WHEREAS, the Health Commission has reviewed the final report of the Mayor's Blue Ribbon Committee on Universal Health Care entitled, ``Achieving Health Insurance for San Francisco's Uninsured" and strongly supports the City's effort to expand health care coverage to an estimated 130,000 uninsured residents; and,

WHEREAS, the Health Commission supports consumer choice with respect to either health plans and/or providers; and,

WHEREAS, the Health Commission applauds the Committee's proposal to create a private-public purchasing program that will make health insurance more affordable by: 

(1) enabling small employers to participate in a purchasing pool that leverages their contributions for health care coverage, and (2) providing subsidies for low-income workers and the indigent; and,

WHEREAS, the voluntary nature of the purchasing program necessitates the existence of a stable and viable safety net to care for individuals not enrolled in the program; and,

WHEREAS, the Health Commission has reviewed the section of the final report which discusses public sector safety net issues and agrees with the Committee that a safety net system will continue to be needed irrespective of the implementation of the purchasing program; and,

WHEREAS, the Department has identified three areas in which implementation of this purchasing program could impact the safety net and these are in the areas of:

(1) number of patients and patient volume utilization, (2) level of revenues, and (3) patient case mix; and,

WHEREAS, the Health Commission believes that to ensure viability of the safety net while this program is being developed, particular attention should be made to monitoring patient volume, acuity, cost per unit of service, and effectiveness of capitation rates to address adverse patient case mix within the Community Health Network; and,

WHEREAS, the Health Commission believes that potential harm to the Community Health Network can be mitigated through:  (1) creating financial incentives to encourage health plans to include safety net providers in their networks, (2) adjusting rates prospectively to account for ``high utilizers," (3) enabling the Department to eliminate co-payments, if appropriate, and (4) allowing the Department to provide supplemental services that are not provided by other networks; and,

WHEREAS, in order for the Community Health Network to be a viable alternative in the San Francisco health care market, it must be seen as a provider of first choice, and not solely a provider of last resort; and,

WHEREAS, in order to ensure that the Community Health Network is a provider of first choice, the City should allocate sufficient funds to enable the Department of Public Health to appropriately market its personal health care services, and to fund needed capital and infrastructure to attract patients; now, therefore, be it,

RESOLVED, that the San Francisco Health Commission hereby supports the recommendations of the Mayor's Blue Ribbon Committee on Universal Health Care and urges the Mayor and Board of Supervisors to support the Department of Public Health's Community Health Network in its ability to successfully compete for covered lives and maintain its role as a safety net provider.

I hereby certify that the foregoing resolution was adopted by the Health Commission at its meeting of Tuesday, June 16, 1998.

Sandy Ouye Mori, Executive Secretary to the Health Commission