in 2007 to help out for a year or so and bring his expertise. and his relationships back to the department to help. he was very well respected by the file. he treated everyone with such great respect. somebody pointed out to me it was like as if you are family the way he mentored you. i would like to close out, if i made this meeting in honor of sean and our condolences to his family. >> thank you. >> i join in that. thank you. >> we are now adjourned. it is 11:34 am.

>> good morning, everybody. good morning! my name is >> in the community that when we build affordable house north a community, we build it for the residents in that community who need it the most and who can barely afford to live here. china town is an amazing neighborhood by it has low income residents who badly need affordable housing. a great project is being built nearby, 88 broadway, which also

includes. this will provide 178 homes for families and seniors many of that's really exciting. many of the affordable unit in the senior housing development are unfortunately still too expensive for the seniors who live there. in fact, 56% of all seniors living in all of district 3 are at 30% of area median income and below and for chinatown, the percentage is even higher. opportunities for affordable housing must reflect neighborhood needs and that means, this senior housing cannot be set at affordable levels that chinatown seniors can't afford. the city is making these senior

housing units even more affordable. today is why we're here to announce that we're going to be doing this by buying down the affordability levels on 13 of those units, which will move these homes from 60% of area medicinit willcost $710 a month. the deepen affordability is made possibility through the city's investment of $1.5 million. this investment represents my commitment that when we build housing that our city meets and

we need to make sure the people in these communities where we build affordable housing can qualify for the housing we build. i'm truly proud of the work that has gone into this project. i want to thank bridge housing for john stewart company, the port of san francisco, the mayor's office of community housing development. i want to acknowledge our community partners in this effort. china town community development center, the chinese progressive association, the community tenants association, and i also would like to thank barburcy coast neighborhood for this support. this is a project that is a part of this community and we haunt to make sure have a real shot at being, maintaining and continuing to be a part of this community which is why this

investment is important. one of our champions on the state side, as it restate relato affordable housing and someone who is working hard, not only for the residents here in china chinatown, our assembly member. [applause] >> thank you. it's fitting that this morning, as it's been raining, just as this press conference is starting, the sun is coming out. as our city has been experiencing the intensity of the housing challenges that we have, today is a bright spot and an important announcement on how we move things forward. let me start by thanking mayor breed, your city departments for your investment in real affordability. and ensuring projects like this move forward. as a resident, i'm grateful to

you and what everyone here is doing. i will say as a former supervisor of district 3, i want to thank the neighborhood associations, particularly the barbury coast neighborhood association, our non-profit organizations from ccdc and the pca and i want to thank bridge housing and the john stewart company and others, for moving forward this important project. i will say, as a chair of the assembly housing committee, i want to thank governor brown and my fellow colleagues for voting and signing ab14-23. some of you may have known that we had to get changes to our state-public trust law in order for the 88 broadway project to include a childcare center, as well as to have the mixed income affordability that is the hallmark of this project. it takes all of us working together to ensure that we are addressing our housing challenges. this is exactly the kind of project that we should be

building. projects that build affordable housing, community, that takes care of families, immigrants and seniors. this is what san francisco is about. i just want to thank everyone who has come together for this important announcement. thank you. [applause] >> i'd like to introduce one of the partners in this effort who is helping with the development of this project, maria debore, the vice president of development for bridge housing. >> thank you, mayor breed. good morning or good afternoon. my name is marie with bridge housing. we're one of the co developers along with the john stewart company. it's a mixed-use multi-generational development with a broad range of housing needs, including affordable housing, middle income housing and housing for the formerly homeless. the project includes retail, a

community-serving childcare center with programs and supports for all children of all income levels and incorporates a robust services plan that tends to the needs of the seniors, families and formally homeless tenant populations that will be living there. the john stewart company and bridge housing are co developers on this project and are very excited about the deeper vulnerability levels at 88 broadway and 75 davids project. the 30% units will serve very low income residents. it will be one additional step towards meeting the deep and continuous needs to create affordable housing opportunities and will be reflected i have housing needs in the chinatown and broader community. the proposed project will pursue the city's goal of integrated a diverse population with the family and senior components of the project. a.m.i. levels will range from

30% a.m.i. to 120% a.m.i. with five 30% units. at the senior building, rents will range from 30% to 70% a.m.i. and will include a 28% homeless as well as the 1330% units that were just added. the developers have done extensive community outreach and held close to 30 public meetings to obtain approval for the 88 broadway and 435 david project. early planning began in 2014 for this project. when most 'em parked on a goal to form the 88th broadway working group to the community input while conceptualizing this affordable housing project. as a result of early engagement and the relationships with the community, the city's vision to create a broad range of affordable housing is finally moving forward. we're excited to start construction in the second quarter of 2019 and we'll have

the first apartments become available for residents in the summer of 2020. thank you. [applause] >> thank you. chinatown community development has been an incredible force of working with the community to make sure that our seniors have access to safe, affordable housing. and they are the ones who brought to my attention the concerns about the ability for the residency, the seniors of chinatown to have access to these particular units, because the affordability levels were too high. at this time, i'd like to bring up reverend norman fong, the executive director of chinatown community development, to say a few words and talk about the incredible work they continue to do to support our seniors. [applause] >> ok. first turn to the person to your left and right and say you are

beautiful. you are beautiful. mayor's office of housing. all right. it's a beautiful day in san francisco and we're here at heart of san francisco. this is it. this is where our city grew from. until today, there are still many seniors that live in chinatown in single rooms. i think we can do better. today, we celebrate every -- the mayor. [laughter] and others who added some. of course we want more but today symbolizes the heart of san francisco's showing real compassion for seniors that should not have to suffer at the golden years of their lives. also i i want to celebrate the team. i want to celebrate c.p.a., the community tennis association, seniors themselves who said we need to get more affordable housing. this change of percentage from

the 60 to 30% is a big deal. so we have to do more of this. mayor breed, i know you will do more where we can find a way to build more affordable housing reflecting the true heart of san francisco and making it beautiful. all right. [applause] >> we do have a representative from the community tenants association. we're going to ask her to come up now and say a few words. [applause]

>> hi, everyone, i'm resident of community tenants association. glad to see the future of both the housing project have set aside for seniors, however, i believe a lot of seniors cannot afford or don't even qualify to apply on the income requirement and rent level is at 15% a.m.i.

>> now we have a good news. the community and may have have been advocating for lower threshold and now the requirement of 13 of the units are lowered to 13% a.m.i. levels. we should see mayor breed and all community members thank you for your work.

[applause] yes, this is just a first step. the city and the community still need to work to fight for more housing. they want to use this opportunity to ask everyone to vote yes on prop c in november election. prop c will provide more housing for individuals, families and homeless people. it also helps to create a cleaner city. most importantly, the tax increase suggests will not effect individual or small business because it targets large enterprise that has

revenue above $15 million. prop c will adjust the current housing crisis. vote yes on prop c. thank you, so much. >> we have the chinese progressive association. [applause] thank you, mayor breed. thank you everyone. thank you to c.p.a. for those words. i'm the organizing director at the chinese progressive association here in san francisco. we are an organizing educating and organizing working families, youth, tenants and seniors in san francisco. i think it's fitting that we're marking progress for the struggles for our community to find affordable housing. here in the heart of chinatown, which has such a long legacy of community advocacy and it has led to the types of livable

community that we've been able to build here in san francisco and in chinatown. we have a long way to go and we're proud of being part of that legacy. we're also proud members of the chinatown coalition for housing justice. which is a coalition of organizations based here in chinatown that began organizing back in 2015. around the time we really saw the very impact of gentrification starting to hit chinatown. with s.r.o. rents going up drastically from an average of $600 a month to $1,000 a month. and seeing the influx of developers trying to profit off of the housing that we believe should be preserved for low income seniors and families who are working and providing services to the city of san francisco. when we first learned about this project, we were concerned about the affordability levels. it was part of a whole program of work that was happening at the time. conversations, surveys, forums

that were being held in chinatown because of the concerns of the community that, even affordable housing was just far beyond the reach and i appreciate the mayor for naming that. these developments need to be accessible to the community that they're committed to serve and we have to recognize that affordable, for someone who is working a minimum wage job in san francisco, is very different from affordable for someone working a different income. we have to make sure that housing units are successful to all and we've lost too many already of our working families. our blue collar workers, our immigrant families, too many people have had to mom to antioch and out of the bay area in order to survive. the members of the chinatown coalition for housing justice, we are really happy today to mark this progress. and to show when community partners and developers and the city come together to really think about the solutions and recognize the needs, we can come up with creative solutions to

make san francisco a place that all of us can afford to stay. thank you. [applause] thank you. i want to thank you for being here. thank you to all of our partners that are here today. we know that san francisco has a long way to go to address what we know is a serious crisis, as it relates to affordable housing. and part of my goal, as mayor, is to make sure that we support the surrounding communities, especially as i said, when we build affordable housing and a neighborhood, it's important that we look at who is in that neighborhood and how are we going to make sure that the people who are part of that community that shop in that community, that are part of the fabric of that community, have a real opportunity to maintain their lifestyle in that particular community. that's what this is about. but we have to do more. we have to make sure that we do everything we can to build more housing at different affordability levels because, as

we've said before, you know, someone making minimum wage, a family of four, it just varies for each family. we need to make adjustments how we provide housing in san francisco and working together we'll do just that. thank you so much for being here today. [applause] breed. >> hi, my name is jamie h.

in this episode, we are featuring the romantic park locations in your very own backyard. this is your chance to find your heart in san francisco with someone special. our first look out is here at buena vista park, a favorite with couples and dog lovers. it is as old as its neighbor and both have a significant forest, a refreshing retreat from urban life. the pass that meander we do under a canopy of 0, redwood, pine, and eucalyptus. chill out and this environment

and you might see butterflies and dandelions. blue jays fly between the eucalyptus. it is ada accessible. public transit is plentiful. six, 24, or 71 bus. we have conquered the steps, we walked the dogs, and we have enjoyed a beautiful view the park has to offer. this is the place to take someone special and enjoyed a beautiful look out. " come to corona heights, located in the heart of this district. it offers a spectacular view of the downtown skyline, the bay bridge, and the east bay. the park is one of the best kept secrets. unlike twin peaks, it is hardly ever crowded. on any given day, you will run

into a few locals. hop on a 37 bus to get there with that any parking worries. locals can bring their dogs to run with other dogs. there is also grass for small dogs. >> it is a great place. it is a wonderful place for the city to provide these kind of parks. the dog owners appreciate it. >> take time to notice the wildflowers on the grassland. and keep your head on the lookout for hawks and other bird life. take your camera and be prepared to review the city in a way you will not forget. it is prominent with beautiful formations that are perfect to watch the sunrise from the east over the bay. this is another one of our great look out.

we are at mount davidson. it has the highest point of elevation in san francisco, 928 feet. this is the place for you to bring someone special. enjoy all of the pathways, trails, and greenery that surrounds you. it provides a peaceful oasis of public open space and great hiking trails. the spectacular view offers a perfect place to watch the sunrise, or, sunset, with someone you love. >> it is a good place to get away from the hectic life of the city. get some fresh air. the view is fantastic. >> wear sturdy shoes to conquer the trail, you have the feeling of being in a rain forest. mount davidson is also a great place to escape the noise and

the apostle of the city with your partner. -- bustle of the city with your partner. it is quite a hike to the top at mount davidson but the view is worth every step. this is the place to bring that someone special. for more information about reserving one of these romantic locations, or any other location, 831-5500. this number is best for special ovens, weddings, picnics, and the county for building. for any athletic field and neighborhood parks, call 831- 5510. you can also write us at permits and reservations. or walking in and say hello at old log cabin, golden gate park. and of course you can find more

information at sfrecpark.org. >> neighborhoods in san francisco are as diverse and fascinating as the people who inhabit them. today we're in the sunset, where we'll join supervisor tang for the inspiration of this show, where we explore san francisco, one neighborhood at a time. hi i'm katy tang the district 4 supervisor in san francisco, which is comprise of sunset and parkside neighborhoods. i think what makes district 4 unique is that we have so many different cultures here. we have so many different

generations of people. different experiences and that makes it a vibrant neighborhood. for example, which you go down urban street you can do to a japanese restaurant, chinese restaurant, american restaurant, and the cultural diversity is just what makes it so amazing my name is ching le, and i'm the owner of the kingdom of bounty. 17th san francisco, 94116. we make the most authentic and different kinds of dumplings and dim sum. recently more and more popular because they are vegetables and meats that we use fresh vegetables and meats in the business. it's really inspired to start discover your district series, because i wanted to find a way for neighbors to come and get to know our small businesses and our neighborhoods. get to know each other, get

know our office, and do so in a setting that was unintimidating and fun. so i launched this idea call the "discover your district," where we go every month to one or two small businesss in district 4 and we have done things such as learning how to make dumplings that we're learning today and there are so many different activities that we have exposed our residents to. >> today is the very special day, because the city of san francisco hosting this for san francisco city. learning how to make dumplings and knowledge of dumplings. they love to do it and all enjoy it. >> this is definitely not my first time making it, so i have definitely improved a lot. the first couple of time s i tried to make dumplelings they looks

inedible. they have definitely improved. there is a special dumpling eating contest, which is amazing. everyone those eat the dumplings that they made and see how many they can do. i'm curious as to how many they going to be able to down today? >> don't forget to write down what you are eating today. >> we make all different kinds of dumplings and enjoy what they made. so after that, we'll have contact how many pieces of dumplings they can eat and announce the winner today.

>> health services board will now come to order. please stand for the pledge of allegiance. [pledge of allegiance]

>> madam secretary, roll call. >>clerk: roll call. [roll call] >> action item number one, please. >> action item number one, approval with possible modifications of the minutes of the meeting set forth, regular meeting of september 13, 2018. >> are there any corrections to the minutes? >> i would like to offer one or two. i would strongly recommend that we put page numbers on the minutes in the future and with that in mind, i'm going to refer to what i believe would be page

3, at the top of the page, above your first bullet. there are two audits in process with k.m.p. -- kpmg that will be reported at the december 2018, i presume, meeting, and an update on the gatsby. it's general accounting standards board. so meeting and correction on s gasb, along with page numbers. >> thank you. any other corrections? i submitted some corrections earlier that will be reflected in future minutes. is there a motion?

>> i move we adopt the september 13 minutes as edited. >> i move. >> second. >> all right. any public comment on this item? no public comment. all right. all those in favor? [voting] >> opposed? all right. item number two, please. >>clerk: item number two, discussion item, public comment on matters within the board's jurisdiction not appearing on today's agenda. >> my name's richard rothman. i've been in health services since i started with the city in 1983, and i've just run across some things that are quite disturbing, but first, i want to thank kaiser for saving my wife's life.

she's still in the system, but i oh, a big gratitude for them. but the not so good part. i just got an e-mail yesterday, kaiser listing their standards of service, and that they're supposed to answer telephone calls within ten minutes. well, the two times that i've called the resource center, it's been over ten minutes, and once i got them, they're very nice. and the other is the durable equipment, and my doctor ordered some for me. i waited two weeks, i left a voice message, called. so the first time, i decided to wait on the phone. i waited 45 minutes, and when i got a human being, they didn't even open my doctor's e-mail for the equipment that i wanted. they didn't have the right one, but still -- and then, when i

called the second time for my wife, it was about 25 minutes. and i've complained, but i think if it came from you, i think we're still the second largest group in kaiser that you could make some changes. and i did call, and the first person i called told me that mitchell wasn't there. he didn't know who he was, but i'm going to talk to him tomorrow about it. but the other thing is i put in a sunshine request and never got an answer to the e-mails or phone calls. i guess they're working on it after i have to call the sunshine task force. so i would recommend maybe the staff and the commissioners get a briefing on -- about the sunshine ordinance and how to implement it.

and thank you. >> diane ehrlich, retired uesf division. in the book that we got for open enrollment, it said about that smile away open dental plan, see pages 25 and 26, but there's nothing on it, no explanation of what you have to do. and i was told by my friend that i need to get a letter from the doctor, the dentist, take it to delta dental. i just wanted to verify that that was the correct procedure. >> is that -- can anybody answer that right now? mitchell, delta dental, would you like to come up quickly?

>> good afternoon. i'm iliana desoto with delta dental. basically, they just need to log into the system, indicate what conditions they have. there's a set of five different conditions, and once they indicate that, they won't -- you'll need to indicate on there your physician information -- name, telephone number -- but after that, you're enrolled in the smile away program. >> so you do this on-line? >> correct, it's all -- [inaudible] >> may i have, diane, would you come back to the microphone so that everybody can hear you? thanks. >> if you don't have kaiser, you don't -- most people don't have a phone number for your physician because you just get the call center. >> right, and that's -- that's perfectly fine. you can certainly just put on there that your physician's name --

>> can you come forward to the microphone? >> yeah, so you don't need to -- if you don't have their phone number, that's fine. you can use kaiser's just toll free number, as long as you indicate the physician's name on-line. if you don't have access to the on-line, you can contact our customer service line, and they can do the enrollment for you. >> okay. this has been said here today. my concern would be how do we communicate this more broadly to others that are going to be dealing with this in open enrollment? >> yeah. we'll take this back and add some information to our processes. >> thank you. >> i'm a temporary helping out sharon who's your account manager, so i'll make sure she knows and she can reach out to the appropriate people. >> thank you very much. >> thank you. >> okay.

>> good afternoon, commissioners, claire zavonsky, retired workers of the city and county, zcsf. i just wanted to thank lisa o'campo and all of the staff that really worked hard at helping us put together a really incredible fair yesterday at the scottish rite rcsf. i actually saw a few active employees coming in because they were in the appropriate uniforms of their positions. so i don't know how many flu shots we gave out, but i think that just about everybody got them. and it was really a well put together and very well organized health fair, and i just want to thank the health service staff, mitchell, abby, lisa, and everybody from well-being that participated yesterday. it was wonderful, and we even got some exercises in. so it was a perfect day, and we thank you all very much and look forward to next year, doing even

better. thanks. >> okay. any public -- public comment? public comment closed. item number three, please. >> item three, discussion item. president's report, president breslin. >> i have nothing to report. is there any public comment on this item? all right. item number four, please. >> item four, discussion item, director's report, executive director jand. >> good afternoon. it is open enrollment month, and i am informed as of today, we've had 3,757 calls, 1,068 applications have been received. over 400 of those are already processed. we had good news, too, early on, about the self-service. folks were using it, and that seems to be going very well.

haven't had any major glitches with the self-service, so that's very promising, and we'll keep you posted on that. we will, today, be talking about the strategic plans and i'll skip over that. and what i would like to jump to, though, however, is the november education forum. we did receive feedback from -- on a survey that we sent tot board members about what topics would be of interest to this board, and about 70 to 100% of the ratings vary from interested to extremely interested in. one is under the rubrick of care navigation, health care navigation. the second is primary care medical homes is the second topic, and the third is pavement reform, so we're working on getting subject matter experts to help us with our presentations on november 8th.

and so that's -- and the other subjects, there really wasn't a -- they were all pretty tight across the board. so we have many other topics to learn, and we'll look for ways to integrate that into future board meetings throughout the year. t the -- and also in your packet was the list of all the farirs and the outreach that the department is doing. there's events daily throughout the month, so the staff is super busy, and i have to say that they seem like they're enjoying it, and i stopped by. our beautiful lobby is quite full very often these days, so -- and we've got some of the newer staff that are on board or acting as receptionists, and

we've gotten some really great comments about their ability to make people feel welcome and comfortable even though they come in and do the math and figure out how long they're going to need to wait, they seem very satisfied about what's going on there. so we're still wrapping up the dependant eligibility verification audit, and we did bring that in house, and are working on the -- on the final appeals process that we're in sort of a second appeal stage. we are also considering how -- what we do with the folks that have not responded to the audit. we have had concerns about people who have found out about it very late or found out about the fact that their dependent has been dropped after getting a bill and used services.

that's always unpleasant and disconcerting, so we're taking all that into consideration and intend on providing a full report to this board in december on the whole process and the lessons learned and what our recommendations will be to address this concern o going-forward basis. and i think that's it for the director's report for today. any questions? >> any questions? >> yes. so the report in december will also include the resolution -- how those issues were resolved, when people missed the deadline for including the dependent and got bills and all that, so there'll be a full report on that, as well? >> yeah. and to date, correct me if i am wrong, mitchell, but when those things have been brought to our attention and we've been able to receive adequate verification documentation, there have been

reinstated back to the july 28 date. >> good. >> all right. any public comment on this item? this is the director's report. come forward. >> yes. i thought that was a very good report. i thought it was really good to have a chance to talk to -- >> could you identify yourself? >> my name is mike delaine. retired fireman, fireman for 36 years, wife kicked off the health care. i also want to give credit to mr. riggs. those are the only two living people to contact me. now, i understand, there's a problem in trying to get the people who have done bad on health care to try to weed them out, but the people who have done good, myself being one for 36 years, i think it's a tragedy, even if you affect one

person out. hundreds of thousands of people -- out of the hundreds of thousands of people that are affected by health care. you guys have a member statement that say we are committed to members, we treat members with respect. we are responsible for our work. i'd like to know who was responsible, but i really like the last bullet point, where it says we have fun and we maintain our sense of humor. it's not fun for me to maintain my sense of humor when my wife it taken off the health care. abby, i know you have a tough job, but if you affect 100,000 of the people doing something wrong, that's something. i've run into eight people in the last month who have been kicked off of health care. not trying to find them. as she mentioned earlier, one of them was a person that broke their hand, wife didn't know she was kicked off until he received a bill. so please take a look at this,

hopefully, this won't happen in the future. thank you for having the patience to listen to my pain in the butt self. thank you. >> thank you. next public comment? >> nice new cell phone. this is my week. found a laptop yesterday, and a credit card, and a cell phone today, hey, hey, hey. got a new job. i just want to -- claire zonsky. i just wanted to mention that one of the problems that i had when i was on the board was a lot of times, members don't open their packets, and they don't open their mail, even when it comes -- says it comes from health service. we send out those notices,

letters, and it's clearly identified from us, but people put it aside. they'll get to it later, and later is when they get the bill for services. but the reason i really came up here was that little brain farther here, i forgot to also -- brain fart here, i forgot to also say for all the vendors that were there yesterday, we had u.h.c. and kaiser, we had both health service open enrollment, and well-being, we had delta dental, v.s.p. best doctors showed up, and that's always interesting. then, we always have something with regard to retirement. all the vendors, everybody had a very full day, and i just want to thank everyone for coming to our open enrollment, and also remind us that whatever it takes, i don't know. we've made the envelopes flashier, we've put notices onto open immediately. i think health service has done all it could to attract attention of our members to open

those envelopes when they arrive, and we'll just keep on doing what we do, but thank you all. i know it's difficult and trying for the staff, as well, but we appreciate all the efforts. thank you. >> all right. item number five, please. >> item number five, action item. san francisco health service systems strategic plan, plan years 2020, 20 -- technically 2022, my typo, executive director yant. >> good afternoon, again, commissioners. thank you for having us here today and meeting in october. i know this is not usual, and appreciate your attention, and allowing us to come forward with final recommendations for our strategic plan for the next several years. this has been a -- a really terrific process that we have gone through, and we acknowledge in the front of the report that, you know, it's really taken a village and really helped us out kicking off with the blue sky date back in june when our heads were filled on subject matter experts, all the new innovations that are taking place on health care. we -- also, then, we took that and our leadership term at sfhss met many times over the ensuing months to consider all of that information and the work that we had before so that we could design this strategic plan. and then, also, towards the end of the process, we also took the time to have all staff meetings on the strategic plan to ensure their input and that staff can see their role in the input plan and also did a number of stakeholder sessions with some of our members to get their input. and that is very informative and very well received, that people

were being invited in to talk about what is important to them. so the process has been very comprehensive and has taken a bit of time, but i think it always yields a stronger product when we all work together, so i do appreciate the board helping us kick that off last june. and so we'll -- i'll just walk-through the plan. there's -- that we changed the format rather dramatically since you last saw this, but the content is essentially the same with some edits here and there, so i'll just walk-through it at a high level and give you the highlights. and then, subsequent to me talking, laticia here at our side will talk a little bit about the work that we've taken this into sort of the next phase of implementation and developed a work plan with our team on how we'll carry out the developments in the strategic plan, and then, also, subsequent to our

presentation, you will also hear from pamela on revisions to our sustainability fund budget midyear that we are -- and this was very much a surprise to me. i come from a rather austere environments where i'm used to doing strategic plans without a budget, so it was really sweet as we got through this to realize we had some funds that we could reallocate and use it to realize some other objectives in the plan, and i look forward to hearing about that, as well. so in the plan, we did restate the mission vision and values that -- the mission and vision is a restated from prior strategic plans, and then, we revisited or values and restated them as the way we're feeling them today. respect value, inclusivity, and collaboration. if you go to page four of the

strategic plan, we have our -- our graphic design has been very helpful to sort of take a snapshot of how we take the strategic plan, the mission cores being in the center, peace, the strategic goals in very short form read affordable and sustainable, reduce fragmentity and collaboration, our membership, recognizing that choice and flexibility is very important and really taking a look at the whole person in health and well-being. this is a big shift in the way that we do our work of looking at people solely when they're ill or injured. we look at them across their life course. as the health system really takes care of people from early days of active employment and well into their senior years. it's very important to take that life course consideration 'cause our needs change over time. and then, we've wrapped -- we

wrapped around all of us the organizational excellence of the health service system staff itself, that we're very committed to carrying out the objectives and stepping up the game and already well -- very well run operation that was just -- i consider myself blessed every day that it's as strong as it is, and i hope to just continue to strengthen the organization as we move forward. one of the areas that i -- we did spend quite a bit of time on developing that may seem like a lot of words on a page, but i think this, again, is where process is very important is these guiding principles on page six. this is the type of document that i think that we will find ours referring to as we develop designs and plans and recommendations to bring to the board because we want to operate within these guardrails, and so we've had a lot of discussion internally about what those guardrails are in each of these categories, and i won't read them to you again, but when we

come back, and we start 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. [please stand by]

-- 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