service person she said not this is not contracted as an urgent care center in the network but not contracted as an urgent care center that's why we didn't give you the name she couldn't give me one person or place in san francisco even though listed on here are 4 she was unable to give any of those and nothing about uc sch uc is too good but she couldn't give me anyone of those smou somehow you have to get this information to the people answering the phone otherwise the people can't get the information. >> we'll look at that call we've about which dialing as members and calling customer service we've done it over 25

times and have not had the same problems and it hadn't to me twice and that's innovate appropriate we talked to the - all our calls are hunters point shipyard in northern california we've meeting met with the entire team we, replay the call and have the person answering the call. >> i don't want anyone to get in trouble i got hung up on once and up to the third try got through that's not easy for our members that's for sure there's anothers and like i said the only one she give me was in south san francisco that's the same answer i got a another thing. the phone is very important you

can you know go to urgent care but a lot of them are longshoremen so unless you know the name of the place even though i can call those places and if the person calling in i wouldn't know the names of the care centers they said we do take united health care so this is the bottom line the cost driver of the longshoremen we should be getting this right this has to be somehow gone to the members in a simple way without the complications. sighing we're going to invite you back next time >> i want to say during the

regular hours they wouldn't take brown and tolling lengthy thought this was that good resource not mentioned. >> for our plan you can go to uc meantime i agree with you. >> the expenditure hours don't appear in our urgent care go directory around the complexity of the benefits designs i everyone thing. >> the bottom line the member has to be able to do that. >> we're working to try to figure out the cal patrick foundation for the medical incline and some of the large medical groups that are integrated it has to be formed around the structure we're really to e trying to get those

to delay as urgent care if you're seeing usf dot if you go to a regular incline it's a regular benefit we want to make sure that is handled appropriately that's why we have this worldwide bifurcation but we need to help the implication on the phone you have to get into that you register on the other hand, on uc register e registration it knows who you are and you get in through the password i had pat who was coordinating to show you that but i locked myself out the home page the landing panel for that

the the second choice and it's urgent care we have some of the tools they're a little bit easier than looking it up through the regular portal but, yeah we need to help get that message out i definitely agree. >> also to reiterate what commissioner has been talking about it maybe beautiful on the computer and beautiful on the app but we have plenty of members that for a variety of reasons especially in circumstances they've needing you're the care may not be go on go back on computers so people richmond on the phone can give out accurate information. >> i agree. >> we'll be following up and reiterating the training. >> f and your following up with phone calls i ask you call from

home not our officers and not have our id phone or whatever i can imagine when commissioner calls in next month i can assure you she will (laughter) there be a great big flashing sign and she's going that's information so i maybe calling you, you. >> and i also wanted to express my thanks for our responsiveness for your request of having representatives of network management group come you guys as margaret people get hung out to dry i want to share a little bit of this heat with you and thank you for coming today. >> thank you very much. >> i like a followup on the it duo detectory she you know our members will get the

information. >> with the concurrence of the commission they need to come back. >> i agree absolutely. >> thank you. thank you. and now blue shield >> good afternoon. including but not limited to is paling brown an area vice president for premier accountants for account management at the board of directors of california i'm joined by the director of the network services of blue shield and tracey barns prornlt responsibility restraining order responsible for the cathy here, here to talk about the services

of you're the care and how your members access he urgent care i'd like to break my comments into 3 sections generally that about the limited access to urgent care the best way for members to access ushth care hmo and to assess it and winldz team works with the medical groups to make sure there's sufficient access and to the best of our abatement directing the urgent care to the care setting setting. with that said our care partners have a vested interest in moving

emergency care to the setting in most of their contracts they're responsible for the professional components of any emergency room claim and as a result you're responsible for the part but the provider have skin in the game and want to direct the urgentcy care we work with the emergency groups to educate our members through communication, through our member services team but we also work with the medical groups to communicate to our members as well. and we have about 45 or 60 percent of your members are in the hmo we've reduced the - in

the last two years and wendy made a point to me easily on the way over here when last year, we get together with the 8 aco statewide and brought the providers together they all acknowledge this is probably one of the harder needles to move in the health care setting and rigorous efforts inform bring adopt emergency room utilization as the best practices up and down the state. i want to talk about progressively the access to it is getting better as many of you know, golden gate was added and added in 2013 there you go to be adding two more emergency room

series west portal and one van ness. >> west portal is there. >> it's all right. there it must be have opened articles you yes. >> it was opened in january of 2013 and ucsf will start operating or in sunday either the fourth or first quarter of 2014. moving to slide 3 i want to take briefing about hmo members access ushth care to keep it simple there are many ways to find urgent care the most appropriate way and the way we've educated our providers to also call your preliminary physician first during hours or

after in the middle of the night they take the diminishing of their prioritized who is obligated to tail u call their member back and if the member choose not to away wait they, assessing urgent care directly and a number of ways to find the care >> so you call our primary care decrease in the middle of the night. >> you may getting get a recording but they page our provider i don't know to what decree i wonder if you know. >> can you speak into the microphone. >> it is required that record it on a service your primary care physician will call you

back in thirty minutes that's a must we need to make sure it's conducted so in the middle of the night the physician is available twenty-four hour. >> i haven't tried that laura. >> we try to monitor it and, in fact, if another great example of the aco work the health physicians have been calling all their physicians at night to find out their answering service is ininstructing them to do and that's another out growth of the

ac l. >> to the priority knows where the care centers are. >> they help to educate their providers on where those are and they educate their members so the brochure in the officers or the posters in the doctors office those are a pretty strong effort to let folks know we have a message to physicians on behalf of our members showing that them exactly where their affiliated urgent care centers are located. >> i think it's important to point out that the primary care figures is and they're back see on the back of the blue shield card. >> good point always the first placing place to live we have to

micro site that's associated with your plan. the top 5 i think tracey mentioned the top 5 medical groups all have a link open their home page that links them to they're specific urgent care affiliate so there are many ways to get the urgent care the best way for the member is simple to follow the instruction on the id card to first call your decrease >> any questions. >> you mentioned you had a tough time keeping the emergency room costs down to me no wonder when people can't find of the urgent care centers it's not been easy.

>> i want to make another point there's no licensing requirement or defines for urgent cervical is one of the if i states that didn't licenses urgent care centers so we are left to our own diess to define what's an urgent care setting you have to have 3 criteria extended hours take walk in patient and same day appoint if you don't do it in the view of blue shield you're not considered an urgent care center you can go to the website click on the urgent care centers and it will be listed by county in the presentation if it didn't meet the 3 criteria it isn't urgent in the view of blue

cross blue shield. >> do you have centers in marin county. >> i'm sorry. >> marin county. >> that's the one county we didn't include. i looked at our top a groups and mary tag 110 north is one of them we'll go back and get it for you i don't have that off the top of my head >> this is how it get started to put a complexities we have members in marin county and in this particular case the gentleman tried to access the urgent care center to stay an point it's great to know during alamed the original question was marin county and we need to still know that. >> okay.

>> why don't you carry on. >> he printed out a thirty mile radius i'm having tracey look at that now but tracey in general do you know. >> you don't go need to know off the top of my head. >> thank you. >> i've sclitd additional information on out of state out of country there are ways to access urgent care as as well in other couple initiatives we've taken upon ourselves we're working with our nurses help listen representatives and our customer service to do target specific training around urgent care that's something we're going to be doing in the latter third or fourth quarter.

the list i have here i checked most of them were good actually and but i had someone call again and they intend to get st. luke's which was after a around emergency room and last time at uc they closed and is on the list so i think your phone people need help >> so our customer service. >> yeah. directing them to st. luke's e.r. >> i'm not a member but most of those uc has a really good set up they take brown and tom nolan after hours and others are limited to that particular like my health group is limited to brown and i've been terribly

alone and forgotten in manhattan >> right. >> i think p e r.c. that's another thing members have to know people want to know what plan you're in someone says blue shield they don't pay attention to brown and i've been terribly alone and forgotten in manhattan they're not familiar with some of the stuff. >> the point is brown and tom nolan is affiliated that's why we instruct people to put their phone number directly our their id card. >> my questions or comments we want to express our thanks for the efforts you've made the follow-up we don't need for you to rupture but we need information on marin county. >> i'll get that information.

>> just marin we've had a particular complaint and for commercial or both. >> why not both just to be inclusive. >> did any of the information go in the open enrollment material. >> no, that's in the open enforcement material we went around and around with expectation of the kaiser we put in the a l before we gave the direction to call the provider. >> what's clearly coming up coming out is how important that card it g do you uses a jenish card if we decided urgent care was a significant issue can we

just to change the language on the back to be very, very clear on that. >> yes. in fact, i've looked at this we would be willing to do that kathy republican it interested in pursuing there maybe we would have to discuss what that looks like directing a urgent care like for instance, call a certain number. >> that's not the boards purview but i was curious about real estate on the card for whatever the administration deems the most important information i'm kind of in the business and didn't know you conceptual require the provider to call that not well nope. >> the only litigation on the card there are c.m.s.

requirements on the piece. >> now and then you send out flyers to people but i mean those kind of reminders would be great to members if you have a problem blah, blah, blah because people didn't know the difference between emergency room and urgent care and in one year we brown and tom nolan sent all their members a flier he recommending to urgent care there are a number for brown and tom nolan to call for urgent care. >> right. >> brown and tom nolan sent something to the members and the example c l u work a punch out card to put on the one hand on your desk or what have you

they're trying to make this available in terms of the posters and so on. >> the magnets remember. >> magnets. >> thank you very much. thank you for coming >> yes. thank you very much. the confirmations are complete with their questions any public comment on that item? >> good afternoon commissioners claire rep r.c. s f i want to here the selma information and have it expanded i write the article for the r.c. sf newsletter i'm getting phone calls from people that doesn't have computers a and are asking about wellness programs asking a number of questions that somehow they don't feel they're getting the information in my way i want

to see that information available with regards to urgent care especially retirees who prefer to have urgent care and not have access to their physicians i think there are not that many blue shield up in sensor or any of those areas it would be nice for the members to know i think that those days we have some hmo metabolizes in that area i want to know about that. >> i suggest you guys may want to connect up today and get it directly. >> thank you next item. >> p oh, i'm sorry. >> dennis retiree from the firdz i'm not sure it's in the works but in the next year's

open enrollment that might be nice to address urgent care a little bit more expand with the urgent care facilities list them in the block let a lot of people don't have computers they don't have a phone number and no more yellow pages it costs a dollar 75 to get the phenomenon company information so it would be a bonus to a lot of people. >> any more public thank you. >> item 7 discussion item report an network and health care plan issues. >> i have. >> i have one. >> yes. an inquiry eric i

don't mean to but you on the spot a few meetings again, we have an understanding e memorandum of understanding that was signed at some fire chief ard meeting to come back and explain that so i'd like to get africa idea when our prepared to come back and educate us on the prelims for the participation by the board and recollection the language recommends but have it clarified in this forum publicly. >> i take that that's a request for a future agenda why not go on to this item. >> okay. thank you and item 8 decision items opportunity to place items on future agenda. >> we've heard one i want to let everyone know in honor of

open enforcement we'll not be meeting no october we planned to do a forum on stat united nations at the suggestion of the doctor, however, he asked us to postpone it we will not have a meeting in october we're doing our small way to make f it it easier and we wish you well in our busiest time. >> now we're in the regular order eric. >> i have no problem doing this in november and work with dr. dodd and yes. >> we are not picking a fight with anyone. i said easily and he want to reiterate the implementation is there that we need to be doing something with certain groups and communicating in certain

because and participate in some forum and it has a broader implementation in my mind if you say it doesn't that's okay. he recognize those deliberations are beyond the scope of what we do but they're asking four participation in certain ways u ways this raises a question >> we'll include the copies of mow in the packet and discuss the direction the board wants to take. >> as i recall too the last that was the transparency issue it was clarified it wasn't optional it was said you will come back and report to the board of supervisors. >> there's two issues that's fine the board of supervisors passed a resolution regarding transparency we've been asked to look at the issue and report

back to the board of supervisors that's separate from the specific from the memorandum of understanding from the city and the alu that sets up the meeting with the s l u with the health commission has the choice. >> i want both of them i recognize them in to their testimony diversity requirement i understand the difference between the labor contract of the board of supervisors we all get that but i'm talking about the principle of the requirements that are being imposed or requested of us. >> i'm happy to explain the language requires and allows. >> okay. thank you. motorcycle >> i wanted to let the commissioners know we'll be going up to hetch hetchy on october 1st