Board of Supervisors - Regular Meeting

Good afternoon. Welcome to the July 21 regular meeting of the San Francisco Board of Supervisors. Madam Clerk, will you please call the roll?

Yes. Supervisor Chan. Present. Chan, present. Supervisor Chen. Present. Chen, present. Supervisor Dorsey. Present. Dorsey, present. Supervisor Fielder. Fielder, present. Supervisor Mahmoud. Mahmoud, present. Supervisor Mandelman.

Present.

Mandelman, present. Supervisor Melgar. Here. Melgar, present. Supervisor Sauter. Present. Sauter, present. Supervisor Sherrill. Present. Sherrill, present. Supervisor Walton. Present. Walton, present. Supervisor Wong. Wong, present. Mr. President, all members are present.

Thank you, Madam Clerk. The San Francisco Board of Supervisors acknowledges that we are on the unceded ancestral homeland of the Ramaytush Ohlone, who are the original inhabitants of the San Francisco Peninsula. As the indigenous stewards of this land and in accordance with their traditions, the Ramaytush Ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. As guests, we recognize that we benefit from living and working on their traditional homeland. We wish to pay our respects by acknowledging the ancestors, elders, and relatives of the Ramaytush Ohlone community and by affirming their sovereign rights as First Peoples. Colleagues, will you join me in reciting the Pledge of Allegiance? On behalf of our board, I would like to acknowledge the staff at SFGov TV. And today, that is Kalina Mendoza and Jeanette Egenlauf. They record each of our meetings and make the transcripts available to the public online. Madam Clerk, do you have any communications?

Yes, thank you, Mr. President. The Board of Supervisors welcomes your attendance here in person here in the Board's legislative chamber, room 250 on the second floor of City Hall. When you can't be here, the proceedings are airing live on SFGovTV's local cable channel or live streaming at sfgovtv.org. As of July 1st, the Board is required to take remote public comment pursuant to SB 707. During the public comment periods, we will prioritize those who have joined us in person and then hear from our remote callers. As a reminder, the board committee meetings are not required to take remote public comment. The board has also approved a rule to address disorderly public comment. Members of the public may keep their comments to remained matters within the jurisdiction of the board or the subject matter, and any comments that contain personal attacks, harassment, or discriminatory remarks shall be redirected. and a failure to immediately redirect those comments will result in that individual's forfeiture of remaining time. We will transition to the next speaker. Please remember to address your comments to the board as a whole and not to individual members. To submit public comment in writing, send an email to BOS at sfgov.org or via US Postal Service to the San Francisco Board of Supervisors, number one, Dr. Carlton B. Goodluck Place, City Hall, Room 244, San Francisco, California, 94102. To make a reasonable accommodation for a future meeting under the Americans with Disabilities Act or to request language assistance, please contact the clerk's office at least two business days in advance by calling 415-554-5184. Members, that concludes my communication. Thank you, Mr. President.

Thank you, Madam Clerk. Let's go to approval of our meeting minutes.

Today's meeting minutes up for approval are the June 16 board meeting regular minutes.

Could I have a motion to approve the minutes as presented? Moved by Chen and seconded by Cheryl. Madam Clerk, can you please call the roll?

On the minutes, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. Aye. Walton, aye. Supervisor Wong. Aye. Wong, aye. Supervisor Chan. Aye. Chan, aye. Supervisor Chen. Aye. Chen, aye. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. Aye. Fielder, aye. Supervisor Mahmood. Aye. Mahmood, aye. Supervisor Mandelman.

Aye.

Mandelman, aye. Supervisor Melgar. Aye. Melgar, aye. Supervisor Sauter. Aye. Sauter, aye. There are 11 ayes.

Without objection, the minutes will be approved after public comment as presented. Madam Clerk, let's go to our consent agenda. Please call Items 1 through 3.

Items 1 through 3 are on consent. These items are considered routine. If a member objects, an item may be removed and considered separately.

Madam Clerk, please call the roll.

On the consent agenda, Supervisor Sherrill? Aye. Sherrill, aye. Supervisor Walton? Aye. Walton, aye. Supervisor Wong? Aye. Wong, aye. Supervisor Chan? Chan, aye. Supervisor Chen? Aye. Chen, aye. Supervisor Dorsey? Aye. Dorsey, aye. Supervisor Fielder? Aye. Fielder, aye. Supervisor Mahmood? Mahmood, aye. Supervisor Mandelman? Aye. Mandelman, aye. Supervisor Melgar? Aye. Melgar, aye. Supervisor Sauter? Aye. Sauter, aye. There are 11 ayes.

Without objection, these ordinances are finally passed. Madam Clerk, let's go to unfinished business. Please call the budget. Items 4 through 19 together.

Items 4 through 19 comprise the annual budget. Item 4 is the budget and appropriation ordinance appropriating all estimated receipts and all estimated expenditures for departments of the City and County of San Francisco as of June 1st, 2026 for the fiscal years ending June 30th, 2027 and June 30th, 2028. Item five is the annual salary ordinance enumerating positions in the annual budget and appropriation ordinance for the fiscal years ending June 30th, 2027 and June 30th, 2028. Item six is the ordinance to amend the administrative code to authorize the city administrator to pause, reduce, or return the annual contributions by the departments that contract for public works to the San Francisco Self-Insurance 30 bond fund. Item 7 is an ordinance to modify the baseline funding requirements for early care and education programs in fiscal years 26-27 and 27-28 to enable the city to use interest earned from the early care and education commercial rents tax for those baseline programs. Item 8 is an ordinance to amend the health code to set patient rates for services provided by the Department of Public Health for fiscal years 26-27 and 27-28. Item 9 is an ordinance amending the administrative code to increase certain utility meter fees and authorize the controller to annually adjust device fees for weights and measures and utility meters up to the maximum allowable under state law. Item 10 is an ordinance temporarily suspending the cap on the use of homelessness gross receipts, tax revenues to fund short-term rental subsidies, and finding that temporarily allowing for increased expenditures on short-term rental subsidies will further the purposes of the R-City Our Home Fund. Item 11 is an ordinance to adopt the neighborhood beautification and graffiti cleanup fund tax designation ceiling tax for tax year 2026. Item 12 is a resolution to approve the fiscal year 26-27 budget of the Office of Community Investment and Infrastructure operating as a successor agency to the redevelopment agency of the city and approving the issuance of bonds in an aggregate principal amount of $275 million for the purpose of financing a portion of OCII's enforceable obligations. Item 13 is a resolution to concur with the controller's establishment of the consumer price index for 2026 and adjusting the access line tax for the same rate. Item 14 is a resolution to authorize the public library to accept and expend a $1.5 million grant of in-kind gifts, services, and cash monies from the Friends of the San Francisco Public Library for direct support for the Chinatown Branch Renovation Capital Project within the period of fiscal years 2627 through 2930. Item 15 is a resolution to authorize the acceptance and expenditure of recurring state grant funds by the San Francisco Department of Public Health for fiscal year 26-27. Item 16 is a resolution to approve the fiscal years 26-27, 27-28 expenditure plan for the Department of Homelessness in support of housing fund. Item 17 is a resolution to concur with the controller certification that department services previously approved can be performed by private contractors for a lower cost than similar work performed by city and county employees item 18 is a resolution to concur with the controller certification that department services can be performed by private contractors for a lower cost than similar work performed by city employees for protected protective services and security services and finally item 19 is a resolution to authorize the Recreation and Park Department to issue an amended permit allowing Another Planet Entertainment to hold ticketed concerts at the Golden Gate Polo Field to take place on the Friday, Saturday, and Sunday, either following or preceding the Outside Lands Festival in 27, 28, and 29 in exchange for a minimum permit fee of $1.53 million per day for two-day events and approximately $2.2 million per day for three-day events through 2029 and with options to extend the permit until 2035.

Chair Chan.

Thank you, President Mandelman. Colleagues, I plan to reserve my comment until next week on our final vote and also the final board meeting before the August recess. I urge you for your yes votes on today's first vote on this budget, which had a unanimous vote to recommend it out of our Budget and Appropriations Committee. I do want to take a quick opportunity here to thank all the members of the Budget and Appropriations Committee for their hard work. So with that, I will reserve my comments until next week. Thank you.

And with that, I think we can take these items. Oh, Supervisor Fielder.

Thank you, President Mandelman. Colleagues, this budget closes a massive deficit without mass layoffs. Certainly not without tradeoffs I'm still wrestling with. Growing police pay by 14% over four years isn't where I would have put our limited dollars. However, in a year with looming federal cuts and no easy options, this board held the line on critical safety net programs that tens of thousands of San Franciscans depend on. And that is a real win. This budget is not everything many of us would have wanted, but it's a fight worth continuing into next year's budget. This win is due in large part to the advocacy, the high level of organization, and the unity among community groups and labor, the people who deliver our city's services every day that allowed us to stave off the deepest cuts and keep critical social service programs running for the people who rely on them. That kind of outcome also depends on partnership inside this building. I want to thank you colleagues for caring and supporting District 9's priorities throughout this process while I was out on leave. In particular, I want to recognize Budget Chair Chan, Supervisor Chen, and Supervisor Walton, along with their staff Frances Shea, Jackie Prager, and Tracy Brown, for their work in partnership with my staff in making sure our district's needs were heard and met at every stage. I also want to thank my own staff, Jennifer Frigno and Sheila Chung-Hagan, who worked diligently to move our priorities forward, making this outcome possible. The diligence with which this board worked through such a difficult budget is a testament to the collaborative leadership of Budget Chair Chan and the commitment of the entire board. Next year promises to be an even tougher budget year. We will still be facing federal cuts and continued attacks from the Trump administration. My hope is that we take what worked this year, listening deeply to community and labor partners, and holding the line on the programs people depend on most, and carry that same approach into next year's budget. And with that, colleagues, I'll be voting in support of these items.

And I think we can take these items, same house, same call. Without objection, the ordinances are passed on first reading and the resolutions are adopted. Madam Clerk, please call item number 20.

Item number 20 is an ordinance to amend the administrative, environment, health, labor, and employment, park, planning, police, public works, subdivision, transportation, and building inspection commission codes to modify numerous reporting requirements, affirm the CEQA determination, and make the appropriate findings.

Please call the roll.

On item 20, Supervisor Sherrill. Sherrill, aye. Supervisor Walton. Walton, no. Supervisor Wong? Wong, aye. Supervisor Chen? No. Chen, no. Supervisor Chen? Aye. Chen, aye. Supervisor Dorsey? Aye. Dorsey, aye. Supervisor Fielder? Fielder, no. Supervisor Mahmood? Aye. Mahmood, aye. Supervisor Mandelman? Aye. Mandelman, aye. Supervisor Melgar? No. Melgar, no. Supervisor Sauter? Aye. Sauter, aye. There are seven ayes and four nos, with Supervisors Walton, Chan, Fielder, and Melgar voting no.

The ordinance is finally passed. Madam Clerk, please call item 21.

Item number 21 is an ordinance to amend the planning code to reduce inclusionary affordable housing program requirements for projects of 25 units or more. Delete affordable housing program requirements for projects under 25 units. allow all projects to dedicate land to the city as an alternative to payment of the inclusionary housing program fee, adopt a process for projects to request a modification to conditions of approval related to inclusionary affordable housing program requirements, delete certain Article IV impact fees, and adopt conforming amendments to various sections of the planning code, amending the building code to reduce planning code Article IV development impact fees and allow deferral of payments of such fees and amending the administrative code to adopt conforming amendments to the requirements of the city-wide affordable housing fund to affirm the CEQA determination and make the appropriate findings.

Please call the roll.

On item 21, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. No. Walton, no. Supervisor Wong. Aye. Wong, aye. Supervisor Chan. Aye. Chan, aye. Supervisor Chen. No. Chen, no. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. Aye. Fielder, aye. Supervisor Mahmood? Aye. Mahmood, aye. Supervisor Mandelman? Aye. Mandelman, aye. Supervisor Melgar? Aye. Melgar, aye. Supervisor Sauter? Aye. Sauter, aye. There are nine ayes and two nos, with Supervisors Walton and Chen voting no.

And the ordinance is finally passed. Madam Clerk, please call item number 22.

Item number 22 is an ordinance to amend the administrative code to state that it is city policy to expand the availability of site-based permanent supportive housing that prohibits on-site illicit drug use among residents to meet the demand of people experiencing homelessness who prefer such a residential option, require that city funding for new site-based PSH for people experiencing homelessness be used for drug-free PSH, require the Department of Homelessness and Supportive Housing to survey residents, and require HSH to adopt rules and regulations establishing standards and protocols for evictions.

Please call the roll.

On item 22, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. No. Walton, no. Supervisor Wong. Aye. Wong, aye. Supervisor Chen. No. Chen, no. Supervisor Chen. Aye. Chen, no. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. No. Fielder, no. Supervisor Mahmood. Mahmood, aye. Supervisor Mandelman. Aye. Mandelman, aye. Supervisor Melgar. Aye. Melgar, aye. Supervisor Sautter. Aye. Sauter I there are seven eyes and four nose with supervisors Walton Chan Chan and feel they're voting no The ordinance is finally passed Madam clerk, please call item 23 Item number 23 is an ordinance to appropriate approximately $1.9 million of boarding of prisoners' revenue and approximately $14 million to overtime salaries and to appropriate approximately $12.1 million from retirement fringe benefits, vehicles, and various capital projects and work orders in the Sheriff's Office to support the Department's projected increases in overtime in fiscal year 25-26. Please call the roll. On item 23, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. Aye. Walton, aye. Supervisor Wong. Aye. Wong, aye. Supervisor Chan. Aye. Chan, aye. Supervisor Chen. Chen, aye. Supervisor Dorsey? Aye. Dorsey, aye. Supervisor Fielder? Aye. Fielder, aye. Supervisor Mahmood? Mahmood, aye. Supervisor Mandelman? Aye. Mandelman, aye. Supervisor Melgar? Aye. Melgar, aye. Supervisor Sauter? Aye. Sauter, aye. There are 11 ayes.

Without objection, the ordinance is passed on first reading. Madam Clerk, please call item 24.

Item 24 is a resolution to approve the second amendment between the Children's Council of San Francisco and the Department of Early Childhood for the provision of the early care workforce compensation and administrative services to support the city's implementation of the citywide plan for early care and education workforce development and compensation initiatives. Increase the agreement for a total approximate amount of 230 million for a term of October 1st, 2022 through June 30th, 2027.

I think we can take this. Same house, same call. Without objection, the resolution is adopted. Madam Clerk, please call item number 25.

Item number 25 is a resolution to approve and authorize the Director of Property on behalf of the Department of Homelessness and Supportive Housing to enter into a lease of real property located at 125 Bayshore Boulevard with WYL-Orient properties for initial term of 10 years with two five-year options to extend, anticipated to commence on July 1, 2026, for use by the Department of Homelessness and Supportive Housing for emergency shelter purposes at an initial annual base rent of approximately $655,000 with 3% annual increases to affirm the CEQA determination and make the appropriate findings.

Same house, same call. Without objection, the resolution is adopted. Madam Clerk, please call items 26 through 28 together.

Item 26 is a resolution to approve the Second Amendment with Canon USA for copier machine leases, rentals, and purchases to increase the contract for a total amount of $15.3 million with no changes to the contract term of April 1, 2024 through December 15, 2030. Item 27 is a resolution to approve an amendment between the city and Cigalo Supply for plumbing supplies extending the term by two years through November 30, 2031, and increase the contract for a new total amount of $15.5 million. And finally, item 28 is a resolution to authorize the Department of Technology to enter into the first amendment to the agreement with Zones LLC for Microsoft Enterprise products, to increase the contract for a new total amount of $115 million, and to extend the term for a total term of September 1st, 2023 through August 31st, 2029, with the option of three one-year extensions.

And we can take these items, same house, same call. Without objection, the resolutions are adopted. Madam Clerk, please call item number 29.

Item number 29 is a resolution to retroactively approve and authorize the general manager of the San Francisco Public Utilities Commission to execute amendment number one to the joint exercise of powers agreement for sewer service with the city of Brisbane and Guadalupe Valley Municipal Improvement District, increasing the duration of the original agreement to December 31st, 2027.

Same house, same call. Without objection, the resolution is adopted. Madam Clerk, please call Items 30 and 31 together.

Item 31 is a resolution to approve and authorize the purchase and sell agreement between the City and Pacific Gas and Electric Company for the City's acquisition of rural property located at 5000 Hunters Point Boulevard in the Bayview neighborhood for the amount Placing the property under the jurisdiction of the Recreation and Park Department and making appropriate findings. And item 31 is a resolution in approving a purchase and sell agreement with Pacific Gas and Electric Company in the amount of $950,000 granting PG&E an easement with subsurface utilities in John McLaren Park under Visitation Avenue and Mansell Street and making the appropriate findings.

Take these. Same house, same call. Without objection, the resolutions are adopted. And please call item number 32.

Item number 32 is a resolution authorizing the Mayor's Office of Housing and Community Development to accept an in-kind gift of consulting services provided by seven Fuse Fellows through the Fuse Fellows program valued at $2,520,000 from Fuse Incorporated for the term to commence on August 1st, 2026 and to expire October 20th, 2028 to strengthen coordination strategy and systems across public health, housing, homelessness, and human services.

Same house, same call. Without objection, the resolution is adopted. Madam Clerk, please call item number 33.

Item number 33 is a resolution approving the Port Commission lease with JPPF 1300 battery for a single-story restaurant space an outdoor dining area located at 1300 Battery Street for a term expiring on May 5th 2046 for a monthly base rent of 5,000 for a total base rent of approximately 1.5 million Same house same call without objection the resolution is adopted madam clerk.

Please call item 40 item 34 item

Item 34 is a resolution authorizing the port to execute the first amendment to the management agreement with Pasha Automotive Services to discontinue a 50,000 monthly management fee paid by the port, adopt revised revenue sharing and special event provisions, and restructure the exclusive use of the port's Pier 8 terminal.

Same house, same call. Without objection, the resolution is adopted. Please call Items 35 and 36 together.

Item 35 is a resolution approving and authorizing the First Amendment to the Loan Agreement between MOHCD and 1234 Great Highway LLC to finance pre-development costs associated with the development of multifamily residential projects affordable to low-income and formerly homeless seniors on the property located at 1234, 1270, and 1280 Great Highway, and a total amount not to exceed approximately $27,036,000 is the resolution approving and authorizing MOHCD to enter into a ground lease for 1939 Market Street with Mercy Housing, California 109 for a lease term of 75 years and one 24-year option to extend and an annual base rent of $15,000 to construct a 187-unit multifamily rental housing development affordable to low-income households.

Same house, same call. Without objection, the resolutions are adopted. Please call item 37.

Item number 37 is an ordinance amending the planning code to increase the number of guest rooms for hotel uses permitted as a conditional use in RH2, RH3, RM1, RM3, RM4, RTO1, and RTOM districts from 5 to fewer rooms to 10 or fewer rooms and making the appropriate findings.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call item number 38.

Item number 38 is an ordinance amending the Public Works Code to waive banner and inspection fees for certain nonprofit organizations in all NCDs, NCTDs, and RTOC districts and affirming the CEQA determination.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call item 39.

Item number 39 is an ordinance amending the fire and public works codes to waive application review and processing fees from permits to abate violations related to the Department of Building Inspections internal quality control audit amnesty program and affirming the CEQA determination.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call item number 40.

Item number 40 is an ordinance amending the police code to provide penalties for the prohibited discharge of fireworks, including that a first offense is punishable as an infraction with a fine not less than $125 or more than $250, and a second and any subsequent offenses within five years of a prior offense are punishable as misdemeanors with a fine not less than $250 or more than $750, or imprisonment in the county jail of not more than six months, or by both such fine and imprisonment.

Supervisor Wong.

Colleagues, this ordinance comes before the full board with the recommendation of the Public Safety and Neighborhood Services Committee, which approved it on July 9th. The term safe and sane can create a dangerously misleading impression. These fireworks may be lower powered and approved by the state fire marshal, but they are not harmless, especially in a dense city like San Francisco. Sparklers, fountains, and other consumer fireworks can cause serious burns, ignite clothing, injure eyes, and start vegetation or structure fires. Fireworks marketed as safe and sane have caused severe injuries and even deaths. Children are especially vulnerable, and adult supervision cannot eliminate the risks created by extreme heat, sparks, dry conditions, misuse, or defective products. San Francisco already prohibits the discharge of fireworks, including those marketed under this category, but our local laws does not currently give officers a clear and practical way to enforce that prohibition. This ordinance would make a first offense and infraction with a fine between $125 and $250, less than a stop sign or a speeding ticket. Stronger penalties would apply only to repeat offenders within five years. This is not an arrest-first approach or an effort to criminalize celebration. It is about ensuring that the law has a real and proportionate consequence. Deterrence works only when people believe there is a reasonable chance they'll be cited. Right now, officers may stop the activity, but often have no clear local citation they can issue. That makes the law easier to ignore and reinforces the impression that fireworks are acceptable in San Francisco. These fireworks also affect more than the person lighting them. They can frighten pets, disrupt families, and be especially harmful to veterans, people with PTSD, and people with sensory sensitivities. A single spark can also threaten nearby homes and residents. The 4th of July weekend also showed the broader strain caused by fireworks activity. Medical incidents on July 4th and 5th were about double the number seen during the same period of last year. while the fire department received roughly 576 calls in 24 hours and responded to two house fires caused by fireworks. We do not need to wait for another serious injury or fire to act. Even lower powered consumer fireworks can cause permanent harm. This ordinance gives the city a practical tool to change behavior before somebody is burned, a home catches fire, or a neighborhood is put at risk. It should be paired with education, outreach, fair enforcement, and transparency. But leaving the law without a workable consequence does not protect our communities. I'd like to thank the San Francisco Police Department for working with us on this legislation and bringing up this potential legislation, as well as the Fire Department for sharing data on it, the SPCA for coming out to speak on its fireworks impacts on pets, and the veterans community for coming out. I also want to thank Supervisors Cheryl, Melgar, Sauter, Dorsey, Mandelman for co-sponsoring this legislation, and I respectfully ask for your support. Thank you. Supervisor Fielder.

Thank you, President Mandelman. First off, the findings in this ordinance read, quote, the penalty structure established by this ordinance is consistent with the recommendations of the civil grand jury, unquote. That is false. The civil grand jury did not recommend any penalty structure for fireworks that are already prohibited locally. They actually recommended data collection, a task force, and public education. Additionally, California Health and Safety Code already prohibits dangerous fireworks, and SFPD does have the ability to enforce state law. SFPD communications around this past 4th of July noted that fireworks that explode, go into the air, or uncontrollably move on the ground can lead to a citation or an arrest. The current local fireworks ordinance prohibits smaller fireworks. This ordinance imposes a new flat fine of $125 to $250 for a first offense, rising to $750 and a misdemeanor up to six months in jail for a second offense within five years. State law already has an enforcement mechanism for illegal and dangerous fireworks, so this ordinance could allow jail time for use of small and insubstantial fireworks, even sparklers. Six months in jail is a long time for a sparkler. If an enforcement mechanism is what this ordinance seeks, it would make better sense to follow the penalty structure already imposed for fire-related offenses. $100 for the first violation, up to $200 for a second offense within a year, and up to $500 for additional violations within one year of the subsequent violation. I'm concerned that this law will ruin lives of primarily young people from low-income households and communities of color and actually make our communities less safe in doing so. And so I will be voting no on this item.

Madam Clerk, please call the roll.

On item 40, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. No. Walton, no. Supervisor Wong. Aye. Wong, aye. Supervisor Chan. Aye. Chan, aye. Supervisor Chen. Aye. Chen, aye. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. Aye. Fielder, no. Supervisor Mahmood. Mahmood, aye. Supervisor Mandelman. Aye. Mandelman, aye. Supervisor Melgar. Aye. Melgar, aye. Supervisor Sautter. Aye. Sauter I there are nine eyes and two nose with supervisors Walton and Fielder voting no the ordinance is passed on first reading Madam clerk, let's go to our 2 30 p.m.. Special order all right our 2 30 special order Is the recognition of commendations for meritorious service within the city and County of San Francisco I

And today we will start with District 2 Supervisor Sherrill.

Thank you, President Mandelman. Would Mary Lindy please, well, why don't you remain seated for a moment? And I'm going to talk about you for a second. Colleagues, today I am honored to commend Mary Lindy for her dedicated service to San Francisco's senior community, culminating with her retirement as the CEO of Heritage on the Marina. Heritage has served San Francisco seniors since 1853, standing as one of the city's oldest and most storied nonprofit organizations and a vital home for older adults in our community. Mary grew up in a large family in eastern Pennsylvania and pursued a career in nursing, earning her bachelor's degree from Eastern Mennonite University and her master's degree in nursing from Drexel, with a concentration in executive leadership and organizational design. Now, she began her career as a neurocritical care nurse at two of the country's most respected institutions, John Hopkins Hospital and Massachusetts General Hospital, before finding her true calling in senior care. Since 1998, Mary has devoted her career to serving older adults, advancing through roles as an educator, director of nursing, nursing home administrator, and continuing care retirement community executive director. across Pennsylvania and California. Before arriving in San Francisco, Mary served as executive director of St. Paul's Towers in Oakland, where she guided the community safely through the first year of COVID-19 with zero outbreaks, earned recognition as a, quote, great place to work in aging services, and protected residents and staff during one of the most challenging periods in senior care history. Now, here in San Francisco, Mary joined Heritage on the Marina's CEO in March 2021, bringing vision and energy to an organization serving some of San Francisco's most cherished residents. During her tenure, she led Heritage through significant transformation, reducing operating expenses by $1.7 million in her first year. She also partnered with the board to double the organization's revenue-generating square footage, fundamentally reshaping the impact of Heritage into its contemporary success. She's also a published author and scholar, contributing to nursing and senior care literature, which reflects her lifelong commitment to advancing the field beyond just her own organization. She's also served the broader senior care field through multiple leading-age California committees and as a leadership coach through the association's Emerge program. Now, it must also be mentioned that Mary is a very proud mother to her two sons, Theodore and Quinn, and to Augie, her puppy, all of whom we suspect are very much looking forward to having her closer to home back in Maryland. But we are not so happy as they are, because we here in San Francisco, whether it is me who's had the pleasure to work with you or the residents of Heritage, many of whom I see here in the audience today, have the pleasure of benefiting from your tireless energy, your compassion, your kindness, and your warmth. San Francisco is for sure losing a light in you, but Baltimore is gaining one. And to me, the greatest gift you have given us is the enduring legacy that Heritage will have as it continues on into the future. So thank you for your compassion. Most importantly, thank you for your commitment to ensuring that San Francisco seniors can live with dignity and live with joy. We wish you all the best as you begin this next chapter with your retirement. Mary, congratulations.

And Supervisor Sherrill, I would be remiss if I did not also congratulate Mary and thank her for her kindness to Bernie and Eleanor Burke, who were my godparents and who finished their lives at the Heritage and had a wonderful time with her and loved her very much.

Thank you. Thank you so much, Supervisor Sherrill. I'm truly honored, and I'm a little overwhelmed by all of that. And I want to say thank you for your ongoing support in District 2. We have really been beneficiaries of that. For me, it's the end of a long career, and I'm incredibly grateful, grateful that I was called to this work. When I first got into this field, my heart was simply drawn to supporting and serving seniors as they entered the last decades of their lives. But I quickly realized that I was getting the better end of the deal. I have learned and grown so much from the people I served. I'm grateful to know the residents I serve, learning from their stories and rich histories, and grateful to witness the daily dedication and compassion of our staff. I'm truly grateful for those relationships. The people in our community are the ones who inspired me, and they are truly the ones behind every decision that we made and every good thing that we achieved. In recognizing me today, you're recognizing those relationships and the quiet dedication and behind the scenes work that I've been so privileged to lead. It was a collective effort to reach the milestone that matters the most, and you mentioned it, working to protect our community and secure housing for our San Francisco seniors in perpetuity. Heritage on the marina reflects the heart and soul of San Francisco, and this commendation is a direct reflection of the staff and residents who make Heritage so special. It has been my absolute privilege to serve them. Thank you.

Up next, District 4, Supervisor Wong.

Can we have art with elders come up? Good afternoon, President and colleagues. Today we honor a program that enriches the journey of aging and a leader whose work reflects the very best of District 4 in San Francisco. As we celebrate Disability Pride Month, I'm honored to recognize Art with Elders and Executive Director Mark Campbell for their extraordinary work supporting older adults and people living with disabilities. Art with elders embodies the spirit of disability pride by creating spaces where creativity, connection, and a self-expression allow every participant to be seen, heard, and valued. I also want to highlight Mark's deep roots in our community. For more than 35 years, Mark and his wife Dee, a nurse at UCSF Parnassus, have made their home in the Outer Sunset, raising their two children and contributing to the district's strong sense of community. The Sunset's peaceful, fog-shrouded character has long supported Mark's artistic practice, his dedication to Laguna Honda Hospital, and his leadership of Arts with Elders. And finally, I want to encourage everyone to join with Art with Elders as they celebrate their 33rd annual exhibit at the Veterans Building from August 16th through September 9th. It's a wonderful opportunity to experience the power of creativity and the voices of elder artists from across our city. Thank you. And with that, I'd like to turn it over to Mark Campbell, District 4 resident artist and executive director of Art with Elders.

Thank you. Thank you. True story. A couple of months ago, I was in my studio in the Avenues painting, and the doorbell rang, and the dogs went crazy, and my son, a 23-year-old, went to the door and had a conversation with someone. And it took a long time. I'm like, what the heck was that about? He finally comes back in and he says, oh, I met a representative of Mr. Wong, the supervisor who's running for election. And I said, oh, wow. I said, did they represent it well? And he said, actually, it was Alan himself. And I said, did you happen to know change your vote or learn anything about it. And he said he was very impressed and we are so thrilled that the results came out the way they did. But what I wanted to talk about is the gift of creativity and the fact that creativity opens doors and builds bridges. And for those who are most disenfranchised, I feel a special force. And we've done the math. We've been around for about 30 years. And we actually have, in that time, worked with over 12,000 seniors in the Bay Area. We have about 50 classes running per week. We have many exhibitions that happen throughout the year. We have these great openings at Laguna Honda Hospital in the summertime, and we invite everyone to visit our website, artwithelders.org, to learn more about our programming. But really thrilled for this honor, and thank you so much for recognizing me and my work. We have Darcy O'Brien here and Iris Hu. And Crystal Booth, who is our program manager, is unable to make it today. But it takes an army. And the real heroes are our students, those with disabilities, those elders who put themselves out there and learn through creativity how to manage the great stresses that come with getting older. We really find value in our program. We understand that it works. It truly does transform lives. So thank you so much for this honor, and we really appreciate that. Thank you.

District 6, Supervisor Dorsey.

Thank you, President Mandelman. Colleagues, in recognition of Probation Services Week, it is my privilege to honor the dedicated professionals of San Francisco's probation departments. And I'd first like to welcome Chief Adult Probation Officer Crystal Tulloch to the lectern. Chief Tulloch is here to accept this commendation on behalf of the Adult Probation Department. Probation professionals, Chief Tulloch. Probation professionals play a unique and essential role in our justice system. Every day they work to strengthen public safety, support victims, promote accountability and help justice-involved individuals successfully return to their communities. Through evidence-based and court-ordered programming, probation officers hold individuals accountable while connecting them with the services and support they need to build healthier and more productive lives. They also serve as important connectors between the court, law enforcement, city departments, behavioral health providers, schools, community organizations, and service providers. I'd also like to recognize the Juvenile Probation Department for its work supporting young people and their families. Juvenile probation professionals connect youth with education, skills training, behavioral health services, and other kinds of community-based support. Probation officers balance opportunities for treatment and rehabilitation with the responsibility to protect the larger community, to supervise individuals, and to ensure compliance with court-ordered conditions. Here in San Francisco, probation provides an effective alternative to incarceration when appropriate. It allows individuals to remain in their communities while receiving structured supervision and support related to substance use, mental health, education, employment, housing, and other needs. By combining accountability and supervision with access to treatment, education, workforce development, and rehabilitative services, Probation helps address the root causes of crime, reduce recidivism, and improve community well-being. Today, we recognize the professionalism, compassion, and dedication of all of San Francisco's probation professionals. Their work changes lives, supports families, and helps make our community safer. On behalf of the San Francisco Board of Supervisors, it is my honor to commend ALL THE PROFESSIONALS OF THE ADULT PROBATION AND JUVENILE PROBATION DEPARTMENTS ON THE OCCASION OF PROBATION SERVICES WEEK, AND IN PARTICULAR CHIEF TULLOCK, CONGRATULATIONS AND THANKS TO YOU AND YOUR ENTIRE DEPARTMENT FOR YOUR SERVICE TO THE CITY AND COUNTY OF SAN FRANCISCO.

Thank you very much, Supervisor Dorsey, for your fierce leadership. It's an honor to work in your light. And thank you to the other board members who have definitely been supportive and or engaged with probation over the years. Probation Chiefs across California during this week, as presenting in front of their boards, is taking this opportunity to recognize that Chief Marlon Washington, Chief of Marin County Probation, died suddenly last Friday at the end of our association's meeting, and so we're all recognizing him this week. I would like to call Chief Katie Miller up as probation, as you recognize. Thank you. You, you, you hear us and you see us just based on your words, supervisor. Thank you very much. And I like super chief Miller to speak.

Thank you. Thank you, Supervisor. As I think you've all heard us say many times, we're the only county in the state with two chiefs. So you get like twice the pack of punch from us. And just really want to thank you. Thanks to you for your recognition and really, really acknowledging today the hard work and dedication of the folks who work in both of our departments, who care about our clients on our end, who care about young people and their families and the community as a whole. This is a really important time for us every year to reflect on what is significant and urgent and essential about our work, and so we're glad to celebrate that with you. Thank you.

One, two, three.

Thank you, Supervisor Dorsey, for acknowledging our probation departments this week. You already had a special commendation in the works when you took that on. So let's do your second one.

Thank you, colleagues, for indulging me for a little commendatory double dipping. But it is really my honor to recognize District 6 institution, the Abaddon Fight Club, and two of its champion fighters, San Franciscans whose achievements in the ring and in our community are an inestimable credit to the city and county of San Francisco. I want to start with Jason JP Peterson, owner and head coach of Abaddon. JP, would you come on up to the lectern? JP is a former professional boxer and San Francisco native who built Abaddon as an old school strictly boxing gym in the heart of our city right on Market Street. It's a place focused on teaching real fundamentals and technique to youth and adults alike, the kind of coaching that can get lost in bigger, more crowded settings. It's a gym by design with classes capped at just 10 people, built around a fighter and fight team mentality where every member trains and competes as if they're one of the club's champions. And the gym's mission goes beyond its walls. JP has also founded a nonprofit connected to Abaddon, the Abaddon Fight Club Boxing Program, which uses every dollar donated to fund equipment and competition expenses for the youth boxing program. giving San Francisco kids the chance to compete at levels they might not otherwise have access to. It's with this kind of spirit that he built a place that isn't just a club, but a community. It's out of that gym and under JP's coaching that today's other two honorees have risen to become champions. Cecilia Dominique Kaiser. Cecilia is a two-time... is a two-time Northern California Golden Gloves champion, a two-time Southern California state championship winner, and a California state Golden Gloves champion. The Golden Gloves is one of the oldest and most storied amateur boxing competition in the country. And winning it at the state level, let alone doing it multiple times in both Northern and Southern California, puts Dominique among the most accomplished amateur boxers that our state has ever produced. But her talents don't stop at boxing. She's also an emergency room registered nurse at UCSF and the owner of Laser Clear Skin Med Spa, a local small business. Dominique represents the very best of what it means to be a champion both in and out of the ring. And also Sugar Suray Mahmoodovich. Did I pronounce it right? Surrey, did I pronounce that right? Surrey is a nine-time national champion, a distinction that reflects years of going toe-to-toe against the very best amateur boxers in the nation and coming out on top again and again. That record made him one of the top prospects in the sport, and it's what put him on the radar to become the first San Francisco native professional boxer signed to Zufa Boxing, a new promotion that launched in January and that quickly landed major media rights deals with Paramount Plus and CBS. Suray just won his Zufa debut on Paramount against, until then, undefeated French champion. And San Francisco will be watching closely on his next fight, which was just announced. He is proof that world-class talent is born and made right here in our city. On behalf of the Board of Supervisors, I want to thank JP, Dominique, and Suray for representing San Francisco with excellence and for the example you set for all the athletes in our city. Thanks so much.

I wrote this last night so I don't mess it up. First off, I'd like to thank Supervisor Matt Dorsey and his office for their support, as well as everybody on the board today. Thank you guys very much. You humble me with this acknowledgment beyond words. But I'm going to still try my best to express my gratitude here. Born and raised in San Francisco, I guess you could say I always didn't make the right choices in my life, and that landed me with a lengthy prison term at one point in time. During that time, I did a lot of reflecting on my life and the mistakes I made, and I was determined not to waste what I had learned the hard way Because if I did, it would have been a waste of life. Before I went away, boxing became my passion. And had I gotten into it at a younger age, things may have been different. But I do believe everything happens for a reason. To help you grasp the story in short, one month before I had to turn myself in for a 10-year sentence, I fought at the Playboy Mansion and on ESPN. 30 days later, I sat on a prison yard thinking what I could have done differently. The next 10 years, I daydreamed about building a gym and using boxing as a platform to help the youth of San Francisco stay out of trouble and athletes in the sport achieve their maximum potential. Fast forward, and here I am, owner of a strictly old-school boxing gym, the only one of its kind in the heart of San Francisco, being acknowledged by the city, which I am very grateful, flanked by my two-time NorCal and state champion and the first pro boxer out of San Francisco signed by Zufa, the newest and fastest growing boxing promotion viewed around the world. And this is in under three years. We are doing it for real, and we appreciate you, San Francisco, for acknowledging us. And last but not least, before I get too long and get yelled at by Tony, I just want to thank Tony Delorio for always being there and supporting us the best he can as well. Thank you, Tony.

District 10, Supervisor Walton.

Thank you so much, President Mandelman. Colleagues, today I have the privilege of recognizing someone whose story is a powerful testament to transformation, redemption, and service to our community, Damian Posey. Damien's journey is one of resilience and purpose. After returning home from prison, he made a life-changing decision to transform his experiences into a mission of giving back. Rather than allowing his past to define him, Damien chose to dedicate his life to helping others create broader futures. Today, he is a respected community leader and mentor whose work has touched the lives of youth, seniors, and families throughout San Francisco. Driven by the belief that everyone deserves a second chance and the opportunity to succeed, Damien has earned the trust of our community by leading with compassion, authenticity, and accountability. His ability to connect with young people has inspired many to pursue education, employment, and personal growth while becoming positive role models in their own neighborhoods. One of Damien's most impactful accomplishments is the creation and growth of the Us4Us organization. More than just a jobs program, it equips young people with leadership, professionalism, teamwork, communication, and life skills that prepare them for long-term success. Under Damien's leadership, Us4Us has supported community events, neighborhood cleanups, food and resource distributions, mentorship initiatives, and meaningful assistance for senior citizens. By bringing generations together, Damien has helped foster a culture of respect where young people learn the importance of serving their elders and seniors receive the care, companionship, and support they deserve. Known to so many as Uncle Damien, he pours his heart into every young person he mentors, encouraging them to see beyond their circumstances and recognize their own potential. His leadership demonstrates that lasting change is built through consistent guidance, meaningful opportunities, and a commitment to serving others. Damien also plays a major role in preventing violence in our communities. He works with young people to prevent retaliations and any escalation of further incidents when issues occur in neighborhoods. Damien's journey from redemption to leadership has become a source of hope and inspiration for countless individuals. His unwavering dedication continues to empower young people, uplift seniors, strengthen families, and build a more connected and compassionate community. Thank you, Damien, for your outstanding leadership and lasting contributions to our community and beyond.

Thank you. I'm nothing without my village, so I need my village to come on up here. Man, if you came up here for Uncle Damien, man, I need y'all to come over here real quick. I'm going to do my best not to be long-winded, because y'all know I can speak. Y'all come on up here. First of all, give an honor to God, you know, without whom I wouldn't be here at all. And especially grateful to my mother, Miss Renee Posey, over here, who gave birth to me 47 years ago. Stand up, Mom. Stand up. Y'all make some noise for this beautiful queen for me, please. Y'all clap it up for this beautiful queen for me, please. Thank you. I want to thank everybody that came out here today and know that, like I always say, they might have called my name, but this recognition and whatever it is belongs to all of us, everybody in this room that's putting up this fight in the community. I stand on the shoulders of my elders. I stand alongside the many, many soldiers who could be standing in this place getting recognized. you know, whom I would not be here without because it definitely takes all of us, you know what I'm saying, to keep up this fight in the community, you know, all the way from project level, 100% college prep, tailor-made, United Players, which Rudy's not here, but I got to pay homage to Rudy because y'all know I came through that UP. lineage, you know, Sean Richards, Creech, SVIP, all of the RTPs, all the YCD, you know what I mean? And I can go on and on, the amazing people in this room, my spiritual advisor who was there for me, Pastor Mark Keyes in the back. Y'all make some noise for Pastor Keyes for me, please. Y'all do a lot of work in the community. Chico, everybody up here, and to my brother, good brother, my assistant Dana, all of the amazing young people who are here, and to all of you supervisors who I know this is not an easy job that you have. This is not an easy job that you have representing each district of this beautiful city that we have. People talk about me a lot, and that's because I do have a big heart. And I'll tell you how big my heart is. It's seven by seven square miles. You know what I'm saying? In this beautiful stolen land that we live on, you know, which I've dedicated the second part of my life because when I was coming up, I wasn't the best son. That's why I always acknowledge my mother. You know, like the brother who just came before me, I also... was unfortunately in prison for 120 months. That's 10 years. But during that time, I received an elevation and enlightenment in my life and understood the importance of representing for those that come after you, the young people. Not forgetting about the seniors in our community, because my mother was a beautiful young mother of 16 years old when she had me. So I had an amazing grandparents who taught me a lot of things. and just loving on all of the people, the houseless. I've had the pleasure of working with Matt Dorsey in District 6 downtown. We know the struggles that his district faced, that all of our districts faced. I've had the pleasure of working with a lot of you guys. And if I haven't worked with you, I'm open to working with you in your district. Because I am primarily D10, grew up But like I said, seven by seven, man, I love every inch of San Francisco. These young people come from every district in our city. And as I leave, I want to encourage you to not forget about them. And like I said, I know this job is hard, but we must. HOLD THE INDIVIDUALS ACCOUNTABLE, THE TECH COMPANIES, THE PROPERTY MANAGERS, AND ALL OF THAT, BECAUSE I'M IN THE HOODS IN THE COMMUNITIES EVERY DAY. WE STILL HAVE BRAND-NEW APARTMENT BUILDINGS THAT ARE BREAKING DOWN, SENIORS THAT CAN'T GET TO THEIR APARTMENTS BECAUSE THE ELEVATORS ARE DOWN. YOU KNOW, VIOLENCE IS GOING DOWN, BUT WE STILL NEED HELP. encourage, enlighten, empower our young people, the community organizations that are out there on the field every day giving back like us for us. So I appreciate you guys. I love you guys. You know what I'm saying? My young people, I just want y'all to know this could be any one of y'all up here. You feel me? This could be any one of y'all up here. And they left, but I want to shout out Gabe and them. They just left juvenile probation because they're giving me an opportunity to work with the young people. I'm in the juvenile halls all the time, in the communities all the time. But on paper, I would look like an individual that shouldn't be doing that. But my city had faith in me, and I promise to continue to keep working and not let y'all down. I appreciate you so much. And Shimon, on your way out, man, I just hope and pray that we get another strong leader like you in our community, man, that really works with the people, talks with the people, comes out and gives back. Man, congratulations. on everything that you've done, you know what I'm saying, the pharmacy. I know they like to talk down to you, but us in the streets, in the community, we know how hard you've been working. We see you all the time, and we appreciate you, and we thank you, man. And I thank everybody that came out here. Big Rich. My brother, Big Rich. My brother, Big Rich, Summer from the Hype Center, Percy, Preston, Tiffany, everybody, all these guys out at SCDC, chee-hoo, because they know I'm Afkasi, you feel what I'm saying? I love each and every one of you. I appreciate y'all. Taylor May back there, man, and my guys, you feel what I'm saying? I've been home 15 years, you feel what I'm saying, giving back. So that lets you know the kids that I was working with, I was 15, they're now 30, doing amazing things in the community. I appreciate and love all of y'all, man. Thank you again. You know I could talk forever, Shaman. We're going to do a big one on the stage.

District 1, Supervisor Chan.

Thank you, President Mendelman. Colleagues, it is my honor, you know, our former Carly, Supervisor Dean Preston has done this, but I feel like it is my honor and my privilege to do this, even though with sadness that partly of it was a bittersweet to recognize Paul Osaki on the occasion of his retirement. To thank him for his tireless service and leadership to the Japanese Cultural and Community Center of Northern California, lovingly known as JCCNC, also for the community to be known the center. While Paul will be recognized at a formal community celebration that will be during our August recess, it is truly a privilege for me to be able to recognize him today in our board chamber. We have done so before for his accomplishment, but today we get to celebrate him for all that he has accomplished beyond the 38 years of his service serving the center. It is truly a labor of love what he has done, not just for the center, but for the entire community, not just the Japanese American community, but truly the AAPI community, but really for the greater community throughout the city. but his mentoring and inspiring the generation to give back to our community so that we could know love and in our community and to serve our community it is because of paul has always been leading by example paul's lifelong contribution reflect the values of Dedication that is a trademark of the Issei and Nisei generations, whose sacrifices, resilience, and commitment to build community create opportunities for current and future generations. Paul's steady and visionary leadership has helped expand the impact of not only JCCNC, the center, but also strengthens the cultural, social, and community fabric of Japantown. Paul's work has a local, regional, and global impact by uplifting the essential work of preserving San Francisco's Japantown, one of only three remaining Japantowns in our country. He has been deeply committed to honoring the past while investing in the future. establishing the Takahashi Ise Heritage Center, one of its lasting gifts to the community, which will help preserve the stories, values, and contributions of the Ise pioneers for future generations. Thank you, Paul, for your unwavering commitment to preserving Japanese American heritage, culture, and traditions, especially during a time where immigrant stories and experiences are being attacked and wiped away. This board, we will have a resolution honoring Paul and that we, to celebrate August 29 as Paul Osaki Day. Thank you.

We have other supervisors who want to say nice things about Paul Osaki. Supervisor Mahmoud.

Thank you, colleagues. I want to add my appreciation for Paul Osaki as well, and thank you, Supervisor Chan, for bringing forward this commendation and the resolution later today. The Japanese Cultural and Community Center of Northern California is a bedrock space in the Japantown community and in the region's Japanese diaspora. Under Paul's leadership, the center transformed from an idea to a key part of the unbreakably strong civic and community fabric that makes Japantown so special. The center fosters and helps grow traditions like the ikebana flower arrangement, kendo martial arts, and the annual Japanese cemetery cleanup, traditions that connect us to the past but also build relationships and kinship in the present. It speaks to Paul's selfless spirit and belief in the Japantown community that what was initially going to be, as I understand it from community members, just a year-long gig translated actually into 38 years of service at the helm of the center. Personally, I've been inspired, Paul, by watching you with your passionate advocacy for the community around keeping hotels open during COVID, but also making sure that J-Town's voice is heard during the redevelopment plans for the Fillmore Safeway as well. He's also been an inspiration for an incredible new generation of leaders who I'm so fortunate to get to work with today as supervisor. Every day is Palo Saki Day in Japantown, but I'm glad that we as a city will get a Palo Saki Day on August 29th. Paul, I wish you a restful and joyous retirement.

Thank you. Supervisor Melgar.

Thank you. I'm not going to belabor some of the points that my colleagues have made, but thank you, Paul, for everything that you have done for our city. But more than anything, thank you for the decades of work upholding Japanese culture and everything that you have given us in terms of your work with young people of paying it forward for the next generation. You have lots of fans here. You will have lots of fans on this side, too. And good luck on your retirement. I know you'll still be doing a lot behind the scenes. But again, from the bottom of my heart, thank you.

Good afternoon, honorable supervisors. Thank you, Supervisor Chan, for this honor. Yesterday at this time, I was actually at 850 Bryant in room 304, which is the jury room. And I was there for like four and a half hours trying to think of how am I going to get out of this? Not that I don't think serving on juries is. I've served on several juries, but I was trying to figure out how am I going to get out of this? And at the end, a judge came up and he said, let me listen to your hardship cases. And so one went up and said, I have to take care of my 90-year-old mother. She said, sit down. And another one went up and says, I'm the sole proprietor of a job. And the judge said, sit back down. And then the third person went up and said, I'm on a cruise. And the judge said, sit back down. And I was thinking like, well, what am I going to say? So when I went up and when he called my name, I said, you know, they took my three excuses. And then he said, tell me what your hardship is. And I said, I got to go to City Hall. And he said, that's your hardship? I go, that's my hardship. He said, that's why I'm here today. You know, I want to thank all the supervisors, you know, that I've worked with over the years, Supervisor Chan, Mahmood, Meg, Chan, Supervisor Field. Although, you know, I really wish you were in Sacramento as our state senator, I'm glad you're here. You know, I had the greatest job of the world working for a nonprofit organization. I fell into it by accident when I flunked out of high school. And my mom said, you know, if you don't start doing something, Paul, I'm going to kick you out of the house. So I ended up volunteering at the organization called the Japanese Community Youth Council. And that kind of started it all for me. I learned self-esteem. I learned what service is. I learned what leadership is. I went to work on the Buchanan YMCA, later the Korean Community Center, then the Asian American Residential Recovery Services, before coming to the center and spending the last 38 years here. Funding issues come up for nonprofits, especially for youth, for children. I really want to encourage you, and I know you have, to fund them. You know, what we can do for our children, what we do for nonprofits, you know, we build communities, we create change, we build a better San Francisco, and unless we get and encourage our youth to be able to be in these positions and to be part of these communities and nonprofits, you're not going to see that happen. So I really want to thank you for your funding of those programs. I want to thank my staff and the interns who are back here. I told them I was going to pay them, but actually you're taking vacation time to be here, so... But again, I had the greatest job in the world. You know, this is going to be the first time in 38 years that I haven't got dinged off of this podium. So thank you very much.

Lee Housekeeper, you're back there somewhere. Come on up. You can bring your people if you want to. Colleagues, today it is my honor to present a special commendation to Lee Housekeeper for his 37 years organizing San Francisco's commemoration of the 1906 earthquake and fire. Before dawn every April 18th, San Franciscans gather at Lotta's Fountain at Market Geary and Kearney Streets. And at 5.12 a.m., the exact minute the ground began to shake in 1906, vintage fire engines sound a siren into the dark. City leaders speak, a wreath is laid, and the crowd sings San Francisco, the anthem from the 1936 MGM film of the same name. Afterward, the procession moves two miles south to District 8, 20th and Church Streets, where San Franciscans spray gold paint on a small fire hydrant known as the Little Giant, the one hydrant that kept flowing when the rest failed in 1906, saving the Mission District. The earthquake commemoration dates back to 1919 when the South of Market Boys, a fraternal organization, began laying a wreath every April 18th at the fountain where survivors gathered in 1906 to search for missing family and friends. The tradition has continued for decades, and for the last 37 of those years, Lee has kept it going. He was born and raised in Chicago. As a young man, he made his way to Greenwich Village, where he lived on Gay Street, and spent his early career in the orbit of the era's biggest musicians, including Janis Joplin. In June of 1969, as the Stonewall riots erupted near his apartment, straight ally Lee lent his garbage can lids to the crowd outside so they'd have something to use as shields against the police. Lee came to San Francisco in 1980, and by 1982, he built his own public relations practice, representing clients that have included Mayor Willie Brown and civil rights attorney John Burris. Lee has called himself the last of the old-time San Francisco press agents. For years, he was also the public voice behind the Christmas toy drive at Lefty O'Doul's, a San Francisco restaurant and sports bar named for the baseball player and manager, which in some years collected as many as 15,000 toys for children through the San Francisco Firefighters Toy Program. Carrying boxes of toys through a bar packed three deep with customers, Lee once said, is sort of like a ballet. He took over the earthquake commemoration almost by accident as it was passed on to him through a girlfriend whose father was the last president of the South of Market Boys. In its early years, the job meant tracking down the living survivors of the earthquake and drawing out their stories one by one before they were lost. The last known survivor died in 2016 at 109 years old, and the ceremony's original reason for being went with him. Chronicle reporter Carl Nolte gave Lee a new reason. It's not the survivors. San Francisco is the survivor. Lee kept the tradition going on that idea for another decade. This year was Lee's last as organizer of the earthquake commemoration. He's passed that responsibility off to the Guardians of the City, a nonprofit dedicated to celebrating and preserving San Francisco's police, fire, sheriff, and EMS contributions, and who've supported Lee in running the commemoration for many years. Thank you, Guardians. Lee has preserved and passed on a tradition that's brought together generations of San Franciscans, survivors, first responders, civic leaders, and neighbors in remembrance, celebrating, and reaffirming the city's spirit of resilience. His legacy carries forward not only through that tradition and his other work, but through his family, his son James Smith and his grandchildren Connor and Katie. Lee, you are a gem. On behalf of the San Francisco Board of Supervisors and the city and county of San Francisco, we want to thank you for making sure this city keeps remembering where it came from. And before I let you speak, Supervisor Melgar would like to say some things.

Thank you. I couldn't pass up the opportunity. I believe this commendation is because of your work on the earthquake commemoration. But I also just wanted to put in that all the other things that you do that people don't see behind the scenes, bringing people together, building community, engaging in gossip, occasionally, especially political gossip, Saturday lunches at St. John's Grill, and all the things that you do behind the scenes to make our city better, a better place, a more vibrant place, a more connected place. So thank you for being such a mensch. Thank you for your support of everything civic for many, many decades. I agree with President Mandelman. You are a true gem, and you have friends here supporting you to prove it. Thank you so much, Lee.

We had a couple of friends here. The floor is yours. And a few of you have passed around some rather vicious gossip at the Willie Brown table and then told people you heard it from Willie. which he gladly accepted. When I first moved here, I moved to North Beach. And it about killed me, all of those nightclubs, all that fun. And I had just come up from working in the music business for a long time, so it seemed a natural. And then I ran into Karen Sapienza, who told me there's a whole lot more to San Francisco than North Beach. She introduced me to her father and Leo Sapienza, who was the president or treasurer of just about every organization in those days, mainly mail, where they could escape and go drinking with some purpose in mind. And in the purpose of the South of Market Boys, it was to make some money at a dinner and then put a, uh, a wreath up. And in those days there were many, many, many survivors. My job for the first 19 years was to go and visit with, I probably visited with for good long times with, uh, as many as a hundred or more, uh, people who were well over 100. Some of them, there's 109, and we had one who was 119. And to hear their stories, and I have to make a difficult decision about who I would offer up to the press. It's just a heck of a good story for everybody to talk about our roots. There wasn't a one of them that wasn't the best speaker I ever heard. And so over the years, we had hundreds of survivors. So coming to that point, which you pointed out about there's no more survivors anymore, there was some talk. about using Carl, but too many people know him and know how old he is, so we didn't use him. I understand that this is a rare occasion, and I am very honored to be able to. And thank you, Rafi. Thank you, Supervisor. Thank you all for honoring me in person in your home. I appreciate it very much. I get flowers. I said they're not going to give me flowers.

Thank you.

All right, so that would take us to our 3 PM special orders. Our first would be item number 51. But as the agenda indicates, the project sponsor withdrew their project application for 1200 Larkin Street. And the planning department has rescinded their associated approval letter. And that means this matter is now moot and is no longer under the jurisdiction of the Board of Supervisors. So we will not be holding that hearing, and nor will we be able to take public comment since the matter is no longer before us. The hearing was only agendized because the public hearing notice was sent before the application had been withdrawn. So, Madam Clerk, let's call our next special order, item number 52.

Item number 52 is a hearing of the Board of Supervisors sitting as a committee of the whole to examine the potential consequences of Kaiser Permanente's proposals and collective bargaining with the National Union of Healthcare Workers for San Francisco residents and employees of the City and County of San Francisco who are Kaiser enrollees for behavioral health clinicians employed by Kaiser and for standards of behavioral healthcare professional practice.

Colleagues, we are now sitting as a committee of the whole to examine the potential consequences of Kaiser Permanente's proposals and collective bargaining with the National Union of Health Care Workers. We have various individuals from NUHW here to present today. Supervisor Chen, this is your hearing. So I'm handing it over to you.

Thank you, Board President. Colleagues, behavioral and mental health care is too important to take for granted. Today, I'm calling a hearing to provide public oversight to the potential consequences of Kaiser's proposals in collective bargaining with the National Union of Health Care Workers. This negotiation will have an undue impact on city residents and employees of the city and county who are Kaiser enrollees. and for behavioral health conditions employed by Kaiser. Today's hearing will also consider standards of behavioral health care professional practice. I want to thank my co-sponsors for this hearing, Board President Mandelman and Supervisor Walton and Malga. I originally called for this hearing after hearing from multiple constituents, including Kaiser patients and Kaiser nurses, about proposals made by Kaiser in their bargaining that have the potential to greatly undermine the quality of care that patients are entitled to, create unfair hardship for workers, and undermine health care standards that were put in place years ago. I know that representative from unions will get into this for more in details, but I specifically want to call out that I have heard allegations that Kaiser is using AI or machine learning to replace clinical judgment. I find this absolutely unacceptable. Mental and behavioral health are incredibly complex for patients experiencing them. And even our best and most robust healthcare systems can be extremely difficult to navigate, especially when someone is in crisis. The idea that we would allow AI to provide clinical treatment or triage for patients is shocking. And I have serious concern that without adequate protective language around emerging technology, we could at best make the patient's mental and behavioral health more acute or at worst, inevitably be responsible for driving someone to Christ. I'm not against technology, but without meaningful data, evidence, and clinical validation that emerging technology is ready for the kinds of work that is allegedly being employed through Kaiser, we are rising in putting patients in harm's way. Yesterday, a complaint was filed by NUHW with the California Department of Managed Health Care and the US Department of Labor, alleging that Kaiser's automated e-visit portal for behavioral health makes recommendations without licensed clinicians review. This is the kind of things I don't believe AI or machine learning are able to do at this moment. AI and other machine learning emerging technologies are not obligated to patient care or wellness. They do not take a hypocritical oath. They are not subject to standardized regulations, tests, or oversights. If someone is seeking out their health care provider to inquire about behavioral health treatment, and they deserve a minimum to be assessed by a licensed clinician on intake. Before we begin, I'm shocked and very disappointed by Kaiser's unwillingness to participate in today's hearing, especially in light of this new complaint. Participation in hearings such as this are an important tool that the board uses to empower the public on key issues of concern. Mental wellness is incredibly important, and how we are taking care of our patients and workers, especially with emerging technology, is more important now than ever. I'm grateful to the members of NUHW, CNA, and other experts are taking time out of their busy day to be here and to educate the public in good faith. With that, I would like to call up Sal Rosali, President Emeritus, National Union of Healthcare Workers, to kick us off.

Should we have Supervisor Walton, I believe, is in the queue first, though.

Thank you so much, President Matherman. And I just wanted to add emphasis to Supervisor Chen's statement around Kaiser not showing up This afternoon, I think it is extremely disrespectful that Kaiser is not here, not just for the fact that fair bargaining practices should be basic for an employer, but when this Board of Supervisors makes a request for an employer to attend a hearing, they most certainly should make sure that they are in attendance. So I just wanted to emphasize how disrespectful that is, that Kaiser has done that, And they need to take note that we know that is disrespectful. Thank you, President Manaman. Thank you, Supervisor Walton.

Supervisor Wong.

Colleagues, as a former hospital union organizer, I believe workers deserve a fair voice at the bargaining table. But this issue goes beyond labor relations. It is also about keeping San Francisco safe, stable, and functioning. Families expect that when a loved one needs behavioral health care, a trained professional will be available before a manageable problem becomes an emergency. When treatment is delayed or interrupted, families are left struggling and situations that should be handled in a clinician's office can instead end in an emergency room, a 911 call or a response from police and firefighters. Maintaining an experienced clinical workforce is therefore not simply a union issue. It is practical public safety, responsible management and better use of our emergency resources. Kaiser serves many San Franciscans, including thousands of city employees. I was born at Kaiser Geary. I urge Kaiser to bargain good faith and reach a fair, sustainable agreement that keeps qualified clinicians on the job, protects continuity of care, and addresses behavioral health needs before they become crises. That is good for workers, good for patients, and good for public safety. Thank you.

President Rosselli.

And I'd just like to first thank Supervisor Cheyenne Chen for calling for this hearing, President Melderman, Supervisor Melgar, Supervisor Walton, thank you for cosponsoring it, and all of you for your ongoing commitment to ensuring that all San Francisco residents and city employees have access to timely, appropriate behavioral healthcare services. No city has taken stronger action over the years to hold Kaiser Permanente accountable for its repeated mental health access and parity violations, and to support clinicians in their fight for the time, resources, and respect that they need to best serve the people of San Francisco. This hearing comes at a pivotal moment, as reported in today's San Francisco Standard, when Kaiser is proposing to exploit new technology to save money and avoid accountability, rather than finally providing the behavioral health care that patients need and that they, their employers, and San Francisco taxpayers are paying for them to receive. Our members stand ready to work constructively with KP management to make Kaiser the best place to give and receive behavioral health care. I still believe there's a lot we can accomplish together, but we'll never make progress as long as Kaiser's intent in trying to silence us and replace us. Thank you again for holding this hearing and for your commitment to achieve real mental health parity, real behavioral health, health care parity. NUHW's legislative public policy director is going to speak next, Benjamin Eichardt.

Good afternoon, President, supervisors, and members of the public. My name is Benjamin Eichert. I'm the policy director for the National Union of Healthcare Workers, representing the 2,400 psychologists, licensed clinical social workers, marriage and family therapists, and other behavioral health professionals who care for Kaiser Permanente patients throughout Northern California. Thank you for holding this hearing. This is not the first time we've been here. In 2022, this board held a similar hearing in the midst of a 10-week strike during which Kaiser was found to have canceled more than 100,000 therapy appointments region-wide. That strike itself came after multiple prior strikes going back more than a decade and multiple rounds of state sanctions against Kaiser's behavioral health services dating all the way back to 2013, which included the imposition of an outside monitor for three years. With your support in 2022, NUHW clinicians won more time for patient care duties that can't be done during appointments, like responding to patient calls and tailoring treatment plans. They also won a voice in the model of care. So after nearly two decades of deficiencies and labor strife, it seemed like Kaiser was ready to begin repairing its relationship with behavioral health clinicians. Unfortunately, it ended almost as quickly as it began. Since we settled that contract in 2022, Kaiser has been assessed $231 million in state and federal penalties as part of two separate investigations. In a 2023 settlement with the California Department of Managed Health Care, which included a $50 million fine, Kaiser acknowledged that it lacks sufficient behavioral health providers and that, quote, this lack of clinical staff has resulted in excessive wait times for enrollee individual therapy appointments. Three years later, the Department of Labor ordered Kaiser to reimburse patients more than $28 million for out-of-pocket mental health care costs incurred because Kaiser didn't provide them the services that they paid for and were entitled to receive. These penalties may seem severe, but for Kaiser, they're a drop in the bucket. Last year, Kaiser reported profits of $9.3 billion. And by year's end, it held nearly $73 billion in reserves of cash and investments. Yet despite these massive financial resources, Kaiser executives backtracked on their commitment to work with clinicians to improve behavioral health care. The 2022 contract included labor management model of care committees that made recommendations on improving care. Now, Kaiser has stopped funding the recommendations of those committees, which they had contractually committed to do. At the very same time that Kaiser entered into its $200 million settlement agreement with state officials, it started using questionnaires and scoring algorithms administered by call center operators and online tools rather than licensed behavioral health clinicians to screen patients who are seeking therapy for the first time. Human engagement and judgment have been removed from this critical point in the process of intake and assessment and initially assigning patients to a care pathway. Despite all this, NUHW clinicians are simply seeking a contract with Kaiser that reaffirms the improvements we've begun together to make things better for patients. Unfortunately, since negotiations started over a year ago, Kaiser proposed reversing the most important gains therapists have made. Kaiser has also proposed what clinicians are calling the Terrible Three. These three extreme demands would degrade the standard of care for patients and set a dangerous course for the future of behavioral health services throughout the region and the state, a course that other insurers and providers will likely emulate to try to save money. The first demand involves artificial intelligence. In its Southern California contract with NUHW members signed last year, Kaiser agreed that the use of new technologies, including AI, quote, is not to replace but to assist bargaining unit employees in providing safe, therapeutic, and effective patient care and support. But now Kaiser is refusing to agree to that language in Northern California, just as it has begun replacing therapists with technology to triage patients seeking care. To mask its intentions, Kaiser's promoting an AI committee. But the committee would have no power at all. Kaiser could veto the union's appointments to it and ignore the committee's recommendations. Their second demand makes a mockery of Kaiser's stated commitment to an integrated model of care, where therapists can work closely with doctors and other caregivers under a unified clinical management structure. Instead, Kaiser is proposing to eliminate contract language, committing that the use of subcontracted therapists, quote, will not result in the elimination, end quote, of employed clinicians. They've even proposed the details of severance packages for clinicians who would be laid off. This would give Kaiser a green light to subcontract an even larger volume of behavioral health services to independent providers performing gig work on mental health platforms. These therapists can't easily communicate with the rest of Kaiser's care team, leaving behavioral health care as a separate and inferior service segregated from the promise of Kaiser's integrated health care system. Kaiser's proposal wouldn't just degrade care for Kaiser patients, it would degrade pay and benefit standards for clinicians, including those outside of Kaiser who have no voice through a union and work at the mercy of insurers, employers, and platforms whose only goal is to keep clinician reimbursements as low as possible to maximize their own profits. The third provision would hand Kaiser total control to determine how care is provided. For the first time, Kaiser is demanding a provision in the contract stating that Kaiser has the sole discretion to quote, determine or modify the behavioral health operating and clinical models of care. This would force therapists to surrender the clinical autonomy they need to do their jobs in compliance with professional standards and state law, and it would invite other major insurers and employers to demand the same of their clinicians. Kaiser's stated excuse for making this demand is that mental health professionals in Southern California agreed to it last year. But what Kaiser doesn't say is that it proposed that provision deep into a nearly seven-month strike and that workers very reluctantly agreed to it as part of a painful compromise to end that bitter struggle. Kaiser's terrible three demands show that instead of working with clinicians to improve care, Kaiser wants to silence clinicians and avoid accountability. And the proposals Kaiser is making at the bargaining table have consequences that extend far beyond one employer. If Kaiser succeeds in silencing its clinicians while moving full steam ahead to outsource care and push patients onto AI platforms, other insurers and employers will have every incentive to pursue similar changes. That would degrade the quality of behavioral healthcare in San Francisco and across California. The Board of Supervisors has consistently stood for equitable access to care, strong public health systems, and responsible corporate conduct. Opposing Kaiser's terrible three proposals is consistent with your values. It would send a clear message that San Francisco expects its largest private insurer to strengthen and not weaken behavioral health care. It would tell Kaiser that innovation should support clinicians rather than replace them, and that integrated care should be more than a marketing strategy. Most importantly, it would tell thousands of Kaiser patients that their city stands with them and those who provide their care to demand accountability from their powerful and well-endowed HMO. Thank you for your time, your leadership, and your commitment to protecting access to quality mental health care for the people of San Francisco and throughout California. Next, you're going to hear from three therapists at Kaiser. who are members of NUHW, Alana Marcucci-Morris, Molly Parsons, and Tiana Loy.

ALANA MARCUCI- Good afternoon. My name is Alana Marcucci Morris, and I am a licensed clinical social worker and therapist at Kaiser Permanente in Oakland Adult Psychiatry. I also serve on my union's bargaining committee. For most of my seven years at Kaiser, I worked as a triage clinician. When someone called seeking mental health or addiction medicine services, whether they lived in San Francisco or Stockton, the first person at Kaiser they talked to would be someone like me, a licensed human therapist with specialized training to assess their condition and their treatment needs. A triage screening is about determining risk and how urgent someone's treatment needs are. Is this person a threat to themselves or their loved ones? Or can they wait 10 days for an intake appointment? Do they need immediate intervention or a wellness check? We make these determinations using our clinical judgment and our own humanity. We ask follow-up questions. We listen to not only what they say, but what they don't say or how they say it. We observe their tone, their consistency, and listen for cues that indicate higher risk or warrant immediate intervention. This is the accepted standard for how triage should work in mental health care. But it's now the exception and no longer the norm at Kaiser. Instead of being able to count on human licensed therapists to assess and decide the best first steps for their treatment, relying on our extensive training, professional judgment, and many years of experience conducting risk assessments, Kaiser patients reaching out for our services now rely on the initial phase of their care being decided by questionnaires that are either read by telephone operators or self-administered online. Their answers are fed into algorithms that instantly decide if a patient qualifies for therapy, a class, an online coaching program, or no care at all. We have filed complaints against this practice, which started in 2023. Kaiser has refused to confirm whether the digital algorithms are generated by artificial intelligence, but their use clearly violates California law requiring triage assessments to be provided by a, quote, physician, registered nurse, or other qualified health professional acting within their scope of practice and who is trained to screen or triage an enrollee who may need care." Kaiser isn't just violating the law by having new technology do the work of its human clinicians. It's violating patient care standards and putting patients at risk. Artificial intelligence and algorithms don't capture what trained humans can. A common symptom of depression, for example, is to minimize your symptoms. When making determinations based exclusively on patient reporting, an algorithm may deem a patient with a more severe condition as only having a mild or less significant symptoms. I see this all the time since Kaiser started using telephone operators and algorithms to screen patients seeking care. So as that work was reduced, my current job, what I do more of these days, is predominantly conducting scheduled intake assessments with people after they've been, quote, triaged by an unlicensed operator or an e-visit on the Kaiser app, typically around two weeks later. The acuity and critical nature of symptoms I am seeing has increased significantly because the app, AI, an algorithm, or an unlicensed telephone operator incorrectly determined that they could wait 10 days to see me. Or they perhaps waited even longer because they were inappropriately booked elsewhere and now I have to fix their care plan. I have watched patients withdraw from substances on camera because nobody told them to go to the ER or consult a physician sooner. Apologizing to patients during an inappropriately booked intake appointment because they expected to be seen by a psychiatrist capable of refilling their critical medication has become a routine part of my days. As a member of our union's bargaining team, I didn't think new technologies like artificial intelligence and algorithms were going to be a major issue in our negotiations. Last year, our counterparts who provide behavioral health care for Kaiser in Southern California settled a contract with language stating the intention of new technologies was to support therapists, not replace us. So we were stunned when Kaiser rejected that exact language for us here in Northern California. We asked their bargaining team flat out if that meant they were planning to replace us, and they said that they wanted that flexibility. I believe Kaiser can't promise not to replace us with AI in our contract because it is already doing it. It is already using new technology to take work away from us human licensed therapists, and it wants to be able to replace us altogether. Kaiser has never truly understood mental health care. The relationship between the therapist and the patient is an integral part of our treatment. Our patients aren't coming to us with broken bones. You can't fix depression with a screw and a nail. This is inherently human work, and we have to use our humanity. I use my human empathy to help patients heal, and I use my human anxiety to keep my patients alive. When my anxiety goes off my internal meter that this patient needs a little bit more of my attention to stay safe, that gives me the chance to lean into their care when those risk factors pile up. As a human, I am also accountable. I can lose my license if I commit malpractice. Will software developers or billion-dollar health plans be held accountable when technology makes a fatal error? I do not see AI being used for good where I work. I see it making dangerous patient care errors. I see it reinforcing racial and gender bias. Yet Kaiser is proposing to increase its ability to lay off therapists and outsource more patients to third-party companies that use chatbot coaching, chat-based therapy, and other innovative behavioral health apps in order to reduce its need for human labor. This isn't about genuine innovation. It's about saving a buck at the expense of patient care and public health. If we don't stop them now, we won't stand a chance down the road. Thank you.

MOLLY PARSONS- Hello, everybody. My name is Molly Parsons. I am a therapist at Kaiser, and I have been for five years. But I also have a private practice where I work with an agency or a third-party contractor and non-Kaiser patients. So my agency that I work for is similar to those that Kaiser wants to outsource care to for as many mental health, behavioral health patients as it chooses, even if that means laying off staff therapists like myself. Now, if you've ever seen a Kaiser advertisement, and they're hard to avoid, you know that Kaiser touts its integrated health care system. All of your providers are under one roof, communicating and coordinating care for you seamlessly. And in fairness, that model, that integrated health care system, is an excellent model. That's why I can't really understand why Kaiser wants to segregate behavioral health from it and treat it as a second-class service. Within Kaiser, I communicate with other care providers to let them know about what is going on with a mutual patient, to nudge them when they've dropped the ball or vice versa, frankly, and to advocate for the needs of clients. I can see what is physically impacting patients, if they've been hospitalized or admitted to the ER, and any test results. I can see what appointments they've attended or those that they've missed. And knowing all of this information helps me provide better resources for each client and helps me better prepare for each session. The opposite is true when I'm seeing patients through third-party contractors. When I open their charts, I don't see any notes from their physicians. I don't know what is happening with them physically or medically. Typically, clients use these third-party contractors for therapy only, and they even get psychiatrist care elsewhere. If I have concerns about physical or medical issues, it's difficult to connect with the other care providers, and so often there isn't any consultation. Outside therapists cannot even prescribe time off work or give accommodations if those are needed. So there's something else to understand about referring people outside of Kaiser. Nearly all of the appointments with Kaiser's third party behavioral health contractors are telehealth. And that doesn't work for a lot of people, like older adults, younger kids, and those who don't have a safe space to take a call from. These issues are part of the reason many Kaiser patients who have been referred to a third-party contractor end up returning to Kaiser. People's conditions often get worse when they've bounced back and forth between Kaiser and external providers. The shuffling among multiple clinicians inhibits the therapeutic alliance and disrupts the continuity of care. What's more, when they return to Kaiser from outside treatment, it's harder for us to meet their needs, because our schedules are so full, we can't see them as quickly as they need to be seen, and we can't give them the frequency that they need. They are stuck, then, choosing between more frequent therapy with an external provider without the integrated model they signed up for and pay for, or to be seen less frequently than they need. One of the most frustrating aspects of the third-party contractors is they see the easy clients with mild issues, those that likely could be seen less frequently, but they are the people who can actually see clients weekly, the third-party contractors are. Kaiser keeps all the severe and high-needs clients to, quote-unquote, monitor them, but tell me, how can I monitor my high-needs clients when I don't have any open appointments? One of the deficiencies Kaiser was cited for as part of the 200 million state settlement agreement was not adequately monitoring its external provider networks. I've been seen as a client myself through these external provider networks, and I can attest to my negative experience. I've had a therapist not show up multiple times, not focus on the issues that I've raised. I've asked for specific types of therapy and been assigned to therapists, and when I meet them, they don't provide that at all. Now, Kaiser wants to be able to rely on external provider networks entirely and lay off its staff therapists. Kaiser's hypocrisy is maddening. In public, it says, join us and you'll get the benefits of integrated health care. But in private contract negotiations, Kaiser tells us that mental health isn't important enough to remain part of its integrated health care system. Look at the big picture. Kaiser has $73 billion in reserves, and it has racked up $231 million in penalties for mental health violations over the past three years alone. Yet one of the main reasons we don't have a contract over a year of negotiations is that Kaiser is insisting on being able to provide a lesser standard of care to behavioral health patients. And the changes it wants to make completely contradict how Kaiser markets itself to the patients we serve. Make it make sense to me. What Kaiser is proposing wouldn't just be bad for Kaiser patients, it would be bad for behavioral health care in San Francisco and California. Kaiser's proposal would further encourage other HMOs and provider groups to treat behavioral health as a separate and therefore lesser service, and follow Kaiser in taking steps to lower their costs and replace human care with technology. At a moment when insurers are already cutting reimbursement rates for mental health therapy, Kaiser's proposal would drive even more California therapists to forego insurance and only see patients who can pay out of pocket. Kaiser clearly wants to radically downsize its behavioral health workforce and rely more on apps and external vendors. We want Kaiser to provide good care and good jobs, just like their ads say they will. Thank you.

Before the next speaker, I would like to tell members of the public there is a prohibition on audible sounds of support or opposition outside of our commendation period. So if you would like to show your support, please use your hands. Thank you.

My name is Tiana Loy and I'm a therapist for Kaiser here in San Francisco. I started late last year to be part of a new LGBTQ plus treatment track. Last month I told management that I was leaving Kaiser because the track had not yet materialized and I wasn't treating the people I knew that I could best serve. But I'm still here because, to my shock, management responded by finally getting the LGBTQ plus track up and running. I'm giving it a shot, but there are still really big problems. So to start, we don't have enough staff or clinical autonomy to do our best for patients, and there is absolutely no excuse for this. Instead of seeing people every two weeks as required by state law, my patients, on average, if they're lucky, have to wait three to four weeks between appointments. There have been times when a client has reached out to me saying, I've had a loved one pass away. Do you have an appointment? Can I be seen sooner? And I have to say no. Other times I've had last minute intake appointments with patients who are higher risk and need to be seen weekly, but I can't see them for three weeks because I don't have any appointments. Kaiser's model of care flat out does not work. It often takes patients a month between when they are first screened for treatment and when they actually start treatment with their Kaiser therapist. By the time they come to us, their symptoms are often worse and they're upset over how they've been treated and that they're going to have to wait another few weeks to be seen again. And so the cycle continues. The screening process itself has been degraded. Now that Kaiser uses telephone operators and AI algorithms to screen patients, there is no method for them to request preferences in a therapist that may influence treatment such as cultural background or gender identity. I've had LGBTQ plus patients tell me they've waited forever to find a clinician with my background and that they were going to forego treatment if they did not come to someone like me. When patients are essentially told, here is your option, take it or leave it, that is not ethical, and that is not good clinical care, not at all. Kaiser's model doesn't just shortchange patients on their way into the system. There's a term we have called Kaiserize. So Kaiser takes evidence-based treatments and offers patients less than a clinical standard. So for example, a 90-minute session becomes a 60-minute session at Kaiser. A program that requires 12 sessions to graduate becomes an eight-session program at Kaiser. Kaiser's model is to keep putting less Cheerios in the box and hope that no one notices. Denying us a voice in the model of care would help ensure no, sorry, would help Kaiser ensure no one ever notices. Kaiser's approach to behavioral health care boils down to this. Keep staffing low and make everyone do nonstop work. In previous jobs I've held, I'd have about 20 to 25 clients per week. But at Kaiser, I'm expected to see 31 patients per week. There is almost never enough time for chart review preparation, clinical documentation, and follow-up care coordination and consultations. If I have a cancellation on my schedule, I have time to pee and drink water, if I'm lucky. But then, typically, I'm immediately booked at the last minute, usually with a high-acuity patient, and almost never enough time to review their charts. Kaiser wants maximum productivity, but we're not making widgets. We're helping people confront devastating trauma and discuss their most private thoughts. We need to be 100% present. But is my last patient of the day getting as much as me as my first patient? My only hope in trying to stay with Kaiser is that we're bargaining for a new contract and that we can make things better. But Kaiser wants to make things worse. They want to be able to put patients into the precious hour or so of protective time I get every day to prepare for appointments and then frantically respond to patient calls and emails, finish making notes and patient charts, and call social service agencies. If Kaiser prevails in contract negotiations, I won't be able to do this job anymore. There would be no break whatsoever just to breathe. It would be physically, mentally, and emotionally impossible to do the job because we're already stretched so thin. It's one thing to work frantically, knowing that your work is making a difference, but it's intolerable when you know that as fast and as hard as you work, it's not enough for the people who depend on you. When I see patients only once a month, it's hard to build rapport. It feels like each time you meet, you're starting over. It's terrible for patients. They get frustrated. Sometimes they get into crisis and need a higher level of care. We all know that Kaiser has a problem when it comes to behavioral health care. The question is, how do we solve it? Kaiser thinks that only management control can fix the problem, but they don't know what the real problem is. They think the problem is that they're getting fined and penalized, and the solution is to silence those of us who blow the whistle on them. So for clinicians like me, the goal is not to help Kaiser stay out of trouble with state and federal regulators. Our goal is to help our patients to the best of our ability. We can't do that if we have no say in Kaiser's model of care. Do you really trust that Kaiser management alone can fix this problem? Because after a year at Kaiser, I certainly don't. Thank you.

Thank you, all the presenters. Before we go to questions, let's call up all the presentations. Can we have Dr. Jasmine Smith, Associate Executive Director of the National Association of Social Workers, California chapters up. And then after Dr. Smith, let's have Dr. Linda Michaels, Chair of the Cell Therapy Action Network. Dr. Smith.

Good afternoon, President, Chair, and Supervisors. Thank you for the opportunity to join the discussion today. My name is Dr. Jasmine Smith. I'm a Doctor of Social Work and Licensed Clinical Social Worker and the Associate Executive Director of the National Association of Social Workers California Chapter, where I lead statewide professional development, policy advocacy, and legislative initiatives that strengthen behavioral health workforce and represent more than 9,000 professional and student social workers supporting vulnerable communities. Social workers are guided by the NASW Code of Ethics, grounded in the principles of service, social justice, dignity and worth of the person, the importance of human relationships, integrity and competence. They are ethical obligations that guide every clinical decision we make and every relationship that we build with those we serve. Additionally, as registered associates and licensed professionals, we are also held accountable to the California Board of Behavioral Sciences to provide competent, appropriate care consistent with our ethical and legal responsibilities. However, many of our members employed by Kaiser have reported that they felt systemic barriers directly impacted their ability to adhere to the code of ethics. First, behavioral health screenings are typically a client's first interaction in seeking mental health care. And it is crucial that they are met with an ethically and culturally competent provider who can not only provide the empathy and warmth required to authentically build rapport, aid the client in sharing their concerns and symptoms. The licensed clinician conducting the assessment has the expertise and knowledge to recognize the subtle signs of crisis, trauma, or escalating risk that may not be obvious in a scripted conversation. It is deeply concerning to learn that Kaiser Permanente has replaced licensed behavioral health professionals with unlicensed staff and algorithmically directed screening tools during the initial intake process since January 2024. The call center operators who apply these tools are not qualified to recognize risk factors, exercise professional judgment, and determine the appropriate level and urgency of care. Additionally, Kaiser has refused to answer whether its screening tools rely in any way on artificial intelligence. AI can only reflect the data that it is trained on, and we know that healthcare data reflects longstanding inequities. Researchers, including Dr. Tierra Tanksley, has recently highlighted how AI can reinforce existing disparities when historical bias is built into the data used to develop these tools. A 2022 study found that a machine learning system algorithm caused black patients to experience 33% longer wait times because it relied on factors that were closely tied to race. And more recently, in 2024, a systemic review found that racial disparities in healthcare AI are driven by biased data sets, historical inequities, algorithm design, and the way these systems are implemented. Kaiser Permanente plans to expand the use of AI algorithms in behavioral health screening and treatment. but when they are doing that, these studies cannot be ignored. Decisions about how quickly someone receives treatment or what level of care they need should not be influenced by technology that reinforces existing disparities. AI can be a helpful tool to support administrative tasks or assist clinicians, but it should never replace the professional judgment of licensed behavioral health providers, especially when patients are seeking help during moments of crisis. Kaiser's actions put it out of compliance with the California's requirement under the Health and Safety Code Section 1367.03, which directs that behavioral health services must be assessed and referred by licensed behavioral health providers. These behavioral health assessments simply cannot be reduced to scripted questions or algorithms because they set the foundation for treatment, and getting them wrong can have serious consequences for patient safety. While Kaiser may claim that there are benefits from this change, since January of 2025, therapists have documented more than 70 examples of negative patient care outcomes associated with these new screening processes, such that patients determined to be high risk experience longer wait times of more than one week to initiate services, again, jeopardizing their safety. I would also like to address the concern of provider burnout in relation to client care. A 2025 study found that high levels of burnout among mental health professionals often caused them to lead to increased staff turnover, causing a ripple effect in which remaining staff members take on heavier caseloads. leading to further burnout and exasperating the cycle of staff departures. This creates an unhealthy environment in which insufficient resources are there to meet patient needs, causing the providers to have less time to dedicate to each patient, less individualized patient care, and in addition to the reduced time for patient interactions, burnout has been associated with decreased productivity and lower quality of work. But most importantly, it undermines the therapeutic relationship as it impacts the client's entombment with their clients and ability to engage with empathy. We have also heard from our members as they have shared the overwhelming burden of not only having enough time to decompress and process between patients. One noted that they have made multiple errors with clients as they cannot be entirely present due to their work overload. Another noted that they see six to eight clients a day and end up working an additional unpaid three hours after a scheduled eight-hour day every single day of their shift, just to ensure that they're meeting their productivity quotas in fear of termination or retaliation. Lastly, one shared that they cannot feasibly provide clients the care they need outside of their appointment time because they struggle with the reality that their clients may not be seen for another month, as their schedule is constantly filled regardless of the appropriate or acuity of the symptoms. While increasing appointment values may appear efficient, Reducing protected time for patient care support outside of appointments limits clinicians' ability to provide thoughtful, coordinated, and comprehensive care. Finally, we are deeply concerned about Kaiser Permanente's increasing reliance on subcontracted behavioral health providers through digital platforms such as Grow Therapy, Headway, NOCD, OpenMind, Rula, SounderMind, and Uplift. Our members have shared that when a patient's regular clinician is temporarily unavailable, they are often redirected to an outside provider instead of returning to their established therapist. These disruptions can make it harder for patients to maintain consistent care and rebuild trust with a new provider, which is especially challenging in behavioral health where the therapeutic relationship is central to treatment. This is especially concerning as Kaiser has long promoted an integrated model of care where behavioral health providers work together across disciplines to support patients. However, our social workers have shared concerns that their experience, recommendations, and clinical perspectives are not being meaningfully considered when decisions are made about how care is delivered. They describe situations where they are directed to follow workflows, treatment timelines, referral processes that do not align with their professional judgment, including pressure to end treatment before patients were ready, keep patients in programs that did not fully meet their needs, or delay referrals for higher level of care even when needed. These experiences highlight why it is important that social workers have a meaningful voice in shaping the systems and policies that directly impact patient care. Patients deserve timely access to licensed clinicians, and providers deserve the time necessary to deliver ethical and effective care. And technology should enhance health care rather than replace the expertise in human connection. For all these reasons, the NASW California urges Kaiser Permanente to withdraw its terrible three contract proposals and realign their practices with ethical care by investing in licensed behavioral health professionals, preserving integrated care, protecting clinicians' ability to provide quality care, and ensuring that technology is implemented in ways that advance equity rather than deepening existing disparities. We ask that you join us in this call upon Kaiser, and we thank you for your time.

Okay, great, thank you. Thank you very much for your interest in these issues. I'm here to talk about them from the standpoint of the evidence base of how and why psychotherapy works and to share some research findings that are relevant to the Kaiser proposal.

Okay.

OK, there we go. I'm a licensed clinical psychologist. I'm in private practice in Chicago. I'm also the chair and co-founder of Psychotherapy Action Network, a nonprofit that advocates for the public's access to care and also for clinicians and the clinical standards needed to provide that care. We conduct a lot of our own research. We've produced a lot of publications from white papers to articles to a book, Advancing Psychotherapy for the Next Generation. And founded in 2017, we've grown substantially since then. I'm sorry, which... Okay, okay, gotcha, thanks. Okay, so what makes psychotherapy effective? It's the relationship. You've heard a lot about the alliance between the therapist and the patient. This has been studied for decades in many different forms of research, and the same conclusion is reached time and time again. This means the therapist must be able to assess, build, maintain, and adapt that alliance with each individual patient over time. When you mess with the alliance, you mess with what makes therapy work, and you mess with what makes therapy, therapy. Effective treatments must also be individualized, not standardized, for each patient, and they must be of sufficient depth and duration to ensure recovery. Each person is unique in terms of many factors, their diagnosis, their complexity, their personality, coexisting issues, trauma history, resources, identities, and more, and the care must be individualized to them. Helping people with issues like trauma, addiction, abuse, relationship stressors, it doesn't work like an antibiotic does where it's the same treatment for every body. When it comes to mental health, different people need different approaches and different models of care. Evidence-based standards of care show this as well. We have to treat underlying and chronic conditions. And when we talk about depth, we're talking about getting underneath those superficial symptoms. And when we talk about durations, we're talking about, for many people, 40, 50, or 75 sessions of care. This is the standard of care. So Kaiser's first proposal is to have sole discretion over the model of care. This directly interferes with what we've just discussed about how and why therapy works. This is messing with the alliance. Mandating a single standardized model of care contradicts the evidence base and the importance of the therapist to assess, treat, and adapt to each patient individually. One size fits all works for no one. With this proposal, I would predict that outcomes will worsen and people will not feel helped or understood and they will drop out of care. Secondly, Kaiser wants flexibility over substituting the work of licensed clinicians with AI and a refusal to maintain the language they agreed to in Southern California. This is very serious. This won't bode well for mental health outcomes either. It's really best to think of AI mental health tools as self-help. That's where they are today. They're self-help interactive guides, interactive journals. They are not an equivalent, let alone a replacement for psychotherapy by any means. So using more AI means giving people self-help tools. The safety risks are very high. I'm sure you have all heard in the press tragic cases of people dying by following the instructions of AI chatbots and the biases and stigmatized information that's inherent in the large language models. No long-term studies exist to show whether AI-enabled treatments even work. And several states, including mine, Illinois, have already restricted AI for these reasons to a support role only, which is where I think it needs to be. And these tools also need to be regulated by the government, by the FDA, just like any other medical intervention. I'm not going to go through all of these, but I just want to show this slide, the risks of trying to replace psychotherapy with AI. The list is long, and there's a lot of serious items on this list. As far as outsourcing without restriction, Kaiser wants the flexibility to outsource psychotherapy to outside providers, which is very concerning in terms of that therapeutic alliance as well as clinician autonomy and job satisfaction. Sending patients to other clinicians directly severs the alliance. This will compromise treatment outcomes, dissatisfy patients, dissatisfy therapists, and increase patient dropout rates. This is messing with the alliance. While this may save Kaiser money in the short term, it's a very costly long-term strategy. When people get effective psychotherapy, they actually have fewer ER crises and ER visits, lower hospitalizations, and actually lower overall medical spending. They take better care of their mental and physical health. The entities that Kaiser wants to outsource to are particularly problematic. There's already research and studies out there showing that these platforms have significant problems in a variety of areas, from treatment efficacy to therapist satisfaction and confidence in the platforms, patient privacy, transparency, and more. Here's a bit more detail on these problems. This is from a research study that we conducted and published last year on these platforms. Privacy problems. These companies don't adequately protect patient information. This is the foundation of care. Their investors are big tech firms, and they outsource to AI companies, and there's a lot of data sharing and AI training going on. Lack of transparency regarding really basic things such as who owns these companies? Who are the major investors? How are therapists even paid? These are questions that therapists who use these platforms currently do not know the answer to. And there are a series of policies that many of these platforms have which really are adding up to trying to replace actual psychotherapy with mere crisis management. regarding Kaiser's desire to no longer protect the full meaning of clinical care, Clinical time includes not just the face-to-face meeting with the patient. There's a lot of consultation, collaboration, and coordination with other therapists. If you're seeing a couple or a family, you have to interact with the other therapist seeing the other part of the couple, the parents, the kids, psychiatrists. There may be medical doctors involved if there are serious medical issues going on. These tasks are just part of care, and they take time. If new intakes are scheduled into this block of time, this is actually quite bad for those new patients, because they're unlikely to be seen again any time soon, and it's also not good for Kaiser. They will be creating a system that just gives an illusion of access without any real meaningful access to care. For therapists, having basic autonomy over their own schedule is a documented protective factor against burnout. Burnout is a direct precursor of turnover, and turnover, as you know, would be exceedingly expensive for Kaiser. It's also really costly for patients. When their therapist leaves, most of them drop out of treatment altogether. Kaiser's proposals taken together will undermine the very factors that make psychotherapy effective and even possible. And there will be negative results and high costs to clinicians, to patients, and even to Kaiser itself. I strongly urge the board to reject the Kaiser proposals and support clinicians and the therapeutic alliance and what we know makes for effective care. If you said we're going to assess and diagnose by a robot and then give the same treatment to everyone regardless of how they respond to it over time and mess with the very thing that makes therapy effective, you know this sounds like a terrible idea. So please, I urge you to stand up for the principles of effective evidence-based care and what we know as far as what works for clinicians and patients. Thank you very much.

Thank you, Dr. Michaels. And let's have our last presenter, Sidney Simpson, registered nurse, Kaiser San Francisco, member of CNA.

Good evening, supervisors. My name is Sydney Simpson. I'm a member of the California Nurses Association. I work as a registered nurse at Kaiser San Francisco in interventional radiology. My siblings from NUHW have highlighted the dangers of unregulated AI in our health care system. I just want to kind of build on that and talk about it from our perspective, the nurse perspective, and how it all sort of fits together. into a really dangerous pattern of decisions being made by Kaiser that blatantly prioritizes profits over patient safety and quality of care. Since the Trump inauguration last year, we've seen Kaiser take an increasingly hostile approach towards their unionized nurses. Kaiser has committed large-scale wage theft against nurses and is refusing to remit owed retroactive payments. Kaiser in San Francisco and beyond is cutting many vacant RN and nurse practitioner positions, leaving our departments dangerously understaffed. Here in San Francisco, Kaiser has administered cuts to RN staffing and primary care and the emergency department, which of course are the main departments by which patients access care. These cuts have resulted in increased delays in care. I have personally seen Kaiser patients, including my own coworkers, struggle to access medically necessary care and actually leave the city or even the state to access that care. While Kaiser has fully launched its new virtual sitter program in which a remote monitored iPad is responsible for preventing patient falls on the inpatient side, the Kaiser San Francisco emergency department has seen a truly shocking increase in patient falls. Nurses have submitted petitions and written letters to Kaiser administrators requesting plans of corrective action to address the cuts to staffing and the subsequent impacts to patient safety. Kaiser refuses to disclose this information. Additionally, Kaiser's vast investments in untested AI signals an effort to divert funding from in-person caregivers to new untested technologies. Nurses are not against scientific or technological advancement, but we will not accept algorithms replacing expertise, experience, holistic, and hands-on approaches that we bring to patient care. If it's what you would demand for your family, that is all we are demanding for all of our patients. Kaiser's using algorithmic systems to quantify nursing workloads and patient acuity levels, which includes shift staffing decisions, RN to patient assignments. This often results in inappropriate nurse to patient ratios and unpredictable scheduling. Instead, patient acuity measurement should be based on an RN's clinical judgment and a hands-on assessment. Kaiser's also implemented a technology that they ironically called the CAST system. And yes, that is really the name of this technology. The tech scans a patient's chart and determines how much time the patient will receive for their pre-surgical screening appointment and whether they will have access to a doctor or a nurse practitioner. We have asked Kaiser repeatedly what specific information the CAST system robot uses to determine and ration that care, Kaiser refuses to disclose this information. CNA-represented nurse practitioners discovered that language translation needs of a patient are not factored into the appointment time of the CAS system. This is fundamentally discriminatory, as translation obviously takes time. Without increasing the length of appointment times for patients with translation needs, Kaiser therefore is providing such patients with less time in their pre-surgical screening appointments than that afforded to patients without translation needs. Kaiser has also accelerated the outsourcing of our patients' care to third-party facilities and entities that do not have the same oversight and union protections. Kaiser's pushing acute care patients out of the hospital and into the home through their Advanced Care at Home initiative. This program places cameras in the homes of acute care patients and replaces 24-hour nursing care with 24-hour surveillance. Kaiser has contracted non-union nurses to surveil these patients from remote and undisclosed locations. Kaiser is relieved of the obligation of cleaning, caring for, and comforting these patients, and this labor now falls solely onto the patient's family members. Our nurses are reporting that many of the patients placed in the advanced care at home program, we call this care all alone instead of advanced care at home. Our nurses are reporting that many of the patients placed in the advanced care at home program are being readmitted to the hospital due to premature discharge. and fractured continuity of care. In San Francisco, many surgical patients under Kaiser are sent to the SF Surgery Center, which is adorned with Kaiser Permanente signage, but it is in fact a distinct and very separate entity from Kaiser, and the nurses working there have no union protections. Nurses have requested information on the policies and procedures, the infection control protocols, and the patient inclusion and exclusion criteria for the SF Surgery Center. Kaiser refuses to disclose this information. CNA has received reports from nurses working at the SF surgery center that without union protection, they're fearful to speak up and advocate for patient safety. With their multi-billion dollar profits, Kaiser could easily expand staffing to extend the hours of both inpatient and outpatient operating rooms to meet the surgical needs of our patients. But Kaiser has refused such proposals and continues to contract out care and operations. So in closing, we call on Kaiser to do better and turn their rhetorical claims into action. With so many city workers and SF residents dependent on Kaiser's care, we appreciate this board working to ensure that the millions of dollars of public funds that are remitted to Kaiser annually are being spent back into the care of city workers and SF residents. Kaiser can demonstrate their commitment to improving patient care by, one, replace vacated positions. Two, increase staffing and patient care capacities. Three, insource outsourced work. And four, provide transparency and oversight of all new technologies. Our experience of Kaiser's increasingly blatant disregard for accepted standards of care, its inappropriate deployment of AI and other tech in place of human health care professionals, and its growing aggression towards its unionized workforce is parallel to that experience by NUHW members. CNA shares NUHW's assessment of the negative effects of Kaiser's terrible three bargaining demands, and we join NUHW in calling on Kaiser to withdraw them. We ask that SF Board of Supervisors support both unions in protecting patients from these attacks. Nurses know that Kaiser can serve our city better and stop using the city and county of San Francisco as a means to collect revenue for their private investment strategies. Rather, they need to invest their multi-billion dollar profits, much of it collected here in San Francisco, back into the care of our communities. Thank you.

Thank you, Sydney. Now let's go to questions. My first round of questions will go to Mr. Eicher. Would you come back to the podium, please? Mr. Eicher. Kaiser has long been known as a labor-friendly healthcare employer, and towards its history of labor management partnership, when and how did this go wrong in the specific case of behavioral healthcare? Most recently, How can it be that the model of care committees were abandoned and the therapists guaranteed a time for patient care support was also gutted after Kaiser had agreed to them as part of the 2022 strike settlement? Tell us what happened.

Thank you, Supervisor, for the question. I wish that I could give you a satisfying answer. I don't know why Kaiser has changed its attitude towards its employees. If they were here, maybe they would tell us, but they declined to come. But you heard just from the representative from the California Nurses Association that they have been taking an increasingly anti-union attitude toward their employees and the unions that their employees have chosen to represent them. We, as I mentioned in my testimony, We thought that the contract in Northern California in 2022 was a sign that things were going to improve, but it didn't last long, very shortly after that. Kaiser changed the way it started to treat its employees during this round of negotiations. As I said in my testimony, they have gone back on their commitment to fund the recommendations of the model of care committees. And I think that if you look at the model of care and the patient care support time issue, Kaiser's proposals are really just about squeezing more appointments into providers' schedules so that they can see more patients with fewer staff and reduce their need to subcontract. Um, they recently told providers in the North Valley, uh, that they can only hire more staff if existing providers are more productive and discharge patients faster. So I think that the change in behavior that you're noticing and that we're saying is, um, really about Kaiser beginning to behave more and more, um, like a for-profit type of entity and trying to squeeze employees more to maximize revenue.

Thank you. It's really clear to me. In this case, I think Kaiser is really using subcontracting and technology to paper over its care deficiencies, rather than spending times and ample resources to continue to recruit and retain enough therapists to meet patients' needs. Can you also elaborate on the extent to which Kaiser currently relies on staff therapists as opposed to subcontractors who provide behavioral health care, and also how the raw numbers and the ratio between them have shifted recently?

yes since the 10-week strike in 2022 to establish our current contract kaiser enrollment in northern california has increased slightly to 4.6 million enrollees while the number of staff therapists has increased very slightly if at all despite kaiser's acknowledgement as part of its settlement agreement with the state and federal government that it lacks the capacity to provide access to care consistent with the timely access requirements of the law The most important fact is this. Since the pandemic, the need for behavioral health care has risen dramatically, especially among youth. In 2023, Kaiser CEO Greg Adams acknowledged that 20% more people came in for behavioral health care than at the same point the prior year. So what we're seeing is that enrollment is basically steady. The number of staff therapists is basically steady. But patient need for care has increased significantly. in order to meet this increase in really demand for care within the timeframes prescribed by law. Kaiser is outsourcing treatment to platform providers and substituting technology for human care. It's stretching its staff therapists to see more patients in the same amount of time. And it's also simply continuing to violate the requirements of the law and failing to meet the increase in its enrollees' needs, hence the multiple and repeated settlement agreements and fines.

Okay, unfortunately, Kaiser's not here. This would be a question that I also would love to ask Kaiser. So you told me that, you have told us, not just myself, about Kaiser's demand for concessions, but what is NUHW proposing in negotiation, and what has been Kaiser's response to your proposals?

Thank you. You know, really, NUHW members are not proposing anything pathbreaking. Our bargaining committee has proposed modest financial increases completely in line with what Kaiser has provided to the union employees of other unions, you know, in recent negotiations. As mentioned, we've proposed language regarding AI and technology that Kaiser has agreed to in other places but is refusing to agree to in Northern California. I think there's one example that really underscores what we see as Kaiser's unreasonableness in these negotiations. NUHW clinicians have requested a mechanism to cap caseload for providers. And this is similar to the way that doctors at Kaiser have a cap. Um, and what we've proposed would accomplish precisely what the department of labor settlement directed Kaiser to do, which is ensure that providers aren't given new patients when their schedules are so impacted that they can't provide their current patients, the access that they need that meets the legal requirements, uh, for timely care. So in other words, NUHW members at the bargaining table have proposed Uh, a transparent and accountable process for accomplishing what Kaiser is required to do per the terms of its settlement agreement that it agreed to and signed with the department of labor. But Kaiser won't agree to that proposal and has not given us a counter proposal of their own. And so I think you look at all of this, um, what's happening at the bargaining table and what's been talked about here today. And it's clear that Kaiser has one standard for medical health care and a lesser standard for behavioral health care. Our members are trying to rebalance that, uh, and Kaiser's refusing.

Thank you for your response. Uh, let's, I would like to call up, uh, Titiana Liu, clinician Liu. Ms. Liu, if Kaiser were to work in earnest with you and other staff therapists in establishing and implementing its model of care, what do you think the result would be?

I think patients would get much better care. I mean, the whole goal, right, is to have more clinicians providing care. So there would be a lot less pressure for us to graduate patients from treatments before they're even ready. And then we'll have more reasonable caseloads for clinicians for us. So then we can truly focus on providing that comprehensive treatment that Kaiser so touts, right? And I think especially with therapy and treatment, it's really important to understand that it's not always a time-limited process, which is what Kaiser wants us to think, right? Kaiser wants folks to think. So some presentations require chronic care and treatment, and oftentimes patients come to us after waiting so long for care and are frustrated with us when we can only see them every three to four weeks at best, and then they give up on treatment and therapy altogether, so they just quit. We are completely letting down our communities, our patients, and people don't realize that clinicians at Kaiser are often in such, sorry, we are under such intense pressure to graduate outpatients when report has hardly even been built and a lot of traumas and other things haven't even begun to be processed.

Thank you, and I think what you just shared, that it's really shortcutting clinical standards, and it's very concerning. What have you and your coworkers done to push back against these practices, and what does Kaiser say when you confront management? And what help have you gotten from professional bodies that establish generally accepted standards of care?

In terms of management support, in all honesty, I haven't gotten very much management support. And this is just my own opinion, because I only work for San Francisco Kaiser. It may be different in other places. But it really feels like it's pushing against a brick wall. We are trying our best to get patients in within an allotted amount of care time, according to state law. But oftentimes we are in a way encouraged by management to, how to say, to in a way, So when our clinical judgment as therapists dictates that a patient be seen sooner than we can actually see them again, the pressure from management is that it's to please revise your judgment and say it's appropriate to see them every three to six weeks so that the delay won't violate state law. So I would say that in terms of getting support from management, it is more of a pushback to follow their policies, their procedures, instead of our clinical judgment practice our ethics and what we truly believe in.

And had you actually did that practice of pushing, like, because we have to follow the legality of, like, the months, and then you actually push a patient and say that, you know, it's okay to see the revisit again in a couple months later? But it's very concerning to me.

Yes, no, and I would say, you know, it definitely varies for me and my own experience and how I work with patients. That is something I definitely don't say. I try my best to fit them in as soon as I can, and in all honesty, transparency is key here, right? We're all working within a system that is hard to push back and change against.

Thank you for your courage. Thank you. Thank you. My next set of questions is for Dr. Michaels. Dr. Michaels, based on the testimony we have heard from NUHW members, it seems like Kaiser is increasingly outsourcing clinical work to practice management companies, which most people call internet therapy platforms. What concerns should we have about how these companies are structured and how they manage the clinicians whom they use as independent contractors?

Well, thank you for that important question. These companies, these platforms are backed by three large and powerful groups. First, private equity and venture capital investors. Second, big tech companies, including Google and Amazon. And third, the major traditional insurance companies. Yes, they are directly involved and are major investors in these platforms. So this trio, they share a focus on profits, and they share a focus on pursuing growth and cost cutting. What they also share is that they don't necessarily know all that much about psychology or mental health care. They're very concerned and organized around how they can make money and make money for their investors, and they are not concerned or organized around what makes for quality care or the conditions needed for patients or therapists to provide that. Also, clinicians who are connected to these platforms are 1099 contractors. This is an Uber model. The platforms have a tremendous amount of control over the policies and things actually that rightly should be clinical decisions. So platforms are obtaining clinical data directly from patients without even asking or informing therapists. They're going around the therapist to get this data. They're also pressuring, for example, therapists in different ways to use their AI scribing and documentation tools. and they're collecting a massive amount of data, and this includes recording and retaining entire transcripts of therapy sessions. Um, so yes, they want the data, which is extremely vulnerable and, uh, private. So they are on the path to training their own chat bots and also developing capitated payment models that will radically change the viability of mental health practice. So many, many concerns. And we documented a lot of this in our research report on these companies last year.

Thank you, Dr. Michael. And also my next question is, what elements of what Kaiser is proposing are different from what you have seen from other insurers? And what impact do you think they would have on industry-wide practices affecting patients' access to affordable quality care and the ability of clinicians to provide its care ethically and sustainably?

Well, insurers are not proposing models of care, for one. They are not messing with the alliance directly as Kaiser would be in their proposals. Traditional insurers are not mandating usages of AI. They are doing other things with AI. They're trying to create their own AI models and products. Aetna even announced a single session AI product for 2027, which is extremely problematic, but they are not showing the same kinds of intent with what Kaiser's wanting to do with substituting or using AI in those ways. But, you know, insurers do try to cut costs, similar to, I think, what Kaiser's doing. But they're not really inserting themselves into the definitions of treatment and directly overriding clinician autonomy in the ways that we've talked about and you've heard about today. I think all of these proposals from Kaiser would really add up to a drastically reduced access to care. for patients, they're going to get less quality care, and these proposals will drive therapists out of the Kaiser network. So if patients want care within Kaiser, they're going to have to wait for it. And if they can afford it, they will probably be likely to seek it outside of Kaiser and pay for it themselves. So I think it would be a very bad recipe for clinicians and for the public.

Thank you, Dr. Michaels. Board President, I don't have more questions if any of my colleagues would like to ask any.

They do. Supervisor Melgar.

Thank you, President. Thank you, Supervisor Chen, for calling these hearings and for your really good questions. I have been a Kaiser member since I was 18. All three of my daughters were born at Kaiser. I have gotten excellent care at Kaiser, not just through pregnancies and childbirth, but also my husband a while ago had a very serious issue Health issue that got him to spend about a month at Kaiser and got nothing but excellent care from the very dedicated and professional staff there. For all of these years, the one exception to that excellent care for my family was mental health related when one of my daughters had an acute crisis. What we access at Kaiser was not great. and left us having to seek other resources than what we had paid for for decades. I take this issue very seriously, having lived through it and having been a loyal and dedicated Kaiser member, and for most of it, having received really excellent care provided by the staff. So I thank you again, Supervisor Chen, for calling this hearing. I recognize that there are some topics that are best discussed at the bargaining table or at mediation. But there's also a level of transparency that I think we need to have given that this hearing is being held in public because Kaiser is such an important part of the network of care in San Francisco. And also Kaiser provides health care for a big part of the employees of the city and county of San Francisco, myself included, and our dependents. So I want to make sure that Kaiser, with our contributions, are putting patients' interests first and connecting patients with what they need and not putting that second. It is an issue of public interest. I am really disappointed. that they're not here. The last time I met with Kaiser leadership was in my role as a land use and transportation committee chair, because they're seeking an expansion of their campus, which I support. And the city and county of San Francisco will negotiate with them. But they're coming to us asking for something. And I think that it is fair to be transparent about what is going on. So I hope they're listening today. I am disappointed that they're not here. And I think that they might have tried a different approach in their relationship with us. But to that end, I will direct some of my questions to Ilana, who spoke earlier. Ilana, are you still here? There we are. So you talked a little bit about what happened when AI tools were first deployed during your work. So I'm hoping that you can talk us through what happened when this was rolled out. What was your response? Not just at the bargaining table, but what was your response with your coworkers when you were told this is what's going on now? What did that look like with your supervisors?

Sure. As soon as we found out that Kaiser had unlicensed clerical staff doing triage work, which was kind of the beginning of this erosion of triage, we filed a grievance, which over two years later hasn't been scheduled for arbitration. We also filed a charge with the NLRB, National Labor Relations Board, which they have since deferred back to the grievance and arbitration process. And we filed a complaint with the DMHC alleging violations of California law, which limits triage to qualified licensed individuals, and the DMHC reports to us that they are still investigating. But interpersonally, we were very alarmed, right? Because I share your experience as having phenomenal care. I've had two babies at Kaiser. I'm a lifetime member. And as an employee in psychiatry, I have seen a much darker side of Kaiser than I ever saw as a patient prior. So my colleagues and I were alarmed, right? I mean, I have been trained. It took me a decade and a half through experience, practice, going through all the state requirements, and I was told when I was going through that by the state, you will, you know, you have to go through this because public safety is in your hands. So my colleagues and I all together, essentially, you know, we've worked our entire careers to access doing clinical triage and to quickly learn that operators and algorithms can just quickly do what has taken me many, many years of experience. And my colleagues, we were all very, very frustrated.

So Ilana, what happens to the patient? So if they are triaged by someone who's not licensed or someone who's not even a person, what happens if then they're assigned to something that's not appropriate or that they feel is not helping them or that doesn't meet their needs? Then what is their recourse?

Right. So to answer bluntly, we don't always know what happens to those patients when the bots and operators get it wrong, especially when they're outsourced because they're now outside of the integrative health plan. So I only really know of the patients who either a provider or themselves are strong self-advocates. So when patients advocate for themselves or the external program determines that they're not appropriate for their program, they end up booked with me. And instead of talking to me a month ago, we're talking down the road when the patient is frustrated, likely deteriorated. A lot of the evidence suggests that the beginning of one's care episode is the opportunity to instill hope. And when we can't instill that hope in the beginning, a lot of people give up. So when they make it to me after great delays, I actually conduct a thorough assessment to correct their treatment plan and connect them to the clinically appropriate care. Oftentimes patients are confused, upset, and they often get angry that they got misdirected in the first place. You know, as I said earlier, apologizing has become a routine part of my day. So, you know, I'm doing what I call service recovery as opposed to the original triage and clinical assessment job that I signed up for many years ago. Bottom line, patients that are already suffering from their psychiatric impairment are suffering even further from the delays in care that the unlicensed operator or algorithmic-based triage creates, and those consequences are unfortunately quite dire. Thank you.

That's my questions. Thank you.

Supervisor Fielder.

Thank you, President Middleman. Thank you, Supervisor Chen, for calling for this hearing. Thank you to everyone who's shown up today. I have a question for Dr. Michaels. Dr. Michaels, at the end of your testimony, you predicted a set of negative results for clinicians, patients, and Kaiser itself if Kaiser management were to succeed in forcing its terrible three contract demands on NUHW members. Could you expand on how you inferred those specific results from the specific content of what Kaiser management is asking NUHW members to accept?

Sure, thank you. I mean, it's not too vague of an inference. These things have been tried in other settings, and there's evidence to show that these are the results. This is what happens. For example, if we think about for patients, if there is a one size fits all or a standardized model, which is one of the things that Kaiser wants to do, we know that that's not going to work for everybody. Different people need different treatment approaches, which is why we have different models and therapists are trained in multiple models and also use the information they obtain from their work with each individual patient to adapt even within a session as well as over time. So we know that when somebody receives treatment that is not the right model or the right approach for them, they don't feel good. They don't feel helped. They don't feel understood. They think therapy doesn't work or therapy doesn't work for me. Maybe I'm not able to be helped. Their symptoms may worsen. They may drop out of treatment altogether. Dropouts will also probably increase from the outsourcing situation when patients are shuttled to different therapists or they have to interact with an AI. This is a direct interruption of the alliance. And so the alliance is the reason and the method by which therapy works. And when you're interrupting that alliance and messing with it, results are going to decrease. Outcomes will worsen. And then finally, when there is a lack of autonomy for the therapist and more burnout, more time pressures, et cetera, and there's more turnover of therapists, then patients are also likely to drop out of care. When their therapist leaves, they'll probably leave as well. So adding all of this up together for the patients, I think outcomes will worsen. People will suffer more and it's unnecessary. There's also for the clinicians, as some people have said, we are duty bound by our code of ethics. Each degree or discipline has a specific code of ethics and we have a state license. And we are accountable to providing care according to those ethical standards and the terms of our license. If something goes wrong, it's on us. And in some of these changes that Kaiser is proposing, that accountability and responsibility would be diffused and taken away. And the AI doesn't have a license. It didn't go to graduate school. This is not a very good plan at all for quality care. And I think while a lot of these policies may save Kaiser money in the short term, which I imagine that is their main motivation for proposing these things, they will actually create new and higher costs in the long term in terms of replacing therapists, in terms of medical costs for patients who don't get appropriate care. It's a very costly long-term gambit that Kaiser is playing here. And it's not good for patients, for therapists, or really even for Kaiser itself.

Thank you, Supervisor Fielder. Supervisor Walton was observing to me earlier that this hearing really would have been a more useful exercise for the members of the Board of Supervisors if Kaiser had deigned to send representation. And I can certainly understand them not wanting to be here to hear this story and respond to our questions. On the other hand, their non-presence suggests to me that the story is basically right and that the picture that's being painted by the workers is pretty accurate of a large business that is interested in squeezing efficiencies out of an under-resourced part of its operation. Um, with bad consequences that are a concern to this board of supervisors, um, supervisor Melgar, you know, as, as you indicated, I mean, we are concerned about how workers get treated in our city. We are concerned about how, uh, folks who live in San Francisco and have, who are members of Kaiser and have mental health needs. uh, are treated and get care or do not get care, but we are also a purchaser. We have, uh, you know, many, many, many San Francisco city employees who either themselves or their families at some point are going to need, uh, behavioral health resources. And we do not want to be subjecting our employees to a situation and our retirees to a situation where they can't actually get the care that they need. The picture we've heard is pretty dystopian. It's sort of your imagination of the worst call center, except you're not arguing with this bot about some product, the shoes. You're arguing with the bot about the kind of care that you're going to get for your kid. And that's not good. I guess I would like to invite Ms. Marcucci-Morris to come back. You're in high demand. I mean, it would be interesting, again, if Kaiser were here. We could have a conversation about what are you trying to do with AI and the ways in which I mean, it sounds entirely believable that they're trying to turn over this kind of intake work to a process that does not involve people. And that seems really wrong and, I guess, illegal in this context. But I mean, I don't think that, as I understand it, The clinicians at Kaiser are not saying no AI never, you're saying AI yes, but use it to make us better as clinicians, I think. But can you talk a little bit more about how AI could be deployed responsibly in ways that would support therapists work rather than replacing it inappropriately? And how could AI help address the staffing shortage?

Sure. There's a long history of technology and innovation really helping the medical field. So I, myself, and as a union, we are not anti-AI. We are not anti-innovation. I know that I sound skeptical about the use of AI, but that's because I care deeply about patient privacy. and care effectiveness. As Dr. Michael shared, you start recording sessions, you enter a third party into the room, the nature of that alliance is severed. There's just no data that supports it. So I want to see that data first before making massive public health decisions. But I've seen how Kaiser has time and time again made changes in our daily operations in the name of improving access or patient care when the changes are more about their bottom line. So as a union, we're not against the responsible use of AI. Using AI that supports therapists, protects patient privacy, and does not remove humans from this human work of therapy, I can see AI used to remove some menial tasks, address operational inefficiencies like paperwork or administrative lag. We're seeing the same problems in those realms that we did a decade ago. So I'd like to see it used there, or maybe even in ways that would help us hone our skills as human therapists. But before AI is deployed at any matter, it is absolutely necessary that the therapists who will be using or affected by AI tools have a real voice in how it's deployed. I fear that the tech industry, alongside my employer, simply sees a profit-making opportunity, including the cost savings of laying off human providers and is not genuinely motivated by improving access, innovation, or overall care experiences. And you mentioned the shortage. So very respectfully, we push back on the true existence of a therapist shortage, especially in San Francisco. I cannot throw a rock on Market Street without hitting five MFTs. You know, the shortage is not...

Please don't.

I will not. Scouts, I promise. Do no harm, am I right? The shortage is not available therapists, supervisors. The shortage are therapists that can make a living on the pay rates of unilaterally determined by the health plans. The shortage are providers taking insurance or willing to accept factory assembly line working conditions that now want to push questionable technology on us as well. That's the shortage here. There are plenty of us willing to work and support human healing when given the appropriate resources to do so according to industry standards of care. And just from a mental exercise perspective, if there is a human shortage, help me understand why laying off the humans committed to the work is the viable solution. I quote my colleague, make it make sense. So that's how I feel about that.

I mean, thank you for that. If our Kaiser representatives were here, I would ask them why this language that seems pretty reasonable and has worked its way into another contract would not work in Northern California. But of course, we cannot ask that question, or at least we can ask it, but it's going into the void. All right, thank you.

Thank you so much.

And then I do have a couple of questions for Ms. Parsons. Welcome back. Hello, thank you. Hello. So you're in an interesting spot in that you're both inside and outside. You are both a Kaiser therapist and you've worked or currently work as an independent provider?

Correct. Yes. But I do not see Kaiser clients through that. We're not allowed to. Everyone heard that, right?

So I'm wondering, given that, if you could talk a little bit more about the differences and the problems that you face working as a Kaiser staff therapist and the problems that you face when working as an independent contract, not contractor, independent provider, and tell us what you think are the best and worst parts of the work on both sides of that divide.

Yeah, so I already named, right, that The integrated care model that Kaiser says it has, when it actually works, it works very well. So as a Kaiser staff therapist, I can see what's going on with my clients. A perfect example is I had a woman who was 41 weeks pregnant, and she was terrified of getting an induction. And I could just look in her chart to see, has she given birth yet? Is she in there? What's going on? What's happening? And in any opening I had, I actually scheduled her to call her because she was terrified. And I actually... Same as some of us here, right, have been through that. I've given birth at Kaiser. I was induced two times. So I can use that personal experience to say, like, hey, this is what you might be able to expect. Let's talk about your anxiety. Let's talk about your worry. I cannot do that when I work as a third-party contractor because I don't have any other notes than my own. There's no information. There's no test results. There's no doctors that I can just message and say, hey, what's going on? Hey, this is a concern they have. This particular client I messaged her OB and said, this is a big concern she has. Just want to give you a heads up. So that's probably the downfall of working with a third-party contractor. In terms of Kaiser, the biggest challenge is time. We've all talked about it. But in our contract right now, every single return patient we have, meaning we've seen them before and they are returning to us those slots, right, for every five of those we see, we have one intake, meaning we've not seen this person before or at least not in the last year. And so the expectation is if I'm getting five new clients a week, let's say, right? Let's say I see 30 patients and five of them are new. To make that all fit, I have to be terminating or closing services with five return patients, which is just not happening, of course. Especially because we don't really get to see return patients as much as we should. So if I see a return patient once every four to six weeks, it's obviously going to take longer for them to recover if I could see them weekly. There are also certain models of care where really, ethically, I should be seeing them weekly. EMDR, for example, is a service we offer. You need to see someone weekly for that. But they're not booked weekly because there's just not time for that. Another issue I see within Kaiser is I'm a specialist. So I do couples therapy. I'm a certified sex therapist. I'm a perinatal mental health specialist. Those are all things that people really want, right? I'm one of three sex therapists within the entire Northern California region. right? And I can put that on my profile in terms of third-party contractor, right? They can go, they can see like, oh, she does this, she does that, that's great, I want to book with her. Within Kaiser, I have worked there for five years. About four years ago, or sorry, about one year ago, so four years in, I found out that therapists could create their own My Doctor Online profile, which if you've had a PCP, if you've been with Kaiser, you can go and look at the doctors and They say information about them. I didn't know we could do that in mental health. So about a year ago, I filled one out. And then I started getting referrals for certified sex therapists. And my manager, who wanted that service, my manager told me to take that off my profile because my schedule was getting too full with people outside of my service area. I refused. I kept it on there. Because legally speaking, you can be seen anywhere within the Northern California region as a Kaiser patient. But that's another problem, right? Even if you have an issue within Kaiser, you're not directed to that specialist. And this has become more of an issue since triage left, right? Since we've had robots and people I don't even know. you know, scheduling into our appointment slots. Because, you know, if like an I, I'm trying not to use the terminology, shortcuts. If an intake assessment coordinator who works in my office says, oh, this patient is, you know, has postpartum depression, he's going to reach out to me or book them in my schedule, right? A robot certainly can't do that, you know? So that's another big issue within working with Kaiser is that clients don't always get the specialized care they need.

So notwithstanding those challenges, it seems like it would be good to bring more care back in-house. And I'm wondering if you have thoughts on things that Kaiser could do to do that and what benefits that would have for the current workforce and for Kaiser enrollees.

Right. So, I mean, you heard that Kaiser's, you know, amount of enrollees has been about the same, the amount of therapists has been about the same, but the enrollees wanting mental health care has gone up by 20%, which is significant. That's a huge jump. So, obviously, it makes sense to have more clinicians, right? That's the obvious answer. And giving us caseload caps, which also makes sense. You know, again, I can't be intaking patients if I have no open slots. And I can't be seeing my patients as much as they need what is actually ethical if I have no slots. So keeping a full staff of therapists, right? Psychiatrists, case managers, assessment intake coordinators, intensive outpatient program clinicians, right? And it does mean hiring more clinicians. But instead, Kaiser's paying to outsource care to clinicians who work for third party contractors who do have caseload caps. Right? Those third-party contractors, we see it all the time, like, oh, we need to refer to the external provider network, which is a whole list of people. And sometimes those certain, you know, like grow or rule or whatever, there are no open slots to refer to because their clinicians have caseload caps. And if there are no clinicians who have openings, that is not a resource that we can send to, so we have to look for a different one.

All right. Thank you.

Yeah. Thank you very much.

If other colleagues have questions or, oh, there we go. Supervisor Chan.

Thank you, President Mandelman. Thank you, Supervisor Chan, for today's hearing. I do not have additional questions. I think what I would like to see is if we're towards the end of this hearing is that since we're holding this hearing as a committee of the whole, is that perhaps we could discuss either subpoena Kaiser or that we issue a letter on behalf of the board supervisor to Kaiser Indicating all the questions that we had today Collectively as a committee of the whole and be able to subpoena Kaiser for the answer to our questions.

Thank you Hey, thank you. Supervisor Chan supervisor Chen. Do you have any comments before we go to public comment?

No, I do Let's go to public comment first and I'm gonna offer a closing remarks. I

Public comment, right?

If you would like to provide public comment on item 52, please line up to speak now on the right-hand side of the chamber. Once we exhaust the in-person line, we will go to our remote callers. If you anticipate providing remote public comment, the telephone number and meeting ID are published on the agenda and streaming on your screen. First public commenter here in person.

Excuse me. My name is Barry Toronto and I am a Kaiser patient. I want to speak first because I have a Kaiser class online in 10 minutes. So it has to relate to this topic matter. They offer great classes and also they did a great job on my cataracts for my eyes. The only thing I don't understand is why they don't care about doing a great job on mental health counseling. That doesn't make sense to me, how you provide all these great services, but you don't want to continue it. I mean, AI, if you watch Two and a Half Men, and Charlie Sheen in The Therapist, You've got to have a therapist, the back and forth. AI doesn't have the graduate degree, which is true. It doesn't make sense to do it this way when all logic goes the other way. So Kaiser has great employees, not only that, but they're not here for their pay. They're here for their patients. So it shows Kaiser should be happy and be here to see all the support for Kaiser patients. But obviously it's about Kaiser trying to save money rather than care about their patient's health. So I'm very much concerned So caring about fellow union brothers and sisters, I think it's important that we get answers from Kaiser and ask them to join the crowd and the community to care about the mental health of the city and especially their patients. Thank you very much.

Thank you, Mr. Toronto, for your comments. Next speaker.

Hi, Supervisors. Ian Lewis, Unite Here, the Hotel and Restaurant Workers Union. Among our members, we have fought for and won health care benefits for 65,000 Kaiser patients around this country, including 14,000 here in San Francisco. And people choose Kaiser because of the promise of Kaiser, the promise of integrated, coordinated, human-based care. That's especially important to a community like ours, where three quarters are born overseas, grew up speaking different languages. Incredibly important to navigate a health system. And they choose Kaiser despite the price. You all know how hard our union has fought for health care, especially in this city. The US spends twice as much as any other country on health care. Northern California spends twice that. Our health benefits for a family cost $18.40 at Kaiser. That comes out of our members' pockets here in San Francisco. That's almost five times the minimum spending requirement in San Francisco for healthcare. It's almost not quite the minimum wage in San Francisco. And I bring that up because it's not for a lack of resources that all of this is happening. It's because of concerted choices. And I know the fact that Kaiser undervalues behavioral health compared to other health care is not a surprise to anybody here. But what you heard today should terrify you as leaders of a city which is the biggest purchaser of health care benefits and leaders of a county that is entrusted with the public health. It sounds to me like Kaiser is leading us down the track of a K-shaped economy in healthcare, where for working people, even those who can give up $18 an hour for excellent healthcare benefits, we are offered inhuman technology and precarious gig workers. And the only people who are going to be left with true human-based care are those who can pay out of cash and out of their pockets. No political community...

Apologies for cutting you off. We are providing everybody the same two minutes. Next speaker.

Kim Cavalloni, San Francisco Labor Council. We live in very strange times. And all of you should be very concerned about the health and welfare of our city employees. We've already had a tragedy happen down in a VTA in San Jose. The mental health of our city employees is critical to them being able to do their jobs day in and day out. The fact that Kaiser wants to lead with the same AI that can't distinguish a cone from a dog to a person on the street and put that in charge of mental health care, you should all be like terrified of what can happen to our workers and what happens in our city and county. We know AI is imperfect, but we cannot allow Kaiser to experiment on our city and county workers. We know it doesn't work. We know AI doesn't value life. It can't. It's not alive. But allowing our city and county workers to receive this type of care is completely unacceptable on so many levels. AI can't value life. It doesn't distinguish whether the cone has a life, a dog has a life, or a person has a life. And them taking it away means nothing to the machine other than someone has to tell it that it was wrong. Thank you.

Thank you for your comments. Let's have the next speaker, please.

Good afternoon. My name is Bindu Mukamla. I serve as the policy manager for the National Association of Social Workers, California chapter. In response to Kaiser Permanente's terrible three proposals, we asked our social work members, comprised of Kaiser patients and employees, how these changes are affecting care. And the feedback we received was consistent. These proposals shift the focus away from clinical decision making towards reducing costs. One major concern was the proposal to have behavioral health triage conducted by call center staff or non-licensed personnel instead of licensed behavioral health providers. As one of our social workers shared, quote, if we want better triage, Kaiser needs a formal intake department, not a call center, end quote. Another shared that even when they identify a patient is in urgent need of therapy, they must still send that patient through a phone triage process with an unlicensed representative before connecting them with care. And of those we contacted, 95% reported being not at all confident that Kaiser cell phone service representatives are consistently meeting California's requirements that limit non-licensed staff from making clinical assessments on determining when patients need licensed behavioral health care. Providers also raised concern about the loss of continuity of care. Patients are being redirected to outside providers to meet those access metrics, even when they have an established therapeutic relationship. One provider described patients being referred to, quote, a brand new provider instead of booking a sooner appointment with their regular provider made to start all over again. So taken together, these concerns reflect a need to prioritize clinical expertise, continuity of care, and patient safety over administrative efficiency. We urge Kaiser Permanente to listen to the concerns of patients and providers. Thank you for your time.

Thank you for your comments. Let's have the next speaker, please.

Hello, good afternoon. My name is Dr. Guillermo Rodriguez, and I'm the Region B Director for NASW California Chapter. It's a pleasure being here. I'm here to advocate for all the social workers, for the team here, for the voices who are here today advocating. Usually policies get implemented when something tragic happens. Let's not get to that point. We want to implement policies to stop any strategies of mental health. On Kaiser's website, it states, quote, we believe a person's physical health, mental health, and social health are all connected and essential to a person's overall well-being. End quote. As social workers, we agree with that. But those words must be reflected into practice. With Kaiser not being here, it speaks volumes. It hurts a little bit, or a lot for some of us. But I wish they could be here so I could hear what they have to say in regards to the voices in today's room. Thank you so much.

Thank you for your comments. Next speaker, please. And as this speaker approaches the microphone, if we have anyone else in the room who has public comment for this committee of the whole hearing from whom we have not yet heard, you may line up to speak along that western wall. Next speaker, please.

Good evening. This has been an extremely interesting presentation, and I certainly think it's important to keep the humanity in medicine and in other activities, certainly in therapy. There were many issues raised about quality, privacy, accountability. Who controls the AI? Who controls changes that might be made? There's no such thing as a fixed item. There are apparently many differences in how AI is working. Who is responsible for making supposed improvements or providing so-called guardrails, which we've heard and read about failing quite a lot? The New York Times had an extended story about a couple whose son teenage son was helped by a chat pal, as it were, basically to work out all the details of how to commit suicide. And as the very last step, the son, for now a second time, said, I'm thinking of... And the Times got the exchanges between their son and the chat... He said, I'm thinking of leaving the rope lying around so somebody will find it. And the chat answered, and I'm paraphrasing, not such a good idea. Maybe you should let the folks learn what you've planned when you have succeeded, basically when they find you in the closet hanging from the bar with a rope that the chat helped the kid make. So the AI is working with a whole different world of who knows what motives and purposes, making money for the company that made it and so on. Big problem. Thank you.

Seeing no other individuals who are in person, we will go to our remote call-in line. If you have not already done so, please press star three to line up remotely. When it's your turn to speak, listen carefully. And when the system says you have been unmuted, that is your cue to begin your comments. Let's hear from our first caller. Welcome, speaker.

Hello. Can you hear me?

Yes, we can hear you.

I support the Kaiser workers. AI is the devil. It's for fucking faggots like Dorothy and Mandelman.

Pausing the speaker's time, we will be redirecting and moving on to the next speaker. Next caller. That concludes the comment queue, Mr. President.

That message was brought to you by your California state legislature, which is not subject to the requirements of remote public comment. Public comment is now closed. Supervisor Chen, this is your hearing.

Thank you, Board President Mendelman. I would like to take a moment to thank everyone who attended today's hearing. I especially want to appreciate the workers. Thank you. Thank you for taking time off to educate us on everything that you are going on at your workplace. Your commitment to patient care quality patient safety is loud and very clear. The things that we discussed today are infuriating, concerning, and unacceptable. It is a shame that Kaiser didn't send a representative to answer our questions, or at least to listen to testimony provided today. Next Tuesday, I will be introducing a resolution calling on Kaiser to drop its terrible 3E contract demands, as highlighted by the testimony and presentation we heard today. With that, I want to shout out to my legislative aide, Jackie Prager, for her work on this hearing and also the resolution that I will be introducing next Tuesday. Through the chair, I would like to make a motion to file this hearing.

All right. I think I just gaveled that, right? OK. This matter has been heard and is now filed. All right. Madam Clerk, let's go to our next special order. Please call items 53 and 54 together.

Yes item 53 is a hearing at the Board of Supervisors sitting as a committee of the whole to consider the renewal and expansion of a property based business improvement district known as a downtown community benefit district item 54 is the companion resolution to establish the property based business improvement district known as the downtown community benefit district ordering the levy and collection of assessments against property located in

that district for 10 years commencing with fiscal year 2026 2027 subject to conditions as specified and making environmental findings the purpose of this committee of the whole is to hear testimony on the proposed levy of assessments of the property and business improvement district named the downtown community benefit district pursuant to the board's resolution of intent intention adopted May 19th 2026 which set today's hearing date and also approved the management district plan and the engineer's report, and the form of ballots for property owners. Details on the covered area can be found in the legislative files. After the hearing is closed, the Department of Elections will count all ballots submitted, including any additional ballots received during the public hearing today, and submit the tabulation back to the board. Members of the public may view the ballot tabulation by the Department of Elections on the basement level of City Hall in Room 59. If the tabulation of the weighted ballots shows a majority protest, the Board of Supervisors will not approve the establishment of the district or impose the assessments. If there is not a majority protest, the Board may then vote to establish the district and impose the assessments. A majority protest would exist if the weighted ballots submitted in opposition to the establishment of the assessment district exceed the weighted ballots submitted in favor of establishment. Ballots are weighted according to the proposed financial obligation of each affected property. The hearing is now open. Supervisor Sautter.

thank you president Mandelman and I want to say a few remarks before we continue on with the proceedings you know I think I have the pleasure of having the most community benefit districts of any district in the city and it is a real honor to work with downtown partnership this is a really special group of people and the work that they do is really phenomenal There's a few things I want to highlight and a few things that I think really deserve to be recognized about how we're doing this. And the first is that this is a partnership model. This is in fact the first time that the port of San Francisco is opting to join a community benefit district. And I think that says a lot about the port and particularly the new leadership of our new director, Mike Martin. we also have rec park looking to work with the community benefit district particularly to bring the new embarcadero plaza and sue beerman park improvements to life and you know i think as you'll you'll hear and as you probably have heard before this is a community benefit district that was stood up at the beginning of the pandemic uh the worst possible time but also the time that we really need to do the most. And you have gone above and beyond in some of the most challenging years in our city, beginning with a pandemic through the economic recovery, and now as we're starting to see light on the other side of things. And this is a process where we are literally asking property owners to tax themselves more and That is a tall task. But despite that I've heard nothing but excitement and confidence and trust coming from property owners downtown and there's a real appetite and eagerness for this expansion and You know, I think property owners have a lot to look forward with with this expansion the downtown partnership has done a fantastic job of Working with our office and with all the city departments through this renewal process. It is an early renewal, which is extremely rare but again, I think it speaks to the ambition of this group of individuals and this collective body here and not only the CBD, but the city departments that I mentioned that are working with. I do want to do a few specific acknowledgements and recognitions. Of course, Robbie Silver, Executive Director of Downtown Partnership, the fearless leader of this organization. Um, and, and we'll work, um, being Dan Kingsley, uh, and then Chris freeze as well. And, you know, I mentioned some of the departments that are partnering on this. There's also a lot of corporate partners, community partners that have stepped up, particularly, I want to shout out BXP and Aaron Fenton, uh, who have been working closely on the Embarcadero Plaza element and park overlay of this. Um, and, and, and, and, and, and, and, and, and, and, and, and, and, and, And lastly, Jackie Hazelwood of OUWD, who has done a fantastic job steering this forward. So I know there's more steps and ballots need to be counted, but I really am confident here and look forward to this expansion and thank everyone for bringing this to the table today.

Thank you, Supervisor Sautter. I believe that we have the mayor's office of economic and workforce development Jackie Hazelwood and then downtown CBD Robbie silver Thank You president Mandelman and good good evening supervisors My name is Jackie Hazelwood.

I'm the community benefit district program director with the office of economic and workforce development I oversee and administer the CBD program on behalf of OEWD and I'm joined here by Casey Ohalik from our team as well. So today's hearing is the culmination of a multi-year planning effort driven by the Downtown Community Benefit District, which does business as Downtown SF Partnership, or DSFP. Through this effort, DSFP engaged property owners, community stakeholders, city departments, and partner agencies to develop the proposed renewal and expansion of the district. pending the results of the forthcoming ballot tabulation later tonight, if approved, the resolution before you today would authorize DSFP to continue operating for a new 10-year term under an updated management plan. Before I introduce Robbie Silver, Executive Director of DSFP, to present on the organization's effort and the vision of the proposed renewed district, I'd also like to just acknowledge several individuals whose work has supported this process. A sincere thank you to the mayor, and to his staff, particularly Adam Thongsvat, to Supervisor Sautter and to his staff, particularly Tita Bell, to Supervisor Dorsey and to his staff, Madison Tam, to our director at OEWD, Ann Topier, Chris Corgus and Casey Ohalik, Director Mike Martin, Scott Lansdell, Amy Cohen with the port, Director Sarah Madlin, Dana Ketchum, and Bev Ng with Reckon Park, staff from the clerk's office, including Elisa Samara, John Carroll, and Monique Creighton, Deputy City Attorneys Manu Pradhan and Hugo Cabrera, and especially Kwong Kwach, Priscilla Tove, and Alice Law with the Department of Elections. Thank you all for your collaboration and partnership through this process. There's a lot of folks. Clearly, this takes a village. I'd especially now like to recognize DSFP Executive Director Robbie Silver and his staff, and DSFP's Board of Directors, many of whom are here today, for their ongoing support throughout this campaign. So turning now to the item before the board today, so the Downtown Community Benefit District was originally established by the Board of Supervisors in 2019 for a 15-year term, beginning on January 1, 2020, and with the intention to continue through December 31, 2035. Although the district is not required to renew until the end of this term, following stakeholder engagement, property owner engagement, and approval by its board of directors, DSFP elected to pursue an early renewal in order to update their management plan and align their budget services and district boundaries with the evolving needs of downtown If approved the renewed district would operate under the proposed management plan and expanded service area for a new 10-year term commencing January 1st 2027 and ending December 31st 2036 As Robbie will discuss in greater detail in a moment, the proposal would expand district boundaries to include the future Embarcadero Park and portions of the Embarcadero owned by the Port of San Francisco. So prior to today's hearing, the district completed the procedural requirements established under the California Property and Business Improvement District Law of 1994. In April, DSFP exceeded the required 30% threshold to initiate the ballot phase. They submitted 107 petitions, which represented just over $5 million in assessments, or 40.38% of the proposed assessment. Following that milestone on May 19th, the Board of Supervisors adopted the resolution of intention authorizing the special assessment balloting process. Ballots were mailed to all affected property owners on June 6th, opening the required 45-day balloting period, which culminates in today's session today. Throughout this process, DSFP worked closely with numerous city partners, as I mentioned, particularly Reckon Park and the Port of San Francisco. On June 30th, the Board of Supervisors authorized the mayor to cast assessment ballots in the affirmative on behalf of the city and county of San Francisco. And I want to acknowledge that Beving was here earlier and is able to answer any questions should there be any follow-ups later on as they come. Another important component, as has been highlighted by Supervisor Sautter, is the inclusion of the Port of San Francisco within the district boundaries. On June 10th, The Port Commission unanimously approved the port's participation in the proposed district. If approved today, the expanded district would include port-owned properties along the Embarcadero, which would represent approximately $882,000 in first-year assessments. Beyond the financial contribution, the inclusion reflects coordinated planning between the port and DSFP to support long-term stewardship, maintenance, and activation along the waterfront while strengthening the connection between the Embarcadero and downtown core. I want to acknowledge that Scott Lansdell and Amy Cohen from the port are also present in chamber should there be any questions regarding the port's participation. With that overview, I'd now like to invite Robbie Silver, the executive director of DSFP, to present on the proposed renewal and expansion. Thank you.

Thank you, Jackie. Good afternoon, or almost evening. President Mendelman, members of the Board of Supervisors, city staff, and members of the public, thank you for being here today and allowing us to present on this topic. I took over the organization in 2020 at the height of the pandemic, and this was before vaccines, so it is quite the surreal experience to be up here today talking about economic recovery for our city and our beloved downtown. This effort is fundamentally about ensuring downtown San Francisco remains competitive and its primary tax base to fund citywide services are resilient and positioned for long-term recovery and growth. Over the past several years, our downtown has faced unprecedented challenges, from the impacts of the pandemic and shifts in office utilization to increasing pressure on public realm maintenance, safety, and economic vitality. And at the same time, expectations for clean streets, safe environments, and vibrant public spaces have only increased. This is the reality that property owners, businesses, residents, and visitors are asking for more services, more activation, and stronger coordination than ever. And early renewal allows us to proactively respond to those needs rather than waiting for challenges to be resolved on their own. Renewal is not simply about continuing existing services. It is about evolving the district to meet the future of downtown. Expansion allows us to bring in additional neighborhoods, commercial corridors, and stakeholders to a unified strategy focus on clean and safe services, economic development, public space activation, and advocacy. Downtown functions as an interconnected ecosystem, and our boundaries and resources must reflect that. Next slide, please. So this is our current boundaries. In 2017, a coalition of property owners and businesses came together with a simple goal, create a cleaner, safer, and more welcoming downtown. We officially launched operations in January 2020, just weeks before the pandemic drastically changed the trajectory of our city and the world. Over the past six years, we've evolved from simply creating a traditional clean and safe district to an organization focused on place management, economic development, public realm activation, and downtown recovery in order to rise to post COVID challenges. Our work focuses on these areas, as mentioned before, and together these functions help ensure that downtown remains a place where businesses can succeed, residents can thrive, and visitors feel welcome. And as frontline stewards over the last six years, you can see these are tangible results from our ambassador teams, from picking up trash, bio-waste, graffiti, power washing, everything that a CBD is designed to do. One example of our ability to innovate has been our partnership with the Downtown Development Corporation to launch the Market Street Ambassador Quarter Pilot. Census Partnership, major employers, city agencies, and community organizations helped funded the program to improve conditions around our downtown transit hubs. Since July of 2025, ambassadors have generated over 71,000 public interactions and contributed to a 53% reduction in safety-related 911 calls in this area. This pilot demonstrates how strategic private-public partnerships can deliver measurable results. And as downtown evolves, we must think beyond maintenance and operations. Our award-winning public realm action plan provides a roadmap for transforming downtown streets and public spaces into destinations that support economic activity, community gathering, and cultural exchange. This plan was created from input from stakeholders, not a top-down approach, but receiving directions directly from the community. These are some of our work that has come out of our public realm action plan that we've been able to accomplish. First landing at Leidesdorf. The Front Street Entertainment Zone, first entertainment zone in the state of California. Our downtown gateway project at the corner of Market and California Street at the cable car line. And of course, Mechanics Monument Plaza. These projects represent what a modern downtown management organization looks like. Through strategic activations, streetscape improvements, and private-public partnerships, we transform these underutilized spaces into community assets. Whether it's landing at Lightest Door, Front Street, Downtown Gateway, or Mechanics, each project demonstrates how thoughtful placemaking can increase foot traffic, support local businesses, and increase downtown's identity. We've also become a leader in producing public events. Programs such as Let's Glow SF, Bastille on Belden, Front Street, and Drag Me Downtown attract visitors, support local businesses, and reinforce downtown's reputation as a cultural destination. Let's Glove specifically has brought more than 375,000 attendees since it started in 2021. So this brings us to the purpose of today's hearing. Downtown San Francisco has experienced renewed momentum And rather than wait until the end of our current term, property owners chose to pursue an early renewal approximately eight years ahead of schedule because they believe downtown recovery can and should move faster. This proposal designed, uh, to design, uh, accelerate recovery, strengthen service delivery and extend support to the Embarcadero waterfront, one of San Francisco's most important public spaces. We've done extensive community outreach over the last year and a half. We established a renewal and expansion steering committee. We've conducted focus groups, hosted community meetings, launched a dedicated website, mailed surveys to every property owner, and completed numerous one-on-one interviews with stakeholders throughout the district. We also coordinated extensively with the Office of Economic and Workforce Development, the Port of San Francisco, and Recreation and Parks. Next slide. One more. Five primary goals guide this effort. First is to strengthen downtown's competitive position. Second, secure the city's tax base and investments. Third, create a stronger platform for advocacy, investment, and economic growth. Fourth, enhance our service delivery and provide operational excellence. And fifth, support the activation of the Embarcadero Park project. Upon our due diligence, we studied downtowns across the country and found our downtown has one of the lowest resources. This proposed renewal helps ensure that San Francisco remains competitive with other downtowns that are investing heavily into the public realm, safety, activation, and economic development. Renewal allows us to significantly expand services. Most notably, clean and safe services will double and transition to a 24-hour operation. This proposal also funds a new homeless outreach program and overnight safety patrols. Lastly, it accelerates our implementation of our public realm action plan, no longer relying on city grants. but focusing on these efforts to boost beautification efforts to support small businesses and our overall downtown recovery. This is the proposed map that expands beyond the existing financial district in Jackson Square to include the Embarcadero and port areas from 43 to 70 blocks. Three service zones will provide focused deployment of resources rather than a one-size-fits-all approach. The expansion reflects how people actually experience downtown today as a connected ecosystem rather than a collection of separate neighborhoods. Different service zones have been designated to match varying service needs while ensuring equitable investment across the district. The next two slides illustrate specific service improvements that make this renewal possible. Again, essentially properties will receive double the amount of cleaning and double the amount of power washing and double the amount of safety programs. In addition, we will create dedicated funding streams directly for economic development, advocacy, streetscape improvements, public realm programming, destination marketing, and business attraction efforts. The proposed methodology was developed through a transparent public process and reviewed by our assessment engineer. Year one is projected to generate approximately $11 million in assessments, supporting an overall operating budget of approximately $11.3 million. And you can see the breakdown in our management plan between clean and safe and placemaking, district identity, economic development and advocacy, and administration, management and contingency fund.

Next slide.

A major component of this proposal is the long-term stewardship of Embarcadero Park. This five-acre waterfront park investment represents one of the most significant public ground projects in downtown San Francisco's history. The proposed park overlay will not be activated until the park is substantially complete and a formal agreement is in place with Recreation and Parks Department. This ensures sustainable funding for programming and activation. It's our vision that all San Francisco neighborhoods will have a place here. Approximately $1.8 million will be raised based on a property's proximity to the park. Over the past year, we've completed the stakeholder outreach, developed our new management plan and assessment engineer's report, and our petition process, and conducted the required property ballot proceeding, and today represents the final step in that process. In closing, the community benefit district model has consistently demonstrated measurable results, cleaner streets, enhanced hospitality and ambassador services, stronger marketing and events, and improved coordination between the private sector and the city. But perhaps most importantly, this renewal is about confidence. Confidence for businesses considering whether they'll stay or grow in San Francisco. Confidence for employees returning back downtown. Confidence for visitors, residents, and investors that downtown is continuing to move forward. And we believe this renewal and expansion positions us not only to maintain that momentum but help shape the next chapter. I also want to take a moment to recognize one of our founding members, Clint Riley, who for not him, this organization would not have come together back in 2017 and 2018, who sadly passed away over the weekend. And we wish his family all the best during this time. Thank you for your consideration, and we're happy to answer any questions.

Thank you. Supervisor Chan.

Thank you, President Mendelman. And please help me understand that it looks like the district covered the port side and that the rate collected from the port side is up to a little bit over $800,000 a year. And so it means that the San Francisco port is paying into that, correct?

That's correct. In this case, the port will serve as the master property owner, but depending on their subleases with their tenants, they'll probably be negotiated that they can pass on some of those assessments onto their tenants or subleases.

That means the Ferry Building?

Could mean the Ferry Building, and then this area we're looking through Pier 5 and 7 as well.

But the district that you currently propose, does not include Sioux-Bearman Park or Embarcadero Plaza.

Yeah, our current district boundaries does not include the port nor Embarcadero and Sioux-Bearman Park. So part of this expansion effort is making sure those properties are brought in and there's a sustainable funding model for programming and activation.

And it also does not include the Embarcadero buildings, which is owned by Boston Property.

Currently not, but BXP is represented here today and will be joining the district.

But it looks like according to your proposal, the benefits inclusive of the park overlay, meaning that you are dedicated roughly about $1.8 million to the park maintenance.

Um, not maintenance, but programming and activation. So at the end of the day, rec and park will be ultimately responsible for, um, maintenance and cleanliness. This will be supplemental and enhanced to whatever the city's baseline services will be.

And the $1.8 million, roughly, is not going to happen until the renovation is completed.

Correct. So that will not be triggered now, and it will not be triggered until fiscal year, most likely 28 to 29, in which time property owners will be notified of the triggering, which will be under the authority of our board of directors. And again, we want to make sure the park itself is significantly completed and ready to receive those funds, as well as we have a satisfactory operations agreement with the Rec and Park Department.

And then with that agreement, we'll have to come to the Board of Supervisors for final approval?

I will have to get back to you on that. I'm not sure on that process.

Hi, Supervisor Chan. No, ultimately it has to, the agreement is between Rec and Park and Downtown Partnership in terms of the specificity of the particularities of the maintenance agreement. Given the fact that there's some aspects of the park that aren't fully solidified, Rec and Park was comfortable with the fact that in the management plan, which is in front of you all today to approve, that necessitates the agreement between Rec and Park and DSFP. on these items to be determined.

But help me understand though, because the $1.8 million is actually coming from the community benefit district. And so then wouldn't it be an accept to expand grant to the rec and park and which is then, or are you saying that the CBD is actually going to be doing the programming worth $1.8 million worth and at park property?

The latter part. So, yes, the CBD would be doing the programming itself. And I should also note, too, as a part of both the petition phase and the ballot phase, on the ballot itself there's language indicating to the fact that property owners may be assessed as soon as fiscal year 28-29 for this additional assessment. So this was clear in terms of the ballot language itself and the petition language itself for property owners as they were filling that information out.

I'm just a little bit confused, because at the end of the day, the benefit district is not inclusive of Sue Bearman and Embarcadero Plaza, which is totally fine, because I would assume Reckon Park would not want to pay the tax like Port does. Especially, it does not generate any revenue like the Port would be with Ferry Building. But then the benefit district can decide what kind of activities and programming go on the public land that is worth $1.8 million? I'm just a little bit confused. I'm just trying to understand, how do we then determine what kind of programming, what kind of activities would then be going on to a public park if Rec and Park, I'm just trying to understand the jurisdiction and just decision process.

Sure, sure. Yeah. Let me clarify one point. So currently Embarcadero Plaza and Suburban Park are not part of our boundaries. Right. So with the extensive conversations we've had with the Rec and Park Department, they're agreeing to join the CBD as a part of this ballot process. And the one roughly 1.8 million will be generated through property assessments as well And it's actually based on a formula that we study with other urban parks throughout the country the closer you are to an urban park the Logically the more benefit you're gonna get and probably increase value foot traffic and things like that So that's where we've developed that formula based on proximity so now that hopefully our ballot process will be approved. Our next step is to work with Rec and Park and work with community to decide how should this park be programmed in the future. So there's still a lot to figure out there. We wanted to make sure as we are doing this process now We couldn't go back in a couple years and then try to do another special assessment. So we're making sure that that funding will be there in the future. And we essentially have about two years to work with the department as well as communities to, again, understand what type of programming. And again, our vision is we want this park to feel like it belongs to everybody in San Francisco and making sure that our wonderful neighborhoods have a place in downtown.

My sense is you will have to come back to the Board of Supervisors for final approval for that agreement, similar to what we have done at Cranco Park, which is with the YMCA. But I look forward to it. I think it's a worthwhile investment, and I appreciate the fact that you're making port pay into the CBD but not Rec and Park, and then you're spending programming and support into the park to the public space, which I appreciate. Thank you.

You're welcome. Thank you.

All right, I don't see anyone else in the queue. So at this time, a property owner who wishes to change their vote or who has not yet voted may speak with the Department of Election staff at a table just outside the legislative chambers. They can provide you with the affidavit and ballot. And after public comment closes, the ballots will be counted. Madam Clerk, we will now open public comment for this matter. And we're going to give every speaker two minutes.

Yes, if you would like to provide comments on the downtown CBD, items 53 and 54, please line up to speak now on the right-hand side of the chamber. Once the in-person line has been exhausted, we will go to our remote speakers. If you anticipate providing remote public comment, the telephone number and meeting idea are published on the agenda and streaming on your screen. The first public commenter here in person, please come forward.

Good evening supervisors. My name is Carolina. I am with the transgender district and we have the privilege of being the beneficiary Community partner with downtown San Francisco within their pride events We are here to support this initiative but also to highlight the impact that these three years of partnership that we've had with them has on not only our community, but also the downtown San Francisco area and mid-market corridor, which is where we predominantly work. We're super fortunate of this opportunity because in being in these events, we've progressively seen more and more engagement, and through that, folks that are bringing their families and bringing in joy and expanding upon that during this time. And we believe that this is an initiative that San Francisco should invest into because this is what San Francisco is known for, more so bringing in community and amplifying joy between generations and people within the Bay Area. Thank you. Thank you for your comments. Next speaker.

uh... good evening i'm chris freeze of redco and harrington so i have the luxury of being both the property owner in the district a currently on four buildings about seven hundred thousand square feet and also being a small business owner so i can speak to my experiences with uh... ttsp and i uh... at very excited to support And I've also played a role in the renewal steering committee here with my partner, Dan Kingsley. So I'm offering up my support and any sort of further questions for the board. But I believe we're in great hands and we're excited to see this move forward. So thank you.

Thank you for your comments. Next speaker.

Good evening, President Mandelman, members of the board. Supervisor Souder, thanks for the shout out. My name is Aaron Fenton, and I represent BXP. We own and manage the Embarcadero Center, which is the largest office retail and public gathering space in downtown San Francisco. I'm here today to express BXP support for the renewal and expansion of the downtown SF partnership. Barcadero Center was not part of the original bid because most of the services that the bid provided was something that we already did ourselves. However, after seeing the benefits the bid provides to the financial district, from its street cleaning crews to its public realm activations, We ultimately agreed to join the district, not only to join the district, but to support its expansion because we believe these services that are being proposed are critical to the recovery of downtown. As property owners and long-term investors, we know firsthand that downtown's success depends on more than just buildings. It depends on having clean streets, a safe environment, strong neighborhood identity, and high-quality public spaces, and consistent programming that brings people together. And these are exactly the type of supplemental services that the Downtown SF Partnership provides. We're particularly supportive of the partnership's role in helping activate and maintain the future Embarcadero Park. BXP is currently leading the development of this transformational waterfront in partnership with the city, and we know that successful urban parks around the country, that great public spaces require ongoing stewardship, activation, cleanliness, safety, and programming to reach their full potential. San Francisco is making a significant investment in downtown's future, including the park. The Downtown SF Partnership is the organization that will help ensure those investments succeed long term, way after the ribbon cutting. So for that reason, BXP strongly supports the renewal and expansion. Thank you.

Thank you for your comments. Next speaker.

Hello, my name is Emily Zhu, and I'm speaking on behalf of the ACLU of Northern California, a property owner in the district. We have three overarching questions about the nearly 70% of the proposed budget allocated towards, quote, clean, safe, and place-making, unquote, goals. Firstly, the plan proposes to increase safety patrols, and so we ask who will conduct these patrols, how, and will San Francisco Police Department be involved? What will these patrols add to the existing policing in the district? Secondly, the proposed district budget includes a, quote, integrated network of security cameras. So we ask, who will have access to this footage? How will it be used and managed? And importantly, how will the privacy rights of those captured on camera be protected? And finally, the budget proposes funding for homeless outreach. And so we ask, what will this consist of? Will the district's plan offer genuine access to resources and services, or simply compel unhoused people to take up residence on the streets outside the district? So we look forward to clarification on these points. Thank you.

Thank you for your comments. Next speaker, please.

Good evening, supervisors. My name is Shadi Kalei. I'm counsel at Empire, and we're within the district. I'm here on behalf of Empire to express our strong support for the expansion of the Community Benefit District. There are few initiatives that we as a company contribute to financially that so impressively and visibly deliver on their promises. The staff of the Community Benefit District are a friendly face at each corner, beautifying, assisting, informing, and keeping safe the community members. When we call DTSFPs there in a timely manner, whether to clean trash, power wash surrounding sidewalks, graffiti removal or otherwise, they're there and they deliver. And what this does for the continuing narrative of San Francisco as a resurging, clean, safe city is immeasurable. They're great partners to us and the city at large. We're also participants in and sponsors of Let's Glow SF. We believe it's one of the more unique programs we have in this city, bringing joy and beauty to this city during the holiday season. And it's a small example of what this community benefit district can do when given the resources that it needs. Downtown SF partnership should be marketed as one of the greater benefits of having a business within the district It's that compelling of a benefit that I believe it would actually incentivize businesses to locate within or remain within the district I urge you to vote to expand the downtown community benefit district. Thank you.

Thank you for your comments next speaker

Hi there, I'm Randy how do I represent Gensler which is the largest architecture and design firm in the world founded here in San Francisco in 1965 we were one of the first employers in the wake of the pandemic to bring our employees back to the office five days a week when we moved into our new location at 220 Montgomery Street. So when we were doing that, the efforts of the Downtown SF Partnership in keeping our downtown safe and clean were absolutely vital to our employees feeling safe, feeling proud to be in the office five days a week. Now that we find ourselves in the fortunate position of being in an economic upswing, the expansion and renewal is absolutely critical to kind of continuing that upswing, bringing together the newly expanded district, creating consistency in experiences for our visitors, our clients who are coming to San Francisco to make big investments in our city and our state Having that consistent experience between the waterfront and the downtown with the placemaking efforts in addition to the clean and safe program is absolutely vital and so We as a large employer in the district absolutely support and encourage you all to vote To support this renewal and expansion. Thank you.

Thank you for your comments next speaker

Good evening, Supervisors and President Mendelman. My name is Drew Conley. I'm the General Manager of Gallery Park Hotel and the Financial District since 2024. I'm here to support the renewal and expansion of the Downtown SF Partnership. Just last month in June, the hotel reached a major milestone where we exceeded the June of 2019 in our occupancy. That's the first metric that we've exceeded that since the pandemic. And even though it's just one measure of a hotel's health, every occupied room represents someone who chose San Francisco. They could have held their meetings elsewhere. They could have taken a different vacation. But they came here, walked our streets, ate in our restaurants, visited our businesses, and formed an opinion that they'll take home with them. When I arrived here in 2024, the hotel had missed its budget every month for the past year. The owners had some serious concerns about the long-term future of the hotel. In 2025, we increased by 20%. And then in 2026, we're forecasted to increase by 20% again. I'm very proud of those results, but I don't think they belong only to us. They're an indicator that people are choosing downtown San Francisco again, and we can see that confidence returning in formerly empty storefronts coming back to life in small businesses across the downtown, including several around Galleria Park. conversations with hotel owners and commercial real estate leaders as well they're actively looking for opportunities to invest in San Francisco again and that's a remarkable and hard-earned shift from just a few years ago this renewal will build on that momentum over the past two years renewed collaboration between the city local businesses and organizations like downtown SF partnership has become has begun to change how people experience downtown. Cleanliness, safety, beautification, and active public spaces may sound like separate efforts, but to a visitor, they are all part of one experience. And that's why the downtown SF partnership matters so much, and projects like the Embarcadero Park are important for that effort to continue this extraordinary momentum. Thank you.

Thank you for your comments. Next speaker.

Good evening. I'm John Dunlap, the residential member of the board of directors of the partnership. I've been on the board about four years. I've lived in the district for about eight, and I can't imagine not having this partnership in existence to help keep the streets safe and clean. The key thing for the residents of the district is to make sure that it's safe, it's clean, that there's infrastructure around to support that. I've served on a lot of boards and commissions in my career, and this is one of the most inclusive, forward-thinking, and aggressive relative to mission organizations I've ever been involved with. The staff is incredible, kind, aggressive, as I mentioned, in doing all that they can to service the district. I appreciated joining the board about four years ago as the only residential member of the board I felt I've had a voice, I've been heard, and that I've been able to get access to resources for residents to be able to have an environment that supports a terrific living environment. Additionally, I wanted to mention HOW IMPORTANT IT IS FOR PUBLIC SPACE INVESTMENT AND SUPPORTING ECONOMIC RECOVERY, AND I THINK THE PLAN AND THE INCLUSIVE NATURE OF THIS ORGANIZATION IS GOING TO MAKE THAT HAPPEN AND GROW. CONTINUING INVESTMENT INTO THIS DISTRICT IS IMPORTANT. AS WE ALL KNOW, THE DOWNTOWN NEEDS TO BE VIBRANT AND SAFE, AND I THINK THIS EFFORT, THIS PARTNERSHIP MAKES THAT HAPPEN. SO I WOULD URGE ALL OF YOU to support the renewal and expansion of this partnership. Thank you very much.

Thank you for your comments. Next speaker.

Hi. I'm a resident of D6. I live on Market Street in Midmarket. Have since the summer of 2021 with my wife who's a transgender woman and myself, non-binary person, also queer. It just sounds like, and from everything I have read, this is for businesses. This isn't for homeless people and getting back their economic recovery, or poor people and making sure downtown and San Francisco in general is affordable for them. I appreciate the commenter who talked about what does homeless outreach mean, what do safe streets and Oh, that shit, SFPD shit. Mean because for me, my wife and I experience, have been experiencing a worsening quality in downtown San Francisco where now we have SF, the SFPD presence has increased incredibly over the last several years. And now every night we have multiple SFPD SUVs with their lights on parked directly like in front of our fucking doors. We now are reading about the drone surveillance that is happening more times than we're aware of because they're so high in the sky, our human eyes cannot see them, but they can see us. And as trans people living in San Francisco, which is supposed to be like one of the safe havens in this country, that is not a comforting thought at all. Being surveilled by SFPD is not comforting at all. Seeing homeless people being harassed to move along, and their civil rights broken, and the Department of Public Works just harassing them, SFPD terrorizing them, the sidewalks constantly being cleaned to keep drugs off them and keep people off them. It's terrible for me. So whatever. Thank you for your comments.

Seeing no other individuals here in person, we will be moving on to the remote call-in line. If you have not already done so, please press star 3 to line up to speak remotely. As I previously stated, personal attacks, harassment, or discriminatory remarks will result in the speaker forfeiting the remaining time, and we will be moving on to the next speaker. Let's hear from the first caller.

All right, it sounds like that.

All right, Mr. President.

Did I mention the California State Legislature?

Thank you, guys. Public comment is now closed. All right, so this hearing has been held and is now filed. The ballots are going to be tabulated. We will return to item 54 after the Department of Elections reports the results. And that, I think, Madam Clerk, takes us back to item 41.

Please call item 41. Yes, item 41 is an ordinance amending the police code to repeal the prohibition on certain types of libraries lending or renting any book, magazine, pamphlet, or other printed matter to any person under the age of 21 unless a person has obtained a membership card with the consent of a parent or legal guardian.

Supervisor Wong. We're not timing Supervisor Wong, I don't think.

Colleagues, this ordinance also comes before the full board of the recommendation public safety and neighborhood services committee. This measure is part of my office's broader effort to clean up outdated provisions in San Francisco's codes, including through our dumb laws contest. The law concerns circulating libraries, private businesses that rented books and other printed materials. This industry disappeared long ago before Blockbuster came along, and now Blockbuster itself has been gone long enough to inspire nostalgia, yet San Francisco is still regulating it. Under the current police code, a circling library cannot lend a book, magazine, pamphlet, or other printed material to anyone under 21 unless they have a membership card approved by a parent or guardian. in writing, signed in person, and witnessed by the librarian. So under this law, a 20 year old could vote, serve in the military, work full time, and get married, but would still need parental permission to rent a book. Repealing this law does not affect our public libraries or remove any meaningful protection. It simply removes a requirement tied to a business model that has been obsolete for generations. Good government means not only passing new laws, but occasionally admitting that some old ones are in fact not useful anymore. I thank Supervisor Sodder and Sherrill for cosponsoring this ordinance, and I respectfully ask for your support.

Madam Clerk, please call the roll on this item.

On item 41, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. Aye. Walton, aye. Supervisor Wong. Aye. Wong, aye. Supervisor Chan. Aye. Chan, aye. Supervisor Chen. Aye. Chen, aye. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. Aye. Fielder, aye. Supervisor Mahmood. Mahmood, aye. Supervisor Mandelman. Aye. Mandelman, aye. Supervisor Melgar. Aye. Melgar, aye. Supervisor Sauter. Aye. Sauter, aye. There are 11 ayes.

Without objection, the ordinance is passed on first reading. Please call item 42.

Item number 42 is an ordinance amending the health code to repeal the prohibition on transporting bread in open baskets or containers on city streets, the prohibition on selling unsterilized rags and other types of cloth to be used for cleaning, and the prohibition on operating a laundry for sterilizing such rags without a permit.

Supervisor Wong. Colleagues, this ordinance also comes before the full board of the recommendation of the Public Safety and Neighborhood Services Committee. Like in the previous item, it grew out of our dumb laws contest and is part of my office's broad effort to clean up outdated provisions in San Francisco's codes. This ordinance repeals two sets of old health codes. The first prohibits transporting bread, cake, or pastries through city streets in open baskets, exposed containers, or exposed vehicles. This provision appears to come from an era when San Francisco was confronting very real concerns about disease, contamination, and even plague. Those concerns were not silly at the time, but today we have modern day food safety laws and residents should not have to wonder whether carrying an exposed bagel down the street could become a public health violation or make you an outlaw. The second set of provisions regulates industrial wiping wags with detailed rules for sterilization, inspection, labeling, and special laundry permits. Again, workplace sanitation is important, but those protections are now covered by modern state and federal standards. We do not need outdated local provisions that leave people wondering whether washing a car Dirty rags might trigger a municipal wiping rag violation. Repealing these provisions does not weaken public health protections or create an enforcement gap. It simply removes overly specific rules that have long since been replaced by modern standards. Good government means passing laws when they're needed and recognizing when they're no longer needed. I thank Supervisor Sherrill for cosponsoring this ordinance and I respectfully ask for her support. Thank you.

I think we can take this item. Same house, same call. Without objection, the ordinance is passed on first reading. Madam Clerk, please call items 43 to 45 together.

Yes, items 43 through 45 are three resolutions determining the issuance or transfer of a liquor license will serve the public convenience or necessity of the city and imposing conditions on the issuance of the licenses. Item 43 is a type 42 on sale beer and wine public premises liquor license to the Love Potion Library LLC located at 284 Noe Street. Item 44 is a person-to-person, premise-to-premise transfer of a Type 21 off-sale general beer, wine, and distilled spirits liquor license to Del Rio Produce Market, Inc., doing business at Del Rio Produce Market, located at 2214 Clement Street. And item 45 is the person-to-person, premise-to-premise transfer of a type 20 off-sale beer and wine liquor license to Food Folk LLC doing business as Food Folk located at 210 Clement Street.

And we can take those items. Same house, same call. Without objection, the resolutions are adopted. Madam Clerk, please call item 46.

Item number 46 is a motion approving the mayoral appointment of James Pappas to the Redevelopment Successor Agency Oversight Board, term ending January 24, 2030.

Same house, same call. Without objection, the motion is approved. Madam Clerk, please call item 47.

Item 47 is a motion approving the mayor's nomination for the reappointment of Lieutenant Leonard Poggio to the Entertainment Commission, term ending July 1, 2030.

Same house, same call. Without objection, the motion is approved. Madam Clerk, please call item number 48.

Item 48 is a motion approving the mayor's nomination for the reappointment of Paul Wolford to the Public Works Commission for a term ending July 2, 2030.

Same house, same call. Without objection, the motion is approved. Please call 49.

Item 49 is a motion approving the mayor's nomination for appointment of Vanessa Hartigan to the Port Commission, term ending May 1, 2030.

Same house, same call. Without objection, the motion is approved. Please call item 50.

Item 50 is a motion appointing Robert Eaton, Gail Geary, Catherine N. Mailer, Christopher Ingram, residency requirement waived, and Brandon Bracamonte, residency requirement waived for one-year terms beginning upon the council's first meeting to the Fire Code Technical Advisory Committee.

Same house, same call. Without objection, the motion is approved. And... Let's go to our committee reports. Please call item number 57.

I will start with items 57 through 62 were considered by the government audit and oversight committee on July 16th and were forwarded to the board as committee reports. Item 57 specifically is an ordinance amending the labor and employment code to revise the criteria for an employee in the city to qualify for parental leave benefits. under the Paid Parental Leave Ordinance by reducing from 180 days to 90 days the minimum number of days that an employee must work before they are eligible to receive parental leave benefits from their employer.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call Items 58 through 62 together.

Items 58 through 62 are five ordinances authorizing settlement of lawsuits with the city. Item 58 is with Pauline Silva Ray for $65,000 involving an employment dispute. Item 59 is with Robert Blaisdell and David Portales for $1 million involving alleged personal injury on a city street. Item 60 is with Alfred Martinez Engineering for $80,000 involving allegations of breach of contract. Item 61 is with Ann Lau for $40,000 involving an alleged personal injury on the city sidewalk. And item 62 is a settlement with Samuel Rosas for $200,000 involving alleged civil rights violations.

Same house, same call. Without objection, the ordinances are passed on first reading. Please call item 63.

Items 63 and 64 were considered by the Land Use and Transportation Committee on July 20th and were forwarded to the board as committee reports. Item 63 specifically is an ordinance amending the Public Works Code to authorize the Department of Public Works to recover the city's costs for abating illegal dumping through administrative enforcement proceedings against persons responsible for the illegal dumping and affirming the Cinqua determination.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call item 64.

Item 64 is an ordinance amending the planning code to designate the House of Latin Rock as a landmark consistent with the standards of Article 10 of the planning code, affirming the CEQA determination and making appropriate findings.

Same house, same call. Without objection, the ordinance is passed on first reading. Please call item 65.

Yes, I'll start with item 65 and 66 were considered by the Rules Committee on July 20th. Item 65 was referred to the board as a committee report, and item 66 was not sent. Item 65 was recommended as amended with a new title to approve the mayor's nomination for the reappointment of Lydia So, term ending June 30, 2030, to the Planning Commission.

Supervisor Wong. I just wanted to say I'm pleased to support Lydia So's reappointment to the Planning Commission. Many of us have had the opportunity to work with Lydia over the years and know firsthand the professionalism, integrity, and steady leadership she brings to public service. She has earned the trust of colleagues across City Hall through her thoughtful judgment, collaborative approach, and unwavering commitment to serving the people of San Francisco. I want to thank Lydia for her years of dedicated service to her city and congratulate her on her well-deserved reappointment. Thanks.

Same house, same call. Without objection, the motion is approved. Madam Clerk, let's go to roll call for introductions.

Yes. First up on roll call to introduce new business today is Supervisor Sherrill.

Thank you, President Mandelman. Today I'm introducing legislation that affects the way that we purchase firearms and ammunition under Chapter 21H of the city's administrative code. And this is an update to legislation passed by my predecessor, Assemblymember Stephanie, that has similarly been enacted in other jurisdictions. The point of Introducing this update was really to build on that work and to make sure that our city upholds the stringent standards to work with only The most reputable and ethical dealers in the country, but also to make sure that our city departments our city purchaser Can follow these rules effectively and efficiently and not consistently have to ask for work around. So I'm excited to introduce this. I'm grateful to city administrator Carmen Chu, the city administration's entire office, but especially the Office of Contract Administration for working diligently on this. And I especially I want to thank Brady Against Gun Violence for their partnership, for their support for the proposed changes in this ordinance, and especially to Assemblymember Stephanie for leading the way on this and for helping us kind of continue to update her work. Thank you very much, colleagues. I hope to have your support going forward. And furthermore, I'd like to be re-referred following Board President Mandelman's comments during roll call. The rest I submit.

Thank you, Supervisor Sherrill. Supervisor Walton. Thank you. Supervisor Wong. Thank you. Supervisor Chan has left. Mr. President, do you want to take the motion?

Sure. Could I have a motion to excuse Supervisor Chan from the remainder of the meeting? Moved by Chen, seconded by Fielder. We can take that without objection. Without objection, the supervisor is excused. You may continue.

Supervisor Chen. Thank you, Madam Clerk. Colleagues, today I am introducing legislation that advances our housing element policy goals for the priority equity geographies. Neighborhoods from the Mission, Chinatown, Bayview, Fillmore, Excelsior, and Ocean Mills are home to communities particularly vulnerable to displacement. These are areas which the planning department, the Department of Public Health, and our housing element have defined as having residents experiencing health and housing risks, economic disadvantage, and other demographic and social indicators. why state and local policy continue to incentivize development within the priority equity geographies through rezoning efforts, state streamlining incentives, and density bonus programs. The housing element calls for anti-displacement, community stabilization, and affordable housing strategies. My legislation helps achieve this goal. For development projects that tear down existing homes, it established a replacement housing standard based on the proportion of low-income renters to the overall population within the priority equity geographies, not citywide. The legislation also established an additional tier of affordability, extremely low income, that is more inclusive of the range of incomes of renters within the priority equity geographies. With this legislation, we are expanding our toolbox to keep this city affordable for our most vulnerable San Franciscans. I look forward to your consideration, and I want to thank Supervisor Walton and Fielder for her early co-sponsorship and my legislative aide, Charlie Chamas, for all his work on this. And the rest I submit. Thank you. Thank you, Supervisor Chen.

Supervisor Dorsey.

Thank you, Madam Clerk. I would ask to be re-referred after the board president.

All right. Then we'll Supervisor Fielder. Thank you, Madam Clerk. Colleagues, synthetic text, image, audio, and visual extruders, also known as generative artificial intelligence, have changed the media landscape and therefore the landscape of what is real and what is fake in the realm of information. Now our everyday feeds are full of synthetic media created by large language models that, as they become more and more sophisticated, are making it harder for the average reasonable person to decipher between content that is unaltered and content that is altered. As well, in the months leading up to an election, voters are fed constant streams of ads from various campaign committees via social media, robocalls, mass texts, mailers, and more. That is why I'm planning to work with the city attorney to determine what legislative action the city can take to regulate the use of synthetic audio, photo, and video extruders, also known as generative AI, in the realm of free and fair elections using the least restrictive means on free speech as possible. The rest I submit.

Thank you, Supervisor Fielder. Supervisor Mahmoud.

Colleagues, today I'm submitting a drafting request for revised legislative proposals to continue the vision of the Affordable Groceries Act. focused on the most time-efficient components that we can move forward on in the coming weeks and months. While San Franciscans will not get a chance to have their voices heard at the ballot box on the original version of this proposal, we as a board still have a responsibility to continue to address the problem of food security directly, as we have been for years. Our residents deserve action on food access, affordability, and the activation of zombie stores that plague our neighborhoods. The new Affordable Groceries Act will include new ideas and expand upon already existing programs that we know make a difference, such as, one, restoring funding to the Healthy Retail SF program to convert corner stores into affordable produce stores, because you can tell a lot about a neighborhood's health by how far someone has to walk for a fresh tomato, and in too many parts of the city, that distance keeps growing. Number two, creating grocery startup incentives by expanding the first-year free program to exempt grocery stores from building and planning permit fees, as well as the expansion of the Store for an Opportunity grant to provide funding for capital build-outs of new grocery stores and food deserts. Because if a grocer wants to open in a food desert, City Hall's own paperwork shouldn't be what stops them. Finally, zoning changes such as legislating new density bonuses for housing developments that incorporate new grocery stores on the ground floor, like New York City's FRESH program and reforms to make subdivisions of existing vacant parcels easier for new grocery stores. This is a drafting request, and the conversation will continue, and I hope it ends with every family in the city having a place to buy fresh, affordable produce within walking distance of their home. Today, in that spirit, I'm introducing a resolution in support of AB 1857, the Grocery Store Access Act, authored by Assemblymember Cecilia Aguirre-Curry, because every California community deserves reliable access to healthy, affordable food. Food insecurity isn't confined to any one part of the state. Across the Bay Area, communities from Vallejo to Oakland to San Francisco have watched grocery stores close and sit vacant for years as zombie stores. And a problem that compounds this situation are restrictive covenants that lock out the parcel from ever hosting a grocery store again. When a grocery store closes, communities should have the opportunity to attract a new operator and not be blocked by these restrictive covenants that keep former grocery sites vacant indefinitely. AB 1857 addresses this narrow but important barrier by making these covenants unenforceable under specific circumstances while preserving local zoning permitting health and safety requirements. Organizations on the front lines of hunger here in San Francisco, including Glide, Fax, and the San Francisco Marin Food Bank, have endorsed this legislation. This bill doesn't require any city to approve a grocery store, nor does it override local land use authority. It simply removes an anti-competitive obstacle to restoring grocery access. By adopting this resolution, San Francisco joins communities across the Bay Area and California calling for policies that reduce food insecurity, encourage fair competition, and put shuttered commercial spaces back to use. Thank you, Supervisor Chen, for your co-sponsorship. And colleagues, I respectfully ask for your support. The rest I submit.

Thank you, Supervisor. Mr. President.

Thank you, Madam Clerk. Colleagues, today I have an in memoriam, two resolutions, and an ordinance. I will do the in memoriam first, and I know there are others who want to speak after that, so we'll do that. That in memoriam is for Clint Riley, who died this past weekend age 79, born in Oakland on January 13th, 1947. Clint was the oldest of 10 children, the son of a milkman and a concession stand operator. He grew up in San Leandro and attended St. Patrick seminary in Menlo park for college, intending to become a Catholic priest. As part of his studies, Clint engaged in social justice research and activism. And although he ultimately chose not to pursue the priesthood, and left the seminary several years before ordination, those experiences kindled his interest in politics and its power to affect change on a broad scale. In the 1970s, he founded Clinton Riley Campaigns and pioneered a new approach to political consulting that brought polling, voter data, advertising, and precisely targeted campaign mail under one roof. He was known for focusing races around just a few key issues and communicating those issues to voters through expertly crafted, if harsh, advertising, and messaging. Clint's talents as a political consultant brought him national recognition and established him as one of the most sought after strategists. Over the course of his political career, he worked on campaigns for Speaker Emerita Nancy Pelosi, former Senators Dianne Feinstein and Barbara Boxer, former Mayor Frank Jordan, and that's just naming a very few of his clients. A 1987 New York Times article described Clint and Riley campaigns as perhaps the most successful political consulting firm of its time. Take a random sampling of San Francisco's campaign consultants today, and odds are they spent at least some of their career working for and learning from Clint Riley. In addition to running candidate campaigns, Clint helped Mayor Frank Jordan keep the San Francisco Giants in San Francisco. and helped pass a $52 million bond to fund the creation of the Asian Art Museum. In 1995, he ended his career in political consulting and began one in real estate. That year, he bought the Merchants Exchange Building in the Financial District, home to the Julia Morgan Ballroom. He would go on to acquire a number of downtown office buildings, event spaces, and hospitality businesses. In 1999, he announced a run for mayor, citing concerns about the management of Muni under Mayor Willie Brown. He lost that bid, but he and Mayor Brown later smoothed over their relationship. And Brown remembers Clint as able and dedicated and committed. He was passionate about local media and journalism. In 2006, he brought an antitrust suit against Media News Group, the Denver-based owner of the Mercury News, and Hearst Corporation, owner of the SF Chronicle, alleging the two were colluding to create a local media monopoly. He later entered the publishing business himself, acquiring the Knob Hill Gazette in 2016 and the San Francisco Examiner and SF Weekly in 2020. Throughout his life, Clint, the child of working-class parents who had limited financial resources, never forgot the generosity of those who helped him obtain a classical education, which he credited as providing the foundation for his larger-than-life career. In 2007, he founded Bay Scholars, then known as the Clint Riley Scholarship Program, to help cover tuition costs for students attending Catholic high schools around the Bay Area. Since its founding, the program has awarded more than $3 million in scholarships to 546 students. Clint was fearless, innovative, clearly a generational political talent, and his impact on San Francisco cannot be overstated. He's survived by his wife, Janet Riley, and his daughters, Jill and Ava. And our thoughts go out to them. Rest in peace, Clint Riley. May your memory be a blessing. I see Supervisor Dorsey in the queue.

Thank you, President Mandelman, for that excellent in memoriam for Clint Riley. I appreciate the opportunity to add my own words to yours and to express my condolences to Janet and Jill and Ava, as well as to the many friends, colleagues, and employees whose lives were touched by Clint's generosity, conviction, and love for our city. I first met Clint Riley in 1990 when I was a young political operative brand new to San Francisco from Boston. He was a legendary political consultant who had famously just fired Dianne Feinstein as a gubernatorial client. It really wasn't until years later that I got to know Clint and Janet, however, and truly appreciate how much they contributed to our city and to its diverse communities. For me as a Catholic, one of the things I most admired about Clint was his groundbreaking leadership as the first lay chairman of the board of Catholic Charities. At a time when lay leadership in the church wasn't common, he represented a brand of liberal Catholicism that appealed to me and that ably demonstrated how faith and public service can reinforce one another. Within our church, as well as within our city, he was a strong voice for social justice, even when it wasn't easy. In fact, for me as a gay man especially, I really appreciated the principle stance Clint took in 2015 when he spoke out boldly against Archbishop Salvador Cordelioni over approaches that were hostile to the LGBTQ plus community. Clint helped to orchestrate a full page ad in the San Francisco Chronicle, whose signatories included Tom Brady Sr. as well as Clint himself, calling on Pope Francis to replace Cordelioni for fostering, quote, division and intolerance. That was also not the first time Clint Riley stood heroically as a straight ally to the LGBTQ plus community. Hank Plant, the longtime broadcast news reporter and anchor here in the Bay Area, recalled on social media that one of Clint's first political acts was to go down to Dade County, Florida in 1977 to campaign against Anita Bryant's anti-gay ballot measure. Earlier today, I was texting with John Whitehurst, whose two and a half years working for Clint taught him enough to spend the next 35 years working as one of San Francisco's top political consultants in his own right. John recalled that Clint worked side by side with a generation of gay political consultants, some of whom were mentors to me early in my career, including Robert Barnes, Jim Rivaldo, and Dick Pabich. Clint Riley was a staunch ally to the LGBTQ plus community and a man of courage and principle who never hesitated to speak his conscience He leaves a valued and enduring legacy to the city.

He loved he will be missed and may his memory be a blessing Supervisor Cheryl Thank You board president Mandelman for sponsoring this this in memoriam You know, what has always stood out about Clint's story is in how many different ways he found to invest in this city. Politics, real estate, journalism, philanthropy, building a family here. In each chapter, he was building something that made San Francisco stronger. Today, local journalism is under enormous pressure, but his decision to purchase the Examiner and commit to its future, invest in its future, was a meaningful act of civic faith that I know I and so many of us sitting here have deep appreciation for. Through Bay Scholars, he made sure that a family's financial circumstances would not be the deciding factor in whether a young person in the Bay Area could access an excellent education. And this impact, again, was not confined to any one arena. His mark was left on a wide range of fields and a breadth of contribution, which is truly rare. His legacy carries on through the lives he uplifted, the institutions he created, of course, the Giants, who he helped keep in the city, and the many other ways he devoted himself to serving the city he loved. I want to extend my condolences to his wife, Janet, his daughters, Jill and Avon, to all who worked alongside him to make the city better. Thank you, colleagues.

Thank you, colleagues. I'll move on to my resolutions. The first is a resolution celebrating the 155th anniversary of the San Francisco Campus for Jewish Living and commending its long record of compassionate care for older adults in our city. Founded in 1871 to care for the aged and infirm members of San Francisco's Jewish community and formerly known as the Jewish Home, today the campus on Silver Avenue is anchored by the Jewish Home and Rehabilitation Center and the Frank residences, and provide skilled nursing, rehabilitation, assisted living, memory care, and one of Northern California's only specialized inpatient geriatric psychiatry units. The campus is one of the largest nonprofit employers in the Excelsior, training the region's next generation of geriatric care providers and serving more than 2,500 individuals and families each year. Work it carries out for anyone who needs it, regardless of ability to pay. I myself will forever be grateful for the care of the Jewish home provided to my grandmother and then to my mother as they each approach the end of their lives. Colleagues, I want to thank co-sponsors, Supervisors Chen, Melgar, Dorsey, and Wong, and ask for your support for this resolution honoring the San Francisco Campus for Jewish Living's century and a half of service to older adults across San Francisco. I'm also introducing a behested payment waiver resolution to allow FilmSF to partner more closely with the San Francisco Travel Association and our local hotel industry. Our film industry depends on partners across the city who help us market San Francisco as a premier destination for film, television, and media production. San Francisco Travel Association is one of those partners, and our hotels are too. They want to invest in promoting San Francisco as a filming destination, and FilmSF wants to work with them. However, since San Francisco Travel obtains film permits through the Film Commission, it is classified as a restricted source, so FilmSF is limited in its ability to solicit or accept in-kind support, even though promoting San Francisco as a film destination is a shared objective. The same is true of hotels. A local hotel recently approached FilmSF wanting to host a film industry mixer, but because that hotel obtained a permit through the Film SF office, Film SF is unable to solicit or accept that kind of support without a waiver. This waiver would authorize the executive director, commissioners, and staff to solicit donations and in-kind support from the San Francisco Travel Association and hotels for a limited six-month period to support Film SF's marketing and industry engagement efforts. Marketing San Francisco as a premier production destination is critical to attracting film, television, and media projects that create jobs, generate local spending, and showcase the city to audiences around the world. Hosting industry events, building relationships with productions, and getting the word out that San Francisco is open for business can help bring film, television, and media projects here, and with them, the jobs and spending that follow. Sponsorships and in-kind contributions like these allow the Film Commission to expand its marketing and community engagement work without relying solely on city funds. I want to thank Monizhe Fataf from FilmSF and Lauren Curry from the City Attorney's Office for their work on this legislation. I also want to thank Grace Wong and Maeve Skelly in my office. And lastly, colleagues, I am introducing an ordinance to update Chapter 7 of the San Francisco Environment Code. Chapter 7 codifies the city's municipal green building requirements. These updates will provide clear guidance to city departments regarding the design, development, and renovation of of city buildings and advance building sector climate goals in the years ahead. They also streamline existing requirements and align them with industry standards, regulations, and the city's 2026 climate action plan. I want to thank Cindy Comerford, Nick Kestner, Barry Hooper, Alice Herr, and Charles Sheehan at the Department of the Environment for their work on this update. I'd also like to thank Rob Kapla from the city attorney's office and Grace Wong from my office, and the rest I submit.

Thank you, Mr. President. Supervisor Melgar.

Thank you, President. I'd like to be added to the memoriam for Clint Riley. I also, like you, Supervisor Dorsey, worked for Clint in 1994 while Clint was running Kathleen Brown's campaign for governor, which she was ultimately defeated by Pete Wilson, unfortunately. But we'll always remember his mentorship. Many, many very strategic and interesting conversations, even ones when we disagreed. And send all the love to Janet and his family. And the rest I submit. Thank you.

And actually, maybe we can have that come from the full board as well. So let's have that be from the full board.

Thank you, Supervisor Melgar. Supervisor Sauter. Thank you, Mr. President. Seeing no other names on the roster.

Let's go to public comment.

At this time, the Board of Supervisors welcomes general public comment. In-person speakers will be prioritized, so please line up on the right-hand side of the chamber. During general public comment, you may speak to approval of the June 16th board meeting minutes. Item 69 through 75, the items under the for adoption without committee reference agenda and other general matters that are not on today's agenda but must be within the board's subject matter jurisdiction. First speaker, please.

Uh-oh.

Not quite. Hi, everybody. Again, my name is Amelia, and I have returned to speak on the removal of the peer counselors from the Street Crisis Response Team. In my individual capacity, I have provided each of you a problem-solving framework to break through the silos between our first response, healthcare, social service, and homelessness systems to fix this. And thank you to the five supervisors' offices that have already engaged with me and my colleagues. One of the clinicians from NUHW said it earlier, something along the lines of, the beginning of the care journey is where you need to inspire hope. And I cannot make a better case for keeping peers on street crisis. National research on certified peer support consistently shows reduced repeat emergency calls and better engagement in care. A 911 engagement that ends in refusal is taxpayer money spent twice, maybe three, five, 10 times over again. Every avoided ambulance transport and emergency room visit is general fund money. Removing peers doesn't cut costs. It moves costs to the most expensive parts of the system. I am interested in working upstream. In the provided framework, I have included a mechanism for Medi-Cal reimbursement for peer services. My first ask, before the recess, sign a letter to the mayor's office requesting he convene appropriate stakeholders and pause the restructuring pending interdepartmental review. If this does not suffice, I ask the Rules Committee to calendar a hearing to evaluate the program and proposed framework I further ask the budget and appropriations oversight to require outcome data before this program changes again in the future. In this hard fought moment of growth for a 24 hour crisis continuum of care, we cannot afford to lose the critical function of peers inspiring people to accept the services we now have. I ask this legislative body pause, examine, and measure. We have to act proportionally across the system of care. Thank you.

Thank you for your comments. Next speaker.

Hello, this is a poem I wrote recently as a San Franciscan. Try not to have an aneurysm, it's just a poem. Another man, a father, an immigrant from Mexico with copper skin was hunted down and murdered by ICE again. I see one of his adult kids speaking into cameras in anguish, crying that his father didn't deserve this. They break my heart, breaking through brick, squeezing tears from concrete tombs. I feel when I see memorialized father, mourning family, absolute evil, sanctions evil, worse than roaming, targeted AI surveillance, powered hunting in the streets. I think of here, my home, empty streets, invisible evil, vanished immigration courts, defunded rapid response network, SFPD targeting humans, queer and trans, Via AI surveillance-powered real-time response center, Chris Larson-funded drones and cameras housed in Donald Trump's tower, swarms of SFPD, indistinguishable from ICE, tackle and attack people who didn't deserve this. My tears are frozen. It's too cold here in San Francisco. Hot Texas expanding ICE melts me. Cold California expanding transphobia frees me. Fight, flight, fawn, clammy panic, quiet panic. Scream, where? We're uncivil and loudmouths if we do. A frozen brick, an exploding brick, a silent brick, a sailing brick, an upright brick, a blood red brick, a historical brick. An extension of my being, atoms, earth bonded in different formations with different properties, mingling electrons, exchange between me and brick. My muscles strain the longer I grip this compact collection of organized atoms, potential energy ignite. Also, you have a colleague spewing racist, Islamophobic, anti-queer, transphobic tropes, and now Red Scare rhetoric. Yet I don't really see anyone countering his fear mongering. Save one or two supervisors sometimes. So your silence allows a culture of bigotry and repression to flourish. And if you don't agree with any of that, you should be an adult to use your words and say something.

Thank you for your comments. Next speaker.

My name is Richard S.T. Peterson. Tribute to Clint Riley, if you've ever really spent time with him, and I, over the years, spent some time with him. He's the greatest phone booth knife fighter in San Francisco history. The good news for me is that I think I still have my license to practice law. And the bad news for many of you or some of you is that I've got my license to practice law. The reason I have this little demonstration here is how easy it is to interrupt even when you think you have everything set up in a law office. This is an optical fiber. It can be cut with a simple toenail clip, put you down. Takes a week before you get even service to come out there and look at what's happening to your problem. There are a lot of issues in San Francisco that I think that can be taken down by, I think, a simple snip of these little fiber optic cables. So some attention needs to be paid to that. But I want to let you guys go before I ramble on and have a nice weekend.

Thank you for your comments. Are there any other individuals who would like to provide public comment in person? Seeing none, we'll go to the remote call-in line. If you have not already done so.

Shout out to Mimi Haas. Love you.

If you have not already done so, please press star three to line up remotely. As I previously stated, personal attacks, harassment, or discriminatory remarks will result in the speaker forfeiting the remaining time, and we will move on to the next speaker. Let's hear from our first remote caller.

My name is Gord Orbison and I live up in Modoc County in the state of Jefferson. I want to talk about Wild'N Out Live here in California and San Fran. Specifically, I hate drannies. I hate them so much. They beat our girls in sports. They beat four bull females in county jails and rape prisons. And they wave their dicks around and demand welfare benefits and free housing. As Edith and Archie Bunker once said, and you knew who you were then, girls were girls and men were men. And if any of these disgusting trainees enter a restroom with my wife, they'll have a bad time. California should repeal special rights for trainees and lock them up in institutions. God bless America and God bless our eternal president, Donald Trump.

Do we have any other callers on the remote call in line? Let's see, none.

I remain unpersuaded that this was a good idea. With that, public comment is now closed. All right, Madam Clerk, please call for adoption with that committee reference agenda items 69 through 75 together.

Yes, items 69 through 75 were introduced for adoption without committee reference. A unanimous vote is required for adoption of a resolution on first appearance. Any supervisor may require a resolution on first reading to go to committee.

Supervisor Sherrill.

Sever number 70, please. Okay.

Looks like that's it. Madam Clerk, can you call the roll on the remaining balance of the items?

On the remaining balance minus item 70, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. Aye. Walton, aye. Supervisor Wong. Aye. Wong, aye. Supervisor Chen. Chen, aye. Supervisor Dorsey? Aye. Dorsey, aye. Supervisor Fielder? Aye. Fielder, aye. Supervisor Mahmood? Aye. Mahmood, aye. Supervisor Mandelman? Aye. Mandelman, aye. Supervisor Melgar? Aye. Melgar, aye. Supervisor Sautter? Aye. Sautter, aye. There are 10 ayes.

Without objection, the resolutions are adopted and the motion is approved. Please call item 70.

Item 70 is a resolution supporting California State Assembly Bill number 2564, which would prohibit retailers from engaging in surveillance pricing.

Supervisor Sherrill.

Thank you, President Mandelman. First and foremost, I want to thank Supervisor Fielder for bringing this up. I think the point of AB2564 to make sure that companies are not jacking up prices on consumers based on any number of things is fantastic. I have some questions specifically regarding some amendments that are going around in Sacramento to address concerns about kind of Let's call it inadvertently prohibiting companies from issuing discounts based on recent purchases. So just to get some time to address those concerns and make sure of that, I'd like to just send this item to committee.

All right.

It's going to committee.

Do I gavel on that? Okay. And I think the last time I did this, I got in trouble because I allowed for dialogue at this moment, which I don't think we get to do. So I think it's gone to committee. All right. Do we have, how long do we think it's going to take us to get the results?

We do have the Sergeant in Arms checking to see with the Department of Elections. We have OEWD just walked in.

Are you done? You're ready, okay. Then we will go back to... 54, thank you. PSNS. Okay, we're now going back to item 54. Madam Clerk, can you please read the results of the election?

Yes. The return weighted ballots voting for the Downtown Community Benefit District was 85.15% and the return weighted ballots voting against the Downtown CBD was 14.85%, further indicating there was no majority protest.

So there is no majority protests. And therefore, Madam Clerk, can you please call the roll on item 54?

Yes, on item 54, Supervisor Sherrill. Aye. Sherrill, aye. Supervisor Walton. Aye. Walton, aye. Supervisor Wong. Aye. Wong, aye. Supervisor Chen. Aye. Chen, aye. Supervisor Dorsey. Aye. Dorsey, aye. Supervisor Fielder. Aye. Fielder, aye. Supervisor Mahmood. Mahmood, aye. Supervisor Mandelman. Aye. Mandelman, aye. Supervisor Melgar. Aye. Melgar, aye. Supervisor Sauter. Aye. Sauter, aye. There are 10 ayes.

Without objection, the resolution is adopted. And that takes us, I believe, to our imperative agenda. Do we have any imperative agenda items, Madam Clerk?

We have no imperative agenda items today.

Then could you please read the in memoriams?

Yes. Today's meeting will be adjourned in memory of the following beloved individuals. On behalf of President Mandelman and the entire board, for the late Mr. Clint Riley.

I think that brings us to the end of our agenda. Madam Clerk, do we have any further business before us today?

That concludes our business for today.

We are adjourned.