Transcripts For SFGTV MTA Board Of Directors 11717 20170118

May be removed from the meeting. Cell phones on vibrate cause micro phone interference. Approval of minutes for january 3 regular meeting. Motion to approve. Second. All in favor say aye. The ayes have it. Item 5, communication. I know of none. Item 6, introduction of new or unfinished business. I like to [inaudible] i nominate Malcolm Heinicke. For chair . I thought we were doing both at the same time. We are just doing the chair. Any members care to address the board . Seeing nonenominating cheryl to do it this she is dedicated and knowledgeable person. The agency and staff and colleagueerize very fortunate to have sheryl step in. She is knowledgeable about mta and transit agencies around the country and world. She is very artechulate advocate for the goals of the agency and spend Many Community meetings during the year so will be a outstanding member of the board. All in favor of Cheryl Brickman say aye . Opposed . Thank you. [applause]. Call for election of the vice chair. We have a nomination . I know this is surprising but like to nominate Malcolm Heinicke. Any other nominations . Members of the public have comments . Seeing none. I like to say we are very fortunate malcolm stepping into the position. So knowledgeable and dedicated and thoughtful and not afraid to take on hard issues. That is the bft benefit of the agency and city. If no other comments i will call the question. All in favor of Malcolm Heinicke for vice chair . Opposed . Here it isi cant believe im giving this up. I was just getting the hang of this thing. Thank you. I want to thank tom nol frn nolan for his service for 8 years. He led through change jz been a calm and thoughtful voice and honored to work with him and call him a friend. His leadership shaped my time as vice chair and will continue to shape and inform my time as chair. Our city and Transit System will be a unfinished project and changing. Helping to create a transportation worthy the great city woompt regoing in the right direction even though bumps and challenges occur but always towards our goal, which is a great city with slnt transportation choices. I think our current and past boards i thank the current and past bord for the work they have done and continue to do. We bring unique speerns and dedication to create a collegeial board and proud to serve along said all och you as well as mr. Reiskin and team and thank you to roberta boomer and i look forward being your 7th chairperson. [inaudible] [laughter] thank you very much. Thank you. Let me justthank you very much. Ill echo comments and thank tom for his services and leadership and i will also say that one of the reason i am taking the position as i enjoy work wg all you so much and particularly ed and roberta and other Staff Members and susan, and while you received plenty accolades and echo them. I respect you a great deal. Let me talk about somebody. I am the second more senior person on the board after tom so normally in the order of things especially with a ambitious person by my slf i would be in the seat but you dont get it by being the longest you get it by being knowledgeable and dedicated and passionate and cheryl is all those things so i look forward supporting you in the position which you deserve. Thank you very much, malcolm. I have the gavel so we will move on. Directors report. Mr. Reiskin. Members of the board and public and staff. I will thank the outgoing chair for many years of Great Service including the dubiate leading the bubious decision to hire me as director, hopefully the new chair will consider that appropriately but do want to thank tom for his many years of serviceess to the board not just while i was here but long before that and decades Service Transportation and other public interests then bay area. It will be a different board after in the wake of your service, so thank you for that and madam chair and mr. Vice chair, welcome. Congratulations, look forward working with you. Not to turn on a down note, but in termoffs my report i had a bad week last week on oo few different fronts. Within the muni system we had two fatalities the causes of which in both caseerize still under investigation but disturbing. The first was last tuesday at the end of the line in dally city on a 14 mission bus. A woman was found unresponsive. The woman is on the bus unresponsive. It was 911 was called and corner came and she was determined to have passed at some point on the vehicle. There were many news stories circulating about this over the weekend and discussion about men ingitis as a possible cause of deaths. We understand as of this morning the san mateo Corners Office ruled out minen jites as a cause of death. We will wait for the final determination and dont think it was muni related but it did happen on a muni bus and thoughts and prayers are with her friends and family. The next day there was a 57 year old man found dead around castro street station. There is a robust Investigation Underway which we are providing a lot of support to in terms of video and anything else that we have will help us all understand what happened, but tragic none the less and for him our thoughts and prayers are with his friends and family as well. Then, shifting gears, last week we also had two bad collision in the city. Pedestrians sthin street. The firstthese are both on the same day. The first was a 67 year old man crossing the street at 19th and judah. He had a green light around 8 p. M. And struck by a car and sustained life threatening injuries. This is a intersection that has history of collision. It is also one where there had been improvements such as signal upgrade in 2009 as well as added leading nrtdivals in 2014. This will be subject to significant upgrade and working with caltrans and going into construction the next couple years but tragic and wish him and his family the best. The same day a scith 6078 60 year old woman was struck at buchanan and was struck and kimed by a truck towing a trailer. Unlike 19th avenue this is not a area with a high collision history and along the union street corridor no real trends in terms of collisions there. None the less, will be following up on that and seeing what there is to be done but tragic all 4 of events happened in the last week. Just a reminder, the importance not all f othese were Street Safety related but the importance of our commitment to vision zero so since we are at the end of the year and have updated numbers for 2016 i like to ask tom mcguire sustainable streets director to come forward and give a update related to vision phreero. Good afternoon directors. We received from the department of Public Health the preliminary year end numbers for traffic fatalities in the city in 2016 and before i give a overview of those i want to make a couple caveats. The first is at least one crash is still under investigation by the medical examiner for its cause and could potentially bree considered a traffic fatality. It is important when we talk about year end numbers there is a lot of year to year variation and a lot of statistical fluctuation so important not to direct too many conclusion. Over the last year as many know there is a very alarming National Trend towards increasing trafic fatalities. All most 9 Percent Nation wide in fatalities and that is trend we are working against in the vision zero cities. Every year we luce about 30 libes on in San Francisco and 200 serious injured. In 201529 traffic deaths and compared to 31 deaths in 2015 and 14 so there was a slight decrease. Looking to the numbers a little deeper thrfs a decline in pedestrian fatalities between 2015 and 16. 20 pedestrians in 2015 and 16, 15 pedestrians. A lot of the 9 Percent Nation wide is cons trailted in pedestrian deaths rchlt we had 3 cyclist in die in 2016 and one motrist die in 2015. Thrfs a increase in the number of drivers killed this year. Only one person was killed in 2015 and 5 in 2016. Back in january there was a Early Morning hour collision south of market involving a california high way patrol chase where the driver and two passengers struck a taxi and accounted for deaths so that accounted for 3 of the 5 fatalities. At the end of the day i think we dont want to draw too many conclusion of this a long term trend. It is a year of data where it went down and up and that is good news going down than up especially given the National Trend bullet have a long way to go. December 31, 2024 which is our end date for vision zero is less than 8 years away and still losing 29 people a year on the streets. This year and years to come it is ourjob to get those 57 high priority engineering enforcement education projects underway to change policy about automated Speed Enforcement and the culture of speeding in San Francisco. The approval of Traffic Signals in south of market and tender line will make projgress and two year strategy will continue to chart the path to getting the number down from 31 to 29 to zero by 2024. That is my update on the vision zero statistics. Thank you. A few other items that have some vision zero connection. One is that a couple days after your last Board Meeting, the San Francisco county Transportation Authority Commission Approved the gearo brt Environmental Impact report. They certified the report and approved the hybrid design which is bus lanes in the center and van ness and richmond portion and side running brt on the eastern portion. There was two small changes made, which was the restoration of the rapid stop at laguna street and local stop at collins street. Other than that, the project was generally approved as recommended so it is a pretty significant milestone for the gearo brt, which i mention in the realm of vision zero because the project we call it brt is really a corridor transformation plauject with significant amount of vision zero elements that are part of it. So, next steps are a lot of Community Outreach will be happening over the next 6 to 9 month jz continue to work with the federal government to get the federal Environmental Impact statement finalized and then well bring that with potential parking and traffic changes for the eastern portion of the project to this body some time in the summer hopefully. So, great progress there. One other item with vision zero connection is that i think it was last week or maybe the week before, the u. S. Secretary of transportation, anthony fox was in San Francisco to join mayor lee and our past and current chairs of the mta board to announce the federal government awarding San Francisco with a 11 million grant to develop innovative transportation Tech Knowledge to address congestion, but also to make sure that the system is safer and more efficient and there are particular elements within the grantthere are 6 different projects and a couple are specifically aimed making the streets safer using technology to address safety issues. So, we will be implementing these in conjungz with the county Transportation Authority. There is Research Support from University California berkeley, pretty exciting stuff particularly anything we Bring Technology to try to make the streets safer so pleased to participate in that. A few other items, we have pretty significant storms last week and looks like we may have more coming this week and just wanted you know to there were lots of mta staff out and about trying to keep the city moving during that time. We had 31 signal outages over the course of the storms late last week and into early last week that our signal shop was able to quickly repair and get back into order. We had extra parking control officers to address things such as signal outages and lots of trees down i understand from public works. They had more than 300 trees down in the city over the course of the storms so having the folks out to direct traffic and redirect traffic was important. There was numerous muni operations and maintenance staff out supporting to keep the systems running. We had a lot of impacts to muni service as a result of the trees and a mud slide, but we didnt have a major flooding including in the subway where we had flooding before and i think that is thank tooz preventative work we did together with public works and pu c. Just want to acknowledge, a lot of folks as we are inside trying to stay warm and dry the field staff are out sthr making sure the city will keep moving and will be ready for the next storm as well. I did want to just speak to the next bus ushue which is issue of great discussion of late. Ill start with the good news is most the next bus predictions are restored based on good work by folks inside and partners, the companies that help us deliver the next bus system. There has been a lot written and said about what happened and why it happened and i guess i would say this, i think there was a confluence of a number of Different Things from work that we were doing to work that others external to the agency were doing that collide said in a unfortunate storm that led to the outage. We worked very quickly to replace it and worked quickly to provide as much information to the public as we could but i recognize it was very significant inconvenience for a lot of folks so want to apologize for the rider jz anyone else impacted. It increensed a lot of folks and take responsibility for the outage. In hindsight i think there is more we could have done to mitigate it from happening but have it up and running for the most part. It was a lesson for me in how important the service is to our riders. The reactions we got was amazing. I dont mean in a good way amazing, but it spoke a lot to how valuable having arrival predictions are for the riders. We are just about past it now and dont expect anything like that to reoccur in the future but wanted to acknowledge that was not our finest day and want to accept responsibility for that. Two more quick things. One is that mayor lee along with mayors from a number of different cities including los angeles, portlands and seattle made a joint request last week to automobile mrfer inviting to improve pricing and specifications of existing electric vehicles for use in all municipal fleets to help reduce fuel and maintenance costs. Obviously most the transit fleet is electric so we know this but much of the non revenue and rest of city fleets and city fleets across the country are not. To the extent we can move those vehicles rks which are necessary to our performing city service so we can move those to the zero emission electric vehicles that have a impact on greenhouse kbas reduce reliance on fossil fuel, reduce air pollution and quality and reduce maintenance. A lot of folks look to San Francisco as a leader because we have a mission free power from hetch hetchy that powers the majority of our muni system and city buildings so i think mayor lee was able to exempify great leadership but have this not just be San Franciscos voice but bring together a coalition of cities to advance for this. There are plenty of products out there for Passenger Vehicles and sedans. There are increasingly a number of electric buses starting to come on the market. This push was to broaden the market to more municipal fleets. Many of the heavy duty truck jz other equipment we use or agencies like public works departments or parks departments, there are not electric vehicles available for those fleets so this was a push from the mayor to the manufacturers to expand their repertoire. And finally, speaking of zero emission vehicles, i was pleased to be joined by former chair nolan, then chair nolan last friday with our director of transit john hailey and his team to welcome thest if of ow neurlightrail vehicles to San Francisco. It arrived over night in our metro east facility from sacramento. This produced by see mans and the first of 260 new lightrail vehicles we are in contract for. It was 2 and a half years in the making to get to this point from developing the first specification and request for pro posal and bringing the contract for your consideration and finally for the board of supervisors approval and exhaustive planning and design and quality assurance, public vetting to get to the point where we have our first vehicle here that is dollar irfbed, which is great. I remiped you the first two traunchs of 6 or 24 vehicles by the end of nest year and 40 after that are expansion vehicles so will be adding to the fleet and starting around 2121 the vehicles after that will replace the Current Fleet under the current schedule so we will have more lightrail vehicles in Service Starting later this year after the first vehicle goes through its paces and safety certifications, but very exciting moment and huge mile stone for the agency. I want to credit john hailey for his extraordinary effort to get the project to this point and look forward to more vehicles rolling in and hitting Revenue Service later this year. That conclude my report. Thank you, thank you very much director reiskin. I know the new lightrail vehicles will do what the buses have with fewer break downs and more comfortable. Thank you for highlighting the next bus issue. I completely can appreciate and empathize in the pain that caused riders. How reliant on the on time arrival cant be overstated so glad we will have that cleaned up. It reminded us again when you first came on board how a schedule if you have predictable Reliable Service and you got on time demand and arrival information a schedule becomes pointless and watching everybody trying to figure out the schedules on the buses i appreciated the fact the mta blog published the schedule so people had a idea of the headway. Directors any questions or comments . Seeing none, mrs. BoomerPublic Comment . Yes, cathy deluca. A opportunity for members to address matters or presented by mr. Reiskin. Good afternoon chair brinkman and former chair nolan and directors and director reiskin. Cathy deluca the policy and Program Director at walk San Francisco and you might not be surprised to hear me today here to urge you all to be vision zero campions in 2017. That is my message to you today. 29 people were killed last year on the streets and only two fewer than the year before and not a big chaimpg. We need every tool in the arsenal and every leader in the public bodies. Eerfben though the pedestrian numbers went down pedestrians make up over half of everyone killed so suffer disproportionate impacts. Of the pedestrians we see a huge proportion of seniors. 75 percent of the pedestrians killed last year were 60 or older so still have a major goal to reach here. What i will ask you all today and every other time i come before you is this year to use this power that you have in the position to make sure that the projects that come before you save lives on our street. I urge you not tew proouv projects if they dont make the streets safer. I urge you not to approve projects with compromises to safety. I would urge you to push staff to bring projects before you that have the most robust safety treatments possible in a comprehensive way. You will see a lot of projects this year along high injury corridors so will have a lot of opportunity to flex your vision zero muscles. Folsom, howard and 6th street and taraval so we need you. Everyone who walks bike squz takes transit on the streets we need you. Walk San Francisco is here to support you in the work. The Vision Zero Coalition is here to support you so with your leadership and commitment i look forward to 2017 being different. Thank you. Madam chair that is the last person who indicated interest to address you on topics presented by mr. Reiskin. Thank you. Item 8, citizen Advisory Counsel report. Madam chair and directors the cac chair isnt here so no report. Item 9, Public Comment. Opportunities to address within the jurisdiction and not on todays calendarment we will start with Lawrence Paul followed by robert [inaudible] madam chair and former chair nolan and directors, just disclose own a taxi medallion and my medallgen i know is at arrow and green and city wide over the years and i believe that a medallion owner or speak about this that im also speaking in the presence of at least economically of the tncs that rubundant in our streets. And i wanted to first just mention that im aware that the city is trying everything it can do to cut back on costs and raise more revenue and the initial medallion sale and from what i was told a couple years ago by Michael Harris that several hundred medallions were sold and know this is a revenue streamprevious revenue stream for the mta. And, so what im appealing today for is the previous proposal that was brought to the board with respect to selling the medallions to companies. I know the initial medallion sale was done as a pilot study and turned out to be a very fine revenue stream and i think that with all of the Market Forces i respectfully request we revisit that at some point in the near future. And thank you for listening. Thank you. Next speaker, please. Robert [inaudible] followed by mark grewburg. Good afternoon. It is funny how everything always collides. You have never done an environmental study on tncs, but since there are approximately 45,000 tncs that operate on a regular basis in the city and we get these figures from the airport so we are all in the same boat, i urge you to do a environmental study because nobody else is going to do it. And the next think you could do is then start putting pressure to reduce the numbers to a workable majority of maybe 5,000. Which sound a enormous amount, but 5,000. But my main suggestion is this, you have to be proactive today and what is proactive is you have to look to all these Tech Companies and ask for bids for driverless taxis in this city. And the reason im saying that because actually they form a Perfect Partnership with taxis, with drivers in them. The supervisors last year said that the population of seniors is going to reach 40 percent in San Francisco over the next 20 years and most of those people will not be able to use driverless taxis because they need somebody to help them get in, get out and actually understand where they want to go. So, they could bow a Perfect Partnership, but it is up to you to go and ask tech people. Thank you. Thank you. Next speaker, please. Mark grewburg, mar cello [inaudible] followed by adam pav locka. Thank you. Congratulations to chair brinkman to vice chair heinicke, best wishes to former chair nolan. I want to speak on behalf the San Francisco taxi workers alliance. I want to put forward some ideas that we will present in a more formal fashion but i wanted to start getting thise out there, ways of improving taxi driver income. This is something that is vital to the future and the existence of a taxi industry in San Francisco. If we cant find ways for drivers to make more money, we are not going to have drivers. So, these are some ideas we have come up and maybe others but i wanted to put them out there. First significantly increase the number of taxi stands. We pulled our membership and have a long list and will be providing that to the mta taxi stands. Take taxis out of circulation. Row deuce congestion, reduce emissions and possibly improve safety. Imlment the system for sharing taxi rides. This has been discussed and discussed and it can and should be done. Establish a system of taxi vouchers or online accounts for City Employees. Cut down on the number of vehicles you need for City Employees. Develop a universal taxi voucher our own line paying system on all cabs. This is different than a app or e system. Explore ways for taxis to compliment the muni services. This is a idea we brouched years ago and never wnt anywhere but the technology we have now it is very doable. Thank you. Mar chela [inaudible] adam pavlocka followed by carl [inaudible] who is the last person bhoo who turned in a speak er card. Directors good afternoon. My name is marcelo [inaudible] long time member the taxi industry. This month is my 28 anniversary. The mockery and nudge of the taxi industry started right here at city hall when mayor lee took the position to support uber and lift. It is Public Knowledge in the state of the city address in 2013, mayor lee not only praised uber and lift, he proclaimed july 13, lift day. The only reason you dont have jurisdiction over tnc is because mayor lee gave it to [inaudible] declined your accommodations on insurance, the environment and unanimously adopted the definition of leased vehicles and perjury vehicles driven for tnc is one in the same. This is your city. There are 45 thousand tnc operating here and they are clogging your streets and destroying your infrastructure and the only thing they give back is foul air. It is so unfair for mayor lee and the mta to continue charging medallion renewal fees at the same time he promote jz facilitates competition. I urge you to wave all medallion fees to holdser jz urge you to tell mayor lee the only way for the San Francisco taxi industry to sur vive is limit the numbers. The city must work with the mta. Thank you. Thank you, next speaker please. Adam [inaudible] followed by carl [inaudible] those are the last two speakers. Hello. Im here to talk about the sfmta 4th speak project between 4th and zoe. Wealth street was close td. Hearing everyone speak about vision zero you sound hypocritical because the last 2 weeks the sfmta refused to enforce no parking and inaction made a one way street two way. There has been no mandate for having a flag man there to direct traffic while two way traffic goes down a one way street. Dpp has been called and been told and told us, we dont have any record of this and not going to enforce. Various messages have been sent including up to last friday to am reiskin as well as his subordinates. We keep laering this will be taken care of, it isnt. This morning when i left for work at 9 30 there were 9 cars parked blocking one lane of traffic making it a one way streets. The contractors were there or supposed to be there at 7 a. M. And reports say work started at 3 30 so the contractors isnt enforcing and sfmta isnt if forcing. If this isnt a city project you would lead on the contractors to follow the blue book and have enforcement there. All i can do that is intention it be pushing two way traffic down a one way street with no protection, no signs, no enforcement and no flagman. What are you going to do about this . Thank you. Mr. Reiskin could we have someone follow up with him and get Contact Information and see if we can address that situation . We will and got email about this and have staff following up today as well. Thank you very much. Next speaker. Carlmic murdo is the last speaker. Medallion renewal fee issuement our monthly lease income plummeted by 80 percent the last 4 years. Many medallion holdererize going deep into debt and worse. At the last board meetsing there was a suggestion to advantage medallion holders over others. That is unfair, we are all suffering greatly. Last thursday january 12 there was a article in the chronicle saying uber is crushing taxi but muni ridership is up 3 percent so the Spokes Person says tnc isnt here is quhie i think you should regard the tnc as foes and not friends. They are Public Safety and traffic jam problems caused by tnc. The carpooling models and [inaudible] will cause problems Going Forward. Finally, you could be selling 500 medallions a year andmericing 1. 25 billion if you get 80 percent the tncs off the road so costing you money. Enforce the state law on the books for 85 years requiring transportation for vehicles to have commercial license plates and insurance. The vehicles with the tnc logo are committing insurance fraud. This is illegal practice and aids and abets drivers under pricing taxi by greatly reducing overhead. It is legal to enforce state law. If you are encouraged to do so you may get 80 percent of the vehicles ouf the road. Fly wheel sued uber over antitrust violation. Uber sells rides below cost and subsidize driver jz reports billions in losses. I note the sf bay guardian had a gument years ago against the sf [inaudible] to concludethank you very much. Jerk anymore Public Comment on this item . Seeing none, closed. Can we move on. Consent calendar, the considers are retune unless a board or member of the public serves or considered separately. I heard no requests that a member of the mublic wishes to have a item severed and not from the board. Approval. Second. All in favor aye. Opposed . The ayes have it consent calendar is passed. Ite itedm 11, the regular calendar. Implement the dolores median pilot for 16 months and approve traffic modifications associated with the pilot. I think we have mr. Nox white presenting. Good afternoon. Congratulations. John knox white and Planning Section Program Manager for sfmta and working on the project nearly two years we are here with a update and overview with proposed implementation for a Pilot Project that would authorize parking alongside the dolores Street Center medians between 14th and 18th streets on friday evening, saturday Early Morning to noon and sundays all day. This is the location and the time at which this practice has a historically occurred in the area but it will allow implementing this and signing it allow to provide daylighting and pulling the parking back from the ends of the medians that provide significant pedestrian and Transportation Safety impacts otaerointersections and also provide much better Public Safety and specifically fire access to the neighborhood, which is currently impacted when vehicles have shortened turn radius because people parking up to and into the intersection. When we were here in august we recommended a 12 month pilot and today we are recommending a 16th month duration which will be a 12 month pilot and allow us to see how the pilot rolls out over a entire year and provides 4 months and and allow evaluations. Again, we have a map in the presentation that was in your package showing it is just the medians between 14th and 18th street. A quick overview where we have been. We had a 9 Month Committee work, which evolved over 7 meetings with Community Stakeholders from Community Organizations, resident and business and park users. We conducted a Community Survey that spoke to all people who traveled to that neighborhood, but focused heavily on the residents. The outcomes as you recall of the survey, was less than a majority of the residents of the neighborhood were opposed it formalizing or removing all the packing. In the end there is stronger support among residents to remove parking but heard from Community Organizations and Small Business community they prefer to allow it to happen so felt the pimet recommended in august and body approved moving forward represented a compromise that was supported by a majority of the stakeholders across the board. So, today we are here with request to legislate that pilot. There were two items this board highlighted. At that time one of which looked at Parking Management strategies as a part of the pilot. Our Parking Group has already started to look at those and identified really the parking manager and strategies and regulations actually exist on all but one block of the area around that. Have identified places in which those regulations could be expanded to different days or hours to have that impact and that will be something we will consider over the course of the pilot as well. And then the second item was insuring there was format for Community Input so we proposed as we did at the time a quarterly Stakeholder Committee to which we will report out and meetings will be public so anyone interested in the issue can hear how it is going and will be a place to hear from the community as to how they feel it is going and the impacts they feel this had. One of the issues we had through the process is finding Business Owners who are busy running the businesses who also want to participate. I knew it started with a p. Participated in lots of meetings and so we will be going to the neighborhood on a quarterly basis to fiend out from the business squz other s how they feel this is going so we are not just hearing from 4 or 5 people but have a real sense of the area. So, as we talked about in august, the goals of the pilot which we believe this recommendation meets is to increase the clarity and understanding of when parking regulation allow for parking and when they dont. We believe that not only will this clarify a lot of conclusion whether you are allowed to park in the area by telling you can, it will bring about what we feel is the feeling of fairness in which it will be clear anybody who wants to use this parking during the parking hours is allowed to do so. Again, as we daylight the intersections there are safety impacts that will make it safer at the intersections for all users whether walking biking or dribeing and by setting final hours it will clarify when you can expect to be towed and our cited for parking late at night and should help cut down and hopefully eliminate all of thenot all of the but occasional cars sitting in the dark in the middle of deloris street. So far we havent had collisions related to that but a matter of time. With that we submitsorry, we have worked with enforcement folks. If sl a concern to the community it is related to will you enforce this. It is obvious, historically we deprioritized enforcement arond the median jz have commitment of the enforcement staff for the first 2 to 3 month weez will be proactively on site enforcing the hours. The intention is give arfbd everybody a heads up that enforcement is about to begin so people are not surprised and dont have lots of complaints about citations but very quickly we want people to understand once the hours are done enforcement happens and to set a expectation there is no parking in places that are not signed during hours they are not signed. With that, that our report. I would like to thank Juliet Wilson who has done most the job on this i brian [inaudible] thank you very much. Just a clarify ing question for me before i ask my fellow directors for any questions, this is reducing the amount of parking space and decreasing by 1 half a spot . Yes. There will be effectively 50 percent decrease. The spots were people formally were parking and anticipating they would have no enforcement those curbs will be painted red . Yes. People are not just demanding on the signs, the curbs are painting red . Yes. Directors questions or clarifying comments before we move to public chaument . Thank you mr. Knox white. Two members of the public are here to address you [inaudible] thank you. Madam chairperson and directors. My name is stefonlaser and lives on dolen street off delorss over 24 years. I prefer no [inaudible] parking i realize given all the factors a compromise is necessary. I think the proposed plan is reasonable but request you consider one change and that is that the sunday parking end at 4 p. M. Instead of 6 p. M. I ask that for safety reasons. During part of the year it is dark before 6 pmp causing a hazard for drivers. Im well aware of the parking and still all most hit cars in the dark. I met with John Knox White in november and this is something we discussed. High did not specifically recommend the change he agreed my suggestion was reasonable given the safety issue. Regarding the specific implementation i am glad to see there is a plan to do a 30 day, one month grace period because i was concerned what would happen there. The other thing i would request is that i would like sfmta to attempt to facilitate agreement between the archdiocese and synagogue that allows the two mission deloris parking lots. This can eliminate the parking and give the synagogue flexibility. There was discussion some time ago but agreement couldnt be reached. Same applies to deloris park church and board of education. They used to be able to use the parking lot across the street and suddenly the fall the new principle decided they couldnt without warning. I ask the city try to facilitate some agreement there. I respectfully ask you consider my suggestions. Thank you. Thank you. Thank you for your continued input. [inaudible] anyone else wishes to address the board if you can make your way to the front or turn in a speaker card. Good afternoon Board Members. Congrat ylshzs chairman brinkman and thank you chairman nolan, outgoing. [inaudible] associate pastor of Cornerstone Church and part the committee John Knox White and team helped facilitate over two years and thank john and juliet and team facilitating a job for a challenges process. I do want to say i think fellow Faith Organization members are not able to make it today but i think without formally speaking on their behalf we are supportive of the Pilot Project and believe this is a compromise for the neighborhoods and faith communities and i think everyone just to communicate to the neighborhoods this will beope toon the general mublic whether going to the restaurants or shopping or Faith Organizations and i just want to reiterate that i believe it is communicate today the board that the Small Business administration San Francisco has also supported this Pilot Project and legalization the median parking on dolores. I believe it was brought up at the last Board Meeting. One reason the data hasnt skewed too much is the gentrification that happened with the people of Faith Organizations who had to move out and drivering into the city is the only opportunity for them to attend their Faith Organizations. Once again, i want to say thank you and hope you consideralso, my Church Actually is part thatparks on cuvaro and independent of the pilot decision so i was under the impression it is a same decision for doloresthank you. Thank you. Mr. Knox, white, a follow up question in light of mr. Luzars comment. I see that the dates and times the parking is permittedfriday until 10 p. M. Saturday at noon and sunday 6 p. M. Do you want to to the twie lite dark dusk issue there . Sure, it was something we talked about. As we wept through the conversation even with the Committee Even though we didnt come to a conclusion there, we looked at everything from adding full day saturday parking to really limiting things to sunday mornings and in that conversation i think what staff came to is the idea of trying to formalize a solution that honored the current and existing circumstances so parking hapbs past 6 oclock we thought 6 oclock represented in the hour a reasonable hour that isnt too dark and maybe one hour of darkness in the evening and couple months for a year. We couldnt find data that suggested people were running into the backs of the cars so a outcome evaluating this is whether at 6 oclock there are no car thrz which suggests we should pull the hours sknack there isnt a damd for that. I think we felt the issue was single cars in the dark than it was a row of 10 cars parked there in the dark. Good. Thank you. Directors, questions, discussion . I had a few. Please. Thank you very much, mr. Knox white. This was a interest progress on this and just a couple follow up spots on the proposal for your consideration Going Forward and for the commitsy to consider Going Forward. It is my bet that this parking is going to fill up as quickly as it becomes available by workers or customers or residents who want to park extra vehicles they might own that they dont have parking for. Once it becomes available to the public and the whole public knows it is available, i suspect like every other available parking space in the city it will be snatched up the moment it becomes permissible for vehicles to park there. Im under the impression the only reason it doesnt happen now is the way it is unofficially managed gave the public the impression they were not allowed to park there because the parking was reserved for the institutions. So, im hoping that we have sort of a plan in place to respond to that once that happens and if it doesnt happen im happy. I suspect it will and encourage you toconsider the idea of putting hourly limitations like 4 hour limitations on that parking or two hour limitations to increase turn over and keep people who shouldnt park there from parking there so it remains available for the intended use of the space. If that doesnt work i encourage to start thinking what it will take to meter those spaces. Again, from the persperktive of keeping the Spaces Available for those who need if and funding enforcement. That is probably something that i would encourage you to just think about as you are rolling the thing out, not necessarily to implement it or look at implementing right away. Again, i hope im wrong. I love the idea of a parking pass. I suspect that the institutions are looking at this. I would hope that the folks from the synagogue would be very open to the idea of letting people park in their lots when they are not there and the other folks in the christian institutions on sundays will be happy to allow the muslims park on fridays or whatever it might be, but there are plenty of times when church lots are vacantfaith based institutions are vacant and it will be cool for the ecminicle council or any counsels that exist to put toorkt a parking pass for their members that would allow for parking to happen in each other lots. I hope you look into Something Like that because i suspect with the reduction of parking they will need something to that effect. Again, really supportive of all this. Im glad to see it has come this far. I know this was a divisive issue for a lot of folks in my conversations i had with people about this but think it is step in the right direction and appreciate all the engagement that members of the community provided in this and again, the leadership on the part of staff and everyone involved so thank you. Thank you, director ramose. That brings up the question if the parking fills up and the Faith Based Community no longer has the easier access they will want to consider some type of Transportation Demand Management Plan or managed parking in the area so that is interesting to watch. Any other questions . Motion to approve . Second . All in favor aye. Opposed . Hearing none the item is passed. Yes, im sorry. I hope that we use this opportunity in work wg this community on this issue to talk about the homeless issue, which is another issue that came up before where we have people in those vehicles living in their vehicles and no place for them to park and since we have a audience with the community at this point, i recognize it is primarily concentrated in that area, but if we can use that as a way to start that conversation too that will be great. Thauchck very much director mord borden. And that conclude our meeting, we are adjourned. [meeting adjourned] those in th please take their seats, well get underway. I now call the regular meeting of the Health Services board to order. Would you please join me in saying 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. Well have the roll call. Roll call. Scott, present. Lim, present. Breslin, here. Farrell, expected. Ferrigno, excused. Follasbee, present. Sass, present. We have a quorum. Thank you. First action item. Item 1 approval of possible modification the minute of meeting regular meeting december 8 , 2016. Do i have a motion . Moved and [inaudible] the minutes the regular meeting och december 8 , 2016. Second. There is a second. Properly moved and seconded we approve the minute of the december 8 regular meeting of the board. Any comments or questions or edits by members of the board . Seeing none, any Public Comment . If not, wree ready to take action. All in favor of approving the minute as distributed say aye. Aye. Opposed . So ordered. Item 2. Item 2, discussion item. General Public Comment on matters within the boards jurisdiction not appearing on todays agenda. Good afternoon commissioners rich rld rothland retireee. Im leer to talk about kaisers [inaudible] which is a property which is a transportation desert. Last time i talked i look adthat web page, they have some information about bestriving alternative services which i didnt think was adequate enough. When i looked today all they had to drive there, nothing about muni. I dont know if they are continuing the Shuttle Services but it want on there and i think since we are the second largest dealer with our agency that deals with kaiser, that we should really tell them that they need to provide better transportation especially like the richmond and the sun set to especially seniors and popeal who have a hard time getting around that they need to provide Shuttle Service. I dont know if they stopped it or not but there is nothing listed today on the web page. You know,u csf has a great Shuttle Service and go around to all the facilities, there is no reason why kaiser cant start at french and go to geary street and they have campuses i think up the street here. I think we really need to providekaiser needs to provide services so that they can get to owen street. Im lucky, my doctors department wnt but he stayed at geary street. If i have to go to owens i rather go to south San Francisco, it is easier for me but think the board should ask kaiser to explain what they will do about improving public transiteven active and retired members. Thank you. Thank you for your comment. Is there publicother general Public Comment on matters not appearing. Herbert winer, city retiree. One concern i have and related to what the previous presenter made is it is public possibly of mta and expect seniors and disable tooz walk a quarter mile to the bus stop. I realize you dont have direct authority over this or jurisdiction or this but this is for the information the board. Actually this policy is done to make the buses run faster and frankly it is a add mixture of the rationalty and cruelty as i pointed out to the board of supervisors on tuesday. This really effects our retirees many who rely on Public Transportation including myself. Im able bodied but the bord should be aware of this. The mta run amuck and has to be brought to heel. It is terrible and aprogess what they are doing. They think for the Public Comment. Any other pub luck comment on matters within the jurisdiction of the board . Seeing none, we go to discussion item 3. Item 3, discussion item. President report. President scott. As part of the president report today i want to acknowledge very outstanding presentation made by a on hewitt on Market Trends and update in the last meeting and make a formal request of them that during the benefit cycle later in the benefit cycle once we get more clarity about what is going on nationally if we ever do. I didnt say that publicly, that you come back and provide us with a update. So, well work with executive director dodd to talk about the time for that to happen. You have done a great job outlining what things could and might be and think with a little time there will be more clarity and i think it is a informative reassessment of some of the things you highlighted during the presentation. I make that request of you. I am also in receipt of the following letter dated december 19, 2016. Dear chairman scott and Board Members, thank you for your commitment to insuring quality affordable Sustainable Health benefits for the Health System members and their depends. Your efforts have not gone unnoticed by hhs members. Not a day goes by that thanks are offered by employees i encounter. At end of january 2017 i will have worked 10 years for the city and coupty of San Francisco and therefore eligible to retire. I will be planning to retire immediately at my 10th anniversary but realize adding a additional month for transition is essential to set the rates and benefits process in motion to establish the Department Budget with Mayors Office and assist any way i can to launch a search fl a new director. This letter is to inform you im resigning as ecextev director on february 28, 2017. I am grateful for the opportunity for professional and personal development i had during the last 7 plus years. We have accomplished much. Established a wellbeing for employers which includes data by department implemented in all payer claim database. Found two successful care organizations, brought theagy into compliance with state and federal reg ylgdsulations and maintain compliance throughout the Affordable Care act. Launched Research Agenda preventing diabetes and participated in research on cancer correlation chemicals women Fire Fighters work with daily. Mostimportantly, kept overall premeial rate increase below 2 percent. We added board of education to the annual board meet ing agendas and met all Customer Services standards. I believe i am leaving hss in cape capable hands and there is much to do in 2017 and beyawn. I will do whatever is necessary to insure a smooth transition. I inyoied working with you the committed member thofz borebd and appreciate the support provided during the tenure with the cyst meez do do not hesitate to be in term what i can do to help. If i can be any help during the transition letd me xoe. Sincerely Catherine Dodd director of San Francisco Health Service system. There was a communication where director dodd extended the time with us until march 15th to help with the transition. I want to make a personal observation relative to this letter and director dodds decision. It can be found in a quote by benjamin franklin. It says for want of a nail. For want of a nail the shoe was lost, with for the shoe the horse was lost, not a horse the rider was lost, not a rider the battle of the [inaudible] all for the want of a horse shoe nail. I find it regrettable that sometimes the exceptional and superior performance of executive drether dodd over time during her tinnier and during this performance particular ly is only minimally recognized for those responsible for compensation practices and actions for Department Heads for the city and county of San Francisco. These actions have occurred despite repeated requests and recommendations by this board even most recently as september of 2016. The consequences of this in my view and im stating my opinion here, process combined with some episodic communications around it that had a very disruptive near term and impact on the operations of the Health Services system and it will possibly adversely or could adversely impact our services to our members. I wish that we had another outcome here and i worked both publicly and behind the scenes to try to achieve that. But we didnt. We are where we are. Catherine agreed to stay on for a period of time to help with the transition and i absolute her for that and wish her every success, personal and otherwise in her upcoming retirement. Also, as a part of the president s report, i am in re seat of a resolution by the protect our benefits group and to talk a bit about process for replacing this physician. I asked and she graitiously came today, the director of Human Resources for the city and county of San Francisco director mickey cal hann so when you please come at this time. I asked her to come so we all can be informed about process and then i will talk a bit about how well work with the pauss that she will outline as we undertake the search. Good afternoon. A bitter sweet opportunity. Pleased to be able to describe to you the services and processes dhr can support the commission as they go forward to fill the position but saddened we will lose catherine. Her achievements are nothing short of remarkable in her time in the position. We have not always agreed on everything, but im shocked. But she is really done her best i think for the benefit of the system. I like to talk about the general process that boards use to replace the executive directors and how dhr can support that. You may not know recently the Police Department has under gone a search and hired a new police chief and Port Commission has done the same. Building inspection. Art commission have all done that and we provide support to that process at the level desired by the board or commission. You can get as much or little of us as you want. We have a prequalified list of vendors who provide Recruitment Service and the advantage of a prequalified list is that we dont have toif somebody is on the list a contract to perform the search can be executed fairly rapidly. If the commission desires to use someone not on the list that can be done but the is a process of proiving they provide equal benefit squz going through the process that can slow things down significantly. Typically what we would do and ill speak generically is we would meet with the usually a subcommittee of the governing body to lead the process. We would look atwe draft a solicitation based on the level of support that the commission would like to have in the search and send that out to the various firms and they would then bid and then bring it back with a recommendation and then the commission either the subcommittee or commission as a whole will 15e79 that and we move forward with that. We have a list ofi have a sheet information sheet if you would maybe you have it to pass out. It lists the firms that we used and we used all of them very recently. Most recently i think Anderson Associates handled the police chief recruitment and alliance for director in my own department. We can also in the solicitation ask them for what experience you have in re cruting for this type of position. I do think it is a very unique position so encourage the commission not to require a level of experience that you might end up with no nobody bidding on it. Depending on how much you want the firm to do i say go between 20,000 to 50,000. On the police chief it was higher because they had a lault of meetings, meetings in the department and Community Areas where people came and kribed what they thought was important in the police chief and also handled it as a commit6tee of the whole because that was their decision. That took 1345u9 longer than it otherwise have but it is a option available to you. We have again you can use the full board or a subcommittee. My recommendation is use a subknhity so the committee can approve the letter soliciting, recommend the firm or choose the firm, approve the initial screening. The subcommittee or board can delegate to the firm, the job of qualifying the applicants in and ranking them in order. Normally they are good, better best aming those who apply but typically they present that to the the commission and commission may say the person you said was middle we like to interview because of x, y or z. That is the screening process that the board would decide how to handle it. There is no hard fast rule. These are exempt positions so no Civil Service exam. You can use the firm to do the contact squz arrange the interviews. We allow them to meet at our offices becausewe like some amount of confenchalty and may not want to show up where they might work so we facilitate the interview process. And then ultimately the of course the decision is by the board. So we couldyou could delegate a lot of it to the firm. Say bring your top 6 as a example. Or you could and you might or might not decide they need a community meeting. Meeting the board and meetings with aerts to determine the profile of the candidate. Or you could handle some of that yourself. If the board decided you wanted student to do most yourself, dhr will help with that. Sample letters and questions and helping set up skype interviews. I want to introduce [inaudible] sorrywhat is her name . Director of finance and administration and runs the processes and able staff member christina [inaudible] who supported a lot of board and commissions. I didnt hear the name of the first . Chand saw icada. Most recently the director of [inaudible] and decided dhr was better. Very happy about that. Thank you for that kind of process. One of the questions i would have is a national starting point is you typically have a member of the staff assigned to work with the commission if we request that . Yes and initially it is chandsa or christina. If you desire to have a person attend the interviews, and help with the questions we might at that point use somebody from our recruitment and Assessment Team to help give you sample questions for example or if you want to doi dont want to say Civil Service but have a scoring system we can provide examples how you might evaluate and record the evaluationoffs the candidates. Any questions from the commissioners on process . We are not talking about specifics today, just process. When we first became a independent department i found the other day the Job Description or duties or whatever, so we can do our own duties or Job Descriptions . Yes. The only thing we wouldif you want to put something there that wasnt legal we would prevent you from doing that. I have a copy of the old one. That fsh a specific request that i was going to make of directorif you could send to the board secretary and i like to send the old one. We have the old onethese type of positions whauv you have on file or whatever the last that you have on file in your office i like for you to send that. Our historian has a copy or anyone else has a copyanyone else have a copy of a prior executive director Position Description so they can be distribute today the board to begin some thoughtful process about what the scope of duties needs to be as we go forward. To the point that you made, i will be prepared part of the next meeting and hopefully be able to announce how we will structure ourselves as a commission to do this and we need a little discussion around that, but also i want to put on the record today that this will be a broad transparent and open process. I want to emphasis that, broad, pranz transpaernts and open process. I envision if we select a firm they are in collinitation with a variety of constituents. We have 4 different employers as part the system and they need to weigh in on this. We have retirees from the different systems so there we want consultation about the profile. There is probably dch different views of what the expectations should be for a new executive director as we move forward so those need to be brought into being as well. Who ever we select will be part of the early part of the process we want them to engage and bring that consolidated information back as candidate profile criteria report, whatever they call it and then we kind of have common cause of what we are searching for, if there is priortiizations among what various constituencies have said so thats our commitment and want that on the record. If i may provide information on that. We can provide you with examples of both solicitation letters and accepted proposals where the commissions have done a lot of this outreach and it would make sense to require the Recruitment Firm to manage that process but that will increase the cost. If instead you wanted to have various Commission Members lead meetings that is another option. In my humble opinion and a decision of the committee, it needs to be a independent party collecting the data so it is consistently done and presented in a format that is comprehensive in the approach. That is what the broad direction from a process standpoint today is and we got tothink this through more to be sure that we havent missed a step. Any questions from commissioners . Yes . Is it ever the case that retiring director can par ticipate in a technical or advisory capacity with a selection of a successser . Absolutely it is up to the commission. I think given thethis probably wont work for you because the time but there is a provision you can double fill a position with a person who is existing and person coming in to have a overlap. It sounds like the outreach you are looking for there will be a gap so the commission will look how to bridge the gap until you have your Selection Process completed. That is why im saying we are better prepared to talk about this next month because it requires the endorsement of this board to make the approach and talk about transitional management and what have you. In the interim we will provide anything we got on the Job Description of course a generic classification which i think is Department Head 4. It is helpful if you could define or give us context of what Department Head 4 means. Yes. All these folks up here, most of them have been affiliated with city and county of San Francisco, they know that stuff but there are a couple that dont have a clue about how you are structured, classified and do your business so if you got Background Information well provide the generic Department Head and kning in the specific duties and provide sample solicitation letters and contracts or accepted proposals i should say for the searches. We can provide broshoes. Normally what we do for confudinchalty we have a link to it the recruitment on the website, we have sth application go directly to the firm. Absolutely. They are not on the job app lication system. The access to the information isnt available to people. Any other questions from commissioners . The question i have assuming this isnt completed by march 15 its not going be. I gather that. Does hr know who the active director will be or we do . We do. We have it weigh in on that. We can support with respect to compensation or appropriate classification or acting pay, but it falls to the commission or board to decide how you want to do that. Anything else . The funding for the search team, where does that money come from . That is your funds, so you will have tothat is why cost is a factor. I will tell you experiencethere is a pretty broad variation of what theyll charge and i believe that the work of some of the 20 or 30 thousand is as good as the 50 thousand but you can look at the material and judge for yourself. The first order of business is have the body make decisions impaneled and help us preparewe will help you prepare solicitation for firms. Alright. Thank you for coming on such short notice and will be more than in touch. Im certain at that. Thank you for the opportunity to address you today. Thank you. Having taken that bit of time and i do want to kind of suggest that we have a very full agenda and we need to be complete with our regular meeting with all the components on the agenda by 4 p. M. Today because there is a closed session and we have to be out of the room no later than 5 t. We have a closed session on a member appeal and the directors review, so i indulge myself to take up the time to kick off the process but ask people to be mindful. Commissioners and general public to be mindful. Is there Public Comment . Good afternoon president scott, commissioners, director dodd. [inaudible] president of the Municipal Executive Association which is the bargaining unit representing a thousand managers throughout San Francisco City Government and part of meas mission is promote professional excellence for city managers and it is in that context that im here today to speak on behalf of mea to commend director dodd for years of Outstanding Services to the Health Service system. In her work to design, negotiate and administer Health Benefits for over 113,000 employees for San Francisco, San Francisco unified school district, city college of San Francisco, and superior court of San Francisco director dodd has shown to be a brilliant professional whos accomplishments include professionalizing the customer interface and improving Customer Services such that hss is a fierce advocate for outcome frz the members. Director dodd improved the sign up system and implemented Wellness Programs for employee squz retirees. Established a data analytic section and established transparency in both healthcare cost and quality but perhaps most impressively her work kept cost down when other Public Employee systems saw increase. Worked to bend that cost curve from a 13 percent trend to minus 3 percent in 2015 and less than three percent in 2016. I cant say enough good things about her professional ability, commit, hard work and leadership. Director doddmea commends for years of Public Service and wish you all the best in your retirement. Thank you for your comment. Any other Public Comment . Herbert winer representing protect our benefits with this resolution. Protect our benefits is dedicated to protecting and enhancing the Health Benefits of all city retirees in the San Francisco Health Service system and protect our benefits was more than 3,000 members and retireeed employees of San Francisco including the San Francisco unified school district, Community College district and San Francisco cort system and in our diverse experiences as employees retirees we have a common goal. Protecting the Health Benefits we earned over the years and protect our benefits through proposition c 2004 established the Health Service system as a independent and separate City Department and whereasprop z 2014 established the 7 member board consisting of 7 members, 4 elected by the members and 2 appointed by the mayor and 1 by the board of supervisors with the City Attorney to serve as Legal Advisor to hss and whereas the Charter Amendment in 2004 established the Health Service commission with full authority to hire the director and proposition c 2011 changed the Health Service System Commission by eliminating one of the 4 elected members positions to the commission and whereas proposition c enl tw 2011 weakened the input of the hss commission by changing the 2 3 rule vote for adoption of plans for members to a simple majority and whereas under charter ab 422 adoption of plan for members. The hss board has the power and be duty by majority vote of the entire to adopt a plan or plans for rendering medical care to memberoffs the system or for the indim fiication of the cost of said care and for [inaudible] against such cause for such care. Such plans may be adopted shol not be effective until approved by ordinance by board of supervisors adopted by 3 4 of the members. The board of supervisors secure a report of the cause and effect och any proposed change in the benefits of the Health Service system or rates of contributions before enacting a ordinance or before voting to submit any proposed Charter Amendment providing may i suggest there are three additional whereases can you move the resolve . I will delete the whereas. Im thank you. The director is responsible for developing and executing policies and methods effecting city wide Employee Benefit program said. Exercising i dont want to be rude, im asking you to move the resolve portion the resolution which is the next item. Here is where the resolve comes in and will give a copy. We have a copy. It is also for review by members the board as well. You can use a extra one. Here is where i state the resolve. Resolve that protect our benefits committee as a Representative Group protecting the Health Benefits of all city and county retirees play a part in the hiring process and encourage the board to create a national and open such to insure fair iness to all member thofz Health Service system. Thank you. Signed [inaudible] thank you for your comment. Any other Public Comment . Good afternoon commissioners. My name is eileen hurst a current City Employees with the Sheriffs Department and former mea president and i would just like to speak to the delima you have in front of you of replacing Catherine Dodd. I dont know how you will do that and dont envee your task. [inaudible] how mea feels about catherinefelt i can tell you just about every City Employee feels the same way and just want to add two things that i think she did spectacular lee well. She promoted wellness and got people to come to helths fairs. She made it easy to walk across the street and get your Blood Pressure checked and cholesterol check without making a doctors appointment and information how to take care of yourself and goot a flu shot so she made Health Accessible and the think i loved most is how you had these yoga classes and zumba classes in city hall so people members of the public and City Employees are walking by and here are all these people in there exercising. It is so promoted health and that was something that was so missing from the helths system before you came. I know that is part of keeping cost down as well but you will never know how many City Employees and how many members of the public are healthier because you are here and i thank you very much. Jerk thank you for your comment. Any other Public Comment . Dennis kruger active retired Fire Fighters spouses and widows. I have sit here second longest to anybody in the room [inaudible] in that time i watched a number of directors come through here and i have never had a director of this organization more qualified to direct it then catherine do dd. I will mitss the meetings every three months. Y0u are lucky to have here. Glad you are taking a real wide view of somebody to replace her because i know it will be very difficult and ill just through out a name for a starter. Clar suvansy. Any other Public Comment . Clar suvansky to refute that last comment. Representing r serks ccsf. From my time on the board i remember when phil carny retired actually died. He was father of high school chum and my colleague randy smith took over. It is a long time ago. I have watched a long succession of directors in that position. None had the qualifications or expertise and none have much as their been a few we loved dearly, none have actually accomplished as much as catherine has during this time so think the shoes are going it be very difficult to fill. More like boots because there is a lot in there. I wish you well in the process. I dont envy you the process. I offer my perspective for whatever if you ever want to consult or get any assistance from me. Im here and available to do that but i just want to say it is extremely hard to go forward because catherine has such a high threshold with regard to everyone who has filled the position and many have come from similar types of commissions and boards and had a great deal of expertise but not the level of catherine and expect the next couple meetings will be full of accolades in that regard. I think it will be a veryi dont know it will be a simple process, but i think that we owe it to our system and to our members to do the best search we can do and mostthorough search we can kw use catherines expertise as much we can to find the new successor. I wont take anymore time but good luck. Good luck members hof board and former colleagues and good luck to you catherine. I think this is a difficult decision you have added so much to the process. You have also added so much to the department. You brought in some incredible people and i think that should be noted as well that we now have probably one of the most funomsl omphenomenal staff and still short staffed given the number of people and benefits we provide we are still operating on a very tight personnelit is small department. It is too small for what we do but think and good luck. Thank you for Public Comment. Any other Public Comment . If not we will move to the next item, which is directors report. Item 4, director report. Director dodd i know this is the last time or next to the last time but take your time. Thank you very much and thank you to all these who commented on my stewardship. I think my directors report is and has consistently been a reflection of what great work the hss staff do. I am merely go to meetings and pull people together. We have a remarkable staff. I am pleased to say that we currently have only two benefit technician positions open and one benefit analyst position open and that we are in the process of making a offer hopefully to a communications manager. That position is vacant since august. And then we have two position open for [inaudible] savings and hopefully wont be asked for more in the budget process this year. I really want you to take a look at the numbers in terms of how many calls we answered. Our call increased by 25 percent. Now the speed to answer increased equally but we maintained with the exception of a couple days when there were glinchs industry standards if not better in the call and inperson assistancement we mailed out 72, 905 conformation letters. Quh i came here we mailed out 5 5 54,000. When you think of that increase it is a profound increase and one the reason our call volume is what it was is because the mail house when we had no control over held on to the letters for two weeks. They went out two weeks late and arrived in the holidays and cut staff and given people time off. So, there are glitchs in the December Numbers and there will be glitchs in the january numbers because we had a difficulty with blue shield for the split families. We have done everything we possibly could to meet those goals and im still proud of the numbers. We are going back and review with the Communication Company the mail house where the glitchs were and why things were two weeks late and will make recommendation tooz the purchasing department. The office of administration for the y whether they should continue to be used mpt we also had to answer calls on the new voluntary benefits. Over 5 thousand people signed up for voluntary benefits and it is interesting, that is a huge percentage. It is more than responded to our questionnaire and i was at a meeting yesterday when people were talking about voluntary benefits and everyone is talking about pet insurance which is one thing gregg menshzed. I hope people realize pet insurance is a legitimate desire just like yoift theft or cretical Care Insurance t. Is throughout the industry one of the most popular benefits there is and think we are serving our employees well by giving them that security that they wont lose that loved one in their family. Data analytics has a very busy end of the year. They have to figure all thethis may sound simple but have to go through all the domestic partnerships and decide whether their income tax eligible and transmit all that information to carefully and accurately to pay roll so the w 2s can besent out. We validated the data for the w 2 and up graded all the pages on the website. Dat a analistics was busy in december. Equallyyou think of december being a easy time. Finance and accounting reviewed in preparation of the city wide Financial System which we are all waiting for, all the policies. They converted the medicare United Healthcare to the new city plan effective january 1. They finalized their agreement with Fidelity National Technology Images so we are beginning to move those files that take up a huge room offsite and scan them so they are electronic. And they completed what you started early last year, the form for applying for reimbursement for surgacy and adoption. In terms of wellness i want you to look at those numbers that are in the draft. We had a 5 percent increase in visits to the wellness scepter and looking at 644 per mujt. Epa had a tremendous increase with 3720 employees reaching out. Eap is working on hipaa requirements to do Telephone Services coming up. And wellbeing service increased by 12 percent over 2015. Click on those links in terms of the wellness report, it is very remarkable. In terms of my business, i met with participating interviewing the communication manager and worked with ann on performance guarantees. We have taken some sthofe choosing wisely recommendations on performance guarantees such as only 29. 3 delivery by c section and looking at mri use for low back pain so we are participating in eliminating duplication and over expenditure. We will be bringing to you a proposal for dependent verification audits. I realize we did a verification audit on children in 2011 and it saved the city 3. 2 million going on and we continued that. You can drop a illujtimate dependent through open enrollment but we will look for them so the city is only paying for people who they should be paying for so that proposal will come to you and fairly certain we can get funding from the controller to pay for it. That completes myi did want to let you all know that next monday is a holiday. We are celebrating Marthen Luther king birthday and will travel to san diego. Tuesday im giving a talk with pbgh on value based care. Coming back wednesday and then thursday and friday ill be in washington dc for the march. I will not be in the office next week, but as i said before, when im in the country i am always available by phone or email and staff can tell you that. I am never farther than my i pone unless it is so cold back there it freezes. Mitchell will be in charch while im out of the office and thats it. Thank you very much. Thank you. Thank you for all the accolades. Any questions by members of the board . Any Public Comment . Seeing none we will move to item 5. Item 5, discussion item. Hss financial reporting. Pamela leaven. Director leaven, we are trying to gallop through as you know. Pamly leaven chief financial auftser. I report on the revenues for expenditures for the trust fund and general fund as of 113016. We have in the trust as of june 30, 2016 the net position was 68. 6 million and project 68. 9 million. The 11. 7 million is subsidized the rates for city plan and favorable claim experience for blue shield which increased by 8. 5 percent over the same period in fy 2015 16 and that is partially off set by rate increases we had first 16 to recover the 14 deficit and the rates for 2017 to recover the 2015 deficit. We also had better claims experience in the self insured dental plan. In the report we show a balance of 58,000 for the healthcare Sustainability Fund. I show the transfer of 150 thousand from performance guarantee received prior to the had current fiscal year for the surgacy and adoption benefits. The benefits was effective as of january 1, 2017 and have no applications wim continue to report on that and no performance guarantees are received for the current fiscal year. For the general fund based on the 5 months of expenditures we are projecting to end the year at budget. Thank you very much. Please remain there. Are there any questions from members of the board . The best doctors, when you report on that the money going in and out for that is that under the Sustainability Fund . It is out of rates. Isnt that part the 3 dollars that goes out each month . It is separate. I suppose i could but it is a per member per month rate and i could put that in a separate line. I think that would be good because i like to see how many people are using this and how much we are paying for it. Director dodd . It is based on a pmpm so not a per member use utilizing it. It is dollar 40 time s however many members we have each month and believe they are scheduled to bring a report after the first 3 months the year. Just so there is a report. They commit today do that and said we wd do that with all the new benefits so that will come back in a format rather than through the financial report. We know the cost. Any other comments or questions from Board Members . Is there Public Comment . Seeing no Public Comment, well move on. Item 6, discussion item. Review of Health Service system fiscal year 2017 18 and 18 19 budget instructions. Pamela leaven. You have report in front of you. Im highlight the staleiant points. The Mayors Office released 17 18 and 18 19 instructions for general fund and have projected deficit of 119 million and 2 834 million in 18 19. This is due to increase in the employer contribution to employee pensions, Rising Health cost, new baseline and voter approve set aside rkss increase in service and position and ongoing costs. The projections do not include unknown impacts from the labor negotiations in 16 17. We have i believe around 40 or 45 unions that are negotiating this year. Any supplemental or new budgetary commitments that the board of supervises might make, any changes in the state or federal budget yearcurrent year over spending is sup lltal appropriations and change in the economy. The mayors instructions we are to propose on going reductions equal to 3 percent in both years. This means that the 17 18 budget request need to be reduced by 97, 442 as compared to the base which is the current years budget and then the cuts must continue into 18 19 along with another additional 97, 442. We are suppose today implement a approach to the future fte approach. This does not mean that we have to do any layoffs, a hiring freeze or keep positions vacant but cant create new fte tfs. We cant request any additional positions. The idea is they dont want togrowth in the number of positions in the ongoing expenses we scr when we have additional positions over the years. And then we are to adhere to the city wide strategic initiative. Only some apply to us but there are residents and families that thrive, clean safe communities, diverse equitable inclusive city, excellent city servicess and a city and region prepared for the future. We will come to you on february 9 with both the General Fund Budget and the healthcare sustain nlt fund which is called the 3 budget instead of 205 and bring that to the finance and Budget Committee and then the full board for approval on the 9th. Are there questions by the board regarding budget instructions . I 34 profoundly impress said sth number of initiatives as we reduce the requirements while we reduce by 3 percent what we are trying to do. That is a remarkable feat but thank you for your commentary. Any questions by the members of had board . Any general comment from the public . Seeing none, we will go to the next item. Finance and Budget Committee matters. Proposed helths system draft and recommended option. I will relinquish the char to commissioner sass. Thank you. The finance committee of the Health Services fwored held a meeting earlier today to review a presentation made by mu ketoa Investment Group. This is organization that the department contracted with to assist us in developing a Investment Policy Statement for the Health Service trust fund. They havethey made a excellent presentation that identified the standards we must follow and statutory requirements associated with investment policy we might have. As it happens the Health Service board is responsible for approving invesmentpologist and to that end we conducted interviews with several members of the department as well as several Board Members, myself and commissioner scott. They worked with our department and through our department gained support from the City Attorneys office and they have come back with a draft invesmentpologist policy for the department. I think a couple key point in the presentation that people should be aware of, the first is that the purpose of the trust fund is important to people to understand and they made two comments on this. The first is we temporarily hold contributions to the end of the plan before dispersements are made. Those are funds that are required to be managed by the Health Service board and department that are liquid in nature and maintained to meet ongoing requirements. In addition, the Health Service trust fund exists as a Funding Source to insure payments could be made if the dispersements that we are required to make exceed the contributions receivered. To that end, the department maintains a Stabilization Fund that is approvaled by the Health Services board and maintains a Contingency Fund which is a calculated value that is based upon the obligations of the organization and the need that our actuary identified necessary to insure under new circumstances would be unable to discharge our obligations to the members and pay premiums as they come due. With that in mind, there is a opportunity to look at what remains of those funds and evaluate how those remaining funds should be invesced invested so those are funds we potentially have discretion over. Currentsly all our cash and cash reserves are included in the citys treasury pool and those invested by the city and the city is under therequired under i think it is section 15 53600 of the california code, those regulations and those requirements limit very significantly what the treasure can invest in. As our consultants looked what investments we could consider should we move away for the treasury funds it was determined we also are subject to the the same code section sthof california code. As a consequences the constlation of investments we could consider are similar and the same as the treasurer can consider. They are short term in nature and fix td ed in naich ture. There is a structure in such a way the principle is guaranteed and liquidity is assureed and return on investment the third in consideration and it is that order those considerations are made. As a result of research and work they did, their recommendation which we approved is that number one, the their recommendation is that theill read this specifically so i have the exact wording here. Page 7. To continue to utilize the treasury pool of the trust fund assets which meets code and includes investment policy reviewed and monitors by the treasury oversight committee. If the assets are invesced in the pool the board receive upidates on perform ons thf funtd and number 2, the board get a annual update from the treasurer and tax clecktder staff and number 3, at least every three years review and evaluate the appropriateness the treasurer investment portfolio and review alternative options. We basically voted in favor of the recommendations and make the recommend aizs to the Health Services board and we also recommend approval of a draft Investment Policy Statement included in the package that is provided to the board and this Investment Policy Statement essentially includes all of the recommendations and items included that i mentioned. I are recommending that the Health Service board approve the Investment Policy Statement and approve the recommend ation made by mu ketoa Investment Group. If there are questions on the topic or Public Comment or anyone on the Health Service board has question about the recommend aigds we have a representative from mu ketoa Investment Group here to answer any questions you may have. What are you going it do . I like to move for approval. There is a second. It is subject to legal review so we bring back the final draft next month if quee have changes. Yes, the recommendation is included. Just to be clear, the recommendation is that we approve the recommendation of the finance committee to the board accept the draft Investment Policy Statement and to accept the recommendations forutilize the treasury pool for the city and have quarterly and annual updates qu once every 3 years review the appropriateness of that decision and consider altnchatives. The investmentpologist is subject to legal review, correct . Subject to legal review. You want to call for comments from the board . I like to call for comments from the board. Thank you for doing this, i know this is a long time coming, so thank you for your efforts. Y i just like to commend the finance committee and also mucadey. A. Finance isnt a strong suit. I thought the preparation at the last meeting or previous meeting for this report and then the report it self including sort of a example of a option using a hipthetical was helpful and made me able to understand it and evaluate the recommendations and i feel comfortable with the motion. I did have one comment. At no time was this effort in any way a reflection on the role of the staff or anyone else in the treasures office. I restated that pretty consistently during the past year plus we have engaged in this work. We have a fiduciary responsibility as a trust fund, as a trust fund to have an invesment policy statement and we needed to provide a rational for developing that policy statement and we think we have done that work. The legal review will make determinations regarding what else or what constraints there are around that under the various charter provisions of the city, but it was our responsibilities as we took this over at a forum this is a fiduciary issue. We thank the Treasurers Office for the cooperation and information they provided the board in the interim period and expect they will continue to do so as we go forward. At this point i think we could open the issue for Public Comment. And a vote. Thank you. I also want to commend you on a incredible job because i remember we had the Treasurers Office in herea few times talking about their policies. Um, i just want to be clear because i look at the draft and i see the following options that currently satisfy these factors under number 5 Investment Options on page 3, you talk about the treasurer pool and quarterly written up dates and then 6. 0 review every 3 years but number 2 investing assets with external investment and number 3, making direct puffins purchase are those two sections eliminating and looking at the treasury pool, quarterly written and 3 years . No. What the investment policy provides for it provides the broadest ability of the Health Services board to consider any of those three options, however, i think it is our current judgment and likely to be our judgment in the future that the treasury pool is the appropriate Investment Vehicle for us. Should there be some event that will cause us to wix wish to make a change if that were to happen the large component the portion required for maintaining liquidity, whatever portion of that invested by the treasurer because they do a lot of overnight investment remains. We will look at a small subset of the fund. Those funds not required for liquidity and includes all the liabilities and all the reserves. I think at the curpt time that amount is around 15 million. That is an amoint we could theoretically make alternative decision if it is appropriate to do so but at the present time and in my estimation i cant imagine a time where that would be a decision we would make and i think it would be a very unusual set of circumstances and one that is a very carefully considered by there board. Those 2 sections 2 and 3 remain, it is just isnt practical and realistic but they are there as part the policy . Great. Thank you very much. Appreciate the clarification. I also call on the chair to identify the consultant that worked with us. Would you come to the podium and introduce yourself for the minutes and hairy whit from muceeda Investment Group. First i like to commend for a outstanding product. I think the presentation in particular is easy for me to understand as a finance person but it was presented in such a way it is very clear to anyone reading it regardless of the background. What the options are and opportunity would be dependent on the option we selected. I was very impressed by one schedule in particular that showed that comparing what the return we get from the Treasury Department with the other two options available to us if you looked at what those options have earned, the differential between those options and auchckzs we have the return the department would have received is 5 thousand per year on average. We are not looking at any meaningful benefit going the additional expense sw work and risk of investing outside the treasurer. I thought that was a compelling slide and one that was very influential for everyones decision. Ready to vote . Yes. I think that you call for the vote if im not mistaken. I gave the chair but ill do it. I will return the chair. Can i just add that our chief Financial Officer pamela leaven worked hard on this over the last several months so they became a team and council weighed in and pamela deserves kudos as well nchlg i think i made her life difficult with all my concerns and questions and confusion about this. Thank you very much pamela. Thank you again and certainly to director leaven working with you in a Partnership Way during the process. Is there any Public Comment or comments from the board . If not we are ready to vote. All in favor accepting the recommendation as stated say aye. Aye. And any opposed . I like the vote recorded as unanimous. We are now moving from finance to governance. From finance to governance. This is my life this last two weeks. I will now turn the podium over to chair breslin. Item number 8, please. Item 8, action iletm. Review and approve result of fishical fy 15, 16. You all have the report in front of you. There is donna cutalky from dhr consultant and highlighted a cupm points of interest and a additional point that happened this year is the executive Staff Opinion was included in one section for the management section. Just will highlight a couple things in the interest of time here. Areas of possible concern, they were a little lower than last year but not still too low. The board received Information Reports that are necessary to careee out duties. That is between neutral and whatever the next one up is here. Neutral and agree so it is not negative either. Board meetings agendas reflect policy matters consistent with board rules. These went down a little from last year and why they were pointed out. Board accepts the decisions of the board even if they didnt vote in favor of them. That went down from last year. Anything i think at 4 percent, i dont think is a concern. Shouldnt be a concern even though they may have gone down some from last year. Potential focus areas were Board Members interactions and meeting activities. Board members are respectful of ideas and opinions, that went down somewhat but still above a 4. Disagreement between Board Members handled professionally, that had gone down too but still agree. The ones that are low would be board provides sound advise to management, that had gone below 4 percent. Challenges management and constructive manner had gone down below 4 percent. Board provides alternative points of view to management has gone down a couple points. Nothing below 3. The one that is low is feasible the board engage in effective management Succession Planning and this was a very low score in there but also the executive staffs report. We have a succession policy which we worked hard on for some time and it is in the directors under terms of reference what the policy is. The director assessment of Human Resource needs and development of appropriate Human Resource programs and procedures including Succession Planning, coordinating with other City Departments as necessary. It is also written in the boards terms of reference we see the Succession Planning was done. Maybe no one was aware of this but we did spend time on this and in the governance rules there is a Succession Plan which the director will say who is in charge and she is out. Even though that didit made me think no one was aware we actually had one. Even though we did respond a lot of time on it last year. Those are the highlights. The ones that went down and low from last year primarily. And i like the idea that we have input from the executive staff. I think it is nice to expand a little bit to the full Management Team maybe next year if possible. Any questions . I like to make a comment on the Succession Planning and the score in that area. I think it is all most self evident that we did want do as well as that with the vacancy of the executive drether we are facing and Succession Planning and from my experience in nearly 40 years in Human Resources isnt about who is operationally leading a function, if indeed the executive is out of the office. That is continuity planning in most organizations to insure the business options and administrative options continue to go on in the absence of the primary or principle officer. Succession planning within the terms of reference is really talking about when there are vacancies. What is the process to find replacements and how low within the organization, at what level should this board be engaged working with the executive director to create a formal succession and Development Plans for the professional staff. So, my view in reading the question, it was not just about operational continuity, it was really about management, succession and professional development and those conversations we havent had in my view, but we will be having as we are getting ready to engage and finding a successor for executive dodd. Thats pretty well laid out by dhr. Right . Any other qugzs . I have one question. Im not in addition to be [inaudible] also statistics. There was one i guess commissioner unable to assess on every category and when you have such a few number anyway, 6 versus 7, i wonder if anyone recalls in 2015 was that the case across the board and was it just not unable to assess . To me raises some question if one feels that he or she cant the questions. It is someone who didnt fill out the form. The prior time everyone did. I just pointed out it does impede the potency of drawing conclusions and the areas of development when changes look large but could be related to 6 versus 7 people making an assessment. Someone didnt fill out the form. Okay. Can i make a suggestion for next year . That is that reminders go to commissioners either by dhr who is doing them or by our secretary. They all go to dhr so the secretary doesnt know who sent them and who hasnt but we could ask dhr to do a reminder and maybe a phone call. I would like to weigh in. I was in contact with donna cutalky and knew who was participating and who was not and sent this commissioner 3 remindsers. Thank you. Do you want to call for a motion or Public Comment . Yes. Motion before Public Comment. I move we accept the Board Evaluation with the focus on the areas of potential improvement. Second. Any Public Comment . All in favor . Aye. Opposed . Unanimous. That will be reflected as unanimous acceptance. We will defer the other action item on the educationaldo you have it . Yeah. Doesnt everyone have it . We didnt discuss it in the governance. Not that governance but a prior one. If you have a report please render it. Well, we have it here. I thought it wasnt passed out. It is in the bipeder binder on the i pad. Has everybody seen it . It is about three pages. Yeah. We went through all this not this last meeting but the meeting before and it was finalized. Everyone from the committee. Everyone from the committee had input so thats why i thought it wont going to be on today. Ill accept that and director dodd has a question or comment or i apologize for not being on top of when the input was requested but i think the point at the bottom of the first page, access pharmaceutical pricing practices is a emoore fs term and may want to say stay abreast of pharmaceutical pricing process. And then gain improved understanding of claims. I think we just need to gain a understanding of claims. Lastly, i would like it if the board understands self funding fully funded flex funded mechanisms because it isnt just claims it is also the other funding mechanisms so those are three additions i suggest adding. Could you say those again . Under access pharmaceutical pricing change to stay abreast to pharmaceutical pricing practings. Under gain improved undering just say gain an understanding of claims data analysis. And then lastly add understand self funded fully funded flex funded mechanisms. Those edits could be added by the secretary . Sure. Are there comments by the board . This is action iletm number 9. Action item number 9. Alright. Any other questions or comments by the board . Do i hear a motion to accept the Education Plan for 2016 . With the editsfelt so moved. It is moved. Second. Properly seconded. Any discussion . I just interject a observation. This board has a 10 thousand budget in this years budget from the general fund for educational purposes and to date we havent spent a dime. We do belong to the International Foundation for Employee Benefits. The advanced Trustee Institute will be held in san hosay jose july in june and there is another Institute Training for certification in public employ er benefits that will be hosted nearbe as well. So whether through those programs or other efforts we need to actively use the funds for which we badgered and begged the city for for the last 3 years or they will come back with the 3 percent thing drether leaven talked about and take it away from us. I ask you to give some thought that are consistent with our role as Commission Members to make yourself available for the educational opportunities. So the ones you just mentioned that are local, could we get a notice sent to the board about these . Sure. So they know they are coming. Yes, but they also come to you every day, your mail box is flooded with emails fwraum the foundation every day. I dont have that. I got a catalog mailing but we can send a reminder of the ones that are close day and dates. Director leaven you look as if you wish to make a comment. If i misspoken with the source of funding i deeply apologize. Pamly leaven chief Financial Officer. Now you were correct but i like to urge the decision if you want to do these things to get me the information now because i need to get the money incumbered so we will not lose it because we are not spending that training money and i want to make sure we still have the ability to have it the following year i ask the commissioner to communicate no later than the next Board Meeting to drether leben and be sure to include our secretary in your communication if you have a desire to attend any of the meetings and ill send out a email remeending reminding which are local. Any other comments or questions . Any Public Comment on the educational plan for 201619 . [inaudible] congrat ylshzs on having a educational plan. I like clarification, is the 10 thousand just for board education . Okay. It was only when the budget crisis hit a number of years ago and all of training and traibl was removed from aevds budget across the city. Did this board stop going to the [inaudible] conferences and trainings because everybody got that cut . We have often encourageed staff especially senior staff but a number of staff to attend those trainings especially when they are local or close by like in tahoe and maupt rea and having this in san jose sound exceptional and very very close by. I would like to strongly recommend to all of you that you take advantage. I realize that a lot changed with regard to the trainings and so there is a lot more available now through dvd and electronic sources so you dont have to go to as many conferences, but what you learn by having some type of dialogue and interaction with other trustees from across the country and other Public Trustees is especially in the specific conferences and trainings that are just for the Public Sector, that is invaluable. It is a double training, it is not only what you get and gleam from the materials but what you get networking with others in similar situations and vauved involved with public plans so i strongly urge you to take advantage of this. 10 thousand isnt a lot of money but if you can go to san jose it is a trip down the road and mileage and if you want to stay a day or whatever it is worth it because these are invaluable trainings and missing from the board for a long time and think it will help you understand the fiduciary responsibility and what we are up against with regard to other plans and gain a Bigger Picture of what is really going on in the Public Sector especially with rart to the benefits so that is from the perspective as a former member of the board i cant urge you strongly enough to participate in these trainings. Thank you. Thank you very much for Public Comment. Any other comments . Thank you for the Education Plan. Comments by the former president [inaudible] i have been attends frg the last two years the helths Care Management conference accept it was paid for by [inaudible] and they didnt charge the Health Service board or Health Service system from the budget so it was paid for by our union. Now since im retired ill take advantage of it because it is [inaudible] any other Public Comment . Any other questions or comments from the board 1234 i thank commissioner breslin for bringing it back. I have a general question, if you dont spend the money wouldnt it be deleted . I think this is a very valuable expense and you dont want it knocked out of the budget so this think is a [inaudible] thank you very much for that comment. We are ready to vote. All in favor say of the motion to accept the Education Plan for 201619 say aye. Aye. Opposed . Passes unanimously. We are now ready for action item or discussion item in rates and benefits. We are going into rates and benefits. For those who are members of the public this is a committee of the whole. It is all of the members of the board. We meet in the configuration to hear any number of reports between now and the time our finl rates are approved and reviewed by the board in june. At this time ill ask director dodd to share with us our calendar for this task. Thank you, you have the calen deder before you. In february we will explain the black out notice. We will look at the city plan adminivateive fees and review claims experience and we will benchmark copays with other localities. In march, we will hear the 10 conte and approve it. Well consider stop loss recommendations and review the claims experience on the blue shield flex funded plan. Rereview the blue shield claims stabilization reserve. It will also present as they do every year the helths Value Initiative in march. In april, we will look at risk scores. These are the scores produced on the Payer Claims Data base. Consider the dental and vision and etna renewal. We rill also consider city plan active and early retirees. Only the seft insured portion of city plan and approve the benefits and premiums for 2018. That is april 13th. In may, we will consider kaiser active and early retirees who will have claims experience and approve premium cuntbutions. Similarly look at the blue shield flex funded non medicare and approve their benefits and premium cuntbutions and the city plan self insured rate renewal for active and early retirees. We will consider at the time a best doctors renewal. We didnt put in best doctors will present first 3 months of statistics. When will that be due . Is that in march or february . January, february, manch. We could probably april. April 13th, i guess they could pull it together in two weeks. If you could just put a note it is at the april or may meeting that we would be looking at that given the transition here we just need to make sure we dont forget. Okay. I know i will be out for the april meeting and would like to hear this so maybe we could consider may. Thats fine. Without objection . And then june youll be voting on theu hc Medicare Advantage fully insured and kaiser senior advantage and hopefully it will besail sthrou all these. Again, this is a reminder that all of our deadlines are governed by the board of supervisors budget process, so if things feel rushed, its not that we cantwe just cant post pone things another month because the board of supervisors must vote on them in july. We dont have the exact dates but will fill those as we go along. Thank you, directser. Is there any Public Comment or any other comment on the calendar . Pardon . Please. Please identify yourself. [inaudible] can we strike the 5th bullet in the april because we are doing it in may . Just want to take that off. That bullet should be in the may . It is already in the may. City plan i see. We just need to get rid of that. Just a point of clarification. Go ahead and make that so, the april 5th bullet should be deleted. It is the third bullet in the may. Translates to that. Alright, thank you for the clarification. Any other Public Comment on the calendar . Hearing none we move on to the next discussion item. Item 11 review funds status for incured about not reported ibr, reserve foru hc. You had before you in the packet this document titled county of San Francisco Health Service board not reported reserves. Eachyear as we begin the cycle we state for public the amounts we are holding as a trust in your incured but not reported reserves for the self funded programs. The three programs we have reserves for for this category of reserves are your flex funded reserve under blue shield, the city plan reserve for self funded city plan which Going Forward is your active and early retirees because the medicare retirees are fully insured with medicare advanlage ppo and delta dental ppo plan. If you terminate the plan at any point in time you have funds on the books to pay the run out claims. The amounts are stated as of june 15. Your june 16 is kaited on page 3. The runchs have not change d and acknowledged and approved by the auditors at the december meeting. They are certified and audited and aprubled by a second set of acwaers. You operate with fully funded reserves and this is informational only. Any questions . Any questions for members . Hearing none, any pubhook comment . Seeing no Public Comment we are ready to move the next item j. Iletm 12, discussion item rchlt review fund status for reserves. And, it is me still. Commissioner sass so adeptly stated in the review a excellent disposition of information on the approved investment policy, you object to legal review. Legal review that you do hold as a matter of practice, apologist approved contingency reserve for excess loss. This is a fantastic liability to cover. It is also fully funded and on your Balance Sheet. The amount allocated and approved by kpmg and here are the amounts that you hold for each the same three programs that you have your reserves because they are self funded you take the risk so if you have excess loss have you assess independent of what you think is good from a independent entity that is acwares an amounts we say under 99 percent chance we will have the money on the Balance Sheet that will allow to cover the risk if we were exposed to loss. The answer is yes. This is fully disclosezed to the public not a mystical number and these are fully funded also so you have this money and it is allocated for this purpose. Any questions from the commissioners . Just one question going fwook had ibmr reserves. The 29 million in the reserve should the Health Service board decide to move away from the self insureed plan and go back to fully insured plan with blue shield or other insuring and replace it is the not true the 29 million is paid out over a 90 day period that would be our liability in addition to a premium on a occurrence based that fully insured plan yep the claims made basis wouldwe have the premium on a new policy as well as 90 pay down . That is why it is maintained, a liability that could be paid in 90 days if we terminate the flex plan . Yes. Just to add a comment. If you went back towhen you paid it out you write it off the books. This is self insured enterprise, you hold quite a few assets for the benefit of the people that you cover. These assets would be erased and on the Balance Sheet of fully insured enterprise if you go that direction. You built a substantial amount of plan assets and sit in very good solid position which every time i get a chance to say this, you are the most volvent policy approved Public Sector enterprise i work for so i always like to say that. We like hearing it. I get gooss bumps when i say that. Any other questions from the commissioners . Is there any Public Comment . Seeing none, hearing no Public Comment we thank you our actuary and move to discussion and possibly action item 13. Presentation of infertility benefit and recommendationism director dodd. As director dodd is approaching the podium i want to acknowledge a letter from supervisor tang that was submitted to the board for its consideration as we are reviewing this item today and she is expressing her very strong support for this item. I wanted to acknowledge receipt of that letter. Thank you. You had a presentation on infertility at the november Educational Forum so some is a repeat. Those that studied it and committed to memory, you can just close your eyes. For those who didnt i do want to go through the technical part of it. The goals for our infertility benefit are provide services that result in a healthy live birt is this presentation available for us to project on the screen . It is on the website so we can pull it up. That technicality is worked on, please proceed. To recognize cull charl diverse individuals have a need and desire to bear children and insure medical treatment reflects the curpt research on the best treatment and medication to insure a healthy live birth. Page 4 you will see a comparison across the three providers blue shields, kaiser and United Healthcare of some the current requirements. Blue shields requires a waiter period. Kaiser has a year or more of attempts. United healthcare has a year or more of unproducted regular intercourse qu woman must be under 35. Blue shield of california provides interest cyto plasmic sperm injection. It isnt mentioned in kaiser or United Healthcare. Preimplementation, genetic determination is covered by all three. This is a genetic test for members at high risk for having embryos with specific genetic diseases. Long term storage varies. Blue shield of california has one retrieval and 12 months of storage per life time. Kaiser has only associated with a gift ibf or zif and one retrieval and 6 months per storage life time. The gift and zif definitions are the same and the cost across the board is 50 percent with the exception of our selffunded plan, which is fifen 0 percent after the deductible is paid. One of the first recommendations that is being made is to change the title of this to infertility and assisted Reproductive Technology because the realty is that for same sex couples it is really assisted Reproductive Technology, not necessarily infertility. On another one of the benefit enhancementi will go through these and if you want to stop me as i go through themthe other benefit enhancement is a requirement for 12 months of frequent unprotected sex between partner thofz opposite sex and to require coverage to include the presence of a demonstrated condition recognized by a license physician and surgeon as a cause of infertility. This comes out of a state law so when the state defines infertility that is exactly how they define it. We recommend eliminating the requirement that remubs the barrier sfr persons of same sex and adding rerequirement with a definition of California Health and safety code. In terms of the age issue, we recommend that we eliminate the requirement of a woman to be under 44 years old to receive the infertility benefit. Elimination removes the age barrier and again compalestines complies on state law with age discrimination. The next enhancement is assisted hatching. As a important part of the process in the furtization of the egg. The unlt of the sperm to pin trait the cell or [inaudible] sfgtv assisted hatching is upgrading the benefit. It hasnt been looked at for 15 years. It was a new technique embryos with a [inaudible] have a higher rate oof implementitation. With assisted hatching a embriaulgist uses micro manipulation to create a small hole and drops that sperm in. We recommend adding assisted hatching as a procedure. [inaudible] invitro fertilization procedure where a sperm is injected to the egg. The single most cause of infur tailty so the idea is to have a good sperm injected directly into that egg. This one is more controversial if you will. It is preimplementitation Genetic Screening which allows the embryos screened for [inaudible] you recall from the november forum that [inaudible] is where there are not 23 sets of chromosomes contributed by the male and female. We want to make sure there are 46 sets of chromosomes and not all embryos are developed with a set of 46. [inaudible] recognizes a major cause of failed implementation these embryos were never meant to be a fetus because they dont have the right number of chromosomes. This prevent the need implanting multiple embryos and reducing the possibility of multiple e births. Note that preimplementation genetic diagnosis is covered for persons with high risk embryos. Pgs a procedure that isnt necessarily approved at this time, but we would like to suggest we approve it when it becomes the standard of care. On the next page you see the single embryo transfer. The process. This is from the American Society for reproductive medicine guidelines. Research shows that 40 percent savings when patients rely on the right treatment paradigm and the idea is comprehensive chromosome screening, single embryo transfer and you end up with a healthy baby. On page 13 you can look at the numbers in general speak for themselves. When you implant with one embryo you have 61 percent of live birts. When you implement with two you have 65 percent of live births. When you imlment with 1 embryo you have zero twins, 2, 46 will be twins. In terms of miscarriage, one embryo you look at 12 percent miscarriage rate but with 2 you have a 20 percent miscarriage rate. Again, preterm delivery, 8 percent with one embryo, 28 percent with two embryos. Total new born intensive care unit days, 80 with one, 373 with two. It is profound different rinse in terms of the outcomes. Birth weight is 34 00 grams versus 2700 grams when you have two embryos implanted and total cost are double when you have two embryos implanted. So, the risk of multiple births higher risk of prematurity and future helthd issues, potential learning challenges as a result as the prematurity. We are able to implant one and have a healthy outcome in 61 percent of those times. Can you state again this for the record the source of this data . The source is from the American Society for reproductive medicine guidelines. This sh it standard of care in reproductive medicine. Can i ask one question. Did the total cost sort of surprised me. Neo natal and icu cost are high so 90 thousand must not include the Reproductive Technology cost to do two embryos versus one. They cant include professional fees, costs of i thought it was low too but we have bay area perspectives on cost and this is a nationalwho knows. You are right, it is probably higher. The only reason i ask because we approved a certain cap and the cap i thrink is going it be reached all most regardless of the kinds of technology because they are expensive. This is a interesting number but the nicu days are not capped. Professional fees pr not capped and all these medicines are not capped. All these things are not capped and so if this is really the total that has one implication for us as fwored members, but if it doesnt include the non cap services then we would need to know that. I wonder what you are referring to in terms of capped . When we suggested a one time benefit of 25 thousand or 50 thousand one time benefit for the services. [inaudible] that is the adoption and sur gaes benefit. Sorry, this is notthey can do this any number of times. They can do it twice per life time and it isnt two live births they get to do this twice. Currently, there is only in one of the offerings it is one shot at it. My mistake. Thats okay. So, 14. So, speaking to that, it is increased the benefit limit to two life time cycles. Not two live birthess but get to try twice and these are the different cycles you look at. We also wanted to increase egg storage up to 12 months. Make sure we have arrangement so if people want to store longer they can. The storage cost are between 300 and a thousand a year andologist have to pay for thawing and getting them to where ever you are implanting them. Available to members. The medical treatment will result in the member becoming infertile. We also wanted to extend that so if for example and this often happens, someone has cancer but they want to make sure they get the eggs out to be stored but will be in treatment for a year, we want to flexibility to make sure that was available. So, enhancements are all on page 16. I have some other data for you. We used the claims database and looked up how many infertility services. United healthcare had none in 2014. None in 2015 and none in 2016. In 2015, blue shield had 15. Kaiser had 57. 2016 blue shield had 35 and kaiser 10 8. Between 15 and 16 the number of infertility treatments doubles. That is for our members. For our members. I want to say that for example assisted hatching cost 750. We are not talking double digit numbers. Adding icsy is 1800 dollars. These are not expensive but they are what is current in terms of the standard of care and if we hadnt improved the infertility benefit in a long time and there are a lot of questions about it and want to make sure it is up to date. It also is a recruitment issue because women are waiting longer till they are older to have children and it is benefit put in all the high tech benefit packages and we just want to make sure it is available to our members. If you went through we could go through them one at a time. Please do not. Or you could just look down them and say you approve all those listed on page 16. I will ask are there questions from members . There is no age limit anymore . The only one who has a age limit is United Healthcare and havent had any infur tillsy service. There isnt a attempt to make the plans uniform . That is what we are attempts to do now. If you approve this is this part the plans . Yes the listing of what they cover will change . Yes. They respond and effect the premium structure but it will be incorporated into our aquil effective 2018. I still had one question. We wanted to extend this and make it uniform, the storage to up to a year. You mentioned for some people they may want to store beyond so they would at risk for the fee but that is available to them but at risk for the cost. They are at risk for the cost and working with a medical provider to figure out if they keep it there or move it somewhere else. Okay. But we only pay storage for a year. Alright. So, i think that we are ready for a motion but like to also be clear what we are moving on. We are going to for our reference turn to page 18 in the presentation. I will entertain a motion to accept all of the items on page 18 and or page 16 and in doing so we will be adding or bringing uniformity to the benefit across all health plans and these changes would be incorporated into the 2018 benefit cycle; is that correct director dodd . Yes i want to opponent out the first point is rename theyeah. Including renaming the benefit and expanding or enhancing these various features. Im willing to entertain a motion to that effect. I move that we rename the benefit as infertility and assisted Reproductive Technology and adopt benefit enhancements as recommended. Is there a second . Second. It is properly moved and seconded that we rename this benefit and accept the and abruv the benefit enhancements listed in the presentation. Are there other questions from members of the board . Hearing no other questions or comments is there any general Public Comment . We have Public Comment. Please approach the podium. Tell us your name and please proceed. Good afternoon, diana cizon a legislative aitd with katy stangs tangs. Thank you for acknowledging and looking alt the enhanced benefits. Spl visor tang is a champion for working families everything from paid parental leave to lactation accommodations and feel the benefits add to that helping our working families decide and provide choice of how they like to create those families. We really appreciate you taking the time and looking updating it and making sure our members have the highest standard of care when creating their families so thaupg thank you for the consideration. I also want to dmote note our letter listed recommendations but left off a couple recommend aigdss including the age maximum so we support all the recommendations on page 18 that were not included in our letter. Page 16. Page 16. You caught it from me. Thank you very much. Thank you. Any other Public Comment or board comment or questions . Yes . I like to acknowledge the work of director dodd and staff for inhanlsments and making sure it is within the guidelines. Make sure we are complying and thank you. I want to acknowledge aon hewitt put in tremendous work and vendors. This is how to get on the same page so improve things working together. With that, we are ready to vote. All in favor of accepting enhancement and renaming the benefits aye. Aye. Opposed . It is reflected it is unanimous. Now, i am going do something very dangerous. I will call for recess for 10 minutes. At 3 20 we thank you for being very timely with our recess and we will now move back to the regular Board Meeting. We have gone through finance, governance, rates and benefits and flow now back on regular agenda items for this Board Meeting and this is action item 14. Thank you. Item 14, approval of Health Services system 2016 annual report. Director dodd. Thank you. In the interest of being brief, i will call your attention to the info graphic on page 4 but i will tell you a lot of work going into putting into the annual report each year and i used it for a presentation yesterday in the adaptive business and people were just in ah how much we do. If you look at page 4 sfgtv. If you look at page 4, you actually can see since just 2012 increase since member lives. It is steep curve. We are spending 11. 1 million on administrative cost and that is to serve overlooking at medical plan enrollment. This is from january of 2016, those are the numbers, but it is to sunch over 114,000 people. There are a couple brokers and employers and they said you do all the benefits administration and that is your budget and i said yeah. Most large employers and even small and midsize contract out the administration of benefits and we do it internally and do it very well. This tells you how much the employer contributes, how much the difference employers contradicted to the trust and how much employees contribute. We administer 28 plans from 10 different vendered and have over 10,000 annual enrollment transactions. 500 annual data inquiries. 28 public meetings. 72,000 open enrollment packets are mailed with 12, 600 unique visits to the officer during open enrollment. Those are just by the numbers. I think you all because you get the mupthy report realize the Wellness Program blasmed and ihighly regarded throughout the city and that we are really using our membership, we called it a activist payer committed to higher value, we use the fact that we are a big elfent elephant in the room when we get together with other employers we say we can demd better and for less and the issue of trance paerns continues until we convince sutter to make the claims transpaernt. We can only point to kaiser as the model for participating in transparency. As soon as sutter does it everyone else will do it. Looking ahead, as you know it will be a bumpy course depending on what happens with the new secretary price assuming secretary price is confirmed. I think we are likely to see the biggest changes in medicare, which will effect our budget greatly our members and will require very facile policy change to keep the programs running. Where there any questions about the annual report . Any commissioners have questions or wish to provide comments . Im impressed with the detail and the breakdown and i think i feel as a commissioner that had preparation for some the issues that jump out and getting back to page 4, one of the issues it doesi just lost it one of the issues that jumped out is the medical cost for kaiser versus United Healthcare versus blue shield i think. And that despite the difference in membership, that there is differential in terms how much money is spent in different places and your graph below thati apologize i lost the page. Page 4 but i am not in the presentation. It shows that it is not because of inpatient cost, it is outpatient and where is that. Where are we spending the money in that sector. Because the pharmacy is relatively similar across the plans. Im impressed by this and it does show where the challenges are. The United Healthcare 42 and blue shield [inaudible] part is we are dwooing more things on a outpatient basis but you are right and pharmacy remained the same the last three years at about 30 percent but no less 30 percent is a lot. It is a page that tells a lot of stories. Are there other comments or questions . I like to thank you dr. Dodd and staff for the report. I am more than impressed and in ah with what you have done. I think it is a lot of hard work putting this through. It is exhaustive process with all the statistics and information and all the numbers that you have put in there considering with the limited number of staff and we have over 113,000 employees that is a lot of work but you [inaudible] i commend you for all your hard work and thank you so much and it is hard we increased by 7 thousand members, a 13 every year yee have been here. It is kind of ah inspiring. Especially the wellness and done a excellent. Service to all the members. I get to give the report, the staff dhuz work. Thank you. Commissioner sass. As alwayss, it is a very professional product and comprehensive and complete and wouldnt expect anything less from you. I wanted to just take a opportunity here to join in thanking you for not only for the service but over the 17 years i worked your service as a commission for department of Public Health. Your services for init mayor as the health cairb person. Mayor nusem and then your service for the department. You are a great example of excellence and commitment and it is a pleasure of my life to know and work with you. Thank you very much. Thank you. Any other comments from other commissioners . I would then generally on behalf of the board want to not only commend and thank director dodd for this outstanding report, but she continues to point back and put the finger behind her, it is sth staff, it is the staff and that is her coleaders are here today. Deputy grigs and deputy len,