Throughout the year. Fiscals. I have already gone over from the oewd. We maintain our budget and exceed our fundraising efforts. And thats 1718 there. Are there any questions . Okay. Thank you so much. Thank you. Are there any members of the public that wish to testify on this item . Seeing none, Public Comment is closed. Mr. Chairman, i would move that we send this to the full board with a positive recommendation. Great. Done. Thank you. [gavel] mr. Clerk, please call item number 5. Resolution receive around approving the annual report for the ocean Avenue Community benefit district for the fiscal year 20172018. Welcome back up, ms. Mar. Thank you. So ocean avenue is an initial assessment budget of 239,578. First established in 2010 and set to expire on june 30th, 2025. Their staff is executive director daniel weaver, the Service Areas are safety and community ambassadors, cleaning program, administration and corporate operations. We reviewed the same benchmarks for ocean avenue c. B. D. , variouses in benchmark 2, theyre required to raise 1 of the nonassessment revenue from i mean, the total budget from nonassessment sources. For all of the four benchmarks, they were able to meet them. Management plan versus annual budget, they met this requirement. They met their assessment revenue versus other income requirements. Their budget versus actuals and they indicated their carryover in their annual reports and designated a spenddown plan. In inclusion, they have conformed well in implementing the service plan in the district. They implemented all recommendations recommendations from fiscal year 20172018. They partnered with o. 34678i. Culture project, a high school to begin ocean avenue arts bazaar and a monthly event series in unity plaza. They worked with Small BusinessFacade Program to make over two storefronts. They maintain several subcommittees and a board of directors. And id like to invite up mr. Dan weaver. Good morning, supervisors. This is an area map of the c. B. D. Basically were along ocean avenue we also provide services to the City College Campus there at the eastern end of the district. We have two very active committees, street life committee, focusing on activation of the Retail District and the business committee, concerned with Small Business growth or attraction, growth and retention. This is a list of our Partner Organizations and nonprofit sector. And our government Partner Organizations. In fiscal year 1718, o. A. A. Secured nonassessment grant funding, which brought our this augments our assessment revenue to bring our total revenue to 429,511, enables us to conduct projects connected to our goals of marketing, beautification, maintenance, and cleaning. Focusing on our largest budget item, maintenance, cleaning and safety, weve employed clean scapes, which provides street Maintenance Service six days a week. Sidewalk and gutter, trash pickup, Pressure Washing and cleaning and graffiti removal, when needed. An arborist now which maintains our urban forest. O. A. A. Maintains sidewalk gardens, an increasing amount i must say. Its a very popular thing in the neighborhood. Sidewalk gardens on ocean avenue and on perpendicular side streets. O. A. A. s project utilize neighborhood volunteers for planting and garden maintenance. And o. A. A. Maintains the ocean, geneva green space and a number of other spaces, which o. A. A. Established through grants in 2017. Thats the wrong direction. Yes. This is our best example of activating a public space. This is the new unity plaza. And this is youth art exchange, Lake Meridian high school and other neighborhood nonprofits celebrating an event, annual spring event in the plaza for the first time. Challenges we have in our district include everincreasing high rents, designchallenged business spaces lead to longterm vacancies. Property owners and Business Owners underinvest in their storefronts, giving some facades a beatup, shopworn experience. And Perspective Development projects threaten to take away sidewalklevel storefronts. And replace them. Opportunities. Theres a high interest in the neighborhood for public art events and entertainment, as well as Tree Planting and landscaping, as i said. O. A. A. Is working to program free Public Events and install new public artworks on the corridor. New businesses establishing an ocean avenue, to bring the potential for Business Owners to participate and advocating for the ocean Avenue Community. Development projects on ocean have the potential to provide new retail spaces in a variety of sizes. Looking back from 1718, when this report was prepared, or focused on, our project and visions include continuing to develop activities around unity plaza, pursuing Maintenance Agreement for balboa park, bart station area, which is a big challenge for us. And other transit yards to make them attractive places and places that are well maintained and safe. Successfully raise funds for a new sculpttural gateway, this will connect the ocean avenue sidewalk and be a pedestrian and planned to be a pedestrian and bicycle route from the new balboa reservoir to the ocean avenue sidewalk and transit. Develop and promote projects in the o. A. A. s 15year plan for the c. B. D. Corridor, that focuses on transit station area, including the balboa park, bart station and the sfmta streetcar maintenance facilities. Thank you. I just want to point out in this final picture the cross on the elray theatre tower. Its ideally going to become a focus on the western side of our Retail District. Although for many years its been not available for people. And it has become very run down. We are trying to work with the owners and developers and move this project forward as fast as we can. This was happening back in 1718. And its still happening. Thats it. Do you have any questions . Thank you, mr. Weaver in any questions . Any members of the public that wish to testify on this item . Seeing none, Public Comment is closed. [gavel] colleagues can we send this to the full board with positive recommendation, without objection . Great. [gavel] mr. Clerk, please call item number six. A resolution receiving and approving an annual report for the top of broadway Community Benefit district for 20172018. Ms. Mar . Lastly, with we have the annual report report for top of broadway. Top of broadway c. B. D. Is the smallest cracked we have in our portfolio. An initial assessment budget of 106,567. Established in 2013, and is set to expire on june 30th, 2021. The staff is the executive director marco epantry and dominick lepantry. District identity, street operations, beautification and order. And administration, organization, and corporate operations. We reviewed the same benchmarks for top of broadway c. B. D. The only variance was they were required to raise 1 of the total budget from nonassessment forces. This the top of broadway c. B. D. Met all following four benchmarks. Their Management Plan versus annual budgets, assessment revenue and other income, they were able to raise 37. 5 in nonassessment revenue. The budget versus actuals and they had indicated their 1718 kariover in the annual reports and designated a spenddowntime line. Our recommendations and findings. The top of broadway c. B. D. Met all four benchmarks. There was a significant decrease in the amount of contributions given to the c. B. D. The number would have been lower, not for a grant that the c. B. D. Had received and utilized in fiscal year 1718. Continued decrease would be hazardous to the c. B. D. s longterm health and to the implementation of its Management Plan. The c. B. D. Was able to maintain an active board of directors and Committee Members as well. Are there any questions for staff . So id like to invite up mr. Dominick lemandry to present on his statements. Good morning. I believe im the last presentation on c. B. D. S today. So thank you. Ill make this brief. As helen mentioned, my name is dominick lemandry. Im the district manager for c. B. D. Our mission top of broadway c. B. D. Is quite simple. Were here to essentially increase the quality of life and entrepreneurial vitality. So just in general, Background Information on the district. It was formed in 2013. It started services in 2014. 39 parcels, over 100 businesses and operating budget of around 177,000 a year. And we provide sevendayaweek sidewalk betweening between 8 0. A budget breakdown. As you can see, the majority of our income comes from our assessments, but weve been very successful in bringing in nonassessment revenue, sponsorships, donations and weve been able to leverage that to continue services, even though we have quite small assessment amount. And you can see our breakdown of our budget right there. The district identity, operations and admin. So our Strategic Vision and plan for broadway is essentially can be bulleted down to a few point. Create a safe environment for the neighborhood, increase the walkability of the neighborhood and different street scape enhancements, further integrate the community in the surrounding north beach community, jon square, get them rolling in the same direction, all, you know, have the same vision of what broadway can be. And we facilitate this mission and this vision through three separate committees, that we, you know, meet regularly to decide and collaborate. So the First Committee is federal cooperations. You know, just like every other c. B. D. Thats presented today, we sweep sidewalks, we pressure wash, we remove graffiti, remove needles. And we move illegal dumped materials. Heres some highlights of our staff. Were able to provide neartotal coverage last year of sidewalks on broadway, with is great, although were small, we produce a lot of trash on our streets. Having the district look presentable day in and day out, definitely a shining achievement of ours. We are able to remove 9,000 bags of trash, over 1200 instances of graffiti. Illegal dumping incidents did decrease, because i attribute that to increased effectiveness of d. P. W. Of removing that off the street before our porters are able to report it and remove. We pressure washed the district 14 times. District identity. Its Smaller Committee versus federal cooperations. But we had big achievements last year. We put in ten Historical Markers in and around broadway. We put up lighting installation, l. E. D. Lighting installation that wind ised over the steps to help illuminate the corridor. We can change it based on the season. So its very exciting. Were able to collaborate to install cams in and around broadway, that are then serviced by north beach citizens. Its a very collaborative effort and were very proud of that. Some community probables. The installation, weve got good press from hood line. Im talking about the probably that were doing and the north Beach Association did at the bottom of grant avenue. The Historical Marker project, putting ten blocks in and around broadway, the surf rider districtwide installations. We put ten cams around broad bray and the can placement, at the corner of kearny and broadway, based off our advocacy. District challenges. A lot of the similar challenges you see all around the city, homelessness continues to be a paramount concern. I can say that definitely has improved over the last two to three years. Illegal dumping of commercial waste, as well as, you know, just residential belongings continue to pop up on our sidewalks. We do our best to get them off the sidewalks as soon as possible. And we have a couple of longterm vacancies on broadway unfortunately. Those are continued sites of, you know, encampments and what not. The bottom photos are the trees fallen over on broadway. Thats all one tree. This is one of the biggest problems we had on broadway this past fiscal year. Where weve had 40 to 50 of the trees on broadway put in after the broadway street scape improvement project. Theyve paved over or replanted. This tree in particular was reported for three weeks on about the dangerous leaning, until it finally fell over and laid on the sidewalk for 72 hours before it was removed. This is broadway. So this is not a side street. This is a very active thoroughfare. Ness something that we continue to work with b. U. F. And d. P. W. On to make sure it doesnt happen again. Part of our organizations, i mentioned a few of them throughout my mention. We couldnt do without help from helen and chris. They run this program very efficiently and very effectively so kudos to them. D. P. W. , and we work very closely with Central Station and the captain there. We have strong ties with the Broadway Community and the broadway cultural society. We work with the north beach citizens, north beach neighbor, north beach business association, t. H. C. And Jackson Square and, of course, supervisor peskin. Thank you. Do you have any questions . Yeah. Thank you so much. Are there any members of the public that wish to testify on this item . Seeing none, Public Comment is closed. [gavel] and i would send this make a motion to send this to the full board with a positive recommendation. All right. [gavel] mr. Clerk, please call item numberhearing to receive the office of the chief medical examiners annual report on staffing and accreditation updates, as required by admin code section 2a 30. Supervisor peskin. Thank you, chair mar. Colleagues, i called for this hearing back in may, after it came to my attention. Actually a perennial issue now for a long time. This dates back to the beginning of this century, with a civil grand jury report in 19992000, that spoke to deficiencies in the medical Examiners Office. I received complaints from individuals who have waited, what i think is far too long and beyond the industry practices, to get death certificates and final autopsy reports. There has been an ongoing chronic staff shortage, a lot of staff turnovers. As a matter of fact, right now we dont we have an acting medical examiner. Our last medical examiner upped and left the medical Examiners Office. It has lost its accreditation. There have been chronic problems with having their annual reports posted online. There is evidence that annual reports have been changed after the fact. And so i want to delve into every aspect of this, with an eye not to be critical, but see if we can all collaborate together with the city administrator to fix it and make it a shining example of what a medical Examiners Office can and should be. To that end, i would actually like to continue this to our first meeting on october, on october 3rd, to give my office a chance to sit down with staff at the medical Examiners Office. So we can start a constructive dialogue in advance of this hearing. So subject to Public Comment, i would like to make a motion to continue this item to the 3rd day of october. Thank you, supervisor peskin. Lets do Public Comment first. And are from any are there any members of the public that want to testify to this item . Seeing none, Public Comment is closed. Do we have a motion to continue this to 3rd october, 2019. October 3rd. G. A. O. Committee meeting. Seconded motion made by supervisor peskin, seconded by supervisor brown. Can we take that without objection . Great. [gavel] and any further business . There is no further business. We are adjourned. Thank you. [gavel] they are joining us today because we know this work is not easy. Im joined here today by the director of Mental Health reform, grant colfax who is our director of the department of Public Health as well as yolanda who has been a client here for some time and she will be speaking to you later today. Thank you for being here and all the folks who are doing the hard work. We know that Mental Health there is a Mental Health crisis here in San Francisco and i know that we often times hear that were being thrown around loosely. But the fact is that as someone who grew up in San Francisco and know that we have had challenges in this city, including issues around homelessness, what i see is something that ive never seen in my lifetime of growing up in the city and that is people who are in serious, serious crisis. Serious need. And the fact is, in San Francisco, the frustration is that we have a lot of resources. We have a lot we have a lot of dedicated revenues to help spousht support people, but we have discovered that the coordination has to be better and more efficient to really help people that we know are struggling. So we have people who have, as we unfortunately know, theyre homeless. They have challenges with addiction. They have a number of other ailments, including Mental Illness, and unfortunately have nowhere to go but the streets. We need to make sure were prepared to meet people where they are. We know that people are cycling in and out of our Emergency Rooms and only to be released, to be back right on the streets where they came from. Our jails and theyre having trouble staying stable in our Shelter Systems and trouble maintaining housing. When i was on the board of supervisors, i had a number of clients that i was specifically dedicated to, to have a better understanding of how the system was working and whether or not it could help to reach them and, sadly, those three clients who im still connected with, are still struggle on our streets. We have to end the cycle. We have to do more and we have to be prepared to make the hardest decisions that weve ever made before. Residents like yolanda are amazing Success Stories and she has been a client here since 2009 and has really turned her life around and im really happy to have her here today. The good news is that, you know, when the city focuses and works together to address these issues, we can actually accomplish great things. Back in march, i announced that we were hiring a director of Mental Health reform because that is exactly what we need to do with this system. Dr. Anton will be speaking a little bit later about what hes been doing suns he has taken over this role back in march to get us on track. Today, we are launching an initiative to help those who are the most in need. At those Cross Sections of homelessness, Mental Illness and Substance Use disorder. And our plan is to better coordinate the care. Now i know youve all heard about the numbers. But the fact is the data with the numbers and the information wasnt necessarily clear. And that is a big part of what we want to talk about today. What is actually we see it. We know it is happening. We heard that there was data, but the fact is there wasnt really data in really clear, coordinated efforts. And so the ability to address this issue comes with understanding what is going on with the people and that includes the data. And analyzing the folks who are in and out of our system, understanding if they were offered services or why they refused services and where theyre located after their refused services. Through this analysis done by the health department, through dr. S nagusaplan and the department of Public Health, we have been able to identify 4,000 people with the characteristics of the population who are really in need through these various diagnosis. And of the 4,000 individuals that weve identified who struggle with these particular challenges, 41 are in crisis, which is demonstrated by their high use of the Emergency Psychiatric Services and 95 suffer from alcohol use disorder and the sad reality is what were seeing is there is a real issue of equity because 35 are african american, despite the fact that we have a population of not even 6 of African Americans here in San Francisco overall. This is just the beginning. The first step of this initiative that we are proposing today is understanding the data, analyzing the data, and also making direct impacts on the particular population and really digging deep into those particular issues with those particular individuals. And now as a result, what we plan to do about it, this is just the beginning of several initiatives that we planned to announce to ream get deep into the weeds of addressing Mental Health in San Francisco. I want to be clear. There is not one thing that we will be able to do to address this issue. There are a number of things that we will put forward over the coming weeks to help the public better understand the issue, to help the public better understand and appreciate the people who are working in this industry, the ones who are helping us deal with these issues every single day. To help People Better understand that there are folks that weve been able to help and to support and that many of the programs that we have in place do work. But there is a need for reform. There is a need to increase capacity and to better examine, you know, new ways to address this issue. The first step in the initiative that were proposing today is to expand individual care coordination for those we have identified. So of the 4,000 and doctor bland will go into a little bit more detail, but to just really center in on those who are most in need and that population and to really target them with individualized coordination. We also will definitely need to get them stabilize and stream the housing and health care process. Because we have to have a safe place for them to be, to recover, to go through whatever process they need to go through to get back on their feet. And we also need to understand that this challenge is not a 9 00 to 5 00 issue. Were going to expand the hours of our Behavioral HealthAccess Center so people can access these services on nights and weekends. Let me be clear that the three elements of the initiative are just the beginning. And so we know we have more work to do to improve transparency and the efficiency of our system and to enhance our services and improve what we need to do for the most vulnerable of our city. We are committed and we are ready to roll up our sleeves and to do the work. Because this is not a political issue. This is about peoples lives. And this is about understanding this population so we can get to the root causes and to help people. It comes with a number of various layers of things that we have to do. And i know some of you are familiar with whats happening with our conservatorship legislation and how its gone through the board and how that is going to hopefully help individuals who are refusing treatment, but in desperate need of services. That is one approach. This is another approach. Weve already opened a new 100 Mental Health stabilization beds and our goal is to open 100 more by the end of this year and focusing on specific things to target this population in a way thats going going to help turn around what we know we see on our streets every day is something that is so important. Im sure you have this same example. You may see this same person on the corner every day, screaming and yelling. And i have a particular individual who removes his clothing and when i see him, i cant help but think this could be my father. This could be my grandfather. This could be my uncle. This could be my family member. And i want to help him. I want to make sure he gets the support he needs. It is not humane to continue to allow this to occur on our streets and that is why we have to move forward with a number of initiatives to help address this. Now what were proposing will not n many ways, be able to solve the issues that we know everyone is facing. Were not going to be able to force everyone into treatment. We know that locally the laws make it difficult to do something of that nature. But we do need to try. We do need to kaord nate our services and we do need to make sure that we are better prepared to meet people where they are. We cant assume that when they walk into the doors of a place like this that they know what to do. We need people who are going to be able to help them understand people who are going to understand what the challenge is and be able to address the challenge and that doesnt include, here, fill out this paperwork and take care of this and bring your i. D. That is not the way we are approaching this particular issue. Its about getting the kind of results where you can see and feel a difference on our streets every single day. So we have work to do in here to talk a little bit more about what were proposing and what hes discovered since hes taken on this role as of march of this year is dr. Nagusabland. [applause] thank you, mayor breed, for your support as we embark on this multiyear effort to transform Mental Health and Substance Use care for people experiencing homelessness in San Francisco. Thank you, dr. Colfax, for embracing the scale of the change we need in order to make a difference for this population and for the entire city. Thank you also jessica for your partnership in this important work as we endeavor to trace safety and civility for our neighbors. I also want to acknowledge the communitybased providers and philanthropists, clinicians and researchers, advocates and clients who dead indicate themselves to improving and saving lives in San Francisco. We will need everyone working together if were going to make the kind of impact that this population in San Francisco needs. Heres what we found out about our population. We looked very closely at who used San Franciscos health care and social services in the most recent fiscal year. And as the mayor pointed out, out of nearly 18,000 people experiencing homelessness, we found that close to 4,000 of them also have both a history of serious Mental Illness and of Substance Abuse disorder. We found racial inequity in the population. 35 are black or african american. When just 5 of San Franciscos population is. 41 of these individuals are high users of urgent and emergent Psychiatric Services and 95 suffer with an alcohol use problem. Now we have seen other large cities analyzed our high use of Emergency Services usually from a cost perspective. But as far as we know, San Francisco is the first to [inaudible] health diagnoses of people experiencing homelessness to identifying a population and tailing solutions to that populations needs. This is how we solve problems in medicine. When a patient comes to us with a complex set of issues, we are not haphazard in our approach. We test. We collect information from collateral sources. We diagnose and we treat. We use data to precisely target our problems. We inknow vaitz and, most important of all, we persist. We are here to solve problems for the entire population and confront a crisis for our city. These are the people who need help the most. Helping them will make the biggest difference for them, for our health system, and for the entire community. When we talk about Behavioral Health, we mean Mental Health and Substance Use. We know that when someone is suffering from a Mental Illness or addiction, it is a lot like a Chronic Health condition such as diabetes or even hypertension. When people are in treatment, they do better. When they have a setback, we dont give up. And when 4,000 san franciscans find themselves in the intersection of Mental Illness and Substance Use disorder, business as usual does not work for them. We have to find ways to use the system to bend in their direction. Im happy to say that this work has begun. As we rolled out the first in what will be a series of recommendations we can say we are entering a new era of collaboration with the department of homelessness and supportive housing. Jointly identifying the people in greatest need and relentless about getting them on a path to civility and wellness. With other city partners, we will be able to keep track of these individuals and wherever they touch our system a Care Coordinator will respond. When we say were increasing access to Behavioral Health care and we can promise, we promise that were going to focus on these 200 most Vulnerable People in this group right now. And Work Together to get them connected to housing, treatment and care. We will be meeting weekly to discuss each of these individuals and tracking their progress. We will outreach to them wherever they are. We will problem solve and remove barriers to accessing care and the lessons that we learn will ultimately help us improve the system of care for more people. Going forward, the recommendations i will continue to deliver to mayor breed will be driven by clinical expertise, by data, by evidence and by the most innovative and best practices we can find or imagine. They will promote equity and transparency in our system of care, that they will advance Harm Reduction and lower barriers. They will build on the legacy of addressing problems that might seem intractable and of making stability, wellness and recovery possible. The clients and staff here at the south of the Health Clinic show us that perseverance every day. With that, id like to introduce Yolanda Morris et. [applause] about 15 years ago, i came to San Francisco because i was being abused and i fled that relationship. I didnt know anyone in San Francisco, i left my clothes and i didnt look back. I was also an au addict and i was an alcoholic and i was homeless. I came here and slept in the alley. Ive been every street out here that you can name and through the years i did want to get help. I didnt know how. And so after more abusive relationships, i finally got a good guy and it was his choice for us to get clean. He said we gotta get clean in order to make it here in San Francisco. Im going to stop doing what i can do so that you can get your act together. And so i decided because ive been in all the shelters out here. I know how the shelters work. I decided to stay next door. I stayed there for a year. And i behaved. From there, i went into an s. R. O. They placed me in a singleroom occupancy is what it is called. A room with a bathroom and i stayed there for five years and prior to me when i first moved into the s. R. O. , my mother was dying of cancer and she didnt tell me because she knew it would take me out. I had a year of clean on me and i didnt look back and thought thats not what my mother would want. Im going to stay clean and im going to fight. Soy went out and found everything that i could find. This is one of first places that i came to because i had a lot of stuff going on mentally and physically. They were able to help me get on medication. They were able to help me get therapy, to get to the root of the problem, what was going on because i had a lot of stuff going on and after doing that, i had a lot of anger issues, depression, suicidal thoughts. I had to do anger management here twice and i finally got it right and i started doing other programs. Glide was out there. Sage was out there. It is not out there anymore. I went to the womens reentry center. I didnt feel comfortable at first because they walk you over there. Ive also been incars rated out here in San Francisco for drug possession and other things of that nature due to my drug use. And so i just slowly said im going to build myself up and started doing things for women against rape and violence. I got an award from the d. A. I like the write. I started writing here. I found out that im a pretty good poet and i do i do poems here every year for the black history month. They embrace me here. Ive been coming here since 2012 getting support and getting help. And i graduated from a lot of programs out there and i started doing peer mentorship through San Francisco state. Ive graduated from ram, ive graduated from nami. I expunged my record. I got my drivers license back. Five years into my s. R. O. There was a program called brilliant corners. They came and gave out vouchers to people who are willing and ready to move out of the tenderloin and i had two weeks left and i fought hard and found me a onebedroom and i got out of the tenderloin. But i still come to the tenderloin because this is an ish yaoufm i know a lot of people here. I always want to do anything that i can to disclose support and help the people in the community. So i continued. Im still with my guy. Were getting married this year. And [applause] thank you. And also i want to say that i was able to get a really good job through help rights 360th called maps and its mentor and peer support. They give you a job and they give you schooling for that. So i was able to do that. And now i teach groups in jail. I teach groups to the men in san bruno on domestic violence. I teach groups to the deputies about crisis intervention training. I go out and volunteer. I do anything and everything that i can to support anyone. We work in all the collaborative court. Now i was an addict nine years ago and this is what im doing now. Through all the help that started here at south end market. You know . They really helped me out an awful lot. They were very patient. I went through several therapists and psychologists. But finally got it right and ill be flying away and graduating from here soon because i am moving on to other things. I have a nice fulltime job now. So, yeah. Thats about it. [laughter] [applause] well, thank you, yolanda, for sharing your story. Its amazing. It is an inspiration to us all. And we wish you the very best as you get your certification in drug and alcohol counseling. Amazing work. Also, by the way, were hiring. [laughter] just putting that out there. Were looking for right people. Im the director of health for the city and county of San Francisco. I would like to thank the mayor and thank you, dr. Bland, and thank you to our host today, Natalie Henry berry and the hardworking staff here. This is one of the places in the citys system of care where people can get their medical care, dental and Behavioral Health care needs met under one roof. Ive seen what the staff here, with persistent compassion have been able to do by partnering with their clients on journey to stability and wellness. They are psychiatrists, pharmacists, Behavioral Health clinicians, nurses and support workers who go out into the community and meet people where they are. Many clients are experiencing homelessness when they enroll in services here and most are diagnosed with both Mental Illness and Substance Abuse disorders. But the work makes a difference. And on my last visit here, i went out with the team. And this is a client, whos now housed, but was ton street for many years. Wheelchairbound, had chronic controlism, refused treatment for many years. But the team continued to engage him, continued to bailed relationship. Helped him when he was ready to get healthy. Helped him when he was ready to get treatment for his alcoholism. And this client, living in the tenderloin, is a valuable member of the community. Is actually continuing to move that forward just like yolanda. Hes now volunteering at the San Francisco aids clinic providing Harm Reduction materials for people who need them. He is moving the work forward and this is the kind of model of peers helping peers in a system that meets people where they are and does whatever it takes to help get them off the street w. This new data and focus on the 200, we can make a difference. I think when people are ready for treatment and volunteer for treatment, that is key. I also think we need to recognize that one of our challenges on the streets that some people will refuse treatment. Some people in the most dire needs of treatment will refuse treatment. So we need to be there when people are ready to go into the services and meet them. When theyre ready. But we also need laws like the conservatorship law to provide people with the support for shorttime conservatorship to help them save their lives. These are lifesaving interventions. And that persistent compassion is what we have seen here and what weve come to expect from our director of Mental Health reform in. A few short months, hes transformed the way many of us think about caring for people experiencing the intersection of homelessness, serious Mental Illness and Substance Abuse disorders. This is a population, as youve heard of 4,000 people who require specialized solutions. Kit take a while. It can take time for them to achieve their goals. But we know that wellness and recovery is possible, as youve heard today. And with our partners at the department of homeless systems and supportive housing, thank you, jeff, for being here today and the Human Services agency. We have agreed for the first tomb on ways to identify, treat and house the most vulnerable population in our city. And mayor london breed to spark the champion of Harm Reduction, someone who understands the inequities that lead to core Health Outcomes and that we must continually push harder to overcome. Under her leadership, San Francisco continues to invest in health care and housing that our city needs. Thank you, mayor breed. And thank you all for being here today. Thank you to the team and lets move forward together. [applause] thank you. Again, thank you so much, yolanda, for sharing your story. And stories like yolandas is why we do the work. It is what we care about the most because the fact is, you know, people go through challenges. People go through struggles. And nine years being clean and sober takes a lot of work. It takes a lot of courage and to get up here and tell your story will have such a tremendous impact on so many other peoples lives and hopefully encourage them to get the help and the support that they need. And i think that is important to remember in having the conversation about the struggles and the Success Stories. Because we are not going to give up. And i know that people in San Francisco are frustrated by what they see on our streets. Im frustrated. But im not going to give up. I think it is important that we have ways to help people. That with our additional 53 million in investment and Behavioral Health program that our additional 100 million in investment, the Homeless Supportive Services indicates that were willing to make investments. Now it is time to put those investments to good use. And to understand that every dollar we spend on this issue is a dollar that can change someones life. And so we have to be deliberate in our approach to really focus on this and make sure it is not a political issue. This is a longterm plan of action that will deliver the kind of results that will help people, like yolanda, get really a Second Chance at living a healthy, productive and thriving life. So thank you for all of you for being here today. And again, i want to express my appreciation to the team and the folks who are working with so many of the clients that i know things can be challenging, but the fact that youre here, i know that youve not given up. This work is rewarding, especially when youre able to get the kinds of results that show that supporting people like yolanda do yield and so it really means a lot to have so many incredible, dedicated people doing this work every single day because it is not easy. And ill tell you that, you know, because you all know that i spend a lot of time walking the streets and having the conversations and going out there with some of our teams and having the conversation. Within two hours of walking just four blocks, i was mentally exhausted with the conversations that i had and also trying to get people the help and the support that they needed and just work that the energy and the emotion that goes into trying to help people every single day is something thats admirable and i want us to really appreciate the folks who are part of, you know, our mental teams and our nonprofit organizations and our homeless out reach workers and even Law Enforcement and the work that were out there doing to help change and save peoples lives. This is the first of many steps that we plan to take and, again, this is, i know, a very complex issue. Its not wraped in the usual political package that the press, i know, wants to see it wrapped in. But this is actually what we need to do. Get into the nuts and bolts, make the right decisions and get out there and make the changes that will help impact the people that we are here to serve. So thank you all so much for being here today. And dr. Colfax and dr. S blanlz dr. Bland will be here to answer any further questions that you might have. Thank you. [applause] shop and dine on the 49 promotes local businesses and challenges residents to do shopping and dining within the 49 square miles of San Francisco by supporting local Services Within neighborhood. We help San Francisco remain unique, successful and vibrant. Where will you shop and dine in the 49 . San francisco owes the charm to the unique character of the neighborhood comer hall district. Each corridor has its own personality. Our neighborhoods are the engine of the city. You are putting money and support back to the community you live in and you are helping Small Businesses grow. It is more environmentally friendly. Shopping local is very important. I have had relationships with my local growers for 30 years. By shopping here and supporting us locally, you are also supporting the growers of the flowers, they are fresh and they have a price point that is not imported. It is really good for everybody. Shopping locally is crucial. Without that support, Small Business cant survive, and if we lose Small Business, that diversity goes away, and, you know, it would be a shame to see that become a thing of the past. It is important to dine and shop locally. It allows us to maintain traditions. It makes the neighborhood. I think San Francisco should shop local as much as they can. The retail marketplace is changes. We are trying to have people on the floor who can talk to you and help you with products you are interested in buying, and help you with exploration to try things you have never had before. The fish business, you think it is a piece of fish and fisherman. There are a lot of people working in the fish business, between wholesalers and fishermen and bait and tackle. At the retail end, we about a lot of people and it is good for everybody. Shopping and dining locally is so important to the community because it brings a tighter fabric to the community and allows the Business Owners to thrive in the community. We see more Small Businesses going away. We need to shop locally to keep the Small Business alive in San Francisco. Shop and dine in the 49 is a cool initiative. You can see the banners in the streets around town. It is great. Anything that can showcase and legitimize Small Businesses is a wonderful thing. [gavel]ul thing. Good morning. The meeting will come to order. This is septem