I put the minutes in front of you. Commissioner chow requested a make a slight change on the top 6 page seven. Ill see text crossed out and other text that has been alded. Commissioners, the revised or edited minutes are before us. For acceptance. So we need a motion. Okay. I think this is minor and i can give it to you but go ahead. So on page 5, 5 of the ones that were in our packet. Sure. Up i number 7. Okay. Just to add precision to the language there because i asked how the stock would be dealt with regarding taxes at the end of the year. What i actually think i said was how the stock would be valg valued for tax purpose. Yes, i will make that change. Okay. While we are making small corrections, page 6. Previous page stated San Francisco doesnt have a present coherent strategy. I would like to amend that that he would like to say commissioner repeat that. Stated he would like p San Francisco to have a coherent transportation strategy. Yes. Im happy with that. Those are good changes that unless there is objection, we would add to the changes for the motion. Any further clarifications if not all those in favor say aye. All those opposed. They are approved. Item three is general Public Comment. I see no one from the public here. We can move on to item four which is the report back to the Planning Committee meeting. So commissioner chung was unable to be with us today. Did i chair the meeting and the meeting took up several items that the commission that the committee is recommending to commissions approval. And ill go through that so that we can then act on the consent calendar following. First is a contract for the Comtel Technology that replaces the old button that is available in most hospital beds and will become stateoftheart in terms of being able to have immediate access to nurses if needed and does a number of other things telling the system what happening to the patient. So, its a completely new system that is going to have a need for Software Maintenance and that is what this contract is for over the next five years. And that has been built into the anticipated budget for the general and so this is the contractor who will be the company that will be maintaining the software. So, that was the first item that we took up. We took up a second item from roma consulting and they will be helping to facilitate our Planning Session this afternoon. But has been awarded a contract for working with the department over the next four years to create a lean process throughout all the department add you remember, it began at general. And they are now proposing that this it began in general in the year 2012. And there have been over 55 workshops already held under this process. And youve heard some of the work that has come out on this lean process and as i said, later this afternoon, well also then be getting a more throw briefing on the lean process and how it will assist our work. But right here, this is a proposal for the entire department for over a fouryear period to be involved with and be taught and be able to carry out the lean process on their own. They have proposed their proposal was forwarded to us at Committee Level in terms of the various subjects that they will take up on items and director garcia has assured us this is what they will need in order to make the department a lean department. And she will be providing updates twice a year on progress of contract and the progress of the department in terms of adopting the lean program and how it has been helpful to us. The committee does recommend approval of this contract. If we are unhappy this afternoon, i guess we could review that later. Hold it until after . Well, we thought we would ask for a approval and we can always ask for reconsideration. I would like to add commissioner to tell president chow that the importance of this also is to try to build the capacity within the department so that we can lean our way away from our consultants as well. I think that is a goal for us then we have already an off of general tha that well build upon for that need to hold on to the services if it should become institutionalized into the department for the future. Very good. In our conversations with the company, company has been involved with a number of organizations in terms of health care, not just at hospital levels but Health Systems and pertinent to us is that they were working with [inaudible] Health System and the hospital and the c. E. O. There who will soon be our c. E. O. At s. F. General. This is a tool that would be one in which the department would then be able to move forward if their planning processes. The committee does recommend approval at the Commission Level of this contract. The remaining contract actually has to deal with working to understand all of the assets that we have real estatewise on the s. F. General and laguna honda campuses. As you have read, the contracts themselves, they actually have describe the number of buildlings if we just stick with s. F. General, its almost inclusive of all the buildings that have not either been studied recently or have been filled and that includes the ones that are enumerated. The buildings are being looked at for four different purposes. That is whether administratively or either biomedically or for housing as far as uses and so, the four contracts are needed for the with the different architects who have different expertise in particular, the two contracts that sound like they are working on the same buildings. M. E. I. Architects and l. D. A. Architects each have different expertise. And so, they will then be concentrating on those expertises in either housing or in terms of looking at the clinical or biomedical use or administrative use. That report will be combined as an s. F. General report. As laguna honda wha theyll look at the back builds that are currently vacant and to whoo availability, how can they be used in these areas also that weve just spoke ton. This is in preparation for the potential of another capital bond issue in 2022. But this would then give us a reasonable inventory of what this department does have available in terms of Available Space that they are going to be needing in order to carry out all the duties they have and you will recall also that were going to have to one day do something with our building here and therefore vacate those services from here also. So this will be an important aspect of looking at how, then, and what Capital Needs well have in the future. So it gives us that background so we know where were coming from. So the committee is also recommending the approval of these four contracts for this purpose. That ends my report. Dr. [inaudible] was kind enough to join. Do you have anything to add . No i would endorse all the contracts as prudent and reasonable. If anyone has any other questions regarding this, if not, we can move on to the next eye testimony. Next item is the dleand contains all the consent challenged review. The calendar is before you. If anyone wishes to extract any items, otherwise were prepared for the vote. Seeing no extractions, were prepared for the vote. All those in favor of the consent and her calendar say aye, that is passed unanimously. Item six is a resolution recommending that the board of supervisors accept a gift of 2,625,000 from the San FranciscoGeneral Hospital foundation for equipment, procurement, for the Priscilla Chan and Mark ZuckerbergGeneral Hospital and trauma center. Mr. Martin sorry. That still happens. Boy, was that sometime ago craig wagner chief financial officer. The resolution before you is the latest request to recommend to the board of supervisors to accept and expend funds from the San FranciscoGeneral Hospital foundation for fixtures, equipment and high tea he new zuckerberg general. Its been engaged in Fund Raising Campaign to bring in private philanthropy to support the effort. Its been very successful. The commission has a proofed today 58. 4 million of accepted gifts as associated with that effort. This weve been doing them roughly twice a year. This is latest installment. We try to september gifts on a relatively regular calendar without coming to you constantly. The program is going very well. Were on track and spending the money and managing within the projected budget so were happy with how things are going, thp help us keep the dollars going out the door. And finish up with expenditures and also carry into the early months of operating the new hospital. The resolution before you, if you approve it, would be a recommendation to the board of supervisors who would actually pass a resolution accepting the gifts so were asking for your support for this resolution today. Can happy to answer any questions. Thank you. Commissioners, the resolution is there any Public Comment . I have not receive ned requests for this item. Were prepared for a resolution that is before you. If we can have a motion. So moved. Approval of the resolution. A second. Any further discussion . What are we doing to celebrate the people at the foundation who are continually generating funds for hospital . Its unbelievable to have these kind of people in our community. Absolutely. Its been an incredible effort. Weve done a couple of things. We did have at the board of supervisors and at the Health Commission particularly at the first installment, we gave acknowledgment to the board that has been active in raise being the funds. There was an event at the new building. It was in november. There was a thank you and honoring of the donors at the actual Ribbon Cutting ceremony for the new hospital that donors were and the board of the foundation were acknowledged extensively. So we really have been trying to make a point of what its not just great for the hospital but great example of how private philanthropy with can work for public hospitals. Were trying do as much as we can. There cant be enough. And to let you know commissioner singer that dr. Chow and i took them to lunch and presented them with awards, the exiting chair and to amanda heras the executive for the commission. Anything else we can think of, we would take into consideration for that. We need them. We need them and we well have further projects. We sat with home to in their Strategic Plan as well and were meeting with them on a monthly basis, greg and i. Keep them ingrained in what were doing. Exactly. Id like to thank our own commissioner sanchez for representing the commission. Im sure thats no small thing. I would add that again, this is separate pertaining to these materials and supplies that would not be in the budget under the city contract were picked up on the radar a couple of years ago. And as we know, many of the donors wished to be confidential at that point in time. In order to move forward on this. But as stated, there are now numerous public thank yous pertaining to the unique leadership. Bear family and you name it. All have been within their own zones been honored. There was another event which was sponsored by the Art Commission to thank many of the donors who had been in the arts and served and donated to this where the artist and the community were invited to look at all the Different Levels of arts and whatever. It was well attended and there was much thanks given to the donors and the artists and it was really extremely well done within the context of how, in fact, they wanted to be thanked in that context. So there is on going events. But in essence, the