However, this meeting will be conducted in all respects as a regular audit and Oversight Committee meeting. Any substantive decision will constitute a recommendation of the Committee Rather than action by the whole board. Mr. Carroll will make a note. At the present moment we dont have a quorum. This committee is operating as the normal committee with a few extra guests. Do you have any announcements. Plea silence cell phones. Speaker cards and documents should be submitted to the clerk. Items today will appear on the october 29, 2019 board of supervisors agenda unless otherwise stated. Thank you. Do we have a motion to excuse supervisor peskin . Can we take that without objection . Who was the mover on that. Roger brown. Please call items one, two, three, four together. One hearing to discuss the removal of 41 out of 55 longterm beddings from the adult residential facility. Agenda item two is an ordinance excuse me. Agenda item two is a resolution urging the department of Public Health to rescind. Item three is submitting the health code to require 55 bed residential facility. Four is ordinance to require department of Public Health to maintain and operate at full capacity 55 bed facility as soon as possible but not later than july 1, 2021. Before that 41 of the 55 beds may be used as Emergency Shelter for people experiencing homelessness. I would like to turn it to supervisor ronen for remarks. Thank you. Good morning i am happy to be here to announce that we have reached a resolution to this crisis that was before us. After months of disagreement on the issue, this past friday afternoon my office, together with worker leaders from the adult residential facility, local 21 and the representatives, dph leaders and Mayors Office and supervisor haneys office worked out an agreement related to the future of the adult residential facility. I am happy to report this will protect is health and stability of the 32 residents who live at the adult residential facility. It is the only boarding care facility for severely mentality ill. No resident will be forcibly removed from their home and the citys longterm beds will be protected. We have incorporated the key aspects into my ordinance. The adult residential facility in committee. There are a few more small details we are currently working on with the City Attorney and those changes will be worked out between now and when it is heard at the full board on october 29th. The amendments we have incorporated in my legislation have been distributed they are as follows. For the next five missouri month five months 28 adult residential longterm treatment beds and 27 Emergency Shelter beds known as hum igbird beds. In april 2020 they will be required to operate an adult residential facility with no fewer than 41 deads. For the five residents who will be offered placements they will we having the opportunity to discuss options with the person before accepting a volunteer transfer. Dph shall provide trauma care training to all adult residential facility staff provided by experts that do not work at the center. There shall employee a working group for management and staff where they come together and discuss issues related to resident care, workplace conditions and other issues. Dph shall insure an objective analysis and review is connected where the residential facility is located no later than march 31st. They shall submit the report to the board of supervisors providing updates with the objective analysis. In addition there is a small typo in the draft i passed out to you. There are two small changes on page 2. Online 18, it should read at this from 55 to 14 not to 11. Scratch out 11 and put 14. Then online 19, it should read ccl approval extends through july 30, 2020, not 2021. Please cross out 2021 and add 2020. I just want to give a huge thank you to a huge list of people because this really was an effort that started from the staff at the arf and the patients and came to my office and supervisor haneys office from the front line workers. Please give me a minute to say a bunch of thank u. S. First, i have to thank supervisor haney, who has partnered with my office on this from day one, both you and your staff abigail are extraordinary and it is a pleasure to partner with you. Caroline gooslin, my chief of staff, has been living and breathing this issue and the Mental Health system in San Francisco. We are going to return to being parents as soon as this is over because our kids have suffered by not having us present. Thank you so much, caroline, your work is extraordinary. I appreciate you every day so much. I want to thank the workers at the adult residential facility and the Behavioral HealthCenter Starting with jennifer who despite being extremely sick is here today because she cares so much for these patients she doesnt let anything stop her. Jennifer, we would not have known about this situation if it wasnt for you. This was kept secret from us, disclosure of the beds was never told the board of supervisors. We would have opposed it. We didnt know. You had the bravery to come forward and blow the whistle what was happening on the arf. You put everything on the line for that. I dont know that there is heroism greater than that. I appreciate you and admire from you the bottom of my heart. Thank you for caring so much about your patients. Then i also want to thank amy wong, sarah larson and jennifer and the many others who spent every single day of their life doing this heartloving incredibly difficult work who care so much about these patients, who are their family and who havent let them down for a moment. You are extra human beings. Getting to know you has made this job worth it for me. Thank you so much for being the Extraordinary People that you are and for caring and loving these patients with the dedication that you do. You really inspire me so much. Thank you. I also want to thank the emergency room nurses who joined with the arf patients. Heather, julie and the conservators who take care of the sickest individuals and and advocate on their baffin behalf. Michelle and victor. You have just wowed us all. We are so lucky to have the quality of care that we have that you provide every day in this city. I want to thank the arf residents, many are here and families for fighting with us and being courageous and telling their stories, marcus and donna. You have really been the most incredible selfadvocates. The family members and especially parents like judith who will never let their loved ones down. I also want to thank the amazing leaders and staff at local 21 and especially vivian. We see you and love you and admire you. Deana and jason and kim from the San FranciscoLabor Council for being there from the beginning. It is the unions that provide the safety for workers to be able to feel comfortable coming forward collectively and taking action on their behalf and behalf of their patients. Without unions workers wouldnt have that safety. We just appreciate organized labor as always. Finally, i really want to thank the mayor and her staff, and particularly doctor grant colfax and Rhonda Simons for sitting down and really, really coming to the table and negotiating on the issues. We appreciate you for taking the time and energy and for listening and for changing your minds. That takes a lot of courage and wwe commend you for that. With that we are probably going to hear from some other colleagues. I wanted to ask supervisor mar after they speak if you can move this forward with recommendation as amended. If you can a it and then move it forward and please file the informational hearing and table supervisor mandelmans resolution and soup sorry the resolution. I didnt realize they are here but they both agreed. They can tell you themselves. With that, thank you so much, everyone. Thank you. Supervisor mandelman. Thank you, chair mar. Yes, going back to when i first heard people telling me that the city was closing or downsizing the arf, i couldnt believe that was true. My initial reaction was there is no way we would do that right now in this time when there is such a scarcity of beds. I was familiar with the work that the arf does and the importance of it. As i began digging, the picture became more complicated and more troubling as we learned that in many ways i think the proposal that came forward a couple months ago was a wellintentioned effort by dph management to fill empty beds. And learning we had for many years had empty beds, not just at the a rf but in the locked facility on the third floor was in a lot of ways even more troubling to me. I thought it was important to make clear that everyone on this board and also to get the mayors concurrence believes we need the arf, a publicly operated longterm care facility for people who cannot and will not be effectively serve would by nonprofits or private operators in the community. I think that for a couple of months at least there has been broad agreement in city hall about that. It is himself important to also important to me as we move to that goal as quickly as possible we fill every bed, which we have not been doing for several years. I am very pleased and grateful for the compromise that labor, workers, colleagues, mayor and department of health have struck. I think it achieves all of the goals that i would have for that arf facility. It makes sense. It is a great compromise. I am happy to echo the request to have item 4 tabled. I would like to be a cosponsor to the amended ordinance. Thank you. Supervisor haney. Thank you, chair mar. I want to echo the long list of thank u. S. Both supervisor ronen and mandelman have put out there. I want to thank you, supervisor ronen for your incredible leadership and advocacy on this. I want to underscore the gratitude for the workers at the arf for the patients and families for raising the alarm on this and not backing down. There was, as we are all aware, many weeks of organizing and direct action and meeting with the supervisors, and i want to thank you on top of everything you do every day for advocating for your patients. I also want to say i am sorry. I think this is something that on top of the incredibly difficult jobs the trauma you experience yourself, hard work and long hours for you and for the people that you serve to then have to have the additional trauma and anxiety and uncertainty that came with this announcement, one which you were not consulted around, i think is especially unfair, and this should be the compromise itself is a lesson in how we should work with each other and whether it is with the dph or Mayors Office or supervisors but it should be a warning this is not the way decisions should be made moving forward. We should be consulting the most important folks, most impacted individuals, residents, workers, unions, and working could lab boratively to lead to outcomes like the compromise if we had done it that way to begin with. I am grateful, and i am also sorry thi this is the way it cae about. I hope we learned a lesson about how we should listen and who we should listen to and how we should work together. I am very thankful we were able to come together to work out the agreement to support the health of the residents and protect the longterm care beds that we need and address the crisis on the streets as boarding care homes close it is essential to protect the longterm beds that we center, and as we seek to expand more, this is exactly the sort of facility that we need to be supporting fully staffing, protecting, and growing. I am thankful for the solid compromise and thankful for the leadership of supervisor ronen and mandelman and the workers and patients who rogue rose them and got us where we have a solid compromise and lesson how to do this better in the future. Thank you. Did you have additional comments . There are a lot of thank u. S. I made a glaring admission. City attorney ann pearson who has not only been the City Attorney on these ordinances but also on Mental Health sf and those ordinances. As City Attorney when there are different parties at the board of supervisors you have to draft all versions of the same thing. That gets hard and overwhelming. I found it strange because normally that would be a conflict of interest. In government, it is not. I have always found it strange as an attorney myself you have to represent th the dualing sids with confidentiality in a timely manner. I hope you are watching, ann, you have done an incredible job. I know you worked weekends and i wanted to also acknowledge your extraordinary work and thank you so much. I want to thank supervisors haney and reaso ronan and manden and i want to thank the staff at the arf unit and the families and advocates for raising your voice to find the best solution. It has been really a great learning experience for me inning our complicated Mental Health and Behavioral Health system, and just learning from all of you and just yesterday i had a chance to visit a wonderful Mental Health facility or Behavioral Health facility in the sun set district to learn about the Important Services they have been providing for decades and to learn a number of their clients are residents in the arf unit and hear from the staff about the importance of the longterm care beds being maintained. I am really glad that all parties have been able to come to agreement on a good plan to teen the unit own and address the issues highlighted that need addressed with the arf unit. I think we will move. Supervisor brown, do you have any comments . I am happy that we have finally worked together and Found Solutions because as, you know, we know when we are talking to everybody on the streets, our constituents this is a top priority. In my district, i used to have the most board and cares in the city. Now half of them have been lost in the last five or six years, which is actually scary. There is one that is up right now we are trying to buy so we can keep everyone there. These are so important we need to make sure that we have places people can go when they need that. I am happy now we are at this place. This is moving forward. It is going to be realty. Thank you. We are going to go to Public Comment now. I have speaker cards. I will read the names. If you can if your name is called please line up on the right side of the room and step up to the microphone. Vivian, jennifer, marcus, connie, jennifer and denise louise. Please state your first and last name. Good morning. My name is vivian. I am president of the board of Mental Health association of San Francisco. I have been a Mental Health advocate for over 40 years, including 20 years in the field. One of the important projects i worked on decades ago was about measure to build what is called the adult residential facility. The need was so obvious and pressing. Never could we have imagined that a time would come when the city would decrease the number of beds and would leave the beds empty while people languished at inappropriate levels of care. We are talking about far more than a physical bed. We are talking about a trained staff to guide people on the path, meals and access to medical care. We are talking about a safe place to sleep under the same roof with peers who can bond over the struggles and grow by sharing concerns and insights. The need for those beds was great when the facility was built. It is even greater now. Thank you. Next speaker. I am jennifer esteem. I want to say thank you to supervisor mandelman and ronen and haney. The need for these beds are incredible. It is real. There are so many people on the street we cannot narrow our scope to serving those only in crisis. We have to understand that suffering with a severe and persistent Mental Illness is a lifelong need and to take people from crisis to quality of life that is lasting means you cant just focus on crisis and homelessness as one piece. Temporary solutions taking them off the street for one day is not enough. I want you to consider as the vote comes soon, as decisions are made here in city hall room 250 and 200 to decide the next step with our Mental Health system. What are the next steps . Collaboration is paramount as we figure out what to do. Will we be focused on policing and putting people in inappropriate settings or will we recognize that prevention and care are most important . When we are talking about regular people like ourselves, we must recognize that they have to be treated with the most concern, care and human treatment possible. That does not mean in jail or forced treatment. It means having Treatment Options credible and humane. I implore you all to consider wisely. Thank you. Next speaker, please. My name is. [ inaudible ] i am a worker at the behavior Health Center. I am thankful to work with our clients for the last 14 years. This is not just a job. I love what i do. I am so grateful to be working there. The last two months felt much longer than the last 14 years. I am hoping and praying that our arf residents do not have to go through this again. I am happy and relieved to hear that they will not be forced to leave their homes. I hope that the arf program and the staff will continue to provide great support and care to our sf Mental Health population. We feel we have heard by the supervisors and dph. I am so grateful the staff members, union, management came together to work and a solution to save the arf and our residents homes. I am looking forward to working with my peers to come up with a plan to make the arf a better home for our residents and to create a better working environment for the staff. On behalf of the members and residents i give a great big thank you to everyone and especially jennifer and the supervisors and others who worked so diligently for the last few months to save the arf. Also supervisor mandelman, thank you for your support and visiting the arf. I really appreciate it. Thank you so much.