Minutes of the Health Commission Meeting
Tuesday, April 18, 2000
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 Roma Guy,
MSW, at 3:05 p.m.
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Ron Hill
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
- Commissioner Lee Ann Monfredini
On behalf of the Commission, President Guy presented a special Certificate of
Appreciation to Paul OMalley, who has worked for the Department for 27 years, first
at the San Francisco City Clinic, and later in the HIV Research Section. He was honored
for his years of commitment to better the lives of persons at risk of or living with HIV
infection, both through his work and his personal support.
Mr. OMalley thanked his colleagues for a tremendous life experience work in the
Department, especially for the last 15 years with his staff.
2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF APRIL 4, 2000
Action Taken: The Commission unanimously adopted the minutes of the meeting
of April 4, 2000.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
(3.1) DPH-Administration Medical Cannabis ID Cards Certification
(3.2) CHN-SFGH Request for approval of a six month extension modification
to the contract with Paralign Revenue Management, Inc., to enhance Medi-Cal and other
third-party reimbursements through an Uncompensated Care Recovery Program at
SFGH, for the
period of April 1, 1998 through December 31, 2000. (DPH compensation for FY 1998-99 was
(3.3) PHP-CMHS Request for approval of a sole source retroactive contract
renewal with Alameda County Health Care Service Agency, in the amount of $979,967, to
provide access to 24-hour skilled neurobehavioral nursing care and adolescent subacute
mental health services, for the period of July 1, 1999 through June 30, 2000.
contracted with Alameda County for services totaling $825,180 during FY 1998-99).
(3.4) PHP-HIV Prevention Services Request for approval of a retroactive
contract renewal with Haight Ashbury Free Clinic, (HAFC), in the amount of $105,649 per
year, to provide HIV prevention outreach services targeting women for the two year period
of January 1, 2000 through December 31, 2000, for a total of $211,298. (DPH contracted
with HAFC for services totaling $13,406,339 during FY 1998-99).
The Department is recommending a 1-year renewal with continued technical assistance.
Darryl Inaba, Pharm. D., Executive Director of HAFC, reported that progress is being
made with the technical assistance on organizational development.
(3.5) PHP-HIV Prevention Services Request for approval of a retroactive
contract renewal with the Regents of the University of California, through
Health Project, in the amount of $178,089, to provide prevention provider training
services, for the period of January 1, 2000 through December 31, 2000. (DPH contracted
with Regents UCSF for services totaling $11,398,542 during FY 1998-99).
Commissioner Sanchez abstained due to conflict of interest.
(3.6) PHP-HIV Prevention Services Request for approval of a retroactive
two-year contract renewal with Stop AIDS Project (SAP), in the amount of $510,258, to
provide venue-based individual outreach services, for the period of January 1, 2000
through December 31, 2001.
(DPH contracted with SAP for services totaling $793,093 during FY 1998-99).
(3.7) CHPP-Health PromotionSan Francisco Pedestrian Safety Program
Request for approval to accept and expend a new grant in the amount of $449,929 from the
California Office of Traffic Safety for a pilot study of pedestrian injuries and
implementation of community driven environmental prevention strategies, for the period of
June 1, 2000 through May 31, 2002.
Commissioner Sanchez stated that many community groups (i.e., seniors and children) may
participate in this program.
Commissioner Parker recommended the involvement of motorists for education purposes
(i.e., Department of Motor Vehicles).
Commissioner Hill also recommended to include Muni drivers.
(3.8) CHS-Children, Youth & Families Services Request for approval to
accept and expend a six-month grant in the amount of $201,921 from the California
Department of Health Services, to meet the health care needs of children in foster care by
increasing public health nursing time, for the period of January 1, 2000 to June 30, 2000.
Commissioner Sanchez requested an update come back to the Budget Committee on this
Action Taken: The Commission approved the Consent Calendar of the Budget
Committee, with Commissioner Sanchez abstaining on #3.5.
4) FOR DISCUSSION ONLY: DIRECTORS REPORT
(Mitchell H. Katz, M.D., Director of Health)
Californias Revenue Projections
Exceptional revenue performance have led the State Legislative Analysts Office
(LAO) to predict that if upward trends continue at their current pace, State revenues will
exceed the Governors proposed budget by more than $4 billion, bringing the total
estimated surplus to approximately $9 billion. The addition of 42,000 jobs per month since
November 1999, a 10.7% increase in taxable sales in the fourth quarter of 1999, a sharp
increase in new home construction, and unprecedented increases in the State employment
withholding payments all contribute to this increase in revenue. Further, estimated tax
payments, which reflect current job and income trends, are more than double the increase
anticipated by the Governors budget. Increased sales tax revenues between December
1999 and March 2000 indicate strong consumer spending both in the 1999 Christmas shopping
season and in the first months of 2000.
In late May, after Aprils tax receipts have been tabulated, the Governor will
release updated revenue and expenditure estimates along with any changes to his budget
proposals (the "May Revise"). It is likely that among the Governors top
priorities will be transportation and education with one-time rather than ongoing projects
being the preferred method of funding. While it is a little early for Legislative
proposals for the expenditure of the States surplus, it is likely that when the
Legislature returns from its Spring break next week, budget discussions will be
accelerated. Senator Burton has already requested that $300 million be earmarked for
mental health programs.
Over the last two months, as the Legislature has held budget hearings on health-related
issues, the Department has been actively advocating for the health needs of San
Franciscans. The Department will continue to monitor the State budget and keep the
Commission apprised of important developments.
Congratulations on 5-Year Technology Milestone
Last week marked the five-year anniversary that DPH went "live" on the Shared
Medical Systems Remote Computing Option (RCO), thereby establishing the DPH Enterprise
Network. Although initially focused on implementing key information systems required for
the transition to Managed Care, the infrastructure was quickly leveraged to support the
full range of DPH data communication needs; including CCSF financials, integration of data
from many discreet application systems and electronic mail on over 3,000 desktops. This
has allowed DPH to be well poised today to fully embrace information technology, use of
the Internet, and the sophisticated infrastructure needed to participate in the new world
I wanted to acknowledge this significant milestone, and compliment the DPH MIS staff
that made it a success.
POPULATION HEALTH AND PREVENTION
Barbara Garcia, Director of Population Health and Prevention, was invited to serve on
the California Senate's Task Force on Homelessness. The Task Force will look at statewide
responses to the issue of homelessness. Barbara's expertise and background will lend a
valuable contribution to the Task Force. I am sure you join me in congratulating Barbara
on her appointment.
The Newcomers Health Program of the Community Health Promotion and Prevention Branch,
in collaboration with Bay Area Community Resources, a local non-profit agency, was awarded
a three-year $375,000 grant from the Tobacco Control Section of the California Department
of Health Services. The program funded by this grant will focus its efforts primarily on
the Russian-speaking refugee and immigrant community in the Richmond and Sunset districts
of San Francisco. The project goal is to increase newcomers awareness of the dangers
of tobacco on the community. For more information please contact Patricia Erwin at
Helios Health Machines
Two Helios Health machines were installed in the STD Clinic waiting room. While waiting
for an appointment, clients can access a variety of health related information over the
Internet. Clients wear earphones to assure confidentially and so they dont disturb
The STD program is now conducting weekly STD screening at the Folsom Gulch bookstore; a
site mentioned by several recently diagnosed early syphilis cases. This is the first time
that the STD Program has successfully collaborated with a bookstore on this type of
activity. To date, over 20 clients have received STD education and 5 have been tested.
An eye catching STD postcard using the take off phrase "Got Treponemes" (the
bacterial agent that causes syphilis) is being distributed at venues frequented by
high-risk clients. A "rainbow colored" flyer was developed for use in venues
popular with men who have sex with men as a way of getting them to think about being
tested for STDs. Disease Control Investigators who are part of our Syphilis Rapid Response
Team developed both of these materials.
State Review of Implementation of the San Francisco Mental Health Plan (SFMHP)
The latest State Department of Mental Health review of our Medi-Cal specialty mental
health services plan was conducted January 11-14, 2000. I am pleased to inform you that
the review was very favorable. Only two deficiencies were found. One was minor and had to
do with contract language that is easily corrected. The other concerned the 24-hour access
line (a problem encountered by most counties). We have already moved to correct the
COMMUNITY HEALTH NETWORK
I am pleased to announce the recent award of $693,750 from the Department of Housing
and Urban Development to be used to support the redevelopment of the Laguna Honda Assisted
Living/Housing for Seniors.
Southeast Health Center Surprise
Last Thursday, (4/13), at approximately 9:20 a.m., a young woman from the Bayview
Hunters Point community walked into Southeast Health Center and announced that she was in
labor. Ten minutes later, Dr. Chris Behrens, assisted by Drs. Shanti Martinez and Elsa
Tsutaoka, delivered a six pound, 12 oz. baby girl.
The mother and daughter were transported to SFGH by ambulance for follow-up care. This
is the first time in Southeast Health Center's 25 years of operation that a baby was born
in the facility. I hope the Commission will join me in commending the quick and excellent
response of the staff at Southeast Health Center, proving once again that the
well-trained, committed DPH staff can and will respond to any public health need.
Medical Quality Incentive Plan
I am pleased to announce that all CHN (City and County-employed) physicians who
participated in the Joint City and County and UAPD Medical Quality Incentive Plan (MQIP)
during this past FY l999 - 2000 received the maximum percentage points possible to receive
the full 3% bonus incentive pay.
Our physician colleagues in Mental Health, the Medical Examiner's office and in
dentistry also performed outstanding, all achieving 3% bonus incentive pay.
CHN Physician performance ranged from 78.5% to 100% based on total number of awarded
points versus total possible points. A performance score equal to or above 75% merited a
The incentive pay is to be distributed in accordance with bonus distribution plan
outlined in the MQIP.
|SFGH Credentials Report
|Changes in Privileges
- Bill Castellanos, Union of American Physicians and Dentists, commended the Department
staff and management for their support for the 3% bonus incentive pay.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEES RECOGNITION AWARDS FOR
THE MONTH OF APRIL
On behalf of the Commission, President Guy presented a team award to the Laguna Honda
||Laguna Honda Hospital
||Tony Wagner, Executive
||Tony Wagner, Executive
|Deputy City Attorney
||Laguna Honda Hospital
|Leslie Holpit, R.N.
||Laguna Honda Hospital
||Tony Wagner, Executive
||Laguna Honda Hospital
||Tony Wagner, Executive
|Deputy City Attorney
|Melissa Welch, M.D., Chief Medical Officer
||Community Health Network
||Tony Wagner, Executive Administrator, CHN
Mr. Christmas acknowledged the CHN leadership of Tony Wagner, CHN Executive
Note: President Guy, with consensus of the Commission, announced that agenda item #9
will follow agenda item #5. Commissioner Hill left at 3:45 p.m.
6) CONSIDERATION OF A SUPPLEMENTAL APPROPRIATION OF $12.7 MILLION FROM THE TOBACCO
SETTLEMENT FUND FOR LAGUNA HONDA HOSPITAL
Dr. Katz reported the Department is modifying its request from $12.7 million to
$9,243,481 for architectural and engineering costs necessary to begin the Laguna Honda
Hospital replacement project. The construction and program management teams would be in
next years budget process. The source of funds for this supplemental appropriation
is from the first payments to the City and County of San Francisco from the State Attorney
General from tobacco settlement funds.
Funds of $9,243,481 will be used for architectural and engineering work necessary to
conduct environmental review processes, to complete planning and programming work, to
secure preliminary permits and to complete architectural and engineering analyses.
Dr. Katz introduced Michael Lane, who was appointed by Mayor Brown as the Project
Manager for the LHH Replacement Project. Mr. Lane reviewed the RFQ process for the
Executive Architect, the Construction Management Proposal, the Environmental Impact
Report, the hiring of the Project Manager and Administrative Assistant, and setting up his
office space. He also reported the formation of a Policy Committee, which will be advisory
to him. He introduced Marilyn Thompson, a Project Manager, and informed the Commission
that, as requested, he would brief the Commission on the replacement project.
- Norma Satten, PECC, encouraged the Department to make more effort for home and
community-based services and to plan for the assisted living project simultaneously with
the LHH replacement, thanked Planning Director Tangerine Brigham for obtaining funds for
the assisted living project.
- Mitch Jesenich and Karen Sherr, PECC, ILRC, HAT, demonstrated the need to have the
scales of justice balanced; need more affordable housing, support services and
community-based services for the disabled; important to have balance between finances for
institutional care and community-based services.
Action Taken: The Commissioners (Guy, Umekubo, Chow, Parker, and Sanchez)
approved the supplemental of $9.2 million for the architecture and engineering team.
Dr. Katz agrees on the need to build more affordable housing and assisted living
facilities in the community.
7) PRESENTATION OF THE 8-MONTH DEPARTMENT OF PUBLIC HEALTH BUDGET REPORT FOR FY
Dr. Katz reported on the latest information as of April 17, that the Department will
have a $10 million deficit instead of $14.2 million deficit. The Department was informed
that an additional $4 million has come in from SB 90 funds. Therefore, the Department will
be requesting a $10 million supplemental at the May 2nd Commission meeting.
This $10 million is the loss from SB 855 Medi-Cal disproportionate share revenues.
Dr. Katz reviewed the 8-month expenditures and revenues for the Department. A copy of
the full report is available for review at the Commission Office.
Commissioner Chow commended the Department for working diligently to stay within the
budget. He feels the public needs to be informed and educated on the facts of the
Department of Public Health budget.
- Frederick Hobson, S.F. Health Plan Board member, referred to his letters to members of
the Board of Supervisors advocating revenue proposals (i.e., modest local income tax,
sales tax dedicated for health care, and a luxury tax) to address the loss of federal
dollars for public health.
President Guy requested Commissioners to voice any concerns over the proposed $10
million supplemental request. Hearing none, this item will be calendared for the May 2nd
8) UPDATE ON THE HEALTHY FAMILIES PROGRAM
Tangerine Brigham, Director of Policy and Planning, provided an update on the
California Healthy Families Program, which has been in existence for 22 months and has
over 262,400 children enrolled statewide. San Franciscos enrollment in Healthy
Families is 7,313. A copy of the full report is available at the Commission Office.
In her update, Ms. Brigham covered background information program expansions and
enhancements, legislation, specific data for San Francisco, and outreach and education
efforts. Ms. Brigham acknowledged Rachelle Lee with the Planning section, who monitors the
outreach contract with Family Services Agency.
The Commission thanked Ms. Brigham for the update.
9) UPDATE FROM THE LONG TERM CARE TASK FORCE (AB 1040)
Tony Wagner and Jennie Chin Hansen, Co-Chairs of the Task Force; Tangerine Brigham,
Director of Policy and Planning; and Bill Haskell, Project Coordinator for the Long Term
Care Integration Pilot Project, provided an update on the work of the Task Force. Areas
covered were background information, the initial and subsequent planning activities, the
operational and budget analysis, the Case Management Study, and policy implications. A
copy of the full report is available in the Commission Office.
The original goal is to bring the Commission a comprehensive plan by October 17, 2000.
However, realistically, the Task Force most likely would bring a progress report on
October 17th; with the final recommendations coming at the beginning of 2001.
Mr. Wagner acknowledged the perseverance of the Task Force members and the consumer
advocates in working towards a long term care plan.
Commission Comments and Concerns:
- Report is informative; encouraged continued dialogue.
- Encouraging to see attention on long-term care.
- Important to look at how this will be adequately funded and avoid a deficit situation.
- What can the Commission expect realistically by October; time should be taken to have
- Encouraging to achieve a one-stop shopping for consumers
- Use of data in the recommendations for the Task Force is a good approach.
- Increasing expectations from the public.
- Monies should go to services and less on administration.
- Incorporate how the Laguna Honda Hospital project fits into the long term care
- Tough questions need to be asked and addressed.
- Need to look at the actual feasibility of the different options.
President Guy would like to see at the October update the different options and
clarification of the feasibility of these options.
- Marie Jobling, PECC Executive Director, expressed strong support for the work of the
Task Force; promoted community-based problem-solving including labor, community,
providers, consumers, and the public to be involved in the process.
- Norma Satten, PECC Board of Directors, expressed commitment to bring Task Force
recommendations to the Commission; need for a more systematic way of serving consumers.
President Guy thanked all of the stakeholders involved in this planning for the future
of long term care in the City and County of San Francisco.
Commissioner Chow left at 5:45 p.m.
10) UPDATE ON THE DEPARTMENT OF PUBLIC HEALTH STRATEGIC PLANNING INITIATIVE
Tangerine Brigham, Director of Policy and Planning, presented the Departmental
Strategic Planning Update, (Attachment A).
Commissioner Parker commended the Department for a good report. He commented that with
all of the health needs and limited resources, can all of the stakeholders involved be
comfortable with a strategic plan.
Dr. Katz expressed that he is pleased with the progress of the strategic planning given
the fact that the Department has to take care of day-to-day issues while understanding
that long-term planning is important.
President Guy encouraged the Department to include in future recommendations the issues
that were taken into consideration during the discussions among the stakeholders.
Commissioner Sanchez left at 6:15 p.m.
11) OTHER BUSINESS/PUBLIC COMMENTS
- April Martin Chartrand, member of S.F. Mental Health Board, thanked Dr. Katz for his
response to her letter and described her experiences as a patient at
SFGH, Ward 6A, March
17-19, 2000; expressed concerns regarding health and safety and patient rights
violations; raised system issues for patient care and the physical and emotional impact on
President Guy pointed out the importance of integrated care.
The meeting was adjourned at 6:40 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission