testing. good. thank you. this is the june 8, 2022 budget and finance committee meeting. i'm supervisor hillary ronen, chair of the committee. i'm joined by committee member gordon mar and will be joined shortly by vice chair supervisor ahsha safai. our clerk is brent jalipa, and i'd like to thank matthew baltazar at sfgovtv. mr. clerk, do you have any announcements? >> clerk: yes. just a reminder to please silence all phones and electronic devices. ed board realizes -- the board realizes that public comment is essential, and we will be taking public comment on ear item on the agenda. for those watching channels 28, 76, or 99, the public call-in number is streaming across the screen. that's 415-655-0001. enter meeting i.d. 2481-542-4313, then press pound and pound again. press star, three or raise your hand to lineup to speak. we will take public comment from those attending in person first and then move to remote public comment. alternatively, you may submit your comments in writing at b-r-e-n-t-j-a-l-i-p-a@sf.gov. and finally, items acted upon today are expected to appear on the board of supervisors agenda on june 14 unless otherwise stated. madam chair? >> chair ronen: yes. can you please read item 1? >> clerk: item 1 is a resolution authorizing the executive director of the port of san francisco to execute a mutual termination agreement for port leases between the port of san francisco and alioto fish company ltd. for the restaurant premised located at 2829 taylor street and the associated warehouse premises located at 360 jefferson street, and to authority the executive director of the port of san francisco to enter into amendments or modifications to the mutual termination agreement. >> thank you so much, chair ronen and supervisor mar. here to talk to you about the proposed mutual termination agreement with alioto fish company. i don't think i need to introduce alioto's fish company or restaurant. this has been an operation since 1925. they have been in this structure location since 1970, a key part of our portfolio and really something that's synonymous with fisherman's wharf and the great attraction that we have there. unfortunately, at the outset of the pandemic, they suspended operations. the port staff and alioto's staff had conversations since then to see if there was a way for the restaurant to reopen, and even though the port was offering base rent on whatever they could sell, the family and staff decided to seek a termination of the lease for their restaurant nearby as well as fish company on jefferson street. we made inspection to ensure the condition of the facilities and brought an agreement to the port commission this past april, which the port commission approved. next slide, please. to summarize the agreement terms, alioto's would surrender the security deposits on both facilities and pay a termination fee. they'll cooperate to ensure all permits are transferred with the building and not with the specific restaurant that's in there. they complied with its s.b.a. covid relief loan. alioto's provides broad release of claims. next slide, please. in closing, i think this is a really bittersweet day. it's really hard to see the aliotos name come out of this facility. they negotiated in good faith, and we hope that they leave with a feeling of something that benefited the city and the report. the facility, while needing repair, the facility is very serviceable. our hope is to get it back so that we can relet it and generate sort of a new operation there that would bring people down to fisherman's wharf and enjoy some opportunities there. we hope the committee forwards this to the board, and i'm happy to answer any questions. >> chair ronen: thank you, and i believe we have a b.l.a. report before we go to questions. >> thank you, chair. nick menard from the b.l.a. this is a mutual termination agreement between port and the fish company. the agreement would forgive approximately $861,000 in rent through june of this year, and the fish company forfeits its payment of $25,000. as we describe on page four of this report, this agreement is relatively more generous than the previous one approved by the board of supervisors in 2021 by approximately $338,000. according to the port, this is -- and as was just stated, the port has been interest in gaining control of this site more quickly than the site of the ferry building, and that sort of weighed on their decision, though we do consider the policy matter to be a matter for the board. >> chair ronen: thank you, nick. any questions or comments? i just want to say that it's a perfect day to consider this because this is a sad day for san francisco. this is a rough loss. a legacy business that's so iconic that's one of the sites of pride of being a san franciscan and being on the port. it's just -- it's heartbreaking to lose this institution, but, you know, thank you to the alioto family for running this incredible restaurant for so many years, and thank you for entering into a rent agreement with the port, and thank you to the port for this. you would think that this restaurant would have money in the bank to sustain this through the crisis, but it is with a very, very heavy heart that i would like to make a motion to send this item to the full board with positive recommendation. >> supervisor safai: may i say something? i know i talk too much. when people think of the wharf, they think of alioto's. i don't want to put all the blame in any way, shape, or form on the restaurant, but i think we as a city need to do more to think about how we're going to revitalize and reenergyize and reset. we were in a hearing yesterday that talked about how a certain percentage of every single penny when you put into paying when you sleep or rent a hotel room is set aside for recharge or refresh. there is moneys dedicated to think about how you're going to refresh hotels consistently, and we have rode on the success of fisherman's wharf for a really long time, but the city needs to be thinking about and working with a partner on refresh. i don't want to be putting it on in any way, shape, or form, on the restaurant. we're going to send this to the full board with a heavy heart, and hopefully, there's some way for alioto's to come back and partner with the city again. >> chair ronen: thank you. can we take a roll call? >> clerk: madam chair, we should take public comment on this. >> chair ronen: we should. thank you. >> clerk: thank you. members of the public wishing to make public comment should call 415-655-0001, meeting i.d. 2481-542-4313. press pound and pound again, then star, line to lineup to begin your comments. we have no speakers in the room. mr. atkins, do we have any callers in the queue? >> operator: there clerk, there are no callers in the queue. >> chair ronen: thank you. public comment is closed. can we now have a roll call vote. [roll call] >> clerk: we have three ayes. >> chair ronen: the motion passes unanimously. thank you so much. mr. clerk, can you please call item 2. >> clerk: yes. item 2 is a hearing to consider the priorities of the long-term care coordinating council to provide needed services for seniors, persons with disabilities, and all residents who require long-term care, and requesting the human services agency, department of disability and aging services, and long-term care coordinating council to report. . >> chair ronen: supervisor safai, did you want to make any comments? >> supervisor safai: we know this has been sometime in the making, and we want to hear about the long time research about the long-term care coordinating council we distributed personal protective equipment, ensured real-time testing was available to avoid the kinds of outbreaks and deaths that affected other parts of the state and other parts of the country and world. yet these actions that we took had some unintended consequences. worsening social isolation and creating in many cases a tale of two cities where some members of the city could keep in touch with loved ones, but lower income families struggled to stay connected. under the incredible leadership from miss susie smith from h.s.a., who joined us, and laura liseman, san francisco conducted research and formed a response. you'll hear from the community that the community is doing work to respond, and i'm honored to represent the excelsior in district 11, home to the best example of long-term care in the nation. our san francisco campus for jewish living, also known as the jewish home. we'll hear from rebecca holtzman to hear about their efforts to keep connected. [please stand by] stakeholders repeatedly mentioned the lack of challenges around social engagement and activities. they were talking about basic social attention. there was also a lot of focus on lack of communal meals. so that was one thing just isolation. a second theme stemming from that increased level of depression. the third thing was boredom. they literally could not leave their rooms. the destruction in dietary and the appropriate food that family members would bring. once people were allowed to resume social activities, people had been isolated for so long, they were afraid of coming out. this theme was the decline, and i alluded to this earlier that there was a decline in cognitive abilities and loss of function. finally, we really uncovered both some of the challenges, but more importantly, the opportunities that digital connection could provide and so we'll talk about that in more detail. so the things in mind for the rest of my time with you here, i'm just going to read some quotes from the study. three people on my unit have died because of lack of visitors. a screen just isn't the same. i couldn't see the important people and they died earlier than they had to. one man told me that he might as well not live because he hasn't seen his family in so long. depression and despair seem to be increasing significantly. they want us to [ indiscernible ] our roots. it drives me nuts. it's just the same old stuff every day. we opened up the dining room and no one wants to return. right now, only one person is eating in the dining room by themselves. people are resistant. that kind of isolation becomes a habit. people don't -- another quote. people don't get over this. a year of isolation just like that. they now have a new normal. wifi needs to be upgraded. it can be a pretty bad connection and then people get frustrated and discouraged. we have a short supply of ipads. we have two total. i'm now honored to turn the mic over to rebecca holtsman at the center -- sorry, campus for jewish living and she's going to talk about her role in the behavioral health group, but more importantly, her direct experience at jewish home during this time of the pandemic, thank you. >> thank you, susie and everyone for your time this morning. so about five years ago, we officially changed our name from the san francisco jewish home to the san francisco campus for jewish living, but that memo did not get out to the community because most everyone knows us as the san francisco jewish home or the jewish home. so i'm just going to go with that this morning. we're located in district 11 right on mission and silver street. and, we were part of the l.t.c.c.c. behavioral health work group. although we are a jewish organization, we have a very diverse resident and staff population. 30% of residents and 86% of staff self-identify as bipoc. it was a bustling hub of robust programming, community activities, spiritual life, and family visits. each month, residents and staff boarded one of our shuttles as we took residents on educational outings to places like the jewish museum and the sf mona. our life enrichment department provided an array of stimulating programs including the popular morning creative arts class which brought together residents for many different units. residents would chat and get to know 1 another while engaging in a variety of creative processes. we had a full evening program each week. we're visiting pianists, violinists and they came to the residence and entertained residents. volunteers from the community served as dealers, and residents wagered up to $0.10 on their hands. we even hosted a visit from a therapeutic cammal back in 2019 which residents and staff are still talking about today. my position between bay area youth and jewish home residents, patients, and staff. in 2019, we launched a youth leadership council as well as the partnership with the brandized school of san francisco and independent jewish school near lake merced. they brought all of their eighth grade students to visit with our residents twice a month. it was a pleasure to watch meaningful relationships blossom between the students and residents as the so-called age divide flipped away. but why does any of this matter? it matters because all of these programs and partnerships helped residents stay engaged and connected with each other and the world around them. these programs and partnerships prevented social isolation, depression, and loneliness. of course, the pandemic changed everything for everyone around the world, but maybe no more deeply and painfully than for people living in skilled nursing facilities. everything came to a stand still as programs, outings, and essential services like physical and occupational therapy were canceled. families could no longer visit their loved ones. residents were sequestered to their rooms and faces were hidden behind masks and other ppe. i specifically remember going up to one of our units in the early days of the pandemic and seeing wheelchairs lined up and down the hallway as each person ate their dinner alone in the hallway outside of the room. it was a stark and devastating scene some residents who were particularly ill with covid were taken to the hospital and never came back. many of our residents lost their lives to covid-19. fear took over at the jewish community home. our community was deeply impacted by covid and i just want to take a moment to remember all of the elders of the jewish home who lost their lives to this virus. we are very grateful to the city and to san francisco department of public health for protecting our physical health throughout the pandemic and we know that the death toll would have been even higher. but the balance was a little off. there was too much focus on physical health and not enough on mental health and social well being. while the pandemic is over for many people, we haven't moved on. we are still socially distancing. while family visitation has resumed, we are nowhere near our pre-pandemic programming. right now as we're here today, two of our seven nursing units are on quarantine because of positive covid cases and residents can't leave their floor. now, residents and staff are asking each other, how can we, how do we move on from the isolation, the loneliness and the lack of connection of the past two years? how do we address the mental health needs of our long-term care residents. when i found out the lpccc was forming a behavioral health group, i was excited to learn about their work and findings. i felt hopeful that maybe we could use the group's recommendations to begin the healing process. i'm going to turn it back over to laura who's going to talk about the group's recommendations. >> thank you, rebecca. i just want to acknowledge the rate of the loss and the sadness for the residents and the staff and the families and loved ones impacted by this pandemic. this is a highly emotional issue. >> i was just going to say the same thing. i think that all of us with senior parents and members and friends and family, we've seen this, even if they were not in a skilled nursing facility, we've seen the impact that this has had on so many different families and lives. so i really appreciated the moment of silence for anyone that was lost during this time. but i appreciate you acknowledging how emotional this is and how important this is. so i know that this has been hard for all of you and everyone that's been involved. so i really want to honor the work that you've done over the past couple of years and continue to do because this is not easy work. it's not easy to see people suffer when we know we can try to do more. >> and, unfortunately, this experience is not unique to the jewish home. right. this is pervasive across all of our skilled nursing facilities. disproportionately impacting low-income seniors and adults with disabilities who don't have access to technology. and that's what brings us to our recommendations. we need to ensure teleconnectivity at a minimum to all residents who can benefit. we also need to implement evidence-based therapeutic practices. so i'd like to share a little bit more about what that looks like for us in our findings from the report. many of the server results indicated that reliable internet is a primary barrier. we live in the tech capital. why are we struggling with an issue like reliable internet. we don't have sufficient devices. at one facility, they have two devices and we need to allocate resources and time for staff and volunteers and others to train and reliably teach people how to use tablets and other devices. so, we're excited about the potential for future partnerships. we also believe in evidence-based therapeutic practices. we know moving forward involves individual and group activities to address the mental health needs of our community. we've outlined a few of them here today. telephonic outreach is something institute on aging has provided through the friendship line. it operate its 24 hours a day. it receives inbound call to support isolated individuals around the country, not just in san francisco. one of the interesting opportunities we had during the behavioral health work was to identify life review groups and for those unfamiliar, i'd like to turn it back over to rebecca who's going to share a little bit about a pilot project that will restore hope in how we can move forward in skilled nursing facilities. >> i'm going to talk a little bit about life review. the department of aging services connected the jewish home to meta fund and we're very grateful that meta fund has provided the jewish home with a generous grant to plan and implement a life review pilot program. i've shared some of the details about the pilot here on these slides, but what we're actually really excited about is the opportunity for residents and staff to process life stages and events including the trauma caused by the pandemic. we are doing the life review pilot program in partnership with falton institute who are providing their staff and expertise to implement the program. one of the goals of the program is to directly address the loneliness and isolation that were a result of the pandemic. the seed money for meta fund is allowing us to build capacity to implement future iterations of the life review program. we've already discussed future groups to include a chinese language group, a russian language group and a group to serve our african american residents our hope is to weave life review into the fabric of our social programming. i'm going to hand it back over to laura. >> thank you, rebecca. so that's an example of something under way that we think we could replicate in other skilled nursing facilities. we request $250,000 a year for a three-year pilot for a site-based therapeutic interventions like the life review. we're also looking for $250,000 for a three-year pilot to increase teleconnectivity including tablets and training of residents. at a higher level, we really want to incorporate the recommendations of the behavioral health work groups into our state's master plan for aging and local play book. we'd be happy to answer any questions and we appreciate your time and attention. >> thank you so much for your presentation. i'm sorry, my father passed at the end of last year in a nursing home and so i'm having a really hard time with this hearing. but um, did you already fill out the form in our add back request -- >> we did not. >> supervisor ronen: you need to do that today. i will have santiago from my office send this to you. and did h.s.a. make that request of the mayor in your budget? >> supervisor safai: can you pull the slide back up for the request. i just had to run to the restroom for a moment. >> so this is coming from the community. i'm serving as a duel role. >> supervisor safai: and they've been working with our office. but we'll work with your office. >> supervisor ronen: okay. make sure, yes, to get those. thank you, you've made an incredibly compelling case and i'm just really happy that you're doing this work at the jewish home and we definitely would like this work to be done more broadly at skilled nursing facilities across san francisco. so this will definitely be a priority for my office. thank you. >> and, thank you for sharing your personal loss. we offer our condolences and i think the impact of this is just devastating. >> supervisor safai: can you pull that slide back up when you get a moment. >> i'm sorry, are you able to see it? >> supervisor safai: the one that was budget related. >> yes. >> supervisor safai: i think supervisor mar has -- i know you were. supervisor mar. >> clerk: we're currently showing end of slide. >> okay. >> supervisor safai: supervisor mar, do you want to ask your question? >> supervisor mar: sure. did you have some questions? >> supervisor safai: i do have questions, but go right ahead. >> supervisor mar: well, thank you so much for the presentation and all of your work on this. really looking at the behavioral health needs of residents in our city during the pandemic. i mean like supervisor ronen, i lost a parent during the pandemic and my mom was in not skilled nursing, but an assisted living memory care facility, so all the issues that you highlighted about the really extreme challenges that the residents and their families faced over the last few years resinate very much with me. so thank you. and i really appreciate the recommendations that you came up with and really excited to hear about the review pilot. that sounds wonderful. you know, i guess i just had some questions that are more about the broader, not so much around the findings and the recommendations because i think that's very clear and compelling to me as, you know, as well. but, sort of the broader need in so you mentioned the scope and i was just curious, with the crisis at laguna honda hospital and it's looking at the worst case scenario, you know, 700 residents there needing to transfer -- i guess i just had questions more about the overall whether we have enough skilled nursing facilities and beds in our city even without the laguna honda crisis. >> no. i mean, we don't have enough skilled nursing facilities. we don't have enough assisted living facilities. there are many kind of mom and pop smaller six-bed or fewer facilities that are leaving the city because they can't afford to stay. and we have a different actually the same long-term care coordinating council group did a study on assisted living facilities, supervisor mar, a couple years ago that was recently updated and we don't have enough. and it's important that we try to do all we can to keep those assisted living facilities and skilled nursing facilities in the city and particularly for people who don't have means to be able to pay. right. so there's not enough. we have data in that report that we can share with you as a followup. and it's challenging for affordability crisis hits, you know, every stage of life. and we don't have enough. >> and, if i may, i'd just like to respond to the crisis for the laguna honda residence. we are going to see displacement throughout the state. we're going to be sending people out of the county and likely be on the bay area in order to meet their needs. again, as susie mentioned, we have a comprehensive study showing the bed shortage there as well. and some opportunities that i'd be happy to share with your office. >> supervisor mar: that would be great. i know the board has a hearing on the crisis next week, so do you have available beds in your facilities currently? >> i don't know particular numbers, but just anecdotedly, the moment a bed becomes available, it gets filled quickly. >> supervisor mar: i called for a hearing and we had a hearing a few months ago on sort of how the city is not adequately planning to meet the support needs and that hearing kind of looked at the full range of housing and care needs to skilled nursing and everything in between. so the budget and legislative analyst office has been doing some research and about to release a report on looking at the gaps and how we can better plan. so i think that's sort of the bigger picture issue that i've been wanting to work on and this is really helpful just to have the ltccc's work on affordable assisted living and on behavioral health needs of assisted residents happening. so thank you. >> i'd be morn happy to follow up with your office as well so we can identify any other research needs for the continuum of care in san francisco. it's a high priority for us. and condolences to you and what a reflection of our community that two of three of you have suffered significant loss throughout the pandemic. i'm deeply sorry. >> supervisor mar: thank you. >> supervisor safai: thanks, supervisor. before we do any more questions and public comment, we also have marie jovlin from the dignity coalition. it would be helpful for her to go through her presentation and if we have additional comments in public comment, we can do that. marie. >> good morning supervisors. it's really a pleasure to be able to stand up here with you all and i first want to say the long-term care council supports which i'm representing today the recommendations that are coming from the long-term care council and i just wanted to acknowledge how the impacts of isolation and loneliness have been made vivid in this presentation this morning. i wanted to just provide a little more context on the issue of technology. i want to start with the city's own words. you have a digital equity plan and it says that all residents have full and equitable access to digital technology and its benefits, so all communities can thrive regardless of demographic. so we're talking about people in skilled nursing facilities, people in independent living, and everybody in between. you know, there was a recent study called the empower san francisco technology assessment that puts a fine point on needs of seniors with disabilities in the city, but it's one of only many studies that's been done that put emphasis to close the digital divide for people in san francisco. you have a paper version of this so you can read the details. i think it also puts attention on the issue of assistive technology. as people have vision loss and other kinds of disabilities, i think it's important to recognize it's not just giving somebody an ipad and saying go do it, but to really make sure they have the kinds of assistive devices that will allow them regardless of their disability to be online and, you know, the needs for assistive technology echo the needs of the people that have been described here already. older adults, low income, s.r.o. residents, black, latinx, and a.p.i. communities and spanish, chinese, and beyond. so one way to look at this. you have the slide thing up there? okay. you have to catch up with me. so i'm already at the point where we're talking about this is a continuum of learning so community based access to internet devices, training, assistive technology and technical support help individuals learn the basics and stay connected whether they remain in the community, whether they move to skilled nursing. and, as has been mentioned before, isolation and loneliness are associated with higher rates of chronic health conditions including heart disease, weakened immune system. depression. admission to nursing homes or the use of emergency services and death. the impact of social isolation of seniors is presenting well beyond how when the pandemic restrictions have been lifted. according to various studies leading to increased problems of dementia, depression, suicide risk and disruptive care. so i just want to say that, you know, as you know, the digital divide is real, the needs are clear, the solutions are available have been documented in study after study and we have a great one that's been presented here today in terms of the impact and the need and just remember that the lack of progress really impacts older adults and people with disabilities in our city who make up 25% of the city's residents. so, we also have an ask and it's a bolder one maybe, but we understand how important it is for people to be able to have what they need to be able to learn these skills and stay connected across the continuum and so we're hoping that you all will be able to provide some support for this as well. if you look at the last page of this, there are a number of seniors serving in other organizations that have shown their support for this effort partly because they're struggling with how do they become hybrid like you all are struggling with that. how do they continue to provide services and support for people in their homes. at the same time not willing to come back into the centers or never could come into the centers before because of their disability and people just itching to get back with their colleagues and service providers out of site. you know, the funding that we're looking for really is the bridge to allow people to do both and to allow for hybrid programming across the board. so that's what i'd like to say from the long term care council in support of the from the dignity fund coalition and support of the long-term care council and hope that you'll consider both in your budget considerations. any questions? >> just so i understand, you gave us a $3.5 million ask. were you hoping that money would come from the dignity fund? >> so the dignity fund did have $3 million every year to be allocated for new needs and issues. unfortunately, because of policies around the cost of doing business, they're significantly less each year to do that, but the committee has made the recommendations and with what's left, they are recommending $350,000 for the one piece of the services and then another $75,000 for hybrid services. you know, it's not final yet just like all the other budget things are final, but it is recommended at that level. >> supervisor safai: so that's in the mayor's budget? >> it is in the department's recommendations. >> supervisor safai: right. exactly. so $350,000 plus another $75,000. and the $350,000 is for? >> it's sort of a range. there have been a number of proposals that have been submitted to them. how it breaks down. >> supervisor safai: so $350 plus another $75, and how does that blend with the request, this additional request? >> i'm sorry, you mean the rest of that large ask? >> supervisor safai: no. the one from the previous presentation. it was $350,000 -- $250,000 for a three-year pilot support increase teleconnectivity and sniffs. it sounds like there's some overlap. >> i think so. here's the thing, you're kind of reaching the budget mash-up point where you're looking at all the areas. pilots is one of the things that's on the dignity fund coalition ask, for example. pilots. various kinds -- so this could be one of those. we have a number that are under way in adult health centers and other community centers. you know, we're all in this together. we're trying to serve the same people on a continuum. and we hope you considering how many of you are in the city and all getting older and developing disabilities and many of us are really isolated that you kind of be bold. >> supervisor safai: i understand, and that's why i just wanted to clarify. as i said, we've received this. some of this is in the departmental budget. there's some additional line items here. i know this conflict with cost of doing business. we will work with the chair to put this in the larger queue budget ofs and. mayor's budget office is here. i think they can confirm just through the chair. can you talk and just confirm what was said on the record in terms of the amount of money that was allocated for would be in this budget. >> yes, supervisor safai. this is the deputy budget director. so the dignity fund grows by about $3 million every year and that's a general fund transfer and i believe what she was referencing was that that additional $3,000,000 can be allocateed as determined by the dignity fund, by community groups and others. so she's suggesting within that additional allocation, this could be one of the uses. however, the dignity fund in the past has often used their growth to match the cost of doing business provided to general fund nonprofits to dignity fund providers. so if they use a certain amount of that $3 million towards b, she's saying that will leave less funding for additional new programming. >> right. >> supervisor safai: so after you factor in all the costs of doing business, there's about $425,000 left over? >> no. i don't have that number in front of me. >> supervisor safai: well you said $350,000 plus $75,000. >> that's the amount being recommended here. the way we look at it as the cost of doing business comes off the top for the dignity fund and over time has decreased in the amounts available. so in a couple of years. >> supervisor safai: i get it. i understand the concept. just if i can have a clear answer. >> if i may, we're happy to work with the department and determine how much it would cost. >> supervisor safai: is anyone here? susie, is there your -- >> yeah. so i know that we have $350,000 for tech projects in the d.a.s. budget, this is obviously a much larger ask. >> supervisor safai: i understand. i'm just trying to get an idea. >> yep. so we have $350,000 in the d.a.s. for technology work. that will be our fee. and then, the long-term care coordinating council, that recommendation was specific to the sniffs because there's obviously needs within the community and there's needs within sniffs and dignity fund supports community needs primarily. >> supervisor ronen: is there a list of what the dignity fund set aside is funding? >> absolutely. so we just recently now i'm wearing the d.a.s.h.s.a. hat, we just had our needs assessment and allocation plan submitted for the next rounds of dignity funding. so we can share that with you. >> supervisor safai: we will follow up, my office will follow up on this and we'll provide more clarity. i understand that there's a push and pull between the dignity fund allocation that's a budget set aside going up and then there's the funds request for there to be an adjustment for costs doing business, but then there's also this additional need there's always this constant pool and all of the enrichment related supplemental supports. that's why we're putting a very significant rail guards around. you can't use it for that and it vane yeah. one of the biggest issues i had is the fact that the mayor did not include a cost of living increase in this budget and that to me was the most glaring, you know, thing that was left out of her budget. >> yeah. speaking from a community perspective. what we get is that the cost of doing business has already been decided to come out of the dignity allocation this year. that didn't happen before we had the dignity fund. so, now, the amount of money that's now going for not just dignity fund but services in the department, that could more than fund what they're asking for here plus many other requests that would serve seniors and people with disabilities. >> supervisor safai: so when h.s.a. comes, we'll have that conversation in advance. it's coming next week. i think we're going to have to have an honest conversation about a certain amount of money that comes out of their budget for cost of doing business and addressing some of these additional needs. >> and just to clarify, the dignity fund is set aside. for next fiscal year, we have the d.a.s. gets $3 million in new dignity fund allocation and $1.7 of that is for cost of doing business increased. it's a separate set aside that was approved by the voters that a certain amount we get next year is $3 million. >> supervisor safai: that $1.3. >> $1.7 is for cost of doing business. >> supervisor safai: so the balance is left. >> anything else. there's a certain amount we automatically set aside. >> supervisor safai: so this year it sounds like there's only $425,000 that's left. >> well, that's just for technology. we're talking about technology. that was the allocation. >> supervisor safai: so there is more things that came out of the -- that are not related. how much of the cost -- how much of the dignity fund growth is set aside for cost of doing business? >> i don't have the percentage. maybe you do there, but -- >> supervisor safai: does the mayor's deputy director have that? >> less than half of the fund is available for allocation this year beyond the cost of doing business and at the current rate, it will be maybe two or three years before the total ability to do any kind of allocation new will disappear. >> supervisor safai: she just clearly said. i just want to reiterate what i just heard. sounds like there's far more than $300,000 that are out of the fund not related for cost of doing business. i understand in future years you're concerned. but this year sounds like there's a little bit less than half of that that's related -- that's not related for cost of doing business. how that gets spread out is related to technology so we will follow up that makes me feel better. that's just quite a bit more. >> i just want to be sure that those funds have also been recommended for case management and a number of other services. you know, i think we can provide you what the dignity fund has done overtime including the recommendations for this year so that you just know. >> supervisor safai: that's fine. thank you. >> and the dignity fund has a comprehensive needs assessment. to just get a broad understanding. >> supervisor safai: got it. okay. i want to ask laura and susie a question. just to come back to the long-term coordinating council's undergoing some restructuring. can you discuss how members of the community can be involved going forward. >> as our current co-chair, our meetings are open to the public. they're posted on our website which i will share for the record and can be distributed to anyone who's interested. san francisco long-term care coordinating council is the group that individuals can participate in work groups as members of the public. they can also attend and make public comment during our open meetings. >> supervisor safai: right. any other questions? >> supervisor safai: no. that was the main thing. i don't know if susie wanted to add to that. >> we welcome expertise and participation as laura said and all of the work of the council and the public, we want people to be engaged. this behavioral health work group was a good example. we sort of form work groups to address specific problems and we bring in the right expertise and those are open to the public. i think the restructuring focuses on long term care and making sure we have actionable recommendations like we have today. >> supervisor safai: great. unless there's any other questions from colleagues? oh, you do. supervisor mar. >> supervisor safai: public comment after you're done. >> supervisor mar: i know we're going to get into the d.a.s. budget in this up coming hearing. i did have a question since we already started questioning around the dignity fund allocation of those. i guess my question is whether the dignity fund or any other part of the d.a.s. budget or city budget is investing in creating new preserving and expanding the care beds that we need, you know, whether that's affordable assisted living, affordable r.c.f.e., you know the chinese hospital is moving ahead with trying to create skilled nursing, but i believe they're going to need some subsidy for that. i was wondering just in the dignity fund budget, is there any investments in sort of preserving or expanding. >> my understanding i don't believe the dignity fund can go to any specific housing. i don't believe they're allowed to use any of the funding for they can provide the patch funding and most people and this again is in that assisted living facility report which we'll share. housing construction. >> it prohibits housing prevents housing construction costs. >> supervisor mar: but it can provide subsidies like affordable assisted living? >> yeah. >> supervisor mar: got it. >> one of the recommendations of the assisted living work group was to leverage some state dollars through the assisted living waiver. the reality is that's an under utilized waiver in san francisco. so the same rate that applies to san bernardino applies to san francisco. it's difficult to leverage those when the facilities see they're doing the cost of business is much higher than san bernardino. i think the specific d.a.s. budget and dignity fund is also something we can follow up on with the dignity fund, it provides a small amount. it's not the systems level. it's not getting at the systems level that you're talking about, supervisor mar. and we appreciate that you have brought that issue in the housing report to look comprehensively at what our city needs to do to age in place and stay in the city. >> supervisor mar: yeah. thank you. i just wanted to note for my colleagues there was a proposal that was submitted from the community for an affordable pilot project residential care facility for the elderly. it's like affordable board and care home project and it included $1.7 million for an acquisition and then, yeah, it looks like $450,000 for an operating subsidy for the first two years, so one project could consume a huge portion of the budget. >> i just wanted to add, we need to be able to provide clearly what the dignity fund can and can't do and in looking back what that really has meant is not a lot of money and it's not just the responsibility of the department of disability and aging to serve older adults and people with disabilities you know, how did that all come together. thank you, chair ronen. >> chairman: thank you so much. >> supervisor safai: i think we should go to public comment. >> clerk: members of the public who wish to speak on this item and joining us in person should line up now to speak. for those listening remotely call (415) 655-0001. the meeting id 24815424313. press pound and pound again. you will need to press star three to enter the speaker line. and please wait until the system indicates you have been unmuted. that will begin your cue to begin your comments. mr. atkins, can you kindly unmute our first caller. >> caller: supervisors, my name is francisco de costa and i've been involved with long-term care more for the seniors for over 40 years. i do not think the way this presentation is done begging for taxpayers' money. it smacks our behalf. and you supervisors are [ indiscernible ] a segment of the population. by thousands of people of color who cannot come to city hall and give you the true circumstantial facts. if you go to chinatown and see the number of seniors in a small cubicles dying of covid while the children and the others are there because they cannot yesterday i asked the board of supervisors. you supervisors have to represent the entire community -- >> clerk: speaker's time has elapsed. apologies for cutting anybody off. we are timing each speaker at two minutes today. mr. atkins, next speaker, please. >> caller: hello, supervisors. this is jessica layman, executive director of senior disability action. i also have served on the long-term care coordinating council and advisory committee. thank you so much for holding this hearing today on all the many issues addressing isolation among seniors and people with disabilities and we want to urge you to follow the recommendations that have come before you regarding behavioral health as well as the connected programs and i will add that unfortunately there is very little money there to put to keep us connected and i also want to urge you to think of isolation among our communities broadly. it also means funding all the kinds of housing subsidies to people can stay in their homes and communities they know. it's also thinking about remote participation for continuing this for people like myself who are high risk and can't come to city hall and still participate in life and making that easy and continuing to have meetings where people can participate remotely. we have the answers, we have a lot of good ideas in front of us as far as how to address isolation and we hope you'll take action. thank you. >> clerk: thank you, jessica layman for your comments. mr. atkins, next speaker, please. >> caller: good afternoon. member of the dignity coalition. so wearing a lot of hats today. i want to say that on the long-term care i would like to keep us connected and specifically highlight the importance of training for the staff because as we know, as we get devices for seniors, very intensive training sometimes to be able to access their device independently. so when we're being called in staffing in addition to staffing we know the demands in our isn't going to be cheap. so i do want to stress the importance of the staffing and costs that are associated with it. out of the cost of doing business, i do want to stress that the dignity fund coalition and really all of our coalitions support the cost of doing business but as was stated by the dignity coalition coach, wanted to come as the costs of increased [ indiscernible ] community as that really was the promise of the fund itself. >> clerk: speaker's time has elapsed. i apologize for cutting you off. good to hear from you and thank you for your comments. mr. atkins, next speaker, please. >> caller: hi, can you hear me? >> clerk: yes, we can. >> caller: yeah. my name is dr. teresa palmer and i'm a geritrician and i have a problem with the whole idea of digital access in long-term care and residential care and nursing homes, the big problem now is families are still being locked out due to covid and there are no therapyists available and if you're in a nursing home for a good reason, you may have cognitive visual and hearing problems as so this whole mental health is kind of like putting lipstick on a pig. there may be an to give medications overused in the absence of person contact. i have grave concerns about this. thank you. >> clerk: thank you dr. teresa palmer for your comments. mr. atkins, do we have anymore speakers in the queue? >> chairman: public comment is now closed. supervisor safai, thank you so much for calling this hearing. it was really important and really informative and instructive. and i just want to send a message to h.s.a. that during the department's budget presentation, we do want a whole section and deep dive on d.a.s.'s budget as well so that we can understand, you thank you so much for fighting for our seniors and the elder community. it's very much noted and appreciated. supervisor safai. >> supervisor safai: thank you. i'm happy that this hearing happened today. i really appreciated working with all of you collectively and respectively. we will continue the conversation. i think that as i've said in my opening statements having i think one of the premier senior living facilities in our district gives us a lot to learn from. a group to work with and a model for the rest of the city as evidenced by some of the problems going on in our public facility, we can all work together to ensure that we have a strong and robust senior plan for those living in supportive and skilling nursing facilities. so, we will follow up. we'll work with you all respectively. thank you to the community living campaign and those that have been involved in creating the dignity fund. because it just goes to show how much foresight you all had in working on this and ensuring that we had this and who could have ever imagined that we would be where we are. we want to ensure we're using the best practices from this study to support our seniors and ensure that they can live out their years with dignity and respect. so we will look at it as chair ronen said, we will work with your office department. please work with my office as we approach the budget hearings this week and glad we got a better understanding about the split, about the cost of living versus how much is there to provide service about $1.3 million. so we will continue to work on this and i really appreciate all the heart felt testimony today, the research, and how it will contribute to our ability to have better care in the city. thank you everyone. thank you, madam chair. >> chairman: thank you so much. mr. clerk, do we have any other items on the agenda today? oh, do you want to file this hearing. >> supervisor safai: yes. make a motion to file this hearing please. >> chairman: roll call vote. >> clerk: on that motion that this hearing be heard and filed. [roll call] we have three ayes. >> chairman: the motion passes unanimously. now, mr. clerk, do we have any other items on the agenda today. >> clerk: that concludes our business, madam chair. >> chairman: okay. this meeting is adjourned. >> the renovation of balboa park, the oldest in the city of san francisco, and now it is the newest part in the city of san francisco. through our partnership, and because of public investment from the two thousand eight fund, we are celebrating a renewal and an awakening of this park. we have it safer, happier, more joyous. >> 3, 2, 1, [laughter] =--[applause] >> it is a great resource for families, to have fun in the city, recreation. >> this is an amazing park. we have not revitalized it without public and private investment. the critical piece of the process of this renovation was that it was all about the community. we reached out to everyone in this community. we love this park dearly and they all had thoughts and ideas and they wanted to bring their own creativity and their personality to bear on the design. what you see is what the community wanted. these ideas all came from the residents of this community. as a result, there is a sense of ownership, pride and responsibility that goes along with what is going to be an exciting park. >> welcome to the chase center arena. you guys feel that? [cheers and applause] >> that's that winning energy. okay. [applause] >> let's give a round of applause for the gold letter warriors for last night's performance. that was amazing! [cheers and applause] >> still confetti on the floor over here. well, welcome to the opportunities for all summer kickoff. we're so happy you're here. i'm your mc, niko romand and i'm a program manager, a partner of opportunities for all.
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