permanent housing but i would say with quicker and broader response. more visibility for people who live and work here. i would see more visibility. yeah, we are focusing on the more seriously ill chronicallien entrenched people. it could be people that you are seeing may not fit that mode, so we would have to talk about how to spread the services in a different way. >> i appreciate that and i guess you touched on this in terms of geographically my sense that there is a big focus on certain areas where we have the most extreme challenges and sometimes it's harder to get attention on some of the areas that maybe

are or not quite as concentrated in terms of the challenges that have problems in the castro or parts of upper market and do you think that this will allow the hot team to have a more consistent broader geographic reach? >> yes. >> okay. thank you. >> one thing i would like to add, colleagues, when i first started talking with barbara and maria around this idea is how do we increase the number of people on the streets reaching out to individuals and what i respect quite a deal is behind every person working on the streets of our case managers is detailed behind them and stabilization beds. i would like to thank all of you working on the supplemental and really thinking about what an enhancement means and obviously something i thought about and why it's important and as you described it is

making a real different. supervisor mar? >>supervisor eric mar: i wanted to thank ms. garcia and matter in ez for the data. i'm looking for the data on the creation of the teams and a lot of it was visible in golden gate park where people are veterans and people with mental illness and lots of women i noticed on my ride a longs. i know we discontinue the vans that went out. could you give us some sense of when we cut back and i see in the data from 2009-2010 there is a significant drop to 2010-2011 with the number of examples of connections with behavior health providers were other types of data. when did we

cut back and what were the justifications for that. >> cut back in the numbers that we've seen? >> and the outreach to golden gate park and key places whenever the homeless were identified. >> dr. para couldn't be here today and could speak more to specifics. as i recall there was no point of investment going to parks. they did a lot of work and there was a mutual decision that the city department wasn't among theany longer getting an investment or return and they would go back in. what we found was that the hot team wasn't very productive. so what we did was make them citywide and designed to respond when there was an issue. so i think what

we'll be able to do now is begin to have them create some relationships with the merchants in the area and to be able to come back and respond more quickly. but to dedicate a team to a physical area when something is not happening is like they are sitting there waiting for something to happen is not a good use of time. that's when we began to go citywide. >> i do want to acknowledge the leadership by supervisor farrell and your staff. i know there is groups homeless organizations and others i think need to be involved in the planning. you are saying that you are looking at how effective it has been and adjusting it's expansion including many new staff and really adjusting to the input. but to what level has the homeless community been involved with this planning process? >> i can certainly address that supervisor to 1 degree. i

will say that before introducing this supplemental we have met with a number of individuals and some of the advocacy groups and obviously as we are doing a lot more on homelessness on myriad of topics and maria was there as well as supervisor kim and a number of other individuals from homelessness and others to discuss supplemental ideas and further budget ideas coming out of that and we made sure they were very much involved in this process. >> supervisor, we will continue that effort. we've always continued to work with in coalition with the feedback response that it was because they get really down to the issues being impacted. so we will make a commitment to do that work with the homeless

groups. we can't do this alone and we have to be very much a part of their process and also engage with them. so you have our commitment to continue to improve that. >> i think as ms. martinez pointed out what i sense from talk wth homeless in ride alongs with patrol when there is an offer of service and not to permanent housing and even social services are needed many people turn it down to have their freedom in the park wherever they are. i'm just wondering how this expansion with the hot team is connected to additional stability of housing opportunities and mental health services and other needs. if you can talk about how this is part of a broader plan for those other

things that prevent people from taking the voluntary option to go along with those teams to get the temporary stabilization beds. >> the director just organized this team under division called transition. transitions does all the placements for the very sick folks as well and has direct access to housing and we'll be able to assess and determine which person is for one of those slots is most appropriate and be more engaging to individuals on the street. i'm not a direct front line worker, so speaking only from what i hear from them is being able to have something to be able to provide them. it boils down to being able to give them some shelter off the street and point them towards

permanent housing and care. that's why we focused this on those three things. and the hot team has very much focused to getting behavior health services. i think that would be the hook for getting people in. it is a slow process of working with people who have been in the park for years. at one time i asked a hot team member, when you go home at the end of the day, what if something happened. he goes, yes. i got someone do his laundry for the first time in 10 years. that's what we are talking about. that's how disabled and sick most of the people that we are who we work with. i know there is a lot of homeless advocates who are really supportive of the hot team staying focused on the hardest to serve and hardest to reach for this service. >> i think you mentioned

additional skills development among the staff. if you can talk a little bit about how we move away from an impression of harassing people into a program and what kind of cultural competence you build into that skills development. >> language. we are in the process of designing this now. it would be to pair a higher skilled or experienced level person with many of the folks that we have now are para professionals and both are important to pair them together. we want more cognitive therapy skills, more motivational interest viewing and more ability to hook

folks into that outreach. >> i know a medical shelter is another issue that they are raising and when i have gone along the ride an along in golden gate park that it's critical that not only mental health but people that have never seen doctors or dentist for many many years. the medical shelter and additional medical support is this new process that you are developing? >> yes. >> do you want to talk about the shelters? >> i have been discussing medical shelter needs with supervisor kim for now over a year. this component of a hot team isn't addressing that but we have in our radar to look at. right now we have a medical respite serve san francisco hospital for the people being discharged have

no where to go to do therapy and it's a wonderful place for people to go to do their healing process. we have a location that it's going to take us time because of the fact that the location will not be available for another 6-9 months. the something on our radar and something we are looking forward to potentially impact. >> okay. supervisor avalos? >>supervisor john avalos: i think i will wait until the budget analyst goes. over all i do have a concern, eye a one pager from the coalition of homelessness which is very different from what i'm hearing, what the supplemental is about. i'm told from the director of public health that they have signed off on the

supplement al. so i'm not sure there has been a complete process on what this money should be spent on. like supervisor farrell said i appreciate you coming forward with ways to address homeless crisis in san francisco. i'm not sure this is the right approach. my questioning is going to be around that and i want to hold off to discuss this with the budget analyst. i'm concerned if we are talking about an annual allocation of $6.3 million, that's a lot of money and there is other things that we want to do on top of that because enhancing the homeless outreach team is only one strand of all the things we need to do around the care of homelessness and program stabilization beds and substance abuse and health services and employment services. that's not in here. if we are doing $6.3 million

that we might annualize, how do we get the hot team to be successful because they need to have places for people to go. if we just fund $6.3 million for the hot team and not for elsewhere, how will we be successful. the $6.3 million is, there is going to be additional money on top of that and we need to discuss what that would be while we are discussing the $6.3 million before we decide to going down the road to spending that type of money on the budget. i'm all for huge investment on the homeless but we have to base it on the whole plan and not just part

of the plan. >> wonderful thoughts. i understand what you are saying. this is the front end of our system as an important one and a back one. i will leave that to the committee to make the decision. i'm not saying the homeless coalition wrote their name on this but there was engagement with them and they have other list and groups have other list of what they would like to see. >> we want to give a stamp of approval of the whole thing we are moving towards. >> that is a process we would like to get in and we appreciate the opportunity to enhance to ensure that we get the services to the most vulnerable. i appreciate your comment, there is many many things we need to do.

>> thank you. before we get to the budget analyst who is here to speak on this item. supervisor breed wants to speak also. breed supervisor breed? >> thank you. we have many challenges to go get to. one of the things that i have heard and i'm a little concerned about that yes the hot team is out there talking to folks but the two biggest concerns is no. 1, a significant number of individuals in specific locations continue to turn down services. and no. 2, there aren't the kind of services that some of these individuals need that the hot team isn't able to offer. when we talk about 300

stabilization beds from my understanding those beds are all occupied and we have and i guess one of our most recent homeless counts is close to 7,000 folks that are considered homeless. we don't have the resource and i'm trying to understand what we are going to be able to offer people. because if we don't have anything to offer, what is the point of outreach. just looking at the information, it has information that you have been able to secure permanent housing for what i believe a large number of people, over 1500 people since 2006, i guess. >>supervisor london breed: i want to understand exactly whether or not this is effectively leading to

results to support and connect the individuals we are trying to serve with access to real services. because doing the dollars, this program in essence cost roughly $20,000 per person based on the number of cases that you are able to manage? >> it's about $46 a day. >> so doing the calculation based on the annual account is $20,000 per person and not including the additional services they receive from the referral services, the general assistance and anything else that anyone is enrolled in to receive benefits. that doesn't take that into account. just trying to understand how effectively this is going to address the issues with the folks. i'm not saying this is the only way to resolve the

issue with regard to homeless in our community, but this is an important piece to connect people to services. if we don't have the services, i'm a little concerned about just the enhancement of the hot team because again, people are not agreeing to the services and they are also not providing the services they need from the members that are out there trying to work with folks in the communities that need the support here. >> i think there is multifaceted, it's a complex issue. when we looked at the reenhancement, the redesign of the team we looked at what are more ways to engage with the people. it's proven in boston with the services provided. a

relationship is created that way. i'm not privy to conversation about how much more permanent housing is going to be designed from the exit rooms. that's a valid question and maybe barbara can speak to what the plans are. we also from the health department are looking at millions of dollars of people going to the er, ed, psych emergency, the sobering center and all of the services that we want to get in front of. these are people we would go find and we would be able to say, we are already investing $100,000 a year in these folks. can we spend $44 a day to try to get them off that trajectory. we are also thinking about implementing managed care for these folks. >>supervisor london breed: i just want to see results. i want to know that from the

investment from this particular dollar figure is actually working. as we look at the amount of money spent on homelessness we might as well take that money to calculate, i don't want to throw out numbers and scare folks, we can pay for their salary and pay for their housing and get one manager and that will do all the things that we continue to do in a city that in some cases don't seem to be changing what's happening and people are still homeless and we are all seeing it every single day. from a visual standpoint, i don't see any movement. i don't see any results and the numbers are demonstrating that that's the case as well. so, i just wanted to put that out there. and again, i am supportive of this item

because i'm supportive of additional support and additional outreach efforts but i'm concerned about whether or not it lead to actual results. >> supervisor, i appreciate your comments. no. 1, this is why i put this forward today to increase knowledge of the outreach and this is the reason for the stabilization beds. it was what i came up with this process and it does no help for this how the reach if we can't provide the services. maria and barbara impressed upon me that if we are going to move forward we need to have beds available and by increasing the staff we are going to have more health care on the street which is hopefully obviously the intention is to have real

results thank you for being here. i appreciate it. so hold on. we may have more questions. i would like to call captain turn as who runs or station here. >> good afternoon, i lost my voice so i will be brief. good afternoon, supervisor avalos, breed, wiener, i'm the captain commanding officer of the police station. i want to thank you for having me comment on the perspective of homeless outreach teams. as stated in our police station everyday what the impact on homeless has on those that are homeless in our city's

residents and visitors. the police department has used the combination of care of homeless and actively trying to avoid punitive measures when we are dealing with homeless population. our officers have experienced times when calls to the hot team have gone unanswered because they simply didn't have the capacity or the resources to respond because they are out helping out another individual. i'm aware of the great work the hot team is able to accomplish and the difference they are able to make and they have the ability to respond. currently they are under staffed and i believe would be able to help more of our homeless population if they are greater resource to do so. the hot team, greater resources would be able to focus on areas on need such

as the tenderloin areas and other parts of the city that have a higher population of homeless. i want to thank the members of the committee for having me here comment on this important issue. i'm supportive of the advance of the capacity to help homeless outreach. >> thank you for being here regardless of listening to your voice. colleagues; any questions? thank you. mr. rhodes can we get your report, please? >> mr. chairman and members of the committee we point out that an approval of $4.5 million supplemental appropriation program which is currently pending before the board of supervisors as well as this request for the

result of the remaining funds of general balance of 38 million . we know the finalize project report for the requested 1387, 500 is still being considered by dph and it's still exploring option for the expansion of the resources is further under investigation. the homeless outreach supplemental appropriation is still to be determined. therefore our recommendation on page 7 is that we recommend that you amend the proposed ordinance to place all of the $1387500 money on the reserve on the final project scopes

details and implementation plan and consider the approval of the board of supervisors. >> thank you. i introduce this to the board and they have decided to issue the contract fees to the workers. it's about a further month delay between now and actually utilize the funds so in full support of doing that. colleagues, any questions for mr. rhodes at this time? >> please, thank you. >>supervisor john avalos: mr. rhodes, to be clear, i was talking about the annualization of this money what would it be? >> it is not understood to understand it. it's an estimate of 5.6, but we have not received finalized budget

details. that's something we would look at as some of the departments provide to us. >> what we have now is a supplemental appropriation that would get us through this current fiscal year. >> that would be the plan and whether or not all that money would be suspended through june 30th, i don't know. this is for the balance of the fiscal year. >> maybe a question for dpp and how long would it take to bring on the staff that we want to pay for with the supplemental. it takes a long time. we've seen some departments take month to bring this along. we have march, april, may, june. left in the fiscal year. is that enough time? >> there could be some time to be helpful, but yes, it takes time to do contractual

profits but we have from non-profits that we can bring staff quicker on that side than our side of the department. it would be a small amount that we can spend by the end of the year. >> we would be making this supplemental appropriation and is there is a commitment from the mayor's office that what we do today will be analyzed in next year's budget and the year after that. the question is for ms. howard. we went through the process last year where we did a supplemental towards this time of year. if there is not anything from the mayor's office to expand our homeless outreach team and other services, i'm wondering if it makes sense to actually approve this today? >> supervisor, kate howard. the budget director for the mayor's office. it a good question. as you know and as you will hear in a few

minutes when the controller and i talk to you about the city's financial outlook in the next 4 years, our forward outlook does assume the inclusion of this supplement al spending next year. that is a projection and ultimately whether those funds are included in the budget is a decision that we are still making a determination on. i think certainly this is an important policy priority for the city and for the mayor and we are eager to work with supervisor farrell and the department to as the plan becomes more solidified. >> and we are talking about this supplemental provision today is for homeless outreach team and related services for mostly homeless outreach team.

what other services are we looking at the budget for homeless services that we expect to include when we start our budget deliberations in june? because if we are only doing homeless outreach services, i'm not sure it's going to be adequate. it maybe top heavy if we are not looking at enhancements on the middle of the back end. >> so a couple of ways to respond to that. one, there is the front inside which is the outreach and engagements that you are talking about here today. there are services then once you have done that outreach and engagement like stabilization beds and shelters and longer term supports which