Transcripts For SFGTV Health Commission 8515 20240622

With them. Very often the volunteer will accompany the staff person, commissioner, but its a staff persons responsibility. Because monday tend to be a slower day, why its closed on monday . Yes, and the thinking is if we can balance that scheduling during the week and the month, we can off balance that. Generally the monday are the slower days, but again i have also had many requests to open on sundays as well. But just cant do that at this particular time. Due to the [inaudible] . Excuse me . Because you need volunteer to open . Right, but we need have to have a staff person responsible. Because its part of our Organizational Program site. And responsibilities in terms of all kinds of things from information, referral to liabilities and things of that nature. And we want to be sure that folks that come to for contact are properly referred to. If Staff Services are not there during the weekend, we try to get best efforts and get their names and phone numbers for follow up. Thank you. Thank you. Any other questions . Commissioner. I have a general question, not necessarily directed to kimochi, it says number of modifications, three. So i wonder this grant was issued or renewed perhaps in 2013. Uhhuh. For five years . Uhhuh. So from 2013 to date, this is the third modification request . Correct. How regular are modifications gone . And if a grant is approved, how soon can an entity request a modification soon after . Thats a good question, with my experience to date, what i have seen in particular with this contract, its a codiby increase and that was cone modification. And last year kimochi was awarded additional money. And this is for the 53 one third. I would say to your question, modifications can happen pretty quickly. Because one of the things that you will have noticed on the commission, we frequently bring contracts to you in may and june for approval. And then our budget doesnt isnt finalized until july. And in the course of that budget being finalized we could end up with a cost of doing business increase or new dollars. So you could see adjustments coming to you really within months. So it can happen pretty quickly. And as monty said it depends on what is going on in the world. Cost of doing business is frequently what you see. And sometimes we have these circumstances like today, where there is dollars available to put into a program. But it can happen pretty quick. Thank you. Any other questions . Thank you. Thank you. Public comment at this time . Any Public Comment . Commissioners, we ask for your support, thank you for all your years of support as well. We are ernestly trying to provide the services that we can. All in favor. Say aye. Aye. Opposed . Ayes have it, and motion is carried. C requesting authorization to renew the Grant Agreement with next village San Francisco for the age and Disability Friendly Community project. Utilizing the village med model for the term of july 1, 2015june 30, 2017, in the aim of 20,000 plus a 10 contingency. Motion to discuss. Motion. Second. We have before you the village Model Service a Membership Organization that provides an array of services such as organized activities and assistance with transportation. And inhome support with minor repairs. And referrals to recommended businesses and health and wellness opportunities. And a wide gamut of Services Provided by paid staff, volunteers and the fellow village members themselves. Another unique village feature is that specific location is not required. Villages utilize public spaces throughout their service area to provide services. For next village recently examples will be disaster preparededness kit distribution. And a new member event at Senior Housing in chinatown. Or a travel talk at the north Beach Library branch. And we have partnerships to help provide additional Transportation Resources to the members. Next village has a Distinct Service area. Generally the northeast section of San Francisco defined loosely as van ness to the east, van ness to the south and bay as at north and eastward barrier. Program monitoring for next village for fiscal year 1415 was conducted in july. There were no findings and next village was found to meet all Service Agreements for the previous year. At the time of monitoring and looking at membership and diversity. Next village at the time of monitoring was 113 members. Among the membership, approximately 22 was identifying as noncaucasian or lgbt, and next village is taking an interesting approach to expand membership and diversity. And they have a staff member with chinese language capacity. They are increasing each in their monthly newsletter, there is always a chinese language article. And they are targeting events in known chinese speaking sections of their service area. I am told that these outreach efforts have paying dividends and they have new chinese speaking members in the past week and that number has gone up quite a bit just recently. With that, i am happy to answer any questions. Commissioner loo. I am looking at the page, appendix page 2. The salary and benefit details. Yes. Okay, the employee fringe benefit is 0 and i thought by law you need to give benefit to the employee, how do they they are paying those costs off the contract. With other funding sources. Well, you know this is one thing i have thought about. Contractors have raised their own money to pay off some insufficiency of the funds. And maybe you know, this should really be part of the budget. Because otherwise its not showing you the actual costs. So commissioner, i think one of the things that we have one of the reasons we have gone to this model is of not asking our contractors to supply us with all the information regarding their budgets. You are right, it leaves us maybe not understanding the full cost for the program. Although in our monitoring and our discussions with the contractors, believe me, we do hear from them about what the real costs are. But its really a matter of administrative support. Most of the nonprofit organizations that we fund do not have really enough infrastructure. And support to do the kind of reports that we require. Because we have not had sufficient support and we ask what is only pertinent to the dollars they spend for us. When we get to the point of funding we have a lot of requirements our contractors, a lot of data requirements and budget requirements. So that is the case, but we have made a decision to do that given the resources that the contractors have available to them. Commissioner sims. Just as a follow on to that, isnt there a requirement that agencies seeking funding from the city provide some minimum standard of noncash benefits to their employees . I believe that the rules are based on how many staff. There is a threshold. So clearly our staff knows that this organization is providing benefits. But it has been my understanding for a number of years, that organizations i am not sure of the number, five or less, do not have to by ordinance. But i would have to check into the rule for you. I am not positive what that threshold is. Commissioner, do you know . I dont know if its i know that all things are mandatory at 15. 15 employees, okay. Commissioner sims. Second question, could you repeat the geographic boundaries. Van ness, broadway and the water. Van ness and west . Van ness to the east. To the east. Yes. And broadway to the north. Yes. Okay, any other questions . If not, i will call for the vote. All in favor of approving say aye. Aye. Opposes . The ayes have it and motion is carried. Last item review and approval of the fiscal year 201516 hicap and fiscal year 201415 mippa budgets. Associated with contracts hi1516 and mi141506. And all subsequent amendments. Could i have a motion to discuss . So moved. Second. Okay. You are on. Could you explain. Yes, so this item before you is actually for the approval of the contract between cda and daas for the funding of our hicap and mippa programs. This contract is just for that and part requires to go before the commission for review and approval. And with that the contract is finalized and we are able to access the funds in the programs in the city and county of San Francisco. We have gone through the solicitation process for the contractor for the hicap and mippa programs, that occurred in the spring and came before the commission and approved. With this its the final step in the process and gets everything moving and the funding flowing. The contract before you is a standardized agreement, it says standard agreement on it. I can assure you this is the contract used between the California Department of aging and the two other aaas in the state of california. With that said, i am here to answer any questions you might have about this contract. Any questions . Does this does this increase i know they have certain communities they go to, does this increase . Or do they stay . The only change, there is no change in the scope of services of selfhelp we provide. The only change when the actual state money came in, it was 2,000 lower than we thought it was going to be, hopefully that wont affect any services. Okay, any other comments . Public comment . Hearing none. I will call for the vote. All in favor. Aye. Opposes . Ayes have it, so the motion is carried. Thank you. Announcements . Hearing none. Announcements . Hearing none. Public comment. Yes. Hi, good morning, cathy spensly, director of the Senior Division at felton. I appreciate your question, commissioner, regarding medication support. We specialize in Mental Health in our agency and geriatric Mental Health. I wanted to let you know its a very important issue, in all of our contracts we have psychiatry and medication support is tremendously support. And with that said there is a huge deficit of geriatric psychiatrists in San Francisco. Thats an issue but we have a lot of support in that area. And the Medicare Service act is a help and with hiring of peers for folks that are less willing to take medications. And a lot of data of how peers help in this area. And lauras law is a state law that various counties have adopted and San Francisco adopted in may. This is compelling serious cases for folks to come to the courts and compelled to take medicat n medications. It was brought forth by family members, [inaudible] and will compel the folks to do it, and almost to the psychological fact of going to the court system. But at the end of the day, its a civil rights issue. Its very difficult to force folks on medication, and thats actually a good thing in the long run. And the best news that the newer drugs are better at their efficacy and reduced side effects. Thank you very much for the question. Thank you. Hi, jessica layman with fsda, and i had two comments on the issue that cathy was speaking about in terms of medications. I want to bring in the room that there is a long history of people with medical Health Issues and forced to take medications. And some things are disproven. Lobotomies for example is real for a lot of people. And there is a Huge Movement of people called Mental Health survivors and consumers and there is a lot of different ways to deal with mental disabilities, and medications is one of them and something to look at as a society. I know that San Francisco Mental Health could speak to how to look at it from a peer perspective and talk about medication. From the white house conference of aging i was so glad to hear that director hinton was able to be a part of it and glad that they held it. I had a lot of concerns about how the community was or wasnt involved. And i understand they talked about including people with technology. But here in San Francisco senior access and other groups really wanted our seniors to be a part of it. And it was very challenging. Part of it we didnt have a lot of notice. We tried to set up viewing sessions and they didnt put out the time and agenda but a week ahead. And the white house conference on aging information was not available to community groups. And then they invited people to share messages primarily through the website and twitter. Which i found almost amusing. Because how many seniors in our community, particularly lowincome seniors on twitter. I think i hope we as a city can do our part and thanking them for theire efforts. But urging them to do better and really involve lowincome seniors in conversations about seniors. Thank you. Any other comment . Public comment . Okay. Good morning. I am linda lou, nutritionist in the office of aging. And want to bring to your attention upcoming Diabetes Program that the Senior Center is helping they have always scheduled and we have sent this information out and shared with daas contractors and the network. We wanted to let you know if you want to pass it on and share with your friends and network. I have hard copies on the table and you would like electronic copies, i can share with bridget and share with you. Hearing no other Public Comments, can i have a motion to adjourn. So moved. Second. Its moved and second that we adjourn the meeting. Thank you. Meeting adjourned. [gavel week. The San Francisco. The reporter has many opportunities to get out and placing play a 4 thousand acres of play rec and park has a place win the high sincerely the place to remove user from the upper life and transform into one of mother nachdz place go into the rec and park camp mather located one hundred and 80 square miles from the bay bridge past the oakland bridge and on and on camp mather the city owned Sierra Nevada camping facility is outings outside the gate of Yosemite Park it dates back before the area became is a popular vacation it i sites it was home to indians who made the camp where the coral now stands up and artifacts are found sometimes arrest this was the tree that the native people calm for the ac accordions that had a high food value the acorns were fatally off the trees in september but they would come up prosecute the foothills and were recipe the same as the people that came to camp camp is celebrating its 90th year and the indians were up here for 4 thousand we see every day of them in the grinding rocks around the camp we have about 15 grinding sites in came so it was a major summer report area for the 92 hawks. Through there are signs that prosperity were in the area it was not until the early part of the century with the 76 began the construction of damn in helpfully a say mill was billed open the left hand of the math for the construction by which lake was used to float logs needed for the project at the same time the Yosemite Park and company used the other side of the camp to house tourists interesting in seeing the National Park and the constructions of damn when the u son damn was completed many of the facilities were not needed then the city of San Francisco donated the property it was named camp mather the first director it was named after him Tuesday Morning away amongst the pine the giant sequoia is the giants inventories first name if our title is camp means theres going to be dirt and bugs and so long as you can get past that part this place it pretty awesome i see i see. With a little taste of freedom from the city life you can soak up the country life with swimming and volley ball and swimming and horseback riding there you go buddy. We do offer and really good amount of programming and give a sample p of San Francisco rec and Park Department has to offer hopefully weve been here 90 years my camp name is falcon im a recession he leader ive been leading the bill clinton and anarchy and have had sometimes arts and crafts a lot of our guests have been coming for many years and have almost glutin up, up here he activity or Children Activity or parent activity here at camp mather you are experiencing as a family without having to get into a car and drive somewhere fill your day with with what can to back fun at the majestic life the essence of camp mather one thing a thats been interesting i think as it evolves theres no representation here oh, theres no representation so all the adults are engine i you know disconnected so theres more connection the adults and parents are really friendly but i think in our modern culture i you know everyones is used to be on their phones and people are eager to engagement and talk they dont have their social media so here they are at camp mather how are i doing. How are you doing it has over one hundred hundred cabins those rustic structures gives camp mather the old atmosphere that enhances the total wilderness experience and old woolen dressers and poaches and rug i do lay out people want to decorate the front of thaifr their cabins and front poefrnz their living room is outside in this awesome environment theyre not inviting their guests inside where the berms are people get creative with the latinamerican and the bull frogs start the trees grow and camp mather is seen in a different light were approaching dinner time in the construction of the hetch hetchy damn the Yosemite Park built Jackson Diane hauling hall to serve the guests it does was it dbe does best service s serve the food. Im the executive chef i served over 15 hundred meals a day for the camp mather folks breakfasts are pancakes and french toast and skranld eggs and hash browns our meal formulate is we have roost lion its reflecting of the audience we have people love our meals and love the idea they can pick up a meal and do worry about doing the dishes can have a great time at camp mather after camp people indulge themselves everyone racks go in a place thats crisis that i air after the crackinging of a campfire a campfire. The evening is kept up with a tenant show a longed tradition it features music i tried this trick and this talent show is famous for traditional things but we have new things the first 7, 8, 9 being on stage and being embarrassed and doing random things unlike my anothers twinkling stars are an unforcible memory admission to camp mather is through a lottery it includes meals and camp programs remember all applicant registration on line into a lottery and have a rec and Park Department family account to register registration typically begins the first week of january and ends the first week in february this hey sierra oasis is a great place to enjoy lifeiest outside of the hustle and bustle and kickback and enjoy and a half everything is so huge and beautiful. The children grew up her playing around and riding their bites e bicycles its a great place to let the children see whats outside of the city common experience is a this unique camp when you get lost in the high sierra Wilderness Camp mather is waiting and we look forward to City Managers Office you here soon take pictures of the view of the city that you soon went forgot. Our first look out and at Buena Vista Park San Francisco heavily forested hill with couples and doing walkers its as old as the near neighbor Golden Gate Park and both have a coast live oak forest and fresh in retreat from urban life and meanders under a canopy of oaks yup lipid u. S. And chill out in this pleasant and quiet environment and you might see butter nice, and dandelion and is squirrels hundred dollaring for their next meal and Buena Vista Park is 88 i now call the regular meeting of the Health Service board city and county of San Francisco to order. Holy stand and repeat the pledge of allegiance. [pleage of allegiance] the board secretary will call the roll. Rollcall. Resident scottvp lim commissioner breslin, supervisor farrell excused commissioner rigo expected commissioneromission or sass. We have a quorum. Item number two, shifted one, im sorry jacob thank you. Item 1 action item. Approval with possible modifications of the minutes of the meeting set forth below. Together meeting of june 11, 2015. Are there any additions or edits to the minutes . I move we approve. Its been properly moved we approve the minutes is distributed and posts. Is there a second Second Chapter properly moved moved and seconded. Approve the minutes as distributed with the regular meeting of approve the minutes as distributed with the regular meeting of june 11, 2015. Is there Public Comment . Hearing none, we are now ready to vote. All those in favor say, aye. Opposed, nay. The nay had. [gavel] item 2, item to discussion item. General Public Comment on matters within the boards jurisdiction not appearing on todays agenda. Is there any Public Comment . Yes, please my name is diane perla. I spoken to you before about nine my dispute withgetting this oral appliance cupboard on the follow is it and i got a phone call from the kaiser represented same that they had decided they were not going to cover it. I would get a phone call from ms. Hill at the Health Services system explaining why because i asked her to send me a written statement so i would understand whats going on. This was about a month ago and i never heard from anyone at the Health Service system. I just think i am entitled to get an answer of what was decided and why. Thank you. Before you go accuracy, just remain there. I want to formally request that your request be given to director dodd and that she follow up with you through her staff member. Thank you. Any other Public Comment . Hearing none, i like to go to item 3 which is the presence report. I do have a few items that i wish to cover. First, i have a privilege under the auspices of the board to participate in an International Foundation Employee Benefits Plan Trustees institute, which was conducted here in San Francisco on june 15 of this year. This was a very wide range in presentation. I found a lot of information in some of the sessions. Some of it was very, in my humble opinion, very elementary, but i think that you have to take that into account given a persons background and experience in the field of benefits. Overall, the program was exceptionally well done. In order to qualify for a certificate of attendance, you had to attend 13 sessions. I did that. I think its worthy that i go on television and say that i got my certificate in the mail, and two days ago. Saying that i really wasnt there. I know there was some question at least in my office, about where i was. I was at the sessions. There are any number of these items that i think will serve us well as trustees, or in our case, commissioners, as we have a little later in the fall and open forum for this board, which director dodd and i have discussing in terms of items for discussion at that session. Not only is it a fiduciary responsibility information that weve asked our good counsel to begin to pull together. It was a very extensive session about. It was another session on various trends, economic and Healthcare Trends that plan fiduciaries and planned designers and administrators need to be aware of. One of the areas to me also very interesting was the fact that there was a session on specialty drugs and a mystery, if you will about how indeed they are developed and priced. For us to pay for. This is been a central question for most multiple employer plans across the country and we been experiencing. As well and its been a big issue at the state. So, ill be happy to share the content of the sessions with any of the members of the board. I downloaded a number of the presentations and plan to send those over to catherine and her team so they can share them with the rest of the board, and wider as necessary. Earlier this week, director dodd sent as a wall street journal article. It summarized a bit of the full report of the academy of actuaries, American Academy of actuaries report, which was released on august 5. So delighted to see our actuary out there, neil, i want to tell you i went i read the full report, neil. Im going to send electronic version of that to kathryn because i think its warrant some review by all members of the board. It is in english. It is in english. Theres not