won't be here next year and we as members of the board trying to meet in obligation i think we should try but this legislation not to be brought back and use asia tool to say you've made a commitment when there's other priorities i want to focus on those are the two major reasons and i think we need to figure out other ways to deal with situations number one we have a budget process and the budget process is over it's time to move on to work on some of the things we're commented to work on and including nonprofits in my district are going to benefit because we've added an additional funding to their organizations but minimum wage peace and the children's fund those those initiatives are

going to add value to our nonprofit organizations as he regarding to those and this is not the right way to go about it >> supervisor wiener >> thank you, mr. president. so i have supported some supplementals and others not support them case by case we're appreciable for things to go through the normal budget process but sometimes things arises in the middle of the year whether an unaccepted federal budget cut or or time sensitive situation we can't wait so it's a case by case. in terms of that specific item i'm not expressing on opinion whether it's a good or bad thing i've supported the business in the past i know we have a lot of

nonprofits when and workers in the nonprofits that could benefit from a cost of doing business adjustment our nonprofit partners in an absolutely essential part of the work and the services we provide and help provide as a city. with that said, what does make me uncomfortable about the resolution it is lesbian the nicaragua substance whether to the some point in this year we should do a cost of living adjustment it's more about the fact we just adapted our budget the mayor signed it i can't remember last week he signed is and the resolution was introduced i guess the same and it strikes me as uncomfortable we guess through a budget process through the difficulties

of a budget analyst report progress making the difficult choices and right as we are approving the budget doing a supplemental i understand the desire to had had supplemental but i i don't like the precedent that it sets. that's not to say you know what might happen if this comes down as a supplemental over the course of the year we'll take that when it and if it comes. i'll say this to those aclu and other nonprofits one of the challenges we had this year as also in the context of the budget we have a very limit set of funds to work with when the budget comes to the board and it's the way the system is set up the mayor has a lot more

latitude in terms of the budget so the budget came to us we had the revenue for our nonprofits partners were larger than i've ever seen them there enormous merit to the transportation and the youth and so forth so it put us in a position where we want to fund as much of that as we can and having to choose between increasing services and the cost of doing business adjustments. i think this year particularly given the size of many of those apps the board went with enhancing the services so i was hopefully in the future the more organized we can have in terms of the increased nonprofit funding the services as well as

the cost of doing business is helpful we want to do right by our nonprofit partners but today i'll not be supporting this resolution >> supervisor mar. thank you >> i'll be supporting in measure and thanks to supervisor campos for bringing this forward. several meetings ago we were confronted with protester who gave compelling arguments in 2007 and 8 the second class status for the nonprofit workers it's a clear devised of the wealth and increasing the wealthy gap in our city this is the least we can do to prioritize the commitment of the

hard working in time workers in the city if maybe uncomfortable since we've golden gone through the budget process as supervisor wiener said but it's our job to comfortable the afflicted so if the in time sectors has not been receiving the benefits we need to help those who are being pushed out of the city and we've heard from the african-american who are being pushed out of the city i worked in the nonprofit sector for decades basically and, that when you can't even put maintain on the table to feed our family we have to consider that so i'm supportive of comfortably the awe neglected as supervisor campos as laid out i wanted to thank my former union aclu not only for themselves and their workers but

for the hard working staff >> supervisor farrell. >> colleagues i'll be brief on the merits people mentioned i don't think anyone in the room doesn't support the continued and last year, we passed out an increase for the nonprofit i felt compelled to speak with my men and women colleagues it is the precedent setting and a half i hope this self-become something we do every year with the intent to supplement down the road i understand why we're here tonight but understanding where we are and look forward to putting this behind us. >> my further discussion.

roll call vote and on item 65 marry supervisor mar. supervisor tang no. supervisor wiener. no. supervisor yee. supervisor avalos. supervisor breed. no. supervisor campos. president chiu. supervisor cohen. supervisor farrell. no. supervisor kim. there are 7 i's and 4 nos per the resolution it adapted and madam clerk could you read our end memoriams. today's meeting will be adjourned in memory of the following individuals on behalf of of the president chiu ms. jane kim write and supervisor kim for the late mr. mark anthony >> with that, i want to thank sfgovtv for their coverage with mel and tholg and with that

colleagues wish everyone a wonderful recess and next open september 2nd michelle's. there's no further business. . ladies and gentlemen, we're adjourned.

>> [gavel] the commission will please come to order and the second will call the roll. >> commissioner singer. >> present. >> commissioner taylor-mcghee. >> present. >> commissioner chow. >> present. >> commissioner sanchez. >> present. >> car da. commissioner karshmer. >> applicant. >> the -- present. >> the second item and i was on vacation and the minutes are an earlier version of the resolution you passed. the updated version should be in your pile so the minutes should reflect the final resolution. >> commissioners we're prepared for a motion to accept the minutes and with the fact that the final version of the resolution will be in the

minutes. motion please. >> i move. >> there is a motion and a second already. are there any corrections to the minutes? >> i had a question. >> sure. >> on the request for follow up from human resources about progress on streamlining and making more effective hiring which seems to be a drag on progress in many of the departments in terms of meeting their objectives. when can we get that update? >> i believe the hr director will speak to you. >> director. >> good afternoon. we have a event in the last week of august and mapping it out and making improvements and i believe i asked to come back in september to give an update and i will check with mark to make sure i'm on the agenda. >> perfect. thank you. >> you're welcome. >> okay. any other comments

or questions on the corrections? if not all in favor say aye. the minutes are approved. next item please. >> the next item is the director's report. >> good afternoon. i am sitting in for director garcia who is on a well deserved vacation in hawaii right now and the first is the launch of the san francisco health network, the sign is behind you and launched on july 30. simultaneous events took place at 28 sites around the city and staff celebrated the creation of the network and each other's contributions. i know rol an pickins is here and can talk about the launch last week. >> good afternoon

commissioners. i am the director of the network. thank you. you will remember when i came to you in february and gave an overview of the development of the network i had slides on marketing and branding so this network launch was the fulfillment of the first part of the marketing and branding campaign which was an internal focus. we described we needed to do internal markets and branding before we went out to the public so this launch event was a culmination of the last months of an internal marketing and branding committee and chaired and co-chaired by staff and our chief communications officer so they had 30 staff throughout the department from community programs, laguna honda, san francisco general and actually did a great job developing the launch activity

itself, a description of what the network is. there is information on all the different sites that the network consists of throughout the city, the various clinics so this was our internal launch and we will come back as we get ready for open enrollment in the fall for covered california and other health plans to do an external marketing communications program, but this was part one, and you will be be hearing more about part 2. i will be coming to the commission in september on an update on the network and we will talk more about communications and marketing. >> thank you. i am sure the commissioners would be happy to help also with our external approach to the public. >> okay. we will get your picture on the muni bus going by. okay. >> just a couple other items in

the director's report related to open enrollment which mr. pickins referenced last thursday covered california and announced the rate for the exchange and the cost will go up by a weighted percentage of 4.2% and covered california region four which comprises the city and county of san francisco saw the largest weighted increase of 6.6%. the other changes in the regions were a reduction of 1% and those areas and increase of 6.3% in orange county. among the five health plans that will be available in san francisco and some blue cross has the largest weighted increase and those that stay with blue cross will have an increase of 10 to

14%. kaiser has the lowest weighted increase at one point 6% and those consumers will have a change of a reduction or a increase of 4% and blue child and health net and chinese community health plan also. finally the environmental -- supervisor cohen has introduced two measures at the board of supervisors to improve air quality in san francisco. one enhanced ventilation for sensitive use development is consistent with a resolution passed in 2013 by this commission commission and require ventilations for certain developments and multi-housing and others. clean construction is a companion measure to improve ventilation at sites to improve enhanced ventilation at

construction sites that. concludes the director's report for today. >> commissioners any questions on the director's report? yes? >> colleen any -- what happened with covered california in terms of rate increases and where the providers for the city and county of san francisco came out relative to other places? anything remarkable about that or was that in line with what you guys expected? >>i think it's in line with what we expected. i think the overall increase state wide was reigning in costs and it's not seen as a large increase. i think there is a wide variety of costs with the providers in san francisco so there continues to be low cost plans available in san francisco. even though we have the highest rate of increase across all plans most plans ranged within the 4% margin, the next closest county

was orange county at 6.3%. i think given our cost of living and other things here it's not unexpected that we landed where we did. >> when you cite the averages are they straight averages of bronze, silver and gold plans or averages of bronze? >> they're weighted averages and consider the increases in the plan and the commissioners in the marketplace. >> okay. >> on the exchange programs here in the city part of the real key would be what premium is at and some are very high and some very low. do the premiums come closer together for each of the plans because after all in the first year it was a guess on the part of everybody about where to go, so the real amount is -- of concern is whether the

premiums had also come close to each other or are they still at a wide variation? >> i would have to look -- the levels vary by age and family size but i think it was expected. chinese community health plan for example came in very . the cost of the premiums were very low in the first year so they were the second highest rate increase among the plans in san francisco which was to be expected to level it out a little bit more. anthem was already a higher cost plan and the increase further -- >> further up, right. okay. and i guess are those now public? >> they are. >> can we have a copy of what you read out because that would be helpful. >> i will send my notes and the increases for the plan. >> okay. that would be very nice. thank you. any other questions? on the director's

report though you didn't acknowledge -- in the sense the laguna honda survey came out very positively, did it? >> yes. i was just reading and trying to decide because it says that it had identified findings from two surveys, and you're waiting for a cdph so do we know that they did give us a clean bill of health or they didn't? >> through the chair if i might. >> sure. >> as we understood it through the committee it was brief in size but they were not going -- and we weren't going to make any absolute either congratulations or due diligence or shore up until we got the written report because there were a couple of

surveys not completed, other dimensions, so that will be forthcoming. that's our understanding and from there we will proceed but at this point it looked like we weren't zapped with that and others but we were written for the actual report which will come within i think 45 days. >> okay. all right. if there are no other questions then we're prepared for the next item please. >> item four is the general public comment. i received no requests for general public comment. all right. shall we move on to the next item commissioners? all right. we will go on to the next item then. item five is the update from the finance and planning committee and commissioner singer chairs that today. >> commissioner. >> this was the first opportunity i had to chair anything. feel free to jump in and correct, amend, beat up my

remarks here. so we met this afternoon for a few hours, and we heard very thoughtful presentation on sexual orientation guidelines and how to capture data, a theme we talked about in the last year, and you get a peek into the extraordinary thought of the staff and the department and how they go about thinking through things, and then we had a discussion about the icb9 contract delays. it's replacing icb10 -- sorry. ten is replacing icb9 and it is a very complicated thing to implement that has been delayed a number of times including recently. nevertheless we will have to -- the bad news we will continue to spend money this year getting

ready for it even though it's delayed a year. that's the bad news. the good news if it wasn't delayed it would have been a crunch on the staff and there is revenue at risk as a result of that so one year is good for us and the ability to do this in a slightly more thorough pace is going to be beneficial to the city, and then we had the monthly contracts report. nothing remarkable about that, and then we talked about in-depth about three separate contracts, reasonably large, related to it infrastructure at sf general and in the city and i think the way to think about this is -- i am stealing someone's else analogy shamelessly but if you think of state of the art electron medical records and information

systems for physicians and patients and nursing staff and everyone else in the ecosystem as cars you need a road to drive on before you can have a car so what these contracts related to basically is the infrastructure, the plumbing, if you will, of a network that meets all the codes which we're required to if you're a health institution which is much different than if you're a retail store for the obvious reasons, and so we heard -- we approved those contract and recommended them to be approved here which i guess we need to vote on in a second, but i think what was most encouraging for me was the depth of thought from the team at sfdph regarding how they're going to stage the investments and how to prepare for the future and how they talked about it so that was super encouraging. >> if i may elaborate.

briefly the sexual orientation guidelines commissioners will come before you for approval for the second so you will have an opportunity to look at that and the contracts will be folded into an it presentation at the august 19 meeting so you can hear about those two. >> and do we need to vote on those formally today? >> in the consent calendar next item you voten mass for all of them. >> yes commissioner. >> yes. i was wondering if there is discussion on the siemens renewal. >> yes. >> and was there any conclusion pertaining to are -- we in fact -- i mean siemens has had a contract with the department for a number of years including certain different pathways that should have been done or done

well, et cetera, et cetera and i am wondering if there are substantial discussions on what the outcomes have been and in particular i thought before we had a three, four year limit and when i looked at this initially there was a fairly long duration and i wonder if this was brought in the discussion. again i am not knocking siemens per se but we used to ask these questions and i am wondering -- >> some of the questions were asked and some weren't. to give context on the contract we're talking about and if bill is here -- >> unfortunately he's not here at the moment. >> let me try and anyone else can jump in. so we are moving in the general -- the new general hospital in about two years. in a perfect world we would have also used as an

opportunity five years ago let's get a state of the art medical system in the san francisco general hospital then and it's unclear to me whether siemens would have been a candidate for being that vendor or not. i think it's up in the air but most talk about two other vendors when we ask them, but that decision wasn't made so we have the practical reality when we move into the san francisco general hospital we need to have electronic medical records and the reality is we just need to move the siemens system over there and that is what this contract is basically to do, and that is a non trivial exercise, but in addition we have struggled as a group here on the whole future of emr, rhr city wide for our work and we're beginning to see in these

contracts thoughtful strategic investment to get ready for that. as we all know it's a very big number, but it's kind of table stakes for the new health care environment so we have to do it and as soon as we can. the joint commission talked about it when they surveyed the san francisco general hospital and made it absolutely clear in order to stay compliant et cetera, et cetera it's hard to think of a reason not to move quickly on this but regarding siemens' past performance on contracts we did not talk about that. >> no, no. again as i said when i sort of skimmed through and i apologize because of the amount of time and as i said in some of the early stages going way back for both our senior programs at laguna honda and at general it required a visit from