>> hello. my name is john kelly. i was born in this great city, and i'm a political liberal. however, over the years i've turned into a fiscal conservative because government too often misuses taxpayer dollars. however, there are some services government must provide, and i am fully supportive of the alcohol mitigation fee for two -- three reasons. the revenue must be spent on the health cost to our city services caused by the alcohol problem. second, the revenues will come from the people who consume the product that caused the alcohol problem. third, among the city services, supported by the alcohol fee, will be substance abuse treatment programs. in a 1994 report by the

california department of alcohol and drug programs concluded that for every $1 spent on substance abuse treatment programs $7 is saved in taxpayer costs. we need more substance abuse treatment programs and an end to the waiting lines to get into these programs. lastly, i want to make a pitch for alcoholism prevention. research shows that more than 40% of youth who start drinking before age 15 develop alcohol dependence. please establish programs to effectively discriminate -- excuse me -- to effectively discourage teenage drinking. and on this last point, i have a flyer that i'd like to pass out to you, supervisors. and thank you for your time. supervisor avalos: next speaker, please. >> good afternoon. my name is tom and i'm an

alcoholic. i have been coming up on four years. i had four months of treatment in rehab that i paid for myself because my insurance didn't. i've owned three bars in san francisco. i currently own glen park station. and i think you placing the blame on a lot of us. i've been reading in the paper about the cost of ambulance, you know, alcohol-related ambulances. you ask any of the people that have spoken here how many times have they called an ambulance for one of their customers. i've seen restaurants where they had to call an ambulance. i'd say out of 10 times an older person having a heart attack or some other physical problem. i think the problem lies with the city of san francisco, and

your very l.a.x. -- in front of -- well, next door to me is a taceria. there has been this pan handler for the last three, four years. i see cops walk by and call him by name and say, how are you doing? when can we get these people off the street? i think there's, you know, some kind of laws against panhandlings. we don't want to fill our jails with a bunch of homeless people. they're overcrowded. why not set up the shelters and detain these people where they have to follow rules and regulations? an article in the paper just the other day about a fellow that said, i don't like to go into the shelter. they don't let me smoke. they make me go to bed too early. well, sorry. there's a cause an and effect to everything. you're making it easy for these

people to cause the problems. the bars, restaurants, aren't. ok. thank you very much. supervisor avalos: thank you. next speaker, please. >> good afternoon, supervisors. debbie from the san francisco human services network. we support the alcohol mitigation fee. a few years ago voters in san francisco approved treatment on demand, but it's never been implemented. there has never been sufficient funds to implement it and every year when we come here at budget time substance abuse services are always the first to be cut primarily because of the lack of any federal or state leveraged funds. so we need to do what we can locally to support those services. and we know that it doesn't show up in the economists' report that the money we invest in substance abuse prevention and treatment will save us tremendous amounts in the long run because of the other costs of getting people off the street are repeatedly put in

the e.r. this makes complete fiscal sense for the city of san francisco. we have tremendous respect for the small businesses and the vibrant nightlife that we have in this city. but a few cents a drink is not enough to keep people away from having a good time at night. and $18 million is a tremendous amount of money to support the services that we need. regardless of how you feel about mechanisms to bring in revenue, whether it's a fee or a tax, whether they're too high or too low, i think most of us agree on one fundamental thing, that they should be fair. these costs are already borne by the taxpayers in one way or another and this is really about who's paying them. given the cost the taxpayers from the excessive use or abuse of alcohol, it is fundamentally fair that those costs be borne by those who are responsible for them. in other words, the producers and the retailers who profit directly from the manufacturing and sale and ultimately the

consumers, all of us who pay a few cents to ensure that the costs are borne ultimately by those who are creating the problem. thank you. supervisor avalos: thank you. next speaker, please. i have one more card. anyone else who would like to speak, please line up as well. selena and anyone else who would like to comment on this item can please come forward. next speaker. >> mr. wright, i spoke last week on this issue and i demonstrated i have 50% towards initiative, 50% against. i understand how the people who are impacted on how their loss of income will be decreased, and i see the way they feel, the way they do but the issue at hand weighs more than the problem that you're suffering. on the grounds that alcohol is contributing into millions of dollars in taxpayers' money being spent on people who abuse and get sick and have to go to

the hospital and use numerous services by the city pertained by the fire department, the police and the doctors at san francisco general hospital. this is a historical moment where the cost of the injury must be shared by the people who are online and handing out the alcohol to the people who need the services. to begin with, you're not the only people who are responsible. this is a historical moment that started out at the tail end of the alcohol chain of the people who were passing out the alcohol to the people who need the services. starting off in the city and county and eventually is going to end up in the state and senate, board of organization and i believe that the brewries, the manufacturers who are making multibillion collars profit on alcohol, the production where the distillation columns used to produce this alcohol should

also share the cost as far as overall states of the united states of america is concerned. but starting off here at the city and county of san francisco. the people talking about they need to have the city attorney look into this. if the city attorney looks into it and incorporates state law pertaining to the section of law that's called contributary negligence where you're not actually intentionally causing harm but yet your alcohol is the reason and main factor on the reason of the problem you could be charged 50% of the services that's being paid. that's called contributary negligence. you're actually contributing to the problem. supervisor avalos: thank you. next speaker, please. >> good afternoon. i was watching this on the monitor last week and the discussion about mandatory, you know, mitigation and what have

you. after that we know we have a problem getting taxes into the city. my concern is the fact that i don't think enough companies are being taxed to help our city because last friday on the news, it was friday night on channel 2, and i've been to some of your offices to give you the news clipping that i received, the mercury news, never san francisco news, there was a press conference this morning at 10:00. they're going to have 50 trucks coming into san francisco on a daily basis for the next three years. and i think you should be able to tax them axle of $1 and you will get more than what you're asking for today with the people that you are trying to get the taxes from. and i think it's no more fair

that people from the outside be taxed coming into our city breaking up the streets and everything in our cities and looking at how much money you will be able to receive if you think about this and make this part of your project that is coming up dealing with taxes. because the big corporations are not being taxed. had is one. -- this is one. thank you very much. supervisor avalos: thank you, ms. jackson. next speaker, please. >> hi. good afternoon. my name is selena and i work for an organization called horizons, unlimited. i know as we hear these arguments, the biggest question is, will san francisco continue to thrive? will businesses stay here? will they continue their payroll? will they continue their services? the yes is yes.

people will still patronize small businesses. i think businesses will be able to reap properties. -- profits. as a prevention provider, we're spending a lot of time looking at cost improvement strategies for providing these prevention services. we're looking at evidence-based practices that we feel will be strong motivators for families to continue to thrive within the community. and speaking on behalf of a lot of families and a lot of youth, there is a lot of support for this bill out here. whether or not families can leave work and come and provide public comment and testimony, we speak on a lot of youth and families against, i believe that the families will continue to support local businesses. but this is money that's desperately needed. there is not enough money in these budgets for us to provide based on the demand for these youth that need these types of services. so we want you to look at it carefully. understand that we're doing our

part to provide these services. and with a little bit more help we'll be able to provide a lot more needed and vital services to the youth and families in our community. thank you. >> good afternoon. my name is charles mcintyre. i'm here once again. i represent the 2700 union glass workers here in the city of san francisco. i work in a glass plant myself. and not only are you talking about losing the retail jobs. you're also going to be hitting the jobs in our industry. the majority of the glass that we make is for the alcohol industry. a lot is for the small wineries, the small brewers. they take a hit. one of the first things they do is they look for different container types or look for another place for their containers. right now one of the main places they're going is china and mexico. we're looking at approximately

-- it could be as much as 300 jobs in this industry. last year alone we've lost over 500 jobs because of this economy. and what that also affects is these jobs are manufacturing jobs. you know, with good benefits, but they're green jobs. when we make the glass containers, these containers go recycled and they go through our furnaces and it's one of the greenest containers there is. it's in the earth. it goes back to the ground. when we start losing these jobs we stop losing the ability to recycle these containers. not only are we hurting jobs, we are going backwards as far as the city wanting to be green and the state wanting to be green. as far as the greenhouse emissions, the more recycled glass we use, it lowers emissions and helps the environment. so when you look at the umbrella of what this fee can do, it can run like a wildfire and we could really devastate

these jobs and this industry. thank you very much. supervisor avalos: thank you. are there any other members of the public who i'd like to -- who'd like to comment on this item? please come forward. >> good afternoon. michael from marine institute. i just wanted to thank superavalos and -- supervisor avalos and the co-sponsors of this ordinance in acknowledging that san francisco is suffering an epidemic of alcohol-related harm and that to establish a dedicated funding source that will treat and provide prevention services is a noble and excellent public health solution. thank you. supervisor avalos: thank you very much. and seeing no other member of the public here we will close public comment. i want to thank everyone for

coming here today and last week as well. your comments here about this item. a lot of folks from bars i know well and love, from the connecticut yankee and bottom of the hill, slims, american music hall, this is not about me coming from a temp rant society. this is about how we can maintain a level of service here in san francisco for our great needs around alcohol prevention and treatment. and it's a -- alcohol's a product unlike other products. there are impacts to alcohol and so looking at this makes some sense from some points of view that we would want to be able to be able to charge a fee, to be able to recover some of the costs we incur as a city and county to deal with the overconsumption of alcohol. and just to renew mexico rate what those are -- renumerat

what those are, identified in our study, the sobering center at the department of public health, our mobile assistance patrol van that often will pick up people who have been drinking -- overdrinking who are on the streets, our community substance abuse services enduring direct treatment costs as well as prevention costs, our beds at general hospital, our jail health detox facility. our fire department services dealing with transports. to our sobering center, also our transports to our hospitals. there are other costs that the city incurs for the overconsumption of alcohol. just this past weekend there were -- there was violence that happened outside a bar that i would say that alcohol had a relationship with. that is not covered in this fee. it's not -- we did not assume the cost in the study because we wanted to have the more --

the most narrow point of view that we could identify for the costs that are incurred by the city. we are charging not the -- we are charging this fee not at the retail outlets, not directly to the retail outlets, not directly to the bars. we are charging the fees to the wholesalers and distributors who are selling the alcohol within the city and county of san francisco. that is a major difference here that we are, you know, what the intent is behind this legislation. there is an impact. i have heard that. that this fee is being passed through to small businesses and i do have -- i do have concern about how that does happen. i have heard your concerns and how they've been expressed to me, and i do appreciate your expressing them. and one thing i want to look at, the part to me that seems most important that i look at is for the people who are small

manufacturers within san francisco, the microbrewerers, the people who sell who are small wineries, how we might be able to look at some kind of an exemption for those people who are wholesalers, but who are small business wholesaler. i don't think they are the type of industry that is manufacturing the products or selling the products here in san francisco to have the greatest impact on the overconsumption of alcohol that leads to these costs that we incur, the city and county. so that's something i will look at and consider for if we are to move this legislation forward today or for amendments for september 7 when this -- if this gets to the full board. so, colleagues, i would like to have your support for that. based on discussions today and last week in that there is a

great deal of concern from the business community, i would like to see if we could have this discussion at the full board with a motion that we send this forward without recommendation for the september 7 meeting when we get back from our break. a motion to send forward without recommendation from the committee, without objection. thank you, colleagues. again, thank you, everyone, for being here. and if beam would like to contact -- and if people would like to contact my office, i will be open for questions on this subject matter. madam clerk, we are adjourned. thank you very much.

when a resident of san francisco is looking for health

care, you look in your neighborhood first. what is closest to you? if you come to a neighborhood health center or a clinic, you then have access it a system of care in the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs. the cole street clinic is a youth clinic in the heart of the haight ashbury and they target youth. tom woodell takes care of many of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across

the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children. women find out they're pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. we initially will see them for their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates.

our doctors here are family doctors. they are able to help these women deliver their babies at the hospital, at general hospital. we also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. >> it's for the city, not only our clinic, but the city. we have all our children in san francisco should have insurance now because if they are low income enough, they get medical. if they actually have a little more assets, a little more income, they can get happy family. we do have family who come outside of our neighborhood to come on our clinic. one thing i learn from our clients, no matter how old they are, no matter how little english they know, they know

how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. they can be child care providers so our clients can go out and work. >> we found more and more women of child bearing age come down with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. how do parents tell their kids they may not be here? what we do is provide a place and the material and support and then they figure out their own truth, what it means to them. i see the behavior change in front of my eyes. maybe they have never been able to go out of boundaries, their lives have been so rigid to

sort of expressing that makes tremendous changes. because we did what we did, it is now sort of a nationwide model. >> i think you would be surprised if you come to these clinics. many of them i think would be your neighbors if you knew that. often times we just don't discuss that. we treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. there are people who come in who need treatment for their heart disease or for their diabetes or their high blood pressure or their cholesterol or their hepatitis b. we actually provide group medical visits and group education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. and it validates the experiences that you have and so you learn from each other.

>> i think it's very important to try to be in tune with the needs of the community and a lot of our patients have -- a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isn't the top priority for them. we need to understand that so that we can help them take care of themselves physically and emotionally to deal with all these other things. they also have to be working through with people living longer and living with more chronic conditions i think we're going to see more patients coming through. >> starting next year, every day 10,000 people will hit the age of 60 until 2020. . >> the needs of the patients that we see at kerr senior center often have