Transcripts For SFGTV Our 20240705

Awesome. With that, well move into fiscal 2223ocoh Fund Annual Report and i believe ill turn it over to ivy. Ivy, if you would. We dont need to do roll call . Okay. Let me actuallyokay. So, good afternoon committee. As you know, we publish our fiscal year 2223 annual report yesterday, so im going to talk about how to navigate the site and some of the key take aways from the report we did. So, just to start, the Controllers Office is responsible for the administration of the our city our home oversight fund, and so as part of that responsibility we report on a few things, specifically the [indiscernible] and impact of the fund. Okay. So used to watching people up here. Okay. So, yeah, as i said, the Controllers Office is responsible for reporting on the use of the impact of the fund and so thats what is laid out here in the fiscal year 2223 annual report. Some of the key take aways are how the city budgeted and expanded the funds over a three year period, and we go into depth on expenditure s for fiscal year 2223, of course, and secondly, we look at the impact of the uses of the fund, and we do that through looking at capacity and services that were added. And lastly, we take a look at how the households that were served we look at the data of the people who are experiencing homelessness or at risk of experiencing homelessness, so that is usually the number of people account or the demographics of that population. So, first off, im going go into the fund. Over the 2223 fiscal year 295. 7 million were spent for the fund. These expenditures have been continuing to increase year by year since beginning of the fund, which is promising and that is definitely related to these programs transitioning from planning phases into implementation phases. Secondly, i also want to point out, there is a continued revenue shortfall that the Controllers Office identified and we will have the Budget Administration division speak a little bit more on that after this presentation. But, if you would like to read more about it, this is like the entry page. This is the executive summary and as you can see, the stuff i just talked about is recapped here, and you can also navigate to each Respective Services area to see specifically about expenditures, populations served, outcomes, all that data, and so as an example, im going to show you the permanent housing page. So, up at the top on each of these pages you can navigate back to the table of contents or to a different page. That covers a service area, but as you see on the right hand side, we have a list of different areas you can navigate to, including the spending on programs, implementation, and more information on the households served. Going back to the report, the executive summary, for implementation and services, the fund was used to support over 27 thousand households, and there were over 1,000 units of capacity added over the last year. Our report also goes into specifically howlets seeit also breaks down not just capacity added, but it also discuss capacity preexisted and sustained over the fiscal year. 1,000 units of capacity were added last year, over 4,000 units of capacity were sustained during fiscal year 2223. For permanent housing specifically, lets take a look at what that looks like for capacity added. Permanent housing unique in that it does have a breakdown for each of the types of households served. We break it down by all households, adults, families and youth, but there is also a breakdown comparing fiscal year 2122 data with the more recent 2223 data, and you can see we cover capacity added each year as well as the total capacity that was sustained. Going back to the executive summary, goinghouseholds served is another good indicator of implementation and uses of the fund. The fund was used to support over 27,000 households, and Homelessness Prevention actually served the most households with over 13,000 households being served. Secondly was Mental Health. Their programs served over 8,000 individuals and Mental Health unique in that clients served is the measure we use as opposed to the households like the other Service Areas. For permanent housing, there were just over 2,000 households served and most of those were accounted for in Scattered Sites programs and then lastly, for shelter and hygiene, over 2700 households served and most of those households were served through programs under temporary shelter programs. And as mention ed before, you can go to each of these individual pages and see those breakdowns. So, going into the demographics, this is a key feature we wanted to focus on in the report. We know the community has a strong interest in Racial Equity so we included a breakdown of the ethnic and racial identities of households served. As you can see, we have a dashboard you can look at that breaks it down, both by program i believe, yeah, the individuals break it down by program, but this is the general analysis of all Service Areas combined. So, the take away here is that, we know from the pit data that African Americans specifically are overrepresented in the Homeless Population, and what our data is showing us, at least this early evidence we are getting so far from the data, is showing that these programs are serving that same ratio of population, which is a good thing. We want that. With these populations, if you go down you can see permanent housing served 48 percent of their households served identified as black, African American or african, which is significant amount. Same with shelter and hygiene, 32 percent identitying as black, African American or african. At the top we break down latina households and each service area the percentage served. Mental healthwe are seeing gaps in the data there. Only 14 percent of households identified as latina served in Mental Health programs ocoh funded. This is compared to the data that shows about 30 percent of people experiencing homelessness identify as latina, so there is gap in the data there, but i know that their department is working on kind of looking at the variability of tracking this each Different Program can track racial and ethnic identity in different ways. They have different categorizations, so i know they are working on getting more consistent with that and exploring why there are gaps in data for these programs. Lets seeso, going down, we also have our outcome section and so, outcomes and households served, we did track positive outcomes and each Respective Service area has their own unique definition area for what a positive outcome, but across the board, they were pretty positive. We are seeing some generally positive outcomes which is promising. Permanent housing had 97 percent of their households served reporting positive outcome. For permanent housing, what we would define as positive out come is whether they were still in the program at the close of fiscal year, or if they exited the program to their own permanent housing. Secondly, we also have the Homelessness Prevention percent. That rate was good as well, 76 percent reporting positive outcome. How we defined positive outcome for Prevention Services waslets seeyeah, retaining housing, so they were able to keep their housing or they found a safe indoor solution to their housing crisis at the time they entered the program. Shelter and hygiene has a pretty significantly low rate of positive outcome at 16 percent. Hsh is exploring this. I know there are some large gaps in the data regarding just tracking where clients go when they exit these preventionshelter hygiene programs. The shelter hygiene programs are low barrier so there is effort Going Forward to figuring how we can track better track the destinations of these people once they are leaving these low barrier programs that they are entering. And then, lastly we have Mental Health where we note it is unavailable. You can read more about Mental Health client outcomes. They actually have their own collection of dashboards they published this year and they also have dashboards that break down like sort and skirt. Those programs, their positive outcome rate was, as well as more details on those clients that were served. But i know that they are also looking into a way to track positive outcomes that can be shared back in our report that we are sharing out. So, that was a little fast, but everything you need to explore and hopefully get your questions answered you can find here on the page. We have our annual report ready to go. It is there first option when you do land on the ocoh page, so yeah, i believe well take questions afterwards. But we can also do it right now if we need. What is your preference . Yes, we can take questions now. Okay. I have a few questions as well. Could we look at the housing outcomes . Can we put it on the screen . Households served, could weis thereis the outcomes you said . Households served in ocoh programs i guess. And is it broken downis there a wie it go into the permanent housing and list what is talked about there . In the permanent housing specifically, yeah. Up at the top is where we have the links to navigate there, but i do have permanent housing already open on this tab. Did you want to look at the households served for permanent housing . Yeah. Justso you said there is over 4,000 that would be served, so that 2272 the capacity. The total capacity that was sustained. I believe that was across all programs. Not just [indiscernible] this 2200 number is the number of people served in the year in this fiscal year, correct. In this fiscal year . Yeah. Some of the data we got before there were misses so the housing out of mohcd was not counted in the Quarterly Report and acquisitions were not included so i wanted to make sure it was comprehensive and included the housing that is outside of dhsh . This data is for last fiscal year, so any housing ocoh funded operating last year should have information about the households served in the housing and the count of the capacity in our data set. Some of the housing may have been purchased last year but didnt open to operation until the next or wouldnt have included some things towards the end of the year, but to the extent a program was operating and serving clients last fiscal year, we incorporated that data. The mohcd Program Within housing is called, family subsidy. Family rental subsidy. There is also a Family Rental subsidies in hsh. Those are both represented [multiple speakers] okay. And then, so in this report does it also have the projected number of units coming online in 2324 . No. In order to get there we have to look at the budget passed with the details there . The february budget versus actuals shows how much money is spnt this year, so we have a plan for february as we do every year, so february we do the 6 month report. Well provide budget versus actual and departments provide information at the february meeting so they are able to provide information of the progress that occurred since july. Okay. Thank you. Go ahead. Okay. Being new to the committee, is this format can you speak into the mic . Sorry. Is this format parallel to previous reports . Yeah. Great. Just looking for ease of comparison. Thank you. Lets seewhat i wanted to talk about is more around how we are disseminating the information and making sure the community is aware of the report. I know people can watch this meeting and get it that way, but we got a lot of calls in the past from Community Members who wanted it to be disseminateed like in other ways. I dont know if that is something as a committee we should be talking about, because yeahit seems like a conversation like communication. We had ideas in the past when people were trying to take prop c funds for other uses and change the legislation and so i think i want to get ahead of that now that we have this report and just put it on our radar. We dont necessarily have to talk about it now, but how do we disseminate reports, other then just talking about it in this meeting . Www. Sf. Gov ocoh on the home page. We keep it as up to date as we can and may be not capturing everyone, but we distribute to everybody on our distribution list that expressed interest. Good. Okay. Including members of the public. So, everybody who attended our Community Meetings if they are signed up to get notification. We do public notification. The committee is welcome to forward the announcement you should have hopefully received in your inbox about the publication because we do that wide distribution from the Controllers Office, so it isonce it is public, so definitely forward to all of your networks to distribute. I dont think that is what member dantonio has in mind. I dont think we have come up with a solution for this and so, i dont know what that looks like. Originally we wanted a website specifically outside of sfgovtv that was a prop c website but we realize we cant do that. Just something for us all to think about and for others who are listening if you call and have ideas, let us know. Thank you vice chair dantonio and i do agree and think it is part of our charge to kind of think about dissemination and we dont have a Community Impact liaiz onnow but we want to get this to everyone who participated in our listening sessions. I with believe laura we still have that list so i can support with that effort. If i get the list i can send to folks as the chair. Also, do we have the ability to make hard copies to give to Community Partners who we know are interested in the information and funded in these different categories as well as partners at dph and hsh and elsewhere . Some of the hospitals and other folks and places where wethey want this information, so just thinking through that. Im happy to work on that, but dont know if we have hard copies, but happy to send an email to the list. This report was created as a series of [indiscernible] for accessibility of the dashboards and the data, so it is sort ofsome of these web pages have interactive information on them, so thats getting people to the website is key. Yeah, so they are able to interact and get the information they are looking for. Theres lots of content here you could print, but it would be very long. Just like the executive summary im thinking or something more abbreviated we can get out hard copy to folks who may notmaybe Community Folks directly impacted that want to see the information. Just trying to think through it, because we dont have a Community Impact liaiz on and that falls on my office so happy to blast on the email and if there is executive summary abbreviate areed to partners not as web based happy to do that as well. We can talk about comparing what the distribution list was and making sure it goes out to the audiences you like it to go out to and then in terms ofhard copy i think is a great suggestion. Especially if it was just like the executive summary. It comes down to miking sure it is meeting accessibility standards, but that is definitely something we can look into. I think translation as well. We can talk more offline. My other question is about unduplicated counts because i imagine that folks are traveling between different systems and behavioral helt and hsh and cross over. Is there analysis around duplicated and who is going in between the different systems . Yeah, definitely. Each of these dashboardsill show you. If you are exploring on your you can see, but each dashboard if they have data notes have a data note section that breaks down, caveats of the data and what is included and isnt. Anything that may have come up, but in terms of duplicated and unduplicated for the most part we tried to get numbers unduplicated and so it was more an accurate depiction of persons served, but there are Different Programs we were limited and you have to look at each individually to see. There is no data unduplicated across Service Areas so the Service Areas could be can duplicated. Within Service Areas there is some element of unduplication coming from the departments, but not across Service Areas. I say this because i know that epic and other efforts that have been made to try see who is traveling between systems and identifying households and drilling down to see specifically the houses served by multiple systems. I believe the city was working on this several years ago to get a whole picture who is served. Sometimes folks are traveling between multiple programs, multiple Department Systems and really be able to put your arms around that household and provide additional support. Yeah. I dont know if thati know epic rolled out and that is crosstalk between Different Health systems, but dont know if there is crosstalk between hsh, Behavioral Health and other departments which i think can be helpful. That work is external to this work so the annual reporting is related to the funding to specific programs so not showing the entire system, it is showing ocoh funded programs and their utilization and capacity, so there is work happening external toamong the broader systems around how to track and manage that. We i know that isnt our work, just saying that is a data capacity we can think about once the city gets there if the city is there, i dont know, to layer on to what is funded by us. I know that isnt our purview, just saying data capacity and we dont have a data officer as well, something we need to fill. Wait, we did newly onboarded data officer, thank you. This is something we could talk about with our data officer. I think that having worked for hsh for many years i think it is ongoing issue, but i want to underscore what was said that, if wouldnt be in reports like this, because this is so focused on specific funding that it wouldnt pick up people served in one of these programs and another program funded in a different way, but there has been ongoing discussion, cant say up to date on it now with how to look at the person being served by what they are using across systems, and i think we are primarily talking about department of homelessness and Supportive Housing and department of Public Health with a few other smaller components, but i think that was partthat is part of what is being looked at with the larger Data Tracking systems, but it is question we can pose to those departments. Apologies, we have a data officer, so thank you. Could we go back to the summary page please . Thanks ivy. So, you know, one reason this is so important and really appreciate you guys work on this is that, there is just a lots of misinformation out there about homeless ness, about what the city is doing around homelessness and what the places where we are having lot of success or at risk, and our situation could get lot worse in terms of the humanitarian crisis we continue to face. I think a piece of this isthe city isnt really great about having information presented in a way that is simple for the public to understand, and often the electeds and some policy makers appointed by electeds put out a lot of misinformation for political blame gain and lot of blaming of homeless issue. It creates a lot of issues so transparency is really important and make it easier for people to understand. I wish i brought my computer because im handicapped now and cant look at this report at all, but i think one thing that i want to comment on is that, the shelter outcomes being so slow in particular i just want to point that out. Im really concerned about that, and i dont think we are doing a good job making sure people entering shelter are ending up at the end of that stay in housing, and we have an opportunity while they are in shelter, because getting housing is so complicated and bureaucracy around it and paperwork and all that stuff,ic it is really really difficult to navigate so you have this missed opportunity while people are in shelter to try to get them in housing because it isnt like a situation where they finally get all their paperWork Together and the city takes their property and lose it away and have to start from scratch and whether that stuff constantly happening from folks. I just want to put that out. Im also a little bit concerned about the low prevention numbers on African American community that were listed there. We know that from the Homeless Oversight Commission and from work that we have been doing with the housing rights committee, there are huge disparities and eviction already among African Americans coming out of Supportive Housing, and then we also know when we look at the private market there is disparities of evictions among African Americans in the private market, a lot of times because the real estate speculation targeted impover rshed community for gentrification and trying to push those out of poor neighborhoods to turn those units over and make big profits. I think that that is really concerning and i think that thats another area i love to see some focus on at some point around really trying to do more targeted prevention that is really trying to connect with the African American community and prevent displacement in that community. Any time you see the big racial disparities, obviously because of the historical context, those are big red flags, so i just wanted to make those two comments. Thank you. Any other comments . I just wouldthis was just published yesterday, so i encourage people and dont have thecant look at it detail, but encourage the committee and others to look at it to develop their questions, because i think that will help us focus on what we do speaking to jennifer, some of your amazing immediate red flags, we need to look at those and understand one, how the data was collected and two, what it says about where we might focus. I dont think well pull that off in a summary and thank you for the summary, but i think what we need to do is review this separate from necessarily in committee, but gather the questions and begin to look at the detail, because i know you mentioned that some of the shelter outcomes were in question in your oversight presentation, so we want to understand that as well because it is very low number. I would suggest that that is the approach we take, because seeing those red flags gives us a place to focus our attention. I would add that, the departments are aware too now with this data coming out and doing their work as well and so, i think it is just helpful toglad you all are interested in this and hopefully take the time to do a deeper dive because there is a lot of data and hopefully it is the visuals and stuff can make it more digestible, but i do think its a helpful place to start, at least with thiswith our retreat just pause it can kind of inform you guys Going Forward where you want to put your focus towards. I would alsoi didnt see the detail of the blast yet. If we sent out to departments i would request we request that they send it out to their lists that doesnt reach some people we want to reach that dont have ready access to computers, but would expand the dispersion of this quite a bit, and so i think we need to ask all departments that are related to this work to also spread this summary report and then they can direct questions back to the committee. Definitely. Any other questions . I think we are good. Thank you so much ivy for your work and the presentation. Now we have a update on the fiscal 23 fiscal 24 fund revenue so invite yuri hardin and carol lu to join us. Thank you. My name is yuri hardin from controller Budget Office here to give you updates on forecastim going to give updates on the forecast on homelessness gross receipt tax, which i will refer to as hgr tax. I like the start with overview. As you know, San Francisco [indiscernible] in the budgets are based on the available information at that time, so but the situation is keep changing so throughout the year we monitor closely the actual revenue receipts, tax revenue receipts and as well as all other factors that could impact the tax revenue and update the forecast periodically to help the policy makers [indiscernible] revenue source. Unfonchinately, at this time, based on what we have learned from last year specifically last year end, we had to bring down our forecast significantly from the prior assumption. The size of the reduction was from 40 million up to 55 million annually. As you know, we had been making downward adjustments in our forecast. These actions are on top of the reductions we had made in the prior years. However, it is important to note that we are in the current forecast we are not assuming any recession. These reductions are made against the prior assumptions and then not the reduction to the prior year Actual Receipts, so as you will see later in the slides that our current forecast for fiscal 24, the current year forecast current year forecast right now is actually a little higher then last years actual. Well keep monitoring the Actual Receipts and then keep updating forecast and then next spring well bring you revised forecast in time for the next two year budget. Im going to talk some of the basics of hgr tax. Taking step back, San Francisco already has general gross receipts tax that are applied to all the businesses. In november 2018, the board approved prop c, implemented the hgr tax. This tax is additional to the general gross receipts tax businesses in San Francisco already paying. While general gross receipts tax is applicable to all businesses, hgr taxes applicable to those businesses with over 50 million in gross receipts. For example, if a business makes 150 million in gross receipts one year, the first 50 million is exempt. The hgr tax will be [indiscernible] remaining hundred million. In terms of rate, just like a general gross receipts tax, hgr tax rate differ by industry as you see in the table in the slide. As to the Taxpayer Base, because of the threshold of 50 million, hgr Taxpayer Base is much smaller and then concentrated with the businesses, large businesses. As an example, in tax year 2022, while general gross receipts taxpayer was over 10 thousand businesses, hgr taxpayer was only 358 businesses, so that will show youthis will show you how small the taxpayer for the hgr tax. One of the consequences for having such a small and concentrated tax paying base is tax revenue will be very volatile and unpredictable. Some changes in the big businesses can have effect on overall tax revenue for the year. Additionally, last year we saw a high level of business tax mitigation and when there is high risk of revenue loss from the litigation, we do not recognize those revenues and in general, when a business bring up litigation, they are not appealing the current year tax, but also prior year tax revenue, so in one year for new tax litigation, it could have like multiple year effect on the one year for that year. Because of these reasons, [indiscernible] came in significantly below budget last two years. In fiscal 22, the actual tax revenue came in 57 million below budget. Fiscal 23, 65 million below budget. Here is our current assumptions comparing with the prior assumptions and the changes between them. As you can see, the changes are significant reductions, but i like to point out for fiscal 24, we are projecting that revenue will come in 255 at this time. This is higher then the prior actual 248. Some of the key assumption we made in the current projection, the first one we are projecting the slow or no Economic Growth in the tax base. In outer years, you see some growth, but those are from inflation factors. Second, we are assuming that current level will continue throughout forecast period. As you know, the higher the [indiscernible] downward effect on the tax revenue. Well keep monitoring this factor. Lastly, as i mentioned earlier, there was high level of litigation activities last year, so we lower the tax base to reflect ongoing litigation. Here the list of the upcoming reports. As we work towards next two years budget for fiscal 2526, the most relevant report for hgr tax is going to be the 5 year financial plan[indiscernible] this is going to be the base of the next two years budget. Closing, as noted in this presentation, we made significant reduction to our revenue forecast from the prior assumption, so the Department Needs to revisit the spending plan to make sure that the spending is align with our latest forecasted revenue amount for the current year and next two years for the budget. Lastly, i like to remind you that despite this significant reductions, and this is the current is the best estimate we have based on the Information Available at this time. However, it is still estimate and anything could happen any unforeseen event could happen and with or without recession our current number could go even lower, so we bear in mind that. With that, do you have any questions . Member friedenbach. Just clarification. Going back to slide 4, it looked like the actuals for 2223 was 257. 5. Sorry. This one . No, back one to slide 4. Slide 4, yeah. See on thethere is circle on the right with the red that saysthat says 278. 6, that was fiscal year 2122 and the other says 257. 5. Yes. Im assuming that is for fiscal year 2223 and on the next slide on slide 4, it has a 10 million difference. Is that a typo . Yes, typo, sorry. Its okay, justp wanted to know the right one. 247. Thank you. I have a couple questions. You said for the year 2223 there is 350 individual Like Companies that pay into the fund, right . Yes. Do we have projections around whether that will go up or down . For example, i know that visa purchased or building a building by mission rock and that probably wont be remote, so will that effect the fund . How many more payers do we envision like in 2425, 2627 . There is also like 50 million threshold. Some businesses could go below the threshold and then totally out of the base, orso, yeah, this is hard to if there is future plans for like leasing up more office space in San Francisco. Because i assume that one of your data point, right . Yes, but 50 million is like reallywill make it like a large businesses, so yes, but i dont thinknot sure carol lu, city wide revenue manager. We dontwhen we forecast we are not forecasting payer by payer, but we are forecasting overall the tax base and then growth so you can in some ways think of growth factor as encompassing whether it is businesses making more money or more payers. Either way, it is more dollar signs in the fund and so my impression and thought what was said is increase is based on inflation, not necessarily more payers pay in. Yeah, we just take the tax base, which is a dollar value and inflating by various factors that change increase or decrease, so our assumpsons are 2 percent, 1 percent, 3, 3, 3 in the forecast and those encompass lots of Different Things that could be payers coming in, it could be more economic activity, but we are not forecasting at that like line detailed level. Okay. I had a couple other questions. As far as the tax litigation, can you speak more to that . And then, how long does the litigation usually last and if they lose do we still get revenue . Yeah, so we cant speak specifically to whatbecause it is con fudential taxpayer information, the litigation but it is large amount. I believe for this fundi think it is about hundred Million Dollars right now. It might be more. In terms ofhow long do they last . It varies. It is matter by matter and what the issues are. Okay. There is no historic average . There is not. It really depends. Some are quick, some of them are years. The ones that the bigger they are, take longer. Okay. Currently those are on the litigation. Those arewe are not recognizing those revenues. It is not going to be why im wondering if in the future there is the potential to account for that revenue. It can go either way. Based on the conversation with the City Attorney and the tax collector, we are differing our best understanding of where isthe might settle and that could be the settlement could be higher or lower so not necessarily once it is settled we get a lot of money. We might have guessed right you still account for something in the budget . Yes. Okay, got it. I thought it was just zero, like not accounting for hundred million at all. We take that into the account and take it outf the base so it is ongoing. Okay, cool. Thank you. Member walton, you have anything . I want to [indiscernible] in terms of go back to slide 4 as well. Just the variations for budget to actual. Im always advocating to close the gap between budget to actual because what we are dealing with and organizations, the community is depending on this fund and making recommendations and forecasting based watt we think will come out of this and i feel like we are in a very challenging time in the city budget and so again, say this every time we have the presentation, if we can try in terms of our input in terms of forecasting if we can try to close that gap as much as possible. It makes our job a lot easier and departments easier as well and sure you hear this across the board because it is very challenging time in the city over the next couple years. I just wanted to speak on that piece and also to vice chair point about the downtown economic recovery plan. Is there any crosstalk and all about crosstalk so hear me say that as well as in terms of system, any conversation with the downtown recovery folks working on the plan, because our funding is so tied to that good work . The Department Workforce economic development, there is new leadership there. Dont know if there is conversation with the Controller Office around the work they are doing to think about what the future of downtown will look like. That really impacts us and are very worried about future revenues for our fund, so curious if there are conversations happening, if you are part of the conversations because that is our funding we are depending on. I think we totally share that concern as well and it is big question for the future of the city as well as revenues. In terms of our role in those conversations, there are representatives i believe various people in the Controllers Office and the controller themself involved in those conversations. I know there are some tax breaks that i think came out of the work with oewd and the downtown activation that policy initiatives that are assumed in the general fund but they dont impact this specifically. It is good idea. We can think about how that might relate to our forecast in our upcoming march cycle. Thank you for that, because i think what vice chair dantonio pointed out, visa, ikea [indiscernible] financial services, so very much connected if there are folks we atracking to downtown they will have workers downtown. It all connects and so would love the controllersure ben is at the table, but love to hear more from you guys on sort of how that could influence some of these projections. Thank you so much. I know this is hard work. Of course you [indiscernible] able to do the forecasting, just thinking high level about who is in our downtown space and again, it still is very much in slow recovery mode, which is really worrysome for us. Thank you for the feedback. Thank you so much. Anything else . Thank you so much. I believe well take Public Comment. Members of the public who wish to provide Public Comment in person please line up at the podium now. Each person will have two minutes to speak. There is no Public Comment in person. Those who wish to comment over the phone call 4156550001 enter access code, 266444140933 then press poun pound and pound again. If you havent done so, dial star 3 to line up to speak. A prompt indicates you raised your hand. Please wait until the system indicates you are unmuted and you may begin comments. Please note you are two minutes. Moderator, do we have over the phone Public Comments . There are no over the phone Public Comments at this time. Thank you so much ivy. Just want to let the public know, we still at this time do not have quorum. We are potentially waiting on one member to join us, so we are still not officially called to orer order and not vote at this time, so well proceed with the rest of the presentations until we get quorum for the vote we have for the tay proposed budget recommendation so ill invite Cynthia Nagendra up to join us and well go into the city wide Strategic Plan on homelessness and kick that off and hopefully we get quorum and can go back to item 3. Thank you director nagendra. Would you want to present on the tay as well . Yeah, we can present on tay first. I want to recognize we do not have quorum at this time. I apologize to the public, we have a member that is ill we are not anticipating to be out and another member who should be joining shortly. We are hoping they can get here as soon as possible so we can take this very important vote. At least we can take Public Comment on the tay item as well if folks are for time purposes. Actually, could we do that first director nagendra . Take Public Comment on the tay Program Planning at this time because i know folks have impacted schedules so take Public Comment and come back to your presentation. Welcome. If you want to line up against the side here, well take Public Comment. Thank you. Okay. Just looking at[indiscernible] hi, im marny regen, she, her pronouns with larkin street Youth Service and cochair of [indiscernible] i want to extend our gratitude to committee and hsh for gibbing the tay providers the opportunity to collectively strat jz how to program the acquisition housing fund for transitional age youth. Tay providers in partnership and young people we serve developed this proposal to provide a range of Housing Options for 158 young people fleeing domestic violence, moving on from transitional housing, or exits Supportive Housing. This means 158 young people can beam or remain housed so they can heal from trauma, continue building their lifeskill and pursue their dreams. 158 young people who grow into strong independent adults making our city a better place fwr future transitional age youth. Thank you for voting to give these 158 young people the safety stability and support they deserve. Thanks. Well take the next Public Commenter. Hi. Good afternoon. My name is [indiscernible] i work in [indiscernible] i have been involved for a very long time in this to make sure all childrens have an opportunity to have a place to live. I think itsbeing a father of two kids, teenagers, and seeing my kids have a place to live and i am formally homeless, sowhich had a opportunity to overcome. I want to see for the youth, a opportunity. We can give the opportunity because we have the funding, so we have the funding, we [indiscernible] and we know for sure these kids want to be super happy where they have a place to live. This is a opportunity these kids never become homeless again. We have money [indiscernible] what we are looking for. We have so many many children on the streets and we dont want our children outside. We want to keep inside all children. We all children to become the future of San Francisco, the leaders of San Francisco. We seeing these kids right here. [indiscernible] but we need these kids right here, so we need to give the opportunity. Thank you so much for voting and supporting all childrens and we need to do more for them. Thank you. Thank you so much. Next commenter, please. Good afternoon members of the committee. My name is adam, the senior tay navigator at sf lgbtq center here to thank and ask to continue support of traditional age youth known as tay Housing Services. Last year the 2022 homeless surveyed showed miners made 95 percent of the house breakdown of People Living without a parent or guardian. As the committee prioritize housing under served communities, lets reinforce 31 percent of 1824 year old in the groups experiencing homelessness for the first time in their lives. Many are survivors of violence kicked out fleeing homes communities or countries. Here the access to service for the tay population and we like for these services to continue. We ask the committee to protect collective investment of tay Housing Service for acquiring housing and fund Ongoing Service in new buildings. Additionally, we ask for more rapid rehousing forte impacted by violence and those leaving transitional housing. Along with more flexible subsidies forte exiting Supportive Housing. We ask and thank ocoh continued supportive youth without housing. We like to thank the committee taking the time tahear us today and your support and thank you hsh for your continued support as well. Thank you. Have a good day. Thank you very much. Next commenter. It is super important we identify and have programming and this has been a collective efforts of tay providers, young people and hsh and it is really important that this vote happen today and we are able to have a clear plan for the funding for the young people we know what happens when there isnt a clear plan. If the funding isnt programmed it gets swept and we ask have that happen for our young people for all the reasons we know, so thanks. Thank you so much. Any additional Public Comment . Okay, ivy. Members of the public who wish to provide Public Comment over the phone, please call 4156550001 enter access code 26644140933, pound and pound again. If you havent done so, please dial star 3 to line up to speak. A prompt indicate you raised your hand. Pleaseerate wait until the system ind icates you are unmuted and may begin your comments. You have two minutes. Moderator, do we have any other the phone Public Comments . We have two callers. Hello commissioners. My name is sheila, a [indiscernible] glide. Glide is a proud member of [indiscernible] we respectfully ask for yes vote towards a range of housing [indiscernible] off the streets and into housing. As someone who has experienced Youth Homelessness [indiscernible] appreciate the amount of dollars in the proezpoal invested in addressing homelessness for total of 158 youth. We want to thank City Partners at hsh being inclusive, for giving us the time and space to come up with strategies that accommodate the unhoused in the city. We thank the providers for amazing work they do each and every day making sure the youth are provided with resources that meet their needs for better quality of life. Please continue to work towards solutions [indiscernible] especially in black and brown communities. Thank you. Hi, commissioners. This is ilsa [indiscernible] sorry not there in person. I also work for larkin street. I want to join my colleagues and urge yes vote for this really thoughtful plan. I love to point out that a fully functioning Youth Homelessness response system is one where nobody stays together and we Work Together as a community of providers to propose allocation plan that creates flow through the system. It gets more people housed and also helps them move on to their next thing. [indiscernible] exit out of transitional housing and into subsidized housing and helps young people exit Supportive Housing into subsidies. It is smart and it goes a long way not just to towards preventing future chronic homelessness, but creating a highly functioning youth homenessness system as possible. Thank you and i do hope we are able to get that yes vote today. There is one caller. Not sure if that was them. Yes, can you hear me . We can hear you now. This is bonny preston, one of your Committee Members and just so sorry im not there today. The covid finally got me after three years, i guess. I have been exposed, i [indiscernible] my husband got a positive test today and im also feeling flu symptoms, so it isnt great. Just wanted to say im really sorry not to be there in person and but i been following along with the presentations and look forward to digging into these issues more with you all in the new year. So, or if we need to have another meeting before the new year. Just let me know. Thank you so much. Thank you so much. Hopefully we can get some advice from the City Attorney. I thought thatill tern it over we have advice presence at the meeting is required to be counted for quorum, so we have explicit guidelines and can forward the memo to have it in your inbox but well follow that guideline from City Attorney that tells us members have to be present in order to be counted as attending. [indiscernible] questions of other commission the differentiation is it counts towards quorum but people can participate remotely, but they dont count towards quorum. I have seen at the Police Commission and seen at sfmta and board of supervisors since this passed members participating virtually with covid. We have guidance we cant count you attending the meeting unless in person. Okay. So, that attendance is what speaks to quorum, and so taking a vote requires quorum and attendance in person at the meeting, so [indiscernible] other exceptions that on that . Apologies, we are trying to figure all our different options here, because we have a pornts vote on the agenda and today and still do not have quorum, so at this time i will invite director nagendra to come back up and to begin the tay Program Planning presentation and then move into item 4, which is city wide Strategic Plan on homelessness. Thank you. Also want to add, there is no more Public Comment over the phone. Thank you ivy. Happy friday afternoon chair williams and the rest of the committee. I am here to give adoing the Strategic Plan first i believe . Youth system planning first. I am here to give you a little of update of what we are doing at the department oflet me introduce myself. Cynthia nagendra, Deputy Director at hsh and we are implementing our 5 year Strategic Plan which started in july of this year. It was a new 5 year plan. Here to tell you about what is happening specifically around youth system planning. Some of the issues that we are trying to solve for and where we are and give you a quick overview. It is not specifically commenting on the funding proposal, but the impetus for system planning is help make sure when funding comes in we have infrastructure and transparency around it. So, thank you for having my slides. You can go to the next slide, please. Sorry, thank you. So, as i said, we have new Strategic Plan, a 5 year city wide plan called home by the bay and its driven by a number of strategies but really meant to have racial and other equities drive every action and goal in the plan. We have a number of things already underway, some of these things in the plan are things we have been doing, but we are expanding many of our inventory, strategies and really focused on system outcomes, before we were looking at population goals and things related to programmatic goals. Well look at those things but the plan is driven by advancing Racial Equity and system goals. Is our homeless response system and city across all departments and funding streams making a dent in homelessness and equitable and reverses disparities. The timeline here is we spent a lot of 2022 and 2023 in the early part of the year developing the plan. We included many many stakeholders, we talked to all most 900 people. 400 people people with expertise and experience homelessness and many providers and we came before this body many times to get input and wanted to make sure people could see them in the plans which is why it is 91 pages long. The key part drives it is there are a number of things high level and even though it is so incredibly detailed, it is still doesnt have all details around subpopulations so there is still some subpopulation planning to be done. That is driven by priorities on funding and capacity on the staffing side of the city and provider side. Just want to highlight the core values a lot of in the plan. Equity justice quality invasion, our core values underpinning whether the strategies, but we are trying really hard as a department to make sure we are holding these in our system change work and cultural change work and we have a new division i lead that is planning performance planning and strategy. We are both responsible implementing the plan and carrying and this is a system wide responsibility but making sure equity justice quality and invasion are actually living and breathing in the plan. It takes a lot of attention and a lot of intentionality around everybody in the department but also across providers people participating in the system or cant access the system. That is ongoing thing that drives the work we do. We finally staffed up in that division so there is staff. We have Strategy Planning Team that is really responsible for some of this but we want to make sure programs, staff, providers are socialized in the plan and see what their role is in advancing these goals. The 5 year goals probably quite familiar with. They are here for your reference. Decrease homelessness and that is 50 percent reduction we are shooting for 5 years. That is july 2028. June 2028. Reduce racial inequities. We focus on baseline data. We want to make sure we include impacted communities so this is our deliverable is early 2024 to have a baseline of data on all the impacted populations in each of the goals. In other words, in goal 1, if we decrease homelessness for total population unsheltered what are we trying to achieve for over represented populations like black and African American house holds and specifically lgbtq and specifically trans and [indiscernible] these are over represented in the system. The increasing number of people exiting homeless, that housing placement goal isnt just about hsh housing placement. Well include data from other as we start to build our system we look at city wide placement into housing, so including vouchers and other placements in affordable housing, but right now this year focused on [indiscernible] supporting people to succeed in housing, stay in housing, very important. Sustaining that housing and making sure we look at it different subpopulations and prevent homelessness. We like to break each down for youth in particular. It may make sense for youth to have a separate goal in each area. Specifically target for youth. Having a target does at a time limit and time line and target is essential in getting to any Real Progress and measuring the progress, otherwise you dont know if you are moving the needle at all so not sure what you are driving towards. That is why we have these Strategic Plan action areas that are supposed to make sure these are the strategies that make those goals real. The plan also comes with inventory targets. How much shelter prevention and housing do you need. I wont go into that but that is part of the planning that went into this plan so we know here is all the interventions we need and we can look at if we dont get the interventions and things in the budget, this is how homelessness will either go up, down, stay flat. We make assumptions in the modeling but we can start to tie outcomes to inventory so that is different about this plan. This is based on what we have in the system now, what we need to achieve these goals, if there are budget items we dont meet, then we have to change these goals. So, we xu we had to do more planning and that is brings to youth. More planning around youth systems and look what the systems in our system was around homelessness response and also prevention shelter housing. These are housing outcomes. I want to bring these up because we looked at the ocoh placement. As you see, i broke up between we have different definitions for youth so some are 1824. That is the federal and state definition and eligibility for many programs limited to 1824, but some programs we have eligibility up to 25 so broke out by that. 1829, 6 fine 7 youth house said ing fiscal year 2223. 229 in 1824 and 2529, 160 youth. The reason i want to break it out, we have been trying to make sure that 2529 dprup that often gets not prioritized in the youth or adult system and why we sort of the providers made this very helpful illuminated the issue wanting to make sure we reach the population and not falling between the cracks, so just wanted to point out there is a group that is housing numbers are taking up. [indiscernible] this isthese are not pretty charts. The [indiscernible] this is 202223. It can be a endicator how many are coming in the system. You see the total number of youth accessed and then 1949 and this is just year to date from the fiscal year. The demographics. It is kind of hard to see. The demographics, i want to say when we look at data transition age youth much higher rate in the tay population, so you will see a higher representation in our coordinated entry demographics. There is 45 percent of 1824 year olds are housed at the rate in our coordinated entry system and there is 34 percent of our overall population. Certainly we are equitable and trying to be more then equitable so there is different ways to break the data down, but this is a example as you can see by the different demographics that we are looking at this more regularly, have a dashboard. One thing we are doing is make sure we do this by program to see this and really trying to focus on making it public so people can look at their own data and programs and understand what they are doing. Really quickly, i dont want to take up too much time. The youth system planning i want to touch on. It all the differentStrategic Plan, youth system planning, we really started to see with we met with the providers over the last year, year and a half, particularly youth providers and people lived expertise the problem we are trying to solve. Do we need planning . Do we need another plan . We dont want to do extraneous work. There is great planning happening in 201819. The providers meet regularly. What specifically are we trying to do and are there challenges and what progress have we made . One problem that has come up in many input sessions and experience at the department that, it is important to make Decision Making policy development and allocation of resources transparent and equitable and it is not always so. Not maybe intentionally, but if you are not a provider that goes to the Community Meetings or advocacy meetings or hsh meetings you may not know how a proposal was developed or why someone was funded. We have the city if city funded process we have a equitable process or rfp, but there are things we can improve along the way and if we dont look through that lens we see places we can change things especially with smaller providers and bipoc led providers. [indiscernible] one of many the providers have coalesed around. Creating a Governance Group with shared Decision Making and represented much like coordinated entry group just created representative of the providers and people with lived experience and demographic populations underrepresented making decisions together in one placewe get input from providers, but having this group actually formalized living within our governance structure for the homeless system and everyone knows this is how the decision was made, people feel represented and can participate. Making participation accessible and making sure data is driving a lot of the decisions. It doesnt alwaysreally hard to communicate sometimes and the idea being this is owned by the community where the city is participating as well. The progress is we there is capacity issues at every level. Hired staff doing subpopulation planning. We just hired a youth manager which is exciting, havent had one a long time. Very excited about that person, they just started. Surveyed providers and met with providers about what the governance structure could look like. There are many examples from communities to do it, but providers haveinput we have got is yes we want a Governance Group and providers to cochair and representative of the system to set a goal and make sure we are new goal on Youth Homelessness and figure how to allocate resources or inform resource allocation through that group. I just wanted to mention also that coordinated entry implementation exity will have Youth Experience and providers provider. This is the group formalized rchlt the coc board, [indiscernible] the Decision Making group for policy for coordinated entry. Long process but more representative of the community and city and community and providers are sitting on it and you see the break down of people on it. It is largely communities. The different departments that par ticipate are on it. Over 69 percent have lived experienced. You can learn more about the implementation on the website but i wanted to mention that because it really effects youth and there is deeper system planning with coordinated entry for youth on that group by the folks that are members of that group. I will stop there because i feel there is a lot on the agenda and you may haveif you have questions, happy to answer them. Ill put myself on if no other members. I dont have a question, i just more a comment. I really like the presentation, thank you. Something i noticed i know we have been talking about is separating native american versus Pacific Islander which you did and that is something i want to see in the prop c data so want to commend you on it. I was going to bring it up, i feel i said it so many times im over being the debbie downer. The same people making the data, so should say the hud data standards, they are new standards that came out a couple months ago and slowly transitioning the data to matchi thipg this is one of the changes, to match that change. One change was separating this out. For our community it is super important. I think all the data should look more consistent, but i appreciate illuminating that and will bring it back to the team. Thank you. Thank you so much. Did you have Something Else . Thanks for all your work on this. I think couple comments. We love to have or i love to see a Strategic Plan on families that is separate plan and yesterday we at the coalition on homelessness along family hespa released a report and that was a recommendation there. There is just huge differences in numbers between what the points in time count is and which shows a few hundred families in San Francisco unified with thousands of kids in coordinated entry system which shows thousands and one agency alone service 7 thousand family members last year and increase in coordinated entry like looking increase in family homelessness by 36 percent, so pretty dramatic numbers that are popping up and i think a big part of our work here is to have that focus to go upstream and work on youth and families as well, so we love to see that happen and i think or i love to see that happen. I think the thing i was going to comment on is that, just on the overall system modeling kind of going back to the earlier slide on thewhich prop c funded the majority of the shelter expansion so pretty significant that we are not having a lot of success in those new shelters and moving people into housing so i feel from a system flow perspective that kind ofthat is going to mess stuff up in terms of what i think your vision is, which is have people have the short stays in shelter and get quickly into housing so i wanted to pinpoint that as well. Yeah. Not quite a question, so ill say that this question and we have been try ing to look at this in a way that tells us essentially what ishow people are flowing through and the demographics and partially why we wanted a Governance Group come together. Sometimes it is not clear what really is happening. We can look at things by programs but iti will say with shelter data in particular and im not saying this couldnt improve, but exit data can be inconsistent because people are not necessarily catching where they are going. If people are housed in the system that is usually captured, but we probably have workcapacity building with our folks doing this work especially the newer programs helping them us all look at things through system flow instead of my Program Outcomes is something we like to have that youth group look at things like, what is the flow through the system . Where are we getting stuffs and where are things not equitable and where do we need more funding . It isnt easy but the direction we want to go. To your point, we want to see how people are flowing through the system. Can you capture that in coordinating entry . The shelter are not reporting and dont know where but presumably the person would show up in coordinated entry somewhere else, so is there a way to tag people through . It is noti think we can see people coordinated entry if they are enrolled and enrolled in shelter. Not all the data is linked, but if they have a certainone person who is going through the system in different ways we can see how many programs they are in. I should not say what imdont have all details around this and how we link data so should come back with answers around that, but i think we have work to do. Whether or data systems are able to do that, but some we can look and make sure assumptions. Yeah, because i think that was what everyone was sold on on the coordinated entry was the promise we are able to dothere was a lot of promises made about coordinated entry, the system didnt look anything like what was promised to the community. It was a different system and i know you are working on trying to actually reform the system and correct all those mistakes made in the creation and that is awesome because it needs to be done. It is justyeah. So, as that is happening i guess that could be one thing looked at as well, because i do thinkin the end we just need a name approach. We need to make sure people are getting the help they need like each individual facing this crisis. Right now they are gettinga lot are getting kicked out of shelter or back to the streets. A lot of people are kicked out of Supportive Housing and back to the streets et cetera. Not necessarily showing up on eviction data, but it shows up in other ways that we are looking at shortterm subsidies back to the streets. This revolving door so feel that is a big part of what has to happen and know that is something you are committed to. Yeah. Our Strategic Plan it will be able to tell more who is comeic in and exiting and are they sustaining housing because that is how the goal is articulate, but we have work to do building out systems that can link data this way. Thank you. That feeds into what i was going to ask how we flag not only youth and everyone in terms of the feedback when someone exits a system how we track and provide intervention when they enter again and that can look a lot of different ways on prevention side and shelter. It sounds we are building out with crosstalk between different systems able to have refinement and data to know who is coming in and out so we are targeting people. That is a good question. As a person exits a program and enters another program in the system and does a Program Enrollment we can track that. It depends onit would be a program that is in our one system, so if someone is coming through Outreach Team that isnt thin one system and has a different system it is difficult to link the data. The way this is issue in homeless system in any community you only know if someone is returning to your system to homelessness if they come back. You touched on outreach or shelter. Come back and see they returned our systems are not link s so that could be something that would be good to know. Did the person go elsewhere or just not come back to the system, we dont have the ability to look at that now. We looked at homeless veteran data to see if there are trends we can learn from, but in terms of our own return to homelessness, it really only if we see someone coming back, maybe there is world linking data systems across the city and they show up in another system. We have a flag for someone who comes into the emergency room. Now we are notthere is [indiscernible] not look ing and seeing if that person is coming from another system. It is challenging to link data systems but going into our programs we have that [indiscernible] im not a huge proponent of big brother, but i think that just in terms of like that goal of 85 percent is pretty high if we try to reduce like folks going deeper into the system after having the one stay in the system providing the other part is providing that extra layer of intervention and dont know what that could look like, but thinking ahead. What is some type of program forlike recidivism and folks in reentry. Is there additional supports we can offer if we know someone is entering the system again and in and out . Just thinking in terms of not just on the data side but the program side if there is extra support we can provide. We are doing work with the criminal Justice System funded by the mc arthur system it looks who is revolving through the jail is and homeless system and try to reduce that revolving door and look at disparities. They are not fullythe systems are not fully linked but starting to look at data that way and create access point at pretrial diversion now where people do in reach assessment on coordinated entry so people dont have to exit before they are assessed so ways [indiscernible] capture them before they become homeless and go on a path to housing instead of going back to the street. I think that is the Hospital System and the jails but what about everyone else not touching the system . That is where the other data piece comes in, but not just speaking to the folks touching jail or Health System, but outside that as well, so that is more i think on that. I dont have anything else. I was going to add i think looking at success based who stays in programs is great. This may speak to some that was brought up, we need to look at who leaves and whether we know where they go solely based on what they tell us or whether they leave without saying anything and if we at least start with those kinds of breakdowns we can see what we know and dont know. People are happy sometimes to leave for other placements that arent in our system, and may not speak that to us because they are happy to leave, but i also think that it is important to track how many people leave programs that we dont know where they ended up, and that would be First Step Towards this, because there are so many systems that right now are not link ed and the one system as it works or improves isnt still going to cover programs that are not in the one system which might be Behavioral Health placement and so forth. I would encourage that to be part of it as well and yet celebrate the success of the people who are in the especially the permanent placements who have success and stay. Then, that also may mean we separate out who is evicted versus who leaves without us knowing and that is also another helpful way to adjust things because evictions hopefully we exhausted intervention at that point. When somebody leaves without saying something, we may only know what efforts were made prior to their disappearance from that program. Just saying, i think that is the breakdown of even in the what we dont know, we could break some things down and may help us understand better. I have a last thought too. Or just piggy backing off what mr. Friedenbach about the Strategic Plan for families because there is a lot of conversations about parenting tay so we miss youth at the access point where they cant do assessment for youth and are sent to the family system so think that will be more revealing for the data. Yes, that is definitely reflective of a lot of input we have gotten and you have gotten to in listening sessions, and one thing that in our redesign and now the [indiscernible] will make these decisions is how towill we change the Access Points who they serve, will they serve more people or multiple populations and there is people who are representing actual Access Points on the group that one of the recommendations about being more accessible to more people and more at the time might look like your family and parenting tay, and tay are all at the same access point and might mean that might be one way that it becomes more accessible. But right now that isnt how it works and breaking things down and looking at that as two different populations we could dig if to the data more, but know that is a issue that has come up and we have seen. Yeah, exactly. I think it helps with the data, because those should be numbers should be counted and the youth data as well as family data. The family system planning i want to say, at some point maybe we can have input from this body about the idea of having Governance Groups, shared groups that help really oversee a particular subpopulation and how thatthe pros and cons of that and is that what wedo we want a Similar Group that does family oversees family system in particular that feeds up to the bigger Homeless Commission and ocoh and other committees or is there ad hoc planning process we get to a plan and oversee it that way. Thank you. Thank you director nagendra. Ill put in a plug for pregnant people. Experiencing houselessness, want to continue moving the needle of that subpopulation within families. Director nagendra did you have a additional presentation . You good . Awesome. Thank you for all your hard work. I think we are going toi want to thank you. I didnt know if there is more on the Strategic Planning. I talked a lot and dont have to say more. That was specific to youth about the Strategic Plan implementation update isnt much more content. I feel we covered a lot and running behind a bit. Okay. Well go to Public Comment. We already did Public Comment for item 3. It sound like you heard some components of item 4. Public comment for item 4. Just to be clear for the record we were hearing item 4 and moving to Public Comment for that item. Thank you. Members of the public who wish to provide Public Comment in person please line up at the podium now. Each person has two minutes to speak. Just to reiterate that is only on the city wide Strategic Plan because we already took Public Comment forte housing. We took it in totality. Yes, we can because it is separate item. We can specific to Program Planning. They were speaking just to the budget on unallocated program funds. So item 3 Public Comment would have referred to the discussion and possible motion tay housing Fund Allocation proposal. The presentation on tay Program Planning was a component of item 3. If youso you did take Public Comment on item 3, which included the tay Program Planning. However, it component of the Strategic Planning so item 4 this is part of the Strategic Plan, which isi will take Public Comment. Thank you. Hi. [indiscernible] larkin street. I just want to thank h is rks h and all the work cynthia is doing to have a plan for youth and system planning as part of the Strategic Plan. Thank you listening to tay providers because home by the bay doesnt have tay or family specific planning, so we know that is desperately needed. I want to also caution against having the definition of tay now be extended from 1829. We see that now in some of the new Supportive Housing projects coming online and we have majortay providers have Major Concerns with literally having 18 year olds and 29 year olds living in the same building. 1824 year olds told us for years that they dont want to live with older adults and people who are older then 24. Different brain development, different stages of development, and on the other side of that, older youth people 2529 get prioritized over younger youth and essentially these Supportive Housing sites will no longer be tay housing, because if you are assessed and get into Supportive Housing at 2829 years old they will be in their 30s and there will be less available units for people 1824 who are already under prioritized by the system, so i want to put it out there that, pleasei still dont fully understand why ocoh sees tay as up to 29 and home key sees it up to 25 and the city is 1824 and it is very a lot for the tay providers to try to get their arms around. My point is that, in Supportive Housing people stay. We ran the first Supportive Housing site in San Francisco in the nation actually, ellis Street Apartments and the people who moved in there never moved out and so we gave the contract back to tndc because they are adulted. We have a concern about 1824 year olds not prioritized and get units in these Supportive Housing sites because older people in their closer to 30 will be there. Thank you so much. This is the city wide Strategic Plan on homelessness which includes all populations served, so thank you. My name is miguel again. So, i want to make two comments and one is that [indiscernible] for the families, so for families homelessness, which suffer trauma and other issues being homeless and in the streets, and also right now so for a family with children they qualifying with [indiscernible] when they go to 18 years old. The kids still staying with parents and dont qualify for moving to housing, right . So, i like to see being more open and [indiscernible] from 1821. The kids living with the parents. One thing is, different issues happen there. The youth including the parents. The youth suffer trauma when they been homeless, so we are housing. So, all these kids they not ready to move into their own selfout to the real world. It is more physical for them to moving outand these kids staying with parents, right till 21 years old. If they have the opportunity they can stay with their parents because they can now living in [indiscernible] they still suffer trauma. Taking more times for the kids to overcome to recover from trauma. It is really important to see that part. 1821 and when coming an adult. For the youths, i like to see in the youthsfinishing my comment. For the youths i like to see more like Youth Opportunities to youth 1824 and because it is the time the youth suffer most trauma and they need more support from us and anybody. The last thing i want to mention is, the families receiving shortterm rent subsidies and it was moved. We including everybody. We moving outside to concord and other places over there. Thank you. Then we need to do something about it. Thank you. Really important you see this because we African American youth and latinos outside and become homeless again. Thank you. Thank you so much for your comments. Ivy. Members of the public who wish to provide Public Comment over the phone please call 4156550001 ifter access code 26644140933 and pound and pound. If you havent done so dial star 3. Please wait until the system indicates you are have been unmuted and you may begin comments. You have two minutes. Moderator, at this time do we have over the phone Public Comments for item 4 . There are no public records over the phone. Thank you and thank you to Public Commenters and thank you director nagendra for all your hard work and for your teams hard work and everyone who has been working on the Strategic Plan. We are looking forward to continuing to track progress and areas members brought up in terms of doing deeper dives and being partnership with you, so thank you for all your hard work. At this time, we are still operating without quorum. We do not have a quorum at this time, so we are hoping that we will get quorum before the end of the session but want to let the public know. We are not allowed to take a vote on tay housing item without quorum so well proceed to item 5, which is coordination item. Director nagendra can i ask you a question . We were not able to vote. These recommend ation have been in front of hsh, you is access to them and we had them at last months meeting and at this months meeting. Is there anything precluding you all moving forward on implementing the recommendations given we are not a chartered authority and you guys could move presumably to implement the recommendations . I dont know the answer to that question well enough because i dont know about thebecause the funds have beeni dont know if the funds have been allocated already. Yes, they were allocated inwe do not need to do athe board of supervisors isnt required to do a supplemental appropriation because they have been appropriated. There is the departmental discussion at this point. Exact ly. We want to take a official stance as a body on the recommendations. Dont want to put you on the spot either. I should not speak on the issue because i dont have the information but i can certainly bring it back and if there is some statement that this body wants to make that help inform that decision or that process. I think we can individually make statements, but we cant vote, so i can individually make a statement to support the recommendations that came from the family homeless Emergency Service provider subcommittee. I i dont know if other members wanted to as well, but just wanted to strongly encourage you all to move on implementing this, because we havethere is so many kids out there on the streets t. Is crazy. I am seeing them every day and they are in really bad shape and we need resources for them pronto. I think the plan is well thought out. Thank you for that member friedenbach. Ill join the chorus and say i support the recommendations as well and i think the urgency is definitely there and support what you laid out in front of us as well as the expertatize that we heard over several meetings as relate to tay support needed so want to go on record to be in support. Members are allowed to make individual comments in support but not able to take official vote at this time. It is my understanding to add a component this plan was developed with hsh input and discussion and so separate from individual support of it and our inability to take a vote i hope our vote wouldnt preclude hsh from coming back and saying this is what we can move on. Informing us ahead of our next meeting. Thank you for that member walton. I dont know i feel everybody said everything and in agreement. Thank you so much. We welcome hearing from your director nagendra on progress made before next meeting working with providesers as you have been doing so thank you are your hard work. Thank you, ill take that information back and well respond in whatever way makes sense to the committee. Awesome. Thank you. Thank you. Again, for the public we have a member out that is ill. We are not allowed to have remote participation only for ada or parental leave so if someone has covid or illness they can not participate remotely. Im excited to present the next item, item 5, ocoh coordination homelessinize oversight commission. We have Jameel Patterson and hali hammer. We will be joined shortly by member jonathan butler. Welcome. We willthe purpose of the item and why we wanted this at the retreat is the understanding we know there is several bodies looking at homelessness in our city and wanting to engage around the work happening because there is a lot of overlap and the work we are doing and want to be strategic and in collaboration with these bodies and informed to not duplicate the work and inform what other bodies are daing to strengthen all the efforts so this is the first time we have done this for ocoh. Been in operation about 3 years and change and i believe all the members accept for member walton have been here since we first started on this journey so we produced several reports; done needs assessment. Just came out with our annual report which i hope has been shared with you all but just like to first hear from you and jonathan will come in soon. Love to hear how things are going at Mental Health sf, what are some of the goals, some of the priorities and challenges in your view. This is informal conversation but i hope not the last conversation we have and you are always welcome to any of our meetings and reach out to any of us and especially me as the chair to engage in dialogue with this committee, but we love to hear what is happening with Mental Health sf. It is big issue in the city. Sying the crisis on the streets every day and all subpopulations are impacted by the Mental Health work so just really want to hear from you guys so welcome. Thank you for welcoming us. I think some of our goals, some things needed is we need to listen to people like member walton who i consider a teacher why he was at hsh. He used to teach the peer mentors. The thing i remember and often times suggest we implement from my experience as a peer worker and also from some of his teachings. There is a lot of veterans in the field that we need to listen to more and need to be more part of the conversation and direction. There is a lot of overlap, but i think the progress that has been made is the defining and Mental Health, homelessness, drug addiction, they are all brought under the same bracket and they do correlate so that helps gives a compass where we need to go, because as he knows, right, homelessness in itself after so long is Mental Health because it is deemed as unhealthy way of living you acclimate to so you see it correlates and why you have officers like office coordinated care. Trying to coordinate resources. It is clients and resources. I will hand it over to member hammer. Thank you. So, thank you very much for inviting us. We represent the Mental Health sf Implementation Working Group. Both of us have been serving on the iwg since inception, and as member patterson referred to, i think both of us have been working in the area of improving the health and wellbeing for people experiencing homelessness in San Francisco for many years. So, Mental Health sf passed in 2019, and the City Ordinance, the aim of had City Ordinance which a number of people worked on, there was a good amount of community input, input from the different city departments working with the board of supervisors and Mayors Office to develop this ordinance who goal is improve the quality of services and access to services to Mental Health and Substance Use services for San Francisco residents who are experiencing homelessness and have eithersorry, serious Mental Health issue and or Substance Use issues. After the ordinance passed, the department of Public Health started working on the programming of outlined broadly in the ordinance, and then i think around the same time worked with the our city our home subcommittee Oversight Committee on the specific budgetingspecific programming that would be supported by prop c funding that was aligned with the ordinance. And soand then the ordinance also spells out that there should be Implementation Working Group with 13 members, 6 of which appointed by the board, 6 by the mayor, 1 by City Attorneys office. We have been meeting monthly, and we can tell you about our work. We doget hear updates on the programming as it evolves and give input as new programming, new services on the horizon. All most all of that programming you all know about, you all have been involved in because a lot of it is, a lot but not all is supported by prop c. So, the Mental Health sf is programatically split into a number different demesnes so the officethese are what is spelled out in the ordinance. Office of coordinated care, street Crisis Response team, the Mental Health Service Center and residential treatment expansion and new beds and facilities as we think and we added in Overdose Response even though that is not spelled out specifically in the Mental Health sf ordinance, that is huge part of the new program work in department of department of Public Health and specifically Behavioral Health services. We have given input to new programming as it evolves. Leads from each of those 5 odomains present to us and we give input. There are challenges. For me the biggest one is the cadence of our meetings. The meeting once a month for three or four hours when this work is evolving all the time, so it is really hard to time our understanding of the landscape and where we are going. It is hard for us to time that with actually giving input to the planning. That is for me the biggest challenge. There are others, but we would really welcome thelove to figure how to sinner jize as we move into the next phase of the Mental Health sf work and prop c funding. Wanted to open up to folks if you have any questions or thoughts in terms how we can better collaborate between our separate bodies. I welcome that. I have a question in regards to thoughts around the street team. There was a report that was commissioned recently anyway the board of supervisors around the street team and wonder if you had a opportunity to dive into that and your thoughts of the street team because they are the front line. Want to hear thoughts and open up to other members, any questions and thoughts you have as well. My thoughts on the street team is, how many people know about them . I think it is definitely a great option to have, other then the police, but i come from working in the shelter system, so i know the street team is fairly new, but i doubt if any of the peer monitors know that option. For a long time it was regular relegated to the tenderloin, which is another thing too. The shelter is another places. I think didnt they just combine with the Fire Department . The Fire Department took over street Crisis Response. I think that was definitely a good adjustment to make, but i think the outreach and engagement as far as the Different Programs throughout the city. I think one thing can be educating all the peer monitors like he used to do. That you had [indiscernible] for the street team. People dont know when you call 911 you can actually have that option to request a street team. Other then that, they do great work. Im really never heard of that. I didnt know it is all through dispatch, so skirtit is very narrowly defined. If there is a safety thing they send the police, so you can try to ask for street Crisis Response team, but i have never had success. If the person is like in the middle of the street they wont send street Crisis Response. Other people want to get the police to respond so call and lie what is happening and say there is a knife or something to get the police there. It is kind ofwhen we originally put that wording in the legislation in Mental Health sf, we wanted it to have a separate line and it was more about having a peer response. Maybe a little clinical supervision, but then theythe Fire Department pushed to be a part of it actually at the beginning because they saw as a way to expand the Union Membership so they wanted to get homeless dollars so that is one thing we are paying for. I have a little different perspective on having the Fire Department involved. I think that it drives up the cost significantly and if just from my perspective looking at prop c dollars i rather see dollars going into beds then going to Fire Department personnel that dont necessarily have the cultural competency and feel people with lived experience who look like the peers you are talking about do a much better job and my understanding on the team is that peers that are there are doing the best job so i rather build on that and not have the highest paid fireman in the nation using homeless dollars. Yeah, but it is really i think the places of coordination to think about that questionone thing is that, there is still a little money and play around acquisition in the Behavioral Health category, so i think as we make recommendations how to spend the money and going and having conversations of Mental Health sf and thinking there is this amount of money and then having that be one of the places we get input that helps us make our recommendations, i think the other area of coordination is that if there is shifting in funding and so if we wanted to make recommendations of we think this particular intervention or this particular thing we are trying for isnt getting us much bang for it buck and like to see the money shifted over and thats hard to do because people are hired and it is like once we invest in something is funded forever, but i think we should be nimble about that and because a lot of this stuff we are playing with and experimenting and if something isnt working that well, i think we need the courage to say look, we need to shift it and we should have the money somewhere else and so, within the Behavioral Health category i think that is dprait conversation to have with Mental Health sf. Prop c is funding the 400 beds, so all most all the new dph beds, the street Crisis Response team which is now Fire Department and peer, and then the big fancy red rigs that sorry annoy the hell out of me. Dont know how much those cost. Coordinated care so intensive Case Management and the Mental Health Service Center, there are two expansions, we just paid for the second and we pay for the sort team. Those are things that come under your purview. It is a big crossover what we are funding and so i think there is a lot of areas for collaboration and you guys are digging down so much more on the Behavioral Health side then we are as a body, so i feel like we could learn from what your guys conversations you are having and that could then kind of like guide us in making our recommendations. Yeah, and wejust to clarify for everybody listening, we are the Advisory Group for Mental Health San Francisco, but so we dont represent Mental Healthto speak to exactly what is implemented, the outcomes that dph is following in terms of targets for number of beds opened, whether the intentions of the spelled out in the legislation, like better response after 5150 for example, we are tracking that, like how often people in involuntarily holds are connected to care right after leaving the emergency room or hospitalization, so i think that would be great dwrou you all to hear about to gohave a report from either director cunnings who is director of Mental Health sf or if you want to focus on one of the domain. What is implemented and how do we know it is working or how do we make changes if they are not like you mentioned member friedenbach. For the treatment beds, i think that was ai was involved in those early discussions when dph forward a proposal to this body about what should be funded in that initial round of funding. Beds were a big thing we wanted to be able to expand with. Prop c funding we are really proud of the fact that over 350 beds have been opened. There is both expansion of existing programming that a bed gap analysis had said we need more of, but also new innovative programs. We have a new Alcohol Program which is funomally successful in terms of improving outcomes for the people admitted into that program. We have expanded our psychiatric respite, hummingbird program, so those aregreat for you all to hear about, and for our body, for the iwg, our goal is really to get understanding of what Behavioral Health service and meant health sf is working on, like the new facility for the Mental Health Service Center. Member friedenbach you had a lot of input what that should look like as do members of our working group, so we are giving input, so that it meets that vision of a low barrier way to access care to connect to services. So, thatsits allwe are all touching the thing from different places, but it sounds like such a great opportunity for us to coordinate and make sure we are on the same page. Need more help in the coordination. [laughter] i want to add to member friedenbachs comment in terms of resources available. I hear outreach engagement is one piece and also like resources coordination so trying to capture some things im hearing. Im curious about the peer monitor program and love to hear from our member walton about that program or anyone else. I am guessing mostly what you are referring to member patterson is that while i worked for hsh, i oversaw a lot of training to all levels of people that worked, especially in our shelter system and other Emergency Response and street outreach, and so i can speak more offline about that, but the thing i think is surfacing for me and having just come into this Oversight Committee in the last few months, i think it is very common when there is money available and there is need available, the first thing we focus on are concrete things. Number of shelter beds, number of treatment beds and so forth. I think what may speak to issues that arise as we look how those are being utilized is, then looking at how we access those. How people access those services. You talk about low threshold, we talk about who can call in skirt rather then police. Those are things i think require a second layer of analysis to look at what makes the most use, but also doesnt overflood the services so they become useless. In terms of trying to somehow create gatekeeping so beds are not unused or services not unused, but used as effectively and make it as easy as possible. It is how we best help people do that and i think as member friedenbach said, some people who want a specific response rather then reporting what they are seeing as a need they report what get the response they feel should come and that will address that as well having worked in the early stages with healthy streets outreach efforts and so forth. I think that speaks to and it isnt just peer education, it is education across the board. Some acceptance of the fact that until we have unlimited services, we have to be somewhat strategic in using the servicess that we have. While we look to add more, we have to use what we have effectively. To add on, the peer monitors are basically the people that work hands on with the shelters. But people like member walton, his education made it to where you were not just babysitting adults. You had knowledge to work with people who had Mental Health problems. And that can mean a whole difference in how a program runs. I mean, from the intake person isnt necessarily a peer monitor, but they still just as important. The intake person could be the difference in a person getting help or a person being shown the door. We dont need peer monitors who work there making things harder for the client, but also if you educate the peer monitor and make the referral expertit isnt that hard to do. I recommend every peer monitor at least have 3 to 5 referrals. Like, dont be the kind of peer monitor when a client comes up to you and needs help in whatever area and you dont have nothing to say. As member walton might know, my mom was brother brown. She had fliers for all the services all over the wall. The peer monitors could look on the wall and refer somebody somewhere. You may just have a client that Needs Housing, but what if you have a client that is coming from a battery situation . That is whole another type of referral. You might cant refer her to a place with men, right . It is like, those kind of things you got to know and then member friedenbach was saying, i think you know, that should be a question. Is the skirt teami wont use overlap, but duplicating the Fire Department . I have different experiences with the Fire Department. I had good experiences, because been situations where clients abuse that privilege to call the Fire Department and they still come. [laughter] just in case. The police is a little different. Somebody might have been calling the problem and police took three hours to come. Fire department, 20 minutes or maybe little more. Most of the time 20 minutes and they are there and they are also part of the team. They are all most a part of the shelter system anyway, so i do think that discussion is the skirt team duplicating services and these are discussions we have on our board. A lot of our members are experienced in the field. They have experience being san franciscans, some are nurses, and we have fireman on the board. I worked in the shelter system. We had discussions on the board. Some of the main things we talk about is really mapping. From my experience, waiting lists, openings. That should be clear. There shouldnt bethere is a waiting list. You can maybe come back at this time. The other part, we should have been had already is, a lottery system to where a person goes to shelter, house and emploid and you have to determine the ones that have Mental Illness that need more care before they get to that point and not sure that is happening. A lot of places look at clients all the same and they are not. They are not. I have seen people who work jobs been in shelter for two years and go unhoused and i have seen people with Mental Illness get a house. That is what the mapping is about is accessibility. At the job i work at, our office is facilitated for meeting every wednesday between 3 and 4 30. There is number of people who come through the building, say this is my firm time coming to na meeting. This person was a working person. A functional addict. I dont want to use drugs anymore. She was crying and didnt know where to go but your place. That accessibility needs to be there. Thank you member patterson. I was looking at an earlier document about the street crisis team and just the mapping of all our Crisis Services and getting that data is super important and just want to second what you are saying in terms of the accessibility piece. I want to not take up too much time, but other members have questions or thoughts you want to share . I want to underscore as we are Oversight Committee you are Oversight Committee, i think we are the ones that have to identify the questions we need to pose to the providers to the city departments about what still needs to be addressed. What needs to be finetuned and major changes is hard, but there is a lot that could be done with finetuning on a lot of these programs. That really speaks [indiscernible] the gaps. Want to hear from you in terms of from a data and information conversations that have been had over the past couple years. What gaps are you seeing . [indiscernible] just curious from both of you. Any thoughts on gaps . I see gaps everywhere. I think the first thing to say from the Health Perspectives our biggest gap, the biggest prp is the shortage of Behavioral Health clinicians is we have behavioralrobust Behavioral Health Service Division of the department of Public Health and we have i thinkwe touch this priority population in all different places and shelters in Supportive Housing on the streets, in clinics and specialty meant Health Clinics in residential and primary care and in jails. We want to provide Behavioral Health service, Behavioral Healthcare in all those areas and if we cant keep our positions filled and filled with people who are committed to this work, people who understand the population we are serving, people who come from the communities we are serving, i think thats the biggest problem, the biggest gap that we still struggling. Getting down to the specific program area gaps, i think definitely psychiatric, skilled nursing. Thats a area of residential treatment that especially with a aging chronically experiencing Homeless Population is a big big need and i think we are realizing the need for beds in those areas. I thinkthere are a lot of different gaps, but i guess those are a couple ill mention to start out. I think we need safer places for people to use drugs and sober up from drugs if they are intoxicated. We have some great examples of sobering center, one for alcohol and one for other drugs and thereswe need to grow programs like that. Places to be where they are using drugs. I can talk [laughter] there is a lot of needs but those are a few ill mention. Gaps and barriers. I think theres gaps with the programs and with the sections. Mental health is defined to coordinate with homelessness, but one thing im not seeing anymore is not seeing the connection between na programs and drug programs and some of the other programs. Like when my mom started mother browns, first thing she did is bring in positive directions. Matter fact, positive directions trained the peer monitors. Na meetings happening at the shelterperfect fishing net. You have what is called Harm Reduction. I talked to somebody that worked at glide. These are 30 year veteran in this work and he said, abstinence and Harm Reduction should work hand in hand. A person might not want to get off drugs, but they get into Harm Reduction and you start slowlyit leads to the abstinence. I remember the shelters used to meet. Not sure if they meet anymore. Did we do away with the changes system . Some of the changes system brought clarity to me because it was Little Things like i might deal with a client but i see notes somebody wrote on a client so there is a better coordination how to deal with this client. In the changing system you pull up a client, the changing system connected to gas a well, right . You pull up the client there is notes and prior history. So now we have more a idea how to approach them. I think there is gaps between the programs to where there isnt enough communication. Im not sure the f they meet anymore. They need to dialogue. There are barriers for the client. One of my experiences, he is [indiscernible] besides the jims, i get more from a client whos been through the system then i do for the actual counselor. You got repeat offenders. What i mean is somebody that they go to jail, you get on ga they work through the shelter and now got housing and that person can write a book on the system. They may repeat, go to jail again, but they know how to work the system, so if they can work that system, why cant we just examine what they did and use it as a script . It isnt one shoe fits all, not trying to say that, but we definitely need compasses and needs to be less barriers for the person that Needs Housing today. For the person homeless today. A lot of people dont know what the drop in centers are about. They are about if you got no where to go, this is where you go, this is rock bottom. It might be somebody sleeping in they car and realize you got a car, you can go to the drop in center and have a car to assist you too. But the person dont got a car. They feed to go to the drop in center and that is another step to get into housing. This is why the peer monitors need to be great referral experts, because there resources need to be tied to the shelters. Access the shelter needs to be a way to get you in housing. As of right now, sometimes they cant tell people about a waiting list. Give me clarity. If somebody suffering from Mental Health issues, that can justwe all got Mental Health issues, everybody at the table. You go through trauma and somebody cant get the answer it is likebarriers, there are barriers, there are gaps. I think people need to be trained. I love how he trained us, because he gave us direction on how to deal with people with Mental Health and how to handle them with care and not get sued too. [laughter] hundred percent. Ill add another thing we are focused on a north star is Racial Equity because know [indiscernible] disproportionateality is black communities affected by homelessness. Just wondering if that is something you are grappling with with your body in terms of Racial Equity analysis , looking at data and who Mental Health is impacting. Want to hear in terms of Racial Equity. That is a big north star for us. We are willynilly on that. We go through the numbers. That doesnt really speak to like what is happening. You know, i dont wantill say this, ill say this, in a lot of ways people do get left out. There may bethere is residents, there are people that are experiencing homelessness and they dont need to be kept in the homelessness and somebody with a sro also still need help too. For people that are in sro, lets take people in the tenderloin who are a step above homelessness, there may be resources that come to the community and might not necessarily come to the black residents, they might know about it to increase their life and wellbeing. I think some black clients they kind of just get maintained in their homelessness and not really get shown options. Some good examples, i like it that hospitality house has a arts program for their clients. Thats another fishing system. Without getting too deep, there is a lot of keeping people in place and not really sharing information about peoples options. People dont know there is funding out there for programs, for certain areas and certain demographics. There are areas in tenderloin where the black people are at. You may have a drug dealer, may have a residents, may have somebody on drugs, you may have somebody homeless, but i see a guy hes a resident but hes selling food. This is like a small seed to block activation. To enhance the life. Some of my experience and this was a program at valencia and i seen true equity. This was a sro banquet, and it was everybody from different walks of life. People from hip hop world that experience homelessness. Transgender. Native american. Latino. Right . But they are all survivors. This is how they saw themselves, and so they were sharing information with each other about how are you coming along in your new living space. It isnt enough of that. Definitely not enough of that. I helped somebody from he was told by a immigration program, our services are not for black people. I was told this with him im like at city hall and [indiscernible] happen to have conversation with [indiscernible] and she made a call somewhere and they jumped on the ball and the lawyer agreed to take his case. Pro bono. I think black people are sustained in their problems and not shown the options that may be out there. They are not open to like funding. A little funding to help activate the community and there is no grapevine communication system. Black people on other black people who have been through the system. Thank you for that. This is a conversation that needs to be had more. At ucsf have been talking about because folks may have bias about black folks and immigration. There isnt that check box offered. Im for immigration. Folks come from nigeria and [indiscernible] it is awakening that needs to happen. I was going to add and answer to your question that, the Key Performance indicators i mentioned, the metrics we are following trying to get to outcomes, so follow up after 5150, wait time for icm for Case Management programs, and the other metrics we are following. When the data is presented to us in iwg we get a racial breakdown, and so we can see where the disparities are, where they are worsening. I think where we are not quite getting to is diving into the areas where we see the disparities persist, inequities persist and diving in. That is a problem and why does that problem persist . Why do be continue to miss this population usually the black African American population . I want to just give respect to our first chair, dr. Lazar was the first chair of the iwg and i think she set the tone for thefor our group to always be asking those questions, those hard questions of if your are numbers are not better in this areas and disparities persist, why is that . Why havent we done a better job to address that and so i think we dont think made enough headway. I think the area where we have the most stark and alarming and probably very good hard data is Overdose Deaths and the numbers arewe first saw broke it down by race were just staggering. I think when we first saw that huge jump in overdose death in San Francisco it was like 4. 2 rate the then among black African American san franciscans compared to other racial groups and lots of work going into thinking to talking to the community to looking to see where the deaths are happening and how can we intervene, but i think we are not making a dent in that disparity and thats the one that justnobody with live with that. We cant live with being in a city with that kind of disparity so going back to community and talk to people, figure once wewhen somebody survives overdose, when there is non fatal overdose and follow up to find out what works of intervening is the work in our post overdose team. I think there still is many questions as answers. Member freed friedenbach. Ivy, what was the number on the Behavioral Health outcomes on African Americans on the Strategic Plan . Has there been progress in placements post 5150 and progress in wait time for icm . So, for 5150s, i was looking at the dashboard and we can send links to the dashboard. I dont think there is a trend down. I think it is up and down and we probably have data only for the last year, maybe little more. I dont thinkto the budget legislative Analyst Report done in i think 2019 that showed the numbers of people that were broke down by Housing Status overall and Homeless Count without service s post 5150. I guess i would say that, i have been working on data driven improvement my whole career. Looking at it closely and figure how to improve. I feel we are just getting the data we need. We are pretty early in the process now. Talking from the dph perspective and now we have to dive really deeply into it data we are seeing to sets targets and see improvements. I dont think we are there yet to answer your question member friedenbach but we are getting good data now which is great. I was going to just really quick put in a plug for health Access Points. Dont know if folks are familiar with that. There a black African American Health Access point. I know there is probably collaboration that could happen there. If you look at the dashboard, that is just65 in october alone. Access again. Mental Health Clinic in bayview. I think it is still there. [indiscernible] a lot dont know about it. Thats the[indiscernible] thats where i brought the client i helped get his immigration, because he it to go see a psychiatrist. That is where i was able to find him help. You got south of market, west side, people are familiar with west side. But there is still a lot of unfamiliarity about the Mental Health clinics and where they are located. You got soma. Thank you for that. I will open up to committee before i take Public Comment and apologize, chair butler cannot join us, but well continue the conversation. This is the first of numerous conversations i think as more data becomes available. The commission is still coming on line and gatherer there data but opportunities for robust collaboration. What was shared today learning about the option when you call the 911, that is something i didnt know myself and sure that information needs to be more broadly shared, so i think the more conversations we have, knowledge is power and for us in the leadership roles spread the information and be in conversation with each other so i appreciate a lot of information shared. I will turn to ivy. Just to answer your question member friedenbach, the Mental Health client outcomes was the one unavailable in our report and we do link to the dashboard we just shared as well as a few others for sort and skirt, but that is a future reporting goal. Yeah. Okay, thank you. Thank you so much. I want to lift up the black Mental Health support piece lifting up in our work because i think is needed. Just with the point around the longer stay you have outside and on the streets, thats leading to the Mental Health conditions and if we know black African Americans are the largest population represented, that need for Mental Health support, very clear and increase and support for that. I really would love to learn more about not just training component of the peer program and more so of deep dive on that program as well continue to read information on it the street Crisis Response team and member friedenbachs point about the involvement of the fire des apartment and out pp comes to see how folks feel about the First Response piece and i just curious about connections to care after the emergency room and connections to care from the street just the linkages and seeing kind of more data on linkage, how that is happening and of course just cultural sensitivity and responsiveness, i think it is really key. Particularly when we think Substance Use disorder and other things in terms of stigma. That is my last question around stigma and your body is around looking how to reduce the stigma. Particularly in the black African American community because coming from that community there has been that stigma of seeking help and so just wanted to hear from you all on that reduces stigma around Mental Health support. Society has to work on itself. I cant control how a individual is conditioned in their life, so if the inclination is grab [indiscernible] i dont know what to do about that. They need therapy on that end, but what i will say, it starts with not looking at everybody as the same when you see a group of people. It starts with realizing we are defined with mental help is. Every single human being live long enough they will have Mental Health. It is there. This is why certain corporations they assign a psychiatrist. I say that to make a left turn or right turn, but i think something to add and it may sound way out of the box but kind of being implemented is there are artists homeless. Singers and musicians, lets like in that direction. I helped some people who struggle with homelessness but became residents helped them produce a rap video, on you tube. Rap video. [indiscernible] by the tenderloin too. Empire records is by the tenderloin. Even if somebody is homeless, you never know what they know. [indiscernible] legendary rapper out of oakland. I think that arts building, the hospitality, a lot of Mental Health right there. People get to draw for they therapy. I would say like i say, this is left turn, but i would say bring [indiscernible] somewhere in the l. That was like great interaction y. I dont know if thrfs there was a fight. Why would you take that away . Other then that, as far as just got to pay for them. Oh. Accessibility, right . Other then that, i would say we need teachings like his. How to care for people. People should know likethe first step isnt looking at everybody as the same. I really dont know how to cure somebodys racism. [laughter] the only thing i add, and dont think our group talked about stigma. I think it is is great question. Im huge believer in integrating Mental Healthcare, Mental Health services, Substance Use service into all health services. You go to a hospital bed and walk into a prenatal visit, you see your regular doctor about diabetes and no matter where you touch the Health System which is huge, we are everywhere, somebody will ask about your Mental Health. Somebody will ask you if you are using drugs or using alcohol, smoking, all those things, and thats my vision is it is so integrated that it becomes to be destigmatized. When i was pregnant 25 years ago maybe i would have looked sideways at my midwife if she said are you using drugs. I would have been like are you making judgments about me . Now we are wanting to normalizing that. We ask every person in prenatal care, not pointing the finger, saying this is normal thing to have Mental Health challenges at all points in life and so thats something our whole person integrated care team we open this beautiful gorgeous few Health Resource center, the maria x over at 7th and between mission and market, it is gorgeous. It is amazing. Just having such a incredible state of the art building to serve people experiencing homelessness and offer dental care, offer prodity, Behavioral Healthcare, it is all there and i think thats what we have to do is acknowledge people have diabetes and people have schizophrenia and we are here to help them. How do we think about the cps as well because working with pregnant folks like the stigma around talking about Mental Health andcannabis while pregnant, that fear oof losing your baby and it is real justified fear. Especially if you are African American. How do we think about that too. [indiscernible] just sort of that piece around owning what youre going through and is that going to enter into cps or police that can lead to worse outcomes, so ill end with that, but i want to open up. Public comment. I dont want to miss if we need to do that. Going to open up to Committee First before Public Comment. I think this last stigma conversation is the first thing i thought about i glad you brought it up, because the issue is how do we create a system that asks people what do you want and what do you need and assess also what they need they might not know without saying and how did you get this way or why do you do what you do and thatsi think thats a great way to approach not solve but approach racism because if im focused on your need, then it doesnt matter who you are and what color you and gender you are and Sexual Orientation and so forth, so i think that is an approach we can all work at, and again put it on our backs as a Oversight Committee, we have to ask that question. Thank you for bringing up the stigma. Thank you member walton. Ill go down the line. I think we are a little sad about lack of able to vote on the tay housing today, which is real bummer and just for the public, we really really wanted to make that happen today but we dont have quorum but i want to thank the guests for commitment and service. Seen you over the years in many different fronts so thank you for being social justice warriors and partnership with us and well continue to do the good work and thank you. I will say this and be very very short. I like our board. Our board comesi dont go if everybody is originally from San Francisco, but we come from a San Francisco perspective, and thats above the race and everything. A Real Community San Francisco perspective that has a grip how the sit a functions and how communities operates so that makes our board special. We have different ethnic groups on the board from asian, european and latino and im black. Thank you to the work you are doing. Ivy, can we see if we have Public Comment . Members of the public who wish to comment in person please line up at the podium now. Each person has two minutes to speak. There no in person Public Comments. Members of the public who wish to provide Public Comment over the phone, please call 4156550001 enter access code 26644140933 then pound and pound again. If you havent done so, please dial star 3 to line up to speak. The system promp indicate you raised your hand. Wait until the system indicates you are unmuted and you may begin comments. Please note you center two minutes to speak. Moderator, do we have any Public Comment over the phone . For the record, there are no over the phone Public Comment. Thank you so much. Thank you to everyone who joined us. We are not officially called to order so nothing to make a motion to adjourn but want to highlight we want have that vote or official vote forte housing item in the new year and we do have i where believe commitment from hsh to start to move towards implementing some of the recommendations they heard from providers and from us and our individual comments. With that, i want to wish everyone a beautiful holiday break. I cant believe it is december and we are entering into 2024. The year flew by and know we will have plenty work in the new year but hope everyone has time for rest and rejuvination and time with loved one. We will end this meeting, part meeting, part retreat for ocoh so thank you for joining. Thank you. [meeting adjourned] the city of San Francisco is invest nothing resources to care for people experiencing a Mental Health or Substance Use crisis on the streets. Is this includes new programs and the expansion of successful pilots worried about you lying on the street here. We can take them to other facilities like Mental Health facilities or shelters or offer resources and connect them to social workers and follow up. We try to provide safety for the public and for them to let them know than i are not in trouble and we are here to offer them many resources and service they may want and takes buildinged the relationships with the public president people we contact with. Takes time and trust. The city street team include Mental Health clinicians, community paramedics, emts, social workers and councillors train in traumatic care u most vagzal interviews. Cultural competence and he deescalation. San francisco 911 when is the emergency . San francisco trained 9 leondis patchers operate inspectly from the police department. Through investments and alternatives to law enforcement, the city ruled the police sponses to people experiencing Mental Health emergencies. Now that we have a team that is geared toward Mental Health that helped dispatchers able to assist the public when call nothing for common they dont think needs an ambulance or fire or police they think they need help. I wanted to be that social worker what wents the extra mile and figured out how to navigate the system. Joy feel great when i help someone thats why i got in the work if you are experiencing an emergency or worry body safety on the street call 911. For nonemergencies use 311. You can learn more about the street Response Program at indiscernible faces transformed San Francisco street and sidewalks. Local business communities are more resilient and our Neighborhood Centers on more vibrant ask lively. Sidewalks and parking lanes can be used for outdoor seating, dining, merchandising and other community activities. Were counting on operators of shared spaces to ensure their sites are accessible for all and safe. Hello, San Francisco. I love it when i can cross the street in our beauty city and not worry whether car can see me and i want me and my grandma to be safe when we do. We all want to be safe. Thats why our city is making sure curb areas near street corners are clear of parked cars and any other structures, so that people driving vehicles, people walking, and people biking can all see each other at the intersection. If cars are parked which are too close to the crosswalk, drivers cant see who is about to cross the street. Its a proven way to prevent traffic crashes. Which have way too much crashes and fatalities in our city. These updates to the shared Spaces Program will help to ensure safety and accessibility for everyone so we can all enjoy these public spaces. More information is available at sf dot gov slash shared commissioner hallisy. Jupiterjones. Here commissioner louie. Here and mazzola. Here and commissioner wintroup and zwart are excused. San francisco rec and park acknowledges we occupant unceded home land of the Ramaytush Ohlone peoples the original inhappen tans. We honor the peoples for commitment to mother earth. As protectors of this land and with their