Minutes of the Health Commission Meeting
Tuesday, April 18, 2006
at 3:00 p.m.
101 GROVE STREET, ROOM 300
San Francisco, CA 94102
1) CALL TO ORDER
President Monfredini called the meeting to order at 3:00 p.m.
- Commissioner Lee Ann Monfredini, President
- Commissioner James M. Illig, Vice President
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner Donald E. Tarver, II, M.D.
- Commissioner John I. Umekubo, M.D.
President Monfredini, on behalf of the Health Commission, noted the
passing of former Commissioner Arthur Jackson. She and other
commissioners were honored to work with him, and he was a wonderful man.
A memorial service will be held on April 30, 2:00 p.m., at the War
Memorial Green Room.
2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF APRIL 4,
Action Taken: The Commission approved the minutes of the April 4, 2006
Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired and Commissioner Chow and Commissioner
Tarver attended the Budget Committee meeting.
(3.1) PHP-STD Prevention & Control – Request for approval of a
retroactive contract renewal with Better World Advertising, in the
amount of $95,200, which includes a 12% contingency, for continuation of
the “Healthy Penis” syphilis social marketing campaign, for the period
January 1, 2006 through December 31, 2006.
- Commissioner Tarver urged Better World Advertising to include more
people of color in its focus groups. He requested that the next time the
contract comes before the Health Commission, the executive summary
include a description of other measures Better World Advertising uses to
solicit and incorporate diverse feedback.
(3.2) CBHS-MIS – Request for approval of a sole source contract renewal
with InfoMC, in the amount of $300,782, which includes a 12%
contingency, to provide ongoing system maintenance and application
support services for the eCURA software application used by Behavioral
Health Services, for the period of July 1, 2006 through June 30, 2007.
(3.3) CBHS-MIS – Request for approval of a sole source contract renewal
with Echo Group, in the amount of $464,470, which includes a 12%
contingency, to provide ongoing system maintenance and application
support services for the INSYST software application used by Behavioral
Health Services, for the period of July 1, 2006 through June 30, 2007.
Action Taken: The Commission approved the Consent Calendar of the Budget
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., Director of Health, presented the Director’s
Commissioner Arthur Jackson Dies
The Department of Public Health was saddened by the news that former
Health Commissioner Arthur Jackson died at his home last week after a
long battle with kidney disease. Commissioner Jackson’s commitment to
the City & County of San Francisco was evidenced by his lifelong
dedication to public service throughout his life. He served as Health
Commissioner from 1992-1996 and again from 2001-2002. Many within the
Department and a number of Commissioners now serving had the privilege
of knowing and working with this extraordinary man who gave so freely of
his time and talent to the service of the community. A memorial service
is planned for April 30 at 2 p.m. in the Green Room of the War Memorial
Veterans Building. Donations may be made in his name to the National
Kidney Foundation of Northern California, 131 Steuart Street, Suite 520,
San Francisco, CA 94105.
Hundred Year Anniversary of the 1906 Earthquake
1906 earthquake survivors, City officials, media from around the globe
and thousands of others gathered this morning at Lotta’s Fountain to
commemorate the 100 year anniversary of the ‘Great Quake’. The ‘06
earthquake and subsequent fire was the largest natural disaster in
United States history until the catastrophic events last fall in New
Orleans and the gulf coast. DPH staff has been involved for months with
centennial planning efforts. Tomorrow the City will stage a major
eight-hour earthquake drill/exercise. The City’s Emergency Operation
Center (EOC) and all Departmental Operation Center’s (DOC) will be
activated to test preparedness and response plans. The DPH DOC will be
operational for nine hours, with a change in personnel mid-day to test
both the A and B staffing shifts. All the hospitals in San Francisco are
voluntarily participating in the exercise.
Tomorrow afternoon, City officials will gather at Fisherman’s Wharf to
discuss scenarios for three possible major disasters in the city's
future: a terrorist attack with a radioactive dirty bomb, the arrival of
a mega-epidemic carried by birds, and an earthquake. DPH has three
representatives at the seminar.
This week, every employee working for the City and County of San
Francisco was issued a Disaster Service Worker (DSW) identification
card. The card identifies workers as DSW by a magnetic strip on the back
and will be used in the event of an emergency to assign staff to
disaster/emergency service activities.
Rally for Day Laborers and Lead Paint Safety
Last week the Department’s Childhood Lead Prevention Program, the Day
Labor Program and the Mayor’s Office of Housing held a rally for Day
Laborers to demonstrate how workers can keep themselves and their
families safe from exposure to lead hazards and other toxic substances
while making home repairs. The rally featured a contractor demonstrating
lead-safe working techniques, Day Labor participants distributed visors
with lead-safe messages and a number of Day Laborers addressed the
occupational plights of their jobs such as low wages, human rights
violations and the instability of temporary employment. DPH continues to
work closely with a number of agencies to keep all workers and their
families safe from lead poisoning.
SFGH Participates in Caesar Chavez Birthday Festival
SFGH sponsored a health care information booth at the Caesar Chavez
Birthday Festival and Parade celebration held earlier this month on the
grounds of the Horace Mann Elementary School in the Mission. Posters and
literature in English and Spanish highlighted personal disaster
preparedness and provided updated information on the medical helipad
project. Those who attended also received emergency response maps from
the SFGH Foundation and self-care health information.
Ana Ghosh and Anna Cornejo, both native Spanish speakers, and Health
Educator Amena Panni and Chris Wachsmuth, RN, represented the
Department. Dr. Katz noted that the community was very interested in
disaster preparedness and the medical helipad project. Most of the
feedback about the medical helipad project was positive. Not
surprisingly, there continues to be questions about noise, safety and
the effects on the neighborhood adjacent to SFGH.
SF Business Times Names O’Connell as Tops in Business Women
The San Francisco Business Times has named Gene Marie O'Connell, our
executive administrator of SFGH one of the “Most Influential Women in
Business in the Bay Area” for the fourth year in a row. Dr. Katz
congratulated Ms. O’Connell on this significant recognition.
3 for Life
Recently DPH’s Communicable Disease Prevention Unit (CDPU), in
partnership with the Asian Liver Center at Stanford University,
completed a pilot project entitled 3 For Life, which targeted
foreign-born Chinese residents for hepatitis B testing and vaccination.
During the course of one year, we screened over 1200 adults,
administered more than 3000 shots and trained 120 volunteers. The
project achieved a remarkable 87% completion rate for those eligible for
the series of hepatitis shots.
Data collected indicated that 10% of the clients screened are
chronically infected with hepatitis B and 40% are immune due to previous
infection, leaving 50% vulnerable to infection and in need of
immunization. Nearly 54% have health insurance yet only 16% said their
doctor had ever suggested hepatitis testing to them (only 25% among
those with chronic infection). This one piece of information speaks to
the need for education among the city’s primary care providers around
the importance of screening for hepatitis B status. Currently, the
greater San Francisco Bay Area has the highest incidence of liver cancer
in California and the country, and chronic hepatitis B infection is one
of the top five causes of premature mortality in the San Francisco Asian
community. A group from UCSF is about to re-launch the project with
expanded services around education and care. Abstracts about the project
have been submitted and accepted a multiple national conferences around
California Injury Prevention Network
The California Injury Prevention Network (CIPN), started by the
Community Health Education Section under a State grant funded by the
Kids’ Plates program, is now on line and accepting members. The Network
will enable injury prevention professionals throughout California to
share resources, to network, and to have blog discussions. In light of
the recent cancellation of the annual California Conference on Childhood
Injury Control due to budget cuts, CIPN may play an even more important
role in disseminating information and encouraging programs to share
information. To view the public areas of the site, go to http://www.healthysf.org/cipn/index.html.
