>> please stand for the pledge.

>> pledge of allegiance. madam secretary, item no. 1. >> roll call. vice-president lynn, ferrel, commissioner scott, fraser. lane. expected. we have a quorum. >> action item no. 1. >> action item approval of modifications of the minutes of

the meeting setforth below 2013. >> are there any corrections to the minutes? >> second. >> any public comment on this item? >> okay. all in favor say, "aye". >> aye. >> opposed? unanimous. >> item no. 2. >> item 2, discussion item president's report. >> as you can see we have dr. dodd back with us today. i'm happy about that. [ applause ] and in the interest of time we'll move on to item no. 3. >> item 3, discussion item, directors report.

>> lisa got pee. directors office. we are very happy to see her today. we have some very good news on the personnel front, our well ness manager is starting on december 9th. her name is now stephanie fisher because she was married last week. she'll be starting december 9th as our wellness manager. we are interviewing the compliance manager and our service manager position closes on monday and we'll start interviews on that as well. we have hired an 1844 to work on our contracting team. actually for the first time in 3 years that i have been with health service system, we lost one of our 1210's to mta. one of our

super star ben fits analyst. we'll surely miss her. moving on to operations for beginning of december has been delayed to mid-january because of the law library also went in on our building and pushed us back a month. we have a significant enrollment. i would like to ask our manager to give that presentation to you. >> mitchell gregs members service manager. the open

enrollment summary is contained in the presentation just behind the directors report. for the sake of time i'm going to put the slides i'm going to review here on the screen. the open enrollment summary for october 2013, we received 6580 applications this year. this is an increase from back in october 2012. probably the reason for that is for plan year 2013, we had a short plan year just prior to that. so we had two actual open enrollments in the prior year 2013. and in the fiscal year we had 7,000 applications. that's probably a pretty average number. at the time of presenting or preparing the presentation we processing

861 applications. as of today we are 72 percent processing the 8423 applications. the typical responses as you can see on the presentation. the calls and in person assistance. we had 2052 calls. that is a 5 percent decrease. however the speed fell sharply. that says a couple of things for last year and this year. last year at this time we were about 5 weeks into the implementation of the system. the analyst are answering calls and learning how to navigate the new system and they need four screen systems to answer calls. that's one reason. this year it probably shows the questions

were shorter, easier to answer, less significant plan changes. we are getting the navigation down and good communication materials for open enrollment from hss. the in person assistance was down 22 percent for the same reasons i mentioned. on the next slide, our open enrollment events were the same this year as last year. we went to city hall, laguna honda, san francisco general, and unified school district and the airport. we went and took applications and answered in other departments. we went to the an heche open enrollment along with the hsf director. the abs employment

specialist helped us with the management cafeteria plan to remind them to turn in their changes. on the next slide it's showing a comparison of applications we received this year versus last year and as you can see at the end of the month is when we get all the applications. the next slide is an open application processing compared to the applications we received versus what we are able to process at the end of that day and we process into 2 weeks of november. one thing i would like to note in this slide issed red asterisks. there are four 1/2 days where we are unable to process because the system is down for payroll processing. we have three of those in a biweekly basis in a

month. on the next slide, it's showing you the typical inbound calls for the year and that is very similar to last year. the last couple of years where we had open enrollment in 2012 and 2011 you can see the calls increased in those 2 years. as i mentioned the speed of call to answer the people are not waiting too long. we were able to stay under our goal of 30 seconds this month for open enrollment. the next slide of the abandonment rate. we were able to stay under our goal of less than 3 percent. i'm going to move on to the last slide that's in your presentation binder. just a couple notes about some additional notes about october 2013. as we mentioned in a couple board meetings we have

done some work in changing the people configurations and how we do enrollment with the management cafeteria plan. so we've been working with that configuration entering them for the first time and so far very little, no significant errors and minor little errors but nothing significant. we had processed at this point over 430 ncp changes. some procedural changes for the management cafeteria plan as well with exception of flexible spending accounts. mea members did not have to enroll in their voluntary benefits. they automatically enroll as the prior year. we still make sure they understood, you don't have to reenroll but if you want to

make changes you can do it by 31st. the confirmation letters we are still entering. we decided to go ahead and release the retiree population confirmation letters. the school district and ccd confirmation letters. we finished that processing. we will be releasing the letters by midweek next week with the act to follow. that concludes the summary that i have unless you have any questions. >> i'm going back to the people

soft being down. given the currency of websites, can you give me some assurance that this is in no way impeding in getting people enrolled? >> it does impede us to some degree particularly this 83. -- year. it goes down for the active payroll processing and it's been down since noon yesterday and it will be down on a thursday prior to a pay period, pay checks being printed on tuesday. this is the first time. we've been at this for about a year. we are behind in processing on enrollment applications this year about a week or so. this week, we had a holiday on monday, we are down today and we were down

yesterday. we only had part of the day on tuesday to end and friday and coming in saturday to catch everything thing up. it does push us back. in a month that can be four 1/2 days total. that's a lot of hours. >> yes. with that in mind, do you have a plan as you get closer to the drop dead date. i know you have to get these names to the health plans and your tapes have got to interface and be accurate. are you planning through that? >> yes. we are planning, basically all the changes that we entered. we have a 60-day advanced notice of all the health care carriers. as we are entering them, they are getting the information now. with the exception of flexible spending accounts which we'll do in mid-december. we actually do have time. our biggest concern is the first pay period for

2014 because we need to make sure the deductions are correct and people have the right enrollments and right premiums. that starts december 20th. we want to make sure the confirmation letters are out and people may get there and they may need to call un. -- in. we are looking to have all the confirmation letters out before thanksgiving so they can take the 4-day holiday and look at their letters. we'll be working after 5 to get that done. >> we are assuming it's beyond your control to influence the process of it being down. is that correct? is there anything that i can say publically that would help you? >> yes. it does impede us in

getting things done and in answering questions when people call getting changes at that time. we have to save these types of changes to people's accounts until we are back up on a friday, for instance. again, this is active ccsf, cc and the retiree groups were able to enter. we were told by the controllers office that in time when they start narrowing that we'll be down for the payroll processing. >> will that be next year versus this year. >> they are telling us in 2015. >> 2 years. >> dr. dodd, i think commissioner scott what you are asking is should the board make a request to the controllers office by next october. the processing, that we should be able to process everyday of the

week at least from october 1st through december 1st. that should be one of the goals because clearly i know the last 3 years even before the people soft implementation, it required us to have over time which is an extra expense to the city and it certainly would save the over time dollars in terms of getting things processed and if we don't have it this year, we'll have over time as well. you have people working hard in the 85-day period and it's really unfair to expect them to put in evenings and weekends because the city can't figure out people soft. >> if we are going to make a formal request, it maybe that it's completely down or maybe it's down for half a day versus the whole day. i recognize

these systems implementations are always bigger than god. there are ways that we can say we want full processing everyday in open enrollment for 2013, but for 2014, we don't want to be down completely all day for two or three 3 days in a given week or two 2-week in a monthly payroll cycle; whatever it is. i think we should say something about it if we can. >> it's usually three pay periods in october. that makes it, so you are down, instead of being down three whole days, you are down four 1/2 days. >> so, i guess i raise the question about how do we make a request to the controllers office? >> that is the question. >> can we request the director

draft a letter for us to endorse? >> what do you suggest? >> we are using the right language. we don't want to in insult anybody. but there is an operational need that we need to address and that is a concern to our members and we need to express our views on that. >> well, i appreciate the board looking into that. >> thank you. >> the next item hs communications. we had a video and it was a huge success and looking forward to doing more video communications. also i want to make sure that we talked a little bit about the member survey which is behind

the first blue tab in your binder and it's a survey of what members valued most and what their concerns were and any other comments. i think what members reported valuing most was affordability, no. 1 was the most common. and also the security of having benefits for their family which is also i think a universal value. in terms of concerns it was cost and best doctors and best care. there is information here and if anybody has any comments or wanted to talk about. but the other thing in terms of concerns was the retiree dental benefit which we heard and talked about which is not giving our retirees not enough

coverage. we'll be talking about that in detail at the december meeting about delta dental and by our actuaries. and where the high tech is occurring and there was some very interesting insights into trends for 2013 self tracking the little -- and other devices people are going mainstream. i guess that's the word that people are using. and open data for people to make better decisioning. that was a finding of 2.0. and employers are looking at wellness in a much expanded definition in stress and care giving and financial help in things that help

employees be able to focus on work and not be having to deal with a lot of things at home. payment reform is another issue. then i thought the other part that they talked about it, health 2.0 was to think about the seven deadly since of health care. too much testing. management systems, electronic medical records that don't share data. that getting the message that it's not your data that you can't have it and that we don't do a good job in handling life care and families members in that time of life. it was interesting to hear that technology was talking about that we all talk about in health care. i also wanted to mention the health care finances is

completed and also in the wellness i wanted to point out that we did just a massive biometric screening at the hall of justice. 267 employees had bio metrics screening. what was important about this is that, i think this is in the slide in the wellness section, there were 361 people where their blood pressure was above normal. there was a lot of people that didn't know they had underlying cardiac risk who found out for the first time at this screening. this is an important kind of activity. it reminds me, we lost and amazing librarian last month. a 51-year-old woman who died of a heart attack. this kind of activities that everyone knows what their risk and labs are is important to prevent that. that brought me the importance of

the wellness activities. i also wanted to point out the wellness resolution that is cl you had -- included in the packet itself. the staff, it's such a foundation component of wellness and looking at what the chp services should look like in the future and that's a rewarding activity to go through that. lastly i wanted to talk about meetings and presentations. we had at the board of supervisors on november 6th, there was a hearing on health care transparency. i was privileged to be able to speak on behalf the joint labor management task force or transparency and accountability in health care which is a collaboration of many of our union leadership from the city and hsf working

together towards the common goal on getting transparency around health care cost and health care quality and access issues. i think it was very rewarding to one, have this kind of a public hearing on such an important issue but also have some amazing speakers there talking about the challenges and how it is really the only way for us in terms of solving health care problems. last i wanted to mention a letter that was put into your packet late. this was a letter from local 21 thanking hsf for working on the contribution models that will help support the affordable and sustainability. it was nice to receive a letter. it was much appreciated. any questions?

>> i would like to thank the communications department for their leadership on the informal survey. as you know i had advocated more at our last meeting. i did have a chance to review the questions before they were sent out and i thank you for that. i think this survey should be a part of our on going process of outreach to try to get more firsthand on the ground reactions about what we are doing and my hope of course next year during the october hiatus that we may do something more formal. thank you. >> dr. dodd? >> thank you, elisa. i wanted to just underscore one thing and thank supervisor ferrel for

his leadership for calling the hearing on transparency and say we are the first local government to really tackle this and hopefully our leadership will have other local cities and counties fall into line. i think margaret's work with the treasurer's office on the healthy city and resolution by supervisor ferrel and passed by the board increases our liasons with the public employees. we are the leaders and it's great to be not only out in front but including other public agencies. i wanted to publically say when we were in the old prop b hearings or c hearings, but the unions made it very clear that they didn't want to have one health care at the civic center, they wanted us to take things to them. we did four health fares and 17

flu shot clinics out and about the city in different departments is amazing. if we are not thanked by the people who asked us for it, i want to point out that we did it and saying thanks for responding to our request because we did it in a big way. lastly, it's listed in our report and i want to highlight the women's collaborative because you know the women's cancer rate of women firefighters is much larger than the national survey. they received a $600,000 grant to do biochemical screening on 90 women firefighters and 90 women city employees who have similar

demographics to the women firefighters. this will be the first in the country, probably the first in the world long-term study of firefighter chemical exposure and we'll be working on recruiting control subjects and did ask could they be commissioners, if the women commissioners wanted to be biomonitored in terms of what chemicals are in your body you are welcome to participate as long as you are over 18. i think, again it was the leadership of our department that pulled them together and got this started and got the huge grant. it's again the first in the country. if anyway if our department is leading on transparency and looking at the risk factors and even in my absence, i'm really proud to be associated with our work. thank

you lisa and staff. >> supervisor ferrel? >> thank you. thanks to katherine for the comments. i want to sup date everyone. i know there were a number of commissioners there. thanks for coming. we did have a hearing on health care transparency in the budget and finance committee that i chair. i just want to echo what catherine said and thank elisa and all the unions that participated in that and the care providers and insurance providers that came to the table. it was our talk with kaiser that prompted all of this action. it's one whenever we all agree where data transparency is something that we believe going to the future is going to be a tool to help drive down health care

cost. i will bring it to this body when i have it but we'll have legislation in the coming months that will empower the hsf board and the staff to demand if there are providers that want a contract with hsf in san francisco to require a certain amount of transparency and open data. it's going to be a good thing for all of us. i want to bring this back to this body for sure and thank you for your support. >> commissioner lynn? >> i would like to acknowledge supervisor ferrel for his leadership and supervisor mar. i want to say thank you. >> dr.