Effective in helping people get their lives on the right path. And thats why were here today. We are here to focus on getting peoples lives on the right path. San francisco is a known, compassionate city, and when you think about the amount of service and resources that we offer to the public, we lead with our hearts or we lead with a desire to help people. For so many folks who have family members who suffer from addiction, this sometimes can be really personal. Wanting to see the city do more to help people get into treatment. It should not be any more convenient to get access to drugs than it is to get access to treatment. And what we are trying to do with a number of our changes and initiatives that i realize are a bit controversial. Were trying to get people into treatment. This is where we are. We see something a lot different with what the drugs are doing to people today than ever before. We see so many more people dying young, dying, not just are going through a situation and getting better, dying on our streets of San Francisco, were seeing more lives lost to this than covid. And with covid, we shut the whole world down. And with these drugs and how potent potent they are, this is poison. This is killing people. And were on track in this city this year to exceed had the highest number of Overdose Deaths than we have since this thing has really taken over, dominated, destroyed and taken away lives. And we need to do something about it. And we need to get uncomfortable with being uncomfortable. We need to get comfortable with being uncomfortable. Al and so why are we here today . Were here because we need to make a significant change. And one of those changes is to require treatment for those suffering with Substance Use disorder when they are seeking to get support from the city and county of San Francisco. General assistance. Ga. It has a lot of different names, but no more. Anything goes without accountability, no more handouts without accountability. So in order to get resources from our city, you will need to be in a Substance UseDisorder Program and consistently seeking treatment. Int and that is really why were here today to make that move, to get people into treatment and get them the support that they need. Our city workers, our street medicine teams, our street Crisis Response team, our Overdose Response team. We have a number of people who are working every day out on our streets to provide to support, to provide programs to lead with compassion. And last week alone , 80 people were contacted and touched out on the streets, asked if they wanted services, provided treatment on demand, and only one agreed. And as you can see with some of the arrests that were making for public intoxication, when people are not accepting help. And so now its time to make sure that we are cutting off resources that continue to allow this behavior for to occur without the accountability, without someone involved in a Treatment Program that could lead to a better life. Its time for us to get serious with treatment and with support for those suffering from addiction in in light of what has happened with the number of people who are dying, were seeing the headlines. Were talking about it. Everyones talking about it now its time to do Something Different about it. This legislation will have to go through the board of supervisors, and i am grateful to have supervisor matt dorsey here in support. And im looking forward to seeing other members of the board board support this very impactful legislation. And to be clear, this will be a fight. This will not be easy, but it is necessary. And ultimately i understand and very challenging and difficult of a decision. It is to make. I am more concerned about the lives that we will save and the people that we will get help in order to deliver this effectively for the public. We want change. Mothers want their children to be healthy and safe. Families want their brothers and sisters back in their homes. And people want to see the folks that are suffering from addiction get clean and sober and get on the right path with like so many people, all that positive direction has helped directly with not only wraparound services, but with housing, with food, with support, with love, with compassion. But not in anything goes approach. And thats why were here today, because its important that this program is implemented as aggressively as possible. We cant say we want to see change and not be willing to make the hard decisions to get there. And today its a hard decision. It helps with the other work that were doing where we are making arrests and were trying to get people into Treatment Court and the folks who are refusing, well, this is an incentive to get them into Treatment Program , into a program that will help save their life and thats what this is about. So i am looking forward to sending this legislation to the board of supervisors. And my hope and my prayer is that as a result, we will then begin to see more people in treatment. And that is the goal of what were trying to accomplish here today to explain a lot more about the program and to go into more depth will be the director of the Human Service agency for the city and county of San Francisco, trent rohrer. Thank you, mayor breed good morning, everyone. As the mayor said, im trent rohrer. Im the executive director of the Human Services agency in San Francisco. Were the agency that administers dozens of Public Benefit programs to benefit over 250,000 san franciscans every year. Its important to note that this change only applies to one of those programs and the program that that it applies to is called the county adult assistance program. In other counties, its referred to as general assistance or ga. This is a program that is mandated by the state of california in all 58 counties to provide cash, aid and other supports to single adults who have no children under the age of 18. So were not talking about families with kids. Were not talking about seniors who are receiving inhome care. Were talking about single adults between the ages of 18 and 65 who have no dependents. Right now in San Francisco, there are about 5200 people in this program. This is the program that provides cash assistance to Homeless Individuals. It provides cash assistance to many formerly Homeless Individuals who are living in our Supportive Housing , along with other other populations means what were proposing to do is to require every one who is receiving cash assistance through this program. So 5200 people to first go through an assessment and screening to determine if they suffer from Substance Use disorder subsequent to the screening for those who who we have confirmed, they have a Substance Use disorder, they will be required to enter into Substance Abuse treatment and successfully participate in that treatment, which we will be monitoring in order to receive that cash assistance. Those who choose not to be assessed or screened, those who choose not to enter into treatment, should they should theyre screened, be positive. Will no longer receive cash assistance. And how much are we talking about . The majority of the individuals who are receiving assistance receive 697 a month. If you are homeless because of care, not cash, you receive 105 a month and a guaranteed shelter bed. Individuals again who did not seek treatment when treatment is called for based on the assessment will lose that cash. Important to note that if someone is in homeless shelter or someone is in support of housing, a large majority of individuals in this program were formerly homeless. They have been housed successfully through care, not cash and through other interventions by the department of homelessness. They will not lose their housing, but they will lose their 697 a month. Why are we doing this . Weve been looking at this data along with with mayor staff and others for really for a number of years. But but there are three data points that really i think, calls for this pretty significant change. One one is about 20 of individuals who receive county assistance have self declared that they have a Substance Use disorder. Now, this is a self declaration and those in the field will agree with me that generally a self declaration is an undercount or underrepresentation of those who actually suffer from Substance Use disorder or addiction. The second data point the department of homelessness and Supportive Housing did a survey in in 2020 to along with their homeless count, where 52 of Homeless Individuals surveyed self disclosed that they had a Substance Use disorder, that they considered a disabling condition. The third data point , the chief medical examiners office, did a report from 2020 to 2022 that showed that 25 of Overdose Deaths during that period were people who had no fixed address. In other words, they were homeless. The data is clear. This is a population that disproportionately suffers from Substance Use disorder. Its a population that is not available, availing themselves of treatment. We have the treatment resources, the Human Services agency will ensure that we fund the additional slots needed to provide them to individuals who want to seek treatment. And again, if they dont seek that treatment, they will no longer be receiving cash aid. We anticipate the process going through the board should it be successful, we will take some months to put the program in place to secure the contracts with providers in order to do both the screening and assessment as well as the treatment, and are really looking forward to making positive change for a population that is too long suffered from addiction in and specifically from opioid addiction. And fentanyl use. So now ill turn it back, i think either to the mayor or to supervisor dorsey, to say a few words. Thank you so much. My name is matt dorsey. I am the supervisor for district six in San Francisco. And it was the conversion of a Public Health crisis in drug Overdose Deaths. And my own journey in recovery from addiction. That moved me to ask mayor london breed and then voters to consider me for a job on the board of supervisors that quite candidly, i never thought i would want, let alone have. But this issue is why i asked for this job and this approach, this initiative is why i am so grateful for the leadership of mayor london breed. I am proud to be here and to support this initiative. I believe it will better incentivize treatment and recovery for a population that is at wildly disproportionate risk for drug addiction and Drug Overdose fatalities. I dont need to remind everybody that we are facing an unprecedented loss of life in San Francisco. San francisco is not alone in that. But we know that we have got it worse here. We also know that coercive interventions can work. This approach reflects a key principle in the National Institute on drug abuse that treatment doesnt need to be voluntary to work. And i just want to repeat that. Please get this guide. This is the National Institute on drug abuse treat coercive interventions can work. Coercive interventions can save lives. Sanctions and incentives like those mayor breed is proposing today are evidence based. And according to nida, can significantly increase treatment entry retention rates and the ultimate success of drug treatment interventions. One additional point i want to make is that i think too much and for too long in the crisis that we have seen in our city, we have been leaving the strongest ally in this crisis on the sidelines. And that ally is represented very well here today. And that is the Recovery Community itself. As a member of the Recovery Community, i will tell you, the people who are going to save my life when i need it, when im at the end of my rope, its going to be my brothers and sisters and nonbinary siblings and the Recovery Community. And San Francisco can oftentimes be a bad influence. But i will tell you, the flip side of that is that we have a Recovery Community that is phenomenal and we need them in the game. This this program will do that. This is going to be something that i think will not only save lives, but give people a chance at a better life. There is a better life on the other side of addiction. And that is true if you are an individual struggling with Substance Use disorder or a city struggling with a crisis. And one representative who i think is just extraordinary at that is the person whos going to speak next. And thats cedric akbar. All right, good morning, everyone, and welcome. Um, you have some people that are here and some people that are doers and mayor breed right now is being a doer and making the changes in San Francisco of accountability. We look at her and we as a city have to hold her accountable. And when we hold her accountable, well, what does she have to do with us . Hold us accountable so when i look at this situation of how how this is going to happen and transfer her and as she said, were still doing this with love and kindness, but its at some point that the people on the streets, the people in San Francisco, we all have to take accountability for our actions and for our consequences. And once we accept those, we can move forward. Im a true believer of everybody staying in their own lane and do what they do best and work for a better San Francisco. So we, the Recovery Community city positive directions equals change and truly support. Mayor london breed on this particular issue and we will support her all the way to the end of this to see it through. So i ask and encourage the citizens of San Francisco, the voters of San Francisco, the people of San Francisco. So whether you land on the ground or you at the top of the pop to be able to support this together and together we can make the change. Thank you. Thank you, cedric, and thank you again for being here and just for some perspective, San Francisco. Spends 650 Million Dollars for Behavior Health programs that help at least 4000 people with a number of services and programs , whether its Behavioral Health, Substance Use disorder. Weve recently added another 350 Behavior Health beds. And our goal, as i said, is consistently to get people into treatment and support that they need. So the public is wondering if were spending all this money, this is just for Behavioral Health. This is not even included in homeless shelter and all the other amounts of money, the millions. And in a two year period, over 1 billion for various homeless shelter beds and other resources to try and help folks. We have seen in the amount of money increased significantly. But what we have not seen is changes to what is happening on the streets. And in fact, you can attribute the based on the number of deaths that weve that weve seen that why is it getting absolutely worse . S why are we losing more people to Drug Overdose just in august alone, 84. And as i said, on track to surpass any of the numbers that weve had in the past post and during covid, we shut the whole world down. We have to attack this program, gram. And the work thats necessary to turn peoples lives around in a way that is going to truly lead to positive change, truly lead to peoples lives being saved. So thats why we are here today. Thats why were grateful. I want to also say that even though we cant compel anyone into treatment, im really grateful for the work thats being done at the state level that is going to add some Additional Resources for Behavioral Health conservatorship and other things that we can use to help get people into treatment. I am grateful for the clarification from the City Attorney around and the work were doing to clear encampments in San Francisco and just for clarity on that. But again, leading with service or leading with offers of help, leading with support, but there can no longer be a climate of anything goes. There has to be an accountability piece attached to that. And thats what this piece of legislation, ann, will bring to the work that we are doing on the streets and with that, i think i will take a few questions from the press. A city or a state that has implemented similar screening requirements that you would point to as a model or example of this. I dont know if i would point to them as a model of or being effect