Minutes of the Health Commission Meeting
April 7, 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
at 3:02 p.m.
- Commissioner Debra A. Barnes
- Commissioner Edward A. Chow, M.D.
- Commissioner Ron Hill
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
2) APPROVAL OF MINUTES OF THE MEETING OF MARCH 17, 1998
- Commissioner Roma P. Guy, M.S.W.
- Commissioner David J. Sanchez, Jr., Ph.D.
Taken: The Commission unanimously adopted the minutes of March 17, 1998.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Lee Ann Monfredini)
President Monfredini pointed out that too many of today's contracts are retroactive and
requested the Department to continue its improvement on this matter.
(3.1) CHN-Tom Waddell-Homeless Programs - Request for approval of new
contract and sole source request with the Bar Association of San Francisco (BASF)in the
amount of $194,028 to provide advocacy and legal and technical assistance to severely
disabled individuals applying for Supplemental Security Income, for the period of date of
certification through June 30, 1999. (DPH contracted with BASF for services totaling
$77,868 during FY 1996-97).
President Monfredini requested the contractor to send a letter to the Department in
five months (October 1998) with an update on its continuing progress towards compliance on
its Board composition.
(3.2) CHP&P-HIV Prevention - Request for approval of retroactive
renewal contract with CAL-PEP, in the amount of $256,496, for the provision of HIV
prevention program services targeting behavioral risk populations and venue-based
individual outreach services, for the period of January 1, 1998 through December 31, 1998.
(DPH contracted with CAL-PEP for services totaling $228,138 during FY 1996-97).
(3.3) PH-CHS-STD Prevention & Control - Request for retroactive
approval of renewal contract and sole source with the Regents of the University of
California at San Francisco (UCSF) - Adolescent Medicine Department, in the amount of
$208,440 per year, for the continued provision of research and evaluation activities to
prevent infertility due to sexually transmitted diseases, for the period of February 27,
1998 through February 26, 2000. (DPH contract with UCSF for services totaling $13,848,952
during FY 1996-97).
(3.4) PH-CHS-CSAS - Request for retroactive renewal contract with Haight
Ashbury Free Clinics, Inc. (HAFC) in the amount of $3,199,751 to provide Target Cities
Project fiscal agent, SSI evaluation, SSI client referral and monitoring, and HUD
monitoring services, and a Sole Source request to implement the Long-Term Care Integration
Pilot Project in the amount of $104,775, for a total contract amount of $3,304,526, for
the period of October 1, 1997 through September 30, 1998. (DPH contracted with HAFC for
services totaling $10,606,732 during FY 1996-97).
(3.5) PH-CHS-CSAS - Request for retroactive approval of multiyear
contract renewal with Institute of Advanced Driver Education and Training (IADET), in the
amount of $211,375 (in client fees only), to provide First Offense Driving Under the
Influence (DUI) services for the period of July 1, 1997 through June 30, 2001. (DPH
contracted with IADET for services totaling $202,778 in client fees during FY 1996-97).
(3.6) PH-CHS-CMHS - Request forapproval ofretroactive modification to the
contract with Ross Hospital to provide: 1) an augmentation of acute psychiatric inpatient
hospital services for children and adolescents in the amount of $60,000. The total
contract amount including this modification is $80,000; and 2) Medi-Cal funded psychiatric
inpatient hospital services for adults for the period of
July 1, 1997 through June 30, 1998. No change in the total dollar amount of
$4,000,000 for adult psychiatric inpatient hospital services for Medi-Cal beneficiaries
for all six (6) hospital providers. (DPH contracted with Ross for services totaling
$20,000 during FY 1996-97).
(3.7) PH-CHS-CMHS - Request for approval of retroactive contract
modification with St. Mary's Hospital and Medical Center (D.B.A. McAuley Neuropsychiatric
Institute) to provide:
1) augmentation of adolescent inpatient, partial hospitalization, transitional
(outpatient) services in the amount of $77,600. The total amount of the contract is
$377,600 including this modification; and 2) Medi-Cal funded psychiatric inpatient
hospital services, for the period of July 1, 1997 through June 30, 1998. No change in the
total amount of $4,000,000 for all six (6) hospital providers. (DPH contracted with St.
Mary's for services totaling $1,045,368 during FY 1996-97).
(3.8) PH-CHS-CMHS - Request for approval of new contract with Family
Service Agency (FSA) for private outpatient psychiatric services in the amount of
$100,000, for the period of April 1, 1998 through June 30, 1998; and $470,000 for the
period of July 1, 1998 through June 30, 1999, to provide outpatient care to medically
indigent and medical psychiatric clients under a managed care model of care. (DPH
contracted with FSA for services totaling $4,422,837 during FY 1996-97).
(3.9) PH-CHS-CMHS - Request for approval of new contract with Family Service
Agency (FSA) for psychiatric services in the amount of $50,000 for the period of April 1,
1998 through June 30, 1998; and $250,000 for the period of July 1, 1998 through June 30,
1999 to provide a residential care facility program to San Francisco Mental Health Plan
enrollees under a managed care model of care. (DPH contracted with FSA for services
totaling $4,422,837 during FY 1996-97).
(3.10) PH-CHS-CMHS - Request for approval of new contract with the Regents of
the University of California San Francisco (UCSF) Langley Porter Hospital and Clinics for
mental health services in the amount of $20,000, for the period of April 1, 1998 through
June 30, 1998; and $100,000 for the period of July 1, 1998 through June 30, 1999, to
provide mental health treatment services for clients who are eligible to receive services
under the new model of care and the San Francisco Mental Health Plan. (DPH contract with
UCSF for services totaling $13,848,952 during FY 1996-97).
This item was postponed to a future meeting.
(3.11) SB 1255 Supplemental -Consideration of a Supplemental
Appropriation Request to fund an intergovernmental transfer payment of $30,000,000 for
fiscal year 1997-98 in order to qualify for
SB 1255 supplemental payment funds, and Medi-Cal Graduate Medical Education
Action Taken: The Commission unanimously approved the Consent Calendar of the
Budget Committee, with #3.10 being postponed to a future meeting.
4) DIRECTOR'S REPORT(Provides information on activities and operations of the
(Mitchell H. Katz, M.D., Director of Health)
In 1994, California voters passed Proposition 187 which denied undocumented
residents access to publicly-funded education, health care and social services, and
required public agencies providing these services to report persons "suspected"
of being undocumented to immigration authorities. The Health Commission and the San
Francisco Board of Supervisors adopted resolutions opposing Proposition 187. Since its
passage, several lawsuits have been filed questioning the constitutionality of the ballot
On March 17, 1998 the United States District Court issued a final judgment finding
Proposition 187 unconstitutional and permanently enjoining the State from implementing and
enforcing the law. Specifically, the Court found the following sections of Proposition 187
The Court's ruling was based on the fact that Proposition 187
is preempted by federal law (i.e., the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, also known as the Welfare Reform Act). California is required
to enact regulations pursuant to the federal Welfare Reform Act and not Proposition 187.
The Court also found that the State had no power to legislate in the area of immigrant
eligibility for federal, state and local benefits. In addition, a 1982 Supreme Court
decision (Plyler v. Doe) held that States could not deny basic public
education to children based on their immigration status.
- Law enforcement agency cooperation with INS,
- Exclusion of illegal aliens from public social services,
- Exclusion of illegal aliens from publicly funded health care,
- Exclusion of illegal aliens from public elementary and secondary schools,
- Exclusion of illegal aliens from public post secondary educational institutions, and
- State Attorney General cooperation with INS.
As the Health Commission is
aware, the federal Welfare Reform Act places restrictions on the type and level of federal
benefits that "non-qualified aliens" and legal immigrants can receive and
imposes time restrictions on the receipt of public assistance (i.e., Temporary Assistance
to Needy Families). We are very pleased with the Court's ruling.
Last month the Los Angeles County Superior Court ruled that the State could not
implement regulations eliminating prenatal care for undocumented women. The Court ruled
that the regulations failed to ensure that women would continue to receive access to
screening and treatment for communicable diseases. It is our understanding that the State
is considering appealing this decision.
In February 1998 the Department reiterated its policy to continue providing
pregnancy-related services to undocumented women. A notice was sent to all Department
staff informing them to continue following normal operating procedures. The Department
continues to work with immigrant rights advocacy organizations to ensure that undocumented
women are aware of their ability to access Medi-Cal for this service.
President's Commission on Consumer Protection and Quality in the Health Care
On March 13, 1998 the President endorsed the final report of his Advisory Committee
on the President's Commission on Consumer Protection and Quality in the Health Care
Industry. As the Health Commission is aware, this Advisory Committee was established to
advise the President on changes occurring in the health care system and how to promote and
ensure consumer protection and health care quality.
The Commission's final report has over 50 recommendations to improve health care
quality. As part of their final report, the Commission recommended adoption of a clear
statement of purpose for the health care system. The Commission recommended that the
following statements be articulated by the President: the purpose of the health care
system must be to continuously reduce the impact and burden of illness, injury, and
disability; and to improve the health and functioning of the people of the United States.
In addition to addressing consumer protection and health care quality, the Commission also
urged the President to continue efforts to reduce the number of uninsured and underinsured
The Department believes that the work of the Commission is critical to ensuring
improvements in our health care delivery system. Implementation of any recommendations
from the report will be at the direction of President Clinton's Administration.
On March 24, 1998 the federal government approved California's Children's Health
Insurance Program -- Healthy Families Program. California is the sixth State to win
approval for its plan. The Managed Risk Medical Insurance Board (MRMIB) still anticipates
implementing the program effective July 1, 1998.
The federal government is not allowing California to access the federal Vaccine
for Children's Program (VFC) under Healthy Families. VFC was established to serve children
who are either enrolled in Medicaid or who are uninsured. A Healthy Families participant
meets neither of these criteria. There is concern that the financial cost of vaccines may
exceed the annual capitation rate that providers receive under the program -- making
participation difficult. The federal government has encouraged the State to look at the
possibility of creating a State-Only Vaccine Program. Under this program, the State may
use federal dollars to purchase vaccines for children enrolling in this program.
Electronic Data Systems will be the administrative vendor for the program providing
day-to-day operational support. Considerable concern was voiced when the State originally
selected a health plan -- WellPoint/Blue Cross of California -- as the administrative
vendor. There was concern over conflict of interest in awarding the administrative vendor
contract and a health services contract to the same health plan. The Health Department
wrote to the State specifically opposing the idea of an administrative vendor also having
a health services contract. After being awarded the contract, WellPoint/Blue Cross of
California declined to accept the award for operational reasons. MRMIB then awarded the
contract to Electronic Data Systems which has performed these types of administrative
functions in other States and is not a provider of health care services.
As the Health Commission is aware, Healthy Families enrollment is voluntary. The
State is holding a series of informational workshops on Healthy Families and has begun the
pre-enrollment campaign. The Department is committed to ensuring that local public health
staff are seen as vital components of any outreach and education campaign for this
program. The Department's Community Health Network anticipates providing health care
services to children enrolled in Healthy Families through its contract with the San
Francisco Health Plan.
Kellogg Foundation Site Visit
I am happy to report that the Kellogg Foundation site visit on April 3, 1998 went
well. We learned at the visit that only 28 sites of the 75 sites that applied were being
visited. I was particularly grateful to have the President and Vice President of the
Health Commission present to show their support of our proposal. Site visitors received
tours of San Francisco General Hospital, Bayview Hunters Point neighborhood, Southeast
Heath Center, and Mission Neighborhood Health Center. They saw a demonstration of our
lifetime clinical record and spoke with Bayview Hunter's Point residents. Drs. Sandra
Hernandez and Sophia Chang spoke about local foundation support for the safety net system.
We will hear by approximately April 15th whether we have been chosen to submit a formal
application. The Foundation expects to award 10 sites a five year grant ranging from 2.5
to 5.0 million dollars.
Adolescent Smoking PrevalenceThe Centers for Disease Control issued new national
data on the prevalence of smoking among adolescents The l997 national data was collected
through high schools, and only included older adolescents. The latest available California
data was collected in l996 from 12-17 year olds, and is only preliminary since the survey
is conducted over a two year period. California data is collected through random phone
surveys, which tends to yield lower smoking rates, perhaps due to the possible proximity
of parents. The 1996 California data is not available by ethnicity. Since the sample size
of adolescents surveyed in San Francisco is too small for statistical significance, no
local adolescent data has been made available through these prevalence surveys.The rate of
increase among California adolescents from 1993 to 1996 was 30%. Specifically, the
percentage of California adolescents who smoked within the past 30 days increased from
9.2% in 1993 to 12.0% in 1996. Nationally, this figure was 80% from 1991 (12.6 to 1997
At this time it is difficult to compare the two sets of data because of the differences
in collection methods and the preliminary nature of the latest California data. However,
there are parallel trends insofar as overall higher prevalence rates, and particularly
large increases among African-American youth.
Policy and Planning Section
I am pleased to announce the appointment of Jessica Wolin as the Director of
Planning for the Public Health Division. Ms. Wolin was most recently a senior planner for
the Policy and Planning Unit. She has impressive credentials in public health planning,
having worked for the Alameda County Health Services Agency and for the California
Department of Health Services. Through the good graces of Tangerine Brigham, Ms. Wolin had
been assigned to assist the Public Health Division over the past several months pending a
formal reassignment. During this period, Ms. Wolin chaired the Public Health Division
Planning Group, organized a successful all-staff meeting, produced the News & Views
newsletter, organized events for Public Health Week and assisted in joint planning with
the Community Health Network. I am sure you join me in congratulating Jessica on her new
STD Prevention and Control Section
Joe Engelman, M.D., M.P.H., from our STD Prevention and Control Section, has just
returned from his second trip to Vietnam as a guest of the Center for AIDS Prevention
Services to provide training on the diagnosis, treatment and prevention of sexually
transmitted diseases at the Dermatovener-eology Hospital in Ho Chi Minh City. During their
first visit in September 1997, Dr. Engelman and colleagues were impressed by the
dedication of Vietnamese clinicians and officials to reducing the prevalence of STDs and
HIV, although the disease control efforts were still developing. They made recommendations
on how to improve clinical and laboratory services, to institute Pap smear screening and
to expand HIV counseling and testing.
On their most recent visit, Dr. Engelman was able to spend time seeing patients,
where he discovered a large degree of self-treatment. Easy availability of antibiotics
resulted in a high percentage of patients whose diagnosis of an STD was made more
difficult by self-administered medication. The director of the hospital concurred in the
recommendation to combine pharmacy education with a national campaign to tighten
regulations on dispensing medications.
Dr. Engelman was also able to visit clinics in outlying areas, including a clinic
that serves low-income commercial sex workers, where he recommended intensified screening
activities, including Pap smears. Dr. Engelman's visits to Vietnam provide an excellent
example of how the training and experience we gain in our local programs can contribute
productively to an international public health effort.
MOU with the San Francisco Unified School District
I am pleased to announce the signing of a Memorandum of Understanding with the San
Francisco Unified School District, in which the Department of Public Health will serve as
medical consultant to the School District. Among other provisions, the agreement
establishes that the Medical Director of Maternal, Child and Adolescent Health, the
Medical Director of Children's Medical Services and the Medical Director of Children's
Mental Health shall provide clinical and programmatic consultation to School District
staff. This agreement enables the School District to take full advantage of the medical
expertise in the Department, and it formalizes a collaborative relationship on a wide
range of programs and services. A newly reconstituted School Health Planning Committee
will soon be convened to design and carry out the larger program goals of the partnership.
World TB Day
The Department sponsored a press conference at the San Francisco Zoo on March 24 in
observance of World TB Day. The event provided us with an opportunity to update the public
about TB against the background of Calle, the elephant, who is currently undergoing her
own effective, if not unconventional, TB treatment. Masae L. Kawamura, MD, Director of San
Francisco TB Control, was joined by visiting officials from the CDC, Sara Royce, MD,
Chief, TB Control Branch; California Department of Health Services; Zoo Veterinarian
Freeland Dunker, DVM; and two TB patients who offered testimonials about their diagnosis
The past year was peppered with high profile TB cases, including Calle the elephant and
three unrelated cases at the Pacific Exchange. 1997 was the fourth consecutive year of
decline in TB cases and we are happy to report that San Francisco has experienced its
lowest TB rate in history. The decrease was almost exclusively due to the decline in
African American TB cases and indicates effective TB control is being established in our
most vulnerable populations. Targeted screening of higher risk groups through outreach
efforts, community awareness and the use of preventive therapy with increased focus on the
homeless and HIV infected is believed to be making its impact. Despite these promising
statistics, TB case rates in San Francisco remains four times the national rate and double
the California rate. HIV, substance abuse, poverty, homelessness and immigration continue
to fuel the high rates. Prevention of TB cases among foreign born San Francisco residents
will be the major challenge in the coming yearas the percentage of TB cases in this group
Multidrug resistant TB remains low, but is an important challenge as these cases may
increase because of the increase of resistant TB elsewhere in the world.
Occupational Safety and Health
The OSH Section routinely receives calls about indoor air quality in the City and
County of San Francisco (CCSF) buildings. CCSF employees may be concerned about
"stuffy/stale" air, or may have symptoms which they feel are caused by the
indoor air quality in their facility. This is sometimes called "Sick Building
Syndrome". In an effort to help CCSF Supervisors and/or Building Facilities Managers
respond to and deal with these concerns, the Occupational Safety and Health (OSH) Section
has developed an "Indoor Air Quality Action Kit". This kit presents a
systematic, user-friendly approach for identifying and resolving indoor air quality
issues. If, after using the kit, the problem has not been resolved, then the information
collected by the client can be utilized by the OSH staff in a more detailed evaluation.
The kit can also be used to evaluate and improve indoor air quality in buildings where
there are no reported problems, but the management wants to be proactive about indoor air
quality. This kit available to other CCSF Departments, as well as DPH facilities. The kit
can be obtained by calling the OSH Section at 554-2793.
Violence Prevention Workshop
The Community Health Promotion and Prevention Section of Public Health in
collaboration with the Violence Prevention Network sponsored a one day planning workshop
last month at the Hall of Flowers. I was pleased to give the welcoming address on the
"Root Causes of Violence". The day was divided into three issue areas focusing
on the Economics, Mental Health, and Oppression surrounding violence in our society. Each
topic was kicked off with a panel discussion by experts in the field followed by group
sessions where participants brainstormed solutions as the beginning steps of developing a
violence prevention action plan.
This conference was a continuation of the October forum which focused on
"Community Rick Factors for Violence: Guns, Alcohol, Media, Witnessing Acts of
Violence, Incarceration, and Community Deterioration". Group discussions and
continuing meetings of the Violence Prevention Network will be utilized to complete the
draft of a violence prevention plan for San Francisco. This effort is one of the final
components of the Department of Health Services funded Violence Injury Prevention Project.
COMMUNITY HEALTH NETWORK
Laguna Honda Hospital Annual Survey Exit Conference
A 15-member team comprised of State Licensing and Certification surveyors and HCFA
representatives concluded a three week certification and survey on Friday, March 13 with
an exit debriefing. This meeting was attended by Health Commission President Lee Ann
Monfredini and members of the CHN Executive Leadership group.
The survey team described their observations and preliminary findings. These
preliminary findings will be reviewed by District Licensing and Certification supervisors
before finalized and returned to the facility.
The survey team reported several items that are of great significance to the Department
and to the future of Laguna Honda Hospital. These items include:
A recision of the waivers would pose a direct threat to the
reimbursement for a majority of the residents in the main building at Laguna Honda. The
LHH Executive Team will develop a response and plan to the issues identified in the survey
preliminary finding. The Commission will hear a special report on this issue later in this
- A preliminary finding of substandard quality of care which they allege is created by the
open wards, lack of privacy and safety issues primarily related to the facility.
- A preliminary recommendation that continuation of the long standing waiver for the open
wards not be granted.
- A preliminary recommendation that continuation of the long standing waiver on
semi-private rooms that do not meet HCFA size requirements not be granted.
March Was Nutritional Services Month - Some Interesting Facts About
Laguna Honda Hospital serves 1,700,000 meals per year to hospital residents and
staff while further providing food service to Adult Day Health Care and the Senior
Nutrition Program. The Nutritional Services Department also has been a placement site for
the Internship for Dietetics with San Francisco State University for over seven years.
During this period, over 30 dietitians have been trained (and one has joined the LHH
Last year LHH was evaluated by the American Dietetics Association (ADA) and was given
an outstanding rating for its role in the training of dietitians. The ADA requested that
Laguna Honda's role be enhanced to a full nine-week program.
Additionally, six students from Merritt College in Oakland were trained in the
"Dietetic Assistant" program. Since 1982, LHH has been a part of graduate
education for the combined Masters of Public Health and Nutrition Degree from University
of California at Berkeley.
We commend the Nutritional Services Department through the assistance they provide to
our neighboring institutions of higher education!
Sharon Nevins Resigns
I regret to announce that Sharon Nevins, Laguna Honda Hospital's Chief Financial
Officer for more than two years, recently announced her resignation effective March 19,
1998. Sharon has been an extremely valuable member of the LHH Executive Committee. The CHN
Leadership Group commends her for taking a leadership role in rectifying significant
budgetary problems which existed when she arrived at LHH two years ago. I wish to thank
Sharon for all of her contributions and wish her the very best in her future endeavors.
Mr. Wagner and Mr. Funk are working with Ms. Zmuda for replacement to this very key
Commissioner Chow requested that a presentation on the Department's collaborative
efforts with the San Francisco School District be calendared for a future Commission
President Monfredini requested the Department to explore the feasibility of an Employee
Recognition Program and bring a policy to the Commission for consideration.
Commissioner Chow encouraged the Department to integrate some of the principles of the
recommendations from the President's Commission on Consumer Protection and Quality in the
Health Care Industry into the work of the 1115 Waiver and Universal Health Care Blue
Ribbon Task Force.
5) CONSIDERATION OF A RESOLUTION PROCLAIMING NATIONAL NURSES' WEEK, MAY 6-12, 1998
Gayling Gee, CHN Administrator, presented a resolution in commemoration of National
Nurses' Week, May 6-12, 1998. She introduced nurses who represent the health care
continuum in the Department. Over 1,000 nurses work for the Department.
Action Taken: The Commission unanimously adopted Resolution #14-98,
"Endorsing the Designation of May 6-12, 1998 as Nurses' Week in the City and County
of San Francisco," (Attachment A).
6) CONSIDERATION OF A RESOLUTION ON AMENDMENTS TO THE SAN FRANCISCO COUNTY ADULT DAY
Gay Kaplan, Co-Chair of the San Francisco Adult Day Health Care Planning Council
and Program Director for North of Market Senior Services, presented the revised Adult Day
Health Care (ADHC) County Plan. The primary role of the Planning Council is to develop
ADHC programs and to develop an ADHC County Plan. (Attachments B and C).
Ms. Kaplan acknowledged the work of Nyasha Junior with the Planning and Policy section
of the Department. Ms. Junior facilitated the planning process and authored the County
Commissioner Chow pointed out that Service Area #1 (Chinatown/North Beach area) needs
an ADHC service provider.
Action Taken: The Commission unanimously adopted Resolution #15-98,
"Authorizing Approval of Revision of the San Francisco Adult Day Health Care County
Plan," (Attachment D).
7) A. PRESENTATION AND CONSIDERATION OF A RESOLUTION
FOR THE PROPOSITION 99-FUNDED FY 1998-2001 COMPREHENSIVE TOBACCO CONTROL PLAN
Larry Meredith, Ph.D., Director of Health Prevention and Promotion, introduced Alyonik
Hrushow of the Tobacco Control Project. Ms. Hrushow presented the Tobacco Control Plan.
The Plan addresses the following three State-mandated priority areas:
1. Reduce exposure to environmental tobacco smoke and support efforts to help people
break their addiction to tobacco.
2. Reduce youth access and availability to tobacco through commercial and social
3. Counter pro-tobacco influences in the community such as advertising, , marketing,
promotion and sponsorships. This priority includes addressing the impact of transnational
tobacco, particularly in communities with large immigrant populations which are affected
transnational tobacco marketing.
The Plan is based on the following budget allocations:
Other "core program elements" that a were integrated
into the Tobacco Control Plan and Budget include:
- $819,000 in FY 1998-99;
- $779,000 in FY 1999-00; and
- $779,000 in FY 2000-01
1. Maintenance of a community
coalition. The State requires that the Tobacco Control Project provide staff support and
technical assistance to the coalition. Other requirements include provision of a mission
statement for the coalition and procedures for involvement in strategic planning.
Additionally, involvement of representatives from high risk populations, those with
expertise in tobacco control, and organizations not receiving tobacco control funding is
required. Coalition members are involved in strategic planning and program implementation
and as media spokespersons.
2. Clearly identified and measurable outcome objectives that focus on community norm
changes. An example of a community norm change is the decreasing social acceptance of
smoking associated with the implementation of smoke-free workplace policies.
3. An evaluation plan for each measurable objective and data collection system to
determine the effectiveness of strategies. Ten percent (10%) of the budget must be
allocated towards an evaluation component.
4. Strategically used paid media and public relations to support policy and education
5. Up to three "planning objectives" are permitted with an action plan as the
outcome. These have been incorporated into the community capacity building and coalition
6. Building the capacity of communities and agencies to address tobacco control issues.
7. Mobilization of the community to support educational, policy and enforcement
8. Active promotion of the statewide toll-free numbers for cessation services in
several languages. The State's position is that the statewide service is a cost-effective
means of providing cessation services. No more than 10% of the budget per year may be
allocated to smoking cessation services.
Commissioner Chow expressed concern that only two groups are being targeted within this
Commissioner Barnes agreed that the Plan should not be locked into serving only two
groups during this 3-year time period.
Dr. Meredith stated that the Department would negotiate with the State to have the Plan
include a needs assessment to determine target groups with the highest needs for smoking
Action Taken: The Commission (Monfredini, Chow, Hill, Parker) adopted Resolution
#16-98, "Supporting the Department of Public Health's FY 1998-2001 Comprehensive
Tobacco Control Plan and Budget," (Attachment E). Commissioner Barnes voted no.
Action Taken: The Commission unanimously voted to reconsider the previous
Action Taken: The Commission unanimously adopted Resolution #16-98,
"Supporting the Department of Public Health's FY 1998-2001 Comprehensive Tobacco
Control Plan and Budget," (Attachment E), with the understanding that the Department
will negotiate with the State to have the Plan include a needs assessment to determine the
target groups with the highest needs for smoking cessation programs.
B. PRESENTATION AND CONSIDERATION OF A RESOLUTION FOR THE PROPOSED MANGINI
SETTLEMENT-FUNDED TOBACCO PREVENTION PLAN
Ms. Hrushow presented the plan and budget for expending the $1.5 million Mangini
settlement funds for tobacco prevention. These funds are designated for purposes of
preventing youth from smoking. The three components of the program will consist of media,
enforcement, and community-based interventions. For a copy of the plan, contact the
Commission Office (554-2666).
The timeline for the plan will be:
Phase I: April-August 1998. Release funds for personnel and operating costs as well as
the enforcement component. Implementation of the media, evaluation and community based
interventions cannot proceed without the staff and operating costs. The enforcement
component will be implemented by the Departments of Weights and Measures and Police, as
described below. Funding will be made available through work orders from the Department.
Phase II: May-September 1998. Develop RFP's for the media and evaluation services and
select contractors through the competitive process. Release funds placed on reserve for
media and evaluation after contractors have been selected.
Phase III: August-December 1998. Develop RFP for community based interventions and
select contractors through competitive bid process. Request release of funds placed on
reserve for this component after contractors are selected.
Commissioner Parker expressed his concern on the evaluation component.
Commissioner Chow encouraged staff to look at ads already developed for youth.
Action Taken: The Commission unanimously adopted Resolution #17-98,
"Approving the Plan for Expending Mangini Settlement Funds for Tobacco
Prevention," (Attachment F).
8) CONSIDERATION OF A RESOLUTION DIRECTING THE DEPARTMENT OF PUBLIC HEALTH TO
DEVELOP A PLAN IN RESPONSE TO PHYSICAL PLANT ISSUES AT LAGUNA HONDA HOSPITAL
Tony Wagner, Interim Executive Administrator of the Community Health Network,
presented the background and history of the physical plant issues at Laguna Honda
Hospital, (Attachment G).
Dr. Katz reiterated the need to develop a creative plan and
convince the tax payers to support the plan.
- The Commission and Department need to respond to the physical plant issues.
- As a quality of life issue, the City needs to view Laguna Honda Hospital as a first
- In the development of a plan, the Department needs to consider other options in addition
to a general obligation bond.
- If a proposed bond is to pass, there needs to be a high level of commitment to convince
the voters on the importance of this health issue.
- The waiver being in jeopardy forces corrections to be made at Laguna Honda Hospital. It
is time to stop making excuses and delaying addressing the physical plant issues.
Public Speaker: Howard Wallace, Local
250 , supported the development of a plan.
Action Taken: The Commission unanimously adopted Resolution #18-98,
"Directing the Department of Public Health to Respond to the Physical Plant Issues at
Laguna Honda Hospital," (Attachment H).
9) OTHER BUSINESS/PUBLIC COMMENTS
Dale Butler, Local 790, announced a press conference for Wednesday, April 15, 1998
on safety devices for healthcare workers.
The meeting was adjourned at 5:00 p.m
Sandy Ouye Mori, Executive Secretary to the Health Commission