[applause.] we grew up together. >> matthew rothschild. (applause). >> one question for people. what is 1181 golden gate. who can tell me what that is? >> the new location for the clinic. >> that is where we will be for the next 14 months. visit us there as well. we are counting on our patients to be with us. we will have you back in 14

months and two days for the celebration. he is bringing champagne so don't miss it. here we go. five, four, three, two, one. [cheers and applause.] we spoke with people regardless of what they are. that is when you see change. that is a lead vannin advantage. so law enforcement

assistance diversion to work with individuals with nonviolent related of offenses to offer an alternative to an arrest and the county jail. >> we are seeing reduction in drug-related crimes in the pilot area. >> they have done the program for quite a while. they are successful in reducing the going to the county jail. >> this was a state grant that we applied for. the department is the main administrator. it requires we work with multiple agencies. we have a community that includes the da, rapid transit police and san francisco sheriff's department and law enforcement agencies, public defender's office and adult probation to work together to look at the population that ends

up in criminal justice and how they will not end up in jail. >> having partners in the nonprofit world and the public defender are critical to the success. we are beginning to succeed because we have that cooperation. >> agencies with very little connection are brought together at the same table. >> collaboration is good for the department. it gets us all working in the same direction. these are complex issues we are dealing with. >> when you have systems as complicated as police and health and proation and jails and nonprofits it requires people to come to work together so everybody has to put their egos at the door. we have done it very, very well. >> the model of care where

police, district attorney, public defenders are community-based organizations are all involved to worked towards the common goal. nobody wants to see drug users in jail. they want them to get the correct treatment they need. >> we are piloting lead in san francisco. close to civic center along market street, union plaza, powell street and in the mission, 16th and mission. >> our goal in san francisco and in seattle is to work with individuals who are cycling in and out of criminal justice and are falling through the cracks and using this as intervention to address that population and the racial disparity we see. we want to focus on the mission

in tender loan district. >> it goes to the partners that hired case managers to deal directly with the clients. case managers with referrals from the police or city agencies connect with the person to determine what their needs are and how we can best meet those needs. >> i have nobody, no friends, no resources, i am flat-out on my own. i witnessed women getting beat, men getting beat. transgenders getting beat up. i saw people shot, stabbed. >> these are people that have had many visits to the county jail in san francisco or other institutions. we are trying to connect them with the resources they need in the community to break out of that cycle. >> all of the referrals are

coming from the law enforcement agency. >> officers observe an offense. say you are using. it is found out you are in possession of drugs, that constituted a lead eligible defense. >> the officer would talk to the individual about participating in the program instead of being booked into the county jail. >> are you ever heard of the leads program. >> yes. >> are you part of the leads program? do you have a case worker? >> yes, i have a case manager. >> when they have a contact with a possible lead referral, they give us a call. ideally we can meet them at the scene where the ticket is being issued. >> primarily what you are talking to are people under the influence of drugs but they will all be nonviolent. if they were violent they wouldn't qualify for lead. >> you think i am going to get

arrested or maybe i will go to jail for something i just did because of the substance abuse issues i am dealing with. >> they would contact with the outreach worker. >> then glide shows up, you are not going to jail. we can take you. let's meet you where you are without telling you exactly what that is going to look like, let us help you and help you help yourself. >> bring them to the community assessment and services center run by adult probation to have assessment with the department of public health staff to assess the treatment needs. it provides meals, groups, there are things happening that make it an open space they can access. they go through detailed assessment about their needs and how we can meet those needs.

>> someone who would have entered the jail system or would have been arrested and book order the charge is diverted to social services. then from there instead of them going through that system, which hasn't shown itself to be an effective way to deal with people suffering from suable stance abuse issues they can be connected with case management. they can offer services based on their needs as individuals. >> one of the key things is our approach is client centered. hall reduction is based around helping the client and meeting them where they are at in terms of what steps are you ready to take? >> we are not asking individuals to do anything specific at any point in time. it is a program based on whatever it takes and wherever it takes. we are going to them and working with them where they feel most

comfortable in the community. >> it opens doors and they get access they wouldn't have had otherwise. >> supports them on their goals. we are not assigning goals working to come up with a plan what success looks like to them. >> because i have been in the field a lot i can offer different choices and let them decide which one they want to go down and help them on that path. >> it is all on you. we are here to guide you. we are not trying to force you to do what you want to do or change your mind. it is you telling us how you want us to help you. >> it means a lot to the clients to know there is someone creative in the way we can assist them. >> they pick up the phone. it was a blessing to have them when i was on the streets. no matter what situation, what pay phone, cell phone, somebody else's phone by calling them

they always answered. >> in office-based setting somebody at the reception desk and the clinician will not work for this population of drug users on the street. this has been helpful to see the outcome. >> we will pick you up, take you to the appointment, get you food on the way and make sure your needs are taken care of so you are not out in the cold. >> first to push me so i will not be afraid to ask for help with the lead team. >> can we get you to use less and less so you can function and have a normal life, job, place to stay, be a functioning part of the community. it is all part of the home reduction model. you are using less and you are allowed to be a viable member of the society.

this is an important question where lead will go from here. looking at the data so far and seeing the successes and we can build on that and as the department based on that where the investments need to go. >> if it is for five months. >> hopefully as final we will come up with a model that may help with all of the communities in the california. >> i want to go back to school to start my ged and go to community clean. >> it can be somebody scaled out. that is the hope anyway. >> is a huge need in the city. depending on the need and the data we are getting we can definitely see an expansion. >> we all hope, obviously, the program is successful and we can implement it city wide. i think it will save the county millions of dollars in emergency services, police services, prosecuting services.

more importantly, it will save lives. .

>> mayor breed: my name is london breed. i'm mayor of san francisco. i am so excited to be here. i have been talking about this legislation since even before becoming mayor. i'm so grateful we're at this point. i want to start by thanking state senator scott wiener for his incredible leadership on this important bill that finally got signed by the governor and one that we're going to be putting into action right here in san francisco. i also really want to thank supervisor rafael mandleman for his leadership and getting it through the board of supervisors so we can move forward on an act

that we know is a critical step to help us address mental health reform like never before in san francisco. thank you to the episcopal community services for hosting us today. the bishop here provides permanent supportive housing for over 100 people in this building, an outcome that we want for all people who go through conservatorship. thank you to the department of adult and aging services, the public conservatorship, the department of homelessness and supportive housing. it does take a village and it takes all of these departments in order to accomplish what we know is an important goal to help people who we know are suffering on our streets. we're here today because we know that compassion and kindness play a role in addressing what we know has been a real challenge. we know that some of the people

that we see on our streets who are dealing with homelessness, mental health challenges, and substance use disorder on our streets are people that we need to come up with new solutions to help. for people who are experiencing just one of those things, it's hard enough, but just imagine all three. the reality is sad. it's a repeating cycle where people are in and out of our jails and hospitals. in the same areas that they once were with no help and no plan in sight. the biggest challenge we have is that in some instances, people are refusing what we're offering. it's not just -- it's not humane to just say that someone has the right to be out on the street dealing with the same challenges over and over again and allow them to do that, especially because we know what happens in

san francisco with the challenges that people are experiencing. that's why we need in some instances to conserve them, to help them stabilize, to provide wrap-around services, and to get them on the right path. for example, el laguna honda hospital, we know that is a rehabilitation center. there are some people who have been given help and support and transitioned out of laguna honda into situations where they can not only live on their own but be provided with support from healthcare workers and other social services in order to live independently. we know with a physical challenge it's possible, so why not with someone suffering from mental illness. thanks to this legislation written by senator scott wiener and signed into law by our governor, we can get started doing just that. as i said before under the board

of supervisors, under the leadership of supervisor a mandelman, we are moving forward and taking the necessary steps to start the process of conservatorship. the city's attorney's office is working closely with others to bring these cases to court and get the help that they need. we all know that san francisco has a long history of providing compassion to people, but when people don't accept help and the alternative is they may die on our streets, we have an obligation to step in. senator wiener's law requires that we form a working group charged with assessing the new conservatorship and making sure we're meeting the needs of those who qualify. i've appointed three members of the working group and two of us

