again most studies so cost sharing at $250 a month is where the cost sharing is impacted hiv and hepatitis c dispropgs effect people of color and transgender and youngest gay men and people that inject drugs those unaffordable high cost drugs lead to humble disparticipants hiv and hepatitis are infection they when we are having the hepatitis c they put our prove lax out of reach for many, many people not only a treat to individual health but population

and community health thank you very much. >> thank you so next, i want to call up james and matt from the san francisco aids foundation and. >> good afternoon supervisors. thank you first i want to thank you for bringing up this important discussion and opportunity i'm james the vice president of public affairs at san francisco aids foundation and i want to start by saying i stand before everyone with tremendous help the reason; right why the progress is one hundred percent when you think about it today community cross the united states for the very first time are designing and implementing plans to eliminate the transition of aided even a

few years ago would have been unthinkable this is progress we can't take for granted now more than ever we have to identify threats to this as we work to make san francisco the first hiv transition we're here today to address one of the threats san francisco aids foundation is concerned does the description between the lack of transparency in the health plans and the clients that be trying to get life saving medications considering the following some covered california plans place in their hiv and help it's drugs between 10 and thirty percent of the cost of the drugs employer plans have similar descriptiony practices we become aware of a formula change at the

one of the largest tech companies in the bay area and that move place oil hiv drugs both a speciality tier increasing caution significantly for hiv employees as well as the hiv negative employees that were taken a drug high out-of-pocket drug costs lead to issues as described earlier several studies have demonstrated that cost sharing results in the consumers for going their medication leading to poor outcomes for individual and the community both hiv and hepatitis c it is acceptable not only for individual height but we work to decrease the load and decrease transition we building that speciality tiering shouldn't be based price costs

plans should development a better exemplification reasonable medical management additionally, we building the rollout of the affordable health care act provides an interpretation opportunity for the insurance companies to better serve consumers by increasing accident transcript around the plan formulas as described for the information is often hard to find and interpret you can't interpret is it is often inaccurate those plans can change by addressing and subtracting drugs and it is impossible for consumers to make informed choices around plans that ultimately determine if they can afford the drug we're making progress and we certainly understand the need for formula changes and want to see new

drugs added on but we must build on the efforts by the establishing industrywide standards to make sure that the reliable information is that place at the start of the enrollment and changes are communicated in realtime for all those who are impacted and those impacted can change the plan without up to the present time we looking forward to working with the city to discuss our concerns and develop an action plan that when a new hiv infection in san francisco isly thank you. >> i'm matthew the navigate our in the past 4 months we've had a pilot program we've enrolled one

hundred and 68 into prep that's been demonstrated mel eligible for the proving lax 60 percent of the individual are insured and 17 are running into issues with speciality care main issue we're seeing with us within my role i've helped individual sign up through public california and the open enrollment period but with that we're seeing individuals choosing plans based on the low premium available because of the high costs in san francisco it is the most available as the previous speakers mentioned awhile having the lowest monthly pro tem as the highest co-churns or insurance or point of care

services i did my best to usual into the silver plan and venting to reduce the debelieving did you believe i'll be talk about how this increases the models monthly premium there are impacts within the service people making more than 5 hundred percent that comes out to $58,000 announcing and across the nation it considerable but in san francisco it puts individuals workplace that price range and the individuals were not able to assess price reductions with the network which helped individuals to reduce the costs this hearing is timely in that

this last week i'm helping a client for 14 months his individual co-pay was $35 a month until recently changed under the speciality tier which brought him up to $500 a month pharmacy bill this was factoring in the fact you have to pay for individual to the doctor as well as the lab during the pricing and gain access to medication through programs you such medication assistance program and a co-pay card and assess network we reduced those costs for the individual is looking at $20,250 a month this is well outside of his financial bracket he came to us seeking proving

lax assess because of the speciality tearing of the medication we provided him a pass and are actively helping him to continue for his access to life saving services. >> i want to acknowledge katherine dodge do you want to say something about this issue with our familiarity. >> thank you katherine dodi want to highlight because we spread your costs across one hundred and 27 lives our members are not effected by those costs i was briefed yesterday by blue shield we spent in the 2014 calendar year $3.1 million on

help it's c but right behind that we spent $2.8 million our overall speciality spending is 2 point plus for our blue shield members the issue of pharmacies a one as hard as we try to keep down our health costs we can't do anything about the pharmacies i appreciate you shining a lien light. >> thank you right now is the the city absorbing those increased costs for speciality drugs or the plans absorbing it. >> not city pays for it. >> and do you see at some point are we likely to see increased co-pay for city employees

related to speciality drugs. >> i hope not. >> i hope not too but i don't want to put you on the spot we don't knows what the future holds. >> the issue come up with a plan design it keeps costs down of keeping costs down is by charging co-pays and the federal government is got a cadillac tax in 2018 as the cost of pharmaceuticals go up we need to stay below the excise tax so we can increase co-pays if we needed to do that it wouldn't it would be co-pays on doctor

visits or lab work but that's the only out let that the federal government allows on the costs pga them on those to the actual beneficiary so there's a train at the end of the tunnel. >> remind me when does our contract come up with blue shield and kaiser. >> we're norwalk the renewables right now are blue shield and kaiser we're not anticipating a plan change for 2016. >> thank you. >> thank you for asking. >> yeah. >> okay with that, mr. chairman i think we're ready for public comment. >> ms. supervisor are there speakers. >> i don't 0 not. >> why in the public comment anyone that want to speak please

come up and if there's more than 1 speaker line up on the far wall anyone wish to comment on item one. >> i think we have one. >> thank you for having this hearing i'm michael smith an out liar about 10 years ago i severely broke my back with a taxicab that was a minor fall actually about t but it caused any veer to be crushed and spinal colonel aluminum to be pitched chronic pain and over the years i've got 10 other bones realized this was a problem two years ago i broke the strongest bone in my body

the femur it had to be with a high-speed car crash but i wasn't in one it took a week of hospitalization and $150,000 for that week after that it was far more expense or competitive 14 weeks of construction i broke the other femur the other strongest bone in the body another $150,000 for hospitalization and the costs were phenomenal i know there's an automatic disease after many months i spoke to kaiser about 8 or 9 months ago at the put me on the bone strengthening drug kaiser said this would be $50 a

month when i went in january, i was surprised by found out that it was 6 hundred and 50 delores dollars for that month it is a bait-and-switch they told me specifically saving me money yet i had to pay this amount of money per month and the problems continue. >> this is the photo i referenced earlier thank you for sending that to me. >> is there anyone from the public who wishes to speak okay seeing none, public comment is closed supervisor wiener. >> again, thank you mr. chairman for allowing me to hold this hearing thank you, everyone who presented i really want to thank blue shield for coming today, i know it's not easy to come to this kind of hearing and

you were the only insurance companies that agreed to come to and i appreciate the candor that the condition exists whatever our views to address it but regardless how we address it that has to be addressed and you know when your that talking about very serious medical continues conditions like hiv or hepatitis or cancer and so on and so forth when you start telling anyone whether or not necessary have insurance but particularly paying monthly promotes for insurance effectively you canned have this drug because when you tell someone they have to pay $600 a month that can be the difference between sickness and health or life and death it is not an

acceptable situation trending in a bad direction trending worse and worse we can have victories had a carries clarified a drug as a non-speciality there's not a lot of we can do voeshl i want to thank the department of public health for the work with the chinese health plans and ultimately at the state level it has to be addressed i'm glad assemblyman chow and ultimately the federal government needs to actually enforce the evicting and the department of public health and public services needs to provide the appropriate combined for this to happen so mr. chairman i ask we continue this to those to the call of the chair. >> we have a second item on

this we'll take that without objection. >> thank you, supervisor wiener for those present so colleagues, we have two more items real quick controllers hearing on the six months status report we'll continue this to the budget & finance committee with the financial plan updated and adaptation to madam clerk call that real quick and go to item 2. >> hearing other than the six months hearing and requesting the controller's office and mayor's office to report. >> so real quick we'll continue open up for public comment seeing none, public comment is closed. >> colleagues, can i have a motion to continue to the april 15th full meeting okay. a a motion by supervisor mar and supervisor tang we'll take that without objection. >> all right. madam clerk call item 2. >> item 2 for the city's economic strategies and requesting the office of

economic workforce development to report. >> thank you madam clerk colleagues, i called for to hearing to have a dignities as we talk about the budget this report serves as one of the 12r07b8g9 reports to derivative our economic policies and thank you oewd for this update for 2014 strategy after thirty years of stagnation our city is seeing it's share of a regional and national growth we're having an opportunity for the full spectrum of san franciscans but there's a ton to do to make sure our economic boom continues for san franciscans of all strips and background there is a ton of work supporting the industry and our small business community as commercial rents is revising and

office space scare reserve this will continue to serve as a guidepost as departments cross our city as they work to implement policies to strengthen our local economy thank you oewd and welcome todd to present. >> thank you supervisor farrell for calling today's hearing in 2004 the voters approved proposition i did mandated the creation of apple economic development strategy in 2014 the city realized the cooperation with the office of economic analysis retailed that in 2007 proportion i talked about this we're before you to present the 2014 update to the strategy that was done in collaboration with the office of economic workforce development and the office of

economic analysis in coordination with mta and arts commission and many others across the city to give you a sense of the structure of today is presentation i'll give a belief overview and innovative you up our colleague who lead this in the office to implement the goals and recommendations of the report ted egging on is going to speak on the economic performances and talk about continuing barriers to job growth in the city i'll be go balk e back up to talk about the conclusion so briefly one the 2007 strategy.org the city's economy into 20 ports driven by financial services like software and advertising and architecture design and

tourism and the exploring of coming to san francisco equally important is the second budget is local services industries as health care and retail and construction, manufacturing and train and transportation those are industries critical to supporting and serving the city of san francisco and serve the local market one the key finding the economic strategy those two key areas did local and export industries are linked that having the export distresses and serving the market is critical but they don't think the math to fill the goods to the businesses. >> the economic strategy included 3 key goals the first was obviously to create job opportunity that draws on the

city's strength we need to insure the second goal we are increasing the levels of inclusion and equality in the job growth in driving down equality and make sure that the economic is driving the resources to invest in its priorities the economics strategy that includes is 9 total across 5 key areas from education and nomination and invite up you laura to talk about what the city's efforts are across the 40 policies and the work we've done for today. >> hello supervisors i'm going to cover some of the actions taken inch breakdown down by the action areas the first is education and training

oewd oewd we've been successful in construction and health care hospitality and implementation and technology we focused on a streamlined path to access our workforce programs workforce partners and clear educational program added them to the report this allows the school district and allows the city to have our academies with the school district curriculum with the pathways to the employment industry. >> finally every 20 percent of broadband the city focuses on the digital literacy and establish and advanced 14th century tech labs in tech centers it serve our seniors and

expand the obeyed over several miles of cable and extensions to our park the north waterfront and treasure island through the civically and through our other facilities action area addresses the governors and climate the most visible thing is the transition to the grocery tax much like our workforce alignment assuring our businesses have a single point of contract in city hall to address their nodes this not only helps to build the riderships but strengthen relationships with group see like the chamber of commerce and spur and sf made and others lgbtq chamber of commerce in 2008, we launched the one stop center providing small businesses one-on-one assistance

in the first 6 years we've served more 16 thousand businesses we launched the online portal school which will provide comprehensive information and allowing them to say in the comfort of their home throughout the business community and self-reliant feedback we've been able to refine our tools for businesses the number one complaint was access to capital we launched the $800,000 loan program that provides loans up to $150,000 for businesses for more capital we laundry a fund that loans up to 50 and $100,000 and focusing on small businesses we launched the program with interests up to a certain amount the diverse

neighborhood 9/11 in neighborhoods and dedicated the staff working with the community a specification action plan to suit their district needs strengthen and opportunities this road map allows to so are a better scrape and the improvement inform our corridor many create cvs and to provide ongoing funding for many of the businesses as well the 2 percent art program funded projects exceeded $4 million up from $245,000 creating new infrastructure but employment opportunity for art professionals which are over 50 percent of the resident we have deeply roads organization amazed

to half a million dollars in addition to the $5 million with the bay area opera house and capital maintenance funded by the art commission on the city cultural center when we tube the quality of life the rec and park department has increased revenue from the leasing of progressions and san francisco voters support it to fund the parks and the nonprofits stepped up for sports fields and community centers action four talks about the robust plans for affordable housing and the commercial has one hundred and 20 thousand additional jobs awhile insuring the industrial phases and insuring we have room for the good middle-income jobs the planning department and the department of building

inspection has worked with a you supervisors to address ceqa providing for applications and shortening the timelines insuring the responsible timeline is accommodate san francisco but was we hear from you often we have to pay attention to the transit it is a system wide moma efficiency for the mta leading to faster more greater access to san franciscans if so on top of the transit projects including the van ness brt and the transbay center and the list goes on and on we've attracted incubators not only for technology but for manufacturing and biotechnology as well those phases allow a person with an idea to give it a try and

provide them with a collaborative environment to test out their businesses business this helps to innovative san francisco in 2007 strategy emphasiss when it says we have expand academies in san francisco looking at mission bay we've succeeded a reach institution and startup that go to large companies and create the secretive environment we're working on this looking at hunters point we're focusing on continuing to drive development and driving the development of our talent as a anchor for commercial development with that i'm going to tu