Skip to main content

tv   Government Access Programming  SFGTV  April 18, 2019 6:00am-7:01am PDT

6:00 am
discussing with the tax collector and city attorney, there are cases today we may have a patient who comes in and has been injured. later on down the road they receive a payment from some third-party insurance. that could be health insurer, insurance payment through a lawsuit, and when those payments are calculated based on partially at least on patient's medical expense and the insurance payment is made in part to compensate for medical costs, in those cases, we do intend to continue to work to pursue that patient. we do get in a situation where the insurance company will pay the patient and the patient does not turn over the reimbursement to the hospital. the tax collector's office works with us in those cases to work to get fair compensation for the hospital for those unpaid services, and in those cases we would still continue to go that
6:01 am
direction. we have written a policy to allow the city to pursue that reimbursement where it occurs. two other recommendations to highlight. we are in the process of study to evaluate our charge master at san francisco general. this is our rates. we are looking at a number of other hospitals to benchmark where we are in comparison to those other hospitals to look at whether our pricing is in line with standards. i will note that from a practical purpose, once we put the patient protections into effect, the rates that we adopt will have very little bearing on the individual patient because we set the out-of-pocket maximums. we set a cap on what to bill the patient based on insurance coverage, and because of that the rates really become essentially the primary function
6:02 am
of the rates is relationship between the hospital and insurance companies. out of our due diligence we are going to go through with the study to determine if there are areas where our pricing is out of line with the industry. lastly, big category what we are doing, and i won't go into all of these individuals, but we have a number of actions underway to improve the way we communicate with and engage with patients around financial issues. this is one of the things we have noticed through this process. there are a number of situations where a patient receives financial statement of some kind and sees large numbers on it, and it is stressful and creates anxiety. it is difficult. ir have been in this line of work for many years. i still learn new things all of the time about how this industry works, and when you are a patient that is receiving this
6:03 am
information, it is very confusing and stressful to try to decipher it. we have seen situations when it turns out the patient did not owe anything or was not going to be billed, they are receiving the statements and seeing the numbers and it creates a lot of stress. we are working to improve communication with patients about what is happening in their financial situation and trying to take that dynamic out of the patient's portion of the conversation. a few things we will be doing there. working with the patients earlier. one of the things that i just referred to is we often will send the patient a statement before we finish sorting everything out with the insurance company. we may get it resolved and the patient didn't need to see that statement or see something they might potentially owe on the
6:04 am
statement, we will delay sending that information out and communicate with the patient that we are working with insurance to avoid unnecessary worry. we will simplify communications with patients to try to put things into more clear language, really highlight in all communications where patients can go to seek help and information about financial situations and be more proactive about how we can assess patients' financial situations and opportunities for them to access these patient financial assistance programs. we have put something in the packeted to show the items we have already put up on the website. some of the communications we sent out to patients. you don't need to look at those in detail, but the goal is to show you we are already underway in creating some of those
6:05 am
communications and getting those posted and trying to do a better job letting patients know how to access health and information right now. we are doing more to public size the hot line that is staffed by the team at zuckerberg for patients to call and discuss where it is their bill and what their options are. we posted frequently asked questions. a lot of activities to improve the process administratively to take confusion out for those that have received services at our hospital. in terms what will happen next? the patient policy changes will be effective february 1, 2019. that is the date we announce the freeze on our previous policies and our intention to revise those policies through the process we have just been through. it will go into effect
6:06 am
february 1st to affect patients with a service date february 1st or after. it will also affect patient accounts with a service date prior to february 1st but had not been resolved, there were still open accounts when we announced the freeze. i will apply that to all work going forward. we expect we can begin working through and revisiting those accounts over the late spring and summer so that will take a little bit of time to do. we will get that process underway. we are also working with the city attorney and tax collector's office on a lot of the administrative requirements to implement this and also to insure in those cases with a third-party payer or legal dispute that we are giving ourselves and giving the city the opportunity to pursue u.s. financial obligations and revenue due to it.
