September 15, 1998, 3:00 p.m.
The regular meeting of the Health Commission was called to order by President Lee
Ann Monfredini, at 3:00 p.m.
2) APPROVAL OF
MINUTES OF THE MEETING OF SEPTEMBER 1, 1998
Action Taken: The Commission unanimously
adopted the minutes of September 1, 1998.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill) Note: Commissioner Hill chaired the Budget Committee
meeting since Commissioner Sanchez arrived at 2:30 p.m. Commissioner Parker was
(3.1) Update on site selection for new dental service awards RFP 018-97
Integrated HIV Services and Other HIV/AIDS Health Services.
Commissioner Parker expressed his concern that the Tenderloin site is inappropriate;
but he does support the decentralized model to increase accessibility for consumers.
PH-Finance Request for approval of a resolution to change the San Francisco
Administrative Code to allow the Director of the Department of Public Health to enter into
and execute written agreements that contain mutual indemnification provisions on behalf of
the City with the Regents of the University of California, UCSF/Stanford Health Care,
Alameda County, San Mateo County and the San Francisco Unified School District.
See Resolution #31-98, "Recommending Ordinance Changes to Authorize the Director
of Health to Enter Into and Execute Written Agreements with Mutual Indemnification
Provisions on Behalf of the City and County of San Francisco, with Five Health and Medical
Service Providers: the Regents of the University of California, UCSF/Stanford Health
Care, Alameda County, San Mateo County, and the San Francisco Unified School
PH&P-CHP&P-HIV Prevention Services Request for retroactive approval of
new contract with Continuum HIV Day Services in the amount of $86,372, for the provision
of HIV counseling, testing, referral, partner notification (CTRPN) and no show follow-up
for CTRPN services, for the period of July 1, 1998 through June 30, 1999.
contracted with Continuum for services totaling $781,456 during FY 1997-98).
(3.4) PH&P-CHS-HIV Health Services Request for approval of four-year
contract renewal with Mission Neighborhood Health Center (MNHC), in the amount of $300,000
per year, to provide early intervention services for persons with HIV for the period of
July 1, 1998 through June 30, 2002. (DPH contracted with MNHC for services totaling
$856,819 during FY 1997-98).
(3.5) PH&P-CHS-HIV Research Request for retroactive approval of sole
source request and new contract with the University of California San Francisco,
Department of Epidemiology and Biostatistics (UCSF), to fund an
Epibiostatistician, in the
amount of $50,000 per year, for the provision of research and data analysis consultation,
for the period of April 6, 1998 through September 29, 1999 for a total contract value of
$75,000. (DPH contracted with UCSF for services totaling $14,794,533 during FY
Commissioner Sanchez abstained due to conflict of interest.
PH&P-CHS-CMHS-Child & Family Request for retroactive approval of renewal
contract with St. Mary's Hospital and Medical Center (dba McAuley Neuropsychiatric
Institute) to provide:
1) Adolescent inpatient, partial hospitalization and transitional services in the
amount of $320,000, and 2) Medi-Cal funded psychiatric inpatient hospital services
for the period of July 1, 1998 through June 30, 1999. The total dollar amount for
Medi-Cal funded psychiatric inpatient hospital services for all six (6) hospital providers
is $5,000,000. (DPH contracted with St. Mary's for services totaling $1,309,310
during FY 1997-98).
Catholic Healthcare West will survey its Board and staff on gender and sexual
(3.7) PH&P-CHS-CMHS-Adult Acute Request for retroactive approval of
renewal contract with Saint Francis Memorial Hospital to provide: 1) 24-hour
acute psychiatric inpatient services to adult patients funded in the amount of $196,498,
and 2) Medi-Cal funded psychiatric inpatient hospital services for adults for the
period of July 1, 1998 through June 30, 1999. The total dollar amount for adult
psychiatric inpatient hospital services for Medi-Cal beneficiaries for all six (6)
hospital providers is $5,000,000. (DPH contracted with St. Francis for services
totaling $196,498 during FY 1997-98).
PH&P-CHS-CMHS Request for approval of retroactive renewal contract with
Davis Y. Ja & Associates, Inc. (DYJ), in the amount of $126,980/first year, to conduct
an annual review of mental health service contracts and write reports of the findings for
the period of July 1, 1998 through June 30, 2002. (DPH contracted with DYJ for
services totaling $210,311 during FY 1997-98).
(3.9) PH&P-CHS-CSAS Request for approval of second modification to
the contract with Haight Ashbury Free Clinics, Inc. (HAFC) in the amount of $971,240, to
extend the term of the contract and continue the fiscal intermediary services for the
federal San Francisco Target Cities Project for the period of October 1, 1998 through
September 30, 1999. (DPH contracted with HAFC for services totaling $9,260,563
during FY 1997-98).
Action Taken: The Commission approved the Consent Calendar of the Budget Committee,
with Commissioner Sanchez abstaining on #3.5.
4) DIRECTOR'S REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department). Note: Dr.
Katz submitted his written report to the Commission.
I am pleased to announce the appointment of Jimmy Loyce as the Director of the
Office of Integrated Care Services. In this new position, Jimmy will serve as the
administrative bridge between the Community Health Network and Population Health &
Prevention, with oversight and management responsibility for the integration of these two
divisions. Jimmy returns to the Department after four and half years as Chief
Executive Officer of AIDS Project, Los Angeles. Prior to his move to Los Angeles in
1994, Jimmy had a distinguished 12-year career in our Department of Health where he held a
number of leadership positions, including Associate Director of the AIDS Office. I
am sure the Commission joins me in welcoming Jimmy as we look to him for ongoing
assessment, planning and implementation of an integrated care system for the Department.
POPULATION HEALTH &PREVENTION
CBS Broadcast on CHIPPS Program
"CBS This Morning" has a feature called "Eye on People" which
aired a program about the San Francisco Health Department's Community and Home Injury
Prevention Program for Seniors (CHIPPS) eight years ago. CHIPPS was recently
selected for a follow-up "Where are they now?" feature. CBS re-broadcasts
the original tape, adding new information using voice-over. The segment, titled
"Elder Proofing," was aired once on September 4, and is expected to be broadcast
again on November 17 at 6 p.m., and November 18 at 11 am EST. CBS will be providing
the Department with a copy of the tape.
Airport Air Piracy Exercise
An airport air piracy exercise will be conducted at the San Francisco International
Airport on September 16. Environmental Health Emergency Responders (as well as
numerous other agencies, including the Federal Bureau of Investigation) will be
participating in the exercise, which involves the simulated release of a "chemical
weapon." The City's Fire Department Hazardous Materials Team Rescue will
perform decontamination and treatment of approximately 50 "victims". The
Environ-mental Health Emergency Responders will serve as technical consultants for the
Urban Health Certified Addiction Treatment Specialist Certificate
A Certified Addiction Treatment Specialist Program has been developed as one of the
system enhancements of the Treatment on Demand Initiative. This certification
program is a collaborative effort between CSAS, and the Community Health Training and
Development Center (a joint project of SF City College and SF State University).
Thirty-seven students from 13 CSAS agencies have been awarded full scholarships to
participate in this certification program. This addiction specialist program
will increase the knowledge and skills of front line substance abuse counselors and will
enhance the quality of services in our substance abuse system.
California State Senate Subcommittee on Disease Morbidity and Mortality Disparity
A new Senate Subcommittee on Disease Morbidity and Mortality Disparity has been
formed to address the reduction of racial and ethnic disease disparities within the State
of California. Informational hearings of this Subcommittee will be held in Los
Angeles on September 17 and 18.
Dr. Tomás Aragón, the Director of our Community Health Epidemiology Section, is
testifying at the hearing. His presentation is titled: "Applied Research: A
Model From A County Public Health Perspective".
COMMUNITY HEALTH NETWORK
Re-survey of Laguna Honda in Progress:
Six surveyors from the State Department of Health Services Licensing &
Certification Division and two evaluators from the Health Care Financing Administration
returned to Laguna Honda September 8. The State and Federal survey team is
re-surveying Laguna Honda to validate compliance with the Hospital's Plan of Correction
accepted on July 10.
This re-survey is significant to the Hospital since it must demonstrate substantial
compliance with Federal and State requirements to continue its participation in the
Medicare/Medicaid Programs. The survey team reported that they anticipate being at
the Hospital through this week. I will advise the Commission of the results of the
re-survey at our next meeting.
Governor Visits the Gallo Institute on the SFGH Campus
Governor Pete Wilson joined with officials of the University and the Community
Health Network at the Gallo Institute on SFGH's Campus this past Wednesday to highlight
the $16.8 million in the State 1998-99 budget to assist the Center. The scientists
at the Gallo Institute are working to prevent and treat alcoholism by identifying its
biological causes and finding a way to block the addiction.
SFGH Section of West-Bay Hospital Conference
Anthony Wagner, Executive Administrator of the Community Health Network (CHN), and
Dr. Martin Brotman, Chief Executive Officer of Cal Pacific Medical Center, have been
elected co-chairs of the San Francisco Section of the West-Bay Hospital Conference.
They succeed Martin Diamond, who was recently appointed President and Chief Administrative
Officer of John Muir Hospital in Walnut Creek.
CHN Begins Strategic Planning
The CHN Strategic Planning Process begins in October. Staff has been
collecting and analyzing data from other public and private providers to frame critical
strategic questions. Building on DPH's 1996 strategic restructuring, the newly
appointed Committee will make recommendations to the CHN Executive Administrator and
Leadership Group on long-range strategic direction. This process will become the
basis for the CHN's FY 1999-2000 operational direction and budget priorities. Dr.
Chow will be a member of this Committee, and the ongoing process will be reported
regularly at the CHN Joint Conference Committee.
San Francisco Airport Medical Service
Yesterday, a celebration was held to mark the culmination of five years of
collaboration between the Department of Public Health's Community Health Network, the San
Francisco International Airport, and UCSF. The San Francisco Airport Medical Service
is the only comprehensive physician practice operating within a major U.S. Airport.
I'd like to thank the following people for helping make the SFO Medical Clinic a
success: Gene O'Connell, CHN Director of Patient Care and SFGH's Executive
Administrator; Chris Wachsmuth, CHN Associate Hospital Administrator of Emergency
Services, Trauma and Rehabilitation; Jerry Rankin, Director of the Office of Managed Care;
Eric Miller, Director; and Carlos Villava, Plant Services. In addition, a special
thanks to the hardworking clinicians, providers, and administrative staff at the SFO
Medical Clinic: Roland Pickens, Clinic Director; and Dr. Garick LeGuyader, Chief
Fire at Anesthesiology Lab on SFGH Campus
On September 11, 1998 at approximately 6:00 p.m., a fire broke out in Building 1 on
the SFGH Campus. Both the Fire and Police Departments responded immediately.
The fire was started when methanol gas was poured in close proximity to the open flame of
a Bunsen burner. The fire ignited one man's shirt.
The fire was extinguished by the automatic sprinkler system. Three people were
injured and taken to the SFGH Emergency Department. One person remains hospitalized
in the ICU in serious condition.
There was no structural damage to the building, however, the water used to put out the
fire damaged a workstation, numerous lab supplies, and some equipment. The UC
Environmental Health and Safety team visited the site that same evening and determined the
area was free of any hazardous materials. OSHA conducted a walk-through visit of the
site and interviewed staff September 14. A Critical Incident review will take place
within week, and we will continue to evaluate all of our internal systems and how they
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS
President Monfredini presented the Department of Public Health Employee Recognition
Awards to the following:Dr. Katz provided an
update on the S.F. Mental Health Plan and a review of options for increasing revenues
and/or reducing costs.
Ms. Jo Ruffin, Director of Mental Health, gave a historical perspective on mental
health managed care; and Louise Rodgers provided data and cost projections. For a
copy of the full report contact the Commission Office (554-2666).
Public Speakers: all of the speakers supported more funding for mental health
- Jennifer Freidenbach, Coalition on Homelessness
- Maggie Cockrell
- William Bacon
- Edward Evans, Community Resources Action Project
- Richard Heasley, S.F. Mental Health Contractors Association
- Eve Meyer, S.F. Suicide Prevention
- Steve Leoni, consumer advocate
- Richard Shadoan, M.D., S.F. Psychiatric Society
- Stephen Zollman, PRAS, Inc.
- Frederick Hobson, S.F. Health Authority Board member
- Jane Kahan, Mental Health Association
- Beth Johnson, Substance Abuse and Mental Health Work Group
- Bill Hirsh, Mental Health Association
- Maria Leib, Chair, Mental Health Board
- Kym Valadez, Swords to Plowshares
- Alison McInness, M.D., UCSF, Caduceus
- Marykate Connor, Caduceus Outreach Services
- Roger Kat, Coalition on Homelessness
- Yvonne Mere, Homeless Advocacy Project
- Estela R. Garcia, Ph.D., Latino Mental Health Coalition
President Monfredini thanked the Department for the data and cost projections requested
by the Commission. She thanked the mental health advocates for their testimony.
Commissioner Guy recommended that the Commission, after getting more precise figures,
consider going back to City Hall after the November election to request a supplemental.
Commissioner Sanchez encouraged the Department to look at private foundations
independent of tax dollars. He would like this item be continued to get more
information on other private funding sources.
Commissioner Barnes commented that she did not have enough information.
Commissioner Guy would like the Department to further investigate other options, (i.e.,
use of Department reserves, accumulated savings in the fiscal year). She suggested
the Commission continue the update on this item to the October 20, 1998 agenda and to make
a decision on
November 17, 1998. She would like this issue to be monitored at the Joint
Conference Committee for Population Health and Prevention.
By consensus, the Commission directed the Department to continue this item to the
October 20, 1998 agenda, to continue looking at other options to fund mental health, and
to bring back accumulated data and finance information to the Commission.
7) PRESENTATION BY THE LONG-TERM CARE TASK FORCE (AB 1040) AND CONSIDERATION OF A
RESOLUTION ENDORSING RECOMMENDATIONS TO IMPROVE LONG-TERM CARE SERVICE DELIVERY CONTAINED
IN THE PROPOSAL FOR A LONG-TERM CARE INTEGRATION PILOT PROJECT
Mr. Anthony Wagner, Co-Chair of the Citywide Long-Term Care Task Force, introduced
Co-Chair Janice Chin-Hansen, members of the Task Force, Design Team members, and Project
Coordinator Bill Haskell.
Mr. Haskell presented the overview of the concept paper for San Francisco's Long-term
Care Integration Pilot Project. The full concept paper is available in the
Commission Office (554-2666).
Ms. Chin-Hansen emphasized a vision for the future and the ability to think
broadly. For long-term care, there is a need for an infrastructure and financing for
people at different levels of income. Work force issues also need to be
addressed. She believes that a partnership and teamwork are needed among community
groups, institutions, health system, and housing.
- Norma Satten, LTC Task Force and PECC
- Karen Young-Simmons, consumer, CIAPA
- Peggy Coster, consumer, CIAPA
- Edward Evans, Community Resources Action Project
Commissioner Guy requested an update come back to the Commission in 90 days
(December/January). On the governance question, there should be an exploration of
the potential capacity of the S.F. Health Authority. She would like the governance
question addressed sooner than later. She encouraged the Task Force to view
institutional care and community care as a true partnership. Her final point was to
encourage a faster integration of the plan.
Commissioner Sanchez thanked the Task Force for its work. He sees the necessity
to redefine funding in order to have sustained funding. One has to think outside the
traditional box and look at integration of government, private and philanthropic
Commissioner Hill thanked the Task Force for its commitment for this plan, which will
be a model for the nation.
Commissioner Barnes endorsed the spirit of the proposed resolution. She noted the
expertise and commitment of the Task Force in this participatory process.
Action Taken: The Commission unanimously adopted Resolution #32-98, "Endorsing the
Recommendations to Improve Long-Term Care Service Delivery Contained in the Proposal for a
Long-Term Integration Pilot Project."
Mr. Wagner stated the Task Force will come back to the Commission in 90 days.
8) OTHER BUSINESS/PUBLIC COMMENTS
9) CLOSED EXECUTIVE SESSION:
PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION.
B. VOTE ON WHETHER TO HOLD CLOSED SESSION TO CONFER WITH LEGAL COUNSEL. (SAN
FRANCISCO ADMINISTRATIVE CODE SECTION 67.11(a).)
Action Taken: The Commission voted to hold a Closed Session.
C. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SESSION 54956.9 AND SAN FRANCISCO
ADMINISTRATIVE CODE SECTION 67.11(b).
CONFERENCE WITH LEGAL COUNSEL - EXISTING LITIGATION.
NAME OF CASE: SUE LONG SOON ET AL V. CCSF
SUPERIOR COURT #987-398
D. RECONVENE IN OPEN SESSION:
1. POSSIBLE REPORT ON ACTION TAKEN IN CLOSED SESSION. (GOVERNMENT CODE SECTION
54957.1(a)(2) AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.14(b)(2).)
Action Taken: The Commission approved a settlement of a total of $90,000, with the
Police Department paying $34,000 and the Health Department's Paramedic Division paying
2. VOTE TO ELECT WHETHER TO DISCLOSE ANY OR ALL DISCUSSIONS HELD IN CLOSED SESSION (SAN
FRANCISCO ADMINISTRATIVE CODE SECTION 67.14(a).)
Action Taken: The Commission voted to not disclose any discussions held in Closed
The meeting was adjourned at 6:40 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission