important. it's great place to work. i think one of of the things that we're so -- i don't know, so fortunate to have, is just these different groups of people that come together, whether they're staff, consumers, whether they're leaders in other ways, they come together to figure out how to do the best job we can. and i firmly believe we have the best department of aging in the country. i really do believe that. [applause] >> so to talk about the dignity fund. the dignity fund is one of those things, i think, it's like having this money falling into your lap was exciting. from a city perspective, they take away the discretion of the city to think about how to handle emergencies and things like that. that said, the other side of it, when people come together to fight for something like that,

it's pretty clear that people feel strongly there is a need. and so to be able to be involved working with the mayor's office and working with the board of supervisors, and the dignity fund coalition, to figure out, how do we shape this so everybody has a say, was for me a gratifying and important task and work. so we knew there were certain things we really needed to do. in the legislation, the legislation basically says the community groups, we need to work with. so we work with the oversight advisory committee. and we're working together to figure out how best to get the money out into the community so that every dollar is used as wisely as possible. and that it's really making impact. we've had to do a lot of thinking about what that means. one of the things that fortunately -- and fortunately, i should say that the

legislation laid out a lot of this for us. because people were thinking, how are we going to do this? what is the best way to go about that? so one of the first things we did as a department and as -- i'm not going to keep saying his work, it's just a group effort -- so one of the things we did was conduct a community needs assessment. we talked to a number of people. we had a forum in each supervisor's district and the supervisors were great working with us. asking people, what do you think about services for older people and people with disabilities? what do you know about already that exists? we got a lot of feedback. we had 29 focus groups zeroing in on subpopulations that i alluded to earlier. we had one that was cantonese

speaking. we had one that adults with disabilities. we had one for african-american adults. we had a group of homeless people. a veterans group. we were trying to figure out, what is it that different groups in san francisco need from this dignity fund? what would they like to see? and then we also just kind of looked at our own data and said, who are we serving right now and what is missing? other people we're not serving as well, are there groups we're missing out on? we pulled together that information and that information is going to inform what we're, working on which is a service allocation plan. in the legislation it says we have a cycle, so we do our community needs assessment, we use that information to figure out what the service allocation plan should look like. and that plan should carry us for the next four years. then we start the whole cycle

again. so we basically modelled this on the department of children, youth and families children fund which has been operating for a lot longer. we had them as a model to look at. we're now in the throes of putting together our service allocation plan based on the community needs assessment. so that is kind of just what we're working on right now. so, i think one of the things that we really wanted to be able to do today also -- how much time do i have left? nobody knows. okay. so one of the things i wanted to talk about that to me is the most exciting, is to talk about how we spent the money in dignity fund. again, it's because many of you in the room are responsible for bringing that to us. we really used the information that we got.

we know there are communities we don't quite serve as well as others and that's one of the things that came out in the community needs assessment. for instance, we could do better serving people with disabilities that are under 60. that has been a problem for years, but the dignity fund allows us to address that. we know we're not reaching latino older adults as well as others and we need to delve into that and figure out what is causing that. why are we not reaching particularly spanish-speaking older adults as well? so that is something we're working on. lgbt older adults. we need to figure out a better way to serve people, in our main stream programs. why do people not feel comfortable coming to them? we've gotten answers and have a lot more questions. so we're going to continue trying to figure out, you know,

how do we answer those questions so we're providing our services as equityably as possibly throughout the city. there are geographic areas that are tougher to serve because maybe there are not as many public sites as the other neighborhoods. so we try to figure out, how do we do a better job of serving those people? and veterans. one of the things we're charged with is serving veterans. we want to be equitable and that veterans feel welcome. that we're growing programs that specifically for veterans. we have a lot to do with the money that we have. and a lot of it was already -- i think marie said -- but basically protected money that was already out in the community. so it gets challenging to figure out, how do with ebreak it out differently?

so one of the things we did that was new, that came out of focus groups, we've done -- we literally -- we haven't gone to commission with that. but we're just about to go into contract with a variety of organizations in san francisco to provide intergenerational programming. one of the things people kept saying, when you're thinking about older adults and the social isolation, social engagement becomes very important. one of the things that brings joy to peoples' lives is being able to interact with other people of different generations. i know for me as a child, to interact with older adults was important. i'm very excited about those programs. one of the things that came out of the initial needs assessment, we need to do a better job of supporting caregivers.

we put more funding into caregiver support programs and are continuing to ask the question, what is the best way to support caregivers in san francisco? are there things we can support number of caregivers from using technology? what can we do? we know respite is important, but also expensive. we're looking at various ways to support. we've done pilot innovative activities at community service centres. one of the things we wanted to continue doing was engaging community with the community centers. are we using the buildings we have as effectively as we can. so for instance, we were thinking sometimes, we have older adults who are still working. they're not going to go to a senior center during the day, but that doesn't mean they don't need social engagement. so what used to be traditional senior centers that closed at 3:00 or 4:00, are now open at

night and they're doing programming that is open at night and cater to the communities in which they operate. i mentioned veterans earlier, but we started doing more service connection for veterans and thought about how to expand and have expanded congregate meals for veterans. again, that's a big priority for us. and we will continue to figure out how to serve veterans as well as we can. we've also again, i mentioned, disabilities, so the two things that we're looking at right now. one of them is really working with the institute -- i see you guys right there. we're working with the long more institute to look at what it would take to have a specific disabilities center. the centers we have that are focused on seniors, they don't

quite do it for the people with disabilities. there are things not taken into the context of the community center, but also there is a different information referral and assistance need for people with disabilities. so we're looking at the best way to set that up and make sure that people with disabilities are accessing services at the rate they need to. and they know, you know, what is available in san francisco. but also just -- we're also just thinking about how to celebrate disability culture through that. so we're in the process of looking at that right now. the other thing, the named department of aging and adult services does not speak to the fact that we work with veterans and people with disabilities. it doesn't say it. that's what we hear from the community. as our agency, human services agency is in the process of re-branding. we're really thinking about the name of the department and what would be more fitting. so we're working with the

community and will be going around and testing names and some tag lines and things like that. so i'm excited about that because i've heard very consistently for many, many years, that the department really doesn't speak to people. and one of the things we want to make sure of, that people in san francisco know where to go to access the services. and then we just been providing services in new ways to new populations. we have started thinking about things that maybe where we're really using outcomes and using evidence-based processes to figure out how to fund things. so one example is nutrition, medicine. we know that there have been studies that show that chronically ill people, when given the right kind of nutrition plan and diet, do a better job. they sometimes can reverse some of the disease and chronic

illness, so we're looking at that model. we're looking at technology at home services, because we know more and more people need to rely on technology. we've done a lot of work bridging the digital divide with the tech council and other folks. and then we're really looking again to promote programs that -- work on programs that promote socialization and wellness. and i mentioned social engagement is such a huge thing. the more we know about what isolation does and how it kills people or makes them sick, the more we're focused on social engagement programs. one of the programs i love is the community choir program. that is because when you think about bringing people together and the joy that music brings and the breathing and the memorization and all of those things, and think about what

actually inexpensive interventi interventionet is, but great intervention, those are the things we need to think more of. 1 in 4 people in san francisco -- well, little more than 1 in 4, is older adult or adult with disabilities. we need to think about the interventions that aren't super costly, working with people upstream, so we keep them healthier so fewer and fewer people need the down stream very expensive services. but again, we're responsible for the department -- at the department for providing the whole gamut of services. those are the things that we're doing with the dignity fund dollars right now. i think we're going to continue working with the community. we'll have a growing pot of money with the dignity fund. and we will continue thinking outside the box. i don't know what we'll be doing

10 years from now, because some of those models aren't here yet. there is more ways to engage with medicare. as people start thinking more about addressing the social determinates of health, we might be able to leverage dignity fund dollars to draw down those dollars. it's really exciting. it's an exciting time for me to be the director here. and again i want to thank all of you for your role in making lives of seniors and people with disabilities as great as they can be in san francisco. thank you. [applause]

>> thank you. on behalf of the dignity fund coalition, we thank you for the collaboration. it's my pleasure next to introduce you to today's moderator. i'm sorry. before i do that, i realize that i forgot to make one of the largest thank yous, that to michael and the staff here at the public library. thank you. we're appreciative to the breadth of the staff and the folks at sfgovtv, who have been helpful in putting together the live stream. it takes a village. it's lovely to have such a wonderful space and so many dedicated people to work on the

project. thank you for your work on this. so, oakland based activist known as executive director of independent living in berkeley, committed to advancing the rights at the local, state and national level. these days, she works as ada compliance matter ensuring that people with disabilities, and functional needs have equal access to high quality medical care. she happens to be exceptional experienced journalist whose column is published monthly in the los angeles times travel section. she offers her time, talents and resources to causes she cares deeply about. she's formerly of my -- it's my pleasure to call naomi a

permanent presently -- personal friend. without further ado... [applause] >> good afternoon. can everybody hear me? in the back, wave if you can hear me. all right. nice to see everybody. one second to... >> oh. [laughter]. >> there we go. get my technology. good afternoon, everybody. thank you for coming out in the rain. i know that for many of us, myself included, it is not easy to travel in wet weather, especially across the bridge. >> can't hear me? >> away from the mic.

>> okay, i will try very hard not to do that. that's going to be hard for me. i'm an expressive talker, so i do a lot with my hands and move my head around. i'm going to try. thank you, mark, for the introduction. i appreciate it. it is such an honor to be invited back by the dignity fund coalition to serve as moderator. i wanted to get it started by inviting our guest of honor to join me. please extend a warm enthusiastic welcome for mayor london breed. [applause] >> i was told when i move my head, they can't hear me in the back. so hopefully -- >> you hear me? okay. good.

>> mayor breed, we're delighted to have you back. so nice to see you again, congratulations. >> mayor breed: thank you. >> it's been six months to the day of your inauguration. >> mayor breed: wow. [laughter] six months feels like years in san francisco time. >> in dog years. and i know you've wasted no time implementing a number of initiatives. for today, we want to focus on some of the commitments you made to older adults and people with disabilities. all of the questions round back to themes from our town hall this session. so no surprises. just a continuation of that great conversation. so before we get started with the questions, i believe you have opening remarks. >> mayor breed: yes, i want to say thank you to the dignity fund for having me here today. it's great to have an advocacy group that is focused on fighting for seniors and those with disabilities. i actually grew up in san

francisco and was raised by my grandmother and it was really challenging once she started to need care. she had dementia and i didn't understand in my 20s how to navigate the systems and in fact, she struggled with walking and there was a lot of frustration that i experienced trying to maneuver in the city. with trying to get her the help and support she needed. so this is really important to me, making sure that members of our most vulnerable community are not forgotten. and that we as a city think about how to makes decisions, policy decisions, how we allocate resources and how we continue to work together to make the lives of our senior and disabled community a lot better than it has been, because it can be challenging. i'm honored to serve as your mayor and honored to work with you as a partner in making sure

we're making the right investments and those investments are touching the lives of the people you continue to advocate for. we know that san francisco has a number of challenges in general with homelessness and building more housing and making sure those housing units are accessible so people can age in place with dignity. which i know this is all about, too. and we'll continue to, i think, address those challenges by working together and making the right decisions and i'm so looking forward to continuing that relationship. i wanted to take this opportunity to thank you all for having me here today. [applause] >> we know you're very busy. you have limited time with us. about 40 minutes or so. we want to make the most of your time, so we budgeted five minutes for each question. we have a timekeeper sitting right there.

>> mayor breed: oh, goodness. >> yes [laughter]. >> mayor breed: i know i talk a lot [laughter]. >> we'll do our best. so we're going to talk about varyious themes we've talked about. first being -- i should say that all of the questions and all of these issues were generated from your community. from older adults and people with disabilities that live in san francisco. so all of these questions come from all of you. so the first topic is housing security and access. at the town hall you made several commitments as regards to housing. i've got about four of them lested. one was to implement a rights to civil council. the law providing legal support to tenants facing eviction. purchase more rent controlled buildings. protect affordable housing from being converted to market rate.

and expand subsidy programs for older adults and adults with disabilities. so i have a multipart question. if you could talk to us about steps you've taken to fulfill the commitments. what actions you plan to take to keep older adults and adults with disabilities housed in the city. and let us in on the challenges you're facing addressing those issues. >> mayor breed: the good news, we've been able to almost immediately fully fund right to civil council so that tenants facing eviction will have representation when they're going through that process. so i'm really excited and proud of that work. we also have moved forward on -- allocating funding for small site acquisition, so we can purchase more buildings. we know there are a lot of people facing eviction, to prevent them from being targets. and purchasing those buildings

will give us an opportunity to protect them and keep them affordable for years to come. in fact, the recent wind fall that you all heard about, is something in that budget where i'm proposing to purchase even more buildings that have a lot of low-income residents, including seniors and those with disabilities. so that is a program i will continue to fight for and fund. in terms of housing and -- i want to make sure i didn't miss the other two. >> it was protecting existing affordable housing from being converted to market rate. >> mayor breed: so part of that is small site acquisition. the other part includes rehabilitation of some buildings that are unfortunately under threat of being lost to the community. a number of places in our portfolio that there are buildings that are in dis repre and need of assistance, not only to rehabilitate, but to assure

hud they're in a state of good repair so they don't come in and take over. eventually, that could be problematic for us as well. we're well on our way to protecting existing housing stock, which has to be equally as important as we develop new affordable housing keeping people housed is what we have to focus our attention on. and allocating resources both in the past budget and the new wind fall. >> expanding rental subsidy? >> we did that, we have expanded rental subsidy. as we increase the amount of money we're able to provide in terms of rental subsidiesubsidi money gets taken so fast. it gets swept up right away. which make it clear there is a need for more. the rapid rehousing vouchers, we

were able to increase those amounts. people come to us when it's too late, already evicted and they end up homeless. that's a great opportunity for us to immediately try to get them back into housing. so increasing vouchers. ets a program we've been able to increase funding. >> so speaking on the same thing of housing, but also homelessness. typically talk of the housing and homelessness are intermingled, but your answer doesn't need to be. tell us what you're doing to combat homelessness and lack of housing, especially as experienced by older adults and adults with disabilities? we're hoping to hear from you on two of your goals that you made at the dignity fund town hall. advancing a $50 million bond for modular housing for homeless and

building 5,000 units per year. >> mayor breed: the good news is, first of all, i'm not going to need to do a modular housing bond. we've been able to identify capacity within some of our existing resources in order to dedicate $100 million to modular housing. and what -- [applause] >> mayor breed: and the reason why this is exciting, because one of the things that i've been pushing for is to look at building a modular housing factory in san francisco. so this is really a down payment, a commitment to a new modular housing facility to ensure its success. one of the most recent proposals again in the windfall of money that we received that i'm pushing for, there is a project that is on hold and is missing a certain amount of money that will get this project done. it's 258 units of housing that

will be built as modular housing. one of the first major modular housing projects in san francisco. so we're filling in that gap funding that is going to get that developed. so that's 258 units of housing for single adults including seniors and those with disabilities. so i am committed to that goal. in fact, we're going to exceed that goal and the good news, we're not going to have to go to the voters for modular housing funding, but we will be going to the voters, hopefully soon, for affordable housing in general. most recently in the capital plan, for the city and county of san francisco, the plan for bond measures that help to protect the city's assets, like our fire stations, police stations, libraries, buildings and assets, typically it has never included any housing. and so what i thought was

important, because again one of our biggest challenges as a city that we face is housing people in general, especially the amount of money that we don't have for affordable housing. so this is another creative tool to provide affordable housing. so i will be bringing forth a $300 million housing bond that will be used specifically for affordable housing, period. so i'm really excited about that. and i wanted to also there was something else that you mentioned on there, too. the 5,000 units. so we are -- we just hired a housing delivery director. someone who will assist us in getting housing projects developed faster. because the city -- we're our own worst enemy when it comes to bureaucracy. we want more housing. we want to make sure that people have a safe affordable place to

call home, but yet we can't produce housing fast enough because of the planning department and the department of building inspection and the fire department and all of these codes. when you think about it, i put out a directive for accessory dwelling units. they're the bottoms of homes. they can be accessible. we call them in-laws because sometimes you move your parents in particular, into those spaess. it was taking like almost two years for someone to be able to get the appropriate permits in order to reconstruct and make their accessory dwelling unit legal. so i put out an executive directive so say, no, we're going to cut back on the bureaucracy, and you have to clear the backlog of 900 units in the next six months. and any units moving forward need to be done in four months with the city departments. because there can't be any

excuse for bringing forth new housing. in terms of my goal of meeting that. it involves getting rid of layers of bureaucracy and being more creative about housing production in general in san francisco. it won't be easy, because the truth is, we have a board of supervisors who introduces legislation on a regular basis and sometimes there is unintended consequences to many of the policies that they put forward which add additional layers of bureaucracy that make it difficult to build more housing. so i'm going to try to work with members of the board and our city departments to try and really cut back on some of these requirements that make things a lot more difficult, which is going to help us get to the goal of making sure that we're able to, at a minimum, a minimum, provide 5,000 new units of housing in san francisco each year. >> everybody in this room and participating via the live

stream, are older adults and people with disabilities, having access to safe, affordable, housing is one of the key ishes. top issues. i believe in organizing and i believe we need a seat at the table. so advocacy is the next theme i want to talk about. as older adults and people with disabilities, a constituency making up more than a third of san francisco's voting population, so a very important constituen constituency, what is it like to see -- what are your thoughts on creating a stronger voice in your office? >> just apply. reach out to my office. we have four vacancies on the disability council. we have other vacancies on commissions in general in san francisco. the commissions you can serve

on, they don't have to be specifically directly related to the things that we're talking about today. we have the public health commission. we have the fire commission. we have the airport commission. we have a lot of commissions and boards in san francisco where having a seat at the table is definitely important to addressing some of the challenges that you face. perfect example. when i served on the san francisco redevelopment agency xhegs and there was a housing project that came before us that was town homes. i fought against it, not because i didn't want the housing, but in dealing with my grandmother, and the stairs, town homes are not accessible. people can't age in place in town homes. what are we going to do to make changes so that when people move into these places, they're able

to age in place and get around their own home? so part of what is important is reaching out to my office. you know making recommendations to my office around boards and commissions and committees and other things that exist where you can make an impact. i'm definitely open to working with you on that. >> serve on boards and commissions, and some are more effect tev than others. >> mayor breed: that's true. >> the positive difference is when there is a direct line to the mayor. and so what about the idea of creating a position in your administration as a liaison between your office and this community? >> mayor breed: so there will be -- as soon as i'm able to hire someone in my legislative office, andres, who is here today is the director of our legislative -- i forget the

position. thank you. he's my policy director. his job is to hire a number of people who have specific focuses on different populations with different things, including transportation. including senior and disability community. and so there will be someone in our office that will be a direct connection to the community. [applause] >> another question about employment and income inequality. you talked to us about one of your priorities to invest and leverage private funding toward increasing opportunities for older adults and adults with disabilities. what programs have you begun or what do you have in the works? >> mayor breed: i'm excited about a program called opportunities for all. it's specifically targeted at

young people in high school. i got my first opportunity because someone believed in me and supported me and hired me and took a chance on me and taught me what i needed to do, to be a part of the workforce. and opportunities for all is making sure we're thinking about the future and the next generation of young people and preparing them for all the opportunities that exist in san francisco, from government to tech, to anything, you name it. and these are paid internships for kids and we've been able to leverage private dollars. and also the private sector and public sector to provide opportunities. we are going to be working again to try and look at the similar ways in which we can work with our senior and disabled community. in fact, my workforce director, josh, is here today as well, because there are so many incredible opportunities. and we were just talking about. there is always something for anyone to do if they

basically -- depending on what you want to do. so making the connections between, you know, what someone can do and is interested in doing, and what is available is something that is important for our office of workforce development to do. we have these places called success centers, where you can come and get assistance and look for job opportunities in various fields and again, josh will be here after and if there is any interest, we'd love to maybe even host a job fair where we can invite people in who are interested in working in various opportunities. so the doors are open to continuing to work. we have a 2.3% unemployment rate in san francisco and that's something to celebrate, but there is still challenges with our african-american population, still challenges with the senior and disabled community, we want

to break those barriers and offer opportunity to all san franciscans and are competed about that and looking -- excited about that and looking forward to it. >> speaking of workforce, we discussed challenges to sustain a long-term care workforce, especially when housing the housing crisis that we face in san francisco. are you considering creating housing opportunities that are specific for long-term care workers in order to better support their availability to live in the city? >> mayor breed: i think what i am most dedicated to is creating more help and opportunities, period. because you have those who are long-term care workers, teachers who need housing, people from all spectrums of employment that need housing. and so we have to create more opportunities. one of the things that i'm most concerned about when it comes to those individuals who care for persons with disabilities and

seniors, is you know, the challenge we have sometimes, especially in affordable housing, is they may live with the person and may assist the person. and then maybe the person passes away, or they end up maybe in a long-term care facility. and that person has no place to live. that person is out of luck, because they're not on the lease. and so part of what i want to do is make changes to the policies around affordable housing, so that they can be protected. so that even if, for example, they're in a two-bedroom, if we could basically allow them to continue in that location until we're able to identify a one-bedroom for that person. that's more humane than saying, okay, you're out of luck because the person you cared for is no longer here. i think we have to make changes like and we have to think about how to increase the size of somebody's place when they need

a live-in or a person to care for them. i want to look at how to change policies to account for so many people who are caring for folks who are basically living with them in some instances. how are we going to make our policies work better to protect them as well? >> you've done a great job already supporting increasing the minimum wage to nonprofit and ihs workers, thank you for that. [applause] that's a very big deal. but i think you know these wages are still far off from a livable wage for someone to be able to sustain themselves in a city as expensive as san francisco. do you see continued support for advancing the wages of long-term care workforce? >> mayor breed: definitely. it's really challenging because part of the issue is the state is gradual -- well, no,

aggressively removing they're support that they provided in the past for ihss workers and the city has continuously absorbed the cost to make sure that many of the folks who are, in some instances, family members who care for their aging parents or what have you, that they have the support that they need to do so. and what we have done in san francisco is taken the responsibility and in fact, you know, the responsibility, the financial responsibility for the city has more than doubled in terms of what we anticipated because of the drastic increase in support from the state. but it's still a really low wage. it's a big expense for the city. in fact, it's one of my single largest commitments in the budget that i've made coming on

board as mayor. it has everything to do with the belief that it's really important, but sadly, as expensive as it is, you know, it's still -- it's still a really low wage for so many of our ihss workers who do really amazing work and caring for people who need support and help. so i'm committed to continuing to make sure that we are trying to work to help support ihss workers as they do this work. i see kelly here, who manages the program for the ihss workers and thank you for your work and your commitment to continuing to work with our office in order to provide the support necessary to support ihss workers. it is going to continue to be a challenge, but one i'm committed to working through. [applause] >> the last time we were

together, you were talking about -- you were recognizing that access to technology is an important tool to reduce social isolation among older adults and adults with disabilities. any programs or ideas that you have in the planning to address this priority? >> mayor breed: i haven't gotten to that yet [laughter]. >> that is so real. >> mayor breed: okay, it's been six months. that's one that i haven't -- i forgot i even said it. i'm sorry. i'm sorry. but thanks for reminding me. so we'll get on that right away. >> we'll circle back to you in another six months. >> mayor breed: andres is here taking notes. we'll get on that. >> i said there were going to be no surprises [laughter]. >> mayor breed: i will tell you, talk about -- i want us to get more creative.

most recently i had a meeting with a school board member who talked about absenteeism and challenges with reaching out to families and parents, and not having enough people to help make the phone calls. i thought, we have -- what a great opportunity to work with folks in our senior community. especially people who are retired who could come and would be happy to make those phone calls to say, hey, your child was absent today, we want to make sure you know. and helping us track the data. so that we can start addressing those sorts of issues. that's just one example, but part of addressing issues around making sure that our seniors are not living in isolation is connecting them to opportunities that are going to be meaningful, that are going to be helpful. and so not just necessarily technology, because half the technology tools that exist, i don't know how to use myself.

but just really working together to try and create ways in which you know we can really open the doors to work with you to provide these opportunities where it could be helpful. helpful to both sides. >> thank you. and thank you for that honesty. that was refreshing [laughter]. wasn't that? okay. along the theme of isolation. so staying connected to community is really important. and for many of us staying connected means living in community. and not being forced into institutions. so you've talked before about developing a strategy for universal long-term care in san francisco. we have fans there. so can you tell us what is being done to advance a vision for universal long-term care that makes it affordable and accessible, allowing city residents to age in place with

dignity and quality of life? >> mayor breed: one of the first things i was so proud to do when i found just a little bit of money when i first started as mayor, is to provide financial support to a few long-term care facilities that were possibly going to close. which meant those almost hundred people would not have had a place to go. so we actually helped to cover the gap funding necessary to keep those places open and keep those people housed in places where they were cared for. and so we do need a long-term strategy. again, i keep going back to just what i experienced with my grandmother. i mean, you know, it was a really tough time in trying to figure out what to do and how to do it. and trying to maneuver through the city bureaucracy was so difficult. just imagine if my grandmother

didn't have me. imagine those people who may not have a family member to help. she had dementia. so she was forgetting things. she couldn't fill out applications. she wasn't paying her bills. there were all these things happening. and because i was able to step in, i was able to help, but it was even stressful for me as a person trying to help facilitate through all of this process. and eventually, i had, you know, we took care of her for years and was able to get her into laguna honda after a long wait list. i think about the fact that we have to develop the right strategy for how we're able to care for people, whether or not they have family members who are carrying for them. whether it's in their place where they live and able to provide support through ihss, or social workers, or other things.

and also there is programs also with the aging and adult services where we could have people brought into different places to interact and engage with people and be picked up and taken home. so some of you might be familiar with those programs. but i think that making sure we have social workers who are investing people in the home, who are identifying the challenges they face, and then making recommendations. because the other thing, you know -- and i hope you don't take offense to this -- but a lot of older people are stubborn and stuck in their ways. my grandmother gave me the blues. i gave her the blues, too. because she didn't want to do certain things. and to get to a better place, it took a lot of work. it wasn't just me. it was getting other people in to have conversations. part of what we have to do with our city, with the social

workers, they have to develop relationships with the people they're helping. that takes time. you can't just show up when there is a problem. you have to consistently show up so they trust and believe you. especially when the time comes and there might be a need to either help them through the process with their existing home, or help them into a facility, you know, basically having someone that you trust is going to be important to that sort of transition. especially, again, if you bring something into somebody's home and you're like, we need to put this ramp in your living room. why do i need a ramp? i don't -- some of you might know what i'm talking about. [laughter]. i don't want a ramp. but it's like, you need this ramp. well, it's in my way, i can't see my tv. you know. i dealt with it all. and it is really challenging, but we need people who are

compassionate people, who care about serving and supporting this community. and who is willing to make recommendations that don't just make it, okay, well let's just put this person here, let's just do this. let's focus on who this person is and how we're going to make sure they have a good life in their home where they're comfortable. that's the first step. if it gets to that point, ultimately, it's going to be the important to develop just really a plan that is going to help us address the issue. and with the additional funding we anticipate as a result of the dignity fund, we're hoping that resources would be available to helping to prepare the plan and also implement the plan. because it will be quite costly to implement. >> we're just about at time. i have one more question for you. and then we're going to leave

just a minute or two to take a picture. >> mayor breed: oh, okay. >> so speaking on the issue of trust, we're going to talk about conservatorship to close out the forum. a lot of work and discussion has taken place around conservatorship, including the passage of sb1045. how do you see that as different from the current conservatorship in the city? and what you share with us on the scope of the program as it will be implemented and what you're doing to prepare the city to provide care in the most appropriate least restricted setting? >> mayor breed: yes. so the difference with -- and what sb1045 does, it gives us another tool. so based on the laws that exist, it's difficult to try and -- like someone who has substance abuse disorder brought on,

psychosis brought on by substance use, that is the biggest challenging population. you all see people who are out on the streets and you're like, why isn't the city doing something? they're either arrested or taken to san francisco general. and then a day or two later, they're right back in the same location, clearly in need of help and support. and so sb1045 really focuses on this particular population. and what it does is, you know, allows us to push to provide a conservator, a guardian for someone who can't make decisions for themselves and in some instances we have mental health stabilization beds to get them healthy. and separately from that, you know, we do have situations where like, again, i keep going back to my grandmother, you know, she had dementia and making decisions, i mean, thank

goodness i did this paperwork with her doctor who started to notice it, so that me and my aunt were able to make decisions for her. but some people are in situations where there isn't anyone designated to make decisions. and i think this is not about being restrictive. this is about getting people to help and the support they need. and there are some that are more challenging than others. they don't always necessarily belong in a jail cell. they belong in a hospital. and sometimes in that particular setting, you know, sometimes those facilities, you know, are locked facilities with certain rooms to accommodate those things. so it's a very complex situation. and mental health is something that we need to start talking about more, because there are different levels to mental health. there are people with dementia. there are people with schizophrenic. there are people who are struggling from all different layers. how are we going to shift the

conversation and have an honest conversation about people who are struggling and getting them the help and the support they need? that's really why i supported this particular legislation. and in fact, through my proposed budget, we are adding more mental health stabilization beds. more than we ever have before. we need them. we can't just say, well, people have rights. we don't want to see someone's rights taken away. so for me, it's really about being helpful and trying to get people healthy and providing them with the resources they need. we've got be able to make the hard decisions to do that. and i am tired of seeing people who are mentally ill, who need help, i'm tired of seeing them in jail. and i want to get them the help and support they need.

[applause] so it's a complex problem. i'm actually in the process of hiring a new public health trek ter. the public health director, whoever is chosen, they have to start thinking about, you know, mental health and how we're going to address the challenges that exist in our society from a broad perspective of those struggling with either depression or dementia, or any layer of challenges that exist. so that is something that i'm definitely committed to. [applause] >> before we wrap up. i would like to thank mayor breed. thank you so much for coming back to talk to us. and our other presenters. i'd like to thank the board of supervisors, wave. some people are here. city department heads were here today along with the mayor's

staff. the dignity fund and its members. the meta fund for partially funding this event. and all of you, the audience, both here and on the live stream. thank you so much for spending the afternoon with us. [applause] >> mayor breed: i want to say again -- that time went by so fast. but again, you know, i can't do this job alone. this is about a partnership. i represent you and part of how we're able to deliver with some of the things that are going to make the lives of all of us better here in our city is just really hearing from you. and getting actively engaged like today is a perfect forum to to have this discussion. it comes from experience related

to my grandmother, but eventually i'm going to become a senior citizen -- [laughter] -- and the fact is, i want san francisco to be easier for me to maneuver, because it's very challenging. and i think back all the time to, like, if my grandmother didn't have me, what would happen? and we see it playing itself out sometimes on our streets, where you see senior citizens, people who can't care for themselves, who need us to do a better job for them. the proposals that i make at mayor will be about trying to address many of these challenges. like conservatorship, it's not about being harsh. if that were me, i would want someone to do something different, more than what we're doing now as a city. i'm committed to working with all of you to address these

challenges. i hope eventually we get to a better place where we don't see anyone on the streets who are homeless. that we're able to care for the people who cared for us a. i want to thank you all of you for having me here today. [applause]