upgrading the charter language for the domestic partners regarding the eligibility for the purposes of retiring health care was drafted when the original domestic partner ordinance was impacted in early 80s or 90s since then the state has impacted a domestic partner ordinance and h.r. has recked partnerships by other states actually, i think san francisco was one of the first if not the first entities to create a domestic partner ordinance i was updating the language what counts as a domestic partner in the charter and if supervisor cowen's amendment gets on the ballot and passes that there will get updated. >> thank you any public comment

on that item on item 11? >> dennis encouraging active and retired firefighters i was going to ask that question myself thank you for the clarification. speaking now personally for no union or retired people i'm concerned with the fact they're in this mou doing away with the 10 county survey for the terms of the contract far be it from me to question anybody's work regarding the employees and what they think that best by over the years to do away with the 10 county survey i'm concerned anytime i see it eliminated for a short period of time as being toe in the door could possibly change the 10 county survey when

i personally over the last 40 years have benefited from any want to make known my personal feelings this is personal feelings regarding the 10 county survey. thank you >> thank you. >> claire i would like to actually expand a little bit on what mr. encouraging said. this language says. the term of this contract only i'm wondering in other negotiations because once the formulas went to the 9383 we went to the percentage formulas the 10 county survey was no longer relevant this was different if it's that baseline and the percentages were calibrated beyond that but i'm

concerned if this kind of language exists in other contacts and other employer organizations have eliminated the 10 county survey i testified last month that's the only benefit that retirees have other than the other charter amendment that impacts our minors so this is significant and i'm worried that's why i'm asking about the charter amendment i'm very concerned that the 10 county survey is gradually be come down and eliminated from the process we don't thank you for the opportunity for collective bargaining and this is significant to establishing a baseline for retirees so i want to know if other bargaining units have, in fact, eliminated language any consideration for the 10 county. i was there for negotiations

they were clear they're not giving up this benefit but to the determined next time they sat down for that >> herbert winn retiree and beneficiary of the system i'm against the 10 county erosion in in any way, shape, or form no matter if it's suspended for one second. i'm not only thinking of myself but thinking of retirees who follow me. and if i start having the erosion of a 10 county survey we'll be showing up at the hospital general saying city hall sent united states so don't do this >> thank you. is there any additional public comment seeing none.

item number 12 >> item 12 discussion item h f h financial reporting pamela levin. >> good afternoon pamela levin cfo cfo health service system today i'll provide a brief summary of the administrative budget this report is based on actual year to date revenue as of april 30th, 2013. we continue to project a year-end fund balance of 94 panama canal .9 million this is less than what i recorded bus the fluctuations in the amount of what we were projecting to add to the balance at the end of this fiscal year is expected as of today we've paid out see 54

thousand in envelopes - incentives and don't expect to see over 3 hundred thousand the projected year-end balance is 5 hundred and 5 thousand. we have had discussions with the controller's office and the mayor's office concerning kari forward a bottle into 2014-2015 it's critical in the budget analysts recommendations colonel to fruition i'm happy to take any questions. >> any questions. >> questions. okay. thank you >> thank you. >> is there any public comment?

>> retired city employee. excuse me. i think we have great concern ore the budget process and the budget analyst is proposing to do we've claimed for a number of years on this to this commission and board this agency has never received credit for the savings that provides to the city multiple million dollars every year we negotiate with regards to the benefits and the cost of three or four employees 3 biggest and north yet when it comes time for our budget we're like oliver may i have more sir, it's upsetting they want to cut the 3 hundred

thousand and make any cuts and diminish the clarifications of the employees that are hardworking and the positions they'll diminish them by one level or factor because the exceptions and the levels are not there whatever we can do to fight we have to ask our colleagues and our sports to be present at the budget hearings and to justify on our on behalf of after saving them over $20 million they'll want to take the guts out of our proposed budget is wisdom soliciting u lutz know and we'll go on record we need to ask supervisor farrell to really do his best as he did last year to be our

standard bearing and help us to get through the budget process and not allow the cuts to go forward. thank you >> thank you. >> herbert wrooirn retiree it's alarming the city is doing well, right now we passed the highest city budget this year and i think it's very irresponsible for the board of supervisors and city administrations to be fiscal retentative. the health service system needs money to function adequately to provide services and keeps people well, and the city workforce well, so the people are not absence due to illness and it's fair this service gets

funding it shouldn't be penciled it's a vitality agency so when i see city administrators making 6 digit salaries 6 digit high salaries the city is not poor to all of a sudden have the city do well, and making those cuts is irresponsible and immoral so i strongly recommend that we dig in our heels and not retreat and fight for every cent we find we need. thank you. thank you >> is there any additional public comment. seeing none seeing noneseeing none - oh, seeing none, teblgs number 13 >> item 13 action item update on wellness center opening and review and approval of wellness

plan. stephanie fisher >> sorry about that. stephanie fisher sf wellness manager. before i get started again, i'm going to ask everyone to take a second and take a break out we're all really, really busy people and guarantee we don't breathe properly so take a breath you're going to have to move and do something in the the subcontractor portion so place a hand on your chest and close your eyes and take a deep breathe into our notices we want to feel our stomach rooifrgz. exhale out through our notices. you'll hear a noise if you find

that the hand open your chest is rising it's not delivering the oxygen we need it's not calming. one more. so. thank you. for taking a moment to breathe we're doing a lot more of that. we're going to start today with the wellness week opening. i have slides. i'm going to do an eubridged version if anyone has a question, please we'll direct to my slide the golden outcomes. so we have the grand opening celebration from that may 19th through the 23rd it was a week woerthsd of activities and we actually had 69 hours of

activities some were consequent active but if you add up all the activities 27 different activities your goal can woody allen was to attract over one hundred folks an average of one hundred and 58 over 2 hundred on two days for a total of seven hundred and 92 different visits we're excited the second goal to have 10 or more sf departments we were targeting the civic departments from other buildings and areas throughout we were planning a geometric analysis. we were excited that we had representatives from 38 different departments as well as all the different employers retirees and spouses the representation was best in this

area. overall we were shooting to have to collect the data at this event we did our best we want to make sure we were getting the input from the folks that were going to come; right? with who came to the first week so our goal was that hundred and 50 surveys we hit 3 hundred and 82 we're processing that data and planning for the next quarter probably at the next board meeting. overall we had 4 hundred and 88 people so seven hundred and 90 visits it was good they came back and they came to two things least so i'm going to move onto the next steps i'm hoping you'll

read about the different activities to see what was popular so see all the folks that helped us to put together this event we have significant support from our vendors as well as rec and park so definitely please take note. but our next stuff on slide 10 to review the surveys we even take into account before reading the surveys we saw the participation during the week and added an evening class to the june schedule and a morning class they were incredibly busy and rec and park worked with us and only in a week turn around that was fortunate we had 25 people that expressed on

interest so we're going to have another event and 24 individuals that expressed an interest in coaching despite we had appointments every week. so we're working to get them scheduled. we pieltd stress coaching offered through one of our are koernlz and we were focused on sf so we'll be planning future events to work with the spouses. any questions about wellness week. ? all right. >> so moving on to the plan. thank you, maria.

what does in this case individual mean >> under were 4 hundred and 88 people that came seven hundred and 92 times so the people might have come twice i like to count those. all right. so the wellness plan so first, i want to thank the sponsors of the wellness plan and the human resources the mayor's office the controller's office and, of course, h f s a big disclaimer a lot of that work was done before i came so it's certainly not my work. we'll go through the goals of the plan have been improved thanks to our conversations last week with the stakeholders and labor so again definitely not all my work. there's been assistance

throughout so our goals are to improve the overall well-being and to help manage razor costs of health care and disables. that's going to take a lot of people to make the goals first we're going to ask the mayor for his public support and encouraging departmental levels from the departmental heads and from all the employees that in the department h f s will be making sure that all our employees have access to certain basic wellness services and training this champion network that will be employees volunteers on the ground when will help us to understand what's happening at the level we'll be training those folks as well as supported the

departmental programs so they're asking me about the things that can happen being able to do the research and provide the tool kits to support the departmental practice writing programs we're going to look at programs through the human resources we're going to looking to the department heads to identify that person that champion business owner but providing the exam with the support they need to be successful i see exam but it would be champions not just the one ratio we're going to see if we can get continual support and the champions are the feet on the ground they're our eyes and ears and voice at the department as we learned during

the wellness week being out through so the more handicaps we have helping the better. those are some of the different players that will be making this plan happen. i want to take a moment commissioner slain who a if i meetings g ago said we should talk about well-being the health assessment instead of being called a health risk is looking at our well-being this is one definition i think it will be different for everyone but it's different than the absence of diseases or preventing diseases or not being sick it's not even just exercising but how we feel

i want to put that in there as well. our plan is a 4 prong strategy. we're making sure we have what we need in place to be successful. of course, we need to motivate employees to participate. some of that is spreading the word and some a variety of tax ticks. then we need to provide programs things that will help them to change their behavior wellness is a journey it's not something you get done we're going to be continually offering services and looking at the data to improve the program and be able to report back. the program will mean hiring new

staff our team member is coming on the 16 so hopefully, we'll have this finalized this last quarter we've been working with stakeholders and others to vet the plan to make final adjustments today, we're here to submit it for your approval and hopefully next quarter the kickoff with the mayor and the training of the champions and the early infrastructure in place to really out the initiatives and do that first moment so people can think about the question of what well-being means to them by the end of the year we'll have the champion counselors we're going to need a

team and teach them how to do that. in terms of motivation we were deliberately and not talking about only financial incentives you'll see but call it motivation because it takes the removal of barriers some with regards and recognize that's easily to forget about we forget to recognize the success so we'll be working at all 4 levels. i alluded to the program in 2014 we're building the infrastructure and assessing the baseline we'll be looking at rolling out programs next year and improve their well-being and feel better about themselves there in terms of debate and

evaluation and rovrt over the years we'll have more data it comes from our ability to collect data and from the clean database being evacuate for the health outcome data we start like building the infrastructure of our data and start to see year to year well-being ethics and also the departments we're going to do a culture survey are necessary making changes in the policies and environment to improve that as well. i was going to touch on a couple of slides in the appendix does anyone have any questions outside of that >> not outside. >> questions commissioner

scott. >> a question about the material i'm seeing our slides and see a document called the wellness plan. >> right. >> would you speak it that. >> certainly the slides are a summary of the plan most have been kit to give you a summary level to make sure we're on the same package for the comment period. >> this is the plan we're hoping to have improved. >> okay. just a clarification. >> in the appendix slide 11 under the well-being assessment this is what we've chosen to show how we're doing? an important foundational piece it is conducted with americans

across the country. over the phone, and there's a nice set of baseline data on those 6 topics for the whole country and it's broken down into geometric areas and congressional easier so we can look at our population vs. accountability people that live in the same geometric area they've done research to show that those measures co- realty with health outcome what's different between this survey that happens over the phone to americans throughout the country is that the version we're going to offer as additional information about the cultures so you're only talking about diseases you may have but nothing do you feel your

workplace supports your health. is your health impacting our performance so the nice part of well-being it includes this section so instead of having to do an additional survey to get the data it's included in here it goes as to people are asking me does my employer encourage me to take physical activities at lunch that sends a message for a conversation to start. on slide 14 you'll see some he thought highlights from the research that's being to be done and this is the next picture the well-being score go ups our health care costs going go down. i'm happy to share this but

they've shown a direct relationship with 7 out of 7 health care costs and measures including the er visits and the hospital admissions from medical costs and other costs that's another reason we choose this assessment and then on slide 16 when considering a health risk assessment we looked at 3 currently offered by our health care plan we choose that one by blue cross blue shield we're going to expand that to everyone it seems to w have one assessment point. how do you get people to take it if they don't take it that's not valid so often the wellness system points at a dollar amount

the challenge is that dollar amount tends to increase every year just to sustain participation it didn't increase the dollar amount gets more people just to get them to take it i'm trying to think about the financial resources we have we were able to talk to blue cross blue shield who participated with bell health that goes the economic approach instead of a dollar amount a contest that you take it and if you've taken it the first week you have a one in 5 change of winning $20 and maybe $500 in general the same per person more people will take

it because they can win larger amazes they can win and 2, 3, 4 weeks they are motivated to take that before the confident the regret if we have e-mail addresses on everyone if you had not taken it and your lucky number was drawn you'd get an e-mail saying you would have one $500 and that regret motivates people because they have the same odds of next week winning we don't have e-mails but we're hopeful that the unions can help us to communicate how many people in the department or union have been drawn so the people are excited and realize it's happening not