nevada. there were no discussions until 2011 and council district 167 said they'll not agree to a rate until they see the transparency. eventually, the two sides met but it's a confidentiality agreement so kaiser wouldn't reveal the details but i'd like to see the process. if they're not able to

of this city and say we're not going to answer your questions, we're going to go ahead, try us and leave it at that. thank you. >> next speaker please. >> good afternoon supervisors, my name is gus. i wanna say that whereas we've seen reluctance and initial reluctance to provide the needs that the committee was seeking of works are actually going down and whereas we both have seen kaiser taking disturbing stances on statewide legislation, i'm concerned about the approach that kaiser is taking with the city. the

notion that an advance by this committee to request that kicked off their health insurance, that does that indicate a good faith attempt by kaiser to work well with the city. we heard representative say earlier they want to move closer with the city. that sounds like a threat to me. if that was a result, that would not be the action of this committee resulting in hundred thousand plus people being taken off their insurance, that would be kaiser. there is room for a deal and a fair deal. one thing we heard from speakers earlier today and

representatives from kaiser themselves, we are seeing rate increases throughout the industry. kaiser wants to grow, but so do working families in the city and as rates have gone up in all sectors, it's been workers within organizations and definitely true here in the city sunday county here in san francisco have been asked to subsidize those increases. their paychecks are getting smaller as /kaoeuzers /pros my

name is stephanie lions. i'm here to say as a member of kaiser, a resident and taxpayer of san francisco and a retired city employee, that you talk about thousands of kaiser members -- i'm one. my husband is facing surgery and cancer treatment in the next several months. i can only say that while i agree with all discussion that's going on, there have months of negotiations to get to this point. surely this discussion could have taken place before the deadline loomed this close

so i do urge you to start this process earlier next year, but please, please do not disrupt the contract process. there are thousands of kaiser members with issues and medical conditions and children and family members who depend on kaiser and kaiser and watched it go from a small imperfect system to a much better provider. so please move this forward and urge your colleagues to vote for it. we're already going through a lot as families, don't put us there anymore. thank you. >> thank you. next speaker please. >> good afternoon. members of the board of supervisors, my name is fred, i'm a broker here in san francisco. as a lot of you board members know, i represent about 1200 small businesses and i just wanted to say i just pulled up on google

about trends and this trend on healthcare before we talk about loss ratio, is running about 6.3 percent to 7 percent. that's just for inflation and on top of it we discuss loss ratios. i appreciate what ciu and the unions are doing because i represent a lot of people who are not highly compensated. i appreciate what hss is doing and these board members to try to make things transparent. i want you to know i work with a lot of insurance companies and a few years ago when my clients were having difficulties a lot of us brokers met with kaiser. they helped us with a lot of carriers that were increasing their individual products for individual people at 28

percent, kaiser listened and made it a lot more competitive for a lot of our members to join. i currently insure about 2000 individuals, represent 1200 companies. just go on line and pull it up and you'll see what trend is. 6.3 to 7 percent. and kaiser is really doing a great job to retain your rates and keep your rates competitive, but i know one thing. they have learned from this experience, and i know for a fact that given the opportunity, kaiser will continue to work with you and try to get to the point where you guys need them to be at. so i urge you to renew this contract. >> thank you very much. next speaker please. >> jean thomas, retired city

employee, 84 years old, 30 year member of kaiser plan. i really related to the last comments. if anything happened today, i think it's that kaiser has come down a bit from its state of not giving information and the hss board has very carefully delineated that they want to work with them. i think we can go forward at this point. please move this package forward to the full board. thank you.

>> thank you very much. are there any other members of the public who wish to comment on items 12 or 13? okay, seeing none, public comment is closed. we have these items before us today that we continued last week. i want to say a few things as the member of the health service board from the representative from the board of supervisors, do appreciate all the dialogue that has gone on the last two weeks. it is a conuation of dialogue that we've been having with kaiser and all providers over the past number of months of this year and something i know that will continue. i will say two things in particular. one, the commitment and the dialogue around transparency -- i have a huge commitment towards that and it's something starting with or discussions -- that is something we need to mandate,

we are all locked in arms about that as employers of city but also our employees. the resolution that the health service board passed out unanimously is a resolution regarding transparency that will be before the full committee shortly. and i reiterate that i continue to work with our city attorney's office regarding legislation we can do at a local level that will make a true difference. second, i do want to make clear that i think it would be a huge mistake if we didn't accept these rates. i am one that am not willing to play football with peoples' healthcare and put tens of thousands of people healthcare security at risk

simply by rejecting these rates. i think there's a time and place and i think we've seen that there's a commitment at the commissioner level and staff level. that is very apparent to me, not only as sitting on the board and here in committee that that commitment for choice transparency is very real. i think it would be a huge mistake for us at the board of supervisors to put all these kaiser members at risk. i think it's something that would be a huge mistake and something i'm not willing to do. i appreciate their different perspectives on this, but i want to state my comments very clearly and where i am. i hope we can send this forward today to the full board. supervisor moore. >> i wanted to thank lisa and greg for if the great work and

all the staff in the hsf and the health service board members for being here. it's been a real learning process. i've been a kaiser patient for 50 years. i'm glad to see that kaiser is managing the costs for different things. i did want to say that i think we're doing our job as a board to ask questions. i still don't have all the answers and i still would like to see more in writing, but i'm very pleased from kaiser that within this last week -- i'll say it hasn't been two weeks. it's been one week since this item has been continued and we've seen come improvements. i appreciate the communication so i understand the system better, the competitiveness of multiple plans and also the kaiser reps i met with and i've appreciated the learning about kaiser through the years. i really

appreciate the openness and a stronger commitment for transparency and accountability. we're working on our local san francisco ordinance and i really applaud supervisor ferrel and senator leno's efforts. hopefully we'll be working with you to encourage more transparency for the whole healthcare system. i want to acknowledge the work of public employees and community groups that have raised the questions from the hs boards meetings 'til now. i'm still

not totally satisfied with what we've come up with, but i'm hoping as this comes to the full board we'll have more written down so it's a clear process of what we the city, and kaiser will do to move forward to make sure it's a fair rate for 2015 as well. i wanted to thank everyone for coming out. for those that are kaiser members, like myself, and i'm sorry to hear of the health issues that some testified about, but my hope is to move this forward with no recommendation today and hopefully at the full board we'll have more written down and commitments so we can move forward. i wanted to say it's been a learning process for me to understand the negotiations of our hss staff but also the deliberations of the health service board. i appreciate

the health service board members. a lot of what you do is really driving kind of the questions that i have. i still would like to know more of how the profit margin is addressed and how the rate setting process is finalized, but i see us as a board -- this is our job to make sure we have the fairest rates and that's why i think as a board member, this has been an issue i've raised with many others from the community. thank you. >> supervisor avalos. >> i want to acknowledge the work of the hss board in negotiating with kaiser and rates. i know i did meet with

kaiser yesterday. i wasn't totally satisfied with the measures of transparency they were offering. they seemed more perspective than what was really -- we were asking for last week was to get into the gist of the 5.25 percent or 3.84 percent if that's what we want to discuss outside of the apa fees. i was looking -- a friend of mine sent me a message about oklahoma where in oklahoma city hospitals are posting surgery prices on line and they're creating a bidding war and the prices are coming down. the oklahoma city surgical center is offering guarantee all inclusive prices

on line. doctor smith and doctor steven [inaudible] almost 15 years ago founded on the simple principal of price honesty. healthcare doesn't really cost that much. what people are being charged for is another matter all together. when we get to the gist of things is that healthcare is not a right, it's not -- it's a privilege and it's a profit that's made on that privilege and i really appreciate the questioning of that profit. if it's a non profit making a profit, it's something we need to question because overall we're seeing the costs increase all across the world where we don't see universal healthcare as the norm. i'd like to get there some day and i think doing our part is questioning how the private sector is charging us on rates. i do appreciate the work that sciu

ten to one is doing. call it bank man ship. i don't know. i think we question and look at how we can get the best offer so far. i don't believe we have it and i'll willing to forward these items to the full board without recommendation and see in the next week there's something else that we be offered to us and i do hope so because i'm not prepared to support at this time. thank you. >> thank you colleagues and everyone from staff, commissioners, members of the public, labor representatives for being here. we have a motion to forward this item without recommendation to the full board next tuesday and we can do so without opposition. mr. clerk, can you please call item number 14?

>> item number 14 -- hearing for report on the outcome of the [inaudible] process for the budget of analyst services. item number 15: clerk of the board of supervisors to commence services. >> i know we have miss [inaudible] here to speak. >> thank you supervisor ferrel, supervisor mar and supervisor avalos. the board directed a competitive process in 2008 that would competitively bid for budget and legislative

analysis. harvey rose and associates, newman and louie received the highest score at that time and have held the contract since then. the contract is now set to sunset december 31 in the current year. i'm here today with our administrative deputy for the department to review with you that process. there is a companion item -- a motion that would have both respondent's name in the motion title. the committee at the end of this hearing could delete that name of that they did not wish to forward to the board for tuesday's consideration. with that i'm available for questions. miss landis if you would provide the overview. thank you very much. >> thank you angela. good

afternoon. deborah landis, deputy direct to have of finance for the board of supervise /sorbs. i have some slides here today and you have those in front of you. i want to touch on only a couple slides. we don't need to go through the whole thing, but in the overview of what we've been doing, i want to point out we've been working on this rfp since december since the board directed us to go out with an rfp so it's been seven months of hard work and we are here today happily near the end of this rfp process with a recommendation for you from our panel. looking at the timeline, today is a key date, but we will be moving forward in the next several months because contract negotiations will take several months to complete once you do further recommendation to the board and once the board chooses that vendor for us to use. so right now we are on schedule to be able to have a contract in

place january 1. that is our hope, our plan and at this point we don't see why that would not happen. moving forward i would just like to thank the other departments that have worked with us, particularly oca, the contract monitoring division and the city attorney's office, paula. all three of those offices have been really instrumental in helping us through this process. i want to point out that our panel for this process is comprised entirely outside of city employment. looking at the scope of work, i believe you all have that and are familiar with it. generally budget and legislative budget analysis. the c proposal is one area we wanted to point out in detail. in the r fp we have proposed an initial term of

four years, 2 million dollars /p-r year, so four years and 8 million dollars. we're proposed that when we enter into the contract negotiations we have up to two additional renewals and we're proposing each for two years so the total full potential as described in the rfp would be up to 16 million dollars and up to 8 years. just a little bit before we get into the recommendation of the panel, the scoring was done by the expert panel that were people outside of the city and the written proposals were scored separately. i wanted to point out that the cmd has asked us

not to publicize the actual scores until the contract is finalized. with that, the panel has recommend that based on the total scores we move forward to enter into contract negotiations with harvey rose. if the contract negotiations are not successful, then we recommend following up with second place, which is management partners. you can ask any questions you like, forward the recommendation to the full board. we're happy to respond to any questions you may have now and hopefully we've expressed briefly, but enough so you can move forward.

>> i'd like information offline about management partners, more information on who they are. i know supervisor max well had raised some questions about in-house -- we used to have in-house legislative analyst office, but i know that previous supervisors had asked if the clerk's office could think about a plan that would be more of an in-house budget and legislative analyst. i'm wondering if you could address that. >> absolutely. as you know earlier in the year prior to coming to the committee in december when the committee directed us to go out with an rfp, we did think about going with the in-house analysis. we are planning on doing a more in-depth study. if we do go into this contract, we have more of a buffer so we have

this window where we can really explore other cities, what their costs are, their services, whether it's in-house, whether it's contracted out and do a much more in-depth comparison. that was part of the direction we got last fall was to move forward with a new contract and when that was in place, do further study. >> any further questions? okay. thank you miss landis, much appreciated. at this time we'll open to public comment. seeing no public comment, it is closed. mr. clerk, i believe we will [inaudible]. do so without objection. as to item number 15, let me -- i want to thank our clerk of our

committee and board and office for all the work. i really have come to respect the hard work and dedication of mr. rose and his team and think they do a great job for us and i'm very happy for that recommendation to the full board and we'll very much be supporting this. so i believe we need to do an amendment to strike management partners from line 17 and line 24. so can i have a motion to do that? we do that without opposition. and then the underlying item as amended 24 do so without opposition. can you please call item 16. >> item number 16 [inaudible] to implement and alternative bid process to award contracts to certain contractors to

provide preconstruction design services for the [inaudible] expansion project. >> okay, thanks. >> good afternoon. edgar from the department of public works. the ordinance before you -- we're seeking the approval for a specialized contracting mechanism to hire sub contractors for the design phase. we typically hire after the work has been designed and put out to bid. we're looking to hired contractors to provide construct ability reviews. this project is going to go under major ex/papblgs expansion and the work will take place while the work is