Minutes of the Health Commission Meeting Tuesday, February 7, 2006 at 3:00 p.m. 101 GROVE STREET, ROOM 300 San Francisco, CA 94102 1) CALL TO ORDER Commissioner Monfredini called the meeting to order at 3:10 p.m. Present: Commissioner Lee Ann Monfredini, President Commissioner, James M. Illig, Vice President Commissioner Edward A. Chow, M.D. Commissioner Roma P. Guy, M.S.W. Commissioner David J. Sanchez, Jr., Ph.D. – left at 5:40 p.m. Commissioner Donald E. Tarver, II, M.D. Commissioner John I. Umekubo, M.D. Commissioner Monfredini announced the Health Commission committee assignments: JOINT CONFERENCE COMMITTEE FOR COMMUNITY HEALTH NETWORK James M. Illig, Chair Donald E. Tarver, II, M.D., Member Roma P. Guy, Member Alejandra Rodas, Youth Health Advisor JOINT CONFERENCE COMMITTEE FOR LAGUNA HONDA HOSPITAL Edward A. Chow, M.D., Chair David J. Sanchez, Jr., Ph.D., Member JOINT CONFERENCE COMMITTEE FOR POPULATION HEALTH AND PREVENTION Roma P. Guy, Chair Lee Ann Monfredini, Member Milo Santos, Youth Health Advisor JOINT CONFERENCE COMMITTEE FOR SAN FRANCISCO GENERAL HOSPITAL Lee Ann Monfredini, Chair John I. Umekubo, M.D., Member BUDGET COMMITTEE David J. Sanchez, Jr., Ph.D., Chair Edward A. Chow, M.D., Member Donald E. Tarver, M.D., Member IHSS PUBLIC AUTHORITY James M. Illig S.F. HEALTH AUTHORITY John I. Umekubo, M.D. SFGH FOUNDATION David J. Sanchez, Jr., Ph.D. 2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF JANUARY 17, 2006 Action Taken: The Commission approved the minutes of the January 17, 2006 Health Commission meeting, with the following corrections: page 2 – “Medicare” in place of “Medicaid.” Page 5 – added to Dr. Katz’s comments “He added that while the San Francisco Health Plan would see a reduction, it decided not to reduce capitation to its medical groups;” Page 7 - Commissioner Sanchez moved that the nominations for President and Vice President be closed. 3) APPROVAL OF THE CONSENT CALENDAR OF THE BUDGET COMMITTEE Items for Approval (3.1) PHP-AIDS Office – Request for approval to accept retroactively and expend the Year 2 subcontract from PHFE Management Solutions, in the amount of $55,140, for HIV Prevention Trials Unit Protocol 039, for the period of July 1, 2005 to June 30, 2006. (3.2) AIDS OFFICE-HIV/AIDS Stats & Epidemiology – Request for approval of a retroactive renewal contract with PHFE Management Solutions, in the amount of $98,483, including a 12% contingency, to provide fiscal intermediary support for the HIV/AIDS surveillance activities for the AIDS Office - HIV/AIDS Statistics & Epidemiology Section, for the period of January 1, 2006 through December 31, 2006. (3.3) AIDS OFFICE-HIV Health Services – Request for approval of a retroactive renewal contract with Catholic Health Care West – St. Mary’s HIV Care Program, in the amount of $216,160, including a 12% contingency, to provide Primary Care Services targeting persons with HIV who reside in San Francisco, for the period of November 1, 2005 through February 28, 2006. Secretary’s Note – Commissioner Illig and Commissioner Umekubo abstained from voting on this item. (3.4) PHP-AIDS Office – Request for approval of a resolution approving FY 2006-07 interim agreements that incorporate an extension of the terms of the FY 2005-06 HIV Health Services Federal Ryan White CARE Title I contracts. Secretary’s Note – Commissioner Tarver abstained from voting on this item as it relates to Baker Places. Commissioner Illig abstained from voting on this item as it relates to Project Open Hand. (3.5) PHP-Housing & Urban Health – Request for approval of a resolution approving FY 2006-07 interim agreements that incorporate an extension of the terms of the FY 2005-06 Housing & Urban Health AIDS CARE Title I MOU contracts. Secretary’s Note – Commissioner Tarver abstained from voting on this item as it relates to Baker Places. (3.6) PHP-Housing & Urban Health – Request for approval to accept and expend a grant from the Department of Housing and Urban Development, in the amount of $982,033, to expand the Direct Access to Housing program for the period of April 1, 2006 to March 31, 2008, and sole source personal services contracts with Community Awareness and Treatment Services and Tenants and Owners Development Corporation, in the amount of $892,800 for the same time period. Commissioners’ Comments Commissioner Tarver noted for the record that the cost of this contract is approximately $14,400 per person. This highlights the cost of supportive housing. With $7 million, the Department could serve approximately 486 people. (3.7) BHS – Request for approval of a retroactive contract renewal with City College of San Francisco in the amount of $91,800 per year, for a total contract amount of $462,672, including a 12% contingency, to provide substance abuse counselor credentialing services, for the period of July 1, 2005 through December 31, 2009. (3.8) CHP-Primary Care – Request for approval of a retroactive contract renewal with San Francisco Bar Association, in the amount of $485,120, with an annual contract amount of $121,280, for a total contract of $543,334, including a 12% contingency, to provide Supplemental Security Income application assistance to the chronically homeless and mentally ill in San Francisco, for the period of July 1, 2005 through June 30, 2009. Items for Discussion and Approval (3.9) BHS – Request for approval of a retroactive contract with the Regents of the University of California Center on Deafness, in the amount of $492,361, to provide mental health and substance abuse outpatient services, for the period of July 1, 2005 through June 30, 2006. (3.10) CHN-SFGH – Request for approval of the addition of HealthSource Global Staffing, Inc., to the previously approved contract of $2,700,000 that is shared by eight contractors: Agostini Medical Staffing, Arcadia Health Services, Inc., Crdentia Corporation, First Call Nursing Services, Inc., HRN Services, Inc., Medstaff, Inc., Nurse Providers, Inc. and United Nursing International, to provide supplemental, temporary per diem and traveling nursing personnel services for San Francisco General Hospital, for the period of July 1, 2005 through June 30, 2006. (3.11) CHN-SFGH – Request for retroactive approval of a previously executed emergency contract in the amount of $100,000 with Nurse One Staffing, LLC, to provide supplemental, temporary per diem and traveling nursing personnel services under a state of health emergency for San Francisco General Hospital, for the period of December 1, 2005 through June 30, 2006, per San Francisco City and County’s Administrative Code, Section 21.15, Emergency Procurement Procedures. Action Taken: The Commission approved the Budget Committee Consent Calendar, including Resolution 01-06, “Approving Fiscal Year 2006/07 Interim Agreements Incorporating an Extension of the Terms of Fiscal Year 2005-06 HIV Health Services Program Contracts for the Department of Public Health,” (Attachment A) and Resolution 02-06, “Approving Fiscal Year 2006/07 Interim Agreements Incorporating an Extension of the Terms of Fiscal Year 2005-06 Housing and Urban Health Program Contracts for the Department of Public Health,” (Attachment B). Commissioner Illig abstained from voting on Item 3.3 and Item 3.4 as it relates to Project Open Hand. Commissioner Tarver abstained from voting on Item 3.4 and 3.5 as it relates to Baker Places. Commissioner Umekubo abstained from voting on Item 3.3. The Commission asked for an update to the Budget Committee in one year for Item 3.8. 4) DIRECTOR’S REPORT Anne Kronenberg, Deputy Director of Health, presented the Director’s Report. Revenue Supplemental Appropriation The Mayor is submitting the revenue supplemental today that was approved by the Health Commission on January 11th. The supplemental is being revised to include additional one-time costs funded with Health Department surplus revenues augmented with State Funding and additional City General Funds that are also one-time in nature. The Health Commission approved an initial revenue supplemental appropriation of $10.26M on January 11th, which was later increased to include $2.4M for work orders and contract expenses. This has now been increased to fund: $1,755,000 for efficiency improvements in the neighborhood health centers, $9,495,000 for furniture, fixtures and equipment for the Laguna Honda rebuild, and $25,000,000 to fund the environmental impact report and design phase for the SFGH rebuild. The supplemental will utilize $27.6M of DPH’s projected surplus revenues, $4M in SB90 state funding and City General Funds of $17.3M. Universal Healthcare Council Today Mayor Newsom announced the formation of a new advisory group, the Universal Healthcare Council. The Council is tasked with delivering a report in 100 days outlining implementation steps for the Mayor’s proposed defined benefit program. Co-chairing the Council are Sandra Hernandez, M.D., CEO of the San Francisco Foundation and Lloyd Dean, CEO of Catholic Healthcare West. The defined benefit program will provide uninsured San Franciscans access to health care services at an affordable cost through the Department of Public Health and the SF Consortium Clinics. Components of the defined benefit program include: Routine health screening and physical exams Prenatal care Primary care Pharmacy Planned hospitalization Emergency services Currently the proposal enjoys widespread support from business, labor and health care advocates. Supervisor Tom Ammiano amended his Universal Healthcare legislation to allow the new defined benefit program as an option. Once implemented the program will require an expansion of our health care system. Dr. Katz will keep the Commission apprised of the Council’s progress. Laguna Honda Special Use District Initiative As the Commission is aware, a group of activists has presented the Department of Elections a signature drive that, if approved, will place an initiative on the ballot that will severely limit future admissions to Laguna Honda Hospital based on age and long-term disability needs. One of the critical elements of public health is to be able to respond to emerging needs of a population, of which Laguna Honda Hospital has a long and proud history. Had this initiative been in place prior to 1980, the Department would not have been able to open an AIDS Ward at LHH. DPH understands and shares the concern that the public has in wanting to protect the residents of Laguna Honda Hospital and have taken a number of steps to strengthen security and carefully screen new patients. DPH continues to admit patients based on the Mayor's directive of 2004, giving first priority to those from the community, those at risk of becoming homeless, and, finally, transfers from San Francisco General Hospital that meet the appropriate criteria. The Director’s Report included clippings from today's Chronicle and Examiner. President Bush’s FY 2007 Budget President Bush’s FY 2007 budget was released yesterday. The proposal predicts a record deficit of $423 billion in 2006 and reduces funding for domestic programs. Overall, a $5.3 billion cut is proposed for non-security domestic discretionary programs, including a $126 million cut to discretionary health programs. When inflation is taken into account, the total proposed cut to non-entitlement, non-security domestic programs is $16.8 billion. Although $11 billion in cuts to Medicaid services were just enacted, the budget would cut another $14 billion from Medicaid over the next five years. Proposed cuts include further limits on intergovernmental transfers, cuts to payments for targeted case management and reduced administrative funding. Greater cuts are proposed for Medicare, which would lose $2.5 billion in FY 2007 and $36 billion over the next 5 years. These include an $8.1 billion reduction in Medicare hospital inpatient and outpatient reimbursements and $6.2 billion in savings generated by phasing out, over the next 4 years, Medicare bad debt payments for inpatient and outpatient hospital services. Medicare payment rates for skilled nursing homes and home health agencies would be frozen in 2007, and scheduled inflation increases for these services in 2008 and 2009 reduced. The budget also allows a scheduled cut in 2007 to Medicare physician payments to go forward. The House and Senate Budget Committees have until April 15 to hold budget hearings, mark up a Budget Resolution and resolve differences between the House and Senate Resolutions. It is not unusual, however, for Congress to miss the April 15th target. Laguna Honda Licensing and Certification Survey State inspectors from the Department of Health Services arrived at Laguna Honda Hospital (LHH) on Sunday, February 5th for their annual Licensing and Certification survey. They are also joined by federal inspectors from the Centers for Medicare & Medicaid Services. There are a total of 17 inspectors. They are expected to conduct their evaluation at LHH over the next two weeks. SF Asthma Task Force Project A number of key steps have been taken by the Board of Supervisors’ Asthma Task Force. Most notably, the Task Force achieved its goal of recruiting and hosting 75 participants at the Certified Asthma Educator Certification Exam Review Course was held on February 2-3 and taught by the Association of Asthma Educators. The Task Force intends to financially support each candidate’s registration and successful completion of the Asthma Educator certification exam and to support ongoing informal seminars and other resources. The National Asthma Educator Certification Board initiated the professional exam process in September 2002. As of November 30, 2005, there were 1,420 AE-C certificants nationwide, with a national pass rate of 70 percent. In their words, “By providing a certification process, patients, providers and healthcare payers will be assured that information provided by a Certified Asthma Educator (AE-C®) is based upon scientifically sound concepts.” Another goal of the Board is to secure third-party reimbursement for asthma counseling by the Centers for Medicare & Medicaid Services. The Task Force reached out to a broad and impressive spectrum of hospitals and clinics that serve patients most in need of asthma self-management education. Many staff in non-clinical programs are involved as well as health professionals serving adults with asthma. Additional financial support for the project has been provided by the Asthma Resource Center, Inc., through contributions to date from Kaiser Permanente SF, CPMC Community Benefits and Genentech. Prop 65 The San Francisco Health Code was recently amended to require the Department of Public Health to enforce existing Prop 65 (Safe Drinking Water and Toxic Enforcement Act of 1986) requirements in all restaurants and markets. Prop 65 requires the public to be notified about the presence of certain chemicals in foods, beverages or other consumer products that cause cancer, birth defects, or other reproductive harm. The San Francisco Law requires the warning sign to be posted in Chinese, Spanish, and English. On January 12th, Environmental Health sent out a letter to food establishment owners and operators explaining the new requirement, along with a list of frequently asked questions and answers about the new law and a multi-lingual warning sign that meets the Prop 65 requirements. Medical Cannabis Dispensary Act The Board of Supervisors recently amended the City’s Planning and Health Codes by requiring a Health Department permit to operate a medical cannabis dispensary, setting up zoning restrictions, requiring the Planning Commission to hold discretionary review hearings, setting up an application process, establishing operating requirements, and requiring the Health Department to inspect the dispensary at least twice a year. Working closely with representatives from City Planning, Department of Building Inspection, and the City Attorney’s Office, the Environmental Health Section began to implement the legislation on December 30, 2005. On January 18, 2006, the Environmental Health Section held a public meeting for owners and operators of existing dispensaries, new applicants, and the media to discuss the permitting process. Application forms and referrals to other city agencies are now posted on the Environmental Health Section’s web page. LHH Credentials Year-to-Date Report, 7/1/2005 to 01/19/2006 New Appointments 8   Reinstatements 0   Withdrawal 0 Reappointments   28   Delinquencies: 0   Reappointment Denials: 0 Resigned/Retired 10 Disciplinary Actions      0 Restriction/Limitation of Privileges 0 Changes in Privileges 0   Additions         0   Voluntary Relinquishments 0 Commissioners’ Comments Commissioner Monfredini said she, Commissioner Illig, Commissioner Guy and Commissioner Chow attended the Mayor’s press conference at NEMS regarding universal health care. The energy in the room was extraordinary, and this proposal has every chance of becoming a reality. San Francisco will again be at the forefront of health care. Commissioner Chow added that business was well represented at the press conference, including people from the Chamber of Commerce and the Committee on Jobs. Everyone is genuinely interested in moving this proposal forward. Commissioner Umekubo is happy to hear that business is supportive of this initiative. Last night at the San Francisco Medical Society Executive Committee meeting, the physicians gave their support for this effort and want to be involved. Public Comments Patrick Monette-Shaw said that the Health Commission and Dr. Katz are using AIDS as a scare tactic to build support against the Laguna Honda Hospital ballot initiative. Mr. Monette-Shaw said it is irresponsible to add more people to community clinics when the Department already has a backlog. There is no provision in Supervisor Ammiano’s legislation to require money to be allocated to primary care. Commissioner Chow supports the supplemental appropriation to fund the next steps for the San Francisco General Hospital rebuild. The supplemental also helps begin the financing for furniture and equipment for Laguna Honda Hospital. Furthermore, the proposed supplemental recognizes that there is an infrastructure problem at the primary care clinics and begins to address these problems. 