people from traveling that road and we commend this to you and hope that you can refer this to the full board of supervisors. thank you. >> thank you. next speaker, please. >> good morning, supervisors, my name is michael gos s, director of the mental health association of san francisco. i'd like to ask people to rise with me in dignity, rise with me in opposition of laura's law. i am a man, a single father, the manager, i have also dealt with serious depression and recovered. this law scapegoats those of us who have dealt with mental illness and mental health conditions. there are many other avenues, over 36 of them in the mayor's mental health task force, that we could have gone the route of. we can still come to consensus and the family members as well. i am asking you all to stand in dignity and in opposition to ab

1421. >> good morning, supervisors, (inaudible) also a consumer mental health service center. i am here to oppose ab 1421 including with the amendments unless we take the forced treatment out and let me turn around so you can see how beautiful the shirt is. it says force is the opposite of treatment and we know this, we have been doing myself 20 years working with the severely mentally ill who are homeless. i am appalled the

institute is going against its own rules. the hearing its several has been traumatizing to some of us when you see the police officer association, everybody who really wants to see more money for the courts instead of more money directly for our people, we need to say we need to oppose the forced treatment part of this legislation. thank you very much. >> thank you, next speaker, please. >> good morning, supervisors, my name is george bakavida, i am a physician psychiatrist and i have practiced here in the city for 20 years. i am vice president of the mission neighborhood health center and we have no -- or i personally have no skin in the game. i am not financially rewarded one way or

the other. my point here today is to discuss two issues. one, laura's law is going to effect primarily persons with severe schizophrenia. now, the concept of schizophrenia have changed. schizophrenia isn't caused by bad parenting. you can't blame mom any more. unfortunately our laws are still predicated on these old discredited theories. schizophrenia, that is the illness that is going to be primarily addressed by laura's law, the serious schizophrenic, is a neurocognitive disorder. it's from disordered cognitive in the brain such as shrinkage of the brain. it is more on a continuum with mental illness and is more akin to alzheimer's than it is to ordinary depression. symptoms of the illness, such

as delusions that occur in a patient within another age group are not a serious barrier to care. for psychiatric patients this is a total baifrier to care. to deny schizophrenics a right to care because of delusions because they can't seek care is inconsistent with established policy vis-a-vis other dementias. it has been painful for me to have to tell patients that your son has to hit you or you have to put him on the street and make him homeless if you are going to get care. we need a modern version of the mental health cares. if i may be so bold to say in your suggestion about having a psychiatrist, forensic psychologist --. >> thanks. thank you. >> (inaudible). >> thank you very much, next

speaker please. a few other speaker cards, we're getting toward the end here. lisa marie, julian plumbador. >> i want to appreciate the opportunity to speak here. i am a psychiatrist, i've been in practice since the mid-60's. in those days we had state hospitals and i actually supported the closing of the state hospital. but today without our state hospitals what we really come up with was a large increase in homeless population and the large increase in the criminal justice of mentally ill. america's statistics are unbelievable the number that we have in the criminal justice system of the mentally ill. and my biggest concern is that people who are mentally ill that are in our criminal justice system. i can certainly understand people who are really -- my heart goes out for

them -- who are against the forced treatment, but i think their hearts go out for their mentally ill friend who are now being incarcerated. i think, we talk about we need more services but when we think if you incarcerate someone for one year it's $50,000 and if we could reduce the incarceration rate we would have much more money for the treatment of the mentally ill. so i urge you, i think laura's law, we do need to reduce the number of incarcerations, reduce the number of people who are on our streets and i think it will be an important step in that direction. thank you very much. >> thank you. next speaker please. >> chairman yee, supervisors,

neither the lchb or ecs have taken a formal position on laura's law so i'm here to speak for myself. i support laura's law because i believe assisted outpatient treatment can be a useful tool when a patient demonstrates symptoms of severe mental illness and resists treatment. the results in new york state from kendra's law show they get better outcomes. the majority of homeless people are not severely mentally ill. laura's law is designed to address the needs of a small number of severely ill revolving door patients who meet the extensive criteria presented in the law. i

respect the views of those who believe laura's law has the potential to violate due process but i do not agree with them. it has no enforcement mechanism when the patient chooses not to comply with treatment. failure to comply with aot is not a basis for involuntary commitment. there's no question if laura's law goes to the ballot it will pass overwhelmingly and for all the wrong reasons. i think a public discussion of this issue will be devicive. i thank supervisor campos for his moral courage in supporting this law. although it is not on today's agenda, i urge the board to continue to create more supportive housing. without such housing to provide stability for the homeless individuals receiving assisted outpatient treatment, your efforts today to provide treatment will be for

naught. thank you very much. >> thank you very much, next speaker please. >> good afternoon, supervisors, lisa marie from the coalition on homelessness. and sort of the most disturbing piece that i want to touch on, because i think that one of the hardest parts about this hearing is you are hearing both ends of the spectrum about how people feel how we should respond to mental health, the people that is most striking to me is this is not an alternative to incarceration. i think that is actually the emotional piece that we're really experiencing here. folks don't want their loved ones to have to go through more trauma to stand in front of a judge to be demoralized, to have to be arrested, when things don't actually result in real healing and getting to people's basic needs and sustainability being met. so i think in terms of the criminal justice sector in our

city and the moves we have been making to make sure we continue to lead the state and lead the country in alternatives to incarceration, that we continue to come up with slueptions to real issues we have been talking a lot about mental aelt and the way our criminal justice system is used to respond to mental health and in a way this sets back the progress we have been making in recent years. that's a real concern, that it's going to reduce the amount of money we are going to spend on our jails, and instead think we will actually respond to the real issues we are facing here that many people before me have aptly pointed out. i urge you to think creatively how we can respond to a real mental health need. i think we all agree the need is increased

accessible, afifrpling and harm reduction based services. thank you. >> thank you. (calling names) i want it offer miss wilcox the ability to speak at the end at the end. >> my name is sandra larson and i've been an advocate in san francisco for mental health clients, having been one myself since 1986. i appreciate all the work people have made to try to assist people, but what helps is love and kindness. >> excuse me, is -- can we

get the sheriff's office? is the lady okay? >> love and kindness. outreach. respite services, the use of peers. treatment services as they now exist as i know them don't have a lot of the capacity they need to be able to help people that have this intensive problem and they don't have the linkistic and cultural language and cultural knowledge incorporated in them. i am very concerned, i know i have a family member you would have to drag kicking and screaming from home and tie them down to it be medicaidd -- medicated to be treated. these programs we have developed with

the aha, these need to be put in the forefront and i feel that it discourages people when they receive treatment, i received treatment that was considered the best for me and was not. and it just turns the whole idea of healing around and in the wrong direction. i don't think you can force people to be healed. you have to love them. thank you. >> thank you, next speaker, please. >> my name is julian plumbador, i am the community advocate for the mental aelt association of san francisco. i have experienced over 30 years of mental health challenges and i oppose ab 1421. i oppose it for many reasons but one of the most important reasons i oppose it is because almost by

definition, ab 1421 is a matter of people without mental health challenges making life choices for people with them. the power differential in that cannot be ignored and yet throughout this conversation i have not seen any of the people holding the power even willing to acknowledge it, let alone address it. people with mental health challenges have been involved in this conversation from the beginning. we're here. you've been hearing some extremely powerful and compelling comments from people with lived experiences today. please show us that you are hearing us when we tell you how this affects us and what we think of this. for myself, my own story, as i said, mental health challenges for 30 years. i've been homeless, i've experienced severe symptoms of schizophrenia, for years i had people trying to make decisions for me and every time they made a decision that they thought was right for me, it pushed me

further away from recovery. the reason i am here before you today is not because of coercive treatment, is not because of forced treatment, it is because of recovery oriented options, options like peer counseling, peer outreach, the wellness recovery action plan. these are the things that empowered me to make positive choices in my own life. today i am employed full-time, i am a powerful advocate for my community, i am a passionate advocate and this is because of recovery oriented treatment options in the community. recovery is real and it happens when we are empowered to take charge of our lives and given the power to choose for ourselves. i urge you to vote no on ab 1421. >> thank you, next speaker please. >> hello, supervisors, my name is claude lambow, i am with the

community improvement district. the does support the adoption and implementation of laura's law to aid the improvement of many individuals with mental illness in san francisco. we realize this is a challenge often exacerbated by homelessness and drug addiction. through our ambassador program each day we connect with people in need of housing to many in need often turn down our health. we know individuals' lives are in stake, people like laura wilcox for whom the law is changed. we believe it can have a significant impact to aid mentally ill individually.

what we have noticing in the union square area are people literally decompensating on our sidewalks, meaning they are having breakdowns. the current system is not working. we are seeing an increase in aggressive street behavior, particularly against our ambassadors when they are providing services, trying to do outreach and just to aid toward the solution we are going to be hiring a social service worker to work with the city to help conduct our outreach and get people the services that they need. so we are in favor of laura's law and thank you very much for your time. >> thank you, next speaker please. >> good morning, i guess it's still more thaning. my name is amanda

wilcox i think there's absolute agreement among all parties that voluntary treatment is by far the preferred model. two, that laura's law, court ordered outpatient treatment, is for a very, very small slice of the spectrum of people with severe mental illness. i would venture to guess out of most people in this room, very few would qualify for laura's law. it's for a specific group of people and by definition of the law, they have had a recent history of hospitalization or incarceration or have made serious threats of violence. and to catch those people and get them into outpatient treatment while they live in their homes in their communities before they are once again incarcerated or hospitalized, that is actually very respectful of civil rights. just to clarify, laura's law cannot force medication. what we have found in nevada county, it's a very collaborative process. offering the treatments voluntarily as

the law requires is getting many people into treatment. the hearing before the judge is have very collaborative. small steps are taken, it actually empowers the individual to take some control over the treatment and agree to a plan. it holds the health department accountable. but individuals in our county who were opposed now are strong supporters because of the rights and the empowerment is does give to those with severe mental illness so thank you for bringing this forward. >> thank you, miss wilcox next speaker please. >> my name is brian sang and i'm a volunteer with the physician's organizing committee. a subcommittee of our psychiatrists and psych nurses and social worker membership would like to see patient treatment implemented in san francisco. we're looking at this in the context of when physician's

organizing committee weren't against a shutdown of the 32 bed psych unit at st. luke's hospital 10 years ago, not only did the county allow them to shut fa facility but we have also lost, we have gone from 88 acute in patient psych beds to 19 in the last decade at sf general hospital. we see nonprofit hospitals like sutter health getting $75 million more a year than the charity care they provide. so when it comes to assist out streeplt, this deals with a small subset of those with mental health issues and we see assisted outpatient treatment keeping people out of the court system and we see that as ultimately being a benefit to the patients. the numbers speak for themselves in nevada f county. for the

41 patients they have applied it to, it has reduced hospitalization by 47 percent, incarceration by 65 percent, homelessness by 62 percent and emergency contacts by 42 percent. our membership is approaching this in the context of patients' rights. we want people to know when they appear in court it's a civil court, it's not criminal and again this keeps people out of the justice system and we say that with power comes responsibility. we want to see the county take more responsibility, especially with more money coming online at the state level for medical and behavioral health. cheers. >> thank you very much. next speaker please, thank you. >> hello, my name is matt lobrai, i am a member of the san francisco police department. i have worked for the police department for the last 16 years. as a police officer i have had to respond to countless calls

to assist those who have been in crisis. many times to get them the help that they need. there have been times, though, unfortunately, that i have responded to calls to assist people in crisis where it's too late. people have taken their lives, and watched members of our san francisco medical examiner's office call loved ones to inform them their family members are gone. i have watched siblings, parents, friends, feel the complete loss of loved ones. i urge you to pass laura's law. >> if there are any other members of public who wish to comment please line up here on the side. >> i am deedee (inaudible)

with the san francisco chamber of commerce. we support laura's law because it will help the most vulnerable members of our society get the help they need but for whatever reason do not access. it provides highly trained mobile mental health teams to those who repeatedly fail the treatment plans offered to them. assisted outpatient treatment helps individuals who is mental condition is substantially deteriorating to recover and stabilize, preventing potential grave disability or serious harm to themselves or others. the san francisco chamber of commerce supports the use of laura's law and urges the board of supervisors to pass this law legislatively. thank you. >> any other members of the public wish to comment? chair yee >> thank you. public hearing is now closed.

supervisor campos. >> thank you very much, mr. chairman. i want to thank all the members of the public who have come out and spoken and this certainly has been a very difficult hearing for me and i certainly share the concern, the passion, that everyone has. this is one of those things where as a legislator it's really hard to figure out how we can legislatively address the very complicated issues that are before us. but for me this is about trying to minimize the bad choices that can be made here. and for me the worst thing that can happen to this issue and to the thousands of people that

are impact by it is to have something as sensitive and complicated as this issue decided through the ballot. i really believe that that would be a huge mistake for a number of reasons. and even though i still have questions about the compulsory nature of the treatment that's embedded in this legislation and i continue to believe that voluntary treatment is the solution, i do believe that i have a responsibility to make sure that whatever is done is done legislatively here at the board of supervisors and not through the ballot box. and it is for that reason and that reason only that i will be supporting this legislation with the amendments that have been outlined. it is not an easy thing for me but i believe that in the end the patients and their families will be better served through a

legislative solution rather than taking this matter to a political campaign that by nature of it being a campaign raises a whole set of issues and problems that quite frankly in the end do not serve anyone. so i want to thank again all the members of the public who have come out and spoken on both sides. i do believe that the changes that have been made address a number of the concerns and if we are going to have implementation of laura's law that at least those changes will address some of the more fundamental issues that have been raised as concerns. thank you. >> supervisor farrell. >> thank you, supervisor yee, chairman yee, i want to thank all the members of the public that came out to speak today both in favor and opposed to

this ordinance. i know it's emotional on many sides and want to make sure that i recognize that and i want to thank everyone for taking the time to be out here today. and obviously in matters like this there are differences of opinion and a number of things i want to talk about, i think miss wilcox spoke about at the end, what laura's law does and does not do. to me this is all about helping those who are most vulnerable in san francisco, those suffering from mental illness who can't get the help they need and especially their families. there are other benefits such as saving resources and serving san francisco, but for me it's the family's stories that are most compelling. i appreciate there are many that

came out today that have been able to get well on their own and i think those stories need to be high lighted and celebrated. every doctor i've talked to, everything i've read, says that's the exception and not the rule. i believe our city residents deserve better and deserve to have this as a resource. i'm proud to have the support and co-sponsors from mayor ed lee, i want to thank supervisor tang, supervisor yee and supervisor wiener. other members such as our district attorney, george gascon, our police chief and fire chiefs who came

out today. i think to me it's been really compelling during the course of looking at this, the numerous doctors and public health professionals and organizations that are supportive of this going forward throughout the state our california hospital association, our psychiatric association, nami, the suicide prevention association all of which sent letters of support. certain homeless supporters, the st. vincent de paul society, if possible we'd like to pass this to the board of supervisors. i think legislation is better when done through the board and i want to thank supervisor campos for understanding some of these issues are challenging for all of us but i

want to thank supervisor campos for your continued willingness to have open dialogue now on this issue among many others and similarly believe that your heart is in the right place here and in terms of wanting to improve what we can if possible. i do believe the amendments that are here that we circulated around, but we have here members of the committee to make sure what we have in front of us strengthen what we already have, keeps laura's law in place here in san francisco and really bolsters the implementation so as the wilcox family themselves mention and i think we all believe, voluntary -- if we can get patients into voluntary treatment, that is the best outcome. so we want to make sure we do that if possible and put those protections in place and at the same time have the back stop of laura's law here in the city and county of san francisco. i want to thank my colleagues for sitting through this