We also we use this information also to think about how we allocate funding. One of the things weve been able to do i guess in the last year with the nutrition request for proposal, we were able to look at the impact we had on people and start thinking about allocating those dollars a little bit differently and you probably remember we talked about that when linda lou came and presented on the nutrition contracts we had. And then in longterm care operations, we launched the support home pilot to serve older adults who have functional needs tore home care. Those unable to buy home care on the private market. And then because thats a pilot, we also have engaged ucsf to conduct a formal evaluation of that program. Now we can go to the next slide. So, Additional Community 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 gunda. And we havent been able to keep that up over the past few years. We need to grow the staff. Were working to do that. And we just get challenges. But once we do that, well be doing more outreach and then i think that will help to get more people in the door. Ok, the other question is, this year the dignity fund is 6 million and next year will be 3 million, is that in addition to the 6 million . Yes. Commissioner loo with the additional 3 million are you going to expand programs like this year, you have some programs expansion, nutrition, et cetera. Next year will be the same . Or different programs . Director mcspadden well be working with the oversight and Advisory Committee to work that out. We dont have a plan in place fort 3 million. Our department has ideas, but we need to take that and put it together and take it to the Advisory Committee and then bringing it here to the full commission. One of the things that happened in the current year is that the dignity Fund Increase paid for what we call cost of doing business increases or inflationary increases. In the programs that are covered by the dignity fund. So thats an issue well have to face again going forward. So a chunk of that money will go to offsetting increasing costs in existing program. Are there any questions for shireen from the public . Any more questions for dan . Yes. On the commission. I like your pie charts. They help me a lot. I am grateful, youre really he helpful. What i would like, if at all possible, when we do the next budget, for this fiscal year, if we could have comparison pie chart for last year and this year, it would be helpful. Absolutely, we can do that. Can i add to that, too. The hsa budget and daas budget compared to the entire city budget as well. Not broken out in extreme detail, but it would be good to see that based on the questions before about how we prioritize funding the needs for the populations, certainly with potential risks in the near future, too. Sure. Thanks. I have a question for dan. Im looking at the mayors fiscal year 1819, 1920, budget projection. Thank you. Why are we still very uncomfortable when you have the revenue increase for social services, ok, and then 1819 is 189. 9 million, and the 1920 is 450. 7, im just wondering how did they arrive at these figures . Yeah, these are the citywide. Yes, i know its citywide. So basically, the city staff that does this looks at patterns of collections, they look at economic trends, they look at any changes in the law, and they attempt to build the revenue forecast around those patterns of growth. You know, this is any governmental entity has to have a model for doing revenue projection. And you know, it will take into account things like population, Business Activity in the case of a local government, the value of real estate. Real estate sales. So all of these things get worked in. San francisco, where we have a fairly vibrant tourist industry, that becomes a big component of it. I know that. They have that revenue projection, i was at that meeting. Do you have does daas have revenue projection . I would say there is a local government revenue projection that is done by the city. And then when we build the hsa budget, we also look at revenues that are much more tied to our actual programs. So when you have social Services Programs that have federal and state funding, we have to be very aware about changes in the federal and state funding. And we build those into our incremental revenue projections. So those come on top of what the city does for city general funds. Ask me a little bit more specifically about what youre looking for. Woo woo commissioner loo its just one of my concerns and im looking at how people do the projection. If you compare, its almost two and a half times. Its huge. Im just curious. I dont know. And you may not know the answer, because they have that. I do not. I will see if we can get there is a presentation document on the forecast, which im happy to share with you how much backup and description there is. I know there is one and theyve developed the models. Im not sure how much they developed. Does daas have projection for 1819 revenue . They do. And they would have projections its not here. They would have projections for 2021. No, we havent provided any detail on that. Ok. Any question from the commissioners . Any question from the public for dan . Is there Public Comment . Yeah. Can you step up . So this is not really a question, but a few comments. Im marie job ling and today, im speaking as executive director of the Community Living campaign i want to send greetings to the daas staff and colleagues and the commissioners. Part of what weve done all along is advocacy and one of the big pieces was to work with for the dignity fund. And advocacy, when you gain ground, you have to stand up and fight when they come to take it away. There is a Charter Amendment at the board of supervisors. There is one particular amendment that they have that is particularly troubling. And it has to do with the way funds would work. Different than what was proposed in the legislation. So the dignity fund, one of the things we liked about it, once money was put in the fund and all of the kind of existing ooa funds, because the new money was put into a fund, portion of that protected but it stays in the fund. It gives us a better chance to plan and allocate over multiple years. One of the things in the amendment begins to change that and spells out a way that funds could be clawed back to the general fund. Not real clear exactly when and how that would happen, and in our talk about policymakers, they say, no, no, you dont have to worry about this, but we know we do. One of the things i wanted to share a case study from our agency in terms of funding that we fought for Employment Services for seniors and people with disabilities. This was predignity fund. So our hope is that in the new world order things wouldnt happen like there. I have to say, the Department Staff was very open and we had meetings and we really i think they heard the issues, but its a systemic issue and we want to be sure that it doesnt what would be fixed with the dignity fund now doesnt have that opportunity. So one of these i can give you. If you wouldnt mind. Is this case study. And really, it just is the way that in the course of doing business, how funding that is allocated in the budget, gets a portion of it, maybe not all of it goes into a contract and these are the ways that the funding can be lost. Its not just about our contract, not just this department, it happens all over the place. We hope youll read that and Pay Attention to what is happening in the rules committee and if youre able go tomorrow. If there is any way to recoup some of the funding for Employment Related Services that would be great, too. Thank you. Any comment . Valerie. Senior center. I dont know where this goes. I have to just be very clear, but something that has been percolating in the community is that were all struggling to keep staff. And we all know that is both because of the cost of living in our lovely city, as well as the fact that the salaries and benefit and things that we want to give the employees continue to grow. So in this kind of morazz of conversations about money, its great to expand programs. I think weve done a great job in support of the department has been stellar, but i do feel like there is this elephant in the room. If you cant get people to work, then there is this money that sits there and or that we have to give it back. So id really i know that shireen mentioned workforce at the longterm care coordinating council. And often times we focus on geriatric aids and that level, but this is a really a crisis. We have physicians that stay open. Were having to bring people in much higher than we have on the normal salary scales to keep them. So i hope that we at San Francisco can figure out a way to do this. I know we cant provide housing for all of our nonprofit employees. But there is this thing that is happening in the background. An example would be that Health Promotion program is very popular. People want it. And weve been invited to certain communities. And even just getting independent contractor exercise leaders is really tough. So when we look at this, if we could also just keep that in mind when we talk about funding. The cost of doing business that the Mayors Office has put in, 2. 5 , just barely, i mean it doesnt even help us stay where were at today. Thank you. I have no answer for you. Sorry. Any other comments . Questions . Announcements . Maybe its lunch time . Motion to adjourn the meeting . So moved. Adjourned. Thank you for coming. Tenderloin is unique neighborhood where geographically place in downtown San Francisco and on every Street Corner have liquor store in the corner it stores pretty much every single block has a liquor store but there are impoverishes Grocery Stores im the cocoordinated of the Healthy Corner store collaboration close to 35 hundred residents 4 thousand are children the medium is about 23,000 a year so a low Income Neighborhood many new immigrants and many people on fixed incomes residents have it travel outside of their neighborhood to assess fruits and vegetables it can be come senator for seniors and hard to travel get on a bus to get an apple or a pear or like tomatoes to fit into their meals my my name is ryan the cocoordinate for the tenderloin healthy store he coalition we work in the neighborhood trying to support Small Businesses and improving access to healthy produce in the tenderloin that is one of the most neighborhoods that didnt have access to a full Service Grocery store and we california together out of the meeting held in 2012 through the Major Development center the survey with the corners stores many stores do have access and some are bad quality and an overwhelming support from Community Members wanting to utilities the service spas we decided to work with the Small Businesses as their role within the community and bringing more Fresh Produce produce cerebrothe neighborhood their compassionate about creating a healthy environment when we get into the work they rise up to leadership. The Different Stores and assessment and trying to get them to understand the value of having Healthy Foods at a reasonable price you can offer people fruits and vegetables and healthy produce they cant afford it not going to be able to allow it so thats why i want to get involved and we just make sure that there are alternatives to people can come into a store and not just see cookies and candies and potting chips and that kind of thing hi, im cindy the director of the a preif you believe program it is so important about Healthy Retail in the low Income Community is how it brings that health and hope to the communities i worked in the tenderloin for 20 years the difference you walk out the door and there is a bright new list of fresh fruits and vegetables some place you know is safe and welcoming it makes. Huge difference to the whole environment of the community what so important about retail environments in those neighborhoods it that sense of dignity and Community Safe way. This is why it is important for the neighborhood we have families that needs healthy have a lot of families that live up here most of them fruits and vegetables so thats good as far been doing good. Now that i had this this is really great for me, i, go and get fresh fruits and vegetables it is healthy being a diabetic youre not supposed to get carbons but getting extra food a all carbons not eating a lot of vegetables was bringing up my whether or not pressure once i got on the program everybody o everything i lost weight and my Blood Pressure came down helped in so many different ways the most important piece to me when we start seeing the Business Owners engagement and their participation in the program but how proud to speak that is the most moving piece of this program yes economic and social benefits and so forth but the personal pride Business Owners talk about in the program is interesting and regarding starting to understand how theyre part of the larger fabric of the community and this is just not the corner store they have influence over their community. It is an owner of this in the department of interior i see the great impact usually that is like people having especially with a small family think liquor store sells alcohol traditional alcohol but when they see this their vision is changed it is a small Grocery Store for them so they more options not just beer and wine but Healthy Options good for the business and good for the community i wish to have more third thursdays at the commons is a monthly event series to really activate krisk centkrisk civic center, fulton mall, and other locations through social operation. In 2016, an initiative called the civic Center Progress initiative was launched, it was launched by a bunch of city agencies and community partners, so they really had to figure out how to program these places on a more frequent basis. Im with the Civic Center Community benefit district, and im Program Manager for the civic center commons. Also, third thursdays will have music. That was really important in the planning of these events. We wanted to have an artist that appeals to a wide range of tastes. Im the venue manager. Good music, good music systems, and real bands with guitar players and drummers. We turned uc center and fulton street into a place where people want to be to meet, to laugh, and its just an amazing place to be. Theres a number of different exhibits. Theres food, wine, cocktails, and the idea, again, is to give people an opportunity to enjoy what really is, you know, one of the great civic faces in america. When you look from the polk street steps, and you look all the way down the plaza, down market street, daniel burns design, this was meant to be this way. Its really special. The city approached us off the grid to provide food and beverages at the event as kind of the core anchor to encourage people who leave a reason to stay. Its really vibrant. Its really great, just people Walking Around having a good time. This formula is great food, interesting music, and then, we wanted to have something a little more, so we partnered with noise pop, and they brought in some really fun games. We have skeeball, we also have roller skating lessons, and weve got a roller skating rink. If youre a passion jail skeeball player like me, and youre deciding whether youre just going to roll the ball up the middle or take a bank shot. Our goal is to come out and have fun with their neighbors, but our goal is to really see in the comments that its a place where people want to hold their own public event. I think this is a perfect example of all these people working together. Everybodys kind of come together to provide this support and services that they can to activate this area. Theres no one agency or organization that really can make this space come alive on its own, and its really through the collective will, not just of the public sector, but both the public and our business partnerships, our nonprofits partnerships, you know, neighborhood activists. I really like it. Its, like, a great way to get people to find out about local things, cuisine, like, its really great. Its a really good environment, really welcoming. Like, were having a great time. We want to inspire other people to do this, just using a part of the plaza, and its also a good way to introduce people if theyre having a large scale event or small scale event, well direct you to the right people at the commons so you can get your event planned. Being a San Francisco based company, it was really important to connect and engage with san franciscans. How great is it to come out from city hall and enjoy great music, and be able to enjoy a comtail, maybe throw a bocci ball or skee ball. I find third thursdays to be really reinrig rat reinriggating for me. Whether youre in the city hall or financial district or anywhere, just come on down on third thursdays and enjoy the music, enjoy an adult beverage, enjoy the skee ball; enjoy an adult playground, if you the office of controllers Whistle Blower Program is how City Employees and recipient sound the alarm an fraud address wait in City Government charitable complaints results in investigation that improves the efficiency of City Government that. 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