Minutes of the Health Commission Meeting Tuesday, April 3, 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 20, 2001 Action Taken: The Commission adopted the minutes of March 20, 2001. 3) PROPOSED ACTION: APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE (Commissioner David J. Sanchez, Jr., Ph.D.) (3.1) DPH-Central Office - Request for approval to transfer the title of the property located at 50 Raymond Street from the Department of Public Health to Visitacion Valley Community Center. (3.2) CHN-SFGH Radiology - Request for approval of a contract modification with The Registry Network, Inc., to provide intermittent, as-needed, seven day a week on-call, professional radiology technologists, in the amount of $270,000, increasing the contract from $173,600 to $443,600, for the existing contract period of July 1, 2000 through June 30, 2001. (DPH contracted with Registry Network for services totaling $526,067 during FY 1999-2000). (3.3) CHN-Office of Managed Care - Request for retroactive approval of a contract modification with the Regents of the University of California, San Francisco (UCSF), to increase the contract from $1,700,000 to $2,200,000 and modify the start date to begin three (3) months earlier, for the period of April 1, 2000 through June 30, 2001, to reflect the effective date of the dissolution of UCSF Stanford Health Care. (DPH contracted with UCSF for services totaling $11,454,369 during FY 1999-2000). (3.4) PHP-Housing & Urban Health/Mental Health - Request for approval of a new contract with Page Street Guest House, in the amount of $1,470,025 to provide residential care facility services targeting difficult to place clients referred primarily by SFGH and Mental Health Rehabilitation Program, for the period of February 1, 2001 through June 30, 2002. (3.5) PHP-Bureau of Environmental Health Management - Request for approval of a retroactive new contract with the San Francisco League of Urban Gardeners (SLUG), in the amount of $87,047, to identify strategies for improving access to nutritious food in the Bayview Hunters Point community and to provide job training and youth interns in the community, for the period of January 1, 2001 through June 30, 2002. (3.6) PHP-Bureau of Environmental Health Management - Request for approval of a modification to the contract with Romic Environmental Technologies to increase the dollar amount by $400,000 for a total revised contract amount of $600,000, to provide hazardous waste removal, transportation and disposal services, for the period of July 1, 2000 through June 30, 2002. (3.7) AIDS Office - Request for approval of a new sole source contract with Harm Reduction Coalition in the amount of $118,000 to provide harm reduction training services to community-based organizations that provide HIV prevention services, for the period of April 1, 2001 through December 31, 2001. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) POPULATION HEALTH AND PREVENTION Problem Gambling Media Campaign The Chinese Community Problem Gambling Project, a project of NICOS Chinese Health Coalition, is launching a media campaign to tackle the issue of Chinese American problem gambling. The Board of Supervisors initially funded the project with strong advocacy from Supervisor Mabel Teng. Through June, television, radio and newspaper ads will appear in Chinese language media asserting that "when one person is addicted to gambling, the whole family suffers”. The project, the first of its kind in the United States, includes counseling, advocacy and outreach services, in response to a study that found that nearly 70% of the City's Chinese American adults consider gambling to be a problem in their community. STOP Red Light Running Campaign The STOP Red Light Running Campaign takes a new approach this month, encouraging drivers to put red light wait time to good use. The full campaign will be rolled out on billboards, street signs, promotional items, and a new web site, all announcing the same message: "Stop at the red. You'll only kill a few seconds." The STOP Red Light Running Campaign represents a collaboration of the Department of Parking and Traffic, the Police Department and the Department of Public Health (Community Health Promotion and Prevention) to increase safety on the streets of San Francisco. Take the Safe Driving Pledge at www.redlightrunning.org. Stop for Kids Safety Week Stop for Kids Safety, an organization started by Marie and Ozzie Williams in memory of the death of their son Robert Davenport from an unsafe driver, continues its 9th annual Stop Light Walk/Run/Ride for Safety April 7th. Mayor Brown proclaimed the second week of April as "STOP FOR KIDS SAFETY WEEK." The event begins this Saturdy at Bayview Park, 9a.m. (3rd and Keith St) and ends at Candlestick Park where trees are planted and again will be planted for the victims of traffic accidents. Representatives of the Department of Public Health, along with elected officials and other city agencies, will join the community in this fight for safety on our streets. For additional information contact Marie Williams (207-2409), Ismael Birch (553-1962) or Leah Shahum (431-2453 #2) COMMUNITY HEALTH NETWORK Videoconferencing Interpretation Pilot The Community Health Network (CHN) is participating in a Videoconferencing Medical Interpretation (VMI) project with Health Access and Highland Hospital Medical Center. The goal of the project is to develop medical interpretation services for limited English speaking patients provided through videoconferencing. The pilot began at SFGH’s General Medicine Clinic offering services in the two most frequently requested languages requiring translation services, i.e., Spanish and Cantonese. A dedicated quiet room was located for interpreters to deliver language services over the VMI application to assure patient confidentiality. The patients are happy with the quick access to an interpreter and the providers have stated that the VMI application gives a clear image with quality audio that is very easy to use. Several additional languages will soon be added to the pilot project. In late April, the pilot will be expanded to Laguna Honda Hospital. Forensic AIDS Home-base Project The Forensic AIDS Project of Jail Health Services is pleased to welcome Home-base, part of a three-year demonstration project which targets HIV positive prisoners. Jail clients who consent to participate in the Home-base study will be randomized into two groups. Group One will receive “Standard of Care” which means they will receive in-jail case management services from the Forensic AIDS Project. Home-base staff will offer Group Two, enhanced case management; individual substance abuse counseling and group health education. The Home-base staff will continue to provide services when the prisoner is released from custody, plus three months of housing and money management. The Forensic AIDS Project clinical staff is responsible for making referrals to the program. This program will be very helpful in assessing the wrap around service needs of this population. Conference on Chinese-American Elders A one-day conference, Enhancing Clinical Understanding and Communication with Chinese-American Elders will be held on April 7th at Laguna Honda Hospital. The Stanford Geriatric Education Center, Laguna Honda Hospital, and the American College of Traditional Chinese Medicine will present the program. The intended audience includes physicians, nurses, social workers, licensed acupuncturists and other healthcare professionals who work with Chinese-American elders. For more information please call the Stanford Geriatric Education Center at 650-723-7063. 5) IN COMMEMORATION OF PUBLIC HEALTH WEEK: RECOGNITION OF INNOVATIVE PUBLIC HEALTH PROGRAM: DIRECT ACCESS TO HOUSING, AND UPDATE FROM HOUSING AND URBAN HEALTH DIVISION Representatives from the Department’s Housing and Urban Health (HUH) Section delivered a presentation to the Commission. The mission of the Housing and Urban Health Section is to promote stability and wellness among people living with poverty, homelessness, and multiple health problems, through respectful healthy services, advocacy and housing. The presentation accompanied the written “Report to the Health Commission, April 3, 2001.” Mark Trotz, Director of the Housing and Urban health Section, provided an overview of the section’s organization. He then spoke about housing activities within HUH, which he categorized into three types of housing: short-term stabilization; transitional housing; and permanent housing. Mr. Trotz stated that the Department has approximately 40 contracts for a total of 1120 housing slots. HUH is active in several other housing policy areas, including improving the health and safety in private SRO facilities, and expanding the Department’s master-leasing of entire SRO hotels. Mr. Trotz identified recent accomplishments of HUH, which include: opening the Ark House transitional housing facility for homeless lesbian, gay, bisexual, transgender, queer and questioning young adults; master-leasing the 91 unit SRO LeNain Hotel for homeless seniors; and developing Autumn Glow, a 15 bed residential care facility for elderly people with Alzheimer’s and other forms of dementia. He also identified other housing projects in development, including: master-leasing the 34-bed Broderick Street residential care facility, which will provide long term care for clients who have been difficult to place due to medical complications and/or behavior issues; and finalizing negotiations for two new master-lease hotels that will provide a total of 105 new SRO units. Joshua Bamburger, M.D., Medical Director of HUH, discussed urban health activities. In particular, he spoke about housing as an important health component, and integrating medication adherence therapy into housing facilities. Dr. Bamburger raised these topics: Action Point, a street-based store front project that provides social support and nursing services to assist HIV infected urban poor to adhere to highly active antiretrovial therapy; Action Point Bayview, the second Action Point Project; the Soft Tissue Infection initiative, and the Heroin Overdose Prevention project. Commissioners’ Comments Asked about clean up and other preparations for master-leases. [On this point, Dr. Katz noted the value of renovations and master-leasing. He stated that from the neighbor’s point of view, the Department has eliminated a place of heavy drug usage, and has maintained property values, while the City receives a cost-effective source of housing, without bond measures or capital acquisitions.] Agreed that the Department and Housing and Urban Health have been successful in providing healthcare and comprehensive services. Agreed that integration of housing and health was encouraging and exciting, and asked how HUH handles people who may be unable to transition [Dr. Katz noted that with today’s HIV drugs, people living longer, and wait lists for housing do not move as quickly as it did in previous years. President Guy recognized great work of team, and stated that leadership of Mr. Trotz is part of attracting a good team. Community appreciates your ability Josh - Evaluating cost-effectiveness of housing; is it money well spent? PRESENTATION OF THE ANNUAL DATA REPORT: OVERVIEW OF POPULATION BASED HEALTH STATUS OF SAN FRANCISCO Randy Reiter, from the Department’s Community Health and Epidemiology Control Section, presented before the Commission. He discussed the Department’s report, “Overview of Health, Public Health Week, April 2 - 6, 2001.” The Report is divided into three sections. “Who We Are” provides a demographic view of the age an ethnic distribution of San Francisco’s population. “How We Live” presents information on conditions that are known to be major determinants of health in populations, including poverty, socioeconomic conditions, air pollution, crime, substance abuse, and risky behaviors. “Our Health” major physical and mental health outcomes. This year’s overview includes the latest data available about important aspects of health and well being of our population. In addition, it contains information about the major conditions that contribute to the patterns of health, illness, and injury in San Francisco. The Report illustrates disparities across groups, determinants of ill health, trends over time, comparisons to state or national levels or national standards, and includes measures of premature deaths or disability. Mr. Reiter called the Commission’s attention to two particular areas. He discussed Disability Adjusted Life Years (DALY), a measure of the overall burden of disease and injury in a population. According to the Report (page 28), the measure allows health evidence to be used to estimate the largest contributors to reduced years of healthy life due to disease, injury, disability, and death. Mr. Reiter also highlighted the prevalence of serious mental illness (page 45). He stated that San Francisco’s rate of almost 8% is believed to be underestimated, but is one of the highest among California counties. According to Mr. Reiter, the Report is widely distributed and freely available on web and hard copy. It is approximately 50 pages, and may be downloaded from www.dph.sf.ca.us, or may be obtained through the Planning Office, Population Health and Prevention, San Francisco Department of Public Health, 415-255-3470. The Commission thanked Mr. Reiter for his presentation. PRESENTATION OF THE ANNUAL DATA REPORT: OVERVIEW OF POPULATION BASED HEALTH STATUS OF SAN FRANCISCO 6) CONSIDERATION OF A RESOLUTION DETERMINING WHETHER THE CLOSURES AT ST. MARY’S MEDICAL CENTER WILL OR WILL NOT BE DETRIMENTAL TO THE HEALTH SERVICE OF THE COMMUNITY *Resolution 7) OTHER BUSINESS/PUBLIC COMMENTS None. Action Taken: The Commission voted to hold a closed session. Action Taken: The Commission came out of closed session at 7:10 p.m. Action Taken: The Commission voted not to disclose any discussions held in closed session. The meeting was adjourned at p.m. Arthur R. Greenberg, Interim Executive Secretary to the Health Commission