> and before we move to do a vote by roll call, i'd like to check public comment. folks on the public comment line, i have a statement for you. for each agenda item. members of the public will have the opportunity to make public comment for up to two minutes. the public comment process is invited to promote ideas or information from the community. however, it's not meant for members of the public to engage in back and forth with the commissioners. please note that commissioners do consider comments from the public when discussing the item and making a request to d.p.h. if you'd like to make comments on the minutes of the march 2 meeting, please press star, three. star, three. all right. i do not see any hands, commissioners, so i will do a roll call vote. [roll call] >> all right. the item passes. >> great. thank you, mark. we will move onto our next item, which is health commission officer elections. at this point, we will accept nominations for vice president of the san francisco health commission. do we have a nomination? >> commissioner guillermo has her hand up. >> commissioner guillermo? >> yes. i am excited and pleased to offer the nomination to commissioner laurie green as vice president of the commission. she's already served in this capacity and is currently serving in this capacity and has been an excellent leader to date. i wanted to speak to a number of qualities that i think make her highly qualified for this position. the clinical expertise that dr. green brings is something that is really critical, i think, to us here on the commission. it's essential to our understanding both the clinical and the quality needs that need to be addressed as a matter of policy and program for the commission hand in hand with the department, particularly as it relates to the healthnet -- health network; that the issues and policies are things that she has a deep understanding had and lends not only knowledge but critical insight. she is a long-standing member of the medical community in san francisco working on behalf of families and children in the city, and so i think that that, again, makes her highly qualified and valuable to the commission and to the residents of san francisco in terms of being able to provide input to the commission on program services and so on. also, being a member of the provider community for both parents and children is very critical. also, being a colleague and a positive force of energy to our problem solving and some probing for the root causes of things to address them in programs and policies is something that i experienced, so i am more than happy to nominate dr. green or commissioner green to, again, be nominated or elected as vice president for the commission. >> thank you, commissioner guillermo. do we have a second? >> second. >> second. >> all right. lots of seconds. commissioner green, do you accept the nomination? >> well, it is such an honor and a privilege. this has been, commissioners, far and away, probably the most fulfilling, exciting, and meaningful thing in my career probably in the last three decades despite the number of events that i get to participate in when people have their children. so it's a real honor, and i would very much enjoy continuing in this post. >> thank you very much. before we continue, mark, do we have public comment on this item? >> i do have a few hands raised. folks, if you'd like to comment on the nomination of vice president elections, please press star, three. star, three. i'm going to go to the one person who has their hand raised. caller, you're unmuted. you've got two minutes. caller, are you there? okay. commissioner, i'm not sure that person knows what's happening or maybe they're not around, but i think they can move ahead with the vote. >> okay. thank you, please, mark. [roll call] >> all right. i do believe we have a vice president. >> thank you. >> thank you, mark, and congratulations, commissioner green. >> it's an honor to serve. i'm really pleased. thank you. >> all right. thank you. we'll move onto our next officer election, which is election for president of the san francisco health commission. do we have a nomination for president of the health commission? >> i believe commissioner christian has her hand up? >> yes, commissioner christian. >> so i enthusiastically nominate commission president dan bernal to serve as president of this very important commission. as you all know, i'm the newest member here. if you remember when you were new how you recall in a way, daunting, it was to join with all the new information. some of you were in the medical profession, but even so, all the information that may have been new to you, all of the circumstances that you had to consider outside of your previous professional work to politics to the needs of many communities in our city, and so like commissioner guillermo, and like commissioner green, this is an incredibly -- i have a co-worker here who wants to participate, as well. i apologize for that. this commission does such incredible work, and it is an immense honor to be a part of it, and it has been for me, since my short number of months since july, when i joined you, the most interesting and fascinating and consequential thing that i've done. so i'm thrilled to be a member, and i'm thrilled to join you here. and i want to thank commission president bernal for the way that he welcomed me on this commission, for the way that he spoke to me about the duties, for the way that he onboarded me, along with vice president green, incredibly generous with their time, and looking out for my interests here and ability to contribute. so i think for me personally, it's an easy choice. i also think that for all of us and for the community, san francisco's been through a lot, and the world has been through a lot in the last year. the leadership of this commission and with the department of public health, but i'm right now specifically talking about president bernal. the leadership that president bernal has provided for the commission, from my perspective as a new person, diving into this time when so much has been requested and required and demanded of the department and the commission, and it has been very smooth, and the department of public health has done an extraordinary job, and i believe this commission has done an extraordinary job in rising to the occasion. and we're not through the pandemic, we're not through the challenge, but we're on our way, and it's critical, i think, for the leadership to continue that we've had. i'm glad that dr. green, commissioner green will stay on as vice president, and i'm looking forward to president bernal staying, as well. i've known commissioner bernal outside of this work for a number of years, and his deep background in policy, in this state, and his knowledge of the workings of government and the needs of the people, and his dedication, his dedication to the needs of the people and in san francisco in particular qualify him beyond measure for this work, and so i ask commissioner bernal to preside as president for another term. >> and i enthusiastically second, and i could not be more agree with what commissioner christian just said. >> thank you, commissioners. i will check to see if there's public comment. folks on the line, if you'd like to comment on the president of the commission election, please press star, three. i'm going to try this person who's got their hand up again. you're unmuted, caller. would you like to make comment? okay. so we can move forward. [roll call] >> congratulations, mr. president. >> thank you. thank you so much, and thank you to commissioner christian for your very thoughtful words. the depth of experience and knowledge you bring in terms of our criminal justice system, behavioral health, and equity in our city is such an enormous contribution to our commission, so thank you, and thank you also to commissioner chung four seconding and to all of my fellow commissioners for the faith that you place in me for this position. today was one year that mayor london breed issued the stay-at-home orders in response to the pandemic. these are certainly extraordinary times, and i know that i, on that day, thanked mayor breed for her leadership and bold steps to keep us ahead of the curve to whatever extent possible and how proud we all are of the decisive actions taken here in san francisco. we all appreciate the great commitment and leadership of the people of san francisco to protect their families and their citizens, as well. everyone's work has been critical to ensuring our work meets the needs of all people. in the next year, i can continue to work to ensure that we support the excellent response to the covid-19 pandemic here in san francisco to address and eliminate the health disparities and to advance our mission of equity for all san franciscans -- health equity for all san franciscans, especially in our black-african american community. so i'm deeply honored for the opportunity to continue serving, and i thank everyone for the work that you've done to bring us through this pandemic and the work that we need to do even beyond this time, and also thank you to our commission secretary, mark moore, who is also excellent. >> how about a quick round of applause to our officers? [applause] >> thank you, everyone. we'll move onto our director's report. director grant colfax. >> good afternoon, commission, and congratulations on the election of the officers. certainly look forward to working with all of you during this next year. i don't know if this is a new year for many of us, but it certainly is for me. in many ways, it feels like 20 years, and in some ways, it feels like a couple of days that the shelter in place went in order. such is covid times. my director's report has much detail in our covid work and our behavioral health detail, some of which we will go into detail later this afternoon, so perhaps, i would go right into the covid-19 update and double back on the director's report if the commissioners request more detail. does that make sense? >> dr. colfax, if we could ask for public comment on the director's report. >> yeah. >> it sounds like that would be a good time to do that since we're going to head into the -- >> i would defer to the commission. >> yes, let's go ahead and do public comment now and then move into the covid-19 update. >> so folks on the line, if you want to make public comment on the director's report, press star, three to raise your hand, star, three. all right. i don't see any hands raised. >> all right. and director colfax's report is available on the department of public health website if anyone is interested. we will move onto item five, covid-19 update, director grant colfax again. >> so thank you, commissioners. this is our covid-19 update on the eve of the shelter in place order, and just expressing my thanks to the thousands of people that have been working on the frontlines over the last year, including our san francisco d.p.h. team. just an incredible unprecedented year with -- with, unfortunately, many people passing from covid-19, and now, as we continue with the vaccine rollouts, some hope at vaccines remain our ticket out of this pandemic. next slide. so with regard to our cases in san francisco, we've had over 34,500 covid-19 cases reported in the city. this is diagnosed, and you can see there that we had a sharp peak during the holiday surge, and now cases are thankfully leveling off, and unfortunately, we've had nearly 450 deaths in san francisco. any deaths from covid-19 is one death too many. i will say because of our actions early on in the pandemic, with mayor breed's leadership, independent analyses have shown that hundreds of lives were saved due to that early action. just to put this into a clear perspective, an analysis at ucsf indicates that if the rest of the country had taken action similar to san francisco early on in the pandemic, nearly 350,000 lives across the country would have been saved. next slide. so this is in regard to our number of cases per 100,000. as you can see, we've had a very sharp decline over the last month or so with regard to cases diagnosed with covid-19. on that far right, you can see the purple curve is starting to level off just a little bit at four per 100,000, especially as we gradually reopen. as you know, in the region, variants are more spreadable, and we have two of the b-117 variants typed in san francisco. again, this is not unexpected, we knew that the variants were going to get here, and it's just a balance of optimism between what the vaccines have and the urgent need of the on going mask and not gather with people outside one's household outside of the current health orders. next slide. so with regards to cases diagnosed, you see the inequities in the pandemic that have been with us. 41% of cases are among latinos, and with regard to the age group, nearly -- over half of diagnosed cases are among people under the age of 40, and yet we are obviously focusing on vaccinating people who are most at risk for the disease, including people 65 and over. you'll see that in the next slide. so this is with regard to characteristics of death. people have died in the city, 85% have been 65 and over. i would just call your attention to the bottom left of this slide with comorbidities. over two thirds of people that have died from covid-19 have had comorbidities. the other people, we don't know their difficulties. and then, with regard to race and ethnicity, you'll see that people who identify as asian account for 37% of deaths, and dr. jim marks, our advanced planning commander at covid command, will be presenting a more in-depth analysis of this after my presentation. next slide. our key health indicators are hospital capacity remains good, and as you can see in these green -- first three green boxes, our rate per 100,000, again, is 4.0. just to emphasize, in december, we hit 43.5 per 100,000, so we're now at a decrease by ten fold of our cases per 100,000. our testing, over 5,000 tests a day being done. it is worth noting that you are on testing numbers -- our testing capacity is robust, and our testing numbers have dropped substantially since the november-december period as testing numbers have consistently dropped across the country. our contact tracing numbers remain good, over 80%. and then, our p.p.e. is at 100%. next slide. you saw in the first slide, the cases and deaths peaking there, as well. you saw a dramatic drop and an indication of cases leveling off as far as hospitalizations a day. we are obviously following that number very carefully. next slide. so just wanted to also provide the commission with an update. our long-term skilled facilities residents have been vaccinated in those facilities, and per your request from two weeks ago, we have modified our facility visitation orders to reflect both the orders of the california department of public health and the california department of social services. this is good news for the residents of these facilities and their families, and you can follow the details there, and these are posted on our website, and we've worked with the facilities to make sure that the information is getting out both from the residence to the families, and at laguna honda, we have no active cases of covid-19 among residents, so indicative of how far we've come in this challenging year, particularly in these facilities. we're at very high risk for covid-19 outbreaks, and the residents were at a high risk for death. next slide. and i do just want to also just emphasize another population that is particularly vulnerable to covid-19. which is the homeless population, and very early on in the pandemic, as you know, we aggressively moved to slow the spread of covid-19 in the homeless population, including putting hundreds of very vulnerable homeless individuals into shelter in place hotels, making sure there were isolation and kwaurnt teen hotels available, making sure that testing was -- was scaled up quickly in shelters and managed outbreaks appropriately, and i think that this work which was done in partnership with homelessness and supportive housing done in partnership with abigail stewart kahn and under the directorship of mary ellen carroll, we've had 678 cases in people experiencing homelessness and four deaths. one death is too many, but this is much lower than other jurisdictions have experienced across the country, and i think certainly we've focused on this population very early on. and as of yesterday, people experienced homelessness in congregate settings or who are likely to go into cop greggate settings -- congregate settings are eligible for a vaccine as well as those 60 or over. just want to 'em if a sees the conditions that we have not talked about too much in the commission. next slide. in terms of vaccinations, we continue to vaccinate san franciscans as quickly as vaccine comes in. we have the