San Francisco County 2015-2016 - California Grand Jury Reports

From the annual report

The consolidated year-end volume. The individual investigations it contains are listed separately below.

📑 Year-End Report

The full consolidated volume; individual reports are listed below.

Individual reports (10)

December 07, 2016 — San Francisco County Jails: Responses to Cgj Findings Respondent assigned by Cgj Year Report Title # Findings Cgj 2016

16 pages 40 recommendations

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Additional Recommendations 40

Not linked to specific findings.

R1: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R2: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R3: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R4: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R5: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R6: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R7: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R8: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R9: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R10: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R11: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R12: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R13: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R14: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R15: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R16: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R17: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R18: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R19: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R20: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R21: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R22: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R23: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R24: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R25: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R26: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R27: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R28: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R29: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R30: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R31: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R32: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R33: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R34: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R35: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R36: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R37: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R38: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

R39: Provide a "warm handoff" to a Case Manager in the community who will receive them. Eligible individuals are clients of the collaborative courts, including Attention arrange for a full continuum of care. (Note that this requires identification Behavioral Health Court, Veterans' Court and Drug Court, as well as the Assertive of receiving hands ready to accept the Case Management program. In addition, Peer Specialists funded by the MIOGR patient). (Mentally III Offender Grant) accompany misdemeanant clients of Behavioral Have case manager or designee accompany the patient to at least the

R40: Provide a "warm handoff" to a Case Manager in the community who will Director of Jail placed in treatment and transportation provided by SFSD, those released to Behavioral Attention arrange for a full continuum of care. (Note that this requires identification community residential treatment programs are accompanied by a case manager. Services & Jail of receiving hands ready to accept the Patients who are found incompetent to stand trial on misdemeanor charges are patient). Reentry Services provided a "warm handoff" to all designated community programs. Additionally, Have case manager or designee accompany the patient to at least the

June 28, 2016 — San Francisco Homeless Health & Housing a Crisis Unfolding on Our Streets June 2016 Photo: Eric Risberg/Associated

47 pages 6 findings 6 recommendations

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Findings & Recommendations 6 findings

F1: Homeless Outreach Team (HOT) should serve as first responder to non-violent incidents involving the homeless. A coordinated intake system is necessary - We heard from many sources of the need for a coordinated intake system. We believe that an integrated, standardized system containing health, housing and police information on the homeless should be available to all service providers to assist them in providing needed homeless services. Although the Health Insurance Portability and Accountability Act of 1996 (HIPAA) restricts the sharing of some health data, this restriction can be waived with permission from the client. A rich set of data available to all providers identifying and coordinating services is needed. Meaningful outcome data should be developed and monitored - Tracking outcome results at the individual level is key to determining program success. However, this appears not to be a priority among homeless service organizations except in federal grants from the US Department of Housing and Urban Development (HUD). We also found that the monitoring of this data by the Controller's department helped the Navigation Center continually improve by measuring client success and failure. Supportive housing and a shared distribution system are needed - We believe that supportive housing with ease of access is needed to move the homeless from the street to a more humane living situation. We found that there is a need for a single housing application system where case managers and housing providers can be properly matched. This would be a common shared distribution system for low income and supportive housing. Realizing that there is insufficient very low income housing available and that San Francisco Homeless Health and Housing tents on city sidewalks are both illegal and a health hazard, we recommend an intensive effort to put very low income housing in place.

Related Recommendations (1)

R1: Homeless Outreach Team (HOT) should serve as first responder to non-violent incidents involving the homeless. A coordinated intake system is necessary - We heard from many sources of the need for a coordinated intake system. We believe that an integrated, standardized system containing health, housing and police information on the homeless should be available to all service providers to assist them in providing needed homeless services. Although the Health Insurance Portability and Accountability Act of 1996 (HIPAA) restricts the sharing of some health data, this restriction can be waived with permission from the client. A rich set of data available to all providers identifying and coordinating services is needed. Meaningful outcome data should be developed and monitored - Tracking outcome results at the individual level is key to determining program success. However, this appears not to be a priority among homeless service organizations except in federal grants from the US Department of Housing and Urban Development (HUD). We also found that the monitoring of this data by the Controller's department helped the Navigation Center continually improve by measuring client success and failure. Supportive housing and a shared distribution system are needed - We believe that supportive housing with ease of access is needed to move the homeless from the street to a more humane living situation. We found that there is a need for a single housing application system where case managers and housing providers can be properly matched. This would be a common shared distribution system for low income and supportive housing. Realizing that there is insufficient very low income housing available and that San Francisco Homeless Health and Housing tents on city sidewalks are both illegal and a health hazard, we recommend an intensive effort to put very low income housing in place.

F2: A helpful website is needed - We found no comprehensive, helpful source for reaching the City's homeless services. We hope that with a greater understanding of how we arrived at the homeless situation we find ourselves in today, we can support a view that we need to help and not blame. A strong commitment to strengthening existing programs will enable the City to provide housing and/or housing with services for the citizens who are unable to provide for themselves. San Francisco Homeless Health and Housing OBJECTIVES The overall objective of this investigation is to evaluate the efficiency and effectiveness of the City's program to eliminate homelessness by examining the inter-agency management provided by the City and examining whether the goals could be better coordinated to result in more beneficial outcomes. These agencies include:

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R2: A helpful website is needed - We found no comprehensive, helpful source for reaching the City's homeless services. We hope that with a greater understanding of how we arrived at the homeless situation we find ourselves in today, we can support a view that we need to help and not blame. A strong commitment to strengthening existing programs will enable the City to provide housing and/or housing with services for the citizens who are unable to provide for themselves. San Francisco Homeless Health and Housing OBJECTIVES The overall objective of this investigation is to evaluate the efficiency and effectiveness of the City's program to eliminate homelessness by examining the inter-agency management provided by the City and examining whether the goals could be better coordinated to result in more beneficial outcomes. These agencies include:

F3: SF Health Services Authority (SF-HSA)

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R3: SF Health Services Authority (SF-HSA)

F4: SF Department of Public Health (SF-DPH)

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R4: SF Department of Public Health (SF-DPH)

F5: US Housing and Urban Development (US-HUD)

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R5: US Housing and Urban Development (US-HUD)

F6: The Mayor's Office of Housing, Opportunity, Partnership and Engagement (HOPE) First Responders We sought to understand which city services are the first to respond to calls about homeless issues and whether the response could be improved. Data Collection and Data Sharing Knowing that multiple agencies, using their own databases, serve the homeless, we sought to understand whether there were negative issues arising from lack of database coordination. Outcome Requirements and Monitoring Realizing that funding is distributed to nonprofit agencies by SF-HSA, SF-DPH and US-HUD, we wanted to understand contract requirements and contract monitoring across the funding agencies to see if there was consistency and if outcomes were effectively monitored. Housing Learning that "Housing First" is a City concept with an objective matching its name, we wanted to know if there were issues in availability of housing and how that affected the programs that are designed to transition clients into supportive housing. SF311.org Knowing that computer use is an excellent way to get information and help, we wanted to know if connecting to homeless services on our SF311.org website was an easy task. San Francisco Homeless Health and Housing SCOPE AND METHODOLOGY We interviewed previously homeless residents, as well as those who provide services to them, to understand why, with all the resources aimed at "solving" "homelessness" in San Francisco, little progress has been made at reducing this population. We examined the outcome measures of several homeless service programs funded or controlled by the City and compared them to the federal requirements for outcome monitoring. When we started this investigation in September 2015, we were impressed with the number of separate City departments providing services to the homeless. As visits and interviews continued, we searched for common practices, information portals and shared tools. We also looked for indications of resource shortages. We wondered if the various City agencies serving the homeless had a good understanding into their client's' situation and predicament. We also asked who was in charge. We apparently were not alone in our questioning; during our investigation our Mayor announced the formation of a new department: the Department of Homelessness and Supportive Housing (DHSH). We interviewed managers working for the Human Service Agency (HSA) and Department of Public Health (DPH). We attended meetings of the Local Homeless Coordinating Board (LHCB) as well as meetings of the San Francisco Interagency Committee on Homelessness (SFICH). We visited the new shelter called The Navigation Center at 1950 Mission, as well as the Behavioral Health Access Center (BHAC) at 1380 Howard and the HSA County Adult Assistance Program (CAAP) building at 9th and Mission. We met with "311" staff and performed our own web searches. San Francisco Homeless Health and Housing

Related Recommendations (1)

R6: The Mayor's Office of Housing, Opportunity, Partnership and Engagement (HOPE) First Responders We sought to understand which city services are the first to respond to calls about homeless issues and whether the response could be improved. Data Collection and Data Sharing Knowing that multiple agencies, using their own databases, serve the homeless, we sought to understand whether there were negative issues arising from lack of database coordination. Outcome Requirements and Monitoring Realizing that funding is distributed to nonprofit agencies by SF-HSA, SF-DPH and US-HUD, we wanted to understand contract requirements and contract monitoring across the funding agencies to see if there was consistency and if outcomes were effectively monitored. Housing Learning that "Housing First" is a City concept with an objective matching its name, we wanted to know if there were issues in availability of housing and how that affected the programs that are designed to transition clients into supportive housing. SF311.org Knowing that computer use is an excellent way to get information and help, we wanted to know if connecting to homeless services on our SF311.org website was an easy task. San Francisco Homeless Health and Housing SCOPE AND

June 02, 2016 — Auto Burglary in San Francisco

63 pages 11 findings 13 recommendations

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Findings & Recommendations 11 findings

F1: Recognize tourists as a valued and welcome guest to our criminal prosecution that seeks all available city. sentencing enhancements.

Related Recommendations (1)

R1: Allow clear sight lines: vehicles should be visible as the driver returns.

F2: Acknowledge vulnerabilities unique to visitors/tourists.

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R2: Provide adequate lighting: Install lighting in areas where vehicles are parked.

F3: Denounce the targeting and victimizing of visitors/ tourists. F.F.5. Finding

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R3: Minimize concealed and isolated routes: Parking areas should be open and accessible.

F4: Recognize the need for specialized services for visitors/tourist who have been victimized by crime. Government must provide essential services to

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R4: Avoid entrapment: Roadways and pathways are through-ways not dead-ends.

F5: Establish the program as a partnership between visitor/tourist crime victims to support their immediate government and the visitor and tourism industry. needs. A temporary replacement identification card

Related Recommendations (1)

R5: Reduce isolation: Parking areas should be near activity areas.

F6: Designate and funds a public safety department to act as supports the victim’s efforts to access banking services, revise flight plans, pass through coordinating agency. transportation security at the airport, or continue their 7. Authorizethe agency to develop industry partnerships. holiday in San Francisco. 8. Authorize the agency to issue a temporary replacement F.F.6 Finding identification card, for visitors and tourists who have had Government, industry and not-for-profit partnerships their identification stolen. can work together to meet needs following 9. Instruct the police, sheriff and district attorney to pursue victimization. vigorous criminal prosecution.

Related Recommendations (1)

R6: Promote land use mix: Mixed usage promotes activity and reduces isolation.

F9: Provide signs and information: Inform of risks and direct toward activities.

Related Recommendations (1)

R9: Provide signs and information: Inform of risks and direct toward activities.

F10: Advise the district attorney to seek sentencing enhancement when it is appropriate.

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R10: Consider overall design, form, and function as part of the planning approval process. Homeowners, developers, and government entities can implement these strategies in new projects as well as the maintenance and management of existing properties. Programs as Deterrents: The San Francisco Community Ambassadors Program is designed to be a non-law enforcement, public safety program. Its members work in teams, wearing bright yellow and black jackets with “San Francisco Community Ambassador” and the city logo printed on the back of the garment. Teams patrol their designated neighborhoods, along major transit/merchant corridors in high crime areas, assisting and interacting with residents as they create a safe presence and resource for the community. Members are city employees who receive extensive training and have resources to call for help and provide assistance. Ambassadors serve the community in many ways: They hand out educational materials and information on city programs and services. They often volunteer for community events, and provide directions and answer questions. And, they serve as a safe and visible presence in the community. The Community Ambassadors Program is administered by the Mayor’s Office of Civic Engagement and Immigrant Affairs (OCEA) and has been praised by merchants and residents in the neighborhoods it serves. The employees are multi-lingual, represent the diversity of San Francisco, and several are individuals who are determined to overcome life challenges from their own pasts and to make a better life. Many of the community ambassadors have transitioned to permanent positions in the private, public and not-for-profit sectors at the end of their 18-month participation in the program. The Community Ambassadors Program is an example of a deployment of human capital for public safety. In addition to efforts to deter auto burglary by prevention, planning, and programs for the would- be victim, San Francisco also offers pre-trial diversion programs for young and first time offenders through neighborhood courts. The presumption of innocence before trial allows many who are accused of auto burglary to participate in alternative programs to incarceration, including supervised release, or home detention through electronic monitoring. Punishment as a Deterrent: Incarceration is a traditional form of punishment used by the American criminal justice system. Incarceration is the most expensive and inefficient form of punishment. The outcomes of incarceration are widely debated throughout society. There are few alternatives to incarceration for communities for managing serious, violent, and chronic offenders. Modern theory of crime and punishment describe five purposes for incarceration as shown in Table 3:23 Table 3: Purposes for Incarceration

F11: Charge the chief of police and the district attorney to collaborate with the United States Attorney’s Office, F.F.7. R.F.1. Northern Division of California, San Francisco, to refer Finding appropriate cases to federal authorities for prosecution Presently, San Francisco does not account for under interstate/international commerce law and/or Federal crimes against victims/tourists. City Government Criminal Street Gang Enhancements. needs reliable information to develop further policy and act to protect visitors, tourists. and the City’s tourism industry. Continued ________________________________________________________________________________________________________________ Response Matrix Findings, Recommendations and Responding Parties Auto Burglary In San Francisco ________________________________________________________________________________________________________________ R.F.1. Continued

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R11: Charge the Chief of Police and the District Attorney to collaborate with the United States Attorney’s Office, Northern Division of California, San Francisco, to refer appropriate cases to federal authorities for prosecution under interstate/international commerce law and/or Federal Criminal Street Gang enhancements.

F12: Include a visitor/tourist identification field on Police Incident Reports to facilitate research and data gathering.

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R12: Provide for the inclusion of a visitor/tourist identification field on Police Incident Reports to facilitate research and data gathering into this problem.

F13: Require the coordinating agency to report annually to the Public Safety Committee of the Board of Supervisors. The report shouldprovide performance metricsabout services offered and make recommendations to inform future policy related to crimes against visitors/tourists. F.F.8. Corresponds to R.F.2. F.F.8. Finding Responder R.F.2. Recommendation Responder The visitor's tab on sfgov.org, the City's Internet Mayor and Director The visitor’s tab on the San Francisco Gov.org Mayor and Director of homepage, does not provide resources for of Department of homepage should contain information to assist Department of visitors/tourists in distress. Technology. visitors/tourists who are in need of victims Technology. assistance and other kinds of support services. F.F.9. Corresponds to R.F.3. F.F.9 Finding Responder R.F.3. Recommendation Responder Visitor/tourist selection on SFPD Incident Mayor and Director Include visitor/tourist incident data as a search Mayor and Director of Reports should be a search/sort field for SFPD of Department of field on police incident report available though Department of incident reports on datasfgov.org Technology, datasfgov.org. Technology, Deputy Deputy Chief of Chief of Admin. Admin. ________________________________________________________________________________________________________________ GLOSSARY All definitions from: Uniform Crime Reporting Handbook (2004) United States Department of Justice, Federal Bureau of Investigation. Crime and Delinquency in California (1993) Criminal Justice Profile Series, Law Enforcement Information Center. California Legislative Information Website (2016). leginfo/CA.gov ______________________________________________________________________________ ARREST: Taking a person into custody, in a case and in the manner authorized by law. An arrest may be made by a peace officer or by a private person." (P.C. 834) BURGLARY: the unlawful entry of a structure to commit a felony or a theft. Attempted burglary is included. (UCR definition) Burglary of a Motor Vehicle: See California Penal Code Section 459, 460, 661) In California, Burglary of a motor vehicle is classified as 2nd Degree Burglary and is punishable by up to one year in the county jail. Under UCR Burglary of Vehicle is classified as Larceny/Theft. CALIFORNIA CRIME INDEX: a group of crimes chosen to serve as an index for gauging fluctuations in the overall volume and rate of crime. These crimes, chosen because of their seriousness and likelihood of being reported to the police by the public, are willful homicide, forcible rape, robbery, aggravated assault, burglary, and motor vehicle theft. These crimes are reported according to definitions taken from the FBI Uniform Crime Reporting Handbook. http://www.plsinfo.org/healthysmc/12/glossary.html CITATION: a written order, issued by the police for a violation, to appear before a magistrate or probation officer at a later date CLASSIFICATION: Determining the proper crime categories in which to report offenses in UCR. The offense’s classification is based on the facts of an agency’s investigation of crimes. CLEARANCE: a crime is cleared or "solved" for crime reporting purposes. CLEARED BY ARREST: An offense is considered cleared when at least one person involved in the commission of the offense has been (1) arrested, (2) charged, and (3) turned over to the court for prosecution. CLEARED BY EXCEPTIONAL MEANS: clearance in which some element beyond law enforcement control prevents filing of formal charges against the offender. Agencies can clear an offense exceptionally if they can answer all of the following in the affirmative. (1) Has the investigation definitely established the identity of the offender? (2) Is there enough information to support an arrest, charge, and turning over to the court for prosecution? (3) Is the exact location of the offender known so that the subject could be taken into custody now? (4) Is there some reason outside law enforcement control that precludes arresting, charging, and prosecuting the offender (for example, suicide, deathbed confession, double murder, etc. COMPSTAT: Compstat is a process or philosophy of crime management, it is not a computer program or software. Compstat is a combination of technical and managerial systems that provides accurate and timely crime related intelligence. Furthermore, it is a measurement system of organizational performance and an interactive system that focuses on organization as a whole, and specifies certain policies to accomplish agency‘s mission CRIMINAL STREET GANG means any ongoing organization, association or group of three or more persons, whether formal or informal, having as one of its primary activities the commission of one or more of the criminal acts... having a common name or common identifying sign or symbol, and whose members individually or collectively engage in or have engaged in a pattern of criminal gang activity. http://www.leginfo.ca.gov/cgi-bin/displaycode?section=pen&group=00001-01000&file=186.20- 186.34 DIVERSION: a disposition of a criminal defendant either before adjudication or following adjudication but prior to sentencing, in which the court directs the defendant to participate in a work, educational, or rehabilitation program. DIVERSION DISMISSED: the successful completion of a diversion program. FBI CRIME INDEX: the FBI chose seven crimes to serve as an index for gauging fluctuations in the overall volume and rate of crime. These crimes include homicide, forcible raps, robbery, aggravated assault, burglary, larceny-theft, and motor vehicle theft. By congressional mandate. arson was added as the eighth index crime in 1979. FELONY: a crime which is punishable with death or by imprisonment in the state prison." (P.C. 17 & 18) FENCE: In the context of this report the word "fence" is used as a noun to refer to a person who buys and sells stolen goods, and as a verb in reference to the act of buying or selling stolen goods. JAIL: a county or city facility for incarceration of sentenced and unsentenced persons. Also known as type I or II facility (Section 1006 California Code of Regulations). HIERARCHY OF OFFENSES RULE: For Federal Crime Reporting Purposes Only: When an Arrest involves multiple offences only the highest among the offences are reported. The Part I offenses are as follows:

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R13: Require the coordinating agency to report annually to the Public Safety Committee of the Board of Supervisors. The report should inform future policy and decisions regarding visitor and tourist related crime, give information about services offered, research conducted, and include significant R.F.2. Mayor and Director of Department of Technology. The visitor’s tab on the San Francisco Gov.org homepage should contain information to assist visitors/tourists who are in need of victim’s assistance and other kinds of support services. R.F.3. Mayor and Director of Department of Technology, Deputy Chief of Administration Include visitor/tourist incident data as a search field on police incident reports available through datasfgov.org. CONCLUSION Auto burglary is prevalent in every community because it represents lower risk and higher gains than many other crimes. The epidemic of auto burglary in San Francisco has many causes; significant among them are population density, wide socioeconomic differences, and desirability of San Francisco as a place to visit, live, work and play. Geography is a significant factor that works against police and works in favor of the career criminals and criminal street gangs responsible for most of the reported auto burglary related incidents. Criminal street gangs are experienced and use efficient techniques that are quick, calculated, and enable them to avoid apprehension. With many of these gangs working at any given time, their prolific criminal enterprises would challenge any city’s police department. San Francisco’s community policing focus benefits the City’s residents as individuals, families, neighbors, and as a community of people with many languages and cultures. Nevertheless, organizing primarily for community policing works to the benefit of career criminals. This is because career criminals move around the City without regard for precinct boundaries, or cross the city limits as they speed out a town. The mobility of career criminals argues for a permanent serial crimes unit at headquarters that enables cross-district investigations. Cross-district investigations are often required to bridge the gap between the evidentiary standard of “probable cause” to make an arrest as opposed to that of “beyond a reasonable doubt” to support charging and successful prosecution. In brief, the Civil Grand Jury makes the following recommendations:  Balance police resources to meet the needs of neighborhoods,  Develop capacity to analyze and respond to auto burglary crimes as a city-wide problem,  Promote prevention through community education,  Support police efforts to apprehend suspects with solid evidence,  Build solid cases for local prosecutors to charge and negotiate,  Identify new approaches to prosecuting cases that protect economic interests,  Introduce a visitor and tourist crime prevention and support programs. We are confident that implementation of our recommendations will significantly decrease auto burglary incidents and prepare the city to identify and efficiently respond to future crime trends. By establishing a tourist protection and assistance program, we advance social justice and protect the character of San Francisco as a place where people want to be: to visit, live, work and play. Response Matrix

Additional Recommendations 2

Not linked to specific findings.

R7: Use activity generator: Signage, storefronts, and community events generate activity.

R8: Manage and maintain for pride: Community pride increases attention to the area.

May 25, 2016 — San Francisco’s Crime Lab Promoting Confidence and Building Credibility

43 pages 1 findings 1 recommendations

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Findings & Recommendations 1 findings

F29: RECOMMENDATION 29 CONCLUSION 30 REQUEST FOR RESPONSE MATRICES 31 GLOSSARY 37 APPENDICES 38 SUMMARY Over the past several years, the credibility of the San Francisco Police Department Criminalistics Laboratory (Crime Lab or the Lab) has been marred by scandals that have interfered with its mission to present accurate, unbiased, and convincing testimony in court. These incidents have ranged from theft in the Drug Analysis Laboratory to the wellpublicized failure of two criminalists to pass a national proficiency test. Our report summarizes the past incidents that have damaged the credibility of the Crime Lab. We point out what remedial steps have been taken to improve the quality of work in the Lab, and we outline additional steps needed to sustain the progress made and prevent similar problems in the future. We found that ● The Crime Lab suffers from being too closely managed by the Police Department. It has been headed by a rotating succession of police captains who lack the scientific knowledge to understand the intricate workings of the Laboratory. Scientific errors and disputes are often handled using a police Internal Affairs model of discipline. This model investigates problems secretively, does not provide transparency, and has the effect of immediately halting constructive dialog between management and criminalists. Under the Police Department, the Crime Lab is often viewed as biased for the prosecution, rather than an independent arm of the criminal justice system. ● The backlog of DNA cases has been reduced. Turnaround time for case completion has also improved, but both need further improvement to satisfy the requirements of all potential users, including crime victims and defense representatives. ● Outsourcing of DNA cases is being used effectively, especially given that the Lab has a reported shortfall of five to eight DNA analysts. Outsourcing has been especially useful in dealing with the influx of untested rape kits delivered to the Crime Lab in June 2015 by the San Francisco Police Department (SFPD). ● Reopening the Drug Analysis Lab, which has been closed since the discovery of cocaine theft in 2010, would benefit both the City and the Crime Lab. ● The Lab’s case tracking system is outdated and lacks modern capabilities. It needs to be updated to improve internal management of cases, as well as to allow better communication with the Crime Lab’s customers: The Police Department, the District Attorney’s Office, and, perhaps in the future, the defense community. ● Although several comprehensive reviews of past work have been undertaken by Crime Lab management, an external audit by forensic experts trusted by all stakeholders of the Crime Lab is crucial to confirm the results of these internal reviews and validate the policies and practices of the Lab. ● Although the Crime Lab is fully accredited, quality can only be assured by a robust quality management system. We recommend ● Separation from the SFPD in a two step process that will eventually lead to an independent Crime Lab. The first step should be to replace the sworn police Director with the civilian scientist manager as head of the Lab. The second step should be the establishment of an autonomous, independentlyfunded Crime Lab. ● Reopening the Drug Analysis Lab. ● Implementation of a modern laboratory information management system. ● More collaboration with stakeholders of the Crime Lab (the District Attorney, Police Inspectors, and the Defense) by ○ Providing restricted electronic access on the status and progress of their cases using a modern laboratory information management system. ○ Seeking stakeholder input regarding appropriate turnaround times and an optimal “nottoexceed” number of backlogged cases in the Crime Lab. ● An independent external review by respected forensic experts whom all stakeholders agree are trustworthy. These auditors should not be selected by the City on the basis of lowest cost but rather because of their trusted reputation. ● Adherence to the goals of California’s AB 1517, the Sexual Assault Victim’s DNA Bill of Rights, which recommends timeliness for analysis of DNA evidence collected after an assault and for notification of the victim, if requested, that analysis of the evidence has been completed. ● More favorable interaction with the Public, using an updated website. ● Establishment of a scientific advisory board which would provide an additional source of technological expertise to the Lab. BACKGROUND The credibility of the San Francisco Police Department Criminalistics Laboratory (Crime Lab or Lab) has suffered due to multiple incidents widely reported by the news media over the last several years. These incidents are summarized below to give an indication of the extent of past criticism. Because some of the incidents relate to evidence presented in criminal cases just now coming to trial after a delay of several years, the credibility of the Crime Lab continues to be questioned as new cases are brought to trial. Sample Switch and Record Destruction. In fall 2008 an analyst in the Crime Lab mixed up two samples of DNA evidence during testing in a homicide case. In a serious breach of forensics protocol, she was directed by her supervisor to relabel the samples and discard the records of the mistake. This breach was subsequently reported by an anonymous whistleblower in a letter to a lawyer in the Public Defender’s Office. The Public Defender’s Office reported the sample switch, its concealment, and other concerns about the Crime Lab to the U.S. Attorney’s Office. In July 2009 the whistleblower notified ASCLD/LAB1, the accrediting agency for the Crime Lab, of the allegations. ASCLD/LAB, in turn, asked for a response from the then Crime Lab director who denied knowledge of the sample switch. Subsequently, upon learning that ASCLD/LAB had confirmed the switch, the Public Defender called for an investigation into whether the destruction of the record of the switch was a criminal act. Theft of Drugs. In March 2010 a criminalist in the Drug Analysis Lab was found to be using cocaine stolen from evidence. The then police chief immediately halted all further drug testing at the Lab, and, in May 2010, closed the Drug Lab permanently. The Drug Lab is closed to this day with its equipment still in place. Drug analysis is currently outsourced to the Alameda Sheriff’s Crime Lab. The Bicycle Case. Also in March 2010, a wellknown attorney contracted by the SF District Attorney’s (DA’s) office to work in its Cold Case section sent the DA a memo highly critical of the competence of a Crime Lab DNA analyst. At the same time, this analyst’s methods were also being criticized publicly by another expert in the DNA community. The case in question, dubbed the “Bicycle Case”, was the State of California vs. Joc Wilson and Emon Brown. In 2007 Byron Smith was gunned downed by men on bicycles in what police suspected was a gang turf war. A second victim had been murdered in a similar manner. In court, the Crime Lab analyst testified that the DNA of Brown was on the handlebars of one recovered bicycle and that of Wilson on the other bicycle. In her testimony, however, the analyst failed to mention that the predominant DNA found on both bikes was actually from a third person who has never been named. By omitting this finding, the analyst was accused of being in violation of the Brady Rule, which states that exculpatory evidence must be shared with the defense. After the defendants were acquitted, their lawyer wrote to the Chief of Police, as head of the Crime Lab, complaining that the testifying analyst had behaved unethically and that her behavior "might constitute criminal conduct warranting further investigation." 1 ASCLD/LAB is the accrediting arm of the American Society of Crime Lab Directors. Marco Hernandez Case. In December 2014 additional Crime Lab problems came to light during the trial of a child molestation defendant. A criminalist uploaded a DNA profile into CODIS, the FBI software program used to compare subjects to known offender databases (see “What is CODIS” in Appendix A). Although the profile was partial and would not be acceptable by today’s standards, the main errors in the upload involved assumptions that were made that altered the results of the search. The defendant was deemed a possible match, but another profile, which also should have been deemed a match, was not pursued. At trial, the excluded profile was brought up by the defense who cast doubt on both the criminalist who was testifying and on the Crime Lab itself. Problems with this CODIS upload by the criminalist and her supervisors have resulted in questioning of many other cases as they come to trial. Pretrial evidentiary hearings have been necessary, further burdening the court system as DNA results are questioned. At least 500 cases were uploaded during this period and have since been reviewed by the Crime Lab. Proficiency Failure. In August 2014 the same criminalist failed a nationwide DNA proficiency examination. A second criminalist, who was her supervisor, reviewed her results and agreed with them, thereby failing the test herself. Notably, these two were the only criminalists of 343 in the nation who failed the examination. Both criminalists were removed from their duties in the Crime Lab, have been investigated by SFPD Internal Affairs, and are participating in further hearings at this time. They have been reassigned to other areas within the SFPD, but they remain on the Crime Lab payroll. OBJECTIVES The Civil Grand Jury undertook this investigation to ● assess the extent to which the Crime Lab has effectively identified its past problems ● evaluate whether the Crime Lab has taken action to correct the root causes of these problems and ● identify additional steps necessary for its continued improvement. SCOPE AND METHODOLOGY The Civil Grand Jury conducted over 30 interviews that included: ● Crime Lab personnel, both current and past. We interviewed senior management, as well as nonmanagement employees chosen to provide a broad view of the Crime Lab. We also interviewed past employees of the Crime Lab for their perspective on historical problems and the culture of the Crime Lab. ● Attorneys, from both the defense and the prosecution, including those whose complaints have led to intense scrutiny of the Crime Lab. ● Users and potential users of the services of the Crime Lab, including district attorneys, public defenders, and police inspectors. ● Directors of other crime labs in the Bay Area and California. ● Forensic experts, including leaders of national forensic accreditation organizations, scientists associated with the National Institute of Standards and Technology (NIST), and academicians, for their opinions on best practices in Crime Lab operations. We wish to thank all those we interviewed for the generous gift of their time and for their thoughtful, candid opinions. We attended a pretrial evidentiary hearing (402 hearing) in which the defense and prosecution debated whether the Crime Lab analyst involved in the Hernandez case was qualified to present DNA evidence to the jury. We also examined many documents related to the Crime Lab, including accreditation documents, whistleblower letters alleging misconduct, official responses to allegations, previous audits, trial testimony, and training materials. We reviewed the 2009 reports of the National Academy of Sciences2 and the California Crime Laboratory Review Task Force3 examining the state of the forensics community. In addition, we reviewed the many media articles about problems in the Crime Lab over the last several years. These articles, which reported the incidents summarized in or Background section, originally sparked the Civil Grand Jury’s interest in the Crime Lab and led to this investigation. Because most of the past problems of the Crime Lab have involved the Drug Analysis and the DNA units, we focused our attention on these units. We conducted this review from August 2015 through March 15, 2016. The National Academy of Sciences, “Strengthening Forensic Science in the United States: A Path Forward” /www.ncjrs.gov/pdffiles1/nij/grants/228091.pdf (accessed 2/13/16) 3 California Crime Laboratory Review Task Force, “An Examination of Forensic Science in California November 2009” oag.ca.gov/publications/crime_labs_report.pdf (accessed 2/13/16) ORGANIZATION The Crime Laboratory is a public laboratory administered and funded by the SFPD. It provides forensics services primarily to the San Francisco Police Department and the District Attorney’s office. Theoretically, its services could be used by others, including the SF Public Defender's Office, but this occurs rarely. Nonusers cite what they feel is bias for the prosecution and long turnaround times as reasons for not utilizing the Crime Lab. Crime Lab services include analysis of: ● Biology/DNA ● Firearms/Toolmarks ● Trace Evidence (gunshot residue and shoeprints only) ● Breath Alcohol Since March 2010, after the closure of the Drug Analysis Lab due to theft of drugs by an analyst, controlled substance testing has been outsourced to another public laboratory. The Crime Lab is staffed with 25 employees, primarily civilians (Appendix B). In the DNA lab entrylevel criminalists (Criminalists I) perform screening tasks to prepare evidence for analysis. Journeyman criminalists (Criminalists II) perform casework to analyze DNA evidence. Supervising criminalists (Criminalists III) are more experienced criminalists who assign cases, coordinate the efforts of the Criminalists II, review completed work, administer grants, and perform other administrative duties. The Technical Lead is a Criminalist III who ensures that the methodology and procedures used in performing casework are in compliance with established standards, that these methods are validated, and that analysts are properly trained. (See Glossary). In the Crime Lab we found the Criminalists II and III, as well as the Technical Lead, to be well educated with master’s degrees. Several had extensive experience in other public and private forensic labs prior to coming to the SF Crime Lab. Many of them were hired recently and were not involved in the scandals mentioned in our background section. Several positions remain unfilled, and the two DNA analysts whose work is under investigation are currently reassigned to other areas within the police department. We learned that salaries for criminalists are highly competitive. In fact, they are among the highest in the nation.4 However, hiring in San Francisco government is a cumbersome process.5 For example, a firearms analyst who was interviewed in 2014 just began working in September 2015. The delay in bringing him to work was attributed to a slow progression through the SFPD Human Resources (HR) process and then the City HR process. An Examination of Forensic Science in California November 2009 ag.ca.gov/publications/crime_labs_report.pdf 5 Office of the Controller, City Services Auditor “How Long Does It Take to Hire in the City and County of San Francisco? Analysis and Recommendations” http://openbook.sfgov.org/webreports/details3.aspx?id=1907 (accessed 2/13/15) FACILITIES The Crime Lab is housed in Police Building 606 at the former Naval Shipyard in Hunter’s Point. The facility has always been considered temporary because the area is slated to undergo redevelopment. In 2014 San Francisco voters approved an Earthquake Safety and Emergency Response Bond to build a new facility, now proposed for 1965 Evans Avenue, to house the Crime Lab. Planning for the new facility, which will also house the Office of the Medical Examiner, has started. Completion is estimated for the end of 2019. GENERAL DISCUSSION A. Daytoday management of the Crime Lab should be removed from direct police supervision DISCUSSION Currently, a professional civilian scientist serves as Manager of the Crime Lab. He serves under the Director of Forensic Services of the SFPD, usually a police captain who reports to the assistant Chief and, ultimately, the Chief of the SFPD. Currently the police captain, the Director of Forensic Services, is also in charge of the Crime Scene Investigation (CSI) Unit and the Identification Unit (fingerprints). Since 2010 the Crime Lab has changed top management at an alarming rate. The last civilian scientist Director of Forensic Services resigned in 2010. Subsequently, no fewer than six police captains have held the title of Director of Forensic Services. Director of Forensic Services has been part of an appointed rotation available to 2530 police captains, a rotation that includes precinct head as well as other posts of higher or lesser advancement. Levels of education have varied. One captain did not have a college degree, and few have had degrees in science. This fact is important because understanding the highly scientific nature and the rapid evolution of DNA technology is difficult. Unintended damage and obstruction to progress has occurred in the past because a captain did not understand the challenges faced by the Lab and how to manage them effectively. As Lab personnel lamented to us, “We keep having to train another captain.” A former employee told us, “I called our captain Captain Chaos.” On the last day of our investigation, a new captain was appointed, the sixth in less than six years. In the 2015 ASCLD/LAB accreditation report, the Crime Lab was criticized for having a nonscientist as its Director. Having a sworn officer as head of the Crime Lab has also led to an approach to discipline based on a police model. When errors or misconduct are uncovered, investigations have been conducted by police Internal Affairs. These investigations are prolonged and highly secretive, often leading to the impression that the Crime Lab is covering up. In addition, many of those we interviewed believe that the police command has tended to overreact to situations in the past which could have been handled instead by remedial training or a change in protocol. The permanent closure of the Drug Analysis Lab was cited as an example. In addition, actual or perceived conflicts of interest could arise when the Crime Lab conducts forensic examinations on evidence relating to police officers, since both are under the Police Department. Examples include analysis of gunshot residue and firearm evidence in officer involved shootings. Most importantly, placing a sworn officer without scientific training as the head of the Crime Lab contradicts a major recommendation of the National Academy of Sciences. In 2009 a blue ribbon committee of the Academy made a number of recommendations to improve forensic science in this country.6 One of its principal recommendations was that all public forensic laboratories and facilities should be removed from the administrative control of law enforcement agencies or prosecutors' offices. The committee stated: “Forensic scientists who sit administratively in law enforcement agencies or prosecutors’ offices, or who are hired by those units, are subject to a general risk of bias.” The U.S. Supreme Court has also underscored the need for independent forensic science. In MelendezDiaz v. Massachusetts7 it quoted the National Academy of Sciences report and warned that, when forensic laboratories are administered by law enforcement agencies, "[a] forensic analyst responding to a request from a law enforcement official may feel pressure or have an incentive to alter the evidence in a manner favorable to the prosecution." FINDINGS F.A.1. The position of the police captain Director has been a high turnover position, and the learning curve for the Crime Lab is steep. Putting a police captain in charge of day to day management has, in the past, resulted in the sworn Director having difficulty understanding the challenges of the Crime Lab and dealing with them appropriately. F.A.2. Under police management, discipline has often been handled using a police model. Investigations of scientific errors have been conducted secretly under the cover of police Internal Affairs and give the impression that the Crime Lab itself is covering up. F.A.3. Once the disciplinary process goes to Internal Affairs, we observed an immediate halt to dialog between staff and management aimed at resolving technical issues in a scientific manner. F.A.4. The positioning of San Francisco's Crime Lab within the police department is contrary to the National Academy of Sciences’ 2009 recommendation that Crime Lab scientists be distanced from law enforcement.

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R29: CONCLUSION 30 REQUEST FOR RESPONSE MATRICES 31 GLOSSARY 37 APPENDICES 38

December 02, 2015 — Civil Grand Jury | 2017-2018 City and County of San Francisco Crisis Intervention:

54 pages 17 findings 15 recommendations

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Findings & Recommendations 17 findings

F1: The CIT Liaison Program will strengthen relationships between police officers, district station captains, and the CIT Coordinator.

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R1: Recommends that the CIT Coordinator and CIT Liaison Officers hold monthly meetings with each district station captain. Each meeting should include regular agenda items relating to district CIT incidents, high frequency clients, and outcomes. The results of each meeting should be summarized in a quarterly review with the Chief of Police. Meetings should commence no later than January 1, 2019. (F1)

F2: CIT Working Group members lack a computing background, which prevents the design of a workable and scalable data collection and reporting framework.

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R2: Recommends that SFPD Technology Division assign a representative to attend all regular CIT Working Group meetings no later than October 1, 2018. (F2)

F3: There are no standard CIT performance criteria, which are necessary to measure CIT operational effectiveness.

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R3: Recommends that SFPD, in collaboration with CIT Working Group, identify both quantitative and qualitative standards to help measure CIT operational effectiveness. Newly adopted standards should include Crisis Response (CR) incidents and jail diversion statistics. These standards should be part of the CIT annual report to the Police Commission. Standards should be adopted no later than January 1, 2019 and be set for inclusion in the 2018 CIT annual report to the Police Commission. (F3)

F4: SFPD determines the deployment of CIT trained officers across the 10 SFPD district stations, mostly based on a traditional police staffing method instead of using a mix of methods, including a more effective data-driven analysis of incidents.

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R4: Recommends that SFPD command staff consider reported CIT incident outcomes in deciding CIT officer assignments. This will help deploy CIT teams in areas where they are needed most. This consideration should begin no later than January 1, 2019. (F4)

F5: While some data collection has been occurring during 2017 and 2018, there have been gaps in the full data collection and reporting for CIT required by the DGO. These gaps include collection and reporting of eSTOP data with respect to CIT. Additional delay in reporting will occur due to implementation of the Racial and Identity Profiling Act of 2015.

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R5: Recommends that newly identified and budgeted programming personnel for SFPD Technology Division be hired no later than October 1, 2018. (F5)

F6: Crisis Response (CR) data is not being effectively collected throughout the crisis incident lifecycle. A lack of “CR” response notations, especially in incident categories such as mental health related and wellness checks, hinders measurement of CIT operational effectiveness.

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R6: Recommends that the use of crisis intervention techniques be reported within the CAD record. This broader designation of CIT incident responses should start no later than January 1, 2019. (F6)

F7: SFPD command staff find it challenging to attend and complete the 40-hour CIT training program, which they need in order to lead their teams effectively in crisis intervention.

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R7: Recommends SFPD command staff be allowed to spread their attendance in CIT training over two or more training sessions. Flexible sessions should start by October 1, 2018. (F7)

F8: The CIT curriculum does not explicitly inform officers of the full range of available community mental health services or other resources that may be used to assist residents who are in crisis. Once trained, officers have only a cursory knowledge of mental health resources, and minimal access to mental or behavioral health consultations in the field, unless they are confronted with high profile crises like hostage situations.

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R8: Recommends that CIT administrators develop a department bulletin which outlines the full range of community resources to support officers who are assisting residents in crisis. The bulletin should be in place no later than January 1, 2019. (F8)

F9: There is little useful information to be gleaned from the current CIT training evaluation process and it does little to determine the quality and efficacy of training.

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R9: Recommends that an academic institutional partner be assigned to assess and periodically review the efficacy of the 40 and 10 hour CIT Training courses. (F9)

F10: Currently there is no trended (longitudinal) survey data from field operations which can be used to evaluate the CIT training program.

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R10: Recommends SFPD officers who have completed the 40 hour CIT training course be surveyed six months to one year later to reflect on the usefulness of individual modules and to determine what worked and what did not work in the training. This new survey should start no later than April 1, 2019. (F10)

F11: In spite of assurances, the jury is concerned that the CED (Taser) certification program will diffuse or delay scheduling of the current 40 hour CIT training program.

Related Recommendations (1)

R11: Recommends the Chief of SFPD publicly state the CED (Taser) certification program will not diffuse or delay scheduling of the current 40 hour CIT training program. This public statement should occur no later than October 1, 2018. (F11)

F12: DPH has no equivalent accountability mechanism to SFPD Department General Orders (DGOs), by which DPH instructs, manages, and, thereby, holds DPH accountable for outlining its responsibilities, particularly in managing its CIT involvement, and collaborating with SFPD.

Related Recommendations (1)

R12: Recommends renewal and elaboration of the current MOU between SFPD and DPH, and the associated DPH manual. An updated draft MOU should be presented to the Mayor for review no later than January 1, 2019 and adopted no later than June 1, 2019. (F12)

F13: DPH has not fully and adequately filled the five budgeted clinician positions. Without these field positions, DPH cannot fulfill the mutual goals prescribed by the Mayor in his 2016 press release.

Related Recommendations (1)

R13: Recommends filling the five budgeted Crisis Intervention Specialist positions with field- ready clinicians. Clinicians should be dedicated to the CIT program and placed in the field no later than October 1, 2018. (F13)

F14: The CIT working group includes mental health clinicians, including those who work directly with CIT, but there is no consistent representation from DPH leadership/management. This results in inefficient sharing and understanding of broader public health information and priorities. The absence of DPH leadership at the working group level underscores the lack of program evaluation and supervision by DPH.

Related Recommendations (1)

R14: Recommends DPH/BHS leadership and the CIT Working Group hold joint quarterly meetings to examine and analyze CIT program data, measure and assess program progress, and identify appropriate program adjustments. These meetings should begin no later than January 1, 2019. (F14)

F15: The CIT Working Group, SFPD, and DPH have improved the responses to high visibility crises in San Francisco. Application of scaled and proactive methods to manage less extreme crises has not received similar attention.

Related Recommendations (1)

R15: Recommends that in addition to the Specialists referred to in Recommendation 13, DPH hire five additional Crisis Intervention Specialists by December 1, 2019. One Specialist should be assigned to each district station for coordination and collaboration with SFPD CIT liaisons in order to prevent crises before they require a 911 call. Initial assignments should be made to the stations with the greatest need, based on calls for service and incident type. (F15)

F16: Dore Clinic and Residence is an example of a valuable and useful community service that facilitates the success of the CIT program, relieving pressure on PES, the police, and the community by providing ongoing professional care for individuals in crisis.

F17: The individuals in both DPH and SFPD committed to crisis intervention at an operational level are engaged, dedicated and doing commendable work in reducing bad outcomes for people in crisis.

∼ June 30, 2015 — San Francisco County Jails Our Largest Mental Health Facility Needs Attention

59 pages 1 findings 4 recommendations

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Findings & Recommendations 1 findings

F1: Have case manager or designee accompany the the patient to at least the first continuing care appointment and assess patient needs to assure future appointment compliance.

Related Recommendations (1)

R1: Provide a “warm handoff” to a Case Manager in the community who will arrange for a full continuum of care. (Note that this requires identification of receiving hands ready to accept the patient.)

Additional Recommendations 3

Not linked to specific findings.

R2: Have Case Manager or designee accompany the patient to first continuing care appointment, and assess patient needs to assure future appointment compliance.

R3: Set up a meeting of the Community Case Manager with the patient prior to his release, in order to have a visual connection. R.E.2. The Sheriff and the Director of Public Health should request the Controller to conduct a benchmark survey of “release assessment” and other performance measures for mental health services in county jails and suggest best practices for adoption at the San Francisco Jails. R.E.3. The Sheriff and the Director of Public Health should contact appropriate departments in Bay Area universities to determine potential interest in having graduate students analyze performance metrics and prepare reports on mental health services provided in San Francisco Jails. R.E.4. The Sheriff and the Director of Public Health should seek out local mental health organizations, such as NAMI and MHB, for recommendations on mental health services provided in the San Francisco Jails and related reentry services. CONCLUSION San Francisco Jails have challenges due to both the facilities that skew towards old and unsafe and the difficulty of staffing enough to allow for training and rotation without excessive overtime. To deal with these challenges, the Jury recommends improvements in intake/custody transfer, facilities, information sharing, and personnel management especially training. Most importantly, the Jury recommends increased focus on treatment of people with mental illness who end up in our jails. Across the country, there are ten times as many individuals with serious mental illness in our jails and prisons as there are in our state psychiatric hospitals.37 As long as the jails in San Francisco continue to serve as the place for treatment of individuals who commit violent crimes while experiencing mental health crises, there is a need for more behavioral health services in our jails and for discharge and reentry planning that is coordinated with the requisite community mental health services. Kupers, ibid, preface REQUEST FOR RESPONSE A. Jail Intake: Transfer of Custody # FINDING # RECOMMENDATION RESPONDER F.A.1. There is currently no R.A.1.a. Jail intake should develop a Chief Deputy of jail procedure that system to communicate and Custody accounts for those track cases where the triage Operations, arrestees referred for nurse determines that the Director of Jail hospital care. arrestee must be taken to a Health Services hospital for emergency medical or psychiatric care before admission to Jail. R.A.1.b. The SF Police Chief and Sheriff, Chief of Sheriff should revisit their Police MOU regarding transport and custody transfer. # FINDING # RECOMMENDATION RESPONDER F.A.2. Arrestees and their R.A.2. In the interest of obtaining a Chief Deputy of arresting officer may more complete medical history, Custody not always understand the Sheriff and the Director of Operations, the importance of full Jail Health Services should Director of Jail disclosure of medical update Intake policies and Health Services history. practices to seek informed consent to contact and receive records from the arrestee's Case Manager, primary provider, and family or friends who may have information about the arrestee’s medical history and therapeutic medications. # FINDING # RECOMMENDATION RESPONDER F.A.3. When an arresting R.A.3. The Sheriff should review Sheriff agency brings an current Field Arrest Card arrestee to the Jail for content and procedures to intake, there is a field assure that best practices are arrest card. employed, and information necessary for the health and safety of the arrestee and jail personnel is communicated in writing. The information should include circumstances of arrest and any observations or concerns the arresting officer may have about the medical or psychiatric condition of the arrestee. # FINDING # RECOMMENDATION RESPONDER F.A.4. Although the Sheriff R.A.4.a. By early 2017, the Sheriff Sheriff has access to multiple should implement a policy and criminal data bases, the procedure requiring arresting arresting agencies do agencies to provide a digital not necessarily share copy of the arrest report, arrest records with the including charges and a Sheriff’s custody staff description of the arrest, within at the time of custody six hours of the transfer of the transfer. arrestee. R.A.4.b. Once the “share the arrest Sheriff record” process of R.A.4a is in place, the Sheriff should require all arresting agencies to comply with the process. # FINDING # RECOMMENDATION RESPONDER F.A.5. The results of a R.A.5. The Sheriff and Director of Sheriff, Director preliminary psychiatric Public Health, in consultation of Health, City evaluation conducted with the City Attorney for Attorney by Jail Behavioral issues related to HIPAA, Health at intake could should develop and implement be helpful to the a policy for sharing with an arrestee’s long term arrestee’s Case Manager (if mental health care if any), the results of a shared with the preliminary psychiatric arrestee’s Case evaluation conducted at Intake. Manager, if any. # FINDING # RECOMMENDATION RESPONDER F.A.6. Although there are R.A.6 The Sheriff should add to the Sheriff and several ways for family inmate handbook a paragraph Director of Jail members and friends to about the importance of Health Services contact custody staff contacting a family member or regarding concerns friend and should provide a about their loved ones 24/7 number that the inmate who are in jail, models could give to this contact. for improvement are available. B. Facilities # FINDING # RECOMMENDATION RESPONDER F.B.1. In Jail #4, old locks R.B.1.a. The Sheriff should prepare a Sheriff jam frequently, causing supplemental budget request safety concerns. Other for funds to immediately maintenance issues address problems with old continue to arise. locks at Jail #4 and any other remaining serious maintenance issues; R.B.1.b. The Mayor should include in a Mayor supplemental budget request the Sheriff’s request for funds to address the problems with old locks at Jail #4 and any other remaining serious maintenance issues; and R.B.1.c. The Board of Supervisors Board of should approve the Mayor’s Supervisors supplemental budget request for funds to address the problems with old locks at Jail #4 and any other remaining serious maintenance issues. # FINDING # RECOMMENDATION RESPONDER F.B.2. Ending use of Jail #4 R.B.2. The Sheriff should make Sheriff would also require interim plans for replacing

R4: Have case manager or designee accompany the the patient to at least the first continuing care appointment and assess patient needs to assure future appointment compliance.

Drinking Water Safety in San Francisco a Reservoir of Good Practice

20 pages 1 findings

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Findings & Recommendations 1 findings

F2006: https://www.sfdph.org/dph/files/EHSdocs/ehsWaterdocs/Cryptosporidiosis_Document_Collection.pdf 35 Cryptosporidiosis Surveillance Project Archive, https://www.sfdph.org/dph/files/EHSdocs/ehsWaterdocs/Crypto/Cryptosporidiosis_Surveillance_Project_Reports_A rchive.pdf Note: The 2015 report was not online as of this writing, but was confirmed verbally at SFDPH. 36 SFPUC Questions Regarding Drinking Water Disinfection, June 2013 http://www.sfwater.org/modules/showdocument.aspx?documentid=4131

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📋C. Examples of M&r Underfunding Risks:

13 pages 2 recommendations

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Additional Recommendations 2

Not linked to specific findings.

R1: conduct an audit of the Workers’ Compensation Division of the Department of Human Resources data gathering policies and procedures,

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R2: report to budget decisionmakers its findings of identified and quantified risks of injury created by deferred maintenance and repairs, and recommend appropriate modifications. So as budget funding tradeoff decisions are made, the Mayor and Board of Supervisors will know what portion of the City’s Workers Compensation liabilities (if any) arise from poorly maintained General Fund department capital assets. R:II.B.1b. The Controller should determine the additional time and manpower cost for the City Services Auditor staff to accomplish this audit and report and include a line item for this cost in its budget request for fiscal year 20172018. R:II.B.1c. To reduce the risk of injury to City employees, the Mayor should include in the proposed budget for fiscal year 20172018 this line item in the Controller’s budget request for an audit of Workers Compensation Division data gathering policies and procedures. R:II.B.1d. To reduce the risk of injury to City employees, and after review by the Budget and Legislative Analyst, the Board of Supervisors should approve this line item in the Controller’s budget request for an audit of Workers Compensation Division data gathering policies and procedures and include it in the approved budget ordinance for fiscal year 20172018. R:II.B.2a. The Controller should assist the City Administrator and the General Services Agency Environmental Health and Safety in developing procedures for periodic analysis of Hazard Logs to identify and quantify risks of injury created by deferred maintenance and repairs. R:II.B.2.b. To provide budget decisionmakers with pertinent information for making tradeoff decisions, the Controller should determine the additional time and manpower cost to develop procedures for periodic analysis of Hazard Logs to identify and quantify Maintenance Budgeting & Accounting Challenges for General Fund Departments 28 risks of injury created by deferred maintenance and repairs and include a line item for this cost in its budget request for fiscal year 20172018. R:II.B.2.c. To reduce the risk of injury to City employees, the Mayor should include in the proposed budget for 20172018 this line item in the Controller’s budget request to develop procedures for periodic analysis of Hazard Logs to identify and quantify risks of injury created by deferred maintenance and repairs. R:II.B.2.d. To reduce the risk of injury to City employees, and after review by the Budget and Legislative Analyst, the Board of Supervisors should approve this line item in the Controller’s budget request to develop procedures for periodic analysis of Hazard Logs to identify and quantify risks of injury created by deferred maintenance and repairs and include it in the approved budget ordinance for fiscal year 20172018. C. Examples of M&R Underfunding Risks (1) Street Trees and Urban Forest

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📋Part Vii: Improving Accounting and Reporting for Deferred Maintenance

59 pages 1 findings

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Findings & Recommendations 1 findings

F42: F:VII.2. The City does not have accounting and financial systems and processes Controller, in place to accurately determine and report the condition of its assets or Department of Public the extent of its deferred maintenance. Works, City Administrator, Director of the Capital Planning Program, Director of the Real Estate Division, General Manager of Recreation and Parks F:VII.3. The City’s capital assets shown in its financial statements may be Controller overstated because its use of straight line depreciation assumes a longer asset life span than is likely given the reducedlife impact of deferred maintenance. F:VII.4. Existing data show that maintaining assets extends asset life and is Controller, cheaper than prematurely replacing unmaintained assets. Director of Public Works, City Administrator, Director of the Capital Planning Program, Director of the Real Estate Division, General Manager of Recreation and Parks Maintenance Budgeting & Accounting Challenges for General Fund Departments 84

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📋Part Vi: Maintenance Policy Implications of Kicking the Can Down the Road:

5 pages 3 recommendations

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Additional Recommendations 3

Not linked to specific findings.

R2: the amount budgeted for Operating Cost and Maintenance Cost of that asset;

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R3: the reasons for any budgeted shortfall; and

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R4: the immediate and longterm consequences of any budgeted shortfall. R:V.4. In furtherance of transparency, accountability and the public’s right to know, GOBAC should prepare an annual report summarizing each General Fund department’s lifecycle Maintenance and Repair cost estimates report and a consolidated report for all General Fund departments. PART VI: MAINTENANCE POLICY IMPLICATIONS OF KICKING THE CAN DOWN THE ROAD: HIGHER COST, LOWER QUALITY, AND LESS RELIABILITY OF SERVICE

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