Minutes of the Health Commission Meeting
May 15, 2001
at 101 Grove, Room 300
San Francisco, CA 94102
1) CALL TO ORDER
- President Roma P. Guy, M.S.W.
- Commissioner Arthur M. Jackson
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
- Vice President Edward A. Chow, M.D.
- Commissioner Lee Ann Monfredini
2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF MAY 1, 2001.
Action Taken: The Commission approved the Minutes of May 1, 2001.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(3.1) CHN-Jail Health Services - Request for approval of a new
contract with Medical Diagnostic for the provision of mobile X-ray
services for inmates of the County Jail and clients of the TB control
unit of the Department of Public Health, in the total amount of
$660,000, for the period of June 1, 2001 through June 30, 2005.
(3.2) CHN-Dept. of Education and Training - Request for approval of a
new contract with HealthStream, Inc. to provide access to internet-based
healthcare regulatory training courseware for employees of the
Department of Public Health, Community Health Network, for the total
amount of $418,250, for the period of June 1, 2001 through June 30,
(3.3) CHN-SFGH - Request for approval of a contract modification with
Healthcare Financial Solutions in the amount of $53,532, for a total
amount of $110,734, to provide reimbursement and revenue optimization
services for San Francisco General Hospital, Health at Home Agency and
Laguna Honda Hospital, for the period of April 1, 2001 through March 31,
(3.4) PHP-CSAS - Request for approval to retroactively accept and
expend a new five-year grant from the State of California, Department of
Drug and Alcohol Programs, in the amount of $1,107,660 ($221,532
annually) to enhance and expand Juvenile Drug Court services, for the
period of December 29, 2000 to December 28, 2004.
(3.5) PHP-CSAS - Request for approval of a contract modification with
Japanese Community Youth Council, Inc. (JCYC), in the amount of
$1,899,365, for a total four-year amount of $2,508,942 to provide
substance abuse prevention services to Asian American youth, for the
period of July 1, 1998 through June 30, 2002. (DPH contracted with JCYC
for services totaling $621,867 during FY 99-2000).
(3.6) PHP-CMHS - Request for approval of a new contract with
Harder+Company Community Research in the amount of $149,983 to develop a
model program for dually diagnosed youth, for the period of April 1,
2001 through December 31, 2001. (DPH contracted with Harder for services
totaling $28,000 during FY 1999-2000).
(3.7) PHP-CMHS - Request for approval of a retroactive sole source
contract renewal with Alameda County Health Care Service Agency (ACHCSA),
in the total amount of $3,300,960 for four years, to provide fiscal
management services and access to 24-hours skilled nursing
neurobehavioral care and adolescent subacute mental health services
targeting individuals with Organic Brain Syndrome impairment, for the
period of July 1, 2000 through June 30, 2004. (DPH contracted with
ACHCSA for services totaling $979,967 during FY 1999-2000).
(3.8) PHP-Health Promotion - Request for approval of a retroactive
contract modification with CAHEED, Inc. in the amount of $70,800, for a
contract total of $207,090, to provide augmented Black Infant Health
Improvement Program services targeting African American families and
communities, for the period of July 1, 2000 through June 30, 2001. (DPH
contracted with CAHEED for services totaling $136,290 during FY
Action Taken: The Commission approved the Consent Calendar of the
4) DIRECTOR'S REPORT
(Anne Kronenberg, Acting Director of Health, presented the Director's
Report on behalf of
Mitchell Katz, M.D., Director of Health)
SUMMARY OF THE GOVERNOR’S MAY BUDGET REVISION
On May 14, 2001 the Governor issued the May Revision to his budget. The
May Revision projects a $1.144 billion increase in revenues for the
current fiscal year (2000-01) and a $4.592 billion decrease in revenues
for 2001-02. This results in a combined two-year reduction of $3.448
billion. As a result, the May Revision reduces General Fund expenditures
by $3.177 billion. (All reductions and increases reported here are in
comparison to the Governor’s January budget.)
It is important to note that these cuts are the result of the economic
downturn and do not reflect any reductions due to energy expenditures.
Revenue increases from capital gains, stock options, personal income tax,
corporate sales tax, and sales tax are slowing down. On May 10, 2001, the
Governor signed a $13.4 billion revenue bond package that will repay the
General Fund for amounts advanced to purchase power for the State. The May
Revision assumes that these revenue bonds will be sold in August and will
reimburse the General Fund at that time.
As in previous documents, the budget declares a declining need for
health care funding at the local level because of:
- Expansion of Medi-Cal and Healthy Families “shifting
responsibility for health care coverage from county to federal and
state funded programs”;
- Availability of local Tobacco Settlement Funds;
- “Growing” health Realignment funds; and
- $53.7 million directed to breast cancer treatment, research and
Budget subcommittees will be holding their final hearings this week,
including consideration of the many items placed on their suspense files
pending the May Revision. Below is a synopsis of health related provisions
of the May Revision.
Tobacco Settlement Funds
The State expects to receive approximately $475 million in tobacco
settlement revenues in 2001-02 ($7 million more than projected in the
Governor’s January budget). The Governor’s May Revision continues to
support earmarking all of the State’s tobacco settlement revenues for
health programs. However, this has the effect of supplanting State General
Funds with tobacco settlement funds and resulting in decreased State
General Fund commitment to health services. The May Revision continues
funding for Medi-Cal, Child Health and Disability Prevention Program (CHDP),
breast and prostate cancer treatment, and youth anti-tobacco at the same
levels as in the January budget.
The May Revision reduces 2001-02 spending for Healthy Families by $44
million as a result of a delay in federal waiver approval to expand the
program to include uninsured parents of children enrolled in Healthy
Families or Medi-Cal and children with family incomes between 200% and
250% of the federal poverty level. The May Revision assumes an October 1,
2001 start date.
The May Revision decreases the current year (2000-01) Medi-Cal budget
by $266.4 million and increases the 2001-02 budget by $367.7 million. The
majority of this shift can be attributed to $175 million of the
Orthopaedic Hospital settlement expense that has been shifted from the
2000-01 fiscal year to the 2001-02 fiscal year. Additional expenditure
reductions in the current year are a result of smaller than anticipated
increases in the cost of nursing facility care, savings in county
administration costs due to reduced caseload activity, and drug costs
increasing more slowly than projected.
In 2001-02, $225.1 million of the projected $367.7 million increase in
Medi-Cal spending is for the Orthopaedic Hospital settlement. Additional
expenditures of $46.1 million for long-term care rate increases (including
a 2.15% increase for nursing homes), $43.5 million for increased county
administration costs, and $25 million for a managed care rate increase
(2%) are also included in the May Revision.
Current year General Fund spending for Healthy Families is expected to
be $6.4 million lower than projected in the January budget due to slower
than anticipated caseload growth. In 2001-02, overall General Fund
expenditures are expected to increase by $10 million. However, net
expenditures are expected to decrease by $76.9 million, in part as a
result of the delay in federal approval of the State’s waiver. The
General Fund expenditure increase is due to a higher than anticipated
enrollment of children with family incomes between 100% and 200% of the
federal poverty level.
In comparison to the January budget, the May Revision reduces current
year public health expenditures by $5.6 million and 2001-02 public health
expenditures by $27.2 million.
The May Revision eliminates the $2 million increase in public health
subvention included in the Governor’s January budget. This reduces
public health subvention to fund communicable disease control and
surveillance at the local level to $1 million statewide.
Current year reductions of $6.1 million are attributed to reduced
caseload in California Children’s Services (CCS), CHDP and Genetically
Handicapped Persons programs. An additional $3.9 million is deducted from
these budgets in 2001-02 due to further declines in caseload and health
care costs in these programs.
The Governor anticipates a reduction of $77,000 in Proposition 99
revenues for 2000-01 and a reduction of $14.7 million for 2001-02. In
2001-02, the May Revision proposes program reductions of $18.3 million to
accommodate reduced revenue and increased caseload in the Access for
Infants and Mothers (AIM) program. These reductions include a $12.7
million decrease in the California Healthcare for Indigents (CHIP)
program. The May Revision continues to budget $24.8 million for emergency
physicians and $114.5 million for an anti-tobacco media campaign.
The May Revision also proposes trailer bill language to limit the
discount given to tobacco wholesalers and distributors for affixing tax
stamps to tobacco products. This will result in approximately $9.7 million
in revenue, which the Governor proposes to use to supplement the
Proposition 99 and Proposition 10 funds, as well as contribute to breast
cancer prevention and research, and the State’s General Fund.
The May Revision includes a net increase of $26 million (a $5.3 million
reduction in General Funds) for community service programs in 2001-02.
This increase includes a $9.5 million federal block grant allocation and
$15.4 million in federal reimbursements for the Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) program and for a San Mateo
County test program. General fund programs in the Department of Mental
Health are reduced by $22.4 million. These reductions include $5 million
to withdraw the discretionary 3% cost of living adjustment for mental
health managed care and a $5 million decrease in the supportive housing
program. The budget continues $20.1 million in supportive housing programs
and $55.6 million for Integrated Services for Homeless Adults. The
remaining reductions of $12.4 billion are for deferred maintenance
projects at State hospitals.
Alcohol and Drug Programs
The May Revision projects a $10 million reduction in current year
expenditures due to a delay in approval of the State Medicaid Plan
amendment that would provide for additional Drug Medi-Cal services as of
January 2001. The 2001-02 General Fund budget for alcohol and drug
programs is reduced by a net of $34.7 million. The May Revision increases
General Fund spending by $12 million for Perinatal Drug Medi-Cal, as well
as, caseload growth and new unit cost services in Drug Medi-Cal. However,
proposed reductions include $7.7 million in adult treatment services, a
$5.7 million in youth treatment services, $8.5 million for drug court
substance abuse treatment, and $24.3 million to reflect the delay in State
Plan Amendment approval.
Aging with Dignity
The Governor’s May Revision includes an additional $57 million
General Fund for 2001-02 for the In-Home Supportive Services (IHSS)
program to increase the State share-of-cost of employee wages for Public
Authority (PA) and non-PA providers, fund the State share of benefits up
to $.60 for various PA providers, and increase Maximum Allowable Contract
Rates. The May Revision also an additional $46.1 million for increased
long-term care rates and eliminates the $1.5 million augmentation for the
Federal Health Insurance Portability and Accountability Act (HIPAA)
The May Revision includes $152.1 million ($37 million General Fund) for
HIPAA implementation within the Health and Human Services Agency, the
Department of Health Services, the Department of Mental Health, the
Department of Developmental Services and the Department of Alcohol and
POPULATION HEALTH AND PREVENTION
As one of the newest refugee groups in the San Francisco Bay Area,
little had been documented on how Bosnian refugees are faring and how they
have adjusted to their new country and its health care, education, and
employment systems. The Newcomers Health Program has recently published a
report entitled "Bosnian Refugees in San Francisco: A Community
Assessment". This project was undertaken to assist staff in program
planning, grant writing, and developing community collaborations. This
report, also posted on the Department's website, presents a baseline
picture of the Bosnian refugee population in San Francisco County.
Senior Pedestrian Awareness Day
Staff from the Department's Community Health & Safety Section
hosted a rally at noon today on the steps of City Hall in recognition of
Senior Pedestrian Awareness Day. The event also kicked off a new senior
pedestrian safety poster campaign and featured several of the seniors
whose photos appear on the posters. Senior pedestrians are being killed at
three times their proportion of the population and once they're hit in a
collision, seniors are four times as likely to die. Today's rally was an
opportunity to focus on the hazards to all pedestrians, and especially the
most vulnerable. Representatives from the Board of Supervisors, Parking
& Traffic and the San Francisco Police Department joined members from
a variety of senior and safety advocacy groups for the event.
Nutrition Services Raises $1000+ for March of Dimes
The Nutrition Services Program raised over $1000 at this year’s March
of Dimes "Walk America." The nutrition services team promoted
their healthy eating and physical activity message wearing "Feeling
WIC and “Feeling Good” Team up at Farmers’ Market
The WIC Program and the "Feeling Good" Project will be doing
outreach at both the Heart of the City and the Ferry Plaza Farmers’
Markets this summer. WIC participants will receive coupons for fresh
produce. Staff will be providing colorful aprons to vendors, distributing
samples of fruits and vegetables and sharing information about healthy
eating. WIC staff will be looking to enroll clients into the WIC program
at the markets from June through September.
The Department recently approved a new policy on "Minor Consent
Primary Care and Mental Health Services. The purpose of the policy is
to provide uniform guidance to the Department's health care providers who
work with dependent minors ages 12 to 17 who present for services with or
without parental consent. This policy will enable primary care and mental
health providers to work together with youth and their families to address
adolescent health issues and offer much needed support.
The policy was developed by the Department's Coordinating Council for
Children, Youth, and Families with input from parents, social workers,
physicians and Nurses. The policy is also available on DPHNet.
SAN FRANCISCO GENERAL HOSPITAL CREDENTIALS REPORT - MAY 2001
Changes in Privileges
Immediately preceding the Director's Report, President Guy stated that
two senior staff people were leaving the Department to accept other
opportunities. President Guy and Ms. Kronenberg honored Tangerine Brigham,
Director of Policy and Planning, and later in the meeting, Melissa Welch,
M.D., Chief Medical Officer for the Community Health Network, for their
many years of service, advocacy, and accomplishments.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEES
RECOGNITION AWARDS FOR THE MONTH OF MAY
On behalf of the Health Commission, Commissioner Sanchez presented the
Mela Yee, Pharmacy Technician
DPH - Community Health Services
Yuki Kubo-Hendricks, Director, Pharmaceutical Services
DPH - Central Administration
Tangerine Brigham, Director, Policy and Planning
6) UPDATE ON 9-MONTH REVENUE AND EXPENSE REPORT
Monique Zmuda presented the Revenue and expenditure Report for the 3rd
Quarter of FY 2000-01. Based upon revenue collected and billed, and
expenses incurred for the first nine months of the fiscal year (until
March 31, 2001), the Department projects a fiscal year end surplus of $2.1
million. However, the Department has not included increased energy costs
in this projection. Based on expected increases to cover and energy costs
in the current year, the Department anticipates that the entire surplus,
plus additional supplementals, will be used to fund energy increases. The
Report was Attachment A.
- Commissioner Sanchez asked whether COLAs (cost of living
adjustments) for non-profits next year were included in the budget. Ms
Zmuda replied that COLAs were requested, but not yet funded.
- Nora Roman, Emergency Coalition to Save Public Health, stated (in
connection with a Commissioner's comment concerning hiring freezes)
that DPH actually did have a hiring freeze, because it does not have
enough staff. Ms. Roman stated that the picture is not okay, merely
because the budget is in balance.
7) UPDATE ON PROPOSITION 36, "THE SUBSTANCE ABUSE AND CRIME
PREVENTION ACT" IMPLEMENTATION PLAN
Barbara Garcia, DPH Deputy Director of DPH for Population Health and
Prevention, and Co-Chair of the City's Population 36 Steering Committee,
presented on behalf of the Department.
Proposition 36 requires probation and drug treatment in lieu of
incarceration, for conviction of possession, use, transportation for
personal use, or for being under the influence of a controlled substance,
and related parole violations. The Act goes into effect statewide on July
1, 200 1.
Ms. Garcia began by honoring and thanking San Francisco District
Attorney Terrence Hallinan for supporting Proposition 36 and for being an
advocate for treatment. District Attorney Hallinan thanked Ms. Garcia, and
the unique team of prosecutors and public health that worked on
implementation issues. Mr. Hallinan stated that addiction and abuse are
primarily medical problems. He added that he saw Proposition 36 as not
just refraining from locking up people for using drugs, but also seriously
begins to cure addiction and abuse in California.
Ms. Garcia described the provisions of Proposition 36, which applies to
individuals convicted of certain non-violent drug possession offenses are
eligible. She emphasized that during the planning process, the various
subcommittees were co-chaired by representatives of criminal justice and
health. According to Ms. Garcia, DPH, as the County Lead Agency, has
coordinated the development of a county plan. She added that the
Department will now need to provide for services or contract for services,
administer funds, coordinate data collection and reporting, and coordinate
evaluation of county programs. Ms. Garcia discussed other issues, such as
programs, budget, stakeholders, and timetables.
A copy of the report delivered by Ms. Garcia before the Commission was
- Marcia Rosenbaum was one of the drafters of Proposition 36. She said
that San Francisco is implementing Proposition 36 the way that the
drafters envisioned. She stated that Ms. Garcia visualized treatment
in a way that gets to the root of the problem.
- Barbara Farrell, Executive Director of the OhIhoff Recovery
Programs, thanked Ms. Garcia and Mr. Hallinan for their inclusiveness
on this issue. She said that this is a wonderful opportunity to
document how treatment benefits the community.
- Nancy Cooper is the Director of the Ohlhoff Women's Residential
program. She stated that women often feel disgrace with their drug and
crime situation, and that it is important to help these women. She
stated that the plan presented was a great job, and urged the
Commissioners to support it.
- Frederick Hobson appeared on behalf of the San Francisco Drug Abuse
Advisory Board, an official body reporting to the Board of
Supervisors. He thanked the Department for participating and
conducting the Town Hall Meetings. He asked the Department to identify
funding for treatment slots.
- Nora Roman, Emergency Coalition to Save Public Health, asked the
Commissioners to look at the peoples budget proposal for this year,
where she said are several exciting culturally competent treatment
- Commissioner Sanchez commended the two Co-Chairs as demonstrating
what counties can do in this area. He complimented the inclusiveness
of the planning effort. The Commissioner added that the bigger
challenge will be the quality assurance to be sure that all systems
- Commissioner Jackson echoed Commissioner Sanchez's words. He stated
that this type of program is essential, and a long time in coming.
- Commissioner Parker believes that this program will add a sense of
justice to the overall system. He stated that the documentation was
outstanding, and that the stakeholders were enthusiastic.
- Commissioner Umekubo thanked everyone for leading the way with this
innovative program. He asked Ms. Garcia what happens after the
presently available 1000 slots are filled. She replied that DPH would
try other capacities. She cautioned that, from a funding perspective,
DPH wants to balance the voluntary treatment programs that the City
maintains now with the Proposition 36 slots because DPH does not want
people to have to face jail to seek treatment.
- President Guy added her support to the leadership that created and
implemented the Proposition 36 policy. She asked how DPH will evaluate
and monitor this program for impact. President Guy stated that DPH
must be ready in a year or two with quality analysis.
8) HEARING IN ACCORDANCE WITH THE HEALTH CARE PLANNING ORDINANCE
(PROPOSITION Q): ST. MARY'S MEDICAL CENTER
The Proposition Q hearing concerned a plan by St. Mary's Medical Center
(SMMC) to close its 22-bed Adult Inpatient Psychiatric Program and to
transition those patients and staffing needs to the 35-bed Saint Francis
Memorial Hospital (SFMH) Adult Psychiatric Services Department. In
addition, SMMC plans to close its Electro Convulsive Therapy Program that
affects approximately 32 patients per year. MSMMC also plans to increase
its Adolescent Psychiatric Inpatient Program from 17 to 21 beds.
Several representatives from SMCC made presentations to the Commission
during the Proposition Q hearing. Ken Steele, Interim President at SMCC,
introduced other SMCC representatives, including: Stephen Krause, M.D.,
Medical Director of McAuley Institute at SMMC; Cheryl Fama, President,
SFMH; Mel Blaustein, M.D. Medical Director for Psychiatric Services, SFMH;
and Jim Illig, Chair, SMMC Community Advisory Committee.
Mr. Steele stated that SMMC is not closing, and expects to break even
financially. He views the closure of the Adult Inpatient Psychiatric
Program as a transfer. Mr. Steele said that although the unit has 22 beds,
its average census is 14 patients. He added that the SFMH facility was
recently renovated. Dr. Blaustein stated that SFMH can absorb the
transferred patients, and that three physicians are transitioning from
Mr. Steele spoke about the level of reimbursements that SMMC receives
from the City, and that the program costs SMMC $1.60 for every $ 1.00 that
it receives in revenue. Mr. Steele stated that SMMC is seeking a rate
increase from the City. Ms. Fama added that SFMH loses money on adult
inpatient psychiatric services.
Attachment C had more information.
- Helga Carlton, has been a psychiatric nurse at St. Mary's Medical
Center for 21 years. She questioned why St. Mary's would close a
needed unit, and why San Francisco would allow it.
- George Oulette is a CNA at St. Mary's. He stated that staff were
told to keep the unit's census low. He believed that the consequences
of the closure would be that clients would be on the street.
- Stephanie Hadabaus, R.N., spoke about the bed closures. She stated
that patients are sicker today, with fewer staff to care for them. She
questioned the safety of the patients, with each nurse caring for 6 -
8 patients. Ms. Hadabaus added that St. Mary's has long provided
specialized services for patients; and that Saint Francis Memorial
Hospital cannot adequately treat the same patients.
- Lynn Herring read a statement on behalf of Naomi White of St.
Mary's. She stated that under the St. Mary's proposal, patients will
be warehoused and receive less care.
- Pam Ernst, R.N., is the Manager of adult psychiatric inpatient
services at St Mary's. She believed that the unit's closure would be a
- Nancy Cox, has been a RN, at St. Mary's for 19 years. She asked that
the closure be reconsidered. She further stated that many people
depend on the unit for care and will find themselves in trouble.
- Nora Roman, Emergency Coalition to Save Public Health, said that she
was concerned with all services, and that cutting any beds is not
sound health care policy. She asked that health care not be viewed as
a commodity, and to support legislative efforts to increase charity
- Ray Castro has been an R.N. at St Mary's for 17 years. He is
concerned about St. Mary's ability to respond to a community
- Commissioner Parker stated that he was concerned about the
downsizing, but that the Commission was receiving mixed messages: 1)
that there are not enough patients to keep the unit open, and 2) that
the reimbursement rates are too low to keep the unit open. Kenneth
Steele responded that payors are not willing to pay full costs of
services, and that the City controls many beds.
- Commissioner Sanchez noted that St Francis upgraded its 35 bed adult
psychiatric unit. He stated that the efficacy and quality of care are
the primary issues. Diane Roberts, Clinical manager of Psychiatric
Services at Saint Francis, stated that the adult psychiatric units at
SMMC and St. Francis have operated at 50% capacity for years, and that
St. Francis Unit was never full. Ms. Roberts stated that the patients
were selected by need, not by payor mix. She offered reassurance that
St Francis will be able to accommodate new people
- Commissioner Parker stated that if St. Mary's does not survive, then
it will be of no use to anyone. He asked whether the low number of
beds was due to financial concerns or related to patient health. Ms.
Roberts responded that, over the last 10 to 15 years, there has been
tremendous changes affecting psychiatric patient treatment and
hospitalization. She added that payors have restrictive criteria for
when they will pay.
- President Guy asked if the beds have ever been filled to capacity.
Cheryl Farna of SFMH, did not think that the 35-bed capacity had been
reached. In response to President Guy's further question, Ms. Fama
stated that there was probably not a need for additional adult acute
psychiatric care beds.
- Commissioner Jackson asked several questions regarding rates and
rate increases. He questioned whether the elevator in the AIDS
Dementia Unit, discussed during a previous Commission meeting, was now
working. Mr. Steele answered no, that the elevator technology was not
yet installed. Commissioner Jackson then stated that from a business
standpoint, a $1.60 service cannot be provided for $1.00.
- President Guy clarified the purpose of that day's Proposition Q
hearing, which was whether the closure of the SMMC programs would have
a detrimental impact upon the public health of San Francisco. She
stated that the Commission does not oppose SMMC maintaining its
priority on adolescent psychiatric inpatient services.
Linda Wang, Director, Adult and Older Adult Systems of Care, DPH,
discussed the future needs for adult psychiatric inpatient beds. Ms. Wang
prepared a Memorandum for the Commission in which she concluded that the
City probably would not be short on adult psychiatric inpatient beds next
year. She discussed average usage, but warned that psychiatric needs do
not always follow averages. Ms. Wang identified peak usages, and out of
county placements. She added that SMMC has provided extremely valuable
services to City.
- President Guy stated that what once was excess capacity is now
consolidated. She questioned whether, with low reimbursement rates,
the City will be faced again with the same situation. Ms. Fama
responded that consolidating 25 to 30 patients would help to bring
costs down. She anticipates improved rates from some of the managed
care companies. Ms. Fama would like to cover the operating costs.
President Guy added that one lesson of Proposition Q is that different
parties must work as allies, for example in seeking higher Medi-Cal
reimbursement rates, instead of competitors.
- Commissioner Sanchez stated that these are difficult hearings. He
suggested looking at alternative sources of funding, such as
foundations and religious institutions.
President Guy thanked everyone for participating in the hearing, which
will be continued to the next meeting.
9) OTHER BUSINESS/PUBLIC COMMENTS
Elizabeth Frantes commented on the Director's Report. She stated that
people need better access to health care, and that the Commission should
listen to providers, and to stop listening to the same people who got the
Department into the current mess. Ms. Frantes also stated that the Healthy
Families program discriminates against childless people.
President Guy adjourned the meeting at 6:35 p.m.
Arthur R. Greenberg, Interim Health Commission Secretary