2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998
Willie L. Brown, Jr.
Mayor
Susan Mizner
Acting Director
Ed Evans
Chair
Vincent Behan
Norma Block
Jack Fagan
Eugene T. Flannery
Elizabeth Grigsby
Michael Kwok
August Longo
Ruth Nunez
Jul Lynn Parsons
Denise Senhaux
Mayor's Disability Council
Minutes
24 October 2003
1 ROLL CALL
Mayor's Disability Council Members Present: Norma Block, Ed Evans, Jack Fagan, Eugene T. Flannery, Michael Kwok, Jul Lynn Parsons.
Excused Absent: Vincent Behan, Elizabeth Grigsby, August Longo, Denise Senhaux
Absent: Ruth Nunez
Mayor's Office on Disability: Susan Mizner, Acting Director; Richard Skaff, Deputy Director; Ken Stein, Program Administrator, Josie J. Lee, Council Clerk and Howard O. Wong, Council Clerk.
Ed Evans, Chair, called the meeting to order at 1:12 p.m.
2 APPROVAL OF THE AGENDA
The Council approved the agenda for the October 24, 2003 Mayor's Disability Council (MDC).
3 APPROVAL OF THE MINUTES
Ed Evans, Chair, inquired if there were any additions or corrections to the minutes. Josie J. Lee, Council Clerk, responded that there are some corrections from the last minutes from Mr. Jack Fagan, Council Member. The following corrections were made: Jack Fagan's correct title is Associate Executive Director (it is not "Associate Acting Director"), Mr. Fagan's correct agency name is T-H-E A-R-C and Mr. Fagan is also the President, Board of Directors of AASCEND ("AASCEND" stands for Autism Asperger's Syndrome Coalition for Education and Networking and Development).
After the above corrections were noted, the Council approved the minutes from the MDC meeting of September 19, 2003.
4 PUBLIC COMMENT
* Bob Planthold, Co-Chair, Senior Action Network, Pedestrian Safety Committee, informed Council Members that his group took action today (Friday, October 24th) to oppose the passage of the motorcycle resolution (introduced to the Board of Supervisors on September 30, 2003) because of its threat to deprioritize sidewalk ticketing of motorcycles and its failure to recognize the parking needs of the disability community. It was defeated on the same date that it was introduced, so a follow-up resolution (# 031651) was introduced. However, this new resolution also has problems. Mr. Planthold made several attempts to contact the Board of Supervisors and their staff via e-mails with no responses. Mr. Planthold understood that the Council cannot take action today, but would like them to monitor the agenda for City Services Committee because it seems like this "ill-fated resolution won't die."
* Jean Lynch, Senior Action Network, Pedestrian Safety Task Force and Paratransit Coordinating Council, concurred with Mr. Planthold's statements.
* Bruce Oka, Chair, Paratransit Coordinating Council, wanted to follow-up on the motorcycle parking resolution as well. He concurred with Mr. Planthold's statements. The block in his neighborhood has 2-3 motorcycles currently parking in sidewalks. He has to dodge in between them. He sees this as a safety issue affecting the elderly, disabled and children as well. He strongly opposes any resolution that allows parking of motorcycles, scooters and other motorized vehicles on the sidewalk. The Pedestrian Safety Task Force is having a meeting to discuss this on Monday, October 27th at 5:30PM in Room 408, City Hall.
* Linda Chapman, SPUR, Homeless Task Force spoke on the problems of separate shelters for seniors and people with disabilities. She also felt that existing shelters need to be more accessible.
* A gentleman spoke via the "bridge line" about his concerns about the Ramp Taxi program. He stated that a number of Ramp Taxi medallions are going to companies that haven't sufficiently served the disabled community. Mr. Oka's group (Ramp Taxi Group, a sub-group of the Paratransit Coordinating Council) is aware of the problem, and believes that users of the ramp taxis should be involved the decision-making process. The next Ramp Taxi meeting is scheduled for Tuesday, November 4, 2003 from 11:00AM-1:00PM at the Paratransit Broker's Office located on 1449 Webster Street.
5 REPORT FROM THE CHAIR
Ed Evans reported that he is requesting the Chief of Police to ask his captains to go beyond citing motorcycles on sidewalks. They should also enforce no skateboards, no bicycles, etc. He also requested that the Department of Public Works help ensure sidewalks are maintained by giving citations.
6 REPORT FROM THE ACTING DIRECTOR
Susan Mizner gave an abbreviated report due to time constraints: She introduced Howard O. Wong, Council Clerk as a new MOD staff member, she welcomed feedback in the new format of mailings - a money conserving effort, and she thanked council members Norma Block and Eugene Flannery who assisted in organizing the agenda and speakers for today.
.
7 COMMITTEE REPORTS
REPORT FROM THE PROGRAMMATIC ACCESS COMMITTEE (PAC)
Ken Stein reported that at the October 3rd meeting, Harry Mar, Chair of the Programmatic Access Committee, stepped down as Chair, but will continue on the Committee. Mr. Mar has served wonderfully for the past several years and was thanked for his work as a Chair. Mr. Stein introduced Council Member, Jul Lynn Parsons, as the new Chair.
Ms. Parsons reported that the next PAC meeting is scheduled for Friday, November 7th from 11:00AM-12:30PM at the Rose Resnick Lighthouse for the Blind. The committee will be focusing on the definition of disability in relation to SF Municipal Code Section 12D, the "Minority/ Women/Local Business Utilization Ordinance," in order to amend the ordinance to include persons with disabilities.
REPORT FROM THE EXECUTIVE COMMITTEE
Ed Evans reported that the meeting scheduled for Tuesday, October 28th has been cancelled. The next meeting will be on Tuesday, November 4, 2003 from 1:30PM-3:30PM in Room 421 at City Hall.
REPORT FROM THE PHYSICAL ACCESS COMMITTEE
Ed Evans reported that the next meeting will be held in the War Memorial Building, 401 Van Ness Avenue, Room 459 on Friday, October 31, 2003 from 2:00PM-3:30PM.
8 COUNTY CLERK'S OFFICE AND PROGRAM ACCESSIBILITY.
Presentation by Nancy Alfaro, Director, County Clerk's Office
Ms. Alfaro presented an overview of the services that the County Clerk Office provides, including issuing marriage licenses, domestic partner registration and performing civil ceremonies. This office is very busy and sees 150-250 customers a day, a number of whom have disabilities. The office is very accessible with a lowered counter area at the information desk, signs with larger font, etc. In addition, she has a good staff that is trained to assist people with disabilities. Staff is on hand to readily assist in making sure the customer understands the forms and can assist in filling forms out as well. There are some services available on-line, but most services require the person to come to the office for the purpose of verifying identification.
Council members commended the County Clerk's Office for their professionalism and high degree of accessibility to the disability community.
9 INFORMATION AND PUBLIC HEARING ON HOUSING ISSUES FOR PEOPLE WITH DISABILITIES.
Presentation by Molly Stafford, AIDS Legal Referral Panel (ALRP).
Molly Stafford announced a public hearing scheduled for Thursday, October 30, 2003 at 10:00AM at City Hall in Room 263. There will be testimony from people living with disabilities, advocates, service providers and housing providers. If you have any further questions and/or would like to testify, contact Bill Hirsh, ALRP, at (415)701-1200 x308.
Some of the issues they will be addressing will be the high housing costs for people with disabilities, lack of sufficient physically accessible housing and discrimination (landlords asking illegal questions, etc).
10 INFORMATION AND DISCUSSION: SAN FRANCISO'S BEHAVIORAL HEALTH COURT, AN INNOVATIVE APPROACH FOR PEOPLE WITH MENTAL DISABILILTIES IN THE CRIMINAL JUSTICE SYSTEM.
Eugene Flannery, Council Member, introduced the topic. A shortage of community services has resulted in the incarceration of people with psychiatric disabilities. Approximately 400,000 people in the United States are incarcerated. A large percentage have serious mental illness. The 2002 Progress report indicated that jails and prisons are becoming "de facto" mental hospitals. Jail settings are essentially punitive instead of a therapeutic; prison staff aren't trained in the mental health field; the cost of the criminal justice system is much higher than the cost of treatment.
Alex Georgakopoulos started his presentation with additional background information on the rise of the mentally ill in the jail system:
* In 1971, the Lanterman Petris Short Act was intended to reduce the load of mental health patients in hospitals and provide them community services instead. Due to the emptying of in-patient facilities without providing for community-based care, many of the patients ended up on the streets without the sufficient services to live stable lives.
* Many living on the streets end up in the jail system.
* A number of the jail clients are considered untreatable by the community. They have a host of other problems, in addition to their mental disabilities, ranging from substance abuse to treatment non-compliance.
* Jail is a dehumanizing and decompensating experience. Clients would benefit more from increased hospitalization and increased outpatient services.
In the last half of his presentation, Mr. Georgakopoulos spoke about the importance of the behavioral health court and provided an overview of the jail psychiatric and jail aftercare services:
* The jail psychiatric/aftercare office serves as the diagnostic gatekeeper for the court.
* There are 94 psychiatric beds - ten for women only. Unfortunately, the female population of mental health clients is growing dramatically. Also, there are10
observation rooms for two clients each in their facility. They also have access to San Francisco General Hospital with 120 additional beds, but that is for the general population.
* Clients receive psychiatric care from 8:00AM-10:00PM - 365 days a year.
* The main goal with clients coming into the county jail system is to maintain the continuity of care coming from community.
* They provide basic discharge planning services for clients who choose not to enter treatment, including getting them into shelters.
* Behavioral health court is therapeutic - the judge addresses clients regarding treatment plans, life issues, successes, failures, etc. It is a respectful and warm exchange.
* 70 clients have participated in the program and 11 have graduated.
* There are a lack of services for persons with developmental disabilities and head injuries (Traumatic Brain Injuries - TBI).
The Honorable Ksenia Tsenin could not attend and sent her apologies via Cynthia Johns, Deputy District Attorney in person. Jennifer Johnson, Deputy Public Defender, took her place in the presentation on the Behavioral Health Court:
* The mission of the Behavioral Health Court is to connect criminal defendants suffering from serious mental illness to treatment services in the community; to find creative and appropriate dispositions to their criminal charges, that take the mental illness into consideration, and decrease their chance of returning to the criminal justice system.
* One of Ms. Johnson's goals is to avoid having clients who don't belong in the system end up in state prison. She estimated that 25% to 30% of her clients are mentally ill from an informal survey in her office.
* Unfortunately, she is the only public defender in the behavioral health court and she currently has 60 clients.
* This entire court has been done with no money. It would benefit from funding, but will need responses/data information to monitor cases which they lack the staff and time to provide.
Council members provided additional networking resources/services such as The ARC, Golden Gate Regional Center, Association for Chinese Family of Disabled (ACFD), Protection and Advocacy, Inc.
PUBLIC COMMENT:
Delphine Brody, HART Committee Member, expressed some confusion on how the Behavioral Health Court operates - whether the client's choice is actually voluntary, when the choice is jail time or accepting whatever treatment is ordered by the judge. Presenters explained that people don't waive their right to a trial, nor do they choose between remaining in jail or participating in this program. The criminal proceeding is still going on. The court asks the client if they want to make a real effort through Behavioral Health Court, and to waive their right to a speedy trial or resolution of their issue. They can change their mind anytime and they have a choice to participate in the treatment program and Behavioral Health Court or not.
The Behavioral Health Court is held every Thursdays at 2:00PM on the 3rd floor (Department 22) of 850 Bryant Street. The public is welcomed to observe.
11 INFORMATION AND DISCUSSION: WHETHER SAN FRANCISCO SHOULD IMPLEMENT AB 1421, A MEASURE THAT PROVIDES FOR INVOLUNTARY PSYCHIATRIC TREATMENT AND ASSISTED OUTPATIENT TREATMENT
Testimony from experts and community members supporting and opposing implementation, including representatives from the California Network of Mental Health Clients, NAMI San Francisco and the Mental Health Board.
Norma Block, Council Member provided introductory remarks regarding AB1421.
AB 1421 permits counties to mandate outpatient treatment for people whose illness has caused multiple hospitalizations or incarcerations, and who have not been successfully linked with mental health services. It was also known as "Laura's Law" and was signed into law in September 2002 and became law in January of 2003. The law allows counties to provide court-ordered outpatient treatment if the patient is likely to become dangerous or gravely disabled without it. To establish local assisted outpatient treatment, the Board of Supervisors must pass a resolution saying that no reduction in existing services will occur.
Points in favor:
* Provides treatment for persons who would otherwise not get treatment.
* May prevent costly re-hospitalization.
* May lead to increase in medication compliance, and a decrease in homelessness and less demand for police services.
* May result in cost savings per patient.
Points Opposed:
* Removes individual choice and control of treatment program.
* Voluntary treatment services haven't been adequately developed or utilized.
* It is not clear that involuntary treatment is effective.
* Possible increased court and hearing-related costs.
Sally Zinman (Executive Director, California Network of Mental Health Clients) quoted a statement from the National Council on Disability that "laws that allow the use of involuntary treatments should be viewed as inherently suspect because they are incompatible with the principle of self-determination." AB1421 extends forced treatment from institutions into people's homes and into the community.
There is a huge gap in community-based services that should first be addressed.
Coercion should not be a substitute for services that are not readily accessible. Available and appropriate services would decrease the need for forced treatment. AB1421 moves away from recovery because other people are making decisions for you and is antithetical to the concept of recovery. The measure also pits family members against clients. Everyone agrees that people need more voluntary services. Choice and self-determination are important. Forced treatment has a chilling effect on people's willingness to continue treatment after the forced treatment period is over. Good treatment can only exist in an environment of choice and freedom.
The presumed need for AB1421 is based on myths and stereotypes of the violent mental patient and the myth that medications are a panacea. Medications aren't always reliable and often have serious side effects. The Lanterman Petris Short Act, which mandates forced treatment, is in effect in California, but it is not consistently understood or sufficiently utilized. There are AB 34 programs, which offer a complete array of self-help programs including medication, housing, social support, self-help centers, employment etc. These programs have been very successful, but are under-funded.
A comparable law in New York has had a disproportionate impact on Black men, and homeless people. The law itself is very vaguely written. The emphasis needs to be on choice and self-determination, rather than outpatient commitment.
Kate Walker (Mental Health Board), spoke in opposition to AB1421. If treatments aren't working, maybe they are the wrong treatments. There needs to be an emphasis on providing basic needs for the greatest number of people. The number of people who would end up in prison or in institutions are insignificant compared to the much greater number of people who lack the basics. The Mental Health Board is having a meeting on Wednesday, November 12, 2003 at 6:30PM at 1380 Howard Street in the 5th floor Conference Room, to consider this measure.
Delphine Brody, Healthy Access to Real Treatment (HART) Committee member, spoke in opposition to AB1421. The vague language broadening police-enforced involuntary treatment will result in a violation of people's civil rights. A wide variety of people (including family members, house mates, landlords, case managers and others, can petition courts and force people into forced treatment for long periods of time. This law would violate the Olmstead Act and have a disparate impact on homeless people and people of color. There would be huge costs associated with implementation. People with mental illness are capable of self determination for their own treatment or self care.
Bridget Brown (HART Committee Member), a mental health consumer, said that this is about choice. Even though the family members of people with psychiatric disabilities are affected by the family member's disability, we need to give greater consideration to the self- determination of the individual.
Linda Chapman said that the choice of relatives of the patients needs to be considered. There are services that people who are mentally ill aren't taking advantage of. It is not a civil rights issue because people with psychiatric disabilities aren't necessarily able to make the best choices for themselves, to take advantage of services available in the community.
Dale Milfay (a member of NAMI San Francisco) and Georgina Trujillo both spoke in favor of AB 1421 because both have a family member who is mentally ill and who they felt would benefit from this measure. Both spoke in great detail about how difficult it was for their loved one and themselves to go through their illness without involuntary treatments. They also believe in free choice. However, they felt that in their personal situation, their loved one was either in denial, unwilling, and/or unable to make choices for themselves. AB1421 would have been of benefit to their disabled family members.
Eugene Flannery, Council Member, shared from his own personal experience as a consumer of the mental health system. He said it was very difficult for him when he was ill because he couldn't trust his own judgment. It took him several attempts to obtain treatment voluntarily, but when he got it, it was very helpful. However, he sees many of his peers on the streets who are incapable of seeking and getting through treatment on their own initiative. He sees both sides of the issue.
12 CORRESPONDENCE
Ed Evans, Chair, received a document and letter from an attorney. It contends that the Department of Parking and Traffic hasn't adequately addressed the concerns of the disability community. This will be discussed further in the Physical Access Committee and then presented it to the Council.
13 PUBLIC COMMENT
No public comment.
14 COUNCIL MEMBER REQUESTS FOR FUTURE AGENDA ITEMS
No requests for future agenda items at this time.
15 COUNCIL MEMBER COMMENTS AND ANNOUNCEMENTS
No comments and announcements.
16 ADJOURNMENT
The meeting was adjourned at 4:30 p.m.
401 Van Ness, Room 300
San Francisco, CA 94102
415.554.6789
415.554.6159 fax
415.554.6799 TTY
[email protected]