hole that hole is drilled slightly larger marathon the anchor size for the e post-office box to flow around the anchor and at expansion is going into the hole the same dinning room we'll switch theameter we'll switch the holes so, now we have the second hole drilled what next. >> this is the anchor and this one has hard and steel threads that cuts their way into the concrete it is a ti ton anchor with the same large square so

similar this didn't require e post-office box. >> that's correct you don't needed for the e post-office box to adhere overnight it will stick more easily. >> and so, now it is good to go is that it. >> that's it. >> the third anchor is a universal foundation plate when you don't have room above our foundation to drill from the

top. >> so, now we have our foundation plate and the tightened screw a couple of ways to take care of a foundation what's the best. >> the best one depends on what your house is like and our contractors experience they're sometimes considered the cadillac anchor and triplely instead of not witting for the e post-office box this is essentially to use when you don't have the overhead for the foundation it really depends on the contractor and engineering what they prefer. >> talking to a qualified

professional and see what bayview. >> a lot discussion how residents in san francisco are displaced how businesses are displaced and there's not as much discussion how many nonprofits are displaced i think a general concern in the arts community is the testimony loss of performance spaces and venues no renderings for establishes when our lease is up you have to deal with what the market bears in terms of of rent. >> nonprofits can't afford to operate here. >> my name is bill henry the executive director of aids passage l lp provides services for people with hispanics and aids and 9 advertising that fight for the clients in housing

insurance and migration in the last two years we negotiated a lease that saw 0 rent more than doubled. >> my name is ross the executive directors of current pulls for the last 10 years at 9 and mission we were known for the projection of sfwrath with taking art and moving both a experiment art our lease expired our rent went from 5 thousand dollars to $10000 a most. >> and chad of the arts project pursue. >> the evolution of the orientation the focus on art education between children and patrol officer artist we offer a full range of rhythms and dance and theatre music theatre about in the last few years it is more

and more difficult to find space for the program that we run. >> i'm the nonprofit manager for the mayor's office of economic workforce development one of the reasons why the mayor has invested in nonprofit displacement is because of the challenge and because nonprofits often commute technical assistance to understand the negotiate for a commercial lease. >> snooechlz is rob the executive director and co-founder of at the crossroads we want to reach the disconnected young people not streets of san francisco for young adults are kicked out of the services our building was sold no 2015 they let us know they'll not renew our lease the last year's the city with the nonprofit displacement litigation program held over 75

nonprofits financial sanction and technical assistance. >> fortunate the city hesitate set aside funds for businesses facing increased rent we believable to get some relief in the form of a grant that helped us to cover the increase in rent our rent had been around $40,000 a year now $87,000 taylor's dollars a year we got a grant that covered 22 thousands of that but and came to the minnesota street project in two people that development in the better streets plan project they saved us space for a nonprofit organization national anthem and turned out the northern california fund they accepted us into the real estate program to see if we could withstand the

stress and after the program was in full swinging skinning they brought up the litigation fund and the grants were made we applied for that we received a one thousand dollars granted and that grant allowed us to move in to the space to finish the space as we needed it to furniture is for classes the building opened on schedule on march 18, 2016 and by july we were teaching classed here. >> which we found out we were going to have to leave it was overwhelm didn't know anything about commercial real estate we suggested to a bunch of people to look at the nonprofits displacement mitigation program you have access to commercial real estate either city owned or city leased and a city lease space become available there is

a $946,000 grant that is provided through the mayor's office of economic workforce development and that's going to go towards boulder the space covers a little bit less than half the cost it is critical. >> the purpose of the organization trust to stabilize the arts in san francisco working with local agency i go like the northern california platoon fund that helped to establish documents of our long track record of stvent and working to find the right partner with the organization of our size and budget the opportunity with the purchase of property we're sitting in the former disposal house theatre that expired 5 to 10 years ago we get to operate under the old lease and not receive a rent increase for the next 5 to 7

years we'll renting $10,000 square feet for the next 5 to seven years we pay off the balance of the purpose of this and the cost of the renovation. >> the loophole will that is unfortunate fortunate we have buy out a reserve our organization not reduce the services found a way to send some of the reserves to be able to continue the serves we know our clients need them we were able to get relief when was needed the most as we were fortunate to arrive that he location at the time, we did in that regard the city has been - we've had tremendous support from the mayor's office of economic workforce development and apg and helped to roommate the facade of the building and complete the renovation inside

of the building without the sport support. >> our lease is for 5 years with a 5 year onyx by the city has an 86 year lease that made that clear as long as we're doing the work we've been we should be able to stay there for decades and decades. >> the single most important thing we know that is that meaningful. >> it has been here 5 months and even better than that we could image. >> with the economic development have announced an initiative if ours is a nonprofit or know of a nonprofit looking for more resources they can go to the office of economic workforce development oewd.com slashing nonprofit and found out about the mayors nonprofit

mitigation program and the sustainability initiative and find their information through technical assistance as much as how to get started with more fundraising or the real estate assistance and they can find my contact and reach out to me through the circles of the city through the lics cc1 test message test text1 underline test text1 italics cc1 test message test text1 underline test text1 italics >> all right. good morning. good morning test text1 underline test text1 italicseveryone. my test text1 underline test text1 italics name's -- [ inaudible ] >> i firmly believe that test t nonprofits do their best work when they're focused on programs and services for residents and their mission not when they're worried about real estate and rent and leases te and how to protect their office space and risks test t of

displacement. that's why test text1 underline test t in 2015, oewd under the direction of mayor leigh and then under mayor farrell, test text1 under created the nonprofit initiative. this was created specifically to help nonprofited strengthen and test t grow in san francisco. our nonprofit sector manager thank you for all the hard work test text1 underline test text1 italics that you do. [applause]. >> this initiative also test t includes test text1 u $3 million in oewd's budget to support test text1 underline test t nonprofits and make strategic and smart investments and help nonprofits stay and grow in san francisco. today we are here at creativity and explore in te district eight test text1 underline to announce ten grants totaling $500000 to ten amazing test tex organizations in san francisco. ranges across all -- all across the city, in a range of service area and program test areas and missions. i want test text1 underline test tto begin first by

thanking linda johnson for -- the executive director for test text1 underline test t creativity explore for hosting us here in your amazing space. you're going to hear a lot more about linda here in a moment but first i want to invite mayor farrell up here to say a few words. mayor farrell was the test longest serving member of the board of supervisors test t and the committee chair. every year my organization went to test t the committee and ask for funding like this, mayor test t farrell was always there to support us and was a strong advocate for the work that we do in the test text1 underline test text1 italics nonprofit arena. >> test text1 underline test text1 italics thanks, todd, and test text1 underline test tex thanks for having us. thanks test text1 und linda for having us here today. it's amazing to are test text1 underline test text1 i here at creativity explore. our nonprofit is what we count on as a city government to deliver services throughout the city of san francisco, services as a government that we don't

provide test text1 underline test text1 italicsdirectly but we can partner with amazing nonprofits in every single district in our city which is what we're doing right now. proud to be here in district eight, and supervisor sheehy has been a leader in this district, as well, to recognize those nonprofits that are making a difference in our neighborhoods. as todd mentioned we're here today to announce that we're making test text1 underline test t a $500,000 grants to a number of different organizations, test t 75,000 of which is going to creativity explore, which is incredible, so please give them a round of plauz for test t that. test text1 underline test text1 italics [applause]. >> and you know, it's inspiring to be here. creativity explore test text1 underline test text1 italics helps thousands of individuals working every year and being exposed to the arts. i was able to speak to gerald every year and you showed me that some of your masks that you've created and you're going to have your own art show.

isn't that test t incredible? [applause]. >> the individual artists test that are back there, you know to me you can't help but tour an organization like this and be inspired and be more -- more and more, i would say, test t motivated every single day to support organizations like this to do the work that they're doing. this is the heart and soul again, of san francisco. we are going to support every single community in our city and these individuals that need our help as a city to see them engaged to see them test t succeeding to see them take pride in everything that they do it is just incredible and i'm proud to be proud test t of it. again, thank you for being here today. congratulations to creativity explore on the grant, but also let's make sure that we take this as test really test text1 italics inexpiration for the future, that we continue to fund nonprofits for the city, that test text1 underline test t we continue to inspire san francisco, that we continue to redouble our efforts to make

sure that every neighborhood has outlets like this to make sure that we service every single san francisco resident. thank you for coming here today. >> thank you mayor. i next want to invite up supervisor jeff sheehy, supervisor the district eight. he also sits on the budget today. he's been a tireless test text1 advocate test t for the nonprofit community, and supports nonprofits and small businesses in the city. i want to welcome up supervisor jeff sheehy. [applause]. test t >> supervisor sheehy: thank you, todd and i want to thank you, linda. what an amazing program what beautiful work that's taking place here today. i am so proud and test tex honored to have your organization and test text1 underline test text1 italics creativity explored in my district. i also want to thank mayor leigh and now mayor farrell for continuing the program. as we know, it's gotten harder and te harder for nonprofits to survive in the test text1 underline test text1 itacity, and test text1

underline test text1 italics this in inno vatetive program out of oewd is really going to help nonprofits stay in san francisco. anybody who worked in the field know how much stress this sector of our connect is under, and the work that they do, as mayor farrell has test t mentioned is some of the most extraordinary and important work test t that they do in the city. i walked through there, the happy faces and beautiful art, it is really something that is "au" inspiring. thank you mayor test text1 underline test text1 italics test tex leigh --e and thank you mayor i don't remember farrell and test text1 u thank you linda. >> thank you, test text1 underli supervisor. i want to invite linda johnson up and i got an opportunity to talk to her on friday, and hear the test text1 underline amazing artists and the amazing test text1 underli leadership she brings to the organization. and the one thing that came through loud and clear is that by us being able to help her

with this grant it frees up her time to create not just a better space for her artists and her organization but allows her to spend more of her focus on the mission of the organization rather than on real estate rather than on risks displacement and worrying about those effects, and so i want to invite test text1 underline up miss johnson to you can at that atalk a little bit about te creativity explored and what that means a little bit to her organization. linda? >> good morning everyone. so first of all, i'm hear to thank the city from the bottom of my heart. for over 30 years we've occupied this space which test text1 underline test text1 itali is the former dance hall, so please tour around and check it out. our artists, our staff and this space are the source of the magic that make so many test text1 underline test t people fall in love when they walk-through these doors, and this is our 35th anniversary year for that whole time, we've been helping artists with test t developmental disabilities develop their test text1 underline

test text1 craft and gain respect as iffull flejed test t members of the arts community. the test text1 underline test t 130 artists that we test text1 underline test text1 italics serve every year develop test skills and te earn money and become a part of a close test text1 under knit community. their work decorates test t many real estate developments around the city and test text1 outside the city and their work is licensed onto products by businesses like test text1 underline test text1 rakudi chocolates and cb test tex 2. over 10,000 people from all over the world visit this gallery and our test t studios every year and our staff are an test t unusually devoted group of people. many of them have worked here for 20 years or more and they do what they do out of test text1 underline test text1 italics test text1 underline test text1 italics real love for the community and the people that they serve.

we are extremely grateful because we have an test t incredible landlord, and his test text1 underline family. we pay below market rate at this site but none theless, we're still struggling. our test t facilities haven't kept up with our growing staff test text1 underline test t and the needs of our artists. as you tour around the test text1 facility you'll see the kitchen facilities that we offer are just a few cabinets and a countertop, and test text1 underline test tex there's no sink. we have no provide meeting space in the office except test text1 underline test text1 italics in my office. where only about five people can sit, test t and there's most important no respite space so that if our artists get overwhelmed and they need a break from the day-to-day, a kweeet place to go there's no place for them to do that: and we've had also no way to accommodate our growing staff as we continue to grow as an organization so the grant is solving so many

problems for us. soon our staff is going to feel appreciated when they can sit down for a break at a wonderful kitchen, and our artists will have a place to go to take a breather when they're having a hard day and they need to be alone. and we'll have a real conference room so we'll be able to repurpose other space in this facility for more work stations to add more staff to work harder to expand our mission and meet more test text1 under needs. and that's going to help us serve more artists and bring more of this beautiful art to the world. so i just want to say thank you to mayor farrell and all the hard working staff at the city and at test t northern california community loan fund who made this investment a reality. it means so much to us. and i also want to give a short shout out to our testgala which is coming up on april 20th. test text1 underline it's called art changes lives, and please check out our website for test text1 undtickets. test text1 italics

[applause]. >> you know in order for initiatives like this test t work, it takes a partnership test text1 underline with the test t nonprofit community, and we designed this initiative to be that partnership, and we couldn't have asked for a better test tex partner than northern california community loan fund. joanne is here today, and she's been a key driver and test text1 underline test text1 italics organizer of this program. i want to invite joanne test text1 underline te leigh up to talk. >> thank you todd. in this rapidly increasing real estate market no other city has provided this kind of leadership to create programs and devote test text1 underline resources to help keep nonprofits in their test text1 u communities. so san francisco has really addressed this crisis head on first led by mayor lee by launching the nonprofit displacement mitigation program, and now, the prop test text1 underline test t nothing further sustainability initiative test t supported by mayor farrell. we are proud to partner with the mayor's office of economic and workforce development, the office of housing and community

development, and the te arts commission to make sure our community based organizations remain in san francisco. so our social service in child care and arts organizations are great at delivering the vital services and creative programming, much like you heard from test tlinda, but they're really unfamiliar with space planning with lease and purchase negotiations and test t tenant improvement budgets. so this test text1 underline test t knowledge gap is compounded with san francisco's volatile real estate market and has put our nonprofit test organizations at great risk. our technical assistance services offered by ncclf through this program helps organizations navigate the hot real estate market and find test t spaces that meets their needs. these grant awards are test text1 underli critical in supporting our community-based organizations to stay in their test t neighborhoods where they are needed, providing security for their clients and staff, and alleviating real estate costs and oftentimes test text1 u incentivizing

landlords to enter test text1 into test text1 i languager termlonger term leases. these awards will support ten organizations test text1 underline test across our city, from test text1 underline chinatown to tender line. i congratulate te creativity explored and all of the entities today and thank the city for developing a model program and especially a shout out to todd and lex te at oewd for their continued guidance. this test text1 und ensures that our social services child care and arts programs continue serving the residents of san francisco. thank you. [applause]. >> thank you, joanne. you know joanne brought up a really important point that other cities in test t other regions across the country have looked to the city of san francisco as a model for how we're supporting nonprofit organizations, and that's taking a page out of the play book that we're doing here but we're also sharing with our colleagues and partners across

the country. this is a partnership of city departments, and i want to thank mayor's office of housing and test t workforcevectionment tom test text1 underline test text1 italics decaney, and talk about the test text1 underline test t arts commission and their help in creating great spaces like creativity explored. >> thank you tom and lex and nccf and all of our partners and all of our elected officials, supervisor sheehy and mayor farrell for championing this initiative. i just recently was sharing some of these promising practices both of our colleagues in seattle and portland and they are really impressed by the investment that we're making here in san francisco in local nonprofits not just in real estate but in the technical assistance and in building the capacity to respond in a very challenging real estate market so i'm particularly thrilled to see in this round of grantees a large number of arts and culture organizations, including test text1 under creativity explored. my long time colleague linda johnson, it's really a great

honor to be in your space today and feel this te incredible art making. we've done some incredible work at helping stablize organizations. there's more work test text1 underline test t test text1 underline test text1 to be done so i'll ill i'm thrilled that these organizations are going to continue so congratulations to all the artists here at test t creativity explored and all the great work that you're test text1 underline doing. thank you. >> thank you. finally, i want to invite up the artists. you know the reason that we do this the reason that everybody is up here today is because of the mission of creativity explored, and what that boils down to is the test t artists here doing amazing work. if you have time, i encourage you to go around and look at the amazing work that these talented amazing artists are actually producing. i want to invite up test t two artists along with paul, who will facilitate a conversation with these test t artists please.

>> hello. i'm test t paul and this is gerald test text1 underline test text1 italics wiggins right next to me. gerald i think the mayor has met him. has some work in this show but also in the studio and evan of course has a test t lot of test text1 underline test text1 italics artwork in the studio. so after this, if you want, me can give you -- i can give you a tour in the test text1 und studio more in depth if you're interested. so i have a question for kevin. so what do you think about getting this money from the city and having money -- you have to come closer to the microphone. >> i want to thank the mayor and i want to thank everybody for this. this is going to be a door opening for our school and it's going test t to help the whole school and it's going to make the building better and i'm really honored that we're getting this grant. and i'm -- i'm very grateful to you for all the grants you're giving and it's really an test text1 underline test t honor.

[applause]. >> and what do you have in your hands there? >> oh, i wanted to show test text1 u the mayor some of my test text1 underline test texwork. >> okay. >> if you could pass that test t test text1 underline test text1 italics on. [ inaudible ] >> and test text1 underline gerald do you want to say anything? >> thanks, you all for coming, and thanks you all for giving us the money to help us out. we need it. thank you. [applause]. >> and thank test text1 underlineyou. test text1 italics [applause]. >> all right. that's it for the program. i'm going to close it down. i do want to thank everybody that was here today and everybody from the city creativity explored thank you for opening up your home. i hope everybody checks them out on the test tex website, test text1 italics creativityexplored.org, and check out the amazing work we've got going on right here in san francisco. thank you, everyone. [applause]. essage cc1 test message test text1 underline test text1 italics

cc1 test message test text1 underline test text1 italics cc1 test message test text1 underline test text1 italics cc1 test message test text1 underline test text1 italics cc1 test message test text1 underline test text1

>> chair cohn: hi, everyone. good morning. oh, god, that was -- clearly i'm the only one excited about budget. okay. all right. all right. let's see. hopefully my excitement will be contagious and you will get fired up. i want to welcome you to the budget and finance sub committee. i want to acknowledge our friends at sv gov tv. tom and leo are assisting us with today's broadcast and we have with us linda wong. she came back to who. sometimes budget gets long and hard. thank you linda for being here with us. i want to

recognize my -- oh my god. it's an all women team today. we have sandy fewer. say hi to your husband. >> supervisor fewer: hi hon. >> chair cohn: we have stefani over here. let's call item four please. >> item number 4, the health code to designate the city attorney rather than the district attorney to institute judicial proceedings to appoint conservator for persons with mental health disorder and compel participation in out patient treatment to the office of the city attorney to institute such proceedings and appropriate fundings for that purpose. >> chair cohn: thank you. so we have supervisor reed that's the sponsor of this legislation. today we have jill neilson from the department of ageing and adult services that will also be making a presentation. the floor is yours. thank you and welcome. >> excuse me, i'm sorry.

>> chair cohn: yes superviseor reed. >> thank you for taking this item first. the legislation before you today amends the health keyedcode to designate the city attorney rather than the district attorney to handle judiciary proceedings related to mental health conservatorships. that's when the court provides a guardian for someone who can't make decisions for themselves. it's no secret that the city is grappling with severe mental health challenges. sadly we have many mentally ill individuals that can't care for their needs and they need a conservator to get the treatment and help they need to get better. being left on the street without this kind of intervention is inhumane and not helping anyone. compounded with chronic homelessness and

sometimes substance abuse these mental health challenges become more acute and must be addressed with sensitivity, compassion and dignity. just the same way individuals dealing with mental health challenges should not be locked up in our jails. mental health conservatorships should be handled like -- should not be handled like criminal cases. being mentally ill is not a crime. these cases should be handled in civil cases, the same way we treat cases related to family law and assisted out patient treatment cases under the laura's law. that's precisely why i brought forward the legislation. by transferring the responsibility of conservatorship cases from the district attorney to the city attorney's office we are decriminalizing mental health issues and ensuring that we are helping individuals get the services that they need to get healthy and stabilized for the

long term. through this legislation -- though this legislation does not mandate that the city fund a specific number of positions in the city attorney's budget it states that it is the board of supervisor's intention to do so. as we enter into more robust budget conversations one of my personal priorities will be seeing that we fund the positions necessary to handle these judiciary proceedings and handle them well. with this legislation you have a commitment from me to work with members oh of the budget committee the rest of the board the city attorney's office and the mayor's budget office to come up with the right number of positions as we consider this legislation today. i think it's important that we educate ourselves and the public about the conservatorship process. conservatorship in san francisco is incredibly complicated and is not something that we as the public -- as

public servants take lightly. this is about temporarily taking away someone's civil liberties for the purpose of providing much needed potentially life-saving treatment. treatment that might not other wise be accessible to them given their mental state. it is critical that we really understand what it takes to conserve a person and understand how many cases the city attorney will potentially be taking on with this legislation. for a brief over view of the conservatorship process the deputy director of programs at the department of ageing and adult services is here today to do a short presentation. we also have john gibner here from the city attorney's office katherine miller from the district attorney's office and heather vinese and cabos gain bessier from the department of health available here today. please forgive me if i have just

completely butched your name. >> chair cohn: you didn't practice that one. >> so i will turn it over to jill at this time. thank you, colleagues for allowing us to proceed with this particular item. >> thank you very much president breed and good morning supervisors cohn superwisesuper superviseor fewer and supervisor stefani. i'm jill. i'm with the department of health services. here we go with the powerpoint. thank you. i've been asked to provide a high level over view of mental health conservatorships in california and discuss the role of the office of the public conservator here in san francisco. first i wanted to thank president breed in her interest in assuring the most appropriate legal representation. our department fully appreciates and supports

the intent of the proposed ordnance. the role of the public conservator is to oversee the psychiatric care of adults that are gravely disabled and not able to accept services on a voluntary basis due to this condition. grave disability is a legal basis that's used for determining the appropriateness of conservatorship. it refers to the inability of an adult to provide for their own basic needs specifically their own food clothing and shelter. the mental health conservatorship system in california is really complex. to start off my discussion i just wanted to quickly clarify a couple of terms that are often misunderstood. lps refers to the name of the bill that was passed in the late 1960s and it took full effect in california in 1972. lps conservatorships mental health conservatorships are essentially one in the same.

i want to distinguish these two terms from the public guardian. there's some confusion about the role and the inner play. the public guardian is a program that's also operated by our department and this program oversees conservatorships for adults with cognitive impairments dementia like alzheimer's decide. -- disease. public conservatorships tend to be established for the life span of the conserve person. when the act was passed the intention was really to end lengthy, indeterminate and involuntary commitments that were really complon at that time. the model that was established under the act is a recovery model. it's really based on the understanding that mental illness is treatable. i have

some codes here. 5150 might be a term that many are familiar with. a 5150 hold can be used for danger to self or danger to others. most individuals that are held on a 5150 generally stabilize within that 72 hour period. they might be released even after a few hours. it's a much smaller percentage of mentally ill individuals that do not recover within a few days. those individuals can be held on an involuntary basis under psychiatric care for additional holds. the office of the public conservator doesn't get involved in these cases until we receive a referral from a psychiatric hospital. typically we don't receive a referral until someone is on a 5270 hold which you can see from this slide here is a 30-day hold. i've provided here

just a really high level data snapshot to help you understand san francisco's current public conservator case load. a few key facts about the public conservator's office also. i've always provided the superviseors with a hard copy of a more indepth data dash board if you are interested. i'll be happy to comment on any of the comments in that dash board if you have any questions. as you can see we have a small team of 14 ftes they are licensed social workers. over all our total case load this past march was 537 clients. usually our over all case load hovers in that general range. in march we received a high of 23 new client referrals but on average we receive about 16 referrals. i've also included here the number of conservers with

pending charges that we will discuss in just a moment. these 77 conservete's are cases that will need to be handed if the representation is moved over to the city attorney. i also just wanted to provide an over view of the different types of mental health conservatorships that are handled by our office. traditional lps conservatorships make up the majority of our cases and those are for clients that are gravely disabled due to mental illness. murphy conservatorships are a subset of those conservators with pending criminal charges. these were previously found incompetent to stand trial and they have serious pending felony charges on top of those characteristics a conservetee is considered to be a substantial danger to others. we currently have 15

individuals on murphy conservatorships. these are cases that would need to continue to be handled by the district attorney's office. in san francisco we are really proud that we are developing some innovative conservatorship programs that allow conservetee's to live in communities that are less restrictive. if you compare our program with other counties in california you will find that we are fairly unique in that sense. our community independence participation program is a voluntary conservatorship program. under this collaborative court model they come to court monthly and they receive wrap around community-based services. we are working to place appropriate conservete conservete conservete's into the community. these are contested. these are individuals that are safely able to remain in the community.

really quickly i just wanted to review the role of the deputy conservator in the public conservator program, the over arching frame work we take is we are really trying to help our clients achieve recovery in the least restrictive setting as possible. our social workers in our program make up a critical part of the conservatees. we have a really close collaboration with the department of public health transitions team around the placement. this slides outlines our current relationship with the district attorney's office and our assigned ada is in court with us at least weekly. she represents our office not just on cases that involve pending criminal charges but on all of our cases including our collaborative court cipp program as well as traditional lps. i also just wanted to highlight that the district attorney actually will handle jury trials

and they have the right to request a jury trial every 6 months. the biggest change looking forward at the ordnance that would -- the biggest change for our office is we would be working with two legal teams opposed to one. here i have tried to lay out the different types of cases that would be handled by the city attorney and those cases that we believe would still need to be handled by the district attorney. as i indicated before, we estimated that there are about 15% of cases that involve criminal charges that we think would still need to be handled by the district attorney's office. we would work with the city attorney on all other types of conservatorship cases including potentially the new housing conservatorship that's been proposed by senator scott weiner through senate bill 1045. working with two different legal teams is absolutely a change that our program can accommodate. we have a very effective working relationship with the district attorney's

office and i feel confident that we would be able to develop the same effective working relationship with the city attorney as well. in fact as you can see the public conservator is very accustomed to working with multiple departments and stake holders. here i listed out the partners that our collaborates with around the care and protection of people including the department of public house, the department of homelessness and supportive housing and law enforcement and the jail psychiatric division just to name a few. it takes a lot of care to provide care for our most vulnerable relationships. many of my partners are here today and i'm happy to answer any questions that i can and defer to them for questions outside of my scope. thank you. >> chair cohn: thank you. i have a few questions if i may. how long has the san francisco's office of public conservator been around? when was it first

established? >> the law went into full effect in 1972. one of the change -- there's been several changes though. we initially -- the office of the public conservator was actually under the state of california. i can't tell you exactly when the office of the public conservator came under das but it's been about 15 years ago. >> chair cohn: so i was wondering, has there ever been any program evaluations or audits of the program? >> we do receive every three years -- we've been subject to an audit from -- actually our partners at the department of public health and it's really around services that we provide that are reimbursed by medical. >> >> chair cohn: is it dps that conduct conduct the audit or a third party? >> i can't speak in great

detail about these audits but we are working with quality assurance divisions at the department of public health. >> chair cohn: okay. so in this particular context we are talking about a grave individual, right, that's suffering from not only mental illness but substance abuse and incapable of living on their own. what other levels of service if not -- probably not under the public conservator but just that maybe das is a part of or the department of public health that you may know of? how do we -- i guess the word i'm looking for is -- i would imagine that there are varying individuals with varying levels of needing help. we saw one earlier today. the one that was in the chamber today probably doesn't qualify for the program that we are talking about today, could use a little support. i'm wondering what are the characteristics that you used to distinguish who gets placed in which category? >> so the department of public

health operates community behavioral health services. >> chair cohn: okay. >> the assisted out patient treatment program is one program that's also operated by community behavioral health services. when we are looking at whether an individual necessitates the restrictive services provided under mental health conservatorship we are first trying to find out whether the individual has the capacity, the willingness to accept services on a voluntary basis. the first point of entry would really be through some of our community-based clinics and certainly we have intensive case management programs that are provided by the city and also funded through city contracts out to cbos. many of those case management programs help to keep individuals that may be struggling with mental illness but not gravely disabled. those programs can be vital to keeping

those individuals independent and safe. the department of ageing and adult service also operating the adult protective services program. about 50% of the cases that adult protective services intervening with involve what we call self-neglect. very often that's an entry point for individuals that aren't maybe struggling with mental illness, perhaps substance abuse and may not have insight into their own needs. our adult protective services workers will go out, conduct unannounced home visits try to engage with clients and try to get them connected to behavioral health services and case management services and a variety -- a broader array of services that we offer here in the community. >> chair cohn: so on -- well, it's page 3 in my hand out but

it's probably slide 6, types of mental health conservatorship, my question -- you answered it but it derives from this slide just to tie it back to the presentation as to where i was going. >> okay. >> chair cohn: i just wanted a little bit more context to it. anything else that you wanted to add? >> in terms of how we determine what type of conservatorship program that we would identify for a client, all of our conservatorships, mental health conservatorships are initiated through the holds, the 5150 hold to start with that is laid out in the lps act. i'm not talking about assisted out patient treatment i'm not talking about laura's law at this moment i'm just talking about conservatorship. so once we have an individual stabilized at a psychiatric hospital we have one of our deputy conservators go out, meet with the client and we work with the psychiatric team and we try to identify the

real key services that we need to identify what level of placement does that client need. so clients that have greater levels of impairment may need locked psychiatric facilities initially out of an acute care setting. clients that are higher functioning, clients that have more insight that are more willing to participate in their treatment and service plan those clients might be eligible to be placed in a community setting. when i say community setting i might be talking about a residential care facility for the elderly or a board and care facility as they are commonly known. we also have clients that we place in sros and we wrap them with a lot of services including home care that might be provided by home bridge or in home supportive services as well as visits from case managers multiple times a week, day programs. individuals that are in the community i will mention

we do have -- that are under conservatorship we have on file with the court what is called an affidavit b. the affidavit b does permit us to involuntarily provide medications. it's something that we have to enforce rarely but it is a tool that we are able to use with those clients that are presenting as higher functioning that seem to be able to function safely in the community. we want to make sure that we are going to be be able to help them to stay on their medications. that's very often the critical piece within the recovery plan. >> chair cohn: thank you. so what will happen to the da staff members previously working on this? >> i don't think that i should comment on that. perhaps -- >> chair cohn: okay. let's do this, this is a natural break. thank you for your presentation. does anyone have any questions for miss neilson?

>> supervisor fewer: what about the out come in these people who go under conservatorship what is the results and what are the impact on these individuals and then the second part of my question is what kind of trends are we seeing around conservatorship? that people are needier that they need more service and therefore more resources? are we seeing -- what kind of trends are we seeing? is this -- have we been seeing the same amount for so many years, seeing more seniors. you can give me a snapshot. what is the impact and the result of this? then the trends? >> well i think that you'll see there on average or conservatees stay under conservatorship for 5 years. although lpss are intended to be short term. what you can see is

that the individuals that we are serving do have serious mental illness and it takes time for them to achieve recovery. in terms of the trends that we are seeing, i think that senator weiner's senate bill 1045 is laying out what one of the most consistent trends that we are seeing at all of our community-based health clinics all of our hospitals. substance use disorder is really a common element in the clients that are coming into our psychiatric emergency rooms that are presenting as being very gravely disabled. one of the things about the somewhat antiquated lps law is that we are not able to use substance use disorder as a try tier yeah for conservatorship. in fact, the lps act only referencing chronic alcoholism. so one of the things that we are hoping to do

with senate bill 1045 is actually modernize this language and provide our courts with the tools that they need to be able to use substance use disorder as a criteria for conservatorship. we are very hopeful. in fact i was in sacramento on tuesday with the mayor's office and with senator weiner and i was really pleased to see that the senate judiciary committee was very own courage -- encouraging and supportive of the bill. i think it could provide san francisco with high schools that we need to reach a broader spectrum of individuals. i don't want to quote too many statistics but we have those prepared for our trip to sacramento on tuesday. it's about 60% of the individuals that are presenting to psychiatric emergency room are actually showing up with meth induced psychosis. there are

other drugs that our homeless individuals out on the streets are using and it agitates psychosis walking to bart or wherever we are going. i think that san francisco people come in close contact with mental illness and there's really an interest at this time to try to broaden the tools that all of us have out our disposal to help those that don't have insight when they are in the throws of addiction and not able to think clearly. >> supervisor fewer: i think my first question isn't how long do people stay in there. under conservatorship. what is the impact? so if we have -- what happens to them after 5 years? what happens to people? what is the out come for individuals? i

think that was my question. >> i'm sorry if i didn't answer your question before. we ideally are moveing individuals into a less restrictive setting and off of conservatorship. ultimately that is the goal. >> supervisor fewer: do you have data or numbers and how many you have moved and how successful? >> i don't have it but i can send it. >> supervisor fewer: if you can send me that data and the data for sacramento. i think that would be interesting to review. i have the same question that super superviseor cohn had, if we move from the district attorney to the city attorney then should we be moving ftes also? their workforce? >> chair cohn: we'll ask that when we get the district attorney's representative up.

>> supervisor stefani: i just wanted the particulars when you are done. >> chair cohn: thank you. i usually listen to the bla report after the staff presentation. >> supervisor stefani: okay. >> chair cohn: right before public comment. thank you very much. >> thank you. >> chair cohn: i'd love to hear from the district attorney's office and the representatives. good to see you. it's been a long time. you've done a great job. >> good morning, supervisors. katy miller from the district attorney's office. our mental health unit is one in my division along with collaborative courts and juvenile units. i wanted to say three things that answer the question. first i just wanted to thank superviseor breed for working with us to clarify that the cases that originate through a criminal matter will still remain with our office. we think that makes sense for a variety of reasons. it tends to be the standard way that this work is divided when you look at how a number of counties also do

this work. so thauj for that. we -- thank you for that. we appreciate the amendment and the clarification. right now we have two staff who are primarily doing this work an attorney who is here with me this morning, leslie cogan that can answer any detailed questions about the process. it varies for her month to month how much time is spent doing the conservatorship work. on average i would put it at 50% of her time. then the paralegal firm, the mental health unit she serves the entire unit and 40% of her work is spent doing this work right now. our intent is to have these two positions be fully doing the work of our mental health unit. so right now this is only a portion of what they do. i think if they had more time they would spend more time doing this and i want to support what superviseor breed is saying about the need to create the three positions in the city attorney's office. i think this

should be fully resourced work to be as effective as possible. it is just a portion of their roles so our hope is with this work -- with some of this work being transferred they will be focused on all of this mental health work that comes out of criminal cases. so the paralegal will be serving the mental health unit in its entirety monthly and the district attorney who does this work will be focused on the cases we keep through this process as well as our other mental health work. that incloo includes that variety of things