mature so adults from 65 and up are available for medi-cal so those numbers will imagination in terms of service provision there are 2 main recommendations that recommendations was around how to deploy services and services should be more ordinary towards clinical services and among the providers and the exceptions of what their services should deliver and the outcomes frousz from the services knowing what the population needs and is i started my remarks talking about housing first and the housing retention the focus because that was the single focus we staffed up in mind and we saw buildings per sites that

had one case manager per one hundred units which given the outcome for the housing retention was the right radio if we're going to figure out what clients need and how to craft a service approach that meets that need it is necessary and the board recommendations we're going to need a lower case management to client radio i think talking about the roving teams to do that gets we're getting ahead of ourselves we don't necessarily know how or where to deploy the roving teams given the report suggests doing better client assessments and fourth as provider was the the city administrator figuring out what the clients needs e needs

through the commission on an approach to lower the case ratios a 1 to 35 portal we're talking about single adults across the portfolio will get us to a place to get better information on clients the thinking we'll simply not drop if 35 to 1 but relook at our fingers with the lower case ratios with a set of recommendations with the service quality while their voluntary in the building that didn't meet that each tenant can't be engaged case managers in buildings with a tendency to come forward and work i don't believe there's any tenant p and quality of case management could engage in services that benefit

him e.r. her we'll be engaged that the mayor's office and with you we'll be dropping those if not to expand the budget dui but to add the lower ratio while we expect xyz a couple for things i'll open up to you guys the report noted some administrative improvements we could make within h s a i am glad we've tubed with our providers a little bit which is the interaction with cash and the cap program and the stability of tenants in the supportive housing issue with that through the cash program even folks who are not accident cash grant the local

system cash between 480 up pays for rent the cap has requirement independent of the tenancy such the workfare or participation in the activities renewal for that your dependency or benefits historically when a client misses a benefit they get discontinued and not have means to pay the rent should they get back on the program they could be evicted i don't know i don't think it's smart to have one arm of the county government doing or reacting to a clients behavior that client is no longer in the system with that kind of ann

annie approach we're looking at and changing the requirement within cap and the first is the clients missing a work assignment they'll get discontinued now we have a 3 strike there are reasons people miss their assignments so you get 1 or 2 misses and the third we'll discontinue we want to do we haven't instituted by the time yet but have a cap program notifies the housing provider so on has missed the first and second appointment can you please reach out and work with them again we have not got to the second part yet

the second thing we've changed and done that as well rather than having clients getting discontinued and having to go through the whole process again we're simply doing an aide restoration so the client we'll see the reason and get them restored that gets them benefits quicker and hoping those 3 changes will we'll track the data will reduce the number of discontinues as well as the clients that are moving towards eviction should those 3 not work the fourth thing we'll look at some sort of temporary rent for the client when he or she is not an cash assistance is could take

several forms if the client didn't have cash a we'll make sure that he or she is not that penalty listed from the provider our goal is not to vetoing folks we as the city are requiring the folks to be evicted we want to address that and we can do that without an ordinance change and the last city recommendation is similar to the ones the orientation of increased orientation around self-sufficiency for people in affordable housing that is going along with the better case manager client assessments and then the engagement into our systems which are geared towards the

clients self-sufficiency and employment training and city college and so we agree with the final recommendation. >> thank you supervisor tang. >> just going back to in terms of the missed appointment that kind of an issue i think it is good to have a 3 strikes rules our trying to implement is there a way we can make it easier for the appointment to be located all in one place so they don't have to go to excessive appointments with the navigation one of the goals that they could pass all the resources at the at hands i don't know if there's thought about that. >> thanks for the question one of the most reason for the discontinues is the workfare we can't do much about that that is dph or rec and park but some appointments we require around

recertification or another job search or other things we require for clients we're looking at the rate the reasons of discontinues and the rates of each so so what we can change for example when a client gets on a brown they get their cash assistance to go to the orientation at a different time and location very often that appointment is missed one area maybe we can do an orientation at the same time, we're examining the programs of reasons folks are losing their cash assistance supervisor mar. >> yeah. thank you, mr. roar and thanks to the controller's office for the report i want to ask you about the aging population and the increased fee they have i know there are senior only sites our report identifies 4 hundred and 50

units seniors within non-senior sites do we have a sense of how many senior from 2004 to now has doubled and a lot of them will be low income so. >> i think even we don't have precise figures on how many seniors but we know that folks are aging in place the report says the stay is around 5 years and in addition to age other factors as well as; right? physical and health needs disability and g 8 percent of our clients their ratios whether age or disability and one of the surprisingly numbers in the report was the row

non-supportive uptick that's our strategy for keeping seniors and disabled folks in housing to have an uptick given the population are eligible 60 percent are a miss match. >> do you know when a why what barriers are low for the h ss. >> maybe the folks are not knowledgeable about the benefits that's a state federally funded program we can expand there's no reason we couldn't do more of affordable housing we'll be addressing that combroirlg. >> i i know that the coalition of supportive housing providers identified barriers like that h s rate and other funding and centralized intact and the other

key issues and barriers they emphasis multi barriers i know that dph and other agencies are looking at this the last suggestion from i think the coalition which i'm sure will speak in the moment moving away from a one-size-fits-all to a addressing the diversity of the population i wonder. >> before we get you agree b with that we should be looking at designing services and buildings that are catered to specific populations so right now we have a mix we have seniors mixed with folks that may be able to go to work and healthy if we get better assessments to our clients the

only way to drop to increase the case manager level in the buildings so be able to see the patterns to move folks to different buildings to take advantage of the scale of provisions self-sufficiency with more worker phone call or to the controllers suggestions keep the population in place but keep roving for specific service needs their diluted appropriately given what we know about the population but absolutely the needs among our folks we've housed are varied across buildings. >> mr. chairman there's a map on page 3 of the handout shows the existence of the geography location of master lease local

operating subsidy and i'm wondering is there a plan to insure that there's more geological recommendation i'm just looking at my district and supervisor tang's district the west side having almost no access to various sites and the concentration in the intermission and even in the southeast parts of city 1, 2, 3, 4 sites in the bayview is there a plan as we look at a 10 year plan or a multi year plan to make sure there's access to close to where people live. >> that map is larger a function of the type building and the building size hive density unit sro's in the tenderloin and in the selma and northern mission one of the approaches we're looking at we have contract with a nonprofit home basis and done

a housing invent that looks at available housing in other parts of the city we might be able to utilize those are 10 to 15 or 20 unit buildings we rent a portion of the buildings to put clients it in make sense to lease a 20 unit building because the cost is high you need certain types of services in a 10 or 20 unit building what a lot of city and counties cities that don't have the sro's is the started site model we do some of that you have 2 and 4 unit at the same time and have roving teams and managers that manage clients

scattered that's the form there are not buildings in this housing market buildings we'll pencil out to rent as a whole i was mistaken i saw one around aging one site on the edge of supervisor farrell and my district that i'm not sure what that is, i think the map in front of you - okay. thank you. >> thanks supervisor mar and mr. roar thank you for your comments one question you talked about the report any thoughts on policies we can put in place to really change that i imagine it is not helping them exiting housing it is costing the city mulches of money to step in the shoes of government. >> again question supervisor i think one of the things we should look at what we require

of the prospective tenant as well as the provider and, of course, the city before that individual gets placed into housing we don't want to create a process that caused the length of time between the person moving into that how's maybe within that 3 week window i think is the length of time it is identified we can do a better job of assessing what the clients needs the initial intact that places the benefits then links to our system to say okay. so and so is no one others xyz some, some some sort of up front look at rather than than having to reengage the client has to engage initially has to sign a lease at this point that's the best time to get at least that

initial information about the benefits either receiving and the eligible ability screen. >> okay there's talk about and i'm sure people will talk about the in take system or cooperated system from our prospective can you see that don't go a lot of good within h s a's portfolio. >> independent of the cash that is governed by its own initiative and the access is gfrd by that ordinance the assessment will do would be to better target folks to you may have the most in need or the birth barriers to housing we talked about the needed to focus

on the chronicle homelessness but the chronic hopgs and the chronically homes resources consume on the other systems that tool if it's a coordinated assessment will better target those housing unit and the types of housing unit to those folks remember we have hot well and other federal funded streams that support our and the criteria needs to be met the coordinated approach that spreads across the two agencies will better target the folks for the right housing. >> thanks very much and thanks for your work much appreciated so i want to offer the

opportunity for dph. >> i should have done that in a better sequence i've posed my questions to the budget analyst i want to make sure i give you the opportunity and thanks for participating. >> good morning, supervisors i head up the housing for the department of public health thank you for having me a lot of items have already been addressed in one way or another supervisor mar talking about the buildings which is enrichment and efforts to the 25 unit it's a wonderful building for the population i'm focusing mostly on the budget analyst report and feel free to interrupt me or request questions obviously a big part

was stating the obvious that permanent housing can be part of the continuous housing we couldn't agree more dph believes in the least restrictive and appropriate placing for housing for the people we sever for many of our homeless people especially this is a higher level of care that or more times restrictive so the housing of our models is merely that we wanted to come up with the least restrictive community based housing that we could for those of our population that can live in the communicated but traditionally we're not able to assess the other supportive housing because of not enough services or our patients sometimes have a somewhat

slanted history that made it hard for them to get in the transition that was an issue that's why we developed our access to the housing it is very much based on in terms of staffing and it definitely is in many ways focused on it being providing stabilization keeping people stabilized and less costing for the city, however i think we have people in our settings that would love to move to other kinds of housing options and we tried to do that our onsite providers tied to do that we don't have as many people options we can access our emphasis and objectives i'll

talk about that they have to do with developing unify connections that including includes marshall that people stay on benefits increase whatever income they are eligible for including if they're working and adjusting their rent accordingly and also seeking outside provides because we may have enough onsite that may be vital for some of our clients conditions there are other people that can get the services hundred dollars u outside that's one of the services that the case managers as well as the medical staff onsite work on i also wanted to say we talked about the access from supportive housing and yet for dph that

means 2 percent evictions more 90 percent stability but i also wanted to point out those numbers does show how much work it takes and how much commitment and how much best practices it takes to come to those numbers without the service providers and the community without the housing development and property management those are not the numbers we have when i look at people living at sites over seven years some of the people i know myself they've not been in housing for the last 20 years more than 6 months i'm preaching to the choir but as the cost continue to be so much less than the other options that dph often has when people get work we have a program in the city i'm

speaking on behalf of dph we have a program skafrt site program in the subsidies people take their subsidy i's they're getting around the seven hundred individuals subsidies which go down in numbers as the price of the units rises the ceilings that we have because of objective fair market value because of the federal limitations in no way allows our population to find a new unit unless neither in place and eligible as a unite above sub rent it is very difficult for

people to use the subsidies we talk about our hiv subsidy provider talked about that a lot it comes up again and again we do so in the scatter site program wiener we have a nursing facility the people that leave the wrap around services i'd like to see it with the services the wrapper services are easily adjusted and as those people may go up and down to the services can there and decrease in that model if so definitely something to work on we're working on not dph on its own in must way we're all working with the housing

authority that has their list not in support of housing and we're working on the implementation we seeing a lot of possibilities at least individual residents be able to transition not just within on our system but between the different departments i think as we able to hopefully have the budget increase the educational in general the activities in general for our population it would make a huge difference in terms of the kind of goals they're setting and the hope they have and the kind of you know steps they're able to take towards that in terms of outcome you know increasing the consistencies of outcomes based on evaluation of

programs the more comprehensive the budget analyst office of how we track and monitor yes, we need to develop the option of comparing with the agencies and the programs and we're you know looking at how to do that within programs we can do that and around exits we have a lot of data and the new legislation that came through around the eviction rates has given you us the possibility of really developing comprehensive spokesman on exits not only the exits that are related to involuntary exits but in general do people go to other types of supportive housing is it federally supported where are the details and i think the

availability of housing we need to move on and many people will speak to that the last 10 year plan for people at the time seemed outrageous in terms of what it was looking at and the goeltsz it was setting many of them were reached i know the situations in san francisco has really changed that kind of collaboration of the city departments h s a and the board of supervisors and the mayor's office or the housing developers in the room here that want to serve a wide variety of people that are struggling with homelessness will allows allow us to make improvements and have a better spectrum of housing option i'll be happy to answer any questions that you have and

just call me back up. >> thank you very much. >> colleagues, any questions at this time? okay thanks are colleagues if no other questions opening it up for public comment i know there are a number of speaker cards first to start off public comment i want to ask dale and our other colleague to come up they form the providers housing network invite you to come up and afterwards i have (calling names) >> good morning, supervisors. >> thank you for holdings this hearing i'm gail the co-chair the provider network. >> i'm gary the other co-chair. >> first of all we sort wanted to talk about what the network