Nursing Scholarship Fund Raiser
San Francisco General Hospital Medical Center is sponsoring the Second
SFGH Gala Fundraiser event benefiting the Dorothy Washington Nursing
Scholarship Fund on Thursday, May 4, beginning at 6 p.m. at the
Ritz-Carlton, 600 Stockton Street. Keynote Speaker is Kamala Harris,
District Attorney. Katie Moe, 206-5928 or firstname.lastname@example.org is the
contact person to purchase tickets. The deadline is Monday, April 24th.
Tickets are $175.
Update on School Health Bill
Dr. Katz updated the Commissioners on AB 2560, which would require the
state to establish a Public School Health Center Program to promote the
concept of teen health centers in public schools. This bill is currently
pending in the Assembly Education Committee, after having passed the
Assembly Health Committee on April 5 by a vote of 10-2. Staff will
continue to follow this important legislation.
Website Hits New Highs
The DPH website continues to be a popular destination. In March 2006,the
number of page views of the DPH Internet site surpassed one million to a
total of 1,068,391 pages viewed. The average number of page views per
day was 34,464 and the average visitor spent 10:46 minutes on the site.
It may interest the Commissioners to know that 107,191 visits were made
to the web page displaying the current restaurant violations posted by
the Bureau of Environment Health, making it the Department’s most
popular site on the internet. The second most popular site is Genital
Warts with STD Basics at third place.
Community Health Network - San Francisco General Hospital, April 2006
07/05 to 04/06
| Reappointment Denials:
|Changes in Privileges
| Voluntary Relinquishments
| Proctorship Completed
| Proctorship Extension
|Current Statistics – as of 04/1/06
|Affiliate Professionals (non-physicians)
|Applications In Process
|Applications Withdrawn Month of April 2006
2 (07/05 to 04/06)
|SFGH Reappointments in Process May 2006 to Aug. 2006
Dr. Katz added that Governor Schwarzenegger has announced his
support for the establishment of a State Public Health Director. This is
an initiative that a number of public health advocates in California
have been working on, and this announcement is good news.
5) PRESENTATION OF THE FY 2006-2007 CONTINGENCY BUDGET AND CONSIDERATION
OF A RESOLUTION
Gregg Sass, DPH Chief Financial Officer, presented the FY 2006-2007
contingency budget. Mr. Sass reminded the Commission that the Health
Commission approved and the Department submitted the base budget in
February that produced a general fund reduction of $7.3 million. This
reduction exceeded the Mayor’s base budget instructions to absorb a $7.1
million cut. The Mayor’s Office has advised DPH of the need to develop a
plan to further reduce its general fund subsidy by 3%. As a result, the
contingency budget is being presented to the Commission.
To the extent the Department can met its contingency reductions with
revenue increases, the difficult task of expenditure reductions are
avoided. In that vein, the primary component of the contingency budget
is $6.5 million in additional revenues from higher than budgeted Medi-Cal
payments, capitation revenue and Short Doyle Medi-Cal, and resumed
payments by the State for SB90/AB3632. Approximately $1.3 million of the
increased revenues will be allocated to Laguna Honda Hospital to address
deficiencies identified in the recent Department of Health Services
The Department has identified two initiatives to further reduce general
fund expenditures while avoiding reductions in services. These
reductions total $1.6 million, with a $1.9 million annualized savings.
The first initiative is the closure of the Workers Compensation Clinic
at SFGH. The second reduction is an equalization of rates that DPH pays
for residential substance abuse services. DPH would reduce the contract
rate for several providers to 120% of the median rates in effect in FY
2005-2006. The goal is to implement this reduction of payment rates
without affecting the number of units of service provided. However, the
clinical focus of the affected programs may change. Adjustment of rates
on September 1st will save $712,153 for FY 2006-2007.
