earthquake. in 1992 the elevator part of the roadway was removed. it was developed into a surface boulevard. today the vanness bus rapid transit project is to have designated bus lanes service from mission. it will display the history of the city. van ness avenue. >> chairman: good morning. welcome to the thursday, april 22nd meeting of the public safety & neighborhood services. i'm supervisor gordon mar, and we're joined by vice chair catherine stefani, and we'll be joined shortly by supervisor matt haney. and also this morning, we

expect to be joined by supervisors melgar and safai. thank you to this committee's clerk, john carroll, and sfgovtv for staffing this meeting. mr. clerk, do you have any announcements? >> clerk: yes. in order to protect the public, board members, and city employees during the covid-19 emergency, the board of chamber and committee room are closed. [inaudible] committee members will attend the meeting through video conference and participate in this meeting to the same extent as if they are physically present. public comment will be available on each item on this agenda. both sfgovtv and channel 26 are streaming the call-in number. your opportunity to speak and provide public comment will be available to via phone by dialing 415-655-0001. once you're connected and prompted, enter the

meeting i.d. today's meeting i.d. is: following that press the pound symbol twice to be connected to the meeting. when you're connected,you'll hear the meeting discussions but you're line will be muted. when you're item of interest comes up, dial *3 to be added to the speaker line. a system prompt will indicate that you've raised your hand. please wait until the system indicates you've been unmuted and you may begin your comments. best practices are to call from a quiet location, to speak clearly and slowly, and turn down your television, radio, or streaming device. everyone must account for potential time delays and speaking discrepancies between live coverage. you also may e-mail me, john carroll, and i'm the clerk of the public safety & neighborhood services.

john.carroll@.org.@sfgov.org. and final, mr. chair, items acted on today will appear on the board of supervisors' agenda of may 4th,s other why stated. >> chairman: thank you. can you please call item 1. >> clerk: one moment. just noting that supervisor haney has joined us. item 1 is a hearing to consider the type 20 off-sale beer and liquor licenses to lucinda's deli

and moore, will serve the necessity of the city and county. members of the public comment who wish to provide public comment on this matter should call 415-655-0001. enter the meeting i.d. 1872694043, press ## and then *3 to enter the cue to speak. mr. chair? >> chairman: thank you, mr. clerk. first we'll hear from the abc liaison unit, and we have officer selmonson to present on the report. the floor is yours. >> you have before you a report for lucinda's deli and moore. this would allow them to operate an off-sale beer and wine premise. we have no letters of protest. no letters of support. they are in plot 642, which is considered high

crime. they're in census track 164, which is considered high saturation. northern station ha no has nooption, but the petitioner should actively monitor their area in order to present the loitering. as of february 21st, the applicant had agreed to the above conditions. >> chairman: thank you, officer salmonson for that report. do we have anyone here from lucinda's deli who would like to make remarks? >> david luavalo. lucinda's an moore is a very popular neighborhood deli that has been around for a number of years. the owner has struggled dramatically trying to keep his doors open during covid, but with the community support he has been able to do that and keep his employees employed. he is hoping that with the 20 license that he'll

generate enough business to hire at least a couple more people, and we're hoping for your support this morning. thank you so much. >> chairman: thank you. i don't have any questions. colleagues, do you have any questions for comments? great. why don't we go to public comment on this item. mr. clerk, are there any callers on the line. >> clerk: thank you, mr. chair. we're joined by jim smith from the department of technology who is monitoring the public comment line. please let us know if we have any callers that are ready. for those watching on cable 26 or through sfgovtv, if you wish to speak on this item, call in now, by following the instructions displayed on your screen. dial 415-655-0001, enter meeting i.d. 1872694043, and press ## and then *3 to speak. mr. smith, do we have any

callers who are ready to speak on agenda item 1? >> we have no public callers in the queue. >> chairman: great. thank you. public comment is now closed. colleagues, this seems to be a fairly straightforward liquor license consideration, adding off-sale beer and wine to a local neighborhood market. and the s.f.p.d. a.l.u. is in support of this and recommends approval. so i would like to make a motion 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 full board with positive recommendation. mr. clerk, can you please call the roll. >> clerk: on the motion offered by chair mar that the resolution would be

served by the service premise, and that resolution be recommended to the board of supervisors. [rollout] >> clerk: mr. chair, there are three ayes. >> chairman: great. thank you. so this will be sent to the full board with positive recommendation as a resolution. >> thank you, supervisions. >> chairman: mr. clerk, please call item 2. >> clerk: item 2 is a hearing to consider that the issuance of a type 57 special on-sale general beer wine and distilled spirits liquor license to do business as the academy located at 2166 market, will serve the public convenience or necessity of the city and county. members of the public who which to provide public comment, call 415-655-0001, enter the meeting i.d. 1872694043,

press ## and then *3 to enter the queue to speak. mr. chair? >> chairman: thank you, mr. clerk. welcome back, officer salmonson to represent the a.l.u. report on this item. >> they have applied for a type 57 license, and if approved, this would allow to operate a special onsale. we have no letters of protest or support. they are located in plot 412, considered high crime, and census track 169, considered high saturation. a.l.u. recommends that the following conditions: (indiscernable) shall be audible in any nearby residence. number two, when the outdoor area is being utilized for the sale and service and consumption of alcohol, they must maintain supervision at all times. number three, the

petitioner shall actively monitor the area in an effort to prevent the loitering of any persons on any property adjacent. and as of april 7, the applicant had agreed to those conditions. >> chairman: thank you so much, officer salmonson, for that report. i believe we have the applicant from the academy here. mr. miller, would you like to share some remarks on this application? >> sure. good morning. first of all, thanks so much for your time. i'm paul, and i'm here with my business partner, nate, and we're asking for your support. we're both natives of san francisco, and we've been in business since 2018. we strive to create a place where people can socialize. and we do things like art shows and discussion groups, and have some awesome speakers. basically we're here to ask for your support so we can continue doing the

community work that we've been doing. >> chairman: thank you, mr. miller for that, and for your unique business serving of the lgbtq community. colleagues, do you have any questions for remarks? seeing none, why don't we go to public comment on this item. mr. clerk, are there any callers on the line? >> clerk: thank you, mr. chair. we'll check with jim smith in a moment to bring us any of our callers who may provide public comment on this item. for those who are watching our meeting on cable channel 26or through sfgovtv, please call in by following the instructions displayed on your screen. mr. smith, do we have any callers for agenda item 2?

>> we have no callers. >> clerk: thank you. >> chairman: thank you. public comment is now closed. colleagues, this second liquor license item also seems very straightforward. and it is really adding an onsite beer and wine and liquor license to a private club, social club, serving the lgbtq community. and so i -- and the a.l.u. is also in support of this with conditions. and the project sponsor has agreed to those, to abide by those conditions. so i would like to, again, make a motion directing the clerk to prepare a resolution determining that this license will serve the public convenience in necessity, and that we send this resolution forward to the full board with positive recommendation. mr. clerk, can you please call roll. >> clerk: on the motion averred by chair mar, that

a resolution would be served, be recommended to the board of supervisions. [rollout] >> clerk: mr. chair, there are three ayes. >> chairman: thank you. so this item will be sent to the full board with positive recommendation through a resolution. thank you, mr. miller -- >> thank you, guys. >> thank you so much, supervisions. i really appreciate it. >> chairman: yes. mr. clerk, call item 3. >> clerk: agenda 3 is the hearing widespread vaccination in the city and county, including but not limited to capacity partners with the state of california and private health care systems and plans for expansion. members of the public who wish to provide public comment on this hearing, call 415-655-0001, i.d.

1872694043, press ## to connect to the meeting, and then press *3 to enter the queue to speak. a system prompt will indicate you have raised your hand. please wait until the system indicates you have been unmuted and you can provide your comments. >> chairman: thank you, mr. clerk. colleagues, this is a followup hearing on our city's vaccination strategy, three months after our first hearing thins committee in january. since then we've made real strides building a vaccination infrastructure under extremely challenging and conditions. it has led to very successful vaccination roll call, and s.f. d.p.h. have really stepped up to make vaccinations available to those with digital barriers, and

people with inadequate health care. i know we face many challenges in the road head to get to full herd immunity and to get through this pandemic, but if we continue to get vaccinated, wearing masks, and take care to follow public health precautions, we are well on our way to fully reopening our autonomy and returning to civic and public lives. i want to thank supervisor haney for calling this hearing, and i invite supervisor haney to share your remarks. >> supervisor: thank you so much, chair mar and clerk carroll and supervisor stefani for allowing us to have this hearing, and for being so proactive in you're yourleadership and vaccine rollout. and i'll get to my thank yous in a minute.

we really have deep appreciation for our health care workers and providers and covid command and d.p.h., and everyone who is really implementing these strategies. as you said, chair mar, this is a continuation of the hearing that we held back in january, and a lot has changed since then, thankfully. when we had that hearing three months ago, there was still a tremendous amount of confusion and concern over the vaccine rollout. plans where fragmented. and eligibility was often unclear, and vaccine doses were very hard to come by. there was a lack of clarity on who should be leading the vaccination efforts in the city, and who should be responsible for bottom-lining the logistics of ensuring that people who needed the vaccine the most could get it. we were yet to open any large mass vaccination sites, and it was hard not only to get vaccines to our constituents, but even to get them simple answers. that is why we, as a board, offered an

emergency ordinance requiring our city to develop a plan to fully vaccinate all san francisco residents who want the vaccine by the end of june, and ensure that there was transparent data reporting so we could see exactly where we were succeeding and following short. since then, we have launched multiple vaccination sites, and thanks to kaiser permanente and sutter health, and our own d.p.h., pharmacies have come on line and mobile vaccination sites have ramped. 42% have been fully vaccinated since then. over 70% of those 65 and older have completed their vaccine. this is a herculean effort, and i want to extend my gratitude to our health care workers, first responders, and the staff and leaders at the department of public health, covid command and the mayor, for their work to get us to this point.

i also want to thank the community organizations and community leaders who have been fighting to bring vaccination sites to our hardest hit neighborhoods, and we're continuing to push our city to do more. as we're getting close to our goal of vaccinating every san franciscan who wants it, there are still some areas that need our folks and action. today's hearing is to provide an update on our vaccination efforts. last week every san francisco resident over the age of 16 is now eligible for the vaccine, and with that comes a new set of challenges. we are still hearing from people who can't find appointments, in neighborhoods like the tenderloin, which are still begging for more publicly accessible vaccination site. and we'll need greater effort to ensure that essential workers and people from vulnerable populations continue with the outreach and we reduce any barriers to access to the vaccine. it is my hope today we can

have a clear understanding of where we are in hitting our target goal of vaccinate everyone by june 30th. our plans for reaching 16 and 17-year-olds, particularly looking to a full return to school in the fall, and what else we need to do to break down the barriers that still exists for accessing the vaccine by technology, disability, and in some cases access to appointments. i'm hoping we can hear what things will look like this summer, what will happen if the eligibility expands to younger ages, and what will happen if booster shots are needed. finally, as we hopefully soon reach a time when vaccine supply may expand demand, i want to learn more about what we are doing to address vaccine hesitancy and how we're correcting misinformation about the vaccine. i've seen some of the videos the department is putting out encouraging people to get vaccines, and i want to appreciate the folks who are working in communications as well

for their great work. at this hearing, we will have representatives from the department of public health and covid command center. i also want to note that the hospital council is here as well, although they aren't presenting. they're here to answer any questions and offer support for this hearing. my intent is we will begin with short presentations from the department of public health and the covid command center on the city's current vaccination efforts, and we'll follow with questions and answers. i want to give special thanks to the two people who will be here presenting with us, who have worked so incredibly hard on this effort. and i know have had to also deal with my many, many, many questions and concerns and feedback and everything else. i want to appreciate dr. boba and director carroll and all of their respective staff and teams. i will turn it back over,

and i believe we have dr. boba from the department of public health to kick us off. thank you, chair mar. >> good morning, everyone. and thank you to chair mar for the opening comments, and chair haney for framing this discussion. i just want to go over a few updates. so if we could get the slides out, that would be great. and i want to recognize director marianne carroll. a lot of the departments have been really essential to this work. the next slide, please. so as was discussed, we are really on this path to getting towards herd immunity, which is our

ultimate goal, to have a significant part of the population protected against covid through our vaccination efforts. we are in the fifth month of our vaccination campaign. it started in december, and it has rolled out and has been highly successful in many ways. our strategy has been, you know, speed, equity, and partner. and we have always emphasized equity as one of the main principles from the beginning of ensuring access to those who have been disproportionately impacted by covid-19, as well as those who have high morality morbidity from covid as well. and we had a three-prong strategy, and this includes our high volume sites, our community vaccine access sites, and our partnerships. we have the ability to vaccinate up to 23,000 people a day through all of the partnerships.

unfortunately, we're still not there, mainly due to the vaccine limitations. the highest number we got to is almost 11,000 per day, but our biggest concern is (indiscernable). we utilized data that we get on a regular basis to see where our gaps are and where we need to do nore. more. it helps guide our strategy. and it is a huge accomplishment for the city. as we look ahead, we have to think about how are we going -- especially as we get towards that last mile -- hg to ensure that people have access, reduce barriers and to reduce hesitancy. next slide, please. so i just want to speak a little bit to the fact that our biggest constraint continues to be vaccine supply. and there is a couple reasons for this, as i

think everybody knows, j & j is currently paused. we will get some information tomorrow as the advisory council reconvenes and moves forward with its recommendation around johnson & johnson. so that has decreased the supply. but, additionally, we have seen almost a 35% decrease in san francisco over the last couple of weeks. and that's because at the national level, there is direct allocations happening towards pharmacies as well as towards certain health clinics. and so that takes allocations out from the state level. and we get everything from the state. we've gotten a reduction in our dosages. so one of the things the team has really been very active about is really hunting more places where there might be extra vaccine that we could take. this effort -- one of these efforts was covered in the chronicle recently where we found out in humble county there was

potentially a thousand doses of pfizer that may go to waste because it was accidentally dethawed, and they didn't have the appointments to meet the needs. so our team was brought into action and it was a whole city effort. an unnamed airport employgraciously decided to go to humble to get the vaccines, and came down, and they got it to the hospital general, and we got shots in arms within the next 36 hours. sows we are uncovering every stone possible to get more vaccine into the city and county. there still continues to be a lot of demand, and given that the supply has decreased to us specifically, we are making sure that every dose that we have gets into arms. next slide, please. so in terms of where we are in vaccine efforts,

the city has gotten a total of about 850,000 doses. and 65% of those 16 and over have at least received one dose, and 42% have gotten fully vaccinated. this -- i also want to highlight our efforts in the 65 plus because this has been a specifically prioritized population, given the fact that most deaths occur in the 65 plus age range. so 85% of those 65 and above have received at least one dose, and 75% have completed the series. that is a huge accomplishment. we still want to make sure that 70% gets to a 90% number. so we continue to be very intentional and looking at our data where there may be gaps, and outreaching to communities to ensure they have access. next slide, please. and then this comparison -- i want to compare san francisco to the rest of the country,

as well as california. this is of the total population, not the eligible population. so the denominator is different for this slide, and that's why it doesn't reflect the percentage. in san francisco, when you use the entire population, 56% of people have gotten at least one dose, and 37% have completed vaccination. and that's compared to 44% in california, and 25%, and in the u.s. total, and we're arguing that the general u.s., as well as within california. next slide. so getting back to how are we building up our systems to ensure there is access across multiple different mechanisms for vaccines, we have developed a very flexible and robust network of vaccines, including the high volume

sites. i think everybody is familiar with moscone, and (indiscernable) and kaiser has a center, and they have other partnerships that they're allowing vaccines. [inaudible] so the health care systems are also ensuring that their patients have access to vaccine. and the other thing is to know about these high-volume sites is there has been a lot of partnerships to ensure that party populations within san francisco have access to those sites. but turning towards our community efforts, we have a san francisco health network which includes our community health centers, as well as the s.f. g., and all of the community health centers, and chinatown, have really made efforts to be accessible to their

surrounding community, as well as the communities centers. and other sites -- other health center sites are coming on board as well. and our community clinics and the consortium are extending their efforts, also. s.f. community health center and chinese hospital and market center, they're all acting as vaccine access sites. when we do seek out them, we have put in neighborhood sites. so the mission has two sites. bay view has a site. and the t.l. has sites as well, as well as treasure island. we continue to really do a lot of outreach engagements and access to those priority populations. and then the final kind of

(indiscernable) and we're working through our mobile units. and i'll talk more about our mobile units in a later slide. but it is another way if people can't get to the sites, we think of ways to get vaccine to them. and then finally, the pharmacies are getting direct allocations, through the wal-marts and c.v.s. and the safeways. next slide. director carroll, do you want to -- >> i can just jump in here. thank you, dr. boba. as you can see, we have a very complex and robust system for vaccines. we're very proud of the high-volume sites, which have really allowed us to hit the kind of majority folks who we can get vaccine out very quickly to, and we have been very successful through these partnerships at our three mass vac sites.

moscone south, which is our largest site, a lot of people are familiar with that, has done not quite, but almost 300,000 vaccines. and so we're on track. it has been open different timeframes, but depending on availability, monday through friday. the capacity there is about 8,000 a day. and we've reached pretty close to that when we've had the supply. it is about a 20 to 25-minute flow through. and as many people know, they have an excellent d.j., with accompanying music. city college is our next site. that was the first site we opened -- let me just back up. moscone south really has been an incredible operation that has been led by kaiser with other partners. i want to give kaiser the shutout. city college, we also have

amazing partnering with ucsf. city college is primarily a drive through, but we have the able to take walk-ins, or people who walk in with an appointment. it is a seven-day-a-week operation. we were able to do 6,000, and that's interesting because we originally thought we could only do 3,000. but we've never done this before, so based on our experience and our ability to kind of shift operations, we were able to go up to 6,000, which is really incredible. and that also is about a 20 to 20-minute flow-through. and, again, much thanks to ucsf for the partnership there. and s.f. market is our site in d-10. we have done about 3,000 vaccines there, open monday through friday. our capacity there is about 1500, and the same

flow-through. sutter has been our partner there from the beginning, and we're very, very grateful. what we wanted to do and what i think we're very proud of is to get these high-volume sites up in locations that were really accessible to folks throughout the city, but in particular in areas where we saw a predominance of covid. and so we have been able to do that in these three sites that are throughout the city that have, you know, different sort of accessibility, and ability to get the vaccine quickly. in addition, i think as dr. boba said, we've been able to partner with these -- we to work with these partners to also do some particular focus on accessibility for different populations that don't have -- you know,

who have a harder time getting in. so that wasn't an easy task, especially at moscone, because we have to go through the state site. so it is quite many, many layers of bureaucratic red tape to make that happen. but, again, everyone has been incredible partners. so our ability to really flow the vaccine to general population is due to this. and i just want to thank everybody from the city that has been involved. and this truly has been a partnership, not only with our health care providers, but, honestly, employees from throughout the city, many, many different departments, who have participated, who have project-managed, who are doing intake and registration -- apologies for that -- and even street traffic control. and we're very grateful. i'm happy to answer

questions. thank you. >> great. next slide, please. so in terms of ensuring there is equity access to vaccine, there are several different ways that the city is approaching this. you know, i will say that the partnerships with our community groups have been critical for this. and i really want to commend all of the community groups that we're working with to reach different populations, and ensure that there is outreach, linkage, and navigation to vaccine sites. we know there are many different strategies that have to be utilized to reach priority populations. for example, we're partnering with the latino task force, with the task force for the blind and other community groups, to utilize our vaccine sites, and to ensure if people,

if they don't have digital access, that they have a community partner that can get them that access. and we're also doing direct referrals for party groups at each of the high-volume sites. we have low-barrier sites that can do walk-in and same-day and next-day vaccinations. and many of our community sites are built with that in mind and are built with community partner that is have that appropriate cultural and linguistic aspects to them. i want to height we have set up a call center. the call center is really meant to outreach to those that may not, you know, again, have the visual access to make an appointment. so they are actually doing mostly outbound calls,

when they get referrals, to set up appointments for people. and they've done a total of 25,000 calls. the majority of those are outbound calls, again, to set up appointments. they are prioritizing people over age 65, people with disabilities, and people in s.f. priority populations. for example, s.r.o. residents that may not have great access to the internet. we're supporting transportation access because we know that is another barrier to get to sites. so, you know, muni is free if you're getting vaccinated, and paratransit as well. there is expanded d.t.t. funding, and the call center makes this aware to people they outreach to. and there are drop-in centers for residents aged 65 and up. and we are deploying

mobile vaccine resources to fill the gap in ensuring our equity lens, and i'll talk a little about that in the upcoming slides. next slide, please. so when our vaccine rollout initially started, we wanted to make sure we were approaching this towards an eye that, you know, the communities that have been hardest hit in san francisco had access to vaccine. this slide really demonstrates the results of that. on the left side you will see the covid cases that have happened throughout the city since the beginning of the pandemic. on the right side is how they have allocated this vaccine and where we're prioritizing our vaccine. you can see specifically the bay view, mission, and tenderloin have gotten the majority of our vaccine. and it, again, was really a focus on wanting to ensure that the communities that have been

hardest impacted by covid have access to vaccine. next slide, please. so i wanted to turn a little bit to talk about our mobile vaccine strategy. you can think of mobile vaccine as a strike team that goes out to fill the gaps in our current vaccine locations. for example, mobile vaccines have gone to vaccinate those that are in in neighborhood health services, to our homebound adults, people experiencing homelessness, to our senior housing sites, to s.r.o.s, to jails, and to people with limited access to health care in areas of high transmission. currently we are deploying one to two daily mobile teams. we could definitely upscale that. the big issue is that we don't have the supply to do that. and additionally, you know, some of the mobile vaccine was going to be done through johnson & johnson. and, again, depending on what the f.d.a. and the

h.s. goals are, we'll have to reconsider the mobile vaccine sites. the teams are out there. we have one to two. and they typically have a nurse and an administrative assistant. for example, they will go to homebound adults that we might get referrals about to go out and vaccinate people. we had a total of 50 mobile events, and on the week of 4/18, and 10 more scheduled in the upcoming future. many are for homebound visits. so mobile vacs has been deployed to the tenderloin, selma, bay view, to chinatown, to name a few. and homebound teams are going all over town. as i mentioned, the key challenge here is vaccine supply, as well as what the future state of johnson & johnson will be.

and the other thing is mobile requires a lot of planning with our community partners, as well as a lot of outreach to ensure we get enough uptake at any mobile event that we do. next slide, please. i want to talk a little bit about vaccinating people experiencing homelessness. as soon as we started vaccineing in november, they planned what it would look like for people experiencing homelessness. this has been a multi-pronged strategy. part of it is looking at the sheltered versus the unsheltered people, and how we would approach that. for the sheltered population, we have worked with our studio partners, as well as h.s.h., and whole person care, and to start to vaccinate. and we started with

risk -- those at highest risk, including our hotel vaccines, and also in congregate settings, such as, you know, our shelters, which also got vaccinated. for the unsheltered, again, a multi-pronged approach here. so for the street medicine and homeless outreach teams, ensuring they have information to provide to homeless individuals, and getting them outreach-preferred, and navigated to vaccine sites. all of the clinics that serve the homelessness populations (indiscernable) are vaccinating their patient clientele. and also the official medicine program at s.f.g..

the other things we're doing is bringing vaccines to locations where people experiencing homelessness tend to go and feel safe. for example, taking vaccines out to encampments, safe sleep sites, and other locations, like needle exchange. specifically for en encampments, we did start to provide moderna, and we'll go out to give the second dosage as well. i want to highlight the photos of two s.f. nursing students who volunteered to vaccinate people. and the approach was very thoughtful for this event. so we provided covid vaccines, but also provided other health care, including pregnancy testing, and we also gave out meals and at maloxone

kit. so all of this work is being done in a thoughtful lens of having engaging and ensuring that people have information they need to decide if they want vaccine or not. the next slide, please. one of the things we are trying to address is vaccine confidence. and basically wanting to ensure that people have the information they need so they can make an informed decision. as mentioned earlier, san francisco, the demand still continues to be fairly strong. but we do know we will reach an inflection point where they may not be true, and that we will, you know, start to see some hesitancy. and we're already addressing that, and have been addressing that. so we're working on approving vaccine ambassadors, with training. and over 450 people have

been trained, and we're working with our city partners to get people trained. and we're working with our city partners to develop compaigns, and outreach, depending on what they're hearing in their communities. and we're targeting specific ethnic needs around these compaigns. next slide, please. there are a couple of things i want the to highlight. we have some great information on our public data tracker that includes how many people have been vaccinated. a break down by race, ethnicity, and a breakdown by neighborhood, so that the public can see how in general we're doing in san francisco. and then the final slide. so what are we doing from here on? as i mentioned, really, we are going full down in our

targeted community efforts to ensure that people have vaccine access and have confidence in the vaccine as well. as was mentioned, we do expect that the fliefer pfizer vaccine will get approved for 12 to 16-year-olds. and it looks like may will likely be the time that that approval occurs. we have been working specifically with the school systems and with other providers that work with children to start doing that outreach. i want to height for the 16 and 17-year-olds, we've been doing a lot of outreach there. in fact, the city college site will be having a couple of events specifically targeting the 16-year-olds and 17-year-olds to come and get vaccinated. the idea is to continue those type of events, so that children can get vaccinated, and that will likely be part of the

strategy moving forward with the 12-year-olds to 15-year-olds. mass vacs sites. we're anticipating that parents may have a lot of questions, and may want to talk to their pediatrician or talk to a doctor. and i'm working with the health care systems to get that up and running as well, once we hear back what the e.u.a. approval is. and then when we start to see the less than 12-year-olds get approval for vaccine, having to work on what that will look like and where, again, children and their parents will want to get vaccinated, and making sure we have the infrastructure for that. and then through all of this, i do think this last mile of getting to that 85% to 90% completed vaccination will be a stretch for that last,

maybe, 5%, 10% -- we don't know exactly -- but really putting in all of the infrastructure now, in terms of outreach and engagement, and to have those conversations so that people can decide if they want a vaccine, if they do want it, that it is available for them. that is ongoing work that has been happening throughout the pandemic -- i mean throughout the vaccine rollout, to ensure we're providing information that is reliable, and so those efforts will continue into the future. and with that, that's the end of my presentation. i'm happy to take any questions. >> chairman: thank you so much, dr. boba, and director carroll, for that presentation and all of your incredible work with the vaccine program, as well as everything before. colleagues, do you have

any questions. supervisor haney? >> suffolk stefani can go before me. i think she had her name there. >> chairman: sorry, i didn't see that. supervisor stefani? >> thank you, chair mar, and supervisor haney for this hearing and to dr. boba and director carroll. i want to extend my thanks to director carroll and dr. boba and dr. phillipe. three incredibly strong women. i believe there is a little bit of a false narrative out there that it took us to get you to create a vaccine plan, while all the while i know that a plan was being worked on. and at the beginning, a lot of the bumpiness was due to the fact we didn't have the vaccines. i have been so incredibly impressed with everything you have done to put this vaccine plan together. also with the individual

help within my constituency. every time we've had an issue with somebody who couldn't find an appointment or having a different issue, you were always incredibly helpful and i'm so grateful to that. i was talking to my chief-of-staff, andy mullen, and you mentioned moscone and the incredible rollout there, and i cannot tell you how many compliments i received from my constituents. and andy said he thanks that sticker board will end up in the smithsonian some day. and i received my vaccine, and i'm fully vaccinated at the bay view produce market. and i ran into supervisor haney on my first dose that day, and we got to talk about how impressed we were with what we saw. i think it is important to acknowledge when something is going right, and to acknowledge good work that is being done in the city. because there is a lot of

negativity out there. again, in san francisco, we have so much to be proud of around what we've done here with regard to the pandemic. our testing protocols, how we basically stood up and provided testing when a lot of our private insurances weren't doing that. we basically footed the bill and put all of those plans into place. and when you look at our outcomes, even with vaccines today, i was hearing only 40% of the entire united states has received their first dose. san francisco, we're at 66%. that is not, again, done by accident. that is done by good planning. and, again, director carroll, dr. boba -- the women behind this -- yes, there are men behind this, too, but i've been so impressed with everything and how you have basically persevered even with the criticism that has, you know -- everything that you have gone through,

i've just been so impressed. it is one of the reasons, too, why here in san francisco we have had the lowest death rates of covid because, again, of our excellent planning and what our department of public health and the mayor's office and our director of the department of emergency management has been able to do. i think it is really important to acknowledge that and to say we're -- yes, there are things that we have been -- things that supervisor haney has raised, hiccups that have come along the way, that we have been able to work together to answer. and i'm grateful for that. i'm grateful for the fact that the board can work with you on these issues. but, you know, we have to say kudos, job well-done. a lot of things in san francisco are really difficult right now, and i think it is important that we show that we are doing some things right. and, again, i can't thank

you enough. and, again, thank you, supervisor haney, for being able to highlight the great work of our department of public health, and to also come in and ask questions and provide solutions where we've needed them as well. so thank you very much. >> chairman: thank you, supervisor stefani. >> i think we do have a tremendous amount to be proud of. i have a few questions. some are sort of broader questions, and some are more specific. one is just at a general level -- and i think that you mostly said the answers to this is yes,

but do we believe we are still on track to vaccinate all eligible residents who want a vaccine by the end of june? or is there even a revised timeline that we have now? >> yeah, i do think we are on track. i will say supply issues are our biggest barrier, and that's what we have the least control over. again, we have built the system and we continue to build it where we're seeing gaps, but as long as the supply continues and there is not any major other issues that come up with the vaccine, i think we will have the ability to say by the end of june vaccine has reached a place where everybody who wants it should be able to get it or or being offered one. these are projections

coming out of the federal government, and that's what we're relying on. >> chairman: thank you for that. i think, as you said, we're getting to a more narrow, smaller set of people who either want the vaccine but haven't had access to it, or may need a little more outreach or a little bit more nudging or a little more specific kind of targeted support, is that -- i mean, do you think about that in terms of sort of the array of different strategies that you laid out there to reach those folks? or is there going to be something that is a bit more systematic to make sure we are providing direct outreach to each of the individuals in our city who we may know for reason, if they're in our system, that we know they haven't been vaccinated and have more direct outreach to them? you know, a part of

that -- and one of the things that i've seen in some different states and cities that we haven't done as much of, but could make sense now, which is some sort of pre-registration in the sense if we know you're one of those people who hasn't yet received a vaccine and you want one, those set of people that we have on that list, that we're actually doing a lot more proactive support and outreach. i actually wasn't aware we are calling that many people, which is really great, 25,000 calls, but it does seem that this last mile may, for those set of people who haven't either yet been able to get an appointment or may some specific support or outreach, or that we haven't heard from at all, is there a more systematic

way to get to those folks? or are we using the multi-prong strategy that you laid out with mobile sites and community sites and all of those things? >> i think for us, the way that we're approaching this is really, again, through our community partnerships and these vaccine ambassadors. the vaccine ambassadorrs going to look at this holistically. there will be some people who will need the one-on-one conversations about hesitancy, and making sure all of their questions are asked. if they encounter someone who just has access issues, and they don't have transportation or digital access, that they're able to sign them up right away. a lot of the work that ambassadors are doing are around outreach and linkages. and they're getting trained so they can address any of the issues that come up to them. and specifically around the hesitancy issue. i do think it is going to be a lot of multiple engagements to ensure that people are feeling supported, that they have that trusted community

member. are there trusted medical providers with them to kind of lead them down this journey of whether to get vaccinated or not. >> chairman: got it. and i do think, you know, maybe this can be something that we get help from volunteers on or such. and we help do some more phone-banking or that kind of thing. there are still people who want to help, and thankfully we've been able to do much of it with the very talented staff that we have and health care providers. but this kind of last mile might require some additional proactive outreach. with that, for people who are homebound, is there a particular -- especially if they aren't connected to a service provider -- is there a particular way that we're making sure that they have access in the sense is there a number they should call? is it, like -- are we

providing on-demand support for people who are homebound to have access to the vaccine? >> yes. so there are multiple ways that we're looking at this issue. one is through, you know -- there are actually homebound health services. so ensuring that all of the homebound health services have vaccine and can provide it to their clients. if they're not getting health care, but there are meal services, they are informing us and we can work with them on how we can outreach to the homebound individuals to get vaccinated. and also working with our senior disability communities to understand the tools and mechanisms that are available to outreach to those communities. it has been a significant amount of our call center work, trying to outreach to homebound as well. so as you can imagine,

home bounds, there has to be a lot of planning around it, especially given the supplies of moderna and pfizer, there is tonight control and things like that, so we have to get a number of people in a certain area that want to get vaccines before we can go out so none of the vaccine goes to waste. but all of that has been worked through, and we've been vacationing them now for at least the last month, but maybe even longer. >> chairwoman: so is there a number they can call? if they're not connected to one of the organizations or one of those services, what options do they have? how are we getting to them? i'm not sure that that was addressed. >> yes, we have a phone number and, we can definitely get that to you, that people can call to access -- to inquire about access to vaccines.

[please stand by]

>> in the terms we don't have a lot of control. we do have communication with them. we can provide feedback. how much that will shift in terms of how they change operations, you know, that is unclear. i do think they are open to feedback and partnerships. if there is a community event we reach out to them to see if they would partner on that community event. we will continue to do that. >> thank you for that. i hope that they can broaden

their access and improve their systems. we have limited sales of what they are doing. a couple other more specific things. the supervisor melgar had a question that she communicated to me around safe way pulling the contract with sf state. is there any particular response that we had potentially working with providers to fill the gap and how we are responding to that situation at that site. >> yeah, definitely. we are working to stabilize the situation there by identifying supplementary to take over the site. >> we are trying to fill in some of that. maybe somebody else can step in. the hours of sites.

we have heard that some of the hours we to administer the vaccine is a barrier for some people. are there options outside of 8:00 to 5:00 or are there nighttimes. some cities have nighttime clinics for people with work considerations. is that something we are looking at or have done? >> especially as the city re-opens and more people are trying to figure out ways to ensure access to the working population as well. right now they are offering drop ins over the weekendses for specific populations. moscone is continuing to offer weekends as well.

city college is amenable as well. i don't know if you have anything to say about that. we are working as we rebuild the sites. a lot of the sites have weekends available as well because they are where community members want to come in. as vaccine is available we have been trying to keep weekends at least at one of our mass vaccination sites open for weekends. we have not yet been able to switch to much earlier or much later. a lot of that has to do with staffing and overall operations, being able to keep them going. certainly as each sort of population comes forward, that has been eligible we are trying to accommodate. we are looking at youth becoming

more eligible. right now 16 and over. we are thinking about the 12 and up in the future. we willed just operations to address those issues. i did want to circle back quickly. on your question about homebound. there is a specific on sfgovtv get vaccinated there is a section for older adults, disabled and homebound with phone numbers and access points to access vaccine. >> thank you for that. a couple last questions. the sf general drop in site has been very good thing to have. i certainly have over the weekend had a lot of panic texts and things from people working

there that felt like there was nobody showing up to it. they had more capacity than they were meeting there. any plans or how are we thinking about the expansion of sites to include everyone for drop ins. right now i don't think in the big sites we have drop in accessibility for the entire city. is it code restricted? how are you thinking about that and that decision? i assume it is based on supply. is there anything in the indicators to make that decision? >> definitely based on supply and the fact that the health clinics are meant to serve the safety net population. we want to ensure that we

continue to make strides there. a lot of that outreach and engagement and getting them navigated to the sites are important. we don't want to lose track of that. there is a balance of opening up to the general population versus the populations most impacted by the decision, poor access in general we are trying to navigate to the site. we do think about this on a regular basis. do we open up, do we try to do extra efforts to reach those populations? there are times general has opened up. not to every zip code but to multiple zip codes. as the outreach strategies continue, we will prioritize the population most affected by covid. >> definitely. that may beings sense. it was for some amount of time it has been a number of zip codes eligible. i appreciate the focus on the

zip codes. it is half the city. those zip codes are targeted populations being reached. those zip codes are diverse. i represent some of them. some also have very high income folks who are part of populations not the target around the equity focus. i am sure there are zip codes in the sunset and richmond who do have residents who are part of this target population. i understand. it is a balance. it is a question that i definitely get so i understand how you are approaching it and why. another quick thing. i get asked about the second shot. in some cases people can't go back to where they were and have

a hard time or got the first shot in another place. how do we handle that? i think people have a lot of challenges and barriers to understand what to do if they got the first shot elsewhere or can't go back to for the second shot. >> it is a great point. we want to emphasize if you are going somewhere to get the first shot you should plan to get the second shot there. circumstances can sometimes get in the way for getting the shot at the same place. this is a place to call the call center to see what is available. the other complicated thing is because vaccine is intermittent in availability. we can't guarantee some site will have pfizer and another site will have moderna. that changes all of the time that is some of the difficulty of trying to match people. there is a team here that can

help navigate our residents to the second shot. >> they should call the call center in that scenario. definitely something that comes up a lot. >> i will add that one thing. we get allocations based on second dose allocations based on first dose. somebody goes to another county for the first dose. that is not in our second dose allocation. we have to strip out. that is why this is a very small percentage. we have to dip into second dose allocations to other people or first dose allocations to provide second shots. >> that may beings sense. i am sure we have some people who do it the other way around as well. they are trying to get the second shot elsewhere or got first shot at one of the sites. i understand that.

i really do appreciate this update. i appreciate the progress we are making and the hard work you all put into this. you know and the hard work that still has to go. last thing. one more question. the potential of needing booster shots. how long do we imagine this infrastructure we set up will be in place? do we have any sense of that? how we are planning for the possibility in some number of months we may need some set of people may need to do this all over again? >> it is a great question. the studies are ongoing in terms how long immunity lasts with the covid vaccinations. i have heard anywhere the trial started last summer. we will see.

this smarhas it lasted a year. could people go a year prior to another booster? does it last longer? there is a lot of data that has to be collected. it is unknown at this point. what i hear from our experts is that there will likely be a booster shot. when? one or two years from now. immediate priority is the 12 to 15-year-olds will be approved in the next month. then 2 to 12 might get approved this summer. that will also take some infrastructure to ensure that people have access to vaccine, children and parents have information to make a choice. >> for the 12 to 15-year-olds we are working with the school district? how are we thinking about what that would look like?

>> yes, working with the school district for outreach in general. outreach strategy around that. also working with our healthcare system to determine the best ways to provide this vaccine. we anticipate there will be a lot of questions and providing that support. community-based strategies as well. still unthose three pronged approaches with maybe a slightly different angle. a lot of people want to talk to a pediatrician. >> thank you so much, both of you, for your work. please as supervisor stefani said to your teams and for your last year for you all it has been, you know, but i am happy for our city and thankful for the work you put into it.

i share the pride that supervisor stefani had with where we are, and i know we have a ways to go. i appreciate you enduring me as well during the last few months and my obsession with every little piece of this. as someone who followed it very closely in every change and everything, i think you have done a fabulous job. i am grateful for your work and leadership. we will keep it going. we are in a great place. thanks, chair mar. i appreciate it. >> i also identify with supervisor stefani's remarks and thank you for your leadership and work with the vaccination strategy and plan, thank you so

much doctor carol. i had a few other questions in addition to supervisor haney's questions. the first is around the role of volunteers in our vaccination work. we had set up an emergency volunteer program where people cosign up to volunteer and help out with the vaccination plan as well as other covid response work. i have observed volunteers in action in some of the vaccination work. i also got vaccinated like my colleagues at the sf market site. it was an impressive operation and i appreciate it that sutter healthcare workers staffing there. there were volunteers staffing to direct us and that was great to see and talk with a lot of the volunteers who were activated for the sf market

site. also another example in the vaccination network which has been impressive in reaching vulnerable communities and all communities in the city. in my district the community vaccination set up by volunteer doctors as part of the clinic. i understand our clinic network and they were from the asian medical group. it is inspiring to see volunteer doctors step up, particularly with bilingual capability to serve the chinese-speaking population especially. i wonder how if you could talk about how volunteers have been tapped and engaged with the vaccination work. >> i will jump in to give a shout out to the volunteers and

with my emergency management hat on to say that we need as many volunteers as possible. nert continues to recruit and train volunteers. the thing about it is that that is a group that is known, background has training and covered from liability perspective. so grateful to the fire department and to that program and each and every volunteer and encourage san franciscans to consider a nert volunteer. it really makes it so much easier and safer for us to bring people in to these kind of operations. operationally there is a lot of training that has to go into these jobs that we are doing,

and sometimes it requires commitment. not just a drop in an hour here or there. i did want to put a plug in for nerd and for the program and encourage people to get involved. >> i think just to speak to supervisor mar's reflections. there has been an incredible amount of willingness to be part of this sevfort because it is such a hopeful effort. people want to be part of this work, and i know there has been a lot of people within the health field that have volunteered their time in addition to the workday to day to really help communities connect communities that they work with to ensure they have vaccine. not every health care office is

getting vaccine. they still want to be part of this work. they have been really grateful to all of the people that have been volunteering around this. as mary ellen said. part of this is part we have to ensure some commitment because there is some training needed especially if you are volunteering to give vaccines and the lodgegis cal nature and ensuring that people trained can be in place for a certain amount of time. the volunteers have been helpful and essential to this work. >> thank you for that. in terms of getting to that. we have capacity with the current infrastructure vaccination up to 20,000 vaccinations each day. so far we have only done far below that.

i think you mentioned maximum 11,000 a day and supply is the main constraint. to get assuming the supply is going to increase in coming weeks and months, to get to the 20,000 each day volume, do we have enough staff capacity? is there a need to mobilize volunteers to help to get to that 20,000 doses each day? >> the infrastructure we built included the staffing model for it. we should have the staff to be able to get there. >> just my other question. supervisor haney touched on it about the under 16 population. the plan for vaccinating that

group. as the parent of someone in the 12-15-year-old category. it is something my family has been wondering and especially at school with the schools re-opening now. we are looking at full re-opening by the fall in mid august for all students. i just had questions about the plan for vaccinating the under 16 population. my first question you mentioned a goal of 85 to 90% vaccination rate. did that include the under 16 population? >> it doesn't. the initial numbers was for those eligible at this point of time. 16 and above. i think if you look at those

numbers still have to be thought through. the 85 to 90% would be for those 16 and above. >> do we have a goal for the under 16 population as far as vaccination rates? >> i think we still want to get to 80% goal because they will beacon grow gating in a school setting. we -- congregating in a school setting. the timeline will be dictated by the approvals and vaccine amount. it would be great before the fall if all of this goes into place. i am not sure we will have the 12 approved by the fall. we have to see.

>> what is the communication plan for parents and families? it seems like right now there is just kind of a lack of of awareness how the under 16 population fits in the vaccination plan. as the parent of one in the 12-16 category. >> on our side we are setting up the plan. i want to be mindful the 12-15 will be same as 16 and above. i don't want to send out a communication. there is a little difference in how it is rolled out. i think we are just wanting to see how it proceeds. if it is the same risk then it

shouldn't be an issue. it would be trying to utilize the different channels to communicate to parents. whether that is the school or city system in partnership to get the word out and through our healthcare system to get the word out. >> thank you for the update and the discussion. >> supervisor, i just got an update. we were able to do at least one day over 16,000 vaccinations in a day. very comfortably we know that we can go to 20 if we vaccine. wanted to share that number.

>> thanks, supervisor haney for calling this hearing. maybe we can go to public comment right now. are there any callers on the line? >> we will check with jim smith from the department of technology bringing us the public comment callers. on 26 or through sfgovtv if you wish to speak call in by following the instructions on the screen by dialing 415-655-0001. meeting id1872694043. pound twice and star to enter the queue to speak. for those connected to the meeting via phone press 3. please continue to wait until your line is unmuted and that is your opportunity for your comments.

do we have callers for agenda item 3? >> we have no public callers. >> thank you, mr. smith. public comment is closed. this is an extremely informative update. follow-up hearing and update on vaccination plan and strategy. thank you, colleagues, and director carroll for the important discussion we have had. supervisor haney, we might be good to continue this item to the call of the chair. >> yes, i would appreciate that. i move we continue to the call of the chair. mr. clerk please call roll. >> on the motion offered by chair mar this hearing be continue order to the call of the chair vice chair stefani. >> aye. >> haney.

>> aye. >> where mar. >> aye. >> there are three ayes. >> thank you, mr. clerk. can you call item 4, please. >> resolution supporting california state senate bill 110, also known as recovery incentives act authored by senator scott weiner and introduced on january 111, 2021 which would legalize the substance use disorder treatment known as contingency management. an incentive based program that gives financial rewards to those struggling with a substance use disorder if they enter substance use treatment programs and authorize medical to cover it.

if you call 415-655-0001 to provide your comments. >> thank you, mr. clerk. supervisor safai thank you for sponsoring this resolution. the floor is yours. >> thank you, chair mar. i feel like the last couple days we have been in committee. which committee am i in right now? sorry. trying to get my bearings. this particular item is extremely important. i am really happy to support california state bill 110 by senator weiner recovery incentives act. it is very important. i know supervisor stefani has focused on a lot of the

conversations about substance abuse focusing on how to transition people out of substance abuse and policies and ways and ideas are new and novel and are effective. sometimes it is simple things that we night not have as much experience with. i will say that i am excited to see more opportunities with contingency management. those in which there is a reward based system to get people and transition them away from their substance abuse and away from reoffending and committing crimes. you will remember the hearing i had about the intersectionality between substance abuse and residdyvism. it came out within the last year about 75% of those had

underlying substance abuse issues. you know, my office is working diligently with the mayor's office to open a peer led substance abuse program. we will push for that in this year's budget. this program will focus on reoffender and for individuals at risk every offending that have an underlying substance abuse issue. contingency management is a way to help people recover. it is offered to encourage those suffering with substance abuse issues a financial incentive in the form of gift cards or other ideas similar to that from abstaining from drug use. there is consistent monitoring of that and as folks are able to prove through testing and urine

samples that they are clean and you build on that. contingency management is highly effective model for substance abuse disorder and beneficial in this cities specially helping individuals with methamphetamine addiction that is definitely that along with fentanyl tied to the overdose issues in the city. today we are very lucky to have the director of harm reduction for san francisco aids to speak about contingency management and they are a cosponsor of s b110. i want to thank senator weiner and colleagues thank you for giving us space for this important conversation. mr. thomas.

>> thank you, supervisor and thank you for being here for this. i believe supervisor stefani had some remarks. >> sorry. i didn't see the chat. thank you, supervisor stefani. >> thank you, chair mar and supervisor safai for this resolution. i applaud senator weiner for introducing at the state leveling. this is an issue i care greatly about. what we are seeing on the streets. 699 people died last year of overdose and it is getting worse with no interventions that are helping right now. i just want to say that it is absolutely imperative to look at all ways of addressing addiction especially listening to those in recovery which is what we did a

few months back now. when we had the recovery working group present their basically suggestions on what we should be doing. what more we should do in the county of san francisco to address addiction. one of those is what you mentioned, the absence-led based recovery program. that has to be looked into. the whole medical issue is perplexing to me. it is a fundamental, it shows nobody understands the cities of addiction like they -- the disease of addiction. medical should cover forms of treatment and it is in the resolution. it is something that must be taken to heart.

i want to applaud senator wiener for sponsoring this for treatment services. with regard to contingency management. listening to addicts in recovery. supervisor safai mentioned gift cards or whatever. some people say that is nothing. to an addict it might be. also, housing. look at salvation army programs and the idea what it means to actually offer recovery services and meet people where they are at, sometimes that recovery is 30-days, 60 days, 90 days, six months, two years. that contingency management has to be looked into and supported providing individuals treatment with a reward system for continuing in the treatment program. we see know it works. aot wouldn't work. it is outpatient treatment. guess what?

there is a report saying it does. we also know with contingency management the peer review analysis from the science journal reviewed 30 studies where contingency management generated significantly better outcomes than other studies. it is important to examine all forms of treatment and make sure we are supporting them through medical in other ways. some of the studies participants were twice as likely to remain clean during programming than par pispants in programs. insurance doesn't cover it. that needs to change. we need to do more to support those who suffer frommarddiction not only at local but state and federal level. there is not just one treatment

to end the overdose crisis we see in san francisco and a cross this nation. we need to follow the evidence and listen to the people who have suffered from this disease of addiction. about every treatment at every possible opportunity. again, i applaud senator weiner for legislation and thank you, supervisor safai for the resolution in support of it. >> before we hand it over to laura. i know you have spent a lot of time and effort and energy focused on this issue. thank you for cosponsoring this. senator wiener let me know the biden administration endorsed this. the veterans affairs using it for a long time. i was happy to hear that from

senator weiner. thank you, supervisor stefani for your leadership and cosponsoring this. if we can have ms. thomas speak now. >> thank you very much. i have a few slides that i am going to share. first of all, thank you, supervisor safai and stefani for bringing forward this resolution and covering my talking points in your presentation. i very much appreciate it.

>> i am the director of harm reduction at san francisco aids foundation and on the methamphetamine task force that developed this as a recommendation. i will cover the bill itself, what the need is in san francisco, how it works and what we provide at the san francisco aids foundation and i am happy to answer any questions. as the supervisors mentioned, senate bill 10 recovery -- 110. it is currently not. it is specifying that contingency management does not violate anti kickback regulations. the legislation is sponsored by the san francisco aids foundation and other organizations including health

right 360 in san francisco. i am happy to let you know this bill passed the senate health committee yesterday 10-1. it is moving forward to senate appropriations next. among the reasons this is needed is because it is currently the best and most effective treatment modality for methamphetamine use disorder. methamphetamine is increasing. methamphetamine deaths are increasing. over half of the deaths involve methamphetamine. this is from the office of the medical examiner. the yellow line in the middle is methamphetamine overdoses last year. you can see the proportion of overdose deaths that included methamphetamine. we are seeing stark racial

disparities in overdose deaths in san francisco. the methamphetamine task force recommended expanding contingency management by addressing barriers to it. this bill comes directly from those recommendations. the department of public health funds some contingency management services and they propose a significant expansion to better address overdose deaths. this is a chart from the department of public health. the methamphetamine line is blue with diamonds in the middle of the chart. you can see all overdose deaths going up. this is through 2019. that blue line with the overdose deaths involving methamphetamine is going up significantly. again, this is pre-covid

pandemic and pre-increase in overdose deaths we have seen since that happened. what is contingency management? substance use disorder treatment intervention to provide rewards for positive behavior changes. evidence is clear that it improves engagement and retention, treatment outcomes, that it is very effective for the broad range of populations. we benefit from extensive research on it and it is recognized by the substance abuse mental health services administration, department of justice, american society of addiction medicine. the department of veterans affairs has widely implemented this across the country. they have been doing this for

over a decade and found it extremely effective. in particular, when it comes to something like methamphetamine use disorder where we do not have a pharmaceutical treatment like opioid use disorder it is important to make this as weedily available as possible. again, one of the main reasons this is not more broadly provided and what this bill is designed to address is the fact that we have in place local and state regulations that say providing anything of value to somebody in treatment can be considered a bribe or kickback. that is intended to address very real fraud and abuse in some programs around patient brokering and so on, but these

incentives are done in a context of a rigorous and effective treatment modality. that is just not addressed yet. that is what this bill would do. the san francisco aids foundation we have been providing contingency management as part of harm reduction, substance abuse disorder treatment program. positive reinforcement or prop. we target gay, by, transmen and women in our program. we found it is incredibly effective as part of harm reduction treatment. in a recent year 63% of people stopped using stimulants altogether. 19% reduced their use. 82% of people in the program

achieved their goals. we have had to as everyone else pivot to a virtual program. we are looking forward to starting to see people in person again. before the pandemic we started expanding to a broader population of people using drugs. mostly those in the syringe access program. a nice article in the new republic this year. tyrone clifford is one of our counselors in our program and a former participant in the prop program and he tells a story. he is one of the people senator weiner invited to testify in support of the bill yesterday. i am happy to stop there and answer any questions that you

might have. >> thank you. you are on mute.

thank you. you are on mute. >> can you talk about the gift cards. i am interested in the distinction between harm reduction versus the base. we are promoting in this budget abstinence base for residdyvism. i want your perspective and what you have seen on the ground. >> thank you for asking that. our goal is to help people achieve their outcomes that they want to achieve. we operate as a low threshold. people are welcome to come in on drugs, not on drugs. everyone is welcome. very low threshold and that is what we found effective.

people need to be welcomed in, feel safe, comfortable. we have counselors available. people can start talking to a counselor whenever they would like, and when they decide they want to participate in prop they are welcome to participate. the approach we found as effective is to be as low threshold and harm reduction oriented and client centered as possible including working with people to set goals around how they want to change their relationship with substances. for many, many people that goal is recovery. that is abstinence. we do not see distinction between harm reduction and abstinence as opposing forces. it is part of a continuum that

people may need to come into our services that are low threshold. they may decide what works for them is going to be abstinence. we will help them achieve the goals. it is up to each individual to set the goals in terms what they would like to do. from our results that 63% who stopped using stimulants that was their goal and we helped them achieve it. for the 19% reduced use. that is their goal and we helped them achieve that. we see that as a success as well. what we also know many part with contingency management afternoon decide they then want to go into more intensive residential treatment. we will help people go to that,

but we believe in operating a very client centered program where people choose their goals. those goals may change over time. they may say i want my boyfriend to stop yelling at me about drug use. they may decide actually i want to cut down on my use. then they may decide i think i want to stop using this altogether. they may change their goals throughout this process. we help them figure that out. that is what our counselors are skilled at doing. >> i understood you all were low barrier, there was a continuum. what i was trying to get clarity on. 62% stopping using stimulants is significant number. you are not going to be allowed -- you wouldn't keep rewarding someone if they were still

using, right? that is not the purpose of the reward based system? is that correct or am i misunderstanding? >> people come in and when they are in the prop program they come in and provide urine sample. if it is reactive for stimulants they don't get a reward. if it is nonreactive for stimulants they get a reward, but they are welcome to if it is reactive and tests positive they can come back the next time. >> you will still keep working with them. i am trying to draw the distinction between the reward and abstinence. can you go back to the other slide the one that showed the drug use and different types of drugs. >> this is overdose by death. that is fine.

obviously everyone talking about fentanyl, methamphetamine, opioids and if you were to put those together that gets the total number of overdoses we had in the past year. can you talk about this program and how you think it impacts the overdose crisis we are having in the city? >> absolutely. thank you for asking that. the largest substance most significant driver is fentanyl. if you look at this chart and say what happened in 2018 to made those numbers start going up? it was fentanyl arrived here. we are late. east coast cities have seen fentanyl before we did but that is what is happening here. some people are choosing to

combine methamphetamine and fentanyl, people using fentanyl but then using some methamphetamine as well to help stay awake and functional. even though methamphetamine overdoses are going up, many of those also involved fentanyl. it is not so much the case that there is fentanyl contaminating supply. they are combining the substances. among the ways in which contingency management can address the overdose crisis is that we are providing people with more education and tools how to identify their overdose risk, how to develop a safety plan, for all program accessing

syringe access. we are able to reach people more vulnerable to overdoses through that program, too. we are helping people meet goals every tewing substance use to reduce overdose risk, providing people with education, information and tools to help prevent overdose. reaching into new populations that may be more vulnerable to overdose. that is how we help address it. >> i appreciate that. i know supervisor stefani has a question. this is my last one. how many people are impacted by this program? how many you worked with. 63% stopped. what was the total number of people you got with this

contingency management? >> that is a good question that i do not know the answer to off the top of my head. we have had this program for 15 years at the san francisco aids foundation. it was provided by walden house before that. i will get the total number of people we have seen to you and i apologize for not knowing that off the top of my head. >> that 63% number that stopped with this. >> supervisor stefani, i know you had a question. >> thank you for being here today and your presentation. you just mentioned and i had a question. you just mentioned in 2018 we were taken off guard with fentanyl and how addictive it is off the charts. i was reading a report out of

british columbia we are now dealing with something more deadly the car fentanyl with increasing regularity in british columbia. is that on your radar and whether or not plans are made for that substance being introduced into the market here? the good news is that narcone addresses these. the response for heroin, fentanyl, car fentanyl overdose is all the same. it continues to be the best tool that we have available. that is why i think in san francisco we have so many

fantastic services and programs on the ground in san francisco aids foundation, the dope project, national harm reduction, distributing naloxone. many members of the board of supervisors are trained to use it through these programs. regardless what the opioid is naloxone is our best response we keep a close eye on what is out there. we hold to build out better drug checking services to better understand what the people in the substances they are purchasing and using. i think we are all very concerned about what is out there. this is the danger of

prohibition and unregulated market people don't know what is in the substance. that is why decriminalizing drugs is going to create a much safer use situation for people. >> thank you. that is another topic decriminalizing all drugs. alcohol is a drug and it is legal and it causes more pain and damage and economic decline to cities, counties, and states in the nation because of the impact on alcoholism. violence and the criminal justice system. alcohol is a legal drug and the studies show it causes more pain and harm than any other drug out there. that is legal. legalizing all drugs is another

topic. back to the questions supervisor safai was asking about the program and how he was talking about the nature of it. i appreciate the low barrier entry. it helps deal with the stigma attached to addiction. people who really have trouble admitting that to themselves they are alcoholics or both and have the low barrier is essential. you mentioned something you want to help them achieve the health outcomes they want to achieve. i think that is a good goal, but i think, too, when addiction crosses over into -- this is my question. when addiction crosses into perpetual harm for an individual using and then harming others.

you don't punish people for being an addict, an alcoholic. that would be wrong. when someone's behavior as a result of being under the influence of methamphetamine or in a car with a .20 alcohol content and gets behind the wheel and kills a family. that is behavior to be reckoned with. my fear is that sometimes when people are seeking help that denial of an addict and alcoholic is so deep and sick and so occurred difficult he -- so difficult to imagine drug without the drug. i am just wondering if with the contingency management is really

there to provide those incentives for people to put that drug down that is causing such harm in not only their lives because if they are stuck in the criminal justice system because they continue to use, there has to be some type of acknowledgment that, yes, the health outcomes they might want to achieve, they still think if they would just go a little more therapy or do this or get this job or get that, maybe everything will be all right. yet the problem is likely their addiction that is causing all of the other issues in their life. denial case is what i am focusing in on. it also goes to enabling. what is actually -- low barrier

entry. relapse is part of addiction and that has to be understood as well. not like you just decide to give up one day and good to go. it is part of it. i just want to make sure that we are acknowledging that very heavy piece of denial that comes with being an addict or alcoholic needs to be addressed in a way that helps that person get the help they actually need. they might not think they want to give up the drugs. i remember victoria westbrook said at the hearing from the recovery summit working group her life got bigger in prison because she gave up the drug and she is clean and sober and is able to use that to help others. i just want to make sure that we

are incentivizing people in a way to get off their drug if they absolutely need to. there has to be at some point where we admit that people cannot do that drug or they are going to harm someone and continue to harm themselves. meet them where they are at and a chiefing the outcomes they want to achieve we need refinement or understanding. what does that mean in this program? do you have people there that understand addiction that have been through it to address that denial to help people get through to the other side? >> we are a state licensed substance abuse program. we have certified licensed

counselors on staff. they are extreme with many of whom like tyrone clifford came through the program themselves and are now working in it as a counselor. the life experience as well as the education to be able to provide these services. i will say that different -- not everyone has the same substance abuse disorder looks different in different people. people have different pathways and things that they need in order to develop a healthy relationship without substance. for many that may well be not using it ever again. for some it may be not using any

substances but other people may do well with cannabis but not with methamphetamine, for example. we do not believe in one size fits all model or approach. that is why we have the client centered approach that we do. so that we can work with people for them to figure out what it is that that works for them, for their family, community. again, for many people that may be not using the substance. we will work with people and continue to work with people trying to change that relationship so that it is not a harmful relationship for them with that substance. that is where the science and evidence around people's relationship with substance abuse disorder works.

it is different for different people. many people find their way out of the problematic relationship without accessing treatment programs or going to a 12-step program. we have extremely skilled and educated counselors, many have personal life experience and we work with people where they are and help them get to where they want to go. we do not require abstinence. we don't identify it as a goal in they don't identify it as their own goal. >> thank you. i absolutely know that one size does not fit all. my brother is a heroin addict.

he is off heroin but still drinks. he lives a different kind of recovery that works for him. i have a sister 11 years sober. she can't drink or take drugs or any of that stuff. she has to be free and clear of any drug. she is in 12-step program. i understand one size does not fit all and it is different from everyone. i understand the denial and everything that i have seen my family go through for my brother and sister who have suffered greatly at the handses of addiction. i care about this subject because i have experience with it. thank you for what you do do

help addicts. it is not one size fits all. we have to meet people where they are at and destigmatize the fact people suffer from this ths disease. we have to absolutely provide paths and different methods of recovery so we can do everything to help people live a better life and get the type of help they need. thank you. >> thank you for your heart and passion on this issue. i appreciate your passion for it. thank you. >> thank you. i would love to be added as cosponsor of this resolution.

i had a couple quick questions about what the pass same of this legislation means for san francisco. you have been doing this already and it changes the potential for reimbursement. does it have any particular immediate consequences that you can share on our ability to expand this model or places where you see it could be implemented immediately if this law were to pass and how many people we might serve in this way? what are the next steps if this were to pass? >> thank you, supervisor haney. unfortunately it would not result in immediate changes in san francisco. i know the department of public health is trying to identify

funding to expand contingency management. this needs to change at the federal level as well. we are fortunate that the biden harris administration identified the barriers to contingency management as a drug policy priority. we are confident that the center for medicaid and medicare services will change their regulations on this at the federal level. it needs to be changed in parallel at state and federal level. senator wiener's bill is at the state level and we will work at the federal level as well. we will be able to use medical dollars for this.

>> it doesn't needly changenition about today federal changes. we are doing it here but not to bereimbursed in the same level? >> that is correct. >> are people part of this program entering the treatment in certain types of similar ways or are there housing situations at all shared or sort of something that is a huge diversity of ways that people come to that? it seems like something that could exist in certain types of residential treatment programs or supportive housing or

otherwise. are there partnerships in that way? prop is funded with h.i.v. prevention dollars through the department of public health. it was created because of the connections between methamphetamine use among gay and bi men and h.i.v. vulnerability and transmission. that is the population that is targeted. we find a lot of people come to us by word of mouth. people who graduated from the program will identify that other friends or colleagues could benefit from this into it. word of mouth is one of the main ways people find their way into this program. as we expanded prop for all to folks who accessed the syringe access, then that has been our fringe access staff letting people know, putting up flyers,

holding drop in groups when we could do drop in groups to recruit people or identify people interested in it. we believe this could be provided in many, many other contexts. residential programs, housing situations makes a lot of sense. i know that the department of public health is eager to expand services looking at the prop v our city our home funding. that would be a question for them in terms where else they will provide this. the new drug sobering center/drop in center is hopefully opening later this year. that is a place where it could be a place to provide these services. we are open to partnering with anyone who wants to provide

these. >> thank you. appreciate your work. >> thank you for the presentation and engaging in this important discussion and your leadership. we will go to public comment. >> sorry. i appreciated the last question from supervisor haney. i wanted to say something for the record in terms that people are aware of the proposals are abstinence base with adult probation. we see this program, as ms. thomas said, if people request or need to be referred to more intensive residential treatment that would be abstinence base. that is the program we are trying to promote and expand and

gets to supervisor stefani's point. i wanted to ask you and get on the record also since we introduced this legislation excuse me resolution in support of state legislation we have been looking into expanding these opportunities in this upcoming budget. we will look for opportunities to do that in partnership with public health and their partners. we see this as an important piece of dealing with overall substance abuse problem and crisis in the city. we are in conversations with our city our home in trying to get continued more support in draft recommendations that would come to the board of supervisors. i wanted to get that out there.

secondly, not to create conflict, but building a little bit more on what supervisor stefani said. i understand low barrier, you have to meet people where they are. i understand there is each person is going to have a specified need. harm reduction here and abstinence based here. recovery summit that was done that supervisor stefani was part of and add adult probation was part of and a lot of current and former addicts were part of. they were crying for help and asking for more abstinence based programs. we don't have those in the city. we don't offer that as much as we offer more pure low barrier harm reduction. we have only seen those addicted in the city increase.

i wanted to get your reaction to that in terms of lack of opportunity for abstinence based. some of it again has been shown to be asked for and requested more heavily by those that are black and brown. just wanted to hear your reaction to the request for more abstinence based and what your thoughts are on that and why we as a city do more of the harm reduction versus more abstinence based treatment and programming. i see this prop program and contingency management as more effective as shown in your statistics when people get to abstinence based they do a lot better in this program. >> i think that the city has an

enormous amount of abstinence focused treatment that our residential treatment programs, speakers, places, ctrc, health right 360 are providing abstinence focused remember treatment programs. you know, i feel like we have got a small handful of harm reduction therapy center, our program, there are not a lot of harm reduction treatment options out there versus the abstinence oriented ones. that said i fully support expanding the services. the biggest challenge that we face is just not having enough options available for people and they need to be cultural

appropriate, accessible, affordable for people. this is part of the work we are have done on treatment on demand coalition. pushing the city to expand the options available to people. i appreciate the work that adult probation have done to identify additional areas where we could be expanding our services. i support expanding our services. people should have the services available that work for them. we also need to make sure there is residential services that are accessible regardless of what medication they may be on, regardless of treatment for other health issues in the treatment programs. you know, i support request for more services absolutely.

i do think the majority of the services we provide or at least majority of funding is for abstinence focused services. >> majority funding is for abstinence focused services? >> right. health right 360, residential treatment programs. >> that wasn't my understanding. i am happy to look into that more. thank you. public libcomment. >> are there any callers on the line? if you wish to speak call in by

following instructions on your screen by dialing 415-655-0001. id is (187)269-4043. press pound twice and star followed by three to enter the queue to speak. for those connected via phone press star 3 to be added to the queue if you wish to speak. for those already on hold in the queue wait until you begin. the prompt will sound like notification your line is unmuted. mr. smith please connect us to the first caller. >> that was an awful lot of discussion for a resolution

supporting 10. this -- 110. this is not going to affect anything in san francisco. we don't know if it will pass. i mean it seems like this was an excuse to discuss the drug crisis in san francisco. it is fine but maybe we should be honest what we are doing here. as far as s b110, why are we spending so much time talking about whether or not we should support a piece of legislation in sacramento that may or may not pass? if it does pass hopefully it won't change anything in how medicaid funding happens.

that is something that happens at the federal level. this is a little bit ridiculous. as far as drug policy goes, i am concerned about the -- pardon. >> you have 30 seconds. please continue. >> i think that the management works but i don't think that our non-profits organizations are really to offer it. we have a lot of problems with kickbacks. we need more oversight before offering these programs. i would rather have legislation focusing on that.

>> thanks. next caller, please. >> good afternoon, supervisors. i am a fourth generation native san francisco in district 7. a temmember for prop 36 in san francisco in the year 2000. these incentive programs, prop for example, are life savers. specifically in my case it was my partner. his participation in the program was a perfect way for him to introduce himself to recovery. it took several instances to get a significant time.

it led him into a six month residential program when he was ready which diagnosed schizophrenia which was treated. if it were not for these programs he would still be on the streets, most likely dead. now he is employed, owns his home abstinent with meth for flee years and he is using cannabis. if it wasn't for this system he would not have had the doorway to the life he has now. i ask for your full support for this resolution for folks like him who don't have any other access. thank you. >> next caller, please.

>> i participated in the prop program when i was unhoused. it was a great program. they do testing. it is hard to fine. i don't know where to pick up a fentanyl kit. if all drugs were decriminalized like in oregon you would be able to -- there is less stigma. it is traumatic. these policies do matter. even if it is federal. look at maine. san francisco passed the ordinance and then the state passed to legalize marijuana. now at the federal level we are about to legalize marijuana.

drugs should never be a policing issue. it should be moved to public health because police don't know how to deal with addiction. they don't know how to deal with it. more harm than substance abuse. i would just i think this conversation is important. i feel like the city has not -- i don't want to use the word failed. anything addressing homelessness. the trauma that i saw from being unhoused previously it comes back when we are trying to apply for covid rental assistance. not enough accountability in government. i don't mean just in the state. in the city. we don't know what other

departments. i totally accept accountability. >> thank you. mr. smith nest caller, please. >> good morning, board of supervisors. thank you for holding this hearing. i am with the h.i.v. advocacy network. i want to say that i think programs like prop and these programs are essential for reaching people using substances in the city who are looking for support in their journey around substance abuse. i want to add that it is crucial that we de stigmatize substance abuse. the more we stigma ties it and decriminalize we push people further underground. we are putting up barriers for people who may need help to

access that help. it is crucial that we refrain this conservation and embrace harm retacks to support people, love -- reduction to love people and empower them in a way that works for them. a lot of people use marijuana. that is partially criminalized for decades in this country. a lot of the drug criminalization results in racist policies. i invite everyone on the board of supervisors to think about substance abuse and support communities in ways that are helpful. sb110 is one way to prove public health interceptions to support folks. it is important that we are a leader on the topic and help

push this to the state level to expand access to folks vulnerable throughout the state. >> thank you for your comments. next caller, please. >> i am francisco dekosta. i have been listening to this deliberation. first and foremost we need a needs assessment. have you all supervisors heard of the name. [indiscernable] corporation? if you do a little research you will find out this company headquartered in san francisco distributed thousands of tons of opioids. what have you done to approach this company so that they can address what you are now delibberating?

if you look at your deliberation, you never once mentioned spirituality. you do have in san francisco now thousands of people on opioids, painkillers, heroin, cocaine abgod knows what. from time to time i watched a documentary on canada. how they address the situation over there. especially the supervisors asking so many questions. the situation at hand. the facts those people who you pay $70,000 per year to give them a tent so they can use drugs. you guys are pathetic, man.

you don't have the ability to do a needs assessment. you are one big line of you folks is live issues. lifestyle issues. >> thank you. mr. smith next caller, please. >> i am rana. i both work and work in san francisco. we refer folks to the program talked about and use harm reduction to get folks where they want to be. i himself use crystal meth. really this conversation is about a lot of things. i want to focus on two things

because of time. it is about shifting the culture in the way we approach drug use and treat drug users. now we don't have spaces like the drug sobering center or sb110. folks are marginalized and not given access to the things they need. to my second point this is very much about access. i am not sure how familiar have tried to access these services that are not oriented towards abstinence orientation. there are not that many harm reduction not abstinence based. i as a person who lived in san francisco and oakland there are not that many places. the media may make it seem that way but it is really not. this is really about changing

the way three see these things to hopefully get to a place where we decriminalize all drug use. it is pay racist war against black and brown people. people don't care about drugs and why they use cocaine. they hate black, brown and poor people. this is what we need. i hope you can support it. we need different options for folks, not just one. harm reduction is what i have seen. a lot of clients in the clinic i tried abstinence and it didn't work. >> thank you. mr. smith have we reached the end of the queue? >> that was the last public comment. >> thank you. public comment is closed. i want to thank all of the

committee members who spoke during public comment. thanks again colleagues and laura thomas for this important discussion about sb110. contingency management. really continuing our discussion that we have had in this committee about how we as city are addressing the urgent drug use addiction and overdose crisis in the city. thank you, supervisor safai for the resolution supporting it. i would like to be added a cosponsor. >> thank you. do you have any closing remarks before we make the motion? >> supervisor safai. >> i appreciate ms. thomas and the aids foundation and supervisor stephanie. thank you for supervisor haney

and marfor joining. we will push even if it is a small step we are going to push to get additional funding for continue genesee management. we are talking with department of public help. they we are doing residential alternative sentencing program. there is a light difference of definition in terms of what we offer in the city. i think most of our city offers kind of on a continuum where people begin low barrier and move toward harm reduction. once on their own they might get abstinence based. my understanding from talking to folks in the field and in the city we don't offer abstinence based treatment in a residential

environment. >> we will continue this. we are excited about this happening. hopefully medical will changed and we will get this funded and expanded to address the crisis that we see in our city. that is an important step forward. thank you today. thank you chair mar and committee members stefani and haney for your support. >> thank you. supervisor stefani would you like to make a motion on this item? >> sure. thank you again. i would move this forward to the full board with positive recommendation. >> on the motion offered by vice chair stephanie. vice chair stefani. >> aye. >> haney. >> aye.

>> chair mar. >> aye. >> mr. chair there are three ayes. >> thank you. mr. clerk please call item 5. resolution supporting california state senate bill 299, authored by senator connie leyva introduced to remove barriers of victims and families of peace officer violence with the california victim compensation board fund. to comment call 415-655-0001. entered the id. pound twice and star followed by three to speak. mr. chair. >> thank you supervisor safai for bringing this forward as well. the floor is yours. >> thank you, chair mar.

this is particularly personal. one of my staff members had their brother killed at the hands of a police officer. it is particularly raw. it is something that i think more often than not we don't spend the time thinking about the aftermath. we think about the cause, person, incident. we don't think about the impact it has on lifelong manner to the parents, siblings and others. that is an important part of the conversation. as we applauded the outcome in the murder of george floyd and we are asked to do more. how each officer-involved shooting has a different set of

facts. 299 doesn't seek for innocence but rather leadership is there to provide support for the family of the deceased. under the leadership of district attorney's office we have started providing services for victim's of police violence. sb299 would allow counties to provide the same services san francisco has. i want to thank the sponsor of the state level. this is something talked about at the state level in the past and will continue to move forward again. i know we have our district attorney here as cosponsor and we have anthony demar tino

representing california for justice. thank you for the space to talk about this today. it so happened at the time in the week we got the verdict. it is a step forward regarding reform and how it impacts families. thank you, chair mar. >> thank you, supervisor. the floor is yours. >> thank you, chair mar. good afternoon everyone. thank you, supervisor safai and the whole committee for the opportunity to speak today on senate bill 299. this couldn't be more timely and more personal not only for supervisor safai and his team but for so many in san

francisco, across the country. the proposed change in state law would follow the policy i implemented last year. would make necessary changes to expand access to sick vim compensation and remove barriers faced by victims and witness's of please violence and other crimes. >> it is important to ensure equal access to services abresources of survivors of police violence. june 9, 2020. my office took action at the lomlevel to ensure equitable relief for those harmed by police use of force. the san francisco district attorney's office policy on victims of police

officer-involved shootings. now provides compensation from victim services funding for those harmed. for those who witnessed it and loved ones of those hope harmed. it includes victims and peaceful protestors lieu may be harmed while asserting their first amendment rights. the full spectrum of people tim packeted by use of force pie the stay. sb299 was inspired by our policy. it will ensure victims of law enforcement use of force regardless of county of resdeswill have equitable relief. it doesn't matter if they live in san francisco or the other side of the bridge if they get

service after harmed by use of force. it is a pathway for survivors to access support. human role and counseling to recover from the trauma and hardship of being seriously injured. compensation is only available when a survivor has no other avenue for covering the cost. payer of last resort. if someone has private health insurance or covered by medical that would cover expenses. as a stop gap this law would ensure no one has to rely on gofundme to bury a loved one killed buy movers. there are limits how much can be

paid. expenses must result from the crime. this is not an open door or flood gate of possible claims. eligibility restrictions currently lomsurvivors out of compensation. victims of police violence do not receive any form of victim compensation and if they do it is years after the harm is done. since my team implemented our survivors of police violence policy we have been providing financial assistance to victims and family members. we only had a handful of request

a policy that sb299 would essentially replicate state law. it is important to remember without the this law some of these folks wouldn't know they can come forward to ask for benefits. in addition to services resources this is also a critical way to inform folks of the services and resources that exist and making sure they come forward to get support they need. we have reimbursed under this policy one family for funeral and burial costs in san francisco in the amount of $7,500. this state law is important because serious juror loss of life has devastating physical emotional and financial impact on those harmed and their immediate families.

funeral and burjuly expenses are $10,000 and family members have no way to pay after an unexpected tragic death. mental health services are a vital resource this would make available to those harmed by police use of force. addressing trauma in the grief that comes with loss of life with being seriously injured requires expertise and professional support and this would make that accessible to those who need it. treatments and therapy can mitigate risk for future victims and violence as well as people who have been harmed or have experienced trauma indirectly, family members harmed ending up arrested or incarcerated. in short s b299 is to help with

all victims. many people may not even require the california victim compensation board resources we offer. when we can connect with community based organizations. or with other closer to home resources. we need to make sure folks know there are resources and stopgap when for whatever reason community resources do not address the needs. because this law would make the california victim compensation board a payer of last resort, it means that we would exhaust all other resources, other forms of insurance, would pay in the first instance. when folks don't have those sorts of supports, there is no insurance, there are no local resources, we cannot simply say too bad so sad.

we must provide support for everyone harmed. we are all aware this week more than ever there is real harm caused when police use force even if that use of force is lawful. it causes harm to individuals, to the family, to the entire community. that harm can do damage as well to the trust in law enforcement and broader criminal justice system particularly by poc who are most affected by crime. i speak 299 to rebuild the trust. we can begin to ensure that use of force is lawful we recognize harm and do our part to support those harms. regardless of what county someone lives in people need support when they are injured or loved one is killed at the hands of the state. i am honored to sponsor sb299.

it is supported by attorneys and survivors and family members and addvo cats directly impacted. california for safety and justice is also a cosponsor. i know they are presenting today and will cover additional detail on the bill including powerpoint presentation. together we are available to answer any questions you may have. we urge you to support the passage of this bill in sacramento. thank you. >> i want to get on the record my lead cosponsor walton i want to acknowledge him as well. chair, mar, to the next

presenter. >> thank you. is mr. demar tino here from the california for safety afternoon justice? >> yes, i am here. >> great. the floor is yours. >> thank you for asking me to present. it is an honor to present. after the da and i want to thank the da phone leading on these efforts and leading with survivors and victims last year and putting them at the forefront. good afternoon, chair and supervisors, i am the government affairs director for california for safety and justice and crime survivors for safety and justice california. we represent 10,000 crime survivors through the state. before i dive into the bill the da covered really well.

i want to thank you for inviting me to speak on sb299. i would like to thank senator for coauthoring this legislation. the bill as the da mentioned is cosponsored by several great groups throughout the state. i want to acknowledge them as well. it is cosponsored by the district attorney, california for safety and justice and well as state controller, brought, yh alive. sb299 will remove barriers of violent crimes in accessing the victim compensation program. this is an opportunity to lead the nation at this moment.

also to build off the amazing work that san francisco is doing regarding this issue. i am going through a few slides. it won't take too long considering the da covered these.s already. california victims compensation program is to access support and covers expenses medical bills, funeral and burial expenses and counseling only when a survivor has in other avenue for covering costs such as insurance. this is a payer of last resort. there are limits on how much can be paid for each expense. expenses must be related to the crime. what is the problem. why this bill? current eligibility restrictions can lock families out of necessary and important

assistance. this requires the board to verify the crime occurred based on the police report. it is giving weight to the opinion of law enforcements. survivors may be denied for noncooperation with police. for most victims they cannot approve without a police report. data by the u.s. department of justice found six in ten victimizations are never reported to the police. they may use victims not afforded the same flexibility. these are wrong for survivors of police violence. the police report is often el elusive and louvers are rarely charged. they must rely on opinion of

police. the very people responsible for the injury may be tapped as documenting it and as signing blame. they can have undeserving survivors who received the message the experience or loss is notes worthy of support. i want toking willing this is national crime survivors for safety and justice. we have been hosting events throughout the week culminating in the saturday event to acknowledge all victims experiences. that is what this is about. what is the solution which the da covered quite well. i will go more into detail. it is critically important to receive support needed to address trauma regardless who caused the harming. survivors of violent crimes should not have to overcome

unjust barriers to compensation. this will improve access to the critical program for survivors. it would ensure the definitions for victims of compensation include victims injured or killed by police use of force regardless of whether the officer is arrested or charged. second, it would bar exclusions based on victim's alleged actions unless they sawed serious bodily injury to another or killed someone whether they cooperated with police following the crime. no survivors denied cover age in the case of homicide would ensure family members have access to assistance for burial and funeral expenses. would allow the survivors to use other documentation than police report to verify the crime occurred extending flexibility.

prohibit denial on the police report in cases of police violence. it would clarify the decisions regarding the eligibility are not addnissible in any other proceeding or use of force. i want to acknowledge this is supported by over 40 groups throughout the state. numerous individuals including our large chapters throughout the state of crime survivors. i want to acknowledge last tuesday the bill was heard in public safety at the california legislature. passed out of committee on bipartisan unanimous support 5-0. it is now in senate appropriations committee. i ask for your support on this important bill. >> thank you for the presentation and for all of your

work with california for safety and justice. i want to thank you for leadership and pioneering work on this needed policy to pave the way for sb299 to ensure equitable relief and compensation for victims of police use of force. thank you so much. of course, supervisor safai thank you for bringing this resolution forward. colleagues any questions or remarks? >> i think everything was summed up well, i made in opening remarks. thank you both for joining us today. i appreciate it and ask colleagues to support this and move this forward. >> public comment. are there callers on the line? >> we are checking for callers in the queue.

for those watching on channel 26 or on sfgovtv if you wish to speak call in now by following instructions on the screen. dial 415-655-0001 id (187)269-4043. pound twice and star followed by 3 to speak. mr. smith please connect us to any caller on the queue for this item. >> supervisors i am francisco dekosta. i am the director of environ maljustice advocacy. i have been involved with community policing for 40 years. let me clearly state to you that our city this city and county of

san francisco is a racist city. one way to look at it is to check on our police department for all the decades. our district attorneys, city attorneys, chief of police, many of whom i know, supervisors, many who are not educated on issues. they don't know what is happening at ground zero. do you think that san francisco should have had a gang task force that created the

information about some gangs and we don't have gangs in san francisco? there are sets that moved away from san francisco and are creating a lot of pandemonium now. this happened because of rogue police officers. i served in the department of defense, department of interior and united states so i know what i am talking about. it is time for our board of supervisors and addvo cats to work with the federal government, to work with this u.s. attorney general to bring up reform. >> that you for sharing your comments. i believe we have one more caller in the queue. please connect us.

>> i am a worker. last year i was -- i am in support of sb299 or this bill. last year i was the victim of attempted assault. i called 9-1-1 because that person kept following me. i was on the phone with the 911. they asked me if i was under the influence of drugs. i can't want to answer the question. i said yes. when they came they searched me for weapons and drugs. because they knew i had used illegal substance they gave me a citation. i was never even connected to

like any sort of facility. now, i need legal aid. i still haven't found it. it is a year already. i am going to e-mail the supervisors. one supervisor here and i haven't gotten response from legal aid. i will try all of you. this whole criminalization of drugs makes it now we are not treated as victims we are looked at as criminals even if we are victims of violence. thank you. >> thank you for sharing your comments. mr. smith let us know if there are any further callers in the queue. >> we have one more caller.

>> good afternoon, supervisors. i am the executive director for california for safety and justice. thank you all for taking a moment to acknowledge the importance of this bill. what it means to so many people whose lives are directly impacted by police violence. i want to thank my colleagues for their leadership on getting this legislation moved. yesterday we hosted a town hall where we had several members of our community directly impacted by police violence talk about their experience and the aftermath. while they are grieving and fighting for justice they are showing up to make sure that this never happens again. if people are harmed no matter who caused the harm especially if these individuals are responsible for keeping the

peace and safety of our community members, they may be held accountable. people receive the help they need and if they don't experience the barriers or be treated as social par rias while they get help or reach out for help they need. you know that the incidents of violence that have taken place targeting black and latino communities across the country are top level of concern. removing barriers for people to get help immediately, for them to do things like bury loved ones, relocate, get access to mental health services and not be treated or restricted because of contact with law enforcement is critical. i want to thank you. thank you supervisor safai and the committee for taking time to hear us and we hope to get your support on this important piece of legislation. >> thank you for sharing your

comments. mr. smith, could you let us know if we have further callers. >> we have no further callers. >> thank you. public comment is closed. colleagues any final remarks before we move this item? great. supervisor haney did you have remarks? >> no. >> it looks like supervisor haney wants to say something. i will wrap it up. >> appreciate your work. i would love to be added as cosponsor. thank you for bringing this forward. >> supervisor safai. >> thank you. we didn't time it this way but i

think the timeliness of this with everything that the country is thinking and feeling this week was extremely timely and this is something that should be moved at the state level and it is respectful for those that have been the victims of violence and police violence. i urge everyone to support this. this is a small but important step in the right direction. thank you. >> thank you. colleagues i will move we send this to the full board with positive recommendations. mr. clerk please call the roll. >> motion offered by chair mar this resolution be recommended to the board of supervisors. >> chair stefani. >> aye. >> member haney. >> aye. >> chair mar. >> aye. >> mr. chair there are three ayes.

>> thank you. mr. clerk any further business? >> there is no further business. >> we are adjourned. thanks everyone. >> thank you, colleagues.

>> clerk: okay. can you hear me now? >> president buell: yes. [roll call] >> clerk: okay. this is the recreation and park commission meeting of april 15, 2021. please note that due to the covid-19 health emergency and to protect board members, city employees, and the public, the meeting rooms at city hall are closed, however, commissioners are participating in the meeting remotely to the same