Minutes of the Health Commission Meeting MINUTES: CLOSED EXECUTIVE SESSION AND  SPECIAL MEETING OF THE HEALTH COMMISSION Wednesday, January 13, 1999, 8:30 a.m. to 4:00 p.m. at San Francisco General Hospital, Room 7M, 30A-B, 1001 Potrero Avenue San Francisco, CA 94110 1) CALL TO ORDER The regular meeting of the Health Commission was called to order by President Lee Ann Monfredini, at 8:35 a.m. Present: Commissioner Debra A. Barnes (Commissioner Barnes was excused from 10:10 a.m. to 12:30 p.m.) Commissioner Edward A. Chow, M.D. Commissioner Roma P. Guy, M.S.W. Commissioner Ron Hill Commissioner Lee Ann Monfredini Commissioner Harrison Parker, Sr., D.D.S. Commissioner David J. Sanchez, Jr., Ph.D. 2) PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION None. A) VOTE ON WHETHER TO HOLD A 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. B) CONFERENCE WITH LEGAL COUNSEL - EXISTING LITIGATION. _____X_____ AS DEFENDANT __________ AS PLAINTIFF CLOSED SESSION PURSUANT TO GOVERNMENT CODE SESSION 54956.9(b)(3)(B), REGARDING THE DENIAL OF A CONTRACT WITH CATHOLIC YOUTH ORGANIZATION (CYO), AND CONSIDERATION OF A PROPOSED CONTRACT WITH CATHOLIC CHARITIES WITH RESPECT TO COMPLIANCE WITH HEALTH COMMISSION POLICY #24. The Commission came out of the closed session at 9:35 a.m. C) RECONVENE IN OPEN SESSION: 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).) No action was taken in closed session. President Monfredini requested another closed session on this issue in the next 30 days. 2. 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 not to disclose any discussions held in closed session. 3) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH BUDGET FOR 1998-99 AND IMPLICATION FOR THE FY 1999-00 DEPARTMENT OF PUBLIC HEALTH BUDGET Monique Zmuda, Chief Finance Officer, presented revenue and expenditure information for FY 1998-99. For a copy of the report, contact the Commission Office at 554-2666. Her presentation included the following: Sources of Revenue Description of Expenditures General Fund Support Mutiyear Revenues Fiscal Year 1998-99 Projections Financial Status Fiscal Year 1999-00 Budget Request She also presented the current year shortfall, the current year reduction plan, strategy options to balance the 1998-99 budget, the FY 199-00 budget strategy, and the next steps in preparing the FY 1999-00 budget. Commissioners' Comments: Expressed appreciation to Ms. Zmuda for a comprehensive, excellent report Commission should have a discussion of the serious consequences of any reductions in the current budget Commission may need to prioritize the needs and will need to know at what point in the budget process this prioritization needs to take place Need to look at population-based initiatives, not just a base budget There are difficult decisions to make, especially on what level of non-reimbursable services should be provided Useful information on the capacity needed for a specific policy direction (i.e., treatment on demand) would help to advocate that policy Ms. Zmuda commented that the City will identify the magnitude of the budget shortfall in March. Dr. Katz emphasized the importance of being aware that any service cuts on the CHN side have an adverse impact on revenues. The Commission looks forward to the FY 1999-00 budget presentation and public hearing on February 2, 1999. 4) DISCUSSION OF THE OPTIONS FOR LAGUNA HONDA HOSPITAL WHITE PAPER Dr. Katz stated that the newly-created Laguna Honda Hospital Policy Committee has been formed. The Co-Chairs are Louise Renne, City Attorney, and Dr. Mitch Katz, Director of Health. The Committee will bring recommendations to the Commission in March. President Monfredini emphasized the commitment of the Commission to rebuild Laguna Honda Hospital and to keep as many beds as possible on the site. Public Speakers: Janet Overboe, Independent Living, encouraged Commissioners to look at funds going to community-based services to promote independent living. The following speakers supported rebuilding Laguna Honda Hospital to at least 1200 beds: Charles Levinson, Laguna Honda resident Taffetta Lassen, IHSS Consortium Teresita Gatan, Local 250 Cindy Bircher, SFGH Discharge Worker, Local 790 Dan Merer, Emergency Room R.N., Local 790 Cynthia Weisman-Kelly, SFGH Discharge Worker, Local 790 Manuel Abullavarde, Laguna Honda Hospital Dale Butler, Local 790 Joan Braconi, Local 250, additionally expressed concern on the timing for a bond process Frederick Hobson, additionally supported assisted living, housing and significant consumer and labor representation on the Laguna Honda Policy Committee The Commissioners took a lunch break from 12:30 to 1:15 p.m. The meeting reconvened at 1:20 p.m. Commissioner Chow raised issues around Laguna Honda Hospital operational costs, the City's commitment to skilled nursing beds, and advocacy for assisted living facilities. Commissioner Guy wants the Department as a stakeholder to show that Laguna Honda Hospital fits into long-term care planning of the AB 1040 Task Force. President Monfredini emphasized the need to have the financial information on operational costs. The Commission looks forward to the recommendations from the Laguna Honda Hospital Policy Committee. 5) DISCUSSION OF HEALTH COMMISSION CONTRACT POLICY #24: ETHNICITY, GENDER AND SEXUAL ORIENTATION OF STAFF AND BOARD OF DIRECTORS President Monfredini encouraged staff and public input on this policy issue. Dr. Katz stated the Department's high priority for cultural competency and ways to improve cultural competency through training, language capabilities and client satisfaction. President Monfredini would encourage the Commission to move forward to improve the policy. 6) OPEN ISSUES PERTAINING TO THE HEALTH COMMISSION Commissioner Chow would like a progress report on the organizational development of the Community Health Network and Population Health and Prevention Divisions, and how issues (i.e., billing, mental health) are integrated between the two divisions. Dr. Katz will bring an update on the reorganization of the Department. Commissioner Sanchez commented that needs should be raised in a uniform process at the Joint Conference levels. Commissioner Barnes expressed her delight with the progress of the reorganization of the Department. Commissioner Chow requested an update on the history and performance issues of the U.C. Affiliation Agreement. Tony Wagner, CHN Executive Administrator, will bring the U.C. Affiliation Agreement to Dr. Katz, the Joint Conference Committee of CHN, and the full Commission. Commissioner Chow encouraged the Commission to have its meetings in the community, outside of 101 Grove. President Monfredini suggested Juvenile Hall, the Health Centers, Laguna Honda Hospital, and San Francisco General Hospital. She also encouraged Commissioners to make site visits to Mission Rock and the jails. Commissioner Parker commented that retroactive contracts still appear on the Budget Committee agenda. Ms. Zmuda stated that the Department is close to its goal but it would take more resources than what we have to achieve the 100% goal. Commissioner Guy observed that improvements have been happening. Ms. Zmuda will provide an update and will also look at standard evaluations. Commissioner Guy raised several issues of concern: The African American community is disproportionately affected in health care areas Collaboration with the schools on children and youth issues is lacking; the Department needs to build alliances with other groups Homelessness among women and children will escalate, given the welfare to work policies In requesting date for planning purposes, she is open to feedback from staff Commissioner Barnes encouraged the Department to enable the Commission to receive the Commission packets by Wednesday or Thursday prior to a Commission meeting. She also wants the larger reports to be given to the Commissioners earlier. President Monfredini requested the Department to send out the Commission packets by Thursday night prior to the Commission meeting. 7) PUBLIC COMMENTS None. The meeting was adjourned at 3:15 p.m. Sandy Ouye Mori, Executive Secretary to the Health Commission