Minutes of the Health Commission Meeting
Tuesday, December 18, 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 3:15 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.
2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF DECEMBER 4,
Action Taken: The Commission approved the minutes of the December 4,
2001 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired, and Commissioner Jackson and Commissioner
Monfredini attended, the Budget Committee meeting.
(3.1) CHN-SFGH Nursing Operations - Request for approval of new
contracts with C.W. Healthcare, Inc. and Medstaff, Inc. and contract
modifications with HRN Services, Inc., Nurse Providers, Inc. and United
Nursing International, for a combined total of $1,375,000, for
supplemental, temporary Per Diem and Traveling nursing personnel
services for San Francisco General Hospital, Community Health Network,
for the period of September 1, 2001 through August 31, 2002.
(3.2) CHN-SFGH & LHH Facilities - Request for approval of
thirteen (13) contract modifications with the following firms: Acker
& Guerrero Roof Co., Inc., Adolph Schmidt General Contractors,
Anderson Carpet & Linoleum Sale Co., Inc., Angotti & Reilly
Inc., Ayoob & Peery Plumbing, Baca & Sons Painting, Floortrends
Inc., McClure Electric & Co., Robert Poyas, Inc., Sabel Painting
Co., Monticelli Painting & Decorating, Sierra Electric Co. and The
Shooter Co., to increase the combined contract amount by $2,162,500,
from $3,825,000 to $5,987,500, for the provision of intermittent,
as-needed facility maintenance services above baseline civil services
staffing for the period of July 1, 2000 through June 30, 2002.
(3.3) PHP-AIDS Office - Request for approval of a retroactive
contract modification with the Regents of the University of California,
through UCSF/AIDS Health Project, in the amount of $41,107, for a
contract total of $139,196, to provide HIV Counselor Certification
services, for the period of January 1, 2001 through December 31, 2001.
Commissioner Sanchez abstained from voting on this contract.
(3.4) PHP-AIDS Office - Request for approval of contract term
extensions with the following seven contractors for HIV prevention
services for the period of January 1, 2002 through June 30, 2002,
Aguilas, Inc., CompassPoint Nonprofit Services, Haight-Ashbury Free
Clinics, Inc., Harder+Company, Iris Center, Stop AIDS Project and
Tenderloin AIDS Resource Center.
(3.5) PHP-Housing & Urban Health - Request for approval of
eighteen FY 2001-2003 Housing and Urban Health Contracts for a combined
total of $6,982,960.
(3.6) PHP- Promotion - Request for approval of a contract
modification with San Francisco Study Center in the amount of $550,000,
for a total contract value of $1,258,856, to provide additional fiscal
agent services for the Pedestrian Safety Project, for the period of
January 1, 2002 through September 30, 2003.
(3.7) PHP-Prevention - Request for approval of a retroactive contract
renewal with NICOS Chinese Health Coalition in the amount of $75,000 to
provide problem gambling prevention services, for the period of July 1,
2001 through June 30, 2002.
(3.8) PHP-Mental Health - Request for approval of retroactive
contract renewal with Saint Francis Memorial Hospital for the provision
of 24-hour acute psychiatric inpatient hospital services in the amount
of (1) $50,000 City funds targeting uninsured adults, and (2) $4,300,000
Medi-Cal funds for three hospital providers targeting Medi-Cal adult
beneficiaries for the period of July 1, 2001 through June 30, 2002.
Items 3.8, 3.9 and 3.10 were discussed together.
- Commissioner Sanchez asked why the agencies had low program
compliance ratings. Sai-Ling Chan-Sew responded that one of the
agencies submitted its declaration of compliance 11 days late. With
regard to the St. Maryís program, client satisfaction is low
primarily because these kids are locked up against their will, and
do not like it. Linda Wang stated that the Department has modified
some timelines because some have been unrealistic.
- Commissioner Jackson asked what makes the timelines unrealistic.
Ms. Wang replied that one factor was that the deadline was during
the holidays, when a number of staff was out, and another factor was
the form being mailed to the wrong person. Commissioner Jackson
emphasized that contractors must get documentation in within the
- Commissioner Monfredini said when contractors get money every
year, they should know the deadlines and just comply.
(3.9) PHP-Mental Health - Request for approval of retroactive
contract renewal with St. Luke's Hospital for the provision of 24-hour
acute psychiatric inpatient hospital services in the amount of (1)
$50,000 in City funds targeting uninsured adults, and (2) $4,300,000 in
Medi-Cal funds for three hospital providers targeting Medi-Cal adult
beneficiaries for the period of July 1, 2001 through June 30, 2002.
(3.10) PHP-Mental Health - Request for approval of retroactive
renewal contract with St. Mary's Medical Center in the amount of (1)
$170,000 in City funds for the provision of acute psychiatric inpatient
hospital services targeting uninsured adolescents and (2) $4,300,000 in
Medi-Cal funds for three hospital providers for the provision of acute
psychiatric inpatient hospital services targeting Medi-Cal
beneficiaries, for the period of July 1, 2001 through June 30, 2002.
(3.11) PHP-Mental Health - Request for approval of retroactive
contract modification with Richmond Area Multi-Services, Inc. in the
amount of $344,081 for the period of July 1, 2001 through June 30, 2002,
to provide childrenís mental health services, for a total contract
value of $4,213,125, for the period of July 1, 1998 through June 30,
(3.12) PHP-Mental Health - Request for approval of retroactive
contract modification with Richmond Area Multi-Services, Inc. in the
amount of $532,269 for the period of July 1, 2001 through June 30, 2002,
to provide adult mental health services, for a total contract value of
$8,341,888, for the period of July 1, 1998 through June 30, 2002.
- Commissioner Monfredini asked if the underbilling problem had been
corrected. Ms. Chan-Sew responded that the agency has instituted an
internal audit to make sure they do not underbill. The executive
director, Evelyn Lee, reiterated this.
(3.13) PHP-Mental Health - Request for approval of retroactive sole
source contract renewal with San Francisco League of Urban Gardeners,
acting as fiscal agent for Southeast Neighborhood Jobs Initiative
Roundtable, in the amount of $50,000, to provide outreach services
targeting African-American residents of the Bayview Hunter's Point,
Potrero Hill, and Visitacion Valley neighborhoods, for the period of
July 1, 2001 through June 30, 2002.
(3.14) PHP-Mental Health - Request for approval of a retroactive sole
source contract renewal with West Bay Pilipino Multi-Service Center in
the amount of $60,000, to provide mental health services targeting
immigrants transitioning to community care, for the period of July 1,
2001 through June 30, 2002.
(3.15) PHP-Substance Abuse - Request for approval of a retroactive
contract renewal with Asian American Recovery Services in the amount of
$5,183,663, to provide substance abuse services targeting for adult men
and women of predominantly of Asian/Pacific Islander descent, for the
period of July 1, 2001 through June 30, 2002.
(3.16) PHP-Substance Abuse - Request for approval of retroactive
contract renewal with Youth Leadership Institute (YLI) in the amount of
$377,795, to provide substance abuse services targeting teenagers and
young adults, for the period of July 1, 2001 through June 30, 2002.
(3.17) PHP-Substance Abuse - Request for approval of a retroactive
month-to-month contract renewal with Women and Children's Family
Services, Inc., in the amount of $1,611,030, to provide residential and
outpatient substance abuse services to alcohol/drug addicted women,
targeting low income pregnant and postpartum women, their children,
their families and/or significant others, for the period of July 1, 2001
through June 30, 2002.
- Commissioner Monfredini, expressing frustration that the problems
with this agency have not only continued but also gotten worse,
asked the Executive Director Mary Daddio and the chair of the board
Adriana Gross to respond to the Departmentís recommendations. Ms.
Gross said the board is recruiting for more board members, and is
taking the recommendations seriously. Commissioner Monfredini asked
for an update to the CHN Joint Conference Committee on January 29th
and for a report to the Budget Committee on February 19th.
Commissioner Monfredini asked the Department to start to consider
alternative services if in fact the contract is terminated.
- Commissioner Jackson asked if there have been past instances of
fiscal mismanagement. Ms. Daddio responded that there had been one
instance, and the person is no longer with the agency. Commissioner
Jackson asked for an explanation of the low client satisfaction
rating. Ms. Daddio responded that the State has reviewed the client
complaints, and found them to be unsubstantiated. Commissioner
Jackson said that it might the time for new leadership. Ms. Gross
responded that the Board is looking at every avenue to ensure the
services remain intact.
