We could move forward to operate all 55 of the arf beds. In addition to these factors, the redevelopment of empty unused beds in the arf could be repurposed to provide additional beds for homeless clients in need of Behavioral Services by expanding the humming bird psychiatric respite program. I would like to talk about hummingbird and why its expansion is important. A background. Hummingbird first opened in 2017 with 15 beds, which as i said before were always full. Then it expanded by 14 beds in february over 2019. Those beds were the result of the beds we asked to go to suspension to use the beds for hummingbird h bird. To date it serves 500 clients. It is a primary discharge for those discharged from zucker bird San Francisco. 30 are from the psychiatric services. This is a safe place to be other than is on the streets where they are the opportunity to engage with staff and be offered services and hopefully willing to accept the services at some point. Next i will review the communication about the arf plan. On july 22 of this year the union with affected staff by this change was neverred and offered the ability to meet with management to discuss the plan. That meeting to discuss occurred this morning at 11 00 a. M. After months of trying to schedule the meeting. Staff and the arf were informed by myself, kelly and linda, the manager of the health center, when we went to the 7 00 a. M. And 3 00 p. M. Shifts to explain to staff what the plan was for keeps 14 bedses on the first floor and relocating 18 residents upstairs. Despite the amount of controversy on this issue. We did not do a sufficient job in communicating the issues involving the arof and proposed change. Going forward we will do better. Where are we now . As the director stated in his report, changes are on hold while the mayor and board of supervisors talk about how to proceed in a way that accomplishes our shared goals. In addition, as always, residents have a choice where they choose to be. If any of the current residents prefer to move upstairs to qualify for of 0 years of age and older. We will accommodate their request to move if they solution. No staff are losing their jobs and that we are committed we will take no further action until the city leaders deliberate this issue and come back with more directive. We are recognizing there needs to be changing in the operation of the arf and other presumes. We are developing a corrective action plan for the arf and we will present that to director colfax. In that Performance Improvement plan, we will make sure that Resident Safety is our top priority and that we also address the issues in terms of Workplace Culture of the a rf so we can improve the operation for our staff and our clients. That concludes my part of the presentation. I will make myself and kelly available to hopefully answer questions you may have. I would like to recognize and invite supervisor ronan to come speak to us. Thank you for having me. It is a pleasure to be back. It was very important for me to come here today and urge you all to get more involved in this situation. I have to say it has been incredibly disappointing from the getgo, and i am here mostly to support the workers of the adult residential facility. I tabled with you that i feel of the Mental Health crisis that is taking place in our streets every single day. I dont know about you. I travel through the mission right by general every day. Every single day i see people often with half naked with hospital bracelets still on that are muttering, screaming, clearly just out of the hospital that are severely mentality ill. We are losing the facilities at rapid rates and where the citys only public run facility able to take care of the sickest individuals is also expanded. Iit is not acceptable. These problems have been lapping for the past five years. Where has been the leader ship on the part of management . All i have heard is blaming workers for problems. When there are conflicts on my staff, people are not getting along, mistakes are made. I dont blame them. I am the manger. I set up new systems. I correct it so so i can function with my main job of representing the people of San Francisco. Na should have been going on in the arf for the past five years. Instead despite reports showing corrective action plan in place, the decision to close the facility at the aim time the mayors tom priority is to deal with the crisis on the street. It is so glaring i dont understand how this is happening in our city. I am angry. I dont understand where the leadership is to act with the urgency i have. This is not the dbm that runs the lost innovative programs in the country. This is not the one that led on violence prevention. We are failing the workers who take care of them every day. I hope you are reading the press. Reading the excellent journallism especially at the local. The art chemdetailed step by step what happened. One of the most disturbing aspects is that there were 11 conserved individuals. I have been talking to their public defender. They were languishing in jail, some for over nine months waiting for a for the problems of management. They have been languishing in jail. When their public defender got fed up and said this is ridiculous, i cant get answers, i am going to sub the department of Public Health. All eight are in beds out of jail. Some lang winninged for 8 months. This is a scandal of the highest proportion. People are waiting in jail so desperately i ll we cant find a bed for nine months until they come to Court Everything i am angry. This is the most humane i have seen. All i have seenence i called the mayors office. We it is by our plan. We have staffing issues and blame the workers. It is not good enough. We have got to do something to get those beds up and running. We are talking about hiring 12 more workers. In two years the department of Public Health doesnt have that capacity so that mentality i ll people can get the care they need. Is that the department we are running in the city these days . I have brought copiesna i introduced when this was happening. Directs the department of Public Health to open beds. Directs the department of Human Resources to take over management of the arf and provide some professional management and staff hires to get this facility up and running and serving the people dying in jails and on the streets every day. I implore you to act with the urgency the workers have and i somewhere on the board of supervisors that most of my colleagues that is lacking the vision and leadership to take care of the crisis on the street. Join us and act with that level of urgency. It is morality and an issue of life and death. Thank you. applause . Before the Department Responds to the repor. Reporter we will have from the speaker, would you add here to the timer it would be helpful to folks behind you and gives us an opportunity to hear from everybody who wants to speak. I thank you in advance a apologize for anybodys name i ruin. I will start with first five. Patrish an shaallen, patricia, jennifer, doctor palmer, janette cooling, i believe. I cant read the writing. I stay at the arf facility. I dont think they should close it down. That is my place of living. I have been there for five years along with my other clients there. I feel that the arf shouldnt be closed down. Thank you. Thank you, ms. Allen. Good afternoon. I am a Mental Health worker at the facility also known as arf. I want to thank you. Thank you so much. I dont have anything to say because supervisor ronen said everything i will agree with what he is saying. I is agree with her. I came to the arf to the Mental Health and living en independeny in the community. It is in the hopes of enabling them to get back into the community. Some clients are able to move to lesser care. Unfortunately, a majority of clients are in need of Constant Care and attention. The ones that need the most care received eviction on august 19. We have an established program serving the needs of San Francisco adult 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 t