36.3 percent higher than blue shield and 37 percent higher than kaiser on the risk adjustment basis. >> the overall decrease since q 12011, that's the high point. you could have picked any other point and they could have been increased if they could have picked q 2, 2010? >> yeah. but if you would draw a line particularly since quarter 2009. it has been pretty stable. yes, you are right but we did have a dry point to reflect a change in population as well as a change in activity to justify the cost. >> okay. thank you.

>> on page 20, the city plan per thousand has decreased 10 percent since 2 years ago. again, that was the high point that we picked. what we are doing if you will looking at the 96 per thousand kaiser 464 at the in point at 62.7. if you noticed as i mentioned earlier, the city plan is not that different in age and male female distribution. so you will notice that the factor one is much closer at 93 percent. you would not expect to see much changes. if you notice the

average length of stay is at 5.9. there is about 1.75 spread between high and low and the blue line of skilled nursing is the most variable of them all of moving on to the cost per day, what you will notice is the current inpatient cost per day is about 62.43. it's an annual cost of 2.5 years. this is not unexpected and quite reasonable trend for this period of time. moving on to page 23. there is nothing as you look at the graph and you will see it pretty flat. the only thing to draw out here is that the growth is about 1.3 percent. there is a slight growth in er rate of 4.6

percent and surgical cost and yet nothing above trend. lastly looking at the procedures per thousand, again, we have the issue of the other 21,000 of the 33778 are other. and we have to work with uhc to see what goes into that very low dollar area. in the generic drug dispensing is 77 percent. pat yourself on the back. this is a 48 percent increase in dispensing. you've almost doubled it. good job. as far as

cost goes, they have gone down which is what you would expect to see in shifts in increase and shifts to generic. the cost per script has decreased 14.9 percent to 104.53 in quarter two. you have the same types of drugs in the actives, however the diabetic increases are in creasing in dollars. in summary what we'll bring to you is information to consider. the city plan's healthful and sustain able retirees. it's not sustain able as it is. we recommend the hs board consider several options for the future of the active and early retiree

pool. one is move the pool with medicare retirees. the second would be to close the active city plan to all employees other than those outside the kaiser and blue shield service areas such as the heche but very small. third we ask and investigate the policies to make the changes to the active plan to draw more people into it to make the plan affordable again. howevercious that does have a down side that it might cause increase rate in population which is a higher volume than the uhc plan. what i want to say these are the consideration we have and they can all concur as individuals or in groups of two or three of the options if you want. so

with that, i would entertain any questions that you may have. >> mr. scott? >> i wanted to go back to your slide 26. you identified for early retirees with diabetes is kind of a therapy that is impacting cost. are you seeing a similar trend around the things around cardiovascular disease related issues? >> when i looked at the top drugs i did not see a repeat, you have the stat ins but because of diabetes you have the insulin that is not all generic and that's where the cost accrue. >> they are present in this? >> they present but not enough to overall impact your drugs >> over time we should be able

to anticipate that that would be kind of an outgoing outcome with this population. >> as the population ages one would see cardiac increases. >> all right. so these are three suggestions that everyone take a look at for some other meeting? >> exactly. >> thank you for your presentation. >> could we take a short break at the request of the board members. >> thank you so much. >> 10 minutes. >> i'm asking for public comment on no. 10. item 11. any

discussion. >> item 12. item to put items on future agenda. >> any public comment on this item? >> sorry. i don't understand. still working on this. >> commissioner fraser. wiener and mar.

>> my suspicion is that it will take a while and whose bill it will make it out. to be clear, it's nothing but unclear now. i will keep everyone updated for sure. >> all right. item no. 13. >> the clerk: item 13, discussion item, opportunity for the public to comment on any matters within the boards jurisdiction. >> commissioners, just one quit note while i'm not hard of hearing is that you don't speak directly into the microphone and especially commissioner fraser, we can rarely hear

almost all of what you say and it gets lost and you swallow the end of your sentences. after many years. too many years of speech and forensics. commissioner, it's great because we hear everything that you say. i would ask you all to please speak directly into the microphone. we have members who regularly wear hearing aids and we have difficulty understanding what goes on and the commission secretary is right on with her comments. everything she says can be heard. thank you. >> thank you. >> commissioners, dennis krueger active and retired firefighters. on behalf of the firefighters i would like to

say hello to catherine and hope that you will all our prayers are going well for you. i have heard a couple things today that kind of fall into that wheel house. supervisors of san francisco have passed a wellness resolution. i think that's wonderful. they are doing research into transparency and cost and hospitals. one of the things that comes up is causes of waste is inadequate primary and preventative care and that's what i'm here to talk about. dental. the most basic preventative care that we have in our society. and our dental program lacks. specifically among retirees who need it the most. i think of a wisdom tooth

that gets infected and a person that can't pay or hasn't got the money to have it taken out. that leads directly to heart disease. what is cheaper to abstract an abscessed tooth or have a heart operation. preventative care includes dental. so i'm looking forward to work with lisa, the deputy director regarding looking into our dental plans and hopefully at least bring retirees up to what the active people are receiving and hopefully increase that for everybody. i was in europe earlier this year, i cracked a tooth. i went into a dentist in switzerland, he looked at it, checked it out and told me what to do and i went in for a price, don't

worry about it. it's taken care of. almost every health plan in europe of the industrialized nations there include dental. if we want to make people healthier, we have to improve their dental. thank you. >> thank you. any other public comments. no comments? item no. 14. >> the clerk: item 14, action item vote on whether to hold closed session to discuss the members appeal has been canceled, so member account overpayment. president? >> all right. i will need a recommendation. >> i move we go into closed session to discuss the item referenced. >> second. >> okay. any public comment on this. all in favor say, "aye".

>> aye. >> all those opposed? right. we'll now be in closed session. >> item 20. action item vote to disclose information regarding machine account overpayments. >> i move that we do not disclose member information. >> second. >> all in favor say, "aye". >> aye. >> opposed? okay. now we have no. 18. >> the clerk: action item, possible report on action taken in closed session regarding member account overpayments. >> all right. all in favor say, "aye". >> aye.

>> opposed? all right. if without any objection, this meeting is adjourned. [ meeting is adjourned ]

>> i'd like to call roll please. >> commissioner marshall. >> sheer. here. >> commissioner chan. >> present. >> commissioner kingsly. en route, i believe. commissioner loftus is excused. you have a quorum. >> thank you very much. welcome to the wednesday, november 13, 2013 san francisco police commission meeting. we have a light agenda tonight on the open session, we have some work to do in the closed session. the chief will be with us in the beginning and then he's moving you have to a memorial.

let's move on to line item number /wurpb. one. >> line item one, adoption of minutes of meeting october 2, 29, 23, 2013. you have is minutes in your packet. is there any corrections or additions? >> i move approval. >> all in favor. >> i. >> please call line item number two, general public comment. >> the public is now allowed to address the commission on items that do not appear on the agenda. speaker shall address the remarks as a commissioner as a whole, not individual

commissioners. neither police or occ personnel or commissioners are required to respond to questions presented by the public, but may provide a brief response. individual commissioners and police and occ personnel should refrain from any debates with speakers during public comment. please limit comments to three minutes. >> before you proceed, i'd like to say i listened to you on doctor marshall's show and learned so much about you from these three minute sound bites we get each week. it was very moving. i think tonight i'll give you three minutes for yourself and three minutes for your son. i want you to explain some things you're feeling that you told doctor marshall. it meant a lot to us. please, you get six minutes.

>> okay. >> hello, yeah. hank you. my name is paula brawn and i'm here concerning my son who was murdered by an automatic gun. as i come here every time i still have no judges. i always bring the names, which i left in the car tonight of the perpetrators that were involved in my son's case. i still have no closure as a

mother. i'm still out there paving the ground, trying to get justice, carrying my son's pictures, hanging them up as often as i can just to have them torn down. we have -- i have no venue to hang these pictures or to hang my help wanted poster. there's a $250,000 reward that i still yet to give somebody to come forth and identify the perpetrators. as i said on doctor marshall's show that i don't hate these perpetrators, i forgive them. i forgive them because i can't die hating them, but i do want justice and i do want them in jail. i do want them to go to jail. i do want to go and say why did you kill my son.

i at least deserve that. i at least deserve an apology from them, whatever they say to me. i want to tell them too, let me show you the love i want you to give to my son, that's what you took from me. yet these perpetrators are still walking the street and i feel sorry for their parents. i wouldn't want them to go through what i'm going through everyday. believe me, i don't want to stand here, i don't want to be here ever. i don't want to be doing this. we have a lot of mothers and fathers out there that are going through this and that i listen to everyday. we stand together and if it wasn't for those other mothers and fathers, i don't know what where i'd be. i still carry my son's picture here that i have to look at

everyday. this is what keeps me strong. it keeps me fighting. i have to do this because if i don't i'd seem like i'm forgetting about my child. it's been seven years -- seven years, everyday i walk out my house and see where my son laid. everyday i blame myself, everyday i think about if i had been there, maybe he'd be alive. and as i say all the time if i had been there i would have took those bullets for my child because my son should have been burying me, not me burying him. i'm at the stage where it's been seven years and i'm still crying and sometimes i think when i come here no one's listening to me, but you say you do, and i believe you.

but this is something i'll be doing for the rest of my life. i want closure. i have want some closure, just a little bit for someone to come forth. maybe i'll never get it, but this is something i'll be coming to do for the rest of my life. i know i keep repeating myself because i don't know what else to say. i make my way here every wednesday. i make my way down to 850 brian. i make my way down here to city hall just to bring awareness to this killing that's going on in the street. no mother should have to go through this, no mother. i want to say to the perpetrators, i don't hate you, but you need to think about -- you have to go to bed everyday, you need to go home everyday, you need to lay down and think about what you've done in your life, just like i go home everyday and think about my son when i lay down.

after school, when i get home all i can think about is him. i have other children, yes, i do. but i'm empty in my heart with one gone. i just need prayer and i hope those names that i gave last time someone can say something about it, i also want to say the -- my son's case number is 060862038 and then anonymous tip line is 575-4444. if anybody know they can call this number and say something. this is not for me, this is for

ever mother out there. like i said, i'm not going to take up my six minutes, but i hope you give it to me next time because i don't have everything, but just continue to pray for me and i'll see you next police commission. >> thank you, doctor marshall. >> miss brown, you were great on sunday. you were great, you were great, you were great and you will be -- and the show was about the code of silence and snitching. you know, it keeps murderers on the street and unfortunately the code or a lot of folks in the community and aside from obviously wanting to life

highlight your case, to put a personal face -- for some reason people don't get it until it happens to them. the whole thing, you are them and you made that very, very, very clear and i specifically appreciated you sat about 20 minutes talking about your circumstances and i had forgotten myself that your son was telling other people to run when in fact -- i mean, you talking about innocent kid, you can't be anymore innocent than telling other folks to stay out of harm's way and then he takes the bullet. so for whatever it's worth, i talked to a lot of people that said your story really got to him. i don't know if it'll unearth anything, but just -- maybe if it doesn't in this case, it will make people think about somebody else, themselves and understand that, you know,

we're all connected. but i just got to say you're a trooper with this whole thing anyway, and you were really, really great on sunday and it got to everybody in the studio and i'm sure everybody that was listening. keep coming, we haven't forgotten. police are on it and just like you're looking, we'll probably be looking for the rest of our lives too. >> i also want to say to the people that he saved too, for all the guys on the stairs who ran, say something. he saved your life. people call my son a hero, but i don't have him. he's not my hero. he was your hero, he was their hero and i think they should open their mouths and say something. say something. you know who you are. you know who i am. you see me everyday. i speak to you. say something. give me some closure. you've

played with my children. you've played on my stairs when you were little. those of you, you know who you are, the people he saved. open your mouths, don't wait 'til it hits your homes until you say something. don't wait. you don't want to be doing what i'm doing right now. you don't want your parents or auntie or uncle doing this. there's other mothers and fathers out there too that i also advocate for and they also need closure too so i'm also speaking for those other mothers and fathers out there also. >> you are, so thank you, thank you very much. thank you for speaking for your son three minutes. >> thank you. >> next speaker. >> good evening. you know, miss brown.

i'm going to prove one point, a mother's love never dies. your son -- he's upstairs watching you. he doesn't -- >> thank you clyde. >> good evening commissioners and director hicks, how are you doing? i have sent and email relating to the new legislation before the board of supervisors for the park hour closures and this has been through a few hearings, it'll be through one more next tuesday and they made some amendments to it, some carve outs, which brings me to the report aspect again since it's recent and fresh and

trying to figure out what reports go where and that has to be hard to decipher, especially when they put reports into law. that talks about piling it up instead of just having the ability to modify or adjust at will. i sent you all an email urging a no vote on this or pulling the support because essentially it has too many carve outs, it'll add stress to the officers who have to enforce this. you know, do i cite 'em for this or that, you know, it's just not well thought out legislation and especially with all the carve outs and amendments, it's not that great. follow up on my 5150 situation, i have not heard anything since the last time i contacted the occ so i'm