fire commission meeting july 12, 23 the nime is 9. . 01. this meeting is held in person. members may attends the mote to be observe and provide public comment at the physical meeting location or calling 415-655-0001 and entering the meeting id access code: 2660 237 2537 ## ensure you near a quiet location. speak clearly and turn off background sounds wait for the item you would like to address. when prompted press star 3 to be

added to the queue. system will notify you when you are in line callers hear silence had waiting for your turn to speak. operator will unmute you. callers will have 3 minutes to provide comment. roll call. president nakajo. >> present. >> president morgan. >> present. >> vice president. >> commissioner feinstein excused. commissioner fraser. >> present. >> and commissioner collins excused. and chief of department jeanine nicholson. >> present remote.

president nakajo will read the lan acknowledgment. ramaytush ohlone land acknowledgement the san francisco fire commission acknowledges that we are on the unceded ancestral homeland of the ramaytush ohlone who are the original inhabitants of the san francisco peninsula. as the indigenous stewards of this land, and in accordance with their traditions, the ramaytush ohlone have never ceded, lost, nor forgotten their responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory. as guests, we recognize that we benefit from living and working on their traditional homeland. we wish to pay our respects by acknowledging the ancestors, elders, and relatives of the ramaytush ohlone community and by affirming their sovereign rights as first peoples >> thank you. item 2, general public comment. members may address the commission on matters within jurisdiction not on the agenda. speakers address remarks to the commission as a whole and not individual commissioners or department personnel. commissioners are not to enter in debate or discussion with the

speaker. the lack response by the commissioners or department personnel does in the institute agreement with or support of statemented made during public comment. >> madam secretary there are members who wishes to comment. >> there is nobody approaching and nobody on the public comment line. >> thank you. why public comment is closed. >> item 3 approval of the minutes. discussion and possible action to approve the regular meeting minutes of june 21, 2023. any public comment on the minutes? >> nobody propping the podium and nobody on the public comment line. >> public comment is closed. questions or comments from the commissioners on approval of the minutes. >> those other minutes of the june 28 meeting. >> june 28 meeting madam secretary on my agenda it says

the 21st. >> fraser you have a question. i do it says on here roll call that commissioner feinstein is excused but she is quoted in the minutes i believe she was here. yes. she was present i will change that. yes. >> all right. thank you. a motion? commissioners? >> like to make a motion to approve the minutes. vice president morgan is there a second. >> i second. and president nakajo, how do you vote. >> aye. motion is unanimous. item 4 chief department report from chief of department jeanine nicholson on issues and events within the department since the meet being june 21 of 23 and including budget, academy, special events, communication and out roach to agencies and the public.

and report from operations, deputy chief luttropp on field operations greater alarm fires, investigation. training and airport division. and report from ems and community pair medicine chief tong. on the ems and community paramedicine division. >> good morning chief nicholson. >> good morning. president nakajo and vice president morgan. commissioner fraser, chief luttropp. and other command staff. i can't z. chief of department this is my report. since our last meeting. first i would like to welcome chief luttropp to the command staff former low. i know that i believe the cho is

in sacramento he is handling a meeting for me up there today. thanks to him. and i'm not sure chief malis in the. room but welcome. our new deputy cho of training. and we have hired a new e search emergency response. assist around department cho to replace chief luttropp that is chief miller he will be with us at our next meeting. so, most low we have been command staff getting in the flow of working together. and it has been going well. let me turn my phone off. first off i want to talk about -- videos. we are looking to leverage video

production this coming year. first at the international association of fire chief conference. which is helping in august. they will be working on a -- 7 minute vo for us. that talks about our over all department operations and history. community paramedicine and emt programs that will run a large conference and will have a huge distribution and i think will benefit the departments profile national low. we are looking at using sfgovtv, thank you for further video production this coming year and our multimedia team. and not just for profile and to show who we are but also for recruitment. and again to show case what we dom looking forward to seeing

how that goes this year. i know a lot of the young people really do watch videos. although, very short videos. love using clips with the video in some of our interviews i have been doing more in terms of autonomous vehicles. yesterday interviewed by nbc bay area investigates. i was interviewed by the london telegraph. last week. and so we are getting kraft. it was in also in times. magazine. about what's going on with ac's in the city.

and you may have heard the california puc has decided to delay the votes i believe until august after july 13th. so -- but really -- more importantly, no real progress has been made with am cruise or other companies in terms of sitting down with us in the engine earring to meet with chief luttropp and operation's people. that is disheartning when we need to make things better. we'll see what happens with the votes delayed again. >> speaking of interviews, we have been conducting interviews as i stated conducted them for the division of training and we have wonderful candidates and selected chief julie mau many of

you know her already from diversity and inclusion office and i previous officer at the division of training for years. she has run united fire service women and their training for years. she is well versed in what needs to happen and she'll be working under chief luttropp. and again the department chief miller will be here next time of you may recognize him of he is one of our search and rescue dog handlers and a stand out in that capacity. we also conducted further interviews for public information officers. we will expand our office a bit and selected just and i know marriano and we will also have several alternates or back ups.

that will be curtis and sam manshaka the end of the month. and -- we are looking forward to that. they will start training on days with jonathan baxter. and ultimately the 24/7 operation. and that concludes my report for today. i again i'm off to the mayor's department head meeting. and chief luttropp is appropriated to -- take you all along. thank you very much. thank you. chief nicholson. do we have public comment on the chief's report? there is nobody approaching and nobody on the queue. public comment is closed. commissioners questions before the cho goes to the major's office at this point?

>> vice president morgan. no, chief is busy and i will be quick but i wanted make a note of it that they will have a rally here friday the teamsters are for against the autonomous vehicle hos can show up police show up. that might help employmented to make that. gi think in the front steps 7:30 friday. the team terse told me. >> may be that would help. that's all. >> thank you. commissioner fraser. >> thank you. >> yes, if you could say chief more about you mentioned no frg progress on meeting autonomous vehicle companies or representatives? and how is that out reaching and they are not upon responding? or? could you say more about that? >> i will have chief luttropp answer that question for you. >> thank you. >> yea. thank you.

and good morning. president nakajo and vice president morgan and commissioner fraser and command staff. what we have been trying to do with the av companies than i have been fairly good partners it public safety out roach and providing training for our membership. and giving us insight on how they believe we should respond. what we had very little movement on is any response from a policy or engineering standpoint on how we can have the vehicles stop intefring with emergency team usa. it is increasing over time and that's a concern. our understanding would be as the vehicles become more atuned to the streets and better at operating and better environment we should see less negative interaction with fire vehicles and staff and the vehicles.

so. at a level of out reach. out reach is there. but answers to policy and engineering and those occurrence we are waiting. >> thank you. i think it is i really appreciate that. it is on the record at that level. thank you, chief. >> thank you. commissioner fraser. chief. i wanted to note to the command staff. that we the commissioners did send a letter in terms of the driverless vehicles and the concerns we had. i wanted to acknowledge that commissioner fraser and commissioner collins wrote letters as well. thank you very much. commissioners. and i wanted to congratulate and see next meeting chief miller. and for information for you chief mau is here special congratulate her.

in terms of her appointmentment my question is as we start to appropriate some more resources of personnel toward public information officers position. is captain baxter remain as a public information officer as part of that team? is there information you wanted share about captain back ter. he will work directly with the folks on boarding. everyone is on the same page and we are all singing from the same sheet of music. yes. >> thank you very much. that's all we have for the commissioners. good luck today and wish you well in terms of your meeting with the mayor. thank you very much. madam secretary. can we move to upon department chief luttropp? >> yes. >> welcome.

>> good morning and thank you for the opportunitiful this will be the operation's update. i'm deputy chief luttropp the operation's update for june of 23. i will start with the first shocker no greater alarm fire in june in san francisco. there are 21 reports fire. 107 boxes with 17 working fires an increase of almost 1 huh human % over the last month. last month was a remarkablely low incidents of fire but greater alarm in that number. with the 17 working fires we responded to 11 water rescue calls and 4 cliff rescue calls the summer months the incidents of cliff and water rescue increase. and we are trying to make moves on the operation's side of the

house to increase. our ability to responded in the water to the southeast end of the city. and we will have more on follow on that. but this month was book ended by 2 large water events. chief reported out the last one was membership in the water off candlestick point and had one just last week in crane cove reporting next month that will result in accommodations. people are doing great work on the water. looking at the working fires distribution for june. they were well distributed. we don't see a focus of -- fires. good distribution. i did include picture this is time. the first is from a fire we had at 537 vermont street. somebody in the room familiar with this fire.

i highlight this one because it its this is after the fire is out and the scene does not appear to be active it illustrated the complexity in san francisco. like chief postel said nobody who does it like us. if you take a close look you see nathis company because of the over head wires and the trees and the physical geography and the built environment, to get that ladtory that position requires hours of training and close team work and requires having that a plan. ladder work like this, illustrates you know the skiflt fire department but goes become to the training element. we completed a well received ufrng tr truck academy with ladder work with division of training and we see the result in a ladder throw like this carried upstairs and had to be

throne at the right spot so not impacted by fire. i think the strong -- second picture i put in here not a fire picture this . is a picture of a helicopter on a beach why is there a picture of this in this goes to our cliff and water operations and the close work we have been doing over the past few combreers this developing our relationship with the california highway patrol and other helicopters. so geo 283839 was issued and dliniated our helicopter policy and you see it in action here. there was no safer or efficient way for this person to be removed from the beach and the helicopter was utilized and i think this will be a great program going forward. i through another pretty picture in this is a july fire i will not talk about that one.

until july. it illustrates a number of concerns we have with hording condition and squatting. moving on fire prevention. if we fast forward a bit through the report you see that they are on pace with the bulk. if you find yourself on page, 12 and 13. you see that fire marshall coughlin who is excused today in this fiscal year this is the report out for the fiscal. which they operate on. and you see that permit inspections by port and district. than i attained 1 huh % compliance. the left one on port property where reads 10% is a typo. i apologize that would be 100% this is recoveryings from the health emergency and covid and

inability to dot inspections and it is workd and caught up on our permit inspections. this summary report on fire loss. that is than i are on the fiscal that will be the total for the year. they approved and comments on the 30 adu's on page 16. this goes to sb9 and the mayor's initiative for 82,000 units of housing. they have been working closely with bureau of fire inspection or sorry. with the building department to finds a way to stream line the process so that his office is allowing as many units to be built with an eye to our access

and our ability to fight fire if we have full buildings built behind others this requires education on the part of our staff. it does require access to be protected and he is working hard to protect that access. our conversations continue with mta for various street scape changes. we got the report from our second head-to-head study from pierce. and they did find that in areas where there were multiple changes to the street environment including bike lanes and others. where hay accumulated they were seeing an affect on response time. that was good for us to hear. we have more to discussion on that moving forward. and that was fire prevention. at the airport. darcy who is excused he is noticing back from another

meeting. they had obviously his list but the events at the airport were they did have an engine fire on a plane and due to the training that they have been able to accomplish at the airport and their increase prescriptional templet at the airport they resolved that. get the plevin returned gate without incident and all the operators were appreciative of that. on the 13th of june, the airport experienced a significant power outage. chief darcy intgradual in the emergency operations and the battalion cho in making sure there was zero interruption in service at the airport due to the power outage. i report there was none. thank the chiefs for that. on the skaejth, they did responded to a lithium battery fire at tsa.

lithium ion is an emerging threat in fire service over all and i imagine the airport will be a heavy emphasis and focus. we have been hear to take your bat reese out of bags they are at tsa. a strong plan of action for increasing the ability to respond to the water. boats will be back in service and once that happens we'll work on an agreement with the airport to bring those boat in our response plan for the southern end of the city, that will be another win. and i want to compliment the people who the changes made in training division and irrelevant stroll lining and new initiatives to meet more than the basic needs they meet at the airport more technical rescue and et cetera and this will increase the ability of the membership at the airport to

responded. so, a total of 569 and i will not point out the rescue this is time. there were 28. and finally, the division of training i want to welcome chief mau the director of training and i know she is looking forward to crush thanksgivingion and imagine mag she will. the 131st class did graduate and not 45 it was 47 and we seen a dramatic impact on over time and staffing with that number. i do want to point out and probably mentioned left time. the quality of this class according to the train and how excited they were and thank you for coming to the graduation i'm are sure heard that also. everything keeps moving now we started a new class. so, on june 26, the 132nd class

started with 58 rekruts. command staff did present to them and they locked like a scared bunch fire recruits. and i'm sure by the end they will be the saltiest dogs we have turned out in the field. we have lost one this week to injury. we are 57 with the class. the bhorn had to leave is a current member. they are an, everemployee of the department there is that at least they maintain employment with us unable to complete the tower now. going down to the special operations portion of the on page 24. this lines out our helicopter rescue technician plan. that is a general order 2340. 24 members were trained to work

at helicopter rescue technicians. we have a policy but now the trin to go with that policy. >> on page 24. it is something we have not highlighted to my recollection in the past. the things you see with the rescue operations and heavy machinery roll out. and the autoextracasion. the captain who is accomplishing training is also on the california state fire marshall cod real for the development of the curriculums we had membership the last few years more involved at that state level and the national level and the development of the training curriculums and koesd i want to highlight that in the future the san francisco fire department's voice is getting out in the world.

so we have our long history and our tradition. we can be happy with that and could be comfortable but not resting on laurels and bring the message out to the state. i want to thank the captain for development of program and bring them back to san francisco and training in them. he is but one. we had members who were very intgradual in the develop of firefighters. i was on a number of these also and chief as well.

420 hours is rable. i want to thank them and coming out they show pride and i thank them for doing that. and i appreciate the efforts of the san francisco fire reserve.

i want to pass that on to the membership. i feel the sense of ownership i'm first luttropp in this fire department i was not born and raised in the city. we have an opportunity we talk about generational change and talk about the motivation of people work and the things they are look for and career in life. we have the last great professions to inspire and provide that sense of ownership

and -- dedication to a jop. it is man is a sharp intellect and -- throws himself in when he did and does. and off doing something great now. and i hope i bring that to the job, thank you for your time. thank you very much, chief we will take public comment on the report. and secretary,

>> well is nobody approaching and nobody on the queue. >> public comment is closed. commissioners? questions or comments to chief luttropp? >> at this point. thank you for your report. chief luttropp. and -- congratulations on your new position. i'm sure will do fine. and you have the benefit coming up under chief postel. i know that will reflect in your performance as well which is a benefit to all of us. and your own achievements as well. your report has good news no greater alarm fire that's great. so lucky june. yes. i guess.

and chief o o'connor retired to the lay low. and in honor of those gentlemen. that's great. i had one question. fire prevention section on page 7. -- the total open accounts were -- very high in 2022. am i reading that? wrong? or why was it so high in 2022 and it is diminished. toward june of 2023?

the numbers on page 7? >> i see the numbers i'm not clear on which line we are referring to. under fire complaints the first couple columns look under 2022, the numbers are so high. 911, 1131, 1222. >> i see. seems. >> thank you. and unfortunately fire marshall cover listen is on a vacation. this is that bridge period where the complaints that would have been open exclude not pursued during the health crisis and covid emergency. this is the backlog. e essentially. number 1129 and 1140 the new received the seconded column,

you see it kind of -- the trends is in the necessary low higher. >> right yoochlt this is just them addressing the backlog and worked hard on this. >> seemed out of whack there. >> 2022. so bad compared to 2023. >> okay. >> you see by the end of 22. how they have jumpod it and addressed the problem. commissioner fraser. thank you chief luttropp. am i saying your name correctly. >> yes,

>> thank you. >> thank you for your report. welcome to that chair. and i have to say that -- it is impressive had we do with cliff water, helicopter, trucks. hill. an amazing thing. i feel that again and again. one question on the helicopter you mentioned collaboration with chp. i can make the order and the policy available. 23839, it had been an ad hoc policy. and they were available to xus did respond we were working with them. not like an mou a method of

operation. when they can and can't fly. we work with the u.s. coast guard we don't have a similar document but similar policy in place.

they are more common place and a new source of ignigdz for fires. and have unique properties once they have thermal run, way and they are burning they are difficult to extinguish and create a very to beingic environment. but for the purposes of airport and tsa. there are multiple policies. thank you. thank you for your report i proeshth your presentation format and your references to

pages as you gave your report. so that the commissioners refer to it. appreciate you mentioned the airport power outage and thank you for that update as well. i also wanted thank you for reference in page references but when you talked about page 25 and the helicopter and noted that chief miller -- the helicopter the rope training and the emphasis of that. i think that is person that lead us or myself occurrence the report. to page 29 talked about nert and keep had i presentation on nert recently with captain tom. come this is all a division of training and acknowledge and

recognize and congratulate chief mau in terms of her appointment as chief of training as well. it is interesting as you made references to the fire reserve on page 29. upon page 31 through with photos. 32-33. that -- we just had a reason conversation myself and vice president morgan. on the fire reserves. and so to empsighs the 420 hours and when they do. is very important and again, a point of information chief mau i did ask commander buck low when he would feel comfortable coming to the commission and doing the presentation. and he did r that somewhere around august or september when they have another opportunity for membership that a time to do

that. i will also help us in the commission be familiar with the work of the fire reserves. so i wanted to -- thank you for this report and. i think we concluded with your report at this point. we are scheduled at this point to have the dms and paramedicine deputy chief tong present? >> good morning chief tong. good morning. commissioner fraser and luttropp. command staff. sandy tong with paramedicine. in so. for the month of june ems

division [inaudible] we averaged 357 calls this last month and that was the same as what we did in may. with a slight decrease prosecute april. not much changed one day we saw over 400 that was all that day. on june 8, members of ema staff and field providers participated in a table top drill conducted near ems. after offices this was a drill this mimicked an explosion and active shooter situation there was 130 patients. so it was an opportunity for us to work with the emsa, representative from department of public health. emergency preparation and response team. pepper. and then the san francisco medical examiner's office they walkedllow how they would manage

this time event and from when the event occurred through what would happen at the hospital this . is an early exercise for folks to be able to better practice what might happen in a large day drill in preparation more functional drill hopefully live there was something for later this year postponed. all of the opportunity for us to practice the events are significant and helpful. and then on june 25. member of the command staff at ems division all paymented in the pride parade. first year we had an ambulance as part of the plan. we are happy to see all of our folks supporting this event. june 30 the ems hosted 25 high school students in the mayor's youth program, operation genesis a program to introduce high

school members on public safety. all of them were able to practice hand's on cpr, stop the bleeds and it is a great time for all of us to feel be able to show them what it is that we do. we hadllowllow there in the picture also talk to the crews and letting them know when we do. in your report this month i asked chief to highway light a type of incident we independent to and this mont he provide information on cardiac arrest. i wanted give you a sum row what that is. this gives you a picture of the more significant events members go to daily and then we probably be able to give you more. detail about had goes in how we run a cardiac arrest. this is a timely issue. it is

time consuming and if we can stabilize and save somebody in cardiac arrest t. is a very intense situation and we want to be able to give all of you a better picture of had that is. during june, the ems division treated 146 cardiac arrests. and responded 146. and of these resuscitation attemptod 51. 40 were transported on the hospital. 11 were terminated in the field meant we did all of the things we could do but were not able to revive them. we report all of this cardiac arrest data to care data base that needs the registry to enhance survival. it is i data base for all nontraumatic cardiac arrests resuscitation is done by 911

provider. and so this includes patient this is receive aed shot prior to our arrival. and so california is one of 30 states that participate in the it gives you a picture of you know when we start comparing data how we do with all of that. how we compare to the national data looks like. so, this month reported 20 patients had a witness cardiac arrest that means there was somebody who was there that saw this person collapse go in cardiac arrest call dmien 11 and able to responded. 6 of those that were shocked with a difib later. 15 had cpr. and of nez, 19 of them returned circulation meaning we were able to get i pulse become or blood pressure. if you look at that of the 19 that we got that had returned

the circulation. out of the 51 that we tried resuscitations that equalled to 38% rate which is great. and next month we will try to do more of a comparative with how we are doing san francisco. and then what we compared to the national level. >> for community paramedicine with assistant chief tang these are june highlights. during the month of union we graduated 10 members. these are station 49ems paramedics who participated in the community paramedicine course. 6 week train pregnant lead by cat ain't dan and want specialed by our lieutenant scott ward. since 2017 able to train 72 members. which we believe is the highest

community paramedicine training program in the state. >> in terments of the we have a multiagency quality improve am group. ems tapped in medical directors are continuing to meet and mote with other agencies that are doing it in the field. and since we added paramedics we have been able to have 20 starts in the fields. and -- according to our data, this is out patient our contra costa colleagues average one start per week and we're 1.6. and then also i think you may have seen there is a mayor's press release this said that our paramedicine will be providing able to place 5150 hold in thes field. we have been training the members through dph. they have gotten in service by our section chief of operations

and now as of monday we are having some of those paramedics provide or place 51'50s in the field. and this is our regular snapshot of the data that is included in the report. one thing to note just this we wanted call out that is in the represent in the this chart. is that this street crisis sponse temrequest for police is 1.2% and that's you know a great metric. we have been sort of responding to the health emergency calls in lieu of the police. and it seems like that has been the appropriate call. we are not need to call police to assist us with these types of incidents. we on board a new data analyst. the thing in thes report will be revised give you a better picture and trend and you know look back what happened in the

previous months so you see how we are changing and improving. >> and he will be working on new dash boards for us and more public facing dash boards we'll put out. more torfollow with when he will do. he started this week we will give you more once he gets on board. and finally i wanted to call out one of the incident this is happened in the left month where it was an effort between ems, suppression and even bystanders. on june 272 individuals found unconscious and unexperiencive of an over dose required nar can and cpr. 2 civilians and off duty staff who assisted prior to engine 26

response. medics and medic 52 and 56 and backed up by c 3 and cp5 in treating the patients. one of the patients was able to receive [inaudible] and able to talk on his way to the hospital. he was expected to have i great recovery the second patient is still in the icu and is more dicey but this is just one of those incidents all of our responders came together and saved a life. that's my report. thank you very much. . chief tong. >> in dam secretary is there public comment. why nobody approaching the podium come nobody on the call in line. thank you. commissioners? >> vice president morgan. >> thank you for your report. chief tong. i wanted ask you a general question. you know i know somewhere i read about the cardiac arrest and the

numbers. out of the number was 146? here? cardiac arrests for june? the number of reported cardiac arrests. >> and you know, ballpark figure, out of those numbers, how many do you think was drug related or induced or -- >> remember we don't have that data. >> you don't have that. >> no. >> not off hand. >> natural causes or this. >> i am -- assured some of them are over dose and we don't know what that number. >> i was curious. >> yea. >> and -- it was good to hear the report about boss firefighter or whatever the chief of boston fire department giving kudos for his relative this is got sick here and experienced the great service

from the san fran fire department. of that's always good and makes us feel good. >> appreciate that. other than that i think the great report. and thank you for your information. >> thank you. >> thank you very much vice president morgan. commissioner fraser >> thank you. thanks chief tong interesting report i appreciated if. starting with the end of your report. that scene with the 2 civilians on the grounds or citizens on ground and people who happened to be there. and you showed up we were called like a movie script. could not make this up that is an amazing thing. i'm assuming that i don't know if this is kept electronic or possible. what the over doses are due to. or you assume they are general low fentanyl or heroin? the me does provide a report every among on over dose and the

case they closed that have been proven to be whether fentanyl or a combination. there are a lot this have combined drugs. they are able to tease out the number of deaths that are related to specific drugs. i think that is interesting, too. you are doing a lot of calls an amaze being volume of work that is accomplished by your group every day. that's incredible. >> i congratulate everybody on that. and also just you know beginning to coordinate with other areas of our staechl bureaucracy and services to finds out getting to root causes and cordinating. i know you are doing that and appreciate that and want to call that out the difficult and he complexity of that. how important it is for all of us as a city to move forward and trying to solve or address the

problem that 457 calless a day represent. >> agree. >> incredible. >> appreciate your report. thank you. >> thank you. >> thank you very much, commissioner. fraser. thank you very much, chief tong for your report. i have a few questions clarification. you reported we have trained 72 community paramedics. is fire department one of the few or is there are paramedicine division in other cities compared to our sns or are we -- different or stand alone in terms of this term? >> yes. i can ask chief tang to come up. >> okay. chief tom.

good morning. chief tang >> good morning president nakajo. vice president morgan. fraser and maurn and command staff. i don't have a hard number for the number of paramedic programs currently in the city. at the high point i believe there are 12. right off the top of my had theed city of alameda has a program. that was trained by our chief tanning and some in southern california we're largest group in california as confirmed by the state ems agency. >> okay. so chief, i'm lead to believe that we are pioneers, if that is the word in terms of the community paramedics with formalization of ems6 team usa street over dose teamful is that

accurate to say we in the fire department are part of -- this new frontier. i think we were a late comer to the pilot of community paramedicine. but once we did join, we were am immediately in the forefront. our call volume is greater than other programs. early pioneer in the sense was star in the 2004. and now we are definitely in the forefront of the community paramedic punch nationwide. so, pioneer and also front runner. >> right. >> using the term pioneer and front runner in terms of the cities do that i have street over dose response team in terms of our community paramedicine division. >> i'm trying to find out if we

other few cities that has a street crisis response team or over dose response team other than compared to other cities. >> nationwide there are many mobile crisis units. there are different configurations for that. here in california and southern california there are a number of departments that have chosen to employ nurse practitioners. i say this similar to the dhs or beta max. we don't know what will be what is going to end up in the end. i believe that community parmedicine is the route it elevated our workforce and trained to do the work. that of here in san francisco, our mission is primary low utilizer. other programs throughout the nation have other programs that

have to do with post hospital discharge. or hospice care and other types. so for us, these patients and individuals are our patients. no one else in the city knows or concerned with the outcome of these individuals more then and there we are. so it makes sense this we our own members the ones that are tasked with finding a solution and how to help people get in better care. >> okay >> 72 members we have in community parmedics is a large workforce we have the largest workforce at this time? i believe we have the largest workforce in the state of california not all 72 members community paramedicine trained are on our units. so 72 is the total. total number that working is in the mid 40's. >> thank you for that. i want one more question.

on our docket in terms of page 9. under street crisis response team is operational period june first through june 30. call for service 1, 170 calls. and average response time and has average on scene time. but in the columns all calls for service, there is a category call remained in the communities this is 486. that you should is unable to locate a number of 179. thaurndz there is a walk away of 62. i'm trying to -- understand completely the remained in the community 486 combined the unable to locate with the walk aways? >> no. that is a separate disposition.

remain in community people that we have a meaningful engagement with. and this individual upon chosen to remain in the community. versus us transporting them to another system of care. unable to locate. that we simply we didn't identify anybody. walked away would be we consider we want to highlight it so we have its own row but somebody that they saws arrive and they just left the scene before we could engage them, speak or know their name. and this occurs frequency. we want to highlight that but we also like the second graph is disposition of engaged individuals. wee leave those walk aways out. we feel we should not be

penalized for not having a positive outcome for someone who chose not to even meet with us. >> right. i appreciate that. and i appreciate the clarity because these are categories we would be interested in. again it helps us commissioners to understand what is going on with our members as they go out in the field and deal with clients in terms of our service calls. thank you very much. for that. thank you very much, thief tong as well. >> may i ask one more question . chief tong or anyone. everyone. which i neglected ask i highlight third degree in the report on page 9 about in the middle resource referrals offers, keksz made and rate. come become with your report.

on page 9. i did not hear your question i thought. >> i have not got there. a question about that middle section on page 9 resource referrals, connection and made. and connection rate is where my question is. going down the right hands side the percentages are pretty good down top about shelter short term and it starts to drop all the way down from there. and specific locality substance abuse dual diagnose treatment is 13% connection rate. i'm not saying you are not doing everything you can do. because i have been out with the msx. i have seen how hard they work to connect people i'm assuming or may be you can tell me the reasons it is a lower such a low percentage. and low number is people just don't want to go? or it is not available?

no beds they are closed? no staff. whatever it is? >> thank you for the question . the single most biggest barrier we face in trying to help people is that people don't want what we have to offer. this is the number one problem and we don't have the ability to compel people. unless they meet the 5150. that is number one. we have a separate reporting area for when we offer a resource to someone the individual accepts it. and it is not available. and -- i don't have those numbers in front of me. at the moment but this does not address that. this is the connection rate for when we offer it and they accept it. >> okay.

>> and then at in point now we have more people trained and certified to put machine on a 5150 hold. will that be in the report? attempts and successes as far as encounters we have? >> yes. this is under street crisis response in group 5150. this is simple low the total number of holdses that have been written in the month of june. that is in the month the total is 26 a mont. >> yes. >> and -- this is not include the time when is we assess someone for 5150 and chose not to write it. we felt person did not meet the criteria. we have the numbers to get for you if you like. >> when -- they are deemed

eligible or qualified for 5150 hold, how much success we have getting them in a facility that is capable. caring for this person. >> we transport everybody by an ambulance and take them to one of our 9 receiving hospitals. the difficult part the challenging part is -- we would like it is large are than what the fire department can do. we need a lot of city agencies working together to get this daya. which hospitals keep people the longest and which hospitals

dismiss a 5150 with an hour that would be informative and i then and there is not anything you are not doing. this is i'm -- just wondering. effort that guess into assessing someone for 5150 and delivering them and they are discharged in an hour. i'm sure. frustrating >> of course. >> entail >> thank you. you are welcome. >> 5150 hold is 72 hours maximum? >> that's correct. up to the physician and the hospital staff to determine whether they release them within the less than 72 hours. >> that's correct. it means they have to be evaluated by a psychiatrist. and the psychiatrist as everhas

the ability to extend this for the full 72 hours and after that, they wanted to extend it on a 5250 for 14 days. some of the hospitals the emergency room physicians authorized to do that assessment in lieu of a psychiatrist. >> in the reference to the commissioner fraser's economy in terms what you answered. it is up to the staff at the hospital in they release somebody within the time less than an hour or 2 hours and the problem is that the upon department don't have knowledge base when that happens that person is released out in the community? >> that's right. >> we don't have access to that information. >> all right. >> all right. thank you very much for that. thank you very much, chief tom. >> appreciate it. . all right. madam secretary.

item 5. public comment on item 6. pertaining to item 6 including public ment on whether to hold item 6 in closed session. madam secretary. any public comment on item 5 >> nobody is approach and nobody on the call in line. why all right. public ment is closed at this point we need to ask the public and the command force and members here to vacate so. we need to vote whether to check 6 in closed session. an action item. why all right. >> i like to make a motion we have closed session. >> thank you vice president mother ab. >> second. >> and thank you. president in fact joe. >> aye joovm this meeting is going in closed we are back in open session. the time is 11:08.

there is nothing to report. and item 2 is vote to elect whether or not to disclose closed session in san francisco code section 67.12a. >> commissioners? like to make a motion we keep in closed session. not disclose. >> not disclose. >> okay. i will second this. >> and president nakajo? >> aye. >> the motion is unanimous item upon 7, adjournment. >> before we adjourn in memory of a form are fire commissioner grift whoin passed recently. i would tloik adjourn in memory of the 2 firefighters that perished in ship fire back east coast. and that at this point this meeting is adjourned.

we spoke with people regardless of what they are. that is when you see change. that is a lead advantage. so law enforcement assistance diversion to work with individuals with nonviolent related offenses to offer an alternative to an arrest and the county jail. >> we are seeing reduction in drug-related crimes in the pilot area. >> they have done the program for quite a while. they are successful in reducing the going to the county jail. >> this was a state grant that we applied for. the department is the main

administrator. it requires we work with multiple agencies. we have a community that includes the da, rapid transit police and san francisco sheriff's department and law enforcement agencies, public defender's office and adult probation to work together to look at the population that ends up in criminal justice and how they will not end up in jail. >> having partners in the nonprofit world and the public defender are critical to the success. we are beginning to succeed because we have that cooperation. >> agencies with very little connection are brought together at the same table. >> collaboration is good for the department. it gets us all working in the

same direction. these are complex issues we are dealing with. >> when you have systems as complicated as police and health and proation and jails and nonprofits it requires people to come to work together so everybody has to put their egos at the door. we have done it very, very well. >> the model of care where police, district attorney, public defenders are community-based organizations are all involved to worked towards the common goal. nobody wants to see drug users in jail. they want them to get the correct treatment they need. >> we are piloting lead in san francisco. close to civic center along market street, union plaza, powell street and in the

mission, 16th and mission. >> our goal in san francisco and in seattle is to work with individuals who are cycling in and out of criminal justice and are falling through the cracks and using this as intervention to address that population and the racial disparity we see. we want to focus on the mission in tender loan district. >> it goes to the partners that hired case managers to deal directly with the clients. case managers with referrals from the police or city agencies connect with the person to determine what their needs are and how we can best meet those needs. >> i have nobody, no friends, no resources, i am flat-out on my own. i witnessed women getting beat,

men getting beat. transgenders getting beat up. i saw people shot, stabbed. >> these are people that have had many visits to the county jail in san francisco or other institutions. we are trying to connect them with the resources they need in the community to break out of that cycle. >> all of the referrals are coming from the law enforcement agency. >> officers observe an offense. say you are using. it is found out you are in possession of drugs, that constituted a lead eligible defense. >> the officer would talk to the individual about participating in the program instead of being booked into the county jail. >> are you ever heard of the leads program. >> yes. >> are you part of the leads program? do you have a case worker? >> yes, i have a case manager. >> when they have a contact with

a possible lead referral, they give us a call. ideally we can meet them at the scene where the ticket is being issued. >> primarily what you are talking to are people under the influence of drugs but they will all be nonviolent. if they were violent they wouldn't qualify for lead. >> you think i am going to get arrested or maybe i will go to jail for something i just did because of the substance abuse issues i am dealing with. >> they would contact with the outreach worker. >> then glide shows up, you are not going to jail. we can take you. let's meet you where you are without telling you exactly what that is going to look like, let us help you and help you help yourself. >> bring them to the community assessment and services center run by adult probation to have

assessment with the department of public health staff to assess the treatment needs. it provides meals, groups, there are things happening that make it an open space they can access. they go through detailed assessment about their needs and how we can meet those needs. >> someone who would have entered the jail system or would have been arrested and book order the charge is diverted to social services. then from there instead of them going through that system, which hasn't shown itself to be an effective way to deal with people suffering from suable stance abuse issues they can be connected with case management. they can offer services based on their needs as individuals. >> one of the key things is our approach is client centered.

hall reduction is based around helping the client and meeting them where they are at in terms of what steps are you ready to take? >> we are not asking individuals to do anything specific at any point in time. it is a program based on whatever it takes and wherever it takes. we are going to them and working with them where they feel most comfortable in the community. >> it opens doors and they get access they wouldn't have had otherwise. >> supports them on their goals. we are not assigning goals working to come up with a plan what success looks like to them. >> because i have been in the field a lot i can offer different choices and let them decide which one they want to go down and help them on that path. >> it is all on you. we are here to guide you. we are not trying to force you to do what you want to do or change your mind. it is you telling us how you

want us to help you. >> it means a lot to the clients to know there is someone creative in the way we can assist them. >> they pick up the phone. it was a blessing to have them when i was on the streets. no matter what situation, what pay phone, cell phone, somebody else's phone by calling them they always answered. >> in office-based setting somebody at the reception desk and the clinician will not work for this population of drug users on the street. this has been helpful to see the outcome. >> we will pick you up, take you to the appointment, get you food on the way and make sure your needs are taken care of so you are not out in the cold. >> first to push me so i will not be afraid to ask for help

with the lead team. >> can we get you to use less and less so you can function and have a normal life, job, place to stay, be a functioning part of the community. it is all part of the home reduction model. you are using less and you are allowed to be a viable member of the society. this is an important question where lead will go from here. looking at the data so far and seeing the successes and we can build on that and as the department based on that where the investments need to go. >> if it is for five months. >> hopefully as final we will come up with a model that may help with all of the communities in the california. >> i want to go back to school to start my ged and go to community clean. >> it can be somebody scaled out.

that is the hope anyway. >> is a huge need in the city. depending on the need and the data we are getting we can definitely see an expansion. >> we all hope, obviously, the program is successful and we can implement it city wide. i think it will save the county millions of dollars in emergency services, police services, prosecuting services. more importantly, it will save lives.

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