Minutes of the Health Commission Meeting

Tuesday, August 17, 1999
3:00 p.m.

101 Grove Street, Room #300
San Francisco, CA 94102


The regular meeting of the Health Commission was called to order by Vice President Roma Guy at 3:05 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.


  • Commissioner Lee Ann Monfredini


Action Taken: The Commission unanimously adopted the minutes of August 3, 1999.

(Commissioner Ron Hill)

(3.1) PHP-CHS-Housing Services – Request for approval to accept and expend a new 3-year grant from the Corporation for Supportive Housing in the amount of $625,000, to partially fund the service and operating expenses at two single room occupancy hotels: the Pacific Bay Inn and the Windsor Hotel, for the period of July 12, 1999 through June 30, 2002.

(3.2) PHP-CHS-CMHS – Request for approval of new contracts with individual private practitioners under the San Francisco Mental Health Plan (Managed Care), in an amount not to exceed $3,300,000 per year, for all managed care providers, to provide mental health services for the period of July 1, 1999 through June 30, 2001.

(3.3) PHP-CHS-CMHS-FMP – Request for approval of multiyear contracts with a network of Family Mosaic Project individual providers for mental health and wrap-around services, including therapy, tutoring, mentoring, respite care and case management, for the period of July 1, 1999 through June 30, 2002, for a 3-year total amount of $1,026,100 and a maximum of $80,000 per year per individual provider.

(3.4) PHP-CHS-CMHS-FMP – Request for approval of contract renewals with eleven (11) agencies for mental health and wrap-around services, including therapy, tutoring, mentoring, respite care and case management, for a total of $1,103,495, for the period of July 1, 1999 through June 30, 2000. The 11 agencies, services and amounts are:

Contractor Service Description Contract Amount
Big Brothers/Big Sisters of San Francisco Mentoring and Social Services $15,060
Catholic Youth Organizations – St. Vincent’s School for Boys Sub-Acute Residential Treatment $68,616
Family Service Agency Fiscal Intermediary for Mental Health Services $98,069
Family Support Services of the Bay Area In and Out of Home Respite $35,000
High Gear Achievers, Inc. Tutoring $40,000
JLC Services (previously known as Jamestown Mentoring Services) Mentoring $150,000
Lincoln Child Center Sub-Acute Residential Treatment $192,750
New College of California Mental Health Consultation $8,000
RISE Institute Mentoring $145,000
San Francisco Educational Services Tutoring $70,000
Victor Treatment Centers Sub-Acute Residential Treatment $281,000

(3.5) PHP-CHS-CMHS – Request for approval of a new multiyear contract with St. Luke’s Healthcare Center, to provide professional managed care mental health services, for the period of

July 1, 1999 through June 30, 2003. Maximum compensation allocated for these services for all network providers is $3,300,000 for fiscal year 1999-2000.

(3.6) PHP-CHS-CMHS – Request for approval of a contract renewal with St. Luke’s Hospital to provide Medi-Cal funded psychiatric inpatient hospital services for Medi-Cal eligible adult beneficiaries, for the period of July 1, 1999 through June 30, 2000. The total dollar amount for psychiatric inpatient hospital services for all six (6) hospital providers is $5,000,000.

Commissioners Sanchez and Hill commended St. Luke’s for excellent services and its important role in providing a safety net.

(3.7) PHP-CHS-CMHS – Request for approval of a multiyear contract renewal with Catholic Charities of San Francisco for $160,720 per year, for a total of $642,880, to provide 24-hour mental health residential services, for the period of July 1, 1999 through June 30, 2003.

(3.8) PHP-CHPP-HIV Prevention – Request for approval of a contract renewal with Filipino Task Force on AIDS (FTFA), in the amount of $61,388, for the provision of HIV prevention services, including multiple group workshops and case management, for the period of July 1, 1999 through June 30, 2000.

Dr. Larry Meredith stated a progress report will be submitted to the Budget Committee.

Commissioner Hill requested a 60-day (October 19, 1999) progress report to the Budget Committee.

(3.9) PHP-CHPP-HIV Prevention – Request for approval of a contract renewal with Instituto Familiar de la Raza, Inc., in the amount of $50,901, for the provision of venue-based group outreach and evaluation, for the period of July 1, 1999 through June 30, 2000.

This item was postponed to September 21, 1999.

(3.10) PHP-CHPP-HIV Prevention – Request for approval of a contract renewal with Lavender Youth Recreation and Information Center (LYRIC), in the amount of $104,291, for the provision of HIV prevention services, including HIV risk reduction education and counseling services targeting behavioral risk populations, for the period of July 1, 1999 through June 30, 2000.

Commissioner Parker requested clarification on #3.10 regarding the unit costs for single session group workshops.

Commissioner Chow raised a question on the multiyear approval for Catholic Charities when the amended Policy #24 is still in its implementation phase. There will be other Catholic Charities contracts calendared for the Budget Committee.

Action Taken: The Commission approved the Consent Calendar of the Budget Committee, except #3.9, which was continued to September 21, 1999.

Note: Vice President Guy announced that the agenda will be adjusted with item #7 being heard prior to the Director’s Report.

Additionally, Vice President Guy called on Shawn O’Hearn, a member of the HIV Prevention Planning Council and a person living with AIDS, for public comments. He raised the following issues: 1) the bathhouse issue will not go away, especially with the privacy issue; 2) the position of the Director of Prevention in the AIDS Office needs to be filled; and 3) critical of the Department’s ad in the Bay Area Reporter on an outbreak of syphilis.

4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department).


Mayor’s Fiscal Advisory Committee (MFAC)

I am very proud to report that Barbara Garcia, Deputy Director of Health and Director of Population Health & Prevention, has been selected to receive the Public Managerial Excellence Award (MFAC) for Leadership this year. This prestigious award, sponsored by the San Francisco Chamber of Commerce, comes with a $1500 cash prize and recognizes outstanding managers throughout the City and County of San Francisco. As the Health Commission is aware, Ms. Garcia has an extraordinary history of commitment, dedication and achievement in her tenure with the Department and to the residents of San Francisco. She will be honored at an Awards Ceremony on October 27th. I know the Health Commission joins me in congratulating Ms. Garcia for this meritorious recognition.


New Adult Immunization Clinic to Open at 101 Grove St.

On September 1, the Communicable Disease Prevention Unit will open a new Adult Immunization Clinic here at 101 Grove St., Room 405. The clinic will provide affordable vaccines, beginning with Hepatitis A and B. In the fall, we will also offer influenza and pneumococcal vaccines, with future plans for adding other immunizations and serological testing.

The Adult Immunization Clinic is in keeping with our public health mission, but with some unique features: we will accept cash, credit and debit cards, but will not accept insurance. Our fees are highly competitive. Hep A is $24/dose and Hep B is $50/dose. (Compare with private providers and travel clinics charging $60-90/dose.) Discounts are available for students and City and County Employees with ID and groups of 25 or more. Individuals who receive immunizations at this clinic will be entered into the San Francisco Immunization Registry. This database will serve as a permanent record for Client’s IZ records and will allow them to access this information from a centralized location.

As a special offer to the Health Commission (and all DPH employees,) the Adult Immunization Clinic staff invites you to join them for a special "run-through" session on Wednesday, August 25th, from 9 a.m. – 4 p.m. or Monday, August 30th, 9 a.m. – noon. Stop by the Clinic in Room 405 and receive a Hep A vaccine for $35 and/or Hep B vaccine for $42. You’ll be protecting yourself against Hepatitis and, at the same time, help us fine-tune our clinic procedures before our opening on September 1st. The clinic’s phone number is 554-2625.

Mission Rock Closing September 15th

Due to lack of securing a new location and the need for the Giants to implement their lease agreement with the Port of San Francisco, Mission Rock Shelter will be closed by Wednesday, September 15, 1999. The night of September 14th will be the last night clients can stay at Mission Rock.

The City, in conjunction with DPH and DHS, will be master-leasing SRO's, securing mental health and substance abuse slots, and securing shelter beds to ensure that as many individuals as possible can transition in to new services.

We will continue to keep the Health Commission abreast of all developments in this transition.

Hepatitis C Resolution

On August 12th, the Board of Supervisors Public Health and Environment Committee passed a resolution directing the Department of Public Health to develop a plan of action to expand and coordinate—with local, state, and federal efforts—Hepatitis C prevention, education, and testing and to provide a status report within three months. The action plan will address the following areas:

(1) Provider and public education; (2) Integrated and comprehensive medical services for at risk populations, especially those who are injection drug users, homeless, mentally ill, or in the jails; (3) Integrated prevention and control activities to at-risk communities, including those served by HIV prevention services such as needle exchange programs; and (4) Coalition building and information dissemination within advocacy and support groups. Dr. Tomas Aragon, Director of Community Health Epidemiology & Disease Control, is leading our local efforts.

Grant for Methadone Program

The Center for Substance Abuse and Treatment/SAMHSA, through the General Acquisitions Branch/PSC, intends to award a sole source Simplified Acquisition to the Department for a Feasibility Study of our proposed Methadone by Physician Prescription (MPP) program. This one-year grant will allow us to conduct a fiscal analysis of the proposed project and many of its attendant issues, such as: reimbursement strategies, administrative costs, training, quality control procedures, database management and evaluation protocols.

STD Control - Syphilis Health Alert

During the past four weeks, the STD Program has identified a cluster of early syphilis cases among gay men in San Francisco that are meeting the majority of their partners through an AOL chat room. Specifically, we have identified 5, and now possibly a sixth case of early syphilis, among white gay men in the City. Three of the 5 men are HIV positive and all report having unprotected anal and oral sex with their partners most of the time. The only locating information they have on most of their partners is their internet handle which makes locating these individuals extremely difficult and challenging.

Because syphilis elimination is a local and national priority, the STD Program has taken a very aggressive approach in handling these new infections which has included:

  • rapidly interviewing individuals reported as being infected with early syphilis and promptly investigating their sexual partners;
  • sending out a provider alert to physicians in San Francisco;
  • notifying the media of this potential syphilis outbreak and taking out a full page ad in the BAR to let as many at risk individuals as possible know about the situation and to urge them to be tested for syphilis as soon as possible.
  • working closely with community based organizations to discuss ways of reaching this high risk population and
  • meeting every two weeks with our STD Program Syphilis Rapid Response Team to discuss open cases and to brainstorm ways of locating and motivating persons exposed to, or at risk of, exposure to syphilis.

Childhood Lead Prevention Program

The August 12th issue of SF Chronicle reported on problems with the Department of Building Inspection’s enforcement of the 1998 ordinance concerning safe work practices on exterior lead paint. The Health Department's Childhood Lead Prevention Program, along with the Lead Hazard Reduction Citizen Advisory Committee, were instrumental in securing this legislation. The intent of the law is to prevent unnecessary contamination of lead-dust and debris generated by work performed on pre-1979 building exteriors. The law requires adequate containment and cleanup of dust and debris, and has already created substantive changes in how property owners and contractors are conducting exterior painting and renovation. As the Chronicle emphasized, this progress could be greatly undone if the Building Inspection Department is not able to follow through effectively with the most flagrant violators.

Senior Injury Prevention

The Health Promotion Section of CHP&P, with the assistance of the San Francisco Injury Center at SFGH, has prepared an update of its report, "Injuries to San Francisco Seniors: Defining the Problem and Prioritizing Prevention Strategies." This latest edition uses 1996 death and hospitalization data to examine the prevalence of injuries to older San Franciscans and the role of prevention programs. Injuries are a large, and frequently preventable, health problem for seniors, with falls, pedestrian injuries and self-inflicted injuries (suicide) as the major causes of death. The report is being distributed to senior-serving agencies and injury prevention programs.

CHIPPS, the Senior Injury Prevention Program in the Health Promotion Section of CHP&P, has received a grant award, jointly with UCSF, from the National Institutes of Health (NIH). This four-year funding will help to support home safety modifications for San Francisco seniors, while funding UC researchers to investigate how older people from different cultures think about their homes and their safety. It will help us to understand what the factors are which encourage seniors to make safety-related changes in their homes.

"Safe Communities" - Pedestrian Safety

The Health Promotion Section has received a "Safe Communities" planning grant from the State of California, under a joint program created by the California Department of Health Services and the California Office of Traffic Safety. This 18-month award will fund community-based planning efforts for injury prevention in the Mission and Tenderloin neighborhoods. The initial focus of the project will be on Pedestrian Safety, with the potential to expand into other community injury-prevention concerns. The goal is to prepare a strategic plan and funding application for implementation funding that the State proposes to release in about 18 months time.

Family Violence Prevention

On September 17th, the San Francisco Collaborative Organized to Prevent Abuse, (COPA), in conjunction with other DPH programs and community agencies, will hold a conference on domestic violence. "Behavioral Health and Domestic Violence: Creating Treatment Plans That Work," targets City-funded mental health, substance abuse or HIV-service providers and focuses on the interplay between these conditions. The Conference is designed to help behavioral health providers to detect, intervene or refer domestic violence survivors and perpetrators. The model will include a cultural competence perspective and workshops will develop protocols for domestic violence and behavioral health.


SF Superior Court Decided in the City’s Favor

Last week, the San Francisco Superior Court decided in the City's favor, dismissing two citations issued by the State Department of Health Services (DHS) against Laguna Honda Hospital (LHH).

The Superior Court judges rejected DHS's contention that LHH provided insufficient supervision and inadequate care planning and found that LHH acted reasonably. Because violations were not established, the penalties assessed by DHS were rendered moot and will not be imposed.

The City Attorney's Office worked with LHH administration and clinicians in successfully defending these cases.

Maxine Hall Center Awarded a Grant

In continuing our focus of domestic violence as a public health issue, the California Endowment, through the Family Violence Prevention Fund, recently awarded a $25,000 grant to the Maxine Hall Health Center. The Center intends to improve its clinical response to domestic violence and develop prevention strategies and programs. In addition, MHHC will be housing the "It’s Your Business Project". The project, which was kicked- off last month by Representative Barbara Lee, is a national program aimed at reducing domestic violence in the African-American community. Leigh Kimberg, M.D. is leading these efforts on behalf of the Department.


On behalf of the Commission, Vice President Guy presented the Employee Recognition Awards to:

Individual Nominee Division Nominated by
  • Lily Xu
PH&P – AIDS Office, Business and Operations Unit Gail Tang and
Carlos Rendon
# 1 Team Nominees Division Nominated by
Clinic Management
  • Dr. Alex Moy
  • Jimmy Yan
  • Kit Chan
  • Lily Loo
PH&P - Chinatown Public Health Center Madeline Ritchie, Center Director
# 2 Team Nominees Division Nominated by
Women’s Care Navigators
  • Alanna Ortega
  • Barbara Cicerelli
  • Esther Thack
  • Sonia Tuthill
PH&P - Breast and Cervical Cancer Services Robin Whidden, N.P.


Monique Zmuda, Chief Financial Officer, provided an update on the activities of the Department of Public Health Y2K Compliance Committee and coordination efforts with the Citywide Y2K Program Management Office. For a copy of the full report, call the Commission Office at 554-2266.

The quarterly report summarizes the Department’s implementation of the Y2K plan to date, and focuses information on remediation efforts of non-compliant systems.

Ms. Zmuda will bring another update to the Commission in November.

Commissioners’ Comments:

  • This is an extensive and comprehensive report
  • The Department was asked if any additional training costs for staff would be needed
  • The Department was thanked for including the payroll system
  • The airport medical clinic is included
  • Vice President Guy requested another update on November 2, 1999.


Barbara Garcia, Deputy Director of Health and Director of Population Health and Prevention, gave an overview of planning efforts to ensure a smooth transition from the 20th to the 21st century. Preparations are taking place at a citywide level with the Police Department as the lead agency, working through the Mayor’s Office of Emergency Services to ensure all city Department participate in planning efforts. Department of Public Health preparations are occurring both at a Departmentwide level and at an incident responses level. Planning for the "Mellow Millennium" celebration covers four days from December 30, 1999 through January 2, 2000.

A copy of the full report is available in the Commission Office. All City employees may be called on during the millennium by the Mayor to act as Disaster Workers in the event of need.

The Office of Emergency Services will activate the Emergency Command Center at 1011 Turk Street on December 31, at 3:00 p.m. Staff from DPH as well as other City Departments will person the Emergency Command Center throughout the millennium weekend. At this point DPH is proposing 12-hour shifts at the Center, which will act as the focal point for Citywide information gathering and dissemination.

Vice President Guy asked how the City will pay for these planning efforts. The Mayor will be fund raising.

Ms. Garcia thanked Chris Wachsmuth and Anne Kronenberg for their leadership in the millennium event planning. The Department will come back in November for another update.


As a follow-up to the Primary Prevention presentation in June, Dr. Katz presented a revised resolution for consideration. He thanked Commissioner Parker for taking the lead on this issue.

Commissioner Parker expressed his approval of the resolution and thanked his colleagues on the Commission, Dr. Katz, Dr. Meredith, Cynthia Selmar, Jimmy Loyce, Barbara Garcia and Sandy Mori.

Public Speakers: supported the proposed revised resolution

  • Basheem Allah, Southeast Alliance for Environmental Justice
  • Beverly Rashidd, Booker T. Washington Center

Commissioner Chow, acknowledging the FY 1999-00 DPH budget allocates $18.8 million to prevention, stated that out of a total Department budget of over $800 million, this is not enough for prevention. He would like to know that we are effectively using current dollars by utilizing criteria to determine success of existing programs. He emphasized that the African American Health Initiative needs to be a part of the policy direction.

Commissioner Parker commented that grants have not been forthcoming for the African American Health Initiative due to lack of commitment from the Department.

Commissioner Umekubo expressed his support for this new direction in the resolution and the timeliness of the resolution for our Department Strategic Planning.

Commissioner Sanchez thanked Commissioner Parker for his persistent focus on prevention and the inequities in health care.

Action Taken: The Commission unanimously adopted Resolution #25-99, "Establishing Policy and Budgetary Support for Evidence-Based, Community-Driven Primary Prevention."

Vice President Guy thanked the staff for the evolvement of this resolution, with input of the staff, the Commission, and the community. She observed the process as a true consensus – building process evolving into the final resolution. She appreciates this process as the way to develop health policy.


Gilbert Criswell, Channel 53 freelance writer, raised the issue that the Health Commission meetings should be televised for public access purposes; questioned the targeting of gay men and the gay press in an ad in the Bay Area Reporter regarding syphilis; and questioned the lateness of the Department of Public Health STD Annual Report.

Michael Petrelis, Accountability Project, commented that the Annual STD Report is three months late and asked when will be report be released. He also requested the results of the Explore Project, targeting gay men in San Francisco, be presented and explained to the gay community.

The meeting was adjourned at 5:00 p.m.

Sandy Ouye Mori Executive Secretary to the Health Commission