the city of san francisco sfgtv meeting for health service board for january 9, 2014 will begin shortly.

>> health service board meeting is now in session. all stand for the pledge. >> i pledge allegiance to the flag to the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. >> all right madam secretary

roll call please. >> roll california. president breslin. >> here. >> vice president lim. >> present. >> >> excused. >> commissioner. >> expected. >> commissioner fraser. >> here. >> commissioner scott. >> present. >> commissioner excused for shlain we. >> thank you item one. >> item one is the meeting minutes for the meeting below. >> are there any corrections to the minutes? >> move for approval. >> second. >> okay. is there any public comment on this item all those in favor? >> aye. >> those opposed?

>> mouse. >> item two please. >> item two president's president. president breslin. >> i have nothing -- oh there will be public comment on this item too. is there any public comment? all right. item three. >> item three discussion item discussion report, lisa ghotbi how about now lisa? no? >> thank you. lisa ghotbi acting director of the health system. starting with personnel we have updates. we are relationship to announce we have hired a administrator manager.

this is a new position for the system and joined us as of monday. she is 12 years of experience working in the payroll -- a similar roll supporting our payroll department in the controller's office and we're lucking to have her with us and lanie is happy to join us. lanie can dedicate her time to the board as the board secretary and we are happy to welcome her to our team. we have a offer pending for the 0923 contract manager. that candidate did not accept the position. it is always a challenge in this city to meet the salary requires of external candidates especially when it comes to health plan contracting which is very highly desired position across the industry right now so we're back to scare one and working to reassess the classification of that position. it is critical for us to get

that one filled and we're sorry that we didn't successfully close that deal but we will work on that one and in the meantime our ceo pam pamela levin will play that roll. we have a new technician that starts next week. that leaves us -- well, five -- six open positions at the moment. three benefit analyst positions we're working to fill. we have two wellness positions we will post soon and we still have a finance position. this is the same position that we got approved with funding with blue shield. incredible difficult time filling this position as well. we had to use outside services to fill in for the finance requirement in the meantime and we are still struggling to get this position filled, and then the last item on personnel is that our director katherine

dodd has made it true treatment and in a speedy recovery. i think i mentioned at the last meeting very tough in the first weeks of december and does two was the highest call volume in the history of hss. this resulted from -- we sent confirmation letters for enrollment out to every member of the health system and there were a lot of people i mentioned last time didn't have the enrollment they thought they had. some of it was errors on our part of but many was -- i think i mentioned -- oh i divorced my wife six years ago why is she on the plan? it's a good effort and taxing fur the team and the first weeks blew the month of the goals and statisticses and our rate was 3.8 for the month and less than the 2% and the

answer much higher so the hss handled over 50,000 years over the year and 13,000 in house visits in support of our membership. communications has been busy. the hss website is updated with all of the 2014 materials. we worked on the planning for the health sustainable plan which is item seven today. we working on a video for open role. as you know we -- i'm sorry for new hire. we had the video for open enrollment and well received by the membership and rosemary is working on a video for the new hire people that come on to the plan and we're working on the communications rfq that will come to review in the next month. the finance team, we're on track with contracting

requirements for the new year continue negotiations with kaiser, uhc and working on the agreements under the blue shield agreement and we will begin work on the kosh rafsa vendor ffp that you will see next month and for this year it's on kosh raservices and wage services and they're the vendor and it's time for a rfp on this service so we will launch that in february. data an littics for hss is active making sure everyone's w2's are accurate and their tax information as it comes to benefits is corrected so we have been working on that the last month of december and we just finished the testing on that today and that is very good and we're working on the other one

for the data base which i think will be ready to launch next month and then on the wellness side with staff nee fisher joining our team we're finishing up the work with the control r controller's office and should be coming forward and working on the kaiser on the roll for researchs proximates and the firefighter study will have and an important cancer study we're interested in seeing the results of and staff is working on a plan for extended services. i think that -- with that i will conclude my report with a note of recent new england journal medicine study health care spending and the "regardless of cost trends

spend suggest far higher than needed and needs continued effort and continuing the implementation of the aca provision." any questions? >> i just have a question. do you plan to send that? is this going to be an ongoing thing sending out the letter of confirmation every year? >> we're certain torn. it was a lot of work but it cleaned up a lot of accounts so i think we will continue to do so. it was financially worth the work and i think we will be online with benefits within a couple of years so i would personally recommend that we continue it until we go on line and people then can get the confirmation electronically and smoother and less costly intervention communication to our members. >> okay. and a second thing,

expanding eap services -- the retirees don't have anything -- well, they do have through the health plans. they have social workers or psychologists, but i was wondering if there is something in eap when you expand it for the retirees? >>i think that's a really good question and certainly one of the topics we are evaluating as we look at the fact that the services are really under resourced and insufficient to meet the needs of the employee population and we're looking at different options to bring to the board to look at what the costs are, what the benefit might be to broth -- to all of the members of the services that don't have eap either under the current offering or current union agreements. we certainly

have divisions of the city that have access to one and some of the other employers that we work with under the system have eap independent of ours so there are options that we can look at to expand the services for the city and count i and also for our retirees. >> good. >> commissioner scott. >> yes, i just wanted to raise a question about the wellness report. will the board see it at some point? i understand the controller requested it and he would have first quack at it but we will get a copy or discussed in this forum? >> it will come to the health service board. they're asked to lead the program for the entire city and you may recall there are budget dollars including the funding of stephanie's position from the general fund and two

additional positions we're looking to fund from the general fund as a result of the city and the controller's office of economic and workforce development for the wellness of the employers and hss is asked to run it and the board is responsible for that as well so i expect it would be march or april. >> thank you. >> any public comment on this item? seeing none item number four please. >> item four discussion item update on financial reports as of november 30, 2013 and budget update. pamela levin. >> pamela levin, deputy director chief financial officer. these are really two different items so i'm going to do one -- first i'm going to talk about the financial report through november 30. this is five --

we had five months now to use for our projections. first i want to talk about the trust fund. we are projecting an increase in net assets of 18.6 million. this is 1.5 million less than last months report so that is kind of expected when you do a projection with only a little bit of data you will be bumping around a little bit. the 18.6 consists of 11. 1 million the city plan assets, and working on the recommendation from the disposition of these assets based on the health service policies and they will come back to you next month. we have been talking about this for a while but february is a big month in terms of writing any types of reserves that we need to have or any types -- according to the health service policies. 1.6 in

favorable [inaudible] blue shield flex fund and incurred but not reported. we continued to look at the success of the flex fund and we will incorporate that information into the rates and rate settings. 4.7 increase in estimated claims experience in the civil insured dental plan. reduction of a million of hmo insurance revenue after the application of the retiree insurance credit. these are similar items we had on for each month, and 1.1 million increase to account for the time of their contribution and filling of claims. there was a discussion

last time for people to carry forward up to $500 to the next year and following. 1.1 million increase for interest assuming nor significant changes in the fair market value of the investments. we have not heard that is going to be a problem and $300,000 for performance guarantees that were placed by blue shield for the short plan year and then just minor adjustment for 200,000 for transfers to the fortfittures of of the general fund and with the balance it will add to the net assets and bring it up to 96 million. as we discussed we do have a list of obligations that we need to keep in our minds when we talk about our net -- our net assets, and that's

still around 68.6 million so we're really looking at a balance of 27.4 million in the trust fund. then in terms of the general fund administrative budget we're still looking at projected balance of 170,000. we as acting director lisa ghotbi mentioned we are seeing -- because we are savings -- because it's taking longer to fill positions than anticipated we are seeing some of the professional services are greater than we thought, but we are still showing savings because we still have some positions unfilled. i think next month when we bring the budget we're going to hone in -- we will have six months of expenditures and hone in exactly where we will be at the in the

general fund at the end of the year. are there any questions on this? so now we get to the 14-15 budget update. february as you know is a big month. we have to submit our budget to the mayor's office february 21, so what i am doing is going over what the instructions we have been given, how they impact our budget in terms of reduction targets, what kinds of things we need to focus on, and just a real quick incaps laigz of what the budget schedule is so in december the mayor released the 20-- 2014, 15 and 16 instructions and we went to a two year budget so i will talk to you about the way