Transcripts For SFGTV Public Utilities Commission 42517 2017

business? do we have public comment on item number eight? seeing none, public comment is closed. next item please. >> sfgov tv could you please show our slide? >> as is our custom, the office of small business is your one stop shop for permits, for find out how to do business in the city and county of san francisco. it is free. so contact the office of small business. >> item number nine adjournment he was we have a motion to adjourn? >> so moved. >> second. >> all those in favor say, aye. [chorus of ayes.] >> good afternoon let you call the tuesday, april 25, 2017, of the sfpuc to order madam secretary. >> commissioner president commissioner courtney and commissioner caen and commissioner vietor are expected shortly we have quorum commissioners you have the minutes of the april 11th meeting any additions or correction. >> so moved. >> and any public comment on the minutes seeing none. >> all in favor, say i. >> i. >> > all in favor, say i. > theiness are approved general public comment address the commission on matters that are within the commission's jurisdiction and are not on today's agenda. i have one speaker request from mr. da costa. >> commissioners welcome. >> in 199 of you all created the san francisco public utilities commission by a mayor named willie brown so many of you are know a lot about how that was created and what's the purpose of this commission. >> yesterday, i was paying attention to the deliberation at the ethics commission and this city and more room 200 as done great disservice to our city and it so happens that one of the 10 california's reaches out to the san francisco public utilities commission i'm not going to name names i use my first amendment rights to mention the names but it is shocking that in the year 2017 the sfpuc the commissioners, other sponsors who have to regulate look the other way so i attended a board of supervisors meeting i think about i missed the last one i missed your meeting the last one 3 weeks ago two advocates were pissed off with the board of supervisors because they're at the board of supervisors including one item that is legislated to the sfpuc millions of dollars are extended because of no due diligence simply you need a checklist if you have the checklist before you and go by the checklist you'll not make such mistakes it is being made injecting for people at home don't dr. time to come here and do want to come here the people how will tree address they having to be educated on issues i i don't want to come here i see that on television but what i'm going to say is this go before the board of supervisors. >> talking about the ethics commission and those deliberations but i'm going to try to use what in the federal system the rico act for the deliberations here thank you very much. >> thank you is there any additional public comment? >> seeing none, public comment is closed. commissioners you have communication that has been provided to you and also to the public any questions or comments on that communication any public comment on the communication items okay. seeing none we'll move on to other commission business commissioners? >> and then move on to the quarterly general manager completely. >> first item i'd like to call up an update on the cleanpowe f cleanpowersf. >> welcome. >> thank you good afternoon barbara hale i have two items to report on for cleanpowersf enforcement and some other mishmash of other sponsors activities on the enforcement we're successfully serving our customers about 80 thousand accounts enrolled our opt out is 3.3 percent overall we have received more updates to supergreen since we last spoke it increased from 2000 plus customers human resources supergreen 2.1 percent of customer base is pretty good our tatter is 5 percent so 2.9 and continuing in the may enrollment activities we had intent to enroll one thousand plus customers that is three hundred and 85 that signed up ahead of time want to be in supergreen 6 hundred and 97. to be in green and auto rolling the customers we're serving our he noivengsz have gone out 2.2 percent opting out out and special workshops that are targeted for the net energy metered customers have more be complicated bills we're tagging a drilled down and held the first of two workshops on april 20th at hayes valley clubhouse people state and my clients spent half an hour answering questions a number of people that signed up for sfpuc that was good the next is april 29th at the eureka valencia rec center if you want to know about the snepz program in terms of other activities we had a number of all the out of office meeting met with san francisco state university wanted to go over he our views on none bypassable charges where we have alignment and we are hearing that pg&e and the two other utilities will will be making a filing at the cpuc today to change the message for recovery those above market coverage to the cpuc and called the portfolio adjustment mechanism the pam so stay tuned we'll looking that carefully that will be a big item that we'll be engaged in we also participated at the hearing in sacramento on sp senator bradford's bill would have required our integrated resource plan our plans how to serve our load to be reviewed and approved at the cpuc so we had expressed concern and opposition to that bill and joined with cal and were successful in getting senator bradford to remove that in the bill have not seen it in print but progressing 2409s legislative process expect to see it in print soon and we'll breathe a say of relief and received new data from pg&e that describes our customers you know our folks that are enrolled including the folks that are enrolled so we get that update annually and we're factoring that update into the poolroom analysis for the gross plan and bringing that to you the full plan not just the presentation as a communication item for the next commission he meeting and also bring a couple of agenda items i want to briefly talk about those bringing the bawsca time extension to the next commission meeting the business practice policy and in particular the resetting of renewable goals to 50 percent by 2020 that was talked about mayor ed lee made a nice announcement on earth day i hope you saw the press it was annoyed to see us providing those benefits for san francisco with that, i'll close and ask if there is any questions. >> commissioner. >> another lafco joint meeting it seems like it modest makes sense for the supervisors if we're seeing on mou. >> we don't have one calendar i'll be happy to work with the commission secretary and with the lafco executive director to establish that if this is what the commission wants. >> through the chair i feel perhaps i'm not sure we want to talk about what is on the agenda but seems like with cleanpowersf rolling out san francisco government audit & oversight commission citywide the late development to get on the on the same page. >> let's look at the agenda and do a joint meeting or structure that meeting in a way it is simile formation an easier way to look at that. >> okay. thank you. >> thank you and for public comment on this item eric brooks. >> good afternoon, commissioners eric brooks sf green party/our city/sf clean energy advocates. so first on specific things in the report yes sb 618 had a major problem but still another problem in sb 618 but staff is aware of we need to push on the author of that bill it is that still has language in it similar to language that was attempted to be put in the big clean energy bill a few years ago that talks about cost shifting from to existing pg&e customers based on building new renewables and having new renewables plans that is opening of the door for pg&e to come up with more excuses so we need to participation it that bill and expecting that bill will be brought back towards the end of the session with amendments that make it bad again, we need to stay on top that i if hear staff mentioned if you devolve me pg&e is also proposing something that was proposed several years ago when san joaquin tried to launch their bond the programs need to set aside in case of failure not $100,000 as now but tens of million dollars and over one hundred millions if they adopt that that policy is pushed by the moply and if they adopt that policy that will be a death for the choices in california and might effect us so if they keep on heading in that direction and on cleanpowersf in general want to reiterate what we're saying at the last meeting we've made a lot of progress but the fact we're not lined up to enroll all the customers by 2018 the fact that we are project by project 2020 to get to 50 percent basic green product everyone is doing that and the fact we have it project moving forward because our brothers and sisters in labor were assured we'll do a local buy out and putting people to origin with the build out that kind of job creation and getting us on track to stop antarctica and the iceland from metaling we need a job and build out plan by 2018. >> along those lines thank you mr. brooks and to commissioner vietors request when you start to talk about the issues we've made this progress when you got into them you can dive deep into the the build outs and the candidates made to the workforce i don't know we can have a line item with lafco and really drill down as far as we want to go i'll i want to put that out there and say probably have to be a joined meeting with that board. >> thank you and mr. da costa. >> way back in the year 2000 we first started having our meeting linked to the community 2002 we attended many meetings in sacramento in today's world i don't think that any progressive person forward thinking person who doesn't want clean solo that we want to embrace it what i find difficult is why you commissioners don't have a birds eye view of that never once do you all mention the rico act and how hydro electrical is come to be and how it is used today with the clean energy even though the word clean is used this energy that sfpuc is providing is not really clean and i don't want to go into that today it is not dirty but not, clean what i want to talk about connected to the point about our infrastructure recently 90 thousand customers were impacted in a blackout how does that impact what sfpuc is providing and the details of it if you want to learn more about that i'll sit down and discuss that with you, we had that problem at the presidio that substation failing and catching on fire whatever now in the marketing some of the speakers stated we haven't reached a benchmark and the novices in that area and maybe we can tweak our system and finally dealing with a monster at pg&e i'd like a tally of all the times pg&e and you all have gone to bat meaning a lawsuit and that's choose one hundred how many pg&e has won and how many you have won thank you very much i'm not going on to the board of supervisors. >> additional public comment. >> thank you jed if 350 sf i guess i want to start by pointing out something that happened this past week the bay area water supply & conservation agency set out a carbon free 50 in the bayview and 085 control measures they'll take over to push in that direction that is something we've been hidden valley involved in for four or five years it is called spare the air-cool assignment and again, the air district it finding the regulatory air agencies part of that will be regulation for them and spreading best practices around from jurisdictions all over the bay and again, setting high standards based on things happening in the bay area and using this district to spread that information and the standards as rapidly and expeditiously to get us to that goal i wish i had the grafted but they'll be short of 2020 extraordinarily short in 2030 and short in 2050 given everything we've read about in the paper and giving us a feeling of superiority over the disaster in the country we need to lgbt and look at the data and look at how far we to go the air district recognized we have that they're looking everything both in the authority and also in power given that i'll highlight for you that cleanpowersf and moving to 100 percent renewable energy is the sooner we can do that the sooner to focus on decartoonish the sproi the sooner we can focus on fully electrifying transportation those things can happen until we replace the foul and if we have community choice programs in other jurisdictions that are already more renewable than we are we need to match that and they'll need to match us we'll be basically meeting the highest standards that are feasible in the bay area to be where we need to go to that end really, really encourage it staff and the commission to the a lot into rolling the rest of the decide into by the end of 2018 we heard in lafco that is feasible we're taking a two year pause in from the 15 percent and looking at the rest of city and given where we need to get to move as quickly as possible thank you very much. >> and official public comment. >> hi good afternoon. i'm melissa a conservatism coordinator with the sierra club and echo two two speakers were talking about i want to urge urge the commission to support a faster gross timeline and recommended to local development of local resources we need a citywide build out plan for this and this will definitely accelerate our energy goal so asking to for you to support improperly san francisco customers by 2018 and making the basic green service available also thank you. >> thank you. >> yeah. >> welcome. >> good afternoon. my name is elaine with 350 san francisco.org one of the things that we do is myself and volunteers from the community go out on sunday streets and street fairs and other things and sign people up for supergreen and i would urge you all to go beyond the 5 percent supergreen and 50 percent of renewable energy you can do better and people in the community they're behind you i think i understand the reasons for being a little bit conservative and not moving faster i think san francisco is the place so you know let's move on and let me say step back and think had is the lynch pin for everything we need to do 100 percent renewable energy then have electrical vehicles and plug them in their 100 percent renewable when you change out your house from gas heat and gas water heat and you change that to protect that's 100 percent renewable and any industrial processes in the sfifksz become 100 percent renewable that's the vision we need to go fast i'll encourage you to continue this but move up the pace and go for 100 percent renewable no reason not to if not enough on the market start building up you built san francisco already thank you. >> thank you. >> yes, sir. >> my name is david i'm speaking as a resident of san francisco for climatic change i - i'm sorry oh, do you want me to repeat what i said anyways, the reason i want to speak because of my concern of climatic change i want to see cleanpowersf implemented as quickly as possible thank you. >> thank you >> good afternoon commissioners brewing president of hate asbury not going to repeat by the way, to booster that in our the neighborhood we've promoted cleanpowersf to all the members to enroll earlier but still want to know when the full enrollment will happen that is possible we've seen it coming on with point communities and other districts i think that is feasible we can do it i'll support with my colleagues that we do our best to enroll everybody by 2018 thank you. >> great. >> jason fried, executive director. once again thank you to the staff they worked with cal cpuc to get the change that no longer makes it did bill that once was i know there are concerns but not as it was and the staff leadership was vital in that concurring and get proper credit for that and not planning on talking about it butt joint meeting i'll be happy to bring that but make sure the mou is not waiting for a joint meeting steps in the process that needs that to be approved before the end of fiscal year so doing that at the next meeting will be important to move forward correctly please keep that moving forward and i'll be happy to work with our staff to figure out a joint schedule but tuesday is the board of supervisors meeting but i'll be happy to make that happen and finally as the other folks said moving forward this as quickly as possible it important and looking forward to working with all of you to make sure that happens and in terms of scheduling a joint meeting i think if you can work with between our staff substantive agenda. >> i'll be happy to and make sure that is worthwhile. >> commissioner courtney it is a defied to have that done and also commissioner vietor is right new commissioners you only recognize one the commissioners from the last time we met it is good to get that joint back together and working towards the final push for cleanpowersf citywide and i don't mean to go to - go to sfgovtv.org- back slash and enroll today. >> thank you. is there any additional public comment. >> mr. kelly. >> so the next item i have up is green infrastructure update tommy is not oh, there you are you want to do the interrogation. >> good afternoon, commissioners tommy general manager for wastewater we're here today excited to give you the latest update on the projects and here to present to you i want to recognize the fact they've been working diligently for the last ten years (calling names) they're working hard and not the easiest thing to do to change out the green and the happy medium to provide our citizens and rate repairs the best rates here's my colleague for the update. >> thanks tommy good afternoon, everybody my name is sarah i'm here to present the green infrastructure update if i can get the slides up great. >> all right. so today we are going to go over the green infrastructure effort the agency has been talking about and the rate allocation and the ssip early implementations and give you a flavor for what you'll see in the collection plan coit in july for the citing strategy but before we dive into the meat of presentation i want to step back and reiterate our definition of green infrastructure because it has changed since the last time we present and the reason we now place a greater emphasis on including flood resiliency and multiple purpose design in the definition that reads green infrastructure is a even though is of engineer and tools it slow down criterion and route the stormwater for the sewer system >> and so the reason we want to use the green infrastructure as part of portfolio to reduce the stormwater into the system and promote infiltration and non-popular use for the sf goals and in addition to revitalizing the water shed function want to provide the community benefits that are part of green infrastructure called the habitat so after seven years of implementation i want to give you a snapshot of what we are with the stormwater management ordinance that was the update the commission asked for to this .305 projects when completed those projects will manage over 100 percent million gallons of stormwater if 25 acres that is kwiend saucer and almost 200 and 20 acres will be separated sewer area and found that