it is actually our table. please invite the people who know best how to craft the solutions to make those solutions. thank you. >> thank you. next speaker, please. >> good afternoon. i am with the coalition on homelessness and i will not pretend like i can speak to this point better than everyone who was before me, but i do want to echo the department of public health claims that most reversals are being done by drug users because they are on the spot and they are informed. contrary to the very large portions of this community. and to dissolve those possibilities of having a community that is present and informed while overdoses happen, i talk about the sweeps. it is killing people and it is absolutely making no sense to put law enforcement and public works in the place of other members that know what they are

doing, that know the signs and know what to do when there is an overdose happening. i think, as the board of supervisors, you have the capability of supporting narratives that humanize these people that are on the street, regardless of how they ended up there and regardless of what choices they are making with the options that they have. you need to rebuild the narrative around these people that is built around compassion rather than condemnation. thank you. >> thank you. next speaker, please. >> my name is lydia. i work with saint anthony's. i have worked there for the past 14 years. in my time there, through my education, most of which i received through our guests, not through training, has been it is time and attention. it is like taking the time and paying attention that garners

the biggest ability to support people. with safe injection sites, with the ability to spend that time and attention with people, you can make real changes to help people to make choices for their lives. when you are approaching someone who is on the street and who is in crisis, it is difficult to have a conversation with that person that isn't directive. we want to move away from that model and move into a model where you can take the time to listen to people and be able to understand. which is they need to understand the help in their lives. we lost two people this year at st. anthony's from our staff from overdose. we had someone overdose in our staff bathroom and we were able to reverse them. we do overdoses -- overdose reversals every week, two, three , four, five, 10. our staff, our onboarding, they are onboarding enormous amounts

of trauma around these issues. mostly because they don't know how to help other than to keep forcing overdoses. thank you. >> thank you. next speaker, please. >> hello. my name is giant -- jane and i have spoken to you many times. first of all, i want to echo every single thing that has been said before me because everyone is saying the right thing, but what i am here to say is to let you know what it is like to live at seventh and mission and let you know that this is beyond a crisis. if this was an earthquake, we would have an immediate response every single city department would pull out everything they have. this is as bad as an earthquake and we are not doing that. so i have talked -- all of my good friends of that department of public health of all the right ideas and we are all working on it. i read it will take two years to open the 24/7 a clinic clinic that we need.

i watch reversals every single day out of my window. my brother died from a drug overdose. i know what this is all about. i know how hard it is and how long it takes to treat. but just reversing a drug overdose without offering follow-up treatment is sending that person right back down that hole. so we need to absolutely escalate everything you have heard here. we need to put every single city resource behind it. we can't wait two years. i watch it every single night. i watched people revived, i watch people die right outside my window. it is not safe for us who are housed and live in the neighborhood. one of my friends testified yesterday. he is disabled and walks with a walker. he can't walk out our door and he can't pass down the sidewalk. all i am saying is this is urgent and this is a crisis. please act as quickly as you can thank you for bringing this forward. >> thank you. next speaker, please.

>> i want to thank the supervisors were getting this hearing on today and thank matt haney for calling it what it is, it is an emergency and a crisis. i work at late harm reduction programs. the harm reduction -- there's a harm reduction t-shirt that says support, not punished. it is a simple message but it is one that has not been inherent in the manner it needs to be. people who have substance use disorders should never be punished or having a disorder. they should be supported and programs should be saving people with dignity and respect and any time that the choice is, should i support or punish and you are choosing punished, then there is a problem with the paragraph that you are using and it will be ineffective. everything -- everywhere where we have had successful interventions have always had a nonjudgmental and a compassionate way of engaging those folks. normally people who use drugs are heavily abusing drugs in our front and center of those organizations.

so we have to rethink how we are doing this and we have to expand on program models that are successful. the expertise in this room, in this community, we know how to do this. the department of public health knows how to keep overdose numbers down. those projects have done incredible work with minimum resources and that's when -- one of the reasons why we have such low numbers here and we have benefited from not been contaminated in the drug supply. it is only going to get worse until we take more action and we have more resources. please direct your resources at the agencies that know what they are doing, that can engage the population and we can take this number down dramatically and any time you think a war on drug solution, law enforcement will never work when it comes to preventing overdose deaths. thank you.

>> thank you. next speaker, please. >> hello. thanks for having me today. my name is william on the outreach coordinator for hep pepsi prevention services. thank you for pulling -- bringing this up. at the end of the day, it has been said in so many different ways where it is needed, but i will say a little bit from my perspective as someone who is out there in the trenches on a daily basis. and who has been doing this work for almost 20 years in the city. i care deeply about the people that we serve. and as someone who, by necessity subscribes to the philosophy of harm reduction, because i do -- i believe in evidence-based and public behavioral health

interventions, and that is what we do in harm reduction. we don't do opinion based treatment. unfortunately substance use treatment was for so long in this country. things are changing. [please stand by]

water and bathrooms.

many people experience homeless use drugs to survive on the street. and when they lack access of basic needs, they can use unsafe ways that increase the risk and preventable overdose. we must ensure we respect the community of san francisco by guaranteeing access to basic human needs and universal mental health access to everyone. safe injection sites are a great way to reduce disease like hepatitis c and hiv. we need to act right now. we need overdose prevention sites now. let's end the epidemic now. thank you so much. >> thank you. are there -- next speaker. >> a lot of the drug people are alluding to are highly toxic substances, these individuals are making bad choices and their vices are killing them, half of

all iv users in the city have acquired hepatitis, it would probably require another quarter of a billion dollars a year to credit them with medication. drug use is sensation-seeking behavior. people may look like terrible wrecks laying on the street or staring at a crack on the sidewalk but rest assuring they are enjoying their high if they are not having a psychotic reaction in public. i drove across mexico years ago, a drug gang dumped 35 bodies on to the highway. a couple months before i arrived and the drug gang disappeared, 40 university students a couple months after i left. we have been reading about communities in mexico being turned into war zones as gangs fight to feet american demand. i would like to know if there is an estimation of the amount of money being spent on elicit substances, how that money is obtained and if local police are

working close with the f.b.i. over the remainder of the bureaus enhanced efforts. >> thank you. are there any other members of the public who would like to speak on this item before i close public comment? seeing none, public comment is now closed. supervisor haney. >> well, first of all, thank you to everybody who came out and spoke. i'm glad we did public comment first because i think you all really added so much to the conversation and so many of the folks doing this work every day and have really been a part of where most of the ideas that are in this legislation have come from. and also i want to thank the dope project and the union, we did a lot of trainings in the community and here at city hall, and i think that was a powerful statement of the collective responsibility that we all have in the course of this epidemic. i have a few things.

but i figure maybe you all might want to go first. i see supervisor stefani. >> supervisor stefani. >> thank you. thank you, supervisor haney for calling this very important hearing. and thank you for everybody who came out out to come and for the presentation. and a few things i picked up in public comment that i wanted to just touch on. i liked what someone said about compassion rather than condemnation for those that are, of course, suffering from the disease of addiction on our streets. also what david said, i think it was our first speaker in terms of having people out on the streets with our peace officers and sometimes public works employees that have experience with addiction and who are homeless outreach team are people that are -- if we are making contact with people, we

have to have people on the frontlines to know exactly what addiction is all about. and i think that that's something we need to get better at in terms of coordinating with responses to what we see on our streets. and i wanted to say something too that i'm very, very, very familiar with addiction and have a lot of experience personally in my family and have been through the ringer on several aspects of this problem. i'm sure you look at me and you probably don't think that. and i -- when you said something about compassion rather than condemnation, i thought, of course, that applies not just to those who are using drugs but those, i think that are affected by people who use drugs, daughters, sons, mothers,

fathers, public. and there are so many people that are affected by those using drugs. and i think we often judge those people as well. and i think we need to suspend judgment for all aspects of this problem. and drug use is not always peaceful. and when we have to respond to it, it's not always pretty, right? and i think a lot of times we don't want to criminalize addiction, of course, but behavior that results in people being harmed because someone's addiction which i've seen in my own family that is very difficult. and the consequence of people's drug use, at times. and that has to be taken care of in a way that i think causes a lot of conflict.

