>> thank you, i want to thank staff and this is really thorough and a great presentation and it's been really fun to see the process and how folks have chimed in and given good ideas and feedback and how that has shaped your thinking. so that's been really great. you know, something that i brought up the last time that we looked at this is that, you know, there is -- i think it's bigger than a maintenance plan, what we have in the entire space is a population that uses it sometimes and has very high social and economic needs. and these beautiful designs don't do anything about that in a pragmatic way. and i'm worried about that. and so, you know, i said last time that i'd like to see it be a navigation center. you know, i know that it's requesting to take some political and economic resources to make that happen.

i just -- i believe in this space. i believe of this being the heart of the city and our civic life and i also want to make sure that people's immediate social and economic needs are met in a way that the space is not taken up with that and it can't be used for something else. as sometimes happens with our current space. so there's not enough bathrooms, you know, the parking and it smells like urine, there's a lot of things about this space that are just a reflection of the needs of folks, you know, that are practical, in that we need to meet. and so with that i hope that you guys also think about that in terms of the space being sustainable going forward. that folks don't disappear, but that we need to address their needs. so with that, thank you so much. >> thank you. >> commissioner richards? >> commissioner richards: i complete with president melgar

around the humanitarianism of making this work and it's not just a maintenance thing but you can integrate trying to achieve higher social goals as well for all segments of the population. so i think that it's a great idea. i have one comment if you're thinking of putting skateparks and dogs anywhere near each other, i would put them as far away as they can. [laughter] they see them coming down and they go nuts. and the last project is this in the 10-year capital plan? in the next two years can we maybe do a funding source initiative to get this going? because we don't want to get to the end of two years and have nothing happen. >> those conversations are just beginning and i think that it's a line but there's no funding allocated to it yet. >> commissioner richards: okay, great, thank you. >> thank you, all. >> seeing further number, 8, 21016-00355p.r.j. for 3700 california street. this is a presentation.

>> good afternoon, commissioners, chris may of planning department staff. this information presen presents on the campus in advance of the public use and of the draft environmental impact report which is anticipated for early next month. the project site is approximately five acres in size and spans one entire city block. and large portions of two other blocks between california and sacramento streets in the persidio heights neighborhood. it has the construction of 31 new buildings, ranging in height from 3 to 7 stories and with heights from 35 feet to 80 feet. and the project proposes 237 dwelling units including 12 single family homes with two parking spaces per unit and 261

multifamily units with 1.5 parking spaces per unit. and the project proposes the conversion of the existing marshall heal building at into residential uses and the retention of the existing building at 401 cherry street with nine residential units. and the site spans 14 parcels wit14 parcelwithin three blocksd and subdivided and redeveloped to allow for modifications to the rear yard, building height and facade modification. on july 11, 2019, the planning commission will hold a public hearing on the draft e.i.r. at which time there will be an opportunity for public comment. planning staff anticipates the certification of the e.i.r. and bringing forth the conditional use authorization and plan unit development applications to the planning commission in january 2020. this concludes my presentation and i'll turn it over to the project sponsor for a more

detailed presentation of the proposed project. thank you. >> president melgar: thank yo you. >> overhead. good afternoon, commissioners. i'm pleased to be here and present to you an informational overview of the proposed redevelopment of the cmpc campus. i'm matt field and i'm joined by our co-developers, groenor americas and architects. if you know the site it's located right on on california street and it borders jordan park and laurel heights, to the east is pacific heights.

and as you heard it's a five acre site that spans three blocks. and there's been 725,000 feet of existing buildings on the site. and the hospital is continuing some limited operations there and will wind down those operations mid next year. and the buildings when they were originally developed were really quite elegant and i think that if you grew up here in the city, i was born at this hospital and my kids were born there and probably a good number of people that i know were born in this hospital, it was really quite elegant. if you look at the lower righthand picture you can see that there was a courtyard that faced on commonwealth avenue and integrated into the neighborhood. today that is really not the case. it is a series of institutional buildings, kind of milk of magnesia color that creates a big wall between persidio heights and laurel heights. i'm going to take you through a visioning process that has began in 2015.

i'm going to try to run through three years in about five minutes so i apologize if i speak quickly and i'll sure that you'll have questions. as you know cmpc when they got their agreement done for the new hospital it mandated a visioning process to be run for the redevelopment of this site in the future. that involved a visionary committee of the four 2345eurbd groups from laurel heights and jordan pacific and sacramento street merchants and laurel village merchants and planning staff and the district supervisor staff. and we ran a series of quarterly visioning advisory committee meetings. i'll take you through the highlights of those meetings in a minute. and we ran a survey through the neighborhood associations and got back community preferences for strong preference for family housing, a strong preference for whatever was built here would fit into the neighborhood context. and that they really cared about the honest process. they felt they hadn't had an

honest process in the past. we held numerous stakeholder meetings. we held meetings with the neighborhood associations. probably in excess of 40 in-home meetings with various neighbors who couldn't attend and other meetings. and then a community open house. ultimately we submitted this plan in late 2017, and it was broadly endorsed by the four neighborhood groups when we brought the plan in. and i'm going to show you a series of urban design studies that we did with the community as part of developing a plan. and you can see the neighborhood block pattern here which is pretty typical of neighborhoods in san francisco. it's got buildings that ring the perimeter and then private gardens in the interior. and you will notice that the block pattern breaks at california street so the grid changes and that creates unique opportunities and some challenges with the site when you think about it. a series of different building types in the neighborhood,

again, fairly typical that the larger multifamily buildings are anchoring corners where they don't have private open spaces behind them and the smaller buildings are tending to infill in between those buildings. a lot of historic architecture in the neighborhood from willis polk, and maybeck and julia morgan and earnest coxhead and this is a robust collection of significant architecture. that led us to studying the elements of historical architecture and what that might mean in a future design for the project from materials to how building facades are articulated. and then landscape. this is a really unique neighborhood in terms of its landscape. it has a row of landscaping and sod as well as buildings and street trees so it creates a real nice pedestrian feel from that double row of landscaping. coming out of the visioning advisory committee, we wanted a

guide to site planning. we got very strongly no glass boxes. traditional architecture to fit the neighborhood and don't make it look like a project, make it look like it's part of our neighborhood. a variety of residential types and buildings, and really strong preferences on the minimizing impacts from parking in traffic. as you can imagine the hospital in the neighborhood has had significant traffic and parking impacts for all of its years of operation. there are over 1,100 employees at the hospital as well as everybody coming and going and it's really had a lot of impacts. so that led us to our site concepts which were to value the historic fabric and features of the site. i mentioned that courtyard on commonwealth before and there's a nice remaining building that is deco that is part of the original hospital on the right and then a multiunit building that is featured on the left.

and thinking about the sight lines and jordan park and the way that the street grid breaks so really thinking about building height where we have tall buildings currently and then thinking about the site lines when we placed buildings in the future. next we were thinking about how we mix these types and densities and what you will see here is that there's really varied roof lines and setbacks and the building heights. you will see on the multifamily building that we're trying to not put two buildings of the same height next to each other so we have that variation that exists in the neighborhood. there's 31 buildings developed on this site so this is a very careful plan as opposed to having a big buildout in the middle and just ringing it with one height. and the next thing that we did, we did some visualization to the neighborhood. what might this look like. this is looking north on jordan at the current garage. with a replacement building being developed there.

this would be looking north on commonwealth avenue into the main body of the hospital. and a potential visual of redevelopment. and then next looking at parker avenue. this is looking west on -- sorry, east on sacramento stre street. ultimately arriving a plan that you can see that is pretty carefully crafted and it's focused on family-oriented housing and we have 75% two plus bedrooms in this project. it's designed to fit into the neighborhood and not look like a project crafted with many different architectural styles. and it's pedestrian friendly. it did have broad neighborhood support. we received neighborhood support letters from each of the neighborhood associations prior to submitting the plan. i'm going to turn it over to our design architects now to walk you through some of the design.

