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.