we are back in recess. madam clerk, would you please read item number 16. >> item 16, to identify the fiscal priorities and requesting the use commission to report. >> that's great, so now we're going to hear from our san francisco youth commission about their budget priorities for the fiscal year 2019-2020, and i will allow them to introduce themselves and i believe we have five youth commissioners presenting today. thank you. >> good afternoon, supervisors.

my name is calvin quick, i'm the legislative affairs officer of the youth commission. i also represent district 5. with me today are commissioners ty from district 8, dong from district 3, and obermyer from district 1. we're here to give an overview of our main priorities and then afterwards, if you have any questions, we would be happy to take them. so, first a bit of background. the youth commission is a charter commission made up of 17 youth age 12 to 23. we're appointed annually, and we are charged by the charter to report back regularly to the board and to gather information and advise the mayor and board on the effects of policies and programs related to youth needs, particularly concerning the budget of the city and county.

so the way the commission has typically fulfilled this duty in the past has been through our budget and policy priorities report. otherwise known as our b.p.p.s. this is a document that we compile starting around february of each year, and that we then present to budget and finance in around april or may. and it's a document that outlines all of our budgetary and policy priorities related to youth, and the problem, of course, that we've encountered with this as a way of communicating youth needs to the mayor and board is that by late april, the mayor and departments have already made most of their funding decisions for the upcoming year, so the budget that comes to the board that's under the review by the board at that point doesn't effectively reflect the needs of youth constituency, because that youth voice was absent during the

earlier phase of the budget process. >> this year the youth commission passed the omnibus preliminary priorities resolution to streamline the budget process. this is to ensure that youth organizations and the youth commission have enough time to work on their priorities and again presenting our budget priorities early allows us to have better say in the board of supervisors budget proposals. so all 17 commissioners are a part of a committee, and each committee came up with their own list of budget priorities after reaching out to their community-based organizations and respective city departments. first, we have the civic engagement committee, so their priority right now is on youth engagement in democratic

processes, specifically about '16 and 2020, and they have reached out to the league of women voters, asian-pacific islander, american public affairs, department of children, youth, and their families, the colorado youth congress, the mayors of hyattsville, maryland, tacoma park, maryland, and berkeley, california. also the city council of golden, colorado, and, of course, the vote '16 local and national chapters. next we have the transformative justice committee. they are focusing on working towards alternatives to incarceration, and they've been working with coleman advocates, crisco cop watch, the department of police accountability, strategies for youth. and lastly we have the housing and land use committee, and they are working on permanent supportive housing for transitional aged youth and the t.a.y. navigation center, and they have been working closely

with the department of homelessness and the supportive housing, the youth advisory board, and the youth policy advisory committee, the lyric lavender youth recreation and information center and larkin street youth services. >> as maggie mentioned, when it comes to the civic engagement committee, our main focus this year has been in increasing young people's involvement in democratic processes, specifically with regards to preregistration, and so our concrete ask as far as budgetary focus is for fee wavers for california i.d. cards for youth 16 to 18. we found during research last year that when it comes to major barriers to registering to vote, for many low-income families, the $30 charge for obtaining the california real i.d. was

prohibitively expensive. so we're looking to secure potential funding through dcyf to waive these fees for families that cannot afford them and to make it easier to preregister to vote. part of this, too, is to increase our constituency when it comes to youth involved in youth organizing for our upcoming push for vote 16-2020, which i assure you you'll be hearing about from us in the next coming months, and given the national moment, what's been happening in georgia, our ask, truly, is for s.f. to make a larger commitment to enabling young people to prepare to take part in their democracy. >> hi, i'm nora. i'm the chair of the transformative justice committee, and our big focus for this year is finding

alternatives to incarceration, so our first budget priority is mandating the instruction of law enforcement officers on cognitive development. this was a priority last year, it was kind of implemented last fiscal year, but we really believe it should be mandatory for all police officers to go through cognitive development training, because it really will improve the interactions between youth and police in san francisco, and although last year it was implemented a bit, we really think that this needs to have consistent implementation throughout the year. our next budget priority is the investment in re-entry program for -- thank you, youth exiting the juvenile justice system. we think it's really important for there to be programs that are invested in the youth exiting the juvenile justice system that give them access to job resources, supportive housing, and enabling them to have access to social workers or

community members to help their transition from the juvenile justice system, and one aspect that's important to this is connecting them with either their families or people they feel comfortable with, because we think the gap between formally incarcerated individuals and their community is one thing, but it makes it really hard to transition out of the juvenile justice system, so we think programs that bring together youth and their families and communities is really important in engaging youth in getting out of the juvenile justice system. thank you. >> the housing and land use have been meeting on the 2015 goal of 200 units of permanent supportive housing. there are outreach in the community, printed housing is a more sustain shl option and gives tay options needed. the goal of the housing plan was to create an additional 400 units for tay by 2015.

today in 2019, four years past the deadline, only 188 unites have been completed. other current estimate totals experiencing homelessness in the city, even 400 units is still not enough. we strongly recommend and urge of committing funds to bridging this gap. everyone, including tay, deserve the right to feel safe. >> in terms of the funding allocated for transitional age use services, we're asking for proportional funding. as of may of 2017, only 8% of the hhs service dollars were allocated for transitional aged youth, and we know from the point in time count that about 20% of the homeless population are between the ages of 18 to 24. we would also like to see the navigation center for transitional age youth be created, since the funding was already allocated in fiscal year

2018 to '19. >> the youth commission's fully aware of the mayor's request of cuts up to 6% of departments over the next two years. we are concerned that youth and tay will be further underserved and disadvantaged as a result of the budget cuts. the city holds many progressive values, one of those values being youth empowerment. we believe the city needs to put money where its mouth is and not cut funding for its programs supporting youth and tay. >> so just to recap, these commissions' central priorities, which we are pushing for in discussions with the departments concerned, we are committed to obtaining increased funding for re-entry programs, services that help youth exiting the justice system reintegrate into society. we are also e committed to our ask that substantial funding be allocated towards the 20

2015 400-unit goal for permanent supportive housing for tay and looking for more proportional in hhs's budget. and finally, while we recognize the mayor has asked for cuts in departments' budgets, we believe for many youth-specific services, cuts will only accentuate the existing problems facing underserved youth and tay populations. it's, in some ways, a matter of whether some programs and services will survive beyond this cut year and perhaps future years of cuts if their funding is cut or withheld this year. so we are opposed to cuts to youth and tay-specific programs across the city and county budget. that concludes our presentation. we're available to take any questions. thank you. >> supervisor fewer: colleagues, any questions?

go ahead, yes. supervisor stefani. >> supervisor stefani: first of all, thank you so much for that presentation and your involvement. it's great to see you up here. i'm impressed with your work and the priorities you laid out here. on the transformative justice committee slide you talked about mandatory instruction for law enforcement officers for youth cognitive development and interactions with youth. i think that sounds really important and promising, and i'm wondering if you know of any programs out there that other departments are using, or if there's a sample program that you're thinking of, or if you know of anything. >> well, there was already a program implemented in the last year, but it only trained 25 officers, as opposed to the 2,000-plus officers in the sfpd. we wanted an expansion of the program to create a program that can be taught to all sfpd officers that works with both

community organizations and the city to create, like, a baseline instruction, because we think it's really important that all officers are trained in this and not just a few. >> supervisor stefani: perfect, great, thank you. >> supervisor fewer: yes, supervisor mandelman. >> supervisor mandelman: well, i would like to echo vice chair stefani's comments about being very impressed by this group and the work that you've done. i also note your calling out the city on some failures around tay housing, and i think that is something that is going to be of great interest to this committee going through the next few months thinking about the budget and thinking how we can get through the budget and perhaps through another round of eraf, certain resources for supportive housing for formerly homeless or homeless youth. that is one thing that was part of the coalition on homelessness

ask for this last go around of eraf, so we're not able to come up with the funds through that, but i'm hopeful that we will going forward over the next few months. and then, of course, the tay navigation center remains a promise that has not been kept, so we are hoping that it will soon be kept, but thank you for your work. >> supervisor fewer: yes, thank you for your work. i wanted to just ask a couple of questions. one, do you have a budget amount that you're requesting for the fee waivers for california i.d. cards for youth 16 to 18, do you know how much that might be in a budgeted item? >> we've talked through some numbers in committee, but i think that would be a matter to touch base again with committee and to reach out, but we can get those numbers to you. >> supervisor fewer: because this is the budget committee, so we really deal in numbers, so when you're telling us you need fee waivers for youth, we need to actually know how much are you allocating, what does that

program sort of look like, how would you reach out, would it be need-based? i think that we do have some models that we, you know, for youth, we can actually look at some models that we can implement this with, and then i wanted to ask you, because i know the resolution is that they were -- we passed a resolution to actually preregister every -- register every sfusd student who's 18, but the ones that were 17 to preregister for them a year earlier, because you were able to do that by law. have you had any kind of hearing on that to find out, or requested a hearing through the san francisco unified school district to find out how successful that program is, what kind of resources are being put towards that? because that's an area you can advocate for resources within the san francisco unified school district, also if there was a coordinator of that program, if

there was someone to really oversee the pushing of that. so rachel norton, who -- commissioner rachel norton, i wrote the resolution with her, she's still on the board until 2020. you might want to reach out to her to call a hearing to see how across the board it's happening in our high schools, because, as you know, the san francisco unified school district educates about 60,000, two-thirds of the school-aged children in san francisco, so they would capture, quite frankly, most of the teenagers, a proportion, of those future voters. because i think that would be -- i haven't heard the results of that and whether or not it's been successful or not and how many people have actually registered to vote. and then what would help would be also to just have even through the department of elections how many youth are registered to vote in san francisco currently, and is there an aspirational goal that you have in mind, because then

we can see what we need to get to that goal, i think, would be kind of helpful. another thing is about the law enforcement, i actually would add in if it's all about youth, then we would also add in about procedures when stopping and detaining youth and also the laws and general orders pertaining to youth and youth in schools, questioning of youth, reading of their rights, those type of things. and it's not just youth cognitive development, but really about the legal framework about youth, too, because if there are officers that have not engaged on a regular basis with youth, then they might not be aware of all the laws that we actually have ordinances that we have governing their behavior or what they can do around youth. and so i just think that would be really important to add in, too. and then, let's see, the re-entry programs, yeah, i

wanted to ask you, because i'm on the re-entry council for the city and county of san francisco, and i'm wondering if you've partnered at all with re-entry, the re-entry council. because they mainly talk about adults in that re-entry council, and it would be kind of, i think helpful, actually, to have youth voice there. because we are looking for ways for people when they come back into general population, what are the supports that they need, and i think that if we -- if we had a youth representative there, it would be really super helpful. and then i also want to ask, the san francisco unified school district stopped giving driver's education and driver's training, but we are hearing now that it is a barrier sometimes to employment for young people. for example, if you want to go into trades, you have to have a driver's license. if you want to be a bus driver or some of these living-wage jobs, you have to know how to drive. and driving is one of those

jobs, to be a driver is one of those jobs that sometimes you don't need a college education and that you can actually start driving and be part of the teamsters right after high school. so i am wondering, have you seen that to be of concern to youth? because i am hearing more broadly it's not so much the 18 year olds, but when they are trying to get a job when they are 23 or 24 that require some driving, that they don't have a license, and actually to get a license in san francisco can be somewhat costly. for example, you have to have someone teach you how to drive, and a lot of people don't have cars. and also if you come from a family that they are not legally able to get a driver's license, then those families, who teaches who to drive? and the san francisco unified school district used to do it. i'm wondering, have you heard if there's a need for a fund maybe or some program to teach youth to drive? and then i'd love to hear about

that. and then i think i just want to echo what my colleagues have said about the tay housing. yeah, considering that the money's been budgeted, what the heck, and so we'd love to follow up on that, too, because the money has already been funded, so what's taken so long, right? yeah, and i think the mayor has requested cuts up to 6%, and we will see, you know, we have very little control over the mayor's budget instructions, and it's true that the mayors and the departments get first dibs at the budget, and so i don't know what they would be actually cutting in there, but i would say that if you are -- that you may want to meet with some large departments and ask and meet with the department heads and ask them about the 6% cut and request that they make the cuts

to youth and tay-specific programs. >> all right, so a lot to touch on there. firstly, when it comes to the amount of young people in san francisco who are currently preregistered to vote, it looks to be 1,724. with regards to the monetary ask, when it comes to the fee waivers for california real i.d.s, the number we have cited and committed to based on all our calculations and research is $60,000. when it comes to the department of elections more broadly, i know we've had some contact with them when it comes to preregistration. i haven't heard much about the resolution automatically registering young people to vote, but -- >> supervisor fewer: excuse me, i'm sorry, charlie, to interrupt

you, but it is supposed to be part of, i think, american democracy, which is a required graduation course for sfusd and all of you guys, so in order to pass that, so that we know every 12th grader is actually taking that class, it's required, and that's why we put it in that class, that there would be a voter registration component. >> yeah, speaking to the curriculum surrounding that civics education, i know -- i believe it was two years ago, one of our commissioners made a hard push when it comes to the board of education to try to mandate more civics education. as far as we can tell, and we have followed up a great deal, we've more or less been stonewalled or written off. >> supervisor fewer: so we are now, i think the board of supervisors are used to the committee who had school board members and board of supervisors, and now -- then they stopped having that

committee. they are now reconvening, if you would like, whoever the chair of that is, you may want to ask that that be put on the agenda. and then you could have the department of elections here, and then you could have also sfusd, their curriculum folks, and then it would be important to know how many youth in the 2020 election would be eligible to vote as a population, right, 1,723, is that a low number, or is that a high number? like, it seems kind of low to me, but wondering what the aspirational goal is then, right, because we know the earlier you vote, voting is a habit, the earlier you vote, the more prolific voter you will be. hence, vote '16. >> we can speak to strategy

around vote '16 another time. we actually just had a stakeholders meeting to set down some of the long-term strategy around that, so we can certainly be in touch with your office around that. when it comes to sfusd and classes to obtain a driver's license, as far as i would guess, if $30 is prohibitively expensive, my guess is $200 driving lessons, of which i believe you need three, certainly would be a barrier, so if there was some way to subsidize that through sfusd, again, that would certainly be an option or idea that the commission would be interested in pursuing. >> supervisor fewer: what i was thinking is, if it's not through sfusd, is it through the initiative of giving every youth a job? and part of job training? what i didn't know is, if this is an issue that youth have brought up or not. if they think it's important. so if it's not important, i

would say you probably wouldn't prioritize it, but if you're hearing that it's important, then i think they want to learn to drive and don't have the opportunity to learn, then i think it's worth exploring actually as part of a youth job development. >> got ya. well, we'll definitely be in touch with our community partners around that question. when it comes to your questions around questioning of youth re-entry programs and touching base with the re-entry council, i'm going to turn it over to nora. >> supervisor fewer: okay. >> hi, i also just want to share that as a youth that is currently in high school, i have definitely heard that very few people i know actually have driver's licenses, and most aren't really looking to get them either, partially because of how long it takes to get a driver's license, and also because it is really expensive to get driver's licenses, and i can't speak to how that affects people looking to get jobs in driving, but i do know that it

is pretty rare. >> supervisor fewer: okay, thanks. so the re-entry council. >> so we -- sorry, can you repeat what you asked again? sorry. >> supervisor fewer: so the re-entry council is a place where a whole bunch of city departments get together, and i sit on it representing the board of supervisors, and we brainstorm about some of the issues that are a barrier to success for people who are coming out of incarceration. so we're looking at those supports. how to connect them to jobs, what is kind of the other supports that they need, housing, those type of things, but also examining the supports that we do have, are they effective, and then also looking at why our incarceration rate is so disproportionately african-american and latino. so those type of conversations we have, too, but if you wanted to connect to the re-entry council, i think it fits in sort

of perfectly about re-entry from youth, for youth, because you do serve adults also. this could be a very, i think, good committee to even come to address one day or about some of your ideas around re-entry for youth, because most of the conversations we have is re-entry around adults. >> yeah, i think that is a really important aspect and perspective to see about re-entry programs for youth, and i think it is very, very similar to a lot of things we're looking at in the incarceration of youth in san francisco and the juvenile justice system. >> supervisor fewer: thank you very much. >> thank you. >> just one more piece to that. just occurred to me, we did receive a presentation from someone from the re-entry council earlier this year. there was some discussion about the proposing of a mandated youth seat or more ideally multiple mandated youth seats, but that's something we'll definitely touch base with. >> supervisor fewer: you may want to advocate for that,

because we do have people who have been formerly incarcerated and there's seats designated for them, too. so it's great to have seats at the table, voices. any other questions? let's open it to public comment. are there any members of the public that would like to comment on this issue? seeing none, public comment is now closed. so, i think i would like to continue this item to the call of the chair. would that be okay? we can take that without objection, so we can call you guys back. thank you very much. so, take that without objection, and then, madam clerk, are there any other items before us today? >> clerk: there are no other items on today's agenda. >> supervisor fewer: thank you very much, our meeting's adjourned.

>> we are in for a pretty speedy meeting today. i just wanted to welcome everyone. i am joined by supervisor catherine stefani, and committee member supervisor rafael mandelman. today jesse larson, we want to thank you from san francisco government television for broadcasting this meeting. madam clerk, do you have any announcements? >> silence all cell phones and electronic devices. speaker cars and jump documents to be included as part of the file should be submitted to the clerk pick items acted upon will

appear on the ferry 26 board of supervisors agenda unless otherwise stated. >> thank you. let's call item number 1, please. >> item number 1 is resolution approving amendment number 1 to the agreement between worksite community mental health center and the department of public health for behavioral health services to include -- --dash increasing agreement amount by 17.9 million for an amount not to exclude 29.9 million. for a total agreement term of july first to december 31st. >> thank you very much. i believe we have the director of d.p.h. >> correct. thank you. i am representing the department of public health back before i get started to, we realized too late there is a clerical error and the short title. so i am just bringing that to your attention. we have already provided an amendment by the clerical error

says the word fiscal intermediary, the long title and the body of the resolution and the report done by the budget and legislative analyst is all correct. i just wanted to point that out. you do have a corrected version that removes that word. today, as was stated, this is a request to amend this contract to continue it after its one-year term period beginning june 30th, 2019 for three years and six months, the current contract has four programs, included in it, and this is a long-term community-based provider. therefore programs are an outpatient clinic, an outpatient crisis clinic, an intensive case management program that we refer to as assertive community treatment, and a child and adolescent outpatient program.

at the outpatient and the crisis programs were both selected to a solicitation process, and our ongoing. one of the policy considerations that was noted here by the board of supervisors was how is their performance one -- when the budget analyst does -- when they did this analysis, they took the scores of each of the unique programs to give an agency overall score, which is fine, but the way that we actually score as my program, so we do separate and unique program monitoring of each program, so it did average out that way to be less then meeting standards. when you look at the outpatient program and the urgent care, in all the years 14, 15, 15, 16, they met standards. in 16, 17 they exceeded

standards. we don't have a performance concern about the continuation of this program with westside. the third program is there intensive case management program. they inadvertently did not provide a submitted application for that solicitation. their past performance where they had an issue was around the deliverables and not meeting the deliverables. this is an intensive case management program where they have a set number of slots, with 139 slots. we are, at this point, continuing the program, but it has had a reduced rate, i mean a reduced number of clients. down from 139 to 80, so it reliance a number of clients that are assigned to their program with the capacity that they can historically provide. and then the fourth program is a children and youth program that

is not continuing, at least how it is, it is not continuing right now after fiscal year 18 -- 18-19, it is not in the out years of the contract. otherwise, we rely upon this program for meeting the target population that they serve, which is primarily african-american, and we work closely with the agency, and would recommend approval. >> okay. supervisor mandelman? >> thank you, chair if you are, again, i am new to this, and i'm just learning my way along, but looking a report like this, to me, it rings some alarm bells, and maybe on misunderstanding

it, or misreading it, there is a listing -- i guess i would like to understand about how these scores are -- what we are measuring. what are these scores ranging from? this is in the b.l.a. analysis. it doesn't sound like we have a minimum score, or do we? and when do you become concerned, when should we be concerned about performance under a contract, and then i recognized it may not be other providers that would do this work, and so in that circumstance, how do we address concerns if we do have concerns? >> right. the scores listed is a range of scores -- all the agencies that provide solicitation have to meet the minimum requirement, so that can screen out anyone at the beginning, if they don't have medi-cal certification, they don't have the required

numbers of years of service, ability to document their services, both -- most behavioral health services are billed to the state to draw down medi-cal. to the door agreed that there is documentation problems, if that's a problem, that is what something else we check in the solicitation process. we also, they have to have experience. there's minimum qualifications that will screen somebody out, and when we do the scoring, the scoring is divided into three categories, with the most points going to the evaluation of a written proposal, and then review of prior performances, and financial management capacity and fiscal integrity. those together is the scoring, we have an independent panel that reviews. this particular solicitation with many of our sins we have

ongoing providers, and so we are meeting the requirements of going out to bid, and in some cases, people, vendors are not reissued contracts, but we also have ongoing services, so we want our providers to be successful. we were not concerned about this score. they met all the requirements. their past performance for these two programs, they've met all the standards. in the last year, it is fully audited and they exceeded the standards. the urgent care is a critical program in our continuum of care. someone is in crisis and they need immediate medication, that is a place where they can go with a psychiatrist always on staff. so we don't have an ongoing concern for that, the other

program, the outpatient children's program, their score was half of the points that you could get, but more than that, within the solicitation, there was missing pages, and there was , it was not a robust solicitation that gave us comfort to continue the program as it currently is under that model, so it is not continuing in the prior years, forward years. at least in that program model structure. the intensive case management program, when i drilled down and looked at the actual scores within the agency, it could be one, two or three, where they had their problem was with meeting the deliverables, in that problem that they had, because they could not retain staff for what they were able to pay, and just not enough staff, which drives down the number of

clients they can serve, that has been a consistent issue with the program, and so what we did is drop the number of clients from 139 to 80. the other thing is that contract, or that peace will go out to bid, but these are clients that have been with this program. this program is 15 years old. i don't know about each of the clients, but they are the highest risk, highest users of the system. so as much stability as we are able to provide, we want to provide, which is why we reduced down to the level that the agency can manage, but we are not putting all the other 80 people somewhere else because right now they are doing a system review and trying to change the model, are looking at changing the model of intensive case management so that there are tears of highest need to, and then you can drop down to a

cheaper level, and lest -- less intense services. all of that is happening now, so we don't want to move any of those 80 clients that could then have a new case manager, and then another case manager. that's why that program is continuing, and we are continuing with deliverables and productivity. it was just the one that is the level of their capacity. so we have adjusted the contract. we feel comfortable having them move forward. >> do we look at client outcomes as part of scoring? >> we do look at client outcomes. the deputy director of adult and older adult services can speak to that, but we do. >> good. >> good morning. >> morning. >> in terms of outcomes, we look at client satisfaction. each year, we take a look at, we

ask our clients, are you better off because of the services we provide? so that is one area. we also have the adult needs and strengths assessment, which is a comprehensive assessment that basically takes the time, at the point in time, and a second point in time and compares progress, so we look at risk factors such as emotional and behavioral symptoms, we look at other risk factors, we look at strengths, so this is done with a case manager and the client together, so it tells a story about whether or not they are able to improve. the other part is it also takes into consideration cultural factors, and so i think, for this particular program, when we look at it, it is predominantly african-american.

there's been a shift in the population, it is hard to retain staff, but the story that clients are saying that basically, in terms of housing, it is one of the biggest challenges, and we might be able to stabilize their psychiatric symptoms, keep them out of the hospital, but still, one of the main challenges for people moving on is stable housing, and it is not just stable housing for clients, but also for staff, so that is one of the challenges with retention, but in terms of outcomes, we are comfortable that clients are showing improvement and doing a good number of healthy relationships. >> we look at psychiatric hospitalizations, we look at incarcerations, we look at a lot of the clients, we look at their health as well.

in terms of physical health, this is also a medically fragile population. a lot of them are high users of our medical emergency room, and they show up in other parts of our system, whether it is in jail, or being homeless as well. yes, we look at all of those. >> thank you. >> all right. >> supervisor stefani? >> thank you. i have a few questions as well. the b.l.a. report indicates that westside has not consistently met their budgeted level of deliverables, and you are telling us you've dropped the expectation of 139 people served to a tee. is that what you are saying? >> they probably should have been another sentence on that sentence. the westside meeting does not meeting their deliverables applies to the one program, the

mission program, and the mission act program is intensive case management, so they have a set caseload, and it was 139, and we have dropped that down to 80. they are only expected to have 80 clients. that is how much staff they have to carry that number in the caseload. >> okay. so i just find a disconnect unit we are dropping our expectations of deliverables of people served from 139 to 80, yet we are increasing the contracts from 70 million to 23 million. i feel like there is a huge disconnect here, and i also don't understand, why are we giving awards to service providers that are not scoring highly on r.f.p.s, have not always met standards, and are not at their budgeted level of deliverables? makes no sense to me. >> okay, so even going into this

solicitation, it is clearly stated, it is not just the top score, so we have a huge city, and we have a lot of different target populations, so we try to have providers that meet all the needs of the different target populations. within this particular agency, there's four programs. two of the programs are outpatient and crisis. each year, in 14, 15, 15, 16, they have met all their standards, they have exceeded the standards in 16, 17, they have done extremely well. we have no concerns. the third program that is in here, they did not submit a bid, but we are continuing to program until we finish our system redesign so we can continue continuity of care for the clients that are in that program

the fourth program is not continuing after fiscal year 18-19, because i did not score well enough to hit our comfort level for the solicitation. so the cost of the program is not changing each year. that one program is coming out and reducing 400,000 each year, but the dollars are going up from 5 million, to cover the rest of the cost of the programs for years to, three, 4.5. they are not getting more money, they are just having, i mean, they are not getting more money on an annual basis, they're getting less because the children's program is coming out >> would you agree that there are steps that westside could take to improve its performance? on the one program that is indicated that they need to? >> the program that is indicated

that they need to improve their performance, when you look at the actual breakdown of the categories of what the performance was, for program performance, westside act in 1617 met their standards. for program for client satisfaction, they met standards. for compliance with meeting all the requirements, they met standards. for deliverables, they did not meet standards, and so between 17, 18, and 1819, 18-19 being the new year as the contract, we have reduced that contract, that program by $639,000, and we reduced the clients from 139 to 80. we believe that readjusting those values that they are paid, and the number of clients will allow them to have a sufficient

level of staffing to meet the needs of the 80 clients. they were not able to staff that to accommodate 139 clients consistently, so we reduced it. >> okay, but do we need to, based on what we need here in the city and county of san francisco, in terms of delivering service to those that need mental health services, do we need to be meeting that 139 instead of just 80, and how do we get to that 139, and what can we do to help westside get their? >> we have been consistently working with westside, with this was also their request. it is a consistent problem. we still had the money, and there were other vendors that applied that already provide intensive case management, so we moved the client accordingly. nobody stopped being served, so that is our number 1 goal in any solicitation or any transition, in any type of funding, or

programming, is to ensure continuity of care of the clients that are already enrolled in the program his. so i feel like we work very closely with westside, and this was an agreement that we reached with westside. >> i guess we can follow up with the budget and legislative analyst in terms of their statement about westside has not consistently met their budgeted level of deliverables, so i wait --dash i will wait to hear more from the b.l.a. on that. >> before we hear from the b.l.a., i want to comment that it is a little disturbing, quite frankly, about the scores, but also that on the b.l.a. report, page 3, he says according to jackie hale, d.b.h. of contract management, all responders to the r.f.p. were awarded contracts, and there was no minimum score required, so what measure do we hold people to? i think this is a really important service that westside

provides, and especially, i'm especially alarmed because this is a place to get the service to mainly our african-american population. when we are not -- to say that in these years, they met the standard, but this year --dash we hear also that they are struggling with some issues structurally within their organization. so what are we doing about it? i think of kicking back on what my colleague said, what are we doing about this? this is a much-needed programming in the community. the community has depended on this program for a long time from what i am hearing. and yet how her answer is we will eliminate the children's program. so i just want to know, this is a really -- this is a big need in the community, and this is one of the only community places that they can get this type of healthcare. i actually think it is

imperative upon us to make them better and help them structurally with the infrastructure so they can serve the intended 139 people instead of the 80. i don't think it's enough to say, well, you know, they have been good these years, and they have these issues, and so we'll just get rid of this program, every time we get rid of a program, we eliminate a program, that means we eliminate service and eliminating service for african-american communities. >> actually we just did a solicitation specifically for african-american services, and that is where the funding will go, because it is absolutely our interest to retain capacity to our target populations. so there was a specific solicitation that we just completed targeting african-americans, and improving their health and well-being in san francisco. >> okay, let's -- if my

colleagues don't have any more comments, ms. miss campbell, our b.l.a. report, police. >> good morning. i'm from the budget analyst office. i wanted to speak a little bit to the question of intensive case management that i think supervisor stefani raised, and has been discussed here. it is not specific to westside as much as to our audit finding from our behavioral health audit. the one area where we felt there was a need for more resources was intensive case management. we did not recommend a number of what was needed, by recommended the department of public health go back and look at their model in terms of increasing the number of case managers. it is also moving people through the system. i do want to speak a little bit to what she said, which i guess the department is looking at at least having tears of intensive case management and case management that might address some of that. that is an area where it might

be helpful for more follow up overall in terms of not specific to this contract, the specific to the concerns about intensive case management. >> rights. it is a part of a redesign for us looking at intensive case management, and so typically our approach has been the community treatment model to do whatever it takes to provide for the most severe, mentally ill, acute population. one of the challenges was that when do you actually graduate and move someone on? you have to move someone on to create slots for another in need. and so what we've learned is that in terms of short-term case management and linkage, that we probably need to split our programs up into tears, and to focus on short-term, more acute, three to six months, and then

really, with what the act program is, falls into our community support treatment team model where we will focus on working with clients for up to three years, but to create flow, in our outpatient system, we are looking at community-based case management, so our outpatient clinics are actually becoming a bit more robust to do some of the outreach and supports that typically are active intensive care management provided. just by doing that, it will create more flow in the system, and i would think that with westside, you are seeing more about rightsizing of the program because there outpatient programs are going to actually pick up some -- are already have picked up some clients that they are actually providing some community-based case management for. so this redesign is something we've been working on for the past year and more to come.

so the wonderful thing about westside is when you think of the different levels i just described that their clients can live within their program, that is their home, so we are able to step them down for intensive case management, to outpatient. the crisis program is able to link a client to their outpatient or to their intensive case management program, so it just creates flow in a different way than how we have things set up before. it doesn't mean that we can't ramp up, but i think that the agreement was, let's focus on a population that is actually doable, and that is where we have settled on the number of 80 it doesn't mean they can't exceed the expectations to ramp up even more, but i think a staffing, what i mentioned before about staffing, that is the biggest challenge for them.

this is a program that deals with the most acute and most severe, severely mentally ill, medically complex populations. in terms of being able to retain staff, it is a challenge, so it is not just this particular community-based organization, but it is a challenge for our workforce. we are supporting them and hopefully this new direction will help address the flow issue. >> do you have anything to continue with? >> in terms of the contract itself, the board is being asked to approve the first amendment to the spot contract with westside from adult mental health services. the original contract was awarded in december of 2017, big but because of delays in being able to negotiate and get it to the board, department entered

into a one-year contract for a $5.3 million. they are now asking for approval of the whole contract through 2022, to not exceed $23.3 million. in terms of our evaluation of the fiscal components of the contract, we are recommending approval. >> thank you very much. let's open this up for public comment period are there any members of the public who would like to speak on this item? seeing none, public comment is closed. colleagues, supervisor mandelman? >> i clearly -- many elements of this conversation are troubling to us. i think it sounds to me like the department probably did the right thing in that if the provider was not able to meet these higher expectations, i do think that freeing up that money that would go to case management being provided by some other entity is probably the right move. i think this challenge around

the nonprofit partners being able -- unable to hire and retain the workers to do the work that we are asking these nonprofits to do is also embedded in this conversation. i am hearing that as well, so i think that's a big conversation the board has been having, and needs to continue. anyway, i will be here yet just curious to hear what my colleagues have to say. >> would anyone like to make a motion on this item? supervisor stefani? >> yes, supervisor fewer, i still have a few questions in terms of -- we put down an r.f.p., and we have people reply to it, we have expectations in that r.f.p., and it sounds like to me that, and maybe just at first blush, i'm not reading this right. a sounds like they are not meeting what they would do in the r.f.p., so we are reducing the number from 139 to 80.

>> the r.f.p. that is listed in here, that is detailed with all these points, they have done perfectly well, every single year. >> how do we get to the point then that we say they are not meeting their deliverables? >> that is the third program. >> okay, but then the third program is not delineated in an r.f.p.? >> no, they didn't apply. >> and very confused at this point. >> there's four programs. >> excuse me one second. please respond when the supervisor has requested you to respond. is there a question from supervisor stefani that you have for her to address? >> thank you, supervisor fewer. i am just trying to understand, i feel like we are brushing over the fact, based on what i am seeing in the audit, that this nonprofit, for whatever reason, having trouble meeting deliverables, and i think it touches on a lot.

the affordability, it touches on a lot in the city and county of san francisco. i am having trouble reconciling how we award this, knowing that we have an audit that says they are not performing at a level that we expect them to. >> okay. for whatever reasons. >> for me, i don't know if we can continue it for a week for more information where we can sit down and have more in-depth meetings about not just this program, and how we are putting out the r.f.p., especially with mental health, is one of the main thing is that people are talking about in the city and county of san francisco. when i am looking at the contract in front of me, with this information, and to approve it at $23 million, i feel like i would like, if it is