also wants to take the opportunity to thank the mayor, supervisor chiu, and supervisor cohen for their dedication in finding a solution that understands the complex nature of how businesses utilize these accounts to meet the mandate of the health care security ordinance. the increased access to health care and minimize job loss. on october 3, the small business commission recommended approval to the board of supervisors with supervisor david chiu's legislation as is. today, you received the recommendation from last night's meeting that we recommend the amendments that supervisor cohen has put before you. we thank supervisor cohen for accepting two of our non- substantive amendments. before you is a well-thought- out solution that publishes the goals of increasing access to health care while minimizing job loss. the office of small business has

consulted with many small businesses, and the small business community recognizes that it is a stakeholder in providing meaningful health access along with noticing, reporting, and finds that the two-year accrual basis rollover will accomplish the goal in improving health access, and the commission strongly in forces the amendment. the small business community also recognizes that the january 1 will poll is a critical issue and must be addressed as soon as possible. the commission thanks supervisor cohen and david chiu for incorporating the recommendation to insure this issue is resolved beginning with calendar year 2012. in conjunction with the broader community, the sbc finds ending this condition promptly is essential to providing meaningful health care access to employees. the remaining amendments the

small business commission support. i and the commission are also committed in working with office of labor standards enforcement as we implement this legislation and monitor businesses so they are utilizing the hra's and work with businesses to increase access to health care. in closing, the small business commission urges you to support -- to support and vote in support of the legislation today to ensure that workers are covered and able to access and utilize their health reimbursement accounts. thank you. supervisor chiu: thank you. why don't we start our public comment on this topic? if members of the public wish to speak on this, please line up on the right side of the chamber facing us. why don't we hear from our first speaker, please? >> thank you, president chiu and

board of supervisors. i am a member of doctors for america, a physician activism group. as independent organizations committed to analyze the impact of policies and protecting and improving the public's health, the equal health network and doctors for america strongly support healthy san francisco. the program is important for providing coordinated health care for women who often work in service sector jobs that typically do not offer health insurance including restaurants, health care, child care, and non-profits. a small number of employers deliberately misappropriate funds contributed by customers that specifically cover san franciscans for the health care they need, averting consumer payments designated for health the san francisco back into the pockets of business owners is dishonest and a violation of our trust.

at a time when there is national agreement that the lack of health care coverage threatens uninsured employees, the practice also shows disregard for the workers who are denied care as a result. employers do not deny that they are subverting the intent of the law and the good will of their clients by paying into health reimbursement accounts, which they used to offer severely limited health insurance products to their employees. they claim that seizing such a misappropriation would be harmful to the economy. the majority of the city's employers to recognize the economic as well as advantages of using the money to help the economic security of low-income san franciscans. we urge the board of supervisors to reject the amendment engage seriously in an initiative to make sure the funds are used as intended, to provide health-care coverage to san francisco workers. thank you. supervisor chiu: thank you. next speaker.

>> hello, board. i wanted to step forward as an employer who is charging a surcharge, as many of the restaurants in the city are, and does put all of that surcharge toward my employee benefits. i am shocked and offended that so many restaurants that i go to have a surcharge at the bottom of their menu, and if you ask your server -- just try doing this -- ask your server, "do you have health insurance?" most will say that they do not or that it is only four full- time people. i asked if they have reimbursement accounts, and they will say they are not sure or have not been told how to use them. it is fraudulent, and my business has been completely comfortable financially with what our $1 per person charge. we have been able to provide full health insurance through kaiser, completely paid by the business for everyone that works even one day a week.

we provide full dental coverage. a 401k with 4% match and two weeks sicklied and two weeks vacation. with the other businesses are doing with that money is beyond me unless it is just going in their pockets. i just do not see that two years of time to spend money that you are not aware you have is going to make any difference. my business is largely staffed by people where english is not their first language or where they feel intimidated to ask for what they are owed. i do not think expanding this one more year so that they can accumulate more that is going to be taken from them is in any way to their benefit. i ask you to turn down the legislation and consider a way that would really close this loophole and give businesses like mine that are doing the right thing if their footing in this city. thank you. supervisor chiu: thank you.

next speaker please. >> i would really like to commend the previous speaker. i am a worker. we need more business owners like her. the problem, as the situation stands right now and as the proposed amendments would make it, is that she is placed at a competitive disadvantage for doing this. these amendments do not fix the loophole, and they do not help me as a worker. if anything, the possibility of a legal challenge places the amendments as having the potential to make the situation worse for me as a worker. it does not matter whether it, january 1, a rolling year, as long as employers have an incentive to take the money back, they will. right now, they are taking 80% back. i am working for my third catering company so far this year. the employees do not know about this benefit. i asked my boss. i asked my boss' boss pierre

they told me it does not exist. i ended up getting health care reimbursement by marching into the vice-president of hr's office and demanding it. since then, i filed a complaint with the city. the company filed a complaint with a lawyer. they are spending a lot of money on a lawyer to say they did everything right when they did not do everything right. because they have an incentive to keep the money, it can be a lot of money, and it is not fair to business owners that give their employees health care to be placed at a disadvantage for that. as long as there's money on the table, employers will want to take it back. i am the only native english speaker at the restaurant, the only one who is college educated, and the only one who would just march up and say, " hey, give me my money." these amendments do not fix the problem for employees who do not have a voice. the money needs to be there to stay to get employers an incentive to give health insurance or to tell them about the reimbursement accounts.

without that, there will always be an incentive for employers to take money back. this does not fix it. the money needs to stay for the employees. thank you. supervisor chiu: thank you. next speaker. >> i work in the intensive care units. every winter, we have people who are young, have small children and were brought into our intensive care unit because of septic shock caused by systematic threat of infection, which is often developed by a simple conditions such as pneumonia, lung infection, or flute -- flu. if the condition is severe, these patients often face death. life-threatening illness can be avoided if those patients could visit a clinic to get antibiotics or even if they could, in the er before

completely collapsing appeared however, most of those patients hesitate to come in for a very long time because they could not afford the $3,000 for the visit. instead of getting medical care, they just hope for a full recovery, which does not happen until after weeks of hospital stay, or sometimes it never happens. it was heartbreaking to see young wives or children at the bedside in fear of losing their husband or father. it is always painful to see these because i know this could have been presented by a single er or clinic visit. their lives could have been saved if they had access to affordable health care, which i believe supervisor campos' legislation will provide. as a bedside nurse, this will affect so many lives in san francisco. i hope we will have universal

health care in the near future, but illness or injury happens every day. it can happen to anyone. we should save one life at a time. thank you. supervisor chiu: thank you. next speaker. >> afternoon, board of supervisors, president chiu. ♪ they work hard for the health care so hard for it, city so i hope you treat us right we work hard for the money and health care so hard for it, city and i hope you treat 'em right and some have worked for years and they have lots of health care security fears they work hard for the health care so hard for it, city

they work hard for the health care so will you please treat them right and when will we see good health care once again ♪ thanks. supervisor chiu: next speaker. >> i will read mine. jim lazarus, san francisco chamber of commerce. we thank supervisors chiu and cohen for presenting the amendments today. we have attempted to reach out to the labor unions and supervisors since last may to work on alternative to the original proposed language, which would have resulted in a $15 million tax, mostly on small businesses in san francisco, putting many of them either out of business or having to reduce their payrolls to meet a cash

mandate that was required by the original legislation. we cannot say that this version today is perfect for every employer, either, because if you are an employer with narrow margins, having to put in effect up to three years of money away per employee is going to be a hardship for many employers and have an impact on business, but we understand the need to put in better notice. we understand the need to clarify the provisions and make them enforceable. we understand the need to provide a rollover january 1 of every year. we understand the need to create more certainty that benefits will be available that employers can afford, and that is where this debate is falling on deaf ears. the vast majority of employers do what they can do. but either insurance is not available because they're part-

timers and are not covered, or they do not have the cash for an actual cash outlay. the accrual system most businesses can live with, and we look forward to working with the board and city departments to implement the amendments that are proposed today. we thank the supervisors and urge their support for the amendment. supervisor chiu: thank you. next speaker. >> small business owner. i come to support supervisor chiu's legislation with supervisor cohen's amendment. quite frankly, small business sees 24 months as a long time, but in the interest of trying to find a compromise, the small business community has come together and supported that. we abhor those that are making surcharges and not giving back to their employees.

we are as offended as everyone is by those, but we do think this addresses those issues. it is a balance. it provides notification. it provides a 24-month rollover, and we think back -- that this is something that will be good for the employees' health and keep money in the economy so we can create jobs. thank you. supervisor chiu: thank you. next speaker. >> julie fisher. i live and work in san francisco. i have worked at the same place the last 26 years. i had the good fortune to half affordable health care, and i applaud the efforts that have gone on so far to make this available to more members, working people of the city. you're supposed to today's amendment. i support supervisor campos. i hope everyone will look closely and remember who will benefit here. employers, the few that have not

been fair and equitable, should definitely be address, but i want to say more than anything that having health care allows me to do my job well, to be an active part of my community. this is some of the goals for you today. thank you. supervisor chiu: thank you. next speaker. >> i am one of the vice presidents of the labor council. i am also one of the founders and leaders of jobs with justice, which is a coalition of labor unions -- 10 labor unions and 15 community organizations. the label -- labor council and jobs with justice feel that these amendments are worse for the workers than the previous loophole was. these amendments basically will hurt the workers, and that is our key element that we look at. how will it hurt the workers? it will begin to shift workers and employers back into these

hra's, which are the cheapest form of health care under our health care security ordinance. so it will be natural for these 20% of these employers who are violating this health care security ordinance -- it is only a small amount of people who are doing this. for this small amount, they will continue to look for the cheapest way to go forward, and the cheapest way is these health care hra's, and these hra's will lead to not any better health care for the workers who really need them. $4,000 or $5,000 a year is not enough to pay for any kind of very large medical bill. so this money needs to be rolled over. as the worker himself said, any time there is an incentive for the employer to give back the money, they will look for a way to get back the money -- any

time there is an incentive for the employer to get back the money. we urge you to look again and work with the supervisors who are interested in closing this loophole. thank you. supervisor chiu: thank you. next speaker. >> i am speaking on behalf of lee's deli, several restaurants in san francisco. i would like to applaud the intent of cohen chiu's legislation. there is a consumer fraud issue and a contribution issue. i do not think anyone disagrees that a restaurant is charging 4% for healthy sf that it should go to healthy sf or summer. i think you could pass that legislation with or without the contribution, so by all means, past the first period when dealing with a contribution issue, i agree with the intent of supervisor chiu and cohen's legislation.

but i appreciate supervisor campos' position here in one word or two words that bothered me was irrevocably designated, which is a term in ira accounts. i feel like using that word is treading very close. the second part of my problem with this legislation is the alternative provision. if the meat and potatoes of the legislation is ruled unconstitutional, then the alternative provision, which businesses are against -- that bill comes into effect. i feel it is sorted disingenuous for this legislation to say, "look, accept this, but if this is wrong, we will give you something worse." thank you. supervisor chiu: thank you. next speaker.

>> good afternoon, board of supervisors. thank you for your time. i am a bridge fellow at the asian law caucus. i am on -- here on behalf of the caucus to urge the board to find a different and better solution to close the loophole in the health care security ordinance. we have a workers' rights clinic for low-income individuals, and we council our folks on a wide range of employment issues. we also provide representation through direct services on wage and hour claims as well as unemployment benefit appeals. a vast majority of the san francisco workers to come to us our modeling will or what is known as lep, limited english proficiency. most work in the restaurants, hotel, retail, construction, transportation industries, and they perform back-breaking labor every day. however, almost all of our workers lack health care, lack health insurance for themselves

or for their families. they are constantly struggling just to get the wages that they have earned. a lot of times, what ends up happening is that the idea of health care kind of falls to the wayside. they can only fight so much. for these same workers, the promise of the health care ordinance has been a critical method of securing some measure of health in -- insurance for these individuals and their families. while the caucus appreciates the good intentions behind the amendment before the board today, we believe that in order to truly address the problems with the local, we have to close it entirely. it is not enough to extend the expiration window for funds placed into expiration accounts. we need to ensure that the health care expenditures required by the ordinance are actually used for employee health care needs. we recently had a worker come into our clinic, and she had incurred a health care expense,

and she was trying to find a way to pay. her san francisco employer -- [bell rings] supervisor chiu: thank you very much. next speaker. >> good afternoon, supervisors. i am here representing our workers said that represents young and immigrant restaurant workers. we are also a member of the progress of workers alliance, which is nine centers in san francisco that represent different communities and different industries. as you know, we have worked on the issue of wage theft that many of you -- not many, all of you took the pledge to end wage that -- theft. this is also a form of that. these hard-learned dollars are not going to cover the medical cost for medical needs that they are entitled to. as a worker center, day in and day out, we see cases where

workers are coming in where they do not have access to these hra's. employers have the incentive to make it difficult for them to not access the accounts or not use the funds to cover their accounts. at the end of the day, we have to think to what lengths are we going to waving workers' -- waiving workers' health and well-being. there are a few businesses that do their fair share and other businesses are not following in their steps, so we are here to oppose this amendment today. thanks. >> good afternoon. i am with the chinese progressive association. we are proud members of progressive workers alliance as well as jobs with justice. i am here to urge you to oppose the amendment being proposed by supervisor chiu and cohen to

the health care security ordinance. we know that right now, there is a debate going on in this country about the 99% and the 1%. there is a debate going on about the future of our economy and the economy needs to serve and how the inequality perpetuated by the 1% is trickling down to crush and keep down the rest of us including small business owners and workers. i wanted to see a show of hands of supervisors -- who here would like to have an hra as your primary form of health care. anyone in the audience who would like to have an arra -- an hra? you should not ask that of your lowest paid workers who are already struggling to pay their rent and survive and raise their families in this city. this is a time we should be coming together as the 99% to fight against the 1% and call for a fare economy that addresses our real economic needs and the needs of all families, not proposing and

passing false solutions that fail to address the real issues and even worse, hurt workers and take us backwards from where we are right now. the member i told you the story about last time i spoke to you on this issue had appendicitis, did not even know about her health care benefits, and had to rely on charity care for her interest -- this did not solve her problem. in fact, it gives her employer an incentive to fire her because she has been there and will have two years accumulated, and he could just recover the money after three months if she does not spend it. we want to close the loophole in a real way so that every worker is allowed the same rights and every employer place by the same rules. we can fight together, the 99% against the 1%. thank you. supervisor chiu: thank you. next speaker. >> good afternoon. i owned a small business, restaurants, in san francisco.

i am year to thank supervisors cohen -- supervisor cohen and president chiu for their amendment that i think are a good compromise of where we stand on this issue. i would like to stick up with the previous speaker left off. i do not have hra and i would not want to have it, but the insurance companies put a limit of 20 hours a week providing insurance. that is the threshold. anyone that works less than 20 hours a week -- and there are many -- do not have any way to be injured. i do not charge for the health initiative, and i provide health insurance. last year, i had a serious accident. i am still paying off many of the bills that my interest did

not pay, so why are we putting small businesses in the same category of some big corporations, big brother that is just out to get -- all the restaurant owners i know, and i can name a lot -- they care for their people. they do the best they can. they work their ass off and i resent the characterization that small-business owners are out there to take advantage of anyone. we are not. i support supervisor cohen and president chiu's amendment. they are okay, i guess. supervisor chiu: thank you. next speaker. >> good afternoon. i am the general manager of escape to new york pizza. i am here to support supervisors chiu and cohen's amendment. i look forward to a manageable

and survival solution to the loophole. we have been going up around and around, and some of the solutions have been unsustainable for my business, and some have been unacceptable for the employees. i am happy to hear and see something we can live with. no solution presented prevents or mandates that an employee in san francisco joined healthy san francisco. they all can do it regardless of what might benefit is. i encourage any of my employees that i cannot give full-time health insurance to to join healthy san francisco. they can use their hra funds for that or not. that is their choice. i cannot make it happen. there is a perpetual conversation about a level playing field and the intent of the law. original intent was to provide health care access. i am in full favor of that. i do whatever i can. an unending pot of money that might pay for part of an appendectomy will not hurt as much -- will not help as much as

an encouragement for employees that need it to use those funds to join healthy san francisco or get a policy with kaiser on their own. the level playing field is a myth. healthy san francisco covers 4000 out of 50,000 employees. let's just get a rational compromise that all businesses can manage and survive. thank you. supervisor chiu: thank you. next speaker. >> good afternoon, supervisors. i am the executive director for the golden gate restaurant association. i do want to remind the board that the folks that we are talking about, 30% of which that are using these -- 30% of the businesses that are covered under the hcso use health reimbursement account in some fashion. that is about 900