Minutes of the Health Commission Meeting
Tuesday, January 30, 2001
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 3:10 p.m.
Commissioner Edward A. Chow, M.D.
Commissioner Roma P. Guy, M.S.W.
Commissioner Lee Ann Monfredini
Commissioner Harrison Parker, Sr., D.D.S.
Commissioner David J. Sanchez, Jr., Ph.D.
Commissioner John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING
OF JANUARY 9, 2001 AND THE SPECIAL MEETING OF JANUARY 16, 2001
Action Taken: The Commission adopted the
minutes of January 9 and 16, 2001
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET
(Commissioner David J. Sanchez, Jr., Ph.D.)
(3.1) PHP-AB75 Project – Request for
supplemental appropriation in the amount of $1,203,219 in State
Emergency Medical Services Appropriation (EMSA) funds to pay for
emergency physician services pursuant to Senate Bill 2132, for FY
(3.2) PHP-Housing and Urban Health –
Request for approval of retroactive contract renewal with Baker Places,
Inc., in the amount of $737,839, to provide mental health and substance
abuse services targeting formerly homeless tenants of eight SRO hotels,
for the period of July 1, 2000 through June 30, 2001.
(DPH contracted with Baker for services totaling $11,110,692
during FY 1999-2000).
(3.3) PHP-Housing and Urban Health –
Request for approval of a new sole source contract with Self Help for
the Elderly, in the amount of $50,000, to assist in the provision of
residential care facility housing, for the period of February 1, 2001
through June 30, 2001.
(3.4) AIDS Office-HIV Prevention – Request
for approval of a contract renewal with Black Coalition on AIDS (BCOA),
in the amount of $86,379, to provide HIV prevention services targeting
high-risk African American transgender persons, for the period of
January 1, 2001 through December 31, 2001.
(DPH contracted with BCOA for services totaling $373,912 during
(3.5) PHP-Community Health Promotion and
Prevention – Request for approval of a retroactive sole source renewal
contract with NICOS Chinese Health Coalition, in the amount of $65,000,
to provide problem gambling prevention services in the Chinese
community, for the period of July 1, 2000 through June 30, 2001.
(DPH contracted with NICOS for services totaling $50,000 during
(3.6) PHP-CMHS/CSAS – Request for approval
of a retroactive multiyear contract renewal with the Homeless Prenatal
Program (HPP), in the amount of $101,977 per year, for a four-year total
contract amount of $407,908, to provide outreach and case management
services targeting poor and homeless pregnant women and/or
substance-abusing women with children, for the period of July 1, 2000
through June 30, 2004. (DPH
contracted with HPP for services totaling $112,262 during FY 1999-2000).
(3.7) PHP-CMHS – Request for approval of a
retroactive multiyear contract renewal with Seneca Center for Children
and Families, in the amount of $2,052,763 per year, for a four-year
total contract amount of $8,211,052, to provide mental health
residential services and day treatment services targeting seriously
emotionally disturbed adolescents, for the period of July 1, 2000
through June 30, 2004. (DPH
contracted with Seneca for services totaling $1,193,413 during FY
(3.8) PHP-CSAS – Request for approval of a
retroactive multiyear contract renewal with Westside Community Mental
Health Center (WCMHC), in the amount of $1,916,198 per year, for a
four-year total contract amount of $7,664,792, to provide substance
abuse services, for the period of July 1, 2000 through June 30, 2004.
(DPH contracted with WCMHC for services totaling $9,784,090
during FY 1999-2000).
(3.9) CHN/SFGH, HAH AND LHH – Request for
approval of two new contracts with the following firms:
On-Call Therapists, Inc. and Preferred Healthcare Registry, Inc.,
for a combined total amount of $259,160, to provide intermittent,
as-needed rehabilitation therapy personnel services (Physical,
Occupational and Speech Therapists) for the Community Health Network,
for the period of February 1, 2001 through January 31, 2003.
(3.10) CHN/SFGH, HAH AND LHH – Request for
approval of a new sole source contract with Physical and Occupational
Therapist’s Registry, Inc. (POTR), in the amount of $244,600, to
provide intermittent, as-needed rehabilitation therapy personnel
services (Physical, Occupational and Speech Therapists) for the
Community Health Network, for the period of February 1, 2001 through
January 31, 2003. (DPH
contracted with POTR for services totaling $78,000 during FY 1999-2000).
Taken: The Commission approved the consent calendar of the Budget
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
HIV Consensus Meeting, Preliminary Report
On January 19th Mayor Brown convened a group of two dozen
researchers and AIDS experts to review current studies and data to
determine the HIV prevalence and incidence rates for the behavioral risk
populations of San Francisco. In a draft report, the group estimates that
the rate of new HIV infections among men who have sex with men (MSM), MSM
who are also injection drug users (IDU) and Transgender male to female (MTF)
is 2.2 percent, up from 1.04 percent in 1997. This translates into 748 new
infections projected for this year. The document is currently under public
The IDU/Heterosexual Consensus Meeting is slated to take place next
month. Upon the conclusion of this next Meeting, a similar Consensus
Document will be produced and undergo the same process before both
documents are integrated and officially released. A copy of the draft HIV
Consensus Data for MSM, MSM IDU and Transgender MTF will be given to all
Commissioner’s and is available to the public at HIVINSITE.UCSF.EDU.
Summary of the Governor’s 2001-02 Budget
On January 10, 2001, the Governor proposed a $102 billion budget. This
represents an increase of $7.5 billion over last year. With a $10.3
billion surplus, the budget assumes $2.3 billion less resources in the
upcoming year, and, therefore, proposes to spend the remaining $8 billion
primarily on education and energy, but also for tax cuts, and to maintain
a budgetary reserve.
With the exception of the Healthy Families program, most of the
policy-related increases in the non-education portion of the budget are
for one-time purposes, such as a $1 billion set aside for the energy
initiative, fiscal relief to local governments, new housing, and air and
water quality projects. While the Governor continues his commitment to
long-term care with modest increases to his Aging with Dignity Initiative,
most of the budget augmentations in health care are attributable to
caseload increases under current guidelines rather than new policy
The Governor has allocated $21.6 billion in General Fund (GF) dollars
for health and human services for 2001-02. This represents an increase of
$1.3 billion over 2000-01 funding levels. However, in 2000-01, health and
human service expenditures represented 27.5% of the total GF budget, while
in 2001-02, they represent 26.1% -- a decrease of 1.4%.
Summary of Major Health-Related Provisions
Tobacco Settlement Funds
The Governor’s budget proposes using all current and future Tobacco
Settlement funds for health care programs. In 2001-02, the State expects
to receive $468 million in Tobacco Settlement funds. Setting aside $23
million in reserves, the Governor plans to spend approximately $445
million for the Healthy Families and Medi-Cal programs, the Child Health
and Disability Prevention Program (CHDP), breast and prostate cancer
treatment, and a youth anti-smoking program. Unfortunately, however, the
Governor is using Tobacco Settlement funds to supplant State General Fund.
As a result, the State’s General Fund commitment to health services will
decrease between 2000-01 and 2001-02. The General Fund commitment to Medi-Cal
alone is proposed to decrease by $132 million.
There are no policy changes for Medi-Cal eligibility in 2001-02. The
approximately $500 million ($215 million GF; $170 million Tobacco
Settlement funds; $115 million federal) in budget increases for 2001-02
are attributable to policy changes the Governor made in fiscal year
2000-01, such as: expansion of Medi-Cal for working families, working
disabled, and the aged, blind or disabled; continuous eligibility for
children; and elimination of quarterly status reports.
Pursuant to a legal settlement, the Governor’s budget provides $64.2
million (GF) to increase reimbursement rates for hospital outpatient
services by 30% effective July 1, 2001. However, as the Department’s
outpatient services are provided under federally qualified health centers
(FQHCs), these rate increases will not impact the Department. The
Governor’s budget does not include the $350 million lump sum settlement
amount for retroactive payments for outpatient services provided between
1992 and 2001. San Francisco will receive only a small portion of that
amount since obtained it obtained FQHC status in 1995 and, therefore, does
not qualify for settlement funds beyond that date. The budget continues a
program to pay Medicare managed care premiums for Medi-Cal eligibles and
maintains funding for ancillary medical services for persons in Institutes
for Mental Disease.
The Governor includes $181.4 million ($91 million GF) in his budget to
continue funding for the 9.2% rate increase for two-plan model rates
effective October 2000.
To continue with the anti-fraud efforts initiated in 2000-01, the
Governor includes $1.4 million ($697,000 GF) to make permanent anti-fraud
initiatives, such as stringent provider enrollment, expanded field audit
activities, increased penalties; and onsite review of laboratories.
The largest increase in health care is the $201.5 million ($115.3
million federal funds; $76.1 million Tobacco Settlement; $0.6 million GF)
expansion of the Healthy Families program to include parents of children
eligible for Healthy Families and Medi-Cal for Children with incomes up to
200 percent of poverty. Healthy Families expenditures proposed for 2001-02
represent a $333 million increase from the 2000-01 budget to serve an
561,000 children, (106,000 more than last year) with incomes up to 250% of
poverty. The budget also includes $3.1 million ($631,000 GF) for caseload
increases for mental health services.
The Governor’s budget includes an increase of $1 million (GF), for a
total statewide allocation of $3 million, for public health subvention.
This will mean a minimal increase, from $24,000 to $27,000, for San
Francisco to perform its core public health functions, such as
communicable disease control and surveillance and activities.
The General Fund contributions for HIV/AIDS services are budgeted at
the same levels as last year. The $5.1 million increase for the AIDS Drug
Assistance Program to maintain caseload and program cost increases are
proposed using federal CARE Act Title II funds.
In the area of prevention, the budget includes: $20 million (one-time
federal funds) for the Community Challenge Grant Program to reduce teenage
and out-of-wedlock pregnancies; $20 million (Tobacco Settlement) for a
teen anti-smoking campaign; $4 million (Prop 10) for the Childhood Asthma
Initiative; and, $1.1 million for the Lead Poisoning Prevention Program.
As Californians continue to use fewer tobacco products each year,
revenues for 2000-01 are estimated to decline $11.9 million below the
2000-01 budget level to $360 million. For 2001-02, revenues are estimated
to decline by an additional $5 million to $355 million. The budget
releases $11 million in litigation reserves, which partially offsets the
$16.9 million decline in revenues estimated between 2000-01 and 2001-02,
for the anti-tobacco media campaign. The proposed budget continues $24.8
million for emergency room physician and specialists under the California
Healthcare for Indigents Program (CHIP). No further relief is provided,
however, to ensure indigent health care services under CHIP. The budget
also includes $11 million, an increase of $4.7 million over 2000-01, for
increased caseload in the Access for Infants and Mothers (AIM) program,
and $11.5 million for increased caseload in the Breast Cancer Early
Detection program and a funding shortfall in the Breast Cancer Control
Account. $65 million in funding for CHDP is shifted from Proposition 99 to
the Tobacco Settlement Fund.
Nearly all of the funding allocated to environmental health issues is
for State-level programs rather than programs operated at the local level.
The budget includes State-level funding for clean beaches, pesticide
regulation and radiation control.
The Governor’s budget includes $55.6 million to continue, on an
ongoing basis, funding for AB 34 programs for the homeless mentally ill.
This will ensure continued funding of $2.3 million for the Department for
outreach and integrated services for homeless mentally ill. The budget
also includes a $21.2 million ($20.2 million GF) increase for caseload
growth and provider rate increases for psychiatrists and psychologists in
the Mental Health Managed Care program and $12 million (federal funds) to
fund Therapeutic Behavioral Services as a Medi-Cal benefit.
Alcohol and Drug Programs
The Governor included the $120 million (GF) designated in Proposition
36 for substance abuse treatment for non-violent drug possession offenders
and also included $20.9 million ($10.2 million GF) for Drug Medi-Cal
caseload increases and to fund the relapse prevention program created in
Aging with Dignity
The Governor’s budget includes funding to continue components of the
Aging with Dignity Initiative he introduced in 2000-01, such as nursing
home quality assurance and the Senior Wellness Campaign. The budget also
includes $1 million ($508,000 GF) to develop an assisted living waiver,
pursuant to AB 499 of 2000, and $1 million ($500,00 GF) for the
development of an assessment tool to identify individuals who qualify for
long-term care in a community setting.
Categorical Health Programs
For uninsured or underinsured individuals with incomes below 200
percent of poverty, the budget includes an increase of $10 million
(Tobacco Settlement), for a total of $20 million, for prostate cancer
treatment, and $20 million for breast cancer treatment.
Federal Health Insurance Portability and Accountability Act (HIPAA)
In order to facilitate compliance with the privacy regulations of the
federal Health Insurance Portability and Accountability Act (HIPAA), the
Governor’s budget includes $22.4 million ($3.9 million GF) for the
Departments of Health Services, Mental Health, and Alcohol and Drug
Programs and the Office of Statewide Health Planning and Development.
COMMUNITY HEALTH NETWORK
San Francisco General Hospital Bond Proposal Planning Process (SFGHBPP)
The SFGHBPP had a successful Kick-off last Wednesday. Gene O’Connell
and the CHN staff from SFGH and the CHN Planning Office did an outstanding
job in getting this planning process started. The process is being
patterned after the very successful LHH bond proposal planning process. As
with LHH, City Attorney, Louise Rene and myself are Co-Chairs of the
overall planning committee. Three sub-committees have been established:
Program – Gene O’Connell, Chair; Finance - Ken Jensen, Chair and
Technical – Carlos Villallva, Chair. All committees have broad-based CHN
and Community representation. The sub-committees began meeting this week.
Recommendations from the planning process are scheduled to go to the
Health Commission on March 20th and the Capital Improvement
Advisory Committee on March 21st. We will again report on the
progress of the planning process at the February CHN Joint Conference.
Laguna Honda Hospital Replacement Project (LHHRP)
As we move forward in our planning for the LHHRP, we are mindful of the
necessity of including ample network representation in addition to the LHH
staff. Particularly, now that the City has embarked on a replacement bond
planning process for San Francisco General Hospital (SFGH) it is
imperative that quality communication occurs between both planning
processes. In that regard, Ken Jensen and Larry Funk met with
representatives of LHH and SFGH last week to discuss those services that
may lend themselves to physical space and operational consolidation on a
single site, whether at SFGH, LHH or at an off site location. Some of the
areas under discussion include Materials Management, Central Supply, Food
Services, and accounting. These reviews will continue over a short period
of time until we make a decision regarding the physical placement of these
services. Efficient use of time is critical to maintain the financial
viability of this project. We will continue to work with the Project
Manager, Michael Lane, Larry Funk and the Architects in bringing this
project to fruition. We have scheduled an advisory group meeting for
February 7, 2001, at 7:00 PM at Laguna Honda Hospital Resident’s Library
located on the 3rd floor of the main building.
Integration of LTC Pilot Project Task Force with the Department of
Aging and Adult Services.
On January 19, 2001, the LTC Pilot Project Task Force reviewed issues
related to the integration of its activities with the new Department of
Aging and Adult Services (DAAS). The intention is to operate planning
activities of the LTC Pilot Project Task Force and DAAS as one integrated
effort and a. transition plan to integrate all planning activities is now
being developed. DAAS will expand the Commission on the Aging into the
Commission on Aging and Adult Services. Additional Commission slots will
be added: long-term care (2 slots); younger disabled adults (1 slot);
veterans affairs (1 slot); and dependent adults (1 slot).
Short-Term Stay Program s Beginning at Laguna Honda
This month Laguna Honda Hospital will begin implementing the
"Short-Term Care Program: Expediting Reentry to the Community."
Short-Term Care is a program providing services to individuals who
demonstrate potential for discharge within 90 days from time of admission,
utilizing rehabilitation interventions and early, aggressive discharge
planning. The Short-Term Care Program will be the first of several LHH
efforts this year to promote early discharge and independent functioning,
and should expedite patient flow through the CHN.
Pharmacy Transition Update
Complete data for the first two weeks of PBM operation (November 16 –
30, 2000) indicate that a total of 2,711 prescriptions were filled for
uninsured CHN patients by 77 community pharmacies located in San Francisco
during that period. In December, 93 community pharmacies were utilized to
fill 6,695 prescriptions. 31% of the prescriptions filled in the community
were filled in independent pharmacies, 48% were filled in a Walgreens
Pharmacy, and the remainder was filled in other chain pharmacies.
In December 2000, the pharmacy at SFGH experienced a drop in total
prescription volume of approximately 29% when compared to the average for
the three months preceding PBM implementation. The average weekday
prescription volume also declined to 823 (from pre-PBM averages of 1100
– 1150.) However, the volume of prescriptions filled at SFGH for
uninsured CHN patients, combined with the volume of prescriptions filled
by the PBM pharmacies, remained the same as it was prior to PBM
implementation. This finding may be interpreted as an indication that the
PBM is continuing to serve uninsured CHN patients. It is anticipated that
the SFGH pharmacy will be able to achieve its goal of wait times
consistent with the community standard (30-40 minutes) for the majority of
patients when the average daily prescription volume is 500 or less.
POPULATION HEALTH AND PREVENTION
Campaign Nominated for GLADD Media Award, 2001
We have been informed that the "HIV STOPS WITH ME"
campaign--sponsored by the Department's HIV Prevention for Positives
Project--has been nominated for a prestigious national media award by Gay
and Lesbian Advocates and Defenders (GLADD)--a major media watchdog
The HIV Stops With Me campaign is an excellent example of the benefits
of public-private partnerships for health education and community service.
Congratulations to Charles Klein, Project Manager, Mike Shriver
(former) Community Advisory Board Chair and our partners at Better World
Advertising. More information about this project can be found on the
African American Health Initiative
The Department's African American Health Initiative participated in the
first health fair held in conjunction with the Martin Luther King Birthday
Celebration at Bill Graham Auditorium. The event was an excellent
opportunity to address the health disparities that impact the African
American Community. Staff was on hand with outreach and information on
breast and cervical cancer, domestic violence, HIV programs and prostrate
cancer. The Adult Immunization Program gave out free flu shots. The health
component was co-sponsored by Kaiser Permanente and The Glide Foundation.
Thanks to Cynthia Selmar for coordinating these efforts.
Community Health Promotion and Prevention
In observance of Child Passenger Safety Week (Feb 11-17), a free car
seat inspection will be held at Gate 5 of the Cow Palace on Sataurday,
February 10 from 9 AM to 2 PM. Trained car seat checkers from San
Francisco, San Mateo and Santa Clara counties will help families determine
the appropriate seat for their children and vehicles, and position the
seats correctly. Call (650) 991-8106 for an appointment. Drive-ins will be
seen on a first come, first served basis.
Housing and Urban Health
The Department hosted a Regional Heroin Overdose Working Group on
January 22. Representatives from Seattle, Portland, Salt Lake City, New
Mexico, Santa Cruz and San Francisco participated. Data, programs,
policies and successes were presented. Future collaborations were planned
with the goal of reducing deaths due to heroin overdose, the third leading
cause of years of lost life in San Francisco.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH
EMPLOYEE AWARDS FOR JANUARY 2001
On behalf of the Commission, Vice President Umekubo
presented the awards to the following:
Stephanie Feldman, Physical Therapist
Rehabilitation Department SFGH
Vinita S. Levet, PT
Evita Mullins, Nurse Manager
CHN – Primary Care
Michael Drennan, MD Center Director, and staff
Nursing – SFGH
Gene O’Connell, Executive Director, SFGH
Note: Stephanie Feldman was unable to attend.
6) ELECTION OF THE PRESIDENT AND VICE PRESIDENT OF
THE HEALTH COMMISSION FOR 2001
Commissioner Chow nominated Commissioner Guy for
re-election as President of the Commission.
Action Taken: The Commission unanimously
re-elected Commissioner Guy as President.
Commissioner Umekubo nominated Commissioner Chow for
Vice President of the Commission.
Action Taken: The Commission unanimously
re-elected Commissioner Chow as Vice President.
President Guy stated the assignments for the Joint
Conference Committees will be announced at the February 6, 2001 meeting.
President Guy announced that the Mayor has appointed
Arthur M. Jackson, who is the President of the Commission on the Aging and
a former Health Commissioner, to serve the remaining term of former Health
Commissioner Ron Hill. Commissioner
Jackson will attend the February 6, 2001 meeting.
7) PRESENTATION ON OPTIONS FOR ACHIEVING UNIVERSAL
HEALTH INSURANCE COVERAGE IN SAN FRANCISCO AND CONSIDERATION OF A
Tangerine Brigham, Director of Policy and Planning,
gave an overview of options for achieving universal health care coverage.
The document outlines additional steps that can be pursued to
achieve the City and County’s goal of universal health care.
Specifically, this document recommends developing a health
insurance program that provides coverage to uninsured children (0-18 years
of age) who are: (1) ineligible for State and Federally-funded health
insurance, and (2) have family incomes at or below 300% of the Federal
Supervisor Mark Leno, Chairman of the Board of
Supervisors Finance Committee, indicated his high priority along with his
Board colleagues for children’s health care coverage.
He would work with the Commission and the Department on this very
Deborah Alvarez-Rodriguez, Director of the Department
of Children, Youth and Their Families, urged Commission to explore all
State and Federal revenues; continue to look at implications for family
members; encouraged the Department to work collaboratively with the Mayor
and her Department.
Melinda Paras, Health Access, stated this is a real
opportunity to take a substantial portion of the children’s population
and take small incremental steps towards universal health care; already
have foundation for outreach; the CHN would be positioned to absorb this
Jean Fraser, S.F. Health Plan, endorses the plan and
incremental approach; submitted written testimony explaining why the S.F.
Health Plan is the logical choice for the program.
Margaret Brodkin, Coleman Advocates for Children and
Youth, supports the planning and outreach; supports coordinated system for
universal health along with DCYF and the Proposition 10 Commission; wants
to participate in planning.
Neil Gendel, Healthy Children Organizing Project,
supports concept of coverage for all children, especially 0-5 years;
access to culturally appropriate coverage.
Dave Fox, retired Deputy City Attorney, supports
universal health care for children.
Dr. Elissa Song, UCSF Pediatrician, commends the
plan; this is first step and should include parents; provide secure source
of funding; do not cut existing children’s programs.
Suki O’Raghallaigh, aide for Supervisor Gerardo
Sandoval, pointed out District 11 has more uninsured children.
This plan is an outstanding approach to provide
health services to children; go forward in increments; thanked the
Department and staff
Thanked all speakers; very important protocol;
critical to have sustained funding
Challenge is how to get the word out and get enrolled
effectively in collaboration with other groups
Supports going at the 300% poverty level, including
vision and dental.
Dr. Katz stated the Department will collaborate with
all of the appropriate entities.
Action Taken: The Commission adopted
Resolution #4-01, “Supporting Achievement of Universal Health Care and
Expanding Health Care Coverage to Uninsured Children and Youth.”
8) PRESENTATION OF THE PROPOSED DEPARTMENT OF PUBLIC
HEALTH BUDGET FOR FY 2001-02
Mr. Matthew Hymel from the Controller’s Office
presented graphs on total City revenues, allocation of revenues.
He pointed out the following risk factors in the FY
Lower beginning balance
Business tax litigation
Stagnant health revenues
Rising energy costs
Monique Zmuda, DPH Chief Financial Officer, presented
a Summary of the Proposed Budget for FY 2001-02.
A message from the Health Director for FY 2001-02 Budget was
submitted. A copy of the full
Budget is available in the Commission Office.
Ms. Zmuda reported the budget reflects the direction
of the Department’s new Strategic Plan.
She pointed out the Department is not assured of receiving the
requested additional $22 million in General Funds.
Without this, she foresees a need for proposed reductions. She also pointed out the importance of COLA’s to the
contractors and will continue to advocate for this.
Ms. Zmuda acknowledged the work of her new staff
person James Alexander, Budget Analyst.
Keith Choy, Mayor’s Criminal Justice Council,
advocated for $200,000 emergency housing as an above the base budget
Alan Gelb, M.D., SFGH Medical Staff, indicated the
budget process was better this y ear; supports COLA’s for UCSF; be bold
and include in budget now.
Frederick Hobson, DAAB, submitted budget
recommendations from the DAAB/CAAB and a Board of Supervisors’
resolution supporting the DAAB recommendations.
Kate Monico-Klein, Forensics AIDS Project, supports
above the base funding for emergency housing.
Jennifer Friedenbach, Coalition on Homelessness,
urged Commission to stand up to Mayor Brown and support the mental health
Belinda Lyons, Mental Health Association, supports a
full-time access advocate position.
L. S. Wilson, Coalition on Homelessness, stated the
need to integrate job training and mental health treatment in the
Darren Lewis, Coalition on Homelessness, urged
funding of 10 peer counselors to work in the community.
Christina Taylor, Community Housing Partnerships,
works with Transgender Outreach and peer counseling; described
discrimination and need for hormone therapy; supports COLA’s for all
Kym Valdez, Swords to Plowshares, supports the
People’s Budget, COLA’s for contract agencies; described the CBO’s
loss of ability to pay bills.
Kate Gudsey; Jail Psych Services, supports increase
in funding for jail health; complex patients in the jails; not able to
recruit and retain staff.
Phil Hopewell, M.D., SFGH/UCSF, described the U.C.
contract; not funding the COLA’s will result in service reductions.
Don Seaver, M.D., Jail Psych Services, needs
excellent clinicians and reasonable salaries.
Talmadge King, M.D., Chief of Medical Services,
supports the high-utilizer program; can’t go into next year without
Alicia Fernandez, M.D., SFGH Department of Medicine,
described high-utilizers of acute services and the conference on this
subject; high-utilizer program is case management based.
Michael Wise, S.F. Network of Mental Health clients,
submitted sample of Voices at Bay newsletter.
Nika St. Claire, Contractor’s Association, urged
increased funding for staffing and infrastructure; urged 10% COLA’s or
forced to reduce services by 10%.
Michael Lyon, Emergency Coalition, described need for
critical care beds; demanded all service cuts restored.
Helynna Brooke, Mental Health Board, supports full
COLA’s and full funding for single standard of care for mental health.
Mark Siobal, SFGH Respiratory Services, described
impact of underfunded COLA’s; will cause decrease in services and will
be out of compliance.
Eve Meyer, S.F. Suicide Prevention, urged to include
COLA’s and described impact on the partnership between the Department
Ward Gypson, M.D., SFGH, supports trauma enhancement
for traumatic brain injuries.
Robert MacKersie, M.D., SFGH, supports ER respiratory
and support services to trauma services.
Sue Carlisle, M.D., SFGH urged to maintain
exceptional care at SFGH; increases in COLA’s; committed to working
Ernest Ring, M.D., SFGH Radiology, supports COLA’s;
described radiology needs; lack of good salaries for staff.
Neil Stollman, M.D., SFGH, described prevention
through colon cancer screening would have to be cut if COLA’s are not
Karen Patterson Matthew, BVHP Foundation and Mental
Health/Substance Abuse Contractors Association, expressed willingness to
support the Strategic Plan but is disappointed on the elimination of
support to CBO’s and COLA’s; urged Commission to refuse a budget that
eliminates COLA’s for contractors.
Darryl Inaba, HAFACI, supports COLA’s for
contractors; considers this a priority in the budget; harder to maintain
Richard Heasley, S.F. Mental Health Contractors
Association, described CBO’s reaching desperation, more difficult to
maintain service levels.
June Duenas, Family Links to Mental Health, supports
children’s mental health to prevent more expenses later in life.
Written testimony was submitted by:
Laura Ware and Joyce Miller, Local Homeless Board
Alan Kaufman, Citywide Case Management Forensic
S.F. Association of Alcohol and Drug Program
Expressed concern of impact on SFGH without COLA’s
to the U.C. contract
Expressed concern of impact on service delivery
without COLA’s to Department contracts
Important to include concern for COLA’s in the
budget and that service impacts will occur without COLA’s
Supports inclusion of the high utilizer program at
SFGH; relook at this
Acknowledged the continuous message that multitude of
safety nets are being threatened
Wants one Department approach to COLA’s not to
separate out the U.C. contract
Indicate in the resolution about the COLA’s and
what you would be losing
Wants to see revision of resolution to include the
concern for COLA’s with consequences on services
Complimented staff on work on the budget
Dr. Katz pointed out in the absence of COLA’s,
there will be service cuts.
9) OTHER BUSINESS/PUBLIC COMMENTS
Commissioner Monfredini raised the question of
starting Commission meetings earlier when agendas are lengthy.
The meeting was adjourned at 7:20 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission