Minutes of the Health Commission Meeting
Tuesday, July 2, 2002
At 3:00 p.m.
101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The Health Commission meeting was called to order by Commissioner
Edward A. Chow, M.D., at 3:10 p.m.
- Commissioner Edward A. Chow, M.D., President
- Commissioner Roma P. Guy, M.S.W., Vice President
- Commissioner Arthur M. Jackson
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner John I. Umekubo, M.D.
- Absent: Commissioner Lee Ann Monfredini
- Commissioner David J. Sanchez, Ph.D.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF JUNE 18, 2002
Action Taken: The Commission (Chow, Guy, Jackson, Parker, Umekubo)
approved the minutes of the June 18, 2002 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Jackson chaired, and Commissioner Umekubo attended, the
Budget Committee meeting. Commissioner Monfredini was absent.
(3.1) PHP-AIDS Office - Request for approval of a new retroactive
contract with New Direction 21st Century in the amount of
$90,000, to provide HIV prevention and education services to young
African Americans, for the period of June 1, 2002 through December 31,
(3.2) PHP-Community Health Education - Request for approval of a
renewal contract with O’Rorke Public Relations and Advertising in the
amount of $75,000, to provide public relations and media services to the
Traffic Safety Project, for the period of July 1, 2002 through June 30,
3.3) PHP-Substance Abuse Services - Request for approval of a
contract renewal with Women and Children’s Family Services, Inc., (WACFS)
in the amount of $200,631, to serve the remaining clients and close out
the residential and outpatient substance abuse services to current
clients, for the three-month period of July 1, 2002 through September
(3.4) PHP-Housing & Urban Health - Request for approval of a new
sole source contract with Lutheran Social Services in the amount of
$120,966, to provide transitional housing and supportive services, for
the period of July 1, 2002 through June 30, 2003.
(3.5) PHP-Substance Abuse Services - Request for approval of a sole
source contract renewal with Latino Commission on Alcohol and Drug Abuse
in the amount of $1,013,555 per year, for a total four-year contract of
$4,054,220, to provide residential substance abuse treatment targeting
adult male Latinos and pregnant and post partum Latina women, for the
period of July 1, 2002 through June 30, 2006.
Items 3.3, 3.4 and 3.6 were discussed together.
- Commissioner Jackson commended the staff for successfully
transitioning the funding and clients so that services could
(3.6) PHP-Mental Health Services/Family Mosaic Project - Request for
approval of renewal contracts with Family Mosaic Project in the amount
of $1,100,186, to provide various wrap-around services through the
following nine (9) agencies targeting seriously emotionally disturbed
children, for the period of July 1, 2002 through June 30, 2003:
Victor Treatment Centers
High Gear Achievers, Inc.
Big Brothers/ Big Sisters of San Francisco
New College of California
Catholic Youth Organization - St. Vincent’s School for Boys
(3.7) DPH-Emergency Medical Services Agency - Request for approval of
a Memorandum of Agreement with the Police Department for Emergency
Medical Aircraft Use of the Public Safety Helipad at Hunters Point Naval
- Commissioner Umekubo asked how much longer it would take
paramedics to travel to San Francisco General Hospital from the new
location as compared to Pier 94. Mr. Petrie responded that it was
one minute less from the Pier 94 location.
Action Taken: The Commission (Chow, Guy, Jackson, Parker, Umekubo)
approved the consent calendar of the Budget Committee.
4) DIRECTOR’S REPORT
Mitch Katz, M.D., Director of Health, presented the Director’s
Last Thursday, the Budget Committee voted to restore funding for
several proposed service reductions. The list of add-backs, which totals
$9.8 million Citywide, is attached to this report. The Board restored
funding for a number of DPH services, including several mental health and
substance abuse service programs. Add-backs for the Department of Public
Health, including a 1 percent cost of living increase for non-profit
contractors and the University of California, total approximately $4.2
million. With these add-backs, the Budget Committee forwarded the City’s
budget proposal to the full Board. However, several unions are still
considering the City’s proposal regarding retirement pick-up. If these
unions reject the proposal, DPH will be asked to make additional
reductions based upon the outcome of these votes. The budget will be
introduced at the Board on July 15th with the final vote scheduled for
Two Direct-Access-to-Housing Hotels to Open in August
Beginning next month, clients referred by the MOST/AB2034 Team, HIV
providers and other DPH providers will be able to move into the 54 units
at the Star Hotel (2176 Mission Street) and 55 units at the Camelot Hotel
(124-126 Turk Street). Baker Places, Tenderloin AIDS Resource Center, and
Lutheran Social Services will provide on-site supportive services at both
Syphilis Education and Prevention
The new DPH Syphilis Awareness Campaign, "Healthy Penis
2002," was launched at a press conference June 27th. The campaign
introducing the characters of “Healthy Penis” and “Phil the Syphilis
Sore” was featured in articles in the Chronicle, the Examiner, and the
Los Angeles Times. Life sized characters of “Healthy Penis” and
"Phil the Syphilis Sore" marched in Sunday’s Gay Pride Parade
and will visit various clubs in the City. Campaign materials such as bus
shelter and retail establishment posters, “stress grips” in the shape
of campaign characters, and informational palm cards have been developed
and distributed to Castro Street businesses, and members of the target
audience. A campaign web site has been established
(www.healthypenis2002.org) which provides information about the campaign,
and information about STDs and STD resources.
Client Satisfaction Survey
CSAS completed a consumer satisfaction survey June 2002. The scope of
the survey process included all CSAS contracted programs in all
modalities, more than 150 programs in more than 40 agencies. Surveys were
available at each treatment and prevention site during a 4-day window at
each site. Survey tabulation has begun, and it indicates that more than
60% of consumers responded. The survey employs standardized forms,
computerized optical scanning equipment, and standardized time frames.
Results can be compared over time or with other departments and
communities. This is the second year of a major collaboration between
Community Mental Health Services and CSAS. Results from both years will be
available in a report by mid-August.
OBOAT pilot (Office-Based Opiate Addiction Treatment)
On July 11th a training will be held for physicians, pharmacists,
counselors and other medical provider staff at the OBOAT pilot sites. The
training, provided by the California Society of Addiction Medicine and
members of the OBOAT steering committee, will prepare pilot site clinical
staff for OBOAT clients.
- Commissioner Chow asked how many of the Health Department’s
one-time Board of Supervisors’ addbacks were restored. Dr. Katz said
that approximately two thirds were added back and one third were not.
The San Francisco AIDS Foundation’s HIV housing subsidy program and
the NICOs anti-gambling program were not restored. Commissioner Chow
said that while the COLA is only one percent, it does recognize our
contractors’ needs. Commissioner Chow asked for clarification that
the Budget Committee’s recommendation does not include funding for
DPH to relocate the Laguna Honda Hospital laundry and continue to
operate it with civil service. Dr. Katz confirmed this.
- Commissioner Umekubo is happy to see that the one percent COLA for
contractors and UC is part of the Board of Supervisors’ Budget
Committee’s recommendation. He commended CSAS for the response rate
to Client Satisfaction Survey and asked how many people were surveyed.
Dr. Partida said that they surveyed all of the providers and received
780 responses thus far.
- Commissioner Guy said that the Commission needs to support
unconventional and sometimes controversial approaches to syphilis
prevention. Dr. Katz said that controversy gets people to recognize
that what is going on is different and requires attention.
- Commissioner Jackson asked if the Laguna Honda nursing positions
that were deleted were restored. Dr. Katz replied that about half of
the positions were restored.
5) CONSIDERATION OF A RESOLUTION APPROVING A PROPOSITION J CONTRACT
TO OUTSOURCE LAUNDRY SERVICES AT LAGUNA HONDA HOSPITAL, FOR THE PERIOD OF
JULY 1, 2002 THROUGH JUNE 30, 2004
Mitch Katz, Director of Health, presented the Proposition J Resolution
for outsourcing laundry services at Laguna Honda Hospital. This has been a
difficult budget year and the recommendation to outsource the laundry
services was made to help the City and County with its budget shortfall.
Dr. Katz emphasized that no one wants to lose long-term employees.
The current cost estimate for FY 2002-2003 to perform the service by
city employees is in excess of $6.1 million, which includes one-time costs
related to the operation of an off-site civil services staffed laundry. In
subsequent years the cost to the City to operate a civil service staffed
off-site laundry will be in excess of $4.2 million.
Staff used two different estimates to determine the cost savings of
outsourcing the laundry. The Department currently pays $.32 per pound for
San Francisco General Hospital’s laundry. However, when that contract
was recently put out to bid, SFGH got a bid of $.29 per pound. The savings
are great using either number. Cost savings for FY 2002-2003 are
$3,297,580 at $.32/pound and $3,628,601 at $.29/pound. Savings in later
years are not quite as large due to the first year capital costs, but
there will still be an annual savings of between $1.3 and $1.6 million.
The Department will retain 15.5 FTEs for the duties of linen
distribution. They want to work productively with labor to place employees
from the laundry into other positions. They were able to do this when they
converted San Francisco General Hospital’s laundry services.
Dr. Katz presented an amended resolution asking for the Commission’s
approval to submit the cost analysis to the Controller’s Office. He
reiterated staff had to look at what was necessary to close the budget
without making service cuts and this was an example of where the
Department could achieve substantial savings without making budget cuts.
- Vincent Harrington, attorney representing SEIU Local 250 and SEIU
Local 790 - The Commission has no authority to adopt this contract and
the Commission’s decision is meaningless. This process can go
forward only if the Mayor makes a decision pursuant to their contract
that he cannot provide the services he is mandated to provide unless
he undertakes this contract. The contract between the SEIU and the
City requires that there be extend discussions, and an arbitrator
would determine if the Mayor could make this decision. The Commission’s
action will be in vane.
- Sal Rosselli, President of SEIU 250 - he has never been so ashamed
of city government as he is now. The union has found millions of
dollars of savings that could be made rather than laying off laundry
workers. This action is fundamentally unfair. The City made an
agreement with these workers and now is taking this away. Outside
vendors that provide laundry services are sweatshops. The laundry
workers spend hundreds of hours just a few years ago to save Laguna
Honda Hospital. They will organize now to stop the contracting out
- Laura Blue, RN - asked the Commission not to cut more staff at
Laguna Honda Hospital. The staffing level in their MOU has never been
met. Last year staff lost more than 3,000 hours of unused educational
time. The cuts to the laundry is another example of how when the
budget gets tough, the city turns to Laguna Honda.
- Rebecca Morrow, PHN - the voters made their wishes clear with regard
to Laguna Honda and cutting the laundry services is not consistent
with what the voters want. There is nothing that frustrates a nurse
more than to need an item and not get it. Nurses have a relationship
with the laundry workers that allows them to work together and there
will not be this relationship with a contractor. This will compromise
- Brian Uyero, LHH Laundry - If you close Laguna Honda Hospital, you
close down what this city is all about-helping people who cannot help
themselves. He has been working at Laguna Honda Hospital for 10 years.
- Raquel Nacdao Icban, RN at Laguna Honda - nurses will not be able to
deliver quality care if the laundry services are contracted out.
Nurses cannot get their requested earned time off. The acuity of
patients has skyrocketed. The laundry services are a vital part of
delivering care to residents.
- Josie Mooney, Executive Director SEIU 790 and president of the San
Francisco Labor Council - asked the Commission to look at the faces of
the laundry workers and imagine what it will be like when they do not
have jobs. If the services are contracted out two classes of
disenfranchised workers will be created: those that are without jobs
and those that will be doing the laundry at another location with
certainly no benefits. She dissents from the proposal and hopes the
Commission will dissent as well.
- Ben Ruvalcaba, LHH Laundry - he has worked in private laundry and
they pay cheap wages. The benefits and wages at Laguna Honda are good.
The laundry workers-and all staff-worked hard on the campaign to save
Laguna Honda Hospital and the people of San Francisco voted to rebuild
it. This included the laundry. They were told no one would lose their
jobs, and now they are proposing to contract for cheap labor. He needs
this job. And it is a violation of the contract, which has a provision
for no contracting out.
Dr. Katz said that there are requirements of any City and County of San
Francisco contractor with regard to minimum wage requirements and the
provision of benefits and while it is true that the contractor is not
known at this time, the contractor will have to comply. And while these
wages and benefits are not as great as what is provided to civil service,
they do exist. Dr. Katz added that the Deputy City Attorney has reviewed
the resolution and believes that it is appropriate for the Commission to
consider and adopt the proposed resolution.
- Commissioner Jackson clarified that this resolution only facilitates
getting the information to the Controller and the Board of Supervisors
but that the decision lies with the Board of Supervisors. He asked if
funds are available for cross training. Dr. Katz replied that
currently there is not, although the Board of Supervisors has
discussed this. Commissioner Jackson asked if a contractor could
provide quality services. Robert Christmas, Chief Operating Officer at
Laguna Honda Hospital, replied he is aware that there some concerns
about the services that are provided by existing contractors.
Commissioner Jackson does not want to see any jobs contracted out, but
he is committed to the additional nurses that were proposed in the
base budget. These positions are his first priority for the budget is
the nurses even though he values the work of the laundry services. He
will continue to advocate to the Board of Supervisors that the laundry
should not be contracted out.
- Commissioner Parker asked if the decision to do SFGH’s laundry
done by a contractor was made for financial reasons. Dr. Katz said
that it was the result of a previous recession. Commissioner Parker
asked if budget savings would be accrued if the laundry staff are
placed in other civil service jobs. Dr. Katz said that if there is a
truly vacant position that can be filled by a laundry worker, then
savings would still be accrued. But this is only feasible if the Mayor’s
Office releases the job requisition. Commissioner Parker said that
even though this proposal attempts to address the budget shortfall, it
goes against the spirit of what the Department stands for in terms of
wages and benefits. We are better off discussing how we get the
necessary funds or how we spread the deficit out in a more equitable
manner. Dr. Katz said that the Board of Supervisors would have to give
an addition $4 million to the Health Department to continue these
services, which is still a possibility. Commissioner Parker asked if
the Laguna Honda Hospital rebuild proposal included on-site laundry
services. Dr. Katz said initially yes, but as the project moved along,
in order to rebuild 1,200 beds the decision was made to relocate the
laundry at Oyster Point.
- Commissioner Guy said that since the Commission’s budget
discussions began in January there was realization that the Department
was going to have to absorb some cuts. She has publicly prioritized
the addition of the nursing positions to the staff at Laguna Honda
Hospital over the retention of the laundry and her position has not
changed. However the Health Commission’s position opposing any cuts,
including the laundry, also has not changed.
- Commissioner Umekubo asked what likelihood there is that the workers
will find other civil service jobs. Dr. Katz said that he could not
guarantee that all workers will be placed but Laguna Honda Hospital
has a large workforce, and they have six months, which gives enough
time to plan. It should be possible with everybody’s cooperation to
make it work.
- Commissioner Chow said that the position of the Health Commission is
to support the Department’s base budget and oppose all of the cuts
included in the 10 percent budget reduction proposal that the
Department was required to submit to the Mayor’s Office. The
resolution being considered today does not change that position. The
resolution is a concurrence with the analysis of the cost savings as
does not call for closing the laundry. However, if the Board of
Supervisors’ final budget does not include funding for the laundry,
then Laguna Honda Hospital will have no laundry services as of the end
of December. This resolution makes the Health Commission part of the
solution to address this problem, should it happen.
Action Taken: The Commission (Chow, Guy, Jackson, Umekubo) approved
Resolution #08-02 titled “Concurring with the Analysis of the Department
Staff and Pending Controller’s Certification that the Laundry Services
can be performed for the Department of Public Health Laguna Honda Hospital
by Private Contractor for a Lower Cost than Similar Work Performed by City
and County Employees”. Commissioner Parker voted against the resolution.
6) CONSIDERATION OF A RESOLUTION APPROVING ORDINANCE AMENDMENTS TO
THE SAN FRANCISCO HEALTH CODE TO UPDATE LEAD HAZARD DEFINITIONS TO BE
CONSISTENT WITH STATE AND FEDERAL DEFINITIONS
Joe Walseth, Childhood Lead Prevention Program, presented the proposed
amendments to Article 26 of the San Francisco Health Code. The ordinance
amends the current code in two respects. First, to broaden the scope of
services that Childhood Lead Poisoning Prevention currently provides to
include case management services to children up to 21 years of age. The
second respect would be to change the standards by which the Department
conducts environmental investigations with respect to children who have
been identified as being lead poisoned to be consistent with federal and
state standards, which are more protective of children’s health. There
is the need to update the lead hazard definitions to be consistent with
State and Federal definitions. Dr. Katz said that these amendments do not
fundamentally change the way the Department provides services.
- Dr. Umekubo asked what the protocol is for screening children and
what mechanism is used to screen children who do not live in houses
that are identified as lead hazards. Dr. Katz said the issue of
whether there should be universal screening of children for lead
poisoning is quite controversial. The official bodies say mandatory,
universal testing of children but there is tremendous provider
- Commissioner Parker said the Department should advocate for
legislation that would address the certification of residential units
being a lead-free environment as part of transfer of ownership title.
Dr. Katz said staff would research if there are other localities in
the United States that have such legislation and bring this
information back to the Commission.
- Action Taken: The Commission (Chow, Guy, Jackson, Parker, Umekubo)
approved Resolution #09-02 titled “Approving Ordinance Amendments to
the San Francisco Health code to Update Lead Hazard Definitions to be
Consistent with State and Federal Definitions.”
7) PUBLIC COMMENTS
Elizabeth Frantes - there is a club on 10th Street and the workers
there are providing marijuana medication to Laguna Honda’s residents. It
is a wonderful place, with online access. This is the first cannabis
sports bar. There is a lot of harassment of women at cannabis clubs, and
this does not happen at the new club. The club needs help and support from
the Department to continue to provide services.
The meeting was adjourned at 4:45 p.m.
Michele M. Olson, Executive Secretary to the Health Commission