Needs assessment highlighted the importance of Case Management in the community. It clearly noticed Service Providers identified a need for increased capacity and consumers provided difficulties of the navigation. They will conduct an analysis of the citywide Case Management system to identify unnet needs and gaps in services and assess streamlining. They will work closely with dos and communitybased partners to provide the department with a comprehensive systems assessment report. This will be accomplished through a broad range of Data Collection and analysis activities. The outcome will be a systems map with key strengths and will outline targeted recommends. I request your approval to enter this contract. A motion to discuss . Moved. Second. Any comments or questions . Any comments or questions from the public. Hearing none, call the question. All in favor. Any opposed. It carries. Item b. Requesting authorization to modify the Grant Agreement with on Lok Day Services for the provision of the health provisionphysical fitness and Fall Prevention program for older adults and adults with disabilities during the period of july 1, 2019 through june 30, 2021, in the additional amount of 117,146 plus 10 contingency for a total grant not to exceed 996,460. Welcome, lauren. I am with dos. Today i will prevent on two grants. Physical fitness and Fall Prevention and selfmanagement of Chronic Health conditions. The purpose of the programs is to provide older adults and with disabilities with disease prevention and Fall Prevention. For this i will present on the physical fitness and Fall Prevention program. This began in july 2019. It is for physical fitness and Fall Prevention, always active program. It provides opportunities to participate in exercise classes that help reduce the risk of falls and injury and improve fitness and maintain independence. It focuses on cardio exercise, Strength Training and balance and unlock with organizations throughout the city to offer the classes. During the last grant term the program added additional eight classes per week. They have classes at 20 sites and host an average of 60 classes per week in multiple languages including english and spanish and mandarin. This proposed an additional staff member. At the time the funding was not available. Thence they they have added an additional fulltime staff. I am happy to answer any questions at this time. Thank you a motion to difficult. So moved. Second. Thank you. Any comments or questions . Did we have where the classes are currently offered . Maybe it wasnt important to the document, but i wondered if we have that somewhere. Unlock maintains always active. Org. They can look up the classes available throughout the city listing the site and instructor and languages for the instruct instructor. Just an observation. A few years ago, one of our meetings we had a presentation on the importance of Fall Prevention. One of the bits of information was that falls are the leading cause of death for individuals over 65. This is the type of program that can save lives. With that any comments or questions from the public . Hearing none, call the question. All in favor. Any opposed . Thank you. The motion carries. Item c. Requesting authorization to moisture the Grant Agreement with on Lok Day Services for the month vision of the Health Promotion of selfmanagement of Chronic Health conditions during july 1, 2019 flu june 30, 2021 in the amount of 130,916 plus a 10 contingency for a total grant amount not to exceed 585,777. Thank you. I will present on the other Health Promotion program which is selfmanagement of Chronic Health conditions. There are two evidencebased programs. Healthy living chronic disease selfmanagement developed by sanford and diabetes empowerment education developed by university of illinois, chicago. They are focused on education and tools to help manage Chronic Health conditions. They learn behavior change goals and coping strategies. Last fiscal year on lok provided six classes each and over three years 93 of the participants showed improvement inning and managing diabetes. Due to changes in licenses they can no longer provide support. The purpose of this is to cover the costs and support a parttime administrative staff to help maintain the quality of the program. I am happy to answer any questions at this time. May i have a motion to discuss . Second. Thank you. Any comments or questions . Any comments or questions from the public. Call the question. All in favor. Any opposed. Thank you. The motion carries. Thank you. Item d. Requesting authorization to modify the Grant Agreement with asianamericans advancing justice asian law caucus for the provision of the Legal Services for older adults during the period july 1, 2019 through junl amount of 21,231 plus 10 contingency for a total grant amount not to exceed 234,535. Welcome reanna albert. Good morning. I am reanna albert. I am an annual list with the office of community partnership. We provide Legal Assistance in immigrant rights, benefit appeals and Consumer Fraud and the specialty on this is housing. Services are based in district three near chinatown. Language capacity includes english, vietnamese, korean, hindi and farsi. They will provide funding for the planning, development and distribution of a quarterly legal newsletter funded by onetime dignity funds. This will be a continuation of the newsletter. Asian law caucus will be the lead in preparing and sendings out the newsletter to decrease administrative burdens providing for the costs. The newsletter is outreach and educational tool that they public in collaboration with other providers. Contents includes housing, health and public benefits, Consumer Rights and Fraud Prevention and more. It is produced in four languages. They are planning to add gaelic this year. I am happy to answer any questions you may have. Thank you. May i have a motion to discuss. So moved. Second. Thank you. Any comments or questions . Hearing none. Any questions from the public . Again hearing none, call the question. Those in favor. Any opposed. Thank you. The motion carries. Thank you. I seem e. Requesting authorization to modify the existing agreement with next village San Francisco for the provision of the village model during the period july 1, 2019 through june 30, 2020 in an additional amount of 100,000 plus 10 contingency for a total amount not to exceed 405,186, welcome michael. I am with the Office Community partnerships. The item before you is funding for next village, one of our two Village Programs. It is through two board of supervisors that we are seeing 50,000 on district two and 50,000 on district three. The district two funding is going to go towards some outreach and new membership drive efforts in district two. The actual on the ground will be a series of events throughout the rest of the fiscal year at two libraries in district two. The rest of the funds, a portion for district three are going towards them. Next village securing or attempting to secure the first office space. Since they were started in 2010 they operated with no office space. In many ways that was one of the cool things about the village inn the program that they could serve, utilize existing spaces, members homes, things like that for service offerings. Over the years they have seen issues with recruitment and meeting new volunteers. It is awkward to meet in cafes and restaurants. When they meet with new members they may not be comfortable in inviting staff or volunteers into the home to work with them. Then there is just sort of the every day Business Space of holding the materials and storage and a location for meeting. They are hoping to resolve those by finding a Small Office Space likely shared within another Nonprofit Organization or in a Larger Office buildingtype situation. The rest of the funding through this going through support those efforts with increased staffing as well as money for materials and funding for rent. Any questions on this item . Thank you. A motion to discuss. So moved. Thank you. Coudo i have a second . Second. Michael, what are the neighborhoods in district two . They are going to host events at the Golden Gate Library in green. The Marina Library at chestnut and webster. Thank you. Any comments or questions . I have a couple observations on this salary and benefits. It seems executive director for such a Small Program is 100,000 a year. That is like 25 of the money we gave them. Secondly, the volunteer salary is increased by 16. 72 . This is the ad back money. What happens if there is no add back money they have to scale back in i am wondering because i have seen other programs executive directors much bigger programs but the salary is not anywhere near 100,000. That is my observation. Also a question on the operating expenses. What is the Program Expense was . 7,630 . It says operating budget. These go to these are materials related to outreach events, including food or other supplies needed. They use some of that funding to purchase Disaster Kits which are very popular among the membership. Thank you. Maybe i will quickly attempt to acknowledge and address the commissioners concerns about the salaries. You know, this is, i think, something that is a challenge for us because we are in very changing Economic Times and high turnover among staff. It is something that all of our agencies are facing where salaries are not high enough, and that simpacketting the ability to deliver work. We want to encourage providers to pay their staff salaries more with an ability to maintain their life here in the bay area, providing services to our clients. I think that while we always look at we get to see the salaries in all agencies. There are very many different aspects. Each agency is unique in the services they provide and what they are paying and things like that and it is tough for us to meddle in that. We have an executive salary not out of range. It is not at the higher range, it is in the middle range of what executive directors are paid. What is unique we are talking about three individuals plus an entire volunteer base running this program, this is an an executive director that is the face of the organization out there working directly with the clients, which distinguishes it from executive director roles in other organizations. Thank you. Any other comments or questions . For some context. You said there are other next village organizations throughout San Francisco. Correct . We fund two Village Programs. One is next village in the northeast section of the city. Then we have San Francisco village, a citywide Village Program we fund. You are talking about the ones that are getting city funded. , arent