Minutes of the Health Commission Meeting

August 7, 2001
3:00 P.M.
at 101 Grove Street, Room #300
San Francisco, CA 94102


The regular meeting of the Health Commission was called to order by President Roma Guy, M.S.W., at 3:15 p.m.


  • President Roma P. Guy, M.S.W.
  • Vice President Edward A. Chow, M.D.
  • Commissioner Arthur M. Jackson
  • Commissioner Lee Ann Monfredini
  • Commissioner Harrison Parker, Sr., D.D.S.
  • Commissioner David J. Sanchez, Jr., Ph.D.
  • Commissioner John I. Umekubo, M.D.


Action Taken: The Commission adopted the minutes of July 24, 2001 with the corrections for the July 10, 2001 minutes on page 6, item #5, to read: “On behalf of the Health Commission, Commissioner Jackson presented the following awards,” and, also on page 6, item #6, the addition of the “Department of Public Health” to the list of departments.

(Commissioner David J. Sanchez, Jr., Ph.D.)

Commissioner Sanchez chaired, and Commissioners Monfredini and Parker attended, the Budget Committee meeting.

(3.1) DPH-Central Administration - Request for approval of a new contract with EPC Consultants, Inc. as fiscal intermediary for P.B. Strategies, LLC, who will provide overall project management services for capital improvement projects to neighborhood Primary Care facilities, in the amount of $58,500, for the period of August 1, 2001 through June 30, 2002.

(3.2) DPH-Central Administration - Request for approval of four new contracts with the following four organizations in the amount of $300,000 to provide outreach services to residents of Bayview, Hunters Point and Potrero Hill, to assist the uninsured in gaining health information and health insurance coverage, for a two-year contract period of July 1, 2001 through June 30, 2003.

Children’s Council of San Francisco (CCSF)


Economic Opportunity Council of San Francisco (EOC)


Potrero Hill Neighborhood House (PHNH)


The Sojourner Truth Foster Family Service Agency Inc. (STFFSA)


(3.3) PHP-Health Promotion - Request for approval of a renewal contract with O’Rorke Public Relations & Advertising, in the amount of $170,000, to provide public relations and media services to the Stop Red Light Running Project, for the period of July 1, 2001 through June 30, 2002. (DPH contracted with O’Rorke for services totaling $244,726 during FY 2000-01).

(3.4) PHP-Health Promotion - Request for approval of a month-to-month contract with CAHEED, Inc., in the amount of $339,000, to provide outreach and prenatal education and support services targeting African American fathers, mothers and infants, for the period of July 1, 2001 through June 30, 2002. (DPH contracted with CAHEED for services totaling $207,090 during FY 2000-01).

Commissioners’ Comments

Commissioner Sanchez stated that the recommendation is to approve a month-to-month contract, and that staff will provide the Budget Committee with a report on the performance of this contract in 30 days, as well as a report when the City Attorney investigation is complete. Commissioner Sanchez said that, in the meantime, staff will be looking at other options for maintaining these services in the event there are any diversions of the existing programs. Commissioner Sanchez stated that, with regard to the Health Department contract, staff has said that they have been working successfully with the organization.

Commissioner Guy pointed out that there are two issues with regard to the contract: the expansion into the Western Addition and their on-going work. Commissioner Guy wants to ensure that both components are part of the report to the Budget Committee. Commissioner Guy also pointed out that there were performance issues raised in the staff report that are separate from the City Attorney investigation that must be addressed.

Commissioner Monfredini stated that the organization is doing good work on the Health Department contract, but that the Budget Committee will be monitoring the contract on a monthly basis.

Dr. Chow stated there is no question that these services are vital to the community, and that the Commission is receiving assurances from staff that the services are being delivered. Dr. Chow said that as each month goes by, there needs to be continued progress, and that the Budget Committee should receive monthly reports for the next two months, in addition to receiving a report when the investigation is complete.

Commissioner Jackson asked if it is costing the city extra funds to have staff on-site to ensure that the non-profit is performing adequately. Ginger Smyly responded that it really is not an additional cost to the program, because the Health Department staff also provides direct services.

(3.5) AIDS Office - Request for approval of a renewal contract with California AIDS Intervention Training Center (CAITC), in the amount of $140,110, to provide HIV prevention services targeting high-risk behavior groups, for the period of July 1, 2001 through June 30, 2002. (DPH contracted with CAITC for services totaling $525,056 during FY 2000-01).

(3.6) AIDS Office - Request for approval of a contract renewal with the Regents of the University of California, through UCSF/AIDS Health Project, in the amount of $327,420, to provide HIV counseling, testing, referral and partner counseling and referral services, for the period of July 1, 2001 through June 30, 2002. (DPH contracts with UCSF for services totaling $10,581,353 during FY 2000-01).

Commissioners’ Comments

At the Budget Committee, Commissioner Monfredini conveyed Commissioner Guy’s commendation of the organization for its strong approach to cultural competency.

Commissioner Sanchez abstained on this item.

(3.7) AIDS Office - Request for approval of a new sole source contract with the Regents of the University of California, on behalf of the University of California at San Francisco (UCSF), Center for AIDS Prevention Studies, in the amount of $369,159, to provide a full range of services for telephone interviews for an HIV Seroincidence Study of men in San Francisco, for the period of July 1, 2001 through December 31, 2001. (DPH contracted with UCSF for services totaling $10,581,353 during FY 2000-01).

Commissioner Sanchez abstained on this item.

(3.8) PHP-CMHS/Child, Youth and Family - Request for approval of contract renewals with the following eight (8) agencies for the Family Mosaic Project, in the amount of $996,334, to provide various wrap-around services targeting seriously emotionally disturbed children, for the period of July 1, 2001 through June 30, 2002.



Type of Service

Proposed FY 01-02 Transactions

Big Brothers/Big Sisters of SF


Catholic Youth Organization - St. Vincent’s School for Boys

Sub-Acute Residential Treatment


High Gear Achievers, Inc.

Tutorial Services


JLC Services

Mentoring Services


Lincoln Child Center

Sub-Acute Residential Treatment


New College of California

Counseling Services


RISE Institute

Mentoring Services


Victor Treatment Centers

Sub-Acute Residential Treatment


(3.9) PHP-Mental Health - Request for approval of a retroactive contract modification with Jewish Family and Children’s Services (JFCS), in the amount of $364,984, to provide outpatient mental health services to refugee children from the former Soviet Union and mental health consultation, clinical and training services for family and center-based child care providers, for the period of July 1, 2000 through June 30, 2001, for a total contract value of $1,277,018 for the four-year period of July 1, 1997 through June 30, 2001 ($404,984, for FY 2000-01). (DPH contracted with JFCS for services totaling $372,034 during FY 2000-01).

(3.10) PHP-Substance Abuse - Request for approval of a retroactive contract modification with Ohlhoff Recovery Programs in the amount of $76,370, to provide residential and outpatient substance abuse services targeting women and adolescents, for the period of July 1, 2000 through June 30, 2001, for a total contract value of $770,753 during the total contract period of July 1, 1998 through June 30, 2002. (DPH contracted with Ohlhoff for services totaling $189,188 during FY 2000-01).

(3.11) PHP-Substance Abuse - Request for approval of a multi-year contract with the State Department of Alcohol & Drug Programs for Fiscal Years (FY) 2001-02 through 2004-05 for the combined Net Negotiated Amount (NNA) and Drug Medi-Cal (DMC) contract.

(3.12) CHN-SFGH Radiology - Request for approval of a two-year contract with the Registry Network, Inc., in the total contract amount of $700,000, to provide intermittent, as-needed, professional radiology technology services, with on-call availability 7 days a week, for the period of September 1, 2001 through August 31, 2003. (DPH contracted with Registry Network for services totaling $414,258 during FY 2000-01).

Action Taken: The Commission approved the Consent Calendar of the Budget Committee, with Commissioner Sanchez abstaining on #3.6 and #3.7.

(Mitchell H. Katz, M.D., Director of Health)

August at Laguna Honda Hospital -- A New Tradition

Last Friday, I began a 4-week stint of doctoring at Laguna Honda Hospital. I am going 3-4 times a week for 3-hour blocks. During this time I am carrying the call pager (for immediate medical problems for which the regular ward physician is not available), checking on residents living on wards where the regular doctor is out sick or on vacation, seeing patients, reviewing monthly orders, and performing admission history and physicals for patients returning to Laguna Honda from the acute hospital.

As with working as a medical attending at SFGH in December, practicing my vocation and interacting with patients is a great pleasure and honor. I have been deeply impressed with the quality of the medical and nursing care at Laguna Honda Hospital.

Working on the wards, whether at LHH or SFGH, is a particularly helpful method of learning about our system and identifying the opportunities for growth. I have noted a high proportion of residents at LHH with serious mental health issues, especially schizophrenia, and schizo-affective, who also have skilled nursing needs. Unlike the MHRF, LHH was not specifically designed in its physical plant nor in its programming to care for people with serious mental illness. Because these patients cannot be moved to the MHRF (they require too much skilled nursing care), we need to intensify our mental health programming for LHH.

Through the actions of the Health Commission, the Board of Supervisors, the Mayor and the efforts of our dedicated staff, we have taken the first steps in this direction through opening the recent psychosocial units. I think there is more to be done. We have already begun planning between LHH and Mental Health to intensify mental health treatment at LHH. We will bring proposals for resolving these issues to the Joint Conference at LHH.

State Budget


On July 26, 2001, Governor Gray Davis signed a $103.3 billion State budget for fiscal year 2001-02. As a result of a slowdown in California’s economy and State revenues, the final budget reflects significant cutbacks from the spending levels proposed in by the Governor in January 2001. In order to establish a $2.6 billion reserve, the Governor cut $554 million from the Legislature’s spending plan.

Highlights of Health-Related Provisions

Of the $554 million blue-penciled by the Governor, $77 million was taken from health programs. Despite these cuts, the budget spends $13.6 billion on health programs, which represents a 9.8 percent increase over last year's spending. Consistent with his veto messages of last year, vetoes related to county health programs pointed to local realignment funds and local Tobacco Settlement dollars that jursidictions may use for any health purpose deemed a local priority.

Department’s Budget Priorities

Notwithstanding the significant cuts in health services, two of the Department’s highest State budget priorities were retained in the final budget: increased funding for Laguna Honda Hospital and funding for trauma care centers.

The budget establishes a program to allow public distinct part nursing facilities to match their local general fund contribution with federal Medicaid dollars. For Laguna Honda, this will mean an approximately an additional $5 million in Medicaid revenue in 2001-02. Once again, Assemblywoman Migden sponsored the distinct part nursing facility budget item on behalf of the Department and we are extremely grateful for her continued support of Laguna Honda Hospital.

The budget also includes one-time funding of $25 million to be allocated to trauma centers like San Francisco General Hospital’s trauma center and provides $5 million to establish a statewide trauma plan. Department staff and the City’s lobbyist worked closely with the Save California Trauma Centers coalition in support of this budget initiative.

Tobacco Settlement Fund

The budget continues to dedicate the State's share of Tobacco Settlement dollars ($475 million) to health purposes, including previous Medi-Cal expansions and the proposed expansion of Healthy Families to include parents. Unfortunately, however, this has the effect of supplanting State General Funds with Tobacco Settlement funds and, as a result, reduces the State’s General Fund commitment to health services.


The budget adds $500 million General Fund to accommodate anticipated increased caseloads in the Medi-Cal program for eligibility changes made to the program in 2000-01. These changes include expansion of eligibility to: provide no-cost Medi-Cal to two-parent working families with incomes below 100% federal poverty level (FPL) and aged, blind and disabled with incomes below 133% FPL; provide coverage to working disabled with incomes below 250% FPL; and to provide continuous eligibility for children and for persons leaving CalWORKS. Last year’s expansions are expected to increase Medi-Cal enrollment by 800,000 people.

Healthy Families

The final budget includes $61.8 million in Tobacco Settlement funds to expand Healthy Families to cover parents up to 250% FPL, pending federal approval. However, the Governor deleted language that would have made coverage for parents under Healthy Families an entitlement. Consequently, continued coverage for parents will be subject to annual appropriation in the State budget.

Behavioral Health

The final budget reduces youth substance abuse treatment programs by $5.7 million citing the General Fund commitment to substance abuse under Proposition 36. Additionally, drug court funding was reduced by $3 million. In mental health, the budget increases AB 34/AB 2034 funding by $10 million, reduces funding for the supportive housing program by $5 million and deletes a $2 million Legislative augmentation to fund the Mental Health Respite Care Pilot Program.

Public Health

The AIDS Drug Assistance Program received full funding in the State budget. However, funding for HIV/AIDS education and prevention activities was reduced by $4 million. The budget also returned local public health subvention to last year’s funding level of $1 million Statewide and deleted a $2 million Legislative augmentation for the Childhood Lead Poisoning Prevention Program.

Maternal and Child Health

The Governor blue-penciled the County Maternal and Child Health Services allocation by $2.6 million. The loss of this funding will result in $183,000 in losses to the Department. Additionally, the Governor deleted a $6.7 million Legislative augmentation that would have increased the frequency of health screening and evaluation services under the Child Health Disability Prevention (CHDP) Program to conform to standards established in Healthy Families and Medi-Cal managed care.

Women’s Health

The budget includes $9.5 million ($5.3 million Tobacco Settlement Fund and $4.2 million federal funds) to phase in a new federal option to provide breast and cervical cancer treatment for women with incomes up to 200% FPL who were previously ineligible for Medi-Cal. The budget also contains $9.1 million in Tobacco Settlement funds to provide treatment for uninsured and undersinsured women who do not qualify for the new Medi-Cal benefit. Screening services will continue to be covered under separate programs, including the Proposition 99-funded Breast Cancer Early Detection program.

Vital Statistics

A new $3 fee has been added for certified copies of birth, death, marriage or marriage dissolution records. The budget provides that these fees may be used by State and local governments to enhance services to the public, improve the ability of State and local health authorities to analyze maternal and newborn health needs, and to analyze the health status of the general population.

State Plan Amendment for Laguna Honda Approved

On July 17, 2001, the federal Centers for Medicare and Medicaid Services (CMS) approved California’s State Plan Amendment implementing Senator Speier’s bill of 1999, SB 1128, which allows Laguna Honda to access supplemental Medicaid payments to help cover the costs associated with servicing the debt on the rebuild. These funds will help the City reduce the burden on taxpayers for repayment of the bond by making federal Medicaid funding available for this purpose. Supplemental payments will be accessible once we submit a certificate of occupancy for the new facility. This effort was strongly supported by our federal delegation, who, together with San Diego's delegation, sent a letter to CMS requesting the speedy approval of this State Plan Amendment.

DAWN Report Offers Good News for San Francisco

We received good news this past week from the Substance Abuse and Mental Health Services Administration (SAMHSA). The agency's recent DAWN Report (Drug Abuse Warning Network), which tracks significant trends in drug related emergency department visits from 1999-2000, is showing a 12 % decrease in drug related ED visits in San Francisco (from 8930 to 7857). This is the first time in over a decade that San Francisco has fallen below the top two in ranking of metropolitan areas for drug episodes, reflecting the City's continued and growing commitment to prevention, increased access into treatment and harm reduction services. A specific indication of how well we are doing in preventing emergency department visits is also reflected in a 10% decrease in heroin/morphine mentions (from 3074 to 2773) and a stable number of methamphetamine/speed incidents (at 591). However, club drugs such as GHB and MDMA and marijuana/hashish are increasing, especially among patients age 25 and under.

The entire report can be accessed on the SAMHSA website at www.samhsa.gov.

Substance Abuse: Ozanam Open and Accepting Patients

I am sure the Health Commissioners join me in congratulating the staff involved in bringing about the successful opening of the Ozanam Medically Managed Detoxification Program that began treating its first patient immediately after opening its doors last week. The new Ozanam Program (Howard Street Detoxification Program) represents a collaboration of DPH, St. Vincent DePaul and UCSF, bringing vital medical services and expertise to a community-based setting. The program has taken 20 existing social model detox beds at the Ozanam, and enhanced them with 24-hour medical monitoring along with the ability to provide oral medication when indicated. Because of these program enhancements and the safe venue they create, we are able to treat individuals who, given the severity of the substance use and co-existing medical or psychiatric conditions, require monitoring and medication to safely withdraw. We expect the majority of our patients will be dependent on a combination of alcohol, sedatives and opiates--which tend to produce the greatest degree of physical dependence.

Children & Families Commission

The Children and Families Commission, with whom this Department has close ties, has just released their annual report. Ginger Smyly, MPH, from Community Health Promotion and Prevention Branch, has served as Chair of the Commission, along with Vice Chair, Margaret Brodkin, of Coleman Advocates. The report highlights the first year's work of the Commission under its new Strategic Plan. The Health Commissioners may recall the advent of Prop 10 which funded the Children and Families Act of 1998, to provide funds to invest in the health and development of children zero to five and their families. The funds come from a new tax on tobacco products. A copy of the annual report, entitled "Year at a Glance," is attached to this Director's Report.

CHIPPS Program Featured in CDC Report

The Department's Community Health Injury Prevention Program (CHIPPS) for senior injury prevention was featured in a news report just released by CDC, titled "U.S. Fall Prevention Programs for Seniors." CHIPPS is one of 18 programs in 12 states providing education about preventing falls, home assessments, safety checklists, and access to home repairs. The complete report is available on the CDC website.

Environmental Health, Solid Waste Enforcement

The State Integrated Waste Management Board has awarded the Department's Environmental Health Section $23,000 in grant funds to support new equipment, training and technical support. The award reflects the Board's recognition of SFDPH's effective monitoring and enforcement of the State's solid waste health and safety standards.

WEDGE Program Fundraiser

The WEDGE Program, which educates San Francisco youth about HIV/AIDS, has teamed up with Macy's during the retailer's upcoming PASSPORT AIDS benefit event. A $10 donation to WEDGE qualifies shoppers for in-store discounts at Macy's Union Square or Valley Fair on September 15th. 100% of all donations go directly to the WEDGE program. The PASSPORTS are available through the WEDGE program office.

Medical Staff Appointments LHH


07/1/2000 to 6/30/2001

New Appointments










    Reappointment Denials




Disciplinary Actions




Changes in Privileges



    Voluntary Relinquishments


Commissioners’ Comments

Commissioner Guy commended Dr. Katz for serving on staff at Laguna Honda in August, and stated that the input he receives will be beneficial during the program planning for the new Laguna Honda. Commissioner Guy would like this information reviewed at the Laguna Honda Joint Conference Committee. With regard to the State Plan Amendment for Laguna Honda, Commissioner Guy noted that last year the Health Commission had extensive discussions about lobbying for increased financing of the health care system, and that the State Plan Amendment is a successful outcome of this effort.

Commissioner Chow commented on the DAWN report, and asked if drug use is increasing in other geographic areas. Dr. Katz responded that yes, other areas are up, and that San Francisco no longer ranks number one. Commissioner Chow continued that this is an excellent report coming from an outside agency that confirms that the City’s commitment to drug treatment is making a difference in San Francisco.

Commissioner Umekubo noted the higher proportion of serious mental health issues at Laguna Honda, and asked if dementia was one of these problems. He looks forward to working at the Laguna Honda Joint Conference Committee to address this issue.

