Before we begin like to reminds all present and attends nothing person all health and safety protocols add hered to. This includes wearing a mask covering your nose and mouth any time you speak. Failure may result in removal from the room. We appreciate your cooperation with requirements in the interests of health and safety. Note that there is a hand sanitize are station at the front of the room. I have a Motor Vehicle in case you need temperature we welcome the public during comment period. There will be an opportunity for general Public Comment at the beginning and on each item on the agenda each comment is limited to 3 minutes. If you like to comment on the line call in and listen or you use the web ex link they are real time the sfgovtv link sometime there is is a delay to make sure you get your hand up in time use web ex or call inform Public Comment will be in person and call in. The commission will take comment first from people in person and then from people remote. Those in person should submit a card to me. And instructions for call nothing remote found on page 4. To access closed captions hover over the live stream the cc logo will show and click on it. Note that city policies with federal, state and local law prohibit harassing conduct against others during Public Meetings and not tolerated. Public comment is permitted on matters went jurisdiction of the Health Commission. Thank you for joining us. Thank you. Thank you to offer the Ramaytush Ohlone land acknowledgment. Ramaytush oholone land acknowledgement the San FranciscoHealth Commission acknowledges that we are on the unceded ancestral homeland of the ramaytush rahmytoosh ohlone olonee who are the original inhabitants of the San Francisco peninsula. As the indigenous stewards of this land, and in accordance with their traditions, the Ramaytush Ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. As guests, we recognize that we benefit from living and working on their traditional homeland. We wish to pay our respects by acknowledging the ancestors, elders, and relatives of the Ramaytush Ohlone community and by affirming their sovereign rights as first peoples. For folks watch being we rearranged the agenda we have pan taftic presentations today and we loaded them to the front of the agenda. Well begin with our next item which is general Public Comment. This is the time to make comment on items not on the agenda. Not on the agenda and i want to note in in case you make comments about laguna honda that is listed under item 7 the directors report. Any comments should be med there. Any comments about lug luge under item 7. I will stop you if you are milking comment about that item that topic on this item. I will read something. At this time members may address the commission on items of enter to the public went jurisdiction of the commission but flot on the agenda. Each member may address for up it 3 minutes the brown act forbids discussing any item not on the agenda including during Public Comment. Each individual is allows one opportunity to speak per item. You may not return to read stimulates from others not attention. Written comment can be sent to the Health Commission. If you wish to spell your anymore in the minutes you may so during your comments. All right. I see a person on the line with their hand up. Let us know you are there. Yes. Excuse me patrick. Yes. Go ahead you have 3 minutes. Thank you. Although laguna honda is Kitchen Floor. As i noteded luge looking comments at the directors report this is general Public Comment. Why this is not im sorry go ahead. It is in the about the closure plan. Anything with laguna honda will be on the directors report. Why no, no, no. It says. So we will move on that is the only Public Comment for that item. Commissioner. Thank you be secretary morewitz. Our next item is hi very close update we have doctor hyman scott and Nyisha Underwood and cohen. Welcome thank you. There is 3 of us will present today on the report. I will do i control the slides. It controlled remote say next slide and she will move it. Im hyman scott a physician in San Francisco department of Public Health work at hiv i will gift update on behalf of my colleagues from the Epidemiology Group and getting zero on the steering committee. Great. Am we will discuss the hiv epi screening prevention and Care Services through the 21 epi report and touching on the initiatives we have to address the disparities that will highlight in the report. We talk about hiv getting to zero and the Community HealthPromotion Health access pointses as well as the disease prevention and control program activities. Will so, as you see in this slide, what we track are Testing Services and these are in medical facilities from january 2020 to march of 22 you see that we had a steep drop off during the shelter in accomplice and that has rebounded and exceed 2019 levels so what we dont have here okay. And so we have had rebounds in our testing and medical facilities but have in the seen the same rebound in our Community Testing cites yet. This is the main component of the report this looks at number of hiv diagnose we have seen. So new diagnose decline. From 2019 levels in 2020, we had lore number of case but a concern our testing declined. And the previous slide and saw a slight increase this year in 2021 from 138 to 160. And that hiv deaths have gradually increases since 2016 and hiv causes continued to decline real seen deaths over dose increasing and over all in san front we are about 15, 600 People Living with hiv and over 70 of those individuals are 50 or older and almost 40 are over 60. The rates of diagnose by gender and race are here, you see these are adjusted for population. The highest rate is among black men in San Francisco at 77 per 100,000 followed by latino men and seen a sloit up tick in latino women. And which is in the equal to black women in San Francisco. And that the over all rates on men of all races have been stitial since 2019 and we have seen the changes among women who are black or africanamerican and latina in San Francisco. And we also look at populations this includes race, ethnicity and risk factors for acquisition this is number of cases not rates. This is not population adjusted. The largest number of case were latin x and followed boy white individuals and people who inject drugs is also increasing. And among our Homeless Individuals and we had largest increase in women and sixtyfour come paired to 2019 levels. We evaluate causing of death. You see, on the far left hiv causes continued to decline. So it is in 2009 and 12 red. 2016 in blue and 2017 to 20 in grey the deaths declined under 30 . Now accidents increased. This does include over doze and in the most recent time period made up 17 of deaths this occurred amongst People Living with hiv. We monitor close low linkage to care after diagnose. Stheez are each year from 2017 on the far left and yellow to 2021 in purple. And looking at over all number of diagnose how many are linked to care within an among after the diagnose in 2021 with 94 an increase from the 2020 levels and close to when we had in 2019. And we look at biosuppression, 612 months; that is stable from last year. And decreased from 2019 levels. We are hopeful we will improve in biosuppression rates. And this is a sum row that looks at different populations. And just to orient you the 2019 is in blue. The 2020 is red or orange and 2021 is in yellow. And you can see the average for each those years 2019 it dropped from 75 to 70 and had a rebound to 72 . We have several populations and women, African Americans, young people and people who inject drugs and nonu. S. Born individuals below the biosuppression average rate in San Francisco and our important population for focus for treatment engagement and care. In this is a slide that looks at housing status. People experiencing homelessness. We look at numbers come paired to nonhomeless on the far left. If you notice in the upon 2021, 95 of people who were not homeless linked to care within a month and had a significant drop in 2020 to 83 . Viral suppression rates are lower. Compared to 80 and versus 50 to 60 . And then receipt of care dropped dramaticically in 2020 for People Living with hiv experiencing homelessness and not near for people who are not experiencing homeless knows in the same viral suppression all People Living with hiv and those when received care we have the large gap in our care out come. I will give a brief update before over to my colleagues. Getting it zero we rearranged our Priority Areas and activities to focus on these areas of need within our city. And at the top of our efforts are centering Racial Equity tow attain health out come for all of San Francisco. These other categories this we focused on. People sprngs homelessness. Rapid initiation of viral therapy at initiation and reengagement. Age and drug over doze interventions. I highlighted topics we are focussed on in the next year. Including preventing stis among individuals living with hiv or using prep. Looking at new ways to use antiviral therapy and intfwrat it to Health Access points and Community Programs to have a descent rollized access to option for treatment. Specialize protocols for restarting individuals rap ird low on therapy. Looking at as people age given the major living with hiv are over 50 and will be over 60 soon. We want to focus effort in making sure we have services that meet the needs of our population as they age. And looking at drug over doze prevention. A stake holder engagement and huwe will move forward to support safe Service Within the citys Harm Reduction strategy. This is a snapshot when we are focussed on this is a list i will not go through all you have the slides and if there are questions i will be happy to answer those. And then another thing we have been try to maintain communication role time as we track what is happen with covid and now with mpx reduction in access to service in many of our communities. We have done town hallos covid and hiv treatment and prep. We have continued to update our website to keep a Clearing House for information and listed the updates and resources we posted and in bold at the bottom. Maintaining our engage and want