Minutes of the Health Commission Meeting
Tuesday, August 3, 1999
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 Vice President Roma
Guy at 3:08 p.m.
- Commissioner Edward A. Chow, M.D.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Ron Hill
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
Absent: Commissioner Lee Ann Monfredini
2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF JULY 20, 1999.
Action Taken: The Commission unanimously adopted the minutes of July 20, 1999.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
(3.1) CHN-Primary Care-Homeless Request for approval of retroactive
contract renewal and sole source request with Bayview Hunters Point Foundation
(BVHP), in the amount of $419,467, for the provision of mental health outreach/case
management services to the homeless, for the period of July 1, 1999 through June 30, 2000.
(DPH contracted with BVHP for services totaling $7,048,785 during FY 1998/99).
(3.7) PHP-HIV Health Services Request for approval of retroactive
contract renewal with Bayview Hunters Point Foundation (BVHP), in the amount of
$92,610, for the provision of HIV complementary therapy services, for the period of March
1, 1999 through February 29, 2000. (DPH contracted with BVHP for services totaling
$7,048,785 during FY 1998/99).
Items #3.1 and #3.7 were approved with the understanding that in 90 days, the
contractor will bring back to the Budget Committee a strategic plan for the agency. The
contractor, along with a member of its Board of Directors, will report every month to the
Joint Conference Committee for Population Health and Prevention on its progress in
developing its strategic plan. The Department was directed to provide technical assistance
to the contractor. If the strategic plan is not acceptable to the Department and the
Commission, the Department will be directed to look for other contractors.
Commissioner Hill stated his commitment to these services needed in the Bayview Hunters
Commissioner Sanchez pointed out the network of resources in the Bayview community and
encouraged the contractor to revisit its mission in the community.
Commissioner Umekubo supported the recommendations.
Karen Patterson, Executive Director of the agency, clarified that much of their funding
is not specific to the Bayview area and that the agency serves a diverse population. She
also pointed out that the HIV complementary therapy contract does not reflect the whole
(3.2) PHP-AB 75 Project Request for approval to apply for, accept and
expend retroactively a grant allocation in the amount of up to $4,910,208 from the State
Department of Health Services, through its California Healthcare for Indigents Program
(CHIP), to provide reimbursement for health services delivered to indigent persons for the
term FY 1999/00.
(3.3) PHP-HIV Prevention Services Request for approval of contract
renewal with Mobilization Against AIDS International (MAAI), in the amount of $73,068, for
the provision of HIV prevention services, including HIV risk reduction education and
counseling services, for the period of July 1, 1999 through June 30, 2000. (DPH contracted
with MAAI for services totaling $335,466 during FY 1998/99).
(3.4) PHP-HIV Prevention Services Request for approval of retroactive
contract renewal with Instituto Familiar de la Raza, Inc., in the amount of $69,073, for
the provision of venue-based group outreach, multiple session workshops and evaluation,
for the period of July 1, 1999 through December 31, 1999. (DPH contracted with Instituto
for services totaling $8,731,281 during FY 1998/99).
(3.5) PHP-HIV Prevention Services Request for approval of retroactive
contract renewal with Black Coalition on AIDS (BCOA), in the amount of $246,687, for the
provision of HIV prevention services, for the period of July 1, 1999 through June 30,
2000. (DPH contracted with BCOA for services totaling $1,047,956 during FY 1998/99).
(3.6) PHP-HIV Prevention Services Request for approval of retroactive
contract renewal with Black Coalition on AIDS (BCOA), in the amount of $227,397, for the
provision of HIV prevention services, for the period of July 1, 1999 through June 30,
2000. (DPH contracted with BCOA for services totaling $1,047,956 during FY 1998/99).
The Department will bring back a progress report to the Budget Committee in October.
(3.8) PHP-Health Promotion Request for approval of new contract with
Polaris Research and Development, in the amount of $158,000, for the provision of
comprehensive evaluation services for the Mangini tobacco settlement funded prevention
program, for the period of September 1, 1999 through June 30, 2001. (DPH contracted with
Polaris for services totaling $492,330 during FY 1998/99).
(3.9) PHP-Health Promotion Request for approval of new contract with
ORorke Public Relations and Advertising in the amount of $477,500, for the provision
of media services for the Mangini tobacco settlement funded prevention program, for the
period of September 1, 1999 through June 30, 2001. (DPH contracted with ORorke for
services totaling $191,987 during FY 1998/99).
(3.10) PHP-CSAS Request for approval of retroactive multi-year contract
renewal and sole source with the San Francisco Drug Abuse Advisory Board (SFDAAB), in the
amount of $51,787 per year, for the provision of advisory services, for the period of July
1, 1999 through June 30, 2003. (DPH contracted with SFDAAB for services totaling $51,787
during FY 1998/99).
(3.11) PHP-CMHS Request for approval of contract renewal with the Regents
of the University of California Clinical Practice Group (UCSFCPG) for the provision of
professional mental health managed care model of services, for the period of July 1, 1999
through June 30, 2001. Maximum compensation allocated for these services for all network
providers is $3,300,000 for FY 99/00. (DPH contracted with UCSFCPG for services totaling
$40,000 during FY 1998/99).
Commissioner Sanchez abstained due to conflict of interest.
(3.12) PHP-CMHS Request for approval of retroactive contract renewal with
Walnut Creek Hospital (WCH) for the provision of : (1) acute psychiatric inpatient
hospital services for indigent children and adolescents in the amount of $60,000 in City
funds (2) Medi-Cal funded psychiatric inpatient hospital services for Medi-Cal eligible
children and adolescents for the period of July 1, 1999 through June 30, 2000. The total
dollar amount for psychiatric inpatient hospital services for Medi-Cal beneficiaries for
all six hospital providers is $5,000,000. (DPH contracted with WCH for services totaling
$80,000 during FY 1998/99).
(3.13) PHP-CMHS Request for approval of retroactive contract renewal with
Ross Hospital (RH) for the provision of : (1) acute psychiatric inpatient hospital
services for indigent children and adolescents in the amount of $60,000 in City funds, and
(2) Medi-Cal funded psychiatric inpatient hospital services for Medi-Cal eligible children
and adolescents for the period of July 1, 1999 through June 30, 2000. The total dollar
amount for psychiatric inpatient hospital services for Medi-Cal beneficiaries for all six
hospital providers is $5,000,000. (DPH contracted with RH for services totaling $80,000
during FY 1998/99).
Commissioner Parker requested clarification of #3.1 and 3.7.
Commissioner Chow reminded the Department of the need to provide information on the
efficacy of acupuncture in HIV treatment.
Action Taken: The Commission approved the Consent Calendar of the Budget
Committee, with the specific recommendations for Bayview Hunters Point Foundation.
4) DIRECTORS REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department).
Governor Davis and civil rights organizations have agreed not to pursue their
respective lawsuits regarding the implementation of Proposition 187. As you may recall,
Proposition 187 was approved by the voters in 1994 and prohibited the provision of most
publicly funded services to undocumented persons.
The measure limited public health care services to emergencies only and requires
providers to report persons who appear to be undocumented to the Attorney Generals
Office and the Immigration Naturalization Service. The Department of Public Health and the
Board Supervisors approved resolutions opposing the measure. In addition, Governor Davis
opposed Proposition 187 because of his belief that parts of the ballot were
In March 1998, the United States District Court Judge Pfaelzer issued a final judgement
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 unenforceable:
- law enforcement agency cooperation with INS,
- exclusion of undocumented persons from public social services,
- exclusion of undocumented persons from publicly-funded health care,
- exclusion of undocumented persons from public-post elementary and secondary institutions
- State Attorney General cooperation with INS.
The Courts ruling was based on the fact that Proposition 187 was preempted by
federal law (e.g., the 1996 Welfare Reform Act).
This agreement preserves the decision handed down by Judge Pfaelzer in 1998. The
components that remain in Proposition 187 relate to establishing State criminal penalties
for the manufacturer and use of false documents to conceal illegal immigration status. The
agreement indicates that the State is allowed to enforce any restriction that has been
adopted under federal laws, such as the 1996 Welfare Reform Act. It is expected that the
agreement will result in the dismissal of two court cases, which challenge the rights of
undocumented residents to attend public schools.
The Department is pleased that an agreement has been reached on this issue. The
Department strongly believes that all residents are entitled to quality health services,
irrespective of their immigration status.
On July 22, 1999, the Department of Public Health submitted its comments to the
Immigration and Naturalization Service (INS) on the proposed public charge rule. As you
may recall, this is the first time that the federal government has defined "public
charge." The rule indicates that health-related benefits are not subject to public
charge consideration (e.g., Medicaid, childrens health insurance program, WIC,
prenatal care, etc.). While we are extremely pleased with the federal government
clarification of public charge, we believe that the proposal should be clarified in two
areas long-term institutionalization and sponsorship. The proposed rules indicates
that long-term institutionalization (except in the cases of rehabilitation) is subject to
public charge. However, the proposal does not indicate what period of time constitutes
long-term in a skilled nursing or mental health facility. With respect to sponsorship, we
have recommended that the INS forms be modified to eliminate questions that ask sponsors
whether they or members of their family have received public benefits.
The federal government accepted comments on the proposed rule until July 26, 1999.
While the proposed rule went into effect immediately (as of May 26, 1999), the federal
government is in the process of finalizing the rule based on comments submitted by
Within the Department of Public Health, we established a Public Charge Work Group to
develop strategies to inform our staff and clients about the new rule. Attached to my
Directors Report, you will find copies of the following:
- a flyer which will be distributed to clients throughout the Department (the flyer will
be translated into Spanish, Chinese, Vietnamese, Russian and Tagalog);
- a memorandum which were distributed to all Department staff with todays paychecks;
- a memorandum from me to our contractors discussing public charge (this memo also had
flyers that contractors could distribute to their clients).
In addition, on August 12, 1999 and August 17, 1999, the Department of Public Health
will hold public charge training sessions for certain staff. The Northern California
Coalition on Immigrant Rights has agreed to participate and present at these training
sessions. The training sessions are designed to discuss the new proposed public charge
rule and to provide staff with information on how to inform clients about this provision.
After these initial trainings, the Department will also conduct more in-depth training
with eligibility and registration workers.
Last week, Governor Davis signed the three budget trailer bills that implement budget
provisions relating to health and human services for fiscal year 1999-00. The bills are AB
1107 (Cedillo), (D-Los Angeles), AB 1111 (Aroner) and SB 708 (Senate Budget and Fiscal
Review Committee). This means that the State budget process is completed. As a result of
the State budget, certain immigrant rights, Medi-Cal and Healthy Families legislation were
absorbed by the budget and will no longer continue through the legislative process. It
should be noted that the Governors signing of SB 708 makes a number of changes in AB
1107 and AB 1111.
AB 1107 is the omnibus budget trailer bill that implements provisions in
the budget relating to health, mental health and developmental services. Key provisions
- Authorizes a state-only program to provide prenatal care services to undocumented women.
This will ensure services to approximately 70,000 pregnant women annually.
- Expands Healthy Families eligibility to families up to 250% of the federal poverty
level. An additional 172,000 children will be eligible. The bill also permits a family
contribution sponsor to pay the required annual family premium. While the program will be
expanded to include immigrant children who entered after August 22, 19996, they will only
qualify for 12 months of benefits. The continuance in the program would then be dependent
upon the federal government providing funding.
- Within Medi-Cal, the bill: (1) allows Medi-Cal eligibility for low-income, two parent
working families earning up to 100% of the federal poverty level, (2) simplifies the adult
Medi-Cal application and eligibility determination process and (3) reduces the State
administrative fee for disproportionate share hospital program by $30 million.
- Establishes the Family Planning Access, Care and Treatment (Family PACT) Waiver Program
to provide services to those under 200% of the federal poverty level.
- Establishes the minimum number of actual nursing hours per patient required in skilled
nursing facilities at 3.2 hours.
AB 1111 is the omnibus social services budget trailer bill. It implements provisions in
the budget relating to social services. The key provision of this bill related to health
is the establishment of a public health nursing program in the child welfare services
program to coordinate health services. The foster care public health nurse will coordinate
with county mental health and local health departments.
Finally, SB 708 does the following:
- Caps future funding for long-term care and renal dialysis services to undocumented
persons to 110% of the 1999-00 estimated caseload.
- Limits state-only funding for ancillary health care services to Medi-Cal patients in
Institutes for Mental Disease to the current budget year. As mentioned at the previous
Health Commission meeting, if the sunset on this repealed or extended, counties will face
an additional $12 million annual cost.
Deputy Director for EEO Appointed
I am pleased to announce that Norm Nickens has been appointed as Deputy Director for
Equal Employment Opportunity Programs (EEO), Affirmative Action and Cultural Competency as
of September 1, 1999. Since January 1998 he served as Deputy Director for Community Health
As Deputy Director for EEO, Affirmative Action and Cultural Competency Norm will
coordinate the Departments efforts to ensure a diverse workforce, enforce existing
prohibitions on discrimination, implement the Commissions policy on cultural
competency, and seek to expand the Departments contracting under the San Francisco
Minority/Womens/Local Business Ordinance.
Previously Norm served as Assistant Director of the AIDS Office from July of 1994
through December of 1997.
Promoting the Department's On-line Accessibility
In an effort designed to promote DPH web site and e-mail accessibility, I have directed
all Departmental managers to add both addresses to new and re-ordered business cards and
letterhead. It is my hope that this effort will result in an increased use by the public
of the information posted on our web site as well as allow us to be more accessible to the
public through e-mail.
POPULATION HEALTH AND PREVENTION
Supervisor Becerril called a hearing on asthma July 22nd at the Public
Health and Environment Committee. A wide range of health care providers, school
counselors, educators, day care providers, researchers, city officials and asthma
sufferers presented testimony. The Department, represented by Larry Meredith, Jennifer
Mann, Karen Cohn and David Ofman presented an overview of asthma hospitalization and death
data plus a summary of the department's outreach, care, education, prevention and
Asthma has been increasing nationally, as well as in San Francisco. While the
department has mobilized its outreach, and prevention efforts, broader, public-private
partnerships are needed. Four overlapping areas require coordinated attention: expanding
access to quality asthma treatment and follow-up care; training and education for parents,
teachers, childcare workers and the general public; research, particularly prevalence
studies; and prevention, through the reduction of indoor and outdoor environmental.
Newcomers Health Program, HIV Prevention Unit, Richmond Neighborhood Coalition and
Jewish Family and Children's Services collaborated to print an HIV prevention brochure in
Russian. Please contact Patricia Erwin, Newcomers Health Program through e-mail or at
705-8552 to request copies for distribution.
On the weekend of July 10, 1999, Free Zone, in conjunction with Dimensions health
clinic, co-sponsored the Health and Wellness track at the "Young, Loud, and
Proud" Conference for hundreds of lesbian, gay, bisexual, transgender, and
questioning youth at Mission High School. Workshops, run primarily by youth facilitators,
covered topics ranging from how the tobacco industry targets queer youth to health issues
facing transgender youth.
"Free Zone" is a collaboration between SFDPH's Wedge Program, the California
Lavender Smoke-free Project, Health Initiatives for Youth (HIFY), and Lavender Youth
Recreation and Information Center (LYRIC). The project was created to address the unmet
health education needs of queer and questioning youth under 20 years old in San Francisco.
Activities include a weekly drop-in group for queer youth and their friends and a media
campaign in SF schools. For more information, look us up at
http://members.aol.com/freezonesf or call Mazdak or Shivaun at 415-554-9098.
Jennabeth Ward, Violence Prevention Coordinator for the Health Promotion Section, was
awarded a certificate of appreciation from Neighborhoods in Transition - a Multi-Cultural
Partnership and Neighborhood Safety Partnership last month. The Mayors Criminal
Justice Council funds both of these groups. The certificate was awarded on the occasion of
Ms. Ward's final meeting with the Violence Prevention Network. Ms. Ward is leaving the
Department after 9 ½ of service, the last five of which she served as Violence Prevention
Family Violence Prevention
On July 19 the San Francisco Collaborative Organized to Prevent Abuse (SFCOPA), a
project of the Health Promotion Section trained 20 foster-family finding agency staff on
the impact of domestic violence on children. In a 6-hour training, the cycle of violence
was discussed, particularly as it pertains to the families of foster-children. Patricia
Van Horn from UCSF's Child Trauma Project who is informed in the physiological changes to
the brain which result from young children's witnessing of violence was the key presenter.
She provided tips on how foster families can best help the children in their homes. The
final presentation focused on how to intervene with youth and adult survivors of domestic
violence, and how to access community resources.
"It's Time to Go Outside" - Smoke-Free Home TV Ad Campaign
The Tobacco Control Program created a media campaign urging smokers with children at
home to smoke outside. Television ads were developed in English and Cantonese and aired
278 times in May. Over 300 viewers called to request an education packet after seeing the
ad. Surveys returned by viewers indicated that the percentage of smokers who went outside
increased from 20.8% to 38.6% after seeing the ad.
STD Prevention and Control
A Centers for Disease Control (CDC) Epidemiologic Intelligence Service (EIS) Officer
(Gwen Hammer, PHD) has been assigned to the San Francisco STD Program for a two year
period from 7/1/99 - 6/30/01. She is an epidemiology, occupational health and safety
policy expert who will be working with the STD, HIV and CD Sections on outbreak evaluation
and response and long term primary prevention studies.
A CDC funded Public Health Prevention Specialist, Katy Turner, MPH, was also assigned
to the STD Program effective September. She will focus on developing, implementing and
evaluating a genital herpes prevention and control program in San Francisco, which will be
the first such program in the United States.
Action Point Open House
Action Point held an open house last Thursday evening to announce its move to 125 6th
Street. The program works with HIV infected persons to help them adhere to the complicated
medical treatments necessary to fight the disease. The agency is using innovative
approaches to help clients stick to the complicated drug regiments including beepers
indicating the time to take medication and a weekly payment to individuals who stick to
their drug taking schedule.
COMMUNITY HEALTH NETWORK
LHH Has New Medical Director
I invite the Health Commission to join me in welcoming Dr. Terry Hill as the new
Medical Director at LHH. For the past 5 years Dr. Hill has been the CEO of the Geriatrics
Medical Group and Medical Director for several skilled nursing facilities and a continuing
care retirement community. He has been the Chair of the Nursing Facility Workgroup and a
member of the Executive Committee of the California Coalition for Compassionate Care. I am
sure the Commission joins me in welcoming Dr. Hill to his new position at LHH.
Grand Rounds LHH
Dr. William Thomas, a nationally renowned pioneer in implementing improved long-term
care programs and environments known as the "Eden Alternative", presented a
special Grand Round at LHH in July. The session was attended by approximately 400
caregivers from all over the Bay Area. Dr. Thomas also toured LHH and provided
consultation to staff on short-term improvements that could be made at LHH while planning
the new facility. Drs. Derek Kerr and Maria Rivero have been certified as Eden Alternative
Emergency Department Changes
To improve patient care and house staff education, and to help decrease diversion, the
Emergency Department has implemented significant operational changes. As of August 1,
- There will no longer be separate surgical and medical areas. Patients will be triaged by
acuity rather than the nature of their illness or injury.
- Areas will be renamed. Eastside will become Zone 1; Observation Ward, Zone 2; Medical
Ward, Zone 3 and Westside, Zone 4. Signs will be posted to direct visitors and staff.
- All attending physicians will be Board Certified emergency physicians (part-time
non-emergency staff will no longer be used).
- Clerical staff will be de-centralized.
- Each patient will be assigned a nurse (instead of a team) who is responsible for
coordinating the patient's care.
Departure Chief of Otolaryngology
Kelvin Lee, M.D., the Chief of Otolaryngology, will be leaving at the end of the
summer. Dr. Lee has been an outstanding clinician, teacher and leader among the medical
Breastfeeding Poster Contest
The WIC program coordinates the Breastfeeding Activities for the County and recently
held a poster contest. The Awards Reception was held today and WIC received a Proclamation
from the Mayor announcing August 1 - 7th as San Francisco Healthy Breastfeeding
Women's Health Center
The Women's Health Center has received a $9,400 grant from March of Dimes to help
establish a breastfeeding center. The Women's Health Center currently has a breastfeeding
support group every Friday morning. This group has been operating for the past year and a
half and has been extremely successful in offering individualized support to women who
have a problem breastfeeding or who have sick or premature babies. It has also fostered
new friendships among our clients.
The new Breastfeeding Center will provide supplies such as electric breast pumps which
women can rent. Other breastfeeding support supplies are available. There will also be a
video and book lending library.
Potrero Hill Jobs and Health Fairs
A job and health fair will be held August 6th from 1 - 7 at the Potrero
Hill Park & Recreation Center at 801 Arkansas Street. The Potrero Hill Health
Center in collaboration with Potrero Hill Family Resource Center will provide interactive
information and services. UCSF Dental students will provide dental screenings.
Entertainment will be provided by MAKE A CIRCUS! Please contact Arla Escontrias 206-2332
if you would like to Volunteer.
Maxine Hall Immunization Fair
Maxine Hall will host it's annual Immunization Fair August 20th from 8 a.m.-
3 p.m. The Fair will focus on back to school immunizations for children living in the
Fillmore and Western Addition Districts. Staff will provide information about Maxine Hall
and other community based programs. Please contact Arla Escontrias for more details.
Report from Deputy City Attorney
Jean Fraser, Deputy City Attorney, reported that the Department of Justice announced
its closing of the investigation into billing practices at teaching hospitals (i.e., San
Francisco General Hospital).
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH WEB SITE
Anne Kronenberg, Executive Assistant to Dr. Katz and Director of External Affairs,
provided an overview of the Departments development of an accessible user-friendly
web site. The Internet Policy Committee (IPC) developed policy procedures and guidelines.
Department of Public Healths presence on the web was in late January 1998. The
webmaster is Barry Siler.
The current web site includes the following information about the Department:
- Health Commission members, background, agendas, minutes, resolutions, policies, reports
and Employee Recognition Award winners
- Department of Public Health Mission Statement and organization charts
- Alphabetical listing of all Community Health Network and Population Health and
Prevention programs with links to information pages on programs
- Department of Public Health data and reports
- Clinic locations, hours and services
- Employment listings
- Vital statistics, birth and death information
- Laguna Honda information page designed to give up to the minute information on the
November bond process
- HIV/AIDS prevention and service information
- Epidemiology and disease control information
- Vaccination and immunization requirements
- Links to many related health sites, including the Centers for Disease Control, State
Department of Health Services, Cityspan, Fire Emergency Services, and much more
Internet usage on the Department of Public Health Web Site (http://www.dph.sf.ca.us) has grown exponentially
from a year ago. Since May 1998, the number of visits to the DPH web site increased by
nearly 800%. An analysis of the past 12 months indicates a pattern of activity that
validates the importance of the internet web site to the public.
Ms. Kronenberg acknowledged the work of webmaster Barry Siler and other Department of
Public Health staff Jessica Wolin, Donna Childers, and Dave Counter.
Commissioner Guy commended the Department for having the web site as a priority for the
benefit of the public. She suggested for the web site the Departments budget
information developed by Chief Finance Officer Monique Zmuda would benefit the public.
6) UPDATE ON THE DEPARTMENT OF PUBLIC HEALTH STRATEGIC PLANNING
Jimmy Loyce, Deputy Director of Health, and Tangerine Brigham, Director of Policy and
Planning, presented a document providing the framework for a strategic planning initiative
for the Department of Public Health. A copy of this document is available in the
This document is structured in the following manner. The introduction section provides
information on the value of strategic planning and how strategic planning can be
beneficial to the Department. The next section entitled "Framework for Strategic
Planning" summarizes the external and internal factors which impact the services
provided by the Department of Public Health. The next several sections discuss the
Departments proposed strategic planning goals, key assumptions, strategic questions,
outcomes and planning process. After a discussion of the strategic planning process, this
document discusses the relationship of this strategic planning effort to divisional
planning efforts within the Community Health Network and Population Health and Prevention.
The final section of this document discusses the proposed communications plan for ensuring
that all staff and interested parties are well informed about the strategic planning
initiative as it proceeds.
Background materials on the Departments mission, organization, core functions,
Federal and State regulations defining County mandates, the demographics of San Francisco,
external changes in the health industry, and internal strategic planning issues were
The timeframe for this planning process would be:
Phase I (Completion: November 1999)
Task: Develop proposed strategic approach to financing issues for FY 2000-01 budget
Phase II (Completion: January 2001)
Task: Develop proposed strategic direction and overall plan
Ms. Brigham acknowledged planner Richard Hodgson for his work on the Strategic Planning
Public Speaker: John Gressman, SF community Clinic Consortium, supported the
planning process and encouraged the Department to collaborate with all of its partners.
- commended staff for a comprehensive presentation and encouraged expansion of evaluation
procedures and inclusion of all DPH partners
- include the document on the web site
- SF Medical Society should be included in the planning process
- encouraged external input from the community to occur prior to the development of the
budget for FY 2000-01
- encouraged the use of existing planning documents and data tools from the public or
advisory groups (i.e., youth reports, drug treatment, 1115 waiver, AB 1040, homeless death
- public input should be formally honored
- letters should be sent to all of the DPH advisory groups regarding the Strategic
Planning in order to have some influence on the Departments budget for FY 2000-01
- update reports should be given at all of the Joint Conference Committees
- importance of evaluation and outcomes to measure effectiveness of programs
- encouraged Department to be more specific about where the Department wants to go
- shifting of priorities need to be noted
- encouraged the Department to make this a dynamic process with engagement from the line
staff and public
Ms. Brigham clarified that in the first phase, the task would be to develop a proposed
strategic approach to impact on a limited basis the finance issues for the FY
2000-02 DPH budget.
Dr. Katz stated the Department will utilize existing reports and will get input from
the community advisory groups. He promoted the idea of bringing monthly updates to the
full Commission so that the public can provide input all along the Strategic Planning
process. He pointed out that the mission of the Department should drive this Strategic
Planning process. This process is not about restructuring the Department. He also
encouraged input on specifics from the Commissioners.
Vice President Guy thanked the staff for its report.
7) OTHER BUSINESS/PUBLIC COMMENTS
8) CLOSED EXECUTIVE SESSION:
A. PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION.
B. VOTE ON WHETHER TO HOLD A 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.
The Commission went into closed session at 5:35 p.m.
C. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SECTION 54956.9 AND SAN FRANCISCO
ADMINISTRATIVE CODE SECTION 67.11(b).
CONFERENCE WITH LEGAL COUNSEL - EXISTING LITIGATION
PATRICIA LOVELOCK V. CITY AND COUNTY OF SAN FRANCISCO, OFFICER GONG, ANDY LITOWSKY,
CHIEF STEPHEN LA PLANTE, SUSAN WORD, PAUL LINDE, CITY AND COUNTY OF SAN FRANCISCO AND DOES
1-20. U.S. DISTRICT COURT #C98-3879 CRB. PROPOSED SETTLEMENT $6,000
The Commission came out of closed session at 5:55 p.m.
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 the $6,000 settlement.
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 not to disclose any discussion held in closed
The meeting was adjourned at 6:00 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission