Health chief ’s fast start
S.F.’s new director in first day on the job heads right into the field, talking priorities
Dr. Grant Colfax had officially been San Francisco’s new Public Health Department director for about three hours Tuesday morning when it was time for his first field trip.
Colfax’s boss, Mayor London Breed, had arranged a visit to a homelessness health fair near City Hall. They and other city officials inched their way through the packed event, surveying lines of people queuing up for coffee, pizza and essentials — socks, hand warmers, blankets, toothbrushes and deodorant. A tent provided privacy for anyone being screened for HIV or hepatitis C.
The walk-through allowed Breed to emphasize the key role that public health initiatives will play in alleviating the city’s persistent homelessness epidemic. Breed has often referred to homelessness as a “public health crisis.”
“We want a healthy city, and part of that is making sure we’re bringing the resources that people need directly to them, and meeting them where they are,” Breed said. “And, of course, it’s important that Dr. Colfax be here because he’s responsible for the whole system. He gets to see it firsthand.”
Breed had announced during her State of the City speech last month that Colfax would lead the city’s largest department.
Asked about his department’s most pressing priorities, Colfax outlined three broad goals: improving services around mental-health and substanceabuse treatment, improving collaboration with the Department of Homelessness and Supportive Hous-
ing “in terms of providing the right medical services for people when they need them to keep them housed, ... and focusing on the health equity issues that we continue to have in this city. Those are the key issues.”
But on top of those objectives, Colfax also must manage a city agency beset by recent controversies.
His predecessor, Barbara Garcia, resigned abruptly last summer, following a lengthy investigation into allegations that she directed a million-dollar city contract to an organization where her wife works.
Then in December, a Chronicle investigation revealed that Amy Brownell, an environmental engineer with the department, had been directly involved in home sales at the former Hunters Point Naval Shipyard, where an allegedly fraudulent cleanup of radioactive material may have jeopardized people’s health.
And the department is working to unravel its controversial “balance billing” system at San Francisco General Hospital, which can saddle patients with enormous hospital bills if they have private insurance. The hospital has suspended the practice for 90 days as officials come up with a plan that would treat privately insured patients more fairly.
“I’m assessing the situation right now,” Colfax said. “We’re going to be issuing recommendations within that 90day deadline.”
In Colfax, Breed has also recruited another supporter in her stalled efforts to open a safeinjection site in the city. Colfax said he was “all on board” to establish a safeinjection site in San Francisco, where drug users could come to receive clinical supervision and clean equipment for using intravenous drugs. Medical evidence, he said, shows that the sites “save lives and improve treatment outcomes.”
Colfax has been praised for his previous work at the agency as director of HIV prevention and research. He was tapped by the Obama administration to lead the nation’s Office of National AIDS Policy in 2012. He was most recently the health chief of Marin County.
At the health fair Tuesday, Colfax quietly surveyed the scene as he introduced himself to health department workers, hastily making plans for later meetings.
“What you guys need, that’s what I need to know,” Colfax said to one health department employee.
“We need to get you one of these,” department program coordinator Eileen Loughran said to Colfax, pulling out a small bottle of Narcan, the emergency drug used to treat narcotic overdoses.
“I have one in my car, but I should have one in my office,” he replied.
“You should have one in your pocket,” Loughran said.