5) RESOLUTION SUPPORTING THE CREATION OF A COMMUNITY LIVING TRUST FUND Commissioner Illig introduced the resolution, and gave some background. The Living with Dignity plan laid out what San Francisco could do to help people get out and stay out of institutions such as Laguna Honda Hospital. Subsequently the TCM program was started. Then in March 2005, the Controller issued a report that included among its recommendations the creation of a trust fund that could be used to support hundreds of people living in the community. Commissioner Illig and others in the community see the opportunity to create this fund now, which is what is before the Commission today. He understands that there is some concern about the amount of money that is initially allocated to the fund, and he is willing to have this discussion. But he wholeheartedly supports moving forward with the creation of the community living trust fund. The time is now. Public Comment Sandy Mori, co-chair of the Long Term Care Coordinating Council (LTCCC), said the LTCCC strongly supports the creation of the Community Living Trust Fund. She urged the Health Commission to support the creation of the fund and urge the Mayor and Board of Supervisors to fund this as part of the budget process. Sandy O’Neill, Independent Living Resource Center and member of the LTCCC, said money must be attached to the resolution supporting the creation of the trust fund. Meg Cooch, Planning for Elders in the Central City, conveyed comments from Mercy Housing, which is opening two new buildings: Mission Creek and 9th & Jesse. The trust fund could help fund these types of programs. Ms. Cooch urged the Health Commission to include $7 million in its resolution. Elinore Lurie, Planning for Elders in the Central City, said a community living trust fund would do a lot to address the gaps in discharge services, and people would not have to scrounge around at the last minute to arrange services. Bruce Allison, Living Wage, said getting people out of the hospital gives them a chance to get back into the community. Herb Levine, ILRCSF, said the Health Commission should not pass a resolution without attaching money to it. This would continue a long tradition of empty promises. Bob Planthold spoke in support of the community living trust fund. Move ahead with the resolution, including specifying a $7 million allocation to the fund. Barry Benda, Golden Gate Regional Center, Jacy Cohen, ARC of San Francisco, Terrence Jones, Westbay Housing Corporation, said they have put together a preliminary plan on working together to develop alternatives for their 33 residents at Laguna Honda Hospital. Tricia Webb, LTCCC, said she looks forward to having the choice to be at home or not. She supports the community living trust fund, and it needs to be funded. Elizabeth Boardman, North and South of Market Adult Day Health Center, spoke in support of funding the community living trust fund. The community does not need a resolution that this is another good idea—they need solid financial support from the City. Ruth Gravitt, Mental Health Association, said the community living trust fund would allow for expansion of community services to address the growing need for services that cannot be provided by institutions. People thrive when they are not living in institutions. Debra Howell, Hydrocephalus Association, urged the Health Commission to support the resolution, which gives people the choice to live at home. David Bonner, IHSS Consortium peer mentor, urged the Health Commission to put money into the community living trust fund to provide more outreach, paratransit services, and other services that allow people to live in their homes. Michael Kwok, Planning for Elders, said people must have the choice to live in the community rather than in institutions. The $7.14 million surplus is a rare opportunity, and he urged the Health Commission to do the right thing. Elizabeth Zirker, Protection and Advocacy, supports the creation of a community living trust fund, which PAI believes would be one step toward compliance with the Davis Settlement. Patrick Monette-Shaw supports the creation of a trust fund, but not using the tobacco settlement money or surplus revenue. Michael Lyon, San Francisco Gray Panthers, said the Gray Panthers have taken a position that both skilled nursing homes and community care are needed. There is enough money for all kinds of care in San Francisco. Marie Jobling, Planning for Elders and co-chair of the LTCCC, asked the Health Commission to prioritize funding for community alternatives and support a funded trust fund. Nancy Brundy, Institute on Aging, said the time is now to invest in community-based living. $7 million is a drop in the bucket. The Health Commission should take a leadership role here. Yvonne Martinez, SEIU 790, said her union supports community services. They agree with the concept of community care, but she is concerned about the lack of detail, including the labor standards and standards of care for home care. She is concerned about the presumption for Option 2. Mel Beetle, 10-Year Plan to End Chronic Homeless Council, spoke in support of a community fund to help community-based services. It is essential. Commissioners’ Comments Commissioner Guy disagrees with linking the $7 million to this resolution. She is not prepared to send this forward with a specific dollar allocation without details about what would be funded, who would administer the program and other details about how this is going to work, none of which is delineated in the resolution. She supports the Health Commission making a commitment that the community living trust fund be part of DPH’s budget for next year. She made a friendly amendment that the last whereas and the first resolved clause be deleted. Commissioner Chow said a trust fund has enormous merit. There is the need to work out a roadmap upon which the fund would be developed and administered. To do this right, the Health Commission needs the details, and he supports a resolution supporting the creation of a community living trust fund and asking the Department to flesh out the details and identify how to structure a fund that works for the long-term future. Commissioner Sanchez said today’s announcement about universal health care speaks to the needs of all people. He supports the community living trust fund, and having funding for the trust fund on the Health Commission’s and Health Department’s budget radar. Commissioner Umekubo supports the creation of the community living trust fund, but believes more thought needs to be put into the details. That said, he does not want to lose the sense of urgency around the trust fund. Commissioner Tarver does not support removing the $7 million allocation from the resolution. Using this $7.14 million would not take money from any other services. Allocating this money shows that it is a priority, and something is lost if references to funding are deleted. Commissioner Monfredini supports the community living trust fund. However, she does not support sending this forward to the Mayor’s Office without assurances that there will be Department involvement in administering the trust fund. She supports making funding for the trust part of the Department’s budget priorities. She asked Dr. Katz to comment on the best way to move forward. Dr. Katz said Health Commissioners have consistently told him that they want to increase the financial commitment to community-based placement. He believes there must be more work on the details of the fund and to what extent Medicaid dollars could be leveraged toward this fund. Commissioner Illig said the LTCCC has developed a lot of the details in its Community Placement Plan, which was distributed to the Health Commissioners. Commissioner Guy said she believes there are significant ideas to allow DPH to make a recommendation about funding for a community living trust fund within this budget year. Is this an accurate assumption? Dr. Katz said at this time he would have a difficult time telling the Health Commission to prioritize funding the trust fund over things like Community Placement or Health at Home. Dr. Katz further believes it is inevitable that Medicaid will begin to pay for these services. The Department could develop the details within 60 days. Commissioner Tarver said the Health Commission is responsible for asking for funding, so he supports the resolution as originally proposed. Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Sanchez, Umekubo) approved an amendment to the resolution to remove the last Whereas clause and to change the first sentence of the first Resolved clause to read: Resolved, that the Health Commission recommends the creation of a Community Living Trust Fund as part of DPH’s budget this year and sustained in the future, and charges the Department to bring back details of how it could be funded and managed within the next 60 days. (Commissioner Tarver voted no.) Action Taken: The Commission approved Resolution 03-06, “Resolution Recommending the Creation of a Community Living Trust Fund,” as amended (Attachment C). 6) 2ND QUARTER FINANCIAL REPORT Gregg Sass, Chief Financial Officer, presented the 2nd Quarter Financial Report. This report presents the second quarter financial projection of revenues and expenditures for FY 2005-06. Mr. Sass noted that this report builds in the supplemental appropriation that the Health Commission approved and DPH submitted to the Mayor’s Office. It does not incorporate the revised supplemental appropriation that Mayor Newsom announced today. Mr. Sass presented an overview of each division in the Health Department. Projected FY 2005-06 Year-End Surplus/Deficit Commissioners’ Comments Commissioner Illig asked if DPH would still end the year with a surplus given the Mayor’s proposed supplemental appropriation. Mr. Sass said he anticipates a small surplus. Commissioner Guy asked Mr. Sass what the structural issues are facing Primary Care. Mr. Sass said that there are two major issues. One is an intradepartmental transfer between the AIDS Office and Primary Care, which is being addressed in next year’s budget. The other issue is personnel services costs that exceed budget. Commissioner Umekubo asked if the city is still anticipating an $80 million deficit. Mr. Sass said he has not heard any change to this projection. 7) PUBLIC COMMENT Louis Dixon spoke about Rogerian Nursing Theory. This is a prevalent cult in our city and hospital. UCSF is promoting Reike healers as complementary care for the poor. Homeopathic medicine is being sold all over the city. He cannot believe professionals believe this. 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 Health Commission (Chow, Guy, Illig, Monfredini, Tarver, Umekubo) voted to hold a closed session. The Commission went into closed session at 5:40 p.m. Present in closed session were Commissioner Chow, Commissioner Guy, Commissioner Illig, Commissioner Monfredini, Commissioner Tarver, Commissioner Umekubo, Dr. Mitchell Katz, Director of Health, Gregg Sass, Chief Financial Officer, Jim Stillwell, Deputy Director, CBHS, Rick Sheinfield, Deputy City Attorney and Michele Seaton, Health Commission Executive Secretary. C) Closed session pursuant to Government Code Section 54956.9 and San Francisco Administrative Code Section 67.10(d) Action Taken: The Commission (Chow, Guy, Illig, Monfredini, Tarver, Umekubo) approved the settlement of the audit appeal of the City and County of San Francisco, Substance Abuse and Crime Prevention Act, OAH No. N2005030518. City to pay $1,088,685.00. City to keep $855,794.00 D) Reconvene in Open Session The Commission reconvened in open session at 6:00 p.m. 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).) 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 (Chow, Guy, Illig, Monfredini, Tarver, Umekubo) voted not to disclose any discussions held in closed session. 9) DISCUSSION OF FUTURE HEALTH COMMISSION AGENDAS The July 4th Health Commission meeting will be rescheduled to Wednesday, July 5. The November 7th Health Commission meeting will be rescheduled to November 14th, so as not to conflict with the election. The June 6th Health Commission meeting will be rescheduled to June 13th, so as not to conflict with the election. Commissioner Tarver asked that the following items be added to the Health Commission’s Master Calendar: Long-term care director, SFGH Rebuild, Primary Care-CBHS integration, revenue enhancement/eligibility and the Chief Operating Officer. 10) ADJOURNMENT The meeting was adjourned at 6:20 p.m. Michele M. Seaton, Executive Secretary to the Health Commission Health Commission meeting minutes are approved by the Commission at the next regularly scheduled Health Commission meeting. Any changes or corrections to these minutes will be noted in the minutes of the next meeting. Any written summaries of 150 words or less that are provided by persons who spoke at public comment are attached. The written summaries are prepared by members of the public, the opinions and representations are those of the author, and the City does not represent or warrant the correctness of any factual representations and is not responsible for the content.