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 MINUTES HEALTH COMMISSION MEETING Tuesday,, 4:00 p.m. 101 GROVE STREET, ROOM 300 or ROOM 302 San Francisco, CA Web Site: Present: Excused: Commissioner Steven Tierney, Ed.D., President Commissioner Sonia E. Melara, Vice President Commissioner Edward A. Chow M.D. Commissioner James Illig Commissioner David J. Sanchez Commissioner Margine Sako Commissioner Catherine Waters The meeting was called to order at 4:03pm. 2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF DECEMBER 6, Commissioner Illig stated that on the top of page 7, the term FTEs should be replaced by positions in the first sentence. Action Taken: The minutes of the December 6, 2011 Health Commission 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: Governor Brown Implements Mid-Year State Budget Trigger Reductions On Tuesday, December 13, Governor Brown announced that the State will implement some of the trigger cuts in the FY State budget enacted in July. The Commission will recall that the budget contained $2.46 billion in potential automatic reductions if the State failed to realize the additional $4 billion in revenue budgeted as a result of the recovering economy. As a result, the State is enacting current year

2 spending cuts of nearly $1 billion effective January 1, 2012, the majority of which impact schools, colleges, and universities. On the health and human services side, the State is imposing a 20 percent reduction in service hours for In Home Supportive Services (IHSS) recipients and elimination of funding for local antifraud efforts for IHSS, although these are subject to court challenge. The reduction is not expected to impact significantly the Healthy Workers workorder that DPH has with the Human Services Agency. The State is also extending Medi-Cal provider cuts and copayments to all managed care plans, although this only affects three plans statewide, the Program of All-Inclusive Care of the Elderly (PACE), the Senior Care Action Network (SCAN), and the AIDS HealthCare Foundation. The state s other Medi-Cal managed care plans saw their rates reduced In March 2011, and are not impacted by this cut. Community Transformation Grant The Centers for Disease Control (CDC) and Prevention recently awarded the Department of Public Health s Population Health and Prevention Division a 5-year $4,076,790 Community Transformation Grant (CTG). This funding initiative represents a new and key component of the Affordable Care Act prevention strategy. DPH is one of just 16 counties nationwide and 35 sites across the country to receive this highlycompetitive grant that focuses on cardiovascular health promotion through transforming communities and empowering people. Participating sections include Community Health Promotion and Prevention, Environmental Health, Community Oriented Primary Care and Maternal, Child and Adolescent Health. Tomás J. Aragón, MD, Health Officer, is leading this effort on behalf of the Department. Grant to Facilitate Integrated Patient Information The Metta Fund, a private foundation focused on the health of San Franciscans, has awarded $125,000 to the Department of Public Health to develop and spread the integrated patient information currently residing in the Coordinated Case Management System (CCMS) through a three-step project. The Department of Public Health will 1) create an individual patient summary covering all medical, ambulance, living situation, and psycho-social information that has been integrated in CCMS from various DPH, EMS, and Human Services Agency systems, 2) display the summary to clinicians by single sign-on in Avatar, and 3) consider the ways this health information technology improves clinicians understanding of their patients and thus improves quality of patient care. DUH Site Fully Rented The 120- unit Richardson Apartments, a newly-constructed apartment building located at the corner of Fulton and Gough, is fully rented and home to 120 chronically homeless people. The building is owned and operated by the Community Housing Partnership and the on-site services are provided by UCSF's Citywide Case Management Team. The capital funding for the project was provided by the San Francisco Redevelopment Agency in addition to state and federal financing sources. DPH referred 100% of the clients into the building from SFHOT, SFGH/Respite, Laguna Honda Hospital, and CBHS Intensive Case Management Teams. Annual Crop Report By law, each county in the state of California has to submit an annual Agricultural Crop Report to the Secretary of Agriculture and the Board of Supervisors. I thought the Commissioners may enjoy reviewing this past year s Agricultural Crop Report (2010) for the City & County of San Francisco. A copy of the report is attached. Asthma Task Force Produces Multi-Lingual Video The SF Asthma Task Force has helped public health nurse Gail Herrick and SFGTV producer Scott Wiseman produce a short instructional video that helps patients get an accurate measure of their lung function using office-based spirometry. The video will be made available in English, Spanish, Cantonese, Mandarin, Page 2

3 Russian, Tagalog and Vietnamese versions, and serves as a great model for providing multi-lingual instruction for clinic-based procedures that occur frequently and usually require onsite language interpreters to be called in. We will soon have the final products accessible through a link from the SFATF's website, and available as DVDs. STD Control and Prevention Addresses Health Disparities Among Youth of Color The San Francisco STD Prevention and Control Section addresses health disparities among youth of color through its Youth United Through Health Education (YUTHE) Program. The YUTHE peer education program was established in 1997 to address these disparities and has since been part of a comprehensive, multi-disciplinary approach to improving sexual health and reducing STDs among adolescents. Comprised of young adults from the affected communities, the YUTHE staff conduct weekly street and venue-based outreach in the Bayview/Hunters Point neighborhoods, organize special STD screening events, as well as provide community health education and training for both high risk youth and staff from youth serving agencies. Annually, the YUTHE team reaches approximately 5,600 teens through outreach and conducts over 70 trainings and workshops. Jacqueline McCright coordinates the YUTHE Program and can be reached at or at Jacque.McCright@sfdph.org. Human Trafficking Awareness Month January is Human Trafficking Awareness Month and to mark the occasion, the Newcomers Health Program and the Cross Bay Collaborative to Combat Human Trafficking are hosting a special training on January 5 at Carr Auditorium, Anti-Human Trafficking & Response in a Health Care Setting. Human trafficking is the fastest growing crime in the world and affects both international and U.S. citizens. A startling 43% of human trafficking cases in California are occurring in the Bay Area. Because 28% of identified victims saw a health or social service provider at least once during their trafficking ordeal, health professionals have the unique opportunity to identify and help victims. It is hoped that with increased awareness, more victims will be identified and linked to recovery services. Deadline to register for the training is December 31. Contact cristy.dieterich@sfdph.org for more information. Health Officer to Serve on Institute of Medicine Childhood Immunization Tomas Aragon, MD, Health Officer, has been accepted to serve on the Institute of Medicine s (IOM) Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule. Sudden Infant Death Syndrome (SIDS) Prevention Aline Armstrong, Public Health Nurse and the SIDS/FIMR Coordinator for the Maternal, Child and Adolescent Health Section, was selected as Chair of the 31st Annual California SIDS Conference in Sacramento. Aline is also President of the Northern California Regional SIDS Council and has been a tireless advocate for decreasing infant mortality rates and promoting safe sleeping for infants in San Francisco. San Francisco had 20 reported SIDS cases from 2000 to 2006 and six reported cases from 2007 to Harley Davidson and Buell Motorcycles Toy Ride to SFGH For the 28th consecutive year, the Dudley Perkins Harley Davidson and Buell Motorcycles held their annual toy ride to San Francisco General Hospital and Trauma Center. A caravan of over 250 bikers arriving on over 150 motorcycles and in 10 muscle cars rode to The General on Sunday morning December 12th. The riders donated over 400 toys that will be distributed to our pediatric patients. We are grateful to the motorcycle clubs and their members who make this annual pilgrimage to San Francisco and provide us with a very generous supply of new toys. Page 3

4 COMMUNITY HEALTH NETWORK SAN FRANCISCO GENERAL HOSPITAL & TRAUMA CENTER DECEMBER 2011 Health Commission - Director of Health Report (12/12/2011 CLIN-MEC) 12/ /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 Voluntary Relinquishments Proctorship Completed Proctorship Extension 0 0 Current Statistics as of 11/28/11 Active Staff 519 Courtesy Staff 576 Affiliated Professionals (non-physicians) 244 TOTAL MEMBERS 1,339 Applications in Process 20 Applications Withdrawn Month of DECEMBER SFGH Reappointments in Process 01/2012 to 03/ Page 4

5 LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER DECEMBER, 2011 Health Commission - Director of Health Report (December 8, 2011 Medical Exec Committee) December (FY ) Month-to-Date New Appointments 0 11 Reinstatements 0 0 Reappointments 4 23 Delinquencies: 0 0 Reappointment Denials: 0 0 Resigned/Retired: 0 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 5 Proctorship Extension 0 0 Current Statistics as of 12/6/2011 Active Medical Staff 99 Affiliated Professionals 2 TOTAL MEMBERS 101 Applications in Process 1 Commissioner Illig, the Health Commission representative to the In-Home Supportive Services (IHSS) Public Authority Governing Board, stated that a Washington State court ruled that cuts to the IHHS budget cannot be implemented without breaking compliance with ADA requirements. This means that any San Francisco IHSS client with reasonable need will not have his/her services cut by twenty percent. Page 5

6 Commissioner Illig also asked for more information on the Senior Action Care Network. Director Garcia stated that DPH staff will research the Network and will send Commissioner Illig information. Commissioner Tierney stated that the DPH STD Prevention Report shows continued increased rates of Chlamydia and asked for clarification on the plan to decrease occurrence of this STD. Director Garcia stated that Susan Phillip, Director of STD Prevention and Control, will address this issue in a future presentation to the Health Commission. Commissioner Melara thanked Director Garcia for inviting the Health Commissioners to the DPH Holiday party. Public Comment: Ed Warshauer, SEIU 1021, stated that the current spectrum of state, federal and international laws protecting health workers against needles sticks is largely due to the groundbreaking work of DPH nurses during the early years of the HIV epidemic. 4) GENERAL PUBLIC COMMENT There was no general public comment. 5) CONSENT CALENDAR There were no items on the Consent Calendar. 6) PROPOSITION Q HEARING AND RESOLUTION: ST.FRANCIS MEMORIAL HOSPITAL BEHAVIORAL HEALTH DAY PARTIAL PROGRAM Commissioner Illig proposed that the resolution stated that the closure of the St. Francis Memorial Hospital Behavior Health Day Partial Program will not have a detrimental impact on the health of San Franciscans. Commissioner Chow stated that he is in support of the resolution because the funds saved by closing the program will be used to focus on inpatient psychiatric services which are an important back-up to the SFGH psychiatric services. Action Taken: The Resolution stating that the closure of the St. Francis Memorial Hospital Behavior Health Day Partial Program will not be detrimental to the health of San Franciscans was approved. (Yes-Tierney, Chow, Illig, Sanchez; Abstain-Melara due to her employment with Catholic Healthcare West, the parent company of St. Francis Memorial Hospital) 7) PROPOSITION Q HEARING AND RESOLUTION: CLOSURE OF ST. MARY S MEDICAL CENTER ADHC Commissioner Illig proposed that the resolution stated that the closure of the St. Mary s Medical Center Adult Day Health Program will not have a detrimental impact on the health of San Franciscans. Commissioner Chow stated that he discussed the closure with St. Mary s leadership and was pleased to hear that all patients of the ADHC have been referred to other services. Brother George Cherrie, Vice President of St. Mary s Medical Center Mission and Community Services, stated that at this time all ADHC patients have either been accepted into other ADHC programs or have been enrolled and are on a waitlist; others have been linked with home health services. Brother George also stated that all employees have been presented with a severance package, ninety days of COBRA and offered the assistance of the St. Mary s Medical Center Human Resource Department. Page 6

7 Commissioner Sanchez stated that at previous meetings he stated his disappointment with the closure. However, since then, funds that had been offered by the Mayor s office to assist ADHC programs remain open have been cut. He understands that St. Mary s Medical Center staff have done all they can to remain open and now supports a resolution stating that the closure will not be detrimental to the health of San Franciscans. Action Taken: The Resolution stating that the closure of the St. Mary s ADHC will not be detrimental to the health of San Franciscans was approved. (Yes-Tierney, Chow, Illig, Sanchez; Abstain-Melara due to her employment with Catholic Healthcare West, the parent company of St. Mary s Medical Center) 8) DPH FY ANNUAL REPORT Lori Cook, Senior Health Planner, presented the report which reviews major accomplishments of the DPH during the Fiscal Year. Commissioner Comments/Follow-up: Commissioner Chow asked for clarification on the twenty-eight percent categorized as Other Coverage on the chart showing the COPC payer source data on page thirty four of the report. Marcellina Ogbu, Director Community Programs, stated that DPH staff will check on this data and will send clarification to the Commissioners. Commissioner Sanchez stated that he is pleased that there is an introduction by Health Commission President Tierney. Action Taken: The Commission unanimously accepted the DPH FY Annual Report and honored Steve Musick, a Laguna Honda Hospital Resident, for contributing his art for the report s cover. 9) OTHER BUSINESS JOINT CONFERENCE COMMITTEE REPORTS Commissioner Chow, Chair of the SFGH JCC, stated that at the December SFGH JCC meeting, the members heard a report on the progress of the SFGH Rebuild and asked for more specificity of data on the timeline and budget. A report on this topic will be made to the full Commission on January 17, COMMITTEE AGENDA SETTING There was no discussion of this item. 10) 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 CREDENTIALS REPORT D) Reconvene in Open Session Action Taken: The Commission approved the Laguna Honda Credentials Summary Report and voted not to disclose the discussion of other items from the closed session. 11) ADJOURNMENT The meeting was adjourned at 4:51pm in memory of Warren Hellman, a great philanthropist and a unique human being. Page 8

9 HEALTH COMMISSION CITY AND COUNTY OF SAN FRANCISCO Resolution No DETERMINING THAT THE CLOSURE OF ST. MARY S ADULT DAY HEALTH CENTER WILL/WILL NOT HAVE A DETRIMENTAL IMPACT ON THE HEALTH CARE SERVICE OF THE COMMUNITY WHEREAS, St. Mary s Hospital, a non-profit hospital and member of Catholic Healthcare West, operates an Adult Day Health Center, which opened in 1984; and WHEREAS, Because of the State of California s budget cuts in the reimbursement of Adult Day Health Center services, the St. Mary s Adult Day Health Center has been operating at a loss in excess of $400,000 to $500,000 dollars a year; and WHEREAS, on August 15, 2011 St. Mary s Hospital notified the Health Commission that it plans to close its Adult Day Health Center, effective November 18, 2011; and WHEREAS, the San Francisco Health Commission, in accordance with the Community Health Care Planning Ordinance (Proposition Q) held two public hearings on November 1, 2011 and November 15, 2011, regarding the closure of the St. Mary s Adult Day Health Center; and WHEREAS, St Mary s has initiated transition plans for the clients of its Adult Day Health Program; and RESOLVED, that the closure of the Adult Day Health Program at St. Mary s Hospital will not have a detrimental impact on the health care service of the community. I hereby certify that the San Francisco Health Commission at its meeting of adopted the foregoing resolution. Mark Morewitz Executive Secretary to the Health Commission Page 9

10 HEALTH COMMISSION CITY AND COUNTY OF SAN FRANCISCO Resolution No DETERMINING THAT THE CLOSURE OF ST. FRANCIS MEMORIAL HOSPITAL BEHAVIORAL HEALTH DAY PARTIAL PROGRAM WILL/WILL NOT HAVE A DETRIMENTAL IMPACT ON THE HEALTH CARE SERVICE OF THE COMMUNITY WHEREAS, St. Francis Memorial Hospital, a non-profit hospital and member of Catholic Healthcare West, operates a Behavioral Health Day Partial Program, which opened in 2005; and WHEREAS, on November 8, 2011 St. Francis Memorial Hospital notified the Health Commission that it plans to close its Behavioral Health Day Partial Program, effective January 27, 2012; and WHEREAS, St. Francis will close its Behavioral Health Day Partial Program and use its resources to strengthen its inpatient program, the primary alternative to the SFGH locked psychiatric ward, by enabling more psychiatrist time to serve patients in its inpatient unit and provide emergency department on-call services; and WHEREAS, the San Francisco Health Commission, in accordance with the Community Health Care Planning Ordinance (Proposition Q) held a public hearing at the Finance and Planning Committee on December 6, 2011 and at the full Health Commission meeting on December 20, 2011, regarding the closure of the St. Francis Memorial Hospital Behavioral Health Day Partial Program; and WHEREAS, St. Francis Memorial Hospital has initiated transition plans for the clients of its Behavioral Health Day Partial Program; and RESOLVED, that the closure of the Behavioral Health Day Partial Program at St. Francis Memorial Hospital will not have a detrimental impact on the health of the community. I hereby certify that the San Francisco Health Commission at its meeting of adopted the foregoing resolution. Mark Morewitz Executive Secretary to the Health Commission Page 10