the two. on page where it says on developing such recommendations the office had seek to build upon -- to protect the status of women. maybe it could in developing such recommendations in collaboration with the status of women. >> absolutely. >> would you be open to that dr. >> i like that but i would like to have reverenc reverence of oe full-time equip lent. >> . so deputy and city attorney can we on page 5, lines 11-13, add the language working collaboration not just building.

it's referenced up above but would be good in that instance. >> john gibner: i think where you place that clause probably matters i think what i heard you say supervisor say phi is in developing recommendations. in the department of the offers of women shall seek to buildpop upon previous recommendations. correct. i think that one seems to make everyone happy. >> i think the over all message is that don't invest in women's needs. we heard from so many about how

they were directed and marginalized. we want to do so much in this area and support the work of the sexual response team and sit at the table with bph in moving this forward so we are not back here with survivors telling these horrific stories. we need dedicated staff and we have been asking and asking for many years and our staffing level has not changes. it say as person with two budgetary constraints. it will be subject to the budget process but it's my belief that we need to ask for what we need to make this happen. >> supervisor safai: so your one full-time can you describe what they would be doing because it's pretty clearly described in here what the staffing would do for sharp. just for the general public's

understanding. >> we convene for example the family violence council, criminal justice agencies, cbos, stakstakeholders on a regular ly basis. that is what we did on domestic violence. we had stakeholders at the same and moved policy reform. we are good at doing that and conferrings with supervisor ronen's office ant th about the prevention piece. we have talked about public outreach and protecting your drink and a number of campaigns to encourage establishment owner to be on the lookout for people drugging potential rape victims. there is a whole schools piece and campus piece and we did

spend 18 months staffing the campus sexual assault task force with 47 recommendations. we have over 20 stewing it is of higher learning in san francisco and those are not going to move forward without dedicated staffing. >> this staff person would be doing a host of issues in con jung with what you said along with collaborating with the commission. supervisor yee. >> commissioner johnson: thank >> supervisor yee: thank you for expressing needs of your office. i am a little uneffortable with this discussion it seems like a budget discussion and i am on a budget committee usually it's

brought up. for us to start this off should be the primary focus and it's asking for specific number of staff for the office and i am supportive of that. i think it's not to say that i'm not supportive of what your needs are, but i think the process should be done through the budget process or at least with mayor's office to put that in your budget, so that is where i stand. i wouldn't be supporting adding another position. >> supervisor safai: supervisor ronen did you want to add something? >> yes, a couple of things. when i made the speech about hue harhowsharp is just an an aspeca major, major problem because once you address it and

informing our own house in the city everyone wants to add things which are so justified. we need all of those things, prevention and trauma and mental health and housing and we need it all there is no doubt about it, but this legislation is not a comprehensive sick. fix. these are focused on the fact that city departments are failing survivors of sexual assault and so it's different and i don't believe this is appropriate. i think through the budget process where the department will have their budget hearing coming shortly before the suggest committee i would also that i am currently through the budget process along with supervisor stefani advocating

for an add-back for the domestic violence consortium that in ordein order --my understandingy

city attorneyny is that if we decide later on to make that amendment which is unclear that there is no problem in term of making that amendment at the department at that time if necessary. can you just speak to that? >> sure in terms of changing the department you can make that amendment in budget and finance

or government and finance instead of rules committee is that the question? yes, either way. you can make the amendment in either committee. >> supervisor fewer: so i stand by the legislation as currently written and i would love it to move forward if this could move forward tomorrow for a vote, i would ask you to because we need additional hearing at a fiscal committee then what i would ask my colleagues to do is send this out of committee with recommendation and if at some point to be determined we decide to amend the legislation to change the department where the office sits then we can do that in the fiscal committee. >> have you gotten a time commitment i know the government audit and oversight has been backed up for months. curious do you know if you will have a hearing anytime soon?

