HEALTH COMMISSION. CITY AND COUNTY OF SAN FRANCISCO Edwin M. Lee, Mayor Department of Public Health

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1 Steven Tierney, Ed.D. President Sonia E. Melara, MSW Vice President Edward A. Chow, M.D Commissioner James M. Illig Commissioner Margine A. Sako Commissioner HEALTH COMMISSION CITY AND COUNTY OF SAN FRANCISCO Edwin M. Lee, Mayor Department of Public Health Barbara A. Garcia, MPA Director of Health Mark Morewitz, MSW Executive Secretary David J. Sanchez, Jr., Ph.D TEL (415) Commissioner FAX (415) Catherine M. Waters, R.N., Ph.D. Commissioner 1) CALL TO ORDER Present: The meeting was called to order at 4:04pm. MINUTES HEALTH COMMISSION MEETING Tuesday,, 4:00 p.m. 101 GROVE STREET, ROOM 300 or ROOM 302 San Francisco, CA Commissioner Steven Tierney, Ed.D., President Commissioner Sonia E. Melara, Vice President Commissioner Edward A. Chow M.D. Commissioner James Illig Commissioner Margine Sako Commissioner David J. Sanchez Commissioner Catherine Waters Web Site: 2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF OCTOBER 4, Commissioner Chow requested that the address of Laguna Honda Hospital, where the meeting took place, be put into the minutes. Action Taken: The minutes of the of the October 4, 2011 meeting were unanimously approved with the correction noted above. 3) DIRECTOR S REPORT Barbara A. Garcia, Director of Health, presented the report which is a current overview of the state of public health in San Francisco. The full report can be viewed at: Safe Routes to Schools The SF Safe Routes to School Program organized International Walk to School Day on Wednesday, October 5 th. Thanks to the hard work of multiple partners, this year was the best Walk to School Day ever! We were lucky to have beautiful blue skies and had a record number of school participating Citywide: 44 schools and an estimated 7,200 students participate. Over 35 families joined Mayor Lee, Supervisor Jane Kim, Marshall principal Peter Avila, Board of Education President Hydra Mendoza, SFMTA

2 Director Ed Reiskin, and SF Recreation Parks Director Phil Ginsburg on a brisk walk to school. Many thanks to Safe Routes to Schools and everyone who made the event at Marshall such a great success. DPH Receives Three Significant Grant Awards Community Transformation Grant: DPH has been awarded a grant of $815,358 annually for five years to implement the citywide the San Francisco Health in All Policies: Transforming Places, Empowering People (SF-HiAP) initiative. This grant is a part of Health Reform's Community Transformation Grants to support public health efforts to reduce chronic diseases, promote healthier lifestyles, reduce health disparities, and control health care spending. Dr. Tomás Aragón will lead the project, which will include partnerships with community-based organizations and educational institutions. Maternal, Infant and Early Childhood Home Visiting Grant: DPH has been selected as a recipient of a Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for $1.196 million from the State Maternal, Child, and Adolescent Health (MCAH) Program. We applied to implement the Nurse Family Partnership with low income, first time moms in high risk communities in San Francisco (including families residing in public housing). Enhanced Comprehensive HIV Prevention Plan: The HIV Prevention Section received a grant for $1.2 million from the Centers for Disease Control and Prevention to continue the implementation of SF's Enhanced Comprehensive HIV Prevention Plan (ECHPP) for two more years ( ). This grant will support multiple health department sections, including STD Prevention and Control, HIV Health Services, and the HIV Prevention Section, to implement activities to reduce new HIV infections and maximize health outcomes. State Legislation Update The California State Legislature concluded its session on September 9, 2011, and the Governor had until October 9 to sign, veto, or allow to become law without his signature any bills passed by both the Assembly and the Senate. The Office of Policy and Planning tracked more than 140 health-related bills that were introduced in this session. A copy of the Department s bill tracking chart, which includes the status of each bill, may be viewed at DPH Participation in Last Month s Southeast Facilities Health Fair Approximately 300 people from the Southeast community attended this year s Southeast Facilities Health Fair, which was held on Saturday, September 24 th. Staffing five tables at the event, DPH was one of 16 agencies that participated. The fair included entertainment, dancing, youth awards, and a raffle. Participants were encouraged to visit each participating agency s display through the use of an incentive card that they had to have stamped at each booth to qualify for incentives. DPH-wide Training Committee Expands Access Education and Training The DPH-wide Training Committee (DPH-WTC) was recently formed to increase access to educational resources and opportunities using DPH s current IT infrastructure to create a curricula accessible to all staff and community partners. The DPH-WTC includes representation from Quality Management, Community Health Promotion & Prevention, Occupational Safety & Health, Laguna Honda, San Francisco General, and Information Technology (IT). The work of the DPH-WTC has focused strengthening the IT framework for education and training. Thus far, the DPH-WTC has: created internet based enrollment tools for DPH staff and the public; created on-line listings of training events and resources; increased public awareness through development of web profile; and developed easier to use web navigation tools. Page 2

3 COMMUNITY HEALTH NETWORK SAN FRANCISCO GENERAL HOSPITAL & TRAUMA CENTER OCTOBER 2011 Health Commission - Director of Health Report (10/03/2011 CLIN-MEC) 10/ /11 to 06/12 New Appointments Reinstatements 0 0 Reappointments Delinquencies: 0 0 Reappointment Denials: 0 0 Resigned/Retired: Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0 0 Deceased 0 1 Changes in Privileges Additions 7 33 Voluntary Relinquishments Proctorship Completed 8 36 Proctorship Extension 0 0 Current Statistics as of 09/19/2011 Active Staff 478 Courtesy Staff 560 Affiliated Professionals (non-physicians) 244 TOTAL MEMBERS 1,282 Applications in Process 101 Applications Withdrawn Month of OCTOBER SFGH Reappointments in Process 11/2011 to 01/ Page 3

4 LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER October 2011 Health Commission - Director of Health Report (October 13, 2011 Medical Exec Committee) October (FY ) Month-to-Date New Appointments 4 11 Reinstatements 0 0 Reappointments 4 15 Delinquencies: 0 0 Reappointment Denials: 0 0 Resigned/Retired: 1 4 Disciplinary Actions 0 0 Restriction/Limitation-Privileges 0 0 Deceased 0 0 Changes in Privileges Additions 0 0 Voluntary Relinquishments 0 0 Proctorship Completed 1 2 Proctorship Extension 0 0 Current Statistics as of 10/3//2011 Active Medical Staff 98 Courtesy Medical Staff 1 Affiliated Professionals 2 TOTAL MEMBERS 101 Applications in Process 2 Commissioner Illig asked for information on the process by which the City decides which legislation it will support or oppose. Jim Soos, Assistant Director of Policy and Planning, stated that City Departments take legislation to the San Francisco State Legislation Committee and recommend support or opposing the bill. Mr. Page 4

5 Soos works with the DPH Division Heads and Director Garcia to identify bills to take to the San Francisco State Legislation Committee for consideration. Commissioner Sanchez asked if there is any plan to consider attempting to lower speed limit zones for early childhood education centers which may not be attached to school campuses. Director Garcia stated that many of these programs are non-profits and that the DPH Environmental Health Pedestrian Safety unit has been looking at this issue. Commissioner Chow thanked the DPH or its participation in the National Health Disparity Survey which will over-sample the San Francisco Asian population. The DPH co-sponsored a press conference to encourage Asian San Franciscans to participate in the survey. Commissioner Chow asked the implication of SB90 for the DPH. Jim Soos, Assistant Director of Policy and Planning, stated that the bill relates to the tax fund that hospitals paid into to draw down additional FFP. Public hospitals were cut out of that process and therefore the DPH gets no reimbursement from this fund. Public Comment: Ed Washaryer, SEIU 21, stated that AB1136 amends the California OSHA regulations that require all patient care units to have a patient lifting policy to reduce skeletal injuries related to lifting patients. He stated that the regulations contained in the legislation are included in the union s contract. 4) GENERAL PUBLIC COMMENT Dr. Derek Kerr stated that past misallocations of over $100,000 of the LHH Gift Fund were not caught by the many administrators on staff at LHH. He stated that having rules is not effective if no one insures that proper procedures are followed. He asked the Commission to continue to closely review the LHH Gift Fund. 5) COMMUNITY AND PUBLIC HEALTH COMMITTEE Commissioner Margine Sako, Chair stated that the Committee heard three presentations. Susan Fernyak M.D., Director Communicable Disease Control and Prevention, reported on DPH efforts to administer TDAP vaccinations to 7-12th graders before the beginning of school. The DPH vaccinated 1,000 students and reached 99% of the target population. Dr. Avantika Nath DDS, reported on DPH Dental Services. Dr. Nath stated that because Denti-Cal is being severely cut, that the DPH will be responsible for paying for dental services that have previously been covered. Dr. Nath stated that it only takes five years for someone with poor dental hygiene to lose their teeth which can severely impact a person s ability to get adequate nutrition. Tangerine Brigham, Deputy Director of Health and Director of Healthy San Francisco, gave an update on three pieces of legislation before the Board of Supervisors regarding proposed amendments to the Health Care Security Ordinance. The DPH will continue to update the Commission on this issue. 6) NOTICE OF RELOCATION FOR A BETTER WAY Alice Gleghorn, CBHS/County Alcohol and Drug Administrator, reviewed the request by this agency to relocate. Action Taken: The request for A Better Way to relocate was unanimously approved. 7) NOTICE OF RELOCATION FOR INSTITUTO FAMILIAR DE LA RAZA, INC. Alice Gleghorn, CBHS/County Alcohol and Drug Administrator, reviewed the request by this agency to relocate. Page 5

6 Commissioner Comments/Follow-Up: Commissioner Sanchez stated that Instituto Familiar De La Raza is a flagship of excellence. However, he is concerned that many non-profits are offering their services in a small geographic area and asked the DPH to consider this fact for future relocation requests. Action Taken: The request for Instituto Familiar De La Raza, Inc. to relocate was unanimously approved. 8) FY 2010 CHARITY CARE REPORT Frances Culp, Senior Health Planner gave the presentation which reviewed Charity Care data for the fiscal year 2010 and included some overview data from the past ten years of Charity Care in San Francisco. She thanked Kaiser Permanente for providing the color copies of the report and charts to the Health Commissioners. Commissioner Comments/Follow-Up: Commissioner Melara asked if CPMC/St. Luke s Hospital is able to reclassify the patients who previously were categorized as Bad Debt into Charity Care. Judy Li, CPMC Vice President, stated that she can request the Sutter Health debt collection department to attend a Finance and Planning Committee meeting to discuss this issue. Commissioner Illig stated that he is pleased to see CPMC increasing access to care. However, because CPMC/St. Luke s Hospital is not requiring proof of income, the data is not consistent in what other hospitals are collecting and it is difficult to compare. Commissioner Chow stated that he is concerned that Chart 5, which shows an overview of the percentage of change in unduplicated Charity Care Patients since 2003 is skewed because of the different way that CPMC/ St. Luke s is enrolling their patients. He asked that a footnote be added to the chart for clarification. Commissioner Chow also requested that Healthy San Francisco data be added to the Chart, Percentage of Residents per District Receiving Charity Care Top Districts. He stated that the additional information may show that a percentage of people who were previously categorized as Charity Care are now enrolled in Healthy San Francisco. Director Garcia acknowledged and thanked all the hospitals that participated in the Charity Care report. Action Taken: The Health Commission unanimously approved sending the Charity Care Report to the Board of Supervisors with an introductory letter from President Tierney. 9) 5-YEAR BUDGET TASK FORCE Barbara Garcia, Director of Health and Greg Wagner reviewed the presentation which proposed that the Health Commission create a 5-Year-Budget Subcommittee of the Finance and Planning Committee. The presentation proposed the following three budget priorities in which budget decisions should be aligned: Integrated Service Delivery System, Public Health Accreditation, and Financial Efficiency. Commission Comments/ Follow-Up: Commissioner Illig, Chair of the Finance and Planning Committee, stated that he supports the creation of the subcommittee. He asked Mr. Morewitz to insure that the public notices include language that indicate that any Commission may attend the meetings. Action Taken: The Health Commission unanimously approved the creation of the 5-Year Budget Task Force Subcommittee of the Finance and Planning Committee. Page 6

7 Commissioner Tierney appointed Commissioner Chow as Subcommittee Chair and Commissioner Sako as a member. He stated that he would also be a regular member. Commissioner Chow asked that the Commissioners relay any thoughts or suggestions regarding the subcommittee to Mr. Morewitz to relay to the members. He also stated that he hopes to make quarterly reports to the Finance and Planning Committee. 10) FY10-11 DPH GIFT REPORT Jen Louie, DPH Budget Director, gave the report. Commissioner Comments/Follow-Up: Commissioner Illig asked for information regarding the funding of furniture and fixtures for the SFGH Rebuild Project. Commission Sanchez, a board member of the SFGH Foundation, stated that the Foundation will provide significant leadership for the fundraising effort. Commissioner Chow asked the status of the LHH Foundation because there is no data in the report for this entity. Mivic Hirose, LHH Executive Administrator, stated that the Administration Code does not require this information and the LHH Foundation declined to submit data, as they have in the past. Commissioner Chow stated that the Foundation is using a City Hospital s name to raise funds and recommended that the LHH JCC meet with the Foundation. Commissioner Melara, Chair of the LHH JCC, asked if the LHH Foundation charter states that they will be raising funds on behalf of LHH. Ms. Hirose stated that she would review the LHH Foundation charter and report back to the LHH JCC in November. Commissioner Sanchez recommended that the Commission President and the Chair of the LHH JCC meet with a few members of the LHH Foundation board of directors. Commissioner Illig asked for information on the IRS 990 forms from the fiscal agent for the LHH Foundation because the LHH Foundation IRS 990 forms only provide basic information regarding the fiscal agent it uses. 11) OTHER BUSINESS JOINT CONFERENCE COMMITTEE REPORTS Commissioner Chow, Chair of the SFGH JCC, stated that at the October 11, 2011 meeting, the Committee heard a report on the Trauma Program and asked Mr. Morewitz to send the full Commission slides from this presentation. The SFGH JCC also recommended that the Hospital Plan for Provision of Patient Care and the Environment of Care/Safety Management Reports be approved by the full Health Commission at the 11/15/11 meeting. COMMITTEE AGENDA SETTING 12) CLOSED SESSION 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 Evidence Code Sections 1157(a) and (b); ; Health and Safety Code Section 1461; and California Constitution, Article I, Section 1 Page 7

8 LHH CRENDENTIALS REPORT D) Reconvene in Open Session Action Taken: The Commission approved the Laguna Honda Credentials Summary Report and voted not to disclose the discussion from the closed session. 13) ADJOURNMENT The meeting was adjourned at 6:21pm. Page 8