>> thank you and welcome back, everyone. we are going to continue with information item no. 8. san francisco municipal transportation agency. muni, that will give an update on a

project called muni forward that includes service changes to limited lines, stops and signage, presentation by sean kennedy. my apology. we are going to informational item no. 7. please excuse me. okay. let me start again. information item sf homeless outreach team: working with people with disabilities. an overview of san francisco homeless outreach teams four service lines. a presentation on services that sf hot provides to people with physical, mental health and cognitive disabilities and some of the issues and challenges. presentation by brenda messkam, muni -- mft director

of sf hot. sorry for the confusion. thank you for presenting before this council. >> i'm brenda meskin, the director of the homeless outreach team. i wanted to talk about a brief overview of the services that the hot team is have the therapeutic transport that transports people from the clinics from emergency centers to the hospital shelters. we try to

identify the multiple services and high users of single services because we are always doing the transport. that's all being logged and when we identify the different client we will present them forward to care management. we also have the san francisco public library. we have a social worker and two part-time fte's with six health and safety associates that are former clients that are more stabilized and they are trying to help us identify patrons of the library that could use our services. we have in addition to our outreach we have increased the amount of, or street outreach workers, we call them case managers because they are doing

case management out on the street, that's knew. and we have the medicine team. that's led by our doctor and our psych nurse practitioner and a nurse and what's new is they are able to go out with the outreach workers and actually help people that could be light wound care on the streets or they deal with a lot of pregnant women that are still out in the streets. they also do psych assessment and trying to engage people and bring them in the clinics. that's the biggest probably addition to the homeless outreach team. the street outreach is like i said it's like street base care management and we are doing a lot of linkages and

referrals to primary care, medi-cal, the cap benefit, ssi so we can still get them help but it will be from the street. we are still identifying the hums and high users on the streets as well and then with the new navigation center we are also assessing different campments in the different districts. the word is out all over by now and a lot of people want to access the navigation center. so it makes it's easier for us and everybody is willing and wanting to go. it makes it a lot easier to do that. that's a partnership with sf

p.d. and department of public works and they do the belongings from then campment and we have the care management. we have 16 care managers and two social workers supervising the two teams. one is here an one in the mission. they are getting referrals from, we triage all clients from different, they can be hospitals, mental health providers, just various. substance abuse providers. we get referrals from all over. it could be street like self referred. we triage them on thursday and pass them out to the different case managers

that have openings. we added also money management. so there is a lot of our population since we are trying to reach the ones that are most challenging and they are not able to maybe access money management through the other services because of behavioral issues. so we hook that up with our own money management on site which is really nice. so we can also do like med management also in collaboration with the money management because they are coming into clinic or they can be seen by our medical team as they comen for their money. so we have a lot of eyes on them and help to stabilize them so they can also get into permanent housing. i guess some of the challenges

is that we have a reduction in our stabilization units. everybody used to call us, we want case management which meant a room. but that's no longer the case. the case management does not necessarily mean the client will get a room. we use them as treatment rooms now. we have a reduction of two-thirds of our portfolio. another challenge is that the stabilization rooms we have are not in wheelchair accessible hotels. there is no elevators. that's the biggest challenge and so we place people for like 2 weeks at a time to do some sort of like, it's whatever the treatment plan is. getting on ga takes 2 weeks. so we'll put somebody in a room, get them an i g and put

someone else in the room for something else. maybe it's going down to the medi-cal office so we can refer them to a primary care procedure or it could be the team is out there and the team identifies they need to be on antibiotics and we use them more as a treatment now. so a lot of clients are now having to utilize shelters. we have 41 shelter beds now and they are always full. some are just doing the 2-week just like a stabilization room where we try and hook them up with whatever services we need. we work with a lot of, i

think most of the clients that we do work with are challenged in someway with a physical disability or mental health or cognitive disability. we have clients who have had traumatic brain injury due to violence on the street or due to extreme alcohol abuse. a lot of clients with dementia a lot of seniors, a lot of clients with service animals. or there are pets and we make them become service animals so they can stay in the hotels and get permanently housed and go to the clinics.

