Minutes of the Health Commission Meeting Tuesday, February 20, 2001 3:00 p.m. at Milton Meyer Gymnasium 195 Kiska Road (at Ingalls) San Francisco, CA 94124 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. Present: Commissioner Edward A. Chow, M.D. Commissioner Roma P. Guy, M.S.W. Commissioner Harrison Parker, Sr., D.D.S. Commissioner David J. Sanchez, Jr., Ph.D. Commissioner John I. Umekubo, M.D. Absent: Commissioner Lee Ann Monfredini President Guy made special presentations to Michael Hart (20 years) and Jan Murphy (19 years) for their dedicated and professional services in the Department. Tony Wagner, CHN Executive Administrator, and Dr. Melissa Welch, Chief Medical Officer, expressed their appreciation to Ms. Murphy for her leadership as the Primary Care Administrator in the Community Health Network. 2) APPROVAL OF MINUTES OF THE REGULAR MEETINGS OF JANUARY 30, 2001 AND FEBRUARY 6, 2001 Action Taken: The Commission adopted the minutes of January 30 and February 6, 2001, with the correction for the January 30 minutes on page 8 to read: "The Commission unanimously elected Commissioner Chow as Vice President." 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner David J. Sanchez, Jr., Ph.D.) (3.1) DPH-Central Administration – Request for approval to accept and expend a gift bequeathed to San Francisco General Hospital from the estate of LeMar Hoaglin. (3.2) CHSS-STD Prevention – Request for approval to accept and expend retroactively a new four-year sub-contract from the Regents of the University of California at San Francisco, in the amount of $387, 775, to perform "Behavioral, Basic and Clinical Studies of Post-Exposure Prophylaxis", for the period of September 30, 2000 through August 31, 2004. Commissioner Sanchez abstained on this item. (3.3) AIDS Office - Request for approval of a contract modification with California AIDS Intervention Training Center (CAITC), in the amount of $70,000, to increase the contract from $178,779 to $248,779, for the provision of early intervention HIV services, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with CAITC for services totaling $269,692. (3.4) AIDS Office - Request for approval of contract renewal with the Regents of the University of California, through UCSF/AIDS Health Project, in the amount of $98,089, to provide prevention provider training services targeting providers of HIV prevention services in San Francisco, for the period of January 1, 2001 through December 31, 2001. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). Commissioner Sanchez abstained on this issue. (3.5) AIDS Office - Request for approval of a new contract with the Regents of the University of California (UCSF), on behalf of the Stonewall Project of UCSF’s Division of Substance Abuse and Addiction Medicine, in the amount of $100,000, to provide outreach services targeting methamphetamine users, for the period of March 1, 2001 through December 31, 2001. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). Commissioner Sanchez abstained on this item. (3.6) AIDS Office - Request for approval of contract renewal with Stop AIDS Project (SAP) in the amount of $231,754, to provide Community Level Intervention services targeting self-identified gay and bisexual seropositive men, for the period of January 1, 2001 through December 31, 2001 (DPH contracted with SAP for services totaling $851,627 during FY 1999-2000). (3.7) CHN-Laguna Honda Hospital – Request for approval of a retroactive contract renewal with the Regents of the University of California (UCSF), on behalf of the UCSF Department of Physiological Nursing, in the amount of $141,725, to provide specialized gerontological care services and student supervision, for the period of October 1, 2000 through September 30, 2001. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). Commissioner Sanchez abstained on this item. (3.8) CHN-Medical Records/Radiology – Request for approval of a contract modification with Mediscript in the amount of $125,000, increasing the contract from $225,000 to $350,000, to provide as-needed medical transcription services, for the period of December 1, 1999 through June 30, 2001. (DPH contracted with Mediscript for services totaling $199,291 during FY 1999-2000). (3.9) PHP-CSAS – Request for approval of retroactive sole source contract renewal with San Francisco State University (SFSU), in the amount of $70,000 per year, for a four-year contract of $280,000, to provide professional substance abuse training and certification services targeting substance abuse counselors under contract with the Health Department, for the period of July 1, 2000 through June 30, 2004. (DPH contracted with SFSU for services totaling $150,703 during FY 1999-2000). (3.10) PHP-CMHS – Request for approval of retroactive contract modification with San Francisco Study Center (SFSC), in the amount of $169,567 per year, for a total of $339,134 for the remaining two years of this contract, to provide outreach and client advocacy services for adults needing mental health services and their families, for the period of July 1, 2000 through June 30, 2002. (DPH contracted with SFSC for services totaling $1,790,069 during FY 1999-2000). Public Speakers: David Pasquarelli, Act-Up S.F., opposes giving funding to contractors in #3.2, 3.3, 3.4, 3.5. and 3.6. Ronnie Burk, Act-Up S.F., opposes funding for #3.2, 3.4 and 3.6; thinks money has been wasted on AIDS research. Action Taken: The Commission approved the Consent Calendar of the Budget Committee, with President Guy abstaining on #3.9, and Commissioner Sanchez abstaining on #3.2, 3.4, 3.5, and 3.7 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) ADMINISTRATION African American Health Initiative The African American Health Initiative of the Department of Public Health is hosting an Educational and Cultural Program to celebrate Black History Month. The event scheduled this Thursday from 4:00 to 6:00 p.m. at the CHN headquarters will welcome incoming leaders, Supervisor Sophie Maxwell, Sandra Nathan, Director of the Department of Aging and Adult Services and Arlene Ackerman, Superintendent of Schools. The Commission is cordially invited to attend. Open House DPH has contracted with the Ark of Refuge to develop and operate a Transitional Housing Program for Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQQ) young adults at 2500 Market Street, recently named the Ark House. The program will serve LGBTQQ young adults, ages 18 to 23, who are residents of the City and County of San Francisco and who are either currently homeless or at risk of becoming homeless. The program will provide housing and services for up to 15 clients at any given time; the stay is 3 to 6 months. Some services will be provided on-site while others will be delivered off-site through formal collaborating agencies and existing programs to which clients will be referred. Examples of services include, but are not limited to: Case Management Counseling & Mental Health Support Money Management Vocational And Employment Medical / Primary Care Substance Abuse Services And Prevention DPH is holding an open house to celebrate the opening of this unique program. It has been a two-year collaboration with Supervisor Leno’s Office, community members, the Health Department, and the Ark of Refuge. Margot Antonetty and Marc Trotz have done outstanding work on this project. The opening program is on Wednesday, February 28, 2001 from 6:00 p.m.– 8:00 p.m. COMMUNITY HEALTH NETWORK SFGH Rebuild The SFGH Rebuild Planning Committee has made preliminary programmatic recommendations for services moving to a new building and services that will remain in the existing structure. Three potential sites on the SFGH Campus for a new building have been considered. Various technical issues are still being explored and financing options proposed. Information can also be accessed through the DPH website or through the CHN Planning Office. Senate Insurance Committee Hearing On February 7, 2001, Anthony Wagner gave testimony to the Senate Insurance Committee in Sacramento, on behalf of the California Healthcare Association (CHA). This hearing was held for Healthcare officials to share their thoughts and give their perspective on the current State and future needs of healthcare and health insurance in California. Those issues were articulated from one panel by health plan executives; by a panel of representatives from the California Medical Association and the CHA panel. Tony specifically addressed the issues effecting safety net providers and the uninsured. The CHA panel also discussed workforce and seismic issues as well as the Emergency Medical System and Trauma. Integration of Behavioral – Physical Health Grant Funded by Cal-Endowment The San Francisco Department of Public Health (SFDPH) Community Mental Health Services (CMHS) and Primary Care Divisions proposed a project to expand and replicate a successfully piloted, integrated community-based treatment approach for primary care patients who suffer from mental, physical and substance abuse disorders. By integrating physical health, mental and substance abuse (behavioral) health services and providers within community-based public health clinics, we proposed to: increase access to behavioral health care and optimize patient wellbeing; achieve overall cost savings for our health care system; establish an ongoing collaborative integration group to sustain and expand an integrated behavioral and physical health care management model across our continuum of care. Dr. Katz announced that the California Endowment, through its Special Opportunity in Mental Health Funding RFP Program, has awarded DPH a grant in the amount of $399,386 to complete this proposed project over a 3-year funding period. Black History Month Activities The Activity Therapy Department of Laguna Honda Hospital will hold their Annual Black History Celebration in the Gerald Simon Theatre on Thursday, February 22, 2001 at 2:00 p.m. This large hospital wide production will be repeated again in Clarendon Hall at 3:00 p.m. The presentation will include musical performances, skits, and exhibits to celebrate African-American culture. Chinatown Public Health Center Now a Member of "Chinatown’s Community Emergency Action Team The Chinatown Public Health Center is a collaborating member of a community effort called "Chinatown Community Emergency Action Team" (CCEAT). The goal of the program is to train persons to become American Red Cross workers at the time of a community disaster, and also to train bilingual individuals to educate and prepare the community for disasters. After initial training, CCEAT members will also be able to educate community organizations. The training will be conducted in March/April on Saturdays at the Health Center. Special thanks to staff pediatrician, Dr. Peter Ng; who has provided leadership to this important program. Chief Financial Officer Ken Jensen, CHN Chief Financial Officer, has accepted the Chief Financial Officer position for ValleyCare Health System, a not-for-profit health care system that operates ValleyCare Medical Center in Pleasanton and Valley Memorial in Livermore. Ken’s last day with the Community Health Network is also March 2, 2001. Director of Planning and Marketing Diane Miller will be retiring after more than 25 years in areas of community and public health. Diane assembled a collection of artifacts, photographs, logbooks and oral histories of San Francisco General Hospital. This project will be catalogued before she leaves. This spring Diane will leave the Department to pursue other lifelong interests in spiritual practice and the study of comparative religions. Primary Care Administrator Jan Murphy has accepted a position as Chief Executive Officer for the Primary Care Service Line for the VA Upper Midwest Health Care network based in Minneapolis, MN. There will be a farewell reception for Ken Jensen and Jan Murphy scheduled for February 23, 2001 at the CHN Headquarters in Conference Room 2001, from 12:00 noon – 2:00 p.m. POPULATION HEALTH AND PREVENTION Dr. Katz convened the Mental Health Forum, a planning group to make model recommendations on Mental Health service needs. It is co-chaired by Jo Ruffin and Steve Fields, and includes representatives from CMHS, Department of Psychiatry, SFGH and Community Mental Health Services contractors. The group is recommending that in the rebuild plans for SFGH that the numbers of acute psychiatric inpatient beds remains flat. The community-based model of care is expected to result in reduction of reliance on private psychiatric hospital beds and allow us to consolidate acute inpatient services for adults at SFGH. SFGH Medical Staff Credentials Report   Feb./01 2001 YTD New Appointments 5 6 Reinstatements 0 0 Reappointments 44 82 Delinquencies 0 0 Reappointment Denials 0 0 Resigned/Retired 12 22 Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0 0 Changes in Privileges     Additions 3 5 Voluntary Relinquishments 1 1 5) CONSIDERATION OF APPROVAL OF THE REVISED LAGUNA HONDA HOSPITAL MEDICAL STAFF BYLAWS Dr. Paul Isakson, Laguna Honda Hospital Chief of Staff, presented the Commission with the revised LHH Medical Staff Bylaws. A four-person sub-committee of the Medical Staff, together with an attorney from the City Attorney’s Office, developed a process to revise these bylaws. These bylaws were also reviewed, recommended and approved by the Joint Conference Committee of Laguna Honda Hospital on January 12, 2001. Commissioner Chow requested clarification of the credentialing process, with the credentials being reported to the full Commission. He also had clarification on the categories of night, weekend and temporary medical staff. Commissioner Umekubo stated that the JCC-LHH recommended to the Commission approval of these bylaws. He also commended Dr. Isakson and his committee for their hard work on the bylaws. Action Taken: The Commission adopted the Laguna Honda Hospital Revised Bylaws. 6) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE AWARDS FOR FEBRUARY 2001 On behalf of the Commission, Commissioner Chow presented awards to the following: Individual Nominees Division Nominated by Joe Walseth, Health PH&P – Children’s Environmental Karen Cohn, Program Program Coordinator Health Promotion Manager, CEHP Team Nominees Division Nominated by Dr. Doug Price Hansen CHN – Tom Wadell Clinic Patricia Birmingham, RN, MS Jay Sheffield, MSW HC/DEAP   Chad Coolidge, EW     Sierra Anderson, HW III     Dr. Donna Douglas Griffith     Dr. Rod Weaver     Adam Luna, HW III     Patricia Birmingham, RN, MS     7) PUBLIC TESTIMONY ON THE HEALTH NEEDS IN THE BAYVIEW HUNTERS POINT COMMUNITY President Guy welcomed members of the Bayview Hunters Point neighborhood. She acknowledged the following individuals for their assistance in organizing this hearing: James Threat, Recreation and Park Department Supervisor Cynthia Selmar, Director of the African American Health Initiative, and Francine Carter Willie Crawford, Facilities Manager, and his staff President Guy recognized District 10 Supervisor Sophie Maxwell, BART Director and former Supervisor Willie B. Kennedy, and Catherine Dodd representing Congresswoman Nancy Pelosi. Dr. Katz acknowledged the following DPH staff for their work with the Bayview Hunters Point community: Cynthia Selmar, Director African American Health Initiative (AAHI) Karen Pierce, Coordinator BVHP-HEAP (Health and Environmental Assessment Project) Betty McGee, Director, HERC (Health and Environmental Resource Center) (a 501(c)(3) nonprofit organization Francine Carter, Program Coordinator AACHIE (African American Coalition for Health Improvement and Empowerment) Beverly Rashid, Chair, AACHIE Public Speakers: Cynthia Selmar, Director of the African American Initiative, described the work of the Initiative and the community. Freddie Smith, Southeast Health Center Director, presented the Center’s brochure and information on the characteristics of people served by his Center in the year 2000. Ollie Burgess, SEHC/PAC Chairperson, listed the health problems in the neighborhood and the staffing needs of the Southeast Health Center. Ena Aguirre, community activist, described the unmet needs in the community, especially health problems related to air quality. Juanita Casey, Network for Elders, indicated the seniors’ need for transportation. Betty McGee, HERC, advocated for funding for the Health and Environment Resource Center. Barbara McLemore, Chairperson of the Tenants Association of Apartment Complexes, discussed needs of residents of four apartment sites and described mold and air quality problems. Marie Harrison, Bayview resident, criticized the Commission for coming here so late and allowing too many illnesses to accumulate in the Bayview; tired of being ill; poor and people of color live in this area; past time for the Commission to step up to the plate. Michael Green, Housing Rights Committee, discussed tenants’ health issues and submitted a document on a review of four AIMCO developments in BVHP; requested assistance for tenants. Kamilah Watson, Infusion-One, encouraged people to come together as a community; youth development is important for future leadership. Wanda Elston, resident, feels that AIMCO and HUD are to be blamed and called for an investigation on them; described problems with raw sewage and mold. Willie Ratcliff, S.F. Bayview Newspaper, described the community systematically getting ill and feels every agency operates at a conspiracy to drive out the residents; encouraged to declare an emergency on health issues; there’s neglect by the City Departments. Leona Goodson, asthma patient, advocated for continuance of acupuncture and keeping the clinic open. Robert Jones, prostate men’s group, advocated for prostate testing in budget; prostate cancer is #1 killer of Black men. Toye Moses, welcomed the Commission and Dr. Katz back again to the community; SEHC is inadequately funded; needs a Medical Director; the community wants action here in Bayview. Dr. George Davis, Executive Director of BVHP Multipurpose Senior Center, advocated for the health needs of seniors; need for outreach workers; expansion of SEHC, investment in Hunters Point, and compassion for the people. Karen Patterson-Matthew, Executive Director of BVHP Foundation, described services of her agency; expressed concern and priority for health issues, additional resources, and advocacy for this neighborhood. Ruben Smith, Hunters Point Boys and Girls Club, advocated for children and youth. Dorothy Peterson, Shoreview Tenant Association, air quality issues related to asbestos, cellulose, fiberglass, and carbon monoxide poisoning; urged AACHI to work with Shoreview residents. Cathy Summers, City College Nursing, advocated for breast cancer information to the community; encouraged funds in the budget for nursing students to bring information to the community. Marion Jones has been a resident for 37 years; described her grandson’s asthma; advocated for children. Norma Faris Taylor, Sistah Sistah, talked about violence as a public health issue; supports prevention programs, families and health. James Evans thanked the Commission for coming to BVHP. Gloria Jones, HERC, described breast cancer programs, the high rates of breast cancer and asthma; requested that more early detection of breast cancer be made available. Ahima Sumchai, M.D., described retro chemical toxicity in BVHP; stated other cities with industrial pollutants have received help; no reason for Public Health to ignore this neighborhood, citing examples of responses to the AIDS crises and issues around tobacco, many health and safety issues in BVHP. Angela Harris, HERC, talked about stress and violence; need more money to help poor families. Representatives from Young Community Developers talked about toxins being built up in this neighborhood; homeless population; want questions answered. Mike Thomas, Communities for a Better Environment, talked about the recent shipyard fire and pollution; need staff to meet with the community. Lynn Westry advocated for cleaning the streets and a safe neighborhood; there’s an overwhelming rate of deaths of youth; youth dying getting younger and younger. Youth representative, Galileo High, advocated teaching young people about the effect of tobacco on their lungs. Española Jackson, CAHEED, described the history from the 60’s; thinks there’s a political ploy to get African Americans out of San Francisco; encouraged people to work with the Supervisors; requested a call for a state of emergency to get funds from the State and Feds. Rev. Victor Medeoris described how asthma from breathing air in BVHP went away when he moved away. Kathy Williams described asthma and mold; displayed pictures of mildew in housing; developed coughing and heart problems. Lynn Freall advocated for mental health along with physical health; demanded services for BVHP. Veronica Lightfoot, SFUSD Dr. George W. Carver School, advocated for more funds in the community. Ray Tompkins described the toxic fire and the fact that no air samples were taken where residents live; Navy has not done studies in the area; encouraged DPH to do an emergency room study on who went to hospital ER’s; all trucks transporting dirt should be covered; Navy came out to the community 27 days after the fire; encouraged preventive medicine. Louise Vaughn feels racism is behind all of this; described the violence, drugs, police brutality; need to submit lawsuits; encouraged community to work with the new Board of Supervisors. Kevin Meltone, Westside Mental Health, described youth on youth violence and killings; described Westside programs and the need for strategic planning. Marjorie Cherry, Faith Community, represents people who could not attend today’s hearing but have a desire to be here; appealed for help. Representative from Housing Authority, domestic violence specialist, encouraged Departments to be accountable, stop being territorial; and stop duplicating services. Derick Gaskin, Young Community Developers, asked Commission what type of solution does it have. Lynn Brown, Community for a Better Environment, described 14 chemical fires, shootings, and the need for counseling of children. Kathy Perry, resident, expressed sadness on the greater health disparities; it’s the City’s responsibility to find out about pollution; need a plan with adequate funding. Jesse Mason, BVHP community advocate, described three generations of asthma in his family; houses were built with substandard materials; need jobs; gentrification is happening. Bruce Campbell advocated that physicians should be trained in environmental illnesses. Dennis English, AACHI member, stated laws need to be enforced; need special district in Bayview to enforce laws; should review DPH and Environmental Health Division; no access to public information, was being stonewalled at DPH. Patricia Williams thinks the waste should be removed from the Navy shipyard. Keith Tisdell, resident, criticized the Commission for allowing only two minutes to speak; slap in the face of the people if nothing is done. Four youth from Literacy for Environmental Justice expressed need for access to nutritious and natural foods. Representative from Samoan community who grew up in BVHP talked about air quality issues and need for outreach to community members. Karen Pierce, BVHP HEAP, gave an update on work of the Task Force; encouraged residents to attend meetings and give input; described pedestrian safety programs. Dee Epps-Miller described the social medical model; encouraged funding from private foundations; advocated for Prop 10 funds to pediatric asthma. Andre Robertson, Black Coalition on AIDS, advocated for people with AIDS and an integrative approach with other physical health needs. Leboriae P. Smoore questioned why people in the community are not able to stay in their homes; government is part of these problems; need for jobs and ways to take care of families. Richard Thomas wanted to hear from the Commissioners as to what they are going to do. Willie B. Kennedy, BART Director and former City Supervisor; stated the voice of her people has fallen on deaf ears; hopes to see changes and assurances; there’s money for programs; described the CIRT Program. Vivian Donohue, Committee for a Better Environment, advocated to keep HERC open and funded and expanded to other areas. Francine Carter, resident, thanked Commissioners for coming out to BVHP; advocated for prevention programs, to clean up the radioactive material in the shipyard, no more band-aid treatment, and the need for long-term solutions; genocide is happening in this neighborhood. Supervisor Sophie Maxwell, District 10, stated there’s a real crisis here; she’s standing with the residents for public health; she knows she has eight votes; something different will happen; need to make a change President Guy expressed her commitment to the Bayview Hunters Point community, indicating the need to act and continue to do more. The data show disproportionate disparities in this neighborhood. Action should be data driven; need to ask science. Commissioner Parker is here to listen and learn; believes the disparities are rooted in racism; community is saying this is no longer acceptable; community didn’t have a plan; have to do something. Commissioner Jackson, a survivor of a kidney transplant, encouraged the community to take blame off the table and solve the problems; clean it up now; address issues now; collaborate to make the neighborhood a livable home. Commissioner Chow stated the importance of hearing the people; committed to all San Franciscans; make your health equal to all. Commissioner Sanchez stated his family was raised in this neighborhood; expressed support for this area as a City and for quality of life. 8) OTHER BUSINESS/PUBLIC COMMENTS None. The meeting was adjourned at 6:55 p.m. Sandy Ouye Mori, Executive Secretary to the Health Commission