health care and lives are at stake today with this vote. if we don't was this, thousands of people will be forced to move doctors and primary care providers and so forth. as well if we don't pass it out by next week, on second reading we do jeopardize open enrollment and other issues with regards to beginning this system. i do want to recognize my colleagues supervisor mar and avalos for discussion over the last few weeks. a number of unions involved in these discussions and questions and i want to recognize, i see a number of the health board here and i don't know if i'm missing someone, but i want to thank them as well as as the staff, the incredible staff that i'm learning to appreciate more everyday from our health care system. i know gray sacs is

back there and a special thanks to catherine day to kath -- dodd who has been instrumental in our health care system and one of the most effectual leaders in our city departments of driving a real meaningful change in terms of our health service rates for our current and retired members. catherine has been on medical leave for a number of months now. very pleased to hear that things are going well. catherine we missed you so much at the service board. i want to thank you for being here today. i know it's such an important matter for you and i want to thank you for all of your work on this matter and also to give you the opportunity to talk. i know that you have been watching by your bedside over time as this dialogue has happened over the past few weeks. i want to give you an

opportunity to speak about it. i know there has been confusion and different statements about what would happen if we didn't pass these rate increases. i think it would be great to give you the at some point -- to speak about this. also, it's great to see you doing well. it's yat to have you back. >> catherine dodd, intermittent medical leave. just got an e-mail from my doctor saying the ct scan we got this morning, my spleen has shrunk. i'm in very good space. i want to thank you for attending the board meetings and all the members of the board of supervisors. this is the first time the board of supervisors has stepped up and learned about how complex our rates are. as you know, with health care reform they have only been

made more complex. i'm very proud of the rate package before you today. it represents the 2 years of work in the county care and represents your decision to take on risk by flex funding blue shield which has kept the rates down. i think it's important to point out that the city's cost are only increasing by 0.7 percent. i think anyone would jump for this increase rate in the country. for employers when you include vision and dental, their rate is higher because they have few people in kaiser actually. their's is 2.3 percent. still lower than the national average, lower than calipers and saving the city tense of millions of dollars over the years and as well as saving our liability. i want to recognize

as the supervisor ferrel, elisa, when i got diagnosed stepped up and has been running as fast as she can. we wouldn't have this package without her and greg sacs come back from retirement. i'm in a stable period right now so i'm glad to be here. your question about what would happen, we couldn't have vendors without a contract and we can't have a contract without supervisors board approval. we are required bylaw to notify people about their benefits and rates that they are going to pay, and we have a penalty if we notify them late. working backwards from open rolement, there is not time to immediate that deadline to have

actual analysis. i'm confident that kaiser is not going to change their business model for one employer at least not this year. when more employers join together perhaps they will. we can't meet those open rolement deadlines, if that happens, 108,000 people will not have coverage. we anticipate 52,000 angry phone calls from kaiser members who will be losing their coverage and having to move to blue shield. the specific question in terms of what about patients who are currently in treatment. i will just speak for them since i'm the voice of one right now. when i come back from a stem

cell transplant where kaiser refers us, i will need to find a new doctor, hospitals demand that transition people's lives are lost and jeopardized. if we fail to do this today and if we make thousands of people move out of kaiser. many people's lives are at stake. not to mention many of retirees who have been with their doctors for over thirty years. i want to assure that the service board has been working on transparency. i urge you to pass this package today. they have already begun to meet with kaiser and set up negotiation for the first week of august and we'll keep you a pprising of our progress. i want to

thank you for your support and encourage an aye vote today. >> thank you, colleagues, i mentioned earlier and i think it's a great sign that we ban -- as a board here and talk about transparency. long-term this is going to lead to a better understanding so as a driver of any future rate in creases as to tackle our retiree health care liability. this is a big deal across the board in somewhere in city as well as an employer as well as all of our employers focus on that issue. i look forward to that continued dialogue. i know there is some other comments or questions, but catherine i want to say welcome back and i'm really proud of where you are. >> thank you, supervisor ferrel, supervisor mar? >> yes, i want to say thank you

to have our leader katherine dodd is here today. i want to say they have been amazingly patient with my ton of questions. if supervisor avalos and i had not raised concerns and held this up for a week, we kaiser with much stronger commitment with transparency and accountability and increased commitment to a stronger wellness practice that includes nurses, flu shots and more research for our city that will benefit our members as well. and the efforts to work earlier in the process so that we have fairer rates for 2015. so my thanks to the hard work and coming out of retirement. and the amazing work of elisa as well. i want to say that we wouldn't be in this situation today with stronger commitments

and hopefully a better rate for 2015 without the persistence of public employees in our city that raise concerns about the profits that were shared with the health service board and the health service system and asking questions that kaiser was not answering. i think the process over the past month has been wonderful for me to learn as a 50 year kaiser patient myself how the system works but also how it's our job as supervisors and public employees to raise questions and also to answer why the rates are going up so much. i'm really appreciative that kaiser sent top level providers to meet with us and came to the budget committee meetings and made an effort to apologize for different statements made in the past and making stronger commitments for transparency and accountability for the future. besides the 11 of us

signed on and thanks for the leadership of supervisor ferrel and the 11 of us signing and passing this today, it's another piece of this effort as to senator at the state thatten insures this from other providers as well. i want to thank those that stood with me to raise tough questions to kaiser. i want to thank those that have attended the budget meetings. commissioner lynn and scott and others as well as the wisdom from supervisor and commissioner ferrel as well. i have learned a lot from this process. i think we'll have a fairer rate in the future. without efforts to ask tough

questions to kaiser we wouldn't be in the situation we are in today. i'm willing to support this and want to thank the staff for their hard work. >> supervisor campos? >> thank you very much, mr. president. i want to thank everyone who has been working on this for quite some time and certainly to supervisor ferrel who represents us on the board. i want to thank him for his advocacy and thoroughness and how he looks at the issue that comes before that body. i also want to thank supervisor's mar and avalos and our partners from labor from sciu who have raised some important questions about this process. one of the things that i hope is very clear to kaiser today is that while we may have differences of opinion among ourselves, that at the end of the day, the

city as a family is unified behind making sure that we do right by our workers, by our employees, by our retirees, what ever differences we have we are going to make sure we get the best deal possibly for this city. i would like to talk about a number of amendments that i will make to the resolution in the hope that with those amendments we can have a united front and we have a unanimous vote here at the board of supervisors. i think this can move forward and to highlight the amendments because we have to take public comment before we move before. i want to look at key things that i'm recognizing and i'm recommending change. one of the

things that this language makes it clear is that the health service board directed staff to pursue immediate negotiations with kaiser to prepare a contingency plan to place city employees and other high quality cost-effective plans in the event that rate negotiations for 2015 do not produce the desired the results. i think it's the responsible thing to do. the appropriate thing to do for us to prepare for that contingency. the health services board would be asked on this resolution to build upon the process that they have already created of consulting with public employee unions and retirees of the system as they formulate objectives for the negotiations. i think it's important to be very clear about that. that what we see here and i think there is always something positive that comes out of challenge is that it really has brought a number

of parties together. and that this staff report back to the board of supervisors. and of course it makes it clear also that we are in support of the piece of legislation that senator has introduced. i wanted to leave this last piece to the end because it's really important to me besides thanking my colleagues, thanking our labor partners and i forget to mention paul kumar who is at the result of these investigations. i do want to highlight the very important role that catherine dodd has played. and quite frankly catherine, you know, things get crazy in the last couple of weeks before our board recess. the best news that i have heard in this whole time has been the fact that you are doing so much better. that to me has been the icing on the cake. i have met a

lot of public servants, a lot of government workers, employees, amazing people, but i had yet to meet someone who is you are passes you and your fearlessness, your dedication, commitment, tenancy and i really think it is fair to say that you have saved the city millions and millions of dollars and one of the things that i think kaiser needs to understand and i really believe this, that, but for catherine dodd, i don't think that this item would be going through today. and i think it's a testament to the integrity, respect that she has on all sides that we are going in this direction. so, my hope and i'm hopeful is that we will end up with a good result as we move forward, you know, kaiser has done some good things. my mom

is a kaiser member, she loves kaiser. they treat the workers well. but at the end of the day, this city is not used to being told what is good for this city. we have to come to terms and understanding on our own. we like to see data, we like to see information. it is not enough to trust what they say. we have to verify it. so my hope is that in a year from now whenever this item comes back that we will have seen the fruits of this labor. because if that result is not there, the same people that are standing united today to support this, will be united in finding an alternative. thank you. >> supervisor yee? >> thank you president chiu. councilman, welcome back. nice to see you. i really appreciate your comments. as supervisor campos was saying, your words

are more important to all of us here and we know how you say these with integrity. with all of these things that you mentioned, these are things that i have been thinking about prior to coming in here today to weigh the by vote in regards to what would happen. i think it's important for us to take your issue point very seriously, but at the same time kaiser really needs to take our concerns and our perspectives from the board of supervisors very seriously and be held accountable for the rates that they are asking for. so this is fair warning, i guess. this is really what it is and that if we are not satisfied a year

from now, we also need to have alternatives. i always want to say that i want to thank kaiser for reaching out to the board of supervisors at the meetings and also meetings with individual guest supervisors, their explanation why i was reading with them this morning helped a little bit with regards to why they have made certain decisions. at the same time, understanding that a year from now, those decisions may not be accepted. the other thing i want to say is that, while we are asking kaiser to be transparent it would be fair

to ask blue shield to do the same thing. although they are higher, explain to me why it's higher. maybe this discussion has taken place in the past, but i'm not part of the past. i would like to hear more of why their rates, the other two providers rates are so high and whether or not we can include even more vendors in this. there are individual vendors that can be part of this system. so, once again, i'm ready to at least for this year accept this resolution. >> supervisor kim? >> catherine, i think really good to see you here. i just want to appreciate you being here. during the past couple of weeks when i think many of us were debating this issue, i

kept asking where is catherine dodd, i want to speak with her. i want to concur with supervisor campos that so many of us trust your leadership because we have seen you fight, we have seen you take unpopular positions because you believe in our city and sound fiscal decisions while saving us money and building a healthier population here in san francisco. there is so many things wrapped up in that. i just want to appreciate your work. i want to acknowledge you and i do think we need to congratulations that we are only seeing a 0.7 rise in our health care cost. we've been seeing our cost come down and when this came to my office, i said what happened and why is this coming before us.

particularly with kaiser, our population is younger and health ear and their usage is going down by as much as 15 percent. but i think with the information that you presented, i'm happy, well, i will be supporting this today. and i also want to recognize our community advocates and labor that have spent a lot of time also trying to raise awareness around this issue. this isn't just an issue in san francisco. this is a statewide national in san francisco. i want to thank those that have pushed accountability that kaiser has made more. i'm going ask them to publically justify their rates. this isn't just a fight for this city. this is

something that i know that our ally has done. they have been working with cal state insurance commissioner jones to push for more transparency, looking how to cap rates and looking for things that actually miss dodd let's the efforts around with blue shield last year. i look forward to working with hsf. i tried to serve on the group, it's because of you that i'm incredibly fascinated by this issue. as we work with cpnc's and now with kaiser that wants to expand and in my district in mission bay, i think it's important and vital that we continue to have that discussion and we grow in san francisco. >> supervisor breed? >> thank you, i really

appreciate the time and effort that all of my colleagues have taken to review this matter especially on the budget and finance committee. i think one of the things we need to and supervisor mar to make sure that we are asking questions and looking at the details. i also know it's not our job to micro manage the department. however, i find a lot of waste, a lot of abuse. i see contracts come to our board of supervisors for millions of dollars and no transparency is looked to in terms of those contracts. i think it's important that our city take a look at those contracts and what are these businesses that are walking away with millions of dollars of city money, who are they hiring, how are they giving back in general, that is

really the conversation that we need to have. as it relates to kaiser, i do have of course the utmost respect for the department and the fact that we do need to move this item forward and support these current rates, but i also appreciate not only the resolution that we are moving forward today to talk about transparency as it relates to kaiser, but i do appreciate my colleagues amendment supervisor campos because, you know, some of the words that he's changed in these amendments clearly make sense. i guess part of what i wanted to ask was because i know we have just received this today, are there, are we looking at supporting and moving this amendment forward, are we looking at making these particular amendments and moving this particular item forward as well or are there concerns about it.

>> supervisor avalos? >> because this item is without committee reference in the agenda, by virtue of being amended today it will continue for 1 week and we'll vote on that. at the same time if there is a first vote of approving the rates, the second and final vote will take place next week and that will be at the same time that we would take a final vote on this item 71. >> great. i just want speak to the amendments, i think they are great amendments and we need to move forward. we also need to pay real close attention to the other health care providers and have them made accountable in the same way. i don't want to mention the over $10 million that the president and ceo make. it not my decision to start to say what salary one 1 person should make over another, but $10

million compared to most people who are kaiser members and what they are taking home and how they are spending significant money in regards to health care, we need to look at the whole picture and what it means and how we can make the right changes for employees and not where we are given information and we have to make decisions otherwise it's threatening other people's health care. this is important to making sure we start earlier. i'm definitely interested in finding out how we plan to move forward especially with other health care providers. also i would like to say with miss dodd, actually before i became a member of the board of supervisors, your actions, and you keep a smile on your face, i know you are dedicated to your worked and you worked to transform to get the city the

best rate possible. i have no doubt that you are doing an effecti job and i definitely want to be supportive in this process and also being supportive of making sure that san francisco is getting the best rates possible moving forward in the future. thank you and look forward to supporting the resolution as well as the other items we have before us today. thanks. >> thank you. supervisor breed and unless there are other comments, let me say a few quick words. i also want to thank everyone for your hard work on this. i don't think there is anyone in this room that would want to see the train wreck if we voted against this measure, but i know that we have many deep issues with regards to the kaiser rates. i want to thank the kaiser employees for meeting with our office and with each other, i want to thank catherine dodd, because of you, and your

colleagues, without this many of us would be inclined to vote against this. i think it's pushing towards accountability. i want to reiterate what you heard from many of our colleagues that if these issues aren't addressed, i think next year's conversation would be more difficult than next year. all that is being said, as supervisor campos alluded to. we will take public comment. we have a lot of hearings and i would like to resolve this at this time. unless there is any objection, i would like to ask for unanimous consent to move public comment just on the kaiser matters so we can vote on it after public comment and let everyone here with relation to kaiser to be here. without objection, madam clerk let's

start with public comment with reference to kaiser. >> if there are public members wishing to speak on kaiser item 71. please come forward. >> otherwise, if there are no members of the public. please step up. >> jane kennedy, retired san francisco unified school district teacher and kaiser member for 40 years. $10 million from the ceo? the things you learn from the board of supervisors meeting are heart stopping. i commend you for putting some bricks to it. the free enterprise system to me seems to be completely out of whack and i could not for bear my shocking reaction. thank you for the assessment. >> thank you. next speaker? >> hi. i think it's important

to know i'm not shamed of my age. i'm 82 years old. i have been a member of kaiser since 15. if you take away my kaiser, i might as well go over the bridge. i have just had major surgery. i cannot be jumping from one doctor to another. i have to have my kaiser and i'm not alone. absolutely not alone in these feelings. help and make sure that kaiser doesn't disappear. i need my kaiser and i'm sure there are many people in this room that feel the same as i do. please don't throw away kaiser. kaiser is a major in this city. please. if i say anymore i'm going to start crying.