Would like to thank Lawrence Brian for starting this meeting. Please make sure to silence all cell phones, complete speaker cards and documents to be included should be submitted to the clerk. And before we get started, can we have a motion to excuse supervisor walton . So moved. Without objection . Thank you. Without objection that motion passes. There clerk, please read item number one. Item number one is a hearing to considered the proposed ordinance by four more supervisors to the march 3, 2020 election to establish Mental Health sf to provide Mental Health services and psychiatric medication to all adult residents of San Francisco with Mental Illness and or Substance Abuse disorders, homeless, you uninsured or healthy sf. Thank you so much. I could not be more excited to be where we are here today. We just came from an incredible rally with over 600 people, healthcare workers, frontline social workers, conservatives and family members, psychiatrists, psychologists and, you know, everyone who has been dedicating their lives to addressing Mental Illness and Substance Use in our city and country. I could not be more excited that today is the day that we are finally moving forward, a major step to get our march 2020 ballot measure Mental Health sf to the people. Supervisor hainey and i, together with the cosponsorship with supervisor marr have worked with the true experts of the field. You could hold down signs at your chest level and you will be removed from the chambers if you hold them up and really i would love to see all of you stay because this is a very important, important discussion. Thank you so much. Supervisor hainey and worked with the true experts in the field to draft this legislation and were very, very proud of the outcome that is before us today. Mental health sf is a universal let me repeat, a universal access to Mental Health care for everyone suffering from Mental Health care and Substance Use disorders. Specifically, this means the city will be providing that care to everyone who is homeless, who is uninsured, unhealthy San Francisco or enrolled in medicale or who has a severe Mental Illness. Anyone who is leaving jail and hasnt been able to reapply for m emedicale. Its for all of San Francisco and if you are insured and have private Health Insurance and cannot access care, which we know happens every single day, Mental Health health sf is creating a new office of private accredittability and well will have advocates there, ready and willing to fight with you alongside you, with your Insurance Company for the care that you deserve and need. Anyone can walk in the centre theres crisis stabilizationandg centre and transportation to and from programmes, includes county jail and Hospital Psychiatric Emergency Services unit. Finally you wont be treated in a silo and go to every provider because you will have a case manager to coordinate that care and will give you a treatment plan and have you navigate up and down that treatment plan based on what youre experiencing today. If you are dealing with a lower moderate Mental Health, you can have a regular Case Management to help you when you need that help to get appointments. If you have homeless and have a lot of other barriers making it difficult for you to access services, youll get an intensive case manager. If you are on the street and you are not ready to trust people yet because you havent been given that reason to trust people into the system, we will have critical case managers that will come out and work with you and get to know you and build that trust with you. When you see people in psychosis and talking to themselves, you dont have to call the police anymore if thats scarry to you. You will have a ful number to cl of Mental Health professionals, to make sure that people are safe. That team is available 24 hours a day, seven days a week and Mental Health sf will meet a huge expansion of services. Right now we know that people are getting stuck in a level of care that they know if theyre able to get into care at all in the first place, they often get stuck at a hire level of care where they dont need to be. We know of people who have spent nine months in jail, waiting for a bed in the system and no longer, that is unacceptable and it is not going to happen in this city. We will help anyone who needs the care get the need. We are finally in in country realizing the diseases of the mind are as important as diseases of the body. When you are diagnosed with cancer or with a tumour, they dont tell you to wait two months and well see you when we can get you if is we may or may not have services to provide you and you can lanquish on the street in the meantime. Well, why are we telling that to people who have an illness of the mind . That makes no sense. And we finally have Mental Health parody in maine and guess what . In sanfrancisco, well have it in practise and in reality, as well. Thats what Mental Health sf is all about. Thank you. If you can instead of clapping do the spirit fingers, that would be much appreciated. We spent months and months and hundreds of drafts and what you have today is a labor of love and came from the minds of experts and Substance Abuse and workers. This has been with a lack of a functioning system and not with the workers itself and we want to make that incredibly clear beforclear. We are in discussione Mayors Office right now and the Mayors Office has not been opened topento a universal systl health care and they have wanted to focus on the 4,000 individuals in the street. I understand where theyre coming from but we want to go bigger and we are in those discusses right now and theyre going well and im very, very hopeful that we can come to you shortly and say, you know what . We dont need a ballot measure. We can implement it right now which would