in the data analytic and in the same situation in the communication budget i'm bringing forgot the 2015- 2016 budget in 9 fvshg year in the past we've looked did planned year it's difficult to do you know reconciliation or compare shakespeare center to make policy decision if they're not together we will be coming with more details on the 205 budget in february on the process of the budget development and going through the process with the board is vivifying i've brought a lot of best practice to the process but it will continue to evolve so i. happy to take ideas you may have

anyhow to improve the process but we right now are on the kind of the critical timeline in terms of our the mayors budget instructions those only apply to the general administrator budget what they've put out in december was that they're projecting the general fund deficit to be $15.9 million in 2015- 2016 and $88.3 million in 2016-2017 this is based on current operations and staff and estimate revenues as a reference point we were they were projecting a deficit projection this time last year for 2015- 2016 to be $108 million by due to strong tax revenue growth and low

unemployment rate and the negotiation of affordable and 3 contracts allowed the deficit to go down they also take into account the november ballot initiative if you recall one of them had not been included in the mayors budget and it was put on later and that had to do with the mta population adjustment that affected the general fund because of the good news we've had they have been able to let us off the hook let the city off the hook the general fund department we don't have to implement the con migrant plan and they have the opening of the public safety building in 2015-

2016 and san francisco general hospital in 2015- 2016 and the central subway in 18, 9 those affect the general fund in one way or another that's the good news so the two year budget instructions are as follows: in 2015- 2016 we have to stay within the bucket approved by the board of supervisors with a couple of changes the first change is any position adams in the current year will be annual list next year and any but what we're going to end up doing is absorbing the aspect of the personnel to the stent that the professional services budget i budget was closed and tight in this year i mentioned before we're going to have challenges in next year

so in 2016-2017 we are to propose ongoing reductions that are equal to one percent of the general fund budget that's a $31,531. >> so it's been the case in many years as far as i remember departments are ruk9d to prioritize operating efficiency we can also submit enhancement requests that increase to provide additional services increase the personnel or enrich programming behind the base budget they'll prioritize ongoing proposing paroles and the proposals must be sported by

analytical base approach what i'm causing augment you shuns they're to address i think areas those are similar to pillars that have been established by prior things that the mayor want to achieve the first is and tyler kind of vague. >> pam pam i think we can see those they're in the materials i understand the importance of enthusiastic way the pillars of augusttion. >> director dodd. >> i believe the total on that groundtion relate to serving the public not enhancing the service for employees it maifrs makes it more difficult to find our needs for additional fund in the

context of serving the public. >> so thank you. >> one of the - so when the original discussions were done when the mayor come to the director and explained what the budget instructions and came to the cfo there were only a few of the goals when we actually issued the budget you instructions they added one other interesting area and that is cross departmental collaboration this may be something that we can look at in terms of and i'm just throwing an idea out it is not necessarily what would happen but in terms of of emerge of member services connections with the other departments so that

maybe an area so the next steps we have to pit together a proposed departmental budget and bring it to you in november right now staff is working on their proposals we will come pile those and put those together and make decisions and then forward that on to you for approval those the budget will safer the mayors instructions and propose ongoing reductions and as itch as possible if proposing embarrassment that meets the goals we'll be implementing the strategic plan. >> okay. thank you. >> are there. >> i have a couple of slides on

the schedule if you want me to go through that or you want me to address the issues. >> i'd like to address the issues the whole process is come back to us in february that way we can reinforce those steps having the action tied to it so are there questions of pam at this point of progress. >> at the 205 where do i see that broke down when i look at that. >> you don't this - in terms of the monthly report it is in there but hard to see that's right why when i come back to you i'll work on a better depiction of what it is spent

on. >> i'd like to see it as a separate item is that possible so you you know it's a separate and on an ongoing basis. >> yes. i can work on that. >> there's not much change between months because many of the - a good amount of 205 budget is projects but i will be glald glad to bring forward a schedule. >> particle on a fiscal year basis you're trying to put together the expenditures i'll agree with commissioner breslin it's good to see those as we go forward. >> i'll be glad to do that. >> are there questions or

comments from the board all right. any any public comment on this item? if not thank you secretary i'm to take the privilege of chair and ask that we take a ohio gene break untilave - the members on board as we'll have a external candidate that will take will be a half an hour i'm going to ask for certain action items and certainty other items on the agenda we'll defer until the next items the action items i'm calling for us to take up on the agenda are action item 12 action item 15 and action item

16. >> what's that. >> pardon me no, that will be one we'll defer all right. the 3 i cited again action item 1215 and 16 they have a certain immediacy we want to do them while we have quorum also printed in the agenda we'll be going into closed session that session mr. be deferred to the next meeting addressed the discussion items we'll take up whether we have quorum or not so we'll take up the action items to undertake for today so with that general guidance i'll call for the secretary to move to action item 12. >> approval the resolution

ordering the 2015 board election for one expiring term and 30 years staff to proceed with the election director dodd. >> you all know we need to do that every time we have i'd like read the resolve this is the elected seat 2015 that it be kushthd by itself director of elections and that nominations be made from february to march 9 and ballets marked inclusive that didn't make sense if they're taking office on my 15 does that. >> oh the term expires on the 15 but they take office then.

>> if there's not a challenge if it's an unchallenged race we'll not have to have an election. >> yes. >> all right. you've heard the resolution is the chair read to entertain a motion. >> he move we move for the health service board election and is there a second. >> it's enrolling moved but we take the resolution as printed and read discussion by the board members public comment? hearing known i'm ready to take the vote all in favor, say i. opposed? >> the next action item is action item 15. >> item 15 action item notification of kaiser

investigation review board rewarding diabetes. >> as you recall this is the slide 5 under the wellness tab should be inserted we've been working with kaiser a year almost identifying the potential research projects we've finally come up with a great project and in order to kaiser to move through their bureaucracies they need to be sure we can do this so stephanie and where is this slide. >> it's in tab 5. >> under tab 5 with the director's report in the wellness section adversities right before the, true vin analysis. >> unfortunately, there's two tabs there's december and january and it's slide 5.

>> i'll give you mine karen. >> you can precede please. all right. >> all right. >> so to give you a little bit of background how we came to be here the kaiser permanente appendix d has the transparency accountability and wellness to one of those was the kaiser permanente with collaborative with h sf for 9 wellness of the group men's we've been working with them to come up with a research study woefrth of those dollars to help to expand our initiative. >> weight of the testimony be working with kaiser permanente division of research so as we

wlooktd this i wanted to cover a topic of diabetes is a huge cost driver and hive prevalent about 80 percent of folks suffer from those and people that have kaiser insurance that's the number 3 cost driver in our theerpg drugs with cost members as this is a wellness study we're looking at to halt diabetes when you look at the population it is even greater folks that are 20 years and older without the lifestyle changes with those with prediabetes will develop

diabetes in 5 years modest wealthy loss can delay it up to 57 percent so the original research from the diabetes with the partnership of the ad c after 3 years a lifestyle intervention is the lense that in the study at the looked the forum which is a drug that helps to prevent twbz and after 10 years down to 18 percent. >> so building on that research the diabetes premise program a 7 percent reduction in weight and fell activity each week the h f

study to evaluate the base outcomes the diabetes prevention hadn't done that so our research questions is which of the two diabetes prevention leave style interferences works and one not works well has a greater wealthy loss we know it's great if you have a great interference that works but if you can't get people to do it so people are here potentially being able to sustain greater engagement looking at those based on the work setting the city has a good type of work that we do so how does the effectiveness of this program differ from the work

program my request we're seeking approval to move forward with the research project and seek approval through the kaiser permanente northern california institutional i rb 80s provide ethnical protection. >> you've heard the recommendation are there questions or comments. >> two interferences you'll be using two. >> yes. a random trial the work site versus the add that people can use at home so see if it's more effective or less than effective than the work site setting those are more sustainable the community programs can be costing so we wanted to see the defensive between the interferences we'll be able to continue in the future as opposed to testing

something we'll not be able to afford. >> i'm talking about the drugs. >> we're not looking want drug only the lifestyle. >> oh. >> even up against drugs the lifestyle did better. >> there's programs with diabetes but very this for prediabetes and last week blue shield is very expensive which is ridiculous to have to get a doctor's referral i don't know why you have to get a doctor's referral to go to o a prediabetes class but there's not near enough emphasis on the prediabetes. >> other questions or comments or altercations from the board. >> one question so once we approve those result studies it

will be in the greater wellness program you'll have an update occupants the results. >> yes. >> okay. great. >> is there a - i'm ready to entertain a motion. >> i max make a motion. >> that's a second and third (laughter). >> any other discussion? comments? public comment r.c. sf president i'm hoping you can do something for workplace programs there are several programs where there are high rates of diabetes and prediabetes when i was at mta or muni i saw the drivers it was really difficult part of the problem getting the departments to really cooperate and hoping

help give employees just like every hour 3 to 5 minute activity break a break from work or part of their state announced work break it helps them become nor active and not glued to their desks so i really hope that this program can enforced i'd like to see a happier and healthy workplace i want to add all my colleagues they're on a drug that has terrible side effects i hope there be a better drug that didn't impact in their ability to get to work on time this is a great program the retirees support it we want to

see more of this we'll support the workforce >> all in favor, say i. of the motion as proposed i. >> opposed? the same sign or a different sign we'll move on the motion is carried we'll noting now move to action item 16 which the presentation of the strategic plan. >> dobd. >> the strategic plan is before you, you post the governance meeting yesterday we'll be adding some additional detail but probably the new sections are related to wellness and data analysis and itch of it it it did not

sisters in terms of whether we can get technology funded but we remain committed to operation excellence the new initiatives are highlighted so there's a hope we'll be able to automate those and it keeps getting punched off maybe not until the second year the affordable health care we'll continue those and the new ones to identify inform mitigate to the excise tax to implement the database and to enhance opportunity to participate in research projects which will improve the well-being of our members and in terms of the that transparent governance our new initiative we'll continue the

initiatives in place and we would like to consider implementing the distribution in the health service for materials and funding conferences for a commissioner to attend one per year and that can be changed and to insure that the i f e b and updates are available to board members in terms of goal 4 we would continue our ongoing initiative and new initiatives would include updating the website and increasing the digital communication with members that requires hurdle and continuing to engagement the departments at a greater level of cultural awareness and this becomes important so we've outlined the threats to success in each one we've talked about the

opportunity and it moves all our goals along and adds wellness and data. >> are there questions from the members of the board? dobd made a high-level reference to our governance committee meeting the chair we kinthd it yesterday an international part of the work of will be quantifying which of those are milestones in 2015- 2016 talk about changing a reinforce going forward what is going to be accomplished if you will, during of the plan as i understand it we'll begin to combvent and talk about which year as we go forward after the

plans adaptation >> are the questions from the board and i'm willing to entertain a motion. >> the health services i move. >> it's been properly moved and seconded are there any discussion from the board members further? any public comment? hearing or seeing none we're ready to vote all in favor, say i. of adapting the strategy plan as outlined and distributed please indicate by saying i >> i opposed? nay it's naming adapted thank you dobd and her team for the formulation so wife covered the required action items we can go

to the regular order i'll call upon the secretary. >> yes. >> (inaudible). >> no, we have not addressed it now that we have time for a moment i'd like to do that. >> we're on number 8. >> well, i'm going to move to action item 10 while we have quorum begging the privilege of chair loans my council doesn't stop me i feel like i'm in control marginally okay secretary item 10. >> item 10 action item approval the stabilization policy. >> and . >> good afternoon. i'm an actual y in fact? the claim

stabilization policy we would like to bring to your recollection that the plan has been added and hewitt's recommendation that the board accept the changes we welcome questions or comments. >> and the major change is doing what. >> the major change is to add the self-funded p po plan to the existing policy. >> thank you are there questions and so currently, the p po plan is on a yearly basis and if you're doing the raven for it goes for 3 years. >> yeah. we're doing yeah, we have the excess of premiums over expense in 2014 so we've got the

stabilization funds in 2013. >> so they're using f it in the following year for the whole autumn. >> your surely right amp tied over 3 years. >> so for the next fiscal year and increase it for the following year. >> yes. >> okay. thank you that clarifies are there another questions? >> no and is there a motion on this item. >> i move to approve. >> is there a second. >> it's been properly moved and seconded we adopt the policy changes as indicated and described and discussed is there public comment? hearing and seeing no public comment we're going not ready to vote all in favor of the policy changes as described and discussed