Minutes of the Health Commission Meeting Tuesday, October 16, 2001 at 3:00 p.m. 101 Grove Street, Room #300 San Francisco, CA 94102 1) CALL TO ORDER The meeting was called to order by President Roma P. Guy, M.S.W., at 3:15 p.m. Present: President Roma P. Guy, M.S.W. Vice President Edward A. Chow, M.D. Commissioner Arthur M. Jackson Commissioner Lee Ann Monfredini Commissioner Harrison Parker, Sr., D.D.S. Commissioner John I. Umekubo, M.D. Absent: Commissioner David Sanchez, Jr., Ph.D. 2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF OCTOBER 2, 2001 Action Taken: The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) approved the minutes of the October 2, 2001 meeting, with one correction to reflect the correct spelling of Richard Heasley’s name. 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE Commissioner Monfredini chaired, and Commissioner Jackson attended, the Budget Committee meeting. (3.1) CHN-Revenue Management - Request for approval of a new contract with Health Advocates, LLP, to enhance Medi-Cal and other third-party reimbursements at San Francisco General Hospital, with reimbursement based on a sliding scale contingency fee, for the period of certification through December 31, 2005. (3.2) PHP-STD Prevention and Control - Request for approval to accept and expend retroactively a new three-year grant from the Centers for Disease Control in the amount of $901,544 to study the efficacy of condom-use skills-building workshops, for the period of September 30, 2001 through September 29, 2004 and a sole source contract with the Regents of the University of California San Francisco, Center for AIDS Prevention Studies, in the amount of $701,226, for the period of November 1, 2001 through October 31, 2004. (3.3) PHP-Mental Health - Request for approval to accept and expend a grant from the California Department of Mental Health in the amount of $2,913,000 for the Older Adult System of Care Demonstration Project, to create an innovative collaborative model among the physical health primary care system, the mental health system, providers of dementia care and adult protective services; and utilizing a residential care facility and peer counseling, for the period of Fiscal Years 2001-02, 2002-03 and 2003-04. (3.4) PHP- Mental Health - Request for approval to accept and expend a grant from the State Department of Mental Health in the amount of $226,566, and a grant from the San Francisco Private Industry Council, in the amount of $832,500, for a three-year youth development and crime prevention initiative, for the period of July 1, 2001 to June 30, 2004. (3.5) PHP-Mental Health - Request for approval of a retroactive contract renewal with Conard House in the total amount of $8,388,980, to provide mental health services, for the period of July 1, 2001 through June 30, 2003. (3.6) PHP-Mental Health - Request for approval of a retroactive contract renewal with Regents of the University of California San Francisco, Center on Deafness, in the amount of $435,397 per year, for a total contract amount of $1,741,588, to provide mental health safety net services, for the period of July 1, 2001 through June 30, 2005. (3.7) PHP-Mental Health - Request for approval of a retroactive contract renewal with Baker Places, Inc., in the amount $6,725,769, for the provision of residential, rehabilitative and intensive day treatment services, for the period of July 1, 2001 through June 30, 2002. (3.8) PHP- Substance Abuse - Request for approval of a retroactive contract renewal with Baker Places, Inc., in the amount of $3,389,541, to provide substance abuse services, for the period of July 1, 2001 through June 30, 2002. Items 3.7 and 3.8 were called together. At the request of Commissioner Monfredini, Monique Zmuda summarized the findings of the audit that was done of the Baker Places, Inc. contracts. Ms. Zmuda stated that she requested that the Office of Internal Audit perform a limited review of the agency’s credit card transactions. The audit found that the agency did not adequately control credit card transactions, that it misclassified expenditures, it did not follow certain federal limits, that there were weaknesses in some purchasing practices, and that there was a lack of an allocation plan for indirect costs. In essence there was insufficient documentation to show why the expenditures were made. It appeared that approximately $30,000 of the expenses could have been personal in nature or not appropriate to be charged to the City and County. Ms. Zmuda stated that as soon as the discrepancies were noted, both the Executive Director and the Chief Financial Officer immediately cooperated with Department staff. Ms. Zmuda feels confident that enough corrective actions have been taken by the agency. In addition, they have agreed to repay the City and County for inappropriate expenditures. Ms. Zmuda ended by saying that she was going to reinforce to all contract agencies, via a directive, that credit card usage must be very tightly controlled. Jonathan Vernick, Executive Director for Baker Places, stated that the agency made serious errors, and they worked very closely with the auditors to address the deficiencies. Mr. Vernick stated that he is the origin of many of the problems they are dealing with, but now they are appropriately dealing with the wrongs of the past. He assured the Commission that this would never happen again. Pablo Bravo, Chief Financial Officer for Baker Places, stated that he has looked at the agency’s internal infrastructure and made all of the necessary corrections. Cory Bush, Vice President of the Board of Baker Places, stated that after the audit findings were presented, the Board immediately got involved to correct the situation. The Board is determined to make sure this does not happen again. In addition, Mr. Bush said that the Board intends to establish a Finance Committee, to provide better oversight and direction to all financial issues. Commissioners’ Comments Commissioner Monfredini said that the programs received excellent reviews. However, the financial problems that were identified by the audit are of great concern. Commissioner Monfredini emphasized that funds were not stolen from the agency, and that problems that the agency is facing are not of that nature. Nonetheless, they still are serious. It is critical that organizations keep good financial records. Commissioner Monfredini urged Baker Places to expand its Board of Directors, and establish a Finance Committee within the Board structure. Commissioner Jackson stated that in these difficult economic times, non-profit organizations unfortunately are very vulnerable in terms of funding, and they cannot afford even the appearance of impropriety. Commissioner Jackson continued that money is tough and the Department needs non-profits and community providers desperately, and cannot afford to lose the trust of the public. (3.9) PHP- Substance Abuse/Mental Health - Request for approval of a retroactive contract renewal with Iris Center, in the amount of $967,783 per year, for a total contract amount of $3,871,132, to provide outpatient and day treatment substance abuse program services, for the period of July 1, 2001 through June 30, 2005.  The Department recommended modifying the contract so the term would be one year, instead of four years. Commissioners’ Comments Commissioner Monfredini, noting low performance ratings given to the Iris Center, asked the Executive Director of the agency to explain the steps that were being taken to improve performance and documentation. Trena Patton, Interim Executive Director, responded that while the services were being delivered, the documentation to support the work was not compiled and reported to the Department. She is working with the program manager to develop a system so that all data can be adequately reported to the Health Department. Commissioner Monfredini reiterated the importance of documentation, because otherwise the Department has no way of knowing if these critical services were delivered to clients. She also emphasized that the Department staff is available to the agency to offer assistance and help them be successful. Commissioner Monfredini concurred with the Department’s recommendation to modify the contract to a one-year term. Commissioner Jackson stated that he was perplexed that the agency itself was not aware that they had a problem. He said that agencies need to be proactive in ensuring that everything is in order. This program is critical to the community, and the Health Department needs to be sure the services are being delivered. (3.10) PHP- Substance Abuse/Mental Health - Request for approval of a retroactive contract renewal with Walden House, Inc., in the amount of $7,310,206, to provide residential mental health and substance abuse treatment services, for the period of July 1, 2001 through June 30, 2002. Commissioners’ Comments Commissioner Jackson commended Walden House for its high-quality services. She asked why the agency had a high level of voluntary discharge in its Adolescent Substance Abuse Treatment program. Jim Stillwell, Interim Director for Community Substance Abuse Services, responded that the Department and the Agency are going to research this question. Don Frasier, Contracts Manager for Walden House, added that clinical staff is examining this issue on an on-going basis. Commissioner Monfredini asked the Department to explain its recommendations that relate to the BASN Program. Mr. Stillwell responded that they will be working with the agency to gather data on both status of discharge and on length of stay for program participants. (3.11) PHP-Mental Health/Substance Abuse - Request for approval of a retroactive contract renewal with Swords to Plowshares in the amount of $422,741 per year, for a total contract amount of $1,690,964, to provide mental health services, for the period of July 1, 2001 through June 30, 2005. (3.12) PHP-TB Control - Request for approval of a retroactive contract renewal with the Regents of the University of California San Francisco, in the amount of $238,764, for the provision of physician and radiologist services in the SFGH TB Clinic, for the period of July 1, 2001 through June 30, 2002. (3.13) PHP-Health Promotion - Request for approval of a contract renewal with International Institute of San Francisco, in the amount of $273,412, to provide refugee preventive health services, for the period of October 1, 2001 through September 30, 2002. (3.14) PHP- Health Promotion - Request for approval of a new contract with Polaris Research and Development, Inc., in the amount of $271,577 to provide services to the Black Infant Health Program, for the period of October 1, 2001 through June 30, 2002. (3.15) AIDS Office-Surveillance - Request for approval of a new retroactive sole source contract with WESTAT Inc., in the amount $324,702, to provide telephone interview services for an HIV Seroincidence Study, for the period of July 1, 2001 through December 31, 2001. (3.16) Central Administration-Finance - Request for approval to increase the revolving fund for Population Health and Prevention by $18,000 to $43,000. Action Taken: The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) approved the Consent Calendar of the Budget Committee, with the modification to Item 3.9 to reflect a one year term, rather than a four year term. 4) DIRECTOR’S REPORT (Mitchell H. Katz, M.D., Director of Health) (Report on activities and operations of the Department.) Numerous Anthrax Scares; Department is Prepared for Potential Bioterrorist Attack Over the past four days, San Francisco has been deluged with calls of suspected Anthrax exposures. To date, all calls have proven to be false alarms, including the substance found at City Hall yesterday. Most of the calls were sparked by receipt of an envelope or package that had a white powdery substance. We had a similar episode today at 101 Grove, Room 100 when an envelope was found containing white powder. This incident is currently being investigated and the room is cordoned off. We have a finely calibrated system for dealing with each incident. After 9-1-1 is called, the police and fire department respond and remove the substance from the premises. The Toxics unit of the Environmental Health Division responds in a consultative role. Our Public Health Laboratory has developed a protocol to test for Anthrax in clinical samples. Understandably there has been great concern from the public about the possibility of the bacterium Anthrax or other bioterrorism. In response to these concerns, the SFDPH web site is being updated daily to provide accurate and timely information about the prevention and control of biological threats (BT) to populations from natural disasters, accidents, or intentional acts (bioterrorism). http://www.medepi.org/sfdph/bt/index.html We have joined with the San Francisco Medical Society in urging Doctors and lay persons to avoid use of unnecessary antibiotics. Dr. Tomas Aragon has done a large number of trainings with our staff as well as with community physicians. Although, there have been no Anthrax reports in San Francisco or in California as a whole, we are recommending that people handling large volumes of mail wear gloves. The benefit of this is that it should prevent exposure if there was an actual Anthrax exposure and it also decreases concern of persons who are exposed to substances that have not yet been identified. More broadly we have done extensive emergency preparedness planning. We have ample supplies of antibiotics and other medical supplies. We have been part of a federal MMST project, which has given us the capability to respond to a number of potential incidents. Dr. John Brown, the Medical Director of the EMS agency gave testimony today at the Economic Vitality, Small Business and Social Policy Committee at the request of Supervisor Sandoval. One unexpected benefit of these false alarms is that it has greatly facilitated our emergency response preparedness, and I feel confident that we have the capability to respond appropriately to any emergencies. Evaluation of Case Management for HIV-Infected Persons Published in the Annals of Internal Medicine The Annals of Internal Medicine published a study evaluating the effectiveness of case management for HIV-infected persons. Consistent with prior studies of case management, we found that case management was effective in increasing the proportion of HIV-infected persons who received key supportive services, including income assistance and health insurance. The most startling finding was that case management also increased the proportion of HIV-infected persons who received triple combination therapy-a life saving intervention. The study was part of the national HIV Cost and Services Utilization Study, which the Department of Health was one of the many collaborators. I was the lead author on the article. The article was accompanied by an editorial urging the federal government to fully fund the Ryan White Care Act so that services such as Case Management would continue to be available. Single Room Occupancy Hotel Fire A fire broke out at the Casa Loma Hotel on the corner of Fell and Fillmore Sunday morning at 7am. Thirty-nine tenants in 22 units were displaced. Department of Public Health was among the first City responders. We set up a Red Cross triage facility at Walden House located one block away at Hayes and Fillmore. All tenants were vouchered into the Travel Lodge for a few nights until more permanent housing could be located. Primary Care Administrator Appointed Dr. Patricia Perez-Arce, currently serving as the Castro Mission Health Center Director, has been appointed to the position of Primary Care Administrator. Dr. Perez-Arce will begin her new appointment on November 5, 2001. Primary Care will be well served by an administrator with Dr. Perez Arce's skills and experience. The Department is very grateful to Gay Kaplan, who has ably filled in as the Interim Primary Care Administrator for the past 7 months. Health Center Featured in the San Francisco Chronicle The Potrero Hill Health Center was featured in the Sunday October 7, 2001 San Francisco Chronicle Magazine. The article, written by staff reporter Mike Weiss, chronicles the history of the health center and describes the support it engenders from the community it serves. The article also documents the concern and dedication of the health center staff. ADAPT Protect of LHH Replacement Project ADAPT (American Disabled for Attendant Programs Today) is holding it’s annual conference in San Francisco from October 20 - 25th. The ADAPT group is a special interest group which advocates for community based care programs and support services for the disabled population. ADAPT is planning a protest at Laguna Honda Hospital, October 21st opposing the rebuild efforts. The Department has been working with other City agencies to ensure the protest is peaceful and does not disrupt normal hospital operations. Laguna Honda resident care programs and progress on the replacement project will continue without interruption. Chinese Women’s Cancer Support The Chinese Women's Cancer Support group held a celebratory luncheon October 11th at the Chinatown Health Center. The book" Our Stories" was presented as well as a Quilt made by the members. "Our Stories" involves 24 women from the support group, telling their personal journeys with cancer. It is a unique and moving account of their experiences. Three of the group members courageously shared their experiences with the audience. The book is in English and Chinese and includes guidelines for cancer screening. To obtain copies call the Health Center at 705-8500. COMMUNITY HEALTH NETWORK SAN FRANCISCO GENERAL HOSPITAL OCTOBER 2001 Health Commission - Director of Health Report (from 10/01/01 MEC and 10/16 SFGH) 10/01 2001 YTD New Appointments 6 71     Reinstatements 1 6 Reappointments 40 353     Delinquencies: 0 0     Reappointment Denials: 0 0 Resigned/Retired: 4 129 Disciplinary Actions 0 0 Restriction/Limitation- Privileges 0 0 Changes in Privileges     Additions 0 16     Voluntary Relinquishments 4 20     Proctorship Completed 0 118 Current Statistics - as of 10/1/01 Active Staff 369 Affiliate Professionals (non-physicians) 183 Courtesy Staff 488 Referring Staff 43 Total Members 1,083 Applications In Process 100 Applications Withdrawn Month of September 2001 0 SFGH Reappointments in Process Through February 2002 229 Commissioners’ Comments Commissioner Monfredini asked how many anthrax cases were reported in the United States prior to September 11, 2001. She also asked Dr. Katz to comment on the repercussions of taking antibiotics unnecessarily. Dr. Katz responded that there have been approximately 130 cases of anthrax per year, most of which were in people who worked closely with livestock. With regard to antibiotics, Dr. Katz said that there are significant dangers associated with taking antibiotic when they are not needed, and he recommends that people not do so. Commissioner Monfredini asked when smallpox vaccinations were discontinued, to which Dr. Katz replied that they stopped in the early 1970s. Commissioner Monfredini thanked Dr. Katz for his calmness and sense of assurance in the face of the anthrax scares. It is very reassuring to the public. Commissioner Parker asked if there are prevention efforts targeting SRO hotels, as it seems as if SRO fires have been occurring frequently. Anne Kronenberg responded that the Mission and Chinatown SRO Collaboratives help tenants of SRO hotels prevent fires. The collaboratives work closely with the Fire Department and the Bureau of Environmental Health. Commissioner Chow stated that, with regard to potential bioterrorist attacks, the ties between the Department of Public Health and the medical community are critical, and the Department has done a great job working with the San Francisco Medical Society, the Hospital Council and other entities. Commissioner Chow said that he had the pleasure of attending the October 11th celebration for the Chinese Women’s Cancer Support Group at the Chinatown Health Center. He said that the fact that women in the Chinese community put their feelings in writing is truly monumental, and it is due to the outstanding and pioneering work of Health Center staff. Commissioner Chow then congratulated Dr. Katz for being the lead author of the Annals of Internal Medicine article. Commissioner Guy commended the staff for their dedicated and consistent response to SRO fires. She stated that staff’s response to the anthrax scares has been laudable, both in regard to calming people’s fears and being ready and able to respond to actual incidents. Commissioner Guy said that, in light of the events of the past month and the critical role the Department of Public Health has in bioterrorism and disaster response, the Commission and the Department might need to examine its mission over the next several months. 5) HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) UPDATE (Diane Keefer, Chief Compliance Officer) Diane Keefer, Chief Compliance Officer for the Department of Public Health, updated the Commission on the status of complying with the health Insurance Portability and Accountability Act (HIPAA). HIPAA, which was signed into law in 1996, has numerous provisions. The Administrative Simplification Subpart is what currently impacts the Department of Public Health. Under this Subpart, all covered entities such as health care providers and health plans must implement standards that are intended to improve efficiency, reduce paperwork, and protect security and privacy of individually identifiable health information. To ensure compliance with the many provisions of HIPAA, a steering committee was appointed by Dr. Katz. Ms. Keefer stated that four task forces have been established to focus on the specific provisions of the HIPAA final rules: Transaction Standards and Code Sets (TCS) Task Force Privacy Regulations Task Force Security Regulations Task Force Business Associates Task Force. Donna Jacobs, Information Sytems Manager for SFGHMC, the co-chair of the Transaction Standards and Code Sets Task Force, gave an overview of the work of the task force. This task force is charged with implementing the standards for the electronic exchange of administrative and financial transactions. Compliance is required by October 16, 2002. Transaction Standards and Code Sets Task Force Next Steps Analyze which systems and transactions will require remediation, either by a contract vendor or through in-house IS staff, to meet the required standards. Complete Business Associate surveys to determine vendor readiness and their timelines for HIPAA compliance. Cheryl Austin, Director HIS, SFGHMC and co-chair of the Privacy Task Force, described the work of the task force. The HIPAA privacy regulations create standards for the protection, use and disclosure of individually identifiable health information. Compliance with the Final Rule for Privacy is required by April 14, 2003. Privacy Task Force Next Steps Assessment surveys of DPH Policies and Procedures (GAP analysis) to determine how Protected Health Information is created, modified, transferred, reviewed, disclosed and maintained by DPH employees. Review each provision of the Privacy Regulations to determine the scope of implementation. Dave Counter, Director of DPH Information Systems and chairperson of the Security Regulations Task Force, overviewed the work of the task force, which is charged with implementing the Security Regulations that are expected to be finalized in the next few months. Compliance with these regulations is required by January-February 2004. Security Task Force Next Steps Continue to participate in all DPH HIPAA management efforts and provide complance monitoring reviews. Convene a formal HIPAA IT Security Task Force to address HIPAA requirements. Formalize the Security Officer function along with the Privacy Officer, and develop a Security Awareness Program. Complete an internal HIPAA Security Gap Analysis. Identify and budget technical components required by HIPAA including data integrity, message authentication and encryption technology. Implement