>> okay, hello, everyone. the meeting will come to order. this is the june 21, 2019 special meeting of the budget and finance committee. i'm chair of the budget and finance committee, joined by

stefani, norman yee, and the clerk is young. i want to thank sfgov tv for broadcasting this meeting. mr. clerk, any announcements? >> clerk: silence phones and electronic devices. any copies should be submitted to the clerk. items today will appear on july 9th supervisors meeting unless otherwise stated. >> supervisor fewer: thank you, mr. clerk. can you call items one, two, and three together? >> clerk: yes, item one is a resolution determining and declaring that the public interest and necessity demand that the construction, development, acquisition, improvement, rehabilitation, preservation, and repair of affordable housing improvements be financed in an amount not to exceed $600 million. item no. 2 is an ordinance calling and providing for a special election to be held in the city on tuesday, november 5,

2019, for the purpose of submitting to the san francisco voters a proposition to incur bonded indebtedness not to exceed $600 million. item 3 is urging the mayor's office of housing and community development to update and amend a 2019 general obligation affordable housing bond report to reflect the bond increase the bond amount and proposed funding and proposed amendments on prioritized uses. >> supervisor fewer: thank you very much. i believe we have ms. kate hartley here from the mayor's office of housing and community development, to speak on this, and president yee, do you want to say any opening remarks at all? >> supervisor yee: yeah, leading up to remarks beforehand and over to kate hartley. >> supervisor fewer: okay, that's great. >> supervisor yee: thank you, chair, chair fewer. last week -- last week, was it last week? i thought it was years ago. we made amendments to support a

$600 million housing bond for the november -- for this november, that will offer much-needed investment in public housing, low income housing, minimal income housing, senior housing, and educator housing. i believe the mayor's office of housing distributed and updated bond report reflect the request be made as a committee last week. colleagues, i think we should feel very proud that we were able to unite together in our mission to invest more funding for affordable housing across the income spectrum and across the many neighborhoods we serve. i want to recognize that this was a months-long process starting with a working group, bringing dozens of different stakeholders together. so please bear with me as i go through my long -- little long list of thank yous. i want to thank our housing bond

committee co-chairs, who helped lead the discussions on the bond measure months ago. that includes malcolm young, tamika moss, miriam malgar, and annie chung. i want to thank the organizers and advocates, who came out for many meetings and thought sessions to discuss our housing needs. i also want to thank mayor breed and her staff for their leadership and collaboration, especially director kate hartley of the mayor's housing -- office of housing, amy chan, andrea bruce, and sophia kitler. i want to thank our comptroller, capital planning staff, and city attorney's office for their work in making it possible to meet our deadlines. i also want to thank the supervisors and legislative

aides who worked hard to ensure we could cover the different needs of our neighborhoods and most vulnerable residents, such as our seniors. we also now have a new dedicated category for educators, a population that is getting priced out and leaving gapping holes, gaping holes, in our school community. the $600 million may seem like a lot, but we have so much work to do to preserve the communities we have left and to build new housing to sustain future generations. as a grandfather, i think of that more and more each day, about how we are helping to establish new roots for san francisco, and that starts with being able to call a place home. with that, colleagues, i hope to count on your support to send this bond out of committee to the voters of san francisco. our next task is to get this

bond passed so we can provide housing as soon as possible. i would like to move items one, two, and three to the full board with a positive recommendation, and ms. hartley, would you like to make some comments? >> thank you, president yee, kate hartley, office of housing development. i actually do not have a prepared presentation today, but i'd like to echo the thanks that you gave, president yee, we would like to thank all our colleagues at the board, at the mayor's office, the many community members who participated in this process, the staff, especially, amy chan, and dan adams, the mayor's staff. we're very pleased to be part of this process, and we know that upon passage, it will make the lives of so many san franciscans better, so we're thrilled, ready to go, and ready to answer any

questions. >> supervisor fewer: great. let's take public comment. any members of the public like to comment on this item? >> every housing bond you get is for high-income bracket people only. the lowest housing income bond come from gordon and his district. you get multi-quadruple trillion and billion dollar bonds for the past well over several years, and each and every bond you get is for high-income bracket people, and i'm getting tired of you campaigning and making it look like you're helping low-income bracket people, the most vulnerable people who need housing. you sit up there and testify, kate hartley, that the lowest income on your bond when you spoke last time is at 80% of ami. that's $68,950 a year, okay, that's how much you got to make

in order to be in the apartment buildings that she made reference to. then you turn around and you got a contradiction on your ami. you said very low income is at 50% of ami. 50% of ami is $43,100 a year, whereas on this same document pertaining to the same year on your ami document, you're saying that the income is $56,450 a year. you got two contradictions there. thereby, the same response, you talk about you're helping very low and low-income bracket people, those incomes are at 20% and 25% of the median. that's $17,250 a year. those are the very same people who's out in the street with the mental disabilities that each and every one of you campaigned and claimed that you want to help. you're only helping people in high-income brackets. that's price fixing. and i don't appreciate you

putting out three of those issues together at one time and only giving me three minutes to talk about it. you have approximately 8,011 people homeless out in the god damn streets. you've been doing this from one bicentennial to the next bicentennial. >> supervisor fewer: thank you, mr. wright. thank you, mr. wright. any other public comment? mr. wright, mr. wright. your time is up. mr. wright -- thank you, michael. mr. wright, thank you, mr. wright. thank you, mr. wright. okay, public comment is now closed. there's a motion. can we have a second? supervisor mandelman second that? >> supervisor yee: chair fewer? thank you for the public comment, and i just want to make

sure that the public understands that in this bond measure, that there's several other categories where the income eligibility actually starts from zero, and we made sure that we're putting legislation through to make sure that some of the senior housing will actually reach those that are on fixed income, which is around 15%. >> supervisor fewer: okay. thank you very much. all right. thank you, mr. wright. public comment is over. all right. we have a motion and we have a second. and i think we can take that without objection. thank you very much. mr. clerk, can you please call items no. 4 and 5 together? >> clerk: item no. 4 is the budget and appropriation ordinance appropriating all estimated receipts and all estimated expenditures for departments of the city for fiscal years ending june 30th, 2020 and june 30th, 2021.

item no. 5 is the annual salary ordinance enumerating positions in the annual budget and appropriation ordinance for fiscal years ending june 30, 2020, and june 30, 2021, continuing, creating, and establishing these positions. >> supervisor fewer: thank you very much. so now we will have a presentation by mary ellen carroll on our healthy streets operations center. >> good morning, chair fewer and supervisors. thank you very much for having me today. i'm very happy to be here today to present to you on the healthy streets operations center. as i believe you all are aware, the healthy streets operations center is hosted by the department of emergency

management, and we provide dispatch services and coordination and support. the hsoc, as we call it, launched in january 2018. it coordinates the efforts of city agencies involved in addressing unsheltered homelessness and unhealthy street behaviors. the core values of hsoc are to lead with services, believe that everyone can change, empathize with the entire community, and that safe and clean streets can be maintained for everyone. the healthy streets operations center has representatives from key departments working together at the department of emergency management, and representatives from those departments, my colleagues are here today. hsoc directs, plans, coordinates responses to unsheltered homelessness and unhealthy street behavior and provides the infrastructure to coordinate the increased investment in

addressing these issues. for 2019 impact data, we have some data here to share with you. our homeless-related requests for service have gone down over the last year about 33%. the average call response time was 123 hours. that has decreased to 90. our citywide tent counts have decreased from july 2018 to january. it's a 40% decrease, and sites with six tents or structures or more have decreased 65% from 17 to 6. as far as expansion of new shelter services -- services and shelter, we've added beds, 691 new beds, temporary shelter, 390, and permanent supportive

housing and behavioral health beds have been increased by 99 between 2017 and 2018. the operational results, engagements by dph outreach are close to 8,000. needle collection since july 2018, over 90,000 syringes collected. encampments resolved by hsoc, 28 sites have been resolved, and individuals linked to shelter or centers through encampment resolutions are 365. and then finally, the budget investments, which i believe we're here to talk about today. so the different categories, the first category is maintaining our existing services and improving coordination. that includes five new fte and one substitution. one of those is at the department of emergency management, and then we have positions in other departments. these positions are liaison

coordinators. they help streamline processes, coordinate meetings, track projects and deliverables, engage with hsoc operational staff, and it adds a dispatcher to maintain the public works call response. for hsh field response, the budget request adds four positions, repurposes two existing positions in order to create a deployable team that can respond to urgent calls working across both day and swing shifts. so this helps us extend our hours past just regular day hours. the team also creates and manages resolution plans related to unsheltered homelessness and negative street behavior. and these funds will also add an additional mode of transportation, which is a resource that is very lacking for the operation. enhancing central dispatch at dm, so part of the hsoc operation includes two full-time

dispatch supervisors. they actually sit within the operations center, which is in the emergency operations center, so they are off the 911 floor and dedicated to answering and directing calls specifically for hsoc. the dph sobering center, so this request expands resources at the 24/7 medical respite and sobering center to expand services for the operation. and finally, there's funds -- excuse me, to allow the community assessment service center to expand after hours as a place where folks can get off the street and access to services. that concludes our presentation. i am happy to answer questions or my colleagues are here also to do so. >> supervisor fewer: sure. supervisors, anyone have questions? yes, supervisor stefani.

>> supervisor stefani: thank you, chair fewer, thank you, director carroll. i have a quick question about expanding resources at the sobering center. what exactly does that look like, and what is the demand and the need? >> i'll have dr. barbara come up and answer that. >> good evening, i'm from the department of public health. so our sobering center, as you all know, there's been an increase in opiate and methamphetamine use. the sobering center originally was created for alcohol so the needs are different, so we're looking at kind of the whole -- >> supervisor fewer: can you speak directly into the microphone, please? >> so we're looking into the whole model to improve the service capacity there. >> supervisor stefani: okay, and what resources will we be expanding? what will this money be going towards? >> so it would be towards things like monitoring, you know, the monitoring for alcohol is very different than any other substances, so the medical equipment around that, as well as the pharmaceutical needs, as

well as kind of the safety issues in the sobering centers. >> supervisor stefani: okay, thank you. thanks so much. >> supervisor fewer: thank you. so i have a question. i see that we are adding -- or proposed to your budget includes $4 million over the next two years, and there are 11 new ftes and three substitutions or reassignments. so how many ftes total does the hsoc have? >> do we have the orb chart with all the ftes? we'll pull that up for you, if we can. because we do have this, and we did present it with our budget. i'm sorry, i don't have the orb chart or that number in my head, off the top of my head. >> supervisor fewer: because we are just seeing here, i think, how many is being added to it,

but i think for us to fully understand how big asoc is, we have to see the entire budget. >> correct, the whole orb chart. we'll, hopefully, be pulling that up. what i can speak to is the ftes are to -- so basically, since hsoc came together over a year ago, almost 18 months ago, the resources were reallocated, so we repurposed, pulled folks off of other responsibilities in order to address hsoc. so in the case of dm, i have an emergency services coordinator. i've been rotating every three months a person to basically manage the operations center. that means those folks are not available to do emergency services coordination for the city and the main mission for san francisco. so one of the requests is to

permanently create a position to manage hsoc. and that's a similar case for other departments. >> supervisor fewer: so when i'm looking at this 2018 operational results summary, and it says needle collection, is that the needle collection that we contract -- we have a huge contract with the aids foundation for needle collection. >> needle collection -- >> supervisor fewer: does that include that? >> i'm sorry, can you repeat the question? >> supervisor fewer: so the needle collection on your data here for 2018 operational results, you say you've collected over 90,000, almost 91,000 syringes. is that through our contract with the aids foundation? >> yes. >> supervisor fewer: okay, so the aids foundation money is part of hsoc? >> no. >> supervisor fewer: okay, then why are you claiming it as your operational results summary? >> it started around the same time and part of hsoc, so they