>> i think that's about it. >> thank you for presenting in council and informing us about the most vulnerable population. cochair supanich has questions. >> thank you for your presentation. i have sooner or -- some questions about the needs are inaccessible. where does someone what mobility impairness go with that physical disability? >> we would partner with transitions. they do have a, they have one hotel, it could be two hotels with

elevators. so if they have a room we can ask them. >> okay. you also mentioned that you have a doctor and psych nurse practitioner and nurse that travel around. do you have a van that you use to go around? >> we have four vans. they can be in vans. we are mostly on the streets. the vans are used to take you somewhere to whatever the district is. >> are prescriptions written and is medicine dispensed and is a nar can available. >> the coalition? >> right. >> great, we know that's badly

needed and when people appear to be sweeping, it could mean something else. >> right. >> okay, that's it for me. >> any other questions from the council before i turn it over to staff? okay. staff, do you have any questions or comments? thank you. >> so the comment that you made about the stabilization rooms being used for extremely. i'm not sure if i understood correctly. the stabilization room doesn't exist anymore as a model. now the stabilization takes place in a shelter environment? >> we enough shelter bedded for everybody that we are case managing even. we'll place people in the stabilization room. treatment is like a laos treatment because we need

to find someone to get their i'd. we have a 2-week period but it can be extended. we have clients under going chemo therapy, radiation. we wouldn't take them out after 2 weeks. >> i thought one of benefits of the stabilization room program was to help them build capacity to transition into a more permanent housing environment and be able to function and thrive to sort of regain some skills that have gotten rusty while living on the streets. >> when is client are on list, when their name is going to be coming up, it could be like 2 months from placement, then we'll put them in a room so we can see whether they are going to

need ihs or care, there are all these issues that come up. we'll address them in the end n our capacity we have like 120. so, it's, you know, it's hard to say who you will give that room to. they all deserve to have a long term room. >> and the business model from one to the better description has changed was with the organization last year for a way to trying to do for everybody which is not realistic as you focused on what is for the high user group. do you have a sense of what is, what are the resources for the people that aren't the hums? >> well, because we don't, like our whole case load right now isn't hums. if we have opens, we take other

people as well. we do have people like i said, you know, the people that have terminal cancer, they are going through therapy. there isn't necessarily hums or high users. it could be the outreach. we have several, we have the union square bid, we have the caseworker assigned to union square. we have the castro care, the 16 hours of case management assigned to the street outreach. if they identify people as well, we'll take themmen in and get them housed. people on ga to get them housed, the list goes quicker. it's always been the focus to try and focus on that population.

>> thank you. >> hi. i'm very glad to finally put a face to the name. i have to say i'm really confuse d about the new model. are you all staff members from the department of public health or are you part of an outside provider or contractor? >> there is still the hsa collaboration, collaboration is hsa, dph and public health foundation enterprises. the majority of the team with the contractor is with public health foundation enterprises as with cats before. >> that's why there is a different contractor and why the names and the face changed.

you mentioned that you lost a backup of hotels, lost stabilization rooms many can you speak to that. why that is and was there a financial we should -- issue with that? >> there was a lawsuit. there was like ten hotels that were identified that were substandard. so we lost because of them. we still have clients that are in some of those hotels by attrition. as they get permanently housed we are not renewing. >> by saying you lost those hotels you are not able to use them anymore for stabilization? >> right. >> and the baldwin just turned to master lease. >> the baldwin and the civic

center. >> right. okay. that is a lot of challenging work, isn't it? thank you. >> i'm going to open up for public comment at this time. thank you. >> we have jackie bryson. >> good afternoon, i'm still jackie bryson as the beginning. i'm just more well informed as a jackie bryson and i'm very happy to see that the hot team finally made a public appearance. this has been difficult. the san francisco local homeless board has wanted to have the hot team come and make a presentation. we were hoping for april, but there seems to be a conflict