capacity to do well over 10,000 vaccines in arms a day. we now have three vaccine products, excellent products, safe products, effective products. i had the pleasure of joining mayor breed today at masking hall health center, where she received a vaccine, johnson & johnson vaccine. our vaccine is such that every door is the right door. low barrier vaccine access is the go for all san franciscans. we have made good progress with 31% of the population of san francisco receiving at least one dose of -- of vaccine, which is higher than the national average by quite a bit. right now, the national average is about 21%. next slide. and this is looking at vaccinations by race and ethnicity and looking at the different populations in san francisco by race ethnic and the facts that you saw on the last slide, and the fact that these numbers really reflect that the eligibility for vaccines started with health care workers and now people 65 and over are eligible. just to point out on the left panel, this is san franciscans over 16 vaccinated overall in the blue bars. they had received one vaccine, compared to the gray bar, which is the population overall. you can see across our system of vaccine administration, there have been fewer vaccines administered to black african american or latino, a population compared to the burden of covid-19, and then, on the left side, you can see the vaccine distribution that d.p.h. has administers, and you can see the much better numbers with regard to the distribution of the vacuumine there. so just to emphasize within the d.p.h. vaccines that we have, we have the ability to ensure the best that we can that vaccines are going to the arms of people who are most at risk for covid-19. next slide. and this is a another -- this -- this slide reflects the geographic distribution of vaccines in the city, and it tells a similar story. you can see on the last panel here, vaccine has been, for the most part, fairly evenly distributed overall in the city. you can -- as evidenced by this map, which shows the distribution of vaccine, again, across all providers, and then, on the right side, you see the vaccine distribution by neighborhood of d.p.h. allocated vaccine, and you see a concentration in the southeastern part of the city which very much reflects the map of covid-19 prevalence in san francisco. and at the bottom, you can see the various neighborhoods that -- where -- where the -- and then, the percent of vaccinated in those neighborhoods. and i would just say also, just to emphasize the focus on people 65 and over, we have vaccinated 72% of the population 65 and over at this time, so good progress there. we do have -- we're continuing to look at our data across the city, neighborhood by neighborhood. it provides a census track to discover where the high prevalence of nonvaccinated adults live and ensuring that our outreach teams, our community education teams, and our community partners are educating and encouraging people who are eligible for the vaccine to get the vaccine, again, at one of the many options that people have now to get the vaccine. again, the delay is the adequate supply of vaccine to make this go even farther than it is right now. next slide. >> the confusion that has been created by san francisco having different guidelines for the state has not been mitigated by san francisco now saying they're going to have the same guidelines as the state, and the nursing homes are not being transparent. please keep in mind this is not granting a privilege to families and long-term care patients, it is a right of free association that is being resumed, and a lot of families and residents are hurting, isolated, failure to thrive, and i ask you to publicize what the rights are in a press release. the departments are going to place ash arbitrary limits thae not necessary or legal. i am seeing this in my mother's own nursing home, which is one of the best nursing homes in the city. we know that the not-for-profit nursing homes are always a little bit better, and so i ask you to not dump this all on the frantically overworked long-term care ombudsman but to create a situation where families can call to have their visitation and care giving clarified to create a hotline for that and to also publicize what the rights are now, and once they are liberalized more, to notify us in a press release. thank you very much. >> thank you, dr. palmer. >> hi. this is jessica lehman with senior disability action. i want to thank the department of public health for making vaccines available to seniors with disabilities and other health conditions. [inaudible] -- for all unhoused and [inaudible] people. one is i know we've been talking a while about -- [inaudible] >> you're breaking up, caller. >> i'm sorry. can you hear me? >> okay. so i want talking about the need or mobile -- i was talking about the need for mobile or house care vaccinations for the very old or very disabled or those who can't get to a vaccination site. we need to make that happen right away, and to make appointments available for people who need them. i was hearing today about home care workers who have been eligible since january, and they still have not received a vaccination, so to find a way to make that work. also, to support the last caller, dr. palmer, that you're working with nursing homes to ensure that people are able to visit and patients are able to receive the emotional and health support from friends and family. >> thank you so much. all right. caller, i've unmuted you to let you know that you're there. >> hello. >> yes. it's your turn to talk. >> yes. my name is betty trainer, and i'm also with senior and disability action. first, i would like to thank the department for allowing people are disabilities to get vaccinated. also, people that are not able to make it out to a vaccination site -- we know people in our neighborhoods who just can't get there, so we really need an emphasis on the mobile vans or other ways to reach these people. i know it was kind of mentioned in dr. colfax' report but if our organization or other organizations can be of help in reaching people who just can't make it to vaccination sites. thank you very much. >> thank you for your comment. that is the last caller, commissioners. >> mr. moore, could i ask to get that last person's contact information and outreach. it would be wonderful to work with that organization, so if we're not already, it would be great to do that. >> i've got her name and organization. i've provide that. >> thank you, mark, and thank you, dr. colfax and those who called in to share their opinion and perspective. we can now move onto the next portion of the update. >> good afternoon. good afternoon, commissioners. this is jim marks. i am currently the planning section chief at the covid command center. >> hello. welcome. >> thank you. in early january, we had come and presented to you data on asian deaths in san francisco from covid, and you had asked for an update, so i'm going to present that update today in six slides, and then happy to take any questions. just to present a perspective, as dr. colfax had alluded to, if you look at the 26 biggest jurisdictions in the united states, san francisco has the lowest death rate per 100,000 population at a little above 50. once you get to the fourth jurisdiction, santa clara, the death rate is actually twice as much or higher than the death rate in san francisco. we can look at the two biggest contributors to the death per 100,000. how many cases per unit population are there, and you can see san francisco has 39.7. that's the second lowest population-based case rate, and then, the second contributor would be the case-based death rate, so what percent of those cases die? and san francisco has the second lowest case based death rate. and those two things together, having a low case rate, which reflects the rate of transmission going on in the community, and then, your case-based death rate determines your deaths per 100,000 population, and we can keep that in mind when we look at contributors to deaths person 100,000 by race and ethnicity. here's a graph of that for the 446 deaths that have occurred to date in san francisco. you can see right above the highlighted green boxes which highlights the asian data is data for all of san francisco, so those 446 deaths population-based case rates. you can see the asian-based deaths per 100,000 population is pretty comparable to the overall san francisco rate, so 56.6 versus 51.3. and then, we can shift a column over, and what we see is actually the asian case rate is quite low, at 21.1. about half of the rate in san francisco and comparable to the -- the rate in whites, and actually five times less than the rate in the latinx population. so the asian population has a lower population-based case rate. however, if we go all the way to the right and look at the deaths per 100 cases, the asian case based death rate is actually the highest in san francisco at 2.7%. it's double the san francisco rate and 50% -- a little over 50% higher than the white race, so that's -- while the overall death rate per unit population per asians is comparable to all san franciscans, the case based death rate is significantly higher. it's more than doubled. so we can start asking ourselves why, why that would be. next slide. so we know probably the single most important contributor to case-based death rates is the age of -- age of the cases, so in san francisco, 83% of deaths occur in those 65 and older. and 65% of the deaths occur in that small population that's over 80. so here, you can see by race, ethnicity, the percent of cases over age 65 and the diagnosis. and what you see, the asian population has the highest percent of cases over age 65 and the highest average age at diagnosis. next slide. we can dig a little deeper in that by actually looking at the histogram, so distribution on the cases, the case count on the y-axis is a function of the age bracket on the x-axis, and the age brackets are every five years, starting with 0-5 on the right and ending 95-100 on the left. i appreciate that the x axis is a little small and hard to read, so i've highlighted the bar with the 65 and over case counts. to the right of that would be 65 and over five-year age increments. what you can see, for the asian population, there's a high fraction that's over 65, and a significant fraction of the population actually of cases that are over -- that are between 80-85, 85-90, and 90-95. so to summarize this part, asians have a higher case-based death rate and are significantly older than the other race ethnicities, a significant fraction of that age. not just above 65, but above 80. and then, the last slide -- the other thing we looked at besides age was cases in skilled nursing facilities, because we know, for example, is that while there are residents [inaudible] these are cases, the numbers overall in asians and non-asians. if you look at the number, 422 total, asians are a little over 40% of cases in skilled nursing facilities. that's pretty similar to the 41% overall of the population. don't have a race ethnicity denominator for the skilled nursing population. however, because the overall asian case rate is quite low, at 3688, compared to whites at 18,403, the actual number of the total number of cases of asians that are in skilled nursing facilities at 4.3% are about threefold higher than non-asians, so proportionately a higher fraction of asians are in skilled nursing facilities, which are congregate facilities, which is easier for spread to occur. and then, if we look at the right, what we can see is that the asian case-based death rate in the skilled nursing facilities, which turns out, it's 21.6%, which would be 36 deaths out of 167 cases on the left. this 21.6%, in the non-asian case-based death rate is a little higher. we would hypothesize that that could be because that asian population in the skilled nursing facilities is older? we don't know that yet. we're digging into that, so to summarize what we know of the -- of the total deaths to date, that the overall death rate in the asian population is comparable to that of all san franciscans, but the overall death rate is lower, but the overall case rate is higher, and we believe that's wholly attributable to the fact that the asian cases are older and disproportionately older at 65 and older. remaining work that we have to do, we're going to dig into the ages of the asian and non-asian deaths in skilled nursing facilities to confirm that the average age of asian deaths is older, and we'll also do a regression analysis of deaths by age, ethnicity to confirm whether there are other nonage based factors that are contributing to that higher death rate. we looked into doing that earlier with the data before the last surge around february, and there just -- there weren't enough deaths for us to be really be able to draw a conclusion, but we'll repeat that. unfortunately, there have been a significant number of deaths during the third surge, so we'll -- our best thinking right now is that this higher case-based death rate is due to the fact that the asian population of cases is older, but we will do some additional data analysis to confirm that, and i'm happy to take questions. i think i'm on mute or you're on mute. >> thank you so much. thank you. thank you, mr. marks. before we go to commissioners' questions or comments, mark, do we have any public comment? >> folks on the comment line, could you please press star, three if you have any comments? all right. we've got one caller. i will unmute you, and you'll have two minutes. okay. caller, you're unmuted. please let us know that you're there. >> yes, this is dr. palmer again. i just wanted to point out with the vaccinations in the nursing homes, the nursing home rate of staff infection and resident infection and similar long-term care facilities is really down to nothing or almost nothing, and this should not be an excuse to prevent visitation and family caregivers coming in if they use the same precautions as staff. i just wanted to put that in here. thank you. >> any other callers would like to make public comment on this item? >> thank you, mark, and thank you for our comments. before we go into commissioner questions, given that both mr. marks' presentation and director colfax' presentations touched on skill nursing facilities, dr. colfax, could you just clarify, what are skilled nursing facilities? >> yes. so the skilled nursing facilities in san francisco are licensed and overseen by the state overall. obviously, we have jurisdiction over the skilled nursing facility laguna honda hospital, and the state monitors and licensed d.p.h. and laguna honda, but the other licensed facilities are licensed and overseen by the state. the local facilities are required to comply with our local health orders, which is why we wanted to make sure that the commission has orders that align with the state, and we've been working with over 99 facilities in the city that were affected by the order so that they and their staff understand the implications and that people and their families can reunite with their families in a way that is safe and welcoming. >> thank you, dr. colfax. commissioner guillermo? >> thank you, dr. colfax, for coming back to the commission with that data and that analysis, and looking forward to the additional data that you're going to bring. i had one question. i don't know if this data is possible, if you're looking at the nursing homes and long-term care facilities. going beyond age as a factor, would we be able to determine if there are comorbidities present for that population that we're focusing on? because the general data that dr. colfax presented show that it's also due to the existence of comorbidities, so i wonder if that's a factor that goes along with age in the asian community? >> i haven't looked at that. i would say that the comorbidity rate is very high? but we can look at one of those things and get it to you when we come back. >> if you, commissioner guillermo, and thank you, dr. marks. our next commissioner is commissioner chow. >> dr. marks, i want to thank you for providing this data because i think it will helpful and will be helpful as the national asian community continues to analyze the raw data that shows that there seems to be greater numbers of deaths in asians in different jurisdictions in the united states but they don't present really the data behind you. i know leaders have been telling communities that this was initially due to the s.n.f. concentration of asians and that the probability was older. i think that commissioner guillermo's requested that we also look at the comorbidities, that that is helpful, but i think more to the point that you were saying is you're really going to go back into depth yet about the s.n.f., because i think that's really part of the key in terms of that, so i really do want to thank you for taking this effort. it looks like a small segment of people in the city, but it has become a great concern as this has become a finding in many of the other jurisdictions but without the data that you have provided us, so i want to thank you for that. i do want to again, also, ask, in the congregate setting, because we do have a lot of the single occupancy hotels, is that also part of the numbers of deaths that were not within a certain number? >> thank you for your comments, commissioner. they're always insightful, so i don't know in we [inaudible] see if there's something there other than just age differences. and then, to your point about other congregate settings, i want to say that if we combine s.n.f.s, s.r.o.s, and other long-term care facilities, they're about 42% of deaths. so s.n.f.s in and of themselves are the largest contributors, but they definitely contribute. those are generally associated with outbreaks, and so we can go back and look at that also by race, by race and ethnicity. there may be that we get so stratified there that we can't look at such small numbers, but we're willing to look at that. the facilities are more kong greggate, and the residents tend to be old -- congregate out. >> thank you. the s.r.o. reports were brought to be a few years ago, such a high percent of the reports of the s.r.o.s were from the asian community [inaudible]. >> oh, thank you very much. >> commissioners, any other questions or comments? >> well, yeah. i'd like to make one more, which is that i know there's been a lot of discussion in the skilled nursing and the need that have been expressed by the public in terms of trying to outreach their loved ones. i think the overall approach from the city has been just like it's been for the rest of our population, showing, therefore, our lowest death rates, and i would imagine that remains true for our big laguna honda. i think over the past years there's been six or seven deaths in a congregate setting of over 800 patients. so i do think that the department should get credit for the fact that it has looked at how, then, to respond to the social needs of that population, and that these rules apply also to laguna honda. so first grateful to the department for having actually, you know, worked hard on a very vulnerable population, and as we know, the s.n.f. portion has been a high proportion of total deaths. i also do think that it's important for us to all under, as president bernal pointed out, and dr. colfax, overall, the skilled nursing facilities are not in our jurisdiction, and i think they will put out advice from the department already on what's to be done. and i suppose if there are any ways in which the department can be helpful, it might target those. but even if it's the jurisdiction of the state, then it makes it hard for the city to just intervene. it's almost as frustrating as watching the board of education here try to work while the city is trying to tell them it's safe to work and standard schools again, so i know this is a major problem, but i do [inaudible] think that it's to say okay, just like we are doing with schools. it's okay to really try to bring these back, and we will continue to try to monitor for any changes. >> thank you, commissioner chow. any other commissioner comments or questions? thank you, dr. marks, for your presentation to illuminate the data. i know what we've seen in the cases and death rates among our asian community members, particularly as they're much more often targets of violence in our communities based on some of the really hateful rhetoric that we've seen over the course of this pandemic, so thank you so much for that. i also would like to say with regard to this overall agenda item and the presentation of the city's response to the pandemic, it's important to recognize our work of the facilities of the city's public health department, and note that there are no active cases now at laguna honda and everyone, so thank you, again, as having a robust vaccination effort there. so thank you to everybody within san francisco d.p.h. and the general and laguna honda for your really extraordinary work that saved lives. with that, we will move onto our next item, which is general public comment. mark, do we have any general public comment? >> sure. i'm going to read a statement first, commissioner. at this time, members of the public may address the commission on items of interest of the public that are within the subject matter jurisdiction of the commission but not on the agenda. for each matter, members of the public may address the commission up to two minutes. all right. so folks, this item is for items that are not on the agenda. if you'd like to raise your hand to speak, please press star, three. caller, i have unmuted you. please let us know that you're there. >> hi. can you hear me? >> yes, please go. you've got two minutes. >> excellent. thank you. my name's ryan murphy. i work the eviction defense collaborative. i am the deputy director of litigation there, and i am here today to request that d.p.h. amend its public health guidance with respect to s.r.o. residents, specifically a good that d.p.h. guidance be amended to recognize that s.r.o. residents in supportive housing are allowed present visitors, and also that d.p.h. put some language in its guidance and recommendations that nonof its rules should be used to support eviction of low-income tenants. so why am i requesting this? is my office, the defense collaborative, we've still got many [inaudible] i personally represent many tenants who are being evicted basically for violating the strict visitor policy, and landlords are relying on this d.p.h. basis to evict. this is incredibly harmful to our older tenants, but it also undermined the d.p.h. purpose of the rules and really what they're geared to do, which is to reduce transmission. i think it's not controversial to say any -- >> sir, your time is up, can you wrap up and finish your sentence? >> sure. i think it would go a long way to allow visitors back in hotels -- >> sir, your name is way up, so i'm going to have to mute you, but thank you so much. >> thank you. >> all right. commissioners, that is the only comment on public comment -- on general public comment. >> thank you, mark. we'll move to our next item, which is the community and public health committee update. commissioner giraudo. >> thank you. hi, president bernal. we had excellent discuss with director almeida. our first discussion was on the housing health service programs. the board of supervisors implemented it in june 2019. this is a pilot program for individuals incapable of caring for their own health and well-being and have refused voluntary services. the [inaudible] is in the pathway for conservatorship is if one has eight or more 5150s in a year, and if one has five or more, they are on the pathway to conservatorship. in a random sample that was presented, 84% of the 5150s called were by either a stranger or a friend. the average age was 50, and the gender was male, and the race was caucasian and african american, but the african american population was disproportionately higher with our population. so the average of one had 10.4 visits with emergency psych services in one year. so it is a pilot program, and it is also integrated with our second agenda item, which is the assisted outpatient treatment program, which moves severely mentally ill individuals into court ordered treatment. it is community based, it's mobile, it's multidisciplinary. and the approach, which i thought was excellent, was whatever it takes to help, we are going to work with that individual to try to make it work. we had 98 referrals. 78 had on going commitments or hospitalizations or been incarcerated. so of the 95, 78 were served, and the -- again, the breakdown of age group was between 26 and 45, more male, african american male and white. 52% of people in the program came from p.e.s. 51% have been in intensive case management, and the redirection in negative case contacts, it's a good reduction for both recycling into p.e.s. or into the jails. what was significantly noted for this program is covid has had a real impact over the years because it has been difficult to connect and contact individuals, so it is, as things loosen up, it is hopeful that more individuals will be served. and the last presentation that will be given on this street crisis response team also impacts the information that i was giving to committee today. and that's the update. >> thank you, commissioner giraudo. before we have any commissioner comments or questions, mark, do we have any public comment on this item? >> folks wishing to make public comment on this item, please press star, three. this is item 7. no hands, commissioners. >> commissioners, any questions or comments? >> well, actually, i did have one, i'm sorry. if i may, president bernal, because laura's law was presented to the commission several years and was controversial by some people, and the city thought this would be an added tool, i wonder if, during the presentation, because it was made at committee level now, and it does look like they're using it, does the department feel like this is a useful rule? it isn't that we need to put people under conservatorship. i think it was one of the sticks over the carrots of the character work with treatment, so i just sense that people were really happy to have this as a tool. >> my understanding, and i think director almeida is on her, too, but laura's law is really the assisted outpatient treatment program, so that is really the mandated court ordered outpatient treatment per the severely mentally ill, so that is, from my understanding, what is preferenced to go forward before conservatorship. and doctor, you might have a little more specific information to answer the question rather than me, please. >> of course. i'm happy to jump in, and thank you for the opportunity. commissioner, i would just is a that, you know, i've mentioned this earlier in the presentation that conservatorship is in the continuum. [please stand by] >> -- patients of the pediatric clinic. let us know that 16% of the pediatric after hours patients are referred by the mission bernal pediatric clinic. also, i provided information from suter like race and ethnicity for the mission bernal and pediatric clinics and after hours services and there was also separate analysis about privately insured patients of all clinics. and, the last thing i want to note just on the data portion from the last hearing is that mission neighborhood, the information they collect from the patients includes age, date of birth, ethnicity, sexual orientation, gender identity. and so that information will be collected at these clinics as well. so under prop q, the health commission holds these public hearings prior to a closure, prior to the level of services in the community. and the health commission makes a determination of whether the reported change will or will not have a detrimental impact on the community. and, as a reminder in the first hearing, a recent health review has reported six closures throughout san francisco. so for this prop q, we are discussing a conclusion that's coupled with a community support. so they obtain the level of services and the community in the same location. and, i want to end just by stating that mission neighborhood is a close partner of the san francisco health network and they are a key part of san francisco's health care community and that based on all of the information and the plans that were provided by both suter and mission neighborhoods, we don't anticipate any major detrimental impacts on the community due to this closure and we are in support of mission neighborhood's growth in san francisco. and, so, if appropriate at this time, i would like to invite patty caplan our chief operating officer of the mission neighborhood to provide a quick update about their ongoing negotiations. >> yes, my name is patty caplin and i'm the chief operating officer. just to update you on our progress with the various health plans through our pre-existing and executed contracts, mission neighborhood can reach 65% of the patient population at the mission bernal clinics. the largest patient group is through the san francisco health plan northeast medical services for medical. we have long-standing collaborative relationships with both the san francisco health plan and northeast medical services which is a fellow federally qualified health center. we also have contract with san mateo and from blue cross and blue shield and we are a medicare provider as well. we are in the process if adding additional commercial agreements and hill physicians medical group that will get us to reaching another 30% of the patients. and brown and tollen has about 14 relevant pairs and products and hill physicians as 16 and we already have agreements with those two medical groups and medical and that is my update. >> thank you. so then to move forward, i just want to mention commissioners you were presented with a proposed resolution today and the resolution that i believe also proposed the revisions from commissioner chow . so if you'd like to go through those revisions, i can read them. >> actually. >> is that the conclusion of the presentation? >> yes. sorry about that. >> thank you very much. so, before we move into any discussion of possible amendment, do we have a motion that the closure of the mission bernal will or will not have a detrimental impact on the health care services in the community? do we have a motion? >> clerk: commissioners. >> i'll move the motion that the transfers of the clinics will not have a detrimental impact. >> clerk: thank you commissioner guillermo. do we have a second? >> commissioner: i second that. >> clerk: commissioner chow. chow actually i have some amendments and we should consider them as coauthors but i'm certainly happy to present that we wanted to put into the whereas is the agreement with the five year grant and wanted to also note that the louise arrangements of both sutter and the mission neighborhood have were consented to be another five-year term if so desired and maybe commissioner christian can also then add as she did on the further resolve on the further in financing that we've received. >> commissioner christian: thank you, commissioner chow, for drafting those to the proposed resolution. mark, could you do me the favor of reading them as they stand right now. >> sure. so on commissioner chow requested or suggested that there be two new whereases and i will read the combined language of commissioner chow and commissioner christian together. i'll do the first one first. whereas sutter bay hospitals and mission bay health will ensure adequate bridge funding for successful transition and second whereas, sutter bay has affirmed it is really to continue the lease in its current location in mission neighborhood health center after five years. and then, for the now therefore it be it resolved clause, i'll read what exists and i'll note what's been added. that with the closure of the mission bernal adult clinic and the admission bernal pediatric clinic, the availability of is the new part of quality primary care and after hours pediatric care, san francisco will not be reduced. and, then the final further resolves has been commissioner christian suggested this amendment: the closure of the bernal adult pediatric clinic will not have a detrimental impact on the health care services in the community, here's the new part, under the term set forth in the new financial plan in the sutter and mission neighborhood health center. >> commissioner: the primary concern i have is whether the sutter and mission neighborhood feels that language is correct. i had questions about how strong the -- and how [inaudible] the commitment to successful transition past five years is, what commitments are being made, if any, to ensure that should the projection be incorrect or inaccurate in any way, that the necessary support would continue and i think this was a question that was raised by several commissioners at the last meeting and i'm not certain that the information that we've been given [inaudible] in the proposed amendment. so procedurally, i'm not really sure where we go at this moment given what i -- i just need some confirmation whether or not the proposed language is acceptable to sutter and to mission neighborhood tip. >> clerk: at this point, we would ask the commissioners who moved and seconded the resident halucination whether or not this amendment is acceptable to them. commissioners. >> commissioner: i accept the changes to the revisions to the resolution. >> clerk: thank you. before we move in to commissioner discussion and/or a vote, mark, do we have public comment on this item? >> while we're checking on public comment i would just like to ask commissioner christian to help facilitate that the new language is accurate and i'm also going to jump in and say that this resolution is not binding, this resolution is a record of what you all at the commission are approving today based on your understanding of the situation. just to clarify, it's not binding to action in the future, it's more like a road map for the commission and the dpa in the future to see what happened today. there are several folks here. >> clerk: and, mark, thank you for bringing that back up. is this an appropriate time to ask claire lindsey and her colleagues to respond to commissioners questions. >> hi commissioners. we are accepting of the amendments and i would like to invite my colleagues from sutter to respond. >> clerk: thank you. >> if i'm understanding and following the verbage or recommendation of the amendment was after we were going in to the additional 5-year lease, then the question is would we be looking to renew that should mission neighborhood want to continue and the answer is "yes". >> commissioner christian, does that respond to your question? >> commissioner christian: it responds to one portion of the amendments that were made. there's also the question of -- at the last meeting, several commissioners brought up the question whether there was any room for as commissioner chow noted whether there is any room for a safety net to ensure the clinic to continue if the projections are not accurate. so, in addition to the lease, there was a question of whether there was any commitment to ensure that financially things would be fine if the projections for some reason were not accurate. and i think that the spirit and the intent of this resolution is to understand that there is a commitment from sutter, whether there is a commitment from sutter but hopefully there is a commitment from sutter but the financial should be after the 5-year period based on the projections for after whatever reason. another pandemic, let's say, might come and there could be costs that no one could foresee. in such a situation, whatever it might be, would sutter be there to continue support for the clinic? i think we need to understand that in determining whether we can say that it will or will not be a detriment for this transfer to take place. >> so i'd love to share with the group today. this has been a very collaborative journey for the past year plus. i mean, really how we came to this grant agreement and the amount really was a collaborative effort and it was based on looking at our historical data. we purposefully did not look at data this past year with the pandemic because it's not an accurate reflection on what's happened in the past. so i mean, if needed, we can talk, but it seems like, i mean, we feel pretty strongly that the grant is pretty accurate and the amount. i mean, i'll ask brenda or patty if they want to add comments from their perspective. >> thank you. do we have additional comments from bernal health center? [inaudible] if not, did that respond to your question, commissioner christian? >> president bernal: hi, brenda. >> sorry. i was having some trouble with the mute. the only comment that i would make is that, you know,, again, we are confident on the performer we developed. i think as a health center, we're also confident on our relationship with cpnc and our ability to reach out to garner more support or to leverage services in a way that would ensure that we continue to meet the needs of the patients that are being served at mission bernal. and, i mean, all we can give as proof is really our history, right, of being able to serve this community and finding resources and ways to do that. clearly, we have other health centers and should we have to also support with some of the revenue from our other health centers, we would do that, you know. that wouldn't be ideal, but we can do that and ensure that the clinics are successful over the long term. >> president bernal: thank you, brenda story. >> clerk: vice president green has her hand up. >> president bernal: i'm sorry. i was not looking at that part of the screen. thank you, mark. vice president green. >> vice president green: i'm sorry i wanted to amplify with what commissioner christian said. if the volume of the individuals come to the after hours clinic which i think is particularly critical for working families, would there be a point at which you would feel the need to close services? certainly many of them closed in the face of covid around the city. and i think it would be very helpful to have the reassurance that those hours will be maintained even if a hyperportion of the commercial patients actually don't utilize the clinics because it's great to have contracts, but the patients still have to decide where they wish to access care. if you could give us that reassurance, that would be really helpful. >> i would say vice president green that we have an amendment for after hour services, but we would have to from a business perspective match the need to the resource. so we do have two other clinics that serve children, so it could be that we might consolidate after hour services. so our goal would be to meet the need of community, but we also have to do it from a business smart perspective. if we see that there's very little demand, then maybe we want to consolidate our after hours services across our sites. >> vice president green: i would just encourage those because, again, it's the population we're trying to serve that have long work days that really utilize those after hours. thank you. >> president bernal: thank you . commissioner guillermo, you have your hand up. >> commissioner guillermo: yes. thank you. this is a comment that encompasses the ability of mission neighborhood health center to respond to the needs of the community that they serve, but it's a general statement also about the fact that community health centers throughout the united states and history, their history have dedicated themselves in fact even more diligently than many health systems that serve the same population to those most vulnerable and most underserved populations in their [inaudible] areas and they are monitored in order to be able to do that by the federal funding sources in order to maintain their status. they have also received and are about to receive hopefully advantageous c-structures, the rate structures that are not going to protect their ability to not only maintain their services but to expand their ability to do more and to network much more comprehensively to reduce the fragmentation in reduction of care. much like the department did when incorporating the department clinics into the overall model health network. and i know with the covid legislation that was just recently passed, there is a significant implication of community health support networks and i just think there's a recognition that particularly for older populations that the place for particularly primary care, family care consistently and across all barriers and challenges that community health centers really provide the most valuable service in this regard and partnership with health systems and their health departments. so i would say that, and particularly, given that mission bernal has been in san francisco for decades and has that commitment. so i understand the concern about sutter, but i also would like to promote that community health centers have the ability to rise above the challenges and that commitment to the needs of the communities that they serve and i think that that's something that we should consider. >> president bernal: thank you, commissioner guillermo. mark, at this time, i'll move in to public comment. >> thank you. so, again, if you'd like to make comment on this item, please press starthree and you'll have two minutes to speak . i will unmute each of you as i see and then we'll go from there. okay. caller, you're unmuted. please let us know that you're there. >> yes. thank you, so much for clarifying that the decision you're going to be making now is not binding and instead it's a guidance for future actions. this is going to be a guidance for future action and we should definitely not pass it because cpmc has old history with st. luke's and southeast san francisco. as one of the services which are not profitable to them. if you ask this about this today, you will continue that service. you, the health commission has been through this again and again on particularly on sutter and st. louis hospital and when are you ever going to learn? thank you. >> thank you, caller. please let us know that you're there. >> hello, my name is kong phan. part of san franciscans for health care during this pandemic, we've seen how these people pull together and the ideals of what a health care system is about to take care of everyone regardless of how much people make or who they are. sutter has a track record of doing the exact opposite. closing the nursing facilities and not adequately meeting its obligations here in the tenderloin medical recipient. we support the sutter community health care. but really sutter just can't simply pay someone else to take the responsibilities for five years and it's not up to mission neighborhood health to be able to prove that it's financially sustainable after five years. i feel like there's a lot of questions and the assurances that we're getting here about whether mission neighborhood can live up to it but really the question should be on sutter. sutter has a burden to show that the closure of these clinics is not going to be detrimental as we look past five years. i don't think sutter has the answer. so i think i urge the commission, i feel like there's great questions being asked here and i really would like to make sure that sutter is the one answering to us as a community. we still consider the mission bernal campus not just tertiary or coronary specialized hospital. people we know are born there, walk past there. we see that campus as still a community hospital and we think that sutter still has the obligation to continue that. thank you. >> thank you. all right. caller, please let us know that you're there. >> hello? >> yes. you've got two minutes. >> am i unmuted? >> you're unmuted. >> hi, this is dr. teresa palmer again. i was attending st. luke's. my kids were born at st. luke's. i worked in the safety net clinic years ago. st. luke's was a community hospital that had a lot of safety net services including the st. luke's clinic and cpmc upon purchasing st. luke's has progressively dismantled services to the surrounding community and underserved people and this is part of the pattern. i have no question that mission neighborhood health clinic is a good organization that i urge you should rule that this is detrimental because this is part of the pattern in prokts of cpmc doing what brings the most revenue to its already very rich corporation and not doing what the people need who live around st. luke's. this clinic serves undocumented immigrants and people who are uninsured and cpmc is trying to buy its way out by paying for five years of some of the expenses. so it can generate more revenue doing stuff like super specialty services, micro-surgery, blah blah blah. so well off ensured rich people will come to st. luke's and make revenue for the corporation. this is not -- this should be judged as detrimental because this is not -- cpmc sutter is not going what the community needs, it's doing what it needs to benefit its revenue and this pattern should not be supported. this should be judged as detrimental. already, we have lost many snff beds. >> your time is up, dr. palmer. >> there no beds in the city because of this. this is enough. it should be detrimental. >> thank you, dr. palmer. thanks. caller, you're unmuted. you've got two minutes. >> hi, can you hear me? >> yes. >> hi, my name's jane sandoval. i'm a registered nurse. i currently work at st. luke's and i've been working there for 36 years. st. luke's now the new mission bernal campus. i'm also on the association board. i've been attending these hearings regarding the livelihood of st. luke's for more than a decade. by the way, i'm also a hands-on bedside emergency room nurse. i'm not a manager or someone from the outside looking in. i live this every day. so the theme has been repeating itself. all these hearings through all these years and the repeating theme is the erosion of services and preserving the mission of health care for the marginalized and the underserved. we as a union and myself as an rn and a patient advocate, we raise our eyebrows because of the track record of cpmc which speaks for itself. i'm concerned not perplexed about it. historically, we've had the attempted closure of st. luke's and those of us who member it. it was a death by a thousand cuts, and, moving forward, it was not easy and fast forward, most recent closures were the sub acute units, it was a fight. and, now we have this closure. so speaking on behalf of the community served and the pooed trick and adult clinics, i know their care matters. mission clinic is a wonderful clinic i don't do you think that but track record speaks volumes. so further oversight, a look at transparency and the process and regard to this change is highly recommended. thank you. >> thank you. all right. caller, please let us know that you're there. caller? can you hear me, caller? all right. i'll try the next one. caller, please let us know that you're there. >> hello. >> yes . you've got two minutes. >> can you hear me? >> yes. yes. >> okay. my name is ken barnes and i'm a physician and i practice primary care at mission bernal campus for over 30 years. my comments are made as words with caution. i was involved with the struggle to save st. luke's in 2007 cpmc announced it was going to close st. luke's campus and make it an ambulatory hub. st. luke's was not closed and sitting there now is the new mission bernal campus. the announcement of cpmc wanting to transfer ownership of administration of the adult and pediatric ambulatory clinic to a mission neighborhood health center brought me back to those days of it wanting to close st. luke's hospital. the commitment of cpmc underserving poplations has always been in question. examples others have shown as stated of the closing of the sub acute, the closing of the alzheimer's residential care, the failure to recruit the promised 1,500 medical patients as part of the 2013 development agreement. the failure to develop centers of excellence and community health at mission bernal also parted with the development agreement and the reducing scrapping of the diabetes center at st. luke's cutting back in bilingual care. rooted in the community. staff is not the issue. the issue is a lack of commitment on the part of cpmc to serving the underserved. when serving in this way, the bottom line is impacted which is what i believe is the driving force of this change. in return for nonprofit status, cpmc much demonstrates its service to the underserved. >> dr. barnes, please finish your sentence, your time's up. >> i'm finished. >> thank you. caller, i'm going to try you again. are you there? >> yes. this is mark aaronson and i'm an ameritas -- >> i'm sorry. go ahead. >> this is mark aaronson. i'm a professor at hastings law school and i worked for the last more than 10 years with the san franciscans for health care housing, jobs, and justice on matters pertaining to cpmc sutter. we submitted a paper to you as a statement and some of the previous speakers all are associated with san franciscans for health care. i just want to emphasize with sutter cpmc it's absolutely important to have in writing an enforceable way exactly what they're going to do. a good example is development in 2013. the dollars, the millions of dollars that cpmc pledged were written in hard written terms and there was no problem of enforcement. the promises in that development agreement that involved the provision of services have not been fulfilled. and, cpmc also goes out of its way to avoid responsibilities that might logically follow. you must nail down everything. this agreement from what i understand from today's hearing and the paper submitted, nothing submits cpmc in an enforceable way could do anything after five years. there are also questions about whether it is there are sufficient provisions for the uncertainties that might happen during those five years. there is no question that there will be a detrimental impact upon services in san francisco particularly for low income individuals as a result of these closures. not withstanding the high quality of services provided by mission neighborhood health center. the image i would like you to keep in mind is from peanuts. you all remember the image of lucy holding the football for charlie brown. and in each instance, she takes that football away from where charlie can kick it. that's exactly what's going to happen here as well. >> thank you. your time's up. all right. i don't mean to be rude to everyone, but i do need to keep the two minutes. caller, you're unmuted. are you there? caller, are you there? try one more time. caller, are you there? okay. commissioners, that is all the public comment that i could help facilitate. >> president bernal: thank you, mark. commissioner christian. >> commissioner christian: i wanted just to start again by making it clear that i have the utmost confidence that the mission neighborhood health center will continue for the next 50 years to do the amazing and excellent job it's done for the community in the last 50 years. this is in that they will do everything within their power to provide the best service to continue to provide the best service to the residents that need them. so i just want to make that clear that my comments were not about the and are not about the ability or any concern about the ability of the commission neighborhood health center. and i want to say how much i appreciate commissioner guillermo's restatement today and her statement at our last meeting about how significant community health centers are and in providing the best care for the community because they are so close to the community. the concerns that i raised today are about the commitment of sutter to enable mission neighborhood health center to continue to do this work should the five year projection prove to be problematic in some unforeseen way. and, i don't even question particularly because of the information that i've received through commissioner guillermo about the role of neighborhood health centers and they're in many ways being the best way for primary care to be given within a community. i don't -- what i wonder is whether sutter is able to commit to make exceptions that they have done with mission neighborhood health center. i understand a third party assistant and figuring out how much financial support will be necessary. if sutter has the commitment they say they have to commit to the community having this resource, why can they not say that should their projections be wrong, the projections they've made in sutter be there to see these commitments through. >> so, yes, we will be there to partner with them, to talk with them if their projections are not coming through to reality. we will be there with them and we will definitely talk with them. >> commissioner christian: so, president bernal, please forgive me for just jumping in. i appreciate you saying you're going to talk to them. it's going to need to be something more than talk. will sutter be there should it become financially necessary? >> i mean, we have committed, you know, for the initial five years for the grant, we will be there to talk with them and to work with them to help. i can't commit to anything financially past what we've committed to right now. but, i mean, we are there, we're here to support. they're going to be working on our campus, seeing our patients, we will be helping to provide the in-patient care if needed. we have to see kind of -- it's hard to project what the future's going to hold and turn out to be in showing. so, i mean, we did partnering with them and working to come up with our best projections of what things can look like over the next five years. i don't know what it's going to look like after. i don't know that brenda knows either or patty, but i think we have a very solid relationship with mission and if there's a need to talk about other opportunities we will definitely be there to partner with them and work collaboratively to explore what that will look like. i cannot tell you that i'm going to commit additional funding at this time because i don't know what that would be. >> commissioner christian: thank you, for that answer. this will be the last thing i will say at the moment is that i don't understand -- first of all, none of us know what's coming. we don't know what's coming at 6:25. none of us know what's going to be coming in five years. sutter is a very financially secure institution. i don't understand what the difficulty is for sutter to say that should our projections prove to be inaccurate. we will revisit the contractual agreement and do what is necessary for this clinic to continue to do its work should our projections prove to be inaccurate. and it doesn't -- based on what you've said right now, your answer to my question is "no," but i won't speak for you and i'll let president bernal take the meeting to wherever it needs to go after this. >> president bernal: thank you. is there any further responses to this question either from dph staff or mission neighborhood health center? all right. our next -- >> it looks like ms. web has something to say. >> yes. good evening, commissioners. i just wanted to jump in here and make sure that you heard what tami said which is that we're long standing partners of mission neighborhood health center. we've come up with this agreement based on the best experience of what we know today and with some sensitivity analysis that we've shared with you and the staff. we continue to be partners with mission neighborhood and should something happen, if it means our projections are not correct, not only will we be in dialog with them at that time of five years, but we actually be will be working with them over these next five years to help make sure there's sustainability along the way. so it's not for the commitment to continue to support them to make sure that these clinics are seasonable past these five years. we'll also be working with them throughout this period of time. i don't think that asking us to commit to financial support past five years specifically is something that we can agree to today, but there's also a lot of other types of support that we work with community clinics on whether it be helping with staffing, recruiting, with outreach, with service partnerships and there's a lot of other things that i think are just as vital and important to the community that we do every day across northern california. so i wanted to just jump in that what you are asking is a commitment to continue to dialog and work with mission neighborhood to make this transition successful. we've reiterated that today and so i hope that that helps clarify what our position is and how we'll work with mission neighborhood. >> president bernal: thank you, ms. witness box. i will take the next commissioner comments in order. commissioner chow. >> commissioner chow: thank you. and, like many people who are in this hearing, some of us have participated all the way back to the development agreement. and, one could say that this isn't necessarily within the spirit of the understanding that we have when we did go into the development agreement and we're talking about the maintenance of community services and a whole range of things that were sort of projected for the neighborhood. but the prop q hearing i see is really quite different. the prop q -- in my mind. the prop q hearing is related to whether or not the changes will be detrimental in the health care services for this community. i think we've all said that it would appear that using mission health center as a deliverer of those services are probably not detrimental. i mean, in fact, it would be quite complementary. the only question is whether or not the private sector patients in the clinic feel that they did or not have the type of attention that they felt they should have and mission has already indicated that they've taken that into consideration. i think commissioner christian has added also for this limited prop q hearing, in my mind, the appropriate phrasing that it's not detrimental providing really that the plan works. that's really what she's saying. and, i don't find that if -- so if the plan works and mission bay is delivering services with cpmc's lease and the lease could be extended and mission itself is saying that they are confident that they're going to be able to do it, i know ms. web doesn't have the financial authority to say we're going to come through, but that's aside from what, to me is the limited question that the change would create a detrimental health care deficiency in this community from everything i've heard about mission and know about them and the fact that they have worked out with sutt er a five year agreement that they feel confident is also one that they believe is financially sound or prop q finding is proposed that that itself is not detrimental. i think the issue of whether or not sutter is upholding to the spirit of the development agreement is the topic that really belongs at the hearing on that agreement which is at the planning commission and that is some things that can be brought to the attention of the city if that was a desire on the part of many of the people who would like to say that this was again further you know a loss of support of services changes from a community center. really, the services are being presented at the community center, at the center at st. luke's, we really haven't changed those services. so from, again, just limited prop here, it seems to me that the transfer not withstanding it be sutter but most particularly because it is mission nand that it creates and it's able to support good services and they themselves said they have confidence in the financial plan that the proposition, that it is not detrimental would seem reasonable. thank you. >> president bernal: thank you, commissioner chow. vice president green. >> vice president green: thank you, commissioner chow, for pointing out we have to not point out this particular develop. and i would also echo what commissioner guillermo said which is i think the expanded support to the community health centers, i think we feel very confident that financially mission neighborhood health center will be in an excellent position to give high quality care and to have all the resources needed to do so. the only thing i would say is this is probably one of the most perfect situations for the sutter system to be able to show a commitment to the community and to help reverse and perhaps improve the perception of the system's support for the needs of the community, especially the underserved individuals in the community. so i would hope that the templates when they also work for the community clinic and transferred patients there, they would look very carefully at that and keep us updated should any problems arrive. especially in the coming five years and beyond. >> commissioner bernal would this be a perfect time to share the proposed changes? >> president bernal: yes. thank you. >> and, folks i read the proposed amendments and this gets back to what commissioner chow was saying that your purpose today is multi-facetted, but your action is based on the resolution, is a resolution. so i will share the resolution with you now. give me one second. give me one second. there we go. okay. can everybody else see this? >> it's in very small print. >> okay. sorry. i can't see what you're seeing. how is that? is that better? that's perfect. >> okay. so i'm not going to go through the whole resolution, but it's in color. you'll see the proposed amendments. >> president bernal: you can stop now. there they are. >> okay. >> president bernal: would you like me to -- >> [inaudible] >> president bernal: do you need one of us to read them? >> no. i'll read them. the five year grant will ensure adequate funding and whereas sutter bay hospitals is affirmed is willing to continue the lease in its current location mission neighborhood after five years and there's one more proposed amendment. >> president bernal: there is? >> further resolve the closure of the mission bernal clinic and mission bernal pediatric clinic will or will not have a detritivore theal effect on the community between sutter and mission health neighborhood center. >> mark, can you scroll up for a second. sorry. keep going. stop. there was an addition there as well. >> yes. thank you. now therefore be resolved the availability and quality of primary care services and after hours pediatric services will not be reduced. thank you. >> president bernal: thank you, mark. and i see commissioner green has her hand raised. is that a holder. >> vice president green: holder. thanks. >> president bernal: thank you, commissioners for all your thoughtful comments and questions and concerns with this. seeing no further commissioner comments, we will move to a vote on this item. mark, would you call the roll please. >> clerk: yes. i was trying to think there was a motion. [roll call] >> clerk: thank you. the resolution passes with a statement of not detrimental. >> president bernal: thank you, mark. okay. we'll move on to our next item and, thank you, again to commissioners for that robust and thorough examination of the last resolution in the provisions. our next item for discussion is behavioral health services and mental health sf update. we have dr. marlo simmons acting bhs director and claire orton. >> could you all let me know who show sharing your screen. >> yes, i'm sharing my screen and it is dr. halle hammer and i who will be presenting. >> president bernal: we're happy to have both of you. >> okay. wonderful. so, one moment and i will share my screen. >> so, commissioners, president bernal, i just want to get clarification before we start. should we expect that all our presentation that are on the agenda for tonight. i just have team members who are waiting to present. i want to get a sense of what the plan is. >> and, to clarify, we're happy to present and we know it's a long meeting and we're happy to delay parts of our presentation. >> president bernal: thank you doctors hammer and orton. with great respect for our staff's time and the investment in their presentations as well as the investment they've made of their time in this evening's meeting, we believe it would be appropriate to postpone the street crisis team presentation until a future meeting, but, again, please know that that is with deep gratitude for their excellent work and i know it's a presentation that we've been looking forward to hearing and will look forward to hearing it in our next meeting. >> thank you, very much. so i'm going to start out and i will say that that is a presentation to look forward to at the next meeting. it's a really really what mental health san francisco aims to do is to remove barriers at all points of entry and for all points along that continuum of care so that we can get people right in to services when they present to us wherever that might be. next slide, please. so just some quick highlights and i will go through this briefly. our director of quality management deborah sherwood retired from the department of public health after 20 years of service and we now have an acting director as we search for a new director. just a few other highlights. we are really excited about the ag transitional care. our team has really done incredible work on engagement and then linkage to care for transitional hu. we also have i think really come a long way during the covid-19 pandemic in our public health activation. it's an amazing work around communication. so regular e-mails that go out to all of our behavioral health staff and contacted providers with updates, connecting them to trainings and support services for people throughout our behavioral health services. so i just want to really commend our communications team and how far we've come during the pandemic. also, yeah. next slide. that's fine. we're really excited and i know you know this to announce that our new director of behavioral health services and mental health san francisco dr. hillary cunnen will be here and start her new role on march 29th. we're thrilled to welcome hillary, she's fantastic. actor director simmons and orton and i have been working closely with her and preparing her any way we can before she's here. she's coming to us from new york city where she is the executive deputy commissioner at mental hygiene. she has led the implementation of new york city's $60 million strategy to address the opioid crisis which was called "healing nyc." it's been a successful program and we look forward to learning from her and having to learn about our system as well as address the other behavioral health crisis that we're facing most notably the crisis in skyrocketing overdose deaths. next slide. i also want to announce to you again a really exciting new leadership appointment. dr. flinders aluminumna farmange has more than 15 years of experience working with children, youth, and families and she's just been an incredible, respective, compassionate, team building acting director for the past two years and we are excited to welcome her as the newest member of our executive team. next slide, please. and, now it's a pleasure to hand it over again to our acting director of work force development and equity, jessica brown. so i'm hoping jessica's on. >> hi, this is jessica. thank you for joining. >> thank you holly. thank you, everybody. happy to be here and support hbs. so just for starters, just to give a little bit of background, bhs has established the office of equity and work force ability known as the office of equity and social justice multieducation back in 2018. and the goal of the oewd is to focus on developing implementing to serve the community as far as mental health. throughout 2019 to 2018, our team has been very successful in collaborating with bhs leadership and dph leadership in developing a structure and activity for racial equity work plan in fiscal year 2019, 2020. and this plan really looked at and guided our work with our culturally linguistic services and culturally competent in language and management as well. we also use this equity work plan to develop positive initiatives and a strategic plan on really evaluating and improving our efforts. one of those improvements included looking in to our dhs department health equity center which is really looking at a respectful culture, acts of engagement outcome and for our work force. we also developed an assessment in collaboration with the mental service staff to really look at our workforce and the reflectiveness of our work force and as it pertains to the communities we're serving and i'll go into that when we talk about our action plan that we developed. with that assessment, we not only look at where are some gaps with our work force, but also figure out on how to recruit, retain, and hire to fit the needs of our communities especially those that are mostly marginalized. and so looking at that workforce disparities was the part of the office of equity and work force development of what our system needs. in collaborations with us doing workforce assessment, we were able to impact a different disparity that we're seeing across our system such as looking at african american and latinx employees reporting higher amounts of stress on the job and also having low levels of trust within units and feeling like they're low level of career development opportunities. and, we'll talk about some of our counter measures to address some of those disparity gaps. also working alongside the office of health equity to better understand these gaps and develop strategies to help with reducing some of these disparities that we're seeing in the workforce. the other component that we developed alongside with working with the mental health services act is developing a culturally congruent innovation practices for black african american communities. the mental health services act prides itself on doing a very robust community outreach service. where we've heard from communities there are outpatient services for black african american communities. so out of those community engagement processes, they will developing a proposal. dr. colfax, please write a letter so they can approve it. for outpatient services that are afro sen trick. and, lastly, you know, part of our office of equity and work force development is working in partnership with cyf, the children, family, and youth to really understand our key process through black and african american communities through a model. it was intended to move the walls and community service sites that are accessible for black african american children. so with lining out all of that, we developed our a3 which is back on the side. you really can't see it. i'll kind of briefly go over it. where we looked at the problems and as i mentioned before, looking at the reflectiveness of our community. we had a high rate of black african americans in our system, yet, we only had 13% of our workforce that identified black african americans of our behavioral health commission and that's lower. we have about 4%. and so really looking at why we have that gap has really developed our priorities for our a3 and also for our racial equity action plan in relation to our racial action equity plan. so coming out of that again as i mentioned, we get our work force assessment and combining that data from 2019 and also the staff serving in 2020. again, to look at the disparity. we levels of trust. workforce and also our latinx. and then also too we received feedback that our black african american and latinx community did not feel that they were seeing an effort on racial equity action within dhs and so this is what actually inspired us to develop these priorities and i'll just go over a couple of them because they're a little bit long winded to address racial inequities. one of them is to look at our racial equity champions and affinity groups. on developing to provide our staff support of color with having trainings on racial equity. also implementing staff wellness retreats being able clinics and staff, a program within dhs to provide informed racial equity to really help our clinicians and our front line staff to be able to have wellness within themselves. lastly, i will say looking into a anti-racist leadership review to really impact any implicit also staff and appraisal reviews and also to ensuring that managers have coaching. and the last thing i will mention for sure this time is the community engagement piece. as i mentioned to you all, the mental service act has a community engagement process because it's been so effective in helping us even to engage the community and repair the broken relationships that have happened over the years. so this process is really developing, we're looking to develop this year a racial equity action plan. sorry. action council that would be in collaboration with our cultural competency task force in order for that task force to have more engagement and racial equity initiatives. and so those are some of the things we are looking to do and also, too, we developed this plan actually in january very quickly after we turned in our racial equity action, our workforce plan and this is actually phase 1. so we have more things we want to initiate. but so far, we've been able to reengage our equity champ on and also to the culture and congruent behavior which i mentioned we will be presenting to the state if anybody wants to attend and support and hopefully with that money that we are approved for, we'll be able to implement this cultural congruent behavioral approach. i will say before the fiscal year ends. thank you. >> president bernal: thank you, ms. brown. >> thank you so much, jessica. and now we'll hand it over to claire for the mental health san francisco updates. >> i believe i'm muted now. can you hear me? >> yes. >> great. i just wanted to thank jessica brown for reviewing the racial equity action plan, but most importantly, not only for her leadership in behavioral health services which is -- which the leadership group is really kind of managed to pull together and provide extraordinary leadership during a time when we were between directors and also for her leadership over the as the equity champion and director for bhs. no now, i'll be moving in to mental health sf presentation. i know that mental health sf is something that has been presented here several times. i know we wanted to regroup and provide you with some updates at this point. this is based off of some legislation after much negotiation calling for increased access to treatment for behavioral health service and with a real focus on people experiencing homelessness who have behavioral health needs. when i looked back kind of historically, i know it had been presented several times about a year ago, there was a very robust presentation with how we were organizing mhsf's efforts and what we really had to do was regroup. despite a lot of the focus shifting to covid during this time, we're very delighted to have the structure, the steering committee and the work groups up and running with very strong leadership. it's also kind of remarkable that a lot of these staff and leadership of behavioral health services has been deployed to the covid effort and there are a number of positions that are open which we're working on but i think it's even more remarkable that we're sort of where we are with mhs for that reason. the reason that greg wagner and i have been the executive sponsors of the mhsf commit. and hali hammer and lucy bland and others including from communications data and analytics, finance, and other bhs leaders are really providing a lot of the content knowledge and leadership of these groups. i just had a couple of things say about the way the domains are organized. you can see here these are the main work groups. the off coordinated care. the mental health services center. the new beds and facilities group and analytics and evaluation. i should also say an important element of mhsf is the working group which as group that does internal and external partner key stakeholders that's overseeing all of the work at mhsf. you can see here is underlying all of the work groups is support of our data and ichlt t. systems. a strong equity lens as well and then we actually have recently made analytics and evaluation its own work group to make sure we get all of the structural things we're trying to put in place. before i go to the next slide, i did just want to comment, my presentation now covers all the work groups except for street crisis team. the reason for that is because we were going to have angelica almeida share the street crisis response team's update. they really had a phenomenal kick off and start and is having a lot of success already and so we're very excited to hear that next full presentation at the next health commission meeting. so the first domain i'll talk about is the office of coordinate care and this is specifically focused on launching the office of coordinated care within the bhs structure but also as a major arm of mhsf. and also just as a side note we're trying to with mhsf not create a totally separate bhs but create a system that's fully integrated with bhs's goals that works seamlessly to both strengthen all of dhs services and build additional services clearly informed by all of the leaders of dhs. so the office of coordinated care will exist within the bhs structure. there's a couple of things that are going on here but this is by way of explanation. we are required to put in place a manage of care structure within behavioral health services. and so, what you will see here there's really kind of two branches of the office of coordinated care. the top elements include things like marketing which is sort of a foreign word to us in public health but we will be getting our heads more around. network add question sea, timely access and there's also a piece of utilizization management. to chart client complaints and feedback etc. and so we will be looking forward to implementing a more robust system within the office of coordinated care. the other piece in the office of coordinated care is the case management piece. this is a critical part of what we do in behavioral health services in general,, but it's really going to be more robust under mhsf. and it includes the intensive case management which is really the which is really again for clients who require very intensive services and then who have a lot of comorbidities and struggles and also case community management which is that next layer of the iceberg. so i'm really looking forward to the office of coordinated care to oversee and bring all of these pieces together. i'll do some hiring updates at the end including for this. i will say that some of the challenges for office of coordinated care are going to include identifying new office space. we are working on that. that's always a challenge for us and some of the successes recently is that the occ leadership have had a number of stakeholder and community engagement sessions. so we're really building in that piece in. the next update is the mental health services center. as you can see, it's a centralized access point for patients or clients who are seeking access to mental health and substance abuse treatment and also for longer term care and so what we are really looking to do is expanding the services that we currently have in our behavioral health access center to expand the hours and to also just expand more access in terms of where referrals can be made, how many hours per day people can receive direct access to urgently to services when they want them. we are looking at currently expanding in the fight it's currently in but we are also looking at additional space and making sure how we can be very available to the san francisco residents who really need these services. so we would like it to be near other city funded mental health services, but also near where a lot of people have behavioral health challenges and are spending their time. so 1308 howard is the current space, but we're also looking at some additional spaces. and, the other thing that we're currently working on is just really working on the phone access there because some people will continue to want to access by phone and we want to have a seamless entry system through the mental health services center. the new beds and facilities. this can get a little confusing. the office of coordinated care is really going to be coordinating access to long term treatment, to psychiatric beds to substance abuse treatment facilities. but we know that a key part of that is the supply. and so the new beds and facilities group is specifically trying to expand our supply of these types of resources and some of -- and that's actually as you, of course, know in san francisco is a tal order, but what we really realize is at some point, we just have a supply demand mismatch and we don't have enough places for people who need these services to go and in the interest of trying to get to treatment on demand, we do need to invest in more partnerships or ownerships ourselves of some of these facilities. so some of the things we are working towards is the drug sobering center. so i believe that there was a question from one of the commissioners about this. we are working very hard on this. my apologies, greg wagner who is my cosponsor could not be hear for this part of the call tonight. he has more details on this, but we are looking at a realistic timeline of maybe more like fall 2021, but we're working hard to get this done. we are also looking at contracting or developing ourselves multiple of these other facilities in the interest of time, i'll take questions at the end about this. i will note that we have a page that's fine treatment sf which is a client page that does allow the patients to see where all the beds are available in town or to see their provider and enable their provider to see that when they're wanting to seek services and so this is one step towards making sure people can get access when needed. analytics and evaluation is another one of our do main work groups. we know a lot of hearts and minds and energy are going to go into this and make sure that we have an impact with everything that we're doing. so that end, we're focusing a lot on the analytics and evaluation piece of that. this domain work group is headed by lauren bruner who is working with dr. bland on the mental health reform project as well as monica rose from bhs who works a lot on their quality management and data and so what we're really trying to do is identify key performance indicators for all of the do main work groups, to track them continuously to have both short-term and long-term measures that we're looking at so we can demonstrate impact and the results of the programming. we also want to make sure that all the do main work groups are working hand and glove and identifying really the key indicators that we need to track. so that's our analytics and evaluation. and, then, finally, overdose response is not something that's specifically in the mhsf legislation, but we have been discussing that as part of our mhs committee hearings because we have a robust overdose response team and as the entire commission knows, we really have been seeing some heart breaking trends in fran in terms of drug overdose and death and so this is something that we really wanted to make sure we stayed on our radar screen and that we brought our overdose response team into close communication and working relationship with the rest of the mhsf work groups. so some of the things that overdose response team is working on is all types of prevention essentially getting naloxone or narcan into all spaces that could possibly use it to prevent overdose deaths in using permit of support housing loss of linkage programming also to make sure that people who are referred to medical assisted treatment are following up and are becoming continuing to be engaged in care. huge thread of bufonorphine and this contingency management to treat our methamphetamine abuse problem and deaths and morbidity from that. and happy to define continuous management better, but it is the one data driven way to keep people in care for methamphetamine addiction. and, we are, of course, going to be tracking the year of what's going on happening as well as more profit measures around engagement and care medical assistant treatment etc. so that is our overdose response. i know it's late in the night. our brief hr update. we've been working very hard on this. we are really happy that dph hr has brought on kind of a special team to work specifically with behavioral health services. the dhs leaders who are working with them are really enthused and grateful to have this type of assistance. one of our big successes recently is we pursued a batch hiring process for our behavioral health clinicians and i will also say this has been really beneficial to both behavioral health services and mhsf and commission 3 as well. so angelica almeida has headed this up and we have brought on 33 behavioral health clinicians. we are also looking at other multiple agencyings witness box bhs and we in addition to all of this, the other thing that we're really trying to put a focus on is we have a number of leadership positions either vacant or newly created positions that need to be filled within bhs that we're going to try to put a priority lens on and prioritize for hiring. a lot of the work on having clear leaders and this is just an example of the tracking sheet. rather than get in the weeds it's really great to have her present every other week. here's where we are. here's where all the hires are. here's how we're moving it along and so we appreciate this piece of data that's coming to mhsf. and so i think that hali and jessica and i are happy to take any questions from the commissioners. >> president bernal: thank you. commissioners, do we have any questions or comments and i am happy to start if others are reaching to raise their hands. first of all, thank you, dr. orton, hammer, and ms. brown and please extend our thanks to those who couldn't be here. [inaudible] your work is critical not only in one of the simple priorities of the department, but also for the mayor and the board of supervisors as well. one sign to me that we may be on track to returning to normalcy is that i will revisit a question i often ask which i would like to continue to discuss what is the impact of having unfilled positions on the work that you do on the capacity and morale and other measures for staff and how can we be of assistance there? that would be my first question. >> i think there's a huge impact. i think frankly with covid and now covid vaccine and mhsf and multiple things, i think everyone's doing at least two jobs that i work with. so there's a lot. i think that some of the work in terms of -- you guys are always incredibly supportive on this front. i do think that we have a new director of hr coming on. so i think that is going to be super helpful. but even before that, i think the hr department itself has really tried to be very proactive especially around these batch hires. so the sort of extra permission we've been given around these things in terms of covid has been really helpful and we're really trying to figure out what of our temporary hires can we roll into long-term hires so maybe continuing to support that process would be great and i'd love to hear what hali and jessica think about that as well because they've been working with hr more than i have. >> president bernal: thank you. >> well, i'll just pitch in and hope jessica will add as well. but i think, you know, one of the things that we've learned over this last year is that we can innovate in terms of hiring. so the batch hiring that you heard about has been really successful. it's taken a huge amount of time and work from a whole team. but i hope we've learned some lessons and can do that in the future. it really makes sense even when we're not in the middle of a public health crisis. i would say, you know, we need to think more creatively and that's one of the things that most impressed me about our new hr director she's a fixer, she's somebody who sees a problem and can communicate what the problem is and bring people together to fix them and i do think things like in-person exams and list our way expired and the last i'll say in answer to your question, president bernal, around what the commission can do, i think that we really need to develop our pipeline in behavioral health services as well as in some other areas, but most critically in this area so that it's diverse, so that we bring on people and support people with diverse life experiences so that we can sustain people, keep them engaged and moving forward professionally in our system. so those are the areas that i'm really excited about and definitely having people like jessica brown in her position and our new hr director, i think we have a lot of potential to innovate and to grow in the areas where we know we have. >> president bernal: thank you, dr. hammer. >> thank you. i'll be quick. you know, just to ensure that we're recruiting as i mentioned earlier in the presentation just a workforce that's very reflective in identity wise of the communities that we're serving. we know especially in san francisco, we have a very diverse community and it's going to be very imperative that we are hiring folks not only that are native to san francisco, but also have lived experiences and are able to provide the level of care and culturally responsive care especially given in the global pandemic. i would imagine that our services or the need for our services will increase even more as we're coming out of covid and trying to get back into some level of normalcy. it's going to be important again to ensure we have the workforce and the staffing capacity to implement everything we're going to be doing with the mental health sf and also trying to integrate some cultural responses of behavioral health and in our system of care and just hearing the needs of the community, they really want to see tare piss, mental health providers that come and that are able to reflect, you know, and address things that are impactful such as systemic racism and ensuring that we have a system that is responsive to that. >> president bernal: thank you. i know the commission wants to acknowledge the challenges and the heavy lift of ramping up all this activity and infrastructure and staffing in the midst of a pandemic and also to ensure there's a very strong equity lens to all of your work. ms. brown, you had mentioned and my system was cutting out a little bit. you had mentioned an event earlier on that was an opportunity to support this work. can you give us that information again? >> yes. well there's two events. so we are actually presenting our culturally congruent behavioral health practices to the state. we have to have state oversight and approval before we can implement any new and behavioral health approaches and so we will be meeting with the mental health oversight and accountability commission on march 25th between 9:00 and 12:00 p.m. to present our proposal and hopefully get our stakeholder, state buy-in for them to approve so we can launch this much-needed overdue intervention that aligns with the human rights commission and even aligning with the initiative to reallocate the police funding into the black community. and another event that i just sent mark was we had a black wellness webinar last week with president walton in collaboration with him on black mental health and needs in the community especially with the pandemic. >> president bernal: great. i look forward to mark sending that along to us as well. commissioners, any other questions and comments for our presenters? all right. seeing none. thank you so much to all of you for the late hour. apologies again to our friends from -- i see commissioner chow. let me just finish the apology to our team members with regard to the street crisis team and, again, we look forward to hearing from them at a future meeting. commissioner chow. >> commissioner chow: yes. i'm not going to be long. i really appreciate the presentation and the thoroughness in giving us where you are with the bhs and particularly the mental health sf structure. and sometime i know that we've asked before that in terms of looking at health equity and as i understand, we're working on the work force right now. it would be nice to sort of take a look at all the health equities that we have. realizing bandwidth is really limited right now with covid but that it would extend to not just only racial, not just only latinos, but the different populations that may be actually feeling this and so, i don't know how we exactly can get that in, but i think it would be nice to see. those are the things overall that we're going to work on even though we're working on the most urgent needs right now. >> i think that's really critical and i think that's one of the things we're trying to do in our priority hires is also hire for cultural and language and that's really an area of critical importance that we're all focused on. >> yes. and thank you, commissioner chow. i mean, you're spot on in that we want to be able to span our culturally congruent practices to other groups as well. if we can get approval from the state and this program for african american communities is successful, we hope to move it over to a core service in bhs and then extend those approaches to api communities. one of my goals as director of the mental health services is to figure out a way to support out a way organization such as rams, rafiki american health center and also horizons in mission neighborhood health. we want to make sure we're able to provide them with funding. as we know, these communities will be tapped a lot for resources post covid. so our goal is also to based off the community feedback is also move those initiatives to api community and subgroups within that community, latinx. so, you know, we're hoping again if you all can support us in this state presentation next week, you know, use your power to influence the state, we can see these things go on long term and i will send that off with that information to mark to send to you all to solicit your support, to gain your support. thank you, commissioner chow. >> commissioner chow: thank you all for your answers especially at this late hour. i appreciate the vision we all have here. thank you. >> president bernal: commissioner christian. >> commissioner christian: i just want to say thank you for this critical crucial work and echo commissioner chow's comments as well and the culturally congruent resources and therapy treatment. so critical and thank you so much for the attention and the detail that you're bringing to this. i really appreciate you. >> president bernal: director colfax. >> thank you, commissioners. i just wanted to take a moment to thank the behavioral health leadership and the behavioral health team for all the work they've done this year and continue to prioritize behavioral health and just to emphasize mental health sf remains a major priority of the department in terms of scaling up and implementing and also with the pandemic, the intersectionality of covid-19 and behavioral health needs, i think it reenforced the baseline needs that were there before the pandemic, but has also augmented the health needs we need to address because of the pandemic. so as we continue our sustained approach to covid-19, we are working on integrating the behavioral health needs of people of the communities that have been affected by covid-19 and particularly as we go forward. so this intersectionality is going to be a key component as we go forward which would not exist before the pandemic. but i think the pandemic is not only highlighted in reinforced the baseline behavioral health needs we've had for many decades in san francisco, but has brought in another level of complexity and need and that's something we're going to need to address as we go forward. so it's complex, but i know that this team is up to the task and it's also going to take a tremendous amount of investment, effort, and time, but we will make sure that it continues to be a priority in the department. >> and, i'm so sorry, i was remiss in not also thanking in particular marlo simmons who has been our outstanding rock of an acting bhs director for over a year. i'm not sure how long. it's really incredible of someone doing her own job and the job of the director. i'm sorry she couldn't be with us here tonight. especially as we are excited for dr. kunins to join us. we really owe a debt of gratitude to marlo. >> president bernal: thank you. before we conclude this item, mark, do we have any public comment? >> would anyone like to make comment on this item, please press star 3. no hands, commissioners. >> president bernal: all right. thank you, mark. our next item, again, acknowledging that we will be postponing the street crisis team update until a future meeting. thanks everyone for your understanding. is there any other business? seeing none. and no public comment on other business. we will move forward to joint conference committee and other committee reports for the lhhjcc meeting. >> okay. thank you. i'm very gratified to be the last item on the agenda. my stomach's been growling for the last hour. so i'll make this short. one of the best things about the meeting that we had this month was on the day that we met i believe my colleague commissioners can correct me if i'm wrong, but that was the first day there were no active cases at laguna honda and that was a really celebratory day and moment to have the meeting there and just again a recognition of the they kept flooding the floor. and for the next four to six months they're going to be doing a whole renovation there and, in the meantime, what they'll have to do for meals for the residents is they brought in a mobile unit that's going to be located somewhere on the fifth floor parking lot in order to be able to provide the meals for the residents there and there was a lot of interest i think on the part of the committee members on how well that mobile unit was going to be able to be in terms of sanitary and safetiness of the food and the nutrition and we've been assured that even as late as today that the ability for the food safety issues that were a concern are fully addressed and they're going to place that in a good spot on the fifth floor with all of the safety measures and the measuring devices and the technology that's required to make sure that the food, both the cold storage as well as the meals when cooked will be safe. we also reviewed the regulatory affairs report, a drug regimen review presentation was given by michelle thoughts the director of laguna honda's pharmacy and then we got a presentation on the rollout of the covid vaccine distribution there at laguna honda. at the time of the meeting, 85% of the residents and 79% of staff had received both doses of vaccine. there was about a little under 300 staff that had not received a vaccine and for varying reasons and we were which consisted of both fear, ineligibility, well, selective ineligibility due to medical conditions that folks had and others. but they were working very closely on communicating with the staff to get that percentage of vaccinated folks even higher. interestingly, the percentage of residents was much higher than the percentage of the staff that were vaccinated and so we're really happy to see that and we had a really nice set of folder or pictures that were presented to us by the staff on, you know, how that all went and celebrations around it which also gave us a really good sense of what the environment is like over at laguna honda since we can't be there in person to get these pictures and just get a sense of what it's like over there. it was really helpful. and then, in closed session, the committee approved the credentials report and we've reviewed our quality reports as we normally do. and that's end of my report for this month. >> president bernal: thank you, commissioner guillermo. seeing no public comment or commissioner questions or comments. we can move on to our next item which is a motion to adjourn. >> commissioner: so moved. >> president bernal: second. >> commissioner: second. >> president bernal: great. mark, will you call the roll. >> clerk: [roll call] >> clerk: great. thank you all. >> good night commissioners. thank you. >> president bernal: thank you again for the privilege of continuing as president of the commission. >> thank you for the willingness to do it. >> erica wong: members will attend through audio and participate in the meeting as if they werephysically present. public comments will be available on each item on this agenda . either the public comment number ison the screen currently . the number is 415-655-0001. again, that number is 415-655-0001 . the meeting id is 187 681 1252. again, that number is 187 681 1252 . then press pound, pound. when connected, you will hear the meeting discussion but you will be muted and inlistening mode only . when the item of interest comes up, press star 3 tobe added to the speaker line . speak clearly and slowly and turn down your television or radio. submit public comment either to the transportation clerk at erica.wong@sfgov.org. it will be soonforwarded to the supervisors and be made part of the official file written comments may be sent via postal service to city hall . 244 san francisco california, 94102. finally, expected to appear on the agenda of march 23 unless otherwise stated. madam chair. >> chair melgar: thank you madam clerk, will you call the first item. >> erica wong: item 1 is an ordinance amending the plan include code to clarify amendments. approved an ordinance number 29682 which gives effect to the market area plan including provisions for transfer of development rights, publicly earned open space, electricity, pr for height, development impact fee, deposits and uses among others and to restore the locations inadvertently deleted and provisions regarding affordable housing to amend open space limits of mass production, lost coverage, cdr replacement and refining. members of the public who wish to provide public comments on item number one press 415-655-0001. meeting id is 187 681 1252. then press pound, pound. if you have not done so already dial star 3 to line up to speak. thesystem prompt will indicate you have raised your hand . madam chair. madam chair, you are muted. madam chair, are you there? i show your screenas muted . perhaps the vice chair is available?we are experiencing technicaldifficulties so if the vice chair is there to pick up the script . >> supervisor preston: i am available, taking afew seconds to see if our chair isavailable to unmute herself . if not i think we can proceed . >> erica wong: can we confirm supervisor peskinis your before we can proceed ? >> supervisor peskin: i am present. >> supervisor preston: unless the clerk suggests a recess to try to troubleshoot, given technical difficulties my inclination is to move forward. >> erica wong: we will get the chair reconnected. >> supervisor preston: lets how her staff presentation on item 1. >> and matt snyder of planning department staff joined by josh who is thehead of land-use and community development . you are going to provide you a presentation on the essential soma legislation. we were here before you i believe infebruary 8 . you continue that so we can provide you some briefings which we've done and through that we understand that supervisor peskin is interested in a couple nonsubstituted amendments and i'd be happy to describe those. i understand they have been forwarded to you just recently. essential soma is located roughly between sixand the second street with an irregular border on the north that reaches market street south . the central soma plan included the creation of a new area plan and implementation document that sets forth a broad range of community benefits worth about $2 billion and a strategy to pay for those including the creation of 2 no central soma impact fees in the creation of a central soma finance distric . the board of supervisors approved this original legislation in december 2018. since that legislation we followed up with legislation in 2019 that created the soma advisory committee . along with the plans for both east and western soma. the planning commission initiated these amendments and adopted them with recommendations to improve the board of supervisors in the fall. since the original approval staff has been moving aspects of the zoning amendments and their improvements. the cleanup legislation according to dataprovisions , we as planning staff would describe three central buckets area the first is to address inadvertent errors and incorrect suchas incorrect cross-references . that more accurately articulates the policy intent and we're here that they may be technically substantive because this policy intent was reflected in otherdocuments such as the implementation document . looking to essentially zoning codes consistent with that and then there are also two substantive changes which i will describe . i was going to show you a slide of the what we are calling clarify amendments since we don't havevisuals . i will describe them for you briefly. the first is an operating strategy . we required it in central soma, one of the things was to create complex operationstrategy . this is one of theamendments we're going to look at today as well . the second project object pr requirements of the central soma zoning including pr requirements for new construction of commercial projects of the house square feet or more and this clarifies this would also be for major additions defined by 20 percent edition with a net 50,000 square of the pr. the third one deals with lots covered limitations as just clarifies there's an 80 percent lot coverage requirement, this clarifies where that would not necessarily berequired . specifically on levels where you have residential units that have exposure to rights-of-way. the fourth is a series of amendments that deal with solar playing requirements, essentially south of market and throughout the city requirements for narrow streets and set down buildings, since also mucking alongwith some additional requirements . there was confusion as to which ones apply so these provisions essentially clarify what size of streets , the different requirements south of market. this is regarding the bmr fees, this establishes boundary from which the fees are collected in central soma canbe dispensed . in the larger soma geography, essentially that was established with the soma stabilization fee and the six as exceptions open space requirements. just with the central soma legislation there was a requirement that it you are unable to provide the full square footage of open space that you were required to pay a fee. the language was a little bit confusing and is just further clarifies that if it's the square footage looking for , you do need to pay the fee. as is regarding community facilities the area similar to the bmr and lose the this establishes the geography in which these collected can be spent. again consistent with one that was established or the soma stabilization fee and finally what we're goingcalling the clarifying amendments , the soma infrastructure fee. the zoning amendment indicated it was only to be spent on transit projects , the implementation documents and this funding plan indicated that it could be spent on both transit and open-space projects so that addresses that. the final sort of set of amendments are what we are calling the three substantive changes and the first is regarding provisions that allow a portion of the open space requirements off-site. this is also one of the amendments we're going to consider today, a planning code allows budget sponsors to require 50 percent of open-space off-site as long as it'swithin 100 feet of the project development . one of the open-space goals of essential soma plan is to look to the adjacent freeway at opportunity to create open-space and the proposed changes would help implement this enabling projects to meet their open-space requirements at a further distance and or as they originally drafted it specifically under or adjacent to the freeway we will talk about those amendments on that one . the second of what we're calling the substantive amendments deals with the provision, one of the provisions for pdr and one of the key sites as you recall. the soma legislation identified three key sites, these were large sites which we could allow for some flexibility in the developments with exchange for some additional community benefits.one of those sites located at 598 grams which is the location of one ofthe new parts , what we heard after the approval on both the central soma plan and actually entitlements for this particular project where they have p.d.r. requirements was an interest of being more community servingretail location . this provision would allow the project to exchange up to 15,000 square feet of retail for that p.d.r. and we should note the types of retail are very specifically defined within the code amendments. and the final and third substantive change is regarding the residual exposure requirements to the essential soma. exposure deals with a dwelling unit having like access. the exposure requirements as they are in the planning code are really gearedtowards less tense development . we revised and tailored the exposure requirements for central soma as described within the ordinance. supervisors, this concludes my presentation . again i'm joined by josh ritchie if you would like i will leave you to him for this amendment. >> supervisor preston: can you repeat the last thing you said western mark. >> matt snyder: i described all the amendments and i was indicating if you would like i will read into the record the proposed amendments that we discussed with supervisor peskin for the record that are now before you. >> supervisor preston: thank you and supervisor peskin, i couldturn the floor over to you thanks for your work on these traditional amendments . >> supervisor peskin: thank you acting chair preston advantage to mister snyder and i want to startby clarifying what happened when thiswas heard . a while back . just through the transition from when i left in december and two when chair melgar took up in january of that was lost in translation but i did subsequently get everything and very much appreciate that everything. that led to a conversation that has resulted in the amendments thatmister snyder just addressed . which there was a little bit of a misunderstanding and i thought that plan had been givento the city attorney . any event the city attorney has had a chance, thank you vicki wong for putting your eyes on the amendmentsthis morning early this afternoon . and i am happy to make those amendments which have been described by mister snyder and are before you colleagues with regard to proximity in the eastern neighborhoods. mixed-use district section two within half a mile of said principal project language so strike the words within a half-mile of said principal project or any parcel that is immediately adjacent to interstate 80 and within the boundaries of central melgar plan area, strike that language and replace it with within the central soma plan area were no greater than one quarter mile outside the central soma area boundary without regard to distance from the principal project area the distance of the off-site open-space shall be measured by the closest boundary of the principal project or as applicable to the closest edge of the central soma plan boundary and the closestportion of the off-site open-space that the first amendment i would like to offer . the second one isin subsection f , open-space provider. that last sentence in provision in subsection 3 would be changed to read as follows. operation and maintenance of this open-space shall be memorialized by a operation strategy developed by the project sponsor open-space provider. a draft of said strategy shall be presented to the planning commission by way of authorization ofplanning code section 321 applies . in all cases said strategy seldom approved bythe director of prior planning department approval of the site for building permit . that includes the amendments thati would like to move after public comment . >> supervisor preston: thank yousupervisor covid and are those your understanding substantive ? >> supervisor peskin: i would defer to cancel. i defer to deputy city internal attorney jensen or pearson . >> this is deputy city attorney jensen and those are not substantive and do not require blowback. >> supervisor preston: unless there are additional comments let's open it up for public comment.>> erica wong: checking to see if there are any colors in view. could you let us know if there are any colors ready? if you have not done so please press star 3 to be added to the q4 item number one . for those on hold continue to hold until it indicatesyou have been on muted . confirm wehave any colors into ? there are no callers into. >> supervisor preston: thank you madame clerk. supervisor peskin would you like to move your amendment. >> supervisor peskin: i would like to use , move the amendment before you and chair melgar thank mister snyder and the planning department and thanked the city attorney for their quick review of that. [please stand by] >> public comment is closed. and supervisor melgar, i'm not sure where you picked up. turning the gavel back over to you. >> supervisor melgar: i just want to say thank you so much supervisor peskin. thank you so much. i ask clerk major if you could please call the next items two and three together. >> clerk: so we haven't voted on the item. >> supervisor melgar: i'm so sorry. okay. let's vote. did someone make a motion? >> we voted right when you joined on the amendment that supervisor peskin put forward. the item has been amended. >> supervisor melgar: i see. i thought i was voting on the entire thing. since we passed the amendment. can someone make a motion. >> madam chair, i'd be happy to move the item with positive recommendation. >> supervisor melgar: thank you. madam clerk, please call the role. >> clerk: the motion is stated by supervisor peskin as amended. supervisor peskin. [roll call] >> clerk: you have three ayes. >> supervisor melgar: thank you. the item passes with unanimous recommendation to the full board. can you please call items two and three together, madam clerk. >> clerk: yes. item number two is a resolution for control to require 6 months to require a conditional use from a residential care facility and affirming appropriate findings. item number three is a hearing to receive the report on interim control to remove a residential care facility pursuant to planning code section 306.7 (i). those who wish to public comment should call the number on the screen. and press pound and pound again. if you have not done so already, please dial star 3 to line up to speak to these items. the system will indicate that you have raised your hand. please wait until the system indicates that you have been unmuted until we get to public comment. madam chair. >> chairman: thank you so much. i think we were joined by supervisor mandelman to hear some remarks. >> supervisor mandelman: thank you. can you hear. >> this is jacob on behalf of supervisor mandelman. the items are to extend the existing controls. to a new reduce. and also the hearing on corresponding planning department report. while the supervisor does intend to move forward with the extension that came to our attention over the weekend that the resolution has drafted inadvertently left out some language monitoring to the controls that were adopted subsequent to their original adoption in 2019. so we are requesting your continuance so we can prepare the necessary amendments and move forward with extending the controls in time for them to be in effect before their expiration which is april 11th. thank you very much for your consideration. i'm happy to answer any questions. thank you. >> chairman: colleagues, do we have any questions from mr. bentless before we take any public comment? >> no. >> chairman: okay. madam clerk, let's take public comment on the continuous request. >> clerk: thank you, madam chair. please let us know if there are any callers that are ready. again, if you would like to line up for these two items, please press star, to be added to the queue and we will unmute you on our end. is there any callers in queue? >> there are no callers currently in the cue. >> clerk: thank you. >> chairman: okay. thank you so much. seeing no callers. public comment is now closed. colleagues, can we have a motion to continue items two and three to the next meeting which is monday, march 22nd. >> so moved. preston. >> chairman: great. madam clerk, can you please call the roll. >> clerk: on the motion as stated. [roll call] >> clerk: you have three ayes. >> chairman: thank you. the motion passes. madam clerk, are there any other items before us today? >> clerk: there is no further business but just for the record, since we are on audio item two and three are continued next week. >> chairman: thank you so much and thank you all very much for your patience with our technical difficulties and thank you to the staff for your heroic efforts to make this happen. thank you. >> clerk: thank you. >> thank you. >> president cohen: wednesday, 539 tm p.m.,march 10th. we've got a full house and before we begin, i'd like to welcome our newest member, commissioner larry yee. sworn in just this morning. he's joining us today. welcome, commissioner yee. so, colleagues, let's go ahead and proceed. sergeant youngblood could you please call the role? >> clerk: yes, ma'am. [roll

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