Minutes of the Health Commission Meeting
Tuesday, February 17, 1998 3:00 p.m.
101 Grove Street, Room #300 San Francisco, CA 94102
1) CALL TO ORDER
The regular meeting of the Health Commission was called to order by
President Lee Ann Monfredini,
at 3:05 p.m.
- Commissioner Debra A. Barnes
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
1) CALL TO ORDERThe regular meeting of the Health Commission was called
to order by President Lee Ann Monfredini,
at 3:05 p.m.
2) APPROVAL OF MINUTES OF THE MEETING OF FEBRUARY 3, 1998Action Taken:
The Commission unanimously adopted the minutes of February 3, 1998.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE(Commissioner David J.
Sanchez, Jr., Ph.D.)
(3.1) Consideration of a request to substitute the "Grant
Application Information Form" for the "Health Commission Summary
of Grant Request" for Health Commission review of requests for grant
Monique Zmuda, CFO, welcomed suggestions from Commissioners on
information to be included in the new Grant Application Information Form.
Commissioner Sanchez commented that the Budget Committee will
periodically review grant and contract policies.
(3.2) PH-CHS-HIV Postexposure Prophylaxis Project - Request to
retroactively accept and expend new funding in the amount of $140,156 from
the University of California, San Francisco, Center for AIDS Prevention
Studies, to provide counseling and medical services for HIV postexposure
prophylaxis services for the period of December 1, 1997 through November
(3.3) PH-CHS-Mental Health Services - Request to retroactively
accept and expend a renewal grant in the amount of $60,000 from the Miriam
and Peter Haas Fund to support a consultant planner to develop policies
and programs for the mental health managed care plan for the period of
December 15, 1997 through December 14, 1998.
Anita Fong is the consultant planner who will continue under this
(3.4) PH-CHP&P-Dental Health Services - Request to accept and
expend retroactively new funding in the amount of $63,295 from the Dental
Health Foundation to provide preventive dental health services to
low-income and immigrant children for the period of January 1, 1998
through February 29, 2000.
(3.5) Central Administration-Finance - Request to increase the
revolving fund for the Public Health division by $8,000 to $33,000.
(3.6) PH-CHS - Request to approve the extension of 54 CARE-funded
AIDS health services contracts from March 1, 1998 through June 30, 1998.
(3.7) PH-CHS-MH - Request to exercise fourth year option of a
4-year contract with Crestwood Hospitals, Inc./Crestwood Behavioral
Health, Inc. (Crestwood), in the amount of $4,341,508 to provide 24-hour
services and subacute locked skilled nursing services for the period of
July 1, 1997 through June 30, 1998. (DPH contracted with Crestwood for
services totaling $6,222,892 during
Commissioner Monfredini expressed to the contractor that the Commission
views the Board and staff compliance policy seriously. She stated that
Advisory Boards are not acceptable for compliance. She suggested to the
contractor to consider adding two more Board members who will be
non-shareholders with voting privileges.
Commissioner Barnes advised the contractor to relook at its bylaws and
increase the number of Board members. She requested the Department have an
alternative plan in place if the present contractor continues to remain
non-compliant. She also noted that this renewal is retroactive.
Commissioner Sanchez suggested this contractor's Board reassess the
importance of continuing to do business with the Department and then look
for models to adhere to compliance. He requested a report back to the
Budget Committee prior to renewal of this contract.
The Commissioners approved the retroactive contract for the current
fiscal year but will review the contractor's plan for compliance prior to
any future renewals.
Action Taken: The Commission approved the Consent Calendar of the
4) DIRECTOR'S REPORT (Provides information on activities and operations
of the Dept.).
(Mitchell H. Katz, M.D., Director of Health)
ADMINISTRATIONEmergency Shelters Opened
The recent onslaught of storms resulting from El Niņo caused the Mayor
to declare a State of Emergency in San Francisco on February 5. The
declaration put emergency operations into place and the Red Cross opened
three emergency shelters in Recreation and Parks facilities at:
- 6th and Folsom, in the SOMA area;
- the Joe Lee Recreation Center, in Bayview Hunters Point; and
- Kezar Auditorium in the Haight.
Since the emergency shelters opened February 6, DPH has provided
medical, mental health and substance abuse services to those housed at the
shelters. The Department has also provided oversight of environmental
health issues. This experience granted an excellent opportunity for
DPH to test its own emergency response program. In addition, the
experience has been an invaluable learning tool for piloting the
integrated delivery system model proposed in the Department's recent
I am pleased with the performance and commitment of DPH staff, who have
worked long hours to assure that all who sought shelter had access to
medical and mental health services.
PUBLIC HEALTH Chlorinated Drinking Water
This past week there was considerable coverage of an article that will
appear in the next issue of Epidemiology which suggests a relationship
between some drinking water and miscarriages. Specifically, the study
suggests that women who drink more than five glasses per day of drinking
water which contains more than 75 parts per billion of Total
Trihalomethanes (TThm) during their first trimester of pregnancy may be at
greater risk for miscarriages. San Francisco's drinking water often
exceeds this level.
While the results of the study are of great concern to us, the study
has a number of limitations. Our staff are working closely with the staff
of the Public Utilities Commission to get more information and to generate
a coordinated response.
In the meantime citizens who are concerned should call the PUC's Water
Quality Bureau at (650) 872-5942. We are currently advising people who are
concerned to speak with their physician. We are also telling people who
want to remove TThm's from their tap water that they can use activated
charcoal filters or they can boil their water.
COMMUNITY HEALTH NETWORK Community Health Network Resignation
It is with regret that I announce the resignation of Richard Cordova,
who served as the Executive Administrator of the Community Health Network.
Rich left DPH last Friday to accept a position as Vice President of the
East Bay region of Kaiser Permanente. I am sure you join me in thanking
Rich Cordova for the fine leadership he provided over the last six years
as Administrator of SFGH/CHN. Rich leaves behind a leadership team that is
capable of taking the Community Health Network to the next step.
I asked Anthony Wagner to act as Interim Executive Administrator of the
Community Health Network. I look forward to working with Tony in his new
role, and am confident in his ability to lead and direct the CHN through
this transition period.
SFGH CREDENTIALING 4th Quarter 1997 Board Report
4th Quarter 1997 Board Report
||Restrictions/Limitation of Privileges
||Changes in Privileges (additions/deletions)
President Monfredini acknowledged Anne Kronenberg, Eileen Shields,
Barbara Garcia, and all Department of Public Health staff who have
worked on the operations of the emergency shelters. Commissioner Guy has
been receiving positive responses to the shelters. Commissioner Chow
complimented the Department staff for responding to the needs of the
5) CONSIDERATION OF A RESOLUTION CREATING A RESERVE FOR THE
DEPARTMENT OF PUBLIC HEALTHMonique Zmuda, Chief Finance Officer,
reported that this reserve will be a Departmentwide reserve that will be
used to replace revenues that have been volatile due to uncertainties of
State and Federal government programs and their rules for claiming and
eligibility. Surplus revenues in the current fiscal year will be used to
establish a reserve fund. The reserve will be replenished to a minimum
amount and when surplus funds are available.
Action Taken: The Commission unanimously adopted Resolution #8-98,
"Creating a Department of Public Health Reserve to Guard
Future Funding Uncertainties", (Attachment A).
6) CONSIDERATION OF THE PROPOSED DEPARTMENT OF PUBLIC HEALTH BUDGET
FOR FY 1998-99, AND CONSIDERATION OF A RESOLUTION FOR A POLICY TO EXPAND
HOUSING SERVICES, PREVENTION SERVICES, AND SPECIFIC INFRASTRUCTURE
PRIORITIESMonique Zmuda, Chief Finance Officer, reported that the fiscal
year 1998-99 annual Department of Public Health budget will be
transmitted to the Mayor and the Controller on February 20, 1998. In
May, the Controller certifies the revenues. In June, the Mayor transmits
the City Budget to the Board of Supervisors. The Finance Committee of
the Board holds hearings on the budget and makes recommendations to the
full Board. The Board of Supervisors votes on the budget in early July.
Ms. Zmuda presented additional information requested by members of
the Commission regarding the Department's budget request for FY 1998-99:
- Cost information on population-based prevention programs;
- Estimated cost and timeline to implement Treatment on Demand for
- Information on the Target Cities grant funded programs which will
be phased out in FY 1998-99; and
- Details on capital projects to comply with Joint Commission on
Accreditation of Hospitals.
Additionally, the following new initiatives were proposed for
inclusion in the budget:
- Risk Management Plan for businesses storing regulated substances
which is supported entirely by fees;
- Further augmentation of rodent control program;
- Action Point Centers for HIV infected persons; and
- An employment reentry program for HIV-infected persons.
The Department will work with the Mayor's Office to develop further
details and specific dollar amounts for the last two new initiatives.
These new initiatives, the Action Point Center and Employment Reentry
Program, were recommended at the Mayor's AIDS/HIV Summit. The Department
will present details of these two new programs at a future Commission
Commissioners expressed appreciation for the clear, organized, and
informative budget document.
Commissioner Guy encouraged the Department to work with the
community-based organizations who already anticipated what is needed and
what the numbers are for an employment program. There should be a
determination about what the Department could do and what should be
Commissioner Chow expressed support for the enhancement of rodent
control. He also supported population-based prevention programs and the
Department's process in determining a population-based need (i.e., study
Commissioner Sanchez pointed out that the proposed budget calls for
major funding and emphasized the opportunity to seek more grants. He
also reported that the Budget Committee will be reviewing the
Department's capital budget.
Commissioner Monfredini expressed her high priority for roof repairs
at Laguna Honda Hospital.
Commissioner Guy expressed her appreciation for a report that
addresses the high-volume census at San Francisco General Hospital. A
copy of this report was requested for each Commissioner.
President Monfredini acknowledged two letters submitted to the
Commission in support of prevention programs:
Gary Rayan, D.D.S., S.F. Dental Society
Neil Gendel, Healthy Children Organizing Project
Paul Causey, AIDS Benefits Counselors
Karen Greener, LIFE Program
Gary Virginia, PWA and AIDS Benefits Counselors
Stephen J. LeBlanc, San Francisco Citizen with HIV
Dan Merer, staff nurse, SFGH, Emergency Department, Local 790, Shop
Dale M. Butler, SEIU Local 790
Action Taken: The Commission unanimously adopted Resolution #9-98,
"Expanding Services for Housing for the Homeless, for Prevention of
Illness, and for Maintaining and Expanding Existing MIS and Other
Infrastructure Within the Department," (Attachment C).
Action Taken: The Commission unanimously adopted the proposed
Department of Public Health Budget for fiscal year 1998-99; and that
this budget be transmitted to the Mayor.
7) OTHER BUSINESS/PUBLIC COMMENTSNone.
The meeting was adjourned at 4:45 p.m.
Sandy Ouye Mori, Executive Secretary to the Health