doing. we have one of the nine receiving hospitals. it is so familiar with san francisco crisis care. we have the model in other cities. my colleagues, at the department of emergency management, and the police department, i am trying to get a meeting with them. this is totally different in a crime scene. we hope to continue this. the memorandum of understanding has been dropped, and i believe

the deputy city attorney has reviewed this. we will have barbara garcia, but as a very good job as a work with the police department, i think there should be an important part of the complication. thank you for bringing this an i am happy -- >> is a reminded of the resiliency, and this'll be part of the discussion. to interact or respond to all of these emergency situations and the effect that this would have.

>> the seven cisco fire department, we have a larger behavior of sciences unit, this is 2011. this continues to be difficult. we see this on a daily basis. we have this in the work life and home life. we have this more regularly than they used to. thank you. >> thank you for convening the conversation with cronin bird and dr garcia. we will hear from john grimes

and jerry moremoto of the department of public health. >> good morning. i am here as the manager who sees the crisis programs -- and we have the assistance -- but actually directs this -- we come through a lot of contractual agreement. we have looked at issues that affect the number of people we're working with. what we found is a degree of

trauma. we want to talk about how to work with people, and we see ourselves as first responders. the hospitalization and some issues, we have the ability to work with people, with six languages. last year, we coal located a number of issues together to see how we can work more efficiently. we actually have a mobile crisis team, and we have pitchout crisis team, that will evaluate

children to the age of 18. this took part in ensuring and convening the task forces. there were a number of suicides to the school's last year. this works with families who are affected by committed to violence. we have a number of programs, that works with the at risk youth, i omelet -- in the non- traditional 30 model. issues of truancy, and the team that works 247. probation and mental health to stabilize families. we have the child like services -- they have the ability to do the trauma-focused work.

you have the same-day assessments, and this will of valuate people for the medications that are needed. we have a number of different programs, and stephanie will talk about the programs that she overseas, the comprehensive crisis. and charlie will talk about the other issues that we do. >> good morning, supervisors. if so the director of crisis services.

as he gave a good overview of our services, i will talk in more detail and get through as quickly as i can. we provide services to those with mental health issues -- with emergency response services. we are composed of five different components, with the adult crisis and the crisis response service, we are 24 hours, seven days a week. responding to scenes of stabbings, shootings and domestic violence. we respond to 80 incidences' per year, with 100% of the clients exposed to the trauma.

we have a 70% exposure rate to trauma, and this serves approximately 150 clients per year, with 80% being survivors of trauma. the client service service want thousand clients per year. we are a multi-disciplinary team, with marriage and family therapists, workers who are exposed and have experienced the first populations. we have the linguistics -- and the other languages that are available by telephone interpretation services. the crisis response provide

services were critical shootings and suicides, with linkages to social services, and provides a 30-60 day follow-up services. with ongoing long and short-term individual support, for communities and families exposed to violence, with the debriefing services and they provide the long-term behavioral therapy to adults, and the behavioral therapy to the youth. many of the clients have faced trauma and are survivors. many are scared to go into neighboring communities, and they will go out to provide those services. many deal with the same issues

of combat veterans, and the job crisis service provides service to children under 18 years of age, no matter what kind of insurance. we respond to schools and emergency foster homes, and we provide assessments for out of control behavior and psychosis. we provide empowerment groups, and short-term case management and linkage to outpatient mental health services, with services to the schools for any kind of sudden death, and short-term medication management. we worked in collaboration with the juvenile probation, to help develop positive coping skills with an interactive social environment. and providing a more structured environment so that the youth

will not read-offend, with 24- hour support for the family and child. you can call our crisis line, and we are also active by the police and the community and other providers. this is our location. this is the 24-hour crisis number. thank you.

>> hello, supervisors. i am an assistant director in the department of public health. i want to talk to about survivors of violence, and some of the things we have been working on in the department. >> when i am talking about survivors of violence, i want to explain some of the things that

this is in relation to streevios in the family because of an act of violence or an injury to an act of violence, or individuals who witnessed a dramatic violent incident. individuals dealing with multiple instances of violence, individuals exposed to the threat of violence. but when we talk about survivors, people have different definitions. we will try to encounter all of this. this is the challenge for the treatment, and one thing is the difficulty, identifying posttraumatic stress disorder. there is simple and complex

posttraumatic stress disorder, and we experience -- a complex pst, where they have multiple events, and the approaches are different. the difficulty is that the symptoms are not immediately there -- and we also need this for our own system, to increase the focus -- not traditional therapy. the other challenge is there is a stigma of mental health services with the general population. we need to talk about ways to use other services with mental- health so people are more open to this. we also experience that the

committees may ask for a lot of services but a lot of times they don't want their neighbors to see this, so people go across the city to get service, and then -- stephanie mentioned that there are geographic safety barriers that we have with the neighborhoods. people cannot come down because they have to cross a certain territory. this may put them in jeopardy. we look at, what is the intervention of violence? we'll get comprehensive strategies with the city departments, community-based organizations and the communities themselves. one model that we have been working on, is the street violence intervention model. i will not go into a lot of

detail. this model, you have heard about. you hear about the price of timidity response networks. there is the northwest timidity response network, and the southeast community response network. the department of public health, the administrative label and in regard to the comprehensive crisis that they have worked on. this is not a prevention model. this is an intervention model. this may continue to climb -- but this is not a true model. along with that, we also worked

in cooperation and communication. we work with the seven cisco police department. they called a crisis response team -- there are some people who are taken to the hospital and we have a good working relationship with the emergency department, and the social work of san francisco general. we contacted some of these and what someone is critically wounded and may pass away we know ahead of time. we work with the district attorney services, and the victims to get them over there. we tried to get them linked up. we work with the trauma recovery center. this is part of the center at san francisco general hospital.

they're not so much doing this on the response, but we are now examining the screening tools. we have a whole set of protocols with the school district, and also, there is a city-wide planning process, -- and this is not showing up right. we have the protocols, with the san francisco unified school district. this is keeping the violence happening from summer school. there is a lot of work with the

committee-based agencies. we have to continue with this. i don't know why this is not showing the whole thing. >> i am not certain what is going on with this thing? >> i have had problems with computers all week. we have to develop a process, with those children or adults that have been impacted. we have the 60-day follow-ups, we work on identifying the posttraumatic stress. we look for screening tools,

these are not assessment tools but screening tools, that may be administered for the community-based agency. they would refer people to the crisis response services. we have a dialogue with the healing circles so we know that they have been impacted. we look for the children you've tool, and hopefully later with the work group. we are developing the treatment, but they comprehensive job crisis service. where are going to get further assessments. we have this with the crisis services.

also, we want to improve the quality of division of services. we are always dealing with cultural appropriation services, and we have to develop strategies, to examine the hot spots, and these hot spots change. we will take this word of the violence may be occurring. and we train to improve the work force. this is part of the community level. we have changed that we will be offering, and we use the trauma recovery center. we never have the word were participants program, and realize the committee behavior,

with some places that we're offering with the violence prevention network. with the staff of the mental health services. and we are developing strategies that become -- a change the cultural acceptance of violence. we use the community-based organizations, and what other thing that we notice is that there is an acceptance of violence, and there is the function about changing that violence is not acceptable. one thing that we feel, is that the jail poster is taking over a lot and mainstreaming a lot, and a lot of people did not realize this about the real cultural

base. how do we make this a real community again? this is about continuing to develop the rules or procedures, so that we can provide services. are there any questions? >> we may have some afterward, or something. i would like to call the next speaker. ricardo acosta of the community response network. >> good afternoon, supervisors. i have a couple of notes here and like to leave you a copy,

when i am finished. so, i am the regional director of the community response networks. we have the neighborhoods that this encompasses, we have the main priority now reach areas, and we also deal with the inner and outer area and these neighborhoods as well. they are led by the bay view and hunters. organization, and there is bayview and hunters point, with all of these neighborhoods.

both of these agencies were comprehensively together, and what we provide, we have two components of the work. and the convention opponent, with the community based organizations. to navigate and access services throughout the city. we're often call in with the school district to prevent the fights from getting out of hand. the second component that we have this the committee intervention teams that both of us have, and this runs into the projects, and we were collaborative with the unit officers and the district stations to make certain that we are on the same scene, for those

services. we are not the traditional model. we have the crisis component, and with the crisis response component, one of these is to organize the city's response systems to make certain there is a comprehensive approach, with individuals searching at 25 years old to prove that retaliation, for safety in the escalating retaliation. when we deal with the issues of violence, we deal with perpetrators that were victims -- and they are the ones we're trying to run interference with

to prevent any future violence. they're out of our control sometimes. and we work closely to be able to communicate with our boundaries, and this work and where this may end and where they need to be stepping in as well. they just got moved out. we have a new relationship with him, and other captains that are very formidable. there are times we need to do some intervention and try to use our connection to prevent the violence before they have to get involved. we have the model and how we operate, with the trauma center and the you see us project -- ucs project.

with the critical injury that happens in the community, we have the system set up, as he alluded to, to deal with the crs program. 80% of the time, we get a call fro mthm the community. we need to verify the situation from public health. we want to cut the many rumors that may be going through the community to make certain that there is clear information for the families and victims when there is a shooting in the community. that is right off the top within 24 hours. we >> we get information from the hospital. because of our close connections. we can do it in a wholistic way and caring way that folks allow

us to relay some of that information when needed. the last part is that we have family support and expedited services with the immediate systems of care. we help families advocate and navigate the victim of crime unit, navigate the system with sfpd when property, clothes, things of that nature are confiscated, we work with families to kind of work those systems and help them with the immediate aftermath of violence. the c.r.n.'s role following a homicide or violent incident is to support both hospital and crime scenes by working with the community, san francisco general hospital, sfpd and to provide answers and information to the family and community. we provide crowd control at the hospital. we help the families connect with the mortuaryy and burial service. the first responders are the ones doing the family and funeral arrangements. we have a close connon