Minutes of the Health Commission Meeting
July 10, 2001
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, M.S.W., at 3:06 p.m.
- President Roma P. Guy, M.S.W.
- Vice President Edward A. Chow, M.D.
- Commissioner Arthur M. Jackson
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner John I. Umekubo, M.D.
- Commissioner David J. Sanchez, Jr., Ph.D.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF JUNE 19, 2001
Commissioner Chow requested a change to his comments regarding the
Director’s Report, in order to clarify his intention. The word “organization”
was replaced with “joint conferences.”
Action Taken: The Commission adopted the minutes of June 19,
2001, with Commissioner Chow’s change noted.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Lee Ann Monfredini)
Commissioner Monfredini chaired, and Commissioner Jackson attended, the
Budget Committee meeting.
(3.1) AIDS Office - Request for approval to retroactively accept and
expend a performance agreement from Public Health Foundation
Enterprises, Inc. (PHFE), in the amount of $69,799, to fund a project
for “HIV Strain Diversity and Nonprogressors”, for the period of
July 1, 2000 to June 30, 2002.
(3.2) AIDS Office - Request for approval to retroactively accept and
expend a performance agreement from Public Health Foundation
Enterprises, Inc. (PHFE) in the amount of $754,360, to fund a project
for “San Francisco HIV Vaccine Clinical Trials”, for the period of
June 1, 2001 to May 31, 2002.
(3.3) AIDS Office - Request for approval of a contract renewal with
Mobilization Against AIDS International (MAAI), in the amount of
$271,838, to provide HIV prevention services to youth of color and
Latino adults, for the period of July 1, 2001 through June 30, 2002. (DPH
contracted with MAAI for services totaling $289,204 during FY 2000-01).
- During the Budget Committee, Commissioner Monfredini expressed
concern that the data had not been collected correctly. Steven
Tierney responded that this contract and all the HIV contracts are
currently out to bid and they will be evaluating each bid on the
work they do and their administrative operation.
(3.4) PHP-Health Promotion - Request for approval of a contract
renewal with Men Overcoming Violence (MOVE) in the amount of $90,368, to
provide family violence prevention services targeting service providers
and community members, for the period of July 1, 2001 through June 30,
2002. (DPH contracted with MOVE for services totaling $79,500 during FY
- During the Budget Committee, Commissioner Monfredini expressed
concern about the organization’s difficulty submitting material to
the Department of Public Health in a timely manner. Alan Silva, the
acting director of MOVE, responded that due to the transition in the
leadership of the organization, they are still developing their
communication structure with the department. Commissioner Jackson
and Commissioner Monfredini requested that the department and the
organization report to the Budget Committee at a future date when
the program has been more fully developed.
(3.5) PHP-Housing and Urban Health - Request for approval of a
modification to a one-time only sole source contract with Mission
Housing Development Corporation (MHDC), the lead agency in a
collaborative to conduct a census of families with children living in
SRO hotels. The budget has been increased from $70,724 to $98,724 and
the contract period has been extended an additional month from April 1,
2001-July 31, 2001 for a new contract period of April 1, 2001 August 31,
2001. (DPH contracted with MHDC for services totaling $70,724 during FY
- Commissioner Monfredini and Commissioner Jackson directed staff to
provide the committee with a report once the census is complete.
(3.6) PHP-Mental Health - Request for approval of a sole source
contract renewal with Echo Consulting Services of California, Inc., in
the amount of $404,935, to provide maintenance and support services for
Community Mental Health Services’ billing software, INSYST, for the
period of July 1, 2001 through June 30, 2002. (DPH contracted with Echo
for services totaling $341,432 during FY 2000-01).
(3.7) PHP-Mental Health - Request for approval of a sole source
contract renewal with InfoMC, Inc., in the amount of $284,500, to
provide maintenance and support services for the San Francisco Mental
Health Plan’s cCURA2 software, for the period of July 1, 2001 through
June 30, 2002. (DPH contracted with InfoMC for services totaling
$143,500 during FY 2000-01). .
(3.8) PHP-Mental Health - Request for approval of a contract renewal
with Calvin Y. Louie, CPA (CYL), in the amount of $539,504, to provide
fiscal intermediary services for the Community Mental Health Services
supplemental residential care facilities, for the period of July 1, 2000
through June 30, 2002, for a total contract value of $8,079,008. (DPH
contracted with CYL for services totaling $4,039,504 during FY 2000-01).
(3.9) CHN - Request for approval of two (2) contract renewals with
the following firms: Asereth Medical Services, Inc. and Rxrelief, for a
combined total amount of $1,200,000, to provide as-needed supplemental
pharmacy personnel services to the Community Health Network, for the
period of July 1, 2001 through June 30, 2002. (DPH contracted with these
two firms for $1,150,000 during FY 2000-01).
- During the Budget Committee, Commissioner Jackson asked staff to
report back to the committee what portion of the total unit cost the
Licensed Pharmacist, Registered Technician and Pharmacy receive.
(3.10) CHN - Request for approval of a contract renewal with Richmond
Area Multi-Services, Inc. (RAMS) in the amount of $1,769,103 per year,
for three years for a total contract amount of $5,307,309, to provide
culturally competent partial hospitalization and aftercare treatment
services targeting the community’s mentally impaired population, for
the period of July 1, 2001 through June 30, 2004. (DPH contracted with
RAMS for services totaling $4,576,229 during FY 2000-01).
Action Taken: The Commission approved the Consent Calendar of
the Budget Committee.
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
Board of Supervisor’s Proposed Budget for FY 01-02
The Finance Committee of the Board of Supervisors completed six days of
budget hearings and reviews for the FY 2001-2002 budget on June 28, 2001.
The Finance Committee recommended reductions in the amount of $178,695 to
the Health Department budget as submitted by the Mayor’s Office.
Subsequently, the Finance Committee recommended that $6,806,093 be added
back to the Department’s budget to fund Contractor COLA’s and program
The Board of Supervisors will vote to approve the FY 2001-2002 budget
on July 23 and July 30, 2001.
The following details the $6.8 Million recommended by the Finance
Committee to be added back the Department’s budget for FY 01-02.
University of California 2% COLA and services.
Non-profit contractor COLA’s.
Jail Health Psychiatric Services contract.
Mission Neighborhood Health Center Excelsior Clinic.
Walden House substance abuse services.
Job training for the mentally ill.
Family Links/ Parent Talkline.
Richmond Area Multi-Services.
Shanti Lifelines - breast cancer case management.
New Leaf mental health services.
Hepatitis C Education Services for intravenous drug users.
Healthcare for Women.
Positive Resource Center HIV support services.
Dolores Street Community Services
Ark House - transitional housing for GLBT youth.
SF AIDS Foundation - housing subsidies.
Drop-In Clinic for mental health services.
POPULATION HEALTH AND PREVENTION
African American Health
San Francisco Department of Public Health's African American Health
Initiative and the African American Coalition for Health Improvement and
Empowerment sponsored the First Annual Community-Based Health Conference
June 23rd at the Bayview Opera House. On June 29th, the San
Francisco African American Health Summit was held. The summit,
"Catalysts for Change", was a gathering of elected officials
(including Assembly Member Kevin Shelley), public and private business
leaders, health plan providers and community leaders, to develop an agenda
for strengthening the African American community in San Francisco.
Proposition 36: The Substance Abuse and Crime Prevention Act
On June 28th, Proposition 36 Advocates, including the Lindesmith Center
Drug Policy Foundation, issued 'report cards', grading 11 counties
encompassing 75 percent of the state population on the quality of their
With an "A" grade, San Francisco ranked the highest (the only
county to receive an "A"), followed by San Mateo (A-), Alameda
(B), Orange (B), Los Angeles (B-), Fresno (C), Riverside (C), Santa Clara
(D+), San Diego (D+) and Sacramento (D). The County of San Bernardino came
in last with a failing grade. To view the report card, please refer to http://www.prop36.org/report.tpl.
San Francisco's plan is the result of a collaborative planning process
that included representatives from the Board of Supervisors, City and
County agencies, Probation, Parole, members of the community, the
Treatment on Demand Council, advocacy groups, substance abuse treatment
providers and the faith community.
Community Mental Health Services Receives 2.5 Million Grant for
The City and County of San Francisco was awarded a Youth Development
and Crime Prevention Grant by the State of California (Department of
Alcohol and Drug Programs, Department of Mental Health, and the Employment
Development Department). San Francisco will receive $834,357 annually for
three years. Children's Mental Health Services, part of Community Mental
Health, will serve as the lead agent for the grant, which is in
collaboration with Community Substance Abuse Services, the Private
Industry Council/Workforce Investment Commission and the Juvenile
Probation Department. The project will serve youth ages 14-18 who have at
least one juvenile probation referral and either a significant alcohol or
drug problem or serious emotional disturbance. Communities being targeted
include South of Market, Mission, Bayview Hunters Point and Visitation
COMMUNITY HEALTH NETWORK
San Francisco General Hospital Credentials Report
Changes in Privileges
- Commissioner Parker thanked the Board of Supervisors Finance
Committee for the budget add-backs, particularly the COLA increases
for UCSF and the non-profit organizations.
- Commissioner Chow commended the administration for the development
of the budget and its work with the Board of Supervisors.
- Commissioner Guy stated that the budget reflects the Health
Commission’s priority to invest in community-based care with such
initiatives as the African American initiative, and to collaborate
with other agencies such as the Police Department and the Recreation
and Parks Department. She noted that community health can be enhanced
when all of the stakeholders are brought together.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEES
RECOGNITION AWARDS FOR THE MONTH OF JULY
On behalf of the Health Commission, Commissioner Parker presented the
- Individual Nominee: Joe Goldenson, M.D., EMS Medical Director
- Team Nominees: Malou Acha, Mila Alcantara and Odessa Fernandez,
Contracts Procurement and Accounts Payable.
6) BAYVIEW HUNTERS POINT TASK FORCE UPDATE
(Rajiv Bhatia, M.D.)
Dr. Mitch Katz provided the Commission with an update on the actions
that have been taken since the February 20, 2001 Health Commission hearing
at the Milton Myers Recreational Center.
Dr. Katz reported that following the meeting, the Department of Public
Health convened the leaders of several city departments to bring to bear
all of the resources the City has to offer, and identify the short-term
and long-term issues that departments can address. Three meetings were
held in which department leaders were asked to prioritize and commit new
resources that could be deployed swiftly to the community in ways that
could improve health.
The following departments participated in these meetings and made
commitments to concrete actions:
- Recreation and Parks Department
- Public Utilities Commission
- Port of San Francisco
- Department of Building Inspection
- Planning Department
- Department of the Environment
Dr. Katz described the commitments of each of the departments listed
above. Further explanation of each department’s commitments can be found
in Attachment A.
Dr. Katz reported that the Health Department would coordinate a series
of meetings for the Bayview around economic issues. He will convene a
meeting with the department heads from the
Department of Human Services, the Mayor’s Office of Economic
Development, the Private Industry Council, the City Treasurer and others.
He will also convene a separate set of meetings around the public safety
issues in the Bayview with the Police Department, the Probation
Department, the District Attorney, the Sheriff and others. These meetings
will be geared toward concentrated efforts focussed on action.
Tony Wagner reported to the Commission the steps the Department of
Public Health is taking to improve and enhance services to the Bayview
community. The Department undertook an informal survey of residents to
ensure community input in the planning process. Two prominent survey
responses were an overwhelming concern with violence and public safety,
and the desire to reconstitute the Ujima Project. The Department plans to
resurrect the Ujima Project at the Milton Myers Recreation Center. Various
DPH services, including WIC outreach, substance abuse outreach and
referral, mental health screening and others will also be provided at the
recreation center. The Department will also provide an array of services
at the housing unit located at One Harbor Road.
Dr. Rajiv Bhatia continued the presentation by reporting the specific
commitments made to address environmental health concerns. The DPH-Environmental
Health Section has:
- Produced and distributed a guide to environmental health services.
- Created a MOU with the Department of Building Inspection to
coordinate responses to mold complaints.
- Developed a comprehensive indoor environmental investigation
protocol to be used in coordination with the Department of Building
Inspection, tenants, tenants’ rights groups, and landlords to
evaluate subsidized housing in Hunter’s Point.
- Agreed to conduct training for subsidized housing residents on
asthma and indoor air quality.
According the to report, the Department of Public Health also made the
- Develop a clinical presence at Hunter’s Point. Services provided:
preventive health, mental health, public health nursing, and WIC.
- Ensure that the appropriate entities both within DPH and externally
are notified to respond to incidents of violence and homicides.
- Produce consumer friendly guide to citywide environmental health
- Station mobile services in the Bayview.
- Coordinate sewage back-up responses with the Department of Building
Inspection and the Public Utilities Commission.
- Coordinate response to mold complaints with the Department of
- Commissioner Umekubo asked the other departments to put timelines on
their initiatives. He also recommended that the Department establish
target benchmarks the Department would like to achieve in a particular
timeframe. He stressed that this is an on-going, multi-year endeavor
that will need monitoring.
- Commissioner Parker requested that the department share what it is
doing with the Bayview residents. He stated that there needs to be a
lifetime commitment to carrying out these projects in Bayview Hunter’s
- Commissioner Chow stated that as these initiatives move forward,
violence and public safety must be addressed, and that it is important
to get agencies such as the Sheriff’s Department involved. He would
like the Commission to receive follow-up reports for each initiative.
Commissioner Chow also asked if this collaboration would be expanded
to other communities throughout the city, and if all the diverse
communities in the Bayview would be able to participate in the current
effort. Dr. Katz responded that they are addressing public safety
next, and that the services are geographically focussed, so all will
have access. Mr. Wagner added that during the planning stages, it was
made clear that this effort would reflect the diversity of the
- Commissioner Monfredini asked if gang activity has been addressed,
as this is a public health issue. She also asked if the department is
using models from elsewhere. Cynthia Selmar responded that the Health
Department is working with a number of other agencies to address gang
issues. The department is looking at best practices. Commissioner
Monfredini then expressed concern that those property owners who are
told to fix up their properties might abandon the endeavor, and lead
to more homelessness.
- Commissioner Jackson stressed that economic development is a
critical issue. He suggested that collaborative efforts be expanded
beyond the departments to non-profits such as SF Works. He also
conveyed a concern voiced by a number of people at the summit that
when the neighborhood improves, it will lose its rich diversity. He
said the department must ensure this does not happen.
- Commissioner Guy stated that the Commission has a new vision to
involve stakeholders in the health agenda. She said that when the
Health Commission and the Department of Public Health undertook the
African American Initiative, it was unclear if it would be successful.
But with every stakeholder involved and all the elements in place, it
has been successful. She also stated that the Commission needs to
direct the next steps, to see quantifiable objectives with benchmarks
so that the stakeholders can identify with the progress, and that
there should be continued discussion in the joint conferences over the
7) LAGUNA HONDA HOSPITAL REINTEGRATION PROGRAM
(Dr. Lisa Pascual, Director of Rehabilitation Services)
Dr. Lisa Pascual, Director of Rehabilitation Services at Laguna Honda
Hospital, described the new Community Reintegration Program (CRP)
developed on the rehabilitation unit and other satellite units at Laguna
Honda Hospital. The Community Reintegration Program is a program for
individuals who demonstrate the potential for discharge within 90 days of
admission, with an emphasis on:
- Functional maintenance
- Discharge planning
- Community reintegration
The rehabilitation staff has developed a database to track referrals,
demographics and outcomes, including clinical data based on nationally
recognized measures. The database provides a means of identifying how
efficiently people get in the hospital, how effectively their function is
improved, and how well this function is maintained as an outpatient.
The Fiscal Year 2001-2002 budget will allow for the following:
- Outpatient follow up and case management utilizing a social worker.
- Addition of Restorative Rehabilitation Aides to enhance functional
maintenance activities for patients in the CRP and FMP.
- Addition of skilled therapists to cover the increased need for
skilled therapy for patients in the CRP and on other wards.
- Commissioner Chow asked staff to clarify why Laguna Honda accepts
patients from other acute rehabilitation facilities such as St.
Francis Hospital. Dr. Pascual responded that Laguna Honda has two
levels of rehabilitative care: acute-level care and SNF-level care.
Dr. Pascual said that often times an individual receives acute-level
care at one facility and then is referred to Laguna Honda for SNF-level
- Commissioner Umekubo asked if staff has developed projections for
the rehabilitation unit. Mr. Funk responded that staff is currently
looking at the data to determine the number of rehabilitation services
they will need to provide at the new facility. Commissioner Umekubo
then asked if there are adequate community resources available for
patients. Dr. Pascual responded that there is a lack of community
resources available for cognitively impaired people who need 24-hour
- Commissioner Chow asked if Laguna Honda is expanding its
rehabilitation component to meet community need, and if additional
resources would be allocated for program improvements. He also asked
staff to explain the environmental changes that have taken place that
make an acute rehabilitation program useful and marketable at this
time. Mr. Funk responded staff is doing extensive planning for the new
facility and trying to make these programs in the new facility as
user-friendly as possible. Mr. Funk said that over the next few weeks,
staff will complete a projection analysis of various types of
therapies that will be needed and the space needs for these programs.
- Commissioner Guy commended Dr. Pascual on her commitment. She stated
that is an important issue for the Laguna Honda JCC, and that the JCC
should monitor it.
8) PUBLIC COMMENTS
The Commission adjourned the meeting at 5:35 p.m.
Michele M. Olson, Executive Secretary to the Health Commission