saying when we get there we've gone ahead because it was probably not prudent on my part to waiting a year. so that we've gone ahead and decided to codify anything that could possibly happen. with that said, this document goes through all of the various changes and one of the things that's important to understand is when we calculate this, there is no gain or loss generated by the egg wip. any premium part of this process we changed some of the language in here to clearly outlaw in the fact that they do not create a gain or loss. we had to add additional language in part of this. i this i think this thing is fully updated for all possibility set for claim restabilization and when you are fully funded for your ibnr

which is first, contingency second, you are very responsible and we use the amization and depending on kaiser and we amortize this over the history of the contract. unless there is any questions, i recommend you an approved the changes. >> i have ready to entertain a motion. >> i move we update the stabilization reserve. >> is there a second? >> second. >> are there questions boo i -- by the board? any public comment? no public comment. >> all in favor say, "aye". >> aye. >> opposed? the ayes have it. i believe we are at a moment to rise and support the full

board. i would recommend we take at least a 5-minute recess. >> madam secretary? >> item no. 9. are we reordering the agenda? >> yes. discussion item, president's report. >> first i want to say that we are going to change our terms around today and hear the action items because i'm afraid we are going to lose our quorum. if there is no objection, we would hear item

13, 14 and 156789 15. there will not be an election because commission frino and i were uno opposed. i want to commend lisa for her hard work in leadership when she's holding down two jobs and the whole staff who were really thinking of the members first. i think it would have been a very tough job to fill in. thank you very much. public comment on this item? now we'll go to item no. 12. >> approval of administrative budget of fiscal year

2014-2015. >> chief financial officer. i extracted some information from the report that went out in your binder on the budget. and put copies of the powerpoint on your desk and i would like to use that so we are all looking at the same thing. there is no new material. it's just put on powerpoint. the first thing i wanted us to do in doing budgets there is a really good reason to start with looking at why are we here, what are we doing? what are we providing? so i wanted to just look at quickly the

health services system mission to improve sustain able quality benefits for employees and their families. i would like to keep in mind that that is our top priority and the budget is how we actually fund doing our priorities and our mission. i wanted to start and a detailed discussion was where are we now, what did we request last year for this fiscal year and what kinds of things do we still need to do? so i put a chart on approved staffing levels and fte's. when we were looking at the budget requesting it for 2013-2014. we requested to

have approximatelly 8 fte's, remember those are not necessarily heads. it's the full time equivalent. when you ask for a new position it's always at.77. that's how you get partial fte aechlz we asked for 799 new positions and asked to be able to fill new positions. that's why it looks funny because we said we want to have the ability to fill two more positions. what was actually approved when you look at the administration and the wellness together was 7.73 new positions and the ability to fill one position. the way attrition works if you were to say i have 10 positions, each of them earn $10 and i have $100 and that's what i go out and spend. the way the budget

works is we don't fund all those positions. that's why, so and it's a fairly arbitrary number that reduces your budget and it constraints you. the request when i got here the request had been let's ask for money so we can actually fill positions. when you look at this purely by numbers, you can say we did really well which we did but there is still significant need in the near future with our needs to get to where we are going. that's where i wanted to focus on us being thankful to where we are now but keeping our eye on the future and saying we need additional resources. as i mentioned last time, the mayor had instructed us to take some reductions. the

reduction targets is 14 1/2 of our general fund is $42,000. our proposal to use to fund this. this is the discussion before about carrying forward up to $500 in balances and 15 the mayor also instructed us to balance with cutting the additional suggested fund and that's almost $69,000 and we chose to use the foefrt. the

6-month report was release d by the controller and we were better than $60 million for the general fund. so what, they may not take the contingency. remember when i met with you last time i wanted to let you know that there are times in which the balance and the general fund is reevaluated. this is one of the times and it was to the positive. we still have to put in 1 percent and we really propose that since we can cut our budget we are not funding what we need to go forward that we use forfeitures and not a fund. it doesn't affect the premium, but this will let us have the ability to not have to cut. we are very lucky this year that we are in a position to do that. we also looked at what if we need to do to augment our

budget. we looked at what our priorities are but we first started with the mayor's priorities which were stated as government efficiency, affordability of services and programs and government innovations. it says that we were supposed to, if we were going to propose anything, we needed to have data ann will -- analytics behind this request. staff took that seriously. we looked at, everybody looked at what they had and how what we've been working towards. in the future we all made proposals and prioritized them and would like to come forward with these proposals. generally they hit the five priorities. enhancing emerge requirements implementation of online and

benefit enrollment and increasing efficiency level and using an will it -- analyticals to provide health services. identifying and complying with changes in federal and local act including affordable care act and proceed actively and strategically rather than reactively. and the hsf wellness center and actively working with other departments to develop their wellness program. finally to increase fiscal control and oversight to ensure vendors comply with contractual obligations. those are the things we wanted to put together. then we put in to funding packages. i will go through this very quickly, a

great deal of specifics that were provided to you in terms of write ups and numbers when we introduced the board deck. i will take any questions you have but i'm not spending a lot of time on any of these. streaming the benefits emerge for e benefits. essentially as you heard our existing benefits administration module of people saw needs quit a bit of work to make it ready to go forward to e benefits. e benefits is i believe 2015. question want to implement it around that period of time some time around 2015. there is a significant amount of work for this. this is a limited duration position because it has a beginning and an end and would include

training. the second is to optimize the system performance through analytics. this is to build among other things an internal data where we can use for our analytics and controllers office is interested in what we are doing. it would also allow us to bring a lot of the dashboard work in-house and us to be able to automate reporting. again, a limited duration position because we feel that we can put a beginning and an end to it. i failed to mention that one of the things when we were putting the packages together we felt that what makes sense for the department in order to be compliant with what the mayor's office and others would like us to do in trying to fund some of the things

ourselves and ask for the other. the upgrading the benefits is clearly a major proposal that the city needs to get around and is involved with and that's why that would go to the general fund. optimizing the health system performance through an alyticals, we would look to other revenues to cover that. and comply with state and local legislation. that is really to allow us to as i said get pro actively track changes in federal state and local stages in our work that would have collecting analyzing and presentation in health data and would help the directors in terms of being

able to provide outreach so that the city can be more of a player region wise and there is an education component to that. that is one position. the next page is the next group of funding packages. the next one is implementing the strategic wellness plan and this is to go to the general fund. we are at somewhat off. it syncs because we have to put our charter mandate before february 21st. you are going to hear the wellness plan and march. we've heard from the other response aureus --

response sponsors and the wellness plan and operating expenditures for the wellness, the work that's done through the wellness center. one of the positions, the major part of the two positions is to help focus on other departments and help them with their wellness activities that includes not just reaching out and helping their coordinators but it also includes providing training, wellness training and increasing our eap capabilities and help on an outside basis. there are training and lots of classes providing that now. the next one is increasing fiscal controls. what we would like to do is have our

department participate in intern program that brings us new talent that the intern program actually trains accountants. that's really the only way to get into city in through that intern program. he's a mentor and supervisor for the interns. they come in and stay 6 months. it's an 18-month program. we get two of them and we may -- two of them for six 6 months and the rest of the year maybe the same person. it's a really good way for us to increase our control and look at how we are doing our financials, how we are working with the contracts and really beef up and make sure that we are doing everything we need to

do fiscally. the other ones are rather minor but very important. we are seeing a lot of workers comp claims and over expending at this time and putting more funds in order to handle that and would like to fund specialized legal services. this would be an augmentation to what is being done now by the city attorneys office. we'll work closely with the manager attorney over staffing and the city attorney himself to see how we define our roles to ensure all our needs are met in a legal standpoint for legal support. we have done a minor amount of reclassifying staff as we have always done to reflect what

they are doing now and minor changes in the number of years. what happens for some reason, the budgeted for the elections the work order for the election department for 14-15 they stripped it out of the budget and they said we needed it back in the phase. we are also asking for general fund for other projects. it goes to the media and information technology and goes to a lot of city leaders who evaluate and make recommendations to the mayor and controllers office on what kinds of it projects to fund. we ask from funding to review

and plan for modernization and digitization to allow us to be able to get a new phone system to have greater ability to answer all the calls that are coming in and we wouldn't be dropping as many calls during the periods of time when it's open enrollment or when we send out letters and we get this huge amount of calls and we have to balance our call volume by people that don't normally deal with these things. there is a lot of capability that we need to get and will also allow to do a lot more monitoring of our call volume and reporting. in the past we asked for funding to actually do this project from beginning to end and we weren't successful. they like the idea but they didn't want

to give us all that money. now we are asking for i believe $50,000 to do the planning, the review, get somebody from the outside and somebody from the inside who know about phones and works with our department of technology and plan so that we go back to request money from the general fund that we'll have a better idea and they will be more apt to fund it. the section one is about reviewing the plan and file room. this is the same project that we had requested the committee liked but couldn't get funded but it was too big and the planning the really honing in on exactly what we need to do and how we would do it would be the first phase that we would requested and more likelihood of getting it funded. the third is a placeholder to replace

our pc's. we are really well positioned from last year's purchases but in the next two years we are going to have to get additional funding. the next steps upon your approval we have to submit the budget to the mayor's office on february 21st it's a charter mandate. at which time of becomes under the mayor's domain. we are going to do negotiations on whatever the mayor is going to propose for the budget. as you know we start pretty in depth talks about it to make sure our needs are fully recognized and put into their priority of how to use the general fund. then on june 1 st or whatever working day is close to june first, the mayor will submit his budget to the board of supervisors. we will as we are able and it's appropriate advise you on what changes

have been made to the budget because it does go through a lot of different reviews. >> okay. commissioners, any questions on this item? >> doctor? >> i just wanted to make a comment and i know i'm speaking to the choir but the health services system is 10 years old at the department. it was evident to director and i that as we walked into the department it was severely under staffed for the work we do and at that time we were under severe recession. we tried to hold on to the staff we have. we are asking for the bare bones to do the work and currently the staff that's handling the job at the department are really stretched to the end of what they can do. this business has gotten so complicated even

more than five years ago, so complicated by paco obamacare and changes in the system and the regulations that we are now having to comply with, the additional reporting requirements. it's really incredible. this is a budget just to barely get the work done and keep the staff. the workers comp claims we are seeing originally is for the ergo nomadic carpal tunnel issues and we have your support and in a year we hope to be staffed up to do this job. >> thank you. >> i would like to entertain a motion? >> i move we adopt the budget as presented and we invite the staff to involve this board publically or privately as you

are going through the other steps of the process. >> i second the motion. >> any public comment on this item? >> i will just take a quick moment to say we have traditionally been short staffed. we have a staff that traditionally has served far more people than any case load in any other city department and i think it's important that we continue to lobby hard to get the appropriate staffing that we need. we are not like retirement. we can't self fund out of our trust fund. the city must understand that the services we provide benefit all employees including the mayor, including the board of supervisors. i applaud you and thank you commissioner scott for asking that all commissioners be involved because we have to be. i just urge you all and

the staff to continue to work hard with the mayor's office and the board of supervisors and the analyst. it's going to be tough to stand up to them, but we really need to fight hard for this budget and to go forward. thank you very much. >> herbert weiner, retiree. while this is a bare bones budget, i don't want to walk in corks. we want to have the health services budget be as robust as possible. this is a very good system and works very hard and probably the envy of every joining county and we want to keep it as healthy as well as the beneficiaries active and retired. >> thank you. any other public comment? the motion is to approve a proposed budget.

all in favor say, "aye". >> aye. >> opposed? item no. 13. kreshg -- city clerk: initiation of rfp blackout period for fsa cobra administrator. >> the necessary that we notice the board and that we reframe from any communication with the vendors involved in the rfp and the vendors refrain from conversation with the board members. this agenda item is to notice the board of the rfp which will begin on march 17th for a cobra and flexible spending account administrator. we have as you may recall we had fbmc which is the name of the company that did our cobra and fsa for many years and purchased by

wage worked about 2 years ago. wage works has been the company administering these benefits. it has not gone out forbid in some time. it's time to go out for -- bid. we are starting that in march. >> any comments? i entertain a motion. >> i move to adopt the recommendation to observe the blackout period for this rfp for cobra administration. >> second the motion. >> is there any additional public comment? seeing none, public comment is closed. >> all in favor say, "aye". >> aye. >> opposed? there are no oppositions. item 14. >> city clerk: initiation of rfp

blackout period for all pair claims data base. >> we began to work the rfp for an all payer database. information will be protected at a personnel level but analyze and understand what the clinical issues that our members need are facing and what we can do to help with their benefit structure and also where the cost are, what's driving the cost. so we are very excited about this rfp and to get going with this and it will mean that all of our payers who do business with it. it's a notice of the rfp which will begin march 3rd for this one. >> any questions? >> i move that we adopt the

blackout period for the purpose of the request for proposal for all new payer data base. >> i second the motion. >> any further comments? all in favor say, "aye". >> aye. >> opposed? none. >> action item 15. approval of recommendeded health care sustain ability budget plan. >> gave the board to dissemination to members regarding plan benefits and cost and per prop c and 20 11 that was expanded to include actuarial expenses to reduce