that some of what the city has been saying is that they are concerned about loss of service for our kaiser members. well, i heard kaiser up here say that their goal was to not have any break in service and that the real question is what are the actual rates are going to be. that's what we are saying. the rates should not increase to $15 million. that's what we want to happen. we want kaiser to come to their senses and understand that they can't just have a blank check from san francisco. first they have to give us information but second of all this is unconscionable. i also want to point out that the person that talked about with the charter amendment says that you have to continue to provide health care, well, that goes to what kaiser just said

that they would continue to provide health care. then the other concern i have is it sounds like that you have to vote yes. well, what's the point in having to vote yes. what's the point of this whole process if the supervisors have to vote yes. this is a democratic process. you can say no. that's what we are asking you to do is to say no. this is completely unjustified. another issue brought up, let's not do it now, let's do it later. i don't think it's a difference. it's the same process with the same time lines and the same process that's going to come up. you need to take a stand now. >> hi, i'm a retired city employee. judy. the speaker

brought up that we can continue kaiser and what i heard them say is that we would make some arrangements if that happened. i also heard other people say that they factor, the law will go into plan one if you don't pass this. you have no option to put the whole group into plan 1 whether they want to be in kaiser or otherwise. so, i think you have a choice between passing this through and dealing with the problem later or having everyone go into plan one. the labor unions have other options too they are not bringing up. they can do a caesar chavez no grapes boycott, kaiser end up in one blue shield and why a boycott makes their point very clear and bring kaiser to the table

with that sort of power play. i don't know much about all of this, but that's all i have been able to gather from the speakers. >> thank you. any other members of the public who wish to comment on this item no. 7? >> public comment is closed. >> do you have any questions? do you want to comment? i know there has been a lot said. i want to give you the chance to take the mic again. >> thank you, i really appreciate all the voices here and i think the frustration and i think anger with kaiser is very well voiced. i think that medical needs of our membership in kaiser take precedence however and i think that the decision to potentially mo away from kaiser can be made in 2015, made in a way much more

responsible to the people that are receiving care by kaiser now. in 2015 if a plan is not resolved, we can close enrollment to kaiser for future enrollment or to allow the choice to bring cost-effective alternatives that members can opt into if they choose. i think that's a more prudent and responsible approach to this problem. >> thank you. just a question for you. and i agree with all the sentiment today. thank you for showing up. the ones that did, i appreciate that. in terms of process, i think we can do a number of things. we have about a week with the full board here that we are in

committee that we can hold the committee and continue it for a week. we have to buy this time schedule pass it out on the meeting by this month. if we do not do that, it would have to be sending it back and directing it to try to negotiate a better rate with kaiser and that would include kaiser because they would have to repackage. would the board of supervisors have to provide direction to do it with kaiser, i want your direction on that implication? >> i think we would expect guidance from the board of supervisors if they are going to reject this rate package and what it is they would like to see as the revised rate package. that will not come

until august, depending on the request. i think i just want to echo the sentiments of the health service system one more time to say that disrupting the care for 40,000 members is something that no one supports. it's one thing moving thirty thousand members from blue shield to city care. that has been done. those are the same physicians, just a different insurance company. this is completely disrupting care. your lab values, your doctors, your primary care physicians, all of your care now has to be reestablished. it such a tremendous disruption that it would be ill advised to do that without a tremendous amount of planning. >> okay. and again, if there is direction to do a plan without

kaiser to come back, because the board rejects those rates and perhaps the direction would be if we can't get a decreased rate to come back with a plan without kaiser. >> we have put blue shield on notice that that might be coming despite our objections and they are ready to prepare a rate for this board and plan a as well. >> so we would have one fully in insured plan as well as the blue shield plan. to be clear, though, because of the 2 percent cap and the reimbursement we receive and i think there is a difference if you want to call it subsidizing rates or not. the current blue shield rate would increase, though? >> the rate for blue shield have moving the kaiser people into blue shield would have to be reevaluated and reset. i'm

not prepared to say if it would be higher or lower. it would have to be completely reset. the membership in kaiser is younger and healthier than the membership in blue shield. >> okay. at that point in time we talk about the competition of the service board, we are going to deal with one provider for the city. >> that's correct. in terms of the cost to the member, the mou's are still in existence which say is pegged off kaiser and the blue shield rate is higher. exactly how that would work for 2014 is a real question. if we don't have kaiser, how do the mou's work. >> i obviously share and express more forcefully my expression and opinion as it relates to the kaiser health service board meeting and share all the sentiment about how this has gone forward. i do

think what we don't have in front of us today which i think would be helpful if we come back to this committee, if you look back 10 years, if you start from the same point in time, when blue shield was increasing rates 15 percent and #16 percent a year and kaiser was 5 percent or less, to take a snapshot down the road is quite a bit ignorant without looking at the history and to say just one time we are not doing anyone a service here. i'm not saying that i would like to see one rate staying relatively flat and the other rate going up by 5 percent. you look at that objectively on a piece of paper, you say why? that's the question that's being asked at the health service board and that's

looking at what's been done. to look at at the historical perspective is completely misleading. i don't think we should be making decisions in terms of that perspective. my perspective and now this is the health service board with a lot of members, my gosh, someone with i consider almost a guru and someone i rely so much on her opinion with decades in city hall t way to move forward is about transparency. i introduced that same resolution here at the board of supervisors. they will be in committee in a few months. i think we need to push the envelope in city hall. i would continue to lead on that. but i

think, that down the road is to lead to lower health care rates and cost. that's the shared goal across everyone's perspective. we join on that as a city employee and employer and members. i understand we may have a difference of opinion today, but from my perspective taking a knee jerk 1 month rejection of rates after a 60 plus year relationship, 10-20 lower rates despite other health providers, i think it's the wrong decision without a doubt. i'm absolutely convinced of that. to me it's a long-term process. you don't just shift providers. it's doctors, it's seniors, young people, families, everything. to change doctors is so

disruptive. you can't plan that over night. i imagine you don't come up with an another kaiser in 1 month. it doesn't happen and it doesn't exist. colleagues, open for comments. i want to hear the final thoughts right now. that is my perspective. i share all the sentiments from this perspective. the way to handle is in a different approach. we need to be responsible for taking care of the big picture as it relates to all of our members. to me the emphasis is on the members and not disrupting that at the same time driving the long-term lower cost. we are going to vote on the full board next week. this is about driving the liabilities down. i look forward joining on that and doing that together. >> supervisor mar?

>> i wanted to appreciate supervisor farrell's expression of frustration of this process and expressing the long-term view that was brought up. i want to thank catherine dodd and the health service system for all the work to make sure that we have the best plan for our city. i want to say too that i'm a lifelong kaiser member and feel that despite the thrive marketing and other stuff they have kept me healthy and my family as well. i don't treat lightly the 40,000 members with this decision. what i'm still frustrated about is questions from health work commissioners and scott and many others and not adequate answers or transparent answers

from kaiser. i want kaiser to return to us to fully support their 2014 premium rate request. i want to see it based on union members utilization by full data. i do feel that kaiser made a representation that they wouldn't dump people off the roll and they would work something out. while it may involve some costing issues. the threat of putting people's lives in jeopardy is not as much as i was concerned with earlier. as kaiser says there is time. my hope is by continuing this item, we buy ourselves more time with kaiser to give us that information so we are confident to make the

best choice. i want to thank everyone for coming out and acknowledge the work of the health service board and the staff for their work. i don't want to jeopardize people's lives. i'm appreciate iv of the comments from everyone here. i recommend we move this item to the call of the chair. >> although kaiser said they would continue coverage, we would not be able to pay them. the city would not be allowed to contribute the amount to kaiser until we had a contract with them. so it would be a very tenuous agreement at best. >> i did want to add then, i'm fully supportive of supervisor farrell and other folks that

require transparency that reach at the state level in a draft of 2015. i feel we have to make a strong stand today and that's why i'm moving to continue this item. >> one comment was around we can just continue with kaiser. i want to be very clear on a few perspectives. maybe from our controllers office, without a contract, how would we get billed and how would we pay? what do we even pay? >> mr. chairman, members of the committee, without a contract, the controller has no authorization to pay. in fact, we would not pay if we did not have a contract. we are correct

in that area. we have the ability to continue an existing contract but that would need to be amended and an approved to continue beyond the plan year. >> okay. and at the same time in time, if it wasn't agreed to to be continued or amended, we would not pay, but at a certain point we'll be charged if they continue to provide health care for our members. >> a contractor does not have the authority to provide services to the city without a contract. and so, the contractor in this instance would take that chance or that liability upon itself. we could not authorize the services to be provided without the contract. the contract is the mechanism by which we make an agreement with a vendor to

provide services and to issue payment and to purposely not have a contract would not be an option. >> okay. so come january 1st, kaiser, if they provided service it would be complete risk of non-payment? >> that's correct. >> unless we amend the current contract. >> we would need the agreement of the contractor. >> you don't think that maintaining the health care for 40 thousand people in san francisco is not incentive for doing that? >> that is a question of the contractor. >> i would think that it is. >> it's not just amended the contract. we need to know what the rates are now so the rate guides are sent out by this month. it's not just a question of waiting a few months to see

if they are kicked over in the contract. those rates need to be figured out now. it's unfortunate that they have not been successful in object obtaining a rate from kaiser now. from where we are now in making such a decision the legal consequences in doing so is going to take time to figure out. so health service system needs to be able to figure out what the rates are for a time in open enrollment. it's unfortunate that kaiser has backed itself into a corner or for whatever reason because they set rates at a statewide level because they feel they can not move for the city without negotiating with other compliant. that's basically my understanding of why kaiser is not going to move. i could be wrong. if you are going to make

it a decision of this import where you are seriously looking at telling the health service system to just come back with a blue shield rate and to get rid of kaiser, that type of decision is something that just requires so much planning and so much i think both actuarial work and other considerations that it's very little time to do that. >> thank you. i do want to acknowledge your work on the health service system board as well as the work from health service system. i think it's really incredible to look at how we obtain cost over the years over the work of miss dodd and your staff. that's been remarkable to see. i do understand that we have had huge increases on the blue shield and blue cross side over the past decade that were well

above and beyond what kaiser was and also says a lot about blue shield and blue cross. now we are looking at increases that kaiser is proposing and not backed by data. we are seeing increases that now it's kaiser's turn to say it's okay to have increases. i don't think that makes a lot of sense either. we don't like increases that are high period. i would be supportive of continuing to the chair and maybe we can get something worked out in a week in terms of getting information that backs what kaiser is doing. i would be happy to hear this at this time. i don't know if i would support it or not. i think another step in the process is actually hearing it again in committee if we have

data from kaiser, great, that could give me a sense of what i would really be open to voting for and i'm willing to go forward for the next week without blinking. i want to thank people from the public for being here, people from the union for being here. i was very happy to see is that local 21 leadership were in the mood as well. that's representation of many workers and employers of san francisco. that's very helpful to kaiser and very significant that folks from those unions were here. i would back supervisor mar's motion to continue to the call of the chair. >> okay. if we do that, that's fine. just to be clear, i will calendar it for next week. again to remind my committee members, to remind kaiser and the whole service staff, we have a full week. if we don't

have it to vote, we are not going to pass it out. this is very real. this is no longer theoretical. this becomes very practical for thousands of people. so supervisor mar, any comments? >> i want to thank the kaiser reps being here and hope there is some dialogue with hhf. i think it's important for transparency and data to back up. >> a motion to move this without opposition? so moved. blah mr. mr. clerk, please call item no. 8.

accepted and expend grant hilltop park lasalle and whitney young. >> good afternoon, supervisor, i'm with the parks and recreation capital division. it's to make improvement to hilltop park. it's located on the south side of the city. the land and corporation with the department -- hold on a second. >> ladies and gentlemen, can you please keep it down. >> the spring of 2011, the public trust and land led a series of public workshops to develop an exceptional proposal for hilltop park for a statewide grant to fund improvements by that process by

that community. in spring of 2012 the state awarded $5 million. the states department started preparation in the design construction agreement with the land to allow to accept the plan and design a construction of the project. the agreement included the $110,000 to improve the management cost for the parks department and environmental review process. the parks and recreation will grant the proposal and require accord with the restriction of the property. the department will maintain and operate the park at the public space for a period of 30 years. property restrictions of this nature has been in place for many years

for state and federal funding programs and was recently formalize this process. the department recommends to accept this project. i'm available to answer questions about the grant agreement and i have a representative from the trusted land regarding the process and proposed improvements. >> okay. thank you, colleagues, any questions. thank you very much. we'll open this up for public comment. anyone wishing to make a public comment. move forward. can i take a motion to move it? we can move it without opposition. >> please call item no. 9.

>> the clerk: agreement san francisco municipal transportation agency commercial paper program not to exceed $100 million. >> good afternoon, we sponsored this commercial paper program. it's pretty exciting for us. we are examining authorization for a hundred million dollars for needs. as part of that we are asking to approve 5 different documents to support this commercial paper program in issuing a paid agreement and dealer agreement, fee letter and commercial paper note offering memorandum. the mta board has an approved this item and it's subject to your

approval. it was issued and the bank won the bid. there is a reimbursement agreement that covers ir -- letter. the overall fee for the program we expect it to be $600,000 a year. the rates are favorable for us. at first year about a hundred million dollars, with $600,000. the hundred million will be used to finance the projects for capital projects in the mta. for example subway,

procurement and other needs. the budget analyst did a comprehensive report. so i won't repeat the information of that report. but i'm happy to answer any questions. >> colleagues any questions. >> can you call item no. 10 with this? >> the clerk: agreement tax exempt and taxable lease revenue commercial paper certificates of participation not to exceed $100 million. >> thank you. director of public and finances of the controllers office. this legislation authorizes an increase of about a hundred million from $150 million to

commercial certificates of participation. we are also asking that you approve the form of documents as it relates to the reimbursement agreement as well as letters of agreement and we are asking that you allow the city agencies to access the program as an example, the port of san francisco, is a smaller agency and does not have the resources to implement their own program. also, we would also ask that as you know the program is set up such that the board has to approve the long-term financing to set up the program. we ask that you allow the use of the program in the event of emergency on the section 3.100 for the city to access that program