6:07 am
we are anticipating that we will have a follow-up hearing at the board of supervisors to update them as we are today updating you on this issue then talk with them further in the budget process. that is the end of my prepared slides. i am happy to answer questions. >> thank you, mr. wagner and doctor as well for the hard work and thank you may or and supervisor peskin for the leadership in recognizing the ushgenesee of the situation. -- urgency of the situation. while it is public among hospitals with most of the patients with medicare or medicate and uninsured. what sets san francisco apart this is the only level one trauma center in san francisco. we want to ensure those in san francisco can receive the excellent trauma care without undue financial burden or
6:08 am
stress. thank you for that. one question for you. is there any change in how the hospital would be pursuing litigation or other measures with the insurers to secure payment for them or is it the same process always in place? >> it will be the same process, and i think the point that you are getting at is worth emphasizing. there are three hospitals. the hospitals, the insurers and the patients. we view a lot of this as an effort to protect the patients but also to continue to be aggressive in pursuing ferry imbursement -- reimbursement fromsures companies. a lot of cases are out of situations where the insurer is not providing adequate compensation for the benefit their customer is receiving. we want to take the patient out of the middle of that. we are providing service and we
6:09 am
will continue to be active in seeking reimbursement from insurance companies and that including the tool kit as you mentioned of policy and legislative actions, legal action and then continuing to appeal and continuing to engage with insurance payers to make sure we are adequately reimbursed for services at our trauma center. >> commissioners. >> thank you for all of the information that you have provided and for your pursuit of this issue. considering it is a significant issue, but again the majority of the patients at our facilities are government subsidized patients and to know that even the small population of affected residents in san francisco are going to be assured equitable
6:10 am
treatment is really good to hear. one of the things i recall in our past discussion was potential of pursuing contracting with insurance companies. i don't know where that has fallen in terms of the follow-up steps. the second question is on the study you are doing. how are you getting your hands on the charge masters for the other hoppings in order to do the comparative study? >> i will take the second one first. the charge masters are published on the state website so that data is available. it is a lot of work to sort through and compare as apples and oranges. we have contracted to do that work. they are trying to sort through
6:11 am
and really create adequate comparisons of that data. that is the real work involved in that. they are underway on that. on the first about contracting, that is a great question. we have been spending a lot of time thinking about contracting. this goes back to even pre-aca where we acknowledged how the industry was changing and started thinking about opportunities to compliment our core to provide care with commercial contracting. we have gone through a lot of iterations with this and spent time with the cromler's -- controller's office. we have had outside firms help us with opportunities. part of the challenge with contracting for us is that the
6:12 am
fundamental bargain in these contracting arrangements. you give a discount in exchange for volume. our position right now at san francisco general is that we do not have capacity. we are full and then some. we really don't have excess volume where it makes it worth it to say we are going to give discount on our prices in exchange for enough volume that we will break even plus. right now if we went into a standard insurance contract, what we would do is give significant discount to private insurance in exchange for very minimal volume. that would just have the opposite effect of what we have been intended. part of this conservation about contracting has been with the focus on the patient. if we were contracted within insurers, the patient would have access to that in network rate
6:13 am
and wouldn't receive the balance bills. i think we solved that issue by putting the out of pocket caps in place. i think that is a more effective way to solve it than to try to one at a time go contract with each insurance company given the situation with our capacity at the hospital. what we are doing through the work that we have done with the controller's office and others, we identified some areas in the hospital where we do have capacity and where we can take additional volume that won't add to our time on ed diversion and it won't displace our uninsured or medicaid programs. we have been pursuing contracts that are kind of more targeted to those service areas. some of those are ob services, potentially post-trauma follow-up care where we can take
6:14 am
the patients that would be additional revenue for the department but that we wouldn't be sacrificing so much on our rates that it would just make the general fund have to pay more and more to the hospital to subsidize insurance. wwe are working actively on a fw of those contracts, and we hope to have some news for you on some of those soon. the other one we worked on in the past and are continuing to work on is to engage with the city's health service system that contracts within insurers for health coverage for city and public employees in the area and whether we could connect through one much those contracts to be in network for some of those health service system services. that was a long answer, but we have been spending a lot of time thinking about that one. >> thank you.
6:15 am
clearly, you have spent a long time in this and in great depth. on the contracts as we were inquiring, it seems to me as you were describing some of the potential services that may have capacity just the thought also of rehab units at laguna and whether, you know, as you are doing this and while we are concentrating in general, part of the master plan originally, as you know, with the build of laguna was to really have the acute rehab available to the community. it is available to the community, but it appears not to have the up take. it might be an issue of contracting that would allow you to actually, you know, be able to use that capacity and also help benefit the city.
6:16 am
>> thank you, doctor. i know we did look at that at one point. i will need to go back to refresh myself. >> the other part you may need more information on is this third-party reimbursement from a particularly not so much just from insurance because it is often related to workers comp and so forth. often then there is this problem of the patient getting payment and whether or not the payment goes directly to the provider. often it doesn't. or litigation, for example in which the patients are awarded huge amounts for their injuries, including the care along with any pain and suffering. it is really quite complicated, and it has gone through, i
6:17 am
think, a lot in which -- i think there is some sort of rule that indicates payments weren't going to be greater than how much was being actually paid or charged or the cost so i think as you are writing these rules, as you said, you intend and want to continue to pursue those for our best reimbursement and they shouldn't take advantage of suddenly certain things. i don't know how to do that but i think that is a very -- i would say specialized area of reimbursement in the law that needs working at, workers comp and third-party injuries and all, tha things like that. >> absolutely. that is an area where we have between the city attorney's office and the tax collect or's
6:18 am
office that is their area of expertise. we work closely with them, but we do spend a significant amount of time and resources on some of those big cases. one of the things that we have done here and this policy change does change the dynamic in terms of the leverage and pressure and ability to collect on some of those, but we have included in our policies essentially a provision that says we are capping through the discount policy or charity care policy patient liability, but in those cases where from is money due to the hospital, eligibility does not apply in those cases and we will turn those over to the tax collector's office and city
6:19 am
attorney's office to pursue those collections. we didn't want to write the policies to preclude ourselves from seeking what seems like a ferry imbursement for the city. >> good because we have a trauma. >> commissioner green. >> thank you for the detailed analysis and having completed this in such a short period of time is commendable. i have two questions. this mainly applies to san francisco residents is that true or is does this apply to anyone? >> it is anyone. if you look at the policies and i didn't go into detail because of the new answers are opaque and required under different legal requirements, but different policies have different criteria. the sliding scale policy, the most generous policy is only for
6:20 am
san francisco residents. the other charity care and discount policies we are required to hold those understate law we are required to have those and they are different primarily in the asset test under the charity care policy. those apply to anybody. these would be out of pocket cap payments for nonsan francisco residents. also, you had asked offline and we had looked initially at the accounts we had the data quickly available for about three quarters of the patients in that sub set of those who are potentially subject to balance billing are san francisco residents. in practice the bulk of the patient in that situation are residents but it applies to those outside of the city. >> you were talking about leverage and working with health plans. is there any concern because we
6:21 am
are helping the patient one aspect of the health plans, the new consumer complaints and that kind of consumer advocacy in the health plan relationships now that we are helping the consumer is that an issue? will the plans be less likely to pay or negotiate because there is an element of pressure lifted as we do this? >> i think that is likely. that is one aspect of this policy, and that is true that part of the dynamic is that when a patient receives a large bill, one of the things they are going to do first is turn to their health insurer and say your job is to pay my bill. the insurer has a customer service problem. i think what we have done here is essentially made the judgment that although that is going to
6:22 am
remove that dynamic from the equation, it probably has the opposite effect we would like on the ability to get reimbursement. from kind of a policy and ethical and care experience perspective, putting the patient in that position where they are kind of at that pressure point between the hospital and the te insurer is the trade-off doesn't make it worth it to leave the patient from that position given the experience they have. there will be that trade-off and there will likely be that trade-off in other cases where we deal with some of the more complex legal or insurance or workers comp arrangements where you are taking some of the pressure out of the negotiation, but again, i think that is one
6:23 am
of the trade-offs and ultimately the judgment here is that our role is to care for our patients and having them in that position of leverage to push reimbursement, it does not seem like the right thing to do. >> so the recommendations in your report represent in many ways a change in how the hospital does business and interacts with the patients. do you anticipate any significant impact on the clinical and administrative staff at the hospital and additional work they need to do, how they interacts with patients? >> i will ask if the doctor has anything to say. there will be administrative changes in implementing this, i know, for our people and patient financial services who is already kind of scrambling to
6:24 am
get some of this moving, we will need to go back and revisit a lot of those claims that were still in the process but not yet closed out and readjudicate and reevaluate those. it will affect our requirements for our accessibility and engagement with patients, more reaching out and communication. that will change some of the things we are doing. i think probably for better, although with a complication this is happening at the time that we are moving to epic and as part of the transition that is going to change almost everybody in the systems day-to-day work. there is a lot of change happening. this is another layer of change but an opportunity to rethink how we can use the tools and
6:25 am
epic to make those changes. the last thing we are also increasing or improving the collaboration between the patient financial services team and office of patient experience at zuckerberg san francisco general and trying to be a could working relationship. i will turn to susan. >> good evening. first of all, i want to thank greg and thomas and their team for the incredible amount of work they have put into this. i can't claim any responsibility for it other than just a reviewer. i want to say how grateful i am to them for that.
6:26 am
secondly, greg is right. most of the changes are going to be felt by the patient financial team. i think for the clinical side it is going to be just a tremendous relief because providers will no longer have to worry on behalf of their patients that they are going to somehow be subject to the large bills. i have already gotten e-mails from providers who said this is such a great outcome, so great for our patients. we are really glad to see things have turned out this way. it is only good for clinical staff. the office patient experience is a small team at the hospital. it addresses all kinds of patient issues and complaints and grievances. long before this issue came up, we knew we had complaints about bills from various quarters. the patient financial team and others at the hospital developed the streamlined process to make
6:27 am
sure everything came through one route eventually and that we resolved things, mainly with the opec team and in the case of bills with the patient financial service the that is worked out. this is a good thing for our patients. >> any other questions or comments? >> i think i was going to comment, if i could, and clarify for sure that we are estimating a loss by limiting the patient out of pocket of $1.9 million to $2.2 million that did not include the issue of negotiations. the 1.9 to $2.2 million is when we look at the difference between what our payments are and what the patients would be paying through their co-insurance deductible.
6:28 am
then there is uncertainty in that because we have limited ability to have really deep insight into that data. we are working with what we have, but that is an estimate. there is uncertainty in the estimate because there is for accounts not paid those are referred to the tax collector's office and some amount of that reimbursement ultimately comes back to us, but that often happens over multiple years. it is an estimate. there is the range in the estimate what the impact will be on the tax collector's ability to pursue those accounts over time, but this is our best guess. we have because we knew that this process was underway in our revenue estimates that we submitted to the mayor's office factored in this estimated reduction in revenue. >> thank you. >> we have an item for action.
6:29 am
resolution approving changes to the sliding scale program and endorsing changes in the financial assistance programs. having reviewed the resolution do we have a motion to adopt? >> so move. >> i would second it with a proposed addition for clarification. if i could then propose in the second resolve to clarify that we are talking about san francisco general as an out of network facility. i would like to add the words from zsfg as an out of network facility. it reads that the new policies and procedures require that insured patients receiving
6:30 am
services at zsfg will be build at no more than cost services. they would pay same as in contract at the hospital. >> if in fact since it is a clarification if there are no objections if the chair accepts it we could vote on that. if there is objection we could go through my proposal as a formal amendment. >> the chair accepts your proposal. we have a motion to approve and we have a second. all those in favor. motion passes. resolution adopted. >> can i comment. i thank you for your vote. i want to acknowledge greg and his team and the hospital team's hard work. greg made this look self ex plannatory but it wasn't by any means. this reflects hours of work. the deeper you dug, the more
6:31 am
complicated it got. they took it back to a place of understanding. i want to acknowledge the hard work and time put into this. >> next item. >> congratulations everyone. item 10. other business. hearing none we move to item 11 which is report back from the april 9, 2019jcc meeting. >> yes, the joint conference committee was a closed session to receive credentials and quality reports. i have no further report. >> all right. item 12 is consideration of adjournment. >> do we have a motion to adjourn. >> so moved. >> second. >> those in favor. a. we are adjourned. thank you. >> thank you.
6:32 am
6:33 am
>> good morning, everyone. >> good morning. >> all right. let me thank everyone for coming up today -- coming out today. it is a wonderful day for our city. okay. and we are all here because we are going to celebrate the project. [applause] and for many of you, the project -- there is a little bit about the project itself, it is 1.8 miles long, and it started
6:34 am
from peach street all the way to mcalester and some people say, from the day to civic centre. so it is a long stretch and we are very excited that this project is complete and as many of you know, this particular street before this project happened, this corridor was one of the high injury network corridors here in city, and through the work of many of the commissions and many people, we have been able to improve the streetscape. today, that path is behind us. how about a clap for that. [applause] >> the streetscape is a makeover that offers several pedestrian crossings, bike lanes, and more importantly, it helps the
6:35 am
businesses along the corridor be more vibrant. we are excited about that. the project has improved lighting and has improved landscaping, it has many new pedestrian bulb outs, a lot of work to the infrastructure, new paving, and of course, underground and sewer lines that also crossed many of the upgrades here. this is a complete streetscape. the project has happened with a lot of strong partnerships, with many community groups that help us to transform the street itself. but as we can see some of the alleys got transformed, so for an alley that we are standing in here today, they have this beautiful new look with enhanced safety elements, and raised crosswalks, and a nice pedestrian scale. that is how many of the streets are supposed to look. they all make up the project of
6:36 am
this streetscape. we all know it also takes whole community, it takes a lot of political leadership to make progress here, and on many of our projects, and leading that charge will make san francisco a much safer and more vibrant and welcoming city, is our mayor, london breed. let us welcome her with a big round of applause for her leadership. [applause] >> thank you, everyone for being here. the rain couldn't stop us from celebrating 18 years of construction to get this project done for the residents, for the businesses, for the people of this community, and i want to thank each and every one of you because i know it has been painful. i know it has been challenging, because of your support, we have been able to get it done. and what we have, as you can see , even in the alley, this beautiful streetscape.
6:37 am
this community will be more vibrant, it will be more resilient because of this work, and also, it will be safer for the kids that are joining us here today from reading elementary school. we have to make sure that they can walk the communities and feel safe. we have to make sure that as people use different modes of transportation like bicycles and scooters, that there are dedicated bike lanes so people are safe. we have to make sure that we change our streetscapes in general and we repair our infrastructure. this project started i think when supervisor peskin was supervisor of the first time, and now we get to finish when he is supervisor the second time around, and it is absolutely amazing. san francisco, as we know, many, many years ago, the infrastructure was developed to support mostly cars getting around. now we have so many more people
6:38 am
living in san francisco. our population has grown. more people who are riding and using alternative modes of transportation. so as that changes. our city has to change. we have to adjust with the ultimate goal of not only moving people around, but moving them around safely. that is what these improvement projects are about, and on top of that, the ability to repair our infrastructure, the pipes and all the things undergrounds that make our cities and our businesses work. that is so important. so critical to the sustainability of our city for generations to come. so i am so excited about the completion of this project, and i'm so excited about what it is going to do to improve public safety for each and every one of us. we know that there are a number of investments the city is making all over all the neighborhoods around the city. we have a lot of work to do, and
6:39 am
i want to thank san franciscans for their support of these projects, for their patients as we move these projects through because we will be a better city once we complete and make san francisco safer for all of us and improve it, especially for the next generation of residents right here to my right who walks through this area and we are so glad to have you, and we are looking forward to more projects like this for future generations thank you all so much for being here today. with that, i would like to invite supervisor at district three, who complains about everything that doesn't get done in a timely matter in his district, he is here today to be happy and excited about this amazing project, supervisor erin peskin. [cheers and applause] >> thank you, mayor breed. i take absolutely no credit for
6:40 am
this because all of it happened when i was out of office. all of the controversy happened under my predecessor, but i really want to shout out the community first and foremost. the lower polk area of district three was historically neglected by city hall, and it didn't really have a voice until john and shirley malone came along and started what became a real community force for the neighbors. i really want to shout out to the polk neighbors. [applause] this 1.8 miles actually stands three supervisorial districts. does represented by supervisor matt haney in the north, district two represented by supervisor, and stefani, and in between in district three, and along that corridor, there were many voices. the middle polk neighbors, the
6:41 am
russian hill and neighbors, the distant -- district merchants, all of him collaborated to make that such an excellent project. i would be neglectful if i did not shout out one name, and that is the name here on this sidewalk that these wonderful students from reading elementary are looking at, and that is an incredible force knelt -- named schulte thomas. still ahead a vision for polk street that we are realizing today. he passed away untimely in 2014 and this sidewalk is in memory. i just wanted to shout him out and say this would not have happened without his vision and his tenacity and having a vibrant polk street. thank you to shall thomas. [applause] and i know that mayor breed said it was an eight-year project. it might have felt like eight years, but it was actually three , and i want to shout out to public works and sfmta who
6:42 am
actually implemented this in the smoothest way possible. i know there were concerns, and they made raj -- representations to the businesses and the residence, and i think all of those representations came true. i think mitchell berg did exactly what he said he was going to do in those first controversial community meetings that we had three years ago, so thank you to public works. thank you to the staff of the sfmta and two others who had to listen to everybody screaming at him about parking spaces being taken away and all the rest of it. this is a transformative streetscape project that i think is going to be something that we are proud of for generations to come. with that, it is my honor and pleasure to introduce the supervisor from district six, supervisor matt haney. [applause]. >> well, let's see if i can get this up here.
6:43 am
is everybody excited about polk street? okay great. this is an impressive turnout, especially in the rain. i want to thank the community. this is a multiyear effort that has been a really alleged by the neighbors and push for by the neighbors. we are tremendous partners in the city. the polk street is one of the premier commercial and residential corridors in our city. finally you will have a streetscape that matches the dynamic nature of this corridor, the people who work here. the many uses that we know. i want to give a huge shout out to the kids from reading elementary. thank you for hosting us and having us here in your hood. they are what this is all about. seniors being able to walk down and use this street in a safe way, in a way that really activates. i tell everybody about the alley
6:44 am
right now. what people say we have challenges with the alley, they look over here. this is the model for what we can do for all of our cities. we have also learned from what we did in polk street so that we can do this quicker, so we can do it stronger protecting the bike less onerous street and we know that when we don't do this, it can be deadly. over the last two weeks we have seen people on our streets and high injury corridors, pedestrians and cyclists who have lost their lives, and this is a solution to that if we do it right. we need to do it quicker and we need to do it with stronger protections, but we have learned from this process, and we know we can build on it and continue the great work. last thing i want to say, thank you to the business community who have stuck with us through this process and i looked down polk street and icy parking and vacant storefronts, it is a challenge that i hope we are able to change now this project is completed and we can really
6:45 am
support the residents here and the business community. thank you to the sfmta, the department of public works, mayor breed, supervisor peskin, and most importantly, to all of you. this is a fantastic day despite the weather, and more to come. [applause] >> and there are many lessons that have been learned on a project like this. and when public works implements these projects, we don't do it alone. we do it with a lot of other agencies. it is my pleasure to introduce the director of m.t.a., ed risk in. [applause] >> thank you. supervisors, it is great to see you all. it is great to be here after so many years. we started the conversation with all the community groups and stakeholders the other folks had been talking about. it was many years ago, but we started that conversation because what we identified, and this is before we had even defined the high injury network
6:46 am
as we know it today, we started the conversation because we saw too many people being hurt as they were traveling on polk street, particularly people traveling by bicycle, and people who are walking. we decided back then before we we had adopted vision zero that this was unacceptable, and that this was preventable. so we sat down and we worked with the many community groups involved. we worked with the merchants, we worked with the residence, we worked with the neighborhood association. you heard many of them named before and it was through that collaboration and understanding what the needs of the businesses where, the needs of the residents in understanding the perspective of transit riders. understanding the perspective of people who use this to bike to work or bike to school and particularly, those who are walking and trying to get across the street, trying to get to where they are going. we took all of that and put together a project that was
