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tv   [untitled]    March 26, 2014 3:30am-4:01am PDT

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doing. in terms of the approach i referred to previously, the over arching framework for us is in terms of the way we would carry out a service plan is maintaining the individual in the least restrictive environment, always trying to keep the greatest level of independence that we possibly can. always trying to create a service plan that is in correspondence -- accordance with the individual that we are working with and the rights to self determination. the packet i handed out to you, the packet will speak to this of right to self determination which is really what distinguishes adult protective services from child protective services. there is this misconception that the adult protective services might have the same authority than children's
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protective services. the truth is they are adults and they have the right to make bad decisions. when would you lose that right and when would an involuntary service happen. it's not a clear cut line, but we would consider a conservatorship for an individual in the event that the individual clearly lacks capacity. and additionally when i say lacks capacity what i'm saying is they lack capacity to make medical decision or financial decisions for themselves and that's because of dementia or a severe mental health diagnosis. we might look at involuntary services if the capacity issue is there and if there are significant safety
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risk to the client. with the clients that are being abused sometimes the safety issue is more apparent. where they have already shown that they are not able to deal with the risk and it would be very appropriate to safe guard finances. in terms of -- neglect, it's someone who clearly can manage their medical care, clearly cannot manage their own really basic necessities. can they provide for food, clothing and shelter. along those lines, i know there was an interest in speaking to the 51/50 criteria. adult protective services workers we do not have 51/50 authority. it's really essentially the way that the welfare institutions
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coda allow for the first step of an lps mental health conservatorship and this is when they are placed in involuntary hold and taken to psychiatric services and even our elderly clients that are on a 5150 are on a through generation at diversion because they are at capacity. when we are at an event that an aps workers tries to initiate a 5150 we call on a crisis worker and they are limited due to staff resources at the time and we are also working with the police. what the criteria is grave disability typically. there are times that the client might be a danger to self or danger to others. but more often with the self negative
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-- neglecting clients there is a grave disability that we are trying to establish. a grave disability is when we are trying to say that this client does not have the ability to provide for his own food, clothing and shelter. the real challenge with the 5150 criteria is that those that have pretty significant mental health issues and trying to apply that 5150 code with that person who has an impairment, an organic brain syndrome like dementia so it's not a good fit. if they go into psych emergency they are very often discharged right away. it is a challenge when you have a self neglect individual that needs a board and care to maintain that
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individual's health and safety needs. it's a crosscutting issue here in this city that we do not have sufficient board and care placement that meet the lower income threshold for our ssi medi-cal population. i'm sure this is not new to the council. aps, we are trying to expand our emergency placement resources, but we have to work within the resources that are available here in this city and even though i currently have support for my department to be funding potential contracts for emergency place a. placements. it's challenging to find someone to work with you because when we
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have a challenging rate, there is not much of an incentive for vendors to be working with us. really it's a challenge. we are trying to be creative. we work in collaboration with the hot team most generally when there is a case that involves abuse by others. so, should i stop at this point and see if there are questions. i know i have been talking for a long time. >> sure, do councilmembers have questions or comments from ms. nielsen? go ahead. >> thank you ms. nielsen for your very interesting topic. you mentioned that aps will knock on doors, so these are doors of families, i assume. i guess my question is, does aps also knock on doors of day programs or programs out there
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for those with special needs? >> do we visit clients at their day programs? we will if we need to connect with a client and certainly we do work closely with the golden gate regional center and so very often especially our clients that when there is abuse by others, some type of situation, it could be very advantages to visit a client at their program because it's a more neutral environment, a safer place to talk about what might be happening at home. but there are the omnibus man office is the licensed board and cares and licensed nursing homes. we work closely with the omnibus man office. they will be the lead agencies and
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we'll provide support as needed. does that answer your question? >> yes. thank you. >> any other questions from councilmembers? i have one. this is a painful subject to think about. you talked about the complications of long-term abuse and how that affects self neglect, so i'm assuming what you mean is that the higher the abuse, the more likely to person is to self neglect as well and that can reinforce? >> what i was actually saying that an individual that is self neglecting is more open to exploitation by others because typically someone
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exhibiting mental health behavior, such as they may not be able to manage their own finances. and let me come in and i can help you manage your finances. a trusted individual and someone who is not minding their checkbook to start with and all of their money from the social security check is gone just an example. there is very little research that has been done in the area of self neglect and actually in the realm of aps casework. it's a growing area of interest, elder abuse, when we say elder abuse we are also referring to abuse with adults with disability. the federal initiative on community living, the administration just recently added to its budget $25 million which is
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supposed to be targeted to establish a national aps data set and also to begin a basic body of research around the area of elder abuse because people are very surprised to learn that there is just, there are very very limited research on the topic. usually the way we are handling this cases is anecdotal wisdom. i'm a licensed social worker and i have many staff that are trained, seasoned and it's not to say that we need research to be able to know to guide us on a daily basis. it's important for the field to have that research to be supporting us and to be establishing evidence based casework practice. it's an interesting question, but what i spoke about earlier is more anecdotal wisdom than anything else. >> how long has adult protective services been in
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existence? >> in its current form it has been around since 1999. it's a baby program. we are still in our maturation stage. prior to 1999, one of my supervisors was here and there were 5 workers and they were answering the phone and working with the police. they were primarily working with physical abuse cases. 1999 actually i feel like i need to acknowledge it was the program director mary counihan that was in my position for about 14 years who was responsible for the state legislation. it was senate bill 2199 and it was so significant for the program. she really expanded through this legislation expanded the mandated reporting laws and aps today is really the only legislation that we've had that's been
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significant which was the 2199 bill which established the 24 hour reporting, for example, a mandate to have tangible services on the books. prior to that there was very little the county had to guide the program. that being said, since 1999 there hasn't been a lot of enhancements to the programs and under the realignment what you find is that county programs really vary. that's really a concertain statewide because elders and individuals with disabilities should be provided equal protection under the law regardless of whether or not they live in san francisco or contra costa county. there is a budget proposal going forward right now sacramento and it would do two things: one to expand the budget statewide. currently there is $150,000 to train
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aps workers for the whole state. we are lucky in san francisco that we have the additional support and we can actually train our workers and certainly statewide that is not the case and what is having greater impact on san francisco is that the budget proposal is requesting a state coordinator for aps. right now there is only.75 full time employees within the california department of social services to actually monitor the aps program which is absolutely in support. there are questions that come up, policies questions and procedures. if there is an interest in what's happening in sacramento, we actually are still asking for support and letters for this budget proposal. i had be happy to get information if it's something you want to think about in terms of sending the
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letter. are there other questions? >> i have one more, i'm sorry. you mentioned you receive 450 calls a month? >> reports of abuse. >> my question is, is that a high for the size of our population? >> yes. that's correct. san mateo county by comparison, san mateo county has almost the same population. slightly under the total population. they have the same over 65 population. i can't speak to the adults with disabilities breakdown. they receive about 100 reports a month. by comparison, we have a lot of reports we receive here in san francisco. i an attribute that to a number of factors. one is that we have a very responsive aps program. the more that an aps program can do, the greater the need and the more calls that you are going to be
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getting. we also have a very services rich community and we have a lot of mandated reporter's here and they are very thoughtful and conscientious about calling in and we have a program with a centralized intake unit and not many have that and you really can lose reports that way. we have a thriving aps program. i would like to think we could be starting to work on prevention and working ourselves so to speak but given the graphics and the issues like here in san francisco. >> thank you so much for coming today. >> thank you so much and i'm happy to come back if there is a need. >> we'll now have some public comment on this issue. i have
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eugenia parrot? >> first of all enormous gratitude for adult protective services. for my housing when they were contacted on my behalf about six or seven months ago. >> speak into mic. >> my residence was 284 mission, france hotel which really closed down. completely infested with violence and drug dealers and other forms of crime. half of the residents of the hotel swore to kill me having observe my calling the police one day. infested with roaches, bed bugs, blah blah, it doesn't stop. to make my story short. the manager of the hotel
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yelled at me and one other disability lady one day. get the hell out of my hotel. you should be disabled to be here. buftly put. now, with adult protective services when they were contacted on my behalf. they promises to get me housing thankfully i was on the housing authority list. i now live in a gorgeous apartment 2698 california with my low income. i and my cat are so happy and so safe. thank you very much. i'm also a survivor of 13 years of tenderloin. under the rule of tenderloin housing. i believe the mayor's office has some familiarity with them. i used to live in new york.
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landlords like that used to be sentenced to several months in their own building. i am not exaggerating. what didn't happen to me. sexual, physical harassment, assaults, attempted rape, blah blah. the list is longer, but, i'm also very concerned once again thank you city and county, thank you adult protective services. we are very happy. i understand there is a transfer of housing authority properties to private ownership and management to private companies unlike housing authority private county as my experience tells me break the law some more
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than others. i saw the list of management companies. they are the better ones. thank you, but still. laws will be broken. housing authority doesn't do this. i'm planning a protest. let me introduce myself once i grab a hold of something. i hope this is addressed somehow because we are concerned. >> thank you very much. >> thank you. >> all right. any other comment on this item? yes? step forward. >> dave tippel. i have been involved with taking care of a number of my elder neighbors and on two occasions have had to call protective services. this was in 1993 and before. there was a particar
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problem in making people sensitive about the signs of either neglect or somebody borrowing money from someone, someone coming into house and taking things. i'm a great fan of inter agency involvement and have used 311 before. and there are definite signs of like a neighbor not being around and somebody else selling the house sort of a thing which i ran into about 10 years ago. one of the things that i did learn was that at that time the police department was about the only portal and i would ask that some sort of guidelines be assembled for 311 as well as
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the police department call centers so that when people have questions they can be certain, it's almost like a formula that you anticipate what you need to ask people to identify a problem. as i said i have had to identify somebody who was borrowing money from one of my neighbors and put together a holographic contract which is illegal but a list of services that he had written in his own hand that he had borrowed $1500 from the owner. there is a better intake formula than there was in 1993.
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>> thank you. >> hello, my name is larry juiceey. i want to be put on your e-mail list. myself, i stayed at district 6 in ambassador hotel. i was happy to see ms. jill nielsen. it makes me happy because the first time i ran into them at city college courses and i know these licensed social workers, they are really great and listen to us because in the hotel scene, i know that there is a lot of people who like the gentleman say exploit, even myself, i'm a person, i have a disability because i'm positive. but i know that i try to go
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everyday and have a better life. when you get home there is so many people in the building asking for money and they won't go to groups. often for 10 years i have been there 12 years at the ambassador hotel and i have asked the property manager to tell people not to ask for money or food on the weekend when they can get that from the case manager. if they see it that will cut down some of them from abuse deal and harassment and neglect. i'm a person who likes to cook and share food in our building. roontly what's going on in the building is we have been having people who have moved in in the last few years who hit us and abuse us. the
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cameras, if they are not catching it they can't do anything about it. they sometimes hit us and they sometimes volunteer when we get the food. they are like a trustee. they can volunteer and get the food and take your money. then they move into a different apartment. it's something that goes on i know in tndc. and the ambassador we have so many people who abuse people who volunteer and they get what they want and try to sell to you if you are not there in the nighttime. it's like constantly been asked for things and hit and we won't mention to telling people not to do these things and they put this on the first and third and we can be hampered
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on things that cut down on abuse. i'm a member of -- i have been going there since 2011 to deal with violence. this you very much. >> thank you very much. >> hello, i'm cw johnson with the organizing group. i just want to commend you on all your hard work and stuff. for 20 years i have lived in sro hotels in tenderloin and one of the thing i'm looking at is maybe we can work together with the city collaborative programs to volunteer to go and get what we call wellness checks. i see who is disabled in the hotel and who is having problems and maybe have a city worker go with some of the tenant organizers to do a wellness check once or twice a
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month just to check on people because i have seen so many death of senior and disabled people and left three or 4 days dead. this has to stop. i think working with the cohabit ors for collaboration, maybe we can prevent some of those deaths from happening and start to make a change. thank you. >> thank you very much. any other comments? great. we'll take a >> we are on agenda item no. 7. we'll hear now from the san francisco public library. the psychiatric social worker leea es guerra. >> we'll start with me, carol straws. thank you for having us here today and you will be
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hearing from me and also my colleagues leah, the public library social and we'll talk about the departmental partnership came to be and we'll talk about other services and leah will talk about day-to-day services. in 2006, the homeless team surveyed 200 library users and people who spend the day at the library maybe housed, maybe homeless, may have jobs, maybe unemployed and may have no where to go for the day but they enjoy what we have to offer. we don't ask people to identify themselves and we try very hard not to make
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assumptions about people's housing, health or job status. we welcome everyone in the library that follows the rules. there are consequences for those who violate the rules and an -- appeals process as well as guidelines. there are an -- appeals process by mayor lee. all of the features are reducing unwarranted behavior rather than targeting groups of people. with adopted an approach where we develop partnerships and work order departments. we offer three-legged stool. public
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works help us with interior and exterior cleaning. another with the san francisco police department, he is in charge of our security, workers, he helps the library staff, security staff to enforce our behavior guidelines. he makes sure that training for security staff is provided and ultimately that partnership is in place to enhance the environment for everyone. and our third main partnership is with the department of public health. that's what you are particularly interested in hearing about and that is what funds our embedded social worker and health and safety associate program which leah will talk to you about. it
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provides resources such as shelters, legal aid and mental and health care and helps us meet the routine needs of our visitors and help our staff provide excellent service and helps them maintain their own safety well being and knowledge base and just to give you an idea of some of the trainings that we've provided to our staff and staff development on such things as the history of homelessness, understanding, substance abuse anger management techniques, limit setting and understanding mental illness and we've partnered beyond public health but we've reached out to the national mental service for staff and public on mental illness, most recently last month. that's some background. at this t