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Health commission adopts conditions for SPMF takeover of five CPMC outpatient services amid community concerns
Summary
The commission voted to adopt a revised resolution requiring CPMC and Sutter Pacific Medical Foundation to secure contracts or LOAs, ensure staff training and culturally appropriate services, and resume diabetes education at St. Luke's or face a finding of detrimental impact; public commenters alleged reduced diabetes educator staffing and access problems for Spanish-speaking patients.
The San Francisco Health Commission on Nov. 29 held a Proposition Q hearing and approved a revised resolution (18-5) setting conditions for the transfer of management of five outpatient services from California Pacific Medical Center to the Sutter Pacific Medical Foundation (SPMF).
Sneha Patel told the commission that three of the five services — the breast health mammography center, the diabetes center, and non-invasive cardiology at St. Luke’s campus — transferred in August; two remained to transfer (an outpatient psychiatry clinic at Pacific Campus and the California-campus diabetes center). Staff said SPMF had contracts with most health plans but was negotiating with Hill Physicians Medical Group and was using letters of agreement (LOAs) to prevent patient disruption.
Public testimony underscored access and staffing concerns. Primary care physician Karen Bridal testified the Saint Luke’s diabetes center had fallen from about "3.6 full time equivalent positions" to "about a 1.4 FTE," leaving many nonpregnant patients without local diabetic RN services and creating language-access gaps for Spanish-speaking patients. Advocate Kevin Barnes and others described cultural-competency problems and warned that moving services to the California campus in Richmond imposes long commutes for many vulnerable patients.
SPMF operations executive Karen Jaffrey and foundation leadership responded that LOAs were in place, that the foundation is hiring an additional full-time Spanish-speaking diabetes educator, and that staffing would increase to 2.6 FTE by Jan. 7 through cross-coverage and hiring. Jaffrey said brief disruptions occurred but there was "no continued disruption." Commissioners pressed for clarity on FTE counts, how patients are informed about available transportation (SPMF reported offering Lyft rides case-by-case), and how the foundation will ensure culturally and linguistically appropriate services.
The revised resolution adopted by the commission says the change "will have a detrimental impact on health care services unless CPMC and SPMF take the following actions": secure a contract with Hill Physicians or continue to execute LOAs, proactively ensure adequate staff training regarding LOA policy, provide culturally and linguistically appropriate services for all affected lines, and resume education for patients with non-gestational diabetes at St. Luke’s campus. The commission also strongly encouraged SPMF to provide updates on service provision and said staff should monitor the transition.
Next steps: The resolution passed by voice vote and the commission requested periodic updates from CPMC/SPMF, including a suggested voluntary report to the commission within approximately six months to assess whether the transition is meeting community needs.
