>> we want to thank the following members of sfgtv staff for covering the meeting today. jessy larson and jonathan, thank you for your service.

>> if we can have a motion to excusing supervisor mar, by spurpt sperp yee, and we can take that without objection. >> and if we can please call the one item that we have, item one. >> and it is an ordinance, revising the healthcare security ordinance to require all healthcare expenditures to be made to establish a city, public benefit program known as the healthcare, access assistance program.ordinance

revising the health care security ordinance to require all health care expenditures to be made irrevocably; to establish a city public benefit program known as the health care access assistance program (hcaap); to describe the public benefits available under each of hcaap's three component programs, healthy san francisco, covered san francisco, and health care access accounts; to set certain eligibility requirements for program participants; and to set an operative date of october 1, 2014. >> >> thank you, very much. and this is an item that i have included in the agenda, and i want to thank my co-sponsors supervisors avalos, kim and mar and this is a long time come and before i go into the key points that i would like to make, i once again want to thank, the office, and particularly sherry, for the amazing work, that she has done. and tapping into the very complicated issue. and it is greatly appreciate ated and we will not be okay today without the excellent work that they have provided. and once, again, to thank my chief of staff, hillary, who has been working for a very long time. and over the last two weeks, i have been working with the

department of public health, and with the objective of developing the amendments to this legislation that address another concerns that we have heard. and as we discuss at the hearing, there may be items included in this ordinance, but the two main points that the legislation deals with, are one the closing of a loophole that has been in existence for a number of years. and that has left hundreds of millions of dollars unavailable to workers in san francisco. and we know that at least 26,000 workers that have been impacted by the assistance of that loophole and then the second piece of that legislation is what happens as san francisco moves forward in the implementation of the affordable care act and the

legislation tried to do, what we believe needs to be done to make sure that we devise the access that every san franciscan has to healthcare and quite frankly codify some of the very same policies that the department of public health have indicated that they will follow, like the idea that people who qualify for the aca, who are currently in san francisco but may not be able to afford the aca, are not going to be kicked out of healthy san francisco and the intent of this legislation was to do precisely what the department of public health has said that they were going to do. and i believe that when the specifics of what the department of public health proposes to do in terms of compliance with the affordable care act and maximizing access to san franciscans, i believe that when those specifics are finalized that the specifics will look very much like what

we have proposed and while we believe that the coverage san francisco portion of the program is a workable program, that as soon as it lays out a way for san francisco to insure that every worker and every resident is insured and i understand that there is always a need for flexibility by city agencies and so we are open and prepared to work with the department of public health to give them the flexibility. we have distributed to the committee and they are available to the members of the public, a set of amendments that i will be making today. and address the specific issue of what happens with the aca i am mri thentation and coverage san francisco piece of the ordinance and the amendments that i will make today direct the department of public health to develop its own plan that the employers made to the city, are used in a manner to get as

many workers insured as possible. and the amendments and the set of amendments require that the department of public health develop this plan by august first, 2015. and that the department of public health seek approval of whatever plan they develop not only from the health commission, but also from the san francisco board of supervisors, and that all of this happens in a timely fashion, so that we can implement that plan for the 2016 coverage california plan year. and in the interim that the department of public health would continue to operate the city option, and in a manner that is consistent with what the guiding principles and the key findings of the 2013 universal healthcare council in the final report that they issued. i believe that these amendments will accomplish the objective of closing the loophole while at the same time giving the

department of public health the flexibility that it desires to develop a plan that it feels comfortable administering. and so the main thrust of what we are doing and the important key and the important component when we have been working on for years is that we finally closed the loophole in the ordinance so that the workers are no longer denied between 80 to 90 million dollars, in money that would help them and their families, including the children, to have basic healthcare. and i call upon the colleagues to join me in supporting to send this to the full board and i also want to take the opportunity and i know that we are going to hear from some folks during the public comment and i want to take the opportunity to thank both sides of this issue who have taken the time to meet with me. and i especially wants to thank

the workers who have had the courage to come forward and to speak about what this loophole has created for them and their families, and this is truly a long time coming. and it could not happen at a more important time. san francisco is in an affordability crisis and as we speak, san francisco arguably the wealthiest city in the country has the fastest growing inequality in the country as well and the gap between the have and the have-nots keeps growing and it is only fair, consistent with the values of the city of saint francis that we finally insure that the tens of thousands of workers that have been denied access to healthcare with money that was fully intended for them to use to provide healthcare for themselves and their families that they finally have what the law always intended to provide them. and so with that, i thank my colleagues, for the consideration and seek their

support. and unless there are any comments, or questions, that we would like to ask the director of public health who is in the audience to director garcia, to please come forward and we appreciate your presence here today. and wanted to make sure that i do give you the floor to provide any comments that you would like at this point. >> first of all, thank you, chair, campos, and supervisor yee. particularly to you, supervisor campos and to your chief of staff, hillary and we want to thank you with the flexibility that you have provided us and i think that we all have the same goal and no matter what the program may look like, the ultimate goal is to get the people insurance and i think that is both you and i, have that same goal in mind and we may have to have the different roads to get there and this flexibility will give us that opportunity to insure that the people as many people as we can get covered by insurance. to strengthen the healthy san francisco is another area that

we would really like to look at as well and as you know the more people that we can get on the insurance, the stronger healthy san francisco will be for those who cannot afford and also do not qualify for the aca. so, we are going to work very diligently and we will be working with the local health plans and i also have the san francisco health plans, full commitment to us to work with us as a potential third party administrator for this program. and any administrative role that they can help us with insuring that we understand how health plans work. and there is a lot of complications in their own it systems but we feel like we can get through that and insure that those who need this assistance for out of pocket, support, as well as in this assurance and that will be all of our goals. and we are also going forward to the health commission in the near future, to talk about the fact that we are going to continue the effort to provide for those until this program is

implemented, for those who cannot afford it. and also, we will see in the future that that may be continued for those individuals who may not qualify for the particular program that we are working on, but we still need to have people have medical homes, and healthy san francisco will be there for them. and we also look at the request and i have and i think very positive support for the health commission and moving forward on expanding healthy san francisco for those over 64 who do not qualify. and moving forward on that and i like to thank the deputy director who was here at the last meeting who was able to represent me well in terms of this program and also helped with your staff to insure that we have the flexibility to make this commitment that we can get more people on insurance, and that everyone in san francisco will have health access or health insurance. and so for supervisor, campos, thank you for the flexibility. thank you, and if i could ask

you a quick question, ma'am? and i just want to make sure that with respect to the dates, that on the time line that i have provided in the amended ordinance, which would be that the department developed the plan by august first, 2015. and is that something that you are comfortable and does that give you enough time. >> that is very comfortable. and we are working as fast as we can on this and we believe that that date is a reasonable date. >> great. >> thank you, very much. >> i know that we also have someone from the office of assembly member tom and nadia conrad and i want to make sure that she or that we give her an opportunity and again, you know, we would not be here today, in terms of having a universal healthcare in san francisco, without the amazing work of tom, and we know that

he has been fighting this for a long time to make sure that we have access for everyone in san francisco. and this is a top priority for him and so we are grateful for his leadership. and with that, i will turn it over to you. >> thank you. >> it is great to be here this morning and thank you to the committee, for hearing us. again, i am here, and i am here on behalf of assembly member tom to read his statement in support, supervisor campos's ordinance. my goal when i introduce the healthcare security ordinance of the supervisor, was to insure that every san franciscan had access to healthcare. and i wanted to remove as many barriers as i could. and we have seen the city become a model for making care available. however, there are still improvements needed. i'm glad supervisor campos is here to carry on the vision,

that i had when drafting the healthcare security ordinance, and supervisor campos has been working diligently with the department of public health on compromised language for amending the healthcare security ordinance. and these amendments will help close the loophole in the ordinance, and maximize the up take of san franciscans with health insurance. and the amendments will also direct the department of public health to develop a plan for using the employer contributions for medical reimbursement accounts for the workers so that they are able to access health insurance. this will make sure that those employer dollars will be used in the right way, to help people get healthcare. when coverage california took effect, we also found people were falling through the cracks. still unable to afford insurance. the campos ordinance will take care of that, creating a safety net and allowing more san franciscans to access the

coverage they need. the city has a great opportunity here. we can amend the healthcare security ordinance so that it works with the affordable care act to make healthcare truly affordable for all san franciscans. we need to make sure that everyone's health needs are met, because it benefits all of us. thank you. >> thank you, very much. and again, we thank him for his leadership and unless we have any comments, do you have any comments? i would like to open it up to public comment, if that is okay? thank you. supervisor. and if i could actually call upon i see here the president of the san francisco labor council, mike casey to have an opportunity to please come up. and i think that we have a manageable size in the terms of the audience and so we are going to do three minutes, which is the regular time that is usually allotted. thank you for being here. >> okay, thank you.

supervisor, campos. my name is mike casey and president of the local two and the president of the san francisco labor council and i just wanted to note that eight years ago when this legislation was initially passed, i think that it passed unanimously. it was determined that there would be two tiers. one being for larger employers, and second, for the smaller employers and i was involved in those discussions and those needs and i remember, the discussions that they have, and actually have occurred, within the mayor's office when mayor nusome, pulled supervisor amiano at the time, and other leaders together to talk about what this legislation, would look like. and it was determined, that there would be two tiers not three tiers. in fact, what has occurred, as a result of this loophole is that there has been the creation of a third trao*er, a third tier, which is exempt,

and there are no exempts. and there were none at the time, and that third tier of employers who have been able to get away with taking back the money, under false pretences for many of the employers who have actually restaurant employers who actually put a amount on the check that should be deducted for healthcare that often goes back into the pocket of those employers. and so, that is fraud. and i remember at the time that there was a clear understanding that this was just a start. and nobody even imagined at the time that it would not cover everybody. in the meantime, hundreds of millions, hundreds of millions of dollars, that should have gone to healthcare of poor and working families, has been kept away from those workers. it has gone back into the pockets of the employers. and i find it amazing, that an unbelievable that we are here today in 2014, 8 years later,

not able to clearly understand that this is fixing something that should have been fixed a long, long time ago. and i come mend you supervisor campos for trying to do this two years ago. and i think that it was a very dark day, when the board of supervisors compromised two years ago. and i can only hope that we can fix this once and for all. and it was never intended to have a third tier, workers, excluded, or exempted from this legislation. and at the time, that legislation was passed, unanimously, i would like to believe that there has been progress made over the last eight years. that san francisco is an even better city, when it comes to taking care of its poor, and working class, who do not have the advantage of healthcare. and to think that we are yet, again, facing the possibility that this could be compromised

once again, or possibly, possibly, deferred, for an extended period is unbelievable and i really hope that we can close this loophole, once and for all. >> thank you, mr. casey. >> i am going to read a few more name, michael pulsano, meril beul. dana viacof. dina lamb. and steve sarver and borden. come up and if you could line up on our left, what would are your right, the aisle. thank you very much. >> go ahead. >> hello, my name is michael lusano and i am a recently on the board of san francisco, organizing project and inner faith action and more importantly i am a 62-year-old native san franciscan who is back where i grew up on tenth

avenue and supervisor eric mar's district. and i was compelled to come today because attending the meeting last week at the board of public health, i was discouraged is the polite word after the meeting because it was basically roughly, 15, in favor and one gentleman against. and i just want to fully support and afopm or pr and i want to support closing this loophole. thank you. >> thank you very much. i appreciate that. >> next speaker. >> good morning, supervisors i'm meril, director of