Minutes of the Health Commission Meeting
Tuesday, June 6, 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 Roma Guy, MSW, 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 Edward A. Chow, M.D.
- Commissioner Lee Ann Monfredini
On behalf of the Commission, President Guy presented a special
Certificate of Appreciation to Shirley Rodriques, Administrative Assistant
to Tony Wagner, CHN Executive Administrator. Ms. Rodriques has been with
the Department for 14 years and has been an invaluable member of Mr.
Wagner’s staff for the past two years. She will be the Executive
Assistant to the General Manager of the Public Utilities Commission. Mr.
Wagner expressed his appreciation for her dedicated work.
Action Taken: The Commission unanimously adopted the minutes
of May 16, 2000.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
CHN-Pharmacy – Request for approval of a new contract
with Asereth Medical Services, Inc., in the amount of $1,100,000, for
as-needed supplemental pharmacy personnel services, for the period of
July 1, 2000 through June 30, 2001. (DPH contracted with Asereth for
services totaling $1,418,820 during FY 1998-99).
This item was postponed to a future meeting.
(3.2) PHP-CHPP – Request for approval to accept and expend a
two-year grant from the California Health Foundation and Trust, in the
amount of $93,756, for the development of Telehealth capacity for African
Americans living in San Francisco.
(3.3) PHP-Housing Services – Request for approval of a new
contract with Episcopal Community Services (ECS), in the amount of
$1,548,696, to provide senior housing and supportive services at the Le
Nain Hotel, targeting homeless, low income seniors, for the period of June
1, 2000 through June 30, 2002. (DPH contracted with ECS for a total of
$1,172,999 during FY 1998-99).
(3.4) PHP-CHS – Request for approval of a renewal contract with
Lifemark Corporation, in the amount of $360,899 per year, to provide
fiscal intermediary services to the Personal Assisted Employment Services
(PAES) program, for the period of July 1, 2000 through June 30, 2002, for
a total of $721, 798 for the two year period. (DPH contracted with
Lifemark for services totaling $1,955,088 during FY 1998-99).
(3.5) PHP-CHPP – Request for approval of a retroactive contract
modification with San Francisco Study Center (SFSC), in the amount of
$422,500, to provide support services to the Health Environmental Resource
Center (HERC), and the African American Health Initiative (AAHI),
targeting African Americans with asthma and/or cancer health concerns,
primarily in the San Francisco Bayview Hunters Point area, for the period
of January 1, 1999 through June 30, 2000. The contract total with this
modification equals $972,500. (DPH contracted with SFSC for services
totaling $1,620,515 during FY 1998-99).
(3.6) PHP-CSAS – Request for approval of retroactive contract
modification with Youth Leadership Institute (YLI), in the amount of
$549,962, to expand existing substance abuse prevention services and to
augment new early intervention and outpatient services targeting youth
between the ages of 12-17 years, for the period of March 1, 2000 through
June 30, 2001. The total four-year contract amount is $1,350,258, for the
period of July 1, 1997 through June 30, 2001. (DPH contracted with YLI for
services totaling $195,906 during FY 1998-99).
(3.7) PHP-CSAS – Request for approval of retroactive new contract
with YMCA of San Francisco, in the amount of $550,000, to provide
comprehensive substance abuse outreach, prevention, education and
counseling services through a youth center, targeting San Francisco youth
who are at risk for substance abuse, for the period of March 1, 2000
through June 30, 2001.
(3.8) PHP-CMHS – Request for approval of a new contract with
Calvin Y. Louise, CPA, for a maximum of $15,557, to provide fiscal
intermediary services for the $3,000,000 Community Mental Health
supplemental residential care facilities, for the period of July 1, 2000
through June 30, 2001.
(3.9) PHP-CMHS – Request for approval of sole source contract
renewal with Echo Consulting Services of California, Inc., in the amount
of $341,432, to provide maintenance and support services for the mental
health billing information software, INSYST, for the period of July 1,
2000 through June 30, 2001. (DPH contracted with Echo for services
totaling $189,270 during FY 1998-99).
(3.10) PHP-CMHS – Request for approval of sole source contract
renewal with InfoMC, in the amount of $143,500, to provide maintenance and
support services for the mental health managed care cCURA3 software, for
the period of July 1, 2000 through June 30, 2001.
Action Taken: The Commission approved the Consent Calendar of the
Budget Committee, with #3.1 being postponed to a future meeting.
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
Mayor’s FY 00-01 Budget
On May 31 the Mayor presented his FY 00-01 budget. The Mayor’s
proposed budget for DPH is $860 million. It includes all new initiatives
and programs in the base budget as approved by the Health Commission in
February. In addition it includes the following enhancements:
- SFGH psychiatric inpatient services - $3.0 million to maintain 92
acute psychiatric inpatient beds ($1.8 million in revenues, $800,000
in new General Fund and $400,000 transferred from Community Mental
Health Services other private psychiatric hospital funding).
- Population Health & Prevention Programs – $1.2 million for
children’s medical services, TB Control, STD, adult immunization,
laboratory, Records and Statistics, medical marijuana ID cards.
- Housing - $1.5 million for 92 long-term housing units for medically
fragile seniors and 50 units for psychiatric clients in need of
placement from institutional care.
- Mental Health - $3.7 million in new revenues primarily for mental
health services to children and youth.
- Substance Abuse - $700,000 in new General Funds for additional
Treatment on Demand and $600,000 in new revenues for 35 additional
methadone treatment slots and expanded youth substance abuse treatment
- $2.7 million in new General Fund to increase contractor salaries to
$9/hour and to provide cost of living increases to contractor
- Funding to maximize patient flow to the most appropriate level of
care - $700,000 of new General Funds.
- $500,000 in revenues for out-of-area managed care expenses for SFGH.
- Equipment - $4.0 million.
- Capital - $7.0 million for SFGH seismic and ADA projects, LHH fire
alarm replacement, Maxine Hall health center renovations, SFGH wound
care expansion and psychiatric ward upgrades.
- LHH replacement project - $3.5 million.
The Mayor’s proposed budget includes $248 million in General fund
support for DPH. This is a $15 million increase in General Funds from the
current year amount of $233 million. The Mayor’s proposed budget does
not include civil service salary MOU increases that are estimated to be an
additional $15 million. Taken together the General Fund increase over last
year will amount to approximately $30 million.
SFGH/Primary Care Bond Delayed
At the end of last week I received notification from the City's Capital
Advisory Infrastructure Committee (CAIC) asking that the Health Department
complete further planning on a SFGH/Primary Care Bond prior to submitting
it to the voters. Although our bond proposal received a lot of positive
feedback, several questions were raised as to how it fit into the
department's overall strategic mission and facilities plan.
Although we were disappointed that the bond proposal was not ready to
submit to voters this November, we do believe that we will be successful
in placing the proposal on the ballot in the near future. This additional
planning period will give us more opportunity to meld the capital plan
with our strategic plan. The background work that was put into the bond
proposal will form the nexus of our revised plan. Also, as I noted in my
report of next year's budget, we received $7 million for capital
improvements, which is a $2 million increase from last year. This will
enable us to proceed on some key capital projects.
Bayview Community Meeting
Over 200 people attended a Bayview-Hunters Point Community Meeting last
night at Providence Baptist Church to explore solutions to the gang
violence and drug activity affecting the neighborhood. The Reverend Calvin
Jones, and numerous other ministers including the Reverend Amos Brown
coordinated the meeting. DPH staff acted as facilitators for the breakout
groups. Both Jimmy Loyce and Tony Wagner were in attendance. The meeting
resulted in a number of recommendations including: organization of a
"youth sit" at Joseph Lee Recreation Center in mid-June,
encouraging more parent involvement, getting Bayview community
organizations to make contact with youth in need, and offering reentry
programs for individuals when they are released from prison.
Organizers spoke passionately stating that the violence the
neighborhood is experiencing is not just a Bayview problem, but it is a
city problem, a nationwide problem.
POPULATION HEALTH AND PREVENTION
Superior Court Hazardous Waste Violation Decision
On May 16th, 2000, San Francisco Superior Court Judge William Cahill,
issued a tentative decision on a hazardous medical waste violation at 490
Post Street, a medical and dental office building, imposing $1.1 million
in civil penalties against the property owner. Environmental Health
Section inspectors Seretha Warren and Jeff Nalle had found that Brugnara
Properties had repeatedly mixed hazardous medical waste with other solid
waste (garbage) and had illegally attempted to dispose of contaminated
medical waste without a valid permit. These activities, documented from
February 23, 1999 to November 20, 1999 jeopardized the safety of employees
handling the refuse. After the owner ignored our inspectors' multiple
attempts to resolve the violation, the City Attorney's Office brought a
lawsuit against the corporation. The investigations, actions, and thorough
documentation by environmental health staff were instrumental to both the
resolution of the hazardous situation and the success of the litigation.
Chlamydia and Gonorrhea Testing
From August 1999 through April 2000, men and women age 15-25 years who
had urine collected for clinical purposes at the SFGH Emergency Department
were also tested for chlamydia and gonorrhea. (ED patients are notified of
the program via posters at registration.)
Among the 234 women tested, 15 were subsequently treated for chlamydia
and 8 for gonorrhea. Among the 54 men tested, two were treated for
chlamydia, none for gonorrhea.
PH&P Personnel Recognized
Steven Tierney, Director of HIV Prevention, was elected to the Board of
Directors of the AIDS Alliance for Children Youth and Families at the
annual meeting in May. He was also elected Vice President of this national
organization for the next year.
Dr. Patricia E. Evans, Medical Director of Maternal and Child Health,
was selected to present at the Scientific Section of the Statewide
Maternal and Child Health Conference held in San Diego. Her paper entitled
"Foster Care Children and Managed Care: Determining Levels of
Risk" was presented on May 31, 2000.
COMMUNITY HEALTH NETWORK
Interim Chief Nursing Officer/Inpatient Director
I am pleased to announce the assignment of Joseph Pendon, RN, MSN, as
Interim Chief Nursing Officer/Inpatient Director effective June 12, 2000.
Joseph currently serves as Director of Medical Surgical Nursing at San
Francisco General Hospital Medical Center..
Joseph came to the hospital from Contra Costa Regional Medical Center.
In his ten years with them, he assumed multiple roles focused on inpatient
operations. As a Nurse Program Manager/Special Project support person and
as Director of Perinatal Services, Joseph was able to build upon his
managerial/leadership skills. Please join me in welcoming Joseph to the
SFGH leadership team.
On behalf of the Commission, President Guy presented a special
certificate of appreciation to Dolores Gomez, RN, MS, Associate
Administrator for Acute Care Services and Chief Nursing Officer for San
Francisco General Hospital Medical Center. She has taken a new position
with Kaiser South Bay as a Patient Care Team Leader. Dolores Gomez first
joined our organization as an Assistant Director of Nursing eight years
ago. Dr. Katz, Gene O’Connell, and Tony Wagner expressed their
appreciation for here administrative skills and patient care expertise.
Commissioner Umekubo expressed his concerns for the ambulatory care
facility and looks forward to a future ballot initiative in 2001.
Commissioner Sanchez pointed out the basic work has been done for the
bond and there may be creative ways to create total access.
Commissioner Hill stated the importance of moving ahead and continuing
to promote the bond.
President Guy sees this as an opportunity to go back and look at the
inclusion of school-based clinics and non-profits into the bond.
5) UPDATE ON IMPLEMENTATION OF HEALTH COMMISSION POLICY #24:
CONTRACTORS’ COMPLIANCE WITH ANTIDISCRIMINATION PROTECTION AND CULTURAL
Norm Nickins, Deputy Director of EEO, Affirmative Action, and Cultural
Competency, presented an update on the implementation of Policy #24. The
Department is requesting contractors to respond on an agency basis not a
program basis. So far, 10 final reports out of 175 contracting agencies
have been submitted. The deadline is June 30, 2000.
- State, Federal and Office of Minority Health all have materials and
definitions for cultural competency.
- Requested copy of community standards for provisions of quality,
health care services for lesbian/gay/bisexual, transgender clients.
- Requested update on the Department’s Civil Service programs’
compliance to Policy #24; the Department needs to have its own
internal objectives for cultural competency
- Requested the annual EEO report to include cultural competency
- Complimented the Department on the implementation of the policy;
very complex issue and not easy to implement with the different
programs and different ethnic groups
- The single point of contact helps to ease the burden on contractors
- Need to look at ADA cost factors for compliance
Dr. Katz pointed out that he has not received one complaint on the
revised Policy #24, in comparison to the complaints received on the
President Guy thanked Mr. Nickens for his update.
6) PRESENTATION OF THE POPULATION HEALTH AND PREVENTION COMPLIANCE
PLAN, UPDATE ON THE COMMUNITY HEALTH NETWORK COMPLIANCE PLAN, AND
CONSIDERATION OF A RESOLUTION FOR A DEPARTMENTWIDE COMPLIANCE POLICY
Dr. Katz pointed out the importance of functioning as one whole
Department. He promoted a single Departmentwide compliance policy with a
single compliance team, with the understanding that each Division may have
The Commission has already approved a policy for the Community Health
Network to create and implement a compliance program. This program has
been developed and is underway. The Population Health and Prevention
Division of the Department of Health has also begun compliance activities
consistent with Federal and State regulations.
Cynthia Bautista, Compliance Officer for PHP, and Diane Keefer,
Compliance Officer for the CHN, presented an update on the current
compliance plan and accomplishments in the area of compliance. For a copy
of the full presentation, contact the Commission Office (554-2666).
The report covered the following areas:
- What is Health Care Compliance?
- A History of Compliance in Health Care
- Operation Restore Trust (ORT)
- Outcomes of ORT
- Other Legislation Impacting Compliance
- Guidelines for Providers
- Seven Key Elements of Compliance Program
- Leadership commitment, including the designation of a chief
compliance officer, charged with operating and monitoring the
- Development of written standards of conduct, which include
policies and procedures that promote compliance
- The development and implementation of effective education and
- A process to receive complaints and procedures to protect
anonymity and go guard against retaliation
- Enforcement of compliance standards and the existence of
guidelines for disciplinary action when there are any violations
- The use of audits and evaluation techniques to monitor
- The investigation and remediation of identified problems and
policies addressing the hiring of new employees
- Compliance Efforts and Accomplishments
- Where the Department is Going with the Compliance Program
Commissioners complimented the Department for a comprehensive report
and pointed out the challenge in the implementation phase, and the
potential costs associated with this compliance program.
President Guy requested a progress report on the implementation of the
Compliance Program be presented to the Commission in January 2001.
Action Taken: The Commission (Guy, Umekubo, Hill, Parker, Sanchez)
#6-00, "Affirming the Commitment of the Health Commission and the
Department of Public Health to Compliance with all Applicable Federal,
State and Local Laws, and the Program Requirements of Federal, State and
Private Health Plans, and Directing the Department of Public Health to
Develop and Implement a Departmentwide Compliance Program."
7) OTHER BUSINESS/PUBLIC COMMENTS
The meeting was adjourned at 4:45 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission