about 75 clients. the impact will either affect the amount of services delivered and/or those types of services. what is significant is tase 60% of clients have undetectable viral load. this is significant because the clinic is outperformed other clinics in the city -- in a city that outperforms nationally. the u.s. centers for disease control estimates that the lifetime cost of hiv care is about $380,000. but for our clients that is only a base amount. many of our clients are high need, triple or quadruplely diagnosed with co-morbidities such as chronic liver disease, hepatitis, diabetes, along with a myriad of other medical and social problems significantly adding to the overall cost of hiv care. when cuts are implemented, it is hoped that clients will receive services elsewhere and they will. they will cycle in and out of

the emergency room, psychiatric emergency services, and the homeless -- [speaker not understood], significantly adding to the cost of care. many of our clients may become high users of medical services. the average [speaker not understood] client uses about $42,000 per year. if just three of our clients drop out of services, that cost could range up to $126,000 per year and that will negate any cost savings proposed by these cuts. please find a way to keep the services in the city intact. thank you very much. >> thank you. next speaker. hello. want to personally and publicly thank supervisor david campos for your stalwart support of our community's most earnest endeavors, first and foremost of today's outcome.

i wish i could say that by being here again we've done ourselves less than justice. unfortunately, i can only say i believe we have done ourselves justice. ladies and gentlemen of the board of supervisors, i respectfully submit that actions speak louder than words, and come election time, you want to win the latino vote. but do you want latinos to win? it would be impossible not to, i trust. thank you. >> thank you. next speaker. next speaker. hello, everyone. my name is juan [speaker not understood]. this is my first time here and i'm speaking. i work at [speaker not understood] and the first time that you come into san francisco, i'm very sad. i feel a couple times dying

because the service -- they cut a lot of stuff in orange county. i'm over here and i hear again, sometimes i wonder, you know, sometimes i don't want to livni more because there's a lot of [speaker not understood]. how they think the people living with hiv? you feel living with hiv? i work with [speaker not understood]. i support my community and i want to continue working and i want to still work in my community because that one is for help my community is not only for latino. it's for each one. it's all my community. i want to support, i want to hear, you know, for everyone. so, i want [speaker not understood] there is no cut of service, hiv service.

so, i think -- think about don't cut any service. before cut, think about it, all the people here. thank you. >> next speaker. good afternoon, supervisors. thank you. my name is [speaker not understood]. i'm here to support my group [speaker not understood]. please, i ask you not to cut the funds because it's a group, we receive great service. mainly it's prevent the hiv -- the people prevent, not to get infected. they are a great deal. we are grateful to live in the great city of san francisco because the city open the doors to gay people, especially latinos. and also i serve [speaker not understood] i'm very glad i

live here in america because this is a great country, beautiful and generous. and as -- i ask you please be generous not to cut our funds. thank you. >> next speaker. good afternoon, my name is antonio [speaker not understood] and i am an immigrant from guatemala, have been here for about 30 years. and from the moment i arrived, which was when i was about 17, i joined the groups that eventually became agiles. i've been with it before it was [speaker not understood]. apart of that i also have been a volunteer, receiving services and food lately. one of the things i just wanted to point out is that throughout the three years living in the city, i have seen progressive cuts to all the different

services serving the community -- latino community. the concern i have in particular in addition to the fact that everything has been said about how this program has proved to be successful and what the cdc calls evidence-based, one of the things that i'm concerned about is the majority of us -- generalizing realize r -- latino gay immigrants, we don't have any families here with us. we only have neighbors or acquaintses from my country. and this place has [speaker not understood] in particular has served not only as a safe house for me, but also as a place where i've been able to not only educate myself about hiv, but receive the services and support services i needed to become a supporter of my community. so, i ask you to please consider everything you've heard so far and i thank you. >> thanks.

next speaker. good afternoon, supervisors. my name is douglas yip. i've been in san francisco 65 years. i've seen everything and i barely, barely survived 20 years at san francisco general hospital. let's be honest. the reason why there are cuts for health care in san francisco, there are two bodies responsible for at least seven years, if not further. number one, mayor's office. number two, board of supervisors. during the last seven years, nothing has been done in regards to cutting the waste, inefficiency and corruption of department of public health. every single penny could be going to the poor people that you supposedly serve, but i don't see any audit. in my opinion, the mayor's office and all the past boards

of supervisors have actively, actively prevented any full public audit of the department of public health. every penny that could have been saved over the years would have gone to the poor people. so, if all the poor people in san francisco have anybody to blame, i say hold a sit-in at every supervisor's office. hold a sit-in at the mayor's office and do not leave until they give you back what they took away from you all these past years. in my opinion, i say shame on the board of supervisors. shame on the mayor's office. and you may be able to fool most people with that fancy talk, but you don't fool educated people. we all know where the money goes and we all know ultimate responsibility board of supervisors and the mayor's

office. i say shame on every one of you for what you have cheated the poor folk all these years. >> thank you. next speaker. yes, my name is ebony jones. i am here on behalf of ifr. i am a client of this hiv agency receiving case management services over all the other agencies receiving mental health services, people living with hiv and aid and transgender women, which i am. for our community, it is very supportive of me, please do not cut our funding. we need more support to help us with our lives. thank you. >> next speaker. good afternoon. my name is sally gomez. i work at [speaker not understood].

and i provide case management services in collaboration with forensic aids project doing [speaker not understood] for the transgender component, part a jail. and i'm just here to please let you guys know, don't cut no more services. we need more money. instead of getting cut, don't cut [speaker not understood]. don't cut fiscal aid, and please don't try with with aguiles. we need the services. every day i go to work, i see the need that my community hasment every day. it's a constant struggle. housing, you know, we need housing, we need other services. instead of cutting, give us more money because that's what we need. i see myself, too, as a community member because any given day, i mean, a job is a job, but i could become a community member and i've been there, i've been homeless. i know homelessness. i noaa dixon. i know mental health, so, please, i'm asking you kindly, don't cut more funding.

please consider us because we need our funding for our community that is crying for help. don't cut the youth and don't cut people living with hiv. as it is, we're already dying out there and we need more money. seriously. thank you, and, yeah, have a good evening. >> thank you, you, too. next speaker. good afternoon, my name is anthony garcia, and i want to [speaker not understood]. five years ago when i came to san francisco, i came with a [speaker not understood] and a viral load of 600 million. these two services that instituted for me at la raza, stone wall, and aides housing alliance that i'm now able to see a brighter future in my life. it is sad for me to see that these services are cut for my brothers and sisters present in this room and they're not able to benefit of these services because every day, less available and less shorten, even shorter. so, at the same time i seen

this beautiful city that there are bus stops making like things services with touch screens and solar panels. we don't need more bus stops, we don't need fancy bus stops. we can use that money for services like what we need now. [speaker not understood] to get to a bus stop. it doesn't make sense. so, please help my community which by the same time i know is your community because we are all infected or affected by hiv aids. so, please do not put that money into something that might not be needed and you are going to have to repair anyway at some point. thank you. >> thanks. next speaker. hi, my name is scott jake on object son. ~ jacobson. [speaker not understood]. i've been clean and sober and i couldn't have done it without these services. i'm back in school, permanently housed, 30 pounds heavier.

before 17 months ago i didn't think i could finish let alone with my school. [speaker not understood]. please don't cut these services. they are so needed and they actually do work. thank you. and also i'd like to thank the people [speaker not understood]. thank you. >> thank you. next speaker. hello, my name is [speaker not understood] and i'm part of the latino lgbt community in san francisco. aguiles gave me so much particularly last year when i lost my job and my health insurance. and it was very -- a rough year for me because of my hiv status. and aguiles helped me deal with my depression. hiv support groups to get a support system i didn't have in san francisco. and hiv health information to help to regain my health. more over, aguiles gave me an opportunity to work as a volunteer with them and give back to my community. it is a safe place where i can

get support, be with my community and get hiv services unlike any other organization. please don't make the cuts because we are going to lose this extraordinary organization that has helped my community for so many years. thank you. >> thank you. next speaker. good afternoon, supervisors. my name is ko shik roy. i'm the executive director of the shante project one of the city's oldest nonprofits for hiv aids and cancer. now in our 39th year of service we will support approximately 2000 hiv positive individuals and would really like to urge you to not -- to stem the cuts that have not only happened in the recent years, but really is a part of a larger historical trend. and what i mean by that is over a decade now, every year the amount of funding that san francisco has received from the federal government for hiv services and prevention has decreased. at the same time every year, the number of people who are

living with hiv or aids in san francisco has increased and there really is nothing else left to cut. and any money that is not restored is going to mean people who need these services the most will not receive them. at shante the program that is affected by these cuts would be the hiv services program which supports some of the most vulnerable hiv positive individuals in this city, individuals who in addition to their hiv status are oftentimes marginally housed or homeless or doubly triplely diagnosed with substance abuse or mental health issues. really, we make a pledge to these individuals when they come to shante they will have at least one compassionate source of advocacy and support so they can access the medical services they need and receive all the support they need. and it is on their behalf that we really urge you to try to backfill these cuts and not let any other services be cut. thank you so much for your time. >> thank you very much for your service. next speaker. good afternoon, supervisors.

my name is darren lamelli and i am a mental health worker and i work for progress foundation. i've been a mental health worker over 15 year. i'm also a native san franciscan. and i want to talk about priority and where the money is going in this city. i've seen an increase or rather a decrease of services happening in the city and it's greatly affecting our most vulnerable [speaker not understood] and homeless. i work with mentally ill seniors that have a diagnosis of a mental health diagnosis as well as usually drug and alcohol issues as well. and there is no place to send these folks. when they leave our program, there's no housing. they can't afford to live here. they can't afford a lot of the outside services we used to send them to. they're no longer available. so, we're working in conditions where we have to provide services for our clients that we don't have.

and, so, i'm asking you to please prioritize the funding to our people here in san francisco. i want you to think about your own parents. i want you to think about -- what would it be like to see your own parents out living on the street? you wouldn't bear it for two seconds. so, we have to think of our seniors here as our parents. we have to look at them, even though technically it may not be our parents, they are. and i've learned more from our clients over the years that i've been doing this work than in school or anything that i've done. so, i implore you to please appropriate the funds to prioritize it to our seniors, to mentally ill, to our program here in the city. thank you. >> thank you. next speaker. good afternoon, supervisors. my name is peter maziak. i'm an organizer with [speaker not understood] working with nonprofits in san francisco. first i just want to say this is the shortest bielenson line i've ever seen. the line is not in the hallway,

there are no overflow rooms and i've seen in past years when the cuts have been 10, 20 times as bad, this board do some amazing things. and i hope that you bring the same passion to restore cuts that you do when the situation has been much worse. with that being said, you know, i think we have the money here. we don't have any funding problem. i think we have a little bit of a priorities problem. san francisco ought to be and continues to be a leader in hiv services and prevention, especially when the federal government drops the ball, i think it's important for a place like san francisco to lead by example and pick that up and show it's really possible. and i think there is enough money to backfill all these cuts and also even provide for some increases. we've dealt with so many cuts over the last years to establish now a new baseline is to basically disrespect all the work that's been done by a lot of these amazing nonprofits. [speaker not understood] there

are a lot of creative things we can do. we have, you know, the boondoggle, the america's cup still not getting the money we think. we have a kaiser rate increase that is giving millions to a very successful company and i think that what we have here in san francisco, we always have a budget [speaker not understood] document and we have an obligation here in the city to show that we care about the city's most vulnerable and we care about the workers who work with the city's most vulnerable. thank you. >> thank you. next speaker. good afternoon, supervisors. my name is gus feldman. i'm a field representative with seiu local tenderloin and i have the proud, proud honor of representing 1600 workers at san francisco general hospital. we represent people who are the porters, the lvns, the cpd technicians, people who sterilize the medical instruments, everyday heroes who are saving the lives the city's most vulnerable. i'd like to first start by secondinging all the comments made by the two previous

speakers as i am also a representative of seiu tenderloin 1. i'd like to is speak more specifically to the dph budget as it pertains to the san francisco general hospital. what peter said earlier right before me is absolutely true. we do not -- we're very fortunate in the fact we not have a budgetary issues this year like we had in previous year. we don't have a funding problem, we maybe have a priorities problem. with that, the dph budget, while it doesn't have the drastic cuts that we've seen in previous years which is positive, there is still plenty of room of improvement. right now there's critical, critical under staffing in san francisco general hospital and if we want the hospital to succeed, if we wanted to really be a provider of choice in which it can capture revenue and excel with the full implementation of the affordable care act, we need to ensure that it is adequately staffed. we did zim propertivs in this year's proposed budget in more porters, more 23 03 patient kara sis tabtionv and 29 03

eligibility workers. however we really have critical under staffing, 26.04 food service worker, 23 90 central processing and distribution techs and 23 92, surgical procedures technicians due to under staffing they can't provide at quality services. they can't get [speaker not understood]. they're being worked to the bone and they can't serve the public properly. thank you. >> thank you. next speaker. hello, my name is lacy johnson, i'm a counselor at [speaker not understood] foundation. i work at an adu which is an a conditional use diversion unit where people can stay two weeks after they get 51 58, they can come there from pas. progress is not getting cut, but many other programs and agencies who we work with are getting cut, and we are all connected. basically what this means for where i work at the adu level is that it is more acute where

i work where there used to be so many wards in san francisco, there are now various [speaker not understood]. instead of coming to wards people are coming to the adu. when we are not able to work with people there is nowhere to send people. we have to send people to the rests, they'll get arrested or go back to the 4079. this is the revolving door of social work. ~ streets [speaker not understood] health right 360, mission neighborhood center, levin street, all these places that are getting cuts. so, what that look like at our level where people come for two week is that you can't get appointments at these places within that amount of time. it takes three months. so, people will come to us, we can't offer people anything, they're still waiting in line. they have to leave after two weeks being like, okay, a month from now, you get an appointment with the case manager. it's not realistic. it's not helping people. we can't do our jobs. please don't de fund these nonprofits. there is nowhere for people to go. thank you. ~ >> next speaker.

good afternoon, my name is joshua rosen, and i am -- and i belong to [speaker not understood] and i'm coming here to speak in support of keeping it open. i have debunked for me a lot of myths and misconceptions about hiv prevention and care and it is important that we keep the most vulnerable populations with access to health care. this is a city that is supposed to be about helping out those who come here from other places because they don't feel safe and it should not be a place about being a bedroom community for the tech industry. >> next speaker. hello, supervisors. director -- i zviv get kind of nervous when i come up here sometimes. ~ still that's why when i councilmember ~ come down here, i keep harping on the same things. i know you all care if there

are going to be any cuts or where to put what. so, i won't even go through that. my name is [speaker not understood] and i just look back, you know, my soul really looks back and wonders how my life is going the way it is right now. and the reason being is i went for a job interview this monday, you know, to get a job doing what i want to do around people that i want to do, mental health and substance abuse. also how i got to that point in my life where i was tired of using crystal meth, being a person at high risk and today still being hiv-free is through stone wall, places like stone call, wellness wednesday which is on sixth street, bbe which is also an agency through the aids foundation.

i go there. i get comfort. if i'm having problems mentally, i can sit in the lobby sometimes and somebody will come through that can talk to me. they're never too busy in there to talk to me. if i'm going through issues about what should i wear to my job interview, i got help there. so, places like this that are really helping gay, bisexual men confront their crystal meth use, confront their mental health use, going back, because i know when i was molested at 13, i didn't have to deal with that until i was in my 30s. so, i'm still dealing with issues like around that, but i'm getting to the point where i do not have support [inaudible]. >> thank you very much. let me just take a moment. if there are any individuals in the overflow room, you can please proceed to the board chamber and why don't we hear from our next speaker.

hi there. my name is beth [speaker not understood], i'm a social worker with ucsf medical center. i work in the women and hiv program. i want to say a couple things and i want to say some things, too. backfill is my [speaker not understood] a smart financial investment because it provides gateway into ucsf that patients may not normally be able to have access to. this is for some of the neediest and poorest residents who wouldn't necessarily be able to access the services at ucsf. they have access to great physicians and great care at uc through our clinic. and just today when i came in, i prevented a hospitalization with one of our patients who came in, potential psych hospitalization. i want to explain i was able to do that by calling our clinic pharmacist, calling our nurse, calling her provider and having a conversation with me and the patient and all these other people on the phone and the be

able to assess her and figure out what was going on. avoid a hospitalization, keep her safe for the evening, tomorrow she'll come to clinic, she'll get a free meal and we'll connect her to care. we'll get her what she needs. so, i don't know where a patient like that is going to be able to go and get those kind of services. the gmc clinic at ucsf has 26,000 patients and one social worker. one full-time social work ir. there is no way they can observe our patients. ~ this is a weekly, sometimes daily occurrence in our clinic. so, just know that this is needed very much so. thank you. good afternoon. my name is courtney mulhern pierson [speaker not understood]. and i first want to thank the mayor and the board for your

strong hiv services in the city. i know we've been coming before you a lot over the last couple years and we appreciate the ongoing support. in particular want to thank supervisors wiener and campos for your strong leadership on this issue. excuse me. i'm here to speak about the need to backfill the federal cuts to hiv prevention and care. unfortunately, despite the mayor's $4 million backfill in his budget, we're still facing, as you've heard, an additional $3.1 million this year and $4 million next year to vital care and prevention services and cuts of these magnitude will be -- of this magnitude will be disabling, particularly at this time of great transition with implementation of affordable care act that our community is facing. for the san francisco aids foundation, these cuts would impact our hiv prevention services for latino gay men and you'll hear from some of our folks today and also our benefits advocate that helps

clients navigate the myriad of services and make sure that they get appropriate care and treatment and also from our stone wall program is our biggest impact. and you've heard from one of our clients earlier. and i will leave the details of that program to my colleagues who are here with me today. so, thank you so much for your continue to support and we urge you to support us more. thank you. >> thank you. next speaker. good afternoon. thank you for holding this hearing. my name is michael cesar, i'm director of health services for san francisco aids foundation. because i have done this many times, i brought the fact sheets with me for the board because i'm inevitably not going to get to say everything i want to say in the two minutes. but what i want to speak to you specifically is the cuts in hiv prevention funding that are part of the [speaker not understood] funding. and this is funding -- hiv prevention funding which goes to the stone wall project which

is the only state certified patient drug treatment program and mental health program that is specifically designed for gay and bisexual men who use alcohol and other drugs. and given that the 2010 hiv prevention plan called out specifically six drivers of hiv in sexual men in the city, four of which are substances, i think it's really penny wise and pound foolish to be cutting services that assist people to get out of alcohol and drug use when they so clearly contribute to new hiv infections. and i think it's crucial that we really look at, you know, how to do these kind of cuts and how to minimize the impact that it's going to have in future funding because the more people that are using alcohol and other drugs are costing the city resources, and the more