hundred or 80 days in shelters not good for kids or families. >> so approximately did you say hundred. >> it is about i said about hundred and 50 it is about hundred and 48. >> looking at our numbers that will- if we were to let's see another $5 million for families housing that seems to be the number you'll need to take care of. >> so of the absolute numbers that sound like it is right the subsidies it is tied to market rate housing and what unfortunately, we've had to do is make that decision is it better to have a family homeless in san francisco or houses in other county waiting for a unit we can acquire without the rents medium rents $34,000 if a family

can move to another county with better rent we're still providing those services and support that's what our nonprofits are forced to do. >> you probably said it the $2 million for the 6 of homeless families. >> it is actually we've housed 66 families with less than $2 million we have several million dollars we have allocated to how's house 2 more families. >> those families are housed elsewhere. >> yes. the last numbers were 70 to percent. >> and that's recorded from the - >> it really is a new it calls for a new strategy around the support programs give us an

example the way that the cal works works if families move to another county other than san francisco that services is to be transferred we have a robust cal works program with earlier education that provides subsidies for the children and two to another county their kids could be in school we have to reorient cal works to get up e keep that intact it is a challenge one we're committed to a family might move to alameda county or oakland if they're in a subsidized job we'll pay for the transportation they'll be consulting in but really is it is a change in the way we're approaching our services and with our nonprofit partners the hampton families are up in

oakland to better provide supports for families. >> maybe this is probably more a question for office of housing do you see structural changes we can make with the revisions other than the middle-income. >> well, i'll defer to mr. olsen. >> there are changes that need to be made at the state level transferring a case out we need a more reasonable approach to the assistance programs all of a sudden the family goes to another county didn't make sense we need to examine can we reorient our system towards a regional approach with a

regional transportation promissory note program not a regional heirs system of safety nets so that's my - >> just one more pious and i'll move on but the jobs that the subsidized jobs our talking about and many of them may get permanent eliminates plummets are those in san francisco. >> yes. almost exclusively. >> we fix the housing. >> we talked about the regional approach we're restricted to use the dollars in san francisco why wouldn't he explore the regional county like alameda county. >> supervisor if i could since you were doling out the tuesdays i want to thank joyce and scott

for stepping up on the navigation center and have come online they deserve a lot of recognize. >> thanks. >> good afternoon supervisor farrell and committee members i'm with the department of aging and adult services i want to highlight a few areas we have 4 areas in the amp and adult services within the division i want to highlight where we're lo the risk of seniors and folks at risk of homeless or living in poverty the first i guess our corner stone program the in home service program we serve over hundred and 22 thousand people

in 9 program i'm sure you're aware of the program is really the home care non-medical program that helps people stay at home we've kind of seen the small and instead growth a few years ago we saw a lot of growth but it is slowed down and we're seeing e seeing about 4 thousand applications per year currently 73 percent of the clients that were 65 or older and 40 percent live alone and in addition to that we have 19 thousand who have independent provider and 62 percent of those are relative caregivers their children serving their parents 42 percent of the index h s are chinese 9th and 37 of all our h

s a clients speak cantonese one of the things we're able to do partly because of the growth and changes within the program we're looking to go beyond the general ascertainment that our social workers do to make the ascertainment of hours we're starting to look at things that are important to help at risk people dementia and looking at dementia screening and the others we're starting to do an initial depression screening the i h s social workers are the first line of defense with people that have dementia and we have a small unit that goes out to see if people need extra services we're looking to implement in the next year we've started to look at hunger

among the h s clients to see if they need food. >> supervisor mar. >> this will help me understand more ms. mcfadyen what's the financial requirement for families to qualify. >> medi-cal level. >> what would that income level be generally. >> hundred and 25 percent of the federal powerful level. >> you mentioned a lot of the of the seniors are isolated and living alone for a single person what would it be $10,000 a year i'm trying to remember what the - really tiny slight. >> $11,000. >> a person in san francisco living at $11,000 a year. >> right. >> the caseload has not been going up but a small slifrth and

many are isolated living lift ev'ry voice and sing by themselves there's a great group caring across the adjudications that is looking at how home care can be subsidized or home programs can be created so a larger group of seniors above that level in poverty could hopefully stay in san francisco i know that is a national effort from the national alliance is working on i'm realizing what a small slither of extremely poor. >> and some people that qualify for above medi-cal but that requires them to pay a share of the costs very expenditure our next area is the protective area services division i want to

highlight the adult protect services program we list all the various neglect cases and i'm pointing out this because they have been some really high profile cases on cluster and harold throughout the city recently and health and safety includes that is sincerely in terms of the highest number and our staff is trained to investigate to see if there is a finding of self-neglect and they work diligently to try to get services the challenging piece of the adult protective services the orderly adult has to agree to services if they have capacity it is challenging our staff is working with them but it is difficult

we have a hoarding pilot we have one dedicated working that is doing inner testify work with the behavior and we'll have the results we've wrapping that study but hoping to see some promise from that approach in our adult protective services with neglect have increasing one to 3 percent every year right now next division i want to highlight our long term care operations division specifically the community living fund we're looking people living in poverty it was a program put in place in 2007 by the mayor and the board of supervisors and really the focus was to look at people that are above the small sliver so

what this program does it 3 hundred percent of less of the poverty level about $30,000 give or take for a single individual that program is really intensify case management they have money to buy equipment or help someone with rent or help with counseling home care it helps them stay saving at home and it is a helpful model this chart really highlights the fact it didn't cost much purchase of service dollars to help someone stay at home the majority receive the community living fund actually live on $2,000 or less and the purchasers are small one time

thing seconds this chart the most often used purchase certify is non-medical home equipment but more expensive items like home care and boarding care is expenditure and the staff working hard our staff works hard to strategy i didn't see or allergies how and spend money so they don't go over open the long term costs we're starting to see the needs for that increase we're spending more on those. >> next, i wanted to talk about our community services and intact division that includes the county and the county in take division i wanted to point out in county veterans services

office we're finally seeing a decrease in 2014-2015 we're seeing the decrease in the termination and there's a couple of things that led to the increase one we have a small staff doing this program and we were actually missing a couple of staff doesn't have the capacity but the other thing the veterans administration i think probably you all read about this in the paper but the conveniences administration is doing a horrible job of processing claims they have in 2013-2014 the veterans administration changed the way to process the claims added staff and now those claims are going through much quicker and simultaneously we fulfilled position weigh seeing those come

back down we have we can't control the veterans administration the veterans administration the process is very comprehensive and our staff makes sure the applications are implemented before they get to the veterans administration their claims are really ready to be approved and often they have to resend and resend we're seeing a decrease and finally wanted to highlight this is the $2.8 million in nutrition add backs you all approval for ammunition in the department of the aging and adult services we are jew just now getting this money out the door of the majority has gone into meals and younger adults are disabilities we've enhanced our grocery

program which include home delivered groceries for people that can stand in line or homebound that is one of the areas that we're in port of the services that is starting to assess what hunger we're working with the food bank specifically and we can have i h s providers pickup food for their clients it's a another food source in home clients last thing i want to talk about we're able a new public facing site with families with disabilities for that years we've not have a centralized location we're at 5060 missions it is hard to navigate we're exciting we're going to have a new sites on the corner of golf

and otis and do everything that goss does with the app h operant and the transitional care but process applications for medi-cal and, california fresh and be part of the cal system with h f a is a better integration and it is also a really hopefully good comfortable place for seniors and people with disabilities to come and get service. >> that's it nonetheless you have questions. >> supervisor mar. >> yes. that's existing a one-stop center that combines all the services with people with disabilities and seniors when it that i i know that's an

identifiable when will that center be up and running. >> hopefully in august or september we'll do a soft launch get the staff in and do something bigger last night. >> what the food security task force and the san francisco general has look at the need it is tremendous for the need was way bigger than the city was able to provide i know we as a a board of supervisors passed a resolution committing to end hunger by 2020 you said money was added back it is only we're only starting to those projects with home delivered meals and groceries and community-based aggregate lunch meal programs

can you dlaubt on that it was my expectation we'll be addressing one quarter of the san franciscan that our budget analyst identified many of them children and growing number of seniors and folks with sdabltsz. >> we have all those programs going we'll have all the money out the door and flowing i took a little bit of time to look at how to allocate all those funds and you know with us we take a lot of time to work with the community providers to strategy allergies the best way to get the money out the don't worry about we've deny that we haven't had time to analyze the

effectiveness to see if we get more funding. >> last week, i was with the coalition of agencies on the rally are as on city hall not only planning for the senior and disability action on third street and many of the centers they're saying that in san francisco we're only serve half of the seminars that need the home delivered meals and fraction that needs accident home delivered groceries we're starting to address more of the population in need in the rest of this fiscal year and leading into negotiation. >> yeah. we'll looked at the effectiveness of the program we have a strong planning unit they're looking at this issue we're mindful we have limited dollars and the network serving

