Minutes of the Special Health Commission Meeting Tuesday, January 27, 2004 at 4:00 p.m. Ingleside Community Center 1345 Ocean Avenue (at Plymouth) San Francisco, CA  94112 1) CALL TO ORDER President Chow called the meeting to order at 4:20 p.m. Present:  Commissioner Edward A. Chow, M.D., President Commissioner Roma P. Guy, M.S.W., Vice President Commissioner Lee Ann Monfredini – left at 6:00 p.m. Commissioner Harrison Parker, Sr., D.D.S. Commissioner Michael Penn, M.D., Ph.D. Commissioner David J. Sanchez, Ph.D. Commissioner John I. Umekubo, M.D. 2)  OVERVIEW OF DISTRICT DEMOGRAPHICS AND DEPARTMENT OF PUBLIC HEALTH SERVICES TO THE OCEAN-MERCED-INGLESIDE (OMI) AND EXCELSIOR Jim Soos, DPH Policy and Planning, gave an overview of the District 11 demographics and health data (Attachment A).  This analysis is based on data from the 94112 zip code, which encompasses the majority of District 11.  The presentation also included a summary of the DPH programs that serve the OMI and Excelsior communities.  Mr. Soos had two corrections:  the OMI Family Center is not a contact program; and the AIDS Office does not have a contract with OMI Family Center.  Mr. Soos, other DPH staff and community members added other neighborhood serving programs to this list: Hip Hop to Health Clinic AIDS Office funds prevention services at City College and the Balboa Teen Center Silver Avenue Clinic (while not in District 11, it serves many residents) Laguna Honda Hospital Adult Day Health Center outreaches to the OMI and has vans that transport people from the neighborhood to the program African American Health Initiative encompasses OMI, and has a number of programs in the area, The Nia Ujima OMI Wellness Center on Randolph Street, which is a collaborative with the Ocean Park Health Center and the nurse-managed clinic and focuses on diabetes and heart disease for people 18 years and older. Prostate Outreach and Breast Cancer Outreach Community members at the meeting expressed concern and disappointment that the other zip codes that are part of the OMI, specifically 94132 and 94127, were not included in the analysis.  Commissioner Penn asked that staff culminate the same demographics for these two zip codes.  3) PUBLIC TESTIMONY ON THE HEALTH NEEDS OF THE OMI AND EXCELSIOR COMMUNITIES Public Comment Nyree Monroe, Executive Director, I.T. Bookman Community Center, said the 94132 zip code has a large number of children.  The Hip Hop to Health Clinic is located between two schools and provides much-needed services, including immunizations.  The clinic is open one day a week.  She said the Hip Hop Clinic is never on the radar screen, and she and others have to constantly fight to maintain the clinic.  There are not enough services in the OMI and when staff makes referrals, they are to services outside of the district.  In response to a question from Commissioner Chow, Ms. Monroe said that they serve approximately 10 clients a day at the clinic.  There is both a scheduled clinic and a drop-in clinic.  Reverend Terry McGray Hill, Pastor, Wright Chapel AME Church, said that a number of organizations in the OMI need places to refer people to, and there are not enough services in the community.  The OMI Family Center only serves the most severe cases.  There are no outpatient services.  AACHIE and the Seven Principles Project do work with the community and faith-based organizations, but there are not enough services.  She also pointed out that if the 94132 zip code were included in the District demographic analysis, the African American representation would increase dramatically.  Agnes Morton, OMI Community Action Organization and SNIG, said the department needs to make sure that 94132 is included in any analysis of the OMI community because community members work hard to make sure this neighborhood is not considered an appendage.  OMI has long been underserved and in some instances downright neglected by city services.  It is the only community without a primary care clinic.  DPH should not expect OMI residents to travel to Ocean Park for their health care.  Further, the Ocean Park clinic is not culturally competent for African Americans.  There are many seniors in the neighborhood in need of health services, chronic disease management and transportation.  The Hip Hop Clinic has a cardiovascular disease prevention program.  Ms. Morton thanked the Commission for the African American Health Initiative.  The community has never received funding from Community Substance Abuse Services, even though there has been a problem for years.  Also, there needs to be evening hours for food pantries and clinics.  Residents work during the day.  Farah Dews, AACHIE’s Community Empowerment Center, said OMI has a lot of violence, just as much as Bayview.  He would like the Department to fund violence prevention programs for the community.  The OMI has no programs.  Other areas get a lot of funds, but OMI has no programs and no funding for youth.  The city leaders do not look at problems in OMI.  The community has some angry youngsters and there is a serious problem with youth segregation, block by block.  Violence is a health issue and DPH must fund violence prevention.  He also stated that youth need to be involved in the Health Commission’s community meetings.  Commissioner Monfredini asked what specific programs youth are looking for.  Mr. Dews said he works at the Stepping into Manhood program at the community empowerment center in Hunter’s Point.  The OMI needs a similar program.  He works with approximately 15 people at any one time for a couple of months, providing job counseling and information, GED assistance and help getting people to college.  He said there is a problem with the Probation Department that resulted in a youth getting killed.  Margie Cherry, Faith Based Coordinator for AACHIE, said that a lot of congregants are seniors who are afraid to go out and cannot get to services.  The community needs more funds.  Children die from violence, and low-income families are not eligible for programs because their incomes are just above the limit.  Cabs will not come to the neighborhood and busses do not come, so people cannot get to their appointments.  She needs more help.  She has contact with 23 churches.  The time for talking in meetings is past.  What the community needs now is more money and more programs.  Don’t just listen—give money. Ronnie Naiker, Ocean Avenue business owner, said successful small businesses work with the community, for example donating health supplies.  So DPH should help small businesses and this, in turn, will help the entire community. Cati Hawkins-Okori, Critical Incident Response Team (CIRT), said CIRT provides services to families of homicide victims.  Her program focuses on the southeast sector of the city and there are not enough resources to serve OMI.  The newly unveiled poster of homicide victims included two people from OMI whose families CIRT could not work with.  They need more money to expand and add staff, particularly male staff.  The Department is working with Family Mosaic to develop a model similar to the fire response team, which will bring more resources together.  Mary Harris, OMI Neighbors in Action, said she hopes this is not a meeting where ideas are heard then put on a shelf.  The community desperately needs the OMI Family Center, which was on the chopping block last year.  Clients are not capable of going to SFGH.  Her son has a mental illness and was served by the OMI Family Center.  After nine months of services, he had a part time job and now he has a fulltime job.  If he had to go by bus or otherwise to SFGH, it would never have worked.  There must be community-based services in the community.  Commissioners’ Comments Commissioner Monfredini asked what services could be provided to prevent the domino effect of further violence that often happens with homicides.  Mr. Dews said the key is intervention through anger management and talking to the individual.  Revenge is often the mentality and a person needs to open up, talk to someone and grieve.  But the people will not talk to just anyone.  It needs to be with someone they have a relationship with, so the programs must be staffed with people from the community.  Ms. Monroe said that the cycle must be stopped much earlier.  Get people jobs, off the streets, and into programs.  Ms. Morton suggested duplicating the AACHIE Community Empowerment Center in OMI, and use existing services such as I.T. Bookman and fill in the gaps with other programs.  Ms. Hawkins-Okori suggested Peacekeepers.  Mr. Dews said services need to be youth friendly.  The youth need to like the activities; otherwise they will get bored and leave.  He recommended a recording and production studio where youth can create public service announcements.  One woman (name not given) said when the city looks at funding, it needs to look at a holistic picture.  Also, the African American community is very spiritual, and people who will not go to a psychiatrist will go to a pastor, so must consider faith-based services.  Commissioner Monfredini thanked everyone for coming to the meeting.  The Commission does not often get the opportunity for this kind of dialogue.  Commissioner Guy said it is hard to hear about the tragedies then put them in the context of the tough budget times.  We need to work together to develop community priorities so that they can be funded.  She asked the neighborhood for ideas about traffic and pedestrian safety.  Reverend McCray Hill said the residents have been vocal about their needs in this area with results such as traffic bulb outs.  She also said the City has talked about Paratransit services for the community because of the neighborhood topography, but there is no money, so people remain homebound.  Commissioner Sanchez said a number of years ago there were gang prevention programs funded through Recreation and Park and community foundations.  But through years of cutbacks, these successful programs have gone away.  Mayor Brown brought all department heads together at a community meeting to talk about violence in the Mission, and this had successful outcomes.  The Health Commission needs to share the issues raised at this meeting with other departments and commissions, and approach these problems cooperatively and comprehensively, because we are losing ground. Commissioner Guy said it is important to the Commission to come out to OMI.  She has heard criticism that this is an underserved area and she wanted to hear more from the residents. Commissioner Umekubo expressed appreciation at all the testimony.  The commissioners are concerned about health, and understand that there are so many other factors that go into a healthy community.  Commissioner Parker thanked the community for welcoming the Commission.  There always seems to be a lack of funding, a lack of personnel, etc.  Our greatest resource is our ability to change the human spirit.  If there is not a spirit of equality and respect, there will never be enough resources to meet our goals.  Commissioner Penn said the fact that the OMI was not encompassed by the demographic analysis illuminates the need to be out in the community.  He said the Health Commission does more than just listen; it is action-oriented.  But resources are scarce, so we will have to work together.  He summarized the action items as he heard them expressed: OMI on the radar Increase funding for existing resources within the community Initiate new programs around violence prevention, increased access and hours to food resources, etc. Programs such as the African American Health Initiative, AACHIE, Seven Principles Project, Nia Ujima are under funded; lack of CSAS funding Senior transportation Youth mentorship, career guidance, conflict resolution services Comprehensive, multi-generational approach Health Commission playing an active role in bringing other departments together Commissioner Chow asked Dr. Katz how the Commission and Department could respond to the issues raised by the community.  Dr. Katz said violence is a public health problem, but the solution is much more complex than medical services.  He will take the offered solutions to the District Attorney and other departments.  He assured the Commission and the community that the recent wave of violence has not gone unnoticed.  Commissioner Chow said the Commission is aware of the community, aware of the needs, and work to address these needs.  But given the lack of resources, it will be an incremental approach beginning with violence prevention.  DPH will work with other departments to develop a response.  4)  PUBLIC COMMENT None. 5)  ADJOURNMENT The meeting was adjourned at 6:35 p.m. Michele M. Olson, Executive Secretary to the Health Commission