>> we have tough times in this room or at least i've had tough times in this room a few months ago, so i appreciate that we're here and we're enthusiastic about working with lisa and the hsf staff and the entire board on our next renewal and on transparency and data reporting. ultimately this comes down to how can we make health care for affordable. there isn't one simple example. we're looking at care transformation which is changing how we deliver care and we're looking to be more efficient and we're looking at the cost of things we get. so we have to buy drugs and contract with ambulances so we're try to go do that as best as possible because those costs get passed onto you of course. we recognize you want to look

at your data for the same reason we want to look at the data. we have the same vision and goals, better care, better health and lower cost. thank you and i'll entertain all questions including about the integrated care management fee. >> supervisor mar. >> thank you for your work with the health service board and the system staff, but coming to the board of supervisors and explaining how we're moving forward with transparency and the acknowledgement that our community needs. i love that thrive. it's prominent throughout the city and the tremendous support to the community based programs is really valuable to me. i'm touring the french campus. i think it's on friday which is in my district and i appreciate this transparency as we move forward. >> i was born at that hospital

too. any other questions in supervisor avalos. >> i got stitched up many times at kaiser hospital. my son was born there. >> thank you for being here. >> excuse me. thank you, sir. we'll have public comment in a minute. i want to thank anyone who did come. those speakers, i think, we'll have concluding comments, but we'll open up to public comment. everyone will have two minutes. i have a few speaker cards and there's more. larry brad shau and brook. please, anyone want to speak in public comment and everyone will have two minutes to speak. >> is this working? >> sir, sir, the podium will work, go ahead.

>> this is -- [inaudible]. stand still is a body. stop it at a good point where it needs to be stem too. [inaudible]. laws and competitions and unless there's market making and market up and down and competitions. point number two, price structure. difficulties allies for price paid for construction. third point, the way and rules for spending in terms of choices. all mutual benefits [inaudible]. one day of opening or one day of closing. one day of promoting and one way of cutting short. one day of live and one day of killing.

one way of discussion and one way [inaudible]. this can be summarized. terms of contracts. wholesalers and sellers. [inaudible]. that matters, thank you. >> thank you very much. next speaker. >> good afternoon supervisor. i want to first thank you so much for all work that the city staff has done for your leadership on this. this is such an important issue and i'm the vice president the politics for 1021. and the same thing has been happening in san francisco throughout the northern california and i wanted to make comments about why it's important that we

attack these issues about cost, transparency and quality. as you know california premiums have stored 170 percent in 2002. and the health care rises, family incomes become very difficult to manage and cannot keep pace of inflation. the insurance cost rise on profit. for example, kaiser profits are $8 billion a year. and high prices, net revenues for california homes increased 11 percent and discharges only increases by 4 percent. the cost are passed onto us in next year's premium. if we don't reform our health care market by having transparency, health insurance will equal 120 percent. we have a chance to

address these problems and not shift them to families and i thank you for your leadership. >> next speaker. i want to take a second to recognize the health service board members that have joined us today. thank you all. mr. bradshaw. >> mr. bradshaw. i'm a long time paramedic for the city and county. i pick up one diabetic patient every shift. as a study, i don't no if this would project, but in a study that was done, it shows 30 percent of our -- of what we spend on care for diabetics is wasted on outcomes that were preventable. infections and outcomes and rehospitalization. that's similar. when i get a diabetic

patient that ask me, what hospital would you go to, particularly in the regular hospital is on diversion, i can get a feeling of what hospital they can go. i don't know if my dee diabetic patient has a leg ulcer. where should they go for the best care. i don't that have data and hsf don't have that data. their own medical doctor don't have that data. kaiser has that data and they track that for the avoidable data. they didn't share the data and that's what we need to drive quality health care. i hope if we move forward, that the board will make data required. >> next speaker accident please. >> good afternoon supervisor.

