>> i can work with our directors that work with the hiv-related issues. >> commissioner: there's been media communication on this. one of the listening sessions at the end of the month is the week after and another one in february. and both were the only two and then you can submit written comments. if that's on our radar at all. >> we'll check in with the appropriate dph representative on those issues. >> commissioner: thank you. >> commissioner: now that we mentioned healthy san francisco, it was not considered insurance i believe under the aca. would it be something the county needs to consider whether we would like that considered on their insurance with the state if there was to be a state

individual mandate because i think there are pros and cons but we are talking about trying to encourage people to sign up. i don't know if director wagner has a view point on this. if we dont have a view point we can't put it in but we perhaps should be thinking about whether or not that should be eligible. >> i think there's definitely a large conversation that i think is broadly captured. i think the state will be looking at a whole number of potential scenarios where the governor has asked for a single payer system to other approaches that would be coverage expansions of other forms other than a single payer. and they become an insurance

product would be a long process and we will have to determine a process for the licensing and how that would operate as a health plan as well as the funding. one of the issues with healthy san francisco is we have a network of participating providers in the city and we provide excellent health care but outside the city's boundaries, we don't have a network or financial or administrative means to pay claims. that's one of the limitation objects healthy san francisco and why we always pursue insurance. i think there'll abe big policy discussion over the next number of years of what is the state's vision for funding to close the gaps for people who remain uninsured and how to leverage the policy discussion to

strengthen coverage option to get more people via it's a form of healthy san francisco or a supplement program to get people on true health insurance. >> commissioner: we're not looking at healthy san francisco as being insurance but as they move along the road of insurance which was the whole purpose from when we went into it it would be a first step and whether it's recognized as a portion of the insurance. maybe they get a 10% rebate back or whatever the penalties are they're looking at and not wanting to take away the incentive to get true insurance. it's something i think within the dialogue and realized it would be important.

and are there any other i would just say again it's an excellent report and you and your staff have given the commission and the city a unique opportunity to look at some of the challenges coming down the pike and with legislation we go to the dance of legislation act. here's something else that may come across in the next year or year after. with our veterans who have served since 2000. there are move and medical

psychiatric and we look back and we know that veterans here in the city consistent one of our largest population groups. we have the data. we have the data taking a look at where we are. so even though people don't think of san francisco necessary as a home port anymore for the military bases we've observed in the past 100 years, we're still the home port for veterans who came here during active duties and whose families and grand kids come back and we may have real challenges again as a city to come up with to expand or have comprehensive services for all of the above and this may be coming across us but the numbers are there and it will provide us with another city with another unique challenge.

how do we provide ac association -- access to service. well done. >> commissioner: commission sanchez are you suggesting within the document we highlight the need of veterans as an opportunity on the federal or state level? >> commissioner: it may be mentioned for the state to look at. >> we can look and see and see if we can incorporate that into the plan as well as commissioner chung's comment on violence. >> commissioner: i believe commissioner chung had a suggested area and commissioner sanchez has a suggested area to highlight. if anybody else has any other areas to make additional revision as we go along otherwise we will then accept

that with the revisions as pointed out. anyone else? no. okay. so the resolution is before us and adding our colleague's comments for the documents. is there a motion to accept -- excuse me. >> clerk: the vote for this resolution will be at the next meeting. this is a discussion item today. >> commissioner: next meeting we're informed how it could be added. thank you. we have legislative plans for 2019 and we would look at the

final revisions and great and thank you for a comprehensive document that every year improves. i like the way you categorize it. it's very clear. >> >> clerk: there's no public comment and nine is the project update. >> commissioner: yes. >> i'm the acting chief information officer for dph. and i'm going to walk you through an i.t. and epic project update. i want to take you back a little bit into 2017 when we were doing planning on the ehr at that point. in january of 2017, dph began working on 14 ready initiatives. they involved governance which

included project governance, establishing a public management office and unified governance program. both initiatives included developing a change management program and training program and communication plan and information governance and revenue cycle management program and resourcing planned and value-based benefit. all the initiatives were developed to make the current ep pick install time line. there were three i.t. go forward initiatives. security and privacy, i.t. operations, network and facilities. so the dph security and privacy team was started in 2016. a chief information security officer should be on board by the end of the month or the beginning of february. this will be our first information security officer. it was established in the beginning of 2018 we had act

being chief information security officers to this point and it will be our first i'll tell you what they are responsible for. the chief information security officers has a team that report up to them and for business continuity and ensuring annual audits for security are performed and any findings discovered that have to be mitigated. the team also worked with the county of san francisco. 567bd operation have been on the service team and the epic team creation and support of the third-party systems to bring full functionality of epic. and we experienced staff last

year and established the epic bill team from operations and within i.t. and people who v volunteered and we did assessments and sent them for training and they're working on the epic project today. the next two slides will focus on infrastructure and our customer service readiness efforts. i'm hoping because it's actually not happening here, so i'm sorry if you're not seeing on your screen a video that plays. and i showed the screen swell but the video isn't apparently doing anything. i spoke about the equipment refresh and virtualization of the work stations. we took them from training on their work station at 157 seconds to 71 seconds. so this is the upgrade of the

equipment in the clinics to prepare them for epic. they got larger monitors and have a faster boot-up time and will have a better experience ti time. i did report on network uptime. for 2018, last time i didn't have the full report for 2018 because i was here in october. so for 2018, we have an average of network uptime is 99.978%. so we can still improve. we have had some incidents so we intend to improve that process as well. you can see on the slide there the refresh schedule which is finishing up this month. respite completed january 3 and hurry scheduled to complete on january 22 and the castro

mission will be completed later this spring because there's construction activity for those clinics. and i presented to you in october so what's different about it is i'm giving you a whole quarter of 2018 averaged out by month as to the incidents that had and you can see in general a reduced occurrence of major incident and result of decreased i.t. tickets an overall the service desk has been helpful. when i'm describing a major incident with disruption to a critical service defined as the for instance for example the lcr would abe critical and the ocr system is critical. when we move to epic, epic will be a critical system so degradation or network outages is what we're reporting in the major incident.

we've been focussing on i.t. talent management. there's 34 permanent open conditions. recruitment remains difficult in the current economy but i can tell you we are hiring and we've been successful in some areas and we continue to work with h.r. to recruit. we've had good success with our 1010 training program. some have been sent to epic to be trained and are successful members of the epic build team and i.t. will continue with the 1010 program and we're looking to expand interns to provide tunts -- opportunity and so grow i.t. and now we're working on appropriate staffing levels for areas where we have staff for decommissioned systems. there's 55 systems that we'll be decommissioning.

so the i.t. focus or 2019 the number one priority is epic followed by vendor management. we had 85 contracts that bedid with epic that means 85 vendors for the most part and significant amount of digitization around dph. so continuing to improve the process is on our agenda. decommissioning and planning for the 55 systems is underway and we are developing an i.t. strategic plan for business needs and technology and i have that completed by march. the last i.t. strategic plan was developed in 2014. and it involved preparing for procuring the dhr. we've pretty much done that so this effort will be moving forward with what we'll be doing for the next five years. wave one is underway and on

track to go live august 3. we're in the testing phase and while there's been issues related to staffing and timely decisions, the build is 98% done with the build required for testing and all teams have plans how to complete remaining build items as well as defined escalation paths to get timely decisions. so i'll be continuing to present this schedule you'll see the col colors are with what we planned to do and in gray we tracked if we went over the time line or kept it. epic is a pretty prescribed. the reason why we're staying on track is we're forced to do that. they give us enough tools and

staff to keep to this and if anything is off track, we have plans on how we get it back on track. for phase zero that ended april 3 and groundwork ended june 1 137 -- june 1. we did the configuration and adoption. the feedback we got about the build. that ran through inform -- november 28 and we're doing testing beginning may 29 and training begins may 30 and we go live august 3 with post-live support going into november. this slide i showed you last time as well. we stepped back. last time i showed you the quarter of the year. the quarters aren't on there any more because we're stepping back

to take into account the staffing we need because there's additional modules and facility moves and they impact what we do in a particular quarter and other lead times and so we'll be back as we figure that out in great detail about what our implement future waves will be and what quarter or even if we come up with the actual date. i want to share some of the epic accomplishments since october. we're using 1735 mission street as the primary location for training and locations at zuckerberg, san francisco general and laguna honda. one thing to note is epic worked with laguna honda for specific needs laguna honda had and they incorporated those enhancements into our february update so we'll have them in time for our live. i'm pleased to have those

registry needs and some printing requirements and some additional things for future waves regarding ambulatory, pharmacy and migration data from the legacy system to the epic test system was successful and has involved the build for the configuration and migration from where it was built to the test system and conversion actually was started and i will tell you that that's underway we just got downloading an initial round of it. four years of our legacy data in the epic system so that involved doing all the mapping necessary to have that happen and we're doing the validation starting this week. sow -- so application testing is ahead of schedule. i went read through the

accomplishments but what i want you to take away from this is the volume of tasks the team has had to do. this has been since june 1. a lot of activity that's been underway since the beginning of the configuration. this is an activity status i presented last time. what i'll do is keep this in front of you so you know what did we report last time and where are we now. in our design and build despite difficulties with staffing, this is pretty much on track. though in our local meetings we have a lot of things we look at. this is overall on track to go live. testing is on track on target. training has gone from a watch state to on track because we were able to secure the lease at 1735 mission for the training -- main training facility. as well as we just released the learning management system so managers can sign up their staff for training this week.

those were the two reasons. on the interface is on track and infrastructure and technology is on track and go live is targeted and we should in meeting without a problem august 3. budgets remain on a watch because we still have contracts we need to complete having to do with live. they're things such as additional trainers and at the elbow support. i wanted to highlight this activity. it is prescribed and they offer a lot of check points along the way to make sure we are going to get live. thigh bring in people who aren't on the project from epic but they are experienced and do an assessment from where we are so it's an outside fresh view of it. they give us tools for go live readiness and this is evaluate

critical areas such as the go live and necessary to evaluate the progress and readiness and risk and system readiness and operational readiness and we'll be doing this at 120 days before live, 90, 60, 30 and 15. so really the final checklist before we take off that we'll be on track. so what's ahead the i.t. folks are ensure weg -- ensure weg finish testing and training and move to stabilization and prepare for future waves and optimization. i want to highlight the training tasks coming up there's approximately 9,000 employees and providers to train and over 12 individual class sessions will be held over eight weeks. an intense a -- of effort in a

short period of time. because it's new i'm sure it won't be without hiccups but we will get through those. i wanted to bring up questions brought up last time. one was the percentage of e-learning to in classroom learning so i'll bring that back next time. we have didn't discussing patient load and if there'll be a reduction when we go live. i don't have a final answer but there's been discussion leading up to that and that's something that will come back to you. we'll also talk to you about super user program. i think the next time we'll bring albert in to talk about change management and keep you updated on that as well. are there any questions? >> commissioner: commissioners, if i can very briefly add a couple comments in addition to what winona said. i can always do this but can i

keep everything in historical context when i look at the report it was six or so years ag when barbara was relatively new into her role and we launched a study to evaluate our i.t. system and talked about an ehr and the result said whoa, you got a lot of to do before you implement and enterprise the ehr overhaul of our system infrastructure and operations an building capacity and system. and it was evident our i.t. just in terms of day to day impact on the department is not where it needed to be. and looking at some of the data we put in the reports, i think it is a remarkable distance that we've come in a relatively short

time by organizational change standards where we have done the infrastructure overhaul. we've got a lot of reason and the up time is where it needs to be and you see a lot of the green on the project status report. it makes it look like an easy process but i will tell you there's a monumental amount of work that goes into keeping those green and winona with the i.t. side with the team have taken the reigns and pushed it forward. there's still a lot of to do so we'll be watching those greens i just wanted to say particularly thanks to winona's leadership especially in a transition

through this project it's done tremendous amount to keep the i.t. department on track and keep this progress moving. >> thank you. it's a true team effort. i have a great team. >> commissioner: well done. hard to believe it's actually here and happening and we're here to see it. we've all gone through many years. good work. mr. wagner was instrumental too because it was a job to convince the city in a novel way was necessary and they were willing to do that because i know that was one of our very practical issues.

how do we tell the number of hundreds of millions over many years. i don't think the city's taken on that. >> we've had a tremendous amount of support from the policy makers in the project. >> commissioner: so i see since you'll have an outside audit so to speak with the dlra march 20, the next quarterly report will on the help confirm how well epic think we're doing >> just to clarify they have an independent audit review. and it's a prescribed spread sheet we own with a full checklist but i'd be happy to bring that back to you assuming the timing is right for the next

presentation. >> commissioner: you should get the kudos they're going to give you. commissioners any further comments. commissioner guillermo? >> i wanted to add my conditi conditiconditio condition -- congratulations for this epic effort in this bill. and six years seems like a long time but i think given the state the system was in in what was required and it's a collaboration of team work you've been able to pull together and i want to con dw t dwrat -- congratulate you and look forward to the next report. i can't wait to see how that

goes. >> it meant we could take care of some things and be ready for epic. while there's an i.t. component to it as a whole organizational part to this. the success rests on the organization adopting this and i've seen change in our organization to make that happen. >> commissioner: thank you. commissioner green. >> i want to say same thing commissioner guillermo said and i'm an epic survivor. as someone in that category i'm impressed the way you're leading and how everyone is coming together and i know what it take and it's monumental and impressive what you're doing. >> commissioner: i think those who have been here long enough realize the different soft starts we've had and it turned out very good because many of us

have gone through various times where we had to have the transition within our own lives and if those people took the time that we are all taking, i think it would be an easier acceptable transfer for many of us. i think considering the complexity of this department and the fact that you've been able to actually have a schedule that shows it's not just the hospital it's the first wave of the delivery system that i think say better achievement than most of us were looking for. >> i wanted to say i think this is really impressive especially from someone who actually start the process at the same time i got appointed to the commission.

i've seen as two years ago we have a lot of questions answered and weren't quite sure if all these things can be implemented on time and so there are a lot of back and forth discussion and to see the progress and it's exciting to see we finally organizing the system to keep up the pace with the current technology. this is just where we start and we can start to go in terms of using the technologies. >> the value is for the patients and the data we'll get from this. >> commissioner: there was no public comment? >> clerk: no public comment. >> commissioner: if there's no further comment we'll go on to the next comments. >> clerk: item 10 is other business and have you the calendar before you and we

revert back to our regular schedule after the holidays so we'll have the meeting and then go from there. >> commissioner: thank you, if you have any questions ask him. >> clerk: item 11 no joint conference committee for a while so nothing to report and item 12 is a consideration of the closed session. >> commissioner: commissioners, a motion for a closed session? >> second. >> commissioner: all those in favor of the closed session please say aye. >> aye. >> commissioner: all those >> commissioner: commission will take a vote to go back to open session. in favor say aye. commission will now take a vote whether or not to disclose the discussions in the closed session. >> commissioner: motion not to disclose close. >> commissioner: all in favor of

not disclosing the discussions please say aye. >> aye. >> commissioner: motion for adjournment is in order. >> so moved. >> second. >> commissioner: all in favor please say aye. >> aye. >> commissioner: this meeting's adjourned. >> growing up in san francisco has been way safer than growing

up other places we we have that bubble, and it's still that bubble that it's okay to be whatever you want to. you can let your free flag fry he -- fly here. as an adult with autism, i'm here to challenge people's idea of what autism is. my journey is not everyone's journey because every autistic child is different, but there's hope. my background has heavy roots in the bay area. i was born in san diego and adopted out to san francisco when i was about 17 years old. i bounced around a little bit here in high school, but i've always been here in the bay.

we are an inclusive preschool, which means that we cater to emp. we don't turn anyone away. we take every child regardless of race, creed, religious or ability. the most common thing i hear in my adult life is oh, you don't seem like you have autism. you seem so normal. yeah. that's 26 years of really, really, really hard work and i think thises that i still do. i was one of the first open adoptions for an lgbt couple. they split up when i was about four. one of them is partnered, and one of them is not, and then my biological mother, who is also a lesbian. very queer family. growing up in the 90's with a queer family was odd, i had the bubble to protect me, and here, i felt safe. i was bullied relatively

infrequently. but i never really felt isolated or alone. i have known for virtually my entire life i was not suspended, but kindly asked to not ever bring it up again in first grade, my desire to have a sex change. the school that i went to really had no idea how to handle one. one of my parents is a little bit gender nonconforming, so they know what it's about, but my parents wanted my life to be safe. when i have all the neurological issues to manage, that was just one more to add to it. i was a weird kid. i had my core group of, like, very tight, like, three friends. when we look at autism, we characterize it by, like, lack of eye contact, what i do now is when i'm looking away from the camera, it's for my own comfort. faces are confusing. it's a lack of mirror neurons

in your brain working properly to allow you to experience empathy, to realize where somebody is coming from, or to realize that body language means that. at its core, autism is a social disorder, it's a neurological disorder that people are born with, and it's a big, big spectrum. it wasn't until i was a teenager that i heard autism in relation to myself, and i rejected it. i was very loud, i took up a lot of space, and it was because mostly taking up space let everybody else know where i existed in the world. i didn't like to talk to people really, and then, when i did, i overshared. i was very difficult to be around. but the friends that i have are very close. i click with our atypical

kiddos than other people do. in experience, i remember when i was five years old and not wanting people to touch me because it hurt. i remember throwing chairs because i could not regulate my own emotions, and it did not mean that i was a bad kid, it meant that i couldn't cope. i grew up in a family of behavioral psychologists, and i got development cal -- developmental psychology from all sides. i recognize that my experience is just a very small picture of that, and not everybody's in a position to have a family that's as supportive, but there's also a community that's incredible helpful and wonderful and open and there for you in your moments of need. it was like two or three years of conversations before i was like you know what? i'm just going to do this, and i went out and got my prescription for hormones and started transitioning medically, even though i had

already been living as a male. i have a two-year-old. the person who i'm now married to is my husband for about two years, and then started gaining weight and wasn't sure, so i we went and talked with the doctor at my clinic, and he said well, testosterone is basically birth control, so there's no way you can be pregnant. i found out i was pregnant at 6.5 months. my whole mission is to kind of normalize adults like me. i think i've finally found my calling in early intervention, which is here, kind of what we do. i think the access to irrelevant care for parents is intentionally confusing. when i did the procespective search for autism for my own

child, it was confusing. we have a place where children can be children, but it's very confusing. i always out myself as an adult with autism. i think it's helpful when you know where can your child go. how i'm choosing to help is to give children that would normally not be allowed to have children in the same respect, kids that have three times as much work to do as their peers or kids who do odd things, like, beach therapy. how do -- speech therapy. how do you explain that to the rest of their class? i want that to be a normal experience. i was working on a certificate and kind of getting think early childhood credits brefore i started working here, and we did a section on transgender inclusion, inclusion, which is a big issue here in san francisco because we attract lots of queer families, and the teacher approached me and said

i don't really feel comfortable or qualified to talk about this from, like, a cisgendered straight person's perspective, would you mind talking a little bit with your own experience, and i'm like absolutely. so i'm now one of the guest speakers in that particular class at city college. i love growing up here. i love what san francisco represents. the idea of leaving has never occurred to me. but it's a place that i need to fight for to bring it back to what it used to be, to allow all of those little kids that come from really unsafe environments to move somewhere safe. what i've done with my life is work to make all of those situations better, to bring a little bit of light to all those kind of issues that we're still having, hoping to expand into a little bit more of a resource center, and this resource center would be more those new parents who have gotten that diagnosis, and we want to be this one centralized place that allows parents to

breathe for a second. i would love to empower from the bottom up, from the kid level, and from the top down, from the teacher level. so many things that i would love to do that are all about changing people's minds about certain chunts, like the transgender community or the autistic community. i would like my daughter to know there's no wrong way to go through life. everybody experiences pain and grief and sadness, and that all of those things are temporary. ♪ >> welcome to hamilton recreation and aquatics center. it is the only facility that has an integrated swimming pool and recreation center combined. we have to pools, the city's

water slide, for little kids and those of you that are more daring and want to try the rockslide, we have a drop slide. >> exercises for everybody. hi have a great time. the ladies and guys that come, it is for the community and we really make it fun. people think it is only for those that play basketball or swim. >> i have been coming to the pool for a long time now. it is nice, they are sweet. >> in the aquatics center, they are very committed to combining for people in san francisco. and also ensuring that they have public safety. >> there are a lot of different

personalities that come through here and it makes it very exciting all the time. they, their family or teach their kids have a swim. >> of the gem is fantastic, there is an incredible program going on there, both of my girls have learned to swim there. it is a fantastic place, check it out. it is an incredible indication of what bonn dollars can do with our hearts and facilities. it is as good as anything you will find out why mca. parents come from all over. >> there are not too many pools that are still around, and this is one-stop shopping for kids.

you can bring your kid here and have a cool summer. >> if you want to see some of the youth and young men throughout san francisco play some great pickup games, come wednesday night for midnight basketball. on saturdays, we have a senior lyons dance that has a great time getting exercise and a movement. we have all the music going, the generally have a good time. whether it is awkward camp or junior guard. >> from more information, visit

>> san francisco health services systems board will come to order. please stand for the pledge of allegiance. i pledge of allegiance, to the i ted states of america and to the republic for which stands, one nation under god, indivisible, with liberty and justice for all. roll call please. [roll call] >> item number -- >> item four is an action ti its of the minutes set forth below.

>> are there any corrections to the minutes? >> i move minutes be adopted as distributed. >> second. >> is there any public comment on this matter? seeing none. all those in favor. >> aye >> any opposed? it's unanimous. item number five. >> discussion item. general public comment on matters within the jurisdiction. >> i received a letter from united healthcare. if you haven't gotten it, you probably will get it. it will confuse the hell out of you. i gotten calls from our members. i'm sure clare has. saying that we can change our health plan from january to

march. we can change our prescription drug plan. it's open enrollment is octobe october 15th to december 7th. all these different thing that don't affect our members. there needs to be another letter sent out by united healthcare telling our members to relax or -- i don't know who else to say other than that. it's very confusing better. i'm sure the health board will be hearing from a lot of members. >> have you seen that? >> i have not. thank you for bringing that to our attention. >> i would ask, is there a member of united healthcare here, plan representative? maybe they can shed some additional light. >> i did sent an email the other day. it was my understanding there was 94 letters that went out to

hhs member. it could be little bit more than that. ly take that back to my team. the purpose of the letter was that medicare changed some guidelines for materials effective 1/1/19. some letters went out october and december 31st that did not have the language on it. the letter that members received was that language. we agree it doesn't apply to group coverage, unfortunately. it is a confusing letter. ly take that feedback. >> i would like to request that we follow the recommendation, that's been put forward by the prior speaker and if you know who the 94 are, that you just go ahead and send a letter to them suggesting it was sent in error and they should ignore it. if they have additional questions they can call you

rather than wait until the noise rises. >> l >> i will let hhs know if there's any concerns doing that. >> thank you. >> i have a question about the dental program. i called delta dental last week to enroll my husband and me. i was told i can opt in but i was told my husband could not. i asked them why, i was psalming that dependents were covered. the person i spoke to delta dental, said call the agency you get your insurance from. i called hhs and spoke to a benefits analyst. he said, oh, we assume dependents were covered. i'll have to check with delta

dental and get back to you. no one gotten back to you. i want to know if dependents covered? >> anyone from delta dental can answer that? >> she wasn't able to be here today? >> does anyone on your staff know? >> i assumed the same thing actually. >> it is affirmed that dependents are eligible. i did hear about this from the staff. we've been getting other question about that. we confirmed with delta dental at that time. [indiscernible] >> thank you. >> i name is gale ow.

i'm a retired teacher. i got the flier regarding kaiser's support with the hmo providing fitness membership and health extras. it's not a problem that it's actually listed for ccsf california. it came to my house. the entry is wrong, diane said to me that she could not get to the web opening by entering this address. my concern is that i clicked around to see what kind of wellness classes that were being offered. in san francisco, there are 115 classes and seminars, etcetera. which is a really wonderful kind of thing.

however, sacramento offers 146 classes. they offer classes that san francisco doesn't offer on things like fibromyalgia, shoulder, hiv, anti-body testing, varicose vain treatment and the resting metabolic rate testing and individual counseling. that's an important thing when you trying to manage your blood pressure. they have a class on starting insulin. in san francisco they offer cpr for children. also, they offer a class called cocaine anonymous. i'm wondering how this works?

thank you. >> are you talking to classes that are kaiser classes? >> yes. sacramento has 146, all those that i read out they have those and we don't. >> somebody here follow through on this with kaiser? >> we will. any other public comment? come up please. >> july brady kaiser permanente representative. ly take that question back. i'm not sure how facility determines which classes are available. >> thank you. any other public comment? seeing none.

item number six. >> discussion item. president's report, report by president breslin. >> president breslin: i have nothing to report other than to say that this is a start of the rates in benefits. i like to remind everyone of our fiduciary duties. i was looking at some old information i had. it said trustees can put the general good entire population as their highest priority. they must act for the sole benefit of the beneficiaries. just a reminder, we are trustees and fiduciaries which means we must work for the sole benefit of our members. any public comment on this item? seeing none. number seven please. >> clerk: discussion item. director's report.

report given by abbie yant. >> good afternoon commissioners. as highlighted in the director's report and reemphasizing president breslin's report is our staff is gearing up for the rates and benefit season and have a full calendar meeting ahead of us. our blackout period began in november. it continues through rates and benefit cycle. we'll be going over the calendar later in the meeting. the strategic plan is continuing to be rolled out and implemented and we have purchased a tool that's turned out to be pretty fantastic called cascade that does just that. it takes strategic plan and helps you cascade down to lower level to try to track and report on activities. our team with brian rodriguez

are helping us populate that tool and we're looking forward to being able to share some of the reports out with board in the future as we learn to use it and get a report. we're happy about that. i wanted to -- we have a couple of reports that we will make from the podium as part of the director's report today. one will be the close out on the diva second, there's two items that actually will be later in the agenda one being the rates and benefits cycle and other being the implements about -- highlighting the key steps in the board election. also, in the director's report we'll have d ma -- marina will speak to the express dashboard.

i wanted to call out that la latisha was able to attend one of the calpers hearing. where they approved redistricting of the calpers region. they went from five to three. we included the materials in the director's report. i found it fascinating how the discipline with which they made the decisions and some of the information is not new to us about the high cost of healthcare in northern california. i felt that was important information for our board to be aware of. latisha is here should you have any questions about that. on the other matters that we track is the things that come up here at the board. i'm working city risk management

to develop a risk management policy which will address some of the questions we had around audits. we're still exploring the home services with kaiser. michael made some comments from the madd report after we closed this agenda item. we're still researching with assistance of our medical experts on the cataract surgery question. we are in process working through a new partnership with workers comp. i'll let pamela speak to any the audits still in progress. i would appreciate if mitchell would come to the podium and then marina will speak as well.

>> good afternoon president breslin and commissioners and board members. chief operating officer of the health services system. the dependent how -- audit report is behind the director's report. as you recall starting around the end of 2016 and 2017, we began a discussion on doing the first full denverificatio depent verification audit. however, looking at not only your fiduciary responsibility but the system fiduciary responsibility doing a complete audit. which is typical in industry standards and benefits and administration as well as the public sector. i wanted to present some of these