budget we're working closely with on the calculation of the reserves based on the financial results of first 5 months of 2014-2015 we projected a $50,000 balance by year-end and we've rice that project based on funding the borrow text and executive directors policy update we're currently not projecting a balance in professional services it is a very, very tight budget this year and will be next year in terms of professional services this year we will be doing reprojects pro-projections it's difficult to do things workplace you know just a few months and then we will continue to closely

monitor expenditures not to sfeed the budget we have very little room for maneuvering i'll be glad to take questions. >> are there questions from the board? pam >> i was also asked in a section to talk about the finance you activities and update even though monthly report we started preparing for the 2015- 2016 are internal audit from last year i apologize for the error what happens every year the controller's office comes in and audit our policies and premiers. >> audit our selective sample of journal entries and produce a

report and discuss both our department and how our department performs against city departments we talk about improvements that can be done which i have welcomed because we want to mayor that we are not only immigrant with the controller's office but that we are going a little further so we can have continuance improvement and i monitor very careful what the expenditures are and how the they're posted and you know there's also a possibility of mistakes which are also there's a possibility of improving they

revving 30 years those mistakes i'll talk about in the next acceptance we started the preparation of our 2015- 2016 budget i'll workshop the reductions and have the actual discussion in february in terms of the incredible we're still working on negotiation and he preparing the negotiation renewals for the 2015- 2016 reinforce we work with the potential vendor from the code administrator and plan to come to you in february and ask for approval for on intent award for that contractor we are trying to do this in an explicit perish way we want them to handle the cobra in july we

complete did report card for kaiser permanente and they've obtained a passing score of 4.9 it out of 5 we're continuing the process towards the execution of a contract amendment how the analytic that machinery marina was talking about we are very close to final lincoln's that negotiation and i hope that to be able to wrap that up in the next two weeks. >> which is a very logical that i hope to do that and then the summary of health care activity and retiree plans were approved and this also includes a smoking sensation

benefit so are there any questions. >> questions from the board. >> well, the sensation benefit not one now already? director dodd >> director dodd there was not a smoking benefit in the u h c plan we equal listed the amount in 2010 between blue shield and kaiser and that was note when that they were reviewing the contract documents that was negotiated in the last couple of months. >> a question how did the abc d they expand on that is there different material. >> i'd like to ask marina to come up and this is something we're going to need to do around this project i've asked the director to do that we use those

terms kind of inside the ball park there's a wide public that if this what we're talking about with the acronyms so when we raise questions it would be upheaval if we say it a couple of times it is necessary for us to once the contract is clushgd that we have a briefing on what you're going to be doing and why we're doing are certain things in the project to continue to educate us and the general membership, if you will about what this thing is going to do in the short term and long term i think there's going to be some continuing refreshment at that point so marina please. analytic manager with specification about the dashboard yeah, we'll end up

gvlt the dashboard over to the cbc you've traditionally seen one time period you'll get a kaiser another a blue shield dashboard we'll be able to give you the holistic view what's going on wasn't the population normally we tend to look at go the the utility shin but we'll have a lot of benchmarks traditionally we haven't had the report will will be far more robust i look forward to come back and going big picture with all the materials we'll be able to deliver. >> more transparent maybe. >> absolutely. >> (laughter).

>> that's also their prayer and hope are there other questions from the board pam is there something more on the topic you care to share with us. >> no. >> that concluded our report is there public comment on this discussion item if not secretary. >> item 7 discussion item health care for the 2015- 2016 and fiscal year 2016-2017 budget rescues pamela levin. >> pamela chief executive officer it seems like we did this yesterday but we are starting the process again for the 2016-2017 budget 2015- 2016 and the 2016-2017 budget arrest this is the first meeting i'll be going over kind of the process what the mayors rooishgdz instructions are for general fund the next step and

the schedules one thing we're going to go doing differently this year we're going to be considering the what's called the 205 bucket that's the health care system availability fund budget which funds it's the charter oils what it fund and we will be going over that a little bit more in the future right now i want to focus primarily on the general fund budget the reason i want to have the discussion on the 205 budget at the same time as the general fund 38 they tie together for instance wellness ties together between what is paid for if the general fund

paid for out of the trust the 205 that's the same thing the same situation exists 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 f