doesn't work for me. they were looking for more robust services outside of those traditional 9:00 to 5:00 hours. then the last area where we heard pretty consistently a desire for support was in alternative medicine. primarily chiropractic care and acupuncture. again, finding providers who specialize in those areas was difficult. for members to find covered providers. and so members often were paying -- reported paying out of pocket or using their fsa funds to access those services with providers that they felt met their needs. and actually we heard that around mental health as well. there were members who had mental health care providers that they wanted to stay with and ended up using their own funds or fsa funds to stay with the providers because they were not covered in their networks. and with that, i'm going to turn it over to shenay who will talk

to you about the feedback we received on the models. >> good afternoon. as part of the engagement process, we presented five models of potential or possible health care model options are or options that are hypothetical options that members were -- could potentially look for in the future. the first model -- during this presentation, members were able to share questions -- ask and share questions about the models, look at the models in detail to figure out what things were appealing and then also talk amongst themselves. really to determine what models were appealing, what questions they had and what were priorities as they select future health care benefits. the proposed models, there were five selected.

the first one was the current plan offering. i won't go into too much detail about that. the second model that was presented was the plan offering third party navigation and advocacy support. for this model, support is considered to be any -- third party service provider that is not at h.s.f. that is not the member's employer and not the health care provider or insurer that advocates for the members and supports them throughout navigation process of health care. the third proposed plan was a consolidated plan that included kaiser as well as one other insurance company. and that one insurance company provided -- will provide both an hmo and ppo. the fourth model that was offered was a system competition model. that model offered kaiser as well as three other fully

integrated health care providers and another ppo. the fifth model was the private exchange model and this was described to members as the cover california model. so you have a variety of insurance providers that offer multiple and various insurance plans at different price points and different services. that is created to offer a little bit of flexibility and choice around offerings, as well as price point for members. one thing that i should note, kaiser was available in each of those proposed models. i'll give you a little bit of feedback from each the models, the model one was the current offerings, i so won't go into detail. model 2 is the current plan offerings with third party

support. when we think about or analyze the data, one of the key takeaways we got from the model, was there was mixed feedback around what third party support services were. when they asked question, it was really around trust. can you trust the third party support provider? what is their level of expertise in the health care profession and medical needs? are they going to -- this third party provider held accountable to the same hipaa standards and laws in the medical field. this was about trust and wondering the fidelity of the provider. one of the key questions that came from that was how third party support impact complicate the overall experience of care. so while members were fairly interested in this, they had a lot of questions about trust fidelity and the bureaucracy

that might come, or the complication that might come with the third party support providers. model 3 was the consolidated plans. that provides two options. the key takeaways around that was how does having three options for health care benefits impact choice? is it going to minimize the way that i'm able to select a provider? is it going to minimize my selection for doctors? will i lose different options around that? and similar with coverage. if we only have three health care options, how does that impact the way that i receive coverage? and the last one was around cost. some people thought that having only three insurance options would either drive up costs, because with only three, that limits the competition. and others thought because more

people might be under each plan, that could drive down costs. that was a big question around costs and there were varying sides of that. the fourth model is a system competition model. this included kaiser as well as three other fully integrated health care insurance providers as well as another ppo. for those of you who aren't clear about what an integrated health care system is, it is all of the care provided under unumbrella. they're provider, insurance company, et cetera. one of the questions was how will integrated systems impact ability to receive coverage outside of network? so by integrated systems having -- housing all of their services in-house, how would

that impact members in seeing specialists or getting second opinions. that was a big concern. and finally, the private exchange model, t this model rad a number of concerns. some of the biggest questions were around how might the plan options and choices affect equity, quality and accessibility in relation to care. a lot of the insurance providers will provide different services at different price points and a lot of members wondered if i select a lower price point for my health insurance plan will that mean that i'm selecting a lower quality of care. so there were a lot of questions around there. there were things that came up

around all of them. third party support services were offered in three of the five models. and they wondered if third party support, could that be offered in all of models?

and another thing that came up again as i mentioned was the level of quality and accountability that the third party provider would have. as we explore different, or as members explore the different options, everyone is worried about coverage, or a lot of people questioned how their coverage is impacted once they retire as they travel or for members independence who live out of the country and out of the bay area. >> i'm going to talk about the major themes of the asks that members had. we asked them if there were any other services they were looking for when they think of what hss

provides to members. and some of these are going to be overlapping with what shenay said about the models. a key theme we heard was around service standards and accountability. what can hss do to extend more support for members to make sure that standards are met and make sure that patients are being served particularly around can we make sure that there are mental health providers available to us. can we make sure that if the benefits say they cover alternative medicine, that the providers are there within network? and could we think about the third party support? because having support in the navigation and advocacy were something members were interested in if they believed it was going to be a high quality benefit they could trust. members also, a lot of issues around communication. again, support around the advocacy and problem solving,

communicating in general about benefits. i know that hss does a lot of communicating, but there was still a lot of things we heard about from people, where members just weren't aware that the service was available to them. so there was -- they were looking for better communication. and another area where they were looking for communication was around the transition to retirement. would say in every single focus group we held, this question came up, either from people who are approaching retirement, people who recently retired, questions around what is this going to do to my benefits? how can i plan for this? what are the implications for me and my family? there were many, many questions that people had about that transition. then the last theme that arose was meeting population-based needs. i know that abbie mentioned we had some focus groups specific to particular populations we

know have specific needs. some of those are first responders. some are lgbtq members or members who live outside of the bay area. and there is work to be done to engage those subgroups and really make sure that we're meeting the needs of those people. i want to note that there are some things that hss is already doing around those areas. that these acs are -- actions are under way. one is around the service standards and accountability. as h.s.s. enters the renewal period, this is an opportunity to deepen the conversations. abbie mentioned they were having conversations about access to providers, particularly mental health providers. as far as enhanced communication, there is an open position for a communications director.

there is a search going on and when that person is brought on board, it is hoped they can promote hss advocacy services that do exist and make sure members are aware of when it's appropriate to call hss. we heard mitchell talking about people calling during open enrollment, but one of the things we heard in the focus group, members didn't actually think to call the health service system when they had issues that arose. we might hear about challenges in finding providers, but very few of them called hss for the support that could have been provided. and lastly, around meeting population-based needs, hss is working to develop strategies to monitor and enhance services to meet the needs of these groups and that is actually something that is part of the strategic

plan. i want to talk a minute about just how the things we heard and the things that hss have opportunities to take action align with the strategic goals that have been outlined in the strategic plan. one of the things that members asked for was that hss continue to negotiate really hard for affordable comprehensive and high quality care. we heard a lot of appreciation that hss was doing that work and they want to see it continue. another of your goals is reducing complexity and fragmentation. and one way in which hss can do that is supporting that transition to retirement. and also encouraging improved communication among providers. we heard from some members who felt like there was just a breakdown in the mune indication of their -- communication of their network and perhaps hss

could advocate for better support around that. engage and support. we heard from members who wanted more variety and more frequent communication around the plan materials. people access different -- access their information in a lot of different ways, so making sure it's available to them early and in a variety of formats was asked for. we heard from a number of members who asked for greater translation services and support. for both support for open enrollment, but in other areas as well. there are lots of languages spoken by hss members. and, again, just increasing the awareness of the services that are offered by hss would be beneficial to members. choice in flexibility. advocating for improved and expanded access to providers, particularly those mental health providers, alternative medicine and the primary care.

and as far as whole person health and well-being, ensuring the wellness programs are accessible to all, including shift workers. we also heard a request that maybe hss had a role to play in providing members with checklist of questions they could ask of their providers, or insurers to help them be better prepared for their own advocating. and we heard a lot of positive things about eap services and members were looking to have those continued and expanded. so i just want to go over big picture summary of what we heard, our key takeaways. number one, the work we did, when we do this kind of conversation with community members, sometimes you hear big surprises. that wasn't the case.

what we heard really affirmed a lot of things that staff is already aware of, both the positive and the negative, which is really valuable information to have. it raises some really important questions for hss around what are the barriers to prevent members from calling hss when they could? and how can this organization strengthen communications with members about plans and benefits? how can we better support members through the transition to retirement? what are additional ways hss can hold providers and insurers accountable for excellent care? and are there targeted approaches to improving outcomes for populations with specific needs. as i mentioned in many of these challenges are already being addressed in actions taken by the organization right now. with that, we're happy to take

questions. >> president breslin: any questions? >> commissioner follansbee: i have a couple of questions. one, it's impressive and i like the summary about this enhances a lot of the themes that we've already been discussing and helps us feel tuned into what the members are. are you happy with the sample size? was that -- what was your target? and number two, i was kind of curious about the response to the urgent care issue. because urgent care has a broad -- we've been dealing with this to some extent over other issues. they have a broad -- it has to do with availability, location, shift workers, all sorts of things. and also without integrated care model, which we support some nonintegrated, urgent care has the specter of actually not bringing communication.