be amazing but we dont have that deal today but rest assured that matt and i together with the Mental Health sf committee, many in the room and ill talk to you about them in a second, we are doing that hard work of defate, discussion and compromise. But where we will not compromise, we need a universal program and thats where, if we cant reap acant reach an agrel go to the ballot. I appreciate the gph and Mayors Office have been engaging in the serious discussions. So with that, before i turn it over to matt and to to supervisor hainey and supervisor marr, i have to give a few extra special thank yous, start wiging with our staff. Our staff have been living and breathing Mental Health sf for a long time. A shoutout to catalinas morales who started us off and studying to become a social worker herself. So maybe shell be one of the social workers in sfgov. Carolyn gusen, i love her and cant thank her. Im sure matt will do this, abigail ribimontimesa, you are a brilliant ray of sunshine and were so lucky to have you in this battle with us. I need to thank particularly the people who have spent countless, countless hours serve on our Leadership Committee for Mental Health sf. There are individuals from ill say the organizations, sciu101, ifpte did i say 21 . And National Union of healthcare workers, nhw, as well am i missing anyone . I think thats theunions. The Assembly Member sil tin didnt has been with us from the beginning and the amazing mark chucklebang. And Labor Council represented by kim tavaloni, sciu101 by katelyn prendavel, jason kloom, local 21 represented by deborah grabel, Julia Harding and i think thats it and nuhw by paul kumar and ryan beaston, 2015 by lerma and Julia Harding. And then zach golden, sarah short from the demand coalition who was just, i think detained by hopefully will be joining us soon didnt then finally weve received amazing support this entire time by the incredible liam mcglofland and jackie kragr. Thank you for your incredible nonstop work on this measure and then finally, there was a little conflict before we came in here. Theres a lot of excitement and emotion but i will tell you the Deputy Sheriffs Association has been supportive of Mental Health sf. So lets just know that they have been supporting us from the getgo on this initiative, because they know what it means when Mental Illness goes un treated. So thank you to them and thank you to huey sf, 2121 and i said that the San FranciscoLabor Council, the consumers and the families, most recently Zach Williams who made a beautiful video and tribute to his father, robin williams, who battled and struggled with Mental Illness in his lifetime and has been a huge supporter of Mental Health sf. Weve had so much incredible imput from all of our communitybased organizations from the getgo, Community Housing partnerships, tenderloin development, coalition on homelessness, senior and disability action, Mental Health association of San Francisco, taxpayers for public safety, st. Anthonys glide, the support of Housing Providers network, Human Services network, Progress Foundation, the National Alliance of Mental Illness, the direct policy alliance and so many more. The reason weve had 100 drafts of this measure is because every time we shared it with the experts, they had new, excellent feedback for us and so we kept making it better and better until we got to the product you see today. So with that, i wanted to thank you all so much for this labor of love, this Community Labor of love that weve all created in Mental Health sf and whether we pass it here at the board of supervisors or at the ballot in march of 2020, were going to make damn sure this law is enacted because its time for change and time for solutions. Supervisor hainey. Thank you. Thank you. This would not have happened the way youve gone to the community and engaged them with respect and humility and its an honour to be a part of this process is a part of your staff in my first nine months of office. For everyone that works in our city, the tenders loin, this is an issue of human rights and people in our city who are in need, who are suffering and sometimes quietly. This is a huge step to make sure that people have care to access and treatment and that we actuallyize Mental Health as a human right and create a model that should be replicated across our country. San francisco has the capacity to do that. Before i go into a couple of things, i do want to make one thing clear that i think is important. This is the peoples house here in city hall and we want you all here. You all this place belongs to you and it is important that you feel safe and that this place is accessible to you. So i think were some things that happened out in the hallway in terms of people were treated that i found unacceptable and folks not in this room with us right now, you have our commitment to have their back because its important that all of you feel safe here and feel that this is your home and can be heard here. And in many ways, thats what this for us is about. Its hearing the people, what theyre experiencing and what their needs are, the patients, families and then making that real policy. So its important that you can find a path to do that, not just with us directly but here at city hal hall. For those fighting to be make substance treatment right, this has been a long journey and i want to recognise all of the people fighting for decades and decades, whether you work in a hospital and trying to fight to make sure theres adequate staffing and youre getting support for a patient on an individual level, whether youre part of the Mental Health association or the treatment ondemand coalition is working and showing up to these hearings for funding, this is not a new issue and Mental Health sf didnt come out of the sky. It was built on all of the fights and the struggles to get us to this point where we have said this is the model we want to see made a reality. And if we will have treatment on demand, how do we actualize that and build a system. Were done with the incrementalism, bureaucrats at the top telling us the need is met. Its not true and real you and you all have been saying that again and again and again and now its time that city hall recognises that and makes changes that reflects that, because we dont want to be here in five years having the same conversation about everything is fine and were taking these little steps. Were long passed that. So the Crisis Response team will respond to how crisis in the street. Far too arc too often i see thee used far too often and that can make things a lot worse. Instead, we need people who are trained to respond in never ways and in ways that we not only stabilize the situation but enter people into a system of care. It just cycles right back. Theres no responsibility for that person and their needs in an ongoing way and thats the commitment we want to make with Mental Health sf. The Office Insurance accountability, this is very important because no one in our city, whatever your insurance situation is should feel alone without someone they can go to fight for them and to make sure they get access to treatment and i want to shout out to the folks from kaisr and uhw fighting for Mental Health within the system at kaiser and many of us have kaiser and weve heard people going months without treatment. They need to get their appropriate care and when they fail, it hurts all of us and ultimately, they will in many cases become the citys responsibility. So we have a direct interest to fight for all residents. And integrating that is a huge fall mental sf will fix. This is separated from the system of housing and so we end up in this sort of round about where you say, well, why didnt the treatment work . Because they were released to the street. Or somebody goes into a Navigation Center or shelter and can you get this person access to care and thats not us, thats dph, thats not what we do. So the result is, of course, that peoples care is not treated with the urgency and the impressive approach thacomprehet desires. This will require us to Work Together to hold the system accountable to make this a reality. I do want to thank our staff one more time, your staff, carlina and carolyn for their extraordinary work. We have been spending, i think. Im thankful for the work of everyone on our committee, supervisor marr and so many others and i think were close to getting this done. Theres a few more steps to take, but ultimately, once it passes, well also have the responsibility to make it a reality because this is one more big step on the road to making sure Mental Health sf is not just a right in name but practise and i know thats what you have fought for in your lives and continue to do. So thank you again. Thank you supervisor ronan for your leadership and im excited to move this forward but im more excited when we start to see the impact it will have in our neighborhoods and residents and communities. Thank you. Supervisor marr . Thank you, chair ronan. I wanted to add my brief thank yous and thoughts before we hear Public Comment and so i just wanted to start by thanking supervisor ronan and hainey and staff for all of your incredible leadership in creating this proposal for universal access to Mental Health services and treatment addiction for everyone that needs it here in the city. Mental health sf is exactly the kind of bold, comprehensive solution needed to address the Behavioral Health cry vi crisisg our city, cutting across all districts, in the Mission District in the tenderloin to the sunset district. Thank you so much. I want to acknowledge all of the community organizations, the frontline nurses and clinicians and social workers and the patients and their families that have pushed us and pushed the city to really address this crisis in a more comprehensive and bolder way. I look forward to having this move forward on the ballot this march or legislatively, whatever is the best approach, and im happy to cosponsor it and support your efforts. Thank you so much and i just wanted to thank the City Attorneys Office and ann pearson who worked on the hundreds of drafts that i talked about with us. They gave us important feedback to give to us. With that, lets hear from you all. Were about to open this up for Public Comment. Please come forward feel free to line up and every speaker will have two minutes. Feel free to get us started. Im a me member of a volunter organization of psychiatrists, therapists, attorneys, family members and others on behalf the severely mentally ill. Demanding treatment before tragedy and i find it encouraging that attention is finally focused on improvement but both bills right now failed to tang int take into accounts y aspects of why our system is dysfunctional. Theres less visible severely mentally ill who live with family members and attempt to ward off disaster for their loved ones and bear the brunts of death threats, visible and physical abuse and disruption of their entire lives attempting to protect their family members. Yet, we have advised by representatives of the department of health to let our loved ones to be destitute to they qualify for services, that is evident. In the 1990s, there were over 100 beds in sanfrancisco and now there are 22. There were four psychiatrists, five primary care doctors and 30 nurses that had a 90 success rate at being able to place people in long. Term stable housing. The entire staff was laid off in the facility and repumped in 200repumped in2004 and these bi, have no mention of numbers or a timeline for how to restore acute, sub acute and pes beds and those who