>> supervisor fewer: the first available date we would have in finance is july 19 because they have to finish the budget first. >> the next available i know we just had a hearing and the next meeting they ever is july 18. >> supervisor fewer: so for me i know it's not only that you have a preference perhaps of keeping it here but asking the supervisors to come out and tell their stories and over and over and over again is incredibly traumatizing. i would prefer since we had an incredible hearing today if we could mover this out and then we will have another hearing because we have no choice and i

know the survivors want to be present at every hearing that this legislation is heard that we move it out of committee today and hear it at a budget committecommittee. >> supervisor safai: if there is still discussions that were going to happen i would going to maybe ask the department of public health and safety and if there were going to be continued conversations and i supportive of your path, your and i have had that conversation, we would be having a hearing on this if we continue before we made the amendments that we would have it before this time so this would not slow down the process at all. >> supervisor fewer: i understand it wouldn't slow down the process but failing to understand why we would need it

again. right now i am not comp templating any amendments. >> supervisor safai: okay i will go to supervisor yee. >> supervisor yee: i just want to be clear about we actually could have a budget committee meeting on july 12. we would have finished our deliberations for presenting to the board at the end of june and then the 4th of july week is out, so actually next budget meeting should be on the 12th. just for information purposes. >> that is fantastic. >> supervisor fewer: there is a meet an confer obligation. i have want this moved as

quickly as possible. i don't believe have another meeting will delay it, but my need is to try to understand the need for another meeting because i am not working on this legislation alone, in fact jane doe, rachel and tiffany helped create this legislation with my office and we are a team, and the women that have been involved in this are very attached to this legislation and we don't feel comfortable having any hearing out everyone present because it is their legislation. i don't want people to have to miss work and coming for hearing after hearing unless there is a purpose for it. >> supervisor safai: for clarify, the rules committees hears appointment to commissions and board and it is the body in

which the administrative code changes happen and this is a major administrative code change. i understanif we are talkerringe this department will sick, that is an administrative code conversation and i am 100% fine with the path that you have laid out so i don't imagine this will require that conversation. you have pretty much stated your path and you want the human rights commission. i do want to hear from the department of public health and i do want you to say a few things about the meet and confer and we don't have someone here from hr do we? are you here from h. r.? so that is why we did the same

thing when we were talking about removing the fees for those that were in criminal proceedings. we have done the same thing when it pertained to every single administrative code change and that's been my prerogative as the chair of the committee and it's not meant to slow down or inconvenience people but to respect the process of this committee and if we were just simply talking about there is going to be additional conversations about budget i would say i 100 percent agree with you. i just want to state for the record the reason why it's important to me as chair of this committee that the conversation happened in this committee if we are talking about ultimately where this new sharp department will sit. you mentioned meet and confer and i know that is one of the issues, and so do you want to lay out the issue and topic.

>> supervisor fewer: we heard rather late in the game a couple days the ago that this legislation will require the department of human resources to offers the unions opportunity to meet and confer given that the legislation allows the department to receive and potentially mediate complaints against union members, so i get it, it's a legitimate meet and confer issue. i think there is a representative here and are you suzanne guard? thank you so much for coming. i don't know if you have anything to add to that. >> thank you for having me it's suzanne gard. i want to thing the supervisors and supervisor ronen specifically and the members of the public who shared their

stories today. i will say that you have all inspired me to say that there are two women both my sister and myself and both of us have been victims of sexual assault in my lifetime. we talk about having purpose in our work when we are looking at legislation like this and creating this kind of office for me personally, that is the kind of purpose i get up and get ready for work and come tock a part of and i thank you for that. the department to have human resourceses looks forward to working with you. it is in section d4 where you talked abou about supervisor ron that provides for you may recommend discipline to other departments about employees to the appointing authority, the department of human resources for uniformed officers of the

police department. [reading] , so when we are talking about an employee's money it is a negotiable item. if there was a disciplinary issue that affected a person's ability to be at work say they received a suspension or off work for a period of time or if their license was affected, that brings up the meet an confer obligation, so our office what we would do is send the legislation to the folks that would be affected and let them know there is a possibility, check out this legislation and let us know if you want to meet and confer and it is up to them to tell us they want to meet and confer and we typically get everyone together in a group and try to handle all the questions at one time so we are not talking to individual union and

hopefully we would be able to take care of it right aaway and i think everyone is on board with what we are trying to establish here with this legislation and i think with explanation we could get through that rather quickly. that would be our hope and our aim and we would work with your office on anything that needs to happen. >> supervisor fewer: which unions would we send it to. >> i would have to do more analysis it would be the pra because the police are called out specifically and one of the organizations we have heard not moving quickly enough or treating people the way they should, the medical examiner's office the public health service. sviu and physician and others and probably about half a dozen in all we would need to reach

out to. >> supervisor safai: thank you for being here today and sorry to have thought that you weren't so thank you for being here today because it's an important point. at what point do you do that. >> we prefer to do them now so we would like to go forward with sending a letter and we can mover it out of committee today as supervisor ronen has requested and we send a letter to the unions to meet an confer. we would like to do those things concurrently. sometimes we do it right way when it's introduced and sometimes things change bur the process of legislation moving forward as we see here and then we understand that there may be obligation for that. i don't know john if you want to add anything to that.

>> dhr attracts legislation and my office tries to flag for dhr legislation that could trigger, meet, and confer and so working together we try to get the notice out as soon as possible in the legislate legislative pd the meet an confer process does sometimes slow down the process and should be completed before the board enacts the ordinance but in the meantime you can hold committee meetings here -- >> supervisor safai: we have an e-mail and i think you received that supervisor ronan seems like there is someone in your office us that has reached out to one of the affected bargaining units did you see that? >> i didn't see that but certainly possible. >> supervisor safai: we got that yesterday midday.

actually it was sent to you and i just happened to get a copy of it. >> i get hundreds of e-mail a day and i'm always behind. >> supervisor safai: supervisor yee i sa, i saw your name on thr was that from before. >> supervisor yee: in regards to meet an confer i have had a little experience with that legislation and it was legislation to trigger the meet an confer at the committee, so i think it happens at different times. i'm notoverly concerned when it happens as long as it happens. you know, chair sefani has a

good point in regards to the rules committee and our duty to listen to the issues that we are responsible for which is department that we choose. i personally prefer i think it should be not with the department of public health because it's kind of odd that it's in the department in which some of the issues might be there and i think it should be outside but that is my own opinion. what i would like to suggest to the chair is that we move this out and move it forward and if there is a decision to possibly change it and bring it back to this committee. >> supervisor safai: are you okay with that. >> supervisor fewer: yeah.

>> supervisor safai: before we do that i wanted to allow the department of public works to say a few words. i just wanted to goat the opinion of the department. >> deputy director of the department of health and i want to echo the courage and the amazing ability to come into a public setting and share your story, it was very moving socker than, sothank you for that. in terms of where this should live director garcia is amenable either way and have been working if this does come in how it would work if it goes to hrc we are amenable to that too, so for us it is just about improving our work so that survivors get the correct treatment at the right time at the right place,

so we are working towards that and with our rape treatment center and our trauma recovery center as well. >> supervisor safai: if it did sit in the department of public health, where would it sit. >> i think operationally we would figure that out. it wouldn't sit in the clinical site obviously because it is overseeing those clinical areas so would be reporting somewhere to the executive staff. >> supervisor safai: from what i have heard today and i'm learning and i know there is people in the room for versed with this because they spent more time but what i heard the human rights, department of human resources, sorry, but what i heard is there are oversight of some of the things that are directly under the responsibility of your department, is that correct?

>> in terms of clinical care cae absolutely. >> supervisor safai: but a lot of work that happens when someone is a victim of rape or sexual assault they are in the hospital and then some of what i heard her say is that some of the affected bodies are people that are part of your staff the that correct, bargainening units? >> so our staff the rns and the nurse practitioners they are trained to actually do these forensic exams. >> supervisor safai: they are doing the exams but the division of labor in this process is someone comes in, the police department we have heard about today but there are other people in the department of public health, so it also makes sense these would not be in your

department so you would have a department to oversee the staff almost makes sense for it not to be in your area to be objective and these are colleagues that you would have to discipline and refer to discipline and speed up an critique and it is about improving the process on behalf of those who have been victims of assault. >> absolutely we are amenable either way. in terms of clinical care we always have to do these types of things. if anybody has adverse outcome as a history care we must answer to that. >> supervisor safai: please don't take my questions and comments as a criticism of your department just more for the process of making this a stand

alone body trying to make a small dent on behalf of those who have been victims. supervisor ronen. >> i couldn't agree more an thank you for bringing that point forward and that is why i placed it in the human rights commission. i have to thank you so much deputy director and deputy barbara garcia because you didn't ask for them and have been incredibly accommodating through this. both the leadership in the department of public health and in the human rights commission are so passionate about seeing this come forward an that is the good news and again i know that you are not asking for this but trying to be accommodating and make it work if it comes to you and i just really want to

appreciate you for that. i agree with you supervisor stefani is that it is the right place for it and i will continue to have this conversation with the mayor's office an i think supervisor yee offered us a great way forward that if we do end up amending the legislation that we will come back to this committee to hear that. i have am hoping that doesn't happen, but if it does we will come back. >> supervisor safai: that seems fair before i recognize you doctor, i want to ask deputy city attorney or a clerk can we put conditions on that to say if it's amended that it would come back or is that more of a recommendation if we sponsor the

legislation. if we have that agreement i am fine either way. you are looking at me like -- >> it's a new one for me. [laughter] the board's rules don't authorize committees to take

i am bloo glad that through yor work and the work of the task force that we are responding to those needs. >> we definitely are. thank you for your leadership. >> supervisor yee: i will turn it over for public comments. >> supervisor safai: seeing none, public comment is closed. >> i would lover to pass this out of committee can we pass it out as a committee? >> there is no to do that it womewill make it to next week's tuesday meeting. >> supervisor safai: motion on the floor is to send this out i think we can do that without recommendations. any other items today? >> that completes the agenda for today. >> supervisor safai: we are adjourned.

>> i want to welcome you here to the civic center hotel. my name is gale dill man, the c.e.o. of community housing partnership. in 2015, this was the second navigation center to open its doors and welcome over 92 individuals living inen ca encampments in the street. this announcement will ensure that before individuals have the opportunity to enter shelter and navigation centers, they can receive vital services and treatments that they so much need and deserve. and on an on going basis. on behalf of all of community housing partnerships, and the 91 navigation center individuals here at this site, we are so excited and honored to introduce our mayor mark farrell. [applause] >> thank you, gale. good morning, everyone.

i want to thank you all for joining us here today. as we all know, san francisco and the rest of our country, and cities around our country, are dealing with an opioid crisis hitting our streets. it's unfolding in our neighborhoods and in our sidewalks in front of our very eyes. fighting this fight means that we not only have to use existing programs but if we're really going to solve the issue and make a dent, we have to be creative. we have to come forward with new policies and new programs that will make a difference on our streets. and that is why we're here today. to announce a significant investment in a new, addiction treatment program with our street medicine team. the street medicine team has long been a part of how san francisco seeks to deal with the health of individuals on our sidewalks and in the streets of san francisco. the street medicine team is on the front lines every single day here in san francisco.

bringing service and treatment to those who need it here in san francisco. the small but vital team works every single day to care for those were in a traditional clinic or hospital, it's simply not the answer and it's not working. their work is rooted in compassion and acceptance and meeting people where they are. including streets, our shelters and our navigation centers here in san francisco. with this new investment of over $3 million a year, we are adding 10 new staff and increasing resources to focus on the drug addiction on our streets of san francisco. and to address the opioid epidemic, right here on the streets of san francisco, the team will be expanding the work that they started with the pilot

that started last year and expanding this program across the entire city. i am proud that san francisco is going to be the first city in the nation to take this approach. san francisco is a leader in so many areas and once again, we are stepping up with professionals that know how to get job run right. leaders willing to take bold approaches to address the issues confronting san francisco residents and those that need our help on our streets. by providing this medicine out of a traditional clinic setting, we're expanding our outreach capacity and taking every opportunity to help those individuals that are on our streets suffering from drug addiction. the program, which sometimes i have trouble saying, is an important part of our larger strategy here in san francisco

and with our department of public-health, to address those struckelling with addiction. which includes detox to residential treatment services. this investment, let me be very clear about this. this investment will ultimately help save lives. and it will improve the conditions on the streets of san francisco. i want to thank a number of people who have brought this program to light today. first of all, director barbara garcia from our department of public-health. [applause] >> dr. sven for his leadership and ingenuity. we knew he would get the loudest applause and he deserves it. our department of homelessness and their partnership in leadership as well. and all the other providers and healthcare leaders that are behind me here today that are working so hard every single day in san francisco.

to get those that are on our streets with the help that they need. whether it's homelessness or drug addiction or the other issues plaguing those on our streets, our goal in san francisco is to be compassionate and get people off the streets, on to their own two feet and on to better lives. thank you for being here today and with that i love to turn it over to director garcia for remarks. [applause] >> good morning. thank you mayor for your commitment to the effort of treatment access for those suffering from opioid addiction. i'm barbra garcia. i want to acknowledge all of the d.p.h. staff here that work every day to heal and support san franciscans who are in need of healthcare. i'd like to give them another round of applause. [applause] we know science has proven, for a long time, with many personal

stories and the medication assisted treatment works. addiction is a challenge of a lifetime treatment and recovery happen and people do get better. mayor lee, a year and a half ago, asked me is there something else that we can do? we need to reach people on the streets who are clearly suffering and in the grips of addiction. what else can we do? we know that some of our traditional approaches of addiction treatment, that is, waiting for people to be ready to come to us to seek help. it doesn't always work for those suffering from addiction and especially if they are homeless. all of our services are voluntary and we have to develop care relations to engage people into care and it does take time. but i really want to thank dr. barrie sven who took this challenge for mayor lee and myself and add this service to

his existing street medicine team. medication assisted treatment. to the streets where he goes daily providing care to the homeless people in need. that is how this program was born. in the fall of 2016. we have served over 95 people since then bringing medications to fight opioid addictions directly to them on the streets. by expanding the program today, we are first taking a big step towards our ability to combat the opioid addiction in this city. the new funding will allow us to directly serve 250 new individuals but we also know that we can serve more once we get those engagements and those relationships because in all of our clinics, we can access the service and medication. so this program is a big step forward to saving lives, lost to heroine, fentanyl and methamphetamine addictions and overdoses. homeless people who use drugs are especially vulnerable and

our health system is adapting going directly to them with compassionate outreach and expertise. we're able to help a group that gets missed in the traditional structure of visits and appointments. our low barrier medication program is just one piece of a city-wide effort to increase treatment. we are also providing emergency rooms at sucker burg general hospital and implementing a new addiction consultant service within our hospital to ensure all physicians at the hospital have access to treatment experts for their patients. the doctors from this service are also here today. so again, i want to thank mayor farrell for supporting all of our efforts to address those with substance abuse disorders and continuing our efforts to save lives. with that i'd like to introduce dr. barrie sven. [applause] >> well, thank you very much,

mayor farrell and director garcia and the city of san francisco for the opportunity to do this. i have been working with people experiencing homelessness in san francisco since 1991. my philosophy in this work is do what works, do what is needed. i didn't come into this work with a preconceived notion of what it is that is going to work. when we see what the problems are, then we develop what are the possible solutions? it doesn't feel like it's a great innovation to say if people are not able to come into a clinic let's go out and see them where they are. i think what feels like an ininnovation about that is many people have the pre conception or the stereo type that a person experiencing homelessness doesn't care about their health.

a person with a substance use disorder isn't very concerned about their health. what we see, day after day, one person after another, is that people are deeply concerned about their health. they may have more compelling concerns. where are they going to eat? where are they going to lay their head down and if they pend on drugs, where will they get drugs to prevent themselves from having severe and awful withdrawals. if we're out there with our team and this is absolutely about a team, not about me as a single physician, doing something, if we're out there as a team we're able to meet people where they are. we see and talk to people about the harms related to their substance use. we also see what the damage to the community related to that substance use is. and we're talking to people about treatment.

you've heard the term bupinorfine. that is our medication that we are primarily using. we're also often recommending and referring and assisting people when it's appropriate, to get to methadone treatments and we're using another medication to treat opioid use disorder. having these medications have changed my attitude towards seeing heroine users. earlier in my career, not that i didn't like heroine users, but i never felt like i had something to offer. now they're my favorite patient. i have something that can immediately change your recollection with the drugs you use and change what your

circumstances are. many people who we see have heard about it and they haven't had the opportunity to talk to medical providers who have expertise and get prescriptions. the basic idea is bring it to people where they are, get people stabilized, and then they're able to move into those next steps because when you are strung out on heroine, when you need to use or else have awful withdrawals, every four to six hours, it's really hard to do anything. what we need to do is provide something that is at least as compelling to people as what is happening to them on the streets. medication is absolutely necessary. human contact, treatment and caring for people is the other thing necessary. with those things in place, and this program expansion, is

allowing us to do that, we have the opportunity not only to reach the 250 additional new patients but that really has an amplifying effect. when one person is on the street felfeeling hopeless and sees thr buddy getting help, that is a tremendous boost to that person being able to take maybe that one more step to say, maybe things aren't absolutely hopeless, maybe there's something i can do. maybe that other person doesn't even have an opioid use disorder. maybe they don't use heroine. maybe they have a problem with alcohol? maybe they have a problem with mental health disorder. seeing that hope where someone is hopeful. the most positive, most effective thing i've seen in this program is one person telling another, hey, i got this medicine from the street

medicine team. i saw dr. evan, i saw one of their nurses. that person saying well, i can't believe it. you were the least likely to succeed guy. you were the worst-off person. you are the person with the worst addiction i know and now you are telling me you are not using? that's tremendous in building hope and that's what we need to do as we address the problems that we see. so i'm going to introduce chris, one of our initial low barrier buprenorp hine patients. someone who will tell you about his experience. so thank you. [applause] >> good morning. my name is christopher rafino and to piggy back on what dr. svens said, one rainy morning, as i got out of jail, and i contacted dr. sven, via

the mail and telephone and to other people, i did not want to use anymore. i had tried many, many attempts unsuccessfully of shaking my addiction to heroine of 28 years. nothing worked. i tried everything. residential programs, everything. well, dr. sven met me out in the rain with my bicycle in hand and the clothes on my back and spoke to me for 25, maybe 30 minutes. he said look, i'm going to do this for you. dodo not let me down. i don't believe i have. three and a half years ago, that occurred right over here. three blocks away from here. my life has changed dramatically. i am a substance abuse councilor myself. i work in a facility across the bay. my life has changed.

i have everything back i lost. i owe my love to dr. sven and buprenorphine. out that i was loosing hope you but i got it. i'd like to introduce someone from the homeless outreach program or the homeless program, jeff >> thank you, chris. [applause] >> my name is jeff with the department of homelessness and supportive housing. i want to thank you all for being here today. i want to thank the department of public-health. homelessness is a complex problem and it requires the partnership amongst many city departments and individuals and people experiencing homelessness to resolve this issue and this is just one of many steps that we need to take. we're very excited about expanding this pilot that we started with d.p.h. many, many months ago. i believe it was in late 2016. i want to thank mayor farrell

for his leadership in expanding this important program. so thank you again for being here today and we'll take questions over at the side. thank you. [applause] >> president buell: recrea craigsation and park commission meeting. please call roll. [roll call taken] >> president buell: with that, let us proceed. >> a couple of announcements. just reminder. so, could we please ask everyone to turn off any