wandering, you know, i think we need to hold each other in check that we're -- really, in order to get through the strategic plan, we're going to try to stay within the guardrails that we've designed here, because it's very easy to lose focus in this complex world that we live in with all the external pressures, so i think the guard rails will be very helpful in that regard. page seven of the plan, again, takes that life cycle, that health cycle view of things. i think all of us can see where we fit in this. one place one day and another place another day, quite frankly, so it's important that we recognize that, you know, we're living, changing organisms for sure, and the way that we interact with health delivery needs to reflect that, as well. and then, just again, we go through the goals at -- on pages 8 -- 8 through 12, really taking

this -- this hard look at retaining affordable and sustainable health care and some of the educational areas that we mentioned are going to be important for us to really look at how we pay for health care, so payment reform is very alive and well. that whole discussion will be important for us to all understand what options are out there and being developed, and how health care is being paid for in different arenas, and what's working and not working. much of this is experimental, but c.m.s. is making a lot of exchanges, and what c.m.s. does eventually rolls down in the commercial world, so we need to be staying on top of that game. reducing complexity and flamt --

fragmentation is also important to the health care system and getting through the right place at the right time. the educational topic that we'll be doing around care coordination is important. there's a lot of pilot programs that are going on, trying to determine, really, what is -- what is best ways to do this, and there certainly is not going to be a silver bullet of any one way. it goes back to the fact that we are all so different at different points in our lives and what is the best way to keep us engaged in our health care and in getting the right kind of support. which folds nicely into the next strategic goal on engagement and support and learning different ways of doing that. and we've talked here today already about different ways, traditional ways that we've engaged our members, whether it's mailing an e-mail, etc.

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-- and perhaps even a shorter life. so i think it's really important, an important value, that we learn how to do that and the city and county is certainly not a single employer. we have many different departments and many jobs and there's no one way to do that either. moving into the initiatives that we have in the plan year, we've condensed them on a couple of pitches here. what we'll be looking here in the very near future, i wanted to draw to your attention that, you will not be seeing here

today the request for proposal for our medical plans. we considered bringing that forward at this point in time but have had to recognize that that is such a volumeness job to do that we can do a better job if we postpone it until the spring. so we will be doing that. and so it will not -- if we -- depending on the comprehensiveness of that initiative will not affect 2020 year but will affect 2021. that does put the pressure on us to address the city plan issue. we know that. we recognize that. and so that's part of our near future initiatives, addressing the city plan now and perhaps a larger r.f.p. for the 2021 year. what we will be doing shortly, and i will let michael talk to this more specifically, we will do an r.f.i. to look at the different tools in the

marketplace that we will learn by doing an r.f.i., getting more comprehensive information and have a better idea about how, when and where to vet, embed, select, purchase the whole slough of choices that are out there. you got a taste of some of those at the blue sky meeting, but we need a process for how we'll consider those. the medical plans are doing something similar, so it's helpful to -- for us to get really smart about what's out there and determine the best approach. so that is the highlights of the -- that i would like to speak to on the strategic plan. i want to pause here -- before i do, excuse me, on page 15, we do have what our success outcomes look like in the organizational

work plan. as i said, this is where we hold our team accountable for creating high standards and organizational excellence. we do have a lot of regulations that we do abide by and need to have a comprehensive audit strategy, so that we are doing audits on a very regular basis of several different kinds, not the least would be hippa, and there are others as well. we really wish to design these optimal plans and really look at the payment reform strategies and how we can look at the ramp-up time to get those types of things. the multimodal engagement strategy, we have a lot of efforts working with our communications and engagement.

we don't have a comprehensive plan on how to do that. i think it's really important that we take a step back on how best to do that in today's age. and then the other two are really talking about evidence-based, standardized planning with metrics. so we're data-rich. and yet we have not fully optimized doing the analysis in a way that drives change in our department, so we'll be embracing that and are embracing that now. we can talk more specifically about some of the things that we have under way to actualize this work plan. but i wanted to pause before i hand the microphone over to leticia and see if there are any questions or comments on the strategic plan at this point. >> vice president follansbee: i want to compliment everybody involved in this.

each draft, how it's been added and how it's enhanced the understanding and clarity. i want to point out one thing, which i brought up individually. we tend to use the word concierge. it appears in the stay well, needs care, and is a patient. and i think on page 14 under engage and support. i want to point out, it's not defined in the glossary. the glossary helps extensively in terms of what is being said. but from the medical provider standpoint, i don't think is what we're talking about. just to remind members of board and the audience that from a medical professional standpoint there are concierge services out

there. and individuals pay anywhere from $800 to $1,000 a year over and above their health premium up to as high as $15 how to to you -- $15,000 to $20,000. that's not the way we're using it. if people understand it in that sense, it's the wrong expectation. maybe we need to define it better or come up with a different term such as individualized or something that doesn't quite have the same impa impact, than that we're going to provide $15,000 individual supplements. >> thanks for bringing that up. i know a number of people that practice concierge medicine and that's not what we're talking about. we're talking about personalized, individualized

care required for certain individuals where they need something hyper-specialized. so let us go back and correct that. it may be that we just remove the term. i don't think we can fight the marketplace. in san francisco, concierge medicine is alive and well. any other questions? >> a question on page 13 and thank you for including in this year's business plan some attention to the plan and the verbal references to it. what i'm trying to understand, you have various, bolded items, some of which say action, and i understand that. some say pilot, i think i have a notion as to what that might mean. and then it says discovery. that's where i lost myself.

i could understand that maybe the actions we were going to take during this year's business plan and come up with some initiative. we might test it out, so on and so on. others, i'm expecting you and your team and others will bring something to us over time and we'll adopt it. discovery, i'm not clear with what you intend there. >> it was a little arbitrary when we went through this in great detail with president breslin and follansbee. some things were fairly clear what we could do now. other things, like the city plan, weigh really need to do some deep dive and discovery into what those options might be for that matter. so that's where the term came

from. >> commissioner scott: so the intent is it will be exploratory -- >> at least initially. >> commissioner scott: thank you. secondly, i'm struggling with the graphics on a couple of -- i think -- i would echo strongly the comments by commissioner follansbee about how you have worked to massage this to make it readable. it's understandable. i think it has a good flow and so forth, but then after i got the logos tied to the strategic goals, i said, they all make sense, but then started to look at the pictures and said, how does that connect to the concept? i'm with you on the complexity on page 9 and that particular graph, that picture. the one that says engagement and support with someone sitting on the telephone, i was struggling with that. i think the notion is, wore

trying to engage the membership and support our members and -- >> and this is one of our member services persons taking -- we're proud of that photography. >> commissioner scott: i understand and i appreciate that. >> both a member and member service person, so want to acknowledge that. >> commissioner scott: i get it. i think something that would be more illustrative of the concept is what i'm suggesting. and similarly on page 11, the same thing. i understand the circle and the faces, but i don't understand the hole in the middle. and the idea is choice and flexibility. and, again, the graphic doesn't seem to quite support the notion. those are minor things compared to the overall tone and communicative depth of the

document. it's very well done. >> thank you. i will take this pause and allow leticia to talk about the initiatives that the staff is doing with the work plan and then i guess we can act on this agenda item. >> good afternoon, everyone. i'm leticia pagan, senior health program planner. i'm here to discuss how we translate the strategic plan into work plan implementation. calling your attention to the screen here at the top portion, i'd like to start off by emphasizing that sfhss prioritizes two important strategies. the first is using key performance indicators. in addition to checking items

off of the work plan list in terms of completion, we're striving to quantify each and every initiative using metrics, whether that be the time it takes to do that, the number of people that were trained, for example, percentage increase, decrease, etc. to more effectively track and measure from a measurement and evaluation standpoint. the next important strategy is referencing evidence-based benchmarks. in addition to relying on internal knowledge and experience as an organization, we're comparing our organizational bench lines against benchmarks in the field to guide continuous quality and improvement. i'd like to move to the bottom portion of the screen to highlight a couple of examples of initiatives in the work plan. this is by no means an exhaustive list but gives an indication of the products explored and the corresponding focus areas the first focus area being

member services. we're exploring the adoption of a network promoter score. this will help sfhss gauge how satisfied the customers are, to what extent they would recommend an intersection with support services. it helps us to quantify our membership from the standpoint of, who are the passives? those that we engage within their action, not necessarily the most satisfied as much as they could be, our detractors, that wouldn't necessary recommend an interaction with us, and those that are promote others, knowing we're a go-to for answers. this is our effort to employ a methodology for gauging and quantifying our service delivery from a membership standpoint. it affords us an opportunity to survey our membership on a more frequent basis, so we can understand the unique customer service needs. the second focused area is

communication. the first touch point is open enrollment preparedness benchmark. it's a measure we're exploring to help us gauge our readiness in relation to being a benefit administrator and open enrollment activities that come along with that. in management, design, analysis and even evaluation. open enrollment drives so much of the work that we do that we're striving to improve continuously not only for the event itself but for the project and work involved leading up to that event the next focus is multimodal communication plan. that was discussed. we're aiming to outline step by step our comprehensive and ongoing strategies to boost awareness and encourage use of the available plans and services. we're using various mediums, individualing 0 raffy, photography, website redesign and doing that for membership

preferences and that our population absorbs information in different ways the final point is enhancement of the customization of our knowledge base. one way to do it is to better integrate the c.r.m. with the sales force. enhancement to the membership services scripts. to unify our response to the members. our member services is our frontline. in order for them to do their work to the best of their abilities, we need to enhance this knowledge base as the primary tools they use. in doing so, be able to better understand why our members call in the first place. what the informational needs are. the next focus area is analytics. beneath that, we're hoping to increase the analytic payability of our claims database to identify high risk and high cost

conditions that affect our membership. whether it's enhancement to software, modules, data pool for specific measure, again, striving to support enterprise systems and analytics in the modernization and optimization. next, staff support. enhancing staff support in benefit education, plan design, well-being. our staff are pooling their resources and time to do the work to the best of their abilities. as we build up priorities to the adoption of the strategic plan, we'll need to evaluate how to support the areas to keep the work moving forward in terms of staff support. the final area, organization alex lens -- organizational excellence. with all the data collected, the lens shifts to the synthesis of

the data. from there, we can refine our efforts and prioritize resources, time, and staff most efficient efficiently. the work plan aims to adopt quantifiable strategies. this is evident as we look at composite scores, because they helped us to quantify the working done and to establish baselines from which we can work forward over the next several years. as we adopt the enhancements we discussed today that align with our work, we can be better prepared to measure the impact of the changes being implemented. and hopefully come back and present findings, using the most disciplined approach. thank you for your time. i'd like to pause to see if you have any questions. >> i just want to be clear. if we say we have an initiative

like city plan, okay, in the 2020 initiative, will this work plan implementation framework, will you then say, okay, at member services we'll do this around this initiative, we'll be doing communication, analytics. i'm trying to figure out how this ties back to a specific initiative within the business plan. >> if we look at the work plan on page 15 where we talk about what success looks like for the team that we call out, optimal plan design and payment strategy, we have not flushed that out as a particular project. we're working on just reorganizing, restructuring how we work together and lay out that plan. and we -- last year, i think,

last year, last rates and benefits cycle it was pointed out at one point that we needed to have some clear criteria about design change. we initiated that. we'll be taking that and have other rubericks for decision making. while it's not outlined here today for you, it's very much part of how we're shifting our work, being very clear from the onset of what the process is going to be and what the timeline and what the outcomes need to be. so, you know, having -- my clerk and i both having our first experience with rates and benefits last year have talked quite a bit about how we could consider changing the process to make it crisper, cleaner, and we see our job as to provide the right information to you to make

those decisions. that's where we're working on those areas. >> commissioner scott: i'm just trying to tie this back to the document, where i'm trying to make that link. >> that's why it's still in the discovery bucket, because it's not clear. it is not clear at this moment how we'll do that. >> commissioner scott: i with just suggest. rather than say "pause it, "like i said last month, i would suggest that as you outline the details of any of the details, that you come up with a framework that will have some of these elements and some detail around budget or staff resources or whatever they happen to be so any time we're looking at that initiative, we're seeing kind of progress along the way using

that same framework. >> i'm totally with you. i'm familiar with that process, having used it in prior jobs and i find it quite helpful to keep us organized and on target. >> unless i'm hallucinating, in one version of the draft, there was an attempt to begin to address that. there were strategic goals for years and how each of those, you know, got ticked off into the five strategic goals. i thought there was a big chart that we saw that had some crossed all five elements and some didn't. so i think that that -- it then disappeared. >> there's a chart similar to what you are describing in the found -- finance or budget report. we tried to make sure that all of the budget items that we were

requesting had a relationship to one of the goals. to make sure you are not outside your guardrails. >> vice president follansbee: i think it's the same vein. i wasn't hallucinating. thank you for clarifying. >> any other questions or comments? >> president breslin: thank you. this is an action item. any public comment on this item? i can make that after the action item. >> we need a motion. >> i move that we accept the strategic plan as outlined and discussed today with some additional maybe considerations that i consider minimal modifications to move forward.

>> i second. >> president breslin: any public comment on this item? seeing none. all those in favor, signify saying aye. opposed? it's unanimous. all right. >> i'd like to add to the motion or add another, if i may. >> commissioner scott: this is a supplemental motion on the strategic plan. i move that a letter of approval and endorsement by the h.s.s. board of directors be drafted for inclusion in the publication and communication of strategic plan and the placement of that letter would come after the introductory letter of the executive director the letter should include citations of the role and commitment of the h.h.s. board to work with h.s.s. staff and leadership in the assessment,

design, development, implementation of all phases of the strategic plan on behalf of the members of h.s.s. and can i clarify what i'm talking about. >> president breslin: does anybody need clarification? >> commissioner scott: there might be. just 30 seconds. sometimes we assume that everybody reads our minutes and knows what the board is thinking and this plan, if i envision it properly, as it's been put together, will real i will be a communications tool that goes beyond just this board and just the administrative staff folk and other folk that may or may not be within the confines of "city government," with whom we relate. to that end, it should be very clear that this is not just the staff speaking on behalf of the

system. the staff and the board are conjoined in this effort and it's not going to be occasionally brought back to us and here's the next thing we need to do or think about. but that we're going to have an engagement process with the board, the leadership, to followthrough on the implementation of the plan. this has been a great deal of work and effort to kind of frame our future for the next few years and this board needs to publicly say that we're going to be on board with that, leading where we can, supporting where we must, to get this done so the letter, as chair of the governance committee, i will volunteer to draft it. give it to the president. and anybody else that wants to see it, including our secretary, who doesn't have a copy of this motion, but i will give it to you. and then we can go on to incorporate that so we're very clear it's a unified effort as

we go forward. >> vice president follansbee: i would like to speak in support of this as well. i appreciate the fact that the role of the health service board was noted in the acknowledgement in front of the table of contents. but i think that such a letter will endorse that the board is taking an active role, not overwhelm in the implementation, but also in the design and follow-up to this and part of the issue around action refers to us. part of the issue about pilot refers to what we expect. and so i think it enhances the fact that the board isn't just willing it look at this and put it on a shelf, but that this is an active document that we help

design and are engaged in and it will be engaged in over the next three years on a regular basis. >> president breslin: motion moved and seconded. any public comment on this item? all right. all those in favor, say aye. any opposed? it's unanimous. all right. item number 6. >> clerk: item 6, action item, approval of san francisco health service system budget revision for fiscal year 2018/2019, healthcare sustainability fund. presentation of the budget, pamela levin.

>> good afternoon. pamela levin, chief financial services officer. in february, 2018, health services board approved the health service system budget, the $3 budget. in the intervening time, we developed the plan that you just approved. now we're looking at aligning the budget with the strategic plan and the goals outlined in the plan. based on the '17/'18 fiscal year close, there is sufficient funding to support this realignment. i will first speak to the revenues, followed by the expenditures, and conclude with a review of a table that is actually projected, but i

realize it's impossible to see. it summarizes the revised budget. the table that is projected is in your ipad. so you will be able to see it a little better. >> is that on pages -- >> page 5. >> page 5 of the document? >> very fine. >> yes. >> okay. >> but i will first start and give some context on how we got to where we are. in '17/'18 the revenues in the carry-forward amount were greater than projected in the budget. in the aggregate, the revenues exceeded the budget ex-pepped tour by $976,000. furthermore, the and well and one-time expenditures were $2 million less than the budget

expeditures due to staffing shortages and city's required procurement process. as a result, the additional revenues combined with the lower expeditures resulted in a $3.4 million carry-forward into '18/'19. this is $357,000 more than what was assumed in the '18/'19 budget. in addition, we project a $50,000 growth in annual revenues for '18/'19 based on the '17/'18 actuals. this is where we get the money to pay for the revised budget and items that we are requesting to be funded. during the budget negotiations, in order to prevent cuts in the well-being budget, sfhss agreed to provide a one-time transfer of $100,000 to the sfhss general

fund administration budget to support on site, well-being activities for sfhss members. sfhss is responsible for the programming of the activity and, therefore, has sole discretion for the use of the funding. these activities are provided under the direction of sfhss and pay for recreation parks instructors and other service providers for activities at facilities where sfhss members work. if the total expediture is less than the budget, we will adjust the transfer accordingly. after the $100,000 transfer to the general fund administrative budget to our fund budget, the revenues in the '18/'19 will

increase $307,000. turning to the expeditures, they're increased $69,000. that was strange. and one-time expeditures for $462,000, for a total of $631,000. despite this increase in expeditures, $1.24 million will be available to carry forward to the '19/'20 budget for one-time projects. the budgeted revenues will be sufficient to support the annual expeditures. now we'll turn to the table that's on pages 5 and 6 of your report. and it's projected on the big screen. i will briefly touch on the key changes necessary to implement

the plan and goals. the revisions in the annual budget are as follows. the budget is adjusts upward by $260,000 for personnel to include all the goals. will be tasked to up support analysis. this change will enhance organizational excellence. benchmarking tools that were discussed in the work plan combined with funding for software licenses require a $25,000 increase in the communication budget and support all five strategic goals and enhance organization alex lens.

as mentioned in the previous legislation, data will be used to inform targeted health interventions that will positively impact the goals for whole-person health and well-being and enhance organizational excellence. to increase analytical capabilities and drive decisions an additional $86,000 is budgeted. it will support sustainable healthcare and reduce complexity and fragmentation. the contingency is distributed among the other expediture categories. one-time expeditures is as

follows. open-enrollment $200,000 for three projects, communication plan will be developed to better engage and support members and reduce complexity and fragmentation. we'll develop and enhance the capability of the client management. a compliance review of materials and modifications will be performed to further support organizational excellence. the one-time budget for operations is increased $232,000 to implement member service payment capabilities, complete a hippa audit to ensure compliance, and creat create additional instructional

videos for our members. increase in expeditures is offset by reduction of $430,000 since projects were completed in '17/'18. the result is a net reduction of $197,000 in '18/'19. organization alex lens is enhanced through the projects. we're budgeting $263,000 to expand the usability and scope of the website redesign and to align with the goals to support our members and enhancing organizational excellence. under well-being, we're budgeting $82,000 additional to evaluation and improve well-being communications and webpages. this will address the goals of whole-person health and well-being and

organizational excellence. finally, budgeting $115,000 for new data feeds for the database and incorporate benchmarking tools and national community of quality assurance. by increasing our analytical resources we can impact the goals of sustainable healthcare and reduce complexity in fragmentation. at the end of the report, there's a summary of each of the details of the revised budget. i'm happy to answer any questions or concerns. >> president breslin: any questions? >> i have a question. my memory fails.

is this where the board educational funds reside in the $3 budget? >> no. that's the general fund budget. >> all right. thank you. >> president breslin: any other questions? comments? seeing none, we need a motion on this item. >> i move that we adopt the revised $3 budget or, as it's calls, the healthcare sustainability proposed revised budget. >> i second. >> president breslin: okay. >> as presented. >> president breslin: thank you. any other -- any other questions? any public comment on this item? seeing none. all those in favor? any opposed? no. it's unanimous in favor. so does anybody desire to have a

break or carry on here? >> yes. >> president breslin: all right. commissioners, time to go. dr. follansbee. back in session. all right. action item number 7, please. >> clerk: item 7 action item. initiation blackout period for all hss vendors as well as expert opinion navigation concierge and muscle skeletal reque request. >> thank you, commissioners, president breslin. as referenced earlier, this is in reference to the r.f.i.s that

will be going out in response to the strategic plan that you approved a few moments ago. i know you are more than accustomed to receiving blackout notice. one of the things that we will do is make sure we don't have ambiguity that we plan on attacking for a 2020 plan year and also 2021. one of the areas, as referenced by dr. follansbee is concierge. it will also include msk and we're dove tailing into our rates and benefits, which begins in february. so giving you that notice now. we understand that the november meeting is an educational forum, so we will make sure that when that r.f.i. is issued, likely between now and then, that we'll notify all of you in writing of the r.f.i. and the specific scopes of services included

therein. i will read briefly into the record the key part of this memo for all of you that is in the packet that all of you have received. and it's defined that a blackout period is a period of time from onset to conclusion of a selection process where communications between board members and service provideders seek egg contracts on matters solely related to sfhss is restricted. this includes face-to-face conversations, telephone conversations, email, text messages, letters, faxes or use of any other social media. if there are any questions that arise regarding anything that you may have seen that will be a future conversation you may need to have and you are not sure whether it falls under this, in an abundance of caution, we recommend that you contact eric rappaport and notify our

secretary as well as sfhss. if there are any questions, we're happy to receive them now and this is something that the board will need to act on. >> president breslin: the blackout period begins now, october, 2018? >> officially, the blackout period would genuine we initiate a search process releasing the r.f.p. and that's when we issue the r.f.i. we will notify you. >> president breslin: it says october 18-june 20, 2019. >> that's correct. it will go through the rates and benefits process and it will play into what happens during rates and benefits. so we need to get that started asap. >> president breslin: so everyone will be noticed when this starts? >> yes, the second that the r.f.i. is issues, you will be notified in writing. >> president breslin: okay.

any questions? >> i would just make a comment and it's contains in our terms of reference and i highlight that to member of the governor's committee and this board because we have to update the terms of reference this year, but that -- what is in place now is wholly sufficient to cover our conduct as board. >> thank you, commissioner, yes. as we did from several years ago, of course, matters of rates and benefits are handled as a committee of the whole now, so it does apply to all members of the board. and we do, on behalf of the finance division and contracts division, very much appreciate how this board has conducted itself here and outside of these chambers, making our lives phenomenally easier from a contracting standpoint. so i would like to thank you for that

>> president breslin: all right. >> vice president follansbee: i want to point out that i'm going tomorrow to new orleans for the 64th annual employee benefits conference through the 17th. and i have been instructed on this and i find it very clear and will be adhering to it. i want to reaffirm that in public in case there is any question that comes up and i keep a record with anyone who i converse should the issue come up in the future. >> president breslin: all right. since this is an action item -- >> i move adoption of the initiation or approve the blackout period for all h.s.s. vendors during the rates and benefits process and through the various programs that have been specified beginning october, 2018, through june, 2019. >> second the motion.

>> president breslin: any public comment on this item? seeing none. all those in favor? any opposed? it's unanimous in favor. >> thank you, commissioners. >> president breslin: thank you. all right. discussion item number 8, please. >> clerk: item 8 discussion item. financial report by pamela levin. >> good afternoon. pamela levin, c.f.o. health service system. this report provided to you summarizes the revenues annex pences of employee benefit trust fund and general fund administration budget through august, 2018, as well as the fiscal year through june 20, 2019. i will first talk about the trust projection. we are still in the audit phase

of the financial statements. unfortunately, the originally had scheduled to have it released the end of october, as we normally do. the city is extremely behind in work that needed to be done as a result of the new financial system. and it is unlikely it will be issued in december for our december meeting. however, i will keep you abreast of the news. we get phone calls every friday and we talk to the auditors once a week, but they are right now relocated to other jobs and will come back when the city is ready to have them come back. so we're going to begin with

what an unaudited trust balance, as of june 30, 2018, of $72.9 million. based on activity through august, 2018, the fund balance is projected to be $74.5 million on june 30, 2019, which is a $1.6 million increase. this projection is based on two months of data, which is always difficult to do. our crystal balls are hardly good enough to do after a quarter of the year projection. so this is subject to change as the year goes by. we're seeing favorable claims experience and unfavorable. there's favorable claims experience for the dental plan and projecting to receive $7.9

million in pharmacy rebates this fiscal year. i reported in the report in front of you using the original budget for healthcare sustainable fund because i didn't want to make an assumption if you would approve it or not, but at this point, we're projecting to end the year on budget. no performance guarantees have been received. as we mentioned before in previous years, the forefeitures for unused flexible spending account balances will not be known until june. in terms of the general fund administration budget, based on the results august, 2018, we expect to end the year on

budget. every year around this time, we are notified by the mayor's office and the controller's office of approval or not approval of our carry-forward request. and we did submit a considerable number this year, considerable dollar value. they are also running late on approving those. so we should know in the next couple weeks what the carry-forward would be. these are for projects and initiatives and contracts that either were not fully expended in the prior year or we've asked for some funding for ergonomic equipment so we can reduce our worker's comp claims and for some special projects.

so that at this point isn't known yet. but in the next financial report, i expect that that will be outlined. and i will report back to you on what has been approved. i will be happy to answer any questions. >> president breslin: thank you. any public comment on this item? >>a discussion item. >> president breslin: item 9. >> clerk: item 9, report on network and health plan issues, if any. respective plan representative. >> president breslin: any public comment on this issue? okay. number 10, please. >> clerk: item 10, discussion item, opportunity to place items on future agendas, public comments on matters within the board's jurisdiction.

>> president breslin: all right. i think we probably have our agenda for next month, for november. don't have to worry about that. dr. follansbee? >> vice president follansbee: we're a seven-member board. and we're still, i think, waiting -- the mayor's proposal or nomination for a seventh member. is there any update on that? >> yes. they're actively working on this matter. >> vice president follansbee: thank you. >> news as of yesterday. >> vice president follansbee: okay. thank you. >> president breslin: item 11, discussion item. opportunity for public comment on any matters within the board's jurisdiction. none?

item 12. >> clerk: item 12, action item, vote on whether to hold the closed session for member appeal. president breslin? >> i move we go into closed session for member appeal. >> second. >> president breslin: okay. any public comment? all those in favor of going into closed session say aye? opposed? >> president breslin: all right. item number 14. >> clerk: item 14, action item. vote to elect whether to disclose any or all discussion held in closed session regarding member appeal. >> i move that we not disclose any of our discussion held in closed session. >> second. >> president breslin: all those in favor. opposed? it's unanimous.

item 15, please. >> clerk: item 15 is also an action item. possible report on action taken in closed session. >> i move that we not report on any action taken in closed session. >> second. >> president breslin: all those in favor? opposed? all right. so that's -- >> i move that we adjourn. >> second. >> president breslin: i know there is no objection. >> good. thank you. go.

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. >> supervisor fewer: the meeting will come to forward. this is a special meeting of the budget and finance committee. i am supervisor sandra lee fewer, the chairman of this committee. i am joined by supervisor stefani and supervisor katey tang. supervisor malia cohen is excused from today's meeting. can we have a motion? owe will do that without