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 that they will end up with hiv

infections. so, you can look at all of my other points in the handout and i have other colleagues with me who will speak to other ones. thank you. good afternoon, my name is william woods. i'm a professor at the university of california prevention for aids studies. i've had the pleasure of working with team members at ucsf who collaborated with the stone wall project to evaluate the program on its effectiveness and reducing risk behavior among gay and bisexual men who utilize the stone wall program at the san francisco aids foundation. so, i'm going to talk a little about two studies that have already been conducted. one was conducted with funds from the federal government between 2005 and 2008 and provided evidence that men who participate in the solo project demonstrated reductions in drug use scores, on the severity

index and increased rates on hiv viral load as measured via [speaker not understood]. the second study was funded by the state of california through the turf program and was conducted between 2010-2012 and provided evidence that men who par ticipated in the stone wall program reduced amphetamine use and risk reduction was [speaker not understood]. we currently have been funded by the federal government again through nih for a five-year study has about to begin to look at another program that stone wall conducts using [speaker not understood] management. contingency management. this trial will basically work with hiv positive gay men who are using the prop program. thank you very much. >> thanks. next speaker. good afternoon. my name is mike [speaker not understood]. i'm the director of the stone

wall project with the san francisco aids foundation and my colleagues michael and bill spoke really eloquently as to some of the thing that -- some of the reasons why we feel like the stone wall project should not be on the cut list. i also want to speak on behalf of the other programs that are on the cut list. i think all of these services are critical services, and critical safety net services for the populations at greatest risk. populations like those that the stone wall project serves. we serve gay men and other msm. we struggle with drug and alcohol issues and mental health issues. but most other programs are not equipped to serve. we are a harm reduction based program that accepts people where they are at anyplace in the drug and alcohol continuum and that means that people that come in our doors oftentimes psychotic unable to relate adequately with individuals and we find a way, we find anyway to be able to work with people so that our folks show progress. and not only can i stand here and say that our services show

progress, but we now have evidence from ucsf our partner to illustrate efficacy of our services. these services are critical safety net services for some of the folks who have no place else to go. most of our folk who come to stone wall project have failed out of other treatment facilities and feel like they're not welcome in other places to get care and support and that's why we're there. and we create models of care that are different than most others in the city and county of san francisco. we meet people where they are truly and that means not only do we offer services for people that are willing to come and open [speaker not understood] with us, we have services for people until they're ready to shag different with their drug and alcohol use and mental health. i implore you to please not cut services because it would mean a great impact to those we serve at stone wall. thank you. good afternoon. my name is chaning lane and i'm a peer advocate at [speaker not understood] services as well as one of the co-chairs of san francisco hiv health services

planning council. and as a formerly homeless person with hiv, i realize how vital the services are that larkin street provide. larkin street offers housing, mental health stabilization, case management, meals, connection to medical care and mental health care and continues to provide these young people with the services for the young people's needs that they have. as a formerly homeless person, i am too old to get larkin street services when i realized i needed them and i saw how maya y ~ my acquaintses were able to [speaker not understood]. larkin street really connects with the young people. we definitely need the serves and and i implore you not to cut the part d funding that is on the chopping block for larkin street and for any hiv services technically, but for specifically part d funding that needs to be restored. thank you.

~ good afternoon, supervisors. my name is laura tannenbaum. i'm the director of specialty housing at larkin street. to add a little bit to what chaning described with our program, i wanted to reiterate the conversation that was had earlier about where the cuts of larkin street have come from. so, our cuts to hiv services are both part of the general ryan white cuts to the city as well as due to the loss of the part d funding last year and that was the whole federal category of funding part d youth funding that was eliminated nationally. and larkin street had a $500,000 grant under that 27aiing that was eliminated. we thank the board of supervisors for backfilling that last year ~ and hope it will be backfilled 100% this year as well. our total ask with the 3.1 million we're hoping the board will restore for hiv city-wide. i also want to reiterate that we cannot overstate the importance of having youth-specific serves for hiv positive young people. we see about 75 young hiv

positive people every year. the majority are young men of color. we know that these folks will not access adult services or most of them will not. they really rely on services that are youth specific, youth culturally com p/e at the timectionv. they walk in the door, they see other young people who look like them who are having similar experience to what they're having. ~ competent. it means serving less young people and those young people will not get services elsewhere. thank you. >> thank you. next speaker. thank you, supervisors. my name is laurie [speaker not understood]. and we provide mental health services and substance use services and those services are slated to be cut in this budget reduction. the kind of care that we give that are supported in that go for everything from peer facilitated groups which are really cost-effective mental health intervention, all the way to psychiatric crisis intervention.

so, there's this whole range would be affected by the cut for us. we work all the way from recently diagnosed folks who are recently diagnosed with hiv to help stabilize them psychologically, get them linked to treatment, and also get them back into the community. we also work with severely mentally ill folks to help keep them stable, to help produce psychiatric emergency and medical emergency room use. ~ reduce the proposed reductions would also impact relationships we have that lots of folks have talked about with other providers. we are a part of two programs at ward 86, [speaker not understood] and we help provide psychiatric services as well as case management services to those activities at general hospital. the centers of excellence should actually be used as a model for how to provide these services in primary care setting. the cost disease is not just hiv that you could look at ward 86 as an example. all these services also support the national hiv prevention strategy by working to reduce

the community viral load by providing the appropriate level of support research, people remain engaged in care. i want to say quickly richard from ward 86 had to leave. he wanted to say if we do these cuts, our successful model of test and treat could turn drastically to a test and wait which would unintentionally increase transmission rates here in san francisco and i create an increased burden on our health system. so, thank you so much for your time and listening to all of us today. >> thanks. next speaker. good afternoon, board of supervisors. my name is benjamin [speaker not understood]. i come from the latino prevention center. came to the group in a crisis. i was able to feel a sense of belonging, of community, a second family. were able to identify with all our peers in there. i was able to learn several

things. i learned how to be safer on my sexual behavior. also how to prevent addiction both drugs and alcohol addiction as well as how to prevent abusive relationships. having groups like [speaker not understood], it's really important for our city in the prevention side. i believe that having an educated city is having a healthy city. thank you. hi, my name is eric. i have the honor of volunteering for [speaker not understood] which you heard about and [speaker not understood] which is the mission neighborhood health center. and both of these as you probably know are small very lean run agencies. they both are involved with the hiv testing initiative that's being pushed by washington and

of course very important and encourage people to stay negative. and with a theory that is better to find a healthy community because in this city it's very easy for an unhealthy community to find you especially if you're new in town or new to the united states. there are hiv support groups which in addition to emotional support bring death presenters, to talk about co-morbidity and health issues so the people who are there are better informed to make better use of their 12 minutes with their primary care doctor when they talk about thing. at hermanos there is somebody in the room today who helps people sign up with healthy san francisco and case management, which is better than, as we all know, better than waiting till you're in the emergency room. we have members being supported and celebrated in regularizing their immigration status which gets them out of the exploitive

world of shadow to build up the city. [speaker not understood]. at this time of city surplus i hope you will listen to the two supervisors who spoke earlier how important it is to keep these well vetted programs going. hi, how are you? my name is rebecca e. white. good afternoon, board of supervisors. thanks for this forum and i'm here to speak about the mental health. i'm here to ask you please, please, if you can at all possible not cut anything else from mental health. the ladies that are in the paper who stabbed two people and two police officers, that lady lives in the same shelter where we live. i'm a shelter resident, and she didn't get the help that she needed. and if we make more budget cuts, we'll have more things like that. whereas people who are in the shelter system who are able to find employment, the businesses that are coming into san francisco and opening up are

small businesses and existing businesses. many of these businesses are not able to provide health care. a healthy san francisco provides that for $240 a year a person can get health care for a whole year. that health care is spent in the public health system, department of public health. and tom wadell and many other places do a great job. so, thanks for this forum and please, i know it's tough, but please, if it's at all possible, please don't cut anything else. thank you for your time. good afternoon, supervisors. my name is [speaker not understood]. i'm a gay man living with aids since two years ago. i'm a living proof that [speaker not understood] for people like me. and i ask you guys, you know, [speaker not understood] to survive. but to help me to help others

to stay clean from hiv because there is a lot we can do, intervention programs for people who are not already [speaker not understood]. so, please, don't help me to [speaker not understood], but help moe [speaker not understood]. thank you. goop, my name is stokes and i want to thank you for this opportunity to speak on behalf of shante. ~ good evening. i am hoping to save it from the cutting block. on each occasion i get to come to the boards of supervisors, i come to under what is of vital nature, and number two, i get to appreciate what others do for me. number three, i learn to actualize as a citizen, and

number four, i come out differently. so, coming out to you is significant because i am constantly practicing how to be morally safe. unfortunately no matter how many appearances before this venerable group, it seems that our relationship has yet to evolve to the point of requiring not my voice here with so many others to stating the reasons for need, which should be apparent, but begging forest raytion of what is now regular classic cutting actionses. surely painful for me. i happen to be a success story. that is my overall health is more stable than ever before. certainly that is due to extraordinary attention provided me. the short and long of my story is that i have variable health, especially correlated with

housing, mental health. we say that i happily agreed to speak on behalf of shante because in the '90s i worked for shante. i have since come around to needing the help of shante. i have cancer. i have hiv since '85. and recently began taking medication. i now take about 25 medications and i've been getting their emotional support [inaudible]. >> thank you very much. thank you. next speaker. good afternoon, my name is dina [speaker not understood] and i am the health director at the san francisco health consortium. of course i am here to recommend that there not be cuts to aids/hiv services. the clinic consortium represents 11 community clinics in total, serve about 10%, little over 10% of san francisco's population. you've heard a lot of

compelling personal testimony and i've been honored to hear that as well. so, i'm going to liven up your afternoon with a little bit of policy 1 speech and say when you go to consider these cuts or other cuts, look at outcomes, look at patient satisfaction, and look at a cost benefit analysis. i invite all of you and i'll be following up with your offices, those of you who haven't already done so, come see our clinics and come see what they do with a lean and mean administrative structure, offered no raises for several years, but a very dedicated staff and clients who feel that they have a place to come for their health care where they feel at home. i feel that there should be more of a rationale to the cuts that have been proposed than just, you know, we got these cuts in washington, this is where we have to go. i think we should really look at what has worked, what ha worked, what needs to work. how can we work with our partners in the city, make things better. we've already seen with the upcoming aca implementation, we

see outreach and wellness workers at the clinic saying, how can i help? i can't wait to tell my clients they're going to be able to get more services. how can i do more? if you want to look at our policy, if you want to look at our outcomes, i welcome you to do so before you make any budget cuts. thank you. good afternoon, my name is david and i am an immigrant from brazil. and i live with hiv for 20 years. and some of the organizations that help with my wellness is aguiles, [speaker not understood], san francisco foundation, shante and project open hand. so, i have four little points here. first is that you as the supervisors are representatives and one of the roles is to represent the minorities and i'd like to introduce you to the minorities here.

and when i was walking in today to the city hall, i saw the lgbt flag, the rainbow flag, and i was filled with pride. but then listened to all the possibilities of cuts and i just wonder if it is just a marketing or is for real. think about the minorities and the lgbt people. so, harvey milk said give them hope, but you are giving them cuts. are you really listening to the people? cuts will only segregate even more minorities. think about that. so, i'm really asking you to think from the bottom of your heart, stop the cuts and fund more this organization. thank you. good evening, good afternoon. my name is [speaker not

understood] authorized by the federal and state government to advocate against policies that adversely affect [speaker not understood]. our program goes to places like victorian manor, university mound, the mental health rehab facility, leland house, peter clavier, so we cover the whole gamut of licensed home care facilities. and many of the residents there who might be adversely affected by these proposed cuts. particularly the behavioral health center, i was invited to the grand opening. they had three floors of [speaker not understood] and now they are eliminating the entire one second floor north and moving individuals either out of county or to laguna honda. my concern as a rights advocate is that everyone who is being moved out because of budget cuts have due process protection under the regulatory system for each of those

facilities and be given a 30-day notice and a right to appeal their move out of county. it's embedded in the regulatory system for the behavioral health care nursing. the regulatory system for university mound, victorian manor and i ask that just because someone's mentally ill they cannot be yanked out in the middle of the month because of budgetary reasons. it defies social justice theory, the lack -- it's really lack of due process. thank you. hello, my name is dennis [speaker not understood] and i'm here on behalf of all these organizations that are nonprofit, specializing in providing services to the lgbt latino community. myself, i'm just going to give you a brief testimony of what

aguiles has done for me. as a matter of fact, i'm working with them right now as a contractor. just from years ago i was sleeping on the streets, and after that i was able to get into a shelter. and right after that from the shelter, i got to an s-r-o room, which i still have, which has been six years. but one of the things that i always felt is that i was lonely. my family kicked me out of the house when i was 15 years old for being gay. so, all these -- the families that we have in [speaker not understood] not just groups but socializing and all these people, all these guys i see here, they are like my family. eliminating or reducing all these services is going to create a great impact in the

latino community. and i think it's better to prevent than curing somebody that has -- might get hiv. thank you. that's all. >> next speaker. good evening, honorable board. my name is franco lopez, [speaker not understood], a member of the board of directors. i'm a client of theirs. i've been positive since 2007. since that point [speaker not understood] has helped me pick up the pieces and start over again. i'm permanently disabled, but through their help i have been able to work my way back up and be a little bit more productive and become a member of their board. i can stand here and recite all kinds of numbers that you've heard all day long and it won't make a lick of difference. talk is cheap. i want to talk about actions. with these cuts that are

coming, you got the attention of the entire latino community. and i want you to pay very special attention to that. we are a growing demographic and we will be the majority in california by 20 42. if you cut these services, where will the latino community go for help? that's for starters. let's talk about action. i stand before you as someone that has pretty much literally donated my body to science. i've already undergone 13 voluntary spinal taps and i've left various internal organs on the operating table, not because i needed to. it's all in the effort to find a cure for hiv/aids. 30 plus years later we still don't have a cure. and right now in america latinos and african americans, lgbtq and msm are the largest growing sector of hiv/aids. please keep that in mind and i

respectfully and humbly ask you not to cut the funds available because if you do before 2013 is out, aguiles will shut its doors. thank you. good evening, everyone, [speaker not understood], i'm the executive director for [speaker not understood]. we have been involved in hiv prevention and health services for some 20 years now and i want to speak a little bit about the hiv continuum of care, how critical it is for the latino community. i first of all want to ask the board that all these cuts be restored, that we not have any dph cuts. i know there's a challenge. i sit on -- have sat in the mayor's cdo task force and i was very happy and relieved that a large portion of restoration occurred. i think this is the opportunity

to make that a complete picture. dph budget is important to all communities. you heard today from the clients who are in, you know, in settings where they need care 24 hours. you've heard from clients who are in other levels of care, substance abuse, mental health, a complete system of care and it has taken us 25, 30 years to evolve this system to where it's at. we're in the right direction. we're doing good care. we know that. on a national level san francisco is a model. not only for hiv; for health care period. so, it's really critical that we take these times that are challenging to all of us and to each of you individually as leaders, but to make sure that you preserve and protect these resources. i wanted to just say about hiv very quickly that for latinos

as previous people have spoken to, we have -- we are a growing population and also in hiv, we clearly have a lot of market work to do. the rate of infection among lgbt latinos, particularly men [inaudible]. >> thank you very much. thank you. next speaker. good evening, [speaker not understood], board of supervisors. my name is jorge [speaker not understood]. today i'm coming to you a the board of supervisors to consider not to make cuts to hiv prevention and hiv direct services. in san francisco we have a variety of services that integrate a system of care for

people living with hiv and [speaker not understood]. once you cut one service, you are [speaker not understood]. so, you want to have a comprehensive service and continuum of care that is effective. we need to avoid cuts. now, in addition also i want to bring your attention to the latino community. i don't want to ask for [speaker not understood] cuts. i want to ask you to increase funding. the [speaker not understood] already have [speaker not understood] and they limit services for hiv services and care. and we see what [speaker not understood] says. latinos having hiv are more likely that incur the system of care in hiv through the emergency room. this is very expensive. so, if we want to reduce costs, we need to increase prevention and direct services and supportive services. and also, latino -- the latino

community, we have a very specific cultural need. many of the services that are available are invisible for us so we need more outreach and supportive services that are appropriate in culture and language. thank you. >> thanks. next speaker. i am brian [speaker not understood]. this is my second time here. i want to share i am a client from stone wall and it's very good, it's been very good. i go to meetings. i've been very -- [speaker not understood] has been good and everything. so, i am -- i don't have hiv, i beat the bullet, but i see now i'm still in the positive mind-set and i'm still strong and i just would ask you guys please not to cut any of the hiv foundation services and

nonprofits like aguiles as well. i'm becoming a client now and a member. i don't go through all the services, but i go to the groups and they're very well -- very warm and welcome and very, you know, i feel comfortable there. and i come from a family, i've been abused since i moved out 21. my family don't respect me and don't accept me at the time. i tend to build my own family here and i feel comfortable here. so, please don't cut them. thank you. >> next speaker. hi, my name is norma [speaker not understood]. i'm not only a client, but a volunteer at the san francisco aids foundation. i'm here to request that cuts be kept in place, economical ones. if you continue