what we viewed as our priorities from the human services network for the very legitimate demands on a tight budget. i commend that letter to you for some of the details. i am i am here specifically to address the need for a cost of doing business increase on doing contracts. the mayor provided for a 1% increase, an unprecedented new move. in the last six years, we have had no interest, but that is only on the first year of a two- year budget. we are straining under six years of flat line budgets and cut budgets in order to try and survive. i do not think there is a more efficient allocation that the board of supervisors could make this year than to invest in the broader 100-plus agencies that serve the most vulnerable san franciscans by acknowledging that we need to climb out of a deep hole of expenses and costs.

we need to start being able to pay our employees, who are really the heroes of serving the underserved population in the community, a decent salary, and a 2% cost-of-living increase would be the most efficient way, in our point of view, to stabilize the sector. i also want to say that hsn is prepared to back what we hope will be a coalition to support a revenue-positive business venture this year. we fought for business taxes in the past, which have been -- been a boon to our economy. we were ready to support the help support, a tax we can get behind so we can grow our capability to serve our most needy citizens. supervisor chu: thank you. next speaker please. >> good morning, supervisors. i am executive director of better places, and i am here today on behalf of the hsn.

for the past seven years, i have come to these chambers to plead on behalf of one or more of our chambers threatened with closure. i have always known how to craft a compelling, substantive, often deeply moving argument for the preservation of these services because with the two undiluted minutes we are 40, you could pretty much do anything. for the first time in over six years, there are no planned reductions for community-based agencies, and, in fact, a 1% cost of this increase. we are grateful to the mayor as well as supervisor chu, who have attended all the meetings the past few years. also -- the ongoing support of many supervisors, but appreciative as we are, organizations cannot survive over half a decade of frozen budgets alongside a will reductions in programs -- in one program or another, while the

cost of virtually everything from food to workers comp to health insurance costs continued to rise. this is not a good business model. the board to take the opportunity in this year to favor the many over the few by adding an additional 2% cost of business increased to the mayor's budget so we can pay our workers for their hard work and their many sacrifices while we ensure the survival of the social safety net that defines the character and values of our city. this is the first year in which there is not a fourth choice between an increase to community-based agencies and having to sacrifice other agencies in the process. thank you. supervisor chu: thank you. next speaker. >> i am here for latinos and

latinas. please do not cut this program. we are trying hard to keep the tenderloin a community, and these mothers with these babies -- they have to keep them close to the because is not a lot of opportunity for them to have the kids go up side and plate. these women need to be educated on their rights as people in the community, in the tenderloin. this is a shame that you guys are going to cut the baby's. the babies do not have any say so. we have to fight for these babies and for these women, single mothers. please -- i mean, you would not do it to your kids. give these kids and opportunity to grow up. educate them, and let them know

that the streets are not all bad. there are buildings that they can go into and get educated. please do not cut this program. if you do cut this program, you will be cutting a community, and the latinos are a part of our community. the mothers -- all they want is a fair chance to raise their kids. thank you. supervisor chu: thank you. next speaker. >> hello. yes or a tenant organizer from the central city collaborative. i want to talk about the latina's. they are doing a lot of good work, and there's really only one place like this that is doing work for the latinas and latinos in the district.

i would like to say that they helped me when i was getting rid of the bus shelter where drug use was going on, and they really helped because they knew firsthand what was going on in that horrible place, as we did get rid of it. so please, help them get the money that they need or whatever they need to keep going. thank you. supervisor chu: thank you. just so i know, in terms of the front of real gross, we're going first for seniors and individuals with disabilities first. i know most of the folks want to go with a group. is there anybody not with a group that would like to speak in these first two rows? >> good morning, supervisors and everybody. i work with the tenderloin never the development corporation, and i am a member of the tenderloin

american community of position. your side a filipino, but your story here to speak and support the latino organization. the only one in the tenderloin. they have a very nice and very amazing program, and this is the only community as speaks on behalf of all the latina's here in the tenderloin. so i asked supervisors to please include them in the budget so they could continue their program. thank you. supervisor chu: thank you. to the front two rows, might understanding is that you guys are ready to speak. >> hello. i am here to speak about the proposed funding -- hprv funding

cut. i am asking you not to cut these, for people that are hiv- positive, such as myself. it is often difficult to find other help. when i needed help, it was only the help of these funds that prevented us from becoming homeless. when my family turn us away [inaudible] normally will be held off the streets. thank you so much. supervisor chu: thank you. first rose, please come on up. if i could ask you to wait. thank you. >> good morning, supervisors.

i am here today representing with my colleagues and our fellow seniors the san francisco adult day services network. we represent seven adult day health care centers, serving over 1000 very frail seniors, whose family and our seniors depend on day care services every day. we are here to request for a total of $441,000 as an emergency community living fund to insure that 78 of the most frail seniors in our seven centers can continue their services while waiting for the state to hear their appeals. the state over the 1000 seniors had denied 70 seniors of the access to day care services, but yet, they have the late the hearing for over 90 days -- delayed the hearing for over 90 days, and only one of the seven cases have been heard.

many of you remember that we came to you for any emergency set aside in case the state eliminated adhc from our programs. $3.4 million was set up here fortunately, the state relented and came up with community-based adult services, to keep the program going, but yet, the center is full of challenges, and we hope that after hearing our frail seniors and center directors, that you will find in your hearts to approve $441,000 as any emergency that back for the network. supervisor chu: thank you. are there other seniors who will be speaking on this item? please come on up. you can use the second microphone, the lower microphone.

we only have one microphone the works at a time. thank you. >> [speaking foreign language] >> my husband has been coming because he has a severe communication deficit. i do not understand what he tells me, and it is very difficult for me to take care of him at home.

i do not know why he is not eligible, but one thing -- when he comes to adult day health center, he feels have fear, and if he cannot come to adult day health center when he is home alone, he is very educated and not feeling happy, and i do not know -- he is very agitated and not feeling happy, and i do not know how to take care of him.

i hope that he can continue to come to the center. it is really my hope, hoping that you will pass so my husband can continue to come to an adult day health. supervisor chu: thank you. are there other seniors? for individuals with disabilities who may want to speak first? go ahead. >> good morning. i am the physical therapist at steppingstone presentation adult day health. i am introducing one of my patients, who is not able to introduce herself because she has severe dementia. she is typical of the many people we seek, and in

particular, unfortunately, typical of those who have been denied services. she is 87 years old. she has many complex medical problems and a history of injury falls. if it were not for our help, she would be in a nursing home. she needs assistance with dressing, bathing, medication administration, toiling, walking, and sometimes simply getting out of a chair. she has been attending our center for the last 11 years four days a week, and she has done very well. she has declined a little bit recently after the death of her husband. the nurse who visited us -- we interviewed her at our center, said she was eligible, but the eligibility was reversed when her paperwork went back to the medical office and a supervisor who had never even seen her said she could not continue attending, she would not be

eligible. community living fund has been paying for her care as she awaits for her hearing, but those funds run out june 30, and her hearing has not even been scheduled. if we could continue to get support from community living fun, we could keep her stable and keep her out of a nursing home. i hope you will support us. thank you very much. supervisor chu: thank you. are there other seniors or individuals with disabilities who would like to speak first? >> hello, board of supervisors. i attend stepping stone day

held. i was married for 53 years, and when my husband passed away in 2008, i missed him dearly. i would not leave my apartment and felt the press, sad, lonely, isolated, and sometimes, i could not stop crying. i was diagnosed with depression, and i have been seeing a mental- health provider for two years. my arthritis and a glove, were sent, which made it more painful to work and very hard to see. i started to attend stepping stone in january 2010 and was able to exercise more often, and my depression was stabilized.

without stepping stone, i would not have been stabilized. i would have been hospitalized and become more depressed. i would like to request the city to pay for the board participants until our hearing, and keep us alive in the community, and enable us to enjoy the last mile of our journey as a senior. thank you very much. supervisor chu: thank you very much. any other members from the first row who would like to speak? >> good morning. my name is orlando witherspoon. i am a stroke victims.

i get their feet at mabina steppingstone center -- i get therapy. at exercise their. the stiffness in my arm, the therapist showed me how to get this worked out. i need this center, and i need somebody to tell me who decided i should not be eligible for my therapy. i need some answers. i need my therapy, you know? thank you. supervisor chu: thank you very much. finally, are there other members from the first row who would like to speak who have not had a chance yet? >> i am a program director at

steppingstone mabini adult day health. as you can see from the previous speakers were clearly eligible for the program due to medical's new criteria. they are both frail, and there -- their diagnoses would qualify for the program. it is unfathomable to think that they would not be qualified. according to medical rules, elders and people with disabilities need to qualify for one category out of the five for assistance. orlando meets two categories. if participants only have the chance to wait for a fair hearing while attending adult day health care in the city, the

city would be proactive versus being reactive and waiting at home. being at home, they would be isolated, depressed, and need further care. for example, going to the er for hospital reasons. if not receiving preventative care from adult day health care. we request that community living fund give elders and people with disabilities a chance to win their fair hearing and allow them to stay at adult day health care, and when they win the hearing, the money will then be reimbursed to the city. once an elder or person with disabilities loses the opportunity to come to adult day health care, most likely, they do not have a second chance to come back, due to declining health. thank you. supervisor chu: thank you. final call -- any individuals from the first row?

