Number of cases under advisement, 11. Number of cases abated, 49. Number of cases referred to the litigation committee, is two. Thank you. Mr. Lowry, just on the accessible business Interest Program which is now kind of starting to build for us. I would not mind in the presentation maybe in february we could have some thoughts on that at some point later on, i know its 4 to 6year program here, but how we are going to deal with a notice of violations on that. If somebody doesnt apply, or doesnt seek out the, to ratify and what is the tenant or the landlord. Maybe an accessibility section. I think we need to keep it separate. My first reaction, we could have huge amount of these, we cant really act on. We cant close out for one reason or another. And it will skew our numbers if we dont have them separate. Historical issues, or d. P. W. Issues to work through, we are trying to do our job with you we cant because its out of our jurisdiction. How we handle that, you know, i think is important. I could bring that up with the working group. Every two weeks concerning this and we could work on putting some type of a form together. I think the first thing that we could do, give you an update on the screening forms. Notices sent out and received and screening forms, an update on whats going on with the screening forms. Yeah, yeah. We have worked hard over the years to get these down, and it is a very difficult program because it involves planning, d. P. I. And building, so we are trying to get a core group together of all three agencies, we could look at them together. Thank you. Thank you. Any Public Comment on the directors report items 8ad . Seeing non, item 9 review and approval of the minutes of the regular meeting november 9, 2017. Move to approve. Second. Motion and a second. Is there any Public Comment . Ok. Seeing none, are all commissioners in favor . Aye. Opposed . The minutes are approved. Item ten, adjournment. Motion to adjourn. Motion and second. All commissioners in favor, meeting adjourned. And adjourn in the honor of the mayor. Yeah, obviously we close in honor of mayor lee and his family, and our thoughts and prayers. Ok. Thank you. Our meeting is now adjourned. Ill call special meeting of the Health Service board of the city and county of San Francisco to order. I would like to have the secretary please call the roll. Roll call, president scott. Vice president lim, [roll call taken] we have a quorum. Happy new year, everyone. Now ready to take up our first action item. Item 1, action item, Public Employee appointment hiring, h. S. S. Executive director position, vote on whether to hold closed session for update regarding board selection of h. S. S. Executive director, president scott. President scott will to entertain a motion to go into closed session for action as described. Properly moved and seconded. Any comment from the board, Public Comment, hearing and seeing none, now ready to vote. All those signify by aye, president scott we are now reconvened in open session. I am willing to entertain item 3 on the special agenda. Clerk action item, vote to elect whether to disclose any or all discussion held in closed session. President scott. President scott will to entertain a motion as to whether we disclose any or all of our discussion in closed session. Not the nomination, just the discussion. President scott discussion. Willing to entertain a motion. I move we not disclose discussion in closed session. President scott properly moved we not disclose any or all of the discussion held in closed session. A second . Second. President scott properly moved and seconded, any Public Comment, hearing and seeing none, all those in favor of the item not to disclose any or all of our closed discussion, say aye, opposed, so ordered. Item 4. Possible report on action taken in closed session. President scott willing to a motion to report on the action taken in closed session during the president s report. Is there i move the report i move the report action taken in closed session. Be disclosed. During the president s report . During the president s report. Ok. Is there a second . Second. Properly moved and seconded that we make a report on action taken in closed session during the president s report. Is there discussion . Hearing and seeing none, is there any Public Comment . Hearing and seeing no Public Comment, we are now ready to vote. All those in favor of disclosing during the president s report action taken during the closed session, signify by saying aye. Those opposed, the motion carries unanimously. We will now adjourn this portion of the meeting and take a recess while we go into our regular meeting. Ok. President scott good afternoon, i call to order this meeting of the Health Service board for the city and county of San Francisco. I would like to ask you to please stand and join with me in the pledge of allegiance. I pledge allegiance to the flag of the United States of america. And to the republic for which it stands, one nation, under god, indivisible, with liberty and justice for all. Ill ask our secretary to call roll. [roll call taken] we have a quorum. President scott thank you. Again, happy new year. And we look forward to undertaking the work of the board and the services that we are trying to provide to our members for