- Jonathan Vernick, Executive Director of Baker Places, said the rate
equalization initiative pays no attention to the public policy goals
programs are trying to accomplish and the outcomes programs are
achieving. The Health Commission should not continue to send cuts to the
Mayor and Board of Supervisors for them to make the decision to restore
- Mike Richards, Program Director at Acceptance Place, said Acceptance
Place provides the only culturally competent services for the population
it serves. Maintaining the program is the most cost-beneficial this to
- Dr. Allan Furhman, Clinical Director, HAFCI Center for Recovery (CFR),
said CFR clients have challenges that other programs cannot deal with
but which CFR works to address. Many CFR clients would not be accepted
anywhere else. The program saves the Department money.
- Dr. Mardell Gavriel, Walden House, said two programs that serve the
most chronically mentally ill people in the system would have to change
there focus as a result of the rate equalization initiative. If rates
are reduced, the clients would increase their hospitalization rates and
emergency room visits.
- Donald Frasier, President of the San Francisco Association of Alcohol
and Drug Program Contractors, said the programs that will be affected by
the rate equalization initiative are the most unique in the county
serving patients with the highest need. It is misleading to use the term
equalization when the result would be closed programs.
- Lewis Eldridge, Deputy Director, Haight Ashbury Free Clinics, said
clients served by CFR are the most vulnerable in the city. CFR cannot be
- Deborah Camarillo, Executive Director, Latino Commission, spoke on
behalf of two programs—Casa Quetzal and Casa Aviva. The rate
equalization initiative would mean a cut in these programs. The Latino
Commission has the only bi-lingual residential services in San
Francisco. More beds are needed, not fewer.
- Sharon Love, Center for Recovery, said CFR taught her that there is a
better life, how to take her medications on time, and other important
things. The program is really needed.
- Irish Kobelt, Center for Recovery, said drug addiction and dual
diagnosis go hand in hand, and CFR deals with both. Programs such as
these need to be maintained. Cutting programs that serve addicts would
- Debbie Lerman, San Francisco Human Services Network, said the
reduction initiatives were chosen without any public process and without
any discussion about public policy implications. The agencies are never
consulted during the process, and are not allowed to help.
- Commissioner Monfredini asked when the deadline for submitting the
contingency budget is, and when the Board of Supervisors would consider
the budget. Dr. Katz said the deadline for submitting the contingency
budget has passed, and will be considered with the City’s budget in
June. There is the hope that the contingency cuts will not have to be
- Commissioner Chow asked if CCSF patients needing workers compensation
services would be able to go to any provider in the City. Dr. Katz if
the Workers Compensation Clinic is closed, he anticipates that the
Department of Human Resources would designate a network of providers
that people could see. Commissioner Chow asked if some substance abuse
providers are disproportionately affected by rate equalization, and are
some cut to such extent that they would have to close. Dr. Katz said
providers that receive a rate higher than 120% of the median would
receive a cut. Those close to the median would make a small cut. Those
much higher would have a much greater cut. In addition, there are many
factors that go into how different rates have been set. Dr. Katz said
staff would provide information about the specific details of the cuts
to the Health Commission.
- Commissioner Guy said if the budget cuts were to come to pass, she
could support the cut to the Workers Compensation Clinic. She did not
support the substance abuse and behavioral health cuts last year, and
she does not want to do so now. She also emphasized the need to make
decisions together. She asked the Commission to consider not accepting
the substance abuse cuts, because we need a break from the dance that
has developed around proposing budget cuts.
- Commissioner Sanchez thanked that staff for preparing these options.
DPH has unique partners in the non-profit service providers. Each agency
serves very different populations. He agrees with Commissioner Guy and
does not want to support the cuts to substance abuse because of the
impact it would have on the most vulnerable and most diverse population
in San Francisco.
- Commissioner Umekubo has been impressed with staff for identifying
revenue to help us meet the Mayor’s budget instructions. He asked if
there was the potential for one-time Medi-Cal settlements, which would
further reduce the need for expenditure cuts. Mr. Sass said DPH has been
very successful with Medi-Cal settlements, but there are not a lot of
opportunities for future settlements. The Department is involved in a
class action regarding disproportionate share, but it is difficult to
estimate when this will be resolved. Commissioner Umekubo supports
removing the expenditure cut to substance abuse.
- Commissioner Tarver asked if the settlement reserves could be reduced
further, so that expenditure cuts could be minimized. Mr. Sass said it
is not unusual to see audit adjustments in the range of $2 million. So
they feel that the settlement reserve amount is appropriate.
Commissioner Tarver is concerned that the Workers Compensation Clinic
provides culturally competent care and other providers may not.
Commissioner Tarver does not want to support arbitrary or politically
minded budget cuts. He is also concerned that the Department’s clinical
leaders are not consulted to the extent they should be about budget
cuts. DPH has to develop its budget contingencies well in advance. He
supports removing the substance abuse rate equalization initiative so
that the Health Commission has more time to analyze it.
- Commissioner Illig is impressed with how well the Department is able
to find additional revenues. Commissioner Illig noted that DPH included
in its budget a 2% COLA, and defended this to the Mayor’s Office.
Commissioner Illig is going to propose to his colleagues that no budget
cuts come to the Health Commission without having first gone to a joint
conference committee. That said, programs should not be arbitrarily cut
because of their rates. There are a number of reasons rates vary, and
these reasons must be more clearly understood. Commissioner Illig asked
if there is a way for additional money coming from audit settlements
could be shared with providers. Mr. Sass said that most audit
adjustments result in DPH is having money taken away. This is not passed
on to contractors.
- Commissioner Chow would like more data about the impact of rate
equalization on each of the programs prior to taking it completely off
the table. A $21,000 cut to a multi-million program may not be that
great of an impact, but another cut to another program might mean
- Commissioner Monfredini said that the contingency budget must be
submitted to the Mayor’s Office, and it is clear that the contingency
budget requires an additional 3% general fund reduction. She believes
that the economic condition of the City is greatly improved over last
year and that there is a good chance that the contingency budget would
not be needed.
- Commissioner Chow is not in favor of leaving it to the Mayor’s Office
to identify the cuts in order for DPH to meet its contingency budget
- Commissioner Illig proposes sending over the budget with an $850,000
placeholder in the budget, but will not support any cuts to substance
- Commissioner Guy does not support the methodology behind the rate
equalization initiative. She would rather close one program and save
$712,000 than to have five programs close as a result of the initiative.
- Commissioner Chow asked the Department to look at an across-the-board
cut in substance abuse and other programs to see if that is a better way
of meeting the savings requirement. Dr. Katz believes the Mayor’s Office
would honor the Health Commission if the Health Commission offered
another budget reduction it thought was more appropriate.
- Commissioner Tarver recommends referring the rate equalization portion
of the contingency budget to the CHN JCC, to come back to the Health
Commission at its May 2nd meeting.
- Commissioner Chow offered an amendment to the resolution that would
allow for the contingency budget to be sent to the Mayor with the
direction to the Health Department staff to review the details of the
substance abuse reductions to minimize the loss of substance abuse beds.
- Commissioner Sanchez spoke against the amendment, and indeed any cuts
to substance abuse services. The agencies that are being cut are the
very agencies that stepped forward at DPH’s request to serve diverse,
vulnerable populations. There can be another way.
- Commissioner Illig spoke against the amendment because the Board of
Supervisors has already adopted a policy statement that substance abuse
cuts are unacceptable.
Action Taken: The Commission (Chow, Guy, Monfredini, Tarver, Umekubo)
amended the resolution to add to the Resolved clause “with the details
of the substance abuse reductions to be further reviewed by the
Department and the Health Commission to minimize the loss of residential
substance abuse beds.” (Commissioner Illig and Commissioner Sanchez
Action Taken: The Commission approved Resolution #07-06, “Approving the
Submission of the Department of Public Health’s Contingency Budget for
Fiscal Year 2006/07,” as amended, (Attachment A). (Commissioner Illig
and Commissioner Sanchez voted no.)
6) HEARING TO CONSIDER BROWN AND TOLAND BUSINESS PRACTICES AND THEIR
IMPACT ON THE CHINESE COMMUNITY
Commissioner Chow said he has been advised by the City Attorney not to
participate in this hearing, and asked his colleagues to entertain a
motion to recuse him from the discussions.
Action Taken: The Commission (Guy, Illig, Monfredini, Sanchez, Tarver,
Umekubo) approved a motion to recuse Commissioner Chow from
participating in this hearing.
Dr. Katz provided the Commission with a context for today’s hearing. The
Mayor, the Board of Supervisors and the City Attorney have spoken out
against the aggressive tactics of Brown and Toland in trying to get
doctors to sign exclusivity agreements. They have done so because of how
harmful these practices are to medical care in San Francisco. Brown and
Toland is the largest and most dominant medical physician organization
in San Francisco so physicians who hope to maintain viable medical
practices often have to be beholden to Brown and Toland. Having a
dominant practice is a problem in any city, but it is particularly
harmful as Brown and Toland is offering incentives to physicians to be
exclusively in its networks. This risks damaging the independent parts
of our system, and particularly Chinese Hospital. All San Franciscans
stand to lose to the extent that these kinds of practices result in
higher prices, fewer choices and one organization determining how people
should get medical care. This is an appropriate issue for the Health
Commission to consider.
- Brenda Yee, CEO, Chinese Hospital, said Chinese Hospital is the last
independent hospital in San Francisco and continues to stand strong in
providing quality, culturally competent medical care to more than 27,000
San Franciscans. It provides critical services to the Chinese Community.
Without the health system, the quality of life of the monolingual
Chinese community would be detrimentally impacted.
- Eric Leung, M.D., said the Chinese Community Health Care Association
is committed to serving the safety net population through Medi-Cal,
Medicare and the San Francisco Health Plan. CCHCA doctors provide many
services to the Asian American community. For the past 10 years Brown
and Toland and CCHCA have had a collaborative relationship without the
need for exclusivity. The requirement for exclusivity means that Chinese
physicians would have to resign from CCHCA. They believe doctors should
have the benefit of preferred status without having to resign from CCHCA.
- Dexter Louie, M.D., has been practicing in Chinatown for the past 30
years. He is assistant medical director with the Chinese Community
Health Plan. CCPH is very unique. It is community owned by the Chinese
Hospital and the goal of the plan is access to culturally competent,
culturally sensitive medical care. The plan serves 27,000 members, 7,000
of whom are with the San Francisco Health Plan. The plan is community
- Joseph Woo, M.D., Chief of Medical Staff at Chinese Hospital and
member of CCHCA board, reiterated that Chinese Hospital is community
owned, is the only independent hospital in San Francisco and the only
Chinese Hospital in the country. He represents 270 medical staff at
Chinese Hospital who are committed to serving the Chinese community
without having to resign in order to participate in Brown and Toland.
- Stuart Fong, Chinese Hospital Infection Control Coordinator and Risk
Manager, talked about Chinese Hospital’s role in the Hepatitis B
screening program. One in ten Asian Americans has Hepatitis B. Screening
is critical because Hepatitis B has no symptoms. Please preserve access
to these services.
- Elena Tinloy, Director of Clinical Services at Chinese Hospital, read
a statement from Dr. Tina Kwan. Dr. Kwan said CCHCA is the largest
non-county medical group providing services to the San Francisco Health
Plan, caring for more than 7,000 health plan enrollees. If pediatricians
were forced to resign from CCHCA, they would not have a vehicle to
deliver care to health plan families. She appreciates the Health
Commission’s support to ensure that CCHCA physicians could continue to
provide services to the Health Plan and other members of the community.
- Angela Sun, Executive Director of the Chinese Community Health
Resource Center, said management of health problems in the immigrant
community can be stymied by language and cultural barriers. The health
resource center, which is funded by Chinese Hospital, CCHP and CCHCA,
was established in 1989. Its mission to meet the need of the monolingual
population. She urged the Commission to save culturally competent
services and access.
Written Testimony submitted for the Record.
- Jean Fraser, CEO, San Francisco Health Plan – My apologies for not
being able to stay to testify in person. CCHCA and SFGH have been
partners in providing excellent quality of care to low and moderate
income San Franciscans since the beginning of SFHP in 1997. CCHCA is our
third largest medical group and a critical part of the network. Keeping
CCHCS intact is critical to meting SFHP’s mission, especially since
Brown and Toland has to date refused to contract with SFHP. We urge you
to support CCHCA in this effort.
- Commissioner Monfredini asked if Brown and Toland had a representative
at the meeting. Mark Ficker, Chief Financial Officer, Brown and Toland,
said Brown and Toland made a commitment not to discuss any of these
issues in public, and will not do so today. Brown and Toland is
committed to settling this issue. Commissioner Monfredini asked how long
Chinese Hospital has been involved with Brown and Toland. Dr. Leung
replied at least 10 years. Dr. Leung said at one point there was the
offer to merge with Brown and Toland but CCHP wanted to keep its
- Commissioner Illig asked if negotiations are still under way. Ms. Yee
said yes. Dr. Leung said that preferred physicians have a number of
benefits: sign-on bonus, share of year-end dividends, etc. In order to
join the preferred network, doctors are asked to resign from all other
medical groups and serve Brown and Toland exclusively. This is what has
presented the biggest problem to Chinese Hospital. Commissioner Illig
asked if it is possible to join another physician’s group. Dr. Leung
said that most physicians could not sustain a viable practice without
being part of Brown and Toland.
- Commissioner Umekubo asked about the perks associated with preferred
membership. Mr. Ficker replied that there is no differential in pay,
however there is a different bonus structure. The sign-on bonus is to
help doctors to buy equipment for participation in the AMR system. Brown
and Toland pays for much of the implementation.
- Commissioner Sanchez said it is an honor to have such distinguished
medical providers in the audience. He is pleased that they chose to
bring this issue to the Health Commission’s attention. What they are
going though is exactly what the medical community has been going
through for the past number of years. The UCSF/Stanford merger resulted
in a two-class system among medical providers, and this was
unacceptable. Chinese Hospital has been serving the community for more
than 100 years. This institution must continue to maintain its
leadership in the community. We need these kinds of dialogues to focus
on quality care and culturally competent health care providers. He hopes
this is one of the outcomes of these discussions.
- Commissioner Guy appreciates that this issue was brought before the
Health Commission, because it will have a huge impact on public health
and on San Francisco General Hospital. Regardless of Brown and Toland’s
intent, exclusivity and a two-tiered system would lead to the
elimination of Chinese Hospital. Chinese Hospital was born out of the
fact of a stigma against the Chinese community. Chinese Hospital is an
integral part of this community and she does not want to lose this
resource. She supports the strategy of bringing this issue to the
public. She supports agendizing the resolution at the next Health
Commission meeting. She supports the principle that it is destructive to
- Commissioner Monfredini agrees with Commissioner Guy and supports the
resolution. She hopes that the negotiation stays open on both sides.
This Commission is committed to keeping Chinese Hospital open as a
resource to our community. She urged both sides to come to the
negotiating table in good faith.
- Commissioner Umekubo, as an independent practitioner, said there is no
question that this exclusivity is detrimental to the Chinese community.
For the physician, there is no win to this situation.
- Commissioner Tarver spoke in support of a resolution, to be voted on
at the next Health Commission meeting. Continuation of culturally
competent services such as those provided by Chinese Hospital is a
priority for this community. He said to look at what happens when
medical groups monopolize within a community.
7) PUBLIC COMMENT/OTHER BUSINESS
The meeting was
adjourned at 6:30 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 noted 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