Thank you. The next item on the agenda. 2 proposed action approval of the minutes of the Health Commission meeting of may 7, 2024. Minutes of the meeting of may 7, 2024. So moved. Second. Is there any Public Comment on the item . We are on the minutes. There is usually a person that comments on the minutes and wanted to make sure you are aware we are on item 2. I dont see any hands. All in favor say, aye. Aye. Any opposed . Wonderful. Thank you. The next item. General Public Comment. At this time members of the public may address the commission on items that are within the subject matter jurisdiction but not on the agenda. Each Public Comment may have two minutes. Each individual is allowed one opportunity to speak per agenda item. At this time, members of the public may address the commission on items of interest to the public that are within the subject matter jurisdiction of the commission that are not on this meeting agenda. With respect to agenda items, your opportunity to address the commission will be afforded when the item is reached in the meeting. Each member of the public may address the commission for up to three minutes. The brown act forbids the commission from taking action or discussing any item not appearing on the posted agenda, including those items raised at Public Comment. Please see page 6 of this agenda for information regarding instructions for making Public Comment. 4 for discussion directors report grant colfax md, dph, director thank you. Give me one second to pass something out. Please begin your three minutes. Public speaker good afternoon, Health Commission. My name is chris. I have spoken here a few times. Public health is going to be getting some great counselors on the 22nd. Its a great first start but there is a bigger issue that we talked about last week and hopefully will talk about the potential resolution. I just handed out a draft letter that we were requesting that all politicians, commissioners, Public Health and Safety Department will sign off on it and we have been doing a lot of meetings, public speaking with the commission and 12 different commissioner meetings. Im going to read it. The statement will be. Will you invite the commission and on anyone giving access to Public Health, safety systems. False injuries, false illnesses, donations, illegal placing and altered for personal or religious reasons. We are going to be giving to the board of supervisors and this is from all the systems that we have. There is an acceptable uses policy for all systems. This is pretty much in line. Some of the wording is a little bit different and well leave that to the City Attorney to sign off on the draft and everyone will sign off on it. And there are guidelines. You need to equal the subscription. If you take out abcd, thats information data, technology, the prescription is not going to work. Thats what we are looking at. Someone is using these systems to take out data and add data to include this. So you can be sitting on a computer and cyber talking to someone and the person thinks that you are hearing these voices and thats concerning. They want to take more drugs, they want to drink more. Thats what we are talking about. This is not Public Health, not public safety. They are trained to do their jobs. Someone gave out these credentials to people who have no business doing Public Health, public safety. Thats what we are talking about. Thank you. Have a great day. There is one remote Public Comment. A person who received accommodation. Im going to unmute you now, sir. Are you there . Public speaker i am. This is patrick. I am speaking on a topic that is not, repeat, not on todays agenda. So again, please dont cut me off. For testimony for todays Health Commission meeting, i inadvertently stumbled on 511, i was totally flabbergasted reading it. Dont apologize, dont explain, a social justice leader providing a 50 Million Foundation with guillermo. Didnt mention guillermos appointment in 2018. Reported that the president for 15 years. Guillermo screwed up badly. The article was substantiated when California Attorney general baca announced this. Superior court guillermo from director officer for fiduciary for any california or other Nonprofit Corporation for three years. April 2025. That stipulated judgment in resulting allegations that guillermo violated Charitable Trust laws was ironically announced seven days before it was to be certified. It barred guillermo from any charitable organizations for three years. How does she get to keep managing the operating budget as part of the judiciary governing body and for lowincome and is a member of the Health Commission. Why is guillermo still on the Health Commission. Why is she still chair . Has guillermo no shame . We should expect. Leaders like guillermo should take responsibility for their actions. She stead fastly refused to take responsibility for her actions. She apparently tried repeatedly to ask guillermo and she never apologized nor explained what was wrong. The San Francisco hospital being sold by common spirit. Didnt abstain from the Health Commission approval for ucst for the two hospitals. The case involved allegations and failed to file federal income forms. Thats it for Public Comment on that item. Thank you. Next item on the agenda is directors report. Director colfax. Thank you, and good afternoon commissioners. I will be going through a few items and happy to take any questions. The first item. Matadorsey introduced legislation for opioid treatment. This will require San Francisco pharmacy, one of the medications to treat opioid disorder. This legislation is by supervisors and will make it easier for individuals to have this life saving treatment when they need it. An important piece of legislation Going Forward in that regard. Another item with regard to Behavioral Health is that mayor breed announced plans to have an assisted living facility in the valley for more than 55 San Francisco senior citizens. Laguna street currently serves as a home and board and care facility. This facility will provide a home for providing 24 hour care for dealing with health necesseties. This is the building in the area that the city needs to purchase. Im very excited about that. We are also highlighting several in regard to the calendar and may is Mental Health awareness month. And we are doing that in many ways including social Media Campaign to highlight our diverse and culturally competent programs and recognizing asian and native american and Hawaiian Heritage month. And as an example of that, Deputy Director of health, joined mayor london breed at a reception ceremony for members who are in San Francisco in the community for the past century. Also recognized aanhpi community by hosting internal events and in training awareness for Behavioral Health services. Last week, we celebrated nurses week which is nurses makes a difference, which could not be true of la honda nurses and treated a period of restructuring laguna honda to be a model of Skilled Nursing facility. I was pleased to be able to join the laguna honda Leadership Team last friday morning during shift change to celebrate and greet the nurses in appreciation of Skilled Nursing appreciation week. It was really great to engage with the teams and visit many of the neighborhoods at laguna honda. And happy to see how excited people are about the improvements at laguna honda and how committed the staff are to continuing our journey for making la honda, the best it can be. In other news, i wanted to note that one of our employees received the rookie of the year award. Maurice de la cruz won the rookie of the year award which was presented at the 2024 Emergency Preparedness training workshop. This continues the journey to ensure that as we bring in our team and emergency response, that we bring in the very best and brightest and it says it all winning the rookie of the year in a statewide competition. Thats really great. Finally, just vsfg continues to focus on the department of equity that vsfg health and hosted its inaugural ceremony and director addressed the full house of awardees and staff making it clear that equity continues to be our priority and you can see the number of awardees recognized there. Just an exciting piece as we continue our journey recognizing equity in the department as well as of course our focus on health equity. Thats my summary of the directors report. Im happy to take any questions from the commissioners. Thank you. Thank you for that summary. And sharing the celebrations and honorees. Its wonderful to hear your report of great news and a lot of accolades for people who deserve it well. Is there any Public Comment . Is there any Public Comment in the room . Is there any remote Public Comment . I see no hands. Any commissioner questions or comments on the directors report . Okay. Seeing none, i guess i had one. Do we know when it comes to the pharmacies, do we have any idea how the public will learn where they can access. Sometimes pharmacies keep closing in the city at such a great pace and if there is anything for example on the website or any of the emergency apps that might help people find it easily, know the pharmacy that have it and access it more rapidly . I appreciate the question, commissioner. I think the main thing is that it has to be prescribed by a provider. I think when they go on emancipation they are asked where they would like to go to pick up their medication. We dont inadvertently prescribe it at one of the commercial pharmacies and we dont prescribe it to someone and if they are told that you have to go to another pharmacy and the provider has to find that out in someway or the patient has to be given this opportunity. Its really about making sure when someone is prescribed it they have to carry it across the city. We are focusing on awareness and we want to make sure that people understand. I think in the midst of our Opioid Epidemic and deaths, of the narrative there is some sense of hopelessness and what can be done. I think we can lift up to ensure that through people telling their own stories and the use of methadone cut the death rate by 50 which is better than most medications advertised on tv. I think its really important that we make it more accessible and we change the social norm about the importance and the value of these medications and make sure that as part of the society, they are available on all pharmacies like most meds should be. Thank you. There were people that had to be to three pharmacies to get it at one time. Do you know when it will be available . I have not heard of a shortage. The day that San Francisco has to ask for it, would be a good day. Thank you. The next item on the agenda is laguna honda hospital and Rehabilitation Center and update. Good to see you. Thank you, good afternoon, commissioners. Director and ceo of the San FranciscoHealth Network and executive sponsor of laguna honda hospital and cms command. Normally im joined by our ceo, but sandra stayed back to work on some items. Shes working hard. Before i provide the update, i would like to provide a brief update to admissions to laguna honda hospital. Since we announced the medicaid program, we discussed what this means for accepting new admissions. This is an excellent question because we know the role that laguna plays in the city with the healthcare system. This is also why we are working tirelessly for medicare certification. Full certification means medicaid and medicare certification. We achieved medicaid from last year. Laguna will resume admissions once we are certified in both programs. That means the medicare certification. We believe that is important because it will show the facility has a clear and definitive staff approval from our cns federal regulators. Nonetheless, while we are awaiting full cms recertification in the medicare program, we are going over all admissions, plans, processes with a fine tooth comb. You have seen those come through the commission in terms of revising policies. We have also reached out to all former residents who were transferred to other skilled facilities as part of the reface of the recertification. We are pleased to share that many of those who were still in nursing facilities have expressed an interest in returning to laguna honda. For those residents who still meet the criteria for Skilled Nursing care, those residents will be the First Priority for new admissions to laguna when we findly receive our medicare certification. Once when laguna receives our medicare certification, we will make sure if there are any additional comments from cns regarding our process and then we will update our policies and procedures and they come back to the Health Commission. We will keep this commission updated on the staffing conditions and the Medicaid Recertification journey concludes in the future. Moving on to our presentation, next slide. Given everything i just mentioned in terms of the status of admissions, its clear that laguna remains focused on our medicare recertification and sustaining many of the longterm corrective actions that have been put in place over the last two years. Recently, we have surveyors on laguna to different capacities, one april 18th through the 19 for a december recertification survey. In addition to being here for that december 2023 medicare recertificatation survey there were two previous plans of corrections related to fall and review one reported incident and 21 anonymous complaints. We are happy to report that there were zero deficiencies identified from that long awaited medicare december survey. And there were zero deficiencies identified related to those two fall. So the team is very proud of that achievement and finalized that plan of correction to move forward with our medicare recertification process. We are at laguna again to review an official reported incident and anonymous complaints. You know in the world of Skilled Nursing facility, we do a tremendous amount of training with our staff in terms of making sure they are aware of their responsibilities as mandated reporters, particularly of abuse, and obviously the facility for laguna pretty much, we report things to our regulatory agencies a couple times a week. So its not uncommon either that we have self reported or anonymous complaints and to make them aware of those complaints. Our team was there april 29th through the third to review reported incidents from the month of march and april. We are happy to report that all of those instances were resolved without a deficiency. There was one deficiency received and again, that deficiency, the plan of correction is being worked on by the team today. There are two plans of corrections that the team is working on with the goal of having those finalized and submitted back to cdph by close of business on thursday of this week. Again our goal is to move this as quickly as possible so that we can assure cdp and cms that we are ready to take that final step towards recertification. As i mentioned that these facilities and reporting anonymous are important and that families and concerned citizens are heard. We take that process seriously and train our staff for anyone that reports inappropriate or does not meet Regulatory Compliance because only when we are aware of problems that we are able to then correct them accordingly. So while it is definitely a challenge having surveyers at the facility on a monthly basis, we think its a necessary part for transparency and residents in the community and makes the institution a better facility. On discharging process, and for most of these residents is on a level of care that is a boarding care. We discharged a few patients and most of them went back home or home of a relative or Supportive Housing for wrap around services. Currently there are 36 who have a need and some that dont need the care and those that are in need of Residential Care under 65 years of age. We continue to work with all of our city agencies and other including working with the California Department of Health Care Services and our local medicaid managed health plans who now under a cal aim reform ensure that the residents have an appropriate level of care. We are really marching all of these key holders to find a placement for these individuals who are some of the most challenging. And its been a year since april 2023, we have discharged 20 residents. Its a testament of the tenacity and dedication of the staff to really work with residents to find particularly communitybased care resour