Minutes: Special Health Commission Meeting
Wednesday, February 5, 2003
At 3:00 p.m.
Board of Supervisors’ Chamber
1 Dr. Carlton B. Goodlett Place, 2nd Floor
San Francisco, CA 94102
1) CALL TO ORDER
The meeting was called to order by Commissioner Chow at 3:10 p.m.
Present: Commissioner Edward A. Chow, M.D., President
- Commissioner Roma P. Guy, M.S.W., Vice President
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner Michael Penn, Ph.D.
- Commissioner David J. Sanchez, Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF JANUARY 21,
Action Taken: The Commission approved the minutes of the January 21,
2003 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Monfredini chaired, and Commissioner Umekubo and
Commissioner Penn attended, the Budget Committee meeting.
(3.1) CHN/SFGH-Radiology - Request for approval of a contract
modification with The Registry Network, Inc. to increase the amount of
the contract from $395,000 to $640,000 and reduce the term of the
contract from September 1, 2001 through August 31, 2003 to September 1,
2001 through February 28, 2003, to provide intermittent, as-needed,
professional radiology technologists services, with on-call availability
7 days a week.
(3.2) PHP-Community Health and Safety Services - Request for approval
of a retroactive sole source contract renewal with American Lung
Association of San Francisco, in the amount of $98,214, to provide
Childhood Asthma Initiative services, for the period of July 1, 2002
through August 31, 2003. This renewal is retroactive due to State
funding adjustments that delayed contract development and calendaring.
The contractor has not been receiving payments under an interim
(3.3) AIDS Office-HIV Health Services - Request for approval of a new
one-time only contract with Project Open Hand, in the amount of
$375,000, for delivered meals, for the period of January 1, 2003 through
February 28, 2003.
(3.4) AIDS Office-HIV Health Services - Request for approval of a new
one-time only contract with UCSF AIDS Health Project, in the amount of
$81,922, to provide outpatient mental health services, for the period of
January 1, 2003 through February 28, 2003.
Commissioner Sanchez abstained from voting on this contract.
(3.5) AIDS Office-HIV Health Services - Request for approval of a new
one-time only contract with San Francisco Food Bank, in the amount of
$72,003, for food solicitation services, for the period of January 1,
2003 through February 28, 2003.
Action Taken: The Commission approved the Budget Committee Consent
Calendar, with Commissioner Sanchez abstaining from voting on Item
Commissioner Chow announced the 2003 Health Commission Committee
- Commissioner Monfredini, Chair
- Commissioner Penn, Member
- Commissioner Umekubo, Member
- Community Health Network Joint Conference Committee
- Commissioner Chow, Chair
- Commissioner Guy, Member
- Commissioner Sanchez, Member
Laguna Honda Hospital Joint Conference Committee
- Commissioner Sanchez, Chair
- Commissioner Umekubo, Member
Population, Health and Prevention Joint Conference Committee
- Commissioner Guy, Chair
- Commissioner Parker, Member
- Commission Penn, Member
San Francisco General Hospital Joint Conference Committee
- Commissioner Parker, Chair
- Commissioner Monfredini, Member
IHSS Public Authority
- Commissioner Parker
- San Francisco Health Authority
- Commissioner Umekubo
4) DIRECTOR’S REPORT
No Director’s Report was presented.
5) PROPOSED FISCAL YEAR 2003-04 HEALTH DEPARTMENT BUDGET
Mitchell H. Katz, M.D., Director of Health, presented an overview of
the proposed fiscal year 2003-04 Health Department Budget (Attachment
- Latanya Hurst spoke in support of saving the Mental Health
Rehabilitation Facility (MHRF).
- Adrienne Warren said DPH need to assist the mentally ill and
maintain the MHRF.
- Emeal Powell spoke in support of saving the MHRF. Her son is a
resident of the MHRF.
- Angela Billy Cassidy, spoke in support of saving the MHRF. He
submitted a copy of his testimony (on file).
- Michael Baker, client of the MHRF. The MHRF runs perfectly well, so
don’t take the chance of change putting people on the street. Mr.
Baker submitted a list of other MHRF residents who are opposed to the
cuts (on file).
- Rochelle Robinson, resident of the MHRF, supports the facility,
which gives a brand new meaning to healthcare. She submitted a copy of
her testimony (on file).
- Iain Reid spoke in support of saving the MHRF. He submitted a copy
of his statement (on file).
- Allah Davies, MHRF resident, advocated for keeping the MHRF open. He
submitted a copy of his statement (on file).
- Ronald Wimbush spoke about how important the MHRF is.
- An anonymous speaker spoke in support of the MHRF.
- Abner Boles, Ph.D., Executive Director of Westside Community Mental
Health, said the proposed budget preserves are being preserved, but
there are cuts in services to children and families that are truly
prevention services. He urged the Commission to preserve programs that
serve children and families.
- Kate Walker, Mental Health Board, spoke in support of the day
- Greg Senegal is opposed to cuts in Walden House’ contract.
- Dr. Brian Greenberg, representing Walden House, spoke against the
- Karen Redus, Walden House, said 12-step programs do not work for
everyone and she is opposed to the cuts to Walden House’s continuing
- Fermin Loza spoke in support of Walden House’s continuing care
- Andrew Hayes asked the Commission to reconsider the importance of
specialized outreach to homeless people. He submitted a copy of his
testimony (on file).
- Reverend Yvette Flunder, Executive Director, Ark of Refuge, asked
the commission to direct another $90,000 to the program the program
can continue at its current census.
- Chris Miller, peer counselor at the MHRF, said the changes to the
MHRF are not going to work for the patients. It will end up costing
more money for hospitals and jail.
- David Mallorich spoke against the cuts at the MHRF.
- Greg Rosko spoke in support of the MHRF.
- Emmet Scanlan, MHRF resident, opposed to closing the MHRF. San
Francisco has the money to maintain this facility.
- Marilyn Williams MHRF resident, opposed to closing the MHRF.
- Abdullah Megahed spoke against the budget cuts.
- Cynthia Petticord spoke in support of the work of the Hope Team. She
submitted a copy of her testimony (on file).
- Jonathan Vernick, Baker Places, supports the principles that were
used to develop this budget, however, some of the cuts in day
treatment affect residential treatment programs, such as Robertson
Place, and he is opposed to such cuts.
- Jerry “Frosty” Wiseman spoke in support of the HOPE outreach
team. Please continue their funding.
- Deborah Smith, employee of the MHRF, opposes changes in the MHRF.
- Danielle Evans, Tenderloin Housing Clinic, spoke in support of the
HOPE team. She has seen the team save lives.
- Steve Fields, Executive Director of Progress Foundation, spoke on
behalf of the Human Services Network. Urged the Health Commission to
take a stand for health care and opposed to the cuts. The Health
Department should no longer have to take this level of cuts when there
are sacred cows in the budget.
- Eve Meyer, San Francisco Suicide Prevention, said suicide is the end
stage of mental illnesses and addictions. Urged the Health Commission
to say no to these cuts.
- Criss Romero, IFPTE Local 21, urged the Department to allow staff to
express their opinions. If the process is going to move forward,
honest, truthful information needs to be given to staff and patients.
- Patrick Monette Shaw - Dr. Katz just testified that DPH was unable
to hire these six nurses, because it had to cut these positions in the
current fiscal year; he now wants to chop the unfilled positions next
year. However, on page 155, Dr. Katz claims -- playing the blame game
-- the nursing positions went unfilled because funding hadn’t been
“added back” by the Board of Supervisors. In realty, the Union’s
assert that the Mayor’s office had not released the requisitions to
fill the positions; requisitions don’t land on the Mayor’s desk
unless funding has been identified by DPH. If you keep postponing
hiring nurses for Laguna Honda Hospital, by the time you get around to
funding nursing positions instead of these Party Packs, the nursing
shortage will be so severe you will not be able to attract nurses to
public health positions in San Francisco. Shame on you for
prioritizing Party Packs ahead of public health nurses! These
"Party Pack" toys are funded using public health funds
diverted from direct healthcare services.
- Rex Spray, RN, President of SEIU Local 790 RNs, understands the
difficult situation facing the Department. The deficit is real, but
they believe the proposed budget is a short-term solution.
- Matt Crawford opposed to closing the MHRF.
- Charles Collin, E.D., Family Services Agency, spoke in opposition to
cuts in day treatment. Last year the Commission was able to maintain
day treatment and should do so this year. He is also concerned about
the second round of budget cuts.
- Pier Schwartz, Family Service Agency, is opposed to the proposed day
treatment cuts. There are no alternatives in place for seniors who
receive these services.
- Frank Ngo, SFGH interpreter services, opposed to cuts in interpreter
services at SFGH.
- Chauncy Taylor, employee at the MHRF, said closing the MHRF will put
people who suffer from many mental illnesses on the streets.
- Georgia Creel, President of Drug Abuse Advisory Board, spoke in
support of the SF Drug Abuse Advisory Board and the City-wide
Alcoholism Advisory Board.
- Ramona Davis, M.D., spoke in support of the Bayview Thunderseed Day
Treatment Program. Case management is not a replacement for day
treatment. Please reconsider these cuts.
- Rebecca Morrow, Public Health Nurse and SEIU member, concerned about
the cuts to the most vulnerable people in the city.
- Randy Joy is opposed to draconian budget cuts. He strongly supports
the HOPE team and the Healthy Realization project. These decisions
will result in death.
- Dr. George Davis, Executive Director of Bayview Hunters Point Adult
Day Health Center, asked the Commission to not cut the program.
- Dennis Raab, MHRF employee, is opposed to closing the facility. Many
people will have to be transferred to facilities outside of the city,
which is more expensive and not fair to patients and families. The
acuity of patients has increased who are not fit to return to the
community. These people will only come back into the emergency
- Richard Heasley, Executive Director of Conard House, said the cut to
their Jackson Street residential treatment facility is being driven by
revenue rather than treatment efficacy. These beds are hard to find,
hard to permit, and hard to license so this is a shortsighted
decision. Mr. Heasley also spoke on behalf of the Mental Health
Contractors Association. Please take a strong stand in the language in
the resolution in favor of public health and challenge the premise
that underlies the Mayor’s budget instructions.
- Jackie Jenks, Executive Director of Central City Hospitality House.
She appreciates the difficult position the Health Department is in,
and said the list of the mental health, substance abuse and primary
care are devastating and urged the Commission to tell the Mayor that
the cuts are unacceptable. She said the self-help center is more than
just a referral service.
- Esther Chavez, Director of Tenderloin Self-Help Center, urged
Commission to oppose closing the center.
- Luther Richert, Central City Hospitality House, said the self-help
center is much more than a referral service. They provide myriad
services to homeless people.
- Suzana McKenzie urged the Commission to consider the human costs
that will result from eliminating the MHRF.
- Lori St. John Baldwin said SFGH should be given more money, not
asked to cut programs. It is the Health Commission’s duty to convey
- Philippa Ruttgaizerm, MHRF employee, is opposed to the closure. The
residents need the current level of care.
- Piers MacKenzie spoke in support of the MHRF. His daughter has made
great progress through her care at the MHRF.
- Toni Maines, said that the Patient Referral and Assistance at SFGH
has evolved. She submitted a written copy of her testimony (on file).
- Carol Cheung urged the Commission not to cut services at Chinatown
Public Health Center.
- Barbara Farrell, Ohlhoff Recovery Program, urged the Commission to
oppose cuts in substance abuse services.
- Merrill Buice, San Francisco Human Service Network, urged the
Commission to send the Mayor a strong message to preserve safety net
services for vulnerable San Franciscans. She submitted a copy of her
testimony (on file).
- Kent Woo, NICOS Chinese Health Coalition, thanked the Department for
using the Strategic Plan to guide the budget reductions, to maintain
Healthy Kids, cut administration before programs, and prioritize
prevention. He is concerned about cuts to the SRO program.
- Renee Saucedo, Day Laborer Program, said they will not accept cuts
being made on the backs of day laborers. Hundreds of people depend on
the HOPE team. Without HOPE, the day laborers will not access the
health services they need. She is appalled that the Commission is
considering eliminating translation services.
- Eduardo Palomo spoke in support of health services for the Day
Laborer Program. Without them there will be an epidemic in the city.
- Julio Loyola, Day Laborer Program, spoke in support of the HOPE
program. Many Latinos need this help in order to survive.
- Ben Rubilcalva, employee at Laguna Honda Hospital, is opposed to
contracting out the laundry.
- Shira Shavit, M.D., Family Practice Resident at SFGH, spoke in
support of the translators at the hospital. 50% to 70% of her patient
panel is monolingual non-English speakers. She depends on interpreter
services-there are not enough currently.
- Reini Jensen, SFGH Physician Resident, urged the Commission to
demand from the Mayor that more money be allocated to health care in
San Francisco. Support staff at the health centers is already at a
minimum and should not be cut further.
- Ed Kinchley, SFGH/SEIU 790, said that if many of the proposed cuts
are made, people will not be able to find prevention services or
primary care services that they need. Need outreach and referral. It
is discriminatory to cut interpreter services.
- Michael Lyon said the Health Commission is not the appropriate body
to make cuts that will kill hundreds of people in San Francisco. They
need to say no more. No justice, no peace.
- Terry Bautista, California Healthcare Interpreters Association, is
opposed to cuts in translation services at SFGH. She submitted a copy
of her testimony (on file).
- Jennifer Friedenbach, Coalition on Homelessness, said the Fire
Department and the Police Department would never accept cuts of these
levels. The Health Commission cannot send a budget to the Mayor that
reduces substance abuse services, day treatment, mental health and
- Michael Weinberg, field representative for SEIU Local 535, said
there has to be other alternatives to solve the budget. The cuts that
are proposed are too severe to the citizens of the city.
- L.S. Wilson, Coalition on Homelessness, urged the Health Commission
to reject all these cuts and demand that the Mayor find savings that
do not target poor people. He distributed a fact sheet to the
Commissioners (on file).
- Raychel Headspeth spoke in support of Walden House. Walden House
helped her change her life and she urged the Commission not to cut
- Delphine Brody, Mental Health Association of San Francisco, is
opposed to the cuts in community-based mental health services.
- Jayne Snook has a brother in the MHRF. Please do not close this
facility. These are not just budget cuts, these are lives. Stand up
and say no to the cuts.
- Pamela Fischer, President of National Alliance for the Mentally Ill,
said her son has been helped tremendously by Walden House and Baker
Places. She is broken hearted that the system is being nibbled away at
because it is a house of cards.
- Teresita Gatan, SFGH employee, said the care the hospital provides
to patients is being compromised by cutbacks. She asked the Health
Commission to recommend more funding to the Health Department rather
than accept cuts.
- William Bradley Bauman is a graduate of the MHRF. The MHRF has many
programs such as yoga, art, money management, library, volleyball and
many others. Do not change the program.
- Karen Patterson Mathew, Executive Director of Bayview, spoke in
opposition to the cuts.
- Kathleen Dobson, Health at Home, is opposed to the proposal to
eliminate three home health aides. Helping people heal in their homes
is less costly than having them heal in a hospital. She submitted a
written copy of her testimony (on file).
- Bryan Uyeno, Laguna Honda Hospital laundry worker, spoke in
opposition to contracting out the laundry. By contracting out, the
other laundry companies will pay poor wages and have poor working
conditions. Sixty three workers will be displaced.
- Byron Holcomb, Laguna Honda Hospital laundry worker, is opposed to
the cuts in the Health Department, and asked the Commission to use the
higher power it was given when making these decisions.
- Sonny Quiniquini, Laguna Honda Hospital laundry worker, is opposed
to contracting out the laundry. Without the workers DPH would not have
a Laguna Honda Hospital today. It has the money because the Health
Department executives received bonuses.
- Mary Kate Connor, Executive Director of Caduceus Outreach Services,
said these cuts disproportionately target people with mental illnesses
and substance abuse problems.
- Clearon Johnson said thanks to the services she received she is a
productive member of society.
- Larry Bevan, Local 250 shop steward, expressed concern about the
reprogramming of the MHRF. He submitted a copy of his testimony (on
- Josie Mooney, Executive Director of SEIU 790, said some of the
proposed cuts are in outright violation of the MOU. These proposals
should not have been made solely by the Department-should have
included unions, community, non-profits and others.
- Margaret Brodkin, Executive Director, Coleman Advocates for Children
and Youth, thanked the Department for supporting the Healthy Kids
Program. But the Commission should reject the concept of
across-the-board cuts throughout the city. Not every department is
equal. Demand a humane and progressive budget.
- Sally Ann Buchmann, shop steward and SFGH employee, said the MHRF
should continue in its current form. She also supports retaining
bilingual services at the hospital. She cannot do her job without the
translators. She also supports the substance abuse program. Don’t
balance budget on overworked city workers and the poor.
- Vincent Villarreal, Psychiatric Emergency Services, the proposed
cuts will mean more patients in emergency services. The MHRF clients
go to PES, and are glad that the MHRF is there for them. Without the
MHRF, the people will get worse.
- Feo Jacobsen, SFGH Department of Psychiatry, is opposed to the
closure of the MHRF.
- Deborah Logan, SFGH Department of Psychiatry, is opposed to closing
the MHRF and cutting substance abuse services. Mental health and
substance abuse services cuts are disproportionately represented in
the proposed budget reductions. Mental health patients have the right
to be treated in their community.
- Otto Duffy, Tom Waddell Clinic Community Advisory Board member, said
the proposed budget cuts will create more activism among consumers,
which is one silver lining. He’s opposed to the proposed cuts.
Testimony submitted in writing by members of the public
- Brad Shapiro - My name is Dr. Brad Shapiro, and I am a family
physician who provides care to homeless families in San Francisco
through the Homeless Families program based at Tom Waddell Health
Center. Given the extraordinary breadth and depth of the proposed cuts
in mental health, substance abuse, and homeless outreach services, I
feel the need to register my strong conviction that these cuts will
have a severe impact on many San Francisco residents. These
deleterious effects will be most concentrated among the people with
the least ability to deal with them and will perpetuate the
circumstances that drive people into homelessness. As you know,
medical and mental illness as well as substance abuse are major causes
of homelessness. Cutting necessary services will not result in cost
savings and will cause increased suffering. Please consider cutting
services and tax breaks to the wealthy and healthy who can take care
of themselves rather than removing the final safety network for people
in desperate need.
- Damon Eaves - Dr. Katz said that it doesn't make sense to have
outreach workers giving information on programs if there are no
programs for the clients to go to. The HOPE team was not a referral
program. Based out of Tom Waddell Health Center, composed of two
social workers and a health worker, our mission was to engage, build
rapport, and offer services to the homeless, street based clients who
were unable to do it on their own. The services offered are already in
existence. This 3-person team provides services to hundreds every
month at the Mission Hotel, Jefferson Hotel, the Man's Place Shelter,
Day Labor Program intensive outreach and our weekly Health Realization
group. There used to be 11 members on the HOPE team, now there are
three, so we have experienced cuts, we don't expect to be left
untouched. All we are saying is we have been "touched"
already. Our job is to create a bridge between the most needy clients
and the services in place for THEM. The reality is, that to have the
service is not enough because many of the most needy clients are
unable to access or tolerate the system without assistance and
advocacy. To save 244k, this vital link is going to be dismantled?
- Irene Lucero - Greetings. My name is Irene and I have been working
at the MHRF since the day it was open. It has been a terrible
disappointment to see the MHRF close down, that also brought a
tremendous impact to both our residents and staff emotionally and
mentally. I have considered MHRF as my second home, I started at a
young age of 22 and I’m now 28 years old and I have seen a great
influence of the care we gave to our residents, the full dedication
and hard work that all my colleagues have exerted for the past six
years, and it was very fulfilling to see our residents discharged and
placed in the community where they are supposed to be, as well as see
them achieve their highest level of functioning. I am truly hoping and
pray that the County will come out with possibilities and ways that
could prevent our facility to be close. Indeed, I do understand the
billion of dollars deficit but I hope that the County realizes that a
lot of lives and families are relying on these organization. And no
matter what happens, I will stay until the bitter end and will give my
full support to the residents, staff and to the MHRF. Lets all be
together and fight to save the MHRF. God bless and hope for the best.
- Craig Allen Diaz - we want the residents to run the MHRF with a new
name and director from residents, staff, or outsider (score)--ranks.
We want current employees of over a month’s seniority, and a good
work record to get a $5000 -- to--$7000 "exception" or
lay-off bonus. We will continue a strong medical presence. The new
MHRF will be run lean and tight on only residents' monies. The City
will save much money in these times of SF budget troubles. We
residents especially want the right to refuse drugs!!!! This will be a
communal democracy, a housing place for low-income people. We admit
there will be big cuts in the budget. We will build and continue
connections with SFGH, with visits to residents at SFGH. We demand the
right to refuse drugs!!!! We demand an open door!!!! We demand housing
now and in the future!!!!
- Jay Wright - My name is Jay Wright. I have worked at the MHRF since
it opened in 1996. The DPH plan to reduce the budget deficit by taking
the drastic step of closing the MHRF is a tragedy. This facility has
provided excellent care for over six years and has been a home to over
150 residents. Not only will the proposed closure displace hundreds of
workers, not all residents function at a level that will allow them to
remain in the MHRF if "reprogrammed" to a RCF, so they will
have to move. There are other ways to reduce the operational expenses
of the MHRF, but at a MHRF meeting Gene O’Connell reportedly said,
"There is no Plan B" when asked what other options were
being discussed as an alternative to MHRF closure. Please tell Mitch
Katz to go back to the drawing board, talk to the unions and come up
with some viable options! The MHRF really is worth saving, just ask
the residents! Thank you.
- Anonymous - To those to whom much power is given: the use of power
must be considered.
- Anonymous - I am a peer counselor who knows the value of mental
health care. If these budget cuts go through, we will be telling those
who have mental illnesses that they are no longer a value to this
society. We are telling them that they don’t matter. We are telling
them that we are a county that encourages freedom but we are not
willing to support basic human rights. People that are ill need to be
taken care of, the hungry fed, the homeless sheltered. Where are our
American and family values?
- Evelyn Bishop - I have been at the MHRF for 8 months. I have been at
other “mental health” facilities from anywhere from two days to
two months, including Bellevue Hospital in NYC. At the MHRF, we are
required to take correct medications for a variety of ailments, from
schizophrenia to manic depression, which includes schizoid defective
disorder, which means that people spend their time talking to
themselves, which can be very annoying, but which the staff at the
MHRF handle with aplomb and calm. At the MHRF, I have had the time and
the care to admit to having been raped and also owning up to suicidal
tendencies, which helped the staff steer me to the correct
medications. I no longer have illusions, hear voices, or long for
death to take away my mental pain. I choose to endorse the MHRF for
its long-term care assistance, in helping me become housed and job
- Dominic Chan, Assistant Director of the Hospital Division of SEIU
Local 250 - The proposed conversion of the MHRF into residential care
facility raises some serious questions about what will happen to the
current clients. About 75-80 percent of the current clients would not
be able to stay in the new facility. What happens to these people and
the families that come to see them? Is the City and County going to
send them all over the state to wherever they can find room? What is
the plan for dealing with these clients who have long-term mental
illnesses? Also, by changing the MHRF’s license, the Health
Commission would be going against the will of the voters. In 1987, San
Francisco voters approved Measure C, which was a $26 million bond
measure to build the MHRF. The building opening in 1996. I am sure
that the voters would not be happy that the facility that was built
specifically for long term mentally ill patients would only serve that
mission for seven years. Local 250 urges the Commissioners to
seriously reconsider converting the MHRF.
- Ed Bell - I am an employee at the MHRF, Mental Health Rehab Worker,
Class 2303, Certified Nurse Assistant. The re-licensing of the MHRF to
a no level residential facility will put many, if not all of our
psychiatric patients at risk of homelessness, decompensation and
suicide. The patients of the MHRF are residents of San Francisco who
have the opportunity to lead productive lives upon ready discharge to
go to work, school, live on their own or back with their families.
These residents are our mothers, fathers, grandparents, our brothers
and sisters, our children and our neighbors. They deserve to continue
to receive vial services, quality services and hope for a productive
place in society. The MHRF gives them this voice just the way it is. I
urge you to not place these patients/people in a situation of
uncertainty and unsafe conditions.
- Jennifer Baity Carlin - Closing the MHRF, a locked psychiatric
facility on the campus of San Francisco General Hospital will not save
money. While it may magically make $8.1 million disappear from Dr.
Katz's new budget, what would happen if the MHRF were closed is this:
The patients would be discharged into unlocked community facilities
where their emotional and behavioral needs could not be met (which is
why they are there in the first place.). Then they would either
assault someone (costing money in police and medical care response),
use drugs (costing money in increased ER and inpatient psychiatric
visits), stop taking their medication (which usually lands them back
in acute psychiatry as well) and (if they were still alive) would be
brought to the ER or Psychiatric Emergency Room at SF General or sent
to high cost locked facilities out of San Francisco. Guess what? All
that costs money too. Thank you.
- Lynn Carman - I represent Dr Teresa Palmer, Mr. Ed Kinchley, and the
Coalition to Save Public Health-SF in a legal action to compel the
City and County of San Francisco to abide by California Health and
Safety Code 1442.5. The Superior Court has issued alternative writ of
mandamus, which commands the Board Supervisors to comply with public
notice requirement of Section 1442.5 before adopting a budget, which
reduces the level of medical services at San Francisco General
Hospital. The Board of Supervisors has adopted a policy, which the
City Attorney states complies with the Superior Court order. The Board’s
motion, M02-204, calls on the Director of Public Health to notify the
Board of any budget provisions, which would reduce the level of
medical services in any health facility in the City and County of San
Francisco. Under the motion, Director Katz is to post the
1442.5-mandated public notices at the entrances of all health
facilities of the City and County of San Francisco with the
information required by the statute at least 14 days before the full
Board of Supervisors holds the 1442.5-mandated public hearing in
advance of adopting such budget provisions. Superior Court Judge
Robertson has continued his order to July 31st to see if the City
complies with the order, and has directed me to apply to the Court for
contempt proceedings if the order is violated. Dr Katz states
unequivocally that his budget proposal will cut the level of medical
services. Therefore, we expect Dr Katz to comply with the motion
MO2-204, under both motion M02-204 itself and the continued Superior
Court order prompting the motion. I request this letter be made a part
of the public record of this hearing. Information to be supplied to
the Board of Supervisors pursuant to its HS 1442.5 obligations must
include the service reductions that would result from cuts or freeze
to the UCSF-DPH contract.
- Patrick Monette-Shaw - DPH’s proposed fiscal year 2003-'04 budget
priorities are totally out-of-whack. DPH’s base budget eliminates
funding for the LHH Increased Nursing Model - intended to provide
residential skilled nursing care to 1,065 low income and homeless
clients with cognitive and physical disabilities -- by $525,919. Page
13: Dr. Katz’s Alice-in-Wonderland logic rationales this cut
stating: “We have never been able to provide increased nursing model
at LHH.” Well, duh! Instead of filling the 6 FTE Nursing positions,
DPH is proposing a $150,000 increase for syphilis prevention. DPH is
now distributing a “Party Pack” incentive to STD survey
respondents; it contains a toy penis, toy syphilis sore, a condom,
lubricant, and amazingly, jelly beans. A third squishable toy, at
unknown cost, is reportedly being manufactured: A toy antibiotic pill.
Where is the evidence-based proof these “packs” will prevent
syphilis cases? Until this Commission prioritizes Nursing above these
toys, Nursing will never become a priority!
- Sharifa Rahman - I have worked at the MHRF as a mental health worker
for two years. I have seen many of our patients who were not able to
live in the community when they came to us, improve with our help to
the point where they became able to live in the community. Most of our
current patients are not able to live in the community (this includes
RCFs). It would be a tragic loss if the MHRF were to be converted to a
RCF. I beg you to stop this proposal and seriously examine the facts
and needs. (Peter Shaw, activity leader at the MHRF, added to the
letter “I agree with all the above. I’ve worked at the MHRF since
- Anonymous - I was patient at the MHRF. Please don’t close it down.
- Greg Peter Gery Rosk - I want the MHRF to stay open and I hope the
MHRF will stay because it is a very nice place to live at the MHRF and
it is a very good hospital. I like everyone at the MHRF and I hope
that the MHRF will have a good place to stay in.
- M. Williams - This is a letter to inform you that I, as a two-month
member of the MHRF facility would like to see this building stay open.
The reason for this is that we the patients require nursing care and
this facility provides it. At a board and care facility, we would not
be as well taken care of. The staff tries to provide for our needs as
well as possible, and we the patients feel that they are fulfilling a
needed role in the community. The reason for this is that what with
people falling mentally ill, there is need for a facility of this
type. I don’t feel that it is right to slash the budget as MHRF
fulfills an important role in the community, a place for mentally ill
people to get better.
- Enola Maxwell, Potrero Hill Neighborhood House, submitted a packet
of information about the ZAP Program (on file).
- The Family Service Agency of San Francisco submitted a packet of
information (on file).
- Commissioner Monfredini asked the Department to look closely at the
day treatment cuts to see if the proposed level of cuts could be
reduced. She would also like a breakdown of the HOPE program budget.
- Commissioner Parker emphasized that we are all in this predicament
together and we need to work together to close the budget gaps. He
will accept any suggestions from the community. He requested a
consolidated list of all the programs that are proposed to be
eliminated or modified, with a clearer description of the impact the
modification will have on services.
- Commissioner Umekubo said we are faced with a situation where we
either have to cut or get more money. We have to leave no stone
unturned to pursue more funding. He is not sure if the budget before
him today is the least detrimental possible, and we need to keep an
open mind. What this situation demonstrates is the under funding of
health care from top to bottom. We need to be creative and minimize
- Commissioner Sanchez said that the safety net no longer exists. The
citizens of this city have dedicated money to build a health care
system that includes a new Laguna Honda, San Francisco General
Hospital, and the MHRF. This quality system is being dismantled, and
we need to explore creative ways to salvage a level of quality care.
- Commissioner Penn said the Commission needs to be clear what message
it sends to the mayor. It does not make sense to ask departments
across the city to make equal cuts. The long-term impact of health
cuts are so much greater than cuts in other areas. This must be made
clear to the mayor. Second, while the philosophy of maintaining direct
services sounds good, reducing ancillary services has a ripple effect.
The Commission does not have a good idea of the potential fiscal and
long-term health impacts of these cuts, and needs more information to
make informed decisions. We cannot cut interpreter services-this
budget should be increased. We need to work with non-profits who are
getting cut to see if the amount of the cut can somehow be reduced.
Finally, we do not have the benefit of the individual division heads’
thoughts, and what alternatives were considered. Need to advocate for
more money and not blindly accept the cuts.
- Commissioner Guy said the health care system is growing but the
safety net is not. She supports that framework that the proposed
budget was created within. The Strategic Plan does point the way, but
the goals of the plan will be challenged by these budget cuts. The
Department cannot improve its situation on its own, but needs the
State and Federal governments. She supports areas that the Department
wants to expand. She would rather make the tough budget decisions
rather than having the Board of Supervisors do it without the informed
deliberation of the Health Commission.
- Commissioner Chow summarized the follow up that was requested by the
Commission: analyze additional revenue sources; advocate for reducing
DPH’s target; provide additional information to more fully
understand the impacts; put the MHRF changes into context explain how
the change affects the mission; more details on what the day treatment
changes really mean-are they essential or just nice to have; rationale
for a 50 percent reduction to interpreter services; reexamination of
the patient referral system function, so that perhaps while there are
no nurses, there is staff to make appointments. Commissioner Chow
emphasized that the Department should be commended for developing a
budget based on a set of principles.
6) PUBLIC COMMENTS
The meeting was adjourned at 7:56 p.m.
Michele M. Olson, Executive Secretary to the Health Commission