San FranciscoBoardof Supervisors Asthma Task Force
Clinical Committee
August 27, 2007, 12-2pm
San FranciscoCity Hall, Room 278
MINUTES
I. Guest Speaker: David Nunez California Department of Health Services, Chronic Disease Control
Gloria explained that ATF is looking at how we can sustain the work that we are doing. We have two clinical studies through Kaiser and CPMC grants.
Clinical Committee related projects:
CPMC Grant ($__)
Kaiser Permanente Grant ($10K)
SF Asthma Network – 2 tiers
AE-C Exam Support
Newsletter
State Licensing Requirements for Asthma CMEs
Website – Got Asthma? 1-800 number –DPH? Breathe CA??
Data
David indicated that sounds like our work is in line with what they feel is important and would fund
Asthma Action plans, home visits, Monitoring quality of care,
Need a physician or administrator champion
Near end of this funding phase and reassessing what worked and what hasn’t
Spoke to their priorities:
1. Looking to do some brindge funding and TA to clinics that are doing good
Freeing up about $500,000 for planning grants for counties to know what the landscape is around asthma, data, resources, ID key strategies
6-10 jurisdictions
ID 1-2 projects with measurable outcomes – trainings for school health, tracking of AAPs in schools
New state strategic plan for asthma going through approval process, hoping it will be approved by Fall.
NAEPP/NIH guidelines were expected to be released on August 29th. Will likely be released online first.
One objective of state plan is to develop and implement statewide standards of care for health plans. Will be meeting with key stakeholders around this. Looking at things like HEDIS measure and expanding beyond that.
2. Will conduct 6-8 trainings statewide on new guidelines and how to implement. Looking to ensure CMEs are offered. Could set the stage for a recurring requirement at the state level. 250 providers per site. Start early 2008 through Spring.
3. Coverage in the health care system
4. Link between ER and primary care
5. [need to fill in]
6. Disparities – trying to improve best practices – culture, cost, location, distance
Gloria asked about bonuses or merit systems for plans providing good systems of care
Dr. Ziring pointed out that the school doesn’t have a lot of clinical linkages. Should be having more input from CHDP.
Need a more coordinated process. Could use funds to better connect resources.
Haven’t made asthma a public health issue to make people understand what they need and where they can be. Need to raise awareness and education. Might need more restrictive statutes and laws. Family advocacy. Numerous strategies.
Would be great for districts to advocate for a more simplified form or process (online?).
There are a lot of flaws with CHIS.
Cancer registry gets a lot of funding from tobacco. Rare.
OSHPD collects a lot of data but don’t analyze it.
Need better prevalence data, hard to report.
MA developed school based registries which was even controversial.
David is focused on disease management and quality improvement.
Summarize what we want
Look at top priorities
TOP PRIORITIES expressed by Dr. Nunez:
Need to agree on statewide standards of care
Need to be able to come up with measures
Require CMEs
Can do through legislation, jumping on board with health care reform, who sets standards with CMEs?
Gail suggested we request that Mitch Katz writes a letter to Drs. in Health Dept.
Make sure we are all on David’s listserv and keep him posted. Take advantage of funding opportunities. Partner on activities.
His staff can provide TA for us.
Pegcan talk to head of CA Medical Board
Look at State Strategic Plan on Asthma
Inquire about whether AEC Plan and Medication forms will be combined.
Invite DavidNunezto SFAN meetings – maybe as a speaker
Might want to focus evaluation efforts in one area
II. SF Asthma Network
Potential Agenda:
PFTs – Andi Marmor (confirmed)
NIH guidelines Susan Janson (confirmed)
Pharmacist (Sharon Youmans contact) or Rita Lam or Lenny Chan – new meds (peg)
Diversity – (Gloria)
Clinic Challenges – UCSF, SEHC,
Larry Posner, allergist from Napa– Peg will contact
Shannon Thyne
David Nunez, asthma in under 6? (Anjali or Peg)
Helen Lu (Gloria) will talk about the Chinese Population or Nadine Burke about African American population
Small group breakout – talk about in September, each of us facilitate how could we best engage supporters at your site?
What are challenges at their clinic? What support would you need?
Lunch
GERD – someone from SF General (Gail, Nan)
Chris Garvey – sleep apnea next time
Steve Lazarus
Tom Waddell – Gene Balabrera
MCH – Lanny Heany
UCSF – Cynthia Kim
Roseanne Dial
Plan for 1 hour 15 mins each – 45 min talk, 15 min questions, 15 min break
Need to proactively send a letter to the supervisors of the SFAN – request release of the following staff.
Need to do 2-3 months in advance.
Anjali will email list and letter
Mail and email letter to supervisors
Follow up with phone calls – divide up between Anjali, Stephanie, Marieand check in with Gail
Food - Breathe CA
Folders – Breathe CA
Next meetings:
October 12th, SFAN Meeting, Location TBD, 8:00am-4:30pm
Committee meeting: September 25, 2007, City Hall, Room 278, 12-2 p.m.
