Minutes of the Health Commission Meeting

Tuesday, December 4, 2001
3:00 p.m.
San Francisco General Hospital
Carr Auditorium
22nd Street and Potrero Avenue
San Francisco, CA 94110


The Health Commission meeting was called to order by Vice President Edward A. Chow, M.D., at 3:10 p.m.


  • 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.


  • President Roma P. Guy, M.S.W.


Action Taken: The Commission (Chow, Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the minutes of the November 20, 2001 Health Commission meeting.


(3.1) CHN-Strategic Planning - Request for approval of a new contract with The Lewin Group to develop a long range service delivery plan for the Community Health Network, in the amount of $350,000, for the period of January 1, 2002 through June 30, 2002.

Commissioners’ Comments

  • Commissioner Sanchez asked if the senior management of The Lewin Group has been reorganized to be more inclusive. Mr. Keith Hearle and Ms. Little-Durham, both from The Lewin Group, responded that they are a section of Quintile Transnational Corporation, which is a privately held company. While the board of directors of the company is not reflective of the communities such as San Francisco, The Lewin Group has attempted to be more reflective of the communities it works in.

(3.2) CHN-SFGH/Pharmacy - Request for approval of a contract modification with Pharmaceutical Care Network, in the amount of $1,500,000, for pharmacy benefits management services targeting CHN indigent clients, and to shorten the contract duration to 15 months ending March 31, 2002, for a total contract value of $9.9 million.

Commissioners’ Comments

  • Commissioner Jackson asked if the new, restructured contract would result in cost reductions. Ms. Sharon Kotabe, CHN Director of Pharmaceutical Services responded that the goal for the new contract is to reduce costs.

Public Comment

  • Michael Lyon, Coalition to Save Public Health-San Francisco, stated that the problems predicted by labor and community members when the PBM contract was approved have happened-the money that was supposed to last for 20 months has run out after 12 months. Mr. Lyon suggested three options for the pharmacy: continue the PMB contract; take advantage of the new Senator Speier bill that allows pharmacies to contract with qualifying hospitals, but without PBM as an intermediary; and DPH to open satellite pharmacies in different neighborhoods.

(3.3) CHN-Primary Care - Request for approval of a retroactive multiyear contract renewal with the John Stewart Company to provide fiscal agent services, in the amount of $89,844 per year, for a contract total of $359,376, for the period of July 1, 2001 through June 30, 2005.

(3.4) PHP-Housing - Request for approval of a new retroactive contract with Tenderloin Housing Clinic, in the amount of $200,000, to provide community programs, tenant outreach and tenant stabilization services, for the period of August 1, 2001 through June 30, 2002.

Commissioners’ Comment

  • Commissioner Monfredini clarified that the money to fund this program is a one-time addback, and urged the agency to fundraise to support this program on an ongoing basis.

(3.5) PHP-Substance Abuse - Request for approval of a retroactive contract renewal with Chemical Awareness and Treatment Services, Inc. (dba Community Awareness and Treatment Services, Inc.), in the amount of $3,108,249, to provide various substance abuse treatment services, for the period of July 1, 2001 through June 30, 2002.

(3.6) PHP-Substance Abuse - Request for approval of a retroactive contract renewal with Horizons Unlimited of San Francisco, in the amount of $1,163,501, to provide day treatment, outpatient and prevention substance abuse treatment services, for the period of July 1, 2001 through June 30, 2002.

(3.7) PHP-Mental Health - Request for approval of a retroactive contract renewal with Jewish Family and Children’s Services, in the amount of $1,129,842, to provide outpatient mental health services to children and youth from the former Soviet Union and consultation to childcare providers and children in childcare, for the period of July 1, 2001 through June 30, 2003.

Commissioners’ Comments

  • Commissioner Jackson, commenting on the agencies in Items 3.5, 3.6 and 3.7, stated that he hates to see agencies that do a great job providing services to the community receive a low rating on their monitoring report because they do not submit the required documentation. The Department needs to help agencies set up systems, and the agencies need to meet the Department’s requirements.
  • Commissioner Sanchez echoed the comments of Commissioner Jackson, and said that negative Program Compliance ratings for otherwise quality agencies are discouraging and must be addressed.

