. >> good afternoon edge happy chinese new year and all that i'm eric mar i'm here with my colleagues on the right be vbs supervisor campos and to my left julie christensen and joined by supervisor jane kim please give

us any announcements. >> electronic devices. completed speaker cards and documents to be included should be submitted to the clerk. items acted upon today will appear on the march third 2015 unless otherwise stated autopsy thank you. i forgot to mention in the the february 19, 2015 meeting of neighborhood services & safety committee of the san francisco board of supervisors mr. evans call item one. >> the items proposed a argument shelter of the such rules and alternative opposed in the imposition of uniform rules and right leg the department of public health and mayor's office on disability report. >> thank you and the sponsor of the hearing is supervisor jane kim. >> thank you supervisor mar and for the committee it's good to see supervisor mar and supervisor campos it is the

first time sitting with supervisor christensen welcome to the board this of the by a drafting process that took place to create uniform rules for the homeless shelters here in san francisco during the process that came up there was be disagreements about a need for uniform rules for the shuttles and the specific rules in the drafting process, however a common ground that came out came in of this process amongst the highlights this is a need in the startle system was designed for homeless as an economic issue a place of safe harpoon for individuals that are generally healthy and are down on their luck however we've seen both from observations from through the data that department of

public health has been collecting that is not necessarily the demographics we're seeing in the shuttles today in the department of public health studies and also through our homeless count we've found that 61 percent of our chronological homeless individuals have a form of disabled condition and 1/5th are seniors they're not built to serve the demographic and ocher our shelter people needs the services the gap between the services we're providing and the clinic tell in particular, the rule that was most talked about was the rule number 18 that allows shelter to refuse beds an example go some place who couldn't get out of bed on their own or required assistance

there's a lot of rationale behind the rule given the fact the shuttles don't have the training to treat the individual that is disabled further we know there are discrepancies that release the patient sooner then they need to, however, if they had a home but not a stable place to get well and better even something simple like a broken leg if i were fraelsz the hospital i could go home and network of supporters could bring food that's not available for our folks who are unhoused this is an issue that has lead to who is responsibility for the care of the individuals that is

lead to our shuttles calling 911 that is an expensive way to address the issue no one wants to see the individuals that are on the streets because our shelters can't help one is continuing trying to push your square pegs in a round hole to 9 staff are not resources to serve the men and women in the city or we can choose to be smarter how to use our city resources to have the transformation of the system i think there 9 years over in the board of supervisors homelessness is not an issue of poverty but a public health issue we'll never be able to help the most chronic and sick people in our san francisco if

we don't address homelessness nominee we talk about resourcing the shelters it is housing is far more cost effective than shelter that that has led us to a stagnation to the shelters are not the most cost effective way even though housing is important cost effective it takes time and to inquire that is a challenge it is costly to hire and rent for the most vulnerable residents our shelter system addresses the homelessness and providing a transition as people wait to get into housing we hope this is a discussion how the

city moves forward together a candidate a system and if i want to look at this way a product that works for our market we're trying to serve the reason he called for this hearing on the auditorium shelter rules by the human agencies to have a discussion about the need through the number of productive meetings with our department of public health and on the conversation is shifting towards addressing the solutions to address the problem i want to thank the human agencies particularly george and kathy and others who took the time to meet with our office i want to recognize ken and kathy from the community services and jenny for the coalition for the homelessness sitting down with

us many, many times as and prepared to delve devolve into the rules but to address what the proposed rules have highlighted i want to give time for the departments to present before i really go into some of the ideas and the topics we've discussed and then of course i know we have many members of the public here to address the committee it is a preying issue in san francisco i forgot to mention happy new year it is the year of the ram i think this is appropriate as we start a 92 new year and the chapter what he think about a new chapter in our homelessness shelter medians i have 3 of our departments here today, we have department of public health, we is where skwlois will be representing the

agency and juliano the deputy director for the mayor's office on disability and i have dpw starting out the presentation, however, i'm flexible on the order. >> supervisor kim can i ask that supervisor campos or supervisor christensen want to make opening remarks. >> i want to say i'm appreciative this meeting is being called i know in some of the conversation with the community-based groups we're doing the best to keep this within two hours i know there's a lot of speakers i want to say i appreciate supervisor kim's approach not to fingerpointing but looking at the solutions i know from the community there's an effort to really express the voice in the diverse communities that are recommended and highlighting the stores and challenges that homelessness people face everyday and how

this may be made more challenge by constricting stricter rules not only rule 18 appreciate the practices that will be brought up in the hearing as well and in many ways as supervisor kim said no point looking at trying to push square pegs through holes but looking at supportive practices that can help lift people out of poverty and address the causes of homelessness in our city it to you supervisor kim and i'm looking forward to this hearing as well. >> so thank you, colleagues. i forget to give the members of the committee a chance to make opening remarks we've started with ms. crumbing u crumb from the human services agency.

>> thank you for being here. >> any member of the public wish to speak on any item. >> at the thank you for having this hearing i am joyce crumb the director of the houses and homelessness division for the human agency i appreciate this hearing and appreciate the preempt we had with the supervisor kim and then our group meeting that we had with coalition on homelessness and e.c. s proifrdz just let me give you a little bit of background those are not in any rules in order to have a shelter facility we have to have rules and those rules actually went into effect in 1999 when we established the shelter grinds advisory committee and when rules are broken and

shelters or an infraction happens in a shelter you could not deny a percent e person access it has to in absentia trade and and hearing we're not adding new rules what we were trying to do with a concern we heard not only from our arbitrators that arbitrate guidance but during the shelter assess group although not a recommendation we heard numerous times that the rules in the sheltered are not applied fairly so we undertook this process with collaboration of all of our shelters and we began in july of 2012 gathering all of the shelter rules across all the shelters in which we fund

we had a series of meetings with our providers along with community meetings to get combating input from our community stakeholders rethought we were on the right track until i guess early december i got a phone call from one of the sdhd from the shelters expressing concern about this process of standard digdz rules what we found in this each shelter had a set of rules although many rules are similar the language and the sanitary period varied for instance in a small shelter it's a if a routine is broken and the same rule that a larger shelter has the larger shelter might impose

a longer sanction so we were trying to standard device the rule and give them a range allowing each shelter to maintain it's individuality and work within that system so that's why we got to the point of let's look at the shelter rules we thought we had the buy in of our shelters during the process we understand change and we also look at criticism at being constructive and to strengthen what we do so last friday when we met with the shelters the one shelter and supervisor kim and her staff and the coalition h f a made the decision not to move forward

with standard dizzying the shelter rules we have a shelter directors meeting on monday because all of the shelters were noted present at the meeting nor a part of a letter that went to my director we are going to have a constitution with tell them on monday but we will not precede with standard dizzying the rules as i mentioned to you on friday what came out of meeting on friday (clapping) thank you. >> were two specific issues that is bigger than h f a it's the rule around clients when arrive at shelters unable to have care and without established support as supervisor kim mentioned earlier shelter staff are not trained to provide health care so what came

out of friday, a small group decision that once h f a garthsd do not when an incident occurs in a shelter right of shelters providers are responsibly for submitting a critical incident report from 9-1-1 calls to some something that happens in the shelter that was critical to the daily operation in the shelters we're going to look at 6 months to a year of data to determine what type of critical incidents have occurred and which one of those critical incident surround see self-care of clients in someone is dropped off from a hospital into a shelter and managed to get a shelter bed in the night time can't get themselves up to go to the bathroom or have an accident this is critical because the staff are not trained to handle

an i want of that nature also what is most important in an incident it is self-care we do have the support of the department of public health and their public health nurse who's assigned to our shelter that's kate kate meets he regularly with the shelter providers to look at needs of the clients who the shelter have expressed a concern in they're not able to care for themselves they're fragile and there's a need for them to be move forward we've agreed to work on a plan i do know the department of public health will speak to that but their enabling more mental health nurses at the shelter to help us in p in delicate

situation that's our pay attention i'm happy to answer any questions you may have. >> thank you very much ms. crumb and thank you, mr. walton just a couple of questions in terms of the when - what happens if someone is not able to take care of them and the shelter can't address their needs how is that individual usually handled. >> i know that scott talks regularly with the shelters so i'm going to ask him to provide an answer to that question. >> thank you very much. >> good afternoon supervisors the rule itself was about the ability to end a recess evacuates the shelters work closely with the nurse sport and

the behavior roving team that supports shelters to try to address the issues in many case because of the alternative to call 9-1-1 they get returned to the hospital it's not an effective electrocution u solution but when a client can't move out of bed and the shelter staff are not trained to do that that's the solution that happens but what happens when those clients are identified there's a great deal of communication between the shelter provider and others often the hospital to try to determine what the solution is we want to avoid the client being asked at the hospital and they're saying the shelter and they get returned back to the shelter we work with the in home

services their hours are limited and not twenty-four hour a day so the clients may have problems outside of a caregiver. >> i do want to appreciate mr. walton and ms. crumb for the work they do they've been responsive to those concerns do you have a sense of what should happen what's the ideal situation in this case so the client is not returned to the hospital not an ongoing cycle. >> i don't think that's a question the h f a can answer we work closely with the care of nurse maybe she can offer a response kate. >> (laughter). >> you're on the hot seat (laughter). >> so the question is what do

we do when people go the the hospital. >> what's the ideal what's the outcome you want to see given right now it is sort of an ongoing cycle. >> it's complicated and each case is very complicated every time i get a referral for someone that can't take care of themselves that 3 involves a lot of parties not ideal for people to be 9-1-1ed out to the emergency room without someone on the other end advocating the emergency rooms are to treat trauma for instance if you have a chronic issue and you're in the er you're not going to walk out you you'll be attached