Engagement and immigrant affairs and sf government tv. Thank you, agnes. Then we also do have overflow seating in the chamber. Is that where we are doing it . It is being arranged presently. Folks can watch from there. Mr. Clerk, do you have any announcements. Please silence cell phones. Your completed speaker calls should be submitted to the clerk. Supervisor mandelman please call the first item. Clerk clerFood Insecurity ag lowincome pregnant people in San Francisco. Supervisor stefani thank you everybody for coming out this morning. I called this hearing because Food Insecurity in San Francisco particularly among lowincome pregnant women and families is a growing problem. Access to food should be a basic human right because it is a fundamental human need. It is limited or uncertain access t to add what food adequate food. People who are hungry or starving is something that affects every neighborhood in every community in this city. Economic insecurity is the primary cause for Food Insecurity. Almost 30,000 of the San Francisco children live in house hole holds below the poverty line. 12,000 of those children live in households earning less than 22,000 for a family of three. We know what it costs to live in San Francisco. We know that there are many thousands more than just those below the federal poverty line facing Food Insecurity. There is a host of government and communitybased programs including wic, calfresh, National School lunch program, school breakfast, Summer Lunch Program and child and adult care food programs. Despite these programs Food Insecurity remains high and continues to rise. In a survey on families on wic, more than half were Food Insecurity, more than half. The consequences can be dire and the stories are heart breaking. I know the story of one pregnant mother who only had enough money for one hamburger which she split between her two other children so she wasnt able to eat herself. Children need adequate nutrition for health, wellbeing and proper brain development. Pregnant women facing Food Insecurity are at extremely high risk for preterm birth. The cost of not being able to eat today can have permanent negative health consequences. In 2013 this board of supervisors passed the resolution recognizing food as a basic human right essential for human health and made a commitment to end hunger in San Francisco by 2020. That is next year. As we will hear today we will not meet that goal. Too often Food Insecurity is treated as a secondary issue. The purpose of this hearing is to bring clarity and focus to Food Insecurity and prioritize it in the same way we prioritize housing, homelessness and public safety. I want to thank martha ryan for bringing attention to this issue. I want to thank the public commenters who we hear from. It takes time, resources and courage to come and share your stories. Understanding your experiences is crucial to understanding this issue. I look forward to hearing for the departments here today and working with my colleagues and the community to get San Francisco back on track to ending hunger. I believe unless we have comments from my colleagues. I know that paula jones will be presenting from the department of public health. Supervisor mandelman before i call on supervisor walton the overflow room is ready, that is the Board Chamber. We cant have people standing in this room i will ask the folks standing go to the Board Chamber and watch and come back if you are speaking during public comment. The deputy can walk folks over there. Thanks everybody. Supervisor walton. Commissioner walton i know many of you know in district 10 there are several communities that dont have access to Quality Grocery Stores or nutritious food. I want to make sure we know and understand with Financial Support and Additional Resources some of our families have to travel miles to get to nutritious foods to get foods healthy for them and their families. I want to thank supervisor stephanie for highlighting the effects on expecting mothers and those impacts as we fight for Food Insecurity. I am looking forward to hearing from everyone hear. Good morning. I am paula jones with the department of public health. What i am about to present is really the voices of many different departments and organizations and many different people. I am here to share with you a summary of what is happening in our city. The number of people in San Francisco who are food insecure is going up. I want to stop for a second to thank you chairman delman and supervisor stephanie and supervisor walton. The number is going up. There is concentrated need among the pregnant people and also their children. We need to address this by focusing on the early life course. It is going to yield a lifetime of benefits. The most important thing to do is close and sustain the gaps for the most vulnerable and be sure we are prioritizing this population. Food insecurity and Food Security is essential to achieving all of the city goals for families. We have the ability to solve the problem. I am going to integrate voices of mothers who spoke during a citywide and yearlong initiative hosted by the Homeless Prenatal Program with Family Support services. Listen to the voices and be led by the people who live the experience of Food Insecurity daily. Supervisor stephanie provided a great definition and background. It means