Minutes of the Health Commission Meeting

Tuesday, September 7, 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 3:10 p.m.
Present:

  • 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 L. Penn, Jr., M.D., Ph.D.
  • Commissioner David J. Sanchez, Jr., Ph.D.

Absent:

  • Commissioner John I. Umekubo, M.D.

2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF AUGUST 3, 2004

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved the minutes of the August 3, 2004 Health Commission meeting.

3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired, and Commissioner Penn and Commissioner Guy attended, the Budget Committee meeting.

(3.1) PHP-Occupational & Environmental Health – Request for approval to accept and expend a grant in the amount of $226,133, from the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, to support the second year of a four year project to improve working conditions for day laborers in the Mission District of San Francisco for the period of September 30, 2004 to September 30, 2005.

(3.2) PHP-AIDS Office – Request for approval of a retroactive sole source contract renewal with Dolores Street Community Services, in the amount of $65,850, to provide HIV peer advocacy and health education services targeting monolingual Latino immigrant men, for the period of September 30, 2003 through September 2004.

Commissioners’ Comments:

  • Commissioner Guy asked that the Population Health and Prevention Joint Conference Committee receive a status report on the agency’s compliance with cultural competency standards. Michelle Long Dixon will prepare a written update for the September JCC meeting.

(3.3) PHP-Violence Prevention – Request for approval of a retroactive renewal contract with the San Francisco Study Center, Inc., in the amount of $106,086, to provide program support services to the DPH Violence Prevention Program, for the period of July 1, 2004 through June 30, 2005.

(3.4) BHS-CYF Section – Request for approval of thirteen retroactive renewal contracts for the Family Mosaic Project totaling $1,015,961, to provide various wrap-around services targeting seriously emotionally disturbed children, for the period of July 1, 2004 through June 30, 2005, with the following agencies: Alternative Family Services, Brainstorm Tutoring, Edgewood Center for Children & Families, Families First, Heritage Residential Treatment Center, High Gear Achievers, Island View Residential Inc., National Deaf Academy, New College of California, Occupational Therapy Training Program/Special Services for Groups, RISE Institute, Seneca Center and Victor Treatment Centers.

Commissioners’ Comments

  • Commissioner Guy asked how outcomes are measured for this program. Dr. Rochelle Frank, Family Mosaic Clinical Director, replied that two research studies have been done, and another is currently underway, to evaluate outcomes. Ms. Peralta will provide a written summary of the evaluation findings to the Health Commission.

(3.5) BHS-Mental Health – Request for approval of a retroactive contract renewal with Instituto Familiar de la Raza, Inc., in the amount of $1,304,899, for fiscal intermediary services for individual service providers of youth, children’s and family mental health services, for the period of July 1, 2004 through December 31, 2004.

(3.6) BHS-Mental Health/Substance Abuse – Request for approval of a retroactive contract renewal with New Leaf: Services for Our Community, in the amount of $1,485,434 per year, for a total contract value of $5,941,736, to provide outpatient substance abuse and mental health services targeting lesbian, gay, bisexual and transgender communities, for the period of July 1, 2004 through June 30, 2008.

  • Secretary’s Notes – the term of this contract was changed from July 1, 2004 through June 30, 2008 to July 1, 2004 through June 30, 2006.

(3.7) BHS-Mental Health – Request for approval of a retroactive contract renewal with Family Service Agency, in the amount of $5,690,602, to provide mental health services, for the period of July 1, 2004 through June 30, 2005.

(3.8) BHS-Substance Abuse – Request for approval of a retroactive contract modification decrease with Mt. St. Joseph-St. Elizabeth, in the amount of $202,212 per year reducing the total contract value to $3,691,892, to provide substance abuse services, for the period of July 1, 2003 through June 30, 2007.

(3.9) BHS – Request for approval of a retroactive contract renewal with Positive Resource Center, in the amount of $392,200, to provide advocacy and training services for disabled, uninsured clients, for the period of July 1, 2004 through June 30, 2005.

(3.10) CHS – Request for approval of a retroactive renewal contract with AmeriChoice, in the amount of $368,800, to provide fiscal intermediary services to the Personal Assisted Employment Services for dental services, for the period of July 1, 2004 through June 30, 2005.

(3.11) DPH- Annual Report of Gifts Received in FY 03-04.

Commissioners’ Comments (at the Health Commission meeting)

  • Commissioner Illig asked how contracts could be approved retroactively when they were not part of a Health Commission continuing resolution. Mr. Leung replied that with some funding sources, including many federal funding agencies, the Department has no indication of whether there will be continued funding. In these cases, the Department needs to wait for word of the award before beginning the contracting process. Commissioner Illig said all contractors should be held to the same standards and City requirements, be they based in San Francisco or in Florida.

Action Taken: The Health Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved the Budget Committee Consent Calendar with the modification to a two-year contract term for Item 3.6. Item 3.2 was referred to the Population Health and Prevention Joint Conference Committee.

4) DIRECTOR’S REPORT
Anne Kronenberg, Acting Director of Health, presented the Director’s Report.

West Nile Virus

On Friday, September 3rd, the State Department of Health Services announced the detection of antibodies for West Nile virus (WNV) in a Western Scrub Jay found in the Presidio. This is the first infected bird found in San Francisco. This serves as a reminder that the public should take precautions to protect themselves from mosquito bites and to prevent mosquito breeding by: (1) applying mosquito repellent; (2) wearing long sleeves and pants at dawn and dusk; (3) closing windows at night or installing tight fitting screens; and (4) eliminating any sources of standing water.

No locally acquired human cases of West Nile virus infection have been reported in San Francisco. Most people who become infected with WNV will not experience symptoms or become ill. About one out every 150 people infected with WNV may develop a more severe form of the illness. Older adults and individuals with lowered immune systems are at increased risk of serious complications from WNV infection. Anyone who develops symptoms including fever, confusion, muscle weakness, severe headaches or stiff neck should seek medical care immediately.

The City’s WNV preparation strategies involve public education, personal protection, provider preparation, disease surveillance, control of mosquito breeding, and the use of larvacides. The Environmental Health Section (EHS) has worked closely together and with the San Francisco Public Utilities Commission, the Department of the Environment, the Recreation and Parks Department, the Department of Public Works, and the Port to develop a West Nile Virus and Mosquito Control Plan that coordinates the City’s response and addresses mosquito breeding on public property.

As part of ongoing surveillance activities, the public should report wild birds that have died recently, especially crows, ravens and birds of prey to1/877-WNV-BIRD. Questions about WNV and reports of problem mosquito breeding areas should be made to 415-252-3805 or 415‑252-3806. Public information on WNV and mosquito control is available at https://www.sfdph.org/ehs and http://www.sfmosquito.org.

Eye Van

The Department of Ophthalmology at San Francisco General Hospital will begin providing mobile eye screening services to residents of San Francisco. Donated to the department by The Friends of the Congressional Glaucoma Caucus Foundation, the 28-foot eye clinic on wheels is equipped with the latest technology and will make weekly visits to CHN health centers to provide comprehensive ophthalmic screening, particularly for patients at risk for glaucoma and diabetic eye disease. In addition to screening services, the "eye van" will be used for department research activities, the first of which is The Asian Eye Study designed to identify eye diseases for which Asian Americans are at increased risk.

3 For Life Pilot Project

Beginning this month, DPH’s Communicable Disease Prevention Unit will begin a yearlong “3 for Life” pilot project in partnership with the Asian Liver Center of Stanford University. DPH will offer low-cost testing for hepatitis B and vaccination for hepatitis A and B at the Richmond District YMCA, the first and third Saturdays of every month for a year. The clinic hours are from 11am to 2pm.

Hepatitis B is currently one of the top five causes of premature mortality in the Asian community in San Francisco – yet it is completely preventable through vaccination. This 3 for Life project is very likely the only project of its kind in the country so we are excited about this new venture to increase awareness about the silent killer of hepatitis B. A press conference will be held at the Richmond District YMCA (360 18th Avenue) at 11am on September 16th andthe first clinic begins September 18th.

Disaster Registry Program Exercise

The San Francisco Department of Public Health, the San Francisco Fire Department (SFFD) and the SFFD Neighborhood Emergency Response Teams and the Volunteer Center of San Francisco will be conducting the FIRST functional exercise of the Disaster Registry Program (DRP) for Seniors and Persons with Disabilities on Saturday, September 18, 2004, 9:am – 4:00 pm

The event will include:

  • Accessing the DRP database
  • Coordinating the assessment teams
  • Checking o DRP enrollees

DPH’s Emergency Medical Services and Emergency Operations Section is coordinating this exercise and volunteers are needed to staff phone banks and visit registrants to distribute disaster preparedness information. We are anticipating providing support (training, transportation and refreshments) for those who can help us evaluate this important component to the City’s disaster response. For more information or to volunteer, please contact Ann Stangby at 355 2605 or at ann.stangby@sfdph.org.

LHH Clinical Leadership Appointments

I am pleased to announce recent clinical leadership appointments at Laguna Honda Hospital. Dr. Paul Isakson has been appointed as Medical Director, and will work with Dr. Timothy Skovrinski who will continue to serve as Assistant Medical Director. In addition, Mivic Hirose and Gayling Gee have been appointed as Co-Directors of Nursing at Laguna Honda. I am confident that the new clinical leadership of Laguna Honda will assure the ongoing provision of quality care for the current residents.

LHH Credentials Year-to-Date Report
7/1/04 – 8/26/04
 
New Appointments

0
      Reinstatements

0
      Withdrawal

0
Reappointments

7
Delinquencies:

0
Reappointment Denials:

0
Resigned/Retired

1
Disciplinary Action

0
Restriction/Limitation of Privileges

0
Changes in Privileges

 0
      Additions

0
      Voluntary Relinquishments

0

Commissioners’ Comments

  • Commissioner Chow noted that the Department’s Communicable Disease Section’s use of provider faxes to communicate information about the West Nile virus was very effective. He urged them to continue to utilize this effective tool.
  • Commissioner Guy asked how the eye van’s time would be allocated to the various clinics. Ms. O’Connell said that the van would visit the various health centers, with visits scheduled via the clinics’ scheduling systems. Commissioner Guy asked if what the Hepatitis B prevalence is in San Francisco. Colleen Chawla will get this information for the Commission.

5) CONSIDERATION OF A RESOLUTION URGING SUPPORT OF PROPOSITION 72, REGARDING HEALTHCARE COVERAGE REQUIREMENTS

Frances Culp, Health Planner, DPH Policy and Planning, presented an overview of Proposition 72. This resolution is a referendum on Senate Bill 2, which created the Health Insurance Act of 2003 to provide health coverage to specified individuals—and in some cases their dependents—who do not receive job-based coverage and who work for large and medium employers. Proposition 72 will appear on the November 2004 ballot and, if passed, would enable SB 2 to remain in effect. If Proposition 72 fails, SB 2 would be repealed.

Reasons to support Proposition 72 and Health Care Expansion

  • It is consistent with city policy of reducing the number of uninsured and increasing health insurance coverage for its residents. An analysis done by the University of California, Los Angeles found that 1.1 million Californians would gain insurance if Proposition 72 passed. At this rate, Proposition 72 would reduce the local uninsured population by approximately 21,600;
  • Health Insurance improves health outcomes;
  • Health Insurance reduces the strain on the health care safety net.

Commissioners’ Comment

  • Commissioner Illig reiterated that support of Proposition 72 means that the SB 2, health insurance expansion, can proceed. If the proposition fails, SB 2 would be repealed.

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved Resolution #11-04, “Supporting Proposition 72, the Health Insurance Act of 2003,” (Attachment A).

6) CONSIDERATION OF A RESOLUTION URGING SUPPORT OF PROPOSITION 63, THE MENTAL HEALTH SERVICES ACT

Colleen Chawla, Assistant Director of Policy and Planning, summarized Proposition 63, the Mental Health Services Act. This proposition would establish a new one percent surcharge on taxable personal income over $1 million. The surcharge is estimated to generate $275 million is FY 2004-05, $750 million in FY 2005-06, $800 million in FY 2006-07 and increasing amounts annually thereafter.

The initiative does not include a methodology for allocating funding for couties. However, it does specify how the money can be used. For the first year, 45 percent is for education and training for the mental health workforce, 45 percent for capital facilities and technology needs, five percent for local planning and five percent for State implementation. The following year, 75 percent of the funding is used for programs, 10 percent for education and training, 10 percent for capital facilities and technological needs and five percent for innovative programs.

Reasons to support Proposition 63:

  • Consistent with City policy to support appropriate and effective systems of care and treatment for San Francisco’s mentally ill residents;
  • There is a significant need for mental health services in San Francisco;
  • Proposition 63 is based upon a service model that works. The models—AB 34/AB2034 and the Children’s System of Care programs—are client-centered, family-focused and effective in promoting recovery;
  • Addresses the historic unmet need for community-based services;
  • Prioritizes prevention and early intervention;
  • Addresses the shortage of health care professionals.

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved Resolution # 12-04, “Supporting Proposition 63, the Mental Health Services Act,” (Attachment B)

7) CONSIDERATION OF A RESOLUTION REGARDING MEDI-CAL REDESIGN

Colleen Chawla, Assistant Director of Policy and Planning, presented a summary of Governor Schwarzenegger’s Medi-Cal redesign proposal. The Schwarzenegger Administration has established several principles and objectives for the redesign including: simplify Medi-Cal eligibility, implement a tiered benefit structure; incorporate beneficiary cost-sharing; expand organized delivery systems; and identify new sources of federal funding participation.
In April, DPH brought together City departments interested in Medi-Cal for discussion about redesign. Participants included DPH, the Department of Human Services, the Department of Aging and Adult Services and the San Francisco Health Plan. San Francisco issued a comment letter (on file in the Health Commission Office) that made a number of recommendations.

Originally the Governor intended to release a Medi-Cal redesign proposal as part of his May Revise. However, the May Revise postponed the release of the proposal until August 2, 2004. In August the Administration announced a further postponement until next year’s budget proposal.

Issues for Consideration

  • Impact of a Section 1115 Waiver, considering all Section 1115 waivers have resulted in a cap on federal funding for state Medicaid programs that is based on historic federal payments to California.
  • Safety Net Financing Issues. Preliminary analysis of the State’s current proposal to restructure intergovernmental transfers indicates that is would create an annual shortfall of at least $530 million in safety net hospital financing. Shifting Medi-Cal aged, blind and disabled beneficiaries from the current fee-for-service system into managed care would further destabilize public hospitals.
  • Cost-Sharing. In addition to having a significant impact on beneficiaries, the Administration’s cost-sharing proposal would also increase the burden on the local safety net health care system.

The Department will continue to monitor and participate in this process.

Public Comment

  • Michael Lyon submitted information about the impact that a Medi-Cal waiver would have on health care (on file in the Health Commission Office). He urged the Commission to include in its resolution having the State Legislature be forced to be part of this process, and not let the governor work directly with Washington.

Commissioners’ Comments

  • Commissioner Chow asked if the Department would have additional opportunity for input between now and the release of the Governor’s proposal in January. Ms. Chawla replied that the California Performance Review Process would be establishing a Health and Human Services Committee that will look at issues raised in its recently released report. She anticipates that many of the Medi-Cal redesign issues will come up during this process.
  • Commissioner Guy asked if San Francisco’s State legislators are aware of this proposal and involved in the discussions. Ms. Chawla said they are all aware, and she does not believe the legislature would allow significant Medi-Cal redesign to go forward without their involvement and consent.
  • Commissioner Guy said the Health Commission would stay apprised of this issue as it moves forward through its Joint Conference Committees.

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved Resolution #13-04, “Supporting Principals for Medi-Cal Redesign,” (Attachment C).

8) CONSIDERATION OF A RESOLUTION URGING SUPPORT OF PROPOSITION 67, THE EMERGENCY MEDICAL CARE INITIATIVE

Colleen Chawla, Assistant Director of Policy and Planning, summarized Proposition 67, the Emergency Medical Care Initiative. If passed, this initiative would provide funding for uncompensated emergency and trauma care and other related services. Funding for these activities would come from a new three percent surcharge on telephone calls made within California. Proposition 67 will appear on the November 2004 ballot and requires a simple majority vote to pass. Funds would be used as follows:

  • 60% to reimburse hospitals for the cost of uncompensated emergency and trauma care;
  • 30.5% to reimburse claims filed by physicians who are not employed by hospitals and who provide uncompensated emergency services to patients;
  • 5% to nonprofit clinics that provide urgent care services to uninsured patients;
  • 3.75% to the California Firefighter Joint Apprenticeship Training Program for training and related equipment for firefighters, paramedics and other first responders.

Reasons to support Proposition 67 include:

  • California’s emergency system is in crisis due to underfunding. In the last decade more than 60 hospital emergency rooms and trauma centers have closed and more hospital emergency rooms and trauma centers report that they are on the brink of financial collapse. Proposition 67 sponsors estimate that approximately $540 million is spent by hospitals and physicians on uncompensated emergency and trauma care each year.
  • Proposition 67 would provide needed financial support for emergency medical care in California and San Francisco. It is estimated that Proposition 67 will provide between $500 million and $550 million for the emergency medical care system in California each year.
  • The uninsured rely on emergency rooms as their primary source of medical care. Proposition would not only provide funding for hospital emergency rooms to help cover the cost of this care, it would also provide funding for urgent care clinics that help avoid unnecessary hospitalizations.

Public Comment

  • Gladys Sandlin, San Francisco Community Clinic Consortium, spoke in support of Proposition 67.
  • Paul Kivela, Coalition to Preserve Emergency Care, spoke in support of Proposition 67. The situation in emergency medical system is severe and the time to act is now.
  • Mary Lou Licwinko, Executive Director of the San Francisco Medical Society, said that the Medical Society voted overwhelmingly to support Proposition 67.
  • Douglas Evans, San Francisco Medical Society, spoke in support of Proposition 67.

Commissioners’ Comments

  • Commissioner Monfredini asked why the coalition selected a telephone surcharge as the funding mechanism. Mr. Kivela replied that there is a nexus between telephone usage and the 911 system. Commissioner Monfredini commented that some of the hospitals that would receive these funds do not do the best job providing charity care. Mr. Kivela said that there is a fund that goes to the hospitals specifically for uncompensated emergency care, and a fund for individual physicians. Commissioner Monfredini said that it is unlikely this Proposition would prevent closures of emergency rooms by hospital administrators.
  • Commissioner Chow asked how funding for various community clinics would help with emergency department overcrowding, given that the clinics are often not open after hours and on weekend. Mr. Hodgson said that that the funding would help the clinics keep their doors open.
    Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved Resolution #14-04, “Supporting Proposition 67, the Emergency Medical Services Act,” (Attachment D).

9) CONSIDERATION OF A RESOLUTION AUTHORIZING ACCEPTACE OF A MOBILE MAMMOGRAPHY FACILITY VEHICLE AND ASSOCIATED EQUIPMENT FROM UCSF

Gregg Sass, DPH Chief Financial Officer, presented the resolution authorizing acceptance of a Mammovan from UCSF. Since June 2001, UCSF has operated a mammovan that provides mobile mammography services to indigent and under-served women in San Francisco. In early 2004, UCSF expressed interest in donating the van, along with the associate equipment, to SFGH. SFGH will incorporate the van into the operations of the new Avon Foundation Comprehensive Breast Center at SFGH as its mobile community outreach component, targeting hard to reach segments of the San Francisco population. DPH has secured a $500,000 grant from the Avon Foundation to support the operating costs of the mammovan.

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) approved Resolution #15-04, “Resolution Authorizing the Department of Public Health, San Francisco General Hospital, to Accept a Gift of a Mobile Mammography Facility Vehicle and Associated Equipment, Valued at $432,716, Donated by the University of California, San Francisco, for Mobile Mammography Services to Indigent and Underserved Women in San Francisco,” (Attachment E).

10) ENVIRONMENTAL HEALTH UPDATE

Rajiv Bhatia, M.D., MPH, Director of Environmental and Occupational Safety and Health, presented an overview of the Environmental Health Section. The Section has a multifaceted approach—ensuring its mandates, moving away from crisis management, building from current issues, taking an interdisciplinary view, working through collaboration, translating health evidence, bridging issues and interests and ensuring program sustainability.
Dr. Bhatia and is staff provided detailed overviews of the following 2004 updates:

  • Symbol of Excellence
  • West Nile/Vector Control
  • Rodent Abatement
  • Food Safety, Sanitation and Compliance Education
  • Massage Program
  • Tobacco Prevention
  • Noise Control and Prevention
  • Asthma Management and Prevention
  • Green Business
  • Jornaleros Unidos
  • Food Systems
  • Land Use Health Impact Assessment
  • EHS GIS

Public Comment

  • Dr. Ahimsa Porter Sumchai, Hunters Point Shipyard Restoration Advisory Board, said RAB passed a motion that DPH formally respond to the 2002 Grand Jury Report on the shipyard. The Grand Jury recommends that DPH review what testing and monitoring has been completed or is underway.

Commissioners’ Comments

  • Commissioner Chow said that the Environmental Health Section provides a breadth of important services to San Francisco. He would like the Population Health and Prevention Joint Conference Committee to discuss individual programs in detail. He asked if the Department responded to the Grand Jury Report on the Hunters’ Point Shipyard. Dr. Bhatia said that DPH did respond, and he will provide this information to the Joint Conference Committee. DPH also has a full-time person reviewing the plans and analyses for the Shipyard. There are ordinances proposed that would require additional monitoring on parcels.
  • Commissioner Illig asked how many people work in EHS and where the funding comes from. Dr. Bhatia replied that they have approximately 120 staff.
  • Commissioner Illig is very impressed by the magnitude of the work that is done, and looks forward to more detailed discussion at the PHP JCC.
  • Commissioner Guy would like more detailed discussions about lead in schools, businesses and residences. She asked that the Symbol of Excellence Recipient be presented to the Commission.
  • Commissioner Penn would like specific outcome objectives for each of the efforts. There is a small amount of people doing an incredible amount of work, and it would be helpful for the commissioners to understand the EHS priorities.
  • Commissioner Sanchez appreciates the comprehensive update.
  • Commissioner Chow offered several suggestions for PHP JCC topics: food safety, retail tobacco, green business initiative, rodent abatement, massage ordinance, food systems and the Hunters’ Point Shipyard.

11) OVERVIEW OF JCAHO’S NEW SURVEY PROCESS

Gene Marie O’Connell, Executive Administrator, SFGHMC, gave an overview of the JCAHO survey process. Without JCAHO accreditation, the hospital cannot receive Medicare revenues. JCAHO could come in anytime after January 2005, with two weeks notice. The hospital has been preparing for JCAHO since the last survey was finished. Staff works very hard to maintain JCAHO standard.

Lawrence Marsco, RN, SFGH’s JCAHO/Regulatory Affairs Manager/Patient Safety Officer, described the major change to the new survey process, which is Tracer Methodology. This is a dynamic process in which the surveyors trace a patient through the system, rather than meeting with upper management to discuss various issues. The hospital will provide a lot of information about its patient population, types of services provided, etc. JCAHO will identify systems that cross systems of care.

Ms. O’Connell concluded by saying that hospital staff is diligently preparing for the survey. A Mock Survey will be held in the beginning of November. There is a JCAHO Readiness Committee, Mock Tracers, JCAHO PEP Committee, a FAQ Committee, Medication Management month and a manager’s checklist. She gave the Commission copies of a videotape that provides additional details about Tracer Methodology.

Commissioners’ Comments

  • Commissioner Monfredini asked how the JCAHO surveyors would be tracked while they are in the hospital, and if patients must agree to be tracked. Mr. Marsco said that patients have the right to refuse.
  • Commissioner Chow asked Ms. O’Connell to clarify the role of the Health Commission. She replied that the Health Commission, as the governing body, is ultimately responsible for the hospital meeting JCAHO standards. The Commission has delegated this responsibility to her, but must hold her accountable. The San Francisco General Hospital Joint Conference Committee continues to stay apprised of JCAHO preparations.
  • Commissioner Penn asked if the new methodology would be beneficial to the hospital or be a major change. Ms. O’Connell said that the surveyors will get a better sense of the population that is served by SFGH, and this will be helpful. But there are challenges.
  • Commissioner Guy does not understand the rationale around moving from a number score to a pass/fail. Ms. O’Connell said there was a lot of criticism that hospitals were using scores inappropriately, and that the core issue was whether or not a hospital was meeting JCAHO standards.
  • Commissioner Chow asked Ms. O’Connell to determine if the new methodology requires any additional role by the governing body. The Health Commission and the San Francisco General Hospital Joint Conference Committee are very involved in the hospital, and accreditation is extremely important.

12) PUBLIC COMMENT

  • Alma Jean Caldwell – she is a client of SFGH Urgent Care. In December 2001, she visited the clinic and received very abusive treatment by a treating doctor. She will submit a letter more fully describing her situation. She is a victim of domestic violence and the last thing she needed was to be mistreated by a physician.
  • Ronald Smith, Hospital Council of Northern California, said that next month the Hospital Council is hosting a meeting with hospitals that have gone through Tracer Methodology. He also presented a mock-up of a $1.9 million check that was given to SFGH that resulted from lawsuits filed on the City’s behalf by the California Healthcare Association.
  • Patrick Monette-Shaw (presented at the meeting, submitted via e-mail) - Before this Commission convenes in closed session with a City Attorney discussing agenda item 15 — the lawsuit against the City regarding Dr. Katz’s unilateral change of LHH’s admissions policy — I remind you: The lawsuit’s paragraph 104 alleges this Commission, by your silence and inaction, appears to approve of Katz’s retaliatory policy to use LHH funds appropriated by City Supervisors in the City budget earmarked for LHH’s long-term skilled nursing care of the City’s frail elderly, in order to pay for “patching” SFGH psychiatric patients out-of-county, which should be paid from SFGH’s separate budget line-item. Two months have elapsed since the June 24 City Services Committee hearing on Katz’s policy change; you’ve done nothing, except remain silent, as have Mayor Newsom and the Board of Supervisors. It’s time to end your silence: Schedule a hearing on Katz’s policy change, as Health Commissioner Illig requested on 8/26. End your inaction; act now!

13) CLOSED SESSION:

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn) voted to continue this closed session to the September 21, 2004 Health Commission meeting.

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)

C) Closed session pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d)
APPROVAL OF A SETTLEMENT IN THE AMOUNT OF $29,000 IN ESCAMILLO V. CCSF, CLAIM No. 03-04261

D) Reconvene in Open Session

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).)
Vote to elect whether to disclose any or all discussions held in closed session (San Francisco Administrative Code Section 67.12(a).)

14) CLOSED SESSION

A) Public Comments on All Matters Pertaining to the Closed Session

None.

B) Vote on Whether to Hold a Closed Session (San Francisco Administrative Code Section 67.11

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) voted to hold a closed session.

The Commission went into closed session at 7:06 p.m. Present in closed session were Commissioner Chow, Commissioner Guy, Commissioner Illig, Commissioner Monfredini, Commissioner Penn, Commissioner Sanchez (left at 7:22 p.m.), Anne Kronenberg, Acting Director of Health, Aleeta Van Runkle, Deputy City Attorney, Larry Funk, Laguna Honda Hospital Executive Administrator and Michele Olson, Health Commission Executive Secretary.

C) Closed Session Pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d)

CONFERENCE WITH LEGAL COUNSEL REGARDING LITIGATION MATTERS – DEPARTMENT OF JUSTICE

D) Reconvene in Open Session

The Commission reconvened in open session at 7:26 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 (Chow, Guy, Illig, Monfredini, Penn) voted not to disclose discussions held in closed session.

15) CLOSED SESSION

A) Public Comments on All Matters Pertaining to the Closed Session

None.

B) Vote on Whether to Hold a Closed Session (San Francisco Administrative Code Section 67.11

Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Penn, Sanchez) voted to hold a closed session.

The Commission went into closed session at 6:45 p.m. Present in closed session were Commissioner Chow, Commissioner Guy, Commissioner Illig, Commissioner Monfredini, Commissioner Penn, Commissioner Sanchez, Anne Kronenberg, Acting Director of Health, Aleeta Van Runkle, Deputy City Attorney, Tom Lakrtiz, Deputy City Attorney, Larry Funk, Laguna Honda Hospital Executive Administrator and Michele Olson, Health Commission Executive Secretary.

C) Closed Session Pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d)

CONFERENCE WITH LEGAL COUNSEL REGARDING LITIGATION MATTERS – MICHAEL LYON V. MITCH KATZ, DEPARTMENT OF PUBLIC HEALTH, ET AL, CPF-04-504376

D) Reconvene in Open Session

The Commission reconvened in open session at 7:05 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 (Chow, Guy, Illig, Monfredini, Penn, Sanchez) voted not to disclose discussions held in closed session.

16) ADJOURNMENT

The meeting was adjourned at 7:28 p.m.

Michele M. Olson, Executive Secretary to the Health Commission