(John Brown, M.D., Director EMS Section)

Dr. John Brown, Director of the EMS Section, presented the commissioners with an overview of the San Francisco Trauma Care System Plan 2001. The power point presentation covered the background, goals and vulnerabilities of the 2001 plan, the changes in the 2001 Plan, the implications for the future of the Trauma Care System and the approval process.

The overall goals of the 2001 plan are:

  • Decrease Injury Morbidity and Mortality in San Francisco
  • Ensure rapid access to appropriate levels of care
  • Ensure seamless pediatric trauma care
  • Improve long-term trauma outcomes
  • Improve injury surveillance, prevention and public education
  • Evaluate Trauma System Quality and Cost-Effectiveness
  • Monitor trauma system process, structures, outcomes and costs with continuous quality improvement process

Dr. Brown provided a summary of the existing Trauma System vulnerabilities, including medical transportation constraints, as well as changes in the 2001 plan.

Dr. Brown then discussed the current status of air medical access. The Emergency Medical Services Section is proposing to undertake a feasibility study for air medical access. This study will provide an objective determination of need, determine potential risks, and determine potential benefits. It will also provide an analysis of potential sites, an evaluation of neighborhood impacts, and cost estimates.

The 2001 Trauma System Plan emphasizes a regional approach to trauma resources. Dr. Brown stated that the American College of Surgeons has certain requirements for Level 1 Trauma Centers. These requirements include community outreach with research, education and patient care expertise, an ongoing commitment to Level 1 care and a trauma center volume. Dr. Brown continued that by regionalizing, EMS increases its ability to keep its Level 1 designation, and its ability to maximize resources by working with other regional trauma centers.

Commissioners’ Comments

Commissioner Jackson asked how the new plan will help the Commission and the department address the issue of street congestion, both in terms of making sure cars get out of the way and that they are aware of where to go. Commissioner Jackson stated that there needs to be a public information campaign about what to do when confronted by an ambulance.

Commissioner Umekubo asked about the plan to coordinate services so that every patient does not get sent to San Francisco General Hospital, which is already so busy. Dr. Brown responded that there are multiple levels of the plan that address that issue, including the reorganization of the Multi-casualty Incident Policy. Dr. Brown added that there will also be a review of the department’s triage mechanisms. Commissioner Umekubo asked if the Department gets subsidized for being the region’s Level 1 Trauma Center, and if they have air medical access. Dr. Brown responded that State allocation of $25 million to trauma centers does take some of this into account, and he is hopeful that this program will be continued and expanded. Dr. Brown further stated the distribution of funds depends on the acuity of patients. Dr. Katz added that people who receive care at the trauma center generally have insurance, in addition to the fact that the type of care trauma patients receive has favorable rates of reimbursement.

Commissioner Sanchez commended Dr. Brown and his staff developing the plan, which truly envisions the critical needs of the trauma system. Commissioner Sanchez noted that, during the Budget Committee, a study on red-light running was approved, and that the information gleaned from this study can be useful addressing the impact of street congestion on access to emergency care.

Commissioner Chow requested that the Department provide the Commission with implementation timelines. Commissioner Chow emphasized the need for air medical access, and stated that the system cannot truly be regional without air medical access at the trauma center. Commissioner Chow continued that, with regard to pediatric trauma care, there needs to be a way to get these patients across the Bay Bridge to Oakland Children’s Hospital, which has the only Level 1 Pediatric Trauma Center in the Bay Area.

Commissioner Guy applauded the patient-centered nature of this plan, and its focus on outcomes, medical access, MOUs with other trauma centers, and regionalization. Commissioner Guy stated that this plan must be integrated with the plans for the rebuild of San Francisco General Hospital.

Action Taken: The Commission unanimously adopted Resolution #14-01, “Approving the City and County of San Francisco 2001 Trauma Care System Plan Revision and Update,” with one Amendment.

