. >> and we will have dph first. >> we are having the dph representative go first. thank you and welcome. >> hi, members of committee. my name is kelly kirk patrick director of administration and operation at sfdph. happy to walk through the changes that took place during the phase of our portion of the dph budget. alright. so the mayor's budget proposes $110 million in the first year of the budget, and $112 million in the second budget for our behavioral health program funded by prop c. it maintains all previously approved programming, with increase of $3.8 million and 6 and $6 and a half million compared to the march presentation. those changes are to fund $3 million per year to fund the heart team over seen by department of emergency management as alternative for law enforcement response for non emergency calls and includes higher projected labor contract cost to include inflation. these are off-set by modest revenue improvements between march and may. we do place the mayor's prop c funding on reserve for programs that are ramping up. we will revisit revenue and

but the shelter problem is not under dph. i don't have specific numbers around what levels of care, of folks need coming out of pef, i will say that tr*, in my conversation with dr. leaer' with whom i worked very closely, there was an awareness that a lot of what is needed is connecting people and helping them to get into care is a mainl or part of what we have been working on together including with the particular office coordinated care. one more section, moving on to overdose. when i come before you to talk about overdose and you heard from dr. coalfax about our program with tele health. we as awe department i think you know, are really aiming to strengthen our efforts, laser focus on fatal and non fatal overdoses and to reduce overdose death disparities in san francisco. we're aiming to do these five things align and coordinate existing and new approaches to maximize our impact. we're really focusing on equity and reducing racial disparities. particularly analyzing assessing gaps and existing intervention sxz who we are n

respect as a expectation at dph was at 84 percent. dph employees understand respect towards patient and colleagues is a expectation. moving to areas of improvement, we had about 60 percent negative response to question, my work unit is adequately staffed. we have taken that very seriously and as mentioned earlier, we are going strong on hiring efficiency. between 40 percent to 43 percent responded negatively to three questions around stress, work load and emotional exhaustion and we see a connection with staffing and coming out of the pandemic and other concerns employees may be experiencing. when asked, what prompt a employee to consider leaving dph, majority noted lack of career advancement as a number one reason. those are areas of improvement and last one here is, respect as reality. as a expectation was 84 percent, respect as reality is 65 percent with a lower positive response from junior front line staff, majority of whom identify as bipoc. going back to data, we were able to understand who among our workforce are not experienc

must provide for support for dph providers to prevent over doses and dph is rolling out facts at p.sh but insufficient to meet the demands for services and lastly cal am offers additional services to meet the demand but for the utilized to ph sites the health plan did a training that was at the request of supportive housing providers network not hsa. homelessness is a public health crisis p.s. h provide a home for the vulnerable community in san francisco (bell ringing) and we need dph collaboration to make sure the residents get the services they need and thank you for your time. >> thank you for your comments. >> next speaker. >> hello, good afternoon i'm matte i work with the supportive housing and a community development manager and i lead the residents leadership initiatives and harm reduction programs as well as many other things and here to address and echo many of the people in regards to the cuts and permanent housing is a home and beginning but not the end when you get that on on the roof you need to give them the infrastructure and help them see the power and we recognize

must provide for support for dph providers to prevent over doses and dph is rolling out facts at p.sh but insufficient to meet the demands for services and lastly cal am offers additional services to meet the demand but for the utilized to ph sites the health plan did a training that was at the request of supportive housing providers network not hsa. homelessness is a public health crisis p.s. h provide a home for the vulnerable community in san francisco (bell ringing) and we need dph collaboration to make sure the residents get the services they need and thank you for your time. >> thank you for your comments. >> next speaker. >> hello, good afternoon i'm matte i work with the supportive housing and a community development manager and i lead the residents leadership initiatives and harm reduction programs as well as many other things and here to address and echo many of the people in regards to the cuts and permanent housing is a home and beginning but not the end when you get that on on the roof you need to give them the infrastructure and help them see the power and we recognize

regarding instructions for making public comment. 4) for discussion: director's report (grant colfax md, dph, director >> thank you. >> give me one second to pass something out. >> please begin your three minutes. public speaker: good afternoon, health commission. my name is chris. i have spoken here a few times. public health is going to be getting some great counselors on the 22nd. it's a great first start but there is a bigger issue that we talked about last week and hopefully will talk about the potential resolution. i just handed out a draft letter that we were requesting that all politicians, commissioners, public health and safety department will sign off on it and we have been doing a lot of meetings, public speaking with the commission and 12 different commissioner meetings. i'm going to read it. the statement will be. will you invite the commission and on anyone giving access to public health, safety systems. >> false injuries, false illnesses, donations, illegal placing and altered for personal or religious reasons. we are going to be giving to the board of supervisors and this is

care plans and through those planning opportunity we have brought in addition $7 million to direct to dph like providing the work with the access to conclude the care coordination or the entire tiers on the neighborhood team and we also supported the other cities agencies and their ability to drive down those funding tints as well as and service million dollars next slide, please. and so finally to share some highlights moving forward we we move from the third year the medi-cal have 2 and a half more years. we are currently planning a citywide calaim strategy violation goal of strategies so like other cities one way a strong coordinated effort and engaging in the studies that are finding the hospitalization that help the programs we will have this by many factors and take that data to improve on the programs to address and improve the whole that person health in a manner and finally, continue to launch the additional initiatives required and shared as a screen shot we'll be engaging the services and monitoring the initiatives and other things in 2025 and health initiatives that. >> no pub

each year we serve over 150 thousand people in dph facilities. that is a incredible number. this care includes receiving life saving emergency services, having your baby delivered. it includes recovering and rehabbing from a hip replacement surgery or living with dementia in a long-term care unit at laguna honda hospital. it includes hiv screening and prep prescriptions at city clinic and include seeing your primary care doctor to get back to school immunization, substance use recover aservice or eye exam. but, our infrastructure is aging and many of our facilities are over a hundred years old. we must fix the aging and deteriorating infrastructure to continue to deliver high quality care. moreover, many of the improvements addressed in the bond will help meet basic regulatory requirements. imagine laguna honda without air conditions on a hundred degree day where we need to move hundreds of patients or san francisco general losing the trauma 1 certification because the fire alarms don't work or the sewage leaking from old pipes, or imagine city clinic, a leader in sexual hea

so we have to go do dph to get this done and more to follow in the months to come.hank the command staff for the memorial day service nancy pelosi was there and many, many veterans a shout out to all the veterans in the fire department. for the work they've done and continue to do. many of i attended the one hundred and three three graduation they were up and coming in the second week and in the field it was a really nice graduation thank you for attending and pretty packed house. fit seven hundred people that recent pretty full. (clearing throat) we also have made offers to the one hundred and three 4 class um, we're hoping to have 54 members in this class and it is due to start i believe um, the 24 june this monday. >> i attended an event in the fillmore called grilling in mow and they've had had event 17 years the fire department received an recognition from the folks that put that event on just for our work in the community. um, really nice event and great music and barbecue that was um, a fun event and glad to be there. we continue our retreats myself, 2, 3, 4

insure dph restores funding for the [indiscernible] housing communities grant. grantee of the healthy community grant and last year started to build our own capacity by rolling and graduating cohort of pacific islander women in the community health worker certificate program. we distribute food and resources to people. we started work on nutrition education and family fitness for people kwr moved into new office space. the cuts to community grants means we no longer are able to bring culturally relevant focus health education and resources to community. urge to restore [indiscernible] to do the vital work we are promised to communities. thank you. >> thank you. next speaker, please. >> my name is sylvia. i was born and raised in district 10 and here to speak on behalf of pacific islander community. we need the funds to be restored. number one, healthy community grant anticipated to be cut. two, the full funding from dcyf needs to be restore td. the services are positive impact on the community. [indiscernible] are serving our youth and families and deserve to ke

i believe the connection to our overall street response, which dph plays a critical role with street crisis response team and overdose team, this is a really valued and cost effective part of our entire coordinated street response. the members of the organization who do this work do engage and de-escalate with folks with complex needs people experiencing homelessness, i and believe the intection is they are to link people experiencing homelessness to shelter or services when appropriate. it is a along the continuum of street response, alternative to police and they are working with people experiencing homelessness who may have behavioral health needs. >> okay, but my question is, is there a social worker? >> i do not believe there are social workers. >> okay. >> we can work with dem and mayor office to get response, but i don't have it in this moment. >> i know this program really really intimately. you may or may not trust me but i went through every dispatch that they did and i found one mental health reference because it writes out what--none of the staff i read their proposal, i

this is only half of $1.5 million dph contract we lost. these funds maintain stability in the agency community behavioral health service restructure [indiscernible] and mitigate the 41 percent horizon budget cut from the loss of the dph contract. as part of our vision to better serve our community and in alignment with mayor priorities propose to direct some funds to preserve and build on the model and are infrastructure we created with our opioid intervention program. i yield my time. >> thank you so much. next speaker, please. >> good afternoon supervisors. silty san francisco. city of san francisco, ross brown with horizon limited san francisco. i worked as a drug counselor in the high schools working with cope sf program offering service. offering workshop and referral to treatment targeting high school age youth of color higher risk of developing substance use disorder. awarded 1 year grant. that grant is about to-ends june 30 and first year implementation received great feedback and ongoing drug counseling in all the high schools in

open air drug and fejs market it involves cooperation of our law enforcement and outreach working and dph public agency and community stptd and stakeholders. intersection 925 builds think little work give agencies tools to gain a handsome on the sale of stolen goods and specifically target bad actors for the hypothetical anyone can come out here avenue dark and in fact, actually just on my walk over here had to work on ma cultivator street fencing accuracy fights and arguments who get to sell that makes our blocks to tentatively and for families to simply walk down the sidewalk and keeps visitors from coming over our restaurants three needs to be flood with reservations have the best food in the tenderloin and - we the heart and consistent work is paying off we are beginning to see change moving in the right direction and new must not stop we must keep on going the striate of san francisco starts with that work thank you, everyone, and with that, i'll introduce the president of mission street michigan - that's where i'm from mission street. >> fernandez. >> (clapping) buenos dias. >> (spe

that i and my office and i think some reporters have had a lot of trouble getting information out of dph about how we and this is particularly relevant during the prop one conversation, getting information about how san francisco spends our mhsa dollars, because because we were the politicians, some of the politicians in this town, including myself, were big proponents of prop one, and prop one had two component s, one being a very large, amount of capital dollars for placements for people with severe mental illness. but the other piece was an implicit rebuke, i guess, to the counties in how they were spending their, prop $63 in a sense that those funds were really not getting used to tackle that really acute california wide need to make good on our commitments that we made when we started dismantling the mental institutions. and i don't feel like this plan that we have here rises to the challenge, and i understand that it is paperwork and that we have to get it done and that we're, you know, it's retrospective, but i don't quite understand why we weren't thinking about it in these terms

the agreement between dph and the national association of city and county health officials is funded by the centers for disease control and is administered through the national association of city and county health officials. this grant is for $98,999 for the term of july 1st, 2023 to july 31st, 2024. the funded activities include mentorship, leadership, consulting and technical assistance, and finally, the resolution is requesting authority for dph to retroactively accept nonstandard terms and the grant agreement with naco. through this grant, the san francisco health department office of overdose prevention will provide technical assistance and capacity building to two other jurisdictions that are funded as part of this grant program. in addition, naco will fund the procurement of gift cards for focus groups, naloxone boxes, and naloxone vending machines, and outreach supplies to be used by the office of overdose prevention and permanent supportive housing to promote overdose prevention. finally, this agreement includes nonstandard terms, specifically that the city agrees to non-bi

resolution retroactively approving an agreement between the department of public health(dph) and theional association of county and city health officials for reducing overdose through community approaches mentorship program, for a term of july 1, 2023,through july 31, 2024, including binding arbitration and anticipated revenue to the city of$98,999; and authorizing the director of dph to enter into amendments or modifications to the agreement that do not materially increase the obligations or liabilities to the city and are necessary to effectuate the purposes of the agreement. >> same house, same call. the resolution is adopted (gavel) next next item (clearing throat) >> 26. resolution approving the seventh amendment to the sublease and property management agreement for treasure and yerba buena islands market rate rental housing between the treasure island development authority and the john stewart company to extend the term by 10 years from june 30, june 30, june 30, june 30, of july 1, 2014, through june 30,2034, with a three year option to extend. (coughing). >> >> same house, sa

resolution retroactively approving an agreement between the department of public health(dph) and theional association of county and city health officials for reducing overdose through community approaches mentorship program, for a term of july 1, 2023,through july 31, 2024, including binding arbitration and anticipated revenue to the city of$98,999; and authorizing the director of dph to enter into amendments or modifications to the agreement that do not materially increase the obligations or liabilities to the city and are necessary to effectuate the purposes of the agreement. >> same house, same call. the resolution is adopted (gavel) next next item (clearing throat) >> 26. resolution approving the seventh amendment to the sublease and property management agreement for treasure and yerba buena islands market rate rental housing between the treasure island development authority and the john stewart company to extend the term by 10 years from june 30, june 30, june 30, june 30, of july 1, 2014, through june 30,2034, with a three year option to extend. (coughing). >> >> same house, sa

we have been able to leverage oewd funding for workforce development and dph funding embedded in theered site team so there are dedicated staff on the team to help folks. >> for a person referred to rapid rehousing, particular person i have in mind that i have been following left a safe camp site and referred to the ecs program and i think she is in the category of the longer time she has been housed yet. when you recognize the person is not able to meet the criteria to increase income, what is option to refer back for permanent? >> usually the provider will reach out to hsh and discuss the situation. there is a transfer request process where you submit the request and we review it and it is approved. >> what is the provider doing to assess? >> currently now because the program is so new i say smaller percentage . our providers try to get somebody in housing before they are making that decision. as we all know, being in stable housing can really change a person's life and mental health, all those things combined and so, i think the ultimate goal for our providers is get them into sta

but dph can approve, if that makes sense. >> thank you. is the detail what the fees will be or any reason? >> whether you sell what is considered low hazard or high hazard food. so there is a range, in terms if you think the calculated annual permit, if you're selling at least four times a year or more, of high hazard foods, you would be saving money by getting an annual permit. and if you're selling low houser permit, four times a year, then the annual permit makes sense for you. >> have you, what is the out reach been so far? i can make my assumptions but. >> in terms of out reach? >> yeah, like the response. >> i would say that this came from the community so, whenever we go and do out reach and participate in merchant's meetings, i get this question a lot. those who started at farmers market and graduated to brick-and-mortar, this was community griffin idea. >> and you know as you're saying that, i want to recognize that i remember having this conversation with dante about this being a particular challenge, being food service. it's bee

under chief pang are keeping really good data around it, and we had a meeting with police and dph and others yesterday-yesterday or today? i can't remember. yesterday. and, you know talked about our collaboration and often the challenges is placement for folks, so--but we are continuing the good work. >> for sure. absolutely. and then the only thing, appreciate the update on the pfas turn-outs what we can do to make sure there are funds available as soon as possible so we can outfit our people in the safest jackets outfits, turn-outs possible. >> we do have a $3 million grachbt grants we will be expending on those turnouts and we also need to be really smart about purchasing, so doing fit testing with two different manufacturers now and we want to make sure this technology works as far as moisture barrier and protecting members in that way. i don't want to put all my money down on the first product that comes out, so we want to make sure there are other-and there are other products being worked on that hopefully will be out by the end of the year, but yes, and we will keep you apprise

but dph can approve, if that makes sense. >> thank you. is the detail what the fees will be or any reason? >> whether you sell what is considered low hazard or high hazard food. so there is a range, in terms if you think the calculated annual permit, if you're selling at least four times a year or more, of high hazard foods, you would be saving money by getting an annual permit. and if you're selling low houser permit, four times a year, then the annual permit makes sense for you. >> have you, what is the out reach been so far? i can make my assumptions but. >> in terms of out reach? >> yeah, like the response. >> i would say that this came from the community so, whenever we go and do out reach and participate in merchant's meetings, i get this question a lot. those who started at farmers market and graduated to brick-and-mortar, this was community griffin idea. >> and you know as you're saying that, i want to recognize that i remember having this conversation with dante about this being a particular challenge, being food service. it's bee

dph will issue a notice of violation or director's hearing is held. and lastly, a hearing officer determines, the penalties, if any. in conclusion, we expect the pilot program to offer a safer or help us offer a safer and healthier environment by reducing crowds and illegal activity, by reducing unsafe conditions that cause community fear and insecurity, by reducing risk factors to public law enforcement, city staff and others. reducing accumulation of unsanitary and unsafe debris and waste, and reducing overall criminal activity. that concludes the presentation. i'd be happy to answer any questions that you may have. thank you so much, commander, supervisor preston. thank you, chair melgar. and thank you, commander, for the presentation and work on this. and, colleagues, i'd like to speak to the ordinance and some proposed, amendments that i intend to move after after public comment, but just to maybe step back, the ordinance before us, as has been described, would close retail stores in most of the tenderloin from midnight to 5 a.m. for the next two