we week with city dph weekly.like us have posed that question to cms, and i believe we're still waiting on the answer although we continually ask for an answer to that question, but while we're still waiting on their answer we're still doing our own due diligence in terms of working with our consultants and our facilities engineering teams to assess if we are held to the current standards what changes or modifications will need to be made so we can still pass the certification survey? so we should know more soon but i think we're in the best place we can be given the guidance we have gotten so far from cms. >> very good. you mentioned we were working with consultants on that too. were they separate consultants? >> they're the same consultants. >> okay. in the transfer plan during this period of time and doing due diligence you obviously conformed do we need to go out of state and what happens if we actually don't find space for a number of these patients because many of them don't really need what the long-term sn

it's still unclear to me because i was told that dph didn't know and now it's unclear to me whether dph didn't know or knew. but there's red flags screaming and you came and asked us to double the contracts without telling us a thing and then less than a month later are asking us to do an emergency $3 million -- it's extraordinary. and never -- now i have been at this board for 12 years and i have never seen anything like this, not anything close. and i have asked for detailed information time and time again and i have not gotten a coherent explanation yet on how we got to this place. and it really appears to me -- and i will say this -- that dph doesn't know. i don't think that dph would not tell us if they knew. mr. andrews, i -- prc needs to know how this has been happening. you have a sophisticated board. you have a -- you know, you have an organization that has been operating these programs for years. how did we -- how did this doubling of this contract get to us less than a month ago and none of these issues were brought to our attention? you know that i work literally 50% of my t

it's still unclear to me because i was told that dph didn't know and now it's unclear to me whether dph didn't know or knew. but there's red flags screaming and you came and asked us to double the contracts without telling us a thing and then less than a month later are asking us to do an emergency $3 million -- it's extraordinary. and never -- now i have been at this board for 12 years and i have never seen anything like this, not anything close. and i have asked for detailed information time and time again and i have not gotten a coherent explanation yet on how we got to this place. and it really appears to me -- and i will say this -- that dph doesn't know. i don't think that dph would not tell us if they knew. mr. andrews, i -- prc needs to know how this has been happening. you have a sophisticated board. you have a -- you know, you have an organization that has been operating these programs for years. how did we -- how did this doubling of this contract get to us less than a month ago and none of these issues were brought to our attention? you know that i work literally 50% of my t

it's still unclear to me because i was told that dph didn't know and now it's unclear to me whether dph didn't know or knew. but there's red flags screaming and you came and asked us to double the contracts without telling us a thing and then less than a month later are asking us to do an emergency $3 million -- it's extraordinary. and never -- now i have been at this board for 12 years and i have never seen anything like this, not anything close. and i have asked for detailed information time and time again and i have not gotten a coherent explanation yet on how we got to this place. and it really appears to me -- and i will say this -- that dph doesn't know. i don't think that dph would not tell us if they knew. mr. andrews, i -- prc needs to know how this has been happening. you have a sophisticated board. you have a -- you know, you have an organization that has been operating these programs for years. how did we -- how did this doubling of this contract get to us less than a month ago and none of these issues were brought to our attention? you know that i work literally 50% of my t

[applause] we are so grateful to be in partnership with dph and west side community services, positive directions equals change [cheers and applause] we are -- that's right. we are very grateful for the support we receive from the board. supervisor safai, supervisor dorsey. supervisor stefani, and supervisor mandelman. at the adult probation department our revision is led by steve adomi. [applause] and destiny pledge, victoria westbrook, devonna smith and daniel amaringa. [applause] this is their vision and they put their heart and soul into making sure that this is a right environment for change. we are so honored and feel so much responsibility for making sure that this works. there are endless possibilities for anyone that will come through these doors and we're really grateful for this opportunity. thank you. [applause] >> you know, a couple years ago, 2019, we kind of set out on this mission with one of my then staff joffreya morris who then went to work for supervisor safai. then we created a portfolio and we had no money at the time and we started to try to figure things out and

to making sure, to hold dph accountable. tohold ourselves accountable . to make this institution continue to be the best it has been and can be. where there are things to be improved let's improve it. cms is there as anoversight by let's work with them . identify what needs to be fixed and let's fix it. bottom line is it's not optional. it'snot an option whether it stays open . it is onthe mental . it is a must. and so i reach out and ask you board of supervisors to commit to that. i asked our mayor to commit to that. whatever we need to do and that couldinclude funding . let's make sure that we keep that healthcare facility accessible to the citizens of this community. and to california. and let's enhance the health care and progress and ideals that we all in closing i want to also ask you to just remember this. laguna honda is a multidisciplinary institution that provides a 360 degree care process. and so in speaking to that let's remember that it serves our trauma one hospitals but it's vital and i'm repeating myself here. it's a vital part of our heal

next slide. >> so behavioral health services at dph.for just some context our total budget is approximately $600 billion. we contract with more than 80 community-based organizations . we provide specialty care. that is specialized mental health or substance abuse disorder care to 21,000 people annually. we also touch many more people via our services where we don't collect or build for medi-cal and have less unduplicated data. so in the behavioral health sector the community-based organizations and providers are essential to our successful deliveryof care and services for the entire system . the contracts that we hold are primarily in offee-for-service structure . that is they provide a particular rate for a unit of service provided . rates are updated annually when there are costs of doing business adjustments as well as contract negotiations with providers in order to align and adjust rates to aim to meet community-basedorganizations proposed costs . we do not set individual rates for members of theworkforce or classification . as thi

next slide. >> so behavioral health services at dph.for just some context our total budget is approximately $600 billion. we contract with more than 80 community-based organizations . we provide specialty care. that is specialized mental health or substance abuse disorder care to 21,000 people annually. we also touch many more people via our services where we don't collect or build for medi-cal and have less unduplicated data. so in the behavioral health sector the community-based organizations and providers are essential to our successful deliveryof care and services for the entire system . the contracts that we hold are primarily in offee-for-service structure . that is they provide a particular rate for a unit of service provided . rates are updated annually when there are costs of doing business adjustments as well as contract negotiations with providers in order to align and adjust rates to aim to meet community-basedorganizations proposed costs . we do not set individual rates for members of theworkforce or classification . as thi

dph informed me that reporting discharges will to these locations would violate hipaa patient privacyrotections. this board will need to do in your toes to continue to obtain that level of detail as of today there have been at least six reporteddischarges . the task for dph is apparently going to quote some line with data about the laguna honda closure plan that doesn't provide a url of wearable where it will be posted online and whether it will report the number of discharges to the community and to out of county facilities. the dashboard must be expanded. spending 5.6 million on the two contracts with hsa t and hma to obtain laguna honda's cms recertification is essential. why is the hma contract through june 23 when this recertification application is to be submitted to cms in early september. the board of supervisors should review the hma contract because of the scope of services to be provided are overly broad. political consultant jackdavis posted online comment . >> thank you for your comments to the board. let's hear from our next color please. >> that evening supervisors. my

next slide. >> so behavioral health services at dph.for just some context our total budget is approximately $600 billion. we contract with more than 80 community-based organizations . we provide specialty care. that is specialized mental health or substance abuse disorder care to 21,000 people annually. we also touch many more people via our services where we don't collect or build for medi-cal and have less unduplicated data. so in the behavioral health sector the community-based organizations and providers are essential to our successful deliveryof care and services for the entire system . the contracts that we hold are primarily in offee-for-service structure . that is they provide a particular rate for a unit of service provided . rates are updated annually when there are costs of doing business adjustments as well as contract negotiations with providers in order to align and adjust rates to aim to meet community-basedorganizations proposed costs . we do not set individual rates for members of theworkforce or classification . as thi

we have 5 aye's. >> motion passedunanimously . >> thank you dph and i think ms. kim already left. please extend my apologies that i called her miss chan. but it's a name is near and dear tomy heart. thereyou are, so sorry .thank you . >> thank you supervisor. >> next up we have hsa and mister clerk could you please call item number five as well. >> if there's a resolution that approves the fiscal year 2022 2023 to 2024 expenditure plan for the department of homelessness and supportive housing fund. members of the public who wish to provide public comment on that resolution should call 415-655-0001. . then press pound twice. dialá3 to line up to see us at the prompt will indicate you have raised her head andwakes a system incase you have been commuted . medicare . >> thank you and we have a director of hsa here. >> morning director. are you doing item 5? >> we can do themin higher order . >> for hsa. >> i think the clerk is going to need to allow screen sharing for my presentation. there we go. well oiled machine.good morning, executive directorof services agency . if we could go t

i would request that dph be prepared to submit those reports not again, not with private data to this board of supervisors while we're waiting for june 14th, to roll around so we know what the number of discharges look like on a weekly basis and what the remaining patient census is is and in the same breath, i believe that when we were wrestling with epic, the database that i would like dph track the types and facilities and where they are as supervisors melgar said some of these facility may be hundreds of miles away so i just want to make sure that we have that level of data as we enter the june 14th hearing and i support this hearing and sadly look forward to it on june 14th. >> supervisor mar. >> i wanted to add to supervisor peskin's request for weekly updates from dph about the seeing where they're discharged to if it's out of county and to what facilities and it should be required by the legislation that we adopted at supervisor safai from the acute care hospitals and long-term care acute hospitals so thank you. >> president walton: thank you supervisor mar and thank you superv

to making sure, to hold dph accountable. tohold ourselves accountable . to make this institution continue to be the best it has been and can be. where there are things to be improved let's improve it. cms is there as anoversight by let's work with them . identify whatfixed and let's fix it. bottom line is it's not optional. it'snot an option whether it stays open . it is onthe mental . it is a must. and so i reach out and ask you board of supervisors to commit to that. i asked our mayor to commit to that. whatever we need to do and that couldinclude funding . let's make sure that we keep that healthcare facility accessible to the citizens of this community. and to california. and let's enhance the health care and progress and ideals that we all in closing i want to also ask you to just remember this. laguna honda is a multidisciplinary institution that provides a 360 degree care process. and so in speaking to that let's remember that it serves our trauma one hospitals but it's vital and i'm repeating myself here. it's a vital part of our healthcare instit

anna from dph is going to be advancing my slide. we will wait for those to pop up. >> i didn't want to mispronounce your name. >> thank you. as the director. >> thank you, chair ronen and president walton for having us committed to serving the youth and families. next slide. >> through the chair -- >> i am working on advancing the slide. >> no worries. there we go. this is to give a robust system of care and many levels of care and programming within each of the levels and the overall budget is about just under $90 million and about 65% of that is estimated to go to contracted providers in the community. any program could end up serving a youth in the juvenile justice system and could be linked to services along this tier and continuum, but the presentation we are focussing on today and the questions we are answer have to do with programs targeting and invested and investing in juvenile justice populations. we will first part with our clinic and give an overview of the contract providers and answer the questions you have for us abou

as i mentioned in partnership with dph and moh. the 100 affordable units, we expect 10% or more of those will be transition units for village residents. and home rise, the current project, will transition all the existing 114 households and roughly 10% eligible for transition units and expect the occupancy there in 26 or 27. the fifth site, the schedule, the developer and unit county there is still to be determined, but they will be having completed the transition units of one treasure island transitions and will focus on completing the transition units and 25% of the building will be transition units so we can transition as many of those households as possible. then just again, the image of the may building that you are familiar with and the star view core building to provide the transition units for the very long residents as well as the new homes for all of the current residents of the catholic charities. i just wanted to wrap up by walking through the initial inclusion area of the additional opportunities that will be available

[applause] we are so grateful to be in partnership with dph and west side community services, positiveons equals change [cheers and applause] we are -- that's right. we are very grateful for the support we receive from the board. supervisor safai, supervisor

of course it has to work in concert with pd, ppw, dph in getting folks help and housing as well. we know that we are just part of the solution. i wouldn't be able to tell you today what the ultimate mixture of the services are, but we know right now, they have provided a really essential function in that community. the downtown ambassadors, similarly, have gotten very, very good reviews, particularly from convention attendees, from businesses, small businesses that are operating in our downtown while we are still trying to get more people back downtown. there are two fundamental differences though, between the functions of the programs, mid market is very much focused on safety and helping people in the community who need help. and the welcome ambassadors are focused on greeting, wayfinding, correcting this awful image of the city we have. we have all read the paper and the news and the people have created this narrative that san francisco is unsafe and you don't want to come here. the data has borne out in the number of bookings we have lost in the past year, fancy food being on

of course it has to work in concert with pd, ppw, dph in getting folks help and housing as well. we know that we are just part of the solution. i wouldn't be able to tell you today what the ultimate mixture of the services are, but we know right now, they have provided a really essential function in that community. the downtown ambassadors, similarly, have gotten very, very good reviews, particularly from convention attendees, from businesses, small businesses that are operating in our downtown while we are still trying to get more people back downtown. there are two fundamental differences though, between the functions of the programs, mid market is very much focused on safety and helping people in the community who need help. and the welcome ambassadors are focused on greeting, wayfinding, correcting this awful image of the city we have. we have all read the paper and the news and the people have created this narrative that san francisco is unsafe and you don't want to come here. the data has borne out in the number of bookings we have lost in the past year, fancy food being on

[applause] we are so grateful to be in partnership with dph and west side community services, positive to work with the people that live on this block. we need to take it block by block and we have to start within our own hearts. don't blame nobody else if you ain't doing nothing, but we have to start within ourselves to be able to make this work. i ain't going to hold you long because i appreciate everybody for supporting and coming out. don't just come today. i want to see you here tomorrow the next day the next day and come out and support this situation. so, right now, thank you all for coming. i appreciate you guys. love you. and -- [cheers and applause] yeah. and i want to bring supervisor safai to the table, please. >> supervisor safai: i don't know if i want to follow him. let me just start by saying god is good ya'll. all the time. all the time. so let me say this and he hit on it and mayor breed said it right. the best elected officials, the best public servants listen because we don't have all the answers. and a few years ago, the black community got together, the recorpse l

heard the program model was in development and early stages and we're grateful to get response from dph about the need to address the possibility including mobile care or other types of support that might reach people where they are rather than another brick-and-mortar that will have hours, almost by definition and might not have the geographic or equitable reach we want citywide. so as a result of that and several conversations with committee members, the members here are recommending that we deploy that $17.5 million in one time balance to treatment bed acquisition rather than behavior health access and drop-in center and i was happy to educated by the members about the existing drop-in centers and under investment -- and under investment and how those can be supported more rear than creating another brick-and-mortar that may not support the community and may not come out in the sincing session so i wanted to highlight that with the recommendations and ours. these are areas of agreement with the department and members on facility maintenance fund, preserving 2% of the value of the cap

[applause] we are so grateful to be in partnership with dph and west side community services, positive directions equals change [cheers and applause] we are -- that's right. we are very grateful for the support we receive from the board. supervisor safai, supervisor dorsey. supervisor stefani, and supervisor mandelman. at the adult probation department our revision is led by steve adomi. [applause] and destiny pledge, victoria westbrook, devonna smith and daniel amaringa. [applause] this is their vision and they put their heart and soul into making sure that this is a right environment for change. we are so honored and feel so much responsibility for making sure that this works. there are endless possibilities for anyone that will come through these doors and we're really grateful for this opportunity. thank you. [applause] >> you know, a couple years ago, 2019, we kind of set out on this mission with one of my then staff joffreya morris who then went to work for supervisor safai. then we created a portfolio and we had no money at the time and we started to try to figure things out and

i will ask you to fully fund cart and place cart in dph's behavioral health instead of dpm.his ensures a focus on behavioral health prevention instead of waiting for a crisis to occur. this program will improve outcomes for people on the street. a police response displays unhoused community members away from their support system. the cart response would focus on moving people off the streets permanently and addressing the immediate needs of all of those involved. instead of moving homeless people around. i personally spoke with police chief scott about this program two years ago and he was supportive of the program that would relieve -- >> clerk: thank you for your comments. next caller, please. >> caller: hi, my name is danielle blacan and i work in san francisco at one of the navigation centers. i urge you to oppose the increased police budget of $50 million. police do not keep us safe, housing does, community care does. and instead i strongly urge the board to fully fund the compassionate alternate response team, cart. and to have community organizations and fund a living

i think i have raised this with dph and others. what you're basically saying, you had a contract for a certain amount and built in as much -- you knew you were going to expand it and built in as much as you could without bringing it before the board which makes no sense because the contingency was future anyway. you could have put in everything you intended to use later and brought it before the board. i guess -- i do want -- having raised this now on and off as it has come up for probably about a year with different departments. have the practices changed at all for hsh? if you have a contract like when it is close, do you try to stay under $10 million? or is the $10 million threshold irrelevant to your contracting. you do your contract with what you think it is going to be, if it is over it comes before the board and if under, it doesn't. >> we are aware of the threshold and time pressures, especially during the covid response of getting resources on the street. we know the board process adds time, but that said, i'm before you e

i think i have raised this with dph and others. what you're basically saying, you had a contract for a certain amount and built in as much -- you knew you were going to expand it and built in as much as you could without bringing it before the board which makes no sense because the contingency was future anyway. you could have put in everything you intended to use later and brought it before the board. i guess -- i do want -- having raised this now on and off as it has come up for probably about a year with different departments. have the practices changed at all for hsh? if you have a contract like when it is close, do you try to stay under $10 million? or is the $10 million threshold irrelevant to your contracting. you do your contract with what you think it is going to be, if it is over it comes before the board and if under, it doesn't. >> we are aware of the threshold and time pressures, especially during the covid response of getting resources on the street. we know the board process adds time, but that said, i'm before you e