the ordinance has been a good catalyst for. >> an array of technologies as you can see on this slide the conform we're getting from the ordinance and, of course, a lot of development is happening in the channel basin and interesting to note in this very dense inner proposed had been successfully designed so for the green infrastructure then commissioners asked about a staffing update how we are implementing this program and the team really want to thank the commission for their leadership in this area with new staff we've be able to improve the level of services inform fulfillment staff and plus the support and those staff do project tracking project review and critically technical sups so every team subject to the ordinance recognizing those are new technologies and folks need technical assistants to get to the process the next steps staffing to build out the intersection to make sure the stormwater function continues in the future and investigating a project review team to assist with supporting the staff for this program. >> the other ask i building was about s mo innovation we found that is exciting is that each project is really used a combination of argue and automobile urban design to have the design solutions on the site so this is a been existing to see the ordinance is also earned new market in this area we've heard from the private sector green infrastructure is new and has to be planned and designed, built think maintained so individuals fulfilling all of those functions and hearing if the design and community that the ordinance as pressed them to integrate their designs early in the process instead of moving forward that is existing and another area is in main streaming harvesting this was unusual and over 70 projects that have selected this technology as part of the their inclines strategies it upped the number of harvesting we're seeing in the city and lastly just initiative design and from in the public realm that is really benefiting our neighborhood and some of the great designs we're seeing coming out of ordinance that is all from compliance with that is happening in hayes valley and now - the next tool we've been using ask the water shed stewardship grant program a small grant program running for 8 years and brand one $.8 million over time and funded the surface green water harvest and structure and engages how the green infrastructure fits into their neighborhood that's a great program we've learned as the stormwater cost allocation this level of investment is not adequate to compare with that so we'll think about that moving forward what we envision for the grant program in the future and to that point the other place that the action has been investing in studying as you may know i think you got a presentation from finance how to effectively allocate stormwater related cost of combined services to customers and this is really interval to what we're doing that the infrastructure as well because it will bring in new customers who have to a date not paid for their stormwater serves and have a grant program to help to less on the impact to customers and so the to date our early implementation projects one in each water shed we have really used those as a learning opportunity and goal to delve into the maintenance and intersection and learn about that it is a great catalytic to get ready for the next phase of it and the status update for the e ic in that table you have a handout with more information about the it but we currently are 4 projects under construction two in the ward one another 95 percent and one in conceptual design as you may know our commitment to build and monitor those projects so that the monitor are relatives can for the green infrastructure we'll be reporting out in the summer about the first round of monitoring results that is exciting and then quick shot of some of the completed facilities out open sunset boulevard by your attention in the ground retention in the ground the grant, the s mo and grant study we've gone over and want to have my colleague talk about what you'll get moving forward that was informed by the efforts to date within the correction system plan that is made up of the elements the team has been working hard to prioritize the projects you'll see that plan today we'll go over the green infrastructure elements you'll see coming down out of that and, of course, all our going once, going twice infrastructure effort within the goals and levels of service that was set forth prior the relevant one forces the green extra to manage the stormwater and minimize flooding to develop the projects for the urban water shed and design for the green infrastructure informed by the e i ps. >> so what you'll see coming out in the clorox for the plan is outlined here i want to take you through each of the tools and provide an example so you know where we're headed with those levels of service in mind we created these sets of projects the first one is the regional stormwater capture at golden gate park and creek floodable spaces that's all in the area of capital and have a grant program with the upcoming stormwater cost allocation and finally we're proposing a training and technical assistance program recognizing that is a heavy lift for the technology so out there educating sole practitioners to get high results for the fleet of steams strategies to reduce the cost to reduce the costs by the late increases. >> use capital to manage the instrument and reduces the flooding and pair that with the programmatic approach so the capital and programmatic goals we're looking forward to and i mentioned we want to bring all the lessons learned to bear on this next effort so this next we want to go quickly through what we've learned and explain how it is moving forward in our next set of tools i think as you've heard cost is a champ we learned that the e i p are expensive and in response the team applied a cost threshold to the projects you'll see coming down in the plan and kind of a decision tool to share when should the agency make the decisions how that is cost effective to spend open infrastructure and - so we're only investing when we know we can manage a significant amount of acre using the green infrastructure and the second challenge because green infrastructure is on the surface that is by nature an interagency collaboration and it is now so the process is not standard for everybody so we need to work hard to propose new partnering straenlts that draws on the strength and be more specific about roles and responsibility to so we have worked to create and green infrastructure specific project development process that all the agencies can use the third challenge we had was just the lack of experience across the city a deep learning across the city family and amongst the contractor that was expected the cities across the country have empowered when they started they're green infrastructure project that's fine and move through the learn curve so in response we have created and launched clean programs and lots materials to bring the practice up and then monitoring data when we started know we had no green infrastructure monitoring data for san francisco that's what the e i p will address and lastly flood resilience we started doing project selection by the resilience was not a criteria in the urban water shed and now specifically targeting flood resilience areas all right. >> what do how mean by flood resilience. >> meaning i think in sfechz presentation i'm not sure tests last commission i believe you spoke about the different problem areas across the country u across the city the drainage problems and what we tried to do now we have it complete we tried to do-si-do spatial planning if we are proposing an infrastructure we will place it in a flood resilience area along with the gray to get the largest performance as possible. >> thank you. >> you're welcome. >> the first tool we're doing to capital is regional stormwater at parks the notion we will articulate the large land areas of parks they're great opportunity and not just manage the stormwater from the site but try to manage the stormwater from surrounding areas tomato misses the acres we're managing and prioritize capture and use to align with the sf goals. >> and those photos are examples how this is implemented in other places this is a capturing the place for 2 million gallons to irrigate all the fields are great pay their fair share really responding to drought, etc. >> the next tool is stormwater management on puc parcels something on our own parcels have a high degree of controls to demonstrate new technologies and learn about the infrastructure approaches and maximize the benefits on our own parcels this photo is for reno where d.c. water has a green roof on top of one of their reservoirs for example, and the next tool is incredible spaces you'll see these in the collection plan the idea the daytime creek and have open spaces that will allow for co-beneficial uses during dry weather and also keep stormwater out of sewer system we'll uses streets and parcels for the stormwater. >> and then the last capital tool you'll see in the collection plan is the streetscape plan a practice for the sfpuc to respond to the streetscape stunt many, many opportunity but we want to do is have a process that allows the public works to adhesive which ones are in fact, the opportunities we don't want to participate indiscriminatory we want to be specific and this tool each dollar goes further and enforce strict performance criteria for this project. >> so the next tool is green infrastructure grants and as you may know this allows us to loefrnl the activities of other sponsors private parcels take up the most area in san francisco so we need to have a smart tool for integrating the green infrastructure into the parcels and capital lee alone will not allow us to leverage all of that in those tools we'll a effectively increase - some example of what this would allow us to do will address the customers impacted by the stormwater late allocations an important pay their fair share with that as that process moves forward and incentiveize public and private line up on the screen side of the room and in addition benefit because the maintenance responsibility lies with the property owner and the puc can have an inspection function to make sure that the performance is done as the project stages that is an example of a grant in new york city as an active urban roof. >> and then finally sanctions we think that in order to have these initiatives be successful we need a stormwater technical assistant program and ♪ area we'll envision services that foster excellence in green infrastructure and inspection and maintenance and those services need to merge engineering with this this is the vantage of green infrastructure over other technologies and been active as you can see our guidebook and want to pair those were technical systems and talks >> and this slide shows some of the other materials we have created over time so with this whole fleet testify projects that you have eaten in the project so far we've deployed them what can you get i'm quickly go through the slides that will show the gallons removed why action excess and time moving forward. >> so you'll see i'm not sure you can see on the genie the color is not coming up but in our handout the first sliver is the perform we've got out of stormwater project that has been approved to date and if you project this stormwater management until three 2 getting the 3 hundreds million gallons per year and add ♪ sliver that is the early implementation project and then all of the tools i described you'll see in the clorox plan and so if we do all of that we can rove half a billion gallons by three 2 with the substantive goal a 5 percent of all the stormwater that lands in san francisco and we also feel like it represents a difference sit down of stools we have capital and programmatic, as well but clearly at the end of this we'll continue to manage the portfolio we wanted to con the course lists this we've been asked what the the long term goal for infrastructure we projected that performance forward along with the stormwater management to see where we can get to if we continue with the stormwater management ordinance that is currently a threshold and add the performance if the collection system plan we're getting close to 8 hundred million gallons a year removed and beyond that if you mix a strategy portfolio of regulatory strategies you can believe we can get to one billion gladdens by 2050 on poor with other sponsors and managing 10 percent of all the stormwater plans in the city so we feel this is a good long term goal and vision to help us dive our effort over time and that's the end of presentation i'd like to take questions if you have them >> thank you yes. >> i have a couple of questions so you had a existence up in the beginning does it say anything about the multiple additional benefits beyond the stormwater management i'm wondering why this is i know there is all kinds of data with the water around job creation, around the unification can you refer to a little bit later it that something not measured or not in the definition i know some of that unite not be necessary for the board of public works. >> that's a great point it is a message behind the definition to say what this actually means within the definition you'll see the word sustainable we didn't go into this in presentation but have several slides what is the sustainable effort mean that's where you get the checklist, if you will, if you meet this definition if this meets all the multiple benefits that's where the priortion happens all the metrics are embedded in the urban water shed and in the pb l tool with the. >> (speaking chinese.) and traffic calming all are embedded within the definition and the tools for the project selection. >> so when you report back on the monitoring of the e i p in the summer will you have that for the economic benefit biological benefits. >> we can make a note the current presentation is focusing primarily on stormwater management performance. >> i wanted to be clear the main reason we're doing it that so manage stormwater. >> right. >> so we look at the triple bottom line if it is not stormwater then the question will we are doing it i think that will be probably not high on the priority list that's why we're looking at the triple bottom line and have all the other factors we'll definitely be you know open to you know track all of that stuff i don't know how to track it but for us we want to make sure when we spend money on green infrastructure we want to make sure that it is performing you know an effort of removing stormwater out of system that is what the engineering side is looking at because you want san francisco make sure and also the placement of where you can place to get the biggest ban for your buck and he's done a great job in working with the collection folks that layers the green and some areas green infrastructure is better than that gray and gray is better than green and yeah. i've been reading and understand there are a lot of additional benefits from an economic perspective in beautifying the city i don't know how to prior i's we want to monitored but things of interest to this commission around job creation, around economic benefits of interest to the citywide but what are those things we'll be monitoring that's the promise of green infrastructure. >> well, let me give you an example of water management the biggest way to reduce the amount of you know water out of the system but what we're doing is requiring property owners to do it i don't know how you define the jobs other than the jobs to inspect it we can anticipate what what the jobs to go to identify been talking to staff we talk about green infrastructure at least he i'd like to get away from on the puc talking about that we want the whole city when they build something green infrastructure is a way to incorporate and change the mindset of folks in san francisco about when necessary build something i'm trying to get away from green infrastructure police or the only agency that is doing green infrastructure we've been trying to make a way when you have a project or d c w that's our components they're looking us to pay to contribute to their projects we're trying to leverage the whole city and all the work they're doing that's a step in the right direction we're looking at other things 5 thousand above construction 5 thousand appealing feet we'll be looking at maybe reducing that to capture for projects we're looking at ways we can leverage more but it all comes to make sure performance is one of the core but also measure the other benefits and just to clarify quickly with that with projects selection all of the projects that are selected must meet the level of service but then when the benefits come in say you with the projects equal in performance and they have to perform for the agencies to invest which ones give us those multiple benefits and help the projects rise to the top so those are substantive in the ways they differentiate equal, if you will, for performance. >> i think that makes the case to go citywide maybe selected bans the criteria but it is also created jobs and recertification program and done the ground water recharge i'll urge that to happen. >> we can track those. >> and i don't see - i appreciate the long term thinking i'm sort of there but really dollars attached it that i know at one point talking about 4 do hundred million range is it fair to say put out there i'm wondering too get to those numbers that are put out there to i'd like to have you come back and said what that will cost to - we like those kinds of savings billion by one 50 this would be amazing and how it fits in with the whatnot and other benefits that we can release. >> we can definitely come back on that number but i will say by the stormwater ordinance it really requires you know developers to do that as part of their projects for us the monitoring costs for us a way to get other people body in on the project and not paying for on our projects so we identified i think 4 hundred over $400 million of green infrastructure what we're doing we're using criteria to denominator where the best places to use green infrastructure or green and gray infrastructure to maximize you know the removal of stormwater and give us the benefits for the community and that's part of the plan that we talked about the collection plan that we're going to roll out so it is about the same dollar value still that is coming in more it could be less but within that range so - and it is very good. >> it won't be until july sorry i have a couple of more and i remember there was an issue last year maybe around the budget for the review process for the stormwater new buildings and i think that the staff we approved two any positions that came in for a total of 4 but didn't see that in here i'm wondering how the backlog part in response to the boogy think that the team is facing in reviewing the designs and plans and the technology and i didn't see all that staffed up kind of want to hear from this is an issue to be thinking about. >> first of all, i want to thank the sf i p team awhile we were undergo that process and the additional ftes the level of services is much better we were out 13. >> now between 4 and 7 weeks which compared to the other agencies is wonderful i'm not sure how how many calls we've been getting from developers but our goal is 4 weeks this is a huge help the extra person. >> okay. i would encourage you and the manager to let us know in the backlog for the guidelines those regulations what we can do with that. >> i want to pointed out that's one off the recommendations to have - yeah. >> cover that. >> yeah. yeah, because we'll have a sustainable amount of money the projects will cover the status like we do in other parts of when we do water hook ups we charge to perform the work we are trying to do the same thing and last. >> last question i think someone respond to the muni mailbox i'm not that's a great question but where the developers put green rooftop - i'm wondering if any projections on who when a that reduces. >> there has been and we've been working closely with the city family the interesting thing u78 u as you may know it was a rooftop ordinance but rolled into the solar ordinance which makes that more difficult to predict what that will do for green infrastructure the developer can choose whether to do solar or a green roof so not a mandated green roof ordinance as before and called the better roof ordinance it has multiple uses and so staff looked at that and saw currently the stormwater management ordinance is the preliminary drive for the ordinance in san francisco and moving forward additional projects that can be captured by the better roof ordinance that we didn't capture otherwise but marginally there it but it is a super strong driver for solar with that said, when we move forward with the stormwater cost allocation that could provide a financial incentive for developers to choose to do a green roof instead of solar to comply we can do either we'll be tracking that as it move forward but the driver will not be super strong until the stormwater allocation is completed. >> i'd like to hear back it from you especially for the long term vision of how that can be because there is a lot of buzz out there around greening up the roofs not only from stormwater retention but also for multiple benefits as well. >> this is an interesting question so we have multiple incentive programs and multiple interests how will we choose to incentive individual landlords green roof as opposed to solar. >> they can co-exist we can do both don't have to expedite with each other. >> it you choose solar we have a program that will help other set but don't have anything for the green roofs so if we have a stormwater fee it is an incentive so you choose that we're trying to balance the two to maximize if you build and comply with the watering if you don't do it on the roof you have to do it somewhere else. >> commissioner courtney. >> i want to echo what the commission said it is a great report i did have the pleasure of hearing more about this may be a couple of years again in philadelphia i understand the impact that we're looking for with respect to the grant piece i'd like to hear a little bit more about that and how it connects to jobs. >> uh-huh. >> what kind of funding we're talking about the thing that concerns me the most not the private land but the public land and when you are talking about granting and i think to commissioner vietors point we'll end up creating jobs directly or indirectly and sometimes, the indirectly piece that kind of captures my eye so i just wanted to have a drill down on that and finally if we're going to be independent on that kind of of an arrangement to contemplate what happens with folks do deliver what happens when we have those arrangements and understanding we pay and then that didn't happen will we sue you know 39 or 59 different parties i think it is not fair to you right here, right now to comment but i need more information on that particular piece specifically the maintenance i think when you grant money your granting it to people that are thinking about stuff or talking about stuff or doing stuff i'm concerned about the doing stuff piece but thank you. >> we'll definitely explain how all the documentations we use for the stormwater management ordinance is informing the grant program in terms of maintenance agreement and all the contracting, etc. that is a template. >> also say that if someone didn't comply there is an enforcement piece, too, and just to throw out there the point we have grants encourage people on their properties doing it instead of us building something so there is a balance but love to - we've had a lot of conversation about that. >> and what about studying ground water impacts two things not only the ground water basins in parts of the city where we have problems with too much ground water but folks should i be comfortable if i have one of the projects uphill from my house. >> yes. you should be in the projects selection tools we have we incorporate all of the technical factors as much as slope and even with the s mo a tech sign off and costs we can delve into that that protect the adjacent property and understand what the facility is doing is the goal to infiltrate or the design. >> thank you. >> yep. >> commissioners anything else any public comment on this item. >> yes. mr. brooks. >> good afternoon. again commissioners eric brooks sf green party/our city/sf clean energy advocates. so i want to speak to this item and the general manager's report in general the to this item i keep on repeating this but we're projecting up to 2050 coping a belittle gallons of water out of wastewater or the stormwater system part of that picture is to keep human watermelon from getting into that system in the in the first place i've mentioned before, no flush toilets if you're going to do long term projections how to save one billion gallons the time to do test pilots of no flush toilets to see what works again theoretically if we searched every toilet to that we'll safe 5 billion gallons of water a year not going two the joint stormwater and sewer system it is time to get off the dime and do test pilots that would be great it to have our staff plug that into this matrix of stuff on general manager report in general it is crucial that we get a report on at the time are tech on treasure island you've noticed treasure island items on the agenda i can't stripped but that is bigger than the items i indicated before at the time are tech has been doing clean up work for the navy in the bayview hunters point and in the bayview hunters point because that is tech filed with the federal government transfers of land were at the time atetrod on the groups met with the epa about this the response from the epa was because treasure island is technically not a superfund site we don't have jurisdiction we need your staff to reach out to the navy and the treasure island development authority and the substance control i think the answers in the navy won't be helpful but the point we need to figure out who's going on and figure out a way for us to halt the transfers and work on treasure island so when you have workers to work on those systems you'll set up for treasure island not imposed to radiation and commissioner vice-president kwon you showed interest brother that would be great if i may to follow up on this and see if we can get a report from staff had is done with tetro tech on treasure island. >> thank you. any other public comment we have a request from ms. firearm wants to talk about the earlier item on now is your chance. >> thank you for the opportunity to give comments on cleanpowersf. >> thank you okay. >> as a c 40 city san francisco as designated as one the urban leaders san francisco is one of the 90 cities in the world that are going to save the world from climate change and san francisco we understand the importance of accelerated conversion of cleanpowersf is an important path to fulfilling our c 40 robots bay area, bay area water supply & conservation agency and california's only compliment goals that why not enroll cleanpowersf sooner than 2019 and for clean energy enroll three hundred residents speakers shall address their remarks to the commission as a whole and not to individual commissioners or department la valencia they've enrolled in the 100 percent energy as a default i talked to the gentleman on the phone and said quite a success in potrero valencia have 95 percent sticking with the 100 percent green option so very few opts out so i ask you to accelerate the basic clean energy and fund for aggressive problems of supergreen the current supergreen enrollment of 2 point 5 percent is willfully inadequate in a city that could a afford 40 percent and more please speed up the conversion to clean energy for the sake of our children and grandchildren and for the sack sake of our planet. >> mr. kelly. >> i thought something else was coming up were will that that concluded my report. >> any other sponsors public comment on the general manager's report all right. thank you all next item is the bawsca update. >> good afternoon commissioner president and commissioners thank you for the opportunity to speak today and first, i have a couple of remarks but the bawsca board is considering the budget at the next meeting in may included in that budget is there level of activity in the water reliability work and actions to respond to the governors actions for that i will come to you after my meeting in may and give us an update i think you'll find that interesting and helpful to understand so my remarks i want to focus on long term water supply restrict as you may know the california san francisco state resources control board stated it's intent to adopt a plan when has stream flow requirements on the lever that will reduce the water available to san francisco regional system for residents and businesses in the san mateo and santa clara county and use that to protect the wildlife in the river those changes can force the reliable conspiracy from 1.8 million residents and agencies that bawsca represents as i mentioned before bawsca supports the objectives at the stat board but can't support the details of proposed plan for the river there better ways to reach the goals and the state board should use the best technology bawsca constituents have reduces their water use to 56 gallons per person on a residential basis one of the lost levels and ready to do their fair share and puc and bawsca have designs to expand the populations water supply reliability bawsca be strongly supports negotiated settle aeshlts for this issue bawsca member agencies and retail customers the puc which supplies the water is required by the decade old court decision and a agreement to provide one and 84 million gallons a day and san francisco is required by the state legislation to submit and report to the legislature quote describing the progress made in the previous calendar years on securing supplemental supplies of water during dry years unquote the problem the puc reports show slow progress with no water supplies coming on line until 2019 this has to change we must find replacement water to provide the bawsca constituents when needed the puc must continue to meet the water supply obligations in 2002 san francisco was fourth or foshsz to repair and rebuild the antiquated system now it must supply bawsca constituents with water to regardless of anticipated state legislation that will reduce their water supply bawsca is prepared to seek help in the legislature but bawsca prefers to continue it's effort with the puc, with staff and others to address those critical issues this results with the puc philosophically it's water requirements that concludes my remarks take any questions and we have copies. >> question has bawsca as a whole addressed the issue of timing for development of additional water supplies right now an example we spent a lot of money for the one and 20 there is a match of demand and revenues can you address that have you addressed that. >> no, we have not we've been talking about with the agencies recognizing that there is some significance here you know that really depends on how quickly everyone rebound with the new plan projections those significantly will chance the results on when that extra supply is needed but i think our history has shown us that these projects take decades and so certainly within a couple of decades for me there is a long path to getting forward between today to have a point to saying are we ready to make that decision on a viable project that's the gap we're seeing. >> as we do the water supply assessments we did the water reliability planning there was a match of demand growth and supply growth through the forecast period as you recall so those identified projects will keep pace with the projected demand. >> correct the issue is that if the state board proposal comes out that is the triggering next step you're absolutely correct within the understanding of the if i go back two years and know what the plan and where we're going in an appropriate spot we're now looking at a state entity possibly adopting a plan or intending to adopt a plan we anticipate that and jump up our level of planning to deal with that. >> yeah. that is certainly the most go thing and this agency is committed to meeting the obligations both in conceptual and our plan regrets that i have a hard minded figuring out what the state boards action may or may not do but legislation that need to be done i suggest at the state board rather than this body. >> can i ask a question. >> sure. >> so i guess the way i'm thinking that is that no matter if the state imposes nothing on us you're looking at our agency to supply a what is comparably the good, the bad, and the ugly and make sure we have a situation where the state others alternatives. >> correct. >> and that's we've discussed that before i think one of the things that is clear about the state where had proposed action that hit word to be implemented as intended it would cost us we'll have to do a lot of development with the obligations. >> i agree 100 percent and the concern i have is that we need to because this is a significant step and anticipated impact from the state board we need to significantly there the puc and needs to significant focus on how we ramp up, if you will, to daed deal with the next increment issue to examine the projects to get to a conversation do we want to make that investment but right now i'm not sure we're prepared to do that or thinking about that at that point. >> thank you, commissioners any other questions. >> okay. thank you. >> thank you very much. >> okay any public comment on item is bawsca report? seeing none, next item is consent calendar >> item 9 calendar, are considered to be routine and may be acted upon by a single roll call vote of the commission. there will be no separate discussion of these items unless a member of the commission, the public, or staff so requests removed from the consent calendar and considered as a separate item at this or a future hearing. commissioners any items you want removed from the consent calendar any members of the public that wants on item removed from the consent calendar seeing none, can i have a motion. >> >> been seconded. >> all in favor, say i. >> i. >> opposed? the consent calendar is adopted that brings us to items 10 and 11 item he 10. >> authors the general manager to increase the in any way, shape, or form commercial notes program from $500 million to $750 million and agreements including the agreements in the principle amount not to exceed one hundred and fifty with bank of america and not to exceed one hundred millions with sumitomo mitsui banking corporation and improve the former of agreement. >> commissioners be eric sandler cfo can i have the slides please. so the the item before you is may thank you perf the the item before you is an authorization of the increase for the paper program for wastewater enterprise and actions associated with doing that before i get into the shorted presentation we utilize the water for the water and wairmentd capital plan improvement program before we issue the bonds to fund it inexceptionally duration construction and the paper program for contracts to enter into long term contracts for construction. >> so currently we have a $500 million c p for the wastewater 61 million dollars of that program of the commercial paper has been issued and the balance of this used to authors and certify contracts bank facilities supporting that in 3-d currently and essentially we're about to enter into a series of large contractors to support the cooperation of it we need to increase the capacity of the program and the proposed there from 5 hundred to $750 million consistent with the 2017 capital financing plan we provided you in september and moving forward this transaction and we are and allows us to continue to implement ssip on a timely basis. >> the contracts that support of commercial paper program are two credit facility agreements so commercial paper is actually supposed sports by letters of credit from banks 0 investors have a bank that will pay that short term borrowing commercial paper is a note that is issued and mauchts mat turns from one day and the credit the investor pays is the bank facility not the puc and dealer agreements which we have with the various dealer with the issuance of commercial be paper over time those are the contracts that are the form of those are in the agenda items for your approval again, the documents that are include the pay agreement are the u.s. bank a trustee agreement and reimbursement agreement with hmo and bank of america and credits with those the fee agreements which aligns the cost of credit facilities in the form of the agreement and finally the offering memoranda the disclose documents the investor is facing. >> you asked to talk about the security we explain in terms of discharging our disclosure obligation and as i mentioned unlike the long-term rain water the paper is with the credit backing is the bank credit facility the offering memorandum describes terms of the issuing and the agreement in details with the bank that supports the program now the bank documents themselves with the banks contain representation of warranty and we've worked with the city attorney's office to make sure that the commission represents are warden squared away those recommendations the amendments need for authorized and hopefully signing the comes at a time are the legally authorized to sign them and material obligation and that the financial statements we provide which are financial represent materially the enterprise and no material adverse change in the finances of the commission. >> so the requested action again to approve the expansion of the watering cpr from 5 hundred to $750 million, to direct us to submit the directed information to the board of supervisors and to approve that relates to the cpr program i'm i'll be happy to answer any questions you may have. >> commissioners any questions. >> there is a motion that has been seconded and any public comment on this item. >> seeing none. >> all in favor, say i. >> i. >> opposed? that item passes. >> item 11. >> approve the conditions and authors the general manager to execute the second amendment for the real property date 2010 between the city and county of san francisco ac with the puc and in the peninsula open space district. >> thank you, mr. carolyn and deputy director manager we are exchanging the easements and finish off the easement. >> i'd like to move the item. >> there is a motion that has been seconded any comments from the commissions any public comment on this item? seeing none. >> all in favor, say i. >> i. >> opposed? none opposed item 11 carries item 12. >> item 12 declaring with the approximate $3,000 square feet parcel under the jurisdiction of the san francisco public works with the lots parcel lot i'm sorry requested the sfpuc to approve the terms and conditions and authors it with george birmingham to sell the adjacent square feet parcel in the sfpuc for a compliance sell of $1 million plus approving the terms and conditions and authors the board of supervisors and mayor to approve the parcels subject to the terms of purchase agreement. >> thank you mr. carlin. >> again, i have a map that actually is kind of hard from the agenda items to see all the paralyzes but those are small parcels will 35 or 34 hundred square feet and the sfpuc is selling a parcel as well if you have a second this is by mr. birmingham and did several with mr. birmingham with the homeland security association and we'll have everything signed and delivered for one million dollars. >> so moved. >> second. >> there is a motion that has been seconded any other comments from the >> all in favor, say i. >> i. >> opposed? none owned and operated item 12 carries item 13. >> authors the memorandum of understanding for the treasure island agree for wastewater treatment facilities serve treasure island and yerba buena island. >> mr. carlin once again dated back to 2011 you approved that between the city and developer we left the question for how to provide the w5ir789 services we've decided to lowest recommend we god go ahead and build that water facility on treasure island to allow us to move ahead with that project. >> thank you so moved. >> second. >> there is a motion that has been seconded >> all in favor, say i. >> i. >> opposed? no. >> item 13 carries and item 14. >> authors the memorandum of understanding between the transportation authority with the sfpuc san francisco san francisco municipal transportation agency and sfpuc with the future maintenance responsibility for public improvement be constructed at the treasure island community development. >> so once again that is a moa that allows us to lay out our responsibility and this infrastructure maybe into less property we want to make sure who coordinates that we have a thorough understanding of that with the developer. >> thank you, commissioners. >> so moved. >> second. >> there is a motion that has been seconded any other questions or comments seeing none. >> all in favor, say i. >> i. >> opposed? item 14 carries item 15 sets the record for the longest agenda. >> adopt the findings prudent to the california environmental quality act approve wastewater i'm sorry water segregation ab for funded projects c e w-7 thirty that 54 about the pipeline replacement and authorize the general manager or his needs to inclement that substitute the approval of the board of supervisors. >> good morning, commissioners and commissioner president this item to adopt the ceqa findings and authorize that for the purpose of allows h allowing us to enter into negotiation for temporary easements necessary for the pipeline. >> thank you, commissioners. >> there is a motion that has been seconded any any public comment on this item? >> all in favor, say i. >> i. >> opposed? item 15 carries. >> items 16. >> 16 for preconstruction and construction services and award contract in the amount of $15 million plus to the lowest qualified responsible and responsive bird ab construction. >> thank you commissioners any questions, comments. >> i'll move that. >> there is a motion that has been seconded on this item? >> all in favor, say i. >> i. >> opposed? item 16 carries. >> item 17 and 18 we'll act on that individually i understand you have one presentation that covers both of them i should say i'm known both of those farms and privileges involved for years and consider them friends and not been involved in the selection process at all and it didn't effect my ability to do my job that's a disclosure i need to make. >> would you like me to read the items. >> item 17 award the agreement state legislative representation to gilbert robison and smith for an agreement with the e r g s not to exceed one million dollars plus and item 18 award agreement federal legislative representation for the services to dearly owen services incorporated with darrell owens not to exceed one million dollars plus over a duration of 5 years. >> thank you good afternoon julia assistant general manager for the affairs i will do the items one contaminate for items 17 we are asking the public works to approve for the state lobbying contract for the advocacy services for the public works and this begins in may 2017 the proposed work is implementing a comprehensive state for the public works for the regulatory issues across the bay and in addition, this lobbying form coordinators with the mayor's office and the lobbying team and i can't imagine from emily in her update last october the rest of the work we're doing at the state and federal level is our lobbyist are crucial kind of how priority to make sure we are able to respond to the effort of the state as background during the two year session for 2016 that policy and government affairs team tracked over three hundred and 50 interests over thirty years for the incentive of the breath and scale so for that year working with the body of our tracking the bills and 58 power bills and other bills that could have impact and barbara hale talked about the effort that we've been working on in sacramento with cleanpowersf and across the date it is a really effort if our lobbyists in sacramento has been pivotal working with that and at the ad m level with that contract it that what we're requesting this time around year term it and have won't include any years which we've embedded in the last contract so if you remember when we came to you that would have been four or five years ago a 3 year term with the option of 2 year extension and with the state and federal lobbying contract we are coming before you with a request. >> commissioners. >> i have a question i remember an issue with the federal lobbyist we were. >> should i answer that now. >> the first one up is the state. >> i'm sorry the state lobbyist and second. >> a second. >> any other questions or comments any public comment. >> all in favor, say i. >> i. >> opposed? the item carries and on the federal number 19. >> i know you read it. >> would you already could that. >> i read them together. >> okay. so for item 18 similar request for a review to the state contracts that will be 5 year term in front of you the changes in about washington, d.c. to defend and protect the puc water rights a high priority so didn't need a lot of explanation doctor and find a lot of value in the work they're doing the question commissioner vietor had asked with regards to how this lobbying from the this relates to supplemental resources we've been working 0 with the mayor's office to add to our capacity the explanation we work with the mayor's lobbyists that is which is different from owen and associates the owen have a day to day sfpuc core operations work we at the puc as many departments put resources through the mayor's office just to support the work that the entire city 0 does in addition, we provide about $75,000 a year to the mayor's office to the pro-active activities they've got the effort meeting the charge with regards to our workforce priority working with the department of labor and with the congressional black caucus when president obama that was in the administration so the pro-active general manager group that harlan helped to co-characterize is support with the holland night and owens and associated is doing our bread and butter power issues etc. >> a lot of work i mean, i would strongly encourage you commissioners to come with us to washington, d.c. to see the great opportunity and done with the he wanted but commissioner caen came with us in the fall a year ago and did a bunch of meetings with you and was surprised like half a day through you guys have 8 meetings a day uh-huh if folks with interested we do about 3 or twice a i can't remember to plan to kind of have the list of meetings with the different departments. >> actually, i would recommend that you come by the way, because a it is exhausting we meet from even from epa to the core of engineers to many office it is a very crazy time we usually can't get everything in you i'd like to move the item. >> thank you any other comments public comment oh, i'm sorry mr. da costa. >> supervisors, living in a different time with someone that we have in the white house who has totally paralyzed the epa and even didn't building in climatic change and so forth and so i came here as you may know that when we have over 45 years of experience you can connect the dots as i trained that the army let me say something let's get real over one million dollars even if it is $5 million with a 5 field i don't mind but let's get real we have to shape what the previous - we're living in a different time and if all goes according to plan donald trump will be in office for 8 years. >> so we have to figure out now if we have the money which we have ways an enterprise department let us channel for things over here local the city will suffer right today, the mayors are meeting p with donald trump not a single mayor from california i think and for sure a lot of the mayors linked to the century city it will be the same they talk about climatic change and will be the same north dakota so the pipeline can't be built it will be the same it we have the money here san francisco public utilities commission and you commissioners we need to use the money here no bs about where we'll go and try to convince donald trump with the legislative stuff and it ain't going to happen some of you all have a beard like i do some of you as old as i am over 70 we've seen it all we've got a joker we don't want to go there i think it is a circle we need to spend every single nickel and dime here in san francisco and spend it wisely thank you very much. >> thank you any other sponsors public comment. >> we have a second. >> all in favor, say i. >> i. >> opposed? item 18 carries thank you item 19 and approval of amendment to agreement c s increasing the grant agreement by one and 80 thousand by an extension of two years. >> thank you mr. richie. >> yes. steve richie assistant general manager for water. this is an extensions with the parks alliance for the guardian of the environment the garden for the assignment cases out maintenance of the garden for public tours and instructions for visitors market value and outreach to promote the garden and enrollment in classes as public education and workshops and school field trips for education in and a variety of other activities this last been going on for many years we continue this for water conservatism and white water use and prevention activities. >> i had and thank you to my colleagues, i asked for this item to be continued i'm prepared to vote but want to make sure for the record number one, i know this group know that well my organization supports this group so i think that is good for me to be able to make those statements as it relates to this group so it didn't have a perspective we have a problem with the i dissolution but i take it seriously when i hear what they think is a lack of transparency and a lack of responsibilities i read all the articles and know what is happening with the ethics commission i read the blog and prioritize the workforce and i think if we get ahold of this conversation as an agency and as a commission we control the narrative i think we'll be more successful moving forward especially, as it relates to the granting and the agreement and the entities we're granting money to i'm focusing my attention on the workforce the reason you end up overtime with kind of a back filled workforce folks working on the puck land but working for some other entities i'm disappointed with the fact that we continue talking about old stuff i don't want to talk about old stuff no more but how we're going to have a policy in place so we can deal with the constituents the rate payers and the public has it relates to our obligations not just fiduciary but our coagulations obligations to the public to make sure there is standards more transparent - the parks alliance has 16 thousand people going to the meeting we can support staff when there is not a policy that we have before us then we're just going to say yes and staff is left out there all alone we said, yes and there is no violation so i'm really trying to is a lot of things before we vote on this item but eventually i'll be asking for support it is it is a heavy lift just to say when we grant to these organizations under the guise of some kind of work performance take place we do that work and as we want to make sure we know what the wage rates are we want to make sure we know that people that want to work 40 hours a week and make sure no ongoing complaints with the fair housing with the e oc their fulfilling an agency purpose without strings attached that is appropriate and i'm just going to appeal to all of us to think about this in terms of just moving forward, be positive about that reject the negative i that think one base frankly, i didn't want to hold that up i know those people they're good people and believe in what we're doing and believe in it i'm glad not another organization people can say i'm not in sync with that organization therefore i'm attaching the grant the general manager has been nothing but supportive rule 200 is supportive and every single gm is supportive it is up to us to decide the egg we want a policy and implement it and make sure we follow it so i'm going to go ahead and move the item after that long speech. >> can i make one comment you know commissioner courtney and i had a conversation about the new 0 policy healed to have rolled out and talk about how to implement it moving forward and maybe some of the things that we want to gather may have to be part of rf the selection process that requires us to do do servicing that's why i want to sit down with the commissioner to talk about how we can make this more accountable and transparent and be more informed before he we make that once this selection is made anguish it could be more challenging but definitely hear you and definitely commented working with you i'm looking forward in working with you on the policy and who to implement the policy. >> and i will add that that is the emphasis of our review selection and the question of our own audit process to make sure those policies are valid we have a motion do i hear a second. >> second and any further discussion any public comment mr. da costa. >> you know commissioners, i heard one of the commissioners parolee clearly some years ago the president made a statement i hope you remember what he said that's what i'm going to talk about some years ago there was a contract given supposedly all the requirement were met but the contractor couldn't fulfill what had to be done. so our young people went all the way to cal berry to do do scaffolding i'll put on the picture and you can see something else took credit our young people went and built a fence and went to homestead and with a native plan and sent off when people make a statement in good faith we put out a bid someone gets the bid through there is no enforcement there is no enforcement all this big guys that get big contracts in the millions they make changes it is a joke go oh, who cares so let me get to the point the muwekma ohlone has requested for some land they can continue what they know when it comes to facht plants that's what people need to go and see to see a continuation the city has 6 or 7 odd resolutions i just gather the cities and counties of san francisco oh, yeah, the muwekma ohlone and nobody gives a i don't want to use the word so what i did was i took the muwekma ohlone to the general manager and present to the chairperson and i did therapy this and that so i represent the muwekma ohlone and i agree with one of the commissioners that when you work you better get paid even we came to an agreement to calaveras and paid them the men were shocked and the woman worked harder than the men and same agreement to the homestead the general manager know about that he didn't mention it we sent it to him when it comes to grants not mickey mouse we don't want mickey mouse gardening we want something that is viable and sustainable and before god is rig right. >> okay. thank you i had a motion and second and any future comments. >> all in favor, say i. >> i. >> opposed? the item 19 carries. >> item 20 and approve the terms and conditions and authors the general manager to execute a 5 year revocable license with the parks alliance. >> i'll move. >> there is a motion that has been seconded any further discussion this item? seeing none. >> all in favor, say i. >> i. >> opposed? item 20 carries. >> madam secretary would you read the items for closed session. >> item 23 will not be heard item 24 existing litigation for partisan and existing litigation for gas and protect and 26 litigation for gas and protect and 28 litigation for gas and protect and item 29 will not be heard. >> any public comment to be heard on items for closed session. >> mr. da costa. >> you're going into closed session i just came from the board of supervisors and one of the things that was discussed was a blackout and how pg&e very poorly communicated with the city not only pg&e but all management for some emergency management office they didn't a poor job if i'm not mistaken back to the sfpuc as i said in my previous comments if you take one hundred cases pg&e versus sfpuc like a soccer game i want to know who wins most of the time. >> i want to know why pg&e wins most of the time? because they got thank you all have one attorney they'll put 50 attorneys if you have 50 they'll put one hundred and i know for a long, long time i mean a long, long time and i know what she's capable that i know what she's capable of you commissioners go behind closed doors and don't have i know not educated on items those kinds of issues legally you can play ball with pg&e in fact, pg&e and all the deliberations we attempt to do they trap us they trap us and they'll go dmrts puck public utilities commission and i think his name was we they could do whatever they want to oh, we'll work with you he'll say what we want to he's got all the clot to do wrong you go behind closed doors and before the attorney it will read all those things and give who is saying not to delay those things none of you will she's got legal let me see i served in the army i know what the hell i'm talking about so go do what you have to do according to the brown act they give us sometime to say something we don't have the information before us i don't care all i can say a create a block for you >> thank you. is there any additional public comment i'll entertain a motion closed session. >> >> we're back in open session. during closed session the commission took no action can i have a motion on whether to dloushs any >> all in favor, say i. >> i. >> opposed? that item passes any other new business for the commission. >> thank you all this meeting is adjourned (clapping) ♪ ♪ ♪ ♪ celebrating the wow. turnout this is our third annual to celebrate pride we notice we didn't have community event for pride. we actual had 19 we had godzilla and are you ball weird names i think its unique we're able to have special event we're all women that relax and have fun you know everything is friendly and kind we're all equal i'm happy that >> secretary will call the roll. >> pating, present. chow, present. bernal,print. san shez. the second item is approve the minutes of the meeting on april 4, 2017. actually commissioners to your right i put a slightly revised version of the minutes. commissioner chow asked me to switch the order the reporting of the elections, so that version simply has the president was elected first and vise president. >> the motion is in order and the edits in are in yellow on your new copy. >> so moved. >> and a second is received. any further comments on the minutes? any corrections? if not, then we will vote on the minutes as edited. all in favor please say aye. >> aye. >> opposed? the minutes are adopted. >> item 3, directors report. >> director garcia. >> good afternoon commissioners. the directors report is somewhat a small today, but the one item i did want to share with you is that the san francisco board of supervisors enacted a resolution on april 11 charging the department of public health with convening a task force to develop recommendations on operation of safe injection service in san francisco. the department will bring together diverse group of phenyl stakeholders to consider ponel opportunities obstacles with sfr vised consumption uvs and the community need for sunchs and feasibility providing such service. the task force will hald public meeldings to solicit input and require today submit report to . meetings will be poseed on the dph website so that is the only item i'll report on and if you have any questions on any other items in the report i'm happy to answer those. >> thank you. did you have a time yet for the initial task force meeting? >> um, we are just finalizing the membership and but as soon as we do i'll send a note to mark to share not only the membership of the committee but also the dates thof meeting. >> okay. commissioners questions to the director on her report? any questions? seeing no questions, then is there any public comment? >> no public comment requests for that item. >> no public comment on the reports so we will proceed on to the next item >> item 4 is general public comment and not received any requests so qu move to itm 4 which is report back from community and public health meeting from today. >> commissioner pateic. pating. >> want to thank the meebs who joined in the community and public health division report. we heard from dr. cora hoover and susan phillips of the dezize control and prevention subdivision. this is the cdcp is a division which helps us across san francisco by promoting access to the imineization by giving flu shots and see the immunization and travel clinic and serve on dezizes for all position thofz city and overvee and help with disease chrome for example when we have to investigate cases of new and straichck diseases of which they have to track 70 old diseases and when we have new diseases like zika or ebola those are the folks at the department of public health that we call on to help us. um, we heard a-as part the work what they have done with regard to the zika response they produce public health elerts many as clinicians received as part of the helt facts system as well as public education. the department things it has done a very good job and i do as well with records to reporting out the risk of zika in pregnancy, helping to [inaudible] fear squz very happy to report that we had no cases in california of california acquired zika. there have been cases in florida but not in california. we also looked at the issue of how following the cdc instructions our services have been coordinating zika screening for newellly pregnant mothers as part of the prenatal studies. so, again our department is the first line response to the i don't want to call epidemics but health related emergencies and we have seen them do very good work. in fact, we just finished the ebola crisis when the national cdc said that ebola was no longer a epidemic in the west african region, they called off their alerts saying travellers to west africa no longer needed surveillance that was done urltier last year. staff had a two week break and zekey oughtbreak came so got a quick haveication and back to work. we talked about how this strains or stresses the servicess kw staff says we have good people and have what it takes to manage including work wg the airport for example if there is a threat of asian flu going on and i think we have seen them now work across systems, the helt system with zika and pregnancy and ebola system across multiple hospitals so very proud of this division because if there is a question of travel related disease or communeicable diseases i think the evidence is our department is ready in a prevention matter and interventional. any questions othen cdcp division? if not i go to-again, i want to thank dr.s cora hoover and susan phillip for excellent job and leadership of their division. we heard from haly hammer who is director of primary care on true north metrixes. these are the outcomes measures that the department has been developing to make sure that we are making progress across our divisions for commissioner bernal. the areas of improvement oregon score cards include quality measures, safety measures, health equitty measures, measure of the care experience, workforce and people development and then a financial stability and this forms one of the essential basis of our pyramid and commitment to becoming the choice for healthcare and wellbeing throughout the city. so, we heard these metrix through primary care and we specifically drilled down into the developing people metrix, so what i will say is that in future months we will be hearing from primary care hopefully on the whole metrix score card as we look at the score card, but we looked at one metmic in particular on developing people and what i'll say to you is our staff have identified san francisco dph as a good place to work. for example, in the last year i had a opportunity to learn and grow. 74 percent of positions said yes. in 2015, 85 percent of positions said yes in 2016. 3 airth percent the front office staff said they had a opportunity learn and grow and last year 52 percent. someone talked about progress at work, the front office staff and physicians have been receiving regular performance evaluation squz a large percentage of staff felt someone at work was invested in their development. the investment in our people is really an investment in the people who take care of our patients, so it's everything passes from one to the other and we talked about their metrix and how they present to us in a more rolled up fashion at a later time. the last thing i wail is one metrix showed there is a certain amont of effort that goes on in the primary care divisions measured as exhaustion. a fair number of staff say they feel tired but they have good morale and like working and are committed to our work, so i think it is the heart and soul of what it like to work with a population in need and with many needs and just really thank our dr. hailey and all the providers who work under her and medical assistance and front office staff for doing hard work and reflecting the good sentiments of the work that they do. so, we'll get into this more as we look at the metrixes. this was one area and hopefully can present the whole primary care division metrix in a score card to maybe the commission after the committee reviews it. >> any questions on that at all? >> i think this is all part of our ability to now begin to look at our primary care clinics now that the data is starting to really be available. thank you very much. we are wil go to the next item then. >> there are no public comment request frz that item. item 6 is rez ligez in support of vision zireo. the goal of zeeree traffic deaths by 20 twenty-four and 2017-18 action strategy. this resolution was introduced march 21 to you and will be presented again. >> there are no edits as last present snd >> there are no change jz today you vote on the resolution. >> good afternoon commissioners. i'm megan weir the director the program and help with the sustainability andologist cochair the vision zero task force. thank you are fr your consideration of the resolution and happy to respond to any questions you might have. >> commissioners, questions-at our last meeting we did ask to see the action plan and the action plan before you now and is valuable, which is what we are being asked of the resolution to endorse for the years 2017, 2018 is that correct? and that is correct. we presented the strategy and field questions to commission meetings as well. the strategy is really a high level document, we are very proud of this work. the department of public health in particular informed a lot of actions that address health and equity, community engagement. we are the lead on evaluation and provide a really strong role. [inaudible] my colleagues is here who works on education and excited about a lot hof it work reflected. >> commissioner pating you had a question? >> 2017, are we already implementing the plan or be implement as of june? >> we are well under way with the actions in the plan. >> other commissioners, any questions? >> i had a exciting update about a key state legislative policy action was ab 342, which the commission supported a resolution in support of automated speed enforcement last year and it made it through the privacy committee today so just got the great-it has to pastz through two committees, next week is transportation but this is a significant milestone and reflects the work of dph, our city partner, mta as well as community advocates so really big deal. it will be a pilot in san francisco and san jose. >> commissioner bernal did you understand what the initiative is at this point? >> yes. >> okay. otherwise you get a brief explanation. >> i do, thank you. thank you for your work. >> absolutely. thauchck. >> thank you. commissioners before you is a resolution. you now have the hard copy of the vision action strategy for the two years, which is very well displayed, so a motion for the resolution is in order. >> so moved. >> second. >> there is a motion and second. is there further discussion on the resolution? if not, we are prepare frd the vote and all those in favor of the resolution please say aye. >> aye. >> all those opposed? the resolution is uninanimously adopted. thank you very much. >> thank you so much and thank you to commissioners. i so appreciate your support as well as director garcia and our leadership. >> thank you. >> note there is no public comment for the item. item 7 is the sfdph human resource update. >> good afternoon president chow and commissioners. ron weigelt department of public health human resource. i try give a update, try to do it it yearly of the human resources section and to our accomplishments. the first line that you provided with packet has to do with aso authority. we have the authority to hire 7416 positions budgeted positions. you see that is studally increasing over the years. this year however, the directions were not add new fte's so going in a neutral budget to the extent we can achieve that. so, the first unit i want to talk about is our merit section. this is through [inaudible] on the end. our merit division manager and she is responsible for the work that the merit section does. they conducted 435 recruitments. in order to fill positions we have to do recruitment that involves analyzing the job, posting the job and taking in applications and screening those applications for the manager. as you can see, in 2012/13, we were doing 293 dipped to 256 recruitments and work of the team we have been increasing the number of job announcements and job recruitments which helped fill our vacancies. this is the twnd trend line showing-i went the wrong way. this is the trend line showing the number of applications we receive each year as a rultd of the recrultment. because of the labor market is tightening we added two recruiter tooz the unit and so we are doing more aggressive recruiting, not simply posting and waiting to see what recruitments-candidates we get, we are actively recruiting nation wide and locally and recruiting for specific targeted populations. these are the number of new hires based on the recruitments. you see it steadily increased so as it increasing the vacancy rates drop which sur goal, we want to get people in the door. when i first hired have stories of years it takes people to be hired. we did the process at zuckerberg for the rn classification with the goal to get it down to 9 odays which we accomplished. either 90 days or breter. the next section is operation divisions. i have two operation managers, karen hill and cathy abella. karen does zuckerberg zeneral hospital which is half the department and cathy is responsible for the other half of the department. as you see here for the new hires, they are broken out in this manner. zuckerberg pcs hire and other division pcs hire jz have various other classifications. a pex employees means they are permanent but civil services. pes means they are limited to 6 months or a certain category they can go as long as three years but don't get permanent status with the city. texas prkts b is provisional meanic we hire you waiting for a list to be published. it is a special category under civil service rules. the classifications we most commonly hire into are these classifications. they are slightly different whether they are zuckerberg or other divisions. zuckerberg the registered nurseerize the largest classification we hire into and as you go down you can see those numbers. at the jcc at zuckerberg we report on the vacancy and give update said to getting the vacancy rate down. so, we had of course registered nurses is the biggest classification within the department, the most popular classification with over a thousand rn 's so one thing we did is figure if we can get the temporary rn's which are p 103 to be permanent rn's. our labor relation section work wg the operation section sent letters to the temporary nurses saying are you interested becoming permanent. we have donethality several times over the last several years so the nurses come in temporary from kaiser or other hospitals and we try to recruit them to be permanent. that was fairly successful this last go around. the other thing that operations does is leaves management. ovthe years people talked about how complicated [inaudible] so created unit. help to manage and work with the manager to understand the leaves and work with the employee because they are complicated. you have federal and state leave jz local leaves. it is a very complicated mailtrix so these unit help the managers understand the leaves. these are the types of leaves we are managing. that doesn't count vacation or normal time off for orelt reasons but these are your special leaves. performance appraisem we talked about that in the past. i like to mention in the past i mejzed we would go to a automatted performance appraisal, electron recollect. we did a pilot project with people soft with the county, we did it here and our managers didn't like people soft as a system for delivering electronic performance appraisal. for the sit city as a work group, dph is on the work group we are trying to figure a solution other that people soft. we went from 2900 evaluations in 2014 to nearly 4800 evaluations completed this past year and starting now to prepare evaluations for the coming year to get ahead of it and get the numbers up even higher. i want to show briefly a snapshot what it looks like in termoffs demo graphic. we-they tend to use the 11 available county workforce as the targ lt population. this is the 11 county workforce demo graphic and our demo graphic. what we have been doing is do report with managers that highest level and working down to show people the dem o graphicoffs the unit. we haven't set specific goals or targets but work with manager tooz where we want to see improvements in and will be do more and more of that. we also have in our eeo unit we have-do ada accommodations and that is when i have a medical condition and come to my employer and say i can still do my job but need a special computer screen or can still do my job but need a special accommodation. so, this is the number of accommodations we have going on currently which is 317 managed by two ada staff so that is quite a volume of work for two people, but 150 each and will add additional resource tooz the ada accommodation process. so, this is just a snapshot to give you a example of the kind of things we are looking at. we not only look what is our demo graphic compare today the available workforce we look as compared to patient population. so, this is smaupshot at zuckerberg, and we will continue foowork on this and get better and better comparing the patient demo graphic to the staffic demo graphic and improving those. so, raunda simmons, she supervisors the ada group and is over the workforce development group. this is raunda back here. raunda she's come to us from the mayor's office and has a background in work force development. this is new and didn't have a training sokez so every the last year we started creating a training section work wg the various training sections in popular health and others to pull the resource squz get a sinnergy going to take advantage of the resources. this plains essentially the individual needs, organizational needs and our ability to connect in the middle and pull that together and meet individual needs and oregal organizational needs. i mentioned in the write up career coaching that we start today do that and got good response and gave demo graphics btd about the people doing that. i also mentioned employee engagement survey in the write up. we are-our next employee engagement survey. we scr done one and will do another probably in the fall. we are just finalizing the contract. one of our recent meetings we talked about jcc i believe the importance of customer service oriented attitude. we inserted in the job postings language about the importance of customer services and care, patient care and will continue to include those statements in the postings and do other things that improve our focus and make sure people we are hiring understand how important that is to us. the other area we have is labor relations. as you know, 99 percent unionized. i think you may be the only staff in the department that are not unionized. willie ramirez is labor relations director. i think he was taking care of a legal matter so not here. as you can see, very large union population of union members and keeps them very busy. it used to be i heard this before at other organizations you hear, we want to do something about a problem and we dont get the support but as you can see that is changed a lot and managers do get the support when they ask for it and work with us so this is a snapshot of the sort things the labor relations work on. that is total of 6 people and looking to beef that up especially as we go to electronic health record and need to probably work with the unions on various aspects of that. last but not least is our pay roll unit. pay roll does as you can see 133,000 direct deposits and have 2 82 pay card. we dont do paper checks anymoreism we switch to pay card so you can opt to not have direct deposit but if you don't have direct deposit you have to use a pay card and that is the cycle and that it is a very busy unit and they do a great job. at this point i'll answer any questions you may have. >> so, before i ask for the commissioners i did ask, what is the total number of people who work and do all this work that is within your department? >> plus or minus 100. there is a unit at zuckerberg and one that takes care of downtown and laguna honda and the clinics and labor relations over the whole thing. turnover that is probably about 7 percent. work wg our business intelligence unit to get better numbers oen that. the tricky part because we have the civil service eexempt employees that are time limited at 6 muchckts they have to leave and looks like a separation so we have to pull it out because it isn't turn over. turnover is we ask you to leave or other things listed on the labor relations report or retirements. >> commissioners, questions. commissioner bernal. >> i like to thaj the director for the report. as a new commissioner it a great #3r50i78er for me so thank you. i look at slide 2 the total recruitment and looking that trend line i wonder how much of that could be attributed to increase demand for service and revenue from the affordable care act and medication expansion? >> i think that a large part is due to afford #rb8 able care act because brf 2014 thrfs a surge in hiring and change in network and department since that time so merit is changing the strategy to react to the situation to increase recruitment to meet the needs. >> in the primary care area we did a great expansion to get ready for aca. also with the new hospital and the expanded in termoffs the number of nurses we needed to recruit. i just wanted to acknowledge the fact that this unit has really expanded their world in terms of really trying to meet the demand that we put on them and you can see the demand is clearly there. also, the area of workforce development which we never had before and want to acknowledge we have raunda simmons who is director of the mayor's office of workforce development so brings experience particularly arounds career coaching and that is what i heard from staff is they didn't see the pathway of promotional opportunities in the department. and so now they have somebody they can talk to and how to create that pathway and what things they need to do. as you know, wree have merit and people have to take tests and get on list soze it is a complicated process and mystifying for staff is a important goal. just want to acknowledge ron's leadership. he came to us from the seattle public health department so great new eyes on our area of human resources and we had a great influence on the larger human resource area particularly in classification around it, where that was not a classification in terms of where we are going with it. trying to catch up into the 21 century with the classification it is a important plauss and want to acknowledge all the staff here because they worked really hard during the last couple years as we are growing and opening a new hospital. >> thank you, director garcia. >> commissioners sanchez. >> i thij it is a excellent report. i would too also just say given-i thought when you came here and wow, all these changes and thought we have all this going oen and never meet part of it and take a look what some of the measured outcomes are at this point in time. it is very significant and shows we are looking at the total profile of the new system we have operating and both in reference to recruitment, retention, in-service opportunities and the quality of care for our patients. the one thing i would comment on and wonder your thoughts because it is something we haven't really seen yet that i dont think has come to full fruition but you mentioned the nursing challenges we have, you were-some of your colleagues asked some of the temporaries if they are interested in permanent tracts and i know you were also discussing new pathways. let's say withu sf school of nursing, sf state school of nursing,u c, the community college which could provide new training. samuel merit in east bay is providing and it is providing some really hand on experiences that the general pertaining to training and internship. i wondered if in fact you know, maybe next year or the year after we will see even more significant results in some of the hard areas that are very difficult to recruit for given the new collaborations you have undertaken and with institutions that haven't been on the radar so to speak as much as other institutions. >> i think given the competitiveness of the labor market especially in healthcare and nursing i don't think we have a choice but to look at the partnerships and we have two recruiters, one specifically at zuckerberg and target healthcare and one down here to help with the ambulatory care but think you are right, i think quee have to look at those as options. >> other questions or comments? >> commissioner pating. >> first question is, so how would we unionize? what would you recommend? >> i couldn't address that. >> [inaudible] >> we need something to unionize for though. first of all, i want to give you kudos. we have been struggling, the presentations you have been giving for the last 2 years really about shortening the hiring and 90 days is as good as it gets throughout the industry. 60 to 90 days to do background checks and think we should declare victory. i think you are there plus or minus a couple days. and then also you filled all the vacancies at sf fgh and know there are a couple folks that we need, but i think you have done a great job with that and i like to the coaches. what other field can you come in as a orderly, that is me and you end up as going to school and become a physician and then you can become i dont know, a union leader or something like that. a health commissioner, yes. the idea of on the job training is i think a investment in the workforce that i really do-i believe and commend it. so, my questions though is if we take those off the ajepda what might we replace as a helt hr workforce issue? i look at it as your job is get people in the box, keep them in the box and then make sure that we have glorious leavings when we retire from the box. i am interested shifting some of your reports in the future to perhaps in the box looking at how we are doing with sick days, how we do with workers comp, how we do with either used or lost vacations if people are not using vacations and reserve balances and maybe even retirements and retentions. this came up in our primary care discussion at the community population health. we wondered how is the workforce and i know we are tracking sometimes-it is hospitals that track unfilled positions--proxy for sometimes morale so interested looking at some of those in future reports. i know it takes time to get down to that level and you have been really managing your processes in hiring and getting filled but as we get staffed, then i think now the question is how well we are committing to keeping our staff. are we keeping them healthy and well and some the standard hr indicator said you may use to look at that. >> the next report maybe different indicators based on what you said. it gives me time to do resuch. >> that is just my thought because i think it is the next level of hr capacity and how we measure all the leaves and the absen teeism and present teeism across our system. >> certainly. >> um, my other two questions are really just more around just general capacity ish oo issue. do we have internal eap through dph? >> we have city wide eap which we reserve to on a egregular basis. >> that doesn't fall in our division? >> no. >> you work with them? >> absolutely. we tend to refer people. >> is that out of hhs. >> i think health service administration but not sure. >> lastly, do you think maybe this is for commissioner bernal at a federal or state level, workforce shortage we are into year 3 of the aca. you hired up and that is really hard, do you think the workforce shortage is solving or do you think it will always be the gride to find open people is there a measure taken in a more broader way to fill the gaps that we experienced? you can just give a general- >> it tightened up- >> harder? >> a bigger labor shortage with the opening of new hospitals. in response we kicked up our recruitment and hired the two recruiters and do other strategies like getting people to work temporary and hire them-reaching out and doing nation wide recruitment and attending recruiting fairs which we had good success with. and also the local area but as commissioner sanchez said we will have to map that even more. nation wide not sure there is any plan or strategy to actually increase the numbers of any significant way, so it is about us being more competitive and a lot is reaching out and contracting people and talking to people and instilling the virtues and benefit of working in san francisco. >> have we had to drive up salaries to make positions more- >> if i could chim in on my own opinion in terms of looking at this. psychiatrist are somewhat difficult for recruitment and one thing we have done is gotten into the fellowship process withu c-we are lucky and fortunate to have the u c medical school as part of us so the psychiatric area. we also had competition with psychiatrist withcretional where they lifted up the salaries and ours are within the physician area-we found a pathway i believe with particularly in forensic psychiatry that is a difficult one for us but with the new fellowship programs working with u c psychiatric services i think that will really help. we do have the ability to help with the pipeline by work wg our own u c. >> i like that. they say the way to get to the young peoples hearts and get them young. you want to get them to vote you start involving them in the process early and they vote as adults, the same if you get them in the fellowship likely to stay in the public system. anyway, i'll end my questions by giving you the kudos and your right too have a victory banner for reaching the 90 day mark filling san francisco general and creating a learning environment in hr department. thank you very much. >> commissioner burn el. >> just in repauns to the commissioner pateings about the federal budget. propose a 400 million cut which will have a long term impact. it is working its way through congress now but that is a significant cut. >> thank you. i will ask certainly the department has gone a long way and your help in the last several years with first the aca and primary care ramp up particularly and then with filling positions at general but i guess we are still about 8 percent vacancy or so. so there is still work to do but you can declare victory for this year. >> i'll take the victory. i realize we have a lot of work to do [inaudible] >> i know different areas are looking at retention because that's part the satisfaction of a job and what not so that may be that you yourself and your department or division don't have to do that, but to get data from-because you want to know hour successful not only that you fill the slot but that slot worked out and maybe want to look are they still here a year later or still recruiting again because we perhaps or the fit wasn't right or where you can learn. >> great idea. >> when i think aside from that and looking how successful you were in terms of a measure restention, what do you see in the coming year? i know you talked about the tightening labor, yet people are still talking about unemployment in the country, so and i read different things we are really tightening up and there is a difficulty in our area maybe, but there are other areas that are still with sort of open land so to speak to find employment. so, where do do you see in the coming year you have your greatest challenges? >> i think one is continued recruitment in a tight labor market because in the bay area it is a tight labor market which means everybody is competing fl the same worker squz there are not enough of them whether it specialty or healthcare. secondly, the city is trying to update the system and update the people soft system and have a new financial component of that, so that will be a challenge as they update those systems making sure we are on board and do what we need to do to make the most of those. of course the electronic health record. preparing for training and preparing our systems to take on the electronic health record will be a big challenge even ipthe coming year and then the year after that. >> so, in the electronic health record you're working closely with the departments it needs and bringing those on according to their schedule or- >> hr is meeting about once a week for about 2 months now with a consultant and with albert eu and now have laurie wallace who is it project manager for the ehr, so yeah we have been meeting and figuring what we need to do to create a milestone and timeline and dlivables so getting on as early as possible to get ahead oit. >> thank you. any further questions, commissioners? thank you again for this annual comprehensive report. >> thank you for your comments and i'll be back. >> thank you. >> commissioners there is no public comment request for that item. item 8 which is whole person care, california medi-cal 2020 waver. commissioner chow asked for packets to be restapled so included staple on the left so it is easier to flow through inyou want to follow. >> they now read left to right instead of right to left. >> good afternoon. >> it is a stapling issue. >> we are playing with this, i want to give a shout out to the hr department and it department. how amazing they are. yay! >> good afternoon commissioners. my name is maria martinez and i'm here today to introduce you to the whole person care medi-cal waver and i'm going cover three things today. one is just how the waver came about with the intent from the department of helt care services. our particular applicationthality was awarded and started on january of this year and a little about the targeted population. all three are complicated so if you have questions feel free to interrupt and i clar fay for you. the whole person care of the department of helths care service looked at what we are hearing about, there are a small number of people utilizing a lot the healthcare cost and they are defined as people in multiple systems and who are not getting well. actually a lot the work we have done here ichb in san francisco over the past 12 years looking at high use in multiple system influenced the gement of the whole person care waver and initiative. i will go over 6 thichcks they wanted to achieve with it. one is they want counties to start working together. they want them to work across the health system into the social system, into all the agencies, the health plans included, the cbo's to try to begin to work together in a different fashion. they were going to finance for us to do that. and the intent of that is wrap around the most vulnerable population and help them get where they need to go in a much more organized fashion. toort we do that. ultimately they wanted us to reduce the high cost, high risk utilization of sunchs the population was utilizing. they would help us by gibbing giving funds to improve the information we are sharing and using to understand our population. and then they also are providing fund to help us look at pdsa and ways of continuously improving the quality of what we are doing ultimately to improve the healthcare status so this was the purpose of whole person care. it is a 5 year waver ending december of 2020. the california carbed out $1.5 billion of funds for this particular waver and a targeted county. counties could apply for it. only 18 of the 53 counties actually applied for it. a vore complicated waver. most the counties that i talked to who are considering applying for it didn't feel like they were ready and understand this complex population like we do in san francisco. there was $300 million left on the table from the $1.5 billion so dhcs is welcoming 18 counties and all the other counties to fight for those remaining $300 million and we are in the process applying for the fund now. it started in january 2017 and i was asked to direct the initiative by director garcia and i'm so excited to be able to do that. in terms of san francisco's award, we were awarded all most $24 million a year, half is a match from the city and county of san francisco and it was for two thrusts if you will. one was how to improve the way in which we work and wrapping athround vulnerable populations and how do we find it solution tooz help us transform the way that we are doing care coordination. we selected here in san francisco the homeless population. we know a lot about it and i'll share what we know and how we are ranking priority for the population now. we know from the coordinated care system which is a integrated data set department of public health has we touch about 10,000 homeless people somewhere in our health system. may be ed or primary care but we are able to track those folks. about half are an medi-cal managed care, the other are on short med kale and some don't have as far as we know any coverage. we look at this population homeless people somewhere in our health system. may be ed or primary care but we are able to track those folks. about half are an medi-cal managed care, the other are on short med kale and some don't have as far as we know any coverage. we look at this population with two perspectives. one is the use of urgent emergeen care and we look it can be medical, that is traditional inpatient ed utilization, but we also look at our medical respite and urgeen want care and ambulance transports. the two other systems we look at is minuteal health system. we look at urgent care, we look at mobile crisis visit, inpatient day squz substance abuse system because we track all this data and we are able to look at use of sobering center, medical and social detox so that is one perspect ovthe high rist population. the second is how long have they been experiencing homelessness and ccms was able to say the first time we noted them being homeless and the last time we noted being homeless and that may list 10 years. they might have had periodic housing status but basically that is a high risk person when you think in and out or straight away 10 years of homeless synchronize. these are the two perspectives we use. in termoffs the 10 thousand folks we stratified into susleer, high and elevated based on the combination of use of urgent emergent service and their length of time homeless. severe is both, high can be either one, and elevated because we all know homelessness is risky anywhere would be considered all the rest the folks. and so not surprising the high user population uses quite a bit more high cost services than the others. for total of about $150 million a year, homeless folks use urgent emergent service. when you look at the stratification those high user 13 percent of the population or 3 quarters of the cost that we spends for urgent emergent care. we are also able to look at diagnosis and i see 9, i see 10 codes coming from the system jz categorize them into serious medical. serious psycho and drug and alcohol. for the homeless population in general you see that is probably not too surprising about a third of all them are suffering with all three conditions. those are seriously ill folks the 30 percent. when you stratify it here you look the high users those are high user and long term homeless, 3 quarters of them are suffering with all 3 serious health conditions. that is phenomenal so we know that these are very sick people and our stratification is playing out in terms of cost and other risk factors which i'll go over now. in terms of death rate, the high users and long term homeless within the one year of treating them, 7 percent have passed. from the data that i have looking over the course of 5 years, 25 percent of them have passed. very sick folks. in terms of incarceration, the rate of incarceration is similar, a little higher for the long term homealize and high users but in general pretty close. we get this information by looking at our jail records. jail health records. if risk factors erase certainly it plays out with african americans. the general homeless population is 33.5 percent compared to 6 percent the general population in san francisco but when you look at long term homeless, it is all most 50 percent african american. that is just stunning. any questions about the data that you might want to ask now because i will move into how we will address? >> very clear. >> yeah. >> what can you say? in terms of how we serve homeless folks here in san francisco, this is our safety net and so the department of human services have food stamps, medi-cal, general assistance. the san francisco health plan is not only a health plan but also delivering healthcare services in terms of care coordination for comp plexpations. the private hospitals and community based partners are out in a fractureed if not just physical way seeing our patients significantly. ems picks them up and taking to many ed's throughout the cystism. department of aging and adult services does case management and in-home support and all kind of services. department of homeless supportive housing is a relatively new department. they have the shelter jz all the places that hold homeless folks. they have servicess in those places. that is where the navigation centers and will talk about those services. so that is a new department. the department of public health you all know how big emens and fractureed our helt care servicess are there which leave the person in the middle trying to figure how to get to all those without a bus pass. in termoffs what we are trying to accomplish in whole person, the first 3 physical, mental and addiction is healthcare services. we trackthality pretty well because we bim for it. all the rest of these things here what we call social determinant of health and in our data and service systems we dont collect it, we dont get paid for it, we don't get support for this and all the way down to they have felon things they need to get to get into housing, they have safety issues they can be dv and issues on the street. do they have skills to get and keep a job and support system. so many have blown out their families and creating supports on the streets and most of the recovery folks that we worked with would tell you without a meaningful rule it is really hard for folks to maintain xae kind of abstinence or any kind of recovery. so, part of what we are trying to bring together is the whole story for this person but also wrap around them in such a way that will help them not only reach their-realize the hemth but to keep it. and so in the whole person care it is a multi-agency efforts. the coleads are it department of homelessness and public health. barb raw garcia and jeff are the chairs of the steering committee and all of these departments are at the table and part the steering committee and going to be part thf committees we create for problem solving and idea generation. we will all be signing a charter which is in the harndout that we gave you, the draft of the charter saying we commit to doing better. what we are purchasing in the fund from the state we will create new navigation centers. those are a innovative thing is doing around low bar resource driven shelters lodger term. the care coordination services will braid all these care coordination and doing something different and will talk about that. expanding the medical respite beds. some of the funds we get from the state will help us get our detox centers drug medi-cal certified. we extend the residential days we have in substance abuse program jz department of aging adult services we will focus on how to keep seniors in the housing and keep them safe. in termoffs the other prong, this is it solution. each one of these areas have one or more multiple data systems that they are putting transactions into. they don't talk to each other so the one person who is going in and out of service may repeat, the intake information may not be known they are already in care coordination somewhere else. so, part of watt we will be doing is creating a data sharing platform in 2018 that is going to enable us to share what we know about no matter what door they walk through so if it is the shelter or ed the privacy appropriate information will be available. we will create together a tool that will have let's say 10 things that will help prioritize the person into housing or care and all those will agree on what that will look like see that is the magic and what wakes me up at 2 a.m. so will have shared care plans and communicate with each other through alert so really excited about potential for braiding together all of this and becoming person centric. terms of whault we hope to accomplish, the first one would be is our clients when ever they touch throughout city and county of san francisco, it is the right place to get the right information to get to the next right place. that their health is realized, reduce the amount of urgent emergent service. they get and keep the medi-cal and that they have housing that is sustainable. in terms of the staff, a lot of the issues they have is clearty around who is high priority so this is a way to communicate, yes, this person is high priority and the direction you need to go with this. and that there is a way to prevent people from getting sicker. in terms of the public, having cupassionate solution to the suffering on the street i think will be a big impact, but also reducing from a public perspective reducing the reliance on general fund and medi-cal. and at the end of the day, january 2021, we want to be able to look back and say we really learned thew work together across the city and county of san francisco for a vulnerable population. how do we take watt we learned and apply to other vulnerable populations be low income families, seniors, whatever it is that we want to prioritize that we now have a process and a relationship built to be able to transfer what we learned to other vulnerable population. so, hopefully i haven't over whelmed with a lot of detail, happy to answer any questions you moithd have. >> there is no public comment request for this item. >> thank you. you did have payment sources and all in the >> yes. >> back. where you going to go over thereat? >> i was going to go there if you had questions about it but it fsh over my 15 slide limits. you have quaegz on it? >> i'm trying to understand or the message is you might want to take just glancing at this because for example, under the summary of the homeless, you got all the breakdrown of the ethnicity and all. these are the people that are a part the total thousand- >> 10 thousand. >> 10 thousand you are talking about. >> yes. this is the information in much more detail than what i plented here but this is what we know about the homeless population. did you have any specific questions on the data, dr. chow? >> i get what is sort of a composite of a homeless population person that would be kind of-i know everybodys unique but what would you say what you would characterize someone? >> mostly male. there are some people who i think we should study for the resilience who are over the age of 60 all the way up to 90. generally speaking, the life expectation is between 50 and 60. as i noted, high proportion of african american, disproportionate share of latinos and trying to think. i think part of the people who are served by a large number of them in the clinic consortium which means we have to reach over to the clinic as well. mostly seen at [inaudible] which isn't surprising but also at the hospital in primary care. the highest users tend to have more primary care visits than highest urgent emerge rnt have more primary care and the others very little. even though they are assigned with us they are not engaging in primary care unless they are the really really sick ones. >> so, you are saying that in that profile most are at the consortium clinic for primary care and come for specialty. many of these. is there a disease profile or would they have substense abruce? >> yes, on the- >> sort of missed-- >> that didn't work. don't know how to do that. >> there you go. just trying to get a picture of who-- >> so, here when you see the medical conditions, we use something called the ilex hauser risk for diagnosis. dr. housing looked at 50 thousand inpatient in boston to determine which comoorebidities were a good indicator of premature mortality. we use that on a outpatient ambulatory basis because it is the only one that includes mental health and addiction. all the others are just medical. so, that is why we use it and applying it in the ambultor session and you see on this page here the types of medical conditions that are included so a very high hypertension and liver disease, very high pulmonary disease. i'm not a physician so can't tell you how far that is ovbut can look at the percentages but when you look over to the red, the severe risk, all most 50 percent have hypertension and all most 50 percent live disease, neurological diseases, so in terms of their risk it plays out in the conditions, prevalence in the conditions and anything else in that i'm dangerous in terms of knowing about but know what we are watching is the tridisorder when they have all 3 that there are very different outcomes. and in terms of is it-we don't know if living on the streets causes one to buffer and drink and smoke or be depressed, who wouldn't be. or if those are a confluence of those factors cause one to be homeless, that isn't something we know. >> some of the interest of the commissioner think about goat toog zero and 20 of percent of the high usererize hiv or aids. thasat population we have to focus on getting to zero. that is the population we will think this will also help with many collected impact initiatives. >> commissioner burnole. >> thank you for the presentation. the data is great and looks like it get stronger so thank you for that. two clarification when you talk about coordination was that among crossing county lines because so many folks- >> right? it is just within the county in terms of accountability for the dollars. in terms of we all know it needs to be a regional thing. we will meet the whole person care will meet together next week and talk about that. i they think that's-i think we all know we got to deal with this together. >> just my second question is you said the second roun of proposals was accepted march 1. has san francisco submitted proa proposal and is there a specific focus? >> we are still in negotiation and haven't had the application accepted yet so a month and a half of negotiation. if it is accepted then there will be a significant focus of whole person care is in the homeless department. >> thank you. >> definitely coordinating across agencies a what this is all about and-- >> so, i found also on slide 18 that we didn't get to, that those performance measures you are looking for in the coming year? >> yes. >> or is this the 5 year? it is actually three years, 2020. >> some of them are due in june and some of them are due in 2020 at the end of it. i will get to that. for the audio sake. these are my sneak in. >> yes. that is what i was looking for. >> yes. um, so some of them will be reported annually and some of them looking at them quickly-some are one time things like the assessment tool. if we just create the tool, we get money for that. the first year of the whole person care we got money just for applyic which i thought that fts cool. the rest of them we either have to make a difference in the impact and health outcomes or do stuff like create a care coordination tool, a assessment tool. create that platform that i told you about and then there will be did we make a difference getting keeping people in permanent housing. so we have a baseline which is 2017 and if incremental improvement in the out comes. >> and so i guess we will be following that. commissioner sanchez. jrsh this is a excellent-as you shared it really gives us a unique baseline right now. as we move forward as you shared, we are now working with a cohort of our agencies looking at a specific population thatd we were not able to do before. >> right. >> and this way it is like on our radar. we have them on our radar and we have our subsets within that same scope, where we can really utilize the data that will be generated even though all systems may not be operational yet but they are coming up per taining to the tracking and data but that will happen because there is communication and trust going on at this point in time. as a example i can think of a couple who would be veterans who dont want to participate with va services but utilize our service public health and other services including the dialysis unit, and they will be tracked in 2 or 3 of the systems and it will take time to really focus on and take a look at you know, how to provide as you said, comprehensive integrated system where we've cut out all the variables that had been limiting our ability to take a look at the whole person. so, it is really a awesome undertaking and i'm really glad you are excited-and we move forward on this and really look for as you said, some really informational outcomes which perhaps many will not be aware if it were not thought about as a possible hypothesize but yet because we have this limited "cohort" we are working with i think it can be excited per taining to watt we can learn from the joint effort so thank you vaer much. >> you're welcome. my pleasure. >> commissioner pating. >> first i want to say to mrs. martinez, congratulations on your promotion or this new phase. you did a great job in compliance and know you'll do a greater job in the new role as well. also, just from a previous life i was a chair of california whole health coalition, this was behavioral substance abuse and primary care that [inaudible] the aca full benefits and glad you doing this and when you talk about right care time and place you are speakic my lan wj and glad you figured how to get past the hipaa issues. that is why you are thinl compliance person with regard to the cross system information shareic. that alone i think wins you whatever brownie star we give out for that. my questions to you are to maybe ask us-help us as a commission to play a role in some of the whole healthcare. as i see it, ewoo have opportunity to weigh in onditions that may come up, one is i vurks drug injection site. one is 4 a.m. alcohol bar policy that is going before the state. we have african american initiatives in the bayview which is hypertension and well synchronize control and tom wudel is under our system and but there is a call for maybe new services in the tenderloin. these are things as a commission we might weigh in on but wondering if you can do a little more analysis on the template. for example, i am wondering where the african american clients are or why african american clients, what is driving that and whether there are a cluster of servicess we should gear toward the african american community and where are they, in the tendser tenderloin or bayview so we can get spinge supporting policy that help you. another is issue of what drugs. those that are using alcohol consider having a different subculture than those using heroin and/or meth and african meerns using heroin and meth or alcohol. i think we can do another level and this is where dr. aragon is my guide trying to do cluster analysis. nowio have siteewide demo graphics but i believe they probably localized even more micro populations by street. we know the drug use on cap street and sishth is different than on polk so if we capture the dynamics maybe we can torg td servicess because as the number gets smaller and smaller it isn't citywide impact, it has to be a finding the pockets, the community of 5 or 12 yee users and figure how to target those and know you are doing it but i'm interested more because i think some the policy iges as will effect us if you look at injection sites. part may say not in my neighborhood but if my neighborhood is where this that is going to help us with some the policy decisions. if you could-doing the different level of cluster analysis recognizing everyone is unique, but there is probably 5 or 6 clusters older folks drinking, younger folks that are traveling through little transient and finding the heroin culture on polk. just making this up, but if you could help us to find those then i think it will be helpful from a policy end to speak to a couple of some of the issues that are going on. so, that is my main request. the second one is more a question. so, of the issues that are not helths related for example education, even housing and some of the basic care initiatives that don't include health services, are those coming out of the 1115-90 is that part the flexibility or 1115-90 is mostly for us on the health side and other services have equal fund so who is paying for the whole range? part is health and part is not health. >> it is a complicated funding structure. so, in terms of pulling down money for doing things, i'm not really sure at the back end where the money goes once we pum that in but basically the servicess are already in place. they are fractureed though. so the social service mostly come out of human service agency and the health services in our backyard along with aging and adult service and the shelter and housing and the health service in housing are in the homeless department. so, we are going to be purchasing some additional services. i don't see them as being the social services that we are purchasing it is like the medical res pite expansion. we are trying to get what we do now more cohesive. >> there is real flexibility in the funding and sounds like we some may come to us and some to- >> existing dollars that we committed from general fund as a example to the homeless housing department. they have a pipeline that is already working and at least developing it. so, trying to leverage that and the wrap around subess for those individuals is where the 1115 wave can come. trying to maximize every dollar we get from different sources but specifically for these programs they are more health related than anything else. >> then i guess as a fullo up, do you director garcia arounds the issue affa little more specificity to help us understand. i thipg there will be future issues we will play a roll in, do you see that as reasonable? >> what you just talked about with cluster analysis i think that is a excellent suggestion for us particularly as we try to target areas. a example is a lead program, we targ eted specific neighborhoods where we work with police at bart areas and we really looked at from a citation piece. but having this data of cluster analysis you can see where the clusters are but to have the numbers suggests we could exactly what you just said. so, this is what i continue to tell maria is that this is a 1115 waver but the bigger job is that when that goes away, we have to have a replaced system of care that we put together because of the status and relakezship how we work together and get a natural working relationship that we always will leverage with each other to insure people get a wrapped around serve squs do whole person care throughout the system not just internally in the department because we need that as well. as a example with our emergency department and looking at their flow, we should be looking at the [inaudible] population going through the emergency room and ask should we prioritize the individuals into lower levels of care as a way to reduce the number of ed visit quickly verses spreading out to a number of people when yoi know you have a concentrated cluster. >> [inaudible] >> exactly. >> [inaudible] >> i think your suggestion is a natural outcome of that, but it is sfozeed to have a lasting effect not just a sillo of fund{that is our hope. >> thank you. >> thank you. so, this is tremendous data that i keep reading and i reading it now because you put it into the context of what i can now understand as i look at the numbers. i'm wondering director garcia, when would be it appropriate to get a follow up on how the project is coming? >> i think twice a year and if we find a place where we come every quarter, i like to give them a little time to get their feet under them and her feet under her. she is in the process hiring people so i would not suggest us to do bng until probably the end of this year calendar year and if we find significant change or outcome we with come in earlier. >> i think we put a follow up report on this by the end of the year because this is a very important initiative. >> if the injection site comes before us and weigh in we may get data. >> sure, we can again maria needs to get that data needs structure and one person right now, but certain we can look and see how we match. >> i'm thinking that we will be looking forward to how this is all beginning to be cohesive and just amazing amount of data that you have been able- >> let me say something about that because over12 years ago maria work would me on the homeless outreach team and we want today figure out a way for them not to dupe wait their work because avenue time they saw somebody they duplicated everything everybody else did for that individual so mariacreted a system of pulling data from 15 plus systems that we thought was significant that homeless individuals will be at. and then she has ovthe years a significant amount of cross-we know the data 10 years ago and started focusing on individuals and so one meeting we had it was like i have seen enough data, let's do something with the data which is get to the top 10 and the next top 10 and started doing that and saw significant drops of their costs and knowing they are at the urgent emergent level of cairb getting primary care homes or stabilizing them in hoizing housing fs reduction in cost so this is a extension of the continued work maria folked on even when doing compliance she worked on privacy and health so just want to acknowledge that we are so much farther ahead because we have this data structure that we have worked on refining and refining and it will be a important part our electronic heth record to allow the physicians to know where the person has been and their story of need and care. >> i just think as director garcia said this is a tremendous extension for the work that you have been doing irn in the homeless project and all those terms on the high utileizers so why i believe we do have a desire to see how this is all going to come out because this is sort of taking the work you have done and now creating even a greater basket for you to actually have a impact on these peoples lives. >> it is a very small team, small but mighty team that has been working on ccms for the laest threne years. carol chatman and can can [inaudible] when i came back hopefully i can share all the people working on whole person care. >> we look forward to your progress. thank you very much for the presentation. >> item 9, commissioners. other business and commissioner chow i believe you want today review the committee assignment. >> yes, commissioner bernal on board we will officially announce the appointment of his term on to the finance and planning committee or placement to the committee and also then dr. pating will be a full yeggural of the zuckerberg general conference committees of today so these are the new assignments for the coming period of time until we need to make new ones. i just wanted to have that announced and thank commissioner bernal for agreeing to serve on the finance and planning committee and also dr. pating for taking on the regular role at zuckerberg. thank you. >> thank you. >> shall i move on? >> yes, please. >> item 10 is joint conference committee reports and commissioner sanchez has a rorlt back from the april 11, 2017 laguna handa hospital jcc. >> commissioner sanchez. >> yes, the jcc was listed as a closeed session meeting so therefore we did vote for closed session and did review everything within our jurisdiction under that including medical and everything from recruitment to also quality assurance so there was annal open discussion and no public speakers and we opened up again at the end and voted to keep matters confidential and there was-it was a good constructive in >> student siteful meeting so thank our colleagues for participating. >> thank you. we can't have questions about a closed session. y item 11 is committee agenda soteing. on july 18 we have committee meetings set and that seems to go with everyones schedules or most commissioners schedules so that's at the moment what is planned. >> okay. good note there and you have the revised master calendar from the 13th of april before you all so use that for your information. and thank you for your cooperation letting our secretary know when in the coming year you will at this time foresee you may be away from a commission meeting. appreciate that. next iletm, please. >> consideration for adjournment. >> the next item is we are prepared for a motion for adjournment. >> so moved. >> and a second. >> second. >> all those in favor please say aye. all those opposed? the meeting is now adjourned, thank you. [meeting adjourned] when a resident of san francisco is looking for health care, you look in your neighborhood first. what is closest to you? if you come to a neighborhood health center or a clinic, you then have access it a system of care in the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs. the cole street clinic is a youth clinic in the heart of the haight ashbury and they target youth. tom woodell takes care of many of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children. women find out they're pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. we initially will see them for their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates. our doctors here are family doctors. they are able to help these women deliver their babies at the hospital, at general hospital. we also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. >> it's for the city, not only our clinic, but the city. we have all our children in san francisco should have insurance now because if they are low income enough, they get medical. if they actually have a little more assets, a little more income, they can get happy family. we do have family who come outside of our neighborhood to come on our clinic. one thing i learn from our clients, no matter how old they are, no matter how little english they know, they know how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. they can be child care providers so our clients can go out and work. >> we found more and more women of child bearing age come down with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. how do parents tell their kids they may not be here? what we do is provide a place and the material and support and then they figure out their own truth, what it means to them. i see the behavior change in front of my eyes. maybe they have never been able to go out of boundaries, their lives have been so rigid to sort of expressing that makes tremendous changes. because we did what we did, it is now sort of a nationwide model. >> i think you would be surprised if you come to these clinics. many of them i think would be your neighbors if you knew that. often times we just don't discuss that. we treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. there are people who come in who need treatment for their heart disease or for their diabetes or their high blood pressure or their cholesterol or their hepatitis b. we actually provide group medical visits and group education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. and it validates the experiences that you have and so you learn from each other. >> i think it's very important to try to be in tune with the needs of the community and a lot of our patients have -- a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isn't the top priority for them. we need to understand that so that we can help them take care of themselves physically and emotionally to deal with all these other things. they also have to be working through with people living longer and living with more chronic conditions i think we're going to see more patients coming through. >> starting next year, every day 10,000 people will hit the age of 60 until 2020. . >> the needs of the patients that we see at kerr senior center often have to do with the consequences of long standing substance abuse and mental illness, linked to their chronic diseases. heart failure, hypertension, diabetes, cancer, stroke, those kinds of chronic illnesses. when you get them in your 30's and 40's and you have them into your aging process, you are not going to have a comfortable old age. you are also seeing in terms of epidemics, an increase in alzheimer's and it is going to increase as the population increases. there are quite a few seniors who have mental health problems but they are also, the majority of seniors, who are hard-working, who had minimum wage jobs their whole lives, who paid social security. think about living on $889 a month in the city of san francisco needing to buy medication, one meal a day, hopefully, and health care. if we could provide health care early on we might prevent (inaudible) and people would be less likely to end up in the emergency room with a drastic outcome. we could actually provide prevention and health care to people who had no other way of getting health care, those without insurance, it might be more cost effective ♪ >> welcome to hamilton recreation and aquatics center. it is the only facility that has an integrated swimming pool and recreation center combined. we have to pools, the city's water slide, for little kids and those of you that are more daring and want to try the rockslide, we have a drop slide. >> exercises for everybody. hi have a great time. the ladies and guys that come, it is for the community and we really make it fun. people think it is only for those that play basketball or swim. >> i have been coming to the pool for a long time now. it is nice, they are sweet. >> in the aquatics center, they are very committed to combining for people in san francisco. and also ensuring that they have public safety. >> there are a lot of different personalities that come through here and it makes it very exciting all the time. they, their family or teach their kids have a swim. >> of the gem is fantastic, there is an incredible program going on there, both of my girls have learned to swim there. it is a fantastic place, check it out. it is an incredible indication of what bonn dollars can do with our hearts and facilities. it is as good as anything you will find out why mca. parents come from all over. >> there are not too many pools that are still around, and this is one-stop shopping for kids. you can bring your kid here and have a cool summer. >> if you want to see some of the youth and young men throughout san francisco play some great pickup games, come wednesday night for midnight basketball. on saturdays, we have a senior lyons dance that has a great time getting exercise and a movement. we have all the music going, the generally have a good time. whether it is awkward camp or junior guard. >> from more information, visit >> we think over 50 thousand permanent residents in san francisco eligible for citizenship by lack information and resources so really the project is not about citizenship but really academy our immigrant community. >> making sure they're a part of what we do in san francisco the san francisco pathway to citizenship initiative a unique part of just between the city and then our 5 local foundations and community safe organizations and it really is an effort to get as many of the legal permanent residents in the san francisco since 2013 we started reaching the san francisco bay area residents and 10 thousand people into through 22 working groups and actually completed 5 thousand applications for citizenship our cause the real low income to moderate income resident in san francisco and the bayview sometimes the workshops are said attend by poem if san mateo and from sacking. >> we think over restraining order thousand legal permanent residents in san francisco that are eligible for citizenship but totally lack information and they don't have trained professionals culturally appropriate with an audience you're working with one time of providing services with pro bono lawyers and trained professionals to find out whether your eligible the first station and go through a purview list of questions to see if they have met the 56 year residents arrangement or they're a u.s. citizenship they once they get through the screening they go to legal communication to see lawyers to check am i eligible to be a citizen we send them to station 3 that's when they sit down with experienced advertising to fill out the 4 hundred naturalization form and then to final review and at the end he helps them with the check out station and send them a packet to fill and wait a month to 6 weeks to be invited in for an oral examine and if they pass two or three a months maximum get sworn in and become a citizen every single working groups we have a learning how to vote i mean there are tons of community resources we go for citizenship prep classes and have agencies it stays on site and this is filing out forms for people that are eligible so not just about your 22 page form but other community services and benefits there's an economic and safety public benefit if we nationalize all people to be a citizen with the network no objection over $3 million in income for those but more importantly the city saves money $86 million by reducing the benefit costs. >> thank you. >> i've been here a loventh i already feel like an american citizen not felt it motorbike that needs to happen for good. >> one day - i pledge allegiance to the flag of the united states of america and to the republic for which it stands, for liberty and justice for all. >> you're welcome. >> (singing). >> (clapping.) >> introduce the san francisco field officer director ribbon that will mirror the oath raise your hand and repeat the oath i hereby declare on oath repeating. >> citizens cry when they become citizenship to study this difficult examine and after two trials they come back i'm an american now we're proud of that purpose of evasion so help me god please help me welcome seven hundred and 50 americans. >> (speaking foreign language.) >> she wants to be part of the country and vote so much puppy. >> you know excited and as i said it is a long process i think that needs to be finally recognized to be integrated that is basically, the type of that i see myself being part of. >> out of everybody on tv and the news he felt that is necessary to be part of community in that way i can do so many things but my voice wouldn't count as it counts now. >> it's everybody i hoped for a bunch of opportunities demographics and as you can see yourself there's a good life for everyone. >> that's why. >> you have people from all the walks that life and they're standing in water 8 hours to be an american citizen and contribute to the city and that's really what makes this worthwhile. >> ♪ ♪ to be. >> hi, i'm average i'm a personal analyst that the human resources examining and recruitment unit and suffix i started my career as a san francisco state university and got my bachelors in psyched and orientational psyche if they had we have a great relationship that the san francisco unified school district i exploded for american people interim shopping mall and become eligible for a permeate job. >> okay. perfect. >> i love working for our human resources services because of the agriculture we're laid-back with a professional mindset although human resources is a challenge we're light a hearted started as a intern guided through the process eventually one day a a deputy director or staying with the puc is where i love it

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