Transcripts For SFGTV Government Access Programming 20240713

Discrepancy to me. Thats why its reported. You cant fix what you cant talk about. You cant talk about what you dont know. I mean, the whole point, which why i said thats in the annual report. People can see it and track it. Before this information wasnt public and wasnt disseminated. Supervisor walton thank you, director henderson and to your entire team. Colleagues, if you dont have any questions. Thank you for having us. Supervisor walton thank you. It is time for Public Comment. Clerk it is. If members of the public who want to speak on the item, we ask you line up over by the cameras. Seeing none oh, here we go. You have two minutes. We ask you that you state your name. If you have written materials, you can leave them with the clerk. David elliott. So for five years, i worked as a trainer with the Police Department Crisis Intervention Team training. For search ive been part of the Mental Health Advisory Working Group or c. Ism t. I have worked with sam on revising the use of force guidelines for the department general order. So i have some kind of background and sense of whats been going on. I applaud you for doing this hearing. Mostly the Police Department responds to Police Commission requests. It seems like the Police Commission, as by design, is the main sort of body that dictates what information this department will provide to others, what they will do. I think theres a role for the board of supervisors. And this hearing is really useful in that part. I hope this is one of many hearings that continue to ask the department for more, for working with other agencies and for doing the good work they are doing. Theyve done really good work. When you look at just c. I. T. In general, use of force, theyve done much, much better. I know there was a recent officerinvolved shooting, but its been a year and a half since the last one. And two and a half years since the last Mental Health officerinvolved shooting. Thats remarkable compared to the way it used to be. I think c. I. T. Works. And i applaud the work of the professional accountability and standards. Theyre doing really good work. [bell dings] and thank you for this hearing. Ill cede the rest of my time. Thanks. Clerk thank you. Next speaker. Hello. A number of years ago i saw an individual, a middle aged San Francisco homeowner, a brain cancer survivor being stopped, questioned, searched and arrested while he had been walking his bike to to gallonnen gate park. The officers claimed that they wanted to search for potential warrants across the bay. His drivers license lists his San Francisco address. There was actually no reason to associate him with the east bay. And the arrest was unwarranted, unjustified and unlawful in my opinion. And the officers were actually being you know, they were being immature, thats why i said that, they need better training sometimes. Clerk thank you. Are there any other members of the public who would like to speak on the item before i close Public Comment. Seeing none Public Comment is now closed. [gavel] supervisor walton, it is your unless you have any concluding remarks . Supervisor walton just briefly. Clerk yeah. Supervisor walton one, i definitely want to thank director henderson and his entire team for the presentation this morning. It really is evident in terms of the inequalities that exist across departments. And at least the feeling of Public Safety about how important d. P. A. s role is. Its a very Important Role and it needs to be recognized accordingly across the city, both in resources and in terms of how we treat the department of police accountability. So we will continue to be having those conversations. And i stated in Public Comment, there have been some shifts in terms of officerinvolved shootings in certain incidents. We still have a long way to go in terms of use of force. Use of force complaints. Of course, the disproportionately of people of color who are involved in those complaints and how we address those, as we move forward. So do want to thank you for the information provided, the quarterly reports, the annual reports. But i would like to continue this to the call of the chair, because we will bring d. P. A. Back, as well as Police Department and other Public Safety providers to have a more full conversation, as we continue to adjust the issues that exist around police accountability. Clerk so i hear a motion from supervisor walton to continue with the call of the chair. We can take that without objection. Mr. Clerk, please call our next item. Kick a resolution declaring a Public Health crisis on Drug Overdoses and drug use and urging the department of Public Health to present a comprehensive plan on how to address the crisis. Supervisor haney has joined us. Supervisor haney, this is your hearing. Supervisor haney thank you. Thank you, chair mandelman, and committee members. Im going to just provide some introductory remarks to open the hearing and ill pass it off to our friends from the department of Public Health. I want to also recognize and thank all of the folks in the room who are here for this hearing. And especially the people who are here from the organizations who are working on this issue every day and who are saving lives. I want to recognize the dope project, San Francisco aids foundation, glide, st. Anthonys, drug users union, the drug policy alliance, r. T. I. International and health right 360. I want to thank again them for their partnership and all of the work that they do. I also want to ha thank the many residents and neighbors in district 6, who have reached out with concern, urging my office and the city to take greater action. I think ive had over 20 meetings across the district where this was the main topic. And im glad that were here today to be able to talk about solutions. You know, i think theres a lot that we are proud of in our city. Theres a lot that i see in my district that inspires me and all of us around folks who are taking action for their neighbors who are in need. And relieving suffering. But theres also things that we need are serious challenges, that we need to respond to more urgently and more seriously. There are people in our neighborhoods that are suffering alone on the streets. There are Small Business people who are struggling to stay open. There are people who need treatment, health care and housing, who are unable to access it. And there are people that are dying nearly every day in our city from Drug Overdose. Its critical that when we have something that is of such a concern, especially in a city that is as caring and is as committed, we respond to it with the urgency and seriousness to save lives and make sure we are providing care for people who need it. So with this resolution is recognizing this crisis and taking a stand to be unified, committed to call our drug use and Drug Overdose crisis what it is, a Public Health crisis. And demand an Emergency Response. The Overdose Deaths in our city have increased this year and last year. And each loss of life is unacceptable and devastating. People in our city are dying from fentanyl, meth and heroin overdoses at the highest rates ever. This drug crisis is impacting all of us in our downtown neighborhoods in particular. And nearly every day i hear from constituents about how drug dealing, drug use and Drug Overdose are impacting their lives. I receive hundreds of constituent calls and emails on a weekly basis. And generally the sentiment is similar of concern. Some of the things, just quoting from things that i received, how can a wealthy firstclass city like San Francisco leave people to languish and suffer on the sidewalk. Why is it hard for people to get people the health they need. Can we ring the alarm to get more state funding. In 2018, Drug Overdose in San Francisco claimed the lives of 259 people. Fentanyl Overdose Deaths increased 150 in 2018. And Drug Overdose deaths accounted for five times as many deaths as either traffic deaths or homicides. This is despite the heroic work our advocates and outreach workers do every day. They save literally thousands of people on an on an annual basis, reversing overdose. This is a Public Health and Public Safety crisis. And we need to respond accordingly. The impact of these deaths and of drug use weighs heavily on my constituents, who want and deserve safe straight street. Those suffering from addiction are also persecuted by the stigma against the disease. As a community, we need to act boldly and compassionately in dealing with substanceuse disorder and Drug Overdose. What were going to hear today is what this Emergency Response will look like, both what were doing and what more we can do. We can no longer accept business as usual. We need comprehensive Actionable Solutions that address the core issues and change the status quo. There are a set of things that ive asked for the department of Public Health to respond to specifically, in terms of what we are doing and what we can do more of. What we know is that we that every day people are abandoned on our streets or cycle in and out of emergency rooms. We lack the intensive Case Management to ensure people dont fall through the cracks. And we need to support the folks who are doing the outreach on the streets every day, with what they need to respond to this crisis. So the seven things that the department of Public Health will be addressing today is how to improve the overall response in outreach to people who may be using drugs, in psychosis or potentially overdosing. Secondly, efforts that d. P. H. Has made access to narcan. One thing that we know is that an opioid overdose can almost universally be reversed by the administration of naloxone. And naloxone is are you teenlied a routinely administered by Emergency Services personnel, as well as outreach workers and providers, as i said, thousands of overdose reversals every year. Third, what efforts are we taking to expand street outreach and use data that we receive on a regular basis to respond more effectively. Fourth, provide regular reporting of overdose and Overdose Deaths and how this data that were collected is used in the responses that were taking as a city. Fifth, how does d. P. H. Plan to increase and support frontline Emergency Responders and Public Safety personnel. Sixth, what has and what is a d. P. H. Doing to identify and establish emergency, detox and dropin facilities. And, seventh, any potential support from state or federal resources. I also want to say that we recently passed Mental Health s. F. , which will transform the way that we are coordinating peoples care and treatment, as it relates to substanceuse disorder. And so we may want to hear some also about how some early steps that we might take will address that. I know folks have asked also about more issues related to streetlevel drug dealing. This hearing is specifically more on how we are addressing drug use and Drug Overdose. We created a streetlevel Drug Dealing Task force. Held a sixhour hearing around drug dealing and have a number of things that are happening around that. But this is specifically focused on department of Public Healths response, which has been meeting this effort and has been a National Leader in how weve responded currently and in the past. And specifically with the work of the dope project. And, you know, im excited to learn from what were doing. But also, you know, wanting to and weve spoken a lot about this to dr. Colfax, knowing what we can do as a board of supervisors, as the elected representatives to support the work and to ensure that were responding with the urgency and the breadth that we require to ensure that in the future were not that things dont continue to go in the direction they are. So with that ill turn it over to eileen from the department of Public Health. And again i just really want to thank you for your commitment and your work and your partnership, since ive been in office. Its really been a pleasure working with you and im grateful for the work that you do. Thank you before you start, we gave you ten minutes for this. Ill be talking really fast. So, good afternoon. And thank you so much for providing us the opportunity to come and speak about our efforts, that address the resolution. My name is eileen lockran. I work with the department of Public Health, in a branch called Community Health equity and promotion. I work directly with communitybased programs that work with people who use drugs and or are experiencing homelessness. So im here with my colleagues today, dr. Phillip coffin and dr. Judi martin. And we will be able to answer your questions at the end. But for the sake of time, were hoping that we can just go through the presentation, which will address the issues that are outlined in supervisor haneys resolution. So the overview, as i said, will just address the issues that are outlined in the resolution. So well just jump in right now with the data. So as supervisor haney nicely summarized, we had essentially a flat number of Drug Overdose deaths. If you look at the chart, the top of the lines is going to give you the total number of opioid, cocaine, methamphetamine deaths in San Francisco each year. Essentially flat through 2017 and increases in 2017 and 2018. If you look at the bottom line, that go up through the careen, those are opioid Overdose Deaths. In the purple, yellow, red is cocaine and methamphetamine deaths. Cocaine and methamphetamine deaths essentially have been stable as a combined entity. Theyve just shifted from cocaine to methamphetamine. These are cardiac or cerebral vascular events. The opioid deaths were also flat, i think in large part to the amazing work by our providers and teams in the community. And people who use drugs on the street, that have reversed so many overdose events. The increase is entirely attributed to fennels. As you can see on this slide, our prescription Overdose Deaths have declined, heroin Overdose Deaths have increased somewhat. The real increase, the jump is in fentanyl deaths over the last two years. There isnt you know, its remarkable that we made it through the Opioid Crisis without an overdose death. Theres no community that i know of, even with far more flexibility in services they can provide, like say vancouver, that survives the introduction of fentanyl unscathed. It is it is a challenging new drug on the street to manage. The project provides naloxone to lay people for overdose reversals. The number of reversals have gone up each year in a pretty remarkable fashion. Theyre on course for further increase this year. 30s are reversals done mostly by people who use drugs for because theyre the people most likely to be present in the event of an overdose. Weve see an increase in the amount of naloxone administered by emergency medical services. I do want to say about the mortality data, we obtain that from the drug reporting system. This comes from the medical examiners office. It takes the medical examiner generally three to six months to close a case. The other issue with the data is that we have relatively small number of Drug Overdose dates, because were not a large city. The variation in Overdose Deaths from month to month is tenfold. Theres a lot of instability in the numbers, which is why we report on an annual basis at this time. So San Francisco has a harmreduction policy. And its been in effect for over a decade. And thats the philosophy of really working with the individual to address their needs, to include them in their in any sort of service and care. One of the important things to recognize is that Harm Reduction is a continuum. And abstinence is a part of that continuum. And a lot of times people dont recognize that. Some of our very successful harmreduction programming is the syringe and disposal program, our naloxone distribution, medically assisted treatment, which is getting people started on often in the streets and the field in our Outreach Team and the sobering center. Syringe Access Programs are really a gateway to services, a way to engage people into care. Because we need to recognize that one type of service does not work for everyone. There needs to be different strategies to meet the needs of the individual. Next slide. So im going to share a slide that this slide shows the number of refills. And again this is because of the great work of our partner, the dope project, Drug Overdose project education program. What refills means is that they are coming back to a Distribution Site to get a replacement of narcan. It could mean that they did a reversal. It could mean that their narcan was lost or stolen. But you can see how that has steadily increased from 2003. And when i say Distribution Sites, its not only our syringes access sites, but its other programs that the dope project works really closely with to be Distribution Sites. For example, st. Johns church in the mission or Mission Neighborhood resource center. There are Access Points for this. Another thing is the jail prerelease, where individuals who are incarcerated are able to get narcan put on their property, prior to release, if they have a history of opiate use. Most recently there is project friends. And this is a program with First Responders, who are able to be a distribution and training opportunity. This is through ucsf and San Francisco general. Its federally funded. Next slide, please. So we have many mechanisms that meet the needs of people who use drugs, because as i said, not one strategy works for everyone. And we have to just have multiple opportunities. One such opportunity is mobile health fairs, where we partner with multiple Service Providers and bring services to the community and connect people. Another opportunity is like supervisor mandelmans district, we have a syringe access site that has lowbarrier medical services. Weve been really successful at the sites, at that site getting people connected to bu bufenorphine. Thats us just having to be flexible. Theres also the mobile methadone van, the harmreduction therapy van. Under Mental Health s. F. , were going to expand and have a crisis team on the streets and its just really listening to and meeting the needs of the individuals that are out there. For whatever reason, people are not going inside. We have to be flexible and creative. Next slide. So one of the items on the resolution was about how overdose alerts. We do a really good job with alerts. And i have to again give credit to our community providers. The dope project, in partnership with our syringe Access Programs, are the foot on the ground. They node whats going on. And as soon as there is sort of a spike in overdoses, they work to develop fliers, to developing messages, to engage in conversations with people who use drugs, so that that word, that message can get out there. To coincide with that, the Health Department works on medical advisories and that is also an alert that gets sent out to treatment programs, navigation centers, shelters, schools, et cetera. And we will expand that to include the board moving forward. So that youre part of the the alert. And then finally, the last effort is acdc. The alliance for collaborative drug checking. And again thats something that the dope project collects drug samples that resulted in adverse effects. And they get those drug samples tested. And that gets reported back to the community. The flier that is there shows an example of how that messaging gets back to the community. [bell dings] so San Francisco has obviously a range of Different Services in terms of treatment, that it provides from sort of prevention, early intervention, all the way to locked facilities. And many different Access Points for that people can access it. And really an effort to try to move people towards the lower threshold options, if they are if thats appropriate for them. The important thing is to have a variety of Different Services, to be able to meet an individuals need, based on the issues that theyre facing. In terms of substanceuse treatment options, the residential treatment, i just want to emphasize, is really only one element of the of whats provided. And 98 of the residential treatment beds are filled by people who are experiencing homelessness. We also have a lot of the exciting things that we provide, not just as a treatment, but also as an Overdose Prevention tool, because of the nature of it includes contingency management, which is one of the most welldocumented, well evidencebased programs for methamphetamine use. We have research straight out of the Health Department, including a study codesigned with director colfax, before he went to the white house, that demonstrated the effectiveness of a medication, the medication for reducing methamphetamine use. I realize were over time. Cut me offer if you need to. The substanceuse Disorder Treatment numbers. Sorry. Never. We have seen a slight decline in the number of people treated for substanceuse disorders through our standard programs in the last four years. The alcohol decline, which is not within our treatment system, its within primary care generally. The alcohol decline i suspect might be due to an increased use of medications for alcohol use disorder. Because thats been a big push throughout the medical community. Its really kind of reintroduce addiction management back into health care, which it used to be very much separated. Go ahead. Sorry. So we have our action plan broken up into immediate and then longterm. Im just going to highlight a few of the items in the immediate. So as part of Mental Health reform, we recently launched findtreatment sf. Org. And let us know the available treatment beds, which is awesome because it will also allow us to see trends and to use that data and to give that feedback back to our providers. Why is agency x consistently have empty beds, where another agency is full. So thats something that we think will help us better serve the community that is suffering from substanceuse disorder. Were also after the meth task force, one of the recommendations that was highlighted was the development of a drug sobering center. Were actively working on that. We are also looking to expand hummingbird, which has been a very successful psychiatric respite. In addition to that, we are adding 62 dualdiagnosis beds. And that will be done in fiscal year 1920. There are a few additional Overdose Prevention efforts that weve made. To be honest a lot of what were presenting is a few a few of the things that are happening. Theres a lot more going on, both within the Health Department and amongst our partners. We have a new project that just got funded to implement Overdose Prevention within s. R. O. Buildings. This is a site where people oftentimeses are alone when they overdose. And so its theres a new a different of set of challenges to make sure we dont lose residents in those buildings to overdose. We have ongoing research, reboot 2. 0. We had a successful trial of a behavioral intervention, among people at risk. And this study is a second followup, full trial thats being done here and in boston at the same time. Were really excited about. In addition in 2019, the Addiction Medicine Service was started at San Francisco general hospital, which is a really exciting opportunity to find people who have substanceuse disorders, make sure they have the tools that are that we can provide them with any of the tools and options that we have available. And patient navigation on discharge to try to make sure they connected with whatever level of service is appropriate for them. Were also working to lower the barriers to treatment. Weve heard from the community, weve heard from providers about the intake process being too long. So were we have been working with our providers to address that. Additionally, our biggest Provider Health right 360 has expanded their hours into the evening. So thats also listening to the community and having an immediate response. We also are expanding tele buopinion. Buprenorphine has been so successful. Were expanding opportunities to have that at points of contact, in addition to other syringe sites. And then, finally, d. P. H. Continues to be involved and support Overdose Prevention sites. So i know that was very quick. But were now open for questions and our apologies for just going on. I have a number of questions. But do you do you have a particular way youd like i know a lot of people, probably want to get a comment. And yeah. We can do questions first. We can do Public Comment first. We can do it any way youd like. Im going to do Public Comment first. A lot of people who are also experts as well. With Public Comment, they can help to add to the conversation and inform some of the questions that well have. And also the last time i did a very long hearing and left Public Comment hanging, so id rather make sure that everyone who is here to speak, has the opportunity to do that. Is that all right . Ill call some names first. We can sit down. You guys can sit down. And well hear from the blue card people first. If anybody else who wants to speak, you can come up as well. So after you line up over by the cameras i guess. Thats the way we do it, all right. We have speaker cards for david lewis, javier, calder, kristin, laura, wesley, andy stone, ryan dell porto, miss ian, road, francisco and then ill just reiterate that folks have two minutes. We ask that you say your first and last name clearly and speak directly into the microphone. If youve prepared a written statement, youre encouraged to leave it with our clerk. No applause or booing is permitted and in the interest of time, speakers are encouraged to avoid repetition of previous statements. Mr. Lewis. Thank you, supervisors, for holding this hearing. David elliott lewis. Lewisinglefamily. Treatment on demand. Theres been so many good ideas mentioned. I want you to applaud you for doing this hearing, for passing Mental Health San Francisco. Bravo, bravo, bravo. For the Methamphetamine Task force, supervisor mandelman ran. And this recommendation for more sobering centers. Heres an idea, proposed solution that could be part of Mental Health San Francisco, which is to create more peer or consumer Employment Opportunities to do outreach. , so the s. R. O. S and to the street. I think bringing in people with lived experience with eviction to actually do outreach makes a lot more sense. Or maybe those people working in conjunction with two nurses through street medicine. To bring low threshold buprenorphine to the streets. Expand street medicine with more consumer, people with peer, with lived experience, paid to do street outreach, to both shutin people in s. R. O. S, where a lot of overdoses happen, as well as to the street, where overdoses happen. Its a costeffective solution to do it. And i think that it could be implemented through Mental Health San Francisco, once the details of mhsf is worked out. So submitted for your consideration. [bell dings] for the future. Thank you, supervisors. Thank you. Next speaker. Good afternoon, supervisors. Ply name is javier. I work with Community Housing pipe and im a representative of the treatment on demand coalition. Again i want to thank you for holding this hearing today. I think its important that in the wake of passing, you know, a really groundbreaking piece of legislation, like Mental Health s. F. , which is going to take longterm implementation, i think its also important to look at it in from this perspective, too and what are some of the immediate steps. I also appreciate how this hearing so far has not been focused on some of the methods that have been used in, you know, generations in years past, which is just increased policing. I think its important to look at the alternatives, to police, because we know the data and the daily anecdotes that we hear from people with lived experience are screaming at us, that we dont need more police, we need more creative solutions. So i appreciate that perspective so far in this hearing. Also i want to emphasize that that people who do work on the ground, like the aids foundation, glide, the dope project are doing some incredible work around reducing overdoses. So its important that we emphasize how well theyre doing and to keep them funded and look for ways to support them. And finally, i want to say that [bell dings] things we can do now are to implement Safe Injection Sites in the places that need it the most. And San Francisco needs Safe Injection Sites now. Its already been happening in philadelphia and its been happening around the world. We know that that works. We need safe injections now in San Francisco. The public wants. The legislators in city hall agree that it works. So we need those right now, too. I appreciate this hearing. And thank you very much. Clerk thank you. Next speaker. Good afternoon, supervisors. Im lauras thomas, the director of the San Francisco aids foundation and a resident of district 10. Thank you for holding this hearing and for acknowledging the role that Community Members play in reversing most of the overdoses that happen in the city. And i appreciate the focus on Public Health. I also would ask that you broaden this a little bit, while overdose may be a Public Health crisis, some of the things that we know increase overdose risk are more related to policing in the criminal Justice System. We know that being incarcerated in jail substantially increasing overdose risk within the first 72 hours, after release from jail, as it increases the number of other health harms. So every time that we are incarcerating someone in jail, were increasing their overdose risk. We know that increased policing increases overdose risks. That studies have shown, you put more police on the streets harassing people, moving people along, and people rush their shots, they use what they have, they take they make the decisions the best they can. But it puts them at increased risk. Targeted at incarcerating people who are using drugs are all going to increase overdose risks. I think its appropriate to look at the Public Health system and what its doing. We need to broad continue to the Police System and the criminal Justice System and see what theyre doing, that is increasing overdose risks. And finally it wouldnt be me if i didnt say obviously overdose revenge sites prevention sites are a key part of the solution that we need here in San Francisco. And thank you, supervisors, for your continued support for them. Thank you. Next speaker. Good afternoon, supervisors. Thank you for your attention to this matter, particularly supervisors haney and walton for highlighting this crisis. My name is wesley and i am the policy manager at glide center for social justice. I am here to speak on behalf of our evidencebased Harm Reduction efforts in San Francisco. And to avoid redundancy. Ill jump right to a few. So its called for by todays resolution glide insists that any increase in streetlevel Crisis Response to address people who are using drugs, in psychosis or overdosing. We should prioritize the Harm Reduction approach. We need to these are just a few. Its not exhaustive. But expand the Syringe Access Services and provide safe smoking and safe snorting supplies and decriminalize such equipment. People who use drugs may do so in a hygienic environment in the presence of trained clinical staff. Provide culturally informed mobile outreach, due to sweeps of homeless encampment. And we need to expedite the treatment of individuals who require access to hepatitis therapy, just as people diagnosed with h. I. V. Are prioritized. Thank you. Thank you. Next speaker. It feels new because of the situation were dealing with with fentanyl. But mostly just anted to say that what we need from City Government is support around undoing the pretty abysmal policy thats on the books, including criminal size people who use drugs and people experiencing homelessness. And thats what we really need from yall. We are out here addressing this issue. We have been, dope project has been around for about 17 years. A lot of programs behind me have been around for decades, addressing this issue. But we cant address what we cant control. So what we need from yall is the support to undo that policy, so hold police and the department of public works and department of homelessness and Supportive Housing accountable as well. [bell dings] most of the people who pass away from overdose in San Francisco do so inside h. S. H. Funded sites. And so its important to name that and im hoping that they can be in the room at some point as well. Thank you. Next speaker. Hello. My name is ryan dell porto. Im the Overdose Prevention coordinator at the San Francisco aids foundation. Thanks for having this hearing. I feel like theres a lot of good things in this resolution. And id just like to acknowledge that us doing Overdose Prevention work in San Francisco has been doing amazing job. And with a lot of support from the department of Public Health. But, you know, with fentanyl the game has kind of changed out there. So we need to adjust. So im just here to say i support this resolution. Just some things id like to add that i feel like should kind of go alongside this is, you know, more training for law enforcement, paramedics, department of public works. A lot of those kinds of agencies can be barriers as far as like overdose response. You know, people get narcan thrown away by the department of public works, which, you know, puts them at greater risk. You know, police arent very arent very welcoming when they respond to an overdose. [bell dings] and paramedics as well. I just feel like some kind of sensitivity training can help and so its more apparent that theyre Public Servants and theyre to help save peoples lives. [ thank you. Thank you. Next speaker. Good afternoon, supervisors. My name is andy stone. Im community mcconnell gages manager with mobilization manager. The reason why our one of the key reasons why our overdoses numbers are as low as we are, because we are working directly with people who are using drugs. Theyre out in the streets and have the resources that they need, including narcan, to reverse overdoses and prevent preventable Overdose Deaths. This is really crucial. Bringing these sites here to get the numbers even lower and prevent even more preventable deaths from overdose. Thank you. Thank you. Next speaker. And we just need to be doing more at this time. With fentanyl its such a game changer and were seeing an alarming rate of overdoses and people that use drugs deserve access to drugs they need to stay alive. Thank you. Thank you. Next speaker. Good afternoon, supervisors. Im with st. Anthony foundation. Just want to acknowledge and thank supervisor haney for calling this hearing. Especially the dope project for training and ed calling our staff. And everyone who is experiencing hodgkins lymphoma, that theyre saving lives every single day. Just want to get personal for a second and take you back to jun. When i noticed a man who was laying on the ground, holding his dogs leash at the bus stop. By the time i made it to the street, five, six people had walked right by. I asked the Security Guard at the hotel how long hed been there. He said about an hour. Immediately called 911. Was able to relay, because i wear a radio sometimes up st. Anthony. Able to get narcan brought down and thankfully 911 First Responders showed up. They were able to administer more narcan. That didnt work and they had to use paddles. Luckily he was able to be brought back. But what i would say is for someone to be lying on the ground in the city for an hour, im not really sure what else constitutes a crisis in this city on market street. I have lived in vancouver, i have lived in montreal. The anticipates to solutions are there if we dont need to reinvent anything. We need to listen to the experts and look at models used in portugal, in canada, across europe. Supervised injection sites are the answer. And i hope all of you will support that. Thank you so much. Thank you. Next speaker. Hello. My name is miss ran. I work at the San Francisco rug users union. Im going to echo a little bit the person who spoke first. Being that during these issues, a lot of what we hear about is treatment and im a big advocate of treatment. But a lot of what we see on the ground level is that most of the people who come in have been to treatment and successfully completed it numbers of times. So posttreatment theres not a lot of options for people, especially if they have like a rap sheet, because theyve been jail to a bunch of times for petty crimes. So it would be helpful i think for my community and you guys to work more together in the future by how to like clear rap sheets or how to get more training for job skills, which is a thing that we do at the union. Very lowbarrier Employment Opportunities. Because posttreatment, postjail and i guess post a lot of programs not a lot of opportunities for this specific community, which i think you guys have seen. Its a revolving door, right. So, yeah. Just a thing to think about. Thank you. Thank you. Next speaker. My name is francisco decosta. Im the director of Environmental Justice advocacy. We have a very, very serious problem with the issue thats being discussed today. And you supervisors should think outside the box. We need a documentary where in all of the places there are First Responders, they should be educated really on what happens when somebody is about to die. This is not a joke. Now today i came, i was in the muni. We had two people fall down in the muni because of a Drug Overdose, opioids. Then you walk by the bill graham, you see that. And children when they see that, its not good. This is the city of st. Francis of assisi. Empathy and compassion. And all you supervisors have to have your heart in the right place. Its not about money, this is about human dignity. This San Francisco was where the United Nations was formed. San francisco can lead, so like when somebody says, oh, we cannot do this in the 80s when we had the aids pandemic. We did it. We had like dr. Silverman. I may have gotten his name wrong. I remember him. He was my friend. Guys like that just did it. Who is going to do it. People are dying on the streets. Thank you very much. Thank you. Good afternoon, supervisors and Public Safety. Well, did you see what i see . Did you hear what i hear about drug use everywhere. Let let us bring, time to be aware time to care let Public Safety unfold let it mold. Let it work youve been told thank you. Thank you. Next speaker. [applause] good afternoon, i were supervisors. Im with the San Francisco aids foundation. Im here begging for a safe conjunction consumption site. I have worked at multiple organizations dealing with this community. The Safe Injection Sites work. We have documentation proving that. And the sooner we have that, the less people down the streets, we need Safe Injection Sites. Onestop shops where we can have medical providers to get the help they need. Thank you for having us here today. Thank you. Next speaker. [ please stand by ] thank you. Next speaker, please. Brian edwards. I am a Community Organizer and advocate for the coalition on homelessness. If we really want to talk about what is responsible for part of the rise in overdoses and making it difficult for people to get into treatment, we really need to have sfpd and d. P. W. Here because this sweep destroyed communities, they destroy Safe Injection Sites, i have been to three encampment his meat sweeps since november 25th. All of them were in your district, matt, and some of those communities existed for years and people to look after each other, i still, to this day , dont know where all those people went. There were people from, on house situations overcoming to those communities. They knew if they odd there would be someone there with narcan. There were five overdoses that were successfully reversed by other drug users in an hour and a half. Some of those people that were displaced over the next month they will isolate. They will die. The city is destroying Community Work wherever it arises on the streets. And not Offering Services or any housing. Sweeps kill. Stop sweeps they managed to place two people in a Navigation Centre and four people in sevenday shelter beds. Is that a success . But for every hearing that involves Vulnerable People at the city and homeless people, we need to have sfpd and d. P. W. Here because they are the ones who are doing the majority of the interventions with our un housed citizens and they need to answer for the damage they do. Thank you. Thank you. Next speaker, please. Thank you. Im the director of the Harm Reduction therapy centre. We are an integrated dual diagnosis Mental Health organization. For 20 years, we have been offering integrated treatment in the lowest threshold drop in centers in San Francisco in most neighborhoods, not quite all. Since january, thanks to some funding, pilot funding from the department of Public Health, we have been able to join our very effective and esteemed colleagues from d. B. H. Who do Public Health work on the streets, and we have created treatment on demand centers, pop up Mental Health and Drug Treatment Centers in six neighborhoods in San Francisco. Because we have established and become a hub for some of our own sites in addition to joining our colleagues with syringe access mobile sites, we have been subject to the same moving along of people that the folks who live on the streets have. We have been able to experience what it is like to be moved along and what it is like to be with the people who are being moved along. I understand that there are efforts underway to perhaps develop a somewhat safer and maybe more stable location for multidisciplinary services. I would urge you to support all of those efforts and i want to just remind you that the Biggest Issue of problem Substance Use is trauma. And the prohibition and the coercion that goes with it is antithetical to motivation, but care and support are the things that actually drive motivation for people to change their behaviour. Please keep those things in mind in regards to the people we are talking about. Thank you so much. Thank you. Next speaker, please. Good afternoon. My name is eliza. I ran the project for eight of his 18 years in existence. I want to echo what all of my Harm Reduction worker colleagues have said so far today. I also just want to make a comment about the history of Harm Reduction. It is a social Justice Movement that is centred around the health and dignity of people who use drugs. It is not a Public Health intervention. And if you look at our sisters of the social Justice Movement, for example, the climate Justice Movement were today, Indigenous People and people most impacted, were ushered out of the decisionmaking rooms by police. I would encourage you to not make similar decisions and have the people most impacted by overdose and the Harm Reduction workers who are at the center of saving every single life of in the city at the table. It is actually our table. Please invite the people who know best how to craft the solutions to make those solutions. Thank you. Thank you. Next speaker, please. Good afternoon. I am with the coalition on homelessness and i will not pretend like i can speak to this point better than everyone who was before me, but i do want to echo the department of Public Health claims that most reversals are being done by drug users because they are on the spot and they are informed. Contrary to the very large portions of this community. And to dissolve those possibilities of having a community that is present and informed while overdoses happen, i