Minutes of the Health Commission Meeting
Tuesday, November 1, 2005
101 GROVE STREET, ROOM 300
San Francisco, CA 94102
1) CALL TO ORDER
Commissioner Monfredini called the meeting to order at 3:20 p.m.
- Commissioner Lee Ann Monfredini, President
- Commissioner Roma P. Guy, M.S.W., Vice President
- Commissioner Edward A. Chow, M.D.
- Commissioner James M. Illig
- Commissioner Donald E. Tarver, II, M.D.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D. – arrived at 3:35
Commissioner Monfredini announced that the Health Commission’s newly
reconstituted Population Health and Prevention Joint Conference
Committee would hold its first meeting on Monday, November 21 at 9:00
a.m. Commissioner Guy will chair the committee, and Commissioner Tarver
and Commissioner Monfredini will be members.
2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF OCTOBER
Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Tarver,
Sanchez) approved the minutes of the October 18, 2005 Heath Commission
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Illig chaired and Commissioner Chow and Commissioner
Sanchez attended the Budget Committee meeting. Commissioner Illig said
the Budget Committee will be conducting its business using a new format.
At each meeting, certain contract approvals will be considered as a
whole, and will not be presented and discussed separately. These
contracts will be noted on the agenda, although if committee members or
members of the public want to discuss any of these items, there is the
ability to do so. The Budget Committee’s goal in doing this is to save
time to focus on the larger contracts, and for the future to enable the
Budget Committee to spend some time talking about other issues besides
approval of contracts.
(3.1) CBHS – Request for approval of a retroactive renewal contract with
ValueOptions, Inc., in the amount of $100,000 per year, for a total
contract amount of $336,000, to function as an administrative services
organization providing out-of-county mental health placement services to
minors, for the period of July 1, 2005 through June 30, 2008.
(3.2) CBHS – Request for approval of a retroactive renewal contract with
Boys and Girls Club of San Francisco, in the amount of $50,900, for a
total amount of $57,008, which includes a 12% contingency, to provide
Early and Periodic Screening, Diagnosis and Treatment mental health
services, for the period of July 1, 2005 through June 30, 2006.
(3.3) CBHS – Request for approval of a retroactive renewal contract with
Children’s Council of San Francisco, in the amount of $174,943, for a
total contract amount of $195,936, which includes a 12% contingency, to
provide child care consultation services targeting center-based and
family child care providers, for the period of July 1, 2005 through June
- Commissioner Chow made comments about all the contracts that are part
of the High Quality Child Care Mental Health Consultation Initiative.
This was not a criticism of the contractors but to better understand the
coordination of the various contracts. Ms. Chan-Sew, Director of CBHS
Children and Family Services, said that this is an interdepartmental
partnership between DPH, the Department of Children, Youth and their
Families, the First Five Commission and the Health Services Agency.
Providers were selected through a RFP process. A number of providers
were selected, including Children’s Council and SF Psychoanalytic
Institute. Both have a long history of providing services. Ms. Chan-Sew
gave the commissioners the 2003-2004 evaluation report. Commissioner
Chow noted that the Children’s Council provides services to a number of
Asians, and that they have staff to work with childcare centers in
Visitacion Valley. Commissioner Chow would like the Joint Conference
Committee to hear a comprehensive report on this initiative. He asked if
this program is a model for other cities. Ms. Chan-Sew said the model is
being implemented in cities across the country, but they are primarily
funded through a single source. So the relationship with CalWorks is
unique to San Francisco’s program.
(3.4) CBHS – Request for approval of a retroactive renewal contract with
Hamilton Family Center, in the amount of $86,375, for a total contract
amount of $96,740, which includes a 12% contingency, to provide
children’s mental health services, for the period of July 1, 2005
through June 30, 2006.
(3.5) CBHS – Request for approval of a retroactive renewal contract with
Huckleberry Youth Programs, in the amount of $153,000 for a total
contract amount of $171,360, which includes a 12% contingency, to
provide Early and Periodic Screening and Diagnosis and Treatment mental
health services, for the period of July 1, 2005 through June 30, 2006.
(3.6) CBHS – Request for approval of a retroactive renewal contract with
Curry Senior Center, in the amount of $530,966 per year, for a total
contract amount of $2,123,865, which includes a 12% contingency, to
provide substance abuse treatment and mental health services, for the
July 1, 2005 through June 30, 2009.
(3.7) CBHS – Request for approval of a retroactive renewal contract with
San Francisco Psychoanalytic Institute and Society, in the amount of
$91,978 per year, for a total amount of $367,912, which includes a 12%
contingency, to provide high-quality childcare mental health services,
for the period of July 1, 2005 through June 30, 2009.
(3.8) PHP-AIDS Office-HIV Health Services – Request for approval of a
retroactive contract renewal with Baker Places, Inc., in the amount of
$104,679, which includes a 12% contingency, to provide residential detox
and substance abuse services targeting poly-substance users or abusers
with HIV disease, for the period of March 1, 2005 through March 31,
- Commissioner Illig asked why the contract was delayed. Ms. Long said
that Baker was negotiating with the Department for a different rate, and
the agency preferred to wait until these discussions were completed.
Commissioner Illig asked Jonathan Vernick, executive director of Baker
Places, if there are term limits for members of the Board of Directors.
Mr. Vernick said that there is an annual election of all board members.
So the term is one year, but this does not preclude people from serving
more than one year. The bylaws say the number of members is not to
exceed 15. Mr. Vernick said that his agency has been working closely
with DPH around a number of financial issues and he is pleased to report
that the financial condition has significantly improved. He also noted
that while some of the issues that have come up are unique to Baker,
many exist for all non-profits. When contractors do not get an increase,
it means that programs will be cut. Commissioner Illig said that the
Commission shares agencies’ concerns.
(3.9) PHP-Community Health Promotion and Prevention – Request for
approval to accept and expend retroactively a new two-year grant from
DHHS, Substance Abuse Mental Health Services Administration, in the
amount of $200,000, to support a project to prevent youth alcohol and
substance use in the Bayview Hunters Point district, for the period of
October 1, 2005 to
June 30, 2007.
(3.10) PHP-STD Prevention and Control Services – Request for approval to
accept and expend retroactively a new four-year grant from the San Mateo
Medical Center, in the amount of $360,000, to establish an HIV/AIDS
Research Center in the Bay Area, for the period of July 1, 2005 to
June 30, 2009.
(3.11) CBHS – Request for approval of a retroactive renewal contract
with Instituto Familiar de la Raza, Inc., in the amount of $1,956,642,
which includes a 12% contingency, to provide mental health/substance
abuse services, for the period of July 1, 2005 through June 30, 2006.
Secretary’s Note - Sai Ling Chan Sew said the increase in staffing is 2,
- Commissioner Illig asked how the Board of Directors is doing. Estella
Garcia, executive director of IFR, said the board is in the process of
reviewing two new board members, one of whom they hope to have on board
by January. One has extensive financial background and the other has a
background in immigration law.
(3.12) CBHS – Request for approval of a retroactive renewal contract
with Richmond Area Multi-Services, Inc., in the amount of $2,800,380 per
year for a total contract value of $5,600,759, which includes a 12%
contingency, to provide mental health services, for the period of July
1, 2005 through June 30, 2007.
- Commissioner Chow asked if the child care consultation services are
included in this contract. Ms. Chan-Sew said that this service is part
of the contract, as well as the behavioral services that RAMS provides
at the wellness centers.
(3.13) CBHS – Request for approval of a retroactive renewal contract
with Addiction Research and Treatment, Inc., in the amount of
$5,103,038, for a total contract amount of $5,715,403, which includes a
12% contingency, to provide substance abuse treatment services, for the
July 1, 2005 through June 30, 2006.
Budget Committee Public Comment (taken at the Health Commission meeting)
- David Moulton said that Asian Inc. is a general partner of a
residential building that is located next to the proposed methadone
clinic. A number of children live in the building. In addition, a number
of children would pass the site on their way to the Tenderloin School
and there is a park across the street.
- Bella de Barres, project Manager of the site, said residents just
moved into this building last December. It is a wonderful facility. The
residents feel good about the street where they live. She did not
receive a notice about the community meeting. She hopes that the project
is not located here.
Commissioners’ Comments (at the Health Commission meeting)
- Commissioner Monfredini asked the agency representative if there was a
community meeting and how this was noticed. Evan Kletter, CEO of BAART,
said the agency has begun the process of preparing to move from Geary
Street to Turk. In preparation to that they held a community meeting.
For the past two weeks there has been a sign posted at the new site
announcing this hearing as an opportunity for anyone to comment on the
proposed relocation. In preparation for the community meeting, he and
his brother and sister canvassed the area around the site, asked
security guards to post notices at their buildings. Commissioner
Monfredini noted that people in methadone maintenance are in recovery
and are trying to stay clear of their addiction. Commissioner Monfredini
asked Mr. Kletter to keep in touch with the neighbors after the
relocation happens to make sure that concerns are listened to and
addressed. And that the clients are protected as well as the
neighborhood. Mr. Kletter said they have a full time security guard and
very strict protocols for their patients. They want to be a good
(3.14) CBHS – Request for approval of a retroactive renewal contract
with Center on Juvenile and Criminal Justice, in the amount of $328,740
per year, for a total contract amount of $1,314,961, which includes a
12% contingency, to provide substance abuse supportive living services,
for the period of July 1, 2005 through June 30, 2009.
Secretary’s note – Mr. Stillwell said the term of the contract is being
changed from four years to one year. So the term of the contract will be
July 1, 2005 through June 30, 2006.
- Commissioner Illig asked if the agency plans to expand its Board of
Directors. Dan Macallair, executive director of CJCJ, said the agency
has undergone a difficult transition over the last three years. He
maintained a consistent board through that transition. Over the next
year he hopes to seat additional board members, with a goal of nine
high-quality members. The board is diverse and represents San
Francisco’s communities quite well.
(3.15) CBHS – Request for approval of a retroactive renewal contract
with Haight Ashbury Free Clinics, Inc., in the amount of $4,913,647 to
provide behavioral health services, for the period of
- Commissioner Chow asked what steps have been taken to stabilize the
Glide outpatient program. Ben Eiland, HAFC program manager, substance
abuse treatment services, said that Glide has been able to reestablish
itself in providing units of service. Last year the units of service
started to slip. There have been historic problems with this program.
They are on target for the first quarter of the fiscal year for the
units of services. Mr. Stillwell said that on a good day HAFC is a still
a world-class organization. They have had considerable challenges in
their financial condition for the past two years. Last spring they had a
substantial change in administration. The contract is monitored closely
to ensure that there is consistency in services. There are still some
concerns about the agency.
- Commissioner Illig asked about the financial status. John Eckstrom,
executive director of HAFC, said that the agency’s financial situation
is in the same as it has been. They are controlling costs, but past debt
is eating away at the margins. The fundraising plan is going more slowly
than anticipated, but they recently retained a fundraising consultant.
The board has been restructured since the last time he was before the
Health Commission. They have become much more active with fundraising in
the past eight weeks.
- Commissioner Sanchez asked the agency to provide more information
about the past debt. Is there a specific timeline for repaying debt, and
can this be renegotiated? Mr. Sass, DPH CFO, said much of the debt is
the difference between the payments that were made to HAFC for Jail
Psychiatric services and the costs that were incurred for 04-05. DPH
must recover the overpayment, but he is working with the agency to
design a repayment schedule. Mr. Sass said that HAFC has not exhausted
all their options yet. Mr. Eckstrum said that they have the debt to the
city, accounts payable debt and other factors.
(3.16) PHP-AIDS Office-HIV Health Services – Request for approval of a
retroactive contract renewal with Haight Ashbury Free Clinics, Inc., in
the amount of $105,325, which includes a 12% contingency to provide
Complementary Therapy Services to individuals who have HIV/AIDS and
reside in San Francisco for the period of July 1, 2005 through June 30,
(3.17) PHP-AIDS Office-HIV Health Services – Request for approval of a
retroactive contract renewal with the Latino Commission, in the amount
of $280,000, which includes a 12% contingency, to provide residential
substance abuse treatment services to adult HIV positive monolingual
Spanish-speaking substance abusers, for the period of March 1, 2005
through June 30, 2006.
- Commissioner Illig announced that the Health Department is sponsoring
two forums for non-profits regarding governance. These forums are
scheduled for November 16th and 21st, both at 5:30, in the Health
Action Taken: The Commission approved the Budget Committee Consent
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., Director of Health, presented the Director’s
State of the City
Mayor Newsom delivered his annual State of the City address last week.
This year’s speech highlighted numerous key public health
accomplishments. Leading the list of accomplishments was the expansion
of the Healthy Kids program to 19-24-year-olds, moving San Francisco one
step closer to being the first City in the country to offer universal
health care. The Mayor also called for expanding the Department’s
primary care clinic hours to provide increased access for our patients.
We applaud the Mayor’s leadership and thank him for his commitment to
On Saturday, October 30th, environmental detectors in the San Jose area
detected a weak signal for Francisella tularensis (Tularemia or Rabbit
Fever). These detectors are part of the national Biowatch Program.
Detectors are located in most counties of the Bay Area, including San
Francisco. No other detectors have registered F. tularensis. There have
been no recent cases of tularemia in animals or humans in the Bay Area.
There have been multiple conference calls this week with federal, state
and local agencies to discuss surveillance, intelligence, notification
and communications, and the consensus is that this incident was most
likely an environmental contaminant, rather than the result of a
Yesterday, DPH sent out a Health Alert to all San Francisco clinicians,
asking them to consider Tularemia in ill patients that present to SF
hospitals and clinics and to alert us for any suspicious cases. Most
other Bay Area Counties sent out alerts as well. Santa Clara County
Health Department is doing active surveillance for Tularemia in
hospitals and clinics close to the detector. Surveillance will continue
until November 13, the end of the incubation period for this disease.
Dr. Susan Fernyak hosted a press conference yesterday with staff from
Animal Care & Control to raise public awareness about the problem of
rabid bats in San Francisco. There have been six rabid bats within the
last two years in the City, necessitating post exposure prophylaxis for
12 individuals. The press conference focused on the need to prevent bats
from entering houses and the importance of avoiding contact with bats,
especially if the bats are having difficulty flying which could indicate
rabies infection. Animal Care & Control responds to nearly 60 episodes
of bats inside dwellings each year. DPH tests approximately 75 animals
each year for possible rabies infection. In a case of ironic timing, the
most recent case of a positive rabid bat in San Francisco was confirmed
yesterday, just after the press conference. Coverage of the rabid bat
press conference was carried by a number of TV, radio and newspapers in
both the mainstream and ethnic media outlets.
As a result of the recent tragedy that culminated in the death of three
children off Pier 37, DPH staff appeared in both local and national
interviews about mental health in general and schizophrenia in specific.
Dr. Bob Okin, Dr. Bob Cabaj and Dr. Irene Sung were called on to respond
to the increased interest in dealing with mental health consumers and
their families. The Department is fortunate to have the expertise in
staff that can serve as spokespeople for mental health during these
Annals of Internal Medicine
Dr. Katz attached to the Director’s Report an article from the Annals of
Internal Medicine entitled, “Clinical Decision Making during Public
Health Emergencies: Ethnical Considerations.” He had the privilege of
working on this piece with Dr. Bernard Lo, from the Division of General
Internal Medicine at UCSF.
