Will agree that we want to build on that. But i do recall i want and of the next few days i would like a better understanding of how the crisis team fits into what we are already doin doing . This is similarly an effort rely on expanding ems6. I want to understand how that has grown and how those ems16s are used. Also, how the mobile crisis team relates to this and any other, you know, outreach thats happening now because i think supervisor ronen and supervisor hainey and the whole boards intention is for a game changer that really changes the experience for people who are in crisis on the streets and really changes the experience of people in San Francisco who are seeing people in crisis on the street. And the question of whether its to be 24hour, but i think it needs to be at a volume that is great enough that is actually impactful and im a little worried that the increase that happened last year again, its been a weird year, a very weird year. But i know ems6 does great work and i know theyre doing things that are saving the system money but gettin getting help to peopo otherwise wouldnt get it and the ems6 folks are just amazing in what they do. Pouring on another couple of dozen people into this system, i just want to understand a little bit more about how it will get us to game changing. And i also agree and i look forward to talking more with you. For me, each of us is seeing Different Things in the Mental Health sf center and what it will provide and we have overlapping but not different priorities with it and overlapping priorities around that. For me, its very, very important that there be a place 24 hours that these people who are interacting with the crisis teams or em6 or mob mobile crisr anybody surrounding people in crisis knows there is a place to take someone that isnt false. I would like to talk more about that. So last year, we talked a lot about the investment and dual diagnosis that was a big deal and we thought it was a really kind of a breakthrough, important thing that we were doing these 55 dual diagnosis tests and then we didnt for reasons that i think are understandable, because we were working with the nonprofit and the nonprofit was looking for real estate and those 55 beds didnt happen. But do we still theres think theres a tremendous need for dual diagnosis beds. As i read the study, the total needs they found was 20 Mental Health residential treatment beds which maybe could all be dual diagnosis beds, but thats a very different it seeps ses like the conversation was different a year ago from the study and im trying to understand how to reconcile those two. You dont have to answer that. Doctor, can you respond to the supervisors question . Im going to ask you to take that. Thank you. Good afternoon, supervisors. And i think my first reaction is that we need for our entire system to be dual diagnosis. We have a lot of opportunities for integration and there shouldnt be as many limitations one way or the other. And the continued need of dual diagnosis beds can be addressed by improving capacity on both sides of the Mental Health and Substance Abuse system and really based on how the beds investment goes this year, exploring how well were meeting that nee needs a it needs to ben ongoing conversation. I think it would fantastic with 11 million we could solve our needs for beds. My suspicion is we probably need 55,000 dual diagnosis bed exposa similar increase that the bed study shows and i think the right way to do this is to make these investments, see if its enough and probably need to do more and then do more the next year, god willing, budget permitting. Which is another reason not to wait, but to get going. And again, i have a lot of concern what happens with this investment if the tax fails and it cannot be that we get to november and the tax reform fails and then were done with this. Like, i i hope that my colleagu, even if we go along with this plan to rely this heavily on the money that we hav we have a com. I dont like reopeningening reon the middle of the year. But this is something we should reopen, because we will be making a decision not to fully address this two years after the audit, and after discussing the same issues for years and years and years and we have a framework now that everyone agrees on. And we cant wait. And so my last question is, why is aot still a pilot . Are we doing any more with this money in the budget . I think its been a pilot in that the staff those particular staff that were talking about are going from temporary were doing a pilot to permanent works and so the aot model is going to be integrated in all of the work were doing around the office of coordinated care and compliments very much that level of the Critical Care management, that they are going to be a part of that team. Is that money i mean, the money in the budget, is there any expansion in aot there or keeping going what weve been doing . It is keeping going what weve been doing, but definitely all of what weve learned from the model, what weve learned works will be incorporated into anything new that were doing under the coordinate auspice of coordinated care. Ok, those are my questions. Thank you. Thank you, supervisor mamdelman. Supervisor walton. Thank you, chair fewer and doctor and to the entire team. Does the new budget provide funding for treatment beds, particularly after the two million was readjusted in the midyear Adjustment Plan . Dr. Simmons, you had some perspective on the daybeds. Can you comment, please . I think there are more studies that need to happen. One possible idea is that within the bed count, were including, i believe, that its 20 beds for the 12month residential, that we could make a portion allocated, which could be a dual diagnosis model based on what we have already developed and that that would reduce capacity from, you know, the adult serving system and we would need to study that more, but we could address tay through the existing Budget Proposal. And so could or would . I could walk out of this meeting right now. I mean, could or would. My understanding, we havent specifically identified a specific number of beds for tay in the beds that are proposed. I know youve said we had problems in the past locating beds for tay. Why wouldnt we carve out beds for tay knowing weve had those issues in the past . Well, i think we certainly could. Its just a matter of how much neglect do we want to have in the beds we find, given weve had historical challenges. But we could do that in this budget, as well. I hope we are able to address that. And how much revenue from the overpay executive tax, if we are fortunate enough to pass it, would be allocated towards filling the Behavioral Health vacancies . Or have you explored that yet . I can speak briefly to that, supervisor walton. The co tax proposed from the November Ballot is not assumed as a Revenue Source with the budget in front of you, to the extent that it did pass, it would be subject to future decisions by this body as to how to appropriate those funds. Well send estimates regarding what the different taxes on the ballot would be worth and were theyre included in the budget or not and so ill have that information in your hands shortly. Got it. You can see im trying to and ba little proactive, if possible. The mayors budget introduces an 11 Million Grant Program in dph and do we know what those funds are going towards . Greg . Sure, supervisor walton, we are putting together a Grant Program that is focused on individuals who have made a contribution through the City Option Program into a medical reimbursement account. Weve had a lot of conversations ourselves and through the San Francisco health plan that administers the program to help them gimp the circumstances with covid and the dollars for a number of reasons are only available for withdrawal for medical expenses under the tax codes and this is an attempt to use dollars from within the City Option Program to provide grants to those that can be used for any expense related to whats going on with covid thats not necessarily a medical expense. So its one of the set of programs that would collec wev. Collectively been working on who are out of work. So up to a 500 Grant Program for those accounts. And those would be administered through the sanfrancisco health plan. Thank you. And does this budget that is proposed right now provide for increased testing in the black community, Pacific Island community, Latino Community and all of the populations where we see increases in disproportionate amount of folks who have contracted the virus and have a high number of cases . For covid19, specifically, yes. It includes an expansion of testing specifically to test in communities where theres the highest rate of covid19 for this upcoming year. And along those lines want are your strategies to address covid19 pandemic in these same communities of color . Well, one of the key things with regard to testing is that we have a mobile testing strategy where we go and follow we go where the virus is. Right now its largely concentrated in the southeastern part of the city. So, for instance, weve implemented two mobile testing teams that are cable of doing 250 additional tests a day each and those are being deployed to the southeastern part of the city and we will also establish a permanent site in the southeastern part of the city, hopefully by september and so that will dramatically increase to test in those neighborhoods in addition to the current testing options that are available. indiscernible . Do you know what those services are . We can certainly provide that and again, i dont know if dr. Hammer or dr. Simmons would talk about those programs but we can certainly get you the amount of dollars that are allocated to those programs. Dr. Hammer or simmons, do you have more information progra programmatically . A lot of our juvenile judgment investments and partnership with the Justice System and we have specific investments we make and we hold the work order for the program which is over a 4 Million Program that is directly related to violence Supreme Court and so therand our populationspecific y intervention, they all have elements that certainly are related to preventing violence, which is a Big Public Health concern. Yeah, it would definitely be great to know the specific investment, particularly looking at the budget for spy and seneca, understanding the youth are involved in the juvenile system and, as you know, with Mental Health sf and our focus on more Healing Center practises, specific to populations that need support and look at Mental Health differently from a cultural standpoint and would love to know that. Thank you. Thank you. Supervisor, thank you. President yee. Yes, thank you, chair fewer. And thank you for all of the questions from the other supervisors. Weve talked about Mental Health quite extensively and i think what missing from me is that we havent really spoken much about the Mental Health needs of young people, younger than tay. And i spoke about Mental Health needs for well, meaning the preschoolers, already, and i know we can work on that pretty well outside of the Public Health system. Department. This is probably a big issue where Mental Health services are needed because so many kids consider suicide and stress. So can you talk a little bit about whether that has come up to your consciousness to know that we have to deal with that and i know we havent talked about it much, but theres a lot of urgency around Mental Health. Im still planning to bring that around after budget. And so hopefully, maybe you have other answers that you dont have any anticipations today. A. Thank you, president yee. Certainly we have a longstanding children and Youth Program that dr. Simmons will talk about and we can get you further information. I will say that given this unprecedented pandemic that were in, we are starting to see really Mental Health effects of people, longstanding effects of the pandemic of people who are very Pivotal Development stages and have to be thought o about n our system of care. Ill turn it over to dr. Simmon for Additional Information and we can follow up with you next week or in a different briefing for your pleasure, supervisor. Thank you. I appreciate your question, supervisor. We definitely would need a lot of time to talk about our full range of chattahooche children d Family Services and we have a lot with the foster care system and the homeless response serving children, where we try to make our services as available as early as possible and we know that and im glad you raised dys, because we know most Mental Illnesses emerge in that period and its important that were there to intervene as early as possible. We have an investment in sfusd and were expanding to middle school expose were doinschoolss in response to stabilized families, to respond to crisis more actively and engaged i engo make sure our services are present in afterschool programs and we would love you to tell you more. We understand about the importance of that age in particular and families are important because anyone in our system is part of a family at some point, regardless of how they identify or define that. So we know that work is important. I appreciate that. And i dont want to say theres no services. Theres just a lack of services. I mean, again, just using this as an example, i believe we have two Mental Health personnel oveh over two thousand kids and its not enough. If we can find ways to strengthen that piece. Im a strong believer to catch things as early as possible, to give our youngest the best chances to succeed instead of waiting for everything to be acute. Hopefully, there are others on the board because i wont be around that long to advocate for that to happen and to strengthen. And yeah, ill look forward to hearing any Additional Information you might have. Thank you. Youre welcome. Thank you. Thank you. So i have a comment, if you dont mind. Oh, supervisor ronen. I just wanted to take you back also in what supervisor yee said, that i think that through our own assessment to the sfusd, students selftestify and many asians contemplating suicide as young as middle and i think thats a silent population around Mental HealthServices Partnership want to emphasize tharound that in the Asian Community and i feel there needs to be much more support to our asian communities. This is what we have heard from Health Councillors in our schools is that asian parents also dont understand the seriousness of students stress levels and how they contribute to a high stress level and weve had suicides. Parents dont want it to be called a suicide, but there have been suicides and i think that it is really not being addressed to the level it should be, but my question to you today is, i see that you have on page six, advanced equity in our workforce and Racial Equity, black, africanamerican health and then, i gets guess, weve hd conversations about this and drt mortality rate and black infants are more likely to die in their first year of life than white infants. In california, the birth outcomes are more pronounced and in los angelos, black babies are three times more likely to die than white babies in their first year of life and a rate of nine. Six for 1,000 in contrast to the white rate of 2. 1 deaths. And so i have to ask you, with almost a 3 billion budget, what resources are putting to this problem . I think it has been persistent and has been consistent in our population. And so, what are we doing to address that . I know there was a grant and that is inadequate and an insult. What are we doing to combat that . I have fought this many times for the mayor and ive spoken to you about it. Ive spoken to many Healthcare Professionals about it, but i want you to know, also, in the Public Health realm of folks, people have said to me, what are you doing about the black infant mortality rate . San francisco is among one of the worse in the nation. And that is really, i think, inexcusable when went are one of the wealthiest cities in the u. S. Thank you. Answer, please. Thank you, chair fewer for the question and the preterm births among black africanamerican population has been a key focus of the department and one of the focuses as part of our black africanamerican health initiatives. You mentioned the dula Access Program and were continuing to work to expand that program and we are working with the Human Rights Commission to execute the abundant birth project which would take out not take out, but it would expand beyond the very specific medical interventions that have been historically focused on to make improvements in realizing that their broader contexts with socioeconomic aspects are likely driving these poor outcomes and while we focused on improving the direct care, access to care for families, that may be necessary but not efficient. Working with hrc, thi