Minutes of the Health Commission Meeting
October 2, 2001
101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The Health Commission meeting was called to order by President Roma P.
Guy, M.S.W., at 3:10 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. Sánchez, Jr., Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF SEPTEMBER 19, 2001
Action Taken: The Commission unanimously approved the minutes of
September 19, 2001.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner David J. Sanchez, Jr., Ph.D.)
Commissioner Sanchez chaired, and Commissioner Jackson and Commissioner
Monfredini attended, the Budget Committee meeting.
(3.1) PHP-AIDS Office - Request for approval of a retroactive new
contract with Positive Resource Center, in the amount of $70,000, to
provide employment development services targeting people living with
HIV/AIDS and seeking to enter/re-enter the workforce, for the period of
July 1, 2001 through June 30, 2002.
- Commissioner Monfredini requested a six-month written report to
the Budget Committee regarding the performance of the contract, in
light of the fact that this program is newly under the auspices of
the Department of Public Health.
(3.2) PHP-AIDS Office - Request for approval of the second year of a
two-year contract with Black Coalition on AIDS in the amount of $246,687
to provide HIV prevention education services, for the period of July 1,
2001 through June 30, 2002, for a total contract amount of $493,374.
- During the Budget Committee, Commissioner Sanchez stated that
clearly the agency has experienced difficulties, and asked the
agency if they believe the have the capability to fulfill the
contract requirements. Anthony Phillips from Black Coalition on AIDS
responded that they are receiving technical assistance from Compass
Point, and that this should help them meet the reporting
requirements. Commissioner Sanchez emphasized the importance of
these services, and asked that staff provide the Population Health
and Prevention Joint Conference Committee with a contract update
every 60 days, and return to the Budget Committee in six months with
a status report.
- During the Budget Committee, Commissioner Jackson stated that the
agency is doing well with client services, but not administratively,
and asked how staff could have overlooked administrative
requirements. Mr. Phillips responded that the agency has experienced
a lot of staff turnover in the past year, and the new staff was not
always aware of the reporting requirements. Marcia Haring from the
Department of Public Health stated the Black Coalition on AIDS is
one of the agencies the Department has targeted to receive technical
assistance for the next three years.
- At the Budget Committee meeting, Commissioner Monfredini asked
what specific steps are being taken to address the long-standing
problems with this agency. The Department has spent money, time and
resources trying to clean up the organization, and yet it is still
experiencing the same problems. Steven Tierney responded that the
Office of Minority Health “Project Ready” grant for technical
assistance will help. Further, the Department is now tracking
continuous quality improvement in ways that have not been done
before. However, Mr. Tierney stated that if the agency does not
solve its problems this year, the Department will work to find
another agency to provide the services.
(3.3) PHP-AIDS Office - Request for approval of a retroactive sole
source contract renewal with Glide Foundation in the amount of $69,877
to provide HIV prevention services, for the period of July 1, 2001
through June 30, 2002.
- At the Budget Committee, Commissioner Sanchez asked when the
agency would meet the Department’s performance standards. Steven
Tierney responded that Glide Foundation is also receiving technical
assistance through the “Project Ready” grant, and that the
agency is already making progress. Commissioner Sanchez requested
60-day status reports to the Population Health and Prevention Joint
Conference Committee, and a six-month report to the Budget
(3.4) PHP-AIDS Office - Request for approval of a retroactive
contract with Glide Foundation in the amount of $249,118 to provide HIV
prevention services, for the period of July 1, 2001 through June 30,
- At the Budget Committee, Commissioner Sanchez requested 60-day
status reports to the Population Health and Prevention Joint
Conference Committee, and a six-month report to the Budget
(3.5) PHP-AIDS Office - Request for approval of a retroactive
contract renewal with South of Market Health Center in the amount of
$62,100 to provide multiple session groups and prevention case
management, for the period of July 1, 2001 through June 30, 2002.
(3.6) PHP-AB 75 Project - Request for approval of a contract renewal
with Lifemark Corporation in the amount of $190,000 to provide fiscal
intermediary services for the FY 2001-02 CHIP Program, for the period of
November 15, 2001 through March 31, 2002.
(3.7) PHP-Housing and Urban Health - Request for approval of a
retroactive new sole source contract with Tenderloin AIDS Resource
Center, in the amount of $73,842 to provide HIV/AIDS Emergency Housing
Program services, for the period of September 1, 2001 through June 30,
(3.8) PHP-CMHS/Children’s Services - Request for approval of a sole
source contract renewal with Support for Families of Children with
Disabilities in the amount of $330,822 per year, for a total contract
value of $1,323,288, to provide consultation and clinical support
services, for the period of July 1, 2001 through June 30,
- At the Budget Committee, Albert Eng from CMHS/Children’s
Services stated that the total amount of the contract over the
four-year term is $720,939, not $1,323,288 as indicated in the
title. The amount for the first year of the contract is $330,822,
and the amount for the subsequent years is $130,039 per year.
(3.9) PHP-Mental Health/Substance Abuse - Request for approval of a
contract renewal with San Francisco Suicide prevention in the amount of
$332,027 per year, for a total contract value of $1,328,108, to provide
suicide prevention services along with Family Service Agency and San
Francisco Mental Health Access line coverage, for the period of July 1,
2001 through June 30, 2005.
(3.10) PHP-Mental Health/Substance Abuse - Request for approval a
contract renewal with Oakes Children’s Center in the amount of
$493,785 per year, for a total contract amount of $1,975,140, to provide
psychiatric day care services for children, for the period of July 1,
2001 through June 30, 2005.
(3.11) PHP- Substance Abuse - Request for approval of a sole source
contract renewal with the Latino Commission in the amount of $655,058
per year, for a total contract amount of $2,620,232, to provide
substance abuse treatment services, for the period of July 1, 2001
through June 30, 2005.
- Commissioner Chow commented that the monitoring report for the
Latino Commission included appropriate comments about cultural
competency, and integrating these comments into the review process
is a positive way of approaching cultural competency.
(3.12) PHP-Mental Health - Request for approval of a contract renewal
with Volunteer Center of San Francisco in the amount of $200,084 per
year, for a total contract amount of $800,336, to provide mental health
safety net services, for the period of July 1, 2001 through June 30,
Community Health-Primary Care - Request for approval of a retroactive
contract with Mission Neighborhood Health Center in the amount of
$150,000 for continued primary care services at the Excelsior Clinic,
for the period of July 1, 2001 through June 30, 2002.
Action Taken: The Commission approved the Consent Calendar of the
Budget Committee with the modification to Item 3.8 to reflect the actual
contract amount. In addition, the Commission direction that status reports
for the contract with Black Coalition on AIDS (Item 3.2) and the contracts
with Glide Foundation (Item 3.3 and Item 3.4) be presented to the
Population Health and Prevention Joint Conference Committee every 60 days,
and to the Budget Committee in six months. The Commission also directed
that the staff provide a written status report to the Budget Committee in
six months for Item 3.1.
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
(Report on activities and operations of the Department.)
State Legislative Session
The State Legislature completed the first year of its two-year session
on September 15, 2001. Several health-related bills were forwarded to the
Governor for his consideration, including a bill to provide funding for
county initiatives that extend health insurance coverage to uninsured
children, bills that simplify Medi-Cal and Healthy Families eligibility
procedures, and a bill that would require the State Department of Health
Services to establish minimum staffing ratios for nursing homes. The
Governor has until October 14 to act on these bills. A detailed report of
this legislative year will be presented to you at your November 6 meeting.
State Budget -- Maternal and Child Health Funding
When Governor Davis signed the 2001-02 State budget in July, he
eliminated $2.6 million in State General Funds that support county
maternal and child health (MCH) programs. To the extent that counties used
these funds to increase enrollment of potential Medi-Cal clients, these
monies were also used by counties to draw down an enhanced federal match,
as high as 4:1 in some cases. In San Francisco, though our State MCH
allocation was $66,243, our total MCH allocation was $213,908 after the
federal match. Statewide, an elimination of the $2.6 million in State MCH
funds would have resulted in cuts of nearly $7 million in services to
needy women and children of our state.
The Administration has devised a way to restore these critical MCH
funds without the need for additional funding or corrective legislation.
By switching State general fund from the State's domestic violence program
with federal Title V funds in MCH, counties will again have State general
funds available to draw down the federal enhanced match. This methodology
will restore all but $650,000 of the total $7 million in MCH funding
counties receive after the federal match. Individual county allocations
have not yet been announced, but it is likely that any reduction in San
Francisco's allocation will be minimal.
HIV Stops With Me Campaign receives favorable evaluation
One of the elements of the 11 point plan to revitalize HIV prevention
for gay men was to increase the prevention message to HIV positive
persons. Specifically, the plan that was presented to the Health
Commission on August 15, 2000, was to increase responsibility of
HIV-infected individuals to avoid inadvertently infecting others.
I have attached the results of the evaluation, which was very
favorable. The campaign exceeded its goals for exposure. Most notably, as
a result of the commercial, 24% of participants said they were more likely
to believe it is their responsibility to keep their negative partners
TOD Planning Retreat
The Treatment on Demand Planning Council (TOD) held its annual retreat
at the Nimitz House on Yerba Buena Island on September 29th. The process,
which also includes review and discussion of epidiemology data, research,
focus groups and community forums, culminates in December, with a list of
new program recommendations to the Director of CSAS. The current TOD is a
diverse group of clients/advocates, governmental representatives and
service providers. The group identified 20 priorities for initial
consideration. Of special note is the number one priority: Maintain and
support infrastructure program so units of service are not reduced.
SFGH Completes Accreditation Survey and MQSA Inspection for
San Francisco General Hospital has successfully completed their State
accreditation survey and MQSA inspection for mammography. This survey is
conducted annually jointly by the Food and Drug Administration (FDA) and
the State of California. SFGH completed both the survey and inspection
with no deficiencies noted.
CHN/SFGH CREDENTIAL REPORT SEPTEMBER 2001
Changes in Privileges
Current Statistics - as of 09/1/01
Affiliate Professionals (non-physicians)
Applications In Process
Applications Withdrawn Month of August 2001
SFGH Reappointments in Process Through February
- Commenting on the HIV Stops with Me Campaign, Commissioner Chow
stated that he appreciates that the Commission is receiving evaluation
results, as they demonstrate the effectiveness of the program.
5) HEALTHY FAMLIES UPDATE
(Colleen Johnson, Acting Director of Policy and Planning)
Colleen Johnson, Acting Director of Policy and Planning, began the
presentation of the semi-annual Healthy Families Report, which details the
efforts in San Francisco to ensure that individuals are enrolled and
retained in the Healthy Families Program. Ms. Johnson stated that the
efforts of the Department are focused on uninsured children rather than
any single public health insurance program, in order to capture the most
individuals for the most programs.
Ms. Johnson introduced Frances Culp, Health Planner for the Department
of Public Health, who continued the presentation of the report.
Program Expansions and Enhancements
Proposed Parent Expansion
Ms. Culp updated the Commission on the efforts to expand the program to
parents of eligible children. In December 2000, California submitted a
waiver demonstration proposal to the federal government. Initially the
waiver had proposed to cover parents up to 200 percent of the federal
poverty level. However, due to an outpouring of requests from many
entities, including the City and County of San Francisco, the State
increased parent’s eligibility to 250 percent of the federal poverty
level. However, CMS has not yet approved the first waiver, and Ms. Culp
said that the issue is now at a stalemate.
State Budget Expansions
Ms. Culp stated that the State Budget assumes an additional 250,000
Healthy Families members by July 2002. This would include parents of up to
250 percent of the federal poverty level, which assumes the approval of
the waiver. The budget also allows applicants to sign a statement that
will verify their income if they have no other paperwork to prove this. In
addition, the budget creates a two-month bridge between Medi-Cal and
Healthy Families. This allows Medi-Cal and Healthy Families recipients who
no longer qualify for their respective program time to apply for the other
Ms. Culp stated that a number of bills that affect the Healthy Families
Program were introduced in the last legislative session. The bills that
the Department will be paying closest attention to are those that allow
for an assumption of eligibility based on enrollment in certain other
programs such as free-lunch programs and the Food Stamp program.
Since the beginning of the program the State has processed 472,121
applications. 8,841 of these applications were from San Francisco. 2,346
children in San Francisco who applied for the Healthy Families program
were not enrolled in the program. The primary reason for non-enrollment
was an incomplete or incorrect application. The State is trying to
simplify the enrollment process. They are developing a joint Medi-Cal/Healthy
Families Joint Application, which allows families to apply for both Medi-Cal
and Healthy Families on the same application. In addition, there is a
backlog of more than 2,000 people waiting to become Certified Application
Assistants (CAAs), who are paid by the State to help families with the
enrollment process. The State has allocated money for training and
processing, so there should be more CAAs helping with the application
process in the near future.
According to Ms. Culp, another step that the State is taking to make
enrollment easier is the development of an online enrollment program,
called Health-e-App. The program has been piloted in San Diego and has
received a very positive response from families.
Enrollment and Retention Data
Ms. Culp stated that there are 468,349 children statewide enrolled in
the Healthy Families program. San Francisco has 9,265 children enrolled in
the program. The Department estimates that between 10,015 and 10,593
children in San Francisco are eligible. This implies that 90 percent of
San Francisco’s children are already enrolled in the program
Enrollment by Ethnicity
- Asian American/Pacific Islander - 82.1 percent
- Hispanic/Latino - 14.6 percent
- African-American - 1.7 percent
- Caucasian - 1.5 percent
- Native American - . .1 percent
Since 1999 there has been a slight increase in Latino and African
American enrollment in the program.
Ms. Culp stated that the neighborhoods with San Francisco’s highest
Healthy Families enrollment (representing 65 percent of the total
enrollment) include the Excelsior, Outer Mission, Mission Terrace and
Ingleside (94112); Portola and Visitacion Valley (94134); Mission and
Bernal Heights (94110); Chinatown and North Beach (94133); Sunset (94122);
and Bayview/Hunters Point (94124).
Ms. Culp stated that almost 3,000 children have been disenrolled from
the Healthy Families program in San Francisco since the program began. San
Francisco is seeing a slightly higher rate of disenrollment than the
statewide average. One of the major avoidable reasons for disenrollment is
non-payment of premiums. Both the State and San Francisco are focusing
efforts on reducing disenrollments for avoidable reasons. At a statewide
level, there are now additional, more convenient options for bill payment.
San Francisco is focusing on strengthening the bond between the families
and the Certified Application Assistants. In addition, the San Francisco
Family Health Plan has designed a postcard that is sent to Healthy
Families members who are close to the date they must submit their
re-enrollment forms. And during the month of August, Health Plan staff
called each of the enrolled families to see if they needed assistance.
Recent Outreach, Education and Retention Efforts
In San Francisco there are a number of outreach and education efforts
underway, which Ms. Culp summarized:
- Bringing Up Healthy Kids (BUHK) Coalition. This is a collaboration
of more than 20 public agencies and non-profit providers, including
the Department of Public Health. Their main outreach has been through
the schools. In September 2001, BUHK distributed over 65,000 Request
for Information flyers, with postage-paid return envelopes to all
elementary, middle and high school students in San Francisco. BUHK is
also going to be contacting families 60 days, 6 months, and 10 months
after enrollment to provide follow-up services.
- Building a Healthier San Francisco (BHSF). This is a coalition of
hospitals, the Department of Public Health and the Department of Human
Services. This group is working with existing school health workers to
train them as Certified Application Assistants, who can then identify
and sign up children for the program.
- Potrero Hill/Bayview Hunters Point Access to Health Care. This is a
project funded by the Department of the Environment for outreach
related to health access for residents of Potrero Hill and Bayview
Hunters Point. Among the goals for the project is providing residents
with information on free and low-cost health care options and
enrolling eligible children, youth and adults into free and low-cost
- SCHIP Outreach Award. The Department of Public Health recently
received a grant from the state to supplement existing outreach
- UCSF CORE Project. This project, in which nine Bay Area Counties are
participating, is designed to support counties in recognizing and
removing barriers in county-administered Medi-Cal for Children and
Healthy Families enrollment and retention processes.
- Elizabeth Frantes stated that the Department should not discriminate
against adults without children by only covering parents of children.
We should not bring more people into the system, when there is not
enough services for people currently being served.
- Commissioner Monfredini asked what happens when an application is
denied because the person is eligible for Medi-Cal-how is it linked to
the Medi-Cal system. Ms. Culp replied that the application is sent to
the County for processing, and the person is then connected to Medi-Cal.
Ms. Culp said that it is her understanding is that a letter is sent to
the family to inform them of this.
- Commissioner Parker stated that when the program was designed, it
was to be revenue neutral. Commissioner Parker asked if the Department
would need more general fund money for this program. Dr. Katz
responded that having people enrolled in Healthy Families decreases
the amount of general fund dollars spent by the Department, because
the State and Federal government are paying for their healthcare.
- Commissioner Chow commented that the Department has good enrollment
numbers, and the focus needs to be on retention. He asked if there is
data on the 10 percent who are eligible but not enrolled. Dr. Katz
responded there is indirect evidence that the African American
enrollment numbers are too low considering their percentage of the
working poor. Commissioner Chow would like the next semi-annual report
to show an increase in the enrollment numbers for underrepresented
groups, including African Americans. In addition, Commissioner Chow
would like the next report to emphasize the outcome of the retention
efforts, and provide more detailed information about the
underrepresented ethnicities, such as how many African American
applicants were denied enrollment because they were eligible for Medi-Cal.
- Commissioner Guy stated that the next semi-annual report should
include the Universal Health Care statistics.
- Commissioner Umekubo was gratified to see the increase in enrollment
numbers since the last report. He stated that the report indicates
that almost all-eligible children would be enrolled if the issue of
non-enrollment due to incomplete applications were addressed.
- Commissioner Parker asked how many children are uninsured in San
Francisco, in terms of not being eligible for any insurance program.
Ms. Johnson responded that the Department has estimated 9,200
uninsured children in San Francisco. 5,000 of these children will be
eligible for the new “Healthy Kids” program. Approximately 3,000
more are eligible for other public health insurance programs. The
remainder of the children would be from families earning more than 300
percent of the federal poverty level, and would be ineligible for any
public health insurance program.
- Commissioner Jackson asked how many children from families that make
above 300 percent of the federal poverty level are uninsured. Ms.
Johnson responded that the estimate is 1,200 children. Commissioner
Jackson stated that this number seems low, given the number of working
- Commissioner Sanchez stated that over time there will be regional
shifts among the Bay Area’s populations, and asked if this was being
factored into the retention analysis. Ms. Johnson responded that she
would look at this issue and include it in the next report to the
6) MENTAL HEALTH ANNUAL REPORT
(Jo Ruffin, LCSW, Director of Community Mental Health Services)
Jo Ruffin, Director of Community Mental Health Services, began the
presentation by recognizing various community partners, and said that the
department’s success depends in large part on contract providers. Ms.
Ruffin introduced Steve Fields from Progress Foundation, Richard Easley
from the Mental Health Contractors Association, and Tim Agar from the
Mental Health Board. Ms. Johnson then introduced Louise Rogers, who
continued the presentation.
Ms. Rogers stated that since the San Francisco Mental Health Plan
started operations 3 ½ years ago, the challenge has been how to provide
greater access to care for a large covered population, while continuing to
manage scarce and costly resources used by a much smaller number of
chronically mentally ill adults and seriously emotionally disturbed
children and youth.
The total Department of Public Health resources to mental health care
amount to approximately $198 million. Approximately 78 percent is in
Community Mental Health Services, 14 percent in the Department of
Psychiatry at San Francisco General Hospital, and 8 percent at the Mental
Health Rehabilitation Facility. Mental Health’s goal is to be able to
offer each of their members a system of care in which the full array of
community support systems and outpatient services are so accessible and
effective that no one must enter the system unnecessarily through
institutional and emergency care. Ms. Rogers stated that accomplishing
this goal requires a greater investment in community care and less in
institutional care. This has started to occur. This year institutional
care constitutes 27 percent of the Department’s spending (although the
percentage is higher-approximately 40 percent-for adults).
Ms. Rogers added that an integration of services between Mental Health
and other systems of care is starting to develop. Many of the systems
changes that have occurred that benefit Mental Health clients are a result
of joint collaboration between Mental Health and other sections of the
Ms. Rogers stated that the activities of the last year are organized
around six strategic plan goals that underlie the effort to reshape the
system of care.
- Expand access to mental health care
- Expand community-based alternatives and decrease the need for
- Improve integration of services for individuals who need multiple
- Strengthen prevention activities
- Create and sustain community partnerships
- Maximize resources and strengthen infrastructure by investing in
staff recruitment, retention and training
With regard to expanding access to care, Ms. Rogers stated that Mental
Health’s caseload grew 39 percent between FY 1994-1995 and FY 1999-2000,
including a 64 percent growth in Medi-Cal patients. The Mental Health
Division increased the percentage of foster care children in mental health
treatment from 20 percent in FY 1992-1993 to 40 percent in FY 1999-2000.
The goal is to reach 50 percent. The Department also attempted to serve
clients where they are to address unmet need. And finally, they are
increasing cultural competency as a strategy to meet unmet need. In FY
2000-2001, 710 providers were trained in cultural competence areas. In
response to Commissioner Chow’s question at the Joint Conference
Committee as to whether the efforts translate into increased access for
minority ethnic populations, between FY 1995-1996 and FY 1999-2000, there
was a 31 percent growth in the Latino/Hispanic population served, a 25
percent growth in the Chinese population served, a 39 percent growth in
the Vietnamese population served, and a 18 percent growth in the African
American population served.
Ms. Rogers then summarized the Department’s efforts to expand
community-based care and decrease the need for institutional care. She
described the following efforts:
- Strengthened the collaboration with the San Francisco General
Hospital Department of Psychiatry to meet the performance objectives
for acute impatient services. The strategy was twofold: first to
increase intensive case management and second to increase the number
of community treatment beds that serve as alternatives to hospital
care. This collaboration resulted in reduced admissions through PES,
maintenance of length-of-stay of no more than 15 days, and reduced
utilization at private hospitals by 170 acute episodes. The Department
projects over $100,000 in savings, which will be reinvested into
additional beds and case management.
- Reduced institutional care for children and youth. Children Services
System of Care Partnership has been able to reduce group home
placements by 10 percent last year.
- Established a Continuum of Community Treatment Beds - New Acute
Diversion Unit (12 beds); Broderick Street Residential Care (34 beds);
Seneca Community Treatment Facility (20 beds).
- Increased Employment
- Provided access to medications
- Police Crisis Intervention Training
Ms. Rogers then described the efforts to improve the integration of
services, which primarily include collaboration with Substance Abuse
Services and collaboration with Primary Care.
Ms. Rogers stated that Mental Health has engaged in a number of efforts
to strengthen prevention activities, including the child care mental
health initiative, the Pilipino Family Strengthening grant, depression
screening, high school wellness, Family Links phone line, and suicide
Ms. Rogers described several initiatives Mental Health has to respond
to violence and crises in communities such as the Western Addition and
Bayview Hunters Point, including a Family Involvement Team and a Mental
Health Plan Ombudsman and Consumer Council.
To meet the sixth Strategic Plan goal of maximizing resources and
strengthening infrastructure, Ms. Rogers said the Department is working
with the University to expand the mechanisms for psychiatric residents to
be placed in the Department’s clinics. The Department is also offering
multi-cultural student stipends to students in Master’s and
undergraduate levels, to encourage them to pursue jobs in Community Mental
Health. In addition, they are providing continuing education to staff in
the Department as well as providers.
Steve Fields spoke on behalf of the Mental Health Forum, which is where
the policy discussions are taking place for the integration and delivery
of mental health and substance abuse services. Mr. Fields stated that,
under the leadership of Jo Ruffin and Barbara Garcia, the Mental Health
system has become a true partnership with the contractors. The challenge
now is to make the community-based system less reliant on institutional
beds. Two areas are critical to accomplish this: develop the whole array
of services including housing; and strengthen the case management system.
Mr. Fields continued that the integration efforts must include both
substance abuse and forensics/jail services.
Richard Easley, Executive Director of Conrad House and chairman of the
Mental Health Contractors Association, congratulated Jo Ruffin on a
compelling and encouraging report, particularly the emphasis on
partnership. Mental Health contractors appreciate the fact the Department
is listening to them, advocating for them in the budget process,
acknowledging them in the Strategic Plan, including them in planning
processes, and inviting them to the table to talk about planning and
program development issues. The Mental Health Contractors Association
looks forward to working with the Department over the coming year.
Tim Agar from the Mental Health Board spoke in support of the Mental
- Commissioner Monfredini asked how an individual would know how to
access the system. Ms. Rogers responded that access started out as a
1-800 number and people being able to walk into any clinic. The
Department realized that this was not enough-that they needed to
engage and serve clients where they are-streets, schools, home, child
care, primary care, etc., which they are doing now. The Department
also has mobile crisis team. Commissioner Monfredini asked if
institutional care is available for those individuals who truly need
it, and cannot function in a lower level of care. Ms. Ruffin said that
institutional care will always be part of the continuum of care,
although their goal is to keep people from reaching the level where
their only option is institutional care.
- Commissioner Parker stated that primary prevention is a priority,
but the resources and efforts do not necessarily reflect this.
Commissioner Parker continued that one element that impacts the
community so much is substance abuse, and the Department should try to
reduce use of drugs and alcohol by at least 10 percent.
- Commissioner Umekubo commended the Department of Psychiatry for its
reduced admission rate, reduced length of stay, and reduced
decertification rate (which is hovering around 15 percent).
- Commissioner Chow emphasized the goal of primary care integration.
He is pleased with the efforts of the Mental Health Forum. He
continued that the system is well on its way to becoming an integrated
system. Commissioner Chow also stated that, as we move into more
difficult economic times, everybody involved in the mental health
system continue their dialogue and cooperation even though there may
not be new resources.
- Commissioner Jackson is encouraged with the increased parity between
mental health services and other health services. The Department is
now more able to help people stay out of institutions and live
- Commissioner Sanchez stated that the report was refreshing,
particularly in terms of integration of services and partnerships with
schools, community-based organizations, and other departments.
- Commissioner Guy commended the staff for its work to truly integrate
services. Commissioner Guy stated that the challenges include refining
the services, identifying where the gaps are, and determining how the
new Laguna Honda will fit in to the system. Commissioner Guy continued
that services to the homeless population is a particularly important
part of the continuum of care, and asked how long the grant funding
would be available. Ms. Rogers responded that the grant was for three
years, but that the Department is hopeful that the funding will
continue beyond that time period.
The Commission voted to recess the meeting for 20 minutes at 5:30 p.m.
The Commission reconvened the meeting at 5:50 p.m.
7) OTHER BUSINESS/PUBLIC COMMENT
8) CLOSED SESSION
A) Public comments on all matters pertaining to the closed session
B) Vote on whether to hold a closed session
Action Taken: The Commission voted to hold a Closed Session.
The Commission went into Closed Session at 5:50 p.m.
C) Closed session pursuant to Government Code Section 54957 and San
Francisco Administrative Code Section 67.10(b)
PUBLIC EMPLOYEE PERFORMANCE EVALUATION:
DIRECTOR OF HEALTH, DR. MITCH KATZ
D) Reconvene in Open Session
The Commission came out of Closed Session at 6:55 p.m.
Vote to elect whether to disclose any or all discussions held in closed
session (San Francisco Administrative Code Section 67.12(a).)
Action Taken: The Commission voted not to disclose any discussions
held in Closed Session.
The meeting was adjourned at 6:56 p.m.
Michele M. Olson, Executive Secretary to the Health Commission