>> good morning, supervisors. i am a program director at bayview adult day health program. these are some of our clients. i am here to represent all of the clients, staff, and seniors serve by our program in the last 30 years or so. we have provided a safety net that is crucial for frail seniors for the last 30 years. without it, families would be faced with the choice of leaving jobs, considering placement in nursing homes. for example, just at our center, 40% of our clients have significant dimension. 40% have major mental illnesses or traumatic brain injuries and the protection and support. rather than outline all the things we do to address issues of a major or serious problems, i've put them in a folder, which i passed out to you earlier.

out of our 100 medical recipients, they have determined 15 people to be ineligible. all of them have serious and persistent health problems and have been referred by their doctors for the service. between those 15 participants, they have been approved by the state department of health care services to meet qualifications in medical necessity that equal more than 80 program years between them. at this point, with the declining health, now, they are being told that they are not eligible. caring for a person with dementia who needs to be directed and watched at all times, toilet, sometimes bed, all the while answering the same question maybe 100 times a day, is extremely stressful. as a participant in the only fair hearing we have had so far for the nonprofit adhc people, it is clear that the state assessments were incomplete,

sloppy, and based on incorrect understanding. we will win, so thank you very much for helping people get from there to here. supervisor chu: thank you. any other folks from the first row? otherwise, we will go back to the line. >> hello. thank you, board of supervisors, for the opportunity to speak to it. i am the administrator for a program of jewish family and children's services, serving 220 frail, elderly, modeling will russian seniors here the $441,000 we are asking for today does focus on a small segment of the total clients that we serve. however, this funding is critical for our centers to function and makes a difference if we are able to continue providing vital services or not. bear in mind that we have already experienced a 10% cutback in our medical daily rate from $76.27 to $68.64 per

person per day. for our center alone, that is a loss of $240,000 in annual income. with this loss of income, our centers are expected to operate at the same staffing levels as before and provide all required services. in addition, the 10% daily rate reduction, we are now facing high levels of client denials by the department of health care services for the program that replaced adult day health care april 1, 2012. the only avenue for these clients to access adult day health care services is to appeal these decisions to the state. besides our center's staff's regular workload, they now must help clients with appeals and be present at the hearing. we are stretched at our maximum. thank you for your time and consideration. supervisor chu: thank you. ok, i think that is it. one more?

>> good morning. thank you. i work at steppingstone adult day health. echoing comments before me, i would like to add that this is all based on an improper and too fast transition from the adult day health care to the new program that we witnessed in the beginning of the year. we are seeing the fallout of it. but i want you to know that we are appealing for our future at the same time. we need help in this transition to insure that we can support these fragile patients who need to go through a fair hearing to continue their services, so this community living fund will allow them to get a fair hearing, and when they win, that money will be given back to the community living fund. as we prepare, we are looking

ahead to transitioning these folks into managed care in october. we feel hopeful about this transition process in providing better care through the providers in the managed care system here in san francisco. we also feel promising results from new revenue opportunities. we are coordinating with hospitals and clinics, and we are partners with the city and other senior agencies in defining a well-coordinated, long-term care integration plan that will ensure that the dull day health is at a center point in keeping people supported as they grow more frail -- that adult day health is at a center point. supervisor chu: any other speakers from the first row? if not, thank you for your

patience. we go back to the line. >> good morning. i am deputy director of mental health association of san francisco and member of the board of directors with community housing partnership. i am year to ask you to increase -- sorry, to some 42% increase for the cost of doing business in next year's budget. over the past six years, nonprofit workers in san francisco have faced cutbacks, budget cuts, and have constantly been asked to do more with less. i would submit to you that these non-profit workers, whether they are a desk clerk, community housing partnership, were one of our response team members, are the heart, the soul, and the spirit of san francisco and what makes the city so great. again, thank you for your patience and understanding to date, and please support the 2% cost of doing business increase. supervisor chu: thank you. next speaker. >> good morning, supervisors.

executive director of the community housing partnership. i have some folks have brought with me and asked to stand during my testimony. today, it was reported that the united states has three distinctions against the rest of the world -- we are number one in incarcerated populations. we are number one in individuals who believe that angels are real, and we are number one in defense spending. i think we need to look at the values of st. francis when doing your budget process this year. safety net services have been decreased every year since 2007. nonprofit contractors have gone without any increase in the baseline funding and have been asked to do more and more and more. nonprofit workers have a right to make a decent living wage that can afford for them to say here in san francisco. i am asking you to prioritize the 2%, a mere $9 million, that would be spread across

nonprofits city-wide, giving us the ability to have some breathing room to increase wages for our workers and help offset the costs that year after year we absorber. supportive housing, the most cost effective solution to homelessness in the city, has lost over $1 million of funding since 2009. we are not asking for a restoration. we are asking for a whole safety net community, that you give a mere 2% to create a 3% cost of doing business. i think if we start here in san francisco, hopefully, when i am in my 80's, and the next person standing here representing community housing partnerships, we could say that san francisco is first in helping its core and needy and immigrant population and the san francisco has the lowest rate of incarcerated individuals -- first in helping its poor and needy. supervisor chu: tnk