Transcripts For SFGTV Planning Commission 20240713

Its about the door and removal of the cooking facilities but just even if the cooking facilities were to have remained the door alone would have been enough to consider it a merger. When you said legally established before they moved in you mean with a permit or was it legal to do it without a permit . A permit would have been required. And that they had a permit and they dont have a permit. Ive got a couple questions. Lets assume that they are not bad people and we deal with bad people and bad actors on a regular basis. And theyve evidently had to deal with omar which is quite challenging already at this point. I love omar but yeah. What is the walk around for this this . Evidently theyre fairly coming along here as residents of this great city and by forcing them to make all these things legal and correct. They own three dwelling units in San Francisco. They could rent them out. Certainly, i mean are all three onebedrooms . I think there are plans here. Yes. All three of them are one bed. Ill put the plans back on the overhead. I couldnt remember, you did put that above. The two units in question are these two. And this is the third unit. Rentcontrolled units so the illegal merger is removing rentcontrolled housing from the citys housing stock. And its exceeding density so it wouldnt be able to be restored under the planning code. Im sorry . It wouldnt be able to be restored under the planning code because this is about density. So they couldnt put a kitchen and a door back . We require them to restore that was there before, what was illegally done they need to undo but if it was legalized, if board says this is in fact legay been merged and the unit counts produced then we wouldnt be able to restore that. We cant remove rentcontrolled units, period. I mean, theres a process they can seek a conditional use to remove the unit. That would be the appropriate process. Theyve known for several years this interior connection is illegal and havent done anything to abate the violation. Can you repeat that . So i can understand the process before them. They need a conditional use authorization to legalize the opening and that also would be the same for the unit loss or no . So the opening is considered to be the unit loss. This is a unit merger. One application for the merger and loss of the unit at one time. They go from six to five units that unit couldnt be restored. Great. Thank you. Thank you. Thanks. Thank you. Is there any Public Comment on this item . Any Public Comment . Okay. Cut to the chase, whats your prescription of keeping a family in San Francisco and not dislocating them and disrupting their life . How do we how does that happen . Theres a process for that, going through the Planning Commission. And you prescribe that and describe that process, could you describe that process in the, in terms of a timeline and also describe that process in a fashion that this family doesnt get dislocated from their Living Conditions during the same period of time. Thats what the bottom line is. As long as they get the application submitted and pursue that, they would be able to stay in the unit as is, as they are today, as they have for many years. And if the Planning Commission approves it, then it would be legalized and it would be in perpetuity. If the Planning Commission denies it they would have the ability to appeal that to the board of supervisors and if that decision is final, then they would be required, at that point, the notice of violation would then take effect and they would be assessed penalties until they address the situation. Could you please remind me an idea of a timeline. Is this week it is, months, years . Its months. Certainly to get a hearing before the Planning Commission could be six months. In the meantime during that period of time when they are going through this process, which is obviously creates stressful situation because you wish for the best and you wish for compassion and humanity, but sometimes it dont work that way. So theres a lot of stress. What happens to them in the meantime . Status quo. They would be no penalties would be assessed as long as they are diligently pursuing the conditional use authorization. If they are not, then we would move to assess penalties. Sometimes the conditional use application and walk away from the permit, they dont respond to request for Additional Information. They dont make themselves available for hearings. So as long as they were diligently moving it forward, and they have an attorney who is doing this exact same thing on another case right now. So there is a that has been months in the making as well. But as long as they diligently pursue it, they would be continuing with the status quo and have their day before the Planning Commission to legalize it which is the process that the law requires. Can i ask just one so you consider the odds of this process moving forward given your knowledge of the past, given your knowledge of the current environment and the terms and conditions that exist with this family, do you consider this a plausible path . You know, no one can say. I would never tell anyone what this board is going to do on any given night. Never know what the Planning Commission is going to do or decide. What they are going to look at that was my question, commissioner swig, could you tell us with these types of mergers that have come forward on this path, how have they been looked at . Do any of them get through or is it a nope, they are not going through . Theres a substantial burden on the applicant. And i would think not the statistics but my estimation is that more get denied than get approved. And i dont know how the Planning Commission is going to weigh if the shortterm rental history is going to weigh in and factor in on that. It had been illegally used for some time now. I understand they are having tenants that are in that sixunit was relayed to me as not a permanent tenant but may be getting the tenants off airbnb but have them for longer than one month stays which is allowed under the law but thats always at market rate, not subject to rent control because no tenant is there for longterm. They are dwelling units. So its probably its possible but maybe a slimmer chance that this would be approved, based on historical . Yes. I think the commission would looking to merge dwelling units and remove rent controlled units. Its a challenge, yes. Depends on the situation can i doublecheck something about what i asked earlier. The notice of violation, they gave mr. Patterson an additional two weeks to search for records which may indicate the door was installed legally, and it says of particular interest if the door was installed prior to 2003, section 102 that cites the doors as constituting residential mergers went into effect. Isnt that saying if the door was installed before april 2003. With permit. And also under that interpretation, i believe that they were required to maintain the cooking facilities in the second, which didnt happen here. Interpretation. But if it was before then you are saying even then a permit was required. Yeah when i read this the first time, i thought after reading this that before april 2003 you could just do it. No and they wanted to know, well, if you prove it was before 03 its free and clear. A permit would have been required but it would have been approvable. Okay. Thank you. Thank you. We are now onto rebuttal. Mr. Patterson. Thank you, commissioners. I want to respond to a few things and clarify a few things. In the shortterm rentals are not the issue in this appeal. But i want to clarify a few statements that were made. The family for a while back was bringing in short term renters with a license as essentially roommates in one of the rooms in their units that they were living in. Trying to make ends meet. They also did occasionally do shortterm rentals in unit 6 down the hall, which they should not have done, and thats why they applied for a second shortterm rental license which was denied and that touched off this whole situation. They stopped doing the shortterm rentals. Unit 6 for some time has been occupied by longterm renters in accordance with the law. And thats their plan Going Forward. They have not had short term renters in their unit with them for quite some time. When the door was installed, as mr. Sanchez said, the door was allowed. This predates section 317. I dont know why the previous owner didnt have a permit for that. We couldnt find one. Situation today is why not get a c. U. . Thats the question, right . The answer is applying for a c. U. , going through that whole process is timeconsuming, very expensive and highly unlikely to succeed. Theres a reason we are here today instead of going straight to the Planning Commission. You look at the numbers. Its extremely unlikely. I wont say zero percent chance. I think they have a compelling reason for this. But its unlikely. The other reason is they dont actually want to merge these two units. What we would like and what we ask of the board tonight is not necessarily to overturn the notice of violation, if the board were willing to keep this, continue it to the call of the chair, the violation would still exist. And when this family someday moves away or sells, it can be reactivated and force them to close that door before they move out or before they sell. They are even willing to record a notice on title, notice of special restrictions requiring this. All they want is to be able to continue living as a family with this preexisting opening between two units. The question of removing the kitchen, that was more recent under the previous permit at the time of the previous permit. The family, the parents are living in the kitchen, to be clear. They sleep in that room. So if they are required to restore appliances in there, they can but they will still be sleeping in that room. So i think this is the request to the board. If you continue this to the call of the chair, and they can continue living as they have. Counselor. People consistently call this the peoples board. And we have wide and broadening powers. Unfortunately just from a brief, and i do have sincere empathy in keeping a family as well as two teachers in here. And im not totally against bending rules. Why are you taking them on pro bono . Im here tonight not charging for my time tonight because i think this is a really compelling case. How did they come upon this is part of it. Because they look like a lovely family, and i would love to help everyone. But as the zone administrator said, their Poverty Level is extreme but they have three t. I. C. S, even though they are onebedrooms and evidently the track record for rental indicates that its hardship. But at the same time i like people that are struggling that are trying to do better with their life. And i too thought about the call of chair. I dont know enough about this case to do that. But i mean Going Forward, if it went to a c. U. , would you be representing them continually for free or would you not . I dont know. I would have to talk with them. That is a lot of work going through that process. A lot of time. They are under a lot of stress in the meantime. I get it and to have your life upside down is crazy. With very little chance of success there i would say. I wouldnt say its impossible. We love our teachers in San Francisco so i dont think its impossible or i dont happenable. But you gave us the work around, its up to us to consider that. Thank you. The key point in what we are suggesting the is units are not lost. There would be no loss of rentcontrolled housing. I thought about that too. Are they into a time constraint at all for that . Or is it just going to be are you recommending an infinite call of the chair . My suggestion would be request would be call of the chair. With a notice of special restrictions recorded on title. That way you have a guarantee if someone else comes into buy it they are going to see that and know theres a major issue with the city that has to be resolved. Is there any issue with it being a t. I. C. S of recording it on the title . Thats a good question. I would have to look at that. Its possible the other owners would need to prove it. But this is it shall these are their units. One other owner, right . One owner downstairs . One other owner. Thank you. Thank you. Thank you. Okay. Nothing further from the Planning Department. Commissioners, this matter is submitted. I think i have a could you put up the planning again . I dont have them. Overhead, please. Thank you. Is there a realm of possibility that a door be installed at the entry hall between that theres a common door to serve both units that the units maintain their separate nature you can require closing that door in between the units and is that a possibility to have a door that serves both, that serves both units in a subkey situation, and then of course you have the kitchen issue to deal with. Im trying to get creative here. I think if we the code doesnt specifically address that situation but generally if we were doing plans and had concerns about units being illegally merged we probably wouldnt allow something along those lines because it furthers the illegal merger. Everything beyond that door becomes the entry door and everything beyond it is a merged unit. They are operating together. Not if the doorways to both units stay in place and they are locking doorways and have numbers on them thats not a precedent we would want to establish. Im trying here. Moving forward. I find that interesting. They remove the merging doorway and they just add even a gate in the corridor, i mean i suppose then theres a potential fire issue. But yeah, is there the entry door then. So your position is the code would prohibit that everything beyond that door is a merged unit, its one unit. I think we really dont we either move this to the call of chair and let them exist as its current or we basically put the guillotine on them not going to put the guillotine on them. Come on, man. One additional though, scott, and ive never seen you guys do this when the department is the respondent, but do you ever settle cases with appellants . Have you considered settling for exactly what mr. Patterson requested, a notice of special restrictions . No. That would come before the board. What we are going to do and typically well be flexible with first of all, that hasnt been proposed to my knowledge. Thats the first thats being heard. I had a conversation with him and he didnt mention about continuing it to allow them to do the c. U. Process. Our standard direction is we wont be able to go through the legalization process or give them time to come into compliance but not indefinitely. We would say you have to address this by the end of the year, 60 days, 90 days, depending facts of the case but never such an openended resolution where it would be put on ice in perpetuity. Nothing within your power to do to extend Something Like that . Not something we have made a practice of. Whether we have the ability to then we are going to be getting that request for every case that comes before us and we are never going to be resolving things. Everything will be in this case why did we do it here for this nice family but we are not doing it. Well, you can always say no. So to give you an example what we have put to the call of the chair in the past, eduardo, is that we had a 17unit building that got caught for illegally, for putting vinyl windows in their property which is a planning nono, and they showed proof that they were not able to financially deal with that. So we stepped that to the call of chair. I think you still have to call the chair. That happened with that case. I think the board did give them a very specified. They said you have to get this resolved in five years which i should probably check on that. Oh, great. Weve had other cases like the union bank signs downtown, the roof level, they were approved in error. We sought revocation of the permit. This is late 2000s. And the board gave them i think ten years to basically remove it. And so they came in at year ten with a permit to remove the signs. Sorry, 2012. Commissioner fung was in the aforementioned case i was active on that. There was a woman who owned a house and she had the windows, and we told her that she was breaching the law and we gave her till 2025 to fix it. So and she happened to be, i believe, in her mid70s, and this was three years ago, so do some math. We gave her an extended life to stick around. So if we could if we could do a similar trick and sorry, and extend compliance until these children are out of high school, that would be a wonderful thing. We would certainly prefer a decision from the board with a timeline to comply versus an indefinite continuance. Just more so what would your language like to see . I mean the board has done this before im asking for your guidance. They must obtain a permit to restore the separation of the units and restore the merged unit within ten years. By december 31, 2030. Why dont we confirm the childrens ages . How hold is your daughter . Seven. So december 31, 2030. That gives you ten years to resolve your issue. Thats better than a i would say merci. [laughter] she would still be in high school at that point. I understand but its ten years, you know, the world is changing at a ridiculous rate as we sit here they may want to sell it at a good rate by that point. We dont know if we have the votes. If the board is inclined i request in addition the earlier of that date or them leaving the unit, because we wouldnt want this sale of the unit or vacating the unit. Or rental vacating the unit for their permanent habitation. Or at what point separating them and correcting the issue. I think thats fine. The kids are older and they have their own apartment. Kind of cool. Want to make that a motion . Ill make that motion. Comment . I guess the matter is submitted. Do we have Public Comment . We already did and no one came forward. I dont remember that actually. Im getting old. Ill make a motion to accept the appeal and condition it that the permit holder has to either restore the property to the code compliance as per both building and the Planning Department or to vacate the property. And that term would be till 2030. December 31, 2030. December 31, 2030. This is abuse of discretion. Also the part in n. S. R. And to record the n. S. R. Special use of restrictions. This is a motion to put it to the call of the chair. No, we are making a decision so its not in perpetuity. Its till the date that we accept it which i see. Ten years down the road. I understand. What would be the language . Please get the podium, sir. To record a notice of special restrictions with the following conditions that the unit be restored no later than december 31, 2030. December 31, 2030 or the time of vacating the unit, either unit, and or selling the property. And it would be if those come sooner than that is. But no later. Thats my motion or we are going to make him a commissioner. We dont get paid enough. N. S. R. Says . Yeah. That the n. S. R. Would have those conditions that finding the property is in violation of the planning code that the units have been illegally merged but requiring compliance, delaying compliance until the earliest of december 31, 2030, their vacancy of the unit or sale of the unit. Vielation until requiring compliance, giving a compliance deadline but finding theres a violation but requiring compliance by that date. No penalties in that time period, i think. No penalties will accrue during the can we clarify this . If we sell units four four and e what if they decide to stay in one and sell the other . Doesnt matter as long as they comply and they are not doing the merger separation, they are complying with the city and county to correct the violations as per code sale or vacancy for either unit four or five . They would have to split them right now its a 50 . I dont know what the agreement is like but the t. I. C. Agreement doesnt seem to be by unit. If they sell one of the units they have to comply. Yeah. One or more. If they sell one or more of the affected units. Okay. So i think i would like to have it i would like to have it that they have to either separate the units or sell, right . I mean correct the problem or sell, right . I think they have to correct it before they sell or vacate the unit. If they correct it they can still live in the units, right . Yeah. Okay. Sorry. Its getting late, i apologize. If i can make one quick comment to the family, we see a lot of people here who violate codes, and it is exceedingly rare and the people who have been on this board even longer can attest, exceedingly rare this board makes exceptions like this, and i hope you will take that seriously and also take seriously that complying with the code is very important. And i would hate for this to invite any further knowing violations of any of the citys laws or codes. Awesome. Okay. Im going to try and read this back. Im tired. Its 10 00. Okay. So who made this motion . Honda. We have a motion from Vice President honda to grant the appeal and uphold the n. O. V. On the condition it be revised to require that there be a delay in the compliance aspect and that an n. S. R. Be followed on the property, which has the following conditions that the unit shall be put in compliance based on the earlier of either the sale of one or more of the units or december 31, 2030, whichever is earlier, and this is on the basis that the on what basis . To retain the error. I would say abuse of discretion. Abusedhis discretion. Wow. Can we really . Error, error, error. Do you prefer error . The only part of the languagy or they need to comply by this certain date . I dont think we need to put delay because its allowing us to yeah. Comply, okay. So on that motion, commissioner im sorry. You are on rare ground tonight. Go ahead. Theres one word left out which is the affected units. If unit 6 down the hall is sold i assume thats not a problem. Just the units with the doorway. On that motion, [roll call vote] that motion carries. Thank you. Merci. A u revir. [please stand by] the San Francisco Health Service system board will come to order. Please stand for 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. All right. Madam secretary, roll call, please. [roll call] clerk we have a quorum. Item 4 the approval with modifications of the minutes of the meeting set fourth below. This is the regular Meeting Minutes from february 15th, 2020. Are there any corrections to the minutes . Seeing none, ill ask for a motion. I make a motion that we approve the minutes from the february meeting. Second. Any Public Comment on this item . Seeing none. All those if favor say aye. Aye. Any opposed. It has passed unanimously. Item 5, general Public Comment from matters of the boards jurisdiction. Please come forward. I have a comment on the assistance dealing with this coronavirus and the healthcare and they have already got someone that had already got it and would not allow them to even be any lessons because the school and i went to in 200 200r this issue and what they did is that they bribed me and tried to make it work where everything was off base that other things that trying to teach me i was really upset about that because of the healthcare issue and they were towing it and because of the example that i am here we get through the coronavirus and this is serious and people, you know, see that. This is something ive always been through. To show an example, if the healing care issue and i shouldnt be ignored or anything in this matter. Thank you, very much. Next speaker, please. Hello, my name is alice mosley and im a retired teacher, although theyve asked me to come back parttime to help out. As of last july. Ive had a serious difficulties with getting my healthcare because i was not told i it not have when i went to sign up for the Social Security and i didnt know about medicare because i never had it before, that i required part a and part b and then i was told after i already signed up that i did not require part a because i it not qualify for premiumfr premium. I think the fshhs should tell all teachers because increasingly, you are going to find teachers who have not accumulated 40 quarters if theyve worked for sfusd because sfusd does not pay into Social Security, who are not eligible for premium free part a. Because i had signed up for it not knowing that, i was billed by medicare forever and ever and i was considered ta lin delinqud when i withdrew i dis enrolled from Medicare Advantage which are sfhhs has us to. Ive got 5,000 worth of bills because i it not find out until months after the fact so id love it if someone could advise me exactly of what the situation is. There is someone at sfhhs who is looking into it but i havent heard and ive got this i dont want my Credit Rating to go down many of its now been rectified but i still have bills for a period of time and i would never have gone to the doctor if i had known. I have medical supplies ordered on october the 31st when my new coverage kicked in on november 1st. I just didnt know. They need to inform teachers as we not paid into part a or part the 40 quarters for Social Security. Someone look in that, please. Thank you. Good afternoon, commissioners. Richard rothman, row tired city worker. Two items about delta dental. It says the maximum of dying knows and Prevention Services to not count towards the maximum. And then on the smile program, which my wife and i signs up for, i just paid my wifes premium but delta dental needs to put out a new flyer. Is this 100 coverage before . Is that included in the diagnostic coverage or is that except from the 1250 calender year all these that are listed on the page here . So maybe they could clarify this with a new flyer because i certainly dont understand it. Then i want to talk about kaiser. When you email kaiser, or their Member Services they come back with answers that really, i dont know, insult my intelligence. The last time i was here, i talked about why when they have contract nurses, they cant electronically communicate with kaiser and the doctors and i got an answer saying they cant answer the question. What kind of an answer is this . You know. And my doctor changed my wifes medication but how is the contract nurses supposed to know if they come out. But i want to talk about Saint Francis pavilion. This place, you should never send anybody, even your worst enemy there. There should be a provision when you negotiate the contract with kaiser, that no City Employee or retiree or any member of the Healing Services system should be sent to that location. That place was dirty, understaffed. He wont go into the details of what happened. Mitch can send you the letter. I just dont feel like it should be publicized. It was one of the most horrible experiences in my wifes and our, you know, years. It was terrible. And im still bothered by it. Why kaiser sends anybody there in the discharge nurse wouldnt eand talk to us and it was filthy. The bed was old style. When you put in the for a st. Johns fran pavilion. Ansanfrancisco pavilion. Clerk this report is given by president breslin. I wanted to mention i received a phony post regarding the coronavirus. Be aware of that. Its going to a lot of people. Instructions seem to be the same, wash your hands and stay out of large gatherings and stay home if well its very important. Our distric director said the ws up tated frequently regarding the virus so thats a go ahead place to lock for Accurate Information regarding the virus. Thats all i have to report. Any Public Comment on this item . Can i just comment, i think that you make really a good point about the information. Were all getting inundated and i think a lot of it is well meaning. I dont think poem are out there to enhance the risk but a lot of the recommen recommendations why look logical at face value are not really shown to have been effective as anti viral mechanisms avoiding ice and water, for example, which was in the message that you got. It was not shown to decrease ones risk of acquiring colds or influenza or coronavirus. And so, i to think the other side of this is that i think the advice that you can get by going to a websites that are monitored and screened and updated regular low, and often refer to so san flare says this. Sanford university doesnt provide healthcare, individuals do, doctors do. They are scientists and theyre physicians and nurses and all so to say stanford is saying this and organization should be suspect and it does to some extent when you start seeing all these different recommendations it doesnt undermine the good information that we can access and the good information because the message sub limb alley is well, why arent they telling us to avoid ice cubes . Why arent we doing told this from our own public Healing Department or the state or center of disease control. I want to reinforce your comment. Its well taken and i think we have a responsibility to help our family and friends and colleagues and under how to access information. Its really trying to cope with a very stressful information for every Single Person in this room and lots of people outside this romijroom, including in the wor. If i could echo some of that, obvious will he we wanobviouslye information. The updated friday directive from department of publicheal h Health Officer just to take it seriously. The recommendations around social distancing avoiding larger gatherings and less essential at the board of supervisors meetings, for example, weve the recommendations are around folks, you know, trying to be throthree or feet from other fos to prevent spread and weve an active in our district, things that bring people together, if theyre vulnerable populations, seniors, folks with Underlying Health conditions to be encouraging folks not to have those sort of Group Gatherings unless those are essential. I just think at every opportunity including for folks in the room or folks watching this on tv, its important for all of us to be making sure those recommendations are getting out there. Thank you. All right. Item number 7, please. Clerk item 7 is the directors report. This report is given by abby yant, the executive director. Good afternoon, commissioners. Thank you all for being here to the. And my directors report i comment on the covid19 19 and our citys Emergency Operation center has been up and running for eight weeks now. We have a department low low a. We are working to keep our members informed by updating the website regularly as chairperson breslin has commented, we have coordinated from the onset with our venders to be sure those micro sites, if you go on a general site you will see one thing and if you go on our site you might see something different. Those companies that we work with cover geographical areas different than San Francisco. We do direct links to our local department of publichealth. We dont do distric direct linky department. We advise those who live outside of San Francisco to connect with their local department of publichealth for local guidance. As far as operations go, at Health Service systems, we are preparing to telecomute where it makes steph and were preparing staffing models do you to the social distances directive or whether we have illness or exposure within our workforce so we have all of those plans under way. And are being very aggressive about working through all of that. Were very active on the covid19 and should any of the commissioners have any questions at any time please, let me know. Moving off of that, we are in a vendor blackout period. We are at the table with all of our major vendors right now and just an admonishment to all of us on the board that those kind of conversations should not take place outside of those renewal meetings. The Health Service Board Election for this year, we did have one very qualified candidate who has submitted all the paperwork and was the soul nominee and she met all the qualifications, we have declared her the newest member of the Health Service board that takes effect in june and between now and then, we will orchestrate the wearing in ceremonies. So thank you and welcome, claire. I will say shes been very helpful in making sure our website is uptodate. [laughter] which i appreciate, its good to have that perspective from outside the organization. I did put in a small paragraph about the Infertility Services update. Were anticipating having on the agenda in april update to the board as we work diligently with blue shield to see we can address the questions brought before the board. Also the next item is the supper antitrust case as i put in here as the update from the Pacific Group on health. That care is still pending Additional Court action and so it is not finalized at this time and we will advise you when it is. We have continued to work on this Mental Health Program Expansion budget to the submitted to the Mayors Office and that will be completed some time within the next two weeks. The operation report i just wanted to call out a few things, one is jessica, she who wasnt able to come today is our new communications director, she just started this week, last week. And it seems like shes been there a while. She jumped in and is not shy about asking questions. Its a great addition to the team. And i it want to add to this that we did receive reluctantly the notice from sha von oconner who is in the audience and has been our Members Services manager for the last throw and a half years has rentered her renr resignation ail 6th. With the modernization of sales force and the ecm and its just been outstanding. We will miss you and we thank you for your service. [applause] just a few other things to highlight as we continue conversations with the School District on how we can continue to partner with them offering benefits is pretty complicate and mitchell can describe it better but its a project that were interested in finding modernizing and helping and working with their newly modernized system in a way that doesnt disrupt the relationship that we have. The new telephone system is on our desk, turned on and well complete the conversion, i believe, were scheduled to awe over again and there was a question about met foreman. The doctor did find a very useful reference we have dig contributed that talks about the question of whether theres a cancercausing ingredient. This article states the fda has been involved in researching this question and at this time they have not determined if there is it doesnt contain it does not contain Dangerous Levels of this chemical and they have an Ongoing Investigation and its certainly a challenging question for them and because it is such an effective drug and theyre really arent alternatives for it its still theyre not recommending any re call here in the United States so i thank our member who brought that to our attention and its an interesting story. Well continue to follow it but at this time, we are following fda recommendations or our practitioners are following fda recommendations. So with that, i think im finished. My Public Comment on this item. Im sorry to hear that shavon is leaving and its the first number i have to help with our reccff members so i wish shavon well but i hope that we can find someone to fill her shoes, shes been invaluable during the time that she has been here and shes been very helpful and abby you cant leave either. Thank you, very much. I think shavon should stay and help us get more even with our healing care and you know, in the healthcare events and it could be more glad if you approve to make sure that lives will get too far in society with our to to whatever and this is worldwide and this already thousands and thousands of people, you know, that is going on and stuff. Better healthcare and in the age we can were putting things off and which we shouldnt have to for our healthcare. For our babies too. Item 8, i believe its Denise Rodriguez, the director of strategic accounts and the Public Sector presenting . Good afternoon. Denise rodriguez with kaiser perm ant tee and its a quiet room today. I wanted to come back this quarter to give you an update and ive committed to doing that every quarter. I know you are very interested in seeing how it progresses in terms of usage and as well as where were at with adding and wheelchair ban and coverage. Im excited to report that weve had 27 transportation requests and successful requests in the month of january alone and that was just with moderate communication. Ive got julie brady here with me, shes one of our medicare consultants that will talk about our plan to make sure people are using the benefit that you are paying for. I will have february numbers by the 16th so as soon as we have updated numbers for february usage, well share that with executive director yant and her team. In terms of the wheelchair van and gurney van, we recognize this is important we recognize the importance to this population we want to serve them. I shared with you the challenges with ragged this benefit so quickly this year and it had to do with cms compliance issues. Were still working towards adding it for january 1st, 2021. No further updates on where were at for adding it mid cycle. I did want to remind you all that you are not paying for that benefit that would include gurney van or wheelchair transportation. You are paying for it which is just the said an wheelchair transportation. Any questions or comments about that beforehanded off to julie to just over the Communications Plan . Thank you. Thank you. Hi, im julie brady. Executive Retiree Solutions manager with kaiser. I wanted to give you an update on the communication plan that we have in place to include out bound phone calls alerting them to the new transportation benefit and we also took that opportunity to remind them about the silver and fit benefit as well. We added the transportation. We created a transportation benefit flyer to outline exactly how they needed to go about seeking this service. That has been added to the kaiser site. We have shared with hss that same flyer so i would work with them it figure out where we can share that flyer if we post that on their website or if there are any upcoming news letters that we can send out to your members so they have the flyer there as well. We are in the process rit now of mailing out a letter to all of your retirees, all of your kaiser senior advantage retirees that will include both the transportation flyer as well as the silver and fit flyer designed to have stepbystep exactly what they need to do so they can get these benefits. We know many people dont necessarily lock at email or respond to phone calls so we wanted o mak to make sure we han a variety of methods. Were also we send aging kits when your members are turning 65 and weve added that transportation flyer to that kit so when they get that kit in the mail, it tells me about the senior advantage plan. It will also have the transportation anier. Also, the open enrollment kits so that will be later in the year. Are there any questions . Since weve coronavirus as come up several times but this is a population that should see itself at particular risk for the complications. Weve been getting lots of emails from bakery and all kinds of what theyre doing. So, does kaiser have a paragraph or a sentence or something that might reassure our members who would like to use this benefit about the sort of methods that are being used to show that these are clean vans or whatever . I would have to get back to you on that. Im sure our vendor has something and maybe we could potentially the letter hasnt gone out. I dont know if theres something that we can put in it although that information is changing everyday. Maybe we can at least post something on our micro site. For them to look at there. And then, would we should we take that back and get some more information to share with district or yant. Im not concerned about what theyre doing because as you point out the instructions and the procedures will change. Just that this is an issue that we address among the other issues about safety and all that. Just so its a generic issue that we include this in our concerns. I appreciate that. I work directly with the person who is overseeing this benefit and ill ensure shes working with the vendor so we got information how theyre managing and cleaning these vehicles. I was coming here today and theyre wiping the handrails down and i felt safe with that observation. Well certainly followup and close the loop with you on that. One more quick question. Of the 27 transports in january, to we know how the recipients were aware of the benefits if it was by a phone call or the email so we can target and i think if we dont have any information maybe its something that we can rehave you to find a more targeted approach to getting the information out. So we do not know how they were aware of it. Is that something we can potentially ask the vendor when theyre taking the calls to ask how the members heard about the benefit . Thats actually a really good suggestion because i think it would be helpful for us to know to be intentional in our communication so well ask it. The plan is to come back again in july and theres a different varieties of data the way they cut the data so im trying to understand that and see what is meaningful so we can bring it back to you all. And we can see if we can add that piece. Thank you so much. Ok. Thank you. Any Public Comment on this item . Seeing none, item number 9, please. Clerk item 6 the financial report. As of december 31st, 2019. This presentation is done by pamela levin, the chief Financial Officer. Good afternoon, pamela levin, chief Financial Officer. Sorry. I had to take a breath. Health service system. The report that is in front of you summarizes the revenue and expenditures for the trust and for the general Fund Administrative budget threw thrh december 31st as well as fiscal year and projections through june 30th. The trust ended the year last fiscal year on january 30th, 2019 with a balance of 92. 2 million. Based on activity through december 31st, 2019, the fund balance is projected to be 91. 8 million, which is a decrease of. 4 million or 400,000. Were projecting a decrease in the fund balance for the uhc ppo plan due to unfavor claim experience for access plus, the fund balance is projected to increase 11. 6 million primarily due to pharmacy rebates and favorable claims experience. For the tria plan were projecting a 4. 9 million decrease in the fund balance compared to last month when we came in it was 5. 8 so we continue to have unfavorable claims but things are getting better. Were projecting a 4. 2 million decrows in the fund balance for tell ta dental. This is intentional to stabilize the rates the healing Care Sustainability Fund will have a yearend balance of 2. 7 million. We expect a one million in montreal earnings although that may change. We wont really know until we get closer to june 30th. 300,000 in performance have been received through december 31st. We have not had any reimbursements under the adoption and surrogacy assistance plan and in december and were projected again to have have the 185,000 from the fund balance for reimbursement under the plan. The amount of forfeitures for unused spending which reside in the trust, until that time for the administration of the benefits. As of december 31st, we have 2 million in pharmacy rebates and the yearend projection is for uhc and ppo plan and trio which is consistent with the previous reporting and right now were projecting to end the year with a balance of 128,000. Theres been no instructions given out by the Controllers Office on any adjustment thats we would need to make in the budget given the effect of the coronavirus on revenues so that is kind of the thing im watching for and will let you know if we get that kind of direction. In prior years when weve had problems, we have in 2008 there were directions sent to departments. If you have any other questions thank you, any Public Comment on this item . No Public Comment. So now were going into our rates and benefits section. And item 10. The presentation of the 2020 rates and by is by the executive director. Thank you, is the rates and benefits calender and i will call to your attention that we do have a special Education Board meeting scheduled currently for march 26th at 1 00 p. M. Given the fluidity of the coronavirus situation we are consideringal continue tive ways of presenting that information. We are restricted current low under charter sunshine brown act on how we would do any meetings so wore taking that into consideration how we present those to the public and to the Board Members and this important understand the rates as you will see seeing them in the months following. So well keep you posted on that and i do want to acknowledge at this time that many of our vendors are under increasingly under travel restrictions our united team is not here due to travel restrictions and blue shield made it here today and kaiser made it here today, delta made it here today, vsp did not make it because of travel restrictions. I think thats kind of a sign of things to come and sort of all things coronavirus that were evolving and adapting on a daily basis so well keep you informed. Outside of that, just so you are clear that im clear, that we have a very important timeline to to to a meeting like that. Please, bear with us as we work our way through this very unique situation. So i just want to out the Educational Forum will not be held in this room, is that right . Did i see an email that said its changed . Yes, so we spoke as Leadership Team and i spoke to the Technical Team at my office and we are going to move it to the Wellness Center so we can stream it since its educationally based and theres no action items and commissiones can call into view the information. Its open to the public and it will be online. Well still have the meeting. Were still going to be the meeting but not here . Just not in this almost. I think Everybody Needs to be notified of that. Special meetings have a 10day notice requirement and at this point hold the date in the calender, please. Can i maybe expound on this. This seems germane because when you see all the recommendations to work from home and alternatives so if we could in the next few months a fact sheet about where those prohibitions and mandates through the charter and the brown act and how they entered our set of rules and regulations because it seems like its not very modern given the technology what were sort of forced to face by this problem but to be the future. It seems like its not very contemporary. Often, under stress we find new ways of being and changing the law can result from that but we are under current state of merge and this county and in this state so i dont want to speak for our attorney that is present but there are legal matters legal questions on how you go about doing these maneuvering in an emergency situation versus an ongoing one. If i could, just to add that there are some are state law issues and its discussion between the mayor and governor. My understanding is there was update to the governors executive order that actually just today that addressed some of the brown act issues that are state law issues. In some circumstances may prevent meetings that are not inperson like this so i too know if the amended order today directly effected our meetings but it is folks are much active in sac sacramento to make sure those adjustments can can be made to bring us no this september re whecentury. The brown act is a good thing. Open meetings its hard to visualize. Yep. Any Public Comment on this item . Ok. And on this, ive been in federal and issue and and and and one reason why i think its very take this and this is a health that were talking about and doing examples with that i can maybe byebye and thank you, very much. Ok. Item number 11, please. Item 11 a stop loss recommendation that is. Good afternoon, commissioners, mike clark and before i begin my presentations today a special thanks to mitchell gregs given our travel restrictions shal. Im glad to be here with you todays to present several presentations and were starting with the stop loss recommendations, this is an not youll review that we do for the Health Service board right around this time of the year to talk about the environment or stop loss reinsurance for the healing plans offered on a cell funded basis or a flex financedded basis by the San Francisco Health Services system. Our recommendation at the end of my presentation will be that sfhhs purchase stop loss pretext for the selffunded and flex funded healing care plans and ill present information as to why that is our recommendation. So on page 2, you see the programs offered today that are selffunded or flex funded, in other words, not full fullien id by Insurance Organization so the claim spenc experience flows thh the members. The United Healthcare for active employees and non medicare retirees, the blue shield, access plus tree owe hmos and active employees and the delta dental of california ppo plan for active employees. So some general commentary around stop loss reinsurance in order to obtain this coverage, plans sponsor would remit a premium to an enter tee who would then reimburse that plan sponsor when the claim cost exceed a certain threshold based on the insurance level purchased. This is an insurance product so when claims not excessive it may not pay out at all but, if the claim amounts are high there will be reimbursement. You expect, during the course of time, the premiums paid by organization would exceed the claims reimbursed otherwise the organizations would not be having a Good Business proppization. We also say at the bottom of page 3, dentsal plans are not candidates for stop loss insurance. Its limited via annual all service and lifetime oth don i i cadonicmaximum. There is a contingency reserve policy today as we note on slide 4. That for very large pools, this is a common approach to financial risk mitigation. Especially in a Public Sector environment and so there is a contingency reserve policy in place that does articulate this purpose for sfhhs and we discussed in january what the recommended contingency reserves were that the board approved as of june 30th. And then specific to the stabilization policy, which is another protective policy for sfhss it provides the ability to cushion changes in planned experience over the course of time to a threeyear amortization of those gains or losses. For instance, today i will present on the blue shield plan stabilization policy so its an added protection besides the policy that protects sfhhs. On page 6, you do have a reinsurance component or a stop loss component on the blue shield flex funded product requirements. As part of these programs, sfhhs is required to have a one Million Dollar per claimant large claim pooling provision which means that there is a premium charge today in 2020 and has been each year prior and will be Going Forward for which that pro voids a one Million Dollar year Access Protection so if a particular claimant were to go over 1 million in total medical and pharmacy claims in a given year, any amount over the 1 million is reimbursed back back to sfhhs well look at what that looks like as an example for 2019 when i present on the blue shield experience later today. On passenger 7, revisiting my recommendation as in prior years, we ask the Health Service board approve today the recommendation for sfhhs to not purchase external stop loss insurance for its selfand flex funded plans into the 2021 plan year and again noting the reasons why that include plan stabilization reserves, the fact that blue shield plans have large claim pooling, and the fact that for dental employer exposure is through the plan design. N any questions, i move that the stop loss insurance for flex funded healing care plans. Ill second. Public comment . All those in favor, aye. Opposed. Its unanimous. Thank you. Thank you. Item number 12, please. A presentation by mike clark from aion. Mike clark, before you is the San Francisco Healing Services report for the 202010couldnt tee survey. I am presenting the information but this is information that is compiled by sfhhs and this is from those that compiled the information you see in this document. So, i will talk through the overview page and note after the overview page just a description of the information that is contained in the rest of the documents. So, as you can see, the over vow page is broken into several sub headings. The process, which is essentially describing how the city charter specifies the survey to be done for the 10 most populous country and to collect the amount contributed by the flier fo reply employee r employeeonly coverage. For certain, covered members, within the city and the plans covered by sfhhs certain members do have the employer contributions determined if part by the 10country amount. So you see Additional Information on the approval of the change rule in april of 2012 by the healing Service Board and there were in major changes chas collected for the plan. Its noted that while information is presented in the document included for the calpers design and the sfhhs designs, those organizations are not enclouded i inincluded in ty survey. You will see the description of the average contribution under the use of the 10county amount. Paragraphs in this page. And see how in june of 2014, the impact of the average contribution on rates was eliminated in the calculation of premiums for most of the act of employees. And you will also see on the right side of the page, at the very top, there will be circumstances where the citys premium contribution may fall below the lesser of the average contribution determined by this report or the premium itself so that the city would pay the difference between the premium m contribution and the average contribution. There are some plans for which the contribution is actually below the 10couldnt tecountyt because thats where the premium level sits. To get to the actual amount that i will ask you to approve today, you will see that under the result and observations section. We have cal could you lated a cd 729,000. 19 to be used in plan year 2021. This figure is 3. 3 higher than the amount in place in 2020 of 705. 92. We describe an example of and information on the method ole gougmethodology. If you turn, yo0 couldnt tease in order los angeles,al amir da, sacramento and fresno and in the right you see the 729. 19 and its an average in the counties represented in the study. The remainder of the information in this report, i will not go through it but its planbyplan premium information for the plans offered by each of these 10 counties as well as detailed plan design information. I go back to the figure on the overview slide, page 2, results and observations, and im asking the healing Service Board to approve a Monthly Contribution of 729. 19 for plan year 2021 item number 13. Clerk review and approve the Vision Service plan fingerprinted by mark clark from aon. Mike clark, aon. In it presentation, i am seeking the Health Service board to be plan year 2021 for the Vision Service plan vision plan offering that ill describe in this document. So as i indicate on the introduction page, there are two plan designs offered to active employees and retirees through Vision Service plan or bsp. There is a basic plan which is offered for many years and it comes with enrollment into any sfhhs medical plan and the premiere plan that offers a higher level of benefit than the traffic than and and members to wh difference between thepren total premium rates and ill show illustrations in a bit where you can visualize that and see what those contribution amounts are. There are sfhhs members who have access to a Computer Vision care benefit and as i stated at the outset, this outlines a recommendation forc for the rats many of at the conclusion of this presentation, on page 2, i will ask you to confirm today rates for the 2021 plan here that enclou include basic rates, premiere rates, Computer Vision care total rates and finally the premiere Plan Participant contribution rates that are over and above what they pay beyond the basic plan. Well go into the following page anpages so you can see those amounts and how Vision Service mandy arrive that given its a plan. So if we go back in time. Effect i have january 1st, 2017, sfhhs and Vision Service plan entered into a fiveyear agreement. The plan here im talking about today, 2021 is the fifth or last year of that fiveyear agreement and initially there was a decrease in rates for 2017 and no change for 20182019 and a provision it would not increase 2 over all depending on how plan experience derived for the plan based on the loss ratio which is the comparison of actual claim experience versus the premiums paid. What happened in year two was the premiere plan was added and it was not part of this agreement for 2017. It was added for 2018 and what is essentially happening, since foretells they elected the plan have benefited well from the parole plan but its also meant that the claim experience for the premiere plan is at a much higher level than the premiums that are being paid by the member. So loss ratio has exceeded more and the 2 not to exceed over all premium increase has kicked in for 2020 and 2021. Is on page 4, if you recall from last year we had a discussion from the Health Service board that led to a rate action with the 2 premium incres so having no change in premium rates for the basic plan of the Computer Vision care benefit because both of those insurance wise, are operating from a financial perspective versus the premiere plan which is the plan creating a very high loss ratio so basically loading the dollar value of the increase no the premiere plan. Were recommending the same for this year. Spreading the 2 increase so that theres no change to the basic plan rates, no changed to the Computer Vision care rates a 4. 1 increase to the premium plan rates so the premiere rates and this mathematically results in a 2 over all increase. I want to show you on page 5 that since the interrogation of the pre more plan, so we now have a third year of enrollment, as of the january 2020 open enrollment cycle, this plan is gaining popularity with sfhhs members. Started out with about 15 of total and it rose to 21 average enrollment in 2019 now a full 1 4, 25 enrolled in a vision plan are enrolled in the pro premiere plan. So while the majority of members remain in the basic plan, which again is part of medical enrollment, it is good to see that this choice that was added for 2018 is gaining popularity for members. So the specific rates on page 6 that im asking you to approve today are the cy2021 column. Cy standing for calender year. We illustrate next to that on the left of the cy2021 columns the current rates that are in place for 2020. And so, for the basic plans, again, you will see no change in the propose the rates. Rates part of the medical rate cards when we present those in may and john. For the premiere plan, you see the total premium rates for the over all coverage and then the total premium rate for premiere minus the basic plan rates become the memberpaid contribution rate and you will see rather lengthy foot note underneath but saying that its a difference in premium over and above just the m. O. , load into the rates that are part of the vision plan basic plan benefits. And then Computer Vision carrie maining at its current rate into 2021. That leaves us to page 7 where i ask the Health Service board to approve the vsp plan rating actions for the current plan dough signs fodesigns which ence change. For the Computer Vision care benefit and a 4. 1 rate increase from 2020 for the premiere plan with the paid contribution impact illustrated on the prior page and to point out before you consider that recommendation just page 8 is a onepage appendix showing the plan design comparison between basic and premiere if it helps you to visualize the difference in benefits. Any comments . Any questions . Well, i sound like a broken record. Year after year, referring to page eight which basically teases out members who cost, look, for other providers of eyeglasses who go to costco and get half of reimbursement and i know we withi went threw the wee calculations and i just do know this we have ever done this in the past, where weve teased out a provider of Healthcare Products either medications or devices and done this and so i guess at some point i would like to hear from our vision care people just how many what their average what percentage of their claims come from costco in each of the two plans and what their average payment may be, does it really justify such a different reimbursement rate. I know that some providers walk by on the stress they say, buy one and well send one street to somfree to aneedy person in cen. Thats great. The benefit of that to the world is incredible. Its one of the few things we can to that shows benefit in our giving. The people who cant afford it can can now work. Im not trying to penalize, you know, those programs but i kind of makes me a little i still question the issue. It wont effect my vote today but it would be noise to kno nia little bit more. I can provide a partial answer knowing that our Vision Service plan representative was unable to attend inperson today. Although i know theyre livestreaming so, any question im not able to answer, hopefully theyll followup with us quickly and we can report back next month. The costco relationship or vsp is relative low knew so it hasnt done Something Like go become in the history of vsp. At some point as more and more pressure came for vsp to consider a and thats what led to the alignment with the costco organization several years ago. Perhaps eight to 10 years ago. Because of costco buying power relative to the buying power of a typical vsp lower cost than a typical Network Provider so vsp constructed the frame allowances this way in order to close low a loin the total percentage of available frames that are available through a non costco Network Provider at or below the frame allowance to then be similar to the percentage of costco provided frames add or below that allowance and so for instance, based on information that it provided to me, probably this 80 allowance provides the ability for someone to purchase perhaps north of 60 of the frames available at costco with no cost sharing beyond the frame allowance and i dont have the specific figure but it just, thats a round about estimate and that is similar to an estimate now granted it may vary depending on Network Provider to Network Provider whether you go no vision provider a or b, et cetera. But the ideas to try to map the approximate percentage of frames someone could purchase in full given those allowances on page 8. We know the costco organization with the much dope deeper discog versus other providers in the vsp network. You raise a great question on what percentage of tole frames dispensed are coas costco that l be something that will last vsp to followup on because i do not know that answer. Thats helpful. Just to be sure im clear, vsp has a network of optometrist who provide frames so the member has to look, if they want to get this reimbursement they have to use a vsp provider thats available to them in a brochure or online. And you can secure benefits outside the network. You are just subject to much more cost sharing on your own for purchasing lets say a friendshiframeoutside of the nee its a retail price versus toes wholesale price that vsp has negotiated and vsps goal in working with the plan design. So for instance, this 150, 300 for non costco is a particular plan dough sign provision offered by sfhhs. Its not a universal approach for all vsp clients as an example. If there were a lower frame a lieuance there woulallowance, ir frames at a non costco without cost sharing because miz frame is under the allowance. Thank you. To i need an action item here . Yeah. I move that we approve the vsp re newell rate a renewal ra. Second. All those in favor say aye. Aye. Opposed. It is unanimous. Item number 14, please. Item 14 review and approve United Healthcare city plans prefer Provider Organization ppo administrative fees, presentation and this is done by mike clark ie from aon. So for your call last month, we discussed for the united healing care ppo city plan the 2019 claim experience and the Rate Stabilization recommendation. This presentation focuses on request for approval of the administrative fees that will be used by aon and the ratesetting process in a couple months for the 2021 plan year for the selffinancedded United Healthcare ppo city plan. This includes their Administrative Services only or aso fees and some fees ill describe and also, we build in the rate card for the city plan b healing care sustainability budget fee. And our aggregate are based on the january 2020 total active early retiree count of 1,857 and you will see fees expressed on what we say pepm so when you see the acronym pepm its per employee per retiree per month. Our recommendations in two areas on page 2, first, approve a 2 over all increase in the base Administrative Services coated by uac for 2021 and when we incorporate other elements of fee payments to united healing care for other programs, approved a total expense pupm figure were recommending for the 2021 plan year. Following pages providing information to support that recommendation. I will start with the base administrative fees. Again, 2 increase is the recommendation. Most of the enrollees in the city plan are cap interested ine two columns. We do have, as of the renewal presentation by united to us, 121 retirees that are captured in the medicare eligible map enrolled in medicare column. I know that sfhss strives to work with retirees to support enrollment in medicare when eligible but again, there are, as of the time of the renewal presentation by united to us, 121 retirees. The reason that the fees on the right side for the medicare eligible but not enrolled are lower, is that theres a presumption that someone is enrolled in medicare when the benefits are paid so just simply a lower amount of administration for those participants. And on page 4, there are Additional Savings programs that United Healthcare sponsors for sfhss that generate savings for the city plan but then also have a shared savings component or the savings are split between sfhhs and uhc. The first of those programs i describe on page 4 its called the shared Savings Program. What that does provide discounts to Service Rates for certain out of Network Healthcare providers that are not part of the primary ppo network, the main network of physicians and providers for you knitted healthcare but they do negotiate a smaller secondary discount with those providers and for that, sfhhs keeps 70 of the savings generated for these secondary Network Providers, 30 is paid back to United Healthcare as a program fee. The Second Program applies to a little bit different facility situation. It limits the planned financial exposure when care by a member is sought at a Network Facility but the treatment is provided by a Network Provider. Which we know from reading about Surprise Medical Bills is something that can occur. Or when an individual is treated to the non contracted facility for emergency care. And similar to the First Program sfhhs keeps 70 of savings generated from this program and 30 is cut by United Healthcare. And then theres a smaller program financially called valuebased contracting which pays financial incentives to certain providers who participate based on achievement of some pro set quality cost and efficiency metrics sfhss financedded thosfundedthose pay. On page 5 i describe a shared savings fee example. So, assuming someone incurs a procedure, 1,000 is the row tail cost and physician a might be a Network Provider and receive a 10 discount so the discounted cost is 500. And that is how the claim is processed. Physician b may not be a Network Provider in the primary network but has agreed to a 20 discount so a lower discount and its part of this shared savings. So that the discounted cost for the service would be 800 and then with the differential of 200, sfhss keeps 70 of that and pays the remainder back to uhc and program fee many of this is this is a example of how the programs work. There are typical in the industry. You can can see on page 6, up through 2019, these programs have generated 6 million of savings, 4. 1 million has been kept by sfhss, about 1. 9 million has been paid back to uhc as their fee. So, bringing everything together, on the uhc ppo administrative fees. We discussed the 2 incres there and again i note in the foot note that theres lower aso feed for medicare eligible but not enrolled. The shared Savings Program fee pepm estimate facility rnc and value based contracting payments are essentially developed by us based by aon on a best estimate of what we think those programs will produce for savings and then the shared component back to uhc and in 2021, based on the last couple of years of experience, and then you will see finally the fifth line item for the total fee administrative fee for the city plan is the 3 sfhss sustainability fee. So our recommendation to the healing Service Board today if you go to page 8, is to approve the 2021 United Healthcare base aso fee which is a 2 increase over the 2020 fee and then approve the total expense pupm figures we show on the prior page which represents a three and a half percent increase over the 2020 total expense figure. Questions . Its an action item. Yeah, this action is very clear. I appreciate the clarity of all of this. So just, so we pay a per member per month to blue shield to institute these programs. To united health. Im sorry, United Healthcare. So we pay on everybody. If they when theres a charge, then they apply they make more money we make money on this as well. So we pay them to do this and then they make more money when they find this. So, i guess, yeah, i just want to be clear on that. Im glad they do it and im glad they make money on it we make money on it it just seems wore paying twice for them to be successful because they should be hopeful low theyll be doing this for everybody, whether we pay for it or not because they could make money with the 70 30. And lastly, theres a discrepancy in terms of the per member per month charges between the three different programs and is there some explanation why the facility rnc went up so much when the others came down . Sure, what aon does, we lock at the most recent two years of Actual Experience in these programs to apply a trend factor to of what we think we will be translated on a per employeeper month basis. So as you can imagine, we have no idea this is a best estimate. Theres been, especially on the facility rnc program, for instance, there was a big increase in the last couple of years on how many dollars ran through that program so you will see so for instance on slide six, we do know each program carved out on its own but you can see in total as an example that your highest savings of any of the five years over all were in 2019 and for the program in 2019 relative to the past where the shared Savings Program intended to have a higher amount. So this it mean, as an example, when you go back and lock at the description of the facility rnc program, well it did mean that there was by having this program in place, cost exposure that would have been purely paid at a high retail basis, you know, unchucked so to speak, for use of an out of Network Provider when someone was going to a Network Facility or someone happened to go in an emergency facility that ended up not being a network. Those are the protections those programs have. Now i will say organizations like aon and our fellow consultants, we work very hard to troy to drive a higher percentage for the client and a lower percentage for the plan of these, special will he as more and more dollars flow no those programs. For instance, you used to be at a 35 share on the shared savings, we brought it down to 30 in exchange for a slight increase last year and that was a winwin for sfhhs because the amount you save in transition to united for this program more than offset the incremental ppm amount that was negotiated in return. I guess the observation is just that again, the frnc program, this is a big teal for members that they would go to a facility thinking that theyre going to get their professional fees covered and they find that maybe even the physician who they are using for the regular care who then comes in and who is contracted, on weekend, is covered by someone else who is not a member so are these arrangements increasing where theres a bigger discrepancy between the providers in that facility who are essentially credentialed to provide those procedures and care and were seeing this as a trend because it is a big jump. It is. And in general, we talk about an average healin healing care tret be 6 increase, the increase of dollars flowing through these programs is much highwa higher. While we appreciate the Health Plans Offer these, as a consulting organization, we encourage the plans to negotiate these particular providers to be in their regular network to the extent that they can achieve that and also encourage migration of the cost sharing where thats not possible. So that for instance, it may be at 70 30 this year but lets migratmigrate it next year to to combat the increase in dollars that are flowing threw these situations. A member has no control over this. The member cannot being exacted to understand when they are getting professional fees who in those kind of situations within a facility, who might be covered and who might not be covered and say no, i wont see cardiologist a today because that cardiologist is not covered by my plan. Ill wait until b comes around. And hope theres a b. Who is covered so this is really an unfortunate situation that we have to come up with fees for. I agree. Thank you, mike. In terms of dollar amount increase its very minimum but i got your point that maybe in the future we could increase or decrease the steering program to at least be able to minimize and increase no more than 2 if it happens in the future to be over 2 so we could negotiate on the shared Savings Program. Thank you. And approximate i will pick up and strive for that for next year. Thank you. I move that we accept the recommendations and to approve the 2. 0 over all increase in the uhc the plan expense per member per month for 2021 for active and early retiree ratings. I second the motion. Public comment . All those in favor. Aye. Aye. Oppose. Its unanimous in favor. Does anyone foal lik feel like a break or would you like to continue on . Im giving you the option. Id like a little break. Well have a little 10minute break at the most. Go ahead. All right. Item number 21. Yes, out of order, item 21 is to vote on whether or not to hold a closed session for the publicemployee performance for the sfhhs executive director presented by president breslin. I will node need a motion. I move we go into closed session for this item. Second. All right. All those in favor. Aye. Opposed. So now we are in closed session. Item number 23. Review and approve number 23. Worwore backwere back in open. Its 23. Clerk im sorry, my apologies. Possible report on action taken in closed session regarding employee evaluation presented by president breslin. I move we not disclose the proceedings of the closed session. Not the report. Yeah. Second. Any Public Comment on this . Seeing none. All those if favor. Aye. Opposed. Its unanimous not to disclose. Item number 24, please. Item 24 is vote to elect whether or not to disclose any or all discussion held in closed session regarding the Public Employee performance evaluation. Presented by president breslin. We have a motion. Ill resay it. This is the time i should be speaking. I move we not disclose that proceedings. Second. I mean the previous one is not the report. Its been taken. All those in favor. Aye. All right. So now we can go back to item 15. Clerk blue shield of california flex funded non medication claims presentation this is presented by mike clarke from aon. What you have before you is our experience document for the blue shield 2019 flex funded hmo plans. Two plans access plus and trio offered to active employees in early retirees. The access plus plan has been offered for several years to the sfhss employees and retirees trio was a new lower premium plan that was first available to members january 1, 2018. What you will see for trio is near two of the trio experience. The reserve increased by 7 on a retiree per moth basis from 2018 levels. This is just slightly higher than a National Cost trend increase. This compares to a total premium increase of 10 on a pepm basis from 2019 levels. If you will recall, the over all rate increases for these plans from 20182019 was 9 and then the incremental 1 has to do with some shifting of members that occurred from trio back in access plus so most trio populations for 2018 stayed in tremendous owe from 2019 but there was some migration back to access plus from 2019 and thats why thing aggregate actual premiums in this plan from 2018 to 2019 increased 10 . And just as a row fresher too, were focused on 2019 plan experience here but its just a reminder for the 2020 plan year, the over all rate premium increase was 2 as we presented at the may 2019 Board Meeting last year. This translates to a loss ratio for the blue shield plans of 95. 3 and the loss ratio was defined as planned expenses divided by the total premiums so another words expenses were lower than premiums by 4. 7 . Fair favorable to the plan and prescription were the most expense it stayed constant versus 2018 a lot of this is generated by a high Prescription Drug rate of use that actually so good news on the pr pre a, that was due in large part to an increase in claim dollars for very high cost claimants in 2019. There were eight victims who exceeded the 1 milliondollar pooling point i discussed earlier in the stop loss presentation versions only five members and 2018. So you will see, i constructed a table here at the bottom of this page 3 that shows what the and you can zizi that after the reimbursements the increase was 9 versus 11 before you considered those reimbursements. On top of page 4, part of the agreement that blue shield strikes with the physician organizations and other providers as part of these Accountable Care organization collaborations, includes incentive payments if they meet certain cost targets per employee im sorry, per member. In this particular instance for 2019, there was a incentive payment earned by the brown and tolland access of close to 1. 1 million after there were no provider collaboration payouts in 2018. We reflect that in this report. There was a slight increase in the over all projected ibnr incurred but not reported reserve so these are moneys on hand to pay for claims that are expected to be paid after a certain date where the services incurred before those dates and the case of us at hss we measure at the fiscal year, june 30th, and then there was a light decrease in the reserve over that period as well. So, on page 5, we show the over all change and experience 20182019 by line item. On a total toll ar basis, now you will see in our first bullet above the table that the average total number of employees and retirees decrease slightly from 2019 versus 2018. These are the actual actual toll dollars. You will see 10 on medical claims being a higher than expected number but then you will also see as you go down the page, large claim pooling. In 2019, there was over 9. 2 million paid back to sfhss on that Million Dollar large claim pooling representative of high cost claimants that included one claim over 4 million total and one claim over three million total and additional three claims that were almost two million or more and you will see the favorable Prescription Drug experience. You will notice the term capitation on this page. Its for certain Physicians Services that are offered. There are fixed dollar amounts per member that are paid to those physicians to provide an array of services. In exchange for the financial renumeration on a permember basis to those physicians. So while page five looks at total dollars on page six we do the math and divide by the employee and retiree members so those are expressed on a per employee or per retiree per month basis and because the head count change is slight, the percentage changes from page 5 to page 6 are similar just slightly higher on page 6 because of the slight reduction and head count. Page 7 is we break out the experience between active employees and early retirees and so the majority of individuals covered under the blue shield plans are active but there are 2800 early retirees in the plan as well. You can see how the experience premiums and the expense components and compare and the loss ratios at the bottom of the page for each of the two populations. So both finish with loss ratios under 100 , meaning the expenses were below the premiums collected. Page 8, just shows month by month dough tail of all the annualized numbers i just showed you so i will not go through that in detail. Page 9 shows the month by month dough tail for access plus. If you are interested in looking at the experience just for access plus, and page 10 looks at trio specific experience for 2019. One thing ill note, you see the correlation on trio to what chief Financial Officer pamela levin presented, you will see for instance, in five of the six months during this current fiscal year, july through december, read for the premium less expenses lyn loin on page , you will see how trio expense has been higher than forecast to bfor the last six months of the year but you will see in the First Six Months of the year more black than red meaning trio ran well so this is a calender year view versus the view from the Financial Reporting that is fiscal year. Then we just have last couple of pages an appendix and glossary of terms. I will be happy to answer any questions you have. Questions . So the ratio is below 100 . All the medical claims went up by around 7 . The paid loss is lower because of the 10 increase so it difference the the ratio below 100 . If we go back when we presented the rate increase for 2019, after a pretty low increase for 2018 with the interrogation of trio, i felt that a higher increase was warranted based on recent plan experience and what the increase was from 20182019 and our team will now take this information and start to work on our rating forecast for 2021 that will present at the may meeting. Any other questions . The only question i have, i think the difference between five and eight is small. Theres no way one it trend this or raise a siren or anything. Anything. How do we look at these high costs to see what was the care provided or issues. Was there a group of dying know sis we need to focus on as a Health Service or whatever. I mean, what happens to these high cost claims internally . Fourth coming on the agenda is our audit plan and we will audit highcost claims this year. I dont know if its been done in the past. It is of concerned and these numbers are so alarming and that we are obligated to do the audit and consider how that how the plan is managing these obviously highly complex cases and so, there are some very good questions to be locked a lookede wont do an audit on the large claims. All right. Accepts this is a discussion item, theres no action to be taken. Any Public Comment . Seeing none, move on to 16. Review and approve the presentation and this is presented by mike clarke from aon. Morning clarkeaon. My final presentation is to provide aons recommendation for the blue shield of california hmo plan Rate Stabilization plan action. You can see on page one this is based on the policy that requires the annual determination financial loss or gain for selffinancedded plans and any difference between expected and actual cost would then be added to the existing stabilization amount and amortized over a threeyear rating period. In the the third paragraph, ita surplus position as what im going to present today. For the first time in many years. So, december 31st, 2014. Its been indeficit for the last six years and i have a buy down of onethird of what is now a stabilization surplus balance for the tree owe plan and access plus. And this should preliminarily be expected to represent approximately a 0. 8 rating buy down when we present the 2021 premium rates in may. And that compares to what is now a 0. 6 buy up and the 2020 premium rates for the blue shield plans. So some history, last march, at this time, we presented a recommendation of a deficit balance. A the board approved and 1,886,000 as a buy out to 2020 active employee and early retiree premiums for access plus and trio which left the deficit Carry Forward balance of 3,791,000 and as i its rated on the last page, we have a surplus position. Page 3, so, in part this switches from deficit to surplus enable by the premium actions that took place and the blue shield plans from 20182019 it creates a flip to a surplus position. Page 4 illustrates a table that shows the comparison of the original expected claim administrative expense contribution and the shortfall or surplus of each plan for 2019 and we expected the revenue surplus of 3,162,000 and we ended up with a revenue surplus of 14,639,000 so that creates the favorable adjustment of 11,000,000. 04 had not 77,000 and what is currently a deficit balance but well flip it over to surplus. And you will see that on page six or five, excuse me. You will see the math behind the figures on the prior page as they cascade into the surplus position that we have calculated as of december 31st, 2019 of 7,686,000 and we take onethird of that and recommend that be a employed to 2021 rate buy down for the blue shield plans that amount is 2,562,000. In summary on the bottom of page 5, what i ask you to prove today is aons recommendation per their requirement of Health Service board approved Rate Stabilization policy that the surplus amount of 2,562,000 or onethird of the stabilization surplus balance be a replied towards buy down across tiers for the hmo plan applied per policy between active employees and early retirees. This will leave a remaining blue shield hmo plan carried forward surplus balance for your 2022 and beyond of 5,124,000. Questions . Comments . This is an action item. I move to approve the blue shield of california flexfinanced rates stability a reply onethird of the surplus for the premium premiums for 20. All those in favor. Aye. Its unanimous. Thank you. Where are we on this agenda if. 17. Well go to number 17. Reports and updates from the contracted health plan representatives. I have one more thing, you are not done with me yet but its not a presentation. So what i would like to do today is inform the Health Service board that on march 9th, 2020, three days ago, Aon Corporation announced intent to come together as an organization with will he iwillis towers watson, a Worldwide Consulting and Risk Management organization just as aon is, and so it is now in full announcement phase we expect that should all regulatory agencies approve the transacti transaction, it will take 12 to 18 months and requires Regulatory Approval from countries around the world. More information on thissance noment is contained on our website i wanted to inform you of this public announcement of my organization. So, the organization willis towers watson, in my starting out in the business, was known as towers parent and at some point they came together with the watheththe wyatt organizatiy came together with will is and watson. It was when i first started. It was my recruiting couldntecounterpart in 1989. I have one question. Weve got word of this and i looked it up online and this is i dont know about this whole field. Aon is a u. K. Company, right . Aon is in ireland but we have been a u. K. Company. We recently switched our Global Headquarters from United Kingdom to ireland but its in the financial district of london. When you say multiple countries have to a of this, how many are we talking about . At every continent . Ive been told 100 countries will need to weigh in on this transaction. Thank you. Again, i say statements today, please refer to our website. I speak to anyone, our website will have the official information that you should be following. Thank you. Good afternoon, Denise Rodriguez and i wanted to take this opportunity because coronavirus, covid19 is on everybodys mind. San francisco is quiet today. And i just wanted to rewind you all or just reassure you all that kaiser is really well positioned to manage this crisis right now and we have Business Continuity of plan, we have a command center looking at managing the situation with our employees and keeping them safe as well as treating the patients and weve been asked by the center for disease coal to participate in the first Clinical Trial for vaccinations and so were really being seen as leaders in this and im sorry, correct myself, National Institute of health. Were collaborating with cdc to help with the Health Infrastructure and respond to the systems to stop this spread of covid19. So, one of the things that kaiser is doing is weve made a donation to 10 leading publichealth organizations to subpoena or the this effort so were out there in the forefront. Additionally, i just want to assure you one of the strengthens of our model for many years weve been able to cover telemedicine which includes tele appointments as well as phone appointment and we have of course our advise line. We are really ramping up on this and theres been an uptick and its more critical that we utilize that service. Were reaching out for or vulnerable appointment appointmo change it to phone if its appropriate. Additionally, were looking at alternative ways to provide testing for covid19. We problem have heard in our medical centers weve had popup tents but its really a drivethru service. You call in and talk to a physician or nurse add vis and they direct you to go get the test. Were not ready to do testing because we dont have enough tests. No one does right now. They will be directed to go to a driveup testing ctstv. Co testi. Wore encouraging our members to go to the cdc as well as our web page for the latest updates. Were adjusting how we care and the cdc provides more guidance. Thank you for that clarification and drivethru testing because in the new this morning is kaiser is offering a drivethru coronavirus testing and i said is that offered to all the members. Thank you for the clarification. You are welcome. It wasnt a San Francisco journal a couple of days ago. We wanted to end on a positive note so im going to hand this off to my colleague to present something positive in our partnership with San Francisco Health Services system. Good afternoon. Debbie with the kaiser perm anent. I would like to provide you with good news with a Research Study between kaiser and San Francisco Health Service system. The collaborative study called comparative effectiveness of two Diabetes Prevention lifestyle programs in the workplace, the city and county of San Francisco randomized control trial was accepted for publication as an original Research Article and the johnal preventing chronic j. This is to evaluate the cdc Disease Prevention Program implemented in the workplace. We appreciate your partnership with your team. Director yant and fisher and todd over the years of the study and well work with the director to come back with another bored meeting to present the process result and outcomes. Any questions . Good news. Thank you. Paul brown from blue shield. I do also want to make a quick comment on covid19, coronavirus. We too are acting in support of governors request to provide access to care re lated to the coronavirus and we are removing all copays related to it for offices at out patient emergency room, inpatient care so theres no copays and were eliminating all utilization levers we might use for an inor out patient state to interact cease to i int you to be aware of that policy. Thank you. Anything else . All right. Public comment on this item . I would like to learn more about this. And you are speaking in this where we will have a more epidemic that costing any other, you know, with our children and our healing care issue, thank you. Any other Public Comment . All right. Public comment is closed. Item number 18, please. Clerk item 18 opportunity for the public to comment on matters within the boreds jurisdiction. All right. This is your opportunity. Seeing none, item number 19. The opportunity for the public to place items within the board of jurisdiction on future agendas. Any suggestions other than what we normally have . No . Ok. Were going in the Governance Committee matters. Since commissioner scott is not here today, i will be doing this. Which item is this on that you are referring to . This is your emotion policies that you worked really hard and i appreciate it. Thanks for, you know, for the property. Thank you. All right. So Governance Committee matters. Were the number 20. The review of the sfhss audit policy and the approval for the audit plan for cal ter year 2020 presented by president breslin. Are you going over this . I would happy to speak to this. As i mentioned earlier, we did develop a Health Service system and audit policy which is an administrative procedure for the department. What i did want to draw that to your attention where we need your approval, however is that we have put together an you had its plan and we looked at what we will be doing for this 2020 year. And theres a number of internal audits that are conducted by hss staff that are on the first page of the planned document including the Financial Statements things like that that you are familiar with. There are other things that you are not aware of and we take a robust Risk Assessment and look at best practice and standard of practices and have gotten good advise and council from aon and some of their subject matter experts. On the second page, its some of the external audits that we required external support and thatten clouds looking, theres a mandate to look at the Mental Health parity so well start with the uhc and looking at that. Were looking at the high claims with both blue shield and kaiser because that is a growing trend of concern and so were diving no that fairly aggressively this year. There are hip a Privacy Security audits and were weighing the city improves the standards as cybersecurity is more and more of a risk and there may be things that we are not regulated by the city that would bee hoff us to take a look at and its under consideration right now. The fraud waste and abuse audit, im sorry, this doesnt have on here but i believe were doing that with blue shield, am i correct . Blue shield and uhc. Thank you. So thats kind of a typo there. So well be doing that this year as well. And this is all presuming that current funding that we have available will continue to be available. These come at a price and all Things Considered its a wise use of our funds. Any questions . So money from this audit is out of where . Our budget. Its been approved . The funds are available. Any other questions . Any comments . We need a motion to approve. I move we approve the audit policy and schedule as presented and incorporated within the presentation. Second the motion. Second it. Any Public Comment . All those in favor. Aye. Opposed. Its unanimous. We are at the end of our agenda, i believe. Yes. So its confusing for me today too. I think this is about you did a good job. All right. This meeting is adjourned if theres no objection. Still a lot of people wonder since the trees have a lot of issues, why did we plant them in the first place . Trees are widely planted in San Francisco. With good reason. They are workhorses when it comes to urban forestry. We have begun to see our ficustrees are too big and dangerous in San Francisco. We have a lot of tree failures with this species in particular. This is a perfect example of the challenges with the structure of the ficustrees. You can see four very large stems that are all coming from the same main truck. You can see the two branches attached to one another at a really sharp angle. In between you cant it is a lot of strong wood. They are attached so sharply together. This is a much weaker union of a branch than if you had a wide angel. This is what it looks like after the fi c. U. Resolution s limb. We see decline. You can see the patches where there arent any leaves at all. That is a sign the tree is in decline. The other big challenge is the root system of the tree are aggressive and can impact nearby utilities, and we can fix the sidewalk around the tree in many cases. We dont want to cuts the roots too severely because we can destabilize the tree. In a city like San Francisco our walks are not that wide. We have had to clear the branches away from the properties. Most of th the can canopy is one street side and that is heavyweight on those branches out over the street. That can be a factor in tree limb failures. A lot of people wonder since these trees have a lot of issues. Why did we plant them in the first place . They provided the city with benefits for decades. They are big and provide storage for carbon which is important to fight Climate Change and they provide shade and really i think many people think they are a beautiful asset. When we identify trees like this for removal and people protest our decision, we really understand where they are coming from. I got into this job because i love trees. It just breaks my heart to cut down trees, particularly if they are healthy and the issue is a structural flaw. I have also seen first hand what happens when we have failures. We have had a couple of injuries due to tree failures. That is something we cant live with either. It is a challenging situation. We hate to lose mature trees, we hate to lose mature trees, good afternoon. I am the director of health. Thank you for coming today and late in the afternoon to learn more about the citys aggressive recommendations to reduce the spread of coronavirus and to protect the Public Health. We are proposing major changes for systems and individuals. I am greatly appreciative of the mayors leadership, partnership with the department of emergency management, with Mary Ellen Carol and the support of city agencies who work, clients and staff will be impacted by todays recommendations. After we learned yesterday of two coronavirus cases among San Francisco residents, we had proof that the virus is spreading in our community. We are taking swift action today. We are making strong recommendations for social distancing that are intended to reduce the spread of the virus and protect individual and community health. Here is the point. In order to decrease the impact of coronavirus on our community, we must reduce the times and places where people come together. We need to protect the people who are most vulnerable to getting sick or dying if they get coronavirus. In Public Health, we fight inif hifhefighfightdiseases all of t. Human viruses need people to carry them. They thrive in normal social circumstances. If we wait to take stronger action until we have multiple confirmed cases and deaths, the window of opportunity we have now will have closed. Looking at other places where there have been more cases and deaths, there are actions that we need to take before that happens. These actions are disruptive. It is meant to disrupt the spread of the virus. It is inconvenience. There will be hard ships and sacrifices for our residents and businesses. It is the best thing for Public Health to protect us from the worsens outbreak spreading across the country and our region. We are in good company. San mateo and santa clara counties have announced similar measures along with king county in washington including seattle. If this works in San Francisco, it may seem like over reaction because the virus spread will be reduced and fewer people will get sick. This is a lot to absorb. Let me review the key elements of the recommendations that the mayor announced earlier. We expect these measures to be in place for an initial period of two weeks, and we will continuously assess their impact to determine if they need to be adjusted. Now, i will go through the recommendations. Number one. Vulnerable populations. Limit outings. Vulnerable populations include people who are 60 years and older and people with certain Health Conditions such at heart disease, lung disease, diabetes, Kidney Disease and weekended immune systems. For these vulnerable populations dont go to gatherings of about 50 people or more unless it is essential. If you can tele commute, you should. Avoid being around people who are sick. Another recommendation number two. Workplace and businesses. Minimize exposure. Suspend nonessential employee travel. Minimize number of employees working with an arms length of one another including minimizing or canceling large in person meetings and conferences. Urge employees to stay home when sick and maximize flexibility and conferences. Do not require doctors note. Consider use of tele commuting options. Some people need to be at work to provide essential services of great benefit to the community. They can take steps in the workplace to minimize risk. Number three. Large gatherings. Cancel nonessential events. Remember postponing large gatherings such as concerts, sporting, events, conventions or Large Community events. Do not attend any events or gatherings if sick. For events that arent cancelled, we recommend having hand washing capabilities, hand sanitizers and tissues. Frequently cleaning hightouched areas like countertops and handrails. Find ways to create physical space t minimize close contact. Number four. Schools. Safety first. If there is a confirmed case of covid19 at the school, dph will work with the school and district to determine the best measures including potential school closure. Do not go to school if sick. If you have a child with chronic Health Conditions, consult with your Healthcare Provider about school attendance. Equip all schools and classrooms with sanitizers and tissues. Explore remote teaching and Online Options to continue learning. Schools should develop a plan for Countywide School closures and families should prepare for potential closures. Number five. Transit. Cleaning and projection. Increase cleaning of vehicles and high touched surface areas. Provide hand washing andtish anothers in station tissues in stations and in vehicles. Number 6. Avoid as possible to protect most vulnerable. Long Term Care Facilities must have acorhave a the coronavirus. Longterm care must screen staff and visitors and turn away those with illness. General public should afvote going to hospitals, Nursing Homes and longTerm Care Facilities. If you are ill call your Healthcare Provider ahead of time and you may be able to be served by phone. Do not visit the emergency room unless it is essential. Number 7. Everyone do your part. The best way for all those in San Francisco to get sick as always with seasonal colds or flu. Wash your hands with soap and water for 20 seconds, cover your cough or sneeze. Stay home if sick. Avoid touching your face. Try alternatives to shaking hands like an elbow bump or wave. If you have recently returned from a country, state or region with ongoing Coronavirus Infections monitor your health and follow the instructions of Public Health officials. There is no recommendation to wear a mask to prevent yourself from getting circumstance. Getting sick. Keep uptodate. Today is a new service to make that easier for those in San Francisco. Sign up for official updates by texting covid19 sf to 888777. That is 888777. You can also visit the Health Departments website at sf sfdph. Org. Thank you. I think we have time for a few questions. We will answer your questions about the cruise ship situation. Thank you. The status for us really hasnt changed since yesterday. The state is working with the cdc and the feds to continue to determine the most appropriate berth for the ship. Now we do not know what the time determination is. We assume San Francisco could potentially still be that location. We also are waiting information. We know about what you do. [ inaudible ] no, they are not. The people on the mexican cruise. How many are there . We have that information, and they have been contacted by the health department. How many . Over 100. I cant give you a number more specific than that. 100 people from San Francisco were on that cruise . Yes. Were they San Francisco residents . Okay. Can you tell us if they are showing symptoms . Or are they being tested . They are told to contact their Healthcare Provider and will follow the guidelines for testing. Are they in the hospital currently . I am not aware of any at this time. What about the situation has the student been tested. I can not speculate on individual testing at this time. What about the two from yesterday. There is no update on the condition of the patients. We wish them well. No one has tested positive since yesterday. As of this afternoon we know additional positive tests. What is your message . Are they to cancel concerts . I hope they will follow recommendations because that is for Public Health at this time. Our recommendation is to cancel large events. Music concerts . Our recommendation is to cancel large events. Is the city canceling large events . The city will certainly follow the guidelines for all city events. Will that include the st. Patricks day parade . The st. Patricks day would fall under these recommendations. Any update on the woman that has been to the campus . I am not going to speculate on individual cases for privacy reasons. I dont have information to share. Any other questions on the recommendations announced social distancing . We have time for two more questions. Are city workers told not to come to city hall . These recommendations will apply to city workers, and the city will add here to these recommendations. We will follow the recommendations as announced today. What about Public Transit . Is someone going to clean buses or trains . We are recommending increased cleaning in touch with our muni leadership to be sure this can be carried out. You mentioned the hardship this might create temporarily for San Francisco businesses. Can you go into that more . I understand this is a disruptive situation. There is a lot of people looking into the Economic Impact of this. Very concerned about it. Looking for potential sources of support with regard to the impact. Our focus is on the Public Health. We need to disrupt social engagement as much as we can to avoid transmission of coronavirus. These are based on the best Global Health information that we have at this time. They are informed by cdc guidelines and consistent with neighboring counties recommendations. Dont go out to dinner, stay out to eat for everybody . I would ask that these were detailed. We are making these available to everyone. Our recommendation is to follow these specific guidelines at this time. Have you compelled private businesses to not have concerts . These are recommendations. You cant force them . These are recommendations. Thank you. I dont think we have any more information about the ship than provided. The Vice President said it would go to a noncommercial port. We on wonder what that means . We only know what we have heard from the Vice President and the media. Thank you all so much for coming. Okay, great. Supervisor fewer good afternoon, everyone. This is the march 11, 2020 meeting of the budget and appropriations committee. I am sandra fewer. Our clerk is ms. Linda wong. I would like to thank sfgovtv for broadcasting this tv. Any announcements . Please make sure to silence all cell phones and electronic devices, complete speaker cards should be submitted to the clerk. Supervisor fewer item number 1. Hearing to review the report on the Controllers Office on the current years expenditure and revenue information and projections as of december 31, 2019, sixmonth budget status report and the mayors budget instructions for 2021 and 2122. Supervisor fewer we have a presentation from city controller on the sixmonth budget status report for the city and county of San Francisco, which was released last month. Ive asked mr. Rosenfield to share early assessment of the impacts of covid19 in the city, although we may not have yet definitive numbers, this committee should be informed in realtime about the financial picture of the city. Thank you for sharing what you can today. Finally, ive asked mr. Rosenfield to give us a brief overview of the new city website that is created since the passage of the budget transparency. Thanks again for all the colleagues that signed on. Im so proud our access during the budget process is being realized. Since our legislation was passed in december, we have seen city departments, not just check off a box, but truly take on the challenge of Holding Public meetings to gain meaningful input. Thanks to departments like the office of economic and workforce development, recreation and parks, and Child Support services for implementing new practices, inviting me to participate in your community presentations. These steps toward the goal of Greater Transparency for allocation of tax dollars are building on years of best Budget Practices from departments like Public Health and will make the budget process stronger. This website is a powerful tool to help San Francisco residents navigate the complex process, so i appreciate the effort from the contr Controllers Office to finalize it. With that, Ben Rosenfield from the Controllers Office. Thank you. Good morning, thank you for having us here today. This is certainly timely and so we look forward to not only talking through briefly some of the highlights from the sixmonth report which we published almost exactly a month ago. Ill talk through some of those updates and well provide you with updates were seeing regarding events in the local economy here today and we can Start Talking here and elsewhere about what the financial implications are to the city. Weve got a couple of updates coming just to let folks know what is coming after this. Our office is working on tax revenue ranging and updates related to covid in the current fiscal year. We hope to have that complete next week. At least for initial range. And then all three financial offices, our office, the boards budget and legislative office and the mayors Budget Office are updating our projections of the next four years. That will be complete tend of the month. Flu on the sixmonth report we publicish each year, we do see good news in the sixmonth report. I know we briefed many of you individually on this, about 98. 1 million improvement in ending fund balance. Ill talk about how that applies to next years fall forecast. The majority of this good news is really being driven by two departments. So we have significant good news over 60 million in the department of Public Health as of sixmonth. And our Human Service agency 20 million. Ill talk about each of the departments in a membership and what is going on in a minute and what is going on there. Ill talk about taxes overall, but the big news is the continued strength we saw in the first half of the fiscal year related to transfer tax. We saw a number of Large Properties trade hands in the year, with payments in excess of 20 million for a single transaction, so we had a lot of strength there. Under the way the citys reserves work, that volatile revenue, a significant portion, ends up deposited into a onetime reserve. And like i talked about most ill talk about in a second, most other taxes are trending toward budget. At least as of sixmonth. And there is some weakness in hotel and some in admissions tax as of the sixmonth mark. This is showing a picture of all the major tax revenues that we feel in the general fund. And you can kind of see on the far right chart column, how the 6month projection various from varies from the 3month projection. Theyre trending toward budget. You see that for property, for sales, for utility user tax, parking tax. And also how significant the real transfer tax news is. That is 71 million. But were we werent seeing a lot of change versus our other previous projections of major taxes. In terms of department, this gives you a summarized view of everything going on with all of the departments and the report itself contains much more information, but overall, departments net improvement of approximately 90 million. You can see where that is falling across the departments, but Public Health and Human Services are the vast majority. Ill talk in a second about them and juvenile probation which i know is of interest to the committee and we do see issues halfway through the fiscal year. So, briefly, for the department of Public Health, this is summarizing that good news in health. Halfway through the year. Its almost entirely on the revenue side and the majority of the good news at Public Health is driven at zuckerberg General Hospital. So patient revenue continues to outpace expectations. And we did have some settlements of prior year claims resulted in onetime revenue at the General Hospital. Another thing for us to keep an eye on here, as you may know, the waiver that the state has with the federal government for many different kinds of Health Services expires at the end of this calendar year. There is a lot of work going on in Public Health departments throughout the country to organize for the renegotiation of that waiver next year. But one important fact is that the state is in the process of completing many years of audits of prior year claims. We have money set aside to guard against adverse findings in the audits and weve been waiting years for the audits to be completed. Were hopeful that with the speedup of the state completing the audit processes, will not only have certainty on these sometime before the waiver expires, but were hoping to have good news. So we dont have certainty on that, but its one were keeping our eyes on, health is tracking and well continue to update as we get news on that. Within the Human Service agency, 20 million net surplus. You can see here that the single biggest change here relates to the way the i. H. S. S. Works, that requirement with the state and there were final changes at the end of the state budget process that are favorable to us for about 13 million and 7 million of other savings largely related under spending in a few programs. In terms of juvenile probation, the big issue we see here stems at the end of last fiscal year and its largely, i think, an administrative capacity issue. I think we have remedied now as a city, but as of 6month mark, the department was operating without a number of key positions in their finance shop. And as a result, the department wasnt claiming federal and state revenue in the way they should have been. Since that time, there is a new finance director appointed at juvenile probation. Weve assigned accountness and there is a budget manager on loan to them. So were feeling more hopeful about the stabilization of the function in juvenile and i would hope to see the number come down by the time we get to the 9month mark. As always, we note in the report where departments are projected to live within their budget, but within that budget overspend their overtime line item. As you know to the extent the department wants to do that, they have to come back to the board of supervisors for reappropriations. These are the departments at the 6month mark we expect will need to come back to the board for approximate for permission or change behavior in the coming months. A quick summary as of the 6month mark, how does this fit in with the story regarding the budget deficit . As you know, the three offices publish projections in the early winter of 419 million projected shortfall over two years. The citys general practice for many years has been to take savings that occur in one year and apply it to the shortfall for next year. If that is the choice that is made i would expect it would be you would have to take the 98 million from the 6month report, apply to the previous projection and that brings us down to 321 million. Obviously, well continue to update a lot of this as we go. This is changed obviously given just this week. But the official next update to the projection itself is the joint report which our three offices will publish at the end of march. So im happy to take questions on 6month mark, or i can move into covid. Supervisor fewer i see supervisor ronen, but do we need a report from the b. L. A. , anything to report at all . No. Thank you very much. Supervisor ronen. Supervisor ronen yes, thank you. Thank you for this. For the department of Public Health higher than anticipated budget, does any of that have to do with salary savings . I believe actually no i believe were projecting that the department is spending at the general to budgeted levels. So, at the 6month mark and well update this at nine months but at the 6month mark laguna was spending we were expecting them to spend to the budget. The General Hospital is actually because they have a higher census than assumed, theyre actually overspending their Salary Budget by 5. 8 million which is more than offset by 50 million in revenue improvement. Then they do have expenditures savings in the other parts of the department. So not the general, not laguna, but population health, Mental Health, et cetera. Supervisor ronen do we know how much salary savings . Its about 5 million in total uses savings. I dont have at my finger tips how much of that is salary, but we could follow up and get that to you. Supervisor ronen okay. And then in for h. S. A. , why are we underspending in cal works and medical. This is savings. Supervisor ronen do we have a sense of why that is happening, because we clearly have the need . I dont, but could follow up with. Generally speaking, these different aid programs have defined criteria as to who is eligible to participate. And to the extent that you project how much participation theyll see, to the extent that participation is higher or lower than that, you see that in our reports. Supervisor ronen id like to know why, because it could be that everyone who is eligible signed up for it could be that we have a problem recruiting and making people feel safe to sign up for the benefits. So it would be great we would be happy to follow up and get more information for you. Supervisor ronen okay. Then do we know why juvenile probation was operating without two key finance positions that were delayed 6 million in federal and state funding . Was that an h. R. Problem . Was that a departmentwide problem . Or the delays from central h. R. Which is happening in practically every department. My impression is this almost entirely driven by issues internal the department. It was kind of an extraordinary moment. Its kind of what has led us to take actions with the new chief to assign temporary help there to help with these things. I personally attribute it to management personnel and operational issues within the department this last summer. Supervisor ronen what was the time period these positions were open and we were failing to fill federal and state bill federal and State Government . The period were seeing the delayed claims was the very end of last fiscal year through this fall. This is not lost money to the city. Its just we will now have a endeavor to reach back and claim for those prior periods and we have with the new chief and with our team and other assistants, we have a group that is working this issue as we speak. Does that help . If there arent other questions, ill move into what were seeing this week. This is an extremely dynamic situation and evolving both from a Public Health perspective and then our monitoring of what the implications might mean for the local economy, revenues and the rest. In our work, we rely on a host of official data points that are often lagged from when the event occurs. Unemployment claims, actual tax filings, reporting from the fed. We wont see some of that data for weeks and months. So in moments like this, we really look to a number of different proxies quickly to get a feel for what is going on. Weve been doing an extraordinary amount of that last weekend and through this week. So im sharing with you, the early data points. We can talk about the things were looking at and working on and ill have more information regarding the tax revenue implications of a lot of this again within the next week. A few issues of great concern. So, prior to the emergency in San Francisco, we had already begun to see declines in landings at the airport, predominantly impacted by china and asia. Youd already seen notable dropoff in landings last winter and into the spring. We commented on these in the 6month report, but you started to see a slowing of tourism into San Francisco and the u. S. From china, but that has changed dramatically in the last week. Landings at the general at s. F. O. This week are down 20 . Thus far this week for international flights. And were seeing it in Domestic Travel as well. So domestic landings at the airport are down 12 this week. That is landings. Thats the number of planes landing. Were endeavoring to get better information from the airlines and we expect to have it soon to the number of people on those planes, but its being reported that those planes arriving are arriving with fewer people as well than a week ago. The actual number of visitors coming to San Francisco or others coming to San Francisco is likely higher than this. The most Immediate Impact of this here within the borders of San Francisco and i think we felt this profoundly already this week, relates to Convention Business. And then spilling over from there into other parts of the hospitality sector. At this point Event Sponsors have cancelled all conventions at the moscone through the middle of may. The cancelled conventions account for 235,000 room nights which is a very large number. We have been spending time this week talking to Hotels Downtown to understand what is going on with their businesses this week. Theyve seen spikes in cancellations, monday, tuesday and even this morning this week. The rate of those cancellations is accelerating. And it is reported information to us, but many Hotels Downtown, if not most hotels are reporting this week theyre now operating at occupancy rates of 2030 . Thats versus the standard that weve grown used to for many years in the city of 8085 . So even this quickly our hotels are emptying out quickly. This kind of level of occupancy is actually worse than what we felt immediately after september 11 to put it into context. Weve been talking to other industries that support hotels and wraparound hotels, catering, other services, special events and the rest. And they have almost uniformly thus far reported to us a mass cancellation of almost all of their business. This is obviously a large part of our local economy. Hotels, hospitality and supporting services and employs a large number of people. Hotels directly employ 25,000 people in San Francisco. And these associatednund, depen how you count them, are tens of thousands of employees beyond that. So very significant and very Immediate Impacts. And the lack of any Convention Business for several months means that we should expect that these kinds of impacts maybe not at these levels but significant, will linger for sometime. Weve also seen this week things beginning to spill over beyond hospitality into other parts of the economy. A couple of indicators we look to for kind of people coming to San Francisco and shopping, not from airports, not from the airport but within the region, bart ridership was down 9 last week. Exits at downtown bart stations over the weekend, which is where were comparing last weekend versus the weekend before, were down more than 9 . So in the low double digits. And then this week, on monday, bart exits downtown were down 24 , versus the monday. Very significant slowdowns. Happening again quickly. This is somewhat related to very large decisions being made by some of our employers in the San Francisco consistent with Public Health advice to encourage telecommuting. So you see large offices downtown and large employers encouraging their employees to work remotely and that means less traffic into downtown and the city from the rest of the region. Over the weekend, you know, one thing we can look at realtime information about what is going on in some of the districts in terms of activity is sampling parking garage occupancy rates. Last weekend, it varies significantly garage by garage, but vacancies rates in the garages were up 2040 from the weekend before. So very significant changes. And its really most pronounced in a few neighborhoods. Downtown, civic center garage, given the cancellations in the civic center and chinatown, chinatown north beach. At least in terms of the weekend work. We have been spending time this week talking to a number of restaurants and restaurant associations to understand kind of what theyre reporting and seeing in the first few days of the week. And there is a broad number of restaurants reporting very significant declines in the sales thus far this week. It appears to be a bit of a different picture. Again, downtown, chinatown, kind of places the tourists go, places that Office Workers eat, are reporting some are reporting losses in excess of 50 or more in terms of this weeks sales. As we get out into neighborhoods where people are potentially staying because theyre telecommuting or otherwise, the losses feel less pronounced. And with some reporting some businesses reporting no loss and no losses so far, bar service, out of the neighborhoods. And then the other thing to note, of course, that restaurants, this is not just spilling into restaurant, but other small retailers, other retail activity. Kind of feeling in that same shape. A very bad week, but worse for those located in the core or in certain downtown neighborhoods. We will know much more about these things in days and weeks ahead, both in terms of the data we have access to, but we also expect more news regarding what the shape of this might be looking ahead. Obviously, there is questions here about two key questions are and i think theyre both predominantly related to how the Health Emergency plays out, theyre ones of duration. And then how spillover works out of these industries into the rest of the local economy and potentially into the National Economy . That would then potentially impact other parts of the economy that were not seeing losses this week, office work, professional services, a whole host of other industries that this week are doing okay. And continue to operate. We will come back next week with some updated ranges of current year tax revenue losses, but just to give you a sense of what were expecting to see, and again, here were focusing on the coming quarter. The last four months of the year, three months of the year. And i think the losses were likely to feel are going to be concentrated in these places. So hotel tax declines are obviously going to be very significant given the occupancy rates i mentioned earlier. And probably in the current year is going to be the Significant Impact the city feels, but we would expect to see losses in sales tax, maybe parking tax and others in this coming quarter. Interest earnings. The money that the city earns on our treasury is expected to decline significantly as well because the federal government has now cut the fed Interest Rate in an effort to stimulate investment. That means that we earn less money on our earned cash, so were quantifying that. And you may see additional federal Interest Rate cuts in weeks ahead which will further erode that. The airport transfer we received from the airport will be down in the current fiscal year and we expect to see others. Well have more on this and we will not have a hard number, but we think its important to present a range of numbers to the board of supervisors, mayors and others can begin planning how to manage this. We will see other impacts that will be deferred to next year, given the way taxes are paid and how this plays out. So business tax, for example, is almost predominantly paid activity now, the tax paid on it will be paid next spring. So that will be a deferred impact. It wont hit the current year, it will hit next year. And well have other implications well include in the later update. I think the loss in the coming quarter will be in the tens of millions, the question is how many . And i hope to have some sense of that next week. Supervisor fewer any members of the public . Hello. The supervisors, i represent the first people of San Francisco, and right here on this podium the chair person rosemary addressed all the supervisors and gave you all some counsel. Weve reached a stage in this city and county of San Francisco where corruption has reached more than saturation point. So when the controller is saying something about this pandemic, if you go to the General Hospital, the turnover of our nurses is over 80 . And if we have the need to have beds for 500 people, thats a minimum because of my training in the military with logistics and all we have like 80 beds. And we have a middle class living on the streets of San Francisco. And we have our supervisors listening, saying something, but it Means Nothing because we cannot say [bell ringing] that we represent the people when we dont do anything for them. Obviously there is a pool of money there that General Hospital has saved and the Human Resources has saved and that is fine, because you know, if you bring ten cpas each one will give is own accounting. If you want, you can say yes or say no. But the bottom line here, supervisors, is you must represent [bell ringing] the people. Supervisor fewer thank you. Any more Public Comment . Seeing none, Public Comment is closed. President yee . President yee thank you, chair fewer. Thanks for the presentation. And its good that we had a good projection for the sixmonth report. Hopefully that offsets some of the bad news coming, moving forward. The question that i mean, all that stuff is really hard to predict and the problem is we dont know how long its going to last. In regards to working with the convention center, for instance, theyve there has been a lot of conventions that have cancelled. Im curious, how far into the future are people starting to cancel . Just to give us a sense of what were looking at. You know, if theyre cancelling things three or four months out, i would say were really in trouble. Yes. And we can report back more, but all sponsors not the city have now cancelled all conventions at the muss coney through may 15th. There are cancellations beyond that. I dont know the count. There are some. And i think there is some hope, depending on how this works that some of the conventions cancelled can be slotted into other slots next fiscal year, but that depends entirely on how our Health Emergency plays out over the coming weeks and months. President yee okay. Thank you. Supervisor ronen yes, assuming that is San Francisco if San Francisco decided to go the route of milan and shut down the entire city, would you give us a sense, in addition to what youve already described, what additional Economic Impacts there would be . I know its enormous, but just get our wheels turning. Yeah, and this is certainly i dont want to speculate too quickly here in the moment, but these are kind of questions were asking ourselves related to projections looking ahead, whether the arc of different possible outcomes from a Health Perspective . What are likely interventions in these scenarios . And in protecting Public Health, by design almost, it avoids interactions and causes other damage, right. So were talking through that. I dont want to speculate. It would be profound though. Already i believe in the sectors were talking about, there is going to be quickly discussions of closures. Youre going to have cash crunches in many of the businesses that are affected. Businesses are very quickly going to phase decisions related to their estimate of what they think the duration of this is and whether it would be in the businesss financial best interests to simply close for a month. I would not be surprised if hotels are having that conversation. I think restaurants in the city are likely already having that conversation. And the broader the kind of Public Health response needs to be, the more profound those kinds of choices spread to every part of the economy. Every part of our business base. And all of their workers. So i dont want to speculate, but it would be profound. Supervisor ronen have you been studying what is happening in italy and wuhan . Some. I know the Health Experts have been working on that more feverishly than we have been in the last few days. Supervisor ronen definitely, theyre studying the Public Health impacts, but the Economic Impacts, kind of what are the measures that those economies are taking . Theyre extreme and they have profound impacts. I have not been to this point this week reviewing the specific economics, but more considering what the Public Health interventions would and then thinking through with our team and others what would the application of that kind of a rule mean in San Francisco . In top level results, you can see impacts to top line, bottom line, indicators in china. China has had a negative quarter for last year in terms of their g. D. P. Growth. I believe that was the first negative quarter in over 20 years. And i think thats entirely driven off of their Public Health response. If that gives us some sense. Supervisor fewer seeing no more comments. Thank you very much. Is there another presentation . No, i think were done. I can very quickly show this new tool off if that is helpful, madame chair. Supervisor fewer one good news thing. Yes, a better topic to end with today, or a little more cheerful anyway. Thank you for giving us this opportunity to do this. As youre aware, chair fewer, the supervisor mar, the sful full board adopted legislation for transparency and required our office to create a website where people interested in the budget process would have access to some of the time line tools, meetings and reporting in a centralized way. So thank you very much to the Digital Services team and the city administrators office, reesa sandler and others in the budget group. We got that site up and live on march 1. Its on the top level of the sf gov website. Weve tried to keep it very simple to make it publicly accessible as possible. Its a single landing page. Plain language, descriptions of the budget process, a calendar and then Department Budgets. Drilling into this a little bit, for example, for the timeline, the process used to develop the budget, which i think is one of your goals, chair fewer, has been increased understanding of how that process works and participation in it. There is a simple timeline that shows the different steps of the budget production process. And in each of these cases, there are links to the key documents that official documents that are considered. For example, the mayors budget instructions here. Budget and legislative Analyst Reports at a later time. The budget book. The proposed budget. The last thing and there are host of other documents archived here for ease of people to find them from the public. And then lastly im sorry lastly, because i know its important to the board and to the members, all Department Budget submissions that have come into our office and the Mayors Office are available on the site for review. Supervisor fewer i just want to say i think this is fabulous. Weve had people go on to this website and theyre just fascinated by the city budget now. Like i think it was such a huge thing that most people, lay persons, myself included, didnt understand. And i think this really makes it accessible to every taxpayer in San Francisco. Which is our goal. Thank you. And any other comments from my colleagues . None . Okay. Id like to make a motion then to file this item. Second . President yee, take that without objection. Thank you very much. Any other business before us today . No further business. Supervisor fewer thank you very much, were adjourned. Good morning, everyone. Welcome to the march 12, 2020, regular meeting of the Public Safety and Neighborhood Services committee. Im supervisor mandelman. Our clerk is john carroll, and i want to thank s. F. Gov. Tv for staffing this meeting. Mr. Clerk, do you have any announcements . Yes. Please silence all electronic devices. Your completed speaker cards and documents as part of the file will be submitted today as to the clerk. Items acted upon today will appear on the march 21st, 2020, board of supervisors agenda, unless other stated. And related to the coronavirus disease, we are asking all attend decees of this meeting to maintain at least four feet between themselves and others, regularly wash your hands for 20 seconds at a time, and try to avoid touching highvolume services as much as possible. Thank you for that, mr. Clerk. For reasons related to the current Public Health crisis, we are likely to continue items 3 and 4. So if anyone is here for those, you should be aware of that. So mr. Clerk, can you please call the first item. Item 1is a hearing to consider that the issuance of a type 57 special onsale beer and wine Liquor License to the owners association, doing business as the four seasons private residences, will serve the public convenience or necessity of the city and county. Thank you. Good morning members of the board. You have before you p. C. M. For 607 mission, Residence Owner association. They have applied for a type 57 license, and if approved, it should allow them to sell special onsale general. There are zero protests, zero items of support. Theyre located on plot 212, consider a highcrime area, and a high saturation area. The southern station has no opposition, and a. L. U. Recommendation is to approve the license without recommending any new conditions. Chairman great, thank you. Is the applicant here, or a representative . Yes. Good morning. Im beth hopalofia, representing the applicant. We understand that the Supervisors Office has requested a continuance of this item and would like to meet with the project sponsor. So were making plans to do that prior to the next meeting date. Chairman fantastic. Thank you. If there are no comments or questions, well open this up for Public Comment. Are there any members of the public who would like to testify on this item . Seeing none, Public Comment is now closed. As the applicants representative said, supervisor haney has requested with continue this item to allow additional time for his office and the applicant to meet. We can continue this item to the march 26th regular meeting and still not go past our 90day period during which were trying to make action. I will move we continue this to the march 26th regular meeting. We can take that without objection. Mr. Clerk, please call the next item . Item 2 is the hearing to consider that the transfer of a type 48 onsale Liquor License to buzz works incorporated, at 365 11th street will serve the convenience and necessity of the city and county. You have before you p. C. M. For buzz works. If approved, this would allow them to operate an onsale. There are zero letters of protest. I understand there are letters of support. They are located on plot 242, considered a high crime area. On census track 1082, considered a high saturation. And a. L. U. Recommendation is to approve this license without any new conditions. Chairman great. Thank you. Is the applicant here . Members of the board, distinguished chair, im ladd coupe, and im the owner and operator of buzz works. Ive been in San Francisco and owning a variety of nightclubs and restaurants during the last 30 years. I own butter, a legacy venue, that has been there for quite a while. I opened up buzz works about four years ago. And weve had seamless integration and carefree operations. Weve been operating as a type 42, which is 21 and up, craft beer sports bar. The only thing that this new application will allow us to do is add a line of craft spirits, in addition to our craft beer offerings, which are the widest variety in the city of San Francisco. We look to complement our existing operations, which wont change because well still be a 21 and up drinking place. There is really no operational changes needed, other than having an additional line of product. Otherwise, you know, we appreciate your support. And we have a lot of support from our neighborhood, from all of the residents. And people who have been patronizing and supporting our operations and our venue for quite some time. And we look forward to moving forward and having a great relationship with San Francisco and the a. L. U. , and the Police Department and fire department, as we always have. Thank you. Chairman thank you. Are there any members of the public who would like to speak on this item . Seeing none, Public Comment is now closed. Colleagues, my understanding is that supervisor haney is supportive of this application. And i dont see any reason not to make a motion or not to therefore direct our clerk to prepare a resolution, finding that this transfer will meet public convenience and necessity, and i will move to forward that resolution to the full board with positive recommendation, and we can take that without objection. Great. Mr. Clerk, please call our next item. Item 3is an ordinance amending the health code to require the director of health to adopt minimum and healthy standards in adult sex venues, but prohibiting them from adopting or regulate doors or mandate unlocked doors in areas where Sexual Activity may occur. Chairman colleagues, as i indicated earlier, although i am eager to have this item acted on by the full board, as part of the citys response to covid19, president yee has requested that Board Members postpone hearings that have large turnouts. So im going to be moving to continue this item to a future meeting, on a date to be determined, by the call of the chair. We do need to take Public Comment on this. Are there any members of the public who would like to speak on this item . Seeing none, Public Comment is now closed. And so i will move that we continue this call of the chair. We can take that without objection. Thank you, colleagues. Mr. Clerk, please call our next item. Agenda item 4 is a hearing to discuss the affects of ondemand delivery and Delivery Companies on Small Businesses. Chairman similarly, this is an extremely important topic, but in light of the current crisis, and president yees direction to postpone nonessential legislation are hearings with large public turnout, im going to, after taking Public Comment, move to continue this to the call of the chair. Are there any members of the public who would like to speak on this item . So ill just rules in Public Comment are we allow you two minutes. Please state your first and last name. If you have prepared written statements, youre encouraged to leave a copy with the clerk. No applause ar or booing is allowed. I will ad lib a small part of Public Comment that i feel it is a wonderful topic for you guys to bring up as a member of Small Business, and seeing the impact of the Delivery Services have had on myself and neighboring businesses and throughout the city. I think it is time that the city does take some sort of steps to regulate the viral spread of this and its impact. I mean, its really killing small restaurants and bars and stuff. And its hurting our bottom lines. Theyve got no overhead the way we do, and most of them use tactics to take advantage of the businesses that they serve. And it really needs to be really addressed. Thank you. Chairman thank you. Are there any other members if there are members of the public that would like to speak on this item, if folks could line up on the far side of the chamber. Hi. I heard what you said about the reasons for postponing it, and i thought that might happen today, but i rearranged my whole week to be here today, and i called city hall to find out if this meeting was happening specifically for this item. Im trying to figure out how in the future to make sure i have to get coverage for people at home, so how do i know if an item and the agenda is actually going to be heard, or if it is not, before i come to city hall. Is there a way for me to check that before i get here . Chairman i answer that or try to attempt to answer that after Public Comment is over. Thank you very much. Chairman are there any other members of the public . You wanted to say the same thing . Im victor eskovito, and we own two restaurants and a food truck. Really, this is really affecting us, where location Means Nothing anymore. And so there is its a real problem. And it could work. We could make it work, and i think it should be something that we should really address because it is going to put people out of business, and it is really going to change. If you want to attract good chefs to San Francisco, they have to start out with a Small Business and then maybe get hired with bigger restaurants. The whole dynamic of the San Francisco culinary culture is going to suffer if this is not really just regulated, and it has to happen. So it would be great to have it really taken seriously. Chairman thank you. Are there any other members of the public who would like to speak on this item before i close Public Comment. Public comment is now closed. So this is an extraordinary circumstance that were in. I would say one way to check on whether a hearing is happening is to call the office of the principle sponsor. In the case of ondemand delivery, perhaps supervisor safai or peskin ts office wouldnt necessarily have known these were going to be continued. Mr. Chair, if we do know, we can pass on this information or we can provide more direct Contact Information of someone who works in the office of the sponsoring supervisor to provide the information. My phone number is also on the front of our agenda. 4155544445, and interested constituents can contact me directly from that phone number. Chairman thank you, mr. Clerk. And the other thing i would say is i would, now for the duration of however long this lasts, i think it is worth, particularly if the agenda item looks like it might be nonessential or something that could be deferred until later, its worth checking before coming down here because we are trying to significantly limit members of the public congregating in any of these rooms and potentially spreading covid19. And, yes, chair ste stephanie . Thank you, chair manhandlmandelman. If you cant come to the next hearing, you can email us and the clerk and let us know your story and it can be added to the file. I want you to know your voice will be heard no matter what, if you cant make the next hearing date. There are other ways to communicate. I feel this is such an important topic. I would like to be added as a cosponsor to the hearing, and just know your voice can still be heard if you cant make the next hearing. Thank you. And i would just like to apologize to the folks who did come down and your voice has been heard, but i hope youll be able to come to this when it does eventually happen, when we are on the other side of the curve. Mr. Clerk, are there any other items before us today . Youve made a motion to call the chair chairman i have made a motion. Well take that without objection. Thank you. There is no further business. Chairman there is no further business, so were adjourned. Thank you. Roughly five years, i was working as a high school teacher, and i decided to take my students on a surfing field trip. The light bulb went off in my head, and i realized i could do much more for my students taking them surfing than i could as their classroom teacher, and that is when the idea for the city surf project was born. Working with kids in the ocean that arent familiar with this space is really special because youre dealing with a lot of fear and apprehension but at the same time, a lot of excitement. When i first did it, i was, like, really scared, but then, i did it again, and i liked it. Well get a group of kids who have just never been to the beach, are terrified of the idea, who dont like the beach. Its too cold out, and its those kid that are impossible to get back out of the water at the end of the day. Over the last few years, i think weve had at least 40 of our students participate in the city surf project. Surfing helped me with, like, how to swim. Weve start off with about two to four sessions in the pool before actually going out and surfing. Swimming at the pool just helps us with, like, being, like, comfortable in the water and being calm and not being all not being anxious. So when we started the city surf project, one of the things we did was to say hey, this is the way to earn your p. E. Credits. Just getting kids to go try it was one of our initial challenges for the first year or two. But now that weve been doing it three or four years, we have a group of kids thats consistent, and the word has spread, that its super fun, that you learn about the ocean. Starting in the morning, you know, i get the vehicles ready, and then, i get all the gear together, and then, i drive and go get the kids, and we take them to a local beach. We usually go to linda mar, and then occasionally ocean beach. We once did a special trip. We were in capitola last year, and it was really fun. We get in a circle and group stretch, and we talk about specific safety for the day, and then, we go down to the water. Once we go to the beach, i dont want to go home. I cant change my circumstances at home, but i can change the way i approach them. Our program has definitely been a way for our students to find community and build friends. I dont really talk to friends, so i guess when i started doing city surf, i started to, like, get to know people more than i did before, and people that i didnt think id like, like, ended up being my best friends. Its a group sport the way we do it, and with, like, close camaraderie, but everybodys doing it for themselves. Its great, surfing around, finding new people and making new friendships with people throughout surfing. It can be highly developmental for students to have this time where they can learn a lot about themselves while negotiating the waves. I feel significantly, like, calmer. It definitely helps if im, like, feeling really stressed or, like, feeling really anxious about surfing, and i go surfing, and then, i just feel, like, im going to be okay. It gives them resiliency skills and helps them build selfconfidence. And with that, they can use that in other parts of their lives. I went to bring amy family o the beach and tell them what i did. I saw kids open up in the ocean, and i got to see them connect with other students, and i got to see them fail, you know, and get up and get back on the board and experience success, and really enjoy themselves and make a connection to nature at the same time. For some kids that are, like, resistant to, like, being in a Mentorship Program like this, its they want to surf, and then later, theyll find out that theyve, like, made this community connection. I think they provided level playing fields for kids to be themselves in an open environment. For kids to feel like i can go for it and take a chance that i might not have been willing to do on my own is really special. We go on 150 surf outings a year. Thats yearround programming. Weve seen a tremendous amount of youth face their fears through surfing, and that has translated to growth in other facets of their lives. I just think the biggest thing is, like, that they feel like that they have something that is really cool, that theyre engaged in, and that we, like, care about them and how theyre doing, like, in general. What i like best is they really care about me, like, im not alone, and i have a group of people that i can go to, and, also, surfing is fun. Were creating surfers, and were changing the face of surfing. The feeling is definitely akin to being on a roller coaster. Its definitely faster than i think you expect it to be, but its definitely fun. It leaves you feeling really, really positive about what that kids going to go out and do. I think its really magical almost. At least it was for me. It was really exciting when i caught my first wave. I felt like i was, like it was, like, magical, really. When they catch that first wave, and their first lights up, you know their face lights up, you know you have them hooked. I was on top of the world. Its amazing. I felt like i was on top of the world even though i was probably going two miles an hour. It was, like, the scariest thing id ever done, and i think it was when i got hooked on surfing after [roll call] you have a quorum. Item 3 announcement of prohibition of soundproducing devises. The ringing of use of cellphones and pagers and sound producing electric devices are prohibited and the chair may over the removal from the room of any person responsibility for one going off in the middle of the meeting. The minutes of february 18th, 2020 regular meeting. No members have turned in a public speaker card. Public comment is closed. We have the minutes ill entertain a motion. Move. Second. All those in favor say aye. Aye. All those opposed. Consider those approved