Minutes of the Health Commission Meeting

Tuesday, June 4, 2002
At 3:00 p.m.
101 Grove Street, Room #300
San Francisco, CA 94102


The Health Commission meeting was called to order by Commissioner Lee Ann Monfredini at 3:10 p.m.


  • Commissioner Arthur M. Jackson
  • Commissioner Lee Ann Monfredini
  • Commissioner Harrison Parker, Sr., D.D.S.
  • Commissioner David J. Sanchez, Ph.D.
  • Commissioner John I. Umekubo, M.D.


  • Commissioner Edward A. Chow, M.D., President
  • Commissioner Roma P. Guy, M.S.W., Vice President


Action Taken: The Commission (Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the minutes of the May 21, 2002 Health Commission meeting.


Commissioner Jackson chaired and Commission Monfredini and Commissioner Umekubo attended the Budget Committee meeting.

(3.1) PHP-Mental Health/Substance Abuse - Bayview Hunters Point Foundation for Community Improvement Inc. Contract Status Report

Barbara Garcia presented the status report, and highlighted the outcomes of the work with the Bayview Hunters Point Foundation (BVHPF). The last status report noted an overall improvement in the agency’s vacancy rates, which was one of the core performance objectives. In April she met with the Mayor, agency staff and labor representatives and negotiated with BVHPF management an effective priority process that substantially lowered the vacancy rate. The agency has still struggled with the Tenderloin Clinic and the Clubhouse, and Department staff made the decision to transfer these programs to another provider. They are determining what process will be used to select the new provider.

BVHPF has continued to do a good job providing substance abuse services.

The Department recommends that BVHPF submit quarterly reports rather than the monthly reports that had been required.

Commissioners’ Comments

  • Commissioner Monfredini agreed that it is time to go from monthly to quarterly reporting. Commissioner Monfredini expressed her displeasure for the record that there were no representatives from Bayview Hunters Point Foundation at the meeting.

(3.2) PHP-Health Promotion - Request for approval of a retroactive contract renewal with San Francisco Study Center in the amount of $138,043, for a total revised contract amount of $489,394, to provide technical assistance and support services for the DPH African American Health Initiative, for the period of July 1, 2001 through June 30, 2002.

(3.3) PHP-AIDS Office - Request for approval of new FY 2002-03 San Francisco City and County General Fund and State of California funded, AIDS Office HIV Prevention Section contracts for a total of $5,239,394, for the period of July 1, 2002 through June 30, 2003, for services awarded through RFP 017-2001, targeting defined behavioral risk populations with the following agencies:



Asian Pacific Islander Wellness Center


Black Coalition on AIDS


Haight Ashbury Free Clinics, Inc.


Harm Reduction Coalition


Iris Center


Larkin Street Youth Center


Lavender Youth Recreation and Information Center (LYRIC)


San Francisco AIDS Foundation


SFDPH Public Health Laboratory


South of Market Health Center - Filipino Task Force on AIDS


Stop AIDS Project


Tenderloin AIDS Resource Center


UCSF/AIDS Health Project


Westside Community Mental Health Center



(3.4) PHP-AIDS Office - Request for approval of a new retroactive sole source contract with the Regents of the University of California, UCSF-Center for AIDS Prevention Studies, in the amount of $150,000, to provide health program planning services targeting and gay and bisexual men, for the period of January 1, 2002 through June 30, 2002.

Action Taken: The Commission (Jackson, Monfredini, Parker, Sanchez, Umekubo) approved the Budget Committee consent calendar, with Commissioner Sanchez abstaining from voting on Item 3.4.

Mitchell H. Katz, M.D., Director of Health, presented the Director’s Report.

Mayor’s FY 2002-03 Budget Transmitted to the Board

The Mayor transmitted his final FY 2002-03 budget to the Board of Supervisors yesterday. The budget incorporates many of the program initiatives that were approved by the Health Commission in its budget review this past Spring. In the beginning of the budget process, the City’s deficit was estimated at $175 million. The Mayor and his staff were successful in reducing the gap to $130 million on April 1st, when the Mayor transmitted his preliminary budget. The Mayor and his staff further reduced this deficit by closing out special funds, refinancing capital projects, using alternative financing mechanisms to support ongoing operations, increased use of cash reserve, and making expenditure reductions. These efforts brought the deficit down to $30 million. The Mayor and the President of the Board of Supervisors then began negotiations with the labor unions to re-open employee MOU’s in order to reduce the City’s contribution to employees retirement by 2.75%. Most of the unions agreed to this proposal in exchange for a commitment, that of no layoffs within these bargaining units. These efforts further reduced the deficit by $17 million, leaving a final deficit of $13 million. In order to finally balance the budget, the Mayor balanced the remainder of the deficit by making expenditure and service reductions, including some in the Department of Public Health.

Also, the Mayor’s budget includes a $20 million reserve to offset revenue reductions that are likely to occur once the State budget is approved later this summer. This reserve will allow the Department to request backfill of funding that may be reduced from the changes to MediCal revenues and other reductions to State funded health programs.

Even with some reductions to Department expenditures, the proposed budget for the Department for FY 2002-03 is $1.030 billion, which reflects an increase of $47 million from the current budget of $982 million. Highlights of the budget includes:

  • 5.5% cost of living increase to civil service employees;
  • Increase census at SFGH by 22 beds;
  • Increase pharmacy cost to reflect current volume and costs;
  • Increase trauma service capacity at SFGH;
  • Increase grant funds of $14 million, including HIV surveillance and prevention, TB ad STD prevention and control, maternal and child health, health promotion, and mental health services expansions;
  • Increase to state funded children’s mental health services and annualization of adult programs;
  • Increase to Jail Psychiatric Services to maintain current year services;
  • Increase to maintain funding for Single Room Occupancy Fire Prevention collaboratives;
  • Increase of general funds match to HIV prevention grant from Dupont.
Other services were reduced from the Department’s original budget submission. They include:
  • Contracting out the laundry services at Laguna Honda for a savings of $1.2 million;
  • Reductions of nursing enhancements to Laguna Honda Hospital of $2.2 million;
  • Reductions of $3 million to salaries, reducing Department’s vacant positions by 42 FTE’s;
  • Deletion of urgent care expansion of $338,000;
  • Deletion of substance abuse treatment funding for programs not yet begun in FY 01-02 by $1.4 million;
  • Deletion of contract funds for programs that have been underutilized in substance abuse treatment system by $1.5 million;
  • Deletion of mental health inpatient, skilled nursing, and outpatient services by $500,000;
  • Deletion of adult day health and acupuncture contract services by $100,000.

It should also be noted that the budget does not include a cost of living for contractors or for the UC contract, nor does it restore funding to remaining many add-backs that were deleted from the base budget.

The Board of Supervisors held its first hearing on the Mayor’s final budget today, and will hold additional hearings on the budget over the next month. The Board of Supervisors is expected to make some changes to the Mayor’s budget to reflect the Boards priorities. Additionally, the Budget Analyst to the Board of Supervisors will analyze the City’s expenditures over the next two weeks, and make further recommendations to reduce the City’s budget. These funds are often used by the Board to restore programs or enhance services.

The next hearing of the Board of Supervisors on the Department’s budget is scheduled for June 19th at 1:00 p.m. DPH will continue to keep the Health Commission apprised of the changes made until the budget is finally adopted.

Baldwin House Hotel Fire

A 3-alarm fire broke out at the Baldwin House Hotel at 74-- 6th Street Sunday morning at 4:04 a.m. The Baldwin House is five-story SRO with over 200-room. The fire had no fatalities, but two residents were brought to the hospital for smoke inhalation. The Baldwin Hotel is home to many seniors, and people with both mental and physical disabilities. An emergency shelter was established at the 6th and Folsom Recreation and Park facility. The Red Cross registered about 170 people in the shelter. The initial health concerns were mental health support and replacing lost medications. Special thanks to Barbara Garcia, Steve LaPlante, Charlie Morimoto, LaDonnis Elston, Josh Bamberger and Carol Baillie for the prompt and effective response. DPH staff has been instrumental in the coordination of services and addressing the physical and mental health needs of these residents.

Advanced Access Pilot

Primary Care is exploring the potential of piloting “Open Access,” a highly successful patient scheduling system, with the support of DPH and the UCSF Medical Staff. The system leaves 50% or more of providers’ schedules open so that patients who call for an appointment are given the option of being seen by their Primary Care Provider or a member of their Provider Team on the same day. Based on results of Open Access programs nationwide, this data-driven system has resulted in elimination of new appointment backlogs and the need for triage nursing, as well as significant reductions in ER and urgent care visits and in no-show rates. A Steering Committee will be set up to guide this process.

Vickie Wells Named AIHA Fellow

Twelve members of the American Industrial Hygiene Association (AIHA) who made significant contributions to the practice of industrial hygiene or related disciplines were awarded Fellow classification. One DPH staff, Vickie Wells, Director of Occupational Safety and Health, was an award winner.

The American Industrial Hygiene Association (AIHA), founded in 1939, is the world’s largest association of occupational and environmental health professionals, and its members play an important role on the front line of worker health and safety. The 12,000 members come from government, labor, industry, academia, and private business. AIHA is the most diverse professional association dedicated to the improvement of the health and well being of workers, the community, and the environment.

Coordinator for Office of Adolescent Health

DPH welcomes Iman Nazeeri-Simmons, MPH, as Coordinator for the newly created Office of Adolescent Health. As Coordinator, Ms. Nazeeri-Simmons will help DPH address the health needs of adolescents in San Francisco, coordinate youth services inside the Department and with other city agencies and the community, and promote emerging adolescent health policies for San Francisco.

Iman most recently worked as the Violence Prevention Specialist at the University of California, Berkeley, where she provided violence prevention programming for a student population of over 30,000. Iman is also a lecturer in the School of Public Health at UC Berkeley, where she teaches an undergraduate course Race, Ethnicity and Health in America.

Commissioners’ Comments

  • Commissioner Jackson asked for a further explanation of the $500,000 reduction to inpatient mental health. Dr. Katz said it is in the areas of fee for service with private providers, use of IMD beds and use of fee for service hospitals. Dr. Katz said that Mental Health has been successful in decreasing the use of fee for service hospitalization by moving people more rapidly into other residential care facilities such as the Broderick House.
  • Commissioner Parker asked if the cause of the Baldwin House Hotel fire has been determined. Anne Kronenberg said that the cause is under investigation. Commissioner Parker asked if the Department monitors safety systems, smoke alarms, etc. Ms. Kronenberg said that the Environmental Health Division inspects the hotels-both public and private-but the number of annual investigations does not cover all the facilities. Commissioner Parker asked when the hotel would reopen. Ms. Kronenberg replied that it is too early to tell when it will be able to be reoccupied. Rarely can people get back in before six months, and it can often be a couple of years. The SRO Task Force has made considerable strides. There was only one fire in the last year that required opening a shelter. But there still needs to be improvement.

Commissioner Monfredini presented a certificate to Larry Doyle in recognition of 36 years of service to the Department of Public Health. The Commission wished him will in his retirement.


Commissioner Umekubo presented the Employee Recognition Awards for the month of May.

Individual Awardee


Nominated by

Delores Junior

DPH/Environmental Health, Hazardous Materials Unified

Sue Cone, Program Manager, Hazardous Materials Program Agency

Team Awardees


Nominated by

Nelly Rodriguez and Diane Mai Tran

San Francisco General Hospital, Human Resource Services, Labor Relations Division

Robert Thomas, Departmental Personnel Officer

Commissioner Jackson left the meeting.


Brenda Lopez, Director, Department of Children, Youth and Their Families (DCYF) presented the Department of Children, Youth and Their Families’ draft Community Needs Assessment. This process is mandated by Proposition D. This is the culmination of 11 community focus groups from the supervisorial districts. The report shows a series of indicators that came from the Mayor’s Children’s Cabinet, which is a group of department heads that convenes on a bimonthly basis to coordinate existing services and resources. One of the goals of DCYF is to have more strategic efforts around new initiatives.

Ms. Lopez discussed some of the projects DCYF collaborates with the Department of Public Health on, including jointly-funded satellite health clinics, the high school wellness centers, the adolescent health coordinator and the high-quality childcare initiative, among others. DCYF recently approved $900,000 for Universal Health Care.

The next step in the Proposition D process, after the Community Needs Assessment is finalized, is to develop a resource allocation plan. Then the RFP process in 2004 will be aligned with the allocation plan.

Ms. Lopez summarized the four Quality of Life benchmarks: children and youth are healthy; children and youth are ready to learn and are succeeding in school; children and youth live in safe, supported families and safe, supported viable communities; and children and youth contribute to the growth, development and vitality of San Francisco. Ms. Lopez then discussed the indicators that are specific to DPH, which include prenatal care, asthma, trends around middle school youth risk behaviors of tobacco alcohol and other drug use and trends in high school youth risk behaviors such as sexual behaviors that lead to unintended pregnancies and STDs.

Overall Recommendations

  • Expend significant resources to reduce the racial/ethnic disparity and inequity among San Francisco’s children, with a focus on African American, Latino, Vietnamese and Filipino youth.
  • Provide services and opportunities appropriate to each community’s cultural and neighborhood norms.
  • Conduct exhaustive and continuous outreach and public awareness efforts for services and opportunities.
  • Integrate services so as to address simultaneous and complex needs.
  • Evaluate all city-funded youth programs to ensure that they achieve stated outcomes and provide meaningful services and opportunities as determined by youth and families.

Commissioners’ Comments

  • Commissioner Sanchez asked as this plan is implemented, how will the Board of Education and the Superintendent of Schools be involved, and how will they become part of the dialogue. Ms. Lopez replied that it is an age-old problem of turf and barriers, but people are engaged and at the table.
  • Commissioner Parker asked how this plan would address prevention services that address such things as dropout rates, tobacco use and teenage pregnancy. Ms. Lopez responded that DCYF does not provide direct services-they fund agencies, they convene, they plan, they empower and they go after grants. They fund many agencies throughout the city that provide intervention and prevention services.


Elizabeth Frantes, C.H.A.M.P. is gone, and people no longer have their medication at Laguna Honda Hospital. C.H.A.M.P. was there for her when no other program was. Many people have lost their community space, and a lot of people are scared and frightened. She thinks that an upcoming rally at the Federal building is a set up to make them look bad.

37311311156099726510641355103926011091107825 (numerical coefficient of his name) - spoke about staffing at 481 O’Farrell for the senior center meals program. One of the women who works there has no business being in a position of responsibility.


A) Public comments on all matters pertaining to the closed session


B) Vote on whether to hold a closed session (San Francisco Administrative Code Section 67.11)

Action Taken: The Commission (Monfredini, Parker, Sanchez, Umekubo) voted to hold a closed session.

The Commission when into closed session at 4:05 p.m. Present in the closed session were Commissioner Monfredini, Commissioner Parker, Commissioner Sanchez, Commissioner Umekubo, Mitch Katz, M.D., Gene O’Connell, Hiroshi Tokubo, Alison Moed, Deputy City Attorney Jason Gonzalez and Michele Olson.

C) Closed session pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d)

Conference with Legal Counsel - Existing Litigation

Proposed settlement of a litigated claim for $250,000 for Cecelia Wade vs. City and County of San Francisco et al, Federal Court Case No. CO1-3165 (MJJ)

Action Taken: The Commission (Monfredini, Parker, Sanchez, Umekubo) approved the $250,000 settlement for Cecelia Wade v. City and County of San Francisco et al.

D) Reconvene in Open Session

The Commission reconvened in open session at 4:33 p.m.

  1. Possible report on action taken in closed session (Government Code Section 54957.1(a)2 and San Francisco Administrative Code Section 67.12(b)(2).)
  2. 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 (Jackson, Monfredini, Parker, Sanchez, Umekubo) voted not to disclose discussions held in closed session.


The meeting was adjourned at 4:34 p.m.

Michele M. Olson, Executive Secretary to the Health Commission