|CDC-Funded Contracts (July 1, 2005 through December 31, 2006)|
|Agency||CDC Fund Amount||12 % Contingency||Total Amount|
|Ark of Refuge, Inc||$225,000||$27,000||$252,000|
|Asian Pacific Islander Wellness Center||$183,000||$21,960||$204,960|
|Asian Pacific Islander Wellness Center||$128,925||$15,471||$144,396|
|Bay Area Young Positives||$185,501||$22,260||$207,761|
|Black Coalition on AIDS||$83,160||$9,979||$93,139|
|Black Coalition on AIDS||$208,107||$24,972||$233,079|
|Black Coalition on AIDS||$182,466||$21,896||$204,362|
|Continuum HIV Day Services||$211,683||$25,402||$237,085|
|Girls After School Academy||$75,000||$9,000||$84,000|
|Larkin Street Youth Center||$141,076||$16,929||$158,005|
|Mission Neighborhood HC||$281,670||$33,800||$315,470|
|Mission Neighborhood HC||$234,630||$28,156||$262,786|
|Mobilization Against AIDS Int.||$205,500||$24,660||$230,160|
|Native American AIDS Project||$233,649||$28,038||$261,687|
|Tenderloin AIDS Resource Center||$489,600||$58,752||$548,352|
|UCSF AIDS Health Project||$1,014,332||$121,720||$1,136,052|
|UCSF AIDS Health Project||$375,492||$45,059||$420,551|
|UCSF Women’s Specialty Clinic||$249,795||$29,975||$279,770|
|State-Funded Contracts (July 1, 2005 through June 30, 2006)|
|Agency||State Amount||12 % Contingency||Total Amount|
|San Francisco AIDS Foundation||$289,427||$34,731||$324,158|
|San Francisco AIDS Foundation||$237,369||$28,484||$265,853|
|Stop AIDS Project||$389,759||$46,771||$436,530|
|Contracts with General Funds (July 1, 2005 through June 30, 2006)font>|
|Agency||General Fund Amount||12 % Contingency||Total Amount|
|Asian Pacific Islander Wellness Center||$141,708||$17,050||$158,758|
|St. James Infirmary||$135,616||$16,274||$151,890|
|SF LGBT Community Center||$150,000||$18,000||$168,000|
|San Francisco AIDS Foundation||$631,696||$54,565||$686,261|
|Stop AIDS Project||$702,768||$84,332||$787,100|
|Tenderloin AIDS Resource Center||$253,898||$30,468||$284,366|
|HIV Prevention Contracts TOTALS||$10,300,545||$1,214,870||$11,515,415|
(3.6) AIDS OFFICE-HIV Health Services - Request for approval of a contract modification with Shanti, in the amount of $179,734, for a total 2-year contract amount of $889,457 ($305,563 for year one and $583,894 for year two), to provide HIV Health Services Planning Council Support services, for the period of March 1, 2004 through February 28, 2006.
(3.7) AIDS OFFICE-HIV Health Services - Request for approval of a retroactive contract renewal with Positive Resource Center, in the amount of $254,837 per year ($509,674 for two years), plus a 12% contingency amount of $61,161, for a total amount of $570,835, to provide client advocacy and benefits counseling services targeting people living with AIDS of HIV disease, for the period of March 1, 2005 through February 28, 2007.
(3.8) CBHS - Request for approval of a contract modification with Resource Development Associates, in the amount of $133,475, for a total contract amount of $235,515, to provide consulting services to develop the Mental Health Services Act (Prop 63) plan, for the period of February 8, 2005 through September 30, 2005.
(3.9) CBHS - Request for approval of a contract modification with Crestwood Behavioral Health, Inc., in the amount of $1,200,000, for a total contract value of $9,947,793, to provide additional mental health bed capacity for 24-hour Skilled Nursing Facility services, for the period of July 1, 2003 through June 30, 2005.
(3.10) CBHS - Request for approval of a contract modification with Sunny Hills Children's Garden Family and Children's Services, in the amount of $112,000, for a total contract amount of $304,416, to provide mental health services for youth ages 12 through 18, for the period of July 1, 2004 through June 30, 2005.
(3.11) CBHS - Request for approval of ten renewal contracts for the Family Mosaic Project totaling $896,847, to provide various wrap-around services targeting seriously emotionally disturbed children, with the following agencies: Alternative Family Services, Brainstorm Tutoring, Edgewood Center for Children & Families, Families First, Heritage Residential Treatment Center, New College of California, Occupational Therapy Training Program/Special Services for Groups (OTTP/SSG), RISE Institute, Seneca Center and Victor Treatment Centers, for the period of July 1, 2005 through June 30, 2006.
(3.12) SFGH – Request for approval to accept and expend a HRSA grant from the California
Department of Health Services TB Control Unit in the amount of $995,759 for Bioterrorism Preparedness and Dual Use Project for Regional Civil Detention of Persistently Non-Adherent Tuberculosis Patients for the period of June 1, 2005 to January 1, 2013.
Commissioners’ Comment (at the Health Commission Meeting)
Action Taken: The Commission approved Items 3.1 - 3.5 and 3.7 - 3.12 of the Budget Committee Consent Calendar. Item 3.6 was held over to the next Health Commission meeting. Commissioner Sanchez abstained from Item 3.4 as it pertains to the four University of California contracts.
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., presented the Director’s Report.
Emergency Medical Services
Over the weekend there was an article in the San Francisco Chronicle concerning two cases of alleged patient abandonment by San Francisco Fire Department EMS crews that occurred in April of 2005. Dr. Katz assured the Health Commission that these incidents were rapidly detected by the EMS Agency through their Exception Reporting system, and by the Fire Department through their Incident Management system, which rapidly assessed the problem and informed both the State EMS Authority and the San Francisco EMS Agency. All EMS personnel involved have been assigned non-patient care duties until the dual investigations (state and local) are completed and a determination is made. The State EMS Authority is handling the paramedic investigation and our EMS Agency is handling the EMT investigation. To give the Health Commission a sense of the proportion that non-transported patients represent to our system, of the approximately 30,000 EMS responses so far this year, about 4,600 involved patients not being transported for various reasons. Of the 77 incidents of all types being tracked by the EMS Agency in their Exception Reporting system since January 1, 2005, 6 have involved patient non-transports and 2 of these 6 have involved potential policy violations and have resulted in the current investigations.
Laguna Honda Hearing
On Saturday, June 18, 2005, the Government Audits and Oversight Committee of the Board of Supervisors along with Assembly member Leland Yee held a joint hearing to look into the California Department of Health Services and CAL/OSHA’s review of Laguna Honda Hospital. There was general agreement that Laguna Honda Hospital needed more resources to care for behaviorally difficult patients and that this would require additional funding at the local and state level. There was a very good turn out for public comment with people expressing a variety of opinions. Some spoke about their desire to make sure that Laguna Honda Hospital did not take behaviorally difficult patients. Others spoke about the importance of finding a solution for funding of and caring for behavioral challenging patients in need of Skilled Nursing services at Laguna Honda or elsewhere. The hearing lasted 4.5 hours after which the Committee continued the item at the call of the chair.
Communicable Disease Report goes On-line
Dr. Katz announced the release of a comprehensive epidemiological review of communicable diseases, managed by the Community Health Epidemiology & Disease Control Section. The San Francisco Communicable Disease Report, 1986-2003 provides the annual incidence for all legally notifiable communicable diseases. Additionally, it describes the epidemiology of 21 selected diseases and compares it with other Bay Area counties, California and the United States. These data are an essential tool for communicable disease control and prevention practice, program planning, and program development. The report can be downloaded from the DPH website. Many thanks to Scott Nabity, Communicable Disease Epidemiologist, who lead the effort to produce and post this comprehensive report.
Green Business Team
The San Francisco Green Business Team, a collaboration between the Department of Health, Department of the Environment and the Public Utilities Commission, hosted its first ever San Francisco Green Business Day Recognition Event. The event was held at Pier 39 in conjunction with World Environment Day 2005. Twenty-one San Francisco Green Businesses were showcased, including the Aquarium of the Bay, Courtyard by Marriot at Fisherman's Wharf, the San Francisco Chronicle, Rainbow Grocery Cooperative, HMR Group and Jardinière Restaurant. Awardees demonstrated exemplary environmental compliance, extensive efforts in toxics reduction and pollution prevention, and energy, water and solid waste conservation. The Team has a growing list of other businesses coming into compliance that will soon join San Francisco’s Green Business community.
5) CONSIDERATION OF A RESOLUTION OPPOSING THE PROPOSED MEDI-CAL RESTRUCTURE
Gregg Sass, DPH Chief Financial Officer, updated the Commission on recent developments in the State Medi-Cal 1115 waiver negotiations between the State Department of Health Services (DHS) and the Center for Medicare and Medicaid Services (CMS). Over the past year, DHS and CMS have been negotiating a five-year Medicaid waiver to restructure safety net hospital financing. Central to the negotiation is the desire on the part of the federal government to replace the existing system that utilizes intergovernmental transfers from counties to draw down federal matching funds (FFP) with a system that draws FFP from certified public expenditures (CPE). The existing 1115 waiver expires on June 30, 2005 and the new system is scheduled to take effect on July 1.
Throughout the negotiations, counties have followed developments closely and, until mid-May, had not opposed the new plan despite numerous concerns. That position was based on elements of the plan that had the potential of stabilizing safety net financing and providing for growth in funding to allow hospitals to meet the demand for care by the uninsured, indigent, Medi-Cal and other patients. However, on May 19th, counties were notified that CMS had rejected the proposal under negotiation and proposed a scaled down version of the waiver that contains none of these features and threatens the stability of the safety net.
Mr. Sass described the importance of having a waiver that stabilizes the safety net. There are 6.5 million uninsured people in California in need of health care. Public hospitals make up just 6 percent of all California hospitals, yet provide more than 50 percent of the hospital care to the uninsured. San Francisco General Hospital is one of those providers. 41 percent of the patients at SFGH are indigent and an additional 28 percent are Medi-Cal beneficiaries. In addition, SFGH is the only Level 1 trauma center serving San Francisco and San Mateo counties. With regard to revised proposal, it is very difficult to determine the exact impact of the plan, since it was announced on May 19th and scheduled to take effect just six weeks later. But the major elements of the plan that are problematic are:
Action Taken: The Commission approved Resolution 10-05, “Resolution in Opposition to California Medicaid Hospital Financing Waiver Currently Under Negotiations with the Federal Government,” as amended (Attachment B).
6) CONSIDERATION OF A RESOLUTION APPROVING THE HOMELESS DEATH COUNT FORM
Anne Kronenberg, Deputy Director of Health, presented a resolution that would approve a form that would be used to collect information about the number of homeless deaths in San Francisco. Since 1987, homeless advocates have kept count of the individuals who died homeless in San Francisco to honor the life and dignity of each person by name. Counting homeless deaths has never been a precise science because there is no way to track whether individuals who died in the hospital or nursing home had been formerly homeless. Death certificates, which are governed by State law, do not include a classification box that would allow the designation of homeless. Beginning in 1992, DPH worked with the Medical Examiner (ME), the faith community and homeless advocates to review the ME’s records to ascertain how many individuals had died without a fixed address. Subsequently, two laws went into effect that greatly restricted access to health related records. The Health Department is no longer allowed to release copies of the death certificates unless the deceased is known by the requester. In addition, there are severe restrictions on the release of comprehensive death indices to the public.
Supervisor Bevan Dufty convened a committee, with advocates from the faith-based community, the Medical examiner, the City Attorney’s Office and DPH, to explore how the Health Department could most effectively and efficiently resume the Homeless Death Count. The solution was a “Homeless Death Count” form that will be filled out by the institution registering the death, the ME’s office, funeral home or hospital. At the time of registering a death by filing a death certificate with DPH, the registrant will also file the completed Homeless Death Form. Staff will remove the form and file it in a separate file drawer. At the end of the year, all the forms will be in one place, making the count a simple activity. Ms. Kronenberg thanked DPH intern Elise Duryee-Browner, who did research and helped develop the form.
Ms. Kronenberg introduced Amanda Kahn, legislative aide to Supervisor Dufty, who thanked the Health Department for developing the form. It is extremely important to Supervisor Dufty that people who die without a home are recognized, and he is confident that this approach will allow this to happen with minimal impact on Health Department staff and resources.
Action Taken: The Commission approved Resolution 09-05, “Resolution Approving The Homeless Death Count Form To Be Filed At The Time Of Registration Of The Death Certificate With Vital Statistics,” (Attachment A).
7) PUBLIC COMMENT/OTHER BUSINESS
The meeting was adjourned at 2:55 p.m.
Michele M. Seaton, Executive Secretary to the Health Commission
Health Commission meeting minutes are
approved by the Commission at the next regularly scheduled
Health Commission meeting. Any changes or corrections to
these minutes will be reflected in the minutes of the next
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 content.