walton and ms. crumb for the work they do they've been responsive to those concerns do you have a sense of what should happen what's the ideal situation in this case so the client is not returned to the hospital not an ongoing cycle. >> i don't think that's a question the h f a can answer we work closely with the care of nurse maybe she can offer a response kate. >> (laughter). >> you're on the hot seat (laughter). >> so the question is what do we do when people go the the hospital. >> what's the ideal what's the outcome you want to see given right now it is sort of an ongoing cycle. >> it's complicated and each case is very complicated every time i get a referral for someone that can't take care of themselves that 3 involves a lot of parties not ideal for people to be 9-1-1ed out to the emergency room without someone on the other end advocating the emergency rooms are to treat trauma for instance if you have a chronic issue and you're in the er you're not going to walk out you you'll be attached together

you asked a lot of the questions i've been asking forever the last couple of months and thank you ms. crumb i don't want to sound like we have the answers but we're about exploring options and we can talk about the resources readily available to address solutions to this issue. >> through the chair. >> yes. >> because my question is wait the magnitude of the issue. >> dpw will go through that. >> and then what are the alternatives to requiring the shelters i guess those are my anecdotal information is interesting but to focus on the issue i thank you supervisor christensen. >> thank you, ms. crumb and mr. walton i do want to bring up the department of public health and just to give a little bit of background on data they'll be presenting today on the demographics of our homelessness e homeless population and the work we've done the studies to he'd some of the issues that was brought up electro the disclosed rule and in particular around self-care and so thank you for being here today. >> okay supervisors i'm here for barbara and i'm the deputy director of the health network and essentially

issue i thank you the h s a and the department of public health for their presentation i know that ms. crumb and mr. walling ton are conscious and the last thing i'll is to the department of public health is that further analysis of the data that i have i think would be really helpful and if there are ways to create additional strategies in terms of how to address the needs of the some of the populations is very helpful to i supervisor kim. >> thank you supervisor campos i just wanted to thank the members of the public that came today it was a lengthy hearing as also an important issue and an issue with a lot of different angles and i think that you know beyond the meetings we've been engaging in it is important to have the members of the public to active gave me and an opportunity to educate the rest of the board as well as the public that are watching and wanting to learn more about how to address homelessness in our city thanks to the public for shareing their stories so thank you for spending our time to advise us on the issue i wanted is to reiterate this of the called because of the ru

. >> who decides whether or not that changes i mean ms. crumb if you can. >> you sure i'm speak to that. >> so there's history to that rule because our emergency shelters fill up really fast when we expand we were initially at vessel and a m e church and moved to first friendship because there was a rise in the number of homes families sooeblg shuttles the history that province is the organization that manages first friendship and the providence the history families will come in they would leave and then not come back which means that proupdz was holding a shelter bed for 2, 3, 4, 5 individuals in the house and wouldn't come back and they'd turn someone away so the discussion they had with us was making that a rule that all family members must come at the same time in order to secure a room - a space so this conversation once again came up because we got a letter from the coalition and since december we've had meetings are the other shelters providers to talk about a call in for providence so that's not something we're not addressing it takes ti

ms. crumbing

ms. crumbing u crumb from the human services agency. >> thank you for being here. >> any member of the publicpeak on any item. >> at the thank you for having this hearing i am joyce crumb the director of the houses and homelessness division for the human agency i appreciate this hearing and appreciate the preempt we had with the supervisor kim and then our group meeting that we had with coalition on homelessness and e.c. s proifrdz just let me give you a little bit of background those are not in any rules in order to have a shelter facility we have to have rules and those rules actually went into effect in 1999 when we established the shelter grinds advisory committee and when rules are broken and shelters or an infraction happens in a