Transcripts For SFGTV BOS Special Budget And Finance Committee 20240713

Any discussion . Call the question, all in favor . Aye. Any opposed . The motion carryies. Now item number 4, the directors report, executive director Shireen Mcspadden. Good morning and happy new year. Is this mic on . So i feel like we just met because the holidays kind of sucked up much of december, so i dont have a huge amount to report. I was in washington dc the second week of december which was actually after we met last month. And i was there for the meetings and they are the National Association of area agencies on aging. The december meeting is when we put together the policy priorities for the next year. So we spent quite a bit of time working on that and the issues that came up were the ones that you would expect. Things like aging and homelessness, food insecurity, the big kind of big ticket items and basic needs issues that are kind of hitting older adults across the country. So i think everybody was really saying we are experiencing the same issues. There also continues to be a lot of focus on workforce, both for the workforce issues we have around care giving and gerontology and things like that, but also there was a big focus on the need for jobs for older adults and the need for support for jobs for older adults and advocacy and all of that. So its always interesting to be there and hear from other people across the country and also kind of sobering to realize that these issues are really so widespread and nobody is surprised by that, but really just the stories are really sobering about what people are dealing with. And i think the fact that older adults get overlooked in big conversations so often. So theres a lot of need for advocacy like what we have in San Francisco, across country. The second thing was i think the big thing that happened in december and into january was that i think all of you read about city college, and i believe we actually spoke about it at the last meeting because it had just happened, city college announced they were cutting back on a number of courses. One of the big cutbacks was the older Adult Learning program. And there were 50 of the 58 existing classes were slashed in the budget that city college put out. And of course that meant that a number of classes that were going to start in january for the Spring Semester were immediately cut and people were told those classes wouldnt exist. And so the city was really very interested, the Mayors Office, the board was really interested in figuring out how to preserve some of those classes for older adults. And fortunately because of the fund, we had some onetime only dollars available that we were able to work with the Mayors Office to structure over three years, so we can use onetime only money over three years to preserve some classes. And its only 17 of the 50 that were cut. And the reason we were able to do the 17 is because they happen to be in Senior Centers that we already fund or in centers that we already fund. So we already had a relationship with these sites. We fund them directly. And what this means is we will be able to fund them directly to continue the classes in those sites for three years. And i think its really great that the city was able to step in and do that. Its a little complicated, because moving it from the city college, part of the city College Budget and that structure into a structure where its run by these various Senior Centers is a little complicated for people to figure out. So we are working through the details right now as to what that will look like. But generally speaking, people in the Senior Centers were really excited that their classes will continue. I think in my 17 years with the department ive never gotten so many letters and phone calls about something. It was clearly striking a cord with the population that we serve in San Francisco. People were very upset about the loss of these classes and continue to be upset about the loss of the classes that are not preserved right now. And i know many of you are involved in the advocacy around that. But for right now we were able to preserve those classes. And i also want to say i think that for the Senior Centers that we partner with, this is a big piece of the programming. And to lose that would have been really hurtful. And those classes are a way that people come in the door, and then they are able to access other services at the Senior Center and also maybe Services Later on down the line on our spectrum of services when they need them. And so preserving that seemed to be very important. The other thing im going to do in my report today is to give you the sixmonth update on our action plan when we met back in september, august, whenever i think it was august or september, and we met in closed session, you asked me to present you six months in and give you an update as to where we are with our annual action plan. So im going to do that today. And im thankful to rose who helped me put it together but also who is going to change over the slides. Can we get this on the does everybody have it up on their screen . Okay. So our Strategic Plan goals, if you go to the well, never mind. Our Strategic Plan goals are in front of you so maintain a Robust Network of communitybased services for older people and adults with disabilities, protect older people and adults with disabilities from abuse, neglect and financial exploitation, provide and support consumercentered programming to best address client needs, expand planning and evaluation efforts to ensure best use of resources and maximize client outcomes and then support and develop and engage professional workforce that is prepared to work with older people and adults with disabilities. So our progress to date, so our progress to date is that we have started 48 actions that are currently in progress, and we have 14 actions remaining that will be started in the second half of the fiscal year. So basically we have 62 actions that we said that we would complete during this fiscal year, and we are well into that. And one of the things that im not going to go through every single action, because that would take all morning, and president serina would not appreciate that. [laughter] its difficult to contain my enthusiasm. Right . But i did want to talk about a few highlights. And so im going to go goal by goal and just kind of highlight one or two things in each goal. So goal one, strategy c if you have your plan in front of you, strategy c is to strengthen San Franciscos caregiver network, including enhanced support for Informal Caregivers and supporting a robust provider workforce. Our action was to strengthen processes to enroll and support ihss independent providers. Previously the Service Center was operating in a small office with really inadequate space and we used to have lines down the street, even in the rain and things like that. So this is really better. And its also better because our Service Center, being able to serve providers as well as clients is really exciting and having everybody in one place really makes sense, so providers can learn about other services. Often providers are people who might need our services in other ways. And so its helpful to have that. We have completed the transition to Group Orientation which provides a much more efficient process. We used to do it one by one, and we really didnt need to do that. And we are currently working with i. T. To build a texting system so that we can text people messages and things like that. We are aiming to have the system functional by the end of the fiscal year. And the texting system we have started using with some of our medical programs and its proven to be popular. So while not everybody appreciates texts or gets their news or information that way, we find that its really helpful for a lot of our providers. And goal two, develop specialized resources or strategies to develop specialized resources to address specific client needs and resolve complex cases including highrisk conditions, selfneglect behaviors and Financial Abuse. Our action was to launch the San Francisco home safe program. So home safe launched in july 1 with 773,000 in funds from the state. Its a partnership of Adult Protective Services, the Homeless Department and the institute on aging. A. P. S. And the institute on aging provide Case Management and purchase of services for clients who are at risk. Bay they focus on people at risk of homelessness due to self neglect, particularly those coming through the Homeless Department. Quarterly meetings to support this implementation and to help build and expand upon the partnership. In the first six months, 25 individuals were enrolled and were on track with our proposal to the state. Our anticipated Service Levels for the twoyear pilot are 120 clients. And so the programs going smoothly so far. Then goal three is to strategy c is to ensure programs are culturally appropriate for the diverse lowincome adults and adults with disabilities, including the first lgbtq aging out of the closet. And action was in partnership with the office of transgender initiatives to identify and Fund Services to support transgender older adults and people with disabilities. So d. A. S. And the office of transgender initiatives held stakeholder meetings to discuss potential services, which i think was really valuable for us. And this is a community that we are really learning about and of course a community that has very, very diverse needs. And also is a community that is extremely at risk as probably many of you know and read about or you have friends who experience what its like to be transgender in San Francisco or anywhere, and so we really wanted to learn what do people need, how do people feel safe, how can we really help this population, especially the population of older adults. The focus on services and resources that support connection and engagement, because thats what people really wanted. We put out an r. F. P. , the process has been completed, and we have two contracts coming to you later this morning. We are excited about that. While we are going to continue figuring out what the needs of this community are, we feel like this is a really great start. And from our understanding, this is the first of this type of initiative in the country. And then goal four, strategy c, was to facilitate planning processes and implementation of efforts to promote inclusion of older adults and people with disabilities within the broader city community. Action two, launch a San Francisco reframing aging campaign to reframe Public Perception of aging. Many of you were involved in this with us, so its been great. I think the community has really taken up the cause of reframing the campaign ran from october through december with public messaging and advertisements and hopefully all of you saw them through the the city. I think our media people did a great job of distributing the wall scapes and the light poles and all the things across the city. But we also had a robust social media piece too. We are now reflecting on the campaign and really thinking about what the next steps are. We had 3700 people so far take the pledge to end ageism online. We still have more coming in. I talked to people this week who said they were going to take the pledge. Im not sure if they have, but thats continuing to build momentum. We will be reconvening a Stakeholder Group to discuss phase 2, focused on increasing Public Awareness of services. If you remember our first phase was to reach out to the general public and say ageism exists, lets think about this together. And then the next phase is to say hey, atmosphere there are services here that are also there are services here that are really great that an older adult could use, all of that. And thats where we are now. And then the goal five was to sorry, strategy b was to explore strategies to develop and operationallize an equity framework. Our action in this case that we are highlighting is train Adult Protective Services on principles of traumainformed systems and create a staffdriven committee to create a plan for applying principles and practice. So staff have been trained on traumainformed systems and d. A. S. Has two certified trainers on staff. A. P. S. Started a traumainformed system staff group to implement the principles. The real reason we did this, and this is a Movement Across the country, but in San Francisco, its being rolled out across the department of Public Health, and we want to do this in the same way with our direct services staff. And staff are working with people who experienced much trauma and are reexperiencing that trauma. And Staff Experience secondary trauma. Some of them have experienced trauma in their life as well and they are dealing with people in trauma all the time. And its like how do we give staff the tools to really handle that in the way that its healthy for them and where they are taking care of themselves and where we are helping to take care of each other. So its been really i think staff have had really i think positive reaction to the training, and we are working through how to really bring some of these principles into practice, because its complicated, and people are really businessy and busy, but its important to maintain a healthy climate with our staff. And so in our areas of focus january to june, so we are always using the Community Needs assessment to help inform where we need to move. We have thought a lot about equity issues in San Francisco and how we serve people who are serving, who we are not. So one of the things that we learned from the Community Needs assessment is that latino caregivers, adults with disabilities and lgbtq and communities of color are not using our Services Sometimes not using our services in the same way. So we want to convene Community Leaders to discuss service utilizeation and equity concerns and really get Good Strategies from the community about how to do better outreach and maybe how to either design new programs or at least make our programs more accessible for the broader community, and we really have good information. And i want to thank rose and her team for doing the deep dives they did so we have the information and we can say now we know who we need to talk to, and we are going to convene those groups. We have a focus on strengthening outcome object is in partnership with our Community Partners. Just had a conversation about this this morning. I think its complicated because we are asking people to collect data. We want to know, of course, that our programs are impacting people in the deepest and in the best way possible, and yet we are asking our Community Partners sometimes to collect more data or use the systems. How do we balance all of those things together and to get to the best understanding of what impact our programs are having out there. Deep dive reports, we have had some great information, but we will be looking at Legal Services trends in asianpacific islander populations specifically, establish the communitybased conservatorship unit to implement the program we have been talking about and you have been reading about in the paper, and conduct Public Information campaign and develop enhanced outreach path for the community to increase awareness of services, which i just mentioned. So thats kind of the big to do in our second half of our year. Thank you. Any comments or questions for shireen . Martha . Especially around first of all, thank you for the work you did around trying to save as many classes as you could. It seemed like the most appropriate things to do was save the ones that have to do with our Senior Centers. Will the goal of trying to get more of these classes back or that be incorporated into our overall goals . And they sort of are. So i get that they fit into many of our objectives, but im just wondering if there will be a strategy for that to try and identify ones that might be good for our new model, that kind of thing, and try to bring more into the Senior Centers . Im not asking for a specific answer today but just kind of in this context will there be some work on that . I think there are going to have to be conversations around what fits best into our Community Services bucket. So right now, we have preserved these classes for three years. And im sure there will be many discussions in the community about what the best approach is and all of those things. Right now and we didnt do actually any research about where classes should be. We just said right now we are going to preserve the classes where they are. And there has to be a lot more conversation, but its a good question. I imagine so. So thank you for that work. Thank you. The issue of secondary trauma is a huge one. And im just wondering, the training program, is that coming out of the department of Public Health . What resources are we drawing on . Yeah, the department of Public Health took the lead on it and continue to. There are other resources they have brought in. They have brought in consultants to work with them but initially the money was from them, but we can also support it and will continue to. Thank you. Shireen, thank you, that was very comprehensive and a great deal has been done. I have a few comments or questions. Regarding a. P. S. , have we developed we have some programs, and have we been able to enhance the programs that reach out to banks and neighbors and Law Enforcement if they spot any potential signs of abuse . Because often they see them first before they become apparent to other people. So, yes, and im going to ask joel, Deputy Director who oversees a. P. S. And ihss and the guardianship programs to answer that question thank you. I did not see you. Our a. P. S. Director. Good morning. Adult protective services. We provide training on reporting to them. We also have a Financial Abuse unit, and we work with Law Enforcement. And we are also participating in a pilot where we are engaging, interacting with banks so they can report directly to us, some of these concerns, so we can take immediate action on those reports. Thank you. Its very important. And as i said, often the last to know are the people who are immediately affected or most concerned. And often the abuser is a relative. So its very challenging. But thank you. A couple of other questions. While we were just last week, the Mayors Office announced budget cuts. And we have a very ambitious slate of programs, many of which are new or expanded. And do we have any sense yet of how the suggested budget cuts or recommended budget cuts will affect us . So i think as you know, commissioner, usually because we are h. S. A. , and we have a large agency budget, we have those conversations across the three departments of the agency. So we have not yet had that conversation. Part of it is i have not had that conversation and part of it is because i was out sick when we were meeting. But we will definitely be thinking strategically about how we do that. One of the things when we think about the expansion of programs is because of the growth of the dignity fund, and at this point the dignity fund is not touched by those cuts. It could be at some point, but right now thats not on the table. And so we can continue working with the money that we have. And so we are doing that. I know the dignity fund at the moment looks like its going to be preserved. But it can change. Theres always wiggle room. Okay. Well, thank you. Any other comments . Commissioner loo. I read in the paper that the city is asking for funds to help with the Community College classes. Is that true . And also would there be a continuation . Thats what i was referring to as the money we used onetime only money, and we are spending it over three years. But its onetime only money. So its not money that is allocated into the future. We already had an allocation plan that has already been approved. The fouryear allocation plan that we brought before you. So this is money that didnt get spent in this fiscal year that we are able to structure over three years. So its the 216,000 per year over three years. Yes. Its for the classes that are specifically at the Senior Centers that we fund. Thats what that is. Okay. And in the future, if the city cant come up with the money, and they will ask us to use to get the dignity fund to help out im just asking a question. A very good question. Its an ongoing conversation. Thank you. Thank you very much, shireen. Thank you, commissioners. The next item on the agenda is employee recognition, the daas commission. Thank you, rose. The daas commission and executive director Shireen Mcspadden about honor maria morabe from the d. A. S. Office of inhome support services. Come on, maria. You look so excited. [laughter] so excited to be honored today. Come on up. Thank you. Its all good. So, all right. So maria is from Inhome Supportive Services. And i would love for all the Inhome Supportive Services staff to stand if possible. [applause] so ihss is d. A. S. s biggest program. And its literally over half of our staff. And one of the things ive learned about ihss over the years ive been here is that things are never static, right . You think you have caring, or you are doing intake or you are doing reception or you are doing clerical work, and thats your job, but actually what happens is theres change constantly. The state is always saying now do it this way, now do it this way. So one of the big things we are doing this year is electronic verification and that is a huge change. Because i know im preaching to the choir but im actually saying this for the public, and thats that electronic verification is a huge change for providers and for clients. And it means that people who hadnt used Electronic Devices before have to learn to use them. And in San Francisco, we know that a lot of older people and people with disabilities are victims of the Digital Divide and they didnt get brought along when the rest of us did. And there are a lot of people in the community doing a lot of work around that, but we are suddenly hit with this need to put 45,000 people onto this new system. And so i want to thank all the ihss staff and also our contractors who work with ihss like the Public Authority and home bridge, for coming together and working on this. Its a huge lift. But we are going to get there. So with cristas leadership, we are definitely going to get there. So, maria, i wanted to say that first because i know that you have been honored and you are being honored this month in the midst of all this work that is happening around you. And you have risen to the top. So im going to read what your coworkers have said about you. Okay . So maria morabe is a very exemplary and professional employee who is worthy of being recognized as employee of the month. She knows her job well, is highly organized and managing her time effectively and consistently performs a large volume of work accurately and in a timely manner. She works very well with her peers and takes interest in learning and shares her learning with her peers. You have a great attitude and treat providers and recipients with compassion, dignity and respect, providing them highquality Customer Services while addressing their unique individual needs. In addition, she has been designated by the ipac supervisor to train existing and new. What does it stand for . Independent provider assistance how to process moment verification. She has coached her peers and equipped them with how to process different kinds of employment verifications. So you are highly regarded by your peers and your supervisor and you are a great resource and support to the rest of ihss and to clients and providers. So thank you so much. [applause] on more of d. A. S. , you are our employee for the month. Thank you. May i say a few words . Of course you may. I have the copy in my hand. I dont want to miss anyone. So first and foremost, thank you to my heavenly father, my family and friends for being here today, a special thank you to the special someone who nominated me, my direct supervisor for endorsing the nomination, our management team, the executive director, of course, and our Deputy Directors, program manager, program director, thank you for your selection. Thank you to the commissioners for allowing us this time to present the employee of the month, 11 months of the year, and the manager of the year in december. And to all of my supervisors past and present, i have four, one direct and three. And our temporary staff and the clerk and lastly but certainly not least, my fellow Human Services technicians, because we have been through a lot in the four years that ive been with ipac, and we have helped thousands of independent providers and recipients transition to the electronic verification process, the electronic time sheet system. We have mastered the employment verification process, we successfully conducted the Group Orientation at 77otis. We have adjusted to our new Service Center, and of course our new schedules, because we rotate various tasks every day. Im blessed to be part of a team thats made up of smart, caring, hardworking and generous people who support one another and enable coworkers like myself to volunteer at various committees and promote inclusion and self care. Since its still early in the year, i want to wish everyone a healthy, happy and productive prosperous new year. Thank you all for your kind attention. Thank you. [applause] [applause] thank you. The next item on the agenda is the Advisory Council report. Welcome, diane lawrence. A little bit different mic. Good morning, commissioner, president , commissioners, director mcspadden. Happy new year. Last month i was at the meeting which why i was not here, so i will give you a report on that tac meeting. Since the council didnt meet in december, i thought it might be advantageous to just kind of sum up what we had done in 2019, because the council worked hard, and i think we have accomplished some things that i hope you will be pleased with. So our first we will get to legislation in a minute. But we basically we began tracking over 50 bills at the beginning of the year, and we settled into 46 by the end. 19 of those bills were signed by the governor, six were vetoed and ill give a report to bridgette, i listed all the veto messages which i promised you back in october. There were 11 bills where no action was taken, and i think we may see those come back, and well know more when we meet next week. And then there are ten under submission that could also come back. The legislators released their priorities for the coming year. And so well see where that goes. Well have a better idea when i report in february. We filled one commission vacancy. We still have two openings. Two board of supervisors seats were filled by the year end with a third pending. So that leaves us and there are four Commission Seats and five board of supervisor reappointments to be made in 2020. So we are hoping to get the Commission Group together as one package, and then see if we can work with the board of supervisors and rules committee to present all of those at one time so we are not dribbling and then we are reaching out to the two supervisors where we have no representation yet. So thats kind of the plan. So keep your fingers cross. We completed ten site visits last year. So i wanted to make sure that when we do it month by month, it doesnt come out quite as large. And i was kind of amazed at how well we had done. The nutrition sites that hadnt been visited in the recent past have all been assigned and prioritized for this year. Well begin reporting on those in february. Pedestrian safety committee, as i was in my november report, i was on vacation then. Provided a preliminary report, and council decided to continue this work in 2020. And we are going to add paratransit, and well get oar transportation issues as well. And we have focused right now on five topics for the year. Like we did last year. The first is census 2020. We are inviting a speaker for january. The master plan for aging and the alzheimers subcommittee, which dr. Ailman who is on the council and on the state commission, is a part of continuing our pedestrian safety, looking at housing, and then the whole issue of isolation. So those are our targets for 2020. Thank you very much. That was very comprehensive. Any comments or questions for diane . Thank you. The joint legislative you will have one next month. I think we have our first Advisory Council meeting next wednesday. And you are back for tac . I am. So we had a robust meeting in sacramento on december 3 and 4. We have the meeting dates for the coming year. They will be in late february. And they will coincide with the advocacy day or capitol day with the legislature. We will meet in may to coincide with senior rally day on may 11. The october dates, we think that should be close to when master plan for aging comes out. So and then in december we always meet the first week. So we talked about the master plan for aging on the engaged california website theres a way to sign up for updates on the master plan and that url is in my report. The department of aging at the state level is launching wednesday webinars that anyone can sign up to discuss the highpriority topics for the master plan. And one can sign up for the webinars on the website. The commission on agings website has linked to the Stakeholder Advisory Committee and subcommittees, and the subcommittee reports are due at various times during 2020 and then will be consolidated into the master plan. There was an Elder Economic forum which commission spears participated in, and there was a white paper