the aging of folks is a credible balance and nutrition is an important part but without the services it is hard to keep folks adams home safely we have to look at that as a system. >> and i asked trent a moment ago about the large number of 20 thousand statement that are medi-cal participant eligible for cal fresh and how the outreach team and the new hires will address that population. >> right >> is that in a one year period what is our yeah. what's the plan so we're insuring that as much of the 20 thousand can be enrolled as quickly as possible. >> into cal fresh i can think about that from a dos prospective one of the things

our staff do we're hussein thirty this process to look at every person is a person for the plan so when we get a referral both our in take system the first one is ask about the cal fresh first to see if that individual qualifies for cal fresh and start looking at other programs sometimes, people qualify for more than one and sometimes only one but they're trained to look at all the programs to see the best fit and our in take manager works with the cal fresh manager and figuring out how to get people own cal fresh if they qualify. >> and the last question you mentioned the community living fund that is important i know the aging housed the sf village

we have the next village a model of bruno heights that no longer exists but serves the my mind and other populations on a neighborhood level but the community living fund is an important part of that in addition to other institutions and i know that as senior groups rallied the demand was to add $2 million to the funding for the community living fund with 62 percent to support board and care facilities and adhering transitions and 36 for home care for people that can't access h s and 20 two percent for home modification to make home for assessable how much is the huge needs for the senior population

will be involved with this budget. >> which of the $2 million with the community money the folks are asking for this is not a current request. >> okay given the boom of elderly we're seeing roadway for the next 20 over and over thirty years in san francisco as our population will grow to be 1/3rd of all our city being seniors of people about 60 do you think we're an age friendly city and what can we do to call ourselves that. >> we're an age friendly city a couple i guess of groups have said that we can certainly do a much better job we put a lot more resources into the services than many cities do but seeing an increase in the population it is hard to keep up with the

demand. >> thank you. >> colleagues if there's not other questions i appreciate your hanging around here we're going to turnover to the department of public health barbara hale and others have been waiting for awhile thank you. we look forward to our our conversation. >> good afternoon, supervisors barbara garcia director of

health what we wanted to focus on the key issues for our 2015-2016 and 2016-2017 budget years you've heard a lot in the previous hearing about the affordable health care act presentation and we and our response to the affordable health care act does focus on vulnerable population and health disparities we've respond to that through the san francisco health network the integrated system we've developed in the department that delivery system from primary care to long term care at laguna honda we also have focused on the population health program that works on communicable health disease in our affordable health care act prelims we've increased enrollment in thetions for all individuals in san francisco working with the h f a and expanded the access to care to

thousands of individuals in the city and one of the things if the affordable health care act is that we have to show health outcomes and proved quality of life so we put a lot of effort into those areas this year we had the great opportunity with having a good revenue based to restore health care programs from prior budget initiative and you've heard a bit from the director of h f a about the citywide programs we've worked with with human resources i mean the human services department which is the navigation center we've provided all the homeless outreach teams and identify people in the street and bring them in and responded to the behavior health program and services

program 5 hundred is another initiative to work with 5 hundred families and work with identifying families that are working who are part of client basis in our department to work with the families who we are already being case managed is a good way to sdwrath h f a we've had an expansion to a recontracting toga new organization we've increased new medical outreach teams and we're pretty much 85 percent staffed in the area of our dispatch area we've also this year be able to invest into the public the federal government between cdc and hertz have lowered our

financial dollars in those areas and so we really want to build our ability abatement in health response particularly around commemorative disease today, the mayor announced the expansion of our medical respite we have a medical respite open ace and mission dollars that will be receiving from the mayors will add thirty additional beds and targeting to those in our shelter system not doing well mel and psychologically the medical respite had been attend to the needs of homeless and vulnerable population and we believe that will lead to better health oungz while avoiding health cost there's are a lot of

9-1-1 calls to the shelter we've added nurses to the shelter to help with the begin of this process the nurses had been part of the referral system was we build upon the medical respite it takes 6 to 8 months for restoration and we look forward to the terrifies services to start as h f s or a we have a permanent direct housing presently 7 by 7 hundred units over 37 sites over the last 5 yrlgz years we've began a laguna honda rental preamble and providing hundred and 50 units to people that can do better in the community for the many years providing over 6 hundred