Will agree that we want to build on that. But i do recall i want and of the next few days i would like a better understanding of how the crisis team fits into what we are already doin doing . This is similarly an effort rely on expanding ems6. I want to understand how that has grown and how those ems16s are used. Also, how the mobile crisis team relates to this and any other, you know, outreach thats happening now because i think supervisor ronen and supervisor hainey and the whole boards intention is for a game changer that really changes the experience for people who are in crisis on the streets and really changes the experience of people in San Francisco who are seeing people in crisis on the street. And the question of whether its to be 24hour, but i think it needs to be at a volume that is great enough that is actually impactful and im a little worried that the increase that happened last year again, its been a weird year, a very weird year. But i know ems6 does great work and i know theyre doing things that are saving the system money but gettin getting help to peopo otherwise wouldnt get it and the ems6 folks are just amazing in what they do. Pouring on another couple of dozen people into this system, i just want to understand a little bit more about how it will get us to game changing. And i also agree and i look forward to talking more with you. For me, each of us is seeing Different Things in the Mental Health sf center and what it will provide and we have overlapping but not different priorities with it and overlapping priorities around that. For me, its very, very important that there be a place 24 hours that these people who are interacting with the crisis teams or em6 or mob mobile crisr anybody surrounding people in crisis knows there is a place to take someone that isnt false. I would like to talk more about that. So last year, we talked a lot about the investment and dual diagnosis that was a big deal and we thought it was a really kind of a breakthrough, important thing that we were doing these 55 dual diagnosis tests and then we didnt for reasons that i think are understandable, because we were working with the nonprofit and the nonprofit was looking for real estate and those 55 beds didnt happen. But do we still theres think theres a tremendous need for dual diagnosis beds. As i read the study, the total needs they found was 20 Mental Health residential treatment beds which maybe could all be dual diagnosis beds, but thats a very different it seeps ses like the conversation was different a year ago from the study and im trying to understand how to reconcile those two. You dont have to answer that. Doctor, can you respond to the supervisors question . Im going to ask you to take that. Thank you. Good afternoon, supervisors. And i think my first reaction is that we need for our entire system to be dual diagnosis. We have a lot of opportunities for integration and there shouldnt be as many limitations one way or the other. And the continued need of dual diagnosis beds can be addressed by improving capacity on both sides of the Mental Health and Substance Abuse system and really based on how the beds investment goes this year, exploring how well were meeting that nee needs a it needs to ben ongoing conversation. I think it would fantastic with 11 million we could solve our needs for beds. My suspicion is we probably need 55,000 dual diagnosis bed exposa similar increase that the bed study shows and i think the right way to do this is to make these investments, see if its enough and probably need to do more and then do more the next year, god willing, budget permitting. Which is another reason not to wait, but to get going. And again, i have a lot of concern what happens with this investment if the tax fails and it cannot be that we get to november and the tax reform fails and then were done with this. Like, i i hope that my colleagu, even if we go along with this plan to rely this heavily on the money that we hav we have a com. I dont like reopeningening reon the middle of the year. But this is something we should reopen, because we will be making a decision not to fully address this two years after the audit, and after discussing the same issues for years and years and years and we have a framework now that everyone agrees on. And we cant wait. And so my last question is, why is aot still a pilot . Are we doing any more with this money in the budget . I think its been a pilot in that the staff those particular staff that were talking about are going from temporary were doing a pilot to permanent works and so the aot model is going to be integrated in all of the work were doing around the office of coordinated care and compliments very much that level of the Critical Care management, that they are going to be a part of that team. Is that money i mean, the money in the budget, is there any expansion in aot there or keeping going what weve been doing . It is keeping going what weve been doing, but definitely all of what weve learned from the model, what weve learned works will be incorporated into anything new that were doing under the coordinate auspice of coordinated care. Ok, those are my questions. Thank you. Thank you, supervisor mamdelman. Supervisor walton. Thank you, chair fewer and doctor and to the entire team. Does the new budget provide funding for treatment beds, particularly after the two million was readjusted in the midyear Adjustment Plan . Dr. Simmons, you had some perspective on the daybeds. Can you comment, please . I think there are more studies that need to happen. One possible idea is that within the bed count, were including, i believe, that its 20 beds for the 12month residential, that we could make a portion allocated, which could be a dual diagnosis model based on what we have already developed and that that would reduce capacity from, you know, the adult serving system and we would need to study that more, but we could address tay through the existing Budget Proposal. And so could or would . I could walk out of this meeting right now. I mean, could or would. My understanding, we havent specifically identified a specific number of beds for tay in the beds that are proposed. I know youve said we had problems in the past locating beds for tay. Why wouldnt we carve out beds for tay knowing weve had those issues in the past . Well, i think we certainly could. Its just a matter of how much neglect do we want to have in the beds we find, given weve had historical challenges. But we could do that in this budget, as well. I hope we are able to address that. And how much revenue from the overpay executive tax, if we are fortunate enough to pass it, would be allocated towards filling the Behavioral Health vacancies . Or have you explored that yet . I can speak briefly to that, supervisor walton. The co tax proposed from the November Ballot is not assumed as a Revenue Source with the budget in front of you, to the extent that it did pass, it would be subject to future decisions by this body as to how to appropriate those funds. Well send estimates regarding what the different taxes on the ballot would be worth and were theyre included in the budget or not and so ill have that information in your hands shortly. Got it. You can see im trying to and ba little proactive, if possible. The mayors budget introduces an 11 Million Grant Program in dph and do we know what those funds are going towards . Greg . Sure, supervisor walton, we are putting together a Grant Program that is focused on individuals who have made a contribution through the City Option Program into a medical reimbursement account. Weve had a lot of conversations ourselves and through the San Francisco health plan that administers the program to help them gimp the circumstances with covid and the dollars for a number of reasons are only available for withdrawal for medical expenses under the tax codes and this is an attempt to use dollars from within the City Option Program to provide grants to those that can be used for any expense related to whats going on with covid thats not necessarily a medical expense. So its one of the set of programs that would collec wev. Collectively been working on who are out of work. So up to a 500 Grant Program for those accounts. And those would be administered through the sanfrancisco health plan. Thank you. And does this budget that is proposed right now provide for increased testing in the black community, Pacific Island community, Latino Community and all of the populations where we see increases in disproportionate amount of folks who have contracted the virus and have a high number of cases . For covid19, specifically, yes. It includes an expansion of testing specifically to test in communities where theres the highest rate of covid19 for this upcoming year. And along those lines want are your strategies to address covid19 pandemic in these same communities of color . Well, one of the key things with regard to testing is that we have a mobile testing strategy where we go and follow we go where the virus is. Right now its largely concentrated in the southeastern part of the city. So, for instance, weve implemented two mobile testing teams that are cable of doing 250 additional tests a day each and those are being deployed to the southeastern part of the city and we will also establish a permanent site in the southeastern part of the city, hopefully by september and so that will dramatically increase to test in those neighborhoods in addition to the current testing options that are available. indiscernible . Do you know what those services are . We can certainly provide that and again, i dont know if dr. Hammer or dr. Simmons would talk about those programs but we can certainly get you the amount of dollars that are allocated to those programs. Dr. Hammer or simmons, do you have more information progra programmatically . A lot of our juvenile judgment investments and partnership with the Justice System and we have specific investments we make and we hold the work order for the program which is over a 4 Million Program that is directly related to violence Supreme Court and so therand our populationspecific y intervention, they all have elements that certainly are related to preventing violence, which is a Big Public Health concern. Yeah, it would definitely be great to know the specific investment, particularly looking at the budget for spy and seneca, understanding the youth are involved in the juvenile system and, as you know, with Mental Health sf and our focus on more Healing Center practises, specific to populations that need support and look at Mental Health differently from a cultural standpoint and would love to know that. Thank you. Thank you. Supervisor, thank you. President yee. Yes, thank you, chair fewer. And thank you for all of the questions from the other supervisors. Weve talked about Mental Health quite extensively and i think what missing from me is that we havent really spoken much about the Mental Health needs of young people, younger than tay. And i spoke about Mental Health needs for well, meaning the preschoolers, already, and i know we can work on that pretty well outside of the Public Health system. Department. This is probably a big issue where Mental Health services are needed because so many kids consider suicide and stress. So can you talk a little bit about whether that has come up to your consciousness to know that we have to deal with that and i know we havent talked about it much, but theres a lot of urgency around Mental Health. Im still planning to bring that around after budget. And so hopefully, maybe you have other answers that you dont have any anticipations today. A. Thank you, president yee. Certainly we have a longstanding children and Youth Program that dr. Simmons will talk about and we can get you further information. I will say that given this unprecedented pandemic that were in, we are starting to see really Mental Health effects of people, longstanding effects of the pandemic of people who are very Pivotal Development stages and have to be thought o about n our system of care. Ill turn it over to dr. Simmon for Additional Information and we can follow up with you next week or in a different briefing for your pleasure, supervisor. Thank you. I appreciate your question, supervisor. We definitely would need a lot of time to talk about our full range of chattahooche children d Family Services and we have a lot with the foster care system and the homeless response serving children, where we try to make our services as available as early as possible and we know that and im glad you raised dys, because we know most Mental Illnesses emerge in that period and its important that were there to intervene as early as possible. We have an investment in sfusd and were expanding to middle school expose were doinschoolss in response to stabilized families, to respond to crisis more actively and engaged i engo make sure our services are present in afterschool programs and we would love you to tell you more. We understand about the importance of that age in particular and families are important because anyone in our system is part of a family at some point, regardless of how they identify or define that. So we know that work is important. I appreciate that. And i dont want to say theres no services. Theres just a lack of services. I mean, again, just using this as an example, i believe we have two Mental Health personnel oveh over two thousand kids and its not enough. If we can find ways to strengthen that piece. Im a strong believer to catch things as early as possible, to give our youngest the best chances to succeed instead of waiting for everything to be acute. Hopefully, there are others on the board because i wont be around that long to advocate for that to happen and to strengthen. And yeah, ill look forward to hearing any Additional Information you might have. Thank you. Youre welcome. Thank you. Thank you. So i have a comment, if you dont mind. Oh, supervisor ronen. I just wanted to take you back also in what supervisor yee said, that i think that through our own assessment to the sfusd, students selftestify and many asians contemplating suicide as young as middle and i think thats a silent population around Mental Health Services Partnership want to emphasize tharound that in the Asian Community and i feel there needs to be much more support to our asian communities. This is what we have heard from Health Councillors in our schools is that asian parents also dont understand the seriousness of students stress levels and how they contribute to a high stress level and weve had suicides. Parents dont want it to be called a suicide, but there have been suicides and i think that it is really not being addressed to the level it should be, but my question to you today is, i see that you have on page six, advanced equity in our workforce and Racial Equity, black, africanamerican health and then, i gets guess, weve hd conversations about this and drt mortality rate and black infants are more likely to die in their first year of life than white infants. In california, the birth outcomes are more pronounced and in los angelos, black babies are three times more likely to die than white babies in their first year of life and a rate of nine. Six for 1,000 in contrast to the white rate of 2. 1 deaths. And so i have to ask you, with almost a 3 billion budget, what resources are putting to this problem . I think it has been persistent and has been consistent in our population. And so, what are we doing to address that . I know there was a grant and that is inadequate and an insult. What are we doing to combat that . I have fought this many times for the mayor and ive spoken to you about it. Ive spoken to many Healthcare Professionals about it, but i want you to know, also, in the Public Health realm of folks, people have said to me, what are you doing about the black infant mortality rate . San francisco is among one of the worse in the nation. And that is really, i think, inexcusable when went are one of the wealthiest cities in the u. S. Thank you. Answer, please. Thank you, chair fewer for the question and the preterm births among black africanamerican population has been a key focus of the department and one of the focuses as part of our black africanamerican health initiatives. You mentioned the dula Access Program and were continuing to work to expand that program and we are working with the Human Rights Commission to execute the abundant birth project which would take out not take out, but it would expand beyond the very specific medical interventions that have been historically focused on to make improvements in realizing that their broader contexts with socioeconomic aspects are likely driving these poor outcomes and while we focused on improving the direct care, access to care for families, that may be necessary but not efficient. Working with hrc, this would be a Pilot Program that would provide cash stipend to women who are expecting and shortly after giving birth, to support their needs and to allow the flexibility for them to decide how to use those resources for the needs that they have at the time. And so its an Innovative Program that we are hoping to execute and have budgeted for, as well. And then we continue to have our state perinatal equity grant, which allows us to continue the programs around addressing the needs of women at risk for having suboptimal outcomes in terms of birth. Ill last dr. Hammer talk more about the maternal childs work were doing, as well as dr. Bennett with some of the work on thele equity side of that. Dr. Hammer. Yes, im going to turn it over to dr. Bennett. The perinatal equity work is a shared initiative between maternal child adolescent health. Dr. Bennett has been the executive lead on that from the office of Health Equity and ill ask her to speak on that. Hello, im having the worst wifi problem and im hoping everyone can hear me. We can hear you. So ththe office of health eqy has been working in different departments because we need wideranging work in in area. Maternal adolescent health has been one of the biggest. The two in the budget right now are the income supplement program, which dph is contributing to, but is also heavily supported by philanthropy and pent to be, me, really, a test for concept and see the outcomes with configurations in their community. The other is the dula program laserfocused on africanamerican and specific islander moms. Those are the groups with the worst outcome and they do work with latin x but thats a Different Program and they are meant to be partially funded by the program and heavily funded by philanthropy, making these to some degree, versing them as organizations, hopefully, in the community and i think both have been fairly successful in rounding out that funding and were starting to see outcomes from at least birth from the dula program and the income supplements and well able to get started some time soon. Ill be really frank. I think that this cannot just be relied on grant funding. That this actually has to be a part of our general fund money. This is where, i think, i want my tax money to go and, actually, im a little appalled that a supplement income, a stipend, in effect, is not going to solve the issue. It is much deeper than that. And i think it is related to housing. I think it is overall stress and i think it relates to employment. I think its all about living conditions, even before prepregnancy. I think that it is much more than the dula program and a stipend program. I think that this actually takes a huge amount of committed financial stream and this is where the general fund dollars should go. I dont think it should be on grant money. I dont think we should be relying on philanthropy. This is our responsibility and this is where we show a commitment with our general fund dollars to actually these births. I think that it is much more than that, i have to say that this is an issue that has bothered me the whole time i have been in office. Ive seen very little action and i know that it is an issue that is not just directly in the house of Public Health. Although, it is a huge responsibility of Public Health. It has to do with all of the supports. I just think that when we talk about San Francisco being one of the most progressive cities in the United States and we allow this to happen, that this is not only an embarrassment, it is actually absent of a moral compass to solve this program. We are not talking about a lot of people. Were talking about about a group of people where we know there are disparities in their Health Outcomes already. When we talk about reinvesting 120 million to the black community, this is where i want my money to go. I want to say as a taxpayer, four generations in San Francisco, this is where i want dedicated fund dollars to go because i actually think this is something we can solve. If i didnt believe that it was something we could solve, then i wouldnt be so insistent about it. This is why i think im so passionate about it because i feel that the investments have to be strong and investments have to be constant and they have to be there every year and we can build on it and we have to hold ourselves accountable to the outcomes. These moms, it is not just at birth, right before better but its after birth, the second year and third year and if we want these outcomes, it has to be duly funded through our general funds and not through philanthropy and not through a grant. So i know this is a bigger issue and you have spoken i mean weve had you here for a long time, but i just ed thi just hat because i think its really important and i want it to be under radar and i want it to be on the radar of the supervisors that will remain here, that this is something that we should dedicate or general fund dollars to and the best practitioners and the best staff and a dedicated staff that we can get to follow this initiative until were actually seeing some really positive results and then even after that because this should not happen in San Francisco. I just wanted to say that. I think youve answered my question. I just felt like i had to say it. This is my last budget year and so i wanted to make sure my colleagues on budget know and that they will follow it. And then i have to ask you, mr. Wagner, you have 1,158 vacancies in Public Health. And why do you have so many vacancies and do you have any general fund higher that are pending that have not been hired that are going through the hiring process now . Thank you, supervisor fewer. So on our vacancies, you have the report from the budget and legislative analysts and this is a conversation that tends to come up each year at budget time. And so we have a number of annual salary ordinance positions and then we have a salaried budget which is less than the total of the annual salary ordinance positions by quite a bit and so our budget assumes that a large number of those positions would be held vacant. If we were to fill all of those one thousand positions, we would overpand by 140 million. So we just dont have the funding in the budget to fill all of those. So my question is, why are you keeping all of those vacancies . Why do you keep those positions then and why are you not giving up those positions . I could say 100, maybe or 200, but over a thousand positions to be keeping vacant is ridiculous because you will never be able to fund those. If youre telling me consistently year after year, you havent been funding them, why are you keeping those vacancies . The second part of the question, do you have any hires out of general fun dollars but in the hiring process not hired but budgeted in your budget . So on the first part of that, why the positions are there and some of the answer is the second part of your question. And so, it has accumulated over time when we take Budget Reduction and comes in the form of attrition savings versus the position. We often ask for that to retain the flexibility for our programs to use different types of positions and theyll have more of a men of positions to choose from to meet the needs that they have over time. But as you point out, we have positions that we need to hire. And we have some critical areas where we are trying to fill. We often spend our salary budget, but we do so partially by using temp dollars, by using overtime and in some cases by supplementing with registry, particularly at our hospitals and so, we do have a significant number of positions that we need to fill and some of those big areas that were focused on are nursing, where we are trying to fill our permanent nursing position so we can reduce reliance on per diem and another large area that well focus on over the coming year is Behavioral Health for the reasons that weve spoken about today and we have gaps in our Behavioral Health system from challenges, from recruiting and hiring process. And so the answer is a combination of two. We do have those vacant unfunded positions, which is a structural thing but we have a big need for hiring particularly to get people in those clinical positions in the door and to decrease our reliance on overtime, on registries and get permanent people in those positions where well have more stability and longer tenures and better patient care as a result. So those are a couple of the big areas were focused on and our ability to hire is one of the key Strategic Initiatives for the coming year. Do you have physicians in the hiring process that you have not hired yet . Yes. How many do you have . We have several hundred. I dont have that figure in my fingertips. So you have several hundreds in the queue now that have started to engage in the hiring process. Is that correct . Correct. You havent furthermorely hired them and theyre not employees yet of the county and city . Thats correct. You have several hundred and you dont know how much it might be but probably in the millions of dollars. Is that probably correct . Yes, although a lot of those dollars would go to replace spending that is occurring in the registry. So you have so what i dont understand, i think, is the number of holding over 1100 vacant positions. please stand by . Chair fewer department of Public Health, during this covid, youve had to pivot and protect all of us, and i just want to say we are completely grateful for saving all of our lives. I think at this time, because were looking at a deficit, we are looking at things that we can save money that we would not normally think about. So you might just think about hiring, but what were worrying about is could we save money in the first year, the fiscal year, and the following fiscal year. Okay. I dont have anymore questions. I want to say thank you very much. I know this has been very long. You have a very large budget, and you carry so much work. I think supervisor ronen has another comment, but i just want to say thank you so much sharing so much information and answering all of our comments. Thank you. Supervisor ronen . Commissioner renne ye. Supervisor ronen yes. And i noticed that dr. Bennett wanted to say something, so i wanted to give her a chance. Chair fewer oh, im sorry. I just wanted to clarify, for both of those programs, the Doula Program, both of them are the results of a really close collaboration of multiple city agencies and the health plans all working together over the last several years, so the funding for those programs is not normal. The Doula Program is something theyre advocating for getting those Services Covered in insurance and medical. The stipend programs hopes to be a reformulation for a way we give funds in our other programs, and so both of them are meant to help us develop longer standing changes in the programs. Chair fewer we are compiling a list of community groups, and so many African Americans are asking for doulas. I think when you have a 270 million budget, 250,000 isnt that much. Supervisor walton d. P. H. Can do more, i think. Chair fewer yeah. I cant leave this off without emphasizing how important that is. So thank you supervisor ronen sorry, chair fewer. I just have one other question, and if you could just summarize and keep it short, and we can talk about it later, but dr. Grant, im just wondering if you can tell us how you feel about this request to remove sheriffs from general hospital. So thank you, supervisor. And judst to clarify, there hasnt been a formal request to remove the sheriff from zuckerberg San Francisco general hospital. Were in the early part of the process, and i think what were looking at with our director of safety and in collaboration with the community and the sheriffs deputy is envisioning a safety of care and looking at where Law Enforcement would be needed in some of the areas. Were very early on in the process. This has been an ongoing discussion at zuckerberg to some degree, and were bringing some of our primary care into the discussion, but thats independent of any Budget Discussion at this point. Its simply premature to speculate on any of the financial implications of that. Supervisor ronen okay. Okay. Thank you. Chair fewer thank you. Now were going onto homelessness and Supportive Housing, which is thank you very much. Thank you, supervisors. Yeah, thank you very much. [inaudible]. Chair fewer at this time, we also have one trailing legislation, so at this time, mr. Clerk, can you call item 4 . Clerk sure, chair fewer. Item 4 is resolution approving the fiscal years 20202021 and 20212022 expenditure plan for the department of homelessness and Supportive Housing fund. Members of the public wishing to make Public Comment, call 4156550001 and enter meeting i. D. 1461698090. Press pound, and pound again, and then press starthree to enter the queue. Good afternoon, chair fewer and supervisors. Im gigi whitley. Before the you is a twoyear Expenditure Fund for the homelessness and Supportive Housing fund. So similar to in prior years, this is really funding a component of our Housing First program, especially particularly for homeless and formerly Homeless Individuals on county assistance programs or c. A. P. The expenditure plan before you totals 19. 410,283 million in both years of the fiscal year, and as you can see, the h. S. C. Doesnt cover the whole fund. This is consistent with prior years of the budget, and we ask for your support. Thank you. Chair fewer thank you very much. Any comments or colleagues from my colleagues about this item . If not, lets open this up for Public Comment. Mr. Clerk, can we call for Public Comment, please, on item number 4 . Clerk yes, madam chair. Operations is checking to see if there are any callers in the queue. Operations, please let us know if there are any callers that are ready. If you have not already done so, please press starthree to be entered into the queue. If you are waiting for Public Comment thus far, we will be taking that after all the departments have presented. For those already on hold, please continue to wait until the system indicates you have been unmuted. Mr. Qu, please let us know if there are any callers commenting on this resolution for the department of homelessness and Supportive Housing fund. Operator yes, i have callers in the queue. I will unmute the first caller. Clerk thank you. Clerk hello, caller . Caller, we can hear you. So supervisors, the whole day long, ive been paying attention to the various elements and the supportive measures, and we all know that housing and those who are homeless are adversely impacting quality of life issues in San Francisco. And so again and again, we see that, in the past, weve had blueprints to address the situation, and were not making progress. In fact, some of our other states do well, and we dont do well under same program that is being utilized. Now, ive been noticing we lack people of color who can give their expertise. For that is linked to cultural measures that we dont want to address, and that he had las to implicit biasness, and so im stating in this two minutes measly two minutes that im given, that our hearts have to be in the right place if were going to address homelessness and Supportive Housing. Thank you very much. Clerk thank you for your comments. Next speaker, please. Hi. I think i pressed the button for h. S. A. Can we speak on the topic yet . Clerk no, were currently yes, not yet. The Public Comment for the budgets for the various departments will be the next Public Comment after this one. Okay. Clerk when we do open it, but yeah, it may be a while. Next caller, please. Hi, ill call later again, for the next Public Comment. Clerk thank you very much. Operations, next speaker, please. Hi. This is hi, this is marty regan, and im asking the board of supervisors to keep h. S. H. Budget whole. This is not the time to cut services for most vulnerable populations in San Francisco. Its time to be bold, its time to use reserves and get our arms around the most Vulnerable People in this city. Regarding homeless youth, these are people in our city who are often hit the hardest in economic downturn. The youth of larkin street, 45 of our youth lost their jobs and significant wages just this year part of the covid impact. They are often left out of bold plans from the city, and were concerned that thisll force them deeper down the road of homelessness. Were asking for a prevention lens, and were asking for a racial justicesocial justice lens for the most vulnerable youth, criminal impacted youth, youth of color, lgbtq youth who are disproportionately overrepresented in this city. They have potential, they have assets, they have strengths, they have resiliency. We need more housing. We need more specific youth Housing Options for them. We need bold, Creative Vision for workforce, and we need to look at our Homeless Population as assets to the city to help us all rebuild. They have an equal right just like the rest of us and a place in this city to help us discover from this, and i thank you for your time. Clerk thank you, miss regan. Just as a reminder to the callers who may be on hold, we are taking Public Comment specifically on the resolution expanding the plan for the department of homelessness and supporting housing fund. If you wish to speak on h. S. H. S funding as a whole, that will be coming towards the later part of this meeting, and you can press starthree to take yourself out of the queue. But for the next speaker, operations, please queue them up. Hello, caller, we do hear you. Hello, speaker, we do hear you, but turn down your t. V. This is your go. Operator madam chair, that completes the queue. Chair fewer that completes the queue . Clerk yes. Chair fewer Public Comment is closed. Id like to make a motion to refer this to the full board with a positive recommendation to be heard in the meet be on september 15. Could i have a roll call vote, please. Clerk on the motion to refer this to the full board with a positive recommendation to be heard on september 15 [roll call] clerk you have five ayes. Chair fewer thank you very much. And now, well start with the presentation on the budget of homelessness and Supportive Housing. Mr. Hahn, you have the floor. Good morning, chair fewer, and supervisors. Im natalie stuartkahn. I use pronouns she and her. Id like to thank the city partne partners who worked tirelessly on this Budget Proposal. Im having a technical difficulty. H. S. H. Will continue to lead with our values of compassion, courage, and common sense. Central in those values is equity. It is imperative that we recognize that the root cause of homelessness is the lack of Affordable Housing, but for people of color, the root cause of homelessness is systemic racism. This budget and this moment gives us the opportunity and indeed the mandates to continue to push even harder to reverse the impact of that racism by equitably housing our unhoused black and brown neighbors. H. S. H. Has, for many years, incorporated equity principals and practices. As the department formed, it began with naming racism as a root cause of homelessness and participating in raefesearch o the topic. Our new coordinated housing system prioritizes people on housing based on topics like incarceration and homelessness. By prioritizing people based on need, pardtnering with communiy based organizations to maximize the organization of marginal groups. H. S. H. Have demonstrated our departments commitment to equity, and there is much work to are done. But we will need help. Creative partnerships with philanthropy will soon allow us to access consultants. The mayors budget before you today proposes an addition to hire for an equity manager, our only staff person focused entirely on this topic to keep equity centered across all of our work. Our d. E. I. Committee leadership team, staff, and partners are poised to make huge progress on equity as we embrace the significant expansion envisioned in this budget, but we will have to hold ourselves accountable. This is one of those historic moments, and we need to rise to it. Focusing on the budget, h. S. H. Proposed budget totals 50 million in 21 fiscal year 21 and 60 million in 22. H. S. H. Budget is growing by 131 each year with record expansion to route homelessned homelessne homelessness. Of the 33. 9 in general fund growth that you see here in 2021, the majority of the funds are allocated to new programming, including 23 million in onetime housing acquisitions, which are matching funds for the state home key, which will allow us to on board new permanent Supportive Housing as well as 8 million for Covid Response for safe sleeping costs, covid costs, and shelter space and staffing that are above what fema will reimburse. Mayor breed announced her Recovery Plan on adults because senior adults have higher level of acuity and vulnerability for covid. As you can see, if the puzzle pieces and funding streams unlou unlock and come together, San Francisco will see an increase in housing needed for the elderly. 1,500 new units of permanent Supportive Housing represent the largest expansion in 20 years, and this would be on top of the robust mohcd pipeline which includes permanent Supportive Housing for adults, family, and t. A. Y. The planning aligns to the advances family goals of not exiting anyone to the shelter in place out on the streets. Despite the tremendous expense of these hotel and the risk of not maintaining their funding. Not everyone in a s. I. P. Hotel will qualify, will need, or want housing. These populations and individuals have become possibly more invisible during covid due to the presumed lower risk of covid, but beyond covid, vulnerable families and others are becoming homeless because they arent able to say in their doubledup environments. It affects our families and young people quickly. This Budget Proposal maintains an investment in prevention and diversion, and we need to continue to work with our family system providers to be able to spend their money faster than ever. Looking at the sources of funds for the mayors plan, we know there are many key financial assumptions that need to work in our favor for success. These are shaded in the table in front of you. These include fema reimbursements continuing until july 2021, unlocking prop c, and of note there, we have only considered onethird of the allocation of prop c funding which would be governed by the prop c committee, leaving two thirds of the prop c unprogrammed for family, t. A. Y. , prevention, and Mental Health. Other Key Assumptions include c. A. R. E. S. Hud funding, personal care, creative philanthropy already happening, and additional state aid. This provides a deeper dive into the adult enhancement. Not yet mentioned by me is that the mayoria budget does continue to provide for the operating cost of the Vehicle Triage Center pilot, which will require deeper dives to understanding homelessness. On the next slide of critical importance to our system of care is that the budget propsal has to existing reduction to services or programs for our c. B. O. Partners. These individuals and programs work tirelessly each day on their frontlines, and they have stretched themselves time and time again during this crisis. The mayors budget does allocate funds into other Navigation Center projects for transitional age youth and 95 for the bayview community. This also does involve belt tightening for h. S. H. So we can ensure we are continuing to expand and that we are using every single dollar efficiently. It cuts funding for hsoc vehicles, and it moves one system funding off of the general fund to allow for other commitments, including critical operating positions. Finally, this slide articulates that the Mayors Office has recently unfrozen our hiring, and we are very grateful. After four years, this month, h. S. H. Will have a fully staffed h. R. Team for the first time ever. This Courageous Team will allow us to support the continuing framework of rapid rehiring. We have lost of support of h. R. For covid due to a work order, so we will need the increased input. We will continue to rely on c. S. W. Resources. The mayors plan also imagines a small right now increase in f. T. E. Specifically focused on the race equity position we discussed, facilities, and other matters. If funding like prop c unlocks, the mayors budget imagines some commensurate funding. Thank you for your time, your commitment to San Franciscos unhoused neighbors, and making San Francisco a shared neighborhood for everyone. [inaudible]. Chair fewer do we have any comments or questions from my colleagues . Supervisor walton . Supervisor walton thank you so much, chair fewer, and thank you so much, director stuart kahn for this presentation. I do have a few question. The first is what is the allocated budget for t. A. Y. Homeless services . I wont thank you, supervisor walton. I will tee up and frame that answer, and then if gigi whitley can provide more context, we will do our best. So as you know from your role in advanced planning, supervisor walton, the existing budget for h. S. H. Is not being cut, so we have an existing t. A. Y. Budget which will remain, and we are deeply grateful for that. We know many other departments are needing to cutback significantly. It imagines an increase for the t. A. Y. Navigation center. More importantly, we are close to drawing down all of our money for the government Rapid Funding project call rising up. What is not in the proposed budget, supervisor and supervisors, is the t. A. Y. Money that would be allocated if prop c unlocks, and that is what we are beginning the advanced process on now with our t. A. Y. Community. In our existing budget, i will turn to gigi whitley to see if she can provide anymore details or content. Hi. Through the chair, gigi whitley. Our baseline project is 63 million. It doesnt include the 880 for the Navigation Center. The mayors invested 10 million in the rising up project. That will be exhausted at the end of 2021, so were looking for hopefully to the unlocking of prop c and other allocated t. A. Y. Funds. The prop c funds would be about 73. 5 million over the twoyear budget. Supervisor walton 73. 5 . Correct. Supervisor walton and isnt rising up, the goal to keep about 40 million in that pot . I can speak to that, gigi. Thank you, supervisor. So thats a 35 million Publicprivate Partnership allocated by mayor breed and sort of seeded by mayor breed. Theres 17 million left to be raised by philanthropy. And as gigi noted, if prop c unlocks, we would be able to seed more money. Rising up is sort of a heading home to sort of double down our investments in t. A. Y. , and what were really excited about, supervisor, thanks to the Partnership Led by larkin, were starting to see our rising up for t. A. Y. Program, and that is getting up to speed now, and were going to need it now more than ever. I dont think its exactly accurate to say its going to be a lot of money, but its something were going to need to invest in very soon, either philanthropically or otherwise. Supervisor walton and does the rising up plan [inaudible]. Well, we have to make sure they go somewhere from safe sleeping villages, and whats the plan for that . I know were doing some best planning work on that, and does the budget take into account where those unhoused folks go . Thank you, supervisor. So all of the covid im going to group the safe sleep with the s. I. P. Expansion for purposes of answering your question. So all of the expansion related to covid, they have been in these s. I. P. Hotels. The entire thing needs to unwind through this expansion in permanent Supportive Housing, rapid rehousing, diversion, and shelter. But safe sleep is a safe space to be right now, so and i know many of your colleagues have you have a real interest in safe sleep. Safe sleep happened to San Francisco, and we have a lot to learn about it. What we have learned is that it provides a stop be place for people to be, for their cortisol levels to come down, a system that has failed them, and a ticket to home ward bound, and maybe a chance to stay there in their community, safe from the streetbased elements, but not yet safe from rain and smoke. So what we want to do is use it as part of the system flow. What the budget imagines, to speak to your question, supervisor, 100 safe slots, ramping down later. Everyone has to go somewhere. No one can be exited to the streets, just like the s. I. P. Hotels. We can maximize the resources, meaning reduce the cost per person of a safe sleep site, learn from the remarkable work across the city, and have a little bit more with the same amount of money. Supervisor walton and so just from your response, because i want to just make sure that we always compare apples to apples. Yep. Supervisor walton and when you talk about the locating permit housing, rapid rehousing, shelter, where does either a, securing more hotel rooms or even the purchase of fall under in your categories . Thank you. So as you know, we are continuing to ramp up the s. I. P. Hotel rooms. Those are not housing, they are shelter. They do not have the same rates, unfortunately, so and they are more expensive than permanent Supportive Housing. So thank you for the teeup to this question. The acquisition of hotels or other properties in the city falls into the expansion of permanent Supportive Housing, the 1,500 units that i talked about. For example, with the project home key application that you all approved or with prop c funding coming online, and we, along with our partners, are gearing up to rapidly acquire, hopefully not have to fix up very much. And i want to make this clear, we are hearing from building owners, hotel owners across the count city who want to engage and partner in this. We need to maximize and ensure that we have the best facilities at the best rates. Supervisor walton i have a lot more questions, but im only going to ask two more because i know i have colleagues on here, and they may ask questions. Can you tell us what h. S. H. Is doing to address the unhoused black population in this city . Yes, thank you, supervisor, for the question. This is going to be the moment to work harder on this topic. Its no longer sufficient for us to declare this in our principles. The 40 unhoused population who are black and the 5 housed population is an unacceptable proportion. The status caused by systemic racism as presented earlier in my presentation, supervisor, i think you know this most, that our communities have suffered. First, every single decision at h. S. H. And every single policy needs to be looked at through an equity lenses. We need to get better at that. That requires further training for us, further training for our partners. We need to include and advance the voices of lived experience, the voices of leaders of color across our c. B. O. S, and our own voices in our organization. Those are sort of the cultural underpinnings how we make uninformed decisions. Practically or from a project perspective and i know we cannot project manage our way out of this, we need to course reentry and reevaluate it over and over and over again for equity. Study shows when coordinated entry if you are black in San Francisco, you are a little bit more likely to receive permanent Supportive Housing through a coordinated entry assessment than if you are not, but we would like to see how much more that can be done within fair housing law, and there are many things were learning from our own National Colleagues and from our own creative thinking. Im really excited about the house blacks initiatives and housing opportunities that are happening, and i look forward to that partnership. Supervisor walton housing entry has been the problem, and its been how can we keep black people from receiving the help that they need . You cant just blame the laws that are in place. It has a lot to do with people who makes the decision in who goes where. Which brings me to my last question is will hsh guarantee that members of the h. O. T. Team with culturally competent in certain communities and allow individuals to come out and decide who has a voice and walks on their streets . Supervisor, i want to thank you for drawing this to my attention, again, a couple of days ago. I think what we can commit to first of all, i want to balance that, you know, the hot team is a nonprofit provider. It is sup vised clinically by civil servants, but the vast majority of h. O. T. Teams are nonprofit providers. We could potentially look at resources and training as we bring them to our full system of care. I would love to talk to you further about how to engage with community about, as you said, who comes out and walks the streets. When ive been out in the bayview with the h. O. T. Team, i know their dedication to that community, and your community is tell us we must do better. Supervisor walton correct. And my community is specifically telling me we want different people, service providers. And again, under the latest assessment weve had, folks and community. And just for my clarification or my knowledge, doesnt d. P. H. Hire h. O. T. Team members . Sorry, no. Our nonprofit provider hires them. Supervisor walton thank you. Just to clarify, they did used to be part of d. P. H. , and they are hosted at the d. P. H. Building, but they are a nonprofit provider. There are many street medicine providers that often get merged with h. O. T. , so it seems like you and i should sort of break some of this apart together so i can understand more of what we need to do. Supervisor walton definitely, along with community. Yes, sir. Thank you. Clerk apologies. Madam clerk, before we continue, would supervisors haney and preston, noted present at 4 01, we have now been convened as a special meeting as the board of supervisors. Chair fewer mr. Clerk, what is a problem for me is that people are not coming up on the queue, so im sorry, im going to ask supervisors to raise your hand. Supervisor mandelman . Supervisor mandelman thank you, chair fewer. Thank you for coming to talk to us today, director stuart kahn. Were going to have publicly a conversation that we have privately frequently and i mean, first of all, actually, before i go there, i want to express the great gratitude that i have for you and the folks in your department who do extraordinary work who i think do not get the credit for the extraordinary accomplishments and achievements that San Francisco has made in housing many, many, many, many, many folks who did not have homes. It is unsatisfying, im sure, to some of my constituents, to hear, but in fact with those hundreds of millions of dollars that we spend every year, we keep 8,000plus folks out of Supportive Housing into a more independent living situation, do a tremendous amount of outreach, and have done super extraordinary work over the last month in limiting the spread of covid19 among our unhoused population in promptly shutting down shutting down shelters, congregate shelters when we became concerned that those were going to be on places where covid would spread among Vulnerable People. In standing up, i think a relatively unprecedented number of hotel rooms for a city of our size. I think there are a number of things that this city can be proud of, and before i say my criticisms, ill just say that. Supervisor, thank you very much for that. We deeply appreciate it, and were proud of the work. Supervisor mandelman and folks in h. S. A. And d. P. H. , and its a shared right. Supervisor mandelman all of that is great, but the wonderful things i just said do not reflect the feeling i think of many of our constituents who think the city is a complete disaster in how we manage homelessness, and also are somewhat incongruous with United Nations findings, and the general reception, that the United States and around the world, were doing a terrible job managing homelessness and dealing with homelessness. To my mind, one of the things that weve talked about, one of the reasons maybe for that failure is San Francisco does not do a great job in taking responsibility and planning for the rest. We do a great job not a great job. For a city and a country that has abandoned its commitment to very lowincome people and housing very lowincome people, we make a real strong effort here in San Francisco to try to get unhoused housing people who are unhoused and to solve the housing problems. But for people who dont have a shelter bed, permanent Supportive Housing unit, hotel room in the time of covid, people outside that sphere, we sort of say to them, implicitly to them and the neighborhoods in which theyre going to try to find shelter, you guys are on your own. And then, unhoused people this has gotten particularly acute during shelter in place, but it was a problem before, and before i was a supervisor, i spent a huge amount of time and my offices time, what do we do with these unhoused folks . We played a game of whackamole, and the block that has come to experience encampments or people make more and more noise until the city finally responds, and maybe some get the funds that were talking about, and others get disbursed. Maybe a few days or hours later, i will hear from people where the new encampment is happening down the block. And it seems to me that ethically, legally, in lots of ways, we need to have some kind of plan for rests for the folks that other set of folks. And i think that, actually, this board of supervisors, even before i was on i mean, not this board of supervisors boards of supervisors have pushed for some kind of comprehensive response that would allow us to enforce our laws and also allow us to be guided by the principles that in San Francisco no one should have to camp in public spaces and no one should be allowed to camp in public spaces. I think supervisor campos, and the cause was taken on by supervisors ronen and haney, perhaps the cause of Navigation Centers for all would meet the need; that if there was a Navigation Center in each district, that we would make a play for enough beds or serious placement that taking care of the rest would happen. Mayor breed talked about building out 1,000 shelter beds in her first term. Some folks have talked about duplicating new yorks right to shelter. But in general and then, during shelter in place, my colleagues on the board, the board has unanimously said, and i personally dont actually know how feasible this is, we should get a revolutionary ordinance, 8,000 hotel rooms, 15,000 hotel rooms, to bring relief to the homeless and our neighbors. I have gotten no point that there is a plan for the rest, a place for all, from the administration. So i have pushed, others on the board have pushed for some version of safe sleep at another cut at this. Would it be possible to set up safe sleep sites, and have enough of them, that we can offer people a place to be that is not the sidewalk that they happen to be on . This has worked to varying degrees where its been tried. I think everett was tried, but it was not, and i think there are a number of reasons why it was not terribly successful. I think supervisor preston ill let him speak for himself but i think he thinks the haight has been a relative success. There has to be some other plan to deal with this issue of being having enough spaces for folks that we can offer one to all in encampments. You are not the entire policy center around us. You are just part of a team, but this doubles down on getting shelter for a portion of the homelessness and actually spending a ton of money and time and resources on the rest. Im done. Supervisor mandelman, yes. We have had this conversation privately. I appreciate having it publicly. I think its layered. Im very pleased in San Francisco that we live our values, and this really focuses on housing to health care. Families in new york stay homeless for the entire first part of their childrens life. I think its a valued conversation, and we continue to live our values. You are correct, that this is its entirely with me. What i will say about shelter versus housing is that you can spend as much on shelter as you do on housing, and so shelter, when supervisor haney and i talked about this with with his really courageous legislation around Navigation Center, it was sure, this is terrific, and we will not expand housing. So what about everybody else . I will not get out of my lane and talk about fees or camping, but i will say im really interested in the idea of what safe sleep is teaching us about the idea of what people need. We know that people who are experiencing homelessness on the street are increasingly wanting in ways that sfriurpri those that even talk to them every day. I think i talked about this with all of you its very expensive right now. We need to bring the cost down. The reason assiits expensive because if you have an empty building that already has water and bathrooms, it costs less to repair that than an empty parking lot. We need to look at other communities marshally that look at increasing the role and responsibility of people nationally that look at increasing the role and responsibility of people that living there. That is absolutely part of what were trying to figure out, and i welcome that conversation with any supervisor who wants to talk about the space in their neighborhood. We absolutely need it to be larger, and where people are. So we have this sort of geographic equity challenges. We need to serve people where they are. I think the plan for everyone else, supervisor mandelman, what ive said to you privately is im not willing to surrender the idea that we cannot end homelessness and make it rare and brief in a period of time. Ive pushed on this, your constituents will be happy to know that ive pushed very hard on this. Im concerned if we say go over here, first of all, over here may not want them there, and that community will be impacted. Secondly, if you go over here, and theres no support, theres no security, theres no resources, that a fire will start; that we will have danger on our sort of dime, on our own on our own recommendation. You would then counter that that is what is happening now on the streets of San Francisco, and i would agree with you, so we have not solved this. Based on our conversations, i have asked our consultants to research nationally the idea, beyond safe sleep, what are communities like us doing for safe places, and what have they learned what has worked and what has failed . Before covid i will close with this. Before covid, safe sleep on the west coast was failing in many, many locations, with some very special, unique circumstances, and we were able to bring those lessons to San Francisco, working with expert providers, our partners across the city who set these sites up urgently but expensively. We need to talk about whdiscu talking about. I know a Research Memo is not enough, but i will get the answer for you. Supervisor mandelman i appreciate you engaging me with this, but i think we need to. Although i appreciate your desire to see San Francisco end homelessness and or make it rare and brief for all, we do operate in an ecosystem that is dependent on actions taken by the federal and state governments, and we will continue to feel their failures in San Francisco. And i do think that the city is simply not asserting spnt for something doesnt keep us from being responsible for it. There are terrible things happening in encampments right now. I witnessed somebody emerging from a tent the other day, and the fact that these sites are not city run doesnt make the city not responsible for them, and i hope that we can achieve something that is better for that. The only other question that i want to ask you about sort of relates to it relates to the plan to build out 1500 new permanent Supportive Housing units i believe over the two years. Weve had a conversation about this. I just want this to serve as notice of a publish. The criteria for getting into the s. I. P. Hotel, while its been a little unclear and has been malleable, depending on covid19, it has become a tool for particularly challenging encampment situations. Theres been interplay between those two goals, but that does leave out youth, families, and it is and folks and people who i think need particular attention because theyre particularly vulnerable trans women of color, for example. And i just want to i believe this is on your radar i know it is, but it shouldnt be that our plan for more permanent exits from homelessness post covid are determined by the steps that weve taken during covid and the need to, you know, keep people from we do need to keep people from moving from hotels back to the streets, but we also need to have Housing Options for youth, families, trans folks, and i just want to make sure we are mindful about that. Yeah. Through the chair, i just wanted to make sure im aware of that and what we need to do. The reason we dont know whos in s. I. Pichp. Hotels. We know who they are, but we dont know enough information on them, are they vulnerable . So yes, the s. I. P. Team is outlooking for vulnerable individuals, and the hsoc team is out there, looking for covid individuals and offering them s. I. P. Rooms and covid rooms. We have a flexible array of services and interventions for people, so yes, thats why its working, supervisor mandelman. [please stand by] we need to do advanced planning in realtime now and it will allow for more housing that will be targeted at transitional use and it will allow for more targeted for example, the risingup initiative which i discussed with supervisor walton could be an interesting place. We could double down on rapid rehousing and prevents for families and say we need this array of families. And so im eager to learn from the community the way we were do around adults what the needs are so if and when that funding comes to us and the committee forms thanks to the controllers staffing, were ready to go and anybody who has people you would like to invite to the conversation or if you would like to have input into that family conversation, beyond the providers that you talk to daily, i would welcome that input. Thank you, supervisor mandelman. Thank you, director. Supervisor hainey. Thank you, chair fewer. And thank you director and to the Budget Committee for allowing me to crash this party. This is obviously a very important issue and set of budget questions for my district and for our whole city. I had a question about the cost of each of the different types of beds that really would fall into our Covid Response. Your presentation says that were doing 179 Million Investment to cover 2600 hotel rooms through june of 2021 and 15. 1 million to support a 200bed shelter, which is 75,000 per bed. Is it accurate that the hotel rooms are actually cheaper than new congregate rooms . So let me frame that question and then, miss whitly can help me with specifics. So approximately and supervisor, these are fantastic questions and the driving of our budgeter. Its so valuable but as you heard me talking about, its not reimburse the by fema. So the hotels, when i last looked were 250 a night, kind of loaded, right. And thats helping people shelter in place and thats a valuable resource. Shelter before covid was somewhere between 70 and 90 a night depending on the shelter and now that we are at 30 , 40 capacities and increasing to 50 occupancy for safety, that has become more expensive, if that makes sense. Same rice, same price tag but per person, more expensive. The housing ranges between 50 and 90 a night and this is why housing is actually cheaper in some ways that shelter right now. And the villages, the resource rich ones are in the 260 range. And so, those are the price tags right now. Is that helpful or is something more i can provide . Yeah, that is helpful. Are the congregate beds that are used as a part of the Covid Response, fema reimbursable like the hotels are . They are to some extent and not all shelters have been repumped. And so ill let gigi take the tough questions. [ laughter ] thank you, abigail and im actually going to phone a friend and call in the controller who is closer to the fema reimbursable and theres hsa staff thats probably on the line that will give a morquio me cojent answer. Theyre likely reimbursable but not likely. And this is one of the areas of ambiguity. Hotels are clearly claimable and congregate shelter is questionable. And safe sleep is almost entirely nonclaimable, were relatively certain. What im having a hard time understanding in terms of why would we use strategies that are more expensive and not reimbursable . Why are we relying more so on the hotel rooms and not as heavily on the other strategies that seem to have more problems in their own way, more dangerous and in some ways less humane . I mean, ive been to the safesleeping slight sites and w them as a last resort, but a far less preferable option to the hotels as a place for people to be living and then if you put on top of that theyre more expensive, i dont understand and not reimbursable, why are we using these . So i can speak to the programmable piece and ill let my colleagues speak on the reimbursement. Hotels, as you know having worked there and sip hotels, as you know having worked there, are very critical for highly covid vulnerable individuals and theyre also very expensive and it has taken every ounce of the dsw effort as well as ceos increasingly stretching themselves to do it. And director roher and i are willing to speak to the limits of availability and the controller can speak about the limits of the funding. From a perspective of what we feel and know that people tell us they need, some people want to come to a hotel room and many people do not want to be alone in a hotel room. Were reevaluating a roommate policy. And many people want to be in safe sleep right now and i agree with you in your evaluation and some people want shelter. We had, as you know, supervisor, a difficult time encouraging highly vulnerable ko covid folko leave shelters to come to a hotel. So what we know individuals experiencing homelessness, this is the number one that they teach you, meet the clients where they are and thats why were getting these 90 70 to 90 rates in places like the tenderloin. We are trying to balance that with what is reimbursable. So theres the need. Theres what works and then theres what is feasible and fundable. And so were trying to balance all of those in this jigsaw puzzle that is the Covid Response. If i could, supervisors, sorry to interrupt the hsa budget process. Youre very welcome. Just a reminder on the reimbursement from fema, the nonvulnerable by fema definition are zero percent reimbursable and that is driving some of our sort of decisions not to house every homeless in a hotel because, you know, at 250 a night, it would be zero. And were even frankly concerned about the reimbursement in general with the fema. I think ben can speak to this. Theyre strict about auditing persontoperson and thats driving a lot of that decision. Id just had, supervisor hainey, this is why the mayors plan and budget in front of you and you know this and supportive is focused on housing. It is both affordable, covid safe and we have unlocking resources that are not things like fema which rely on the current occupants in washington to help us out. Got it. That is helpful and i do think that its important for folks to know because i think theres a sense, particularly with the safesleeping site or shelters that its cheaper than hotels and hotels are the more expensive option and thats very much not the case. So for the people who are on our streets right now, i know there was a tent and structure count about a thousand or so, which was up from january,lying the, g the many people not counted by the metrics. In this budget, are there things that focus on bringing them inside . What is the plan for those individuals, particularly if new hotels are not in this budget . How are we going to bring in the thousands of people who are out there now . So we started with before covid, we started with approximately 5,000 unsheltered neighbors in our community and as youve noted and supervisor mamdelman, we had to get our shelters rapidly and supervisor ronens district in kind of an emergency mode. So some people went on to the street as a result of that and many, many people are out on the street anecdotally and we need better data, newly during covid because of what i started talking about around families. They were staying with someone, they were doubled up and because of covid, they cant stay on so and sos couch any more. These are folks not living unsheltered. And so, we believe we were at a peak in People Living unsheltered in may and that was when april, may, when the tenderloin when you live, i work, was in such dire straits. And the city kind of wrapped its arms around that community. And the beauty, i think, is very much restored and im greatful for that. I think we should talk to the department of Emergency Management and dem about sort of all of the people that are out there now. What i know is that a member of that team is that the plan is currently, you know, two to three resolutions of specific encantments each week. I know youre in touch with them about whats your crisis and how we bring hstoc behind the tenderloin and the hot Team Continues to be outside looking for the most covid vulnerable to bring into hotels to invite others into shelter because thats the job of hsh is ending homelessness and that continues, but that wont solve the street conditions. And so, the plan is there are more hotels coming online. As you know, we are focused on the tenderloin and the mission, the bayview, thelma and castro and we need all of those resources available. The mosser of the resources th , the better the conditions in the passion of the colleagues who work there. And so the plan is to go back to resolution by resolution and i heard hstoc talk today about 49 large inca49large encantments. That does not speak to supervisor mandelmans what about everybody else. The other thing we havent talked about here and i believe talked about it with the department of Public Health, and i hope you will talk about with chief nickelson is the really bold plan around Community Paramedics for the psychiatric. So in my mind, theres three buckets, the hstoc resolution, the psychiatric emergencies that are either alarming or excuse me, the Behavioral Health, the Substance Use and psychiatric that are either alarming, upsetting or incredibly angering to those of us that live in sanfrancisco, depending where you sit and the everybody else. So we are doing better in the first two categories and we need to continue to look at the third category. Ok. Yeah, im a little more than ae concerned about the fact that we have had some success in the last few months on relying more heavily on certain strategies like the hotels and that. There isnt a significant increase for those that would meet the need that still exists on the street. I think it would be useful to talk to the controller or door director moore before the costs. I gave you a ballpark and it doesnt need to be right now but thats one of the driving factors here. Its not that we dont all believe in the importance of the hotels. Such that we dont run into a home where 100 of the cost becomes a local one and that will occur at some point and we dont know when. The budget assumes it will continue through june and i believe its one of the reasons that the plan that the proposed budget reaches to is to try to complete the placement of people out of sips by that date. To the extent we climb to a higher target in the coming year, it creates some cost in the shorter term and creates a greater cost in the longer term to create the alternative placements for folks coming out of the hotel. And i dont know if thats helpful and clearly the choice is in front of you with the budget but those are the two cost pressures that i see. Got it. Ana couple of other quick questions i wonder if you could answer. I know there were some number of buckets of underspending from 1920 transitional housing placement, 541,000 and 598,000 and homeless reach over one million and why was there so much underspending and how are these carryover funds used in the budget . Yes, i will ask miss lee to speak to that and thank you for that question. Through the chair, deputy director. I believe youre referring, supervisor to the bla audit, which identified a point in time and a projection of yearend spending. We were doing better this year in getting funding and contracts out earlier. Covid hit and we certainly got behind and i think the other thing youve likely heard from our nonprofit partners over the years is given what was at the time a very tight job market and certainly the high cost of living to live in San Francisco, they were behind on their own hiring and having challenges, spending down their own budgets. And some of that projected fund balance was identified at the ninemonth report and i believe there is additional projected fund balance from our department used in the final budget and that would be a question for the mayors budget director but in general, if it is a fairly deminimum mus amount, most providers ask to carry that forward for onetime needs. I think its important to point out that some of what the report talked about really dealt with federal funds which we have certainly had trouble spending down because of the various restrictions on those funds. But more than that, those funds are often offcycle and dont match the budget cycle and that needs to be taken into account. Im happy to answer further questions about the audit. I didnt fully prepare to answer audit questions but happy to do what i can. I think it will be good because im sure this will come up around the bla report and having some response to some of the things that came up and i know there will be a hearing on that and ill ask one last question which is about housing subsidies which is, in this budget, i though theres a number of different housing subsidies that are included and which ones are new or expanded or at the same level . Are there any that are growing significantly or added to or being cut back in some ways . I was having a hard time sort of understanding how each of the different types of subsidies are being either grown or reduced in the budget . San francisco has a lot of housing that is physically based and supervisor hainey, youve become an expert on this. We need flexible subsidies. We launched a subsidy pool after many years of efforts to make that happen and we were really excited to have subsidies that launched the movingon initiative which is part of our housing ladder and so we believe in short, median, longterm subsidies that allow people to move around the community, to sustain their exit to homelessness and thats a part of the array of services that people let us know that they need and miss whitly can hopefully speak to the specific budget questions. So through the chair, there are no reductions in any of our ongoing programs in the mayors proposed budget, including ongoing subsidies. The budget does, through the mayors Recovery Plan, account for 1 1500 new units of housing. As director stewart mentioned, 200 would mean throughou philanc fund asking were lookin and wee November Ballot to understand the prevention problem somes, emergency subsidies, rapid rehousing and, of course, permanent Supportive Housing can be unlocked, not just for adults experiencing homelessness but families, families at risk of homelessness and then are traditional age youth. And thats where the expansion comes from in out budget and really, the budget is based initially on getting through the fiscal year with the covid expansion and the investment in project home key that the mayor announced and then to go beyond that point, similar to what you heard from the dph presentation, its really reliant on that tax measure and then, you know, Additional Resources that would come to tru fruition if the georecovery pond passed geo georecovery bond passed. Anyone else . Supervisor preston . Thank you, clear fewer and committee members. Thank you for all of your work and thank you, director fewer. Let me just start by saying that i want to give some credit where its due beyond all of us who are politicians or who work for the city to try to imagine where we would be look at these expenditures were it not for the vision for homelessness advocates going and getting prop c on the ballot and passed. And i wont put you on the spot to ask because i knew we dont have a lot of time. But i think we all need to envision how bad this would be in we did not have prop c funds which hopefully will be unlocked following the this november. And i see the increases, the significant increases, over 100 million, as we talked about, coming to the department and i think were all in agreement of the need to really tackle the homelessness crisis and address the tragedy on our streets. I do need to note as the d5 supervisor, that im concerned with how the decisions are made around whats a priority neighborhood and what isnt. I represent a district that i would say in terms of the spending here and the plans from what i can tell, this is kind of being left in the different and really, looking at the neighborhoods, western addition, we have a significant and growing homelessness crisis. And you know, you referenced a list of Priority Areas for the upcoming year and i guess my first question is, particularly given the discussion of a Racial Equity lense . Im not hearing anything about serving that area as a priority. Supervisor, i assume youre talking about street as opposed to bringing a Navigation Center, but im happy to say a little bit more. I want to make sure im understanding your question. My question is anything. So you outlined the strategies and a number of neighborhoods that are priority neighborhoods. The philmore and western edition are not in there. The only new thing has been the safe sleeping slights that was referenced but asking for those two areas which are increasingly impacted by homelessness. Why is that not on a priority list and any plan in what youve outlined to address that neighborhood . Thank you, supervisor preston, for that question and this is why i dont like to get out of my lane on street conditions. So the original protocol around priority neighborhoods for sip and other resources, which is in my purview was those neighborhoods based on where people were, based on hstoc evaluations and the point in time count. The reason this needs to be a dynamic, which i would encourage a conversation with director carol expect director of Emergency Management who has been incredible partners on this and i know you all speak to them daily, to constantly reevaluate that. The reason that count was done recently, supervisor preston by hstoc was to specifically understand where people are. We though that people experiencing homelessness move around and we know that an encantment with two people in your neighborhood and is relatively ok can balloon very quickly to being not ok. And so, i would encourage that conversation and that conversation around priorities. You should wipe away what i said about those neighborhoods because i that is now dated information that hstoc has more data about where people are in the city. That was the original geographic. Im happy to speak to where people go, the bringing them out of homelessness in your neighborhoods. Ok, well, i dont want to belabor this but i want to understand this. Sure. To the extent there are priority neighborhoods and i understand its dynamic and a lot of discussions that happen and it concerns me, who is setting that priority . Theres a huge amount of funds and allocated to address homelessness along the strategies that you have outlined and there is some understanding and every time i engage and this is not specifically hsa but anyone in eoc, command center, trying to get clarity, there are clearly a set of priorities around neighborhoods served, populations served and who is setting that priority . Is that you as the director of hsa . No. Who is setting that priority . So again, supervisor, i would encourage you to speak with the department of management. I know thats a frustrating answer. My responsibility is to make sure there are places for people and i also have a foothold in this because we oversee the hot team which is a partner to hstoc. The way those priorities are set are a combination and theyre driven by data and i dont know what the department of Emergency Management will say, but several years ago, we had a whole data tool driving how we moved encantment when we able to end all before a massive regression and then covid. I think we need to be datafocused. You and i spoke about this yesterday. So we talk about where people are housed and unhoused in need and not where people are the loudest or have access to make that concerns known. Im not saying this is arbitrary but if theres a process and strategy here, its not one that is apparent to the public or to this supervisor. But ill move on. I have other question. And so, on the issue just to ask a little more on the issues that we touched on a little bit about Racial Equity, talking about the street issues and western editions, lets look in terms of the resources. What is proposed in this budget to add capacity in the western edition . Thank you. So this is the second half of your question, but its much more comfortably in my lane. So, across the system of care, we have buckets of money if the key assumption unlock and if the controller releases funds, for example, that are on reserve, for safely we have shelter but those projects are quite spoken for in the budget and we have the continuation of things. First friendship was this your neighborhood and we have replace ed this with a hotel in your community and then we have housing. Where the safe sleep and housing will be will depend on where we find space at the right cost near folks who need it and so, you and i spoke yesterday about what that looks like during covid and what are the spaces that are Cost Effective because all of you have incredible boots on the ground that can help the department of real estate supporting us to find all these locations and so its not allocated, supervisor, by district, that way. There are no longer resources for dropin and the resources that were in the philmore and i understand you can address plans to open alternate, but that was a resource that was available serving folk overwhelming or the africanamerican community, not exclusively in the philmore, but that resource was in the philmore and no longer available. Im asking are there any new resources to increase the infrastructure and capacity to provide shelter in Homeless People in the western edition . The answer is that maybe through the profit c funds and that discussion will happen in the future, i understand. But what im trying to understand, is there anything specific in this Budget Proposal that is targeting increasing that capacity in the western edition in the philmore area . We need to make a connection. When you close one door, you have to help people navigate to the next door. So there is not a shelter planned in district five or in the communities that youre referencing and there are buckets of money for permanent Supportive Housing expansion when there are buildings available for safe sleep when we find locations. We talked about a Creative Concept of a safe sleep location that ma maybe one day could cont to a shelter. Those are the kinds of things we would like to partner with you on the reality is that theres people experiencing homelessness all over San Francisco and they are disproportionately africanamerican and thats facts in evidence, yes. We have to move through this Racial Equity. Racial inequity. It may benefit the africanamerican people because of the disproportionate theres nothing specifically allocated to increase the infrastructure for serving homelessness people in the neighborhoods that i referenced. So im missing it. I corrected that. I think you should speak to the department of Emergency Management about the street components. Ok. But theres nothing in the current Budget Proposal or how these funds are allocated that would provide either a new shelter, a new emergency dropin facility and i understand you and i are talking about these things in the district about potential ideas. But in those neighbors, nothing decided as a part of this budget to provide that kind of infrastructure for Homeless People in the western edition or philmore . Not to my novembe knowledge s budget. This location was ideal because it served so many neighborhoods so effectively and centrally. And the decision that the mayor had to make to reallocate the resources because it would have been so expensive for a short period of time is a difficult one, im sure. We have that physical space and so i think we have retained that physical space and we need to look at the best use of it to help supervisor hayes valley, western soma and whatever the area of the castro is that comes down the hill there near the center. Looking forward to partnering with you to make 33 goff a reality and, you know, were months delayed on that but hopefully we can do it. I wanted to go back to follow up on a couple of things that supervisor hainey asked about just on the 2600 searc sipp, how many of those are new to be acquired in 21 . Im sorry, the 2600, so we are at the number were at today and that would be a good question for director roher and several hundred more still anticipated and then we reach the cap the controller was talking about financially. About 100 still to be under contract and that will likely happen and might happen before the end of the fiscal year. Got it. And if you were to add a thousand hotels factoring in reimbursement, what would be the additional cost of that and would that be in the current budget . That would have to be, supervisor, in addition to the current budget. We built to keep in mind, the budget is the cost of the 2600 or more hotels, but its the decant or exiting so its almost a double cost. You pay the average, 250, fully loaded per night for every new room. Because we are so committed to not exiting anyone to the street, that requires an additional solution on the back end and whether thats problem solving, rental subsidy and permanent Supportive Housing or whatever, so a double cost. The cost alone of a thousand new rooms just on that frontend is 250 a nighttime night times a d and take 25 of that would be the general fund cost. If we hit another surge and thing get much worse, well have to are recalibrate and readjust in terms of the need for hotels rooms or additional isolation. But right now, the plan is to begin exiting over the next 13 months, to begin exiting and complete exiting by the end of the 13th month. With the exiting not starting until after november. Correct. It sounds like youre factoring costs beyond the fully loaded costs of the hotel room for people who have exited. Is that right or not . Youre telling me its not just the cost of the rooms but the cost of after someone has exited where we are placing . Correct. In terms of total burden to the city, supervisor preston, the numbers that director roher is giving you is the cost per night of a hotel room. But once we bring someone inside, were committed to placing them somewhere and so we have to fund an exit. But the numbers hes speaking about are specifically the hotel costs. And we get the reimbursement on the hotel but not on the subsequent place that the person has moved to next. That is correct. That becomes the expanded homelessness response system which has never been properly funded. Bylaw. If we added a thousand rooms, assuming maximum fema reimbursement, it would be 65,200 a night. Or 1. 87 million a month. Is there a pro jected cost for sleeping sites if if its doubled . Supervisor preston, thank you, we spoke about this yesterday and this is where i think we have the most opportunity and work to do within the mayors current proposed budget. The range of costs, like a safesleep village, which is a small site but has virtually no staffing is cheaper but less productive for the people staying there than a village. So the costs have varied widely across provider and site and so, as you and i talked about, its just like shelter in that it needs to be an economy to scale. We want it large enough but not too large. And we are currently doing that analysis, crossing it against locations in the city. And so, you know, in our dreamland, we would have 120 folks to be able to say, we would have as our advocates have expertly recommends, we would have residents involved in the work and we would have to figure out with those who set up the sites and the rest of the City Partners how we can get that to be less expensive, the onetime cost. We need to bring food and security cost down. This needs to happen on every line item and so we need to work on that to bring that cost down. I can not put a number to it, publically. There isnt a number to it now as to what it should be. I dont we were not responsible for safe sleep when supervisor mandelman passed that legislation. I apologize that im not familiar where that number came from but i think many of us are surprised and concerned about the costs currently. And they started out in an urgent way, in the way they needed to and they need to get more efficient now. They must. If we can get them more efficient, we can get more of them, but i cant give you a goal number yet. Thank you. Sorry, chair few officer. Yes, i was just going to say, so i am following this conversation and i actually think that if youre saying they must be more cost efficient. Is that correct . Yes, they are very well run generally speaking and were grateful. Were talking about safe sleeping villages. Is that right . Yes. So my question has always been, why arent we using facilities that we know have bathrooms and toilets and water access already . Why arent we using sites that we know public buildings and can be adjacent to public buildings that we know already have toilets, already have sinks and already have water . If youre telling me that is the expensive part, why arent we using those buildings . So what is it . Why arent we doing that . Because quite frankly, ill just say we have public buildings that actually do have toilets and they do during the 1989 earthquake, we were able to set up showers in the hall of justice basement. So i just dont see, there is what i dont get. Because ive been doing this conversation and i have a whove encantment and had a fire and i guess theres concentrated areas and you have concentrated areas you are working on because what your data tells you, this is the bulk of the most Vulnerable People are living and when you look i think the frustration is also, theres no plan for these other areas that are experiencing growing homelessness and, also, theres to relief. I also think that so we have public buildings already that have toilets, that have sinks and electricity and that have all that stuff and i just dont know why were not using them. So if youre telling me it has to be more cost efficient, yes, i completely agree. Why are we bringing water in . Why are we bringing toilets in . We already have them. We built them with taxpayer money. Theyre not used now and all of these buildings are closed. Why arent we using them . We could have them in every neighborhood. We have recreation sites in every neighborhood that have toilets. My head shaking was sort of, yeah, i agree with you, its a bummer, we cant. When we started covid, my team assessed literally hundreds of buildings to your point, supervisor. We want ones with bathrooms, an easy shower hookup and we decided not to use rec centers because of the childcare sites and wanted to leave those open for other programming. We approached the School District and they didnt not want us to use their gymnasium. Were a city rich with resources. You looked at the school site and they said no and we just walk away . This is what we do . We dont go to the school board . Supervisor fewer, i think and transteam and the department of real estate have been looking at every building, everywhere and we have some models for how this can work. With supervisor mandelmans mediation and encouragement, we had a really Remarkable Partnership with the School District at evert. It was short term and they believe school was opening and it was cost ineffective to stand up a site there only to close and other complications with that location. But there are properties and i think the School District has really shown Remarkable Partnership around the existing program which we are all thrilled is fully funded in the mayors proposed budget which is taking care of families during this crisis in a covidsafe way. That started with parents pushing their School Community and the leadership and that principle and supervisor ronen and forgive me if i dont give credit to all of the incredible stakeholders, coming together and saying these are our families and even then it started with only being available for families in that school and there werent enough of them and people pushed again and they got more comfortable with the idea of that use of space and now its available to any family that has a child in the school system. So we have examples of how when we partner and we bring people experiencing homelessness to public facilities, the sky does not, in fact, tall down. Fall down. The state gives this to us for a dollar. We have to do more. Im agreeing with you, supervisor fewer and director roher, we have to do more of that and we have to fundamentally change the way we think about people experiencing homelessness and what theyll do to these facilities that are not being used. Ok, so weve used the hall of flowers in an emergency and why cant we use it again . Thats on our list and a planned surge shelter for covidpositive individuals. Were in negotiation with a private high school for their gym angym and i dont want to rl the name because were still discussing that with them. As you know, we looked at bill graham and always something about why we cannot. We approached the inciden interh council and the churches are too small and have programming. It sounds like im making excuses after excuses. Im as frustrated as you and they keep doing exhaustive searches, looking at port property. Othats why we have the rvs in supervisor waltons district. If it will help, i can provide you with a list of every site we have looked at and the reason it didnt work out and its literally over 100. Yes, supervisor preston, i see you anxiously awaiting to speak. Go ahead. The response on that topic as well as a couple of other questions, but i dont want to interrupt. I know you were midflow on this issue, which i agree with you, i dont want to interrupt your line of questioning on this. I just want to say so we have the north court of city hall. I mean, im saw, no one is even there at city hall now. What are you trying to accomplish. Like for surge, we have the fine arts set aside for surge. And then we also have the hall of flowers for surge and when do we say that, ok, we can give it one of the sites for surge but we can start to actually have shelter for people there . When do we say that . When is that point . Thats more abigails lane than mine because im the covid person. But that then becomes a cost issue which is why i asked who. Theres a surge shelter that we have in the surge budget prepared for, but if youre talking about a longerterm shelter for homeless, thats a cost and thats not built into my budget or abigails that is before you today. So were saying that we canf not finding sites or an issue of the money . Supervisor, i was referring to covid sites. Thats what my team is tasked what doing. Congregate sides fo sites for cd positive. Supervisor fewer, before the crisis, we were slowly but surely making progress with things like 1925, 888 posts and 33goth. Supervisor preston, you have been look for a space in your community for a long time. The department of Public Health was making progress in district eight. I think that was good and never, ever fast enough. We want to embrace community and neighbors want to visit these hotels and bring food and supplies, but we need to keep the germs away. So i think youre exactly spoton supervisor. Director rohers team has been looking at every community which has a funding ability attached to it. When before we needed to find the money, the site and create community adoption. So if we could take even one of those away, we could do more things faster. Supervisor preston. Thank you. Just a comment and then some other questions, but on this topic, i just want to be clear because as chair fewer said, we have plenty of sites for the congregate or safe sleeping villages. To your point, i have when you say ive been looking for a long time in my district, its not been hard to find sites our district or Property Owners and schools. Thats not a problem and i want to be clear that, like, my sense and you can correct me if im wrong, were making decisions around cost, a decision not to put more people into hotels or safesleeping sites because of the cost of our commitment, which i think is strong and an important commitment that people dont commit those facilities on to the streets. And so, thats what is driving this. And i think its important that we be upfront about that. To chair fewers point, whether its parks, whether its public property, whether its private Property Owners, and different apartments are ready to step up, whether its a safesleeping site or solutions, i just dont think thats the limiting factor. I have to say their was told before i took office in december, i was hard to find a Navigation Center and within a month and a half, weve ha weva Property Owner who was wanting to move forward. And so this is about how much are we going to spend to house people now and its not even the cost of shelter now because as supervisor hainey pointed out, the most Cost Effective solution so far is hotels and that many of those costs, not all, but for certain individuals, 75 of the costs are reimbursed and were making this around the cost of when they exit and thats our limiting factor. Not that we cant find the hotel rooms and not that we cant find the sites, right . We can, we could. We made that commitment, but it would be expensive and i assume its not in the budget being proposed. But im a little alarmed looking at this budget when we have or the presentation when we have only 145 new tents proposed that say sleeping sites. My colleagues are reacting, as well, only another 100 hotel rooms does seem very much as assume scormuch, itsdoubling df Supportive Housing but not offering any meaningful solution or increased funding for the temporary things that would get people off the streets. Supervisorsupervisor, there e 2,600 and probably more, because people Share Hotel Rooms and they have increased the shelter capacity in San Francisco more in the last five, ten years and a significant one in the bayview and lower excuse me if i could finish. Moving for. The housing is not Just Healthcare but less expensive than shelter and safer. You said that the shelte shelterinplace hotels are cheaper and thats not the case, the housing is and Permanent Solutions where people have tenants rights. Separate from the values around that, that is also where thes these this is not a room but whatever this is, this room, are not going to be governing much of the money if it unlocks. Much of the money is allocated by the voters already and if the controller releases it after the november election, it cannot replace fema money. So i hear what youre saying and i agree we need more of everything. This mayors Budget Proposal offers the single largest expansion in housing. , in subsidies and potentially tay and family. And it continues to drive on shelter and sleep. This is a part of the twothirds not spoken for. We are also able to increase our investment in rapid rehousing, which is a fundamental exit to homelessness for families and tay in San Francisco and need to focus as an exit for adults. We have to stop paying only attention to permanent Supportive Housing and the beautiful but expensive shelter in place concepts. Youre spot on that part of our exit not exiting people to the streets is that we have to think about the exit. It would be irresponsible. Ok, supervisor preston, i am going to have to what im going to do, im going to invite you to keep staying with us and hsa is next. And so we are going to be looking at hsas budget. I think that, actually, at this point, i have hsa left and mta left and the airport left and support level and then i have Public Comments and so, what i would like to do is Supportive Housing will come back to us. This is the only time theyre going to be here and i think they are scheduled to come back, also. So what i would like to do is move this along. This is our first sort of conversation with them around their budget and then, please stay with us because we are now going into hsas Budget Discussion. Im sorry that we have people that had called in at 10 00 to be on Public Comment and they were in the wrong line and they are waiting to give Public Comment, also, and most are from parent voices and im trying to be sensitive it will be after 9 00. Supervisor mandelman, did you have another question . I see you in the queue. We were making great progress to shelterinplace and working with the Public Health department and if you look in the right way that street conditions had improved possibly over the i was thinking about the hummingbird site. Im not aware of a location or budget available in this proposal that focuses on 1925, 888 and we had to repurpose the funds for 33 which would have served five along with other districts. So not the fun funds for a d5 Navigation Center . Yes, eliminated the fun fundr 33 goth. Yes, and on the plan for homeless families, i wanted to ask if families can be included in you referenced a new flexible pool earlier and im wondering if families are included in that . Thats a terrific question and thats funded by philanthropy focuses on chronic homeless adults and creates a mechanism for a flexible pool which we would love to see expanded creatively to serve all playingpopulations and could lot with community with prop c funding, for example, because we know families want to be spread around the city and not in one location. Thats a great question, supervisor. Thank you. And then last question, just in terms of new people on the street, because this is something we battle with a lot of misinformation out there, you know, you referenced some of the causes of rising numbers in the streets, folks who are marginally housed and tight situations who had to move, i just want to dispel this. A large number are brand new from elsewhere and do you know offhand, what percent of people on the streets are brand new to San Francisco, who have moved here in the last couple of months . Thanks for the opportunity to clarify that and i will be brief, chair. In the beginning of the pandemic, we saw an increase in peeping coming from elsewhere and, in fact, we learned and had to follow up swiftly, that people were released from institutions and jails with bus tickets to San Francisco and that happens from time to time and there was a flow here. Now were not seeing a massive inflow and we will not know a datadriven answer to that question until our next point in time count. Thank you, thank you, chair fewer. Sure. Please stay with us. Hsa is next. Miss abigail kahn, im looking at your vacancies and i see you have 19. This is something that i think has plague plagued your departmr awhile. Do you have any hires pending right now but have not been hired in their general fund vacancies . I will let miss whitly step in a moment, but thank you for highlighting that and this is one of the benefits of of th tha audit without a full hr team and so were grateful that our team is robust now. And the vast majority of our vacancies, a im looking at a chart now. The one thing i want to call the attentioattention for the board, there is one position pending approval of the budget which a substitution to ensure that we have our equity manager helping us to do the work. Deputy director whitly, can you speak to anything more specific related to the hiring . This is including a fine offer and background check and i have a breakdown to go over with you. The one positions, youre in the position of hiring all 19 vacancies . We have a number of positions held open for attrition or asneeded but weve been doing an aggressive recruitment over the year. Were asking for an expansion around facilities and shelter, which we need to continue to manage this operations that are fully staffed. Thank you very much and i just wanted to mention that we are looking at vacancies, but we are looking at these positions that havent been filled yet. And even if theyre pending or close to being filled, they have not signed a contract yet and therefore, theyre not employees yet and i think at a time of, further, but considering were 1. 7 million budget, were looking to be the most Cost Effective at this time. Our last three hires happen to be transfers from other city departments and were considering to hire, were reallocating within the city and trying to use our talented city staff efficiently by bringing them to hsh so thank you. We see you again next thursday. So well see you next week and thank you and well see you next week and with that, we have hsa. We have now the department of Human Services with ingrid, also. And emily gibbs and emily kaplin. There you go, made it larger. And supervisor walton, are you still with us . Im going to ask the clerk he need to be excused. We can do that from the vote later on to continue with the items. Thank you very much. Here we go and the floor is yours. Here we go, ok, supervisors, good evening. Im the executive director of the Human Services agency and so i will jump right into it and its late, a long day for everybody and starting with just the overview of the Human Services agency and as you know, its three city departments with really one Administrative Foundation with admin support, department of Human Services of which im the director, the office of early care and education and ingrid is with us and the department of disability and aging services and miss mcfadden is here and i will kick it off with the Human Services portion and then turn it over to my colleagues. And so, just an overview of hsa, and im talking about all three departments. And as you know, we deliver safetsafety net service ands fod Health Insurance through medicale and placement providing the services to single adults and families and then, of course, a significant system of early care and education and then we provide protective services for children through our Child Protective Services and adult through Adult Protective Services and a whole array of services for everyone from birth to later stages in life. And as you see on the slide, we touch about 260,000 unique people in San Francisco every year through one or more of our programs and services. Major increases in the oec through the prop c opening, as you know, thats in the budget for 2021 and significant increase in our feeding in response to covid and that it will be included in the dos budget and the one Million Dollars increase for ihss is the wage increase and the impact on the general fund of that and given the economic downturn due to covid, we anticipate significant increase in our cash assistance programs in Human Services, specifically in county and assistance programs for adults and families. You can see the total of 19 million there and the bottom is our attempt to move thousands of people into subsidized employment through our jobs now, expansion to provide paid sick leave to employers in San Francisco so that their employees could take sick patients if they get ill. So next slide. And you asked in our presentation to lay out the fte count and we lay this out by department and you can see the bulk is in the department of Human Services, almost 1500 employee, dos, about 336 and admin, 330 and oece, small but mighty with 23 staff. The increase in fte, that is not an increase in employees. What that increase represents is a shift from positions that were in a project budget that shifted from that project budget into our base budget and that has to do with the expiration of what is called the 4e waiver which is a funding stream for our Child Protective Services division. So basically, its just that 4e waiver expired in the current year and so, were moving it out of that fixed money project into the base budget. So its not additional people. Its just a budget artifact. So, excuse me, so that means that the people were funded by a different Funding Source other than general fund and you switched them over . Kind of, supervisor. So the 4e waiver was a fiveyear demonstration project authorized through the federal government that provided us a fixed amount of funding for fostercare and Child Protective Services each year, which was a way to assure that we would receive the same amount of dollars, even though our fostercare caseload declined. It was to prevent placement into fostercare rather than only when someone was in fostercare and we got credit for good work in reducing kids in fostercare and there was Preventative Services and other things. And were shifting those positions into the standard or regular funding stream for child welfare. We get funding to administer programs and so youll see here in the slide that about almost 50 of our funding is from the federal and state sources and we have a significant amount of money in our budget in restricted local either through the dignity fund and you see that represented there and you know that means its not discretionary but restricted for specific purposes. And then the last 20 represents the general fund that is, in part discretionary but its local shares of costs in order to dry down the federal or state dollars. So not truly discretionary. Next, please. Theres an increased need due to the significant unemployment in the city, but also, weve been deeply engaged, as you know, housing and we had a long discussion about the hotels that we propped up, almost 2600 units and feeding, primarily through the department of aging or the department of disability and aging services. Ingrids shop is providing essential childcare support and then i mentioned the paid sick leave and personal businesses in partnership with the office of economic and workforce development. We are a very clientcentered sort of Interactive Department and our transactions are done face to face and weve had a huge shift in the way we deliver our services and we had to close the lobbies to the public and shift to primarily online, phone application and renewals and we do have our lobbies open for specific inperson requirements, the state requires an inperson visit with picking up a replacement, electronic benefits card or Something Like that. When we see increases in our caseload, that funding generally has to follow and so, for example, when we see our calfresh caseload increasing by 40 , that means the state will provide additional administrative dollars either to hire for staff or pay staff overtime to do the work. Same with thing with medicale. They anticipated a statewide increase in caseload of 60 and accordingly statewide 600. We think about what growth do we need in services or staff, but also what revenue could we use to offset some general Fund Investment and replace it with the state and federal dollars. Because there was such a significant investment of state money, thanks to the governor and legislature, we were really able to meet a lot of the general fund targets by swapping out general funds and replacing it with federal to expand jobs no. We have small reductions with communitybased organizations. In the department of Human Services, thats in family and Children Services and i can walk through some of those if you like and theyre small reductions and youll hear from director meskita, there are reductions in oece. Of course, equity, the Service Agency has been long embedded in the Program Planning and decisionmaking and literally for decades. The populations that we serve, whether its on cash assistance or benefit programs or Child Protective Services tend to be disproportionately communities of colour and so we have long looked at how our programs can impact and improve the lives and families, seniors and kids who are low income and disproportionately people of colour. We know a lot of lower waged workers are started. And ensuring people that lost their jobs can food food on the table for themselves and their families. We will focus on the populations and then, of course, our hotel room acquisition for vulnerable homeless on the street and disproportionately black africanamerican. I had a question of about jobs now. So do you have impact data on that . How long have they stayed in the jobs . E have done rigorous studies and we have data with edd allowing us to track participants longitudally. We know that over twothirds of people in jobs now retain their employment up to three years after they leave us and a significant portion of that twothirds sees waiv sees wage progression. We implemented jobs now in the recovery act under president obama in 80 and never imagined this is the program we may be looking at for the city. The only reason i ask this because the internet archive in my district, he had hired people and those people were still working there and its been a long time. And they raved about the program. Sorry to interrupt you, i was thinking about jobs now, considering where we are with the huge unemployment that were experiencing, that jobs now seem to have run to perspective programs. I do remember the internet archive and they were an enthusiastic participant. Thats great you remember that. And i will talk to you a bit about our jobs now, proposed expansion in a second. In our cap program, these are single adults receiving cash. In these programs that all of them have Employment Services tied to them and some state and federally funded and some locally funded and that sort of leads into our strategy because our strategy is not simply to provide that safety net support of healthcare, food and cash, but we need to get folks into employment and so how are we doing that . So the next slide shows that the first goal is the representation of the Fiscal Representation of the caseload and so 9 million, additional cost is backed by state and federal revenue. However, the local hit, the general fund is the cap, 100 general fund, supported and were projecting a 10 million increase in costs for providing that income support. And i mentioned the increase, it was a ten Million Dollars in current year and nine million into the fiscal year for the paid sick time, called the working familys First Initiative and basically provides cash assistance to employers to provide their employees with sick pay. We dont want people trying to work when theyre sick. We dont want people to when theyre sick go home and not get paid and that is with oewd. The last piece, supervisor, and im glad you brought it up is jobs now. So what we did is we took that additional state funding for calworks, predominantly, and we still have 7 million left over to significantly expand jobs now and were going to were proposing to add a thousand more wage subsidy slots on top of the alreadyfunded 3600 slots that we have and so, when we were under president obama in 08 to 2010, we employed over two thousand people and these were not lowwaive jobs. The average wage was over 40,000 a year in income. Whether its medicale, you are helping a family get through this and so, its interesting, a lot of the same people are still with my agency when we did jobs now, including me and my leadership and workforce development. And so we can hit the ground running. We have a panel already set up for Early September with Small Business who were something 90 of the placements, over a decade ago, to launch this and say, hey, were not only putting people back to work, but Small Business, were supporting you, too. And i remember from the first goaround, a lot of Business Owners said to me, hey, this allowed me to reopen or stay open or even expand because it mitigated my risk in that i didnt have to sort of bet and hire people that my business will thrive. We can go ahead and open and expand and we hope this same thing happens. The beauty is were using state and federal dollars and not on the back of the general fund. Thats the end of the Human Department of presentation and i can turn it over to my partner. Whatever you would like. Turn it over so we get it over with. [ laughter ] does anyone have any questions for director roher now . Lets move on, then, to president yoursel yees sweet s. Good evening, supervisors. I know youve had a long day. I only have two slides. Im the director for the San Francisco office of education and currently, what were doing with some of the changes with the office of care and education has really to do with the pandemic. We fund over 350 sites across the city that are licensed to early care and education sites and since march, midmarch, most of the sites had to close because of the shelterinplace. The majority are back online starting in july, but they are working under a very different guideline. And part of that has to do with the Public Health guidance that limits the number of children that are abl in preschool, infar toddler care and providers are having to do difficult things with balancing a strict budget because our system is really based on a childs reimbursement basis. When your classrooms are cut by 50 and you have the operating costs of a full classroom, it makes it very, very difficult to operate. And so weve been supporting programs throughout the city in many different forms, including grants, supplemental grants to help them be sustained throughout our shelterinplace since this is how were going to be working for the next year. The state has many problems like we to and their reimbursement, the baseline funding for many providers, including the School District has remained flat in terms of the funding and San Francisco has had to, you know, pull a lot of the weight. This year, what were focusing on is our Core Services and prioritizing based on the Public Health equity guidance, which is providing services to children who are of colour and also are marginalized and having to bear the brunt of just systemic racism through any of our systems. We are putting them ahead of the line and they are receiving access for inperson and specific learning. Were looking at maintaining the childcare capacity hold and providers dont need to bear the brunt, economic brunt of this system and its a part of our economic recovery, as well. So far, we have over 75 of families returning into their childcare spaces and that is because most of the families who receive the childcare subsidy are working and theyre a part of the essential Service Workers and part of essential services. And they feed to have stage, stable childcare during this pandemic. And sadly, we had a loss in peef, 9. 3 million for this year and next year and next year we dont know how that will look like. And so, we have to make some concessions because of the not only in the piece revenue but other state funding, as well. Next slide. But theres a light at the end of the tunnel. Were all crossing our fingers and toes, hoping that the measure in november will pass, which will allow us to unlock the dollars and last year, we had a series of Community Engagement where we asked or community, parents and providers and people who are a part of the Early Childhood system around prioritizing the profb dollars so we have a lot of information if that money becomes available, one of the things we want to prioritize is to be able to advance our workforce. As man of you know, our teachers are the lowest paid and that is unfair and unjust. And so we want to make sure that were increasing not only the quality but also the takeout and that includes many women and women of colour across our system, both in Early Childhood education, including childcare. We want to increase access for our baby expos babies anded to e many babies wait on waiting lists and we want to make sure that children have the best opportunity and ensuring that every program has access to professional development and that we have quality standards so that were guaranteeing children and families the best outcomes and, of course, we cant do this without shoring up or fragile ece system. And so, you know, over the next year, were working very closely with the Family Childcare association. Were working with our ece teachers and ensuring that they have the resource needed to operate under these conditions. But we no that we need more resources into the system. And thats the end of my presentation. As i said, it would be short. Or brief. Thank you, ingrid. And yes, president yee. Thank you, director. The current budget, looking at the 1920, last years budget, 35 million allocated for your office and how much of that is coming from calworks . Did you hear the question . Are you asking how much is coming from the hsa Calworks Program for childcare . Correct. State is providing additional funding in stage one in line with the caseload growth. Thats gone way down, hasnt it, from a long time ago . Yes, the caseload has gone ge down as well. Were over three thousand families. In 1998. With the influx of dollars when we passed the measure in november, do you feel there needs to be extra staffing to deal with your budget . [ laughter ] yes. [ laughter ] were a very lean staff right now and this is something we will explore once the proposition passes, but for now, we have not added any positions. And so its not reflective no. I was wondering about that. And then, i know that a year and a half ago. Correct. We had a series of Community Meetings to engage in the planning of prop c. So the planning for prop c, when people were talking about it was really a different orientation that we would have money for the rest of our lives and it could be ruled in a particular way. And so, are you making any plans for that could look very different from that plan because of the nature of how its coming into your budget and because were dealing with issues we would need to reason gaugr community. Theres two Top Priorities for new funding and one is to really address the compensation issues of our early care and education teachers and the other is to increase access, especially for our babies and toddlers. I think theres enough money to do that, but theres the issue of everybody of programmes closing down, too. And thats something that i think your office needs to look at very carefully in terms of allocation of funding. Otherwise, you wont have any teachers to help with the compensation as they close down. They need to see how the early recovery will affect the situation and we will be looking at all of those areas. Yeah, because part of it is more towards the Family Childcare providers in which many dont necessarily have the city supporting all their slots. And so theyre pretty vulnerable to losing the people that they fill in the rest of their programs with. Hopefully we get through this and ill probably engaged with some of your thoughts in the necessity few months. Thank you. Thats it. See, quick. Thank you, ingrid. I think president yee has been worried about it, but overall, weve been worried about it, too, just because we know that so many providers are having such a difficult time, you know, and i just think that, also, you know, its also about the ability to also continue, as you ohknow, to train the staff a lel of professionalism and make into a profession because i think that when people the area of Early Childhood education has been actually, you know, minimized impact and i think that it is so important that we frontload the zero to five and this is we get the most bang for our buck. Were talking about equity and opportunities and it starts right there. Im sad that president yee will be off the board because, actually, i think hes educated the board, too, on Early Childhood, the experiences but the fact that the Teaching Staff is paid so minimally and its really travesty that people dont understand the importance. Its somewhat shocking and so, anyway, i want to thank you and its good to see you again. Thank you so much. Were going to hire president yee as a consultant, just so you know. You should. Hes so helpful. Is sheree next . Yes. Can you hear me ok . Hi, how are you. Another topic dear to our hearts. Well, thank you, chair fewer and committee members, youll be really thrilled to know im beating up my colleagues because i have only one slide and hopefully we can get through it quickly and ill answer your questions. Thank you. Due to the citys revenue pro projections, this has been paused in the legislation and despite this and our provider has stepped up to ensure to provide services to people with disabilities and older adults in the covid landscape. Our Community Partners quickly shifted operations to ensure they could provide services to people at home and a major concern is isolation risks, particularly as older people and adults with disabilities are more likely to consider strict adherence to shelter in lace, even as the city opens up. Were implementing a number of strategies for engagement, such as conducting wellness calls, ensuring that people have access to technology at home and developing an online curriculum to ensure older adults and people with disabilities will stay connected. Then theres nutrition and Food Security. Food support is one of the top areas people are asking for for support from us. Evacuee shifted contract budgets to better support nutrition and Food Security among the populations we serve and our providers offered grab and go or home delivery. Our Department Also launched the great place delivery program, a program developed by the state that utilized local students and food providers to make and deliver meals, providing support to both older people and local businesses. Internally, dos ramped up the resource hub, the onestop shock for accessing dos services and they were going certainly day sa week. In partnership with the sh acaue project, we created a Serve Program and helps older people with disabilities meeting essential needs by dropping off medications, walking pets and more. Dos continues to support the older people in adults with alternative housing sites for Multidisciplinary Team with Supportive Services and early in the pandemic, this payment facilitated charges from laguna honda to reduce transmission risk. And other major budget changes include a providers wage increase of 7 75cents an hour. The delay saved 1. 7 million in the ihs effort for fiscal year 2021. It includes 45. 7 million for the covid19 food support budget for fiscal year 2021 and this includes support for four programs aimed at supporting populations to shelterinplace or at least access food close to home. The isolation and quarantine food Program Brings groceries to food insecuring individuals and to Health Professionals or a contact tracer to quarantine. The mealsinplace provides to people in San Francisco so they do not have to travel outside of their areas. And there is fund for alreadyestablished dos providers to accommodate expansion. And finally, i know trent addressed the importance of equity, but i want to add comments added to dos. Equity is important in our work because of the inequity and how they accumulate over a lifetime. We strive to partner with community of colour and services and implementing our programs. And we contract with a diverse array of communitybased organizations, invite partnering with trusted organizations and we are able to connect with hardtoreach groups and programming. These partnerships allows us to learn from clients and providers about population trends. This is edent omany were involvs assessment process Holding Public forums in each supervisor district and we held 29 focus groups with priority and hard to reach populations, spanish speakers, africanamerican older adults and people with vision impairment. That assessment included an Equity Analysis to understand how groups that face barriers do or do not utilize services. We use these findings from the assessment to shape or plans and priorities and while this is a fouryear process, we do deeper dives each year and gather that information and use it to create our allocation plan for the dignity fund. So thats basically what i wanted to say to you this evening. If you have any questions, im happy to answer them. Thank you. I think you did a wonderful job. It was incredible that we were talking to the ederly and their wait list was, like, 500 people waiting for meals and they just got a bunch of volunteers, you know. And i think that because of that, i felt like my Senior Community and disabled Community Felt they had a safety net around them and theyre being taken care of in this very scarry time, especially for seniors. I think it was wonderful and this wage increase of 35cents an hour, thats mco, right, that we were able to get the 75cents, is that right . Yes. And were trying to work on the extra 25cent cents and that was a part of the agreement, too. And in hindsight, we should have fought for the full amount. Theyre doing gods work, considering theyre making 16 50 an hour and the majority of them seniors and women of colour. And that is incredible. President yee. You got on the needs of seniors right away and i felt like it was scarry at the moment there, of what will happen to all of the seniors. Theyll be isolated without food and in between the nonprofits and your department, i think we did a good job in San Francisco. I mean, my district for instance, on top of that, my volunteers basically call every single and tried to reach out to make sure theyre ok. But for the majority of them, they said, theyre being taken care of and some of them a few of them said they had to food and that was taken care of. And so i want to thank you and your staff for stepping up, really. I would like to thank a lot of the city staff from different departments who have stepped up during this covid19 emergency. At the same time, we havent stopped in trying to develop Affordable Housing for seniors and thank you for your involvement in this and it looks like were getting closer to something over at laguna honda hospital with the developer already signed on and i dont know if the sos funds goes where does that land . Who administers that . Thats ocd. And hopefully, clea chair fe, hopefully we can add more money into the sos fund to pac make se the 30 300 slots at laguna honda can serve seniors with fixed income. Yes. The fund thats already allocated is inadequate. Ill just say that. The need is so high and so great. I just want to say, also, that i feel my cdos feel they were very well supported by your department and i dont think that we could have pulled it off without your help. And so, really, i think that my cdos are wonderful and in this case, they needed support and i think your department was great killing and helping them to serve and theyre still doing it. Thats great, the support, so thanks im really, really proud of my team and im also proud of our network. We worked very hard and worked very well together. So thank you for that. Its great. And so, colleagues, any more questions . Supervisor ronen. I jusyou have a lot of fans n this board of supervisors and thank you for all of your work and staffs work. About the 25cents for the ihsf workers, can you update me specifically on that . So the rate that we negotiated with the workers, theres a 25cents thats missing and thats in the next budget years . Is that right . Vince is going give us some numbers, right . This was scheduled for a dollar on july 1st and the board of supervisors restored 75cents of that dollar and so thats a 25cent gap. And so, for the full fiscal year, its been budgeted at 75cent raise as opposed to a dollar . Its butched budgeted on the 75t level at which that increase can occur. Correct. What would be the cost of the additional 25cents . We can work that number up for you, supervisor, and provide it as a followup to this meeting. A million, maybe, or so. I think Something Like that is roughly right, but let me get back with the specific number
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