there organizations that are modeled like this in vernal heights . I have heard of different villages. People in different parts of the city created these organizations. Maybe they are not funded by the city. Sure. There are a number of grassroots neighborhood based programs. That is getting the context here. I have heard of other ones that arent funded . Correct. We have done this where we have to be strict in how we define what we call a village for funding so it is not just a big blur. Meeting the definition of what we callsy village which is outlined in the scope, we have two of those organizations we fund for the city. Because of that, if someone happens to go to the library in district three because they hear about it, it is a public library. Right. Will they address that if someone lives in a different part of the city they werent meant to be part of that outreach but they go to that program, will they be informed of the other programs . Other opportunities. They can i guess they can ask about that. They are not turned away from next village necessarily because of where they live. I wouldnt think so. I know there is more interest in it, more proliferation. It is a good point to check about. Thank you. Thank you, commissioner. I wasnt on the commission when this program was first approved. I just am curious how the membership fee works. How is that collected . What happens if the person cant afford it . This Village Program is a membership based organization. We ask for an annual membership fee that we set at minimum of 120 per year. The agency can add just that as they see fit. Why we find this interesting, this is the village model is one that developed outside of dos. I think they started around 2009 or 2010. We were involved three years later. They became to our attention and became of interest to us for a couple reasons. One, an interest in the model itself. This is really a highly focused on member satisfaction. They need to keep that person engaged and responsive to the services they need. Every year they have to get them to continue to contribute to keep the organization alive. I think we are interested in that, in it being a highly consumer focused program. The other thing with this is that these are programs that typically are popular with moderate and upper income membership. That is not always a group that we have been the best at reaching with dos services. We are here to serve all older adults and adults with disabilities. We target towards the greatest economic and social need. We saw an opportunity to reach a population we are not usually getting and helping them get information about aging and agingrelated services. That information is not necessaris notnecessarily, mone. We know we are doing an excellent job of serving people with the greatest economic need. Over one in two people. We really wanted to figure out a way to reach what is known as the forgotten middle, people who often are not served in any system. We wanted to make sure we were doing that in some way. It is a great model that has a lot of social engagement and a lot of momentum by itself. One of the other things we know because we have heard this across the country. The village model is hard to sustain by itself. Having Government Partnership helps make it much more sustainable, especially in San Francisco where the costs are so high. Thank you. You answered my question. Any other comments or questions . Any comments or questions from the public. Hearing none. Call the question. In favor. Any opposed. Thank you, the motion carries. Item f. Requesting authorization to modify the existing Grant Agreement with Felton Institute for the provision of Community Services, during the period of july 1, 2019 through june 30, 2010. In an additional amount of 50,000 plus a 10 contingency for a total amount not to exceed 307,045. Welcome bakery anna albert. Good morning again, commissioners. The modification for felton will provide tuned r funding to support additional staffing for the Community Services program. The Community Services program aims to increase Socialization Opportunities for consumers, provide physical activities to bring people together for education or wellness purposes. Services are based in district 10 in the visitation valley neighborhood. Language includes english and cantonese. It provides activities to the consumers at the community center. They will be offering a three week disdisaster preparedness plan. They have got a better sense of the cost and needs of the program. With this they will be able to provide an additional 144 hours of activity schedules and additional 23 hours of outreach. They will be able to serve an additional 38 unduplicated consumers. I am happy to answer any questions you may have. Thank you. May i have a motion to discuss. Second. Thank you. Any comments or questions from the commission. Any comments or questions from the public . Hearing none, call the question. All in favor. Any opposed. Thank you the motion carries. I team g. Requesting authorization to enster into a new Grant Agreement with q foundation doing business as aids Housing Alliance sf for the provision of limited term housing subsidies for older adults and adults with disabilities during the period of november 1, 2019 to june 30, 2021 in the amount of 1 million plus a 10 contingency for a total grant amount of not to exceed 1,100,000. Welcome rick appleby. I am a Program Analyst with the office of community partnership, rick appleby. We were pleased this year to get the board of supervisors ad back to help with limited term housing subsidies. A couple years ago we got the first funding for that. This year we received 2 million. The r. F. P. Allowed for five years so we recalled the previous contractors, one of which is q foundation. Q foundation has been around a long time as aids Housing Alliance. We are glad to be able to help them do these limited term subsidies again this year. The term limited term subsidies has to do with the fact we have a limited amount of money and there are p. M. Situations for people where they only need help a short period of time. A lot of other subsidies are ongoing, maybe lifetime for those in serious situations that cant afford rent. In this case we look for folks that need a shorter amount of time within the two year terms of the contract. Q foundation is one of those agencies. I am happy to answer questions. May i have a motion to discuss. So moved. Second. Thank you, rick. I have a couple questions. On page 3, it says the amount of the subsidy and length of the subsidy to be determined based on the client assessment of need, resources and transition plan. Then on page 4 the second bullet point says the goal will be to bring the Household Income to rent ratio of 30 although the client portion and rental subsidy decided based on assessment and Financial Resources and need. There is nothing here language about the limit in terms how long the subsidy could last and if the ratio doesnt get to 30 , what happens . In this particular case, the subsidy in this contract will end by june 30 of 2021 so we are looking at that length of time. A limited amount of money. Excuse me. I want to understand. That means someone receiving this subsidy it could end in two years even if that individuals need has not changed . Yes. The 30 is a guideline, and if it doesnt quite get to 30 because of the subsidy, that is okay during the course of this contract. We did sort of try to provide some flexibility to meet everybodys individual needs in this. It is not as strict as some of the other contract models. Does that answer your question . Yes, it is a bit openended. As you read, folks are to be, you know, informed this particular program is a limited term and when it will end. Both agencies q foundation and the other all hav have componenf Case Management, either through contacts with the organization or community to help people find other housing, employment, social benefits, that can help them on going after the end of this particular subsidy. Any other comments or questions. How do people know how to access these programs . Is it generally through the agency or is there a broader way people access the system and are referred to the agency for them. There is a variety of ways. Q foundation has a list every feralist of the programs. I think hospital social workers are a primary referral, mayors hoves on housing Mayors Office on housing knows about the programs. Any other comments or questions . Any comments or questions in the public . Call the question. All in favor. Any opposed. Thank you, rick, the motion carries. Item h. Requesting authorization to enter into a new Grant Agreement with selfhelp for the elderly for the provision of limited term housing subsidies for older adults and adults with disabilities during the period of november 1, 2019 through junf 1 million plus a 10 contingency for a total grant amount not to exceed 1,100,000. Welcome back, rick. The other agency is selfhelp for the elderly. The last contract two years ago was the first time they started doing subsidies. We are glad to help them with that this term. As you know selfhelp for the elderly is a large multi mass setted organization to bring a lot of assistance when people are in housing crisis. Employment, Case Management, all of the things selfhelp has to offer they put in place to help people in the moment and when the subsidies end. What else can i say . Selfhelp for the elderly. The model focuses on people who need shorter term subsidies of six months or less. They are looking at folks in immediate crisis. Maybe who were injured and lost their job, had a husband who passed away and cant afford the rent. They step in to help the people right in the moment and for a limited time. It goes beyond six months sometimes. That is really their intent to find other services for those folks within six months. It is a different model than we are used to, but they were successful last time and i am sure they will be again this time. Any comments or questions from the public . We do have some. Thank you. Good morning. I am emilie from selfhelp for the elderly. I would like to thank you for this program. We want to give you a snapshot of the clients we have served for this program. Over 65 of the clients in this program pay more than 65 of the income through rent. Some pay 90 from their income for rent. The majority of these clients are sro. Some are in Affordable Housing with extremely high recent and some are in apartments. We are able to receive title of 287 referrals and provided 220 seniors and adults with disabilities in the 15 month term. Over 90 of the clients were safely housed after they exit this program through custom housing plans and support services. 57 referrals were screened and linked to support Services Without providing subsidies. There was a diversity breakdown. 57 are api population and 23 are caucasian. 12 africanamerican, 5 latino, 3 american indian. I would like to thank you for this opportunity to serve the clients and we look forward to continuing to do that. Thank you. Any other comments or questions from the public. Call the question. All in favor. Any opposed . Thank you. Thank you, rick. Item i. Requesting authorization to modify the existing Grant Agreement with ymca of San Francisco for the provision of Community Services during the period of july 1, 2019 through june 30, 2020 in an additional amount of 50,000 plus a 10 contingency for a total amount not to exceed 166,375. Welcome paula salta. Thank you. I am with the offers of community partnership. This is to restore and stabilize Community Services funding and Service Levels at the ymca branch. This is the department of aging and the Community Services partnership. This is a hub in the community where folks of all ages congregate. There is a gym, lap pool and face for activities. This funding will support activities for older adults and adults with disabilities including tai chi, flower arranging and day trips. Last year participants were able to experience the cultural tour at the presidio and the gardens. Over the summer some spent two nights at the ymca where they participated in hikes led by naturalists and attend yoga classes. The language is english, spanish and cantonese. I am open to answering any questions you may have. A motion to discuss . Second. Any comments or questions from the commission . Really quick question. Does somebody have to be a member of the y to pay membership fees to get in the programs . Not really. There are a few activities that you have to be a member for, but a majority of the activities offered for older adults and adults with disabilities are free and you dont have to be a member. Any other comments or questions . Any comments or questions from the public . Call the question. All in favor. Any opposed . Thank you. The motion carries. Item y. Requesting authorization to modify the existing Grant Agreement with the curry senhe your center to the provision of Community Services for older adults and adults with disabilities during the period july 1, 2019 through june 30, 2020 for an additional amount of 33,406 plus 10 contingency for a total amount not to exceed 587,391. Welcome back rick appleby. The California Department of aging is supplies funding for additional outreach around the Curry Senior Center that will receive this funding. The hope is, particularly in the tenderloin that this additional outreach will get to more people. I think it says the tenderloin is an area with a high eligibility and not necessarily a high awareness that people are eligible for calfresh. They will do additional outreach to get as many people on to the new calfresh under the new calfresh rules as possible. They are a longtime agency right down there in the tenderloin and it was nice to see them supplement some of their salaries of staff with additional language capabilities. We look forward to them doing this work. May i have a motion to discuss. Second. Thank you. Any comments or questions from the commission . Hearing none. Any questions or comments from the public . Call the question. All in favor. Any opposed . Thank you, rick, the motion carries. Item k. Requesting authorization to modify the existing Grant Agreement with sequoia livings for the provision of Community Services for older adults and adults with disabilities during the period july 1, 2019 through june 30, 2020 for an additional amount of 103,405 plus a 10 contingency for a total amount not to exceed 1,435,639. This modification will cover two items. First is the Downtown Center will receive city funding to support outreach opportunities for the expansion. This is an outreach application. This is the provision to help clients in checking the verification documents needed. Outreach will inform client clients about application procedure and nutrition benefits of calfresh. Second is to fund a coordinator for the program. This best practice Community Services program was first developed at the aquatic park. The purpose is to support older adults in seeking and findings pathways to living women by integrating the Resources Available at the other service center. It is changing from a center with positive programs to a community to support for growth. They will conduct the initial assessment with Interested Individuals and the individuals are able to set their own personal goals for increased wellbeing. This assessment builds new progress and evaluates the outcome. Uses a americancentered approach embraces all human development. They will set their own direction in life. The languages are english, cantonese and mandarin. I am open for questions. Motion to discussion. So moved. Second. One question. Is sequoia living in any way associated with the sequoias continuing carry timer community, which is a presbyterian organization . Yes part of the same organization. Okay. Commissioner lou. It is not a presbyterian group. It is now sectarian, i believe. From is from is a is a tae p. Is a tie there is a typo. To continuing genesee 10,341. Total is 103,405,000. Do you see that . The total is correct. But then the contingency column should be moved to the total column currently should be moved to the contingency. Do you have the same document . Yes. We will make sure it is corrected. It is just a typo. Any other comments or questions . Any comments or questions from the public . Calm thcall the question. In favor. Opposed. The motion carries. I team l. Requesting authorization to modify the existing Grant Agreement with golden gate Senior Services for the provision of Community Services for older adults and adults with disabilities during the period of july 1, 2019 through june 30, 2020 for an additional amount of 30,000 plus 10 contingency for a total not to exceed 11,463,653. Welcome back rick appleby. Hello again. Board of supervisors to help the Senior Services at the senior senator to continue the work in district work. A couple years ago they officially started the richmond i forget the acronym. Networking of providers and advocates and consumers to come together to talk about increasing awareness of residents of district one about the Services Available to do a Needs Assessment in the community at large. At the end of last year they provided a resource directory as part of the contract to lift the different agencies in district one available for people. This year we will continue to have the collaborative meetings. They have a staff person dedicated on this work. They will be focused on the advocacy issues for people with disabilities in the district one. They will have focus groups and pull together a report that talks about what is most important to folks who live in that district. May i have a motion to discuss. So moved. Second. Comments or questions. Commissioner lieu. What is the Community Music center 10,000 . What do they do . What is it, i am sorry. Capital expenditure details. That music centerpiece for that choir. Good. Any other comments or questions from the commission . Any comments or questions from the public . Call the question. All in favor. Any opposed . Thank you. The motion carries. Thank you, rick. Item m. Requesting authorization to modify the existing Grant Agreement with Legal Assistance to the elderly for the provision of Legal Services for older adults during the period july 1, 2019 through june 30, 2020 for 90,000 plus 10 contingency for a total not to exceed 750,611. Welcome bakery anna albert. Good morning. The modification will provide funding for Financial Abuse attorney funded by onetime only dignity fund. The Legal Assistance provides Legal Services to older adults. Their services are based in district 6 near mission street. Language includes english spanish and korean. With this modification the Financial Abuse attorney will work with the adult protective services, the virtual unit to respond to complex Financial Abuse cases. The attorneys and social workers and law enforcement. The Financial Abuse attorney will assist older adults victim of Financial Abuse. It includes undue influence and fraud and scams. In addition to representation. This attorney be will lead trainings and workshops on preventing elder abuse. It plans to serve 30 clients this year. May i have a motion to discuss. So moved. Thank you. Any comments from the commission. This is a very important program. The collaborative approach is critical to making it succeed. There are so many people involved with so many different agencies. It is a rampant problem and it is important to take steps to address it. Any other comments or questions . Any comments or questions from the public . Call the question. All in favor. Any opposed . Motion carries. Thank you very much. We are down to general public comment. Any comments from the public . Seeing none, motion to adjourn. Second. Thank you. The meeting is over. Growing up in San Francisco has been way safer than growing up other places we we have that bubble, and its still that bubble that its okay to be whatever you want to. You can let your free flag fry he fly here. As an adult with autism, im here to challenge peoples idea of what autism is. My journey is not everyones journey because every autistic child is different, but theres hope. My background has heavy roots in the bay area. I was born in san diego and adopted out to San Francisco when i was about 17 years old. I bounced around a little bit here in high school, but ive always been here in the bay. We are an inclusive preschool, which means that we cater to emp. We dont turn anyone away. We take every child regardless of race, creed, religious or ability. The most common thing i hear in my adult life is oh, you dont seem like you have autism. You seem so normal. Yeah. Thats 26 years of really, really, really hard work and i think thises that i still do. I was one of the first open adoptions for an lgbt couple. They split up when i was about four. One of them is partnered, and one of them is not, and then my biological mother, who is also a lesbian. Very queer family. Growing up in the 90s with a queer family was odd, i had the bubble to protect me, and here, i felt safe. I was bullied relatively infrequently. But i never really felt isolated or alone. I have known for virtually my entire life i was not suspended, but kindly asked to not ever bring it up again in first grade, my desire to have a sex change. The school that i went to really