is not only in our network but a customer we fully expect that should the attorney general allow prime time to purchase them they'll continue to be in our network. >> are there other questions. >> director dodd. >> i wanted to say i did have a conversation s request sutter they contacted me and i mentioned it in my director's report it's important for the board to recall some of you weren't here that three years ago sutter coming in came in when they wanted to buy up the whole business and put st. francis and st. marries out of business when we launched the acos we want different premiums

the brown and tom man sutter premium will be higher than that assuming the utilitytion matched better to be safe than sorry but the premiums effect the costs sutter wouldn't allow us we wanted to create real competition we talked about removing sutter because they were driving our costs up so all the work you've done over the last 3 years to null lists migration i only needed 10 percent in the hospital to blow that out of the water we'll be back to trying to convince people to pay more by largely because of sutter so it he kind of is something we asked for indirectly

and it is happening and sutters rates are higher than any place else in northern california they drive the hospital market and only the hospital p that they compare with a cedarcy new that's the hospital to the stars if we're going to keep please line up on the screen side of the room or anthem or whatever our system we have to control those hospital costs and today blue shield is unable to control them. >> i have another question so assuming this happens and people h that have doctors in the sutter group and have to pick a new doctor does blue shield have a cap on how many patient the doctor gets. >> i believe some thafls has been done about in discussions

with other medical groups whether there's sufficient capacitate there any doctor at any time has the right to close their practice but as of now we feel there is certify capacity of primary care physicians in the community. >> have you reached out to them to make sure they can handle the workload if your sick and can't get an appointment. >> i don't know if our network incredible people have had those dysfunctions i'll add for people in the course of treatment tlrgs a continuity of treatment for the plan so that you know should somebody needs e.r. flowering cancer treatment europe behavioral health or another needs there's a continuity care where they'll see a sutter

provider under those circumstances. >> i want to add the network transition plan was approved by the state department the health care they look forward those soft things to make sure dollars adequate capacity and they found it to be meeting state requirement. >> are there other questions i'd like to thank you both of you for coming on short notice to provide some additional background our on the topic we're not at the end of it and we'll be calling you and wish you well in our endeavors i guess from my own prospective i'll like to hear sutter to explain in the interest of fairness and balance and representation but i think the data speaks for itself quite frankly we'll have to see how it precedes to the

conclusion thank you, again, for coming today. >> thank you. we'll continue to keep you appraised through director dodd. >> thank you. >> is there anything else on that topic. >> public comment. >> yes. as also let's hear public comment on that topic oh, yes. >> can't let it go president of the retired employees of the sfoiks ore phones are ringing off the hook we've been talking to talking to those who represent rertsdz police and fire that have been calling and how it impacts our members commissioner brought in mri run and son on uniformed personnel

are affected we've told many members their primary care will physicians may not be impacted if they're part of brown and tom man or hill or mothering any of the medical groups as the dr. pointed out that occurred to us immediately this is very distressing and i'd like to invite a representative from blue shield to come to our meeting next wednesday and talk to our membership because their very, very concerned we have a lot of blue shield members among retirees and i think if i want to commend blue shield for whatever they're doing to try to negotiate those and i understand that mp mc is the highest cost in the network since 1947 and now it's a sutter facility and continues at high costs retirees

are extremely concerned and i know that activities are being sure because they have families and many of the considerations that the retiree network when our older and have to look for a new physician it's traumatic and our members are really urging blue shield to do whatever they can to be able to maintain the continuity of care and no problem on april 1st and they'll be able to go forward but cost and continuity of care and retirees are in a panic thank you. >> thank you. >> dennis kruger activity and retired firefighters i see some of the alternative hospitals are going to pick up the membership after sutter is terminates and

number of hospitals are for is all i'm wondering through the sale of the hospitals they'll be eliminated as alternative choices for our members and number of the two of the hospitals in the san mateo area i believe i know one for sure has blue shield taken that into consideration that those possibles are sold will they still be alternatives and any other public comment? and is there do you care to respond to many as one the blue shield representatives? >> yes. we do not anticipate any change in the rest of our

network configuration as a result of the sale of daughters of charity to prime to that should that happen and we continue to negotiate with all our providers our contracting people are doing this amendment with itch smaller medical groups and hospitals so they're very professional how they go about f that this has which happens to be the biggest to folks in northern california i welcome the opportunity to present any constituency within the retirees or unions i've spent the better part of the last two weeks talking to our largest customers 2, 3, 4 northern california with only possibly one expectation they're all behind us one hundred percent wanting united states to fight this fight so i welcome the opportunity. >> i'm sure that the

representative who will be contacting you to conclude that presentation are there other questions or comments public comment at this point? if not again, i'd like to thank you for coming today and we'll be in touch to get an update to our next meeting whether it be through you or through the executive director but again, thank you for coming on short notice to share your perspectives on this issue >> the next item is item 4 action item election of health commission commissioner scott. >> i wish to vacate the chair in favor of commissioner

breslin. >> nominations are on for the health board i nominate randy phycology for president of the health service board. >> i second that. >> can i second that. >> second and any any public comment on this item? all in favor, say i. and i opposed? >> it's unanimous we have a new president congratulations. >> (clapping.) i had thought the vice president would be on here we usually do that together. >> thank you i'm to claim the privilege 67 asking the former vice president thought that board be the vice president again and go through that at the next meeting we also as a result of jean frazer leaving the board have an vacancy that's mire hope

to have a a new commissioner identified that's the mayors prerogative we'll abide by his timetable i have no other comments and i consider it to be a approved privilege and honor to be able to serve in this capacity it was quite shocking when jean called in october and said she was going to be leaving and sirens then i've had the good pleasure and honor to work with kaeblg e katherine in preparing this meeting and look forward to doing this this the future to the commissioners i want to be available both formally and informally to you as we do our work and various membership and constituency of our system it's my hope and

expectation i'll find some way to be a part of meetings or gathering or what have you as we go forward i said it at the beginning of my tenure as a commissioner yes we need to meet not only at many time but other opportunity and as president of that board i'll try to actively find a way to eric legally do that as we go forward and thank you, again, for this privilege and we'll precede with the balance of the agenda item 6 discussion item ss h reporting as of november 2014. >> good afternoon pamela levin chief financial officer in the interest of shortening the

meetings looichlg i'm going to briefly go through the report on the trust fund and the general fund administrative through november 30th if there's additional questions i'll be glad to go into detail when we end last fiscal year john june 30th, 2014, the assets were $92.8 million based on the activity the net are $85.9 million a decrease of $6.9 million associated with a $4.4 million increase in the projected city assets and $6.4 million in blue shield neglects net assets 5.5 increase net assets he associated is favorable claims

and self-insured he dental plans and 8 hundred thousand decreases in stimulated estimated hmo from the use of the early retirement - i. >> reassurance program. >> reassurance which i'll report on later $800,000,000,000 increase in net assets from interest income that includes the interest on the e e rp fund and 4 hundred thoisdz enthuse decrease for forever turns due to the transfer of the general fund prudent to our 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