we feel we have heard by the supervisors and dph. i am so grateful the staff members, union, management came together to work and a solution to save the arf and our residents' homes. i am looking forward to working with my peers to come up with a plan to make the arf a better home for our residents and to create a better working environment for the staff. on behalf of the members and residents i give a great big thank you to everyone and especially jennifer and the supervisors and others who worked so diligently for the last few months to save the arf. also supervisor mandelman, thank you for your support and visiting the arf. i really appreciate it. thank you so much. >> next speaker, please. >> i am jennifer. i am a social worker working as a behavioral health clinician on the third floor. the clients i work with are san francisco residents who need the beds like the beds at the arf, residential beds to be able to get out of locked treatment. first of all, i want to really thank supervisor haney, supervisor ronen and supervisor man

one safety concerns put out by dph do not hold water. in the last year from 2017 to 2018 there is one substantiated citation and three at the rcfe one floor up is held open. going to fill to capacity according to this plan. also, the staff that are blamed for the citations are floating up. they work upstairs. the plan is to have them go upstairs. they are already going upstairs. the staff work down stairs. that is happening. this argument that one floor is not safe while the other is doesn't hold water. the citations upstairs are about events leading to a client's death. the humming bird extension is not doing harm. it is doing harm. they are locked and can't go home. there are 41 people that need somewhere to go. there is a reason the whole community of the san francisco front line workers are coming out. they are getting good care. thithis is a good place. we beg you to hear the word of the public and weigh it against the messaging of d.p.a. to look at what is going on here. thank you for taking time to hear us out today. >> thank you.

together with worker leaders from the adult residential facility, local 21 and the representatives, dph leaders and mayor's office and supervisor haney's office worked out an agreement related to the future of the adult residential facility. i am happy to report this will protect is health and stability of the 32 residents who live at the adult residential facility. it is the only boarding care facility for severely mentality ill. no resident will be forcibly removed from their home and the city's long-term beds will be protected. we have incorporated the key aspects into my ordinance. the adult residential facility in committee. there are a few more small details we are currently working on with the city attorney and those changes will be worked out between now and when it is heard at the full board on october 29th. the amendments we have incorporated in my legislation have been distributed they are as follows. for the next five missouri month -- five months 28 adult residential long-term treatment beds and 27 emergency shelter beds known as hum igbird beds. in april 2020 they will be

discuss regular care among other issues and no later than march 31, dph shall submit a report on the analysis and review and actions taken to date with regards to this legislation. we have been informed by the city attorney's office that the creation of the working group is the substantive amendment and we are working out the details regarding the structures and the parameters of the group together with the worker's management and dph staff. i will, therefore, be making a motion to duplicate the file to address the working group detailed separately at committee. meanwhile, i hope all of you today will join me in voting to pass the agreement and compromise legislation today. i want to thank you to everyone who is part of the fight to save the arf and who work closely with myself, supervisor matt hainey, my staff and supervisor hainey's staff to bring us where we are today. i especially want to thank the workers at the behavioral health centre who have fought is hard for their health patients and for jennifer who lit the fire under all of under the all of ue issue because we wouldn't h

dph tried to hide the plan to close the arf from the union. they did not want to put anything in writing. they told the members to lie to the residents. this should not happen. when we reached out to dph five different times, they refused to negotiate with us, refused to engage with workers. they went around and blamed workers for this. this is unacceptable. until dph starts getting their act right and starts respecting their own workers, these issues will keep happening, the workers will keep fighting. the patients will keep suffering because of this. i thank you for helping us with this campaign. i am afraid it probably won't be the last time because dph if they are going to keep acting like that it is not the last time. thank you to all of the workers. >> next speaker. >> i appreciate the fact there are far fewer homeless visible on the streets these days. i appreciate that is city has taken so many into the new navigation centers. i applaud the mayor's initiatives. i have volunteered at a homeless shelter a long time ago. it is a trying po

without these workers and staff you would have no bhc, no arf, no dph. thank you so much. >> jeff esten, michelle, sarah larson, robert rogers. >> police say your name. >> good afternoon, i am vivrian. i have been a mental health advocate for over 40 years including working in the field for over 20. decades an go we fought to have the mental health residential facility built. we expected that it always would be fully utilized. recently there was a plan to switch some beds to navigation center beds. this essentially pitted one group of people needing services against another. the community revolted. before the publico speak, san francisco in an incentive action sent formal notices to vacate to some residents an the the adult residential facility. getting that frightening notice can really set them back. evicting mental health clients to get positive press about homelessness is a shameful political strategy. then the plot thickens. a number of beds at the facility are empty. why? people wait for months stuck in inappropriate levels

you will be hearing about that today directly from the dph in terms of history and public comment. i look forward to that part of the agenda. just to emphasize with regard to vaping, the california department of public health urges everyone to refrain from vaping given the current status of vaping risk. since june of 2019 the california department has received reports of 90 people in california who were hospitalized for severe breathing problems and lung damage. san francisco does not have any suspect cases we will be diligent in that regard. nationally the epidemic associated with pulmonary injury grew 52% compared to the prior week. there are 805 from 46 states with 12 deaths reported. we continue to be vigilant on both the regulatory and the policy fronts. with regard to the recent heat wave on september 24 and 25, the national weather service issued a heat advisory in san francisco with temperatures in the 80s and 90s. they worked together with the department of emergency management and joint information center for city agencies to coordinate efforts and share messages to stay

this might be a question for dph? >> i don't think we have that answer? >> supervisor mandelman: if you have 1200 and there are 4,000 we know we are far short of providing case management even for the folks who we would prioritize in an ideal system. >> right. i think you may know about this, but i want to make sure that can you put the screen up? within city-wide we have a range of services, some teams are more mobile, have smaller caseloads, general funded and mhsa funded. their ability to address the high priority is different from the 25-1 caseload. i don't think we know how many of those folks are case managed, some are. >> supervisor mandelman: priorit even all of them have assigned case managers. >> a lot of work to do. supervisor haney. >> supervisor haney: thank you. similar questions across the different levels of care, is there a standard ratio of patient to case managers? >> standard? >> supervisor haney: what is it like like for the kind of the higher levels? >> let me give the numbers. city-wide stabilization programs, three different teams

i alsot to a community health needs asst breakfast the other day with chf tong and heard from dph and somr folks and met with afterwards w. bennett who is the director of interdivisional opportunities. e are really looking for ways to collaborate, whether with dph or hospitals, in terms of what we o to impact not just call volume t people's lives on the street. it to on the 16th, mayor breed andh attended the welcome kickoff foe international association of firefighters human relations coe conference. we both spoke that morning. we went -- we had the t shakeout at rosa parks school ad thank you for attending, vice president covington. and then te preed events on the 17th. thanko president nakajo and vice presit covington for attending the piet that was held up in marina greet was a treat to have jerry shannn there who is a retired firefigho was really -- made a huge impach his work during and after loma . on the 19th we had the 30-year t drill anniversary. as we know, t came out of the loma prieta earthquake. it was founded afte, because they wanted to do somet. we had a meeting with

so we are really looking for ways to collaborate, whether with dph or hospitals, in terms of what we can do to impact not just call volume but people's lives on the street. i went to on the 16th, mayor breed and i both attended the welcome kickoff for the international association of firefighters human relations committee conference. we both spoke that morning. we went -- we had the great shakeout at rosa parks school and thank you for attending vice president covington. and then the preed events on the 17th. thank you to president nakajo and vice president covington for attending the pier event that was held up in marina green. it was a treat to have jerry shannon there who is a retired firefighter who was really -- made a huge impact with his work during and after loma prieta. on the 19th we had the 30-year nert drill anniversary. as we know, nert came out of the loma prieta earthquake. it was founded after that, because they wanted to do something. we had a meeting with the stress unit yesterday. myself and chief velo and our chief of health and safety, chief parks. we met with th

think the leadership recognizes the incredible work that people do every day at the arf and a cross the dph facilities. i want to express my perspective your work is valued by me. i think when i visited many of you described the members of family and some of you have worked there for 19 years. not to say there are not issues and concerns. when you see problems consistently in the arf, i want it not to be either other. you can have good staff caring for patients kept safely and providing good care and there can be some problems and those need to be a shared responsibility across the leadership and management and front line staff. to express that going forward. whether the arf stays at 32 beds, whatever hatches i am committed to fix -- happens i am committed that we can fix these problems together. thank you. >> it is in the hands of the commission. commissioners. >> thank you, doctor pickens and supervisor ronen. i wrote down names but there are too many to mention. thank you for turning out to show how much you care about the services provided at the a rf and caring for those in need. i did

then yesterday was the final test and dph was going to come back and check but unfortunately failed third time. that's when we decided we needed to move all the clients out of the facility. >> staff are also upset. >> program director at star. has there on inspection? >> 2016, we were clear. >> taking it extremely seriously. >> reporter: partnered with star last year, asked how they're taking ownership of the lead contamination. >> as soon as it came to our attention, took quick answer to get the families to safety. >>> east bay, two people dead and third in hospital after shooting in richmond this afternoon. police say responded to shot spotter call. neighbors tell us the area is normally quiet. >> it w bop bop bop. and pause, bop bop bop bop. another four times, probably ten shots. >> police say two people were in a car when shot. neighbors and people who appeared to be family members came to the scene, upset of course. police are searching for suspects but don't believe there's immediate danger in the neighborhood. >>> varsity football game will not be played tomorrow. >> safety concer

and then yesterday was the final test, and dph was going to come back and check and everything unfortunately it failed for the third time. that's when we decided we needed to move all the clients out of the facility. >> all the staff are also upset. >> reporter: lucille is the program director at star. has there been a lead inspection at star in the five years that you have been here? >> in 2014 there was a lead inspection of the building and we were clear. >> we are taking this extremely seriously. >> reporter: the department of homelessness and supportive housing partnered with star last year. i asked how they're taking ownership of the lead contamination. >> as soon as this came to our attention we took quick action to get the family to safety. >> reporter: other children staying at the shelter have been tested for lead and are waiting for their results. cath thick chaolic charities sa families will be moved out by friday evening and placed at other shelters and hotels which will be paid for by catholic charities. the city hopes to reopen the home next year. >>> happening today two protes

i want to thank the folks in dph who are pioneering new programs and working with treatment providers. when they see the empty beds come up with new ways to get people in those beds more quickly. i think there is a disconnect between the report and the state of access to treatment in san francisco and the experiences i have seen and conversations i have had with people in the justice involved world but even those folks waiting a few days or not seeing a path to housing or something else after treatment. it means we are not there in important ways on treatment on demand. there is a ton of will in this building right now to make significant changes in where the city is around behavioral health services and around substance abuse treatment. it is the issue of our day. there are proposals from supervisors and the mayor, and i think treatment on demand needs to be a central part of that. we have a methamphetamine task force going now and i think through four meetings we have had conversations that are youthful and will lead to recommendations that will be use full. if folks in the treatmen

there's no reason that management should be lying about hiring people when dph is 20% understaffed and we need some fresh blood up there at the top. i think the city missed a really great opportunity to bring something like that in. because, as i said earlier, we need a lot of new clinicians and that being said, i would like to say also that laguna honda hospital, 1600 beds or 1200 beds whatever, is still empty and it's a fabulous asset to be ignored. i don't know why it's there deteriorating except for a few redecorated offices whoa need a facility where people can stay until they're stabilized and i would like to see option there. it would be really great. >> my name is june bug and i'm with the health justice academy and the san francisco heath plan advisory and aim a poor magazine and a former san francisco commissioner and because i'm someone that cares and i experienced trauma in my life and i have mental health issues. all my issues have a lot of issues that go down to my basic needs being met. and so, i'm someone who needs wrap-around services in my life. i'm at the mercy of th

recommended both by the cdc, center for disease control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. >> i actually was in the project here when i first started here it was in trials. i'm currently on prep. i do prep through city clinic. you know i get my tests read here regularly and i highly recommend prep >> a lot of patients inclined to think that there's no way they could afford to pay for prep. we really encourage people to come in and talk to one of our prep navigators. we find that we can help almost everyone find a way to access prep so it's affordable for them. >> if you times we do have opponents would be on thursday morning. we have two different clinics going on at that time. when is women's health services. people can make an appointment either by calling them a dropping in or emailing us for that. we also have an hiv care clinic that happens on that morning as well also by appointment only. he was city clinic has been like home to me. i been coming here since 2011. my name iskim troy, client of city clinic. when i first le

a navigation center or shelter and can you get this person access to care and that's not us, that's dph, that's not what we do. so the result is, of course, that people's care is not treated with the urgency and the impressive approach thacomprehet desires. this will require us to work together to hold the system accountable to make this a reality. i do want to thank our staff one more time, your staff, carlina and carolyn for their extraordinary work. we have been spending, i think. i'm thankful for the work of everyone on our committee, supervisor marr and so many others and i think we're close to getting this done. there's a few more steps to take, but ultimately, once it passes, we'll also have the responsibility to make it a reality because this is one more big step on the road to making sure mental health sf is not just a right in name but practise and i know that's what you have fought for in your lives and continue to do. so thank you again. thank you supervisor ronan for your leadership and i'm excited to move this forward but i'm more excited when we start to see the impact it

will be closely in communications with dph on the resources to be added. i want to mention on the taxi card we did launch by telephone. you can call if you have a credit card you can call and add value to your paratransit debt card. online access is being pilot tested right now. you need a credit card to purchase online that is being tested by the pilot participants. it is a soft launch for the general public using paratransit. those are the things we have been working on. i wanted to mention that i heard julie talk about the chronic operator shortage. we had a similar short age earlier this year. we have resolved that. never totally resolved you are always recruiting for operators. we have addressed it, our on time performance is over 90% on the van service. that is with a five minute before and 15 minute after promised time, performance window. our drivers are delivering the on time performance. that means nine out of 10 rides are on time within that performance window. we expanded the dedicated fleet by 18. 18 new vehicles. we conducted the satisfaction

then 223 residential substance abuse disorder treatment beds. 178 are funded by dph. there are other purchasers who purchase beds for low income. parole purchases beds. they are all for san franciscans, not all purchased by the county. it was difficult for us to pull data on what percentage of our clients have a re-occurring mental illness. when we pull the data it pulled a number that said 1495 people which is the equivalent of the people receiving addiction treatment. it was pulled by diagnosis. some have more than one mental health diagnosis. at least half if not more of the clients we serve have a re-occurring mental illness. there is a perception we don't take those people with mental illness and we do. we take people who have been hospitalized or coming out of the hospital. stand stand >> i have a whole slide and the next slide works through the intake process and it will show you where there are a lot of places to fall off and i'm interested in that, as well. for detox services, we can do the same-day placements because it's an emergency service. they meet medi

yesterday was the final test, dph was going to come back and check and everything. unfortunately it failed for the third time. that's when we decided that we needed to move all the clients out of the facility. >> other children staying at the facility have been tested for lead, they're still waiting for results. >>> dianne feinstein and kamala harris are asking the epa's watchdog to investigate to see if the agency abused powers when it accused the city of san francisco of improperly dumping waste into the pacific ocean. the chronicle reports the two senators are asking the epa's inspector general to see if the white house was involved in the decision. on wednesday, a notice of violation was issued accusing the city of sending waste into the ocean and bay. president trump recently said that exact scenario was happening in the city, then the epa followed up. >>> happening today, two protests will be held in oakland calling for making the streets safer. this is days after a woman was killed in a hit and run. heung jung was crossing the street with her 4-year-old niece

yesterday was the final test, dph was going to come back and check and everything. unfortunately it failed for the third time. that's when we decided that we needed to move all the clients out of the facility. >> other children staying at the facility have been tested for lead, they're still waiting for results. >>> dianne feinstein andg the e watchdog to see if the agency abused powers when it accused the city of san francisco of improperly dumping waste into the pacific. the chronicle reports the two senators are asking the epa's inspector general to see if the white house was involved in the decision. on wednesday a notification of violation was issued accusing the city of sending waste into the ocean and bay. >>> happening today, two protest protests will be held in oakland calling for making the streets safer. she was crossing the street with her 4-year-old niece when they were both hit tuesday morning. the garfield elementary school community will hold a protest before and after school today. she just picked up her niece and they were walking home when they we

i mention it, because in dph, we're responsible for the sheltering. it's a multi-process. our job is to have ready the cache -- and it's not that kind of cash, it's the cache of supplies. >> the current sheltering plan for any incident in san francisco we've identified locations throughout the city that can function as potential shelters. in that collection, we've also identified those that are ada compatible. not all are. we hope they become so, but we also recognize we want to provide the highest level of care we can at the shelters consistently. some individuals may have a particular need, so when an event comes up, we have not pre-identified shelters, but we have a list of places we can have shelters. and we'll let the community know certainly where those are, so they can come to the locations. >> mr. herman: thank you. >> ms. senhaux (chair): before we move on to the next question. i want to add that in addition to all of this work that is being done so far, we have an active disability functional needs working group that is a combination of many city staff, community

substance abuse treatment and presenting the plan to meet that demand and requiring the budget include the dph plan. so today in 2019, how are we doing? a walk on the streets of san francisco would suggest not that well. i am hoping we can unpack that a little in today's hearing, move and look at facts and data and begin the conversation about the necessary next steps to make good on treatment on demand. what are the successes since 1996? i know there have been successes. i have seen first hand the amazing work so many great providers are doing to change lives throughout the city. there is more to be done. i am hoping today we can explore not just the gap between our current reality and the promise of universal immediate access to high-quality drug treatment and we can explore the gap where we support those coming out of treatment. in may at the budget and finance committee we held a hearing on the budget. at that hearing we learned 44% of the people exiting residential treatment go to streets or shelter. this is alarming. it suggests we need significant investments not only in treatment but s