>> good morning. the meeting will come to order. welcome to the thursday, march 25th meeting of the public safety and neighborhood services committee. i'm supervisor gordon mar and committee member matt haney will be joining us. and we're also joined by supervisor melgar for item number 3. thank you to john carol and i'd also like to thank sf gov staff for this meeting. do you have any announcements? >> i do. for one thing i want to note that, mr. chair, in order to protect the board members in the 2019, the chamber and committee room are closed. this precaution is taken pursuant to all local federal state and local orders and

directives. committee members will attend the meeting. if they are physically present in their committee room. public comment will be available for each item on this agenda, both san francisco cable channel 26 and sfgovtv.org. you have an opportunity to speak and provide your public comments on today's agenda by dialling by phone (415) 655-0001. once connected the meeting i.d. is 1874560963. press pound. when you're connected. you will hear the meeting discussions ongoing but your line will be muted and on listen-only. when your item comes up, press pound followed by star 3. please wait until the system indicates you have been unmuted

and you may begin your comments. best practices are to call from a quiet location to speak clearly and slowly. everyone must account for potential time delays and speaking discrepancies we may encounter during the live streaming. alternative, you may submit public comment in either of the following ways. you may e-mail me john carol. my e-mail address is john.carroll@sfgov.org. you may submit your public comment by paper by mailing it to our office at city hall. city hall 1 dr. carlton b. goodlett place, san francisco, california 94102.

>> supervisor mar: thank you, mr. clerk. can you please call item one. >> clerk: agenda item 1 liquor license 496-14 street. members of the public who wish to provide public comment on this hearing should call the public comment number which i will repeat. (415) 655-0001, enter the meeting i.d. of 1874560963. press pound and then press star followed by 3 to enter the queue if you wish to speak on this hearing. mr. chair. >> supervisor mar: thank you, mr. clerk. we're going to first hear from the san francisco a.d.c. liaison unit. officer sellenson you're here

to report. >> yes i am. good morning. bar part time if it's approved this allows an on-sale beer and wine public premises. there are no letters of protest or letters of support. they're located in block 403 which is considered high crime. 202 is considered high saturation. alcohol liaison unit recommends with the following conditions that a petition shall actively monitor the area under their control in an effort to prevent the loitering persons adjacent to the property as depicted on the a.d.c. and no noise shall be audible at any nearby residence and as of february 3rd, the applicant had agreed to those above listed conditions. >> supervisor mar: great, thank you officer sell nenson

for that. i would like to see if the applicants would like to make a remark. >> sure. justin dillal here. along with my colleague jeremy castillo here as well. we are extremely excited to be opening a bar in the mission in san francisco. it's been a dream of ours for a long time. jeremy and i have both worked in bars in the city the last several years and, yeah. kind of crazy opportunity due to the covid. a lot of shutdowns that happened. but we're super excited to have this opportunity to do what we've been wanting to go for a long time now. >> supervisor mar: thank you. and you're agreeable to the recommended conditions by the a.l.u.? >> absolutely. we're 100% committed to working with the neighborhood to make

it a positive place for everyone involved. >> supervisor mar: great. thank you. colleagues, unless you have any remarks, why don't we go to public comment. mr. clerk, are there any callers? >> clerk: thank you, mr. chair. for those who have already connected to the meeting by phone press star followed by 3 to be added to the queue if you wish to speak for this item, agenda item number 1. for those in the queue please wait until you're prompted to begin. those watching on our meeting through cable channel 26, if you wish to speak on this item, please call in now by following the instructions on your screen. i will repeat them. dial (415) 655-0001. enter the meeting i.d. of

1874560963. mr. chair, just for a moment while i check. we have no callers in the queue. >> supervisor mar: thank you. public comment is now closed. i understand that supervisor mandelman is supportive of this transfer in his district. so given that, i would like to move that we direct the clerk to prepare a resolution determining that this license will serve the public convenience and necessity and that we send the resolution forward to the board with positive recommendation. mr. clerk, can you please call roll. >> clerk: yes. i will prepare a resolution finding the public needs and necessities will be served and on the motion by chair mar that that motion will be

recommended. [roll call] >> clerk: mr. chair, there are three ayes. >> supervisor mar: great. thank you. thank you mr. dolezal, and good luck with your new business. >> thank you very much. >> supervisor mar: mr. clerk. please call agenda item number 2. >> clerk: agenda item 2. liquor license transfer. located at 845 market street will serve members of the public that wish to provide public comment on this hearing should call the public comment number which is still (415) 655-0001. meeting i.d. 1874560963. mr. chair. >> supervisor mar: thank you, mr. clerk. welcome back officer sellnenson

to represent the report on this item. >> okay. bloomingdale's has applied for a type 21 license and it's proved to allow them to provide an off sale general premise. zero letters of protest. zero letters of support. they're located in a plot 210 which is considered high crime. high saturation. the tenderloin station has no opposition. a.l.u. approves with the following condition. no distill should be. no wine shall be sold in bottles or containers less than 750 milliliter. beer or malt beverage should only be served in prepackaged multi-unit quantities. number four, the following alcoholic beverages should not be sold in quantities more than three individual containers for sale. that would be beer, malt beverages, and malt liquor

products. pre-mixed wine products commonly known as wine coolers and premixed distilled cocktails. and they shall monitor the area under the control to prevent any loiters on the premise. and, as of yesterday afternoon, i received an e-mail from the a.b.c. licensing rep that the applicant had signed those above conditions. >> supervisor mar: thank you, officer, for that report from the a.l.u. is the splint jacquelyn hercshfield here to make any comments? >> yes, sir. i'm here. can you hear me? >> supervisor mar: yes. we can hear you. good morning. >> good morning. on bhaef of bloomingdale's requesting recommendation of approval from the safety and

services committee. as well as the planning department and the police department have granted their approval. we are looking to enhance, you know, the high end shopper's experience at our locations. we currently, you know in our home section provide accessories, high end wine and bar accessories and we would like to provide high-end alcohol as well. for a one-stop-shop type of situation. >> supervisor mar: thank you. >> we will comply with conditions. we have agreed to that. sorry. >> supervisor mar: great. yeah. thank you. thank you for that. colleagues, do you have any questions or remarks? if not, why don't we go to public comment. mr. clerk.

>> clerk: thank you again, mr. chair. we're checking to see if we have any callers in the queue. i will repeat the routine. if they're interested in giving comment on agenda item number 2. you will dial (415) 655-0001. enter the meeting i.d. of 1874560963. press the pound symbol twice and then press star followed by 3 to enter the queue to speak if you wish to speak on this item, agenda item number 2. hang on just a moment, mr. chair, child i check one more time. and i'm seeing we have no callers in the queue for this item, mr. chair. >> supervisor mar: thank you. public comment is now closed. colleagues, i understand supervisor haney, in a you're supportive of this transfer? >> supervisor haney: correct. >> supervisor mar: so i would move determining that this

license will serve as public convenience and necessity and that we send the resolution forward to the full board with recommendation. mr. clerk, can you please call role. >> clerk: yes. i will prepare a resolution that the necessities will be served at the direction of the committee and at the motion of chair mar will this item be recommended to the board of supervisors. [roll call] >> clerk: mr. chair, there are three ayes. >> supervisor mar: great. thank you. also, thank you officer sellmanson for your work and your presentation this morning. >> thank you. >> thank you. >> supervisor mar: please call item number 3. >> clerk: agenda number 3 is

the city's reimbursement practices and maximizing funding. including but not limited to mental health med-cal administrative activities. members of the public please call (415) 655-0001 to enter for public comment. >> supervisor mar: thank you, mr. clerk. thank you, supervisor melgar, for calling attention to this important issue. >> supervisor melgar: thank you so much supervisor mar. i'm so excited to be in front of your committee for the first time. thank you supervisor stefani and haney for providing us the opportunity to hold this hearing. what i am hoping to achieve today is for the board and the public to gain a better

understanding of the city's medi-cal reimbursement practices and how we are not taking advantage of every available state and federal funding source for mental health services. at the board, there has been a lot of attention focused on the mental health crisis for many of our residents and the monumental efforts under way with mental health sf, thank you supervisor ronen and haney. i think we can all admit that after a harrowing year, we are facing a parallel pandemic with a mental health crisis. for all of us maintaining mental, physical, and social well being. how we as a society, we will address our collective trauma. we are receiving increasing

reporting of young people visiting the hospital due to suicidal thoughts or suicidal iduations. there is a deeper challenge to provide comprehensive mental health services to our children and youth specifically. so when i learned of prior board hearings and the california health report that san francisco was leaving millions of dollars on the table in medi-call reimbursements, i was pretty floored. every dollar we have claimed means we have left funding to impact support for children and our youth. that's not something we can live with. not when services are underfunded as is and when these services make such a tremendous difference in the lives of children and families. one of the components of the

community school model that is the foundation of the students' rights initiative that supervisor ronen and i have been working on is mental health services. both preventive and treatment available to young people and families at our public schools. youth organizations such as chinese progressive associations youth mojo have been working on this issue for years. it successfully got the school board in 2019 to pass a resolution to create schools as a space for student driven healing, transformation and growth and bring more resources into the schools like pr counseling. the youth commission is also watching this issue very closely and offering incredible insight on how to ensure responses that are led by youth voices. i look forward to future discussions about building out a comprehensive mental health system for our youth and children. today, i want to focus on the technical aspect of funding and

administrative support systems. so i'm really excited to share this that many efforts are under way and i want this board to be active partners to lift up and support this work. today, we have alex briscoe who is the principal of california's children trust. also, the department of public health and our own budget and legislative analyst office presenting. i want to note before we start that some of the department and agencies we requested to be here are not present today because their direct billing goes through the department of public health or dcyf. the san francisco school district was unable to staff today but their work will be covered and they are a very crucial partner in this work. through chair mar, i would like to start with the presenters and ask that we save our

questions until the end after we all present and i am very excited to ask alex briscoe the principal of the california's children's trust to begin his presentation. thank you. >> thank you supervisor melgar. i wonder if i can have the screen share activated help. that's activated. thank you. so i'd like to begin by acknowledging the many public sector leaders who've made today's presentation possible. in particular, the department of public health, the all children all families coalition, dclyf, hsa and numerous others. and, i'll ask that the elected officials and others listening take a deep breath. i had a mentor who said to me we have the most complicated

descriptions for the things we understand the least and there's probably no more winding road and difficult public sector administrative challenge than medi-cade. california devolves the vast majority for understanding and accessing these funds to the local level and it's really complex and difficult. and i will without doing too much on my background, i have directly worked in and built. i've been an emergency social worker, worked in schools, directed and designed mental health services for children. and for seven years, i was the health director in alemeda county. i worked having to work payroll. so i have the deepest respect for drew, dr. cofax and their team. this is tough stuff but a great opportunity. with that, i'm going to jump in. i'm going to move quickly because i have about 10 minutes. i'm going to give you some of the detail.

i'll skip it because supervisor melgar nailed it. there's something going on with kids. it's not just them crazy kids. there's actually real data. it's a uniquely difficult time to be a young person. if you didn't believe that before the pandemic, you probably believe it now. and we could spend the next weeks discussing why. is it 400 years of structural inequality? is it the availability of social media platforms on mobile devices beginning in 2009? is it a wealth of value that equates with merit? the answer is all of those things have made it an extremely difficult time to be a young person. and i'm going to take you through the map of medi-caid. and then i'll name the four projects that we have initiatived. and i'll finish with a couple comments about some statewide reform which hopefully will make your work easer.

first, supervisor melgar's comments the lives of children something happened. twice as many kids in our culture have tried to hurt themselves. there's a 100% increase. while length of state meaning the numbers of days you spend in the hospital decreased across our health care system for all disease burdens. it increased for pediatric mental health. young people told us. we actually asked them and they told us since 2005 they have self-reported need and it should come as no surprise, despite our progressive rhetoric as a state, we rank among the worst states in the nation in terms of access to mental health services. only 5

across our state. san francisco outperforms this data by about a percentage

point. san francisco is about 6.5% in the number of children who touch the system. the good news is you guys do better than the state. and we project as you all know that this number will increase meaning the number of working poor families that are falling into poverty is growing significantly. hopefully the stimulus act will impact that. and you always have to aggregate this data by race. 81% of those 6 million children are nonwhite. the suicide rate for black children is twice that of their white peers. so if we make -- if we have committed to making systems healing centered, it's just not a question of the mechanics we're about to talk about. it's not about getting that few million dollars here and if i million dollars there. we have to acknowledge the impact of structural racism on poverty and the social and

emotional health of children. it's not like all of a sudden twice as many kids got that logical. more than half the children who attempt suicide have no diagnostic history at all. hopefully, the resources we're about to talk about can contribute to that reimagining. i'm going to skip this slide. supervisor melgar did it better than i did it. go team. we suck clinically. we are seeing dramatic increases in utizization. whatever you call a crisis. that's what we're in now. oakland has seen a 100% increase. things are tough. so i want to teach you medi-caid in one slide. the underlying financial structure is always the same. and this is what i would ask

elected leaders to hold. i'm not going to ask you to hold every piece of business transaction that drew and his team have to do. but you can understand the basic concept of it because every dollar includes these two pieces. every dollar includes the federal dollar and the state or local dollar. these have technical terms. the nonfederal dollar is called federal financial participation. but you can distill every medicaid structure to this structure. you can think of it like a pot of gold sitting in dc. you get a dollar if you put up a dollar. the rules are different for each transaction. the ratio can be different. every dollar, every expenditure has a local and a federal match. so i would invite elected leaders and those listening today to be c.p.e. hunters. think of yourself as someone who's always looking out into my network of expenditures and

say where am i spending money on low income people. this is the formal definition from the department of health care services c.p.e.. these are all fancy words to mean a federal match and a local expenditure. let's talk about how that federal dollar flows through the states and counties. how does it show up in the lives of children and families. the first and biggest way is the health plans. in san francisco, you're a two-plan county that's the san francisco health plan and anthem blue cross. the school districts can bill medi-cal directly. really important the state plan amendment was just passed that expands their ability to bill. community health centers. health 360. and also your own san francisco health network are all federally qualified. they get an enhanced reimbursement.

the public health department itself can claim for case management and administrative activities. we'll talk about that today. public hospitals have their own way and the regional center. these are the seven different ways and not all of them are within your control. some of the health plans are directed by the state. some of the regional centers are surround the local health systems. the challenge for children and families is they don't care about these lines on the map. for them to negotiate these multiple systems who continually struggle with lack of resources, lack of accountability between and among them, we really struggle. and, again, it's nobody's fault. if you want to ask why are we where we are given that we have the fourth highest tax base in the nation and the 38th most spending, this is why. when everybody's responsible, nobody is. if you think of these thing,

our children, our families trusted us to meet with key stakeholders and identify opportunities and we did. and we were able to secure a philanthropic resource. 26 family resource centers received more than $15 million. so they received first five more than safe and sound and we analyze every single one of their budgets and the department of public health. and we developed a strategy. the rest of the frcs will come on board july 1st. it's a massive collaboration with all of your players. it's very much a pleasure to

work with so many people aligned and this will produce about a $15 million to $16 million expenditure ongoing. what's really important to note is if you can't reduce the amount of money you give to the frcs because any time you reduce the funding you spend, you reduce the claim you get. are you with me? we've been really clear that these dollars have to be considered on top of existing investments, not as a mechanism to reduce your existing investment. with that said, the next project we identified with ocof was the children's center. the most prevent interaction is in the first three years of their child's life. they go 12 to 15 times. we structurally deny access to services to the mom.

you can only bill once a day. so we work with the state and fed. plus being adopted around the state. also, we're working with san francisco unified school district. they have over 105 social workers that are not claiming medicaid. they're also getting a flood of money for school re-opening and other sources. we anticipate almost $100 million of new revenue will come into the school district, but it will be one time. so teaching and working with the school district for those kids who stop showing to up to zoom. everyone is aligned there. there's big opportunities.

we've been working with the department of behavioral health services division to look at the opposition. associated with the 1135 waiver. that's the federal disaster declaration that changed some of the rules of medicaid for the duration of the pandemic. there's opportunities for year department of health under that waiver. there's also opportunities to claim for administrative opportunities. these are defined as different direct services like health fairs like engaging communities and services. we will begin a direct charge long winded way of saying that if you divide all four of these

projects up you end up with somewhere between $6 million and $10 million revenue. these are all conservative efforts demonstrated. so in conclusion, this is what we call the trust for frame work solution. how will we reinvent mental health. so overtly anti-racist. we will figure out how to get more money because we're not spending enough. we will change the nature of the benefit. that's the new benefit we created with the state. so that we can promote justice. thank you for having us and again, thank you to all of the public and private funders who are supporting our work.

>> supervisor melgar: thank you very much. i'm wondering if there's any questions before we move on to the next presenter? >> supervisor mar: i don't have any questions, but i just really wanted to thank mr. briscoe for this really informative presentation and, yeah, just highlighting yeah, such an important issue and work that's happening and then more specifically the need to maximize us to maximize the federal funding that's available to us to really address the needs here in our city. >> supervisor melgar: i worked in a nonprofit agency that

provides a substance abuse order. one of the great things about the work that you're doing is the capacity building that you are providing for the department in terms of being able to, you know, train the trainers. to understand some of these issues and i am wondering if you think that the staffing infrastructure that we have currently with the four project is adequate to be able to make this work sustainable in the long run. >> well, i think i need to defer that question supervisor melgar, to drew and his team. yeah. i think it is. and i think actually that the skill and will is there. there is, you know, first of all, i need to say i'm a san francisco constituent. so i love living here. and, sometimes what it's meant is that we've funded things

that in other jurisdictions, you have to claim for and so that means it's as much unpacking the kind of history of progressiveness as it is any kind of capacity issue. drew, charlie, sair, marleau and team are all excellent. they know this work as well as anyone. historically, there hasn't been energy and pressure to get these dollars. yeah, again, so i don't see it as a capacity issue. i just see it as a almost focus issue. in terms of the staffing necessity, i think we need to figure that out. >> supervisor melgar: okay. thank you so much. i know when you were in alemeda county, you were tenacious about getting the reimbursement dollars when other counties

made an effort. and i am curious how you went about, you know, building the system's culture because that sounds to me like what you're saying. it's not so much a capacity issue. it's sort of a culture of wanting to do it. >> first. i need to say my mentors, vanna chavez who has since passed away. she grew up in a trailer in hayward, didn't have a college degree. and she used to say to me you have to hustle for medicaid as hard as poor people hustle for rent. and i feel that same energy from drew and their team. everybody's super open and they want to do this. i think if you ask where that culture came from it was from the people who taught me this work. >> supervisor melgar: i love that. hustle for medi-cal dollars. so that pieces out perfectly to

welcome drew morell from the department of public health who will present on that department's efforts. >> thank you. >> supervisor melgar: drew, are you with us? >> how's that? i unmuted myself. thank you supervisor melgar. thank you, alex. i appreciate this time to kind of talk through. i think i would like to level set and make sure it's clear. like i'm really speaking to the behavioral health portion of alex's slide. the california children's trust and the engagement they have with the city right now.

the target for my presentation today is the behavioral health portion of it. particularly on the f.r.c. side and additional claiming opportunities. but the presentation today, the focus is on what we can do for behavioral health claiming both in mental health and other opportunities. i appreciate the time to speak to it. it's an important, somewhat technical issue. sometimes people are bored by it but i'm always excited to speak to it. and i'm excited. i'm happy to be joined by fara aremond. let's go. here is an overview of the overall neighborhood health budget. it gives the flavor of the spending on the and authentic

then on the right is the revenue sources. we're really talking about the medi-cal reimbursement here and our administrative and other costs that have sometimes exceeded the state limit of allowable amounts. now, all of this is a big caveat for 1920. i think alex mentioned there was a waiver by the governor to lift the cap for the duration of the covid public health emergency. so we're really dealing in a different world this year with not having the same limits on what we can claim for administrative and other reimbursements and that's really meant a world of difference. we're still preparing the cost report but we expect it to be about a $3 million difference for d.p.h. this year. inclusive of that or external

to that, we continually work on optimizing our revenue and claiming practices. for direct services, the focus it has been to continuing to enroll clients in medi-cal, improve our screening and enrollment practices. we look for any opportunity we can for direct billing including peer services. outside of the direct treatment services, we have taken this year with alex's prompting a really targeted review on how we can better leverage our claiming opportunities for administrative costs. that includes utilizization that often falls into an admin and claiming diversity bucket. in addition to that, we're

reviewing and this is really where alex's work is directly involved. opportunities for mental health medi-cal claiming, this is a particular claim that says if we have the support of a time study or otherwise can say it's 100% of effort, we can claim cost directly to the state. e.p.h. had previously participated in that program and we ran into challenges starting in 2016. so i'll speak to the challenges. and this is where we have like a friendly discussion when, alex, i appreciate the work and the partnership. i do cringe a little bit when we talk about a federal match guaranteed. it's not guaranteed that we have a federal match. we've had the experience of

state audits that come six and seven years after the claim has been submitted and they find that there's a gap of 15 minutes in a particular employee's time and we are subject and lose the money six years back well after the money is out the door. that being said, that time study requirement was something that the state chose to implement in 2016 to say there's a new requirement for both to allocate their time in the clinical codes and allocate their time with d.p.h.

mh.m.a.a.. so this is really where we're challenged to implement mental health maa is to find ways and there are ways to claim under mental health maa without having to time study. in addition to the time study requirement, there are claims and that is some of the work that alex referenced was outreach. so there's particular type officers outreach that would be qualified ungd mental health m.a.a. that we are reviewing right now. we're reviewing the top 10 contracts that hold outreach dollars and trying to find areas that we can pinpoint mental health m.a.a. in one particular point. that would be for us to claim for that under mental health

m.a.a., fund it without the need for a time study. the challenge there is the audit window. we would be in a position of claiming funding a contractor, and then holding on to time records for that contractor for six, seven years and waiting to see for audit risk. i think that's manageable, but it does put some pressure on a choice of basically an audit deferrell or audit risk threshold. all of these are manageable. this is what we're working through right now with alex's help and i think happy to take any questions. appreciate the time. >> supervisor melgar: thank you. so much, drew. i know how challenging it is to work with the state and the medi-cal and thank you so much for all your diligence and trying to get every penny that we can.

i know that -- i had heard that you were working on developing a new app to figure out how to do billing in an easier way for providers. is that still happening? are we leveraging some private funding to do that? >> i think that's one of the elements of alex's work and that would be to the extent that we do have a time study app that helps when a clinician or a contractor engaging from the mental health m.a.a., but before we get there, we're at a stage where we may not need a time study. if we are able to find activities be civil service or contractors that are dedicated to a particular mental health. in those situations, we just direct charge and there's no need to time study because 100% of their time is dedicated to

that. in that case, the state has a different threshold for what document nation is needed for mental health m.a.a. >> supervisor melgar: also, for this board of supervisors, we can convince the state to not require this anymore because it's not a federal requirement, right? >> that's correct. it was a choice by the state for implementing mental health m.a.a. in 2016 and i hope to convey just how much their different choices at the state level have an impact on what we can claim and what we can't and that's really born out both with the lifting of the waiver this year going from 15% to 30%. that emergency action by the governor really changed our claiming dynamic for 1920. and this implementation plan, you know, when that was chosen introduced a time study

requirement that was really prohibitive for us continuing with mental health m.a.a. this is all changing the document requirements and working with the time line for audit reimbursements. i see is very much in line with the cal efforts which is just in general to make it less complex and less time burdensome for locals that the state is pursuing. >> supervisor melgar: well, thank you so much, drew. and i think, you know, i'm not going to speak for my colleagues but i think we are all very interested in making sure you're successful in that we can raise as much money as possible to support this work. thank you. and so next through the chair, i would like to invite fred russo and carl fatell from the budget and analyst office to talk to us about those efforts.

>> okay. thank you. chair mar, members of the committee, and supervisor melgar. i'm fred russo from the budget legislative analyst office. i'm going to speak today about our review of current efforts to increase medi-cal reimbursement for behavioral health services. i do have some slides. i will share here. and, are those showing up? >> yeah. we can see it. >> okay. great. so supervisor melgar asked our office to do a review of medi-cal administrative costs and reimbursement practices and the city's behavioral health

services division of the department of public health and the background of the question was this information that supervisor melgar mentioned and the other counties had been increasing their reimbursement through this mechanism called mental health m.a.a. or medi-cal health and administrative activities. it's a charging mechanism, reimbursement mechanism. so just the background on that fiscal year 2018-19. only 12 of 58 california counties filed claims using this mechanism. as mr. murell mentioned, san francisco discontinued claiming against this in fiscal year of 2015-16. but we did find that alemeda county had began claiming and this is when alex briscoe who spoke earlier was there and

they increased their mental health m.a.a. reimbursements from $3 million to $17 million annually betweenen 2004 and 2014. going after the mental health m.a.a. dollars. the reports we showed got an increase statewide from $17.9 million in fiscal year 2017 to $41.7 million reimbursed in fiscal year '20. while that sounds good, it's a small number of county that is are claiming. in fiscal year 1920, for example, los angeles county only got reimbursed $4 million and obviously their administrative costs are significantly higher than that. so there's a general reluctance to use this mechanism by counties. alemeda county being a great exception and we're interested,

of course, in can what occurred in alemeda county be replicated here. very quickly for context, the behavioral health services budget and drew mentioned this also. but we are looking specifically at the mental health side of behavioral health services and not including substance use disorder in this discussion today. so for fiscal year 2018-19, $316 million. drew had an update for more current years but we wanted to focus on this so we can track through how the reimbursements have worked use the that year as our baseline. and, on the revenue side, here we show the total of the $316 million again and you can see the federal financial participation which you heard referenced earlier was about $91 million.

the state money that's shown here which is realignment in two versions and mhsa and mental health services act funding is shown there in the three rows and that all together amounted to $133.9 million or about 42% of the revenue services and the county general fund is a big piece of the revenue sources for san francisco more than you find in many other counties in california because the city is committed to providing general fund revenues beyond what is required for medi-cal reimbursement. quickly, this is just a pie chart and it shows the breakdown and this is showing the county department of mental health provider network. you can see kind of the breakdown here mostly state and federal resources. and, here, this shows the community based organizations in san francisco general

hospital. similarly, there's a big chunk for federal and state. but what we also see here is the general county funds and work order money about $70 million in fiscal year 2018-19. so a lot of that is directed to our community-based contractors who provide behavioral health services. i won't go through this. i think it's been discussed in detail, but just generally back to this idea of the federal government provides a match of the 50% level of cost. so between the state and the federal government, the city is eligible for this one-to-one match of our costs that are incurred using the state and local funding and then matching it with the federal financial participation. and, this chart is just showing how certified public expenditures work. it's pretty straight forward. i think it starts at the local

level, goes to the state, funds are matched, and the federal government provides the 50% match. and then it tracks back down to our department and the direct service providers be they either contractors or to the department itself. so the behavioral health services division can claim medi-cal reimbursement through four basic services. direct services is the bulk of it. that's charging for or claiming reimbursement for costs that are incurred in providing services to medi-cal beneficiaries. then there is a mechanism called general administration and, through this, the department can claim an automatic 15% on top of the or on the direct service costs that are eligible under medi-cal for services. so all kinds of administrative costs like outreach and

contract administration, planning and policy development can be billed through that mechanism. a third is quality and utilization review. but it's also performed by clinicians and others in addition to providing direct services and other tasks that they perform. and then finally, this fourth mechanism mental health m.a.a., which we've talked about, this can be claimed in addition to this 15% general administration and there are certain categories of activities that are allowed under that that were also allowed under general administration. but there's a reason to claim both and i'll get to that in a minute. the key to all of this is behavioral health services cost report. this is a very complicated reporting system that tracks staff and contractor activity by activity and modes so that

they can determine whether or not certain staff costs and contractor costs can be claimed for medi-cal reimbursement. on the general administrative costs, and that's the second one shown in the box here where there's 15% of costs that can be claimed. what has happened in san francisco in recent years is that the actual eligible cost exceeds 15%. and so, in that sense, some money is being left on the table because only 15% can be claimed. now, some of that could be recovered through mental health m.a.a., but as we mentioned, san francisco's department is not claiming mental health m.a.a. and hasn't been since 2016. so there's the potential for additional funding for behavioral health services we conclude and this is after we've spoken to drew and some of the staff people in behavioral health services and looked at some of their

documentation and also interviewed alex who's working with them. alex briscoe from c.c.p. this is the type of activity that can be reimbursed as i mentioned previously. so how to increase the reimbursements. there are a lot of these categories that can be shifted. right now, there is staff and contractor time spent on what's called mode 45 activity which is medi-cal speaks for certain administrative activities. but it's not eligible for financial participation or reimbursement. this could include, for example, outreach. but if it's outreach for people for nn medi-cal programs, it wouldn't be reimbursed through the current mechanism. but medi-cal outreach can be reimbursed under mental health

m.a.a. and that's right now included in that 15%. but it can also be claimed under mental health m.a.a. so the idea would be to shift those mental health activities and claim mental health m.a.a. and allow other act its that are not being reimbursed to be claimed through the 15% general administration mechanism and/or mental health m.a.a. because both mechanisms allow for reimbursement of the same activities, but the 15% general administration mechanism allows for more activities to be reimbursed than m.a.a.. they can be moved in to m.a.a. that allows for the department to claim some of these costs that are not being recovered now because they exceed 15%. in addition, there's a strategy that can be employed and alex mentioned this so i won't go into a lot of detail which is if the contractor's direct charge for some of their

administrative activities, that can be reimbursed and it doesn't require the extensive time studies that are needed to fully utilize the mental health m.a.a. mechanism. so this chart is sort of showing what i just described and it's shifting a lot of the activity into the mechanism that allows for reimbursement of those particular activities and tasks and taking full advantage of these two sources, the general administration up to 15% of direct services cost and then mental health m.a.a. which allows for additional reimbursement that's being obtained now. we intended to come up with what might this actually entail or what this could mean for additional revenues because i think drew made the point quite

strongly and we're certainly sympathetic. this is not just easy of filling out forms, there is a time quality requirement which is time tracking by staff and contractors that isn't being done now. it would be an additional task that they would have to take on. there's an administrative cost to rolling it out and making sure it's done right and ensuring that, you know, an audit down the road will not show that, in fact, some of the funds that were claimed and reimbursed have to be repaid to the federal government. so but putting that aside just to get a feel for some of the numbers, on this 15% cap of what's left right now, we estimate about $3.2 million could be claimed and that's just the funds that are over the 15% cap that aren't being claimed right now and this is a portion that potentially can be reimbursed through federal financial participation. and, by the way, that's -- i

think we're being conservative. we believe there is probably more and you dig into the cost report as alex and his group and drew and his staff are doing now as they start this analysis that's under way. on the contractor side, this is, right now, we have about $286 million budget and that's from fiscal year '20 for contractor time. that includes some of their administrative costs but they have a lot of administrative activities that aren't getting reimbursed because they aren't claiming against the mechanism like mental health m.a.a. and they don't have the 15% general administration reimbursement in the same way the department does. so contractors have some opportunity here. we just came up with an estimate to give some feel for the magnitude and this is based on the assumption if the contractors are spending like say 5% of their time or costs

covering unclaimed administrative time which we do not think is an unreasonable assessment, that would translate into about $7 million in reimbursable costs and the portion of that could be and maybe could be reimbursed to this direct charge method that i described a minute ago that doesn't require a time study to the extent the contractors do implement a time study mechanism the funding reimbursed could be probably higher than the $7 million. but this is just to give some feel for the magnitude and to address the question of is this worth doing. whether it's a time cost study or burden staff and what we would be obtaining in additional revenues. this shows that the $3.2 million that we estimated for potential additional reimbursement based on the 15%.

and, here you see there's $25 million that was incurred and identified in administrative costs for the department, but only 12 -- or $9.6 million of that was reimbursed to the federal financial participation. whereas, $12 million or $3.2 million more could have been if that was all claimed and reimbursed using mental health m.a.a. in addition to the 15% cap. i've talked about the contractors and other staff as well and the potential there. it wouldn't require time to stud to do at least some partial claiming for their administrative costs, but it won't capture all the administrative costs. so the good news about that is there's even more potential to be reimbursed. the bad news is it does require implementing time study. on the horizon, the federal waiver and other speakers that

mentioned this where the general administrative costs can go up at least for a year starting in 2022 from 15% to 30%. so that's certainly good news. we'll allow for increasing the federal medi-cal reimbursement for department costs and we know already that they are more in the neighborhood of, you know, 20% or more of costs that have been identified it probably will not be difficult to get the full 30%. and, then the initiative that's under analysis through c.c.t. and the department will certainly aiming at increasing medi-cal reimbursements and we're optimistic about what we understand what we're doing that there's potential there. and, finally, the cal aim initiative will simplify medi-cal claiming requirements in the future and that's certainly good news for the

department too that has to deal with this complex reimbursement process on a daily basis. we did provide some recommendations and thought that just given the complexity of this and the difficulty of tracking medi-cal revenues, we thought it would be wise for the board to request the b.h.s. report back on a 6-month basis or so on how this analysis is going, what changes are being implemented such as time study requirements and what kind of results are occurring as hopefully medi-cal reimbursements increase as the changes get under way. >> supervisor melgar: excellent idea. thank you so much, mr. russo. thank you for the presentation and the recommendation. >> thank you. >> supervisor melgar: so that's it for our presenters. chair mar, we do have dr. faraman here from the department of public health.

i do have one question for her before, you know, we close this up if that's okay. dr. faramond, are you here with us still? >> i'm here. thank you supervisor melgar. hi everyone. >> supervisor melgar: i was wondering if you could tell us a little bit what efforts are under way to ashrine and coordinate the system of care centering children and youth and, you know, i know that when we spoke, you have some ideas about what additional funding if were available you could use for this. >> yes. thank you, supervisor melgar. hi everyone. thanks for having this hearing. i want to start by -- i will get to your question, supervisor melgar, but i want to just start by say echoing what supervisor melgar said at the beginning of this hearing. there's a lot of focus on the mental health. and as you can see in drew's

presentation, the children and family behavioral health services is a small fraction of the budget in compareson to the rest of the system. even though we are a smaller system and children and youth and families is a smaller population in san francisco, it's really important to invest in children, youth, and families to prevent them from being target populations in mental health sf. so i really appreciate this effort to identify for resources and support to invest in the children and youth family system of care. i have to say, we do have a robust mental health. i can speak to the specialty mental health system that i oversee. there's a lot of nonspecialty services that happen in primary care and other preventive efforts, but in thinking through the specialty mental health services, we do have a robust system and we have really tight partnerships with the school district, child welfare and juvenile probation.

there are a lot of efforts to reenvision the care. board of supervisors close juvenile hall work efforts. there is a lot of efforts around thinking through a continuum of mental health care from prevention all the way to sort of a secure and detention facility that is going to look different than the current one we have in place. so there's a lot of efforts where we are aligning our systems and thinking through a continuum and there's a lot of effort and focus with the school district between dcyf, the school district, and children and youth families. i just wanted to take this opportunity to pitch. i know i mentioned this to supervisor melgar. i just want to put out into the ethos while i have this platform that two of the major needs we have right now as a behavioral health system for children and youth family, especially this past year, the increase in acuity of youth the

increase in referrals, intense management, wrap around support, hospitalization stays, contact with our crisis system, acuity is through the roof and our top two needs are three beds for a crisis residential type of setting, like a 2 to 3-month stay. beds are hard to come by. all younger kids get placed out of the county and those are for short acute stays and the residential beds are also really hard to come by and they have to be system involved. so the school district or child welfare has to do that. if we have a two, to three-month bed stay that would be one top need. just $1.1 million and then the other top need is substance use. if there's anything that we're

really lacking in our system, it's substance use treatment and the needs are increasing. so we need to expand outpatient providers, get a residential bed and $2 million would help us with that. i also just want to say at the state level we're really a model of san francisco county for our behavioral health services, for our use of our data and in our agency partnership and with the school district child welfare and k.p.d. >> supervisor melgar: thank you so much for all the work that you do. chair mar, i'm wondering if any of your committee members or yourself have any questions for the presenters about this issue? >> supervisor mar: thanks again, supervisor melgar for calling importance to this hearing. actually i did maybe have a question either for mr. murrell

from d.p.h. or mr. russo from the d.p.a. for this issue that was heighted. it seems like there's an opportunity for us to get more reimbursements through medi-cal and through the state for administrative expenses for these very important programs. but then the -- there's a question of whether that extra burden on tracking those hours and reporting is worth it. so i'm just trying to understand this issue a little bit better and so for d.p.a. and mr. murrell. i understand from a.

>> chair mar, if i can just direct that for a moment, the data we have shows $17.9 million claimed across the state so definitely there's been an increase. more counties are claiming it. but i have to add, alemeda county is about half of that. so they definitely can be the leader which tells us can be done. i think more assessment should be done about what they did specifically. luckily alex briscoe used to be the director there.

other counties have done it as well and increased their reimbursement, but not at the level i suspect of their actual costs but there's an uptick in it and resistance to it as well for reasons that have been discussed this morning. >> supervisor mar: thank you. i think i noticed from your, mr. brazir from your presentation, you mentioned on the horizon there is a federal waiver that will allow us to increase the administrative -- allowable administrative reimbursement from 15% to 30%. so basically doubling it. >> correct. that is i believe and probably mr. murrell can confirm this, i think it's a one-year deal. it will be great to catch up but it's not an ongoing arrangement. >> it's actually extended for

the life of the public health emergency. so it was initiated effective in march 2020 and has been ongoing since then until the governor declares the end to the public health emergency. >> supervisor mar: do we have an estimate how much that increase from 15% to 30% allowable mental health administration expenses means for the city? >> yeah. it's a little tricky, but preliminary for 19-20 we think it netted us about $15 million in the initial cost claim. part of the difficulty is managing that estimate between our initial claim which is due in a week on march 31st for '19-'20. and reconciliation that comes

five years after the fact, many of the costs count against the admin and others and counted as direct services which allow more cost to go to admin and other and we're playing with the 15% cap. but our initial estimate is about $2 million to $3 million in '19-'20. >> supervisor mar: thank you for all your work on this. and supervisor melgar for your attention on these issues. >> supervisor melgar: thank you, chair mar. i think that i will also hope that we can, as a board support the work in a meaningful way. >> supervisor mar: supervisor stefani. >> supervisor stefani: thank you, char mar and through the chair to supervisor melgar. thank you so much for this incredibly important hearing. i care so deeply about the

mental health of our children and the issues around substance abuse. i definitely want to partner with you on anything i can. i also want to again call attention to the recovery summit working groups recommendations around youth programming and what we should be doing more for substance abuse programming for youth and the question we don'thave to get into now and whether or not the funding in question today is what exactly can be reimbursed in terms of the youth programming on substance abuse issues whether or not that can be used for absence based programming with full blown, you know, not just harm reduction which is obviously extremely important as well, but whether or not we are allowed to match public dollars when it comes to absence based programming.

i also had recently met with a lot of addiction doctors from ucsf and this was a conversation we had as well and i want to do anything i can to help on this issue and again, supervisor melgar, huge fan. thank you so much for this incredibly important subject and for pushing what we need which is the matching dollars and of course the programming and thank you to all the presenters as well. >> supervisor mar: thank you, supervisor stefani. for making the connection to that. it's really important hearing you held recently. and let's -- supervisor melgar, i don't know if you have any final further remarks. >> supervisor melgar: just thank you supervisor mar, chair mar. i just want to thank alex briscoe for being here.

i'm really excited for what we're going to do together. i want to make a special point of thanking maria stew, the director of children, youth, and families and our children our families counsel for leading this effort for bringing alex in, for having the vision and the foresight to elevate the mental health of children and, thank you to drew murell at the department of public health. marleau simmons, dr. faramond, the department of public health and of course to fred russo and carl for the budget and legislative analyst. so in closing, i'm hoping, chair mar, that you would be willing to continue this at the call of the chair so that we can check in as mr. russo had advised us to do on this ongoing work and to see if we can make progress. thank you so much for the time and energy. >> supervisor mar: thanks

again, supervisor melgar. and, yeah, i'd be happy to make that motion after public comment. mr. clerk, are there any callers on the line for public comment? >> clerk: thank you, mr. chair. we're continuing to work with the department of technology for caller who is want to comment on this hearing. for those who want to speak on this item, now is your opportunity. please do so by calling the following number. (415) 655-0001. after you've dialed the number, please enter the meeting i.d. which is 1874560963. press the pound symbol twice and then press star followed by 3 to enter the make a motion t

excuse supervisor haney. can you call roll, mr. clerk. >> clerk: on a motion offered by chair mar to excuse

supervisor haney. [roll call] >> clerk: mr. chair, there are two ayes. >> supervisor mar: thank you. and i move that we continue this hearing to the call of the chair. >> clerk: on the motion offered by chair martha this item be continued to the call of the chair, vice chair stefani. [roll call] >> clerk: two ayes once again. >> supervisor mar: thank you, supervisor melgar. and all the presenters. we look forward to seeing you back at the following hearing. mr. clerk, can you please call item number 4. >> clerk: agenda number 4 is an ordinance amending the police code's require peace officers who request a temporary emergency gun violence restraining order.

and to apply the california penal code pro vision penalizing violations of different types of restraining orders. parallel to gun violence restraining orders issued by an out-of-state jurisdiction. members who wish to provide public comment on this agenda item please call the public comment number. (41) 565-5001. i.d. number 1874560963 and press pound. >> supervisor mar: thank you, supervisor stefani, for your incredible leadership and dedication to the issue -- the extremely troubling and serious issue of gun violence in our country and especially coming after, you know the past week of just more tragedies. so thank you so much and thank you for sponsoring this legislation. the floor is yours.

>> supervisor stefani: thank you, chair mar. i really appreciate that. obviously, it's been a very trying time. not only did we have the mass shooting in atlanta and boulder, but there were other mass shootings that weren't as publicized and it's just tragic that this type of violence continues to happen in our country. it is very emotional. it is -- it's angering. it's so many things and you know we just have don't to push and use everything we possibly can to combat gun violence in our country because the american experience here is unique and it's one that we must do everything we can to erase from this on our country and i just thank you for those remarks. i'm turning our attention to the ordinance before us today is the expansion of our local law here on gun violence

restraining orders. i know you know what that is. i will say again that gun violence restraining orders they're also known as red flag laws and they empower house hold members or law enforcement officers to petition a court in order to temporarily remove a person's access to firearms before they commit violence. we know in many shootings that there have been signs and warning signals to family members like the one in isle vista in santa barbara where my dear friend richard martinez lost his only son. then, the family called the sheriff's department, their son had written a manifesto and they just had an inkling that something bad was going to happen. there was nothing they could do. they could not remove the weapons or do anything, and, unfortunately, lives were lost. so our first g.v.r.o. was

passed in california in 2014 and luckily, i was able to pass a version of that in 2020. that allowed us to create this new tool which is a civil tool, not criminal. and it allows the san francisco police department to prohibit or join an individual from owning, purchasing, possessing or receiving any firearms or ammunition when that individual poses an immediate and present danger of causing personal injure to themselves or to others. we know now that the need is greater than ever. we were just hearing about mental health in the prior hearing that the -- that suicide and mental health is something that is plaguing our children and not just children. obviously, i've had an increase in suicides in my district over the pandemic. and, also, we're seeing a rise of violent threats from right-wing white supremacists nationally and locally.

here, shootings in san francisco are up 62% from 2019. and the problem is getting worse. in quarter four of 2020, actually, october through december, shootings were up by 219% from 2019. we've been in extended lockdown. it's put an incredible strain on our residents' mental health and the intensity in number of calls into the suicide prevention hotline has absolutely increased. so the ordinance before you today takes advantage of recent changes to state law that allows localities to strengthen our existing gun violence programs. this ordinance enhances our current programs in two ways. one, officers are required to serve and file g.v.r.o.s with a court in a reasonable alternate of time.

now reasonable is defined as no later than three days after issuance. and, two, it allows san francisco to treat gun violence restraining orders issued in other jurisdictions as if they were issued locally. this means that we will not have to file a separate gun violence restraining order if one has been issued in another state. in addition to expanding our program, these changes will update our local law to conform with california state law. i do have a minor nonsubstantive amendment. the amendment adds the phrase "in coordination with the city attorney's office" in three places. additionally the title on page 1, line 5 has been changed to "as specified" rather than "no later than three days after issuance." despite this minor change, it remains in the body of the ordinance. so if you have any questions,

the city attorney's here of course. i have invited commander raj and sergeant patrick sway to present and answer any questions about the program or the proposed changes and i just want to say to commander viswan and sergeant bay, thank you for your service. we all know that in boulder, officer eric talley gave his life to protecting others. he was the first on the scene and he didn't lose his life. he gave his life to protect others and he had seven children and i just know every morning you all do the same and i can't thank you enough for the service that you provide to san franciscans. so, commander viswany if you'd like to present now. >> thank you very much and good morning.

thank you for your support, supervisor stefani. members of the public safety committee and members of the public that are joining us. my name is commander raj vicswanny. within the investigations division, we have the crime gun intelligence unit and that unit specializes in gun crime. they interact with local partners, federal partners, state partners on reducing and tracking gun violence and gun crime. and, within that unit, sergeant pat specialty in addition to going out there every single day doing search warrants, getting guns off the street, he is the department's liaison for gun violence restraining orders. he manages the program, he trains and he also interacts

with the city attorney and makes sure that the gun violence restraining orders are at least reviewed and filed correctly. i apologize for -- i will repeat some of this stuff here. i'll try to be very brief on it. okay. did that show up? >> yes. we can see it. >> okay. so i'll quickly go through the definition of gun violence restraining order as the way the police department sees it in our policy and our bulletins. we do have bulletins and training that dictate gun violence restraining orders. so basically, it is a temporary gun violence restraining order that the officers initially file. it evaluates the person and looks at if they are an immediate threat to themselves

or others and if they're in danger of causing public, causing personal injury to anyone by the use of a gun, access to a gun or purchasing it. like i said, it is a temporary order initially and what officers look at is there are other less restrictive ways and, of course, that somebody has already prohibited this order wouldn't apply to that. this is for generally people that fall within that gray area and that gray area's really important because and this is very timely to boulder, colorado, and a lot of these mass shootings or these shootings that fit into the gray where somebody really doesn't have a criminal record. they don't necessarily have mental illness to the point where they're 51/50 but family members are concerned and that's actually been expanded.

so i'll go over some of the background. so ab14 in 2016 authorized the courts to allow police officers to use the gun violence restraining order as a tool. initially, it was for law enforcement and certain members of the family that generally live with the subject that we're going to get the restraining order for. since then in 2019, ab61 expanded that and actually work place environment expands it to workers, co-workers and schools. if somebody has a concern in those different locations, they would get authorization from their employer or notify their employer before they seek a gun violence restraining order.

again, the purpose of the gun violence restraining order is for the officers initially to take and seize the guns and issue the person a 21-day order preventing them from access to guns and purchasing guns, but what it does allow, it allows the person to stabilize and there is a due process where the court can actually review what's going on. and they can have family members testify. they can have people that are concerned that basically testify. in that, so the one other thing that ab61 triggered is ab12. so initially, it was a one-year ban that a permanent gun violence restraining order can restrict. that has now been extended for up to five years with the option of every year the person can petition for the order to be reviewed by the courts.

so there is a built-in due process. and, these are rare, just to let you know that somebody has to legally be able to have a gun for us to use that. but like in boulder, and i used this with just i wanted to tell you that i don't know all the details of boulder, but what i do know is something like that, if that was to happen in san francisco and we knew that ahead of time, this would definitely be appropriate to be able to prevent that person to purchasing that gun and if he already had a gun and allows us to see and evaluate what's going on. we do train our patrol officers that this is a tool. what they do look at is they do look for a firearm nexus either into threats or access to it

when they interview family members, witnesses. does this person have the up of a legal gun or are they in the process of trying to get a firearm or possess it from somebody else? they'll collect the evidence, video, they can directly file the gvro with the judge or they can go to the cgic unit. the second role in this is our investigations bureau. they will investigate after the fact and get an exparte gun violence restraining order if that is necessary. if for some reason patrol didn't think it was necessary, investigations can seek it. they also work with our crisis intervention team. if there is somebody with access to firearms that is showing some type of mental distrust or some type of concern our c.i.c. unit can

initiate that. of course the city attorney's office and liaisons helps us file and some cases even track the order through court and the court's role in this is, of course, the evaluation. i've already covered everything on that. so, as far as the gun violence restraining orders, the type of incidences would be something like a road rage incident. the states would have side shows. a lot of the side shows, the guns we're recovering are illegal guns. if somebody did possess a legal gun that was theirs, we would seek a gun violence restraining order against that person. so somebody discharging a firearm in the air and they were detained, that shows they were in police disregard for public safety. we would probably seek a gun violence restraining order and

have the court evaluate if it should be permanent. and, of course, any kind of credible threats to workplace or schools. if we run the person and find out they have firearms and the threat is credible, we would seek the gun violence restraining order. patrick faye who is also online, patrick, if you can chime in. if you can give us an example of a recent case that we have sought gun violence restraining orders. >> yes, sir. good morning everyone. one case in particular that came to mind almost immediately was last year, in the early spring, officers responded to an incident that it was two neighbors. it was for lack of a better term an escalating argument that had gone on for over several months.

the argument started with a verbal argument banging between walls for people to quiet down. at one point, the subject in this case came out holding a baseball bat, got into a further argument with the neighbor and then the final incident was that person came out and said i'm going to kill you. spit in the face of the other person. officers responded out. after interviewing multiple people in the building, this gentleman who possessed an older firearm but that was not registered, other neighbors had seen him with the firearm. and due to the diligence of the officers, they were able to establish a firearm nexus, obtain a gun violence restraining order. our night investigations unit came out and got a search warrant from a judge and we were able to search that person's residence and seize the firearm. it's a pretty clear cut case as you see escalating arguments

that most likely they probably prevented an incident from rising to the level of actual gun violence. >> thank you very much. there was another incident actually in supervisor stefani's area which was somebody was doing donuts in the middle of an intersection in a truck, and that person was shooting a firearm out. the officers got the plate, they got the location of where he was at and they made a traffic stop and seized that firearm. i believe with that one, we also applied for a gun violence restraining order because it was a illegally owned firearm by that person. just to give you an update right now. last year we had eight. this year so far, we've had one. and, again, we continue to

train our officers on this and we're going to actually expand the training. we currently are using this state video for training. we're going to actually do our own video and highlight different circumstances. i've also been in touch with lieutenant molina of c.i.t. and i remind him that we do have the access to gun violence restraining order resources for the c.i.t. unit. he just says that recently, most of his contacts are people that are already prohibited. so he didn't need to seek that. he was able to seize the firearms without it. and, before i close, again, i wanted to thank supervisor stefani on just highlighting gun violence in general. it is definitely a problem in most metropolitan cities. san francisco has seen a 390%

increase. to give you an example, year-to-date, 2020, we had 10 shootings. this year, 2021, we're over 50. so just to highlight where everything falls. just last night, officers were in pursuit of somebody with an assault rifle and they recovered multiple guns last night. so it is -- we deal with it daily and really appreciate your suspect. thank you. the if there are any questions from anybody. >> supervisor stefani: thank you, commander. that was very helpful. yeah, i mean obviously gun crimes in san francisco, they need to be taken seriously and a three hundred ninety% increase is absolutely

unacceptable. i do have one question for you. what is the biggest obstacle to expanding the usage? i'm very happy to see that we've gone from one to eight and i know you're working extremely hard on educating everybody and it takes time. and, again, i thank you for the attention you've put into this and same with sergeant faye. so just wondering if there's an obstacle to expanding the usage of the pandemic or anything like that. >> and i actually talked to sergeant faye about this that do we have more people that should not have firearms that are displaying some type of threat that it could escalate into gun violence. what i was told was during the pandemic, it's still going on, but during the initial year of the pandemic, they've had a few of them. this year, they haven't had that many. most of the gun violence we're seeing is a lot of illegal

possession of firearms. they're either [inaudible] used by members shooting at each other. but i will continue to champion the availability and the tool. and, as you know, any one of these incidences could be a mass shooting. so just having that tool is really important. and i think as new officers come in, this is something i think we'll have to keep continuing because it is still fairly new to san francisco. so it is something that we're going to continue to check. i want to start in-person training where they actually go station to station. we're just waiting for all our officers to be vaccinated and everything and then we're doing more in-person training. so that should be happening within the next two, three months. >> supervisor stefani: thank you so much for that and i

think people need to know too that last year was a record number of guns in this country was purchased. 50 million to 70 million i think and there's already 400 million guns in circulation and, also, you know, we see at the federal level a background check bill still not being able to be passed at this point in time even though 90% of americans believe in background checks on gun sales and i don't think people realize that 28 states do not require background checks on all gun sales. and those guns move over state lines and i said yesterday or two days ago at the board meeting what happened in gilroy, the gilroy garlic festival. i cannot get the image out of my mind about that little 6-year-old jumping in a bouncy house and losing his life

because of a gun that was purchased in nevada which wasn't allowed here in california. so this is serious. the fact we have more guns in circulation. we're coming off a pandemic where we just had a hearing about the mental health and the trauma that so many are experiencing. this is something that we cannot ignore. and, again, i really cannot thank you both enough for the attention you're giving it. when i went to the san francisco police department originally to pass this, the first ordinance in 2020, you know, you were -- everyone was so great and we really appreciate the thought that you're giving to it in terms of going station to station and getting everyone educated because everyone needs to know about this tool. and not just police officers, but we need to let our hospitals know, we need to let our c.b.o.s know that this is something that can be utilized to protect someone from taking their own lives and to protect someone from taking the lives of others.

so thank you again. and i also want to thank my legislative andy mullen. so thank you, andy. >> thank you everyone. any other questions? >> supervisor mar: yeah. i have a question. i want to thank commander vaswanee for implementing the gun violence restraining orders here in san francisco. yeah. i had a question around you said there were eight gvsos in two thousand twenty and one this year. i was just curious whether any of those involved were a result of a request from a loved one or an employer or school or were these most or all resulting from just a police

investigation of like a side show or things like that. >> no. these were police investigations. so an actual family member can go directly to the court to petition it. these are all police generated. >> supervisor mar: got it. yeah. do you know for gvso's that are more initiated by loved ones, what the numbers are. >> i don't know what the numbers are, but what i hear from just the is that the type of incidents are where family members go get one would generally be dementia, where somebody older has maybe

firearms that they've purchased over the years, but now they're in a condition where they really should not have a firearm because mentally, they're having challenges. they'll get a notice from the doctor or they might even ask the doctor to participate in getting a gun violence restraining order. so most family instances are that. >> supervisor mar: thank you. and just my other question with -- so the gvsos that are issued through this ordinance that supervisor stefani really has led on through law enforcement, these are temporary? for one year? >> they are initially 21-day temporary. the court can make them permanent to one year. they have the option to make it 1-5 years depending on the

gravity of the case, what type of threats they were. you know, like a neighbor dispute can continue over years so the judge can make that determination. some of them, the judge might decide it's a shorter order, but it gives the person time to stabilize, get treatment, get help and then state would have to come back to the court to remove the order. >> supervisor mar: got it. thank you. thanks again, supervisor stefani, just for your leadership on this and in sponsoring, you know, the first ordinance, that created the framework for the use of gun violence restraining orders and through law enforcement and now this ordinance to sort of further strengthen it and clarify it and align it with state laws. i would love to be added as a cosponsor. why don't we go to public

comment. are there any callers on the line? >> clerk: thank you, mr. chair. we are continuing to work with maria pena from the department of technology to bring in public commentors who wish to comment on this ordinance. for those watching our meeting on cable channel 26 or streaming through sfgovtv.org. call in (415) 655-0001 following that into the meeting i.d. of 1874560963. press the pound symbol twice and then press star followed by three to enter the cue to speak. while we're waiting for our first caller i'm going to note that supervisor haney returned to this meeting and has been here since 11:29. ms. pena, can you bring us our first caller? >> hi, my name is ruth bornestein. i'm part of a leadership team

of the san francisco chapter of united against gun violence. we are very much supportive in gvros in general and these amendments in particular to enhance the process. so thank you, supervisor stefani, for bringing it and, supervisor mar, for now cosponsoring. i do want to add that it was really, as a brady member but also as a citizen of san francisco, it was just wonderful to hear commander viswanee speak about this and also learn more about the sfpd's effort. so i'm glad i was able to join and hear all of that and i thank all of you for your attention and work on this. thank you. >> clerk: thank you very much ms. bornestein for participating in the discussion. there is another caller on this

item. caller, please go ahead. >> thank you. committee members, my name is barry pearl. my wife and i are also members of the san francisco leadership team of brady united against gun violence. and, as ruth indicated, brady united supports efforts nationwide to adopt and implement red flag laws such as the one adopted by california and san francisco and we support the efforts to strengthen and further implement the gun violence restraining order as proposed by supervisor stefani.

my wife would also like to briefly talk about her own experience and how if such a law had been in place at the time it would have certainly helped her situation. >> anymore callers on the line? >> no more callers in the. >> i do want to thank ruth bornestein who's done so much work with brady to make sure we don't have gun shows who i've honored at the board before. thank you to you both. again, we need people like you to keep going on this issue.

so, yes, so, first i would like to move the amendment that i've handed out and that i spoke of in my opening comments. >> okay. >> supervisor mar: mr. clerk, please call roll. >> clerk: [roll call] >> clerk: mr. chair, there are three ayes on the amendments. >> supervisor mar: supervisor stefani would you like to make. >> supervisor stefani: yes. i'd like to move the around ordinance amended with a positive recommendation by the board. >> clerk: authorize that the ordinance be recommended. [roll call]

[please stand by]

>> tuesday, march 23, 2021. president kimberly brandon called the meeting to order at 2:23 p.m. [roll call] >> clerk: madam president, all members of the commission are president. item 2 is the minutes of the february 22, 2021 port commission meeting. >> so moved. >> second. >> we have a motion and a second. can we please have a roll call vote. [roll call]