to 250 people. that's 5% of our caseload. >> they haven't taken advantage of the other job works and these are people who actually come for 66 hours a week and how long of an average time would you say that someone, a recipient like this is in a workfair? >> i don't know specific to work fair. the average months on aid throughout the year and we may have people on county assistance through the course of a year, we may serve three times that number so wall it 15,000 people coming through our doors. >> they come and go? >> right. if you look at a 12-month span the average number of months on cap is seven or seven and a half months. that's the average. of course you have at either end of that you have people who have been consistently on.

we even tried to insentavise spokes away from workfare with a higher grant. we have grant differration. you can do something else and get a higher grant and we had people chose work fare. >> there are a lot of people who say i want something more. i'm able to work 30 hours a week and i want to do that. i share your concern and i kind of see the angle you are going at and look, they're doing six hours a work and they're not getting anything out of it so job training is not preparing them for the next step. but for some, that's all we can do and they appreciate the structure and they get their

cash assistance and benefits in exchange. >> do you think these individuals that do this workfare and it seems to work for them because it's enough for them to live on in their living conditions with some other assistance? don't you think a part-time job, a steady part-time job would have better outcomes for these folks? >> absolutely. why is why we offer that to them. you have the option. you can go into jobs now and go to a part-time job. you can go to job training and you can volunteer at a non-profit. giving the client a choice in every step. reaffirming that choice when they come in for benefits. nevertheless, you still have a couple hundred choosing workfare. >> and a question, are you proposing increase or decrease in the number of g.e. positions? >> we are flat. >> ok. are you proposing an increase or decrease in the number of civil

service positions? >> flat as well. are there positions that would be transitioning from permanent to temporary or being contracted out? >> not contracted out. we have a whole series of substitutions. it's really too early in the process to know how we're adjusting that. we often have from year to year you have different departmental needs and you may need to substitute positions so we do that constantly and it's part of the budget submission in june. >> thank you, very much. i appreciate it. now i think we will hear from sherine. from the department of aging adult services. >> good afternoon supervisors, sherine, director of the department of ageing and adult services. i'm just going to go over some caseloads first. so, just want to start with in-home supportive services

which sour biggest program at d.o.s. ih. we serve about 25,000 clients or we served about 25,000 clients last year alone unduplicated and we had about 22,400 independent providers serving that clientel. on average, clients get 98 hours a month, which on the private market if they had to pay for that it would be almost $3,000 a month. it's a really great benefit for those people who need it. i wanted to talk about integrated intake in referral. in 2016, with the support of mayor lee, we were able to open up our dos benefits and resource hub at the corner of goff and otus and we wanted to help streamline the intake process for people who need our services and make it easier for them to

find us. we constantly are up against people not knowing where to find senior services or services with people with disabilities and we wanted it to be our hub for those services. what we have are people can access home delivered meals, they can come in and sign up for those and they can call in and do it online. they can also make reports of abuse to adult protective services and they can get support of services and also we co located our county veteran service office there. so, last year we had about close to 15,000 intakes for those programs. we received close to 28,000 calls. we were able to work with about 2800 veterans and file 5700 claims for veterans, which result inside about $4 million in retroactive benefits for those veterans. in office on the aging, we have now served over 34,000 people in

the last fiscal year and that is an increase of more than 10,000 individuals annually since five years ago so we've really increased in those services and those services are things that really help people engage in communities such as senior centers, meals and those things. i know, you are all very familiar with those. just wanted to highlight some of the things we're doing in our various programs. thank you to mayor lee, he put that into the budget last year and so we were able to get it up and running last year and it has a clinical focus for clients who can't provide for their own basic needs due to substance abuse. the unit was launched in may of 2017 and we've since served 285

clients in that program. in that unit. about 50% of the clients were referred because they were at high-risk of loosing their housing. and to date, almost 80% of the clients whose cases have been closed were found to be safe, stable or thriving at time of closure as a result of their a.p.s. intervention. we're really excited about the results of that unit. you've heard a lot about conservatorship today and if you asked questions. we continue to work in partnership with the department of public-health, community behavioral health services within d.p.h. and the homeless department to assist people who are experiencing acute mental illness or grave disability because of that. we're continuing to expand the community independence participation program that provides for community-based conservative o.p.p. ship and we work actively to keep people who need conservatorship at the

settings. you asked about placement. half the people in our program end up being out of county but we're really working on this community based program that helps people stay here if they agree to conservatorship and you know, we're really able to serve them better in support of housing or places like that within the city. so far we've assisted over 50 people in that program. the number may be lower but the threshold is very high for someone who can towell actuallyn that so we're excited about that number. we're participating, the inner agency high priority case review meetings and we're very excited to be involved in those meeting. it's clear you are asking questions about someone who has been 5150 multiple times. the key is getting the resources in place at the right time. right when that person needs resources we need to have the

placement and we have been given the jurisdiction, the authority to serve and all of that has to happen and it's really great we're doing this inner agency collaboration and looking at each individual needs. also just the change in representation from the district attorney to the city attorney that supervisor sheehy, you referenced that president reid was in the legislation related to that. we're working closely with both teams to make sure that the transition happens as smoothly as possible. and then in home support of services, home bridge is our provider that does what we call contract mode so they work with people who really can't manage their own worker. they provide the workers, they train the workers, et cetera.

so it's kind of our highly vulnerable i.h.h.s. population they're working with. one of the issues they've been facing is just this very, very high turnover. of course the economy has been good and people can find jobs elsewhere and working with this population is tough. it takes great workers and dedication and commitment and passion and so, we wanted to work with them. they were having a 60% or 70% turnover in their home care staff and so, we helped them to implement a tiered wage and essentially, we're study the tiered wage and see if it helps that workers are getting paid more. they start off-the-record with a $2 increase and then some of them will be able, with extra training, will get access higher amount so up to $3 over the minimum page.

and then moving on to our community based services, i know everybody knows about the dignity fund and we just finished the dignity community needs assessment part of the dignity fund legislation. we will be reporting part of the legislation says that there needs to be a joint hearing of the aging and adult services commission and the oversight and advisory council of the dignity fund so we'll hold that on apri6 here in city hall. and there are some highlights from the report that i just wanted to point out to you. and one is that toss is serving 1-4 of the community based programs. this doesn't include inhome support of services, it's really that 34,000 people we mentioned and the equity analysis is factors are accessing services at higher rates. in particular, we're really pleased to see that toss is

serving half of the low income seniors and this ind indicates we're doing effective strategic targeting of populations that we know really need our services. and then we've identified research and analysis such as breaking out the communities in color to see how we're really doing within and across those groups. and also, the lgbt population. we just started really collecting the sexual identity and sexual orientation identity. we don't have good data how we're serving that population. we expect to have better data around that next year. when the aging and adult services commission has approved the community needs assessment, i'll be bringing it to a

committee of the boards and it will go to the full board for their approval, before june. and then lastly, i just wanted to mention the support at home care pilot and that was really interesting that was championed by erik mar, former supervisor, before supervisor fewer. what we're doing is focusing on a middle-income population that can't afford home care outright but may be able to pay for a little bit of that home care. these people don't qualify for in home support of services or community living fund but we want to see if they can really benefit and stay at home more easily if they had up to 18 hours of home care per week. and so, we're really still recruiting people. we want to find more people with disabilities who are under 60 to participate in this study, it's really a study.

we're working with the institute on aging who is administering the program for us and they've engage ucsf to do a thorough evaluation and looking at utilization, looking at quality of life indicators, et cetera. so we're going to be very excited to find out the results of that are and see if it's making a difference for people. when we talk about making a difference, is it keeping them out of the hospital. is it keeping them at home, et cetera. and then lastly, we're enhancing outcomes. focusing on performance objectives in our community contracts. and just trying to do this while not over taxing our community providers. of course we always want to ask for more information but we hear from them that we are trying to do things without a lot of margin so we want to make sure we're not asking too much, at the same time we want to move to a much stronger focus on community impact on client

impact, et cetera. i want to give one example. we're piloting evidence-based measures to track loneliness and nutrition risk and implementing follow-up procedures to ensure clients have access to appropriate further resources. i think that's the end of my report. unless there are questions i'm going to turn it over to september gerard. >> any questions? >> yes, i had a couple. one does your eviction prevention unit work with the sheriff? i did have a conversation with her where she mentioned that for seniors because she has to do it and she comes across folks that are not aware of what is happening to them. >> we do work closely with the sheriff and we can make sure the deputy sheriffs understand how a.p.s. works and we work closely with that. >> my understand question was the dignity fund.

so long time survivors of h.i.v., the interface isn't working well? >> we're very interested in working with long-time survivors of h.i.v. the request that came to us didn't quite fit the dignity health funds. i'm continuing to work with the h.i.v. and aging task force and find ways that we can help we as a coming up next through dignity fund or other ways help support them and it didn't quite meet the criteria what we're doing and also i think there was another issue with the panel and volumes we're asking and we're interested in working with them. >> it's a challenge for that

community to manage this system and i know that there's a lot of confusion on where people should be going for this support and they don't fit in the dignity fund so many of their request have health components but from the patient or client standpoint, they're not really separable. you have people living with h.i.v. 20, 30, 40, well not 40, well actually, some are 40. so you have people who are aging with h.i.v., you know, 60% of the people with h.i.v. are over 50 and that will be 70% soon and we're not finding a place for that community within the city funding structures and they don't seem to fit here and don't seem to fit there.

given what people have survived, and given the support, the enormous amount of support that that community drummed up for passing the dignity fund, it's a challenge trying to figure out what advise i can give to that community to try to participate and have some sort of relationship -- you know, just to have something happening for them as they age. >> i mean, what i would suggest supervisor, is that if maybe through the h.i.v. and aging task force, if they set up a meeting with me and we can just literally talk about what the challenges are, maybe we can help them -- i could help them figure out what the right path is. and i think so that didn't happen. so we had some asks that came in and they didn't seem quite related to dos but if they were able to just have a conversation about how they might go about it, maybe that would be the best way to do it. i'm happy to have a conversation with them about that. >> it's hard if it ends up being something i have to deal with in

the add-back process. you know, it's -- >> i can talk to them. >> this community has been through a lot. and the trauma that they've experienced and the loss that they've experienced. the effects of aging and h.i.v. presents unique burdens to this community and the ability to self-organize and really direct is a challenge. at the same time, to maintain some sense of community when so much of, you know, so many people have lost so many people. the social isolation is a huge issue. and so it just feels like rather than help it's like you guys pull it together and figure it out. they've been pulling it together and figuring it out for 30 years. >> they have, but i think we have to work within the

constraints of our funding and so i think if they came and talked to me about it we can figure something out. i really do. >> thank you. >> thank you. >> thank you very much. i just have. you said the report is going to be coming out on april 4th or the results? >> yeah. the report is public and i believe that we have already sent it to each of you through your aids. if you haven't received it i'll make sure it went down. i thought it had. it's public. >> just very quickly in a couple sentences, what do you see as some of the gaps or trends that we will have to address in our budget cycle probably in the years to come? i know that there have been estimates that the senior population is one of the largest growing populations in san francisco. i know in my district it is. and the need is going to be great and that we're seeing, we just had a report on home care. we've had a report on skilled

nursing beds, we've had a report on a lot of these homes that take care of seniors and they're closing because of a high cost of san francisco and so can you give us a snapshot of where do you think this is trending and what some of the gaps are. [ please stand by stand by for captioner switch ] s

lot of the jobs are going to be, and that's where the need is going to be. thank you. >> supervisor fewer: thank you. and now, i believe we have last but not least, the fabulou is the office of early care and education. >> good afternoon, supervisors. again, i'm september jarrett. our city is home to about 48,000 children under the age

of five, and we believe thatbyy getting our youngest residents off to the strongest start, we can avoid some of the challenges that they face later. with that start, they'll be productive citizens. with that, i would say just a few things. a key point of the critical piece of early years is access to high quality care and early childhood education. in frisk frissan francisco, vil of our children are growing up in households where parents are working, and half of our household struggle providing hey quali high quality learning that they prefer. san francisco's stepped up to

meet the challenges. our work next year, like we and my colleagues shared, we're lucky enough to really steward and san francisco's a leader nationally in drawing down state and federal funds to close the early learning gap for families, and we are also a leader in investing local dollars because in a national context, the state's as far behind other successful industrialized countries that really invest in families when they're young, in that critical standardup period where lifetime earnings of parents are low because they're early in their career, typically, and the cost of really giving the kids that education and support that they need is high. so many other countries, the u.s. has yet to catch up, really invest publicly in that critical window, and in san francisco we're proud to make a difference and demonstrate some good practices. some of our priority, laies, l

year, we created an enhanced san francisco tradition of closing the gap for children and families and launched a new program called early learning scholarship, continuing to leverage state and federal dollars, and trying to meet families' needs with a sliding scale, early care and education program that draws down and meets our lowest income family needs but works up the income ladder to more working families that might not be eligible for state and federal assistance but can't yet afford the high cost of quality in san francisco. with this reshaping, we're now reaching 7500 young children and their families under the age of five, and we're serving about 680 more kids than we served year to year with the same dollars and we're drawing down -- we're closing the gap and drawing down more state and

federal dollars, about 18% more than we were with this new approach. looking ahead to next year, early care and education, we do want to try and offer the many small businesses and nonprofit child care centers that do the hard work of educating and caring for our children a cost of doing business increase to meet their increases expenses. we're also really working hard to try and get better information out to families and programs. we don't right now -- finding early care and education is one of the most difficult choices a parent or a caregiver can make, and finding quality timely relevant information about your program options, what your share of cost is, and whether or not the city's financial assistance can help you and your household is so really hard to navigate. so we're actually through the mayor's start-up and residence process, we accelerated building a new digital portal,

one-stop shop in three threshold languages so parents, on their schedules, nights and weekends, not just days when we're working, can really be empowered to know their range of options and the financial assistance we offer? i hope to be sharing with you -- we'll actually have beta testing of parent programs and professionals and we'll be happy to share that with you and engage your districts and networ networks in testing that new information portal. like director mcspadden shared, we have a workforce challenge in san francisco. education and early childhood care is among some of the most physically demanding work and among some of the lowest paid in the city, and we have a lot more to do in recruit, retention and compensation work? we're looking to expand the number of spaces in early education programs to prove sprisk's a leader in planning policy that really support and

promote the employment of family home child care centers, and lastly we have an opportunity because the city's children are everybody's responsibility to further some public and private partnerships to close the gap for families, and with that, i'll take any questions. >> supervisor fewer: so thank you, miss jarrett. actually, i just have one of the same questions that i asked for sherreen, which is what are we seeing about urgent needs and gaps? >> well, there -- we -- we're fortunate enough to have a san francisco citywide plan for early childhood education, which was endorsed by the nature yo and board of supervisors in 2016, and we setup four prior areas and northstars that we're moving our system towards.

first, we share the vision that every san francisco child will have access to an affordable high quality learning setting. within that, we have several thousand low income subsidy eligible families who've asked for child care financial assistance for whom were not receiving financial assistance from the state or federal government, so one unmet need is really clearing the list essentially of families that have the need and are working. the second is because of the social policy framework, we're having this middle income or missing middle where there's working parents working hard that quite -- can't quite afford the full cost of quality, so there's a missing middle that we have an aspiration in this early learning scholarship approach if this were available where parents are paying a portion of cost but getting if financial

assistance. there's kind of a hard cliff right now. you hit that wall, you meet that dollar an hour base, and you could lose your child care assistance. i would be remiss to say our third priority is really our workforce. folks work hard -- there's nothing harder, i think, than managing a classroom of young children, at least for me. excuse me. but we have some recruitment and compensation challenges. one example, the cost of living in san francisco is high, as we all know, for -- for all of our san franciscans and families in particular. our workforce right now in a community based setting or a family child care home may be ashi as earning on average, even with a b.a. or b.a. work, less than 40,000 a year. that's far below an average two bedroom rent right now plus

important. so while it's noble work and important work, the pay is below what the professionals need to thrive. as one of our family child care advisors reminded me, she said i can't pick up my family child care business and commute in from oakland or alameda or somewhere more affordable because child care homes they're home is being licensed and operated to care for other san francisco children. so those are the three pressing gaps. we do have additional challenge, which i think is important to lift up? because of fragmentation in different program and see some challenges in state and federal policy, our early care and education is hard for busy working parents of diverse cultural backgrounds to navigate. and so a fourth priority is to lift up and make better, more clear information available and also make our programs easier to understand, access and engage with and retain. thank you. >> supervisor fewer: thank you very much. a lot of similarities between

daas, also. thanks. so let's open this up for public comment. are there any members of the public that would like to speak on these items. seeing none, public comment is closed. colleagues, any questions, comments for our presenters today? seeing none, thank you very much. can i have a motion, please, to file this item? [ inaudible ] >> supervisor fewer: oh, supervisor. are you making the motion? that's great. okay. so we will file this item. thank you very much. and madam clerk, are there any other items before us today? >> clerk: no, madam chair, there are no other items on this agenda. >> supervisor fewer: thank you very much. the meeting is adjourned.

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testimony. good morning. we're going to begin our program. and as always, remember that we're in the presence of god. first of all, my name is sister mary kiefer, i'm the vice president for mission integration for st. mary's medical center and the bay area center of dignity health. i'd like to welcome all of you today. in my world i would say this is the day the lord has made, let us rejoice and be glad because it took a lot of work to get to this point. and great blessings to the partnerships with the city and county of san francisco and ucsf. as is our practice, we step back from the busyness of the day and tap into our spiritual side. it's my pleasure to offer this

dedication to you. as we bless that ground, we stand at the sacred intersection meet grace and humanity. as we bless that ground, we set it apart for the special purpose of healing body, mind and spirit. may the architect of our lives bless those whose vision has brought us to this moment. bless those who gave form to the dream, who honed plans and laid a firm foundation. bless this ground that gives of itself to support the center of healing. may this building live lightly on this earth, using resources sparingly and respectfully. bless those who have constructed this space. may they know that they are healers. may the jobs created by this

project sustain families who call this city their home. bless future generations who will come here to work that all might experience meaning and purpose in their labor. cement the past and future with the present that we may be of one accord in our partnership. and bless these rooms, that they may be strong enough to hold a client's pain and pourous enough to allow our own humanity to seep through our sterile processes. may it pulsate with our good deeds and flow with justice and compassion for all who seek healing within its walls. amen. now, it's my pleasure to ask mayor mark farrell to continue on. thank you. [applause] thank you, sister.

thank you. it is an honor to be here this morning to celebrate the opening of our healing center here at st. mary's. mental illness is one of the biggest issues facing the city of san francisco right now. it is evident on the streets and reflected in the homeless population, but it is also happening behind closed doors. today, represents a huge step in the right direction with the what the city is doing to work and solve those issues. mental illness encompasses so many things, conservativeship is not the only solution. we do so much here in the san francisco. those with challenges need our help as a city. we have worked over the years and partnership with mayor lee and his team, first we passed laura's law a number of years ago here in the san francisco with the help of barbara garcia.

we have a place where they can go and receive the help they need. but conservatorship is a huge part of the solution and today's celebration is a huge step forward for the san francisco. we are doing things like opening up new beds and places for people to go when they need to come off the streets. we're partnering with other groups and people in sacramento like senator weiner. also, the integrated agency team where we focus as a city, multiple different departments under the 40 most people on our streets, those are the frequent flyers through our health system, our ambulances and police and fire departments, through our hospitals. and other services. the to make sure they get the care they need, but also that we work together as a city so we

can conserve those that need our help. let's not lose focus. this is about getting the people on the streets the help they need. so they can get on their own two feet and onto better lives. i'm honored to be here today. this is a celebration and it takes so many people to come together and there are so many people to thank here today. first of all, i do want to thank our late mayor ed lee. it was his vision and his pushing last year to put the $5 million into the city budget and it was his really vision to make today happen. and we celebrate today in his honor. i believe that in honoring that commitment, we will continue to fund this in our city budget moving forward for the next few years as well. i do want to thank barbara garcia and the department of public health, there are so many things that under her leadership have done to get today ready and to make it happen. least of all, not least of all,

is the fact that within eight months this center is open. and anybody here who is familiar with government regulations, that this center was opened within eight months is a miracle. [cheering] [applause] so a huge credit to our department of public health under barbara's leadership for making that happen. i want to thank our two partners. lloyd dean from dignity. thank you for your partnership. this is a dignity hospital, we're very proud to be here today to celebrate. mark lair from ucsf, your support. president breed, a leader on the issue as well on the board of supervisors. this has been a collaborative effort. we would not be here today without everybody standing behind me, but we would not be here without the vision of ed lee. i'm honored to be here today. let's make no mistake. this is one step in the right

direction in solving mental illness here in san francisco and work canning hard to get people off the streets, but let me introduce the woman had made it happen, barbara garcia. [applause] good morning, everyone. barbara garcia, but behind me is the incredible staff. behind me are people who did the heavy lifting. this is such an incredible part of over 115 beds that the department has opened up in the last year. so this is a really important program because it does have the highest level of care next to an acute hospital. but it also has the opportunity to provide people with intensive care services to help them heal. that's why this is called the healing center. we do that also from a recovery model and from a peer-based model. today, you will meet a lot of staff here. i got the honor to meet them. they went through 80-hour life

training, actually, because they not only have lived experience, but have family members. anyone in here could probably raise their hand if i asked do you have a family member suffering from mental illness or addiction and many of us would say yes. this center is really a focal point for the department, but we also have other levels of care that are more voluntary. people can walk into this. this is a little different, people are mandated to be here, but they have the right every 30 days to determine whether or not to continue here. but let me tell you, if you walked in here, i think you would be welcome to know you will have an opportunity here to be loved and supported to your recovery of our chronic disease. that's one of the areas we're trying to get people understand. mental illness and addiction is

a chronic disease. i hope this reflects the love and support we want to give our community members. eight months is an incredible force. they say government happens in two times, lightning time and glacier time. i think it's so important we get services off the ground. we could not have done it without the partnership we have. $3 million of renovation in this building. we couldn't have done it ourselves. so dignity had the area that we are in today, so let's give them a round of applause. [applause] sometimes hospitals, we think of hospitals as acute services, but today we can think of hospitals as multiservice levels of care and that's the direction of hospitals as well. then you have the issue of renovation and partnerships and they've been a great partner,

150 years affiliation, and then you have the fact that we want to share and be able -- there is a great need at the medical center as well, so we have a partnership. uc has allowed us a million dollars for renovation. we're appreciative of that as well. [applause] the department provides many services on its own. but to have a community-based organization with the kind of outstanding experience of crestwood behavioral health services is incredible and we're fortunate to have them. patty, who you'll meet, said we're going to do this and do it in this time period, i followed right behind her. i walked her walk. and i have to tell thaw it's been an incredible process. we had to take on the state department of health. they wanted this to have cement floors here, because they thought this was a prison, so we

taught the state as well for those who have mental illness. i don't want to underestimate the addiction, we see these as separate as well, this is a program not only going to deal with mental illness, but addiction needs as well. so with that, i just want to thank everyone for all of the work that all of us have done. i want to acknowledge a particular person on my staff who i follow very closely, she's about my height. you can guess, that is kelly. i want to give her a hand. [applause] she does incredible work every day, taking people from the hospital, taking people from the streets and putting them into the right level of care. and sometimes, folks, we don't have the right levels of care and we have to create those. this is one of those. i'm sure you're going to enjoy the day today as you walk through this beautiful facility. thank you very much.

>> good morning. this is a special day, special day for the city and county in a very -- and a very special day for all of us at dignity health. i want to thank all of you for joining us for this momentous occasion. just a quick story. i have a granddaughter that is 5. i try to call her in the mornings before she goes off to school, and she always asks me what is it that i'm going to do today? and she says, papa, what are you doing today? it was hard to explain our gathering here, so i said we're going to be dedicating a new place, a new home that will help serve and take care of people with mental illness and mental challenges. and she said, well, are you going to be staying there?