- Commissioner Monfredini was very saddened by the tragic death of the
three children last week due to their mother’s mental illness.
- Commissioner Illig asked Dr. Katz if the Mayor’s Office has followed
up with him on the plans to expand universal healthcare. Dr. Katz said
yes, and that the Mayor is fully committed to expanding the Healthy Kids
Program. He sees expanding primary care clinic hours as one way to
expand access. With regard to the audit, Dr. Katz has been told that the
Mayor was speaking specifically about primary care. Mayor Newsom sees
the recent success with the restructuring of Tom Waddell as a model, and
is interested in understanding how many patients are seen in each
clinic, what the productivity numbers are and where opportunities are.
Commissioner Illig wants to make sure that the Mayor is aware about the
cost of these initiatives with the hopes that these initiatives are
funded through an addition to the budget.
- Commissioner Sanchez said that the Mayor spoke at the Mission Language
and Vocational School dinner and reaffirmed the excellence of our
primary care model and the importance of these services.
5) APPROVAL OF SAN FRANCISCO GENERAL HOSPITAL MEDICAL STAFF BYLAWS
Andre Campbell, M.D., SFGHMC Chief of Staff, presented the revisions to
the San Francisco General Hospital Medical Staff bylaws. The revisions
were discussed and approved by the Medical Executive Committee and
approved by tally of votes by the active Medial Staff via e-mail poll
dispatched September 8, 2005.
Dr. Campbell highlighted three of the changes. There were changes to the
specification of visiting privileges to state that the visiting
privileges are granted for a specified period of time, and that the
Chief of Staff shall inform the Governing Body when visiting privileges
were granted for a patient care need that could not be met by a member
of the medical staff. Another change is to proctoring duration. In the
past it was not recognized that it could take more than two years to
complete proctoring for a rarely performed procedure. The change to this
section is to acknowledge that proctoring is dependent on the number of
cases, not length of time. The last change Dr. Campbell highlighted was
the elimination of the Diagnostic Services Committee and creation of the
Clinical Care Committee. This change came out of a medical staff
retreat. The Committee’s goal is to look at services provided by
different specialties and try to streamline the operations and make
things more efficient.
- Commissioner Chow asked that change from “his/her” and “he/she” to
“their” not be made at this time, so that staff can ensure that it is
indeed necessary. Dr. Campbell said that this could be done.
- Commissioner Illig asked if the medical staff includes other medical
professionals, for example providers of complementary therapies. Hiroshi
Tokubo, Director of Quality Management, said that the are privileges for
physicians to practice alternative therapies, but alternative providers
are not part of the medical staff. Commissioner Umekubo added that often
time acupuncture is performed by physicians who have been credentialed
to do this.
Action Taken: The Commission approved the Medical Staff Bylaws, with the
exception of the change from “his/her” and “he/she” to “their.”
6) DEPARTMENT OF PUBLIC HEALTH ANNUAL REPORT
Scott Boule, Deputy Director, Office of Policy and Planning, presented
the Department of Public Health’s FY 2004-05 Annual Report. This report
summarizes some of the Department’s major accomplishments from the past
year, including the revision of the Strategic Plan. The report is
structured to show readers how the Department is configured, the
characteristics of the population it serves and what activities the
Department does to fulfill its mission to protect and promote the health
of all San Franciscans. Mr. Boule presented demographic information
about the population served by DPH, including information on gender,
ethnicity, age, income and insurance status. He also reviewed the DPH
structure, which includes the Community Health Network and Population
Health and Prevention, and reviewed the four Strategic Plan goals. The
Annual Report described myriad programs throughout the Department in the
context of which Strategic Plan goal and objective it was designed to
further. Mr. Boule’s presentation highlighted a few examples:
- Upgrading Primary Care Facilities
- Working with other safety net providers to improve diabetes care
- Expanding access to primary care for patients of all ages
- Expanding health insurance coverage for young adults
- Making neighborhoods more walkable
- Improving working conditions for day laborers
- Expanded hours at the Urgent Care Clinic
- Improving access to eye care with the “Eye Van”
- HIV/AIDs Centers of Excellence
- Increasing the number of supportive housing units available
- Providing partner notification through the Internet
- Making TB screening more efficient and more accurate
- Updating SFUSD’s TB screening policy
The FY 2004-2005 Annual Report is available on line at www.sfdph.org,
through the “Get Reports and Data” link.
- Commissioner Illig is concerned about the number of Dr. Katz’s direct
reports. Did he have this many before the budget cuts? Dr. Katz said the
budget cuts increased his direct report. He is also concerned about the
PHP/CHN distinction. For example, the AIDS Office provides direct
services, but is considered part of PHP. Dr. Katz said that the HMA
report recommends that the Department form itself as a delivery system,
with a Chief Operating Officer (COO) to operate the system. This is
similar to what the CHN was meant to be. It had two main limitations,
the first being that Community Behavioral Health Services was not
included. The second is that the dual structure was created during a
time of tension when people thought the hospital overruns negatively
impacted mental health and substance abuse. There has been a vision
change to embrace the goal of a delivery system. The COO would be in
charge of this system, and nothing else in the Department. Dr. Katz
added that AIDS has a huge impact on the delivery system, but the AIDS
Office itself does not provide direct services. Commissioner Illig asked
what would be the difference between the COO and the long-term care
director. Dr. Katz said the COO would be responsible for the flow of
patients throughout the system, not just long-term care. The long-term
care director would be specific to long-term care with a substantial
knowledge base and a focus on long-term care planning. Commissioner
Illig said this is an excellent report. He appreciates the simple
descriptions of the Department’s programs. He looks forward to using the
Annual Report as tool to plan for special Budget Committee
presentations. He suggested that the Health Commission should consider
having joint meetings with other bodies that govern long-term care.
- Commissioner Guy said this is an excellent report, and she wants to
maximize the Commission’s use of it. Annual reports serve many different
purposes, and it is important that the points in the plan are connected
to the Strategic Plan. The Strategic Plan is a tool of accountability
for the Health Commission, and a living document. The work of the Joint
Conference Committees should be linked to the areas of the Strategic
Plan on a regular basis, not just annually.
- Commissioner Umekubo said he was struck by the increased revenue
collections over the past six years, and asked if the Department has
reached its max. Dr. Katz said that in the current fiscal year the
Department is exceeding its revenue target. Commissioner Umekubo asked
the status of cuts to the Medicaid program. Dr. Katz said the Department
is safe for next year, but we could see a significant drop in revenues
two or three years from now. He will keep the Commission informed.
- Commissioner Tarver said the annual report did not reflect the impact
of the budget reductions and position eliminations. With regard to the
Strategic Plan, there is the opportunity for more specific objective
outcomes. Ms. Kronenberg said that there are specific outcome
objectives, but these were not included in the Annual Report due to
length. She is happy to share this with the Commissioners. Commissioner
Tarver asked where the planning takes place to prioritize services and
restorations, in anticipation of a time when there is not a deficit. Ms.
Kronenberg said the steering committee that was formed as a result of
the HMA report is looking forward to doing this type of planning.
- Commissioner Sanchez lauded staff for an excellent report, and
reinforced the point that core CHN administrative staff was lost during
budget cuts, and it is critical that this be restored.
- Commissioner Chow said the Department has done an excellent job
creating a document that incorporates a number of reports that were
previously reported separately. The report gives the Department and the
Commission the ability to prioritize. He is very pleased that the
Department has stayed together, rather than breaking up and creating an
Authority, as was done in other jurisdictions. The San Francisco
Department of Public Health has the potential to be the public health
model for the nation. The Annual Report and Strategic Plan would not be
possible without a unified system.
- Commissioner Monfredini said this is a working, interactive report.
Many annual reports are put on a shelf, but this is not the case at DPH.
Ours is an ongoing planning tool.
7) PROPOSITION 99 UPDATE
Jeffrey Leong, AB 75 Coordinator, gave a status report on the AB 75
Project. The AB 75 Project began with the passage of Proposition 99 in
1988. This created the state Cigarette and Tobacco Products Surtax Fund
to conduct anti-tobacco use campaigns, fund tobacco use research and pay
for health services for the uninsured, through the California Healthcare
for Indigents Program (CHIP). SFGH receives funding through this program
for indigent medical services. In FY 05-06, the allocation is $1.2
million. The program also reimburses private hospitals and physicians
for uncompensated medical care provided to uninsured adults and
children. For FY 05-06, this amount is $500,000. Proposition 99 also
requires the City to provide and/or pay for follow-up treatment services
to CHDP-screened children. And through MICRS, it requires submission to
the state of an annual data report on all medically indigent patients
seen by SFGH and DPH. Today, there are additional revenues for indigent
care including SB 12/Maddy, Emergency Medical Services Appropriation and
local general funds. The total revenues for this program are $4.26
The mission of the AB 75 Project is to provide access to health care,
promote health and well-being and prevent serious illness and disability
for indigent families and individuals through the funding of health
services, and by partnering and advocacy for care. The goals of the
- To effectively administer state and local grant funds
- To pay providers in a accurate and timely manner for the provision of
emergency, obstetric and pediatric services to indigent San Franciscans
- To insure that CHDP-screened children receive follow-up treatment
services at no cost to the families
- To submit accurate and complete indigent care data to the state.
Mr. Leong described the County Hospital Program, which pays for
uncompensated care provided by San Francisco private hospitals to
persons who are medically indigent or uninsured, and the Physician
Program, which pays for uncompensated care provided by San Francisco
physicians. The Hospital program currently is used to pay for large
dollar amount inpatient stays for medically indigent at CPMC, Chinese,
St. Mary’s, St. Francis, UCSF and St. Luke’s hospital. For the
physicians program, more than 90 percent of paid services are in
hospital emergency rooms, including CPMC, St. Francis, St. Mary’s, UCSF,
St. Luke’s and SFGH. Funds are allocated between community physicians
(80 percent) and UCSF at SFGH physicians (20 percent). Mr. Leong
described new program initiatives:
- Conduct program review/audits to assure compliance with program
policies and procedures.
- Expand dental provider network to provide better access for
CHDP-screened children requiring follow-up treatment
- Advocate for children’s health insurance coverage and use of existing
insurance sources, such as Healthy Families and Healthy Kids
- Develop mechanisms for general assistance and homeless populations to
have greater access to medical care, including reimbursement of services
in hospital emergency rooms.
- Commissioner Chow asked what the program’s administrative overhead
cost is. Mr. Leong said it is a little less than 10 percent. He added
that the Department successfully reduced the Americhoice contract by 25
percent. Commissioner Chow thinks it would be worth opening a dialogue
with Chinese Hospital to see if they could participate in the program.
Mr. Leong will do so.
- Commissioner Illig asked if AB 75 has an allocation formula. Mr. Leong
said that for the hospital program, there is a formula based on
uncompensated care. Mr. Illig said it does not seem right to pass
through money to private hospitals that are not doing enough charity
care. He suggested a charity care threshold to be eligible to
participate in the program. Dr. Katz said this would require state
- Commissioner Tarver asked if the hospital’s decision to seek
reimbursement under this program is voluntary. Mr. Leong said yes, and
hospitals choose which patients they want to apply to the CHIPs account.
8) PUBLIC COMMENT/OTHER BUSINESS
There was no public comment.
With regard to Other Business, the Commission set a hearing regarding
the future of St. Luke’s Hospital, including the impact of the
elimination of outpatient mental health services, for the November 15,
2005 Health Commission meeting.
The meeting was adjourned at 6:15 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
Any written summaries of 150 words or less that are provided by persons
who spoke at public comment are attached. The written summaries are
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