programming to go beyond 90 days. i'm wondering if there's room in the city's programming to contract with a provider that is an abstinence only provider, and if not, why not? when we say there's an array, there would be people who might presumably for whom abstinence might be something worth trying. why would we not contract with them as well? >> by far, most people that go into treatment are looking for abstinence. and we support that totally. >> why would we require the -- why would we require all the providers in the universe that we deal with be people be providers who are willing to not have an abstinence model? >> it's not that they not have an abstinence model. it's that being inclusive of people relapsing.

>> but given people can go to different programs and if the one -- if the abstinence only program is just you can't -- that didn't work for me. folks are going to try different programs probably. what is the harm in having abstinence only programs in the array of options? >> so abstinence programs definitely have worked over the years for people who fit in and can stay there. we're concerned that the people who don't, not be dropped. and that's what we mean when we say that there has to be harm reduction approaches. and also, in the middle of this epidemic, there has to be a response to overdose, if it happens, inside the program. regardless of whether a person was abstinent yesterday, they may relapse. >> why is that on the program rather than -- i mean, why -- a person tried the abstinence program. it's not working.

we can move people between programs, right? if program a wasn't working, wouldn't we try program b? >> yeah. but we have to know it didn't work. if they just leave, it may take us a long time to find them. we want the help to be immediate. like the intensity of treatment to be increased in response to that. the one program that sees itself as abstinence-based does that. they put people who relapsed into their management program, detox program. >> what is that program? >> the salvation army program. >> is that a program that we are able to contract with? in >> so they -- they didn't meet the 2016 r.f.p. for various reasons. but they do contract through forensics. so several forensics grants.

so prefer that sometimes people who go through being incarcerated and are coursed into treatment, sometimes the people who are in treatment say this has to be abstinence based. >> do we measure the success of those programs against the success of the non-abstinence-based programs? >> every program is successful if people can stay, usually. so we don't have a good way to measure it. it's not intent to treat measure. you don't take 50 people and send half one way and half another. most of the people in forensics are coerced into treatment. and don't have much -- [simultaneous speaking.] >> i think it would be interesting to try to get a handle on which programs work for whom. how do we compare them? what are the right assessment measures?

rather than kind of -- and maybe these decisions in the 2016 r.f.p. were based on actual data and the kind of assessment i'm thinking we should be doing. but i'm not totally confident from your responses today we're doing those assessments and comparisons of different programs and how well they work and who they do or don't work for. >> i'm sorry. we have a regular measurement. it's called outcome measure that we do for every program. it's part of being licensed. you have to do that. and one of the things we look at and it's part of our contract as a performance measure is reduction in use or abstinence. and we measure that every year. and we have a 70% rate of that. and so we look at that every year. and we have, you know, reflective data discussion about any program that doesn't meet that. and why not.

anybody in in treatment for at least 60 days we expect them to reduce use and/or become abstinent. residential programs, most of them have institutional abstinence you might say. so it's a little bit not fair to use that measure and compare it to outpatient in the real world, where people are more likely to relapse. >> all right. thank you, dr. martin. this is, you know, clearly a conversation the city is going to be continuing. and thank you for your work. i'm reminded -- this hearing has reminded me we are well overdue for another treatment on treatment on demand. the last one was september of 2019. vice chair stefani and i called for that at the time. i think everyone, including supervisor haney was shocked by the city's assertion we were meeting treatment on demand goals. i think some of the questions supervisor haney asked about,

are we trying to get customers? you may meet your treatment on demand goals if you're not not seeking to boost demand. but i think it is well past time for us. i hope there was a 2020 report. i don't know if there was because of covid. but we ought to have another treatment on demand hearing. i'm imagining vice chair stefani might be interested in doing that and supervisor haney and others. thank you, everybody. thank you, vice chair stefani. >> thank you. i know chair mar has questions. i'm quite baffled that you said 12-step programs are not treatment. i don't understand why psychologists, psychiatrists recommend people go to a.a. or n.a. for treatment for alcoholism. i don't understand how that can be said. and also, this discussion around maybe programs dropping people of 12-step programs and maybe a

particular program might have those rules in place, but anyone in recovery knows that relapse is a part of recovery. and in 12-step programs, you're never shunned away for relapsing. everyone knows that that is something that happens with alcoholism, addiction. if you relapse and you're in one of the 12-step programs, you will be welcomed back. you will be welcomed back with open arms. there's no dropping anybody. and i just want to make that very clear. and i also want to make very clear that there's a lot of recent studies out on 12-step programs. in the "new york times" in march of 2020, basically saying it's the closest thing in public health we have to a free lunch. i'm not going to read the quote, because i know a lot of people want to speak in public comment. and chair mar wants to ask some questions. and i want to give a chance to some of the people in the recovery working group that also have additional questions.

so chair mar, with that, do you have any questions? >> chair mar: yeah. thanks, vice chair stefani for calling this incredibly important hearing and for this really really important discussion we're having today. i want to thank all of the presenters, community advocates and leaders for sharing your powerful personal stories. and really also your recommendations for what ready needs to happen based on your lived experience. and really struggling with these important issues for years or decades. i do want to really acknowledge that. i hear and support your call for the urgent need to expand access to treatment and recovery programs. our city alongside our harm reduction programs. and also, i really hear and support your call for community-led, peer-based and really black-led solutions and

programs. my colleagues have already sort of touched on a lot of the questions that i had for dr. martin. but i did have one question more around services and supports for young people and transitional-age youth. as a parent of a teenager i was struck by but not surprised by the information presented that i think it was 61% of the survey respondents began struggling with drug and alcohol at the age of 18 or younger. and 17% at the age of 13 or younger. you know, i believe one of the presenters, rico hamilton pointed out our city currently has very few or maybe zero treatment programs specifically for young people. so dr. martin i wanted to see if

you could respond to this, the need for really targeted programs for young people, transitional age young adults. >> yeah d.p.h. has a division for behavioral health. there are programs that are specific to adolescents. the way they approach substance abuse disorders, knowing that that's a time when people start using, is to do sort of wrap-around services in case management and also address emotion and mental health issues. usually there's a lot of trauma. and one of the features about that early phase of people starting to use drugs, is that

the diagnose, the formal diagnose is -- can vary a lot from day-to-day. so it's important to keep addressing it. but they may not need the high levels of formal treatment until -- they might need it for a short time, is what i'm saying. so there's more chance of getting over it, the sooner you address it. the other thing we know about youth services is that the earlier the age of beginning to be exposed to drugs, and the higher and more frequent the exposure, that the more of trouble they'll have later. they won't do as well in, for example, in school, training, and jobs and so on. and the outcomes are much

harder. so we have prevention programs for youth. and in particular to reduce binge drinking. we have a strengthening families program. which is essentially a primary prevention program training adults to talk to teen-agers about drug use and teaching teen-agers to talk about adults about drug use. and modelling it over a family meal. and having it, you know, monitored and for fidelity and supported. and that's an evidence-based program that eye effects people 20, 30 years later they're still doing better than the people who didn't do that program. so i am glad to have evidence-based primary prevention programs in the city. i think that the co-training of

people of the providers like the social workers and counselors and therapists who work with adolescents includes not only mental health but substance abuse disorders and should continue to do that. it's not that we don't have programs. it's that they don't show up on the substance abuse side even though they're cooccurring. probably the place in substance abuse treatment is the pregnancy programs. because it's a younger crowd usually that gets pregnant. and also, of course, we see the people who are on probation, the young people. and homeless youth substance abuse treatment is offered there

by medicine folks. >> chair mar: thank you, dr. martin. i know the working group members have their hands up for questions, so i believe we have people waiting to speak in public comment. but vice chair stefani, did you want to take -- do you have further remarks or do you want to lead the... >> supervisor stefani: thank you, chair mar. i don't have further remarks at this time. i feel we turn it to public comment now and, steve, we come back to you and go to those that have their hands up. i see victoria and tom want to weigh in in. does that sound good to you, steve? chair mar, can we open it up for public comment. >> chair mar: great. mr. clerk. >> clerk: thank you, mr. chair. operations will check to see if we have callers in the queue who are ready. for those who have connected via

phone, press star followed by 3 to be added to the queue if you wish to speak for the agenda item one. for those on hold in the queue, continue to wait until you're prompted to begin. you will hear a prompt that informs you your line has been unmuted. that will be your opportunity to speak. those watching on san francisco cable 26 or streaming link or www.sfgov.org, please call in now following the instructions on your screen. you'll dial 415-655-0001. enter the meeting i.d. for today's meeting. the meeting i.d. is 1877819333. following that, press the pound symbol twice and then press star followed by 3 to enter the queue to speak. can you connect us to our first caller.

hello. is there a caller on the line? if your line has been unmuted, it's your opportunity to speak. is there a caller here? we hear you. >> my name is james daggs. i've been listening to the presentation. and you know, my family came to san francisco from a segregated south to have a better opportunity in san francisco. and we never thought that a generations and generations would be living with drug addiction. however, listening to this meeting, we've seen that the department of public health --

you know a lot of policies make a lot of sense in theory. however, in working and practice, some of the work that steve are doing in the community is true -- it's policies that truly work. we need to have more options and different treatment for individuals in san francisco can get the treatment that they need. and i definitely know that the work that they are doing, it works. you know, me as a young person that experiences substance abuse and in the criminal justice system, i've seen how a community-centric program helped me. the supervisor and everyone made great points. hopefully you're taking it into consideration so we can have a program that truly helps the community that helps the african american community.

that understands the need of the community. and not people who have -- don't really understand the community, is not giving the community what they need. we need more options. and more opportunities to serve our community. programs that are led by african americans and led by the african american community that has a deep interesting in helping the community so that we can continue to move forward. you know, a lot of people are dying from these drug addictions are our family, our kids, our loved ones. and it's truly hurting them. you really won't understand the experience... [beep] >> clerk: thank you for participating. can you bring us the next caller, please. is there a caller on the line? a reminder once again, if you

hear from the system your line is unmuted it's your opportunity to have your two minutes. caller, begin. >> hi. good afternoon. my name is rebecca jackson. i'm with the center on juvenile and criminal justice. and i run a program in the city that is called cameo house, we're an alternative sentencing program for homeless women with children here in the city. 90% of the women who are in our program are women of color that come from the neighborhoods of the tenderloin, the bayview, the mission. 75% of those mothers are -- 75 percent of them are mothers. and the population that we try to serve here are extremely complicated in that they are coming from points of extreme poverty.

they've experienced homelessness. many of them have mental health challenges. mostly based on complex trauma they've experienced from life, years of domestic and street violence. substance use. justice involvement. a lot of times leading to active c.p.s. cases. adrian had spoken early on in this meeting that show that women are the fastest growing population that is suffering from these situations. and their situations are perpetuated. and they use substances for all of these different reasons. and as a provider, we are long-term. and we are abstinence-based. it's our experience that abstinence-based programs is vital. and so is the length of stay.

we think that it's a travesty, because where do these women go? where does a homeless woman of color in san francisco who is dealing with these challenges, with these barriers, where do they go? what options are available to them? [beep] >> clerk: thank you, rebecca jackson for participating in the discussion. can you bring us the next caller, please. >> hello, everyone. my name is malik washington, the editor of the san francisco bay view national black newspaper paper. i am a recovering addict. i'm a person released from federal prison. i'm in the community. i stay at the tenderloin. i'm at the taylor center. i don't want to talk about that. i have litigation with that place. i do want to talk about this: what are we going to do about

cameo house? it is a black woman, rebecca jackson, providing services for black and brown women, who have suffered from ptsd, mental health issues, substance abuse issues, sex trafficking! we do not have another program like this in the city. yet there are entities and individuals that are trying to defund cameo house. we need to look at it, people. my name is malik washington, the editor of san francisco bayview black newspaper. thank you for letting me share and have a blessed day. i want to thank all of you for the work you're doing. >> clerk: thank you, editor washington. can we get the next caller, please. >> good afternoon. [indiscernible] i'm -- harm reduction strategy -- the stigma

people with punishment and shame. through education, opportunity, supportive services and respect. people are punished for drug use. many people will continue to use drugs and engage in chaotic behaviors despite abstinence and conservatorship -- with respect to life of people who use drugs. our harm reduction services are vital to the cities most vulnerable communities to make our cities safer and healthier, including the risk of tran mission of hiv and hep -- hepatitis c. it's disappointing to hear the board of supervisors with self-acknowledged, unsubstantiated themes. [indiscernible] harm reduction

steps fully support the individuals -- access treatment modalities -- while some people have used drugs -- [microphone interference] >> wide spectrum of services to support people every step of their journey. -- alongside people who use drugs. our network of providers have strong working relationships with the california department of public health. people understand the actions is the continuum of care. overdose and other public health consequences will continue so long as we criminalize and put barriers to the most vulnerable. [indiscernible] [beep] >> clerk: thank you. could you bring us the next

caller, please. >> the harm reduction policy with the san francisco aids foundation. i want to say a big thank you to supervisor stefani for your very clear acknowledgment about how harm reduction works and that you support it. i want to thank steve adami and his recovery work group ensuring these conversations include the voices of those most affected. but i feel there's a profound misunderstanding why some services no longer exist in san francisco. the harm reduction policy was -- in 2000. most of the services that used to exist were eliminated in the 2009 budget cut. there are hundreds of millions of dollars of valuable community-focused services. and we have not started to come

back and rebuild those services. that's why we've lost so many of these. i want to echo the desire to have culturally focused to have black-led -- harm reduction, this ongoing pitting of harm reduction against abstinence treatment. so much of the city's funding goes to the residential treatment programs that by and large are serving people for whom abstinence or recovery is their goal. this idea that somehow we have extensive support for harm reduction services doesn't ring true for those of us on the ground, understanding there's so much more needed to save lives -- abstinence treatment

programs. i heard cedric's call to speak. and i'm ready and willing and happy to help figure out how we can expand... [beep] >> clerk: thank you, laura thomas for your comments. could you bring us the next caller, please. >> hello, i'm a provider serving as a health educator at the san francisco aids foundation. at today's hearing, it was mentioned there are open beds for treatment programs but those beds are not getting filled the rate they go. the question was posed how do we raise awareness? how do we get treatment options in front of people who use drugs? the answer, we access people where they are at. harm reduction are for people to learn about treatment options.

accessing services, people who use drugs are not giving access to lifesaving supply that help keep them alive -- examining

from using drugs to 100% abstinence takes multiple steps. some take all steps -- all 12 steps at once. others take one step at a time. harm reduction is -- thank you. >> clerk: thank you, caller, for sharing your comments. could you bring us the next caller, please. >> good afternoon.

i was part of the original team that implemented prop 36 in 2000 with bruce. and there was a definite choice to put that program through the department of public health to treat the substance use as a public health issue. we -- you had to try really hard to not get a treatment slot. in prop 36.

because we understood that relapse is part of the disease. unfortunately, it happens to be. we just found a program or another modality that worked for them. i've celebrated by 28th year of sobriety. when i heard the number of programs no longer in san francisco. i was appalled. half of those -- at least half of those gone were ones that we used for prop 36. we had good success rate. i also think there's a fallacy that people don't seek recovery until they're ready. this is not true. every time i had an encounter with harm reduction program, i knew that there was another way. and it was slowly building upon itself as a previous caller

said. i really hope that san francisco can find an answer to this. the fact that we've had more people die from overdosing than covid last year is appalling. [beep] >> clerk: thank you for sharing your comments. could you bring us the next caller, please. is there a caller on the line? . are we able to pass over a caller and come back? or is this the last one? it's one of the better programs to participate in.

it gives us the ability to see where we're going. the programs in san francisco has given me opportunity that has taken me out of my shyness and inability to feel comfortable. and allowed me to come outside of myself and not be ashamed of who i was but who i'm going to be. i'm grateful for that. i thank you forgiving me the opportunity to say that. >> clerk: thank you for sharing your comments. is there anyone further on the line to provide public comment? >> mr. chair, that completes the queue. >> chair mar: thank you, operations. public comment is now closed. i want to thank everyone that called in during public comment to share your perspectives on these important issues. vice chair stefani, do you want to move to close out this hearing? >> supervisor stefani: yes. i want to make a few comments on public comment and make sure we have victoria and tom i think

wanted to say something. but i do want -- i do want to thank those who called in for public comment. i think, you know, it's really unfortunate that it turns into a conversation of harm reduction versus abstinence or versus any other type of program. and to the first point, no one is talking about removing options off the table. no one is doing that. we're talking about adding things that this -- you know, this recovery group finds effective for themselves. i want to thank laura thomas for your comments. i want to continue the conversation with you, because i don't think we should be pitting methods of treatment against one another. and you know, as we think about the emotion behind addiction, emotions -- the emotion behind recovery and trying to understand why it drums up a lot

of these feelings of what -- we're against one another. it's not that. i think for addiction or anyone who is an alcoholic, an addict, sat through 1,000 alanon meetings because your family members are, and you know if your brother does one more of a certain drug, a drug of choice, it could be his last. when you know your sister takes one more -- could lead to her death, you know, when you feel that emotion, when you have that pain in your life, when you know what addiction can do to people, and you know addiction is a disease and people do things under the influence of alcohol and drugs that they would never

do sober, and then, they get in trouble for it, and its know -- they're not bad because they have a disease of addiction, what they might do from that, could be bad. could be criminal. the emotion behind addiction and the emotion behind recovery is real. and i think we need to acknowledge that for all the people here that have spoke, whose lives have been turned around. when victoria spoke, she finally got recovery. and that feeling of having recovery and knowing your life could be so much better than it was before when you were doing that drug, and you want other people to know the same experience. it's not just that you think someone might need methadone or narcan -- we have to continue those methods of keeping people

alive and meeting where they're at. but i think when people have profound experience with addiction, profound experience with a family disease of alcoholism and addiction and all of it, co-dependancy, all of it, when people grow up in that trauma, when people feel that trauma on a daily basis, they -- sometimes when they hear harm reduction, they feel -- they know that their siblings, they know that their parent can't take one more hit. they know their parents or their siblings or themselves can't take another sip of wine, because it will lead to destruction. i think that's where the emotion is getting in the way of sometimes the conversation of pitting these different methods against one another. laura, i definitely want to continue the conversation with you. i admire your work. and we have to meet people where

they're at. and sometimes where people are at and what this has shown me and what i hope has shown everyone through the recommendations, sometimes people are at a place where they cannot do their drug of choice for another minute. and we have to recognize that. we have to recognize, try to intervene in a way that is helpful. and leads people to paths of recovery. so that is what i intend to do in this hearing today. i think we've done a good job. and i appreciate all of the presenters. and i look forward to continuing to working with you, dr. martin. i'm hoping we can facilitate another conversation with you in working group off-line. and continue to talk about this. because we cannot continue in san francisco as we are now. it is unacceptable.

and we know there are programs out there that help people. so i want to turn it back over to steve to close it out. i know, steve, i really want victoria -- seems like she's had her happened up. i want everyone to feel like they've been heard. that's why i called this hearing. before we close this hearing out that those of you who have taken time to share your lives with us, your stories with us, have the chance to comment. and then, please know i'm going to ask to continue this hearing through a call of the chair, so we know this discussion is not over today, because it has to continue. steve. >> thank you, supervisor stefani. i want to make a couple of comments and i'll call on my peers to close out the meeting. first, i also want to acknowledge laura thomas. we've had a long-standing relationship when she was with the drug policy alliance. we value her work. i don't know why i feel i have to continue to say over and over

again. nobody is saying stop doing harm reduction. what we are saying is it appears our values are different. i'm no different than the guy at hyde and jones with a syringe in his arm. i'm now in a leadership role, overseeing staff and had somebody left me there, i wouldn't be sitting here. we believe people can change. because we changed. was it fun? no. but thank god somebody cared about me enough to tell me the truth about my life! the judge who sent me to prison last is a friend of mine. it's incredible to me that if you had a son or daughter dying on the streets of san francisco, that you would not be interested in an all-hands-on-deck approach to get them off the thing that was killing them! it's shocking to me!

it turns into this conversation about we want to respect the dignity of people using substances, of course, of course. we get that. but dr. martin, with the utmost respect, doubling down on the same things that are in the tenderloin, killing people, is problematic. it's problematic. we are going to do our outreach as soon as covid breaks. we're going to do our own outreach to talk to people. i believe drug addicts are the smartest people on this planet. they're brilliant. but it's tough to deal with the trauma that leads you to drugs, as adrian said, with a syringe in your neck. we have to be honest about the conversations, man. it becomes very polarizing. most of the people that gave public comment -- [audio interference] >> i'm willing to bet they've been to prison or been homeless

or had a syringe in their neck. i am willing to bet. all of us have. i think we laid out a good case. we're not asking anybody to stop anything. what we're asking you to do is embrace change. embrace that people can change. that we don't need to live on methadone. we don't need to live on suboxone. we don't need free housing. what we need is a fair shot at getting our lives back together. we all got that in different ways. you know, i recognize that i probably shouldn't be where i'm at. somebody believed in me. we believe in others. cregg and cedric run a group on friday nights, 25 years now, don't get paid. people show up on covid every friday night. you want to talk about what the people in the community need? somebody should contact cregg and cedric or adrian.

it's obvious to me that nobody is listening. and it's sad. it is incredibly sad. and i want to say it one more time. my thoughts, my views, my opinions are not reflective of where i work. they're reflective of who i am as a person. and the friends i choose to keep and the people i continue to associate with. the biggest difference between this entire conversation today is what department of public health views, because they have a big job dealing with a lot of stuff. and what we value on a microlevel. and i think if you believed in approximate people, like we believe in if people, things might be different. i want to make one last point and turn the meeting over to my colleagues. you mentioned d.p.h. abstinence-based treatment. harbor life is not funded

through the city money. it's funded through the state board of community corrections. they were told they had to do medically assisted treatment in their wellness center. why is everybody opposed to funding a black-led treatment program? what do you have to lose? more of the same? i mean, we had 700 overdoses last year. could it get worse? could we have more on the street shooting dope? do we need more kids walking down the street where people are shooting dope? when can we be honest about the state of the affairs here? it's taxing to constantly have to go in and make sure you're super cognizant that you might hurt somebody's feelings. i'm a drug addict. you can't call me that in san francisco. i'm a substance user or something. no. i'm a drug addict. i lied, cheated and stole every day. i did a bunch of time and probably should have done more. i want to be honest.

i don't believe i could get clean in san francisco today. i'm grateful for the intervention i received because it propelled me to a place where my family answered the phone. i have friends. i can pay my rent. i have a job and i have healthcare. i couldn't do that with a syringe in my neck. i couldn't do that strung out on methadone or suboxone, relying on government to give me free housing. i'm able to do that every day because i get up at 6:30. i come to work. i work to 9:00 or 10:00 at night. i don't ask for extra money. i do what is asked and give it my all. why? because there was a woman in 2014 i met when i was in graduate school who believed in me. she taught me a lot. and that's why i'm here today. so i try to pay that forward and believe in others. i really want to encourage dr. colfax to come meet with us. that's who i would like to talk

to >> change is possible. and you have to believe that internally. you have to believe that people want to and can live differently. you just saw examples. our working group has 80 people in it. we're no different than the people in the tenderloin or the mission or in soma right now, possibly dying. i'm going to turn the meeting over to victoria westbrook and call on tom wolf and richard beal. and supervisor stefani, thank you. >> this is victoria westbrook again. dr. martin, you said that most people you're dealing with at the s.i.p. hotels and community are not seeking treatment. i went to treatment not seeking treatment. right? as a drug addict, what i was seeking was drugs and more drugs and more ways to use drugs.

so i really think that -- and there could be a lot of reasons why people aren't seeking treatment, right? in addition to the fact that what they want to do is keep using because that's what they know. they could have been to some of the programs and not gotten clean, so why try again? or know people who have gone to programs and didn't get clean. there's a lot of reasons for that. we can talk to people in different ways than we are right now with community members to let them know that they can go to treatment. i never felt demonized or stigmatized in my abstinence-based program. i have no problem saying i'm an addict. i don't feel any shame around that whatsoever. so i just want to put that out there for supervisors that may not understand certain things about addiction. thank you. i think tom wanted to speak, too.

>> thanks, victoria. and judy, i know you're in a tough position, because you're the only representative here from d.p.h. i commend you and you know in stepping up. and listening to everything. so look, you know addiction is a lonely disease. it's a disease of isolation. but recovery in the community, as you could see here today, we're a community. there is a community of people in recovery in san francisco that are willing and wanting to step up and punch up for san francisco to save people's lives on the street that are struggling with addiction. and anyone struggling with addiction, we want to show you there is a better way. we want to show you change can happen through recovery. and as an example, when i was on the street, when i was outreached to on the street, it was to give me clean drug

paraphernalia, which is great. but nobody talked to me about treatment. on the street, i had no idea where i could access drug treatment in san francisco. these are some of the things we're asking the board of supervisors to sit down and have a conversation with us and the department of public health about so we can start improving our -- and start utilizing our resources to promote and share the gift of recovery through treatment with people so that we can at least give people on the street an opportunity to make that choice. right now, the only choice that is given to them is that if you want to use, use safely and don't kill yourself. that's the choice that is being presented to people. and i fully support that, because i was in the tenderloin yesterday. and all my time, including the time on the street, i've never seen such desperation as i saw last night on golden gate and hyde last night ever in my life. these are the things we want to help facilitate change with. i would think and i think you

would agree, judy, we all have a recovery community in san francisco, want to reach over and work with the department of public health and hope project and glide to help supplement the services offered right now with harm reduction. with viable, easy access treatment options. we want to be part of that conversation and help. that's why we're here. thank you so much. >> richard, you're the last one and maybe cedric and we'll wrap it up. >> okay. all right. so dr. martin, thank you for coming. hopefully, next time we'll get a chance to talk. i was listening to what you were saying. and you mentioned the 15 detox beds and the 32 residential beds. and we have thousands and thousands of addicts out there using. i hate to tell you, 15 beds isn't enough. and they're not even -- those

beds are not funded by d.p.h. and rental assistance has more beds. those few beds are not enough. there's only a handful. there's no place to go. when i got clean i sat down in the detox and there was 50 other people and laid on a mat. they don't have a mat now. they don't have a place. there's no detox to go to. there's no place for addicts to get cleaned. the doors are all closed. we need more treatment access. we need more treatment programs. you know, it's so obvious that what we're doing is not working. and everybody wants to use the excuse, covid. and everything wasn't working before covid. what covid did was exacerbated everything. case managers stopped seeing people because of covid. i heard a lot of issues that you brought up because of covid or -- and then, the thing that you said about housing and d.p.h. don't do housing. that's a problem in the city itself.

housing, d.p.h. needs to come together and get a solution. you talked about going through the step down programs from seven months and two years. i did transitional housing. i know every day thousands of units were opened. and then, when they move people into housing, guess what? because they don't receive support services and substance abuse services, they use. the they don't pay their rent and go into that vicious cycle all over again. it's a system that is bound to fail. it's set up to fail. and the sad point is that the money is going to the problem, instead of the solution. that's the problem there. if they had a bridge from residential housing to transitional housing to permanent housing, there wouldn't be that gap. you talk about the break in the link. you said it.

i don't know where they go. i don't know where they go after they do the shelter-in-place after fema started paying the money. it's 100% funded by fema. what happens when fema ends? they go to the street and use dope again and go back to the same vicious cycle. we have to do something different. it's not working. thank you. >> i'm sorry. sorry. i get that on our end. supervisor stefani, thank you for calling this hearing. chair mar, appreciate your time. supervisor haney and mandelman, john, for coordinating all this stuff. and supervisor stefani, to your staff, especially andy. we are incredibly grateful for your work and your commitment to people in recovery.

and dr. martin, it's great to have you on board. and it's great to have you as part of this conversation. i know that you've been really committed to the street-level drug dealing task force. i know tom speaks highly of you. i think while some of our values may be different, i think our overarching goals are in the continuum where they fit together. we really would like to continue this conversation. we need to find a way to get people off of drugs. that should be the goal. we're commit today doing whatever is necessary. whatever the board would like, we're here. please let us know. supervisor stefani, thank you again. this was an amazing hearing. >> i'd like to say i appreciate what everybody said. and i was listening. and i am a director. so hopefully, we'll continue to have the conversation. >> supervisor stefani: thank you, dr. martin for being here.

and thank you, steve, and everyone. thank you, chair mar for scheduling this and thank you to my colleagues.