a lot of formulas in it or anything else. Its really a very excellent summary of trying to find the Drivers Behind core medical inflation and the cost related to that more broadly across the country. It would be worth our while to kind of have that in our background as a prep piece, if you will, for the november form that were going to be having. So it can serve as a springboard for that get the wall street journal did a fine job in summarizing it, any actuarial report i think will give you a little more detail about how thathow they to some of the summary points, that particular link came from the International Employees benefit plans on base. Thats how i found. It just was one of those things as part of their daily updates. We are all members of that group and so youll be getting an email daily from them. A lot of the stuff does not apply to is that you can skip right there. Occasionally, there are these articles that are there. There is also a report that has come across my attention by a Consulting Firm by the name of deloitte. Not a small firm. It is a survey on Consumer Behavior for people that are participating in exchanges. Its the first such nationwide report on that issue. Some of the conclusions might tend to be surprising to some folks well people are going just to go to the exchange to get it insurance covers. Every some of the early indicators are that people are trying to make informed choices about various kinds of services, that they are indeed, trying to inquire about Preventative Care and how its to be utilized in their circumstance for themselves or family, and there are other things that we would want to assume that people are doing around how they are using their Health Benefits. Day in and day out. Doctors visits, owing to the hospital, whatever happens today. So, this is another piece that ill send along to catherine for distribution, but i think its an enlightening starting point because in my mind, the question is, are members doing similar things . We are seeing things in this particular larger arena that might be very useful and the question is, can we learn from that and encourage our members to do likewise. Sauce on that along to everybody for your perusal. Lastly, as far as my report, it is my great privilege and honor to say that we have a full Health Services board. I expect a little pause reaction around the table. With the appointment of dr. Stephen elliottgood im not going to recite his entire resume, but hes had a very very distinguished medical career here in the bay area. More recently, at kaiser, but also part of the uc system serving at uc San Francisco. He has taught in medical schools. Hes done very special work in hiv and aids research. He has served as a medical leader in many many dimensions, both here locally, weaselly, and nationally. I am honored that you were willing to take time out of your day to be a part of our group, and i look forward to working with you commissioner falkenstein. Do you have anything youd like to say . College essay is actually a privilege to be asked to join this board. Ive been a resident of San Francisco since 1977 and in practice here i started my training internal medicine at ucsf at that point, and retired in february of last year. So, 30 some odd years of medical practice. I would say that i practice in essentially every hospital in the city, after which dont exist anymore. It wasnt my fault. Partial halo, french i could go on and on. I was cheap that staff at davies. I spent half of my professional career in what we call fee for service. But starting in st. Lukes and then in 1998 joined kaiser in the discipline of infection diseases and hiv medicine that i was also president of the dental medical society for agent. I really feel this board and the medical community that very well into my own passions. I hope to learn a lot from every Single Person in this room. Thats whats fun about this. Thanks thank you commissioner. We will look forward to working with you. So with that, that concludes the president s record in alaska theres any Public Comment . Good after good afternoon commissioners. Clairepresident of retired employees and a former member of this board. I like first of all to welcome the doctor. Its really wonderful to see a full board again and it sounds like youre the kind of experience that will be helpful and beneficial to all the members and two other members of the board. So welcome. I also want to comment you, commissioner scott, going to and the conference finally. It was something that we did a lot more when i was on the board in earlier days, when the citys budget was so bad that all travel and training was removed from most budgets, are board get into the traveling to those conferences anymore, and the staff couldnt even though i think our travel and was to be paid out of the trust. But, its very important. Theres much to be learned in those conferences and i would strongly urge that we really, while there are a number of those presentations that are available electronically, there is something much more valuable in the person to person, the actual conference to beat it. It sounds like you discover that. Because you interact with others. You find out who knows what and who doesnt. Just that, networking, milling around, when everyone called is extremely valuable. We also previous commissioner went through quite a career in the Public Domain withinbecause he served on our board and is also work for whatever actuaries. So i think the possibilities are there and id like to encourage everyone to take advantage of those conference opportunities. The ones that are specific to publicnot public health, but our public lands. They are the most beneficial and theyre so much to be learned. So, thank you very much. Its very interesting to hear the information that you presented and i look forward to trying to access some of that good i just want to add likely, retirement board yesterday did it fiveyear demographics report. I think while their populations are not the same, there is some very valuable Information Available on that report. I can get it electronically or be happy to share it. Thank you very much. Excellent. We look forward to receiving it if we can. Thank you. Is there any other Public Comment . Hearing none, item for item for discussion item. Directors report. Director. Catherine. Director of Health Services. My report is behind tab for. Much like we have a complete Health Service board we are very close to having a complete hsf staff. We are in the final stages of filling the graphic artist position, which is woefully needed. Since we added bonus, rosemary, our communication managers work has just quadrupled. So we did an initial interview and would do the final interviews on the 21st of this month. And have a graphic artist and an assistant person in place. It just unfortunate we could not have done it. We the budget was signed into law on i think august 1 and we will have filled this position 21 days. This is record time for the city and county. But, a lot of the open enrollment work was done. Nonetheless, we are also in the final process of hiring the analytics staff person was going to work on the claims database. We have with us to new staff people. Marie, murphy. Read you want to read your and please stand. Please stand. Marie has a phd in sociology. Thats not why i hired her. Shes a Research Assistant for the departments. I will credit her with the eloquent testimony that in your book today on the codes on advanced care directives. We also have with us this should allhow to icy alaskan . I was right on. He is working on emerge to image 9. 2. Transition. We are delighted to have him. He has years of experience with kaiser. So, welcome. Jeff kleiner, who is not here, after 25 years, we promoted into senior eap and were adding a staff position in eap. This is the first time would increase staff for Employee Assistance program in 12 years. The operations manager, our new Operations Member Services manager will begin on august 17. He will be at the next Board Meeting and he comes from usc w has lots of experience. And we will continue to keep two positions empty per the requirement of having attrition savings in the budget. Which is kind of ironic. Nonetheless, were almost fully staffed. Maybe someday we wont have to keep positions empty. In terms of operations, all customer goals were met. I just want to point out, we stopped 17 people on the holdover list. Thats down significantly since i came. For those of you who dont know what the holdover list is, if you are laid off, you get Health Benefits at the same benefit rate you have for five years. Thats for you and your dependents. Every year we are required to make them certify that they dont have access to other coverage. So nothing for people actually have other coverage. Because they found other work. Open enrollment, preparations begin in june and we are in the midst of editing and editing. The changes include the new United Healthcare national lapd ppo. They also include the new fsa vendor for our fsas. We implement the cobras in july. We are doing what they call six meetings as we convert to peoplesoft 9. 2. So thereve been several of those trying to make sure that transition goes smoothly. I think it significant to say we enrolled 700 new retirees in the last two months. So, thats a huge amount of work for our benefit staff. Im going to skip through other than to say among you all approved the budget for the enterprise contract management solution, and that was approved yesterday. Now all we have to do is select a vendor and start scanning and its very exciting. Im waiting for years for that. The web statistics are in your binder. Finance wise, we went before the board of supervisors. We responded to the board of supervisors budget analyst twoand were successful in having a majority of our cut being stored and restored and we want for the board of supervisors and i was approved and the funding on electronic contact Management System was what was in jeopardy. So its exciting to actually see that come to fruition. In your binder, you will recall you requested that wellness present to you every quarter. Stephanie fisher, i wellness manager, is that eight Data Analytics training in sacramento. She cannot be here. She asked me to highlight a couple of things. So in the mitre ar in the binder are to reports. The highlights include that we had to 93 unique participants in the First Quarter of the year. And for 90 in the Second Quarter of the year. In the Health Wellness center. Eap served 61 new contents and continues with 95. So thats another place where i just have to comment dhr. They really are moving requisitions through quickly. Deposition, jeff was promoted on monday and we had the position filled within two weeks. So hopefully, this will continue. We have a fitness event that attracted 270 people in three hours. It went through 10 different stations of things that can do. That is like. The key thing is we were new people. There were the same people that come to our classes. I want to thank the vendors who all came. The provided activities and handouts. We have recruited an additional 64 wellness champions in different departments. We now have well over 120 of them. Stephanie fisher presented the accomplishments of the wellness program, and the wellbeing assessment. We all took that wellbeing assessment last december. They finally calculated all the data and presented it by department. So, you were at a meeting that the mayor called. You were given a report on what percentage of your employees took the wellbeing assessment, and what the wellbeing assessment said. So, were peopledid they want help and stress management class undernutrition . Helping exercise . Help do they want to Work Environment to improve . Not only did you get the results, but she thenshe and her stafftthen gave you suggestions of what you can do to address the issues that showed up in your data. She offered to meet with Department Heads and she met with several already especially the large Department Heads. To go over specific ideas and things they can do to respond to the wellbeing issues that came up in their department. I just will say, lucille attended the event and kind of got all the Department Heads excited. Not that lucille is uplucille from the giants. Not that she is the picture of health. But she was lithe and at the meeting. The Diabetes Prevention Program Research study that we are doing with kaiser, that has been submitted. It was approved. To the irb. So that study will disseminate effectiveness of a worksite wellness online intervention versus a Group Intervention intervention to prevent diabetes good were getting ready to mail several departments employees and have people take the test again to do a prediabetic screening metabolic syndrome screening. I did want to highlight in rosemarys reports on the eap services. I want for my new the increase. The number of people, even though gene retired after over 25 years of service. In the Wellness Center visits, i think what is interesting is that weve had new people. These are people that are not previously engaged. So, thats always exciting. The interactive seminars decreased. Township your seminars. Because of fewer seminars. But they included nutrition by taliban. Managing stress dealing with difficult people. Understanding or metabolism. We are really getting the word out there so people know how to manage their health. I have also included just a statement on the 12th parity law that insurance are not the filling of promise. Marie murphy will be working on querying all of our vendors to really say, how do you define mental parity and are retreating Mental Health the same rate we are treating physical health. Mental bonuses, as you know, is a chronic illness. In response to the chairmans request, weve implemented an email address and phone number for the board and we did have responses because we made that public at the medicare meetings. So, i put one of them that camethose go togratefully. The board now has kind of a sounding board for people. I will point out in terms of vendor issues, the uh see is in the final stages of negotiating a contract with john muir. There are 28 claimants that might be effective should they not be successful in negotiating a contract, but maybe theyre not sending anything appear theyre not required by law to. We dont have a managed care plan there. Ive added some items of note. Let me just go back for a moment to Data Analytics. It actually entered our first set of data. After you know, it was this time last year you were approving the abcd and we now have data and we are actually its exciting to have entered data. Thats from marina was also at that time. If i might, in terms of a telephone number for the hss board. I like to at least have that part of this broadcast. Absolutely part of this broadcast. Absolutely part of this broadcast. Absolutely 4155540662. The email is health. Service. Board. At sf dog. Org. Thank you. I just added some items of note. You referred to them earlier to my commissioner scott. The mergers and it positions continue both at the insurer level and at the provider level. The largest ever is the anthem is acquiring cigna. Its still being contested in terms of monopoly power. But it willit shows that the market is narrowing down for from five dollars to three. In terms of the insurance market. Uht will remain the largest in terms of revenue, but anthem will have a Larger Customer base onceif this goes through. This continued uncertainty about seton hospital, which is where many of our patients are admitted. The daughters of charity secured 259 from Blue Mountain is going to operate a health system. Thats a nonprofit for three years after which they could acquire the chain and transition it to a forprofit system. So, thats the current plans for seton. Average california. You may hurt has increased their rates by 4 . Interestingly enough, the Medicare Trustees report, which referred to earlier, is saying that medicare policy are going up 4. 2 . Thats the range were looking at. Last week, for the third time since the passage of the Affordable Care act, the cmsthe federal Government Produced their readmission penalties and thats one of the key indicators of quality care. One of the things we monitor in our organizations. Among hospitals that were find include sutter, oscillates, summit. Summers seep into the centerrenzo. Kaiser south of San Francisco. St. Francis usf el camino and johnny are good i went to the listenable to where we had patients. No one is perfect. Thats how cms is funding things. I know additional items other than i will be out of the country the next two weeks. Mitchell, who will hopefully be back tomorrow, will be in charge. April Financial Officer will be in charge of all things finance. Im fairly confident over that amount thank you, director. Get any questions from the board regarding any aspect of the report . Is there any Public Comment . Hearing none, we will accept the report as given. We will move to discussion item number five. Item 5, discussion item ages just Financial Reporting as of ages just Financial Reporting as of may 31, 2015. Pamela levin. I would like to take this public opportunity to knowledge the tremendous work effort of catherine and her team. In preparation of the budget and its submissions and all the interactions that go on to get that monster done. I thank you for that. I commend you for your hard work. Im pretty a pretty positive outcome after we went through it all. So thanks. Thank you. Payment of 11 Deputy Director chief Financial Officer. I do want to take a minute to introduce our new im sorry. Contracts manager. She started in june and has coalesced so well with the team that seems like shes been here for long. Her name is . Amara marilyn. Would you please them. Well, welcome to hhs. Thank you. Today im reporting on the revenues and expenses of the Employee Benefit trust fund. Also known as the trust fund and the general Fund Administrative budget. Through may 31 as well as fiscal year ending objections through june 30. Where we are right now, just kind of in broad generalities, is that the fiscal year closed on 30 june. There are still transactions that are being processed and we always are behind a month in terms of its report. However, the projections that we have here are the general fund our actual actually based on last week and it was absent just a couple of transactions. The trust fund is the audit is started, and we think we are going to bounce around where are at and what are present in the report. The audit wont be concluded until october, and i believe that it will be presented to you in december. The balance of the trust fund on june 30, 2014 was 92. 8 and right now we are projecting and right now we are projecting at 70. 5 million. It will be similar between that and 80 million. I believe at the end. The projected decrease of fort 14. 3 million includes the reserves for unpaid claims and as a result of the following changes city plans has a 3. 4 million decrease in fund balance. This is attributable to 2. 2 million increase in fund balance and offset of 5. 6 million decrease in fund balance. We have had favorable claim experiences. Weve had pharmacy rebates. But, what we did was we used some of the fund balance, 1. 2 million, subsidizing the 2014 rate so that was the first half of fiscal year 1415, and then we also used 3. 7 million were the 2015 rates, which is the second half of 1415. Then, we had also used. 0 7 million without funding premiums in 2014 bringing in the 939383 contribution model. You will note, if you remember, we get by down the 16 rates also for city plans. The flex plan to my right now we are seeing a decrease of 17. 2 million in fund balance. I hope we have 2. 5 million in pharmacy rebates, that is offset by a 19. 7 million decrease in fund balance. Associated with 12. 7 million unfavorable claims experience, we are monitoring that on a very regular basis. Having discussions with the acos, and trying to improve or reduce claims or claims expense in the amount were paying out for claims. There is also a 4. 9 Million Associated with subsidizing the 2015 rates from the claims stabilization reserve. Then, 1. 1 due to the use of erp funds. Other seems to be is in the past because a lot of it occurred in the first half of 1415. Fiscal year versus calendar year, and plan your. Then, there was 1 million associate with funding premiums in the 2014 plan year for unions, except 939383 contribution model knows from the last part of the 2 the shield profit pledge. Other balances that are attributed contributing to the 14. 3 million decrease, overall decrease, in fund balance, is we havetheres always send him. This is the dental insurance plan. Even increase in fund balance with favorable claims. Kaiser and blue shield insurer hmo plans. We have an increase associated with that premium revenues including the use of er which reduce members premiums. We have an increase in interest, . 7 million due to the cash balance that weve been carrying, including the erp funds that we know ended in the end of 2014. Forfeitures, weve had a decrease in fund balance associate with transfers to the general fund. To the general fund. To the 1415 budget. That, for performance guarantees, we have a . 4 million increase in fund balance. We are working withto make sure we are cover all required deserts. We do this during the process of the audit of the financial statement. Overall, we are in a healthy state for the trust. Not overly healthy, but not unduly healthy. So, just where im fairly comfortable with it. In the general Fund Administrative budget, we projected a balance of 1. 3 million by year end. Thisa lot of that is due to delays in hiring. We have asked for carryforwards or we will. Its in the process. 200,000 in professional services. 70,000 in work orders. So, the general fundsounce of 1. 8ounce of 1. 80 million will be turned to the general fund it as i mentioned, there still some offsetting entries that are being put into the system, and i monitoring those very carefully. Are there any questions . Questions by members of the board on any aspect of the Financial Report . Maybe one question on the 12. 7 million unfavorable variance with blue shield, to have a sense of whether that is from i merely an issue related to price of services was at issue more related to Volume Services . Neil. Outlast the actuary to come in. I think its kind of a combination of goals. I think more so than we are not been successful in keeping people out of the emergency room. Theres not a good sense of making sure that the services are given in the appropriate venues. For instance, there is somei mean, my senses there still some surgeries done in patient that should be outpatient. Theres a lot of discussions about length of stay has increased. Theres a lot of bouncing about. One of the things we did have was the 12 increase due to sutter. During the negotiations, when they stop talking blue shield and sutter stop talking we ended up having to pay the sutter hospital rates which were 12 more than we wouldve paid otherwise. We are not seeing the type told that acos had inwhen the acos first started. Neil, j do you have any comments . Please introduce yourself. Neil kosher. Aion ashtray for Health Systems check that the question was volume versus price. Yes. Their answer is there is an increased volume and prices have gone up. To add to what your cfo spoke to, i would say cost specifically specialty drugs, escalated in this time period with several fc drugs coming on board. His increased cost specific to just that. By an estimated 4 million of that 12. Its representative of that is the other issues and the fact that the aco though we are optimistic on a performance the level we shouldve started with. So those are several of the drivers. So,