Transcripts For SFGTV Government Access Programming 20240713

Initiative to address the needs of the highest utilizers of Public Health services. On the fifth of november a broad update. We are concerned about the health and wellbeing of those in San Francisco. We take our role seriously and we will continue to use our meetings as a public forum to discuss important Public Health issues. Members of the public are always invited to attend and provide input. I am mark. Health commission secretary. If you have Public Comment, please hand a slip to me. If you would consider today, there are a lot of people who feel passionately about what you are here for. As others speak, they may have different opinions than you, try to be respectful. Be silent in your show of your opinion by either doing Something Like this or this. If you like what is being said. If you dont like being said do this. Vocalizes is not respectful to the person at the podium. Please consider that. Item 2. Approval of august 20 and september 17 meetings. In front of you is slightly revised Meeting Minutes for the 17th. I was to add it was adjourned 4 29 p. M. Due to disruption of the meeting. Please consider that version for your approval. The minutes are in the hands of the commission. If you have comments about the first set of minutes on september 17, please do so now. We will follow with the minutes from august 20th. I move approval of the minutes. Second. Those in favor signify by saying aye. Is that both sets . I move september 17th. Second. A. Item three directors report. Good afternoon, commissioners, grant colfax director of health. We have a full agenda this afternoon. I will highlight the key items in the directors report in front of you. One thing that is exciting, the first item. Yesterday mayor breed and the department of health announced a new Overdose Prevention program for the hotels to be carried out. This program is in response to the rising number of Overdose Deaths in San Francisco, approximately which 30 occur in single room occupancy hotels. This program is based on the successful tenant Overdose Response program from vancouver. We will work with the sr operators to develop the prevention programs. It will expand the Overdose Prevention further and support installation of naloxone boxes. That will begin later this year. The Health Department supports Harm Reduction Coalition Drug Overdose Prevention project which provides 15,000 doses of naloxone to thousands of those witnessing overdose in 2018 alone. The drug Overdose Prevention product reported 1658 overdose reversals that year and is on track to double that in 2019. We are concerned about overdose death in San Francisco. We are doing everything we can to minimize that terrible situation, and this project is a major step forward to help people most at risk for overdose. I want to emphasize that on september 24th, the mayor and the director of Mental Health reform announced plans to launch an online inventory of dph Substance Abuse and Mental Health treatment beds, we want to be sure there is increased transparency in terms of bed availability in the city within the system. We expect this public web page will improve the timely access to treatment and Health Providers make the best use of beds in the programs. The first space in november will have withdrawal management and 90 day programs. In the second phase the short term beds will be added. In addition to transparency this will help data driven decisions where we need to target new investments and bottle mecks in the bottlenecks in the healthcare. We are going to spend time on the Behavioral Health system today. The department has chosen to pause changes while the mayor and board of supervisorses have a conversation how to have expanded access to services. You will be hearing about that today directly from the dph in terms of history and Public Comment. I look forward to that part of the agenda. Just to emphasize with regard to vaping, the California Department of Public Health urges everyone to refrain from vaping given the current status of vaping risk. Since june of 2019 the California Department has received reports of 90 people in california who were hospitalized for severe breathing problems and lung damage. San francisco does not have any suspect cases we will be diligent in that regard. Nationally the epidemic associated with pulmonary injury grew 52 compared to the prior week. There are 805 from 46 states with 12 deaths reported. We continue to be vigilant on both the regulatory and the policy fronts. With regard to the recent heat wave on september 24 and 25, the National Weather service issued a heat advisory in San Francisco with temperatures in the 80s and 90s. They worked together with the department of Emergency Management and joint Information Center for city agencies to coordinate efforts and share messages to stay cool, hydrated and connected. City officials remind the people about the importance of window, water and pet safety. I think as we see the effects of Climate Change continuing, dph will ensure that we are resilient in the city with regard to our adaptation to Climate Change, including potential health risk for residents. That is a final note. I am excited to announce tomorrow the mayor celebrates the groundbreaking for the maxine hall remodel. She will celebrate the remodel, to improve safety during an earthquake. Locate primary Care Services and for the construction maxine hall will move to a temporary clinic on golden gate avenue. We want the community to be informed of that. As a provider i recently visited. The staff is committed and clients are receiving great care. It is time for refresh. I am excited that is happening tomorrow. Thank you very much. I will take any further questions on the directors report. Commissioners. I thank you for the report in regards to especially the coordination during the heat advisory, and because we were in chinatown just several months ago. I am wondering what type of coordination actually occurred in chinatown for that because it would be a very good example of what we are trying to do down there. I believe that doctor aragon has an update with regard to the specifics there. Thank you. Good afternoon. I am sorry i dont have an update. Doctor baba does. Thank you, doctor chou. There are a couple places impacted with heat. We checked in with the chinatown community. Chinatown has a library with airconditioning, which is great. The messages really went to the community. As with all of these incidents we debrief to see what we can improve in our communication. We will keep our eye on how we are able to respond to that community during these heat advisories. We did the same thing with bayview because that has a lot of heat as well. Thank you. Other questions . Thank you, doctor. No Public Comment for that request. Item 5 report back from the finance and Planning Committee from today. Thank you. I am sure commissioner chung would have been pleased today in our reports on the monthly contracts we were able to get some outcomes. The outcomes were quite satisfactory. On the block of the monthly contracts that included the Fountain Institute that is actually a Diversion Program and then several programs that actually were looking at improving employment from the university of california and the positive Resource Center. We spoke somewhat at the positive Resource Center if that information was getting back to primary providers in a way that they may find it useful to understand how their clients were assisted beyond the medical illness. We heard request for a retroactive contract with the San Francisco Community Health authority, San Francisco health plan, administering the San Francisco covered mri program. It is a contract that goes back four years. Because of the changes of funding in which the Services Rendered by the San Francisco health plan on behalf of the mra program and changes in the mra program, there have been some delay, therefore, being able to actually pay for all of the services which the San Francisco plan continued to render. The retro activity will include also an additional two or three months to the end of 2019, at which time all the San Francisco health plan tpa type contracts for the covered mra and other tpas would be brought fort to the finance and the commission. At that time we will be able to understand better the allocation of the types of services being rendered for those people in the various programs. Barring that, then we also have one more contract which relates to an outside vendor to perform mixtures of different compounds and types of medications that we know longer do, and it is a certified contractor from the fda and will giv give us a Super Service at the general for those types of medications. At the consent calendar we will ask for consent on all of these contracts. Questions from the commissioner . I apologize. I made a mistake as we went forward i skipped general Public Comment. Hold any questions on the report back and go to item 4, general Public Comment. I apologize. It wasnt intentional. I hold an egg timer. Everyone gets two minutes. When the buzzer buzzes, finish your sentence so the next person can come forward. For general Public Comment, mike hill, crystal duran and heather roninger. I am one of the nurses in the er. Our concerns are about General Hospital Emergency Department staffing issues, transparency, lack of, promises made to us at the joint commission that were supposed to be built into our contract. For instance, the ratio change in the er. We havent had any information funneled down to us how that will be accomplished. We assume they will hire temporary staff for the changes. That is not the safest way to care for our patients. If that is the plan, but we dont know the plan. There has been multiple issues. Care start is another implementation that didnt respond to any of the input from the nurses that have to work the care start program. It is not safe to our patients. There are so many different issues the other nurses with me will speak about. I wanted to introduce those problems in the er. Would you identify yourself for the record . Mike hill, nurse in the er. Thank you. Good afternoon, commissioners. I am actually going to read a letter on behalf of one of my colleagues. One of my colleagues felt fear in speaking out because of retaliation. I will read this. I am crystal. I am a nurse in the Emergency Department at San Francisco general. For nearly half my life i worked as a nurse in the Emergency Department at San Francisco general and for the department of Public Health. Our department