Minutes of the Health Commission Meeting
Tuesday, November 18, 2003
at 3:00 p.m.
101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The meeting was called to order by President Chow at 3:06 p.m.
- Commissioner Edward A. Chow, M.D., President
- Commissioner Roma P. Guy, M.S.W., Vice President - left at 4:45 p.m.
- Commissioner Lee Ann Monfredini
- Commissioner Harrison Parker, Sr., D.D.S.
- Commissioner David J. Sanchez, Ph.D.
- Commissioner Michael Penn, Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE MEETING OF NOVEMBER 4, 2003
Action Taken: The Commission (Chow, Guy, Monfredini, Parker, Sanchez)
approved the minutes of the November 4, 2003 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Monfredini chaired, and Commissioner Chow attended, the
Budget Committee meeting. Commissioner Umekubo and Commissioner Penn were
(3.1) PHP-AB75 Project - Request for approval to authorize adoption of
the County Description of Proposed Expenditure of California Healthcare
for Indigents Program (CHIP) funds for fiscal year 2003-04.
(3.2) CHN-Primary Care - Request for approval of a retroactive renewal
contract with Bayview Hunters Point Multipurpose Senior Center, in the
amount of $55,554, to provide therapeutic day treatment services for frail
elders and disabled persons living in the Southeast quadrant of San
Francisco, for the period of July 1, 2003 through June 30, 2004.
(3.3) AIDS Office-HIV Prevention - Request for approval of a
retroactive contract modification with Better World Advertising to
increase the contract amount by $150,000 for a new contract total of
$520,000, to provide HIV prevention social marketing campaign services
targeting behavioral risk populations, for the period of January 1, 2003
through December 31, 2003.
Commissioners’ Comments (at Health Commission meeting)
- Commissioner Parker asked what outcome objectives are being
measured. Mr. Windt, Executive Director of Better World Advertising,
described the evaluation that was done for FY 2002-03, and submitted a
copy of the evaluation. Jimmy Loyce added the AIDS report would focus
on the connection between research, prevention, health service, and
(3.4) AIDS Office-HIV Health Services - Request for approval of a
retroactive renewal contract with Positive Resource Center, in the amount
of $140,000, to provide employment development services targeting people
living with HIV/AIDS who are seeking to enter/re-enter the workforce, for
the period of July 1, 2003 through June 30, 2004.
CHPP-Health Promotion - Request for approval of a sole source
retroactive contract renewal with Booker T. Washington Community Services
Center, in the amount of $285,000, to provide SevenPrinciples Project
services targeting African Americans, for the period of September 30, 2003
through September 29, 2004.
- Commissioner Monfredini requested an update to PHP JCC in Spring
2004 on the status of hiring a permanent executive director.
(3.6) BHS-Mental Health - Request for approval of a retroactive
contract renewal with the Homeless Children’s Network, in the amount of
$255,697 per year, for a total contract value of $1,022,716, to provide
mental health services for the period of July 1, 2003 through June 30,
(3.7) BHS-Mental Health - Request for approval of a retroactive
contract renewal with NICOS Chinese Health Coalition, in the amount of
$67,872, to provide mental health outpatient services for the period of
July 1, 2003 through June 30, 2004.
Commissioner Chow abstained from voting on this item.
(3.8) BHS-Mental Health - Request for approval of a retroactive
contract renewal with Progress Foundation, in the amount of $9,729,503, to
provide mental health, residential, outpatient and day treatment services
targeting adult residents of San Francisco, with special services for
senior, African American, Asian, Latino and homeless communities, for the
period of July 1, 2003 through June 30, 2004.
Commissioner Monfredini commended the agency for its consistent high
scores across programs. Mr. Fields noted that DPH is working with its
larger service providers such as Progress Foundation to develop a
measurable outcome strategy that looks at the systemic effectiveness,
rather than evaluating unit-by-unit, program by program.
(3.9) BHS-Mental Health - Request for approval of a retroactive
contract renewal with West Bay Pilipino Multi-Service Center, in the
amount of $67,200 per year, for a four-year contract total of $268,800, to
provide mental health services targeting immigrants transitioning to
community care, for the period of July 1, 2003 through June 30, 2007.
Commissioner Monfredini asked for the performance report to be
presented to the CHN JCC when it is completed.
Commissioner Chow noted that this is one of the few contracts that
serve the Filipino community. He asked how many Filipino youth are being
served by DPH and where these services are provided. Ms. Chan Sew said DPH
serves approximately 400 Filipino youth under 19. They receive services
through this contract, through the Balboa Teen Clinic, through RAMS, and
programs like the Family Mosaic program that has a Tagalog-speaking staff
person. Commissioner Chow asked for a special report to the CHN JCC about
the various services that serve the Filipino and other smaller Asian
communities. Ms. Chan Sew noted that Japanese Community Youth Center is in
the process of completing a needs assessment for Asian youth in San
(3.10) BHS-Mental Health - Request for approval of a retroactive
contract renewal with Westside Community Mental Health Center, Inc., in
the amount of $6,393,212, to provide mental health services and fiscal
intermediary services targeting adults and youth/adolescents, for the
period of July 1, 2003 through June 30, 2004.
(3.11) BHS-Mental Health/Substance Abuse - Request for approval of a
retroactive contract renewal with Walden House, Inc., in the amount of
$9,135,851, to provide residential mental health and substance abuse
treatment services, for the period of July 1, 2003 through June 30, 2004.
This contract was continued to the December 2nd Health Commission
(3.12) BHS-Mental Health/Substance Abuse - Request for approval of a
retroactive contract renewal with Bayview Hunters Point Foundation for
Community Improvement, Inc., in the amount of $7,287,312, to provide
substance abuse and mental health services targeting adults and children,
for the period of July 1, 2003 through June 30, 2004.
- Commissioner Monfredini congratulated the agency for its
performance. The agency had some difficult years but those are behind
us and the services are excellent.
- Commissioner Chow commended the agency for receiving three-year
accreditation by the Commission for the Accreditation of
(3.13) BHS-Substance Abuse - Request for approval of a retroactive
contract renewal with Haight Ashbury Free Clinics, Inc., in the amount of
$5,617,050, to provide substance abuse treatment services for residential,
outpatient, day treatment, prevention and outreach programs, for the
period of July 1, 2003 through June 30, 2004.
- Commissioner Monfredini asked how the agency plans to turn around
its services. Ben Eiland from Haight Ashbury Free Clinics replied the
infrastructure has been put in place and the programs are improving.
Commissioner Monfredini asked for a progress report through the CHN
JCC to the Budget Committee in three months.
Action Taken: The Commission (Chow, Guy, Monfredini, Parker, Sanchez)
approved the Budget Committee Consent Calendar, with the exception of Item
3.3, which was discussed separately, and Item 3.11, which was continued to
the December 2nd Health Commission meeting. Commissioner Chow abstained
from voting on Item 3.7. After separate discussion, the Commission
approved Item 3.3.
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., Director of Health, presented the Director’s
Yesterday, Arnold Schwarzenegger was sworn in as the 38th governor of
California. As he pledged in his campaign, Governor Schwarzenegger's first
acts in office included an Executive Order rescinding the recently
increased vehicle license fee, and a call for three special legislative
sessions to address workers' compensation reforms, drivers' licenses for
undocumented immigrants, and the State budget. The vehicle license fee
funds local government and realignment for health, mental health and
social service programs and a rescission of the discounted fee requires an
equal contribution from the State General Fund to keep county budgets
whole. The Executive Order orders reinstatement of the General Fund offset
for local government and refunds to taxpayers who have already paid the
higher fee. However, these funds must first be appropriated by the
Legislature, which the Governor has requested they do in special session.
The Governor's second executive order suspended all proposed State
regulations for 180 days and called for a 90-day review of current
regulations imposed under the Davis administration to determine if they
cause "undue harm to California's economy."
Grants Awarded to DPH by the San Francisco Health Plan
Dr. Katz announced that five grants totaling $426,085 were awarded to
DPH by the San Francisco Health Plan through its “Access Enhancement
Fund.” Sincere thanks go to the Health Plan for their support and
congratulations go to the awardees for their following proposals:
- UCSF/SFGH/Children’s Health Center to extend evening and weekend
- Ocean Park Health Center to implement and evaluate a chronic care
model for treatment of diabetes;
- Chinatown Public Health Center with the Department of Ophthalmology
to purchase equipment for a mobile program that would provide
ophthalmologic services at many sites in DPH;
- SFGH Urgent Care Expansion to purchase equipment for a six-fold
increase in urgent care exam rooms; and
- UCSF/SFGH/Children’s Health Center to expand asthma clinic
appointments by 45%.
Occupational and Environmental Health Section (OEHS) Clean and Green
The new OEHS Clean and Green Programs assist San Francisco regulated
businesses in developing more ecologically sustainable business practices.
The OEHS Clean and Green Program was launched in 2002 and focused first on
toxics use reduction and product substitution. The Clean and Green Program
is currently focusing on the automotive industry and 47 of these
businesses are now operating "clean and green".
Dr. Katz reported that OEHS received a $36,000 grant by the San
Francisco Foundation to support our Hazardous Material's program's Clean
and Green business development with the SF Mission District auto repair
facilities. The project will develop a Toxics Reduction Campaign with
input from neighborhood businesses and then train local businesses on
regulatory compliance, on strategies to reduce their use of toxic
chemicals, and opportunities to reduce pollution.
State Rehabilitation Council Appointment
Congratulations to Eric Ciasullo, Director, HIV/AIDS Return to Work
Initiative, for his recent appointment to the State Rehabilitation
Council. Mr. Ciasullo is also president of the Board of Directors of the
National Association of People With AIDS and has fought the HIV/AIDS
epidemic for more than 15 years.
Natural Gas Rate Increases
Last week, the Public Utilities Commission notified all departments
that natural gas rates are going up. Using the most likely scenario, the
potential impact to DPH is over $840K.
TB Program News
Beginning November 3, 2003, the San Francisco TB Control program in
collaboration with the Department of Public Health Laboratory will begin
using the QuantiFERON-TB Test (QFT) to screen selected patients for TB, in
place of the tuberculin skin test (TST). The QFT is an FDA approved blood
test for use as a diagnostic aid in the detection of latent tuberculosis
infection (LTBI). The QFT test will initially be available through the TB
control program, and DPH is planning expansion of availability to all
Health Department clinics in San Francisco currently providing TB testing.
Last weekend DPH became the first public agency in California to begin
distributing anti-overdose medication to heroin addicts. The Naloxone
program requires people who receive the drug to be trained in how to
administer it to overdose patients. Last year in a study partially funded
by DPH, 24 addicts were trained and given Naloxone. Study results showed
that participants witnessed 20 overdoses, using Naloxone successfully in
14 cases. The other six overdose victims were not given Naloxone for
various reasons. Naloxone has almost no side effects, it works by blocking
opioid receptor sites in the brain.
McMillan Sobering Center
KTVU Channel 2 sent a reporter and crew to take a look at the new
McMillan Sobering Center recently. They will be airing a special
seven-minute segment on Sunday, November 30, during their 11 p.m. news
magazine hour, “Second Look.” Thanks to Barry Zevin, MD, Medical
Director, and his staff for coordinating the activities of the reporter
DHS Star Performer Award
Congratulations to Leah Thiebaut and Lannie Heaney, DPH Foster Care
Public Health Nurses, for being recognized by DHS as a "DHS Star
Performer". This is the fifth year DHS is doing this. The program is
specifically intended for DHS employees to recognize their
accomplishments, yet these two individuals were nominated, as they were
thought very highly of by colleagues at DHS in their role as vital
partners to the smooth and efficient delivery of health care services for
children in foster care. The award will be presented at a private
reception today at Herbst Theater.
Last Thursday EMS and Emergency Operations Section (EMSEO), and
Community Health Epidemiology and Disease Control (CHEDC) coordinated the
local exercise of the statewide health and medical disaster exercise. This
exercise evaluated the City and County of San Francisco's capability to
respond to medical and health needs following the deliberate dissemination
of a biological agent within a fictitious indoor concert.
Following the discovery of the release of a biological agent within San
Francisco, CHEDC dispatched and coordinated epidemiological surveillance
teams to identify patients, and potential patients. CHEDC also issued
health alerts to clinicians and health care facilities citywide, and
worked with the Public Information Officer to develop critical public
information. At the Department’s Operating Center (EOC), EMSEO queried
and coordinated the medical response of every hospital and ambulance
provider within San Francisco. Representatives from DPH Human Resources
and Operations provided logistical support, including securing personnel
and vehicles, which would be necessary during a real incident.
Additionally, the Office of Emergency Services Amateur Communication
System provided redundant communications with DPH health care
institutions, and regional OES.
As in any exercise, DPH identified areas for improvement, but also
learned that steps the Department has taken since September 11, 2001 have
materially improved its ability to respond to a biological or other
Health Network/San Francisco General Hospital Credentials Report:
Health Commission - Director of Health Report (From 11/10/03 MEC and
7/03 to 11/03
Changes in Privileges
Current Statistics - as of 11/1/03
Affiliate Professionals (non-physicians)
Applications In Process
Applications Withdrawn Month of Jan 2003
7(07/03 to 11/03)
SFGH Reappointments in Process Def 2003 to Mar 2004
- Commissioner Chow asked if the new blood test for TB would
differentiate people with BPG. Dr. Katz said it would. Commissioner
Chow asked if this testing in more expensive. Dr. Katz said they are
currently piloting the program, but he anticipates that test will
eventually be used in all places where testing is done. Dr. Katz said
it is likely the test itself is more expensive, but is more efficient
in terms of staff time, so it should not be more expensive to
- Commissioner Guy asked how much San Francisco gets from the Vehicle
License Fee. Gregg Sass said the total VLF currently is $192.4 million
comprised of $79.8 million for health and welfare and $112.6 million
of discretionary funds. The amount eliminated by the Governor was
$129.9 million comprised of $53.9 million of H&W and $76 million
of discretionary. For this fiscal year, Mr. Sass anticipated that the
increased fees would only be there for the last 9 months of the
current year and did not budget $38.3 million.
So the current year reduction is $91.6 million citywide. Next year
the cut would be the full $129.9 million. Assuming DPH’s share is
approximately 20% of discretionary GF, it would have exposure of $18M
this year and $26M next year, but there is great pressure to get the
cuts backfilled by the State and it is too early to predict what the
final effect will be. The commitment to backfill H&W is a concern as
it could theoretically be funded from the discretionary component. But
Mr. Sass was also told that there is public safety money in that portion
which would be politically risky to raid.
5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE
RECOGNITION AWARDS FOR THE MONTH OF OCTOBER
Dorlee Chavez, RN
Southeast Health Center
Cheree Richson, Principal Clerk, Southeast Health Center
Barry Zevin, MD
McMillan Stabilization Pilot Project
Barbara Garcia, PHP Deputy Director
Commissioner Chow presented a Certificate to Sister Miriam Walsh for
her 21 years of dedicated service at Laguna Honda Hospital Pastoral Care.
6) HEALTH CARE ACCOUNTABILITY ORDINANCE UPDATE AND CONSIDERATION OF
A RESOLUTION URGING THE BOARD OF SUPERVISORS TO INCREASE THE HOURLY FEE
AND A RESOLUTION TO AMEND THE MINIMUM STANDARDS
Anne Kronenberg, Deputy Director of DPH, provided the Commission with
an update on the Health Care Accountability Ordinance (HCAO). HCAO
requires that City contractors or lessees provide health coverage or pay a
fee to DPH to offset the City’s costs of caring for the uninsured. The
goal of the ordinance is to insure the workforce. Business may comply with
HCAO by offering insurance that meets the minimum standards or make
payments to DPH to offset care for the uninsured. A third option, a local
health coverage plan, has been determined to be economically unfeasible.
Minimum Standards - Background and Recommendation
The Health Commission has sole responsibility to evaluate and update
the minimum standards. Current minimum standards, set in 2001, are not in
line with available small business health plan options. At the previous
HCAO update to the Commission, staff believed that AB 2178 was a partial
solution for small businesses, but PacAdvantage products do not meet the
minimum standards. Insurance costs are increasing and co-payments are more
The staff recommendation is keep the components of the benefit package
the same, but increase allowable co-payment amounts. (Ms. Kronenberg
pointed out that, since the report was developed, there has been
discussion about an alternative recommendation. This was discussed later
in the presentation.) The increase would allow employers to purchase 2 of
3 PacAdvantage plans, 3 of 4 Kaiser plans and 1 of 3 Blue Shield Plans.
Increased Fee to DPH - Background and Recommendation
Companies can choose to make a payment to DPH rather than providing
insurance. The fee is $1.50 per hour per employee, with a maximum fee of
$60 per week per employee. In FY 2002-03 DPH collected $153,755. The
Health Commission may review the fee and recommend a change to the Board
of Supervisors. The monthly maximum for the HCAO fee is $240, which is
less than the project monthly insurance premium cost for 2004. Staff
believes that the HCAO fee should not cost less than the average monthly
premium, so recommends increasing the fee from $1.50 per hour to $2.00 per
hour. The weekly maximum would be $80 and the monthly maximum $320 per
Ms. Kronenberg said they still believe that small businesses should
have access to plans that meet the minimum standards. There may be another
option to have a two-tiered system whereby larger businesses would be
required to meet the current minimum standards, and the revised standards
would only apply to small businesses. Larger businesses have the ability
to negotiate for packages, and can negotiate one that meets our standards.
Smaller businesses do not have this option. Staff does not have a
recommendation yet, and would like more time to develop this alternative.
Dr. Katz added that, regardless of what the Department and Commission
may desire in a health insurance product, there are realities in the
marketplace and it does no good to specify requirements that do not exist.
However, in talking to the advocates, it was felt that the larger
employers might use the revised standards to water down their current
health benefits. This led to the idea of a bifurcated system. Dr. Katz has
asked staff to research the issue further, and identify the most
appropriate definition of small business. Dr. Katz said they also
considered the option of reducing the scope of benefits, but ultimately
decided against making this recommendation.
- Karl Kramer, San Francisco Living Wage Coalition, asked the
Commission not to approve an increase to the co-pay, and re-examine
the creation of a city administered health insurance pool. The taxi
drivers’ legislation, passed in 2002, mandates a similar pool. This
would take the insurance companies out of the loop. He supports
increasing the fee the businesses pay.
- Richard Heasley, Executive Director of Conard House, representing
the Mental Health Contractors Association, said the sooner the City
pool becomes available, the better. There is no funding for this
unfunded mandate, and it is not clear if the City will fund the
payment increase. He is also concerned that this requirement only
impacts a small number of on-call employees at his agency, and inserts
the City in the agency’s labor negotiating process.
- Debbi Lerman, Human Services Network, said the HSN supports delaying
the decision on this issue, as the recommendations have not been fully
aired. One concern is dealing with on-call, temporary workers who only
occasionally work 15 hours per week. In addition, there was a
commitment by the City to provide a pass-through to non-profits to
fund this requirement, and this has not been consistent. Need to
ensure that there are affordable, mid-level plans available.
- Dale Butler, SEIU 790, SEIU is concerned about the co-payment
increases. He said the ordinance has been a powerful tool for getting
for-profit businesses to provide health insurance. He supports further
examination of the bifurcated approach.
- Dale Hess, San Francisco Convention and Visitors Bureau, said it has
been a struggle to find carriers to provide coverage to part-time
employees that meets this ordinance. No carrier is willing to talk to
businesses about covering people who work 15 to 20 hours. He is also
confounded by the requirement to pay individuals who do not live in
San Francisco the $1.50 per hour, but employees who live in San
Francisco do not get the money-it goes to SFGH. He supports the
creation of a local insurance pool. He also said that any insurer that
offers insurance to City employees should be required to provide
insurance to this group of employees.
- Commissioner Chow asked Rich Waller, Office of Contracts
Administration, how many employees are covered by this ordinance. Mr.
Waller said there are approximately 3,500 contracts that are subject
to this ordinance, but he does not know how many employees are covered
by these contracts. This is identified through individual,
investigative audits. To date they have audited 73 contracts.
- Commissioner Sanchez asked if the audits found differences in
compliance rates between non-profit and for-profit companies. Mr.
Waller said that there is no difference.
- Commissioner Parker endorses universal health coverage, and the
basic problem is that small businesses cannot get insurance for their
employees. There will never be universal coverage until there is
something for small businesses. Commissioner Parker said this issue
has not been adequately examined, and the co-payment should not be
increased until there is more information.
- Commissioner Monfredini said that she supports the two-tiered
system. She wants small businesses to be able to provide insurance,
and not have to make the decision to fire employees in order to meet
the requirements. She supports delaying action until more research has
- Commissioner Sanchez supports further analysis of a two-tiered
- Commissioner Guy supports further research of a two-tiered system,
with a few cautions. The problem of spiraling health care costs cannot
be solved at the local level. We need to maneuver through the system,
and find ways to provide insurance to our workers.
- Commissioner Chow also supports further analysis of this issue. The
public raised an interesting idea of requiring businesses that provide
insurance through the Health Service System to provide a product for
this pool of workers. Commissioner Chow said a local pool was not
economically viable for 400 employees. But if we identify a greater
number of people, perhaps we can re-examine a local program. Dr. Katz
will reevaluate the feasibility of developing a local pool, although
there are significant challenges. Dr. Katz said he can bring this
issue back to the Commission in two months, about the two-tiered
system and other steps that can be taken.
Action Taken: The Commission (Chow, Guy, Monfredini, Parker, Sanchez)
deferred action on the two resolutions.
7) CHARITY CARE REPORT AND CONSIDERATION OF A RESOLUTION SUPPORTING
SAN FRANCISCO’S CHARITY CARE ORDINANCE AND URGING FULL COMPLIANCE WITH
Colleen Johnson presented the Fiscal Year 2001 San Francisco Charity
Care Report. This report is required by the Charity Care Ordinance, which
was passed by the Board of Supervisors and signed by the Mayor in 2001.
The goal of the ordinance is to enable the City and County of San
Francisco to evaluate the need for charity care in the community and to
plan for the continued fulfillment of the City’s responsibility to
provide care to indigents and the uninsured. The ordinance contains both
reporting and notification requirements.
Hospitals subject to the ordinance are CPMC, Chinese Hospital, St.
Francis Memorial Hospital, St. Luke’s Hospital and St. Mary’s Medical
Center. SFGH is exempt from reporting, it has voluntarily complied with
the ordinance for both years that reporting has been required. In
addition, Kaiser voluntarily complied with the ordinance for this
reporting cycle, and UCSF has indicated that it intends to comply with the
ordinance for FY 2003. (Public hospitals and HMOs regulated by the State
Department of Managed Care are exempt from reporting under the ordinance.)
Chinese Hospital participates in the Hill-Burton program, and Hill-Burton
charity care is excluded from the City’s and State’s definition of
Ms. Johnson provided a summary of the information that was provided by
the reporting hospitals.
The five reporting hospitals received 142,620 applications for charity
care. Between 113 and 123 applications were denied. Though charity care
services are provided to residents throughout the City, the largest
proportions of charity care services continue to be provided for patients
who reside in the Tenderloin, the Mission, Bayview/Hunters’ Point and
Potrero Hill neighborhoods. A total of 83,285 charity care services were
provided by the reporting hospitals. SFGH provided 81% of those services.
St. Mary’s and St. Luke’s each provided 8%. The types of charity
care-inpatient, outpatient, emergency-provided by each hospital varied.
Hospitals’ charity care expenditures ranged from approximately
$900,000 at St. Francis to approximately $56 million at SFGH. When
comparing the percentage of all licensed beds to the percentage of charity
care provided, SFGH provided a disproportionate amount of charity care
Together, all six reporting hospitals provided $35 million in charity
care in excess of the benefits from tax exemption. However, when SFGH is
excluded, the five non-public reporting hospitals received tax benefits of
$21.2 million beyond what they provided in charity care. Two of the five
hospitals-St. Mary’s and St. Luke’s-provided charity care in excess of
Looking forward, legislation that expands charity care reporting and
policy requirement was introduced by Senator Ortiz, but died in the 2002
legislative session. It may be addressed again in 2003. There will be
changes to the State charity care guidelines.
- Fred Seavey, SEIU 250, said the Union supported this ordinance to
educate people about their ability to get health care via charity
care, and ensure that policy makers have an array of information about
services available. The report clearly indicates the failure of the
City’s largest hospital to provide any significant charity care.
CPMC enjoyed tax breaks of $61 million, sent $100 million in profits
to its parent company in Sacramento, yet only provide $1.5 million in
- Leslie Bennett, Consumers Unions, supports the ordinance and the
reports that have been generated by DPH. The reports provide a full
picture of the charity care provided in San Francisco. It is
unfortunate that even though the ordinance has been in effect for more
than a year, there are still hospitals that do not comply. They
support all efforts to bring hospitals into compliance, including
- Commissioner Monfredini said DPH should ask the City Attorney to
begin the process of civil action against non-complying hospitals.
Also, she is disappointed that St. Luke’s denial rate increased
since it was taken over by Sutter. Finally, she is disappointed that
CPMC provides so little charity care and gets such large tax breaks.
She noted that the Hospital Council should have been at the meeting to
address the Commission and answer questions.
- Commissioner Sanchez said this reports gives DPH a baseline of data;
now DPH need to take that to the next steps of pursuing civil action.
He said it is so frustrating for the Health Commission to sit through
Proposition Q hearings where hospitals say they are going to do
various things, and then see that they are not in compliance, and do
not provide their share of charity care.
- Commissioner Chow complemented Ms. Johnson for her continued
diligence with the report and getting the Commission the most updated
information. It is disappointing that the Hospital Council has not
provided the Commission with any comments. This report was distributed
early at their request. This is an important report.
Action Taken: The Commission (Chow, Monfredini, Parker, Sanchez)
approved Resolution #18-03, “Supporting San Francisco’s Charity Care
Ordinance and Urging Full Compliance with its Provisions,” (Attachment
8) PUBLIC COMMENTS
- Kevin Horne spoke about the restrictions in the methadone maintenance
program. Mandatory detox can lead to serious convulsions or even death. He
asked that a panel of doctors discuss this problem.
The meeting was adjourned at 5:35 p.m.
Michele M. Olson, Executive Secretary to the Health Commission