we recommended that they seriously consider a lottery system that would a sign students to a school at the same time giving families the opportunity to go to a different school if they wanted to. we recommended they redefine the attendance area and have them attend closer to home. some department managers will say thank you. thank you for bringing this to light. thank you for identifying the problem, thank you for your work. others will wish that we had not asked the questions. may be don't appreciate the way the report is worded. disagree the problem identified is a problem. one of the things a civil grand jury has to be careful about is

that you maintain an objectivity and your report be factualy based and that your recommendations are based on findings. it's reviewed by the presiding judge and he orders a grant. the mayor's office is required to make responses within 60 days and the board of supervisors is responsible for responding in 90 days. in the past 2 years, they have undertaken to have hearings where the reports are reviewed, the grand jury has an opportunity to testify or make comments. the departments are invited to come and make comments where they agree and disagree and the public can comment. if a person would like to learn

more about the reports that can go to the sf gov and go to courts, you will find civil grand jury. the advice i would give to anyone trying to understand and short on time. i would go to report and each one has an executive summary in which we tried to explain what we're looking at and then i would go to the back and read the summary of the finding and read the recommendations. if you read those 3 sections, you would have a fairly good idea of who we looked at, what we found and what we recommended.

president chiu: goodell afternoon. welcome to the board of supervisors meeting for august 3. madam clerk, could you read the roll? clerk calvillo: [reading roll]

mr. president, all members are present. president chiu thank you. could you please join me in the pledge of allegiance? colleagues, you should have copies of the june 29, 2010, board minutes. we have a motion to approve these? emotion from supervisor mar, seconded by supervisor campos. that is approved. madam clerk, did you have any correspondence? clerk calvillo: i have no correspondence. president chiu: could you please read item number one? clerk calvillo: [reading]

president chiu: either in the that what to sever any of these items? supervisor mirkarimi: yes. president chiu: could you please read the roll? clerk calvillo: [reading roll] there are 11 ayes. president chiu: those items are adopted. could you please read these next items? clerk calvillo: i did not approve the sublease of property located on the southeast corner of of tv boulevard -- octavia boulevard, with a monthly base

rent of 5000 others per month. president chiu: supervisor mirkarimi? supervisor mirkarimi: perhaps you have seen this in the press. i want to thank the land use committee who did a very good job in advancing this. i liked this idea very much. the swath of land in district 5, in the octavia boulevard, in this corridor that straddles two of our supervisors' districts, it has great prospects for development and plants, but because of the downturn in the economy, those plans have been interrupted, and so, creatively speaking, imaginatively speaking, those parcels remaining vacant for an untold time, there is an opportunity to do something in a way that is a win-win for all. oewd, i want to think of them for their leadership in moving this forward.

the on the above, architecture, and design for this work and making this happen -- the envelope. four other neighborhoods that also went to move forward, in smartly and use -- for other neighborhoods. it has been stalled because the economy just will not let us get where we want to go, so if there were temporary plans, entrepreneurialism, to hope revised neighborhoods, that helps bring in nurturing to the economy, these two parcels and the plans that i think are well suited for this fit that ticket. enthusiastically, let's support this. president chiu: colleagues, on this item, can we do this same house, call? without objection, this resolution is adopted. madam clerk, please call items 10 through 18, the bayview hunters point shipyard.

clerk calvillo: these are from the economic and man use. they pertain to the redevelopment plan for the bayview hunters point for the hunters point shipyard project, approving and authorizing the interagency agreement, haven't many elements of the general plan, public works, building, and the planning could, to establish the permit process requirements establishing special-use districts, the height and bulk of those districts, and demanding that gio -- code in total for the hunters point shipyard korea development plan. -- shipyard redevelopment plan. president chiu: colleagues, any discussion? if we can take a roll-call vote on items 10 through 18. clerk calvillo: [reading roll]

there are 10 ayes, one no. president chiu: these ordinances are finally passed. item 19, please. clerk calvillo: i 19, and implementation of outpatient treatment and requesting the comptroller to develop an analysis. president chiu: supervisor alioto-pier? supervisor alioto-pier: thank you very much, supervisor chiu. colleagues, the item before us has been before us twice. there is the legal and clinical treatment structure necessary to

give a severely disabled people with mental illness to have failed to engage in treatment after repeated incidents of services available. the support they need to achieve a meaningful recovery. the concept between ab1421 and another is about allowing them to live on their own. assisted outpatient treatment consists of services provided in the community to help the severely mentally ill. they are provided by community- based, multi disciplinary, highly trained and dedicated mental health teams. the actual services include whatever the individual needs to get well and stay well. those services include substance abuse and crisis intervention services, benefits, applications, and money management help, peer support, medication support, housing

assistance, vocational training, socialization, and recreation, plus the supervision of intensive case management so the individual can success utilize the help provided to him or her. when we discussed this two weeks ago, there were questions regarding both medication and funding. regarding the medication issue, although lauras law does not allow some medication, medication can be included as part of a court-ordered treatment plan, which experience shows in other counties in new york, the patients more than likely agree to take their medication. if a person refuses to comply with any of the terms of the treatment plan, including taking medication, if that is part of the plan ordered by the court, then the treatment team may try to persuade the patient to comply. if that fails, the statute permits the person to be involuntarily hospitalized for 72 hours. during this 72 hours in a

hospital, they will be reassessed, and a hearing will determine whether they have the capacity to accept medication korean regarding that is designed for -- to accept medication. regarding prop 63, whether a person has a voluntary or involuntary status. this means that a consumer or a client under court supervision may not be prevented from receiving services funded by prop 63 because of a status related to a court order. this has allowed nevada county to design a particular kind of program that can provide prop- 63-funded services to their patients in their laura's law program. money can say in san francisco. using our dollars in correctly

and efficiently. between 2006 and 2007, in the budget year, the latest statistics available, san francisco has the third highest rate of 72-hour holds. also known as 5150 holds. it is the fourth highest rate in another area. we can look at other states, los angeles county, and in addition to the los angeles pilot program out of the jail, they now have a new hospital discharge program that refers individuals into their treatment program. they are all reporting positive results, albeit on a very small scale. for example, los angeles looked at five individuals. 3 loss positions in a year for a total of over 100 hospital

stays. once they entered into the program, los angeles reported zero hospitalizations. also, three of the five were homeless, and no zero have been homeless since entering into the program. -- now zero have been homeless. those that have refused or failed to engage with committee services or the program in which the enrolled prior to entering into the aot program, although four of the 54 out of benefits when they enrolled, and without benefits, they are being made available. we do not have to look for to know that this will work. unfortunately, in san francisco, an individual has decreed a crime before receiving structured treatment. statistics out of our behavior record show that those participating in assistant

outpatient treatment report a 72% decrease in homelessness, a 25.3% decrease in psychiatric inpatients of positions, and a 40% decrease in another area. also, out of the 190 mentally ill persons participating in the behavioral court program, 140 are actively pursuing employment, and 85 are employed. based on all of the evidence, we owe it to the mentally ill and san francisco is to their families and others to a least try, rather than turn our backs on the possibilities for improvement in our mental health system. i urge for your support. president chiu: supervisor daly? supervisor daly: thank you. let me go ahead and read a letter from an organization within san francisco wrote, the mental health association of san francisco.

the lead to the sent to us. san francisco board of supervisors will be asked to consider a resolution making this, otherwise known as it laura's law, active, and while this would suggest earlier mental health treatment which was largely based on severe, involuntary the events, such as restraints, and sector, it does have one huge similarity, involuntary treatment. assisted outpatient treatment. it still does not work. there is the already financially stressed mental health system. other new programs for very few patients. laura's law proponents point to showing positive outcomes for people receiving of comes -- receiving benefits.

other studies that do compare the efficacy of the programs and enhanced services, both with or without in volunteer services, show no difference between the two groups, other than the fact mapping -- no surprise there. just provide better services, and there is no reason to take waitpersons rights while doing so. we do not need another study. anyone who lives or works here knows that there is a clear need for counsellors working at the street level to help care for the disabled population, so how to korea for yet another locked? . how do we afford yet another law? -- how to korea for yet another law? -- do we afford yet another lot -- law? whether this makes sense or

whether this voluntary treatment is humane or in here main, looking at who supports and who opposes this current efforts, and having been here for 10 budget cycle, i think at least eight of them are where we have looked at cuts at community-base coach rick competent services -- culturally competent services. they have been here fighting for this in previous years. and despite the applause for those who spent the better part of their lives or the last two years in these chambers for the month of june to save these services, who oppose this law, it is a bit frustrating. it is a bit frustrating when the

proponent of this in some korea political weight of the mine -- line have not been there when it comes to saving the services that actually work. itkendra'-- kendra's law. this has been slowly eroded over the years by the alignment that supported this lock with the mandatory component. so, , this is not just bad for those in the been working day in and day out on the frontlines in the mental health field in san francisco, and it is not just bad for the overall majority. it is bad politics, it is bad form, and having been here fighting to save this, this is

frustrating. president chiu: supervisor avalos? supervisor avalos: thank you. colleagues, this is a very troublesome vote for all of us. the subject matter in this legislation, we have had tragedy in my family because of mental illness, a tragedy that is unimaginable for any family to an doerr, so i know what is at stake for many of the families who would like to see this legislation passed, and it is very difficult to stand here and be opposed to legislation, and i am opposed. there is the issue of up whether voluntary or involuntary things are credible, whether a voluntary, mandatory services

are at work. there is a lot of contention of their with mental health services. mandatory outpatient treatment for those who need it. under federal substance-abuse and mental-health agencies, they did a report a few years ago, a national consensus on mental- health recovery. 100 texters, clinicians, care givers, and family members gave 10 fundamental components of recovery and did not mention mandatory services, but, instead, they talked about choices that people can have for their services, stressing autonomy, independence, and i think that these are the values that many people here incidences

go think work. for the people who are proponents of investing -- in enacting this law, i do not think we have an apples to apples comparison. what we can do in san francisco and was inactive -- enacted in york state was kendra's law, and they also approved money to back it. we do not have that here, which gets to the ultimate point about how we enact 1421, laura's law. we would not be displacing indymac up -- any mental the services, and i cannot think we could look at ourselves in the face and say that we will hold

an attack the services we have why we are implementing new services. we know next year, we're going to see enormous cuts to our republic of service, public safety, wrecked and parks, libraries -- rec and park, and these are going to be in jeopardy, as well. i do not think we can never a real conversation about what we have to safeguard while we have a program for involuntary mental health services. i do not think it is possible. there are some requirements of have to be followed for the implementation of laur'a's law. it would have to be the voluntary services are not reduced.

we also have to come the board of supervisors would have to guarantee that the support services are not being reduced, including housing services. we cannot look each other in the face and say that would not be affected by the program. we have to have an open discussion at the local level. we have not had our health commission make a determination about warren's law -- laura's law. we also have prop 63, which provides dollars for mental health services. we have a county plan for how we will be using and accessing prop

63 dollars, but our current plan does not talk about enacting laur'aa's law, so there are many reasons why i believe we are not ready to look at this. i do not think it would be a good process for us to say that we do. president chiu: supervisor campos? supervisor campos: can you. i am glad that we are looking back at this item. things a been expressed by a

number of my colleagues. but i personally have issues with the involuntary treatment. i think we can have a debate about this. i think if we're talking about that issue, it is important for us to know the efficacy or the effectiveness of what is proposed, so through the chair, i the question for the director of public health, whether, in your opinion as a health-care professional, do you believe that this law would be effected in terms of accomplishing the objectives that are underlined the law? >> dr. mitch katz, director of health. thank you, supervisors. no, i do not think so.

the people we're talking about have psychotic illness. ciccotti illness only response to medication. this is different from other mental health problems, such as depression, which responds very well to group therapy, but psychosis requires medication, and laura's law does not increase our ability to require medication. we are used to the idea, for better or worse, of restricting people's rights. every time i have to sign it koran to the order or in isolation order because a chemical disease, such as tuberculosis, ibm infringing on someone's rights, and the ethical principle is not infringing on someone's rights unless you have efficacious treatment, and because laura's

law does not allow for medication, i do not feel it does that. president chiu: thank you. thank you. supervisor mirkarimi. supervisor mirkarimi: thank you, mr. president. through the chair to dr. mitch katz. he asked the initial question i would ask, but following up, short of the of the cases treatment -- the efficacious treatment allowed in laura's law, is there anything else that remains in the application of laura's law where there is something meritorious in its effect? >> supervisor, i do not think so. i want to say, also in response

to supervisor alioto-pier, your desire comes from absolutely the right place. i can talk about it in my own family. having someone with a serious mental illness is one of the most devastating things. it is incredibly hard and difficult, and i certainly, you know, can understand any but saying, "well, we have to try something. " but, still, we do not try things unless they will work. los angeles has chosen to do it through laura's law, and we are doing it through the court, where people are told by a