Received eviction on august 19. We have an established program serving the needs of San FranciscoAdult Mental Health population for the last 14 years. Instead of building on the program and increasing beds, the program has been losing beds. Not because of the care we are provides. I ask you to consider the individuals you are affecting before making changes. That will have a negative impact on the more helpless clients. Displacing the Mental Health and taking their home are not the solution to the homeless issues. Lets address the facility issues and Work Together to solve them so we can all retain our beds and continue to serve the members of the community. Thank you so much. [applause. ] thank you. I am Theresa Palmer a long time san franciscan. Usually i talk about longterm care. This whole thing is extremely upsetting, and my hope is the department of Public Health can improve from the fallout of this fiasco. Keeping longterm care beds empty because of what amounts to dphs lack of will to fill them is unacceptable. I cant help having the paranoid thoughts the mayor wanted to gain political points by keeping beds empty to say she could offer navigation beds then in the coverup. I may be off on that but that is what it looks like. This disregard for the mentally ill is chilling. I hope this thought is not the case. There is no easy solution to the long and short term beds in San Francisco. Surely we can do a better job by working together. Please work with and not at odds with those in City Government in San Francisco who really care. Dont close down arf beds, staff them and reopen them. Work with supervisors haney and ronen who are looking at ways to fix this. Thank you. Marcus i cant read it. Houseman, i believe. Janette cooling. Vivian and amy. I am marcus heisman, a resident at the arf off and on since 2009. All i got to say is, is this discrimination against gay people like myself secretly, and i think 10 times before you kick people out on the streets. It is not safe out on the streets. Thank you. I am janette connelly, and i live in the reseptive Behavioral Health center for more than 15 years. I went from there and i worked in the acute care psychiatric area, and i see that you keeping beds empty at the Behavioral Health center when there is an ample amount of people ready to go from acute care and in the medical area of San Francisco general. It is just almost criminal. We have huge amounts of people getting acute Care Services that really need to be on a lower level of care and they are unable to move because there is empty beds not being filled. To change them and the bhc that it is now called is just i dont know. I think you need to find a better solution to find the Navigation Center or shelter to open them up in the city. Bhc is doing a good job of caring for the patients in the facility. A lot of people work well there, there is need for it. If you close down the needs met there now, what is going to happen to people that are in the jails, in the medical area, and in the psychiatric area that need to go to a lower level. If you eliminate a lower level area you are going to have a bottleneck. You will have the psychiatric areas in the acute areas of general bottlenecked and you will create a big problem, in my opinion. Thank you. Amy wonk, vivveon, jennifer. I am amy wonk. I am a Mental Health specialist on the third floor of the Mental Health center. I have been working there 20 years. What i have seen over the time and time again is the lack of transparency of the management. The lack of the transparency i just heard thank you. He mentioned a couple things that stood out that i have to mention. He mentioned the 14 beds. There are 13 beds now. One bed was made for or attempted to be made to a washer and drier room. The other one is noncompliant with the state regulation. One to two years to correct the problem. I have spoken to several colleagues. That has not happened. Where is the transparency. If transparency. The people impacted and the residents who lived at the arf. Because when they are not being transparent that is under mining the actual good work that the staff had been doing for the past 10 or 20 years that i have been there. They have been doing a phenomenal job, and so by under mining the clinical work of the staff, it compromises the care of the residents. I am very concerned the residents will suffer trauma, deterioration from the poor decision of suspending the arf beds. The members of the health commission, we are demanding to really to rescend this notice and open up the arf beds. I am vivian, a staff representative for local 21. We represent some workers at the bhc. I am here on behalf of staff who requested i make some corrections on doctor pickens presentation. Here are some corrections as follows. Doctor pickens gave incorrect statistics in his presentation. None of the bhc staff has been terminated. Number two, the number of citations he sited is incorrect and in addition to that the state determination of noncompliance is related to a death which occurred on the sfgh campus. As representative of the staff i am here to say dph has got to stand by the staff and not be throwing them under the bus. In addition, i would like to mention especially ms. Kelly. We would love it if you would Say Something good about the people who make dph run. Stop insulting staff, stop insulting workers in public. Without these workers and staff you would have no bhc, no arf, no dph. Thank you so much. Jeff esten, michelle, sarah larson, robert rogers. Police say your name. Good afternoon, i am vivrian. I have been a Mental Health advocate for over 40 years including working in the field for over 20. Decades an go we fought to have the Mental Health residential facility built. We expected that it always would be fully utilized. Recently there was a plan to switch some beds to Navigation Center beds. This essentially pitted one group of people needing services against another. The community revolted. Before the publico speak, San Francisco in an incentive action sent formal notices to vacate to some residents an the the adult residential facility. Getting that frightening notice can really set them back. Evicting Mental Health clients to get positive press about homelessness is a shameful political strategy. Then the plot thickens. A number of beds at the facility are empty. Why . People wait for months stuck in inappropriate levels of care when, in fact, there are empty beds . At first the county claimed the state forbid them from filling the beds. The state quickly denied this and followed a perplexing periods of excuses for not filling beds. We read there was trouble fills staff positions. Then the story shifted again. They were aware of staff negligence and error so they left beds empty rather than expose new admission to say that. What about existing residents. Identifying staff negligence and error at not correcting it is, in fact, negligence and error. They didnt provide services for people needing care. They deemed the staff incapable of doing so properly. This must not go on. People are waiting for services. Thank you. Commissioners, secretary, thank you all for having this hearing today. I see appreciate the time. Everyone in the audience, i appreciate you coming out. The system is broken. Thithis is a symptom. There are 30 beds to close on december 1st. Six beds on november 18th, 18 beds on the 17th of this month. That is 54 beds between today and december 1st. We do not have capacity to place 54 people. Rye now at the arf and rcfe there are 46 empty beds. I talked to the Deputy Director today and he informed me the state licensing body told him if people are not placed from the bed that is going to close the home to close this month, they will be sent to the emergency room at San Francisco general hospital. This is unacceptable. How much more do we have to spend if 18 people show up at the emergency room with no emergent need except for housing, which we have been providing for a number of years for them . We have open beds right now sitting vacant we could have put them into a mop ago when we month an go. It is because of the neglect from leadership to the people we contracted with. Even the contractors are mistreated and decided a 35 a day rate is not enough. The same kind of care we see given to the staff has been given to the contractors and given to the clients. It is not okay. Time. Sarah larson. Hello i am sarah larson, Mental HealthTreatment Specialist working since 1986 at ph. D. We are so isolated we have had to be on the edge of closing to have a voice. It has taken 20 years to get attention to mismanagement. We are a microcosm of what is wrong. I met to get clarity on where this is going. We found them to be defensive, rude and hogs tile rather on hostile rather than the permanent beds management has the right to make decisions and file grievance. They are suspended arf because of errors and staff conflicts. No conflict management, no team building. It looks like i ca looks like it leadership. New staff are to learn on the job. No clerks and little staff support. The arf would be a great facility if we invested with leadership with a plan to run it. We have been in a crisis of leadership for beds. This is a political decision, not a necessity. We are not on the verge of losing the license. Management is trying to outsource the workers making a living wage with underpaid nonprofit staff. In the meantime our contract with transitions expires in less than six months. Neither row land pickens or the resource representatives admit to the knowledge of the contract. It was signed by pickens and hiramoto. We deserve better, our clients deserve better and the citizens of San Francisco deserve better. Dph has got to change. Robert rogers, judith crane,roma guy and jennifer. You can come up in any order. Whoever gets here first gets to speak. Good afternoon, commissioners. I am judith claim. As a past employee with over 30 years working with the city, i get how difficult it is to institute change. As a mother with a son with schizophrenia currently lives at the arf we cant afford not to. My son entered with the jails after being beaten by eight police officers. He was moved seven times during the first year of treatment. Now you are telling me that it is unsafe for him to be at the arf where he has been for two years . He has finally found some stability. I dont believe he is unsafe. While it is needing major reforms, it provides low barrier longterm care for severe Mental Illness that is rapidly disappearing. He was moved from hummingbirds. It does not provide longterm care for people with severe Mental Illness. Keep the beds open at the arf, that Service Improvements be helped to move them to independence. Schizophrenia is a painful condition. I have witnessed my son suffer. Not only suffering from his condition. He is suffering from our system of care. Please dont reduce the needed resource. Thank you. Good afternoon. Roma guy from taxpayers for Public Safety. We attacks payers for public taxpayers for Public Safety want to and our support. We want to thank you for having this meeting finally and bringing your leadership and listening ears to problem solve not only be this issue but many as many speakers have said to other issues that are in cries cease in this modern era. The arf, from our point of view, is just another mishap in plugging holes in a leaky old barrel. We must change the Healthcare Systems approach at the leadership level, Management Level and at the practice level if we want to meet the challenges of this era. We did it with h. I. V. , and some of you were part of it. I know you are sitting here. We did it with healthy San Francisco. We are doing it with pedestrian safety. Why not Behavioral Health . We are behind other jurisdictions and there are many lessons to learn as well as the ones i have sited in our own county and city. We are not problem solving, we are fighting, not helpful to the people we want to solve problems for e. We have chosen positions we must take them on. Be visible, transparent and accountable in the modern era. Thank you. I am michelle. I think you called my name. I will speak for robert rogers. He left. I am a social worker and i work as a conservator. I am speaking on behalf of private citizens. I think it should be obvious at this point be this is not a good idea. There are enough people saying the same thing over and over again. Front line people in the system every day, and a sign of good leadership is when you recognize that may be you have made a mistake and deciding to not make that mistake if you are getting a lot of feedback from the people on the front line like myself, the staff, the doctors, psychiatrist, every Single Person working in the system thinks this is a bad idea. We should stop doing that. Also, i work on the third floor. I work on the psychiatric facility. You cant tell you how many meetings i have sat in and had to look my client in the eye to tell them that even though they worked through their care, they did everything i asked them. They took medications, went to groups, took showers, they did everything and they are ready to go to a lower level of care and i have to sit in the meeting and tell them there is nowhere to go. We have those meetings month after month, and then to learn there were beds below us they could have gone to. I cant tell you how angry that makes me and how sad it makes me for our system, and if i was my client, i wouldnt trust me after that. How can we have a therapeutic relationship when they do everything i ask them to do, and those are very difficult things, then i cant give them the thing they have earned which is to come out of a locked facility and be able to walk out on the street. Thank you. I have one more. I am jennifer. I work at the locked facility on the third floor of the Behavioral Health center, i am a social worker there. I work with San Francisco residents there involuntarily hospitalized for treatment knowing they are going to work through. Like mitchell is saying, go home and they cant go home for months. There are people there for over a year who cant get out, similar to jail. They cant get out. They need a home like the arf. Two points. One safety concerns put out by dph do not hold water. In the last year from 2017 to 2018 there is one substantiated citation and three at the rcfe one floor up is held open. Going to fill to capacity according to this plan. Also, the staff that are blamed for the citations are floating up. They work upstairs. The plan is to have them go upstairs. They are already going upstairs. The staff work down stairs. That is happening. This argument that one floor is not safe while the other is doesnt hold water. The citations upstairs are about events leading to a clients death. The humming bird extension is not doing harm. It is doing harm. They are locked and cant go home. There are 41 people that need somewhere to go. There is a reason the whole community of the San Francisco front line workers are coming out. They are getting good care. Thithis is a good place. We beg you to hear the word of the public and weigh it against the messaging of d. P. A. To look at what is going on here. Thank you for taking time to hear us out today. Thank you. Kim, San Francisco labor council. I agree with just about all of the public testimony that has gone on here, and i think dph is in a pathetic state. I was here testifying before this Commission Many years ago when laguna honda ceased receiving medicare because of the 700 violations. We are talking 10 violations over a four year period. Dph is not telling the truth. The people who are supposed to be telling the truth are lying. I think it is pathetic. We have called the state to ask them about the status of the arf, and they have assured us. It is on the website the arf is no no way in jeopardy of closing. Why they are perpetrating that is beyond me. This department is playing politics with peoples lives. Their sole job is to care for the folks and they would rather play politics . They need to be ashamed of themselves. If we need to clean house, start at the top. It is time to start caring for the people who come to us when they are most needed. I have been talking to taxpayer groups who should sue the department over there. I was there when Behavioral Health system when this center was built. It was to be a long term Behavioral Health center, and that is what the taxpayers paid for. The fact you changed it without discussing it with anybody . I think you all should be sued. It is pathetic, sad, and dph needs to do better. Thank you. Any more public testimony . Please come up. I am ei am ed de steal. I have a long history of depression and anxiety. This spring it got bad. I ended up in the hospital. I am in the kaiser system. I went to the emergency room. From my personal experience i was able to move from the emergency room to the hospital fairly quickly within six to eight hours. Other patients with me were in the emergency room two or three or four days before they could get a bed. There were patients with me in the facility waiting on longer term beds they couldnt get in. They were in the short term facility when they needed to be in the longterm facility blocking the bed for someone in the emergency room. This is what is going on at arf. If people arent able to ge