6:47 am
complicated. it was not an easy solution. there are different neighborhoods as the supervisor said that this goes through with different crash profiles, different geometries, and we had to knit it together into a project that would definitely meet the needs of all of the stakeholders while making the street safer and i think that is something we accomplished. just accomplished. there are trade-offs along the way, but we were able and there's a lot of controversy along the way, but we are able to get to a consensus project that is resulting in a polk street that i think is a quantum step better than what we had before we started this project. a quantum step better in terms of safety, in a quantum step better in terms of fatality and livability, and really supporting and advancing what is great and special and unique about the polk street corridor and the multiple neighborhoods that it runs through. we are just very pleased to be
6:48 am
here on this day. as others said, lots of lessons learned. we need to do more of this and we need to do it better and we need to do it faster, but we have a great product here because of the great collaboration among so many different stakeholders throughout this process and also , i want to acknowledge, in addition to the mayor and the supervisors, the great leadership by the sfmta board of directors that had the tough job way back of approving this project amid all the controversy there is one director who was on the board at that time here. the difficult work of approving the project and getting the funding together so we could move this forward. i want to thank all of our partners and community stakeholders and congratulate all of the neighbors along polk street for this great project. [applause] and one of those stakeholders that has been with us from the start, sometimes working with us , sometimes fighting with us, but always advocating for safer
6:49 am
and better streets in san francisco, has it been the san francisco bicycle coalition. i want to invite the executive director of the coalition up. [applause]. >> thank you. thank you to you and your team for putting on this event. special thanks to mayor breed for your remarks and supervisors peskin and haney for being here. we are here today to celebrate the completion of the polk street improvement project, and there are some wonderful things to celebrate for an alley in front of us, that is a great example of what the city can do to make our streets and alleyways more human scale. we have great new pavements, there are sewer lines, so many wonderful things that are the result of this project. i do want to call out that from a bicycle safety perspective, i'm not sure we are 100% complete and what we need on polk street. with only like a part of the project containing fully protected bike lanes, this project, whether it was three
6:50 am
years or eight years to go, when it was approved, it doesn't quite meet the standards that we have established today or protection and safety for people who bike on our vision zero high injury cora doris. the streets where we know people are getting injured and killed. we are at this this point because polk street the project we are celebrating today, is the result of a process that started years ago. what we have learned since then is that all of the outreach and planning and construction delays , they are not necessary to wait whether it is three years or eight years, to get the safety improvements that we need for people who bike. we have seen with the leadership of mayor breed and members of the board of supervisors that we can get those safety improvements in the ground in a matter of months rather then years. so the lesson in the take away from me here is that there are these important projects where we are transforming our streetscapes and they are important to get right. we need to be speaking out for the voices of young people, for seniors, for people who bike, but they're also things that we
6:51 am
can do immediately to make improvements. i'm so happy again, in response to the recent fatality that supervisor haney mentioned on howard street, that the city is stepping up and putting the safety improvements in the ground to help save lives and prevent more people from being injured. we look forward to working with the mayor's office, with the sfmta to evaluating polk street, to seeing how it works, what needs to be fixed and tweaked, especially from a bicycle perspective in the months ahead, and hopefully, making improvements to close those gaps and safety and protection where we know they exist. the memories of the lives we have lost and that the lives changed by people who were seriously injured demands that we continue to make fast and real change. thank you so much. [applause] >> okay. presenting s.f. walk is dodi.
6:52 am
please come on up. >> good morning, everybody. thank you, mayor breed, supervisors. i stand here today thinking a lot about a phone call i received recently a couple of weeks ago from a woman who was seriously hurt and hit and a hit and run just a couple of blocks away from here, and she thankfully survived the crash and that was one of the hardest because i have ever received. the calls never do get easy, it is projects like polk street where we do the necessary work and put in the time and energy and investment into streets like this where we know that they are streets that need our attention because people are going about they're daily lives and still encountering unsafe conditions. i am so happy that one of our city his most dangerous streets has gotten safety improvements.
6:53 am
the crosswalks, the bulb outs, divisibility striping, because we know that this is the work that it takes to save lives. the project was designed at a time before we had the city's goal of vision zero. before we had leaders like mayor breed who made it clear that people's safety is the number 1 priority above anything else. that means we have a lot more work to do here on polk street. we have to be more aggressive about the quick changes. yes, we all do stand here today in celebration because this alley is beautiful, we have amazing pavement and so many good things that we know are improving this corridor, but as a city, i think that we are ready to take more than small steps towards people's safety. we really need to be racing towards the future for everyone, of every age, every ability who is on our streets. thank you so much.
6:54 am
next, please let me welcome christian martin, the executive director of the lower polk c.b.d., whose organization was definitely a key partner in the development of polk street. [applause] >> thank you so much. thank you all for being here on this rainy day. we are thrilled to see everybody out here. thank you, mayor agreed and supervisors. i hope direct to -- director numeral, right rough, thank you to the lower polk neighbors for your vision and the clarity and explain to the city what we do want to see more of as opposed to what and who we don't want to see more of. it is critically important. thank you to the d.p.w. workers, the engineers, the architects that had a hand in creating this
6:55 am
beautiful space, for your hard work, skill and dedication, it speaks for itself. many of you may notice, but it bears repeating that in the tenderloin and lower polk neighborhood, there is the amount of open space is equivalent to two people sharing a yoga mat. let that sink in. what we know about open spaces is critically important to the mind, body, in spirit and that is simply not enough. so we are very proud to add an alley to the available open space in the neighborhood, and we hope, for the benefit of the future, that we can continue to keep it clean and safe. i would like to thank the staff of the c.b.d. for doing the hard work day in and day out. johnny, andre, john, ronald,
6:56 am
ronald, we appreciate you, we see you. i would like to thank the board of the c.b.d. for giving me the support to do what i do every day. i love my job. thank you to all, thank you to the sponsors for your amazing investment in this neighborhood for the health and vitality. thank you to the st. francis foundation for all the work that you do and the neighborhood parks, our friends and colleagues at other c.b.d., thank you so much. randall, everybody else who i don't see. and i would like to reiterate what supervisor peskin said about shall thomas, a man who i didn't have the pleasure to meet , but whose legacy and vision you are all standing in. thank you.
6:57 am
we are incredibly proud to be the stewards of this amazing, magnificent public space. it is a responsibility that we take seriously, and we hope to infuse our future programming with equity and inclusion so that this alley can fulfil the promise and the pride of this special day. thank you very much and let's cut this ribbon. [cheers and applause] >> thank you, a christian. christian has been an incredible partner and there's been many, many neighborhood groups, many businesses, a lot of people who have been involved in this. i do want to thank the planning department, i want to thank the public utilities commission. they have also been part of this project. i would also like to thank m. squared and the contractor who worked very closely with all the neighbors to make this project happen. [applause] >> and personally, a voice of appreciation for our project team.
6:58 am
without them, this major undertaking, they actually got it done in a very nice day. a big hand for all of them. and now at the moment we have been waiting for is the children from reading elementary school will come over here and cut the ribbon. i want to thank everyone for coming out. police enjoyed the polk street and any experiences that you have, share them with us so we can do better. thank you. thank you. >> can i get some girls over here? okay, here is the thing, watch your hands, don't put them in there, and don't put them in here. i you guys going to help me count down? >> five, four, three, two, one. [cheers and applause] [applause]
6:59 am
7:00 am
-- with liberty and justice for all. [gavel] commissioner, if i may call the role. >> a yes, please. >> commissioner hirsch. >> here. >> a commissioner taylor is excused. >> commissioner dejesus. >> here. >> a commissioner elias. >> a here. >> commissioner, you have a quorum. also present is chief william scott of the san francisco police department and director paul henderson from the department of police accountability. >> thank you. good evening, everyone. this is the april 10, 2019