the services that target the most vulnerable in san francisco. please. thank you. >> my name is nicole johnson. i am speaking on behalf of the 24-hour drop in services. a lot of what i have to say it has been said before and it will be said again. the most severely mentally ill homeless women in san francisco are our clients. they are often so debilitated by psychosis, paranoia, that they are not able to access dph services. the services are not useful for them. they are not useful if they cannot be accessed. that access is what we provide. the women are currently living in places and not fit for habitation.

the center -- we lure those women in. they come in to watch a movie or to experience an environment in which they are not protected. our case managers have an opportunity -- in which they are not rejected. our case managers choose moments for intervention were these women are likely to be receptive to services. this is a very cost-effective program. we are also among the programs that have been invited to pursue matching funds. it is generally accepted that every dollar spent in substance abuse services prevents $7 in future spending.

these programs to get women off the streets and prevent the kind of harmful environments that will impact their health and make them a greater expense to the city. thank you. >> i am the executive director of the community mental health services. it provides services in the tenderloin. i been doing this very thing for year after year after year. our budget keeps getting decimated. even when a flat budget here comes along, i get to eliminate 1.2 positions because the mandated health care coverage goes up 20%. they sure, we are facing another $100,000 cut -- this

year, we are facing another $100,000 caught. the safety net is being shredded. i thought years ago to establish a single standard of care. i get to suffer because of that. 34% of all of our clients are in healthy san francisco. i get to be targeted for cuts. the most vulnerable population down in the tender line -- tenderloin it's the biggest cuts for services. 34% of our clients are homeless. most of them have legal encumbrances. they are in poverty and trauma. a pill won't fix it.

it is not a very good idea. thank you. [applause] >> good afternoon. thank you for the opportunity to speak today. we provide the property management services for 450 supporting housing units. i am here to ask for your support and opposing the submitted the proposed budget cuts. -- i am here to ask for your support in opposing the proposed budget cuts. they have served the highest -- supportive housing has proven to

be cost-effective for addressing homelessness. the climate for development is uncertain, at best. we're likely to face a significant decrease in the pipeline of affordable housing units. there are 800 people on the waiting list for the program. this is up from 500 people last year. this is a very narrow target of our overall homeless population. you may be moving existing tenants, as you are cutting an opportunity for 109 more people to come off of the streets. if you look at some of the cost data, folks were moving in the first year, they're seeing a decrease in cost.

thank you for your time. i just wanted to urge you to take a closer look at that cut. thank you. >> good afternoon. i and the co-director -- i want to highlight a few concerns. dph has made large investments in camelot. they are thriving communities and they are safe, clean buildings. divesting now seems on unwise. all the tenants are formerly homeless adults with mental health and physical health issues. relocation to another property

would be disruptive to dispel it -- to the stability of the tenant population. almost everyone in the building receives health services in the surrounding mission neighborhoods. moving them to another neighborhood would be disruptive. the camelot is a thriving property. the to exciting new projects are crafted to help the part of the city's plan to end homelessness. they will serve a very specific populations. diverting of those targeted new units seems in direct contrast to the city's goals and fiscal prudence. the proposal to -- camelot is fully accessible and we have not

had a problem finding people were willing and able and excited. bill leases are up for renewal soon. -- the leases are up for renewal soon. it seems like a difficult time to make the cuts. i hope you will not support the cuts. thank you. >> i am the executive director of hospitality house. usually, we would have 20 or 30 of our participants to speak about the cuts. we decided this year, it is becoming unethical for us to involve our participants. it really destabilizes our community. we have not pushed out the call to folks. we hope we do not have to. we're hoping this can get turned

around. hospitality house is an example of one of those unmatched general fund cuts that will have a drastic impact on our most vulnerable citizens. we are facing a $295,000 cut in the two-year budget to our self- help centers. 45% of our folks are african- american. this represents a cut of seven positions come up 14 positions. this is half of our peer advocacy program. we're seeing an increase in the need and a decrease in the services in the community. we are below is a threshold services that are available to people -- we are the lowest

threshold services that are available to people in the tenderloin. they are dealing with hiv and aids. we need to keep providing these services. i am not quite sure where people will go if we are not able to continue. i want to support the other programs here. unmatched general fund pay for a lot of low threshold services. thank you for your attention. >> good afternoon, supervisors. i am a program manager with hospitality house. we provide substance abuse services at the basic level. we work with our participants who have trouble fighting in some of the higher functioning programs. the therapy, peer counseling.

our participants come in with different types of crises. they're always immediately connected with staff or therapists. we are the safety net of safety nets. i have been here before. our program, we have helped save and improve the lives of the members of our community. we're able to -- we engaged with a woman who was having a mental health. down right in the middle of the street. helping our participants become employed after not having worked for so many years. sometimes to connect people to

primary care. some of our people have not seen a doctor in over 10 years. i am here to emphasize the importance of what we do. we are a safety net to the rest of the safety nets in the community. we helped save and improve the lives of people in our community. thank you. >> i am an advocate for hospitality house. i started there 10 years ago. i used to live in the shelter, i was homeless, and i had a drug addiction problem. if it was not for the individuals working at hospitality house back then, showing me the tools to use to get my life back together, i would probably be still on the

streets. today, i have been with hospitality house for 10 years. i have been with the tenderloin clinic for eight years. this saturday, i will have 10 years clean and sober. [applause] i want to ask you guys to restore our funding. what i would like to see from each one of you is to think outside the box. thank you. >> good afternoon, supervisors. i am one of the program managers and hospitality house. i run the community arts program. every year, we endorse cuts and we have been operating at just the basics. a loss of $295,000 would be

devastating. we would be closing a few of the programs. you might think that art is something that is esoteric. it is not. we provide resources to people that do not have the means. last year alone, we had over 1800 individual artists that came to the art program. these are people we get off the streets that provide -- and provide them the opportunity to be creative and express themselves. please keep us in mind. it is something that is really basic and we have been around for quite awhile. we would like to continue. thank you. >> good afternoon. i am with the coalition on homelessness. i want to take things back and look at the health department

and what they have been facing. over the last five years, over $60 million in cuts in services. we of that situation in the city where we have lost about half of our homeless drop-in centers. we have had many programs close. we have lost mental health treatment programs, substance abuse treatment programs, which i could go on and on. at the same time, it because it is an economic recession, we have more people turning to the public health system for help as they lose their jobs, health insurance, as more people become homeless. we have over 50% increase in the number of people seeking shelters. 300% increase in families seeking shelters. the acuity level of people has gone way up.

the level of crises that people -- all this into costing the city so much more. what are you looking at? you are looking at cuts that are disproportionately targeting the most vulnerable people in san francisco. the reason for that to is this emphasis on unmatched general fund. you have an elimination of affordable housing by raising the rents on people with aids. you have losses in the drop-in centers. you have hundreds and hundreds of homeless people that are relying on that for basic needs. you have cuts to case management in the shelters. we would like you to restore all of the cuts to the health

department and try to increase funding. thank you. supervisor chu: thank you. >> good afternoon, budget and finance. there is something, but there is nothing. i have not seen a psychiatrist in years, and what does it do? there is no medical help. the cataract operation was great. they have done nothing else. i had all of these places to go. i do not know where they are. by the time you got that aids disease, you would go crazy. it is a silly thing. you have to be super gay -- that is what they want. i cannot go see anybody. i saw barry manilow. who else is going to talk to you? do you know what i mean?

you must have some very expensive boyfriends and girlfriends. they will charge you to get it anyway. i have not seen one bit of help. i go by a general hospital, i want a reason to go there. but then i end up going to the channel 20 or else i'd go to the flea markets. there is no excuse. people need to help each other a little more. the doctor said he did not want to see me no more. and then you would not all be ♪ cryin' over ryan's fund ♪ ♪ now you're gone and you gotta

carry on ♪ ♪ you've been cryin' ♪ thank you. supervisor chu: thank you. >> good afternoon. i am from the san francisco human services network. thank you for this early hearing. it is good to get this stuff out on the table. i was going to speak about the impact on the health department. jennifer did a great job of letting that out. there are three areas of decisions that the mayor and this committee are going to have to take on. first of all, to what extent are we going tolay our values on the line?

secondly, the general fund cuts, a $4.8 million across the board cuts that range anywhere from 4% to 25% depending on how different services are impacted by the formula. it does not take into account questions like, who are the clients that will be impacted? how much will this cut destabilize the program? out of those programs over other costs we're facing? there are a couple of million dollars in other cuts. the hiv housing subsidies, residential support of housing. it is about $6.5 million. we have this expense $7 million for usf.

the mayor's office is taking responsibility for whether or not nonprofits. they should not be cutting these services. we're cutting the services to the most vulnerable. i hope he will work with the mayor to take care of both. thank you. supervisor chu: thank you. >> good afternoon. i want to echo what the last couple of speakers have said. at this point, flat funding is a cut. we have seen a significant increase in the health care costs.

if you look at the flat funding and you look at the increases, we're seeing that on the ground. we are seeing higher acuity. we are seeing higher caseloads. at this point, we need to refund the cuts and increased funding. thank you. supervisor chu: next speaker. are there any other members of the public that wish to speak? >> i am a volunteer with the coalition on homelessness. i would like to speak in favor of hospitality house. these people are the best. when i first came here, you cannot tell by as much weight as i have gained, but i had a crack

problem. oh, my god. they have done so much for me. they got me into housing. i went through their internship program. one of the best things it did for me is held with my self- esteem. and feel better as a person. when mike kansas manager -- when my case manager left, i was upset. i had some things going on. he said, don't worry about it. i will take over. i will do this for you. as program manager, that is not in his description. you know, excuse me.

supervisor chu: thank you very much. [applause] >> [inaudible] i will be brief. they are doing a good job for homeless people. a lot of the homeless people can be artists and they are creative. do not close hospitality house down. supervisor chu: are there other members of the public that wish to speak on items one and two? public comment is closed. supervisor wiener: thank you.

i want to thank everybody who came out today. for the ryan white funding cuts hearing. this is going to be a very challenging year. the projections for the deficits are lower than what we had anticipated and lower than last year. it becomes harder and harder, and with this additional $7 million in hits from the federal government, we have our work cut out for us. i am clabber able to have this hearing early and began a very -- i am glad we were able to have this hearing early and began a very public dialogue. thank you. supervisor chu: supervisor kim. supervisor kim: it is always important to hear directly from the community.

thank you to everyone. i do not know if -- one of the issues that has repeatedly come up over the years, it gets exacerbated every year, we make the same cuts. although it looks like a small cut every year, when you think about what we have had to cut every year for the last five years, it is hard to get an overview of the services. i thought it was really helpful to get the graphic of the ryan white funding. what that has meant overall. i was hoping that you could talk about the context of the cuts that have been made over the last several years. >> absolutely.

your staff is doing a good job. i have the summary of the history of our caucus. spending -- of our cuts. spending reductions over the last five years. i will distribute copies. there are a few different things going on. if you go back and look at all the initiatives that went in front of the health commission and ended up making their way into the budget, it and that being a large number. there have been some significant reductions in the department during the worst years of the recession. the other thing to keep in mind as we look at this is that some of these reductions were not necessarily service cuts. some of them were of efficiencies that we probably

should have and would have done regardless in order to free up funding for other priorities. other pieces of this are reductions, but they ended up coming back to the department in other ways. for example, we have some position reductions over here, but we do not show the cases in which, for example, last year, we added positions to meet our federal requirements. those positions are not reflected on this sheet. it is something that provides information, but it has to be taken with the caveats in mind. this is the last five years of -- it is the last four years of initiatives that were approved by the commission that ended up making their way into the budget, broken down by division

within the department. what you see here is the cumulative total of those proposals adds up to $98.6 million over the past five years. if you step back and take a look at the big picture, the budget has grown over that time. we have not reduced our budget and there have been other funding increases that have come and simultaneously. this is what happens if you add up the list. as you would expect, the largest reductions are several years ago as we were starting to come into the years where we had significant budget deficits. that has come