are with us today. simon pang is the department of the san francisco fire department and has experience with outreach on the streets every day. thank you for joining us. kelly dearman is the executive director of the san francisco in home supportive services public authority. thank you, kelly, so much for your work in this effort. rachel rodriguez is the co-founder and director of the community payee partnership. she wasn't able to join us today but will be part of the committee. there will be a larger working group that will meet later this month and ensure this group meets the goals it intends to do. this conservatorship is not going to solve all of the issues on our streets, but it's better than what we had before, which was absolutely no way to compel people to accept help. but that's why we're continuing

to invest in behavioural health beds. the city's budget includes $50 million for substance use and mental health treatment beds. we've launched a comprehensive behavioural health initiative to help the approximately 4,000 people that we have identified who are in the most need of mental health care and substance use treatment. our city departments are working diligently to create personalized care plans for the 230 people of this group who have the most acute challenges. i want to thank dr. naguseblan for the work that he's done to get us to a place so that we understand what we need to do to start to make smart efforts so that we know the programs that are working and we're investing in those programs and making sure that they work for the people that we're trying to serve. the fact is for the programs

that aren't, we need to make a change because we know that there is a need to move forward and address this issue appropriately. we're also expanding our hours at the behavioural health access center and we're opening additional new beds at our hummingbird west beds thanks to tipping point community. all of these things combined are going to help us achieve what our goal is, and that is to address the crisis. people use that word and throw it around freely, but there is a crisis with mental health in our city. not just what you see on the stre streets, but in general. we need to get rid of the stigma attached to it and we need to make sure we have the tools in place to address it in the most appropriate way. we are committed to making the serious changes necessary and we are so lucky to have a very

thoughtful legislator who understands these challenges and who is willing to develop partnerships in order to fight to deliver them so we can make the appropriate changes and investments right here in san francisco to make them work for the residents who need them the most. at this time i would like to introduce our state senator scott wiener and thank him so much for his incredible leadership on this issue. [ applause ]. >> thank you, mayor breed. i really want to thank the mayor for her extraordinary leadership on the really severe mental health and addiction challenges we see on our streets every day. this is a problem that has been many, many years in the making and has to do a lot with state-wide and national failures around our mental health and addiction safety nets, around housing and having enough of it. it's hard at a city level to grapple with these issues, but

the mayor is really taking tangible steps to do that. this legislation has been a two-year process, as often is the case, with hard issues. sometimes you have to go back a second year, and this is what we did this year with sb-40. i want to acknowledge the mayor, when she was a candidate, was the only candidate for mayor who supported what we're doing here. i think the people saw that. regular residents of san francisco understand that there is a real problem on our streets and that we can't have business as usual. because business as usual has not made things better. we have to be willing to try new things. this legislation, i was told when i was sworn in as a new senator, never try to expand conservatorships in california. it's impossible politically. you'll never be able to do it. what we learned is of course it's hard and it concerns civil

liberties, which is something that we have to be very mindful of and very cautious when you're depriving someone of civil liberties. but ultimately if you do it in a smart and a focused way, people get it. in the legislature honestly this was overall not a controversial bill. it was controversial in the advocacy community, and we of course respect our devote -- advocates and worked with them. this is a bill that got almost unanimous support on the floor of the assembly. the biggest criticism i received from colleagues, including some very liberal democrats, is why isn't this program in my area because we have people dying on the streets as well. part of what this legislation and this conservatorship program is about is that it is completely unacceptable for us to sit by while people are unravelling and dying on our

streets. it's not good enough to say we have voluntary programs that people can accept. when someone is sleeping in their feces and has open sores all over their bodies that they are not having treated, when someone is running in the middle of the street screaming at cars in the middle of traffic, to say that person should simply be expected to accept voluntary services and take control of their life in that condition, that's not reality. so we as a city, we as a state, need to do more to save these people's lives. these are our neighbors. these are members of our community. it is not progressive to just let them die because they're incapable of accepting voluntary services. i acknowledge that there are people who have concerns about conservatorships. like i said, i'm very mindful of the civil liberties implications. that's why this legislation is

very focused. in fact, some of the critics of the legislation have said it's narrow. yes, it is narrow. this is narrow and designed to really help a small percentage of homeless people who are so severely addicted and so severely mentally ill that they are dying on our streets. we know that two-thirds of homeless people have no mental health or addiction issues. they're simply poor and can't afford housing. even of our homeless population that have mental health and addiction issues, a large majority are capable of accepting voluntary services. that's what we need to focus on. but for a small percentage of our homeless population, voluntary services are not enough. what we need to do is to help them, and a conservatorship can do that. this legislation, like all conservatorships in california, has strong due process protections. you've got a public defender, a judge oversees it. you can have essentially a

trial. it ramps up and starts out with 28 days. if it continues after a psychiatric evaluation and a court hearing, it can go up to six months. the judge will have continual involvement so that if the person gets better sooner than six months, that it can be terminated early. this is really about saving lives. i want to again thank the mayor and supervisor mandelman for their extraordinary leadership in san francisco, to convince the board of supervisors to opt in. i want to thank our department of public health and dos and the fire department for working closely with us in sacramento. and captain pang in particularly repeatedly over a two-year period drove to san francisco to testify and and give real-life examples of the people his team was responding for who were in such deep crisis. it geled what was going on for

my colleagues. thank you and it's my pleasure to bring up our champion on the board of supervisors, supervisor mandelman. [ applause ]. >> good morning, everybody. when you speak after scott, you have to adjust the microphone. this day has been a long day coming, but it's an important one. the mayor talked about the crisis that we face, we have a crisis, but we have a significant drug problem in san francisco. we see it on the streets. you can walk out onto the sidewalk in my district or pretty much any district in this city and see it, but we also see it in our emergency rooms. i know simon is going to be speaking shortly. roughly half the folks that go to these places are taken in with nothing in their system. we have a system of meth psychosis and inebriation.

that spills over into other emergency rooms. it places a tremendous challenge throughout the public health system to have so many folks struggling with these issues. then we see it in the morgue, honestly. one of the largest predictors of whether a homeless person will die on the streets is whether they have a meth use disorder. this is a moral imperative to address these issues and it is critical for the future of san francisco. i want to express my tremendous gratitude for the backbones of steel in the form of senator wiener and mayor breed that have made first sb-40 happen. i am absolutely confident if the mayor had not made this a top priority, this would not have passed the board of supervisors and we would not be implementing this locally. it was her threat to go to the

ballot that got sb-45 implemented here in san francisco and gives us the opportunity to take advantage of sb-40. i want to express my thanks for that. the fight for sb-1045 was harder than it should have been. this is a small program and a pilot to test out the approach. the vehemence to it was unwarranted. pointed at a larger disagreement, senator wiener talked about the folks that championed voluntary services as an alternative to these two bills and that was a man practice we heard over and over again. it is to the mayor's great credit that she has been a leading proponent of expanding voluntary services and has put in the money to expand access to housing to low-income folks and making the mental health beds

available and the work that she addressed. it is not an either/or. it is a both and. as was said, we are not going to get there if we ignore the sickest people on the streets, the folks who do not know that they need help. those people have to be our highest priority. there are fiscal reasons for that. financially they are a huge challenge for the city, but more importantly it is a moral imperative. i am excited to see the department of public health and the office of the conservatorship to implement this project and see if it works and go forward and implement more pilot programs. senator, we will be coming back to you and asking for more legislation because we have a crisis, as the mayor said, and we need bold, persistent experimentation until we have it solved. thank you. i think i am now introducing a hero of mine, simon pang with

ems 6. thank you, mayor, for your extraordinarily good appointments to the working group. kelly dearman is a constituent and amazing and rachel rodriguez is fantastic. and simon pang sees these challenges and problems every single day and is tireless and amazing. simon pang. [ applause ]. >> i am a member of ems 6. a san francisco fire department team that together with the homeless outreach team, the health department's street medicine, shelter health, and medical respite teams provides care to the most at-risk, highest-needs population of our community. people we engage have untreated mental illness, severe substance abuse disorder, chronic and acute medical illness, and are largely homeless. we start with a cup of coffee,

then lunch, and we listen to their story. then we become their advocates and connect them to city resources, detox, drug treatment, mental and medical healthcare, and if possible, a pathway to housing. most people we engage and help don't need this bill, but perhaps you've seen that person in stool-soiled clothes that hasn't moved from their location in hours with skin red and swollen with infection, that is wholly dependant on the kindness of others and the emergency response system for survival. you might have rightly asked, why doesn't someone do something? but what if that person refuses everything the city has to offer, including housing, what then? to allow this person to publicly deteriorate and die is not acceptable. mayor breed, senator wiener,

supervisor mandelman, thank you for listening and for acting. sb-1045 and sb-40 provide a tool to help those who can't care for themselves get on a pathway to health and a pathway to housing. thank you. [ applause ]. >> thank you. as you can see, here we are and this is an incredible step forward. we have a lot of work to do in san francisco, and it just brings me back to really why i felt like i wanted to do this more in the first place when i served as a member of the board of supervisors. there is an individual who was one of my constituents in the community, a senior who was s z sitz -- schizophrenic, who has drug challenges and who those in the community have tried to

serve, in and out of navigation centers and treatment centers, has gotten violent with police officers who know him and have tried to help him instead of arrest him. just a number of challenges. when he's in a good place, he's the greatest person and such a swe swe swe sweetheart. he needs help when he gets social security, he would get robbed. this one person and what he has gone through and the challenges that exist, i was so determined to do something more to make sure that he is getting the help and treatment and support that he needs because everyone is wondering why and i'm not going to mention his name, but if you live in the area you probably know who he is. now we have an opportunity to do more. this is really about not trying to hide people or move them off the streets because we don't want to see it.

this is about trying to help people because that could be you, that could be your grandmother, that could be your father, that could be your brother, anyone in your family, and then what would you do? what would happen if there was nothing you could do to help get them the help and the treatment that they need? this is really the most humane way that we could propose to make a real change in san francisco. all roads lead to housing. we have got to be sure that we have safe and affordable places that people can call home when we provide them with the help and support they need. when it is all said and done, that is one of the most critical things we need in san francisco to address the challenges that exist. this is why all of us are here today to fight for the people who deserve that right in one of the greatest cities in the

world. thank you so much for being here and all the incredible support that we have gotten for this effort. it is truly, truly a village that has come together to address this challenge and we will one person at a time. thank you all so much. [ applause ] [♪] [♪] ♪ homelessness in san francisco is considered the number 1 issue by most people who live here, and it doesn't just affect neighbors without a home, it affects all of us. is real way to combat that is to work together. it will take city departments and nonprofit providers and volunteers and companies and community members all coming together. [♪]

>> the product homeless connect community day of service began about 15 years ago, and we have had 73 of them. what we do is we host and expo-style event, and we were the very force organization to do this but it worked so well that 250 other cities across the globe host their own. there's over 120 service providers at the event today, and they range anywhere from hygiene kits provided by the basics, 5% -- to prescription glasses and reading glasses, hearing tests, pet sitting, showers, medical services, flu shots, dental care, groceries, so many phenomenal service providers, and what makes it so unique is we ask that they provide that service today here it is an actual, tangible service people can leave with it. >> i am with the hearing and speech center of northern california, and we provide a

variety of services including audiology, counselling, outreach, education, today we actually just do screening to see if someone has hearing loss. to follow updates when they come into the speech center and we do a full diagnostic hearing test, and we start the process of taking an impression of their year, deciding on which hearing aid will work best for them. if they have a smart phone, we make sure we get a smart phone that can connect to it, so they can stream phone calls, or use it for any other services that they need. >> san francisco has phenomenal social services to support people at risk of becoming homeless, are already experience and homelessness, but it is confusing, and there is a lot of waste. bringing everyone into the same space not only saves an average of 20 hours a week in navigating the system and waiting in line for different areas, it helps them talk, so if you need to sign up for medi-cal, what you need identification, you don't have to go to sacramento or wait in line at a d.m.v., you go across the hall to the d.m.v. to get your i.d.

