Minutes of the Health Commission Meeting Tuesday, June 15, 1999 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 3:12 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 THE REGULAR MEETING OF JUNE 1, 1999. Action Taken: The Commission unanimously adopted the minutes of June 1, 1999. 3) CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner Ron Hill) (3.1) CHN - Jail Health Services – Request for approval of retroactive modification to the contract with Symphony MobileX Correctional Diagnostic Services, to maintain the provision of portable X-ray services to inmates in the San Francisco jails and extend services for an additional year, in the amount of $230,353 for the 18-month period of January 1, 1999 through June 30, 2000, for a total contract amount of $439,672 , covering the period of July 1, 1997 through June 30, 2000. (DPH contracted with Symphony MobileX for services totaling $139,546 during FY 1997-98). (3.2) PHP-CHPP-Tobacco Free Project – Request for approval of new contract with S.F. Study Center, in the amount of $167,702, to provide fiscal sponsor services for the Community Capacity Building Training Center for the Tobacco Free Project for the period of July 1, 1999 through June 30, 2000; and $171,193 for the period of July 1, 2000, through June 30, 2001. (DPH contracted with S.F. Study Center for services totaling $420,379 during FY 1997-98). (3.3) PHP-CHPP-HIV Prevention Services – Request for approval of retroactive sole source and contract with the Regents of the University of California San Francisco (UCSF), Center for AIDS Prevention Studies, for the provision of professional consultation services for the completion of the Asian Counseling and Testing Study, in the amount of $56,365 per year, for the period of January 1, 1999 through December 31, 1999. The sole source request is for an annual amount of up to $65,000 per year, for the period of January 1, 1999 through December 31, 2001. (DPH contracted with UCSF for services totaling $14,314,598 during FY 1997-98). Commissioner Sanchez abstained due to conflict of interest. (3.4) PHP-CHPP-HIV Prevention Services – Request for approval of renewal contract with Larkin Street Youth Center (LSYC), in the amount of $108,477, for the provision of HIV prevention services targeting behavioral risk populations, for the period of July 1, 1999 through June 30, 2000. (DPH contracted with LSYC for services totaling $1,158,091 during FY 1997-98). (3.5) PHP-CHS – Request for approval of a modification to the contract with Managed Care Solutions (MCS), to act as fiscal intermediary for the provision of dental and optical services by non-Department of Public Health providers, to clients of the County’s Welfare to Work Programs, in the amount of $410,899, for the period of June 1, 1999 through June 30, 2000. (DPH contracted through MCS for services totaling $1,396,539 during FY 1997-98). (3.6) PHP-CHS - Mental Health Services – Request for approval of renewal contract with Pathmakers of California, a mental health provider group, for the provision of outpatient mental health services as part of the network of San Francisco Mental Health Plan providers that are limited overall to $3,300,000 per year, for the period of July 1, 1999 through June 30, 2001. (DPH contracted with Pathmakers for services totaling $160,000 during FY 1997-98). (3.7) PHP-CHS - Mental Health Services – Request for approval of renewal contract with Jewish Family and Children’s Services (JFCS), for the provision of mental health services, in the amount of $81,250 per year, for the period of July 1, 1999 through June 30, 2001. (DPH contracted with JFCS for services totaling $81,000 during FY 1997-98). (3.8) PHP-CHS - Substance Abuse Services – Request for retroactive approval to accept and expend a grant of $87,864 through a subcontract from the University of California San Francisco, Institute of Health Policy Studies, for research activities to evaluate the impact of treatment on demand policies, for the period of January 1, 1999 through December 31, 1999. Commissioner Sanchez abstained due to conflict of interest. Action Taken: The Commission approved the Consent Calendar of the Budget Committee, with Commissioner Sanchez abstaining on #3.3 and #3.8. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) (Provides information on activities and operations of the Department). ADMINISTRATION Laguna Honda Bond Initiative The Board of Supervisors voted overwhelmingly last evening to submit the $299,000,000 Laguna Honda Hospital Bond measures to the voters for the November ballot. In addition, the Board voted unanimously to request that $1 million per year of the tobacco settlement funds be dedicated to tobacco education, prevention and control. White House Conference on Mental Health Last week the White House Conference on Mental Health was held chaired by the President’s Mental Health Advisor Tipper Gore. The Administration unveiled measures designed to improve mental health. The proposals provide parity, improve treatment, bolster research, and expand community responses to help those with mental illnesses. The Administration’s highlights of these initiatives include: Ensuring that the Federal Employees Health Benefits Plan implements full mental health and substance abuse parity. All participating health plans must offer full mental health and substance abuse parity to participate in the program. Accelerating progress in research. The National Institute of Mental Health (NIMH) will launch a $7.3 million study to explore the nature of mental illness and treatment. Encouraging states to offer more coordinated Medicaid services for people with mental illness. The Health Care Financing Administration will advise all state Medicaid agencies that: (1) Medicaid reimburses for services provided in Assertive Community Treatment; (2) Medicaid recipients are entitled to medications approved by FDA; and (3) Medicaid providers and beneficiaries should be educated about their ability to enter into "advance planning directives." Launching a pilot program to help people with mental illness get the quality treatment they need to return to work. A new five-year, $10 million demonstration to provide treatment for SSDI beneficiaries with affective disorders -- approximately 500,000. Educating older Americans and their health professionals about the risks of depression. The NIMH and the Administration on Aging will launch an outreach initiative to educate the elderly and their healthcare professionals about mental illness. Reaching out to vulnerable homeless Americans with mental illnesses. The Department of Housing and Urban Development will launch a new initiative to encourage communities to create safe havens where homeless mentally ill Americans can get treatment and care. Implementing new strategies to meet the mental health needs of crime victims. The Department of Justice (DOJ) and the SAMHSA will partner to ensure that strategies are in place to address the mental health needs of victims of violent crime, such as terrorism or mass violence. Developing and implementing new strategies to address mental illness in the criminal justice system. SAMHSA and DOJ will hold a conference focusing on how the criminal justice system can prevent crime by mentally ill people, and address the needs of offenders with mental illness. Implementing a new comprehensive approach to address combat stress in the military. In six months the Department of Defense will issue a report on an implementation plan for a more comprehensive combat stress program throughout the military -- at least 30 percent of those who have spent time in war zones experience combat stress reaction. Launching the expansion of the "Caring For Every Child" mental health campaign. A five-year, $5 million campaign to highlight the special mental health needs of children -- at least 10% of American children and adolescents may have behavioral or mental health problems. Improving the mental health of Native American youth. Allocates at least $5 million for a collaboration between the Departments of Interior, Justice, Education, and HHS for ten Native American communities to develop effective strategies to address mental health needs of youth in settings, such as the home, school, treatment centers, and the juvenile justice system. The suicide rate for Native Americans between the ages of 5 and 24 years old is three times higher than the rest of the U.S. population in this age group. Summary of Selected State Health-Related Legislation The following is a summary of selected State health-related legislation for the current legislative session. The Health Commission requested this summary as a precursor to the Department’s annual report on State legislative activity. The Department has been closely monitoring approximately 500 health-related bills introduced in this legislative session, which began in December 1998. June 4, 1999 was the deadline for bills to be passed out of their house of origin in order to be considered this year. All bills that did not pass are now "two-year bills," and will remain inactive until January 2000. The following lists some of the bills that remain active in 1999 that would most impact the Department, and a few 2-year bills that are of major significance to the Department. For bills to pass in the 1999 session, they must be approved by the Legislature by September 10, 1999. The bills must then be signed by the Governor by October 10, 1999 to be enacted. I have listed the current status and position taken by the City and County of San Francisco in parentheses after each bill. If the position was adopted by a resolution of the Board of Supervisors, I have indicated so. For all other bill positions, the San Francisco State Legislative Committee, comprised of City Department, Mayor’s Office, and Board of Supervisors representatives, adopted the position at the request of the Department. Acute Care Hospitals: Staffing AB 394/Kuehl (Senate Health and Human Services) (Watch) would require hospitals to maintain certain nurse-to-patient ratios, and would limit the nursing-related duties that may be performed by unlicensed personnel. The estimated financial impact of AB 394 for SFGH is $1 million annually. AB 675/Thomson (Senate Health and Human Services) (Support) has been forwarded by the California Healthcare Association as an alternative to AB 394. The bill strengthens current federal language (including penalties) in the utilization of a Patient Classification System to drive staffing. SFGH is in full compliance with AB 675’s requirements. Cancer AB 40/Wayne (Senate) (Support) would establish the Breast Cancer Treatment Program to provide breast cancer treatment to uninsured and underinsured women with income levels at or below 200% of the Federal Poverty Level (FPL). SB 1154/Speier (Assembly) (Support) would establish the California Breast Cancer and Gynecological Cancer Treatment Program within MRMIB, for women with income levels below 300 % FPL who do not qualify for Medicare, Medi-Cal, or private insurance. County/State Health Billing AB 319/Thomson (Senate Health and Human Services) (Support) would advance 25% to counties at the beginning of each fiscal year for Child Health Disability Prevention Program (CHDP) administration, medical therapy and administration of the California Children's Services Program (CCS), and HIV education and prevention services. Health Insurance Expansion/Uninsured - General AB 26/Migden (Senate) (Support-Board) would provide for the definition, registration and termination of domestic partners and would require health plans and disability insurance group policies to include an offer of domestic partner health care benefits as an elective coverage option. SB 480/Solis (Assembly) (Support-Board) would create a process for thoroughly examining the options for achieving universal health insurance coverage. Specifically, the bill would require the State Health and Human Services Agency to annually report on this issue to the Legislature beginning December 1, 2000, and to develop proposed legislation to implement universal health coverage, to the extent feasible, for introduction during the 2001-02 legislative session. Healthy Families/Medi-Cal For Children AB 43/Villaraigosa, AB 93/Cedillo, and AB 1015/Gallegos (Senate) (Support) are the Assembly’s package of bills to reform and expand the Healthy Families Program (HFP) and Medi-Cal for children. The package would simplify and make more uniform eligibility requirements for the Medi-Cal and Healthy Families programs, including providing health insurance coverage for the entire family and for all documented immigrant children, streamlining the application process, and enhancing outreach to potentially eligible populations. Several other bills remain active and address these and other reform issues, such as: Medi-Cal presumptive eligibility (SB 87/Escutia); increasing the HFP income eligibility threshold to 250% FPL (SB 102/Solis) and Medi-Cal eligibility to 133% FPL (SB 111/Figueroa); requiring HFP to pay for CHDP follow-up treatment (SB 112/Figueroa); and establishing a HFP purchasing credit mechanism (SB 168/Speier). In addition, AB 100/Thomson and SB 92/Hayden are other active bills that address some of the above issues. The Budget Conference Committee has approved funding for several of these expansions. AB 1061/McClintock (2-Year; not yet heard in committee) (Oppose) would repeal the Healthy Families, Medi-Cal, Maternal and Child Health, Access for Infants and Mothers (AIM), AIDS prevention, and other health care programs for low-income individuals. The bill would instead enact the "Access to Affordable Choice Act," to provide personal income tax credits for qualified medical costs. AB 1363/Davis (Senate Health and Human Services) (Watch) would require the MRMIB board to include school-based health centers as traditional and safety net providers under the Healthy Families Program (HFP). Current law requires MRMIB to designate a community provider plan in each geographic area that is the participating plan with the highest percentage of traditional and safety net providers. Subscribers selecting the designated community provider plan are given a family contribution discount. HIV/AIDS AB 103/Migden (Senate Health and Human Services (Support-Board) would require the State Department of Health Services to develop, implement and evaluate a statewide coded HIV reporting system that does not use names. Implementation would be required by no later than January 2001. SB 1029/Haynes (2-Year; Failed in Senate Health and Human Services, Reconsideration Granted) (Oppose) would require the State to establish a mandatory, statewide HIV names reporting system. Data collected would be used to conduct partner notification and contact tracing, in addition to other purposes. AB 518/Mazzoni, Shelley (Senate Health and Human Services) (Support-Board) would authorize cities and counties to implement clean needle exchange projects and would authorize pharmacists, physicians, and certain persons authorized under those projects to furnish hypodermic needles and syringes without a prescription or permit. Immigrant Health Care AB 52/Cedillo (Senate Health and Human Services) (Support) would re-enact critical health care programs for all Californians who need them, without respect to immigration status. The programs which would be authorized include: California Children's Services Program; Genetically Handicapped Person's Program; Alzheimer’s disease diagnostic and treatment centers; State and local mental health programs; developmental disabilities services; special education programs; and other services for children with disabilities. SB 82/Vasconcellos (Assembly) (Support) would re-enact State-only Medi-Cal coverage for pregnancy-related services for undocumented women. Funding for this program is included in both the Governor’s and the Legislature’s proposed FY 1999-00 budgets. SB 82 and AB 52 are necessary because Former Governor Wilson’s executive order requiring verification of immigration status and denial of services to undocumented residents under 200 programs has not been rescinded by the Governor Davis. Long-Term Care Nursing Facilities: Staffing AB 1160/Shelley (Senate) (Watch) would make a number of changes to existing law, such as: establishing goals for direct care SNF staffing; increasing citation fines and payment requirements; revising the calculation for determining nursing hours in SNFs and ICFs; requiring specified disclosure of licensee information; directing DHS to develop and implement Medi-Cal nursing facility reimbursement system reforms (but exempting nursing facilities which operate as a distinct part of an acute hospital) and a variety of other accountability, record keeping, reporting, staffing, training, and enforcement requirements. Medi-Cal AB 155/Migden (Senate Health and Human Services) (Support) would require the State Department of Health Services to submit an amendment to the State Medicaid plan in order to take advantage of a federal option that allows disabled Medi-Cal recipients who return to work to be eligible for Medi-Cal. As long as individuals’ countable income does not exceed 250% FPL, eligibility would continue with premiums ranging from $10 to $200 per month. AB 359/Cedillo (Senate Health and Human Services) (Support) would reduce the State’s administrative rake-off of Disproportionate Share Hospital (DSH) funds by $40 million. The Budget Conference Committee has approved a $30 million reduction of the administrative fee. AB 715/Firebaugh (Senate Health and Human Services) (Support) would require the State Department of Health Services to continue providing 100% reasonable cost reimbursement for rural health clinic (RHC) and federally-qualified health clinic (FQHC) services through 2007. The federal Balanced Budget Act (BBA) of 1997 included a provision to phase out cost-based reimbursement to federally qualified health centers beginning in federal fiscal year 1999-2000, however, the BBA also provided states the option to continue 100% reimbursement to FQHCs and RHCs until 2003. SB 673/Escutia (Assembly Health) (Support) would extend Medi-Cal transitional benefits for families leaving CalWORKs by requiring only annual statements of earnings or assets to reaffirm eligibility, rather than quarterly re-certification. SB 780/Burton (Assembly Health) (Support) would enact a number of measures designed to simplify and streamline eligibility for the Medi-Cal program, such as: permitting Medi-Cal applicants to submit a copy of the prior year’s tax return to document gross income; elimination of resource requirements and the limitation on employment hours for Medi-Cal beneficiaries; permitting parents of children who are Medi-Cal beneficiaries to apply for Medi-Cal with a mail-in application; and providing twelve months’ of continuous eligibility for Medi-Cal. Medicinal Marijuana SB 847/Vasconcellos (Assembly) (Support) would establish a 3-year program to be called the California Marijuana Research program, under which $1 million per year would be allocated for studies intended to ascertain the general medical safety and efficacy of marijuana, and, if found valuable, to develop medical guidelines for the appropriate administration and use of marijuana. SB 848/Vasconcellos (Assembly) (Support) would require the State to develop and implement a plan for the safe and affordable distribution of medicinal marijuana. Mental Health AB 34/Steinberg (Senate Health and Human Services) (Support-Board) would provide four-year training and planning grants to counties with significant numbers of homeless mentally ill adults and older adults. Grants would be extended beyond four years if a county reduces incarceration rates by twenty percent. AB 88/Thomson (Senate) (Support) would require health insurance coverage parity between limitations on mental health care and other health care. It is designed to require health plans to cover specific severe biologically based mental illnesses, such as schizophrenia and persistent clinical depression. SB 468/Polanco (Assembly) (Support) would require health insurance coverage parity between mental health care and other health care with respect to co-payments and limitations. This measure would require health plans to provide coverage for the diagnosis and medically necessary treatment of mental illness as defined in the Diagnostic and Statistical Manual IV. Prevention SB 405/Ortiz (Assembly Health) (Support) would require the Department of Mental Health to establish several programs to prevent suicide, including: Gatekeeper training pilot programs through 3-year contracts with counties or nonprofit organizations; evidence-based suicide treatment pilots; a public awareness and education campaign targeted at junior high and high school students; a 24-hour central statewide suicide crisis line that links callers to local services; and a central Internet-based data base on suicide and community resources. Public Health AB 1557/Migden (Senate) (Support) would require any person performing venipuncture and skin puncture for the purpose of withdrawing blood in clinical laboratories to be certified as a "certified phlebotomy technician," and to meet training guidelines to be developed by the State by January, 2001. SB 269/Ortiz (2-Year) (Support) would increase the local public health subvention for basic population-based disease control functions to 60 cents per capita or a base of $100,000 – whichever is greater. The Budget Conference Committee approved a portion of the funds needed for this increase, $7.7 million statewide. SB 1256/Polanco (Assembly) (Support) states the intent of the Legislature to appropriate an unspecified amount to the Department of Health Services for screening of uninsured individuals at high risk for hepatitis C. School-Based Health AB 210/Wildman (Senate Education) (Watch) would establish the Healthy Student Partnership Fund to make funding available to schools for capital outlay projects to improve physical space for student health services. Tobacco Settlement Dozens of bills were introduced to specify how the State’s share of the national tobacco settlement funds may be spent. However, none of these bills moved out of the Appropriations Committees of the Senate and Assembly by the deadline, and are thus two-year bills. However, in late May a coalition of state health organizations and Democratic legislators came together in an effort entitled "Don’t Let Tobacco Funds Go Up in Smoke: Use Tobacco funds for Health and Health Care." The Coalition is urging the Governor and Legislature to dedicate a separate fund for the tobacco settlement monies which will ensure funding of health-related programs such as smoking prevention, patient treatment for smoking-related illnesses, and research. POPULATION HEALTH AND PREVENTION HIV Prevention Planning Council Community Forum On Thursday, June 3rd, the HIV Prevention Planning Council convened a community forum to gather information on the HIV prevention issues surrounding private spaces in public sex venues. The event was held at Mission High School and drew approximately 60 members of the public. The panel of speakers included: Michael Petrelis (Queer Nation), David Pasquereli (ACT-UP San Francisco), David Attyah and Steve Filandrinos (Health Watch), Bill Woods, Ph.D. (CAPS), and myself. Advocates for privacy testified during the public comment portion of the meeting. The HPPC approved a motion to be sent to the Health Commission recommending the removal of bathhouse prohibitions. After the meeting, a procedural error was identified which nullified the vote. At the subsequent meeting of June 10, the council voted on the following motion: "The HPPC recommends to DPH that unless clear and compelling evidence exists to demonstrate that private spaces in commercial/public sex environments increases the rate of HIV transmission, that DPH rescind the current policy that prohibits private spaces in commercial sex establishments." The motion passed 9 "yes" votes, 6 "no" votes, and 1 abstention. This recommendation does not endorse reopening the bathhouses, or a ballot initiative about commercial sex establishments. TL/SOMA Action Point Adherence Project The TL/SOMA Action Point Adherence Project (APAP) will be moving into a new site July 6. APAP is a collaborative project of the SF AIDS Foundation and the Health Department that provides medication adherence support for HIV infected homeless or marginally housed individuals. APAP will be moving into a site on the ground floor of the Rose Hotel, 125 6th Street between Mission and Howard. The site has been built-out specifically for this purpose. Services provided at Action Point include medication storage and dispensing, nursing and individualized medication adherence assistance, case management, mental health, substance use treatment referrals, acupuncture and pharmacist consultation. In addition, HIV Prevention Point will provide needle exchange services on site 3 days a week. Tom Waddell Health Clinic and the UCSF Student Homeless Project will provide urgent care medical services 4 days a week. APAP has the capacity to provide services for 150 individuals and will be open 7 days a week noon to 6pm. These services have been provided since March 1 at the San Francisco AIDS Foundation, 1 6th Street. Children’s Lead Poisoning Poster A new illustrated poster, "Has Your Child Been Exposed to Lead?" has been produced by the Children's Environmental Health Promotion Section for clinic waiting rooms, so that parents will become aware of risk factors for lead poisoning. The poster is based on the risk questionnaire portion of San Francisco's Targeted Lead Screening Policy. To order in English, Spanish or Chinese, contact the program at 554-8930. STD Prevention and Control The St. James Infirmary established to exclusively serve sex workers, opened June 2nd from 6-9 p.m. Eleven sex workers were seen during the first clinic. All STD tests were negative. Treatment On Demand Planning Council The Substance Abuse Treatment on Demand Planning Council held it's June 3rd meeting in the San Francisco City Jail to gather first hand reports on the treatment needs of the jail population. After a presentation by the Sheriff's staff and a discussion with Sheriff Hennessey, the Council went into the dormitory area. Half of the Council visited with approximately 100 men in the 'Roads to Recovery' and the other half with approximately 40 women in the 'Sisters Program'. The incarcerated men and women were strikingly frank and articulate in their descriptions of their substance problems and long list of recovery related needs. Recurring themes were the scarcity of: culturally and linguistically appropriate material, treatment in jail, assistance with the transition out of jail into community programs, community programs easily accessible to ex-offenders, dual/triple diagnosis treatment, life skills preparation, and support for vocational development. The information gathered will be used to help the Council prepare next year's list of Treatment on Demand priorities. COMMUNITY HEALTH NETWORK LHH Annual Survey Completed A team of 18 State Licensing and Certification and HCFA representatives conducted Laguna Honda's annual recertification survey from May 25th through June 10th. The survey team presented preliminary findings at an exit conference on June 10th. The survey team reported no substandard care findings. The team did identify a number of minor deficiencies, and referenced ongoing concerns about the quality of life conditions in the open wards, and the non-compliant size of semi-private rooms. We expect to receive the final survey report in approximately three weeks. At that time we will have a clearer picture of the State and HCFA's concerns about the physical plant environment and its impact on census. I extend my congratulations to the management and staff of Laguna Honda for a successful survey. LHH Gero Psych Unit Opens I am pleased to report that the first of three specialty social behavioral SNF units opened on June 7th at LHH. The Geropsych Unit, which will provide enhanced clinical and programmatic services for residents on the second floor of Clarendon Hall, was the first unit to open. The staff for this unit have participated in an intensive, customized training program for the past 2 weeks and are very excited to begin providing care for the residents on the new unit. The Med-psych and Neuro-psych units, which will round out the complement of the 3 new social behavior units, will open in 3-month increments. Bridge to Wellness Program The Bridge to Wellness Program, a program of the Department of Psychiatry at San Francisco General Hospital and operated by contract with Richmond Area Multi-Services, Inc., will be moving to another location. Staff has located a site at 1460 Pine Street (between Polk and Larkin) in San Francisco, which will adequately meet the needs of the clients of the Partial Hospitalization Program. The site is zoned for such use and will not require a "change of use" or Proposition I. The Health Commission’s "Good Neighbor" policy is being followed and staff is doing outreach to the community. A meeting is scheduled June 16th from 4:30 - 6:00 p.m. to describe the program, answer questions and respond to neighborhood concerns. The contract for this program is currently in year two of a three-year contract (July 1998 through June 2000). Sylvia Villarreal Resignation It is with regret that I announce the recent resignation of Dr. Sylvia Villarreal, SFGH's Chief of Staff for the past year. Dr. Villarreal set a high standard of leadership for SFGH's medical staff. She was a prominent player in ensuring that we passed the recent JCAHO survey. Dr. Villarreal will spend the next year working as a private pediatrician at the Taos Clinic for Children and Youth in New Mexico. I am sure you all join me in wishing Dr. Villarreal well in her new endeavors. Juneteenth Juneteenth, the observance of freedom from slavery, is the oldest African American holiday. On Friday, June 18th, the UCSF/SFGH Circle of Sisters in conjunction with CHEARS, will host a Juneteenth celebration in the SFGH cafeteria. There will be music, entertainment, soul food and the announcement of the Juneteenth Essay contest winners. Saturday and Sunday June 19-20 Maxine Hall Health Center will participate in the Western Addition's Juneteenth Festival at Kimball Park. Staff will share a booth with Healthy Families, Lead Prevention, Environmental Health, and Breast and Cervical Cancer Prevention staff to provide interactive information to the public. If you like to volunteer for this event, contact Arla Escontrias , 206-2332. SFGH Appointments: 6/99 YTD New Appointments 13 92 Reappointments 26 208   Delinquencies 0 0   Reappointment Denials 0 0 Resigned/Retired 29 102 Disciplinary Actions 0 0 Restriction/Limitations – Privileges 0 0 Changes in Privileges   Additions 0 22   Voluntary Relinquishment 01 05   Current Statistics – as of 6/4/99 Active Staff 334 Affiliate Professionals 133 Courtesy Staff 536 Referring Staff 60 Total Members 1163 Applications in Process 70 Reappointment In Process 48 Reappointment Requested not Received 32 (Due through 8/99) 5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR JUNE 1999 On behalf of the Commission, Vice President Roma Guy presented the awards for the month of June. Individual Division Nominees Nominated by Adam Luna Lolita Rivas CHN – SSI Project/Tom Wadell Clinic PH&P – Mental Health Geriatric Services Patricia Birmingham, RN, MS Thomas Mesa, Director, Geriatric System of Care Team Nominees Division Nominated by Children’s Environmental Health Promotion Staff Karen Cohn Joe Walseth Gail Herrick Haroon Ahmad Christine Martin Leticia Medina Harriet Lem David Lo Frances Gonzalez Kathy Chiu Sarah Saavedra Ihsan DuJaili Lawrence Lee Karen Yu PH & P – Community Health Promotion and Prevention/Children’s Environmental Health Promotion Staff " " " " " " " " " " " " " " " " " " " " " " " " " " " " Karen Cohn, Program Manager Public Speaker: Neil Gendel, Healthy Children Organizing Projects, thanked the Commission for recognizing the Children’s Environmental Health Promotion Staff. 6) CONSIDERATION OF A RESOLUTION ADOPTING THE SAN FRANCISCO COMMUNITY ASSESSMENT REPORT DEVELOPED BY THE BUILDING A HEALTHIER SAN FRANCISCO COLLLABORATIVE At the Commission’s request, Tangerine Brigham, Director of Policy and Planning, presented a resolution regarding the assessment report presented by the Building a Healthier San Francisco Collaborative. Commissioner Guy encouraged the Department to disseminate the report throughout the Department. Ms. Brigham stated that the report is available on the Department of Public Health web site and the Director’s Fast Facts through e-mail. Additionally, an Executive Summary is available. Commissioner Chow proposed an amendment to the resolution indicating the Department’s usage of this report in its Strategic Planning. Action Taken: The Commission adopted Resolution #21-99, "Supporting the ‘Building a Healthier San Francisco Collaborative: A Citywide Collaborative Community Assessment’ Report,’" as amended by Commissioner Chow. 7) PRESENTATION OF A RESOLUTION AUTHORIZING THE DEPARTMENT OF PUBLIC HEALTH, VITAL STATISTICS, TO ACCEPT PASSPORT APPLICATIONS PURSUANT TO DESIGNATION OF AUTHORITY FROM THE U.S. STATE DEPARTMENT Dr. Katz presented the following: Population Health Records and Statistics is the section of the Health Department charged with registering into the City’s care, all records of births and deaths occurring within its legal limits. Our staff maintains, amends and corrects these records. When an official government record of a birth or death is required, and upon payment of all statutory fees, our office issues legal originals of such records to all who may apply. Customers making such a purchase at our office, or any of the thousands like it across the country, present the legal original to other agencies of government, such as the Department of Motor Vehicles (DMV); Social Security Administration (SSA); Veterans Administration (VA), Immigration and Naturalization Services (INS); the U.S. Passport Service, and State or local welfare agencies. With encouragement from this office, certain such agencies routinely confer with us to verify documents purportedly issued by us. Within moments, typically, we are able to accurately confirm the authenticity or the fraudulence of the record. It is this capability, predicated upon our skilled recognition of the indications of fraud which has motivated, in large measure, agents of the local Passport Agency to seek our cooperation in receiving and screening applications for passports. After studying the Department’s operational capacity, the Department feels confident that it can respond effectively to the projected volume and the attendant demands of providing passport acceptance services at 101 Grove Street. Furthermore, with an initial investment of about $1,000 in equipment, the Department will be able to provide photos to applicants who complete passport applications at our service window. Taken together, the $15.00 passport acceptance fee at a proposed $10.00 photo fee, is conservatively projected to add no less then $35,000 to General Fund revenues received annually. Dr. Katz acknowledged Ed Hernandez, Director of Vital Statistics. Mr. Hernandez also was selected as winner of the best budget idea for decreasing expenses or generating revenues in the Department. Mr. Hernandez reported that the present first floor space for Vital Statistics will be expanded to include this passport service. Action Taken: The Commission adopted Resolution #22-99, "Authorizing the Department of Public Health, Population Health Records and Statistics Section, to Begin Accepting and Processing Passport Applications Pursuant to a Designation of Authority from the United States Department of State." Note: Commissioner Sanchez left at 5:05. Commissioner Umekubo left at 5:15 p.m. 8) PRESENTATION AND CONSIDERATION OF A RESOLUTION REGARDING PRIMARY PREVENTION Dr. Larry Meredith, Director of Community Health Promotion and Prevention; Brian Katcher, Health Educator; and Ginger Smyly, Deputy Director, presented an update and covered the following areas: Overview of Population-Based Primary Prevention Evidence Basis for Primary Prevention Community Engagement Exhibits Prevention Strategies Key Primary Prevention Projects – four Budget Cycles DPY Funding Levels. Four Budget Cycles Inventory of Prevention Programs – Two Budget Cycles Highlighted Programs Children’s Environmental Health Promotion Injury Prevention: The CHIPPS Program Countering Pro-Tobacco: The Tobacco Free Project Violence Prevention: Violence as a Public Health Issue Highlighted Areas of Need African American Health Initiatives Alcohol Use and Population-Based Prevention Dr. Meredith acknowledged Commissioner Parker’s ongoing advocacy for prevention. President Monfredini stated the proposed resolution would not be considered today but will be continued to a future meeting. Public Speakers: Expressed support for the proposed resolution, participation in strategic planning, continued partnership with the community, violence prevention education, crime prevention, and prevention as a long-term process. Neil Gendel, Healthy Children Organizing Project Linda Mack Burch, BVHP Healthy Start Marie Hoemke, SFUSD Asthma Task Force Dr. Mary Beth Love, S.F. State University Gloria B. Soliz, Safety Network Program Broderick Lee, Coordinator for Violence Prevention Gene Coleman, Citywide Alcoholism Advisory Board Dee Epps-Miller, BVHP Healthy Start Gill Criswell, CUSP, objected to this agenda item because data and information on education on prevention of HIV were not available to the public. Letters of support for prevention were submitted from Beverly Rashidd and Lynda Boyer-Chu, RN, MPH. Commissioners’ Comments: The proposed resolution would be part of preparation for the FY 2000-2001 DPH budget An apology was expressed for any miscommunication with Department staff There is a need for short-term and long-term goals for prevention The resolution needs to include how information on prevention programs get out to the public (i.e., public awareness program), a commitment to prevention, and a commitment to find funds It is a challenge for the Department’s Strategic Plan, in the context of limited funds, not to pit one program against another. What is really needed for Population Health and Prevention with the broad Strategic Plan for the Department? Population Health and Prevention should bring forward a comprehensive prevention plan with costs and expected outcomes This is the first step towards a long-term plan for prevention What is the public awareness and general public education aspect of prevention? A revised resolution was requested for the July 6, 1999 agenda 9) OTHER BUSINESS/PUBLIC COMMENTS Public Speaker: Lincoln Madison expressed his non-support for the Department’s regulations for sex clubs and thinks the Commission should exert its authority over the regulations. President Monfredini referred to the City Attorney letter dated June 15, 1999 explaining the authority of the Director of Public Health to issue standards relating to sex clubs. The meeting was adjourned at 6:05 p.m. Sandy Ouye Mori, Executive Secretary to the Health Commission