and i think we need to understand that aspect of it. i have so much compassion for people who are suffering from addiction. i think more than you will ever know. and i want to thank you, again, supervisor haney for calling for this. i also just want to make sure that we are all on the same page in terms of understanding that not only is the crisis for those that are experiencing addiction, and we have to find a way to help them, whether or not it's increaseed use of narcan, making sure we have people going out with our police officers who do go out to get called to events that could harm the individual using drugs or somebody on the other side of that. and we need, i think, to have compassion for all those

involved. and i want to continue to participate in the conversation and want to make sure that we suspend judgment and try to hold space for not just those that are suffering from addiction but also those that are affected by somebody else's addiction. and like i said, those, the passer by, that's someone's daughter, that's someone's son. it's someone -- it's the police officer sometimes who doesn't probably even want to respond to that call. and i know that the sweeps are an issue, definitely. and you want everyone responding to someone that is suffering on the streets with compassion and not with aggressive force or anything like that, of course. but i just want us to try to hold space for the entire -- the

entire problem of one's addiction. and like in 12-step programs, all the jum too, it's a harm reduction -- people judge harm reduction, people just abstinence. it's whatever works for people trying to recover. it's one of the reasons in the program, people make a list of those they harm and become willing to make amend to those they have harmed. so i want to hold space for all of it and have compassion for every person that is touched by the problem of addiction. so thank you, again, supervisor haney for calling this very important hearing. >> supervisor walton. >> thank you. i just want to reiterate the understanding that, one, we know we have a crisis that exists in our city right now, and it is a health crisis. and it needs to be addressed as

such. one of the reasons why i'm very positive and excited about mental health sf is because we will be sending out mobile crisis teams with medical and mental health professionals versus law enforcement. and that is an important piece of the work, because we cannot continue to send folks out to work with our population that has addiction and substance abuse issues and try to address it with law enforcement and punitive means and strategies. and so we are committed as members of the board of supervisors to address this health crisis with strategies that are -- and responses that are under the lens of addressing this as such, as a health crisis. and we are going to be focused on doing that together, whether it is safe injection sites, sending out folks to work with

our population that have the expertise, experience and working in our communities and with our communities that suffer from addiction. i did want to just a quick question as we talk about the street-based engagement strategies that you are utilizing on our team. are you also working with the vehicle triage center? is that your team that's going to be out? >> we are not currently working with the vehicle triage center. but we are constantly looking at other partners that we collaborate with but at this point, no. >> thank you. >> i will echo the thanks of my colleagues to you, supervisor haney, for authoring this resolution and for your commitment on this issue, which is heart breaking and tragic. and i am struck, whenever we have a hearing that touches on

these issues how -- we talk about the siloization of city services but how siloed our conversations about these issues are and the conversations of folks who are impacted by encampments are just completely -- the head space of folks who are experiencing an encampment is in such a different place. and if there was some way to have these different conversations somehow like kind of engaging with each other as someone who is participating in both sets of conversations. i don't see a universe in which encampments are going to be allowed to remain in terms of the health of the people who are living in the encampments, i fully accept the healthiest thing might be to allow the encampments to remain where they are and i can't imagine in a democratically-governed cities that we are going to move to a

place where the sweeps end entirely. i think the burden on the city is to find better, healthier ways of creating other spaces for people to be. and i think over the next year we need to take a hard look at whether our shelter policies are expanding the places for people to sleep in a way that gives folks an alternative. are we giving people places to put their stuff so that their stuff does not become an impact to the community? are we giving people the places where they can use drugs safely? are we managing the ongoing addictions of people who have been to treatment over and over and over again? you can increase your funding for residential treatment beds and it's not going to work for everybody, and those people aren't terrible people, they just need a way to live. so i want to thank you, supervisor haney, and i'm eager to work with you on this. >> thank you. and thank you for your work and

your leadership on the meth task force and the many hearings you've been in with this, and particularly looking at meth and how we can respond more effectively there. i'm going to -- because i promised this wouldn't be a super long hearing, i'm going to sort of say a few things and that i would love to have follow-up on, and i know we are an ongoing conversation as well as with the partners in the room. so rather than having you come up and answer each of these things, i'll sort of put a number of things out there, and i hope we can find a time to have follow-up on these things. the first is i'm very excited about the street-based engagement. and one of the things that i would like to understand is how we have the level of street-based engagement that's necessary to meet the need and how we understand that and how we measure that.

many of these things, whether it's the mobile outreach medical teams, encampment health fairs, harm reduction therapies, how often they are out there, how many people they are reaching, goals around reaching more people. and obviously in partnership and coordination, because often we'll see there will be very large numbers of folks who are out there and having an understanding of how we are reaching them. and then under the harm reduction approach, the levels of engagement that we are bringing them into and how we understand sort of that set of goals that we have of folks who are out there. and i know that there are different areas and i obviously represent a district where there's a lot of this, but it's not only in district 6. this needs to be more of a citywide response. i live on haight and eddy and i walk to tenderloin every day and have some sense of what it looks like there. but i'm sure mission and haight

street and other places as well and getting a sense of really what that looks like and how we can be more supportive. a lot of this, i recognize it's a shared responsibility, what more do we need to do under that? i went on a ride long with ems6 and thinking about the approach they are taking and how this fits into this and that sort of model, you know, i think often in terms of the silos, people mention that h.s.h. and police and d.t.w. need to be a part of these conversations. i agree. there's also the fire department. i think it plays a role in this and sort of how they are being integrated in a way that's helpful and effective. the detox and drop in and sobering center conversation i think i still need a bit more there. it came up when i was meeting with folks who do street outreach saying this is a need we hear about again and again and there's not a lot of places

for people to go. and i see there's some sort of longer-term plans around that. but how are we really moving with urgency in light of the emergency that we are facing to establish those locations and i know it was part of the recommendation for the meth task force as well, but really moving much quicker on that. the data and reporting is something i would like to continue that the dialogue around, the fact that i'm still referencing 2018 data and we are in 2019. i would like to understand why we can't do better on that. i introduced an ordinance that maybe it's not do better, it's how are we -- what data do we have and how are we using that effectively to respond with our community partners to get the information out there to save lives and also as city hall more broadly, without knowing -- i have no sense of the sort of the

trends or the locations, like as someone who represents the communities that are -- have a large part of the impact, i have no knowledge when there's huge amounts of -- whether it's overdose or deaths on the streets that i represent, i have no knowledge. and it's not about me but it's about our city government and our partners and everybody knowing the data that they require to be able to respond. i love some of the comments about both peer outreach and how we do that effectively and post-treatment opportunities in terms of of the stepdown and what is the level of need in terms of folks who are coming out of treatment to make sure that they have housing available. i know this has been an issue in a lot of other hearings we've had as well. it seems like a lot of people said that -- and i agree that we

have been a leader, and we've been doing a lot of things that are effective, but one of the things that changed in a big way is the introduction of phentynol. and i didn't hear how that has changed what we are doing and the response that we have. because things are different. and we expect that in some ways it could get worse. and so how is this issue of phentynol changing the things we are doing as a community and what people are seeing and what the needs are? i absolutely -- we spoke a little bit about the connection between making sure treatment is available for people who want it, when they want it. when i was out meeting with folks and doing street outreach, there was some sense that some folks might be open but if it's come back the next day or the other day, and it's a lot of barriers to access. and there's not housing guaranteed on the other side.

they might not want to participate in that. or it may be much more difficult for them to participate. and kind of as a general thing, one more thing and a general thing. the overdose prevention sites and safe consumption sites, i've been of the view we need to move on this immediately and quick liz live as possible. i think that's been the view of the community as well. we are all in dialogue, many of the folks in the room along with laura thomas who is here and the mayor's office around how best to do that because of the legal questions. but we are going to push as hard as we can on that to make it happen as soon as possible. and a general thing and part of the reason why i introduced this resolution with others is because i think that our residents and supervisor mandelman and the community is demanding of us to understand the severity of the crisis that

they are seeing and experiencing. and they want to see a response from the city that meets that crisis. and i sort of had a number of things that i thought would be the categories and there's a lot of stuff here. i'm not sure i see something that is as big or as urgent in terms of addressing what's happening right now. and i want to understand what that would be, because we need to make sure the funding is there. we need to make sure the input is there and that there's the commitment from us as a city, because i think for a lot of folks, and i'm sure all of us are out there every day, what we are seeing, what we are hearing, who we are talking to, some of that may not be based on opinion, not on evidence, but we do see evidence of increasing overdose deaths. there's no doubt about that. and what we can do to stop that from happening and what we can

do to address the broader crisis. i think it's our responsibility. and i hope that we can have bigger, more urgent solutions that meet the level of the crisis that we have. and i just want to end this by saying i appreciate your work, i appreciate the work of everyone in this room. none of this is an attack on the work that's being done. it's a shared commitment for what we need to do together and what you need from us to be able to fulfill our responsibility to you and your work. and our responsibility to the residents and small businesses and everyone else who are screaming and yelling for more assistance. and so with that, lots of things to follow up on, and i want to appreciate you for allowing me to have another hearing here on this topic. and i know that we will continue the conversation, and certainly all of us will continue our work together to respond.

thank you. >> thank you supervisor haney. i don't think we can have too many hearings on this topic. i do share your desire and interest to see us make things move faster and get them bigger. so thank you. i'll move we forward this to the full board with positive recommendation. we can take that without objection. thanks everybody for coming out. mr. clerk, do we have any other items before us? >> that concludes our business for today. >> well, then we are adjourned. ...

san francisco is surrounded on three sides by water, the fire boat station is intergal to maritime rescue and preparedness, not only for san francisco, but for all of the bay area. [sirens] >> fire station 35 was built in 1915. so it is over 100 years old. and helped it, we're going to build fire boat station 35. >> so the finished capital planning committee, i think about three years

ago, issued a guidance that all city facilities must exist on sea level rise. >> the station 35, construction cost is approximately $30 million. and the schedule was complicated because of what you call a float. it is being fabricated in china, and will be brought to treasure island, where the building site efficient will be constructed on top of it, and then brought to pier 22 and a half for installation. >> we're looking at late 2020 for final completion of the fire boat float. the historic firehouse will remain on the embarcadero, and we will still respond out of the historic firehouse with our fire engine, and respond to medical calls and other incidences in the district. >> this totally has to

incorporate between three to six feet of sea level rise over the next 100 years. that's what the city's guidance is requiring. it is built on the float, that can move up and down as the water level rises, and sits on four fixed guide piles. so if the seas go up, it can move up and down with that. >> it does have a full range of travel, from low tide to high tide of about 16 feet. so that allows for current tidal movements and sea lisle rises in the coming decades. >> the fire boat station float will also incorporate a ramp for ambulance deployment and access. >> the access ramp is rigidly connected to the land side, with more of a pivot or hinge connection, and then it is sliding over the top of the float. in that way the ramp can

flex up and down like a hinge, and also allow for a slight few inches of lateral motion of the float. both the access ramps, which there is two, and the utility's only flexible connection connecting from the float to the back of the building. so electrical power, water, sewage, it all has flexible connection to the boat. >> high boat station number 35 will provide mooring for three fire boats and one rescue boat. >> currently we're staffed with seven members per day, but the fire department would like to establish a new dedicated marine unit that would be able to respond to multiple incidences. looking into the future, we have not only at&t park, where we have a lot of kayakers, but we have a lot of developments in the southeast side, including the stadium, and we want to have the ability to

respond to any marine or maritime incident along these new developments. >> there are very few designs for people sleeping on the water. we're looking at cruiseships, which are larger structures, several times the size of harbor station 35, but they're the only good reference point. we look to the cruiseship industry who has kind of an index for how much acceleration they were accommodate. >> it is very unique. i don't know that any other fire station built on the water is in the united states. >> the fire boat is a regionalesset tharegional assete used for water rescue, but we also do environmental cleanup. we have special rigging that we carry that will contain oil spills until an environmental unit can come out. this is a job for us, but

it is also a way of life and a lifestyle. we're proud to serve our community. and we're willing to help and we're willing to help people in any way we can.

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to shape the city's future. - thank you for considering a career with the city and county of san francisco. blame, -- bleiman, and i am the president. we do ask that everybody turns off their cell phones or puts them on silent, including commissioners and staff. i want to thank sfgovtv and media services for sharing this meeting with the public