presented, if i read my notes correctly, on Elder Economic issues. The p. S. A. S all have to report and then theres some general reports and im not going to go into details. But what basically came out in those of us that were there, the focuses have been on the census. Wildfire safety and emergency planning. The master plan, there are some big changes coming in l. A. County and l. A. City because we know how massive it is and how they structure their p. S. A. S and and seeing how the county and cities can work together. And then theres focusing also on homelessness, shared housing. Future topics that well be talking about are shelfstable foods, Adult Protective Services, Public Benefit and care giving. We had a presentation on the California Healthy aging initiative from the California Department of Public Health. And this is to align resources with focused leadership. Its a Program Within the department to coordinate and develop a healthy framework for california. They are looking at the Healthy Brain Initiative and there were two in rural counties, three in urban counties. They are also looking at a way to set up a unit just for addictions, not just opioid but alcohol, gamble, any kind of addictive behavior and handle it as one. The goal is to launch this in october. We also had a presentation on creating a welcoming environment for all. And it was presented by the friendly visitor coordinator for the laven darr Senior Center in east day. This was formed in the mid 90s. It addresses some of the issues that shireen just spoke about with the lgbtq community. And they have two major programs, friendly visitor program, working with Community Volunteers to visit isolated seniors with the goal of visiting the isolated seniors at least once a week and safe and visible design for healthcare workers to make the community more comfortable and speaking appropriately with lgbtq seniors. This program and their training is posted on their website and available to anyone. We also had a very thorough presentation on census 2020. It is wellfunded by the legislature as commissioner pappas knows. I want to say april 1 is camp day, so youll be hearing more about that. Complete count is very important. The other issue that is theres a lot of concern, i think, around two things, one is citizenship questions, and there are none. There are nine questions which are already available online. And theres a lot of worry about Cyber Security and hacking, and the Census Bureau is taking that seriously and is working diligently to make sure the data is secure. I want to say there was over 20 million. There was a lot of money the governor put in the budget. Our last presentation was by helping communities prepare for natural disasters. Its a program that started in june last year in collaboration between the state and communitybased organizations with 50 million in funding. And the goals were to include a sociallydiverse and isolated communities to bolster resilience and empower selfs for safety. 24 counties were given grants and Catholic Charities made the presentation had contracted with eight. One of them was San Diego County, and we had a representative from San Diego County speak to us. They have done things like alert San Francisco, much like we have with 311 where they can alert folks with text messages. A reverse 911 where theres emergency call and then goto bags, what do you need . They have put together door fliers for Contact Information and what the presenter spoke about has allowed people to begin to think about those issues and have conversations within their families. They have put together training curriculum and the types of emergencies talked a lot about smoke detecters, especially in wildfire areas, earthquake preparedness. They are very specific, and they are trying to make them culturally specific as well. They have completed the top ten tips have been completed in san diego, and they have modified it from Imperial County because Imperial County is more rural. Our next meeting is at the end of february. Thank you. You have certainly been business. Thank you very much. Any questions . Any questions or followups i need to do . Okay. Thank you. Next up is the longterm care coordinating council. Kelly dearman. Welcome. Good morning, commissioners, president serina, happy new year, everyone. I am going to give the report from the december longterm care coordinating council meeting. The big news is that we have a new ltccc member who will serve as the Second Department of Public Health representative. It is alex jackson, and he is the Deputy Director of adult systems of care at the Public Health Behavioral Health services. And because we like to put people to work immediately, he will also serve as the cochair of the Behavioral Health workgroup. So at the last meeting in december, of course, we had updates on the master plan efforts and master plan on aging, and in particular we had a robust discussion about how we can encourage the consumer perspective and Stakeholder Input throughout the whole process. So many people that we want to make sure can participate so that voice doesnt get lost. We had a discussion about census 2020, in particular since so much is being done online, we want to make sure our older adults and people with disabilities are count. We talked about the dignity fund. And we had a presentation on accessible Transportation Services, and i understand you are going to hear that. So i wont give it away. And we had a meeting yesterday, but im not ready to report on that. Thank you. Thank you, kelly. Any questions or comments for kelly . Thank you very much. The case report. Good morning, commissioners. Happy new year to all of you. Case members enjoyed a very Festive Annual Holiday Party last month. It was actually the largest turnout that any of us could remember, all enjoying fine food and beverage, good philip and a shall we say very spirited White Elephant gift ex change. A good end to the calendar year. Last month we submitted our formal funding request to director mcspadden for budget year 2021. It will be the letter itself will be included in the report that you will receive from bridgette. The total of the request is 1,468,956, which is somewhat higher than the previous amounts that i spoke of last month in summary. That was due to as we were preparing the final draft and reviewing the realities of the cost of doing business in San Francisco were looked at as well as wanting to aim to achieve optimum results for our seniors and people with disabilities. Just to summarize the ask includes five categories, aging and Disability Resource Center Salary Equity in the amount of 213,000, outreach campaign, which would include funds for individual agencies to do their own outreach as well some funding for our getting there together event 2. 0, which is scheduled for september 13. The total for that item was 400,000. Isolated lgbtq seniors, efforts to reach and engage this marginalized population, 295,000. Trainings for agency staff, to better equip them to do the work that we do, topics that were suggested, this is not finalized by any means but include ableism, compassion fatigue, budgeting, et cetera. And that was for 60,000. Behavioral health support, this is an area where most of that increase from the amounts in my report last month were, to include two clinical staff, so two psychologists to rotate among Service Centers, not only assessing and dealing with individuals but also training for staff to better equip them to do their work on a daily basis. The total for that is 500,000. At this months meeting, which is monday, this coming monday, particularly note worthy for two reasons, one is that our featured presenter is louise aaron erinson, professor of geriatrics and author of the New York Times bestseller elder hood, which i highly recommend. We are really excited to have her joining us. The other reason of note is that this will be the first, the case meeting will be followed by the first dignity Fund Service Provider workgroup meeting under the new leadership model which will have Dignity Fund Coalition coleading the four annual meetings. At this meeting, Melissa Mcgee from the office of Community Partnerships will be presenting on the dignity fund data and evaluation report. And then we hope to have time for a significant conversation discussion with attendees on what they want to see on the agenda for these meetings Going Forward as well as envisioning what they see this group being and becoming. So we look forward to that very much. Next month, we will have a Transportation Panel presentation with representatives from s fm ta and transit riders talking about current Transportation Resources for seniors and people with disability as well as efforts, advocacy efforts Going Forward. We are looking forward to this quite a lot as transportation has been and remains one of our primary areas of concern and effort. And in march, we will have someone from the census back again just prior to that, because we agreed it is quite important. And also we are looking forward our board is looking forward to next month a board retreat. Its been a couple years since we had one, and we are finally able to schedule most of a day to really get down and do some looking at Strategic Planning as we go forward. I want to close with a sincere thank you to director mcspadden and the commissioners and everyone that was involved in helping restore the elder Adult Classes that we were able to maintain. This will remain one of our areas of attention. We will be working with Dignity Fund Coalition about advocacy efforts towards the other classes and looking in the future. So we look forward to working with you on this very, very important topic. And that is it. Any questions i may answer . Thank you. Any comments or questions . Thank you very much. Item number 5, any old business . New business. The San Francisco municipal transportation agency, paratransit presentation, erin mcauliff. Hello, commissioners. Erin mcauliff is under the weather so i will be giving the presentation in her place. And you are . My name is jonathan chang, im a paratransit planner and i work in the Accessible Services department at San Francisco municipal transportation agency. Sorry. So it is a part of the Taxi Services division at m. T. A. We help manage several programs, including the Paratransit Program as well as the discount office, and we help oversee the m. T. A. On various aspects of accessibility projects throughout the city, including the capital projects, bike projects, pedestrian projects as well as emergeing mobility. So what is paratransit . It is the doortodoor Transportation Service as available to a. D. A. Eligible riders. Currently m. T. A. Contracts out to the administration of the daytoday service. So it is responsible for the a. D. A. Eligibility certification process. They are responsible for media sales, Service Quality monitoring as well as customer interface. We also provide transportation for the Paratransit Program. They are the provider are the access service. They also contract out to every taxi company in the city to provide taxi service to paratransit riders as well as to two nonprofits to provide service for our riders. So in order to qualify for paratransit an individual has to be unable to use the service some or all the time due to a disability. They have to First Complete an application and once they submit the application, the application is then reviewed by a certification analyst. The analyst may call the individual in for interviews to go to maybe elaborate more on their able to use the service as well as to verify some of their health conditions. Based on all this information, the analyst then makes a determination as to whether or not someone qualifies for paratransit. If the individual doesnt agree with the determination, they can appeal that decision. So s. F. Access is the prescheduled a. D. A. Van service. The van service is comparable to muni. So it has the same hours as well as the same service area as muni. So the van service operates 24 hours a day, seven days a week, 365 days a year. It serves the entire county of San Francisco, northern san mateo county, Treasure Island and the marin on the weekend. The individuals can reserve a trip up to seven days in advance. The second mode of transportation that we provide to our eligible riders is group van. This is Group Transportation for a. D. A. Eligible riders going to and from a single location like employment work site as well as d. A. S. Funded nutrition programs. All the routes are prescheduled and are done in coordination between the Service Providers and social service agencies. And we have three providers, including two nonprofits. On the third transportation mode we provide are taxis. Every taxi company participates in our Paratransit Program in acore dance to the citys transportation code. In addition to the fleet of suvs and sudans, there are 40 Wheelchair Accessible taxis available. Riders are issued a debit card which they can use to pay for the meter fare or taxi trip. The taxi trips are a subsidy. The we provide a subsidy to the user. For every 6 the rider gives we put 30 of value on to the debit card for them to use to pay for the meter fare. One of the more recent initiatives we have taken is the launch of mobility magnet center. This seeks to serve as a onestop information and Referral Center for older adults and individuals with disabilities. We understand that in the city theres a lot of transportation that can be overwhelming to anyone, especially someone who is new or who has a new doctor. So we are trying to provide for individualized, one on one training and assistance to older adults and seniors and people with disabilities. In addition to all the a. D. A. Programs, we have several programs that are administrate and provided through the Paratransit Program that doesnt require a. D. A. Eligibility. One is a shop around program. This provides transportation to and from Grocery Stores for seniors and people with disabilities. Another one is the go service which provides food transportation for seniors and people with disabilities to go to cultural and social events to help reduce social isolation. And the Third Program we provide is paratransit plus, which is a taxi program that is available to riders who may not qualify for paratransit but may have difficulties for certain trips in which taking the bus isnt the most optimal means to getting to their destination. So we do provide travel training, both Group Orientation where we talk to a group, we help, we provide an overview of the features of muni as well as trip planning tools that they can take advantage of as well as individual travel training where we work with the individual one on one to help them, familiarize them with the bus route they can take to go to frequent appointments. We are also dedicated to incorporating more technology in communicating with our riders about our services and such. We partner with slide wheel to allow our paratransit taxi riders to use their app to request a taxi. In particular, if you are a wheelchair user, you can specifically ask for a wheelchairaccessible taxi using the app. We have launched a taxi online portal, which allows for paratransit taxi riders to pay their portion of the taxi of their taxi debit card as well as view their trip history and report lost or stolen cards through this online interface. And we have two advisory committees who advise the m. T. A. Paratransit about the accessibility issues that they face throughout the city. One of them is the paratransit council. This is comprised of paratransit riders, Service Providers and communitybased represent i haves. They advise the m. T. A. On Service Quality issues with paratransit as well as help assist us in policy development. The second one is the multimode accessibility advisory committee. They advise the m. T. A. On accessibility issues regarding the munis fixed route as well as bike and pedestrian projects. And im going to turn the floor over to staff who will talk about the project and their communication with the public. Thank you. So im going to just touch on briefly state your name. My name is stefani morales, im a Public Information officer with m. T. A. And i handle communications for the van ness Improvement Project. Im just going to go over what the van ness Improvement Project bus stops are currently and sort of the consolidation process that has gone on there. So as you can see, we have 11 permanent stops that are a result of the consolidation process that really began as early as the Environmental Impact study. This was long before the construction happened. But this has been in project planning for a long time. And outreach about these changes happen throughout the process of the implementation of the bus stop consolidation. But a lot of the main outreach also happened in 2016 prior to construction to make sure that the public knew these changes were going to be coming. And so some of the reasons for bus stop consolidation really is to we essentially removed four bus stops that are going southbound and five bus stops that are going northbound. And the purpose of this is to really help maintain the traffic circulation during construction as well as Transit Service reliability and efficiency. And the selected stops were chosen on various criteria. Some of that is including walking distance. We wanted to make sure that there was stop spacing, street grades, transit connections that were being accommodated, as well as existing passenger usage. And as far as meeting the needs during construction, so as a lot of you might know, bus stops, temporary bus stops can change depending on when construction might be impacting these bus stops. So what we provide, and its the first time we are doing it with a project with m. T. A. , is temporary bus stop platforms to help provide all of our customers with accessibility as well as temporary benches. So we do move those along with the temporary bus platforms as needed. We also have office hours, which gives us the ability to have the public come to us and let us know of any issues regarding not only bus stop changes but anything else concerning the project. We also have a 24 7 project phone line and this is something that we put on our website that we distribute in a weekly newsletter that is in newsletters that we send out to members of the public, especially those that are along the van ness corridor, so that they can call this number at any time with any concerns, including concerns about bus stops or any changes. And temporary bus stops always have to be within 250 feet of the original stop. We also alert the public of these stops with signage along the corridor. So this is just some of the ways that we are addressing the bus stop, the temporary bus stops that can be moved at times because of construction impact. And thats mainly what i had to say about what we are doing in regards to construction right now. So i think i will be passing it over to my colleague, sandra who will be talking a little bit more. Excuse me. May we have questions at the end of the entire presentation, then . Will that be all right . Yes, i will be sticking around. Thank you. Good morning. Im in the Service Planning team at muni that includes stops management, and thats what i will focus on today. What i hope to focus on is share an overview of the stop changes s. O. P. , which is as we go through in thinking through whether a stop change request or something we have identified will go through. And also to highlight how we have incorporated a screening tool on which we collaborated with senior and disability action to incorporate that into our stop changes s. O. P. The s. O. P. Has been in place for one year. And we collaborated with senior and disability action on the stop changes streaming tool in 2016. So projects that were initiated before and anything that was legislated before did not go through these steps, but Going Forward any new projects will. And so here we have the list of all of the Different Reasons why we might have a stop change in muni. And one of the reasons we came up with this is we realized it was not just our team that was coming up with the stop changes that we were recommending based on feedback from the public, operators or performance data, but also other teams, for example, the livable streets team that implement bike lanes, et cetera. A lot of the projects when they were coming up with them, it was necessary to adjust some stops to make sure we were able to make room for everybody on the street. So we wanted to come up with something that made sure that everybody that was generating stop changes were thinking through all the different considerations that we consider important to implement the change. So this is way to small, but we will have a larger slide later. This is essentially what the stop change s. O. P. Goes through and prompts anybody who is trying to letting and implement a stop change has to go through and think through before doing so. So we have a planning phase, we then have which is a good idea, is this not a good idea, what are the things to think about, and then we have outreach, going to the community and saying we think this is a good idea, this is why, and getting feedback, and then based on that going through another Decision Making of should we go forward with this and try to legislate this or not, and thats another set of steps which is this change is coming to you. Considering a stop change, these are the different considerations that we take into account based on guidelines and best practices. Did i move it . Sorry. So intersection control, when we have a stop sign we try to have this stop placed at the stop sign rather than the other side of the intersection. Thats to avoid stopping twice, once for the stop sign at the intersection and again after the intersection. So sometimes when we adjust stops, its for that. Its for making, improving our performance and making sure we can go fast, but a lot of time it wont extend the distance more than crossing an intersection. We wont do it when, for example, we have a Senior Center or another trip generator that benefits from having the stop right outside their location. Sidewalk space, is there enough space for people to wait and queue up, what are the grades. We have different limitations, i think an 8 percent grade that we avoid placing stops unless its necessary. Curb space, spacing of the stops themselves, how often and frequent do they come along the line, trip generators, transit opportunities, properties, terminal stops, all of those are things, and we have very specific guidelines on how to think about these things. And so once somebody has thought through all of this, we prompt them to go through the screening tool, which ill go over. So this is again a little more detail about how we think through things. And we can cover that in the questions. These are our stop spacing guidelines that we have that were adopted by our board. So they are much more spaced apart in rail and rapid bus but local bus depends on grades, et cetera and how frequent or how close together they are spaced. We have some guidelines on how the length of our stops in order to be able to serve the stops and make sure that we get to the curb and do an accessible stops. And here are the different when working with disability action we came up with four different questions that if any of them qualify as part of the stop change we are trying to make, we need to notify them right away, sit down and discuss why it is that we are trying to do this, way before we go to legislation and go to public hearing. So the staff is within 650 feet of an entrance to hospital, public facility or center for people that are seniors or have disabilities. It will stop by 300 feet or more. The proposed stop will be on a grade of over 60 percent, the stop proposed has a shelter but alternative stops do not have shelters. So will the stop quality downgrade because of where we are trying to site it. Stop proposed for removal is accessible but alternative stops are not accessible. So all of those are red flags for getting in touch with senior and disability action right away. And this is the form we provide for them any time we are thinking about doing a stop change, providing them with very specific information that they have requested. And we also usually provide a diagram that explains this is what it will look like, this is how much people will have to walk further or closer for a stop change. So once we assess the balance of support and opposition for the stop change, mainly with s. B. A. And bringing this up with the public, we do doortodoor fliering a lot of times. When we evaluate whether its worth bringing to legislation. So Supervisors Office is another place we stop to get a sense of support. Parking removal is another factor that will determine how much support we have. And then we have best practices on noticing for when we are going to go forward with the stop, so make sure inconvenience is minimized and that we are clear, et cetera. Thank you so much. Thank you very much. It was very comprehensive. And im sure there are questions and comments. Commissioner pappas . Just a request. This was a lot of information. Would it be possible for us to get the electronic version of what was presented here . And in particular, drilling down to the paratransit presentation, how do you do outreach to the community to let them know about these services . And can you make that available to us too . So we actually require our contractor to do at least 20 outreaches each year, but they do way more. We actually have a manager here. She is responsible for organizing the outreach to not only communitybased organizations but social workers and anyone who may need services. And they keep track of it on a spreadsheet. In particular, they are trying to put a bigger emphasis on doing outreach in areas identified in the communities of concern. So we are constantly doing outreach. And we also have our advisory committees. They meet the executive Committee Meets every sixweeks, and then we have smaller subgroups that meet each month to focus on a specific aspect of the transportation modes that we provide through paratransit. Thank you. Regarding paratransit, your presentation indicated reliance on taxi cabs. But we have fewer taxi cabs in the city. How has the Paratransit Program been affected by the increase in lyft and uber and other Services Like that . So i think the one thing i didnt show on the presentation was the number of trips taken by paratransit users on taxis has actually increased over the past couple of years. I think the impact of t. N. C. S has been most impacting on the taxi programs which are the wheelchairaccessible taxis, because those vehicles cost a bit more to operate and you would have to convert a mini van into a wheelchairaccessible vehicle, so thats more cost to the companies as well as the drivers. So what we have done is we have placed several incentives in place to help support the drivers. We have a 10 incentive thats available to all taxi drivers who provide wheelchair trips and we bump it up to 15 if they provide trips in the outlying neighborhoods like bayview as well as if they provide trips during the nighttime to wheelchair users. We also have an airport short pass, so if a taxi driver does at least 30 wheelchair trips in one month, they can go to the head of the line at the airport, and thats extremely valuable for taxi drivers. And we have various incentives to encourage taxi drivers to purchase their own vehicles. We provide 650 each month to new ride taxi drivers who purchase and operate their own vehicle. So we are trying to strengthen the taxi program which we felt has been most impacted by the growth of t. N. C. S. Thank you. A couple other observations. One, i think the outreach from my experience has been very, very good, and i was very happy to hear about the summary discussion of the van ness Improvement Project, which people are working very, very hard on addressing the issues and undoubtedly encountered many things they had not expected. I live at the San Francisco towers which is a Retirement Community just off van ness between van ness and franklin on pine street, and there are many different Senior Housing developments in that neighborhood. And that has been the decision to permanently move some of the bus stops. It doesnt sound like a lot if you are ablebodied to have to walk an extra 350 or 600 feet to get to a bus stop, but it does have a huge impact on many of the seniors who live not only in my building but in many of the buildings around there. And while the outreach has been commendable, i have not noticed as many changes in response to concerns from those individuals. The emphasis seems to be on speeding up bus service, which is understandable, but it seems there is an inherent conflict. And i would like to have somebody address that clear conflict and why it seems that concerns are raised but not always addressed or even occasionally addressed. Yeah. And thats something that we have definitely heard a lot about during the outreach and when we speak to folks about those issues. As far as my understanding goes, a lot of these changes, the permanent stops, a lot of that was sort of decided really early on in the project, again, the Environmental Impact study being one of the stages in which these were decided. And i think that at this point, as far as i understand, its not really possible to change the permanent stops that are now being sort of planned for and will be under construction fairly soon. And so that is a concern that i will definitely continue to take back to my team. And any accommodations that we can make now during the construction process to make it a bit easier on the neighbors and folks using those stops, well sort of look at things to see if theres any way that we can make it sort of more amenable. But as far as i understand, there was outreach during the Environmental Impact study. And one of the main things that came out of that, or i guess the reason for the changes, the bus stop the permanent bus stops, was that the biggest concern was that efficiency and was making sure that the bus stops were ensuring Transit Service was moving quickly and efficiently through the corridor. But i definitely hear that concern. And its something that i can continue to bring back to my team. And if there are ways that we can help mitigate that, then im sure that we will continue to look at that. Thank you. And i would like to remind you that the senior population of the city is growing very rapidly. San francisco has the highest percentage of seniors of any big city in the country. And while its gratifying to read about the accommodations made for individuals who are interested in bicycling and bike paths that are being created, thats not an option for people as they get older or for many people as they get older. So, again, the outreach has been commendable, but the results have not been very satisfying. And this is not directed at you. Obviously these decision were made a long time ago, but anything that can be done to revisit those, and i speak for other people on the commission who live along the van ness corridor who probably share my concerns, and im an ablebodied individual who walks six to seven miles a day. So it is a very serious matter. And im sure you are aware of it, but i just wanted you to hear it directly. Thank you so much for that. Any other comments or questions . Martha knutzen. Hi. I should disclose i also sit on the committee that advises the van ness Improvement Project. So commissioners hear know that i got very involved in pedestrian safety, and im always talking about the van ness Improvement Project whenever i can as it relates to senior issues especially and disabled issues. So i actually have a little bit different question because i get a lot of them. And they hear me advocate for those things every month. On Paratransit Program, so its actually a different question, are all of the things that you mention, especially the Shopping Service and van gogh, i didnt know about that, are those all only people who are not available to only people who are not able to take muni . Some of these programs have different qualifications . So for the shop around and van gogh services, we just have an age requirement. You have to be 65 or older or have r. C. C. Discount i. D. , you have to qualify for that or if you are a. D. A. Eligible, you can qualify for those services. You dont have to be an a. D. A. Eligible rider. Those are two great programs. I didnt know about them. And especially in view of the other question about outreach, that would its just very, very helpful to many, many seniors to know about that, especially i live on van ness, its so difficult to shop along van ness because of the bus stops and the changes that are always being made. So im just saying that in particular it would be very helpful for people to know about that. It might be something thats available to people and help them to get around on these really business corridors. So thats great. Great. Thank you. And one other question about so interested in the stop theres all this study that goes into making sure that when you make changes in stops. Im not sure it was embedded in here, but one of the things that seniors face, and especially people with disabilities face, is crossing streets. So it may seem like when i was younger, i never thought about that. But now with packages as you get more frail, things like that, you notice that. When you make changes to stops, is that one of the many things that are considered . So what im talking about is one bus you are taking one away, stops, and then are you going to have to cross a street to get te opposite direction, and im not saying that in the right way, but if you follow what im asking, do you consider that for people . Absolutely. Any time we change a stop from one side of the intersection to another, you have a shift in who has better access, because there is probably going to be but in takes into account the frontage, the businesses, is there a senior facility, those are the things that we came up with the senior and disability action as part of the screening tool, and thats absolutely something we take into account. We very rarely unless its a huge operational issue move something from one side of the street thats close to a trip generator that seniors need to get to and move it to the other side. It is absolutely something we consider. What im asking, this whole thing about you are going one way and can you catch that bus going the other way without yes. You know what im saying right. Yes. Thats also something we take into account. What are the connecting bus lines and how are people going to get to it. So i watch a lot of seniors and people in wheelchairs and walkers really planning that trip. Okay and you can see how they have to get off and where they are going to go and becoming more and more aware of that. Thank you. Thanks for the reminder. Thank you. Any other comments or questions . I have one question. So you went through the process of an individual to sign up and if they get denied, they can appeal, what is the process for a nonprofit . I notice you have two of them . So im just curious what how that differs. Talking about what is the process with self help. So those who are care providers, they are contracted with trans to provide the service to their sites. They went through an r. F. P. Process in 2017 in order to become Service Providers. There was a third one in central latino, but they have since dropped out. Oh, i see. So they are providing services. They are providing services to Services Provided to them. I understand. They are providing services to our riders to various sites throughout the city. Got it. Thanks. Thank you. Any other comments or questions . I would like to thank the m. T. A. For taking the time to present this comprehensive presentation. Its been very informative. And i hope that our suggestions and concerns are raised to the appropriate levels, and we may get some results. Thank you very much. The next item is another presentation. And it is Kelly Dearman again for Inhome Supportive Services Public Authority. Welcome back. Thank you. So just before we get started, im Kelly Dearman, director of the San Francisco Inhome Supportive Services Public Authority. Im here with my policy analyst jane lee. So any questions will go to her. So what we wanted to do today was give you very briefly an overview of what we have been doing over at the Public Authority and some of our outcomes to date. I will say that its been really great for me and our staff to work with ihss under cristas leadership and also with director mcspadden. I think we really are doing some wonderful things here in the city. And im really proud to be working at the Public Authority. So first off, this looks daunting, but it will be really quick. We are just going to give you a little bit about what our programs are and how many people we are serving. But first i just want to tell you about the great news that happens with us is that every year we do have an independent external audit done and then also d. O. S. S. Does a fiscal and compliance audit. In 2018 and 2019, d. A. S. Said you have been doing so well they give us a good performance waiver, and they did not do their normal fiscal audit. This is huge. This says that we have been doing great work, and i will say since our director of finance and operations has been with us since 2010, every single external audit and audit we have had done with d. A. S. , there have been no findings. So we are super proud of that. Moving onto programs, in terms of the registry, so the objective is to help consumers find independent providers enrolled with ihss. So if you look to see what we have been doing in 2019, we provided 3,555 referral lists to a little over 1400 consumers. And about 44 percent of them hired providers off of that list. And while that may seem like a low number, theres a huge amount of work that goes into when somebody gets the list. They have to then call people on the list, interview people on the list and hope that people answer the phone and that someone will actually come and work for them. So 44 percent is a high number. Our goal was to provide registry lists to at least 1,000 people. And as you see, we provided over 3,000. For providers, the goal is to recruit i. P. S to our registry, and we also provide trainings and help them provide work opportunities. So did i miss one . Its not on here. Sorry, no, thats fine. So as you can see, we had last year 489 applicants. Of that number, 321 were trained in San Francisco we require that every independent provider go through a 48hour training before we put them out for work or before they can be on our registry to hopefully get hired. And of that, 321 who were trained went through the training, 252 actually made it to our registry list. Thats because we also then have to go through their references and some people dont make it through the whole training. Its very complicated. So what we have now is we have 302 active independent providers on our list. So we always have people available for consumers when they call and 401 registry providers who are fully employed. In terms. Emergency on call, we want to make sure we are able to provide services to ihss consumers who dont have a current independent provider. The goal is to fulfill at least 90 percent of all service hours. So far im happy to say i think we fulfill 100 percent of those. So in 2019 we had 481 unduplicated consumers who received this emergency oncall service. And we serviced over 9,000 hours. So we are pretty business over that. We also have a mentorship program. We are really lucky here in San Francisco, most other counties dont have a mentorship program, but we find that if consumers can be trained properly on how to use ihss, it creates a more sustainable relationship between them and their provider. So what you see here is that we have about 363 consumers who were referred. To our mentorship program. They were referred from social workers or from our staff at the office when people call in and ask for a list. Usually if a consumer calls and is asking for their second or third list, we will refer them to the mentorship program. Its, of course, optional. Some people decide not to do it. But most who do find it is quite helpful. So we get about 32 referrals per month. And there are 101 consumers per month who are working with mentors. And of the you can see from here, of the 353 that were referred, 98 were able to hire someone. And thats just because a point in time when we looked. For some people it takes longer for them to do the hiring. One thing i forgot to bring here today that i will make sure you all get is another thing we did is we created a consumer handbook. So its all things ihss. And mentors use that when they are talking to consumers. Its a really great book. Its the first of its kind in the state. And we are now working on getting it translated into our other threshold languages. Lastly, we provide benefits, health and medical and dental benefits. We get about 147 new providers signing up for Health Benefits per month and about 107 signing up for dental benefits per month. And right now there are about 11,500 providers who are enrolled in the San Francisco health plan healthy workers. Okay. So then also we processed criminal background checks and provide affordable Live Scan Services to potential independent providers. So the number is going up in terms of the number of Fingerprint Services we are doing. Thats because we have started doing this last year, i think. Im going too fast. Sorry. So we started doing this last year, and now im happy to say that not only are we doing it at our office, but we are doing it at 77 otis a couple times a week as well. The idea is we want to make it as easy as possible as we can on providers so they dont have to go to many places to just be able to sign up to be providers. So that seems to be working out really well. And also in our office we process the criminal background checks to make sure that people meet the requirements in order to be able to be providers. Lastly, as a result of union negotiations, we hand out supplies to independent providers. And that includes hand sanitizer, masks and gloves. And we have been doing this just for the last six months. And we hand out about 600 to 700 packages of supplies per month. So i will say that we are super business over in our office. My staff works really hard, and i think we are doing everything we can to make it easier for providers and for consumers to be able to access the services that are available to them and serve the people of the city. Any questions . Thank you, kelly. It might be helpful for newer commissioners if you summarized how a consumer qualifies for ihss. What are the requirements . In terms of income or right. So in order to be able to qualify, you have to be medical eligible. If you are, you would call cristas shop, and they would arrange to have a social worker come who would determine how many hours per month you are entitled to. And once that happens, you can hire whoever you want. And about 85 percent of consumers in San Francisco have a friend or Family Member that will do the service for them, which i will also just add, keeps people housed, because then they know they can get paid to provide the service for a friend or Family Member, so there will still be income coming in. 15 percent who dont have a friend or Family Member who end up calling the Public Authority, and thats why we have a registry to help them find someone. We do know that number is going to continue to go up as San Francisco is a real transient city, and many people dont have friends or Family Members who can do it. So we are there to make sure there are providers available who can come and work for these consumers. Thank you. And also the services can be on a temporary basis if someone is discharged from a hospital, for example, and needs help for a few weeks then that can also be arranged through ihss. It doesnt have to be ongoing. Correct. So a lot of times with our on call service, its people who are being discharged, havent yet set up a permanent situation, and we assist them during that process. I just would like to publicly commend kelly. I have the unique privilege of working with her as your representative on the governing body of the Inhome Supportive Services Public Authority. That body is very representative of both the caregivers as well as those who are getting the care, both the Human Services agency as well our commission have a representative. And for the past i think almost two years, i have been serving in that capacity, and i have seen the incredible work that both kelly and the staff are doing. It is a monumental undertaking, and i just wanted, for the record, to commend you. Thank you. I was also fortunate enough to serve on the governing body for about ten years. Yes. And i watched dramatic changes and improvements. And it was very gratifying. And in particular, the structure of the governing body, which allows for multiple viewpoints to be expressed and multiple needs to be raised and addressed. It is not a topdown process at all. It is much more a bottomsup process, and a very collaborative one. I think kelly has done a remarkable job in her tenure, and she has put together a remarkable team. I think we are very fortunate. I think San Francisco is way ahead of the rest of the state. And i have a question around that. What is the current governors attitude toward ihss . I dont want to rehash previous administrations but what is the current administrations attitude toward ihss . The current administrations attitude, and please correct me if im incorrect, is a much more favorable attitude towards ihss and what we do. Thank you. Thats gratifying. Not surprising but gratifying to hear. Any other comments or questions . Commissioner loo . Yeah, you said that the providers have 48 hours of training. Who did the training . So we so home bridge provides the training for all of our independent providers. Okay. And then the social worker, when you get the referral, social worker would go out and visit and determine the hours. And how often do you reassess . Annually . They are consumers are assessed annually. Yes. By the social workers at ihss, not the Public Authority. But apparently consumers can call and ask for a reassessment whenever they want . When they have a need. When they have a need. Okay. One other question i think is important to address, there may be some consumers who arent comfortable making decisions about who to hire, or they are not capable of making those decisions. How are their needs addressed, kelly . So thats why we have the mentorship program. And the mentors are consumers who are currently using the service or have used it in the past or providers who have used it who are current providers or not. And the mentors get trained about how to talk with consumers and how to help them. Those mentors will sit with consumers while they make the phone calls, while they interview, and will help guide them through the whole process, will talk to them about things like communication skills and how to best advocate for yourself. And then also as i said, the consumer handbook, which i forgot, which i will make sure you all get, also has pullout pages about here are good questions to ask, this is what you should do in this situation, but the whole idea is to try to build the consumer up so that they can handle it on their own. But there are some consumers that are not capable. Yes is that so for those consumers who are not able to hire and fire on their own but are sill stihl able to live at home and in still able to live at home and community, they would go to home bridge. Home bridge would send their providers or their employees, and they will send them out to do the work. So this is fabulous. And i have talked to many people who are using these services. Im just curious. How long is the process does the process usually take for someone on who is going to be their provider . Is that a process like i had someone and it didnt work out, and i got another one, and its a sticky relationship, im going to put it that way. So it depends. There are 85 percent of of the people have a friend or Family Member lined up. For the registry, its more complicated, because these are strangers coming in who might have to do intimate caring for you. So for some consumers, they know what they want, who may they need, and they can make a decision right away. For others, it could take several months. But do you know off the top of your head if we have a like, what the common time frame is . Or do you have metrics aroun we do have that, yes. I just dont have it with me. But im happy to provide it to you. Okay. Commissioner loo i have a couple questions. These are folks that in order to get the dental and health insurance, how many hours do they have to work per week . You have to work 25 hours a month in order to get medical. And 25 hours a month consistently over three months to get dental. So do they get it after a few months working or just immediately . They get it after three months of working. Three months of working. Okay. And so hold on one second. Come closer