attorneys and public defenders and mental health advocates, the conservatorship association, hospital, . so he's really trying to gather as much information as he can that will help inform further drafts of the legislation. so i think it looks one way now and will probably look differencely by the time it is finished and we'll see. >> ok. thank you. it will be interesting at some point, you know, what the opposition or the concerns are. so that we could all learn from that. earlier this week, i think the "chronicle" had an article that st. mary's hospital would be opening up more beds, to double the number of beds for people who need to be institutionalized for severe psychiatric problems who happen to be the most chronically homeless, but they are called the frequent flyers who -- so, that is a step in the right direction to address, give them a safe place to be. but it all is a package. it all has to work together and the laws need to be -- to give us more flexibility in making

decisions for people who clearly can't make them for themselves. >> it is a package. and i think even before the legislation passes there will be some opportunities to have people move into that -- into the new st. mary's wing. and i got to go to the press conference earlier this week with the other people that you saw. if you saw them in the paper. you know, i think what the health department is really trying to do with this particular wing is to make it much more -- make it a more clinical setting and make sure it's really comfortable. it looks very, very different from the state hospitals that i visited where, you know t floors are cement and there is a lot of emphasis on really keeping people separated. and all of the other things that actually don't really contribute to people's mental well-being. and they're calling it the healing centre because they really want to focus on it and have it be a place of healing. that was kind of heartening to see that.

that even if people have to be in a [inaudible] situation, that it is being treated that way and thought of as a healing place. >> thank you. any other comment or questions? thank you very much, dianne. next item on the agenda is the long-term care cooeder nating council report. >> good afternoon, commissioners. the long-term care kaord nating council has not met since the last commission so there's no report. >> thank you. tacc report. i don't see cathy russo. ok. and finally the case report. >> good morning, commissioners, director mcspadden. i'd like the apologize that no one was here to give a report last month. unexpected change at work prevend me and none of my fellow board members was able to react. apologies for that.

last months at our membership meeting we had a very full agenda, which began with a presentation by michael yeo on the neuroscience of addiction, which actually provided some good data, but also some good, usable information. he is an excellent presenter. he is with nicos, the chinese health coalition. we also furthered our advocacy work, which i'll talk about here in a moment and then elected our officers for this year. i'll be staying on as co-chair and welcoming to work with me catlin morgan, christina irving from family caregiver alliance will be our secretary and patty clement who was here earlier, has so wonderfully agreed to serve as treasurer, that thankless job.

we are determined, at our bore, to strengthen our organization so you'll be hearing me talk about efforts -- you've heard me talk about efforts, but continue to talk about efforts to strengthen, broaden, deepen our advocacy work. both in scope, in terms of alliance with other organisations. we currently are a member of budget justice coalition and we will be talking on a regular basis with, certainly, the digby fund coalition and others. this is a deliberate ratz effort on our part to be in alignment with all of the other agencies toward better serving our older adults and persons with disabilities. so, last month i was going to report on our formal ask letter

that was given to director mcspadden last month. i believe you have a copy of it. i encourage you to read it. there is a lot of information in there. certainly if you have any questions, let us know. we would be happy to tell you how we came to the numbers. to reasoning behind you we selected those areas. it was quite an impressive process of getting feedback from our member agencies and drilling down from there. our meeting -- the membership meeting this month will be next monday. again, another excellent presentation by dr. anna chodos, ucsf at zuckerberg in the department of geriatrics on compassion fatigue. she did this as a training

offering by daas last fall that i was impassioned to attend. compassion fatigue is a nice way of saying "burn-out," which is something that our disability services agencies who serve an ever-growing population with an ever-growing amount of need and particularly specialized needs struggle with. we all know this is one of the most, if not the most expensive city, in the nation and so keeping staff under the best of skns a challenge. and certainly in our line of work, all of these additional characteristics just make it more challenging. so, it is a very interesting training and we invite you all to attend. we will also be continuing our annual advocacy campaign.

next on our dock set our annual postcard solicitation where we hand out postcards at various senior service agencies, which we will then deliver to -- personally to the supervisors and to the mayor. this will be followed then next months and in early may with a phone call and e-mail campaign. we are shifting our focus from the written postcards to the electronic and phone call version simply because we realise that is the way of the world today. and then finally, in may, we'll schedule individual meetings with the supervisors and the mayor to present our ask. we will be doing this in conjunction with budget justice coalition, which has a very active advocacy effort and i think that is it. are there any questions i can answer? >> thank you. any comments or questions? commission? commissioner loo.

>> could you repeat the date and time on the training you have with the psychiatrist, or the doctor? >> coming up monday, the 12th. 3:00 p.m. >> at the open house? >> correct. >> any other comment or questions? commissioner lang? >> do you have the budget justification worksheets that go along with the letter? >> certainly. >> that something i can get from you today? >> absolutely. >> thank you. >> and in that regard, just a little clarification. the case request $1.5 million in continued and $3 million in new funding for six dids, so the total is $4.5 million. thank you. >> correct. >> any other comments or questions? thank you very much. >> thank you. >> general public comment. this is the opportunity for the public to comment on anything that is not on the agenda.

hearing none -- any old business? new business? requesting authorization to enter into a new grant agreement with brilliant corners for the provision of the scattered site housing and rental subsidy administration programme during the period of july 1, 2018 through june 30, 2023. in the amount of $15,379,070 pluss a 10% contingency for a total grant amount not to exceed $16,916,977. fanny lapitan, thank you. >> good morning, commissioners. good morning. if you'll just bear with moe, i'm nurse ago cough. onces in a while you might see me clear my throat. again, my name is fanny lapitan. i'm a programme analyst for the

long-term care operations at daas and i'm here today to seek authorization to enter into a new grant with brilliant corners for the provision of the scattered plan housing and rental subsidy administration or sshr's aid programme. a very long acronym. i will be highlighting the important areas in the scope of services. the sshr is a nram will facilitate independent community living within san francisco by providing housing options to individuals in skilled nursing facilities including laguna hospital and zuckerberg san francisco general hospital, for those at imminent risk. of nursing home or institutional placement but willing to live in the community with the appropriate support. this programme is funded by the community living fund or c.l.f., which is administered through daas. in order to be eligible for sshrsa, individual meeting the c.l.r. criteria, that includes being 18 years and older. being a resident of san

francisco, have income up to 300% of federal poverty level. have a demonstrated need for service or resource that will serve to prevent institutionalization or enable community living. and be institutionalized or deem to be at risk -- imminent risk of institutionalization. in addition, potential participants must have a level of care that must -- that can be reasonably met in the community with supported services. and must be able to comply with the programme requirements such as rent payment, housing retention and lease rules. because it is a fund of last resort, eligible individual must have no other resource or alternative to acquire appropriate independent housing. all referrals to the programme will come directly from the c.l.f. programme at the *ins tuesday on aging or i.o.a. i.o.a. is the c.l.f. provider of intensive case management and purchaser of goods and services. i.o.a. conducts a thorough

assessment for c.l.f. which includes eligibility determination and evaluation of needs and service plan. those individuals found eligible for the sshr's aid programme are refered to brilliant corners. during the grant term, brilliant corners will provide services that include person-centred planning through coordinated efforts with c.l.f. and daas. it will also identify and acquire housing units through corporate or master leases and administer rental subsidy to programme participants in which no more than 50% of the person's monthly income will be paid toward rent. in addition, lit provide tenant land lord liens on services, housing retention services, unit habitability antenanlt well-being inspection and will manage unit modifications for reasonable accommodations as needed. brilliant corners will be conducting programme eligibility reassessments on an

annual basis or as needed and will enable participants in accessing other affordable housing products interested in or eligible to graduate out of the programme. annually the programme will serve a minimum of 110 unduplicated par -- participants and defined by monthly occupancy of participant and includes all the services to be provided that were by the grant mentioned. during the grant term, the housing stability satisfaction with housing and independent community living will be evaluated to assess programme impact. at this time, i'm happy to answer any question the commissioners may have. >> thank you. prior to fanny's presentation, commissioner loo and i had questions about the detail in the expense. >> in the budget, yes.

>> table. and if you could just go through that. it is on page -- the human services grant budget summary by programme. line 17 indicates that it is to be calculated, line 16 times line 15, but the numbers don't tie out. >> yes. so, that -- that -- there is a correction, commissioner. so, that line 17 that says "indirect cause" and then there is an instruction there that says line 16 times line 15, that -- that shouldn't have been there. the indirect cost 15% is reflected on all the salaries and benefits and operating expense with the exception of two items under the operating expense under other. that is the rental subsidy and client utilities. so, those two items were not subject to the 15% indirect.

so, the calculation is correct. it's just the labelling, i believe, of that line 17 that's making it -- >> if you could just -- so, salaries and benefits and what else? >> and all of operating expense detail, minus line 29, that's rental subsidy and line 30. client utilities. so, the totals for those two items. >> oh, i see. yeah. ok. ok. thank you. >> good morning, commissioners. john sitikawa with contracts t. way we handle what we consider pass-through cost indirect are based on salaries and benefits and operating costs in general. but when a contract has passed through costs, like wages for ihhs workers or benefits or things where we're passing a large amount, sometimes those expenses are pulled out so the agency doesn't receive an

indirect on a large sum of money and that is why the calculation removes that from there. >> i'm grateful to hear that. that makes perfect sense. what might be helpful is just send out a little reconciliation so that -- because we're approving this without actually having the information in front of us and it would be very helpful if we had the numbers in how the calculation plays out so that -- so we have it -- >> ok. we can change the spread sheet so that it clearly shows that that amount is taken out. >> i don't want to hold up the approval but i want to make sure what we're approving. your explanation makes sense, but i think we should have it documented. >> ok. >> so thank you. >> thank you. >> any other comments or questions? >> well, maybe in future, if that is the case, you have maybe a star explanation at the bottom to make it easier. because i calculated several

times like, gee, it can't be. i know the total is right. so something is missing. so, it will be helpful. >> we'll do that. thank you. >> thank you. >> commissioner lang? >> sure. first of all, thank you for speaking with me earlier. >> yes. >> but i still want to raise a couple of the questions publicly. i'm most concerned that this was a sole-source contract and i need to understand how that happened and why. >> ok. so, prior to the contract, the contract has been -- is transfered from the department of public health so prior to the contract being transfered to daas, brilliant corners has been providing housing and rental subsidiary information for the san francisco department of public health since 2009. the programme currently has 106 participants and policing from brilliant corners who hold the master lease of the individual units. these leases are not

transferable and brilliant corners currently the only known provider of scattered site housing. that is the main reason that the grantee was selected for the sole source. but john might want to add more. >> sure. again, john sitikawa, director of contracts for h.s.a. generally as a rule for public contracting, we want things fully competitive bid, we want other c.b.l.s to have the opportunity to bid on this. some of the things that are trickier are contracts that involve leases, involve residences, some site-base reasonable doubt challenging. to give this kind of an example is the history of this contract came from d.p.h. d.p.h. has a red crossism in in the administrative code that allows them to automatically put sole source under certain circumstances, which h.s.a. does not have. we have to come up with a justification when we do sole source that is different than

dphs. what is challenging with this contract is that it is master lease-based which means the organization holds the leases, not necessarily the tenants. you have about 110 clients and from what i understand, the turnover, and that is about five to 10 a year. so, in contracting, if at some point we were to r.f.p. and find a new contractor who then would get the new services, they would start at like the new tenants, five tenants and take years and years to build up to a certain point. meanwhile, you have a number of clients that are kind of already grandfathered in that we would not want to make drastic changes that would risk stability for their housing. it is kind of a complicated thing, trying to bid this out. but what that would mean for a population that is relying or living in these lease apartments over time so that we can continue paying and make sure they get continuous

support and care. >> i think i'm following you. the question i have, though, is d.p.h. when -- what are we callingit? one second. brilliant corners was managing this, who provided the services then? d.p.h.? on one hand you have the master lease, that is one piece of it. and then you have the liaison services piece of this. am i following? pardon me? >> that would be brilliant corners. >> ok. brilliant corners was providing the liaison services under d.p.h.? it is brilliant services also going to provide the case management for this piece? >> no. nros case management for sshrsa

programme. brilliant corners works in collaboration with c.l.f. programme which provides the intensive case management. >> ok. >> any other -- >> i'm just curious, how long has this agency been in business? brilliant corners. >> how long have they been in business? they were formerly known as west bay housing corporation. we have someone from brilliant corners who can speak a little bit about their history. i'm not sure exactly when they started. but the san francisco department of public health contract has been in -- that one started in 2009. >> ok. thank you. >> i have a question regarding the liability. who actually is leasing these rental units from the different property owners? is it the city and county of san francisco? >> no, it would be brilliant corners. >> ok.

so, which brings me to the next question. on the operating expense detail, line 40 has an insurance amount of $12,200 as well as line 18 has insurance of $11,600. line 40 has directors and officers insurance. what is that liability insurance cover? >> i'd like to bring up nellie from brilliant corners to explain the detail for that. >> ok. >> hello, all. so, the liability insurance for these corporate lease units, that is a requirement because in order for us to be able to acquire these units, there is a renter's insurance piece to that. but then in lieu of that, brilliant corners is providing corporate liabilities on each of those units and that

liability insurance will cover any type of property damage and just anything within like for the lease requirements in general. >> ok. thank you. earlier, fanny, you mentioned that among the requirements, the individual has to be a resident of san francisco. how long do they have to be a resident? or is there a time requirement for their residency? >> generally, it's based on c.l.f. criteria. so, it's c.l.f. criterias for residency. san francisco residency. and i don't believe that there is -- i think they have to just show proof of residence, showing an i.d. that they have to live within san francisco. >> and, again, this is new and it's an admirable programme. but it does generate a great many questions. among the potential housing

sites listed are market rate multifamily housing. how likely is it that we'll be able to place anybody in mark rate multifamily housing that's not covered by rent control laws or anything else? how likely is that? >> i'd like nellie to respond to that question, commissioner. >> i'm just curious, why would they do this? yes. >> most of our current portfolio consists of market rate units. >> they're market rate units? >> that is correct. >> and covered by -- not covered by rent control in any form? >> we have probably a very small percentage of that portfolio, which is covered by rent control. >> and then what is the inducement for the property owners to take in tenants like this as opposed to, in today's market, when they can get so much money for vacant units? what is the incentive for property owners to rent to the clients? >> well, how this programme

structured is that there is a portion of rent, which is paid for by the client and then the rest can be subsidized through this programme. so, essentially those market rates are being covered. and some incent civ that the monthly rent is paid in a timely manner and there is a third party that is involved to mitigate it into concerns. >> thank you. >> i had two questions. one is getting a sense in general of the breakdown of how many units of the 110 per the different types of housing channels. might be helpful to know in general of how much in each category we're talking about. whether it is multiaffordable family set aside housing and shared leasing opportunities. that would be great. and then to the other point about in terms of cost coverage. i know there's no golden rule and certainly san francisco, we're in a bit of a crisis in

microcosm where costs are increased quite a bit. there's no golden rule in terms of how much of a monthly gross income someone is supposed to spend on their housing. but 50% of monthly income going toward rent on the part of the participant as they put that skin in the game [inaudible] on a general average. i know in san francisco, we're in kind of a fever pitch when it comes to how much rent that we all pay. just wanted to get a general sense in terms of does 50% seem high or are there other indicators. how do we arrive at that figure? i just want to get a bit more information? >> sure. well, i have to say i think the 50% has been actually the marker since the start of the programme. the structure was actually to be first placing people into market rate units, which of course those rental rates are fairly high within the county. so, i think that 50% was set to

be able to help recupe as much as we can. and i would say there hasn't been any challenges, actually. but no one's sure if the client is contributing with that portion. >> ok. >> in regards to your question about the portfolio and what it consists of, i would say again a majority of our portfolio, so that is at the market rate with units and roughly, i would say, 10% is going to be through a master leasing that we have actually with affordable properties here within the county. >> ok. do we have a sense of what the breakdown -- what the average rent cost is? for these different types of units? >> yeah. with the market rate, for those units, it will be studio units. the average from our current portfolio right now would be roughly $2500 a month for studios.

and for our affordable housing portion of that, it can range anywhere -- i would say the average would be about $300 to $400 a month. >> and i did have one other follow-up question. just looking at the appendix salaries and benefits and how many housing coordinators there are, i believe there's five which would be for 110 clients, that's about an average of 22 clients per housing coordinator? has that been the kind of standard since the programme started? does it seem from kind of an on the ground sense that that is a manageable number of in terms of interactions being able to do the annual safety checks, the monthly check? does it seem to work out well? is that on par with other similar types of programmes? >> yeah. so, that has been the case with ratio, i would say, from the beginning. and our services are going to be flexible based on the needs of the individual as well.

so, you know, we do have a general guideline of being able to meet people in the community on a monthly basis. so there are people who are fairly stable in the community and the service can be every other month or quarterly or a phone call. it is based on need but that case-ratio is generally what it has been and it is fairly manageable. >> ok. i guess -- go ahead. >> just a couple more questions. i noticed that brilliant office vent relatively modest. it's about $2500 a month. and so rupp in the building or have a long temple lease? >> yeah. so, brilliant corners has been a space at 1390 market, which is right down the street here and those are going to be, you know, current numbers. we are spending now. so yeah. we've been in long-term lease at this location.

>> and finally, she is making too much. and no longer qualified for this programme. does that happen with any kind of regularity, is that ok for this programme? >> it has not arised for anybody to make income, to be able to rent within this market currently now. so we do have guidelines and someone would not be deemed and eligible for this to make it two and a half times the monthly rent. so, with those guidelines, we probably will not foresee that there would be an individual who would -- to be able to take

over the lease and assume those rental payments. >> ok. thank you. any other comments of the commission? >> i did have one more question. >> outcome objectives, it talks about programme participants have other housing options, at least 75% of participants who exit housing will secure housing appropriate to their needs, etc., and goes along with your former question as well. so, what happens to the other 25%? generally. >> i mean, of course -- >> go ahead. >> you know, our services, of course, we want to prevent, like with any type of -- like we have a loss in housing that -- but i think with that 25%, they won't be falling with these type of categories. whether they're moving out of county or they -- they thought they could be in shelters.

but at the same rate, we've given the longevity of the programme, we have not come in with that case where -- within those individual exiting the programme. they didn't have an alternative option for them. >> there kind of a landing pad plan in place. if it did arise? >> that would be for us -- like to provide resources in regards to shelter and to make sure that --le like you said, a case management agency involved to help care them through. >> sure. from c.l.f. side? >> yeah. >> any other comments or questions? >> yeah. this programme is a transfer from the public health department. is that right? how long did you handle -- how long ago was the programme under the public health department? for how many years? >> since 2009. so, last year there was a transition period, so about seven years. sorry, eight years. 2009 to 2017.

it was under the department of health. >> so this is the first year for daas so we have to do assessment every year. is that right? sole what are the criteria that daas use to think that they will refund, continue the programme? >> that would be -- they need to continue to meet the criteria for c.l.f. programme, and as i mentioned, it's 18 years of age, being a resident, having 300% of the federal poverty level, income. so the c.l.f. criteria is what we used. >> commissioner, does that answer your question? i think one of the things we can say about that is that even though department of public health had the contract for many years, d.p.h. and daas work very closely to develop this programme. both the housing side and the community living fund side and we, you know, we essentially looked at it as one programme,

even though department of public health was really handling the housing peels of it. and so more recently, departments of public health decided that this is -- we really see this as part of the community living fund programme. we think it should go to daas because of that. we've had a lot of opportunities to work really closely with brilliant corners. certainly fanny and carrie and linda edlestein, etc., have been very, very involved with the creation of this programme. and there is a reason at the beginning that we really wanted to have scattered site housing and not just single room occupancy housing for people exiting from laguna honda and other skilled nursing facilities or hospitals. and so, you know, we basically noted that people did better if they were in scattered site housing and that they did better with wrap-around services, etc., etc.. so i think obviouslis in a new contract for us to monitor and

we need to monitor it as well as department of public health did. but it is easy, i think, in a sense for us because we're already involved with the clientele. >> thank you. >> first of all, i want to thank you, shireen for that explanation. my concern is that we're getting ready to sign off on a $15 million contract for five years and it just raises a lot of flags for me. particularly because it was sole-sourced and i don't have any information before me regarding the monitoring or the assessment from d.p.h. now assuming that all of that is well, it says, ok, we should probably entertain this. but it gives me great pause when we have such a large amount for one contract going out, under sole source, for five years. and i just need to say that for the record. >> i share commissioner lang's

concerns. and of another concern, we'ves been reading a great deal about the ongoing shortage of skilled nursing facilities in san francisco. and we have a five-year contract. and one of the requirement requirements -- requirements for this person to be eligible is they be a resident of san francisco. if they are in a skilled nursing facility outside of the city, would that impair their ability to be eligible for this programme? when they're discharged? if they're down in westlake, daly city, would they still be eligible for this programme? being cared for outside of the city? >> the referrals to the programme, commissioner, comes through c.l.f. and c.l.f. receives referrals from skilled nursing facility within san francisco. within san francisco county. so, we wouldn't necessarily know that there is a san francisco resident living in -- outside of this county unless

they're refered to c.l.f. >> but that wasn't my question. my question was we have a declining number of skilled nursing facilities in san francisco. hospitals are getting out of that business. it is sa declining business. so if we have fewer facilities and the same number or greater need of people needing the services, they will be sent to skilled nurses facilitis in other areas of the bay area. so, would that affect their eligibility to equal fill for this programme if they've been in a skilled nursing facility in daly city for six months? >> so, upon referral to c.l.f., if they can establish they are qualified in c.l.f. and the residency for san francisco, then they are qualified to be refered to this programme. >> so, it is all determined by c.l.f. >> yes. >> ok. thank you. any other comments or questions? as you see, we all did our homework.

>> i just wanted to go back to the early comment about monitoring and it is a large granltsz. the sxwier time that d.p.h. had the contract 12i7bs000, we have received the monitoring points and they've passed exceeding over 95% of all of them with no demerits and we did a monitoring last year in the spring and they met all their requirements. so, there is no concerns in terms of monitoring. >> ok. thank you. >> thank you. that is encouraging as well. any comments for the public? >> good morning. patty clement and i'm with catholic charities and we have been a partner of the c.l.f. programme since its inception and i can tell you that working with brilliant corners and the complexity of the clients we serve in c.l.f. and having scattered site housing has been a huge benefit for the clients that we serve and they do so much better in the community than they would if they had to go to single room occupancy

because there's support through the case management answer they've done thing and brilliant corners has been a part of it where they see a client might be struggling a little bit moving out of the nursing home and you have that instant dmounlts your own home and then how do you look at support beyond that. i think they've gone above and beyond in some cases with what they've done to help make this successful and i would recommend that you go ahead and approve. this it has been working really well for all these years and i understand your concern, commissioner lang. but this is really complex and it's really hard when you have master leases to do something with lots of different agencies. thank you. >> thank you, patty. any other comments or questions from the public? any final comments or questions from the commission? >> the only comment i have is i'd like to schedule time to see this programme upfront, you know? so i will work with whoever i need to in order to make that happen. >> ok.

we will make that happen, commissioner. thank you. >> thank you. >> and i'm not sure what the regular review schedule would be, but i certainly hope that it's at least annual and that we -- because this is new to us. and it is as admittedly complex and certainly has a very, very good reputation and there is no reason to think that that will change. i still think it would be beneficial for members of the public if we have an annual report on how it is working with any specific measurements as possible. >> and i think that one of the things that carrie wong will be doing is to report to you on the community living fund, which she does every six months. and that also she includes this as part -- she will include this as part of it because it goes along with community living fund. so, you will definitely be hearing every six months a report on community living fund and it will include brilliant corners since that is part of

our approach to the community living fund service. >> great and we have a specific report on this programme and this agency. >> we can add that. >> that would be great. that would be very helpful. >> since there are one or two reports from the public health department, maybe we can get a copy of that. >> thank you. >> we do have those so we can make sure that you get those. >> commissioner? >> i would like to also -- i would love the chance to be able to visit and see how the programme works on the ground as well as i'm sure -- >> maybe bridgette can afford that and as many commissioners can make it would go. >> sure. >> fantastic. the other question i have is just -- this new programme, obviously it is very important and so just wondering what portion of the community living fund that this now occupies. the greater pie. >> i would say it is at $3

million and the total c.l.f. is at $9. so, one-third. >> ok. thank you. >> thank you. ok. call to question. all in favour? >> aye. >> any opposed? [laughter] ok. thank you. item passes. thank you very much. >> thank you, commissioners. >> the next item on the agenda is item 7b, requesting authorization to enter into a new grant agreement with self-help for the elderly for the provision of a residential care facility for telds earley during the period of july 1, 2018 through june 30, 2023 in the amount of $728,210, pluss a 10% contingency for a total grant amount not to exceed $801, 031.

welcome back. >> thank you. i'm seeking authorization to enter into a grant for self-help for the elderly at autumn grow, alzheimer's care home. auto glow is a residential care facility for the elderly or rcfe in san francisco for the cognitively impaired seniors 60 and older who have been diagnosed with alzheimer's, park kinsons or other-related types of dementia. it is currently owned and operated by self-help for the elderly. autumn glow provides assistance in a unique nonmedical facility in the hayes valley located at 654 glow street. it has nine rooms with 15 beds. six of the rooms are double october pan siz and three of the rooms are single occupancy. services include room and board, supervision by professionally trained staff and dementia care, personal assistance, full house keeping and laundry services,

medication management, individual designed personal care plans, three nutritious meals daily and between-meal snacks and wide range of daily activities and programmes. all services are provided 24 hours a day, seven days a week. excuse me. but residents may join daycare services proud off site by self-help for the elderly adult daycare. they are provided by multilingual staff which includes cultural and language needs. to be eligible for autumn glow, individual must be seniors who have been diagnosed with alzheimer's, park kinsons or other types of dementia and qualify as tenants based on the u.s. department of housing and urban health or h.u.d. criteria. and be eligible for admission as determined by titlele 22 regulations governing rcfe. autumn glow will consider

individuals referred by laguna honda hospital or other service agencies, provided such individuals meet all the mentioned criteria and that they do not have any health conditions or care needs that will require an intensive or high level of care. this specific health condition or care needs detailed in the appendixa of the scope of the contract. staffing currently at awe tome glow includes the director of housing services, the assistant administrator, the work shift rotations, providing the personal care services for the residents around-the-clock and they also have two full-time kaox on work shift rotations preparing the meals and snacks daily. in the daytime their ratio of direct care residents 1-to-5 san in the evening it is 1-to-7.5. it will provide residents that will include new and existing residents and they will also

provide a minimum of 5200 units of service. it's per resident and includes all the services to be provided by the grant as mentioned. during the grant term, the resident's level of care assessment satisfaction with services and physical wellessness all be evaluated to assess programme impact. and i'm happy to answer any question the commissioners may have at this time. >> thank you. any comments or questions for the -- commissioner lang? >> why is this one sole sourced? [laughter] >> very much the same -- similar to what brilliant corners was transfered from the department of public health. autumn glow is a project initiated and sponsored by the elderly in 1996 when i was incorp rated as a nonprofit public corporation. it was funded by a capital

advance financing and the mayor's office of housing to require the 15-bed alzheimer's care facility. and the facility opened in 2001. autumn glow is card separate legal facility. and it is because legal arrangement for out of necessity for the h.u.d. funding, only self-help for the elderly will provide it without any interruption to the service. so it was also a d.p.h. contract, again, like a realignment where it better fits within the department of services because of our mission statement. >> ok. >> senator loo? >> uh-uh. >> commissioner wallenberg? >> i had a couple. thank you for continuing to stay in the hotseat. [laughter] so in terms of service delivery, there's nine rooms, 15 beds.

and i just was wondering during the -- it says -- sorry, it says provided off site by self-help for the elderly daycare services at additional cost. i guess what type of service levels are you getting for that additional cost, how much is that? how much are these programmes being stressed during the intake process that these are available? these are the types of services. and then, i guess, how much additional cost. what types of services? is it being stressed at intake process and what's the breakdown of off site and on site? >> so, when we say additional costs to the resident, that's actually a separate service. the adult day services for the elderly is not part of as tum glow. -- autumn glow. >> in that sent, what are those additional services and how much is that being stressed that these are available during the intake process? >> sure. the additional services would

be the types of services they would receive when they go to the day services. they have the social activities, they have meals. they have -- some specific programmes, specific to that adult day service. >> it clear to them and their networks when they sign up or -- >> yes. that would be clearly explained to the residents and their family. >> ok. and then i just had two other quick questions if that's all right. one on page four, appendix a. we're talking about notifications to families and other appropriate parties of residents going forward. i'm just curious on what the frequency of that communication is. i guess how often in terms of residents' ongoing needs do the staff and the programme coordinators reach out to family members or that individual's -- >> yeah. to get a definitive answer, i'd

like to welcome the director of services at autumn glow. he would have that answer. >> thank you. >> good morning, commissioners. the frequency actually depends on individual residents there. we monitor the health conditions on a daily basis, actually. so our -- on average, we notify their families approximately once every three months to -- once every three weeks. >> and i guess i had a follow-up question that's similar on those lines. in terms of documentation, we were talking about the staff assesses each resident's tiebltz perform activities of dayly living. every six months. and then skipping down a couple of lines that the staff completes an annual appraisal and service plan for each resident.

for me, to determine the activity's daily living ability and also just a general plan for each resident, on an annual basis seems a bit long. >> ok. >> certainly when you already -- when you're talking about a daily check. >> like i mentioned earlier, it's actually a daily check and then on the -- we actually have a more in-depths reveal every six months from that. >> ok. thank you. >> thank you. commissioner loo? >> yeah. i have a question actually on the salary and benefits and i'm looking at it. every year is the same. how are you going to maintain the staff? >> oh, the budget? yeah. >> because there is no cola, there's no cost of living increase at all. every year the rate is the same. i'm just kind of concerned how can you maintain staff? >> it's difficult. [laughter]

in addition to grants -- you know, the residents themselves or family members have to pay the fees and then we actually have a little bit of an increase every year for the service fee. in addition to if there is any increase for funding as well. >> can i -- >> and the -- >> good morning again. john sitikawa, director of contracts. but the other part of it for the city is that periodically the city applies colas to contracts and that is the opportunity. but the city policy is to apply that as a whole across the set of contracts. this is a general fund contract that would be eligible to receive colas and cogbies as the city granltzes them.

as you know the ones from this year and last year, they were 2.5% cola. so, when the next cola comes out, we adjust this contract with the cola that is provided to the city. >> and the other question i have maybe for the -- for james, i know some of the residents may go to adult day health. so, what kind of activities do you have for the residents? >> there are daycare centres, which is about two to three times a week. they engage with the residents in club activities. >> ok. such as? >> such as exercises that they work together to strengthen the physical as well as mental well-being. and then they are actually nurses, p.t.o. there on site to monitor individual's health, condition.

and some of the residents have a mild-to-moderate dementia. they are closely monitored by special staff on site. as well. and so usually the activities are in a group basis and they usually last for about three, four hours during the whole period of about six hours when they are there. so that includes activities such as chair exercise as well and games for the residents. yeah. >> just out of curiosity, i know that we gave you folks just kind of -- $801,000.

what percentage is that of your whole budget? i'm just curious. >> ok. the whole budget is about $650,000. >> how much? >> $650,000 for the -- so you are talking about the $800,000 for five years, right? >> yeah. >> per year is about $140,000. so our annual budgets is about $650,000. >> ok. thank you. >> i have a couple of questions as well. the requirements include individuals suffering from dementia, parkinsons and other forms of dementia. but do the patients with park kinsons, many of them don't have dementia. it often affects parkinson's patients. so are they parkinson's patients with dementia or parkinsons in general? >> dementia is a general term

for us and parkinsons is one of the disorder of dementia and they're very closely -- they're very similar, actually. so with mostly memory loss and the disabilities of performing some of daily activities by themselves. >> certainly the activities, i understand. but i've known and know several people with parkinsons who have had it for many years and they have no memory impairment. it's separate. it does eventually affect their memory. but they can go for long period of times with very long period of time. does the ombudsman programme visit, does the ombudsman visit your facility on a regular basis? >> they do. >> ok. great. and finally, what happens is the dementia grows greater? becomes more than you can handle? what happens to that patient? >> it gets more severe, if they require hospitalization, you

know, we transfer out to the hospital and from there, either they will be transferred out to a long-term skew nursing facility. >> ok. >> yeah. >> ok. all right. thank you. any other comments or questions? commissioner lang. >> the $145,000 yearly amount, is that similar to what you were getting before? >> yes. >> thank you. >> ok. any comments or questions from the public? hearing none, call the question -- all in favour? >> aye. >> any opposed? >> thank you. the motion carris can. >> thank you, commissioners. >> any announcements? any additional public -- oh. commissioner, sorry. >> i was really glad that, as part of director's report, she spoke about reimagine. and especially the conversation sabbath in response to commissioner loo's question about how about promotion.

i'll take this opportunity to extend an invitation to my colleagues and certainly to the members of the public to come tomorrow morning at 8:00. it's an ungodly hour. to the interfaith council's monthly breakfast where reimagine will be presenting. and i'm guessing that their out reach to so many community agencies like ours, you will see -- you will see these sort of presentations throughout the city. so i think on a grassroots level, that's happening. so thank you, director mcspadden. >> any other announcements? any final public comment? hearing none, motion to adjourn. >> so move. >> second. >> second.

>> good morning, ladies and gentlemen, i want to welcome to you committee. i'm the chairwoman and to my right is sandy fewer and to my left is supervisor catherine stefani. i want to recognize our friends at sfgovtv. tom and lawrence. thank you for your assistance and i want to recognize the clerk of our boards