Minutes of the Health Commission Meeting
Tuesday, February 1, 2000
101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The regular meeting of the Health Commission was called to order by President Lee Ann
Monfredini at 3:05 p.m.
- Commissioner Roma P. Guy, M.S.W.
- Commissioner Ron Hill
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner John I. Umekubo, M.D.
- Commissioner Edward A. Chow, M.D.
- Commissioner Lee Ann Monfredini
- Commissioner David J. Sanchez, Jr., Ph.D.
2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF JANUARY 18, 2000
Action Taken: The Commission unanimously adopted the minutes of January 18, 2000
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner Ron Hill)
(3.1) DPH-Administration Request for approval to accept and expend a gift
of $96,154 bequeathed to San Francisco General Hospital by the estate of Kathleen Mason.
(3.2) CHN-Office of Managed Care Request for approval of an
Administrative Services Agreement between the Department of Public Health, CHN and UCSF
Stanford Health Care, on behalf of UCSF Medical Center and the UCSF Stanford Medical Group
Facility at UCSF, to provide administrative services to their enrollees of the San
Francisco Health Plan, for the period of January 1, 2000 to December 31, 2000.
(3.3) PHP-CSAS Request for approval to accept and expend a new grant from
the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services
Administration, in the amount of $475,000, for three years, for the creation of a
community based medically managed detoxification program, with a sole source modification
to the contract with Baker Places. Inc.
(3.4) CHS-HIV Health and Prevention Services Request for approval of new
retroactive contract with CompassPoint Nonprofit Services, formally known as the Support
Center for Nonprofit Management, in the amount of $252,000, to provide consultation and
technical assistance services targeting HIV Health Service CARE providers, for the period
of November 1, 1999 through February 29, 2001.
Action Taken: The Commission approved the Consent Calendar of the Budget
4) DIRECTORS REPORT (Report on activities and operations of the
Department, and may include activities within the Community Health Network and Population
Health and Prevention Divisions) (Mitchell H. Katz, M.D., Director of Health)
POPULATION HEALTH AND PREVENTION
In response to the increase in pedestrian injuries and fatalities, the Community Health
Education Section (formerly Health Promotion) of CHP&P is involved in a number of
collaborations that support community actions for safer streets.
The Mission and Tenderloin neighborhood "Safe Communities" planning grant was
funded by the State Department of Health Services January 1, 2000.
St. John's Educational Threshold Center, San Francisco Neighborhood Safety Partnership
and Walk San Francisco will work with the Health Department to develop local strategic
planning to reduce pedestrian injuries. The State will consider proposals for
implementation funding based on this planning process.
The California Office of Traffic Safety (OTS) has awarded CHP&P a 2-year grant of
approximately $450,000 for a "San Francisco Pedestrian Safety Project,"
scheduled to start in April 2000. This project will include data linkage efforts, bringing
together Police, ER, Paramedic and Parking and Traffic Engineering data to develop a basis
for targeting and evaluating interventions, with the collaboration of Community Health
Epidemiology and the SF Injury Center. The Community Health Education Section will
initiate a Community Capacity Building effort that will provide mini-grants to community
groups organizing to improve pedestrian safety.
The Community Health Education Section has been part of the Traffic Calming Technical
Working Group of the San Francisco County Transportation Authority. A recommended set of
guidelines for traffic calming, with a priority on pedestrian and bicycle safety, and a
proposal for continued involvement by the Health Department in the community education and
advocacy aspects of traffic calming, went to the Commissioners on January 24, 2000.
Michael Radetsky, from the Health Education Section, will be a "resource person"
for the workshop on "Pedestrian Safety, Traffic Calming & Walkability" at a
day-long forum being put on by the U S Department of Transportation at the Fairmont Hotel
on February 8, 2000.
Crisis Intervention at Cobb School
Sai-Ling Chan-Sew of CMHS received a call from the Department of Children, Youth and
Families (DCYF) January 19th, requesting help with a critical incident at Cobb
School. A paroled father, under restraining order to stay away from his son, had called
the school and threatened to harm the principal if she prevented his visitation.
Sai-Ling was asked to go to school to facilitate a discussion between the police, SFUSD
administration, and DCYF, regarding the best plan for the identified student. She
facilitated a meeting with all the parties that afternoon. She then met with the staff and
parents to identify issues of immediate concern for the rest of the student body.
On January 20th, Sai-Ling returned to the school with Keith Hutchinson, the
director of Child Crisis and met with administrators the principal, and teachers. They
went through the issues listed the day before, and created action plans and point person
for the plan. Staff expressed moderate to high level of anxiety and fear. Sai-Ling spoke
to some of the staff individually, and Keith deployed two Child Crisis staff to be
stationed at the school for the remainder of the day to speak with teachers and staff. The
father turned himself in later that same day.
COMMUNITY HEALTH NETWORK
New Mission Pediatric Clinic Site
Beginning February 7, 2000, the Castro-Mission Health Center (CMHC) will be stationing
its Monday afternoon Mission Pediatric Clinic at the site of CARECEN (Central American
Resource Center), 1245 Alabama Street near 24th Street. The target population is Spanish
speaking families with infants to 12 year-olds. Wellness services will be provided,
including immunizations. For continuity of care, referrals will be made to primary care
providers at San Francisco General Hospital's Children's Health Center (6M) or the Family
Health Center, and CMHC.
|SFGH Credentials Report
|Changes in Privileges
| Voluntary Relinquishment
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH FY 1999-00 REVENUES AND
EXPENDITURES FOR THE FIRST SIX MONTHS
PRESENTATION AND CONSIDERATION OF A DEFICIT REDUCTION PLAN FOR FY 1999-00
Monique Zmuda, Chief Financial Officer, gave the 2nd quarter FY 1999-00
Revenue and Expenditure Report, with a proposed reduction plan addressing the deficit (Attachment)
Commissioner Parker pointed out the biggest problem is the shrinking reimbursement
rates, having to sacrifice our infrastructure, thereby having our healthcare system to
crumble. He encouraged the Department to find other ways to correct the deficit.
Commissioner Umekubo observed that as Department revenues stay the same or decrease,
the Department is always "catching up."
President Guy appreciates the Department giving the facts, even though it is not good
news. These trends at the State and Federal levels have been anticipated. Additionally,
our population mix is changing; and there is a need for more chronic care and less acute
care. That is why the Commission requested the Department to develop a Strategic Plan.
Simultaneously with the development of this Strategic Plan, the Department has to address
a deficit within the present fiscal year. To compound this dilemma, there are no new
monies to invest in any changes in direction or priorities. The Commission, by consensus,
directed the Department to move forward with its deficit reduction plan.
- Johnnie Burnside, SFGH patient, opposed the move of the UC Renal Dialysis Unit from SFGH
to another neighborhood; this will cause hardship to patients.
- Ann Kyle, SFGH patient, wants Renal Dialysis unit to stay at SFGH.
- Shannon Coughlin, CHRIA, patient advocate, promotes universal healthcare; is in close
contact with patients and providers; encouraged Commission not to live within the budget.
- Nora Roman, R.N., Emergency Coalition to Save Public Health, stated the healthcare
system is already decimated and is in a crisis; SFGH is behind in submitting Medicare
billing; look at ways not to cut the budget.
- Dale Butler, SEIU Local 790, stated this is an unacceptable plan to cover the deficit;
referred to a booklet "State of Health Issuance" at: http//chpps.berkeley.edu/hpp/
6) PRESENTATION OF THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO AFFILIATION
Tony Wagner, CHN Executive Administrator; Gene OConnell, SFGH Executive
Administrator; and Dr. Philip Hopewell, UCSF Associate Dean, presented the
Affiliation Agreement, which is the framework for the relationship between SFGH and
and sets forth the agreements and understandings of the parties respective to their
responsibilities, rights, obligations and expectations. The contract defines the services
purchased by SFGH and the amount paid to the University.
They included in their presentation:
- Budget Process
- Monitoring and Evaluation
- 1999-2000 Budget
- Description of Services
- Utilization of House Staff
- University Contributions
In the changing health care environment that affects both SFGH and UCSF, there are now
challenges to both organizations. Within the context of the DPH Strategic Goals and the
budget process, both UCSF and SFGH are in the process of reviewing all services.
The full report is available at the Commission Office (554-2666).
Commissioner Umekubo requested clarification on physician professional fees and where
those revenues go. These revenues are retained by the University and used to pay for
clinical and academic programs only at SFGH.
Commissioner Hill thanked the Department and UCSF for the very informative report.
Commissioner Parker expressed his appreciation for the information and orientation on
the Affiliation Agreement. He feels it is essential to have this partnership and observes
the partnership to be working well.
President Guy sees the DPH/UCSF partnership as positive; and in these changing times,
the budget problems need to be solved as partners. The trend is more focused on population
health and community-based care. She also raised the question of productivity studies and
Ms. OConnell stated the UCSF Affiliation Agreement has a budget amount of
$52,135,170. The preparation of the annual contract budget is done in conjunction with the
preparation of the SFGH budget and according to the process outlined in the Affiliation
Agreement. The SFGH Administrator and CHN Chief Financial Officer provided the Associate
Deans Office with utilization projections and anticipated changes in the scope of
purchased services. The contract budget is then brought to the Executive Administrator of
the Community Health Network.
Dr. Hopewell emphasized the interdependence between SFGH and UCSF and the mutual
benefits for both parties, including the community as a whole. He cited examples of
national models at SFGH in partnership with UCSF, such as the HIV Clinic and the
Tuberculosis Center. He also referred to the impact of the research projects at SFGH. Many
areas of research (i.e., homelessness, long-term care, and substance abuse) are relevant
to the community.
Acknowledging this is the first time the Health Commission has been presented with an
actual document on the U.C. Affiliation Agreement, Dr. Katz indicated his goal is to give
the Health Commission an opportunity to understand the Agreement and be able to set
priorities in relation to the budget. It would be important information to have the number
of clinic encounters in relationship to the FTEs in the Agreement. Decisions made on
the Agreement would affect the Department and UCSF differently; but priorities for the
clinical services would need to be made as partners in the Agreement.
- Lee North, UCSF patient, expressed support for Dr. Amy Kendrick and his disappointment
on her dismissal from the UC HIV Clinic.
- Frederick Hobson, Board member of the S.F. Health Plan and U.C. Positive Health Clinic
patient, supports Dr. Amy Kendrick; described his experiences with various physicians at
SFGH and UCSF; urged the Commission to include in the UCSF Affiliation Agreement standards
for quality assurance, patient ratios, access to care, and notification to patients on
changing their physicians.
- President Guy commented that the information on the Affiliation Agreement helps to set
the stage for overall Department budget discussions. She thanked Ms. OConnell and
Dr. Hopewell for their informative presentation.
7) OTHER BUSINESS/PUBLIC COMMENTS
- William Kramer, AFSCME, advocated keeping the UCSF Renal Dialysis Center open and
opposed the sale of the Renal Center to a for-profit company.
President Guy announced her Commission assignments for the Committees
The meeting was adjourned at 5:00 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission