Minutes of the Health Commission Meeting
Tuesday, December 7, 1999
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.
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Ron Hill
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF NOVEMBER 2, 1999
Action Taken: The Commission unanimously adopted the minutes of November 16,
1999, with the correction of a typographical error on the name for Dr. William Goodson,
President of the S.F. Medical Society.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
(3.1) Update from Bayview Hunters Point Foundation on requests from the Health
Department of Public Health staff, Barbara Garcia and Michelle Dixon, provided updates
on the contractors organizational development plan and the HIV services contract.
Due to the late submission of the response to the monitoring report for the HIV contract,
another site visit will be rescheduled. An update on both the organizational development
plan and the HIV services contract will be provided in March 2000.
Karen Patterson Matthew, Executive Director of Bayview Hunters Point Foundation,
reported the organization will be able to make the recommended short-term and long-term
changes, as put forward by the Support Center consultants.
(3.2) CHN-Office of Managed Care Request for approval of a new service
agreement between the Department of Public Health and Beech Street Corporation, the
preferred provider organization (PPO) engaged by the Health Service System for City Plan 1
enrollees commencing November 1, 1999 and automatically renewable each year.
(3.3) PHP-CHSS-TB Control Request for approval of retroactive contract
renewal with the Regents of the University of California San Francisco (UCSF) at San
Francisco General Hospital (SFGH), in the amount of $227,435, to provide physician and
radiologist services at the SFGH Tuberculosis Control Ward, for the period of July 1, 1999
through June 30, 2000. (DPH contracted with UCSF for services totaling $7,888,724 during
Commissioner Sanchez abstained on this item due to conflict of interest.
(3.4) PHP-CHSS-TB Control Request for approval of sole source contract
renewal with the Regents of the University of California San Francisco (UCSF) in the
amount of $2,711,327, to provide Model Tuberculosis Prevention and Control Center services
to local and national TB health care providers, for the period of December 31, 1999
through March 31, 2001. (DPH contracted with UCSF for services totaling $7,888,724 during
Commissioner Sanchez abstained on this item due to conflict of interest.
(3.5) CHN-Medical Records/Radiology Request for approval of multi-year
contract renewal with Bay Area Medical Transcription (BAMT), in the amount of $250,000, to
provide medical transcription services for the Community Health Network, for the period of
December 1, 1999 through June 30, 2001. (DPH contracted with BAMT for services totaling
$135,000 during FY 1998-99).
(3.6) CHN-Medical Records/Radiology Request for approval of multi-year
contract renewal with Mediscript, in the amount of $75,000, to provide medical
transcription services for the Community Health Network, for the period of December 1,
1999 through June 30, 2001. (DPH contracted with Mediscript for services totaling $25,000
during FY 1998-99).
(3.7) CHN-Medical Records/Radiology Request for approval of multi-year
contract renewal with Transcription Stat (TS), in the amount of $250,000, to provide
medical transcription services for the Community Health Network, for the period of
December 1, 1999 through June 30, 2001. (DPH contracted with TS for services totaling
$145,000 during FY 1998-99).
(3.8) PHP-Policy and Planning Request for approval of retroactive new
contract with Northern California Coalition for Immigrant Rights in the amount of $60,000,
to provide outreach services to public charge clients, for the period of November 1, 1999
through June 30, 2000.
(3.9) PHP-HIV Research Request for approval to accept and expend funds in
a new four year performance agreement from the Public Health Foundation Enterprise, Inc.,
in the amount of $211,587 (for the first 12 month budget period), to conduct a preventive
HIV vaccine phase-three efficacy trial in adults at-risk for HIV infection, for the period
of September 30, 1999 to September 30, 2003.
(3.10) PHP-CSAS Request for approval to accept and expend a new grant
from the Center for Substance Abuse Treatment (CSAT) Substance Abuse and Mental Health
Services (SAMHSA) in the amount of $246,423, to develop a Community-Based Practice
Research Collaborative, with a sole source contract in the amount of $25,000 to San
Francisco State University, and a sole source contract in the amount of $25,423 to the
University of California San Francisco, for the period of October 1, 1999 to September 30,
Commissioner Sanchez abstained on this item due to conflict of interest.
(3.11) PHP-CSAS Request for approval of retroactive contract renewal with
Horizons Unlimited, in the amount of $4,342,236 or $1,085,599 per year, to provide day
treatment, outpatient and substance abuse prevention services to youth and young adults of
the Latino population, for the period of July 1, 1999 through June 30, 2000.
contracted with Horizons for services totaling $1,212,673 during FY 1998-99).
Department of Public Health staff Jim Stillwell reported a positive progress by the
staff and Board of this agency.
Commissioner Hill is recommending this contract be renewed for one year, instead of
(3.12) PHP-CSAS Request for approval of retroactive contract renewal with
Women and Childrens Family Services, Inc. (WCFS), in the amount of $1,893,470, to
provide residential and outpatient substance abuse services to alcohol/drug addicted
women, targeting low income pregnant and postpartum women, their children, their families
and/or significant others, for the period of July 1, 1999 through June 30, 2000.
contracted with WCFS for services totaling $2,061,586 during FY 1998-99).
(3.13) PHP-CMHS Request for approval of retroactive contract renewal with
Saint Francis Memorial Hospital (SFMH), for the provision of 24-hour acute psychiatric
inpatient hospital services, in the amount of: 1) $156,498 in City funds targeting
uninsured adults; and 2) as part of a network of six hospital providers for $5,000,000 in
Medi-Cal funds, for the period of July 1, 1999 through June 30, 2000. (DPH contracted with
SFMH for services totaling $196,498 during FY 1998-99).
Commissioner Umekubo abstained on this item due to conflict of interest.
(3.14) PHP-CMHS Request for approval of retroactive contract renewal with
Saint Marys Medical Center (SMMC) for mental health services, in the amount of: 1)
$320,000 in City funds targeting uninsured adolescents; and 2) as part of a network of six
hospital providers for the provision of inpatient hospital services targeting
adult beneficiaries for $5,000,000 in Medi-Cal funds, for the period of July 1, 1999
through June 30, 2000. (DPH contracted with SMMC for services totaling $2,337,412 during
Commissioner Umekubo abstained on this item due to conflict of interest.
(3.15) PHP-CMHS/CSAS Request for approval of retroactive contract renewal
with Walden House, Inc., in the amount of $6,834,982, to provide residential mental health
and substance abuse treatment for the period of July 1, 1999 through June 30, 2000.
contracted with Walden House for services totaling $8,383,220 during FY 1998-99).
Commissioner Sanchez requested, for the future, an evaluation of the Treasure Island
programs provided by this contractor.
(3.16) PHP-CMHS Request for approval of retroactive contract renewal with
Westside Community Mental Health Center, Inc. (WCMHC), in the amount of $5,609,338, to
provide mental health services, for the period of July 1, 1999 through June 30, 2000.
contracted with WCMHC for services totaling $13,932,678 during FY 1998-99).
Commissioner Umekubo pointed out an error in the reporting on the number of crisis
clinic patients served by the contractor.
(3.17) PHP-CMHS Request for approval of retroactive contract renewal with
Edgewood Center for Children and Families, in the amount of $1,683,245, to provide mental
health services targeting children and adolescents, for the period of July 1, 1999 through
June 30, 2000. (DPH contracted with Edgewood for services totaling $1,396,872 during FY
(3.18) PHP-CMHS Request for approval of retroactive contract renewal with
Progress Foundation, Inc. (PFI), in the amount of $6,726,476, to provide mental health
residential treatment and other mental health services to adults, for the period of July
1, 1999 through June 30, 2000. (DPH contracted with PFI for services totaling $6,166,045
during FY 1998-99).
(3.19) PHP-CMHS/CSAS Request for approval of retroactive sole source
contract renewal with San Francisco State University (SFSU), in the amount of $150,703, to
provide mental health foster care training and substance abuse counselor training
services, for the period of July 1, 1999 through June 30, 2000. (DPH contracted with SFSU
for services totaling $179,716 during FY 1998-99).
(3.20) PHP-CMHS Request for approval of retroactive contract modification
with Seneca Center to increase the contract by $513,177, for a total contract amount of
$1,193,413, to provide mental health residential treatment services targeting seriously
emotionally disturbed adolescents, for the period of July 1, 1999 through June 30, 2000.
(DPH contracted with Seneca for services totaling $1,415,406 during FY 1998-99).
(3.21) PHP-CMHS Request for approval of retroactive new multi-year
contract with Instituto Familiar de la Raza, Inc. (IFR), in the total amount of $4,144,128
or $1,036,032 per year, for the provision of mental health services targeting adolescents
and youth, for the period of July 1, 1999 through June 30, 2003. (DPH contracted with IFR
for services totaling $4,526,738 during FY 1998-99).
(3.22) PHP-CMHS Request for approval of retroactive contract modification
with California Pacific Medical Center (CPMC), as a provider within the San Francisco
Mental Health Plan, for the provision of outpatient mental health services for the period
of July 1, 1999 through June 30, 2003. (This contract is part of the $3.3 million Mental
Health Managed Care outpatient plan).
(3.23) PHP-CMHS-MIS Request for approval of new sole source contract with
Echo Consulting Services of California, Inc., in the amount of $224,059, to provide
software licensing and maintenance services for INSYST, for the period of November 1, 1999
through June 30, 2000, as a result of a contract assignment from United Behavioral Health
to Echo Consulting Services.
Commissioner Hill complimented Department of Public Health staff on the progress to
decrease the number of retroactive contracts; however, more improvement needs to continue.
Commissioner Guy pointed out for #3.12 the need for Board development and an
appropriate number of Board members.
Commissioner Sanchez stated the need for all contractors to comply with these standards
for Boards of Directors.
Action Taken: The Commission approved the Consent Calendar of the Budget
Committee, with the specific recommendations.
- Commissioner Guy abstained on #3.10 and #3.19 due to conflict of interest.
- Commissioner Sanchez abstained on 3.3, #3.4 and #3.10.
- Commissioner Umekubo abstained on #3.13 and #3.14.
On behalf of the Commission, President Monfredini made a special presentation to Ben
Gale, who is leaving after 12 years as our Director of Environmental Health to become the
Director in Santa Clara County. Mr. Gale managed both the Consumer Protection and Toxics
4) DIRECTORS REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department).
States Supreme Court Ruling On Indigent Care
In late November, the California Supreme Court ruled that counties must continue to
provide essential medical care for residents who cannot afford to pay for those services
themselves. As you recall, the case concerned Sacramento Countys decision to reduce
or eliminate health care for some low-income residents. Sacramento County had proposed
that residents who received General Assistance or those who did not quality for other
welfare programs would only be eligible for free emergency medical care.
The court declined to define precisely "subsistence medical care" but stated
that, at a minimum, a county must provide "medical services necessary for the
treatment of acute life-and-limb threatening conditions and emergency medical
conditions." The ruling reaffirms the need to maintain a health care safety net for
low-income individuals. The ruling also stresses that the Legislature previously
eliminated requirements that counties provide the same quality of health care to residents
who cannot afford to pay for those services as non-indigent individuals receiving health
care services in private facilities. Finally, the Supreme Court indicated that if a county
chooses to determine a financial eligibility standard for county health services, it must
consider "whether implementation of the standard would leave some residents who are
incapacitated by age, disease or accident, and whose condition is not relieved through
other means without subsistence medical care."
We are pleased that the California Supreme Court reversed the judgement of the Court of
Appeals and reaffirmed that counties are the providers of last resort.
As the Health Commission may be aware, Congress has approved the federal budget. A
significant impact to the Department is the Balanced Budget Refinement Act of 1999 (BBRA).
The Balanced Budget Act of 1997 proposed sweeping reductions in critical health care
funding for safety net providers such as DPH. While the BBRA primarily focuses on
restoring Medicare reductions, there are a number of revisions that affect Medicaid
funding. Highlights of the Balanced Budget Refinement Act of 1999 include the following:
Permanent extension of the disproportionate share hospital transition rule for
Californias public hospitals. As a result, California public hospitals will be able
to calculate their hospitals specific caps at 175% of unreimbursed
uninsured expenses. This provision was critical to ensure that California maintains its
disproportionate share funding.
The sunset date for states to spend $500 million for Medi-Cal outreach and enrollment
has been removed. The 1996 Welfare Reform Act provided these funds for states to ensure
that individuals leaving welfare would retain their Medicaid coverage. These funds were
due to sunset at the end of this year. It is our understanding that California has spent
between one-third and one-half of its $80 million allocation for this purpose.
The phase out of cost-based reimbursement for federally qualified health centers has
been extended. The Balanced Budget Act phased out the Medicaid requirement that States pay
FQHCs on the basis of cost. The phase out was due to begin in 2000 when States would be
required to pay on 95% of reasonable cost, and then by 2004, the requirement would be
repealed all together. The 1999 BBRA extends the 95% requirement through 2001-02 and
indicates that a study will be conducted to determine an appropriate rate structure for
FQHCs after 2004.
In addition, the Labor -- HHS Appropriations Act includes $25 million in SID money for
the Healthcare Access for the Uninsured Initiative. These funds will help improve the
coordination of safety net providers who serve the uninsured, as well as filling in
service gaps. This bill also includes $15 million as a grant program to States to develop
programs and approaches for expanding health insurance coverage for the uninsured.
While we are quite pleased with the adjustments to the Balanced Budget Act. Next year
the Department of Public Health in concert with other public hospitals, health advocates
and providers will advocate for freezing further Medicaid disproportionate share hospital
reductions given that this was not a part of the Balance Budget Refinement Act of 1999.
In addition to these budgetary changes, last month the President signed the Work
Incentives Improvement Act, which expands access to health care for people with
disabilities. This is particularly critical for individuals with disabilities who wish to
re-enter the labor force but have difficulty doing so because of preexisting conditions.
The Legislative Analyst Office (LAO) recently released a report providing projections
of general funds, revenues and expenditures for the current fiscal year go through
2004-05. The California economic outlook is quite good. It is estimated that this fiscal
year 1999-00, the States year-end reserve would be over $2.6 billion. This is
significantly more the estimated $881 million that was proposed earlier this year for the
States year-end reserve. The significant revenue will trigger further reductions in
vehicle license fees. As the Health Commission is aware, a portion of vehicle license fees
is used to fund realigned health, mental health and social services.
The Legislative Analyst Office projects that Medi-Cal benefits will increase on average
6% annually mainly due to increases in rising health care costs. CalWORKs spending
is projected to decline in 2000-01. With respect to Medi-Cal and CalWORKs, this year will
be the first time that most families and children enrolled in Medi-Cal will not be welfare
recipients. The Legislative Analyst Office projects that this trend will continue such
that "almost all of the decline in welfare caseload will be offset by an increase in
the number of Medi-Cal" families and children who are not on welfare. The Governors
proposed fiscal year 2000-01 budget will be released around January 10, 2000.
State Children and Families Commission
Proposition 10 revenues will total approximately $700 million in 1999. Of this, $560
million will be distributed to counties (subtracting the States 2% share). San
Francisco has received its first Prop 10 payment of $5.6 million, representing amounts due
from January 1999 through August 1999 and interest thereon. Hereafter, Prop 10 payments
will be made to counties on a monthly basis.
On November 5th, the State Commission staff convened a meeting of
"large" counties including San Francisco, to create an opportunity for
networking between local Commissions and to present the State Commission's media strategy.
Though San Francisco is considered a small county in terms of the distribution of Prop 10
funds, we were invited to attend due to San Franciscos status as a major media
The State plans to fund pilot or demonstration projects in counties identified among
the States top ten priority areas. These pilot projects will be funded out of the
States 2% of the Prop 10 funds and it is anticipated that they will help mitigate
some critique from the media regarding the delay in implementing county programs. To date,
there has been no expenditure of Prop 10 funds as the only county that has completed its
plan is Alameda County and it has only done so very recently.
The State has scheduled another meeting for December 17th in San Francisco.
This meeting will be a workshop for local commissions to discuss and devise strategies to
communicate the mission and programs of Prop 10 locally.
Local Children and Families Commission
The Early Childhood Interagency Council will be nominating members to a Strategic
Planning Advisory Committee that will conduct the bulk of the planning activities with
staff. Included in their charge will be the implementation of a civic engagement project.
Housed at Starting Points, the civic engagement project will gather community voices,
including those most difficult to reach: parents and other caregivers, to ensure that
community input remains an integral part of all phases of the planning process. The
planning process is scheduled to be completed in the spring of 2000 in order to be
compliant with the State Commissions timeline for accessing funds.
For more information, San Franciscos Children and Families Commission website is www.sfprop10.mocyf.org. The website of the State
Commission is www.ccfc.ca.gov.
SRO Hotel Fire
A two-alarm fire broke out at the Western Hotel, 335 Leavenworth Street late in the
evening November 26th displacing residents. The Red Cross responded to the
residential hotel fire shortly after midnight with representatives of the Health
Department, Office of Emergency Services, Department of Human Services and the Mayors
Homeless Office also on the scene. This particular hotel had a sprinkler system, so damage
to the building was contained to one unit. Due to an electrical outage, smoke and water
damage, residents were unable to return to their units. Approximately 40 residents were
displaced. A temporary shelter was established at the Recreation Center located at 6th
and Folsom, and fire victims were moved to the shelter by MUNI. Residents were able to
return to their rooms three days after the fire when the damage had been assessed
and the power was restored.
Y2K Plan Update
The Department has issued to the Health Commission its quarterly status report for Y2K
Compliance for the period ending November 30, 1999. In this report, we note that staff
continues to work with the Citys Y2K Program Management Office to insure
coordination of contingency planning and Y2K readiness. In the past quarter, the
Department staff participated in several external Y2K efforts. These included
participation at a Board of Supervisors hearing on the Citys Y2K plans, a
planning conference convened by the Mayors Office, and a focused training effort
with the Citys Office of Emergency Services to review and finalize Y2K related
emergency operational planning.
As you know, a complete inventory and assessment of all of our MIS, medical and
facility equipment and systems was conducted. I am very pleased to report that 100% of our
mission critical systems and equipment has been tested as compliant or successfully
remediated as of this date. Our supplies and distribution systems have been assessed as
compliant, and we have planned for delivery or additional supplies for the millennium
events. Finally, we have developed contingency plans and have developed appropriate back
up procedures in the event of an emergency resulting from Y2K failures, either within DPH,
or elsewhere in the City.
In summary, DPH has completed a significant process in order to eliminate or minimize
disruption from the Y2K millennium event. Significant technical and professional resources
have been allocated to the compliance effort and the Department will continue to consider
this area a high priority. Full completion of our Y2K compliance plan indicates that DPH
is well prepared to insure continued uninterrupted business operations though the
millennium event and beyond. As the millennium approaches the Department will continue to
monitor its compliance and enhance its readiness procedures to insure optimal response to
this historic event. The Department will schedule a final Y2K project closure update for
the Health Commission in the weeks following the millennium event.
I am attaching a copy of the quarterly status report for your review.
COMMUNITY HEALTH NETWORK
State Licensing & Certification Team Returns to LHH
On December 6th, a team of State Licensing & Certification Surveyors
arrived unannounced at Laguna Honda to conduct a resurvey and verification of a Plan of
Correction submitted December 3rd. The survey team announced it would be at
Laguna Honda through December 8th. I will advise the Commission of the outcome
of the resurvey as soon as the results are available.
U.S. Department of Justice Representative Visits LHH
A representative of the U.S. Department of Justice is visiting Laguna Honda today as
part of its ongoing investigation concerning the civil rights of residents. The Hospital's
Leadership Team and legal council from the City Attorney's Office are conferring with the
DOJ representative. I will keep the Commission apprised of any new information that may be
forthcoming as a result of this week's DOJ visit.
POPULATION HEALTH AND PREVENTION
Asthma Training Report
The Primary Care section of the CHN, the Childrens Environmental Health section
of Population Health and Prevention, the American Lung Association, UCSF, SFHP and various
pharmaceutical companies teamed up to present a series of trainings entitled "Asthma
in the Primary Care Setting". Workshops were held at Ocean Park, SFGH, Maxine Hall
and Chinatown Health Centers with over 400 physicians, nurses, respiratory therapists and
other health providers attending. The workshops were geared towards primary care providers
of asthmatics with the major feature being the review of the National Institute of Healths
latest guidelines and standards of care for asthma treatment. We were fortunate to have
Stephen Lazarus, Susan Janson, and Homer Boushey as presenters from UCSF, as well as our
internal SFGH experts, Rajeev Venkaya, Kevin Coulter and Karen Smith from Excelsior
We recently surveyed and assembled data on the oral health status of San Franciscos
low-income children, as well as the availability of treatment services for the low-income
population. We sent out surveys to all agencies serving the dental needs of this
population and received information back from most of these agencies. Most of the
screening data was collected by our own DPH staff who regularly screen children in schools
in an effort to track community needs and help access these children to needed services.
We know that 46 percent of low-income elementary school and 18 percent of low-income
preschool children have untreated tooth decay. As a result, we are targeting these age
groups for increased prevention efforts.
In the future we will perform a quality needs assessment that looks closer at the adult
population, where we currently have little information. I am attaching a copy of the
report for your review.
Effective December 1, 1999, the STD Clinic will begin utilizing GCLCX to diagnose
pharyngeal gonorrhea in clients who report more than one receptive oral sex encounter in
the past two weeks. A study was done with 202 men seen in the STD Clinic who reported
having receptive oral sex to compare the efficacy of GCLCX with GC culture. The results of
the study indicated that 10% of these men were positive for GC using the GCLCX test
compared to 4% using the GC culture.
On November 16th, the STD Program held a community forum for Men who have
Sex with Men (MSM) to discuss STDs and their impact on MSM in San Francisco. The forum
included a presentation on the epidemiology of STDs and another on proctitis, genital
ulcer disease and urethritis. Translators were available for attendees who were hearing
The Community Health Promotion and Prevention Branch has been awarded a Pedestrian
Safety Program grant from the State Office of Traffic Safety. The grant will fund data
linkage and surveillance efforts, to provide the data needed to design interventions to
reduce injury to pedestrians, and community capacity building, to involve residents and
agencies in improving pedestrian safety.
Adolescent Health in San Francisco
I am pleased to provide the Commission with two new reports regarding the health of
children and youth. "A
Snapshot of Adolescent Health in San Francisco", developed under the auspices of
the Adolescent Committee of the DPH Coordinating Council for Children, Youth and Families,
provides an overview of key health and socioeconomic indicators for San Francisco's young
The second report, "The
Health and Well-Being of San Francisco's Unified School District Students, K-12",
demonstrates the strong interdependence between student health and school performance.
Both reports emphasize the largely preventable and treatable nature of the health
conditions associated with child and adolescent mortality and morbidity and the need for
expanded psychosocial services for our children, youth and families.
HERC Grand Opening
The Grand Opening of the Bayview Hunters Point Health and Environmental Resource Center
took place on November 20, 1999. Over 100 residents and supporters attended and were taken
on tours of the facility. The ribbon cutting, by Supervisor Alicia Becerill was witnessed
by District Attorney Terence Hallinan and representatives from Congresswomen Nancy
Pelosi's office. Supporters shared refreshments and entertainment and received information
on breast cancer, asthma, prostate cancer and the environment.
Commissioner Chow requested information on how the HERC integrates with the Department.
He suggested a quarterly report on this important project.
Commissioner Guy requested an evaluation component be included with this project.
Commissioner Sanchez commended the Department for the three Department of Public Health
reports on Children and Youth.
5) CONSIDERATION OF A RESOLUTION WHETHER CHANGES AT UCSF/MT. ZION MEDICAL CENTER
WILL OR WILL NOT HAVE A DETRIMENTAL IMPACT ON THE HEALTH CARE SERVICE OF THE COMMUNITY
Observing that no official representatives from UCSF/Stanford Health Care or UCSF/Mount
Zion were present to respond to questions, President Monfredini expressed her
disappointment and dismay for the perceived disrespect for the Commission and its Prop Q
process. She also feels the Commission was not being told the truth at the November 16,
1999 Prop Q hearing, especially when a week later, the UCSF/Mount Zion Emergency Room was
Ms. Joyce Newstat, UCSF Community Relations staff, was present but could not respond to
questions on behalf of UCSF/Stanford Health Care. President Monfredini thanked Ms. Newstat
for her ongoing cooperation and responsiveness to the Commission. President Monfredini had
requested multilingual signs be posted; and Ms. Newstat quickly responded.
Ms. Newstat expressed a misunderstanding on the attendance of official representatives
from UCSF/Stanford Health Care.
Public Speakers: Raised negative impact on Russian emigres, cutbacks by UCSF at
San Francisco General Hospital, lack of the Countys ability to do anything, and
concerns for the Mt. Zion staff and long-standing role of Mt. Zion.
- Greg Smith, Bay Area Council
- Frederick Hobson, S.F. Tomorrow and S.F. Health Plan
- Jacqui Gough, CNA
- Kevin Reilly, CNA
- Dr. Reuven Jaffe
Commissioner Chow had questions regarding the availability and time frame on the number
of critical care beds. He requested responses prior to any decision on the proposed
Commissioner Hill expressed his support for the Prop Q process and requested the
representatives to attend the next meeting.
Commissioner Parker stated there is lack of respect and courtesy to the Commission.
Commissioner Umekubo recommended to continue the proposed resolution to the December 21st
Commissioner Guy encouraged UCSF to divulge information on future cutbacks to services
at San Francisco General Hospital.
Commissioner Sanchez encouraged the Commission to move forward on the consideration of
Commissioner Chow stated his disappointment for the perceived disrespect to the public
on the public process.
Action taken: The Commission continued this item to the December 21st
meeting and requested Ms. Newstat to notify Mr. Stempel, Dr. Goodell, and Dr. Goldman to
attend this meeting.
Action taken: The Commission added an amendment, proposed by Commissioner Guy,
"Whereas, additionally, there will be a loss of skilled nursing beds with the closure
of the UCSF/Mount Zion Skilled Nursing Facility, thereby decreasing the number of
available skilled nursing beds in the City and County of San Francisco; . . ."
6) UPDATE ON MILLENNIUM EVENT PLANNING
Department of Public Health staff, Anne Kronenberg and Chris Wachsmuth, provided an
overview of the Departments comprehensive, departmentwide planning process with
other City agencies and private health providers to ensure the health and safety of all
San Franciscans and visitors during the 4-day millennium celebration. There will be a
coordinated health response utilizing technical preparedness, health prevention messages,
disaster preparedness and management, augmentation of current direct care services and for
the first time ever, the addition of DPH Field Care Clinics at several celebration sites.
They reviewed the Department of Public Health Millennium Celebration Response Plan:
- Mission and Goals
- Planning Assumptions
- Venues and Casualty Estimates
DPH Millennium Celebration Public Education
- Prevention Messages
- Health Services Available Millennium Weekend
DPH Millennium Disaster Response
- Organizational Charts
- Emergency Operations Center (EOC)
- DPH Operations Center (DOC)
- DPH Medical Command Center (MCP)
DPH Millennium Direct Services
- Field Care Clinics
- SFGH Services
- Community Urgent Care
- Institutional Police
- Ambulance Services
- Special Programs for Youth
President Monfredini requested a follow-up report after the millennium celebration.
7) PRESENTATION OF THE CHILDRENS SERVICE PLAN FROM THE DEPARTMENT OF CHILDREN,
YOUTH AND THEIR FAMILIES
Deborah Alvarez-Rodriguez, Director of the Department of Children, Youth and Their
Families, provided an overview of the 2000-2002 Childrens Service Plan. She
emphasized that this is a 2-year planning cycle and is focusing on outcomes and results.
She also encouraged the Commissioners to give her feedback on the plan.
Commissioner Chow encouraged the continued collaboration and coordination between DPH
Commissioner Guy pointed out the importance of integration of data with community input
Commissioner Parker noted the need for balance among boys and girls programs.
The Commission thanked Ms. Alvarez-Rodriguez for a comprehensive plan.
5:00 P.M. TIME SPECIFIC:
8) PRESENTATION OF SCHOOL-BASED HEALTH SERVICES AND CONSIDERATION OF A RESOLUTION
ENDORSING THE PROPOSED PLAN BY THE DEPARTMENT OF CHILDREN, YOUTH AND THEIR FAMILIES, TO
PROVIDE SCHOOL-BASED/SCHOOL-LINKED PHYSICAL HEALTH AND MENTAL HEALTH SERVICES IN TWO HIGH
SCHOOLS IN THE SAN FRANCISCO UNIFIED SCHOOL DISTRICT
Jimmy Loyce, Deputy Director of Health; Deborah Alvarez-Rodriguez, Director of the
Department of Children, Youth and Their Families; Sally Chow and Trish
Administrators from the S.F. Unified School District, presented recommendations for
school-based, school-linked services expansion at San Franciscos high schools. For a
copy of this report contact the Commission Office (554-2666).
During the FY 1999-2000 budget process, the Board of Supervisors placed $550,000 on
reserve (one-time only) in the DCYF budget for school-based health services. The Board of
Supervisors asked DCYF to convene a School Health Task Force with representatives from the
Department of Public Health, the San Francisco Unified School District and numerous public
and private agencies, including private health plans, youth advocates, and health service
- Sustainability is needed
- Need to include all high schools
- Programs need to be youth-friendly
- Youth need to be involved with planning and development
- Exciting to see the three departments working together
- Health promotion and prevention need to be included
- Positive commitment and response from the School District are encouraging
- This program will succeed and expand
- The Principals from Galileo and Lincoln High Schools voiced their support for the plan.
Action Taken: The Commission unanimously approved Resolution # 27-99, entitled
"Endorsing the Proposed Plan by the Department of Children, Youth and Their Families,
to Provide School-Based/School-Linked Physical Health and Mental Health Services in Two
High Schools in the San Francisco Unified School District" with an amendment by
Commissioner Chow changing the words "governing body" to "Policy Steering
9) OTHER BUSINESS/PUBLIC COMMENTS
The meeting was adjourned at 6:35 P.M.
Sandy Ouye Mori, Executive Secretary to the Health Commission