projecting a balance of $50,000 for the year-end. we have staffed up and we continue to staff up. we have obligations for contracts that we need to meet and then the big unknown is with the passage of prop b that wasn't considered in the mayor's budget because it was placed on the ballot after the mayor and the board finished the 14-15 budget. so that is a whole. it was estimated a couple months ago as $20 million shortfall to the general fund. initially that was allocated to department based on a formula of 1.5 percent of the general fund budget. however, that is

totally being reconsidered and relooked at as you imagine by the mayor's office they have not put out instructions yet about any actual cuts that we need to make. this fiscal year or how it would roll into next fiscal year. we expect that to happen sometime around christmas and i hope i can come to you in january to give you information on what our instructions are. if the reduction exceeds the savings we are going to have to do a major reallocation of our expenses. that is a concern and it's as i mentioned to senior staff and others it's a tight budget this year. we knew that going in after we went through the budget analyst process and we have

to be really cognizant of that. but that doesn't mean we can't in next year's budget propose things that are really necessary in order for the department to continue operating in a way that is it needs to be for our employers. >> any questions? >> >> what is the amount? >> >> approximately $50,000. it's about 46 or something like that. >> so your 50,000 is $50,000 is you are plus in your personal services? >> >> i need to make a is surplus in order to be able to fund the contingency. i figured

out a plan to do that and the only place we can possibly cut in order to do that is in our professional services. so yes, we are going to have to figure out a way to have savings in professional services. this $50,000 is gone as far as i'm concerned to meet the mayor's needs. hopefully it won't be, it won't increase. >> if it doesn't happen you can use that $50,000 to pay for lost equipment, stolen? >> to pay for what in ? >> >> the equipment stolen. >> that would require an allocation. so essentially we are looking at every single so

so sooner litary expense because we have had equipment, the alarm system in order to be able to protect our assets if we were to be broken in again. so all of that i have to find a way to fund. it's got to come out of materials and supply unless i go and request a is surplus transfer. >> all right. any other questions from commissioners? >> any public comment on this item? >> >> seeing none, we are going to take a 10 -minute recess until by that clock at least because i think there are different clocks. 2:40.

>> she's going to call the next item. item 8. action item review results of 2014

health service board performance evaluation and approve recommendations to the board. >> the meeting was on november 9th. how much you would like me to repeat here. there were 9 recommendations as action items we can take in going forward. would you like me to read those off or should we just -- >> i'm going to assume the commissioners have read them? >> yes. >> i move we approve these recommendations. >> is there a second. >> second. >> great, any questions, comments in >> just an objects --

observation and comment. some of these have a multilayer issues behind them. it would be the government's committee to go back with details that might support one or more of these steps. it's not more like these are the nine things we are going to do. i wanted to put that clearly in the record. i have made a motion in the committee to send the full committee forward risking in a public forum says this is the plan of action for the next two 2 years. it is not the case. it's rather that this directionally sets out to where we are going and we would bring these back for further discussion. >> there were a couple there that were also noted on our last evaluation two 2 years ago which we hadn't changed. part one was the education

issue for the board and another one was to talk about the trust, a policy for the trust. that was also brought up in the last evaluation and nothing has changed. going fort the governor's committee should look at this closely and have a meeting more than we had in the last couple of years. that would be my suggestion. under the circumstances -- it's been moved and seconded. is there any further comment. >> do you have any timelines on quarterly reports on the progress of these recommendations or some timelines that say for no. 1 just for an example that we did to be done in 2015 or in

nine 9 months or 12 months otherwise we have these recommendations with no timelines of when we are getting to meet all of this. >> i think the committee should decide how they are going to calendar these on the agenda, the items otherwise it will be on the agenda next year. >> any other comments or questions from commissioners? >> any public comment on this item? >> >> i'm speaking more as a former member of the board. i'm glad these items are on the table. one of the concerns identified had with the budget problems a lot of the board education was going through

the cracks and there was a time when anyone was brand new on the commission would be sent off to one of the conferences to do if fiduciary training. there was a lot of good that hadn't been done on the board because of budget constraints. there is a definite limitations as to how fund money should be spent but when it has to do with an issue that impacts the entire membership, it can be in fact be paid out of the trust. i see this as very valuable and i would expect that it not only go on here but governance that there would be more discussion about this in the future and i would commend you to bring this back before the board. i think it's a benefit

and enhances the staff. thank you. >> any other public comment? >> great, this item has been moved and seconded. all in favor say, "aye". >> aye. >> any opposed? all right. there you go. no ab sensations. next -- abstentions. >> item 9. approve timeline for skuf directors 2014 evaluation. >> we discussed this timeline for directors evaluation hadn't been done since 2010, so what we decided is we would go back to january 2013 to kind of include some extra time and take into consideration that our director was out for a time. so i would move the time

period for january and we solicit from the director time period for consideration. that could mean back to 2013 for the directors input for the evaluation. 2010 was when the last one was given. it would be 2011 on. so that's my motion. >> is there a second? >> i is second. >> any discussion? >>

>> you have the timeline as far as the period covered, but when are we going to do? >> >> this is before the is survey and before any written comments from the board. >> is this to be done within the next three months? 3 months? >> >> yes, as soon as possible because it's way over due. we are waiting for dr. department dodd to finish the is survey. >> any other questions on comments from commissioners? >> any public comment on this item? >> all in favor say, "aye". >> aye. >> any opposed? there is no opposition and no abstentions. thank you. next item. >> item 10. discussion item.

risk scores report. >> good afternoon, what i bring to your attention and i have two things so i'm going to talk on these. the presentation terld and why i'm here today. in december 11, 2012, we discussed the metrics pool for the kaiser and uhc and at that time we were able to get from vendors a very clean set of rx tapes, pharmacy tapes and run the analysis and we presented that analysis. what we suggested at that time was that the kaiser had a much better set of risk and the differential

was approximately 5 percent. so we presented this material, we used the information that we could and risk scorings where you take all the drug use over the period of one 1 year and you say if they took this drug you add it to go and accumulate it and say this risk that is this data and the end result is if one is normal, or above that, it means you used less resources or more resources. this is the actuarial tool to establish what the set of risk looks like and they like to take into consideration what is going on that we can probably effect through wellness program and they call that perspective analysis. for a diabetes program for that.

you like to score your population. when you have a big population you want to be current and you want to say how they stack up against the other. >> i just wanted to ask you if you can slowdown if you could. i think the concept of prospective and current are important and i want to make sure everybody is getting it. >> i think that's fine and i think people can also ask questions. >> you want me to start over? >> okay. i will slowdown. we have created an answer and once we had the answer, kaiser said, woah, you did this on rx and we have a completely different pattern.

>> please do not use rx. >> i will use pharmacy. we have a different way of prescribing pharmacy. can you do this analysis on a medical diagnosis and report back to the board what you find out. so you said we are here in terms of better risk, blue shield is here and we don't think we are that far apart. we ran all the data and it's a very actuarial exciting process fosh -- for a person like myself. it's like a christmas party for me because it's neat stuff. this is a big day for me because i get to talk about risk analysis, so big times. that being the case, we rerun the information and what we want to report back to you is that the spread or the differential risk is

not 15 percent but when you incorporate a medical diagnosis approach to this is more like 10 percent. i sent this to the kaiser actuaries and they concur. what does this mean? >> we are right here at a 1.17 with blue shield and 1.08 with kaiser when we do retirees. we've established through playing year 2013 what do two populations look like, what i would like to share with the report in brevityey i would like to say we have done this and the risk score has improved and that is worthy of consideration. when we look at the current risk with blue shield when we looked at aco, the risk score dropped from 1.7 to 1.1. the aco's

eliminating admissions therefore lowering the risk score. if you don't use resource and they don't have anything to put into the risk simulator, then it goes down. you are frowning. >> you -- i am frowning, because you still have a diagnosis but you may not be admitted for it. >> the only way the data is collected is upon admission. >> is it only hospital data? >> >> it's hospital data. >> you don't use outpatient data. >> it is hospital and outpatient data but if you don't have the resource use, it