whole purpose is how do we support i mean how does the foundation support to provide these resources to maintain the excellence and training of San Francisco general and young, old, two and three generation foundations. Its astounding to see commitment there. I just want to say i concur. Its an ongoing communication and dialogue and something that will be there and it was a safety net when many, many years ago, we were worried about if the seawall was going to collapse and they came to our aid and have continued to come to our aid. We want to make sure that that is a continuum of support for us. Sfghs. I found the leadership extremely dedicated and was pleased to be able to work with them and well continue to have opportunities to work with them. Them. So at the resolution, weve had discussion. Are we prepared for the vote . All in favor, say aye. All those posed, resolution has been passed unanimously. Thank you very much. Thank you commissioners. Item seven is creating Healing Organizations in a regional system of care. Good afternoon. My name is lynn dolce. Im the directer ffer for foster care Mental Health. One of the trauma inform Care Initiative which is what were going to talk about right knew. Get my glasses on. Its right in the middle of the screen. This one. Thank you. Youre welcome. There are my notes. Can you get them. Thank you. So on behalf of director garcia and our team, with the Trauma Initiative system of care. Im grateful for the opportunity to be before you today. As you know, or may not know, but i probably do know, the trauma is the number one Public Health concerns we face today in the county. Trauma and toxic stress have been linked to Many Adverse Health outcomes including diabetes, heart disease. Lung ailments. Cirrhosis of the liver and suicide. Trauma impacts more than the individual. It has a Ripple Effect on our communities. As such, at the department of Public Health has steen that a need for a preventive, collective, collaborative approach was needed to address trauma. Were used to thinking of trauma as a Behavioral Health incident. We think about ptsd and trauma in young children. What we know is that trauma impacts entire communities mostly disproportionately to communities of color, particular lit Africanamerican Community and Latino Community here in this county. And when you add racism, bigotry, poverty to the issue of trauma, you get a toxic brew. Thats what our clients and patients are coping with on a daily basis when they come through our doors in the department of health. Thats what our staff is coping with. I think the reason why this paradigm shift is happening now is because we realize that we can spend and we have spent lots and lots of money on evidencebased practices to address trauma on an intervention level, one o to one intervention level and even family level, until we have a system thats a Healing Organization, its just a practice that we do. I could be the best welltrained therapist in the county, as long as my patients are experiencing trauma and stress,. My hour with them isnt going to hit the mark for our patients. Were looking at organizational change in addition to practice improvement in our offices. The ideology of the project was really in conversation with director garcia. Realizing that we had a lot of work do that our staff was suffering. That we werent really hitting the outcomes we wanted to hit. As we began to take a deeper look into why that was and is. It became clear that address trauma on an organizational level was something we needed to do. So we developed the curriculum, we call it trauma 101. This is a curriculum where every employee in the department of health, all 9,000 of us will be trained in a basic, fundamental training around what is trauma and how it impacts us. In addition we developed traumainformed principles that we can begin to look at how to integrate organizationally throughout our department and developed competencies around the principles so we could measure weather our organizations are making the change and how is that is impacting our staff and patients and outcomes. Really, our method is to teach, to sustain and support and study how this is impacting our organization. Sorry. Just hitting next. Thanks. Okay. So relationships matter. They rule the world. Big business, corporate america, and even in the department Public Health. How we feel about each other makes it a difference in how we do our work. In order to become a Healing Organization, we needed to talk about three things in an open way. Talk about the centrality of relationships and healing. The way in which trauma can destroy relationships and how intentional leadership can combat the trauma on our Delivery System. The problem is when our Delivery System is siloed and fractured. When our organization is reactive, when our leaders become numb, the service delivered reflects that system. Relational leadership is something that in the trauma 10 is training that we deliver to all the staff is a key message were trying to impart to our staff. So instead of having a reactive, numb, fragmented isolated system, we teach our workforce basic information that has the potential to dhaipg change the way they think about their work and interact with each other. The shared knowledge and language of trauma within our workplace is a place to start these conversations to really lead the change. A core message of our work with our staff is unifying our system. We cant make meaningful lasting change in our silos. We have to come together and learn how to collaborate. Weve developed a local approach and now we have a regional and National Approach for what we use this in this county. As you know, we get hurt in relationships.