our city staffers such as there is no transparency with anyone nor the public. can you help us understand what that entails. >> i will attempt to. i'm here on behalf of the city attorneys office. good morning supervisors. actually it was this board that passed this section of the administrative code section 15.104 which authorizes dph to enter into an agreement with basically a cooperative united health care systems that then in turn contracts with innovation to do the negotiations. now, in the very language of that administrative code section dp h is required to agree to

united health -- uhc's terms and conditions. so it was a measure passed by the board. obviously the board could revisit that language. i think as dave woods indicated on behalf of dph that if certain pieces and information are made public, we definitely would lose our ability to leverage better prices. even prime vendors would be reluctant to act on our behalf because of another locality could point to san francisco as being able to acquire a

certain price and a certain drug and manufacturers would start to back out of negotiations. so it's something again that the board could look at. bus there are disadvantages. >> when was that code? >> i believe 1997. >> do you know if our predecessors were aware of the implications of not being able to view the prices? >> i don't know. i can look into it. >> from my standpoint, it seems a bit kofkaist that the industry is essentially saying that we will negotiate with city governments but only do that if a handful of bureaucrats and city staffers do this with zero scrutiny

and i understand that they might say to us that if you are unwilling to an abide by secrecy and trade confidentiality agreement but that affects our public transparency law and to have competitive pricing. that's what i'm grappling with. i certainly understand if there are many cities that do this we would be concerned about getting cut out but it's in the interest of all the organizations that are negotiating with the government cities to have more transparency. if you have any thoughts on that? >> i understand the concern. i think we often need to identify the slice of pharmaceuticals that we would be looking at so we essentially only the supreme

court ruled in after san santa clara can move the pricing from the manufactures to the price. now we are looking at the inpatient piece. of that piece you have a number of drugs that are protected on patent. so those drugs are protected. other companies claim they have proprietary rates as to the drugs. i don't have an immediate suggestion other than

other than what we can do. this is an evolving area because there is certainly rocketing cost of prescription medications is that dph can explore what organizations exist in vendors that perhaps don't have quite so stringent terms in their agreements. >> which i think is a very interesting possible next step. it occurred to me that if our department of public health reached out to department of public health's of other major cities and we all collectively asked for a little bit more transparency there might be some movement that could be helpful so it's

not just san francisco. that's one idea. another observation i would have is the issue of pricing in the area of hospital cost that for many many years was incredibly untransparent and this past year the obama administration released hospital pricing throughout the country and it was a water shed moment where hospitals can compare prices and consumers of health care can compare prices. the federal government hasn't done that in terms of pharmaceuticals but in our outpatient cost we have lower prices than other areas and two-thirds of the other inflated cost and try to get what we think of the fairist cost for residents that just can't afford the drugs that we are talking about. but, i look forward to working with your office as well as the department of public health

in moving this forward. >> i would follow that up. that is action at the state level would be equally helpful in terms of requiring greater transparency. >> i understand that our state senator mark leno offered sb 746 to offer lower drug prices. unfortunately that was a bill vetoed by the governor. we are all here trying to figure out what to do in san francisco to move things forward. this you for your work. colleagues, at this time unless you have any other questions, i would like to open it up to public comment. i know we have a fair number of public comment cards. let me call up the following individuals who submitted cards. jessie brooks, daniel

ramos, bates, michael lion, duke, kelly and those are the cards that i have at the moment. if you want to step up, you have two minutes.2 minutes. thank you for your leadership on this. >> thank you for having this conversation. my name is dale glutsdz and bay area regional foundation and we were the major funder for prop b and dealing with the hiv epidemic and i'm very aware of life savings medication. i met a lot of people with other health conditions such as cancer, heart disease and diabetes who also struggle to afford medication. these people are all races and financial means. a city that struggles to remain

affordable, lower cost to medications is crucial. thank you. >> next speaker? >> good morning supervisors. my name is daniel ramos and i work with aids foundation as a pharmacy representative and pharmacy case manager. as a professional in the health industry i have worked in the bay area for 10 years here in the san francisco and east bay helping people find ways to afford medications that they need to survive, life saving therapies. my current role as a pharmacy representative and pharmacy case manager i see firsthand to some medications that cost pennies to make are sold at staggering high prices. for those with top insurance plans, a typical medication maybe only a few dollars, but those who are uninsured, the exact same

drugs could cost thousands of dollars per month. we mentioned earlier mr. woods mentioned the new oral hepatitis c therapy, $1200 per pill and the treatment is about 3 months. it's the newest probably one of the most effective course to hepatitis c as we know it bus also one of the most expensive anti-retro viral therapies that hit the market. many insurances are not covering it at this point and definitely medi-cal and medicare are not covering it whatsoever. the point being is that pharmaceutical cost, lowered cost would increase access to people who cannot afford it. there is really nothing worst than seeing a patient struggle from buying life saving medication to other items

such as food and clothing. this resolution is a smart way to address an issue that is being ignored at the state and federal level. drug manufactures have made sure there is no limit. >> thank you. next speaker. >> good afternoon, i'm reverend daniel. city of oakland church. i would like to say thank you for passing this measure and this you to the entire san francisco area and community. it's imperative that we get this medication and everybody's medication that needs them that can't afford them. few people may know it but i have tested positive for hiv in september of 1988. along with a diagnosed i was given a life expectancy for 11 years. had it not been for the grass roots organization to provide

medicine to me. i wouldn't be here today as things trickle down budget wise it does work and does matter. there is nothing more disheartening that you can get help and get to the doctors and they say your medicine is not on our list. we can't give it to you. it's discouraging and at the same i want to say thank you and god bless you for all that you are doing for us. it definitely working. never think it's going in vein. it's definitely working. i have seen many things in my life that i would not have seen were it not for your efforts. >> next speaker. >> thank you for putting forward this resolution on drug pricing. it's just a reflection of the outrageous profits of the drug companies and this whole aspect of

secrecy is a tribute to the free market system. i'm michael lion and worked at san francisco hospital for 15 years and i want to give a historical for why these issues are so important particularly with dph. in 2000 dph closed one of it's pharmacies in san francisco and patients had to wait in line for 5 hours. there is a major take back where san francisco pharmacy would continue to stay open. dph would contract for the non-for profit benefits manager and the pharmacy oversight committee was set up and i was on that committee. by april 1, 2003, we concluding that providing community pharmacy

services has cost the city approximately $3.5 million more per year than it should have for the last three 1/2 years. it included about $1 million more in fees in service management fees and $2.5 million for the drugs themselves. this was because the city was unable or unwilling to abide by 340 b regulations that are necessary to have the program. to give you an idea of how important this was is by 2005 dph was charging patients above the poverty line $5 for each generic and $10 for each brand name drug and they were thinking of doing this for below -- >> thank you very much. next

speaker. >> good morning supervisors. i have been politically active since i was a child and my concern was for the populations that are left out of many of the things that this country prospered on into war, after the war and things going on back then that were not able to afford the medications necessary to keep

them going especially diabetics. the legislation that prop d brought forth i thought was a marvelous thing for the city to be doing because of the population involved who have extraordinary needs for prescription drugs and simply cannot afford them whether or not they are insured. many times the insurance co-pays are tremendously costly and and various companies say you can't get our drugs because your insurance doesn't cover this particular drug and you have to get another type of drug and that doesn't work. i would hope that this legislation goes forward. i noted specifically the last next to the last further resolved you mentioned transparency and pricing for health care and prescriptions. they need to go hand in hand

starting with the prescriptions. the health case -- care issue is tremendous. >> thank you. i want to call up a couple more folks. if there are any other individuals who wish to speak on this topic, please lineup. ms. kelly. >> hi there. my name is kelly. i take drugs. i take drugs to help me walk. i take drugs to help me with my blood pressure. and when i see farma do you agree is helping to raise my blood pressure. because there is a difference between being ridiculously rich and very rich. and without transparency drug makers become ridiculously

rich and our people become at risk, ridiculously at risk. i'm very proud for san francisco voting 80 percent for proposition d. many of san franciscans can afford, but we stand here to tell you, we want everybody to be able to have drugs. we believe that you can work on this. the transparency is a very difficult thing and we learned about that today. i believe that we can work on ways to making a transparent what the markup is on drugs and what we can bargain for. i used to work in a jewelry shop and pawnshop and i know that the only thing that has a higher markup than jewelry and

luggage is drugs. maybe i should have sold drugs. i didn't. i believe that you have to help our seniors, you have to help our poor, you have to help our homeless. you have to help our immigrants, and you have to help people like me get the drugs they need to survive. >> thank you. >> good morning supervisors. my name is lee. i spend thousands of dollars or asthma medication. the reason is we can't just have one inhaler or one neb lieser. it's his

life, it's children's life. these fair pricing is crucial because of the skyrocketing cost. i'm going to kaiser to spend $200 on a breathing treatment. working class people can't pay this and they are struggling and they shouldn't have to choose between paying medication and someone's life. san francisco has always stood up for families and this resolution supports this type of family to help the families and make a difference in their life and no one has to choose from their health and their lives and this will help make life affordable. thank you. >> thank you. next speaker. >> hello, supervisors. my

name is jessie brooks. i'm an hiv/aids advocate and also hiv positive. i have seen the impact that high drug pricing has had on patients. i have seen pricing co-pays where have to decide whether to pay the co-pay or to eat. those situations. i was very active on prop d and so glad that san francisco passed it. this drug traffic is a run away train. how do you stop a run away train? you stop it. before long if we let it keep going it's going to collapse our system. it's one of the issues that wasn't taken care of in the affordable care act. it should go hand in hand with drug cost. also i have seen

patients, i'm one of those lucky patients where the city and state are paying for it. in the end, many are paying and there are a lot of people that don't qualify just by a margin for city and state help. so they are struggling each month to pay for their drugs, life sustaining drugs and in 98 they created hiv medicine that help people live. these are drugs they have to take everyday. as someone said earlier they created a hep c pill but it's $1,000 a pill. if federal insurances try the old treatment which is harsh and doesn't work like the new drug first and then maybe offer them the new drug. in the end

patients that are poor are going to suffer. thank you. >> thank you. let me ask are there any other members of the public who wish to speak on this topic? is there any additional public comment? seeing none, public comment is closed. >> i want to thank those who came to speak today and i appreciate you come here and show casing our voices from our disabled community, senior communities and individuals living with hiv and aids and representing their families from every part of our diverse city. i also know that we have a lot of work to do and i want to thank the staff and the department of public health for your creativity and attorney staff to move this topic forward. this is a topic that has been around for many

many years and there is not head way at the state level that we want to see. my guess is i share the perspective that support proposition d that we hoke -- hope that san francisco can lead the way to the counter parts around the state and country. i want to thank my aid catherine russia who has attended lots of meetings for understanding this topic and john, thank you. with that, colleagues i ask for your support that we move this out to the full board for a positive recommendation and move this issue forward. >>supervisor london breed: colleagues, can we take this without objection? the motion passes with positive recommendation. thank you all for coming today. >> madam clerk call the next

item, please. city clerk: [hearing - drought preparations] sponsor: breed hearing with the public utilities commission and department of the environment to review their plans for preserving water, and protecting san francisco's watershed from drought and fire, given we are in the midst of the worst dry spell in 100 years, and governor brown has asked all californians to reduce their water use by 20 city clerk: [hearing - drought preparations] sponsor: breed hearing with the public utilities commission and department of the environment to review their plans for preserving water, and protecting san francisco's watershed from drought and fire, given we are in the midst of the worst dry spell in 100 years, and governor brown has asked all californians to reduce their water use city clerk: [hearing - drought preparations] sponsor: breed hearing with the public utilities commission and department of the environment to review their plans for preserving water, and protecting san francisco's watershed from drought and fire, given we are in the midst of the worst dry spell in 100 years, and governor brown has asked all californians to reduce their water use by 20 okay. give me 1234 -- give me one moment. i call for this issue with the department of environment and we as a board and city are facing a biggest drought in many many years. 2014 is projecting to be even drier. it's funny that it reigned for almost a week straight after i called for this hearing and maybe even yesterday. maybe this hearing was designed for good luck. >> keep calling for more hearings. >> unfortunately even with those rains we are still way below average. the necessary levels at hetch hetchy. at

the february levels in february 2014, water shed was at 40 percent of the snow level and snowpack was 22 percent of it's normal level and we have some of the best tap water in the country. it can be easily forgotten and the water has to come from somewhere. the hetch hetchy reservoir system through a marvelous civil engineering is still dependent on the river and the snowpack in the sierra nefd nevada and 2.6 million people depend on this. and it's going to make the state vulnerable to fires. as you know the rim fire burned for 69 days and threatened the hetch hetchy

reservoir and was saved thankfully tourette fire -- to the fire departments. governor brown declared a state of emergency and called on californians to reduce their water energy by 20 percent. the sf puc is asking can ustomers to voluntary reduce their water usage by 10 percent. the department is outlining actions to reduce the water and develop alternative sources of water. today i would like to ask puc and department of environment to address the topic. no. 1, the current water supply and projection for 2014 and 2015. and the plans how we will

meet the puc's goal of a 10 percent usage reduction. no. 3, and overview of city water unl by the department. what are the departments doing in terms of consumption and conservation and who is doing well and not. no. 4, how are we protecting the water system, maintaining and updating and improving the water structure and guarding for fire and funding for immediate projects. no. 5, long-term planning. how are we planning for population growth. what are we doing to find sources water whether it be desaulization and i know puc grant was putting a proposal on hold and i would like to hear more about that. what are the departments doing to educate water customers,

no. 6, to educate customers about the needs to previous and the methods to preserve. those are my objections today. thank you all for being here and with that, i want to turn it over to richie, assistant general manager for water. >> thank you, madam chair and supervise ofrments -- supervisors. the last time we called for reduction it rained. when people start paying attention, we get somewhere. i would like to start off with this slide that will answer your questions but i will answer those as i go along. what i'm basically going to talk about in the water supply condition and outlook for us our volunteer 10 percent reduction effort.

what the departments are currently doing as well as our users in the city itself. our recent water system improvements to get to that reliability system that you talked about and state and federal legislation that are in the works that hopefully can provide funding for some of the activities that we need to engage in to really save more water here. first, on the water supply conditions, the current water supply in our reservoir is 98 billion gallons which sounds like a lot of water but when you need about 32 million gallons per day, it's not a lot of water. we have 12,000 acre feet in our system which is a back up water supply. i will talk about how we plan