|
| Contractor | Type of Service |
Proposed FY 2000-01 Transaction |
| Big Brothers/Big Sisters of San Francisco |
Mentoring & Social Services |
$ 15,362 |
| JLC Services |
Mentoring Services |
$165,000 |
| Lincoln Child Center |
Sub-Acute Residential Treatment |
$254,558 |
| RISE Institute |
Mentoring Services |
$135,000 |
| San Francisco Educational Services |
Tutorial Services |
$ 60,000 |
| Victor Treatment Centers |
Sub-Acute Residential Treatment |
$312,557 |
Commissioner Parker complimented the program for its excellent monitoring program.
Commissioner Sanchez emphasized the importance of having the multilingual staff capacity. The Department sees the importance of bringing new young people into the field.
Commissioner Chow commended the Department for comprehensive information for #3.1. He also requested a progress report on the implementation of Policy #24 to the full Commission in October or November. He pointed out that non-service providers (i.e. advertising, evaluation) also need to have cultural competency.
Commissioner Umekubo requested clarification on the criteria and process for 2-year renewals for prevention contracts.
Action Taken: The Commission approved the Consent Calendar of the Budget Committee, with Commissioner Sanchez abstaining on #3.3 and #3.4.
4) DIRECTOR’S REPORT
(Mitchell H. Katz, M.D., Director of Health)
ADMINISTRATION
Medi-Cal Managed Care
The State Department of Health Services has expanded the mandatory Medi-Cal managed care population. Effective July 2000, the State will begin converting children in the 100%, 133% and 200% of federal poverty level aid categories (aid codes 47, 72, 7A, 8P and 8R) who are still in fee-for-service Medi-Cal to mandatory enrollment in Medi-Cal managed care plans. This will occur in two-plan model, geographic managed care and county organized health systems counties.
The State has received approval from the federal Department of Health and Human Services to begin this conversion. Children in these aid categories are:
As of January 2000, the number of children statewide in percent of poverty aid codes was 226,445, with 170,397 in fee-for-service Medi-Cal. This change will affect 23 counties. In San Francisco, there are 3,346 children in these aid codes – 486 of which are already enrolled in either the San Francisco Health Plan or Blue Cross. The distribution is as follows:
| AC 47 |
AC 72 |
AC 7A |
AC 8P |
AC 8R |
Total |
|
| Fee-For-Service Eligibles |
645 |
1,349 |
866 |
0 |
0 |
2,860 |
| Managed Care (Voluntary) |
0 |
0 |
||||
| Blue Cross |
28 |
100 |
65 |
0 |
0 |
193 |
| SFHP |
47 |
149 |
97 |
0 |
0 |
293 |
| Totals |
720 |
1,598 |
1,028 |
0 |
0 |
3,346 |
The mandatory enrollment of children currently in the percent of poverty aid categories will be phased in from July 2000 to October 2000. The Health Care Options program contractor (MAXIMUS) will handle the mailing and enrollment process. Notices will be sent to parents informing them of the need to select a health plan for their children. In addition to informing the participating health plans of this change, the State has also sent notices to community-based organizations in the affected counties.
Healthy Families
More than 300,000 children have been enrolled in the State’s Healthy Families Program. San Francisco’s enrollment is approximately 8,000 children. While the State continues to enroll more children each month, it should be noted that approximately 2 million children are still uninsured.
To ensure that the State Child Health Insurance Program (CHIP) is successful nationwide, the federal government has provided more flexibility to states. Specifically:
President Clinton has signed the Agricultural Risk Protection Act of 2000 (HR 2599) which gives states and school districts the option to share information from school lunch applications with state Medicaid and CHIP agencies. This provision enhances the ability of states to identify children eligible for benefits and enroll children in these programs. This provision goes into effect October 1, 2000.
The Department of Health and Human Services issued a policy notice indicating that it will consider Section 1115 demonstration proposals that will expand coverage and improve enrollment, health care outcomes and access to health care services for children. DHHS further states that it will support demonstration initiatives to extend coverage to low-income parents, within the constraints of the State CHIP law and available funds. The notice states that DHHS will only consider section 1115 demonstrations once a state has had at least one year of experience providing child health insurance under State CHIP. In addition, DHHS further states that a state must provide assurances that it has met the primary purpose of State CHIP before demonstration projects will be considered.
The DHHS approved California’s Healthy Families state plan amendment to allow a Family Contribution Sponsor to pay a child’s Healthy Families premiums for the first year of enrollment. A sponsor must register with the Managed Risk Medical Insurance Board and cannot be a Healthy Families provider, government entity, school, participating plan or a non-profit or charitable organization that operates a facility that is a provider in Healthy Families.
The State has issued its most recent report on the utilization of traditional and safety net (TSN) providers within the Healthy Families Program. Based on calendar year 1999 data, the key findings are:
The proportion of children enrolled in plans using a primary care physician model and who are using TSN primary care providers was 51 percent. For the San Francisco Health Plan, 100% of the enrollees had TSN providers.
Seventy-nine (79%) of those children with a TSN provider as their primary care physician selected the provider; the remaining 21% were assigned by their health plan. No assignments were made to TSN providers by the San Francisco Health Plan.
More than half of the Asian/Pacific Islander and Hispanic/Latino children, in health plans using a primary care physician model, were receiving services from a TSN provider.
Families whose primary language was not English were more likely to be receiving care from a TSN provider.
Drug Treatment Diversion Program Initiative
Eight statewide initiatives have qualified for the November 2000 ballot. Proposition 36 would require drug treatment for nonviolent drug offenders rather than incarceration. Offenders convicted of nonviolent drug possession offenses would be sentenced by the court for up to one year of drug treatment in the community and up to six additional months of follow-up care. The ordered drug treatment programs could include various types of treatment methods, including residential and outpatient services and replacement of narcotics with medications, such as methadone. Certain offenders would be excluded from Proposition 36 including:
The initiative appropriates $60 million in State General Funds for 2000-01 and $120 million each year thereafter until 2006 at which time funding would be subject to the State’s budget process. Funds would be allocated each year to county governments to offset their costs of implementing this measure. The Legislative Analyst’s Office estimates that after several years this initiative will save the State between $100 million and $150 million annually due primarily to lower costs for prison operations. Counties are anticipated to experience a net savings of about $40 million annually due to lower jail populations. Both Mayor Brown and the San Francisco Board of Supervisors have given their support to Proposition 36.
20th Annual Municipal Fiscal Advisory Awards –
Each year, the Municipal Fiscal Advisory Committee to the Mayor (MFAC) selects a number of managers to receive the Public Managerial Excellence Awards.
This Department was privileged to submit three top managers for this year's nominations: Anne Kronenberg, Executive Assistant from Central Administration; Larry Funk, Executive Director of Laguna Honda Hospital from the Community Health Network; and Norm Nickens, Deputy Director for EEO, Affirmative Action and Cultural Competency from Population Health & Prevention. Although none of our managers were selected as winners this year, they will be recognized at the Awards luncheon and reception in October.
Personnel
Michael Brown, Personnel Officer currently assigned to HR Labor Relations at SFGH has been reassigned to the 101 Grove HR office replacing Kin Gee, who has moved to Rec and Park. Michael’s assignments include HR Labor Relations for Central Admin, PH&P, and CHN – Forensics and Primary Care.
Michael will be spending some of his time at both locations until we complete the selection process to replace Kin Gee.
POPULATION HEALTH AND PREVENTION
HCV Conference
The Health Department was well represented at the recent Fourth International HCV Conference held in the City August 10-13. The conference theme was "moving Hepatitis C to the top of the Agenda" and was co-sponsored by the Department. Numerous Health Department staff including Tomas Aragon, Director of Disease Prevention and Control, Barbara Garcia, Director of Population Health and Prevention and myself made presentations on HCV prevention and treatment efforts in the City as well as the plans for future expanded services to address this emerging disease.
Postal Urine Screening Project
The Department's STD Branch is currently engaged in a pilot project testing the feasibility of a new way of screening for STD's. The new type of DNA test allows for a urine specimen to be unrefrigerated for relatively long periods of time before testing. The new approach--dubbed Postal Screening because specimens are sent through the mail--takes advantage of this.
As you know, gonorrhea and chlamydia are the two most common bacterial sexually transmitted infections and are at elevated rates among several communities in San Francisco. Because untreated STD's are associated with HIV transmission (and the rate of new HIV infections appears to be increasing) new methods to find and treat STD's are important. Research suggests that diagnosing and treating STD's will reduce the spread of HIV. For all of these reasons, the Department is trying Postal Screening in an attempt to reach those that do not regularly seek STD screening.
Postal Screening allows people to be tested without leaving the privacy of their own homes. Individuals pick up a testing kit or receive them by mail, provide a urine specimen, and mail it back in the boxes provided. The postage is pre-paid and pre-addressed to DPH. Testing is free and confidential. Names are requested to provide a reliable method of contact should the test be positive.
Testing kits are currently available at the pharmacy of Walgreen's on 18th St. @ Castro and at the nearby Market St. Gold's Gym. This form of screening is entirely new and, like many of the programs coming out of Dr. Klausner's STD Branch, is unprecedented in the United States.
The trial run continues this week through tomorrow (August 16th) and will be continued if it is successful. I will keep the Commission apprised of the test outcomes.
Newcomers Health Program
Newcomers Health Program of the Community Health Promotion and Prevention Branch would like to congratulate staff member, Samira Causevic, for being chosen by refugee service providers in San Francisco to represent them at the 2000 National Women's Refugee Leadership Conference.
Resignation
Joe Abrego, Information Technology Manager for Population Health and Prevention resigned from the Department of Public Health to accept a technical management position at MUNI. Joe was instrumental in the development of key IT functions for the Department. I am sure you join me in wishing Joe success in his new endeavors.
SF Immunization Coalition will receive Grant Award
The San Francisco Immunization Coalition will receive $30,000 grant from Mt. Zion Health Fund.
The Coalition has been addressing the disparities in immunization rates among priority populations, beginning with the African American community. The newly awarded grant will be used to run focus groups aimed at identifying barriers to on-time infant and toddler immunization.
Dental Services for Homeless
The Department's Dental Services branch has been awarded $170,000 through "Healthcare for the Homeless" funds to build a dental clinic at Tom Waddell Health Center. Tom Waddell has approximately 9000 homeless clients. I will keep the Commission members informed of a start-up date for these badly-needed services.
COMMUNITY HEALTH NETWORK
2000 Physician Leadership Program for Medical Directors & Department Chiefs and Chairs
Elizabeth Johnson, MD, Talmadge E. King, MD, Lori S. Kohler, MD, Renee Navarro, MD, Lisa Pascual, MD and Melissa Welch, MD have been selected to participate in the 2000 Physician Leadership Program for Medical Directors & Department Chiefs and Chairs. This is a two-day session that will be conducted in San Francisco on September 11-12.
Participants in the program will develop and enhance their leadership strategies with a team of physicians from their institutions. This program is specifically designed to meet the needs and demands of safety net institutions and will provide in-depth training and mentoring to physicians who have executive level operational responsibilities.
LHH Facility Replacement Project Status Report
Michael Lane, Project Manager for the LHH Replacement Project announced the final rankings of the three Executive Architectural teams competing for the project. Anshen and Allen with Gordon Chong and Associates ranked in first place, the Laguna Honda Design Consortium ranked second, and Kaplan McLaughlin and Diaz with Gearson Overstreet ranked third. After a public review process, the City will initiate negotiations for professional fees with the successful team. Mr. Lane is hopeful that programming and design work can commence in September. Meanwhile, work on the preliminary environmental impact report continues.
LHH Prepares for Annual Licensing Survey
Laguna Honda Hospital is expecting its annual unannounced State Licensing and Certification survey at any time. Staff is preparing the Hospital environment and clinical programs for the survey process. I will advise the Commission when the survey process begins and the results as soon as they are available.
Announcement of New Chief Nursing Officer
I am proud to announce Sue Currin is returning to SFGH October 6th after a two-year hiatus as the Chief Nursing Officer. For the past two years, Sue has been at Oakland Kaiser Permanente Hospital and Health Plan serving as the Quality & Service Leader for the East Bay Service Area.
I know the Commission joins me in thanking Joseph Pendon for serving as Interim Chief Nursing Officer. Joseph will return to his role as the Director of Medical Surgical Nursing when Sue arrives in October.
Departure of Eric Miller, Director of Facilities and Plant Services
I am sad to announce that Eric Miller, Director of Facilities and Plant Services for the Department of Public Health will be leaving September 15th. Eric worked for DPH in various capacities for the last 15 years. Eric is leaving the Department to go and work for Oakland Kaiser Permanente Hospital and Health Plan. A farewell reception will be held September 13th from 4-5:30 p.m. in the SFGH Main Cafeteria.
Successful Inspection of San Francisco General Hospital’s Mammography Services
Congratulations to San Francisco General Hospital Medical Center's Department of Radiology for receiving the highest score in their latest federal Mammography Quality Standards Act (MQSA) and California State inspection of Mammography Services.
The inspection compared specific items in six major areas (equipment performance, technologist quality control, medical physicist survey, personnel qualifications, medical reports and outcome audits) to required standards.
Thank you to Ernest Ring, MD, Chief of Radiology; Lori Strachowski, MD, Director, Mammography Services; Richard Hollingsworth, Director of Radiology; Joan Patropolos, Radiology; Gayling Gee, Associate Administrator; and all of the Mammography staff in assuring the quality of mammography services at San Francisco General Hospital Medical Center.
Mental Health Rehabilitation Facility – Recipient of APNA’s Best Practices Award
The Mental Health Rehabilitation Facility Program has been selected to receive the American Psychiatric Nurses Association BEST PRACTICES AWARD for Best Treatment of Schizophrenia in an Inpatient Program.
Dr.'s Mozettia Henley and Peggy Wilson submitted the proposal "Beyond Old Boundaries: A nursing model for the new millenium" which was selected for the award. Dr. Henley serves as the Program Director of the Mental Health Rehabilitation Facility and Dr. Peggy Wilson is the Clinical Nurse Specialist for the Mental Health Rehabilitation Facility.
The award will be presented at the opening of the 14th Annual APNA Conference in Washington, DC, in October 25, 2000.
| SFGH Credentials Report |
8/00 |
2000 YTD |
| New Appointments |
12 |
123 |
| Reinstatements |
1 |
8 |
| Reappointments |
22 |
252 |
| Delinquencies |
0 |
0 |
| Reappointment Denials |
0 |
0 |
| Resigned/Retired |
17 |
109 |
| Restriction/Limitation-Privileges |
0 |
0 |
| Changes in Privileges |
||
| Additions |
0 |
1 |
| Voluntary Relinquishments |
0 |
0 |
Commissioner Chow inquired about the status of mammography services. Gene O’Connell reported no decisions have been made yet; the Department is exploring how to best provide mammography services, including the use of a van; any policy change would come to the Health Commission.
Commissioner Parker inquired about a replacement for Eric Miller. Gene O’Connell has a transition plan.
Commissioner Parker also inquired about the impact of the Healthy Families and Healthy Workers programs on the number of uninsured people in San Francisco. Basically, Dr. Katz reported the increasing number of uninsured people (i.e., 10,000 new uninsured every year) far surpasses the number of people insured by these programs.
Commissioner Guy pointed out that Latino and African American children have low enrollment rates in the Healthy Families Program.
5) CONSIDERATION OF A RESOLUTION FOR THE DEFINITION OF HOMELESSNESS
Anne Kronenberg, Executive Assistant to Dr. Katz, submitted a proposed resolution on the working definition of homelessness within the Department. Ms. Kronenberg reported that the Department of Public Health Homeless Coordinating Committee (HCC) was formed last spring by Dr. Katz to improve access to and the quality of DPH homeless delivery system. The Committee has started an inventory of homeless programs within the Department. This has proven to be a difficult task because the term "homelessness" is interpreted differently by program areas. The City and County of San Francisco does not have an official definition of homelessness. After researching numerous definitions the Committee came to consensus on a definition for Public Health.
Ms. Kronenberg also submitted a list of the members of the DPH Homeless Coordinating Committee.
Commissioner Chow recommended a "working" not "official" definition.
Commissioner Sanchez pointed out that once a citywide definition of homelessness is determined, the Department would use the citywide definition.
Commissioner Hill emphasized there are no conflicts with any State or Federal definitions.
Action Taken: The Commission (Guy, Umekubo, Chow, Hill, Parker, Sanchez) adopted Resolution #9-00, "Adopting the Working Definition of Homelessness as the Department of Public Health Definition", with amendments.
6) CONSIDERATION OF A RESOLUTION ON HARM REDUCTION
Dr. Joshua Bamberger, MPH, Medical Director for Urban Community Health, reported:
The harm reduction policy requirements were originally presented before the Commission on October 19, 1999. Subsequently, presentations on this resolution have been made to a number of Joint Conference Committees of the Commission, as well as a number of community councils and boards, including the HIV Prevention Planning Council, CARE Council, Treatment of Demand Council, Drug Abuse Advisory Board and Citywide Alcohol Advisory Board. In addition, the resolution has been presented for comment to key divisions of the Health Department, including Maternal and Child Health, Community Mental Health Services and the Population Health and Prevention managers group.
The proposed resolution addresses the integration of harm reduction into key activities of the Department and will be used as a foundation for philosophical and programmatic changes. Dr. Bamberger will come back to the Commission on the progress on the implementation of this policy.
President Guy commented this policy is helping the Department to go into the future; this will be the official framework to guide the Department. She would like to see in 4-6 months a progress on the implementation of this policy.
Commissioner Parker expressed his support for the resolution.
Dr. Bamberger stated this policy promotes individual respect and moves people towards better health.
Action Taken: The Commission (Guy, Umekubo, Chow, Hill, Parker, Sanchez) adopted Resolution #10-00, "Adopting a Harm Reduction Policy for Substance Abuse, STD and HIV", with the addition of "including Department of Public Health contractors."
7) PUBLIC HEARING, IN ACCORDANCE WITH THE HEALTH CARE PLANNING ORDINANCE (PROPOSITION Q, 1988), TO CONSIDER THE IMPACT OF THE FOLLOWING CHANGES ON HEALTH CARE SERVICES OF THE COMMUNITY AT PACIFIC COAST HOSPITAL: SUSPENSION OF THE LICENSE FOR 20 ACUTE CARE BEDS AND INPATIENT/OUTPATIENT SURGERY
Sharon Tourville, Management Consultant to Pacific Coast Hospital, provided information on Pacific Coast Hospital’s closure of its 20 acute care beds and inpatient/outpatient surgery. This closure affects 20 employees and five managers. The Podiatric Medicine School will remain in place; the Podiatric Clinics will remain on site; the podiatric residency will remain; no laboratory will be on site; some radiology will remain on site.
Dr. Katz had given technical advice to go forward with the closure for patient safety. He also assessed there would be no public health impact with the closure.
President Guy stated that at the September 19th Commission meeting, in compliance with the Health Care Planning Ordinance (Proposition Q), the Commission will determine whether this closure will or will not be detrimental to the health service of the community.
Upon Commissioner Sanchez’s inquiry on compliance to Prop Q, Deputy City Attorney Jean Fraser indicated that due to the circumstances at Pacific Coast Hospital regarding required staffing, the Commission is in compliance.
8) PUBIC COMMENTS
Michael Misenti, Derek Silva Community Tenants Council, submitted a petition from residents of the Derek Silva facility (Catholic Charities) expressing dissatisfaction with the level of opportunity to participate in community/program development.
9) CLOSED 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.
Commissioners went into Closed Session at 4:40 p.m. Individuals in the Closed Session were Commissioners Guy, Umekubo, Chow, Hill, Parker, Sanchez, Mitch Katz, Jean Fraser, Jackie Kaur, Tony Wagner, Larry Funk, Melissa Welch, Adrianne Pon, Hiro Tokubo, Terry Hill, Sandy Mori.
C. CLOSED SESSION PURSUANT TO GOVERNMENT CODE SECTION 54956.9 AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.11(b).
CONFERENCE WITH LEGAL COUNSEL - EXISTING LITIGATION
OLLIE FERGUSON V CCSF, CASE # C98-01463 MHP, CASE # 308092, PROPOSED SETTLEMENT FOR $20,000
CONFERENCE WITH LEGAL COUNSEL – EXISTING LITIGATION
CALIFORNIA GOVERNMENT CODE SECTION 54956.9(a)
DAVIS ET AL V CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY ET AL, U.S. DISTRICT COURT FOR THE NORTHERN DISTRICT OF CALIFORNIA, CASE # C00 2352 SBA (FILED JULY 13, 2000)
The Commission came out of the Closed Session at 5:20 p.m.
D. RECONVENE IN OPEN SESSION:
1. POSSIBLE REPORT ON ACTION TAKEN IN CLOSED SESSION (GOVERNMENT CODE SECTIONS 54957.1(a)(2) AND SAN FRANCISCO ADMINISTRATIVE CODE SECTION 67.14(b)(2).)
Action Taken: The Commission approved the $20,000 settlement for the Ollie Ferguson case.
No action was taken on the Davis et al case.
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 5:25 p.m.
Sandy Ouye Mori, Executive Secretary to the Health Commission