[laughter] and i'm thinking even at 5, she knows something that i don't know. but i would tell you, this is a beautiful, beautiful facility and truly together with all of the partners and certainly barbara and all of the support from the board of supervisors, from the mayor, and so many people that i can't take the time to list. this will change and begin to change san francisco. so i want to thank you for joining us, thank all of you for being here. it has truly been an honor for us to work with barbara, to work with the city, the county, and to continue on our quest here at st. mary's to impact and change

health care in this city in a way that allows us to serve the most needy and the most vulnerable. as has been said, all of you know, mental illness is one of the most vexing, complicated and critical challenges, not just facing us here, but facing our nation. but we, together, here are doing something about it. i will never forget the call, because i got so many of those calls, from the late mayor ed lee. and when he calls, you take his call. and he said, lloyd, and i said yes and he said i need your

help. when he says that, it's not just i want to have a consultation with you. but he explained what he wanted to do and he said, i need partners and you have been there before, and i need you to step up now. so this collaboration is a significant health capability that through partnerships we are together about to present to this city. and i just want to recognize and thank the incredible work of the hospital council and the city's emergency department physicians for helping us identify, not just the need, but the specifics of the issues and for pulling us all together to stand here today to do something that i think

history will show was one of the significant events in the journey of this great city. thank you. [applause] >> thank you, i'm mark laird, president and c.e.o. of ucsf health. sister mary, as you were speaking, all i could think of, i believe it was st. augustine who said, spread the gospel and if necessary, use words. >> st. francis? >> ok. i knew i shouldn't be wading into this territory at st. mary's [laughter]. >> one of those things. >> it was one of the saints, thank you. st. francis, medical center, it all comes together. but i think the point of this is this is not just talking about

doing something about mental health, this is doing it. and i am so proud of our affiliation at ucsf with the city, mayor lee, who was a special man, mayor farrell, potentially future mayor breed, all the people in the city who have really helped us move forward and make something important happen. but i do want to spend a moment talking about dignity health, what an amazing organization it is under lloyd's leadership, the team at dignity health is spectacular. always focused on doing what is best for the community. and at ucsf, we believe that's our calling, putting the needs of the community first and trying to address those in every possible way. as barbara garcia said, we've enjoyed a fantastic 150 and we weren't there in the beginning -- >> no, we were not.

>> close. 150 year membership that is the envy of the medical centers across this nation and we want to build on. i want to acknowledge one special person, so many special people, dr. jackson, who is our doctor for behavioral health services. when she came to ucsf she asked a lot of questions. what are we doing in the community? and the answers were not enough. with the partnership with dignity and crestwood and the city, we feel like we're really on the cusp of doing something important. i want to say thank you to everyone who worked on this. we will be there supporting all the way. thank you. [applause] >> thank you. i'm patty blum, i'm not the

c.e.o. just saying. i also -- [laughter] -- i have been with crestwood for 37 years. as a provider of health care services and psychologist i came to this field because my heart drew me here because i'm a family member. and i live each and every day looking to do what we do better and looking to serve more people. and looking to fully engage in every single way that we can to increase hope and love and gratitude. each one of us, each employee we have and each person we serve, each community member we run into. so we have a saying that we stole from the consumer movement, nothing about us without us. so i'm speaking up, i'm going to grab our newest director of education. come on up, deanne. deanne robinson. [applause]

we as an organization put the people who we serve first and foremost every single day as every good health provider does and we could not have found better partners in ucsf. and we've been partnering with san francisco since 1976, providing services for san franciscan s. and we're here today. this is a long hard-fought battle. without a doubt, barbara garcia, our late mayor, this would not have happened and with the tenaciousness of mauja, rita, john alan, this is a partnership that took every person. as recently as saturday morning,

7:30 a.m., conference call with the c.e.o. of st. marys. i'm going to let deanne talk. >> hi, i'm deanne robinson, i want to say thank you everyone for being here today. this is really important and special to me because i am a person who has received services for substance abuse and mental health. i just want to tell crestwood thank you quickly recognize and

gratitude some of the leadership who have brought this forward for most of you, the eight months, literally, several of us, mauja and i, had not walked on the campus before march 10th of last year. and we moved mountains with an incredible organization, who serves the state of california very well. with rigidity. >> nice to put it that way.

[laughter]. >> so we have honored them as well and have plaques that are going to them. but i've asked our local administrator -- the first one is for mauja and each one of these is for your fearless commitment and compassion to the people of san francisco. [applause] >> support rita. this is for rita. [applause] for barbara garcia. [applause] for our mayor mark farrell. [applause] for kelly. [applause]