Minutes of the Health Commission Meeting
Tuesday, February 16, 1999, 3:00 p.m.
At 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.
Present: Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Ron Hill
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF MINUTES OF REGULAR MEETING OF FEBRUARY 2 AND THE SPECIAL MEETING OF
FEBRUARY 8, 1999
Action Taken: The Commission unanimously adopted the minutes of the February 2 and
February 8, 1999 meetings.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
DPH-Administration Request for approval of a resolution to accept, sell and
expend a gift of stock with an estimated value of $49,200 bequeathed to Laguna Honda
Hospital by the Barbara Wylie Trust and a gift of $78,871 bequeathed to Laguna Honda
Hospital from the estate of Ermeth Dirovizza.
(3.2) CHN-SFGH Request for retroactive approval to accept and expend a
new two-year grant from the State Department of the Youth Authority in the amount of
$71,000 to provide a laser tattoo removal machine and maintenance costs for the period of
January 1, 1999 to December 31, 2001.
(3.3) CHN-SFGH HIS Request for approval of retroactive contract with
Deliverex, Inc. to provide medical record storage, retrieval and delivery services for San
Francisco General Hospital's Health Information Services in an amount not to exceed
$375,000 for the period of January 1, 1999 through June 30, 2000. (DPH contracted with
Deliverex for services totaling $354,000 during FY 1997-98).
(3.4) CHN-Pharmacy Request for approval of second modification to the contract
with Asereth Medical Services, Inc. (AMS), in the amount of $840,000, for a total contract
amount of $2,600,000, for the provision of temporary pharmacy personnel services for the
period of February 1, 1998 through June 30, 1999 (DPH contracted with AMS for services
totaling $1,760,000 during FY 1997-98).
This item was deferred to after discussion on item #7 on the agenda. Subsequently, this
item was approved.
(3.5) HP Substance Abuse Services Request for approval of retroactive
sole source and renewal contract with the San Francisco Drug Abuse Advisory Board
in the amount of $51,787 for the provision of substance abuse advisory services for the
period of July 1, 1998 through June 30, 1999. (DPH contracted with SFDAAB for services
totaling $51,787 during FY 1997-98).
(3.6) PHP-HIV Prevention Services Request for approval of retroactive
renewal contract with Haight Ashbury Free Clinic, Inc. (HAFC), in the amount of $81,689,
for the provision of HIV counseling, testing, risk reduction and partner notification
services, for the period of January 1, 1999 through December 31, 1999. (DPH contracted
with HAFC for services totaling $15,119,656 during FY 1997-98).
(3.7) PHP-HIV Prevention Services Request for retroactive renewal
contract with Haight Ashbury Free Clinic, Inc. (HAFC), in the amount of $169,509, for the
provision of HIV prevention, case management and venue based individual outreach for the
period of January 1, 1999 through
June 30, 1999. (DPH contracted with HAFC for services totaling $15,119,656 during FY
The Department has placed this contractor on probation for this specific contract. The
contractor submitted a written response to the monitoring report.
Commissioner Hill reminded the Department that documents for Commissioners should be
included in the Commission packets or could be faxed to Commissioners in sufficient time
for their review. Otherwise, the agenda item will be continued to the next meeting.
Commissioner Hill recommended approval with the request the contractor come back in 90
days (May 18, 1999) with a follow-up report to the monitoring report.
(3.8) PHP-HIV Prevention Services Request for retroactive renewal
contract with Mission Neighborhood Health Center (MNHC), in the amount of $134,257 for the
provision of HIV prevention program services targeting behavioral risk populations and
evaluation of HIV prevention services, for the period of January 1, 1999 through December
31, 1999. (DPH contracted with MNHC for services totaling $868,910 during FY 1997-98).
(3.9) PHP-HIV Prevention Services Request for retroactive renewal
contract with CAL-PEP in the amount of $268,533, for the provision of HIV prevention
program services targeting behavioral risk populations and venue-based individual outreach
services, for the period of January 1, 1999 through December 31, 1999. (DPH contracted
with CAL-PEP for services totaling $243,138 during FY 1997-98).
Action Taken: The Commission approved the Consent Calendar of the Budget
4) DIRECTOR'S REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department).
Congresswoman Nancy Pelosi (D-CA) is co-sponsoring two bills which will directly impact
the health and well being of San Francisco. For several years, San Francisco has attempted
to meet the health and psychosocial needs of persons with HIV or AIDS. Congresswoman
Pelosi will be introducing the Early Treatment for HIV Act. This bill would expand
Medicaid coverage for asymptomatic, HIV-positive, low-income individuals, making it
possible for these persons to receive drug treatment and primary care before they develop
symptoms of AIDS. This Act would extend medical care to persons with HIV and reduce the
number of uninsured persons with HIV through expanded Medicaid eligibility.
In addition, the Congresswoman has introduced a bill to address California's inability
to access the Vaccine for Children program under Healthy Families. The bill would amend
Title XIX of the Social Security Act to clarify that those children who would have
received free immunizations because they were on Medicaid or uninsured, can continue to do
so now that they are enrolled in their state CHIP program. California is one of 23 States,
which need this legislative amendment. This amendment is needed to ensure that children
participating in Healthy Families are immunized on time and that there are no
disincentives for providers to provide vaccinations.
We would like to acknowledge Congresswoman Pelosi for her advocacy on behalf of health
issues in San Francisco.
California Healthy Families Program
California's Healthy Families Program has been in existence for seven months. A total
of 64,971 children have been enrolled into the program statewide. Current Statewide
estimates are that 328,000 are eligible for the program therefore, in the first
seven months of the program, almost 20% of the eligible children have been enrolled. In
San Francisco, 3,507 children have been enrolled into the program. The City and County of
San Francisco ranks fourth in the State for Healthy Families enrollment.
City Hall Open House
The Mayor and the Neighborhood Alliance co-sponsored an all day Open House at City Hall
February 6th. Each City department had a table with brochures describing
services and staff on hand to answer questions for constituents. Although the rain kept
the numbers in attendance low, the turnout was enthusiastic and positive. The Health
Department had a huge volunteer turnout. In addition to brochures, DPH gave away key
chains, balloons, magnets, condoms and 7 car seats to deserving members of the public.
Many thanks to those who helped plan the successful event.
POPULATION HEALTH AND PREVENTION
TB Advisory Council
Last November, Department of Public Health TB Controller, L. Masae Kawamura, M.D., was
appointed to the Advisory Council for the Elimination of Tuberculosis by Donna E. Shalala,
the U.S. Secretary of Health and Human Services. The Council meets quarterly in Atlanta,
Georgia and makes recommendations to the Secretary of Health and Human Services and the
Director of the Centers for Disease Control and Prevention (CDC). The Council considers
policies, strategies, objectives and priorities addressing the development and application
of new technologies. In addition, the Advisory Council reviews the progress that has been
made toward eliminating tuberculosis. The Council consists of ten members, including the
Chair, that are selected by the Secretary from among the nation's most knowledgeable and
respected authorities. I am sure you join me in extending congratulations to Dr. Kawamura
for this prestigious appointment.
COMMUNITY HEALTH NETWORK
Creativity in Psychiatric Education Award
The San Francisco General Hospital Department of Psychiatry received the American
College of Psychiatrists Award for Creativity in Psychiatric Education in the United
States. The award recognizes SFGH's Ethnic/Minority Inpatient Programs that take into
account the impact of culture and ethnicity on the way mentally ill patients' deal with
distress. Congratulations to all those involved with the design and staffing of this
|Changes in Privileges
|Current Statistics as of 2/2/99
|Applications in Process
|Reappointment In Process
|Reappointment Requested not Received
|(Due through 4/99)
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR
On behalf of the Commission, President Monfredini presented the February Department of
Public Health Employee Awards to the following employees:
- Biasbas, Esperanza, PH & P/Fiscal
- Rivard, Thomas, PH & P/Comm. Health and Safety Services, Bureau of Environmental
- Rosello, Benedicta, PH & P/Comm Health and Safety Services/STD
Team #1 - PH & P/Community Health and Safety Services, Bureau of
- Ambrose, Jim
- Awwad, Mamdouh
- Cone, Sue
- Cushing, Stephanie
- Fosdahl, Patrick
- Golden, Gayle
- Halbach, Ed
- Jin, Pam
- Junior, Delores
- Lee, Albert
- Leong, Liz
- Lum, Les
- McCaulou, Cherie
- Morris, Caitlin
- Padilla, Sylvia
- St. Jean, Virginia
- Stewart, Paula
- Tang, Jin
- Tong, Edmond
- Cynthia Woo
Team #2 - PH & P and Community Health Network
- Batres, Ilma
- Carrillo, Ernestina
- Castiglione, Phil
- Frattaroli, Lynda
- Gillen, Janet
- Gonzales, Gloria
- Hagan, Tom
- Hartfield, Marcus
- Hines, Alexander
- Kaplan, Gay
- LaRock, Bill
- Mitchell, Penney
- O'Brien, Kathy
- Patchell, Tony
- Peck, Julie
- Pena, Marian
- Sampera, Ana
- Shafae, Bette
- Trabing, Mily
- White, Ricka
6) PRESENTATION OF THE CHILDREN'S SERVICE PLAN FOR 1999-00 FROM THE MAYOR'S OFFICE
OF CHILDREN, YOUTH AND THEIR FAMILIES
This item was continued to the March 2, 1999 agenda.
7) CONSIDERATION OF A RESOLUTION APPROVING THE DEPARTMENT OF PUBLIC HEALTH'S
SUBMISSION OF A BASELINE BUDGET FOR FY 1999-00
Dr. Mitch Katz presented supplemental information on proposals to reduce pharmacy
expenditures at San Francisco General Hospital and more information on patient census.
President Monfredini reiterated that the Health Commission will take responsibility as
a governing body to make policies affecting the public health of the City.
Commissioner Hill expressed his concern from a realistic and practical point of view
that public health funds are limited. He has researched at the Federal, State and local
levels to find there is no money to bail out San Francisco. He sees the Health Commission
as a policy-making body with the Department staff implementing these policies. He believes
that SFGH cannot be maintained with the present open-door policy. The present situation at
SFGH is making it an unsafe place for patients and employees. As a member of the governing
body, he is committed to stand behind the Department staff. It is his opinion that all
outpatient pharmacy should immediately be stopped.
Opposed recommendations for pharmacy cuts:
- Sang-Ick Chang, M.D., CHN Pharmacy Council
- Daz Lamparas, Local 790
- Brett Nair, Local 250
- Opposed 4P Closure:
- Paul Lee, Detox Discharge Planner
- Supported Welfare Workers:
- Cindy Wiesmer, POWER
- Larry Lattimore
Supported more funds for DPH budget:
- Ed Kinchley, SFGH
- Doris Mitchell, Local 250
- Dale Butler, Local 790
- Tim Otto, RN, SFGH
- Kent Woo, NICOS
- Jennifer Freidenbach, increase in med detox beds
- Joe Wilson, Coleman Advocates
Letters submitted to the Commission regarding the budget:
- Neil Gendel, Healthy Children Organizing Project
- Beverly Rashidd, African American Health Initiatives Planning Committee
Commissioner Chow asked for clarification from the Deputy City Attorney regarding the
San Francisco Welfare and Institution Code Section 17000 obligation to provide medical
services to indigent residents of the County. Presently, the Department has an open-door
policy to meet the present demands. Jean Fraser, Deputy City Attorney, stated that Section
17000 only applies to non-sponsored patients. The County is not obligated to give services
to Medi-Cal patients. Commissioner Chow also expressed concern for the proposed pharmacy
The Commission continued this item after the 5:00 p.m. time specific agenda item.
7A) CONSIDERATION OF A PROPOSED RESOLUTION REGARDING POLICIES PERTAINING TO PHARMACY
Action Taken: The Commission adopted Resolution #5-99, "Approving Changes in
Outpatient Pharmacy Services at San Francisco General Hospital," which was amended by
Commissioners Hill and Parker voted no.
8) 5:00 P.M. TIME SPECIFIC:
CONSIDERATION OF A RESOLUTION DETERMINING WHETHER THE CALIFORNIA PACIFIC MEDICAL CENTER
CONSOLIDATIONS WILL OR WILL NOT HAVE A DETRIMENTAL IMPACT ON THE HEALTH SERVICE OF THE
Dr. Martin Brotman, Chief Executive Officer of California Pacific Medical Center
(CPMC), reviewed the proposed consolidation and presented more information requested by
the Commission regarding licensed and actual beds.
Commissioner Parker asked Dr. Katz whether the proposed changes would have a negative
impact on the Department. Dr. Katz replied due to the major shortage of skilled nursing
beds in the City, the proposed decrease in skilled nursing beds at CPMC would have a
negative impact on the Department.
Commissioner Hill reminded CPMC of its obligation to provide charity care. Dr. Brotman
indicated CPMC can commit to provide charity care.
Commissioner Chow noted that there is a decrease in the total number of skilled nursing
Commissioner Guy stated that she is not convinced that the shortage of nurses is the
reason for the lack of ability to maintain the skilled nursing beds. She also requested
information on CPMC's charity care and the community benefits programs. Additionally, she
would like CPMC to collaborate more with the Department.
Commissioner Sanchez stated that he sees redefined leadership addressing these issues.
Public Speakers: Advocated that proposed consolidations are detrimental
- John Borsos, Local 250
- Denis Tryon, CPMC
- Eric Hall, California Nurses Association
- Pat Hendricks, Local 250
- Dale Butler, Local 790
President Monfredini requested factual information about charity care provided by CPMC.
She also encouraged dialogue between CPMC and the Department about diversion.
Commissioner Chow, Hill and Guy expressed that the decrease in skilled nursing beds is
President Monfredini stated she does not see CPMC's consolidations to be detrimental.
Action Taken: The Commission (Chow, Guy, Hill, Parker, Sanchez,
Resolution #6-99, "Determining Whether the Clinical Consolidations at the Davies and
California Campuses of California Pacific Medical Center, Will or Will Not Have a
Detrimental Impact on Health Care Service of the Community". President Monfredini
President Monfredini encouraged a meeting with CPMC and the Department regarding the
skilled nursing beds.
The Commission took a 5-minute recess at 6:23 p.m. and resumed the meeting at 6:28 p.m.
The Commission continued its discussion of item #7.
Commissioner Parker feels that the Department is the safety net for the residents of
San Francisco. There are unlimited needs and limited funds; so he posed the question of
how large the safety net should be. With more services and more needed funds, more taxes
would be an option. He believes there should be short term and long range plans in place.
Commissioner Guy encouraged the dialogue to continue and more data to be forthcoming.
There is a need to build a consensus on institutional care and public health in a modern
environment. She believes the outpatient pharmacy should close, with a focus on the needs
of the MIA's. She also encouraged a continuous monitoring report on the closing of 4P. She
supported a census level of 310 beds, with the staff being able to say no at certain
levels at SFGH.
Commissioner Sanchez thanked the public for the testimony. He expressed support for the
Department's recommendations. Additionally, he stated that the safety net should be
Commissioner Umekubo expressed concern for the clinical impact on patient care. There
should be on-going monitoring of the results from these decisions. He supported the
Department's recommendations and suggested to see what the private sector can do to
decrease the impact on SFGH.
Commissioner Hill again expressed the Department cannot continue spending money it does
not have. There has to be a clear policy direction about SFGH.
Commissioner Guy would like to have an honest and frank dialogue in order to turn this
Action Taken: The Commission adopted Resolution #4-99, "Approving the
Department of Public Health's Submission of a Baseline Budget for Fiscal Year
1999-00" with an amendment being added.
9) OTHER BUSINESS/PUBLIC COMMENTS
The meeting was adjourned at 7:05 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission