Minutes of the Health Commission Meeting
Tuesday, August 15, 2006
101 GROVE STREET, ROOM 300
San Francisco, CA 94102
1) CALL TO ORDER
Commissioner Monfredini called the meeting to order at 3:15 p.m.
- Lee Ann Monfredini, President (left at 5:30 p.m.)
- James M. Illig, Vice President
- Edward A. Chow, M.D.
- Roma P. Guy, M.S.W.
- David J. Sanchez, Jr., Ph.D., (left at 5:30 p.m.)
- Donald E. Tarver, II, M.D.
- John I. Umekubo, M.D.
President Monfredini announced that the September 5th Health Commission
meeting has been rescheduled to September 12th, 3:00 p.m.
2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF JULY 18,
Action Taken: The Health Commission approved the minutes from the July
18, 2006 Health Commission meeting.
3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE
Commissioner Sanchez chaired, and Commissioner Chow and Commissioner
Tarver attended, the Budget Committee meeting. The Budget Committee
requested that the following items be moved from the Approval calendar
to the Discussion and Approval calendar: 3.5, 3.6, 3.8, 3.12, and 3.14.
Items for Approval
(3.1) AIDS Office-HIV Health Services – Request for approval of a
retroactive contract renewal with AIDS Legal Referral Panel, in the
amount of $213,724, which includes a 12% contingency, to provide legal
services for individuals diagnosed with HIV or AIDS, for the period of
July 1, 2006 through December 31, 2007.
(3.2) PHP-EHS & OPP – Request for approval of a contract modification to
increase the contract with Industrial Emergency Council, by $42,000, for
a new amount of $101,900 which includes a 12% contingency, to provide
Chemical, Biological, Radiological and Nuclear first responder training
for health care workers in San Francisco, for the period of June 19,
2006 through November 31, 2006.
(3.3) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Lutheran Social Services, in the amount of
$186,855, which includes a 12% contingency, to provide supportive
services and case management to residents of the Hazel Betsey site, for
the period of March 1, 2006 through December 31, 2007.
(3.4) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Baker Places, Inc., in the amount of $999,382
which includes a 12% contingency, to provide supportive and case
management services, for the DAH tenants at the Star and Camelot Hotels,
for the period of March 1, 2006 through December 31, 2007.
Secretary’s Note – Commissioner Tarver abstained from voting on this
(3.7) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Catholic Charities CYO, in the amount of $876,157,
which includes a 12% contingency, to provide partial rent subsidy and
housing advocacy services through the Assisted Housing Program, for the
period of March 1, 2006 through August 31, 2007.
(3.9) PHP-Housing & Urban Health – Request for approval of a retroactive
renewal contract with Larkin Street Youth Services, in the amount of
$972,945, which includes a 12% contingency, to provide comprehensive
housing and attendant care services for young adults 18 to 25 years of
age, for the period of March 1, 2006 through August 31, 2007.
(3.10) PHP-Housing & Urban Health – Request for approval of a
retroactive renewal contract with Ark of Refuge, Inc., in the amount of
$506,964, which includes a 12% contingency, to provide residential
substance abuse treatment at Restoration House for HIV-positive women
and transgender women of color, for the period of March 1, 2006 through
December 31, 2007.
(3.11) AIDS Office-HIV Prevention – Request for approval of a
retroactive renewal contract with UCSF Positive Health Program, in the
amount of $166,936, which includes a 12% contingency, to provide HIV
prevention services, for the period of July 1, 2006 through December 31,
(3.13) PHP – Environmental Health Section - Request for approval to
accept and expend a grant from the California Department of
Transportation, in the amount $98,000, in support of a two-year project
for a community-based transportation plan to foster neighborhood and
project design that enables more walking and biking for a healthier
Treasure Island, for the period of January 1, 2007 to January 1, 2009.
(3.15) BHS – Request for approval of a contract renewal with Brainstorm
Tutoring, in the amount of $134,000, which includes a 12% contingency,
for an annual amount of $80,000, to provide tutoring and education
counseling services through the Family Mosaic Project, for the period of
July 1, 2006 through December 31, 2007.
(3.16) BHS – Request for approval of a contract renewal with RISE
Institute, in the amount of $287,280, which includes a 12% contingency,
for an annual amount of $171,000, to provide an after school program
through the Family Mosaic Project, for the period of July 1, 2006
December 31, 2007.
Items for Discussion and Approval
(3.5) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Black Coalition on AIDS, in the amount of
$622,369, which includes a 12% contingency, to provide support services,
case management and groups at the Brandy Moore House, a transitional
housing program, for the period of March 1, 2006 through December 31,
- Commissioner Chow is concerned by comments in the monitoring report
that it will take some time for the agency to turn things around
financially. Black Coalition on AIDS is an important agency, and he
wants to make sure the agency is taking steps to resolve fiscal issues.
Yvonne Watson, Black Coalition on AIDS CFO, said there is a new
administration, cost-cutting measures have been instituted and there is
an aggressive fundraising policy. This has allowed them to reduce the
accumulated deficit. The agency does not have an operating deficit.
Commissioner Chow asked for a six-month report to the Budget Committee
to make sure this progress continues.
(3.6) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Catholic Charities CYO, in the amount of $779,810
which includes a 12% contingency, to provide supportive services at the
Derek Silva Community, a supportive housing site, for the period of
March 1, 2006 through December 31, 2007.
- Commissioner Tarver said Housing and Urban Health has very well
defined housing objectives. He asked how this level of detail could be
applied to supportive housing services. For example, what would be the
most appropriate outcomes for case management and how would they be
measured. He would like staff to develop outcomes for future combined
(3.8) PHP-Housing & Urban Health – Request for approval of a retroactive
contract renewal with Walden House, Inc., in the amount of $122,573,
which includes a 12% contingency, to provide supportive services in a
permanent housing environment at the Planetree Program, targeting very
low income adults who have disabling AIDS/HIV and substance abuse
concerns, for the period of
March 1, 2006 through August 31, 2007.
- Commissioner Tarver asked Walden House to consider the same question
about developing objectives for supportive housing. Donald Frazier from
Walden House said they could report and develop outcomes for the work
that they do. The work is already being done.
(3.12) AIDS Office-HIV Health Services – Request for approval of a
retroactive renewal contract with Immune Enhancement Project, in the
amount of $232,156, which includes a 12% contingency, to provide
complementary therapy services for individuals diagnosed with HIV or
AIDS, for the period of July 1, 2006 through December 31, 2007.
- Commissioner Chow is concerned that some very good objectives will be
revised in the next contract. What are the revisions going to entail?
Francine Austin, DPH program manager, said the agency submitted its
report yesterday, and came very close to meeting this objective. The
reason this objective is being revised is to make it more congruent to
how the clinical staff interacts with the patient. The goal is to
improve the outcome objectives.
(3.14) PHP – AB 75 Project - Request for approval to accept and expend
retroactively a grant allocation in the amount of $1,495,565, from the
California Healthcare for Indigents Program (CHIP), State Department of
Health Services, to provide reimbursement for health services delivered
to indigent persons, for the period of July 1, 2006 to June 30, 2007.
- Commissioner Chow asked what method is used to decide the split
between the county side and the private side, and then how is it decided
what specialties and services are funded. Mr. Leong said the funding for
the hospitals is what is before the Commission today, not the funding
for physicians. That funding comes from a separate pot. The hospital
funds are allocated in accordance to state rules in accordance with
levels of uncompensated care that is provided. For the physicians fund,
80% of funds are available to community physicians and 20% of funds go
to UC doctors that work at San Francisco General Hospital. Commissioner
Chow said there is a perception that this funding is no longer
available, so more outreach should be done about its availability.
(3.17) PHP-Housing & Urban Health – Request for approval of a
retroactive contract renewal with Baker Places, Inc., in the amount of
$2,749,132, which includes a 12% contingency, to provide residential
treatment, supportive services, continuing care services and rental
subsidies for persons with HIV/AIDS, substance use and mental health
issues, for the period of March 1, 2006 through December 31, 2007.
Secretary’s Note – Commissioner Tarver abstained from voting on this
(3.18) PHP-Housing & Urban Health – Request for approval of a
retroactive renewal contract with John Stewart Company, in the amount of
$2,280,889, which includes a 12% contingency, to provide property
management services serving the Direct Access to Housing sites, for the
July 1, 2006 through June 30, 2007.
- Commissioner Tarver commended the agency for the Units of Service that
have been achieved over the years.
(3.19) PHP-Housing & Urban Health – Request for approval of a new
contract with Citizens Housing Corporation, in the amount of $226,505,
which includes a 12% contingency, to provide supportive housing services
and rental subsidies at the Folsom-Dore Apartments, targeting homeless
adults, for the period of October 1, 2006 through June 30, 2007.
Secretary’s Note – This contract was continued to the next Health
(3.20) AIDS Office-HIV Prevention – Request for approval of a new
contract with Instituto Familiar de la Raza, in the amount of $126,140,
which includes a 12% contingency, to provide HIV prevention – HERR
(Health Education and Risk Reduction) services for youth, for the period
of August 1, 2006 through December 31, 2007.
(3.21) BHS – Request for approval of a contract renewal with Baker
Places, Inc., in the amount of $8,824,716 for a total contract of
$9,883,682, which includes a 12% contingency to provide mental health
services, for the period of July 1, 2006 through December 31, 2007.
Secretary’s Note – Commissioner Tarver abstained from voting on this
(3.22) BHS – Request for approval of a contract renewal with Calvin Y.
Louie, CPA dba Louie & Pak, LLP, in the amount of $8,150,700 per year,
for a total contract amount of $9,128,784, which includes a 12%
contingency, to provide fiscal intermediary services for the period, of
July 1, 2006 through June 30, 2007.
Secretary’s Note – Commissioner Tarver abstained from voting on this
(3.23) BHS – Request for approval of a contract renewal with Crestwood
Behavioral Health, Inc., in the total amount of $9,000,000, to provide
24-hour skilled nursing facility services, for the period of July 1,
2006 through December 31, 2007.
- Commissioner Tarver noted that there is a continuing discussion within
DPH about how to move people to the appropriate level of care, prevent
people from going into ADUs, being placed out of county, and other
long-term care issues. He looks forward to this being discussed at the
Community Health Network Joint Conference Committee. Commissioner Tarver
asked for information about each individual Crestwood facility, not just
the aggregate information. Staff will be able to do this.
(3.24) BHS – Request for approval of contract renewal with Mental Health
Management I, Inc., dba Canyon Manor, in the amount of $4,052,572 per
year for a total contract amount of $9,077,761 for two years, which
includes a 12% contingency to provide 24-hour, locked mental health
rehabilitation services, for the period of July 1, 2006 through June 30,
- Commissioner Tarver asked if the Alternatives program has made a
difference in the number of African American men that are
institutionalized at Canyon Manor. Alan Jamison, Program Director from
Canyon Manor, said that the African American male population in their
community is extensive and the Alternatives program has been successful.
(3.25) Central Administration – Annual Report of Gifts Received in FY
- Commissioner Sanchez thanked the trustees that serve on the
foundations for their hard work in raising these funds.
At the Health Commission meeting, Commissioner Sanchez asked Mr. Sass to
update the Commission about the application of the COLA that was
approved by the Board of Supervisors to DPH contracts. Mr. Sass said the
budget includes a 3% COLA for general fund programs. This has been
allocated to the various DPH divisions in accordance to their portion of
general fund dollars. Each division is allocating the COLA based on
various criteria. Mr. Sass reiterated that the COLA is available to
general fund contracts, not grant contracts. Commissioner Illig asked
that the criteria be public and consistent within the divisions, so that
agencies know what to expect. Mr. Sass noted that the contracts that
were approved by the Health Commission today were prepared prior to the
budget being approved by the Board of Supervisors. The 12% contingency
provides the mechanism for modifying these contracts to reflect a COLA
Action Taken: The Commission approved the Budget Committee Consent
Calendar. Commissioner Tarver abstained from voting on Items 3.4, 3.17,
3.21 and 3.22. Item 3.19 was continued to the next Health Commission
4) DIRECTOR’S REPORT
Mitchell H. Katz, M.D., presented the Director’s Report.
New Human Resources Director
Dr. Katz announced that Elizabeth M. Jacobi has accepted the position of
DPH Director of Human Resources, replacing Ed Gazzano who retired in
July. Elizabeth comes to us from the Department of Human Resources, City
and County of San Francisco, where she is currently on assignment as the
Appeals Coordinator. She has also served as Assistant Manager of the EEO
Division and was an attorney specializing in civil litigation practice
with a local private firm. Elizabeth received her BA at University Of
Virginia and her law degree from the College of William and Mary.
She brings extensive experience in Civil Service, employment law and
collective bargaining agreements and conflict resolution.
Dr. Katz thanked Bob Thomas who is serving as Acting Director for the
Department until Ms. Jacobi moves to DPH in September.
AIC Voted Best Place To Get Shots
Dr. Katz reported that the Adult Immunization (and Travel) Clinic was
just voted the "Best Place to Get Shots" by the Bay Guardian readers.
Following is the full text from the August 2, 2006 “Best of the Bay”
SAN FRANCISCO BAY GUARDIAN, August 2, 2006Best Place to Get Shot(s)Where
on earth do you think you're going? And why weren't we invited? If your
travel plans require a passport, the item on the tippy top of your to-do
list should be a visit to the San Francisco Department of Public
Health’s Adult Immunization and Travel Clinic. While some private travel
clinics seem to specialize in the jab-and-run, this attractive nonprofit
clinic makes sure you have all the info you need. Whether you're nervous
about the side effects of malaria drugs, wondering about altitude
sickness, or figuring out which countries require yellow fever
vaccination certification, the caring staffers will take the time to
answer your questions. So get all your vaccines for a reasonable price,
pick up a cache of antibiotics in case of the stomach nasties, and
browse the clinic’s library of Lonely Planet guidebooks. Don't wait
until the last minute; illness makes a lousy souvenir.101 Grove, Room
102, SF. (415) 554-2625, www.dph.sf.ca.us/aic
Mental Health Services Act Update
The MHSA Advisory Committee will be holding a community forum to receive
broad community input on mental health issues on August 30th from 3-5
p.m. in the Bayview at the Southeast Community Center.
CBHS has completed the review of 28 applications from 16 agencies that
were submitted in response to a Request For Proposal (RFP) for services
that will be funded through the Mental Health Services Act. The results
of this review were distributed the week of August 7th. Contract
negotiations are beginning and we hope to have this process completed
and services initiated by early October. The RFP review process included
significant participation by community members interested in MHSA; 30%
of the total review panel members were community representatives.
Environmental Sampling Exercise
The Environmental Health Section and the Public Health Lab collaborated
on an environmental sampling drill as part of DPH's bioterrorism
prevention planning. This environmental sampling technique will be used
to evaluate areas of contamination in the event of a large-scale release
of a bioterrorism agent. The EHS Hazardous Materials Emergency
Responders tested new sampling equipment and methods, used sterile
sampling techniques, and practiced crime scene evidence collection
procedures while wearing full personal protective equipment. The Lab's
Chief Microbiologist provided control specimens to evaluate the
effectiveness of different sampling methods, and will analyze the
samples using recently acquired Polymerase Chain Reaction (PCR)
technology. The samples will be analyzed using a new series of
analytical reagents for a number of CDC Category A and B bioterrorism
agents that are also naturally occurring in the environment, which will
provide useful background data to DPH in the event of a potential
bioterrorism incident in San Francisco.
Last week the Bureau of Environmental Health held a public hearing on
the Department’s new rules and regulations for the control of bed bug
infestations in the City. The hearing focused on owners and mangers of
all Single Room Occupancy (SRO) hotels and pest control companies
licensed to do business in the City. Over 150 individuals were in
attendance. Representatives from community based organizations, the
Department of Tourism and tenant advocates also attended. Staff answered
questions and presented the new regulations which included prevention
requirements, training for hotel staff, reporting and responding
procedures, managing infested furniture and materials, and tenants’
responsibilities for prevention and control.
The new regulations recognize that effective control of bed bugs
requires an integrated pest control method involving everyone who has an
interest in their eradication such as hotel owners, building management
companies, tenants, pest control companies and a number of City
Earlier this month and in conjunction with the California Department of
Health Services, San Francisco Department of Public Health issued a
media alert to warn the public of the potential for contracting Vibrio
parahaemolyticus (Vibrio) through the consumption of raw oysters from
Washington State. Both the State and the City have seen an increase in
the number of reported cases of Vibrio beginning in late July.
Vibrio is a bacterium common to saltwater environments. Generally, the
level of this pathogen is low in the ocean, but it can increase when
water temperatures rise during the summer months. Inadequate
refrigeration following harvest, transport and storage may also allow
the bacteria to multiply to levels that may cause illness when oysters
are eaten raw or are under cooked. Symptoms, which generally begin one
day after eating contaminated food, can include watery diarrhea, often
accompanied by cramping, nausea, vomiting, fever and chills. Most
individuals recover without treatment within several days. Severe cases
may require medical treatment, but infections are rarely fatal.
Individuals who are at high risk of severe illness include those with
chronic liver disease, cancer, AIDS or other conditions that weaken or
compromise the immune system. The majority of cases are not life
threatening in the general population.
The Department will continue to monitor the number of cases of Vibrio
reported locally and will respond with additional warnings and public
outreach if needed.
Sign the Steel Beam Party
We will be celebrating a construction milestone for the Laguna Honda
Hospital Replacement Project with a "Sign the Steel Beam Party” in
Now that the steel frames are up, it gives us the opportunity to invite
LHH residents, their families, staff, volunteers, the Mayor, the Health
Commission, Board of Supervisors, neighbors, and community supporters to
sign their names on two steel beams before they are hoisted into the new
buildings. Having this party is our way of thanking everyone for helping
us reach this milestone and signing the steel beams is also symbolic of
“signing off on the new hospital.” This party will be a great
opportunity for the hospital and will send a positive statement to the
community that we are moving forward.
The Commissioners will be receiving an invitation to this event as soon
as the time has been confirmed with the Mayor’s Office.
Shape Up Coalition Wins Grant
Last week, the Shape Up Coalition was awarded a $60,000 Healthy Eating
Active Living Community Health Initiative Grant by San Francisco Kaiser
Permanente. The grant will support the work of Bret Harte Elementary
Parents group and the Alice Griffiths Housing Residents group to assess
their neighborhood and identify ways in which they can create changes
that will support healthy eating and active living environments. This
grant was developed by the Coalition in partnership with the Mayor's
Communities of Opportunity Initiative. The grant will also be used to
support changes proposed by the community members, and will be leveraged
to identify other funding sources. Grant activities will commence in
Stadium to Stadium Race
Over 1000 individuals ran, walked and strolled this past Sunday at the
first Stadium to Stadium race, organized by the Mayor's Office of
Community Development and Communities of Opportunity. Mayor Newsom
kicked the race off at Monster Park with the help of Supervisor Maxwell
and ultra marathoner Dean Karnazes. The event culminated in a fun-filled
health fair at AT&T Park. A number of DPH programs were represented
including the Southeast Health Center, STD Prevention & Control, and the
Shape Up Initiative.
Several DPH staff were seen crossing the finish line including
Commissioner Tarver. Special thanks to David Nakanishi and Mark Ghaly,
MD, who helped make the event a success. Race proceeds will benefit
Southeast health programs.
Community Health Network, San
Francisco General Hospital, Credentials Report, August 2006
07/06 to 08/06
Changes in Privileges
Current Statistics – as of 08/1/06
Affiliate Professionals (non-physicians)
Applications In Process
Applications Withdrawn Month of August 2006
2 (07/06 to 08/06)
SFGH Reappointments in Process Sept. 2006 to Dec. 2006
- Commissioner Tarver appreciates the participation of DPH staff in the
Stadium to Stadium Race.
- Commissioner Chow noted that the AIC deserves the thanks of the SF Bay
Guardian, but also the thanks of all San Franciscans. He has heard numerous
favorable comments about the travel clinic, and is a good reflection of the
- Commissioner Umekubo refers patients to the AIC for travel vaccines and
- Commissioner Guy said that bedbugs are a growing problem, and is this part
of the effort to contain this problem. Dr. Katz said yes, and in fact the
Department recently received an allocation from the Board of Supervisors to
do eradication and furniture replacement. Commissioner Guy said she heard
that the Tom Waddell elevator is being replaced. Is this indeed happening?
Dr. Katz said it is happening, thanks to the work of Anne Kronenberg and
- Commissioner Umekubo asked if the bedbug problem is a nationwide program,
or just localized to San Francisco. Dr. Katz said it is a national problem.
5) PRESENTATION OF THE EMPLOYEE RECOGNITION AWARDS FOR AUGUST
Commissioner Umekubo presented the Employee Recognition Awards for August.
Team Award: Behavioral Health Billing Systems - Division: PHP Finance -
Nominated By: Anne Okubo
|· Maria Barteaux
· Chan Yin Ching Ma
· Susan Mose
· Tasneem Shaikh
· Connie Tam
· Chi Phan
· Mew Ling Chan
· Juan Clara
· Urmila Damania
· Set Hoe
|· Jocy Tabaco
· Larry Pye
· Yvette Hannah
· Reggie Milton
· Pablo Munoz
· Retha Pedigo
· Patcharin Reynolds
· Claire Skiffington
· Estifanos Tsegan
· Thomas Outt
|· Isabel Abat
· Mary Covington-Walsh
· Peter Kim
· Lisa Selva
· Martha Vallin
· Robert Geller
· Elena Huynh
· Wendy Leung
6) HEALTH ACCESS PROGRAM UPDATE
Mitchell H. Katz, M.D., presented an update on the Health Access
Program. Dr. Katz said the Mayor and Supervisor Ammiano signed an
ordinance into law on August 7th that combines the HAP model with a
health spending mandate affecting businesses with more than 20
employees. Dr. Katz described the roles and responsibilities of the
various entities involved in implementing HAP, including the Health
Department, CAO, Controllers Office, San Francisco Health Plan, Office
of Treasurer & Tax Collector and others. The HAP Advisory Council,
co-chaired by Lloyd Dean and Dr. Katz, will provide expert consultation
on implementation of employer spending mandate, membership, rate,
benefit package, network, utilization, costs and evaluation. The
committee was designed to include the crucial constituencies of labor
and business, public and private providers, health advocates,
philanthropy and the Controller’s Office.
The Health Department has two distinct roles. It is the organizer of the
HAP and a provider of services within the HAP. Perhaps the greatest area
of implementation work will be preparing the Department to receive HAP
members. Dr. Katz said the goal is to use HAP as an opportunity to
re-envision the Department’s health care delivery system. Dr. Katz will
be creating a HAP administrator position to lead this work. There will
be two department committees, each of which will have subgroups. The
work of the committees will be reported to the Department’s Integrated
Steering Committee and ultimately to the Health Commission. Dr. Katz
said upcoming milestones are:
- December 15 – first draft of regulations for employer mandate issued
for public comment;
- January 31, 2007 – Interim report on HAP status to Board of
- July 1, 2007 – Implementation date
Dr. Katz said the HAP will be good for the hospital and will increase
resources for behavioral health. Dr. Michael Drennan has reinvigorated
Primary Care. The HAP provides an opportunity to reorganize in a
positive way with new resources.
- Commissioner Guy asked if the HAP Advisory Committee members have
specific terms. Dr. Katz said that no terms were defined. Commissioner
Guy hopes the advisory committee takes on the challenge of defining and
publicizing what its role and goals are. She is also interested in how
the Health Commission and Health Department view itself and its role in
this true paradigm change. She is looking to the CHN Joint Conference
Committee to work on this regularly. She looks to her Commission
colleagues and Dr. Katz for guidance on what to focus on first, and what
should be on future discussion lists. The next report to the Health
Commission should include a presentation by Jean Fraser and Dr. Katz
about the contracting mechanism and relationships with providers. She
also wants a discussion at the around the CHN JCC about developing the
evaluation component for the HAP.
- Commissioner Illig is hoping for monthly updates at the CHN JCC, with
a full report to the Health Commission prior to the Health Department
reporting to the Board of Supervisors in January 2007.
- Commissioner Umekubo said HAP would hopefully lead to increased
utilization of primary care, preventive procedures, specialty services
and other services. What is the plan to accommodate this increased
utilization? Dr. Katz said the program committee will determine how much
increased capacity the Health Department needs, and where the growth
should happen. Dr. Katz added that there has been a lot of thought about
how to plan enrollment to take capacity into consideration. Two areas of
concern are in terms of capacity are new appointments for primary care
doctors and specialty care. Commissioner Umekubo is interested in the
effort to enroll private providers. Dr. Katz said the relationship with
the private providers would be through the San Francisco Health Plan.
Commissioner Umekubo wants to be sure that all private physicians be
given the opportunity to participate in this program.
- Commissioner Sanchez said the HAP provides a unique opportunity to
look at the health provider model and enhance it to provide the health
care of the future. He encouraged all institutions to take advantage of
- Commissioner Tarver is interested in the role of the Health Commission
with the San Francisco Health Plan being a vendor. The new entity that
the Health Commission is charged with building may need to look
different from the current San Francisco Health Plan. He would like the
Health Commission give input to SFHP on what the HAP will look like.
Commissioner Tarver is very pleased that a key message of the program is
that the City’s legal and moral obligation to provide access to care to
low income residents is protected. Commissioner Tarver requested that a
representative from the SFHP attend the monthly CHN JCC meetings. His
concerns include integration of formularies, streamlining administrative
procedures and application forms, how to get existing systems to be
compatible, faster access to the system of care, and freedom to choose
- Commissioner Chow said the Health Commission has more than one role:
the oversight of the DPH delivery of services; the responsibility for
implementing the HAP; and protecting the health of San Franciscans. The
Health Commission must submit to the Board of Supervisors a report that
describes how the program will provide health care security for San
Francisco residents. He also stressed that when we talk about access, we
look beyond access to Health Department services to include and embrace
private providers. The Health Commission needs to hear from SFHP its
plans for including private physicians and hospitals and ensuring access
to high quality culturally competent services from the private side. The
Health Commission, not solely at the CHN JCC, should discuss this issue.
One key issue for the CHN JCC is how DPH’s primary care and behavioral
health systems will expand capacity to meet the needs of the HAP. With
regard to the communication plan, the Health Commission should be an A
level stakeholder, not a B level stakeholder.
- Commissioner Monfredini asked to whom the HAP administrator would
report. Dr. Katz said this person would report to him. She said that if
there are challenges and setbacks to implementing the HAP, the issues
will come to the Health Commission and DPH, not the Controller or Office
of Labor Standards or any other entity. The organization chart should
reflect this. She is very pleased with this program, and looks forward
to offering it as an example to other counties and states.
- Commissioner Illig wants to discuss the details of DPH’s contract with
SFHP in terms of expected outcomes. He was also very pleased to read in
Dr. Katz’s report that the HAP will drive DPH integration. Dr. Katz said
it is very important that HAP not exist as a separate system.
Commissioner Illig said it should be noted that the legislation
stipulates that funds collected for this program go to the SFHP, not to
the Health Department.
- Commissioner Guy noted that the chart presented today is not a
decision-making chart but rather a work flow chart.
- Commissioner Chow said the Medical Society could organize educational
meetings about the HAP.
- Yvonne Martinez, SEIU 790, said the union is concerned about a couple
of things. First, that there be substantive discussions about what it
will take to make this program a success. There are number of issues
that workers on the ground will face during implementation: adequate
staff, reliable equipment, etc. There are critics of the program who
will look for every opportunity to criticize the program, so we need to
get out in front of challenges. She provided an example of a geriatric
program that is greatly understaffed.
7) 4th QUARTER FINANCIAL REPORT
Gregg Sass, Chief Financial Officer, presented the 4th Quarter Financial
Report. The report presents the 4th quarter financial projections of
revenues and expenditures for DPH for FY 2005-06. Projections include a
revenue surplus of $27,483,000 and expenditure deficit of $3,882,000 for
a net favorable surplus of $23,601,000. Compared to the 3rd quarter
projected surplus of $21,009,000, the projected surplus has increased