my name is rebecca and i'm a registered nurse and a member of sci 1021. larry talked about the data and we need it not just on pricing but outcomes. patients wants that data and we don't know what to tell them. we have ads are with the best guesses. that's not how we do things in medicine. i'm better off buying a used car in san francisco than i am trying to figure out which provider, which facility provides better karat a reasonable cost. when i buy a used car, they give me a car fax and it says that car has been involved in five collisions or that car was a rental. i have the data. it gives me the information to make the best decision. right now you have the power to look at regulation, to look at legislation, to promote

transparency because secrecy is never a good thing. thank you. >> thank you very much. next speaker, please. >> i wanted to answer your question, supervisor. last year the commute hospital of san francisco sent $179 million dollar on health care. >> next speaker. if anybody wants to speak in public comment, come forward. >> i want to congratulate you for pronouncing my name right. i'm going to make a short comment. i think this is a wonderful hearing that we're having today and i thank the supervisors and the speakers forgiving this presentation. i've had a long term interest in health care and why it's so ex pen -- expensive and why

they can't provide the same amount of care. it's instrumental in making this possible, patly behind the scenes and i know they said theft is very interested in the same topic. if us, as ten to one members, we represent many of the people who are in the lower income level would are really impacted when the price of health care goes up, so we really look forward to continuing to work with all of the parties, the critical role we play is helping to mobilize the public. it's not enough just to have discussions, you have to also have the power to bring the negotiations about that will lower the cost of health care. so thanks everybody, again. >> thank you. >> next speaker, please. >> excuse me, sir. everyone has two minutes to speak. sorry, sir. you've already spoken in public comment. thank you very much.

>> next speaker, please. >> hi, good afternoon supervisors. following on the hearings that were held with the kaiser rate renewal over the summer and we're hearing today, there have been general statements made about transparency and the willingness to be more transparent. that's a shared go, et cetera. i'm wondering if we can get something a little bit more specific because what we're talking about in terms of transparency is transparency in cost, transparency in pricing and outcomes also, rate quality, metric. i'm wondering if the kaiser representative can commit to anything as far as transparency such as acute and chronic conditions and how those compare across the bay area, kaiser facilities, something like that. >> thank you very much. are there any members of the public who wish to comment on this

item? >> mr. daily. supervisor, welcome back. >> i'll go once. thank you mr. chairman, first. let me thank you and this committee for your work on health transparency and for the follow through and for -- we thank the health service system as well and their professional staff for a thorough presentation and to follow through with what's happening. but following up on jeffrey's comment, i was going to speak on the next item, but i'll take this opportunity to say, you know, look, our union, this city, our state senator in sacramento had a bill for some of this very same purpose, sb 747, passed. with barely a

whistle was vetoed by jerry brown. there was little in the veto message, so why we appreciate the talk about the transparency from council and kaiser, it's clear that the hastings is what we need to get the transparency we need. i won't speak on that next item when that comes up, but thank you for your work and pursuing this and you have a partner in the house of labor to make sure this happens, thank you. >> thank you very much. are there any other members the public who wish to comment on items one or two. we call them both together. okay. seeing none. public comment is closed. i would like to wrap up here by thanking everyone who came today and especially

those who put in the hard work, like lisa and the union workers and all the speakers that came and many flew from out of town and i want to thank our state hospital council and i want to thank kaiser for being here. we are uniformly in agreement that transparency is something that we need to pursue as a city. there's no disputing the facts about rising health care cost. i think some of the most stark slides that we've seen today are in rising health care prices verses income and it's eating up our family's income in san francisco and across our country. it's an issue that as an employer. i want to thank

anyone who came together but has been working on this issue since the summer. we have legislation that's in draft form that we'll be working on together to be introduced in the relatively near term to really make sure that san francisco is a leader here and we can be an example and do it right in san francisco and to lower cost outcome. i want to thank anyone involved and look forward to working -- continuing to work on this topic not only today but in the future and making a difference in our city. supervisor mar. >> i want to thank farrel on this and he's got the health service staff. i wanted to be added as a cosponsor of item 2. despite the health service

boards members, i feel we're benefiting the public in what we're doing here and it's our role as the board of supervisor when we want more information and we demand that transparency and i hope we work together at the state level. i don't think we would have had this discussion without a strong voice from the community and the labor saying let's have a dialogue with this with mutual respect. i'm glad that kaiser and i saw rose here earlier, but really the hospital rep working with communities to make our on health system work better with equity focus as well. thank you. >> thank you supervisor mar. so if there are no other comments, colleagues, items 1 and 2, so i'm going to continue 1 to the college of the hearing. we can do that without objection. item 2 is the motion in resolution supporting transparency and thank you supervisor mar for

your cosponsor ship and we can move that forward. thank you everyone. >> mr. clerk, we're going to move onto the rest of the agenda. call item number 3. >> item number 3 ordinance appropriating $13,786,681 of parking garage revenue and expenditures to the municipal transportation agency consisting of $8,513,825 for the 5th and mission parking garage and $5,272,856 for the ellis-o'farrell parking garage in order to support the department's projected revenue and expenditure increases. >> item number 3 ordinance appropriating $13,786,681 of parking garage revenue and expenditures to the municipal transportation agency consisting of $8,513,825 for the 5th and mission parking garage and $5,272,856 for the ellis-o'farrell parking garage in order to support the department's projected revenue and expenditure increases. >> okay. thank you very much. i had some knowledge from the mta speaker, i don't necessity if anyone else from the mta -- i'm sorry. i saw you earlier. thank you for being here. >> good afternoon supervisor. steve lee. the $13.8 million garage revenue and expenditures

supplemental appropriation before you, $8.5 million for the garage and 5.3 for the farrel garage. it's a result of the sfmta refinancing the debt owed by the corporations that ran those two garages. in july of 2012, the mta refunded $6 million for the 5th and mission garage and $2.5 million for the garage. the mta terminated its lease with the two garage corporations. so historically the garages were run in a way that the corporations collected all of the gross revenue and paid all the expenditures and at the end of the fiscal year gave the mta the net income, so within the mta budget, the only budget

line area was the reflection of the net income. now that the mta is running the garage directly, we need to have an expend tour so we can run them. we recommend that you approve this. >> thank you very much. colleagues, any questions? could we go to our budget analyst report, please. >> good afternoon, chair farrel and members of the committee. campbell from budget legislative office. we recommend adjustments to the ordinance with locating the correct amount of money of the ordinance which the department agreed with. otherwise we recommend the approval of the ordinance is amended. >> okay. thank you very much. any questions, colleagues for the budget analyst? we'll move onto public comment. are there any members of the public who wish to comment on item number

3. seeing none. public comment is closed. colleagues, we have proposed recommendations. we have a motion to approve those. we can do to without opposition and the underlining item as amended, can we make that amended for approval. thank you very much. item number 4, mr. clerk, can you please call item number 4. >> item number 4 resolution extending an agreement between the city and county of san francisco and s & s trucking corporation from december 20, 2013, through december 19, 2015, and increasing the estimated cumulative contract amount from $9,000,000 to $13,500,000 for hauling biosolids sludgee and grit, pursuant to charter, section 9.118 bb. public utilities commissionn. >> item number 4 resolution extending an agreement between the city and county of san francisco and s & s trucking corporation from december 20, 2013, through december 19, 2015, and increasing the estimated cumulative contract amount from $9,000,000 to $13,500,000 for hauling biosolids sludgee and grit, pursuant to charter, section 9.118 bb. public utilities commissionn. >> i know we have agreement that this item will be continued for one week until our next meeting. so unless -- is there anyone from the pc that wish to comment? we don't

need it. we're all in agreement. we'll skip the budget analyst report. we have to open up to public comment. anyone wish to comment. seeing none, public comment is closed. colleagues can we have a motion to continue in one week. we can do so without opposition. clerk, please call item number 5. >> item number 5 resolution retroactively authorizing the sheriff's department to amend the existing contract with global tel*link for inmate telephone services, which will result in an anticipated commission to the inmate welfare fund of more than $10,000,000 over a four-year period from june 1, 2010, through may 31, 2014, with a one-year >> item number 5 resolution retroactively authorizing the sheriff's department to amend the existing contract with global tel*link for inmate telephone services, which will result in an anticipated commission to the inmate welfare fund of more than $10,000,000 over a four-year period from june 1, 2010, through may 31, 2014, with a one-year option to extend the term. >> we were supposed to have bree, maybe they aren't here yet. mr. clerk, can you go forward and can we call item number 6. >> item number 6 resolution authorizing the execution, sale, and delivery of a multifamily housing revenue note in an aggregate principal amount not to exceed $22,000,000 for the purpose of providing financing for the acquisition and rehabilitation of a 175-unit affordable

multifamily residential rental housing project known as tenderloin family housing; approving the form of and authorizing the execution of a funding loan agreement and a borrower loan agreement; providing the terms and conditions of the note and authorizing the execution and delivery thereof; approving the form of and authorizing the execution of a regulatory agreement and declaration of restrictive covenants; authorizing the collection of certain fees; approving modifications, changes and additions to the documents; granting general authority to city officials to take actions necessary to implement this resolution; and ratifying and approving any action heretofore taken in connection with the note and project as defined hereinn. >> item number 6 resolution authorizing the execution, sale, and delivery of a multifamily housing revenue note in an aggregate principal amount not to exceed $22,000,000 for the purpose of providing financing for the acquisition and rehabilitation of a 175-unit affordable multifamily residential rental housing project known as tenderloin family housing; approving the form of and authorizing the execution of a funding loan agreement and a borrower loan agreement; providing the terms and conditions of the note and authorizing the execution and delivery thereof; approving the form of and authorizing the execution of a regulatory agreement and declaration of restrictive covenants; authorizing the collection of certain fees; approving modifications, changes and additions to the documents; granting general authority to city officials to take actions necessary to implement this resolution; and ratifying and approving any action heretofore taken in connection with the note and project as defined hereinn. >> thank you. we have the mayor's office. >> join with the mayor's office of housing and community development. good afternoon, supervisors. the resolution before you will authorize the issuance of proceeds to pay for rehabilitation at tenderloin family housing located at 201 church street. the sponsoring team including china town community development center as the owner and general partner with union bank as the construction lender purchaser of tax credits and limited partner. union bank has finally approved the transaction and will pay $15 million in equity in exchange

for the tax credits. with proceeds from this foet and other sources, c cd c will complete capital work which is reroofing and water proofing the exterior and upgrading the elevator and painting and improving common spaces and select units. tenderloin family housing is 174 units that has 12 studios and 42 bedrooms and 37 three bedrooms so it's a family development. the building is approximately 20 years old and contains one manager unit. eligible households must earn below 50 percent and 60 percent area median income per tax year credits which is consistent with the regulatory agreement that was put on 20 years ago by the development agency. for a person, this is an maximum

income $43,000. for a family of four, the maximum would be $61,700. at the 60 percent limit, a single person must earn below $50,000. continuing the use of the slightly higher t tax limits as oppose to the cmi will allow the owner realizing slightly higher revenue on all units except 53 units that's serving households that earn no more than 46 percent ami. existing households will not see a rent increase due to this refinancing. the non state restricted rent will remain in place until the next annual

rent increase which will allow rent to be changed according to the percent change in ami, which is most stand policy. the state restricted units have a different calculation for setting rent and based on the projects need which would have been under three percent. the repayment of the note is solely subject to project revenue and does not impact the city's budget. we anticipate closing all construction financing within the next three weeks. the project is slated to begin construction shortly there after and complete construction in 2014. we have shannon dodge who is a project manager at china town community development center and she and i are both available if you have any questions. thank you. >> thank you very much. colleagues, any questions on item number 6. okay. we don't have a budget analyst report.

no public comment. public comment is closed. colleagues can we have a motion to move forward and we can do so without opposition. thank you very much. why don't we go back. we already called item 5, so we'll go back to that item, please.

>> go ahead. >> members of the board, my name is bree and i'm the ceo the sheriff's department. our existing contract for inmate phone services which is with a company called gtl needs to be extended for one year. gtl provides phone service for inmates paid by the inmates. from this revenue 60 percent is reduced from the revenue and deposited in the fund and used for the benefit of the inmate. and in addition gtl pays $100,000 into the fund each year. gtl was selected through an rsp since 2009 and has been

our contractor to 2010. this would be the first of two possible extensions and the extension will run from june 1, 2013 to 2014. as apart of extending the term of this agreement, we would increase the rate of the commission from 60 to 65 percent which would result in an additional $60,000 being deposited into the inmate welfare fund and this is used for the benefit of the inmates under our care. in addition in preparing for today's hearing, i noticed that the title of the resolution did not reflect the most current draft that we sent to the clerk, so if you could supervisor farrel, the title should read resolution should read to have telephone inmate services from june 2013 to may 2014 with a one option to

extend the term. i'm here for questions. >> colleagues, questions. seeing none. we'll get to the city attorney in a second. mr. rose, can we go to your budget analyst report, please. >> yes, mr. chairman. on bottom of the page 6, the sheriff's department received $2 million in net revenues from the inmate telephone service agreement with gtl. in our report we put global tel link and that's two annual payments and that period was from june 1 to 2010 to may 31, 2013 and that's on page 17 on the table in our report. on page 18 in the fiscal impact section, we point out that the sheriff's

department estimates that as the sheriff's department just represented that the increase from 60 to 65 percent of gross telephone revenues is a result in an estimated 60,965 in annual revenues. on page 19 of our report, you notice table $19 of our report, you notice table two, there is $1.99 million in the fund as fiscal year 2013. we have two recommendations, supervisors, for your consideration. they're on page 20. we recommend you amend the resolution. let me give you background. there's another contractor prices which was a source contract which never came before the board of supervisors. under that contract required a waiver which was not obtained but