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tv   [untitled]    November 5, 2014 2:30am-3:01am PST

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wait list grew longer we did not get as many referrals and i think that is kind of standard of what happens in the community, and you, as long as the referrals point of entry is open, and the people can get into the program, you are going to see a lot more referral and we have a waiting list and some people will stop trying to get on the list when they know that there is a bottle neck and we are continuing to see the zip code, 94116. and which is primarily, laguna honda hospital as a major place of referrals. and then, of course, tender loin and the haze valley areas as well. and actually 32 percent of our referrals are coming out of laguna honda hospital and in terms of service requests, the highest request, are for case management and inhome support, and housing, always, remains in the top. and there was a time, when we had greater dollars, and then in the dimension when they had
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access to because money had been set aside in the health department for this program to access the housing particularly for the people leaving the hospital and there was a more fluid operation in terms of housing, but again we don't have any more, mental health and substance abuse and assisted living devices are also high on the request level. the total amount of the program expenditures of $2.8 million, which has been the norm now for some time, and you will see that something that i am very, interested in, and i am very pleased about, is that the average cost per person is 557 dollars a month and i think that is an extraordinary amount when you think about who is being served in this program. and now clearly we have the people who are much higher than that and the people who are lower and it brings us to the norm, but, when you think about over 500 people, served, and you think about that particular, and i think that is
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pretty amazing and i think that later in the report you will see that some things align this line are happening in two of the counties and i suspect that is one of the reasons and turning to page 3 looking at systemic changes in the trends that are effecting a clf, you will see, the second bullet there, that, well, yeah, on the second bullet, and that the housing were recently awarded a contract with the health plan (inaudible) put together a community living fund and program and i think that is enormously exciting given that when we first started, i remember approach of a foundation, and asking for money to do some research on this program. because i thought that really, do the research when you are starting and not at the end and they said that this could never be replicated any place else, only in san francisco, it is wonderful now to see that other communities have really learned
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the lessons of what a flexibility fund can do to help people live at home, and also come out of institutions. and then, for the first bullet on page 4, santa clara now is doing the same thing, and both (inaudible) and santa clara are two of the eight counties that were selected for the coordinating care initiative to move into the full service managed care and so we see that santa clara is doing the same thing and i am glad and appreciative to say that they have worked with both of those counties to help them to be successful in area for work out the details of how this program could be set up, and so on. and i think that the disappointing thing, in this year, that we are in, is that our deversion and community in the integration program, the dcip and essentially, the electronic tool is no longer able to be accessed and this is due to health department
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concerns are on privacy and so we are working across the departments to try to figure out how are we going to share the data, when it is in the best interest of the people that we are both serving to make sure that they get the best from all of us, and they get the most complete plans and so we are working hard to see that that gets reinstated. but this has been a very important piece to the community living fund, and the work that we have been doing there and so we are working hard to see what can be done, in that area. the second bullet from the end, you will see the san francisco and the consumer mentor program, xh is housed at the public authority is on hold right now and that is because they are re, really looking at that programming and thinking about a redesign, and so when that is back on, line, we will be back to tell you about it. and then what you see, i think
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in the last few pages are the charts and i did the quick math and if you take $25 million over the course of the program, and with the, and what that is to say 26,000 people and that is $9,000 per person and i mean, really that is pretty amazing. >> and given that so many of these people have come out of institutional care, where frankly, just the city's portion at laguna honda is $100 a day. and so, we are enormously proud of this program, and we are glad to take any questions and then, i think that rose is going to spend a little time going over the third report, because this is an incredible analysis of a particular group of people during a particular time in terms of a program's success. so, open to any questions.
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>> commissioner? >> on the chart labeled is it ior one? labeled one, it says that the number of clf clients served by homecoming continues to increase. and the increase is seen nominal almost slightly up to flat and i wondered if that is due to funding ceiling that you are maxing out? >> are you looking? >> you know, the bottom chart. >> and the homecoming itself is a separate program, and it is at san francisco senior center and it is money that is set aside for people coming up through transitional care and so the people coming out from the hospital, >> okay. so it is really not. >> it is not part of this and it is less dollars, but it goes
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and, it goes to it and to a different program. they have access to as much as they actually need, and but, and so the spending each year, and varies, because so, it might be just somebody coming out of the hospital and they can't pay for their medication and we will, and we have an apartment but it could be and we need a grab bar and they didn't have one and it is just like the immediate need and so that, it kos go*es up and down a little bit based on what the program needs and not our control over it. >> any questions? >> commissioner? >> how long do you follow the clients off of their (inaudible) in the home or, i mean, in the... (inaudible). >> you know as long as we need to. and so, when we first set up
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the program, especially with the folks coming out of laguna honda, we said that we would follow them at least two years. and we will just see, a lot of times we transfer them to a lower level of case management and the people are doing well and they don't need us any more, but we, if we go out at a year and two years, just to check and see how they are doing. we do like an oversight, and then if we do or bring them back into the program. >> and we change. >> and the care. >> right right right. and so it is just, it is just, it really is just depends on the individual person and we can't stay in there for as long as they need us, which could be like three or four years,
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whatever, but generally, i think that we generally we end up staying for a year if somebody needs an ongoing service, and then we are still involved, and we are not as actively involved in terms of the case management, but, there is an over site checking in with them, regularly making sure that they are still stable. >> okay, thank you. >> commissioner sim? >> i would love to hear a little more about the identification of these scattered housing units and one of the reports talked about some of the very practical problems that could arise, or have arisen, placing some of these at risk patients from the availability of the drugs in the neighborhood or the problems that might come up with the circumstances of the patient in a larger unit and i would love to hear you talk about the mitigation of those issues. >> sure, you know the scattered site program was contracted out
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to west bay housing, and they, they and their staff worked closely with clf and their case managers and the rest of the team, to when we we would look at what the best what the need was, did they need the scattered site, is that the best way to go, or do they need a unit to direct access to housing which has on site services and nursing service and they have got a desk clerk, and you know, they can be more tolerant of different kinds of behaviors and so, we would look at that. and for the scattered site ones, and that is our first choice and we would like the people to be out in the community as much as possible. and for the most part, it worked well, with the wrap
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around services. sometimes issues would arise around screening or behavior or friends, or alcohol, or drugs. west bay housing did a really good job of working with the management in the buildings. and they would, they would get on any issues and we, a lot of time, we bring in the case management and we really try to ease the situation and sometimes we have to move the people out, in order to retain the relationship with those buildings. and if we moved them out, we would probably move them into a dah, building, one of them, and sometimes the people, and in and the people that were in a dah building and the things really settled for them and we would move them out of the building into a more independent and we also, ran into some problems, and we a couple of people that we set them up in really nice apartments and really nice buildings and these were folks,
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both of them had been homeless for a very long time, and they really had trouble with adjusting to being in the whole apartment and in that kind of a setting, and we ended up moving them into sro buildings. >> i saw that. >> and they, you know, they did really well. there was, and they had a level, and so, you know, we had our own and we wanted to put them in a nice place and that worked for us and it did not work to them and so, it is, it is, it really opened our eyes to really looking at what is that person is saying, and how can they best cope,? what do they need? and, you know, our focus is maybe, like somebody should stop drinking but that is not realistic but how do we allow them to live in the community
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and carry on and have the choices of how they want to live. >> one more thing is that we also found that people had a lot and we were surprised at how much mental health issues, were a problem. it has made a difference in the terms of the case managers knowing how best to deal with the people, but also, to be able to make a connection with them. and allowing the people to live, how they want to leave and for us not to be judge mental, and just learning. >> yeah. >> and if i can hole the mic for one more, and i am going to try to combine a couple of
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things in one question partly i think that it relates to the peer mentor program that is tabled for a moment, but it also, it might relate to some of the demographic profiles that are trends, like, you know, 77 percent male, and a little bit younger, than i might have expected the population to be. and the ethic diversity patterns don't seem to match perfectly to the general, ethic diversity stats of the city. and so, i am wondering, you know, what is the thought? peer mentorship seems like a really lynch pin concept. and depending upon how this works and i am wondering if some of the demographics are working against that? or not? >> so i just say, that the peer mentor program out of the ihs public authority, is where they primarily someone, who is disabled is going to be leaving laguna honda hospital or
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thinking about it any way. the public authority would match them with the peer who has a disability, and who lives in the community, to talk to them about how, and just how it is. to live in the community. and how it is to get around. and how... >> and actually take them out. >> how do you go to the bank? how do you do this and ride muni? >> right, so it is a very practical, and so, i think that what we are seeing, at laguna honda is that this younger population, is primarily caucasian, yes, there is some diversity but a lot of disabled middle aged, or younger, white, males. and so, i think that whenever we look at our dem graphics, you know, i am always asking, what kind of out reach are we doing? are we making sure that we are getting? and i think that if you look at this program, over almost, ten years now and not quite, but close, you will see that there were years when we had you know
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the greater diversity and now, we are, and we have got, kind of this population that we are looking at. >> and does that give you some... >> okay. >> thank you. >> thank you. >> could we... >> yeah. >> and okay. >> thank you. when the veterans and so we have a third piece of the report. >> i don't see mine. >> it is stapled into this. >> okay. >> and so, i think that again, this is a report, that rose johns was a graduate student at the time that they did it now on the staff prepared for us, and i would just ask her to share some highlights with you, because i think that this gives you a deeper look into both (inaudible). >> good morning, commissioners. so, as... >> you might want to pull the mic up. >> yeah.
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>> and so anne has the report that i completed when i was in graduate school and uc berkeley public policy and social master's program and now i am with the hsf planning as six weeks ago and i think that you actually started pulling from some of the data in my report in what you were just talking about because it is stapled to the back of the six-month report that you received. >> yes. >> but just to highlight a couple of key points, i think, what linda and i really were interested in or noticed, in the data was that the population that i was focusing on, which is those consumers served by both clf, and the dsip deversion and we noticed that they tend to be middle aged and male. and that is notable, because often the people think about seniors, and when we are talking about taking people out of skilled nursing facilities, but this population does tend to be younger. which means that they have a
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lot more time ahead of them that we can help them live more fully, in the community. part of this project was looking at this clf purchase, services. and what i found was that services both in terms of the total dollars spent and the number of purchases tended to be clustered around the discharge and they were primarily related to setting up a home. for these individuals, who are leaving laguna honda and had not lived in the community for a long time and so a lot of the purchases were things like putting in a stair lift. or, putting down a rental subsidy. and or excuse me, a rental deposit. and i think that something that we are pleased to see is that based on my attempt to do a cost calculation that was more comprehensive and i looked at the costs as well as housing costs and through the meals through the office on aging what we found is that the cost of putting these people,
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pulling them out of laguna honda and to support them, appears to be much lower than the cost of living in honda for a year i think. i calculated the cost of supporting someone in the community is $32,000 that is not a comprehensive cost estimate, a lot of these consumers are accessing other services through the department of public health that i didn't have data on. this cost, 32,000, is much lower than the projected cost in the year in laguna honda, which is $32,000 for one year. >> and those are the highlights, any questions or do you want to move on with the agenda today? >> i heard you say that you wanted to move on. >> and no in questions, for the..., okay. >> other than to say thank you for doing the work. >> yeah. >> it was quite enjoyable. >> thank you.
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>> it says the veteran history project. >> right. >> yeah. >> okay. >> good morning, commissioners president james, and director hinton thank you so much for having me here this morning, my name is gabriel ledeen and i am an attorney here in san francisco and i am going to talk about a federal initiative called the veteran's history project. and ask for your help in reaching senior veterans here in san francisco. >> you looking at two. >> and i know that and thank you for your service and i am also a veteran and i served in the marine as an officer for four years and that is why this project is so important to me. >> okay. >> the pro-yekt and a product of the federal statute and congress directed the library of congress to establish the program in 2000. and since then, they have collected, a stories of over 90,000 american veteran and
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they have archived them and made them publicly available through the library, and on-line, data base and also, physically and in dc through the archives. the library relies on the volunteers for these stories of veterans and the volunteers like myself, go out and find, the set ran and interview them, and record those interviews and then submit them along with the required paperwork to the library of congress, where they are archived. and now the library has encouraged us to focus our efforts on senior veterans, particularly world war ii, because the population is rapidly dwin delling and way nt to capture those while they are still here and available for interviews and now. the most difficult part of this process and locating these veterans and extending to participate in the program, and that is why i am here today.
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and i have reached out to the office on aging and adult services and we had a meeting last week, we sat down at a table and she proposed a fantastic idea that we sit down and have a meeting with the activities directors for several of the senior centers in the san francisco area. and we are planning on doing that. i am here today to let you know about this project and the effort to locate the veteran and to ask you about any help that the commission can give in extending our invitations to the veterans in the san francisco area, who are participating in the program and i am happy to take any questions. >> i have an invitation for you. >> okay. >> come october 11th, that is saturday, the american legoion, we meet once a month, 1524, power street. >> okay. >> across the street is (inaudible). >> great. >> you probably know some of
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those members. >> i probably do. october 11th, and i will be there. >> thank you very much. >> and 11:30. >> and good lunch at 12. >> outstanding. i mean, that these meetings tend to be the best way to find veterans particularly senior veterans and i have attended numerous meetings in the east bay, over in concord, they have a meeting every third thursday of the month in the back of a dennies and brings over 100 veteran and on the d-day commemoration, they had five stand up and tell their stories of par participating in the d-day, invasion. and so, thank you for the invitation, i will be there. >> i would just suggest that most of these veterans are probably getting health services, and so i hope that you have been out to the va hospital, a lot of them are in the cafeteria, and just, they have different venues outside and around and so most of them are already getting care. and so you just step out to the
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va hospital. and there are a lot in the lobby and i know that ucsf has free, not ucsf, but uc berkeley, their law school had a program that they were giving advice free legal advice to veterans so, you might want to have a little table out there and i am sure that you will get a lot of stories out there. >> out standing, i appreciate that recommendation as well. >> one other, and have you been in touch with sldn. >> no. >> and i think that i have that right and i will pull it up and i know that i don't have the service to pull it up. >> it is lgbt advocacy organization and they were formed to work for the don't ask don't tell and i think that it exists in the city and headquarters here and there are two people that i know, zoe doning is one that you may remember as a navy officer that was drumed out of the military
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and has had a very successful career in the community, and sthe will be a resource for you and, bob dokendorf who has been active in that organization and he is a retired navy officer. >> fantastic, i will reach out to them. thank you. >> one of the things, too, and because i work with the library, and they have story corp, which is it regarding older and i am working with them, and they are recording older people history and they have got to do that with older african americans in their history in san francisco. and so, they may be something that you might want to use their services. >> absolutely. >> and so i have a meeting at 11:30, so... >> okay, i will talk to them. thank you so much. >> and commissioners i advise you and i would love to sit down and do your interviews if you would like to participate in the program. >> i have some stories. >> okay. >> thank you so much. and unless there are any further questions? >> i appreciate your time. >> thank you. >> thank you.
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>> okay. public comment? >> hi, again, i will make this quick i wanted to give an update on the work that we have all talked about as far as improving the conditions in sors and people with disabilities and we have a film training about the lifes of the residence of the in the hotel and that will be on the 21st, from 2:00 to 4:00 at the san francisco main library and that is free and open to all. thank you. >> and okay. and thank you, >> what time was it? >> 2:00 >> yeah. >> 2:00 >> okay. >> review and approval of the fiscal year 2014/15 california department of aging,
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supplementary nutrition assistance program, education snap, ed, contract sp 1415-06, and all subsequent ad mendments staff, linda lau. could i have a motion to discuss? >> so moved. >> second. >> it is moved and seconded. >> okay. >> good morning commissioner and director, our department of aging adult services is requesting approval to enter in a new contract with the california department of aging, and to participate in one-time program called the supplementary nutrition assistance program, education, and it is called snap ed for short and the state, actually, received 2.5 million dollars, of federal funding, and to fund that 20 par participating area agencis on aging and we are one of them. and so san francisco, we are based on the interstate funding
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for that and we will be receiving 119,000, and 84 dollars for the fiscal year of 14, 15 and we have an agreement with the state, to select three low income senior news sites or housing sites, and that meets the requirements which is 185 percent of federal poverty level for the dem graphics and we propose to it and the project is several found and one of the ideas is to by growing and harvesting and having these gardens, and the urban gardens that they will be able to increase the access to the healthy food as well as also the activity and the physical activitis that they might enjoy.
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and we will be working with the recreation and parks department to help with this project and they have a lot of expertise in this area, and we already reached out to them, and they have some contracts that they already work with that have the expertise to help us build the gardens in the sellive sites as part of this project and this is to provide the education and so there will be usda approved, curriculum to include and for these participants for these sites and one of the approved curriculums is esmart and live strong and we will be using that along with the other tools that they will provide to us and part of the project is to be able to evaluate the preand post test to see what the
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impacts will be. and we will provide the programs and offer these to the selective sites and one of them is ti chi and moving for better balance and this is, there are contractors, and that are able to have been certificated to be able to provide this and so we will be subcontracting, and to offer this train to trainer type of program, and so that, sites that will, that are interested in offering this, will be able to send, either a staff, or a volunteers to attend this training, and then, bring it back to the program, and then there will be staff to basically, help over see the program, and then making sure that it is implemented in appropriately, and along with that, there will be other curriculum called eating smart and living strong and i mentioned about th,