Collaborations. I wanted to talk about a few things were doing in addition to our regular programming. We have implemented a number of the recommendations of the lgbt aging policy task force that came out, that is spearheaded by tom nolan, and its just really exciting to see these recommendations turn into programs. Weve talked about some of those at commission, but i wanted to mention that one of the things that weve done more recently is to start Training Staff and also training our cbo partners to collect Sexual Orientation and gender identity data in keeping with then senator weiners local ordinance. And there is another state legislation that basically requires the same at the state level. So were a little bit ahead of the game. A lot of colleagues across the state havent started collecting the information and are freaked out about how theyre going do it. Im proud to say weve trained staff and were starting to collect that data. Our staff, since you know these people, im going to mention them, tom nolan, dana levit and mcgee did a fantastic job of putting together the training and they took their time and did it as volunteers. They went out and trained the majority of our staff. We still have some staff left to train, but they did a fantastic job. So that was good. And then our aging and disability friendly San Francisco work has our task force just concluded its work. As i think you know, we had a 12month process with the task force and looked at what we call domains that affect older adults and adults with disabilities in San Francisco. So thinking about, an example being transportation, another technology. How are we doing with respect to older adults and adults with disabilities . Are we do we have great programs . What do those look like . What are our strengths . And where can we do better . So this group was very enterprising and energetic and came up with 200 recommendations for us to follow and we took that, the 200 and brought them down to 27, which we thought was a little more manageable for this year. And were going to be even with those 27, we have prioritized some of the 27. Basically what were think being, what are efforts that are under way we can track and monitor . So we can show initialed success in this first year. So there is some new things were taking on, but a lot of it is looking at efforts that are going on in various departments, particularly daas. But that would, what are things were doing well that are under way . Were also thinking about the necessity of a campaign that not only talks about our programs and what is available to older adults and adult with disabilities in San Francisco, but also about combating ageism, so those are things well be embarking on that came out of that process. Longterm care coordinated council. One of the so we have so im the new cochair along with ann, were working together to lead the council. We really want to focus on it being a policy for the mayor and hoping to engage the Mayors Office in the work were doing and have them Work Together with them on some of the policy recommendations for longterm care in San Francisco. One area were working on is workforce issues currently. Were taking our three meetings, the meeting that we just had and the next two to talk about workforce. The first meeting was about older adult employment. And marie and kathy did an excellent job on leading discussion on older adults employment in San Francisco and the importance of that for financial reasons and also for socialization. And then the next meeting were going to talk about employment for adults with disabilities. And then the third area of focus will be really on the longterm care fork force. And the challenges we have with not having enough workers and thinking about how we might guide those policy recommendation force the city. Its recommendations for the city. Its exciting work and those meetings are open to the public if you want to come and sit in. I wanted to flag two upcoming events. One of them is today, changing language, changing minds, reimaging San Franciscos narrative on aging. Its at 2 30 to 4 in koret auditorium in the library. Hopefully, youre coming. Hopefully, you got the invite. Is it 2 00 or 2 30 . 2 00 is registration, the actual event is 2 00 is better, because we really want people to be there early to sign in. But thats really an opportunity for us as a city to start thinking about how we tackle ageism. The Frameworks Institute has done Interesting Research and Data Collection on how people feel about aging and how people prefer to talk about aging. Its a chance to hear about that and have a lot of us get common understanding of how we might shift the conversation in San Francisco. I hope you can be there. I wanted to mention reimagine week, which is coming up the week of april 1622. And that is partnership between the Palliative Care work group. Its one of the work groups of the longterm coordinating council and collaboration between our work group and an Organization Called endoflife collaborative which came out of ido. Its work that ido did. Its a weeklong series of events focused on conversations around end of life. And so were very im very much interested in being part of this because i think end of life and just Palliative Care in general, thinking about Pain Management for people with chronic conditions and chronic illness is not easy for us to talk about. So the work group is really focused on talking about it, making sure that physicians really Pay Attention to Palliative Care and that they let their patients know about Palliative Care, regardless of whether their patients regardless of their insurance, regardless of their income, regardless of where they come from. And its about getting comfortable with this conversation. Its about making sure that families are talking and all of that. So i feel passionate about the issue. And i think im working with a group of people who all feel very passionate about it. Think being advanced care directives and how do we make sure everybody has one, and those kinds of things. So this is really kind of the events are varied. Its social services, its medicine, its the arts, entertainment, comedy. There is going to be a whole series of events that week and well be sending out for information about it as soon as we know, but a lot of nonprofit partners are part of this. Some of the partners are having events at their places and there are some that are going to be downtown in fancy venues. So it will be really exciting. And i hope that each of you can find a way to take part in that. I think thats all i have. Unless you have questions for me. If commissioners have question for shireen . I have a couple of minor questions. Probably the first, for those of us who cant make the afternoon gathering, is there a way to see that information . There is. So the Framework Institute actually has information on their website. So thats i can give you the link, ill have bridgett send it out. That would be helpful. Director mcspadden also i think were going to be doing followup events because a lot of this is not just about framing the conversation, but what do you do with the conversation . So how are we going to get the conversation out to people who live in the city and what does it mean if we want to create a campaign . All of those things. So well be talking a lot about it and there will be other ways to get involved. A quick question. Just think being the goff site, are we comfortable with the frequency of drop ins and intake in general. Its hard for me to remember what we projected. We knew it would start off slower than say some of the other sites, so we have San Francisco benefits net sites that are overwhelmed sometimes. One of the things we wanted to do was make sure our staff had time to spend time with clients when they came in. So we didnt project to have as high of numbers as the other sites have. Were going to continue to adjust that and look at that. And part of it is, people still dont know about it. Its one of the things we found out with the Community Forums and the survey, you know, just initially looking at some of the stuff, we know that people dont really know what is available. And so one of it kind of ties in with us doing a campaign and getting out there with the services and making sure people understand what they might be eligible for, or they can come and ask. And its still a challenge for us. I think once we start doing stuff like that, well see the numbers go up. Sure. Thank you. Two more minor things. When you talked about the office of public conservator, you gave numbers as to how many clients we have. And missed that. Could you repeat . Director mcspadden those numbers i gave were specific to the community, so we have this Community Independence project where people essentially agree to conservatorship. And therefore, they can continue living in the community. They need to accept treatment. And follow the treatment plan. So we have had 47 clients since that program started and its been three years maybe . Since we started it. Its been several years, three or four years since we started it, i believe. We have currently 18 clients active on that. Our whole Conservatorship Program is a bit over 500 i believe. Ok. I had a followup question on that, too. Does that, the 500 number and 18 current active clients, is that in line with the need that we believe is out there . Director mcspadden its hard to project the actual need. I think one of the issues is and partly why i mentioned making the system more seamless, is because we see people falling out of the system and then reentering and reentering. So there is something that needs to happen differently, right . And so whether it means that we dont have the right housing, whether it means were not getting them to conservatorship when they need it. Some of it is timing, some is collecting the history of somebody to present it to the court. There are barriers and one of reasons there are barriers, it was created as a last resort solution for people. Obviously, if you can get them to agree to treatment and not be conserved, thats ideal, because the whole the law is basically that somebody is served in the least restrictive setting and that includes how they get housed. It also includes this particular type of legislation, i mean, when you go to court, and file conservatorship, youre saying take away that persons rights to make certain decisions for themselves. And so, thats a last resort, right . So its really hard to project exactly what the numbers should be. But i do assume if were able to figure out a way to make the system seamless, well see more people coming in, referrals coming in. I guess the other question i have, may not be able to answer it now, but i wanted to know a little bit more about the campaign. And how the campaign fits into the or aligns with the budget instructions to maintain the current client level with anticipation of increased clients due to the aca. And how that mixes with the budget. Just grappling with it. Thats a really good question and its always a delicate balance. I think one of the things we want to make sure of is that people understand that services exist. And certainly we dont want people not getting our services if they need them. Particularly, we have protective services. I guess particularly, we provide food for people. We dont want people going hungry, we dont want people in abusive situations so we want to make people understand that our services exist. There are situations where were not able to serve everyone who needs the services but what is important is that they know about them and they track that and we have beeniadvocate for f. Not all the funding i think dan mentioned that San Franciscos really fortunate, we have such a large share of general fund supporting our office on the aging programs for instance, but it also supports our other programs. But it doesnt have to come from here. I think building the case is really helpful. These conversations are going theyre going on everywhere in the united states. And it kind of helps to build a bit of momentum to say, hey, this older adult, this group of older adults, people with disabilities is growing and we need to really figure out how to serve this group. The only thing i wanted to add, i appreciate the notion of building the case. I understand it. The only concern i have is that we create an anticipation of services for people and were not able to meet their needs. Agreed. Thats a very hard issue to deal with and figure out. Its hard to figure out what the best way to approach it is. I totally understand what youre saying. Thank you so much. I have a couple of questions that go back to dans report. In the total revenue increase, the dignity fund was included in that . Im sorry . The total revenue increase, projections for the mayor budget and what the shortfall would look like . Yes, it was. As i said before, the dignity fund statutorily increases by 3 million a year. It is one of a fairly good list of voter approved setasides that are part of the projection process each year. Sure. Two other short questions. One is, so you talked about baseline, setaside, just employee costs in general and there has been directives not to grow any ftes, but no directives from the Mayors Office to make employ reductions, correct . Thats true. We will keep the fulltime head count. 2200 in the agency and in daas. 300 and something, i should have the number, but i dont. In any event, we will not be reducing head count. My last comment was going back to the beginning, commissioner langs concern as well, so needs are growing, city projecting a shortfall, over 60 of the budget relying on state and federal that could be at risk and setasides. At some point are we going to hear plan on how were going to mitigate some of these future concerns . Well, im not sure how much were going to mitigate in the short term. We will budget in a way that does continue to fund the program areas. So we will, for example, have increased costs in ihss. And the Mayors Office is ware of that and that is taken into account in their projection and its not part of their expectation well be reducing those costs. Thats already accounted for. You know, as our sort of standard inflationary increases and things like that. To the larger point, that the population ages and as needs grow, i think we dont have a really fully fleshedout longterm vision. You know, we do budgeting in a biannual cycle and were covered for that, but the longer term is an issue we all need to work on. Is there plans to form in terms of advocacy to the Mayors Office, supervisors, Public Awareness campaigns, but within the department itself, clearly i know there is a diligent dedicated brilliant staff working on these things, but in terms of looking at the long term, ways to advocate . The way that money gets added is we work on a vision. A vision for the programs for the longer term. There are discussions between the agency and the Mayors Office about making additions over time. That has certainly happened. And as you know, in San Francisco, we have an addback process which is i guess really plays at part of the legislative process, or the board phase ott process, where dollars have certainly over the last years steadily been added to the program. So thats the other way the program has grown historically. Sure. I think in addition, so just thinking about vision. I mentioned at the state and federal level, there are a lot of conversations and i think we run into some of that bias that i mentioned earlier, i call ageism, enableism, where people dont want to talk about stuff or fund it. Given the growth of older adults in particular nationwide, were way behind where we should be in these conversations and were going to the other way when we think about cuts to Social Security and medicare, so there is a lot of work to do around that. I would agree. On the state level, certainly one of the things that came light in the ihss discussion in the last legislative session was sort of the propensity to think of this program, which is a huge, huge personal Assistance Program serving over half a Million People statewide. A growth area. Its a huge and growing cost. But not thinking of it so much in terms of the growth in personal Assistance Services that is something that is going to happen for an aging population. And in a growing aging proposition. And the fact that people need more in the way of personal assistant services is a good thing. Its an art fact of the fact that people are living in the community longer and living longer. And we havent come to terms with that as a society. Question for shireen. Since you opened the golf street veterans hub, or whatever it is called, do you see increase of clients going there . I think its about the same as it was. I mean, what i think were doing better is linking them to other services and we continue to work on making that even better. So before hand, our office was really stuck out there by itself and one of the issue we had was that the staff didnt feel like they were part of the organization. We made a lot of improvement just by moving them in with other programs that are part of daas. So i mean, i think thats where weve seen the biggest improvement. We have about, i guess, under 30,000 veterans in the city, not all of them qualify for the services. Its pretty specific. And so the numbers even when they shift may not shift a huge amount. One of of the other things that happened, though, is that we used to do quite a bit of outreach in that program and we had outstations at fort miley, the v. A. Hospital, and we had outstations la gun