Case, we file a complaint rgs , if it is less than serious, we review it with the chief. It is affecting the personnel file and they are protected from public disclosure. Once the investigation is done we notify the complainant. Over a month the cases we close, one can look at see the nature of the cases and get that information but its going to be sanitized of officer information and complaint information and we also have a mediation program. So someone who wants to have the opportunity to talk with an officer through a trained mediator, there is a process of cases. Another part is the collaborative aspect that our agency has. We investigate complaints but also based on complaints and based on what Community Members come to us about, we have the opportunity to work with the Police Department and community organizations. So cit is one of those examples. In 2010, the San FranciscoPolice Department they issued a five year study on officer involved shootings. They were looking at officer involved shootings from 20052009. In that report in the officer involved shootings, 5 of those involved individuals who were in Mental Health crisis and had a history of Mental Illness. In response to that study. Our agency was asked to participate in the study and we were asked to make recommendations. Part of what we did was look to see what was happening across the country and what are the best practices for Mental HealthCrisis Response and we learned a lot about the model and we wrote a recommendation to the Police Department and Police Commission that we in conjunction with Community Based organizations with the Police Department really look at study with this model of response. The Police Department to its credit sent officers to memphis and also sent myself and paid for me to go which was really, a really huge collaborative step and we were able to work with the actual founders with major cochran and meet with Mental Health groups there and come back and work with Community BasedMental Health department and there was a hearing before the Police Commission and a great discussion about the memphis model and how that can enhance the police response. It was really an historical event in 2011 when the Commission Adopted the model. There is a whole resolution that outlines the model and also some aspects on how the police and community can Work Together in enhancing response to crisis calls. So thats kind of the thumbnail sketch of our agency and our role and hopefully moving forward with cit. But i wanted to make one last comment and thats about president obama, he had pulled together a task force in november, december. It was a task force specifically to bring together and listen to organizations and Law Enforcement about how to really enhance Police Community relations especially in the light of everything going on in this country. The task force issued their final recommendations in may and part of the recommendations highlight cit and its remarkable to have that really underscoring the role of cit in communities. The other part of you know there is a whole host of recommendations, but one that really stood out to me was that the task force talked about how important it is for communities to work with Law Enforcement to review Police Practices. So in that regard, i see our agency is a bridge that works with the Police Department and Community Based organizations to have an opportunity to really review Police Practices and to Work Together to improve them, to design new ones. So i look forward to working with all of you and other members of the communities to advance these changes and policies. Thank you, i welcome your questions. Thank you. We are going to open up for Public Comment and cochair supanich has a question. Hi, thank you for your presentation. I know nothing about the Citizens Office for complaints. This is educational. I was wondering, you say you have a staff of 32 and most are investigators. About how many complaints do you get annually . Between 700800 per year. That seems high to me but i dont know. Is that National Average . I think San Francisco, our agency is a fairly unique model and it depends on the size of cities. Most certainly there are other agencies that have larger and smaller numbers of complaints. I was wondering if you could recite your website address slowly and also the phone number. Yes. Its sfgov. Org occ. Our phone number 4152417711. I dont have the tty phone number with me right here. I do have it in my briefcase. Okay. Thank you. Any other questions from the council . Staff . Thank you very much for coming to speak with us today. Im always interested in policy, can you tell us about what sort of policy initiate ives you are working on now and in the future. What im working on to put together the department general order on cit. There is a whole program, but it also now will involve revisions to already departmental orders. Thats one of my projects. I continually, i do a lot of work around language access. I do a lot of work around youth and right now arrest of parents when a youth our child is present at their parents address. Also in looking at complaints at policies and in general bulletins that enhance the way Police Interact with the different communities. Thats very much how our office operates as well. We look at the complaints and help to identify the initiatives that might be needed to fix problems more structurally. So we certainly appreciate that. We look forward to working with you. I would like to offer my staff to support your efforts on policy development and also participating in some of these round table conversations to help improve the quality of the training which sounds like sits its had a lot of great work done so far. Any other questions . Through the chair. Thank you for coming and i want to publically apologize for the miss pronunciation of your name. I have a question about mediation. Who decides if a case gets mediated. Can the complainant say i want to have remediation versus going through this long process and the second part of that question, whats the percentage of cases that goes to mediation . Thats a great question. Most cases the complainant says i want this case to be mediated. Mostly they are the less serious occasions where there is miscommunication. It requires the complainant and the officer to be interested and most of the time we have complainant and the officer interested and we have Many Community trained mediators who are involved. Our agency a ranges the mediation but we are not actual mediators, we have Community Based mediators. Great, thank you. Thank you. I want to check in with the bridge line. Anyone there . No. We are going to close Public Comment. Thank you very much for being here. Thank you very much. We are going on to information item no. Nine. I would like to welcome Cecilia Oconnor executive director doer clinic. My name is Cecilia Oconnor. I work at the doer clinic. Its a psychiatric Community Based clinic for people experiencing crisis. Prior to that, i worked at San Francisco psychiatric emergency for the last 10 years. And a psych nurse. My experience with Law Enforcement with this experience, i have a lot of firsthand experience. I am one of the early members of the cit. I was quite excited and thrilled that this was going to go forward. And one of those reasons is that one of the unintended positive consequences of that entire project was that in a Health Care System that is incredibly siloed to the detriment of any client trying to seek services. An example of that and probably many of you in this room are aware of or know people who have experienced this. One individual maybe working with so many different providers, but none of those providers speak to each other. So we have this incredibly complex and extremely difficult to navigate system for most people. If you add to that, the challenges of being in crisis and having the several Mental Illness and having disabilities and being homeless and having a Substance Abuse problem and having a medical problem like hiv, its a miracle to me that people get help at all sometimes. The unintended consequences of the cit, for the first time i was able to meet many of my sort of Community Providers and individuals who work with the same clients, but we had never spoken to each other our paths had nerve crossed and it was a unique and positive experience and the beauty was for the most part in a somewhat very hyper structured system there was the Health Department, Human Services agencies but there is no care coordination for people. I bring this up because the police are at the affect of that and that was something i learned early on. When Police Officers started to come into, when i was at San Francisco general and someone brought the person to us, many times they brought the person because they were extremely concerned about them and this person wanted help. They were not coming involuntarily and this person was seeking treatment. And that seem individual appearing equally disorganized would be on their beat and on the street again. So one of the questions that is asked and what i do with the cit with Law Enforcement is try to do a very brief history of the treatment and why they are that way. And explain the patient rights and explaining this Service System we have and on the side my own cohort agencies and jennifer talks about the courts and a lot of contention relationships between Mental Health and Law Enforcement that is also the history. I think for many of the Police Officers statistically if you look at the fact that 25 of the calls that they get currently involve a behavioral Health Crisis and as many of them said they dont feel completely equipped to manage this and they are at a loss why we as behavioral providers cant provide these services to people and need their help and we call them for help and tell them how to offer that intervention which does not go well. A lot of what we are trying to do with through the cit training with the clinic is develop these relationships. I have met some incredibly empathetic and compassionate men and women in Law Enforcement. Its always amazing to me and i think part of what we are really hoping as an outcome from the cit is more understanding of our roles, more understanding of the challenges we both face so instead of directing this at each other, we together look at what can we recommend systematically as some of the things we can all support. One example of this is within San Francisco at the moment we are experiencing an epidemic of methamphetamine abuse. It has unbelievable consequences for Law Enforcement and health care providers. Truly tempt at the moment there is no true services for people who are intoxicated at the point of psychosis for this. The emergency room manages these individuals, we see them at psychiatric emergencies and a lot of people arent Given Services and there really is no recourse. I think part of the frustration that Law Enforcement has is how would we fix this, how would we go about changing this. One of the longterm goals with crisis intervention is People Like Us who are front line providers we can unite and find a Common Ground through cit, through some kind of collected Agency Response to make policy changes, to make and address the powers that be within the city and say, this is something we are, we have the data, we have the information, we have the people we can subscribe to and we have a plan that we can manage this. Unfortunately when we are dealing, we have a Health Department and we have hsa who deal separately with housing sheltders and we have sort of in terms of behavioral health, the Substance Abuse is approximately 80 of them also have a Substance Abuse disorder. Its a significant impact. I think its much better than it was but i feel there is so much more that can be done. I thank you for having me here. If there is any questions, i like jennifer like most of us we can talk endlessly about our particular issues and the zeal with which we approach our work. I would be interested to know if you have any specific questions. Thank you, well open up to Public Comment and i believe cochair supanich has a question. Or two. Thank you for coming. The picture you paint is concerning, and i want to welcome you to work with this council and the Mayors Office on disability in anyway that we can help i would be willing to help. The complicated combination of Substance Abuse, Mental Health, physical health, homeless is almost in surmountable. I agree with you. I dont know how they get the services they need. I may have misunderstood what you were saying, but other than the cit taking people with Mental Health issues to the hospital Mental Health ward, is there any other linkage to Services Going on for people . That was my opening. I do the primary opening and address at cit because what i talk about is sort of what the array of services looks like and how it works in San Francisco. Prior to the door of the clinic opening, or police if they have to take someone for psychiatric evaluation it was by their general order to a designated receiving facility. The only designated receiving facility in San Francisco in the psychiatric emergency is really small. It should be somewhere around 2022. I was there one morning when we had 30 patients in that place. To me it was miraculous we didnt have. We were creating more trauma than we were solving truthfully. What i was aware of was we needed an alternative clinic. We are not a designated receiving facility but we can take people and we do take people from police who want help and looking for help and do not need to be involuntarily contained. We do not do any kind of involuntary restraint or medication. However this is one of the tragedies of the system. Health care is pretty good monday through friday, 95 00 p. M. In the weekends or holidays there is a minimal amount of resources. The Mental Health association has implemented a line because the truth is someone who is struggling doesnt need to go to the hospital at 3 00 a. M. They need someone to talk to. The beauty of the warm line is someone can call and just talk to. The warm line is staffed by people who have experience. You are talking to someone who can really relate to what you are experiencing. My belief is also that there is an entire range here of a service that we can provide for the community for each other that is based on that because what happens right now is that for anyone, someone you love, someone you care about and whether you have private insurance or none if for the first time in your life you are experiencing a Mental Health crisis, to try to Access Services is extremely challenging because you are forced to go to a medical emergency where im sorry there are very many people in an emergency room and a Mental Health crisis is not in their purview. And being a nurse for almost 40 years, they dont know what to do and they dont have the skills to manage it. We have separated Mental Health separate from the entire being and what we are looking at is you have to talk to somebody who knows about that. As opposed to just the basis of you can hear what the person has to say. Saint frances, ucfs, saint marys, saint lukes. That was the place in San Francisco. You went to an inpatient unit and the most expensive kind of treatment and not the most effective for many people. We are now looking at some alternatives. The best alternatives would be the prevention for crisis. The best alternatives in my world if i ran for everything because i dont know how familiar you are with this. A month ago a psychotherapist started a psych walk. She got trained volunteers and they took chairs and sat on the street, many of them sat outside here. They sat and had a sign that said i will listen to you they encouraged people to sit and talk. It was wildly successful. Not only for the people who talked, but the people who listened. To me it was a godsend because the truth is, i would having lunch with denise sandoval, that developed lava mae. She saw somebody 1 day. She was in a cab ride going through the tenderloin. The taxi driver said, welcome to the land of broken dreams. Shes a san franciscans. She came from business, not from Mental Health and she approached a woman on the street and she was crying and she said whats the problem and she said i will never be clean again. Since then shes had one of the best programs that exist in the city. I know for a fact having worked for the city and county, if it had been a county agency which crossed so many areas, wed still be talking about it. My belief, my hope is that in this community we have a grand desire to do better particularly with the homeless situation with people who are mentally ill, with all of this. What would support Law Enforcement would be if they had more recourse. If there was in every community in the city, a place during the day where someone can walk in and sit down and without filling out a mountain of paperwork and just talk to someone. It would have an enormous benefit. It would be cheap, it could be well managed and incredibly effective. That kind of solution, i feel like on the side of where i come from which is the over here with we have to bill medical and we are becoming more and more convoluted with all of our it systems. An emergency room dr. At San Francisco general they have four or five different systems to put information in. How do we find information about a client . How do we track somebody if we dont have a way to follow someone who has a Mental Illness, who is hiv positive and getting methadone and also on housing list and also trying to get their benefits and all of this . How do we do that . I dont know how the clients manage it. Its a test to the resilience of the people we serve. I would be happy to explore some of these areas where perhaps we can propose to the city, why dont we do some of these things that are fairly simple, fairly straight forward, but would have a huge impact and they dont require a lot of money. I dont know, thats a very long answer to your question. But the truth is that is one of the biggest problems is that if you are new to the system and in crisis and trying to get help, your resources are very limited. If you call Suicide Prevention and if you are suicidal, they are going to call the police who then most people dont realize are going to come to your home and take you in handcuffs in the back of a police car to the hospital. Most people are appalled and horrified by this, many are. That is the system and unfortunately we dont have an alternative to that. Thank you. The situation just seems to get more and more complicated the more i listen to you. I just wanted to tell a short story talking about people who just want to be heard. I worked for an organization that has an open house once a week for drug users. My job was to go around with an ur sac survey that i did but what i did i asked them questions and then listened to their stories. And everybody wants to be listened to. Dpa organized during those years trying to eliminate those silos and trying to integrate more efficiently, has that helped . Im a contractor for cds so i have to be tactful. I can only speak for myself and say that i feel that within dph, there is for the most part i think we are still struggling with this siloed system. The reorganization and some of it, there was a plan to have more of a Transitions Program where we had one individual managing or helping Care Management for somebody who had multiple issues and i dont know where it is or why it got stalled. I can only speculate. What i would say is im not sure what the answer is, but i do know thats why i love the cit because nobody ran it. It wasnt run by hsa, by the Police Department, it wasnt run by anybody. We were all in it together. There was no entity like that in the city. Thats the beauty of cit. I wish there was more. What we need is a container a framework where people like myself, like jenny, the Mental Health association, like michael who is gone now, if we can all get together and say before the city makes anymore policy decisions about where this money is going to go, lets look at this and have this input. Because sometimes we dont share too well together. We dont work too well together. Its an over stressed system and the problem is that often people are working in their own wheel and lose track. Services wide, there is a lot we can do but more we can do to make it easier. Thank you. Tactful honesty. Thank you. Council member at that time kostanian has a question. Thank you, we were facing issues not only from people Offering Services but the community. They were totally floored that there was