opportunities. the health department has done big things and i see this going forward. >> we have public comment. some of the hand writing i cannot read. i will announce the first name and last letter. jessica w. doctor theresa palmer. jennifer e. dana k. >> i am jessica a student pharmacist from usf. first comment 85/12 passed the edge later and requires cultural training. i would encourage as part of that plan the city of san

francisco its own cultural competency training. the population in san francisco is different from much of california. a cultural training would not be adequate to help provide the compassionate care necessary for the population of san francisco. second part of comment is related to what came up earlier. i work at a retail pharmacy nothing breaks my heart more when they come in to pick up the medication and they don't have the insurance papers. it takes days. they are homeless and they have to leave the pharmacy after 14 hours and don't get medication. they might be without de beat esmedcase and we can't find them to get the updated information. if we find the insurance we can't provide them what they needed. it is almost like the efforts of

the healthcare providers are almost gone to waste because they don't get the therapy that they need. >> than thank you. >> i am jennifer. i have multiple comments. regarding cultural competency, i heard statements about linguistic competency. in recent bargaining dph changed the way that they compensate staff when they offer services to clients in the native language. staff are discouraged from speaking in the native tongues because they are not compensated for it. staff are told do not speak the foreign language unless you are certified that is appalling.

regarding icm. i have to say thank you for talking with staff. when the criteria for step down was developed, it was not developed with any input from staff. if we change the way we do things to expect it to work we should not rely on consultants or those of the administrators we need to talk to those doing the work and touching our clients on a day-to-day basis. there was a moment where we mentioned stabilize, adults who do not stabilize. this brings me to the arts. the clients who are users of services in a high way need more care for a long time. this is a severe illness. when beds at the arf are closed we are not able to stabilize people to maintain the stagization. -- stabilization. we negotiated with the mayor and

came to an agreement about if arf. there are 23 beds vacant and 54 beds lost right now. people are evicted from the man or, from the aurora home and from -- 54 are evicted, homes are closing with 23 vacant beds and are not allowed to move people. i do know why that is. these people need a home. >> thank you. >> the thing that strikes me as essential pieces to puzzle with 4,000 people is the intensive case management. basically doctor sung said they did not increase capacity for intensive case management. thing whiteled down the waiting

list and some could go to other places but they had to increase the caseloads. doctor bland tells me 4,000 people, 90% don't have intensive case management. there is a critical absence of staff. i heard a lot of acronyms and aspirational starts but i didn't hear about when these 4,000 people are going to get taken care of. it sounds like at the rate we are going they are not going to get taken care of unless you get more staff and you really do it. it is very discouraging. >> thank you.

i have deanna law. >> i am deanna long i work for the san francisco community clinic nonprofit community health centers throughout san francisco. we specialize in providing culturally competent care in different neighborhoods. i just want to call out two things. that doctor bland and could fax mentioned that i was happy to hear. one is emphasis on the behavioral health work force. you

there are those with an

emergency medical bill. ab1611 would protect these patients against the emergency surprise bill. >> thank you. that is all the speakers i have. is there anyone else who would like to speak on these two items? if not it is in the hands of the commission. if you have a question or comment please identify the presenter to address that comment or question to. >> i think i don't actually have a question at this point because i think that the initial presentation on the challenges facing our behavioral health services was extremely comprehensive. i thank the doctor for taking on the role of the acting director to move forward with as much progress as you have been able

to do. i think that the key thing she has laid out and doctor bland identified was not so much the identification of the problems because those now have been very well elicited and certainly the doctor has helped summarize the issues that we are facing especially as you look at the homeless. i think the doctor has broadened that to say and the rest of our population needs a certain amount of support and health. we have heard the issue of cultural competent, the need clearly of language capability, the challenge of being able to actually meet the client. i don't think to say we are not going to say that. any door wherever would come in and now we are also looking at how we can outreach and try to

meet them where they are. i understand that we may go outside the doors to be able to bring them in at whatever location you are with your diagram, for example, but we need the outreach. this has been a very good discussion about how we are facing behavior health. i think the doctor for the next four or five years is saying that we may be looking at a change of even the entire process of both mental and physical health if the state's program about medicaid is actually carried out. going through a number of hoops yet, but she is warning us again and that fits fairly well with the rest of our presentations this afternoon in terms of all of the possible changes and even the planning commission issues of what to do about facilities.

i think that only shows the dynamic process that healthcare is undergoing. what i i see is one of the biggest challenges to try to answer these needs is really what is it that we are going to be able to have as a work force and it goes back to i think our health network was talking about. the real challenge right now is we are going to have all of these ideas, some of which are going to need immediate implementation to help the homeless, to help those who actually also have other mental health programs that are not homeless but need the same help because some of them are also on the streets. they are not getting the care they need. how many are not going to be able to be from the homeless population in the intensive care they need. where do we get that? we heard from the community

consortium they have trouble and we have heard that, i think that is really one of the biggest challenges. i understand with the new director of human resources we need to identify people or we can't put them in a system and we have to accelerate how we work with identified personnel, potential personnel because they will go elsewhere. the identification of personnel and keeping them going is almost as critical as looking at opening the new hospital or as we were looking at the personnel for management of the epic program. i see that as a lesson that i have gotten today that is a real challenge and how our director is going to be able to work with

the different -- well what opportunities they are going to have. i could ask the director what he view views as a way to move on this and what we might look for in terms of implementing what are very nicely developed and certainly well thought out ideas. >> i am sorry are you specifically asking about the work force? yes, we can't identify personnel to carry out the programs that we are working on, we are not really going to move the needle. >> this is something that is for michael brown in the back now, our new hr director i talked with nim within his first hour of starting laying out a plan to focus and recruit on these positions. going back to your comments, we

have a proof of concept with regard to hospital skill. it takes considerable resources to do that, right. if you look at what mayor breed has talked about as increased investments in the work and we need to talk across the different stakeholders including unions and civil service to provide incentives for people to come and stay in the work. we have been looking at things to have more opportunity for people to stay, other incentive programs as well. we also need to create a culture of excitement with h.i.v. having reengaged in the h.i.v. clinic there. there are people that worked there for years. i think they could get compensated better in other places. they are mission driven and

inspired. i think many of our behavioral health team are committed to that. we need to expand that perspective in our culture that people can be shown to make a difference in that way. it is a combination of focus, data, priorities and making sure that this is a priority and people are supported in moving that forward. i would repeat that. also, shifting the culture with regard to where we call a difference when we do epic. many in the room were major contributors. it was a heavy lift, but we did that lift when we addressed the h.i.v. epidemic, we found a way to do that. key is those were not issues just one part of the department, right? that was not the only job of a

director within the units or section. that was a department priority and resources were brought forward to do that to make a difference. this problem didn't happen overnight and we are not going to solve it overnight. as you saw with the behavioral health network we are making structural changes to have a road map to go forward starting now and into the near future. >> one final comment with jeff. in regard to the work force. it is very important that work force be able to not just have the knowledge and the credentials. this is where i think unless we do that we don't reach equity. we can't answer the disparities. whether it be because of a

cultural issue in terms of working with african-american communities or with some of our other foreign language speaking communities that we are able to also work with that. i know that is the real challenge. it is very important for us to be able to answer the disparity especially for a fairly sizable part of our population. >> thank you. >> i would make a comment that for the first time in many years i have been a part of the system i see a cultural shift in the government entities in relationship to the community that we have been serving all of this time. what we need to do is continue that cultural shift in the government and cb o community so that when we deliver what has been presented today that those communities, those cb os and the department people are invested in and committed to

doing the work because without that shift, we will be having this conversation next year and i do not want to have it next year. i want to also suggest that because it was so explicit in doctors presentations we understand where we are going now we have though create resources and will to get there. i thanks you both for the reports that were educational for me as well. other comments. >> i would echo that. you have done a very comprehensive job of identifying the population. of course, the challenges of the work force and the aspects about the population that is so critical. i wonder if you collaborate a little bit how you envision the behavioral health services

working to the goals. do you have any targets? i know there are some about how long it takes to house people, what percentage would be housed in certain period of time. that is not part of mental health. are there any new targets you have developed that you think you can reach in the near term? i also notice i think there are 800 people right now working within the mental health system. have you thought about how you u can redeploy these people to the top of their licenses, incorporate remote providers, which is a huge opportunity for us, where you are going with that. where within the system you expect to find did leadership and creativity to move along in these paths you have outlined? >> thanthank you for the questi.

i am going to invite doctor sung the invite the second half of the question. i was assigned for two years to complete in survey to make these recommendations. it is important to acknowledge with in the two year timeframe there are many recommendations that our team is working to help the health development develop a framework for implementation we won't be present to see them did deployed. with respect to the work force, it is important to come back to the community member's comment. one of the key investments the mayor agreed to make is to supplement the number of intensive case managers. we have a target and goal. right now we have one case manager for every 17 clients.

when people have complex needs like the 4,000 based on our success in the department, full-service partnerships is one case manager to every 10 clients that requires more people, more case managers and also resources to recruit and retain. in thinking about the outcomes i have been pleased with the support and collaboration with the deputy director of support services looking at developing clear outcomes for the intensive case management services across the board. as pointed out earlier the system has been very closely focused on compliance and regulatory measures which are process measures. we are now taking the shift to ask the difficult questions about what where the actual outcomes associated with the

interventions. we think about care coordination and particularly for intensive case management, what is happening with housing status? how much do they spend time in jail? are they engaged in meaningful activity? are they engaged in physical and mental healthcare consistently? the baseline measures. we are pleased to have the partnership to assess the case management services at that level. i would like doctor sung to respond to the second half of the question. >> thank you for the question. i think the question was redeploying staff? yes, because we have to meet the needs of the changes moving forward. how do we deploy them? what will it lookalikes? we need to fill the current positions. that is one of the challenges.

we prioritize this and i appreciate the partnership as well. thinking about what is it going to take to hire staff and keep staff? what they see is you know what happens when you change staff, there is a loss of connection with clients. they have to learn. they get burned out if you have a one to 17 caseloads and they leave again. it is a cycle. the shifting will have to happen at the same time. does that make sense? >> thank you. >> thanthank you, doctor sung fr your service today and as we go forward. >> would you like to economic in? i would like to know the

commission has lost quorum. this is an informational session. would you like to check in about if rest of the agenda? >> yes, we have two other items the fourth quarter report and the office of compliance and private seize annual update. i would request that we move those to a meeting in the future. i am making that request to my colleagues up here. if there is no objection we will do that and i will have mark schedule it for us. >> i agree. >> we have agreement. we will move those items to a future meeting. >> you can consider adjournment at this point. you are unable to vote because you are not a full body so the meeting is adjourned. good night.

[♪]d night. ♪ 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. [♪] we are celebrating the glorious

grand opening of the chinese rec center. ♪ 1951, 60 years ago, our first kids began to play in the chinese wrecks center -- rec center. >> i was 10 years old at the time. i spent just about my whole life here. >> i came here to learn dancing. by we came -- >> we had a good time. made a lot of friends here. crisises part of the 2008 clean neighborhood park fund, and this is so important to our families. for many people who live in chinatown, this is their backyard. this is where many people come to congregate, and we are so happy to be able to deliver this project on time and under

budget. >> a reason we all agreed to name this memorex center is because it is part of the history of i hear -- to name this rec center, is because it is part of the history of san francisco. >> they took off from logan airport, and the call of duty was to alert american airlines that her plane was hijacked, and she stayed on the phone prior to the crash into the no. 9 world trade center. >> i would like to claim today the center and the naming of it. [applause] >> kmer i actually challenged me to a little bit of a ping pong -- the mayor actually challenge

me to a little bit of a ping- pong, so i accept your challenge. ♪ >> it is an amazing spot. it is a state of the art center. >> is beautiful. quarkrights i would like to come here and join them >> the new friday farmer his market is in the u.n. plaza. it features the best of san francisco. grab fresh foods and veggies from the heart of the farmers' market. shop from marker -- local vendors. engage in free diy craft sessions and grab lunch representing cuisine from around the world.

[♪] >> we offer 60 varieties of organic fruit and 30 varieties of conventional. one of our best sellers so sellers is our manager in. it is super sweet. we sell 600 pounds a week. one of the things they like about the market as i get to see my regulars on a weekly basis. i get to meet their families and kids and it is really good to be here. san francisco won my heart. >> one of our vegetables that is very popular is kale. a lot of people go for dino kale our mission is to make sure we have access for everybody to get organic foods, no matter your financial status. >> we make greeting cards, invitations, enamel pins, and we do workshops. i am participating in this market because it is a great opportunity for local makers to sell to a really diverse community of people in san francisco. >> they partnered with the market here and invited us to

come out and reach out to the public. we are going to do a full event of workshops where you get to arrange your own bouquet. we will teach you all the tricks and techniques and you will be able to take home a bouquet of your own. you. [♪] >> we really are wanting to bring opportunities to the community to introduce these local makers to a larger audience. >> this is my own pakistani recipe. it goes with rice, chicken, lamb we have a very delicious drink. we have a lots of variety of foods. [♪] >> we do lots of different curries. we do three different types of wontons. >> spring rolls, too. that's right. >> it is really great they are bringing out local artists from around the city to participate and really help us making our business more successful.

. >> i just feel like this is what i was born to do when i was a little kid i would make up performances and daydream it was always performing and doing something i feel if i can't do that than i can't be e me. >> i just get excited and my nickname is x usher my mom calls me i stuck out like a sore thumb for sure hey everybody i'm susan kitten

on the keys from there, i working in vintage clothing and chris in the 30's and fosz and aesthetic. >> i think part of the what i did i could have put on my poa he focus on a lot of different musical eras. >> shirley temple is created as ahsha safai the nation with happens and light heartenness shirley temple my biggest influence i love david boo and el john and may i west coast their flamboyant and show people (singing) can't be unhappy as a dr. murase and it is so fun it is a joyful

instrument i learned more about music by playing the piano it was interesting the way i was brought up the youth taught me about music he picked up the a correspond that was so hard my first performing experience happened as 3-year-old an age i did executive services and also thanks to the lord and sank in youth groups people will be powering grave over their turk i'll be playing better and better back la i worked as places where men make more money than me i was in bands i was treated as other the next thing i know i'm in grants performing for a huge protection with a few of my friends berry elect and

new berry elect and can be ray was then and we kept getting invited back you are shows got better we made it to paris in 2005 a famous arc we ended up getting a months residencey other than an island and he came to our show and started writing a script based on our troop of 6 american burr elect performs in france we were woman of all this angels and shapes and sizes and it was very exciting to be part of the a few lettering elect scene at the time he here he was bay area born and breed braces and with glossaries all of a sudden

walking 9 red carpet in i walgreens pedestrian care. >> land for best director that was backpack in 2010 the french love this music i come back here and because of film was not released in the united states nobody gave a rats ass let's say the music and berry elect and performing doesn't pay very much i definitely feel into a huge depression especially, when it ended i didn't feel kemgd to france anymore he definitely didn't feel connected to the scene i almost feel like i have to beg for tips i hey i'm from the bay area and an artist you don't make a living it changed my represent tar to

appeal and the folks that are coming into the wars these days people are not listening they love the idea of having a live musician but don't really nurture it like having a potted plant if you don't warrant it it dizzy sort of feel like a potted plant (laughter) i'm going to give san francisco one more year i've been here since 1981 born and raised in the bay area i know that is not for me i'll keep on trying and if the struggle becomes too hard i'll have to move on i don't know where that will be but i love here so so much i used to dab he will in substances i don't do that i'm sober and part of the being is an and sober and

happy to be able to play music and perform and express myself if i make. >> few people happy of all ages i've gone my job so i have so stay is an i feel like the piano and music in general with my voice together i

>> the bicycle coalition was

giving away 33 bicycles so i applied. i was happy to receive one of them. >> the community bike build program is the san francisco coalition's way of spreading the joy of biking and freedom of biking to residents who may not have access to affordable transportation. the city has an ordinance that we worked with them on back in 2014 that requires city agency goes to give organizations like the san francisco bicycle organization a chance to take bicycles abandoned and put them to good use or find new homes for them. the partnerships with

organizations generally with organizations that are working with low income individuals or families or people who are transportation dependent. we ask them to identify individuals who would greatly benefit from a bicycle. we make a list of people and their heights to match them to a bicycle that would suit their lifestyle and age and height. >> bicycle i received has impacted my life so greatly. it is not only a form of recreation. it is also a means of getting connected with the community through bike rides and it is also just a feeling of freedom. i really appreciate it. i am very thankful. >> we teach a class. they have to attend a one hour

class. things like how to change lanes, how to make a left turn, right turn, how to ride around cars. after that class, then we would give everyone a test chance -- chance to test ride. >> we are giving them as a way to get around the city. >> just the joy of like seeing people test drive the bicycles in the small area, there is no real word. i guess enjoyable is a word i could use. that doesn't describe the kind of warm feelings you feel in your heart giving someone that sense of freedom and maybe they haven't ridden a bike in years. these folks are older than the normal crowd of people we give bicycles away to. take my picture on my bike. that was a great experience. there were smiles all around.

the recipients, myself, supervisor, everyone was happy to be a part of this joyous occasion. at the end we normally do a group ride to see people ride off with these huge smiles on their faces is a great experience. >> if someone is interested in volunteering, we have a special section on the website sf bike.org/volunteer you can sign up for both events. we have given away 855 bicycles, 376 last year. we are growing each and every year. i hope to top that 376 this year. we frequently do events in bayview. the spaces are for people to come and work on their own bikes or learn skills and give them access to something that they

may not have had access to. >> for me this is a fun way to get outside and be active. most of the time the kids will be in the house. this is a fun way to do something. >> you get fresh air and you don't just stay in the house all day. iit is a good way to exercise. >> the bicycle coalition has a bicycle program for every community in san francisco. it is connecting the young, older community. it is a wonderful outlet for the community to come together to have some good clean fun. it has opened to many doors to the young people that will usually might not have a bicycle. i have seen them and they are thankful and i am thankful for this program.

>> hi, everybody. good morning and thank you for being here. thank you to the foundation for hosting us and i am pleased to be joined here with a number of our leaders including my partner in these initiatives, supervisor mandelman as well as our new district attorney. and members of the task force. i just want to thank all the members of the task force who participated in this process. i think supervisor mandelman and i had a conversation when he and i talked about this task force and what he wanted to do with it , and he said specifically to me, i don't want to do a task force that does a report that just sits on the shelf