Minutes of the Health Commission Meeting May 1, 2001 3:00 p.m. at 101 Grove, 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, M.S.W., at 3:10 p.m. Present:  President Roma P. Guy, M.S.W. Vice President Edward A. Chow, M.D.  Commissioner Arthur M. Jackson  Commissioner Harrison Parker, Sr., D.D.S.  Commissioner John I. Umekubo, M.D. Absent: Commissioner Lee Ann Monfredini Commissioner David J. Sanchez, Jr., Ph.D. 2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF APRIL 17, 2001  Action Taken: The Commission adopted the minutes of April 17, 2001 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner David J. Sanchez, Jr., Ph.D.) (3.1) CHN-SFGH/LHH - Request for approval of a contract renewal with Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP, in the amount of $100,000 per year, for a total contract amount of $500,000, to provide as-needed, specialized legal services to the Community Health Network, for the period of July 1, 2001 through June 30, 2006. (DPH contracted with Hanson, Bridge for services totaling $150,000 during FY 2000-01). (3.2) PHP-Housing and Urban Health - Request for approval of a one-time. Four-month sole source contract with the Mission Housing Development Corporation (MHDC), the lead agency and fiscal agent for the Mission SRO Collaborative, to conduct a Census of Families with Children Living in SRO Hotels, in the amount of $70,724, for the period of April 1, 2001 through July 31, 2001. (DPH contracted with MHDC for services totaling $245,000 during FY 1999-2000). (3.3) PHP-Disease Prevention - Request for approval of a retroactive modification to the multiyear contract with Mission Neighborhood Health Center (MNHC), to increase the annual amount by $15,350 for the third year (7/1/00-6/30/01) and the fourth year (7/1/01-6/30/02), for a new annual total of $58,821 each year, for the provision of clinic immunization and education services to at-risk children up to four years of age. The contract total with this modification equals $213,045 for the four-year period of July 1, 1998 through June 30, 2002. (DPH contracted with MNHC for services totaling $835,606 During FY 1999-2000). (3.4) AIDS Office - Prevention - Request for approval of a retroactive contract renewal with the Regents of the University of California on behalf of the UCSF AIDS Health Project, in the amount of $64,000, to provide HIV Prevention for Positives training services to service providers of HIV-positive individuals, for the period of January 1, 2001 through December 31, 2001. (DPH contracted with UCSF for services totaling $13,999,667 during FY 1999-2000). (3.5) DPH - Central Administration - Request for approval of a resolution approving an extension of the terms of the FY 2000-01 contracts for the Department of Public Health’s Population Health and Prevention and Community Health Network. Action Taken: The Commission approved the consent calendar of the Budget Committee. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) POPULATION HEALTH AND PREVENTION $2 Million in Grants for Mental Health Programs for Older Adults Governor Davis announced the Department of Mental Health’s intent to award approximately $2 million in grants to four counties. These grants are for the development of Older Adults System of Care Demonstration Projects beginning July 1, 2001 as part of the Governor’s Mental Health Initiative. The counties selected to receive these grants include: Tuolumne, San Francisco, Stanislaus and Humboldt Counties. The grants will allow the four counties to develop model services to adults who are 60 years of age or older, who have been diagnosed with a mental disorder or have a functional impairment. Community Health Promotion and Prevention Pedestrian Safety The National Highway Traffic Safety Administration will feature the work of the Department’s Community Health Education Section in their May publication "Building Safe Communities." This innovative community-department partnership was funded through the State's Office of Traffic Safety, and DHS State and Local Injury Control Section. The Mission and Tenderloin Safe Communities Projects plan to improve pedestrian safety in their communities. Thanks to staff, Michael Radetsky, Nicamer Tolentino and Stephanie Dunlap, for their vision for innovation, and to community partners, St. John's Educational Threshold Center, Adopt-A-Block, Safety Network and the Neighborhood Safety Partnership/SAFE, for all their hard work. As part of a community-based pedestrian safety effort funded by the California Office of Traffic Safety, the Community Health Education Section is working with local neighborhood groups on selected safety projects. Four grants of $10,000 each were awarded this month to Chinatown Community Development Center, William R. De Avila Elementary School PTA, OMI Neighbors In Action, and Walk San Francisco SOMA project. The projects reflect a broad mix of different groups, neighborhoods, and interventions Community Health Education On May 16th, CHES staff will offer an all-day Community Action Training, focused on developing organizing and project development skills among community partners. The Community Action Model, developed by CHES based on the successful work of our Tobacco Free project, uses interactive exercises to build community capacity to organize around a wide variety of Public Health issues. STD Control April was STD Awareness Month. The STD Control Section worked with bar and club owners to get them to offer free admission or free drinks to patrons who show a card validated by City Clinic indicating that they were tested for STDs. This is a true collaboration between the community and the Health Department and shows a real commitment by these club owners to "join the STD Program in the fight against the spread of STDs." This innovative program was publicized in a press release issued by the Health Department on 4/5/01 and was highlighted in articles in the San Francisco Chronicle, the Bay Area Reporter, the CDC Daily STD Update and on several local TV and radio stations. It was also covered by a TV station in Seattle, Washington. Health Promotion and Education at DHS The PAES Project -- a pilot venture undertaken jointly by DPH and DHS -- combines the efforts of our two departments as well as non-profit agencies to implement strategies in the integration of primary and behavioral health services into a welfare-to-work Personal Assisted Employment Services (PAES) Program. DPH staff and providers are training DHS staff how to incorporate health early in the welfare-to-work process, including linkages to primary care, dental care, mental health, HIV/HCV/STD and substance abuse treatment services. Practical tools, guides and educational materials are provided to help clients understand and make the connection between health and employment. Support for this training has been provided by Dr. David Ofman, Primary Care Section; Jim Stillwell, CSAS; Sylvia De Trinidad, Health Promotion Section; Elizabeth Davis, HIV Prevention Section; Julie Javrostsky, Dental Health Education Program; Dr. Tom Neill, DHS PAES Section; and Po Yee Au Lindahl, DPH's PAES Program Analyst. Funds from the AIDS Office are enabling Glide HIV Prevention Services and the Black Coalition on AIDS to provide HIV/STD/HCV prevention and education series for PAES clients on a long-term basis. COMMUNITY HEALTH NETWORK SFGH Volunteer Dinner This past weekend, the Volunteers of San Francisco General Hospital Board hosted a celebration for the SFGH Volunteers at Gabbiano's Restaurant in San Francisco. Over 100 people attended the event. Mayor Brown; Robert Christmas, President of the Volunteers of SFGH Board; Gene O'Connell, Executive Administrator of SFGH; and Renee Cibulka, Director of the Volunteers of SFGH, were among the keynote speakers who expressed their appreciation for the very important work that the volunteers provide SFGH. There are over 900 volunteers at SFGH who assist in the daily operations of the hospital - from collecting clothes for patients, delivering medications to the Emergency Department, to providing chaplaincy services. The Department is deeply indebted to the volunteers, the Volunteers of SFGH staff and board. 5) HEALTHY FAMILIES AND CHILDREN’S HEALTH INSURANCE UPDATE Tangerine Brigham, Director of Policy and Planning, delivered an update on Healthy Families and the San Francisco Children’s Health Insurance Initiative.  She highlighted the eligibility for the Health Families program, and recent enhancements that include:  budget increases to cover program growth; increased budget funds to expand outreach efforts; and coverage of legal immigrants through budget allowances and legislation.  Ms. Brigham identified recent legislation, including the passage of AB 2415, that concerns eligibility for qualified aliens.  Ms. Brigham discussed enrollment and retention issues.  According to Ms. Brigham, the program has enrolled approximately 77% of the eligible population.  She then discussed the avoidable and unavoidable reasons that families leave the program, and reasons for ineligibility.  Ms. Brigham identified proposals to extend Healthy Families coverage to parents.  She concluded her presentation by describing the Healthy Families consumer survey of health plans that assessed the satisfaction and experience of families within participating health plans.  Ms. Brigham focused on the survey results of San Francisco Health Plan families. The complete text of Ms. Brigham's written report is enclosed as Attachment A.  Commissioners’ Comments Commissioners sought clarification concerning whether a person who was covered as a child could retain coverage even if that person also was a parent of a child.  Ms. Brigham responded that a person who was otherwise eligible for coverage would remain eligible for coverage, even if that person were a parent.  Vice President Chow asked about funding opportunities.  Ms. Brigham responded that the Department was looking to the Mayor, the Board of Supervisors, reallocation, foundations, and other City Departments, especially for outreach efforts.  Vice President Chow was encouraged by the short time lines contained in the report.  President Guy asked whether outreach was analyzed by ethnic group.  Ms. Brigham responded that presently the analysis is reflected by community group, not by ethnicity.  The Commission looks forward to a more detailed report on this aspect.  Vice President Chow raised issues concerning language and cultural interpretations of the questions on the survey.  He stated that different groups may have different interpretations or understandings of the terms “satisfaction” or “dissatisfaction,” and that within the Chinese speaking community, expressions of dissatisfaction may be more meaningful and more important than high survey scores Commissioner Umekubo was happy to see how numbers have jumped statewide; he expressed concerns with the application process, stating that a simpler process could encompass 9 – 10% more children Commissioner Parker stated that Ms. Brigham’s presentation demonstrates the importance of universal health care.  Dr. Katz added that, even with several City efforts, we still fall behind on health insurance coverage. Commissioner Jackson expressed concern with health insurance coverage and housing for the working poor and working uninsured. Public Comments: Gladys Sandlin, Director of the Mission Neighborhood Health Center, added that in the Latino community many people do not apply due to immigration concerns, a fear that she said is often instilled by attorneys. Michael Lyon, Emergency Coalition to Save Public Health, asked the Commission to think twice regarding the children’s health initiative.  He stated that the clinics should be open later hours, and that DPH’s age 0-18 proposal would mean that San Francisco would be subsidizing private hospitals. 6) ADOPTION OF STANDARDS OF PRACTICE FOR THE PROVISION OF QUALITY HEALTH CARE AND SERVICES FOR GAY/LESBIAN/BISEXUAL Barbara Garcia, Deputy Director for Population Health and Prevention, spoke about the proposed standards. She stated that fear of discrimination and stigma causes many Gay, Lesbian, Bisexual, and Transgendered (GLBT) individuals and their families to postpone or decline health care. The purpose of the proposed standards is to communicate a set of guidelines for service providers to increase their ability to meet the need s of GLBT and their families. The full text of the report is enclosed as Attachment B. President Guy asked to see updates through the JCCs. Commissioner Jackson wanted to ensure that there was an outreach to seniors, so that these people know that they can get services and respect. Ms. Garcia stated that DPH will work with other Departments that have relationships with seniors to meet that goal. Vice President Chow offered suggestions to make the wording more precise and to speak to principals. President Guy and Commissioner Parker stated that the expectation is to incorporate these standards into Policy 24, which is scheduled before the Health Commission in two months. Commissioners Chow and Guy urged that the Community Advisory Committee for Policy 24 invite representatives from the GLBT Task Force on Standards of Care to work together on this issue. Public Comments Gloria B. Soliz, Coalition of Lavender Americans on Smoking and Health, and GLBT Task Force Standards of Care, stated that the standards were working documents that should be provided separately to the GLBT community, and to their providers. She also believed that the document should be placed on line. Clair Skeffington, DPH Finance and Operations, said that the standards are a wonderful start and inclusionary. She would like to see the percentages of staff sent to culturally competency training. Dr. Suzanne Dibble, U.C., expressed an interest in Standard 4 (Standard 4 states that any research conducted by, through, or in conjunction with DPH shall include GLBT individuals and their families and shall include, where appropriate, questions on sexual orientation, behavior, and gender identity along with other socio-demographic variables). 7) OTHER BUSINESS/PUBLIC COMMENTS Paul Hendrickson, Bayview Clubhouse, stated that he is a consumer and is not receiving the services that he expects from the Bayview Hunters Point Foundation (BVHP). He stated that the BVHP is not trying to hire for service positions. Linda Zaretsky is the President BVHP charter, Local 790. She stated that DPH officials have worked hard with BVHP, but that it has not helped. Ms. Zaretsky stated that fewer children are served today than in 1997. She said that the BVHP administration and board have been unable to collaborate with mid level staff, community, and DPH, especially in the area of mental health. She asked for the Commission’s help. Faye Roe, is a local representative for BVHP union members. Referring to BVHP, she stated that the quality of care will suffer with the low salaries of staff. Ms. Roe said that the BVHP administration is incapable of collaboration with the workers, consumers, and the community. Dale Butler, staff person, Local 790, stated that in his union of over 30,000, workers do not suffer as they do in BVHP. He stated that BVHP returned unspent money because it failed to provide services, and does not pay sufficiently high wages. 8) CLOSED SESSION a. Public Comment on All Matters Pertaining to Closed Session None. b. Vote to Whether to Hold a Closed Session to Confer With Legal Counsel. (San Francisco Administrative Code Section 67.11(a) Action taken: The Commission voted to hold a closed session. The closed session began at 4:45 p.m. c. Closed session Pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.11(b) Conference with Legal Counsel - Existing Litigation Proposed total settlement of $50,000 in Khary Butler vs. CCSF, San Francisco Superior Court, Case # 993-756 d. Reconvene in Open Session 1) Possible report on action taken in closed session (Government Code Sections 54957.1(a)(2) and San Francisco Administrative Code Section 67.14 (b)(2) Action taken: The Commission approved the proposed settlement of 50,000. 2) 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. This closed session ended at 5:10 p.m. 9) CLOSED SESSION a. Public Comment on All Matters Related to the Closed Session None. b. Vote on Whether to Hold a Closed Session Pursuant to Government Code Section 54957 and San Francisco Administrative Code Section 67.10(b) Action Taken: The Commission voted to hold a closed session. The closed session began at 5:15 p.m. c.. Closed session pursuant to Government Code Section 54957 and San Francisco Code Section 67.10(b) Public Employee Hiring: 1551 Executive Secretary to the Health Commission d. Reconvene in Open Session 1) Possible report on action taken appointing the Executive Secretary to the Health Commission (Government Code Section 54957.1(a)(5), and San Francisco Administrative Code Section 67.14(b)(4)) 2) Vote to elect whether to disclose any or all discussions held in closed session (San Francisco Administrative Code Section 67.14(a)) Action Taken: No report issued. The Commission voted not to disclose any discussions held in closed session. The meeting was adjourned at 5:30 p.m. Arthur R. Greenberg, Interim Health Commission Secretary