all current and future HIPAA security requirement solutions as a top priority for DPH information technology work teams. Ms. Keefer described the work of the Business Associate Task Force, which she co-chairs. This task force is charged with identifying all DPH contractors that have access to protected health information, and ensuring that they are HIPAA compliant. Business Associate Task Force Next Steps Identifying and defining vendor relationships to determine which fall under HIPAA regulations. Developing contract addendum language for inclusion in identified contracts. Ms. Keefer then described the training needs and cost implications for the implementation of HIPAA. Commissioners’ Comments Commissioner Jackson asked for a cost estimate for HIPAA compliance. Ms. Keefer responded that it is difficult to predict the cost to the Department of Public Health, but the industry predicts a $22 billion cost over ten years. However the industry will reap some savings as well. Commissioner Guy asked how the department would ensure that DPH contractors and UCSF comply. Ms. Keefer responded that they are currently working with UCSF, and have two UC employees on the steering committee. They are developing an MOU that states that UCSF will observe all privacy requirements. Mr. Counter said that, with regard to the security issue, they have a collaborative relationship with UCSF, but some challenges exist. UCSF is building firewalls around its patient data. However, there is a philosophical perspective that research data should be open and accessible. In the future there will need to be a policy decision about the level of protection for research data. Commissioner Chow asked about the current practice for sharing patient information with contractors. Ms. Keefer responded that the Department performs access audits so they can see who is accessing what information. She added that the Department can terminate contracts if they do not comply with security and privacy requirements. Commissioner Parker asked if, since HIPAA is a federal mandate, there were any federal funds to support implementation. Ms. Keefer responded that there were not. 6) ENVIRONMENTAL HEALTH ANNUAL REPORT (Dr. Rajiv Bhatia, Director, Environmental Health Section) Dr. Rajiv Bhatia presented the Environmental Health Annual Report. Dr. Bhatia described the activities of the past year using a power point presentation . Dr. Bhatia began the presentation by stating that the mission of the Environmental Health Section is to ensure safe and healthy living and working conditions for all San Franciscans. Dr. Bhatia then described the strategies of the program. First and foremost, Environmental Health enforces the mandatory environmental health laws and regulations. To do that requires working with other agencies in interagency collaborations. Then Dr. Bhatia described desired outcomes, which include program consistency, legal compliance, an informed public, active collaborations, evidence-based interventions and healthy policies. Dr. Bhatia then highlighted some of the programs that Environmental Health has focussed on over the past year. First, the section developed specific quantitative program standards and quantitative measures. They focussed on revenue enhancement to ensure that private businesses pay for the services they receive. The Section also has been spending a lot of time on disaster and emergency response. A special enforcement project was developed at Fisherman’s Wharf to address a burgeoning rat infestation in the area. Environmental Health has been working with the Department of Building Inspection to see that the sources of indoor mold are addressed. They assisted the Housing Authority in the clean up and development of the contaminated property at Bernal Dwellings. In addition, the Hotel Inspection Program Unit has broadened its role to participate in the SRO Hotel Work Group. With regard to assessment and information, Environmental Health has done research on the Potrero Power Plant and Diesel Bus Emissions. Dr. Bhatia then discussed two community programs that Environmental Health has been involved in: Day Laborers Partnership and Youth Envision. The goal of the Day Laborers Partnership is to reduce occupation injuries and public exposures due to construction. The Section has held bimonthly trainings, distributed Spanish language fact sheets, and sought grant support. The goal of Youth Envision is to improve access to healthy and affordable food in Bayview Hunters Pont. The Section has trained 20 youth interns, conducted more than 200 food access surveys, identified four primary food strategies, conducted five community presentations, started a farmers market and collaboratively sought funding. Dr. Bhatia then described the intervention research that had been performed by the Section, including an analysis of living wage on health. Dr. Bhatia then spoke about Health Impact Assessments, a policy tool to assess public policy, public programs and public decisions for health impacts. These assessments specifically reflect shareholder values, local knowledge, data and evidence, and a broad variety of impacts. They are pilot testing this with the Redevelopment Agency. They hope to do approximately 10 Health Impact Assessments this year. Commissioners’ Comments Commissioner Monfredini asked how the Environmental Health Section was dealing with the pressures of the past few weeks. Dr. Bhatia responded that staff is under a lot of stress, but working together and supporting each other. Commissioner Chow asked how many staff work in the Environmental Health Division. Dr. Bhatia responded that there is approximately 110 staff. Dr. Bhatia said that while the scope of work has grown, the staff really has not. They have been able to achieve the same standards through efficiencies. Commissioner Umekubo asked what role the Department plays in cleaning toxic sites that are beyond the jurisdiction of the City and County of San Francisco. Dr. Bhatia responded that, with regard to the Hunters Point Shipyard, the U.S. Navy is the ultimate decision-maker. However, the Department has a staff member assigned to the project to monitor all proposals and progress. Dr. Bhatia stated that the Department has a very limited role in situations such as these. The best way the Department can be effective is to stand behind the community. Commissioner Parker asked if the Department could project healthcare cost savings that have resulted from the implementation of the Living Wage Ordinance, given the mortality data that resulted from the analysis. Dr. Bhatia responded that mortality data does not allow for these projections, but he could conduct more of those studies and look at what the research shows. Commissioner Jackson asked whether the restaurants were informed in advance that they would be inspected. Dr. Bhatia said they were not. Dr. Bhatia added that, in the next few months, a website would be established so the public can see when a particular restaurant was inspected, what the findings were, and the date any violations were corrected. Commissioner Guy asked about the progress of the mold program. Dr. Bhatia responded that, in the specific targeted areas, there is a lot of activity. The Department recorded all the instances of mold in those areas. Most people were able to comply with the requirement to clean in up. The challenge will come when the mold recurs, and getting at the root cause. The Department is working with the Department of Building Inspection and Supervisor Maxwell’s office. 7) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR THE MONTH OF OCTOBER Commissioner Harrison Parker presented the employee recognition awards. Awardees Division Nominated by Cynthia Selmar, Director, African American Health Initiative Community Health Promotion and Prevention Larry Meredith and Jimmy Loyce, CHPP Maureen O’Neill, Social Work Supervisor CHN-Silver Avenue Family Health Center Lisa Golden, M.D., A. Kane, M.D., and other SAFHC staff 8) CLOSED SESSION A) Public comments on all matters pertaining to the closed session None. B) Vote on whether to hold a closed session (San Francisco Administrative Code Section 67.11) Action Taken: The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) voted to hold a Closed Session. The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) went into Closed Session at 5:25 p.m. Individuals present were all commissioners except Commissioner Sanchez, Mitch Katz, Gene O’Connell, Alison Moed, Mathew Rothschild, and Michele Olson. C) Closed session pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d) Conference with Legal Counsel - Existing Litigation Proposed settlement of unlitigated claim for $30,000 in the Luis Lazaro (a minor) vs. CCSF et al, Superior Court, Case #00-04054 The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) came out of Closed Session at 5:48 p.m. D) Reconvene in Open Session 1) Possible report on action taken in closed session (Government Code Section 54957.1(a)2 and San Francisco Administrative Code Section 67.12(b)(2).) Action Taken: The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) approved the $30,000 settlement in Luis Lazaro (a minor) v. CCSF et al, Superior Court, Case No. 00-04054. 2) Vote to elect whether to disclose any or all discussions held in closed session (San Francisco Administrative Code Section 67.12(a).) Action Taken: The Commission (Guy, Chow, Jackson, Monfredini, Parker, Umekubo) voted not to disclose any discussions held in Closed Session. 9) OTHER BUSINESS/PUBLIC COMMENTS None. 10) ADJOURNMENT The meeting was adjourned at 5:49 p.m. Michele M. Olson, Executive Secretary to the Health Commission