ok, thank you. supervisor mirkarimi? supervisor kim: -- supervisor mirkarimi: very quickly, what is the remainder of the subcontractor amount that the city is dispersing to lyon- martin. >> of the $322,000 over the contract, a total of $160,000 was advanced on both sides. so you have the remainder of about $170,000 remaining on the contract. the department would certainly look to end work with eric and his physical team to determine what would be inappropriate advance amount. -- what would be an appropriate advance amount. we would certainly be able to do that for lyon-martin. supervisor mirkarimi: and with

the clinic -- and with the clinic then be renewed as a candidate in the fiscal year in july? should all the corrective actions that have been mentioned here take place, then the renewed amounts starts all over again with the new fiscal year? >> certainly if in fact lyon- martin is able to fulfill all components of the action plan, and raise the additional $500,000 they believe they need by march 31, there would be no reason for the department to contract with -- there would be no reason for the department not to contract with lyon-martin. we would have additional monitoring program and reporting on the very monthly or quarterly basis to make sure that the department and city as a founder

is knowledgeable about the fiscal condition of the organization. in terms of the amount itself, the amount they would receive under healthy san francisco would be reduced because we are in the process of transitioning some of their clients at this time, so they would not receive the entire amount there because they are serving fewer people. but with respect to the mental- health and substance-abuse contracts, because they would have to be annualized, those contracts would obviously be higher. supervisor mirkarimi: okay. >> just a follow-up question, could you explain when it is appropriate to do it and advance? -- when it is appropriate to do in advance? when is it that dph feels or analyzes and determines is

appropriate to do the advance? >> the first thing is we want to make sure that first lyon- martin has fully invoiced us for the services. for example, we have advanced them on the behavioral health side and they are in the process of completing those invoices. we want to have all of those invoices before we advance them again, just to be sure that we can document the service being provided. that is something we all want to happen. second, we would want to meet with eric and the cfo in charge to get at what their monthly cash flow needed is. certainly, the $300,000 that has been raised to date has been very helpful helping the organization meet its cash flow, but we want the information about what their monthly meeting is before we release the money. i believe on march 12, when eric

goes to the board, that information will be a component of that. that would be a second thing that we would want before. and third, i think it is important have a good sense that other founders, philanthropy, and/or other donations are forthcoming to help meet the $500,000 need before we would advance. there is the chicken and eight of the huge advance funds to an organization to help them meet their payroll when, in fact, it may be by march 31 the are not able to raise the $500,000? we want to see where they are on their long-term fund-raising strategies for the $500,000 before advancing those dollars. i think those three conditions would be required for the department to go forward and

advance any additional dollars above and beyond the $160,000 we have already advanced. >> thank you. supervisor mirkarimi: thank you. i will call from a series of cards, but now it also like to invite the former supervisor who has been part of the flank on the ground rallying people's opinion in support of save lyon- martin. >> thank you for letting me speak briefly, and i want to acknowledge and thank you, both supervisor mirkarimi and supervisor kim were at the incredible event that was held for lyon-martin. my first point is i have been proud as a supervisor to have been a partner with lyon-martin and feel very strongly about their continuation. more than any other service in the city, our health services

have to be culturally competent. i think you'll hear from individual sharing their personal testimony that without lyon-martin, their health needs would not have been met. i think to imagine a san francisco in which we transitioned out of lyon-martin would be difficult, impossible for me to see. with the lgb community center, you have all helped us improve the viability of the center. one of the key elements was a philanthropist came together, the foundation came together and took part in the planning. as a result of being part of it they made significant financial commitments. i like to think with the work already taking place and moving forward, recognizing the health department has been engaged with the community clinics consortiums that we need to quickly bring together the

foundation stakeholders. i think to seek city funds, which is a legitimate question for us to ask in this difficult time, i think $150,000, if we meet the goal, we would be matching almost at a five-one basis. the energy that you see at this hearing and in the community to support lyon-martin i think will continue, and i will redouble and contribute everything i have contributed over the past month, and i think many members of our community will do that. i think we have to say there are so many individuals who approached me on the street and say with their insurance has been -- what their experience has been with lyon-martin. what you have here today is a small cross section of these individuals have -- who have relied on the simple health center. i have the upmost confidence. i very much appreciate this

hearing being held. i appreciate the community commitment that we are seeing, that you will continue to see, and i think the foundation will step up and work with the department to keep lyon-martin open. thank you. supervisor mirkarimi: thank you. i will call from the yellow stack of cards that i have. please come forward. rabbi david, morgan russo, gabriel holland, thomas, and danny. supervisor kim: before the public comment gets underway, i like to thank supervisor dufty for being at the hearing. i also like to thank all the people who came to the hearing today and say to dph, lyon- martin, for all the hard work that you have put in to make this a possibility. unfortunately, i will have to leave at 6:00.

i just want to let you know ahead of time. but i think you for coming out and sharing your stories. >> thank you. my name is david. i am a san francisco resident and a rabbi. religiously, jewish tradition recognizes the committal and civic commitment to help those in the community who are most vulnerable and offer the protection and care. i think i am at the winged the supervisors and the implications of a potential loss of lyon- martin are not only local but reached nationally and internationally, given the role that san francisco plays in world culture. if san francisco does not make extraordinary efforts to help these people, how are we going

to convince less progressive communities and the u.s. and worldwide? attention must be paid. mahnke. supervisor kim: -- thank supervisor mirkarimi: you. thank you very much. next speaker, please? >> miami transgendered woman. -- i am a transgendered woman. at 58 years old, if lyon-martin ceases to exist, i would be back to rolling the dice for my health care. i would not seek it. it is too frightening. i am from new jersey. i began my transition there, and it was a whole lot different dealing with the health care

system there. i am assured -- i am insured, disabled, on social security, so i am covered, but i am more concerned about most of the people that lyon-martin serves. they are not here. they're looking for cover from the rain. and is just -- it would be really hard. i worked as a stand-up comedian in san francisco, and i -- i just cannot imagine a san francisco without lyon-martin. i just cannot. it is so safe, so

compassionate, and thank you. supervisor mirkarimi: think you very much. next speaker, please? >> supervisors, gabriel holland. in 1984, started the process of coming out as trans injured -- of transgendered. i started coming out, and 1996, 1997, sought out transgendered health care and had an amazingly hostile experience with my health care provider, kaiser, to drive me away from ever seeking gynecological care, i was so traumatized. that said, i went to lyon- martin to get hormonal treatment, and had such a positive experience and understood how important transgendered health benefits

are, and out of that experience work with other transgendered activists to pass health benefits for city employees in 2001 and working on legislation statewide to provide health-care benefits and the anti- discrimination legislation. things have changed, no question, and some would say things are better. i can say that the thing that is true is they are the model in many ways, and it has profoundly influenced not just san francisco, nationally and internationally what it looks like to provide health care for transgendered. and the needs is very specific. and i also think they're one of the more sensitive places in terms of training women. across the board, they have been

a model of care. the only thing i would sit with this, i think we are poised, supervisors, to save lyon- martin. we are pleased in that moment, and your action could send the right message and help in terms of foundation and other big fund raised -- and other big fund- raisers which would be at the chicken and egg. once they get the sense that you are willing to do things to say if lyon-martin, that could reshape the debate and bring it together in terms of saving lyon-martin. supervisor mirkarimi: thank you very much. next speaker, please? >> hello, i am a nurse practitioner at a clinic in the city. i'm a registered nurse at san francisco general hospital. i just want to remind the supervisors about the great stress of closing lyon-martin on the already overburdened department of public health. i have no people to wait and the

emergency room 40 hours before they get a bed. there has been a time when there has not been and i see you open. -- there has been a time when the i.c.u. has not been opened. i personally tried in the past few months, and there has been a weight of three months to get an appointment. i think it is in the department of health's interest and the patient's interest to keep the clinic open. thank you. supervisor mirkarimi: thank you. before this next speaker, i will read a few more names. the kathleen, linsey, brian. >> good evening, supervisors, i am thomas. the issue in front of you is not whether the individuals are entitled to medical treatment

but whether or not lyon-martin should be the provider. i am very troubled by the questions posed by this committee and the dearth of answers provided by lyon- martin's leadership. there are no protocols in place to prevent another shot down without advising clients and patience of where to go next. there is no budget presented to you tonight. in fact, there is no leadership people on the lyon-martin board at the present time. they will have a new board and the executive director has been on board today is. -- has been on the board to days. but it makes economic sense to give them $160,000, because if you don't, they will be a greater financial burden on the general fund. i will say this, if you give

them the $150,000 loan, there should be conditions on the loan. number one, he should get guaranteed they will get the additional financing, from either the public or other foundations. second, they should provide a budget that is realistic and that they will be an ongoing entity in 2012. finally, let me say that the problems with lyon-martin, the department of public health has failed to do the oversight. the department of public health, they have to ever see the budget. so these nonprofits and the department of public health has not achieved that. thank you. supervisor mirkarimi: thank you. next speaker, please?

>> hello, i am a disabled 55- year-old woman. when i started at lyon-martin, it was ok, i will go to that clinic. i had no idea. i had lost my last job. i had been almost two years on unemployment. i am talking about $100 per week, living in san francisco. i lost my housing. i was unbelievably depressed. there were days when my arthritis prevented me from time in my shoes and i stayed home and did not get out of bed. once in a while i would go to the library. in going to lyon-martin, i found credible, comprehensive,

kindness, care, and ability. mental and emotional and physical. maybe the staff is not officially train to transform a from healthy san francisco, but that is what happened because of their addressing all of my physical, emotional, and mental needs. i became more confident and aware that i was entitled. they helped me do that. they wrote letters for me. they got me in that. that was because of the comprehensive health care. i am sure i am one of their 17% of homeless. there is a niche, and there are more people like me who need lyon-martin health care. there are an unbelievably caring and qualified staff. thank you. supervisor mirkarimi: thank you. next speaker, please? >> thank you for your time. i live a couple blocks from the clinic.

i am a community member, friend, a supporter. i moved to san francisco a couple years ago for a job, but also because i knew san francisco to be a really special place. outside of san francisco, the world feels like it is falling apart. people are being intimidated and silence for their beliefs at an alarming rate. people who are in the most critical need are being further marginalize, pushed further out to the fringes, there needs de- prioritized compared with others. i'd like to san francisco that san francisco is a special place. i would like to think that we as a city are better than that. i joined the save lyon-martin community group a month ago. in the last month, i have seen

thousands of people, patients, community members like myself, other supporters who have come out and done everything they can to support this clinic. emotions are high. i have seen people crying at the prospect of losing this critical resource. some of us have been fighting with each other over how best to save this clinic. but i have not seen anyone turn their back on lyon-martin. and that is why we are here today, to ask that you, supervisors, not turn your backs on the clinic, that you not turn your back on the committee that is in such critical need -- on the community that is in such critical need. i think that we as a city are better than that. thank you. supervisor mirkarimi: thank you.

next speaker, please? >> hello, supervisors. thank you for your public service and leadership on this issue. i am brian, the executive director of housing and san francisco, and hopefully i speak for my other organization executive directors who could not be here to say we all have to stand together when times are tough. san francisco does not let people fall off the cliff and we cannot let organizations fall off the cliff. that is what sets us apart, part of our values we're here to support today. a few notes. lyon-martin, five under thousand dollars, that is fifty-five cents per day for health care, and that is a reasonable investment, especially for parts of the population that are extreme risk of hiv infection.

if they are preventing people from getting hiv, it is saving the city $660,000 of lifetime medical costs. it is a wise investment. i think if people fall through the cracks, there will be consequences. i am also here to encourage everyone to not hobbled the organization. if we're going to invest the time and energy, let's do it right and put them on solid ground at and not have them living along in a way that does not serve anybody well. also, i come from the local community. they're very opinionated. it would like to express our opinions. i have not heard one single person make any kind of criticism whatsoever about the quality of the care they are receiving. that is weird, because my people like to complain. i haven't heard nothing.

so this is simply an administrative problem, something that needs to be fixed, and we need to fix it. thank you. supervisor mirkarimi: thank you. next speaker? >> hello. the last 10 years of my life i have spent dealing with my health. it started with a broken back and broken feet at the same time. it took me three years to recover. that led to a series of pains all over my body. when i arrived in this country 10 years ago, i was broken. i had the support from my family, the support from my friends. actually, let me rephrase that, my friends were there. they were here. i found lyon-martin.

when i did, what happened to me was simply the light shine. because of the care, the compassion, and the incredible ability these people have shown to percent and give to every single person who walked through the door. there was absolutely unique. it was truly the only place in the world i have been that can make me feel so at home, so that these, and cheerful. the work that the people do is remarkable. i will use the words that were used by our jewish friend, yes, it is a model. we cannot lose it without losing part of our identity. did i hear the ring? it is time over? supervisor mirkarimi: keep going. >> as i was saying, a piece of

our identity will be missed if we let lyon-martin go. money, in matters of health, they are senot supposed to be in the same conversation. the last few years i had a tumor in my liver removed. it was found by lyon-martin. the next year i was found with breast cancer. it was found again by lyon- martin. at this time i had no money to support myself. if it was not for this clinic, i would not be able to tell you i am cancer free for the third time. thank you so much. supervisor mirkarimi: thank you. before the next speaker, i will call more names. gloria, james ward, sid nova, and cara.

>> so i am glad i voted for you, supervisor kim. anyway. so i have coordinated and trained staff members and volunteers a nonprofit organizations and fund-raising developments. i have trained thousands of the years. in all my years of fund- raising, i have never, never seen the massive amount of money raised and the number of people -- more than 17 other people donate -- more than 1700 people donate. i think the people of san francisco are fighting for this. i am fighting for this because many of my friends depend on lyon-martin, includingtwo who could not be here today because of disabilities. one said if lyon-martin closes,

people will die. another said lyon-martin, is the only place i felt safe enough to get my hormones. if they close, i don't know what i will do. two these folks, queer folks fo of color trainmen school students in transgendered health care, and they tell me or stories about the level of health care -- they tell me horror stories about the level of health care. i think that lyon-martin patients should not have to leave just because lyon-martin board any sick of the leadership messed up. i think our people deserve the day of seeing their doctors. this is not about charity, this

is about justice. we also know that our public health systems are already strapped, and there is not a single clinic that can take on 3500 people. thank you. supervisor mirkarimi: thank you very much. next speaker? >> thank you, i am gloria. back in 1991, the clinic received a grant from the tobacco-free project, the department of public health, to start a stop smoking program for lesbians and gay men. when that. and it, that could have banned it. it could have just been a blip on the screen. but it is an example of how lyon-martin health services has been inspirational and given leadership not only did the city but the state and beyond. the program continues to this day, and when i leave here i am going to a graduation. there have been over 100