so please if you can help me with their problems, feel free to call, 2595, saturday, we meet on thursday night. we would glad for you to come out and be in our meetings sometimes and let us all know about the various resources. we pray for you. supervisor olague: thank you. thank you for testifying and also it's encouraging to know that you actually utilize some of the services and it really helped to know that. thank you. mr. christoph from san francisco crisis care. >> can i speak from here? can he? yes. >> wonderful. let me introduce myself. i am christoph sandoval.

i am the chaplain's for san francisco crisis care and a volunteer. how appropriate, how appropriate is it today that maggie stepped up here and really demonstrated human suffering to us because that is the critical question for us is how has a community, we come together to address the continuum of suffering in this city. i said earlier at the press conference, we are truly a city that is built on the premise of offering compassion and support to people in need and yet it is a tale of two cities. it's a beautiful city, and yet another part of the city has tremendous suffering. today, there two of us presenting today. i'm also the president of west side community services and the board of directors there. i'm a member of the clergy at the cathedral of st. mary of the assumption. in an interfaith group, i see maggie and i see parents and i see brothers and i see sisters

and i see children coming to me for spiritual care support at st. mary's in the face of tragic loss. the darkest moment in a person's life is a loss of a loved one. and to hold that is difficult. today i would like to present you to you a special needs assessment. if you can put it on the screen, that would be great. they don't need to see me. you see my bald head in the back, good. so one of the things that we say our mission is to preserve hope in the face of tremendous loss. and the basic piece is this. we have 25 fatalities in the city and county of san francisco not related to life thening illness or terminal illness. in another carnation i was a aids activist and worked in the project, we're talking about vehicle fatalities, suicides.

we do not do homicides, the public health does a tremendous job doing homicides. question provide support, but there is six nonvehicle accidental deaths and 14 others. let's break it down a little bit so you can see what i'm talking. about here here is what we actually do. we work with suicide, from suicide prevention, we refer to them. we're about there between two and eight hours working with paramedics, fire officials, police officers and of course, the medical examiner's office and at times, of course, with the department of public health. we deal with issues of violence, obviously we don't do homicide. if there are catastrophic injuries or limb loss, we can be called on based on request. natural end of life and terminal illness for adults and seniors and perhaps one that is very dramatic and difficult

even for our volunteers is to deal with as i said, sudden infant death and incidents dealing with infants, children, and youth. the other thing is how does this loss affect, who in fact are the survivors? immediate family, extended family and friends, neighbors and neighborhoods, schoolmates, co-workers and unrelated witnesses. so the impact of traumatic loss ebbs out from the moment that loss takes place. some of the things that survivors can face is the decedent's body is placed for many hours awaiting transportation or transport anywhere between four to eight hours. we also face tragedy, they're all alone, are overwhelmed by well-meaning friends and neighbors, people crowd around grieving in a public place with onlookers and reporters. i tell you, i have had to back

them off. i'm out on the streets, as old as i am, i'm out there marching around. people can't think clearly to pick up the phone and on and on and on. if you have had a loss in your life, you know what it feels like. you know the trout process. survivors really face a fork in the road. when san francisco crisis care program, some find a path to healthy fulfilling productive new lives because we actually act like lightning rods that help present the gift of witness and presence and we can sort of hold people. many people sort of wander off without this support into depression, trauma, suicide ideation, substance abuse, alcohol, domestic violence, school failure, job loss, family breakdown, hopeless and other high risk behaviors. without support, our coping mechanisms as human persons are demolished. if the union between two people that love each other, families

and friends and significant others, this is the kind of psychic wound to the sirt and to the soul that takes place. what do we actually do? let's get down specifically? san francisco crisis care fills a missing niche of emotional support to survivors at the very time of fatal incident. now, remember, you notice they didn't say spiritual care. i didn't say mental care. i didn't say physical care. i said emotional support which means as human beings, we need a humanitarian response to these kinds of losses. we draw from all of the disciplines of experience and science and of faith. the other piece is that we, san francisco crisis care filled a missing niche of practice contact support to survivors by bridging them to the safety net of san francisco providers onsite as they happen, including to our friends here intentionally at the department of public health, the fire department, everybody, and of course the safety net of providers that are incredible in the city.

you know them. you know them quite well. san francisco crisis care gives paramedics, fire officials, police officers, and medical examiner's office another tool in the toolbox for survivors at the time of sudden and unforeseen death and loss. i am going to stop there and ask david vincent who is the director to come up and finish off before i end with a last word. david. >> thank you, christoph and thank you survivors for allowing me to be here. a little bit of background on community crisis care. the first program in a major city started in san diego, it was started about 25 years oogs. it was a pilot program that was launched by a group of police officers in partnership with the community and their thought goes back to that fork in the road that christoph mention aid few mention ago. they would go out on these

scenes of a heart attack or respiratory failure or whatever and see if there was no one there for the survivors. they piloted this program. it was successful very quickly. in 25 years, you see the orange county intervention program in partnership with muni palts with los angeles county, riverside crisis program, sacramento, portland, seattle, las vegas, phoenix, but there giant gap here on the west coast and that is here in the bay area. so a couple of years ago, we began assembling a coalition here in san francisco to start a model program for the bay area. essentially, as christoph mentioned, the way the crisis care program works is that we have col untears from all walks of life who are trained and available on call to respond to questions from police, fire, medical examiner officials to go to the scene immediately and

the volunteers are there on scene with the survivors of the trauma. the majority we go to are natural events, cardiac events, respiratory events, also suicides, second biggest ones, accidents, unintentional overdoses, falls, drownings, things like that. the volunteer on scene offer a number of very basic practical services. they are not clinicians for the most part and to the extent they are, they don't act in a clinician's role. they're there just to provide a neighbor to neighbor, human to human compassion for support. they give the person a place to express their grief. they help the survivors what is

happening, what is happening next, what is happening in a day. they help make phone calls. they explain who the various public safety officials are. they can notify other family members of what is going on. they give them basic information on how to care for themselves, how to care for one another and give them referrals to other agencies as christoph mentioned. it offers a number of benefits for public safety personnel and to the city at large. it brings a calming presence, even for a natural death, if you're just a grandma dying of a heart attack, next to grandpa and the grandchildren can be a very high intensity incident and we bring the stress level do you. it brings good will between the city and the community, between the officials and the fire department and local communities. it gives officials comfort that once they leave the scene and go back on patrol or back to the firehouse that somebody is taking care of that family. >> i'm not going to go through

all of this. we have a lot of speakers to come up and talk. the one point i wanted to bring up, we have given the city a draft memorandum of agreement to formalize our relationship here. our volunteers, a number of whom are in the audience here that hopefully you'll hear from today, we have now responded to a want to say 34 activations, primary from the fire department, although a few from the police department and medical examiner as well and there is much more opportunity to get out there, i can assure you, but we can't do that. we're kind of limited in a number of operational ways until we get that memorandum of agreement in place. the city's attorney office, katie porter has reviewed it. she had a couple of comments and recommendations which we have made an incorporated to meet those questions that she had. we now, we basically need the chiefs andth director to sign it.

ideally, we would like to get dr. hart to sign it as well, the chief medical examiner. that would be a good fourth signature if that is possible. that is essentially where we stand right now. we would love to have, actually, we already do have san francisco as a model for the rest of the bay area. we would like to take the fabulous volunteers you have here and start working in san mateo county, alameda counties and the others as well. i want to be conscious of the time. if you have any questions, i would be happy to answer them. supervisor olague: none at this time. thank you, though. >> let me end with a quote and then an ask. most of you know that volunteer organizations provide a great deal of value to focus. at the site of my work, we have 1,500 volunteers in the streets, tremendous agents of the city. the same is true for here. as we learn those lessons from that epidemic to step up and to do this kind of work is critical. we do require some emergency

seed money which i think the board knows that i have asked for on behalf of the agency and on behalf of the citizens of san francisco. this is a very tough time in the city and county of san francisco. we know it. we need it and so you know what we're asking for and we just want to say that to you. at the same time i want to go back to the human piece. because our whole theme is hope. here is an interesting quotation. men can live about 40 days without food, about three days without water and about eight minutes without air, but not one second without hope. and i say this to you because as i take people to -- i do funerals. i go to the mortuaries, i comfort people there to end. i support people during their life transition experience at the bedside. i have to tell you that the greatest gift that we can give them is the gift of these volunteers. the strength for the journey is each other. the one lesson i learned in the

aides epidemic and i learned by doing the work in the streets, love really is the question and love really is the answer. thank you for allowing me to be a clergyperson. supervisor olague: thank you. i would like to open it up for public comment at this time. members of the public that would like to speak, you can line up over here or you can, whatever is easier for you. >> hi, i'm a crisis response volunteer, one of the crisis care volunteers and have had the tornado of going on many of the calls that we have had since the beginning. i want to give you a flavor for them. we have talked about the logistics but what it's like to be there. when i get called usually by the fire department of who we have a good relationship, i arrive there, meet a partner and stepping in knowing very little about what has actually happened. all i know, a suicide, a death of a child, the death of an adult or whatever.

we have been prepared to groups. i have been in the home of a russian family, of a burmese family, of an indian family, of a african-american family. it is a challenge to speak their language, their emotional language and how to be emotional support to them. i will speak a little bit about one of the responses that i did which actually in the newspapers. i don't think i'm confidentality. it was a suicide two weeks ago admission to do loriest children. the caretaker of the church who is of indian descent usually starts his day asking the homeless to sleep there to leave the space. there was a man lying there and he had blood on his hand and on his face. he came up to him and said do you need a doctor? and the man barely responded, so he called 911 and when he come back, he saw that the man had a gun pointing to his temp and said, no, please, please

don't do anything. we can help you. instead the man shot himself right in front of him. i was called by the fire department and showed up on the scene within 20 minutes of the incident, so really soon after. i was able to take the man to a private room within the church, in an office and actually speak to him. i had the time and the luxury for being with him for three hours. i think those three hours were crucial. it really is within that fish phase that offers the most people and help people so they are not spiraling down into serious mental health problems. supervisor olague: thank you for your work. there is an initial warning and a big bell. >> i was lucky to meet this man in the street two weeks later and he was so enthusiastic how he was able to survive that incident by having that initial response.

i wanted to let you know we do help people. thank you. >> i'm dan rosen, a retired city employee and also a clergy person at times. supervisors elsbernd knows. i want to relate one call. i have been to a couple suicides, i have been to a drowning and a number of natural deaths. d.p.h. has their hands full with the other violence and homicides. can you imagine you're having a picnic with your dad on sunday. you go to work on monday expecting everything to be fine and you receive a call going to your dad's home. your dad has died by a heart attack during the night. totally unexpected. you arrive home, an elderly aunt lives with the dad who has a touch of dementia and doesn't understand what is going on. paramedics extend their

condolences. the medical examiner determines it's a natural death and the job is done. the daughter is left now to care for the aunt and her dad. i don't know what to do. i have never experienced this. what are my next steps? who do i call? as a crisis care responder, we're there to offer that emotional support to help her through the emotions of it, the shock, the trauma, and also to help her get her own resources together and to help her engage a funeral home, to help with the great aunt, to get her belongings together, to help her pack the car, to wait for the funeral home to come. we're there to comfort her. do you want to see them take the body out? no, we don't. we move her mother location. we give the support and encourage her that she can get through this and make a difference. without crisis care, basically she would have been home alone. we provide a service to

neighbors. thank you. >> good afternoon. i'm leann roden and i'm a san francisco crisis care worker. i'm new to the city. i notice what a caring city this is and so when i heard the call to get training for this special work, i responded and went through 44 hours of training, much of which is to train us in protocols so that we can act quickly and in an exact fashion in certain situations. and one of the things that we are really, really trying to do and have succeeded in most cases is the immediate response to these calls. for example, i'm quite often the shift manager and the call will come into me. within 24 seconds, i'm on the

line with the firefighter or someone like that and they tell us the address, the situation, and we put out an alert, an email alert which goes to all of our workers. we get calls. we assign the case to someone and within 20 minutes, we have two volunteers there. they don't go in alone. they go side by side. they care for our community members. my definition of community is we. if we are not there in these most important hours of a person's life, we're not a community and so for those that have this special need, i'm very grateful that i can respond. thank you for all of your help. >> good ann, supervisors, thank you very much for having us here. in the interest of time of other volunteers speaking, i just want to say on behalf of the san francisco crisis care advisory team of which i'm the chair of and i have had the

privilege of being the chair for i think almost three years now, i just wanted to let you know that this organization, david came to san francisco over four years ago to form this. so we're really as a crux and a watershed, but it's had a long history already in the city of building a focus. it's been my honor and privilege to work with the advisory team, a dedicated teams of individuals that took the message and mission of what we're trying to do to heart and have worked very hard. we have lived through the hiring of christoph and working with krisoff which has just been a great gift to the organization, seeing two volunteer graduations at this point. i just want to emphasize that this is really an organization that is going through a process that is establishing itself in a really thoughtful logical way collaboratively. as i representative from kaiser permitty, we're privileged to be a part of it. i wanted to tell you, thank you very much.

>> good afternoon, supervisors. my name is jile, i'm a volunteer for san francisco crisis care. i respond to one of the calls and i went to see a woman in her early 30's who had just lost her baby. she went to sleep and she woke up and saw that the baby was dead. she called the paramedics and the paramedics were unable to revive the baby. i want each of you to imagine just for a moment what it would be like this problem for you. this mother was destroyed. her husband was not with her. he was in jail. he was unable to help her.

we were able to inform the jail and to contact the father so the father could talk with the mother and talk about the baby. things could be worse if someone didn't call us to help this woman. thank you very much. thank you. >> good afternoon. my name is christina johnson and my son was murdered in the hayes valley apartment complex in 2011. i unfortunately had the opportunity to see my son

murdered, laid out there murdered and i actually didn't get any kind of response for me and consolianses for my family, my other three children at this time that this happened. he was laid out for a couple of hours and i did not know it was him. it is really important in my experience that we get some kind of response help. i had to deal with funeral arrangements with the medical examiner's office. i didn't even get a chance to see my son until the day of his wake because of the trauma that he sustained because of the injuries that were given to him. he was shot in the head. that was very trauma

advertising. i went to the medical examiner's office. i spoke with them. they turned me away. i broke down and cried. i couldn't call anybody. i didn't have anybody to talk to deal with this. for the families, it's really important us to have some kind of help in that manner. i have three other children, one is 18, he is a boy, and then i also have a grandchild that my son was left with, that i got left with with my son. that's a bittersweet pill. i just would like for more to be done for the families that have lost someone because it is very needed very badly. thank you for listening. supervisor olague: thank you. >> good ann, supervisors. i carrie my employee everywhere i go. my son albert was shot and killed in a drive-by shooting on january 7, 2007.

it's still an unsolved murder case. why i'm here today is to support your programs that you want to put into effect for more funding or whatever it is to help survivors of homicides or any other crimes victims, period. i know for a fact that this pain never goes away. it's been five years and thank god. i have met the people that i have met to go through this time, but i still do have two other boys who still suffer to this day. for the loss of their brother. even though i can try and tell them to seek services, i can't force them to do anything, so i think it's just a matter of time and their healing process before they are going to take the step that they need to take

to get better. what i'm hearing today is good. the services that you have in place with all of these other o when my son was killed. we didn't have all that and the money was there. help was $7,500 at that time and i heard that you have reduced it. my son's funeral cost $17,000 so that was a big help. the day of the actual killing, i had nobody there at the hospital. it was all chaos at the hospital. my kids and their friends were punching walls and kicking, just lost control completely because of the death of their brother. i really hope that you can put more of these programs from point one from when the

homicide happens so that these other children don't have to suffer like mine did and not getting that immediate help from the hospital. supervisor olague: thank you. >> thank you. >> good afternoon. i'm dr. marion jones, the chief executive offer of west side community services and i'm here to talk about why i believe that we need an expansion of our current system to meet, they are going to be in this system or any other system. just listening to the last two two women speak and my experience in the community, there are no words to describe what happens when a mother buries a child. when a child loses a mother, they're an orphan. when a spouse loses a partner,

they're a widow. there are not words to describe what happens when a mother loses a child. and i think this is important because it speaks to our need to have a greater system of care, a larger system of care, not only clinicians, but people in the community, survivors and the community also including spiritual support, but it is my hope that we can come together and we can support programs likes crisis care and other programs in the community with support from the services where we receive the bulk of our funding so that we're not jumping over each other and we can really have a coordinated response, any response that meet the long-term needs. i also know that in many of the cases where you have a su