(3.8) PHP-Mental Health - Request for approval of a retroactive contract renewal with Westside Community Mental Health Center, Inc. in the amount of $5,042,493, to provide various mental health and fiscal intermediary services for the period of July 1, 2001 through June 30, 2002.

Commissioners’ Comments

  • Commissioner Monfredini, referring specifically to the Adolescent Day Treatment Program, asked if the new model that was developed will address performance concerns on a long-term basis. Ms. Sai-Ling Chan-Sew, Director of CMHS Children and Family Services, responded that they now have additional educational staffing from the San Francisco Unified School District, and believe they have a good program.

(3.9) PHP-Mental Health/Substance Abuse - Request for approval of a retroactive contract renewal with Family Service Agency of San Francisco, in the amount of $5,434,911, to provide children’s mental health, adult care management, geriatric, substance abuse and fiscal intermediary services, for the period of July 1, 2001 through June 30, 2002.

(3.10) PHP-AIDS Office - Request for approval of new FY 2002 Federal Centers of Disease Control and Prevention contracts, for a total of $6,844,978, for the period of January 1, 2002 through December 31, 2002 for services awarded through RFP 017-01, Targeting Defined Behavioral Risk Populations, with the following agencies:

Ark of Refuge

$ 176,585

Asian Pacific Islander Wellness Center

$ 421,097

Bay Area Young Positives

$ 111,334

Better World Advertising

$ 370,000


$ 167,722

California AIDS Intervention Training Center

$ 327,711

Glide Foundation

$ 286,310

Health Initiatives for Youth

$ 83,983

Instituto Familiar de la Raza

$ 380,144

Mission Neighborhood Health Center

$ 142,702

Mobilization Against AIDS International

$ 427,138

St. James Infirmary

$ 166,825

SFDPH Forensics AIDS Project

$ 343,710

SFDPH Maternal and Child Health

$ 57,105

SFDPH Special Programs for Youth (SPY)

$ 155,639

SFDPH STD Prevention and Control Services

$ 595,671

SFDPH San Francisco General Hospital

$ 267,530

Shanti Project

$ 302,670

South of Market Health Center

$ 78,392

Stop AIDS Project

$ 320,086

UCSF/AIDS Health Project

$ 687,190

UCSF/SFGH/Substance Abuse Services

$ 105,110

UCSF/Urban Health Study

$ 546,263


$ 186,432

Walden House

$ 137,629



Commissioners’ Comments

  • Commissioner Jackson asked if the funding follows the trends identified by the data. Steven Tierney said yes. He added that the Department expects to issue an RFP next month to specifically to provide services to young African American MSM, which is the newest emerging trend.
  • At the Health Commission meeting, referring to the number of contracts that had performance or program compliance problems, Commissioner Parker commented that it seems agencies vary from year to year on how they meet their performance objectives. He said that the Department needs to help agencies do a better job of performing consistently, and has to keep tabs on the agencies to ensure that they are indeed performing. Dr. Katz responded that the Department’s goal is to do a good job with technical assistance as well as evaluation.
  • Commissioner Monfredini stated that, during the Budget Committee meeting, committee members conveyed to staff and agency representatives that they do no want to see the same program monitoring ratings in next year’s contracts.

Action Taken: The Commission (Chow, Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the consent calendar of the Budget Committee, with Commissioner Jackson abstaining on Item 3.8.

Commissioner Chow expressed the Commission’s heartfelt sympathy for President Roma Guy and her family for the loss of President Guy’s mother.

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

Substance Abuse and Mental Health Services Administration (SAMHSA) Grant

Community Mental Health Services (CMHS), has been awarded a three-year SAMHSA $1.2 million grant, "Transgender Life Care". The goals of the project are: 1) To develop and implement sensitive mental health services at a primary health care setting for MTF transgenders with co-occurring multiple problems; 2) To build service networks among community collaborators in order to assure appropriate assessment, treatment, evaluation, and referral services for the targeted transgender community; and 3) To expand existing community outreach efforts to MTF transgenders.

The project will be conducted by a broad coalition including the Castro Mission Health Center; Health Studies for People of Color (HSPC), Center for AIDS Prevention Studies (CAPS), University of California San Francisco (UCSF); Walden House substance abuse treatment services; four AIDS Service Organizations (ASOs) providing transgender specific programs; and consumers. Wayne Clark, Ph.D. is the Principal Investigator.

Children and Youth DV FREE

On November 15th and 16th, Children and Youth DV FREE, a project of the Community Health Education section, provided training to 20 youth and their service providers. The training, targeted to Asian and Pacific Islander San Franciscans, focused on popular education and community organizing strategies that can be used to change youth attitudes and values regarding intimate partner violence.

Commissioners’ Comments

  • Commissioner Chow asked Dr. Katz if he was considering any program adjustments to handle the problem of current year overexpenditures at San Francisco General Hospital. Dr. Katz responded that the Department might request a non-general-fund supplemental appropriation to help San Francisco General Hospital get through the rest of the year. Funding for the supplemental could come in part from increased revenue that has resulted from the increased census at the hospital, a higher-than-budgeted intergovernmental transfer and salary savings.
  • Commissioner Monfredini said that San Francisco General Hospital has exceptional staff who is working far beyond what is expected of them. She recalled that there have been budget years when city departments have been asked to sacrifice for one department that is having budget problems, and might this be done for the Health Department this year. Dr. Katz responded that that is more likely a solution for the new budget year, not the current budget year. He said that in the coming year, the hospital is expected to absorb $11 million in salary increases, and there is no way it can cut that level of expenditures. Given that, the Commission, the Mayor, the Board of Supervisors and the public will need to have a public debate about the city’s priorities.
  • Commissioner Chow expressed the Commission’s appreciation for the hospitality of the staff San Francisco General Hospital, and that it is a pleasure to meet at one of the finest public hospitals in the United States. He is also very pleased that the Director of Public Health attends at the hospital once a year. This gives the Director the perspective he must have to make prudent and appropriate decisions.


Commissioner John Umekubo presented the awards to the following persons.



Nominated by

John Dang

Community Health Network, Refugee Clinic

Patricia Birmingham, Nurse Manager

Mozettia Henley, RN, DNS

San Francisco General Hospital, Administration

Ernestina Carrillo, LCSW, Albert Gaw, MD, Alex Anagnos, MSN, RN, Linda Fenn, MA, Maureen Burns, RN, John Butts, RN, and Cher Brown, CNS

Terry Dentoni, RN, BSN

San Francisco General Hospital, Nursing

Sue Currin, RN, MSN, and Renee Navarro, MD

La Francine Tate

San Francisco General Hospital, Administration

Gene Marie O’Connell, Executive Administrator, SFGH


Gene O’Connell welcomed the Commission to the hospital. Ms. O’Connell stated that she sees San Francisco General Hospital Medical Center (SFGHMC) as having three separate but integrated parts: it is the only level one trauma center in the Bay Area; it is the only psychiatric emergency center in the city; and a mental health rehabilitation component. The hospital’s vision is to be the best public hospital in the country. The presentation was organized to show how the hospital is meeting the Health Department’s Strategic Plan goals.

Goal: San Franciscans have access to the health services they need, while the Department emphasizes services to its target populations. 91,693 unduplicated patients are served by SFGHMC each year. SFGHMC is the community hospital for this area. 49 percent of patients come from the neighborhood surrounding the hospital. The data indicates that all the efforts to link patients to a primary care provider are working.

Goal: Reduce inappropriate institutional care and approve patient flow. Ms. O’Connell stated that this goal has received the most emphasis, and described the following activities:

  1. A group of multi-disciplinary staff convened a Bed Utilization Committee to see how patient flow could be improved. A number of things happened: SFGHMC discharge lounge; condition yellow/condition red; increased 4A SNF capacity; patient rounds by chief nursing officer to facilitate patient flow; resource roving registered nurse to assist with expediting discharge and admission of patients.
  2. Collaboration with CMHS. PES was able to reduce the rate of hospital admissions from 38 percent in 99-00 to 33 percent in 00-01. Decertified days in Psychiatry decreased, and they were able to maintain an average length of stay of 15 days. Ms. O’Connell emphasized that the collaboration with CMHS has been very successful.
  3. ISIS Clinic. Emergency room usage and acute inpatient usage for infections has been drastically reduced. The clinic exceeded its goal, and has served more than twice the original estimate of clients.

She stated that the continued challenges to meeting this goal are that actual census continues to exceed budgeted beds, and there is a lack of appropriate, available community placement.

Goal: Ensure that CHN continues its vital role. Ms. O’Connell highlighted the work done around trauma services and disaster planning. This past year, the Trauma Nurse Practitioner program was instituted, and three nurse practitioners were added to the trauma team. She recognized the work of the San Francisco General Hospital Foundation, which raised over $650,000 during its trauma campaign. With regard to disaster planning, SFGHMC held Earthquake Preparedness Month, and Earthquake Safety Fair and a SFGHMC disaster exercise, and the hospital is participating in the Metropolitan Medical Response System.

Goal: Improve Integration of Physical and Behavioral Health Services. The hospital has emphasized increased collaboration with Mental Health, Substance Abuse Services, and community-based programs, and she highlighted the OZANAM program that was started last year. OZANAM is a 20-bed medically assisted detoxification community-based program. She said that through this service, the hospital is really able to have linkages with community-based service. Another example of furthering this goal is methadone expansion. This was a priority last year, and they where able to increase the slots from 265 to 380, a 43 percent increase. She then discussed the Medical-Behavioral unit on 5C, which allows a cohort of patients to receive integrated services, and highlighted the extremely successful Mental Health Rehabilitation Facility.

Goal: Disease and injury are prevented. Ms. O’Connell highlighted breast cancer services and injury prevention. The San Francisco General Hospital Foundation had a successful fundraising campaign to improve breast cancer services, and SFGHMC successfully completed the accreditation survey and MQSA inspection for mammography. In October 2001, the CDC awarded $4.5 million to the San Francisco Injury Center at SFGHMC to continue its work on injury prevention for five more years.

Goal: Cost efficient and resources are maximized. The hospital is meeting its budgeted FTE per bed. In addition, they have decreased inpatient “bill hold” which has resulted in lower accounts receivable and higher cash flow.

Goal: Address Infrastructure Needs of the SFGHMC campus. Various planning efforts are underway, including long range service delivery planning, DPH/UCSF collocation exploratory planning, UCSF chancellors long range development plan SFGHMC subcommittee, SFGHMC Institutional Master plan and the SB 1953 compliance plan.

Goal: Improve recruitment, retention and training. A Nursing Retention and Recruitment Committee has been formed to develop a retention plan that will guide the hospital in addressing nursing workforce issues over the next several years.

Goal: Partnerships with community. Ms. O’Connell discussed Health at Home, and said that without their work, patients would not be discharged in a timely manner. She also highlighted the collaboration with UCSF, and emphasized that their relationship with UCSF is a true partnership, and that everything presented as part of the Annual Report reflects this collaboration.

Ms. O’Connell then summarized the next steps:

  • Prepare and pass JCAHO/state licensing
  • Participate in SFGHMC master planning
  • Complete ECG consultation in developing UCSF payment methodology
  • Meet all standards as defined in San Francisco Trauma Plan
  • Implement the Avon grant for improving women’s services
  • Implement pilot to transfer Institutional Police to the Sheriff’s Department.


J. Renee Navarro, M.D., Chief of Staff, SFGHMC, presented the Annual Medical Staff Report, and highlighted some of the activities that have taken place over the last year. Dr. Navarro stated that Dr. Philip Hopewell could not be at the meeting, but his comments have been incorporated into her presentation. She stated that there are 20 clinical departments at the hospital. She also previewed some of the bylaw amendments that the medical staff hopes to bring forward in February. She then described the medical staff composition, and the number of new appointments, reappointments and resignations over the past year. She highlighted three new programs that were developed last year. First, the medical direction of the trauma program was formalized, and in July the first Trauma Program Medical Director was hired. Second, trauma nurse practitioners were added. Third, the Traumatic Brain Injury program was established, with the goal of improving the care of the neurotrauma patient. The SF Airport clinic program was discontinued and transitioned to Catholic Healthcare West.

Dr. Navarro then discussed various performance improvement activities that were done last year by Internal Medicine, Family and Community Medicine, Community Primary Care, Radiology and Obstetric, Gynecology and Reproductive Services, including the very unique Orientation Clinic program that was developed by Internal Medicine for GMC new patients and the Pediatric Asthma Clinic that was established by Community Primary Care.

Dr. Navarro then described the resident training program. 820 residents rotate through SFGHMC per year; 209 per month. Attending physicians provide operational oversight of residents. There is an oversight committee to ensure that each department is following the mandate that residents work no more than 60 hours per week. Dr. Navarro stated that $80 million of research is performed by UCSF faculty members at San Francisco General Hospital.

Dr. Navarro concluded her presentation with a summary of medical staff next steps:

  • Bylaws to the Health Commission for Review and Approval (2/02)
  • Departmental Rules and Regulations Updated
  • Patient Safety Initiative - Reduction of Medication Errors
  • JCAHO - Spring 2002
  • Task Force on the evaluation of physician ICD9 coding, in an identified effort to improve revenue generation
  • Physician staff recruitment and retention
  • Programmatic development: traumatic brain injury; Women’s Injury Center
  • 2002-2003 Budget, City, State and Federal restraints.


Sue Currin, Chief Nursing Officer, reviewed some of the changes in the Hospital Plan for the Provision of Patient Care policy. The plan describes patient care services, and is based on identified patient needs. The bulk of changes are in Section XIII-Care of Patients section of the plan. The plan focuses on the entire flow of the patient, from before admission to before and during discharge. This document serves as a general outline of how patient care is delivered, and staff is always looking at ways to make this more efficient.

John Luce, M.D., Medical Director for Quality and Utilization Management, discussed changes in JCAHO standards concerning patient safety and reduction of medical errors. Revisions to the previous Quality Improvement program have been made to include these new requirements. One such revision was changing the name of the committee to the Performance Improvement and Public Safety Committee (PIPS), to reflect the new JCAHO terminology. The goal of the committee is to promote a culture toward proactive efforts to reduce errors and reporting of medical errors and adverse events in a manner that has not been done before.

Dr. Luce then discussed the communication pathways and reporting structure. The PIPS Committee, and in turn the Medical Executive Committee and the governing body, receive information about unusual occurrences, clinical risk indicators, adverse drug events and a number of other things from a variety of sources. The PIPS Committee identifies issues and makes recommendations to the Medical Executive Committee. They are instituting an on-line “unusual occurrence” system. The PIPS Committee is responsible for selecting at least one process annually for proactive risk assessment, and that adverse drug reactions has been selected for review in 2002. There are no significant changes to utilization management.

Commissioners’ Comments

  • Commissioner Monfredini asked how the revised policy differs from previous practice. Dr. Luce responded that the hospital has always had quality improvement programs, but now there is more emphasis and intensification of efforts.
  • Commissioner Jackson, with regard to medication errors and adverse drug reaction, asked where the immediate response occurs. Dr. Luce responded that the report of the error is immediately given so that the individual case can be responded to.

Action Taken: The Commission (Chow, Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the San Francisco General Hospital Medical Center Policies and Procedures: Hospital Plan for the Provision of Patient Care; Performance Improvement and Patient Safety (PIPS); and utilization management.


Hiroshi Tokubo, Director of Quality Management, CHN, presented the Performance Improvement Report. JCAHO requires the governing body to play a role in promoting performance improvement activities and initiatives, which is done through the Joint Conference Committee. Mr. Tokubo highlighted three performance improvement projects that were undertaken last year.

Advance Directives. Mr. Tokubo stated that hospitals are required to provided information about Advance Directives upon admission and document that this has been done. Mr. Tokubo stated that overall compliance increased from 82 percent to 88 percent, which is a remarkably high compliance rate.

Infection Control. Mr. Tokubo said that a two-part audit was done. One part was generic to all units and one was unit-specific.

Patient Satisfaction. SFGHMC voluntarily participated in PEP-C, a three-year survey of patients post-discharge. There were a number of strengths and improvements gleaned from this report. One finding was that after discharge, patients thought they had inadequate information about when they could resume normal activity, what indicated they needed to call the doctor, etc. As a result, staff very quickly developed and instituted new Patient Discharge Instructions.


Rod Auyang, Human Resources Manager, presented the 2000-2001 Annual Competency Report, which insures the competency of all staff involved in providing care to patients and residents. The report identifies training needs and evaluates the effectiveness of the competency program. Competency is assessed by conducting annual performance appraisals and successful completion of required courses and training. Mr. Auyang stated that after receiving a deficiency during the 1999 JCAHO survey for not completing performance appraisals in a timely manner, SFGHMC Executive Committee charged a CQI task force to evaluate the organizational effectiveness of the performance appraisal system. This resulted in a redesigned and simplified evaluation tool. In FY 2000-2001, 98 percent of performance appraisals were completed in a timely manner. Of the 2,755 employees who were assessed in a timely manner, 47.5 percent “exceeded standards” and 51.2 percent “met standards.”

With regard to medical staff competency, all physicians who practice at SFGHMC are evaluated during initial appointment process and every 2 years thereafter. For FY 00-01, 591 physicians were granted privileges through the initial appointment or reappointment process. Registry staff is also evaluated. Volunteers’ performance is assessed jointly by SFGHMC department and the executive director of the Volunteers to San Francisco General Hospital.

Mr. Auyang then described the education and training accomplishments for FY 00-01 as well as the educational needs assessment. He then discussed next steps:

  • Continue to improve performance appraisal tool based on feedback from survey sent to all supervisors regarding their satisfaction with the new tool.
  • Continue to expand the curriculum offered to staff through HealthStream.
  • Focus on Patient Safety Curriculum, Patient Education, CPR Programs, assault Management, Mandatory Education and JCAHO preparation.

Commissioners’ Comments

  • Commissioner Chow commended the staff for getting to 98 percent compliance.


John Kanaley, Senior Associate Administrator, Support Services, presented the Environment of Care report. There are seven disciplines within the Environment of Care: safety management; security management; emergency preparedness; medical equipment management; hazardous materials and waste; life safety management; and utility management. With regard to security management, overall crime statistics at the campus continue to decrease, but staff perception of their security is low. A pilot program to transfer DPH Institutional Police to the Sheriff’s Department will be implemented. He discussed the hospital’s emergency preparedness activities, and said that communications remains the biggest obstacle in preparedness. Mr. Kanaley highlighted key programs, including the development of an Asset Management Program to plan for obsolescence and replacement of equipment.

Mr. Kanaley highlighted significant life safety and utility management concerns. The JCAHO standards for life safety assess the building based on 1999 standards. The building was built in the 1960s. The staff is developing a compliance plan. The second issue is the Power Plant, which has the following significant concerns:

  • The plant is beyond engineering economic life. It was designed in the 1960s and is inefficient and unreliable.
  • 1 Boiler out of service for 8 months
  • 1 Turbine generator out of service 8 months
  • 1 Air conditioning chiller out of service t months and still not at 50% capacity.

The Mayor’s energy program is funding the replacement through the Public Utilities Commission.

Mr. Kanaley said the third significant issue is the underground storage tank.

Public Comment

  • Michael Lyon, Coalition to Save Public Health-SF, expressed concern about people’s ability to access care at SFGHMC. Guards are questioning people coming into the hospital, which has upset some people, particularly at the Women’s Option Center. He said that, although this does not seem to be a problem any more, patients should not have to disclose confidential patient information. The hospital needs to find another way to control access.
  • Jason Grant Garza, commented on security and the denial of emergency services. He was arrested at SFGHMC by Institutional Police. He said that the Institutional Police should be accountable to an agency other than DPH. It is inhumane and unacceptable.


Carlos Villalva, Chief Architect for SFGHMC, presented the SB 1953 compliance plan. SB 1953 concerns the seismic safety of two buildings on the SFGHMC campus: main campus-all acute care functions; and service building - central power plant. The compliance plan, which is due by January 1, 2002, requires an outline of the corrective actions to be taken, and a timetable by which work will proceed. The compliance plan can be amended if necessary until July 1, 2004. Mr. Villalva stated that they anticipate submitting an amended plan after the various planning processes are complete.

Mr. Villalva summarized the various timetable deadlines: life safety work by 1/1/2002; extension request by 1/1/2003; upgrade the Service Building by 1/1/2008; build new acute care facility by 1/1/2013; additional seismic work by 1/1/2030.

Multiple planning processes are in process to determine the best solution for San Francisco, as follows:

  • Strategic healthcare planning phase over next six months to fully consider the programmatic issues.
  • Institutional master planning for the SFGHMC campus to determine the best hospital site, and the backfill strategies, to be complete by 1/2003.
  • Long-range development plan for research and academic space needs at SFGHMC in the future.
  • Consideration of a joint facility with UCSF at Mission Bay.
  • UCSF planning processes should be complete by the end of 2002.

Several critical decisions will occur during calendar year 2002 such as the number and types of hospital beds, range of services to be housed in the new facility versus other sites, location of the new facility at SFGHMC or Mission Bay and the cost of proposed project to the city.


Kathleen Murphy, Deputy City Attorney presented the amendments to the bylaws. The bylaws set forth the duties and responsibilities of the governing body. These include receiving and acting on recommendations for the Executive Administrator and the Medical Executive Committee. There is a new JCAHO standard that calls for the hospital administrator to be selected based on specific criteria, so this is included in the Bylaws. Ms. Murphy discussed the JCAHO standards of Governance. There are two types of changes. One is to reflect changes in practice. The most noticeable example is the change in administrative reporting structure reflecting current practice and the fact that the Joint Conference Committee is now, after Sunshine Ordinance, open to the public. The second type is to update the language in accordance with current JCAHO requirements and jargon.

Action Taken: The Commission (Chow, Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the San Francisco General Hospital Medical Center Governing Body Bylaws.

Commissioners’ Comments

  • Commissioner Monfredini said that the Commission needs to be totally committed to a new facility because it will play a critical role in getting San Franciscans to support the bond. There is no doubt that San Francisco needs a new hospital, and it is going to take a lot of work and dedication. Commissioner Monfredini also commended the staff for making huge strides since last year, when the medical staff expressed some very real concerns.
  • Commissioner Chow said that the Health Commission adopted a resolution last year supporting a new hospital, and this commitment remains unchanged. Commissioner Chow is very appreciative of the cooperation between medical staff, administration, Director of Health and the Commission this year in trying to respond to the city’s health needs. The Department is facing new challenges, but San Francisco General Hospital is one of the cornerstones of the Department, and the Commission fully intends to continue to reach the vision of being the finest public hospital in the United States.
  • Commissioner Jackson said the timing of the bond issue is critical. He was at the emergency room last week for five hours with a staff worker. The staff was incredible and communicative. The staff treats patients with grace and dignity under very stressful conditions.
  • Commissioner Umekubo commended Ms. O’Connell and her staff for laying out the Annual Report so well-this will serve as a focus point for the JCCs. He also said that the rates of compliance are amazing, and tremendous strides have been made since last year.
  • Commissioner Sanchez stated that all the colleagues that presented this evening are to be commended for the depth of their presentations.
  • Commissioner Parker thanked staff for their hard work over the past year, and for the very in-depth presentation.




The meeting was adjourned at 6:10 p.m.

Michele M. Olson, Executive Secretary to the Health Commission