some of our residents were formerly homeless and many lack medical support before arriving. we have served over 1000 in our 25 years. most of those residents experience it as their final home. we have always had a waiting list. i mention this to emphasize that the demand continues. in recent years, residents have represented approximately 10% of the aids deaths in the city of san francisco. we are a vital safety net for the city. we currently serves 45, more residents a year, with ryan white been our primary funding source. we would have no choice but to reduce admissions and leave some of our beds empty. we would be receiving the

funding for 30 residents a year. ten or more would likely end up suffering and or the dying alone. the reality is that most of those individuals would end up visiting san francisco at general repeatedly. we are -- are administrative expense ratio is well under the 20% industry standard. thank you for your consideration. supervisor chu: thank you. >> good afternoon. i am a health services manager at larkin street youth services. i work as a part of the team that serves 45 youth who are

living with hiv and aids. teen-agers and young adults are different from beyond our children and older adults. they are working on autonomy, and they are impulsive and fearless. it is an exciting and dangerous time. the proposed ryan white cuts will impact our ability to provide a youth-specific counseling to young people. i fear we will be left with increased numbers of young people in the bay area who are hiv-positive and not even know it. i fear our community load will increase substantially. many young people do not feel comfortable or save engaging in adult services. the most significant relationships are with peers. the role of the peer advocates

is to support them and connecting with providers, go with him to appointments. it is crucial in getting youth engaged. our young people deserve the support funded through part d. thank you. supervisor chu: thank you. next speaker, please. >> i am happy to have a chance to speak with you today. i heard about this meeting from my case manager at larkin street. i meet with them every wednesday. it is an example of the services that i use. i have been using it for a year. i came to san francisco because i could not find anything to help me out as a homeless youth.

san francisco was the place i came and i found stability and structure and housing and support. i do not know where i would be right now if i had not been there this past year. all of my peers, this is unimportant place for me to meet other people like me. -- this is an important place for me to meet other people like me. without that, i feel like i am lost in this universe. these services are vital. i urge you to find some way to make it happen. people are depending on you and they may not even realize it. it is going to hurt when it is gone. thank you for listening. supervisor chu: thank you. >> good afternoon, supervisors.

i became a client of larkin street in 2007. as a homeless youth, i have gone through a lot of things in my childhood. larkin street was the one that provided. advocacy -- peer advocacy and support. also therapy. it was where i went for my services. tomorrow is my birthday. i am 25 tomorrow. but i am looking towards -- what is going to provide people would support that i have gotten? i think that is very important. thank you. supervisor chu: happy early birthday. thank you. next speaker. >> good afternoon, supervisors. i am a person living with aids

and die and volunteering on the planning council for the last 12 years -- and i am volunteering on the planning council for the last 12 years. but planning council has been advocating locally, state, and nationally, for the past 10 years. we have been working hard for people living with aids, documented and undocumented. one more thing that i want to share with you is that the city of san francisco -- it is a sanctuary city. it has been the compassion and has a diverse citizens in this county. the model of the health care system would be devastated with a 20% cut. when i started, i had nowhere to go. i had no family.

without having a partner that is a nurse, i did not know what to do. it will not only affect the u.youth, the older age population, latinos, chinese, dad -- japanese, all of us. i urge you to be advocates for people and the citizens of san francisco. thank you. supervisor chu: thank you. >> good afternoon. i am here representing -- as a member of the transgendered community, i've always understood the importance of taking an interest in my personal health and awareness around hiv prevention.

i too big this awareness to all the supportive services i received -- i attribute this awareness to all the supportive services are received growing up. i can say that the work being done around prevention and care has been beneficial to myself and to the community. whether it is on the rise in attendance and participation and our education group, larger numbers of people interested in maintaining and updating its chevy statuses, or more people engaging in support of case management -- updating hiv status is, or more people engaging in support of case management, these services are changing lives. it is important that we continue to raise awareness. we to keep the hiv care network here in san francisco. thank you. supervisor chu: thank you. >> good afternoon. i have been receiving hiv care

services and i am also the co- chair of the agency's consumer advisory board. i am doing my best to represent the clients. i have a good relationship with my doctor and my health has been improving. i have been receiving -- in addition to my medical care, i received case management, hiv treatment and education and mental health services. i am able to speak my native language. it is because of these programs and i am able to maintain my health and well-being. a 20% reduction could mean the full hiv care staff could be eliminated. that would mean the specific language could be eliminated. an entire group of clients would not receive competent care.

please do not let this large spending cuts happen. keep supporting the hiv care community. thank you. supervisor chu: thank you. i or read a few more cards as well. -- i will read a few more cards as well. >> thank you for this opportunity. sorry about that, i am a little short. catholic charities has three programs that receive ryan white funds. we provide 135 beds. a licensed care facilities to the chronically ill. we need to have 24 hours care

for our residents. ryan white cuts would mean a decrease in certified nursing assistants. as mentioned, the major savings and expenditure reductions -- the idea was that they would transition clients to the community programs so that they can move into the community. we are the beds. we hope this is recognized when you are discussing ryan white cuts. thank you for the opportunity to speak. supervisor chu: thank you. >> i am a resident of district 9. i am a client, a volunteer, and

board member of project open hand. 7 -- food is a basic need. as a board member, i know we currently have the largest deficit ever. we cannot make up these cuts. it is a trickle down effect for myself, clients, and people for hiv. 75 percent and never doctors say that food is essential to their treatment plant. -- 75% of their doctor said that food is essential to their treatment plan. >> we need your continued support. i am here today to talk about the drop-in center located on

13th street. in the proposed budget, and received a 25% cut in funding. it's = $193,000, which would equate to 6 staff. dph and a director have said that no program would be eliminated from their budget. with the reduction of that staff, that dollar number, the hours would have to be reduced. it is the only 24 hour drop-in center for women and families. last month, we served about 120 single adult women and 50 families. we provided them case management, we linked families to substance abuse treatment,

mental health services and permanent housing. i would have to say we started doing this on december 27. i go in the morning and women say thank you. i would like to think they are thinking me personally as the director. but i know my job is to get and keep money. they are thinking before a back door, that room to sit in. without it, you will have one in -- you will have women back on the streets under the overpasses. thank you. supervisor chu: thank you. >> good afternoon. thank you for giving me the opportunity to speak.

i speak to you today as a person living with hiv. i first received services as a client from the aids legal referral panel. i've been volunteered with them and served as co-chair on their board of directors. i came seeking help for a housing issue that was causing great stress. the staff attorney was able to help me quickly and i was so impressed with them that i started to volunteer with the agency. every day that i am there, i see so many people who are incredibly stressed. they have nowhere else to go. by serving on the board, i learned how they use their government funding to leverage millions of dollars in donated legal services. i 20 -- a 20% reduction in the care funding would result in a loss of a staff attorney.

reading hundreds of clients without access to legal services. -- leaving hundreds of clients without access to legal services. a lot of people use the word "devastated." it would be devastating to people with hiv who rely on the legal services. they are already stressed out to the limit. having one attorney gone, and it would be devastating. the legal services help people with hiv stake in their homes, keep their jobs, help them with insurance problems. we really need -- thank you. >> i am here as the president of

the harvey milk and democratic club. hiv has been deeply affected the lgbt community in san francisco. the club has long advocated for hiv funding and services to meet the needs of these people living with hiv and those at risk. san francisco has had a proud tradition of taking care of your residence and communities when the federal government would not. in light of these federal funding shortfalls, the club called on the mayor and the board of supervisors to work together to come up with general funds to replace the loss of federal dollars to ensure the people living with hiv do not lose access to these life-saving services. on a personal note, 16 years ago, i family was called in to watch me pass away as i had 11 t cells.

the services have allowed me to come a bit of a success story. please restore this funding and help the community. thank you very much. >> hello, supervisors. i am the executive director of the housing alliance. it stand in solidarity with all communities opposing cuts across the board. we need to be framed this as not just cuts, cuts, cuts. i encourage all of you to tap into your god-given creativity to ensure that the city is getting its fair share of opportunities for increased revenues. the housing alliance does not receive any ryan white funding. we are lucky in this situation. what is critical about that is

the housing alliance, because of our funding source, we are able to serve people who are not eligible for services under the ryan white care act. we're able to serve a broader spectrum of people. while we oppose all the cuts, i want to challenge some of the framing around the calls for the $300,000 in taking away from the pockets of people with hiv by increasing their contributions. the plan is not affordable. i was toreframe the statement that they are spreading hiv subsidies and alignment with other subsidies -- in bringing hiv subsidies and alignment with other subsidies. i find it annoying when people are living on $279.

lastly, i would bag each of you -- beg each of you, use this opportunity to find ways of incentivizing jobs for disabled people with aids. the most important service i ever received was getting a job. supervisor chu: thank you. >> i am a patient at the hiv clinic. the clinic helps me. case managers, social workers. without them, the clinic is open for a check -- the clinic is

open on wednesday mornings for hiv women. if you cut it, where would we be? we need the funds to keep going. i depend on it. other women depend on it. it helps me get through rough times when i did not have anywhere else to go. you cut it, we do not have nothing. in order to keep the service, it is really needed. please do not cut the funds. we really do need it. thank you. supervisor chu: thank you. i will call a few more names.

we have opened up public comment for both items. >> good afternoon. i am a case manager for catholic charities. i am a case manager, i also worked at the 360 clinic. during clinic days, when access mental health, social and case management services. they see their primary care provider. it provides people with stability, care, and emotional support. the 20% cut to the ryan white program would devastate these much needed services. these services serve the poor

and disenfranchised. >> thank you for this opportunity to speak. my name is allison smith. we provide behavioral health services for the largest adult homeless shelters in this city. we provide individual and group mental health services that assist individuals to raise their level of functioning linked to primary care services, and avoid a higher level of emergency services. three years ago, mental health and substance abuse specialist or pulled out of individual cell sites -- individual shelter sites. at that time, we have funding

for 10 case managers to serve the most acute clients. this current fiscal year is due to put the budgetary constraints, we were forced to slim down our team even further it is not ideal and more case managers are needed, but we're still able to provide a safety net. the message i would like to convey to date is that if these cuts go through and we lose almost 25% of our budget, the safety nets in the shelters will be drastically compromise. there is no fallback provider. thank you for the opportunity to speak today. >> thank you, supervisors. i know you have heard from a lot of us today. i work with allison.

as alice in mentioned, we are extremely affected by the reduction to the general funds in these contracts. some small programs are exempted, those with $600,000 or less we are just slightly over. we are facing a cut of 25%. i want to underscore -- this is really affecting folks that are falling for the cracks. these are not the folks already accessing primary-care clinics. the nature of their disabilities prevents them from knowing they even have a disability. they are not willing or able to apply for sources of funding that would help us to meet their needs.

case management services and community services save the city money. we are helping people avoid unnecessary hospitalization and remain stable in the community. an investment in our program will save the city money. you have to look at a slightly longer term view. i believe we have a great deal of value. thank you very much. >> i am the executive director. i am here to oppose the 25% cuts. these cuts severely impact service is too vulnerable homeless people and severely cripple safety net services. we assume responsibility for the drop in center on the later part

of november. it is the starting point for homeless women and their families. they cannot navigate shelter and other services. they need the drop-in center as the starting point. we brought considerable expertise from other programs. transforming it into a resource center where women are actively engaged in services that move them out of homelessness. if the cuts go through, it will literally gut these services. it will eliminate the case management. stopple be cut in half. the hours will be reduced -- staff will be cut in half. hours will be reduced. this is the city's most successful outreach and housing effort to date. it is a partnership between --

partnership. they serve people that cannot access services otherwise. there will be no outreach presence on the street. it is ironic that they are actively pursuing certification and yet we are proposed for cuts. supervisor chu: thank you. >> id san francisco, us outreach team. -- i am with the san francisco homeless outreach team. special projects, golden gate park, stuff like that would be completely gone. the rest of it is $144,000. it is about 2.5 case managers.

that is about 141 people that will be out on the street without that case management. we carry about 15 clients per case manager. we are cost-effective, we are integrated. we house 200 individuals last year from the case management team. we did just about everything on the outreach side. and i think we do it very well. this is the second year in a row, i am here to support not cutting a woman's place drop-in center, not cutting the start program. these are the programs that help the most vulnerable. and we are. i will be in training tomorrow about billing. we are already on back track. i have a timeline that i could send you.