is pushed to unsustainable point. The ed is a disaster scene almost daily. As safety net of the city we reflect the picture of the community. The department of Public Health and city are not well. Our population is more complicated and desperate. Imagine unhoused with cancer, diabetes. It is cruel and heart beating. We are a special group. We are drawn like special forces to this department. We have the knowledge and the skills to bring back people from the dead, literally or care for an 85yearold fractured hip fall patient, 7yearold hit by a car. Kisdisaster is taking a toll. One colleague tried to decrease antidepressants and cried and had to go on it. A group of p103s are on a six month leave of absent for stress and Mental Health reasons. We have contract rns making 30 of total staff. I have never been in such a hostile stressful environment not only from the management but from the patients with complicated desperate needs. They are promised by leadership, dont worry, we will take care of everybody. Do you think the zuckerberg building with hundreds of millions on lobbies, balconies and hallways is providing effective quality Public Healthcare . Really . What percentage of our patients would agree with you . We see the multitudes it is failing. The sad suicidal teenager doubles up in a room with a person in a severe combattic episode or the 90yearold with dementia next to the psychperson who cant get in the group hope. They are on the street. Finish up, please. Thank you. It is time for the painful honesty, the abuse scandal, people jumping out of the windows and the admitted patients in the ed getting bills for care impossible to provide. Please finish. The hundreds of care patients are waiting in the triage area and getting a full ed visit. The goal of numbers and ignoring front line staff has costs which may include juror death or detriment of patient as is and staff we want to care for mom, dad, sisters and brothers. Please help us. Ladies and gentlemen, please respect the people be anhind you. There are a number of people to speak. We are giving you two minutes. Please respect those folks and give them the opportunity to speak. We want to hear from all of you. Thank you. I am krista durand, er nurse. Contract bargains is over. Now there is no reason to think we are asking for raises. We are here because we said we would return. The leadership style at San Francisco general has a culture of intimidation is so severe we fear interaction with management. Our rn director pushed 50 of the best leaders out in less than four months. Why wasnt this a red flag to the administration . This is having detrimental effects of the Mental Health of the staff and distracting them from providing staffing care. Adding an additional layer of leadership not transparent to maintain control is having direct effect on patient outcomes. Front line staff are being dictated to risk licenses. They are aware of it and has done nothing about the administration poor implementation of programs. I became a nurse to provide compassionate and competent care. It is my duty to advocate for the patients. The petition we sent to you guys shows a lot of violations. If you turn a blind eye now you are going to be part of the problem. We sent multiple letter goes with the same outcome. You let Administration Lie with numbers and charts. Now we have submitted the explanation of the crisis. What are you going to do . Are you going to do something what people diane Staff Members are injured or commit suicide . I am heather a nurse in the er12 years. I have been here before. I thought about how to convey the severity of the situation to you. We tried emotional pleas that havent worked. San francisco general is about compassion, not quality care, data. These are data points to consider. 25 to 30 of the emergency beds are housed with admitted patients every day. We get zero nurses to help support their care. 50 of our most trusted respected and experienced leadership staff are forced out of positions in the last four month. 50 . Our department houses from eight to 12 behavioral 12 Health Patients in acute psychiatric bases in space designed for four. Resuscitation area exceeds level of 15 to 17 patients. It is designed for six. We discharge 700 patients each month out of the waiting room. That is where they receive all of their care, in our uncomfortable perfectly public waiting room. 63, that is the number of nurses who have signed the petition sitting in front of you today asking for your help. Asking you to engage. You dont need lean workshops and Software Programs to understand what is going on with our patients. You need to talk to the staff. You need to listen to what they have to say. Thank you for your time. Thank you. Those are all the slips i had for public testimony. Does anyone else want to speak on general Public Comment . Call the next item. Thank you everyone who chose to make Public Comment. The petitions are in your packet for item 7. It is altogether. I want you to know it is there. Item 5. We have gone through with commissioner chow, review of the finance and Planning Committee meeting. I would like to know before the concept calendar the dph staff asked to change the amount on the second contract. They had incorrectly figured out the contingency. 4,431,259. As you vote i