Minutes of the Health Commission Meeting Tuesday, May 21, 2002, at 3:00 p.m. 101 Grove Street, Room #300 San Francisco, CA 94102 1) CALL TO ORDER The Health Commission meeting was called to order by Commissioner Edward A. Chow, M.D., at 3:10 p.m. Present:  Commissioner Edward A. Chow, M.D., President Commissioner Roma P. Guy, M.S.W., Vice President Commissioner Arthur M. Jackson Commissioner Harrison Parker, Sr., D.D.S. Commissioner John I. Umekubo, M.D. Absent:  Commissioner Lee Ann Monfredini Commissioner David J. Sanchez, Ph.D. 2) APPROVAL OF THE MINUTES OF THE REGULAR MEETING OF MAY 7, 2002 Action Taken: The Commission (Chow, Guy, Jackson, Parker, Umekubo) approved the minutes of the May 7, 2002 Health Commission meeting. 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE Commissioner Jackson chaired and Commissioner Umekubo attended the Budget Committee meeting. (3.1) Black Coalition on AIDS HIV Prevention Contract - Status Report Steven Tierney presented an update on the Black Coalition on AIDS HIV Prevention Contract. In addition to the report that was included in the meeting packet, Mr. Tierney submitted a matrix that showed Black Coalition on AIDS’ progress. The agency has received an acceptable rating in both the follow-up report and the most recent monitoring report, which will be presented to the Budget Committee at its next meeting. Commissioners’ Comments Commissioner Jackson asked how the agency addressed its staffing problems. Dr. Tierney said that this has been an on-going problem that the agency’s executive director and Board of Directors are addressing with technical assistance. Mr. Tierney said that at the moment they agency seems to have everything in place, which is reflected in the acceptable ratings they received in the most recent monitoring report. Commissioner Jackson expressed concerned about the staffing fluctuations, and what affect they will have over the long run. Commissioner Umekubo asked if the agency’s performance has improved since the last monitoring report. Dr. Tierney responded that their performance has improved significantly since the last reporting. Public Comment Patrick Monette-Shaw - Concerned that Black Coalition on AIDS is going down the same path as the Bayview Hunters Point Foundation. The contract monitoring report is not sufficient to measure performance improvement. He urged the Commission to find culturally competent organizations that will get the work done and keep staff employed. This contract was discussed separately at the Health Commission meeting. During that meeting Duane Poe, the executive director of the agency, addressed the commissioners. Commissioners’ Comments - Health Commission Meeting Commissioner Chow requested that the Budget Committee, at the time the contract with Black Coalition on AIDS is considered for renewal, determine the intervals at which the joint conference committees and Budget Committee receive status reports on the contract. (3.2) DPH-Glide Foundation HIV Prevention Services Contract - Status Report Mr. Tierney gave an update on the Glide Foundation HIV Prevention Services Contract. When the contract was renewed in October, the monitoring report showed that the agency needed improvement in staff consistency. The agency had an innovative plan to merge their AIDS services into Glide’s health services organization, which is better staffed and provides more supervision. This merger has been carried out, and they have improved significantly and received an acceptable rating in both the follow-up report as well as the monitoring report for contract renewal that will come to the Commission in the future. Commissioners’ Comments Commissioner Jackson asked if the merger enabled the agency to maintain the staffing level or if it resulted in reduced staff. Mr. Tierney said it allowed them to maintain the workforce but reduce and consolidate management. Andrea Goetz, manager of HIV and AIDS Services at Glide, added that the structure was reorganized, and they have maintained the staff for the past year. Commissioner Umekubo asked if the agency was meeting its units of services. Ms. Goetz said that they are working to meet the units of services. They are working very closely with Compass Point. This contract was also discussed at the Health Commission. Ms. Goetz addressed the Commission, and reiterated that the agency has worked to meet the Department’s requirements. (3.3) PHP-AIDS Office - Request for approval of a retroactive contract renewal with Harder + Company in the amount of $76,900, to provide Standards of Care technical support for the HIV Health Services Section, for the period of March 1, 2002 through February 28, 2003. (3.4) PHP-AIDS Office - Request for approval of a retroactive contract renewal with Public Health Foundation Enterprises, Inc. in the amount of $793,082, to provide AIDS Office Research Unit clinical trial services, for the period of July 1, 2001 through June 30, 2002. (3.5) PHP-AIDS Office - Request for approval of a retroactive sole source contract with Public Health Foundation Enterprises, Inc. in the amount of $84,171, to provide AIDS Office Research Unit HIV Vaccine trial services, for the period of September 1, 2001 through August 31, 2002. (3.6) PHP-Mental Health - Request for approval of a retroactive contract renewal with the Regents of the University of California in the amount of $4,007,211 to provide citywide case management mental health services, for the period of July 1, 2001 through June 30, 2002. (3.7) PHP-Mental Health - Request for retroactive approval of a new contract with the Regents of the University of California in the amount of $317,381 per year for two years, to continue the provision of Crisis Resolution mental health services targeting Psychiatric Emergency Services clients, for the period of July 1, 2001 through June 30, 2003, for a total contract value of $634,762. (3.8) DPH - Request for approval of DPH annual patient rates effective July 2002. Commissioner’s Comments Commissioner Umekubo asked which entities were surveyed. Mr. Sass said one survey was a room rate survey of seven Bay Area hospitals, including two county hospitals. A second, more extensive, survey was done by a consultant who had several benchmarks with several other hospitals. The third study was a high-level comparison of OSHPOD (State of California Office of Statewide Health and Planning Department) public disclosure data. Commissioner Umekubo asked if a survey was done for primary care rates. Mr. Sass said one was not done. The increases in primary care range from 5%-7%. Commissioner Jackson asked what the highest increase was. Mr. Sass said the highest rate increase is 70% and in this instance, DPH is still less than what other hospitals charge. (3.9) SFGH - Request for approval to accept a gift of the construction and equipment for a comprehensive breast cancer center from the Avon Products Foundation, through the SFGH Foundation, and the naming of the center as “The Avon Products Foundation Comprehensive Breast Center.” Commissioners’ Comments Commissioner Jackson asked if the Center would have a place for community support groups to meet. Ms. O’Connell said that the patient education area or, during non-clinic hours, the waiting area could possibly be used for groups. She said that an integral part of the program is having people support each other. If there is not enough space for this, they will always make rooms available at the hospital. Ms. O’Connell will raise this issue when she meets with the architect. The Avon Products Foundation Comprehensive Breast Center resolution was also discussed at the Health Commission meeting. Commissioners’ Comments - Health Commission Commissioner Chow asked when the facility would be open. Ms. O’Connell said May 31, 2003. Commissioner Guy complimented staff leadership from the Foundation, the hospital and UCSF. She said the research is very clear that group support is critical for patients, and wants this need to be addressed. Ms. O’Connell concurred that support groups and patient education are very critical parts of the program. Action Taken: The Commission (Chow, Guy, Jackson, Parker, Umekubo) approved Items 3.3 - 3.8 of the consent calendar of the Budget Committee. The Commission discussed Items 3.1, 3.2 and 3.9 separately. Items 3.1 and 3.2 are status reports and required no action. After separate discussion, the Commission approved Item 3.9. 4) DIRECTOR’S REPORT Anne Kronenberg, Deputy Director of Health, presented the Director’s Report. Governor’s May Revision to the 2002-03 State Budget On May 14th the Governor released the May Revision to his proposed 2002-03 budget, which includes several proposals to address an estimated $23.6 billion State budget gap. This budget shortfall is $11.1 billion greater than that anticipated by the Governor in the budget he released in January. The Governor proposes to bridge this gap in a number of ways, including: Program reductions, for a savings of $7.6 billion) Tobacco settlement securitization, to secure revenues of $4.5 billion (this is up from the $2.1 billion proposed in the Governor’s January budget) Vehicle license fee offset reduction, for a savings of $1.2 billion $.50 increase in the tobacco excise tax, for revenues of $475 million The majority of program reductions were taken from health and human service programs, with the State Health and Human Services Agency facing $2.8 billion in reductions. The budget also continues to rely on the passage of federal legislation to increase the Federal Medical Assistance Percentage, which the Governor estimates will bring an additional $400 million in Medicaid revenue into California. If enacted, the Governor’s budget is estimated to reduce revenues to the Department of Public Health by approximately $4 million in the upcoming fiscal year. In addition, several Medi-Cal changes will reduce enrollment in Medi-Cal, thus increasing the numbers of uninsured who will seek care at the Department’s hospitals and clinics. Following is a brief summary of the key heath-related proposals included in the Governor’s May Revision and the anticipated impact of these proposals on the Department: Vehicle License Fee (VLF) – partially reverses discounts to vehicle license fees and continues General Fund (GF) backfill of the remaining VLF reductions.  By increasing the VLF tax to vehicle owners, reliance on the GF to backfill for these funds will be reduced by $1.2 billion.  This will avoid reductions in realignment revenues at the local level. Medi-Cal – The overall reduction in funding for Medi-Cal is proposed at approximately $1.1 billion.  Disproportionate Share Hospital (DSH) “Administrative Fee” – increases the DSH Administrative fee by an additional $31 million (on top of the $55.2 million increase in the January budget), for a total administrative fee of $115.9 million.  This $31 million increase will result in a $2 million loss to San Francisco General Hospital. Selected Optional Benefits – eliminates adult dental services, psychology, medical supply services, independent rehabilitation center, acupuncture, occupational therapy, podiatry, and chiropractic, for a savings of $526 million – $263 million GF.  The Department is in the process of quantifying the revenue impact this provision will have in the coming fiscal year. Provider Rate Reductions – reduces provider rates to levels in place when the Governor took office, for a savings of $94 million – $47 million GF.  Rates related to long-term care and children’s services will not be impacted.  Specifics on what rates will be reduced are not yet known.   Quarterly Status Reports – reinstates Medi-Cal quarterly status reporting, for a savings of $310.8 million – $155.4 million GF.  Statewide, this is expected to reduce the average monthly Medi-Cal beneficiaries by 247,000.  Children will not be affected.   Two-Parent Working Families – rescinds expansion to 100% of the federal poverty level (FPL) and return eligibility to 67% of FPL, for a savings of $184.2 million –d $92.1 million GF.  Statewide, this is expected to reduce the average monthly Medi-Cal beneficiaries by 146,000. Express-Lane Eligibility – defers express-lane eligibility expansions to July 2005, for a savings of $51.6 million – $25.8 million GF. Pharmacy Reimbursement – rescinds prescription drug reimbursement increases dating from January 1, 2000, for a savings of $23.8 million – $11.9 million GF. Dental Services for Children – limits dental cleanings and basic exams for children to one visit annually, for a savings of $7.9 million – $4 million GF. Mental Health –  Systems of Care – eliminates both Adult and Children’s Systems of Care programs, for a savings of $42.6 million.  This would eliminate the Children’s System of Care program in San Francisco and reduce the Department’s revenues by $1 million.  Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and Therapeutic Behavioral Services (TBS) – requires counties to assume a 10 percent share of cost for growth in these programs, for a savings of $35 million.  This would reduce the Department’s revenues by approximately $80,000.  AB 34/2034 Programs – reduces the budget for programs serving the homeless mentally ill by $10 million, leaving $55.6 million for this program.  This proposal is not anticipated to affect San Francisco’s AB 2034 program as the budget proposes to eliminate unspent funds.  Managed Care Rates – rescinds Medi-Cal rate increases provided in 2000-01 for psychologists and psychiatrists, for a savings of $5.6 million. AB 34/2034 Programs – reduces the budget for programs serving the homeless mentally ill by $10 million, leaving $55.6 million for this program.  This proposal is not anticipated to affect San Francisco’s AB 2034 program as the budget proposes to eliminate unspent funds. Managed Care Rates – rescinds Medi-Cal rate increases provided in 2000-01 for psychologists and psychiatrists, for a savings of $5.6 million. Healthy Families Parent Expansion – there was no mention of the Healthy Families parent expansion in the May Revise. The Governor has expressed his support of the parent expansion if the Legislature can find the estimated $265 million to fund it. Coverage Bridge – includes $2.6 million to establish a two-month Healthy Families to Medi-Cal coverage bridge. Child Health and Disability Prevention Program (CHDP) Gateway to Comprehensive Health Care – includes $2.7 million to develop an Internet pre-enrollment application to streamline enrollment from CHDP into Medi-Cal and Healthy Families. Both the Senate and Assembly Budget Subcommittees on Health have met since the Governor released his May Revision. Each house restored many of the health cuts contained in the Governor’s budget. However, the challenge now will be to fund the proposals the Legislature has indicated it would support. The Department will continue to work closely with the Mayor’s Office and with our statewide partners to minimize cuts to the health care safety net. CHN Patient Flow Project Under the leadership of co-chairs Gene O'Connell and Barbara Garcia, a CHN Patient Flow Committee was established to realize the Department’s goal of eliminating psychiatric administrative days at San Francisco General Hospital by August 1, 2002. As a result of cross-departmental coordination and the evaluation of policies and practices, administrative days at SFGH between January and April 2002 dropped 59 percent – despite a 28 percent increase in hospital admissions. Youth United Through Health Education (YUTHE) Tomorrow night at 10 PM, MTV will be airing a documentary on Youth United Through Health Education (YUTHE) Program, a peer-led HIV/STD Prevention program within the Department’s STD Prevention & Control Services Unit. Each year, the YUTHE Program reaches more than 4,000 at-risk youth between the ages of 12 and 22 years of age. The YUTHE staff conducts single session groups, community-based street outreach, venue-based group events and risk assessments in high neighborhoods with high rates of STDs. The YUTHE Program was chosen to represent California because it is widely recognized as a model peer-led program serving youth at risk for HIV/STDs. Prevention Messages at Bay to Breakers Expo Through a series of fortunate occurrences, the Department was offered an opportunity to exhibit (free) at this year's Bay to Breakers Expo at Bill Graham Auditorium. Within a very short time, Isabel Auerbach, Perinatal Outreach/Health Education Training Center, was able to pull together a lively booth with the help of many Departmental staff and featuring a variety of prevention programs. An estimated 30,000-40,000 people attended the two-day Expo. Those who stopped at the DPH booth were drawn in by posters from traffic safety, family planning, dental health and disaster preparedness. Giveaways included "Chill" antenna balls, family planning calendars, and condoms. The booth also distributed information on prenatal health, car seats, sudden infant death syndrome, mold, adult immunizations, and safe sex. This Commission would be proud of the speed and the team spirit that fueled this last minute and highly successful outreach. We are grateful to everyone who dropped other projects and made this event happen. Chlamydia Reduction Project Earlier this month, the Department launched the West Hunter's Point Chlamydia Reduction Project. In response to high rates of chlamydia in African-American youth and young adults, the project will screen 2,500 African-Americans between the ages of 14 and 25. The three-month project is a collaborative between the Providence Foundation, the Health Department and youth serving agencies in the Bayview area of the City. Tobacco Free Project The Tobacco Free Project has produced a 30-second television advertisement to demonstrate the hazards of smoking in a car, particularly for children. The ad shows that after lighting one cigarette inside the car, the concentration of particulate matter – small, lung-damaging particles contained in tobacco smoke – increased more than 100 times with the windows rolled up. With the ventilation turned off, the concentration increases by a factor of 350. The ad will be aired 567 times between June 3 and 23 on cable TV programs such as Fox News, Arts and Entertainment, CNN Comedy Central, Lifetime, VH1 the Food Network and Discovery Channel. Adolescent Health Coordinator Hired Iman Nazeeri-Simmons, MPH, will join the Department on June 3, 2002 as Coordinator for the newly created Office of Adolescent Health. As Coordinator, Ms. Nazeeri will help DPH address the health needs of adolescents in San Francisco, coordinate youth services inside the Department and with other city agencies and the community, and promote emerging adolescent health policies for San Francisco. Departure of Wayne Clark, Ph.D. Wayne Clark, a senior administrator in Community Mental Health Services (CMHS) has been selected as the new Director of Behavioral Health Services for Monterey County. Wayne worked at the Department for 28 years, serving as Director of the Alcoholism Evaluation and Treatment Center, Director of Substance Abuse Services, and most recently as Executive Team member in CMHS. Wayne assumed his new duties on May 6th. StopHep Works out at Gold’s Gym - Hepatitis Prevention for MSM Underway Tomorrow, the Communicable Disease Prevention Unit will officially launch the StopHep campaign in an effort to raise hepatitis A and B vaccination rates in the gay and bisexual community. Gay and bisexual men are at increased risk for both hepatitis A and B. Even though safe and effective vaccines are readily available for both diseases, less than 16% of MSM have been vaccinated for hepatitis A and less than 20% have been vaccinated for hepatitis B. The prevention campaign will utilize several components, including: public service announcements; discounted vaccinations at Gold’s Gym in the Castro on Wednesday and Thursday evenings from 4 PM to 7 PM; a press conference at Gold’s Gym, distribution of flyers in the community, and an educational component for public and private medical providers. COMMUNITY HEALTH NETWORK, SAN FRANCISCO GENERAL HOSPITAL CREDENTIALS REPORT May 2002 Health Commission - Director of Health Report (From 05/02/02 MEC and 05/13/02 JCC) 05/02 2002 YTD New Appointments 13 76 Reinstatements 0 0 Reappointments 36 185 Delinquencies 0 0 Reappointment Denials 0 0 Resigned/Retired 15 100 Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0 0 Changes in Privileges  Additions  Voluntary Relinquishments  Proctorship Completed 0 1 37 2 5 60 Current Statistics - as of 05/01/02  Active Staff  Affiliate Professionals (non-physicians)  Courtesy Staff  Referring  Staff Total Members 375 127 479 42 1023 Applications In Process  Applications Withdrawn Month of April 2002  SFGH Reappointments in Process June or Oct. 2002 2 90  ytd 13  195 Anne Kronenberg introduced Susan Jacobson, Executive Director of the San Francisco General Hospital Foundation, and Dr. Grossman, President of the Board of the San Francisco General Hospital Foundation.  Ms. Jacobson and Dr. Grossman presented the commissioners with mounted emergency disaster preparedness maps. Commissioners’ Comments Commissioner Guy said it is important to observe that the State contributes very little to the Department’s supportive housing services, and a main goal of the Department and the Commission is to increase State support.  The cuts in the Governor’s May Revise will lead to even more homeless families.  Commissioner Umekubo commended Gene O’Connell and Barbara Garcia for the improvement in Psychiatric admission days. 5) PRESENTATION OF THE DEPARTMENT OF PUBLIC HEALTH EMPLOYEE RECOGNITION AWARDS FOR THE MONTH OF MAY This item was continued to the June 4, 2002 Health Commission meeting. 6) PRESENTATION OF THE EMERGENCY MEDICAL SERVICES AWARDS Commissioner Chow presented the 2002 Emergency Medical Services Awards to the following individuals:   EMS Field Provider Award: Kevin Chocker, EMT-P, San Francisco Fire Department EMS Hospital Provider Award: Richard Naidus, M.D., St. Francis Hospital EMS Community Member Award: Mike Sugarman, KCBS Radio 74 Raymond Lim Excellence in EMS Award: David Floersch, EMT-P, San Francisco Fire Department 7) EMERGENCY MEDICAL SERVICES (EMS) SECTION PRESENTATION Dr. John Brown presented the Emergency Medical Services (EMS) Section presentation.  Dr. Brown highlighted the major accomplishments of the EMS system during the past years: Increasing deployment of the Rapid Paramedic Response System by the San Francisco Fire Department.  There are now an average of 8-10 fire engines deployed daily with paramedics on their crews. Enhancements to EMS Communications.  All ambulances (BLS and ALS, public and private), hospitals, public safety agencies and the Emergency Communications Department are communicating with each other on the same radio system every day. The increasing enrollment in the Disaster Registry Program for senior and disabled persons (currently more than 4,700 individuals). The increasing number of Public Access Defibrillation programs (33 are now in operation in the City and County of San Francisco).  Extensive evaluation of the Field Care Clinic System put in place for the Millennium event mass gathering New Year’s Even 1999-2000.  Dr. Brown highlighted the EMS System response intervals (time from the initial call to the arrival of the vehicle to the location of the victim), which is one area where they are making slow progress but he is not yet satisfied.  The EMS system has made demonstrative improvements in the Code 2 response times but the Code 3 response is still over ten minutes, although just barely.  (“Code 3” means red lights and sirens; “Code 2” means no lights or sirens.)  Further progress is needed, and this demonstrates the importance of the full implementation of the Rapid Paramedic Response System—this is the key for San Francisco to get its response interval under the standard. Dr. Brown updated the Commission on the status of the EMS helipad at San Francisco General Hospital.  This has been through a strategic planning process and incorporated into the Trauma Plan. Currently helicopters will land at Pier 94, which is a non-permitted temporary facility.  As of July 1st this will no longer be an option. Staff has negotiated an MOU with SFPD to use their site at Hunters Point, and this facility should be in place by July.   An issue is that this facility is 10-30 minutes away from the hospital by ground transport.  The ideal situation is to have helicopters go directly to the hospital. Dr. Brown said a vendor was selected through an RFP process to perform the feasibility study for the helipad at SFGH.  This will be a long process and they could use the Commission’s support throughout the process.   Dr. Brown highlighted a conclusion in the report that they did not find any evidence for the routine use of field care clinics for mass gathering events.  They are working with the Police Department on the permitting process for mass gathering events to ensure that all events have an EMS plan.  Field care clinics are very valuable as a disaster resource, but not in their specific use for mass gathering events.   Commissioners’ Comments Commissioner Umekubo asked Dr. Brown’s opinion of the private hospitals’ state of disaster preparedness.  Dr. Brown said they have come a long way since September 11th.  UCSF, the Kaiser System and Sutter hospitals have been participating in events and drills.  Dr. Brown emphasized the need for a citywide drill with all of the hospitals and emergency response entities in San Francisco.  Until there is this type of exercise, we cannot see how well prepared we are.  Commissioner Umekubo said that one of the concerns among the chiefs of staff is the communications link with the EMS command center during an emergency—how many beds they have available, their capacity to handle patients, etc.  Dr. Brown said hospitals are able to communicate this data through the HART system.  However this information is from the emergency departments and the question remains how to communicate with the rest of the hospital staff. Commissioner Parker asked Dr. Brown to more fully describe the public access defibrillator program.   Dr. Brown replied the model is that a facility sponsors the program, purchases and maintains the equipment over a period of time train staff on the use of the devices.  In addition, the defibrillators are place in a public area and available for members of the public to use.  The American Heart Association CPR training includes training on these devices.  Commissioner Jackson asked if there are areas in San Francisco that are difficult for helicopters to land in. Dr. Brown replied that the areas of the city that are the most difficult to reach are on along the beach and cliffs along the north and west sides of the city.  Commissioner Jackson asked if there is a shortage of paramedics in San Francisco.  Dr. Brown said he could not give specific information.  The Fire Department has detailed information about the paramedic workforce, including retirement statistics, recruiting new paramedics, cross training paramedics and fire fighters, etc.  In the Bay Area there is a high demand for paramedics that contributes to the shortage, which he believes is significant.   Dr. Brown is concerned for the future because the number of EMS calls is slowing increasing.  The city needs to stay proactive.  Commissioner Guy asked what challenges the EMS System is facing, particularly in the aftermath of September 11th.  Do our objectives need to be changed as a result of September 11th and how does the EMS system ascertain the validity of terrorism threats when they have become much more frequent?  Dr. Brown said that things that enhance overall disaster capability—a good communication system, a good command. control system, etc —are the most important things and will benefit San Francisco no matter what the challenge is, be it an earthquake or bioterrorism.  A positive outcome has been the disaster awareness culture that has developed.  There has been a lot more interest from the Department and the public about training and preparation.  As an example, the emergency preparedness map is very popular.  Capacity issues need to be evaluated to determine how they can be used in the event of a disaster, for example the VA-Fort Miley site.  He said the money from the federal government is starting to be dispersed to local governments.  Commissioner Chow said that the Health Commission strongly supports a helipad at San Francisco General Hospital.  It is a vital component of the trauma program.  He asked that the discussion around the future of the field care clinics be referred to a joint conference committee.  He is concerned that as we add more ambulances the response times have not decreased.  Dr. Brown said they saw some improvements in Code 3 calls when Rapid Paramedic Response System was implemented.  Commissioner Chow asked for an analysis of the response times, with a progress report to the joint conference committee within the next three months.  Dr. Brown added that this report could include an update on the Rapid Response Paramedic Pilot Program. 8) TIME SPECIFIC:  4:30 P.M. PROPOSITION Q (HEALTH CARE PLANNING ORDINANCE) HEARING St. Mary’s Hospital withdrew its request for a Proposition Q hearing because they no longer intend to close the outpatient pharmacy at the Sister Mary Phillipa Health Center.  9) PUBLIC COMMENTS Patrick Monette-Shaw - attended yesterday's Ryan White Care Council meeting. He has several problems with the contract with LaFrance Associates. They were required to do 800 surveys, and only did 71% of this. Also, only 28 of 54 providers who were sent surveys completed the survey. Surveys are two months overdue. Grand prizes have not been issued. Peer reviewers have not sent back their comments on the report. The report is two months overdue and is impeding the work of the CARE Council.  10) CLOSED SESSION* *Continued from May 7, 2002 This item was continued to the call of the chair. A) Public comments on all matters pertaining to the closed session B) Vote on whether to hold a closed session (San Francisco Administrative Code Section 67.11) 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 a litigated claim for $18,800, Mariano v. CMHS and SFUSD, Special Education Hearing Office, State Department of Education, Case Nos. SN 02-00356 and SN 02-00632 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).) 2. Vote to elect whether to disclose any or all discussions held in closed session (San Francisco Administrative Code Section 67.12(a).). (Action Item) 11) 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 went into closed session at 5:00 p.m. Present in closed session were the Commissioner Chow, Commissioner Guy, Commissioner Jackson, Commissioner Parker Commissioner Umekubo, Deputy City Attorney Jane Richardson, Robert Thomas, Gene O’Connell, Anne Kronenberg 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 a litigated claim for $20,000, Lurati v. CCSF, California Department of Fair Employment and Housing, Charge No. E200001 Action Taken: The Commission (Chow, Guy, Parker, Umekubo) approved the settlement of $20,000 for Lurati v. CCSF, California Department of Fair Employment and Housing, with Commissioner Jackson abstaining. D) Reconvene in Open Session The Commission reconvened in open session at 5:14 p.m. 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).) 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 voted not to disclose any discussions held in closed session. 12) ADJOURNMENT The meeting was adjourned at 5:15 p.m. Michele M. Olson, Executive Secretary to the Health Commission