>> >> november 13, 2014,

>> city of san francisco >> health services board >>

we are going to call to order the regular meeting of the health services board for thursday november 13, 2014.

please remind me as i'm sure you will if i forget to speak into microphone. all right. pledge of allegiance. >> i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation, under god, indivisible, with liberty and justice for all. >> roll call. please. city clerk: >>president jean s. fraser: scott: >>commissioner karen breslin: excuse. >>commissioner wilfredo lim: >>commissioner jordan shlain, m.d.: expected. >>commissioner sharen ferrigno: we have a quorum. >> item 1. approval of

minutes of september 11, 2014. >> all right. any corrections? >> hearing none. can we approve? >> >> i motion to be approved. >> okay. any public comment? >> is there any additional public comment? seeing none, public comment is closed. >> all in favor say, "aye". >> aye. >> any opposed? item passes. next item. city clerk: discussion item. general public comment on matters within the board's jurisdiction not appearing on today's agenda. seeing none. next item. >> item 3, president's report. >> i have submitted my resignation due to family and work obligation. i will have good-bye remarks at the next meeting. it was a very difficult decision to make

but one that i had to make for my prior commitments to my work and family. i will be here today and december. i know the mayor is looking for a replacement. any public comment? >> >> well, i would just like to say we'll miss you and you are a great asset to the board. >> don't say good-bye yet. we have two more meetings. thank you for your comments. national weather -- next item. >> action item. approval of commissioner randy scott replacement governance committee member. >> i have commended commissioner randy scott for my replacement and move for approval for that action today. >> i move for approval of randy scott. >> second.

>> is there any additional public comment? seeing none, public comment is closed. all in favor say, "aye". >> aye. >> any opposed? great, next item. >> item 5, directors report. >> thank you, commissioners. i want to talk about a couple things that are not in my report. no. 1, our offices were broken into two 2 weeks ago now. we arrived to find a huge boulder thrown through the window in rosemary's office. the good news what they stole was a television screen and broke a projector in our conference room. we'll put it in the budget for next year. that's the good news because they didn't steal any computers and of course this was the section of the office where our computers are and

our phi, personal health information is and our new floor, that's all locked off. if they left, they couldn't get back in and they were just after, they looked in some file drawers. it was disturbing and it feels extremely, annoy that -- now that it gets dark at 5:00. we feel it's having to do with people climbing. there is construction and they just jumped from roof to roof. we'll be working on windows. pam is supposed to give me that report tomorrow and we'll make a decision of what we can afford towards alarming the

windows. the building has no responsibility for that and the city doesn't carry insurance on things like that. so it was a learning about a lot of things for all of us. but pretty disturbing to walk into. i also will tell you that we were notified by kaiser and you probably saw it in the news that the california nurses association is taking labor actions against the kaiser facilities and they assured all the kaiser members and employers that it's business as usual there and by canceling certain division routine, elective procedures but no shortage to care. the other thing, the legislative committee, you recall the mayor convenience the legislative committee is is made up of some

departments, the board of supervisors and the mayor's office. we submitted priority similar to those of last year which included competitive pricing for hospitals, increase transparency and we also included wellness that you wouldn't be discouraged from implementing wellness programs as some legislation had done last year. so that went into the meeting yesterday. then, i includes in your packet kind of a policy analysis from the pacific group on health. this is one of the benefits of being a member but i think the key point is that no one is predicting a repeal of the affordable care act coming out after the elections, but there is an anticipation of a

repeal of the medical device tax which is 2.3 percent and a repeal of the corey fee which you recall went into our rate and you have an introduction of a copper plan. so right now we have bronze, silver, gold, and platinum in the state exchanges. they are considering the implementation of a copper plan. so you have that kind of two page midterm election analysis that you can refer to. we also we are asked to submit, so you have page 16 of the state legislative committee report and i just yesterday found this from kaiser foundation visualizing sponsored

insurance shhh showthat while our been at the top, our rates haven't gone up. our trend is flat whereas these trends continue to go up. the predictions are that the trends will go up this next year. i wanted to in terms of my report i wanted to give you an update on personnel. we are we -- welcoming pamela back full time. she's back full time now and we are also welcoming back rosemary patino. she came just after enrollment ended. i wonder why. we asked her to stay back until enrollment is over and we'll be welcoming sochi ba

har as. and corrine on finances. you will hear from finance from the auditor. in terms of vendors and contracts, i have been working with mta on our substance abuse services. we already met with kaiser, but we are taking a tour of the kaiser substance abuse treatment center on friday and blue shield is coming in to talk about what their substance abuse services look like. what's exciting at least on the kaiser side and i will let you know what i find out on the blue shield side was kaiser passed a treatment on

demand. i'm not sure we have fully implemented. in terms of our firefighters, our unified -- uniformed officers they do get treatment on demand and they are followed closely. we are going to try to have that expanded and make sure it exist on blue shield and officers and entrance is -- transport workers. so that's going on. you will hear from marina on the negotiation of the all peers data base. marina and david flores worked on that. i'm not going to talk about that. i do want to call on mitchell grace from operations to talk about what the last 31 days and the open enrollment.

it's the busiest since we came since open enrollment in 2010 . and the numbers are pretty staggering. i will say that one of the things we've done every year since i came that the unions have asked for off site enrollment opportunities. this year we had eight off sites enrollments. to make it available for people so they don't have to come in to talk to a benefits analyst. we are extremely proud of that. how are we doing here? >> one second. having our operations staff almost completely staffed really made a difference in terms of getting enrollments input. we'll give you the final

numbers next month because we have input from the community college and unified school district. mitchell? >> >> mitchell graves from the management of the health services system. i'm going to present from october 2014. starting on slide 2 on page one, i want to mention that we had open enrollment for the first time in the wellness center in the first floor of the building at 1145 market. >> sf govtv, we have a presentation. it's like talking to the wizard of oz. >> magic. >> now we are talking to bill gates. >> we wish. [ laughter ]

why don't you go ahead. >> we were having our first enrollment for the first time in the wellness center and that worked well. speaking to the people not only about open enrollment but wellness and wellness activities and well being assessment was very successful for us and a good working relationship just like brothers and sisters do. just a few trafficking or traffic issues with people how we get people through there successfully but other than that it was very successful. so back to a few of the numbers, this year we received about 1,000 more applications than last year and higher than 2010. we are counting the type of changes that were increased. as of november 4th, when this report

was written we have basically 63 percent. but as of today we processed 95 percent and remaining ccd and usd applications to enter. this year we did a little bit more counting. whereas we automatically count all the phone calls. we had 10, 3000 that we spoke to as far as enrollment is concerned. the calls 6700, 63 percent from last year. the speed of answer was about 0 10 seconds. that was a 44 percent decrease from october 2013. that means more benefits analyst on phones and answering questions and better

communications. the band rate was less than 8 percent and the people that showed up to the third floor for non-open enrollment ibs -- issues was about 1500 which is an increase from 2013. probably those showed up thinking open enrollment was on the third floor. there wasn't any significant non-other open enrollment. we saw a percentage of them who came to sit down and saw a person from open enrollment. on page 2 of the top slide we averaged 300 calls in october for open enrollment. keeping that in mind all service goals were met. we are generally getting better in answering calls faster. and like we do in the

past about five years for open enrollment we sent a couple benefits analyst and some wellness employees too starting with public works october 1st, they had a health fair so we had information about open enrollment and fisher went to hetch hetchy october 2nd. we went to unified school, city hall, laguna honda october 7, and we went to san francisco general october 8. we also went to sfo october 9, 850 bryant and for the 1st time we went to the facility at the mill and they have about 500 employees there and we were able to schedule that this year. on the second slide on page two, i wanted to give you an example in blue here of day

by day the amount of applications that were received. that is in blue. in comparison in gray are the ones we were able to enter each day. you can see we basically kept up with it pretty well except for the last week of course because everyone is turning it in in the last week. the asterisk, these were the days that we were not able to enter all day because it was down for payroll processing. >> may i interrupt? >> i say -- see our board president sent a letter, the prior board president sent a letter, have we gotten any responses to this change in the future? >> >> yes, it's also in the presentation in the last slide the response to the letter sent by hhs, by the board. i

will talk more about it in a second but what they gave us is an additional half day. the wednesday half day that they normally had us out, they gave us those five hours, technically three hours because we have lunch during that time lunch period scattered through that time. we got basically three hours a day times three for nine hours and i demonstrated that a little bit on this slide here that you can see on wednesday is which is the day before the red asterisk we were able to process those. we got 400 additional applications processed during that additional time. i will show the letters in responses. the first slide on page 3, to show you the calls from year after year, basically the same about open enrollment. the calls

have been going down not only through this year but year after year for the past five years. the next slide on page four, the top slide is showing the abandonment rate which is also significantly decreasing and under our goal of three percent for the entire year but over the past five years as well. and personal assistance, the second slide on page four showing you open enrollment similar to 2012 -2013. we had less people coming in but all in all the same. i will skip page 5 because of the typical operations report for every board month, and then we'll go to the second slide on page six where i discussed the letters about the down time. as we just mentioned earlier that hhs sent a letter on

behalf of the health services board to the control office asking about the down time specifically in october where we have three pay period processing days for a total of four 1/2 days, 36 hours, where 18 benefits analyst can't enter. hhs met with the controllers payroll department on september 26, to discuss the time. director department -- daud and i met on that day. they responded on october 10th offering system availability wednesday from noon until 5:00. they agreed to 3 p.m. wednesday which is 11, 12, we can on -- only

process retire eechls -- additional access for three 3 hours for those days for a total of nine 9 hours outside of 36 that we usually have off. hhs was able to process at that time it was 250 since we have the third day of november 12th, approximately 400 applications. the reason it did not allow additional time available for the system was because they needed full system processing resources during that day to what they call "calculate payroll" and on thursdays they perform this and they basically need all their full system resources for that type of process. so that was basically their response. >> well, i appreciate your

patience and director daud's effort, but this is like a continuing irritation. we got through this like we did last year. last year we stopped, this year we have a half day. is there any prospect that this is ever going to get resolved or are we at our natural limit? >> >> the one thing that helps with this interaction between hhs and the controllers office, is they have decided that starting january 2015 that they will keep allowing us to have the access to the system after that period because they saw that it wasn't really messing too much with their processing on the wednesday and that they were able to staffing wise move a little bit around to start the process at 5:00 and continue

on thursday. so it's a third of a step with where we want to go with progress. >> so they are saying that you will have a half day next year? >> >> right, that is their plan right now. after they called this as an experience of that this will allow access. the problem and i can kind of understand this is that when their processing payroll, the payroll that's being processed, the pay period is still accessible to us. that wednesday they do not want to make any changes that are going to affect payroll for the day. it's okay to make future changes, but the concern is the pay period starting and us making changes. we apparently did a good job of pushing any type of changes aside where we

wouldn't touch that pay period that's getting ready to be processed. they felt with that experience they should be able to allow us additional five 5 hours after january 1st on wednesdays. >> well, i'm going to ask the president at the end of this report to write a note of thanks for the consideration of this year and the commitment for next year and the hope that in the years ensuing that we will have full access to the system. i think we at least need to ak what -- acknowledge what they have done but it still idles our staff during this critical period of time to the degree that we continue the conversation and build the rapport and so forth but full processing is where we want to be at the end of the day. >> all right thank you. >> actually, i wanted to make a couple of comments. in my

prior life i ran member services as well and i would like to say that these are extraordinary results and to have such a huge in crease in value. >> thanks for the board for speaking up to the down time. that really helps. >> the other question i'm curious about, so you saw the spike in request for assistance. do you all do you do any kind of analysis or can you even anecdotally do a root cause analysis to determine what's making people call? >> >> we basically we do meet with the benefits analyst and ask what are the common things that you are hearing, what are the unusual things you are hearing. what we hear is i don't want to make any changes . the second highest one we