are connected. much of the department, we integrate all our services into hsoc, and so a lot of the 311 calls that do go to hsoc are -- gets deployed for those. >> supervisor fewer: sure, but actually, i don't think, though, you can claim you've collected over 91,000 syringes, because we have a very hefty contract with the committee actually approves to do this collection, so actually i don't think that's accurate. i can see that you help facilitate maybe where you might get a call and they say there's a syringe in a playground and the aids foundation goes out and picks it up, but, quite frankly, it is not the hsoc operation that is doing the pickup of it. so i just think it's a little misleading to add that type of information in. pushback on me and also my colleagues, but when we're trying to get to the impact of

it, of hsoc, and all these dollars that are going to it and also in addition of millions of dollars that are going to this operation for the next two years, i think that we should have accurate information on the impact, because we might be collecting maybe 91,000 syringes without hsoc, quite frankly. i mean, just to say, you know -- i also want to ask the total -- i'm going to be sort of frank and say that when i see -- what i see with hsoc is that it's really not operating a lot in my neighborhood and that we get calls -- i mean, we're telling people to call 311 all the time, right? but we wait a long time, and sometimes no one ever comes out, and i just think that let's be honest about where you -- where this is concentrated in, in san

francisco, and where you're using, let's say, 90% of your time, 50% of your time, the response is not good in my neighborhood. in fact, every time hsoc, what i'm hearing, pull actually from district police officers that could be handling some calls, quite frankly, and i'm hearing from my own district officers that, yeah, they get pulled off to go to hsoc. so i just don't know the enormity of this department or this endeavor, because we're not seeing it in a lump sum. we are seeing -- for example, in this summary, you're not telling me the total amount of ftes in hsoc, and then you have to say, oh, then let me go get that information. actually, that's what we need to actually understand what the hell -- not hell. what is -- what are the impacts of these public dollars that are going to hsoc.

i mean, i just want to say, i say this as sort of a total layperson about it. i've only had a couple of presentations on it, but to see these budget requests this year added ftes to this and yet not seeing the impact, quite frankly. so one of the questions, and maybe this is for jeff is, what is the impact that hsoc has had on our homeless population? and is it true that we're just moving folks around that we are hearing to other districts and not getting to the core and also we have a homeless outreach team that also connects people to shelters. we have other -- so how is our hsoc folks doing something different than our hot team? are we duplicating it? this is -- i think i'm hoping that some of my colleagues also have the same questions.

thanks. >> thank you, supervisor. jeff with the department of homelessness and supportive housing. when i started my job about three years ago, one of the things that was really striking to me is the lack of coordination between public health, public works, the police, and our new department around addressing issues around street homelessness. everybody was working kind of in their own silos around this work, and what hsoc has done is provided us ability to coordinate with multiple departments, including some that are not here today, sheriff's department, mta, rec and part, adult probation, have all been -- 311, have all been active participants in hsoc, and what we've been able to do as a result is to better coordinate efforts and some of the i think most important things that are often overlooked when we're talking about hsoc is our ability to sort of extremely

high needs individuals with very complex situations by coordinating efforts with multiple departments, issuing bolos for individuals who are in need of assistance, that way it's not just a hot team looking for them, but public works, sfpd, public health, and we've had some very good successes in some of your districts getting people like this assistance. so that coordination has been critical to our efforts. it's not duplication, it's a coordination of effort. >> supervisor fewer: so i fully understand, jeff. so how many high-need individuals have you served? how many of them? and what has been the outcome for these high-need individuals? >> so i'm not sure if we have -- i do not have data -- >> supervisor fewer: do we collect data on that? >> yes, we are doing weekly case conferencing on individuals. i can only give you anecdotal

information. i think dh may have specific data, but we have seen individuals who have been struggling on the streets for many, many years, some of these clients have been known to me personally, you know, have gotten into laguna honda and housing as a result of some of these efforts. folks who were in neighborhoods, who were desperately in need of assistance that we really struggled with and it took multiple departments working together to be able to provide those individuals with very, very complex situations, assistance. >> supervisor fewer: so i think that the data i would like to see is how many high-needs individuals have you assisted, and what levels? so for example, is it just going out and having a conversation with a high-need individual to assess needs? that's very important. also, i think it is how many have you helped to get off the

streets? if you don't have that data now, do you have that data now? >> not right here, but we can definitely get it to you. >> supervisor fewer: okay. i just want to say this. this is a hearing at the budget and finance committee on hsoc. this is the kind of data that actually should be included when you are having a hearing before the board of supervisors on just hsoc. this is a very simple data point. i don't understand why we don't have it right now. i think that for us to really look at what we're doing in the committee hearing is the hearing on the whole hsoc, so it is -- i would say it hinders our ability to fully understand the impact of public dollars going to an initiative that is requesting

another $4 million over two years, when we don't fully understand the impact that it's had. and for us to fully understand the impact that it has, it means that we need accurate data, and we don't hold the data. you hold the data. so if you see this level of frustration, it is not personal. it is really about our inability to make a decision when we are making these budget decisions in order to have the accurate data. it's super important. it is what, quite frankly, our taxpayers expect of us. so having said that, i think -- i think i would appreciate you getting the data to us, and i'm hoping that we have taken note of the data that's requested. one, what is the overall budget for hsoc? how many ftes? let's ask how hsoc -- the fte

count has grown since it started. what is the impact on high-need individuals, if that's who we are targeting? and what has been the outcome for these individuals? and are we seeing the impact that we've had? i am not saying this is an easy job. i am not saying that this is not an expensive job. and i don't mean to be harsh or rude. i just think that what we want to know is, is our millions of dollars having the intended impact that we want? and so i am now going to look at the roster and see that supervisor ronen has some comments also. >> supervisor ronen: yes, thank you, chair fewer. so what's always confused me about hsoc is it was modelled after a program we started in the mission, jeff, but the model

that we had in the mission, which worked really, really well, was that we had a navigation center in the mission, we went street-by-street and invited people to move into the navigation center. the vast majority of people wanted to move in. we didn't give them short-term stays. we allowed them to stay for quite some time to turn their life around and have an entryway into housing. and then where we got a little hung up at the end was when we were down to i think at our best, 30 individuals who refused to go into the navigation center, and we were sort of lost on what to do about that, especially when they weren't committing a crime, and so the police couldn't do -- so that's where we got stuck. and then from then on we've been going sort of up and down in terms of people sleeping in the

mission. we've reached capacity at the division circle center, although we are increasing it and i'm hoping things are going to get better once we do that, and so -- that was a great model, and it worked, but it was because we had spaces in the navigation center for people to go. and so i guess what i'm wondering is we don't have spaces right now in our navigation centers. i know that the mayor has a goal to expand beds by 1,000. i don't even know where we are in that goal, but even and when we get to that 1,000, it still won't meet the capacity we need to deal with people on the street. so what actually happens with hsoc? it seems like without the model we had in place, where there was a place for people to go, that it was just about moving people around, so i'd love to hear from you how it's actually working.

maybe we're moving people around in a better coordinated way, but we're still just ultimately moving people from one neighborhood to the next. and if that's the case, i'm not sure it makes sense to continue to add additional staff to this model, because i'm not sure that it's having the intended impact on the ground. so especially given that the impact numbers that you give us relate to 311 calls, they relate to the time in which a call is answered, not what's happening with the individuals that are homeless. and what frustrated my constituents beyond measure, the house constituents, not the constituents experiencing homelessness, is they call, sure, maybe they get a response in hours, the police come, ask the people to move, they move, the police leave, and they come right back, and they make a new 311 call, and that's what's

happening. then they email me, i forward the email to you, and it's just a lot of resources, a lot of people working on it, but no actual change for anyone on the ground. so if you could talk to us a little bit more not so much on 311 calls going down and, you know, the average call time. i'm actually not that interested in that. i'm interested in are we getting people to a stable place and and, you know, making sure our neighborhoods are safe and free of people sleeping in the streets in a sustainable way. >> yeah, thank you, supervisor ronen, and thank you again for partnering with us on the model, which was in many ways the model for hsoc, and it was, i think, one of the more successful things we've done in the city around addressing street homelessness, and i think everything you said is absolutely correct. what we're trying to do with this expansion is give us the

ability to model more effectively, both in our budget and other budgets, what we saw with md-hop. we opened 246 beds and will have more open by the end of the year, and we have a clear path to get to the end by 2020, which we're very excited about, and you're right, we need those beds in order to be successful, but at the same time, departments like the department of emergency management and the san francisco police department and all the departments, really, have been swapping staff in and out of hsoc. we've had a hard time -- you know, we are struggling to capture data, because we don't have any full-time staff there. we really appreciate dem and the police department really, you know, lending staff as they can to this, so our budget request, which i think is probably the largest in this, is to allow us to have a staff person there all the time, so we make sure we are, indeed, always leading for services that every call is coming in is being triaged by

somebody on my staff or my public health staff to make sure we are sending people to address the right situation and also what we're trying to do with this is to allow the hot team to actually go back to do what they were originally charged to do, which is not to be first responders, but to actually be in specific neighborhoods doing outreach to the hardest to serve individuals in developing relationships and not having to respond constantly to 311 and other complaints. dem also, who, you know, i think there's also been -- and i think supervisor fewer is correct, we need to have better data, but again, we've all been struggling, you know, it's an incident command model, so nobody is necessarily in charge. it's multiple departments, but dem is trying to add a position in here that will allow us to better coordinate all of our efforts to have one person who will be accountable for what's happening at hsoc to be able to collect data from the various departments, which is

challenging, because there's almost ten departments involved in hsoc at this point. so i do believe that this will make a difference. certainly, you know, our budget request will allow, again, the hot team to focus more on the districts that the staff have been assigned to and not to constantly be responding to 311 calls. we'll have specific staff who are responding to those calls rather than in some ways cannibalizing the hot team to participate in this, but that's what all the departments have been doing and we've had some really extraordinary successes. the departments who are asking you for additional funding, which i believe are primarily dem, dph with a small amount, and our department, are doing so, so we have the resources to ensure we are better coordinated and leading with services. i think as these new shelter beds open up, that will create new opportunities for us to do better and to replicate what we were able to accomplish together in the mission district throughout the city. of course, it's a lot more challenging, you know, the mission district at the time had about 400 people experiencing

homelessness, as we've discussed. saw a nice reduction relative to other parts of the city in the point and time count, so we're looking at a much bigger footprint now across the city, and i believe these resources are necessary if we're going to replicate this work and allow us to, frankly, provide the police department with some relief in having to be the first responders in most cases, and it will provide us the ability to have dph and hsh more present in the community in responding to these calls. >> supervisor ronen: i guess i just -- until those extra beds open up, walk me through. a neighbor calls to complain and what happens? >> so a neighbor calls, a 311 call, so what's happening now is the 311 call is being sent over. there's a screen in the room where hsoc is operating, we see the call come in, there will be a dispatcher, there's a dispatcher from 911 there,

public works has a dispatcher there, as well as a police officer and oftentimes, but not always, due to resources hsh or dph have a staff member available, and we'll see what the call is, see if we oftentimes know that person or recognize the tent or recognize that situation and try to send the right person out to make the response. if there are no hot team members available and no dph outreach workers available, the police end up being the first responders to that. and again, our budget at least will mean we had always have the ability to do -- to be the first responders. >> supervisor ronen: but what do they do when they get there? >> when we get there? whether it's my staff or the police department, we offer people navigation center beds or shelter beds, and we are every day coordinating. we have a board up there that shows the number of beds that are available. it's true that we are running out of beds every day. two days ago we ran out of beds at 5:27 p.m. and actually kind

of stopped an operation that we were working on, because we were full. but as we expand beds, we will have more capacity to do this, and i also want to add that, you know, it's not likely any of us will be able to hire any of these positions until december, and then by december, we are going to have 300 additional navigation center beds open. so i believe this is synced up fairly well in terms we are adding resources and beds at the same time and will allow hsoc -- we are a little bit stalled right now, just because we are at capacity, but again, we are expanding that shelter capacity. >> supervisor ronen: so if we're at capacity in our shelter beds, then nobody goes out? >> staff will go out and talk to folks and say, hey, you know, you got stuff strewn all over the place, you're blocking the sidewalk, could you please not do that? we don't have beds available for you right now, but we do need you to comply with the law and make sure the streets are safe. if somebody's in crisis, we're

certainly going to either call 911, depending on the crisis. if we see somebody who's very, very sick or a family with a child, we will make sure that that person gets to a place of safety, you know, in urgent or emergent situations when it's just, you know, somebody who's struggling economically and living on our streets, we're not going to ask them to leave unless we have a place for them to go to. we are going to ask them to comply with some basic, you know, we have a healthy streets card we hand out to folks that gives basic guidelines on being the best neighbor you can when you're struggling with probably a worst situation you've ever dealt with in your life. and sometimes it works and sometimes it doesn't, but at least we're going out and making connections with folks. the other thing that we're doing if it's the hot team that's able to go out first or somebody on my staff, we're able to see if they are in the coordinated entry system, and if they are not, the team is able to assess people right then and there or schedule an appointment if they

are not willing or ready to do that in the moment. so i do think positive things are happening. this is far from perfect, but i will say the level of collaboration that i'm seeing is so much better than it was three years ago, and director carroll and chief scott have been -- and director colfax, have been amazing partners and i think genuinely want to see us lead with services and the budget request we've put in is what will allow us to do that. and even if we don't have a shelter bed available, as i know that you know, supervisor ronen, oftentimes people who are -- and i don't want to say somebody is refusing a shelter or service resistant, refactory to treatment is what a doctor would say or they've had an experience wanting them to not accept what we're offering, we're building relationships with folks. we're knowing who's out there and building relationships and coordinating with our colleagues to make sure, you know, there are instances in which we'll say, hey, could you please, there's somebody in this

location, this is going to be an hsh or dph case, everybody, please, leave this person be, they are struggling, they are trying their best, and we are trying our best to develop a relationship. and that has led, as i said, to some really profoundly -- i don't know what else to say other than just joyful successes that we have had with folks. two folks, individuals, that i have been aware of long before i took this job, that are now -- one is safe in a dph facility and the other is safely housed, and i can tell you that never would have happened if we didn't have this level of collaboration. and before it would be barbara garcia and i on the phone trying to coordinate or maybe me calling chief scott and now we're able to call hsoc and say, hey, this is what's going on, and everybody who's there, please coordinate this. not that i don't enjoy doing the case conferencing with my colleagues, it's more efficient and appropriate for this to be done.

and in many ways, what hsoc is, is an institutionalization of the strong relationships the department heads have been able to develop in order to best serve the individuals who are on the streets. >> supervisor ronen: and do you have a sense of how often the shelters are full, where we don't have a bed? >> these days, it's, like, always. and in some ways, i'm really proud of the fact that we have been able to drive down the vacancy numbers in our shelters. there are people who do not show up for reservations, but we don't want to take that bed away from them, because it's not a best practice. we'll give them 48 to 72 hours to show up, but in general, every bed is either reserved and every nav center bed is being used or targeted for a specific intervention, you know, in an encampment or something like that. that was not the case, i would say, a year ago, and now we're seeing it just fill up incredibly quickly every night. two nights ago, 5:27, i got the phone call, we're done, we are

full, but fortunately, we do have 300 new beds opening up in the near term, which will help, and hopefully, they get opened up as quickly as we can before the rains happen, and we do have funding this year to dramatically expand our rainy day shelters, and we will rely on hsoc to be able to better coordinate our ability to get folks into those shelters when the weather is bad. >> supervisor ronen: so the budget request that you have, does that account for the fact that the new workers will not start until december, or is this a full year long? >> they are -- our budget numbers are -- so the first year it's expected to start, you know, three to six months in. so, yeah, we have accounted for the attrition, or the time it's going to take to add these positions. yeah. >> supervisor ronen: thank you.

>> thank you, chair fewer, director, thank you for all your work. actually, started -- i think a clarification on -- isn't really for you, but the needles, i think that number is low. i think that there is work happening out of public works, not out of the aids foundation, that is absolutely hsoc related to needle collection, so i think -- anyway, i think your chart may be underdescribing what you are doing in terms of needle collection through hsoc, but anyway, that's an aside. i guess i represent a district that does not mean the city is not making progress on homelessness, but for housed folks in these neighborhoods, at least in district eight, that

are heavily impacted, they have yet to see improvement based on hsoc commitments, and that could be because san francisco is getting so swamped by these challenges that we can't see improvement or even know how much worse it would be but for hsoc and the changes we've made over the last couple of years. it could be that hsoc has created a lot of improvements in the system and rationalization of allocation of resources and better coordination among departments that meet a number of needs of public policy goals, do not actually directly translate into better conditions on the streets, which is my suspicion for my district. i don't think that the answer is that hsoc is a failure, which is another possibility, but i think

that it is not just -- in terms of addressing the needs of my housed and business constituents, who i think can reasonably expect that they should be able to live and do business in an environment where they are not consistently confronted by people with psychiatric conditions, seemingly just out of control, i think it may not be just a question of for that particular problem, i'm not sure that it is just about some additional resources. i think it may not be we just haven't reached the tipping point, you know, the real -- the original kind of conflict of a tipping point. oh, we haven't quite gotten there. i think that there may be a need for a rethinking of how we are responding to street conditions, sidewalk conditions, period.

i think that what we have now on our streets is pretty unsustainable from the politics of the city and from kind of the frustrations of san franciscans and is going to generate at some point a very significant backlash, which i think will be -- could be pretty ugly and bad. [ please stand by ]

about what is happening to these high users of medical services. how many are getting moved off the frequent flyer. what is happening to -- and then that was one, the sort of folks who have psychiatric or substance abuse -- substance use

needs. the other challenges we have in breaking up these gatherings of folks who may not be from san francisco, who are, for example, camping in dolores park and whom we seem to week after week, month after month, police go out, they talk to these folks. and the encampment moves around, but never leaves. and we have to be able to figure out a better way of dealing with that. i do think -- and i've raised this before, i think we need to be able to enforce our laws and we need to be able to offer a place to folks who really don't have anywhere else to be. and i think it makes sense to look at sanctioning spaces that can be safely, you know, kept up. but as a last resort, just a

safe place to be, that is not in the middle of a struggling commercial district. and i think, with that i want to thank you, because there has been tremendous successes and accomplishments and the what you're asking for is to make your department, which is very new, to staff it up, because i think it was understaffed when it was started. >> if i could respond, and just one of the things that hsh is working on in partnership with other departments, we're working with ucsf to do a study that will be done in the next 3-4 months, to talk about where there are gaps in the system for people not accepting services. i'm sure that the idea of a safe place where people could be is going to be one of the things that is discussed as part of that, as we're speaking to people on the strs