Minutes of the Health Commission Meeting
Tuesday, October 5, 2004
SUNSET MENTAL HEALTH BUILDING
1990 41st Avenue
San Francisco, CA 94116
1) CALL TO ORDER
The meeting was called to order by Commissioner Chow at 4:15 p.m.
- Commissioner Edward A. Chow, M.D., President
- Commissioner Lee Ann Monfredini, Vice President
- Commissioner Roma P. Guy, M.S.W.
- Commissioner James M. Illig
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
Commissioner Chow announced that, due to personal and professional
reasons, Commissioner Penn has resigned from the Health Commission and the
Mayor has accepted his resignation.
Commissioner Chow announced changes to the Commission’s committee
structure and assignments. Effective November 1, the Population Health and
Prevention Joint Conference Committee and the Community Health Network
Joint Conference Committee will be merged into one Joint Conference
Committee. Commissioner Chow, Commissioner Guy and Commissioner Sanchez
will be the members of the new committee. Commissioner Illig has been
appointed to serve on the Health Commission’s Budget Committee.
2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF
SEPTEMBER 21, 2004
Action Taken: The Commission approved the minutes of the September 21,
2004 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired and Commissioner Guy attended the Budget
(3.1) CHN-SFGH/Radiology - Request for retroactive approval of two
contract modifications with Medical Contracting Services and The Registry
Network, Inc., to increase the combined contract amount by $825,000, from
$75,000 to $900,000, to provide intermittent, as-needed, professional
services of per diem and traveling radiology technologists with 7 day a
week on-call availability, for San Francisco General Hospital, for the
period of July 1, 2004 through June 30, 2005.
(3.2) PHP-Community Programs/AB 75 Project - Request for approval of a
contract renewal with AmeriChoice, in the amount of $171,638, to provide
fiscal intermediary services for the FY 2004-05 CHIP Hospital and
Physician Program, for the period of November 15, 2004 through March 31,
(3.3) BHS-Mental Health - Request for approval of a retroactive
contract modification with the Fred Finch Youth Center, in the amount of
$373,143 for FY 2004/05, for a total contract value of $2,064,001, to
provide Therapeutic Behavior Services, Rate Classification Level 12 and
14, and Dual Diagnosis mental health services for adolescents, for the
period of January 1, 2003 through June 30, 2005.
(3.4) BHS-Mental Health - Request for approval of a retroactive renewal
contract with Instituto Familiar de la Raza, Inc., to provide mental
health services to children, youth, families and adults residing in San
Francisco, in the amount of $1,803,761, for the period of July 1, 2004
through June 30, 2005.
- Commissioner Guy asked if the decrease in the contract amount would
have an impact on programs. Estella Garcia from Instituto Familiar de la
Raza said that the funds that are being transferred from the contract were
for fiscal intermediary services, which was an entirely administrative
role. IFR’s programs have been funded at the baseline level.
(3.5) BHS-Substance Abuse - Request for approval of a retroactive
contract renewal with Catholic Healthcare West dba St. Mary’s Hospital
and Medical Center, for the provision of acute psychiatric inpatient
hospital services, in the amount of 1) $170,000 in City funds targeting
uninsured adolescents, and 2) $3,093,539 in Medi-Cal funds for all acute
inpatient hospital providers targeting Medi-Cal beneficiaries, for the
period of July 1, 2004 through June 30, 2005.
- Commissioner Sanchez asked if the “Needs Improvement” score in
program compliance on the last monitoring report was an isolated incident.
Ms. Bennett from Catholic Healthcare West said it was an isolated
incident, there has been a reorganization and now there is a system in
place to prevent this from happening in the future.
(3.6) BHS-Substance Abuse - Request for approval of a retroactive
contract renewal with Catholic Healthcare West dba Saint Francis Memorial
Hospital, for the provision of 24-hour adult acute psychiatric inpatient
hospital services, in the amount of 1) $50,000 in City funds targeting
uninsured adults, and 2) $3,093,839 in Medi-Cal funds for all acute
inpatient providers targeting Medi-Cal adult beneficiaries, for the period
of July 1, 2004 through June 30, 2005.
(3.7) BHS-Substance Abuse - Request for approval of a retroactive
contract renewal with Ohlhoff Recovery Programs, in the amount of $388,431
per year for a four-year contract total amount of $1,553,722, to provide
residential and outpatient substance abuse treatment services targeting
women and adolescents, for the period of July 1, 2004 through June 30,
Secretary’s note - the contract was changed from a four-year contract
to a one-year contract, July 1, 2004 to June 30, 2005.
- Commissioner Guy asked how the agency is addressing issues raised in
the corrective action plan. Barbara Farrell, Executive Director of Ohloff
Recovery Programs, replied that the agency has enriched the program to
make it more interesting and engaging for youth. This should be reflected
in the next client satisfaction survey.
- Commissioner Sanchez was glad to see such a well-defined corrective
(3.8) BHS-Mental Health/Substance Abuse - Request for approval of a
retroactive contract renewal with the Regents UCSF-Center on Deafness, in
the amount of $477,681, to provide mental health/substance abuse
outpatient services, for the period of July 1, 2004 through June 30, 2005.
Commissioner Guy is interested in the strategies the Center on Deafness
will use to improve outreach, and asked for a report to the Community
Health Network Joint Conference Committee in six months.
(3.9) CHPP-Health Promotion - Request for approval of a contract
modification with Study Center, Inc., in the amount of $390,422 for a
total contract value of $3,810,183, to provide additional fiscal sponsor
services for the Tobacco Free Project Community Capacity Building Training
Center, for the period of July 1, 2004 through June 30, 2005.
(3.10) CHPP-Health Promotion - Request for approval of a retroactive
renewal contract with Polaris Research & Development, in the amount of
$464,800, to provide Black Infant Health Improvement Program services
targeting African American parents, for the period of July 1, 2004 through
June 30, 2005.
- Commissioner Guy asked that the client satisfaction survey results be
brought to the Population Health and Prevention Joint Conference Committee
in early 2005.
(3.11) CHPP-AAHI - Request for approval of a retroactive renewal
contract with Black Coalition on AIDS, in the amount of $400,176, to
provide fiscal agent and support services to the African American
Coalition for Health Improvement and Empowerment (AACHIE) as the community
partner for the DPH African American Health Initiative (AAHI), serving
African Americans city-wide, for the period of July 1, 2004 through June
(3.12) SFGH - Resolution granting the Executive Administrator of San
Francisco General Hospital the authority to administer the Adult
Residential Facility and Social Rehabilitation Program at the Behavioral
Action Taken: The Health Commission approved the Budget Committee
Consent Calendar with the modification to a one-year contract term for
Item 3.7. Commissioner Illig and Commissioner Umekubo abstained from
voting on Item 3.5 and Item 3.6. Commissioner Sanchez abstained from
voting on Item 3.8.
Item 3.8 was referred to the Community Health Network Joint Conference
Committee for a follow-up report in six months.
Item 3.10 was referred to the Population Health and Prevention Joint
Conference Committee for a report in early 2005.
4) DIRECTOR’S REPORT
Mitch Katz, M.D., Director of Health, presented the Director’s
Chiron Loses License to Manufacture Vaccine
This morning, Chiron Corporation announced that the United Kingdom
regulatory body has temporarily suspended the company's license to
manufacture Fluvirin influenza virus vaccine, preventing the company from
releasing any of the product during the 2004-05 flu season. DPH receives
approximately 98 percent of its vaccine from Chiron. Currently, the
Department is suspending all flu clinics and is awaiting instruction from
the CDC regarding the possible release of a limited amount of vaccine
manufactured by Aventis. As of this morning, Maxim, who receives its
vaccine from Aventis, was continuing to hold flu clinics at three San
Francisco sites. Two Maxim flu clinics are scheduled for tomorrow. We are
advising the public to call their primary care providers regarding
available flu vaccine. Dr. Katz will keep the Health Commissioners
informed as this event develops.
Transitions in LHH Administration
Larry Funk, the Executive Administrator of Laguna Honda Hospital (LHH)
announced yesterday that he wished to focus his work for the next several
years exclusively on the LHH replacement project. To do that, he resigned
as Executive Administrator of LHH effective October 31, 2004. Dr. Katz
will be appointing him as a Transition Coordinator for the new building
effective November 1, 2004. In this job he will supervise the choice and
purchase of finishing and equipment for the new LHH and organize the
transition of all clinical and support services from the old building to
the new building. This is a critical assignment that follows closely Larry’s
commitment to the new LHH, as exemplified by his extraordinary work on
Dr. Katz is pleased to announce that he has appointed John Kanaley the
new Executive Administrator of LHH effective November 1, 2004. John has
been with DPH as Senior Associate Administrator at SFGHMC since 2000 when
he was recruited from Kaiser Permanente, Fresno. John has more than 23
years of progressively responsible experience in the Health Care
Administration, Building Management and Engineering / Construction Fields
and hold a master’s degree in Public Health from California State
Dr. Katz has worked very closely with John on a number of projects
including the SFGH rebuild process. He is certain he will be a great
leader for LHH. During the next 3 weeks Larry and John will be working
together to assure an orderly transition. He congratulated both of these
great staff members for their commitment to the Department.
Mildred Crear, Director of Maternal and Child Health, Retiring
Mildred Crear, Director of Maternal and Child Health (MCH), will be
retiring in November 2004. Mildred began her 41 years of service to DPH in
1963 as a public health nurse. Through her visionary leadership several
programs evolved that improved the health of diverse populations in San
Francisco, including Family Planning, Black Infant Health, Fetal Infant
Mortality Review, Child Care Health Consultant Program, and the Universal
Home Visiting Program that offers every new mother a home visit from a
public health nurse. Under Mildred’s direction, Nutrition Services have
also improved the health of women, infants, children and families. Mildred
is widely and affectionately known for her ability to expand services and
generate revenue, her compassion for people, inspirational leadership, and
her comforting bright smile. Mildred’s retirement dinner is November 19,
2004. For more information please contact Renee Anderson at Renee.Anderson@sfdph.org
or Twila Brown at Twila.Brown@sfdph.org or 575-5712.
Sally Liska to Provide Hurricane Response in Haiti
Sally Liska, Director of DPH’s Public Health Laboratory, has taken
her vacation time to assist with hurricane response in Haiti. Sally will
be providing technical assistance to help setting up laboratory capacity
for monitoring enteric (cholera, typhoid, and paratyphoid) and other
diseases. Dr. Katz and the Health Commission are proud to work with a
competent and dedicated professional like Sally who is generously donating
her time and expertise to provide assistance to communities in crisis.
TCM Grant Funded
Community Behavioral Health Services has just been awarded a Targeted
Capacity Expansion grant for Methamphetamine Treatment by the federal
Center for Substance Abuse Treatment. The new program will be a
collaboration between Stonewall/Magnet, STOP, Continuum and CBHS to
replicate and evaluate the successful UCSF methamphetamine treatment model
in the Continuum setting. It was fully funded at $500,000 per year for
three years. Congratulations to the CBHS team and its partners on this
exciting new project.
The CHNs Look To End Abuse Permanently (LEAP) program will host the
first annual "Walk for Healthy Relationships" walkathon and
family resource fair at Sharon Meadow in Golden Gate Park on Saturday,
October 30th from 10:30 to 2pm. LEAP provides domestic violence
training and resources to SFGH, primary care sites and community-based
clinics in San Francisco. They also maintain the CHN Intimate Partner
Violence/Family Violence Web page and help design and run domestic
violence support groups at SFGH. The walkathon is intended to raise
awareness about domestic violence and to raise funding to support the work
of the LEAP program. For more information, contact Dr. Leigh Kimberg at
(415) 292-1300 or e-mail firstname.lastname@example.org.
InSPOT to Debut tomorrow
In another innovative use of the Internet, Internet Sexuality
Information Services (I.S.I.S) and the STD Unit are kicking off a new
partner notification option tomorrow for men who have sex with men (MSM)
using peer-to-peer e-mail postcards or "e-cards." At
www.inspot.org, MSM who have been diagnosed with an STD can choose from a
number of hip, funny and to-the-point e-cards to let their partners know
they may have been exposed as well and should get tested. The site was
designed with input from community advisory members. Dr. Jeff Klausner
will be hosting the press event tomorrow at 10:30 a.m. at Harvey Milk
Plaza to promote the site and discuss its role in the prevention of STD.
He will be joined by Deb Levine and Ted Kennedy of I.S.I.S. The Health
Commissioners are welcome to attend.
Dr. Katz introduced Supervisor Fiona Ma, who thanked the Commission for
having a meeting in the Sunset. She also acknowledged Dr. Katz and Terry
Wong for all their hard work.
- Commissioner Illig commended the Department for the InSPOT website. It
is a very clever way to confidentially and anonymously notify partners.
Commissioner Illig would like the Health Commission to look at the grants
that it receives and expends in a new way, and will examine this issue and
make recommendations as a member of the Budget Committee.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE
RECOGNITION AWARDS FOR THE MONTH OF OCTOBER
Commissioner Sanchez presented the October Employee Recognition Awards:
Patricia Erwin, MPH
Program Manager, Medical Director, Ocean Park Health Center
Ginger Smyly and Newcomers Health Program Christina Carpenter,
Lisa Johnson, M.D.
Medical Director, Ocean Park Health Center
6) OVERVIEW OF DPH SERVICES IN SAN FRANCISCO’S SUNSET DISTRICT AND
DEMOGRAPHICS OF ZIP CODES 94116 AND 94122
Jim Soos, Senior Health Program Planner, Policy and Planning presented
an overview of the demographics of the two zip codes that predominantly
make up the Sunset (Attachment A).
Supervisor Ma commented about the pedestrian fatalities in the
neighborhood. She works very closely with the Police Captain of the
Taraval Station to try to keep the fatalities down. The Sunset district
has the highest rate of ticket giving, has had two DUI stings along 19th
avenue, crosswalk stings, and other efforts. She is working on installing
more countdown signals.
- Commissioner Guy asked how many of the pedestrians who were killed
resided in the two zip codes. Mr. Soos said most of the people lived in
the district. She asked how families are defined. Mr. Soos said his report
uses the same definition as the census-related by blood or by marriage,
with or without children. Domestic partners are not included in the
definition. Terry Wong, Executive Director of Sunset Mental Health, said
one of the issues is multiple families living in one house, and asked if
this is reflected in the household income data. Mr. Soos replied that the
census looks at household income, which would include the incomes of
multiple families in one household. So the income level in one household
may look higher than it would be when compared with another single family.
He will delve into the data further to see if this can be culled out-based
on household size.
- Commissioner Chow said it is surprising that self-inflicted death is
one of the top five causes of death. Do we have an explanation? Mr. Soos
said he only has the raw data. Commissioner Chow would like to delve into
this issue more deeply in terms of how it compares to the rest of the
city, what are the actual numbers and is this issue more pressing in the
community than in others that warrants additional support.
7) PUBLIC TESTIMONY ON THE HEALTH NEEDS IN THE SUNSET COMMUNITY
- Eileen Ditmer raised the issue of lack of board and care housing for
clients in the Sunset and generally. When people lose their housing in
this community, they do not have anyplace to go. Hotel placements are not
appropriate for many DPH patients. Other places have dedicated housing
that she cannot access. Commissioner Monfredini asked why not, and Ms.
Ditmer replied that those slots are dedicated to agencies’ own client
bases, and there is plenty of demand. Dr. Katz added that he would have
Marc Trotz look at the available supportive housing units.
- Commissioner Guy said to remember that the new Laguna Honda includes
independent living and this should be included in the problem-solving
- Dr. Terry Wong, Director of Sunset Mental Health, said the center has
1,100 open cases and four separate programs: adult, children,
socialization and dual diagnosis. There are 2,400 unduplicated clients per
year. In the services they provide, they are finding that they are barely
able to provide these services with the staff they have. The client
population is 30% Chinese, 20% Russian, 5% Korean and 10% children. They
are faced with a dilemma about preserving cultural competency. The areas
of the city where Asians families are moving do not have culturally
appropriate services, and the patients come to the Sunset. They are
overwhelmed and unable to meet the demand. In addition, they serve a lot
of children but do not have separate children’s program so borrow from
the adult program to provide Chinese language services to children and
their families. Approximately 25% of the Chinese population they provide
services to do not live in the 94122 or 94116 zip codes.
- Commissioner Monfredini asked for actual data, and Dr. Wong is in the
process of getting this. Commissioner Chow wants to ensure that there is
an appropriate number of bilingual staff to meet the needs of the clinic.
The other issue is adding language capacity to other neighborhoods so
people do not need to come all the way to the Sunset if they do not live
- Commissioner Monfredini asked how to take this to the next level,
realizing that there isn’t money now, but may be in the future. Dr. Katz
said this discussion should happen with Dr. Cabaj.
- Commissioner Sanchez noted that there are a lot of schools and child
care facilities in this area, and DPH should look at expanding Wellness
Center. Dr. Wong said they provide services to the Lincoln Wellness
Center, partner with the Sunset Neighborhood Beacon Center and provide
on-site services to many schools.
- Commissioner Chow asked for a progress report on this issue to the CHN
- Commissioner Guy wants the follow up to include children’s services
- Sasha Mosalov - Sunset Russian Tobacco Education Project, located at
Ocean Park. The program began four years ago and includes popular smoking
cessation programs, media messages through the Russian television.
Continue to broaden healthy living programs in the Russian Community and
do workshops through Ocean Park and Jewish Community Services. Provide
yoga classes, healthy eating classes
- Olga Radom, said the Russian community is invisible, but still has
many problems, including depression, heart problems, cancer, diabetes,
etc. There is a large population of Mongolian people that speak Russian
and this community needs help. Commissioner Monfredini asked who is
emigrating from Russia. Ms. Radom said it is families with kids, older
folks, and often single political asylees. She gave the Commission a
report that profiles the Russian-speaking Newcomer community in San
Francisco (on file in the Health Commission Office). Commissioner
Monfredini asked if it is acceptable in the Russian culture to acknowledge
depression. Ms. Radom said many problems lead to depression, for example
it is hard for older people to learn English, so this leads to a large gap
between kids and older people. Also, very educated people from Russia
cannot get comparable jobs here, and that is depressing.
- Patricia Simpson, patient from Ocean Park Health Center, said that
she is at the clinic because she does not have insurance. She thanked the
Commission for having the public health system. It has saved her life and
she knows how hard it is. She said services in the Sunset make a huge
difference for the patients particularly given how difficult it is to get
from the Sunset to other areas of the City. From a patient point of view,
access is very difficult. It took five months to get a clinic appointment,
and it will take two months to get a follow-up appointment. She urged the
Commission to find some way to increase the number of physicians and
nurses and increase access.
- Lisa Johnson, M.D., gave the Commission a fact sheet (on file in the
Health Commission Office) and reiterated other speakers’ comments around
access and language capacity. Her main concern is the San Francisco Health
Plan. They have 2,600 SFHP enrollees, the majority of whom are healthy
workers, who tend to be middle age and have health issues. People come
from throughout the city because of the language capacity. She would like
to establish a reasonable patient panel size and be able to limit
enrollment to a level where they can provide services. Dr. Katz said that
if DPH were to limit SFHP enrollments, this would have disastrous fiscal
impact. If we make cuts to people with insurance, those services would
still be provided, but to people with no insurance. It is true that we run
open systems even though we don’t have enough appointments. This is a
tough issue. When the economy improves, he is committed to improving
- Commissioner Illig said that other clinics in San Francisco should be
considered part of our system, and the focus should move beyond DPH
services. The Department should work harder to partner with all the
services in San Francisco that have capacity, for example the Sister Mary
Phillipa clinic. Dr. Katz said that the partnership with Sister Mary
Phillipa is working quite well. He has also met with the Community Clinic
Consortium about partnering on a similar model. Commissioner Chow asked
that the JCC track this through reports from the Primary Care director.
- Mark Bernstein, M.D. advocated for the socialization program at
Sunset Mental Health. He said they get many patients from throughout the
city, and that it is a very important program. He thanked the Commission
for coming to the center, and said that many patients from his program are
at the meeting.
8) PUBLIC COMMENT/OTHER BUSINESS
The meeting was adjourned at 5:55 p.m.
Michele M. Olson, Executive Secretary to the Health Commission
Health Commission meeting minutes are approved by the Commission at the
next regularly scheduled Health Commission meeting.
Any written summaries of 150 words or less that are provided by persons
who spoke at public comment are attached. The written summaries are
prepared by members of the public, the opinions and representations are
those of the author, and the City does not represent or warrant the
correctness of any factual representations and is not responsible for the