get hundreds of millions in tax breaks. Thank you so much, next speaker, please come forward. Im concerned about the weakest in the system, similar to the woman on the street. This woman on the street, waiting for somebody. As a resident board member, ive also been a consumer Mental Health service this is San Francisco. So, several months back, even before Mental Health sf was announced, i was working with the treatment on demand council and a small group of us met with hilary to tell her about treatment on demand, why it was so important and why she should support it. And she said, oh, you like treatment on demand . Have i got good news for you. Dont tell anyone yet. We have this idea for a universal Mental Healthcare program in San Francisco. We were thrilled to hear about it and weve been on board since. I was part of a group that hilary and others and matt consulted with for in put. Ive been a strong voice asking for more mobile outreach. I was listened to and thats been part of the program and the navigation component is a crucial park. I want to see this passed. Because i want to see this passed, id like to make the following recommendation. Im really afraid that you are going to be coming headtohead with urgent care sf and the Mayors Office. Because i want to see this passed, i hope you will consider possibly bringing it to a vote with the board of supervisors. Thank you so much for doing this, supervisors. Thank you. Thank you, next speaker. Good afternoon, i am a member of the senior disability action and i was the first promoter peace and creation. Where should i start. Maybe ill start with me. I went to the previous for confession and i said should you go to someone for counseling so i went to kaiser to try to get an appointment and i got the application and i got there. You are not psychotic. Were not going to see you. Im still waiting. Im here to support you because everyone knows its a San Francisco and hugged and kiss a leper too and we should too. I said thats everyone. So i am supporting you guys and also, not always with senior disability so there are 4,000 people on that email plan so i can tell them. I would go back and i had a social welfare background but if i would go back and be a case worker too. I know my housemate has an 18yearold son and im encouraging her to get him into the healthcare field. It branches where theres a will theres a way. Outside you have the nurses and the sheriff help that poor lady who fell down. We have a way. We have to have the will so include everyone exclude no one. Include everyone, exclude no one. Healthcare now Mental Health. San francisco. Hi, my name is veronica forbes. Ive been a social worker for nine years. I am a community Behavioral Health specialist homelessness expert and the original Program Manager of the Navigation Center. In San Francisco, my clients waited one to throw months in jail or decompensating in the streets or shelter from Mental Health and drug abuse services. When someone seeks help and is put on a wait list, theres a very narrow window of time to make a difference and when missed, it takes months to years until the theyre ready or able to seek help again. All the while, theyre spiraling downward in their ability to function yet San Francisco makes cuts to the Mental Health rehab center, Residential Care facility and acute diversion units and im here to tell you all to support Mental Health sf because living people with Mental Illness and drug addictions in the streets or criminal enforcement system is ineffective and its dangerous and its wrong. Hi, my name is wind could haveman and im Vice President of aft2121 at the city college of San Francisco. And we are grateful you have crafted this legislation and we support it and i want to talk as a mother of a child that has severe meth illness. She is doing well today. Shes 37yearsold and shes had four episodes such that she was 5150ed. She has chemical dependency issues and schizophrenia diagnosis. Today shes leading a healthy, full life with friends and a meaningful job and shes a social justice advocate for climate change. The reason is because she had the resources that she needed. She had the when she was in crisis she had them after she was in crisis and before she was in crisis. She was lucky because she had a tiger balm and the mom that had resources. When i pass young people on the streets or even not so young and in their 30s or late 30s, and i see my daughter could have been that if it werent for the resource thats she had available. Thank you for this legislation. Dont compromise. Hi, my name is victoria and i represent a compassionate day. We are activists working on animals and environmental issues. Although Mental Health is not our area of expertise, we all have members touched. It is in compassionate and dignity for all and a snub of membera number ofmembers wantedr support. Thank you so much for your work. My name is liz, ive been working with homelessness and Mental Healthcare for the past nine years. For the past five years here in San Francisco including at places like tenderloin housing clinic, Progress Foundation and saint anthonys. When i was contacted by caro lena from ronens office and she asked me to i had a experience with my friend who was in San Francisco very depressed, not bad enough to need to go to the hospital but struggling and he was staying wit staying with med shuffling around to get access to services. He worked in an acute diversion units that provide residential treatment of and connect them in care so we knew the system and i knew the system and we made every effort to get him connected to care he needed to get back on his anti depresents. Like said, he wasnt bad enough to go to the hospital but most days he was too afraid to leave the house. He was dead by my second meeting. This is the system were in. Most people do not have those resources. They do not know the system as well and they do not have people who will fight as hard. If someone like that cant get access to care under the system we have, we need oversight and we need over tight outside of the d. P. H. System in order to ensure things like this dont happen. Thank you very much for doing this. Hi, everyone, my name is Jennifer Steen and im here today to say some things that initially i said i wasnt going to say. I wasnt going to say that we need Mental Health not handcuffs. During the rally someone fell on the steps and it was nurses who rushed to her aid. When the deputies came they said dont move her, how was she supposed to get help sitting in that place. Nurses make an assessment because were trained clinicians and we were able to decide it was medically safe for her to move. We had noise outside these doors of this chamber and the deputies went too far. In the psychiatric emergency room, i have seen police and sheriffs and Highway Patrol men and bart police and any other Law Enforcement who might touch someone in the city of San Francisco come in and ask us to do our jobs, which is to serve in a crisis and help people with their Mental Healthcare. In those moments when they enter our room, they know we are the right people on the job. In the streets, in peoples homes, in the neighborhoods that we serve, our clinicians arent there. One of the tenants of Mental Health sf is to make sure that trained clinicians are responding to peoples psychiatric emergencies. Trained clinicians, not people who are trained to kill. We have to make sure that as we work with the Mayors Office that trained clinicians are sent out every single day to save people and to respond at the appropriate manner and the appropriate care. Not rough, fast, over zealous because they are never going to hurt someone by accident or on purpose. Hi. My name is cheryl shang and i work with team dc organizing. My story my story. Couple years ago, i was homeless in the street addicted to drugs. I got psychosis and i was 5150 eight times. When i was in the hospital i would plead with the doctor in the psychiatric ward to please keep me. They would let me out within 24 hours. Had there been treatment on demand it wouldnt have occurred over and over and over again. Theres people out there and they need help. They need help. They need treatment on demand. They have a right to live again. They have a right to recover theyre human beings. I am a human being. I went back to the dock or to thank him and also ask questions, why do you keep letting me out and the doctor said because there was no place to put you. There was no place to put you and when a bed did come available, i kept you because you kept coming back. You people are one of the lucky ones he told me. People shouldnt have to get Mental Health by luck. By luck. We should be treatment on demand for all. Every individual perso single p. I thank you so much. I thank all of you so much for doing this. Look at me. [applause] were not throw aways, we can thrive when we get the treatment that we need. Thank you. Good afternoon, supervisors. My name is Curtis Bradford and im cochair of the tenderloin people congress. So, im here today obviously to speak in favor of Mental Health sf. Thank you for hearing our input and incorporating that in the version that we see before us today and we have the the right solution for the crisis. I want to say that i agree with David Elliott that i think theres prefer able action options goinactions tothe ballo. If we want to go to the ballot we will fight and win. And were willing to do that. I would call on the other supervisors now and the mayor to think about that. They need to work on that and we need to pass it as legislation not only because its a better way to govern but also because the crisis on our streets demands action now. People are dying now. March 2020 is a long way off. Im calling on all the supervisors to sign onto the sf legislation now. Sign on as cosiners now. Lets pass it on the board of supervisors with unanimous consent and im heard to hair the mayor is having conversations with us. I call on her to continue that and work with the board to get the best version possible but i also want to say it needs to pass the board with enough that we can make sure it gets implemented and makes a difference and theres oversight because i dont trust the system to implement it without that so thank you for doing this and lets get it done and pass it now. Thank you. My name is cw johnson and i just want to applaud all your efforts. This is the most progressive proposal i have seen in a long time that supports meth health so let me get down to it and i speak as someone who lived with meth Health Challenges most of my life. I believe having two proposals does not make sense and the Mayors Office and the board of supervisors cannot continue to operate in the world of provision. We know people who are struggling with Mental Health challenges that are homeless and need help right now. Im support Mental Health sf because its comprehensive and it doesnt address all the needs of the people. Thank you. Good afternoon, supervisors, my name is judith and i work for the San Francisco department of publichealth for 20 years. I was the founding director of homeless connect and im a member of the Moment Health board and today im speaking as a mother of a son who three and a half years ago ended this system empty and he was beaten by eight Police Officers during his first psychotic event. Since he has been in the system he has had seven placements and he has been 5150 three times and this is the child of someone who knows this system and can help him access this system. This system is really broken and i appreciate so much that you guys are moving forward quickly on this legislation and if someone said earlier every second makes a huge difference in not only someones lives but whether they continue to trust the system. As i was waiting on mine, i received a text from my sons intensive case manager and he, for the first time in three years, formed an attachment to tell me that theyre moving him to another intensive case manager and this is what we do in this system theres a program in 2003 they did away with their Mental Health institutions and committed to keeping people in the community no matter where they are in the Mental Health spectrum. I urge you to look at this model and i thank you. We cannot wait a moment more. Thank you. [applause good afternoon, tar from the executive board of harry milk club. I want to thank the supervisors here and the people in this room that brought this proposal to the place it is right now. I think its important to reflect on the fact on how government reacts to crisis. When our countrys attacked, the government responds with full force. Will we endure an earthquake here in the city, the government responds with full force. What we learn from the aids crisis was that populations that are disenfranchised are left to the cold and it takes a ground swell of support to get the response of the government. Were also explaining the same thing here and populations that are facing to address and we have to go full force. My own father spent his 70s as a homeless alcoholic in new york city. Despite the fact he didnt want the family to help him it was frustrating to see what he was going through. A city with a resources like new york not delivering a solution. San francisco also has the resources. We have billions of dollars transacted in these this is eye crisis that we have to put full support behind and Immediate Response to. Thank you. Hi, my name is general he will holland and give been a practitionepractice tishpractit. Im representing myself as a practice nish tepractitioner an. In the 80s we had two years in a halfway house. We have maybe three months. This is a psycho social issue. The Mental Health that i see with people has to do with the race, classification or identity in the world and how theyre seen and how theyre recognized for what they suffer with. I dont believe its just a medical condition but it is very disabling and we need this sf Mental Health right now. I do want to tell a story about board and cares. I dont know if people know what theyre. Theyre part of the Mental Health system and theyre going away. They have 23 beds and theyre closing december 1st. I have a client though has to go to antioch. She was at Napa State Hospital for 15 years. She gets really psychotic and she hits people and shes isolated. Shes done really well in intensive Case Management services and the Mental Health system since she left locked. I dont know what is going to happen. Antiok is supposed tantioch ise services than here. I want to thank everybody who worked on this. Good afternoon, my name is fatty anfatima and im part of e treatment on demand coalition. The majority of the clients that i work with are incarcerated, poor and working class, black and non black people of color, with histories of systemic and interpersonal trauma and im here to share my support for Mental Health sf. Which was collectively informed by both front land workers and people and communities with lived experience. Its clear theyre relying on the current Mental Health system and Law Enforcement doesnt work. Otherwise we wont need Mental Health sf to address this crisis but we do. Continuing to rely on Law Enforcement as urgent care San Francisco suggests will only continue to escalate the crisis. However, Mental Health sf will give people like our clients the easily accessible, comprehensive curlilily appropriate. We call upon the rest of San Francisco elected leaders to trust front line workers, people with lived experience and support Mental Health sf. Thank you. Good afternoon, im ryan with the National Union of healthcare workers. On behalf of the 15,000 members of the nuhw including 4,000 Mental Health clinicians im here to express our strong support for Mental Health sf and in particular the office of private insurance accountability that supervisor haney mentioned earlier. We know that having private Health Insurance does be mean the same thing to having access to adequate Mental Healthcare and appreciate the opportunity for the city to take a role in ensuring that those folks receive the care they need and deserve. Thank you. Jennifer freedom with the coalition of homelessness. The coalition on homelessness is standing behind and standing up for members healt Mental Healthy supervisor and the mayor needs to do as well. You can just walk around San Francisco and see with your own eyes that our system is completely broken. And this fallacy that w that wea system thats working well and instead its the fault of the person who is experiencing Mental Illnesses has got to stop. I mean, lets look at what were doing to people. They dont have housing for many folks or theyre thrown out and they dont have access to care, theyre basically left on the streets have everything fall apart to them and go into crisis again and again and our response is a police response. Our response is a situation where you are either locked up and brought to pes and spit backout to the streets or you are locked up and brought into jail. You know what, from our experience, folks, when they get to that point have already been locked out of treatment when theyre trying to get care. There are more choices than being locked out or locked up in fact, theres a whole ocean in between those and this notion that we socalled let people disintegrate on the streets and its not compassionate, were not letting anyone, were