WHEREAS, the Steering Committee and its sub-committees, were formed to develop recommendations to guide the Director of Health and Health Commission on health policies in the future; and,

WHEREAS, the Department also consulted its Executive Budget Committee, Community Health Network Leadership Group, Population Health and Prevention Management Forum, and various department provider organizations and provider groups in the development of financial strategies; and,

WHEREAS, as the first task of the strategic planning process, the Steering Committee has prepared findings and recommendations to set priorities for the FY 2000-2001 budget; and,

WHEREAS, the Committees recommend that the Department of Public Health reaffirm the policy to develop alternatives to inpatient and acute care, and that the Population Health and Prevention division prioritize patients of the Department's institutional services for admission into community-based and sub-acute care settings; and,

WHEREAS, it is recommended that the Department of Public Health expand community-based services, including substance abuse treatment on demand, mental health alternatives to hospitalization, increased opportunities for independent living and supportive housing programs, a soft tissue infection control program and options to provide long term care, such as home health services, adult day care and in-home supportive services, in order to reduce the use of emergency services, inpatient care and hospital-based skilled nursing facilities and to improve efficiency and quality of patient care; and,

WHEREAS, the consensus is that the Department of Public Heaktg implement Health Commission priorities to expand prevention services, particularly to high-risk populations and targeted neighborhoods as identified through health needs assessments and epidemiological data, including African American health initiatives; and,

WHEREAS, the Committees recommend that services be integrated between and among the Department of Public Health units and whenever possible, funding be blended, to foster an integrated approach to providing services with other agencies within the City and other health care agencies (e.g. IHSS, the San Francisco Community Clinic Consortium)

in order to reduce duplication and increase access. This includes the integration of HIV services with substance abuse treatment and mental health services, and behavioral health services with primary care services; and,

WHEREAS, it is the consensus that top priority for new funding be used to improve and enhance the infrastructure that supports priority programs.  Specifically, there should be increased funding to upgrade and maintain the Department's facilities, information systems, equipment, medical records, housekeeping, quality assurance, finance, human resources and contract compliance; and,

WHEREAS, the Committees recommend that the Department of Public Health develop enhanced models of skilled nursing services, including a med-psych and/or neuro-psychiatric skilled nursing program, to reduce the number of decertified acute psychiatric and medical days; and,

WHEREAS, the Committees recommend the revision of current, or the development of new system-wide benchmark measures, to evaluate the performance and quality of services; and,

WHEREAS, the Committees recommend that contract staff (including the University of California Affiliation Agreement) be provided the same cost of living increase that is provided to civil service staff and to increase funding for pharmaceuticals, laboratory services and clinical supplies to meet inflationary adjustments, cost increase in drugs, and to correct for prior underfunding; and,

WHEREAS, the Committees recommend the allocation or reallocation of resources as mandated by Federal and State agencies, including funding to meet initial requirements of Hospital Seismic Safety Improvements (SB1953), nurse to patient ratios, compliance programs, and staffing and programs for skilled nursing, as required by the Department of Justice and Health Care Financing Administration; and, 

WHEREAS, the Committees recommend the allocation or reallocation of resources to correct salary savings and fringe benefit shortfalls; and,

WHEREAS, the Committees recommend that contract development, monitoring and payment processes throughout the Department be improved by consolidating administrative processes and automating invoice processing and payment; and,

WHEREAS, the Committees recommend increased collaboration with the San Francisco Department of Human Services and the State, and outreach to populations potentially eligible for Medi-Cal, and to increase eligibility functions citywide; and

WHEREAS, the Committees recommend that the Department of Public Health advocate for the passage and implementation of key legislative initiatives that will increase funding to safety net providers, expand access to care, and improve managed care operations; and,

WHEREAS, the Committees recommend the Department of Public Health collaborate with the University of California to determine financial and programmatic impacts on patient services at the Community Health Network, to coordinate strategies to address potential increases and decreases in services, and to provide salary increases in accordance with the University of California Affiliation Agreement; and,

WHEREAS, the Health Commission acknowledges that without increased funding, the reallocation of existing resources may result in service reductions or the redefinition of the scope of services; and,

WHEREAS, the Health Commission expects the Department staff to operate programs within the approved revenues and expenditures for the present and next fiscal year; now, therefore, be it

RESOLVED, that the Health Commission endorses the recommendations within the strategic planning process to set priorities for the FY 2000-2001 budget.

I hereby certify that the foregoing resolution was adopted by the San Francisco Health Commission at its meeting of Tuesday, December 21, 1999.

Sandy Ouye Mori, Executive Secretary to the Health Commission