peer based he say escorts to community-based services to serve 300 folks. the second ask is to restore family and children's mental health services that experienced severe cuts in six years to put five clinical directors at the five agencies and the stayover program. that represents a critical intervention for children who are a factor of three times more likely than peers with stable housing to experience behavioral challenges. for young people we ask for full-time psychiatrist to serve the system of care to serve a lot of youth over a short term period with all kinds of short term and longer term services. then two access point clinicians

to comment the psychiatry ask for coordinated entry service. thank you very much. >> next speaker please. >> good afternoon, supervisor. thank you so much for calling this hearing. this is very important. i have been meeting with a few of you over the last few weeks and months. i am the c.e.o. of prc. bill just beat me. again, thank you for holding the hearing. we made notable gains in key areas of treatment. it is clear our system of care needs to be assessed comprehen civil to be sure we have providing the most effective interventions. we have behavioral health services which includes 143 beds

of crisis, 117 beds of supportive housing. most recently and a big nod to kelly here who helped us with the humming bird project. we partnered with the two week at the zuckerberg general. we have seen a significant increase in the utilization of that program. approximately 2000 people move through the program and we see about a 10% to 15% transition from behavioral health at zuckerberg to the treatment program. we look to increase those numbers. behavioral health respite works. we need to grow. i would say as recommendation in terms on the back end stabilizing the programs. co-ops are needed. we need to increase capacity one

way is to look at the small side acquisition to make it more robust. lastly the disproportionate amount of people of color in the system. we need to look through a racial equity lens. thank you for your service and leadership. >> thank you very much. a few other names. vivian, meg, allen, spencer, theresa, cw johnson, sarah short. jessica. next speaker, please. >> thank you for holding this hearing. it has been alluded to a couple times. the forced treatment of people undergoing psychosis.

this may seem to address problem in the short term. unfortunately, you have to examine the long-term consequences of this i am a psychology researcher. it is the belief you have autonomy over your own life. this has negatively impacted by forced treatment. it turns out people who have higher internal locus control believe they have autonomy over their own well-being do better in treatment for psychosis. in coerce i feel forcing people to people in the treatment in the long-term you are decreasing the variable. you need long-term preventative strategies like providing housing, providing addiction treatment, providing beds, clinics, things that have

previously been discussed. thank you. >> thank you. next speaker, please. >> hi jennifer. 20 years ago in my early years of working at the coalition in homeless we went out and asked consumers what was going on with them. what we found was not what i was expecting. folks were barely coherent. they were so dirty it was impossible to know what race they were. they were outside the system. one be person hadn't spoken to another human being for months. we named it locked out. contrary to the victim blaming that was alive at that time folks were trying to get care and were locked out of care. what we found was that the system is set up in a way that is inaccessible because of the

very condition the system is supposed to treat. you catch that? so appointments for people who can't keep track of time, paperwork for people without a home. folks wanted help but were not getting help or they got help and were spit back on the streets to see conditions worsen. the ones who did get treatment over half felt the services did not meet their needs. these are system failures. these are not personal. here are quotes. i was trying to get back on medication they gave me the run around i went to prison. i was arrested and taken to psychcode. we still hear the quotes. facing same issues folks in worse shape than 20 years ago.

we have two sets of recommendations. meeting people to address the issues i talked about, and we have prop c adding $70 million. we need the funds to bridge for when those funds are released. we have a set of recommendations. here they are. >> thank you. next speaker, please. >> i am meg. i am a nurse at san francisco hospital for 32 years. when i first started working at the general san francisco was a model for mental health services. iit is a shadow. i want to point out the city has the money. it needs the political will. with the tech companies, there is the money to do this.

you just need to have the political will. thank you. >> thank you very much. next speaker, please. >> i am a nurse at san francisco general here as public citizen on behalf of all citizens of san francisco, all people here to say what meg said and what people have said. the mon he neis present in the city. do we have the people to write the budget the people to say that having 35% of psychemergency patients readmitted in 60 days is okay? no, it is not. we need to continue hiring people. we need to have a budget for staffing in addition for budget for services. we need to make sure when clients are leaving that they don't go to a second step. why should they have to go from psychemergency to hummingbird or to the clinic when they used to

go to the point of care? it doesn't make sense to give a second barrier. i think having hummingbirds is great for some things but not appropriate to send people from i be steadof -- instead of to the crisis center. the behavior court has a high need and also budgeting moneys for people who have been incarcerated means that people when leading incarceration should have money from that system. i don't think that general budget money should be used for bhc patients. they absolutely need that level of care, they need the services but they should be paid for by jail funds and not by general funds. thank you very much for this hearing.

>> thank you for the opportuni opportunity. i once saw statistics. i am talking about nation statistics. 90% of the people that succeeded in committing suicide never ever had a therapist in their whole life. i think that is something to think about. yesterday i was videotaping a sweep attempt at jones and mcallister of somebody who was suicidal barely talking and he was not well enough to move his shopping bags and three officers came. his name was kevin, and he was sighted. he was a humble honest guy.

he was asked where are you going? he said i don't know. that is a lot going on on the streets today. i am adult traffic, run away, arranged marriage immigrant waiting for process that the federal government doesn't want to tell me. without the city's wonderful services, i would not be alive today. we are doing a great job. i am an example of a great outcome, but i think we could do better. the crisis at the crisis center connection to acute diversion is very difficult and there isn't enough mental health with diagnosis co-ops to land on. i think there is a way if we

could incorporate more normal people. i know rams is trying to put in more. [ inaudible ] >> that we incorporate our whole city so there is snow stigma from high school. it is okay to open up without stigma. >> thank you very much. >> thank you. next speaker, please. >> good afternoon. thanks for your time. no one is addressing that we do not have enough professionals in the field. i can work at my front desk for $16 and i have a four year degree as drug and alcohol

councilor. i can make 19 to 22. we need to allow in the budget for the professionals to be paid to help the individuals. currently we have no beds. the training for the support services is horrendous, disturbing. they are killing people. i have people in shelters on four year waiting lists. that shouldn't help. the shelter should be a place of motivational interviewing where they are motivated to the next step. i believe the pop-up homeless outreach. we are looking at incarceration and institutionalize. we need a place where they can stabilize, give them water food, let them think for themselves if they want to move on. if it is their choice we should have navigation center, hummingbird. i am 14 years in recovery. the city saved my life.

it didn't treat me this way. i was in psychemergency and given to add adult diversion where there was a medical. we need to increase by 10 fold. we need over 30,000. i have a mission statement. i don't have it with me like everybody else. then again moving you are looking at a timeframe three to six months. it takes a year for any drug and common sense to get focusing within a year. iit is your social. care, love, community, commitment. we need to take them more than 24 hours and not discharge them with their pjs on. >> thank you very much. next speaker. >> good afternoon. i am here with the san francisco

aids foundation. i want to present a proposal $2 million to fund piloted of prevention services in san francisco. these are known as safe consumption sites or supervised injection sights. they work and provide spaces for healthcare professionals where adults can use the drugs with sterile supplies and find referrals for substance use and mental health systems to reduce overdose deaths and prevent new infections, we deuc address thef people using drugs. we had discussions about how much we need these services. i feel like we have support these are needed here afternoon will work here. we are asking for the funding to make sure those pilots can happen. thank you.

>> thank you very much. next speaker, please. >> good afternoon. i am with senior action. i just want to say a few things. first, the most expensive thing in life is poverty. we keep on treating that, you know, in a way that it only generates more poverty. it is really hard to hear, people are working hard, yes. are they working effectively to create a system that is more equitable? that is what we need. i am here to support the ask and to remind people that those

people that are in mental health, you know, need they can't wait. they need support now. bill said it. housing is health care. if you really want to do something about all of the people in mental health need right now you need to think about housing. the support systems that we all keep them from going back to the street. please create a better system. thank you. >> next speaker. >> thank you for your time today. it is a very important issue. i am ivy mcclellan with treatment on demand. i am a long time public health activist in the city for over 22

years. i really want to speak to again what many are echoing in the room. housing is critical to this entire issue, this complex web. so much would be addressed if we thought more about the structural inequality happening. if we think about the weighs in which keeping people housed before they become homeless, how do we have better services to keep people housed? emergency funds, more emergency funds. having better wraparound support services. that to me like a home reduction approach in housing are critical to this issue. it is a complex web. i work would as a relief councilor for over five years. i saw the reinvolving door. we could give them coping skills to send them where?

to abysmal situations that didn't support their needs to get help or healing. i want to again echo what people are saying here about comprehensive assessments on the ways to address those gaps. with this the city should conduct a comprehensive assessment. i echo the increased case management and alternative approaches to issues of substance use and homelessness and mental health. we have to stop criminalizing people for what is going on and shine the light on where this is going. >> thank you very much. >> i am vivian. i am currently president of the

mental health association of san francisco. i have been a mental health advocate for over 40 years including two decades working in the field. mental health and substance abuse services must be properly funded. they are health issues. you wouldn't tell a person with a broken leg they have to wait 90 days to see a doctor. our system does that to people with mental health and substance abuse needs. we must help when help is needed. let's increase our success rate. first, dramatically change the scenario by promoting advanced dreck continues for mental healthcare. allowing people the dignity of deciding the care in advance of possible crisis. it is human nature to resist being told what to do. people given choices are better outcomes than those with forces

treatment. second increase the use of peers as part of teams to increase trust and credibility. third, incorporate nonprofit services in treatment plans. fourth. it is effective to provide serviced and housing. last long time 2308 up is essential to -- long time follow up is essential. i have worked can clients who made sensible choices when we reviewed options together. trust is a two-way street. let's travel it. >> i would like to say ditto to what vivian said. i am terry bora on the mental health board and served on several city task forces.

what i have come from misdemeanor. -- from maryland. i have served on a county adjacent to washington, d.c. we thought you people on the west coast were ahead of us in everything. i have come to live here now for 10 years, and i am seeing a mental health system that is a disaster, uncoordinated. it is not just stepped down. you have to think about step up because many of the people in our system who need care move in both directions. nobody ever talks about how do you move up? are all of those beds filled? i have a laundry list i will be out of time. i am sorry that ann from the

police department was not able to testify. there should be in the health department budget money for more clinesitiocline -- more clinici. i have coordinated the work group for five or six years. the health department is playing a critical role. i believe in the services first what coalition and what they are doing. i believe we need more supportive housing. i think you in your role could do mandates. i lived in 800,000, nobody could have been discharged to a shelter or the street. it was mandated that this could not happen. there are many options. lastly i would like to say bring together the wonderful people that were on your task force and

have them it is for three weeks and you would have a plan for this city that you would be proud of because there are so many well educated people here and people that know how to do this. >> thank you very much. next speaker, please. >> i am theresa palmer retired nutrition and work with senior disability action. my main plea is for massive increase in intensive case management services. also, there are just too many barriers for low income seniors to get mental health services and stabilization. there needs to be a tight link with housing. the fact 44% didn't come out until the end of the hearing, it is an indication these people need to get on the same planet.

you shouldn't have to be psychotic and go to pes to get services. we need neighborhood based outpatient and out reach services. we need outreach teams, crisis management and the hot team to be adequately staffed and we need on call 24 hour. if the hot team needs to refer to someone only open 9 to 5 there needs to be someone on call at other times to make the link. i live near haut street every time you called for someone who is in trouble the hot team told me the reasons they weren't going to come. we have a long way to go. i am very grateful for you for listening. thank you very much. >> next speaker. >> i am allen cooper. i work with the voluntary

services first coalition. when i retired as professor at stanford i took a job with health right at the job core. it was noted in my two years the number of people coming to job core with mental health issues was increasing. that was a national problem recognized. for me in particular the problem was they came often with complicated medical regimens, and psychiatric regimens. i was an internist. i was not comfortable writing them. to keep them on treatment i would have to write that because it took so long to get appointments. why isn't there more money in the budget to shorten the wait time for psychappointment.

it took two months. i am writing drugs that scared me. now, i volunteer at msc south clinic and see the people who have appointments or complicated regimens that they can't follow or keep them. that is why we need intensive case managers. we are not going to pay them enough. that is why you have vacancies. we have to increase psychiatrist salaries and case management salaries and increase this budget. thank you. >> hi, i am spencer hudson on my own behalf today. i have spent 35 years testifying to numerous government committees and i would like to comment on how astounded i am by the quality of the performance of the city departments who have testified today and by quality i

mean complete lack of quality. initial statements were vague and lacked detail. they seem to have come with the mind set let's do the minimum we can to get out of here as soon as we can. their inability to answer your questions is just not acceptable. their inability to simply provide additional information about what they have told you is not acceptable. not acceptable to say they need more staff, then when asked for a staffing plan tell you they don't have one. this is simply not the way it has to be. i am a homeowner and taxpayer in the city. this is just not good enough. excuses such as the staffer knew is not good enough. excuses such as these are new issues we haven't thought about before are not good enough. excuses such as we didn't

anticipate this question is not good enough. i am amazing you are able to do your job because they are not giving you the information you need to do a adequate jock of managing them and they are not giving you enough information for you to make an informed decision. pathetic. thank you. >> good afternoon. i am angela. i work at homeless prenatal program here to ask you to support critical behavioral health services portion of the act. i want to speak to the importance to fund the expansion of mental health services for homeless families. this would fund five homeless directors. they would not only be able to provide direct services to case managers but to supervise interns to expand therapeutic

services for homeless families. there would be a priority in bilingual clinicians to serve the immigrant families we see in homeless services and these services available to those not eligible for medical. homeless children are three times more likely to develop behavioral health problems. they are fou four times more liy to have developmental delays and twice as likely to repeat a grade or dropout. homeless mothers are 50% to experience depression and ptsd as the general population. if homeless families are given proper mental health support, the children are far less likely to experience homelessness as adults. the funding proposal would

greatly increase the capacity to 450 households to receive therapeutic services. thank you. >> good afternoon. i am carla roberts with the homeless prenatal program with angela wanting to receive support especially for family mental health. there was not a lot about families today. mental health is important. it could obtain stable housing access to education and families are able to drive in their community. we prop ride free mental health -- provide flee mental health support. i am working with a man who had to give up her children about eight years ago because of a mental health break. by her receiving the services she is opening the case to retrieve those children as well

as getting ready to have a healthy baby. the client has received mental health services and is making moves to recertify. she had access to mental health services. thank you. >> good afternoon. jordan davis. d6 resident. former consumer of mental health. i will start with numbers. you fool around with numbers. one in seven in return on investment substance abuse treatment. that means substance abuse treatment is good and it works. 85% in bookings in-county jail that mental health and substance abuse issues. what is the moral? we are spending too much on

incarceration and not enough on mental healthcare. maybe it is fiscally responsible to have treatment on demand and to meet people where they are at. that is where i support his pa. if a woman of color wants a woman of color therapist they should get it. forced treatment unnecessarily does not work. that is why i oppose this expansion of conservatorship. i want to say one of the most crucial pieces and i know you talked about it a couple weeks ago. housing is really important. it is four years since i got off the street into the navigation into housing. i am still trying to rewire my brain. if you think i am bonkers now. you should have known me then.

a quote an ounce of prevention is worth a pound of cure. there are people who could be cured. it is too late for me but whatever. >> good afternoon, supervisor. i am the executive director. today i speak on behalf of the hiv/aids pro vitder network. these are individuals who have been living with h.i.v. for 25 years, 30 years, as you heard 35 years or longer. the funding was initiated by a former member of this board, jeff sheehy as i am sure you know h he is a hiv survivor. he needs through his career of

work h.i.v. positive how significant and often ignored the mental health needs for long-term survivors are. the $500,000 he allocated have allowed the h.i.v. nonprofits to expand group therapy, isolation reduction, group outings to other appropriate mental health providers. they home bound or face severe isolation and who often times are overlooked. lastly, i think the significances also lies in some of the unique aspects of the demographic. long term hiv survivors lost families to aids and who were

told themselves they would be dying soon and they never expected to be here. for many of these folks this will be the first time they are untreated and undiagnosed ptsd will fully be addressed and not letting the services continue would be a real step back for the city. >> thank you. i am not going to call any more cards. come up if you would like to give public comment. next speaker please. >> jessica layman. good afternoon. thank you so much for your attention to this issue. i want to share the story of someone i talked to yesterday. she has to be at work today. victoria is white transgender, 73, she has depression and apings sighty. she needs a therapist. she she needs healthcare.

this is not a story that is shocking and heart breaking. it is very, very common. it is a great example we need to not focus on services for people in crisis but to make services available before they get there. our members identify the need for better more available mental health services as the top priority. services need to be available and competent and reach people isolated and coordinated with housing and other services. sca calls for treatment on demand. we support the hespa act. we urge funding for voluntary services, not involuntary. may is mental health month. i want to remind us to center voices of people with mental health disabilities who understand this bette better thn anyone.

thank you. >> hello, supervisor. i am nato green with 10-1. i work with the registered nurses of department of public health, dph don't hide data, don't ask questions they don't know the answer to. they don't track data to justify increasing the budget in the way the mayor did not want to hear. the nurses say the mental health issues on the streets are affecting every single service. we are hearing from nurses in the emergency department and labor unit and medsurge not just mental health services are seeing the mental health services and they don't have the support to meet the snead. to give you a sense how under staffed the city is. tomorrow we were to talk about

chronic under staffing. during this hearing i found out from the city they don't have enough staffing to release one nurse from pes for two hours to talk about under staffing in pes because pes is under staffed tomorrow because of the sweeps. we need a budget to provide the services. we don't have that budget now and we don't have the staffing to reflect the services we will repridreproride and don't fill n the course of the job. we are constantly crawling out of the vacancy. the only reason that staffing shortage doesn't show up to you more visibly is because it is done with -- temps.

>> good afternoon. i am here as a member of the juvenile justice providers. i am to speak about better solutions for youth and young adults with mental health needs within the criminal justice system. as we know, many of our young youth and young adults coming in contact with the criminal system have experienced significant trauma and have mental health issues. incarceration and long-term confinement, punitive strategies do more harm than good often leading to continued offending. in contrast community based alternatives have been found to decrease reoffending even for youth. i am here to share that the importance of well resourced

continuing care that includes a range of supports and community-based supports and the assets to promote health and healing to improve family functioning and meet essential needs and to strengthen the communities they live in. you know, we want be to show the importance of the community based alternative and investment for both prevention and intervention and also i want to after hearing all of the presentations just reiterate how important it is to include the voice of youth and families in the community with the experience because often times the data and information that the city is presented with from the systems don't match reality of experiences how important it is to bring that into these conversations. thank you very much.

>> i want to thank you very much for having this hearing. it is important. i am denise doory. i want to let you know. 38% of people released from psychemergency services were not offered services. i went to see if i had lyme disease. they wouldn't test me. i went to every hospital in san francisco nobody would test me. the only thing they were willing to treat me for was urnary infection. they were willing to give me antibiotics. i have been on the strong antibiotics for two weeks. they told me my numbers were high. i have been on antibiotics for

four years. i was diagnosed at 13 with depression. i was a happy kid then after breathing second hand smoke for years my tonsils were as big as golf balls. they thought it was a brain tumor. it was my tonsils. the doctor was infecting kids with pneumonia. i lived with that until i was 62 then i got the right antibiotics to treat lyme disease which got rim of the a typical pneumonia. i am living without brain fog. i would rather have lyme disease than the pneumonia. all i could do was moving furniture. i was strong.

i could lift heavy stuff. that was my living. i had cognizant difficulties. i couldn't make friend ships. it was rough. thank you for listening. >> good afternoon, supervisor. i am joyce. i am also with senior disability action and on the filipino ministry. i don't know where to start. i have been to kaiser. when i tried to go have health what do you call it? psychiatric healthcare? you can't have services. i didn't get any services. that is there. now, i go back, my very first ba was in social welfare. when i took the class in deviant

behavior. my professor said deviant behavior is a normal reaction to an unusual situation. a normal reaction to an unusual situation. so when you have mental illness, no wonder if they don't have housing, if they are food insecure, don't have health care, so i angry it rating what others said. we need more healthcare. don't go to jail, use that money to hire health care. cycle of poverty. without a good job and no good salary no good house no good house you go down with mental health. it is all intertwined. with our community organization

we do one-on-one. we find out what is wrong, survey. then we have a bunch of community organizations that we can get together and we can give you the list with the department. check on us. also, last thing, st. francis the patron saint. >> i am rebecca miller. i am a senior disability action. from a personal experience as adolescent when i first developed physical and learning disabilities, i knew firsthand that secondly it was a definite need to have mental health services available so i know how

important it is because of my own experience for others to need these as well. 38% of people released from psychemergency at san francisco general were not offered any services according to the city's 2018 behavioral health audit. we need intensive case management rather than appointment time and expecting them to show up. we need social workers to find people where they are in the evenings on the weekends to build relationships to get them to services. we need culturally appropriate for seniors. we need services that are are accessible to people with all disabilities located in neighborhoods throughout the city. many seniors are homeless for the first time in their lives. with and without homes they are isolated. we need mental healthcare to

reach them and support them. the treatment on demand coalition recommends the city conduct a comprehensive assessment of the public health crisis or address barriers for solution. we agree with 2018 performance audit recommendations. increase intensive case management, more supportive housing and alternative approaches to behavioral house. we urge more funding to substance youth services. >> thanks so much for the attention by this body to this important issue. i am a san francisco resident for my whole life and representative of 360. we serve 10,000 low income in san francisco with primary care and mental health services.

the point is made for why we need more and high-quality resources directed to the issues. i want to bring up three items that we are hoping to fund and political will. first is residential treatment programs appropriate for high needs substance users including methamphetamine users. small disorder services with mental health needs. second is increased supply of system navigators to help people transition between stepping down from psychemergency services and jail and correcting them back to treatment. third is low barrier treatment options for people not ready to access robust treatment programs. chill out spaces to find respite daily and be connected to more services over time and evidence

based practices like contingency management shown effective for those using methamphetamine. thank you. >> good afternoon, board members. it is sarah short with community housing partnership housing for homeless san francisco residents. we are a member of the treatment on demand coalition. you have heard that phrase today. i want to explain what it is. it is as simple as it is sounds. it is removing barriers for low income san francisco so everybody has a shot to get the services they need. it is not actually such a fringe idea. is voters approved treatment on demand for the city of san francisco back in 2008. unfortunately, we never really got the system on the ground

that we expected due to budget cuts and lack of priority. meanwhile, obviously, the need kept growing and the stakes got higher with the housing market, now lack of access to treatment can really need the difference between housed and on the streets homeless. it can make the difference between getting access to housing or not being well enough to get the services in order to get inside a unit like community housing partnerships. what resulted in all of the things you have heard today, not enough case management, long waiting lists, people not meeting eligibility rights, people having to call back every morning at a certain time.

all of these things that make it virtually impossible for people that are challenged with these issues that we are talking about mental health to get the services they need. there is in fact a ripple effect created by this. >> good afternoon. i am doctor lewis and the director of clinical services. i have been with conner house for 20 years and i am familiar with the outpatient and residential system. we house 700 individuals every day in our sr hotels and

apartments programs. out of that dph funds 450 beds. out of these 450 bleds we have -- beds we have 200 beds they have access to. i oversee the mental health services of the 400 beds. i don't need to emphasize how the expansion of the programs is important to solve the crisis we have now including expansion of apartment programs so that our residents can recover in nonsro and not the tl and not soma neighborhoods. also, i know we have talked about how to get people into supportive housing because our residents have been living longer than the reported cut

short mentality rates. we have a huge aging in place issue where there is no higher level of care for them to go when supportive housing is no longer appropriate. also, i want to address the wage disparity between cpo and civil service, kaiser and uchs. we don't have the money to hire staff and retain staff, to retain the excellent staff we have to cut in order to pay them. i hope that you would address the wage disparity issue. thank you. >> i will try not to eat the

microphone this time. cw johnson here as a citizen. i want to talk about what involuntary services could look like. i remember being in san diego in the 1990s. there was the west side, north side the crisis center that was a house that housed eight to 10 people. when you went there, you would call 911, they would ask you the questions. we will send a police officer to take you to the hospital or connect you to the isis crisis center. you would go in there. the first day you get rest. it was a two week to 30-day minimum. what happened was that you got one-on-one therapy, group therapy, you had to engage in community action, you had to cook, clean, do gardening.

you were active in your own mental health. also, they had social workers that would come in and people from unemployment, from employment or from ga would come in and make sure you had income and housing before those 30-days were over. you guys are the greatest resources in the world. the programs here are not working. maybe we need to research what works so that we can bring that into our system. thank you. >> thank you very much. in other public speakers that would like to speak. seeing none. public comment is now closed. colleagues any last comments? >> yes, colleagues i want to just thank doctor sun who is still here. i see kelly is still here. i see appreciate you staying to the end to listen to the

community who we are hearing from every day and who has experience just doesn't match the data we are provided for dpa. i know you are brand-new i am looking forward to working with you to improve the situation. thank you for everyone who stayed during this very long hearing. there is so much brilliance within the community and so much experience and knowledge about how we can actually create a system that works, one that, you know, we have pieces and programs that work right now. an overall system of care does not exist where people can move hopefully down but sometimes up when needed, and really stabilize and be productive members of society. i wanted to mention one other thing, and our second to last speaker from conhard house set

me up. mostly because it wasn't in the bla report and i want to make very clear that it is a top priority nor me in terms of the budget process. that is the idea of this co-op living. i want to talk about it for a moment because we didn't focus much on the housing piece today and the housing piece is crucial if we are going to stop the hamster wheel. as we discuss judgments and priorities to address the crisis of mental health across the city and on the streets, i want to call attention to the very effective solution we should be utilizing more. there is a significant lack of housing for peak exiting the mental health programs and this leads to mental health problems.

there is a model used since the 1970s using apartments and single family homes for cooperative living for people with chronic mental illness. there are many able to thrive in sro buildings and i have deep respect for our nonprofits who do amazing work. for many dealing with psychiatric and addiction issues. the key is to be away from the chaotic neighborhoods and the surroundings. instead the cooperating living opportunities model provides fasillated living and household settings. for many this is the type of housing that opens the door to stability in their life. this is a proven model with many years of successful items. currently prc and baker places

house about 263 individuals in approximately 50 properties in neighborhoods across the city. placing four or five residents together to share a home with 24 serve household case management services. until now almost all of the cooperative living units are private owners. in san francisco current rental market they are subject to the same eviction threats the renters face. by purchasing the units we would have what we need for near and long-term. dph would provide the oversight and direct the client placement and we would need real estate expertise. it