creating a separate plan for the city plan enrollees with limited plan choice due to geography. i illustrate the rating impact for those individuals later in this presentation. the lower overall plan cost uhc provider with no adverse impact on members, change for prescription drugs to match blue shield, increase out of network deductibles and the rate ratios for the city plan early retirees. to consider a and e on page 17, it would require an action to suspend the stabilization reserve policy by health service board because we are recommending the application of $1,065,000 of that remaining $1,107,000 rate stabilization balance, it would require a one-time suspension of the self funded stabilization reserve

policy to enact our recommendations a and e. >> are there any questions until. >> no further questions. i am ready to entertain a motion. >> i would move to approve items a through e on page 16. >> moved to approve items a through e on page 16 as recommended and reviewed. >> second. >> there is a second to that motion. any discussion? >> quick question. can rate cards you have on the

next few pages including the $1,065,000. >> correct. >> it would be nice if there is a rate card without the use of the $1,065,000 so we could see the impact of that. >> i will allow you to derm i could walk the board through the status quo with changes. >> yes. [please stand by]

>> all right.by] if so, are there any other comments or questions on the pending motion? is there any public comment? hearing, seeing no public

comment, we are going to take a roll call vote -- oh, we do have public comment. sorry. if you don't move, you lose, but we'll always come back to public comment, always. >> try making this -- >> please get the microphone down and please state your name. >> maureen shea. retired. i hope i'm making this comment at the appropriate time, but i do feel, in listening to what has transpired, although it seems greek to me because i don't attend many of these hearings. it seems to me that this alternate plan, this medicare advantage hasn't really benefited many of the members of the plan, the early retirees, etcetera. i have some concerns about the

medicare advantage coverage for rehabilitative services. i was, one, in the city plan for many, many years, found it met my needs beautifully. medicare advantage, i'm still -- i have been very fortunate that i haven't needed medical services during the past year extensively. i certainly don't think that medicare advantage is meeting the needs of the participants in the same manner as the previous health plan did. so i support what commissioner breslin has recommended and possible opening up the city plan, one, to all retirees as it was before. >> thank you for your comment. is there any other public comment? >> herbert weiner.

i am concerned about the gradual erosion of the city plan. i am concerned about being gradually phased out. presently, we only have two alternatives as retirees, either united health or kaiser. and as alluring as united health seems, there are little dope traps. like, when you have lab tests, you have to pay for them, and emergency room services are higher than before, $15 more. and what i'm afraid of, you're looking at a duopoly, where you have two choices, and essentially they're going to be the same. i like the idea of bringing back the city plan for

everyone. i would like to see that because it's more competition, and more competition means that we get greater benefits. it also means that the employer gets good benefits out of it, too. so i have to admit that i don't keep up with the complexities of what has been presented. i -- it -- basically, i'll have to go back and get an mba to understand it. but at the same time, i get a general gist that there's a potential phasing out of the city plan, and i think this is very dangerous. thank you. >> thank you for your comment. is there other public comment? >> good afternoon, commissioners. this has been a very painful and very difficult process, and i've tried to look this over very carefully. and again, we're talking about non-medicare early retirees,

and their availability on plan one, including the active -- there's also the actives that have no choice. there's other alternatives for them. the problem i have is the prescription drug copayments and the out of network deductibles. i remember very, very long and difficult discussions about the out of network deductibles and why we actually ended up making them the same as the in-network, and i think basically we found there was no big difference in terms of costs and people were going out of network any way because a lot of that has to do with specialists and people -- and other providers that they may be referred to for other kinds of treatment. the problems i have with a through e are c and d. those increases, if you're increasing premiums and then

you're also changing the drug copayments, and while it doesn't seem like a lot, you know, it's $5, it is a lot because early retirees, just like those of us that might be on medicare end up with various health kinds of problems, and their prescription costs are high. and when you start adding $5 or more perprescription, it starts to add up significantly, and people are then having to choose how they're going to live, if they're going to get their prescriptions or not, and that's where i have the problem. because even with early retirees, and especially with early retirees, they don't retire at the full rates, and a lot of them are on much more restricted income than those who might have retired a little later, and many of them retire early because many of them have problems, they have physical problems or medical problems that have forced them to retire early. so in many ways, they're a disadvantaged group. so my problems are c and d and

to see if there's some way you can work that out to reexamine what you're doing with city plan and keep the prescription copayments and the deductibles the same, i think that would be much more beneficial to our members. thank you -- the early retirees. >> thank you for your comments. is there any other public comment? >> just trying to see the difference -- >> any other public comment. >> excuse me. >> any comment -- further comments from the board at this point? >> just trying to look at the note. without the changes, the difference in the price without the changes, and with the changes... >> so we talked about the 3.8% out of your rate increase. all three b, c, and d would take that down to a 1%

increase. if we were to eliminate c and d actuarially, we would be looking at a 2% increase. i'm looking at, for instance, slides nine through 12, and i know i'm stating information to you that is not in the presentation. >> sorry. >> but when i look at the financial impact -- so, for instance, on slide ten -- let's go to slide 15, actually. >> slide 15? >> because we can see it altogether. so when you add the two numbers for b, 685,000, add the two numbers for c, 290,000, add the two numbers for d, 33,000. so there was more of an impact on b than c and d. >> there's, like, a $200

difference for an early retiree, $200 less. >> so if i can go to slide -- i'm going to go to slide 30. >> oh, yeah, i was just looking at that. >> slide 30? >> so slide 30 summarizes the projected monthly employee and retiry contributions, so what the member pays for 2018. so that's py'ed 2018. that's what's now in place. 29, sq, is status quo. if you made none of the changes that we've presented today, these would be the contributions for 2019 for the participant on a monthly basis. 2019 with changes that would apply to the existing city

plan, so applying b, c, d, and e, so this is where you see the benefit of the implementation of the network change, b, the deductible change, d, and the copayment change, c, that's the difference in the rates between 2019 sq, status quo, and 2019 with changes with the added layer of benefit of e to the last two columns: the early retiree plus one, early retiree plus two or more. and then, finally, you see 2019 cp-cna, so that is the city plan choice not available. the separate plan that we've talked about in recommendation a for the 73 active employees and 436 early retirees who do not have access to all plans,

they would pay the same as what was earlier approved today that the blue shield access plus participants pay. so page 30 is early retiree. the next page, 31, is for the 196 83. >> questions from the board regarding proposed motion that is on the floor, which is to approve the recommendations a through e as outlined on page 16 of the presentation? >> page 33. >> and on page 33 -- further explained on page 33?

hearing and seeing no further comment, we're now ready to vote. we will take a roll call vote on this activity, please, secretary. [ro [voting] >> thank you. >> the motion carries unanimously. i'm now ready to entertain a motion on the action that is proposed on page 17. is there a motion?

hearing and seeing no motion, there is no action to be taken on the item on page 17, and so we will need to go back and recalculate the rate impact of that for the city plan increases for 2019. >> yes. >> all right. >> so what would be the -- what would be applied to it if we just used the regular rate, not -- not buying it this much down? it would be one-third, right? >> so the 2019 status quo rose on pages 30 and 31, no changes, 554,000 applied perpolicy to

2019 rating. >> so -- >> what's your balance -- >> so if we don't suspend the stablization policy then the rates that we think we voted on just now aren't really the rates. and that assumed we suspended the -- >> hold on, the rates. >> we're doubling the rates. >> we're voting on the proposals. >> proposals. [inaudible] >> the rate cards that are contained in the presentation contain stable -- all the recommendations being incorporated. so what will be brought back to us in june since we did not choose to apply the recommendation as contained on that page 16 would be recalculated rate cards, and we'll see the magnitude of increase resulting from that. >> okay. >> now, also, the actuary, michael clark, was pointing out that we can see some of that

impact already by looking at pages 30 and 31, where it says 2019 status quo, sq. those would be the rates. so the employee rate is going to go -- or if they're retiree rate will go from 117-64 in the 93-83 from 117 to 232, and you can read the rest of the table, by not applying or suspending the rate stablization. >> so if i may -- >> yes. >> page 30? >> page 30. >> so the status quo represents the combination of page 19, where we say an absence of stablization adjustments, the rates go up as illustrated on

page 19. and then, the very last row of page 21, which is the policy application of one-third of the december 20 -- or 31, 2017, rate stablization fund balance, $1,661,000. the funding is one-third that amount. so my understanding is that's what you voted, and this is the status quo scenario. the combination of our page 19 and page 21 commentary. >> status quo is what you are applying here, a through e. >> so when we apply the a

through e, that is where we get the change rates that are on 30 and 31. >> okay. then go to 30 and 31 again. >> and then a specifically creates the fourth row, the 2019 cp-cna or city plan choice not available. i think the question, then, is the application of the $1,065,000 that was attributed to pay for a and e. >> so the rate would change from 2018 for the request single retiree 117 to either -- to $218 or $232. >> so with a through e approved, it would change to 218.42. >> all right. so it's a $100 increase.

>> and then, for those 73 -- i'm sorry, 436 early retirees, they would pay $100.26. >> i understand, but i'm just saying given the actions that we've taken today, i just want the board to realize we have the numbers in front of us. all that's going to come back to us next month is a straight rate card without any of this detail. so we have the data in front of us now, and i just want everyone to be very clear as to where we are. so we're saying the current rate for the retirees are shown in py-2018, retiree, retiree plus one, retiree plus two. >> not necessarily, because the one with 2019 with change -- >> it doesn't -- >> no, i want to be clear with what i just stated. i said we see in plan year 2018, the top line, what the rates are for current -- that

we're currently paying, that these early retirees are currently paying. the subsequent lines are illustrating what happens if we did nothing. >> understood. >> okay. the next line is a through e, is that correct, that -- >> but that includes plus stablization. >> is it plus stablization? >> yes. >> yes. >> yes. >> so these are the rates that do include the application of strategies of a and e. >> yes. >> yes. >> plus b, c, and d, but necessarily hasn't been discussed, then, in absence of the spending stablization policy is the $1,065,000 of

additional employer money to enact a and e. if it's not then applied for by the stablization moneys, that, i would view, as an open question still. >> yeah. the rate is going to be higher at some level if we don't use the full stablization recommendation, correct? >> the employer spend will be higher. >> the employer spend will be higher. all right. so what we will see next month is tables developed without the use of stablization based on our action today. >> okay. so just as an illustrative example, the third row versus the fourth row, so 73 employees and 436 retiries who live in

areas without any other selection, that's about a $118 permonth difference. so the person living outside of california, based on the approval of a, is going to pay $100.26. so we've created city plan choice not available with rates -- retiree contributions that are the same as for the blue shield access plus minus. what now hasn't been determined is that person would have otherwise paid $218.48. how does that extra $118 perretiree only get funded? so if it's not funded by application the remaining rate stablization reserve moneys, the open question is how does

that become funded? >> well, the action of the board today is saying you shouldn't use the rate stablization money. and as a result, you're going to come up with a rate for early retirees that is going to be substantially higher in that category, by my lights, unless i'm missing some math here. >> yeah. so if i could clarify, mike, stop me if that sounds really bad. but in the past, the votes have been let's use additional funds to directly buydown the rates as a pass through, and so the rates would actually change, contributions may go up or down. what you've created in a through e, you've created a new plan which is in essence going to be cheaper out of area, and it's going to funnel for subsidy, more dollars are going to go to early retirees based on the charter. so you've introduced new cost, new subsidy for the out of area plan and reduced contributions,

so that's a win. but the new cost has now been introduced by adding the plan. the mechanics of the charter are going to dictate that. and so the question is if we're introducing about $1 million of employer cost, you let that just flow through to the employers naturally through the charter. or because you have $1 million of unused stablization, do you say we voted to access this cost. we're going to vote to cover it. it is you've introduced a new cost, so do you want to cover that cost or let it flow through to the employers naturally. >> no. say your premium is still 1,000. you buydown that 1,000 with the rate stablization of, say, $10. that becomes 190. for retirees, it won't make any difference because it actually

reduces the rates because you still have the ten county survey. the difference is the retiree subsidy, but by paying it down, it's the employer who will be paying for it. not the retiree. >> all right. i'm just saying that we need to be clear so that our actuary's clear when he comes back here, and apparently we are here. somehow, the employer is going to pick up the $1 million based on what we just approved. >> so if you think about it, claims don't change through what we've talked about with a and e. they do for b, c, and d, but they don't -- we're not impacting total health care spend with a and e. what we've done is we've suppressed the contributions that certain members will pay in 2019 for a and e relative to

what they would have otherwise paid without it. >> got -- got that. and without the subsequent use of stablization funds, there is an overall increased cost to this plan, and it is left to the employer to absorb the rest. >> that is correct. >> all right. so that's what i want on the record today. all right. >> okay. i just want a clarification. it isn't that we're not going to use any of the reserve, because we would normally use, like, one-third, which is 554,000, we're not going to use all the reserve. >> correct. we're applying one-third perpolicy. >> so out of the 1.6. >> 554 -- >> so we've got $1 million we still have in the stablization reserve, and i look forward to the conversations next year around how to use that, rather than 42,000. all right. thank you very much, mike.

this has been more than enlightening. >> thank you. >> thank you. all right. >> no way, they're going to sub. >> director yant? >> time to get out of here? >> no. i would beg the board to sit one more item on the actuarial consulting item, please, so we can stick to our timeline. >> a line item's been called for regarding the actuarial services selection, and that is in our regular board meeting. >> yes. >> all right. that's where we are. >> okay. item 12, discussion and possible action, request to approve ai consulting, inc to provide actuarial and consulting services to the health services board and health system in services resulting from the health selection process. executive director yant.

>> yes, please. >> thank you. and given the hour, i will be very brief and pamela will walk us through the process that we use to make the recommendation today to approve aon consulting. as you know, you tasked me with this job when i was hired, so we're delivering, i believe, on time, and it's been a highly educational and highly professional endeavor that we have taken, so let me have pamela walk you through the steps and hear any questions that you might have. >> okay. thank you. >> pamela levin, chief financial officer, health services system. i have with me our contracts manager who's sitting down at this point. >> and he is? >> he is michael visconti. he has an injured leg. >> i saw him hobble to the front, and i'm hoping it wasn't a result of this rfp process. >> he didn't have to kick

anybody. >> thank goodness it happened the night after the selection. >> that's fine. no details. >> so it's recommended that the health service board approve ratify and award the contract award to aon consulting to provide actuarial consulting services to the san francisco health board and the san francisco health system and authorize hssf to provide with the negotiation of the contract with aon. aon received the highest score from an evaluation panel that consisted of city managers, two of them from the office of the controller, two from the health service system, and one from the san francisco employee retirement system. in terms of the rfp, the hfp requires respondents to confirm several new conditions and contractual requirements, including the following: detailed provisions regarding

consent to re assign personnel at the request of hssf, restriction on request of performing services concurrently for other city departments, comprehensive transition planning prior to contract termination, heightened performance guarantees, and a thorough preemptive legal review of a new form that the city is using effective 2017. in terms of the selection process, we issued the rfp on february 8, and the preproposal meeting and conference call was held on the 21 of february . ten individuals, including prospective actuaries from five actual firms participated. questions were submitted from five firms and an addendum was issued on march 9. proposals were received on march 23 from deloit

consulting, llp, dickerson employee benefits, inc, willers, towers, watson, and aon consulting, inc. hssf staff first reviewed the proposals for minimum qualifications. all four written proposals were submitted to the evaluation panel for review and scoring. all four firms participated in oral interviews, where they responded to two hypothetical scenarios. the scores were then combined with the scores from the written evaluation, and the top scoring firm was aon. in terms of the evaluation criteria, between the written proposals and the oral interviews, it was a total of 600 points. the evaluation, the written proposal was 300, and it looked at the clarity of the cover letter, table of contents,

executive summary, the surprising actuary, and key -- supervising actuary and key staff experience, project approach and strategy to services, pricing for the services, and then, reviewing of the contract form specification proposed performance guarantees. we then held the oral interviews, and they were scored on the introduction of the firm and their closing statements and their response to each hypothetical scenario in terms of their approach to problem solving, communications and collaborations -- >> and we can understand those criteria, so would you then move to the panel rankings and make any other comments? >> sure. the ranking of the panels, the total panel evaluation resulted in aon consulting services coming in first, followed by willis, towers, watson, deloit

consulting, and dickerson. the protest period started on the 11th, and it'll end on the 17th. if there's no protests, we'll begin negotiations with aon. if we're unable to negotiate a satisfactory contract with aon within a reasonable period with approval by the board, we may terminate negotiations and begin contract negotiations with the next highest-ranked firm. >> and your recommendation is? >> our recommendation is that you approve, ratify, and confirm the contract award to aon consulting, inc. >> i move to approve, ratify and confirm the contract award to aon consulting as the highest ranking evaluation on

the rfp. >> second. >> and i think we need to include listing a, b, and c in this item. >> and authorize the director to take all steps necessary to negotiate a contract with aon consulting services, to provide health services to the health services system and the health service board, and take any other action regarding this rfp process. >> all right. you've heard the motion based on the recommendation. is there a second? >> second. >> there is a second. it's been properly moved and seconded. are there any other questions or comments? i would like to make a comment to pam and to michael on their expert handling of this process from start to finish and for all of those who, on the hss team, who worked to support you in getting it done. it's a laborious process, one

that is complicated by all the things that makes our procurement process here in the city and county of san francisco both challenging, unique, and thorough. and my thoughts, based on what i observed, you handled it in an expert way, and i want to thank you for your professionalism. are there comments from the board on the recommendation? is there public comment? hearing and seeing no public comment, we are now ready to vote. all vote in favor, signify by saying aye? all those opposed. it is reflected this it is a unanimous decision by this board that aon consulting be our actuary and we undertake the items in the action item. >> yes. >> thank you, again, pamela and mike for your hard work. >> thank you. >> now, we have not been as complete as a board as we

should have been today for a variety of reasons. we've not heard a financial report. i would expect to here from commissioner sass in great detail if he disagreed with any aspect of that before we move to adjourn at this meeting. and we've also not allowed the executive director to render her full report, but i would like to have her take a moment to comment on two personnel actions at this time out of your director's report. >> yes. i did want to recognize that our secretary, leiani has noticed us that she'll be retiring as of june 1. so we'll be grieving her loss before she's even gone and are working diligently to find a replacement, which will be a challenge, of course. but i did want to acknowledge publicly and before the board the years of service that she

has had with us and wish her all the best in her happy retirement. >> thank you. >> we also have another tenured employee who's been with the city for 23 years, and 13 years at hss, and that is vince makanurni, and he retired last week, on may 4. so we have a -- just sort of a steady stream of folks that are choosing to end their careers with the city in our office. so we wish them all the best. >> well, we want to thank both the staff member for his service to the system, and to our dear secretary, we've -- i hope that we as a board will have a more tangible way of thanking you at our next meeting. that is our plan. >> thank you. >> congratulations. >> congratulations on your retirement. >> thank you. >> i threatened that prior to the meeting that we cancel her

benefits, extended her age, and she didn't have enough service qualifying years, any number of things, and it was all untrue. so again, laini, thank you for all that you've done, and we look forward to our next meeting. >> thank you. >> director yant, is there anything else that we need to mention. >> just two quick things that i'd like to be on the record, given the fact that we started the meeting talking about the dependent eligible survey, and as of this morning, we have 64 dependents voluntarily dropped, the audit is doing what we expected it to do. that is all good news, and it will continue. the other thing i want to make sure that the retirees should know, we'll be doing a survey on may 26, so i just want people to be be aware that that's coming.

>> thank you. director levin, cfo, thank you for the preparation of the report and the monthly report, and the work that went into that. even though you didn't render the report publicly today. all right. we'd like to go to discussion item 14, please. >> discussion item 14, report on network and health plan issues, if any. >> are there any items from the health plan partners? i would like to thank kaiser specifically for helping us to reduce costs by coming in with a decrease in preem numium. i don't know what we did. we expect that to be a multiyear guarantee going forward -- i'm just kidding -- no, i'm not kidding. all right. thank you again for your partnership. discussion item 15. >> item 15, discussion item, opportunity to place items on future agendas. >> any items for future

agendas? i would only note that, again, the board will be meeting for strategic planning session on the 22nd. it will be public announcements about the location, timing, etcetera, for that meeting. discussion item 16. >> item 16, discussion item, opportunity for the public to comment on any matters within the board's jurisdiction. >> are there any public -- is there any public comment on any item that's within the jurisdiction of this board? hearing and seeing none, we stand adjourned. [ gavel ] [music]

>> san francisco city clinic provides a broad range of sexual health services from stephanie tran medical director at san francisco city clinic. we are here to provide easy access to conference of low-cost culturally sensitive sexual health services and to everyone who walks through our door. so we providestd checkups, diagnosis and treatment. we also provide hiv screening we provide hiv

treatment for people living with hiv and are uninsured and then we hope them health benefits and rage into conference of primary care. we also provide both pre-nd post exposure prophylactics for hiv prevention we also provide a range of women's reproductive health services including contraception, emergency contraception. sometimes known as plan b. pap smears and [inaudible]. we are was entirely [inaudible]people will come as soon as were open even a little before opening. weight buries a lip it could be the first person here at your in and out within a few minutes. there are some days we do have a pretty considerable weight. in general, people can just walk right in and register with her front desk seen that day. >> my name is yvonne piper on the nurse practitioner here at sf city clinic. he was the first time i came to city clinic was a little intimidated. the first time i got treated for [inaudible]. i

walked up to the redline and was greeted with a warm welcome i'm chad redden and anna client of city clinic >> even has had an std clinic since all the way back to 1911. at that time, the clinic was founded to provide std diagnosis treatment for sex workers. there's been a big increase in std rates after the earthquake and the fire a lot of people were homeless and there were more sex work and were homeless sex workers. there were some public health experts who are pretty progressive for their time thought that by providing std diagnosis and treatmentsex workers that we might be able to get a handle on std rates in san francisco. >> when you're at the clinic you're going to wait with whoever else is able to register at the front desk first. after you register your seat in the waiting room and wait to be seen. after you are called you come to the back and meet with a healthcare provider can we determine what kind of testing to do, what samples to collect what medication somebody might need. plus

prophylactics is an hiv prevention method highly effective it involves folks taking a daily pill to prevent hiv. recommended both by the cdc, center for disease control and prevention, as well as fight sf dph, two individuals clients were elevated risk for hiv. >> i actually was in the project here when i first started here it was in trials. i'm currently on prep. i do prep through city clinic. you know i get my tests read here regularly and i highly recommend prep >> a lot of patients inclined to think that there's no way they could afford to pay for prep. we really encourage people to come in and talk to one of our prep navigators. we find that we can help almost everyone find a way to access prep so it's affordable for them. >> if you times we do have opponents would be on thursday

morning. we have two different clinics going on at that time. when is women's health services. people can make an appointment either by calling them a dropping in or emailing us for that. we also have an hiv care clinic that happens on that morning as well also by appointment only. he was city clinic has been like home to me. i been coming here since 2011. my name iskim troy, client of city clinic. when i first learned i was hiv positive i do not know what it was. i felt my life would be just ending there but all the support they gave me and all the information i need to know was very helpful. so i [inaudible] hiv care with their health >> about a quarter of our patients are women. the rest, 75% are men and about half of the men who come here are gay men or other men who have sex

with men. a small percent about 1% of our clients, identify as transgender. >> we ask at the front for $25 fee for services but we don't turn anyone away for funds. we also work with outside it's going out so any amount people can pay we will be happy to accept. >> i get casted for a pap smear and i also informed the contraceptive method. accessibility to the clinic was very easy. you can just walk in and talk to a registration staff. i feel i'm taken care of and i'm been supportive. >> all the information were collecting here is kept confidential. so this means we can't release your information without your explicit permission get a lot of folks are concerned especially come to a sexual health clinic unless you have signed a document that told us exactly who can receive your information, we can give it to anybody outside of our clinic. >> trance men and women face really significant levels of

discrimination and stigma in their daily lives. and in healthcare. hiv and std rates in san francisco are particularly and strikingly high were trans women. so we really try to make city clinic a place that strands-friendly trance competent and trans-welcoming >> everyone from the front desk to behind our amazement there are completely knowledgeable. they are friendly good for me being a sex worker, i've gone through a lot of difficult different different medical practice and sometimes they weren't competent and were not friendly good they kind of made me feel like they slapped me on the hands but living the sex life that i do. i have been coming here for seven years. when i come here i know they my services are going to be met. to be confidential but i don't have to worry about anyone looking at me or making me feel less >> a visit with a clinician come take anywhere from 10

minutes if you have a straightforward concern, to over an hour if something goes on that needs a little bit more help. we have some testing with you on site. so all of our samples we collect here. including blood draws. we sent to the lab from here so people will need to go elsewhere to get their specimens collect. then we have a few test we do run on site. so those would be pregnancy test, hiv rapid test, and hepatitis b rapid test. people get those results the same day of their visit. >> i think it's important for transgender, gender neutral people to understand this is the most confidence, the most comfortable and the most knowledgeable place that you can come to. >> on-site we have condoms as well as depo-provera which is also known as [inaudible] shot. we can prescribe other forms of contraception. pills, a patch and rain. we provide pap smears to women who are uninsured in san francisco residents or, to

women who are enrolled in a state-funded program called family pack. pap smears are the recommendation-recommended screening test for monitoring for early signs of cervical cancer. we do have a fair amount of our own stuff the day of his we can try to get answers for folks while they are here. whenever we have that as an option we like to do that obviously to get some diagnosed and treated on the same day as we can. >> in terms of how many people were able to see in a day, we say roughly 100 people.if people are very brief and straightforward visits, we can sternly see 100, maybe a little more. we might be understaffed that they would have a little complicated visits we might not see as many folks. so if we reach our target number of 100 patients early in the day we may close our doors early for droppings. to my best advice to be senior is get here early.we do have a website but it's sf city clinic.working there's a wealth of information on the

website but our hours and our location. as well as a kind of kind of information about stds, hiv,there's a lot of information for providers on our list as well. >> patients are always welcome to call the clinic for there's a lot of information for providers on our list as well. >> patients are always welcome to call the clinic for 15, 40 75500. the phones answered during hours for clients to questions. >> it. >> shop & dine in the 49 promotes local businesses and challenges resident to do their shop & dine in the 49 within the 49 square miles of san francisco by supporting local services in the neighborhood we help san francisco remain unique

successful and vibrant so we're will you shop & dine in the 49 chinatown has to be one the best unique shopping areas in san francisco that is color fulfill and safe each vegetation and seafood and find everything in chinatown the walk shop in chinatown welcome to jason dessert i'm the fifth generation of candy in san francisco still that serves 2000 district in the chinatown in the past it was the tradition and my family was the royal chef in the pot pals that's why we learned this stuff and moved from here to have dragon candy i want people to know that is art

we will explain a walk and they can't walk in and out it is different techniques from stir frying to smoking to steaming and they do show of. >> beer a royalty for the age berry up to now not people know that especially the toughest they think this is - i really appreciate they love this art. >> from the cantonese to the hypomania and we have hot pots we have all of the cuisines of china in our chinatown you don't have to go far. >> small business is important to our neighborhood because if we really make a lot of people lives better more people get a job here not just a big firm.

>> you don't have to go anywhere else we have pocketed of great neighborhoods haul have all have their own uniqueness. >> san francisco has to all >> good evening and welcome to the main ninth, 2018 meeting of the san francisco board of appeals. board president frank fung will be with the presiding officer tonight and joined by vice president swig, commissioner honda and we expect commissioner bobby wilson to arrive after items five