Clerk is brent jalipa and thank jason at sfgovtv for broadcasting this meeting. I will make a motion to excuse visor walton from todays commit each why dont we begin with announcements. Thank you, a reminder for those in attendance silence cell phones not to interrupt our meetings the board and committees are convening hybrid meetings for Public Comment and Remote Access and comment via phone. Public comment on each item. Those in person will speak first and those who are weighting on the phone lineful for those watching remote and streaming through sfgov. Org the Public Comment number is strolling when connected you will hear discussions but will be in listening mode. When your item come up and Public Comment is called those in person line and up those on the phone dial star 3 to be added to the line. If you are on your phone remember to turn down your tv and listening device when each speaker allowed to speak unless otherwise stated. Submit comment in writing e mail them to myself. Upon brent dlt jalipa sfgov. Org. If you submit it e mill tell be forwarded to the supervisors and include as part of the official file. You may send written comments Via Postal Service to city hall 1 dr. Carlton b. Goodlett place room 244, San Francisco, california 94102. Items acted upon today are expected to appear on october 24th. Thank you. I like to excuse supervisor walton from todays meeting. We have a vote . On this motion. To excuse supervisor walton from the meeting vice chair mandelman. Aye. Chair ronen. Aye. We have 2 ayes with member walton excused. That pass. Read item 1 item 1, a resolution retroactively authorization public hasnt accept and extend a grant 100,000 from Purchaser Business Group for a program calhive Behavioral Health collaborative july 1 of 23 through january therein of 27. Member who is wish to comment press star 3 to enter the line. A prompt will indicate you raised your hand. Madam chair. Rachel is online . Perhaps . Im here. Grit. Thank you. Welcome. All right. So i can share a bit about calhive. It is i 3 year improvement collaborative focused on integration of Behavioral Health services and primary care. That is when we are all about, trying to treat Behavioral Health services as routine medical care by the california equality collaborative it started this past july. We are one of 8 organizations within california serving 650,000 members that have been selected to payment of this collaborative focused on supports us improving how we integrate the services to primary care now. And it will help us with expanding our screening and referrals for patients with mild to moderate conditions. Fantastic. And i will also yes. Add, i dont know if sure, direct benefit is increasing Patient Access to Behavioral HealthServices Part of the proirm care setting and improving the out come this patients are presented with. Well is access and out come. Sounds great dont think there are questions if we can open this up for Public Comment . Member when is wish to speak item 1 and joining person line and up those remotely press star 3 to enter the line. For those in the queue continue to wait until you have unmuted. No in person speakers here. And just checking. We have no one in the queue. Public comment is closed. I like to make a motion to send this to the board with positive recommendation. On that motion vice chair mandelman. Ayech chair ronen. Aye. We have two with member walton excused that passes unanimously. Thank you. Mr. Clerk read. Item 2. Item 2 a resolution approving the Grant Agreement with pick Episcopal Community service for the cova a shelter extending the term by 10 months a term of december 18 of 21llow august 21 of 2024 increasing the amount by 5. 1 million for a total not to exceed 15 million. And authorizing hsh to enter in amendments or modifications to the agreement not increase the obligations or liabilities or decrease the benefits to the city. And we are in receipt of a memorandum from your desk this item be referred as a Committee Report for the october 17 board meeting. Members joining remote and wish to comment press star 3 to enter the lionel. Thank you. And emily cohen from hsh will present. Thank you. Good morning vice chair mandelman im emily cohen with department of homelessness and Supportive Housing im before you today with a resolution that would approve the third amendment to the Grant Agreement between the d. Homelessness and Supportive Housing with the Episcopal Community service for service the cova shelter located at 655 elis street. This amendment would extend the term by 10 months to the end of august, 2024 and alignment with the booking agreement for that hotel. This amendment would increase the not to exceed amount by 1. 5 million a total of 15 million for 10 months of service at this shelter. The site has the capacity to serve 109 adults across 89 rooms. A couple are larger. Can fit multiple peopleful operations like service, daily management. Janitorial, meals. Case management and all of the service involved in operating the shelter. The cost of the agreement for fy23 24 is 144 dollars per bed per night, includes 2 hot meals per day. The other cost associated with this project is the 75 dollar per night booking agreement approved by this committee. Jot program accounts for 89 units of our over 2460 bed adult shelter system. 568 of these beds including the cova are noncongregate. We have been growing the noncongregate of the system since covid. As october fifth occupancy was 95 . Open nothing december of 21 and the end of last fiscal the site served 255 people. And continued to be popular site for folks living unsheltered in the community. This site has a high acceptance rate when offered in the community. I will stop there and take questions. Before questions well hear from the budget and legislative analyst. Good morning. Nick from the budget and analyst officer. A resolution approved the third amendment to hsh grant with Episcopal Community service it extend its through august of 24. And increases Spending Authority by 5. 1 Million Dollars. The grant alighthouse hsh to fund to operate a shelter at 6 55 elis street the capacity of 109 adults. There was a performance monitoring site visit in april of 23. By hsh staff. Which found this ecs failed to comply with the most of the Major Contract requirements. And you other than under take activities they were paid to do this year. They were some significant operational findings including not providing train to staff or wellness checks in the keeping a log of maintenance requests of guests and 91 of the service out come or service and outcome goals in the agreement turning over rooms referring clients to services or clients document red for housing. Were complete. So, i think this is a very significant set of findings and in fact hsh did require a corrective action plan for Episcopal Services to remedy the findings and the department has reported to us that than i are going to go become to the site, mid year in january of 24. To do another site visit. Buoy do think that another check in before it is less than a year agreement. Or exception i think another check in would be the board level would be warranted. This reason our recommendation for the department on come become during the budget process and provide you an update about the performance of this grant. You know my impression is that a lot of the change, a lot of the issues here have been pinned on a site manager replaced. I you know i do it is more me an open question whether a larger organizational issue here. And so for that reason a check in in june at the budget process where the department can say, look the provider is back on track. Delivering the service or we could went back in january did in the see improvement so we switched providers and this is also significant because as we discussed on page 6 of our report. Funding for the guarantee is shifting state sources to the general nunned is a local low funded program at a time when the mayor issued budget instructions. I think it makes sense it move forward today but check become in, in june. Thank you i wonder if the Deputy Director could independent to the blas concerns and recommendations. Absolutely. Thank you, chair. You know appreciate mr. Miin regard and their work. This is as he noted we have done will Shelter Program monitoring at this site. The findings were unacceptable. And enter in the i corrective action memo which Episcopal Community service is a huge provider of social services in the community. Findings were not consistent with other Program Monitoring of other programs under their leadership. Since that time in april we had a productive, very dill gent working relationship with ecs to correct these. Replaced the site manager at the cova. And actively hiring a new care cord narrator. The dataent row is updated daily. And all client intakes and exits are updated within 24 hours of move in our move out. It was a challenge. Most rooms are cleand and ready for new guests within 72 hours which is our big findings. And only rooms with significant damage off line longer than that. The intake paperwork and program orientations are completed with each client upon move in. And increased daily room inspections and improved keeping update logs. A lot of the prescriptional issues identified did go become to a staffing issue. And and a bit of context this start during the shelter in place. It has been we dont know if we have funding keep going. There has been back and fort for the provider we have not had that contract for more then and there a year at a time. The leadership has been responsive and is now operating the program in a way that is more consistent with our standards. We will had another site monitoring scheduled in january. We will do informal needed between now and then and the regularly with provide and our shelter team to ensure operationers improving and the out come of the program continue to improve. We are happy to report become during the budget press on how that guess. We could also yea. That is a good solution. Good recommendation. Supervisor mandelman. This raises interesting questions about how we are using hotels for maun congregate shelter. The one hand. Am i understanding this, the per might cost is 140 per room plus 75. Correct the year you guest 80,000. Seems expensive for shelter. Yes. And yet may be is in the enough. To make this shelter work. Or may be it is. Can you talk b. Is there how are we using im interested in how we are using hotels or using shelter theyre is like a room. That feels very much like psh but shelter. How is this building fitting in our portfolio, when are we using it for. How do we decide who is going in there . These are all great questions. Throughout chair being supervisor mandelman, this program is more expensive on per night per bed base than our congregate shelters. This is in the as much on the operating side although some and a lot on the booking agreement. Book agreement because we enter in this agreement during the beginning of the pandemic and it was an urgent time to bring on hotels quickly. Lots of advocacy from the board and board and open hotels quickly we opened 25 and had is one and pid a promotium for the hotels we opened during the covid pandemic. We kept this and 2 other hotels to function as shelter. And they add an important component to our system in this they are attract ever to folks living on the street. Often times more than a congregate shelter. Offer more privacy. More dignity. 2 meals a day. And but what we see is we are paying a higher price. Goal for the longterm is enter in a master lease for this property or similar property so we could bring down that night lie rate and pay a flat annual cost or monthly cost for the lease similar to with other shelter projects or longterm lease. I think that would bring down the cost am noncongregate programs have a staffing and need staffing to be monitoring folks. And so providing the wellness checks. Engaging folk its is harder when they dont come to the dining room. There is a lot of proactive work on behalf of the. Staff. The Community Service system here and can answer questions about staffing better than i could. I say i dont know this we need to fund more staffing as much as ensure that every position is filled. That the site and others. This is a challenge cross our sector. To have enough staff to feel operate our programs. I would be surprise federal in the an over doze death at this building do you know how many . I dont know. We can find out while we are talking. And can you talk about how our system is who gets this . Yea. Whats the profile of the person going in the door. So, it various. We have a central shelter place am process. On a daily base every shelter report in vacancies go in the system. And those beds are allocated daily tow a variety of team usa. Include the homeless out reach. Healthy streets operation center. Street Crisis Response team. Hospital discharge and transfer. Really depends when gets the beds allocated. Why this is the cadillac. How do you get the cadillac. Depends on the out roach and how it is going and what we want to match people who need this service. We see a high aqueuity in this building and a lot of folks coming in sleeping outside who have not been sleeping in other shelters. It is diverse. Do you have data on how many folks there are would have a Mental Health diagnose. I dont have that with me im sure we can get. I would love all that stuff. I have concerns. How long are people staying there . We dont have a limit on shelters we see folks varying in their leth of stay. Across our system about 90 to 100 day system our average what is the average. Joy dont have specific data would love that. We can get that and curious also for data on where people are going to if they are going to other shelter or the street or dsh or other. We will get that to you. And then what extent is are any of the look back, are any of the measures, they were not meeting the metrics that we had done. Any related to their management of the street outside. The facility. You know we have a Good Neighbor policy in all of our program contracts. But it has until now has not been. Not been something we had measurable bench marks electronic in the our Program Monitoring this is manage we are w to add to the programs cross the board. Tell take awhile that is manage we are look to create bench marks and deliverables on. There have been 4 over dose at this site in the last fiscal year and 2 we know were reversed and 2 we dont know the out come of. At the time the person was taken to the hospital. We might not have gotten that update. Surprisingly a delightfully low. Very positive. Transgenderic as the 2 deaths are. I think it would make sense and i think i mean supervisor robe sxen i talked about this but if we will be making the claim we need to put more. We need more facilities. Whether shelter or housing or all of the above. And i think i still believe the city does a poor job of ensure the facilities we put in neighborhoods. Supervisor ronen has been a champion of facilities. We still are in the doing the job we had be as a city ensure the facilities are a benefit in the a detriment. Im not sure what is hatchoth 600 block of ellis i know the 700 block was you know has a lot of challenges. This was a Tourist Hotel prepandemic a neighborhood that is struggling. I think we want to make sure that the use are in the making things worse. So. Yea. I dont know if anyone wants to address anything. You dont have to. Good morning. Im chris the chief Program Officers at esf. I am happy to address your questions. For context, the program started as a shelter in place hotel. Last winter it bipartisan a winter shelter. And in upon january this year it became a noncongregate shelter. We had a series of changes and each has a different operating model and expectations. So, the monitoring happen in the april and operating under shelter model since april and our staff did in the transition well from having provided several years of sip service its now providing the shelter service, which is miles an hour hands on, which is more engaged with the guests. We appreciate hsh rerue and their support and working with us to enabling improvements. Bear with us a lot. The we are happy to come back in june hsh was out scombrft went through a full monitoring and the improvements were well noted. We appreciate that and the continued support. As to the street. We pay a lot of attention to the street in front of the building. The block is dense. On the street as you know. And we dont have the staff or capacity to monitor the entire block. We keep our side of the street our plot there as clear as we can. And i think it is a whole neighborhood effort that would need to happen. We are willing to be part of the solution as well. What is your sense how many folks in the cova are experiencing disorders . I dont have i number for you i would hazzard to guess. It is similar to all other shelter environments. S i would say. More than 50 . We have shelters that are specifically you know recognizing that the folk there is have Mental Health issues and pend machineo trying to address those. I made a deal how expense than i is. Might be not expensive enough. Are you resourced to address the Mental Health, Behavioral Health and, diction needs of the people we are throwing at you. When positive in the last year the case managers to the shelter environment, this cant be u