we also have access to support service hotels the most pref atlanta prevalent provider is connor house and a variety of locations in the city. we also have access to cooperative housing through progress foundation on a mental health model. those housing outlets are available to folks who are stepping out into less restrictive settings. we have an enhanced support model for people who are living in

apartments and especially created as part of the chamber's lawsuit settlement agreement a rent subsubsidy program and we'll talk a little bit more about that as well. and residential care for folks not quite ready to live in a residential setting. board and care both for adults and for elderly and the city has agreements with various programs throughout the city and some folks from laguna have stepped to board and care as they skill build they will actually be able to step down again to a lower level of care so we continue to monitor them once they leave. so the program was established as part of a response to the chamber's lawsuit and in order to access

it you must be a resident of laguna honda and there's a maximum subsubsidy that the city can provide up to a thousand dollars a month. ria will talk a little bit more about the buildings currently in use. >> the increasing rents in the city of san francisco which everyone is encountering you know when this program started rolling it was viable to get a pretty good apartment for the average ballpark of 15 hundred a month 13 hundred to 15 hundred a month and now days that's hard to to find and housing is getting more challenging faced with that so that will be the challenge of

making sure that program stays viable what may end up happening is because the cost of each unit will go up over time is that the number of units that we'll be able to provide will get tighter. the amount of money that we have available to subsidize is not going to get any larger just because of the budget constraints that the county faces. so i'm going to turn it over to ria who talk a little bit more about the program. >> good afternoon everyone. the diversion community integration program originated as part of the settlement agreement however we really made it our own started in 2008 and assisted individuals who were referred to or diss

charged from laguna honda. we have pulled together resources and skills experts in the community to discuss how we can implement the program and to give the individuals who were living at laguna honda the best access to community services besides the housing it's more than housing it's also access to community based services or wrap around services and who are in the program? like kelly mentioned, part of the chamber's settlement but there's also individuals who are wait listed and also those clients exception to that are clients who were admitted to short-term rehab however short-term based rehab means

30-days. the numbers: since january 1, 08 to june 20, 2013 the total enrollments are 2598 members currently it's 1463. as of that same period there were 270 members housed in either scattered type housing independent type housing and again, when we discuss these clients we also discuss under comprehensive community based

services or direct access to housing and under the laguna honda rent subsubsidy program. currently 98 members housed through scattered type housing in the fox plaza and really in housing especially when the rent wasn't so high, members and the folks who were really involved in housing thought what would be good housing and clients are expressing preferences too and would be a good fit for them and 27 units are fully accessible are rolling showers so when clients are being presented to our meeting we identify what are their needs we discuss how we

can accommodate that in the community prior to discharge and there's also home safety evaluation conducted by laguna honda to make sure all the medical equipment and modification are going to meet the needs of the client. >> and laguna honda rental subsubsidy program covers rent unit modification and repairs. kelly also mentioned that part of the settlement is the quality assurance and happens to be the director and one of the many quality assurance we conduct are home visits and also we look at information and feedback of members who already left laguna honda after 6 months of living in the community it's a mail in survey satisfaction survey and we

admin dmin ister that every -- [inaudible] months. i have the medical services i need. it's a scale where they can indicate i strongly agree, agree disagree and not applicable and the question that i have the mental health services i need and part of the 14 questions. and the most recent survey that we conducted done early this year we have a 21 percent return response rate and actually for mail in survey, the threshold is 10 percent and we always exceed the 10 percent, 20 or 30 percent at one point and there's one important question and we ask if they are satisfied with the

overall quality of these services and of the 21 percent responders they said they are one hundred percent satisfied with the quality of services and when i mentioned this, again, it's the collaboration of the department of aging adult services and department of health and many community based organizations such as public authority peer mentors and also community meeting fund. thank you. >> at this point you are welcome to ask us questions. >> councilmember zarda? >> i'm sorry did you bring some handouts? i don't know if you had some available for us to review? >> yes, we did.

>> thank you so much. >> okay. thank you. >> are there any other questions or comments from councilmembers? >> oh roland okay. >> as part of the discharge process of laguna honda residents, they are going to have a discharge fare, basically, december fifth between 1 p.m. to 3 and basically it's to provide information for residents and staff, resources are available

in the community. the social service department had invited independent living resource center of san francisco, they put a booth together or table to share some of our service you know the programs that independent living center offers so it's a great way to let the residents know that there are services available for them to engage in the community. >> i agree. i had them participating that discharge fare and i had my third one and this december is going to be my 4th one i believe and you are right laguna honda staff are really engaging their residents they call them residents, to

attend this type of fare and they are creative they are doing some drawings now to get them to attend and participate and in the booth get information and from what i'm understanding we're expanding and it's always been well received because i stay there from beginning to end and there's an instead n steady stream of people asking for information. >> can you say that date again? >> december fifth, thursday at the center at the main level, the new building. >> any other councilmember questions or comments? >> i'd like to make one -- first thank you both for your presentation. i just have a

question -- are you still using mentors with people say they intern enter the community out of an institutional setting? it matched people with mentors who already lived in the community to help them adjust and adapt to living outside an institution. >> yes, we actually use peer mentors and we also can have access to the department of public health peer mentor program for mental health advocates as well so depending on somebody's presentation and need we actually match up. >> how do people get involved in that peer mentoring. >> the social worker can make the request and the match is made and that peer usually

follows you all the way from the beginning to the end and there's adjustments made if the fit isn't exactly right. they can apply to the public authority and if they are interested they can call ria and call us at the department of health. it would be great if we can get more peer mentors we like to have a broad array of folks to have good matches. thank you for that. >> staff. yes, car la? >> thank you for the chair. thank you so much for your presentation today you might have covered these points but i didn't quite grasp them how many people from laguna honda have left laguna honda since the agreement began and were you able to meet the settlement agreement number and see what is the plan moving forward now that the agreement time has

concluded? will thereby there be the same level of commitment to this program as there was previously? >> to answer your question 2598 and currently enrolled in laguna honda because we start there and as of june 1463. >> it might be that you use the term enroll. >> it meant they met the criteria and if it's rehab it's not short-term. >> uh-huh, okay. >> in terms of of the commitment to the scattered site i think you are asking specifically. we did not have a demand for the 500 units that were originally proposed. every person that requested a

scattered site unit was granted one. rather than say we're going to have a threshold number to meet we're really doing it based on need and appropriateness so there's a commitment from the city that we'll continue to provide the program. >> so 500 units. >> i think it was 270 that ended up actually being issued so far. >> any questions? >> that answered my question. thank you. >> john paul did you have a comment? >> one of the thing that kind of concerns me i heard programs for mental health and substance abuse how is the community reintegration population and the population coming out of laguna honda that will be

discharged from the program how will that relate to the affordable care act especially since we have a january 1 deadline for applying? >> most of the people vast majority are medical eligible so most enrolled in medical so they will be able to select the h.m.o. that they will participate in and they get the same notification that anyone living in the community gets to decide which way they want to go. so that's accessible regardless of whether you have medical or not. so it's a service as needed. >> is there some support because everything we hear in the press it's still very challenging to apply for these services online but certainly there's other programs by the

state but is it helping people bridge this? >> laguna honda has an eligibility unit so currently there's an eligibility unit that can actually help make sure somebody gets access to their entitlements while they are there. within the city as a whole the department has certified eligibility workers that have been designated to assist in doing applications for folks so the people that aren't connected can be hooked up with an enrollment person. >> thank you. >> councilmember zarda? >> thank you and thank you for your presentation it's very very important to the community. just to follow up

on something you had mentioned rising rents that we're all experiencing in san francisco the ability to provide someone housing most likely will be decreasing in reference to how that relates to the 500 units originally demanded in that lawsuit how do you feel the number leftover will be impacted by the rising rents. >> i think it's going to be a matter of the pace of the demand for the scattered cite and it's possible that if the demand is not suddenly going to spike that we will probably be able to accommodate despite the fact that the rents are increasing. the a arra y of selection is going to shrink as

time passes that will get more challenging. i think it's early to say whether or not we're going to have to scale back but right now we've been able to accommodate to the demand so it will definitely be something we'll keep an eye on over the year or two. so >> thank you very much. that would be great to have a follow up report to this in the coming year just because of the rent crisis i would say so thank you. >> yes. >> councilmember wong? >> about the increased rents and all this i know most of this

program is more focussed on the san francisco county. with the county consider maybe going out of the county? i know it's probably difficult but rents in san mateo, east bay may be lower but i know it's very difficult to transition a resident of san francisco over there but maybe have to explore the possibility so that people can be discharged or at least be able to live in the community. >> it's a very good point and i don't think we would not entertain that as a possibility , no resident exiting laguna has requested to leave the county the majority are the reverse they would much prefer

to stay. >> all right. we'll move onto public comment on this item. mr. shaw? >> thank you as you may know i used to work at laguna honda hospital secretary for a decade and when the justice department proposed this program i opposed it and i attended many long-term care counsel meetings excessing my frustrations with it they were ordered to cut 420 beds from laguna honda and now we're hearing that there's only 98 placements what happened to the patients and they can't get

skilled nursing care anywhere between eureka and bakersfield because there's no skilled nursing for long-term care. when i was the secret secret ary at laguna honda wrote a proposal when we wrote that proposal, short-term rehab was defined as ninety days. why was it cut to 30? could that explain why my friend was stuck in that for months? needing too much rehab because his rehab care went over 30-days? and he could have maybe been rehabbed to ninety and stayed in town and not be dumped out

of county to antioc h. if thereof there have only been so many people taking advantage of this program in a 5 year period that means it's had a miserable rate of success. to these voucher programs? i have repeat ly tried to get daas the long-term care coordinating counsel to admit where are they being diverted to? is it to board and care in town board and care out of town? i strenuous ly object to roland, wong's creative suggestion to

save rent money by dumping people out of county when you do that you diss enfranchise san franciscans from their native city why aren't you asking how many people have been dumped out of county? they won't give me the data, will they give it to you? i need to go to supervisor campos and have him hold another hearing to find out what's happening to the seniors that can't get into laguna honda. don't you care whether we're being dumped out of county? >> thank you mr. shaw any other public comment on this item. okay public comment items not on today's agenda we will limit

you to one minute. strict limit. >> this is not on the previous agenda. this is on what i believe should be on one of your future agendas that you absolutely request that decip provide you with summary level data on discharge locations and begin reporting on the number of out of county discharges. i have begged the about the period department of public health to start making laguna honda staff in the program report the discharge locations. is it board and care? is it to the street? is it out of county? this body needs to take an interest in it and

quickly. >> thank you sir. >> item number 14 correspondence. there is no correspondence. >> item number 15. announcements. any announcements? councilmember kostanian. >> i would like to answer. possibly in january i'd like to have a meeting on the census for hospital dial ysis patients. >> absolutely i'm fully aware of the staff who operate the renal center at sfgh are extremely concerned about this and should this counsel hold a

hearing i'd venture to guess probably the same group of passionate dedicated citizens who showed up at david cam pos's hearing would show up here also hoping to change the world for dial ysis patients so they don't have to start transporting to oakland to get dial ysis you need to focus on this issue you need to ask lhh why they never got around when somebody in the assembly got state law changed to permit having dial ysis centers in skilled nursing facility. >> we are out of time i'm sorry. >> this meeting is adjourned. t

>> good afternoon and welcome to the november 13, 2013, meeting of the board of appeals. the president is chris wong and joined by the vice president. and commissioners. to my left it deputy city attorney robert brian heel provide the board that legal advice and the boards legal assistant. we're joined by representatives of the boards administrator and also representing the planning department and planning commission