had no idea how to handle one. One of my parents is a little bit gender nonconforming, so they know what its about, but my parents wanted my life to be safe. When i have all the neurological issues to manage, that was just one more to add to it. I was a weird kid. I had my core group of, like, very tight, like, three friends. When we look at autism, we characterize it by, like, lack of eye contact, what i do now is when im looking away from the camera, its for my own comfort. Faces are confusing. Its a lack of mirror neurons in your brain working properly to allow you to experience empathy, to realize where somebody is coming from, or to realize that body language means that. At its core, autism is a social disorder, its a neurological disorder that people are born with, and its a big, big spectrum. It wasnt until i was a teenager that i heard autism in relation to myself, and i rejected it. I was very loud, i took up a lot of space, and it was because mostly taking up space let everybody else know where i existed in the world. I didnt like to talk to people really, and then, when i did, i overshared. I was very difficult to be around. But the friends that i have are very close. I click with our atypical kiddos than other people do. In experience, i remember when i was five years old and not wanting people to touch me because it hurt. I remember throwing chairs because i could not regulate my own emotions, and it did not mean that i was a bad kid, it meant that i couldnt cope. I grew up in a family of behavioral psychologists, and i got development cal developmental psychology from all sides. I recognize that my experience is just a very small picture of that, and not everybodys in a position to have a family thats as supportive, but theres also a community thats incredible helpful and wonderful and open and there for you in your moments of need. It was like two or three years of conversations before i was like you know what . Im just going to do this, and i went out and got my prescription for hormones and started transitioning medically, even though i had already been living as a male. I have a twoyearold. The person who im now married to is my husband for about two years, and then started gaining weight and wasnt sure, so i we went and talked with the doctor at my clinic, and he said well, testosterone is basically birth control, so theres no way you can be pregnant. I found out i was pregnant at 6. 5 months. My whole mission is to kind of normalize adults like me. I think ive finally found my calling in early intervention, which is here, kind of what we do. I think the access to irrelevant care for parents is intentionally confusing. When i did the procespective search for autism for my own child, it was confusing. We have a place where children can be children, but its very confusing. I always out myself as an adult with autism. I think its helpful when you know where can your child go. How im choosing to help is to give children that would normally not be allowed to have children in the same respect, kids that have three times as much work to do as their peers or kids who do odd things, like, beach therapy. How do speech therapy. How do you explain that to the rest of their class . I want that to be a normal experience. I was working on a certificate and kind of getting think Early Childhood credits brefore i started working here, and we did a section on transgender inclusion, inclusion, which is a big issue here in San Francisco because we attract lots of queer families, and the teacher approached me and said i dont really feel comfortable or qualified to talk about this from, like, a cisgendered straight persons perspective, would you mind talking a little bit with your own experience, and im like absolutely. So im now one of the guest speakers in that particular class at city college. I love growing up here. I love what San Francisco represents. The idea of leaving has never occurred to me. But its a place that i need to fight for to bring it back to what it used to be, to allow all of those little kids that come from really unsafe environments to move somewhere safe. What ive done with my life is work to make all of those situations better, to bring a little bit of light to all those kind of issues that were still having, hoping to expand into a little bit more of a Resource Center, and this Resource Center would be more those new parents who have gotten that diagnosis, and we want to be this one centralized place that allows parents to breathe for a second. I would love to empower from the bottom up, from the kid level, and from the top down, from the teacher level. So many things that i would love to do that are all about changing peoples minds about certain chunts, like the Transgender Community or the autistic community. I would like my daughter to know theres no wrong way to go through life. Everybody experiences pain and grief and sadness, and that all of those things are temporary. The commission will come to order. I will take roll call. [roll call] i would like to take the opportunity to introduce a guest and our audience and we will have a longstanding working relationship. She is the new the mayors new Health Policy director. Shelley . [applause] do you want to say hello to us or are you good where you are . [indiscernible] hi, everybody. You are rather welcome to call me