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San Francisco DPH details EPIC EHR adoption and budget-backed expansion of addiction, syringe cleanup and survivor services
Summary
At the Health Commission meeting, the director said the EPIC electronic health record entered adoption Phase 2 with a planned August 3, 2019 go-live and outlined mayor Farrell's budget additions including expanded street-based buprenorphine treatment ($3 million annually), a ZSFG addiction medicine team, $750,000 for syringe cleanup staffing and sugary-drink-tax-funded community grants.
The Department of Public Health told commissioners that its EPIC electronic health record implementation advanced into adoption Phase 2 and is scheduled to go live on Aug. 3, 2019.
"We are very excited that ... the health record ... has transitioned into the adoption phase," the director said, adding the project timeline included a planned go-live date of "August third of 2019." The commission was shown a progress chart included in the director's written report.
The director framed the mayor's proposed budget as focused on homelessness, neighborhood cleanliness, public safety and long-term equity. She described a set of department priorities that the mayor's office added or funded: an expansion of street medicine to provide low-barrier, medication-based addiction treatment; a hospital-based addiction medicine team at Zuckerberg San Francisco General (ZSFG); increased staff and equipment to clear syringes from public spaces; and grants funded by the sugary-beverage distributor tax.
On addiction services, the director said the department would expand its street medicine team by 10 staff who will provide buprenorphine induction and medical follow-up, supported by peer outreach workers. "Buprenorphine is a highly effective opioid treatment drug," the director said, and the mayor's budget includes "$3,000,000 annually for staff and pharmaceuticals," partially offset by about $900,000 in medical revenue.
The budget also includes about $300,000 annually to create an addiction medicine team at ZSFG to provide in-hospital treatment and link patients to community follow-up. Separately, the department would add $750,000 a year to fund 10 full-time positions to conduct targeted syringe sweeps and install three additional disposal kiosks in high-need areas; staff said they were exploring kiosk placement near some BART stations.
Revenue from the 1-cent-per-ounce sugary-beverage tax (approved by voters in November 2016) is being directed to health equity programs: the director said the two-year mayoral spending plan channels nearly $20 million of tax proceeds across the budget period, including $13 million to DPH and $3.8 million annually for community-based grants aimed at prevention, food access and physical activity.
The director also described investments to expand services for sexual assault survivors and to add staff and capacity for assisted outpatient treatment (AOT/Laura's Law), including $800,000 for Trauma Recovery Center staffing at ZSFG and $400,000 for additional case management for AOT clients.
Finally, the director said DPH had been notified that federal reimbursements tied to SB 1128 might be disallowed and that the department, working with the mayor's budget office, had set aside approximately $56 million from management reserves to cover any required repayment.
The department will present final budget changes after board hearings and negotiations with the Board of Supervisors and return to the commission with a complete update when the budget is finalized.