you always have enough food. Food insecurity means you have a lack of money and resources and affordable food in the neighborhood. It is challenging to eat healthy. Healthy food is expensive. Not having enough food impacts the entire household, not just one member. Being food insecure is because of not having money and the resources close to you. One food program is not enough to solve the problem. This impacts all sectors of society, especially health and education. It is severe in early life and they are lifelong impacts. Food and nutrition is critical to support a healthy pregnancy and developing baby. The first thousand days after conception are the most important time for brain development. It is between conception and two years old that 80 of the brain is developed. Future health risks, also, can be programmed during this early time of nutrition including obesity, hypertension and diabetes. Calories are not enough. Key nutrients needed to support nurral development are missing from lowincome pregnant womens diet. Cheap food is low in nutrients. Not having enough food at this time may lead to lifelong deficits in the brain. As supervisor stephanie said, Food Insecurity during pregnancy increases risk for diabetes. The impact so parents is very depressing, increasing anxiety and many mothers talk about the shame this they feel. It is time consuming to prepare food. As most of us not food insecure, we can eat out, do takeout, get delivery. These are all very expensive. For someone who doesnt have the money, they cant afford this. For children not centering enough food is connected to and anemia, poor academic achievement, increased hospitalization and more dental carries which negatively impacts attendance. Addressing this is integrated to achieving all goals for children and families. In 2013, the Food Security task ford, the board of supervisors task force issued a report and in response the board passed the aggressive charge and goal of achieving Food Security by 2020. We have made progress through increased investments in food programs and people with disabilities. We expanded existing local innovation. However, what we didnt anticipate was the dramatic increase in the cost of living and income inequality. It is now harder to afford basic needs. Last year the task force completed a report summarizing what we know about Food Security in San Francisco, data from programs and surveys where people were asked and larger sample sizes so we know using the questions to align with the u. S. Da Food Security module. Here is a summary of our recommendations. I have been monitoring San Franciscos food program data for over 15 years. What i saw in 2018, especially data points relating to children, were extremely concerning to me. The data for pregnant san franciscans was alarming. The food Program Infrastructure including for food preparation, warehouses, store rage is at storage is at capacity. We rely on them to deliver the programs. They are all at capacity. For our population level measures. What we know about Food Security across the city, we rely on data from the California Health interview survey. This is conducted by ucla through phone interviews and respondenneds answer respondents answer Food Security questions. This only ask to those below 200 of poverty for a Single Person that is a little less than 25,000 a year. For a family of four less than 52,000 a year. I want to acknowledge we know People Living in San Francisco above this level of poverty are struggling to meet basic needs. This graph shows more and more struggle to afford food. The number has almost doubled since 2005 because of population growth. Our Food Insecurity rates are above state average. Economic particularly affects our africanamerican community. They make up 5 of the population. 54 have incomes below 200 of poverty. These disparities must be addressed. They are very much concentrated in africanamerican communities. The next three slides show where there is concentration of low income families. This shows geographically by zip code where those with a live birth and received care through public insurance over the past five years live. Getting healthcare through public insurance requires having a low income. For someone pregnant 213 of poverty. The largest number is 94112 which mirrors other service trends. Next is 92124. Then 94110. In 2018 there were 2100 live births in San Francisco to people on public insurance. I have a problem with buses. The bus drivers wont let mothers go in with big strollers. That makes it difficult to take food like that. Now, this next slide is showing where the children who are enrolled in medical live and how many. Eligibility is about 266 of poverty. For a single parent less than 45,000 per year. With one child and family of four is 68,000. It shows where the children are in greatest needs. Dark is higher numbers of children. The importance of the next slide is the same kind of map showing children and young people under 18 years. The total number of that as of july 2019 was 4640. Now, important things that we learnelearned from the program t 50 of lowincome pregnant and 60s of the families are Food Insecurity. In a survey over 1,000 city college students. Food insecurity was very hi, 41 . With students with children it was higher at 53 or one in two. In a Different Survey on School Readiness 20 of those in kindergarten come to school hungry. We know when school is out there are fewery sources available to families over weekends and holidays. We learned the free dining rooms are seeing more and more families coming for free meals. Some have special areas in the dining room for families. I want to tell about the after School Supper program. This is a program that runs by sponsors located in after school programs. Now this program was sponsored by we have several, one was communitybased organization that provided after School Suppers to children in the southeast sector. One day they closed operations with no notice, leaving 1,000 children and families without this important resource. Because of Program Rules and because there were not very many sponsors, not enough to pick up that slack, no other organization could pick up those sites. Calfresh are the first line of defense against Food Insecurity and hunger. As supervisor stephanie read there are many programs. You have a summary and all of the rules from the Congressional Research service. Programs are supplemental. One program is not enough to assure a household food needs are met. There are Many Community and faithbased organizations with limited funds and distributing free groceries through a large food pantry operated by the Marin Food Bank including healthy childrens pantries in schools and daycare. They are governed by federal policy framework. It determines who is eligible, how much benefits are given, where food can be purchased where sites can be sited what is done with leftovers. Examining part of like one of the questions that i was asked to prepare for is the root causes and structural obstacles. The quote from the mother at the top. I am not financially stable. First comes the rent and the bills come and whatever money is left is for food. This is around affording basic needs and more residents are struggling. Now, the federal programs. This framework leaves many in San Francisco without food. There is a low power of benefits, the benefits equals 1. 40 per meal. This is a national problem. The urban institute found that across the country, the benefits were not adequate to meet the low income food needs for a meal in all of the counties, in 99 of the counties in the country including the district of columbia. Food costs in San Francisco are 30 higher than the national average. Funding isin adequate to run these programs. They are more than the federal reimbursement pays. It requires local funds to operate the programs. There is an impact we have put in many policy initiatives like increasing the minimum wage which is really important, and the impact of that, the School District the executive director of student nutrition services, jennifer, sent me analysis. When the minimum wage increase. In 2014, 62 of the kids qualify for free and reduced meals. The more you qualify for free you get more money from the federal government to pay someone who is qualifiered. In 2017 it dropped to 52 . They are feeding all of the kids but getting less reimbursement to do so. Eligibility restrictions. The quote tells the story best. It is stressful if you make too much you are not qualified but you need the help. You can be 20 over the limit and you wont qualify. We have new threats. As we all know with the new immigration rules around public charge, calfresh and snap, the National Name for the program, has been included what is considered a public charge. We have a new proposed rule that would eliminate this eligibility which streamlines the process. If you are qualified for one program you are automatically qualified for another. There is a proposed rule that would eliminate that. I want to just say again at the bottom just our food safety infrastructure is at capacity. Now, there are some promising practices that we can look to as we start to think about how we are going to recommit and address this issue. We can build on federal programs. I have examples for some of these. Colocating programs with the same population, make it easier for people, expanding the services, increase the reach and purchasing power. One example is when people use food stamp card at farmers markets they get a certain amount matched in dollars, some state and some local dollars. Some of the strategic local solutions. My favorite word at this point is and, meaning it is a good idea and we need to do that. We somewhere programs that are really sort of a universal approach to feeding everyone. It reduces barriers. At the School District they implemented Community Eligibility to feed everybody in 50 to 60 schools that is a universal approach. Another one is the food bank network. Everyone in need can come there. It is also important to target our efforts to address disparities, to have targeted programs for residents who need more. That is the more costly option. That is also part of the solution. Another recommendation is to adopt standard measurement for Food Security. We have much better information on specific populations. Our department of aging and Adult Services have all adopted this standard measurement. We need to really just monitor our systemwide use at programs and services and build on what we are doing and support Infrastructure Investments to expand food programs. I want to really leave with this is a slide of the voices of the mothers who participated in the focus groups with Homeless Prenatal Programs. We asked what actions can we take to improve your food needs . This is what they told us. I want to acknowledge all of the mothers who participated and the different organizations and staff that provided input to this. Thank you. [applause. ] thank you, paula. That was extremely informative. I have a few followup questions. It seems like it is an under studied issue. I am wonder what makes it more difficult to understand really the true scope of Food Insecurity in the city and then what data or information should we be gathering regularly to have a more complete picture and a continued focus on it . Thank you. This is something that the task force we have been monitoring. It takes a lot of work. It is something we need to do more often and we need a city wide look more often. It is important to know how many people are in need and where the need is concentrated and what helps. Those are the key points we want to know. We need to ask the residents the standard Food Security questions. We need to be asking the same questions. There is the hunger vital signs, a line to this national Food Security household survey. We could use that. There are also longer once ones ones if we want to know more. We need to monitor the system. We need to monitor the programs and services to understand from a system perspective what needs attention. We need early like a Monitoring System to give us an Early Warning sign so we dont have like one cb o drops off. They were located in san mateo county. We would have a better understanding of Early Warning signs this might happen. I think we can build on what is already happening. We can build on what the task force is doing and the food bank missing meal study. There is a streamlined and very regular monitoring with individual level and system wide level. Thank you for that. On food deserts which was mentioned in the opening marks. That plays a role to make it more difficult to get access to food or continues to keep them food insecure. Are there programs in place to support to encourage food providers to move to food deserts. I think our office of economic and Work Force Development has worked very hard to attract retailers in many districts especially the tenderloin and district 10, and that is really hard. There is a consolidation in retail food and they make decisions based on bottom line. Definitely we need Grocery Stores and fullservice ones in all neighborhoods. We also need and we have a Healthy Retail program with our corner stores. We need to look at how do we get more Grocery Stores in the areas that need it. When you said food providers we have an incredible network of communitybased partners. They are already hosting a wee weekly pant tree. We need to see what to support them to expand what they are doing. Many of them are using their own staff time to host the pantry. It is not even funded. How can we support them more to expand what they are doing, to really support the staff to do what they are doing, and think about having specialists in the communitybased organizations that know how to navigate their clients to food resources. Another thing you said that stood out to me is the transportation issue in terms of mothers try to get strollers on community and getting around. I know what that is like with two kids myself, no longer in strollers, but i have been there. It seems like to me one possible solution to improve food delivery options where transportation is unavailable is something to look at. There are so many programs that do that now. Door dash and uber eats and private companies. Are there any public or private food delivery programs to help address this specific need . This is an area that you have honed in on. It is extremely important. We do have some, you know, communitybased programs that deliver prepared meals through our home delevery home program for seniors. We have that program to build on. I have, you know, seen in the washington, d. C. There is a partner with uber to give rides to people to guilty groceries. Philadelphia is working with lift to do that. We have a lot of options and we need to be testing these options. There is a pilot at the National Level with snap to pilot grocery delivery and online ordering. We need to see how that is working and when it is not available because the pilot participants are services San Francisco. We need to see what the lessons are from that. Supervisor stefani i have more questions. I know the federal government has taken a number of actions, unfortunately, that could exacerbate Food Insecurity. Can you talk about those changes and specifically what you were touching about on the end. Food insecurity among the immigrant populations. I wonder how their participation is chilled because of the federal government. The climate is very chilled. People are scared. What i would like to do is ask my colleague, susie smith from Human Services agency to speak to that. I am Deputy Director for policy and planning at Human Services agency. We have been tracking participation among immigrants in the Calfresh Program and cal works programs since the election and precampaign of President Trump giving all of the antiimmigrant rhetoric and hostility at that point. What we have seen among calfresh is a decline in cases that had of hav have a noncitizen. Since november of 2018 we have seen a 23 decline on the households with a noncitizen. We are hearing people are scared to go to the food bank, scared to go to normal based supports that would be a refuge in people for times like this. We have been very involved in supporting litigation against the public charge rule which is one of the biggest rules to chilling that we have seen in decades. Commissioner walton thank thank you for the presentation. I want to touch on what you were talking about in terms of the federal government. When we look at slide 13 promising practices. I received an email from the San FranciscoMarin Food Bank that says the Trump Administration is making an attack on eligibility for the snap program which is going to take away Food Assistance from over 3 million people. Reiterating the importance how we show up for advocate for federal programs, the continued fight against this tyranny at the federal government, attack on our communities that rely on support so they can get over the hump and particularly families in low income communities. We are going to take some action at the board of supervisors to let the Trump Administration know this is not something we support, but we need our community to show up and talk to our leadership at the federal level. From is a program that does deliver to our seniors across San Francisco. They deliver thousands of meals each day. We need to do more of that to figure outweighs to increase the programs that meals on wheelings can provide. This is timely to have this conversation right now. Thank you. Public comment. If there are members of the public who would like to speak on this item, we ask that you line up over on your right side of the room, my left side of the room. Speakers have two minutes. Please state your first and last name clearly and directly to the microphone. If you have written statements leave a copy for the official file. No applause or booing. Speakers are encouraged to avoid repetition of previous statements. First speaker. I want to say thank you for having me here. Good morning, you gentle people. I work as a volunteer with students that i serve and the students are 18 to 22 years of age. I have been working with the omi program for over 7 years. I really and truly love working in the program. My profession is a job coach for students that are 18 to 22 years of age, and i teach them life skill classes. We go all over the city, and their favorite place to be is the food bank. I want to thank my generous staff of people that i work with. They are my leaders, and i dont mind coming in on tuesday. Would you please stand up, you great, wol wonderful people. [applause. ] and my top supervisor over there on the corner, please stand up. [applause. ] i also want to tell you that i give great reverence to my leaders. It is honor and it is fun to work at omi. Omi has a big hat. They do not only food, they do food for thought as well. We are here focusing on food. I can say that omi has been a big effort in presenting food to a number of clients, and this started in. Thank you. We have to allow each speaker with the same amount of time. Your time is concluded. Thank you for letting me speak. You can drop information off at our offices, too. Thank you. Next speaker. [speaking foreign language. ] hello everyone. I represent district 11, and what i want to highlight is the food quality and the food quantity programs. I used to be a tour guide, and before i retired, i thought that the benefit from our u. S. Government was very good. The people can get their food that they want and get anything just because the program that the government provided, but the thing is that after i retired, every month probably i only can get 195 and my rent i have to pay 800. For my cash flow i have 100 to use every month. I found out when my Community Organizer helped me to apply for calfresh, and when i get the food i want but the food almost expired. It is really bad food i cannot eat. For example i give potatoes. When i bring them up to home it almost, you know, it is really i have to throw it away. I really feel grateful we can have that kind of cb o to help us. I am single but i think the food is not enough for us. We think for the household with children the food is not good enough for them. I am hoping you can increase the quality of the food and the quantity of the food as well. Thank you. Next speaker. Hello, i am sabrina hall, district 10 resident born and raised in San Francisco. High rates of growth and property has played a role in the eco system called San Francisco. I have never been impacted by the food insecurities until i moved back to San Francisco in 2017. When me and my four children were in Hamilton Family shelter. My son is allergic due to the toxic waste in district 10. How am i going to feed my son. There is not a lot of healthy food options, there is st. Anthonys and glide memorial. Now that i am housed, i worked so much that i didnt notice my 16yearold daughter brought pregnant and has a baby. Homeless prenatal has a lot of healthy food options. Now that i dont have a vehicle when it is time for food give aways when i have my cart i am not allowed on the bus because i have so much food or i have my cart or grandsons stroller. Many times i have a peskaterian. They dont sell the foods most grocery foods have. There is a Fried Chicken shack on every corner. My daughter does offcampus because they dont have enough food at school. I am too scared to complain that i did not have enough food i might get a cps case like many parents who did complain suggest. Thank you. We will share with the honored members of the public please respect the boards rule against applause during the hearing. It will show us down. If you want to support a speaker you can do so by racing your y raising your hands. Next speaker. I am Angela Jefferson representing homeless prenatal. I am a single mother with three children. Food is expensive. I dont receive food stamps. I have to watch how i spend my money. There are a lot of Liquor Stores as opposed to not a lot of healthy food. My younger child is on a diet. My daughter has gained weight with the fatty food. The food in district 10 is expensive. There are sales for cheaper food with sugar and salt. I am asking for you to make it reasonable if there are less Liquor Stores children wont be as hyper, overweight, insecure of their weight and just have things more healthier for our children. It is hard on a limited income to budget your money to buy your food. It is not a problem to buy healthy food but it is a problem when you dont make as much money. I am asking they make it more reasonable. I dont receive food stamps. We dont have dietitians. You have to be wealthy to have that. I have to look up to feed my daughter healthy. I fed her unhealthy food. I am asking for help to get more affordable foods and not so many Fried Chicken places around. Thank you. Next speaker. Good morning, thank you for listening. I am christy. I work at Homeless Prenatal Program. I am a facilitator for prenatal care. I really worry about all of the clients. You know when i do my prenatal appointments they complain about not enough food. The shelter does not provide enough food. I am worried. They feel depression or they dont have transportation. They say please help us, find a solution because we love to have a meal. Women with babies feel like, you know, sad. They have feeling. They dont want to do anything at home because they dont have money. Some clients can only pay the rent and the bills. Food is lasting. Moms is really say please speak for us because they are at home right now and when i go to the hospitalization they provide it but the family is big. I am always looks to say we have snacks. I provide snacks to the hospital and when i have my home visit, too, clients really need. When i have postpartum, some clients are high risk all because of food. Thank you so much for listening. I will translate for the next client from the Homeless Prenatal Program. Next speaker. Good morning. I live in the city. Now, i live in the shelter sometimes because i dont have money for my baby. Thank you. Thank you. Next speaker. [speaking a foreign language. Good morning, my name is maria. I also am from the Homeless Prenatal Program. Hpp helped me with my pregnancy and also after pregnancy. I receive a food bag every week, but also, you know, i am low income and it is very helpful for her to increase the food bag to three times a week. Right now she really is scared she doesnt qualify for more service because of the president and it is advocate for hpp to include and feel happy because i receive a lot of benefit for Homeless Prenatal Program. Thank you. Supervisor mandelman thank you. Next speaker. [speaking foreign language]. Good morning. I am a client from hpp. Hpp helped her during the pregnancy and right now. Before she was homeless, now hpp helped her to live in a shelter and also she is here because she wants to advocate for food. Hpp is providing a food bag. She wants it two or three times for a week. She is concerned because they want to say to her, they feel frustrated because they dont have too much food for her family. They say thank you. Supervisor mandelman thank you. Next speaker. [speaking foreign language] she is a client from hpp. Hpp helped her during her pregnancy. She has two kids. Before that she didnt know the resources that they can apply for food. Hpp helped her apply for food. Right now she is concerned because the new president they are going to take it away from her kids. She is with immigration and feels like it is care. Right now she thanks homeless prenatal. She has food for the kids and it is important to have healthy food for her family. Thank you. Supervisor mandelman thank you. Next speaker. [speaking foreign language] her name is maria campos. She is a client from hpp with three kids. She appreciates hpp because it helps her with her problems like she had in the past. The economy right now, she has three kids. Before she was applying for each week. Now she applies no more. She is worried about this president , and the other concern she has the is transportation. The drivers say no, i cant give you space because the stroller is too big. This food is not left at your home. That is why she feels desperate and needs to go to hpp but it takes a lot of time to get there. Supervisor mandelman thank you. Next speaker. Good morning. My name is elsa. I am one of the hpp clients. I am here to advocate. I am a little nervous. They helped me through both ofpregnancies. When it comes to food, it is difficult to, you know, to survive in the city with my husband is the only one that works. I take care of my kids. We cannot apply