Minutes of the Health Commission Meeting
Tuesday, May 19,
1998, 3:00 p.m.
At 101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The regular meeting of the Health Commission was called to order by President Lee
Ann Monfredini, at 3:05 p.m.
2) APPROVAL OF MINUTES OF THE MEETING OF MAY 5, 1998
- Commissioner Debra A. Barnes
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
Taken: The Commission unanimously adopted the minutes of May 5, 1998.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner David J. Sanchez, Jr., Ph.D.)
(3.1) CHN - Request for retroactive approval of contract modification with
Asereth Medical Services in the amount of $2,670,000 for the provision of temporary
pharmacy personnel for the period of February 1, 1998 through January 31, 2000 for a total
contract amount of $3,000,000.
This item was postponed to a future meeting.
(3.2) PH-CHP&P-AIDS Office - Request for retroactive contract renewal with
UCSF AIDS Health Project, in the amount of $435,251, for the provision of HIV Counseling,
Testing, Referral and Partner Notification, for the period of January 1, 1998 through
December 31, 1998. (DPH contracted with UCSF for services totaling $13,848,952 during FY
Commissioner Sanchez abstained on this item due to conflict of interest.
(3.3) PH-CHP&P-AIDS Office - Request for approval of retroactive renewal
contract with California AIDS Intervention Training Center (CAITC), in the amount of
$136,015, for the provision of HIV prevention program targeting behavioral risk
populations, for the period of January 1, 1998 through December 31, 1998. (DPH contracted
with CAITC for services totaling $145,172 during FY 1996-97).
Commissioner Sanchez requested this contractor come back to the Budget Committee in 60
days (July 21, 1998) with a status report on any compliance issues in the monitoring
(3.4) PH-CHP&P-AIDS Office Request for approval of retroactive
renewal contract with Haight Ashbury Free Clinics, Inc. (HAFC) in the amount of $100,913,
for the provision of HIV prevention program targeting behavioral risk populations, for the
period of January 1, 1998 through December 31, 1998. (DPH contracted with HAFC for
services totaling $10,606,732 during FY 1996-97).
(3.5) PH-CHP&P-AIDS Office Request for approval of retroactive
renewal contract with Mission Neighborhood Health Center (MNHC), in the amount of
$120,491, for the provision of HIV prevention program services targeting behavioral risk
populations, for the period of January 1, 1998 through December 31, 1998. (DPH contracted
with MNHC for services totaling $794,025 during FY 1996-97).
(3.6) PH-CHP&P-AIDS Office Request for approval of retroactive
renewal contract with Stop AIDS Project, Inc. (SAP), in the amount of $230,321 for the
provision of HIV prevention program targeting behavioral risk populations, for the period
of January 1, 1998 through December 31, 1998 (DPH contracted with SAP for services
totaling $937,172 during FY 1996-97).
(3.7) PH-CHP&P-AIDS Office Request for approval of retroactive
renewal contract with Glide Foundation in the amount of $50,653, for the provision of HIV
counseling, testing, risk reduction and partner notification services, for the period of
January 1, 1998 through December 31, 1998. (DPH contracted with Glide for services
totaling $ 226,161 during FY 1996-97).
(3.8) PH-CHS-CSAS - Request for approval of retroactive sole source contract
renewal with Chemical Awareness and Treatment Services, Inc. (CATS) in the amount of
$58,171 in client fees to the Department to provide 30-month multiple offense /
driving under-the-influence, chemical dependency and poly-drug abuse treatment services
for the period of January 1, 1998 through June 30, 2001. (DPH contracted with CATS for
services totaling $2,566,823 during FY 1996-97).
(3.9) PH-CHS-CMHS - Request for approval of new contract with Pathmakers
of California, a mental health provider group, in the amount of $160,000, for the
provision of professional mental health services for the period of June 1, 1998 through
June 30, 1999.
(3.10) PH-CHS-CMHS Request for retroactive approval of contract
modification with Family Service Agency (FSA) in the amount of $100,000 for the period of
April 1, 1998 through June 30, 1998 to provide outpatient care to medically indigent and
Medi-Cal psychiatric clients. Total amount of contract including this modification is
$670,000. (DPH contracted with FSA for services totaling $4,422,837 during FY 1996-97).
Action taken: The Commission approved the Consent Calendar of the Budget Committee,
except for #3.1, with Commissioner Sanchez abstaining on #3.2.
4) DIRECTOR'S REPORT
(Provides information on activities and operations of the Department)
(Mitchell H. Katz, M.D., Director of Health)
The Governor released his annual May revision of the budget Thursday, May 14th.
Projected General Fund (GF) revenues are up by $4.21 billion over the original January
estimates. The revised budget includes $15.2 billion GF expenditures for Health and
Welfare programs, an increase of $121.3 million from the Governor's January budget
Of great concern is the Governor's proposal to reduce the Vehicle License Fee (VLF) by
75% over five years. The proposal would reduce the VLF by 50% effective January 1, 1999,
and again by 50% effective January 1, 2002. This would create a total estimated revenue
decrease of $6.6 billion over the five-year period. The proposal is opposed by the
Legislature's Democratic members, and is expected to be a major issue in budget
The VLF generates $3.9 billion annually in revenues that are constitutionally dedicated
to local governments. A percentage of VLF in combination with ½ cent sales tax revenues
provides funding for the State/Local Realignment Initiative. Annually, on a statewide
basis, approximately $63.8 million of VLF revenue is allocated for mental health services,
$765 million for health services and $13 million for social services.
In 1997-98, the Department is anticipated to receive a total of approximately $57.6
million from VLF: $53.8 million for health services and $3.8 million for mental health
services. These funds provide vital health services to vulnerable at-risk populations.
Moreover, the City and County of San Francisco General Fund receives approximately an
additional $130 million discretionary VLF funds, much of which benefit public safety. The
Department of Human Services receives approximately $351,000 in VLF.
The exact impact of the Governor's proposal is unknown at this time, since it is a
partial, phased-in reduction, and many of the implementation details have not been
disclosed. The Governor and Department of Finance say this proposal will not affect
counties because lost VLF funds will be replaced with State General Fund money, dollar for
dollar, and the current allocation schedule will remain in place.
However, this is not entirely reassuring because there is no constitutional guarantee
on the allocation of State General Fund (GF) for health and social services realignment
programs. State GF dollars are subject to annual legislative or administrative attempts to
divert the funds elsewhere. For example, if State GF are not provided and this proposal is
implemented January 1, 1999, the Department could potentially witness a $15 $20
million reduction in State revenues next fiscal year. In addition, there are many
unanswered questions, such as increased local reliance on the annual State budget process,
and greater vulnerability and diminished reliability of the State's GF as a source for
funding realignment programs. The Department will work closely with the Mayor's Office and
San Francisco's lobbyist in Sacramento to monitor this proposal and its impact on health
and mental health funding.
Following are summaries of other key health-related proposals:
An increase in $12.4 million State GF to eliminate the State's "take-back" of
county funds in the Medi-Cal Administrative Claiming Fund and the Targeted Case Management
Claiming Fund (MAA/TCM). In 1997-98, San Francisco's portion of the take-back is $1.4
million. In 1998-99, elimination of the take-back could result in a revenue increase of up
to $1.25 million for San Francisco.
Tobacco tax revenues are growing up $10 million for fiscal years 1997-98 and
1998-99. The May Revision proposes to allocate these funds to health education, county
health services, and research programs focused on reducing tobacco use, particularly among
youth and young adults. However, the California Healthcare for Indigents Program (CHIP)
continues to project a $4.6 million decrease in 1998-99. For San Francisco, this would
result in a decrease of $500,000 to $600,000. The Department will continue to monitor this
proposal and assess the fiscal impact on San Francisco.
The May revision includes full-year funding (for 1997-98) for pregnancy-related
services for undocumented immigrants as now required by court order. The Department is in
the process of determining the fiscal impact of this.
An increase of $36.1 million GF for mental health services to CalWORKs recipients to
correct and supplement the original budget of $9.1 million GF.
An increase of $14.5 million ($7.2 million GF) for the addition of smoking cessation
products to the Medi-Cal contract drug list.
The AIDS Drug Assistance Program: appropriates an additional $2.6 million in federal
Ryan White CARE Act funds; an increase of $4.7 million for addition of new drugs to the
ADAP formulary; and a net savings of $8.9 million due to increased efficiencies resulting
from centralization of pharmaceutical services offset by increased program utilization.
A 2.84% increase for a Cost of Living Adjustment (COLA) for SSI/SSP, however no
COLA is proposed for CalWORKs grants.
According to the State constitution, the legislature must pass the budget by June 15,
1997; the fiscal year begins on July 1, 1997.
Pregnancy-Related Services for Undocumented Residents
As you know, in early March 1998 the Los Angeles Superior Court issued an injunction in
the Milagro Doe case, which prohibited the State from implementing the regulations to
terminate State funding for pregnancy-related services for undocumented women. The State
subsequently filed a writ asking the California Appellate Court to overturn the
injunction, and on May 7, 1998, the Appeals Court issued a decision refusing to do so.
This means that the State is prohibited from terminating funding for several months -- at
least until the trial in this case is held, or until a further appeal is heard. The trial
is currently scheduled for November 1998.
Earlier this month, Governor Wilson unveiled a proposal to create a new Department of
Managed Health Care. You may recall that this was one of the major recommendations coming
from the Managed Health Care Improvement Task Force.
The new Department of Managed Health Care would focus solely on providing oversight to
the managed care industry. The Governor believes that this department will improve the
State's role in ensuring quality and affordable health care for those who have insurance.
In order to monitor health plan accountability, this new department would have a Division
of Consumer Services.
The Department of Corporations (DOC) is currently responsible for the administration,
enforcement, and regulation of health care service plans. In addition, the DOC oversees
commodities, securities and franchise investments, and lenders and fiduciaries. The
Governor's proposal would eliminate the Department of Corporations.
The lender and fiduciary programs of DOC would be consolidated into the Department of
Financial Institutions (DFI) which oversees banks, S&Ls, credit unions and industrial
loan companies. The DFI would be renamed the Department of Financial Services.
The reorganizations are scheduled to take effect on July 1, 1999.
University of California Breast Cancer Grant
I am proud to announce that the Community Health Epidemiology Section has been awarded
a one-year grant in the amount of $84,911 from the University of California, Breast Cancer
Research Program. The grant will provide for a half-time Project Coordinator and two
half-time Interviewers to be hired from the BVHP community. It will also provide
incentives to study participants and for a Project Research Assistant. The Principal
Investigator on the grant is Daramola Cabral Evins, DrPH, PA and included the
collaboration of coinvestigators Drs. Arthur Coleman from the BVHP Health Care Task Force
and Marion UCSF Department of Epidemiology and Biostatistics.
The purpose of this research is to determine why breast cancer mortality is higher in
African American women compared to whites, and what role inadequate follow-up care plays
in explaining these racial/ethnic disparities. This has been an issue voiced by the
African American community, and is of great concern to the Health Department.
Stop Red Light Running Campaign
The Emergency Medical Services Section released the results of a study that provides
new insight into the minds of red light runners. The study shows that most red light
runners regard themselves as good drivers and believe other red light runners are the
problem, not them. In fact, many don't regard themselves as red light runnerseven
after admitting to having run a red light more than once.
The findings are based on focus groups of San Francisco residents who admitted to
running a red light more than once. The focus groups, conducted in March 1998 as part of
the agency's Stop Red Light Running Campaign, were designed to get to the root causes of
the behavior. Other than a few overlapping habits and opinions, red light runners break
down into two distinct categories: distracted drivers and aggressive drivers.
Do nearly everything while driving, including eating, putting on make-up, daydreaming
and project planning.
Think other red light runners are the real problem.
Run red lights for lots of reasons, including speeding, afraid to stop because of
tailgaters, and, of course, not paying attention.
Have great animosity toward other drivers.
Believe drunk drivers are more likely to hurt someone than red light runners.
Run red lights for lots of reasons: "I'm in a hurry. I think I can gun the light
and make it." "I'm just there when it turns red," and "The yellow is
Don't feel bad about running red lights if there are no other cars around, such as at
night or early morning.
One startling difference is in the way the two groups viewed drivers involved in fatal
accidents. The distracteds were outraged at these drivers and believed they deserved
"jail time" because "a car is a weapon." The aggressives were more
sympathetic: "Everyone makes mistakes," and "The knee-jerk reaction would
be to condemn them but you can understand how it happens." Future campaign efforts
will be directed towards these groups of individuals.
San Francisco Housing Authority Session
At the request of the U. S. Department of Housing and Urban Development, the
Environmental Health Section prepared a half-day training workshop to staff of the San
Francisco Housing Authority. The specific purpose of the workshop was the provide training
and information on mold and mildew problems found in homes. The workshop brought in local
and guest presenters from areas of expertise which included indoor air quality, vector and
rodent biology, and general sanitation. Approximately 20 students participated in the
workshop conducted at the Housing Authority office on April 15th.
Pool Safety Training
In preparation for the swimming pool season, Environmental Health staff organized a
free training session for owners/managers/pool technicians May 12th at the Cathedral Hill
Hotel. The purpose of the training was to provide information on pool safety, sanitation,
and maintenance. Additionally, the workshop focused on the new State law requiring Ground
Fault Circuit Interrupters (GFCI) installation. This law was came about as a result of a
tragic pool death that occurred in San Mateo County last year involving a young girl
swimming in a pool that was not equipped with a GFCI device. The Department's Public
Information Officer is working with Environmental Health to develop a PSA advisory
alerting pool/spa owners of the new requirement.
Hazardous Waste Database
The Hazardous Waste Program is developing a database and mapping program to identify
the location and levels of contamination at known sites within the City and County of San
Francisco. This database will provide greater information to interested environmental and
business groups regarding the location of these contaminated sites. Presently, there does
not exist within the City a single source that provides this information. Two student
interns from Woster Polytechnic Institute in Massachusetts are developing this project.
The Interns will complete the project in approximately seven (7) weeks.
COMMUNITY HEALTH NETWORK
Department of Justice Findings Letter
The CHN Executive Staff in consultation with the City Attorney's staff has begun to
develop a response to the DOJ Findings Letter on Laguna Honda Hospital. Laguna Honda
Administrators have communicated factual information about the Findings Letter, to the
Board of Supervisors, the press, employees, union business representatives and volunteers.
A press briefing and tour of Laguna Honda was provided on May 7th. The Hospital has
received strong community support via a number of telephone calls received after the
release of the DOJ Findings Letter. The census and admissions at the facility remain
strong, which is an ongoing indicator of the community's confidence in the overall quality
of services provided. I will keep the Commission apprised of our progress on this
Annual Licensing and Certification Survey
The State Licensing and Certification Division and HCFA have requested additional
information about Laguna Honda's Plan of Correction to the 1998 Annual Certification
Survey that was submitted on May 8. The Hospital is continuing its dialogue with Licensing
and Certification and HCFA representatives and providing additional information to ensure
inter-agency collaboration. I will keep the Commission informed.
Hospice Unit Featured in AARP
In the May 1998 American Association of Retired Persons Bulletin (AARP), Laguna Honda
Hospital Hospice was featured in a three page report. The article described several
Hospice programs across the country, including Laguna Honda's 28-bed facility. Color
photographs of LHH's Hospice garden with a resident and caregiver was included in the
article. This nationally distributed newsletter praised the hospice concept and shed light
on this healthcare specialty. I commend all the staff at Laguna Honda Hospice for the high
quality service provided to the community.
LHH Celebrates Hospital Week
In honor of National Hospital Week, Laguna Honda hosted a number of events and
activities during the week of May 11-15. A staff and resident table tennis tournament was
held in Simon Auditorium as well as exercise and fitness classes taught by Drs. Rivero,
Stinson and Zoe Austin, P.T. The week culminated with a barbecue in Clarendon Valley for
residents, staff and volunteers followed by Laguna Honda Hospital Employee Night at 3 Com
Park where over 100 employees enjoyed watching the Giants play the Mets.
Nomination to the American Academy of Nursing
Anne M. Hughes, RN, NP, Clinical Nurse Specialist for HIV and Oncology at SFGH has been
nominated for membership in the American Academy of Nursing. The American Academy of
Nursing is an organization of 1200 distinguished leaders in nursing who have been
recognized for their outstanding contributions to the profession and to health care.
Anne is the immediate past president of a national nurse's organization, the
Association of Nurses in AIDS Care. She has been active in nursing and HIV/AIDS issues
since she came to SFGH in 1989. She believes that her nomination to the academy is also
recognition of the entire nursing services at the CHN/SFGH. I am sure you join me in
congratulating Anne on this well-deserved recognition.
Update on Health at Home
Health at Home, the department's home care agency has been experiencing exceptional
growth. Two hundred visits per month were being conducted in July 1997; today the volume
is 1500 visits per month with over 300 patients on service. The most common diagnoses
being treated by Health at Home include respiratory conditions, cardiac conditions,
cancers and HIV/AIDS.
CHN Patient Care Council
Mr. Wagner reports that Gene O'Connell and Dr. Melissa Welch (the CHN Director of
Patient Care Services and Chief Medical Officer, respectively), completed the final draft
of the CHN Patient Care Council which was approved by CHN Leadership on May 13, 1998.
The Patient Care Council (PCC) is the operational arm of the CHN. The Council will be
comprised of membership representatives from the entire CHN Continuum of Care: the UCSF
Dean's Office, DPH Public Health Division, CHN Quality and Utilization Management, the
Consortium Clinics, and the Office of Integrated Care (TBD).
CHN Presentation at City-Wide Community Advisory Board
CHN Leadership was invited to the meeting of the City-Wide Community Advisory Board for
the community clinics on May 13, 1998. Mr. Wagner provided a status report on the
reorganization of the CHN and offered his vision and goal for the Network to be the best
public health delivery system in the country. Dr. Melissa Welch explained her role as the
CHN Chief Medical Officer and described the function of the CHN Patient Care Council.
Reports from representatives of advisory boards to individual clinics were also presented.
April statistics are available in the Commission Office.
Commissioners Chow and Guy requested a presentation of the Stop Red Light Running
Program. Data and public education issues should be highlighted.
Commissioner Barnes encouraged the Department to bring a well thought out plan to the
voters for the Laguna Honda Hospital ballot initiative.
On behalf of the Commission, President Monfredini expressed unanimous strong support
for a Laguna Honda Hospital bond.
Commissioner Parker inquired on the Department's capacity to provide health promotion
and prevention regarding AIDS.
Commissioner Sanchez commended the Department for the data and statistics provided to
Dr. Katz acknowledged Diane Miller's work on these monthly reports.
5) CONSIDERATION OF A RESOLUTION CREATING AN EMPLOYEE RECOGNITION PROGRAM FOR
DEPARTMENT OF PUBLIC HEALTH EMPLOYEES
At the request of President Monfredini, Dr. Katz presented the Department's plan for an
Employee Recognition Program:
DPH agrees with the Commission that a Department-wide employee recognition program
should be developed recognizing outstanding performers at all staffing levels. The plan
should include those working with patients, as well as those individuals who work behind
The program should select awardees that unite DPH programs and encourage teamwork. We
want to make sure we are rewarding our top "assist" players as will as our top
"scorers". The award should be both formal, at the Commission level, and
informal, recognizing the winner in front of everyone at the job site, peers,
subordinates, consumers and bosses.
Recognition shouldn't be confused with incentive programs. Recognition draws attention
to employees who perform. Incentive programs use techniques to induce people to achieve a
specific objective. Research shows that although incentives are effective in motivating
employees, that the simple act of recognizing people as individuals is essential for long
Many recognition programs in the City have come and gone because there was not a
commitment from management. DPH is committed to the creation of an employee recognition
program for the long haul. This is a time of great change in the Health Care industry. The
new employee recognition program will be a nice way to show appreciation to our front line
We have discussed the desired objectives of an employee recognition program and
strongly believe that the program's objectives should support DPH's vision and goals. The
purpose of the employee recognition program is as follows:
- To say thank you to an outstanding employee or team of employees for their exceptional
work and service.
- To recognize those employees who exhibit excellent performance in fulfilling their jobs
- To communicate a focused message to the rest of the Department, highlighting results.
Nomination forms will be available at the Department's Human Resource offices.
Supervisors and managers may nominate an outstanding employee, a team of employees, or
individuals may nominate themselves. To be considered for nomination an employee or team
of employees must display success in at least four of the following areas:
- Outstanding on-the-job performance in carrying out day-to-day duties and
- Employees who deserves special recognition for the work they perform on behalf of our
clients, or the public. This may be noted by management, or in letters written by
consumers in appreciation of exceptional service.
- Development of an innovative idea or suggestion resulting in a change of service
delivery or a cost savings.
- Improvement in individual or team work methods resulting in timesavings, workflow or
general safety improvement.
- Development of a program whose main intent is to provide a particularly innovative or
needed service to the public that has the by-product of shedding positive light on public
health. (i.e.: something like the SFGH Tattoo removal program)
- Ability to work with other employees and assist wherever needed or requested.
- An employee who is always dependable and follows through with assignments without
prodding or reminders.
For the first few months, managers will be responsible for getting the word out to all
employees in each Division. Human Resources will be the coordination point for the
Department and will distribute a flyer with a nomination form attached. This will be
posted on all bulletin boards at job sites. In addition, the Director will announce and
publicize the program in his biweekly e-mail newsletter, "Fast Facts from Dr.
The Commission directed Dr. Katz to operationalize this program, with input from the
- It should be the discretion of the selection committee on the number of awardees each
- Reliability, instead of dependability, should be emphasized.
- Avoid "popularity" contests.
- Teamwork as well as individuals, can be recognized.
- A frontline employee should be involved in the selection process.
- Selection process should be even-handed and democratic.
- Eliminate the phrase "without prodding or reminders."
Action Taken: The Commission unanimously adopted Resolution #21-98, "Supporting
the Development and Implementation of a Department of Public Health Employee Recognition
Program, (Attachment A).
6) TIME SPECIFIC: 4:00 P.M.
PUBLIC HEARING, IN ACCORDANCE WITH THE HEALTH CARE PLANNING ORDINANCE (PROPOSITION Q,
1988), TO CONSIDER THE IMPACT OF THE FOLLOWING CHANGE OF HEALTH CARE SERVICES OF THE
COMMUNITY AT ST. MARY'S MEDICAL CENTER, 450 STANYAN, SAN FRANCISCO, CA:
CLOSURE OF THE OBSTETRICS PROGRAM AT ST. MARY' MEDICAL CENTER
Rosemary Fox, Vice President/Chief Operating Officer, presented this information:
After careful evaluation and consultation with our medical leadership, the decision was
made to discontinue the Obstetrics Inpatient Service at St. Mary's.
Since reopening the unit in August 1996, there has been an average of approximately 120
deliveries a year. The national market standard for a quality OB impatient program is
approximately 2000 births per year. Despite numerous initiatives to increase obstetrics,
volume deliveries have not shown growth. Maintenance of a small service such as ours,
makes recruitment and retention of staff, as well as maintenance of the skills, very
Our operating losses for the 18-month period that the program was in service were
greater than $2 million, and an additional capital investment of $2-3 million would have
been required by the end of 1998 under OSPHD guidelines.
Several market factors also contributed to the decision to close the unit: declining
child-age bearing population in San Francisco, consumer expectations for full service
obstetric services, and an inability to recruit OB/GYN practices. St. Mary's will retain
its prenatal and postpartum services on an outpatient basis, and parenting classes will
continue through our WomanKind Program.
Our OB physicians enjoy medical staff privileges at California Pacific Medical Center,
St. Luke's, UCSF, and our sister hospital, Seton Medical Center in Daly City. Ambulatory
OB and prenatal services will be continued while deliveries occur at these other
Fortunately, we were able to offer positions at our Catholic Healthcare West facilities
to all the nursing staff.
President Monfredini inquired about St. Mary's Board support for this closure and the
availability of counseling for future mothers transitioning to another hospital.
Commissioner Chow inquired about the care of indigent patients.
Commissioner Guy requested a letter indicating St. Mary's commitment to serve indigent
patients and indicating its public responsibility.
After Ms. Fox indicated the unit is presently closed due to lack of staffing and
concern for quality of care, President Monfredini expressed disappointment on St. Mary's
and Catholic Healthcare West's lack of compliance to this Proposition Q hearing. She
encouraged Ms. Fox to have the CEO of Catholic Healthcare West present at the June 2, 1998
Commissioners requested information on what actually has been done regarding this
closure, what patients have been told, and what has been the disposition of patients and
President Monfredini continued the public hearing of this item to June 2, 1998. At the
subsequent meeting of June 16, 1998, a determination will be made by the Commission.
Later in the meeting, President Monfredini informed our Deputy City Attorney Paula
Jesson, about the non-compliance of St. Mary's Hospital on Proposition Q. A letter from
the Commission will be sent to St. Mary's Medical Center documenting its non-compliance to
Proposition Q procedures.
7) TIME SPECIFIC: 4:30 P.M.
CONTINUATION OF A PUBLIC HEARING, IN ACCORDANCE WITH THE HEALTH CARE PLANNING ORDINANCE
(PROPOSITION Q, 1988), TO CONSIDER THE IMPACT OF THE FOLLOWING CHANGE OF HEALTH CARE
SERVICES IN THE COMMUNITY FROM DAVIES MEDICAL CENTER:
DAVIES MEDICAL CENTER (DMC) HAS SIGNED A LETTER OF INTENT WITH CALIFORNIA PACIFIC
MEDICAL CENTER (CPMC) AND SUTTER HEALTH FOR THE ACQUISITION OF DAVIES MEDICAL CENTER BY
CALIFORNIA PACIFIC MEDICAL CENTER
President Monfredini abstained from participating in this issue due to conflict of
Vice President Sanchez presided over this item. Greg Monardo, CEO of Davies Medical
Center, and Dr. George Lee, representing California Pacific Medical Center CEO Martin
Brotman, M.D., made presentations on more information requested from the Commissioners.
Legal Counsel from Sutter Health, Bill Aseltine, responded to legal issues.
Supporting the Acquisition:
- Robert Reichert, Davies patient
- Dione Bowers, Davies patient
- Samuel Crocker, Davies volunteer
- Opposing the Acquisition:
- Frederick Hobson, SF Tomorrow Board of Directors
- Phyliss Tunson, Davies employee
- Marcy Fraser, individual
- Sal Rosselli, President of Local 250, SEIU
- Carla Woodworth, California Physicians Alliance
Commissioner Parker stated that the labor issues should be resolved prior to a Health
Commission decision. He would consider consumer support, future provision of charity care,
and the long-range goals of Sutter Health and CPMC. He also is interested in why Davies
did a turnabout with CPMC after Davies sued CPMC.
Commissioner Chow requested a copy of Attachment 1, referred to in the CPMC Board
resolution. He also wants to know the level of charity care, a better picture of which
services will continue, and the commitment to skilled nursing beds given our Laguna Honda
Commissioner Guy stated the Commission is not receiving complete information; and the
governance question in relation to the role of Sutter Health needs to be answered.
Commissioner Sanchez requested more information on the Board of Trustees and a copy of
the plan for this acquisition. He stated it is the civic duty and responsibility of the
Health Commission to conduct a Proposition Q hearing in a public forum. The information
given to the Commission thus far raises more questions for further information.
Commissioner Barnes' priority is to continue the services and to represent the
interests of the residents of the City and County of San Francisco. It is still unclear as
to which party(ies) have the ultimate decision-making authority. She requested further
financial and governance structure information and a copy of any affiliation agreement.
She also encouraged more information to employees and that more discussions with employees
Dr. Lee explained the governance structure, emphasizing that CPMC will be the
decision-maker at the local level. He pointed out that Sutter Health is the parent
organization and that there is no plan to decrease services at Davies Medical Center.
Mr. Monardo submitted to the Commission tax information requested from Local 250.
Vice President Sanchez stated this item will be on the agenda for June 2, 1998.
8) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH COLLABORATIVE EFFORTS WITH THE SAN
FRANCISCO SCHOOL DISTRICT
Due to the lateness of the hour, the Commission continued this item to a future
9) PRESENTATION OF THE RECOMMENDATIONS FROM THE MAYOR'S BLUE RIBBON COMMITTEE FOR
UNIVERSAL HEALTH CARE
Tangerine Brigham, Director of Policy and Planning, presented the report from the
Mayor's Blue Ribbon Committee on Universal Health Care. See Attachment B.
President Monfredini acknowledged the excellent work of Ms. Brigham and how proud the
Commission is of her work with the Mayor's Blue Ribbon task Force. President Monfredini,
Vice President Sanchez, and Commissioners Guy and Parker attended this morning's Mayor's
press Conference where Dr. Sandra Hernandez presented the Report for Universal Health
Commissioners Guy, Barnes and Chow expressed concerns on the impact on the public
safety net, the Department, and incentives for employers and small businesses.
Because of the importance of this subject and the need to have public comments on the
report, President Monfredini continued this item to the June 2, 1998 Commission meeting.
She encouraged Commissioners to call Ms. Brigham with questions.
Commissioner Chow requested the Department to present to the Commission the impact of
the plan on the public safety net and related problems in carrying out the Department's
Public Speaker: Frederick Hobson, SF Health Authority
10) OTHER BUSINESS/PUBLIC COMMENTS
The meeting was adjourned at 6:40 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission