ensuring the patient flow to the most restrictive level of care. programs that were within the san francisco health network to impact this flow were brought together under the oversight of this newly created division. the transition division flow for utilization management for all levels of care. it was created to provide necessary care for the entry and service points throughout san francisco health network to contribute to recovery and wellness. we went from least restrictive to most restrictive to permanent housing and kind of everything in between. that's just our division in a nutshell and i will turn it to stella chow who is in our managed care

office. >> thank you. good evening, commissioners. i would like to share with you our accomplishment in the office of management care. we implemented as mentioned we implemented the office of managed care and have successfully hired, thank you, that was not in the agenda, pushing the button. we have successfully hired two key management positions. let me introduce diana give era, who is the associate of administrator for office of managed care and patient finance and managed care. since may we have standardized the management care membership reporting which allow the managed care to look

at the managed care membership number for our network services on a monthly basis. in addition to that, we've also finalized a contract with loss medical services through san francisco health plan. in this new agreement, not these medical services will provide primary care services. ucsf and primary practice group will be responsible for the care and the san francisco health network is responsible for the hospital and ambulatory services. in office of managed care we also prepare implementing the policy changes for the healthy san francisco programs which becoming effective this month and january, 2015.

in the next few months we'll continue to explore the possibility of planning a couple of health plans in covered california and hopefully we'll have good news to share with the commissioners in the next >> , i.e., move to manage the membership page 2 of the management care update it the enrollment trend because of various system and transaction issues our overall enrollment is over 7 thousand in japan from 83 thousand in december good news is that of august our business has been normal listed we have been able to have a membership with a slight gain of

seven hundred members as of august the network it responsible for providing hospital services to about 83 seven hundred members of which it provides predicament care services to 76 percent of this total membership and the consulate clinic is accountable nor it the primary care services for the remaining 24 percent so the pine shop braeblgdz the enrollment by programs as you can see medi-cal continued to account for a lion share of our membership by healthy san francisco participants and healthy workers and healthy kids in order to have healthy growth of our membership and respond to the changing landscape in health care we'll need to continue our efforts in contracting with

managed care and cover california health plan and with the legislature to got up with a confidence that allows the network to respond in more timing to the market changes and competition now i'd like to i'm going to turn it over to rachel the director of our communications thank you. >> thank you stella good evening, commissioners and director comparing is let's see if i can do this oh, lord i didn't there we go it shows here but not there okay. i'll just start talking i'm cleaning up the rear here of

the last presentation and going to take with you about marketing pea branding efforts so hass as there many new endeavors to the san francisco health this is branding and marketing we've never done before our strategy in talking this on with a girl communications to get our own house in order so the staff of the network knows the staff to that's perfect and another one i assume will work to help the staff a work toethd together and identify the network stressing strength and act an little ambassador since the staff has the most connect some of the infrastructure is depicted on our slide briefly highlight we did have a dph committee of 35

people throughout the department and many disciplines that worked together over the summer to develop your marketing effort we quadruple with the top 3 message points that san francisco health network is the only complete health care system in san francisco and encompasses from prenatal to other trauma cares as well as long term care and the laundry list we're the only complete system our top goal is to increase the value of the services that we provide to our patients staff and to all san franciscans and that we are a community-based network we're by the and for the community and sever a difference population have a difference staff representing every neighborhood and listen to community button those methods were developed by staff and helped us to

articulate the network as we've begun our work we have created brand infrastructure there's a style for staff that is business cards and letterhead and the local card the look and feel of the network we have a logo the bridge you see here we have a tag line contest over the summer that had more than 4 hundred participants and 5 hundred entries to help build that enthusiasm and to help us again describe ourselves sunkly this is your branch to wellness our san francisco logo tag line from our contest moving forward we're going to be turning our attention to external marking and communications a couple of

highlights more to follow one we do have a new website 0 launched on october 15th i encourage you to visit that and give us feedback we're pleased about how to started out and also identifying a contractor with the marketing and branding expertise to help to support our efforts in particular someone that knows the san francisco market and the medi-cal manage market had he has experience with complex co-branding issues we have a fabulous partnering with ucsf and work request community partnerships as an organization that's not done branding and marketing before we'll benefit from the expertise how you incorporate all of that together into the network in a woo that's well communicated internally and externally and ultimately helps to drive our business i'll stop there and go

back to restraining order london land to wrap up if you have questions i'll take those and i feel like i should be on the giants team with the cobra here it's important to say while we've made significant progress we have challenges known and unknown ahead finds us some unknowns including include the outcome of the 20/20 waiver the medi-cal's waiver that expires in october 2015 the state is expected to submit submit a waiver in 2015 although that's questionable but it's the timeline and changes in the future evolution of the cover california challenges and issues and concerns will around the

patient retention and growth the ongoing growth of 85 and health realignment that are previously coming our way to take care of uncontemplated care and the players as at the exercise and exit the market how it affects us? an exceeded review of our journey so far we're welcome to take our questions and if i can't we are it my colleagues will ball park. >> thank you listening to this phrase that come to my mind was the making in the future it feels like you've made huge strives as a team what barbara describes as taking the wonderful silos my guess is like eating a meal in a fine

restaurant we looking at looked in the kitchen that's a the hard part on one hand having an incredible safety net system in san francisco that's rare and trying to get out the way we've also done things to kind of address an entirely new environment i want to congratulate you guys it's infest but to everyone congratulations (clapping) thank you. >> questions? thank you thank you rolland and congratulations to you and all your team in doing this great work i was reminded of the joker in batman it was so graphic >> this is from our young people. >> i have a question about your

integrated services you listed them in terms of how your managing the network work how are you integrating women's services as reproductive health it's griffin driven the the affordable health care act but i'm curious n the network i didn't see anything i wanted to get clarity. >> sure within the network women services versus the primary care is a speciality for us the woman that made the network may have her primary home at one the clinics or the san francisco general that has a principle care component that's a standpoint component while we didn't particularly call out women's services there are

embedded in the speciality side particularly by the services on both sides it's an important primary care within the network. >> okay. is is this a seam also process for women. >> i would hope it is i'm looking at our primary be health care. >> i mean, i personally look like to see things i'm a visible person i don't see that delineated any were it's a seem also to get health or mammograms or anything. >> good afternoon i'd like to show you some of the things we're working on we're working in primary care on the speciality side with the women's

health clinton departments of beginning colonel to insure that women no matter they enter our system can get pregnant tests early assess a prenatal care and condo receptions and options whether wherever they enter our system we have a long way to go but taking this very seriously in making sure our primary care clinics can provide the counseling referrals a have a relationship with provider prenatal care within our city and county system or at the hospital what a woman needs for entrance care early seas it a heated measure it is smlg something we attract track to

make sure we're doing a good job we take it seriously we provide whole women's care to the patients as well as those who have not entered our system to make sure when they came in we provide the services as well as gave me her in long term continuity care over the course of her lifetime. >> she can easily navigate the system. >> that's our goal 0 no matter where they calls she'll get even though same day pregnant tests and the preanalytical care but we're working hard on that we're working with the child ambulance and health dwindles on an approach to young women's health care to make sure they can get

the services as well as establish a primary health services when it she's in our care. >> thank you. >> you thank you very much. >> commissioner singh so i think i direct this to director picking evens thank you very much for commissioner on the staff the wife tour you have great staff and people and what i appreciate about the public health network is the commitment and the spirit to renewal and rejuvenation in moving forward i worked with the organization and he in terms of winners you guys are the giant to me. >> you know with that said there's obviously a lot of work as we're building capacity so i you don't don't want to speak to the building capacity but if i

framed today's discussion some areas i'd like to focus on its no transition we're going to get there that's noteworthy commenting but explain we're becoming the moving from the system of last choice to the system of first choice and becoming the first providers who are we becoming the preferred provider for who's our market and the competition talk about what the commissioner is talking about it's really bigger the aide for the demographics and the risky didn't quite hear in my of the presentations other than we're still the safety net but we're viewing into something beyond and until we answer that question we're not going to be

building our system we don't knows who we're providing services and the second question i'm to follow-up this is more than an capitalization building the capacity at our level across the continuum it great but i want to hear more not today but the transitioning of the levels of care because you know we're got the city low we have to work across to transition is where you're going to save money and provide equality i know we have great providers and every patient gets one hundred and 10 percent services when you e7bd up at mcdonald's and twhn that's the concern who are our customers and navigating across the system and you know what dollars are following them and

last thing we are a pop one hundred project for me when you take did costing and acute let me see clients and track them we learn a lot i want to hear more about the tape one hundred it shows glaringly all the high costs glitches but the opportunity for potential for about revere's that those are the 3 things but again my thimgsz up you guys are super stars to do all the work in one or two years no one across the state has got the jews as itch as you guys. >> thank you very much and in the hour i won't provide all the answers but i we will certainly follow-up with more information. >> do we have a marketing kind

of i've notice in certain circumstances about market. >> rancho that's a and 10 percent of our time and 10 percent of marlene's a time this is something we need to research more and hope you'll support that effort had you see it come before you in a biggesty process (laughter). >> actually to that end i was going to ask how you you'll know if you're successful many our marketing plan what are the metrics you're looking for again not here but as we move forward that dovetails tails on my colleagues comment both who is the market and how do we know if we're successful again, the actress ladies wow. it's terrific i - the issues around

access and capacity that are also drive so many of satisfaction and people wanting to be part of the in effect the department of managed care guidelines 15 days and then the realistic assessment so what happens if we don't make that and what happens with the people are anti liars what's itself mechanism what are those parts of the process and i'll say we're obligated to meet the department of the health care dwoifk and we'll make sure we do that hopefully, we'll be successful but we'll come as close as we can and realistically one has the responsibility if i can't reach it comboirp but get the sources from the outside for example,

you saw what happened at the va system in thermals of they're not meeting the demands we'll have to look at those. >> hopefully no one had those. >> right. >> so i have a couple of quick comments i also wanted to echo what the commissioners this is an imperfect process to see how far you've begun i really like the bridge to wellness on the subject of wellness this is what i want to see how you're planning on integrate really the wellness into the system of delivery if we look at some of the marketing tools they don't have to lease their bedroom to see the doctor in front of in

front of the of the computer and it is pioneers and what sets us apart in addition to having the entire strumming spectrum of services and how do we actually you know whether i think rather than sell the medical services and how do we listen and really get input about you know the patient side of this service you know how they receiving the service. >> what kind of input we're going to have there are certain things that patients are interested in found out to assess their own records and these understand whatever that notice is or how to prevent from you know getting sick and i know that helps to be part of this and how do we as a system do better that's the tension when we created healthy san francisco

it's about preservation it is to continue on that presented e trend it's great to have the speciality clinics but what happens when you get sick. >> absolutely in terms of wellness this is not including this in the presentation but i sure you, we can come back we have a tremendous amount of wellness activity throughout the network and primary care in our san francisco general works with the population health dwindles to make sure we're plugging in on the network side in terms of the larger commitment to the department of public health we're happy to share all wonderful things of wellness we have vevenz into sgraktd medication in terms of actic a

punch and therapyic initiatives we were are not able to fit into the context of the presentation. >> i epic we're going to hear from you periodically and more strategy iga's what you want us to dive into at what up to this point in time in certain points of the year to get a snapshot of things in the network i want to thank my colleagues on the commission and all of you, we have more questions than we have for the hour we'll certainly talk about the great work you've done talking about the reality on business in this mode but that's where we are we do have to move on we're going to lose one commissioners at 7 and need 4 votes in the closed session i apologize for

that i do think there's been a consistent theme of amazement and pride in what you guys have accomplished so that only sets the bars a little bit higher for next time and that's a challenge. >> thank you very much. >> and commissioners i've talked to director garcia we'll try to schedule this is this as a main event because your worried about the time all right. item number ten is other business. >> okay. i assume there is no public comment. >> no one. >> it's the report on the sf g h. >> it's actually before that the business is where you approach other things to mention. >> anyone. >> okay item 11 is a joint conference report there was not

a meeting it should be the october 28th meeting. >> the general hospital the committee reviewed the chounl meetings and the draft annual report and the environment care of report that is the hospital rebuilding transition report and the hospital administrators report and also the are patient services under the medical staff report it is for the standardized procedure we updated the that has for the lab tests and the list critical sf g h lab values and in closed session the committee approved the credential report and the other report. >> great, thank you moving on item 12 is the agenda setting any comments or. >> this was an excellent

meeting can we make the comment from the wonderful chair and no public comment on item 11 or 12 now we have a closed session. >> is there another motion. >> move forward we'll go into closed session. >> can the last person close the door thank you i spent the weekend filling out - we are

>> well, good morning, everyone and well, to the sf food bank (clapping) it's a great day to be here and kickoff the beginning of sf incubates 20th anniversary and love local sf