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 healthcare and coverage and access, it is eleven non-profit community healthcare, and more than 10 percent of the city's population, and i am here today to support this legislation and illustrate why it is needed because coverage california is

not affordable for the many san franciscans who currently enrolled in the healthy san francisco coverage but eligible for coverage california. last fall i had the pleasure to train, 115 staff from the department of public health on how to enroll people in the coverage california, many have been working with the clinics and the population since the program began in 2007 and they know these patients very well, they were so excited to learn about the program and the prospect of helping people enroll. and well, when we got to the part of the training about the cost of the premiums, the cost of the co-pays and the cost of the deductibles their eyes got very wide. and mouths dropped open, and coverage california is significantly more expensive than the healthy san francisco program. and these staff knew that the first time they saw the sticker price that it was going to be unaffordable for their patients. staff who were very upset and even angry. they so wanted to be the bearer

of the good news, and now they tell them that their coverage was going to be out of reach. this was not a job they wanted. their fears were realized i have countless stories directly from people that i have worked with that the coverage california costs are not affordable, and he told me that his wife could not sleep at night, knowing that they could not afford the least expensive plan and that they could scrape together and borrow enough to coverage the premiums for a few months and they could not afford the co-pays. and what good is the insurance? we are asking the board to make the full scope coverage more affordable for more as soon as possible. >> thank you. >> i am going to read a few more names. >> caroline and amber bauer and caroln, and scott hage, and brenda, beros and i apologize

if i miss pronounce any of your names. >> good morning. my name is dana and i am a leader also at the san francisco organizing product inner faith action. and we represent tens of thousands of familis in san francisco, and as part of the pico network, we held the healthcare security ordinance and the affordable care act into law and we want to see them work together for bring healthcare to the most possible people. and the universal healthcare council agreed on a few principles, one of which was that healthcare should be paid for by the coalition of the community of employers, of the employees, and of the government. and for this reason, the loophole has got to go. it is unfair to other employers, who have been paying what the law requires, and with

the golden gate restaurant association thought all the way up to the supreme court that said no, this law is the law. and it is valid and constitutional and binding, and then they figured a way to get around it. and unfair to the employees, who don't get their healthcare paid for by employers who are using loop holes. and it is particularly unfair to the restaurant patrons who for so long paid an extra portion for their meals in a good cause, and happy to be supported for the employees, and they did not realize that three quarters of that money was not going to the healthcare. and that that is entirely unfair and just really fraud lent and so thank you supervisors for your support of this ordinance and please bring it to the full board, and get it into law. thank you. >> next speaker, please? >> hello, supervisors i'm dina and i am the vice president for

policy and advocacy at the san francisco clinic, and i am just here to say that we are proud to be san franciscans today because there was a problem the supervisor and the department of public health worked hard and hillary has made huge efforts and we have all worked together to bring a modified version of this ordinance. so i think that i just want to say on behalf of us and all of the patients that we serve, 90,000 in san francisco and mostly low income and we are particularly going to be glad to say that the seniors that they don't any more age out of healthy san francisco. or for some reason they are not eligible for medicare and we are just proud that we have been able to bring this and get this and get it passed and we hope to get it passed and be able to tell our patients some good naoutds and so thank you for your work. >> thank you for your hard work too. next speaker, please?

>> thank you, supervisor campos, for your leadership on this topic and i am steve, the owner of san francisco soup company. and while i think that we definitely want good healthcare coverage for workers in san francisco, and residents in san francisco, and i think that we will disagree on how we accomplish that. and i am afraid that the biggest problem that we have in the city is affordability and it is affordability for everything and while healthcare is a high priority, i think that healthcare is a higher one, and i am concerned and the version of it what will do to affordability in the city and the problem with the law is that it is the law of unintended consequences and when we try to metal with the free markers and we are not careful we can have the unintended consequences as we have seen over the last few

years. and the problem is that some businesses can easily afford this and other businesses just simply can't. and we talked a lot about the restaurant industry. and how is the restaurant industry dealing with this and we are dealing with the back actors and the people have been collecting the money with the serious charges that are not applying it to healthcare and however, over all, a concern amount of money has been collected and businesses have been able to survive, over the last five years. but i think that everyone understands and agrees that only whatever the number is, 25 percent of the money has actually been spent. and if the businesses have to actually spend 100 percent of that money, that four percent surcharge that you are seeing

now has to become 14, or 16 percent surcharge. and that is what i am concerned about. and i am concerned that the only way that businesses can manage this increase, and these increased real costs is going to be through the price increases which will make the city of san francisco even more unaffordable to those who can at least afford it. and this is going to have a ripple effect through the entire economy. and on top of the increases in the minimum wage that we all know are coming and the very dramatic increases in minimum wage. and personally, i prefer a single payer healthcare system. i think that everyone in our country and city should have good healthcare. and i think that there must be another way and other ways of solving this problem, rather than forcing the employers like myself who hire the people who have the low skills, and have to pay 20 percent more for healthcare and employing these

people and ver we are and i am proud of hiring the people that i hire and the problem is that... >> thank you. >> when you hire people at the lower end... >> thank you. >> you have to pay more. it effects them even more. >> thank you. >> that is the problem. >> supervisor campos? borden the golden gate restaurant association and i am going to focus the comments on the inner portion of the legislation and we agree that we would like to see more people covered under coverage california and if there is a subsidy model that works, that makes a lot of sense, but one of the issues if you are pulling the funds and they are going anywhere other than an mra account it is a tax and it should be dealt with differently and i think that we have always said that we would be interested in talking about a tax if our goal is to make sure that we can provide insurance to the broader space of people across all segments. and the issue is that the city is 54 percent and i think that

there is a misconception that money is sitting around that we are recaptured after 24 months because the employees did not spend it was because the employers were being mean and cruel. the city's own mra, and only 54 percent utilization and that says that there are people who have these accounts, who don't need them. some of those people are people who have insurance already because under the employee spending requirement of the city if your insurance cost less than the hourly spending requirements you still have to meet that requirement in another way, and the health reimbursement were birthed out the fact that the employers needed to reach a dollar amount. and we always contended with the implementation of the affordable care act that this law should be amended to allow the employers that provide insurance that is aca compliant and which has a threshold of 9.5 percent of income, and that those people should not have an additional spend, and we additionally contend that

especially because of the individual mandate that if an employer offers the insurance and they should not be on the hook for creating an account because the people have declined insurance that has to be affordable to them by federal law and the other thing that is problematic to us is that because of the change of the affordable care act, the smaller businesses and those with less than 50, it is much more challenging in this environment to provide the healthcare and it will be easier for the people to get a better deals and it is a real problem that we need to look at and the businesses have the same challenge of finding the plans and when the employees don't take the plans up it makes it difficult for them to provide the affordable insurance. and we really need to look at who is actually an mra accounts and who are in hra accounts on many of those people who actually don't need coverage, in san francisco. and they are other reasons, let's change the law to make it more compliant with the affordable care act. and focus on providing insurance, and i think that is what we all want to do. >> thank you.

>> i am going to read a few more names, marindugan, connie forge. and alisa messer. >> okay. >> good morning, supervisors, campos and yee, i am the vice president for the para professionals for the united educators of san francisco and also a working parent and i represent the parent professionals who are low income workers in sfusd. and i know that the struggle that it is to keep the health insurance and to make ends meet. uesf supports compromise because it will close the loophole to be sure that the money goes to the working people and there are laws that the public health department to come up with a plan to cover working san francisco. and we appreciate co-sponsors supervisor kim, mar, and avalos and we applaud supervisor yee for his commitment to close the

loophole and now let's hope that mayor lee and the board of supervisors move out to cover all working san francisco, as the affordable care act is implemented thank you. >> thank you, very much. next speaker? >> my name is amber bauer and i am the political director at the san francisco labor council and i want to applaud supervisor campos for being steadfast on your work on this issue and the supervisors who have come forward, yee, in support of, and with the political will to really close this loophole. i have had the opportunity to work with some of the workers that are affected by this, and you know, this is not about, not wanting to use the money or not being able it is not being able to use the money. and i get to go back today, hopefully after this vote, today and say, you know, this city does work for you. we do care about you. and we have worked for years to close this loophole.

and you guys deserve this money. it is your money, and you use it for healthcare, and this is what the legislation was really brought about to do and i feel like we are use of it and i appreciate then and the work of dph on this issue, to bring it forward and thank you, again. and for all of the support here as well. >> thank you. >> next speaker? >> hi, my name is brenda bares and i work in dph at one of the primary care clinics and i am happy that this is coming forward and this is needed and i think that one thing that has notd been talked about is what that money could be spent on to improve the people's healthcare out comes which is also one of the purposes of the affordable care act. and education, for the patients. and to keep them healthy before they end up in problems or in the hospital, could be expanded and there are so many things that need to be expanded and

the specialty care and primary care so that we can get everybody in and the people can stop having the problem of not being able to get an appointment and these are the things that i have seen and thank you very much supervisor campos for bringing this forward and this is something that is needed. those of us who work on the healthcare on the ground providing this healthcare we know that it is something that has to happen and so thank you very much. and keep. >> and thank you very much. >> next speaker. >> ariana, political coordinator, and the tender loin, thank you supervisor campos and i also want to thank, supervisor mar, yee, and avalos and kim for their support on this legislation and it is very important, and i am glad that we are getting closer to having a legislation, that does close the loophole, and it is a difficult thing to close and that we continue to provide healthcare for all of san francisco thank you for your time. >> next speaker.

>> scott, houty, cal insurance, and let me start on a personal note. i own a small business and i have 28 employees. and i provide insurance, and i pay 100 percent to the insurance. and this year, for the 6th year in a row, i got over a ten percent increase, and i got a 15 percent increase. and but all raises the issue of affordability. a lot of businesses don't have the margins that i do and they just can't afford that. but the two comments that i would like to make is first of all i think before moving through with this, i think that it is important that we get a statement from the federal government that this is legal. we know that the health reimbursement act was found to be stand alone was found to be illegal. and we would contend that you need a statement from the federal government saying that it is. the other thing that is

important on that, is that if you set up an hra account now, and if it was determined, well, if you set up an hra account now as stand alone, you are subject to 100 dollar a day penalty and if the mra, was found to be similar, to be hra, the businesses that now are using the mra, could be subject to 100 day penalty and i think that it is important to we get a determination from the federal government and the second part, is if you go into an mra, that does not, and if you have got over 50 employees that does not meet your obligation for aca and so you would have to pay everything, for the hcso, plus, you would be subject to 2000 dollars per employer penalties over and above that. and i think this needs to be looked at more closely and hope that you will consider that. thank you. >> thank you, very much. next speaker, please.

>> maruen dugan and i am a registered nurse. and i am a san francisco resident and thank you to supervisors campos, mar, avalos, kim and my supervisor yee for your work on this. and as i speak in favor of closing the loophole and to be sure that all of the patients get the access to needed services and access is a huge issue and i see, when the patients finally get access and they struggle to get the basic and the needed follow-up care. and many healthcare workers across all struggle whether we have limited insurance or no insurance, and i just think that it is a tragedy. and obviously i have the healthcare as a human right and it is a tragedy, as well as in the city that the basic services and we struggle to provide for the patients. >> thank you. very much. >> next speaker, please? >> supervisors, connie, from the san francisco labor council. one of my new jobs is to be out in the bay view hunters point organizing over 10,000 of our members who live there and i

want to tell you something, about the statistics there. this issue, this issue about closing the loophole is about providing access to every single san franciscan. and without closing this loophole, we are missing a 90 million dollars that is owed to them and and the workers get

the coverage they need, my god son cannot longer go to the college and he is working to pay rent and he does not have a cell phone and cannot afford health insurance and just in my neighborhood, the other day at my local market, the woman who was always, smiling when i send money to my niece to pay for

her healthcare, through western union, she is gone, that is one day, because she found out that her sister with the new affordable care act is going to be $700 a month and does not how the family is going to be able to afford it, and any way that we can support making affordable healthcare, really affordable through any channels i strongly support and i am the only person in my family that has a job that has healthcare and it is really difficult to watch them suffer. >> thank you, very much. >> and next speaker, and any member of the public who has not spoken but would like to speak, please come on up. >> thank you very much. >> hi, i am alisa messer city college of san francisco and the labor council and i want to thank the supervisors for bringing this forward and for your leadership, and supervisor campos on this issue. and a week ago, at this time, actually, i was watching more than 50 nurses cross the stage of the city college of san

francisco, graduation in their white caps and gown and it was a celebration moment and in fact we had many graduates, and city council of san francisco trains more healthcare workers than any other institution in the bay area, and it is an important place, but unfortunately i know that those nurses and those newly graduated nurses who are crossing the stage i know that my students in my classes, whether they are working in the restaurant industry, or in all sorts of places in san francisco, and frequently can't afford healthcare. and go without healthcare. and i see it all of the time and they told me their stories all of the time. and this closing this loophole, is incredibly important, and we thank you for your leadership on this, and it has been more than eight years and there are 90 million dollars, that goes untaped that i know from talking with my students, that they don't know about, that they don't have access to. and so, we need to do that education, but we also need to insure that we close this

loophole so that san francisco students, and that all of san francisco has access to healthcare including our immigrant communities and whatever else that we can do. this is a very important start. and it is an important move. and so, thank you for your leadership and it is time to do it and let's close the loophole. >> thank you, very much. >> are the young people,

that need our help in the future and i am really happy that we gave continued this item for a short length of time to strengthen the language so that we are sure that we will have a successful program. and so, not only will i want to make a recommendation, that we send it off to the full board and the positive recommendation, but i also would like to co-author at this point. [ applause ] >> thank you. >> thank you, very much. >> supervisor, yee, thank you. and one of my make a motion, to

amend the legislation, along the lines that have been outlined before, and you have a copy of the amended language. and if we can amend that and the motion is to amend it. so we can do that without objection? >> without objection. before we vote, i just want to make a couple of points and i will be very brief. again, i want to thank all of the speakers that have come out. and you know, the thing about these policy specifics and sometimes good people who have different perspectives and i understand and respect that but i do want to provide some context. yes, affordability is the issue of the day in san francisco. but, you cannot talk about affordability and only focus on housing. a big component of the city

being affordable is the ability of any individual to actually have access to healthcare. and the reality is that someone is paying for what is happening right now. and what is happening in these businesses is that these businesses to the extent that they are not spending this money on healthcare, they are balancing the books, on the backs of workers. and so the question is not whether or not something needs to be done but whether or not the status quo is correct and i have a problem with 26,000 workers being denied access to healthcare and i appreciate some of the comments that were made and the reference to those people who as i supposedly have the low skills. and there are still people, and they still have healthcare needs basic needs and the fact

that they may not have the high skills that others may have, does not mean that their kids are not entitled to see a dentist once in a while. and does that mean that if a woman is pregnant that she does not have the right to go see a doctor to make sure that she has a healthy baby? having low skills does not mean that somehow you are not going to have access to the very basic thing that a human being needs, which is healthcare and i want to note and i want to close today, with a quote, of someone that i admire who talked about the importance of healthcare and said, and that is dr. martin luther king. and this is what he said, of all of the forms of inequality, injustice, and healthcare, is the most shocking and inhumane. i believe that dr. king spoke

many truths and had many points of wisdom. but i really appreciative that he captured how critical and how basic healthcare is to anyone's existence. and it does not, allow someone to live in san francisco and to afford to stay in san francisco, if they have housing and if at the same time, their kids are sick, and that is why this is so basic and so fundamental, to who we are. and so, i am very proud to have the co-sponsorship of supervisor yee, and i want to thank you, supervisor. and again, i want to thank all of the people that have come out to speak, on this item. and so with that, if we could have a motion, to have this item move forward? >> with a recommendation? >> a motion, with the moving forward the ordinance, with

these amendments. >> so, motion to move this item forward as amended? if we can take that without objection? >> without objection. >> thank you. [ applause ] and mr. clerk, do we have any other business before the committee? >> there is no other business. >> thank you. meeting adjourned. thank you. 1, 2, 3, 4 great.

okay. the regular meeting of the board of education of the san francisco unified school district for new mexico tuesday, may 27, 2014, is now called to order. roll please. mr. haney. ms. maufas. okay sdrvm.