in-we do not need >> all right, let's get going. a lot of smiles out here today. hi everybody my name is phil i'm the general managers of your san francisco recreation and parks department. and welcome to the city's newest park. wants to make that help inform that decision or that process. >> i think we can individually make statements, but we can't vote, so i can individually make a statement to support the recommendations that came from the family homeless emergency service provider subcommittee. i i don't know if other members wanted to as well, but just

wanted to strongly encourage you all to move on implementing this, because we have--there is so many kids out there on the streets t. is crazy. i am seeing them every day and they are in really bad shape and we need resources for them pronto. i think the plan is well thought out. >> thank you for that member friedenbach. i'll join the chorus and say i support the recommendations as well and i think the urgency is definitely there and support what you laid out in front of us as well as the expertatize that we heard over several meetings as relate to tay support needed so want to go on record to be in support. members are allowed to make individual comments in support but not able to take official vote at this time. >> it is my understanding to add a component this plan was

developed with hsh input and discussion and so separate from individual support of it and our inability to take a vote i hope our vote wouldn't preclude hsh from coming back and saying this is what we can move on. informing us ahead of our next meeting. >> thank you for that member walton. i don't know- >> i feel everybody said everything and in agreement. >> thank you so much. we welcome hearing from your director nagendra on progress made before next meeting working with providesers as you have been doing so thank you are your hard work. >> thank you, i'll take that information back and we'll respond in whatever way makes sense to the committee. >> awesome. thank you. >> thank you. >> again, for the public we have a member out that is ill. we are not allowed to have

remote participation only for ada or parental leave so if someone has covid or illness they can not participate remotely. i'm excited to present the next item, item 5, ocoh coordination homelessinize oversight commission. we have jameel patterson and hali hammer. we will be joined shortly by member jonathan butler. welcome. we will-the purpose of the item and why we wanted this at the retreat is the understanding we know there is several bodies looking at homelessness in our city and wanting to engage around the work happening because there is a lot of overlap and the work we are doing and want to be strategic

and in collaboration with these bodies and informed to not duplicate the work and inform what other bodies are daing to strengthen all the efforts so this is the first time we have done this for ocoh. been in operation about 3 years and change and i believe all the members accept for member walton have been here since we first started on this journey so we produced several reports; done needs assessment. just came out with our annual report which i hope has been shared with you all but just like to first hear from you and jonathan will come in soon. love to hear how things are going at mental health sf, what are some of the goals, some of the priorities and challenges in your view. this is informal conversation but i hope not the last conversation we have and you are always welcome to any of our meetings and reach out to any of us and especially me as the chair to engage in dialogue

with this committee, but we love to hear what is happening with mental health sf. it is big issue in the city. sying the crisis on the streets every day and all subpopulations are impacted by the mental health work so just really want to hear from you guys so welcome. >> thank you for welcoming us. i think some of our goals, some things needed is we need to listen to people like member walton who i consider a teacher why he was at hsh. he used to teach the peer mentors. the thing i remember and often times suggest we implement from my experience as a peer worker and also from some of his teachings. there is a lot of veterans in

the field that we need to listen to more and need to be more part of the conversation and direction. there is a lot of overlap, but i think the progress that has been made is the defining and mental health, homelessness, drug addiction, they are all brought under the same bracket and they do correlate so that helps gives a compass where we need to go, because as he knows, right, homelessness in itself after so long is mental health because it is deemed as unhealthy way of living you acclimate to so you see it

correlates and why you have officers like office coordinated care. trying to coordinate resources. it is clients and resources. i will hand it over to member hammer. >> thank you. so, thank you very much for inviting us. we represent the mental health sf implementation working group. both of us have been serving on the iwg since inception, and as member patterson referred to, i think both of us have been working in the area of improving the health and wellbeing for people experiencing homelessness in san francisco for many years. so, mental health sf passed in 2019, and the city ordinance,

the aim of had city ordinance which a number of people worked on, there was a good amount of community input, input from the different city departments working with the board of supervisors and mayor's office to develop this ordinance who goal is improve the quality of services and access to services to mental health and substance use services for san francisco residents who are experiencing homelessness and have either--sorry, serious mental health issue and or substance use issues. after the ordinance passed, the department of public health started working on the programming of outlined broadly

in the ordinance, and then i think around the same time worked with the our city our home subcommittee oversight committee on the specific budgeting-specific programming that would be supported by prop c funding that was aligned with the ordinance. and so-and then the ordinance also spells out that there should be implementation working group with 13 members, 6 of which appointed by the board, 6 by the mayor, 1 by city attorney's office. we have been meeting monthly,

and we can tell you about our work. we doget hear updates on the programming as it evolves and give input as new programming, new services on the horizon. all most all of that programming you all know about, you all have been involved in because a lot of it is, a lot but not all is supported by prop c. so, the mental health sf is programatically split into a number different demesnes so the office-these are what is spelled out in the ordinance. office of coordinated care, street crisis response team, the mental health service center and residential treatment expansion and new

beds and facilities as we think and we added in overdose response even though that is not spelled out specifically in the mental health sf ordinance, that is huge part of the new program work in department of department of public health and specifically behavioral health services. we have given input to new programming as it evolves. leads from each of those 5 odomains present to us and we give input. there are challenges. for me the biggest one is the cadence of our meetings. the meeting once a month for three or four hours when this work is evolving all the time, so it is really hard to time our understanding of the landscape and where we are going. it is hard for us to time that with actually giving input to

the planning. that is for me the biggest challenge. there are others, but we would really welcome the-love to figure how to sinner jize as we move into the next phase of the mental health sf work and prop c funding. >> wanted to open up to folks if you have any questions or thoughts in terms how we can better collaborate between our separate bodies. i welcome that. i have a question in regards to thoughts around the street team. there was a report that was commissioned recently anyway the board of supervisors around

the street team and wonder if you had a opportunity to dive into that and your thoughts of the street team because they are the front line. want to hear thoughts and open up to other members, any questions and thoughts you have as well. >> my thoughts on the street team is, how many people know about them? i think it is definitely a great option to have, other then the police, but i come from working in the shelter system, so i know the street team is fairly new, but i doubt if any of the peer monitors know that option. for a long time it was regular relegated to the tenderloin, which is another thing too. the shelter is another places. i think didn't they just combine with the fire

department? >> the fire department took over street crisis response. >> i think that was definitely a good adjustment to make, but i think the outreach and engagement as far as the different programs throughout the city. i think one thing can be educating all the peer monitors like he used to do. that you had [indiscernible] for the street team. people don't know when you call 911 you can actually have that option to request a street team. other then that, they do great work. >> i'm really never heard of that. i didn't know- >> it is all through dispatch, so skirt-it is very narrowly defined. if there is a safety thing they send the police, so you can try to ask for street crisis response team, but i have never had success. if the person is like in the

middle of the street they won't send street crisis response. other people want to get the police to respond so call and lie what is happening and say there is a knife or something to get the police there. it is kind of-when we originally put that wording in the legislation in mental health sf, we wanted it to have a separate line and it was more about having a peer response. maybe a little clinical supervision, but then they--the fire department pushed to be a part of it actually at the beginning because they saw as a way to expand the union membership so they wanted to get homeless dollars so that is one thing we are paying for. i have a little different perspective on having the fire department involved. i think that it drives up the

cost significantly and if just from my perspective looking at prop c dollars i rather see dollars going into beds then going to fire department personnel that don't necessarily have the cultural competency and feel people with lived experience who look like the peers you are talking about do a much better job and my understanding on the team is that peers that are there are doing the best job so i rather build on that and not have the highest paid fireman in the nation using homeless dollars. yeah, but it is really i think the places of coordination to think about that question--one thing is that, there is still a little money and play around acquisition in the behavioral

health category, so i think as we make recommendations how to spend the money and going and having conversations of mental health sf and thinking there is this amount of money and then having that be one of the places we get input that helps us make our recommendations, i think the other area of coordination is that if there is shifting in funding and so if we wanted to make recommendations of we think this particular intervention or this particular thing we are trying for isn't getting us much bang for it buck and like to see the money shifted over and that's hard to do because people are hired and it is like once we invest in something is funded forever, but i think we should be nimble about that and because a lot of this stuff we are playing with and experimenting and if something isn't working that well, i think we need the courage to say look, we need to shift it and we should have the money

somewhere else and so, within the behavioral health category i think that is dprait conversation to have with mental health sf. prop c is funding the 400 beds, so all most all the new dph beds, the street crisis response team which is now fire department and peer, and then the big fancy red rigs that sorry annoy the hell out of me. don't know how much those cost. coordinated care so intensive case management and the mental health service center, there are two expansions, we just paid for the second and we pay for the sort team. those are things that come under your purview. it is a big cross-over what we are funding and so i think there is a lot of areas for collaboration and you guys are digging down so much more on the behavioral health side then we are as a body, so i feel like we could learn from what

your guys conversations you are having and that could then kind of like guide us in making our recommendations. >> yeah, and we-just to clarify for everybody listening, we are the advisory group for mental health san francisco, but so we don't represent mental health--to speak to exactly what is implemented, the outcomes that dph is following in terms of targets for number of beds opened, whether the intentions of the spelled out in the legislation, like better response after 5150 for example, we are tracking that, like how often people in involuntarily holds are connected to care right after

leaving the emergency room or hospitalization, so i think that would be great dwrou you all to hear about to go-have a report from either director cunnings who is director of mental health sf or if you want to focus on one of the domain. what is implemented and how do we know it is working or how do we make changes if they are not like you mentioned member friedenbach. for the treatment beds, i think that was a-i was involved in those early discussions when dph forward a proposal to this body about what should be funded in that initial round of funding. beds were a big thing we wanted to be able to expand with. prop c funding we are really proud of the fact that over 350 beds have been opened.

there is both expansion of existing programming that a bed gap analysis had said we need more of, but also new innovative programs. we have a new alcohol program which is funomally successful in terms of improving outcomes for the people admitted into that program. we have expanded our psychiatric respite, hummingbird program, so those are-great for you all to hear about, and for our body, for the iwg, our goal is really to get understanding of what behavioral health service and meant health sf is working on, like the new facility for the mental health service center. member friedenbach you had a lot of input what that should

look like as do members of our working group, so we are giving input, so that it meets that vision of a low barrier way to access care to connect to services. so, that's--it's all--we are all touching the thing from different places, but it sounds like such a great opportunity for us to coordinate and make sure we are on the same page. >> need more help in the coordination. [laughter] >> i want to add to member friedenbach's comment in terms of resources available. i hear outreach engagement is one piece and also like resources coordination so trying to capture some things i'm hearing. i'm curious about the peer monitor program and love to hear from our member walton about that program or anyone else. >> i am guessing mostly what

you are referring to member patterson is that while i worked for hsh, i oversaw a lot of training to all levels of people that worked, especially in our shelter system and other emergency response and street outreach, and so i can speak more offline about that, but the thing i think is surfacing for me and having just come into this oversight committee in the last few months, i think it is very common when there is money available and there is need available, the first thing we focus on are concrete things. number of shelter beds, number of treatment beds and so forth. i think what may speak to issues that arise as we look how those are being utilized is, then looking at how we access those. how people access those services. you talk about low threshold, we talk about who can call in skirt rather then police.

those are things i think require a second layer of analysis to look at what makes the most use, but also doesn't over-flood the services so they become useless. in terms of trying to somehow create gate-keeping so beds are not unused or services not unused, but used as effectively and make it as easy as possible. it is how we best help people do that and i think as member friedenbach said, some people who want a specific response rather then reporting what they are seeing as a need they report what get the response they feel should come and that will address that as well having worked in the early

stages with healthy streets outreach efforts and so forth. i think that speaks to and it isn't just peer education, it is education across the board. some acceptance of the fact that until we have unlimited services, we have to be somewhat strategic in using the servicess that we have. while we look to add more, we have to use what we have effectively. >> to add on, the peer monitors are basically the people that work hands on with the shelters. but people like member walton, his education made it to where you were not just baby-sitting adults. you had knowledge to work with people who had mental health problems. and that can mean a whole difference in how a program runs. i mean, from the intake person

isn't necessarily a peer monitor, but they still just as important. the intake person could be the difference in a person getting help or a person being shown the door. we don't need peer monitors who work there making things harder for the client, but also if you educate the peer monitor and make the referral expert--it isn't that hard to do. i recommend every peer monitor at least have 3 to 5 referrals. like, don't be the kind of peer monitor when a client comes up to you and needs help in whatever area and you don't have nothing to say. as member walton might know, my mom was brother brown. she had fliers for all the services all over the wall. the peer monitors could look on

the wall and refer somebody somewhere. you may just have a client that needs housing, but what if you have a client that is coming from a battery situation? that is whole another type of referral. you might can't refer her to a place with men, right? it is like, those kind of things you got to know and then member friedenbach was saying, i think you know, that should be a question. is the skirt team-i won't use overlap, but duplicating the fire department? i have different experiences with the fire department. i had good experiences, because been situations where clients abuse that privilege to call the fire department and they still come. [laughter] just in case. the police is a little

different. somebody might have been calling the problem and police took three hours to come. fire department, 20 minutes or maybe little more. most of the time 20 minutes and they are there and they are also part of the team. they are all most a part of the shelter system anyway, so i do think that discussion is the skirt team duplicating services and these are discussions we have on our board. a lot of our members are experienced in the field. they have experience being san franciscans, some are nurses, and we have fireman on the board. i worked in the shelter system. we had discussions on the board. some of the main things we talk about is really mapping. from my experience, waiting lists, openings. that should be clear.

there shouldn't be-there is a waiting list. you can maybe come back at this time. the other part, we should have been had already is, a lottery system to where a person goes to shelter, house and emploid and you have to determine the ones that have mental illness that need more care before they get to that point and not sure that is happening. a lot of places look at clients all the same and they are not. they are not. i have seen people who work jobs been in shelter for two years and go unhoused and i have seen people with mental illness get a house. that is what the mapping is about is accessibility . at the job i work at, our

office is facilitated for meeting every wednesday between 3 and 4:30. there is number of people who come through the building, say this is my firm time coming to na meeting. this person was a working person. a functional addict. i don't want to use drugs anymore. she was crying and didn't know where to go but your place. that accessibility needs to be there. >> thank you member patterson. i was looking at an earlier document about the street crisis team and just the mapping of all our crisis services and getting that data is super important and just want to second what you are saying in terms of the accessibility piece. i want to not take up too much time, but other members have questions or thoughts you want to share? >> i want to underscore as we are oversight committee you