Minutes of the Health Commission Meeting Tuesday, March 20, 2001 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 3:05 p.m. Present During the Meeting: Commissioner Edward A. Chow, M.D. Commissioner Roma P. Guy, M.S.W. Commissioner Arthur M. Jackson Commissioner Lee Ann Monfredini Commissioner Harrison Parker, Sr., D.D.S. Commissioner David J. Sanchez, Jr., Ph.D. Commissioner John I. Umekubo, M.D. 2) APPROVAL OF MINUTES OF THE REGULAR MEETING OF MARCH 6, 2001 Action Taken: The Commission adopted the minutes of March 6, 2001. 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner Arthur M. Jackson) (3.1) CHN - Request for approval to accept and expend a new three-year grant from The California Endowment, in the amount of $399,386 for “Integrated Behavioral and Physical Health Care in Community-Based Public Health Clinics”, for the period of February 15, 2001 to February 14, 2004. CHN-LHH/HAH - Request for approval of a new contract with Healthcare Financial Solutions, in the amount of $57,202 to provide reimbursement and revenue optimization services for Laguna Honda Hospital and Health at Home Agency, for the period of April 1, 2001 through March 31, 2002. (3.3) PHP-Children’s Environmental Health Promotion - Request for approval to accept and expend a grant from the State Department of Health Services in the amount of $435,000, for “Removing Barriers to Effective Asthma Management for Infants, Toddlers and Children up to Five Years of Age”, for the period of March 1, 2001 to June 30, 2002, and approval of two sole source contracts, one with the American Lung Association for $123,877, and one with the San Francisco State University/Yes We Can Urban Asthma Partnership for $225,548, both for the period of April 1, 2001 to June 30, 2002. (3.4) PHP-CMHS - Request for approval to accept and expend a new two-year grant from Eli Lilly and Company to fund the sole source contract with Westside Community Mental Health Crisis and Outpatient Clinic in the amount of $250,000 to enhance medication adherence for clients of Community Mental Health Services, for the period of May 1, 2001 to April 30, 2003. (3.5) PHP-CMHS - Request for approval of a retroactive new sole source contract with Mt. Diablo Medical Pavilion for the provision of acute psychiatric inpatient hospital services targeting uninsured children and adolescents, in the amount of $200,000 in City funds, for the period of January 1, 2001 through June 30, 2002, and in the amount of $4,300,000 in Medi-Cal funds for four hospital providers targeting Medi-Cal beneficiaries, for the period of July 1, 2000 through June 30, 2001. (3.6) PHP-CMHS - Request for approval of a retroactive contract modification with Edgewood Center for Children and Families in the amount of $99,990 to establish a placement alternative consortium for youth needing residential care, for the period of March 1, 2001 through December 31, 2001. (DPH contracted with Edgewood for services totaling $1,761,526 during FY 1999-2000). (3.7) AIDS Office - Request for approval of a retroactive renewal agreement with the State of California Department of Rehabilitation, San Francisco District (DR), in the amount of $116,859 to enable San Francisco to leverage Federal/State vocational rehabilitation funds of $420,060, to provide vocational rehabilitation services targeting persons with HIV/AIDS seeking to enter/re-enter employment, for the period of July 1, 2000 through June 30, 2001. (DPH contracted with DR for services totaling $114,000 during FY 1999-2000). (3.8) AIDS Office - Request for approval of the FY 2001-2001 Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 Title I, Title II and General Fund contracts for a combined total of $35,853,088, for the period of March 2001 through February 28, 2002 for Title I funds, April 1, 2001 through March 31, 2002 for Title II funds and July 1, 2001 through June 30, 2002 for General Fund programs with the following agencies: AIDS Emergency Fund AIDS Legal Referral Panel American College of Traditional Chinese Medicine Asian Pacific Islander Wellness Center Baker Places Bar Association of San Francisco Catholic Charities California AIDS Intervention Training Center Chemical Awareness & Treatment Services, Inc. CompassPoint Nonprofit Services Continuum HIV Day Services Dolores Street Community Services Family Service Agency of San Francisco Family Support Services of the Bay Area Glide Foundation Haight Ashbury Free Medical Clinics, Inc. Immune Enhancement Project Instituto Familiar de la Raza Iris Center Legal Services for Children Lutheran Social Services Lyon-Martin Women’s Health Services Maitri AIDS Hospice Marin County Mission Neighborhood Health Center New Leaf Positive Resource Center Project Open Hand Quan Yin Healing Arts Center San Francisco Community Clinic Consortium SFDPH Community Health Network -Forensics Services SFDPH Community Health Network -Health at Home SFDPH Community Health Network - Primary Care SFDPH Community Health Network -SFGH SFDPH Community Health Network-SFGH-Positive Health Pract. SFDPH Community Health Network-Tom Waddell SFDPH PHP Mental Health Services SFDPH PHP Public Health Laboratory SFDPH PHP STD Services SFDPH PHP Substance Abuse Services SFDPH PHP Housing Services Ark of Refuge, Inc Baker Places Black Coalition on AIDS Catholic Charities Larkin Street Youth Center Lutheran Social Services San Francisco AIDS Foundation Walden House San Francisco Food Bank San Francisco Suicide Prevention San Mateo County Shanti Project Tenderloin AIDS Resource Center UCSF/AIDS Health Project UCSF/Center on Deafness UCSF/Pediatric AIDS Program UCSF/Substance Abuse Services UCSF/ Women’s Specialty Clinic University of the Pacific-School of Dentistry Walden House Westside Community Mental Health Services     Commissioners’ Comments: The Commission agreed that St. Mary’s Medical Center funding in the amount of $1,234,862 shall not be approved, pending an update from the Department of Public Health concerning the relocation of St. Mary’s AIDS-Dementia Unit patients to St. Mary’s Skilled Nursing Facility (SNF). Commissioners Monfredini and Jackson posed questions concerning, among other things, the number of clients served and the methods for identifying clients. Commissioners Guy, Chow, Monfredini, and Jackson expressed concerns regarding St. Mary’s Medical Center, especially in light of the Proposition Q question. The Department assured the Commission that the Department is in communication with St. Mary’s, and would report back to the Commission. Action Taken: The Commission approved the Consent Calendar of the Budget Committee. Commissioner Guy abstained on the San Francisco State University contract on #3.3; Commissioner Jackson abstained on the Westside Community Mental Health Crisis and Outpatient Clinic, #3.4 and #3.8; Commissioner Sanchez abstained on the UCSF contract on #3.8; and Commissioner Umekubo abstained on the St. Mary’s contract on #3.8. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) ADMINISTRATION State Charity Care Report Last year the California Legislature enacted AB 2276 (Cedillo) which requires the California Attorney General to prepare a plan for evaluating whether additional charity care or community benefits standards should be imposed on non-profit hospitals in the State. Last week the Attorney General (AG) issued a plan identifying key issues that should be considered in establishing such standards. The AG acknowledges that California does not impose any substantive charity care or community benefits standards on non-profit hospitals. You may recall that SB 697 (Torres) imposes a planning and reporting duty on non-profit hospitals with respect to the community benefits they provide. The AG recommended the following: The Legislature should designate a lead agency to perform the evaluation. Currently, the Health and Human Services Agency, Attorney General and Department of Managed Health Care provide oversight to non-profit hospitals. The evaluation should include an examination and formulation of uniform standards to be applied to non-profit hospital transactions. Specifically, the Attorney General proposes that definitions and measurements of charity care and community benefits be developed. The lack of a uniform and an agreed-upon definition has thwarted attempts to do a comprehensive assessment of charity care. The Legislature should define the scope of issues related to the role that Boards of Directors of non-profit hospitals play in ensuring the delivery of appropriate care and community benefits to their communities. The Legislature should define the scope and the methods of assessing the impact of corporate structure on the delivery of healthcare and community benefits by non-profit hospitals. The Legislature should direct the evaluator to develop alternatives to adopting charity care and community benefits standards and to provide assessments of health and financial impacts of each alternative on affected stakeholders. The lead agency should ensure input from a wide-range of stakeholders. The Legislature should establish realistic budget and deadlines for the evaluation. The AG’s report is currently being reviewed by the Legislature. The Legislature has an opportunity to either ask for additional information from the AG and/or start the evaluation process by designating a lead agency to perform the evaluation with respect to charity care and community benefits standards. The Department will keep the Health Commission apprised on this effort as it proceeds. On a similar note, it has been reported that the Internal Revenue Service has issued a field service advice memorandum on charity care provided by tax-exempt hospitals (Modern Healthcare). The IRS memorandum indicates that a hospital policy on indigent care is insufficient to satisfy the charity-care requirement of a community-benefits standard. It further states that “a hospital also must show that it actually provided significant healthcare services to the indigent.” While the memorandum carries no legal precedent, it does provide a glimpse into the IRS’ enforcement approach. The memorandum cites several revenue rulings and court decisions that support its position. According to the IRS, providing free or subsidized care to the indigent is an important indicator to the courts and the agency that a hospital promotes community health. The IRS also provides a series questions that staff can ask to determine a hospital’s charitable policies and activities. POPULATION HEALTH AND PREVENTION Mental Health Community Mental Health and the California Institute of Mental Health are sponsoring a conference on April 26th called "Pathways to Wellness": A Dialogue on Recovery. The conference will examine: What recovery is and its roots in rehabilitation Services and approaches to improve client access Tools to increase the quality of client/provider relationships Its impact on adult and children services The conference will feature clients, providers and family members talking about their experiences with recovery. SRO Task Force A workgroup from the SRO Families Task Force Committee held a forum to study the impact on the development of children and families growing up in SRO's. The meeting was a success and included over 40 representatives from advocacy groups, City agencies and providers. The group examined issues relating to the physical, psychological, social and cognitive development of children living in these buildings. An outcome of the forum was a series of recommendations about how to improve the health and well-being of children living in SRO’s. COMMUNITY HEALTH NETWORK Laguna Honda Hospital Update Health At Home and Laguna Honda Increase Collaboration Members of the Health At Home leadership team visited Laguna Honda on March 7th to discuss increasing collaboration in getting Laguna residents into community settings. The Health At Home Medical Director, Chief of Client Services, and Chief of Social Services met with the entire Laguna Social Services Department and select nursing and medical staff. All parties agreed that having health At Home staff members meet with the Laguna resident and interdisciplinary team before discharge and having Laguna staff meet with the resident and Health At Home tem after discharge - would increases residents’ chances of successful community placement. Laguna Honda Hires two Peer Counselors In February, Vincent Beehan became the peer mentor coordinator at Laguna Honda Hospital. Mr. Beehan serves on the Board of the Public Authority and the Mayor’s Disability Council. In March, Karen Young-Simmons began work as the first peer mentor. Peer mentors can have inestimable value in reducing institutional dependence by serving as role models for successful community living. They will help Laguna Honda residents find resources, learn transportation routes, and develop contingency plans for mishaps. Residents who are actively seeking discharge or contemplating discharge are eligible for peer mentor services. Three Laguna Honda Clinicians Chosen for Pain Program The University of California Academic Geriatric Resource Program recruited three Laguna Honda staff members to attend a program called “Managing Pain and Suffering in the Elderly” in Los Angeles on March 15-16. Anne Hughes, RN, CNS, NP, Michelle Fouts, PharmD, and Victoria Behrman, MD will attend the train-the-trainer conference, which will be led by a nationally known team of experts. The Academic Geriatric Resource Program is covering the expenses of the Laguna staff members with the understanding that they will train others in cutting edge programs to reduce pain and suffering. Personnel Announcements New Director for Quality Improvement Department at Laguna Honda Mivic Hirose has accepted the position of the Director of Quality Improvement at Laguna Honda Hospital. Ms. Hirose has served as Assistant Director of Nursing for approximately 1-1/2 years. We are developing a transition plan, which will allow for Ms. Hirose to assume her new duties in a timely manner. I will to extend my personal thanks to Hiro Tokubo who has served as the Interim Director for many months in addition to his CHN responsibilities. Examiner’s Bay to Breaker’s Event to benefit LHH Mr. Ted Fang, new owner of the San Francisco “Examiner”, has advised Laguna Honda Hospital of his desire to have the LHH Replacement Project be one of the beneficiaries of proceeds from this year’s Bay to Breaker’s event. Mr. Fang has indicated a preference to have the proceeds apply to furnish and equip the new Childcare Center which will be an integral component of the new campus. We extend our appreciation and gratitude to Mr. Fang for this thoughtful generosity and continued support for the mission of Laguna Honda. SFGH Credentials Report 03/01 2001 YTD New Appointments 02 08   Reinstatements 02 02 Reappointments 46 128   Delinquencies 0 0 Reappointment Denials 0 0 Resigned/Retired 11 33 Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0  0 Changes in Privileges       Additions 03 08   Voluntary Relinquishments 03 04 5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE AWARDS FOR MARCH 2001 On behalf of the Commission, Commissioner Jackson presented awards to the following: Individual Nominees Jackie Clarke, RN Division CHN - Forensics - Health Services Nominated by Joe Goldenson, M.D., Medical Director, Jail Health Services Dora Chang CHN - Forensics - Health Services Frank Patt, Assistant Director, Jail Health Services Kathryn Eng, Director, Health at Home CHN - Health at Home Gene O’Connell, Executive Administrator, SFGH        Team Nominees Regina Pera Gina Garcia Maria Aleman Christia Mea Melody Doan Michelle Valentin Allan Gonzalez-Ruiz Ruth Barretto Andy Chow Donna Childers Ronald Alvarez Division PH&P Human Resources and PH&P MIS Nominated by Frank Patt, Assistant Director, Jail Health Services Diana Guevara Donna Louie John Aaron Ed Ang Sheri Lee Robert Perry Agnes Davis CHN-SFGH - Patient Financial Services Ken Jensen 6) PRESENTATION AND CONSIDERATION OF A RESOLUTION RECOMMENDING THE SAN FRANCISCO GENERAL HOSPITAL REBUILD Gene O’Connell, Executive Administrator, San Francisco General Hospital, and Carlos Villalva, Executive Project Manager, briefed the Commission concerning the San Francisco General Hospital (SFGH) rebuild project. Their briefing began with an overview of the background issues, planning processes, assumptions, and charges. They then presented detailed, site-specific rebuild considerations. The briefing identified three bond options: $472.7 million; $387.8 million; and $299.8 million. The presenters described legislative considerations and next steps in the process, including completing the SFGH Institutional Master Plan, collaborating further with UCSF, and increasing community dialogue. The presenters recommended waiting until 2002 to bring a bond measure before the voters, which they stated would provide the Department of Health with additional time to build upon the original assumptions, incorporate the legislative changes and Master Plan, explore collaborative efforts with UCSF, and elicit further community input. Public Speakers Christopher Sabre, stated that he lives 2 ½ blocks from the site, and is concerned about the size of the project. In his view, there have been inadequate community meetings. Rae Ann Emery said that the new project will take views away from her residence. She asked that the project not be rushed. Judith Berkowitz stated that not enough planning had been done, and that the project was not a rebuild, but an expansion. She asked the Commission to postpone consideration of the measure. Babette Drefke said that she was a long time Potrero Hill resident. Her suggestions to the Commission included: conform to a 40 foot height limit; do not build up to property line; do not expand buildings on hospital grounds; keeps lawns and greenery; and retrofit the red brick buildings. Dr. H. T. Debas, Dean, UCSF School of Medicine and Vice Chancellor for Medical Affairs, served on the rebuild planning committee and supported that process. He asked the Commission to consider the academic and research needs of the faculty. Michael Lyon stated that there was a concentration of medical facilities for the indigent around San Francisco General Hospital. He stated that the SFGH plan may be insufficient to meet future medical needs. Nora Roman, Emergency Coalition to Save Public Health, stated that she was happy that the Department’s recommendation is not to bring a bond measure before the voter’s now. She said that there had been only one community meeting held on this issue, and that the plan needed more community and worker input. Dr. Katz’s Comments Dr. Katz thanked Gene O’Connell and her staff for their good work. He added that there are many issues related to rebuild project ahead next year, including: 1) State legislation, especially issues relating to seismic standards; 2) how to best collaborate with UCSF, and 3) addressing community interests. He further stated that the Department will know more about pending State legislation in October or November. Commissioners’ Comments Echoed Dr. Katz’s comments, congratulating staff for their good work, including the amount of work that staff accomplished in a short period of time Pleased with recommendations; 2002 date provides opportunities to work through many of the issues raised Raised the need to respond to issues concerning UCSF collaboration and research aspects Raised the need to respond to issues of technology, and the increase of dually diagnosed and psychiatric patients in the Emergency Department. Stressed the need for more community input concerning the rebuild project The Department and Commissioners agreed that the Department would present a progress report to the Commission by October 2001. Action Taken: The Commission agreed with the recommendation to wait until 2002 to bring a bond measure before the voters The Commission directed the Department to present a SFGH Rebuild Progress Report to the Commission by October 2001 7) PUBLIC HEARING IN ACCORDANCE WITH THE HEALTH CARE PLANNING ORDINANCE - (PROPOSITION Q, 1988), TO CONSIDER THE IMPACT OF CHANGES ON HEALTH CARE SERVICES TO THE COMMUNITY AT ST. MARY’S MEDICAL CENTER Several representatives from St. Mary’s Medical Center (SMMC) made presentation to the Commission during the Proposition Q hearing. Ken Steele, Interim President at SMMC, began with an overview of the SMCC and Proposition Q. He apologized to the Commission for not providing the required 90 days notice for three of the four program closures. Mr. Steele stated that he looks forward to improving the communication between President Guy, the Commission, Dr. Katz, and himself. Mr. Steele stated that, as a result of the actions taken in January and February 2001, St. Mary’s financial picture has improved dramatically. He told the community that St. Mary’s is not closing, is not for sale, and that he wants to ensure the viability of St. Mary’s now and far into the future. He described each closed program, closure dates, number of staff and patients impacted: Adult Partial Hospital Program (closed February 25, 2001); the Outpatient Psychology Clinic (will close June 30, 2001); the Outpatient Pediatric Clinic (closure date: March 23, 2001); and the Radiology Oncology Service (transferred to St. Francis Hospital, March 2001). Mr. Steele also discussed two other SMCC Units. These are the HIV-Care Unit, which Mr. Steele said was relocated to another SNF Unit at SMCC, with patients receiving the same service at a different location, and the Medical-Psychiatric Unit whose patients were transferred to different St. Mary programs. In addition to Mr. Steele, several other SMCC representatives presented before the Commission: Stephen Krause, M.D., Medical Director of McAuley Institute; Brother George Cherrie, Director of Mission Services, Spiritual Care, and Community Services; and Jim Illig, Chair of the SMMC Community Advisory Committee. They described in further detail the financial, clinical, and staffing aspects concerning the closure or transfer of the SMCC programs. Public Speakers Allen Fitzpatrick, R.N., stated that the skilled nursing staff from the HIV Dementia Care Unit has been laid off, and the patients no longer have the freedom, care, and support that they experienced. He further stated that the nurses in the skilled nursing unit received proper orientation or training to enable them to safely care for the new patients. George Ouellette, R.N., told the Commission said that he has been a nurse at St. Mary’s for 23 years. He stated that some patients are displaced into units were they do not receive proper care, and patients at risk due to their wandering tendencies. Helga Carltonis is a CNA (certified nursing assistant) at St. Mary’s. She described a patient that she observed as increasingly isolated, hopeless, and despondent, and who counts on St. Mary’s for care and safety. Rob Eshelman is legislative aide for Supervisor Matt Gonzalez. He spoke about the Supervisor’s views generally concerning Proposition Q, and St. Mary’s failure to notify properly the Commission. Mr. Eshelman stated that as private hospitals make cuts, the need for health care grows, and the impact on SFGH increases. He asked the Commission to take steps to minimize the impact of the program closures. He also spoke about a proposed ordinance that would add an enforcement mechanism to Proposition Q. Sheila O’Neill, a nurse at St. Mary’s, spoke about St. Mary’s patients with AIDS-related dementia. She stated that St. Mary’s is no longer offering a separate, locked unit for these patients’ safety. In addition, Ms. O’Neill stated these patients now housed in the SNF Unit, are at risk and place other patients at risk. Nancy Borsocchini is a staff nurse at St. Mary’s skilled nursing care unit, into which the AIDS-dementia unit was incorporated. She stated that wanderguard alarm bracelets and anklets now have to be used for patients who were formerly in a secure unit. Ms. Borsocchini told the Commission that one day the alarms went off 28 times in one hour. She further stated that there is not enough staff to watch these patients on Saturday evening and Sunday. Ray Castro, R.N. at St. Mary’s, worked at the medical-psychiatric Unit for 15 years, and opened the AIDS-dementia unit about ten years ago. He stated that these patients need specialized treatment and staff. Fred Seavey, SEIU, Local 250, regrets the contraction of health care in recent years. He urges St. Mary’s to work with the City, employees, and unions to ensure that St. Mary’s patients have access to the health care that they need. Lisa Cohn, Ph.D., spoke concerning the closure of the Adult Psychiatric Partial Hospitalization and After Care Intensive Outpatient programs at SMMC. She wants the patients to stabilize, increase their functioning, and live the highest quality of life at the lowest level of care. Dr. Cohn is concerned about the psychological impact of repeatedly disrupting patients’ services for this patient population. Nora Roman, Emergency Coalition to Save Public Health, stated that non-profit hospitals should serve the community. She stated that the standard for charity care nationwide is 3%, but that Catholic Healthcare West devotes less than 1% of its gross revenue to charity care. She was opposed to the St. Mary’s closures. Mary Ellen Deignan is a 30-year employee at St. Mary’s Hospital. She described examples of where the closures increase the need to find proper placement for the patients. Dr. Katz’s Comments Dr. Katz described the value of Proposition Q public hearings and Commission debate to evaluate different ideas. He stated that closing the Radiation Oncology Unit may have a positive impact for public health. Dr. Katz suggested that regionalizing expensive equipment purchases, such as a linear accelerator, health care institutions are able to spend more money locally for the types of services that people need more frequently and closer to patients’ homes. Commissioners’ Comments Noted that Proposition Q concerns not only program closures, but also assesses the impact of reducing or eliminating services provided. Need to ensure an opportunity for public dialogue in advance of closures or reductions, as envisioned by Proposition Q. Acknowledged Mr. Steele’s apology concerning St. Mary’s failure to notify the Commission properly, but stated that St. Mary’s lack of proper notification is not tolerable. Noted that this is not the first time that St. Mary’s notification had been late; the Commission’s 1998 resolution (#23-98) concerning another St. Mary’s Medical Center program closure stated that St. Mary’s failure to provide proper notice was isolated, and that the Commission could count on St. Mary’s compliance in the future Expressed concern about the safety of patients and quality of care during the transfer period Noted the City’s contract with the St. Mary’s AIDS-Dementia Unit, and the public testimony concerning St. Mary’s not providing these patients with proper care and safety due to downsizing. There are sharp differences between the testimony of St. Mary’s officials and public comment by St. Mary’s clinical staff. Need to ensure that patients are provided appropriate clinical services and are kept safe, and that the facts concerning patient care and safety are reported correctly to the Commission Requested St. Mary’s and the Department to provide the Commission, for the Commission meeting of April 3, 2001, with a Monitoring Report concerning the level of care, safety, and other issues concerning patients from St. Mary’s AIDS-Dementia Unit, and on the issue of governance President Guy requested an update from Mr. Steele regarding the care and safety of patients moved from the St. Mary’s AIDS-Dementia Unit to the SNF Unit. She also requested Mr. Rose, a representative of St. Mary’s, to update the Commission on changes to, and the new role of, the Community Advisory Council. Mr. Steele and Mr. Rose agreed to the request. Identified the need to update realistic options related to continuity of patient care and quality of care; and be certain that patients can reasonably access new services As clinical programs are transferred, need adequate transportation for elderly and frail patients to get from medical campus to campus Commissioner Jackson requested a report on charity care statistics from Mr. Rose. Mr. Rose agreed to this request President Guy requested that Mr. Rose separate charity care from community benefits. Mr. Rose agreed to this request. Raised the need to ensure viability of hospitals in San Francisco Action Taken: The Commission will further consider this item at the next meeting. 8) OTHER BUSINESS/PUBLIC COMMENTS None. 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. The Commission went into closed session at 6:50 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 - EXISTING LITIGATION PROPOSED SETTLEMENT OF $125,000 IN SARONA COLLINS ET AL V. U.C. REGENTS AND CCSF, SUPERIOR COURT CASE NO. 309-463 Action Taken: The Commission came out of closed session at 7:10 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 settlement of $125,000. 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 7:20 p.m. Arthur R. Greenberg, Interim Executive Secretary to the Health Commission