|
| 1995 | 1996 | 1997 | 1998 | Projected 1999 |
|
| # of AIDS cases | 1678 | 1118 | 360 | 304 | 230 |
| % decrease | 33% | 68% | 16% | 25% |
As you can see San Francisco also had a much larger decline of deaths between 1997 and 1996, and between 1998 and 1997. However, it is unmistakable that the number of deaths keep decreasing. It would be highly improbable that we could continue to see decreases the size of 68% in San Francisco as we’ve seen between 1996 and 1997 each year. We know that protease inhibitors are not a cure. They do not work for everyone, in some people resistance develops, and some persons have side effects that preclude them from taking protease inhibitors. The fact that AIDS deaths continued to decrease should give us increased motivation to make sure that everyone benefits from antiretroviral drug combinations by increasing the number of people who are HIV positive who know they are positive (through increased voluntary HIV testing) and increase in programs that address access and adherence to treatments (for example HIV Action Point Center).
Food Handler Training Program
Beginning January 1, 2000, all food facility owners or operators will be required to have at least one person on staff who has completed and successfully passed the certified food handler training program and exam. The new requirement is a statewide mandate of the California Food & Safety Law. Facilities who do not comply with the new State regulation face closure.
To help food facilities meet the deadline, the Department of Public Health will be offering low-cost food handler training classes in English, Spanish, Cantonese and Mandarin. Training will begin September 1, 1999. The eight-hour training classes will cost $89 per person. Once an individual becomes certified, they will be required to re-certify every three years.
Mental Health
The Mental Health Services Section is sponsoring a series of community meetings to gain input on priorities to implement the Single Standard of Care funds provided by the Board of Supervisors this year. These meetings will provide input to the development of an RFP to distribute the $1.3 million in the 1999-00 budget. As you know, the Health Commission endorsed the Single Standard of Care Policy when the city implemented the Mental Health Managed Care Plan in April 1998.
Community Health Promotion and Prevention
I am pleased to announce the publication of a new book by Brain Katcher, Public Health Pharmacist with Community Health Promotion and Prevention. Brian's book, MEDLINE: A Guide to Effective Searching, is an explanation of how to make the best use of MEDLINE, the National Library of Medicine's premiere bibliographic database. The book has received support from leaders in Public Health including, past Health Commissioner Phil Lee. Congratulations to Brian.
COMMUNITY HEALTH NETWORK
Primary Care
The CHN, through a recent formation of a Primary Care Management task force, is working to improve our mammography rates and cervical cancer screening for 1999-2000. We hope to duplicate the highly successful Immunization Shoebox model that dramatically increased last year’s immunization rates for children at CHN primary care clinics.
Maxine Hall Health Center was recently awarded a $5,000 grant by the West Bay Breast Cancer Partnership (UCSF, Institute For Health and Aging) to focus on mammography re-screening rates for women over 50. This funding will help develop a viable model which can be adapted at all sites over the next year.
Our goal is to achieve Healthy People 2000 goals in both mammography and cervical cancer screening.
New Associate Administrator at Laguna Honda Hospital.
Please join me in congratulating Mivic Hirose, RN, MS on her new appointment as Associate Administrator at Laguna Honda Hospital. Mivic currently serves as the Director of Medical Surgical Nursing at San Francisco General Hospital. Prior to her role as Director, she served as a clinical nurse specialist for 15 years at San Francisco General Hospital. Her operational understanding of numerous departments within San Francisco General Hospital will aid in further strengthening the Community Health Network as she assumes her new position at Laguna Honda Hospital.
President Monfredini thanked Vice President Guy for chairing the past two Commission meetings. She also congratulated Rolando Bonilla on his new appointment to the Youth Commission.
Commissioner Parker asked for clarification on AIDS statistics and the food handler training program.
Commissioner Chow asked how the Department is responding to the new population of HIV infected individuals. He requested AIDS statistics reports. Dr. Katz reviewed our present programs but indicated our current programs are not decreasing the rates of infection. The Department of Public Health is locating new areas to do intervention. The message is to get treatment for HIV infections.
Commissioner Hill commented on the alarming yet sad increase in unsafe sex among young gay men.
Public Speaker: Michael Petrelis, AIDS Accountability Project, commented on the Annual STD Report being late and that he is not seeing an increase of STD in the gay community.
5) MONTHLY UPDATE ON DEPARTMENT OF PUBLIC HEALTH STRATEGIC PLANNING
Tangerine Brigham, Director of Policy and Planning, presented an update that included a proposed committee structure, the divisional planning priorities, data and information needs, and a web site development. For a copy of the full report, contact the Commission Office at 554-2666.
Ms. Brigham also reviewed the proposed process for inclusions of a strategic approach to financing issues for 2000-01 into a budget development process.
Ms. Brigham reported that each of the divisions – Population Health and Prevention and the Community Health Network – have developed long term working priorities which support this strategic planning process. They are as follows:
Population Health and Prevention (PHP)
- Prevent injury and illness through primary prevention activities
- Respond to the health needs of communities and populations at particular risk for adverse health outcomes (i.e., African American, homeless)
- Respond to health issues that cut across communities (e.g., substance abuse, violence)
- Ensure efficient, effective and accountable programs and services (this refers to PHP and contractors)
Community Health Network (CHN)
- Deliver care in the context of the public health mission to provide quality, comprehensive, culturally-proficient health services
- Continually strive to improve customer service by being patient-focused and supporting staff
- Strengthen integration with the CHN to better serve patients
- Invest in infrastructure and maximize the revenue base in order to ensure that the CHN can provide the most cost-effective care based on health outcomes
- Comply with licensure and regulatory requirements
For Central Administration, the working priorities are:
- Strengthening infrastructure with the Department
- Ensure adequate funding for the Department by maximizing revenues
Commissioners’ Comments:
The next update will be scheduled for September 21, 1999.
6) UPDATE ON IMPLEMENTATION OF AMENDED POLICY #24: CONTRACTORS’ COMPLIANCE WITH ANTIDISCRIMINATION PROTECTIONS AND CULTURAL COMPETENCY
Norm Nickens, Deputy Director of EEO, Affirmative Action and Cultural Competency, provided an update on the implementation of the Commission policy on antidiscrimination and cultural competency.
President Monfredini encouraged the Department to maintain the high priority and quality on cultural competence with training of Board and staff.
Commissioner Guy commended the approach to cultural competency by looking at national standards and Department internal existing standards (i.e., mental heath cultural competency criteria). She encouraged the Department to pay attention to the format in the Commission Budget Committee documents and get feedback from the Commission Budget Committee.
Commissioner Chow acknowledged the "Cultural and Linguistic Competence Standards and Research Agenda Project," DHHS Office of Minority Health, 1999. He pointed out the importance of validating culturally competent care that has come from the community. He also feels that while patient satisfaction is an important standard, there are potential fallacies in the instruments used. We need to improve these instruments to include cultural sensitivity. There may be different ways to survey different ethnic patient groups. Commissioner Chow also requested the Department’s Civil Service programs be in compliance with the Commission policy.
Commissioner Hill complimented everyone involved with this implementation. It is an excellent start with many challenges.
Commissioner Parker is pleasantly surprised that the Department is pulling this together. He promotes cultural competence in an effective way; and our policy should be a role model.
7) PUBLIC COMMENTS
Michael Petrelis, AIDS Accountability Project, stated the Department is giving confusing information to the gay community and recommended public meetings with the gay community, the dissemination of the annual STD Report, and the presentation of scientific facts to the gay community.
8) CLOSED EXECUTIVE SESSION:
A. PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION
None.
The Commission went into closed session at 5:05 p.m.
B. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SECTION 54957 AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.10(b) PUBLIC EMPLOYEE PERFORMANCE EVALUATION
DIRECTOR OF HEALTH: MITCH KATZ, M.D.
EXECUTIVE SECRETARY TO THE HEALTH COMMISSION: SANDY OUYE MORI
The Commission came out of closed session at 6:00 p.m.
C. RECONVENE IN OPEN SESSION:
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.
9) CLOSED EXECUTIVE SESSION:
A. PUBLIC COMMENT ON ALL MATTERS PERTAINING TO THE CLOSED SESSION
None.
B. 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 to confer with legal counsel.
The Commission went into closed session at 6:04 p.m.
C. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SECTION 54956.9, AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.11(b)
CONFERENCE WITH LEGAL COUNSEL - ANTICIPATED LITIGATION:
SETTLEMENT OF UP TO $98,000, INCLUDING HEALTH CARE COVERAGE, FOR MICHAEL LIAS VS CCSF, COMPLAINT FOR DISABILITY DISCRIMINATION, PURSUANT TO GOVERNMENT CODE SECTION 54956.9(b)(3).)
The Commission came out of closed session at 6:16 p.m.
D. 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).)
Action Taken: The Commission approved the proposed settlement of up to $98,000 (contingent upon the City’s obligation to pay for Plaintiff’s health benefits.)
Commissioner Hill abstained on this item.
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.
The meeting was adjourned at 6:17 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission