Minutes of the Health Commission Meeting
Tuesday, December 15, 1998, 3:00 p.m.
at 101 Grove Street, Room #300
San Francisco, CA 94102
1) CALL TO ORDER
The regular meeting of the Health Commission was called to order by President Lee Ann Monfredini, at 3:05 p.m.
Present:
Action Taken: The Commission unanimously adopted the minutes of December 1, 1998.
3) CONSENT CALENDAR OF THE BUDGET COMMITTEE
(Commissioner David J. Sanchez, Jr., Ph.D.)
CHN-Office of Managed Care – Request for approval of retroactive renewal contract with UCSF Stanford Healthcare for the provision of tertiary care services in the amount not to exceed $1,700,000 for the period of July 1, 1998 through June 30, 1999.
Commissioner Sanchez encouraged the contractor to include a timeline and specific actions in its compliance plan.
Commissioner Barnes looks forward to hearing about progress towards compliance.
Central Administration - Request for approval to accept and expend a new one-year grant in the amount of $119,250 from the California HealthCare Foundation to complete planning for a long-
term integration pilot project for the period of January 1, 1999 to December 31, 1999 and for the same time period, sole source approval for a new contract with the Haight-Ashbury Free Clinics, Inc. in the amount of $113,570 to provide fiscal agent services to administer the grant.
(3.3) PHP-CMHS – Request for approval to accept retroactively and expend a renewal grant in the amount of $96,658 from the Miriam and Peter Haas Fund to provide an integrated model of targeted consultation for the period of April 1, 1998 to March 31, 1999.
PHP-CSAS – Request for approval of retroactive multiyear renewal contract with San Francisco Pretrial Diversion Project, Inc. (SFPDP) in the amount of $62,948 for the provision of substance abuse court diversion/referral services for the period of July 1, 1998 through June 30, 2002. (DPH contracted with SFPDP for services totaling $61,115 during FY 1997-98).
(3.5) PHP-CMHS – Request for approval of retroactive renewal contract with Saint Mary Pharmacy Management Services (SMPMS) in the amount of $1,850,691 to provide community-based pharmacy services for the period of July 1, 1998 through June 30, 1999. (DPH contracted with SMPMS for services totaling $1,673,691 during FY 1997-98).
(3.6) PHP-CMHS – Request for approval of retroactive renewal contract Progress Foundation (PF), in the amount of $5,716,045 to provide 24-hour residential, partial day and case management services for the period of July 1, 1998 through June 30, 1999 (DPH contracted with PF for services totaling $5,328,757 during FY 1997-98).
(3.7) PHP-CSAS – Request for approval of retroactive renewal contract with Asian American Recovery Services (AARS) in the amount of $1,318,047 per year to provide substance abuse residential, prevention, day treatment, intake and outreach services for the period of July 1, 1998 through June 30, 2002. (DPH contracted with AARS for services totaling $1,376,745 during FY 1997-98).
(3.8) PHP-CSAS – Request for approval of retroactive multi-year contract renewal with Chemical Awareness and Treatment Services, Inc. (dba Community Awareness and Treatment Services, Inc.) (CATS) in the amount of $2,961,158 to provide transportation and residential substance abuse treatment services for the period of July 1, 1998 through June 30, 2002. (DPH contracted with CATS for services totaling $3,861,190 during FY 1997-98).
(3.9) PHP-CSAS – Request for approval of retroactive contract renewal with Horizons Unlimited of San Francisco, Inc. (HUSF) in the amount of $1,212,673 to provide outpatient, prevention and day treatment substance abuse services to youth and young adults for the period of July 1, 1998 through June 30, 1999. (DPH contracted with HUSF for services totaling $1,316,337 during FY 1997-98).
(3.10) PHP-CMHS – Request for approval of retroactive multi-year contract renewal with Richmond Area Multi-Services, Inc. (RAMS) in the amount of $2,053,295 per year to provide multi-lingual mental health services to residents of San Francisco for the period of July 1, 1998 through June 30, 2002. (DPH contracted with RAMS for services totaling $1,242,237 during FY 1997-98).
(3.11) PHP-CSAS – Request for approval of retroactive renewal contract with Women and Children's Family Services (WCFS) (formerly known as the Women's Alcoholism Center) in the amount of $2,061,236 per year for one year to provide residential and outpatient substance abuse services to women for the period of July 1, 1998 through June 30, 1999. (DPH contracted with WCFS for services totaling $1,964,471 during FY 1997-98).
PHP-CSAS – Request for approval of retroactive renewal contract with Bay Area Addiction, Research and Treatment, Inc. (BAART) for the period of July 1, 1998 through September 30, 1998, and new contract with Addiction Research and Treatment, Inc. dba BAART for the period of October 1, 1998 through June 30, 1999, to provide Methadone maintenance and counseling services for the combined total amount of $4,329,178 for the period of July 1, 1998 through June 30, 1999. (DPH contracted with BAART for services totaling $3,462,262 during FY 1997-98).
Commissioner Hill raised the question of the need to increase the number of Board members because the contract amount is significant.
(3.13) PHP-HIV Services – Request for approval of retroactive renewal contract with Regents of the University of California, UCSF/AIDS Health Project in the amount of $94,172 for the provision of Ward 86 mental health services for the period of July 1, 1998 through June 30, 1999. (DPH contracted with UCSF for services totaling $14,794,533 during FY 1997-98).
Commissioner Sanchez abstained on this item due to conflict of interest.
Commissioner Barnes requested President Monfredini re-issue her original letter to the U.C. Regents on Policy #24 since a new Governor has been elected.
Commissioner Hill requested an update be brought back in 90 days (March 16, 1999).
(3.14) PHP-HIV Prevention – Request for approval of new contract with Black Coalition on AIDS, Inc. (BCOA), as fiscal agent for New Village, in the amount of $86,379, for the provision of HIV prevention services for the period of December 30, 1998 through December 29, 1999. (DPH contracted with BCOA for services totaling $914,604 during FY 1997-98).
An overview of a transgender project in the African American community was presented.
(3.15) PHP-CMHS – Request for approval of retroactive renewal contract with San Francisco Study Center (SFSC) in the amount of $391,826 per year to provide management and fiscal intermediary services for the Office of Self Help, the Socialization Program (STEP) and the Center for Special Problems for the period of July 1, 1998 through June 30, 2002. (DPH contracted with SFSC for services totaling $521,662 during FY 1997-98).
(3.16) PHP-CHPP - Request for approval of sole source and new contract with San Francisco Study Center (SFSC) in the amount of $550,000 for the provision of asthma prevention and case management, breast and cervical cancer outreach and education, one-time studies, health assessments, and the establishment of a non-profit umbrella organization to address the unmet health needs of the Bayview/Hunters Point community for the period of January 1, 1998 through June 30, 2000. (DPH contracted with SFSC for $521,662 in FY 1997-98.)
Public Speaker: Ena Aguirre supported the contract and encouraged the hiring of neighborhood residents.
(3.17) PHP – Status Report on Catholic Charities' compliance with Health Commission Policy #24.
Bob Prentice gave an update on discussions with Catholic Charities administration and staff.
Commissioner Barnes thanked Dr. Prentice and Mr. Frank Hudson (Catholic Charities CEO) for their efforts. She also acknowledged the letters from Catholic Charities employees. Although she would not advocate this methodology, she feels that the compliance requirements have been met.
Commissioner Hill thanked all of the parties involved. Although he would not see this methodology as a regular practice, he felt that the contractor is on the right track and looks forward to the submission of more letters in order to assess the demographic data.
Commissioner Sanchez commented that this volunteer effort to obtain the demographics is a different methodology; but he looks forward to additional letters from employees. He proposed that a deadline date of January 20, 1999 be imposed to receive letters from employees. The Department will then be able to assess the progress towards compliance to Policy #24.
Public Speaker: Frank Hudson, CEO of Catholic Charities, supported this methodology of compliance towards Policy #24.
Commissioner Guy proposed #3.15 be continued to January 1999 because the follow-up report to Policy #24 was not submitted by the deadline indicated in the monitoring report.
Commissioner Chow raised the question of the criteria used to determine the use of a fiscal intermediary for #3.2. An explanation in the Commission packet would be helpful.
Action Taken: The Commission approved the Consent Calendar of the Budget Committee, except for #3.15, which will be continued to January 1999. Commissioner Sanchez abstained on #3.13.
4) DIRECTOR'S REPORT (Mitchell H. Katz, M.D., Director of Health)
(Provides information on activities and operations of the Department).
ADMINISTRATION
Healthy People 2010
The U.S. Department of Health and Human Services (DHHS) is currently in the process of developing Healthy People 2010 health promotion and disease prevention goals for the nation. Healthy People objectives were first established in 1979 and are meant to serve as a guide for national health policies. The overall goals of Healthy People 2010 are to increase the quality of a healthy life among Americans, and to eliminate health disparities among racial/ethnic groups.
Last week, DHHS convened a regional meeting on the proposed 2010 objectives and public health infrastructure. The draft version of Healthy People 2010 includes more than 530 specific objectives within 26 health categories, such as maternal child health, access, health services, environmental health and medical product safety. The meeting was held to foster input from individuals and organizations on Healthy People 2010. Department staff attended the meeting.
State and local health agencies, and community agencies conveyed the following themes during the public testimony:
- The lack of data sources, both availability and reliability, especially at the local level, to track a state or locality's progress in comparison to Healthy People 2000 and 2010 objectives.
- Concerns that the proposed objectives were too numerous and cumbersome for widespread use by policymakers and the general public. There were also concerns that the objectives should be broadened to incorporate community-wide indicators such as poverty, employment, community safety, and other factors that have a significant impact on community health.
- States and localities have made some progress in integrating Healthy People 2000 objectives into their assessment and program development efforts, but use of the objectives are not as widespread as they should be.
The Department will continue to track the development of Healthy People 2010 and comment on the objectives before they are finalized in January 2000.
DPH Personnel Rise to the Challenge During Power Blackout
The Department played an important role during the recent power outage experienced by San Francisco and surrounding counties on December 8, 1998. Patient care at DPH inpatient facilities continued uninterrupted and outpatients were appropriately triaged and transported when necessary. The Emergency Operations Center at 101 Grove swung into operation shortly after the disaster declaration by the Mayor's Office of Emergency Services and coordinated efforts by other DPH facilities to cope with the circumstances. As the day wore on, all staff remained calm and professional and the care and concern exhibited for patients, clients and each other was remarkable. I recommend that each employee utilize this opportunity to review their own personal survival plan in case of disaster (including having an office disaster preparedness kit with flashlight and batteries), and that each section critique the performance of their internal disaster plan and how it functioned during the blackout. The Department remains committed to optimum disaster preparedness in order to carry out our mission in times of crisis to City residents and visitors.
Use of Parking Garage for Needle Exchange
The Department has been involved in a number of efforts to support needle exchange programs in San Francisco. These programs have made a significant contribution in helping to prevent the transmission of HIV infection in the intravenous drug-using community. As part of these ongoing efforts the Department has been working with the San Francisco AIDS Foundation to identify potential indoor locations for the exchange sites; most sites currently operate at outdoor sites.
With the winter rains about to start the Department has offered to host the Civic Center needle exchange site. The site currently operates out of Civic Center Plaza on Monday evenings. This site will be relocated to the parking garage at 101 Grove Street as of Monday, January 4, 1999. The site will only operate for two hours per week, from 7:00 p.m. until 9:00 p.m. on Mondays.
The impact on use of the garage will be minimal. As is current practice, the entrance ramp to the garage will be closed to vehicles after 5:30. Vehicles may still enter or leave the garage through the exit ramp. The entrance ramp and a limited space at the base of the ramp will be used for operation of the needle exchange site from 7:00 p.m. until 9:00 p.m.. Staff and volunteers from the AIDS Foundation will be on site from approximately 6:30 p.m. until 9:15 p.m.. Staff and volunteers will actively monitor the use of the site at all times. Staff, volunteers and clients will not have access to the rest of the building.
POPULATION HEALTH AND PREVENTION
1999-00 RYAN-WHITE (CARE) AWARD: I am delighted to report that Congresswoman Pelosi's Office called us today to tell us that our Title I CARE Award was $36,218,513 for fiscal year 1999-00. This award is only $176,401 less than our award last year. Because of the increased number of EMAs qualifying for CARE, many EMAs received significantly smaller awards than they had in previous years. San Francisco would be expected to have received a significantly smaller award as well because our epidemic declined more rapidly than other cities because of the successful prevention efforts in San Francisco. The fact that our award is so close to our award last year is due to the excellent application that was written by the AIDS Office in collaboration with the HIV Planning (CARE) Council. It is also a testimony to the successful community planning effort that we have through the HIV Planning (CARE) Council.
Profile of Injury in San Francisco, 1998
The "Profile of Injury in San Francisco, 1998," a joint report from the Department, the Trauma Foundation and the UCSF Injury Center at San Francisco General Hospital, was released to the public and the press on December 2, 1998.
The report, compiled every two years, is an overview of injury deaths and hospitalizations in the City and County. This year, the report included a comparison with three other California cities: Oakland, San Jose and Los Angeles. S.F. injury rates were lower than Oakland, but higher than San Jose and Los Angeles.
The report is an important source of information on what and where specific problems exist. For example, it includes maps showing where in the City concentrations of pedestrian, bicycle and firearm injuries have been occurring. It will be an essential tool in our planning process, to reduce injury in San Francisco.
Factors Influencing the Learning and Performance of Bystander CPR in an Urban EMS System
Dr. John Brown, EMS Section Medical Director, will be presenting "Factors Influencing the Learning and Performance of Bystander CPR in an Urban EMS System" in poster format, at the annual meeting of the National Association of Emergency Medical Services Physicians January 8, 1999. Of the 500 cardiac arrests every year in the City, bystanders witness 43% and only 33% of those witnessed have CPR performed prior to EMS units' arrival. The EMS Section has been attempting to determine, through surveys and focus groups, what barriers exist in the City to learning CPR and applying it to those in need. Recommendations from this study will be used to improve CPR and other interventions designed to decrease mortality from cardiac arrest.
Reggie Project
The Reggie Project (also known as the Health Services Research Section) has a new home in Community Health and Safety Services. It will join the Epidemiology and Evaluation Section, directed by Rani Marx, Ph.D., MPH. Reggie is a standardized computer-based client registration system at 68 nonprofit agencies and DPH, that provide health and social services to low income persons living with HIV/AIDS in San Francisco, Marin and San Mateo Counties. Reggie enables clients to register at all agencies by registering only once, and enables service providers and DPH to collect accurate and useful data for care coordination, planning and reporting. Rani Marx has been working in DPH for the past seven years, conducting health services and prevention research. Jan Gurley, MD, the former Director of the Health Services Research Section, is continuing to devote 20% time to this important project, while she cares for a sick family member.
Award Granted to Community Substance Abuse
The San Francisco Community Foundation has granted Community Substance Abuse Services $60,000 for 36 months for the revision and continued development of their Treatment on Demand Plan. This plan is developed in conjunction with the Treatment on Demand Council and identifies prioritization and policy issues for the development of a Treatment on Demand system of care. Congratulations to CSAS for this award.
COMMUNITY HEALTH NETWORK
DOJ to Visit Laguna Honda
The Hospital received confirmation this week that the Department of Justice (DOJ) will be returning to visit LHH from January 13-15, 1999. This visit is a continuation of the DOJ's investigation regarding the civil rights of institutionalized persons. Preparation for the DOJ visit is underway at the Hospital. I will keep the Commission informed.
Special Holiday Show for Residents
LHH Volunteers Inc. is sponsoring the Annual Holiday Show for LHH residents on Friday, December 18th at 2:00 p.m. in Simon Auditorium. This gala variety show is one of the highlights of the year for the LHH residents. All Commissioners are invited to attend the show.
SFGH 4th Quarter Board Report
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5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR DECEMBER 1998
President Monfredini presented the December Employee Recognition Awards to the following:
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City Attorney Louise Renne appeared before the Commission to express her support to rebuilt Laguna Honda Hospital, using funds from the tobacco settlement. She has been asked by the Mayor to spearhead the planning for the rebuilding of Laguna Honda Hospital. Ms. Renne stated she will be working closely with Dr. Katz and his staff. She gave an overview of the recent tobacco settlement and stated that the City can begin planning now on how to spend the tobacco monies.
6) CONSIDERATION OF PROPOSED BYLAWS FOR THE COMMUNITY HEALTH NETWORK MEDICAL PRACTICE GROUP
Dr. Robert Okin, Interim Chairman of the Medical Practice Group, presented the proposed bylaws for the CHN Medical Practice Group. The Medical Practice Group will serve as the collective and independent voice of the providers in making recommendations regarding matters such as policy, budget, high level personal decisions, space allocation, and managed care activities to the CHN Leadership Group.
The proposed Medical Practice Group will include providers from the community-oriented Primary Care Clinics, Forensics services, Laguna Honda Hospital, and San Francisco General Hospital. Therefore, providers throughout the CHN continuum of care will be members of the MPG and will be represented on the MPG's Executive Committee.
Commissioner Chow recommended an amendment to the proposed resolution of approving the bylaws for the MPG.
Commissioner Guy expressed her support for inclusion of the Consortium Clinics in the bylaws. She strongly encouraged the Department to have a timetable for an affiliation with the Consortium.
Tony Wagner, CHN Executive Administrator, indicated the CHN is working on an affiliation with the Consortium, with a goal date for completion of June 30, 1999.
Action Taken: The Commission adopted Resolution #38-98, "Approving the Formation of the Medical Practice Group of the Community Health Network."
7) TIME SPECIFIC 3:45 P.M.: REPORT ON HOMELESS DEATH REVIEW, 1998
Dr. Tomas Aragon, Director of Community Health Epidemiology Section, presented the 1998 Report on Homeless Death Review. For a copy of the report, contact the Commission Office at 554-2666.
The findings were:
- For the period December 1,1997 through November 30, 1998, 157 homeless deaths were identified from Medical Examiner records. Over the past eight years (1990-1997), the annual number of homeless deaths averaged 118 per year.
- This year's annual review marks the highest number of homeless deaths in the past eight years. There were 103 deaths in 1990, 110 deaths in 1991, 125 deaths in 1992, 98 deaths in 1993, 113 deaths in 1994, and 138 deaths in 1995, 154 deaths in 1996, and 104 deaths in 1997.
- The average age of those dying homeless during 1998 was 42.3 years overall, with an average of 38.7 years for females and 42.9 years for males.
- Twenty-two (14%) of those dying were female, 134 (85%) were male and one was transgender (less than 1%).
- The ethnic distribution among the 134 males was 56% white, 25% African American, 12% Latino, 2% Asian and 5% unknown; and among 22 females 50% white, 41% African American, 5% Latino, and 4% unknown. The ethnicity of the only transgender was white. For 1998, the estimated ethnic distribution for San Francisco was 43% white, 11% African American, 16% Latino, 31% Asian/other.
- Drug Poisoning remained the leading cause of death among homeless people (62). Accidents claimed 13 lives and alcohol use 10. Heart disease and suicide accounted for 7 each, severe infection 4, and other causes 10.
- At the time of this report, the cause of deaths was known for 141 persons. Of these deaths, 86 deaths were attributed to drugs or alcohol use: 40 deaths involved heroin (27 of these deaths involved heroin in combination with other substances), 11 deaths involved cocaine, 23 deaths involved other poly-drug overdose, and 19 deaths involved alcohol (10 only alcohol).
- One hundred and forty-seven homeless deaths were evaluated for the presence of drugs or alcohol. Of these, 43 (29%) did not have drugs or alcohol present at the time of death, 21 (14%) showed the presence of alcohol only, 72 (49%) had the presence of drugs only, and 11 (7%) had the presence of both drugs and alcohol.
- Of the seventy deaths (47%) that occurred outdoors, the cause of death for 63 decedents was known (the leading cause of death was drug poisoning claiming 28 lives, the second leading cause of death was accidents accounting for 12 deaths, alcohol use accounted for 6 deaths). Fifty deaths occurred indoors. Of the remainder: 16 died in hospitals, 11 died in homeless shelters, and 2 died in jail. In eight cases the location could not be determined.
- Eighty-two deaths occurred during the six-month span of December 1997 through May 1998 - the months of heavy rainfall attributed to El Niņo. During the other six-month span of June 1998 through November 1998 there were 70 homeless deaths.
- Homeless deaths, while still concentrated in some of the poorer areas of the City (94 deaths or 63% in the Tenderloin, Inner Mission and South of Market combined), occurred in 29 different neighborhoods throughout San Francisco. The neighborhoods experiencing the highest number of homeless deaths were the Tenderloin with 36 deaths, the Inner Mission with 35 deaths, and the South of Market with 23 deaths. Since last year, the number of homeless deaths doubled in the Tenderloin (from 17 to 36 deaths) and South of Market (from 12 to 24 deaths). The other 26 neighborhoods experienced anywhere from 1-9 deaths.
Arnette Watson, member of the Community Advisory Board for the Homeless Death Prevention Project, emphasized the human side of the homeless death statistics.
Commissioners' Comments:
8) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH ANNUAL REPORT
Joanne Kimata of the Policy and Planning Division presented the Annual Report. The report reflects the Department's core activities, including assessing and researching the community's health, developing and enforcing health policy, and providing quality health services.
For a copy of the report, contact Joanne Kimata at 554-2636.
- The report includes the following:
- Message from the Director
- Health Commission
- Organizational Chart
- Hearing from You
- Assess and Research the Community's Health
- Develop and Enforce Health Policy
- Provide Quality Health Services
- Partner with the Community
- The Department's Advisory Groups
- The Department's Contractors
- Demographics of our City
- Health Status of San Franciscans
- The Department's Clients and Services
- 1997-98 Financial Information
- The Department's Workforce
Commissioner Barnes complimented Dr. Katz, his senior staff, and frontline staff for all of their good work.
Commissioner Guy raised the question on distribution of the report.
Commissioner Chow encouraged the Department to have the report on the Website for the whole year.
President Monfredini thanked Ms. Kimata for an excellent, comprehensive report.
9) PRESENTATION OF ENVIRONMENTAL HEALTH INDICATORS FOR SAN FRANCISCO
Dr. Rajiv Bhatia presented an annual data summary on environmental health. He reviewed some key points which were:
- Environmental Health Section activities are guided largely by State, Federal and local regulations and mandates. These regulations focus on consumer protection (food and water), hazardous waste and materials, solid waste and other environmental health risks.
- Air quality nationwide is improving and San Francisco's air quality is quite good relative to many parts of the nation. However, new studies continue to detect health problems at the lower levels of air pollution, and data regarding non-criteria air pollutants is limited. Thus, ongoing efforts in research, pollution control, and standard setting are necessary.
- San Francisco's water is safe for drinking, based on established standards. Ongoing examination of the water supply is critical, as microorganisms that transmit disease may not always be measurable by existing monitoring systems. In addition, historic contamination of the San Francisco Bay will be an ongoing concern even though there are controls on the introduction of new pollutants.
Certain groups bear a greater burden of adverse environmental risk factors while they also have less access to positive attributes of the environment. The Department of Public Health will continue to pursue research and develop initiatives to address environmental justice concerns.
Note: Commissioner Barnes left at 5:40 p.m.
10) PRESENTATION OF BACKGROUND AND OPTIONS FOR REBUILDING LAGUNA HONDA HOSPITAL
Dr. Katz gave an overview of a white paper on Laguna Honda Hospital, as well as the policy options regarding its future. (Attachment B). For a copy of the complete white paper, contact the Commission Office at 554-2666.
Dr. Katz would like to bring to the Commission a consensus on the right size for a new Laguna Honda Hospital.
Public Speakers:
- Jason Hataye, SFGH volunteer
- Sister Miriam Walsh
- Kay Bromley, LHH volunteer
- Gil Thomally, Committee to Save LHH
- Joan Braconi, Local 250
- Virginia Leishman
- Doris Mitchell, Local 250
- Jeff Sheehy, Committee to Save LHH
- Donna Calame, citizen advocate for long term care
- Norm Burns, Local 790
All of the speakers supported a 1200-bed capacity. Ms. Calame advocated for more support for community-based services and alternatives to institutionalization.
President Monfredini thanked Dr. Katz for an extraordinary white paper. She referred to Health Commission Resolution #28-98 which was adopted on July 21, 1998 and promotes 1200 beds for Laguna Honda Hospital.
Commissioner Barnes is in support of rebuilding Laguna Honda Hospital.
Commissioner Guy expressed her support to rebuild Laguna Honda Hospital at the 1200-bed level. She strongly encouraged the AB 1040 Task Force to discuss the issue on the number of beds and bring a recommendation forward to the Commission. She also requested a progress report from the AB 1040 Task Force in February.
Commissioner Chow would like to create a dialogue within the AB 1040 Task Force and with the public. He also wants information from existing counties on their long term care policies and what exactly are the county's obligations for long term care. He encouraged the Department to gather comparative costs with other counties. The financing through revenue bonds instead of a general obligation bond should be analyzed.
Commissioner Sanchez thanked the public speakers. He also referred to Health Commission Resolution #28-98.
Commissioner Hill thanked the public for its input to the Commission. He reaffirmed Health Commission Resolution #28-98.
Commissioner Parker expressed his appreciation to Dr. Katz for outlining the options. Commissioner Parker is in favor of rebuilding Laguna Honda Hospital at a minimum of 1200 beds and up to 1500 beds based on the needs in the future. He also commented on the need for creativity to have funds for replacement programs and to come up with other ways to promote health.
President Monfredini indicated no policy decisions are to be made today. There will be other public meetings to discuss the white paper. She thanked Dr. Katz for his excellent presentation.
11) OTHER BUSINESS/PUBLIC COMMENTS
None
12) CLOSED EXECUTIVE SESSION:
A. PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION.
None.
B. VOTE ON WHETHER TO HOLD CLOSED SESSION TO CONFER WITH LEGAL COUNSEL. (SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.11(a).)
Action Taken: The Commission voted to hold a Closed Session.
The Commission went into Closed Session at 5:35 p.m.
- RAY RIVERA V. CCSF, SUPERIOR COURT CASE #989-490; PROPOSED SETTLEMENT: $15,000
- STEPHANIE COBB V. CCSF, SUPERIOR COURT CASE #992-002; PROPOSED SETTLEMENT: $7,500
C. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SESSION 54956.9 AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.11(b).
CONFERENCE WITH LEGAL COUNSEL - EXISTING LITIGATION.
D. RECONVENE IN OPEN SESSION:
The Commission came out of Closed Session at 5:58 p.m..
1. POSSIBLE REPORT ON ACTION TAKEN IN CLOSED SESSION. (GOVERNMENT CODE SECTION 54957.1(a)(2) AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.14(b)(2).)
Action Taken: The Commission approved the $15,000 settlement for Ray Rivera V. CCSF, Superior Court Case #989-490.
Action Taken: The Commission approved the $7,500 settlement for Stephanie Cobb V. CCSF, Superior Court Case #992-002.
VOTE TO ELECT WHETHER TO DISCLOSE ANY OR ALL DISCUSSIONS HELD IN CLOSED SESSION (SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.14(a).)
Action Taken: The Commission voted to not disclose any discussions held in Closed Session.
The meeting was adjourned at 6:05 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission