Minutes of the Health Commission Meeting
the Health Commission Meeting
Tuesday, September 19, 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 P. Guy, MSW, at 3:20 p.m.
- 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 John I. Umekubo, M.D.
- Commissioner David J. Sanchez, Jr., Ph.D.
2) APPROVAL OF THE REGULAR MEETING OF SEPTEMBER 5, 2000
Action Taken: The Commission adopted the minutes of the
meeting of September 5, 2000.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner Ron Hill)
(3.1) CHN-Finance – Request for approval of a contract modification
to extend for six months a contract with Toyon Associates, Inc., to
provide reimbursement and revenue optimization services for San Francisco
General Hospital, Laguna Honda Hospital and Health at Home Agency, in
the amount of $222,133 for the period of October 1, 2000 through March
31, 2001, for a contract total of $560,664 for the period of October
1, 1999 through March 31, 2001. (DPH contracted with Toyon for services
totaling $338,531 during FY 1999-2000).
(3.2) CHN-Laguna Honda Hospital – Request for approval to accept
and expend new grant funds in the amount of $453,098 from the U.S. Department
of Health and Human Services, for construction of one of the two temporary
central power plants for the Laguna Honda Hospital replacement project,
for the period of August 2000 to September 2001.
(3.3) CHN-Pharmacy – Request for approval of a new contract
with RX Relief in the amount of $250,000, to provide as-needed
supplemental pharmacy personnel services, for the period of October
1, 2000 through June 30, 2001.
(3.4) CHN-Primary Care-YGC/SPY – Request for approval of a
contract renewal with St. Mary Pharmacy Management Services (SMPMS),
in the amount of $135,000, for the provision of as-needed pharmacy services
for clients of Youth Guidance Center and associated programs, for the
period of July 1, 2000 through June 30, 2001. (DPH contracted with SMPMS
for services totaling $3,853,509 during FY 1999-2000).
(3.5) CHN-Primary Care – Request for approval of a sole source
contract with Central City Hospitality House (CCHH), in the amount of
$531,505, to provide drop-in and self-help services for the homeless,
for the period of July 1, 2000 through June 30, 2001. (DPH contracted
with CCHH for services totaling $531,505 during FY 1999-2000).
Commissioner Hill stated this contract would be approved, with the
stipulation that an update be brought back to the Budget Committee in
two months (November 21st.)
(3.6) PHP-CSAS – Request for approval of a sole source contract
modification with Henry Ohlhoff House, Inc. (HOH), in the amount of
$166,360, to augment a new residential care substance abuse service
program targeting women with children and/or women who lost custody
of their children, and who are enrolled in the Personal Assisted Employment
Services (PAES) Program, for the period of July 1, 2000 through June
30, 2002. The total four-year contract amount is $631,257 for the period
of July 1, 1998 through June 30, 2002. (DPH contracted with HOH for
services totaling $149,881 during FY 1999-2000).
(3.7) PHP-CSAS – Request for approval of a contract renewal
with Latino Commission on Alcohol and Drug Abuse (LCADA), in the amount
of $463,590 per year, to a total four year contract of $1,854,360, to
provide residential substance abuse services targeting adult male Latino
residents of San Francisco, for the period of July 1, 2000 through June
30, 2001. (DPH contracted with LCADA for services totaling $509,353
during FY 1999-2000).
Commissioner Hill requested data on clients reflecting success of the
(3.8) PHP-HIV Prevention – Request for approval of a contract
renewal with Black Coalition on AIDS (BCOA), in the amount of $246,687
per year, for two years, for a total contract amount of $493,374, to
provide HIV prevention education and evaluation services, for the period
of July 1, 2000 through June 30, 2002. (DPH contracted with BCOA for
services totaling $822,098 during FY 1999-2000).
(3.9) PHP-HIV Prevention – Request for approval of a contract
renewal with Black Coalition on AIDS (BCOA), in the amount of $232,028
for FY 2000/01, and $228,028 for FY 2001/02, for a total contract amount
of $460,056, to provide HIV prevention education and evaluation services
for the period of July 1, 2000 through June 30, 2002. (DPH contracted
with BCOA for services totaling $822,098 during FY 1999-2000).
(3.10) PHP-HIV Prevention – Request for approval of a contract
renewal with Lavender Youth Recreation and Information Center (LYRIC),
in the amount of $104,291 per year, for two years, for a total contract
amount of $208,582, to provide HIV prevention services to youth between
ages of 12 and 24, for the period of July 1, 2000 through June 30, 2002.
(DPH contracted with LYRIC for services totaling $104,291 during FY
(3.11) PHP-HIV Prevention – Request for approval of a contract
renewal with San Francisco AIDS Foundation (SFAF), in the amount of
$514,955 per year, for two years, for a total of $1,029,910, to provide
HIV prevention services targeting men who have sex with men, for the
period of July 1, 2000 through June 30, 2002. (DPH contracted with SFAF
for services totaling $5,484,482 during FY 1999-2000).
- Tate Swindell, Act-Up S.F., spoke against approval of the contract;
critical of Director’s salary and no response to his public testimony.
(3.12) PHP-Housing – Request for approval of a new retroactive
contract with The Ark of Refuge, Inc., in the amount of $674,798, to
provide Transitional Housing Program services targeting Lesbian, Gay,
Bisexual, Transgender, Queer and Questioning Young Adults 18-23 years
of age, for the period of April 1, 2000 through June 30, 2001. (DPH
contracted with Ark for services totaling $353,822 during FY 1999-2000).
Marc Trotz, Director of Housing Services, reported on the ongoing efforts
with the neighbors with community meetings, input into the contract,
the formation of a community advisory committee to Dr. Katz, and addressing
- Anne Farrar opposed the approval of the contract and the contractor;
stated she is not a NIMBY; feels this program does not make sense.
- Judith Hoyem owns a home across the street from the facility; feels
facility is inappropriate for young people at risk; asked Commission
to scrutinize the budget for this contract.
- Joe Foster feels this is a misguided program; important to have
neighborhood interaction; asked Commission to look at the budget.
- Felix Smith is a new neighbor; concerned about services provided
to these youth.
- Debra Stein hosted a series of meetings as a pro bono mediator;
recognized all parties who have worked towards the contract; good
cross-section of neighbors who have participated; urged Commission
to validate the negotiation process by approving the contract.
- Brian Cheu;, LYRIC, gave background on the project and expressed
support for the project.
(3.13) CHSS – Request for approval of a retroactive renewal
of a sole source contract with the Regents of the University of California
San Francisco (UCSF), in the amount of $83,585, to provide SFFD Medical
Director services, for the period of July 1, 2000 through December 31,
2000. (DPH contracted with UCSF for services totaling $11,235,592 during
For #3.12, Commissioner Monfredini asked for clarification on meals being
brought in and the role of a pro bono lobbyist.
For #3.7, Commissioner Chow expressed concern for a 4-year contract since
it is a new start-up and recommended a 1-year contract. Phyllis Harding,
CSAS Director, concurred with the recommendation.
Action Taken: The Commission approved the consent calendar of
the Budget Committee, with #3.7 being a 1-year renewal.
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
Appointment of Jimmy Loyce to AIDS Office Director
It gives me pleasure to announce today that James ("Jimmy")
Loyce, has accepted the position of Director of the AIDS Office. As the
Commission is aware, Jimmy has extensive experience in developing and
administering HIV/AIDS services and prevention interventions. He served
as the Associate Director of the AIDS Office from 1991 to 1994. From 1994
to 1998 he was the Executive Director of the AIDS Program for Los Angeles
Increasingly, the Department has recognized the importance of providing
HIV prevention services for HIV positive people. We have also recognized
the importance of providing health services, such as substance treatment
and mental health, to persons who are HIV negative so that they can stay
negative. Given this, our separation of HIV/AIDS into separate divisions
of Health Services and Prevention no longer is appropriate. Also with
so many reports of increasing episodes of unsafe sexual behavior I felt
it was crucial for the Department to have greater focus around HIV/ AIDS
issues. I can’t imagine anyone who can better provide that focus than
Jimmy will retain the title of Deputy Director of Health for AIDS Programs.
He will continue to report directly to me as a way of ensuring that HIV/AIDS
issues have the highest prominence in the Health Department.
Federal Guideline on Language Assistance to Persons with Limited English
In late August, the U.S. Department of Health and Human Services issued
a written policy guidance to assist health and social services providers
in ensuring that persons with limited English skills can effectively access
critical health and social services. This was done under DHHS’ Office
for Civil Rights (OCR) which by law is responsible for ensuring compliance
with the law. The guidance is a result of President Clinton’s Executive
Order 13166 that addresses serving persons with limited English skills.
The executive order requires each federal agency to have written policies
on providing effective service to those with limited English proficiency
who are served by federally funded programs.
The guidance outlines the legal responsibilities of providers who receive
federal financial assistance from DHHS -- such as hospitals, HMOs and
human service agencies -- to assist people with limited English skills.
The guidance emphasizes that providers have flexibility in designing effective
programs to meet the language needs of the nation's increasingly diverse
populations. Some of the state-administered programs where access for
persons with limited English proficiency may be especially important include
the State Children's Health Insurance Program (SCHIP), Medicaid and Temporary
Assistance to Needy Families (TANF).
DHHS has informed states of the new policy that is designed to enhance
the nation’s "ability to reach our national goal of eliminating racial
and ethnic disparities in health, and will assist in increasing opportunities
for persons with limited English proficiency to improve their socioeconomic
status." As outlined in the guidance, satisfactory service to limited
English proficient clients should include:
- having polices and procedures in place for identifying and assessing
the language needs of the individual provider and its client population;
- a range of oral language assistance options, appropriate to each facility's
- notice to LEP persons of the right to free language assistance;
- staff training and program monitoring; and
- a plan for providing written materials in languages other than English
where a significant number or percentage of the affected population
needs services or information in a language other than English to communicate
This guidance will be provided the program managers within both the Community
Health Network and Population Health and Prevention. In addition it will
be provided to our Affirmative Action/EEO Director, Norm Nickens. I fully
endorse the federal government’s most recent guidelines and will work
to ensure that they are implemented within the Department of Public Health.
POPULATION HEALTH AND PREVENTION
Hunters Point Shipyard Parcel E Land Fill Fire
On August 16, DPH staff participated in the response to a fire at the
Parcel E landfill on Hunter’s Point Shipyard in the context of our role
in assessing health risks due to hazardous materials incidents. DPH staff
made recommendations to ensure the safety of firefighters and ensured
CCSF staff working downwind of the fire. Since our understanding was that
the fire was limited to the surface vegetation and would be contained
shortly, DPH did not consider additional evaluation was required at the
On September 11th DPH learned from a Navy fact (released September
8th, 2000) that areas of the fire were still smoldering underground
and because of the potential for hazardous materials releases the Navy
had initiated air, soil, and water samples on September 8th.
While DPH does not have regulatory responsibility of the site, we do
want to be able to effectively evaluate risks to residents in the community
and workers on the shipyard. While it is challenging to evaluate risks
given that it is unknown what is burning, dilution of smoke, the direction
of prevailing winds, and the mixed use nature of the landfill all indicate
that health risks to San Francisco residents are likely to be minimal.
DPH has requested that analytical results from the air sampling be forwarded
to us as soon as available. Preliminary review of one air-monitoring sample
did not reveal the presence of any unusual or concerning exposures. The
navy currently plans to manage the remaining smoldering areas by installing
a "cap" to suffocate the fire. We will continue to obtain information
from the Navy and the EPA as it becomes available in order to best assess
the risks to San Francisco residents and employees.
Community Health Epidemiology
Community Health Epidemiology and Disease Control has been awarded a
three-year CDC grant to integrate hepatitis prevention and control activities
into existing prevention services. The primary focus will be on hepatitis
C prevention and control. The project director will be Dr. Tomas Aragon.
CHP&P Awarded Grant
I am pleased to announce that CHP&P was recently awarded a 2-year
$800,000 grant from the State’s Office of Traffic Safety for its proposal
to utilize a community-based mini-grant program to improve traffic and
pedestrian safety in San Francisco. This mini-grant will expand traditional
traffic safety participation to include a broader range of community members,
community-based agencies and other partners to plan, implement and evaluate
innovative solutions to pedestrian and traffic safety challenges.
The Changing Face of Women's Health, a national exhibition, makes its
San Francisco Bay Area debut October 7th at the Exploratorium.
This exhibition makes a dramatic statement in terms of just how far women's
health has come and allows a woman to identify her individual risk factors.
Funded by the Centers for Disease Control and Prevention, the National
Institutes of Health, metropolitan Life Foundation and Pfizer Women's
Health, this exhibition is the first major touring presentation dedicated
solely to the latest scientific information about women's issues. This
exhibition embraces the concept that women's health issues are created
and shaped by society, biology and personal behavior.
Exploratorium Museum staff have worked extensively with local women's
health providers to develop a local imprimatur on this national exhibit
which should prove exciting and informative.
The Neighborhood Health on Wheels Van (N'HOW) has begun operation. The
N'HOW Van is part of the Prevention for HIV Positives Demonstration Project
within the HIV Prevention Section. N'HOW provides access to HIV, STD and
Hepatitis testing services, urgent medical care and HIV Prevention education,
counseling and referral services.
N'HOW is designed to bring services to individuals at high risk for HIV
infection, where they reside. The current operation is located in the
Polk Gulch area and has been very successful in attracting new clients,
providing them counseling and testing services and referring them to primary
care and related services.
Future sites will include the Mission, Bayview-Hunters Point, the Western
Addition and the Castro. N'HOW is staffed by a Nurse Practitioner, a Physician-Medical
Director and three Health Workers. This project is expected to identify
individuals in need of medical care and build the bridges they need to
get them to Community Health Centers and other DPH programs. For more
information, please call James Rapues at 554-9131.
STD Prevention and Control
Last month, the STD Program pilot tested the feasibility of postal screening
for chlamydia and gonorrhea. As of mid August, approximately 500 kits
were distributed either through the mail or were picked up at two popular
community based locations (Walgreen’s and Gold's Gym) in a predominantly
MSM area of the City. To date, approximately 100 specimens (20%) have
been returned for testing. Results on 42 of the 100 specimens yielded
one positive for GC and two for CT, for a positivity rate of 7.1%. Results
of the screening have been so favorable that Walgreen’s has indicated
that they would be willing to continue to have them available on site
and one of the City's sex clubs, Blow Buddies, has indicated an interest
in making them available to their clients.
COMMUNITY HEALTH NETWORK
Laguna Honda’s Annual Survey Begins
On September 11th a team of seven State Licensing and Certification
Surveyors arrived unannounced at Laguna Honda to initiate the annual recertification
survey. Six additional Surveyors, including specialists in Acute Services,
Pharmacy, Nutrition and Medical Records have now joined the State team.
The Surveyors reported that they expect to continue their survey process
through this week. I will advise the Commissions of the date and time
of the exit conference.
Laguna Honda Replacement Project Planning Process Begins
Michael Lane, representatives from the Executive Architecture Team, Tony
Wagner and staff will initiate the LHH Replacement Project Planning process
by convening a public information meeting on Thursday, September 18th
at 7:00pm at St. John’s Church, 501 Laguna Honda Boulevard. This meeting
will provide an overview of the planning process, project schedule, and
a question and answer session. This meeting will be the first of many
opportunities for the public to provide input into the planning process.
The week of September 25th, the project team will make similar
presentations to LHH residents, volunteers and staff.
I have asked the Project Team to provide a comprehensive status report
at the Laguna Honda Commission meeting November 7th.
Conference on Community-Based Long Term Care
The CHN Division of Primary Care and Laguna Honda Hospital are collaborating
on a conference entitled "Community-Based Long-Term Care. The Role
of the Primary Care Provider", to be held on October 6th
at Laguna Honda. Presented by the California Association of Long-Term
Care Medicine, other collaborators include the California Geriatric Education
Center, the Stanford Geriatric Education Center, the Goldman Institute
on Aging and On Lok. The conference will focus on practical tool and decision-making
framework developed to help physicians and other health professionals
link patients to community-based long-term care services.
Positive Health Program Receives State Support
Congratulations to the staffs of the Positive Health Program and the
AIDS Research Institute (ARI) who received a $1.25 million funding in
a special ceremony held in the SFGH Comfort Garden last week. California
State Assemblyman Kevin Shelley presented the check to Dr. Volberding.
The funds will be distributed among ARI programs including the clinical
and research programs on Ward 86.
Chinese Women Support Group from Chinatown Health Center
The Chinese Women Cancer Support Group at Chinatown Public Health Center
was identified on the Website and interviewed by a journalist in Hong
Kong doing a story on breast cancer. This is an excellent exchange of
ideas and program information and sharing experiences of Chinese women
living with breast cancer in the United States with people abroad.
SFGH Credentials Report
Changes in Privileges
- David Pasquarelli, Act-Up S.F., described deaths of Gay men from protease
inhibitors; believes HIV does not cause AIDS and AIDS is over; submitted
a letter to Charlotte Kent, STD Prevention and Control, regarding data
on male rectal gonorrhea.
- Todd Swindell, ACT-UP S.F., believes HIV is theoretical; described
stereotypes of Gay men; Gay men have been vilified.
- Mike Petrelis, AIDS Statistics.Com, submitted the HIV Prevention Strategic
Plan Through 20005; stated Gay men should practice safe sex; San Francisco
is HIV hypocritical, no numbers reported on rectal gonorrhea; why is
the Department not giving numbers?
Commissioner Chow commended the Department for continuing to be in the
forefront of AIDS/HIV.
Commissioners congratulated Jimmy Loyce for his new area of responsibilities.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION
AWARDS FOR SEPTEMBER 2000
On behalf of the Commission, Commissioner Parker presented the award
Jean Cruz-Holdaway, CHN
Tom Waddell Health Center
Damon Eaves, MSW,
Health Worker II
Homeless Outreach Program (Hope)
Coordinator, Hope Team
6) CONSIDERATION OF A RESOLUTION DETERMINING WHETHER THE SUSPENSION
OF THE LICENSE FOR 20 ACUTE CARE BEDS AND INPATIENT/OUTPATIENT SURGERY
AT PACIFIC COAST HOSPITAL WILL OR WILL NOT HAVE A DETRIMENTAL IMPACT ON
THE HEALTH SERVICE OF THE COMMUNITY
Audrey Magneson, representative of Pacific Coast Hospital, was present.
Action Taken: The Commission unanimously adopted Resolution #11-00,
"Determining Whether the Closure of 20 Acute Care Beds and Inpatient/Outpatient
Surgery at Pacific Coast Hospital Will or Will Not Have a Detrimental
Impact on the Health Care Service of the Community."
7) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH DENTAL SERVICES
Samantha Stephen, MS, RDH, Director of Dental Services, presented an
Overview of the Department’s Dental Services.
- Commended staff for a comprehensive report
- Acknowledged the first Oral Health Report from the Surgeon General
and the first time a Dental Services presentation was calendared for
the Commission agenda
- Encouraged the Department to have a liaison with the School District
for dental services
- Policy issue is how the Department and Commission view dental services
and health services
- Emphasized need to outreach to private dentists and the challenge
to serve the homeless population
- Suggested periodontists serve children
- Oral health should be integrated into overall health
- Fluoridation needs to be supported
- Integrate oral health into the Department’s Strategic Plan
- Need to educate physicians and re-educate dentists
8) PRESENTATION AND CONSIDERATION OF A RESOLUTION FOR RED LIGHT RUNNING
Dr. Larry Meredith, Director of Community Health Promotion and Prevention,
presented an overview of the Stop Red Light Running Program.
The following persons involved in collaborative efforts for the program
were introduced: Bridget Smith, Director, Livable Streets, Department
of Parking and Traffic; David Valle-Schwenk, Coordinator, Red Light Photo
Enforcement Project, Department of Parking and Traffic; Quijuan Maloof,
Stop Red Light Running Program, CHP&P; and Kevin Camora, Pedestrian
Survivor and Advocate
Kevin Camora, small business owner and video producer, showed a video
on a pedestrian fatality case.
Action Taken: The Commission unanimously adopted Resolution #12-00,
"Endorsing Stop Red Light Running Week."
9) OTHER BUSINESS/PUBLIC COMMENTS
10) PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION
The Commission went into closed session at 5:30 p.m. and came out at
Individuals in the closed session were Commissioners Guy, Umekubo, Chow,
Hill, Monfredini and Sanchez.
11) CLOSED SESSION PURSUANT TO GOVERNMENT CODE SECTION 54957
AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.10(b):
PUBLIC EMPLOYEES PERFORMANCE EVALUATION:
- DIRECTOR OF HEALTH, DR. MITCH KATZ
- EXECUTIVE SECRETARY TO THE HEALTH COMMISSION, SANDY OUYE MORI
12) RECONVENE IN OPEN SESSION:
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 discussions
held in closed session.
The meeting was adjourned at 6:35 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission