tv Government Access Programming SFGTV May 22, 2019 6:00am-7:01am PDT
dealing. we see people in wheelchairs selling their drugs for extra cash. these are all things that the city can do something about. why do we have a methadone center and two s.r.o.s, a bar, offices, and now, you know -- [inaudible] >> these are all city policies that, you know -- the problem isn't going to -- the problem has to be pulled apart piece by piece, and it's not going to happen in just one street. i do support the task force, by
for over the past 20 years, we've been in the tenderloin district, and now for generations, we've had families who have lived with open air drug dealing, open air drug use, and all the problems that go with it. we live among four sites that are disconnected. what that means is every day, our staff, with their families have to navigate all the traumas that has happened in this tenderloin district. we have kids who we ask more and more recently to reflect on their time in the tenderloin and their boys and girls club. and they don't even mention it anymore. they've normalized it, something that should not be normal. and what has ended up happening is we go through your essays to get in college, they don't even
mention it no more. this is a very beautiful, tune time for us to really make some changes. i look forward to seeing what we do next because there's a lot of energy, a lot of argueses, a lot of people that are ready to do something great here. what we're looking for is to have a system changing procedure, to allow changes in practices to really occur. this task force is definitely a step in the right direction, and i can't wait to see what happens next. thank you. >> supervisor mandelman: thank you. next speaker. >> my name is felicia smith. i'm the tenant organizer at the hotel at hyde and geary, half a
block away from where a major drug organization is at. i moved there five years ago, and i noticed when i first moved there, there were all these 13 and 14-year-olds out there, and i knew what they were doing. and i wondered, why aren't they in school? and now, it's the same guys out there, and they have become more aggressive. i walk out my door, and within 15 feet, i've got them saying, do you want something, mama? do you want something? it got to the point where i finally screamed, i don't do drugs. they're getting more aggressive, they're getting meaner. i would like to say one thing, that we've had a lot of
negativity here. i've been in san francisco 39 years. this is my fourth time around in the tenderloin. it is the best time. it's a community now. i can walk down the street and have people say hi, felicia. how you doing? or give me a hug, come across the street. the three times before, i didn't know anybody. it is a community now. now we just need to get rid of the drug stuff. thank you. >> supervisor mandelman: thank you. next speaker. >> good afternoon. my name is eric arguella ao an work at the glide community justice center as a community organizer. i think to have a long-term
sustainable out come that has sustainable communities, it's best to learn what are the issues. it is history of trauma, drug use, and poverty will play a role. we all know criminalization, incarceration, war on drugs has not worked. it only creates a system of punishing then taking a holistic healing approach long-term. this needs to be addressed by bringing members of the local community who are the experts, who understand the del indicate balance between surviving and thriving, people of color who understand experienced profiling on a day-to-day basis, individuals in recovery and such. the outcomes will be truly informed, well thought out, and
in a harm rubbieduction approan a long-term approach. thank you. >> supervisor mandelman: thank you. next speaker. >> good afternoon, honorable supervisors. my name is riannon baylard, and i am the executive director of operations at u.c. hastings law. thank you for addressing this epidemic that is overrunning the tenderloin. i oversee policing and security for hastings and this is an issue that we deal with on a daily basis. our staff are scared to come to work. our students, if they choose to come, many who come to the neighborhood decide not to attend hastings because of what they see here. those who do choose to come are scared to go-between buildings, and yet these are individuals
that have a choice. they can choose to go to school or work elsewhere. as has been said, there are many in the tenderloin who do not have another option, including many seniors and children as has been mentioned multiple times. so i see an opportunity here for us to come together, to reject that the tenderloin has and continues to be a dumping ground for drug activity and activities that more affluent neighborhoods push out of their neighborhood and into the tenderloin. i don't know what the solutions are. there have been a lot of good suggestions that have been provided to today, but i believe if you are all commit today convening this multidisciplinary task force and also commit to recommendations that come from the task force, it will be a step in the right direction, and hastings stands ready to partner with you in these efforts. thank you. >> supervisor mandelman: thank you very much.
next speaker. >> hi there. i'm a resident, and i work in the tenderloin. listening to all of these people talk, i realized something. you know, i'm not smart enough, nor am i -- well, we'll just leave it at that. i'm not smart enough to figure out what will work on this task force. but i do know for sure what won't work. i think it was in 1914 was the first several mandated markets laws was -- narcotics laws was established. now, i don't know what is right, but i know a path to follow, and that is what we have done in the past. so you've got to be thinking outside of the box because buying -- hiring more police
may seem like that's a thing to do but that's the worst thing because that's all we've not done in the past. so all i can say it i don't know what you can do differently, but please, let's think outside the box and let's be a task force that can do something for a positive change and not just be the same old, well, we did this last year so let's do it this year because it's too difficult to come up with something. really meaningful, and have it work. thank you. >> supervisor mandelman: thank you. next speaker. >> my name is tony page. i'm a resident in -- off the -- off of 6th street. i'm also a volunteer at glide. the reason why i've come, you know, we're talking about open air drug dealing. thing is, where i live, i see it all the time. and most of the people i see
doing it truthfully are kids. i'm seeing, like, 13, 14, 15, 16-year-old kids doing it, and they're the ones that aren't making that much money off of it. it's the people that send them that's really making the money. a lot of these kids are doing it just for survival. i think it would be a good idea to come off of this task force so we're not criminalizing them. some of them are doing it because they don't see any other opportunity. we need new ideas, you know, to help bring this solution to a close, you know? and we also need a way to diverse the interests of these kids so that they don't think that drug dealing is the only way to go, you know? maybe more education or where
to find more hobbies or common interests or something, just something, you know? because these kits -- kids are our future. that's all. >> supervisor mandelman: thank you. next speaker. >> my name is fione o'shea. i'm a resident of 9th street. i.v. drug users that come down to the alleys after they purchase, if they're not in their cars because people do come in their cars to purchase in my neighborhood, too. most of the drug dealers in my neighborhood come on b.a.r.t. [please stand by].
>> -- that their police department is interested in increasing that foot patrol, maintaining what they installed on the streets. i think there's a lot of people we see every day in the neighborhood, and whether it's street sweepers, the neighbors that live in the building or the neighbors that live a block away from us, one of the things we'd like to see on our blocks are guys and girls in uniform. >> thank you. >> supervisor mandelman: thank you. next speaker. >> hi. my name's john hui. s.f. native, born and lived here all my life.
we've heard the stories of other people. mine is nothing special, but i want to share it any way. growing up, i experienced things that people of color experienced. when my mother and i would go to chinatown on the weekends, she was harassed by this female police officer. because she didn't speak english, she didn't know what to do. my god father told us about issues he had to deal with growing up just because he's black. i was allowed to graduate from s.f. state with a criminal biology degree, but i wanted to get a degree in criminal justice. i'm back to school, trying to finish that up. i have a cousin that, you know, i've known him since he was two years old, since he moved here. great child, bubbly.
he moved out to the tenderloin, and growing up, he's just been distant. he got to hanging around the wrong people. he doesn't listen to anyone. it's heartbreaking to see these things. i, yeah, just wants to put that out there and share that. thanks. >> supervisor mandelman: thank you. next speaker. >> hi. my name is michael nolte. i want to thank you for having this hearing but i also want to thank you for having the hearing yesterday on the same thing, particularly, having a hearing on the assets and what does the city pay for? i think if a lot of these people could understand what is being paid for and not being paid for and how to improve it, that's part of the issue we need to address. business owners in the area are concerned about property
damage. they're also concerned about -- as a resident, i'm concerned about how to keep the items in the stores that's affordable. when that damage gets passed along to the consumer. i'm also a moderator of many message boards in the neighborhood. obviously, the elected officials are not necessarily moderating -- monitoring what's going on on those message board. they'd see the complications we have and maybe would do a -- find some solution just by what's being posted on the message boards. also, those who have been arrested in the past, there needs to be some skills be offered them so they don't
recause problems. i think that's a major problem in being rehabilitated so they can move on with their lives. in the past, we've had in san francisco, the guardian angels, and the guardian angels, they made a difference and can maybe do something that can fill in some of the gaps. thank you. >> supervisor mandelman: thank you. next speaker. >> officer krupke. is it a problem of excessive crimes? is it a problem of excessive crime control? the problem is both. so let's have another committee. we'll fill it with the staffers of all the n.g.o.s. it -- it occurred to me that this district, this
neighborhood is -- because of the redistricting and the nature of redistricting, it's being threatened to being put into three separate districts. and also under jane kim, under her leadership, tens of thousands of people in the tenderloin line in district three, outside this district. this is what has allowed this community to come this far, which is pretty amazing. don't you dare, don't you dare put someone on that redistricting commission that has not served on a single government board like what happened last time. >> supervisor mandelman: thank you. next speaker. >> i just wanted to say -- --
to hiv and then more recently, things like mrsa and other antibiotic resistant diseases. we fight these things with the drugs that are sold out there. people don't talk about that there. part of what kept that down there is opium, and what it does to the immune system. for people to shutdown that open air market which makes or streets safer for something we have to have as a consistent issue in manhattan, that's a scary thing. it's just something to be aware of. thank you. >> okay. >> supervisor mandelman: thank you. next speaker. >> good afternoon, supervisors. my name is wendy, and these are
some of my thoughts. you can't solve open air drug dealing without reducing demand. reducing demands means treatment for substance use and mental health issues. but please consider this. the city spends $7 million per training class of the police department of about 50 people with an average of 35 that comes out of each graduating class. they come out, and they make $93,000 a year. no student loan debt, okay? first, is training for those of us in the helping profession, whether it's social workers and the like. people who work in these
professions, they take training on their own, come out with lots of student loan debt, and they make about 40 to $45,000 a year. just food for thought. >> supervisor mandelman: thank you. are there any other members of the public who would like to speak on this item before i close public comment? public comment is now closed. [gavel]. >> supervisor mandelman: supervisor haney? >> supervisor haney: well, first of all, thank you, chair mandelman. you're going to think twice before you're going to -- let me see your agenda before i bring items to your committee again, but i hope it was a worthwhile experience. this obviously is something that really, you know, most directly impacts the neighborhood that i represent but it's important to our
entire city and to all of our residents. supervisor mandelman has put forward actually a task force that relates specifically to meth. as i heard all the calls for creating a task force around this issue, i think it would be great to talk to you about what you've learned already from that process and what it would look like. so i just want to thank you and supervisor stefani and supervisor walton for letting us be a part of it. i want to thank everybody who's still here. i think it shows how committed we are to finding solutions around this. i really want to apologize, and i hope you'll extend apologies to folks who wanted to share but who couldn't stay. there are people working on
safe passage every day. i just want to say i appreciate them. this was a department heavy hearing, but i think it was an important thing for us to do. it really showed us what is happening, it showed us ways we can take as we pursue paths forward as a committeunity. i'm committed to having further conversations in the community about what those next steps will be, and we can have further conversation with a lot more opportunity for more comment out in our district. that'll be the next step. i also want to say i am incredibly impressed by comments of the members of the community today. it was also really hopeful to me that there was such
unanimous and strong support of a task force. to be clear, that's not what i was calling this hearing to do, and i think it's all that much more powerful that there's a mandate to do that because the community came and said this is what we want. that did not come from me, that came from the district. i am a resident of the tenderloin, i live on hyde street. i think if there's a community that can come up with the solutions and do this the right way and deal with the complexities and have empathy and understand all sides of it, it's our community in district six, not just in the tenderloin but in midmarket and soma, as well, and throughout our district. so there will be next steps. i learned a lot. i have a lot to process, as we all do, but this is not the end of it, this is -- we are going to continue this with urgency. the intention is not to refer it to some committee and you don't hear anything for a couple years. we're going to have to think
about what we want that task force to do, what the timeline will be, and what the immediate short-term changes and prosecute priorities ne priorities need to be right now. we have budget changes coming up, so i need to know what to move forward for for some long-term changes. thank you, supervisors, and to everyone who came out. sorry for the length of this, but more than anything, thank you for your commitment. i also want to let you know, a number of the departments did stay for the entire piece. oewd, the captain, the district attorney's office. so we appreciate that, as well -- our b.l.a., as well. thank you all for being here, and next steps coming very soon. appreciate it. >> supervisor mandelman: thank you, supervisor haney. this was a very long hearing.
i think it's longer than you anticipated. it's longer than i anticipated. i know that i and some other colleagues had to rearrange some previous engagements. i guess for supervisor walton and stefani, i pledge to do a better job in the future of figuring out how long things are going to be taking and limiting our staff presenters to a shorter period of time. i was thinking somewhere around hour two that if there's any neighborhood that is deserve of a little extra attention at city hall, it's -- you know, it's probably the tenderloin, and so i do think this was four hours well spent. i also think that as you say, the issues that came up here touch on larger issues that affect our criminal justice response, our response to substance use, our response to issues that are not neighborhood specific but do go
across the city. given the interest of the board and the mayor and all of san francisco and more effectively tackling these problems, i think it was also a useful hearing in that regard. as you say, there are a lot of task forces and efforts going on, the meth treatment folks are working. i thought it might make some sense to have some sort of blue ribbon around mental health and substance abuse, but there's some critical call for attention on the tenderloin. any way, i won't go on too terribly much longer, except to say that supervisor haney, you're okay with having this heard and filed -- you have two options. you can have this continued to the call of the chair, in which case, it would sit in this committee. if you wanted a further hearing, you could just pull it. i think i would prefer to have it heard and filed. >> supervisor haney: you don't
want to do this again? yeah. heard and file. if we move forward in the task force, it would be the introduction of a task force. you can close and file this e one. >> supervisor mandelman: excellent. so i will have this heard and filed with no objection. mr. clerk, are there any more items before us today? >> clerk: that completes the agenda for us today. >> supervisor mandelman: mr. clerk, thank you so much for your patience and help today, and with that, we are adjourned.
>> hi, everybody. welcome to laguna honda. [cheering] >> and before we get started, my grandmother spent almost 14 years here at laguna honda, and so many of you took incredible care of miss camelia brown. i want to give a special shout out to denise and so many people here who day in and day out take care of some of our most vulnerable folks that rely on us to care for them every day. we are so grateful to be here with our governor, gavin newsom. [cheers and applause]
>> he has already hit the ground running, and we know from experience of being a former mayor of san francisco, he understands intimately all the challenges that we as a city face, which really is going to be so incredible for our city and cities across the state of california for all the things we know we need to do to change california for the better. laguna honda is a key part of san francisco's health network, which cares for one in eight san franciscans. primarily people who are uninsured, low income, or for -- from our immigrant communities. and includes not only laguna honda, but san francisco general , and smaller clinics across our city, and health services in our county jail. here at laguna honda, more than 1,000 patients each year receive care for complex conditions like
h.i.v. and alzheimer's and dementia, and other mental illnesses and disorders, and we have, for patients who are suffering from strokes or brain injuries, or spinal injuries, or other trauma. these treatments require long-term and specialized care, as so many of you here know, and they commonly include medications as part of the treatment plan. however, it is a well-known fact that these medications are expensive, and can drive up the cost of healthcare for millions of people who need these drugs to survive. the san francisco health network is constantly working to find ways to save money on drug costs for uninsured patients. we work with federal programs like the 340 b. program that provides drugs at a discounted rate for some of our facilities, but facilities like laguna honda
, or our county jail, our behavioral health clinic, they don't qualify for those federal discounts. not to mention the medications used in treatment plans at these facilities are some of the most expensive medications. the health network purchases more than 3,000 drugs for patients who don't qualify for 340 b. discounts, and just the 25 most expensive drugs, of those costs, it because our city more than $17 million each year. when we have people struggling on the streets of san francisco, with mental health challenges and substance use disorders, or people spending thousands of dollars on life-saving medication for h.i.v. and aids, or people fighting a battle with cancer, we need to be focused on helping them recover and heal,
not whether or not they can afford to pay for the medication this is the same case at many healthcare facilities, not only in san francisco, but across the entire state of california and the nation, and this is why i am so thrilled to be joining governor gavin newsom here today to announce a san francisco will be joining the efforts to bring down medication costs in our city. [applause] >> we will work hard to bring down the cost of those medications. we have worked hard over the years, but we know there is so much more that we can do, and by joining forces with other counties across the state, we know that we can make a difference in the lives of millions of patients. we are joined here today by two
other bay area counties in making this commitment, alameda and santa clara county, and please join me in acknowledging our new department of public health director, dr. grant koufax who is here with us today [applause] >> at this time, i would like to call to the podium colleen who has spent about 13 years working for the department of public health in san francisco. she is an incredible health care advocate, now heading up alameda county department of public health. [applause] >> good morning, everyone. it makes me so happy to see so many familiar faces here, and to be able to bring my new county in partnership with my old city and county in this really exciting endeavor. alameda county is pleased to stand with governor newsom to leverage the collective garb --
bargaining power as a state in its counties to lower the cost of prescription drugs for all californians. i would like to thank the governor for his leadership on this important issue. alameda county's vision 2026 is in alignment with the health forward agenda. vision 2026 is our comprehensive effort to set a course for a decade that anticipates community challenges and maximizes our ability to meet residents's needs in this rapidly changing world. vision 2026 foresees a thriving and resilient population where individuals and communities are empowered to overcome adversity and be supported so they can grow, flourish and be self-sufficient. essential to achieving this vision is our ten goal of healthcare for all, which seeks to ensure that every person in alameda county has access to the care and services they need to live their healthiest lives.
governor newsom's collaborative approach to obtaining prescription drug costs will put us closer to a comprehensive solution for affordable and accessible healthcare for all. collectively, public healthcare providers and other safety net providers in alameda county, spends tens of millions of dollars each year on prescription drugs for our county's most vulnerable residents. while many of these drugs are acquired through the federal 343 b. program which may or breed referenced, drugs purchased for individuals accessing our behavioral health services or our inmates and our jails do not this means that we are surely paying more than we need to for these medications, diverting valuable resources from other safety net programs and services this presents an important opportunity for our county and others to partner with the governor's healthcare team to explore how we can make drugs more affordable in our safety net healthcare system.
additionally, this approach will foster regional collaboration through the sharing of information and protocols and best practices. alameda county is looking forward to partnering with the governor's office, and our county colleagues to explore the promise of this timely endeavor. at this point, i would like to welcome miguel marques, marquez, the chief operating officer for the county of santa clara. [applause] >> thank you, colleen, and thank you governor newsom for inviting slight -- santa clara county to participate in this event and in this work, and thank you mayor breed for hosting this event today. over the years, santa clara county has implement it programs to expand coverage and affordable options that move us closer to providing healthcare for all. indeed, our board of supervisors has officially supported a single payer healthcare system. and santa clara county, we are proud to operate three hospitals , and a dozen clinics located throughout the county.
each of which provides high-quality, integrated healthcare to the 2 million members of our community. like the governor, we know that innovation through the healthcare system, including a path to single payer systems will help us reach our shared vision of better health for all. that is why we are excited by the opportunity to work with the governor and with so many other partners throughout the state to take on the high cost of prescription drugs. year after year, pharmaceutical companies continue to increase the price of brand-name drugs. we all need to ask the question, do prescription drugs really have to be that expensive? wild drug purchasing practices are complex, we must look for and implement innovative solutions to reduce these costs. federal policies have not done enough to control drug prices. in the absence of federal leadership, local and state
government need to partner and need to think creatively about how to leverage our collective buying power to negotiate better prices for our residents. last year, santa clara county valley medical center spent more than $120 million on pharmaceuticals. giving the extrude nearly high cost of prescription drugs, we have been looking for opportunities for savings. we welcome the chance to work with the state and with other partners to explore options to reduce these costs. as you know, public helps it -- health systems play an especially important and unique role in delivering care, services, and treatment to the patient's in the communities we serve, especially the uninsured and the underinsured. we are a safety net healthcare system that is proud to offer top-notch care to all who need it, but to do that, we need to explore all opportunities to
reduce costs whenever possible so that our limited resources can better be spent to help the homeless, the mentally ill, and other vulnerable members of our community. a number of years ago, the county of santa clara was the first county in the nation to ensure that every child, regardless of immigration status , could get healthcare services. we are especially proud to support the governor's efforts to become the first state in the country to provide coverage to young, undocumented adults. thank you, governor for leading the way for these young adults. santa clara county and the state of california have aggressively implemented the affordable care act. it has been a huge success. just a couple of numbers. in santa clara county alone, more than 100,000 -- 140,000 residents gained coverage through this expansion. another 45,000 plus have
subsidized coverage through coverage california, that is just in santa clara county. and most important, the bottom line number, the uninsured rate in santa clara county has dropped by 50 3%. so the time is now to take the next step. we are fortunate to have a governor who is a champion for these important issues. we look forward to working with the governor to make better health for all, california's highest priority. thank you very much. [applause] >> thank you, miguel. i also would like to take this opportunity to introduce someone who has been a champion for laguna honda, our supervisor for district two, catherine stefani is joining us here today. thank you so much. [applause] >> and now i would like to introduce our governor, who we all know was a former mayor of san francisco, someone who led innovative programs, pushed to
really change san francisco and california for the better, same-sex marriage, he was the one who put forth the idea and opened the doors for so many people to get married at city hall, when so many people attacked them on this issue, and now it is gone global and has been recognized throughout the united states, 311 was just his brainchild, this innovative resource that we use to call to deal with a number of challenges in the city, so many incredible resources that we use today, and now, is a governor in his budget , he will continue to provide the support and the resources that we need to address many of the challenges that exist in san francisco. we also should know that he really led the charge on the rebuild on the hospital to the new facility that we see today.
the governor of the state of california, gavin newsom. [applause] >> thank you, thank you. this is fun coming back. the couple of you were showing me photos ten years ago, pregrey hair, and this is remarkable that this place opened. i remember standing here during the ribbon-cutting, and i think i used a line, which i am now reminded of, at the time we were doing something with a skilled nursing facility. also ten years ago, that was novel and no one was investing in this place. people so the county couldn't afford it and we had to move in a different direction. we get it when it comes to skilled nursing facilities and keeping people in place. we are on the leading and cutting edge and doing something no one else is willing to do. i remember saying that the mayor
of athens said, he says, we do not imitate, for we are a model to others. i say that then, nine plus years ago, i will say it again today in the context in the spirit that brings us here together around the issue of prescription drugs. we do not imitate because we are a model to others what we are advancing here today is new, what we are advancing here today matters what we're doing today is what i expect others to be doing tomorrow, not just other counties joining california's purchasing pole, but other states joining california's purchasing pool. leveraging our resources, big buyers mean lower costs. the fact is, in the state of california, 13 plus billion dollars a year, your tax dollars
are currently being spent on prescription drugs. i will repeat that, 13 plus billion dollars a year. the problem is, we were isolating the purchasing. we had jails doing their purchasing, we had the state hospitals doing their purchasing , we had our retirement system doing their purchasing, we had the va doing their purchasing, we had our medi-cal system, which is 13 million strong, we were only leveraging 2 million of those 13 million in our purchasing pool. just combining the medi-cal system alone, taking the 2 billion and leveraging the purchasing now with 13 billion is going to drive hundreds of millions of dollars of savings on an annual basis. we project in our budget that we just submitted a few weeks back, or a week or so ago, that we will save conservatively $393 million because of this
purchasing effort. that's just on an annual basis, $400 million of money that we otherwise would spend that would allow us to provide discounts, to provide additional subsidies to reduce those costs each to each and every one of you. if we are not curious about these drugs, we are not curious about addressing the cost as it relates to the issue of healthcare inflation. this is one of the principal drivers. we have seen close to doubling of our costs in the state, doubling of our cost in the state, just in the last nine years. this cannot continue. with all due respect to big pharma, i have no problem, no gripe with people being successful, i don't begrudge success, i appreciate competition, i appreciate research, i appreciate the kind of innovation that we pride ourselves on, but i don't like
people taking advantage of other people. i don't like gouging, i don't like windfalls, i don't like folks, you know, getting massive bonuses and, you know, at the expense of folks that are struggling on the streets and the sidewalks. this is a foundational principle , it is a value i know laguna honda community shares. it is a value that san franciscans share, it is of value the mayor shares, it is shared broadly throughout this state and substantial of lee, around this region in santa clara, in alameda, that value now is being brought to the forward in terms of counties joining the state purchasing pool. we had hoped this would happen in a year or two, maybe three, but here we are, just weeks after announcing l.a. county joining our purchasing pool, no three additional counties are joining the purchasing pool. this is remarkable. the momentum is real, and this
is exciting because we are actually making progress in realtime. this is not just platitudes, this is not just a tweet, this is not just a promotion, it is not just a promise, we are seeing things happen in realtime , so i just want to thank the enlightened leadership that you heard from today. they didn't need to do this, it was wise to do it, but they didn't need to do it, but the fact that they are doing it, and they are doing it on the front end, is an extraordinary testament to mayor breed's commitment not passing interest to bring down the cost of prescription drugs and the cost of healthcare in this county. colleen's commitment and miguel 's commitment to do the same is a big deal, so i don't want to undersell this moment. i want to appropriately sell it. i want to overhyped -- i don't want to overhyped it, but this is significant. we have governors calling this
state wanting to join our efforts. we believe this is the beginning of a different frame of momentum not top-down, god bless watching congress, pretzels trying to deal with big pharma, this is bottom up. it is a new frame. i will tell you, a california, we just reached at $3 trillion year mar. we punch above our rate, and there are only four nations on planet earth that carry more wait then the state of california. we are truly a nationstate, the fifth largest economy in the world, the united states is one of those economies ahead of us, only a few others that have the capacity to do what we are doing as a state. now the second largest purchaser outside the v.a. and the united states itself in the country. this is important. i want to express and acknowledge the hard work of our team in sacramento that is working overtime to get this
right, to make sure we do it right. i want to thank the counties for building that momentum, and i want you all to know that we are inviting the private sector to join our purchasing pools. we want to see companies large and small also join in and take advantage of our ability to leverage and to sit at that table as one purchaser, not just aggregated as thousands of purchasers. we are formed -- where pharma has the power, now we are taking back that power and we are leveraging that power over the table. hugh merrow costs 96% more in the united states than it does in the u.k. some medications are 100% more then the folks in the u.k. give me a break. with all due respect, it is not just about well, we do the research on the development, we have to pay for that, the people who do the most research and the development are people like you. through our grants, through our
tax dollars. they leverage those, they supplement those, and we are proud of that research. but give me a break. they do it because they can. they do it because no one is pushing back. they do it because they leverage influence of the people like me. they come in with a lot of money and they come into leverage their point of view and they usually scare folks instead of doing the right thing, but they can't scare the leaders assembled behind me, and the cannot change the trajectory of a state that says, we have had enough. we are better than this. we will do more and we are going to leverage our voice in a way that respects the people of this state that we represent, so thank you all for coming out. thank you for being part of this announcement and all this extraordinary momentum and know this, in closing, this is just one of many things the state of california is doing to expand healthcare in this state. our budget, briefly, is going to
expand coverage regardless of your immigration status. our budget will double substantially and increase by doubling our annual contribution and our medi-cal system through proposition 56. forgive me for boring you on that, but we will increase our reimbursement rates, more trauma screenings, more early screenings to address issues before they manifest, we are going to deepen subsidies for low income families on the health exchange, and expand subsidies into the middle class. the only state in america that is expanding subsidies for families earning up to $150,000 a year. we are very proud of these efforts. our goal is universal. our goal is to get this done through a single parent financing system, but until we advance those ideals, we will build pragmatic steps, make progress each and every week
until we ultimately get to those goals. thank you, san francisco, thank you to mother nature for adding a little energy, thank you mayor breed for hosting us here today. [applause]. >> thank you. >> i don't know if there are questions, how do you want to do this? i will let the electives go, and supervisor, very wonderful you are here as well. any questions, we will do it out here. we will let you all go. thank you, guys, very much. [applause]
[♪] >> i just don't know that you can find a neighborhood in the city where you can hear music stands and take a ride on the low rider down the street. it is an experience that you can't have anywhere else in san francisco. [♪] [♪] >> district nine is a in the southeast portion of the city. we have four neighborhoods that i represent. st. mary's park has a completely unique architecture. very distinct feel, and it is a very close to holly park which is another beautiful park in san francisco. the bernal heights district is
unique in that we have the hell which has one of the best views in all of san francisco. there is a swinging hanging from a tree at the top. it is as if you are swinging over the entire city. there are two unique aspects. it is considered the fourth chinatown in san francisco. sixty% of the residents are of chinese ancestry. the second unique, and fun aspect about this area is it is the garden district. there is a lot of urban agriculture and it was where the city grew the majority of the flowers. not only for san francisco but for the region. and of course, it is the location in mclaren park which is the city's second biggest park after golden gate. many people don't know the neighborhood in the first place if they haven't been there. we call it the best neighborhood nobody has ever heard our. every neighborhood in district nine has a very special aspect. where we are right now is the mission district.
the mission district is a very special part of our city. you smell the tacos at the [speaking spanish] and they have the best latin pastries. they have these shortbread cookies with caramel in the middle. and then you walk further down and you have sunrise café. it is a place that you come for the incredible food, but also to learn about what is happening in the neighborhood and how you can help and support your community. >> twenty-fourth street is the birthplace of the movement. we have over 620 murals. it is the largest outdoor public gallery in the country and possibly the world. >> you can find so much political engagement park next to so much incredible art. it's another reason why we think this is a cultural district that we must preserve. [♪]
>> it was formed in 2014. we had been an organization that had been around for over 20 years. we worked a lot in the neighborhood around life issues. most recently, in 2012, there were issues around gentrification in the neighborhood. so the idea of forming the cultural district was to help preserve the history and the culture that is in this neighborhood for the future of families and generations. >> in the past decade, 8,000 latino residents in the mission district have been displaced from their community. we all know that the rising cost of living in san francisco has led to many people being displaced. lower and middle income all over the city. because it there is richness in this neighborhood that i also mentioned the fact it is flat and so accessible by trip public transportation, has, has made it very popular. >> it's a struggle for us right now, you know, when you get a
lot of development coming to an area, a lot of new people coming to the area with different sets of values and different culture. there is a lot of struggle between the existing community and the newness coming in. there are some things that we do to try to slow it down so it doesn't completely erase the communities. we try to have developments that is more in tune with the community and more equitable development in the area. >> you need to meet with and gain the support and find out the needs of the neighborhoods. the people on the businesses that came before you. you need to dialogue and show respect. and then figure out how to bring in the new, without displacing the old. [♪] >> i hope we can reset a lot of the mission that we have lost in the last 20 years. so we will be bringing in a lot of folks into the neighborhoods pick when we do that, there is a demand or, you know, certain types of services that pertain
more to the local community and working-class. >> back in the day, we looked at mission street, and now it does not look and feel anything like mission street. this is the last stand of the latino concentrated arts, culture and cuisine and people. we created a cultural district to do our best to conserve that feeling. that is what makes our city so cosmopolitan and diverse and makes us the envy of the world. we have these unique neighborhoods with so much cultural presence and learnings, that we want to preserve. [♪] >> good morning everybody and welcome to the commission on aging and adult services. madam secretary, please make t