that is really not a long time. i was pleased to have that number because i thought that is a manageable number. unfortunately it isn't manageable for adult protective services give chb the high level of cases we are dealing with, it is a a challenge to keep cases open for 4 months. it is a obstuical to provide visits once a week a month. 88 percent resolve the health and safety code viications and 75 percent of the client preserve their housing. we didn't preserve everyones housing which is unfortunate and part of the learning process. we did also find there were benefits from the model in terms of mental health improvement, anxiety rates were improved, but what we did find is anxiety rates at

certain points flux waited. it causes anxiety to become aware of what is happening to open your eyes to the seriousness the hoarding and cluttering. we found there were times the anxiety rates spike but overall there was improvement. there were improvements in levels of depression. depression was very commonly found among folks in the pilot study. in terms of hoarder rating scales, not going to go into the hoarder rating scales, but we use scales doctor [inaudible] was able to recommend for us and found those who were living in conditions that were the most cluttered recollect probably the most at risk they improved the most. they benefited from the

intervention. we a actively trying to find way tooz integrate what we learned from the pilot into our practice. one of the things we have done is embrace a harm reduction model. harm reduction isn't new to adult protective services but where these cases we have clients that are living in a sro yount filled to the brim and maybe bed bugs on top of it and the only tools we have is say, we'll pay for a heavy clean up and that is why have a picture of a man in hazmat suit because we do that. we will pay for a heavy clean up. we are not doing it because we want to, but it is really in many cases is the only recourse for us. in some instances with pilot participants we did pay for partial clean ups to try to get the

unit, the residence to a manageable level where the client could start to actually address the hoarder and clutter situation on their own. sometimes it was so over pp weming trying to do a partial clean up. we are lucky to have a special payment fund, tangible service for adult protective service. they are meant to pay emergency food, emergency home care, rent, getting your locks changed in domestic violence, we used them to pay for heavy clean up vendors. i don't know if this is happening across the state and grateful for the funding to do that, but this year we spent over 50 percent of our budget between july and september and the vast majority of what we spent was spent on

heavy clean ups and bed bug preparation. there is very often bed bug infestation that go along with hoarder and cluttering. it is a challenge for us and struggle to manage those cases. we did develop stronger collaboration with dph and environmental health and also cbhs. the cbhs was able to hire this past year a psychiatric social worker working with environmental health and it has been very very helpful the psychiatric social worker who can try to engage clients opposed to just going out and citing because that is what environmental health does is enforce a regulatory code. they site, they don't assist. they don't resolve socthis position is very helpful. my sense is

they need more staffing and we are struggling together to try to handle the cases the best that we can. we have made progress. we have a long way to go in terms of-i'll get to recommendations. i'll skip this slide that allows for engagement in the sake of time and talk about recommendations. recommendations that came from the pilot study and also just from looking at the service gaps from the aps perspective is that we really need to development home based case management and skill building that assists adults with disabilities with hoarder disorder. there is no specialized case management service for adults that have hoarding disorder. there are case managers throughout the city that are working with clients and trying to help clients that have hoarder disorder, they don't necessarily have the

training. i know for a fact they don't have funding they may need to pay for partial clean ups. one thing we would pay for is plastic tubs and shelving, this makes a big difference. how do you organize if you don't have storage? i think about my own closet at home. we need to have this case management, it is doesn't exist now in the city. also, we need to make sure adults with hoarder disorder have the ability to access quality-high quality treatment in behavioral health care. this is a mental health issue and know cbhs is working to try to increase capacity, increase the level of expertise. we had a struggle. they are struggling with us and appreciate the partnership. it is a new area for everyone.

we are trying to learn together but now the case management programs that exist don't have the expertise. recommendations i listed, develop flexible funding used for low income adults with disabilities to assist with decluttering. this is referring to the funding. i think other agencies especially community based benefit from having a flexible fund for small client emergencies. sometimeatize is a hundred dollars but where do you get that to pay for key items that may the difference. developing bed bug eradication. aps is dealing with a lot of beg bug cases. we don't have the expertise to deal with beg bugs. that is a whole other day. it is a major issue. there is no place within the city, there is a doctor

[inaudible] in charge of environmental health and provides his expertise but he can't do it alone so for social workers it can be complicated. if you talk to someone about how to eradicate bed bugs especially in units that are filled to the brim, it is very very complex. insureing all case managers that work adults that have hoarder disorder they have access to training, high quality training. right now mha has training and they don't have the funding to offer it for free. providing additional funding so the high quality training is free and accessible for community based organizations would so helpful. we are helpy to help with training but our department can't do it alone. i have slides here that will

show another client, this is a success story. this is a bedroom highly clutders and there is a somewhat section of the bed that is usable. there is a lot of hazards. tripping hazards. we see a nursing home stay or hospitalization could happen from tripping in your own home. this is a picture that shows success. we have a client with a double bed to sleep on in a nice clean bedroom. the dignity that we provide to people when they are able to sleep in a bed comfortbly and cook in their own kitchen, it is remarkable. i want to turn this over to john franklin. thank you for letting me use so much of your time. >> this will be a short a

ddendum to what jill said. john franklin. manager of the institute on compelsive hoarder and clutter and the response team. a couple years asince we have presented at the body and nice to be here. i'm cochair of san francisco task force on compelsive hoarder. [inaudible] clabilator on the program and outgrouth suggestions. we are so grateful for aps moving outside of their lane and doing this necessary project and also to building inspection to have the documentation that says this works, we know this works. in 2009 and i can send this out to folks, this report on beyond overwhelmed had all the major players, dph

[inaudible] on this report and they addressed the impact of hoarder behavior in san francisco and recommend specific proposals to address the issue. many of the proposals are imlmented in the last 6 years. we know what works. the hands on long term case management and skill building. thank you aps to take that on and prove it works. on our side the peer support including support groups, home visits and really modeling the realty of recovering. a side note, i was talking to my sicrytist at kaiser and it came up what i did for a living and he said you mean people really get better. yes. that is exact late what we mean so that is what the peer response is bringing and we are internationally known for this model. also, access to treatment

specifically cognitive behavioral therapy is what works. nha and ucsf are completing a study-free treatment for 300 people 16 weeks of group therapy-16 sessions over 20 weeks and we are starting to compile the evidence of that and yes it works and the peer base and therapist led are about equal unless we win. that is 300 free treatment lots over the last 3 years. all these projrects established san francisco as national and international leader in understanding and responding to the challenge of collecting behaviorment we are it, i get called from around the world and do a international conference every year. nha has been involved for 17 years, that is way before the

television show made it popular. unfortunately many services are ending, like the high top program or ucsf study are cut back bike the peer response team. department of aging and adult service is a supporter of the key services so thank you again. going forward the main challenge of our task force is assure the services are fully funded and available of people. i'm here on behalf of the task force to invite you to our every other month open meetingsism we have one next friday, january 22 and that is at department of aging and adult service from 2 to 4, 1650 mission street. 5th flew. if you would to talk to me about that i'm john franklin, that is

john @ mental health.org. [inaudible] we had a great last 5, 6 years and would like to take it to the next level so thank you and any questions jill is here too. >> any questions from councilmembers? okay. >> thank you presenters for being here today. i'm very excited about this pilot program because it connects people with the service they need besides the hoarder problem and they can be a part the treatment plan to see their environment change and therefore as you show the results, cuts down on evictions and getting them the help they need so i think this is very exciting program and a great step going forward trying to identify

bouse housing is a key issue for people and seniors with disabilities in the city and county of san francisco. i commend the program and hopefully you will come back. like to hear more stories about the clients and impact and know you mentioned funding and training is a crucial part of the program. thank you very much for sharing this with us. >> thank you. any other councilmember? i would like to say i'm very excited [inaudible] are being applied to this intervention. i am a big harm redictionest, i don't see any challenge that [inaudible] client standard approach, they are part of the process of change, you meet them where they are at and progress is charted and they can see how they changed. i have a

friend with hoarding issues and what i found to be one of the sad sas pects of this is the isolation they produce. they don't want people over and if they have someone over there is no where to sit and visitors are aghast what they find. i think the weekly visits would start to relieve that and also it -the shame and guilt surrounding the disorder. i think that is one the biggest barriersism . thank you very much. no one crossed that thresh hold in 10 years. we just recently thank tooz the dos funding started a family and friends support group to help how tasupport these people. i think the most frustrating thing is

thumount of time weep spend looking for things, it is challenging to be his friend. also, the other thing that occurred is this is like a process of becoming conscious and that can be painful and cause depression and anxiety and be a complicated process for people. that is why we have been around for 15 wreers because i get calls from people saying i was in your treatment group. [inaudible] we are still there and we still have the week laely support group going on for 17 years, so it is that long arch and also the immediate eviction help that aps can give and all those things are necessary. >> i have a quick question and i'll stop yakking. what is the percent of

relapsh? >> i could guess, but since there has never been a long term study- >> i think a lot of people once they recovered-it isn't something you necessarily because of the stigma want to cop to. we have a wonderful core of people that had the recovery process and harm reduction principle is building for relapse so would say extremely frequent. it is nice to people, if you come back 3 times at least we are there to come back to. people report it was easier a second or third time to get it back under control. >> thank you. any staff comments or questions? >> i want to thank jill and john for being here. i have a question and john you mentioned the tv show

giving light but i imagine this issue has been around a long time. my question is why suddenly are we giving the time and space that it deserved over a long period of time? >> that's a good question. in therapeutic literature it was considered a minor subset of ocd and now it is much more prevalent and everybody knows that. the same happened in england and australia people say we don't have that here because it is so stigmatized and secretive. there are studies it is more stigmatizing to have a family member with hoarder than acute out patient schizophrenia. i know

the research was only in the last 15 years and that-the television show which is a noon realty show that keeps my phone ringing, when that took off because it is so senitational, it is a secret, it did bring a lot of this in the open. people are on the team and said i didn't know and i was watching oprah and there it was, so the idea there is a community and hope and hope for recovery all of this is very very new and very exciting. i guess we all to go through the door of the hoarders tv show to get there, but it really was a help. >> thank you. >> anything else from staff? do i have public comment from this item? yes? this comment is-general

comment but do ayou want to comment on this specific item? we'll come to that soon. we have general public comment in a couple minutes. >> [inaudible] my name is [inaudible] retired physician and i'm a member of the california senior legislature and a member about 14 years. i'm here to complain about a agregious problem with the complaints that is filed with the department of justice regarding lack of hand rails on public staircases in the city of san francisco. as a member of the california senior

legislature we find it a serious problem. the reasonime i'm leer is because i went to the department of justice in washington and recommend you start off with a local administrative office. i went to the office of [inaudible] and they recommended research that i address the mayors office of disability, so i did and the reasons they recommended is they did research work and this is what they told me. at t park was build in accordance with the california building code and ada standards. this was sought to insure optimal accessibility and has exceeded ada requirements according to the

mayors office on disability. as a result of [inaudible] between the giants and city and county of san francisco, a redevelopment agency, architectural firm were appointed. the city was involved in all the planning and ada coordinator was appointed a member of the cities advisory board. i sent that to the mayors office on disability and this is what i got back in return by e-mail. thank you for your e-mail, both [inaudible] reminded you by telephone, you can follow up and complain to the following people. the department of building inspection, department of justice or call att park. i e-mailed him back, hello

[inaudible] and donna. thank you for your time and interest in the following complaints to the mayors office. it seems the ada coordinator was appointed a member of the recreation advisory board and safety hand rails were not built in all the areas of the stadium. as a retired military physician i would be the ultimate responsibility of the mayor as captain of the ship to be sure the ada [inaudible] what i would like to do is send someone to pass this around so they can see what i'm talking about. i'll get them back hopefully. the stadium has been there since the year 2000 . i made complaint to the

stadium with no response at all. saying 40,000 people are and-seniors. when we get old we get frail and loss of balance and it is dangerous to go up or down stairs with the hand rail >> we'll take tyke to look at the pictures but public comment has run up. your time is up but i'll will take a look at the pictures. i want to thank mrs. franklin and nielsen for coming today. the next item is [inaudible] >> thank you, carl rujohnson director of mayors office of disability. i have 3 items, the winter shelter program and el nino storm. the single room

occupancy elevator project and new ledgeilation on all jnder bathrooms. after-my report i want to turn things over to donna to tell more about the crisis intervention team training she has been a part of. first on the winter shelters and el nino, el nino is here and characterized by greater than normal heavier rain fall due to the warming patterns we have over the ocean. for people living on the streets of course without shelter this is something that can become a life threatening event to be exposed to rain and cold for period of time. it can cause a variety of illness, pneumonia is at the top. for folks in

tents the tents may give shelter for a few hours but if you have sustained rain storms that in and of itself isn't enough to protect you. each year around thanksgiving the city of san francisco in collaboration with the interface council opens up the winter shelter program that takes place in a number of different churches that open the doors, but because the rainy season this year is so much heavier than normal, the city planned to set up these pop up shelters to try to house approximately 1200 people we would expect may need to take better shelter. the pop up shelter program is something that is really organized through the human services agency and most of you know ben aims who is the emergency response coordinator for hsa. what

human service agency and health department and our office and the mayors office and a variety of other parties do is we monitor the weather reports to see if the rain is going to be for one night, 2 nights, how much will it be, how cold will it by and based upon that information the city plans to open up temporary shelters to get people through the storm. now, last friday was the first activation of this new emergency shelter program and what the city did is 2 things, one was they increased capacity at the existing homeless shelter sites. placed like -the shelter that is at 8th and howard. also the shelter at 5th and

bryant run by saint vincent de paul and shelter on polk street and they have rooms where people come in and sleep on mats. the first response is increase capacity at the existing shelter system, but the second response was actually to open up temporary shelters to recreational and park facilities. one wasue gene friend and the other mission recreation center. the shelters open last friday night and staffed by city staff primarily from human service agency and visited by a medical team provided by department of public health and i stopped to see how operations were going last friday night and they were not to capacity. in other words, there were not as many people there

as there were mats for people to sleep on, but my observations were the people who came in off the street were so happy to be off the street they fell asleep all most as soon as they got there which i think is a indication of their relief and appreciation for having a safe and dry place to sleep. what i rely appreciated was that the shelter staff created these little gift bags they put on their pillows that included clean socks and a snack and it was like going the ritz. the special feeling you get knowing someone left you a gift. my report on that first activation is i thought it went really well and key to that success was really the involvement of the homeless outreach team, the hot team members who developed such

a great trusting rapport with the community so when they go on the street and find that needs shelter those people trust them and accept their transportation to that site. the latest conference call i was in on today, they are considering doing the same thing sunday night this week because it is expected to be about a inch to a inch and a quarter of rain, but as of the time of the conference call they hadn't quite made that decision. on the information side for people who want to know when the emergency pop up shelters are activated and where they are located, the best contact really is 311 because 311 is the central service for information and referrals. another good

resource would also be going to the sf 72 hours .org web page. last week they used that venue to help to publicize this. also recently staff asked me the question, what should i do if i see someone on the street that looks like they need help. looking like they need help could be maybe they are walking into traffic or perhaps they look cold or they are not responding when you speak and the answer to that question is any member of the public sees somebody on the street that looks like they need help is first call 311 assuming it isn't a life threatening thing that you observed, but if you have seen something that looks like somebody is clearly ill and requires medical

treatment then you want to call 911. those are the 2 resources for people who really want to help people that they see in need. we will continue to keep you briefed on the pop up shelters as they go through and if they open sunday i'll visit again to see how things are going. there were a large number of people with disabilities that took advantage of the shelters. it isn't the easiest thing to transfer from your chair to the floor, but i think this population actually does that often and even there was cost available they chose mats on the floor. the next item to tell you about is our sro elevator project and this is a nice segue continuation with the senior and disability speaker we had earlier because i think you probably

have remember how we talked about this issue as a serious advocacy need around people who live in single room occupancy hotels primarily older buildings and the older buildings have elevators that lived long past their life span. what happens when the elevator is old and needs to be renovated is they break down. for many people who have disabilities and seniors living on fixed income, this is a source of affordable housing and if the elevator in the building breaks down you can be trapped in your home or trapped outside of your home for hours, for days and months in some cases. with senior and disability action advocacy the board of supervisors

allocated 250 thousand dollars through jane kims office and that 250 thousand dollars is with the mayors office on disability and what we are doing with that is we are paying for elevator assessments at sro hotel locations. the thought behind that is if we give the hotel owner the information about what is needed and a estimate for how much it will cost we are more likely to get the cooperation to actually start the project to be able to do these very very important elevator over hauls. we did a outreach to sro hotel owners and have our pilot group now of 3 who accepted this offer and we will be scheduling the elevator assessment very soon. we just referred that

over to our contractor. our hope is that this is phase 1. we do the assessments with the 250 thousand dollars first and what we can do is demonstrate the need to the board of supervisors to develop a loan program or a actual grant program to really help these property owners take on that task and fix the elevators. the next item is all gender bathrooms. i have worked with supervisor campos office and specifically with his aid carolyn gusen and [inaudible] from human right commission and jessica nom[inaudible] on new legislation for all gender bathrooms that was just introduced this

last week. the legislation is cosponsored by supervisor farrell and it will apply to public accommodations which are privately owned businesses, bars and restaurants as well as city owned or leased facilities. what the legislation will do is it revices the plumbing and building code to require existing single occupant restrooms currently designated as gender specific to undergo a change and become all gender restrooms instead. the beauty of the legislation is it doesn't cost hardly anything because the way you make that change is just change the sign. the importance isn't to be underestimated because the transgender community and gender ambiguous and neutral community faced a lot

of severe discrimination and safety concerns when they make a effort to use a restroom that somebody thinks they shouldn't be using. we are so proud to be a part of this effort because this is about human rights, this is about civil rights and dignity, but it is also about disability rights because we have many tales and experiences of people with mobility disabilities who have a family member or personal care assistant that accompanyanys them to a restroom that may be a different gender. it could be your spouse our your employee and what happens is people get challenged going into a restroom if we have two people of different genders going into that space. from a accessibility

perspective what this also means is that it doubles the options, so if you have a mens and womens restroom you have to wait for the one that is available, but if you have both of them as all gender restrooms and we are talking about accessible restrooms now you have the choice of both. there was a press conference last week and joanna [inaudible] spoke to share her experience from the personal care assistant perspective, but also as a parent of a small child and how this is something that is good for families because it is not always the easiest thing to take your child into a differently gendered bathroom. we are very happy to support this legislation and we can keep you posted as progress is made and moves from introduction to committee to full board

hearing. that concludes my reports today and at this time as i mentioned-did you have a report as well? we have 2 staff reports. we'll start with [inaudible] who will tell about the trends since we last met and after that we'll transition to donna to talk about the crisis intervention team. >> good afternoon council and members of the public. healther kittle and ada grievance and intake coordinator at the mayors office on disability and it has been a while since i presented a case summary report for you, so for today i'm going to discuss the different complaint trends and issues the office received for 2015. the office received

701 inquiries which involve information referral and request for ada assistance. 94 percent were made from thapublic and 6 percent from the public. [inaudible] legal resources and questions about the requirements providing effective communication for deaf and hard of hearing individuals. we also processed 106 complaints, 55 curb ramp requests and 12 requests for accommodations. the main complaint trend report were instruction tooz the public right of way that had to do with construction zone jz blue zones blocked. we had complaints about accommodation issues and service and housing service programs. we aul increase in the report about effective communication issues and the

issues involved barriers to service and participation for deaf and hard of hearing individuals as well as blind individuals. in these incidences staff were not aware of the responsibility to provide effective communication and as a result of these complaints they were reminded of the cities obligation to provide effecive communication and trained to provide the preferred method of effective communication, the auxiliary aids and service. there is a increase in reports of effective communication issues because our office conducted a outreach event to the deaf and hard of hearing community to inform them about their rights to request these types of services so they have a equal opportunity to participate. denise [inaudible] joined us at

the event and were glad to have her there. event organizers and businesses to be mindful to make sure your programs and services are accessible to everyone. everyone has a equal opportunity to enjoy them. this can be as simple making sure any televised events have captioning on. it is simple to do and something that is over looked at times. another resource for you that we have on our website for businesses and event planners is accessible event check list and the list includes information about how to create a acsaysable meeting noteest, how to choose a site or losquaigz create a set up and provide effective communication. it can be found on the website at www.sf

gov/mod. and another reminder that if you experience a disability access issue or have a question or concern, please contact the mayors office on disability and we can provide you with resources or assist with a complaint if it is related to a city program or service. you can reach us by calling our office at, 415-554-6789. or you can reach us by tty at, 415-554-6799 and you can also e-mail us at, mod @

sfgov.org. or simply call 311. this concludes this months report. thank you. >> good afternoon councilmembers. i would like to give a presentation around the crisis intervention team. given some of the interactions between the police department and people with mental health disabilities i did want to give background about a meeting that happened in mid-december between members the crisis intervention team working group and chief of police, greg sir. the crisis intervention team as you may know is a group of highly trained specialized officers that go through additional training how to interact with people who may have mental health or behavioral issues and

how to use what we call, time distance and repore. the working group consists of the mental health board, tenderloin housing clinic, public defender and community based organizations and people who have come in contact with the crisis intervention team and helping to lend their support to the training. this meeting took place in december, it was about 6 or 8 members of the crisis intervention team working group and out of that meeting came a commitment from the chief of fincncial and human resources into the crisis intervention team program to help support the week long training. next week is a training happening for cadets. it is from

tuesday of next week to friday. i have been asked to give a presentation work wg people on the autism spectrum and best practices on interaction techniques and what to look for. i want to give that a update because i know it is something that is in the news recently, so it is nice to hear we are moving forward in that collaboration. thank you. >> thank you all for your reports. general public comment about items not on todays agenda? alright. we'll move on. is there correspondence? >> there is no correspondence >> councilmember comments or announcements? >> no >> we'll move on and adjourn. thank you. [meeting adjourned] behal

the

staff at st. anthonys it is great to have your here this morning. [applause] >> here at st. anteanys work with people who are homeless and those on the virj of becomes homeless and what we have sheen more aunch unforch-footly than not is people that feel isolated and excluded so very happy to see when the mayor has something to say about the homeless pop ylgds he comes to the tenderloin and st. ancyanys. we insisted those we serve the homeless in particular are not the problem, they are brothers and sisters. the problem has to boo with us and the way we structure our liferb jz cities and thijsss like that see great to see when we want to do something about homelessness the mayor is coming

forward and making good proposals for how we can solve our problem, not fix the homeless. >> [applause] >> there are a lot of people here working for years on that problem. it is a problem for the whole community but it is also one we need to thitsy to step forward to help us do so we welcome the mayor in his remarks today. without further ado, i would like to recognize a couple people here that have come and been long involved ing these issue. angela alota is here today. from the san francisco interfaith counsel we have mikem pops and rita chimal. supervisor marc farrell is here. supervisor jewel

jewel yechristensen and all the department heads here of the city and all the community based organizations that are represent. thank you for coming and welcome to st. anthony's >> good morning everyone. thank you all for being here. let me begin with just comment about some things that have occurred in the last 48 hours that i know are on peoples minds and want to address that right off before i get fl to had body of the speech. but i want to start out with some words about the officer involved shooting that occurred yesterday in the bay view and

rutted in the death of a man. let me first say that any time, any time, there is a officer involved shooting i take that extremely seriously and so does our chief. i have seen the video too you know, you look at the video and you just-before my words came out, we were yelling drop the dam knife. i already spoken to the chief and there will be a thorough and transparent investigation of this incident without delay and know the public deserves this and expect it and i expect it as well and will make sure the community knows all the details about this. i also want to take a moment of silence with all of you to remember the victims of the tragic and sensely shootings in san dern bernardino yesterday.

our thoughts are with the victims and families and the people of san francisco grieve with them. but you know, you know what they really deserve? those families deserve action. deserve the congress that will stop this madness, stop and by enacting sensible limit ozen deadly fire arms and they need to do that now. [applause] we cannot just accept this. we cannot just accept this. thank you. thank you. and again, good morning everybody and thank you for being here. first again i want to say thank you to the [inaudible] and barry for

hosting us this morningism barry you and the staff for helping the needy and velinable throughout the city is a inspiration to me and it is never tiring to cut turkey with you bury. i also want to say thank you to our elected and appointed officials and community leaders and pleny of the non-profits providers are here this morning, thank you for joinsing us today. i'm very proud for being reelected your mayor. this is a wonderful city and want to say thank you to the voters of san francisco who believe in our solutions oriented and collaborative approach to solving problems and have asked us to return to do more. thaupg for placing your trust in me for the next 4 years. this is the greatest city in the world and i'm

honored and humbleed as the mayor to serve another term. you know, i often said and will continue saying i love the city, i love it as much of any of you and also with you. i love that we never run from the challenges. we confront them with our progressive optimism and something that has come to define our city in all of us. we tackleed a whole lot this last 5 years and some the most complicated and intractable challenges remain and i ran for a second term so we can work on them together. foremost among the challenges wrun we struggled with for decades is homelessness. let there be more doubt, the collective best effort like service providers like all you in

the room today have certainly made a difference. i know that because i have been paying a attention to this for many years. while i may be a little silent sometimes, i watch, i talk to people, i engage and once in a while i might be lucky enough to hand out a key. you are the ones, everyone in the room, you are the ones giving the hor heroic rfts at front line staff on a midnight shift at the shet ers and do the outreach and are case managers with a challenging loud. or you may be the one cleaning up the streets so people might have a cleaner street to be on because that is the only place they have. the best evidence of all of the

work collaboratively is the over 20,000 formally homeless people living indoors. living independently and with the social and emotional support that they need and that the needs that are met with our city services or they might be back in their home towns. but, despite this we haven't eliminated homelessness. as we house and serve thousands, they are replaced by new thousands. people, people who fall in homelessness here, people sent from other states or people who arrive every day seeking a better life in our city. as a result we continue to have people living on the street, under the freeway, in tents on the sidewalk and some even without tents. all

together, more than 3500 people are street homeless in san francisco. human beings. human beings with hopes, with fears, susceptible to cold and rainy weather. human being who deserve or compassion. we know there are nearly the same number of people without homes that are living in our shelter, treatment programs or temporary situations. friends , this isn't a healthy way to live, you know that and i know that, especially if children are a part of that family. it is not just a growing problem here in san francisco by the way and we all know that as well. major cities across our country, la, new york, honolulu, seattle and more and the state and federal governments offer