the coming year, and with that, we will go to action item one. Approval with possible modifications of the minutes of the meetings set forth below, special closed session of december 14, 2017, special meeting of december 14, 2017. President scott are there any edits or additions or amends to the minutes as described . If not, im willing to entertain a motion for their approval. I move we approve. Moved, is there a second . Second. President scott properly moved and seconded we approve the minutes for the closed session december 14, 2017, and the special meeting of december 14, 2017. Any comments from the board . Is there any Public Comment . We do have Public Comment . Dennis krueger, retired firefighters and spouses. I want to make a statement that last month at the december meeting i made some inaccurate statements and i would like to apologize to the board for that. But that, i will be coming back again regarding hearing aids and cataract surgery during open rates and benefits. Thank you. President scott rates and benefits. Thank you very much for amending your statements regarding those comments that you made in the last meeting. And i would just make a footnote that this last Public Comment was also made to me right after the meeting, so thank you again, dennis. Appreciate it. Any other Public Comment . Hearing and seeing none, now ready to vote. All those in vote signify by saying aye. Opposed, carries unanimously. Well now go to item 2. Discussion item, general Public Comment on matters in the boards jurisdiction, not appearing on todays agenda. President scott is there any Public Comment on matters within our jurisdiction that do not appear on todays agenda . If there are such matters, i would ask those individuals to please approach the podium and when you do make your statement, please introduce yourself by giving us your name. Hello, commissioners, my name is gail bloom, im a retired member. I ask your secretary to pass forward a couple of items. They are kind of personal as you can see. The first one is an unpaid bill to suter hill by united for my daughter who is a dependent, and this apparently is a problem that extends beyond my daughters coverage. United is not paying bills to the extent possible because they are not recognizing suter as a preferred provider. And so they are treating them as out of network care and if youll notice, im getting past due bills and they are about to go to collection. And so i would like someone from united to go back and figure out why it is that they dont recognize suters health i. D. Numbers, and ive been told they have already resubmitted it a couple times and ive been told by suter that it is a problem insurance wise with united. So im just bringing that to your attention. President scott before you go, did you bring this issue to the h. H. S. Staff through Customer Service . I did, and they said that i could either write to them or bring it to your attention directly. President scott im going to ask acting executive director griggs to discuss this with you when we are in recess or before you leave so we can get to the bottom of it. Thank you. Im sure its just an administrative issue and certainly know its not personal. President scott thank you. One other item. This is also something that i find curious. And it came up because one of my prescriptions wasnt offered to me as part of my insurance. My prescription coverage. And so i was recommended by my doctor to look at something called good rx. Now, my prescription, which you can see in front of you, is a tier 3 drug for a variety of reasons it was not available. It should have been 45 for three months. But just using this website, which is like available to anybody in the world, you can see that the prices range from 11. 22 to 36. And it seems to me curious that an Insurance Coverage that we are paying a lot for doesnt compete very well against some random website and so ive been using this for some time, but i thought i would bring that to your attention. President scott thank you. Director griggs, do you have any comment on this second item . On the second item, i will take that back to the office and do some research, operations manager. And i understand that a lot of medical professionals have been doing research on their own coverage, and they are shocked that their own insurance isnt as effective with pharmaceuticals as organizations like good rx. And i advise everybody to look at their look at their pharmaceuticals. Because it is really significant, particularly for people who are in donut holes. President scott thank you for those comments. Any questions for the board on the comments, none. All right. Please introduce yourself. Good afternoon, my name is richard bronman, retired city worker and kaiser member for i cant remember how many years. But last couple of weeks ive had some really bad experiences at kaiser. I think maybe when we renew the contracts that we ask for feedback and somehow kaiser has to be responsible. I had the occasion to be in the emergency room saturday night. They were very overcrowded. I dont know why they didnt have more staff there. But i ran into one of the meanest nurses ive ever had the encounter to. She was just really nasty. She didnt even have a name tag on, so i couldnt report her. But the other is the pharmacy. I get all my pharmacy by mail and i went to renew it and it said one, i had to go into the pharmacy, and i was very curious because its a generic medicine and why. So, i called up, i must have spent almost an hour on the telephone because the operator did not know, she had to talk to the pharmacy, did not keep the pharmacist online, then she had to connect me again, i had to wait another time. This all could have been handled by email if the pharmacy would have emailed me or emailed my doctor that the dosage is changing but ill get the same amount. Instead of me waiting, you know, spending an hour on the phone. Even if i went to the pharmacy i couldnt have picked up the medicine because the doctor would have had to approve it. So, i think, you know, when rates and benefits come up, that somehow kaiser needs to be held accountable. Maybe if we withhold the payment for a couple of months, you know, theyll get the message. And let the other nursing staff, you know, has been really great there, the doctors are really great, i cant, you know, complain about the other service. But you know, i think we should expect the best service and i know we are all not perfect, but at least we can strive to make things better when we find things that are not that need improvement. So, i wanted to bring it to your attention and to hopefully the kaiser rep in the audience today. Thank you very much. President scott thank for your comment. Any other Public Comment on matters that do not appear on todays agenda . Hearing and seeing none, now go to discussion item 3. Item 3, president s report, president scott. President scott my discussion item will be a report that the board just voted on at the end of the last closed session to disclose the action that we had taken during the course of that closed meeting, and the prior efforts by this board to find a new executive director. Before i begin that, i want to give some thank you, and i would like to have pamela levin, our chief Financial Officer to come to the podium while i address her for a moment. Pamela, i know that i speak on behalf of the board without consulting with them, but im going to say some things to you that i think are in the spirit of commendation for the hard work and efforts that you provided during the course of this transition. It isnt publicly maybe known that this past year the city and county of San Francisco went through a whole massive change in the financial and budgeting system. New chart of accounts, all kinds of stuff that was supposed to be maybe done a year or two back or a year or two hence, but all came crashing down on your shoulders this past summer, and you gave great leadership to not only the work and the effect, the implementation of that system and this department, but also provided good guidance to collaboration with other departments within the city and county of San Francisco, while maintaining your month in and month out reporting to this board on the assets of the trust and its activities, along with all the other contracting activities and so forth. And i wanted to say publicly to you today, thank you for continuing to show the type of professionalism and dedication to the system in your role as chief Financial Officer during this time of transition. So, thank you very much. Thank you. I could not have it without having such a great staff. Thank you very much. Thank you to you and your team. [applause] president Scott Mitchell does not have to stand, hes up here with us, but our chief operating officer and acting executive director, mitchell griggs. I know that sometimes during a period of transition, mitchell, its very easy to kind of lean back and sort of let things be as they are. And again, i know that on behalf of the board, that that did not happen during this transition period. You not only maintained all the operational stuff you had to do, we also made some new benefit offerings under your leadership and guidance. We experimented with open enrollment electronically, which we hope we can expand. We completed some of the aspect of our claims Management System to utilize in a slightly different way and a number of other innovations that were directly attributable to your leadership and your staffs work during this time. And so on behalf of the board, i want to commend you publicly. I have said this to you privately many times, for your hard work and effort and my hope is we can in a more tangible way provide some recognition for you as we go forward. So, thank you again for all youve done during this period. Mitchell. [applause] now, also maybe not as impacted by the transition, but lani scott has kept it operational day in and day out, and you have our commendation and recognition for all your hard work during this period of time. I know that sometimes i may not have been as clear in my requests of you but youve always been very patient and i appreciate that, and thank you for all that you do on behalf of the system. You are welcome, thank you. And to the broader h. H. S. Staff, if you are listening, or you might be seeing a replay of this, your teamwork and professionalism absolutely has caused us to be in a very good place. We recognize that it has been somewhat disconcerting not having an executive leader, but at the same time, by working as you have very collaboratively with mitchell and with pamela and the other Management Team members, we have been able to serve our members well during this past year without gaps in operations or Customer Service and you are absolutely to be commended on the hard work you have done throughout open enrollment and day in and day out, and working with our members. And on behalf of the board, we thank you for doing what you have done and what we know you will continue to do on behalf of our members, and thats to the whole staff. So, thank you. So, this search process began as you know last, late april or early, really, effectively, early may. And we have been working at trying to find a replacement for the immediate past executive director. We retained a search firm to work with us. Assigned executive was heather renchler. She is not able to be here today due to a family members personal circumstance and is back in ohio. But i told her that if she were here, i was going to say thank you on behalf of the board for the professionalism, thoroughness and diligence that she and her firm brought to the search. I dont think we would have been able to get through this process as easily as we did, even though it might have been frustrating at certain moments. But as easily as we did without her Firm Leadership and guidance and that of her firm. So, i wanted to thank her publicly for what she did to assist us in coming to this point. We have had we had a stage of input and consultation with active employees, with retirees, retiree organizations, members of the commission, individually, visiting with heather regarding what would be the appropriate profile for the next executive director for the Health Service system. What needed to be emphasized, what needed to be highlighted, what would be some essential criteria, preferred criteria, and so forth. The commissioners on this board worked and participated actively in every stage of the process during this search. We had to have special meetings, closed meetings in some cases. They were full in their attendance and participation in doing this work. We did go through an interview process, there were 53 applications, we narrowed it down. Personal interviews, screening interviews, first stage interviews with the finalists and then final interviews, and these commissioners participated actively in all of those meetings. I want to thank them for discretion, hard work, the fact we did at times may have a little disagreement on process or procedure but we got through it, and i appreciated their cooperation and support. So, we have found not only the person, we have made an offer, the offer has been accepted and my task and duty, warm duty, to present that person to you today. The name is abby ant. Abby, would you please come forward . She knows some people. Thats a good thing. Yes. Claire is wondering why i was here. Abby is going to be joining the system on february 12th, officially as the executive director. She currently is serving at the st. Francis hospital in a role of Vice President of mission and Advocacy CommunityHealth Services. She is a 17 shes been with them nearly 18 years. Prior to that she had a role and responsibility with the city and county of San Francisco in the health department. And spent some nearly ten years there. Abby is a seasoned, experienced health professional. Shes published, i was overwhelmed by the variety of articles that both she has authored and interviews that shes participated in on a wide range of health care and Health Service issues that i think represent the kind of strategic view and knowledge of this field that the system needs going forward. Shes also been an active member on a wide ranging number of boards, cofounding some communitybased initiatives to help deliver services to the homeless and the needy in our city. And she has done a number of other activities on a voluntary basis and one of her questions has been privately and trying to sort out how she will continue to do some of that work, with not incurring a city of San Francisco conflict of interest. I said to her privately, i appreciated her patience with our process, but i think its more than its a consensus of this board we have found the right person for this next stage of leadership and service to our members in the Health Services system. So abby, we welcome you, we look forward to working with you, and i would ask if you have any comments that you would like to provide, and i understand you have members of your family here today as well. Yes, thank you, thank you very much, president scott and the commissioners. It was a long process and im very happy to be here today. I have offered my resignation at the hospital this morning in order to be free and clear here today, and big transition but i did meet claire out in the waiting area and we were discussing sort of the third career, which it feels like to me, and its really an exciting opportunity at this stage for me to be welcomed back into the city having met with the controller this morning, its nice to be back in familiar territory and know i at least understand the first few chapter, having worked with the city in the past. Thats helpful to be here. I want to acknowledge my husband larry and son robby who are here. Please stand. Very supportive of a mom who likes to work a lot, so i will continue to do that, but im really looking forward to working with you and working for this very valuable benefits for all the City Employees and retirees and working with all the stakeholders and i know there are many, to work with and get to know and understand and its very nice to hear the high praises that you have sung for the staff of the agency, that really is a comfort to hear that kind of recognition for the work thats been well done and well managed over the year, and certainly make my transition that much easier. So, very much appreciate it, thank you. President scott thank you very much. Ill ask if the commissioners have any comments they want to make. I have two comments, one to thank you, president scott, during the leadership during this process. You thank everyone else but yourself. I would like to extend my thanks in particular and i have not talked to other members of the board, but your leadership. Its a tough and long process. Ive been incredibly impressed. I want to thank you for that. And also say that not listed i guess in your background is, our days at st. Lukes. And i want to assure the members from my own remote experience that abby is tough, and she comes across as very nice. But your interests will be represented quite well with every party. There will be no exception. She does not give anyone an easy path out when the discussions are tough. And i want to reassure everyone in that record as well. President scott thank you. Any other comments . Im one of those people who have known you for many, many years, and a privilege to work with you on a committee at the department of public health. Welcome you to the department, and also the city family. Great place to be, great place to work and we are lucky to have you. And i also want to thank you for giving me one of the brightest moments of my new year so far. Thank you. President scott thank you very much, abby. Well be in touch, as you know. Thank you again. That is the president s report. Is there any Public Comment . I would just like to say thank you, too, for the heavy lifting that you did through this whole time, and i also want to thank mitchell for all the great Customer Service hes done, ive heard so many good things from the members. So, thank you for filling in and doing all this. President scott all right. Any other Public Comment or board comment . Happy new year, commissioners. Abby well hold your application in abeyance. I just want to thank you, commissioner scott, and all of you for participating in this process, and thank you to also the staff that you commended really are very deserving as is the entire staff of Health Service. I think they have always been exceptional, and they continue to be exceptional in every way. And that we welcome abby back. It was really an interesting surprise to see her in the hallway going and what are you doing here . And so now we know. And we are looking forward to a very good year in 2018 and to some more outstanding performances from everybody, but thank you all. I know its been a grueling process because ive been through it in the past, at least a couple times. And we cant thank you enough for all of your hard work and also to all the staff, mitchell, pamela is just incredible and the rest of the staff back in the office. We value them very, very much in our membership and we value all the hard work that you all do. So, thank you and happy new year. President scott thank you very much. Any other Public Comment. Hearing and seeing none, the next item. Item 4, discussion item, directors report, acting executive director griggs. Board report for the december work, so we are in january, but looking back and highlighting the december work, and we are in the mode of thanking everyone, i want to thank the board for this opportunity. Its been a challenge, educational, its been fun, actually. Believe it or not. It has been a lot of hard work, and just to reiterate, specifically pamela and marina coleridge, the staff has been helpful but thanks to them and their support, having to put some things of operational, things on to marina and pamela stepping up with her expertise and how the city financial stuff works. So, thank you to all the staff. It has been a very busy year. And we are about to start a new rates and benefits cycle which well talk about in just a moment. But i want to go over what personnel positions we have currently open. We do have a 1209 benefit technician open and we are creating a new list, as most of you are familiar with the city process, that does take a little while. We have two benefits analyst positions open and reviewing a current list and scheduled some interviews for mid january. We also have 1802 research assistant, Job Description is written, or rewritten, i think its important that the new executive director is on board. This is a position that offers a lot of support to that position. So, it would be necessary to have the input from the new director on that position. We also have a Senior Administrative analyst vacant. The position has been posted. Our illustrator and art designer has been filled and the candidate selected starts on tuesday, and his name is ryan clous, and hopefully we can have him at the next meeting, i believe its 7th or 8th. And filled assistant educator position, a projectbased position, temp exempt and filled by someone who currently works at h. S. S. , her name is ava fuday. A busy year, december is when our confirmation letters good out, i think we had about 74,000 of these letters go out. I mentioned the last meeting we scattered those over a few days so we would not have 70,000 calls on the first day. What we have noticed by comparing to 2016, what we do, we compare open enrollment in certain months to the year prior and years prior, what we have noticed is we had a decreased in bound call volume for december, even after the confirmation letters started hitting, and decreased drop in consultations, speak come in and speak to the Member Services and we had a significantly increased speed of answer. And then 264 fewer abandoned calls. All in all, what is that telling us, successful enrollment, so decrease in enrollment errors or problems with communications. What we look at as successful communication process by the decreased calls and confirmations. Also during this time in december, this allowed us to catch up with our regular enrollment process. 40,000 open enrollment applications does not mean we dont have new hire and Family Status applications and things to process, we caught up on all those, as well as our reporting. We do a lot of reporting, we get a lot of reports on enrollment and premium issues and reconciliation, so we managed to catch up on that during december. Data analytics, managed by marina coleridge. We still have several programs we are working on as far as programming the 2018 planned year changes. A lot of those happen to be strategic in the sense we wait for a particular time, the retirees reductions start at the end of the month. After the active employees, the first pay period in the year. We are working on those, that means a lot of programming, testing, and going back and fixing things. And also at a yearend reporting, part of the Affordable Care act is still in effect. So, we still have to do our 1095 reporting. The i. R. S. Did delay the deadline for that this year to march 2 but we are on the path to have it out january 31st. President scott remind me of the cost of that project last year and the number. Costed out, i think, was it year before last, marina . And i dont recall. President scott like 3 million . It was a lot, and what was substantial, the number of hours that we had to do in programming, we did the first year. So, it does decrease because we have the programming now, and there was no significant changes or compliance with the form. But that is a good question. I think we should put that into our management report next if you would. I we say these things like casually, you know. We are sending out 1099s and doing this, and there is an administrative cost to all this, and that employers are bearing and not to say whether its right or wrong but its a hidden cost, its there and its got to be done, and in order to kind of take a longer view of what employers can and will be doing under whatever the Affordable Care act takes in the future, it has cost to us as an organization. We should recognize that. Yes, and we will. We will look back at the original implementation and then probably do a comparison on what it took for 2018. President scott thank you. A couple of things that you are going to see highlighted in each division, tearing apart the Strategic Plan and the annual report as far as the format of it and information and redoing it. Tin cle we do a Strategic Plan, this meeting, we have decided to postpone that to march at this point so the new director can be on board and provide input. Annual report should be completed and up for your an action item in february. You can see that each division now is focussed on updating those two reports. Finance and accounting, another fun time of year for them, as we begin the budget. Development to meet the targets presented to us by the Mayors Office, and well have further information later with pamela. Communications, again, communications plays an integral role in the 74,000 confirmation letters. As i have said before, we have a newish now Communications Manager, carol karimi, who jumped in and dug in and did the same thing with our confirmation letters. So we are very happy that, to have her on board this year. And shes also playing a key role with me in going through the wording and the communications of the annual report. So, a lot of her work, as far as graphic design, how its going to look and what its going to say, is going to be up to her when you see that next month. She will also be working directly with the Graphic Designer starting on tuesday for an onboard process, the first time we have had a Graphic Designer and Communications Manager at the same time, hopefully longer than 2, 3 months as it was last time, so new having both of the staff on the same time, so a lot of work and improvement in the communications. And speaking of the improvement in the communication, we had a significant increase in people who were actually reading our e news. E news is email we put out every month, people sign up for it through our website, it can be active employees, retirees or anyone can sign up for it. And we didnt have at the time, we didnt have the reporting tool, but since we found a way to go on account and sent out 15,600, which is about the same as we did last year, but we had a 10 increase of people who actually open it and read it. So that jumped up from 5200 to 7,000 this year. Doing something right as far as communication. We want the email to be attractive to people, open it up and read it, a lot of great information in the emails. So, briefly about wellbeing. E. A. P. Overall has served about 30 more people through their services and thats both individual counseling and Organizational Services like trainings and consultation, and i think its very important to note as this is a service thats very important to the staff, especially if you think of some of the things we went through last year. Both within the city and in the state and the country, and other places. Most of the increase is due to promotional. More than usual of the campaign we are here for you campaign. So, i did want to highlight that. Outside of the different division, the directors meetings, as usual with the holidays, they do slow down a little bit and thats good for me. To get some work done in the offers. We did several really good meetings during the month of december and two were utilization meetings with blue shield and kaiser and i think we have some good information to provide to you through the rates and benefits process about utilization and costs happening with the two plans. Unless the Board Members have any questions, that concludes the directors report. President scott questions from members of the board regarding the directors report . I notice in the wellbeing area that we had some 19 departments that completed the wellbeing at work awards for, or received that this past year, and i would be interested in knowing the level of increase that represents. Stephanie, do you have that information with you or you want to president scott it is the first year for the award, all right. And how many total departments are we talking about . I know im cross talking through director griggs, how many total departments do we have in the city . How many . 60. President scott 60, all right. So, onethird of them have gotten there, and we are looking for the rest to move along, is that the idea . That is the idea. President scott thank you. Any other questions from the board . Any Public Comment . If not, well go to the next item. Item 5, discussion item, h. S. S. Financial reporting as of october 31, 2017, pamela levin. Pam levin, chief Financial Officer, deputy director. This months report summarizes the expenses for the Employee Benefit trust fund, also known as our trust, and the general Fund Administration budget through october 2017, and the year end projections through june 30, 2018, are presented. I want to first talk about the trust projection. On june 30th, 2017, the trust balance was 72. 5 million. Based on activity through october 27, 2017, crossing the year, very confusing. The fund balance is projected to be 70. 9 million as of june 30th, 2018. This is an increase of 3. 6 million from the last months report. The 3. 6 million increase is due to a combination of continued unfavorable claims experience in city plan that is offset by favorable claim experience in both the blue shield flex funded plan and the delta dental selffunded plan. We have not received any performance guarantees or pharmacy rebates so far this year. Those tend to be towards the end of the fiscal year. And since the distribution of this report last week, we have had a 15,000 reimbursement under the adoption and surrogacy plan that will be paid out later this month. The amount of flexible accounts will not be known until june. And First Quarter of 1718, projecting that we will end the year on budget. Any questions . President scott any questions from the board regarding the financial statement. Mr. Sass. Looks like through october very few items charged to the account and everything closed out through the open enrollment period, november, december, or what is so, the projections in this report for the 3, health care sustainable fund, have been looked at and combed through for our presentation next month on the budget for next two years. And so we, this is just a general projection. We expect that we will, well, im still working on it, honestly. So, i know there are a lot of onetime projects that we expect to finish this year, or at least get a good start on, like the website and some of the work that needs to be done on the benefits and some of the construction that needs to be done. In terms of operating on the ongoing, the expenses for open enrollment are pretty much complete. I think if you look at the projection that well present coming up, its about 282,000 that we have spent on open enrollment. The others are kind of i believe that we will spend less than whats projected right now, but as i said, we are combing through it to come up with a tighter projection in order to be able to see how much money well have available for the next two years. Just to follow up. The main reason i ask, putting together the budget plan for the coming year and the year after, to the extent there may be some balances left in this account that are unspent, i would hope that part of the plan would be to really fully utilize this fund to cover as much of our expenses as possible to meet as much of the mayors targets as possible in our operating budget. The more money we are able to utilize the fund for, the less money remains in the administrative budget, the more progress we make towards trying to get a plan through the Mayors Office without any significant cuts. I appreciate that. One thing that we have to keep in mind, the Sustainability Fund is the revenues are paid by all four employers and all four employers should get benefit of what is being done. So, thats kind of the line of demarcation in the general budget and the health care Sustainability Fund. So to the extent that we can do that, and we have several balancing plan type of actions to do that, we will do that. Well maximize as much as we can. All right. Thank you. President scott any other comments from the board . On page five under d. It says 3 per member per month for communication wellness, actuarial work, tote pal premium paid 90 to 100 by employer. Im not sure. I dont understand what that means. What page five. I actually am missing page five. And they are a, b, c, d footnotes on page five. Oh, ok. And she was specifically referring to item d, 3 per member per month for communications, wellness, actuary work, paid 90 to 100 by the employer. Right. So, the way the footnote is to point out a couple things. Number one, that refers to the health care Sustainability Fund and the applicable uses per charter are wellness, to reduce the cost of health care, and communications. That is baked into the premiums and the amount that each people pay, so its 3 per member per month is moved over and that is used for these items. The point of saying 100 90 to 100 paid by the employer is that to the extent that the premiums are funded with various contribution models, that, too, is reflected in terms of the the health care Sustainability Fund. Its its a little convoluted in terms of the way that is stated and i will be more than happen to clarify that in future reports. Yes, because i cant imagine the employers paying 100 of this, 3 per member per month is coming out of their checks. I i agree with you on that statement. I as i said, this is a convoluted way of stating it. So if if the premium, so, you are a member of sciu for instance. 100 paid by the employer. When since the 3, its baked into the premium, the 100 is paid by the employer. And therefore, it is an accurate statement to say that thats paid for by the employer. We dont charge the individual because the individual has negotiated in the Union Negotiation to have their full benefits paid for by the employer. For certain union, right . Only a few of the unions are still on that, and only a few unions are still on the 90 10. Most of the unions have gone to the 93 939383. So in the charter, for the charter amendment, the wellness, that is a wellness comes out of the trust. Right . Wellness comes out of the trust, to the extent that the wellness is, benefits all four employers. So, if, you know, if we are doing something thats solely for City Employees only and the reti retirees are not participating and employees are not participating, we dont use that source of money. We did a look who is benefitting from the wellness programs, moved over to the general fund, we are relooking at that, and partially based on necessity, partially based on ensuring that we are budgeting in the right place, you know, and reusing the funds in a fiduciary fashion, we are looking in that. But not we cant put 100 of the wellness on the Sustainability Fund if that activity is not offered to everyone. Ok. I think i need a little tutorial in this whole section here. A lot of this does not make sense to me. Ok. And i would ask that maybe director levin, that maybe there be as we are preparing the budget, for budget review, that we incorporate into that some of these descriptors of sources of funding and how they can be utilitilized and so forth. I know we did that a few years ago, and it passes memory, in terms of the details of it. So, i would ask as we are preparing this years budget cycle and related documents, that we call it a glossary or reference notes or whatever, so we have a birds eye view, not overwhelming detail, but birds eye view and sources of funding and utilization. All right. Any other questions from the board . All right. Any Public Comment on the Financial Report . Hearing and seeing none, now go to the next discussion item. Item 6, review of the Health Service system, fiscal year 201819, and fiscal year 201920, budget instruction, pamela levin. Pamela levin, chief Financial Officer. I am glad we already started thinking on the lines of the budget. I just want to quickly go over what our instructions are and talk a little about the next steps. So, last month the Mayors Office released the 201819 and 1920 budget instructions. As you know, we are on a twoyear budget cycle and we do two budgets. These instructions are for our General Fund Budget and we also present our Health Care Sustainability budget. And all that will come to you next month. The instructions were in response to the deficits from the fiveyear Financial Plan for 1819 through 2122. Deficit for 1819, 88. 2 million, and 173. 4 million in 1920. And its based on current operation levels and estimated revenues. While this is a significantly lower ant