President Miles asked presenters
to keep their presentations to three minutes, with two minutes for questions
and answers, due to the full agenda.
St. Francis Medical
Center
Joe Beth Walt, Manager
- Community Health & Volunteer Services
Ms. Walt welcomed the Commissioners
and public to St. Francis Memorial Hospital. She stated that one of
her responsibilities as Manager of Community Health, is working with
various community organizations in the area. St. Francis Memorial Hospital
has organized round tables to look at issues within the community; these
include Women, Children and Families, the second round table was on
HIV and AIDS, a third on mental illness and substance abuse and a fourth
on seniors. A recent Senate Bill required all hospitals to document
and show how they are serving the community. This year the hospital
decided that they wanted to go back into the community and meet with
people to find out what they thought were the ultimate health issues
in the surrounding areas. Through their community Advisory committee
and round tables they found the same issues appearing, they are housing,
access to health care, dental care for children, environmental issues
and the largest new issue is homelessness for women over 50 with no
mental illness.
Department of Public
Health (DPH)
Commissioner Roma Guy,
President - Health Commission, DPH
Commissioner Guy opened the
presentation by the Department of Public Health by introducing the Commission's
position on the Health department's strategic direction which includes
trying to focus on a continuum of care that is more focused on prevention
and more towards primary care. She indicated that the Health Commission
is mindful that poverty is the largest indicator of health status, and
since women are the poorest and they take care of children and are more
exposed to family abuse, they are more vulnerable. The challenge for
women and girls and the public sector around health in the year 2000
is on financing what we need.
Kate Monico-Klein, Director
- Women's Services, DPH
Ms. Klein hopes these presentations
are the beginning of a dialogue. She stated that women's health issues
are complex and feels that if we are to successfully improve the health
care of women we need to be flexible in our service and we have to offer
a variety of accessible, affordable health care models. We need to talk
about diseases long before their diagnosis if we are to prevent them.
We must retain traditional services that Public Health is known for,
such as family planning, while responding to new and emerging issues.
It is the mission of the Department of Public Health to prevent and
promote the health of all San Franciscans. In a one year period the
Department of Public Health sees more than 50,000 women in primary care
clinics alone.
Mildred Crear, Director
- Maternal, Child and Adolescent Health Services, DPH
Ms. Crear stated that this
unit is comprehensive, and includes family planning, adolescent health
and HIV testing and counseling. They encourage woman to do pre-conception
planning. They are currently working on a folic acid program, to encourage
women to use folic acid as it may help with pregnancy and prevent heart
disease. They do outreach and education for women to get involved with
prenatal care early. The Child and Adolescent Health Services also has
a toll free line, breast cancer outreach, screening and referrals and
well child visits and referrals. They have a home visit program, where
health workers and public health nurses visit pregnant woman before
and after they deliver to ensure that they have the right care and their
children have primary care. They also have a Teenage Pregnancy Prevention
Committee, working on outreach and training peer counselors.
Commissioner Marks expressed
an interest in the folic acid study, and requested more information
from Ms. Crear.
Cynthia Selmar, Director
- African American Health Initiatives, DPH
This is a prevention program
in the community health promotion and prevention branch. The African
American Health Initiative was created by San Francisco Department of
Public Health in November of 1998. It was created out of the growing
number of diseases related to African Americans. African Americans are
behind all other ethnic and racial groups, for all age groups, and gender,
regardless of socioeconomic status and are dying at an alarming rate
from preventable illness and injury. The African American Health Initiatives
goal is to improve health outcomes and to reduce health disparages among
African Americans. They plan to accomplish this by promoting health
prevention programs, community participation and empowerment programs
and building community capacity by looking at strategic planning and
community wellness.
Jan Murphy, Administrator
of Primary Care - Community Health Network, DPH
Ms. Murphy stated that this
division provides care through 14 community based health centers and
six clinics at San Francisco General Hospital as well as an Urgent Care
center. Their focus is on prevention and the lowest level of intervention.
They provide quality affordable care at the most cost effective means
possible based on a family practice model. They serve approximately
85,000 individuals annually, over half are women. They have women focused
clinics within their primary care centers. Some highlights of things
they are doing recently include a lactation center, domestic violence
screening as a routine part of health care, and the largest transgender
clinic in the state. This clinic provides medical care and psycho social
and mental health counseling to people who are or have changed genders.
Commissioner Roma Guy,
President - Health Commission, DPH
Commissioner Guy closed the
Department of Public Health presentations and asked for people to take
a strong advocacy stand on creating a paradigm shift in health and moving
into primary care as an investment in our community and prevention.
Commissioner Guy asked the Commissioners to be open and advocate and
endorse this for all women.
St. Anthony's Free Medical
Clinic
Beryl Shaw, Clinic Administrator
- St. Anthony's Free Medical Clinic
Ms. Shaw stated that St. Anthony's
Free Medical Clinic is a primary care clinic located in the heart of
the Tenderloin. They have existed for over 40 years and serve children
and adults up to age 60. Forty to fifty percent of their patients are
female. St. Anthony's Free Medical Clinic has seen changing demographics
in patient population in the Tenderloin. Thirty to forty percent of
their patients are homeless, many are transgendered. There are many
undocumented women, drug addicted women and several different languages
are spoken. The Clinic is free and receives no government funding. They
send their patients out for any specialty care to San Francisco General.
Primary funding for the Clinic is from private funding and bequest.
Dr. Ana Valdez, Physician
- St. Anthony's Free Medical Clinic
Dr. Valdez stated that for
a long time St. Anthony's has been considered a urgent care clinic and
currently has been making a shift towards primary care to meet the changing
needs of the community. The are seeing more mental illness, more TB,
STDs and HIV, more asthma and respiratory disease and more MS disorders.
They are seeing more senior patients who are undocumented, and are ineligible
for health benefits. Illiteracy is a big barrier for many of their patients.
The clinic sees approximately 15,000 people a year. They have an in
house pharmacy that takes advantage of indigent funds.
Bay Area Women's Resource
Center
Jacky Spencer-Davis, Associate
Director - Bay Area Women's Resource Center
Ms. Spencer-Davis stated that
they are not a health center or health clinic, but they see more than
400 women walk through their door every month. A lot of what they see
is poor health. Housing is a big issue for people living in the Tenderloin
the housing market is making it costly for people whose income is low,
therefore many people live together in small units, causing health problems.
With the large number of children living in the Tenderloin a school
was recently built. The school addresses components of health, including
mental health and dental clinics. Ms. Spencer-Davis sees a lot of stress
and isolation borne out of poverty.
Katie Groner, Pediatrician
Advisory Board Member -
Bay Area Women's and Children's Center
As a Pediatrician, Ms. Groner
spoke of the many parents and their children she sees without insurance.
Many times the children are in better health than the parents. Particular
issues they see are nutritional issues related to poverty, anemia, asthma
and domestic violence which may be related to stress in people's lives.
Language barriers and fear are barriers to health care for many people.
The Center gets its funding from corporation grants and private donations
and receives no government funding.
SAGE Project
Norma Hotaling, Executive
Director - SAGE Project
The SAGE Project is an organization
for and by survivors of abuse, prostitution and trauma. They are a human
rights organization and work on the behalf of women and girls who have
been exploited. In San Francisco they have developed a model program
that is used throughout the world in the treatment of women and girls
involved in prostitution and who have experienced violence and other
forms of exploitation. The SAGE program is a trauma and drug recovery
program and recently they have started a health service program. SAGE
has a number of other components and sees about 300 to 325 women and
girls a week.
President Juanita Miles thanked
all the presenters for their work and looks forward to the Commission
working more closely with their departments and organizations to build
a supportive relationship.