♪ today we will probably see around 30 people, and averaging about 20 of this people coming to cs for follow-up service. >> for a participant to qualify for services, all they need to do is come to the event. we have a lot of people who are at risk of homelessness but not yet experiencing it, that today's event can ensure they stay house. many people coming to the event are here to receive one specific need such as signing up for medi-cal or learning about d.m.v. services, and then of course, most of the people who are tender people experiencing homelessness today. >> i am the representative for the volunteer central. we are the group that checks and all the volunteers that comment participate each day. on a typical day of service, we have anywhere between 40500 volunteers that we, back in, they get t-shirts, nametags, maps, and all the information they need to have a successful event. our participant escorts are a core part of our group, and they are the ones who help

participants flow from the different service areas and help them find the different services that they needs. >> one of the ways we work closely with the department of homelessness and supportive housing is by working with homeless outreach teams. they come here, and these are the people that help you get into navigation centers, help you get into short-term shelter, and talk about housing-1st policies. we also work very closely with the department of public health to provide a lot of our services. >> we have all types of things that volunteers deal do on a day of service. we have folks that help give out lunches in the café, we have folks who help with the check in, getting people when they arrive, making sure that they find the services that they need to, we have folks who help in the check out process, to make sure they get their food bag, bag of groceries, together hygiene kit, and whatever they need to. volunteers, i think of them as the secret sauce that just makes

the whole process works smoothly. >> participants are encouraged and welcomed to come with their pets. we do have a pet daycare, so if they want to have their pets stay in the daycare area while they navigate the event, they are welcome to do that, will we also understand some people are more comfortable having their pets with them. they can bring them into the event as well. we also typically offer veterinary services, and it can be a real detriment to coming into an event like this. we also have a bag check. you don't have to worry about your belongings getting lost, especially when that is all that you have with you. >> we get connected with people who knew they had hearing loss, but they didn't know they could get services to help them with their hearing loss picks and we are getting connected with each other to make sure they are getting supported. >> our next event will be in march, we don't yet have a date set. we typically sap set it six weeks out. the way to volunteer is to follow our newsletter, follow us on social media, or just visit our website. we always announce it right away, and you can register very easily online.

>> a lot of people see folks experience a homelessness in the city, and they don't know how they can help, and defence like this gives a whole bunch of people a lot of good opportunities to give back and be supported. [♪] shop and dine on the 49 promotes local businesses and challenges residents to do shopping and dining within the 49 square miles of san francisco by supporting local services within neighborhood. we help san francisco remain unique, successful and vibrant. where will you shop and dine in

the 49? san francisco owes the charm to the unique character of the neighborhood comer hall district. each corridor has its own personality. our neighborhoods are the engine of the city. >> you are putting money and support back to the community you live in and you are helping small businesses grow. >> it is more environmentally friendly. >> shopping local is very important. i have had relationships with my local growers for 30 years. by shopping here and supporting us locally, you are also supporting the growers of the flowers, they are fresh and they have a price point that is not imported. it is really good for everybody.

>> shopping locally is crucial. without that support, small business can't survive, and if we lose small business, that diversity goes away, and, you know, it would be a shame to see that become a thing of the past. >> it is important to dine and shop locally. it allows us to maintain traditions. it makes the neighborhood. >> i think san francisco should shop local as much as they can. the retail marketplace is changes. we are trying to have people on the floor who can talk to you and help you with products you are interested in buying, and help you with exploration to try things you have never had before.

>> the fish business, you think it is a piece of fish and fisherman. there are a lot of people working in the fish business, between wholesalers and fishermen and bait and tackle. at the retail end, we about a lot of people and it is good for everybody. >> shopping and dining locally is so important to the community because it brings a tighter fabric to the community and allows the business owners to thrive in the community. we see more small businesses going away. we need to shop locally to keep the small business alive in san francisco. >> shop and dine in the 49 is a cool initiative. you can see the banners in the streets around town. it is great.

anything that can showcase and legitimize small businesses is a wonderful thing.

>> good morning. welcome to thursday, october 17th meeting of the government audit and oversight committee. i am joined by supervisor brown, supervisor peskin is running late this morning. thank you to the committee clerk. i would like to thank sfgovtv for staffing this meeting. we are joined by supervisors ronen and mandelman. we are grateful to our colleagues for joining us