number of 31 occurring conditions that track in this data base and in the serious medical conditions you can see that in the population is lower than the over all homeless population for transgender and for this year's populations and again you can see the data which is a little bit lower, and not much, transgender is higher and the subject abuse and conditions are dropped and alcohol. and tay are at 43.3 percent and 81 percent and then, to put more in it and the people are diagnosed with all three medical, serious conditions, and substance abuse conditions and that makes up on a 35 percent of the homeless population and also makes up the gay population and the 61 percent of the transgender

population and while the tay are low, and i do want to point out that they are much higher when it comes to only, site conditions. and 13.8 percent and up to 6 percent and so that when you talk about the depression and the health problems that our homeless youth face. >> supervisor avalos? >> just a question, looking at, you know, it is often thought that the young people, are more healthy. and elderly people and adults, so what do you describe for the conditions? >> and the conditions that the people come with? >> yes. and so this hiv and there is also, and i didn't have a chance to consult with the medical staff, but there is a really high number of chronic pulmonary diseases and these are serious conditions, as they are and it is they are in the ccms and then, the variety of other commons, because the population is not that large,

as really spread out. and this is the people not being able to take care of the physical health the way that we think about it, and the people that grew up in the familis that might be in college that have medical services available to them. and so, >> and being hiv positive does that count as a serious medical condition. >> yes, absolutely. >> okay. >> and actually, for hiv, aids, and transgender, we have 32.4 percent, i wanted to point out, there is a much larger percentage than the over all 8 percent. so, i turn it over to michael and he is going to tell you about the primary care programs and i will come back and talk about the mental health programs. >> good morning, supervisor and pleasure to be here to present to you. what i wanted to focus on just very quickly was what we do in

primary care. and perhaps, to offer a little bit of hope as i talk about the very specific issues that we deal with, though. and so what i wanted to point out quickly, sliding? >> that it is states statistics show that we provided the services to 8500 young people between the ages of 13 and 24, which is below it so imented to throw it in so you could see that.

in a drop in time and anyone between the ages of 16 and 24, can just drop in, and don't need an appointment. and we do it on a thursday drop in for the younger aged kids there and larkinn street is probably the definitely biggest site that we see the homeless youth and we are on the campus of the services right next door to the drop in center, and hip hop, and are two, very small clinics and they operate, part time. but they were neighborhoods again, where there are particular needs that we tried

to reach those. we also have two school sites and it is important to keep the kids from being homeless and keep them in school and giving them support services so they don't end up on the street. the green is the tay population and we have seen a significant change over the last five years in who we are serving at these sites and we are seeing the

less younger folks and we are seeing a huge increase in the tay youth that are accessing these services. it has been, an amazing experience, where about 70 percent of the clients are transgender, and with aca and with all of the changes that have come down, we are able to offer, a feel like a tremendous array of services there and including working with the number of young people who are moving on towards surgery. and so, it is just an amazing experience to see there. >> michael? >> yeah. >> hi, thank you. >> just a question, and i am looking back at a couple of slides, here. and it talks about school sites? >> yes.

>> and there are two, but we have wellness centers in all of the high schools. >> we do have wellness centers in all of the high schools. what these represent is that there is an add balboa is the only comprehensive care clinic and maybe what i should say is that what is important to me with working with. and what they offer, is pretty much, mental health issues, and other services and there are no other primary care reproductive services, it started in 1986 and burton three years ago, and we added services there two days a week and so that we are trying to get more and more health services out. >> and we used to have the health, and a comprehensive health service, clinic in the mission high school,; is that correct?? >> that is correct. we used to. >> and is there any plans of doing anything new to get more health clinic services in the high schools?

>> i would say, at this present time, the director of the public health is very interested in the school based healthcare and i have been working with her to look to expand the services in high schools. >> because the initial high school one was quite examplery. >> yes it was sad to see it go and there is hope that it could come back. >> and i want to mention, someone brought up earlier looking at the issues that tay youth face and, yes n deed, medical issues we are seeing increases, in that, but i think that this is also, really important to look at this and the figure of the system health services needed and the substance abuse services needed and all of the sites that we work on is the comprehensive healthcare. and because, these are probably in my mind, as important or more important than the services for primary care. and but, we often face primary

care is when the young people come in is they have a significant substance abuse issue we don't have anywhere to send them and once you get beyond prevention, or early intervention, we are lacking in the city and we need to see more residential service and more services for these folks in the mental health and substance abuse and i am getting way over nigh time. >> thank you for your presentation >> and thank you, for the public comment here and, there is a policy here on the chambers not to be clapping. so if you would like to show your enthusiasm, you can wave your hands like this. thank you and we are hear to answer the questions if you have them and i have him here who is the program manager.

>> (inaudible).

and one of our programs that are specific to the case and living in the hiv and we have the subsidies. and it will open up a program that is able to offer 6 housing slots.

i think that you will hear in the public comment that there is a conversation that especially for the homeless, k, is the 18 to 24 range and really is just the people enough time to stabilize. i am going to go through though rather quickly and so if you ask me you will see a lot of the same players and the street and the services and often involved up to the house, and so the community of the services pay the program and in

the ship and a lot of those programs are funded by the mental health services act which is set aside from the four tay youth and mental illness and some of these programs and in the next slide you will see some of the school based youth centers wellness programs. and this was talking about earlier and so these are, and these are specifically, for the tay and if there are a lot of integrated and the collaborativive services, from the community behavior services. i think that i will make a lot of notes while we have the

public comment moe. important is to improve the data collection on the lgbtq population and ten percent of the dem graphic and age and so force and we want to have it as the city department and particular holders to impose the relevant houses and services including for the aging lgbtq population and for the aging population with hiv

aids. a lot of the services are in the programs and the different kinds of funding and the ems slots. everyone wants to track it. and if you have questions i am happy to tell you about the lgbtq data or anything else that you would like to hear about. and you also have it on the slides. >> thank you. >> colleagues any other

questions for dph? >> this was the last hearing that we held for now and i want to thank you for all of your time, and margo, and joyce in particular, and so at this point, we are going to open it up to public comment and there are a number of speaker cards that i have and if you have not filled out a speaker card, and you want to speak do so up here and i am going to call a few people in but first i want to call wall from uc berkeley has to catch a flight. and everyone is going to have two minutes to speak. >> i am the mother of two proud san francisco proud teen and a

faculty member who has been studying in san francisco since 1996 and i am here today, as a physician, to tell you about the results of our research. and about a condition suffered by thousands of san francisco youth every year and this condition leads to a rate of death eight times more normal for men and 13 times normal for young women and although, more san francisco youth, 15 to 24 suffer from this condition than from hiv hepatitis and cancer together, there is good news, the condition is preventable and curable, that condition is homelessness. letting the youth live on the streets costs our soeft a half a million dollars in social cost and lost productivity. and what can we do?

one i am proud to be working on the housing, in the harrison building and in the short term that you like hillary and jessica who will speak later will have a place to call home and they are already taking incredible steps to turn their lives around and two, we can extend the tracysingal age serves to all poster care youth in california. and we should implement the plan to end, the homelessness published by the youth project and end it by 2020 finally we must stop criminalizing the youth for the poverty and creating more barriers for them to get healthy education and

jobs, they are our youth and let's give them an arm to a life and not a ticket. thank you. >> thank you very much. >> next speaker? >> hi, everybody, brian, the director of the youth housing alliance, and we have heard some about the defining the need about lgbtq homelessness and we know that 2100 percent of the city's homeless are lgbtq and even though we are 15 percent of the population. and 21 percent of the respondents in the aging report hit an unneed for housing assistance and 42 percent of those seniors said that they were uncomfortable using services as an lgbtq person they felt discriminated against and stigma, and other barriers through accessing services from our main stream providers. in 2008, 47 percent of san franciscos with aids were 50 or old and her 13 percent were above 60 age, and that is

increasing demographic. and 90 percent of those survey respondents in the hiv and aging policy report says that housing was the number one concern and weiner had reiterated that we have a growing problem of disabled people with aids, who are losing their employer's responsered disability and transferring on to a smaller ssa grant which is putting their housing at risk. and so, what we want to do is examine what are some of the drivers and barriers that are leading to this disproportionate rate of homelessness in the lgbtq community, and then, also, what are some of the unique impacts of that homelessness, and i think that a big part of it is telling you right here, that i came to this hearing hoping to hear about the department plans for addressing the historic equities and investment in services targeting the lgbtq community, and i have not heard that. i did not hear about what kind

of budget line items are included in this year's plan and now that they know, that there are these disparities i have not heard about any out reach plans or in investment in funding, anything to try to address the problems. and i think that that is really telling. thank you. >> next speaker please? >> good morning, supervisor, we actually have a presentation and we are asked to do that for today, >> sure. >> and we do the slides and if we could go through briefly. >> okay. >> all right. >> thank you. >> yeah, thank you, (inaudible) and i work with tsf, and the transitional san francisco and housing the department of youth and their families. and to your point, who just spoke and we will just jump ahead since we are expecting to

present earlier with more time to some of the recommendations and it has been engaged in the 18 month process with over 18 individuals from the cross city departments that have spoke here and the community based organizations and the young people themselves, and as a result of this work, we did a needs assessment and a planning process to essentially identify where are the biggest priorities that our city should be focusing on, and what are some of the biggest needs? and so, to talk about some of the biggest needs that we have aside from the data that we have already heard, a few key things that were identified, and some of the needs related to housing, or definitely are around and not only access to affordable housing but specifically, in more safe, neighborhoods and unfortunately a lot of the housing that does exist is in the areas that young people don't necessarily feel safe in.

and right? and some of the others is awareness of the housing availability, right? it is something and it is hard for the young people to keep track and be aware when there is some availability or certain beds available for them to go and take advantage of that opportunity. some of the others, are actions specifically for tay parents and families. and this is one of the gaps that we have seen in the city is not enough for the parents. and then transition planning and support as they are exiting and finishing completing some of these programs, and so that they can be self-sufficient and be able to be independent after the program. and some of the others, are more comprehensive homeless count, and that accounts for marginally housed youth and couch surfers which i know that you spoke to and there has been a huge step up this year. but there is still more that can be done to capture some of those young people that don't

identify as homeless or if you asked them may never say it. due to a lot of stigma and there is a lot of the practices, that can be utilized to strengthen our homeless count. and that is also, i have to say is a thing, because, if we are not capturing like, how many homeless young people we have, right in and we are missing a young amount of young people, then we are not going to come up with the right solutions and strategies and we are never going to allocate the right appropriate amount of resources and so this is huge, when it comes to the right data to then, formulate the best strategies and allocate the resources appropriately. and some of the other barriers, are prohibitive. and the eligibility restrictions, right? and there are certain programs that have or so restrictive and have a specific requirements that is a presents a huge challenge for the young people to access the housing and of course, where we already know some of the waiting lists that

the young people have to deal with. and i going to have her talk about the policies and recommendations in terms of next steps, and the process for planning, and implementing across the city departments. >> thank you, very much. >> and we have the copies of our policy recommendations at the front. and just to be quick, the first is really to continue the pipeline of housing to meet or exceed the goal for 400 units. that was set to be reached by 2015, and we have been working with the department of public health, and hsa and our office of hope, to continually, push for additional units and we feel that 400 is actually locally insufficient, and a lot in san francisco, and it is nice but it is totally not enough. and we would really welcome, a greater number of units and also a greater range of types of opportunities available. and we want to be able to report, annually on the progress that we are making on the tay housing plan and this

is as i mentioned is to diversify the housing options to the tay young people and for some it is short term and it might be some immediate financial assistance and a short term bed, but for some of these people they need longer term supports and so we support a range of opportunities, for the young people. and then, finally, we are going to be working with the office of hope hsa and dph to do the annual evaluation of the effectiveness of the tay housing options in san francisco. and so we will look at how effective they are in reaching the young people that need them and take a look at wait times and the duration times and the application process and etc., and so we look forward to being able to do that and report back to you and bi annual basis. >> okay, thank you very much for your report. and i appreciate the time. >> okay. next speaker, please? >> why don't i call a few cards. >> susan, from the homeless young alliance and jefferson,

fellows, and laura and zach murray. >> thank you, so much for hosting this hearing today, we really appreciate the opportunity to speak about youth homelessness in san francisco. and i think that a lot of the important information has been shared and i do want to clarify a couple of things and talk about the effective strategies for addressing the homelessness. and first of all just to be clear on the numbers and the point in time counts it is actually 1902 young people that are homeless that identified in the point in time count and there is the 914 that were in the youth specific point in time count, and there were additional youth identified in the over night count and then the numbers and i think that there were some on the duplicate those numbers and so 1902, is actually the accurate number for the count for the youth who are unaccompanied miners under the age of 18 and 18 to 24. we see 2300 a year and there are 5700 young people who are homeless in san francisco each year and i think that it is

really important to many speakers have said it that the youth do notify as homeless, always, so the youth actually take the huge effort to hide their homeless or don't have a reliable or safe place to say and they are not always on the streets, they might be staying with a boyfriend or pimped and might be trafficked and there are a number of reasons why the youth are invisible and there is a city wide strategy to try to add, 400 units that is identified as the work of the task force and we are making progress, but we are not at 400 and that number is insufficient. and what is most important for the youth homelessness is that we have a continuous strategies available to address the needs of homeless youth and that is the emergency housing and shelter and subsidies and that is transitional housing and that is and has the high level of service and address the

mental address issues and to be able to successfully transition out of housing and our goal is to prevent the chronic homelessness and that they complete and be able to lives in a part of that community and that the range of housing options that we have in san francisco for the youth now is actually great and it is just completely inadequate and so we just need to build on all of the great options that we have created. and lar instreet is a provider but there are many providers and i think that we need to invest in all of those providers. >> thank you. >> and i am out of time. >> do you have anything else? >> no. >> i have a lot more. i have like hours more. >> and then, yes. >> next speaker, please? >> >> hi, jennifer, coalition on the homeless youth. so, as we are hearing today talking about the homeless youth, and the homelessness in the lgbtq community, there is a

story, and there is a story behind every individual who is young, and experiencing homelessness. and it is a tragic story, it is a story filled with fear and uncertainty and a lot of trauma and a lot of abuse. no place to call home. no feeling of safety. and it is tragic. and it is a tragedy really san francisco can avoid. we don't have to be doing this to people. and that is what we are doing, we are doing it to them. and san francisco is an incredibly afluent city and this year in particular, we have a lot of resources and right now as we speak, the mayor's office is deliberating on what direction the budget is going to go. and it is right there, across the hall. there are steps that we can take, and we really should not be okay with anything else and there is action that needs to happen and we need to fund the housing that is being talked about and we need to make sure that we