Sonia E. Melara, M.S.W. President Margine A. Sako Vice President Edward A. Chow, M.D. Cecilia Chung David.J. Sanchez, Jr., Ph.D. HEALTH COMMISSION CITY AND COUNTY OF SAN FRANCISCO Edwin M. Lee, Mayor Department of Public Health Barbara A. Garcia, M.P.A. Director of Health Mark Morewitz, M.S.W. Executive Secretary Belle Taylor-McGhee TEL (415) 554-2666 FAX (415) 554-2665 Catherine M. Waters, R.N., Ph.D. MINUTES HEALTH COMMISSION MEETING Tuesday,, 4:00 p.m. 101 GROVE STREET, ROOM 300 or ROOM 302 1) CALL TO ORDER Present: Sonia E. Melara, President Margine Sako, Vice President Edward A. Chow M.D. Cecilia Chung David J. Sanchez Belle Taylor-McGhee Catherine Waters The meeting was called to order at 4:13pm. Web Site: http://www.sfdph.org 2) APPROVAL OF THE MINUTES OF THE HEALTH COMMISSION MEETING OF MAY 15, 2012. Action Taken: The minutes of the May 15, 2012 Health Commission meeting were unanimously approved. 3) DIRECTOR S REPORT Barbara A. Garcia, Director of Health Mental Health Medi-Cal (MH-MC) Certification In Fiscal Year 2011-12 the Department of Public Health partnered with the Controller s Office and a non-profit consulting firm to identify, document and streamline a Mental Health Medi-Cal (MH-MC) certification process, so that county-funded agencies that provide mental health services would have the tools and information necessary to achieve certification. The implementation of this new process began in March, 2012 with the kickoff of CBHS's first formal 12-month Medi-Cal Certification Session, attended by three substance abuse agencies seeking certification for four sites. The next scheduled Certification Session will begin in August, 2012 and is expected to focus on supportive housing providers. If you have questions, or would like more information, Michelle Ruggels, Administrative Analyst, 255-3404 or email at michelle.ruggels@sfgov.org, is leading this effort on behalf of the Department.
HIV/AIDS Research Section Wins Five-Year Summer Mentoring Program Grant The HIV Research Section was awarded a five-year National Institutes of Mental Health R25 grant to develop a 12-week summer-mentored research experience for college students from under-represented backgrounds in science. Jonathan Fuchs, MD, and Willi McFarland, MD, both internationally known researchers, are the principal investigators for this new and prestigious effort titled SHARP (Summer HIV/AIDS Research Program). Drs. Fuchs and McFarland selected four scholars from over 100 applicants, three from Bay Area schools (City College, State, and Stanford) and one from as far away as Arizona State University. The students began their research studies on June 4th. They have a formal seminar series on research methods, health disparities and HIV-specific topics, and will be presenting their project results at an AIDS Office-wide Research symposium on Friday, August 17 th from 4-7:30 p.m. at 25 Van Ness, Suite 70. The s are encouraged to attend to help us support and inspire the next generation of HIV/AIDS researchers and scientists. Computerized Provider Order Entry (CPOE) at SFGH Computerized Provider Order Entry (CPOE) has arrived at San Francisco General Hospital. Providers are now able to go to a computer terminal anywhere in the hospital and enter orders that go directly to the unit where their patient is located. The orders include nursing therapies, medications, dietary instructions, and lab tests. CPOE kicked off on May 15 on Medical-Surgical Unit 5D and will roll out every two weeks to the other Med- Surg units this summer, then further into other hospital units. With CPOE, we anticipate an improvement in patient quality and safety by reducing medication errors, improving order legibility, and decreasing the time spent on verbal/telephone clarifications. It will increase efficiency and compliance by standardizing orders and streamlining the ordering process. This project is part of the technology section of the hospital s strategic plan, helping us to achieve Meaningful Use of Health Care Technology as defined by the HITECH portion of the federal stimulus bill (American Recovery and Reinvestment Act). Expanded Kindergarten Retrospective Study The 2011 Expanded Kindergarten Retrospective Study (EKRS) is conducted every three years to determine an overall "up-to-date" immunization rate for two-year-olds in San Francisco. This information is used by policymakers, providers, and public health to help determine immunization-related goals and projects. This year, San Francisco Department of Public Health analyzed 1,766 kindergarten students from 18 public and 19 private schools in San Francisco schools (25% of the City s schools) to determine how well-immunized the children were when they were age two years. The overall Up-to-Date (UTD) rate for 4DTaP, 3Polio, and 1MMR at 24 months for San Francisco was 79.3%, which was, coincidently, the same result as the 2008 retrospective study. For three and four year olds, however, results were much more positive, with up-to-date rates of 86.4% and 89.3% respectively. The Department will be communicating with pediatric immunization providers that they are doing well at immunizing children, but can do a little bit better at focusing on all immunizations required by age two. The EKRS also revealed that, for the first time, there is no difference in immunization rates between public and private school students, but there continues to be a disparity in rates among ethnic groups, especially between African Americans and all other ethnicities. A one-page summary and the complete report are both available at http://www.sfcdcp.org/izchildren.html. June is World Refugee Awareness Month Community Health Promotion & Prevention's Newcomers Health Program and Family Health Center's Refugee Medical Clinic are celebrating "Refugee Awareness Month" as an opportunity to recognize the many contributions refugees have made to the City, and the challenges they have overcome. The Family Health Center's Refugee Medical Clinic and Newcomers Health Program are also celebrating 33 years of collaboration responding to refugee health issues in San Francisco. Maps, banners and one-thousand origami cranes will adorn the clinic during the month of June to represent wishes of happiness, long life, and recovery from illness Page 2
or injury. On June 20, World Refugee Day, Newcomers Health Program will celebrate with community partner Arriba Juntos and others with an afternoon of food, presentations, booths, music, and a talent show. California Alcohol and Drug Program (ADP) Inspection Completed State officials from the California Department of Alcohol and Drug Programs (ADP) completed their planned three-day educational visit and tour of our Office Based Opiate Addiction Treatment Programs (OBOT) http://dphnet.dph.sf.ca.us/obot/default.htm on May 11. The evaluators were pleased with their tour and evaluation and no deficiencies are anticipated. We also hope to receive approval of Ward 86- Positive Health Program's application to be an OBOT site within the next several weeks. The State officials also got a firsthand look at the newly-installed and fully-alarmed safe at the SFGH pharmacy. They were especially impressed with their visits to Project Homeless Connect and a tour of the Directly Observing Dosing program of HIV medications at Ward 93 Opiate Treatment Outpatient Program (OTOP). Such activities showcase the cutting edge programs that San Francisco is known for establishing. Immunization Training for Medical Assistants The Communicable Disease Prevention Unit s Immunization Program recently completed three successful trainings for 75 medical assistants who, through a hands-on training class, also learned proper vaccine storage and handling practices, proper vaccine administration techniques, and received the latest updates on vaccine recommendations. Both public and private sectors were represented with medical assistants from Kaiser, Glide, NEMS, Noe Valley Pediatrics, Native American Health Center and our Community Oriented Primary Car (COPC) sites. These trainings are another way for the Immunization Program to keep closely connected with the community and an ideal opportunity to remind participants that the Department of Public Health can provide a variety of resources and serve as a source of technical assistance when needed. Laguna Honda Partners with Chinese American Coalition for Compassionate Care Laguna Honda will announce a community partnership with the Chinese American Coalition for Compassionate Care (CACCC) at a press conference on June 8 at 1:00 p.m. at the hospital. CACCC is dedicated to the advancement of palliative medicine and end-of-life care in the Chinese American community. Sandy Chen Stokes, a geriatric nurse specialist and public health nurse, is founder and Executive Director of CACCC. Laguna Honda and CACCC will be sponsoring two weekend-long training sessions in July for palliative care volunteers from the San Francisco Chinese community. The partnership furthers Laguna Honda s implementation of the Health Commission s 2002 standards for Culturally and Linguistically Appropriate Services (CLAS) and the hospital s strategic goal of community integration. Laguna Honda Leadership Staff Begins Walk in My Shoes Project Laguna Honda managers began an initiative this month to experience the hospital from the perspective of line staff. Managers will spend a day working alongside porters, food service workers, home health aides and others to learn what it is like to walk in their shoes. The initiative is intended to build relationships, honor the work of line staffers and deepen managers understanding of the organization at all levels. Neighborhood Tour Laguna Honda staff will be the guests on a guided tour of landmarks in the West of Twin Peaks neighborhood on June 13. The tour is part of the hospital s community outreach effort. Health s are welcome to join. Our thanks to Melara for arranging the event. Picnics in Betty Sutro Meadow At the request of some Laguna Honda neighbors, the hospital anticipates opening Betty Sutro Meadow for community picnics this spring and summer. The executive team is sorting out logistical and regulatory matters related to opening the campus and looks forward to the opportunity to further integrate Laguna Honda into the life of the neighborhood. Page 3
California Society of Addiction Medicine Congratulations to Alice Gleghorn, Community Programs Privacy Officer and County Alcohol and Drug Administrator, who will receive the Community Service Award at the California Society of Addiction Medicine (CSAM) Conference and Annual meeting later this summer. This award was established by the CSAM Executive Council in August, 1985 as the Achievement Award or the Merit Award to be awarded to "someone outside the health professions." Over time, it came to be called the Community Service Award and is primarily awarded to a non-physician or a non-medical person who has worked to support addiction treatment. Past recipients include Betty Ford, Hon. John Burton, Wesley Chesbro, and Reverend Cecil Williams. 4) GENERAL PUBLIC COMMENT There was no public comment. 5) FINANCE AND PLANNING COMMITTEE Chow, Committee Chair, stated that the Committee reviewed the June Contracts Report and individual new contracts listed in the Consent Calendar and recommended that the full Commission approve all contracts except the following which it recommended deferring approval until the July 17, 2012 Finance and Planning Committee meeting when additional clarifying information requested by the Committee will be presented: ANNUALIZED CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH AMERICAN MEDICAL RESPONSE DBA SAN FRANCISCO AMBULANCE TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) ANNUALIZED CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH PRO-TRANSPORT-1 TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) NEW CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH KING-AMERICAN AMBULANCE COMPANY TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) The Committee also gave input regarding the 2011 Healthy San Francisco Annual Report outline and will review the draft at its September 4 th meeting. 6) CONSENT CALENDAR Action Taken: The following were unanimously approved by the Health Commission: DPH JUNE CONTRACTS REPORT* REQUEST FOR APPROVAL OF A NEW CONTRACT IN THE AMOUNT OF $65,000 WITH FISCAL EXPERTS, INC. TO PROVIDE ACCESS TO A WEB BASED TIME STUDY APPLICATION TO BE USED TO SUPPORT THE MEDI-CAL ADMINISTRATIVE (MAA) AND TARGETED CASE MANAGEMENT (TCM) PROGRAMS OF THE DEPARTMENT FOR THE TERM OF JULY 9, 2012 THROUGH JUNE 30, 2015 (36 MONTHS) REQUEST FOR APPROVAL OF A NEW CONTRACT IN THE AMOUNT OF $269,397 WITH BRUCE LOEFFLER / ENSPIRON TRAINING COMPANY TO PROVIDE SERVICES FOR THE SERVICE EXCELLENCE PROJECT (MOTIVATIONAL LECTURE BASED) FOR SAN FRANCISCO GENERAL HOSPITAL FOR THE TERM OF JUNE 5, 2012 THROUGH MAY 31, 2013 (24 MONTHS) REQUEST FOR RELOCATION: DPH TOM WADDELL HEALTH CENTER AND HOUSING AND URBAN HEALTH CLINIC Page 4
REQUEST FOR RELOCATION: CENTER ON JUVENILE AND CRIMINAL JUSTICE The approval for the following contracts was deferred until the July 17, 2012 Health Commission meeting: ANNUALIZED CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH AMERICAN MEDICAL RESPONSE DBA SAN FRANCISCO AMBULANCE TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) ANNUALIZED CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH PRO-TRANSPORT-1 TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) NEW CONTRACT IN THE SHARED AMOUNT OF $2,400,000 WITH KING-AMERICAN AMBULANCE COMPANY TO PROVIDE AS NEEDED BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE TRANSPORTATION SERVICES FOR THE TERM OF JULY 1, 2012 THROUGH JUNE 30, 2022 (10 YEARS) 7) REVISED BED BUG RULES AND REGULATIONS Karen Cohn, Program Manager, gave the presentation. Sako commended Ms. Cohn for her highly effective work with the tenant and landlord communities in the development of the revised rules and regulation. She noted that at the May 15, 2012 Community and Public Health presentation of this topic, members of the tenant and landlord communities all lauded Ms. Cohn and the DPH for its inclusive process; in addition all stated that they were content with the revision. Comments Chow asked how commercial hotels are impacted by the Rules and Regulations. Ms. Cohn stated that the only provision that does not apply to the commercial hotel industry is the supplying of mattress encasements; however most commercial hotels take this preventative step anyway. Ms. Cohn added that most commercial hotels do an effective job of training their maintenance staff in inspection, prevention and treatment of bed bugs. She also added that hotel guests are not classified as tenants. Sanchez asked whether there are issues with local university dormitories. Ms. Cohn stated that she is unaware of any incidents of bed bugs at local university dormitories but that they would be appropriate venues for public education on the issue. Taylor McGhee asked who is responsible for providing education to tenants. Ms. Cohn stated that person giving out the lease to tenants is responsible for distributing educational materials. Melara asked for the list of relevant responsibilities of the tenants. Ms. Cohn stated that tenants are responsible to report incidents promptly; ask for reasonable accommodation in a timely manner; and cannot knowingly bring in contaminated items. 8) CITY AND STATE BUDGET UPDATES Greg Wagner, Chief Financial Officer, gave the presentation. Director Garcia commended Mr. Wagner and Jen Louie, Budget Director, for their effective work in developing and negotiating this year s budget. She also stated that due to shrinking HIV prevention and treatment funds, she has negotiated agreement to merge the HIV Health Services and HIV Prevention Planning Councils into one body. Page 5
Comments/ Follow-Up: Taylor McGhee asked how far in advance does the DPH prepare budget projections. Mr. Wagner stated that the DPH developed a two- year budget and that the Health Commission 5-Year Budget Subcommittee is developing a 5 year budget projection. Waters asked what sources are creating a loss in General Funds. Mr. Wagner stated that there is a change in the rules in how to deal with the prior year s budget fund balance. In the past, it was rolled over to the next year. However because this is the first year of a two-year budget process, this year the revenue share is split over two years. Waters asked if any of the $6.6M in HIV funding is devoted to HIV prevention and if the budget situation continues to improve whether the DPH will be able to again conduct targeted prevention efforts to high-risk populations. Mr. Wagner stated that this amount represents both HIV Treatment and Prevention funds. Director Garcia stated that merging the two HIV Planning Councils should increase the overall effectiveness of the use of Federal HIV funds. Chung stated that San Francisco is facing an aging population that is likely to lead to higher healthcare costs in the future. She encourages the Health Commission and DPH to be part of the leadership involved in city-wide discussions involving aging and healthcare. Chow stated that Commission priorities regarding San Francisco s aging population should be made in conjunction with other relevant City Departments and Commissions. Chung also stated that combining the HIV Councils in Hawaii proved highly problematic and requested updates on the San Francisco process. She added that if the pilot studies of HIV Pre Exposure Prophylaxis (PREP) indicate it is an effective HIV prevention method for high-risk populations, the HIV portion of the DPH budget may be impacted because of the cost of the medicine regime. Sako requested data showing the impact of the past few years budget cuts on various vulnerable populations and the service system. Sanchez thanked Director Garcia, Mr. Wagner and all the DPH staff involved in working on this year s budget. Melara stated that she attended a meeting of the Mayor with all Commission Presidents to review the budget. 9) OTHER BUSINESS JOINT CONFERENCE COMMITTEE REPORTS Sanchez chaired the May 22, 2012 LHH JCC meeting and reported that the Committee heard a Replacement Program Update and a presentation on the Family Satisfaction Survey. COMMITTEE AGENDA SETTING Melara requested that all s submit dates that they are not available in June, July and August to Mr. Morewitz so that he may coordinate the Health Commission Planning session. She also asked Mr. Morewitz to put the decision to cancel the July 3, 2012 Health Commission meetings on the agenda for the next meeting. 10) ADJOURNMENT The meeting was adjourned at 5:50pm. Page 6