>> way of your >> commissioner singer >> commissioner chow commissioner john >> ms. sanchez is just

arriving. >> welcome ms. sanchez. on the ureter >> the second item on the agenda is the approval of the meetings of november 18, 2014. >> we are preparing for a motion for the approval of the minutes motion to approve >> is there a second? is there a second? is there further comment, corrections are there any public comments? >> note >> all those in favor of the minutes of november 18 please say aye. opposed? the minutes have been accepted >> item 3 is the reference report >> good afternoon commissioners. on the ebola update i have dr. [inaudible] here and i wanted to do an update and see if you have questions for him he is available. we have a great job of planning and also preparing for ebola. our staff, we have been looking at this as a major preparedness activity and so we have already have identified over 15 individuals who could be utilized if [inaudible] any

other significant response to e bola issue. i think that's a good practice for us. also, cdc has sent out a document on the 35 treatments centers throughout the country and we are monitoring some individuals as they come back at most at low risk, and so, i just want to acknowledge dr. cardigan [sp?] an office app and this has been a full department response including san francisco general hospital and all the hospitals all the clinics are pairing with protective equipment so if you want to give a important message to all of you is that the department is in preparation and also the fact that i think our staff has really stepped up to be prepared for any incident they may have. tom o'dell street, please as you know tom o'dell our clinic is the largest clinic

for homeless individuals and we still have a portion here in the department and the street behind us is called [inaudible]. supervisor tim change the name to tom o'dell place. so i had the opportunity to make mrs. o'dell and tom o'dell's daughter, along with other activists in the community. we just wanted to acknowledge that our street behind us has been changed and, o'dell to mike as you know was a physician. he was a position at tom o'dell could i started my career at toronto and my first day there was to read the book about of the [inaudible] olympics he would i just wanted to acknowledge that tom o'dell memory is still alive in this department and we know the street named after him. we had a documentary on our

[inaudible] task force which aired on november 23 on ms nbc. it's looking at the issues of some of our work by our environmental technicians and they coordinated the [inaudible] task force with other departments. the document lends considerable time on the issue of human trafficking at these facilities. hhs has announced its new regional director which is ms. stafford jones, who was the chief ceo of the california association of public hospitals. she is based in san francisco and represents california, arizona hawaii and separate territories in the pacific. so we welcome her to the region. my [inaudible] portal was launched and so this is the portal for our san francisco health network patients. it's a new website that will allow patients to be part of their

inpatient outpatient health records at one site. hospitalizations will be able to view their discharge documents to the portal website in addition to receiving a physical copy at the time of discharge. they will find their discharge instructions, discharge medication list and a list of vital signs and lab results. this is the beginning of the work that we have to do with our electronic medical records to ensure our patients have access to the records so we are happy about this new opportunity to further empower patients in their own healthcare. i'm proud to announce throughout the department we provided $67,000 to combine charities campaign. these are donations to community-based nonprofit organizations throughout the city and throughout the state. so that -- we are very happy with that. also just about and one who is a manager chinatown public health [inaudible] she was invited to speak at the academy of the dietitian and

[inaudible] she spoke on the topic of [inaudible]. included inducted into the chinese-american dietetics association hall of fame getting its annual meeting so we want to congratulate tackling. we reported that and if there's any questions i'll be happy to answer them. commissioner >> thank you dir. garcia. i think that the my sf health portal being launched is a great first step in where we are trying to get in terms of integrated data access both for providers and our clients. is there a way where we can take a virtual -- the commissioners could get a log and take a virtual tour of this tool. >> absolutely we can arrange for any commissioners i would like to deduct it on the that and get back to all of you about that. thank you. >> any further

>> commissioner pating >> dir. garcia you're very modest. i didn't hear the you mentioned the war that dr. aragon one in the minutes. >> it's actually a leadership program toby will be attending and we don't know all the full details but we will be working on disparities for latinos and chronic diseases and african-americans so thank you both dr. aragon and i look forward to working with the crusty foundation on it. >> thank you and congratulations. >> i think we also did want to hear from dr. aragon concerning the latest update, which is constantly changing as were aware. on the ebola program here in the city >> yes. so now that cdc were now: at the [inaudible] program is the best way when trying to not use the word quarantine because gets people concerned. we have not been quarantining

people but really monitoring them because most of the people i've been at low risk. probably the biggest thing is that today hhs and also the white house put out a press release. identifying 35 current hospitals there called a bowling ebola treatment centers. three of them are in the bay area which is kaiser, open kaiser sacramento not bay area but closed in nus your cfs and the other hospitals will come on board we know that you have [inaudible] in california will become ebola treatment centers. they also denied a second category of hospital that the calling ebola assessment centers. the idea there is that the truth is that the only people who are really concerned about coming down with ebola are the people we are monitoring. basically were capturing every. coming back. so we know who's been potentially exposed and the people who would become sick would come out of that group of people. so the idea is that if

they develop any symptoms and some of them will, they would go to and ebola assessment center, and if they test positive they would go to a treatment center. that's the general plan for the us. the way they would are going to do it in california, would probably go to use the ebola treatment centers for both those categories. just because a number of people that were following is small enough that it just makes sense to send everybody to one place where they can really develop the proficiency and quality of care for those patients. so that's really the only real news. i would say in general things seem to be turning around and west africa. there's little more optimism that were making impact globally that's it. >> questions >> first of all i want to thank the director for now sending report and update. the selection of centers [inaudible] i just wondered if in fact because san francisco

is always been and -- we've always had our eyes open pertaining to not only situations. nationally but even internationally. there is been a group of many of us have known as young doctors who have gone always above and beyond in order to not only respond but to sustain that commitment when in fact an epidemic is way past that stage. the reason i bring this up is because there has been a great deal of scuttlebutt and concern going to national from some of the academic health science centers where [inaudible] drs. without borders and others have been in these areas for years and years and they really have reached a point of diminishing returns almost. one of the major bones of their having, of course, as they set up in these different

programs and try to sustain what is being done, many of their staff have had to-four rotations back and forth because the pool of professionals has not been what has been before because another critical problem is that many of the supplies that have been sent from the us are no longer available because the us has said ebola is a big priority and therefore we've got to make sure all our regions have adequate supplies. this is like a game where all the sudden the ship goes out to sea and all of a sudden everybody aboard says we need to import the government patient and patient is left without any supplies. the same is thing is happening. we've been getting a lot of pr pertaining to those people from every country's going in and really make any significant difference. [inaudible]. many of the cuban physicians go and i'll provide arrived without

any supplies, training, or anything other than just what in fact they left cuba with. resulting not just other supportive groups that have been involved continuously since this began are now being required an order to train and provide assistance and provide supplies and training for these different cohorts but all of a sudden you're seeing a small group of really exceptional committee people sort of lost under the weight [inaudible]. i know that at least through here in san francisco to our communities i know us cfs we've had many many folks over the years from drs. without borders and public health groups from berkeley and many of the positions and [inaudible] and there's a real urgency for us to take a look at maybe internally through our networks and share some of these

concerns with some of the folks back in washington and the regional commission. and say here is something were concerned about because these folks to come out and they are [inaudible] they don't have supplies into something we could do maybe as a nation to make sure they're being [inaudible]. i hate to be long-winded on this but this is been going on on and on and it's getting worse rather than better. i certainly [inaudible] and bring it up of department of public health as we've always been very much involved in many many first responders etc. tom you always been very active in these >> we been the in very close contact especially ucsf because anybody who goes over to monitor them when they come back and you csf has been an incredibly collaborative and cooperative in working really closely with us. one thing i do want to call attention to the white house press release is many pages is actually very detailed that is actually a

really good document because it was actually addresses a lot of the issues that you brought up including the international response the other countries that are getting involved. so it's actually has a lot of detail congested and some some of the things you're mentioned. one other thing i do want to mention that i forgot to mention, they're doing the journal of medicine came out i think the last issue is that there was there is a vaccine that is been tested and is producing an antibody response and now can go onto the next phase of clinical trials in africa. so that's fantastic news i want to share. >> if i could >> yes >> is it possible the commission grabbed copies of the white house commission errors this >> no until 12 noon today it is now available. we will make sure you get it. it's an excellent document and covers very detailed. >> thank you. >> the only one i have has embargo on it will try to get you one >> [inaudible]

>> dr. aragon thank you because i cannot ask you one more question because i want to bring it down to international. that is the work you are doing to be sure that the hospitals and physicians are informed on a fairly regular basis >> we speak to the hospitals to my ceos every single week and their support calls with the managers of infection control and we've started our site assessment so we have a team of people going to each of the hospitals making sure that they have core level of her paired [inaudible] >> that's screening level >> correct >> will be coming even before they get to the treatment level >> correct but ideally what will probably happen is that anybody who becomes symptomatic worm understand it would go to ucsf. everybody needs to be prepared in case somebody slips through the cracks but that's going to be unlikely. >> okay.

>> one more question. just from a data perspective, so those are patients you just described that you will know are in the city and in the system. if a patient goes to ucsf who does not come from your surveillance network but another one, we do know that? >> absolute. what happen california is been split up into [inaudible] areas. ucsf will be -- i'm not sure how big it is. includes the bay area may be bigger but the people from outside our county. and us. >> [inaudible] >> absolutely. in communicable diseases the counties, the states and the cdc we communicate all the time around medical diseases is a very good communication network. >> start about the question. the incident command center, it has been activated to meyerson is that correct >> the incident command

center? or the >> the city command center >> ics yes. were currently activated. >> how long will that stay activated? the media certainly [inaudible] >> what am beasley towing the staff is that we need to be prepared for this for the next year. that's how we are responding to is because if we stop activating and then react it's not a vision. for the health of our witness a activated until further notice. >> great. >> thank you. >> any further questions? if not then -- is there any public comment comment there's no public comment or question. it will go on to the next item >> next item is general public comment and i've received "request does anyone have any request? >> then we'll move on to report from the finance and planning commission to it >> commissioner chong >> yes good evening commissioner. the finance and planning committee met today before the commission meeting

and we had a really pretty long discussion around a few different topics including looking at rising the contract policy and one of the reasons to really look at revising the contract review policy is that the committee doesn't believe that we need to review every single contract and we also want to give a enough flexibility and [inaudible] to the staff who probably have more experience overseeing these contracts. at the same time we also want to look at where we can place bigger role in managing the risk of some of these contracts. so, currently, it stands we are going to revise the policy so that any

contract that is $500,000 or more will come to the committee for approval and then to the commission. and while doing that we also want to really be more focused, not just about unit of services being delivered, but to really look at impact and outcomes of these dollars that we and best in these community partners and organizations. so, that will come to the commission probably sometime in january or february so everyone can contribute to that discussion before we approve the new policy. then, other things that we looked at today, it's on your consent calendar including the new site approval for house [inaudible] they are going to move from their current location that is

been [inaudible] for over 20 years for a new location on howard street and also on the consent calendar you have order court contracts that need your approval as well as 2014 december contract reports. and then one other thing that i think is worth mentioning is about collective action plans. we have not heard about corrective action plans on many contractors and so this is relatively new to some of us who have been on the commission for less than three years. so, there were two contract contractors that have been put on the corrective action plan

and it sounds like they are pretty good outcomes. we also want to be able to really look at this as a more preemptive effort mike rather than reactive effort, of knowing that they already have these things happening. so were having some discussion into how we can do this better because at the end of the day this is really about how to deliver the best quality services to our community, to our clients. right now we have agreed that if there is a corrective action plan with any contractor that we currently have a contract with it will come to us rather than wait until the new contract approval when it comes to us. so, just have a quick

item and i'd be happy to answer any questions or dr. chow our commissioner singer if you've anything to add to that. i think i would add for commissioners to be aware that the committee is rewriting the process for the review of contracts that currently [inaudible] at $500,000 will cover 90 percent of our contacts at cost. it actually would then allow us to really look at a lower number of contracts themselves and can do better. and i'm courage you all look at what will be the draft proposal that will come to the finance committee and hopefully den we will then at the finance committee at next months meeting bring it to the commission for its approval so that it can be put into place

for 2015. we are looking at a half year period of time for assessment to see what other additional parameters might be used to make this a more effective review and a more collaborative review with the department. so the $1 million special >> that was proposed we are currently speaking about using a $500,000 threshold. it equals another may be 40 contracts in the course of a year, but it does add 10 percent of the total and there is still at 90 percent and then we can still after six months look to see what we still want to continue that or not because i was a monotonous see all 40 and you're not going to see 100 percent of that point. but it would be to see which ones than our or are not because they still meet may remain significant. >> the current proposal still [inaudible] >> correct. it will then be looked at for a final recommendation to the commission. yes >> is not a whole lot of changes to the current version

of the draft but what we did see is that if we look at just untaxed on 1 million or above is about 82 percent of all the contracts. but if we actually take that to $500,000 then it will still be responsible for like over 90 percent and that will still give the staff a lot of flexibility because it's more contracts that are under $500,000 but there's a lot over a lot of organizations that actually are related, kew note, associate with that. so it's over almost 200 organizations him talk about that are under $500,000. it's just a handful of just big contracts, guess big contractors. that way i think it's more effective and better use of our time and

expertise and more higher policy level discussions >> i want to thank the finance committee brawl that to digest >> you be digesting that at the next committee >> mr. sanchez >> [inaudible] >> i was and ask [inaudible] is the committee has not been reviewing those for corrective action plans for let's say $25,000, 50,000. it's been revisited again? it will be part of the new process. if i read through here, it has a report on contracting and finance including corrective action plans and the same is true for sole-source contracts in report on uses, but there is no specific or recommendation will be forthcoming pertaining to these two key areas? >> so what we do now is we

actually have not had too many corrective action plans. the two that we have up-to-date are the most current ones from comic since two years ago. also, what we would like to find out is that when we look at these two corrective action plans we feel that we might be able to actually provide more support if they come to us in a more timely manner. so that is where that discussion was. it's not about the size of the contract. compared to the governance. their leadership. by fiscal management and the licensing. those are the issues that we have two book interview >> commissioner, all corrective action plans will come to the commission?

>> that's right. i think the discussion has been helpful and i think we shall distribute at the annual contract amount matrix that we got from the cfo to everyone so they can see the quantities that we are talking about. any further questions to the finance chair mike if not, then any public,? >> no public comment >> we go onto the next item >> the next item is consent calendar. the items that were just describe the commissioner john >> the consent calendar is before you. it's been moved by the finance and planning committee for items are on it. is there any extractions? otherwise, we will vote on the consent calendar as a whole. >> i move we accept it. >> it has been moved to the committee. so prepare for the vote if there is no further discussion. all those in favor

please a aye. opposed? the consent calendar has been accepted. thank you very much. >> thank you measures item 7 is out care master plan determination application review for the jewish home >> good afternoon commissioners on calling [inaudible] and at your november 4 meeting i presented the proposed budget by jewish home where they are proposing to maintain their skilled nursing facility services, to expand psychiatric services, expand assisted-living services and create a new program called the square to serve older adults within both on their campus and in the community. at that time i provided you with the draft resolution that found that project was consistent with the at our recommendation that healthcare services master plan and should be

considered for incentive by the planning department and their planning process. so i know that commission secretary included all of the items in your packet. i won't go over the presentation again but i'm happy to answer any questions that you might have. also jan [inaudible] is also from the jewish home is also if you have any additional questions on the project. >> the resolution is before you go we can take public comment first. if there's any >> there's no public comment >> no public comment. commissioners, comments or a motion to move the resolution? >> i move for approval. >> [inaudible] >> is been moved and seconded and what the resolution up. discussion is on the resolution. i want to commend staff for putting i think -- as this is the second now that we've had on these determinations so i think we are able now to for to the planning commission the rationale set in this case

asked for consideration. for what definitely seems to read as improvement in the both quantity and public quality of the care that's going to be provided to our seniors. so that's my comments. any further comments on the resolution? if.were prepared for the vote all those in favor please a aye. opposed? the resolution is passed unanimously. thank you >> thank you very much >> thank you very much for the work you've done >> item mate is [inaudible] in san francisco. zero hiv infections zero hiv gas zero hiv stigma >> thank you so much commissioners for allowing us to present what we think is a very exciting collective initiative. i do have slides and in your slide are both the -- all right.