>> so we're just coming up on our 10 minutes that we're -- >> i'll be very quick. >> how long do you need? can you do it in three? >> three minutes. thank you, commissioners. i'm dan lobus, and now i'll tell you more about o our design. on top it says the cmcp hospital buildings as they are today and the site that would have 31 buildings have a variety of styles to reflect the tremendous diversity of traditional architectural styles used in this area of the city. each building will have its own personality inspired by classical and san francisco venacular precedence. you can see the two historic buildings that we're retaining and also in the center at the commonwealth, the garden court referencing the original historic condition that matt mentioned earlier. building heights and setbacks vary along california street to

create an urban design pattern consistent with the surrounding neighborhoods. the buildings deploy pitched and flat roofs which vary throughout the project and setbacks at the upper floor will reduce the apparent building mass and height. and fasads will have porches and bay windows and balconies and balstrads. and a variety of building types are reflecting zones, heights and to create a harmonious fit into the neighborhood. for example, we have a 40-foot height limit on a good portion of sacramento street so we have smaller buildings on the edge of the site where they provide a transition to the neighborhood fabric and a tall building where a tall building currently exists today. our design employs a full range of typical neighborhood materials, including stone, brick, stucco and clabbered in various colors along with wood

shingles. detailing is in stone or metalwork depending on the character of each building. and highlighted here are four buildings with varying combinations of stucco and stone and varied versions of stucco and stone rusticated detailing. they have local buildings that inspired their design. highlighted here is the building in brick with dressed stone trim and a building in wood shingles with a rubble stone base, a hallmark of our design is the use of a varied palette employed across multiple buildings in different ways. time prevents us from highlighting each building but these few examples give you an idea of the range and the variation proposed across the site. responding to the objectives set forth by the advisory committee the proposed design is intended to reflect the diversity of building types and styles and the rich landscaping found in the traditional san francisco

neighborhoods. the result is an organic composition rather than a quote/unquote project, a design that makes its own statement but fits in seamlessly at the same time. thank you for allowing us to show you our design today. just as matt showed to show you three years in five minutes i was struggled to show you 31 buildings in three minutes and we look forward to coming back soon to have a formal present situation more detail. >> great, thank you very much. so we'll open this up to public comment. i've got two cards. charles ferguson and susan corasas. and anyone else who would like to speak line up. >> charles ferguson, i'm here to speak on behalf of the secmento street merchants association. the president is terry terioka and she's a single mother of a young child and has to work so she was unable to appear here

today and ask moody to speak on her behalf which i am doing. both organizations were members of the visionary committee. let me step backwards in time, 25 years ago when i was first elected president of f.a.n., i had one task assigned to me -- make sure that the hospital was not -- the hospital is at 1101 van necessary avenue that does not get built in our neighborhood. it was a painful experience, but we succeeded. the next step was to get a voice in the decisionmaking process as to what was going to replace cmpc in our neighborhood. and you've heard about the visioning process and that took me a lot of time to wield enough political power to get at the table and to have a seat. we did that. that was the next step. the third step was to convince the developers to do something

that was compatible with our neighborhood which as you have heard -- and it's my belief, and thank you for your tip commissioner richards -- that we are the largest eligible historic district in the city. so the next thing was to convince the developers to do something that was compatible with our neighborhood. we think both sacramento street merchants association and the neighborhood think that they have achieved that goal. so let me -- this is a joint statement from both organizations. both f.a.n. and the sacramento street merchants association, have been active members of the visioning advisory committee for 3700 california street from the beginning of the process. we recommended this project to be approved, especially for its consideration of neighborhood housing, scale, and design. we especially appreciate the project has a variety of building designs so that the project doesn't look like a

single mass. and we thank robert absterm and associates and t.m.j. are g. to have our neighborhood to have proportion and architectural beauty. a very important factor in our decision to support this project is its response to the parking congestion caused by the current occupant, c pmc. and we believe that it will be mitigated by the current design. we support the parking plan, hoping that it will create a better layout for many decades to come. we wholeheartedly appreciate the efforts by t.m.g. to select one of the nation's leading architects to design the housing and to make it into a long-standing contribution to the look and feel of the neighborhood. it's a thoughtful sign that will help our neighborhood to retain a sense of character and pride of place. thank you very much. >> president melgar: thank you. any other public comment on this

item? >> good afternoon president melgar and commissioners. i'm kathy devon-ginsee with the laurel heights improvement association. and i attended every meeting help by t.m.g. partners in the visioning process and i was pleasantly surprised by the accurate information provided and the candid discussions that occurred. this developer did not just go through the motions of meeting with the community. he had legitimate concern for how the project was fit within the character of the neighborhood and he made an honest effort to modify his proposal in a way that would address concerns of neighbors and mitigate impacts on the area. for example, early in the process individual neighbors told him they didn't want retail uses in the project because they didn't want the traffic that the retail would bring and he

immediately dropped the idea of bringing retail into it. and he modified the appearance of the building to reflect concerns and comments of neighbors, surrounding the site, and in order to achieve a harmonious and balanced result he built within the zoning rather than seeking to upzone the property. and he didn't maximize the amount of construction within the existing zoning, he varied it. he engaged a distinguished architect, the robert a. stern firm that develop beautiful buildings that complement the area. and in this process we did not have to face a developer who sought to impose his proposal on the neighborhood. and from this experience i i have come to the belief that whether a legitimate and successful planning process is conducted depends on the integrity of the particular developer. so our wholehearted support is behind not only the successful results here but also the collaborative process used by

this developer. thank you. >> president melgar: thank you very much. any other public comment on this item? public comment is now closed. commissioner moore. >> commissioner moore: i think that it is that many have looked with anxiety on what would come out of this site. partially many of us have been patients in the former hospital and know the neighborhood. i have friends that live on adjoining streets and i'm very happy to see a very thoughtful process to heal the site and to bring it back into the context in which it was originally created. and i'm very comfortable with your analysis, with your findings, with your analogs and the way that you have described the story. so i'm excited to see you move forward with what you presented today and i couldn't be happier to hear that you had complete support and the voice of the neighborhood is indeed what we don't hear today complaining

that it doesn't work, etc. and a project a few blocks down is the opposite of what we have heard today. congratulations. >> president melgar: commissioner fong. >> commissioner fung: you know, i think that it goes back to my point that i brought up at the beginning of the meeting is that if the intent is to just show us where they are, that's one thing. but if the intent is to have commissioners bring forth comments of concern, then we need to see something beforehand so that we can make that decision. i'm not comfortable with just seeing something like this, similarly to what happened last week and yet to be able to make cogent decisions or comment on the issue. so i think that we -- as a

newbie please enlighten me on what the intent is on these informational project presentations. a question for staff on this is, what's the height limit on california? >> sorry, the height limit on california? just a sec. it is 80 feet the whole way. >> commissioner fung: immediate block or how many blocks adjacent? >> you have -- >> commissioner fung: if you have a comment come... >> the 80-foot zone is just on this property. >> commissioner fung: just on the -- >> and it's know not entirely on this proprietary. there's a 40-foot zone as mentioned up on sacramento. >> president melgar: thank you. before -- i was going to just say commissioner fung, this

commission talks a lot. you know, we usually have a lot to say and it's usually a deep discussion with a lot of different issues. i think that i have enormous respect for all of my fellow commissioners that everyone, you know, brings a particularly different angle to the conversation. and it's always useful. we have often asked for informational presentations on complex projects because it allows for us to, you know, to be given information, to think about things, talk to the folks in the public, to our fellow commissioners and you know, to have a more nuanced understanding for the next time that we hear either the informational presentation or something about the environmental review or when we finally get to vote on it. there has been time for discussion. and, yeah, it's not new. and particularly for multifaceted projects that require, you know, more layered nuanced understanding of what's

going on with the community, with the politics, with the planning, you know, it's helpful. so i find it really helpful and i hope that you will too. okay. >> commissioner fung: some of us are just a little slower, that's all. >> president melgar: but this allows for us to deliberate in that way. yeah. >> elizabeth john here, northwest team leader. to reiterate that point, we sometimes bring these large projects to you informationally before you see the draft e.i.r. so it's not the first time that you're getting information on a project. we give an introduction before that. so that the e.i.r. is not the first look. >> president melgar: thank you. commissioner richards. >> commissioner richards: would you be able to send the powerpoint or the p.d.f. to us and it would be helpful to have this in printed form too. >> president melgar: commissioner hillis. >> commissioner hillis: just a question on how you'll build this out. and i appreciate how this fits in contextually and it's not just a big building kind of

circling an open space. so we don't get that enough i think on these bigger sites. but you actually got a parcel out these various buildings and sell them or have them designed by different architects? or are you all going to build them? >> we're going to build it. >> commissioner richards: and it will stay as one parcel? >> it gets sub-divided. >> commissioner richards: great. i appreciate it. and a note on the design, i mean, i like that you're going to take cues from the neighborhood and i hope that it looks like it's built today, you know. i get that there's a balance all the time between kind of modern architecture and contextual and fitting in with the neighborhood but i think that it could be done and you obviously have a great design team. but it looks like it's built today but takes cues that are wonderful in this neighborhood and incorporate them. but still has kind of a more contemporary-modern look. but, obviously, fits in, which i know which is tough to do. so thank you.

>> president melgar: thank you, commissioner richards. >> just one comment to what the commissioner said. you can see some like the 1990s or the 2000s and it's when you look into the future to see what is timeless, though it mimics the past and it's the present. >> president melgar: thank you. >> clerk: item 92018-014905cua at 1711haight street. >> before your presentation i introduce to you katie wilborn, a new planner on the northwest quality rant and arrived at the planning department as an intern last summer and focused on writing the russian heritage context statement. she originally hails from louisville, kentucky and has a masters in interior architecture

and a graduate certificate and and we be thrilled to have her and to introduce her to today. (please stand by)

>> there are no other massage establishments in the haight street district or within a 300 radius. it's necessary and desirable and the department's recommendation is to approve with restrictions. i'm available for any questions. >> commissioner: do we have a project sponsor? >> i'm paul horcher, retired. it's my pleasure to be the attorney for the project

sponsor. i'd like to say initially it's an excellent job representing the city very well. very nice to deal with. now, she's covered everything i could think of. you may want to know more about the interior of the place. there are no individual massage rooms or locks with doors. they a refreshing approach. they have curtains that subdivide the different massage areas. there's not necessity for

privacy per se because clients are fully clothed at all times. to tell you more about the project sponsor, she's a thai american and lives in san francisco. she's the one-fourth owner of a place of the same name located at 4328 gary street. and there's a clean bill of health. no trouble whatsoever. good reviews on yelp.com and came out with an average of 4.5. i know it's social media but you read the reviews this place has credibility in the neighborhood. apparently they mention about the neighborhood meeting that

was important and useful. and there were two major concerns. not concerns but comments, frankly. they were tired of the vacant space and it's been vacant a number of years. there's a complaint on file to that point. they also wanted to us have therapeutic massage in the haight ashbury neighborhood so it's a good fit for the neighborhood. this is anita sukasiri which is a managing member. >> good afternoon, sir and madame. thank you for letting me talk to

you. let me tell you what thai massage do we introduce the pedal message in thai style with deep body massage. this type of body work the clients wear comfortable clothes. it is known in thai. it's known as the engine massage. our target audience is adults who receive a massage for medical or health reasons such as pain management, soreness, stiffness, injury, rehabilitation or illness and adults who receive a massage for relaxation, stress reduction. our vision of the company the business highly competitive. we believe with the name of of yara traditional thai massage we

have been in business seven years and guarantee the best service to the customers. >> do you have any questions? >> commissioner: we may, after public comment, thank you. >> after that we will take public comment. two speaker cards, katherine kennedy and mr. william kennedy and anybody else who wants to come and speak, please do so now. >> i'm katherine kennedy on behalf of iyara massage when i heard they were coming to haight street potentially i was very excited. i didn't realize at first when we started talking about a massage, potential massage parlor it's one i'd been to before and i had looked on yelp and found a place. i live nar haight ashbury and

found a place nearby on gery street i had to drive to. has very good reviews. i had a have -- very good experience. i don't normally go get a massage. there's not a lot of services in the neighborhood where i live so to hear they were coming to haight street potentially was a really great thing. i'd like to see them open. >> commissioner: thank you next. next speaker, please. >> good afternoon, everyone. i'm william kennedy. i am the owner of the order the parlor will be in. i bought that building in 1980 after living there for 10 years

prior and so i've had children born there. in other words, it's a very family oriented business. i like long-term tenants. i've had several that were there more than 25 years and due to changing things, people get older and things change retire and move on. i'm happy i have a qualified tenant willing to take that space especially currently with the work going on in haight street and the redevelopment i think it's a good fit for all of us. >> commissioner: any other public comment on this item? with that public comment is now closed. commissioner moore. >> move to approve. >> second.

>> commissioner: seeing nothing further there's been a motion seconded to approve the matter with conditions on that motion. [roll call] >> clerk: so moved. the motion passes unanimously 5-0. >> commissioner: okay. we're adjourned.

[♪] >> with san francisco animal care and control, we care for all animals, any species. we get 10,000 a year. they are victims of abuse and violence, and we take them into our care. >> i felt really passionate because i had personally seen first hand what my family was pushing for rescue dogs and conditions that some of the animals and staff are working in >> we are excited to be moving into this new shelter. our current physical plant is in terrible shape. i like to describe it to people as the building is working against us rather than for us. this shelter was put together in six months, 30 years ago, in a building that is now 80 years old. our staff and our volunteers are amazing and wonderful and they are warm, but the space makes it difficult for people to connect

with the pets. we have families coming into adopt, we have families surrendering their animals, people looking for their lost dogs, and they are all crammed together in a very small, emotionally fraught space. our heating and ventilation system is very poor. right now, our shelter is not capable of good ventilation, to prevent the spread of disease. we have no security features. our veterinary suite is cramped into one room. we can only perform one procedure at a time. [♪] >> one of the main lessons learned from hurricane katrina was that people were really reluctant to evacuate if they were hearing that their pets were going to be left behind and not cared for. >> in the event of an earthquake , we need to be off the grid for 72 hours. it is unlikely we would be able to fulfil our mission to take in domestic pets that need to be

temporarily with us while their parents are out of their homes. in the new building, will be able to meet those earthquake standards. [♪] >> we are standing at the site of the future facility, that is the beautiful brick building you see in the background behind me. the brick building is part of the showplace square historic district, which is a collection of brick warehouses and factories that were built in the late 19th century. this building was originally built in 1893 as the original coal-fired power plant in san francisco. it has been owned and operated by munimobile ever since. >> the building we chose for the project for a number of reasons. one, we are not that far from the existing animal care and control facility. the san francisco spca is nearby , and it is a nice nexus to have in the center of the city. [♪]

>> what we are doing is we are going to be seismically upgrading the building. it is an unreinforced masonry building, and we are going to be installing floor plates across the space in order to put in all of the animal housing. >> will be able to have our animals in a different space. would be separating our small animals into multiple rooms. right now we have reptiles and bunnies and birds, everybody all crammed in together. >> the tricky part is how to find open space in this existing urban environment. we did that by inserting in open air courtyards, and using the rooms for other dogs and small animal runs. [♪] >> three, two, one! [cheers and applause] >> when the new a.c.c. opens and two years, it will be incredible we'll finally have a world-class facility that our animal shelter needs in the city. [♪

>> good morning, everyone, meeting will come to order. welcome to the may 13, 2019, i am supervisor ronen, seated to my right, supervisor walton, and to my left, supervisor mar. clerk is victor young and thank kalina and scott from sfgovtv. >> make sure to silence all phones and electronic devices. completed speaker cards to be included should be submitted to the clerk. items acted on today, may 21, board of supervisor agenda unless otherwise stated.

>> item 1, whether the services with wrap around services and adequate beds, mental health counseling, psychiatric and psychological services, and funding levels to serve the population serviced by the program proposed in the pending ordinance, 181402. and item 2, authorize proce proceedurees -- city attorney to institute judicial proceedings to establish housing conservatorship, evaluation of the implementation of the housing conservatorship program.

>> thank you very much, and joined by supervisor mandelman, the sponsor of these items. would you like to make the opening statements? >> members of the rule committee for hearing this today, and mayor breed, and even the most modest efforts are likely to face a tremendous up hill slog. never one to shy away from a fight, senator wiener is back with sb40, we will hear more later. i do not agree with him about everything but he is fearless and relentless and i am grateful for his fearlessness and relentlessness on this issue. i want to thank the department of public health and office of public conservator for month and

years of service on sb1045 and 40, and how to make local implementation work. and thank my co-sponsors, supervisors brown and stefani. colleagues, there are two items before you today. as required by sb1045, item 1 is a hearing on the sb1045 local implementation plan prepared by the department of public health and the office of the public conservator and resources available for implementation. item 2, authorizes creation of the housing conservatorship program here in san francisco. second, establishes the working group. and third, makes findings determining resources required to serve the sb1045 population are available to support the success of the program without reduction of voluntary mental health services nor reduction of services under programs. this ordinance is many, many

months in the making. last year the state legislature passed sb1045 authorizing five-year pilot program for san francisco, san diego and los angeles counties to seek temporary conservatorships. in san francisco, it will allow the office of the public conservator to petition the superior court to be the appointed caretaker for dual diagnosed individuals, wrap around care, service, treatment and management of the affairs for the duration of the conservatorship. and an act allows people gravely disabled by a serious mental illness. but laws written 50 years ago, co-occurring serious mental illness and substance use disorder. working with the san francisco department of public health, senator wiener crafted sb45 to

address the legal pit falls that exclude too many mentally ill people from care due to the fact the primary disabling condition is drug addiction. impacts of substance abuse on a growing number of unhoused people suffered from untreated mental illness. nearly half of all patients are brought there suffering from meth intoxication. and we know many of these individuals keep returning over and over again. we are seeing these same individuals show up in hospital emergency rooms and jails or worse, one of the increasing number of unhoused people dying from meth overdoses, twoen 2016 and 2018, meth was the most commonly found in homeless deaths. employing a public health response in a strict legal

framework. any conservatorship must meet a number of objective and sub jec testify tests. individuals considered for conservatorship must suffer from both a serious mental illness and a substance use disorder. they must have been placed on an involuntary psychiatric 5150 hold at least eight times in the prior year. county must have tried other less restrictive alternatives and a judge must establish the conservatorship is the least restrictive to provide for the care. these requirements appropriately set a high bar for a 1045 conservatorship, and estimates are likely to apply to fewer than ten people a year. even if senator's bill sb40 passes, the largest number of

people will be certainly fewer than 50. it's temporary and can be granted for no longer than one year. conservatorship automatically terminates unless renewed by the court. the potential person will be represented by a public defender throughout the process and has the right to a court or jury trial as well as the right to contest or petition to end the conservatorship early at any point. sb1045 was signed into state law in september. mayor breed and brought the legislation in november. since then, office of public health and public conservator have spent many long hours thinking through plans for implementation. and held three meetings with stakeholders to discuss the plan. i want to thank all those who participated in those conversations and those directly by email, call, text, twitter

message, as well as here today. now, i at times over the last several months have wondered if ever so many have spent so much time, energy and effort working through and fighting over a program that seems so modest in its ambitions. it is tempting, colleagues, i am sure, to conclude that this 1045 stuff is really just not worth the effort. clearly i think that it is. even if we only reach a handful of folks at first, i believe we must try to get those hardest to reach people, get care to the hardest to reach people, the sickest, and those least likely to voluntarily seek help. as the opponents realize, there is a larger principle at stake here. we all believe san francisco, well, i hope we all believe that san francisco must do more to expand access to voluntary mental health and substance use treatment services and i'm excited we have a mayor and

board of supervisors who are singularly committed and pretty united with regards to that goal. but we could double the availability of voluntary services tomorrow and we should. and i still do not believe we would reach the population 1045 seeks to bring into care. friends of mine in recovery sometimes speak about hitting bottom. but the 1045 population hit bottom a long, long time ago. and while i agree that involuntary treatment cannot cure a substance use disorder, neither can you be in the treatment, if the meth addiction has the reason to feel or want anything other than the next high. for some people, involuntary is necessary, and you shouldn't have to go to jail to get that. that is the point of sb1045. it is a small pilot to help a few people and to test an idea

that might be able to help more. i ask that you approve this ordinance today and forward item two to the full board with positive recommendation. if you are not comfortable do that, i ask you send it forward without recommendation so we and all of our colleagues can discuss these complex and important issues as a full board. we will hear a presenttation on the plan from the department of public health and the office of public conservator, and the amazing simon pang from e.m.s.six who does incredible work with this population every day. the folks, the other folks presenting, jill nelson, as well as angelica alameda, justice involved behavioral systems with the department of public health. and available for questions, dr. antoine bland, new director of mental health reform who was

until very, very recently the lead psychiatric emergency services and i'm very excited that dr. planned is in this role. dr. grant colfax, shareen mcfadden, and kelly hirmoto, director of transitions of the department of public health. so, with that. >> can i see if any of my other colleagues have opening comments? no? no? i just -- make a few opening remarks. i wanted to start off by just saying how much we all agree that abandoning mentally ill people to wander the street without care or medication is morally wrong and dangerous and i agree with the mayor and supervisor mandelman that our

system is broken. i think we have seen that in the last few hearings we have had on the subject at the budget committee. and that i desperately want to help mentally ill people and people suffering from substance abuse who are very ill on our streets. be all know that when reagan closed the mental health hospitals in the 1980s we never created an alternative place for people to go and it's way pastime that we build a modern care system for people with mental illness and substance use disorders. i also want to make it clear that i believe that some people need forced treatment. i believe in conserving people in certain circumstances and i believe in the l.p.s. conservatorship process. i also believe there are changes that would make the l.p.s. process better. for example, it's a no brainer to me and i would change it, shouf happened years ago, that

l.p.s. conservatorship includes drug addiction. not sure why it has not happened at the state level. i would be open to broadening the definition of danger to self. under l.p.s. i had a year-long experience trying to help a mentally ill substance user in the mission district, an elderly woman lived at the 16th street bart station for two years and i learned that the only way we could have conserved her is if we had a broader definition of danger to self. she was clearly dying in the streets, but because she could articulate where to get food and that she could make it to a shelter, we were not able to bring her indoors. and that was -- that was hard, that was hard to watch. we eventually succeeded because we did basically the equivalent of intensive case management and

got her to voluntarily come indoors. but that was a hard process. but i want to say i'm looking forward to this hearing and hopefully getting a lot of my questions answered, but i've been very skeptical about 1045, and i'm not yet convinced that it is workable at all or even a useful law to address the people suffering from mental illness and substance addiction on our streets. we have been told that as written it will help five people, supervisor mandelman said maybe ten, and many proponents of the law admit it is specifically designed for those individuals addicted to methamphetamines. yet drug addiction experts, including health right 360 who we rely on in san francisco are opposing the law and say this will not work to help meth

users. or meth addicts. finally, before we get this hearing going, i want to say that while there are strong feelings on this topic on all sides, i want to echo supervisor mandelman and say i have no doubt especially given your deep personal experience with mental illness that supervisor mandelman's desire to help is absolutely genuine, and while we may disagree on the strategy, absolutely united in our desire to help people suffering from mental illness and substance abuse on the street. and i just want us all to remember that, as we are debating and talking about this strategy because this is really a desire on all our parts to help and to just make sure we are doing it in the most effective way possible. i just wanted to say that to you from the get-go, supervisor

mandelman. and with that, would you like to run the hearing, or do you want me to call the speakers up, however you want like to handle it. >> i'm happy to call folks up. >> all right. so, and we don't have that many people to call up, i think jill and angelica are starting and then simon. i believe we also have -- i did not identify her but we have the director of city-wide that can help with questions. and city-wide does case management for many people, including folks who are likely on our high users list. go ahead. >> good morning, supervisors. again, i'm dr. angelica alameda, and with the department of behavioral health services. share just an overview of our presentation.

thank you. ok. so, this is just an overview of our presentation for today. we just wanted to orient us to the conversation, discuss how we see bill 1045 fitting into the landscape in san francisco. so, want to start off by saying as was just discussed, we know the landscape has changed, not just in san francisco but california and nationwide. and when the act was passed, what we are doing now and the complex needs of individuals we are serving looks very different. what we know in san francisco, we have a methamphetamine and opioid epidemic. and there are individuals of complex behavioral health needs that are vulnerable and unable to care for themselves in the community. n