Meeting in person will be allowed to speak first and hear Public Comment from those on a telephonic Public Comment line. The Public Comment call in number is 4156550001. If you call in, you are prompted to enter a meeting id and the id is 26614816334 after you entered the meeting id, press the pound symbol two times and youll hear the meeting discushz. Your line is in listening mode only. When your item comes up and those in person line up to speak along the curtain wall of room 250 and those on the telephone dial star 3 to be added to the speaker line. If you are on the telephone please remember to turn down the volume on the television, computer, streaming device. You may submit Public Comment in writing invite you to do so by either emailing your comment to me, the Public SafetyNeighborhood ServiceCommittee Clerk at johncarroll sfgov. Org. Or send to city hall, 1 dr. Carlton b goodlett place, clerkophorous, room 244, california 94102. Items acted upon today are expected to appear on the bord of supervisors agenda of october 17, 2023 unless otherwise stated. Thank you mr. Clerk. Please call the first item . Consider the premise to premise transfer of type 48 on sale general Liquor License to 790 bush street venture inc. To do business as ad hoc located 779 bush sever the public convenience or necessity. Thank you. I like to welcome officer from the sfpd abc liaison unit. Good morning. 79 bush applied for a lice nss and allow them to operate on sale public premise. Zero letters of protest, zero of support. Plot 158 is considered high crime. Census 121, high saturation. Central station has no opposition and recommend approval. Monitor the area under the control in a effort to prevent loitering on persons adjacent to the premise and any entertainment not audible at near resident or consideration point. Thank you. Any questions from colleagues . Are there representatives from the applicant present . Good morning. David. Let me just start off by saying, this application has been 9 months in the pipeline. Due to the conditional use process requirement extensive outreach performed. Preapplication meeting and no one showed up to meeting. The Planning Department received 8 letters of support and during the Commission Hearing they described the application and project as being total step with the city Recovery Plan for market and union square. Thatsthese applicants have been doing business in San Francisco for over 30 years. Have a good track record and hoping you will support this application. Thank you so very much for your time. Thank you for being here today. Colleagues, any questions . No. Okay. Mr. Clerk, may we please open Public Comment . Very good. Anyone who has Public Comment on agenda item number 1, Liquor License for 779 bush . If so, please line up along the wall my left hand side. Appears we have no within in the chamber i two listeners and appears there is one who has comments on this agenda item, 1. Could we please be connected . Yeah, i would just like to comment on the liquor issue. I like to say that malcolm x rightmake life bad for black people and think it is disgusting hang on a second. We are not going to tolerate those type of comments, so please mr. Clerk, if you hear Something Like that cut them off immediately and anybody else in the queue, those comments will not be tolerated in this committee. Thank you madam chair. Appears we have no further callers in the queue. Thank you, Public Comment now closed. I like to movei do want to state for the record the district 3 supervisor is okay with this and like to move that the clerk prepare a resolution making determination the premise to premise transfer of type 48 Liquor License to the applicant would serve the public convenience or necessity. May we take this motion without objection and send the resolution to full board with positive recommendation . Alright. Madam chair, hearing i will prepare resolution supporting the applicant and you move to send to the board of supervisors with recommendation. On the motion [roll call] madam chair, no opposition. Thank you. Please call the next item. Just a moment. Item 2 is hearing to consider the person to person premise to premise transfer of type 20 off sale beer and wine Liquor License to valencia inc. As valencia whole foods 99 valencia serve the public convenience of the city and county. Thank you, welcome back officer salmonson. Okay. Valencia who foods applied for type 20 licenses to operate beer and wine. Abc received 10 letters of protest. They also received 3 letters of support and one petition in favor. They are located considered high crime. Census tract 20801, high saturation. Mission station had no opposition and alcohol unit recommend approval with following conditions. Monitor the area under the control in a effort to prevent loitering of persons on property adjacent to the premise or depicted and shall be responsible for maintaining litter adjacent to the premise over which they have control. Thank you. Colleagues, any questions . Do we have representative of the applicant present . Thank you for your time. My name is [indiscernible] the owner of valencia whole foods. Today coming to talk in the reference of our Liquor License transfer. Also called valencia whole foods. This is not a new lice nse and transfer that aurd exist. We embarked on the journey due to the high request we received from our customers. We want to insure we make our Shopping Experience the best and insure that ewoo provide one stop shop for our customers. I like to know this license would serve a specialty wine and beer. Family owned business and we have been part of the mission 30 years. We are respectable and responsible individuals and owners and looking to expand our product to our customers. We hope you support our application and thank you for your time. Thank you. Colleagues, any questions . Mr. Clerk, please open up Public Comment. Thank you. Well have Public Comment for agenda item number 2. This being the Liquor License proposed for 999 valencia. If we have anyone in the chamber, come forward now for two minutes. Seeing none, do we have any callers connected remotely . No callers, madam chair. Thank you. Public comment is now closed. For the record, this is in district 9 and district 9 supervisor is okay with this moving forward, so like to move the person to person premise to premise transfer of type 20 sale beer and wine Liquor License would serve the public convenience or necessity. Take this without objection and send to full board with positive recommendation . On the motion to send to board with recommendation to Public Safety neighborhoods services, [roll call] madam chair, no opposition. Thank you. The next item, item 3 is supervisor preston. I do not see him in the chamber. So, i believe we can go to item 4, because i see supervisor chan and appears ready. Thank you supervisor chan. Please call item 4. Item 4, a resolution urging the San Francisco department of Public Health to create a program to provide resources and education for victims of gun violence regarding their rights to File Lawsuits against gun manufacturers in aaccordance with state assemby bill 1594. Thank you. Supervisor chan, would you like to present the item . Yes. Thank you chair stefani and colleagues on this committee. Thank you so much for scheduling this item for hearing. I really also appreciate for your consideration. We are here to expand San Francisco response and accountability for victims of gun violence. Last year in 2022, phil tang drafted and governor newsoms signed into law ab1594 which gives victims of gun violence the right to sue manufacturers of fire arms for the harm of gun violence for violating California Law. Gun violence plagued our country for decades, but really definitely as we think about california, we are not immune to gun violence even at the most progressive state in the nation. When it comes to gun violence prevention. So, as we know, just this week President Joe Biden announced the first ever White House Office of gun violence prevention overseen by kamala harris. This epidemic needs to be addressed and the time is now. But i also just really want to highlight the work that has been done on the local level and want to thank our chair, Catherine Stefani. I want to say before i elected to office, what i just so admire and remember i reached out to supervisor stefani then was, she was the one leading the call to calling out the National Rifle association as Domestic Terrorist Organization for us and to call out and people like nra or organizations like nrs is what caused some of the trauma in gun violence domestically in our nation and throughout and why we must just bring attention to this and i just want to thank her work and recognize that this is only building on the things she has done and so which all the more i appreciate under her leadership as our chair for me to schedule this resolution before you and to have your support. In 2022, the data from the San FranciscoPolice Department shows there were 139 victims of shooting, gun shooting, gun violence that resulted in injury or death in San Francisco. Of these, 67 percent of the victims were black and brown. This violence impact our communities of color. We must do better. Ab1594 establish the right for all victims of gun violence in california to sue fire arm manufacturers for the harm their cause. If they establish a violation of California Law and so with that, my legislation today is to urges our city to create a program for victims of gun violence in San Francisco to insure they are aware of their full rights and availability of services in San Francisco and california. Today well hear from our department of Public Health colleagues, the office of District Attorney to talk about what services are offered to gun violence victims and how we can improve and also ouralso well hear from our ucsf Trauma Recovery center about the wrap around project who supports our most vulnerable victims of gun violence. But today colleagues, i have two amendments to correctto amend the language. It is clerical errors on myfrom our office that we need to correct. If i may i would like to ask the chair to distribute the amendments and but also you guysthank you for having the copies ready and then if i may to continue with the hearing. Yes, i want to say a few shorts words. Thank you for bringing this forward. There was a time a lot of elected politicians shied away from gun violence prevention legislation and now i am very happy to see that many, especially democrats are jumping on board, and and i want to thank the advocates. I have been doing this work since columbine. [indiscernible] Brady Campaign after jim brady and advocates push ed the legislation forward at the state and could not do it without them. We have to give more attention to gun violence prevention and the victims. There are so many lives shattered and destroyed because of gun violence wreaking havoc. It is number one cause of death of our children in america and shameful so i want to thank you for bringing this forward and very excited about the opportunity since we are talking about victims that this could be folded and worked on with [indiscernible] bobby lopez from office of victim and witness rights. Especially with the grants manager. There is so much we can do with this nigh office and i think this is a perfect opportunity so thank you again to supervisor chan for bringing this forward. Thank you. With that, i am going to call on department of Public Health. Good morning and thank you supervisor chan inviting me to speak on behalf of department of Public Health on the resolution regarding programming and resources for the victims of gun violence and the rights to File Lawsuits against the gun manufacturers in accordance with state Assembly Bill 1594. Stephanie felder, the director of comprehensive Crisis Service and hope sf wellness for department of Public Health. Our Program Makes sure that people that are impacted by violent incidents get Mental Health services immediately following a incident. This includes homicides, shootings, but not limited to gun shootings. Our comprehensive Crisis Service also work closely with the Victim Service division at the District Attorney office as well as with ucsf wrap around and Street Violence Intervention Program and other Community Based organizations. We collaborate together to make sure that in the immediate aftermath of a homicide or shooting, which involves a lot of trauma for those impacted and we work closely with them to help with the healing process. In support of this resolution, dph is committed to providing information and resources to victims regarding their rights to sue the fire arm manufacturers and sellers for violations of state law concerning the sale and are marketing of firearms as stated in california state Assembly Bill 1594. We envision developing Multilingual Education materials made available in the event they decide to follow through with suing the gun manufacturers. As stated in the resolution, dph will work with the mayors Budget Office identifying funding and staffing as necessary for the Educational Campaign once this resolution has passed. Thank you and happy to answer any questions you may have. Thank you. As chair stefani mentioned, what the board has done in the last budget is to establish a Victim Services office of Victim Services. I am not too sure if it has been official announcement that directorit will be under the leadership of ivy lee, but curious if the department of Public Health is in communication with inmayor office and potential continuing establishments of the office of Victim Services . Yes, we work closely with the mayor office, violence prevention. Is therei know you mentioned it is the passage of the resolution. I think colleagues that is part of the amendment today is that we are hoping to amend the timeline formally was january 2023. We understand through the conversation too, we held off with the conversation around budget of the establishment of the Victim Services office of Victim Services, so with your support championed by supervisor stefani, now that is approved so we amending the laj wj to january 2024 to give time. With that amendment is it feasible for department of Public Health to be able to respond by january 2024 . Yes, with the materials, yes. We should be able to. Wonderful. I really appreciate it. Thank you so much for your effort on this and with that, colleagues, i see supervisor dorsey. Thank you so much. I want to express my appreciation to supervisor chan for her leadership on this and also chair stefani for your long Time Leadership on these issues. With sf General Hospital here and in the room i do want to point out, one thing that is remarkable i think and probably too under appreciated the number of people injured in gun incidents is 113. The fact that only 26 were killed is really a testament to the trauma surgeons and the work that medical professionals are doing at zuckerberg General Hospital and i just wanted to mention that because i think its too often under appreciated. But thank you for everything you are doing and thank you to colleagues for their leadership. Any other questions . Any other presenters . Yes. Thank you and thank you so much. The next presenter is from the San FranciscoDistrict Attorney office. Thank you so much for being here. She was here yesterday at the budget and finance committee talking about Victims Compensation and restitution so appreciate you being with us here today. Absolutely. Good morning everyone. The chief Victim Services with the District Attorneys office. Thank you for allowing me this time. A little about Victim Services in the District Attorney office, last year we served approximately 10 thousand victims of violent crime. We will serve folks who have charges or even cases who have not been charged. We receive our referrals from Police Department, walkups and Community Based agency that have connection to Community Members impacted by violent crimes. Right now i think what i really want to highlight here is our mission truly is to collaborate with Community Based agencies, because what we know is gun violence impacts communities. It impacts more then just the individual, that is directly harmed by that crime. And so what is important is that we build connection and trust with Community Based agencies so they will reach out to Victim Service despite the stigma work ing with the District Attorney office to receive their rights and receive the services that they are well deserved. One of the ways we are doing that is through community advocacy. We are pairing up advocates with specific communities that through the statistics have higher rates of gun violence and placing them in Community Based organizations. And through that placement, the community is starting to hear that hey, i dont have to go to a District Attorney office to receive services. I can actually go to the neighborhood blank resource that and there will be a advocate there i can disclose what is happening in my Community Around gun violence. With that, we can educate them on their resources and some of those resources are restraining orders. We help folks get restraining orders, particularly as they relate to gun violence. We also help them get compensation when they have been harmed through the cal bcb board and as we spoke yesterday, urgent funding when that is needed. And so, i think ultimately our goal is to lower the threshold for reporting and make itsort of relieve the stigma around that. Ill pause there. Thank you. Because what is interesting through the time that we try to draft this legislation, the most importantly to have a better understanding the state bill and the challenges around the implementation of the state bill. Yes, while we have thanks to the bill ab1594 that now the victims of gun violence have the right to sue gun manufacturers, is there any way you can walk through more about the challenges around it too and but so what work on to overcome those challenges to make sure when they understand their right to sue or overcome the challenges . Er i would say that informing folks of their rights is one thing and then understanding that after traumatic event having the capacity to follow through on some of that could be very difficult, so i feel having resources to really insure they have an advocate or someone that can walk them through the very complicated process of a lawsuit would be very important. Someone who can follow up and i think thats one of the challenges and obstacles or districate attorney advocates have. They hold 250 to 500 cases, managing restitution, managing get to court on time so a case such as this would be i say a high needs case where there is a lot of followup, there is a lot of emotional harm that they will be managing and so having partners that can do that with us or resources to do that would be important. So, during this time and again, we know that this is just a new law that just passed very recently and that still trying to sort out the process and reallyglad to see the establishing the city is establishing the office of Victim Services to centralize some of the services, but i agree with you that it is true that expertise is still within the District Attorney office and these are very complicated cases and while we want to provide all the services that we can and support we can with victims of gun violence, we also understand we dont want to jeopardize the case that the District Attorney is working on and make sure we have successful prosecution. Could you walk us through what in the coming months what are the steps that the District AttorneyOffice VictimServices Unit is thinking about how we can Work Together if it is resources sphwhat are the steps to make sure while these things are very challenging and difficult, but there are ways to overcome it. Absolutely. So, little bit about me. Im a psychiatric Nurse Practitioner so live by the creed of hipaa. Also the general raised me. One of the big learning curves i had walking into the District Attorney office is understanding brady and understanding things that are disclosed to my advocates are not confidential. In a lot of the meet with mayor victim Rights Office, we have been discussing how to leverage Community Based organizations to actually be the holders of what should be hipaa protected information and keep our advocates in the lane of marcys rights, giving resources, making sure they understand the legal and criminal justice process, restitution and things of that nature. That is really beeni meet weekly with ivy. Been Great Partnership and delineating our lanes and also how to leverage us as an expert in respects to marcys rights and the criminal just ice process. Assessing our lanes and really pursing out what is hipaa, what is brady and what i dont want my advocates to have information to so they dont get called on stand and potentially harm a case. Will the timeline of january 2024 be able for you to come back to sort of educate us to tell us then moving forward what a victim of gun violence can expect in the event they want to sue and able to sue the gun manufacturer . You know, i love to say yes and learning to say lets shoot for it. I say that simply because i know right now the victims of Rights Office is working on assessment. I was one of the participating members that crafted that assessment, so i would love to see it data that they receive back from that and i dont know when that will happen. Once the data comes i feel we will have a way to delineate what our Victim Service office can do and what the victim Rights Offices how can support. Thank you. I understand why i definitely appreciate the department of Public Health has made a commitment to say, they have the education materials ready by january 2024, i are look forward seeing the partnership from the dist rict Attorney Office and office of victim right and be able to collaborate and carrying out beyond the education piece and then see the implementation of it. Ill follow up in january 2024. Yes. Thank you. Thank you so much. I want to thank you for participating in the Needs Assessment with the office of victim and witness rights. I i do want to say one thing about this. We are notifying victims of their rights to sue gun manufacturers, which is great, but the problem is, we dont have funding to help them sue. These are civil cases. Dont have a right to a lawyer like in a crimical case. You just dont have that right. Civil cases are not cases the da office can take on, but i think working with office of victim and witness rights we can work on right to counsel and measuress like that like with prop f in 2018 for tenant facing eviction. Like we did with last summer with prop d, Domestic Violence victims. I think this is a great way and resolution that gets us on board in terms of informing victims of their rights, but taking the next step is getting the funding in place, maybe right to counsel, that could be a state thing they do or something to do at the local level, but i really appreciate everyone really talking about victim rights and accordinating together on all the issues that come up around how people are victimized, which unfortunately are a myriad of ways. Absolutely. Thank you for your service and all you do. Thank you. Do we have anything else . One more. Thank you chair. Ypt to highlight i agree with chair stefani but putting money where our mouth is. With your advocacy in the last budget was about roughly all most 300 thousand to our City Attorney around gun violence and just look forward seeing exploring that and how we can take that next step as well. I look forward to getting the education piece ready and then we can definitely talk about that and i look forward seeing that happening. We have dr. Sarah mets, director from ucsf Trauma Recovery and partner to the wrap around center and thank you so much dr. Mets for being here. My team and i are excited for you to be here to talk with us about just from your expertise about caring for victims of gun violence to help us understand our colleagues at the District Attorney office as well as department of Public Health have talked about their sides of expertise and how they provide around service, but i think you provide the whole care, the wrap around care, so thank you. Yes, of course and thank you so much inviting us to be here today. Want to formally express gratitude for formally acknowledging the role wrap around has and caring for director of the ucsf trauma recoferby center and we also work very closely and have since inception with the wrap around project. I think as a city i think we are very fortunate that with all the players of the table provide i think thoughtful response to gun violence. We wish we were all out of work, but that being said, the Trauma Recovery center sever all victims of violence. We provide comprehensive evidenced base, evidence informed trauma focused mental hent service and case manage to survivors of interpersonal violence including gun violence. Our services are free. It doesnt matter if you have insurance or immigration status and we are a jack of all trades. Not only are we experts very well trained in providing trauma focused Mental Health support, but we provide pretty comprehensive clinical Case Management and that can include supporting survivors through the court system if they do move forward with prosecution. Specifically as it relates to gun violence, we are so fortunate to have wrap around as a partner and as mentioned earlier by supervisor dorsey just so privileged to be working directly with the trauma surgeons at San Francisco general. The trauma Recovry Center was founded by bill sheckter recognizing we have amazing medical interventions to help people heal, but they are suffering. We can put them back together but not healing them and that is how the trc got born is recognizing that it isnt just the physical impact of the injury, but what happens to the survivors life after that . In the blink of a eye their life is changed. If they were the sole source income earner for the family, if they now have physical limitations that impact their ability to caregiver or to work, with the wrap around project, the trc now has a dedicated what we call bridge clinician that is embedded in the project to highlight the importance of a multidisciplinary comprehensive response to gun violence so we are also part of the [indiscernible] meetings with the mayor office. Again just to have that lens and so we go bedside with the wrap around violence prevention professionals to meet with survivors of gun violence to help support the family, to help support them and to introduce the idea of having the trc provide support. So, working to try to dispel stigma around the Mental Health impact of trauma, and working hand in hand with the project to coordinate care for the survivor. If we work with a survivor at the Trauma Recovery center isnt yet connected with wrap around project, we are referring to them to get all their amazing resources and supports and similarly that they would be referring to us for Mental Health support. Just to share i think it is safe to say about 2024 percent of the clients we serve are direct survivors of gun violence or victims of homicide so see quite a significant proportion of folks impacted by gun violence. Thank you. I do understand you have a clear close connection with both the Law Enforcement agency coming through. Are there any times that in terms of i say transitional care, meaning, physical care and then you sort of hand them off to now Law Enforcement in the case it is involved, or other agency and partnership. Could you elaborate more about that transition period . Sure. What is it Trauma Recovery centers role and in terms of where we fall in order of events so to speak . Assuming your initial care, the physical care and sort of as you transition to the wrap around, could you explain just a little and elaborate the steps into that . Sure. Really it is outside of the emergency intervention, wrap around and trc can be bedside quite soon. Of course we want to insure it is a appropriate time for the family and the survivor and take their lead if they are like get out of here. But we really start providing services straight away. As i mentioned, their life is changed immediately. For all we knew they had to be at school to pick up their child and nobody asked them yet, do you have responsibility right now that needs attention . Even those small real life needs, we will start tending to immediately at bedside. Again, folks can refuse our services, but we keep trying and so actually one of the expansion of the partnerships between Trauma Recovery center and wrap around project is in october we will be launching a multidisciplinary postsurgical aftercare clinic recognizing a lot of folks we are missing their medical aftercare appointments so looking at all of these as opportunities to provide some dose of Mental Health support as well as informing about the resources that they have access to. Utilizing this as a opportunity to provide that necessary medical intervention as well as showing up as a Multidisciplinary Team with violence prevention professionals and trc. I think as far as trc and wrap around, we can be present from beginning to whatever end is. We dont necessarily come out of the picture at any particular point and depending when folks want to engage us, they might be at varying phases of healing, of legal proceedings, and so depending where they are at, we adjust our treatment plan accordsingly. When you say that there are a lot of folks not showing up for postcare, do you have a percentage and do we know why . Great question. I dont have the numbers for that. I think the trauma surgeons from wrap around would have a much better guess, but it was a enough that they realized they needed to create this clinic and they have actually seen increase in attendsance and so part of us putting together this clinic is brainstorm barriers folks accessing care and trying to get ahead of that. There is potential mobility issues, resource issues, child care issues for them to be able to pget out the door, and so really trying to not only be practical in the support we are providing, but also making it efficient and impactful for them when they show up. Thank you. Colleagues, that is exactly why we have this resolution too is with the goal that like, we understand it is very complicated situation and very complicated dynamic, all depends on the victims personal circumstance and conditions. I think the goal with this resolution is hoping that we can start a conversation that coordinate all our Law Enforcement agency, department of Public Health, including ucsf with these type of wrap around service that it is not just about the fronts end of care, but back end of care, postcare when we can follow up because we know that perhaps until the victim is ready to sue a gun manufacturer it may not be the first thing on their list as a gun violence victim. It may be sometimes well after they recover first physically and somewhat mentally, so what we are hoping is that we can learn more about this process and so just thank you for your presentation today and help educate us better about the process of what is available and how gun violence victims recover. Thank you so much for the presentation. My pleasure. Thank you chair. I want to take a quick few minutes to do the final remarks and just want to thank all of you for hearing this resolution today. I think that San Francisco has come a long way. I started out as ai talk about too many times already, but in city hall supervisor maxwell in 2006. Homicide victims was 103 that one year and one of the cases that what i remember the most and deeply impacted all city wide was a homicidegun homicide at ella hutch during broad daylight, after School Programming and it took place in the restroom at Ella Hill Hutch center. That was all the kids were during the after School Program and out and about playing sports in the community center. When that took place in fact supervisor maxwell was the chair of the Public Safety and Neighborhood Services. We end had a joint meeting with the Police Commission in that space so that it was hours on end of Public Comment and see how gun violence, even if just one incident where it took place and how it took place impacted not just the victims of gun violence and families, but the entire community and entire city. The people that turned out for Public Comment made a deep impression on me about how important not just the care for the day of the incident but after for those who witnessed it, heard about it, learn about it or know the family members that experienced it. Trauma gun trauma is real and last for a long time, and so i thank you for continuing this work. I think its very critical. I am grateful that the gun violence has significantly reduced in San Francisco, but one is too many, so with that, thank you chair stefani for your work and leadership and are thank you committee for the time to give us to hold this hearing and have presentation. Thank you supervisor chan. I do want to thank the wrap around project for the incredible work they do. Encourage colleagues if have not to tour their place near sf general. I have done it twice and it is amazing and i cant impress upon everyone how vital their work is. Every day in america more then 200 people sustain a non fatal gun injury and we dont talk about the gun violence ongoing and sustaining as much as it deaths, but something that we really need to focus and thank supervisor chan again for this resolution. If there are no comments from colleagues, i think we can open up Public Comment. Thank you madam chair. Well take Public Comment in person first for agenda item 4. Resolution urging creation of programming and resources for victims of gun violence. Appears we have foe speakers joining in the room. I understand we have 11 callers listening to the meeting and there are 5 who want to provide comments on item 4. Please connect us. Supervisors, banko brown please stop the speakers time. First, city policy along with federal, state local law prohibit discrimination harassment. Second, Public Comment is permitted on matters within the jurisdiction of the committee. Violates city policy. Well move to the next speaker. Can we get the next speaker, please . Hello,b good morning. So, just to clarify things, because i dont know if people close their eyes on this one, but a gun is a object, right . It is a object. A knife is a object. A car is a object. A bottle is a object. All those things are objects, so i think what we are missing here, the key element is the killing element and that being the mentally ill. Anyone who points a gun or drives a car off a cliff, or stabs somebody on main street in San Francisco is mentally ill. I think holding a manufacturer of a object would be like holding a manufacturer of a knife used to kill an individual on main street or holding the manufacturer of say a tesla car driven over a cliff with kids in it, the kids should sue tesla. The focus should be 988, Mental Illness. We dont want anyone to die from gun violence and really when you think about it, fentanyl is a object. Fentanyl is a drug. It is person place or thing. If isnt a person, not a place, it is thing. Fentanyl, if ucsf promoted it, anyone who took fentanyl under the promotion of ucsf can sue ucsffamily sue for the death. I think Holding Objects and manufacturers of objects is irresponsible. I think holding the element of the Human Elementholding the person accountable for their Mental Illness would be more proper, so i just want to make sure we are understanding these are objects. They are notthey dont kill people. The Human Element does. Thanks so much. Thank you for sharing your comments. Next speaker, please. Thank you San Francisco speaker, could you please speak directly into your microphone, we are barely hearing you. Can you hear me now . Yes. This is bill [indiscernible] a gun violence survivor and i understand this is one of the last testimonies. I will support whatever position supervisor stefani takes but that isnt on the agenda. What is on the agenda is resources for victims of gun violence. Let me tell you what [indiscernible] i was denied the opportunity to address the defendants [indiscernible] it is a trauma i tried to keep recessed and down for many years. I also want to speak against Mass Shootings and the time i tried to lets say i was in a very dark place in the late 2010, because i was retaliated against. What gave me courage to keep going to reunit the fire was supervisor stefani courage under fire and taking on the nra knowing she was making herself a target. Great courage [indiscernible] and getting after with [indiscernible] like free speech safe zones and safe gun storage are the acts of a leader and she is a hero and i want tothe reason i [indiscernible] was to cheer her on and others in the fight to end it. What i wanted to say directly to the defendants whoi had to fight off, i will gladly have suspeneded the sentences for fighting me if they would just get rehabilitation and help to break the cycle of gun violence. That is what we need to focus on. We dont need to just sue the manufacturers of mass murder machine, we need to sue the animals who dont secure the guns. Need to go after them with [indiscernible] and finally, on a very personal level, i want to thank the clerk office enabling the remote testimony so those who have pain and trauma in our lives can try to help others in this and join forces with a real hero, a brave leader thank you for bringing your comments to committee. Next speaker, please. Hi. Can you hear me . My heart goes out to the victims of gun violence. I think that is terrible thing to have to deal with. There isa lot of things we can do but there is also not a lot of things we can do because a lot of shootings are done with guns that are illegal obtained, and just it effects lawabiding citizens that own fire arms such as myself. When you have to get to the root of the problem and it sucks that most of these people doing it are filthy stop the speaker. You heard previously about harassing and discriminatory evidence. Well move to the next speaker, please. Hello. Can you hear me . Your time is running. Can you hear me . Yeah. Alright. The Second Amendment guarantees lawabiding americans the right to keep and bear arms but [indiscernible] politicians and gun control proponents argue the laws are necessary at the cost of infringing on our consitutional rights. [indiscernible] most of these guns criminals using fire arms that are felons are getting guns illegally anyway. They are doing illegal underground sales, buying guns from family members or stealing them. Purchase from other criminals. Stealing from peoples cars. We have Law Enforcement corrupt and selling fire arms to drug gangs. People are bringing guns from oneair to another. Having the gun laws are not doing anything accept escalate and make it profitable for criminal to traffic fire arms and the people committing the crimes are not 50 year old white men, they are typically please cut the speaker. As with the previous now two speakers during the general Public Comment periodspecific Public Comment period on item 4, that speaker has heard our admonishment to refrain from discrimination and harassment. Well move on. I understand no callers in the queue, madam chair. Thank you. Public comment is now closed. Colleagues, any questions or comments . Supervisor chan, would you like to comment further . Just urge the committee if you can make the motion to move this to full board with recommendation. I am so grateful and it is regrettable to hear some of the Public Comments today. Thank you so much. Thank you supervisor chan. I do agree. I would like to first move the amendment presented today and send the resolution to the full board with positive recommendation. May we take the motion without objection . We are going to request we take a roll call vote for those. Take a roll call on the amendments first. On the amendments as presented. [roll call] no opposition to the amendment s and on the motion to recommend as amended to the board of supervisors [roll call] madam chair, no opposition once again. Thank you so much. Thank you supervisor chan. Mr. Clerk please call item 3. Yes, just a moment. Item 3, ordinance amending the police code to prohibit armed guards drawing or exhibited fire arms other then hollster to protect property. This is sponsored by supervisor preston. Welcome to Public Safety committee. Thank you chair stefani and thank you for promptly recalendaring this after the technical issues prevented it being heard at the last Committee Meeting, and do want to start out thanking my cosponsors, supervisors walton, ronan, chan and president peskin. Thank you again for hearing this and thank you Committee Members. So, i introduced this legislation shortly after the tragic killing of banko brown, a young transman shot and killed by a Security Guard at a local walgreens. Banko as you know was shot by a Security Guard trying to confront him by walking out of the store with less then 15 of candy. In the days and weeks that followed we heard outrage and pain from family loved ones and members of the lgbtq and black community in particular. All of whom deeply effected as were we all by the circumstances of bankos death. As my office worked with Community Members and advocates to try to find ways to honor banko browns memory and prevent Something Like this from happening again in the future, we were dismayed to find out the San Francisco police code currently states that Security Guards may draw their weapons in response to an actual specific threat to person and or property. This is unacceptable. I believe strongly nobody should ever have to die just because they are suspected of stealing property and human life is worth more then property and the city laws should reflect that. While the city is limited in what we can do because of preemption by state regulations for Security Guards, we can at least insure that our laws are in line with state standards and free of uncertainty on key issues of safety. This ordinance before the committee today will make San Franciscos law consistent with state training standards which state Security Guards should not draw weapons unless there is a imminent threat to life and no other option to the use of deadly force. Quoting from page 3 twoe of the California Bureau of security and Investigative Service fire arm training manual. I also want to recognize and thank supervisor dorsey for pointing out also the consistency of this proposal with existing dgo that govern our Police Officers in San Francisco. Thank you for bringing that to our attention. The legislation before the committee does two very basic things. Deletess the reference to property from sections 1750. 19 and 1750. 20 of the San Francisco police code to clarify that drawing or exhibiting firearm in defense of property only is not permissible for a Security Guard. And secondly, and thanks to city Attorney Office for the recommendation of this clarification of changing handgun to firearm to insure the language covers all types of firearms. I know that chair stefani has been looking at article 25 for some time in a slightly different context and are want to recognize that work and thank her for taking that on. I believe that this effort that is more targeted to this specific issue is complementary to her work more broadly on reforms to article 25. I want to thank [indiscernible] from black women revolt against Domestic Violence and [indiscernible] young Womens Freedom Center for all their advocacy on this issue, and i like to thank my legislative aid, Melissa Hernandez for her work as well. Hope to have the Committee Support on this to make the important change to city law. Happy to answer any questions and thank you for calendaring the item. Thank you. Supervisor dorsey. Thank you chair stefani and thanks to colleague supervisor preston and i are did as you mentioned, the standard for Police Officers to use weapons in department general order 5. 01 is this is based on totality of circumstance. A specific articulate threat to Bodily Injury or death. This is about the use of deadly force. Strictly regulated and makes no sense what so ever we would have a different standard more permissive for property when sworn officers have more rigious standard so appreciate your leadership and identifying something that needs to be fixed and happy to support this. Thank you. Supervisor engardio. Thank you. Was there thought towe are talking Security Guards and not Police Officers to go through many weeks of training. Sure listeners watching or streaming will wonder a Security Guard is allowed to have a firearm . Was there thought to tackling that issue . Through the chair, and thank you for the question. That is something you and i discussed in the aftermath of the killing of banko brown and looking at that issue. My understanding is that state law governs the extent to which Security Guards are allowed to have weapons, and we are not at liberty to legislate on that issue. I dont think that we have the ability even though it is a interesting policy question of the extent to which Security Guards should be allowed to have weapons. My understanding is we dont have a lot of latitude locally regulating that. Thank you. I want to thank supervisor preston for this legislation. Very supportive. As you mentioned when i was talking to deputy City Attorney, we have been looking at article 25 for over a year now and especially reforming the way the city regulates private security. It is absolutely critical. I can share stories later about why this came up in district 2 and how concerned about the lack of oversight of some of the private Security Guards rchltt especially when we know private Security Officers outnumber Police Officers 5 to 1 in the city which cause a lot of cause for concern there. I also want to mention article 25 at the San Francisco police code created in the 70. It appears to never have been looked at again unit ilwe looked at it. The definitions and provisions are extremely archaic and interplay between the local rules and current state law is murky so your legislation is a small hrf not small but porn step towards thend and lot mere to do but thank you very much for bringing this forward. I like to add as a cosponsor if possible. Supervisor preston, do you have any knowledge else to add before we go to Public Comment . Nothing beyond just to say i look forward working with you oni know you are undertaking this longer term effort and it is very strange when you look at this provision. The extent to which Security Guards are out there doing their work and we have these regulations that are often out of step with state law and so i think i appreciate your work on the broader cleanup there and i think we felt urgency to move on this particular narrow but important issue, but i think there is certainly more to be done, so look forward working with you on that. Thank you. Mr. Clerk, can we open up Public Comment . We will take Public Comment on item 3, the police Code Amendment regarding drawing firearms by armed guards. Thank you everybody. [indiscernible] pronouns are she, her and i want to say black lives matter, defund the police, disarm security. In the mean time it is time to pass bankoes law because people are more valuable then property spaens when it is 14 worth of snacks. Thank you everyone for supporting this but i was not expecting three members [indiscernible] but whatever. I am sick and tire said of trans people and black People Killed and brutalized. This is the least he can do to help but when this passes we want to make sure there are reparations for the black community and more [indiscernible] it doesnt end with gun violence. Gun violence is gun violence whether happens to a innocent person or not so innocent person. Whether it is private actor or Security Guard or Police Officer and dont think you can jush refuse to do this and just because you pass you can pass your sorry pathetic selves oen the back and think you prevented violence. Just want to say that just grateful come to this point but pass this out now, i yield my time. You especially to nazis. Do we have anyone else in the chamber with comment on item 3 . Seeing none, well turn our attention to two public callers. Hi, everyone. Cofunder of [indiscernible] against Domestic Violence and killing of banko brown made national news. Making this amendment will [indiscernible] Security Guards drawing weapons over property. Thank you sfr visor preston for hearing the Community Cries and [indiscernible] help us in this work. Justice for banko brown does not stauf with this amendment. Happy to hear supervisor engardio asking about state regulation and better training of Security Guards. My organization reached out to senator wiener and been structed to come back in october to bring forth a banko brown law. That will basically seek to remove armed guards from Family Stores and grocery stores. While we continue to pray that attorney general [indiscernible] will investigate and prosecute banko browns murder, we will not hold our breath so thank you San Francisco through the leadership of supervisor preston and really moving forward what the city can do [indiscernible] greater state legislation. Thanks. Thank you for sharing your comments with the committee. Next speaker, please. So, the drawing of fire arms by armed guards, so in response the firearm is a responsibility. Use proper cause for doing so. If i were a gun owner i would never point a firearm at a person simply because i have been trained and training is the key. Making good rational decisions when your life or someone elses life is in danger. What i sawwhat we saw previously was the murder at the walgreens on Market Street so that was absolutely a loss of control by the Security Guard. This should apply to cannabis shops to julie stores, banks anywhere there is a armed Security Guard with a firearm and firearms should not be allowed. If the bad guys have the firearms will we have a shoot out, or we have [indiscernible] concealed carry to protect ones selfand family. Thanks. Bye. Thank you for sharing comments. Next speaker, please. Hi. This is adam from d6 and i haveon the one hand, i completely agree with the sentiment behind this, but on the other, i think we need to look at why this is happening. If stores did not just get armed guards everywhere out of the blue. I remember 10, 20years ago you didnt see armed guards in stores when you went around San Francisco. They are there for a reason. They are there because attacks have happened. It is the same thing with car breakins. We got a rash of car breakins throughout San Francisco and the last Committee Meeting the best our leaders could come up with is tell people not to leave stuff in their cars. That doesnt work, because cars get broken into when nothing is in the cars. We dont have the police force interested in protecting the stores, the people, et cetera. Maybe there is another answer. Maybe we have non police resources, but the fact of the matter is, now we dont have that. So, okay, you take away from stores, does that mean we are going to see more ccw holders doing vigilante style justice . Everyone out there wants to avoid gun violence, but people also want to feel safe. What are we doing on [indiscernible] thats what im not seeing here from our leaders. Im seeing a lot of performative action, but not actual root cause problem solving. We shouldnt be asking why we are passing this legislation, we should ask why did this legislation even have to come up. Thank you. Thank you for sharing comments. Can we have the next speaker, please . Can you hear me . We can hear you. Please begin. On the armed guards, i think it is good we have them, but also think Everybody Needs to get their concealed carry permits. Just in case one of the we will stop the speaker time for a moment just to remind everyone once again, city policy federal state local law prohibit discrimination harassment and your language cross the line. I understand we have no further caller in the queue, madam chair. Thank you mr. Clerk. Public comment is now closed. Supervisor preston, would you like to say Closing Remarks . Thank you to the Committee Members for your statements of support on this and those who cosponsored and hope to have your support and hope to have the full board support. Thank you. Thank you. I also want to thank [indiscernible] for calling in and all her good work. I would like to move this forward to the full board with positive recommendation. Motion offered by chair stefani, recommend to the board by Public Safety. On the motion [roll call] madam chair, no opposition. Thank you. We are going to call an item out of order. We have supervisor safai with us today and hewree are going to jump to item 6. Item 6, right . Mr. Clerk, please call item 6. Item 6 is hearing on office of chief medical examiner report on accidental Overdose Deaths issued on january 18, 2023. Thank you mr. Clerk. The item is sponsored by supervisor safai and cosponsored by me and happy to welcome this morning, so supervisor if you are ready ill turn it over to you. Thank you chair. I want to thank the Department Heads for adjusting their schedule. I appreciate them being here today. I know there is a lot of move pieces and people pulled in 5 Different Directions so appreciate coming out. I called for the hearing because the city is in the worst overdose crisis in history and i want to understand what our Police Department, District Attorney, Public Health department and Homelessness Department are doing to combat this. If this years data trends continue at the current pace we are on track to have by far the deadalist year in city history. The situation is getting worse, not better. It is important for those departments and i know they have been, but to continue to work in collaboration and have very similar goals. Lets put theour city in context. Overdose rates have been growing across the United States impacting communities big and small rural and urban. The roots of the crisis are deep. Trauma, Mental Health, poverty, existing Health Disparities among communities all play a role and a deadly drug that continued to impact San Francisco in a way we have never seen in the form of fentanyl. Across San Francisco, among the hardest hit counties in the country. According to the chronicle overdose analysis, San Francisco has 7 highest overdose rates with 500 thousand people or more. The overdose rate is 8. 7 per 100 thousand residents of january 2023 and most recent month the cd c has data. Three times higher then the national average. No surprise it is not hitting everyone the same. Black and latino men are among the demographic dying at the worse rate and disproportionate rate compared to white male counterparts. Well hear from dr. Roda, a profile of who is overdosing emerges. Men, 83. 5 percent male. People of color. 55 Percent People of color versus 38 percent white. 32 percent black. 18 percent latino, 4 percent asian, 1 percent native american. They are older, 55 and older is 34 percent. 42 percent is 3554 and 15 percent are 1534. And this is important to note, 68 percent have a fixed address versus 28 percent are homeless or address cannot be found. That is 68 percent. Also a city problem not just a tenderloin or soma issue of the fixed addresses overdose rates more death rates occur outside of the tl and soma then in those neighborhoods. 63 percent versus 39 percent. More deaths occurring outside the tl, 38 for 67 polk street, russian hill has more overdose then tl and soma has a percentage of the small populationism fentanyl changed everything and the drug driving the crisis. 81 percent of the people who have accidental overdose had fentanyl in the system after we hear from the medical examiner i want to understand from Law Enforcement the strategies to shut down the drug supermarkets that poison and kill rez dnlts of the city, the 7th highest rate in the country for large cities. Want to understand from dph if the Prevention Strategies address these trends we see in the data and if we are effectively reaching the populations in need of help versus the right type of interventions. And at the same time, do we have the facility and do we have it capability to serve the population in need . Do we have the Available Services and thats something that has come out more then ever in the last few days. Better understand how hsh is preventing overdose and housing and shelter system in terms of requirements and what the policies are. And lastly i donts want to hear what we are doing, i want to know what is working and not working. Thank chair stefani for cosponsoring the hearing and turn it over to you chair if you like to say a few words or want to get into the presentation. Lets get fl to the presentation. Great. I think we are going to go first to the medical examiner and call up the District Attorney because she has to leave. Hopefully she can hang with us a few more minutes. Thank you. Good morning board and my name is dr. [indiscernible] here on behalf of office of chief medical examiner. May we please have the slides up . Thank you. [indiscernible] director. One of the main things and core [indiscernible] office of chief medical examiner is Death Investigation and forensic service. We investigate all non natural deaths and any natural deaths [indiscernible] Death Investigation commences when the investigation is on the scene by our investigators collecting photos, narratives history and collecting the body back to bring to the premises. A topsy is performed quickly and specimen collected. [indiscernible] performed and reported out to our medical examiners and help perform this report. The cause and manner of death is determined. The cause of death being the disease or injury. The manner is universal manner including natural, accidents, suicide, homicide or undetermined. Today we are focused on accidental manner and overdose the cause of death. Our case load has increased since 2018 by around 1150 annual deaths investigated. To the last year 1677. This year we are 2 3 of the way through the year and predict chief medical examiner predicting just over 1800 for the case load. We are currently from january to august at 1280, which is 20 percent increase just over the last year even. Historical data of annual accidented overdose specifically from 2009 to 201516, about 180210 accidentsed overdose determined in the city county of San Francisco. In 2017, 18 and 19, we started to see increase doubling and sometimes tripling the rate. It was in 2020 when this chamber enacted an ordinance to require our office to report these Overdose Deaths. Directsly to the mayor, the board of supervisors and director of health. That was a requirement [indiscernible] three time s a year to collect this data and prepare a report. We do it monthly just due to internal effectiveness and also to aid any efforts by policy makers and health partners. These are performed on a monthly basis and available on the website. The report specifically contain death data, drug data, Demographic Data and chronological data to map out the dates of death in the trend lines. So, after the 2019 and when these reports were enacted and when we took over the annual reporting, we have seen about 4 time increase from that typical load from or case load i should say from the previous decade where we are now current status of over 700 in 2020 and this year at 563, which is a first 8 month of the year or 2 3 of the year so predicting 4 time increase of what was observed the previous decades and this is in the line with the three [indiscernible] the first being Prescription Medication and heroin phase 2 was the last decade and the last 6 or 7 years has been due to fentanyl specifically. The specific drug or drug classes, we also report that to describe profile these deaths. You can see here fentanyl accounts for 70 to 80 percent of these Overdose Deaths. Additionally, meth is around 54 percent. Cocaine from about 3745 percent, heroin decreased over the last 4 years, more see then historically and just about 8 percent of Overdose Deaths. Opioids also decreased. One thing here described is the meth and cocaine[indiscernible] also have fentanyl, so our drug profile really are poly substance. It is usually a number of drugs that contribute to the cause of death. Lastly, demographic details is provided to try to help determine the populations and that demonstrates, gender, race, age, fixed address and death location and these are in the ordinance we try to meet on a monthly basis and available again on the website both the current year and previous three years. Thank you. Hang tight. We are juggling a bunch of different schedules so well call you back up to ask questions and set more context. Want to give it da the opportunity to say a few words and answer a couple questions before she has to take off. Thank you da jenkins. If youyou had a presentation. If you want to say a few words and i can ask a question or two before you have to go and someone from your team might be here. Thank you supervisor safai for calling attention to this very significant issue. I cant tell you how many mothers and fathers i have spoken whos children die from fentanyl ovdose and understand the depths of their pain and why this is such a significant issue we must address. Ill first talk about what my office is doing but more importantly, we know that currently we are not doing enough so ill talk also about what more we need to do as a city. As you all know, this topic has been of priority to me and my Administration Since i took over a little over a year ago. As a result, we have seen all most 2 fold rise in the number of arrests for fentanyl dealing and other drug dealings which resulted in my Office Filing over 1,000 drug dealing cases since i took over last july. We have a currently 90 percent filing rate on those cases, which tells you one, they are being investigated properly but two, that we are not taking this issue lightly. We in the last year gone to trial in drug dealing cases five times which more then we can say for the previous five years probably in the San Francisco da office. We most recently secured a conviction just last week in a fentanyl drug dealing case for repeat offender of selling that drug. A part of needing to deal with the drug dealers isnt simply filing charges t is what happens once those cases are filed. One thing thet i have emphasized is we cannot allow egregious drug dealers offantinal nor repeat offenders of the sale of this poison to cycle back to the street on their own as a result istructed my office to take a position that the sale of fentanyl in San Franciscorupts one of the most significant Public Safety risk s we see in San Francisco. It is equivalent to just basically handing someone a loaded gun and we have to treat as such. As a result we filed 248 motions to detain drug dealers in custody while their cases are open. Those 248 motions represent people who have 2, 3, 4 even 5 open cases for drug dealing. They are been arrested 5 times for the possession or sale of fentanyl or other drugs. People who have significant amounts of fentanyl including enough sometimes to kill half or more of the city of San Francisco with respect to doses. We have still as been very open seen reluctance from the court to grant those motions. We only had 19 of those motions granted to date, which means we still have most of these drug dealers back on the street selling the same poison. We have to as a city make that focus, that just like we wouldnt allow someone who shoots a gun to cycle back on the street immediately, we cannot allow those who are selling death to do so either. One thing i think we need to focus on in order to improve the situation with respect to overdoses is to conduct thorough Death Investigations related to these Overdose Deaths. We need to be looking into who the sellers are that can be tied to these specific individual deaths. As we know, not every fentanyl dealer is out on the street. As you said, many of the people who died are people who are housed, people working individuals, many have been sold this drug thinking they are buying something else. Many of these dealers are people that we dont see out on the street in the tenderloin. The only way to track them down is to conduct thorough Death Investigations to try to track down who these specific sellers are, tie them to the death and i have said to the city of San Francisco, i am willing to charge those individuals with murder, should we believe that we have sufficient evidence to do so. Until we get to the point where we are taking a closer look at these deaths and who specifically is causing them, we are going to continue to struggle on this issue. I aed voicated to the state legislature that we have to be able to give admonition to fentanyl dealers a thet time of pleas and convictions that they will face murder charges potentially if they can be tied to a death that yet to be approved by the state legislature but continue to advocate for it and yield to you now supervisor for any questions you have. Thank you. Can you say a little more about who is involved or who would be involved in the thorough Death Investigation . It would require both coordination with the office of medical examiner, they have investigators as you just heard that show up to the scene and collect some amount of evidence related to the death. The San FranciscoPolice Department of course. We have to have their assistance their crime scene investigators. We need cell phone analysis to be a part of that, to outsource to other agencies in order to see if we see evidence in that phone of who they contacted in order to make that purchase potentially, but that could take coordination with federal or state Law Enforcement agencies as well. And then, what do you think is not working right now . What isif you could make one or two changes, what would be the one or two changes you would like to see . I think in my arena the main change we have to see is a bench willing to see this problem for what it is, and to understand that particularly for repeat offenders they must remain in custody. There has to be a Public Safety put first in San Francisco and also allow us disruption in the market, which is not happening. From the other standpoint, i say we have to stop enabling the users. I say that from my heart that it is not what is best for them to continue to putmake this easy for them to be able to risk their lives in taking this drug and that means again of course disruption in the sales market, but it also means as a city we are going to have to stop providing as many items as we do to enable this use. We have to stop making it easy. We have to start giving them a incentive even outside the crimial just ares system to get into treatment and now there is noincentive. Last question and then any colleagues have a question for you before you leave. You said you filed 248 detention motions, the Court Granted 19. Can you explain that a little more and what the impediments are for the court says impediments for granting those motions and why you believe that isnt happening . At the time somebody first appears in court on a felony case, the da office has the opportunity to advocate to the judge whether or not we believe someone presents such a significant Public Safety risk that they should not be released while their cis case is open and remain in custody. We have a body of law with criteria what consitutes a Public Safety risk to that level and in 248 cases why we believe these individuals in their situation present a level of risk that qualifies under the law for detention without bail so meaning not offered bail, they have to stay in while their case is open. We dont have the ability though to do that on our own. We can only appeal to the court and ask that the judge rule they have to stay in. Let me ask a quick question because this is important and adult probation is not here and probably should have had them here. What role does adult probation play because 128 have multiple cases. Can adult probation revoke someones probation and have more expediting hearing in front of the judge with you to make a determination . Yes. That would require they be on formal adult probation. That means they had to sustain a felony conviction within the past 2 to 3 years and are that simply is not the case. Most of them wereif convicted at all in the last 2 and a half years most were receiving misdemeanors and put on informal probation so that is why adult probation isnt having a opportunity in most of the cases to weigh in or file a motion to revoke that probation. Most of these people were let out over the past three, four years repeatedly by judges and again have picked up new arrests, new cases filed and once again released over and over again. That is the problem. With we make that argument to the court under the law those motions are not being granted. What is the judge saying . 128 of these have more then one bench warrant, more then one open case, you get enfront of the judge, this is multiple case person for the same offense, what does the judge say in that instance . Most of the time the initial judge is punting for lack of better word the motion to preliminary hearing judge saying, there is insufficient time or it is better for the person who hears the preliminary hearing to make that decision even if they are looking for less restrictive means of release even when we argue there has been history of bench warranting sometimes that is not being taken seriously. They are being often times put on electronic monitoring as alternative. We had a judge say they dont have time and unwilling to address these motions. We have seen a various number of responses. Got it. Okay. So, i think one thing that we hear more and probably better coordination, understandingi wonderend with this, if there is is a more thorough investigation with the medical examiner, sfpd, Cell Phone Technology companies and others involved, if you have put togethers a better investigation does that allow for stronger argument then by the time you are in front of the judge or filing for prosecution, does that make the case better . Not at the outset of normal drug dealing case. We have 72 hours from the time of arrest to file a case. You are not going to conclude that level of investigation that quickly. These are for drug dealers arrested usually in the act of selling. When we talk about a overdose death occurring, there is no institute of limitation on murder, but we have to be able to invest resources to conduct these investigations and so thats the more pressing issue. That could lead to charge of murder . It could. Got it. Any questions colleagues . Supervisor dorsey. Thank you chair stefani and thank you supervisor safai. Mostly i want to express gratitude. I live in a neighborhood that has seen a level of public drug use and worse brazen public drug dealing in levels we have never seen. I think it is really important what you are giving voice to today. Fentanyl dealing is the deadalist crime in San Francisco history and it is important that we have leaders like my colleagues today and you who recognize that. I share your frustration with folks who dont. I think i am hopeful people will get there. One thing that happens when we see the loss of life we are are seeing, this becomes personal to more and more people and it is personal to many of us here. One thing i just say is that, there is also a effect that happens that i see playing out in the city where people are really losing confidence in government. It is delegitimizing when we do a great job of giving tickets and parking violations, the things that government will do while they are watching these kinds of drug scenes and brazen lawlessness play out. It is something that for those of us who believe in what Good Government can accomplish. We got to take this seriously and appreciate you are. My question is, i am working on local priorities and legislative things. Is there anything at the state legislative level we as a body can be advocated for along with you . You mentioned notification and priorities, but certainly, like i said, these dealers while i believe they know many base said on things i heard about the danger of what they are selling, i think to have a judge or prosecutor at the time they are in court taking a plea, guilty plea to a charge, be admaunshed they are selling death and could be charged with murder. Same with dui cases could be helpful. Put people on notice and whether it helps steer 5 away from doing what they have been doing that saves a number of lives, so i think we need to continue to push for that piece of legislation. There is one other thing that when i have expressed frustration i share with you about the bench, time off the street is a really important thing. At least making progress on what we are doing and when we have these kinds of Revolving Doors it is infeariating, enabling this potently lethal drug to be sold with impunity and the bench isnt respecting we have to get this off the street. What i hear sometimes from advocates is they cite a humpfry case and dont have a lot of familiarity with it. Can you give explanation . It is case law that changed what it requires of us to prove regarding the risk someone poses to Public Safety to be detained without bail. Again, i think this is a matter of the court educating themselves. Us as a society educating. Everyone wants to attack this problem the way we tried to the crack epidemic or heroin epidemic. That is not what this is. As you well know supervisor. We have to address for what it is. The most deadly drug the countsry has seen. It is killing the unhoused and mentally ill up to the elite in apartments so we have to look at this differently and say to ourselves, what is the truth of the matter here we are dealing with and it is worse then guns in San Francisco right now. I cant say across the country, but certainly in San Francisco it is killing more peoplethone guns are but we are not treating that way. We have to. Thank you. I just wanted to thank you da jenkins for your incredible work. It is so nice to know you have a 90 percent filing rate oon had cases and up by 72 percent. I think i got that right. I just want to echo what my colleagues supervisor dorsey said in terms of the risk this poses to a subset of people who are suffering from a disease. A dead ly disease and stigma around that is bad enough. They lack will power, there is something wrong with them they cant stop doing the drug or taking the drink or whatever it is. The fact we are not mustering every from the bench to every person in this City Government that we are not doing everything to protect the people suffering from this disease is just beyond alarming and i just thank you for your good work and look forward really continuing to push on the isue because i think we are getting further and further on it, so thank you. Thank you for adjusting your schedule. Well continue to work with you and follow up with your staff. Appreciate all your hard work on this. Now we can call up the pd. I think the pd is next in line to present today. Morning. Commander [indiscernible] Police Department field operation, oversee mission station, tenderloin station as well as d mac drug Market Agency coordination. I will echo what everyone said. Part of the issue is this overwhelming permissive open air drug market that is occurring out there. Lack of overall consequences, and the looking at it in terms of risk reward profile. There is a lot of reward, not a lot of risk. In that vain, San FranciscoPolice Department has really realigned priorities, certainly in terms of tenderloin station, the d mac just mentioned and looking at the priorities in terms of supply and demand, the risk reward profile, but along those lines, disrupting and deterring narcotic sales and doing that by rechanging the risk reward proposition specifically for drug traffics via enforcedincreased enforcement and parltnering with the District Attorney office for increased prosecution and other partners including United StatesAttorney Office. Also reducing the inflow of illegal narcotics. Specifically into the operational areas of the tenderloin. Applying pressure to known transit lines through investigations. Finally, reducing demand for narcotics. Partner with city agencies and Pair Services with enforcement. Along those lines we are realigned some of our Department Resources over to the d mac, specifically talking about the narcotic Investigation Unit went from investigations under Field Operations bureau. We created a enforcement team. This Team Obviously targets folks with outstanding warrants and in particular to support the initiative, they have a focus on fugitives with specifically with warrants relateing to narcotic sales just as it da spoke about. There is constant interaction there and there is is a known lest of folks that have those type of warrants outstanding. Finally, we created what is gone as 11550 team, which focuses on open drug use and contacting subjects that are using drugs in public. So, just to get into the d mac specifically to give you a view an idea of what it is about. It is really accordination center of city agencies, state agencies as well as federal agencies. Idea being breaking down the eco system into drug trafficking, drug use and illegal vending and focusing down utilizing all city resources, city agencies leveraging their abilities, their strengths in order to combat the issues in those specific branches. We have allied agencies from the state level to include chp, national guard, bart, cdc, meaning California Department of corrections. And then finally, we have federal partners as well coordinated to include all of the big name youz know about, federal bureau of investigation, dea, Drug Enforcement obviously, atf, u. S. Marshal so coordinate the effort together through the d mac. Just to get into some statistics and successes we are seeing in terms of from the Law Enforcement perspective. These are fairly aligned with what the da spoke about, butd breaking down the drug useer arrests and those are specifically simple possession, paraphernalia. Last year year to date january through september 24, 485 arrest. 2023, 768. That is a 58 percent year to date and year over year increase. In terms of drug trafficking, 2022, same period, 393 arrests. In 2023, 707, so 80 percent increase during that same period. And then finally, in terms of fentanyl seizures, which over the last year incompass about 64 percent of the narcotics taken off the street compared to last year, we seized 94 pounds of fentanyl. Year to date this year we seized 218 pounds, which is 132 percent increase during that time period. Ill stop there. Any questions . Thank you commander lou. Appreciate it for being here today and giving us a update. Want to hit on the point on the da brought up about sfpd investigations on Overdose Deaths and trying to track down the individual involved in that who dealt the drugs to them. How often does that happen and whats thehow does yourPolice Department coordinate and do that investigation . Right now we dont have the unit that is specifically set up for overdose investigation. If a if nercotics on regular basis during the investigations do what is called a phone dump and so there have been linkages to death, but specific unit to look into Drug Overdoses specifically does not exist now. Not asking specifically for a unit, im asking for, is there a plan in place and do you investigate Overdose Deaths likethat is what the District Attorney was saying that what would be helpful in terms of determining people volved since a lot of deaths are not happening out on the streets, have you all investigated and do you investigate these Overdose Deaths . Currently my understanding if it is ruled an accidental dth there is no a investigation thats initiated by our department. Got it. Thats goodi understand pulled in a lot of Different Directions, but that was one of the strongest recommendations from the da is figure a way to do investigations with the medical examiner, her office and you all in particular. How do you thinkif there is shooting that occurs you have a victim crime unit or can you explain how you deal with fatalities that seem to be murder . What area of your Department Investigates murders . That is homicide unit. You have a homicide unit that is doing that already . Thats correct. How big is the homicide unit . When they are at max nm it would be roughly 16 investigators. Got it. Is that under your command . The investigation bureau. That is investigation. You are in d mac . Correct. More on the supply side . Roithd. Right. Both supply and demand side a bit. I saw the statistics the da put forward, said they have 511 individuals that they have been involved with open cases, bench warrants and you all are putting a lot of that energy into focusing on actual dealers that are on the streets. Can you talk about that . Yeah. Just to address your first question, as far as overdosea body that look into overdose death we are looking into standing one of those up so matter of talking to the subject Matter Experts known in san diego has a good program, so we are starting to look into tell me about that . They have a Investigation Team that looks into overdoses and tries to find who is responsible for selling and getting the drug to the individual . That is correct. They do have a specific body that does that much like what the da described. A lot of phone work, a lot of technology to get into phones of victims overdose to try to go upwards and find if there is correlations to specific dealers that are selling drugs leading to deaths. And has that been successful . Have they been able to find individuals and then bring them to trial for murder . So, i am not a expert so dont want to speak out of turn there. Just aware they have this correct. Okay. They have norcotics units or street crime unit that do this on a regular basis 7 days a week, day and night. A narcotic investigative unit, they are working out there every day as well, but in particular in partnership with federal agencies as well for example, dea. In addition, we pair it with chp for example. Chp we partner with them to not just do Traffic Enforcement. It is a coordinated effort to do [indiscernible] of supply coming into San Francisco. Someone that would be monitoring the main thoroughfares that lead to the tenderloin knowing drugs are transported into the area. We step up enforcement with the help of chp for that particular reason. In addition to it is just a uniformed deterrent when we pull cars over out there. We utilize by bus, we utilize spotting cases and spotting case is a officer would go into position of concealment, watch drug dealing happen and when they feel have probable cause to effect the arrest they get a arrest team to come in and arrest the individuals that are conspiring to do that particular crime. The other portion of it, working with federal partners, dea, u. S. Attorney office is we have a component known as adoption of cases, so not only do we work in partnership with the da to bring cases, but we also turn over cases to the u. S. Attorney office that fit their criteria. Those casesarrests made by sfpd personnel, but because of the element of the particular case, it can be adopted over when they fit federal criteria for prosecution with the feds as well. Let me ask you another question. One thing and you probably saw this week a proposal, one thing we hear over and over again, a lot of places you see open air drug dealing and people on it street selling drugs are predictable locations but dont see officers there and present. Can you talk about that and responding to those that would say, why are we not putting officers in that area to supress that drug dealing . By the way, appreciate the work you all have been doing in coordination. See a volume of seizures and drugs turned over and think beginning to have a impact so thank you for the hard work and coordination you are doing. Just want to talk more about Actual Police presence in the community and what impact that would be because we keep hearing over and over again. Sure. I think i break into populations when i answer a question like that. There is drug dealer population. We have had a decent amount of success with that and will continue to do so. The other population you are talking about is these hot spot areas you are talking about. Also encompass a user population as well. So, that in terms of a Police Department response is a little more difficult and i think the user population is what you really tend to see in terms of the masses of people that the community has issue with. From the Police Department standpoint, we have really what amounts to misdemeanor drug user type codes, paraphernalia, under the influence, those sorts of things so misdemeanor type of tools. Time off the streets. Supervisor dorsey mentioned that, misdemeanor is a misdemeanor, so there is a bit ofit is revolving door. Thats where we utilize the strength of d mac to pair enforcement efforts with services so that we can try to get folks who are of the user population into services. Colleagues, any questions before we go to dph . Supervisor dorsey. I just have a quicki wanted to ask for i think what im asking for is clarity, because you mentioned tenderloin and focus on the tenderloin. Sometimes i think people in my district and if i didnthad not experience working in the Police Department, i understand sometimes it is referred to as the Tenderloin Police district is much larger then the tenderloin neighborhood. I would be remiss not to point out that south of market neighborhood has more Drug Overdose then the tenderloin. In terms of location of death, there are some months in april, may, and july, south of market was the number one rated place where we see drug Overdose Deaths and certainly where we see a level of public drug use and drug dealing. Im hopeful that the d mac is flexible enough to cover south of market neighborhoods. In tenderloin please district and outside also. Can i get clarity on when people hear what the focus is south of market. And also the polk street corridor. There are other zip codes that are getting bad. To answer your question, i think what i presented was tenderloin specific, but to answer your question, you are right. We see a lot of drug issues, 7th and mission, 6th street, 600 block of eddie heading to the northern. We are very aware what we are doing in the tenderloin causes displacement, so that is in fact what we do every day is start with certain hot spots, we focus on through d mac through daily scouting, we bring all these resources to the table, city agencies, Law Enforcement resource and say okay, these are hot spots, because it changes rapidly. It is quick reacting market. And then based on what happens based on initial response by the city or by agencies, we then move off and kind of deal with the disruption and that may take us to south of market or northern places that border the tenderloin. Yes we focus on outside the tenderloin with our resources. I just want to follow up. In terms of the data you are using, do you actually have data on usage and overdoses resulting in death . Do you have that hot spot data so you can better focus patrol efforts . Are you able todo you have that . I dont have that with me, but we do have the data. Does that help you better focus your patrol efforts in terms of where people are most likely overdosing leading to death, or using where they might . Yeah, it informs us on what in terms of historical data, but what we do with it d mac we go out every day and see where people are and that informs what we do throughout the day multiple times per day. Okay, thank you. I want to say one more thing too because a lot of people refer to the accidental overdoses and i dont think we should call any of this a accident. I think a accident is often understood to be unpredictable, achance occurrence or act of god and avoidable and when you look at most injuries or deaths in event leading umthey are predictable and preventable and think that is the case here and all most dismissive to those suffering from Substance Abuse to labeling these deaths accidental. Yeah, i meaninteresting point. I dont think anyone intends to take a drug and kill themselves but this drug in particular, it is so powerful and unpredictalable and makes it unique as you said supervisor dorsey and stefani, this unique impact it has not just San Francisco but the United States and many urban and rural areas. We seem to be moving slowly in terms of how we are responding to this. There is a supply and the demand side. We will be talking about demand side and call dph up next, but the idea that we dont have coordination to look at the overdose itself to see to investigate where that happens thenas we said, if it were a murder or gun or shooting, it would be a whole Team Assigned to, but we are having all most two people a day overdose in San Francisco and where and who are sending and putting the drugs in their hands and particularly when they are responsible for handing them something that they dont understand that the magnitude of what they are handing to the individual. Often times the amount of fentanyl that is laced to the particular drug is so unpredictable it can have that outcome. I think it is something we have to follow up with the Police Department on and the District Attorney, medical examiner. Might be one of the results of this hearing to talk about better coordination and looking into particularly when you see the statistics where not say everyone of the individuals who are drug dealing is selling fentanyl but many are. 128 of individuals and bench warrant status have more then one open case. A lot of the same people selling a lot of the same drugs and getting out and doing over and over and and over again. Good to know if those are the people responsible for the people dying to draw that connection. Well work with your department. Thank you commander lou. Congratulations on your promotion. We miss you in the ingleside, but thank you for being here and your hard work. And thank you colleagues for your questions. Well call up dph. We are going to get slides set up. Good afternoon. Hillary conens. Department of Public Health. Thanks so much Committee Members. Chair stefani for convening this hearing. We want to share with you our work and approach to this very deadly and continuing to spiral crisis. Just to set the National Context for a moment, Overdose Deaths are a crisis nationally. You can see that in 2021 which is the last full official year of cdc data, our deaths nationally exceeded 100 thousand. Bidens drug zar is anticipating we might lose 165 thousand lives annually by 2025. This is a crisis preoccupying all of us in Public Health, myself included and is really a tragedy. I think as chair stefani already said yesterday also, these deaths are not statistics, these are people who are loved, thousands of san franciscans have died from Drug Overdose and everyone of these deaths is a tragedy. We call accidental for epidem logic and me terms, but i concur strongly that they are unintentional and we need to tackle every way we can to prevent the loss of these lives. Additionally, Overdose Deaths are increasing in San Francisco. In 2023, compared to 2022. As you heard from the medical examiner, the majority involve more then one substance, but vast majority using preliminary data involve fentanyl. I also want to point out that we saw a decrease in Overdose Deaths from 2020 to 2021 and flattening from 2021 to 2022. That was in the context of covid epidemic with wildly increasing rates in 2020. Similar to what we was happening nationally, and with the addition of a number of Public Health programs, which ill detail for you. We saw some reason to have optimism that we were at least doing flattening of the curve. The story this year is obviously very different and causing us and you to really intearigate all we are doing and ask us and all of us hard questions about what else we can do. As you also heard the majority of Overdose Deaths occur in a resident not in the street. Approximately 1 3 among people without a fixed address, but also important to note they are occurring city wide, even if they are disproportionately effecting people experiencing homelessness. So, we have to hold both these things in our minds as we think interventionsism. The other thing to highlight nationally and in San Francisco, overdoses disproportionately effect black African Americans in San Francisco represent 6 percent of the population. 32 Overdose Deaths to date in 2023. We use the rate about 5 times higher then the city wide rate and unacceptable. I listed categories we are operating that includes prevention, which includes education engagement and support. Aiming to strengthen street treatment and other Substance Use services. We know that this is a crisis of a magnitude that dph must work across the city with all our partners to implement what we are calling a whole city approach. We are also really lifting intending to lift up and elevate and center our need to reduce Racial Disparities. Finally, we know we need to take a data informed response and approach and well speak more about that as we go. We are aiming to vigorously engage the commune teon Overdose Response and reprevention. You you heard me talk since i arrived we established a office of Overdose Response. Funding this primarily with Mental Health services act or state funding. This is a enabled us to build a Robust Community engagement. Conduct training on Overdose Prevention and how to connect to care reaching Community Members, Community Based organizations, syringe access and disposal sites, high risk housing settings, Entertainment Venues, Faith Base Organizations and city staffmentf we rely on dph staff and Harm Reduction coalition and [indiscernible] reach people who use drugs. We are also focused taking a neighborhood based as well as followup of non fatal overdose approach using street based care and outreach. We also implemented a specific non fatal Overdose Response program for people who are housed where we go to peoples houses. Some of the amplification of our work in the last year includes distributing naloxone during the Overdose Prevention and education. We have distributed more 72 thousand naloxone doses in 2023. We reached 5,000 people with a online overdose recognition and response training. We engaged more then a thousand members of the public who received overdose recognition and response training in person since february 2023. I like to mention we are partnering with Entertainment Commission to reach more people who may be at risk by night life and other venues. We are providing information about care and treatment and all of our Overdose Prevention trainings, knowing Overdose Prevention is one first step in what we need to do. We initiated a request by mail Naloxone Program so people not otherwise engaged with services can receive naloxone and Overdose Prevention information. We provide free naloxone at the dph pharmacy, community events, the lobby of the county jail and of course upon request. We are also working with you to support legislation that requires all retail pharmacies in San Francisco to stock and post signs about its availability. We are specifically amplifying our focus on reaching people in Supportive Housing, with Overdose Prevention and treatment delivery. Doing this in partnership with our Community Based partners from the national Harm Reduction coalition, working with our colleagues at hsh as well as the San FranciscoSupportive Housing network. We are training residents and staff in overdose recognition and response. Installed more then hundred emergency Overdose Response cabinets and delivering bup nor 15 using Behavioral Health pharmacist to more then 80 residents across more then 25 housing sites in order to help folks stay in care. Overdose prevention and response is critical part. Highlighted 3 services on the slide in front of you which we coordinate among the dph and cross city workers. We have a neighborhood based Behavioral Health team with regular consistent engagement for high priority unhoused people with serious Behavioral Health conditions. Working with d mac as well as neighborhoods and neighborhood associations to follow people lodgeitudinally to aim to engage them and retain them in care. As i also mentioned, we have Overdose Response and follow up team deadcaded to providing follow up after someone experiences non fatal overdose. People that had a non fatal overdose are increased risk for subsequent fatal overdose within 72 hours of the overdose event, our Engagement Team as well as our team specifically working with people who are housed aims to out fp reach to the individuals to engage them and draw them into treatment and or teach skills to prevent future overdose. Our Street Medicine Team of clinicians has served more then 3,000 people experiencing homelessness incorporating Substance Use treatment and Risk Reduction into their work. We know more is needed and what i want to highlight here is our framework and approach informed our work to date and how we will approach the coming year. First of all, as has been mentioned, thank you supervisor stefani, disease of addiction is a disease, it is a life threatening illness. We are aiming to save lives by delivering effective treatment. We are aiming to save lives by pulling people into care. Persisting to incrjs encourage them to enter care and accept the help that can save their life. We do this by creating a set of programs across a continuum aiming to reach and provide care to people in their particular as we call it, stage of change. You see this under the arrow in front of you. Whether somebody is precontemplateive so not ready to make a change, conmplative, thinking making a change, preparing to make a change in the action phase of making a change or in the maintenance phase often called recovery, we are aiming to reach people with services that not only are appropriate for their stage of change, but aim to move them across these stages in order to deliver life saving care. I want to share with you some key examples of the work that we have been undertaking to strengthen that continuum of care. First, and particularly for folks who might be precontemplateive or contemplateive thinking making change we want to reach them. Our Community Partners provide low barrier Holistic Care to people who use drugs. Dph funds these organizations to provide syringe access and disposal. While sterile supplies are available. Service aim to be comprehensive to improve the health of people who use drugs and we aim to take a holistic approach. You can see the list of services that our company these low Barrier Services and the picture that you can see in front of you is our debose site in which a medical provider is present on regular basis. I also want to share our approach characterize is only about needing beds and that is a vital part of the continuum. I also want to say to make the point treatment is more then beds. Most people many people with Substance Use disorders stabilize outpatient care. It is often the lack of stable housing that brings people experiencing homelessness into residential treatment. I dont mean to over generalize this, but just to say that many people,b including folks i have taken care of over my many years in clinical practice can and do recover in outpatient care. The other point to make around fentanyl in particular is that we know from our science the most effective form of treatment for opioid addiction includes the use of medications, methadone or buprenorphine. These can be provided in outpatient settings. Methadone is highly regulated and can only be provided in licensed opioid treatment programs. It is regulated at the federal and the state level. Bup [indiscernible] can be prescribed in primary care settings as well as Specialized Drug treatment settings. The other principal here is people exiting residential treatment need access to care and housing. Recovery is hard without a stable place to live and recovery is hard without the opportunity for ongoing care to maintain stability and prevent subsequent need for Residential Care. These are some of the statistics about folks we treated in the city in 2022. We are aware of about 5,000 people treated for Substance Use disorder across dph programs. 2500 people in San Francisco received buprenorphine. That is both dph and non dph programs. About 2300 receive methadone for opioid use disorder. Nearly 575 residential treatment admissions and about 1100 people used withdraw management services. Again 2022 data. We made someworked hard, i want to acknowledge my team and all dph. Worked hard to expand a number of services along this continuum. That work has been enabled by proposition c focusing expanding service for people experiencing homelessness. We worked to expand medications for Addiction Treatment as well as other high impact treatments. Dph expanded access to these medications at key sites by a variety of tactics including increasing hours of operation, increasing staffing and increasing ability to do in community treatment. You can see some of the programs listed on your slide. I do want to acknowledge we have been challenged at times in terms of workforce shortages, which are both a national and local problem. There have been times where expansion is slowed by challenges identifying appropriate numbers of staff. This is true for both dph ourself as well as our contracted providers. I also want to mention another form of treatment called contingency management. This is a form of treatment that has been found to be the best most effective for treatment of stimulate use disorder with increasing evidence around other disorders. Contingency management is one of the prior speakers said, really incentivizes or provides incentives for people coming into care. Providing a reward for a healthy behavior. There was just terrific article today which well get out to you highlighting the work of one of our providers, San Francisco aids foundation in providing specifically contingency management to latinx folks in the city. We are aiming to scale up contingency management further in this coming year. Some of our successes, some of which i mentioned in 2022 our office based the opioid treatment Outpatient Program at zuckerberg San FranciscoGeneral Hospital which serves about 700 patients a year has had more intakes in the summer of 2023 then it did all 2022. We will have that data more formally available soon. Our visits at Maria X MartinezHealth Resource center serving people experiencing homelessness has seen up to 300 more visits per month and treated more 600 patients with medication. As i mention ed, we are delivering medication to promote retention and care to more then 80 patients and 32 Supportive Housing facilities. In addition to the contingency management program, i just mentioned, four of our Specialty Drug treatment programs are initiating contingency management under a Pilot Program under medical reform that is supported by the state. We are also working to expand Substance Use disorder residential treatment and care. This is a vital part of our continuum also. Dph currently has approximately 2500 beds. These include more then 560 Substance Use beds, we mean withdraw management, residential treatment, and residential step down known as recovery or sober housing. Mental health sf, has funded the addition of 400 new beds, 350 of which are opened with an additional 50 to come. We have approximately a 5 percent average vacancy rate of these beds, with the following caveat. We have seen uptick in treatment entry to Residential Care in the last two quarters starting in the winter of 2023. You can see this and track along on our newly released dashboard, which ill show you a screen shot of later. Of note, among the new beds of the 350, specifically addressing Substance Use, these include 70 residential step down beds at treasure island, 20 beds at soma rise drug and 75 beds at the mina project for justice involved adults and for which we collaborated with colleagues in the probation department. Treatment is not enough. We have added support to reach and engage people with complex needs. Importantly and the last 18 months we established scaling up the office of coordinated care, who has the goal not to lose anyone from care. Our priority populations are people experiencing homelessness, leaving hospitals, and leaving jail, and for folks with serious Mental Illness after involuntarily psychiatric hold. Expanded Case Management and treatment, and as you already heard, we connect closely with our street teams and street followup. I want to just turn to a few last slides to discuss our city and Community Partnerships in order to strengthen our whole city approach. I want to mention and really with gratitude many colleagues at the city departments. Online overdose recognition response training has been taken more then 5 thousand times by staff across 12 city departments. We conduct daily coordination with our colleagues in San FranciscoPolice Department, department of emergency management, San FranciscoFire Department and department of homelessness and Supportive Housing on street engage and response. Holding weekly Case Management and coordination with our colleagues on high priority individuals in order to follow folks longitudinally. We are collaborating closely with colleagues as you hear from department of homelessness and Supportive Housing on access to medication treatment as well as Overdose Prevention naloxone training and access. We are working with our colleagues in the Fire Department to improve upon follow up for people seen by street Crisis Response teams, [indiscernible] and improve linkages to care. Passed the Overdose Prevention policy legislation and working on that implementation. Finally, thanks to you among others supervisor dorsey, supporting legislation to require San Francisco retail pharmacies to supplystock and advertise naloxone. This is a crisis that needs all to think creatively and press as hard as we can to turn this around. I want to are you all most done . Sorry. I have two more slides. Okay. If you can summarize that would be great. We have a bunch of questions and still havent heard from hsh, so helpful. Great. Sorry for the lengthyness. We do want to communicate all we are doing. Appreciate it. How seriously we are taking this. We appreciate it. Addressing Racial Disparities and Overdose Deaths among black African Americans is high priority for us. We are working to strengthen and establish meaningful engagement and partnerships with new Community Partners and organizations in black led and predominantly black serving organizations. You see specific partnerships and accomplishments on this slaid and we know much more is needed. We are aiming to transparntly track both overdose trends and related treatment metrics. Launched a dashboard last month or earlier this month. Aiming to centralize Data Collection on drug related metrics, including fatal and non fatal overdose thanks to many partners including the ocme. Also aiming to put up Treatment Access and utilization data so that it is more easily accessible and visible to interested people. We are also holding by weekly meetings with Community Members, front line staff of Service Organizations to review the data and aim to align our efforts. And i thank you for your attention. Thank you. So, i know you said treatment is not all about access to beds, but we had a strong announcement today about requiring people this week from the mayor saying people need to be drug tested and sent to treatment if they want to continue to receive general assistance. Just want you to comment on give us your opinion on forced treatment, or mandatory treatment. I want to hear from experts and want to understand what the science says. Maam, please. Please stay in control. Thank you. Well hear Public Comment after the discussion. Thank you. [indiscernible] she said that in the presentation. We will hear Public Comment. You will have a opportunity to address the committee then. [indiscernible] no one is asking you to leave. [indiscernible] would you liketo come to Public Comment . We will have Public Comment later on. That would be helpful. [indiscernible] thank you. Doctor. [indiscernible] are youare you here represent ing a department or yourself . [indiscernible] are you on city time or your own time . Are you on your city time or your own time . [indiscernible] thank you. Thank you. Thank you. Thank you. [indiscernible] thank you. Thank you. Thank you. Thank you. Thank you. Can we get back to the hearing, please. Thank you. Thank you. [indiscernible] thank you. Doctor. The question is, we are talking about access to beds. There was a letter you sent to supervisor mandelman and stefani and not being able to access only 50 percent of the people are able to access beds and this week there was a proposal that talked mandatory and forced treatment so want to hear a professional opinion on forced treatment. [indiscernible] sure. I dont know if your mic got turned off. Thank you. If i may take the first part of the question. There was if i may offer points of clarification about access. First of all, since my arrival in San Francisco we have undertaken as you just heard significant expansion of a number of services as well as a number of aiming to improve our ability to track access. And know where things are. That specific number you are referencing is with regard to withdraw management service. A shift happened where one provider who had been providing withdraw management gave up that service voluntarily and shifted to a new provider. We arethat provider has been providing withdraw managealment hr360 all most a year. The number we provided is the number of folks walking in and seeking withdraw management and we are sorting through and aim to have more clarification about that number. I want to clarify that we are aiming to turn away no one, but then to help navigate them to appropriate levels of care. Some of the folks present with more complexity medically then withdraw management can handle. They are naveigated to other services. There are times folks leave before completing routine assessment to make sure it is safe. We are aiming to find increased mechanism to retain them in care and finally for times that the program is full, we have fortunately some opportunities like with the soma rise drug sobering to have a place for them until we get them in. I dont want to overgeneralizewe dont have perfect access and parse out that particular number. My understanding in the answer to your second question is that hsa is going to be take broad approach to treatment and we will work closely with them to make sure that needed resources are in place. I didnt hear you answer the question about forced treatment. I think that this is a area that is complex, and we want to work with hsa as they implement the program. And we are committed to doing that. Can you give us a general opinionbecause we heard over and over again from dph that forced treatment does not have good outcomes. Just want you to talk about that in general. So, i think the science around compulsery treatment comes from both the medical side and the criminal justice side. Most of the science just to be clear has been coming out of the criminal just ares literature where the studies have often found out of the population level mandated treatment again on the criminal justice side is often not as effective as voluntarily treatment. Do you feel confident based on the numbers you presented of 50 percent of the individuals turn away, you feel confident regardless of force but access in generali feel we had the conversation yesterday, based oen the number of available beds for those that are seeking treatment do you think we have enough of that available currently . What ilet me say a couple things that one is, we have available certain kinds of treatment. We have available medication treatment. We have available in general outpatient treatment. We know that we need more City Contracting ability to move to scale up when there are agency such as there was with hr360 covid outbreak to identify other beds. We also need to be able to and turn beds on if there are moments where demand is increasing. I want to acknowledge when ii know in yesterdays Board Hearing there was conversation about treatment on demand, and i look forward speaking with all you about that. When i was here last year, last years treatment on demand report our demand had not seen the up tick we saw in the last 6 months and so we are working aggressively to be able to meet that demand through ability to turn on additional contracts through a number of different mechanisms. What about the work qu w your department . You mentioned the mena, something i worked on and it trp in terms of sober living. I didnt hear you talk much about sober and clean housing and since we are talking forced treatment and science, curious about what your opinion is on or what work we have done to expand more sober housing and abstinence based treatment. What i heard from you and you and i have been in the conversation, from you and Community Members there is a need to have places to live for folks trying to not use drugs and abstinent from drugs in ways not triggering and be away from the scene and the substance. We have expanded supportive or transitional housing and i mention the mena project, which is a successful collaboration where we have established transitional housing, the housing is supportive, we have wrap around Clinical Services both for Substance Use and Mental Health that sames to give people supportive place to live. What we termed residential step down intended for people existing residential treatment, it is local name, state wide and nationally that form of transitional housing would be called Recovery Housing or sober housing and we opened 70 of those beds in addition to the 75 at the mena. Where are those . Those aremight have to get back to you. I think the majority of those are treasure island. Got it. Colleagues, any questions for dph . I dont want to dominate. I have more questions but i want to give you all the opportunity. I have a few questions and go to supervisor dorsey. Substance disorder is a family disease and missing the mark somewhere and this constant uncovering how we can do better is necessary and hope we get to a point where it is not and hope we figure it out. In focusing on treatment oen demand which supervisor mandelmanlooking at the beds out there, i think beds are extremely important in terms of knowing people who need that type of treatment and need to be away from other people doing drugs or wanting to be arond likeminded people and i know there is 20 uncontracted withdraw management beds at harbor light and wonder if dph considered purchasing those . I think we are looking at multiple options, including that. Certainly we are working with Salvation Army as you likely know. Okay. The 41 uncontracted residential treatment beds at harbor light similarly figuring ways in which we can Work Together. Okay. I know you mentioned soma rise too and the mena project and my understanding those arent licensed treatment programs. Right. And similarly residential step down is not. Transitional housing islet me listen to your question. Trying to figure out where we are spending resources. Is our money well spent and look at soma rise and we are looking at different ways to get whether or not we are spend our money in a way we get the service we contract for. Soma rise has 9. 8 million for 2 years which is 671 per day per bed for the 20 beds there. Then i look at harbor light, which is a licensed Drug Treatment Program that charges dph my understanding is 115 per day, and just wondering how are we investing . Would that be a better investment or am i off on my math . I would need to back on the math. Let me say a couple things about the difference in services. I think soma rise is really aiming for folks 24 7 access, with filling up with regular frequency as a place that ems can drop people off, the street teams can refer people to who are intoxicated on the street and may be disruptive on the street and need a safe place to be. It is potential high level of medical needs on site, because folks are potentially not physically stable. I think typically harbor lights, and withdraw management, see lower illness of folks and may need lower level of medical supervision and also not admitting people 24 7 so that comes with additional staffing needs. We are happy to go through and you are asking questions which i appreciate about where we are getting value and how we are spending money to get results. Thank you. Ill turn over to supervisor dorsey, but i may have more questions. Thanks so much chair stefani and doctor. I really appreciate that. Before i get started i was planning on just mentioning that iwhen i saw that felicia and Jeffrey Greer came in i was going to acknowledge them. In addition to Felicia Jones long Time Leadership with wealth and disparities in the black community. Felicia jones founded healing the village collaborative that is united advocacy in the black and Recovery Community both to address a crisis that is putting black san franciscans 5 times the overdose risk. She is doing gods work and hope we can understanding and forgiving. These are issues deeply held and deeply personal and so i want to submit and also Jeffrey Greer from San Francisco recovery theater is part of that and i wanted to acknowledge him here today. The question that i had was aboutim a supporter of and want to everything to make sure we have medically assisted treatment and agree that methadone and looking at the National Institute on drug abuse from 2018, there is a reference in there that medically assisted detox is first stage of Addiction Treatment but by itself does little to change longterm drug abuse. Iscan i ask is this something that is on a continuum and how long are people on treatment . Are we trying to move people to drug free recovery eventually . Im not familiar with that exact sentence you just read and so the current position of National Institute on drug abuse is that medication for Addiction Treatment are the most effective way to reduce risk of overdose and to reduce return to drug use or relapse among people with opioid addiction. I will say what the science says about length of medication treatment. As far as we know, the best science says, that longer term use of medication is more effective in preventing relapse or return to drug use then shorter term. What is shorter term, what is longer term . The studies only go outthe most rigious studies go out a couple of years. We know from longer term studies that continues to be true over many years. In my view, and in my practical view as addiction medicine doctor, and i worked with many people on methadone and buprenorphine, i have conversation about what they want and aspire to and i aim to council them that there is uncertainty about relapse and potentially high risk of relapse when they go off medication. Doesnt mean they shouldnt and it doesnt mean that they shouldnt try. My worry as a doctor is that with the deadly drug supply now, a single relapse can be deadly. This was less true earlier in my career in new york in the bronx with a lot of heroin. The other point that i like to make is as we have been talking about and as you know, we know, addiction can be acronic illness and relapse is common, not inevable, but common. Like diabetes, like high Blood Pressure where the focus as a doctor on those illnesses is your Blood Pressure controlled and is your sugar controlled, not whether or not you are on medication, how much medication, when we take you off the medication. To me the goal is helping people be as well as they can be and if medication is part of that, to not dwell on how long, how much, but instead how is your life going, how are we helping you get better and stay well. Thank you. Just want to state for the record, appreciate the work with supervisor stefani in the past and you were not on the board yet, supervisor dorsey but you picked up the mantle. We did the work with the trp in union square nob hill. The first one in a really long time. Black lead organization focusing on recovery. Using former adicts to help those currently addicted and recover. Think it is a phenomenal model we tried to replicate that some and think we had some success. There are additional opportunities and beds through the Salvation Army. They have beds that are available to continue to expand. The point i was trying to make before it got little heated was, if we are going to begin or if there is a attempt to force people into treatment, and we have 575 recovery beds and only 50 available, there is a estimate potentially maybe another thousand and that isnt folks on the street so you try to expand, we have to do a massive expansion for treatment and recovery, and thats what i want to hear more about in terms of what dph can do and provide, because if we have a massive increase of need, how do we fill the need . We put 4 million, one of my Top Priorities in the budget process this year, Budget Committee member, we put 4 million in for sober living. Your department is working on coming up with a plan on that right now. We are hoping it will expand the number of sober living beds in the city and there will be partners that have the experience to expand that opportunity. Thats what the attempt of thiswe want to see what the city is doing, what we are not doing, what the gaps are and how to expand it and be more effective. Sorry, prnlly based on the science the literature and research we have done, forcing people into treatment in exchange for services has been tried before, not successful and will come up short so i need to know from your department if we start expanding and offering more services and seeing a increase of those that need to recover, whats the plan to expand the numberwe started to have the conversation yesterday. There is additional providers that want to do that Salvation Army is one, other groups out there, but there is major loss in the number of beds for Treatment Recovery and i think contingency management is great, expand that, proven to be successful, but we need to bring more partners and have a very aggressive agenda how we expand that and the numbers as you point out, they are horrifying to see fifen percent of the population is African American and over 30 percent of those that are dying African Americans, something is inherently wrong in what we are doing. I said a lot, but it is about expanding, working with partners, about getting the right resources out there and aggressive manner and whatever we are do tg now isnt working. Two people a day and numbers point to we see increase. We can deal through Law Enforcement on supply side, but we also have to deal with demand side and think we need to change some of what we are doing to get a better result. If you want to respond to that. The number of beds i think is important what the plan is for that and you already have given your opinion on forced treatment. Another story came out today citing the science that says it is not an effective manner, and can add to more overdose and death so a certain concern out there. I want to say i share your sense of and all our sense that this is tragic what we are living through with the number Overdose Deaths and it is true nationally and locally i think the impact of covid both on ability to staff and run programs, the ability to serve people is a different world along with fentanyl then the one we went into before covid. I want to acknowledge that. Our teams are working their hearts out. My team to stand things up as quickly as possible. Supervisor to answer to your question, i think we want to move more quickly and take advantage of partnerships and opportunities and get stuff into place and be responsive and listen to community need, and try Different Things to make success happen here. Thank you. If we supervisor dorsey my recollections of the response that doctor offered to the question about the effectiveness of cours was interventions or mandated treatment was it is not that voluntary treatments are more successful. I think thats intuitive. We would expect somebody who wants recovery well have a better outcome then someone whom it is coercive intervention. That is different thing to say that coursive or mandated treatment are ineffective. I will cite this principals polk of drug treatment from the National Institute on drug abuse. Updated january 2018. It is clear treatment does not need to be voluntarily to be effective. Sanctions or enticement from Family Employment settings and or crimial Justice System can significantly increase treatment entry retention rates and success of drug treatment interventions and dont think it is a accident one of the departments doing the best work in the space is the department of adult probation just because there is a criminal justice sanction there. There is a thing and i say most people whether its the government sanctioning or coercing or spouse will leave you, i think most people personal experiences are that it isnt just for the sake of being in recovery they seek it. There is some kind of thing that they are hitting bottom or forced to or mandated to or coursed into it. I get theres voluntary treatment will have better outcomes, that is intuitive and should expect that, but i dont think accurate to say mandated treatment doesabout work. I want to be clear, with thei want to make a clear distinction because i have been onewe did the program with adult probation as a alternative sentencingism in the criminal Justice System and repeat recidivist and there is the opportunity there to provide an alternative and sometimes compelling that is one thing versus i will take away your ability to put food in your mouth or you can gothats a very different argument to make and thats the distinction we have in front of us today that has been talked about and think that is tying your general assistance our welfare and ability to put food and pay your rent or thats a very different distinction. Yes, i have been a supporter of what we did through adult probation. One of the biggest champions of that and that has proven to be successful and well continue to work with dph on that. One more question. This [indiscernible] i am not sorry. [laughter] habit. Around prevention education and if engagement and support and you said something that triggered a question in terms of we are not dealing with the drugs we are dealing with in the 80. Herointf t is night and day and Needle Exchange programs that came out of hiv crisis so critical and necessary and we still have them today, and now we have foil and pipes and my understanding is that that is to prevent the pred of hiv, help b, hep c and blood born diseases. When you said that because this is what you hear from friends in recovery, thank god i got sober before this all hit or i would be dead. Thank god i ended up in prison and had a choice between prison and treatment and chose treatment. I hear a lot from friends in recovery, and i am just wondering, the is a feeling and hear from constituents a lot, that we are reallymake it easy for people to get high here. We make it really easy for people to do drugs here and there is just this feeling and that we all most promote drug use when we hand out foil and pipes different then the Needle Exchange in the 80 and the reasonerize the same to prevent diseases. When you look how it is tipped upside down in terms what you said mptd the heroin in the 80 different from fentanyl and sythetic drugs on the market today causing what we are talking about, people dropping dead every day. Are we going to look at whether or not handing foil and pipes is the best thing to be doing considering the deadly nature of the drug they are doing even with those tools that are supposed to help save them from hep b, c, hiv . Are those things outweighing this risk which is death . Just trying to wrap my head around this idea of, are we engaged in prevention methods that are stuck in the 80 when it is 2023 . Not suggesting before anyone goes crazy on twitter, not suggesting we stop it, but there is this feeling that we in San Francisco are handing out like candy and making it really easy for people to and it makes me nervous because i know that what is out there is so deadly. We are talking narcan in pharmacy. Have you considered looking at a different approach or examining the approach with a different lens . I really appreciate the question. I think this is the conversation very much in the air in the city and also if i may nationally. Let me answer as a doctor, i know when i taken care of people not interested in the moment in making a change in their drug use, my name objective is to get them to keep coming back to me, because i know every time they come back to me, it is another chance i have to chat with them about making changes that could be helpful. That is what i believe that we know from the science with some of the changes in context, absolutely not. About the increasing deadliness offantinal. What we call the low threshold or Harm Reduction programs are there for those folks who may not be ready to do abstinence or stop, but may be ready for other things. Whether it is seeing a physician to get their wounds taken care of. Helping treat depression. Helping reconnect with family or a benefit. And it is not we shouldnt just be doing that, and we are not, we need to think about this holistically, grabbing people, whether they are not ready now for a change to the people who are ready to come into treatment. We got to scoop them up when they ask. I just offeri know this may not be a totally satisfying answer but think we need the continuum and we need to think about making sure all parts are working well and that is ongoing Work Together. Thank you. Thank you great question and great point. Anyone have questions or comments . Okay. Thank you doctor. Appreciate you and well follow up. Thank you for putting this very detailed presentation together with your team. Thank you. I think hsh is our last presenter today. We should have a brief presentation. Then go to Public Comment. Good afternoon board members, chair stefani, supervisor su, thank safai, thank you for calling this important and timely erhaing. Emily cohen, Deputy Director asked to share about how we prevent overdose and Overdose Deaths in program serving people currently or formally homeless. As said by every presenter today, we are in a National Crisis when comes to overdose and our Department Takes this seriously and acting with extreme urgency in addressing and responding to this crisis in our community. Across all hsh funded programs in the system of care we are committed to serving and being accessible to people who use substances. We are committed to offering them the opportunities and options to connect with treatment and care. We are implementing Overdose Prevention policy required by local ordinance, which includes required trainings, public postings and protocols for hsh and our contracted non profit providers in both shelter and housing and drop in services. In july 2023, we enter under to agreement with the dope project to provide training and Technical Assistance to Homeless Service providers. Last year launched a incident dashboard internally, which allows us to in real time track trends and instance of situations that happen in our programs. Overdose is one thing that can be tracked here as well as other challenges that might be taking place in our programs and rather then collecting the data sort of after the fact now we are seeing in real time and actively reviewing that data biweekly with our programs and partners so we can be noticing trends right away and making changes to address them. This data reflects critical needs for ongoing Overdose Prevention training and resources for our non profit providers who are on the front lines of reversing and preventing overdoses. Some of it data we are seeing in Supportive Housing and shelter last fiscal year we were aware of and we dont always know everything that happens in the lives of somebody experiencing homelessness when they might be out in the Community Running errand doing business something might happen but we are aware what happens in our programs. We did have 234 overdoses within hsh funded shelter and housing and 60 percent of which had documented successful reversals. That does not mean the other 40 resulted in fatalities. We have a large gap in the data because folks might leave and go to the hospital and we might not get adont have a great way to close that loop. We are working with the Controllers Office to develop better metric how we measure overdose reversal and track that in the lives of our clients. And we will use that data to help guide investments in our Overdose Prevention work. Of these overdoses that i noted, 67 were reported across 40 permanent Supportive Housing sites and 51 had documented reversal. 18 percent or 12 unfortunately resulted in known fatality and in the shelter systemi should also say, 68 percent of our sites reported only having one or no overdoses. There were 167 overdoses reported across 28 shelters we operate last fiscal year. 58 percent we documented reversals. We also know 3 percent of those resulted in the known fatality. And 32 percent of our sites had one overdose and 46 percent of our sites had under 10 overdoses. So, i will stop there. I will make a note. The fatalities of overdoses for shelter is much lower then innoticebly lower then housing programs because of the congregate nature of the programs, much higher levels of staffing and monitoring going on. I was asked to provide site related data so what i want to share is that in our Supportive Housing site as i said before, 68 percent of our housing had one overdose documented in the last fiscal year. 30 percent had 25 overdoses, and these are not fatal overdoses. And 3 percent had more then 5 overdoses, so we are looking at where in our system these overdoses are taking place so we can work closely with the providers to prevent them. Appreciate you including hsh in this hearing and happy to answer any questions you might have. Just looking at these numbers. Any particular buildings withyou can come back up. We will ask you a couple questions. Any particular buildings in your portfolio or shelters you are seeing this happening ati couldnt tell when the numbers were flashed up. Sorry about that. Thats okay. There are buildings that have higher incidents of overdose, but what i think is more important metric to look at and what we are looking at with the Controller Office so dont have the data yet, is the ratio of reversals to overdoses. Yes, we want to stop overdose happening in the first place, and make sure that our reversals are keeping up with the rate of overdose. And we are largerthe couple of projects that have the larger numbers of overdoses are bigger projects which makes sense. When you say projects housing buildings. Not shulters . Shelters as well. We see the highest rate of do you see particular providers that are repeating . We do see there is a pattern in the shelter system in terms of provider, but it is also correlated i think with higher reversals in those programs, and lower barriers to entry. So, one thing just for the record we did when we did prop c mandatory oversight is required mandatory audits. We will begin the audit process of the shelter system. One reason i asked if it is a particular provider that is in the areas where the overdoses are happening, so thats something for us to follow up with that information because it could be part of the management practice s. I understand low barrier is one thing, but there are other places in your system that have low barrier that are shelterby different providers and maybe different outcomes. That is a important point because i think one reason why we did the audit of the services and providers to the non profit is that to insure that people that are doing things well are rewarded and people doing things not so well can be diverted or not continued and so, i think thats a important point to specify. One thing that i did when we toured a facility is there a general rule tosome buildings are not mandate that the building is clean and sober. There is a clean environment. Some are low barrier and deal with people with addiction, but have you shifted and change philosophy within your department and expand the number of options available that are clean and sober environment . Thank you supervisor for the question. Through the chair, i think the most important thing and most impactful thing we can do for somebodys health who is struggling with Substance Use disorder is move them off the street. Staying oen the street is detrimental to recovery, and so whether in shelter or housing one of the key principles is welcoming and accessible to people who are using, so they have a place to be indoors safe, supported and hopefully on a path to recovery. That said, we know that People Living in our buildings, living in the Supportive Housing to be specific, there is a smallmaybe noti dont know the percentage but a group of tenants who would be better supported and frankly would prefer to live in a environment that was clean and sober, so we have been hearing that from our tenants and so in response we are in the process of developing a program that would be a opt inSupportive Housing traditional model, but that everyone would be committed to clean and sober lifestyle within that project. What is the timeline for that . We arei would guessalways reluctant to give timelines on projects i dont have a ton of control over but i say early to midnext year. That something we talked about this is what the funds are used for. We fought hard to insure that money would be there, so i just again want to say we are trying through adult probation. Supervisor dorsey we can agree we are trying through hsh and i think having more of those options expands the opportunities for people to be in a environment. This is voluntary . What i want to say to that effect supervisor is that within a system that is driven by the principle of Housing First we want housing that needs the specific needs of our tenants and that means having a diverse pool of housing options. Absolutely. I like you to follow up and give us the opportunity to which buildsings have the higher rates of overdoses and providers are involved in that if wu can follow up i appreciate that. Supervisorchair. Other questions . Little confused because you said one of the most important things to prevent overdose and correcti might have misheard is get people off the streets but when i look at the statistics in terms of where the deaths are occurring, 71 percent have a fixed address, is that correct . I believe that is medical examiner data. That is folks in Supportive Housing or in non subsidized housing. What i meant by what i said chair stefani is that in the General Health of anyone, the most important thing we as the department of homelessness can do is bring them indoors. Leaving folks on the street is bad for Health Physical behavioral Substance Use. And see that point. It does worry me sometimes when you hear about the sro and i like to know more information where these Overdose Deaths are occurring. If you bring people inside a very dangerous situation with addicted to drugs which we know from the 2022 time count report 52 percent unhoused survey reported having problems with drug or alcohol abuse. If you bring them to a environment where the party next door, a drug dealer here, it is violent, all these other situations and you expect someone to try to get off drugs, it is all most impossible for people to get off drugs when they have everything handed to them in life. P it is a very difficult thing, so yes that should be our goal all times, but cant pull them into situations that are as dangerous. Given housing but havent provided Treatment Options or we havent done outreach specifically administered for those dwelling that have Substance Abuse disordersf i feel we need more data around what we are doing once we people are in sro and i told you too, in terms of people on turk street. I heard they want to leave the housing they have because they feel they are trying to stay sober and cant in the environment they are in and we have to respect that. I brought recovery summit network, Recovery Working Group here to talk what worked for them and people who are live their life in recovery every day. It is daily decision not to use alcohol or drug and told us what they need and it is always to be around other people who are likeminded working the same program. That get results for themselves and friends. I just want to make sure because when i looked at the fixed address, and i am floored. We have a captive audience in the sro. We know they are suffering from Substance Abuse disorder and put them in dangerous situations or situations that are not likely to lead to success for them. Where can we do better in both housing and Public Health . In those policies. Thank you, i appreciate that. I want to reiterate thait in fiscal year 2223 there were 67 accidental overdose reported in our Supportive Housing programs so sro and non sro. Hsh funded housing. That is sort of relatively low to the 70 percent of folks who suffer overdose who have a fixed address and doctor talked why i didnt want to go in the detail about intensive collaborative work we do with dph for tenants in Supportive Housing. We really work and you all funded recently budget increase the Case Management level in Supportive Housing and overdoses was one of the driving reason frz doing that. Connection to treatment and ongoing Recovery Support is a big part of the Service Packages we provide once somebody moves into our housing, and somebody in the shelter that is offered to them as well. We definitely work closely with dph to insure medication could be delivered to the Supportive Housing site, access to treatment, if somebody needs to leave Supportive Housing and go into residential treatment they can get their Supportive Housing unit back. We changed a lot of rules about that, worked with the federal government on that several years ago, so i hear your urgency supervisor and we share that and Supportive Housing includes support. Thank you. Thank you. Thank you chair. Great question and glad to hear that the funding that we provided is increasing the number of case managers that can help refer. Still goes back to dph in terms of access and availability for treatment and again, we like to know which buildings this is happening the most, which shelters and provider are out there and may or may not be doing a good job with it comes to that. Any other questions before we go to Public Comment . Thank you. Mr. Clerk, please open Public Comment. Thank you. Well take Public Comment on item 6. [Public Comment] my name is Jeffrey Greer, San Francisco recoferby theater. Ill be there in a minute. I just wanted to get in here. I got another meeting to go to and address the fact that i think the messaging is a big problem. Obviously there is a lot of passion that we have around the subject. I do support Felicia Jones and her efforts. There is a lot of good coming out of the village meetings we are having. Forced treatment, is that a term that is happening . If you are arrested for being a drunk driver and they send you to drunk driving class or take your license so you dont kill somebody, is that forced or safety . If im losing my job and got to get unemployment and tell me okay, in order to get unemployment i got to do a job search, is that forced work . I mean, i believe me, i am not an endorser of anybody telling what i do and where i go and when i can do it. If i want to get blasted i should be able to get blasted but it shouldnt effect my community and so really the messaging is it really forced treatment . I dont think so. I have a alternative. I can get my 600 a month and attend a drug treatment class, okay, or i have cannot. Anyway, Jeffrey Greer. Thank you for sharing comments. Good afternoon chair and members. Wesley with health right 360. [indiscernible] 15 percent by 2025 and address Racial Disparities. Recent ocme and cdc data shows San Francisco experienced 21 percent increase in overdose during a 12 month periodnding april compare today the prior year. 5 times higher then the state rate. 21 higher then the nation. Racial disparities intensifyed. Responses driven by best practice in Public Health and addiction medicine and local expertise. Instead, the city adopting a regressive consequence driven approach which is contributing to the dead last year on record and driving to use in isolation and shame. Enforcement approach to people who use drugs undermine overdose recovery and criminalized Substance Use and disorder and blur line between care and punishment. Providererize not blamed as a attempt to defect criticism from failed policies and unmet demand that long exceeded local capacity. These policies lack evidence and not consulted with nor [indiscernible] low threshold evidence based culturally inclusive and voluntary. Many programs are under staffed getting people in treatment takes people. Address the crisis we recommend you execute the prevention plan and adhere to evidence based Public Health strategy. Thank you. Thank you for sharing your comments. Anyone else here in room 250 with Public Comment on item 6 . Seeing none, well turn our attention to folks connected remotely. Please be connected to the first of 5 callers. Supervisors, first and foremost, stick to the accidental death report and none of you spoke about the precursors. The precursors the material or the element and added to that are all sorts of things, even rat poisoning. When you bring these presenters here and they have no clue what they are dealing with when it comes to what the term is fentanyl, you all are just talking and talking and talking and 90 percent of what you spoke, especially those who are subjectively involved either personally or have a relative, they get so involved in that thing that you dont do justice to the agenda item. The controller cannot do an audit. We need an independent auditor, one that knows about precursors, and how to prepare and how damaging their are to life. So, you wasted a lot of our time trying to say things that are not important. This is a death and life situation, which you have no idea how to handle because you do not know what a precursor is and how harmful it can be and you do not have experts. Two or three years thank you for sharing your comments. Sorry to cut you off. We have to move to the next speaker because we reached the two minutes limit. Can be connected to it next speaker, please . Thank you. Public safety Neighborhood Services committee, joe [indiscernible] i just sat through after my successful [indiscernible] speak to item 6, which is disappointed that i didnt see or hear any conversation about not doing drugs in the first place. Drugs are bad. They are awful. Drugs dont make you strong like supervisor stefani, drugs dont make you brave like other supervisors. I want to walk a fine line here. I dont want tocongratulate individuals in the recovery, but i also want it clear that we need to say no to drugs, because it is just not good for you, and the harmsupervisor stefani gave a beautiful speech about what happens to families of those addicted and a beautiful speech touched my heart and reaffirmed my decision not to do drugs, and i think if more people heard that beautiful message of moral courage and strength and thoughtfulness that we can have more people turn away from drugs. I just really think we need to just say no to drugs and i want to [indiscernible] i understand if it doesnt. Thank you for public service. God bless and protect Catherine Stefani and her family. Thank you for sharing comments. Next speaker, please. Hi. I just first off want to thank you guys for discussing this topic. It is in my opinion one of the most pressing issues not only here in San Francisco, but across our nation. The fentanyl overdoses are getting worse and worse every day. When the Opioid Crisis started in the 90 which is why all these people are seeking opioids on the street laced with fentanyl and are dying it started with purdue pharma. These farm suit could companies are to blame for what we are seeing today. Purdue pharma was owned by the Sackler Family , which is pretty much the most evil family in america. What they have been described as. And they are also speaker time. Sorry. Will pause the speaker time from here. Remind everyone as i had to for previous hearings, city policy and federal and state local law prohibit discrimination and harassing language during the meeting. Keep on topic and move to the next speaker. Still 4 speakers listed. Next speaker, please. Good afternoon chair and members. [difficulty hearing speaker due to audio quality] thank you for sharing comments with committee. Next speaker, please. Here we go. Couple things. Housekeeping. There needs to be a agenda item for general Public Comment that gives [indiscernible] specific to the topic. So, fentanyl was created by a doctor in the 50. A doctor created for medical purposes for medical use only. This is now recreational drugismt we see other recreational drugs. We need to create a new drugs. We had drugs, pincillin in the 30 and lsd in the 60, all these drugs and cocaine and everything. My recommendation less lethal drul drug that [indiscernible] but i dont know, i hate to promote drugs, but lsd maybe. Less lethal. Something that gives them thatuephoric experience without killing them. Fentanyl is a deadly drug. [indiscernible] the doctor who produced it did not intend to bebeds came up. The shelters General Hospitals is a insane asylum. I invite city officials to go to General Hospital and the shelters. People are mentally ill. We are dealing with mentally ill people that are out of their minds. They are take agdrug that can kill them. There is no such thing as a accidental overdose. They know what they are taking. One pill could kill. My recommendation, offer a drug that should have been offered 5, 6 years ago to offset the killing or theuephoric experience then fentanyl. That is the only way. Looking forward to general Public Comment. Thank you. We need to move to the next speaker. Could we be connected to that speaker, please . Hello [indiscernible] live and work in district 3 and student at the university of San Francisco. Urge to support the implementation of wellness hubs and Overdose Prevention plan expand program [indiscernible] [difficulty hearing speaker due to audio quality]. People have to live with and work on for the rest of their lives [indiscernible] my father over 45 years sober. If he hadnt received the treatment i would havent the opportunity to call and talk to you. Every day we delay the result [indiscernible] crimialization has not been and will not solve the crisis. Please support the implementation of the Overdose Prevention plan and best practice grounded in Public Health. Thank you for your time. Thank you for sharing your comments. I understand that was our last caller. Thank you mr. Clerk. Public comment is closed. Supervisor safai, do you have Closing Remarks . Just want to say thank you chair for scheduling this. Thank you supervisor dorsey and engardio for hearing this. Thank the departments coming out today and those in the public that commented. Appreciate we have a lot of information to go over. I think there will be further conversations about tying benefits to treatment along with expanding treatment beds along with exploring and looking into how we can investigate when there is a overdose coordination through the departments to see if there is repeat in terms of the person that is committing that crime and selling those drugs to the individuals if it is repeat seller as the District Attorney said work wg the Police Department. Want to see which providers of the permanent Supportive Housing or shelters, where many overdoses are happening if that is a common reoccurrence we need to look and determine what is working well and not working well and particularly looking at how we can expand the amount of beds for treatment because it seems we dont have enough based on the demand we need. I think there is a lot more work to do. This is as many said, one of the worst crisis that this city has faced. I dont think the response has been as strong as it could and should and needs to be given the massive amount of people dying and seems on pace to exceed the worse year we had. I appreciate all you over the last number of days and weeks and time shared personal stories in terms of addiction and your families and all of us i think have our own personal experiences to bring to the table, but much of this needs to be about better coordination between departments insuring this is elevated in such a way that we understand that this is a crisis that is impacting the entire city, and San Francisco is one of the top places in the country where these deaths are occurring, so again, i would if the chair entertain i like to continue this item to the call of the chair so we can come back and measure progress and determine things we have done to adjust and make changes. Thank you. Thank you. I would like to entertain that motion. Or make the motion to continue this item to call of the chair. Motion offered by chair stefani, to continue the hearing to call of the chair. On that motion [roll call] there is no opposition. Thank you mr. Clerk. Please call item 5. Number 5 is ordinance aminding the health code to require each Retail Pharmacy in the city to stock at least two boxes of opioid antagonist such as naloxone used to reverse opioid overdoses. Thank you mr. Clerk. This item is sponsored by supervisor dorsey and i will turn it over to him. Thank you chair. I will try to keep opening remarks to about a hour. Kidding. I think we can do this quickly because so much of this hearing i think set the stage for this, but this is legislation that would require all retail pharmacies in San Francisco to stock opioid antagonists such as naloxone mpts this is a life saving medication known for reverses opioid overdose. This comes at a time when the narcan brand naloxone nasal spray has just become available for over the counter sales. The u. S. Food and Drug Administration approved it for over the counter sale last march and since then aware there is another one revive was june or july was also approved. Im hopeful that well drive the price of these down asgiven everything we talked about for the last hearing, we need to do everything to make sure this is widely available as possible. The majority of pharmacies in San Francisco stock naloxone, mandating it be carried by all retail pharmacies all the time is a important step to make sure it is maximumly available and help 7 save lives. I want to express appreciation to department of Public Health and [indiscernible] hand off to you. I thought it was notable and ask if you can touch on even in the city that you expect that we would have universal access to this under the prior existing law when it was available, being available over the counter, secret shopper surveys found it want as available as we thought. There is a need for this legislation and appreciate the work dph has done on this so like to invite dr. Hom to speak on this. Thank you. Good afternoon chair stefani, vice chair engardio and sp supervisor dorsey. Thank you for inviting to speak. Director of population Behavior Health in Health DepartmentBehavioral Health service. The legislation requires retail pharmacies in San Francisco to stock at least 2 boxes of opioid antagonist in order to reverse opioid overdoses. The Health Department request approval of the proposed legislation because greater availability of naloxone known by brand nay narcan is a tool to save lives. This legislation closes a gap for availability in our city. When given in a timely manner reverse opioid overdose including fentanyl overdose. Over the past year our Department Online overdace training has been taken more then 5 thousand times educating employees and members of the public how to recognize a overdose and use naloxone. Trained 1 thousand people in person, schools Entertainment Venues and Community Organizations across the city. Thousands more trained by dedicated Community Partners. We get asked, where can i get naloxone . We want to be able to say go to your neighborhood pharmacy and they will have naloxone, but we cant. There is a gap in accessing this medication in our city. According to data we collected in the Health Department roughly a quarter of retail pharmacies in San Francisco do not have naloxone in stock. This bill requires retires to stock at least two doses of naloxone and post signs about availability close the gap. The legislation mirrors legislation enacted in philadelphia effective increasing access to this life saving medication. As you mentioned over the counter naloxone available beginning this month can go to the pharmacy is critical and timing. Fentanyl causing unprecedented loss of life locally and nationally. Pharmacy distribution complement efforts include distribution of more then 72 thousand doses of naloxone in 2022. We are on pace to exceed the number this year yet important gap will remain without this legislation. Of course we want those to be healthy and recovery but that isnt possible if they died of overdose. Prevent people who use drugs from dying until ready and interested seeking recovery. Naloxone is safe, effective, easy to administer and saves lives. We encourage wide spread access including through this proposed legislation. Thank you supervisors for your consideration and happy to answer any questions you have. Thank you. Any questions from colleagues . Shall we open up to Public Comment . Thank you. Check to see if we have Public Comment on item number 5. Here in the Board Chamber if you have Public Comment on item 5, please come forward to the lectern. Appears we have none. I understand we have one caller on the line who wants to comment on item 5. Could we please be connected . Thank you mr. Clerk. Joe again and because sp supervisors were [indiscernible] i will repeat comments from before. I would appreciate if there was a focus on preventing drug use in the first place. Thats the problem here. I dont want to blame people who are in recovery, thats not the issue here. It is good people in recovery are good people, strong people, good humans. For those who want to choose to use if you are going to do this, and end up in the hospital i want you to have supervisor stefani record a message so we have a voice that can cut through whatever aaddictive cloud in the world and wake them up and get that soul on the path to recovery because supervisor stefani [indiscernible] take on anything. She is super strong and [indiscernible] this would be the last Public Comment ever. It is important for us to show support and want to stress, we need to stop focus on drug users in the street, we need to stop it in thest it place because it isnt good for Public Health and i dont mean to be insensitive but not good for tourism and appreciate supervisors paying attention. Thank you for your public service. The rest i submit. Thank you. Thank you for your sharing your comments. Any further callers . Please be connected to the next caller. Hi. San francisco again. Curious about this. Basically by stocking retail pharmacies we are asking the community to go into the pharmacy, run into the pharmacy, hopefully pay for it or dont know what the deal is, but asking the community to do the dph job really and saving the lives. Just curious about that. Curious how it happens and curious if the Community Needs to be trained, how it is administered, what the process is and there will be people that are watching [indiscernible] i should have ran to walgreens and got this drug or whatever. Reversal drug. [indiscernible] fly across the city to save lives. There has to be a better way. Community engagement ambassadors to have on hand, but this is really bad. Once it is reversed what happened . They do it again tomorrow or [indiscernible] i just trying to understand the concept here. Thanks. Thank you for sharing your comments. No further callers. Thank you mr. Clerk. Public comment is closed. Supervisor dorsey, like to make a motion . Sure, make a motion to send this legislation to the full board with positive recommendation. Motion offered by member dorsey this ordinance sent to board of supervisors with recommendation of Public Safety. On the motion [roll call] there is no opposition. Thank you mr. Clerk. Please call item 7. One moment, please. Item 7 is a hearing on the state of Traffic Enforcement and Street Safety in the city. Thank you mr. Clerk. We have supervisor mandelman today who is the lead sponsor on the item and will lead the hearing. Thank you chair stefani for finding time for this on what i know is a packed agenda and thank you colleagues for hearing this today. I think this will be relatively short but it will be neither the end of the conversation nor the beginning. Just to talk about the history of this from my perspective i joined the board in 2018. Supervisor fewer [indiscernible] decline in traffic citations that was already notable in 2018 so we had hearings and there was an effort to i think one class was put through to add folks to Traffic Company, and but the trnd line did not change, and when supervisor haney was on this board he had hearings on the state of Traffic Enforcement in San Francisco, and noted the decline in enforcement at that time, and tried to get sat the reasons for that and of course the Transportation Authority has vision zero hearings multiple times each year tracking what is going on in our progress toward or lack of progress achieving vision zero, the 10 year old vision to get to zero traffic fatalities by the end of the year. The trouble is, last year was the deadalist year of traffic fatalities since 2007 and that is notwithstanding 10 of Million Dollars in infrastructure to try to make the streets safer and i have to believe that the lack of safety on our streets for pedestrians and cyclists has something to do with the fact that we have moved from on average Something Like 350 citations a day in 2014 to i think at about 10 or 11 a day on average now. This hearing actually not only is not the first hearing on Traffic Enforcement, but it is not the first time we had this hearing. This hearing started in october of last year after we learned where we were coming in terms of fatalities last year. We sent a letter of inquiry this year to the department to try to get the summation statement of what is going on, what happened, what contributed to decline in enforcement over the last decade and to invite the department to formulate a plan to turn that trend around and ambitiously we framed as get back to 2014 levels, perhaps with a greater focus on the 5 violations which are violations most likely to lead to pedestrian injury or death. The Department Gave us its response in july and i thought there was useful information in that letter worthy of reopening this hearing and talking about it publicly and trying to get more focus on it. Some is not a surprise to this committee or this board or certainly Police Department, but i think needs to be amplified and reiterated which is we have a massive Staffing Shortage in our Police Department which is impacting Public Safety response everywhere and hitting Traffic Enforcement particularly hard. I dont believe that completely explains the story, because that trnd line of declining enforcement predated declines in staffing, but i think that Staffing Shortage makes it really hard to figure how to turn that trend line around. This letter was forthcoming in another way that i also want to shine light on and may have depending on the presentation may have questions for commander jones here with us. The letter talked about the Administrative Burden attached to each citation today that did not exist in 2014. Some of that is a result of changes in state law, some is maybe things we have done locally, and that is interesting to me because it sounds from the letter a traffic stop that might have taken 5 minutes or 10 minutes out of a officer time 10 years ago is likely to take away 20 or 30 minutes of their time now based on the additional Administrative Burden. But the last part of the letter which was the enforcement plan was the shortest piece of the letter and i think of a work in progress. It talked so called, directed operations and it seemed like there is a shift away from counting the number of citations to something happening broadly across the city on any given day, towards more focused operations on particular trouble spots. We can talk pore about that today. Nothing in there is measurable. The only measurement we have of what our Traffic Enforcement looks like is still citation and by that measure, we are doing terrible. If we switch to another measure that may be the right thing to do, but think we need to be thoughtful how we do it and important for the department and policy makers and public to understand the goal. I put forward a goal 2014 level. Clear the department didnt think that was possible and wasnt going to play my game, but i invite the department to think about today or Going Forward because as i said, this hearing will keep going. How can we think about a plan that the department can hold itself to and policy makers can also and public can also see. So, thats kind of where i think we are with this. We have commander jones who has only been in charge of special operations for a minute or at least a couple months. Ment thats correct. And we have captain shields the captain for Traffic Company here as well, and i know you have a presentation which looking forward hearing. I will have some questions, some of my colleagues are on the committee may as well, but dont imagine we will take too much more of your time. I know it has been a long day. Commander jones. Thank you so much supervisor mandelman and good afternoon supervisors. Commander jones, special Operation BureauTraffic Division. Im here today to follow up on a hearing that began last fall and to provide updates regarding current state. Vision zero, sfpd are support vision zero and assist in elimination of traffic fatality and improve Street Safety overall. The vision zero strategy, education, enforcement, engineering and evaluation. In terms of education Traffic Safety compains are done by sfpd as well as collaboration with other city agencies mta in particular, and the sfpd maintains a presence on social media. A notable example is valencia street. We worked with mta to educate through social [indiscernible] we did lots of traffic stops that result in advicement to get the Community Oriented to the changes. I like to high height one of the educational methods are traffic stops that result in warnings only and i think that sometimes that component is missing from the conversation. Ill discuss in more depth. In the first two quarters of 2023 did 1600 plus stops that resulted in warnings and advisements and effort to educate the community and positively impact Traffic Safety. We are focused on changing behavior and educational enforcement is a means of achieving that goal. Also used very traditional enforcement included many directed Operations Supervisor mandelman mentioned and these directives enforcement operations are planned and target specific issues. Much of this directed operation come as a result of community feedback, city Agency Feedback and examination of high injury corridors. The Traffic Company did 164 directed operations between january and june. 57 percent focus on the 5 efforts and 41 percent focused in high injury corridor locations. Ime rur sure most have seen this before but the map on the left is the Vision Zero High Injury Network as of 2017. The places where the most serious traffic related injuries and fatalities occurred in the city. The map on the right is heat map of the collision locations over a 8 year period and as you see, most of the injuries remain true to the High Injury Network corridors. So, this map shows the traffic fatality crash loations from last year including the mode of transportation of victims. Again, most of the fatalities occur in the High Injury Network corridors last year and pedestrians were the most prolificly effected. So, overall traffic citation numbers are declined tremendously over the last decade. In a later slide ill discus factors to the trend. Of this decline. But i will say however if there is any consilation here we are on target to outpace numbers in 2022 so going in the right direction but acknowledge we have a lot of work to do we issued 50 percent more citations the first 2 quarters in 2023 then 2022. That was [indiscernible] versus 1839 durs the same timeframe last year. Currently as of august, issued 3493 citations. I thij it is important to note the these citation counts are not inclusive of red light camera violations which add 8561 citations. Focus on the 5, issued 2109 citations as of august this year and also expected to outpace total from 2022. Just refresher, focus on the 5 include speeding, red light violations stop sign, failure to yield to pedestrian and failure to yield while making a left or uturn. In terms of enforcement in 2023, 60 percent of the citations were focus on the 5 violations. This percentage has gone up significantly since the 24 percent from 2014 and think we will outpace 2022 which saw the highest percentage ever at 62 percent. Traffic fatalities august 2023 we had 16. 12 fatalities were pedestrians, 4 vehicles and none on bicycles this year. We still have several months to go but down from last year at this point. We experienced 42 percent decrease in traffic fatalities during the first 2 quarters of 2023 then the same time period last year. That was 19 in 2022 in first 2 quarters versus 11 in 2023 in the first 2 quarters. This bar graph shows the number of injury collisions and fatalities. Experienced fewer injury collisions with prominent dip in 2020 due to covid and change in traffic. Traffic jaergz also remain lower then years past in 2021 and 2022 and this appears to be holding it true for 2023. We have not reached prepandemic levels which is a good thing. In termoffs transportation mode, year after year the most numerous groups injured in traffic crashes are drivers vehicles however pedestrians are the next most injured group typically and over the last decade consistently are the most numerous traffic relaitded deaths. Pedestrian safety is something we are focusing on in the upcoming months of enforcement particularly at the Traffic Company. Why is all this happening . There is some hope in the data points in terms of current state and progress, the Traffic Enforcement picture isnt great. Citations continued to decline year over year since 2014 and like to spend time discussing factors that effected traffic citation totalings over the last decade. These factors are by no means excuse and do not account for the gravity of it decline, however they had impact on enforcement. So, the first thing i like to discuss is staffing. Decline in staffing has absolutely impacted traffic citation totals. 606 officer short of the baseline of 2182. Patrol staffing declined 25 percent since 2016 yet calls for service remained steady averaging 441 thousand annually. Less officers less people available to handle calls for service. Which means offices are spend egmore time respondsing to calls. That has impact on proactive time or selfinitiated time which is that time that officer have available to do other type of work that are not generated by 911 calls. Traffic stops fall to this bucket of time. Less time yields less traffic stops as officers run from call to call with little to no time to spare. As you can see from the chart on this slide, as the number of sworn Members Department wide declined, so is the number of sworn officers in the Traffic Division. The number of sworn personnel peaked in 2014 at 77. Exceeded well over a hundred years prior to that. We have 31 less sworn officers in the Traffic Company for total of only 46 and of those 46, 22 ride motorcycle and perform Traffic Enforcement. The balance are functioning in supervisor capacity conduct traffic collision investigations, commercial vehicle investigation, stunt driving response, administrative duties or assigned to Traffic Company temporarily. The staffing decline is also directly impacted vision zero squads. Traffic company used to have significant presence with the dedicated squads but 2020 the vision zero squad was 2 sargegents 5 officers before disbanded due to staffing level. Because staffing decreases Traffic Division officers are tasked with myriad other supporting duties outside Traffic Enforcement. The Traffic Company handles demonstration events fatal and major injury collision escorts and high visibility presence as part of crime and violence reduction. Time is divide and less Time Available for Traffic Enforcement efforts. Another factor is expanded administrative work load. Traffic enforcements action is taking administrators requirements are in place that didnt exist in 2014. In order to comply with bill 953, the racial identity profiling act, Law Enforcement officers required to make data entries on all traffic stops under theofficers required to answer 16 questions some of which had multiple additional subcategories questions for every traffic stop they make. The department is transitioning to new system called bench mark that have little if any time saving benefits for the officers. Just to be clear the entries are not optional, they are required by the state and legislation. Body worn camera requires administrative time. Much have footage upload and tagged and information reviewed for accuracy. The additional workload for traffic stops increased the time required spent. The stop takes about 10 minutes, but if there is additional estimated 10 minutes spent on required administrative work in addition to stop itself that brings the total up to 20 to 25 minutes for every stop made. Additionally, we have the pandemic related changes that impacted traffic citations to some extent. The most obvious change was deprioritization of Traffic Enforcement to minimum covid contraction risk. There was a tremendous decrease in citations between 2019 and 2020 from 42. 971 to 13. 995. Post covid the traffic landscape also changed. Commuting to San Francisco declined with more people telecommuting to far greater extent then ever before and tourism also decreased and hopefully only temporarily. 20 percent less vehicles traveled south bound over the Golden Gate Bridge and that was 4 million less cars. Street flow also altered with introduction of slower speed limits, slow street strategies, signal timing changes and streetd design modifications. These are good things that crint positive to Traffic Safety however we dont understand the impact quite yet and these changes have to be studied over time. Finally, educational enforcement not captured. I mentioned previously. They do have a impact on traffic related behavior changes which is what we are striving to keep the streets safer. Enforcement involve traffic stops but not result in citations but advisement and warnings about unsafe behavior. I think if we dont include these moving forward, like not truly understanding the effort we are putting forth. Again in the first two quarters sfpd did 1600 plus traffic stops that result thin warnings and during the same period that complemented 2751 citations issued. All this to say is that, these factors play roles to varying extent in the decrease in traffic citations over the years. So, lets talk about strategy. What are we doing . We have strategies put in place to increase Traffic Safety efforts. Supervisor mandelman [indiscernible] used by the Traffic Company. These interest the planned operations target specific issues that we get information from either through our own examination through Community Members or city patners and these enforcement operations focus the mission as well as time spent on enforcement efforts as it relates to them. Traffic company itself did 256 directed operations from january to september and 59 percent of those were focus said oen the 5 efforts. The Traffic Division also oversees grant monies from California Office of Traffic Safety and works with district stations to provide them with funding for traffic related overtime to conduct directed operations in districts. These are operations targeted at safety issues. In addition to directed operations, i believe we need to enhance our Data Collection and Data Analysis. We need a better graph on statistics related to educational enforcement and regularly look how many traffic stops we do that result in advisement and warnings and at to the convirsation. Better understanding how the stats impact Traffic Safety and engage if behavior is changed at a result of the enforcement. Additionally, the department is ramping accountability. District station captains are brought in every 2 weeks to have specific discussions around their Traffic Enforcement efforts and Traffic Safety in their districts. Monitored challenges brought to light and plans to try to propel Traffic Safety efforts forward and i really believe this internal monitoring and account will be key. All this to say, there are multiple factors effecting trafing citation numbers we can do better. These factors do not explain decline in citations in entirety and working to truly understand what is contributing to it and make specific efforts to increase enforcement and make the streets safer. With that, i would be happy to answer questions. Thank you commander jones. I have two little with the slides. Slide 7 i think you were describing the larger percentage of focus on the 5 in citations and thats kind of good but depends on it denominator and denominator is still correct. Quite low. Little i understand and that is fair. The othernot misleading, but i think requires context which you gave which is the slide that shows decline in injuries following in the wake of the covid pandemic, not reaching prepandemic level but that is more explained by information elsewhere in your slides about the overall decline in traffic in the city. Yes. Okay. So, i want to tackle the staffing issue, the Administrative Burden issue and enforcement plan. So, on the staffing can you update us the extent i heard Different Things whetheri think the most recent class had 6 people in it. The most recent class that graduated had 6 people. There is a class that i believe started this week with 25 and think there is a additional i think 25 people in the academy now. The classes are larger. Are they anywhere near the 50 individuals we used to have a on regular basis . No. This isnt area of expertise, but if 25 in a people in a class and something less graduates from the class that is probably still not what we need for the departments growth plan they correct. Yes. The number of the people in the acaedomy will not outpace attrition, so at best probably we remain stagnant many yearwise the hope of growth later on. I can talk about this for like 4 hours if you wanted to. Dont think you want to today. Well continue this and should continue the conversation and staffing is a important conversation and supervisor dorsey is taking the lead on efforts to try to address that at the board of supervisors. In that context which was the last time there afs Traffic Company class and do you anticipate there will be . What we are trying to put proposal forth for internal and infant stages but thanks to leadership of captain shields, really if people cant be dedicated full time to Traffic Enforcement in the Traffic Company then we can train officers to be able to ride the motorcycles who would offset Traffic Enforcement in a back fill or overtime basis but there isnt a full class of Traffic Safety officers riding motorcycles in a few years. Okay. The hope you are internally proposing perhaps there could be a class that doesnt get full time Traffic Company but get people who can do Traffic Company work when there correct. You raise the issue of overtime. We are spending 10s millions of dollars on overtime. Are we spending overtime on Traffic Enforcement . Majority overtime is grant funded at this point. There is overtime related to if held over for traffic collision investigations, if required to work events in addition to normal duties on their day off, it would in that capacity, but i think to the level being spent on other things, no. Not close. The grants are how much are the grants . Not sure what the total amount is but there is a bucket of money that the Traffic Company oversees and basically works with district station chaptens but dont think the cup run ethover. Curious about that as we continue the conversation. And then just the last kind of i think what is going on with staffing is when the department is robustly staffed officers who are may not be in Traffic Company but doing proactive policing are doing some Traffic Enforcement. Yes. And then officers in Traffic Company are generally doing Traffic Enforcement. Yes. The staffing crunch means officer if they had more time to do Traffic Enforcement are not doing that and pulled way from doing Traffic Enforcement type of work to do other things that other responsibility of the department. Yes. You are hit both ways. We have less traffic officers therefore less officer frz Traffic Enforcement and because we have less people thin department those resources at the Traffic Company are being pulled in Different Directions to meet all the needs. Alright. On Administrative Burden and the tradeoff we have made without i think being aware we are making the tradeoff or the extent. Some have been made for us at the state level so if we want to think whether there is a way to get more officering out of our officers it might be a matter of advocating for changes in state law that would be state wide and that isnt something we can deal with in San Francisco. There are locally there are dgo and there are administrative requirements put on the department by the Police Commission i believe. Has the commission looked atare you aware those dgo may have added to the Administrative Burden . I dont think they looked at it in and of itself in the context of Administrative Burden. I think obviously when a policy is discussed they discuss in entirety, but i think all the different Administrative Burdens aggregate over time and i dont think that there is specific conversation being had to my knowledge about Administrative Burdens a it relates to each policy and that includes traffic policy. It seem s the efficiencyi appreciate the need for more officers, but we need to be trying to get as much efficiency consistent with policy goals and hope the commission is thinking about those tradeoffs and asking those questions. Thats for another day as well. So, i want to enforcement plan and dont think you are ready to give it to me. I think that we are going to be ready to give it to you. Leadership turned over pretty drastically in the last couple months, so now i have a solid team in place. I think we have two fold issue. We need enforcement plan as it relates to the department and what is under our purview dedicated to Traffic Enforcement. I do believe we can work out a very specific Strategic Plan relating to traffic if forcement to get the numbers up and that is honesty putting the pieces in plain to get that done now. What is reasonable period of time to give you to have that more robust plan and maybe have more data to show us . I think in the First Quarter next year we should have our feet under us and be able to have assessed the situation enough to put measures in place in form of a plan. After conversation and Public Comment and ask this committee continue this hearing to call of the chair but come back the First Quarter and you will show us more robust plan as well as more data. The datai am trying to understand what the department is saying about citations. Citations are measurable. It seems likeseems you are deemphasizing them in light of direct operations potentially as a measure, the educational enforcement. How many times officers stop and not give citation. Where are you thinking about citations as the right measure or a important measure of how much Traffic Enforcement . That is the only one you are presenting, but it also seems the letter you are not responsible for deemphasize or attempt to deemphasize citations as the right measure. I dont know how we can have conversation about transferic enforcement without discusing citation levels. What i wanted to introduce today is there is this pool of stops happening that are not resulting in citation but traffic stops and effort for educational enforcement to change people behavior, make the streets safer. I think we need to understand that better, but i think moving forward we are going to have to continue to look at traffic citations as a measure of Traffic Safety but also think we need to look at the stops and make sure are these citations issued in the right places and right way s and have desired effect . Are they making the streets safer and put closer to the vision zero goals. I think all those things are pieces of the puzzle and we have to do a better job bringing all that information together to really understand because i think if we do very specific things, those specific thingsthat is all there time we have is do very specific things one would hope the specific things we are doing are increasing Traffic Safety, lowering the level of collisions, making sure less people are injured, so thats what i like to see moving forward is a better understanding of the full breath of the picture. It would be interesting when you come back to us if you have concluded that those are useful to measure. The department can measure and epresent those. Agreed. And putting more meat on the bones how long they last, what they look like, what you get out of them, what prompts them. We have fairly robust Data Collection for the Traffic Company as it relates to the directed operations. You noticed im speaking for the Traffic Company and their statistics because i know them so i can tell where they were and how many citations were issued, tell whether they focus on the 5 efforts or who generated it complaint in the first place. All those things we keep good stats on, however, our focus is Traffic Enforcement and district stations have a myriad of priorities and another Data Collection measure that is the balance. How to collect data and work with the other district stations to support them in doing additional Traffic Operations with whatever resources they have available and then make sure we have all the information to understand what is working and not in that Data Collection sphere and knowing they may not have resources to devote to collecting all the stats but that is a conversation that will be part of the plan and speak more specifically next time. The 200 odd operations you referenced were Traffic Company operations . Yes. What makes something a operation . What makes it operation is we put pen to paper. Identify a specific goal. Identify a specific location and that information is disseminate. Think of 256 minitraffic plans. Got a complaint from x Community Member from me about clipper street. You about clipper street. You gave us information about clipper street, this is what is happening there, these are the period of enforcement we will do it and it is more then just saying can you go out and do Traffic Enforcement on clipper street. We are measuring what the results are from those and defining them as a operation. We are director people to do these enforcement measures. It isnt a optional thing. Two more questions. One of them is from district 9. Related to valencia. Okay. As part of vision zero, mta responsible quick build projects with one of the most critical being the sener running valencia bikeway pilot that launch august. Key to the success and safety is the left hand turn restrictions for vehicles off of valencia. I should note that i consulted with City Attorney about the ability to ask this question given my residential on valencia. I amdont know if far enough away but this is because this is a Traffic Enforcement question i am able to ask this. Do you have citation data and dont think we got this before hand so may need to follow up. Do you have citation data on valencia . What do you need to provide more regular consistent enforcement . What are you doing about valencia. I spoke about this earlier. We can pull the citation stops. I dont have them here today. I did mention that especially when they were trying to orient the communities there were a ton of stops being done by the officers that resulted in advisement and warnings. This is going into place. We need to orient. You no longer can make the left turn. So, there was specific attention paid to valencia street, and we can follow up with information. It was very much a heavy focus in the beginning as it was unveiled what those stops look like now i have to check. The d9 office is [indiscernible] great if you could get that over to us. My last question, i asked for your department to work on a policy around the use of drones for side shows. It strikes me that given the Department Policy around chases and not givingnot raising the risk to Public Safety and chasing after cars, having police cars chasing non police cars throughout the streets of San Francisco as a rule, absent extraordinary circumstances, drones potentially could be a tool to try and fill that gap. I dont think it is a tool that is available to you now, but maybe you can confirm that and wondering if you know it is a tool other departments use around Traffic Safety. I think we have to do more research. My understanding is that there are some other agencies that do use drones in that capacity. What i have been told. We need to do our homework on this more. Any tool that will help us enforce traffic laws and provide for the safety of the streets is of course one we love to have available. You aremta is getting a new tool in terms of automated enforcement. That is mainlyhow is automated enforcement going to work between mta and you . Are you talking in terms of red light cameras . Red light cameras i believe we have them [indiscernible] which are slowly and expensively rolled out that are frustrating to some. I mean the automated Speed Enforcement that will be allowed. My understanding is that thats on the governors desk right now. If that goes into play i believe San Francisco is a pilot city that project is being spearheaded by mta. We had conversation about it yesterday. The way they explained to me is that they believe they will issue administrative violations, so those citations will probably not come through the Police Department. The red light camera violations do. The difference being red light camera moving violation not speed isnt, but there is different policies related to that. So, again another tool that would be helpful to have. Mta is really the lead on that. Okay. Not seeing questions from anyone else, so lets go to Public Comment. Very good. Now hear Public Comment on agenda item 7. If you have Public Comment on this discussion about Traffic Enforcement and Street Safety come forward to the lectern and hear from you two minutes and then folks connected remotely. Please come forward if you are ready. I want to commend supervisor mandelman for bringing up this issue and bringing out the fact that the Resources Available for Traffic Enforcement just like graffiti abatement at the Police Department are severely limited. I live at 100 van ness. From my apartment i see a great extent of van ness avenue and i see virtually every day motorcycle hot roders who ignore speed limits and zip up and down even in the bus lanes to get where they are going. We have not had a horrendous accident recently but a couple years ago at least two the car that was hit was turned over. It isthis is a area where all the good things we talk about, 20 mile hour speed limits are not go toog work because the guys and girls who are in these vehicles are having a great time speeding. We need enforcement. I realize we have a limited amount of resources, but we need to do something about it. Related to that, a number of these vehicles make a loud noise. They have i think disabled whatever mufflers. Limits the amount of noise that can be made and but that requires enforcement too. But the speeding and the noise in many cases go together and i hear and see both. Speaker time concluded. Thank you for sharing comments. Next speaker, please. Hi, luke bornhimeers, thank you for calling the hearing. I urge you to call out sfpd diprioratorization of Traffic Enforcement dating back as far as 2013. Pushback on the narrative decreased Traffic Enforcement is a result of staffing or funding and do everything to urge chief scott sfpd and mayor breed to focus on the 5 violations on High Injury Network. This hearing is occurring in part as a result of [indiscernible] analysis of Traffic Enforcement data last year which was featured in sf chronicle and i had the honor helping with. [indiscernible] first hearing at which steve and i presented, i analyzed sfpd staffing and fundling data since 2013 when Traffic Enforcement violations decline to currently non existed levels. Staffing and funding shows that total staffing and funding have stayed relatively flat compared to 97 percent if decrease in enforcement and that is before factoring the number of people served to remote work. Traffic enforcement is down because sfpd deprioritized not staffing or funding. Urge to call out deprioritization of Traffic Enforcement dating back as far as 2013. Pushback on the narrative decreased traffic enforce sment a result of staffing or funding, do everything to urge chief scott, sfpd and mayor breed to prioritize Traffic Enforcement if unwilling or unable i urge to explore unarmed traffic if forcement and shifting funding to infrastructure that increase roadway safety specifically the creation of conducted network of bike lanes that help people shift more trips away from thank you for sharing your comments with the committee. Next speaker, please. Hi. My name is [indiscernible] i have been homeless over 23 years on purpose. Having a double murder caused by officer williams scott, jr. Who put me on the streets and took away everything i had because i had said no i didnt want to marry him. This right here, you are not supposed to show pictures. I will pause your time. Hang on a moment. This is a i will pause your time for a moment so you understand that we are taking Public Comment just on item 7 right now. [indiscernible] thank you for sharing comments. We need to hear from the next speaker now. [indiscernible] thank you. Speaker time concluded. Thank you for sharing your comments. Thank you for sharing comments. Next speaker, i believe we are going to remote comment line now. Good afternoon Committee Members. Jody [indiscernible] executive director of walk San Francisco and express gratitude to supervisor mandelman and committee talking about Traffic Enforcement. As it is needed to get closer to ending traffic related deaths and injuries in San Francisco. As you know, last year one of the wirs Traffic Related Fatalities and this year is in the wrong direction. 14 [indiscernible] incity lost more this year in the same time last year including three pudistrens in the last 6 weeks and one was a 4 year old child. What i find criminal the vision zero squad is disbanded to focus unsafe streets isnt a priority for department. We are talking people lives lost, families devastated. These are people trying to cross the street. It makes sense to us that all departments that have committed to vision zero use the very limited resources to focus on known dangerous locations in the city. High injury network. The 12 percent of San Francisco streets 68 percent of our severe fatal crashes occur. This is why walk San Francisco has been asking the San FranciscoPolice Department to target limited enforcement oen the High Injury Network. With enough frequency and visibility to help shift driver behavior. Behavior change is needed. This is necessary. Keep driving in San Francisco must understand that dangerous driving behavior will not be tolerated. Thank you. Thank you. Next speaker, please. Good afternoon commissioners. Members of the board. My name is Richard Rockman and i think priority we have to wait all 5 hours for this hearing. It says something about what they think about Public Safety. You should invite the president of the Police Commission to the meeting and ask them why they are telling officers not to write tickets and not toPolice Officers afraid of racial profiles. Now they have to spend 25 minutes writing a report. Why should they stop cars for speeding if they get in trouble because put down the wrong information on the ticket and have to spend 25 minutes writing the ticket. Maybe next time you have a hearing, ask the Police Commissioners to come and i heard that the police are slowing down. They just dont want to write tickets. I live off fulton street on 37th where there is 25 mile hour zone and walking and car came speeding down fulton street and all most hit me. I became all most a statistic. [indiscernible] International Speedway andonce i saw them out there, but they dont come out to the outer richmond. How can i walk safely to Golden Gate Park and the lake if cars speed down fulton street . The city is becoming unsafe for senior citizens, mta has to [indiscernible] police need to do their job, and it isnt a shortage of police, it is getting the police them to do their job. They are not doing their job, and it is your job to make sure they do their job and maybe they need to change the state rules and but i suggest you have the Police Commissioners come and ask them why they are telling the police thank you for sharing comments. Next speaker, please. Hello. My name is steven [indiscernible] Data Analysis that published in the San Francisco chronicle that shows the sfpd was writing 10 trifeic citations per day city wide. That story was [indiscernible] call the hearing and like thank him. Last october presented to the analysis to the committee. [indiscernible] increase traffic seft in San Francisco. None have been implemented so restate again. Number one, chief scott direct all the traffic enforce ment resources to focus on the 5 on the High Injury Network. Analysis shows between january 2021 and may 2022 only 18 percent of citations were on the focus 5 violations and that number shed should be at least 90 percent. The San Francisco [indiscernible] most likely hit by a car and no surprise every one of the intersections on the High Injury Network. I ask why isnt Traffic Company enforce focus on the 5 at the intersections . [indiscernible] and get deadly crashes down. Two, must release data on a daily basis. Time consuming [indiscernible] analyzed and commander [indiscernible] after presented to the Committee Last october and offered to help and my offer still stands. Number three, crash data released more then 36 months. How can we evaluate impact of enforcement strategy if enforcement and crash data are stuck in a hole . Full year since published analysis of Traffic Enforcement and 30 have been killed by a driver. Drivers continue to crash vehicles and hurt someone in San Francisco thank you for sharing your comments. Sorry for cutting you off. We have to move to the next speaker. Connect to the last speaker, please. I was wondering this is item 7, i believe there should be 8 for general Public Comment. San francisco again. Street safety is the name of the item. Street safety means that everybody should be safe. There is no expectation of privacy in public. What does that mean . Cameras everywhere. Mandelman brought that up. Cameras, get the high powered cameras. Watch what we say. I spoke to spiderman and super man and told me to remind you be careful what you say. You know why . [indiscernible] not so good people but people are listening. Lets try to keep the Staffing Shortages to the minimum perhaps. I dont know. There is no expectation of privacy in public. Anybody [indiscernible] high powered cameras to protect the public and again, Street Safety means people can protect themselves. State of california needs to stand your ground. That means if you are mugged or jumped on the street you can protect yourself by any means possible and prove that in the court of law. [indiscernible] says no one remain silent at all times. That means if a officer or anyone stop you you do not have to answer any questions. You do not have to identify yourself, but thats just for those lawabiding citizens that feel threatened by Law Enforcement. Need to get that out there. Let us know if there is going to be general Public Comment for number 8. I will be working till 8 oclock because im doing all the Community Duties here. Bye. Thank you. Mr. Vice chair, i see we have no further callers in the queue. Anyone else interested in testifying before Public Comment is closed . Seeing none, Public Comment is now closed. Additional comments or questions from colleagues . Go ahead. Thank you vice chair engardio. I dont have questionsism i want to thank commander jones and captain shields for your work and for all the folks doing the work every day and the department. I want to thank folks who called in and especially folks who came as well. [indiscernible] and steven bridge who were the impetus for the story last year that got a lot of traction and was very impactful in this conversation, which has notthe conversation is going on, i think we are looking to the department and hopeful even in an environment of short staffing we can do better and i do think the point that thethis is a hard problem to solve given where we are with staffing, but the decline in enforcement over the last decade precedesfar receded decline in staffing, soand given what we choose to prioritize with overtime dollars we should be able to i think do something, while we struggle with Staffing Shortage. The conversation is going to continue and i have a lot of faith and confidence in commander jones and captain shields and hopeful when we come back early 2024 there will be something that looks more like a plan and something we can actually track through successivethis meeting should foin and we will watch a graph go in it other direction along some set of measures which may be citations and maybe other things as well, but to give the public some confidence that we actually are doing Traffic Enforcement and focusing on enforcement that will make a difference in keeping people alive. With that, i would requesti move since now a member of the committee, i move we continue this hearing to the call of the chair. May we take the motion without objection . Mr. Vice chair for a bit of housekeeping, supervisor stefani being absents we received a memo appointed supervisor mandelman in her place. It is order to make a motion to excuse supervisor stefani before we take action. You may move that. So, it has precedents. Made a motion to excuse supervisor stefani. On the motion [roll call] mr. Vice chair, no opposition on the motion to excuse and now the motion to continue to the call of the chair offered by supervisor mandelman as a member of committee. On the motion vice chair [roll call] once again, no opposition. We have the best clerks. Anymore items before us today . There is no further business. Thank you. We are adjourned. [meeting adjourned] [music] maintaining fire safety is everyones responsibility. For your safety, if you see an active fire or fire safety hazzard, report it immediately. Here are tips on reporting fire safety hazards in San Francisco. Depending you may call 911 or 311 the city 24 7 Customer Service center. When to call 911. Call 911 when you see a fire or open flame source in public. Call 911 if you bench a person using open flame device you believe will result in injury or property damage. 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And contact 311 to report fire safety concern or complaint that does not involve an immediate threat to life or upon prosecute. Remember, your reporting can save lives you can report unanimously. If you need to ask a fire inspection question call the San FranciscoFire Department 415five 583300. To finds outer more about the San FranciscoFire Department visit our website. And learn more about the 311 tomer service shared spaces have transformed San Franciscos streets and sidewalks. Local business communities are more resilient and our Neighborhood Centers are more vibrant and lively. Fire blocks and parking lanes can be for seating and merchandising and other community activities. Were counting on operators of shared spaces to ensure their sites are safe and accessible for all. When pair mets, firefighters and other First Responders arrive at a scene, they need clear visual access to see the building entrances, exits and storefront windows from the street. That means parklets should be transfer in the areas above inches above the sidewalk level. Its best if these areas are totally unobstructed by transparent materials may be okay. You can check with Fire Department staff to make sure your site meets visibility requirements. Emergency response crews and their equipment need to be move easily between streets, sidewalks and buildings, especially when they are using medical gurneys, ladders and other Fire Fighting tools. That means that parklet structures need a three foot wide emergency feet every 20 feet and 3 feet from marked Parking Spaces and emergency access gaps need to be open to the sky, without obstructions, like canopies, roofs, or cables and should always be clear of tables, chairs, planters and other furnishings. Emergency responders need to use ladders to reach windows and roofs to buildings and the ladders need unobstructed overhead clearance and room to be placed at a 72degree angle against the building. 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