Minutes of the Health Commission Meeting Tuesday, November 16, 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 3:12 p.m. Present: Commissioner Edward A. Chow, M.D., President Commissioner Roma P. Guy, M.S.W. Commissioner James M. Illig Commissioner John I. Umekubo, M.D. Absent: Commissioner Lee Ann Monfredini, Vice President Commissioner David J. Sanchez, Jr., Ph.D. 2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF NOVEMBER 9, 2004 Action Taken: The Commission (Chow, Guy, Illig, Umekubo) approved the minutes of the November 16, 2004 Health Commission meeting. 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE Commissioner Guy chaired and Commissioner Illig attended the Budget Committee meeting. (3.1) AIDS OFFICE-HIV Prevention – Request for approval of a retroactive contract modification with Harder+Company Community Research, in the amount of $55,274, for an increased contract total of $175,274, to provide technical support services to the HIV Prevention Planning Council and additional RFP support services, for the period of April 1, 2004 through December 31, 2004. (3.2) CHPP-Health Promotion – Request for approval of a retroactive contract renewal with the International Institute of San Francisco, in the amount of $223,833, to provide preventive health services, including outreach, medical interpretation, health education and referrals to documented refugees and immigrants, for the period of October 1, 2004 through September 30, 2005. Commissioners’ Comments Commissioner Illig commented that the relationship with the International Institute of San Francisco does not seem like an independent contract relationship. If this is the case, the contractor should not be held to the same requirements as other agencies, such as the cultural competency report. Ms. Erwin, DPH program manager, said she and Margi Dunlap, executive director of the agency have had specific discussions with Norm Nickens regarding the requirement for a cultural competency report, and it is required. Commissioner Illig requested that if Ms. Dunlap had specific recommendations for how the contracting relationship could be improved, to submit them in writing. (3.3) BHS-Mental Health/Substance Abuse – Request for approval of a retroactive contract renewal with Larkin Street Youth Services, in the amount of $358,481 per year, for a total contract value of $1,433,924, to provide substance abuse prevention and mental health services targeting homeless and runaway youth, for the period of July 1, 2004 through June 30, 2008. Commissioners’ Comments Commissioner Guy welcomed Ms. Price, the new executive director. She asked if Ms. Price was committed to the actions outlined in the Corrective Action Plan. Ms. Price said she is fully committed. Action Taken: The Health Commission (Chow, Guy, Illig, Umekubo) approved the Budget Committee Consent Calendar. 4) DIRECTOR’S REPORT Mitch Katz, M.D., Director of Health, presented the Director’s Report. DUI Prevention The Department’s Traffic and Pedestrian Safety Program, in Community Health Promotion and Prevention, received a grant from the State Office of Traffic Safety, for the San Francisco Attitudes and DUI Prevention project. The purpose of the grant was to raise awareness of the dangers of driving under the influence (DUI). On November 11th, DPH, with help from a number of community partners, kicked off the “Bar Nights” campaign, to inform bar-goers about the costs of, and alternatives to, drinking and driving before they receive a DUI. During “Bar Nights”, volunteers from the Kappa Kappa Gamma Sorority House at the University of California, Berkeley (all over 21) engaged bar-goers in conversations about DUI, while handing out cocktail napkins and wallet cards with information on DUI costs and transportation alternatives. Posters in the bathrooms warn of the financial and emotional costs of DUI, and the need to make a plan before you leave your house or office for drinks or dinner. The taxi cards were a huge hit. Media coverage of the kickoff was excellent, with stories in the SF Chronicle, Examiner, Oakland Tribune, etc., and on KCBS, KTVU, KSRO, KFOG, and others. An additional series of Bar Nights is planned. Working at Laguna Honda Hospital Yesterday Dr. Katz began working as a ward physician at Laguna Honda Hospital (LHH). As the Commission is aware, he is a member of the LHH medical staff but has not had a chance to work there for a while due to providing medical care at SFGH, Southeast Health Center, and Silver Avenue Health Center. Dr. Katz is glad to be back at LHH. He is proud of the excellent care provided to an extremely diverse group of patients, and he intends to continue to work both clinically and administratively to make LHH a continued success. He described for the Commission on of the complex patients he admitted to LHH earlier in the day. San Francisco General Hospital Credentials Report for November (from 11/08/04 MED and 11/10/04 SFGH JCC 11/04 07/04 to 11/04 New Appointments 19 98   Reinstatements 0 0 Reappointments 26 172   Delinquencies: 0   Reappointment Denials: 0 Resigned/Retired: 14 77 Disciplinary Actions 0 Restriction/Limitation-Privileges 0 0 Deceased 0 0 Changes in Privileges   Additions 4 39   Voluntary Relinquishments 4 20   Proctorship Completed 11 40 Current Statistics - as of 11/1/04 Active Staff 450 Affiliate Professionals (non-physicians) 182 Courtesy Staff 529 TOTAL MEMBERS 1,161 Applications In Process 24 Applications Withdrawn Month of November 2004 0 5 (07/04 to 11/04) SFGH Reappointments in Process Dec. 2004 to Mar. 2005 201 Commissioners’ Comments Commissioner Illig asked if there was an update to the actions the Commission took at its last meeting regarding the budget cuts. Dr. Katz replied that he forwarded the resolution and specific recommendations to the Mayor’s Office. The Mayor’s Office has not made any final decisions. Commissioner Guy is pleased that Dr. Katz is attending at Laguna Honda Hospital this month. It is important that the Commission and public hear that the decisions that are made are working in terms of individual cases. 5) PRESENTATION OF THE EMPLOYEE RECOGNITION AWARDS FOR THE MONTH OF NOVEMBER Commissioner Guy presented the Employee Recognition Awards for November.   Team Awardee Division Nominated By Pediatric Asthma Clinic Children’s Health Center, SFGH Cleo Moore, R.N., Nurse Manager Shannon Thyne, M.D. Nan Madden, PNP Gail Herrick, R.N. Trina Stella, R.N. Yu Ruo Wang, R.N. Arthur Hill, Community Health Worker Sylvia Raymundo, Community Health Worker 6) ADOPTING FINDINGS PURSUANT TO THE CALIFORNIA ENVIRONMENTAL QUALITY ACT FOR THE HUNTERS POINT SHIPYARD REDEVELOPMENT PROJECT Items 6, 7 and 8 were presented together. Michael Cohen from the Mayor’s Office of Economic Development provided background on the Hunters Point Shipyard and an overview of the action pending before the Redevelopment Agency, which is the transfer of Parcel A. He described key dates in the City’s effort to redevelop the shipyard including the closing of the shipyard in 1974, the placement on the shipyard on the list of “Superfund” clean up sites in 1989 (it was de-listed in 1999), the creation of the Hunters Point Shipyard Citizens Advisory Committee in 1991, and the adoption of the Hunters Point Shipyard Redevelopment Plan in 1997. In December 2003, the Redevelopment Agency entered into a development agreement with Lennar/BVHP for the first phase of development of the shipyard. In May 2004, the Redevelopment Agency entered into a legally binding Conveyance Agreement with the United States Navy governing the conveyance of the parcels at the shipyard. Parcel A is now ready to be transferred. Recently, after 14 years of study, all of the relevant federal, state and local environmental agencies agree that it is safe for the Navy to transfer Parcel A to the Redevelopment Agency for residential use. In addition to the formal environmental regulatory processes governing Parcel A, the Redevelopment Agency and the City have independently confirmed that Parcel A is safe for residential reuse. In addition, new city ordinances have been designed to ensure that development activities at the shipyard are closely monitored. The amendment to the Health Code Ordinance that is being considered by the Health Commission is one such ordinance. Finally, Mr. Cohen noted that if unexpected environmental conditions are encountered after Parcel A has been transferred by the Navy, the Navy remains legally responsible for cleaning up such contamination. Rajiv Bhatia, M.D., Director of the Department of Public Health’s Environmental Health Section (EHS) and Amy Brown, also with EHS, provided an overview of the actions before the Health Commission. Dr. Bhatia said that based on all investigations and actions to date, he does not anticipate any health risks as a result of development on the shipyard. The regulatory requirements under proposed Article 31 of the Health Code will add an additional layer of caution and protection during the redevelopment process. Best practices for mitigation, soil transport and monitoring for contaminated areas will be used to prevent any harmful exposure on Parcel A. He also spoke about the broader health concerns of Bayview Hunters Point. The Health Department has been involved in numerous investigations and assessments about health risks in the community. These investigations demonstrated that residents to have greater rates of hospitalization due to chronic disease, shorter life expectancy, higher rates homicide. But the investigations found that there are many factors that contribute to this—inadequate housing, lack of access to nutritious food, violence, etc. The Department’s focus on these broader conditions has led to some improvements in health. Amy Brownell, Department of Public Health, overviewed the specifics of the actions before the Health Commission. The three actions are: CEQA Findings – Adoption of California Environmental Quality Act (CEQA) findings as required under the CEQA statute Health Code Amendments – Adoption of an environmental ordinance to govern redevelopment and ensure that conditions at Parcel A remain protective of human health and environment Interagency Cooperation Agreement – Execution of an Interagency Cooperation Agreement to facilitate cooperation among City departments and the San Francisco Redevelopment Agency with respect to compliance with City laws. Saul Bloom, chair of the Redevelopment Agency’s Citizens Advisory Committee’s Environment Reuse Committee and executive Director of Arc Ecology, said he is confident that the necessary actions have been taken to secure the public’s health. Mitigation is at the core of protecting public health and the environment. There are facilities that generate pollution in Bayview Hunters Point and have a negative impact on the community, and these facilities do not receive the scrutiny they need. The shipyard is not one of these. He shared the one remaining concern of the CAC, which is the enforcement of mitigation measure. Mitigation measures that lack proper enforcement mechanisms do not have the power to protect the community. Enforcement is a necessary component in making activities a success, and this remains to be negotiated. That said, the community has had substantial success in cleaning up the shipyard and he hopes the community will someday see the fruits of this labor. Public testimony was taken for each item. Public Testimony Francisco De Costa said the Commissioners did not hear anything about the shipyard being a Superfund site. The Commission should focus on the problems about the shipyard, not the overall negative conditions of Bayview Hunters Point. Espanola Jackson said the City was never concerned about the clean up of the shipyard. There was not a RAB board in San Francisco until the 1990s. The RAB board is the important entity, not the Citizens Advisory Committee. Dr. Ahimsa Sumchai, founding chair of Radiological Subcommittee of the RAB, encouraged the Commission not to adopt the CEQA resolution because it is not true. A document has been published that shows there is radiation on the site. Linda Richardson acknowledged the efforts of Mayor Willie Brown, Senator Feinstein and Congresswoman Pelosi for their work on the shipyard. The Bayview Hunters Point community has worked closely with the Department of Public Health to bring about environmental awareness. The community is actively engaged in this process, and is watching closely. They are ready for development. Dr. Raymond Tompkins, associate professor of chemistry at San Francisco State University, said the report on the shipyard is grievously flawed. The report never looked at the sewage system. The Navy’s practice was to pour radiological materials down the drain. The City needs stricter regulations on this matter. Jim Salinas spoke on behalf of the members of Carpenters Union Local 22 and urged the Commission to support the resolution. The city and developer has met due diligence. He hopes the developer puts union members in the Bayview Hunters Point community to work. Azalio Merrell, Local 22 union carpenter, said the developer has assured them that this will be a 100 percent union job and provide community employment. She will be able to work on this development and afford to live there. Charlie Walker said let’s get moving at the shipyard and put people to work. If we can put a man on the moon, we should be able to get the shipyard going. Darnell Ingram, Carpenters Union Local 22, asked the Commission to move forward so the community can have affordable housing and jobs. Kevyn Lutton, member of the Restoration Advisory Board, said the RAB has been fighting very hard for adequate cleanup and they have been steamrolled by the Redevelopment Agency. So they are concerned that the Redevelopment Agency will be responsible for monitoring this project. Essie Mormen said her family has had to leave the area because of illness. Doctors have said that there should be a 10-year study of the affects of the Superfund site. The community needs help with men getting prostate cancer, women breast cancer, kids asthma, etc. She does not agree to transfer parcel. Marie Harrison, member of the RAB, expressed concerns about the process. The city has managed to dig more ditches and separate this community. The community members put in a lot of hours and should be afforded the opportunity to be heard. She has vested interested in the shipyard being cleaned to its utmost. Please take two steps back before you make and error. Michael Lyon, Gray Panthers, asked why the Health Commission is considering adding other factors to the already negative conditions in Bayview Hunters Point? Olin Webb, Bayview Hunters Point Community Advocates, said the history has been to not do anything in Hunters Point. He wants black contractors to participate in the clean up actions that are underway. He is supportive of the actions. Let’s learn how to clean this place up, and be part of the action. Willie Ratcliffe, Bay View Newspaper, said the Bayview is not a poor community and has the highest rate of homeownership. But there has not been any investigation about why people are dying in the community and we should not put more factors out there until we know why. This is the Health Commission’s responsibility. Do not get on the train with the developers. Reverend Ted Frazier, Black American Political Association of Northern California, said there are health problems in the community that need to be looked at, but he is supportive of the actions before the Health Commission because lack of jobs and economic development are part of the problem. The situation should be continuously monitored by move forward. Commissioners’ Comments Commissioner Illig asked for a clarification of the difference between the Restoration Advisory Board (RAB) and the Citizens Advisory Committee (CAC). Ms. Brownell replied that the RAB is a Navy-appointed body and advises the Navy on the shipyard. The CAC is an advisory body to the Redevelopment Agency. Commissioner Illig asked if the RAB approved the transfer. Ms. Brownell said the RAB was not involved in the approval for this issue. Commissioner Umekubo asked for clarification about the Navy’s liability in the event of unforeseen events. Ms. Brownell said the developer has an insurance policy that will be tapped into in the event additional clean up is required so that clean up can occur in a timely manner. Then the developer would pursue the Navy for reimbursement. Commissioner Guy asked the radiation experts retained by the Department to comment on their findings. Tom Widner, Certified Health Physicist and Industrial Hygienist with ChemRisk, reviewed all reports provided by the City and the Navy. With regard to the storm drain, there are some contaminated areas on the shipyard. However, based on the information provided to him, Parcel A sewers are safe, even during high storm flow. Commissioner Guy asked what leverage is available on Parcel A and other parcels if, in the future, other contamination is found. Ms. Brownell said that the Navy would pay the cost of dealing with undiscovered contaminants on Parcel A. The Navy still owns the other parcels, and is responsible for the clean up, and it has to be done properly. Commissioner Guy asked for clarification about the CEQA resolution that is before the Health Commission. Elaine Warren, Deputy City Attorney, said the CEQA findings are before the Commission because the actions before the Health Commission are part of the implementation of the Redevelopment Plan, and the CEQA documents where done on the plan and its implementing actions. Before the Commission takes actions in furtherance of the plan, it needs to adopt CEQA findings that ask that the Commission consider the information in the CEQA documents, agree to adopt the mitigation measures, with the Health Ordinance one of the tools to implement theses implementation measures, and acknowledge that even though there are certain impacts that cannot be mitigated fully, the project has benefits that warrant moving ahead with the implementation of the Redevelopment Plan. Action Taken: The Commission (Chow, Guy, Illig, Umekubo) approved Resolution 21-04, “Adopting Findings Pursuant to the California Environmental Quality Act for the Hunters Point Shipyard Redevelopment Project,” (Attachment A). 7) APPROVING AN ORDINANCE ADDING ARTICLE 31 TO THE HEALTH CODE AND AMENDING SECTIONS 659, 1120.1 AND 1227 OF THE HEALTH CODE TO ESTABLISH SPECIAL RESTRICTIONS FOR ACTIVITIES ON THE HUNTERS POINT SHIPYARD AND MAKING ENVIRONMENTAL FINDINGS; AND APPROVING REGULATIONS IMPLEMENTING THE PROPOSED ORDINANCE (See notes from Item 6) Public Comment Clifton Smith, technical advisory to community coalition, said the main community concern is that they be adequately protected. This has not been done, as there is more clean up required. Kevyn Lutton said the EPA takes second seat to business interests and their approval is no protection. Lenar is a business, and the community has been ignored. Dr. Ahimsa Sumchai asked the Health Commission not to adopt Article 31 because it is wrong. Dr. Raymond Tompkins said he is very much for development, but he wants it to be safe and sound. It is the responsibility of the Health Commission to protect all the people. And there needs to be stricter enforcement of dust reduction because of the increase sensibility of people of color to certain heavy metals. The Navy has been a horrible landlord and the Redevelopment Agency does not take any actions. DPH must monitor compliance with the regulations. Jim Salinas said the Health Commission must approve the proposed ordinance in order to implement the required mitigation. Willie Ratcliffe, San Francisco Bay View Newspaper, said there has been no investigation of the Parcel E landfill so there is no way to know it is safe. Action Taken: The Commission (Chow, Guy, Illig, Umekubo) approved the following amendment to the proposed resolution: WHEREAS, on March 31, 2004, the San Francisco Redevelopment Agency and the Navy entered into a legally binding Conveyance Agreement governing the transfer of the shipyard (the "Conveyance Agreement); the Conveyance Agreement gives the City and the San Francisco Redevelopment Agency a number of tools above and beyond what is required under CERCLA to cause the greatest practicable level of cleanup at the shipyard, including requiring that the State and Federal regulators concur that a parcel is safe for its intended use prior to the transfer, including Parcel E, and the Conveyance Agreement incorporates Federal laws that require the Navy to retain responsibility for unexpected environmental contaminants and to indemnify the San Francisco Redevelopment Agency and its transferees for such contaminants; therefore, be it Action Taken: The Commission (Chow, Guy, Illig, Umekubo) approved Resolution 22-04, “Approving an Ordinance Adding Article 31 to the Health Code and Amending Sections 659, 1120.1 and 1227 of the Health Code t ADDING SECTION 106.3.2.5o Establish Special Restrictions for Activities on The Hunters Point Shipyard to Address Potential Residual Contamination and to Authorize the Department Of Public Health to Implement These Restrictions, Impose Penalties, and Charge Fees to Defray the Costs of Implementation and Making Environmental Findings; and Approving Regulations Implementing the Proposed Ordinance,” as amended (Attachment B). 8) AUTHORIZING THE DIRECTOR OF HEALTH TO ENTER INTO AN INTERAGENCY COOPERATION AGREEMENT IN FURTHERANCE OF THE IMPLEMENTATION OF THE HUNTER'S POINT SHIPYARD REDEVELOPMENT PLAN (See notes from Item 6) Public Comment Michele Senders, representing Senator Feinstein, urged the Commission to enter into the Interagency Cooperation Agreement. This project needs to move forward with this project with the developer. Clifton Smith said that CERCLA requires that the Commission makes sure that all regulatory requirements have been met to the fullest extent, which means the remaining environmental hot spots must be removed. Kevyn Lutton said the Navy is cleaning up according to the Redevelopment’s Plan for each parcel’s use. The Health Commission is not giving fair weight to residents who have been working on this issue. Dr. Ahimsa Sumchai asked the Commission to not enter into the Interagency Cooperation Agreement, as the Commission does not need to take any action at this time. Dr. Raymond Tompkins said if the Health Commission passes this resolution, it should make sure that there is a designated staff person to diligently monitor compliance with the regulations and requirements. Willie Ratcliffe, San Francisco Bay View Newspaper, is disappointed that the Commission has jumped on this train. It is environmental and economic racism. Commissioners’ Comments Commissioner Guy said this issue is polarized, and asked if DPH has contractual legitimacy for the actions they are approving so that the Department can focus on and be part of problem solving. Dr. Bhatia said Parcel A is clean and safe for people to develop and live on. The Department will maintain an ongoing level of scrutiny on all cleanup activities. Dr. Bhatia said the Department takes all concerns seriously, and other agencies respect DPH’s opinions. Dr. Katz added that it is not surprising that there is distrust about science, because prior statements have been untrue and promises have been broken. He hopes that this distrust will be reversed when people see a thriving community instead of disuse. The added housing units and increased economic development will also positively impact health. Commissioner Chow said the added layer of regulations provided by the Health Code will provide more protection for the community. Action Taken: The Commission (Chow, Guy, Illig, Umekubo) approved Resolution 23-04, “Authorizing the Director of Health to Enter Into an Interagency Cooperation Agreement in Furtherance of the Implementation of the Hunter's Point Shipyard Redevelopment Plan,” (Attachment C). 9) DEPARTMENT OF PUBLIC HEALTH ANNUAL REPORT This presentation was continued to a future Health Commission meeting. 10) CONSIDERATION OF A RESOLUTION URGING THE ACCEPTANCE OF FOOD ASSISTANCE AT THE ALEMANY FARMERS MARKET This presentation was continued to a future Health Commission meeting. 11) PUBLIC COMMENT/OTHER BUSINESS Doerte Murry asked why the neighbors were not notified, pursuant to the Citizen’s Right to Know Act, when Haight Ashbury Free Clinic started a new needle exchange program. She also asked if the Department has a plan for getting money back that was taken by the CFO of HAFC. 12) ADJOURNMENT The meeting was adjourned at 5:48 p.m. Michele M. Olson, Executive Secretary to the Health Commission Health Commission meeting minutes are approved by the Commission at the next regularly scheduled Health Commission meeting. Any written summaries of 150 words or less that are provided by persons who spoke at public comment are attached. The written summaries are prepared by members of the public, the opinions and representations are those of the author, and the City does not represent or warrant the correctness of any factual representations and is not responsible for the content.