- Commissioner Sanchez emphasized that these are very difficult
clients, and if ever we need to maintain the highest standards, it
is for this at-risk population. The Board of Directors and the
Executive Director might need to revisit the agencyís mission and
determine if they are able to provide the highest level of services
for all the various programs. Further, as dollars decrease, if there
is no documentation that programs are working, the funds are going
to go away.
- At the Health Commission meeting, Commissioner Parker raised the
issue of numerous contracts having low program compliance ratings.
Monique Zmuda responded that two factors contribute to the program
compliance difficulties. First, there are more contract requirements
than ever before. Second, DPH is stricter in its monitoring.
- Commissioner Jackson suggested that at some point the Department
consider imposing penalties on agencies that do not submit paperwork
Action Taken: The Commission approved the consent calendar of the
Budget Committee, with Commissioner Sanchez abstaining on Item 3.3,
Commissioner Chow abstaining on Item 3.7. and Commissioner Umekubo
abstaining on Item 3.10.
4) DIRECTORíS REPORT
(Mitchell H. Katz, M.D., Director of Health)
(Report on activities and operations of the Department)
Fire December 15th at 275 Turk Street
A three alarm fire broke out Saturday evening at 10:25 PM at 275 Turk
Street. The 66 unit 5 story apartment building housed 159 residents
including families, infants and seniors. The group includes Spanish,
Tagalog, Cambodian, Bosnian, Arabic, and English speaking families. All
residents were evacuated safely. The fire spread to all five floors via
the light well, and there was extensive damage to at least 5 apartments
and the roof. The building was closed by the Fire Department, and PG&E
shut off the gas and electricity, so no one was able to return to an
apartment. A Salvation Army hotel across the street immediately invited
the building residents into the lobby and dining room, and the staff later
housed several of the families in vacant rooms. The South of Market
Recreation Center was also opened as a shelter.
On Sunday, Charlie Morimoto worked with staff from DHS to assist the
families in identifying temporary housing. By Sunday evening all residents
of the shelter were housed in motels, and the recreation center was
closed. It appears that many of the families will be able to reoccupy
their units before Christmas. Charlie will continue to work with the
families and case managers from DHS to ensure that the residents needs are
CSF/DPH Electronic Mail Project
As part of a City-wide effort to standardize electronic mail services,
the Health Departmentís Information Technology team in collaboration
with the Department of Telecommunications and Information Systems
completed the installation of a new E-Mail system in November. Over 4,000
DPH users were transitioned to Lotus Notes over a period of two weeks
making DPH the first and largest City Department to complete the project.
The implementation went very smoothly, and IT staff are continuing to
assist users throughout the Department with training and support issues as
they arise. The new system meets all of the Departmentís requirements,
including the privacy provisions required for HIPAA. The Departmentís IT
staff, under the leadership of Dave Counter, are to be congratulated for
the successful completion of a very complex and difficult task.
SFGH/LHH Data Network Project
The Departmentsí Information Technology team has begun a major
overhaul of data network capabilities at San Francisco General and Laguna
Honda Hospitals. Working in conjunction with engineers from Pacific Bell,
currently obsolete network equipment will be replaced with state of the
art data transport devices over the next four months. This new network
will provide the infrastructure needed for the upcoming HIPAA security
regulations, and will allow for the ongoing functioning and future
expansion of data services at both locations.
Diesel Exhaust Ordinance
On December 10, 2001, Supervisor Sophie Maxwell introduced new
legislation to the Board of Supervisors to limit the amount of diesel
exhaust emitted by electrical generators. Diesel exhaust is a known toxic
air contaminant and a likely carcinogen.
If adopted the ordinance will:
- ensure that diesel backup generators used in the City and County of
San Francisco are registered with the Department of Public Health;
- require new backup diesel generators to have the best available air
emission control technologies;
- limit the time of operation of diesel backup generators during
The Departmentís Environmental Health Section is designated as the
enforcement agency for this proposed law. Diesel backup generators that
provide electrical power to certain public and medical facilities would be
exempted from the requirements of this ordinance.
Tobacco Cessation Services Mini Grants
The Tobacco Free Project allocated Master Settlement Funds for tobacco
cessation services targeting San Franciscoís special populations and
ethnic communities. Seven mini-grants in the amount of $10,000 each were
awarded based on a competitive application process. The agencies selected
address the following populations: LGBT adults, LGBT youth, Asian pregnant
women with smoking family members; Chinese male smokers; pregnant
non-Kaiser members; Russian speaking immigrants; and HIV/AIDs patients.
The American Lung Association of San Francisco and San Mateo Counties,
Asian Perinatal Services, Chinatown Health Center, Prevention Resources,
and UCSF Positive Health Program were among the agencies selected for
African American Health Initiative Conference
On Dec. 12th the African American Health Initiative co-sponsored a
forum entitled "African-Americans' Healthcare and Medical Research:
Beyond the Legacy of Tuskegee". The Keynote speaker was Dr. Alvin F.
Poussaint, M.D., Harvard University. Dr. Patricia Evans was one of the
panel discussants. There were approximately 350 in attendance; the program
was taped and will be aired at a future date. Cynthia Selmar, Director of
the African American Health Initiative will inform the Department of the
Contractor Meeting on FY02-03 Budget
On December 6th, Community Programs brought together over 50 people to
discuss the impact of a projected $175m city deficit in FY02-03 on the
Department and the implications for contractors.
In response to the anticipated reduction, the following departmental
strategies were discussed:
- reviewing consolidation of departmental functions
- prioritizing services based on the strategic plan
- working towards the integration of physical health, behavioral
health, housing and social services
- focusing or refocusing community services to reduce hospitalizations
and accept hospital referrals
- determining where revenues may be increased to fund expenditure
- reviewing the productivity of civil service programs and determining
the impact of reducing positions and/or closing programs
- reviewing all Contracts for potential program reductions, based on
productivity, contract compliance and performance
- choosing not to backfill expired grants or continue programs funded
with one time Board of Supervisors or Mayoral funding.
SAN FRANCISCO GENERAL HOSPITAL, DECEMBER 2001
(from 12/10/01 MEC and 12/11 SFGH)
Changes in Privileges
Current Statistics - as of 12/1/01
Affiliate Professionals (non-physicians)
Applications In Process
Applications Withdrawn Month of November 2001
SFGH Reappointments in Process Through April 2002
- Commissioner Monfredini, referencing the fire at 275 Turk, asked Dr.
Katz to provide a summary of the fire prevention efforts. Anne
Kronenberg responded that three SRO collaboratives have been formed in
the Mission, Chinatown and Tenderloin. One of the primary roles is to
work with the Department of Building Inspection and the Fire
Department on prevention. This latest fire was in an apartment
building, not a SRO, so was not part of the SRO collaborative focus.
Ms. Kronenberg said that it is a constant battle to make sure the fire
safety tools are in the buildings.
- Commissioner Sanchez, commenting on recent reports about no heat in
some San Francisco classrooms, asked if there is a way for the Health
Department to inspect each school for heat, carbon monoxide leakage,
ventilation, etc. Dr. Katz responded that he would work with the
Commission to identify how the Health Department can help, but the
greatest challenge is that many of the facilities are indeed
- Commissioner Jackson asked what authority or leverage the Department
has over the school district vis-ŗ-vis facility safety. Dr. Katz
responded that if there is a health hazard, the Department is able to
close down the school, but beyond that, the Department has very little
5) ANNUAL AIDS UPDATE
Jimmy Loyce, Deputy Director of Public Health for AIDS Programs,
presented the Annual AIDS Update. Mr. Loyce emphasized that this report is
a result of the efforts of all AIDS Office staff, and acknowledged Dr.
Willi McFarland, Dr. Jonathan Fuchs, Dr. Sandra Schwarz, Dr. Steven
Tierney, Dr. Doug Sobesta, Brenda Walker, Michelle Long Dixon and Laura
The AIDS Office was founded in 1984 with a staff of four and now has
157 employees. At the request of Dr. Katz, in 2002 the AIDS Office was
reconstituted for two reasons: the Department wanted to speak with one
voice on the epidemic; and a unified AIDS Office was needed to provide
leadership to the 11-point prevention plan. The AIDS Office budget is more
than $78 million, and sources are the General Fund, Federal funds and
grants, State funds and private foundation grants.
There are two Community Planning Councils-HIV Prevention and HIV Health
Services. The HIV Prevention Planning Council provides input on plans and
priorities for services and target populations. The HIV Health Services
Planning Council prioritizes services and allocates funding by service
category. Both are constituted of citizens of San Francisco.
Mr. Loyce provided an overview of HIV/AIDS in San Francisco, including
estimates of HIV Prevalence and Incidence for 2001, and ethnic and gender
breakdown of people living with AIDS in San Francisco. Mr. Loyce then
discussed the risk groups, and stated that men who have sex with men (MSM),
and MSM injection drug users make up 86 percent of the AIDS cases in San
Francisco. AIDS cases peaked in 1992 then started declining. Mr. Loyce
then presented a number of maps that showed the geographic distribution of
AIDS by population and census tract.
Mr. Loyce then discussed the future direction of the epidemic:
- More new cases among MSM
- Fewer new cases in IDUs, which is directly related that to the
needle exchange program
- Increasing numbers of HIV positive transgendered individuals
- Slower progression to AIDS and longer survival with AIDS
- Increasing proportion of cases in people of color
Mr. Loyce presented an overview of the various research efforts that
are underway, including studies focussed on prevention for high-risk HIV
uninfected, prevention for HIV positives and prevention of disease
With regard to HIV Vaccine trials, there have been more than 60 trials
to test over 30 vaccines so far. Most vaccines are only in the early
stages testing. There are two later stage studies: the VaxGen trials and
the NIH sponsored HIV Vaccine Trials Network (HVTN). DPH is one of the
HVTN core global sites, and the first planned trial with more than 10,000
volunteers-Ĺ MSM and Ĺ heterosexuals-will start in 2003. DPH is also one
of 61 VaxGen Phase III sites.
Mr. Loyce highlighted some of the studies currently underway in the
Surveillance and Seroepidemiology Section, including a door-to-door HIV
prevalence and incidence survey of men who live in low income
neighborhoods, a study to determine factors that contribute to compliance
with HAART (Highly Active Antiretroviral Therapy) and trends in causes of
death among person with AIDS in the era of HAART.
Mr. Loyce then discussed the HIV non-naming reporting system. In 1999,
the Health Commission took a strong position opposing the use of names for
reporting HIV cases. Surveillance conducted a pilot study that
demonstrated that complete and accurate data could be collected without
the use of names. The State proposal uses unique identifiers, not names.
HIV prevention services include outreach, workshops, social marketing,
risk reduction counseling, HIV testing, prevention case management, media
development and needle exchange. Behavioral Risk Populations are used to
prioritize and target services to those at highest risk of HIV infection.
Three tiers were developed: Tier 1 (highest risk)-MSM and transgenders,
both male to female and female to male; Tier 2 (high risk)-injection drug
users; Tier 3 (lower risk)-non-IDU heterosexuals and women who have sex
HIV Health Services include primary medical care, home health care,
dental care, housing, substance abuse treatment, mental health care, case
management and peer and treatment advocacy.
Mr. Loyce described Project Reggie, a centralized computerized client
registration database at all agencies receiving CARE Act funding.
Consumers and advocates felt strongly that patients be able to register
one time, and be know throughout the entire system. Project Reggie allows
this to happen.
Mr. Loyce discussed key findings from recent CARE evaluations,
including: CARE serves those it intends to reach: injecting drugs,
poverty, having dependents, unstable housing and low health status are
associated with not getting needed services; and barriers include agency
factors, emotional issues and lack of information about services.
Key Challenges facing the AIDS Office:
- Decreasing federal funding - cuts to seroepidemiology,
surveillance and prevention, and an anticipated cut to CARE Title
I. In addition, the federal government may no longer allow
appropriated but unexpended dollars to be carried over to the next
- Decreasing state funding - cuts in prevention and testing and
- Decreasing San Francisco general funds
- Decreased private resources available for our community partners
- Increasing access to prevention for at-risk populations with
- Addressing increasing incidence among MSM
- Expanding cultural competency and capacity to address health and
prevention needs of emerging populations, including the
- Linking prevention, health services and research to improve
services to clients
- Addressing the needs of the multiply diagnosed and homeless
- Commissioner Monfredini asked if the workforce re-entry program for
people infected with HIV was still in operation. Ms. Long Dixon
responded that this program, which is funded through the General Fund,
is going well, although its success depends on favorable state and
federal legislation that has not yet been approved.
- Commissioner Umekubo asked the incidence of AIDS due to blood
transfusions. Dr. McFarland responded that this has been the biggest
prevention success, and the number of cases is negligible. Dr. Katz
added that Red Cross statistics indicate that this would happen in one
in a million cases. Commissioner Umekubo asked if the use of HAART had
any negative medical outcomes, besides drug resistance. Dr. Schwartz
responded that, with regard to resistance, while it is true that a
number of individuals who are on therapy may at some point become
resistant, the AIDS surveillance data shows that there is an overall
improvement in survival. Dr. Schwarz said they looked carefully at
conditions that could result in death that would have been due to the
use of HAART, and found potentially a small increase in pancreatitis
but the other conditions that they thought would be associated with
the use of HAART were not seen.
- Commissioner Parker asked if there is a standard prevention message
or a variety of different messages. He also asked if the community at
large is addressing the need to identify new messages. Dr. Tierney
responded that there are a variety of targeted prevention methods and
messages, and that both the HIV Prevention Plan and the Departmentís
11-point plan emphasize reinvigorating and reinventing the prevention
messages. Dr. Tierney added that in the next year they intend to
increase the State funding that is spent on prevention for HIV
- Commissioner Jackson asked if the Department is successful in
monitoring the sex clubs. Dr. Tierney responded that the Coalition for
Healthy Sex, a group of sex club owners and Department of Public
Health staff, has been reorganized in the past year. In addition, the
Departmentís STD division is working with the club owners. This
on-going relationship ensures that the rules and regulations are
posted and that the staff has been educated around risk reduction and
prevention messages. Commissioner Jackson asked if the Department has
ever considered closing the clubs. Dr. Katz replied that there is
nothing in the law to prevent the opening of a sex club. However, if
the Department becomes aware of a problem, it sends a written warning.
If changes are not made, a second letter is sent saying the club will
be closed by the Health Officer.
- Commissioner Chow asked staff to more fully describe the Early
Intervention Program. Ms. Long Dixon responded that the concept is to
put programs in the neighborhoods where at-risk people live, and serve
them early with therapy before they get AIDS. This program has
expanded to the Bayview Hunters Point neighborhood. Commissioner Chow
then asked the status and promise of the HIV vaccine trials. Dr. Fuchs
stated that the Department has completed the second year of a
three-year trial. Interim analysis showed excellent safety. The trial
needs to continue through the third year before efficacy can be
- Commissioner Sanchez commended the AIDS Office. He also said that
many agencies that received federal dollars are experiencing the same
problem of losing unspent dollars that previously could have been
carried over to the next year.
- Commissioner Guy asked Dr. Schwarz to respond the San Francisco
Chronicle article about the increasing resistance to HIV combination
drug therapy. Dr. Schwarz responded that this is not surprising, as
the HIV virus mutates rapidly. Regardless of that, survival rates are
increasing. Dr. Katz added that the treatment decisions are getting
more and more complicated, but so far science keeps bringing new
therapies even as the old ones become less effective. Commissioner Guy
thanked staff for their professionalism in responding to adverse
situations, for clearly communicating with the Commission and for
developing partnerships in an era of controversy. She asked what
lessons have been garnered from the last five years. Dr. Tierney
responded that the primary lesson is to stay focused and respond
immediately. Dr. McFarland said it was to remain vigilant and quickly
catch shifts in the demographics of the epidemic. Mr. Loyce stated
that is was to have community-based strategies. Dr. Katz stated that
good public health is constantly changing, and that innovation is of
6) DEPARTMENT OF PUBLIC HEALTH ANNUAL REPORT
Frances Culp, Office of Policy and Planning, presented the Department
of Public Health Annual Report. The first part of the presentation
focussed on the inside of the department: its workforce, community
advisory boards, contractors, patients and budget. The second part of the
presentation was organized around the Departmentís Strategic Plan Goals
and strategies, with Ms. Culp highlighting various Department programs and
accomplishments for each goal.
Goal 1: San Franciscans Have Access to the Health Services They
Need, While the Department Emphasizes Services to its Target Populations.
- Strategy: Focus population based public health services on the
entire community and personal health care services on target
- The Emergency Medical Services (EMS) Section Disaster Team,
which released the Level 1 Multicasualty Incident Policy and
focused on health and medical responses to threats of bioterrorism.
- The Tom Waddell Health Center, which opened a Dental Clinic to
serve homeless and HIV positive patients.
- Strategy: Expand health coverage to the uninsured to improve health
status and access to care.
- Health Care Accountability Ordinance, which will result in
health coverage for an estimated 16,050 San Francisco workers.
- Healthy Kids, which will help cover the estimated 5,000
uninsured children in San Francisco.
- Strategy: Ensure that the Community Health Network continues its
vital role in the delivery of health care.
- The Trauma Center at San Francisco General Hospital - three
trauma nurse practitioners were added to the team.
- The Mental Health Rehabilitation Facility
- Strategy: Improve integration of services for target,
vulnerable, at-risk populations who need multiple services
- The Office of Housing and Urban Health - development and opening
of the Broderick House.
- Strategy: Use data and evaluation more routinely and uniformly to
guide program planning and priority setting.
- Community Substance Abuse Services partnership with the
Treatment on Demand Planning Council to use qualitative and
quantitative data to identify 12 major priorities.
- The Epidemiology and Evaluation Section of the AIDS Office,
which evaluated the HIV Prevention Case Management Program to
determine new guidelines and standards.
Goal 2: Disease and Injury are Prevented
- Strategy: Strengthen primary prevention activities of the Department
- STOP Red Light Running Campaign
- Back to Sleep Campaign, to educate new parents about Sudden
Infant Death Syndrome
- Strategy: Address social and economic determinants of health
- Community Mental Health Services creation of a Vocational
Liaison Committee to expand employment opportunities.
- Community Health Education Section release of the RoadMap for
Goal 3: Services, Programs and Facilities are Cost-Effective and
Resources are Maximized
- Strategy: Continue to adopt a financial strategy that enhances
revenue and reduces expenditures by avoiding institutional care
- Community Mental Health Services increased case management
capacity and the ability for case managers to access community
services, rather than institutional care.
- Laguna Honda Hospital and Rehabilitation Center created the
Community Reintegration Program.
- Strategy: Improve recruitment, retention and training of Department
- San Francisco General Hospital created the Nursing Retention and
Recruitment Committee, which will identify key retention issues
and develop a retention plan to address the nursing workforce
- Strategy: Design an e-government strategy and presence for the
- The Management Information Systems Staff undertook a number of
projects to improve the Departmentís Intranet site, including an
online staff directory, legislative tracking system and medical
cannabis ID card system and staff training tutorial.
Goal 4: Partnerships with Communities are Created and Sustained to
Assess, Develop, Implement and Advocate for Health Funding, Policies,
Programs and Services
- Strategy: Increase local, state and federal advocacy for efforts
under the direction of the Mayorís Office
- The Office of Policy and Planning worked closely with Nancy
Pelosi to secure $1.105 million for HIV Services and $1.105
million for Treatment on Demand, and worked to secure an
additional $25 million for Californiaís trauma centers.
- Strategy: Explore opportunities to partner with other providers and
the community on common health issues
- The Department was the lead agency for the implementation of
- Jail Health Services collaborated with Continuum and the AIDS
Office to implement the Homebase Project/HOPE Study.
- Strategy: Continue to expand assessment of community health needs
- The Bayview Hunters Point Task Force released the Community
- HIV Prevention Research Section enrolled 736 high-risk men who
have sex with men into Project Explore.
- Commissioner Monfredini thanked the staff for the clear and concise
- Commissioner Umekubo stated that it is amazing how effective the
Department has been in instituting the changes that have been
necessary over the last few years. The lesson to be learned is that
this is a changing world, and we always need to think about ways to
make things better and more cost effective. This annual report really
lays out how the Department has done this.
- Commissioner Sanchez congratulated Department staff for its
commitment and compassion.
- Commissioner Parker complimented staff for how well they have
adhered to the Strategic Plan. This demonstrates that the Department
does have a comprehensive plan, and should be supported with
7) PUBLIC COMMENTS
The Health Commission meeting was adjourned at 5:35 p.m.
Michele M. Olson, Executive Secretary to the Health Commission