From contracted health plan representatives. Anything from the health plans . Seeing then. None. Come forward, claire. Public comment on this item . Thank you, clear, retired and play San Francisco. The reason im bringing Public Comment for, i have been hearins item in this action. Ive been hearing for members that their physician are asking them for certain annual fees. Ive heard it anywhere from about 200 1,500 per year that the physicians are asking. We are not sure if it is what they call for concierge service. These are from u. H. C. Members, not kaiser. Basically none of the retirees have discussed this issue, mentioned it, brought it forward, or responded to my questions, want to be identified. They are real people. Im not making this up. The question is, are physicians allowed to do that . Make a request of their members and say, if you want to stay on my patient list, and if you want to get a better response, or you want me to be your physician, pay me that extra 500 per year, or 1,500 per year, or 200 per year, so i keep you on my patient list to get i thought we have equal access, across acrosstheboard, to all of our physicians. Because we have United Healthcare coverage, or we have blue shield. I really cannot say if any of these people are blue shield. Most of the ones i have talked to have all been medicare. We are questioning what this practices, and is it legal within the contract with United Healthcare. What this means for our members . Some members cannot afford that. They dont want to reveal this, because they do not want to lose their physicians as their primary care physicians. They like those doctors, they have been with them for another five years. You understand what the issues are here. The question i have, it seems like it is some kind of extortion. Is this something our retirees are going to look forward to, is it something that people are required to pay, not required to pay . And then, what does that mean . One of do you move to the bottom of the patient list . What happens if you dont pay those prices. I have been in communication with abby and mitchell, this is brandnew to them, from what i understand. The members, retirees, are fearing the danger of losing their primary care physicians if they come forward and reveal who they are. Thank you. Could summary from United Healthcare come up and asked blaine how this works somebody from United Healthcare come up and explain how this works . We have the Medicare Advantage ppo plan, which has an on differential benefits and out of participating providers that are in our network cannot charge a fee to the members to be seen. Not participating providers can do that, its up to the member to choose the provider and pay that fee if they want to see the provider. We cant do anything about that. If you can get some examples, you have to identify the member, if you can identify some of these providers we can follow up and see if they are in our network. If they are we will definitely take action with those providers. Thank you for that information. This practice, from my perspective has been going for quite a while. This is not new. The concierge services, which is the reason why it has been becoming more and more popular. I think the solution that you have offered, is a good one. That is, if members have concerns than they ought to be able to check with their carri carrier, United Healthcare, for example, to find out what the status of the provider i am quite sure, theres a reason why no kaiser physician does this, because is prohibited. In any ppo network, it would be prohibited as part of the contractual relationship with that carrier. I think there should be a mechanism for them to find out. There are some providers who will, in fact, say, i have a Practice Management consultant and he or she has advised me to change my practice. And now charges additional fees and that will give my population better access. I will ask you to find another provider if they are not in the ppo network. They cannot have both. They cant be in the Provider Network and do that. There is a mechanism. It is not legal for a certain group, but for another group, physicians are independent practitioners, and they have the ability to do that. It can be up to 15,000, per person, or i think it may have gone up. I know a practice where it was starting at 15,000 per person, or 25,000 per year for a coup couple, that was over and above their healthcare plan. This is not substitute for any healthcare. You cannot give up your United Healthcare, or kaiser, or blue shield, if you sign up Something Like this, it is not Health Insurance it is just improved access. Would anybody that did that be considered a concierge, even if they just say we want 125 a year, or Something Like that . Ive heard this before i have seen all kinds of promises being made, certain physicians have said, you know, i dont have saturday off hours, but if you sign up for this additional service, at whatever rate, i will have expanded office hours, including late afternoon, saturday hours. I will promise promise responsive to phone calls i will promise responsive phone calls and email access. They offer a menu of benefits for this category. I have seen people promise this, and actually not deliver. Members pay 500 to have a saturday appointment, and the office is never open on saturday. It is a buyer beware. There is a menu of what this entails. I will say, you know, for members who pay 10,000 or whatever, its an incredible service. Those providers accompany members to their specialty appointments. They close their office, close their availability to other members so they can go see the oncologist. That is White Glove Service in a way that most of us probably dont benefit. Those members who can pay that, do get some service on it may be worth it to them. Any other comments on the subject . Seeing none. Okay, item number 14, please. Item 14, opportunity for the public to comment on matters within the boards jurisdiction. Good afternoon, commissioners. My name is erica, and i recognize that the item i am concerned about, typically speaking is not on the agenda today, the fertility benefits. But my understanding, you do not meet next month, so i wanted to share my thoughts again, just to keep it on the radar. Again, i want to thank you for listening, and really hearing my concerns, and also thank the staff are all of the time they have spent on this. I want to states, as a reminder, that the investigation that was conducted by the department did show that my experience was not unique, or isolated, and it was validated. Also, a reminder, should you make this policy change it does not make the process any easier. I do not think people are going to flock to come do ivf. It is not an easy process. Even with the windows of coverage that i have been able to get, i am Something Like 34,000 in, and i failed in my attempts. So, i think this is an amazing opportunity, although it does not make the process easier, it will allow equity and access to the benefits, which is really priceless. The three things i wanted to point out is in order to make the benefits a fertility benefit, versus an infertility benefit what should be considered for deletion is the demonstrated condition that leads to infertility. That is what makes the difference between something being a fertility benefits, or infertility benefit. If you delete the necessary demonstrated condition, then it would be a fertility benefit. What was being proposed last month, a 50 coinsurance benefit for insemination services. Insemination services is a medical term. It means something very specific. Insemination services is not ivf. It is not retrievals. Its when you take a sperm and an egg to serve to fertilize it. It is not the transfer. It is not genetic testing. It is not egg freezing. Something along the lines of insemination services, egg freezing, ivf and all fertility related services would really get you at, what i think, the commission is looking for his equity and access for all fertility benefits. The last thing is, in the proposed policy, it says 50 coinsurance. My suggestion, for consideration, is to delete the number 50 , it ties the hands of the department to negotiate in the future, potentially more, 55 , 60 . I am not a city attorney, just maybe using the word coinsuran coinsurance. I dont know if that means 50 , or that can mean whatever the differences. To put it in that the policy of the department wanted to negotiate higher benefits, in the future, they would have to come back and change the policy. Thank you for your time. And thank you for giving me more than three minutes. All right. Item number 15. Item 15, opportunity to place items within the boards jurisdiction on future agendas. Any suggestions . Anybody have something they would like to put on our next agenda . Seeing none. Our next meeting, a reminder, is november, not october. Any Public Comments on this it item . All right. We are on item number 16. This meeting is adjourned. Francisco. G is adjourned. My name is fwlend hope i would say on at largescale what all passionate about is peace in the world. It never outdoor 0 me that note everyone will think that is a good i know to be a paefrt. One man said ill upsetting the order of universe i want to do since a good idea not the order of universe but his offered of the universe but the ministry sgan in the room chairing sha harry and grew to be 5 we wanted to preach and teach and act gods love 40 years later i retired having been in the tenderloin most of that 7, 8, 9 some have god drew us into the someplace we became the Network Ministries for homeless women escaping prostitution if the months period before i performed Memorial Services store produced women that were murdered on the streets of San Francisco so i went back to the board and said we say to do something the number one be a safe place for them to live while he worked on changing 4 months later we were given the building in january of 1998 we opened it as a safe house for women escaping prostitution ive seen those counselors women find their strength and their beauty and their wisdom and come to be able to affirmative as the daughters of god and they accepted me and made me, be a part of the their lives. Special things to the women that offered me a chance safe house will forever be a part of the who ive become and you made that possible life didnt get any better than that. Whove would know this look of this girl grown up in atlanta will be working with produced women in San Francisco part of the system that has abused and expedited and obtain identified and degraded women for century around the world and still do at the embody the spirits of women that just know they deserve respect and intend to get it. I dont want to just so women younger women become a part of the the Current System we need to change the system we dont need to go up the ladder we need to change the corporations we need more women like that and theyre out there. We get have to get to help them. I went through a lot of struggles in my life, and i am blessed to be part of this. I am familiar with what people are going through to relate and empathy and compassion to their struggle so they can see i came out of the struggle, it gives them hope to come up and do something positive. I am a community ambassador. We work a lot with homeless, visitors, a lot of people in the area. What i like doing is posting up at hotspots to let people see visibility. They ask you questions, ask you directions, they might have a question about what services are available. Checking in, you guys. Wellness check. We walk by to see any individual, you know may be sitting on the sidewalk, we make sure they are okay, alive. You never know. Somebody might walk by and they are laying there for hours. You never know if they are alive. We let them know we are in the area and we are here to promote safety, and if they have somebody that is, you know, hanging around that they dont want to call the police on, they dont have to call the police. They can call us. We can direct them to the services they might need. We do the three one one to keep the city neighborhoods clean. There are people dumping, waste on the ground and needles on the ground. It is unsafe for children and adults to commute through the streets. When we see them we take a picture dispatch to 311. They give us a tracking number and they come later on to pick it up. We take pride. When we come back later in the day and we see the loose trash or debris is picked up it makes you feel good about what you are doing. It makes you feel did about escorting kids and having them feel safe walking to the play area and back. The stuff we do as ambassadors makes us feel proud to help keep the city clean, helping the residents. You can see the community ambassadors. I used to be on the streets. I didnt think i could become a community ambassador. It was too far out there for me to grab, you know. Doing this job makes me feel good. Because i came from where a lot of them are, homeless and on the street, i feel like i can give them hope because i was once there. I am not afraid to tell them i used to be here. I used to be like this, you know. I have compassion for people that are on the streets like the homeless and people that are caught up with their addiction because now, i feel like i can give them hope. It reminds you every day of where i used to be and where i am at now. Tenderloin is unique neighborhood where geographically place in downtown San Francisco and on every Street Corner have liquor store in the corner it stores pretty much every single block has a liquor store but there are impoverishes Grocery Stores im the cocoordinated of the Healthy Corner store collaboration close to 35 hundred residents 4 thousand are children the medium is about 23,000 a year so a low Income Neighborhood many new immigrants and many people on fixed incomes residents have it travel outside of their neighborhood to assess fruits and vegetables it can be come senator for seniors and hard to travel get on a bus to get an apple or a pear or like tomatoes to fit into their meals my my name is ryan the cocoordinate for the tenderloin healthy store he coalition we work in the neighborhood trying to support Small Businesses and improving access to healthy produce in the tenderloin that is one of the most neighborhoods that didnt have access to a full Service Grocery store and we california together out of the meeting held in 2012 through the Major Development center the survey with the corners stores many stores do have access and some are bad quality and an overwhelming support from Community Members wanting to utilities the service spas we decided to work with the Small Businesses as their role within the community and bringing more Fresh Produce produce cerebrothe neighborhood their compassionate about creating a healthy environment when we get into the work they rise up to leadership. The Different Stores and assessment and trying to get them to understand the value of having Healthy Foods at a reasonable price you can offer people fruits and vegetables and healthy produce they cant afford it not going to be able to allow it so thats why i want to get involved and we just make sure that there are alternatives to people can come into a store and not just see cookies and candies and potting chips and that kind of thing hi, im cindy the director of the a preif you believe program it is so important about Healthy Retail in the low Income Community is how it brings that health and hope to the communities i worked in the tenderloin for 20 years the difference you walk out the door and there is a bright new list of fresh fruits and vegetables some place you know is safe and welcoming it makes. Huge difference to the whole environment of the community what so important about retail environments in those neighborhoods it that sense of dignity and Community Safe way. This is why it is important for the neighborhood we have families that needs healthy have a lot of families that live up here most of them fruits and vegetables so thats good as far been doing good. Now that i had this this is really great for me, i, go and get fresh fruits and vegetables it is healthy being a diabetic youre not supposed to get carbons but getting extra food a all carbons not eating a lot of vegetables was bringing up my whether or not pressure once i got on the program everybody o everything i lost weight and my Blood Pressure came down helped in so many different ways the most important piece to me when we start seeing the Business Owners engagement and their participation in the program but how proud to speak that is the most moving piece of this program yes economic and social benefits and so forth but the personal pride Business Owners talk about in the program is interesting and regarding starting to understand how theyre part of the larger fabric of the community and this is just not the corner store they have influence over their community. It is an owner of this in the department of interior i see the great impact usually that is like people having especially with a small family think liquor store sells alcohol traditional alcohol but when they see this their vision is changed it is a small Grocery Store for them so they more options not just beer and wine but Healthy Options good for the business and good for the community i wish to have more
comparemela.com © 2020. All Rights Reserved.