so i'm just curious to know if you have enhanced -- first the question about the numbers and then about the urgent care issues and if you have a sense of what members thought that meant and what they wanted. >> so the first question, i think we were aiming for more. and i will also say we were happy with the turnout we got. primarily because the representation was so diverse. we looked at so many different measures for where people worked, where they lived, what their educational background, languages, race, ethnicity, all these factors and plans. and we felt like we were hearing from the spectrum of members. i think we were aiming for more like 200 and in the end we got 117 focus group participants. and then additional close to 50 who provided surveys. so we got close to our number. and as i said, i felt like the

representation was good. i also felt that there was a lot of consistency in what we heard which is useful to hear. you know, the things that people were happy with, the things that people were frustrated with, and the questions they had around the models. when you start hearing repeats of the themes again and again, then you know you're hitting a lot of what you want to hit. the question around urgent care. i should mention that there is a report that we're finishing that has a lot more detail on all of these aspects, so you'll be able to look at that when that's complete. but i would say it's interesting that you bring up that point of the connection and coordination between urgent care and other care. because one thing that people did say was that they liked urgent care particularly when it was available in association with the hospital, so not free

standing urgent care clinic, but the urgent care aspect of their own network, because then they knew that the information would be communicated and if there was a problem that urgent care couldn't take care of, it could be escalated to an emergency room in their network. that said, there was a lot of appreciation for the free standing urgent care clinics. especially those who can't make it to a doctor during the regular office hours. >> i would be interested, now that we've had this foray in terms of getting feedback from the director. and we've made a larger decision to defer, going out to the market, how we're going to sort of keep this fresh to align with that action. >> nice queue up for my closing remarks on this. thank you very much.

i didn't even pay him to do it [laughter]. i want to say that the recommendations concludes our findings are in alignment with goals. while there are areas identified as opportunities for improvements, the findings reflect a positive experience interacting with health care providers. these findings are really qualitative in nature and confirm that the benefit design serves members through quality, sustainability and well-being, core facets of the mission of hss. and we are staying abreast of the health care market place in an ongoing way. as we begin this renewal process for plan year 20-21, we will in parallel continue the ongoing market assessment to determine what the right time to advance one of the new models for the health plans and restart the

procurement process. so this is kind of a moving train which we, i think, have on reflection have really -- it's been of great value thinking deeply about what it is we're trying to accomplish and getting this input from experts and members that is complimentary. so i think that will all inform us. i've asked my team to help put together what that parallel process would look like to sort of double-team an annual renewal process, while we fully prepare for a new procurement process. just because of the length of time that it will take to do the full procurement process, we will have to do it in parallel. and i believe we'll be able to do that this year. the market is the market. the sutter decision i think will

be very informative. the rollout of the canopy product that you see is going full force. so there are some major shifts occurring in the market. anthem is making a play in town. so there is quite a bit happening that we're tuning into and paying attention that -- that is the rationale behind why we delayed in this last year. so it seems as though it were the right decision looking back on it. but it is something we have to look at in parallel with our responsibilities to have a solid renewal for the 21 year. >> i just want to thank the consultants because i think that the report shows number one, understanding of the issues that we are concerned about, and also from the responses that i heard, that the respondents who

participated also were willing to respond in depth. and did not respond in a superficial or casual way. that's something we should thank you and all the respondents who did participate by questionnaire or in person. i want to thank everyone. >> president breslin: any public comment on this item? seeing none. item number 12. >> if i may, i would just like to add one thank you to natalie and letisha on the team that led the effort to engage our members. and it is a herculean effort. it's an area of growth that we have and the reason we're bringing in a communications director, because we don't have the best way, clearly, yet, to communicate around these types of issues. the open enrollment messages are get through well, but we perhaps can learn from that and continue

down that path to more readily engage members on as-needed basis. item 12. reports and updates from contracted health plan representatives. >> good afternoon, denise rodriguez with kaiser permanente. last time, i stood before you and you had many questions about the transportation benefit we're adding january 1. i wanted to come back with more information. we were remiss in not providing an upsooner. so a -- update sooner than now. so my apologies. what i would do is start with defining the benefit. commissioner scott asked what are we paying for. i want to explain the exclusions and what caused the exclusion of a particular benefit and what our plan is moving forward. the benefit -- and i also want to emphasize that the rates that

you're charged for the benefit does not include the excluded benefit. i'll walk through that. so the benefit, if we cover up to 24 one-way trips -- i just woke up with a scratchy throat, so i'm sorry if i'm not clear. we cover up to 24 one-way trips, 50 miles per trip per calendar year. it's for nonmedical transportation. there is a few conditions that need to be met. need to be going to a appointment for a covered benefit in the evidence of coverage of course. they have to use the vendor that we contract with. so pretty basic stuff in terms of that. this cost that a member would pay for the transportation is zero co-pay. so that's covered at 100%. there are nonmedical transportation exclusions. i think the one that was particularly of interest last time is transportation for members who require a gurney

wheelchair van. that is excluded and i want to explain why. let me emphasize though, if somebody is in the wheelchair and can make it to the curb, then the driver will assist them getting into the vehicle, store the wheelchair and get them out. and getting them in the wheelchair again on the way to the appointment. so when we rolled out and offered the benefit, it was with the idea it wasn't going to be fully implemented, that we were going to roll it out with what we could provide in a short time frame we had. we started discussing the benefit in may and june. many of you commented, and from i think the audience as well, last time, there are many vendors that pride that service. that -- provide that service. that is correct. the challenge is we have to go through a regulatory process to contract with them and cms has requirements that we have to meet. and we have to get system changes done to track it internally. and that takes about a year.

and so what we try to do to get this to go to market for january, was to look at what is a vendor that we're already approved to use. and that's the vendor we use for the medi-cal population. they don't have the same requirements for the gurney, we're able to access other services to provide that benefit to the medi-cal population, but because of cms requirements, we're not able to that now until we contract with the new vendor. so that's the challenge that we're faced with right now. i also want to emphasize that in no way are we trying to exclude anybody. that is certainly not our intention. our intention was to try to meet the needs of what we heard from the medicare population with san francisco health services system to provide a benefit that would benefit the majority of the

population initially. i do also want to say this is the benefit that we're only offering to san francisco effective january 1. so it's kind of special in that way we're the only one we're doing this with because you had so much passion around this. as we continue to fully implement the benefit, we expect to add the benefit going forward. i can't give you a time frame. if it's going to happen 2021. but what i am committed to doing is having more check ins with you all. you can decide how frequent that can happen. i need to stay close to mitchell and abbie -- executive director yant, around how the implementation is going because this is a new benefit. and we want to make sure that any bumps in the road get addressed quickly and effectively and efficiently. so i will stop there and see if you have any questions or

comments. >> well, thank you for answering my preliminary questions. and from what you said, where you are at the beginning of january will not necessarily be where you are maybe mid year in terms of trying to contract with wheelchair services or get the appropriate clearances? and i think i heard you say you're trying to work that through to do that. >> so we're starting that process. it takes about a year. we've been focused on trying to get this up and running since january 1. now that we're there, they're starting the process to add the benefit. they're working with the current vendor to see if they could add it. that would be an easy fix, but we also have to get the systems up to speed to meet the requirements of cms. so to answer your question, i don't know. we're working on it. i will answer to say we're committed and working on it.

i can't give you a time frame. but i will know more as the year goes on and will be happy to provide an update. >> i would be interested in at least a quarterly update in the area to track your progress. i recognize that licensing and vendor contracting in your organization, like in most large organizations, takes a bit of time. so, some kind of status would be helpful. >> okay, then i plan to come back again in march, unless sooner. >> i appreciate the update. i think it's quite -- i understand what the issues are and the hurdles that have to be met. listen, in my own mind, i was distinguishing wheelchair to gurneys. gurneys are a much bigger deal. i was not focused on people who need to be in a gurney. that is a bigger hurdle. i guess the question i do have, though, one question, one point,

does the -- say someone is in a wheelchair and needs an attendant to help them get to the appointment, you know, a spouse, partner, whatever. are those people transported as well, or do they need to then help their dependent into the van and then leave and come by a separate route? because that would make a difference to me about the comfort level, about access. >> okay. i'm going to pause and ask one of my colleagues if they know that. if not, we'll have to come back. my gut tells me they're included. so, yes, they can ride in the car with them. >> commissioner follansbee: good, because i'm much more comfortable with that. when we do revisit this, if he could have a sense of how many didn't qualify. so we have a sense of the volume. because none of us want to make

a big deal over an issue that really is, you know, can be handled another way. if we had some data on your access. >> and i think that's why the quarterly check kinz will be good. we have communication plan we're working with abbie on right now to roll it out. the first month is going to be slow. the second month it will build. and the third month we'll see more. so we'll keep you apprised of what is going on through regular check ins. >> commissioner follansbee: one more question. so it covers the san francisco facilities, mission bay and then the geary and french campuses, but doesn't cover south san francisco or oakland or -- i'm a little confuse about the limitation? >> it's a benefit for your entire population, so depending on where they live, it would cover them up to 50 miles per trip. >> commissioner follansbee: thank you.

that claver -- clarifies it. >> thank you. >> i'm going to give denise's voice break and make our second couple of announcements here. so we do have a strike notice from nuhw, the national union of health care workers is that will begin the 16th of december and will last through the 21st of december. these are nonphysician behavioral health professionals. and so they will be going on strike. we do -- we are prepared for this. all facilities will remain open. routine appointments may be rescheduled, but anyone who needs care will get care and we're prepared for that. we also have received notice of a sympathy strike through the operating engineers local 39. and those are engineers for the

facilities in northern california. so i wanted to make sure is that you were aware of that strike notice. the second announcement that i have is that we have chosen a new c.e.o. and this was -- many people have commented this was very quick. i think this speaks to the fact that we've done a lot of succession planning and gregory adams has been named the c.e.o. of kaiser permanente. more than 30 years of appearance in the health care industry. a longtime kaiser permanente employee and really has worked closely with bernard overtime, so we're exciteed as an organization to have a new c.e.o. and i wanted to share that with you. >> president breslin: any public comment? >> actually, not a public comment on that.

another vendor update. >> go ahead. >> i'm with aon, i'm not a health plan, but i do have update at the request of executive director yants over the medical. i did reach out to them and had a conversation. i wanted to give you an update on what the conversation was. so i pulled off -- at the top, i've included the link that i looked at, which is the one medical website under faqs. so the link is there. it's in regard to the annual membership fee we heard some membership complaints around to access their provider. and what i highlighted at the bottom of the first page is that payment of that annual membership fee is not a

prerequisite for receiving medical care in one medical office. >> president breslin: what does that fee give you? >> the way one medical described it to me. they think about it in two pieces. they provide the care in the office and then they have technology. so their app, making appointments online, virtual visits, senior electronic medical record online through the app, kind of that concierge piece. if you wanted to see a provider, dr. smith at one medical, you can pick up the phone. you can call. you can make an appointment. you can see the provider, have the appointment. it will go through your insurance. and that's the end of it. there is no problem with that. if you want these additional technology services, you would pay that fee. in addition, at the bottom of this, it says for more information click here.

one medical does have financial assistance and so if members wanted to call in to see if they are eligible for financial assistance, they can do that as well for the annual membership fee. it does appear they would potentially help with some of their out-of-pocket costs, no co-pays, but the other out-of-pocket costs. if we want more information, we should invite one medical back to speak with you. does that help? >> president breslin: yes. that's makes it more clear. first you say they can't charge a fee. and then you say they can charge a fee, but -- so thinks the reason they can -- this is the reason they can charge the fee for extra technology. that makes sense. >> correct. >> commissioner follansbee: i'm not sure i need to hear more from one medical.

i do think that it does raise again the issue of the question i asked of our outreach survey about urgent care and all that, because obviously you know, to buy membership in one medical would be think being getting ongoing care. i mean, like, urgent care. in their own sense. and i don't think that our own networks, through any of our providers, actually, they belong to any of those networks. i think that would be something -- >> one medical? >> one medical. >> they do. >> commissioner follansbee: they do? they are? >> yeah, they kind of -- i don't know for certain who all they're connected with but i think it's pretty much everybody. >> commissioner follansbee: maybe we do have them back, because the member who is a hill physician patient is seen there,

is the lab and the encounter automatically transferred to some medical record? so there is continuity of care that we heard the members want? there are pieces about all of this that i still am a little bit confused. i can understand the ease of making an appointment online if you're getting your physician care at one medical, because they're all over the city and i assume outside the city limits, but i don't know. again, these are issues that we would need -- would want to know in terms of how to direct members in terms of -- what members want and need. this is not really a substitute if it doesn't meet certain criteria. >> they came on the market 15 years ago? and they've been around a while and they were cutting edge when they came on market with all the technology. and they've stayed focused on primary care and they have expanded. i'm not aware that they do

urgent care. >> no, not in the office, but they would have virtual urgent care. >> yeah, so during regular business hours, that type of things, but they don't run any of the urgent care clinics that i'm aware of. >> commissioner follansbee: the question is, can people walk in and get care? >> yes. >> i know they don't have 24-7 coverage. i have former colleagues who joined one medical as physicians and so there is nothing in my mind about the quality of care they deliver or the technology or anything, that's not the issue. the issue is really this wholistic approach to the delivery of health care, which i think is something that we as a board, we as a health service system, are really interested in promoting. >> maybe we should ask them to come. >> president breslin: any public comment on the item? thank you very much. no public comment.

moving on. item 13. >> item 13, opportunity for the public to comment on matters within the board's jurisdiction. >> president breslin: public comment? clare? >> good afternoon, commissioners. i'm representing dennis kruger and firefighters. dennis couldn't find parking. found the garage overfilled. and so he sent me a text. he was very frustrated and he left.

>> so they're following up. they want to wish everybody happy holidays. by the way, we loved abbie's, director yant's message, it was nice to see. and that was pointed out at our retiree meeting yesterday when we had the party. so we are here to wish everyone happy holidays and also -- sorry, always to thank the staff. we have the best staff in the world. i'm sorry, i get broken up about it. health services workers, our staff is the best in the city and i've worked in a lot of different departments. i won't tell you stories, okay? but we have the best. they work hard for us all year. open enrollment is a killer. and they make it easy for all of us. and all the services that they

provide, you just need to know that all the retirees are grateful. and all of the associations, whether it's retired fire or vpoa, or retirees, all of us are extremely grateful. happy holidays and happy new year and see you next year. >> president breslin: any other public comment? seeing none. item number 14. >> item 14, opportunity to place items within the board's jurisdiction on future agendas? >> president breslin: i think we have our work cut out for us. any public comment? we're going to closed session and have to be closing the doors. >> item 15, vote whether to hold a closed session for the public employee evaluation for hss executive director. this is presented by president.

>> i need a motion -- >> i move that we vote to hold a closed session for the public employee performance evaluation. >> i'll second it. >> president breslin: public comment? all right. all those in favor? okay. unanimous. we will now be going into closed session. >> president breslin: we're back. item 17. >> item 17, possible report on closed session regarding the employee evaluation presented by president breslin. >> i move that we not report on the action taken in closed session regarding an employee

evaluation. >> president breslin: that's 18. but i don't know what this 17 is. 17 is the action. reporting of the action. >> i move that we not report on the action taken in closed section regarding employee evaluation. >> second. all right. all those in favor? opposed? it's unanimous. item number 18. >> item 18, vote for elect whether to disclose any or all of the discussion held regarding the employee evaluation in closed session. >> i move that we not disclose any or all of our discussion held in closed session. >> i second. >> president breslin: all those in favor? any opposed? it's unanimous. all right. so this is item number 19. this meeting is adjourned. >> happy holidays. >> happy holidays.

[cheers and applause] >> let's give it up for the tree all right. good evening, everyone. around of applause for the young people theatre company and its director. they were amazing. they will be performing the little mermaid next month at the museum. bring your family, come out and support. all right. let's get everybody up. are we ready to light this tree? [cheers and applause] [♪]

my name is phil ginsberg. i am the general manager of your san francisco recreation and parks department. we want to welcome you to the 90 th, think about that. the 90th annual tree lighting. this started december 20th, 90 years ago on john mclaren's birthday and his spirit is here tonight because it is not raining. [laughter] this is truly one of our signature events of the year. certainly one of my personal favourites. and if you see all the incredible stuff happening here down j.f.k., if you haven't walked down the street, there are rides and food and games and you get a goat of conservatory of flowers from night bloom or the outside of the building and the inside of the building are all lit up. it is super cool. the start of our show tonight is right next to me.

our mayor, london breed. mayor, thank you for joining. we will have you wait just a second. the mayor is a magician and she will make the magic happen tonight with this tree. before we make that happen, we need to acknowledge some other special guests who are here that make this happen tonight. they have joined me on stage. present tonight we have state assembly member phil taking who is right there. [applause] i think our assessor recorder carmen to is here or on her way, and then we have our recreation and park commission, our president, mar buell -- mar you will and all of the commissioners.

we have a number of other folks from the parks and recreation advisory committee who are here who helped guide park policy. we are grateful for their support. and i see a few special department heads starting with our police chief bill scott who is here. i saw deputy chief david lazar, the head of the department of the environment is here. and many other special guests. if i have missed anybody on this stage, i apologize. i saw a project level in the house. thank you very much. we do events like this four times a year. our family friendly free events would not be possible without

the generous support of our sponsors or partners including kaiser permanente, byward market , the san francisco parks allianz, i saw the president of the parks alliance in the house, and recology. and of course,, none of this would be possible without the hard work of the best staff. the best and hardest working staff in city government. the recreation and park department staff. let's give them a big round of applause. [cheers and applause] so let me talk for a quick second about the tree itself. this is san francisco's official holiday tree. this tree was planted by john mclaren. it is a monterey cypress that is over 130 years old. it has aged a little bit. it might have lost a limb or two over the years, but it is still

standing tall. tonight it is sporting over 550 lights. and what makes this tree lighting special is that this is the last tree lighting, this is 100 -- the 149th year of golden gate park. so next year we will celebrate the hundred and 50th birthday of our entire park system in san francisco. let's give that around of applause. [♪] i mentioned our partners and i want to bring up one special partner. we have many, that help us provide programs and provide services for kids and help us to special events tonight. one of those partners is kaiser permanente. tonight, the chief operating officer of kaiser his here to

join us in celebrating the start of the holiday season. help me welcome miss miller who will come up and say a few words [applause] >> good evening, everybody. happy holidays. welcome to tonight's festival on behalf of kaiser permanente. we are a proud sponsor of recreation and parks' annual tree lighting ceremony. can you believe it is 130 years old? what we would like to do is celebrate tonight and also welcome you to the theme for this next year which is making friends one data time. the 150th anniversary or celebration of golden gate park. 150 years. give that a hand. [applause] in honor of that, we come together across this beautiful city to this world renowned park to meet with friends and family and to make new friends as well.

reminds me of the campfire song, make new friends, but keep the old. that is how this city grow stronger and strengthens through his relationships. we will continue to support these beautiful events and we hope that you, too, will take advantage of tonight's festivities. thank you again on behalf of kaiser permanente. >> thank you. all right. so she is truly our park champion and chief. let's get it lit, she says. she really likes to party and she is not particularly patient, but let me bring her up. ladies and gentlemen, our mayor, london breed. [cheers and applause] >> thank you. all right. i love the theme music. first of all, thank you all so much for coming out today and braving the rain to be here with us tonight to celebrate 90 years

of a time honored tradition here in san francisco right in front of mclaren lodge. this is an amazing, fun event. fun for the whole family. i love the idea that we have so many incredible officials here, but i will need some kids to help me light this tree. [applause] so i see these patient young people raising their hand right down in the front row. have your parent bring you on up to the side of the stage so you can help me like this tree. [♪] i need some help here with this switch. [♪] all right. come on up. i think we might be almost at capacity. hold on.

come on over. come on, you guys. are you going to help? do you want to help? yes, i love it. you are brave. okay. this is what we are going to do. gather around the podium. gather around the podium, kids. stop trying to crash, parents. all right. because we know how to count, we will do the count down starting from 10, and then we will hit the switch. i will ask you, what is your name? >> jr. >> i will ask you and what is your name? >> sia. >> i will ask you to put your hands here because when i say to move it and to liked it, then you have to switch it real fast. okay? everybody in this place is going to help us count, but not until we say -- we will start with 10.

are you already? are you ready? okay. let's start. ten, nine, eight, seven, six, five, four, three, two, one. [cheers and applause] >> good job. thank you so much for helping us here today. have a wonderful december celebrating joy with your family friends and community. happy holidays, everybody.

>> good afternoon. the i