(David Ofman, M.D., CHN Medical Director for Primary Care Services)

Dr. David Ofman, Medical Director for Primary Care Services, began the presentation by providing an overview of the various staff who developed this urgent care clinic initiative. Urgent care is provided at various sites in the health care system. Most of the sites do both primary care and urgent care. The most pressing need for urgent care is for unaffiliated patients-patients who are not already connected to a primary care provider. There is tremendous demand for urgent care for unaffiliated patients.

Dr. Susan Obata, Medical Director for Urgent Care Services, continued the report to the Commission with a power point presentation. The presentation included the history, goals, scope of services, current utilization data, and future direction and recommendation for the Urgent Care Clinic.

The primary goal of the Urgent Care Clinic was to better integrate urgent care into the continuum of primary care and to strengthen the relationship between the community primary care system and hospital-based services.


  • Provide after hour care for Community Health Network patients who cannot access limited community health centers’ evening/weekend hours
  • Augment the services provided by the San Francisco General Hospital and Medical Center Emergency Department
  • Maintain a commitment to access for all residents by eliminating financial, linguistic, physical and operational barriers
  • Provide quality services that treat illness
  • Promote and sustain wellness
  • Prevent the spread of disease, injury and disability.
  • There are a number of Urgent Care Issues, including: inadequate primary care capacity; growing number of uninsured and underinsured; work constraints of patients; limited access to urgent care facilities in San Francisco; increasing acuity of patients; and the requirement for case management.
  • Future Direction and Recommendations:
  • Reconfiguration of services, for example providing more urgent care times on Mondays and Fridays, and less primary care.
  • Patient education of clinic procedures for medication refills, the on-call physician system, and the availability of social work or substance abuse services.
  • Provide opportunities for primary care provider’s work in an urgent care clinic every so often because patients are more inclined visit a provider who they have already seen.

Commissioners’ Comments

Commissioner Parker stated that the creation of this clinic was the prudent thing to do, and it has been very productive.

Commissioner Chow asked staff to provide him with more detailed information about the geographic areas with the highest utilization. Dr. Chow stated that as the department moves into a different focus, there needs to be more discussion about how much emphasis will be on additional after-hours primary care and how much on more urgent care services to lessen the burden of the emergency department. Dr. Chow requested a report to the CHN Joint Conference Committee with more details on the future direction of the Urgent Care Clinic. Dr. Obata stated that the majority of the patients they see at the clinic really need primary care, rather than urgent care.

Dr. Sanchez stated that access and continuity are the keys of primary care, and we need to pursue how to meet these needs.

Commissioner Umekubo commented that access to primary care in a timely manner, in a way that does not overburden the ER, is very important. He asked Dr. Obata to explain in more detail the process for getting an unaffiliated person into a primary care clinic. Dr. Obata replied that the Urgent Care Clinic staff refers patients to the patient referral system, where they would then schedule a primary care appointment or receive a specialty clinic referral. Commissioner Umekubo asked if there was any data to indicate what percentage of patients receive care at a primary care clinic, once they are referred from the Urgent Care Clinic. Dr. Obata replied that 15-20 percent goes on to receive primary care.

Commissioner Guy stated that this an excellent report with extensive data than can be used to determine the future of the Urgent Care Clinic in terms of expanded service. She stated that the CHN Joint Conference Committee should discuss this issue in time for the next budget year.




A. Public Comment on All Matters Pertaining to Closed Session


B. Vote on 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 5:40 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 $100,000 in the Scottie McKinney v. CCSF, United States District Court, Case # 00-0175.

D. Reconvene in Open Session

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 $100,000

Vote to Elect Whether to Disclose Any or All Discussions Held in Closed Session (San Francisco Administrative Code Section 67.14(a))

Action Taken: The Commission voted not to disclose any discussions held in closed session.

The closed session ended at 6:10 p.m.


The meeting was adjourned at 6:11 p.m.

Michele M. Olson, Executive Secretary to the Health Commission