from abigail stewart kahn, district eight resident, department of homelessness and supportive housing. >> good morning, supervisors. thank you for having me. as supervisor mandelman said, i'm a district eight resident, so thank you for having me, supervisor. my name is abigail stewart kahn. i'm with the department of homelessness and supportive housing, and i also want to make sure to acknowledge the department of transgender initiatives and their work and support in this area. according to the 2017 point in

time count, 5% of people experiencing homelessness are transgender and 1% are gender queer nonbinary, and this is a survey response of 1,000 individuals which is conducted in conjunction with the better known visual count portion of the point in time count. while less than 1% of the general population in san francisco experiences homelessness, a needs assessment conducted by the horizons foundation found that 15% of transgender and gender nonconforming san franciscans had been homeless in the past year. the point in time count also provides us additional data about the particular health and mental health vulnerability of the lgbt community which we address in our report. at the department, we think about the sogi ordinance in five ways. here, you can see a sort of snapshot of where we are in our

progress, and i'll get into each work area in a bit more detail as we go through the presentation. for data collection and training, the important context which claire noted already is that our department was formed in 2016, and in 2017 launched the one system to consolidate 15-plus existing data systems which governed homeless services in the city before the creation of the department. full implementation of the one system is h.s.h.s strategy for full sogi compliance. however, currently 40% of h.s.h.s data system are compliant and consolidated into the one system. one system intake and assessment forms are now all sogi compliant. from a training perspective, h.s.h. has trained over 50 nonprofit partner agencies and 75% of department staff on sogi

data collection within the one system and we're working with the office of transgender initiatives. staffing constraints have made the deployment of the one system slower than expected. in order to become compliant with the sogi ordinance in reasonable speed and also meet our other significant data concerns, h.s.h. has submitted a request for increase in resources via the committee on information technology in this year's budget proposal. confidentiality and privacy is also a critical component of the sogi ordinance. h.s.h. is a hipaa entity, and thus any data collected in sogi is held that way. we are currently working with the city attorney's office to develop appropriate language for implementation into our grants, and i also referenced the waiver pending so we can

address the language question of sex at birth. in the future, monitoring and reporting will be done on the one system. in the meantime, h.s.h. will evaluate the potential use of h.s.h.s carbon system which is still or grants management system which has a new sogi compliant function and will evaluate its use as an intermediary step. at this time, we can only share early stage and noncomplete analysis, but we did want to share where we are today. in the fall 2018, h.s.h., with our partners, conducted approximately 4,200 assessments of adults experiencing homelessness as part of what we termed the coordinated entry assessment blitz, and here, you with see the early results -- you can see the early results, again, noncompletely around gender and sexual orientation. here, we compare that data to the 2017 point in time count

which i referenced earlier. and here, you can see beyond the -- beyond information in the one system, some of the programs which are held still in their own data systems, and where they have sogi compliant questions and where they're not yet compliant. again, as i referenced, the goal is to move everything into the one system, which is sogi compliant. this information on this slide is for fiscal year 2017 and 2018 on the issue of gender identity, and here is the quarter one and quarter two fiscal year 19. moving forward, there's the same information on client sexual orientation, and you can see the gaps in our information here. and finally, for quarter one and quarter two of fiscal year 2019. so for next steps, h.s.h. needs to move with focused speed to move our additional clients into the one system.

we need to finalize the waiver to improve language, and we need to add sogi compliant language to all relevant contracts and we will evaluate the use of carbon to sogi's approach. as more data becomes available, h.s.h. will be able to provide a better report to the city administrator's office. we were asked specifically to talk about additional training efforts and plans. h.s.h. currently connects department and staff to trainings offered by h.u.d. and specialized trainers in the community. we are hard at work for a 2020 training plan which if resourced will roll all to all providers. we are including lgbt all access training and cultural humility work within that training plan. while we have significant work to do to come into sogi

compliance and work with this initialation, there are plenty to be proud of. we are proud of our work with existing nonprofits in the community that have been on-line many years to serve the queer community in homelessness and transitional age youth is 50% lgbtq. some of those are referenced on this slide. h.s.h. will continue to focus on our homelessness response training plan, and as data becomes available, intends to integrate sogi compliant data into our hsh management dashboard, which is how we review and quickly detect issues if there are issues and make plans to address them. we will continue to partner with o.t.i.s new services guide and portal to ensure access, and we are continuing to evaluate safe spaces

specifically for the adult and t.a.y. shelter community and in the next few months we're opening coordinated access entry points for youth which are operat are -- we're looking forward to working with our community to bring those on-line. in closing, h.s.h. needs to address -- addresses the need to serve diverse populations effectively in our strategic framework. this is mission critical for h.s.h. we're working to address the disparities that have led to overrepresentation in certain communities, including the lgbt community and the homeless population. thus far, we've held a series of meetings on racism and homelessness and joined a national collaborative call spark and produced a number of action steps. still we have a greet deal of work to do -- great deal of

work to do in this area, and we need a plan. we need to have analysis in that plan, and we need to address the over representation of specific communities in the homeless population. h.s.h. will be developing specific goals as a supplement to our strategic framework that will include addressing disparities in the lgbt community and we look forward to partnering with the mayor's office, the board of supervisors and the community on those efforts. thank you. >> supervisor mandelman: thank you. seeing no questions from my colleagues, i will jump in and ask a few. >> sure. >> supervisor mandelman: so i think when i'm looking at this -- actually, i missed something when you were going through. >> yeah. >> supervisor mandelman: on slide 16, i guess. so what is the safe spaces? >> we're always looking and evaluating at new spaces and

the need for spaces specific for this community and whether those need to be expanded. we have specific goals as we've talked around the t.a.y. population and are working to advance those. >> supervisor mandelman: okay. great. so it looked to me that there is a pretty significant discrepancy between the population that's showing up in the point in time count and the population that's showing up in the one system. >> right. from early analysis -- so -- yes, go ahead. >> supervisor mandelman: well, it looks like the population going into the one system is more male, and more straight. >> that's what the data shows. the one thing is because the proportion of the lgbt population of the youth community experiencing homelessness is not truly represented, we're hopeful that that will resolve itself, but we're tracking it extremely

closely, and it's specifically why we're rolling out these youth access points. >> supervisor mandelman: that might not explain the discrepancy around trans folks. >> okay. >> supervisor mandelman: that -- yeah, i'm not sure. any way, so then, i want -- then, i just -- the question about jazzy is great, and a great way to honor her memory. when i look at the language allowing clients to select their gender, allowing clients to use their preferred name, those are probably things that every shelter ought to be doing. >> correct. >> supervisor mandelman: yeah. >> if the slide is unclear, those are the policies of all of our shelters, and it jucst

happens to sit under jazzy's shelter. >> supervisor mandelman: i'm not sure you can actually have an lgbtq shelter, so one of the things that i've heard, in particular, trans folks may not always feel welcome there, and that may not always feel like a safe space. and then, i think it's useful as you do this analysis and you look what's going on with the one system and why people oregon m oregon -- people may or may not feel represented, we have an overrepresentation of trans folks in the homeless population. trans folks are also particularly vulnerable,

particularly women, in some shelters. and i think one of the issues -- i think what we may here quite a bit in public comment is experiences of folks who are feeling that the current shelter system, because it does not specifically address the needs of trans folks and in particular trans women is not meeting the needs -- if you don't specifically address those needs, you're going to persistently undercount. you have to call out we are going to do count of trans folk, similar to what we're doing with trans age youth. >> yeah. thank you for that feedback, supervisor. i think it's something we hear very loud and clear from our community partners, as well. i know that my colleagues in the division are working closely with the office of transgender initiatives who are helping us understand that

community feedback, and we're looking -- we're kind of in process on evaluating that approach. >> supervisor mandelman: great. thank you. >> thank you. >> supervisor mandelman: up next, we have brian chiu, the director for the mayor's office of housing.

>> all right. brian chiu, executive director for the mayor's office of housing and community development, using he, him, his pronouns. so we implemented our sogi data collection just before the beginning of our 17-18 grant year, and the way that we chose to do it was by including within our orientation sessions for all of our grantees, we have about 191 separately

funded programs to inform our community based organizations about how best to include all of the new data as they go through the intake process. we had included some voluntary data before, but it really hadn't been built extensively into our system, so we included all of these new data categories for sexual orientation and gender identity into our on-line grants management system. we also included it in the application process, so through the dalia affordable housing portal, we've included all of these questions so we're able to now track all of the individuals that apply for affordable housing, and we're also beginning to implement in into our annual monitoring report so the reports that we get from all the affordable housing units that are in our assess management portfolio will now begin to include all

of this information. some of the feedback i think that we received sort of raised some interesting questions in terms of the ability to -- well, a lot of our community based organizations serve very population specific constituencies. i think what that shows is that especially when you look at asking these questions across generational boundaries and across cultural boundaries, it's very important to kind of get into the weeds of how to actually translate documents and actually translate across cultures. i think we've moved into it, but just for example, some of the feedback we've had -- so for example, we fund groups that provide primarily services to monolingual cantonese

speakers. it was interesting how to bring this up to a community that's not really familiar with answering questions at all about gender identity or how you translate questions about gender identity into cantonnese or farsi. while you may initially receive some push back, that we really wanted it to be seen as a learning opportunity so that individuals don't see it as this is just another city attempt to capture data that's not useful, but to really say this is why we're asking this question, this is what it means. maybe you haven't thought about it before, but it actually does

impact your community, but we're still working on that. here's an example of what it looks like across our community service organizations, and you'll see that if you add up the number of individuals that chose to openly identify as gay, lesbian, same gender loving, questioning, it comes out to about 6 -- a little over 6% of our clients. again, it's a little hard to tell what the baseline is. we've all read studies that the number of individuals could be as high as 10%. is that high? is that low? i didn't include it on this slide, but what we've found is across our community service organizations, it actually changes depending on what kind of service you're trying to reach. so at the high end, homeless services, for example, had about 14% of individuals

identifying as lesbian, guy, bisexual, people that access our housing programs, again about 11%. these are services that are specifically offered to individuals in public housing or r.a.d. housing. it was a very low number, even though there was a lot of individuals, but less than 2%. so i think one of our questions is are people in public housing comfortable being asked that question. if you're receiving services, do you feel that that information would be made confidential? do you put yourself at risk if you're identifying yourself that way, so i think it's something for us to look further in to figure out, is it a case of people not actually being served or is it a case where people actually feel uncomfortable answering those questions. similarly, on the gender

identity question, when we ask that across all of our programs, it was a little over 2% of all of our programs that identified as trans or gender queer. again, is that an underestimation? i know that in one of the reports that o.c.i. put out, it was at 6%. hard to know, but i think we can always do better. here's one of the results of a program that specifically targeted the lesbian, gay, transgender or queer community, we are fortunate enough to fund lgbt center, lyric, ucsfs program that's focus on the

queer community or the trans community. you see the number is a low of 27% up to a high of 100%, so i think that just shows the value. while i think it's important to have the breadth of all of our programs being culturally competent and serving l, g, b, and t individuals, it's important to target those groups because you're never going to reach those groups unless you target these groups that help those individuals. so moving onto the housing side, this information is based on looking at who's actually applying in 17-18 for all of our rental and ownership opportunities. and if you add it up across the board, across sexual orientation, about 12% of all of our applicants identify as

lgb questioning. we do have a specific grant to the lgb center which expressly focusing on increasing access to housing by that community. if he look at the numbers for gender -- if you look at the numbers for gender identity, not as strong, and of course, you note that the number of rental applicants is much higher than the number of ownership applicants. i think this can reflect a number of different options. one, having to get the word out to more individuals that identify as trans that can access ownership opportunities. i also think in terms of the individuals that we're working with, unfortunately, even our affordable housing opportunities that are set at let's say 50 or 55% a.m.i. are not affordable for a lot of the

folks that we work with. that's just a problem of our housing system. so many of our trans folks say we can go through a home ownership certificate training, but we're nowhere where we need to purchase, so i think that's something to think about. i also think we recently implemented -- which we haven't done before, and we should have done so before, advertising in papers like the b.a.r., which do reach a certain portion of the l, g, b, and t population. what we've found from talking to individuals that really, the way that a lot of our trans clients get information is through word of mouth, being reached by a trusted

intermediary. this is just an example. we have a plus housing program, which is setup for h.i.v. positive individuals. here, you can see that the percentage of people that identify as l, g, b, or t is much higher. we don't want to conflate sexual orientation with hiv or aids, but we know that the aids crisis certainly affected the gay community much more than many other communities. here's the information in terms of what about the occupancy look like for all of our units? the report i showed you before was for application data. if you look at the occupancy data, it doesn't look bad at first. it's about 12.2% of all of our units roughly matches the applicant data. again if you looked at what was

missing, it's really on the transgender side. for rental data, we have perhaps four individuals on the rental side that identified as trans that actually got into our rental units. as you can see, we really didn't have one individual that identified as trans in our ownership units. again, i think a combination of outreach and what i anticipate would be an income gap, a significant income gap. >> supervisor mandelman: did 17-18 include open house? >> it did not. it did not include 55 laguna or 95 laguna. i think this is what i said before, 11.753% identifying as lgbtq. some of the barriers that we're looking at include, i think working more closely with our affordable housing providers and our property managers.

one issue that came up was that many individuals, especially trans identified individuals do not necessarily feel comfortable in either r.a.d. housing, public housing or affordable housing. often those properties are day-to-day managed by property owners which are not nonprofit housing property owners, and i think there's definitely a need for additional training for those providers. the last portion here does not focus on programatic barriers relating to our department, but we decided to include a specific focus group for the queer community, one held at lyric and then autos focus group with the trans community that was convened with the assistance of st. james infirmary and taja teas coalit

to reach out to these individuals. most people receive their information through a trusted neighbor, colleague, friend, and so i think that much of our traditional networking and outreach may not work until we identify those trusted intermediaries. lastly, we hope that our work will be strengthened by our relationships with two of the current cultural districted. we have the leather and lgbtq the compton transgender, and we hope that working with them, we'll be able to further expand our reach.

so i guess the big take away from us is that it was a successful effort. we feel that we can do much more to work with our community-based organizations, especially the ones that don't specifically target the l, g, b, and t communities, but there's more work to be done, especially with the trans communities, because i think those individuals in particular trust a much smaller range of community-based organizations, and those community-based organizations are -- have much less capacity and are not resourced to the extent that many of our other organizations are, so i think that's the period of growth for us. so that's the end of my presentation. i'm happy to answer any questions you might have. >> supervisor mandelman: thank you, mr. chiu.

[applause] >> supervisor mandelman: thank you, brian. unless you want to respond to that, we'll move on frto d.p.h. all right. from department of public health, we have brian and ashley. >> good morning, almost afternoon. thank you, chair mar and other supervisors in particular. i just want to set the context, and then i'm going to let ashley who's set a lot of the leadership do the speaking for us. we have had a very long process and part of that is we've been working on how we should look at data and data collection for this community since 2008, so when we reopened the issue, it became a very long process

involving all parts of the department in essentially a year-long meeting process to look at priorities. a very early priority was if we were going to do this was we were going to add names and pronouns in our fields? we're doing that by getting rid of many of our computer systems and getting on a comprehensive medical record in august of this year, so there was some tension in how much we could change when we were setting so many systems, but that we did a significant amount of change so that people's correct pronouns and their correct name and all their sogi data would be collected in the system? the other thing is we've got state mandates that require this. we've put it into our medicare application, so the population that we're looking at is not the population of people that came through our doors, but our entire catchment of population

that we were supposed to collect. so we are on a long process to get everyone, not just the people who've come through our doors, so take that with that grain of salt when you see those numbers. >> thank you, supervisors, and thank you office of transgender initiatives. great. as dr. bennett was mentioning, there was sort of a culmination of good timing, a lot of policies in place, pay for

performance dollars attached to collecting sogi data that really helped create a lot of structural support for rolling out this project throughout the whole d.p.h. i think dr. bennett also mentioned, you know, with on you hour patients are seen throughout the system, they could be seen in multiple locations. it's difficult to pinpoint exactly where their data was collected? outside of this graph that i'm about to present, b.h.s. is finish the year -- did finish the year about 15% -- behavioral health services, and we also did have data in place, jail health, but we weren't able to get that data out of our system in time for this report. here with our major electronic health records, we can see that in the sfg emergency

department, they ended their year -- this is -- i'm sorry, let me just describe, this is a snapshot due to people moving out of -- in and out of different parts of our large health system? so in the emergency department in the month of december, about 20% of their patients had sogi data complete for psychiatric emergency services. they were almost at 40% all over the network that we're looking at, and this bar chart was about 40%, and the high providers were laguna honda and primary care. >> supervisor mandelman: explain to me, what's the barrier fore collecting more data at p.e.f.? >> yeah. i think that when patients present at the emergency department, there can just be a lot going on. there's a lot of staff, and we're working to phase them more in next year as we look to

ones that haven't been keeping up. >> when people arrive in an acute psychiatric emergency, we are not likely going to get data from them? and this also includes people who are not -- who may have been counted in the system but had not been seen in that particular place? so again, it's the issue of what's the catchment and who's actually been seen, so that's 20% of the people who are counted. >> supervisor mandelman: so do you think those numbers will go up much? >> they will because partly you don't have to get your numbers counted there, so those are people who see primary care at some point, those are people seen by shelter medicine. so if you're caught once in the system and people move throughout the system, we then have your data. >> supervisor mandelman: oh, and you would go up under

p.e.f. because we would see we had seen you in primary care. >> the people in primary care have been more closely collected. >> supervisor mandelman: and why couldn't primary care be 1 100%? [inaudible] >> supervisor mandelman: because some people might not answer, i suppose. >> so some of it is people declined to state, and some of it is that there are some places that have been better at asking the question than others. we know we track them by clinic, and we know that some clinics have been better at asking every person the question than others. some person comes in with four cries kids, we -- crying kids, we ask them that, but not always. so we're getting better, but not always. this includes the months that people were still learning.

>> supervisor mandelman: and going forward, in the 18-19 report, when that comes, how are we going to evaluate -- how are we going to -- you seem to have a sense of some clinics might be doing a better job, some clinics might be doing a better job. as we look at this, we don't have any way of telling whether this is a good number or bad number and how it varies. let's say for the 18-19 report, how should we think about how much of this data has been collected and whether that's as much as should be and whether -- and whether frankly d.p.h. is doing a good or a bad job on this mandate? >> so i think what we are can ae trying to do is ak -- we're trying to do is acknowledge as a developmental process. we had an understanding early that it was mandatory for staff to ask and voluntary for people to answer, but that mandatory

for staff to ask still requires training, and that as seen having to ask may be harder to ask than in some cases. asking, you know, an elderly grandma with dementia, versus asking a 19-year-old are two different experiences and staff approached those differently, and they'll get better at them as they go, but it's been a developmental process for staff. >> supervisor mandelman: thank you. >> thank you for those questions. in primary care where the patients are empanelled, we can get a better look at sort of where you're getting at, which is where are those patients being seen, and we have more expansive identity that they're reporting in those settings, as well?

here at the top of the slide are breakdowns? so we made a sexual orientation minority, like, pooled populations, which includes lesbian, gay, bisexual, transgender, loving, and not said. at the end of the calendar year, we had about 60% or 15,000 in this denominator. you can see in the younger population, it decreases a little bit. when it's matched for the homeless population, you can see a decrease there. for our gender minority population i think different to some of the other sites we did get to have a two-step data collection which includes sex assigned as birth, so this is gender ex-pansive category which includes gender queer and gender nonbinary and people also who identify differently

than their sex assigned as birth, and in the primary population it's about 2% gender ex-pansive and also matched to health care for the homeless, again, an increase. we took a selection from multiple divisions, the examples of programs that they fund that are specifically tailored to this population? and came up with a specific selected spending of our department, $23,071,502. okay. i think that this is a lot of us who had the opportunity to work on this project are really proud how we rolled it out because of our engaged stakeholders and staff really wanting to build a culture change in the network and in

our health care delivery systems to focus and prioritize on training staff. communityi communicating to both patients and staff what was happening, especially the message for patients being that we're asking everybody, and anybody can decline to state. and teaching staff that there may be a big community benefit to having this data. patients often want to disclose this data because they understand this can help us address the needs of our community. and another highlight i think for our network is the focus on patient experience, being able to address patient griefances, which is sort of a new outcomes where patients have mechanisms letting gender or health s.f. or other allies in the system know, and we can retrain as needed. dr. bennett mentioned that we have added name and pronoun to

many of our health systems, and we collected this information on a paper form that was also translated into all of our threshold languages, which was a big learning experience for us. and we look forward to epic going live in august. and because of the national efforts to work on sogi data and name and pronoun, we think that we're going to have major improvements as far as this information being able to everybody who needs it and being of benefit to patients. more details about our training, the training work group led by behavioral health services, the department of education and training, zuckerberg general and others really spent a lot of time developing our own curriculum that we all really feel great about, and we had an outside consultant come in to do a train the trainer with many of

our staff who then went out and delivered these trainings through the course of the last year. in this table to the left are all of the training touches. there are both on-line and in person trainings available? so you can see that high impact of our training efforts throughout the department. i think that we're looking -- >> supervisor mandelman: actually, can i -- >> yeah. >> supervisor mandelman: they're impressive numbers, but they don't have denominators, right? >> yeah. the reason why, it's partially a double count because some overlap occurred where people were both taking on-line courses and attended in-person training, and this takes a little bit more effort to decide exactly what percent of

our staff has been exposed to those trainings, but we expect it's relatively high, 60% or more. [inaudible] >> clerk: please address the panel from the microphone for everyone's benefit. thank you. >> i'm sorry about that. so we backfilled -- >> supervisor mandelman: it was mandatory. >> it was mandatory. we went from location to location. we actually did quite a few of them. we backfilled nursing shifts, so we had a very concerted effort, so we expect that it's a very high percentage of the staff, but people are always absent or on vacation. there's always some turn, but we expect that the numbers are quite high. we're not entirely confident who the people that were double counted were -- >> supervisor mandelman: but you think you're over half. >> we think we're quite significantly over half of the population. >> supervisor mandelman: and

the training will continue over the coming heyear, and you're hoping to get to close to 100%. >> we'll have to retrain. this is considered mandatory annual or biannual training for people, so there'll be another round as we go forward. >> supervisor mandelman: how do you figure out who hasn't been trained? how do you figure out that particular document is just never going to the training and how do you do an intervention with that? >> so when we have areas that -- we've done a couple of retrainings for areas who have not done as well, and we've trained those areas, and we've found areas without specific training.

>> supervisor mandelman: are you finding resistance in the system? >> no, actually. i think there is individual resistance of particular people for their own individual reasons, but there hasn't been leadership or mass staff resistance. >> supervisor mandelman: how do you handle the individual? >> we worked very closely with e.e.o. from the beginning, equal opportunity office, to make sure that people understood this was a competency for their job and not -- not an expression of their personal belief system, and that it was required for staff and voluntary for patients. it's just a job requirement. >> supervisor mandelman: thank you. >> thank you, supervisor. so i do think that there's a lot of opportunities moving forward to advance our, like, higher-level goals for this project, the intentions and the

purpose of this project. i think that with creating these networks in the whole system sort of gives us a pathway to elevate patient experiences when, as dr. bennett mentioned, when we have a grievance, we can go to that unit and do some reworking, retraining with staff. something disrespectful occurred, and that's not aligned with our values. we are going to be working with sites that have been slower to roll out and making sure that they can get caught up to some of our higher performers. epic is a large transition that i'm sure everybody's familiar with, and we'll be working to build in sogi components into that training and look at those work flows and ensure that they're effective and everybody understands how the information is entered and how it can be

best used. i think most exciting and to the heart of the whole ordinance is to begin to look at health disparities. so while we're in our earlier stages of implementation and data collection, we're being careful how we look and compare this population among our metrics, but we have been able to take a look at a couple and are interested in ways to start building support for addressing these in our system. just early analysis, some of the metrics that we routinely track are actually gendered. for example, chlamydia screening is among women age 16 to 24, but even when you limit the population that way, you can see a disparity among cis gendered and gay. this bears out in the literature frequently, and we

also notice it among our patients in san francisco. people who have a depression diagnosis, it's -- it's presenting in a greater volume in our gender minority population and also the same for our sexual orientation minority population. >> supervisor mandelman: great. so -- thank you. on paper, it looks like d.p.h. has been slow, but i understand it's been a deliberate process and you're ramping up. do you have what you need in terms of resources, staffing to be able to meet the demands, mandates of this sogi data collection or should you be asking the mayor and us to be giving you more resources to gather this data correctly? >> i think we do have what we need. it has to be gathered by the

staff that we have. we don't think it'll work to be something other than in the process of your normal medical care because it normalizes why we need this information. it's just part of your care, and partly because we don't want stray -- it's part of your medical record and we want to maintain all of those privacy rights with this data, so i do think we have what we need. in terms of staff, part of what took so long, because we have 24-hour services, we had to have an on-line version of training, so wre had to de had an on-line training which took quite a few months. now that we have that in place, it's a much easier process to train and retrain people.

i think logistics as much as we were very deliberate about the cultural component and privacy rights and how comfortable people felt. i think between the deliberative process and logistics, we just necessarily needed more time to make it happen. >> supervisor mandelman: all right. thank you. next up, department of children, youth, and families, sarah duffy. for people wanting to speak, we have department of children, youth, and families, and h.s.a. together and then public comment. we're getting close.

>> good morning, supervisors, and thank you also to the office of transgender initiatives in help us prepare for this presentation. my name is sarah duffy. i'm here from the department of children, youth, and families, and i'm here to talk about how we've implemented the ordinance and our collection of sexual orientation and gender identification data. okay. so for this presentation, i'm going to focus on the data collection that we do for our disconnected transitional age youth. so dcyf, we fund programs from age zero to 24. we have a lot of programs for youth 5-24, but we collect client data on sogi for our

disconnected transitional age youth only, so that is the focus that i'll be talking about today. we began collecting sogi data for our programs, about 15 programs serving disconnected transitional age youth july 2017 as complying with the ordinance, and we based our collection policies and procedures on initiatives published by the department of public health. dcyf doesn't do any primary data collection from clients. we fund over 150 local organizations that provide services for children, youth, and families, and those grantees or c.b.o.s collect the gender identification and sexual orientation data directly from clients and enter it into an on-line administration system that dcyf

administers along with other demographic data, such as date of birth, home ethnicity, and so on. we rely on that data for dcyf. these are the questions -- the questions and response options recommended by d.p.h., and we've been collecting them sin since f.y. 17-18. we had an additional question, what was your sex assigned at birth, and we took that out at the request of the city administrator. in 17-18, we provided about $3 million to serve disconnected t.a.y., and according to the data provided by c.b.o.s and entered into our data system, we served about 1,000

participants. unfortunately, we don't have sogi data for all of those clients because many of those had records before we implemented the sogi questions, so the data that i provide is not going to be for the full 1,000 youth in 17-18. in 18-19, we started a new funding cycle, and we shifted from funding 15 programs that we were piloting to serve transitional age youth to an r.f.p. that would allow them to aid identify the youth that they served, and we have about 68 programs that identify that they'll be serving -- at least part of the participants that they serve will be disconnected t.a.y., so that's the university of data collection that we're talking about. in 17-18, we had sexual orientation data for 611 of those 1,000 participants, and we see from that data that

about one-third indicates that they were bisexual, gay, lesbian, loving, other, or questioning. in 2018, we had sexual orientation data for about two thirds of that population. you can see hear about 15% indicated, and 9% declined to state. so we are only at midyear, and we are actually rolling out a lot of changes to our data reporting system. so we anticipate and will work with our c.b.o.s to try to increase the number of clients with the sexual orientation data. they actually have until august of 2019 to get this data in, so it's a little brit incomplete t midyear, so we anticipate these percentages to change when we look at the full 18-19 data. [please stand by]

>> so we anticipate again these percentages to change at year end. here are some additional terms for gender identification, in addition to the standard ones that we collect. i also want to point out that we have partnered with sfusd to collect sogi data from youth in middle school, high school age, and also transitional aged youth through our youth surveys. these are anonymous surveys, but we do ask questions on sexual orientation and gender identity. they look a little bit different then the ones in our contract management system, and that is because we worked with the school district to determine which items to include, and they are the same items that are on the youth risk and behavioral

health survey that the district administrators also. so we wanted to make sure we were in line -- in alignment with the district. this will be great. we typically get around 10,000 surveys back, so we will have that data as well to tell us more about the sogi fields for our younger participants, as well, they just won't be identified. >> okay. >> so i'm not going to read they're all of these, but these are just -- we were asked to provide a list of programs that potentially serve lgbt youth. these are the lists of programs served in our pilot year for transitional age youth programming. we have 16 programs there, and again, we shifted how we fund and now we have about 68 programs that have identified surveying, so these slides have that full list. in terms of steps to address underrepresentation. we are really committed to

learning from the community about what the needs of the lgbt youth community are, and we do a lot of focus on that in our needs assessment. we take that into consideration as we do our allocation plan and right of ever request for proposal, which identifies populations in san francisco that we hope c.d. owes our serving. we will continue to do that. i pointed out a couple places where we want to make sure where we improve the response rate so we look really closely at the sogi data. we have added a feature in our contract management system that shows the demographic breakdown of participants for every program, and it shows up every time a program submits an invoice. they see those demographics. it is front and center as of 18- 19, including the sogi data points for programs. we have that. we look at it regularly and