and three from the commission. five plus three is eight. eight people make-up a committee. and you need 4 plus one for a quorum, which is five. we had five people there. and that is the quorum. okay? that is... there was a quorum. the long term care council committing, any other questions? >> good morning. >> >> and if it is... that is..., and now that i can't see you 5u8, this is jessica lehman and we are going to have a different member of the long term care council giving the report, this month we get me

and so the council met on thursday september 11th and there were three major items on the agenda, and the first was the care task force, and which is about looking at the needs in the community and identifying resources and needs. and the council heard the recommendations from the four work groups. and over all, recommendation is to have a care advisory board, and that would operate under the long term coordinating council and one of the co-chairs of the task force is our very own anne hinton and if you have questions i am sure that she can help with that. another issue that came up on the council that actually has been coming up in the community quite a bit is, looking at the group of people who are long term survivors of hiv and aids. and there is a great tag line about envisioning our future we never dreamed of. and so it is for the group of people who are dealing with the issues that people had not planned for and so there a

project called community connect, which may be similar to the homeless connect, project. and the last item was a legislative update and although i don't need to say anything about that and it has been covered today and the other thing that i wanted to mention, was that the same day, as this meeting, we did the first of the five town hall meetings that the council will be doing as part of the scan brand about developing and sustaining the long term coordinating council, and so the first town hall meeting was the senior and disability candidates that we had david chiu and campos that are filled by tom, and i think that the people considered it a success and we had more than 100 people there and yeah, covered a lot of different issues. so that was good. and the next meeting of a long term coordinating council will be next thursday, october ninth from one to three at the auditor um, and of course, the guests are always welcome, thank you. >> thank you.

>> any questions? >> yes, was it long for... (inaudible). >> yes..., the location that the auditorium? >> i don't have the exact address, it is on odus street. >> okay. >> on saturday. >> oh, i got it now, it is just the name i did not catch that or connect with. >> and i am sorry for not waiting for the questions. >> what time is that >> the october the ninth? >> 1:00 >> thank you. >> thank you. >> any other commissioners? >> okay. next report is tacc. yes, we need..., and we did not have a meeting. >> it will not have a meeting until december. >> december? thank you. >> case report?

>> good morning commissioners and director, my name is linda merlin, and i am the director of the richmond senior center in district one of the city. case had its annual board retreat on september 15th and we talked at length about restructuring and revisioning committees and bringing more case members in to committees. we are also working on our budget platform, and advocacy plan for next year, now. and with the idea that if we do it now, we will be right on top of everything. we are also rewriting mission statement and vision statement just to keep it updated. our next member meeting is october 13th and we are going to be talking about animals and seniors. how seniors and the disabled can keep their pets and agencies that will work with them.

thank you. >> thank you. >> questions? >> commissioner loo? >> what time is the meeting, and where is it. >> the meetings are at 3:00 p.m., 3:00 to 5:00 p.m. and they are at project open hands on the second floor. >> okay. thank you. >> thank you. >> okay. any questions, any questions? okay. and now we will open it up for the general public comment. and if you have some comments, and you have three minutes. and would you please come forward? >> president james and council members, good morning.

>> good morning. >> and (inaudible) my name is greg norman burton and i reside with my domestic parter rose white in the water shed of san francisco and i am retired, i survive on my social security, and receive medical and cal fresh through san francisco. i am dressed like this because i am currently under going treatment for prostate cancer and have suffered for a lifetime with anxiety and depression as well as undiagnosed ptsd. three weeks ago at this time i was in prostate cancer surgery. and my surgery was performed by one of the most imminent surgeries and educators in the country, dr. peter carroll at the university of california at san francisco. dr. carroll does not do many surgeries, he has done 2500 of them and he gets a pass. but the urology residents at

san francisco general, particularly dr.s hansen and bain, push for it. i want to emphasize, that money could not have bought this particular surgery. the only way i could have received it as an average american is through the affordable care act. and in short i am receiving world class medical care and given my life back by the people of san francisco. i should be here praising ucsf, sfgh and the clinic network and literally dozens of wonderful people that i have met in the last two months of dealing with this disease. it would be fitting that such an event should take place in polosi's district, since it it is her leadership that has allowed this to happen at all. instead, we have what rosa is about to tell but this event, jeopardizing and tainting the success to what was all

indications a wildly successful surgery. >> president james and commissioners good morning, my name is rose white, and i live at 30 day street with my domestic partner greg burton and i suffer from conditions and i have been a client of the (inaudible) agency since 2011 and 2012 i made two unsuccessful attempt to work and the second of those, and the failure of it caused a nervous break down that lasted for most of the last two years. about a year ago my ptsd was retriggered and a suffered months of suicidalization and i had refused to apply for social security because i believe that i could boot strap the appropriate employment for myself. very soon and for part of that time i refused to apply for food stamps.

we currently receive medical and cal fresh, the only income is $813 retirement payment and in july, faced with the negative bank balance and i applied for cal, cash aid linked to medical, and in person, and i requested an assessment, i have yet to be contacted by them. i was given an appointment to apply for general assistance, on august 25th. on the morning of the 26th, because of the cancer operations that i have had to miss the 25th. i arrived there determined to see somebody who could help me. right. and i apologize for this.

and so, i was told that a worker could come to my home and they did, and they on september 11th, while my partner was still in the hospital, and the pointment had taken a long time to get which i was grateful. and he has been operated on the day before and it was awful to have the meeting with the social worker, but i did this and i was qualified for general assistance. we received one payment on the 16th, on the same day we got a notice of action saying that because we received income from ssi, our food stamps were going to be stopped. and that was not true. and had been entered in error by (inaudible), and on this day, i personally had my (inaudible) and was taken to urgent care, vomiting bile, on the 23rd i went to hsa to try

to take care of this paperwork and was fingerprinted and gave over the document and stuff, andvy been taking the emergency anti-anxiety medication, and the worker became annoyed with me and tried to cut off my benefits. she knew that i had these disabling conditions, because she had been to my home, but she said, when i asked for more time to give her the documents, she said that if i should not or could not do it was not her fault. >> okay, >> there is more. >> please, i beg you. >> hold on. just a minute. we usually allow three minutes, and we do have i would like to is it okay, with the rest of the commissioners that we allow because the term is three minutes. >> and i know that you took yours, and she is the second

speaker. so... >> i ask for... unanimous consent that we will continue listening. >> for how much longer? >> another three minutes. >> okay. >> thank you. >> thank you commissioner. >> any objections? >> none. >> okay. >> and so, she told me that it would not be her fault if i could not get the documents to her on time and knew that i was anxious and i had ga unto meet her in person in her office and she turned me away, and greg was discharged from his additional two day admitting on the 25th, and on the 26th i called to ask for help from the ada desk where i thought that i had been helped earlier, and i just through a young woman who explained things and she confused me and i became upset and started crying. she seemed to me to be saying that the benefits had been cut off that the ta would be taken

back and it seemed to me that we were going to have to pay back the money that we didn't have, we had already spent it because we needed it. and that they were taking back our food stamps as well. and he had to step in to deal with this and having only just come home from the hospital. >> okay. >> and now, we get to the crux of it. >> at the close of business last friday, at the very last moment with his last job of the day, i talked to the ga, supervisor about this case. and at this point, it was clear that because i do not receive ssi, nor does rosa, we have never received ssi, there is no record of it. that there was a clerical error at minimum on the part of the general assistance staff. that was going to result in our

losing my food stamps. i asked the supervisor what could be done to remedy the situation caused by his error? his advice was to not file for a hearing, his advice was to supplement the lack of our legitimate benefits, his suggestion, was to get on ihs, and commit fraud. and i spent all day question and morning trying to request a hearing so that our benefits would not be cut today, due to the failers of the state hearing and due to the failures of every single voice mail system in this entire structure i was not able to file a hearing and our benefits are

cut. this is the first time i have been able to find anybody who can do anything about it, and i do not expect to you do so today. but as the... said, this will not stand. after this meeting, we will be finding council, and determining appropriate legal, state and administrative charges. our statements this morning, are being emailed to representative palosi's office and mayor lee's office of disability, i look forward to discussing with them ways to resolve the situation for the benefit not only of us, but for awful the working class and poor people in san francisco who desperately need, not only the services but the hope of the services provide. we did not ask for this. all that we want to do is heal, and to think about the warriors moving to san francisco. every night before we sleep, in the cab on the way over here at

every point, we chant together, the huddle chant, we are all that we have got. we are all that we need. and that is the truth. now if you will forgive us, i need to go home and rest and have my nursing assistant go and clean me up so i can talk to doctors about catheters and whether or not i need chemical cautoriization of my weeping flesh, thank you. >> thank you for your comments. and i am sure, yeah. thank you. >> >> thank you all very much. >> you are welcome. >> have a peaceful and great day. >> thank you. >> thank you. >> is there any old business? any new business and non-action item and no vote required,

community on living and annual plan? >> so, president james and commissioners, i am going to go over the annual plan for 2014, and 2015, with you and then i am going to take you through the 6 month report and just say that rose jones, and linda edelstene are here with us today and so in the packets there is a report that rose put together and so she is here to answer any questions that you might have about this really interesting report and of course, linda is here to help me answer any questions that you might have about the other two documents. and normally, i would go through the six month report, first. but, i think that there is some back ground information in the plan itself, that is helpful for us to review together, and so i am going to start there. >> so, the community living

fund, was established, i believe in 2006. and it is all general fund dollars. and although, we do some time studying with that money so that there is a little bit of federal money there, but it is essentially a $3 million fwund that was created by the mayor, and at the time, and the board, and to help people who are living at home, and wanting to stay at home, but don't necessarily have all of the goods and services that they might need to do that and it was also established to help the people who were in skilled nursing facilities such as in the honda hospital to come back into the community and many of these people are folks who have resided in facilities for year, or 15 years or ten years, so they have lost obviously their home, and the things that would help them come back into the community. and so, the fund was established for that reason.

and because this was a locally designed program, we were able to raise the level of entry into the program, so it is 300 percent of poverty. both on assets and on income. and it is for all adults and so any adult, who meets the minimum requirements is or has access to the fund. >> the program's design was based on work that we had done, people had done here in california. and the msfp and the linkage program which were primarily in the case management programs and also had the ability to buy services and other goods that people might need. lots and lots of restrictions on those programs, but nonetheless, that is the format, and the design of those programs was pretty eloquent in its origins. and we also looked at a program in philadelphia where they do

something similar. and with it and we looked at the information that they had and so the program that you have in the community living service design based on the three, programs, so, it has court and in the case management and the case managers have very small case loads, anywhere from ten to 20 ten to 15, and which is not the norm, and the norm is more like 40. and again, the case managers can buy, goods and services that they and the client have worked together, and believe that are important to put in place. and they only do this, after all of the other resources have been exhausted. and so first of all the case manager has to go and look for those things and other places because many things do exist. and then, again, if they don't, they can purchase them. >> so what you see, we are directed, ordinance for this program, and it says that there will be, an annual plan that will be designed out of our office, and in addition to that, there will be a 6 month report, on what has happened

with the consumers that have been served and the dollars that have been served and spent and so on. and so what you see in the annual plan, is really a report that comes to you not for vote but for your review, it also goes to the department of health, and it will go to the board, of supervisors, and of course, the mayor's staff, as well. and i would just i think, that i highlighted a few portions of the report, itself. but, i would go to page 4, and just talk a little bit about anticipated budget and policy considerations. so, you may remember that about a year or so ago, we were successful in negotiating with the san francisco health plan, for dos to be the central point, of for new and consumers who were looking to be joined with the (inaudible) health

program, and we had and so we are the initial intake and the folks that were here today and that were coming to them. and then, we pushed those referrals out to the community partner which is the institute on aging and they sent a nurse and social worker because that is the model for review before you can get to the adult to help and they send a team out, that review and if they qualify, then they are referred to the appropriate health center whether that is the one in the bay view or the downtown area, wherever they might be. and so that will be continuing. i thought that it was interesting, in and within the noting and in this write up, that we are now working with, and we have been working with laguna honda services all along, but now we are looking at helping the folks in the civil and the city college and initiating the services with the vocational rehab services and the community based adult

services and so clearly what we are finding as people are being discharged from laguna is that we have a number of people who are cap able of work and want to work, and you know, if this many years later, there is many opportunities for people and so there is work going on in that area as well. and which is very, exciting, i think. go on to page 5, you will see, under the data collection, we evaluate this work that we are doing, on a regular basis. but we have added two new out come measures, and this year, because we were meeting and exceeding the other ones that we had and so we have added two. and this one, is the first one is that percent of care problems are resolved on the average after one year of enrollment. and we are looking for at least an 80 percent success in that and the second one is that the

percent of clients will have readmissions and admissions to acute hospitals within six months. and we are looking for an 80 percent, on that and so that will be and those will be new measures for us. and we have an advisory council and we have had from the very beginning of consumers, and community folks, to initially it was to help us as we are designing the program to make sure that we got it right in terms of what consumers were problems for consumers and you know, we think that our thinking is great but you know, not always, and so, and now, we use the advisory council, really to do and evaluate, and things and so that continues. and i think that that is all in that part of the report. and in this particular report. and so, i would entertain any questions, from this one, and certainly, linda is here to answer any questions on this one and then we will go to the

6-month report if you like. >> permission to see them. >> under the consumer input category there is an anonymous yearly survey and it did not address the response rates and i did not see the data that was related to the events and i was just curious about the end of that story. >> it is a periodic report and so it will be with the next six month report. >> i see. >> can you generally comment about the response rate? is it high? >> you know, it is not bad, it is around 30 percent, usually, but that is actually. >> that is good. >> that is good. and we have been changing around how we have been doing it to try and pull in more... >> and well, i just have one other question, under anticipated expenditures in the add back process, they received a one time funding to hire a consultant and i wonder if it is hired yet and if so, who it

was. >> it is not hired yet. >> it is not hired yet. >> thank you. >> any other questions? >> yes, you mentioned about 300 percent of the parts of the line, and i, okay, give me the basic, what is the... go, part... >> so it is the federal. it is the federal poverty level. and it is near the income? >> it is, i do believe that it is around 15,000. >> okay. >> so, it is up around 40,000. >> actually,... >> and what is... >> and 11,000 and so it is like, and so, 11,000 a year, for one... >> okay, not 13,000. >> no, 11,000. >> and so, for we do, 300 percent of... >> 300 percent. >> and so it is like, 33,000. >> and if, and the person

income whatever source it comes from, it is less than 33,000, and that is... >> she is eligible for them, and for the fund? >> exactly. >> thank you. >> thank you. >> so it is the capture people who are not eligible for medical and have too much money for medical but not enough money to be able to provide for their care. >> okay, and another question. i believe that the funds started in newsom's term with $3 million dollars a year and every year, it is put in $3 million dollar a city. >> correct. >> and that is enough to cover all of these, even though they caused an increase. >> no. >> we would not want to give the impression that $3 million takes care of everything. because this... >> and this is. >> this is actually, the

patient needs. >> and no. >> in order for from the hospital to home. >> no, we know that we have more people who need this service than we can provide a support for. so, we have and we have waiting lists, and in the first two years, we actually spent more than 3 million because of the way that the fund works, you get 3 million each year and you don't spend it, you rolls into the next one and you get another three million, and so in the first year, we did to the spend the whole thing, we did not have the program up and running until december or january and next year we had 5 million dollars to spend and we spent a majority of it, and so the 3 million dollars, obviously serves the people and it serves very well but it does not serve everyone who needs the program. >> question, so how many people are actually served through the community living fund? and meaning, how many people were taken out of the laguna

honda? >> so it is two groups, it is the people who are in the community who are at a risk of being institutionalized and so they are actually like a nursing home level of need, and we try to keep them in the community. >> and a lot of those folks are already, they already have services and case managers, but they seem to have risen to a point where they need that extra help and then the other group are people who are in institutions and who probably are still or could stay in institutions and they have that level of need. but we bring them out into the community and give them that. and the services. >> actually wh, we get to the 6 month report, we have got, i think more information in there about numbers of people, and class, but, and >> yeah, and there is, and there is a program, and the program over the last, it is from 2006, more to 2007, and so we have got like 7 years or so.

and it serves to 2600, just over 2600 people. >> okay. >> and in total. >> right. >> individuals. >> and thank you. >> thank you, i think that it is a very good program. >> it is. >> and commissioners? >> yeah, you know, i have a question. what are the medical home equipment and the special needs in could you give an example of what are the special needs? >> so, is there where it goes? ... is this... >> it sits in the... >> and this is like the generous and stuff. >> second. >> non-... and no. >> and i am wondering commissioner, and president james if we should just move to the second report and i think that the questions are going into that area and we could cover that real quickly. and then we can cover and because i know that commissioner sims has questions in this area as well. >> i think that we do things for the house, that are not medical, and