Minutes of the Special Health Commission Meeting
Tuesday, May 11, 2004 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 Commissioner Chow at 3:05 p.m.
- Commissioner Edward A. Chow, M.D., President
- Commissioner Lee Ann Monfredini, Vice President
- Commissioner Roma P. Guy, M.S.W.
- Commissioner James M. Illig
- Commissioner Michael Penn, M.D., Ph.D.
- Commissioner David J. Sanchez, Ph.D.
- Commissioner John I. Umekubo, M.D.
2) APPROVAL OF THE MINUTES OF THE MEETING OF MAY 4, 2004
Action Taken: The Commission approved the minutes of the May 4, 2004
Health Commission meeting.
3) PRESENTATION OF FISCAL YEAR 2004-2005 DEPARTMENT OF PUBLIC HEALTH
CONTINGENCY BUDGET AND CONSIDERATION OF A RESOLUTION REGARDING THE FY
2004-2005 DPH CONTINGENCY BUDGET
Mitchell H. Katz, M.D., presented the proposed fiscal year 2004-2005
Contingency Budget for the Department of Public Health (See attached
Powerpoint presentation, Attachment A).
- Commissioner Sanchez asked for clarification that inpatient dialysis
service would not be eliminated. Dr. Katz replied that inpatient
dialysis services will be maintained. Dr. Katz added that when UCSF
stopped providing dialysis services, SFGH took over with the hope that
it could make it work. In every instance except the $1.6 million in
capital costs that would be required to meet JCAHO standards, SFGH
could have made it work.
- Commissioner Illig asked if the community-based providers who will
be serving some of the mental health clients from Mission Mental
Health and Sunset Mental Health have been selected. Dr. Katz said the
Department would go through an RPF process for the agencies. In the
case of Mission ACT, the two remaining programs are run by UC.
- Commissioner Penn asked if there are additional people at Laguna
Honda Hospital laundry that need to be reassigned. Dr. Katz said that
all the employees have been reassigned to other jobs. Dr. Katz added
that the Department would still need laundry workers for tasks such as
- Commissioner Umekubo asked if there are enough dialysis slots in the
community to absorb the SFGH patients. Dr. Katz said that one of the
reasons DPH agreed to take on the service was because of the concern
that people would end up being treated in the hospital at a higher
cost because there was inadequate outpatient capacity. However, now
the situation is different, other facilities have completed their
renovations and there is now capacity.
- Isabelita Evangelista, please to continue to provide funding for the
Potrero Clinic. Doctors and staff are very good.
- Manuel Vasquez, the closing of Mission Mental Health will mean a
reduction in services. The proposal eliminates 11 clinical positions.
They embrace integration, but not at the cost of the Mission
- Eric Seely, Senior Psychiatric Social Worker at Mission Mental
Health. If cuts need to be made, they should be across-the-board, not
just at Mission Mental Health and Sunset Mental Health. It feels like
communities are being pitted against each other.
- Lucy Vargas, Social Worker at Mission Mental Health, pleaded that
service continue to be provided in the community. Clients will not
leave the community. Tom Waddell clinic is excellent, but it is a
- Tesde H. Torgia spoke in support of the Mission ACT.
- Susan Gamboa, Mission ACT. She appreciates that this is a budget
emergency, and staff is prepared to go into emergency status by
finding a transition space in the community where there is lower rent.
But keep the services in the community.
- Mary Anne Sirring, Mission ACT, please keep these services.
- Michael Sauter, Health Worker at Mission ACT, said staff has worked
to keep people out of the hospital and to become engaged with the
clients. Now they are being told that because their clients are
stable, they no longer need this level of service.
- Larry Huerta said the program has helped people. It should stay
- Theresa Archuleta spoke in support of the Potrero Health Center. She
is also concerned that the Urgent Care at SFGH has too long of waits,
so the people go to the emergency room, which is very costly.
- Bruce Folsom, Social Worker with Southeast Mission Geriatrics. He
works very closely with Mission Mental Health. If this change goes
through, many of their elderly clients would have to be transferred to
Southeast Mission Geriatrics. Also, the only two City programs serving
the geriatric population are being targeted.
- Jim Salaices said Mission ACT helped him after he tried to commit
- Silvia Solorzano, Mission ISC, said the higher ups do not need to
give up their pagers and cell phones, they need to visit the clients.
- Eleanor Dwyer, Mission ACT, said the program’s successes are now
being used against them. She submitted a written document (on file).
The clients are not ready to step down. She proposes finding
affordable facility costs to remain intact.
- Monica Soto, Social Worker at Mission ACT, read from three of the 21
letters of support that she has for Mission ACT (on file).
- Victoria Gonzalez, clinician at Mission Mental Health. The clinic
has been a light in the community for more than 20 years. The current
plan represents the destruction of services under the guise of
integration. The Department has spent years developing these services;
please save these services.
- Orlando Tolbert spoke about the cost-savings of Mission ACT. Mission
ACT is part of the solution to long-term care.
- Laurie, spoke in support of the services at Mission ACT. She was
very supported at that clinic. When people are in crisis, they cannot
even get on the bus.
- Charles Evans, consumer at Mission Mental Health. The program is
very needed in the community-it is the best model and program he has
ever seen. Staff is using peer counselors to help free the staff
- Jan Sparks spoke in support of Mission ACT. Without this program he
would be going in and out of hospitals. The staff helps clients hold
on to their freedom and assure their futures.
- Donna Martinez, Mission ACT, this program has helped her completely.
She is triple diagnosed. They care about one another, and the program
needs to stay open.
- Juanita Valenzuela, spoke in support of the Potrero Hill
Neighborhood Clinic. Please keep these services open.
- Deborah Hughes, San Francisco used to be the city that knew how. The
private sector will not serve these patients. Eligibility workers need
to be in the clinics.
- Eileen Auerbach, OT at Mission ACT, said that the research that was
used as justification to close ACT distorts the research. The key
factor in successful step-down is when the same staff members worked
very closely with the client in the same location. She submitted a
letter to the Health Commission (on file).
- Manuel Mena, mental health clinician, said the proposal guts the
safety net services to the Latino community. Community-based providers
are not safety net providers, so they will not be able to pick up the
clients that are losing services. The Department should look for a
building with cheaper rent.
- Evangelist LaVonne V. McIntosh, she stands as an advocate of Maxine
Hall Health Center, Mission Mental Health and other health programs.
- Rosalind deLisser, Nurse Practitioner at Mission Mental Health and
Mission ACT. Mission ACT and Mission Mental Health are already on the
cutting edge of integration. She was hired to integrate primary care
services at these two programs.
- Dr. Raul Moncayo, Director of Training at Mission Mental Health, the
reduction takes the guts, heart and brain out of mental health
services for the Mission community.
- Richard Heasly, Executive Director of Conard House, said he and
others were pleased with the Mayor’s decision to not require a $37
million reduction from DPH. The plan is an affirmation of non-profit,
community-based services that serve every neighborhood and every
language. The Department gets a lot of value from community providers.
- Jesus Velez, Mission Health Center, over the past six years he has
had several relapses, but each time less work because he gets services
at Mission Mental Health. If he cannot see his psychologist, who knows
what will happen.
- Larry Burgheimer, community mental health is supposed to be
preventive, cuts will have long-term repercussions.
- Hywel Sims, referenced a letter he submitted (on file) that points
out inaccuracies in the Department’s justification for reducing
funding to its programs.
- Vincent Price, on behalf of Mission ACT, if not for this program he
would be dead or in an institution.
- Randall Humphreys said it has taken him 15 years to find Mission
Mental Health. Do not close these services.
- Jonathan Vernick, Executive Director of Baker Places, said he
empathizes with changes that happen as a result of budget cuts. This
year’s budget cuts come after much deliberation about the budget
shortfall, and the proposals make sense by emphasizing integration.
- Steve Fields, Executive Director of Progress Foundation, said that
the safety-net community programs always seemed to bear the brunt of
the cuts; this year these front line services are maintained. There is
no cut that happens in the health budget that does not cut into blood
and bone. He looks forward to the Mayor proposing a revenue bond in
November so that some of the priority 2 programs could be restored.
- Isabel Santos, Sunset Day Treatment Center, there are enough people
in the Sunset that need these services.
- Rhonda Giarretto, Public Health Nurse from Tom Waddell, said DPH
already has clinics that do not have the capacity to serve current
clients. The proposal has no details. Please involve the people who
work day-to-day in these clinics in these decisions.
- Karen Patterson Matthew, Executive Director for Bayview Hunters
Point Foundation, said there needs to be changes, and hope that the
decisions are made in a rational manner.
- Alan “Mickey” Shipley, if you ask clients to go to a new
location, they have to start their whole lives over again.
- Nancy Lewis, FNP at Cole Street Youth Clinic, spoke on behalf of the
programs for youth. Please save their clinic director’s job. Michael
Baxter has provided tremendous services. Under his leadership, the
clinics have made a difference in the lives of so many San Francisco
- Pam Fischer, President of NAMI San Francisco, said that Sunset
Mental Health has the only socialization program in the city. Please
save the Mission clinics and Sunset Mental Health.
- Jane Kiskiras said the proposed cuts are the same as were proposed
by Governor Reagan, and you have seen the results of this. Need to
find more and better funds, not cut programs. Private businesses
should do more to help.
- George R. Williams, said people are being ripped off by
pharmaceutical companies. If the Department keeps throwing money at
pharmaceuticals, it will not have money to provide services. The
Senior Action Network has 12 bills in the hopper, and will have 1,500
at a rally tomorrow.
- Terry Wong, spoke in opposition to the closure of Sunset Mental
Health. It is a comprehensive agency serving adults and children. One
of the unique programs is the Socialization Wellness Recovery Program,
which could not be continued if the program is consolidated.
- Jay Sheffield, Social Worker at Tom Waddell Health Center, DEAP
assists the most vulnerable people in San Francisco. Since January
2002 have achieved 200 successful SSI applications. The program has
saved the City millions of dollars.
- DeForest Woods, representing 5th Street Agenda and Mental Health
Association. In order to help a person with mental illness, you have
to get to know him or her. He pleaded with the Commission to think
twice about making these cuts.
- Matsumoto Ichiro Kenneth, spoke in support of Sunset day treatment.
The treatment gives him serenity, harmony, peace and so many other
blessings. It gave him a chance. It is a very safe place. The older
people that are served by this program will probably end up at Laguna
- C.W. Johnson, client at the Sunset Mental Health Center, said this
is the most integrated service program he has ever seen. Do not take
- Teresa Friend, Homeless Advocacy Program of the Bar Association,
spoke against the elimination of the DEAP program. HAP’s successful
partnership with DEAP saves the City millions of dollars per year,
plus gives the patients better medical care. The community-based
provider only serves people who are currently in treatment.
- Patricia Perez-Arce, Ph.D., Director of Castro-Mission Health
Center, said the base and contingency budget cuts will result in
reduced services at the primary care clinics of up to 25 to 30
percent. 39 clinical and staff positions are being eliminated, as well
as all health center directors. There are other ways to save money.
- Jennifer Gunn, RN at the SFGH Dialysis Center, said most of the
dialysis patients speak a language other than English. These patients
could not receive training and education in their own language at any
other facility in San Francisco. None of the current workers will work
at the private, for-profit dialysis centers that the Department is
proposing will serve these patients.
- Madeline Burnell, Social Worker at the SFGH Dialysis Unit, said the
unit sees homeless, people with mental health and substance abuses,
and people who speak a variety of languages.
- Ligia Jeanette Vasquez Villigran, spoke against closing the dialysis
- Victor Travis, Health Educator at the Balboa Teen Health Center. The
staff is very distressed that their center director, Michael Baxter,
has received his pink slip. If the Commission is concerned about the
health and welfare of young people, they should hold on to Michael
- Stella Rubenstein, spoke in support of Michael Baxter and read from
a letter from the Balboa High School principal and assistant principal
- Madeline Ritchie, Center Director at Chinatown Public Health Center,
spoke against the proposed primary care cuts. The Commission must
recognize that there is an enormous need for mental health and medical
services in San Francisco. We need to collectively look for new
revenue, and not be pitted against each other.
- Donald Frazier, Walden House, said it is good that the proposed
budget saves direct services, except one. Walden House was targeted
for cuts in the baseline budget. He recommends restoring funding for
the cuts that were made.
- Anonymous supporter of Sunset Mental Health. Mentally ill people
tend to be isolated because of the stigma of mental illness. He has
gone from a socially isolated individual to a tax-paying worker
because of Sunset Mental Health.
- Evelyn Soto, consumer of services at Mission Mental Health, as well
as a peer counselor. She is a peer counselor and graduate student
because of the care she received at this clinic. The clinic is very
easily accessible by BART and busses. She is also concerned that
people who get services at primary care clinics will not welcome
mental health clients.
- James Beck, HAFC, it is unacceptable that there is no revenue bonds
for critical services, unacceptable that mental health services are
being cut, now we are funding the school district out of the general
fund. That said the Department must be commended for focusing on
administrative cuts, rather than direct services. It is really
- Dr. Rudy Rodriguez, Medical Director of the Dialysis Unit, is
baffled by the proposed closure because nothing has changed since the
department decided. If the unit is closed, it will take a long time
for the clients to find other chairs. Most dialysis units in San
Francisco do not accept emergency MediCal. Approximately 10 percent of
clients have emergency MediCal. There are viable options to closure.
- Angie Gonzalez, works in the Dialysis Unit, said these clients are
going to end up in the emergency room and end up costing the city more
- Kathryn Fontcuit, physician assistant at the SFGH Renal Center, said
they have met their budgetary goals, passed hospital and DHS
inspections, and it is appalling to see that they are now threatened
to be closed. Care is not the same at private dialysis providers.
- Dr. David Pearce, Chief of Nephrology at SFGH, spoke on behalf of
the Renal Center. The center serves the most vulnerable patients in
San Francisco. The dialysis is and can continue to operate in the
black, even considering capital improvement costs.
- Inez Ascencio, Southeast Child and Family Therapy Center, spoke in
opposition to elimination of the senior social workers. The cuts would
impact client services. She provides services to clients. In her
program specifically, 125 clients would be impact.
- Juan Pauli, Director of Mission Family Center, said he is disturbed
that the cuts are not evenly distributed. Also, too many people in the
trenches who are being cut.
- Cristy Johnston, speaking on behalf of Mauricio Vela, spoke in
support of the senior social worker position at Southeast Child and
Family Therapy Center. She is one of the only Spanish-speaking social
worker who provides direct services. Do not cut her position.
- Anna Ulbrich, Bernal Heights Neighborhood Center, spoke in support
of the senior social worker position at the Southeast Child and Family
Therapy Center. The statement that this cut will not impact direct
services is false.
- Estela Garcia, Associate Director, Instituto Familiar de la Raza,
said that on the one hand the budget recognizes the importance of
community-based providers. But on the other hand, she is concerned
with the dismantling of mental health services. There needs to be a
process for putting these changes in place.
- Richard Marquez, Mission Anti-Displacement Coalition, profoundly
opposed to this round of cuts, particularly the closure of Mission
Mental Health. The people of the Mission district will bear the brunt
of these cuts.
- Leticia Perez, spoke in support of Inez Ascencio, who has worked
with her for several years. She is one of the few bilingual staff at
- Mary Kate Connor, Director of Caduceus Outreach Services, said it is
very clear that anyone with psychiatric illness is being disregarded.
Over the last 15 years, cuts in the Health Department have been
disproportionately targeted toward mental health services.
- Dr. Paul Quick, Tom Waddell Health Center and DEAP, said that he
cannot imagine where they are going to put the clients from Mission
Mental Health, and it is not a culturally appropriate location for
Spanish speaking clients. With regard to DEAP, this program targets a
population that is not currently connected to services. He submitted a
letter for public record (on file).
- Junie, client at Mission Mental Health, please do not take the only
services she had.
- Debbie Lerman, Human Services Network, applauded the Mayor for
letting the department submit a budget with less than 15 percent of a
contingency cut and that preserves direct services. There needs to be
leadership in identifying new revenue.
- Barbara Farrell, Ohlhoff Recovery Services and chair-elect of the
Treatment on Demand Planning Council. Applauded the Department for
looking at administrative reductions instead of service cuts.
- Jeanette Hassberg, said all over the state cuts are targeting people
with psychiatric disabilities. The services are so much more important
than the buildings they are in. The program helps save the city money.
- Michael Lyon, Coalition for Public Health, asked how far these cuts
are going to go. Patients just above the poverty level are going to
pay more for their medication. Health patients are going to be sent to
clinics whose infrastructures are already being destroyed.
- Martha Hawthorne, Public Health Nurse at Castro Mission, said the
Health Commission must clearly articulate that this is a budget of
despair. She submitted information about the Dimensions Health
Services (on file).
- Jerry Berbiar, member of Coalition for Public Health, said Castro
Mission has helped him immensely. The services that helped him are
being dismantled, and this is unacceptable.
- Laurie Hampton spoke against the proposed cutbacks, and submitted
her comments for the record (on file).
- Jennie Woo, Public Health Nurse at Chinatown Public Health Center,
the centers will be very chaotic without center directors, and having
medical directors do administrative work will reduce the time they can
spend providing medical care.
- Laura Guzman, Mission Resource Center, spoke in opposition to cut to
Mission Mental Health. This is a slap in the face to the Mission
community. The clients will not go to Tom Waddell. The services are
- Derrie McClure spoke in support of Walden House residential
- Larry Geffen spoke in support of funding for residential beds at
- Athena Pierce, speaking in support of Walden House, said the program
is losing funding for beds for people trying to become active members
of society. If they are denied a bed, they are denied a chance to
- Donald Adams spoke in support of Walden House residential treatment.
Without this program, he and others would be back in prison. Treatment
is more cost effective than sending people to jail.
- Roy Steele spoke in support of Walden House residential treatment.
- Hjalmar Bjorkman spoke in support of Walden House residential
treatment. This program gives him the help he so desperately needs.
- Kevin Rose, representing the owners of 2712 Mission Street. There
has been a lot of discussion about the high rent for this lease. The
owners are willing to renew an option to purchase a below-market rate.
The ownership group is a 20-year resident of the city with ties to the
Mission. The owner is not currently making a profit.
- Ruth Rivera spoke on behalf of Mission Mental Health and Mission
ACT. People who live in the Mission will not be able to go to other
- Jan Shropshire, PHN at Chinatown Health Center, said the health
center is a magical place. The clinical directors provided much-needed
leadership. Chinatown Health Center has a history of cost-effective
quality services. Why fix something that is not broken.
- Francisco Da Costa, Director of Environmental Justice Advocacy, said
there should be no cuts, but rather increased funding.
- Eve Meyer, San Francisco Suicide Prevention and President of the
Mental Health Contractors Association, which voted this morning to
support this budget, even though it is a bitter pill.
- Andrea Leung, Asian American Mental Health Task Force, spoke in
support of continuing services at Sunset Mental Health. She is very
concerned about where the clients will receive proper service-the
community-based provider is not even known.
- Otto Duffy, Tom Waddell Advisory Board, said there are policy
options available to sidestep these cuts.
- Mark Bernstein, psychiatrist and Medical Director at Sunset Mental
Health, said he first heard of the proposal to close the sight four
days ago. It makes no sense to reconfigure this program in a sterile
environment miles away, which is already facing staff shortage. It is
foolhardy to sell an on-going resource for one-time cost savings.
- Robert Freeh, client at Mission Mental Health, said he is not ready
for change or to go to a different person for services. Do not close
- Dr. Brandon Vance, Mission Mental Health, said he has seen the
strong relationships that staff has developed with the clients. The
location is very important. People in the Mission district are
unlikely to consistently go to another location for care.
- Thalia Gravel, Transgender Lifecare Project at the Castro-Mission
Health Center. There is only one person who is really truly
experienced with the needs of transgendered people, and this person is
the Transgender Lifecare Project.
- Iris Goodwill, Tom Waddell Clinic, said the clinic still accepts
patients into primary care even though they do not have the capacity.
She finds it unrealistic that the proposed cuts will not affect
patient care. There are inaccuracies in the contingency budget
- Larry Bevan, Local 250 Shop Steward, commended the budget for
targeting administrative positions. But one area of concern is the
cuts to mental health. There are not enough services currently, so
where are these 1,300 people going to go.
- Barbara Devaney, Bayview Hunters Point Foundation who sees clients
at Sunset Mental Health, said without this clinic there would be a
loss of community.
- Ying Zhang-Chiu, Sunset Mental Health, said this is the only mental
health service provider in this area that has the language capacity to
deal with this population. The clinic is the home and the lifeline for
- Tina Shereen, Family Practice resident at SFGH, said the clinics are
already stretched to capacity. She was unable to get follow-up care
for a patient because the clinic was not accepting patients at this
time. Cuts to support staff will make an already difficult situation
- Christine Dehlendorf, Family Practice resident at SFGH, said there
is already a shortage of capacity in primary care; her patients cannot
get timely follow-up appointments. Cuts to clinicians and support
staff will overwhelm and already overwhelmed system.
- Cynthia Pon, psychiatric social worker at Sunset Mental Health. The
savings from the proposed cuts are primarily being directed to
community-based alternatives. So the real result is only a
displacement of mental health clients.
- Jane Ma, the proposed budget impacts for civil service programs
without any discussion or involvement of program staff. Sunset Mental
Health is a unique program that has worked collaboratively with Ocean
Park for many years.
- Pam-Pam Gaddies, Operation Save a Life, said that violence is a
health issue, and she invited the commission to visit Sunnydale and
- Lisa Leighton, PHN at Silver Avenue Clinic, spoke against the cuts
to primary care nurses, including the elimination of the director of
nursing for the CHN network. She said the Department is losing revenue
due to inadequate billing.
- Eun Joo Justice, psychiatrist at Sunset Mental Health Center, said
that Manhattan has no homeless people because they provide long-term,
expensive mental health services. Here, the Mayor wants to reduce the
homeless population, yet he is cutting mental health services.
- Allegra Melillo, Resident and the Family Medicine Clinic at SFGH and
doc at Ocean Park Health Center. Sunset Mental Health saves lives, and
we really need to look at the long-term effects to the community.
- Patrick Monette Shaw (submitted via e-mail) - Initiatives DEPT1 and
DEPT2 in the Contingency Budget don’t list job classifications for
83.51 FTE positions being eliminated. Ethically, this Commission
cannot approve this budget without first knowing which positions will
be eliminated. You must table voting on this budget until the public
learns which healthcare safety net positions are being eliminated.
Health Commissioners have no business recommending in the last
paragraph of your draft Resolution to the Board of Supervisors and the
Mayor that the Commission supports employees continuing to pay the
7.5% retirement awarded in lieu of a wage increase years ago. You have
no business asking me to pay 7.5% for a second year. Instead, ask the
27 San Francisco companies on the Chron 200 list who earned $10.5
billion in net income last year for 7.5%. That would yield $787.5
million, solving this year’s and next year’s purported deficits.
Make big business pay its fair share!
- Written testimony
- Gary Robinson, Union of American Physicians and Dentists,
submitted a letter expressing opposition to the contingency budget
- Commissioner Penn thanked the Department and Mayor’s Office their
hard work. The spirit of the reductions is commendable, but the
practical execution of the cuts will be damaging. The timing has been
so condensed and he feels extremely uncomfortable taking action on
this proposal today. The cuts disproportionately affect vulnerable
populations, and the draft resolution does not reflect this. Finally,
it is very difficult to evaluate the contingency budget without seeing
- Commissioner Sanchez said the term “budget of despair”
accurately describes the proposed budget. One of the main focuses of
the Department has been to provide culturally competent services. The
Public Health Department has been a leader in some of the best models
for health care, including homeless services, wellness centers, and so
many others. This is now being dismantled. We need to look at
alternatives to closing the Mission mental health clinics. There are
no other resources in the Mission. Other health centers are at
capacity. He would like to remove the two Mission mental health
programs from the contingency budget, and will propose a formal
amendment to the resolution.
- Commissioner Umekubo thanked the public for its testimony. In times
of crises, people step up with cost-savings ideas that should be
considered. The contingency budget contains good elements and bad.
There are close to $10 million in reductions that do not affect
services, and this is positive. The Health Commission should try its
best to preserve the services that will have an impact on direct
- Commissioner Guy said the staff provided a positive context for
evaluating the proposed budget, which is helpful. The budget partially
moves the Department in the right direction, but the Health Commission
needs to make clear other cuts will have a devastating impact. The
Health Commission was not given the time it needs to fully deliberate
upon the impact of these cuts. Whether it is the intent or not, the
public health sector is really being dismantled. She wants the Health
Commission to reflect on the cuts, and the testimony, before taking
action. The Health Commission cannot judge the impact of the
administrative cuts. It is the Health Commission’s responsibility to
ensure that quality assurance is maintained. She asked why the
services provided by DEAP are recommended to be provided by a
contractor. Dr. Katz replied that it is his assessment that they could
get as many clients eligible for SSI for less money. It is a different
model. Commissioner Guy is concerned that the Mission mental health
clinics are proposed to be closed to save money on rent. How can the
integrity of these successful services be maintained? She also heard
the same concerns around Sunset Mental Health. Culturally competent
services are not easily replaced.
- Commissioner Illig said his first reaction to the plan was relief
because he knows what could have been on the table. Also, Dr. Katz did
the right thing by focusing on administrative cuts. Structural changes
mean integration, reorganization, and reduction in administrative
services. This can be painful and in a perfect world would be done
with more time to plan. But the fiscal shortfall necessitated that
this be done now. The public testimony clearly conveyed the human
costs of these cuts, for both clients and staff. The staff will have
the extra burden, as well as staff of community-based organizations,
of working with clients to make sure they are not lost during the
restructuring and integration. He is concerned that one third of the
general fund cuts are in mental health. He clarified that Shanti
serves some of the most vulnerable homeless individuals. The Health
Commission and the Department need to work with the Board of
Supervisors to get revenue packages on the ballot to backfill some of
- Commissioner Monfredini supports the budget, but also supports
revisiting the mental health programs in the Mission. She commended
Dr. Katz for taking internal cuts first. Commissioner Monfredini
trusts that Mr. Sass, the DPH CFO, would re-examine billing system to
make sure that the Department is bringing in as much revenue as
- Commissioner Chow said this was a very difficult budget, and staff
and the Mayor’s Office must be commended for reducing the magnitude
of cuts that needed to be proposed. Staff took cuts internally first,
with the effort to maximize preservation of services. That said there
are cuts in services. He has asked that the Primary Care restructure
be brought to the Health Commission for more detailed discussion.
Action Taken: The Health Commission approved an amendment to add the
following language to the resolution:
After the 7th whereas, “Whereas, the Commission has heard extensive
testimony about the reconfiguration of mental health services within the
After the 1st Further Resolved, “Further Resolved, that the
reconfiguration of mental health service in the Mission must be studied
further prior to the Health Commission recommending its submission to the
(Commissioners Chow, Guy, Monfredini, Penn, Sanchez, Umekubo voted for
the amendment; Commissioner Illig voted against the amendment.)
Action Taken: The Health Commission unanimously passed Resolution
#09-04, “Regarding the Fiscal Year 2004-2005 Contingency Budget, and
Urging the Mayor and the Board of Supervisors to Work Together to Minimize
Reductions to Health Services,” as amended (Attachment B).
4) PUBLIC COMMENT
The meeting was adjourned at 8:30 p.m.
Michele M. Olson, Executive Secretary to the Health Commission