Committee is authorized to meet in person. Each speaker will be allowed three minutes to speak. You can call 4156550001. Again, its 4156550001, access code 1461188903. Then press pound and pound again. When connected, you will hear the meeting discussions, but you will be muted and in listening mode only. When your item of interest comes up, dial star 3 to be added to the speaker line. Best practices are to call from a quiet location, speak clearly and slowly and turn down your television or radio. Alternatively, you may submit Public Comment by email and it will be forwarded to the committee and will be included as part of the official file. Please note this meeting is recorded and will be available at sfgov. Org. Were going to call the meeting to order. Its october 20, 2020. Please call the roll. [roll call] great, at this time we have a quorum. Thank you, well now move into item two for Public Comment. Do we have any Public Comment at this time . So item number two, opportunity for the public to comment on any matters within the committees jurisdiction that is not on the agenda. Access code is 1461188903. Then press pound and pound again. If you havent done so, please dial star 3 to line up to speak. A system prompt will indicate that you have raised your hand. Please wait until the system indicates you have been unmuted and you may begin your comment. Please note you will have three minutes. Im checking now to see if there is anyone raising their hand. We have one. Im going to go ahead and unmute this person and this person can speak for three minutes. Good morning. My name is sandra. Im a leader in faith and action bay area and st. James epis can poll church. Im here with other leaders in faith and action. Faith and action bay area is a network of over 100 congregations and individual Community Leaders in San Francisco and san mateo county, working to uphold the dignity of all people. We are a multiracial, multiling gal, and cross Class Organization thats led by those most effected by injustice, such as low income renters, workers, immigrants, women and youth. We are bound together by a shared commitment to ensuring the full rights involve people in our community and the desire to connect our spiritual belief with our civic actions and practices. Prior to the pandemic, our Housing Advocacy focused on city rent subsidies for low income seniors at risk of becoming unhoused. From the experience of our latinx leaders in the Mission District find themselves unable to meet the requirements to obtain the Affordable Housing opening in their neighborhood. The pandemic expanded our scope of issues as we made outreach calls to the community and heard that the priority of rent subsidies was now joined with our dire need to obtain safe for our neighborhoods. It turned into our campaign for no seniors without homes with three priorities, moving vulnerable homeless seniors to hotels as an emergency measure, assuring they can move into safe permanent housing when their time in the hotels ends and continuing focus on preventing vulnerable seniors from falling into homelessness. We are currently phone banking around the election, which is a great opportunity to do further listing in our community on issues of highest priority to them. Many of the issues coming forward will relate to the work of this committee. You have a unique opportunity to address the issue of homelessness in San Francisco by creating new and accountable mechanisms for financing and delivering services. We will be walking you through this process, providing you input along the way. We look forward to your good work and the day we can be together in person. Thank you. Thank you. So are there any further Public Comments . Give me one second. Hello caller . No, there is no Public Comment at this point. Okay, thank you. Well move into item 3, approval with modification of the minutes from september 16th. Is there a motion . Andrews, so moved. Is there a second . Second it. Moved and seconded. Any discussion . All in favor say aye. Aye. Sorry, this is john sorry to interrupt. Before the vote on each item, you should take Public Comment. You had general Public Comment at the start but for each item, sometimes during the discussion or any time before you take any vote, the committee needs to take Public Comment. Okay. So any Public Comment . Members of the public who wish to provide Public Comment on this item should call. If you havent already done so, press star 3 to line up to speak. Please wait until the system indicates you have been unmuted and you may begin your comments. Please note that you will have three minutes. Give me one minute, im going to check if we have any callers. In the meantime, can i note that it doesnt appear that the minutes have been posted publicly and there was a recording of the meeting and so are we approving the recording or is there a written minute . I got a lot of questions from people about that. So the minutes are posted in september section. There is a link that says minutes to it. So they are posted. Im happy to send you the direct link if that would be helpful. No, i got it. I just wanted to make sure the public knew where to find these items. Its been a little confusing for folks, i think. A lot of times people dont think about going on the office of the controller website to find the documents. So, i think we need to keep making it clear to folks where to go for information about these meetings. Thank you. Thank you member friedenbach. Is there any public meant comment at this time. No Public Comments. So its been moved and seconded. All those who are in favor say aye. Aye. Any opposed . Any on extension . All right, its been movedd ewe nam mousily. She is on the attendee list. Okay, ill go ahead sorry. Chair williams, we had a question to change the agenda item so marlo can join later. If you can take the items out of order, thats permissible. So i know we want the supervisors here to respond to questions, are we still in line with that timeline for if were moving abigail . I checked with her staff yesterday and it seemed fine. I have Marlo Simmons on the line. Okay, thank you. And were actually going to take item five. This is the background presentation on the plan and possible action by committee. So we have the interim director to present to us first. Is abigail here . Yes, can you hear me . So well move to your item if you want to begin your presentation. Thank you. Thank you. Good morning chair, vice chair, members of this remarkable committee on this auspicious day. I didnt say much last time except for how much im excited to be here and echoing what i heard from the Public Comments and i look forward to being here in person as we continue to move through the pandemic. I have been asked by the committee to share background on h. S. A. s framework and brief update, very brief about how the strategic framework is playing through during this pandemic. So, chair with your permission, i will begin to share my slides. This is always the moment of truth on technology. Please just bare with me if i cant get this to work. Can somebody let me know they can see my slides . We cant see it. Give me one second. Try now. Okay, let me try again. How are we doing now . We can see them. Its in presenter mode. Im not sure if you need to go to full screen. Okay, thank you. So are you seeing apologies, we worked this out beforehand. Are you seeing the current slide and future slide . Yes. Thank you. I am currently seeing my full screen so give me a second to try to sort this out. Yes, we can see it now. The full screen . The presenter mode. Oh good. Everybody just wants to join my presentation today i think. Hang on, let me try this again. Im going to stop sharing and try again. Even with a dress rehearsal, im having challenges. How about now . Yes. Wonderful. Again, my name is Abigail Stewart kahn, the interim director. Thank you for inviting me here today. As i begin and throughout, if anyone knows me, i spend a lot of time on gratitude and i think thats important during a Global Pandemic to lift up the people, people experiencing homelessness whose voices we listen to as closely as we possibly can, all the way through all of our stakeholders to thank them both for their input, guidance, and collaborative work. I would like to thank the members and the board, and i know were joined by the homelessness coordinating board, our remarkable nonprofit partners, h. S. H. Staff and partners of the covid command center. So im delighted to share an update on the city and county of San Franciscos homelessness response system, knowing that i am simply the ambassador of this message. Im hoping the slide had advanced. Chair, i can see your face, so if you can continue to give me some visual queues, i would appreciate it. So the department of homelessness and supportive hou housing launched. We wanted to create a laser focused coordinated response on homelessness. San francisco has been very ahead and has a lot to be proud of thanks to many people on this committee on unique approaches to homelessness. The founders of the department felt that the city was behind on a coordinated and strategic approach. The department formed and formed its mission to make homelessness in San Francisco rare, brief, and one time. Im very happy to speak about what those terms mean. Theyre quite defined in our strategic framework and in National Best practice. For reference, i joined the department in august of 2017 as the director of Strategic Partnership to take the Community Input that had already been collected before my time and the National Best practice and to issue the five year strategic framework in october of 2017. So, thats just one milestone. You cant just write a plan. Since then and even during that time, we were hard at work. The homelessness response system is really the foundation of all of our work. We talked about six core components of the homelessness response system. I will say there is so much conversation appropriately about homelessness in San Francisco, so one thing we find very helpful is to focus on these six core components so we can locate and navigate all of the service rich environment and have people understand at least for the department where these pieces of work slot in. So we have outreach, the department and the department of Public Health, do a tremendous amount of outreach, some through Civil Servants and some through contractors. We do problem solving and pre y pretty prevention work, and we can get into what each of these mean. We launch coordinated entry, which is a National Best practice that had started up in San Francisco and moved more robustly with our partners in the last two years. We have shelter, housing, and the housing ladder. We will get more into the definitions of these, but i will always come back to these as the six core components of a strong homelessness response system. So as we go through, we have outreach around street homelessness. Most famous among these is the Homeless Outreach team. You see the pictures here. This is a combination of Public Service and Civil Service, as well as a nonprofit provider. They do work across the city. Their mission is to look for the most vulnerable among the Homeless Population but also to provide basic resources to everybody. So here you see a mask being handed out. We had to pivot back and forth, for example, between masks that are important for air quality and masks important for covid. This is a team thats constantly learning. They are responsible for bringing inside over half of the individuals who have come into the shelterinplace hotels just for some covid context and theyre not the only outreach guests in the field. We have other contracts that focus on young people and so on, so that we can be culturally responsive in our community. Several years ago, the department of Emergency Management and several partners formed the healthy streets Operation Center, which is currently under the department of Emergency Management. So our teams are part of it but not the whole part. And there is a lot of really good work that has been going up and down. I feel like were in a strong position with our partners now. Weve been focused during the pandemic to update our Prevention Strategies and allocate money that we already had available for homelessness preventi prevention. I would be happy to get into the details of that and that would be important for the committee to attend to. Im not trying to pass judgment about the importance, but for us, they focus on the moment of housing crisis so that we have a better understanding of focusing our resources of the homelessness response system to people who we have much more predictability will become homeless or are literally homeless if intervention does not occur. Im hoping im being clear there. All very critical parts of an infrastructure, but ours zbbegi at the moment of housing crisis. Homeward bound partners with the community to connect. Incredible stories here. There is also increasing training for all of our systems of care. Theyre training us and were training with them, on how we say to people, we dont want you to come into the homelessness response system. Even the best shelter is not where i want you to sleep. What does it look like to get safe tonight . Then somebody might say i can stay with my uncle if i was able to do x, y, or z. Some of this has adjusted significantly because of covid, so ideas like staying with your uncle has become more challenges and we know the resilience of people experiencing homelessness is profound. So we continue to lift up these prevention diversion strategies. Coordinated entry is our pathway to equity. We will need to go into a deeper dive on equity with this committee but i just want to focus why coordinated entry is important. It helps us to preserve scarce resources for people who are the most vulnerable among the population. Those in the hotels are the most vulnerable to covid and then we also have a population of people who are most vulnerable longterm homeless. And the Assessment Approach allows us to understand how to match which housing intervention or which treatment, not to make this some sort of a treatment based approach, not the sense of medical treatment, but the best interventi intervention. I used to say many on the committee are experts on this and helped us write this strategy. I wanted to make sure were laying the ground work. As for the patients and the people that are in fact experts in this and feel free to add comments as we wrap up according to the discretion of the chair. We have coordinated entry for use, coordinated entry for adults and for family. We do not yet have all of the data nor do we have the single unifying database available to fully drive this system and it could be interesting at some point in the future to learn how we are where we are accelerating our data work. We are fully launched and we are Just Launched. It was Just Launched when the pandemic hit. We are intending to use the pandemic to speed coordinated entry process and navigation to housing. Shelter is often the most talked about in our community, certainly the prop c legislation imagined some expansion and values the importance of shelter for safety. I will just add that we consider safe sleeping villages, for example, to be a form of shelter, although they dont have a roof over them or a lock on the front door. So during covid, they have been a very important response. We know from our unhoused neighbors that these kinds of outdoor safe places to be are something that is very valuable to them and we learned quite a lot from National Best practice and also from our own experimentation really during covid about what a successful safe approach and what is a more challenged one. Of course a little bit older in San Francisco, our navigation cent centers, we change our process during the winter and inclement weather and our traditional and temporary shelter. Its confusing based on the term because people are not on the lease so its not a permanent exit from homelessness. So its just relocating people and housing. We know housing is the solution to homelessness and we know more than ever during this pandemic that housing is healthcare. I want to lift up the providers and the h. S. A. Staff out there who work everyday to maintain peoples housing. We have eviction, we have a low eviction rate in our vast permanent Supportive Housing portfolio. And permanent Supportive Housing was begun by many of you here in San Francisco. Its something that we can be very proud of. We have permanent Supportive Housing and other Housing Solutions for every aspect of our system of care. One thing that is not as frequently discussed are mediumterm Housing Solutions. Some people call these things like rapid rehousing, which we can get into. We locate that again in our housing bucket. Another thing i want to draw attention to is during the pandemic, with philanthropic partners, we have a subsidy pool, which is a way to pool resources and create a scattered side approach to housing. Here you see a beautiful picture inside a building. This is a beautiful mosaic made by tenants in that building together before covid when people could do art projects together and we visited that building and admired this art tremendously. People think of it as a building, but we need to continue to push ourselves to think of permanent Supportive Housing as Affordable Housing with Supportive Services and the wear is flexible. You can have a scattered side approach where a caseworker may visit you or call you, or you can be in this one picture in this beautiful work of art. A new component of our response system. Everything about homelessness is about flow, about preventing people from coming into homelessness an once the crisis occurs, flowing people out as quickly as possible. While permanent Supportive Housing needs to be permanent, there are people who, when housed for many years or for a short period of time want to move on. In an environment as expensive as San Francisco, while they dont need the rich social services anymore provided via permanent Supportive Housing, they may in fact need Affordable Housing. The moving on initiative is a model where we paired a Housing Authority voucher with services, lighter services, and people moved on into the community. Since the Housing Authority was unable to continue to provide those vouchers, then we have some hope on that front going forward. We pivoted this approach to be buildings that are in different communities, buildings that have more amenities, so we can help people to move on. We continued that during covid. Taking steps many months ago before covid, if anyone can remember that and before as the department formed, we talked to people experiencing homelessness. We talked to expert providers. We talked to expert h. S. H. Staff and we asked what does it look like for a person experiencing homelessness . This is the image that drew me to this work. We saw a similar work in the Family Violence work, which is where i come from. Each hour represents an actual path that a person experiencing homelessness has to take. An interview or conversation where they have to share their story of perhaps why they became homeless and what help they need. We know as a community this is not a trauma informed approach, even though each person in each of these blue squares wanted to do the right thing. So we had this fractured system of care, robust, but fractured. The people experiencing homelessness would have a different experience of a system based on which door they knocked on. So if they knocked on chair williamss door and she was one of the best caseworkers in the city, they would have one experience. If they knocked on the caseworkers door that was newer, they would have an entirely different experience. It relies on the person experiencing homelessness, meaning people with more resourceso resources often do better. We want to take care of the most vulnerable. This is the homelessness response system now. This image is not perfect. Were constantly trying to improve upon it but i hope people can see themselves and the six core components located within here. You can see where the healthy streets Operation Center is working with encampment and working into the coordinated entry system. Our h. O. T. Team can do assessments in the field. We know that hospitals, schools, and other mainstream systems can come in and we need people to walk up to a front door and refer themselves. So the first thing that happens when you come into our system of care increasingly is a problem solving our diversion conversation. So in our updated figure, that word assess and problem solving is reversed. We want to say how can we help you solve your homelessness tonight without longterm dependence on this system of care. We know this wont work for everyone but for other communities like connecticut, they seen a 75 reduction in families experiencing homele homelessness through diversion alone. They have been able to close shelters because theyre able to prevent people coming into this system of care. After a problem solving conversation, if there isnt a solution available that day, we remind our people were working with, problem solving is a continuous resource. We will have that conversation with you again. Right now lets do a coordinated entry assessment, which was developed with the guidance of the local homelessness coordinating board and the various subcommittees to create a system that prioritizes excuse me, my dog has just entered. Shes okay, she wanted to see everybody. Excuse me. So, the so we do an assessment and somebody receives an answer that your housing referral status, meaning youre considered one of the most vulnerable and we want to get you access to a problem solving status. We go back to that diversion conversation. This gets refreshed every six months because we know circumstances change. People unfortunately get sicker or been homeless for longer and they change our status for system of care. Based on that, housing referral status or problem solving status, people are referred to the available and right housing intervention. Increasingly in our family and youth system, we have a wonderful rapid rehousing program. Thank you to the providers that work on rising up and heading home. Then we have the most permanent Supportive Housing of any community per capita in the country. We know that its a valuable resource. There you see the housing ladder, ultimately the goal is people being able to be housed on their own. When the pandemic became with us and real for us, we asked and no one expected coronavirus. We in fact saw we needed to doubling down on it. The definition of vulnerable needs to change on who was likely to pass away from the virus. We wanted our system of care to divert people out of the system while preserving the scarcest resources for the most vulnerable. They operated by h. S. A. Staff or nonprofit providers, it has not only not stopped and declared essential services but in some cases, they accelerated. This is really something to be proud of. In many communities, things have just shut down for people experiencing homelessness. While we still have so much work to do, we really want to acknowledge the work of our front line workers. It allows us to respond to these dangers. We strengthened our commitment to equity in the face of the i would struggle with this language because the Racial Injustice has always been there but now were experiencing a much more visible version of it for some people. For those of us in this field, housing justice has been part of, or the reason we are in the field, but i think nationally were at a moment in time where conversations about building equity and housing justice is even more critical. Again, we continued to serve and provide all of our essential services, which allow us to serve more than 13,000 people in our community. We have achieved some of our strategic framework goals. We helped to create a better, more organized system responding to street homelessness. We were able to functionally end unsheltered family homelessness. This does not mean that a family may not become homeless tonight. It means we have space in our system of care to shelter them tonight. If i were to become homeless tonight, there is space at a shelter. That has maintained during covid, but we also know that families, there may be more becoming homeless. Were working on the data around that but we know that many people dont want to come into shelter because of coronavirus. Many unsheltered folks tell us they want to come into shelters so being outside feels more dangerous, everyone understanding the risks of the coronavirus. We completed a detailed plan to reduce Youth Homelessness when the strategic framework was being written, the community was part of a deep process and we didnt want to publish a goal or process related to youth that would up end that deep community process, so we worked with that group to set a goal of a 50 reduction in Youth Homelessness, which is an addendum to our strategic framework. As we talked about extensively, we designed and implemented and we are now improving the coordinated the entry system for adults, families, and youth. We did that ahead of schedule. We now see the pandemic has really reversed that work and were working with partners again in a covid safe way to bring people inside. We have a lot of work to do. We need to implement performance accountability across our programs and i want to slow down here for a second and talk about just how important this is, how important this is to this mayor and this board and how difficult it is to set systemwide, citywide performance metrics that are based on National Best practice that resonate here and to hold ourselves accountable to it. Everybody is doing good work, but it doesnt mean that theyre meeting the metrics. So we have a lot of work to do here, to drive accountability. We set a goal to end family homelessness, to reduce Youth Homelessness by 50 and chronic homelessness by 50 . I will stop there, wrapping up again with my gratitude and some support from partners at h. U. D. Noting that youth San Francisco has shown the country what a compassionate, data driven Public Health response to people experiencing homelessness due to covid19 could be and you are bold in rehousing individuals during and post covid. I will take that quote and pass that to all of the community as we have to be proud of and we will not stop there. We have so very much work to do together. Thank you for your time. Thank you director stewartkahn. I want to recognize that member miller has joined us. If Committee Members can please raise i dont know if it shows up as blue, but raise your hand in the chat area, i will be able to call on you for question. All right, vice chair dantonio. Im sorry, i have a good amount of questions, but i guess a good place for us to start would be just some definitions. So can you define family homelessness for us . So the citys definition, if i understand your question correctly vice chair excuse me for one second. Come in. Im so sorry. This meeting ended being scheduled when i have first grade class. So im trying very hard to respect my time. Vice chair, i know youre right there with me. So, the definition of homelessness is there is an h. U. D. Definition of homelessness, which is focused on literal homelessness, unsheltered, living in a shelter. The citys definition includes people who are doubled up and living in unstable living conditions. So, sometimes in our strategic framework we pivot between an h. U. D. Definition and the city definition and we try to make it clear when were making that distinction. So in this presentation, which definition were you using . Thats an excellent question. You mean when we we use the citys presentation generally in our strategic framework and then our modeling is sometimes based our data modeling, which is now outside covid, its based on an h. U. D. Definition but generally we refer to the citys definition. The one caveat is [inaudible] okay, so a follow up on that. Coordinated entry is mandated federally. When were talking about coordinated entry homelessness, are we including the h. U. D. Definition or families living in s. R. O. S or things of that nature . Thank you for that clarification. In San Francisco, families who are h. U. D. Definition, literally homeless, or living in shelter are welcomed to a coordinated entrance. People living doubled up in an s. R. O. [inaudible] so all definitions of family homelessness is welcome and is part of the implementation, but it [inaudible] im sorry, what did you say . When you done question, remute yourself so the answer is clearer for everyone. Okay. Okay, thank you. Yeah, i guess as far as prioritization, what happens if you have no prioritization . Thats also on my list of questions. Sure. So, i want to make sure we really focus on appropriate language. We rolled the priority status. We now use housing referral status. Its important and i am sure that the committee would agree that everyone experiencing homelessness is a priority to the city, but we wanted to distinguish between housing referral status and problem solving status. So to specifically answer your question vice chair, the if you are not housing referral status, you are problem solving status. That would mean that you would have access to homeward bound, to one time grants that could help you get yourself rehoused, to all of the homeless prevention grants available, and connection across the city. You would continue we hope, connected to the coordinated entry and access point system so that if things changed in your life, your status might change. One of the things that is super important is that we be honest with ourselves and with people experiencing homelessness about the resources we do and dont have. In that kind of spaghetti picture, where everybody went everyo everywhere, they often got this answer. Im so sorry this is happening to you. I want you to maintain hope. Im going to put you on all these wait lists and hope something works out. Without a lot of understanding, say you were the case manager, of what the realities of that was and less understanding for that person in crisis. So, it was unintentionally, not particularly honest. So as difficult as it is when somebody is not housing referral status, we find that people appreciate the honesty and it helps us to dig in on that diversion conversation. Okay, sorry. I have another follow up question. That is also on my list. What does the one time diversion or the one time grant, what does that look like . How much is it . What does it look like . Great question. So i like to come back to you with the specifics because its different for adults, young people, parents, and families, and i dont want to get the numbers incorrect and have to correct those in a public record. Its a relatively new process and much information is available on our website and were working to improve that area of our website and then also as the coronavirus hit, we were adjusting it further. So thats why these numbers are not as fluent as i like to be and i prefer not to get them wrong but i can offer to get that back via chair or vice chairs direction or Controllers Office direction on how to provide that in a way thats in alignment. Thank you. Sorry, i dont want to monopolize but i want to go through my questions. How often do you get feedback from the community, whether its youth, adults, or families, and how do we find that info publicly. Specifically on coordinated entry vice chair . Yes, thank you. Experiences with coordinated entry. Interesting, let me give some framing for that question. As you noted because its a federal mandate, coordinated entry and federally funded in San Francisco, it is governed by the local homelessness coordinating board, which formed subcommittees, which are public and highly attended on each piece of coordinated entry used. There were also groups of people experiencing homelessness in each of those categories. As a coordinated entry experience, there is a standard kind of Satisfaction Survey and updates that happen. As we begin this process, the intention was to keep going back to those groups and to any new groups we needed to talk to, to the people that have been through coordinated entry, those people who have been housed by it and those who it didnt work for and say what worked and what didnt work. One thing that we know isnt working is speed. Were doing very well getting people into the system of care. We have work to do particularly around trusted relationships with transgender communities and we formed some new partnerships around that. Im happy to get into much more of that, but i dont want to take too much of the committees time. So we know that people kind of come in the door in a relative equitable way. We believe the assessment itself, based on data and feedback, not just our belief and hope, our fact based belief is that it prioritizes people relatively equitably or proportionally to their experience of homelessness, based across various racial groups for example. We know from that moment that someone is housing referral status, sometimes the speed to housing is too slow based on National Best practice and our own metrics. So thats the place we gotten tremendous amount of input and weve been working for far too long. Youll hear my frustration here, for far too long to speed that process. I am more hopeful this month thank you noche, she is also hopeful, about our ability to push through that and picking up the stones saying whats going on here and how we can fix this, even during a pandemic and were not there yet. You didnt ask me my perspective, but i wanted to make sure people in community here know we are listening to people about this. Okay, thank you so much. Yeah, i know that was part of obamas recommendation, that every six months we get feedback from the community accessing cord nateded entry. I feel that going into the shelters and the streets, seeing peoples real experiences, to see how we can help fix that. That would be really important personally to me, i think. Thats something ill be sure to bring back to the local homeless coordinating board as well. Thank you, and my last question is about the moving on initiative. I know that has been successful in san mateo county. So, i guess like you were saying that were not receiving vouchers anymore for h. U. D. For that. How does that work now . Are we connecting them to Affordable Housing to project based section 8 . What does that look like now . Yeah, i think one of the hardest things that happened in the sort of very short history of h. S. H. Is pairing it with moving on. It was a Successful Program with strong evaluation behind it and its changing lives. Its not only exiting people from Supportive Housing but creating more Supportive Housing. So thanks for acknowledging that other communities have continued to have access and were hoping that we get these back online. Were getting good signs from housing authorities, so we are hoping we can sort of unpause that soon. In the meantime, we have been creative with the larger, stepping up or housing ladder. So if we find a building that has better amenities or is in the neighborhood that is not traditionally associated with permanent Supportive Housing and its one were bringing on through our pipeline, we will designate that as our housing site. We have one opening up with many people ready to step up that housing ladder. We are also looking at, i mentioned the flexible housing subsidy pool. Were interested in whether a scattered site approach with a subsidy, but with less resource, Supportive Housing resource, and the early funders of that initiative is very interested in that as well. They were early funders in moving on. I think we have a lot to work on. And youll hear that im a constant optimist from when they turn the pipe back on, well have different approaches to the housing ladder in San Francisco. Thank you so much. That was my last question, thank you. Thank you. Im going to member friedenbach and then member leadbetter. I want to remind the community, we have 30 minutes for this item before moving to the next item. Member friedenbach. Thank you so much for the question. I just wanted to circle it back to the initiative as were talking about definitions. You defined homelessness in the initiative and it includes people who we typically think about as homeless being on the streets, living in an abandoned buildings or cars, but it also includes families who are in s. R. O. S and families who are doubled up. So that was very intentional. We dont really see much difference between in our conversations with families, families who are in shelters where there is a private room for families and the family who is in an s. R. O. , except for the time limit thats imposed on them in shelters and in many situations, the families who are in the s. R. O. S are in the worse situation and the development of their children is significantly delayed because of the unhealthy housing theyre living in as is the developmental delays. Often times doubled up, our situation is very unsafe. You know, frequently involve trading sex for a place to stay, et cetera. We want to dissolve those unnatural barriers that we put up to make sure that impoveri impoverished families have a place to call home. The other part of that is important for us to remember that came up is that the funds have to go to currently Homeless People as we define it. Housing ladder is not a prop c allowed expenditure because people who we would be using that on already have housing. I think there are other funds that can be utilized for housing ladders that we can try to capitalize in our system, but that would be outside of the our city, our home scope, in terms of how the money is spent. Thank you. Thank you member friedenbach. Well go to member leadbetter. Thank you abigail for that presentation. I also just want to say hello to the public out there. I also received a lot of interest from the general public and i know that there is a lot of support from the community. Its strange as we sit here and see everybody, but we know that youre out there. Thank you for the time youre spending with us. I think we are in charge of creating a plan to end homelessness, and its very helpful to see the basic framework to which were trying to do this in the city. I really want to help the city of San Francisco to get to a point to end homelessness that really looks at the data. The question is and what i hope to see today and maybe well get to it is how are we identifying ho homeless [inaudible] really understanding the volume of homelessness and what it takes to end it and what are the costs. You know, so i ensure that there are communities out there doing things like system modeling, which really puts some numbers to this work. I hope we can get there. Thats what goes on in my mind. Whats the need an whats the gap and the gap is tremendous. We all know the gap is tremendous. Theyre not pleasant numbers to look at. They are difficult numbers to look at when you say what its going to cost to end homelessness. With prop c, we have an opportunity here. So i think it would be really great to look at examples. So it would be lovely to see the initial framework of that and how we incorporate that in. And we could potentially look at the system modeling tools they u used. I think it would be very exciting to move in that direction. Thank you. We will dive into that data but i want to thank the interim director for your presentation and are there any other comments you want to make before we take Public Comment . Thank you for that opportunity. I think San Francisco is at an incredible moment. For those who worked on the passage of this proposition, thank you and congratulations. To this committee, thank you and congratulations and you have a tremendous responsibility and the Department Joins with you in that responsibility and that mission. I think to community and people experiencing homelessness, we continue to want to hear from you. We continue to evolve to meet needs and to member leadbetters comment, we did do modeling. Some of it is challenged and data is all over the place with covid, but we look forward to and we were asked at future meetings to bring that forward. We look forward to continuing to bring that forward at the guidance of this group and just really want to say how proud i am to be in San Francisco with a community that aligns its values to take care of the most vulnerable and thank you all and thank community for your care about this work. Thank you, i see the member has her hand raised. I know were out of time here and i want to leave time for Public Comment but thank you abigail for the great presentation. I know you are also tracking a lot of data and placements and i guess i have questions on whether youre tracking inflow and what placements you are tracking. I know you are. You guys have some great dashboards and i wanted to know for the commission, what would be the most helpful thing for us to look at to get a sense of the benchmark and the tracking that youre already doing, so that we can build off of that, to kind of inform our work with your data. Sorry, were you asking me to weigh in on that or are you making that statement . If theres a place that we should be looking for that or whether we can ask for that to be brought to the commission in some way. Great, so i think what i love to do is to take that guidance back and make recommendations to this committee. For those who want to do homework, we have a huge amount of Data Available on our new website. A lot of it sits on the coordinating board report and we have public facing dashboards that give you a sense, but its just the tip of the iceberg of what we know and what we have visualized for data. Were constantly pulling sources of data and creating new visualizations and tracking. I think inflow is really important. I think nationally i was on the phone with a National Reporter yesterday. People are having a hard time understanding what covid will do to inflow. Any inflow data we had beforehand, people dont know if we should rely on it, multiply it on something. There is some research but not a lot. We would love to think about the kind of data thats relevant to bring here so we dont go into that data overload and get nowhere. What i hope and i believe the committee will continue to ask us for is this race equity data related to all of that. Are more people of color becoming homeless because of covid . So every time you ask for data, im going to hope youre also asking for me databases on equity. Thank you. Thank you so much. Now were going to go to Public Comment. Do we have any Public Commenters . Members of the public who wish to provide Public Comment on this item should call 4156550001, access code 1461188903. Then press pound and pound again. If you havent already done so, please dial star 3 to line up to speak. A system prompt will indicate that you have raised your hand. Please wait until the system indicates you have been unmuted and you may begin your comment. Please note you will have three minutes. We have a caller on the line. Welcome caller. Hello, my name is chris and im the director of chronic Homelessness Initiative at tipping point. I wanted to say a couple things. First of all, thank you abigail for the presentation. It was really helpful. Also thank you to the commission. We are in an exciting place in San Francisco. We cant effectively address homelessness in the next couple of years. We look forward to working with you to do that. One of the things i wanted to offer is that we work with both the department of homelessness and d. P. H. To do some contracting work with consult tavents to give us the analysis thats necessary to create the plan that well need to effectively address homelessness. We want to offer that in partnership with the commission and the department. Just to follow up on something that julie said, we would be interested in helping to do some systems modeling so that we can understand what are the populations of homelessness, Homeless People, what are the strategies to house those populations and what are the costs of that. So that we can create a very coordinated and focused strategy for each group of homeless folks with the intent that we will be able to have the right strategy for the right person, at the right time and i look forward to working with you all to create that plan and strategy. Thank you very much. Thank you. Are there any further Public Comments . Checking now. There are no callers on the line. Thank you interim director and members for your questions. We continue the conversation and will get back to you in terms of data and thank you for being here. We will now move to item 4, a background presentation on San FranciscoBehavioral Health and possible action by the committee in response to the presentation. We have Marlo Simmons, the acting director here with us. So director simmons. Hi, good morning everybody. I appreciate you accommodating the schedule switch and abigail especially appreciate you going first. We have state auditors here this week. So, i am excited to be here. We were really, really pleased with the recent court ruling and moving up what we thought would be a delay in the funds coming to San Francisco. We are very committed to working with this group to realize the internet behind the legislation and we are also very pleased and of course not surprised that Mental Health and Substance Use services came out as a top priority and really giving us an opportunity to do better. So i was asked to provide an overview oh, can i im not projecting the slides. Can you project slides . If you want to pass me the presenter ball, i have the deck up ready. Great, passing it now. Thank you. So we can go to the next slide. So i was asked to provide an overview of Behavioral Health services across d. P. H. And to give an update on activities we have going on around Mental Health s. F. So we can go to the next slide. So there is a lot of information that we tried to simplify into one slide. So Behavioral HealthServices Follow a broad continuum of care. If you were to see a full map of all of our services, it would look much like abigail before coordinated entry slide, so we have a lot of things happening, but theyre not as organized and accessible as we hope they will be very soon. We serve about 25,000 clients a year in our Mental Health and Substance Use treatment services. We also serve tens of thousands of people in our prevention and Early Intervention work. Our budget as a whole for Behavioral Health is 500 million a year and partnerships we have with community organization. We contract with about 80s. B. O. S and they deliver about 60 of our services. For Substance Abuse services, its almost exclusively Community Based organizations so were looking at two third of our services delivered. We cannot talk about the system without acknowledging the importance of our c. B. O. Partners. So looking at this triangle, it shows the range of services we offer. So our prevention and Early Intervention services are designed to be out in the community, low thresholds in identifying the early signs of Behavioral Health issues. We have resources invested in child care programs, schools, in homeless and senior drop in centers and care clinics. Some examples of the work that would be relevant for this committee and the population experiencing homelessness are partnerships with organizations like central city housing, senior center, just to name a couple and as you move down, our continue of care, we have outpatient and intensive Case Management program. Its really in anything that it takes level of Case Management. Next we have residential and crisis programs followed by the most restrictive and reserved for the highest acuity clients, the facilities and hospital stays. Our clients can and do enter our system through a ton of different entry points. Over the years we acknowledge and this is one of the things we are pleased to see, a recognition with our access and flow through the system needs to be improved. We have a lot of good places in place, but we do need more. Its about helping people succeed in the program. So we actually operate two managed care plans. So similar to the San Francisco health plan or kaiser, we run a managed plan for Mental Health and one for Substance Use. They are both intended to serve the population so there two in San Francisco and if they need services above what you would get at a primary care setting, they would get it through us. Each of those systems have different rules, different privacies, and how we integrate those services has not been as easy as we would have liked. We deliver services and purchase them from c. B. O. S and we have our Early Intervention system. In thinking of the triangles over the years, as we had lean budget years, we had really prioritized services that generate revenue. So that leaves us with a lot of the services in this triangle. So the beauty to prop c and the focus on Behavioral Health, this is going to provide us with flexible revenue that we had not historically had access to to build all of the things we know we need in addition to a medical treatment system. There is a last point i wanted to make about the system. The resolving door approach had a quote in it saying you will hear their suffering a their brillian brilliance. Its talking about the people experiencing homelessness and the challenges they have in accessing the services. That quote is so powerful and hearing their suffering, we hear that frequently. We know there is so much room for improvement and the brilliance piece goes to the values that they hold, a recovery value that anybody, even people with Mental Illnesses can live full and meaningful lives. One of the ways you will see that showing up is in our peer workhorse. So ten years ago we had six peers employ in our system and now we have 350 peers. So people who have come through the system has established their own recovery and are now giving back to the system. When it comes to engaging populations, the staff is magic and brilliance is such a great word for the staff we have developed over time and to see people going from receiving services to delivering report really has been just an incredible experience. Next slide please. So we do have room for improvement, we do serve a lot of the population already. Between Substance Use and Mental Health, were seeing 25,000 people a year. There is an overlap between the two systems of clients about 2,000 clients that receive services in both. If you look at the top chart and on the far right, it shows the percentage of our clients in 1819 are experiencing homelessness. So we have a large percentage of this population. I also, you know, a lot of the focus is on serving the p. E. H. , or i hope that we dont forget the needs of children in youth. We done a lot of work in the system of care Behavioral Health, but there are a lot of Vulnerable Children and families we serve that i want to keep in mind for all the system improvements. For our Transitional Age Youth Services that we really spent a lot of time working on in the last few years, weve embedded Behavioral Health resources in all of the youth access points. We better integrated behavioral Youth Services across the housing system, especially with larkin street and also expanded specific mobile services. So, we have some foundation to build from and then the last thing i wanted to say on the slide is again, i think we have a closer relationship with the homeless response system than people realize because our services are not always visible or well marketed. As of last year, looking at the 43 agencies or showing up in the system, we have contracts with about 16 of those agencies that total about 26 million. So, while we have all the improvements, we also have the rich array of investments that we can leverage in the work were doing. So next slide. So, within d. P. H. , in addition to those Services Managed by Behavioral Health services, there are a lot of other services across the department. So, at the hospital, we have an inpatient psychiatry unit, psych emergency services, which is something that i think this group is well aware of. There is a Behavioral Health center which has a longterm Residential Program for older adults. We also do Psychiatry Services for the residents and Outpatient Services in addition to Substance Use and ambulatory care. And ill talk about the other pieces in that. We worked hard as a department under the leadership of hammer to build out the Behavioral Health structure in am bad ne news ambulatory care and ill touch breaiefly on that in a minute. Next slide please. Thank you. So i wanted to highlight some of the work weve done in the last couple of years, specific to community experiencing homelessness and the first one is we had one time funding from the state about a couple years ago and it lasted about 16 months. It was called the homeless mentally ill outreach and Treatment Program. It was a grant from the state, again, one time, and what we did with that funding is we invested in additional peer services, and implemented a mobile Harm ReductionTreatment Program with the Harm ReductionTherapy Center and we worked with ucsf citywide to develop a Case Management for individuals with a high level of need and really helping them to better connect. A lot of these resources have pivoted to support the work were doing in the shelterinplace and because this is a one time funding, we are really looking for resources to continue this and these services seem alone with the mission and intent of prop c, so the timing of the court case is very hopeful for that, so these programs continuing. The shelterinplace hotels, which was an amazing achievement by the city to help 2,000 people move indoors, and of course they have been working to address the Behavioral Health needs of that population. So weve done some training with the on site staff at the hotels in understanding Harm Reduction. We implemented a consultation line so staff on site who see concerns or become concerned about someone living in the hotels can call and have either someone come out or just talk through what theyre seeing. We engaged our peer support that i talked about and pulled our peers into working directly with the guests in the hotel. Theyre doing individual group, inperson and using telemedicine or telecare tools. We also expanded low threshold services, again with Harm ReductionTherapy Centers to do on site support across the hotels and then similar to what we did with the grant, wire contin were continuing to have citywide do whatever it takes when someone needs an intensive level of services. And from this work and just from years at d. H. S. , when were talking about supporting clients with Behavioral Health issues, its way more than just treatment. We need to help people get access to housing, help people find work, find meaningful social connections. So there is a quote that i love from one of our clients that they said as my life got bigger, my illness got smaller. It really talks about how helping someone to build their life can sometimes be the best medicine. So when we talk about Behavioral Health, we want to make sure were including things that are beyond behavioral treatment services, which is also a big part of the picture. Next slide please. So many of you are probably familiar with the programs listed here. They represent really across d. P. H. Some of the most effective and visible investments that weve made in serving people experiencing homelessness. I wont go into a lot of detail but medicine, sheltering, the health system, nursing staff that we have across the supportive handoutsing sites, medical respite, and we are creating we have recently created a new division with an ambulatory care. We recently, just in the last couple of months hired a person managing that division. She came from h. S. H. , so that division is managed by holly hammer, which i mentioned earlier. Theyre both serving them as holistically they can and integrating services. So most of these programs here as Behavioral Health integrated, but we definitely have opportunities to enrich whats available in these programs and also be intentional in building bridges to the treatment system and then you know, of course expanding the treatment system. Next slide. The urban health clinic, another d. P. H. Program with a lot of integrated services with Behavioral Health. Again, we hope to expand the capacity of this clinic, as well as improve the linkages. Next slide. So, we have a lot of opportunities to improve. You know, central City Hospitality house talked about the current reality were living in and what he said and i may not have the quote exactly right, but what were seeing on the streets today is this collision of racism and poverty and Global Pandemic. Its playing out on the streets for the whole world to see and its driving out awareness of the failures of our system and driving a louder call for help and improvements than we ever heard. Now we have all of that, plus this incredible amount of resources to bring all together. There are a lot of ways we know we can do better and just a couple examples. You know, in 1819, we discharged clients back to homelessness and we have a lot of clients, about 7,000 clients a year that get discharged from emergency Psych Services and 30 of those get discharged without connection to care. We know in the last eight months that we had 450 Overdose Deaths in San Francisco. So there is not a question about the critical level of the need and now having these resources available, like we really i hope you guys can join in some of the hope for our system to improve. So some of the opportunities we have is that we in thinking of Behavioral Health services across the system, we have learned that we really need to better support the front line staff in those programs. At the end of the day, they are the front line. They are the first ones that will see the clients, the first ones that will know there is an issue, and training them to understand how to address Behavioral Health issues, interact with clients that have them and understanding when to call for help and how. We need to work on that, better outreach in marketing to educate the community about our services. We have a lot of things that people dont know exist and that navigation and better care coordination, we need services, but we also need the glue that holds it all together. We know that there are specific access to barrier issues, or barriers to care that we need to address. We know that we need more treatment beds, intensive Case Management slots and prevention treatment and the street Crisis Response work were doing. We hope it will address some of the challenges of street crisis were seeing. Next slide please. So there has been in the last few years, this growing interest in better meeting the needs of this population. So we had great work happening under the mayors leadership with Mental Health reform and the work of dr. Antoine and his team. We now have Mental Health sf legislation thats come out and provided a great framework for much of this work. We also for Behavioral Health services, have been working on these improvements over the years. Now we take all of this work and merge it together with prop c and we have this common set of priorities, which gives me hope that this merging can be done successfully. Know the target population, know that we need to increase access points, the hour and services that are available and coordination and up our game around Harm Reduction. Next slide. So ill talk about Mental Health s. F. And some of the things were doing in that area. New legislation by the board and the mayor in september, go video hit. The target population for Mental Health s. F. , specifically calls out adults experiencing homel s homelessness. They have Mental Health and Substance Use smaissues. It talks about improving the system for all medical clients. This will benefit every other person served in our system. There is legislation, they want for our services to be more mobile, meeting people where they are, making it easier to access services, provide more locations from respite to treatment, more capacity and improving the care coordination. Its a really great vision. There obviously is profound alignment with prop c and what the legislation set out to do. Next slide please. For d. Pvpt d. P. H. , its similar to how we did our project management for the epic roll out, which is our Electronic Health record being fed across the department. We need strong project management support and we are also getting a lot of support internally from our data in i. T. Partners, h. R. , hiring is a huge issue for our system right now. Were of course pipelining and our equity work needs to be embedded in all of this. So the five main areas, and ill talk about a couple of these, is the office of coordinated care, which legislation spells out. Street crisis teams, the Mental HealthService Center, new beds and facilities, and the Implementation Working Group, which is a body similar to this committee to oversee and help around the Mental Health s. F. Implementation. We also have a new director for Behavioral Health services. So the position that im currently sitting in is going to be moving out of ambulatory care and higher up in the order chart and will be reporting directly to dr. Colfax. Then we will be starting our Implementation Working Group some time were aiming for december. Hopefully that date will be set soon. Next slide. So we know we have things that need to happen in order for us to be successful. The project management support, we are estimating about 50 new Civil Service positions that we will be hiring, many more resources going into contracts. We do need to invest in a lot of staff to make all of this happen. Were also trying to fill a current 90 vacancies across d. H. S. We have some foundational improvements we need to make that really show our progress and outcomes. Then we have to closely collaborate with Community Groups. There are so many people invested in Behavioral Health improving that we need everyone to be working towards the same vision and there is so much alignme alignment and finding space. Real estate continuing to be a problem in San Francisco. Its a little bit better with covid but still a challenge. Next slide please. So the office of coordinated care, again, a foundational big piece of Mental Health s. F. Im not going to go into the information on the right for the slides coming up. Were really injures just wanting to show that we want to come up with implementation, deliverables, timelines, so there will be more information on that. I wanted today to talk a little bit about what the office of coordinated care is and one of the goals is that we will start to see coordination across d. P. H. And really the city when it comes to Behavioral Health. So even the private hospitals and everything d. H. S. Serves needs to be better connected. We need to let the Community Know more about our services and train our staff and partners with consultation and linkage. In response to people experiencing homelessness, Mental Health s. F. Is very concerned and increase the availability of Case Management across the board and thats something i know is important to this committee and looking at that Critical CareManagement Level of services that is very intense, usually for the term to help engage people and of the friendly stocking approach to get people in Case Management. Anything it takes level of care, but it could be ongoing for a couple of years. We need more Case Management capacity in our outpatient programs so we can see more clients and meet their needs and encourage people to show up to appointments. So the office of coordinating care has been the driving engine behind the implementation of Mental Health s. F. And the community. Next slide. So this is one of the pieces of the work, ahead of the curve on the timing. Weve been working on street Crisis Response team and theyre basically there are about 21,000 calls a year for responding to a mentally disturbed person, which is not an ideal term, but thats just the coding for the call. What we want we dont want the police to be the ones responding to Mental Health crisis on the street. We want our new teams that were building to be the ones to respond. So these new teams are made up of a paramedic, e. M. S. , Behavioral Health clinician and peer. Those teams and i think yeah, they will be doing crisis intervention on the street and we have the connection to the office of coordinated so people cycling in crisis, were going to have a place to help them connect and those can do intensive outreach. Next slide please. So what this shows, the rollout of these teams. We are hoping to have the new teams the first team live by the end of november and then youll see that over before the end of the fiscal year, well have six teams and then growing beyond that. I talked a little bit about the teams, as far as the coverage, were really wanting to be very data driven so based on the calls coming in currently, where are the calls coming from . What time are they coming . The teams will be deployed in a data driven way. We will have 12 hour coverage, seven days a week. Exact hours were still working out and hopefully by the end of the year we will have 24 7 coverage, if that is something we need. Then the street Crisis Response teams will be responding to those calls very soon. We have continuing goal to get input from people. One thing that we are aware of is that we see a lower number of 911 calls coming from the southeast sector of the city, which were not surprised by. We want to pay close attention to that because as these Services Become more visible to the community, we want to understand that if that number will increase or if 911 as an entry point is a problem because of trust and concerns. A lot of people dont want to call the police in a Mental Health crisis, so thats one of the issues were starting to talk through. Next slide. So the Mental HealthService Center really speaks and again it speaks to providing low threshold access to services. The legislation is specific in saying that they want staff, city staff or an Academic Institution staff to operate the program in the city building, so the goal is to have 24 7 access to Mental Health and Substance Abuse assessment, Case Management system, quick access to urge care thats needed. Pharmacy, Psychiatry Services, and transportation to get to and from the site. There are a lot of things we want to take into account and look at our partners on what this program should look like. Were excited of the Implementation Working Group for Mental Health s. F. One of the first things theyre going to get into is the design of this program. Well hopefully have more information soon. Next slide and i only have a couple more slides. We acknowledge there is a need for new beds and facilities. So we know that across the continuum, there are particular places where we have bottlenecks so people who are sitting in hospitals or sitting in jail simply because there is not a bed to place them in. So that has to stop. So again, the connection between prop c is clear. We know and they have in this years budgets to do more beds on Residential Care facilities, Mental Health treatments, and new drug sobering center, a plan that we were hatching for a meth serving center dissolved with covid. We wanted to come back to that service model. The Hummingbird Program has been successful in working to open a second hummingbird and we know our Crisis Response team that is going to be on the streets are going to need places to bring people. We need to improve access and we also need more. So having the crisis diversion program, the new one, capacity is a goal. Then the work, a lot of this work is based on an analysis that the Mental Health team did in analyzing the flow. We want to redo this every year so we can continuously be sure were building the system based on what were seeing in the data. Next and last slide is again, looking right ahead of us, the next six months are going to be really focused on foundational Infrastructure Development so that we can get this work done and really the hiring is one of our top priorities. Really, developing strong collaboration with other city initiatives and the prop c committee, obviously is key in this. There are also efforts happening, like alternatives to policing and redirecting funds from the Police Department that those groups have the same goals, right . They want to see equity there. They are also concerned about how racism impacts the community, better information, quicker access. So there is this alignment in all of these things that will drive the improvements for Behavioral Health. The vision that came out of the Mental Health reform work is something that we are very committed to and i wanted to close with this kind of recommitting to this. P people experiencing homelessness should have access to high quality healthcare that matches their need. It increases recovery and to efficiently deliver Behavioral Health services to people experiencing homelessness and these extend to everybody in our system. Thats the end of my presentation. The next slide is just a thank you slide and then im happy to answer questions or go wherever the group wants to go. Thank you so much director simmons. I also want to recognize supervisor ronen is here with us. I know were at time for this item. Super ronen supervisor ronen, do you want to make any comments . I am trying to unmute. Can you hear me . I wanted to be here to answer questions. My understanding for your last meeting is that you were interested in understanding how the investments made in Mental Health s. F. , where they were going. I asked d. P. H. To present that to you today because in addition to understanding how the program works, understanding how the investments go to support that program, was my understanding of what you wanted to hear. Are there any questions you may have . Supervisor, we did bring our teams here, so greg and jenny. So if there are questions about that, we can field them. When we talked with you about that need, it was to get into the budget detail, we had already passed the submission for formal information submission. We are prepared to talk a little bit about that today. Thank you so much. I want to invite if there are any Committee Members with questions for this task. I do not see any i do, but i cant i need to make sure i get this. Yes, its under participants and there is a stack i see now. Vice chair dantonio, member friedenba friedenbach. I got it. Someone else can start it this time. Thank you. Okay, so well go to the member. Thank you. Thank you marlo for that great presentation. That was really helpful and i know there was a lot you had to pack in there so i appreciate you helping us understand all the different programs and how they fit together. One of the things i heard you say that im sure if you had more time, we would love to dig into it, how you want to improve Behavioral Health outcomes for people experiencing homelessness. One of the things that i was wondering about is for better coordination with the homeless and housing system. I was curious that there are ways that you i have to imagine that your Behavioral Health outcome improves for clients when theyre in housing and i assume that one of the things that you are probably looking to do is have better discharge planning for people back into housing. So im curious if you track housing placements for your clients and you can say a little bit more if you have plans or it sounds like youre working well with the Hotel Programs right now and where the coordination is and what you wish for you had in Housing Resources for your clients. Yeah, abigails presentation really talked about that. We just need more housing across the city so, this work is very hopeful for us and we dont really provide housing. So because h. S. H. Is the holder of the Housing Resources, we need to be really working very actively with them to be sure again that we are providing that supportive training for the staff and the housing response system that we are integrating as many on Site Services as we can and better linking some housing programs into our system, so that includes things like if somebody leaves a placement for a residential treatment, they are coordinating so we have their placement to go back to. So there are so many opportunities for us to improve. We have done over the last three years, around transitional aged youth have done collaboration with h. S. H. And have really embedded a lot of things that are working very well, that we want to expand across the system. H. S. H. Is incredibly open to the partnership and we strengthened it during covid, but collabor e collaborate collaborations we have to continually focus on. Help me again, im sorry. Youre muted. Do you track housing and do yo you have an idea what your discharge outcomes are . We do know for a lot of programs, something about when people are discharged. The member i quoted in 1819, we had 27 people on average a week discharged to the streets. There definitely are opportunities to improve our data collection. We need those data systems we need to do a better job being more accurate. One of our challenges is that a lot of our low threshold programs, so the data isnt showing up. So there is a lot of work. We do try to track some stuff. Yes, thank you. And i just wanted to contextalize my comments and ill be done. I think with the proposition c fun funds, i think were trying to gear all the different activities and getting more people housed. Thank you for your answer. I appreciate it. The other thing, the last point, its not just our services needing to expanded for those experiencing homelessness or unsheltered but how were present in all Supportive Housing. Thats a lot of the training for the front line staff. Theyre the first ones that will see oh, im concerned. There is something happening here and we dont want it to escalate to an eviction. That person is on the street may become a crisis and then we catch them. We need to go higher upstream. Right, thank you. Well go to member friedenbach. Hi, thanks so much for the presentation and in particular for really identifying some of the challenges that were facing in the Behavorial Health system. Thats really what we need. I have some specific requests. I like to we need a breakdown and we need to certify spending, give details, but in the last presentation, 66 million was programed for Mental Health s. F. We need to break down exactly what you guys are thinking about using that 66 million for, so we can look at and see if it fits in or doesnt fit in with the vision. We need a cost of each item. What has been a great concern to a lot of us is the loss of board and care facilities. It would be purchasing the facilities on the mark. There is the cost of the two building boarding care facility on shotwell that was bought by a developer. Perhaps there is an opening to buy that back and get that back for folks. I noticed there are folks still living in that building and other opportunities in terms of boarding care facilities. I also like to see a cost analysis of how much it would cost to expand the coop housing for Behavioral Health and again, number of people served and how we could possibly do that. We need to get these kinds of details for us to move forward here. Thank you so much again. I appreciate all the work you are doing. We do have many of those details ill follow up with you offline to make sure im getting all the details you want. The new beds, expanding the unit cost, or how much were able to reimburse, intensive Case Management slots, new services, there are a lot of things within the prop c that are what that 66 million is making up, but we need to get you the details. We will do that but the alignment is there. Supervisor ronen has been clear in the need for us to be mindful of the legislation. You know, Mental Health s. F. , we were trying to get ahead with Mental Health s. F. We won prop c, we knew the funding was coming. The idea is to bring stuff forward and not injures just keep going backwards in time. We were confident we were going to win the court case. The idea was to move forward and there were other initiatives. Mental s. F. Encompasses a lot. There is a lot of radical restructuring of the Mental Health system and within that, we as a committee need to weigh in on what the priorities are. A big part of Mental Health s. F. Is increasing the bed capacity and all of this stuff. We need to look at things and make recommendations. We need to make clean recommendations of this is what our priority is for Behavioral Health and i cant imagine anything that we would recommend that wouldnt fit into Mental Health s. F. It was a change up of the whole system and making sure people got the care they needed. There is a lot of alignment but we need to weigh in as a body on what the priorities are and we need to know what the priorities are. There needs to be transparen transparencies. If i could just very briefly, im from the Controllers Office. In talking about the structure of this meeting and the next couple of meetings, its important to us to bring forward some of the foundational documents for this meeting, Strategic Plans, and our hope is to bring more specific details back at the next meeting and beyond. We didnt want to start we didnt want to put it before. So the questions and feedback is super helpful and will help us bring details back for the next meeting. Thank you so much. Well go to the member. Sorry to interrupt. Im just i have requested that those details be at this meeting meeting, member friedenbach. So im a little frustrated because thats why im here, to be able to answer i dont need to be here to answer so im missing my Transportation Authority meeting to be here so im going to leave now. I am going to say it would be nice for d. P. H. Would be clearer. I knew thats what this committee wanted and i asked you to bring it to this committee and now ive been here for no reason and i seen that presentation several times. If we would have Clear Communication in the future, i would appreciate that. I am frustrated at the moment. I appreciate you all and i will be here the next meeting when i go over the financial data. It was clear as day to me that thats what this committee requested the last time around. I dont know. Im frustrated. I will see you next time, and miss my meeting again next time. Thank you supervisor ronen for making time to join us today. Thank you. Thanks supervisor. Thank you, well go to the member. Youre muted. Sorry. Is it on . Yes. Good. [please stand by. ] so Behavioral Health, we use a very broad term. So its really people who are at risk of experiencing homelessness actively, you know, couch surfing. But we include a very broad set of definitions when we talk about people experiencing homelessness. And a lot of our data indiscernible thats awesome, thats awesome. Thank you. I think that is important. I wanted to shout out to the 350 hired and i think that is awesome and i hope that we can do that in all of our programs, especially in our homeless and housing services. And just around hiring like another sorry, my daughter it was just around the h. S. H. Had around hiring folks. And having a difficult time hiring folks and creating these new positions. I might be wrong on this, but the budget like rolls over for h. S. H. , like, it just turns into money they didnt use. So i just wanted to see what the terms are. And maybe we dont have to answer that right now. What are the plans for hiring, how will you mitigate that, what happens if the funds, if we dont hire people . What will happen with the ideas of programs if we dont hire the right people, if we dont get the right people on board. I dont know if you have an answer for that or think about that for future meetings . We have a lot of things in place that were working on to improve the hiring speed for the Civil Service jobs, right. And then the c. B. O. S are going to have a big part in all of this as well and they dont have quite the challenges in hiring that we do. And, greg, are you still on . I was going to see if greg could answer your question about the rollover and also just maybe make a comment about the like the transparency. But my understanding is that absolutely i mean, we have since were ready to share theres confusion about what the focus of this agenda was. So, greg, i dont know if you can could speak to that. Sure. Hi, everybody, greg wagner, department of Public Health. And well send around some documents that have some of the financials and talk about it. And your question specifically the way that these funds because of the nature of the proposition and the Controllers Office can weigh in on this too, but those funds would be held in a special account. So at the end of the year, when their general fund if they fall back to general fund balance, these funds are separated and would continue to be used for the purposes approved in the measures. So its a little bit different than some of those other situations. And overall, even in cases where we have funds that are unused at the end of the year, we often have those earmarked or held against a contract which allows them to carry forward. So were very attune to that. And we can talk about that in more detail with you. So, again, on the larger budget numbers we have that data where i am prepared to discuss sorry if you missed the opportunity today. Thank you so much. Yeah, and if we could get a breakdown of how much would be administrative expenses, only because prop c, only 3 of the funds are supposed to go to administrative expenses. And a lot of the things that it sounds like that h. S. H. Are trying to do are admin expenses and we want to really see tangible things for the Homeless Community rather than administrative. I understand the purpose of administrative things, that you need them to roll out the program, but we want to just make sure that its no more than 3 . And that would be like, how that actually breaks down. It wouldnt be 3 of h. S. H. , it would be 3 of prop c. It would actually have to be less because we still need the administrative funds for like the other prop c things as well. So if you guys could break that down for us as well. Thank you. Thank you. Theres another question . And i wanted to answer it was more of a comment. Okay, and then, marlo, just two more questions for you. What does s. U. D. Stand for, when you say s. U. D. Programs . Within the medical its Substance Abuse disorder. Thank you. And the last question is around k. So, you know, theres a big fear of c. P. S. , and so what are you doing to develop trust with the Homeless Youth, and also if we could get an age breakdown and also the side being served with this one. Sorry, that has been discussed here, so, thank you. Yeah, and all of the specific requests for data or information, theres a lot of detail and i want to be sure that we get it right so if theres any way that we could get from the committee, heres all of the stuff that we want from d. H. S. To give better introspection. And the youth are 16 to 24 year olds and its really that transition from child to adult where we see a lot of young people get lost to the system. And weve done a lot of work over the lastly years to build those services for youth. Did you say specifically Child Protective Services . I know personally until i turned 18 theres no way that im touching any system. So, like, what are we doing around that . Because, if like a 16 or an 18 year old tells a therapist that theyre homeless, thats a red flag. So, like, i mean, i dont even know if theres a way to address that but if were targeting 16 and 18 year olds, unless theyre emancipated youth, but theres a lot of nuance there and i think that the earlier we catch Homeless Youth the more impact that we can have on their lives. Yeah, so i just want to make sure thats something that were thinking about, because i think that a lot of those nuances, because unless you have been through the system indiscernible . Yeah, we have a lot of Different Things happening with transitional youth and id even be happy to share some of you that with you offline in more detail. Its a complicated issue but we do have, you know, very deep partnerships with the Homeless Youth alliance, markham street, and so a lot of the organizations that are out and actively on the street. And i would say that they are more equipped, maybe than our adult serving systems and being sensitive to those issues. And we also have resources at the access point. So it seems like a very complicated issue. And i think that one of the big issues as having been an advocate is that there is kind of a monopoly of services under larkin street so thats something that i would want to think about when distributing the funds. Theres no onesizefitsall and a lot of youth end up getting denied services through larkin street and then it becomes difficult for them to access anything. So, what does that look like . And making sure that theres an equitable distribution with the money to different programs. Yes. Director simmons will be sending all of these behavioral requests and the same to h. S. H. , and well reach out to all of the Committee Members to have that in advance of our meeting and our retreat for us to review. So i want to definitely thank you for your time, director simmons, and i do looking at the time, is there any members that need to leave the meeting or can stay with us to continue on in the agenda . I just want to make sure that we dont lose quorum because i know that its 11 40. Is there anyone . Member reggio . Yeah, i would need to leave by 12 30. But i also think that we have at least one more substantial presentation . Is that right . We have two, actually. So, yeah, i think that it would be counterproductive to go two more on this and i wonder what, you know, if one of those presentations might be saved for the retreat . Thats what i was going to recommend. I know, i am going to look to member friedenbach, would you prefer us to because this is a really great presentation and we want to have time to dive into. Do you want to go into your presentation today or move this to the retreat . Well, i think that if the presenters i think that the original plan was to do a brief overview and ive been waiting on the call for quite a while. So i feel that if theyre cool with doing it, then we should go ahead and do the brief. And then if we want to do a deeper dive, you know, later, we can arrange that. Im going to recommend for item 7 for our staff that we can move that to our next meeting because i know that we already have sort of an overview on this. If we could table item 7, any objections to tabling item 7 . Okay, seeing none, well move to Public Comment at this time. Is there any Public Comments . Clerk members of the public i just have one i have my hand raised. I want to make one comment. Its okay. I think that i was i left it raised for quite a while before that. So it might have been um, it just strikes me that this committee is going to have a very difficult time making recommendations we can stand behind. If the departments arent remaining together with the Controllers Office and robust infrastructure that we have for planning, if theyre unable to bring us a rightsized system to us. I mean, we need to understand what is rightsized for a Behavioral Health program and rightsized for the Homeless Youth. And what is the need, our strategies funded at an adequate level to get to the goals of either housing or wellness for our communities, right . So that planning work really needs to be brought to us in a much more, more robust way, so that we can make recommendations that are practicing recommendations. Again, very willing to participate in anything that is required to get to that planning. I know that its super complex, but as im hearing this, you know, theres similar challenges, right . Im concerned that both of our systems might be overinvesting in outreach and underinvesting in the higher levels of care whether that be psychiatric or Behavioral Health side, or housing on the housing side. Medically assisted treatments. And so we can not necessarily have equal housing. So that to me is what at stake here for the rightsizing question and its going to be up to us to make recommendations without, like, taking indiscernible that approach. So im very excited about all of the improvements and i thank you indiscernible . I can look indiscernible and knowing that we have all of these pieces. I just think that we need a plan if that makes sense, right . Thank you. Thank you, member bel leadbette. Clerk members to provide Public Comment should call 1 415 655 0001. Access code is 1461188903. Then pound and pound again. If you havent already done so, please dial star, 3, to line up to speak. A system prompt will indicate that you have raised your hand. Wait until you have been unmuted and you may begin your comments. Please note that you will have three minutes. Checking now. There are no callers for Public Comment. Thank you. Any additional comments from Committee Members on this item before moving on to item 6 . Seeing none, i want to thank director simmons for joining us and providing us the information. We have a lot to think about and thank you for your presentation and the time from the staff and yourself. Moving to item 6, the presentation on the coalition on homelessness stop the resolving door report summary and possible action by committee in response to such presentation. I will turn it over to member friedenbach and her colleague. Im actually not the one presenting. It goes to chris haring, i believe. Okay. Thank you. Yes, thank you. Im chris haring. Im a fellow Harvard University assistant professor of sociology at ucla. Ill present findings [broken audio] through prop c, with my colleague caesar and cici who are also on this call. Ill now share my screen for get up our slides. Okay. Can everyone see the slideshow . Great. All right, so the report which is nearly 100 pages, so were just going to be highlighting a few of the key findings today, but i encourage you all to look online. Were going to briefly touch on each section of the report. Ill go over the methodology and then hand it over to tracy who will talk about prevention and then well discuss shelter and Substance Use treatment and Mental Health treatment which are all of the key sections of the prop c funding and conclude with some specific findings about transgender homelessness. So our study utilized the communitybased preparatory action approach to research which means that the community in which our research took place was involved in every step of the research with the community. And we were guided by subject Matter Experts from universities around the bay, including u. C. Berkeley, and s. F. State and santa clara university. And while they helped us to create the methodology and the survey tools, we had a wide range of groups craft and revise our survey instrument, including various agencies like the department of Public Health and the homeless department, as well as Community Groups and service providers. We hired a team of around a dozen people, all who had lived experiences with homelessness. Who actually proctored the surveys. And some who were even homeless at the time of this study. And two of those peer researchers are with us today. They carried out more than 500 surveys across the entire city. And also conducted 25 indepth focus groups. We had a representative sample that closely matched the 2019 pointintime count. I can go into this in more detail, but as you can see we were really matched on to the race, gender and Sexual Orientation of the pointintime counts. About half of those who we spoke with were staying outside and the other half were in some forms of shelter, which is off from the pointintime count but close. And we sampled those who were older than younger, but overall representative. And with that, ill now hand it over to tracy, who if we can unmute her, i believe that shes an attendee she will present our findings about prevention. Can everybody hear me . Yes, thank you. Thank you. A key part of prop c is funding to keep people housed in the first place. And our survey began asking a number of questions about how people became homeless and what steps would have helped to prevent this. Excuse me. One surprising findings is that 51 did not have a lease, and with many of those just becoming homeless and offered the tenant protections that we fight so hard for in San Francisco. Next slide, please. When asked all of the reasons people became homeless, the primary reason reported by 43 of participants is they lost housing because it was no longer affordable. As you can see in the breakdown, this was as often as income simply being too low, as it was due to a loss of their job. Next slide, please. When asked what type of housing, people were in immediately before their current experience of homelessness, we found that a disproportionate number had been in some kind of governmentsupported or Affordable Housing such as Supportive Housing, the below market rate housing and public housing. We found that 13 of those surveyed, more than one of 10 of those currently homeless, had been in the citys permanent Supportive Housing immediately before becoming homeless. A separate question asked our participants if they were ever in permanent Supportive Housing and 18 of the participants reported previously that they had been in permanent Supportive Housing at some point. This finding is in line with the 2015 study by the budget legislative analyst which found that after three years that 47 of permanent Supportive Housing residents had left their housing. And permanent Supportive Housing as it currently exists plays a significant role in the revolving door in and out of homelessness. Next slide, please. So as far as policy recommendations first, when asked what interventions would have prevented their homelessness, rental assistance was reported as having been the most helpful. Nearly onethird or 32 of the survey participants who answered this question reported that the rental assistance would have prevented them from losing their housing. Interestingly, 78 of those who said they needed rental assistance would have only needed it for one year or less. The fact that the survey found that many of those experiencing homelessness were not on the lease to prevent homelessness only through tenant projection measures and the need for cash rental assistance. And the finding is that the primary reason is that rent was no longer affordable supports the intervention of this policy intervention. Next slide, please. Focus Group Participants discussed the needs for more services and supports such as paid programs and direct rent payment and Case Management to ensure that people who enter can remain housed without returning to homelessness. They also felt that the economy really mattered. Basic essentials, including access to ones own bathroom and kitchen above their own needs above even their own safety when asked about important factors they were looking for in housing. Our finding is that one in six of those currently homeless in San Francisco have already been in Supportive Housing, and our homeless programs are part of the revolving door of in and out of homelessness. While we need to increase the number of units we also need to improve their quality. Furthermore, the city agencies and the Housing Providers do not accurately capture why it is that people are leaving this housing. This needs to be remediated. So now im going to turn it back over to chris to talk about shelters. Thanks, tracy. All right, so im going to talk about shelter and the majority of survey respondents currently resides outside either regularly used shelter when it is available or have tried to access shelter and have been rejected. And so although our pointintime numbers, you know, showed this split the majority of those are currently staying outside i think that this is really significant to show that many of those outside have or do use shelter when they can. In addition, San Francisco shelters present the barriers of access to many survey respondents and so when we asked folks who had used shelter in the past five years why it is they werent able to access, we have received the following answers is that the main response being that no beds were available or long waits. Now the primary barrier to shelters to those who have not used shelter ever in the past five years was the Bad Reputation or a bad experience in the past that, you know, had been more than five years or longer. And so these are barriers that we will need to address in our shelters. We found a real demand f found e diversity in the system. We found that there was almost equal demand for both the clean and sober shelter as well as a shelter that would allow those actively using drugs and alcohol to safely use onsite. We also asked participants if the city had a legal free campsite where you could camp outside in your private tent and have access to toilets, showers, and have some basic security, would you prefer to stay there as opposed to existing shelters. 58 reported that they would and 10 said maybe, and only 32 said theyd prefer the current shelters. So this is really an indication, you know, of how poorly our shelters are doing and how much well be looking at the shelters. 44 were currently in shelter at the time of the meeting and i know that we have experienced with this a little during covid and its something that we may want to consider, you know, or improving our shelters. And participants we asked what would be the most useful services to be improved within the shelter and housing Case Management and Case Management were at the top. Furthermore, findings indicated a need for a variety of deeply Affordable Housing options and the transparent pathways to housing along with that housing Case Management. Hi, well talk now about Substance Abuse. Hi, i am caesar perez, im a peer researcher. So ill be sharing results of the Substance Use section. So a third of the participants reported using substances. The graph on the left of people who reported that having issues with substances and the persentages of those reporting issues with the following substances. Methamphetamines and alcohol are at the top. On the right we can see that the percentage of who responded that a particular substance being the primary substance that they could use treatment for, yeah, needed treatment. Next slide. All right, so what we can see largely is that Substance Abuse treatment is working for the majority of participants. So 80 of participants who attended treatment reported that it either partially or totally helped them to meet their goals. Lets see here. So the most common treatment settings were residential Treatment Programs, followed a. A. A. Or n. A. Or detox programs and other peer support programs and finally other treatments. However, over half of those reporting substance issues remain untreated. And then i just want to also be clear that although using Harm Reduction approach, we also understand that not everyone who who reports using substances being an issue, that needs, wants or is ready for treatment now. Next slide. So some of the barriers to accessing Substance Abuse treatment is the access is too confusing or difficult to navigate. The rules could be are many times too strict. Theres a lack of availability, especially for residential treatment, and the treatment is too costly. And also its difficult from one of the participants. When i was homeless i was really looking online for where i could go for help and there wasnt anything online. There wasnt anything like that. You cant ask google, what can i do. And the only way that i found treatment is by going to hospital. Lets see here. All right, next slide. So about okay, so in the survey we found that finding a split on Harm Reduction and space. And 54 responded they would remain in treatment if active use is permitted, and while 46 reported that indicated that an absence only is what worked for them. Next slide. And so what we also uncovered is that posttreatment, many people are returning to homelessness. So here on the graph in the gray, we asked what was your housing situation during your current or more most recent treatment. In purple was what was your housing situation immediately after when you left the most recent Substance Abuse program. So what we can see lets see here trying to see here what is clear sometimes is that when an individual returns to homelessness after treatment, is that that homelessness in itself is traumatic. And there can be many triggers in the environment that where they are. Next slide. please stand by go back to school, the kinds of activities that make them feel connected to the larger community. Those who do exceptional in these programs but still need longterm support can still be eligible to move into the coops. These are permanently Affordable HousingAffordable Apartment with about two to four residents each. These offer independent support from a dedicated case manager that residents can call on whenever needed. Next slide, please. [inaudible] she started crying as she told us how desperately she wants a professional to talk to who can help her manage her stress levels and help her guide her children more safely through this time. She told us that all of the places she had contacted for support had wait lists so long that there was no knowing when they would be helped she would not helped. We heard this repeatedly from many other participants, as well. Next slide, please. Other im sorry. One second. Other barriers to access here included a lack of information, available explaining the types of therapy being offered and how to get into it. Another explained that their physical disability kept them out of Mental Health care, people who speak languages thank other languages other than english and those who are transgender. Next slide, please. We understand that Treatment Facilities for people with Mental Illness are expensive in the shortterm, but when compared to the cost of allowing people to spiral into psychiatric crisis and back out onto the street, it is the most affordable solution ethically and morally. When someone is in a psychiatric crisis, our city should be dispatching skill counselors to assist with the service and not police officers. There are many other recommendations in the full report, but for the sake of time, im now going to turn it over to caesar, who will discuss the situation for trans and gender nonforming people struggling with homelessness. Hi. This is caesar again. My pronouns are he and him. So first, im going to read this report real quick. So in my community, there are a lot of people who just dont have access to housing, services, or shelter because of the color of their skin. [inaudible] next slide. All right. So so binary gender classification and racism made many people feel unwelcome in the shelters. The primary reason for transgender study participants departure from the shelter was to escape mistreatment, and less timed out while 16 were kicked out. And i just have to read this quote here from a trans latino. In my experience in shelters, many people want to victimize me, for example, harassing me in the bathroom. They tell me i have to use the mens bathroom and not the womens, and this is genderbased violence. Here, we have [inaudible] in the past five years, and this is already brokendown in the next slide. So our recommendations are to prioritize hiring staff to hiring transgender staff to serve transgender shelter and other service users. Create trans and lgbtq friendly housing to keep trans and gender nonbinary people safe [inaudible] and shelters and other Homeless Service programs. Next slide. Thank you. Yeah, thats all. So we can just take any questions that the committee might have. Thank you so much, and thank you for all your work. Im a big fan of cbpr, so just really appreciate this presentation. So i see member [inaudible], do you have a question or a comment . No, sorry. Thats my leaving my hands up to yeah, i noticed with this [inaudible]. We all have to make the effort to put our hands down, so apologies for that. But it looks like there are no questions or comments at this time, and i know we are just so grateful for this presentation, and i know the committee would love to do a deeper dive on the work that you have done, which is now really important. So well go at this time to Public Comment. Is there any Public Comment . Clerk members of the public who wish to provide Public Comment on this item should call 4156550001, access code 1461188903, then pound, and pound again. If you havent already done so, please dial star, three to lineup to speak. A system prompt will indicate you have raised your hand. Please wait until the system indicates you have been unmuted, and you may begin your comments. Please note you will have three minutes. Checking now. There are no callers on the line. Beiokay. Again, thank you to all our amazing presenters, and thank you to member friedenbach for this, and well definitely come back and do a deeper dive. Well move to item 8, discussion and planning for our next meeting, so setting dates and any potential agenda items for our next committee meeting. Is there any members that want to request agenda items . Member nandra . Hi. I think we probably ended up talking about this before when we were planning the retreat, but i wanted to have a little bit of a discussion on governance and process for the committee. It might end up on the retreat, but if not, i think its a priority for us to figure out our structure and Decision Making process. Absolutely. Thats definitely on our agenda for the retreat in addition to the data that were getting, so thank you. Well now go to member miller . I am concerned because i know that we were able to have or the city was able to house a few thousand people. At least in the tenderloin, the tent count is down in the 20s or early 30s. What im concerned about is the time is running out under h. U. D. , and i want to really start looking at how are we going to support the people for ongoing housing . Whats the plan . How many people are in what kind of housing, how we can sustain that, how we can open up other kinds of housing, things like that . I think its very important to get the foundational information, but i also think that were kind of looking at a a looming time bomb that i want to make sure that we are able to get in front of so we dont have, you know, hundreds or thousands of people coming back onto the street. Thank you. Thank you for those comments. Well go to member reggio . Well, tacking onto the point on governance, i think somewhere we should distinguish between or see if we can understand the differences in role among the several related committees. Im thinking of the implementation worker group from Mental Health, for example. Are they planning in that regard, are we planning in the same regard . How do we link these things . Planning in relation to the local homeless board, so i think those are things along the way that we want to look at. Thank you, member reggio. That is a great point. I know that there are a number of moving pieces and governing bodies that we need to be acco coordinating for that. Are there any other members that want to propose any agenda items for the next meeting . Member ledbetter . I dont know if its for the next meeting or retreat, but it might be helpful for us to see a tutorial on the homeless management system. I think theres a lot of interesting Racial Equity data that was being spread out through the stella program. If thats going to be helpful, it might be good to look at that stuff. Theres multiple, multiple data streams. I dont know how were going to approach that, but just wanted to put that out. Thank you. I see member friedenbach, and then member nandra, did you want to speak again, as well. Wiyes, but ill wait until okay. Sorry. I was on mute. We mentioned it earlier in the meeting, but i think going into very specific questions how we want the information laid out. One thing that hasnt still been laid out, we still need the backfill 198 million that still needs to be presented to us in discussion and approval not approval, but any other program money in lineitem detail. Julie ledbetter mentioned the kind of breakdown, and i think cynthia was wanting this, too, exactly how much money is going exactly in what category and how many people are being served, and in the Strategic Plan of h. S. H. , they had a really clear graph on that, but that was from a couple of years ago. It would be good to have that updated so we can have the stuff from there. And then, i think the basic things, other id like to see all of the properties that have been talked about by the city in terms of i had mentioned boarding care facilities, but can we look at the pipeline, the Affordable Housing pipeline, bring some of that forward, have it go to Homeless People. What are some of the homeless funds that we can do to have some purchasing and capital of some of those things. I think getting that information data wise would be really helpful in brokendown in a very tangible way. Absolutely. Thank you so much. Im taking notes on these requests, and also email us data requests, as well, so i will now go to member neandra. Hi, thank you. I should have mentioned this earlier, but it was brought up what i wanted to say, in future presentations and the presentations were super helpful today, but i think a lot of what im asking information for is details on what people want to use prop c funds for and how that fits into their overall budget so we can really understand what their asks are and kind of where that funding may have been coming from before and whether its new funding, so any discussion around that in future presentations would be really helpful. And again, back to this idea of really having a better understanding of what all of the any of the agencies that are putting funds into homelessness or housing, whether its Mental Health outreach, Behavioral Health, or Mental Health because its really spread out overall the different agencies. It would be great, and maybe this is a huge ask, but for us to be able to see kind of a funding pie, what percentage is going to outreach services, what percentage is going to rental assistance versus permanent housing, etc. , so we can understand what the gaps are . And i want to say, if this is appropriate for the retreat, ucsf has access to ccsf data, but we can use it to help put together kind of a fuller picture of the scope of the problem, the population that we can help bring to bear some of the data in the system to the retreat so we can look at the problems and what the solution is. So just to make sure that im capturing what the ask is, just kind of the outreach of Mental Health is . Yeah. Theres outreach dedicated to homelessness, people experiencing homelessness, and theyre spread out over different agencies. Im not sure if we would have to ask different agencies or not, but that would be really helpful. I think thats it i forgot oh, member [inaudible] if folks dont lower their hands, people dont know who wants to speak, but member friedenbach. Im clicking it after i speak, so i dont know if thats putting it up or not. But one thing we talked about at the last meeting is [inaudible] unifying principles. Like, we have our big picture, these are the things we want in terms of our priorities, you know, and then, we can just have stuff coming in against that and develop consensus around that, i think, is really important. And and then, i think, we need to know how many people are going t into coordinated entry and getting sent back out onto the streets and how does that breakdown racially, other demographics, yeah. Great. Yeah. These are all really great, and definitely, ive got information in an email for our two retreats. If we have to have work groups under this committee, as well as the other part of it is looking at the data, like you mentioned, looking at the demographics of unmet need and some other data items that have been presented today. So is there i see member led bett ledbetter . I did have one more thing. My hand is actually up this time, and thank you to vice chair. You actually did a really great job today. So getting to cynthias point, we want a map of, like, a system model with understanding the strategies and understanding the access, and i think we heard a little bit from [inaudible] in, you know, San Franciscos been a huge p. S. A. Town. Like, you know, weve done amazingly well with permanent Supportive Housing. Its not the only solution, but weve seen in the presentation a revolving door that it has its own limitations for permanent improvements, so i would like to see some of the progressive ideas like [inaudible] in San Francisco that will serve a lot of people. Were really embracing rapid rehousing and other shortterm Mental Health supports models, so kind of thinking around that, that were really planning for multiple strategies, even if theyre not currently major strategies that we use. Thanks. And adding onto that, i just want to make sure that they dont forget to bring in the diverse piece. I think ab diversion piece. I think abigail yes, and actually, i see laura marshall. You have your hand up. Yeah. Just from a logistical standpoint, you kind of want to nail down the retreat information because i think thats coming before the next meeting, and want to make sure were confirming the dates and kind of the goals for that. So i know that mary as well as some others have did a poll for all of our availability. Do we have the results of that poll . We do have the results of that poll. There are so theres one, two four, four time slots that teseem to work the best f most. It would be thursday, november 2, from 1 00 to 4 00, and we have tuesda have monday, november 2, from 1 00 to 4 00, and tuesday, november 9, from 1 00 to 4 00, or wednesday, november 10, from 1 00 to 4 00 or 2 00 to 5 00. So are there dates that work for People Better . And we are two sessions that were going to i think it might be it might be good to have them i know these are long days, but it might be [inaudible] to have them back to back, like the 9th and the 10th so we can have that continuity of conversation and kind of [inaudible] for peoples schedules. I would prefer that, as well. Yeah, i would prefer that, as well. I see member fridenbach has her hand up. I said i would like that, as well. Is there anyone that would object if we did monday, november 9, from 1 00 to 4 00 and then november 10 from 1 00 to 4 00 or 2 00 to 5 00 . So member [inaudible] is not available on the 9, but he is definitely available on the 10 from 1 00 to 4 00 and then 2 00 to 5 00. So we have a member who cannot do those dates. Is he available on the 5th . Hes not available on the 5th. Hes not available on the 5th or the 9th . That is correct. But also, i mean, julia, did you say that you were available on the 9th and 10th, as well . Yes. Okay. cause the original response that i got, you werent available, so theres a chance that if you pick those two dates, theres a chance that brett may be available, but it seems like those two dates have the most people. So would those work for you, julia, the 9th, and the 10th . Yeah, ill make that work. It sounds like all of our committee is available the 9th and the 10th, and i think its the best thing to have those back to back just so that everything is fresh. Is there a preference on the five on the 1 00 or 2 00 p. M. Im going to make it 2 00 to 5 00, even though im going to be missing something else. Is there a preference, of the 1 00 to 4 00 or 2 00 to 5 00 . Can i jump in . Yes. Im wondering, if we can have fairness to all of us, and if one of you could reach out to brett. If we land on two dates the [inaudible]. Yeah, no, were going to do that outreach. Yeah, okay. Also, mary, check the excel spreadsheets that i sent you, and i had an error from when i was available. So we just need to circle back with brett. Yes. And he can do the 9th is that correct or he cant do the 9th but the 10th, is that correct, mary . So he can do the 10th, and on the 9th, he is unavailable. And then, it was Julie Ledbetter that was unavailable on the monday and tuesday, but from my understanding, shes available on all, is that correct . [inaudible] ill make anything work, but let me just doublecheck well, it sounds like we really just need to circle back with brett to see if we can make the 9th happen because it sounds like everyone is available those two days, and i think it will be the tuesday, november 10, 2 00 to 5 00. It doesnt seem like thats any objection to that, so the main point is just to really get back to brett on the monday, november 9, 1 00 to 4 00 p. M. If he objects, well circle back to the committee if theres any challenge with that. All right. We need to go to Public Comment. Is that i have to get used to that every time. Clerk okay. So members of the public wishing to provide Public Comment on this should call 4156550001. If you havent already done so, please press star, three to lineup to speak, and a system prompt will indicate that you have raised your hand. Please wait until the system indicates you have been unmuted, and you can begin your comments. Please note you will have three minutes. Checking now. There are no callers. All right. So well now move into adjournment. Is there a motion to adjourn . Motion to adjourn. Okay. Thank you. Just need a second. Second. All right. Its been moved and seconded. Any discussion . Seeing none, all in favor of adjourning at 12 29 p. M. , say aye. Okay. So thank you, everyone, and well be in touch on planning for the retreat. Good morning. The meeting will come to order. Welcome to the october 29, special meeting of government audit and oversight. I am the chair of the committee joined by vice chair and Committee Member haney. Thank you to the clerk and i would like to thank sfgovtv for staffing this meeting. Mr. Clerk, do you have any announcements. To protect the public, Board Members and City Employees the board of supervisors legislative chamber and Committee Room are closed. This is taken pursuant to all various local, state orders and directive. Committee members are participating in video