. >> okay regular board of health service board it in order january '88 please stand for the pledge and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all.

>> roll call please. sxholt expected commissioner wilson's supervisor jane kim commissioner keane we have quorum. >> first item please. item one action item approval that possible modifications of the minute regular meeting of november 15, 2014 are. >> my correction to the minutes seeing none do we have a motion. >> i move to approve the minutes to the meeting of the november 13th 2014. >> second any public comment on this item? no public comment all in favor, say i. of approving the minute say i opposed? unanimous

okay item 2 please and item 2 discussion item general public comment on matters within the board's jurisdiction not appearing on today's agenda. >> any public comment please come forward. >> my name is diane i want to give something to the board i want them to consider including in the benefits package i have sleep american people necessary i use a appliance kaiser paid for the oral appliance for the first year, however, not the follow-up treatment i h have had before the board the guidelines from the academy the american academy of sleep medication they recommend that anyone who wears an oral appliance e lines should be seen once a year to have

their appliance connected checked to make sure it's not effecting their jaws or teeth i've talked to my sleep doctor he recommends doing that but the insurance wouldn't pay for it is caught between the dental and medical the dental say it's a medical thing i'm not sure which one but something that insurance should cover and so does the american academy of sleep medication this is their guidelines for the treatment of sleep apnea what an oral alliance the follow-up recommends that you be seen once or twice a year a check up i think our insurance should pay for it i want to present this to the board and ask that they look at this to see it gets covered who do they

recommend you say. >> the sleep dentist once you have the approval you go to a sleeping dentist they make the appliance and makes sure it fit our mouth and you go back to see it fits my sleep dentist she send me to kaiser to do a take-home sleep test to make sure it is still working but won't pay for the dental to get the appliance checked. >> somebody will look at that and get back item 3 oh we can't do item 3 the president is not here we'll pass that item until

i arrives also i believe we should pass item four until i arrives item 5. >> item 5 discussion item director's report director date of birth. >> thank you commissioner breslin the director's report is longer than usually we haven't met but done a lot in the past few months personnel wise a gentleman was appointed a chief executive officer and here today mitchell and metabolismal has been with us for over two years and over 3 year sorry thank you and before he came to us he worked with the i s w he has lots it experience and known to

vendors and departments and hit the nail on the head and still doing his old job we've filled we still a a benefit textbook on i hope to fill it soon the new positions that were in the budget to begin in january including one posted a government principle programmer analyst for the awe logics department and posted as well as a program manager for well in-laws those interviews are occurring now we're setting up interviews for the finance contract staff and trying to fourth what to do with the assistant manager the list is so old every time you call

someone their have a job i'm going to let finance present under the finance topic under vendor contracts we've been working closely with ann daily if not multiple times a day i toured kaiser substance abuse we met after the increase from the police and fire it was very impressive a state of the art in the tenderloin on more than 12 hours a day they've really, really good success statistics we were successful in meeting with the mta to look at the

substance dawes bases from both major providers and really got in touch in terms of of the mta who they need to call it 3 that information has been shared with police and fire we spent long hours devising and redevising the "x" sister tax in terms of of the transparent is resolution i've met with the 3 major vendors and blue shield was limited in the amount of data the hospitals were willing to make transparent i sent a letter asking for a transparency and pivoting we have an database the

only hospital i heard back from was sutter they don't do tearing and they would really prefer a global cap rather than giving us claims data they've been operating for years in kaiser by the way weenter have to work with them to get the data so sutter's answer was not exactly the right one i will forward those answers see into the wrvrdz who passed a resolution i was fortunate enough to tour the kaiser innovation center with the folks w the garfield where is health care going to be in 20 years and it happens to be during the time they were training people in front of the center the infection techniques

what's unusual throughout the country it is academic centers that are designated as ebola centers in the bay area kaiser actually got an ebola treatment designation that's unusual but it is fascinating to watch the training we reviewed carefully the united health care contracting guidelines and we actually asked them to do this a couple of years ago this is exciting they'll be steering people to providers that have a specific outcome measurement november calm visits were average usually in an open enforcement after people get a confirmation letters the calls

go up and newly letter you have in your packet the calls were lower this year in terms of that confusion you however we make up for that this last monday when we hit seven hundred and 12 calls usually, we're looking at one hundred and one hundred and 20 seven hundred was a lot about the skipped pay period those retirees know we're moving first page a pay in advance to a pay as you go that information was if the on enrollment in the guide and in the section is it fair to say on our voicemail system that went out if the e news and printed in the letter but people were still spriept they are more money in their checks than normal there feeling were a lot of calls they got the

information off the voicemail system i'm going to ask we met with ann to plan the sutter rate audit you'll recall the land use limited the calls that sutter could make we're in the process of doing that and we worked with finance on the e e rp summary you'll take action on today when we - i also met with kaiser research along with stephanie you'll hear about that in terms of communications i already mentioned the confirmation notices but when you imagine 63 thousand letters going out in spitting despite of a large amount of work if i payment

through the managers deck she's had a very very about his busy two months so i'm going to kind of skip through all of that and i'll call on the divisions in a moment after i kind of say that i we met with the mayor's office after the initial excise tax analysis and posted for the december meeting and reviewed the "x" sister tax in terms of general numbers we've been meeting with the h.r. as we did last year the state protective committee and the mayor we asked to make transparent a priority and asked the blending of the medi-cal excise tax be a

regulatory federal level issue and that at the federal level we oppose increasing the age of medi-cal which is in the republican house budget to increase their age for eligibility to 67 it will be a hardship for the general public and financial hardship for the city and county arrest city college district had a choppy on enrollment and when we finally print the books we had to print them without rates we finally got them to agree to last year's rates we took out the subsidies and published them and then their mind was changed again we had in mile-an-hour confirmation letter we had to say that is not

the rate with on enforcement if you want to make changes i can we had no changes but it created a second on xrorment when was complex and culp so many i was honored by chuck cowgirl with the ymca with my wellness when i worked in the mayor's office oh, so many years ago, i attended the webinar and trained that was a national webinar this was available to the board but no one could attend i'm now the new chair the national committee for social security and medi-cal and attend their board meeting which i had them schedule the board meetings

on the we understand only gone one day for travel signs e.r. since i'm the chair i can have them meet on this weekend much to the members dismay we i attended the pb h choosing wisely i want them to make a presentation it's a specialist organizations combined to do a whole consumer education program through the consumer reports it's really, really well craft to help people to make decisions and not immediately need an mri or an x ray or whatever so i'd like to ask them to come o to present and perhaps in the next contract ask our vendors to

participate in choosing widely campaign the mta had a diabetes conference we met with the diabetes foundation person yesterday to see what is available they have a lot of materials it stephanie will roll out through wellness and i put in what the anticipated changes to medicaid are and to see president obama's budget before although the senate voted them down they're likely to be in the house republican and they'll have to push obama to look at that this includes the surcharge on the charge for consumers it didn't say effect our members but anyone that is paying for

medicine gas it increases the part c and d premiums their taken out of your social security check that's for everyone it increases the b co-pays for home health to $100 per episode and s. it increases the guilty to 67 that has a significant impact on our excise extension that's the section where our premiums are the highest i'd like to briefly call on operations and then david wellness to update things so operations how did we do? >> mitchell chief executive officer of the health care system i wanted to briefly talk about

operations as far as our end is concerned on the third page of the deck after the director's report second slide it says year-end enrollment we've received 26 thousand calls a decrease in 2013 and member services animal a little bit over 13 thousand with the 2014 a 21 percent increase from 2013 just a little bit about on enrollment 2015 flexible spending accounts we have 34 hundred about the same or 33 hundred and the tenant care 985 increased in 2014 on the no objection page i want to bring to your attention the plan

enrollment tb on enrollment as you can see the top line is defenseless 2014 the second line is january 2015 so by december 1st, 2014 we had done our just of late enrollments and that type of things blue shield did well, for family coverage at one hundred and 24 it's the first time it's increased in 3 years that shows a lot about the work that agents have define to get the enrollment important stabilized the other thing to bring to the boards attendance the on enrollment is one hundred and 65 separate tabs that you know have to complete for on enrollment and i wanted to just add to the point that we had a 21 percent increase in person

assistance that has implications to people are accustomed to get that in person help they have to go online it's a culture change hopefully, we'll work with the analysts to have better serve because people are accustomed to getting personal service i'll echo what mitchell pointed out this is the first time that blue shield has not lost members but in fact had a small gain so all of the work this board did in terms of the funding and the department did in terms of norwalk the working with d hr fornix the premiums as well as the sinces you passed resulted in exactly

what we minded we curved immigration auto of the blue shield for 24 particular year the reason we put in the one hundred and 66 tasks someone asked to get a better sense of what we do this is how complex doing an open enforcement is thanks other questions. >> congratulations to mitchell. >> i know you do a great job. >> i look forward to working you, you. >> before you retreat congratulations to the successful on enrollment and the deputy for this fine team kathy republican leads my perennial question since i took a seat like stopping payroll at the last meeting i made a suggestion a letter be drafted this witness

to the president i think i'll be writing that letter i guess (laughter) my point i know they've made adjustments i want to solicit a letter they made adjustments but had an impact on the adjustment put that on the to do list thank you for your help. >> thank you >> okay i'd like to call upon marina give us an update that was a question and data analysis vice president scott and commissioners to continue with mitchel's presentation echo on the work going into on enforcement within the packet summer of the statistics that go into the

system configurations with people having a support our benefits administration i won't read that to you suffice is to say we've gone from e or o e to calendar work that takes a lot of time to prepare the w 2 henry adams and other reporting and rolling on the planned year i want to say we've got a specific time of year we're busy all year one thing to the next back in the november meeting we presented on the ap cd requesting our approval to enter into a contract with the database at that point there was questions raised by sfoelt regarding the elevation for that vendor and who the panelist were

and a little bit about the vendor that was selected there's a separate memo in our packet. >> can you tell me where that is. >> it's right behind. >> i think that was embedded with the director's report. >> i could be wrong. >> okay it's after. >> it's after the kaiser wellness research study section that's in the directors materials. >> so it's just before the blue page. >> thank you and in the interest of brief it i won't read all the material but we had 7 key areas used in

our elevation criteria the panelist i've listed them with their backgrounds i'd like to certainly raise taken into consideration attention we felt we had qualified commitments this gentleman has served in american people advisor capacitate with our agency for health care research and quality and so provided a number of key insight and before county in terms of having that public employer went will the challenges we're facing and administering the benefits and that gap doesn't help decision makers move forward there's in sight i'll a leave it there

unless additional questions. >> thank you marina for providing this information for one it heights my degree of confidence knowing that truman is a company that acquired metro staff and they were an excellent vendor in the olden form this is an o from any prospective i think we'll find a good product from them and it achieves the kind of long term results we're looking for so this to me pass been more than illuminating and for any project of this scope and scale that is kind of what we want to put on the record we did a due diligence not just about the money and the approval and the direction from the board of supervisors to we're doing it and did indeed spend time and

get expertise in making the selection so thank you for doing this. >> thank you very much commissioner. >> and i should do a shout out to relinquishing in the finance department worked overtime quite literally often the community college rates and accommodate an unusual employer question. >> just for the record you can't can you remind me is there a fee. >> yes. tests not enough (laughter). >> we charge them both the school district and the xhuj per member per year and it's probably something we should re-evaluate and that money becomes part of our

administration budget. >> okay. >> lastly i'd like to call up stephanie to give us the exciting data on the being the assessment we were confusing when we first met i want to point out in the deck her report got put together the kaiser research east actually goes under tab it begins on slide 5 it is under tab 15 she's only going to talk about wellness and well-being. >> i'll remind you of that stephanie with the health services system the bullets in the director's report are both from the december and january meeting they give you the early status on the va and the final status but just wanted to give you the