, housing case management and help people get on to a special case services like food stamps, etc., but the case management as the committee has started to define it is looking for employment, housing, mental health services, and also looking to a shelter staff in working with clients who may not necessarily seek out those services. to have a case manager within the shelter to perhaps utilize something similar, but that happens in the shelter so that clients they may think of as lead people who need services but are not self-referring, but there is something on site or to take them to larger sites with the case management can work with those clients. supervisor campos: you talked about the number of tokens that

are provided. in your report, the executive summaries say that the agency allots about 1250 tokens a month. what is the actual monthly would be any in terms of tokens that the shelter systems have? >> again, i do not have that data. anecdotally, i can tell you that in the committee goes out and conduct site inspections, particularly at locations that also do reservations, one of the first questions they ask is if you have tokens, and if the majority of the time, the answer is no. i know that at providence, which at certain times of the year also acts as a family shelter, they have a certain amount of tokens, and they give some to the family members so the family can come back into downtown and go back out.

in 2010 and 2011, the hsa put out 1000 tokens, and they have increased that in october to 1250. >> -- supervisor campos: you said that was enough to give one -- >> approximately. there is 1134, and a percentage of those people are on a program where they might get a fast pass, but just to give you an overall sense, that is what to do distribution would look like. supervisor campos: i have more specific questions, but i do not want to belabor the point. how does the shelter monitoring committee work with regard to hsa? i'm trying to understand the relationship between this committee that is supposed to provide essentially some oversight about the shelter system and what is the

committee's relationship to hsa structurally? >> the shelter monitoring committee was created and made changes to the administrative charter. it is an independent body. it has two main purposes through the four different pieces of legislation that have changed since it was started. one is to conduct site inspections, a minimum of four a year of each side, and provide that information to the board of supervisors, the mayor's office, and any other individual that requests it, and the second is an implementation of a standard of care that the committee not only takes from plants, but in the changes that were made this past summer, that when they are now conducting investigations, they can initiate a complaint at that time, where before, the process was always a client-driven. hsa has a seat on the committee.

they hold the majority of the contracts for the shelter for writers. their relationship is the -- that we provide information about the concerns and the data we have collected to all agencies. some of the information the committee has provided around access issues have been part of the change in policies around reservations days and changes locations as part of another process, so hsa has the information from the shelter monitoring committee, the service providers themselves, and my understanding is they use that information in making some of their decisions. supervisor campos: is the shelter monitoring committee under hsa? >> no, it is not.

as far as i understand, it is under the legislative branch. it is under the board of supervisors that created the administrative code. the staff is a department of public health staff, but the shelter monitoring committee is not under the department of public health. supervisor campos: the committee staff its staff of hsa? >> of dph. i am employed by the department of public health, but i work for the shelter monitoring committee. supervisor campos: in terms of a report like this, let's say you outline the problems you have outlined in this report -- what happens to that report? >> the information is provided to the board of supervisors and to the mayor's office.

the human services agency and department of public health respond to any questions we have through the information request. at times when recommendations are made, hsa will respond to them. they are not required to. as far as the complaints, that is information we continually try. we provide it on a quarterly and annual basis through these reports, and we also provide follow-up information to all the sites. supervisor campos: who insures that the problems identified by the shelter monitoring committee are unjust? >> through the center of care complaint process, it would be the department of public health because the standard of care process is a complaint process in which a complaint is filed by a client, the site response.

the site says the client is not satisfied with their response, we do a follow-up investigation and submit our findings to dph and the site. supervisor campos: 1 the report says there's no verification that -- when the report says there's no verification that staff are being trained along the lines of the organs the code requires, when there are issues around transportation, dph is the one -- >> i'm sorry, i misspoke. supervisor campos: who makes sure that the concerns you have identified our address? >> i do not know. the key the data to the supervisors. it is our understanding that the data gets shared with the hsa as the contract holder, and they make changes as they see fit with the data we have provided. this did care component is the

component -- the standard of care component is the component overseen, by the department of public health. the data in the standard of care reports themselves provide a system overview and system recommendations, so it would fall within hsa. supervisor campos: 90. supervisor mar: -- thank you. supervisor mar: thank you for the quarterly report, but it is becoming clear there is no accountability in how the system works. if i were sitting here, i would be fuming about this. i'm starting to understand why they called it the runaround. i guess i just have a basic question, more from a human level -- how far have become towards a more people-centered process that supervisors amiano,

campos, and others have been advocating for along with myself >> that is a challenging question to answer. you have to look at some of the individual sites to see some of the improvements. i will say that will world, you are seeing some of the same challenges that were reported in 2006. where i think you have seen improvement that has been documented, part of the work of supervisor amiano was about making basic health improvements within the standard of care, and you are seeing more access to personal hygiene products. i feel that is a big improvement. early on in 2006 and 2007, you started to relators put into every single shelter, and every single staff person at that

point proceeded with very thorough training. not every site now has a defibrillator. the staff that i interviewed, most people have not have first- aid training. supervisor campos: thank you very much. why don't we provide this opportunity to hear from the department if they want to add anything or respond to what has been said. good afternoon. thank you for being here. >> there were a lot of this characterization's -- this characterization -- mis characterizations made today. i would like the site manager or the program manager for both of the shelters to respond because i cannot talk on the everyday,

grass roots level, but she is here, she is taking notes, and she can respond to some of the things. i do want to say that's quarterly reports are prepared, and we do take into consideration through community meetings with all our shelter providers the recommendations made from the shelter monitoring committee, and i do have a staff person that sits on the committee. yesterday, this report that you have in front of you was addressed, and i did not get the full report until yesterday evening to respond to some of the things that were there, but this has been -- what has happened throughout the entire shelter monitoring committee process is that even though i was a member of that committee from the very beginning, the it takes up until the 24th power to

actually approve the report. the substance is there, but if you are working from a draft the day before, and i do not get it until towards the evening time, it is really hard to respond to some of the issues. supervisor campos: i think you raise a very important point. is there a reason why we could not have a process where the report is presented, and then there is an opportunity for hsa to respond and have at least more of engage process where it is both sides talking about what the report says and actually being able to talk about some of the specifics. >> exactly, and when you came on board, that was the process, that it was a report presented to you. if you for any of your fellow committee members had issues with the report, then we could

come back and address them, but what i want to say before cathie gets up to speak is the enhancements to the shelter monitoring committee where it was monetary issues has never been fully funded. supervisor campos: let me ask you this -- in terms of process, do you think this is very substantive stuff that has a lot of facts, a lot of details in the. i'm trying to understand if in terms of process, would it be better for us, having heard the presentation from the shelter monitoring committee, to then give you an opportunity to look at this report and maybe come back to us? >> i would love to respond, but a lot of things that bernese said today is not in this report. that is some of the issue that i have.

she talked about the defibrillators. one shelter did not have a defibrillator. when we put them in, we put them in all of the shelters, the single and the family, and most of the conversation here is about singles, although the family schulz's to come under the shelter monitoring committee legislation. it would really help me because i think some of the issues i have is if i'm presented with a report and when the report is given verbally, if it goes of what is written, then i have to write down some of the things that were said that one was not fair to discuss today -- that i was not prepared to discuss today, so, yes, that would be helpful. supervisor campos: why don't we left cathy say whatever she needs to say, and i will ask some questions. please come forward.

and you for being here. >> [inaudible] that includes next door and the sanctuary, and we do have 534 beds. i have only been director since july 6. one thing i would like to say is i really believe there is a place for the shelter monitoring committee. [inaudible] i think there is a role there. i think we all want the same thing, and that is a clean, safe living environment, as impact and humane as it possibly can be when we are sheltering and housing 334 votes in one building and 200 in the other. i think we are all about the same thing. i would like to see that we have a more collaborative

relationship and are working together in problem-solving. one of the questions you have asked, and i'm not sure if i am answering it, but i had just responded to three investigations from the shelter monitoring committee in the past month, and our dph -- that was me. many days, for over a week. not just, "the fix this year" and five minutes later, it is broken, but what can we do as far as long-term solutions? that is part of the corrective action report that i filed, and that is what i think we should be all about, long-term solutions. one of the questions i would like to make, and again, i was not prepared to be here today, but i do want to emphasize that the last case managers that are embedded in the shelter. we have tony, benefits advocacy,

who is part of the team, who is actually embedded next door. we have a bilingual case manager who is embedded four days a week at sanctuary. we have another bilingual, spanish-speaking kansas manager who works 3.2 days at both sensory and next door. we have a mental health certified clinician who works one and a half days embedded next door, and another certified mental health specialists who is two and a half days next door. i think some of the information -- we need to be careful what kind of information is being disseminated. supervisor campos: thank you very much. again, we want to make sure you are provided an opportunity to respond to everything that is in the report, so i do not really expect you to provide anything substantive in response at this point, but just from my

perspective, just to tell you, the things that jump out in the report that i would like to hear from hsa in the near future about -- on the issue of training, i think it is really important for us to get a sense from your perspective where department's compliance with the changing requirements are granted -- the training requirements are, in terms of the level of training provided to agency employees. i think that is a very important component of making sure we are operating as we're supposed to be. >> correct. when the changes were made back in may through this committee to training to be provided to the shelters, we were also in negotiation with a lawsuit filed against the city.

the western region c advocacy project, which was finally approved by the courts on august 13. part of that lawsuit required more extensive training back hsa is to put in place. we got the changes to the shelter monitoring committee, and we have the lawsuit just kind of sitting for a while. training has been occurring, but the lawsuit now mandates that 100% of all shelters the are trained on a list of things, so we just met with our shelter directors yesterday to go over that list. we have to have the training started and in place by december 13, so that is what we are working with. supervisor campos: i appreciate that, but again, going back to the focus of the report, it

focuses not on the lawsuit, but on what is already required under the code. >> right, and the losses strengthens what is already required under the code. -- the lawsuit strengthens what is already required under the code. supervisor campos: what i'm trying to understand is what is your level of compliance with respect to training provided under the code? >> i do not know whether -- where those numbers came from. supervisor campos: irrespective of whether those numbers are from midget accurate or not, i think we need to hear from you whether or not that is the case. i know you are working on this lawsuit, but this requirement has already been in place for quite some time. >> each quarter, all of the

shelters are required to submit a quarterly report. what that quarterly report covers, along with my staff going out to monitor that agency, is the list of trains that occurred within the quarter. supervisor campos: i think that what i would say is what i expect to hear from your department is, "yes, we have trained our staff. we have trained 100% of our staff. we have trained" -- you know, whatever the percentage is -- "and we have trained them on these things." it is hard to give the numbers on context. what does that mean in relation to the total number of employees you have? >> i can say with certainty that all of our shelters have trained their staff. it might not be 100%, and i

cannot give you a percentage today, but those are things that come up here, and i do not want to respond from the hit -- supervisor campos: right, which is why i'm saying we do not expect a substantive response today, but we do want you to be able to come back and give us that response. if there is training, that is fine, but there is a difference between 100% compliance and a number that is much lower. >> right, but this extensive list here is evidence that training is occurring. supervisor campos: it defense on how you see it, right? if training is occurring for 15%, as they said, yes, training is occurring for 15%, but that also means it is not for 85%. on the issue of case management, i think that is another issue i would like to hear more about because at least the report

talked about only 11 case managers for the population of 1134. again, i think it would be helpful to get the numbers from you can get a better sense of what the case load of these case managers actually is and what happens where there is no case manager available, and maybe just provide some clarity on that. i think that would be helpful. >> and if you want that today? supervisor campos: this is just about getting that information in the near future. and the same issue on transportation. if you could also address the issues raised. supervisor mar: and on the training, the information on the impact of the lawsuit settlement would be very helpful. i'm just noticing from the quarterly report that i guess there are 10 training areas under the standards of care that already exist, and cultural sensitivity is a critical one,

so even just knowing the breakdown of whether cultural sensitivity is part of the training and which sites it is being done. i think it should be done at all and it has to be a tremendous priority within the system, and i would appreciate the information. i think this has been a productive hearing, that we need much information and much stronger accountability. supervisor campos: thank you very much. before we go to public comment, i want to say that i appreciate the agency being here. we want to make sure you are given the opportunity to respond and adequate time to do that, so we will schedule a follow-up hearing on this, but i do believe there are some really serious issues raised in this report that are extremely troubling, and i think that the sooner we can get to a response, i think the better.

so thank you for being here. with that in mind, why don't we open up for public comment? if there is any member of the public who would like to speak, you each have two minutes. >> i apologize. i'm actually on the agenda on items seven, but i have to be in court at 4:00, so i did not know what to do. i will have to leave in 15 minutes. supervisor campos: let us finish this item, and we will try to get to you as soon as we can. thank you. first person on this item please. >> afternoon, rules committee. ♪ oh, i give my love to be here here, shelter there knowing that the rules committee is here to care

hoping you will be to help every shelter where hoping you care know we know will always be there in one shelter everywhere and in view are beside this item, i know will care, and i hope you will become report aware here, sheltered there knowing that the rules committee can this city will care for a place to go, and i would like you to know i would like it to be very good i want shelter everywhere and if you are beside the shelter, and i know that you will care

and you will be aware of the reports and feed their here sheltered there and everywhere shelter here there and with money and lots of love, will in -- won't you care ♪ >> thank you. next speaker please. of >> [inaudible] the shelter training manual is 10 chapters. as you might imagine, we have quite a bit of turnover with shelter staff. we have about 101 to 120 staff. all new hires before they enter the door get four hours of training orientation. in addition to that, we also do a rich training schedule that includes cultural sensitivity,

trans gender sensitivity, crucial conversations, sexual harassment, etc. the one weakness we are working on is mandating the training. we do a pretty good job the first year, but after that, getting and mandating it. i also want to i alsohsa -- i also want to say that hsa does come annually to inspect the training manual. thank you very much. >> thank you. director of the coalition on homelessness. i think what you are hearing in the report is that our collective efforts to transform shelters into places where all persons are treated with dignity and respect and where human rights are embraced and where they are launching pads into permanent housing is still in process. there is a lot of hard work being done. collective work on all sides.

homeless people are working hard to transform the shelters, and shelter providers are working hard. i just wanted to cover two things in particular. one is around the intent of the shelter monitoring committee, to ensure that shelters are meeting the standards of care. if not, the legislation calls for the department of public health to do an investigation and levy a fine if they are not in compliance. the hope is that no fine would ever be levered -- levied against the shelter, that they would take corrective action and back it would not get to that place, but unfortunately, this tail end of the process has proven to be the most problematic. dph has never found a site to be out of compliance, and that is not a problem if the shelters have taken corrective action, but that is not totally clear. one of the things you have in front of you is a response from