communication around hiv, covid and mpx. All right. I will turn it over to my colleagues. Thank you, doctor scott. Hello commissioners my name is Nyisha Underwood upon im the quality improve am manager in the Community Health equity and he prosecute Motion Branch. Im the acting manager for our ending the Epidemic Initiatives and i lead the development in writing of the Health Access point. Today i will talk about the Community Program this is we have that are addressing the hiv, help c and sti disparities. Y received funding from cdc as a part of the National Ending the epidemic hiv Epidemic Initiative a 10 year aimed at ending the hiv epidemic by 2030 and sf keep added goals of e eliminating help c. As well as rusing stis we call it ending the epidemic rather than ending hiv epidemic. Plan is built on Strong Foundation of principles and have yous you see listed here. This plan is a living document. And tell dive the implementation of hiv, hepc and hiv prevention over the next 10 years. We are in the third year of ete. And the plan is linked here on the slide. Thats the website to the link. For the plan. So the populations that ete prioritizes are black africanamerican, latin x. Transwomen, people who use drugs and people who are experiencing homelessness and people with incarceration experience. All of the activities and ete are status neutral service. Which means that anybody regardless of hiv status is entitled to receive comprehensive care and support. Some of the other activities listed here are the mobile contingancey management the equity competence prosecute Motion Branch. This Program Funds the sudden fran aids foundation to provide street based out reach and interventions for people experiencing homelessness and people who use drugs. Focus is also on communities who smoke and inject and or inject fentanyl. The other resources offered for the program are incentives over dose Prevention Services, on going counciling and drug Testing Services. We also have expanded access to prevention care through home testing program. Take me home. And then there are texting remindsers for city clinic enrolled prep patients. This texting platform alighthouse patients to know about new resources such as the new lab based home testing program. We also have focus Community Engagement through community grants. We funded several, 7, Community Based organizations called, caps. That provide meaningful dialogue to the communities. All the priority populations that are talked about in the beginning. They advise dp heart attack on delivery methods and funding. One other thing we were able to do through the capps was provide 50 ofh on delivery methods and funding. One other thing we were able to do through the capps was provide 50 of funds to compensate the Community Members for their expertise and time. Jot other activities is Regional Planning across almeida county with east bay getting to zero and San Francisco getting to zero and we are doing this to increase the prep access regionaly. Lastly, i will talk a bit about the Workforce Development opportunity through chilly. The Community Health leadership initiative. D ph is using this to hire, recrew and support staff on the ete prior population. They are learning Racial Equity competence Health Equity and Harm Reduction. Im sure you heard a lot about the last couple of months and as well as i of course today a colleague presented on contracts but the other things that we are doing is that we developed a framework called the Health Access point. The contract start date for them are january 1. Of 2023. And they are a one stop shop of services for several population this is we are funding. I will show that next. It is to provide the goal of the Health Access point is it provide ensure that all of San Franciscos have high quality of care and treatment and attain optimal health. One of the things we did with this rfp would be intentional. About address being equity competence focusing on the populations that have the greatest disparities in hiv, hepc and stis. Half of the funding went to the black, africanamerican and latin x population. Something else different is that we are intgreg grating the testing will be provide across the 3 diseases and increased emphasis on hrm reduction and over dose prevention and the other services that we are requiring the healing access point to provide. We are have Health Access points for each of the populations listed here. The last program i will touch on is opt in the out reach prevention treatment and integration for reaching people experiencing homelessness. I like to acknowledge my colleague in the back approximate who leads these efforts for tip and if there are questions directly related this program she can answer those for you. The 4 main components of this project are collaboration and coordination. Hiv, heshgs he pc and out reach and linkage to the San Francisco aids foundation hepatitis c Wellness Program n. Collaboration and coordination piece, our communities the commune Health ResponseTeam Partners with the foundation, glide and street medicine and provide treatment in bay and the tend