Minutes of the Health Commission Meeting Tuesday, October 17, 2000 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 Roma P. Guy, MSW, at 3:15 p.m. Present: Commissioner Edward A. Chow, M.D. Commissioner Roma P. Guy, M.S.W. Commissioner Lee Ann Monfredini Commissioner Harrison Parker, Sr., D.D.S. Commissioner David J. Sanchez, Jr., Ph.D. Commissioner John I. Umekubo, M.D. Note: There was a change in the order of agenda items. President Guy announced that on Friday, October 13, 2000 Commissioner Ron Hill resigned from the Commission effective immediately. President Guy acknowledged his work on the Commission and his leadership as Chairman of the Budget Committee. 2) APPROVAL OF THE REGULAR MEETING OF OCTOBER 2, 2000 Action Taken: The Commission adopted the minutes of the meeting of October 3, 2000. 5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR OCTOBER On behalf of the Commission, Commissioner David Sanchez presented the October awards to the following team: Cathy Hayashida, Judy Lariviere, Suzanne Daly, and Helen H. Tong, of Population Health and Prevention were nominated by Judy Bachman and Cliff Young 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE Note: Commissioner David Sanchez chaired the Budget Committee, with Commissioner Parker and Commissioner Monfredini present. (3.1.) PHP-CHSS – Epidemiology and Disease Control – Request for approval to accept and expend a grant in the amount of $174,841 from the Centers for Disease Control and Prevention, for the development, implementation and evaluation of the viral hepatitis prevention and control program, for the period of September 30, 2000 to September 29, 2001. (3.2) PHP-Health Promotion – Request for approval to accept and expend a two-year grant from the State Office of Traffic Safety (OTS), in the amount of $798,353, for the development of a community-based mini-grant program to promote solutions to traffic safety problems occurring within a variety of geographical and socio-cultural settings, for the period of January 1, 2001 to December 31, 2002. (3.3) CHN-Pharmacy – Request for approval of a new contract with Pharmaceutical Care Network (PCN), in the amount of $8.4 million, to provide pharmacy benefits management services for uninsured Community Health Network clients, for the period of November 1, 2000 through June 30, 2002. Public Speakers: Bobbie Rabinowitz, representing SEIU Locals 250, 790 and 535, does not support approval of this contract because it would result in the closure of the outpatient SFGH pharmacy; expressed Union’s point of view that approval would be a direct violation of the MOU; urged Commission to table the issue until arbitration is completed. Tim Hessong, pharmacy technician, opposed approval of contract, which is not a money-saving measure. Michael Born, pharmacy technician, concerned about patients and services; use the Department’s own clinics and hold on to SFGH as a safety net. Nora Roman, ECSPH and CHRIA, stated this is a decrease in services to the community and represents a change in policy; abandons people who cannot pay; critical of procedures from problems with prescriptions. Frank Bashford stated the SFGH pharmacists’ salaries are too low. Ed Kinchley, ER social worker, feels there are too many loopholes in the plan; he has not seen the contract to critique it. Commissioner Monfredini asked whether privatization is in violation of the contract. Jean Fraser, Deputy City Attorney, indicated the Union is in the grievance process. The Mayor has already approved this direction through the budget process. If the Commission does not approve this contract, the contract is dead. Commissioner Parker expressed his concern about the pharmacy services and feels this program should be reconsidered. He asked whether the Department has a backup plan. He feels if a private contractor can do this, why can’t the Department do it? Commissioner Sanchez referred this item to the full Commission since there are other public speakers who wish to testify before the full Commission. (3.4) PHP-Central Administration – Request for retroactive approval of a new contract with San Francisco Study Center (SFSC), in the amount of $237,000, to provide fiscal agent services (for the Community Health Institute) for community based acupuncture, Chinese medicine and therapeutic counseling services through the Community Acupuncture Clinic program, for the period of July 1, 2000 through June 30, 2001. (3.5) PHP-CMHS – Request for retroactive approval of a contract renewal with St. Luke’s Hospital (SLH), for the provision of 24-hour acute psychiatric inpatient hospital services targeting adult Medi-Cal beneficiaries. The total contract amount for three hospital providers is $4,300,000 in Medi-Cal funds, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with SLH for services totaling $5,846,000 during FY 1999-2000). (3.6) PHP-CMHS – Request for retroactive approval of a contract renewal with St. Mary’s Medical Center (SMMC), in the amount of: (1) $300,000 in City funds, for the provision of acute psychiatric inpatient hospital, partial day hospitalization and transitional outpatient services targeting uninsured adolescents, and (2) $4,300,000 in Medi-Cal funds for three hospital providers for the provision of acute psychiatric inpatient hospital services targeting Medi-Cal beneficiaries, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with SMMC for services totaling $1,554,862 during FY 1999-2000). (3.7) PHP-CMHS – Request for retroactive approval of a contract renewal with Saint Francis Memorial Hospital (SFMH), for the provision of 24-hour acute psychiatric inpatient hospital services, in the amount of (1) $156,498 in City funds targeting uninsured adults, and (2) $4,300,000 in Medi-Cal funds for three hospital providers targeting adult Medi-Cal beneficiaries, for the period July 1, 2000 through June 30, 2001. (DPH contracted with SFMH for services totaling $156,498 during FY 1999-2000). (3.8) CHS-Housing Services – Request for retroactive renewal approval of a contract with Caduceus Outreach Services, in the amount of $95,480, to provide pro-bono psychiatric treatment to homeless and formerly homeless low income persons; case management and counseling services; and training, education and advocacy work regarding issues that affect the lives of psychiatrically-ill people, for the period of July 1, 2000 through June 30, 2001. (3.9) CHS-Housing Services – Request for approval of a renewal contract with Catholic Charities of the Archdiocese of San Francisco (CCSF), in the amount of $420,640, to provide housing with comprehensive support services to persons with AIDS or disabling HIV who are very low income residents of San Francisco, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with CCSF for services totaling $2,038,977 during FY 1999-2000). Commissioner Monfredini acknowledged a letter from Brian Cahill, interim CEO of Catholic Charities. She inquired about any heating problems in the facility. The staff of the program indicated no complaints of heating. Commissioner Sanchez pointed out the excellent services of this contractor. (3.10) CHS-Housing Services – Request for retroactive approval of a renewal contract with John Stewart Company, in the amount of $304,670, to provide property management services at the Windsor Hotel, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with John Stewart for services totaling $1,001,016 during FY 1999-2000). (3.11) CHS-Housing Services – Request for retroactive approval of a renewal contract with San Francisco AIDS Foundation (SFAF), in the amount of $469,422, to provide Partial Housing Subsidies and Housing Waitlist Services targeting very low income homeless San Francisco residents with AIDS or disabling HIV, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with SFAF for services totaling $2,662,268 during FY 1999-2000). (3.12) AIDS Office-HIV Health Services – Request for retroactive approval of a contract renewal with Community Dental Care, Inc. (CDC), in the amount of $651,429, to provide decentralized dental services targeting HIV positive, low income residents of San Francisco who are uninsured or underinsured, for the period of March 1, 2000 through February 28, 2001. (DPH contracted with CDC for services totaling $651,429 during FY 1999-2000). Michelle Dixon, AIDS Office, indicated a progress report on this contractor will be brought back to the Budget Committee in December. Commissioner Monfredini pointed out much improvement is needed with this contractor. Commissioner Sanchez expressed his concern about the capability of the contractor. He urged the Department to reassess the situation and decide to continue, discontinue, or re-bid the contract. The contractor, Gene Dowdy, DDS, provided his perspective on the program and an overview of his capacity and work on the contract. Commissioner Parker stated he has a lot of problems with this contractor. The areas in question include: frequency of services, fee schedule, distribution of services, measuring the quality of work, needs demographics of the patients, and whether there are unexpended funds. He would recommend a month-to-month contract, with retroactive approval from March 7, 2000 through October 31, 2000. Commissioner Sanchez recommended another site visit in November, with an update at the Budget Committee meeting on December 19, 2000. At the December meeting, the Department will be required to re-bid or to approve this contract from November 1, 2000 through February 28, 2001. (3.13) AIDS Office-HIV Health Services – Request for retroactive approval of a contract renewal with Glide Foundation, in the amount of $119,985, to provide case management, peer advocacy and treatment advocacy services targeting HIV positive individuals in the Tenderloin, for the period of March 1, 2000 through February 28, 2001. (DPH contracted with Glide for services totaling $419,354 during FY 1999-2000). Michelle Dixon, AIDS Office, reported improvement has been made since this monitoring report. Technical assistance is being given to this contractor. An update on this contract will be referred to the Joint Conference Committee for Population Health and Prevention in December. (3.14) AIDS Office-HIV Prevention – Request for retroactive approval of a contract renewal with Glide Foundation in the amount of $263,645, to provide HIV prevention services and counseling, testing and referral services, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with Glide for services totaling $419,354 during FY 1999-2000). (3.15) AIDS Office-HIV Prevention – Request for approval of a contract renewal with Mobilization Against AIDS International (MAAI), in the amount of $200,723, to provide HIV prevention services to Latino youth between the ages of 16 and 24 and Latino adults and transgenders 25 years and over, for the period of October 1, 2000 through June 30, 2001. (DPH contracted with MAAI for services totaling $323,625 during FY 1999-2000). Commissioners requested an update in two months (December 19, 2000) at the Budget Committee meeting. Commissioner Monfredini stated her displeasure with this monitoring report. Public Speaker: Michael Petrelis opposed approval of the contract. (3.16) AIDS Office-HIV Prevention – Request for retroactive approval of a contract renewal with Regents of the University of California at San Francisco (UCSF) - AIDS Health Project, in the amount of $176,914 per year for two years, for a total of $353,828, to provide HIV prevention services targeting behavioral risk populations, for the period of July 1, 2000 through June 30, 2002. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). Commissioner Sanchez abstained due to conflict of interest. (3.17) AIDS Office-HIV Prevention – Request for retroactive approval of a contract renewal with Regents of the University of California at San Francisco (UCSF) - AIDS Health Project, in the amount of $327,420, to provide HIV counseling, testing and referral services, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). Public Speaker: Michael Petrelis spoke against giving funds to this contractor. Commissioner Sanchez abstained due to conflict of interest. (3.18) PHP-Housing - Approval of a supplemental appropriation of $250,000 in general funds for a transitional housing program for homeless Lesbian, Gay, Bisexual, Transgender, Queer and Questioning (LGBTQQ) young adults. Public Speaker: Mitch Thompson, S.F. Recreation and Park, supported the program and the young people being served. Commissioner Chow commented that problem contracts should be identified earlier prior to being calendared t the Budget Committee. Commissioner Parker observed there were 13 retroactive contracts on today’s Budget Committee agenda. Action Taken: The Commission approved the Consent Calendar: 3.1, 3.2, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 3.10,. 3.11, 3.12, 3.13, 3.14, 3.15, 3.15, 3.16, 3.17 and 3.18. Due to conflict of interests, Commissioner Umekubo abstained on #3.6 and Commissioner Sanchez abstained on #3.16 and #3.17. Item #3.3 was referred to the full Commission for a decision. (3.3) CHN-Pharmacy – Request for approval of a new contract with Pharmaceutical Care Network (PCN), in the amount of $8.4 million, to provide pharmacy benefits management services for uninsured Community Health Network clients, for the period of November 1, 2000 through June 30, 2002. Monique Zmuda, Chief Financial Officer, provided a summary of the proposed new contract with PCN. Public Speakers: Bobby Rabinowitz, SEIU Local 250, urged the Commission to table this matter pending a Union arbitration process. Dale Butler, SEIU Local 790, advocated not to contract out the pharmacy services and to table the issue. Virginia Leyva, Bay Area Legal Aid, stated the closure of the outpatient pharmacy at SFGH will negatively impact low-income clients; asked Commission to reconsider. Rosalyne S. Montgomery, Transgenders United for Equality, advocated not to close the outpatient pharmacy. Michael Lyon, Emergency Coalition, opposed approval of contract. Lynn S. Carman, attorney, stated this contract is a bureaucratic nightmare; requested Commission to take this issue off the calendar. Mary Magee, Local 790, described the impact of this plan on pregnant women. Ed Kinchley, SFGH social worker, advocated to table this contract; accused Deputy City Attorney of half-truths; no documentation this plan will save money. Aurora Grajeda, TransAction Y, stated health services are not to make a profit but to serve the poor; withdrew an award to Dr. Katz from a transgender group Nora Roman, ECSPH/CHRIA, discussed inadequacies of the contract; poor planning of DPH; this plan is decreasing services; no fee waivers, no quality assurance. Josie Mooney, SEIU 790, indicated reasonable people can differ from time to time, there would be serious consequences of this contract; this would be in violation of the Union contract and a clear effort to undermine the Union contract. Maria Martinez, Mission/Bernal Heights, commented on the impact on neighborhood clinics; critical for poor people and patients who use the SFGH outpatient pharmacy. Commissioner Monfredini expressed concern about moving forward to approve this contract if the Department is not honoring the Union contract. Jean Fraser, Deputy City Attorney,  Commissioner Monfredini observed that if today the Commission does not approve the contract, the issue dies. If approved, the issue moves forward to the next stage in the process. Commissioner Sanchez questioned tabling the issue; if this issue is tabled, nothing would go forward. President Guy asked Commissioners to reopen testimony from the public. Commissioner Chow questioned reopening public testimony. He would support reopening if it applies to everyone and not only certain speakers. Dr. Katz clarified some misinformation given by some of the public speakers. He described the similar prescription program for mental health and AIDS patients; the formulary issue; the 116 choices of where to go for medication; the legal questions which were adequately answered by Ms. Fraser, Deputy City Attorney; and the budget approval process was already supported by the Health Commission, Board of Supervisors and the Mayor. President Guy stated every Commissioner may ask questions of individuals providing public testimony. She requested clarification from Josie Mooney, SEIU 790, on her point that no City Department can initiate contracting out. Ms. Mooney stated if the Commission tables this item, the Union will meet before going to arbitration. Otherwise, the Union will seek an injunction. She stated she was not here to delay the contract; she was here to kill it. Commissioner Sanchez asked about the evaluation of these pharmacy services and how is quality assurance integrated into this contract. He moved to table the contract, but there was no second to his motion. Commissioner Monfredini expressed her uncomfortableness about moving forward to approve this contract. She would like more discussion and information on the contract. She also would like more legal information and would want to have an understanding of the Mayor’s perspective on this situation. She would be in favor of continuing this item for more education and information. Commissioner Umekubo would like more information on the contractor, the quality of care, and access to care. Commissioner Parker supports patient satisfaction and patient convenience. He suggested doing a pilot project. President Guy felt a resolution to this issue would not be here at the Health Commission but should be with the Mayor. Dr. Katz reminded the Commission of the November 1, 2000 start date for this contract. There would be financial consequences. Dr. Katz encouraged the Commission to vote up or down because this has been a long process; and the Commission had already adopted the policy issue through the budget process. Dr. Katz recommended the Commission consider a special meeting of the Commission if there is a continuance. Action Taken: The Commission unanimously voted to continue #3.3 to a special Commission meeting on Tuesday, October 31, 2000 at 3:00 p.m. The Commission requested this issue be discussed at a meeting with the Mayor prior to October 31, 2000. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) (Report on activities and operations of the Department, and may include activities within the Community Health Network and Population Health and Prevention Divisions). ADMINISTRATION Combined Charities The annual Combined Charities campaign kicks off October 23rd. Please look for information and pledge forms that will be handed out with paychecks October 24th. If you have any questions, please ask your campaign coordinator. Anne Kronenberg, overall DPH coordinator, LaFrancine Tate, SFGH coordinator, Steve Koneffklatt, LHH coordinator and Wayne Clark, coordinator for PH&P. POPULATION HEALTH AND PREVENTION Grants The Department received a letter from the Center for Substance Abuse Treatment (CSAT) awarding funds for the Action Point II grant (HIV Treatment Capacity Expansion). This grant will support HIV medication adherence for 70 HIV+ individuals who reside in the Bayview as well as methadone maintenance treatment for 40 of those 70 clients. This project will be a collaboration between Population Health and Prevention and Southeast Health Center and the Institute for Community Health Outreach/Nia. The grant covers these services for 3 years. STD Prevention and Control The STD branch continues to be awarded grants for a variety of programs. These incude: $50,000 for monitoring trends and prevalence of STDs, TB and HIV risk behaviors among MSMs who seek services at City Clinic and the Tom Waddell Transgender Clinic. $277,930 for integrated surveillance systems for communicable diseases to link AIDS data with STD data and other variables. $40,000 for monitoring the prevalence of STDs and TB infections among persons entering SF County. Community Health Promotion and Prevention The San Francisco Violence Prevention Network is sponsoring "Peace it Together" - a day to join together to promote peace & prevent violence using a public health approach. The event will provide examples of effective public health models to address violence prevention that relate to alcohol, firearms and witnessing violence. The sponsors hope to gain specific input and direction from forum participants to continue development of a long-range strategic plan for Violence Prevention in San Francisco, including identification of activities. The event will be held on October 25th from 8:00 am - 5:00 pm at the California State Building. Peace it Together brochure is on the home page of the DPH website. Newcomer's Program The 20th Anniversary Celebration of Newcomers Health Program and Refugee Medical Clinic will be held November 1st, from 3:00-5:30pm at Refugee Medical Clinic (SFGH Campus, Building 80, Ward 85). We would like to extend a special invitation to the Health Commission to attend. Staff, providers and volunteers should RSVP to Patricia Erwin at 705-8553. COMMUNITY HEALTH NETWORK Community Initiative – Prostate Cancer Last Saturday the African-American Men’s Health Initiative, an initiative of the Bayview Hunters Point Health and Environmental Resource Center, sponsored a successful community education program focusing on screening of prostate cancer. Prostate cancer is a disease with high incidence among African-American males. Cynthia Selmar, Commissioner Parker and Dr. Arthur Coleman were acknowledged at the program with awards for the leadership in this effort. Among those participating in the day’s event were Mayor Brown, Supervisor Amos Brown, Dr. Mack Roach, Commissioners Roma Guy and Harrison Parker, Tony Wagner, Dr. Melissa Welch, Health Center Directors Michael Pile and Freddie Smith Employee Recognition Dinners The Laguna Honda Hospital 19th Annual Employee Recognition Buffet Dinner, Halloween Ball and Costume Contest will be held Friday, October 20, 2000 at Patio Espanol, 2850 Alemany Blvd. Beginning at 6:00 p.m. until 11:30 p.m. The SFGH Employee Recognition Banquet will be held Nov 17th in the cafeteria at SFGH. All SFGH and UCSF employees with 10, 15, 20, 25, 30, 35 or more years of service will be honored. Successful North of Market Senior Services Annual Dinner Congratulations go out to Gay Kaplan, Director North of Market Senior Services, Terri Brown and Arla Escontrias, dinner co-chairs of this year's Annual Tribute Dinner held October 12th at the Argent Hotel. The event was lively, elegant and met this year's fundraising goal. Attendance was high and included a special visit from Mayor Brown. Honorees for this year's Francis J. Curry award were: New Leaf Outreach to Elders program, for their "lunch bunch" program, and Evan White, Bay T.V. News Anchor- a long time champion of services to the elderly and underserved. The recipient of the Joseph Mignola, Jr. award went to the Arc for their innovative/collaborative services to the Developmentally Disabled adult. SFGH Credentials Report 10/00 2000 YTD New Appointments 13 150 Reinstatements 1 10 Reappointments 45 340 Delinquencies 0 0 Reappointment Denials 0 0 Resigned/Retired 12 130 Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0 0 Changes in Privileges     Additions 2 4 Voluntary Relinquishments 2 2 Public Speakers: Todd Swindell, Act Up/SF, claims the Department is not up front about accurate numbers for rectal gonorrhea, syphilis, shigella; referred to Dr. Katz’s letter to the Bay Area Reporter. 6) UPDATE FROM THE LONG-TERM CARE TASK FORCE (AB 1040) Tony Wagner, Co-Chair of the Task Force and Executive Administrator for the Community Health Network introduced Sandra Nathan, newly appointed by Mayor Brown as the Department head for the new Aging and Adult Services Department. Ms. Nathan thanked the Commissioners for the opportunity to speak. She expressed her agreement with the findings of the Long-Term Care task Force. She welcomed the opportunity to decrease Department barriers and to broaden the view of having a coordinated system of care so that seniors and disabled can maintain themselves in the community. She would like to move in an integrated fashion. Mr. Wagner; Jennie Chin-Hansen, Co-Chair of the task Force and On Lok Executive Director; and Bill Haskell, Project coordinator for the task Force, provided an update on the activities of the Long-Term Care Pilot Project Task Force since April 2000, and its efforts to develop a comprehensive plan to improve long-term care service delivery for older and disabled adults; and propose a long-term care integration pilot project in San Francisco to the State Department of Health Services (DHS). In summary, the Task Force has adopted recommendations related to: governance structure; waiver authority; and project phasing. First, the Task Force recommends that a Governance Working Group be established to re-evaluate all options for the governance structure of a pilot project and develop a proposal by March 2001. Second, the Task Force recommends that concurrent 1915(b)(c) Medicaid waivers be sought on behalf of San Francisco by the State Department of Health Services, Office of Long-Term Care, as a basis upon which to implement a pilot project. Third, the Task Force recommends that the pilot project be implemented in manageable incremental phases; the first and second phases under the current fee-for-service reimbursement system, and the third phase (if determined desirable) under capitated managed care. The complete report is available at the Commission Office. The other topics covered were service-related and administrative costs of a pilot project, relationship of the pilot project to Laguna Honda Hospital, the continuing role for DPH, and relationship of the pilot project to the Department’s Strategic Plan. Mr. Wagner outlined the next steps. Commissioner Chow commented the plan so far is a reasonable proposal. He commended the Tank Force’s ability to change with the circumstances and to incorporate the Commission’s concerns. He supports the integrated approach. Commissioner Umekubo, concerned about the financing aspects of the plan, asked if there is a commitment to funding the waivers. There have been no commitments. Commissioner Sanchez commended the Task Force in establishing a world class model. Public Speakers: Marie Jobling, PECC, supports the planning process; shared results of meetings with consumers; submitted document of the Long-Term Care Consumer Empowerment Project. Luis Calderon, CIAPA, advocated for a strong role for consumers; promoted the concept of "nothing about us without us." Fran Watkins, consumer, promoted the waiver concept; does not want to be on welfare; is looking for ways to protect her assets. Gloria Williams, PECC, SAN and CIAPA, supports affordable housing with support systems to keep people at home. Debra Howell, PECC, urged the Commission to remember the "upper poor;" urged expansion of IHSS Share of Cost pilot project, the increase for eligibility, and an initiative for long-term care. President Guy commended the Task Force for a comprehensive report. She acknowledged the work of Bill Haskell, Project Coordinator, and indicated her support for this social/medical model with case management. She would like the Task Force’s recommendations and final report to come back to the Commission in January or February. Mr. Wagner will check with the Task Force and get back to President Guy. 7) PUBLIC COMMENTS Michael Petrelis, AIDS.Statistics.com, posed questions on cutting salaries before cutting services; submitted his letter to Dr. Jeff Klausner on the annual 1999 STD Report, his letter to Dr. Katz on an HIV consensus meeting, and a letter from Donna Shalala to Congressman Tom Coburn. Ronnie Burk, Act UP/SF, commented on AIDS services, a former Health Commissioner; sees continued greed and graft of funds; reconsider the direction of the City. Betty Best, Act Up/SF, concerned with the state of public health and the budget; need for more emphasis on nutrition; San Francisco is in a lot of trouble. Todd Swindell, Act Up/SF, referred to a new article on a former Health Commissioner; promoted the appointment of an Act Up/SF person to the Health Commission; observes greed and corruption in San Francisco on the backs of gay men. 8) OTHER BUSINESS/PUBLIC COMMENTS None. The meeting was adjourned at 7:00 p.m. Sandy Ouye Mori, Executive Secretary to the Health Commission