countless applications for big business, big enterprise, and consumers of all stripes, perhaps the most impactful and immediate and tangible solutions for our city is that 5-g will enable fixed wireless access for the home and small business. those markets are ripe for competition, particularly now as so many people are working and schooling from home during this extended pandemic. consumer demand is very, very high. we've never seen it higher for reliable high speed broadband access in homes and small businesses. so fixed solutions like 5-g home are a game changer. it solves what we've been talking about in kmupgss for a generation, the last mile for deploying reliable high speed

broadband -- communications for a generation, the last mile for deploying reliable high speed broadband, and it requires a concerted effort. 5-g home will provide a third option beyond what the incumbent telephone and incumbent cable companies offer today. it will lower prices for consumers, provide more options for consumers, others who depend on broadband in this digital age. next slide. thanks. while industry will need to play a leading role in bridging the digital divide, and we are here, and we are ready, the

hard truth is state and local governments also must play a leading role, and to further that hard truth, san francisco city policies, with all due respect, have exacerbated the digital divide. we've been meeting with city leaders and departments for over two years, and while some good progress has been made, there is so much more that needs to be done. and frankly, san francisco, my hometown, is falling behind other cities. city leaders must not only look to industry but look in the mirror and work in partnership with industry and stakeholders and community organizations to adopt the critical reforms needed because it is in all of our interests to do so. specifically, if you look on this slide, these are some of the barriers that we face to

deployment. specifically, that the city's master license or m.l.a., to attach equipment to light or utility poles was implemented the same year as super bowl l, five or six years ago. next slide, please. so again, this should be a top

priority for the city, and we at verizon have worked successfully with many california cities to align on reasonable, workable, aesthetic design standards to deploy 5-g at scale in digital equity zones in a timely manner. other cities in california have been forward looking and have made the tough decisions needed to lay the groundwork for 5-g deployment at scale. if san francisco does not act now, we risk losing our competitiveness to other cities and other regions. verizon is farthest along in l.a. and san jose in california. we've deployed 500 sites in los angeles and are working on over 4,000 more in the next several years. we've deployed over 400 sites in san jose and counting. we have partnerships with the cities of sacramento, san diego, long beach, and san

jose. oakland recently amended its m.l.a. to lay the groundwork for citywide 5-g targeting digital equity zones. those cities have aggressively leveraged network enhancements to help bridge the digital divide by working with carriers to make deployment conditions desirable with reasonable and workable design standards. next slide, please. here are some examples of verizon's small cell deployments in san francisco. the first is a 4-g and 5-g lte pole design that we've put on

our deployments. the next slide is a 4-g only deployment that is on a city steel light pole. the third picture is a colocated 4-g and 5-g, and then, the last picture is a representation of a deployment that we would like to make, a stand-alone 5-g deployment on a city-owned steel pole, a light pole, in the right-of-way. we have not yet deployed that, however, because of the uneconomic and noncompliant m.l.a. that we have with the city right now. we also need to get real here. there are certain laws of radio frequency physics that we're dealing with. wireless cannot be undergrounded, and 5-g colocation in many places is infeasible due to interference.

beware of people trying to sell you the magic monorail that will solve the problems of everyone. if it's too good to be true, it likely is. the longer the city takes to try to find the perfect exclusion, the more the city is exacerbating the digital divide, and the more adamant carriers will be to adding new poles in the right-of-way. the good news is that, for the most part, there are ample city poles in the right-of-way if we could renegotiate our m.l.a. to make it scaleable and cost effective at scale. there are a few isolated

targeted areas that new roles will need to be deployed because of a lack of poles in the right-of-way or pg&e poles in the right-of-way, and we are working closely with city departments and the city attorney's office on article 25 to accommodate this infrastructure. techniques like microtrenching where feasible will help to make this happen. we've been very successful in using narrow band or microtrenching methods in other cities across california and across the country. we would like to request the use of this method here in san francisco as it reduces traffic and resident disruption during deployment. so in closing, we have some additional slides if there are questions about our 5-g home

offering or what we've done in other cities, but let me close out by saying that this is a big deal, and should be a top priority for the city, and for me, it's personal as a san franciscan who loves our city and wants to see it thrive. we have a plan to deploy, but respectfully, outdated city policies and old fashioned city hall red tape are holding us back. we are here and have been working with city leaders and departments for many years, but we need the city to move with a greater sense of urgency to get this done. we want to continue to work in partnership with you and other

city leaders to get this done, and again, i want to thank supervisor safai and chairman mar for calling this hearing, and i'm happy to take any questions that you may have. >> supervisor safai: thank you, mr. reyes. i'm going to ask a few questions, and then we'll move onto the next presenter. i'm just going to ask that we keep the presenters to keep it to less than ten minutes because we have a whole broad list of presenters today. so wanted to jump in with a few questions. the first one is the f.c.c. has a new emergency broadband benefit in san francisco that would deliver internet service at no cost. what's your position on that? would you like to participate in that? >> yes. verizon is a big supporter of the f.c.c.s and congress' emergency broadband benefit, particularly during this pandemic, but it's not enough.

it's one leg of the three-legged stool, but without the other two legs and without a permanent solution on the affordability piece, it's not going to be enough. >> supervisor safai: so do you plan to work with the city on outreach on this program? >> absolutely. >> supervisor safai: and how many families in san francisco are you supplying mobile hot spots for sfusd families? >> so i don't know that i have that information for you right now, but i do want to say -- thank you for asking the question -- we are working in partnership, again, lausd -- no offense -- led the way to make a digital learning offering with verizon. very, very cost effective for the school district, and then, we opened up that model for all california school districts, including sfusd, which is participating in that program.

i don't have the exact number because our customer is the school district. the end user students and the end user teachers who are benefiting from that no-cost program is really under the control of sfusd. >> supervisor safai: okay. so my follow up was going to say, how can the families continue to stay connected after in-person school resumes, but if you don't have that information, it would be good to get back to us on that. so during the pandemic, has your network been strained during distance learning or any other reason during the pandemic? >> i am proud to say that verizon prouds itself on being the best, largest, and most reliable network in the -- prides itself on being the best, largest, and most reliable network in california and in the country, and while we did see huge and dynamic spikes in consumer demand

almost overnight beginning in march 2020, our network was able to handle that. we did see a lot of people shifting to their home broadband and going on wifi and coming off the l.t.e. network, but i can tell you, i live in forest hill, and we're in a utility undergrounded area, and even though comcast passes my home, literally, it would cost me about $10,000, like a new sewer pipe, to dig it up and put in a new drop-in. so my only option beyond any home and my verizon wireless l.t.e. is an at&t d.s.l. so imagine if it's hard for me to get it, imagine how hard it is for someone in the portola to get it. >> supervisor safai: okay. let me ask you one more question, and if you could be brief in your response.

what is verizon doing to making sure it's affordable to low-income consumers? >> so wireless has, for a long time, become an increasing alternative for wire line broadband. the problem has been with 4-g l.t.e., because you need to manage network and capacity, there are frequent limitations that have to be placed, but 5-g built right solves that because there will be no data throughput limitations or caps, so the capacity issue is solved. >> supervisor safai: okay. great. thank you, mr. reyes. appreciate it. we'll follow up. as you said, this is the beginning of a conversation. we appreciate your insight, and understand your frustration, and we'll continue to work with you. thank you. >> thank you. >> supervisor safai: next up,

we have cammy blackstone from at&t. i should have reminded folks, but if you could try to keep it to ten minutes or less, we would appreciate it. >> sure. i'll do my best. my name is cammy blackstone, and i'm the director of external affairs for at&t. thank you, supervisors, for holding this hearing. at&t agrees with you. we believe that everyone in san francisco deserves access to fast, reliable digital service. you asked several questions. what actions are we doing to close the digital divide in the shortest possible, and the other was how will these actions impact the city's economic recovery. so in the last ten years, at&t has invested $10 billion here in our wireless and wireless

networks in san francisco. we do provide several programs that address the digital divide, and we do plan on continuing that rk would. we have a plan called access at&t which allows households to access the internet for $10 a month. as far as programs we support in the digital equity space, just in san francisco alone, in the last ten years, we have contributed $7.5 million directly to san francisco organizations, some like you see right here, and that does not include the 12,000 hot spots that we provided to the san francisco unified school district for students who lack the internet at home during covid. it also does not take into account the $800 million that that at&t contributed to this --

>> chair mar: are you trying to show slides because we're not seeing anything. >> i am. oh, shoot. hang on. why are my slides not coming up? let's see, i'm doing this -- share content. hang on. >> clerk: just so you know, we do have a copy of your presentation, as well. i have paused your time, but i can scramble and put up your presentation, if you'd like. >> all right. let me see. i think i'm making progress. can you see it now?

>> clerk: yes. >> just back to this overview, $1 billion invested in san francisco in the last ten years, and the 10 clr access a month that we offer to qualifying households. just going back to the work we do in the digital divide space, $7 million to san francisco organizations, and that's something that we will do moving forward. at&t also provided $200 million in a nationwide effort with distance learning, and we did provide san francisco unified school district with 12,000 hot spots, as well. as far as when it's not covid, we have the digital u program, where we work directly with low-income senior groups, like self-help for the elderly, 22nd street seniors groups, and give

them sort of introductory lessons. this slide was given to us by the california advance services. it is california, not san francisco specific, but it does show that 98% of california households do have access to broadband at speeds of 25 megabits per second and also 95% with speeds up to 95 megabits and faster. 73% of low-income residents are unaware that there are discount internet services available, so any help that we can get from you would be great to get that word out. these two slides are from a study that was done last summer by the california public utilities commission. the map on the left that's mostly yellow, that shows wireless availability -- connectivity that's available in san francisco, and it also shows the speeds. so if you're looking at that map, the closer that it gets to

red indicates the higher speeds that are available, and the closer it gets to a deep blue indicates the slower speed. so as you can see, most of san francisco is in the mid range. now, should those speeds be faster? absolutely, and we agree 100% that they should. the city should incentivize some of the companies like at&t and verizon to put higher speed access by shortening some of the permitting process. as you can see, most of san francisco is covered. the areas in red are not, but those are park areas, like

golden gate park and presidio. we're -- temporarily waiving data and internet overage fees. we'd really like to get the word out on this, because when we're talking about increasing participation, this should be a big focus, that -- there's been

a bunch of studies about how 5-g will affect the economy and employment rates, consulting group study found that the 5-g economy will create roughly 150,000 new jobs in the bay area. 2021 accentture study found that it would create up to $253 billion additional g.d.p. and 2.5 million jobs in california over the next five years. so rudy talked about some of the challenges that we face locally trying to build out our

networks. in conclusion, everybody wants all of san francisco and all americans to have equal access to fast and reliable broadband. there's a bunch of things that are going on right now, and at&t believes that strategic collaboration with and investment from the federal government will help provide efrl access to broadband.

congress -- universal access to broadband. there are a number of things going on with congress. we want to modernize the f.c.c. lifeline program. that would be helpful, and then come up with sustainable funding because congress needs to enact sustainable funding. basically, the fastest way to close the digital divide is to get find federal efforts, locally ease the permitting process, and encourage local companies and these provided companies to go ahead and do what they do best in building out these networks because we do agree with you. we want to collaborate on this challenge, and we're here to solve it for you. >> supervisor safai: great. thank you, cammy. i'm going to ask a couple similar questions. so you heard the questions

regarding the f.c.c.s new emergency broadband benefit in san francisco that would deliver internet service at no cost. do you plan to participate in that, and what's at&t doing? >> yes, we plan to participate in it. >> supervisor safai: do you see any opportunities for a collaboration with the city in outreach of that program and how you can help to promote it? >> yeah, sure. i mean, in fact, it would be similar to what we've done with the access program, where we try to reach out to people. i will say that there's been some challenges that have been put in place when we were just trying to bring attention to the access program, we faced some hurdles with the san francisco unified school district getting the word out, but, you know, we're happy to do whatever it takes to let people know that these programs are available to them. >> supervisor safai: okay, great. and you mentioned in your presentation the number of hot spots. did you say 7500?

>> 12,000. >> supervisor safai: okay. so how many families in san francisco do you think you're helping? >> we provided 12,000 hot spots. i don't know if those went to families that have three kids. i don't know if each child got a hot spot. i believe it was per household, so i would say 12,000 hot spots, 12,000 households. >> supervisor safai: okay. and was that sfusd? >> yes. >> supervisor safai: okay. great. and do you have any suggestions for how these families could continue to stay connected once in-person learning resumes? will those hot spots remain? >> yes, those hot spots will remain. the san francisco unified school district is subsidizing, i think, the monthly fee for it, and it would be up to the school district on whether or not they would continue to

subsidize those. >> supervisor safai: okay. and do you know if that subsidy comes from their budget or do they get money from the federal government to subsidize those hot spots? >> we built the network for it for free, and then, they got a very discounted monthly rate that will continue through this school year. i don't know if they got a special grant to continue it or not. >> supervisor safai: okay. and then, do you think or has your network been strained due to the distance learning or pandemic or any other reason during this past year? >> i would say the wireless network definitely saw a lot more traffic, and we did not have issues with our broadband. we definitely had requests for more fiber, but we've been able to survive it.

>> supervisor safai: okay. and then, the last question is the same that i asked before. do you think that your wireless 5-g service would be a substitute wire line for broadband, and it would be affordable for low-income consumers? >> you know, i'm not the pricing person, but we do work to make our services as affordable as possible, so yes, i believe that we will make it as affordable as possible. >> supervisor safai: and do you think it'll be a substitute for the wire line? >> it could be. where wire line is not able to be deployed, we do face a number of challenges in san francisco. not just the terrain, but what is underground, it's like spaghetti when you see all the various wires and lines that are underground, but where we're not able to deploy our fiber, i'm sure that the wireless line would be a good

substitute. >> supervisor safai: okay. thank you. appreciate it. thank you so much for being here today. we're going to go onto the next presenter. mr. clerk, can you please put on a timer for ten minutes, make sure that we're staying on point for the presenters? is. >> clerk: yes, i will, and i have up to this point, as well. >> supervisor safai: okay. i figured you had. i just wanted to make sure. >> okay. are you able to see my screen? >> supervisor safai: yes. >> okay. great. i just want to say good morning, chair mar, vice chair stefani, committee member haney, and supervisor safai. for the record, i'm dylan l. young, director of operations

for comcast affairs. closing the digital divide, as described in the etrf, as -- ertf, is a social and economic issue. we have committed to doing so to level the playing field, and that's why we created internet essentials in 2011 so low-income people have access to the power of the internet in their own home. [please stand by]

>> it is the nation's largest, most comprehensive and most successful broadband adoption program and internet 'ems have connected more than 8 million low income people to the internet at home. and we know that 75% of internet essentials households are headed by women and 80% are people of color. with 2021, it's comcast 10 year anniversary of internet essentials and the comprehensive approach to the digital divide.

research tells us that there are three main barriers to broadband adoption and as you know cost of service, a lack of functioning equipment, and a lack of digital lit what see so internet essentials have been designed to hit these barriers head on providing a affordable high-speed internet to households at no cost for 60 days and for $9.95 a month and there's no contract, no credit check, no cancellation fee, no installation fee. we have a separate process and team of employees working with folks on internet essentials and focused on nothing else. on equipment, internet essential customers can purchase a subsidized and discounting computer under $150 and an awareness and training, comcast works with digital literacy training and households may participate in three digital skills online training. we've he can accelerated our preach to reach as many people as possible and working in san

francisco such as community youth centers, boys and girl's clubs, the ymca, asian pacific community center, west based filipino service center, mission neighborhood centers, mo magic, self-help for the elderly and the sf tech council and many others. we've also worked with the city such the human rights commission, shout out to director davis in supporting the annual historically black colleges and universities fair and getting the word out through the hsa lifeline fair where camy and i, before the pandemic and after, we've been working virtually and also physically and we're able to staff a table and talking to folks. speaking at community based organizations meetings and we're thankful for the collaboration and commitment of our community and city partners and the true power of this program comes from us. here are some numbers

nationally. so in san francisco we have contributed 140,000 through the give to sf fund to support digital literacy train food security efforts through the pandemic and also other services at the community hubs. for public partnership we have funding and connecting large of numbers to broadband access at home and who is funding essential services to be offered at no cost to low income school district families in the city. and in addition to internet essentials, we learn that households with two essential workers and children may need more than just in home internet. it's part need with the city and community based organizations, serving, as the city's municipal hubs. where students can connect to internet and participate in distance learning. in san francisco, comcast has connected 34 community hubs at no cost serving over 800

students. we've also contributed 800 laptops to students at these hubs and provide 12 months of free internet at home through the internet essentials program with each laptop. we provide connectivity at the community hubs at the boy and girl's will you be and district 2, presidio community and district 6 all three success center locations, united players and to name a few and we've been in close collaboration with dory from dcyf and alex bond from the digital equity and brian roberts from the department of technology and it's been a great partnership. so to support businesses owned by black, indigenous and people of color, comcast created rise. a multi-year commitment to provide marketing, creative immediate why and technology services to bipoc small businesses providing $5 million of grants to hundreds of these small business and the deadline to apply is may seventh and the

website can be found at comcast rise.com. they have a plan to event social justice and equality with $75 million in cash and $25 million in media. and they'll be distributed over the next three years. june 2020 we have the lock standing commitment with this to help drive lasting reform and champion a more connected equitable and just world within the community and in the company. and in comcast 44% of our workforce identifies as people of color and then 35% women make up our workforce and in leadership 40% of women and 25% identify as people of color and 50% of our board of directors are people are women or people of color and we're a committed to increasing diversity further. let me wind up and say we look forward to fostering closer partnerships with the city, community based organizations and stakeholders and we know our

work is not done and what we've accomplished has grown out of a local grassroots effort driven with partners on the ground and we invite partners at every level. government, non-profit and academic as well as the private sector use their unique capabilities to help us close the digital divide together. thank you and i'm available for questions. >> thank you, dillon. so, i'm going to ask the same questions but a little bit different to you. the first one is about the new emergency broadband benefit program and san francisco and that will deliver internet at no cost. do you plan to participate in that? >> yes. >> do you see collaboration of how we can bet people aware of this program so they can participate? >> yes, absolutely. thank you for that question.

we want to continue to partner with the city to see where we can strategically be most helpful. i think an example was, like through the community hubs, we work with department of technology and we want to continue working with community based organizations on the ground and we really know their communities and being able to reach folks. and so, yeah, we're really looking forward to how we can collaborate closer and to close the digital divide. >> how many households have signed up? >> i don't have the figures but as of 2019, i believe we have 50,000. >> do you see any barriers about getting people signed up for that? >> i think it's really about

furthering awareness and if i demonstrated we have different solutions for different folks with different needs and different areas and so, i think helping build awareness through various forums, like this one,. >> great. ok. are there any constraints on your service delivery currently? >> we are proud in terms of reliability. right when the stay at hem orders were put in place last

march, we did notes a 30% to 50% jump in terms of capacity and our network folks were working 24/7 continuing to work 24/7 to manage and upgrade and expand our capacity to meet demand. >> thank you for being here and the work that you are doing and the work with our school district and use. appreciate that and thank you for the presentation today. >> i'm going to call up jerry mixson if he is on the line. are you there? >> good day. this is yolanda. i'm going to go ahead and share my screen. thank you for this opportunity. we take this opportunity to come before you to say thank you so much. so, digital mobility is here to

demonstrate what we have put together for bridging the digital divide as we are all aware of digital divide is a issue and problem in our communities for some time. in order for to us do that, we have to change the way we are doing things because we have a (inaudible) that has been disenfranchised from digital technology and specifically the black community and communities of color. this is the crux of the model to deliver positive options for positive outcomes. in order for us to do that, a wise man said that you have to bridge in order to build a bridge, you have to be on both sides of that bridge. and in order for us to build a bridge, we have to get on the other side. if you listen to the presentations, we have a lot of infrastructure that is here and a lot of delivery but what is happening is that the side that has been excluded has not reach the other side of that bridge and a man that said that is the c.e.o. and founder co-founder of

digital mobility and we comprehend that in order for us to overcome this, we have to look at underlying issues. a lot of the issues we spoke about on the agenda items earlier today related to the health issues and the substance abuses. all of those are going to always come back to digital equity and the reason that is so because the resources that we have that are available are made available online and covid has made that so much more intensified and so we know that we have been in the situation where we have institution amized discriminatory practices where we have excluded population buzz the time has come and we have the duty not to injury and when we have identified those issues, we have we have to retore and that restoration must be made and we know that we have issues where we have been excluded and and some peck knowledge in almost every realm, so we have

been faced with issues in our communities where we have been the lowest on the totumpole for economic, inclusion for technology, housing, transportation and education and these things did not happen by accident these things are planned and we have the data to prove it as well as the apology so we're looking to change things so in order to change, we have to collaborate so we have federal state, local, non-profit, corporate partners that we would bring to the same table to have the same message to deliver the same solution because what we have is a bunch of issues that we don't even have a single definition of what equity and conclusion means. these words of frequently used in vane and most are not even aware that the wordy quality and equity are not the same. so let's talk about having seek access when we talk about having equal access and reduce our crime rates to eliminate poverty

and to eliminate the prison system and violence in our communities based on the family destruction, if you look at the department of labor monahan report, he gives the report. this is something they gave the case for they called it the case for the negro and this is published since 1960. it goes a lot further back than two decades. i'm happy to say this day that san francisco has taken the charge to address this issue, san francisco is the first in the nation to take the lead to its address the fact that we have a responsibility. under the international convention for the elimination of all forms of racism, we have a duty and san francisco, last year, were on a one year anniversary declared antiblack racism of public-health hazard and it is a public-health hazard and not only effects blacks and people of color it affects us both and we see now the mental

illness, abuse and alcoholism these are symptoms of bigger problems we need to unite in order to address. we bring the subject matter experts but first we must focus on the voice of the community. because we see solutions that are brought to the table that do not include the voice of the community. if the voice of the community is not embedded into the solutions, we will go another 500 years with the same problems and because you see the same numbers, you will see the same target of populations that are at the bottom of numbers, how do we build and restore? we have to look at what wore doing. the issue is that when we look at the appropriation of funding, we have to specific targeted communities that are literally left out. let's talk about south of san francisco, where we have a entire community that's been

left behind. we can talk about sunny day, fill mor, army streets, tenderloin and these different areas that we have historically, i was born in san francisco and due to gentrification, i no longer live there. my mom and my dad had to leave san francisco. now this is going back to the '60s and this same issue that we spoke about are the same issues we talked about today. why? because there is no collaboration. if we don't stop we're going to be in further decline. if you look at every great nation and not the lowest at the bottom of the totumpole the nation falls. today we're saying we'll build a bridge but no one is on the other side of the bridge. there are those that are there but they don't have the resources. the ones if you go to is there, go to the voice of the

community. go over to hatters, some of these other places that have facilities and they need funding because they're one of the last entities that are standing and they're one of the few making a difference. we have to take into consideration, when we build our programs, we have to make sure that we have a difference to understand the differences in cultural, differences in languages, differences in our home environment, differences in education, differences in life styles, differences in opinions, we have to unite. so one of the things that i'll give a good example for you was digital mobility has done, think outside the box. we partner with san francisco libraries and in 2021, let's go back to 1849 when they came for the 49ers. san francisco is a gold mine. you are a leader. you already established the foothold so now we have this library which is a gold mine, i can go into the library's database is find anything i need. we have the job, they're teaching and training, they're giving education how to get job

skills to get a job at a high rate. we have our co tenderloin and we have jvs, all these programs that are working and we're collaborating as one so we can come into a united definition of what equity and conclusion means. all these things we've spoke about today are awesome and great and unless we come to a one conclusion as to what this really means, now when we talk about expanding the infrastructure, why aren't we talking about looking at those who have been left behind? i see equality. this is an example of equality. i'm allowed to run the race. my mom and dad would not allowed to run on the race because of jim crow, i'm allowed to run on the race. no one has taken into account the fact that my mom and dad were not allowed to run in the race or go to college. we're not allowed, because of cultural differences, we were excluded and we were put no

ghettos and all these place zoos places sowe start the race and e those burdens. we don't have the same things that everyone is running and we have to take the steps to make sure that we do the things that we need to do in order to make sure is that we're all having equality and we all have masses and best practices and standards so that we can build cross functional dynamic teams from every industry and not just from the government, because no one can build a bridge alone. that's one of the things that we know we cannot build the bridge without the voice of the customer and it means a community and we cannot build a bridge without collaboration and we cannot build a bridge without having a single focus and we

look forward to joining and furthering these efforts by having our passports. >> thank you, ms. louis. i appreciate your presentation. i'm going to ask you a question and we're going to move onto the rest of the presentation here. what support do community based agencies like yours need to end the digital divide. if you can give a brief answer, we'll continue the conversation. >> resource and collaboration. if we can become a voice when we have strategic planning so they're not one shoe fits all so we can customize those based on the communities we're serving and provide resources to the community members that have services. we're lacking the resources. >> thank you so much for you taking the time and joining us today and thank you for your presentation. i'm going to now move on, mr. chair, we have 10 city department that's will do a brief presentation on what each of their departments are doing.

first i'm going to call on eric shaw, the director of mayor office of community and development and then call on the remaining city departments and at the close of the presentation, eric will hand it back to me to conclude the presentation and offer some amendments to my resolution today,. >> good afternoon, chair mar, members of the board of supervisors, members of the public. my name is eric shaw, director of the mayor's office for housing and community development. i am pleased to be here today to kickoff a presentation that will illuminate the efforts to bridge the digital divide and provide a glimpse into what steps must be taken to ensure all residents can participate in digital society. this afternoon you hear from my member and a member of other departments regarding the digital equity work we have engage in since before the pandemic start and how we envision a path forward. before i began, i will provide a

background on digital equity networks. the san francisco digital equity initiative has been housed with the agency since the mid 2019 under the alex bond. and under his stewardship we have provided internet access at no cost at hundreds of affordable housing residents. strategic plan and digital equity playbook that have been instrumental for guiding this work. this slide toes data from the american community ser have i sn 2019 that 386,000 households in san francisco of the 386,000 households in san francisco, 16.8% lack broadband and 7.6% of the residents do have any access at all. next slide. this map details the census

track with the lowest internet access rate that coincides where a large percentage of the city's affordable housing is located. together the department of technology with many concerted efforts to provide free internet access to our residents living in these tracks via the housing partnership. according to recent san francisco unified school district data, 22,000 students are and 13,750 have no reliable internet access. the american community survey data demonstrates that black latino american indian chinese and filipino households are more highly representatives than other demographics when it comes to lacking internet access. did broken up with language at home with similar trends coming to light. i'm going to focus on how we bridge the digital divide starting with a brief overview

of our fire year plan. with rapid digitalization as a result of the pandemic remaking the workforce, schools, healthcare and city services, the city has responsibility for bridging the digital divide and sharing the all residents have the digital tools and skills to be successful. this strategic plan was the result of a process --

. >> there's markings, and even though, like, around the same number of interns actually puts more laptops in homes, a lot of laptops were actually shared in households, so we wanted to bring that awareness that the laptops included in our summer internships are actually being shared, and that there would be

more access instead of students trying to navigate their cell phones or electronic devices. could you go to the next slide. also, this is a slide, again, that just talks about the number of devices that are shared amongst members of a household. only 60% of the interns this summer had a laptop that they did not have to share with other people in the household, and the additional 40% of the household, they did have to share a laptop with one or more interns. you know, increase the internet access in san francisco but also increasing the number of devices or laptops for interns to use when they're in their paid internship, and also, could you go to our last slide. and the last slide, this is our internet barriers.

you know, two of the internet barriers that we saw this summer was laptops and technological access. one of the other barriers that we're encountering is bandwidth. you know, do not have the access to really withstand all of the devices that are being used in certain households. and then, it is, a lot of technological devices. the internet that's being provided, they're not strong enough to hold the capacity that we are actually [inaudible] and i think that's the end of the presentation for the human rights commission. >> supervisor safai: thank you. >> thank you very much, and next, we'll hear from the committee on information technology. >> good afternoon, supervisors, and thank you for inviting me to join this hearing.

i just want to start and say thank you again to alex spahn and the work that he's done. we're very passionate about this topic and helping the city move forward on it. and i hope that when we're talking about going forward in terms of city, we really learn lessons from gentrification in the last 20 years. when we create spaces, we have an opportunity to change the character of our community, whereas when we invest in people, we're helping our community grow. that's something i've been inspired about the community equity program and addressing the digital divide. it's not just about the internet and the equity issue, but how are we addressing all of the different factors of the

digital divide. next slide, please. for coit's perspective, we are responsible for writing the city's five-year technology plan, as we're thinking about the future investment and where we're going in the future, equity and accessibility has been central to the way we're thinking of it. covid has had a large impact in the way the city is operated, so we've created the city's first-ever inventory to see the state of city services. in that survey, we found we have 967 individual residential facing services across all departments. i'm happy to state when we did this report in september, most departments had services up and running, and we are continuing our operations. however, we also asked what level of accessibility are these services digital devices, specifically in terms of mobile devices but also have they been designed for people with

disabilities or low literacy or some of these other factors that are part of the digital divide? and from that, we found 194 services of the 967 actually meet the standards of truly being universally accessible. next slide, please. so i'll be brief here. we'll be talking in the future about the five-year technology plan and the state of city services and what we are doing in the future, but i hope that we can talk about how our services contribute to the digital divide and how we can make sure that what the city is doing is truly accessible to all residents. thank you. >> okay. good afternoon -- oh, good afternoon, supervisors. dylan schneider, manager of public and policy affair with the department of public housing.

abigail spahn is not here, so i will be presenting on this topic. i just want to thank supervisor safai for having all of these presenters on this topic. it is important for us to be looking at and exploring digital equity, so i just want to recognize how much i've appreciated the partnerships and the work that has happened, and that we are really looking forward to continuing to work with all of our city partners, elected officials, as we continue to identify and learn and pursue new opportunities to increase digital equity and access within our system of care but within the city, as well. next slide, please. so i wanted to start with a quick overview of digital access within our temporary shelter system. as you can see from the slide, 20 of our 21 congregate shelters that include

navigation centers provide wifi access to guests, and 17 of the 21 shelters provide on-site computer access to get to a computer lab. and the one site that i note on here as not having wifi is exploring options and does have a computer lab, so we are really happy and really want to thank our partnerships with the department of technology and the director, who has helped us bring on-line city wifi in many of our sites, including the last two navigation centers that were just opened in 2021. there was a partnership between h.s.h., department of technology, mohcd, and monkey brains to bring that on-line. in addition, i.t. team has been working to upgrade computers at existing shelters so they run faster and with a more secure operating system.

next slide, please. so this slide demonstrates our site-based permanent housing portfolio, and it's based on a recently conducted survey with our housing providers. 38 sites offer wifi to tenants, and 39 sites offer computer labs. as part of our due diligence and commitment to digital equity across this portfolio, we are in the process of following up with all of our survey recipients, and we look forward to sharing more with you as we continue to collect the unique needs and challenges across this portfolio. one thing i will note as we've heard from our providers is that many of the shared challenges are the challenges that we as a city share which is really working with old,

predigital age infrastructure, and looking at how we can explore different partnerships and opportunities to support these providers, providing more access in some of these older buildings, and, certainly, funding, as mentioned, many times here is always a consideration both on the on set and implementation of that infrastructure, but also the i.t. expert sees in staffing that's needed to support both tenants and the systems as they continue. so again, very excited to continue this work as we look at serving our formerly homeless residents in d.s.h. next slide, please. i also want to quickly highlight in initiatives that have happened during covid-19. so through the covid-19 command center, we are available to access the guest access shelter

program. this included the covid emergency shelter, shelter in place hotels, isolation and quarantine states, and the majority of safe sleeps. i also wanted to thank supervisor safai's office, who we worked with along with community partners who were staying at a vehicle triage center to the power house community hub to support virtual learning. and as i mentioned before, we really appreciated the partnership with the department of technology and mohcd and monkey brains that provided free wifi at our community centers this year. and also, we want to thank our partners. this is such an important topic. we know it is increasingly more important, especially as our guests need the tools to continue to explore options to connect and stay connected in an increasingly virtual and especially during covid isolating world, and so we're very committed to continuing to work with our city partners,

with our private partners, and with our community partners to support partnerships that will support the over 14,000 households that access the homelessness response system and support them with that digital access and literacy. thank you. >> supervisor safai: thank you, dylan. thank you, dylan. thank you for joining us today. i know we've gotten your slides in advance. if you could just focus on the digital divide aspects, we would really appreciate that. >> i can definitely do that. good afternoon, chair mar and supervisors. [inaudible] for the san francisco housing authority. as linda mentioned earlier, we

are working collaboratively with mohcd to install wifi at our two largest public housing sites, sunnydale and potrero to make sure our residents have access to real dependable wifi and internet supports, especially for our youth to be able to access education. this map shows areas of our sunnydale and potrero sites, which shows 865 units. households are aged grade three to 12. these are households that we targeted for our distance learning support initiatives. sunnydale has a total of 563 units, 268 of which have youth in grades three to 12, or 418

youth. potrero terrace has a total of 301 occupied units, 130 of which have youth in grades three to 12, 191 youth, and potrero annex, which is not shown, has 96 occupied units, 15 of which has youth grade three to 12, 15 youth. because the annex is slated for demolition in 2023, it was more cost effective to provide individual households free wifi service through providing enough hot spots paid by sfhta. next slide, please. in collaboration with hope s.f. and h.r.c., we purchased 500 [inaudible] this year for youth so that they are able to engage fully in distance learning. we targeted youth who lived in

our public housing communities and are outside of the san francisco unified school district system so that we can adequately ensure no youth gets left behind. we work through our community partners, such as the samoan community development centers, c.a.r.e., and the bayview y. linda, next slide, please. according to national youth research [inaudible] high rates of absenteeism are being observed. to address these concerns, we're working with mohcd to provide grants to the sunnydale boys and girls club, and potrero neighborhood health, both of which have an established presence at our site. each will receive $130,000 and both communities will be able to benefit from these services. sunnydale boys and girls club will provide culturally competent tutoring and academic

skill building to approximately 160 students weekly. they will serve as liaison and help improve coordination and communication amongst our families, schools, and community partners. potrero neighborhood health will provide mental health services serving 120 youth per week. they services would have a consistent presence on-site and be provided by black practitioners who can meet the unique needs of our families. together, these services are extremely important and can help improve current academic trajectories and address social and emotional learning. the remaining gap and on going challenge will be to identify solutions to continue the support for digital literacy and mental health services beyond this one-time [inaudible] so this concludes my presentation, and i will turn the presentation over to susie smith from h.s.a.

>> supervisor safai: thank you. >> good afternoon. hello. everybody. good afternoon -- good afternoon. can everybody hear me okay? >> supervisor safai: we can hear you. >> okay. thank you, and i'm deputy director for policy and planning at the human services agency, and, of course, h.s.a. is serving one in four san franciscans at all stages of life, and we're compromised of three different city departments, so i'm going to present information on some programming from the department of disability and aging services as well as department of benefits and family supports. next slide, please. starting with daas, so daas launched a program called s.f. connected back in 2011, and

this program provides computers, access, and literacy training in over 50 labs across the city. we purchased over 200 computers for these community labs and serve over 2,000 adults and individuals with disabilities annually. the program [inaudible] and digital divide. we have six c.b.o.s that are the leads in this program, and they provide the actual digital literacy training. the program, since the pandemic, has distributed 200 devices to older adults and

people with disabilities and people with connection issues. they're funding mini grants to san francisco c.b.o.s to test new programs and pilots, and we're going to be working closely with the metafund, at the data, to see what comes out of that and see what success looks like. next slide, please. at the policy level, daas funds and staffs the s.f. tech council, which launched back in 2015, and this is an intersectorral council for

people with disabilities. it believes the way to address the divide is to partner with various stakeholders, to members of the communities, various c.b.o.s, philanthropy in order to provide digital access to all. it's the first of its kind in the country, and it seeks to be a model of inclusivity in other places. this is funded by daas, and it's coordinated by the nonprofit, the community living fund, mohcd, the mayor's office of disability, and public library all sit on this council and help us on this partnership. daas has also been looking at the intersection between behavioral health and technology and how we can get older people and adults with disabilities into telehealth now and post pandemic. we have heard and experienced from our partners the extreme

loneliness, social isolation, anxiety, increased rates of suicidality that have been triggered in people with disabilities and older adults, and we are looking into some of these issues and looking at telehealth as a way to deliver some helpful services. in that vein, we've launched a behavioral health project to learn about the mental health challenges, the gaps in services, and the role that digital services has been playing to help connect people, particularly in skilled nursing facilities where there's been such extreme isolation, so we're surveying all of these skilled nursing facilities in the city, asking them about digital access, devices in their facilities, what program

they're doing, what programming they're doing to train the residents to be able to actually use devices and the kind of staff supports needed to make that work, so we're really interested -- the survey just went out recently, and we're really interested in those findings. and then lastly, on the daas front, we are in the early stages of working to pilot an lgbtq telehealth project. this is also being funded by the meta foundation, the meta fund, and this is to use therapists volunteering their time to provide telehealth therapeutic services to lgbtq older people and people with disabilities, and we're working as part of the design work to flush out the model and, again, are excited about it and will be tracking it to see its efficacy. next slide, please. [please stand by]

-- internet plan and even things like supplies and the ability to charge and store those devices safely. so we have been able to rely very heavily on our partners, so for our city, rec and park and library sites, worked in partnership with the department

of technology, office accuracy, and we were able to lean on the department of technology in the office of digital equity. and our cvo sites comcast subscribers, fortunate to have comcast. now in terms of our connections to the school district, it was also extremely important to be able to work in partnership with them, because we needed to register our devices through their management system. and that allows for the sort of centralized management of those devices, dealing with any updates or making sure the young people have the ability to access the different digital tools they are using, super important and fortunate to have that partnership. and lastly, ongoing issues or troubleshooting that needs to happen. and once again, able to find the partners from the offices of

technology, department of technology, digital accuracy and troubleshooting as well. next slide, please. >> and so on this last slide, we detailed the cost for the devices, applies, connectivity and bandwidth, since our inception in september, and totals over $1.4 million. i'm not going to go into much of the details here, you can see the different categories and the numbers, but i did want to pull out one final thought for this grouping is important moving forward. and that has taken an incredible list for us to put the initiative together, and it's really taken strong effort from all the partners involved and everyone who has stepped up has brought something crucial to the work. the way the folks came together for the initiative is true testament of the type of partnership we need in the city to ensure that our residents have the highest needs have the things they need in order to address those needs. and so to me, as much as this

partnership has been fruitful and making sure this initiative can get off the ground, it really -- in a lot of ways lays that foundation for the future, and so the ability to be able to pick up a phone, send a quick email, be able to sit down and discuss some really important issues with our city partners, with the school district, members of the community, that's a really important thing for us because there will be additional challenges that come about as we move forward and we as a department who is solely focussed on ensuring young people have what they need to grow up and thrive in this city, we are excited to be a part of those conversations and efforts and feel the work we have done paves the way for us to continue to do that. that's going to end my slides and i will turn it over to the office of economic and workforce development. thank you. >> thank you. good afternoon, thank you for having me, supervisor, and safai for attending our careers and

tech expo just before the pandemic. my name is orion willis, tech sf. economic and workforce development provides access to free tech training and job placement services for locals. highlighted earlier in the presentation, the local digital divide is highly correlated to economic divides in our community. while tech assess and the entire portfolio workforce program funded by oewd, do not have specific strategies for bridging the digital divide. the programs do specifically provide low income job seekers with opportunities to upskill and access a higher standard of living, includes being able to afford high speed internet and tech devices. additionally, a majority of our job centers provide access to computers and internet services, and the resources help level the playing field by breaking down certain digital barriers.

the department has work in collaboration with san francisco digital equity initiative, as well as the committee on information technology, to leverage existing city programs as a means to provide additional technology and job training resources for locals. next slide, please. to drill down on one specific workforce program, i will highlight tech sf assessments and how they increase our collective digital capacity. tech sf, from on ramp programming to apprenticeship opportunities. our programming incorporates work-based learning, stackable credential, for the competitive industry. a snapshot of some recent investments. in the current program year, invested 1.6 million across nine

local tech training programs allows san franciscans to access technology and tech training. from basic digital literacy to apprenticeships. invested $584,000 into programs and outreach and neighborhoods with low internet access rates, including the southeast sector of san francisco. overall, tech sf investment will provide services and resources for more than 600 locals. here a couple of outcomes i would like to highlight as well. since 2012, tech sf has supported more than 3,000 local job seekers metriculate to tech jobs, and students placed in employment, earn $28 an hour, $5.8 million in wages going back to the community for every 100 students who attain employment. on average, spend about $3,000

training the students. next slide, please. here a couple highlights of oewd work supporting small businesses. oewd is working with neighborhood economic development partners under existing grants to support small businesses building their online presence, including marketing and the sale of their products. collaboration with facebook career connections program, the h.s.a. jobs now initiative and oewd, a program will train 50 san franciscans in digital marketing and employment opportunities at 50 local small businesses. intention of this pilot is to support the businesses recover from the pandemic by boosting their online presence and helping them generate enough revenue to employ the digital marketers when the wage subsidies expire. we have launched to support businesses and job seekers

negatively impacted by covid. moving forward, oewd will increase recovery efforts that focus on building the technical capacity of businesses online. existing and future services, provided by oewd invest in neighborhoods division, facilitated through commercial districtses across the city. our neighborhood partners have been providing one-on-one workshops and training online presence in digital literacy, as well as workshops and guidance in navigating grant and loan applications that support business sustainability. supported the communities for generations. and with that, that concludes my part of this presentation. thank you very much on behalf of oewd for addressing this challenge. >> this is linda jarel, some

summary slides for looking ahead. as we look ahead, this work has been described, the services the departments provide have been clearly outlined and i think it's a wide variety that adds value to the community. and so in summary, the departments have all presented their good work and effort on digital equity with a wide variety of services. this results, the results and outcomes will be new economic opportunities, access and education for unserved residents. the pandemic has highlighted the incredible need and importance of internet service and the economic recovery task force included digital equity recommendations and the initiative, ensuring affordable connectivity and internet service, distributing computers and devices to vulnerable populations, building capacity

of new users, small business and nonprofits. what is exciting is that many of these, all of these initiatives have current action and work underway. installing fiber now based on priorities set by mohcd, working to feed and understand how we can deploy fiber more efficiently with d.p.w. chinatown, wi-fi project service to the s.r.o.s. looking at federal and state programs to offer grants and funding to our efforts. we are drafting standards and a business plan for procurement and distribution of devices, and a very exciting initiative, office of civic innovation is working with oewd on an e-commerce implementation for small businesses, play book will

help our small businesses go virtual during the pandemic and after. so the next step looking forward is the history and report on strategy, planning costs and schedule for closing the digital divide, and that is scheduled for june as well as we will continue to explore federal funding opportunities. thank you, supervisor safai, chair mar, and the public safety and neighborhood services commission for consideration and help on this essential work. i'm sure all of us will be happy to take questions. >> thank you, linda. i think we are -- for the most part i'm just going to make a few -- i know this was a lot of

presenters, however, in order to address the digital divide, we had to see what we are doing as a city to tackle this issue. today i think we have made, a clear picture what each department is doing to address the digital divide, and it's our job, my job as a legislator to find areas to speed up the efforts, working with linda and the team and others in the city that have laid tremendous ground work already today. again, the digital -- we are just really looking to gather information in the first presentation. and we are not trying to reinvent the wheel. i plan to work collaboratively with the city department and the director to create buy-in for what i think will be a successful opportunity for our city to achieve really closing the digital divide. now we really have to focus on what that substantial impact

will be, so really want to thank linda and her team for working on my request to put together this review of this effort over the past 20 years. so, really want to give you a strong shout out, linda, to you and your team and the different departments that participated today. so, miss chair, if it's ok with you, i would like to make a few amendments to the resolution that i have. >> sure. supervisor safai, i would just maybe like to offer some remarks before you do that. >> sure, absolutely. please do. >> first of all, i want to thank you for calling for this very comprehensive and informative hearing and also to thank all the presenters for sharing an overview to your organization and agency's work to close the digital divide, foster digital equity, and respond to the new challenges over the past year

during the pandemic. i really appreciate the work, all the work that went into creating the five-year digital equity strategic plan. so thank you to mayor breed and director shaw for your work and leadership on that, and also the recommendations on digital equity from the economic recovery task force, that are now the basis of the resolution to appreciate all that work. and these issues are incredibly important and especially now as the shift to more online work and school and life was accelerated by the pandemic, and i think these issues are really evolving, continue to evolve with the technology, evolving and so this is a very long but very important and informative hearing. so, thank you. >> thank you, mr. chair.

any other colleagues like to say anything? i don't want to cut anybody off. i have 1 or 2 more words and if we could do the amendments. obviously if there's anyone from the public that wanted to comment. >> yeah. >> supervisor safai, maybe you could introduce your amendments right now. >> great, i'll do that. and before i do that, i wanted to add to my remarks, appreciate the private sector and employers and companies that participated and provided their information and offered up some good constructive criticism, we take those to heart, to look at that with linda and her team in the city and facilitate that. we don't want to be the roadblock to the digital divide here, so i take those comments seriously and appreciate the presenters today and what they are doing on behalf of helping the community and we are going to try and push some more to

participate in the good partners and continuing to help bridge that divide as well. so, with that said, mr. chair, i have a few amendments that i wanted to read into the record. none of these are substantive changes, just some clerical edits i'm making to insure the language is concise and meeting the objectives of the october 2020 task force set forth in section 5. amend the short title, urging the i am -- implementation, and digital divide and we did email these to all of you. also i have an, like to amend the long title to say resolution urging the implementation of three recommendations, october 2020 economic recovery task force report that the city, 1, high quality computers to vulnerable populations, two,

bridge the digital divide with affordable connectivity and 3, build the technology capacity of new users, small businesses and nonprofits, and urging the department of technology to review the city's efforts over the past 20 years to close the digital divide and provide the board with the cost for the three recommendations. and page 1, line 14, sfdt, please delete sf and should read dt in parenthesis. line 15, office of digital equity, and page 2, lines 7 and 8 as well. page 2, line fives, delete sros and replace, permanent housing sites. and add with moacd serving.

and page 2, line 10, after city-wide, including by tell -- telephone. and resolve the board of supervisors at the city and county san francisco, recommend 5.4, 5.5, 5.6 of the october 2020 task force report and the board of supervisors urges the department of technology to provide the board by june 1, 2021, with a written estimate of the cost implementing recommendations in sections 5.4, 5.5, 5.6, and further resolve the board of supervisors urges the department of technology to provide by the board by june 1, 2021, with review of the efforts put forth by the city to close the digital divide over the past 20 years. that's it.

thank you, mr. chair. >> thank you for that amendment. supervisor safai. duly noted. supervisor haney. >> thank you, chair mar, and thank you supervisor safai and to all the presenters. much appreciated. that was very informative and supporting however i can. one question that i wanted, and i'm not sure who would be the best of the many folks here to help address this, but if there's someone here who might be able to address the questions around the digital divide and access on treasure island, we have had a number of folks come to us from the island about sort of irregular, you know, access to high speed internet, lots of

outages, if treasure island has been a part of how we are thinking about, you know, really ensuring across our entire city, you know, fast access to the internet and access to technology more broadly. >> chair, through the chair, mr. chair mar, supervisor haney, the specific island, all the residents, residents living in a particular type of housing or just a general? >> just a general question. i don't know if -- >> i would ask linda to answer that question. >> this is linda with the department of technology. yes, and there are improvements as part of the treasure island development plan to completely ring the island with fiber and provide service. at this point in time, you are

correct, it is very difficult to get service on the island, and the service that's delivered via microwave, does not have the bandwidth for full use, but we can bring you some solutions and work with our industry partners to see what's possible in the short-term until the island has been built, and the fiber is installed. >> great. i would really appreciate that, i'll have my staff follow up. actually fairly recently we got a couple folks who came to us from the island saying that they were having a lot of challenges with internet access. thank you, appreciate again this presentation and everybody's work. >> thank you, supervisor haney. public comment. mr. clerk, are there any callers on the line? >> thank you, mr. chair. maria from the department of

technology is checking out to see if we have callers in the queue. for those, press three, and prompted informing you your line has been unmuted. for those watching on san francisco cable 26 or via streaming link, if you wish to speak on this item, please call in now by following the instructions displaying on the screen. that would be by dialing 1-415-655-0001, following that, i.d.1874861805. press pound symbol twice, and then star followed by three to enter the queue to speak. i understand there are a half dozen members of the public who wish to speak on this item. first caller, please.

>> hello, my name is dell seymour, from the tenderloin, thank all the presenters today with their fantastic presentations and the history. we have been talking about this for about ten years, and equitable way, and we have comcast and at&t have some things in their service area, responsibility to do, but we are not talking about placement. how many people have you hired from the tenderloin? how many people have you hired from surge island, how many have you hired from bayview. how many have you hired from lakeview. so, this is a major part of it. we are still looking like ten years ago as far as placement in these organizations. you are giving us access and all of that, but are you giving us

places where we can start making our own determinations in life. so i want to make sure the conversation comes back to that topic and not just on access, because to me, that's a distraction from the real barriers that society has placed on communities like the tenderloin, like treasure island, like bayview, like fillmore and like lakeview. thank you for the opportunity to speak to you all this afternoon. and supervisors, thanks for hosting these folks, thank you. >> thank you, dell seymour for sharing your comments. miss pena, the next caller please. >> hello, preston ray. i'm a resident of the richmond district and work at monkey brain, a locally based internet service provider here in san francisco, isp partner. the board can elevate strategies the departments are already using to close the digital

divide. you've heard about the fiber to housing program, gotten thousands of affordable housing residents online before and during the pandemic lockdown. program is a comprehensive solution that builds permanent public infrastructure, provides the best speeds and reliability in the country to people where they live, no means testing, implemented future-proof telecom wiring standard and innovative instruction, and service interventions. fiber to housing program has eliminated broadband access disparities, a revolutionary achievement. and yet the technology plan notes over 100,000 residents do not have access to their home. i encourage the board to take the fiber to housing program early success to heart. expand publicly owned fiber to more types of housing, and part

of the building code of building and renovations in san francisco, and organize support in the places where the program is present. city will be in the driver's seat to ensure everyone gets online and not at the mercy from a conglomerate, and being connected in the home is a right, not -- >> next caller, please. >> hello. i'm director of i.t. for the neighborhood development corporation. city departments and partners for speaking and your work. owns and manages housing, and 8% of the household, less than $15,000 a year.

[please stand by]

>> thank you foryour comments, could you bring us the next caller please . >> this is annacalling on behalf of the bay area council . the private sector including verizon, at&t and comcast are willing to invest significantly and the technology and infrastructure needed to implement robust it citywideand inclusive .

we heard san francisco to partner with the private sector to achieve our mutual goals of addressingthis divide and closing this gap in the shortest time possible . thank you. >> could you bring us the next caller please? >> good afternoon, my name is maurice rivers, executive director at omi and i'm a very proud member of omi invest black. i like to thank supervisor safai for bringing up this important topic because the pandemic has exposed the digital divide especially in our black and brown communitie as much as cost and access to technology our barriers, the lack of focus on digital literacy is even more of a problem .we must finish the job of bringing affordable broadband to everyone in san franciscoadditionally in omi

lakeview, bayview hunters point, fillmore western tradition and the tenderloin . thank you so much . >> thank you very much maurice rivers could you bring up the next caller please ? >>caller: can you hear me now? >> please begin. >>caller: thank you for tackling this vague and timely topic. i'm not going to focus on private providers today except to say there should be a program similar to care or pg&e lifeline for telephone customers to reduce the cost of services for low income residents. perhaps that already exists. given the number of city departments i think there's an opportunity to combine some agencies here . i think the smaller offices should be under a single umbrella agency on access diversity and equity. you can expand on that in the future.that idea would

consolidate administrative functions allow program staff to work on programs and less on admin and overhead. if thatcan be done through the administrative code great, if it takes a charter amendment ,

-- to be add as a co-sponsor to

the resolution. >> thank you. >> and, supervisor safai is it okay to close the hearing -- >> can i make one last comment in response to the callers? i wanted to thank dell preston and val and morris for calling in and our office will reach out to continue this dialogue. we have heard great things about the work that they are doing and in the community and with different stakeholders. so my office continue to work with the community steak holders and providers to address this need and we'll continue that conversation. so, again, just thank you to everyone and i know that this is long and i appreciate the committee's patience but this is an all-encompassing issue, so thank you for the lifeway, chair mar, and thank you for joining me as a co-sponsor. and if and we would like to come back if we have more

information. and and i appreciate all of your patience. >> great. so i'll move that we continue the hearing, item number 3, to the call of the chair. >> did you make a motion to accept our amendments already? >> so i'll do that. and i'll accept the amendments as presented by safai and also that we recommend the resolutior 4 to the full board as amended. yeah. >> so i'm hearing three separate motions. the first being a motion that agenda item number 3, the hearing, to be continued to the call of the chair. and that that motion is offered by chair mar. on that motion [roll call vote]

>> aye, and add me as a co-sponsor also. >> clerk: [roll call vote] mr. chair, there are three ayes and continued to the call of the chair, and i'm also hearing now a motion to amend agenda item number 4, the resolution to incorporate the amendments read into the record [roll call vote] mr. chair, there are three ayes on the motion to amend. and, finally, i hear a motion that the resolution to be recommended as amended to the board of supervisors. offered by chair mar on that motion [roll call vote] mr. chair, there are three ayes >> thank you.

thanks, everyone, for this -- >> thank you, everyone. thank you so much. >> mr. clerk, any further business? >> there is no further business before the committee. >> great, we are adjourned. thanks, everyone. although we did not see that

evidence of claimssuppression in the prescription drug experience . the prescription drug plans prices will look at the exhibits here shortly for the most unfavorable part of the increased driver whereas medical claims were the most favorable expense change driver in 20/20 again driven by the impact of related questions and especially in the second calendar quarter of 2020. it was also a significant decrease in the claim dollars that were paid for very high cost payments from 2019 to 2020 including fewer individuals that exceeded the $1 million point and access plans. you see the chart at the bottom of the page illustrating what the actual cost changes were were actually a decrease for medical even after the change too longclaim reimbursement. relative to a prescription drug increase of 9.9 percent . the administrative fees increased bytwo percent .

capitation which is a portion of medical cost that are attributable to certain positions delivered medical services are actually most services ordered by physicians that increased by five percent and there were very nominal changes in the reserves in the blue shield plans. this chart illustrates the total dollars for 2019 versus 2020 four the premium selected which again declined slightly by $3 million versustotal expenses . on an aggregate basis total expenses came in just about flat when we look at a per employee per month basis, you see the two percent increase in total expenses on a per employee basis for employee and retiree versus the one percent increase inpremiums collected . so experience is from 2019 to 24 domination of access plus

treo. this is the exhibit that illustrates the employee experience versus early retiree experience and what component of total cost. premiums for active employees are approximately 263 million versus about 66 million for early retirees. in both cases the premiums collected did exceeded the expenses slightly for 2020. so to get into more insight on what is driving cost within the blue shield hmo plans, there were 29 members that exceeded $500,000 in paid medical or prescription drug plans and discounted for 24 and a half million of the total claims that we looked at earlier but almost 3 million of this was reimbursed back to fhs for the large claim pulling attributable to individuals who

exceeded $1 million. and the predominant diagnostic cattery categories for these claimants exceeding 500,000 included cancer , cardiovascular conditions and substance. this chart was provided to us by blue shield to illustrate the chronic condition problems within the blue shield hmo populations. on the left side of the chart you will see what'scalled episode treatment group . essentially aclassification of the chronic condition . musculoskeletal being of the top. what you see there the next three columns show the overall population where py's prior year 2019 and cy's current year year-over-year change and you also see similar statistics for

the activeemployee population in the middle of the page and the non-medicare retiree populationon the right side of the page . and if you look at this , the musculoskeletal diagnosis so having to do with your bone system or muscular system is ... tend to have the highest prevalence of chronic conditio among all members of the plan . although because there were fewer services deliveredto members in 2020 related to the pandemic , blue shield observed a reduction in the percentage of overall membersattributable to musculoskeletal conditions . hypertension or high blood pressure is the second most prevalent condition and actually the most prevalent for the non-medicare retirees and then rounding out the top five and hsa is mental health substance abuse, hyperlipidemia is also known as high cholesterol and diabetes is the

fifth most prevalent condition for this population . this chart illustrates the impact in a couple of ways from the pandemic on 2020 utilization. we saw a reduction in outpatient surgeries, especially during the second calendar quarter and so the gift you see in the chart relates to the start of the pandemic in march with a lowest amount in april but then starting to insulate from there. and the other element ofthe pandemic is we saw an increase in physician driven telehealth , members connecting fire either video or telephonic visits. with their physicians. coinciding with the start of the pandemic here in march. and plateauing in april with the highest weight of physicia driven telehealth .even though it is reduced some sense it is still far greater than the rates of telehealth aboard the before the pandemic

announced. and then from utilization standpoint, just to cover a couple ofmetrics , and show the impact of reduction in plant utilization by members as a result of the pandemic and office closures that especially transpired from march to june. we see for instance editions for thousands of this is a rate of hospital additions for 1000 covered lives in the plan. we saw 89 percent reduction in emissions per thousand. als stands for average length of stay also saw shorter length of stay for those who work in the hospital. we did see an increase in the paid amount per day because presumably these were more intensive hospitalization needs of 2020 versus 2019. and then from an outpatient perspective we saw more of a reduction in services per thousand but again, probably

more intensive service needs on an outpatient basis. led to an increase in the per unit cost more outpatient services including things like outpatient surgeries. some statistics in terms of direct care which franklymay be somewhat understated . because this isdata that gets recorded , to blue shield but there may be tests that were administered to blue shield members in other venues such as the testing made available through sfhss so overall there were 2800 of the 35,000 total lines and blue shield plans with the covid claim process by blue shield, 3800 tests administered that ran through the plan. 34 auditions which on a baseline of 34,000, 35,000 covered lives is actually a fairly low rate of hospital

admissions for care. those who were admitted have an average length of stay of 8 and a half days and a total of about 2.8 billion of total claims processed for covid care. and prescription drug utilization first for the active employee group we saw an increase of about eight percent and that was all attributable to increase in averagecost for prescription drugs . the prescription drug utilization actually help study through the year. and we also saw the generic drug fill rate which is a percentage of total medications that are dispensed as generic. maintain a steady 86 percent through the year. for retirees we saw a lower trend in claim dollars per member per month and was primarily attributable to a two percent increase in the utilization of prescription drugs that you see in the third row of this chart. the average paid for

prescription drugs stay the same from 2019 to 2020. and then we have some additional detail in the appendix and we will go through this but we break out the cost between access cost and treo. what i like to do is pause for any questions you may have for i make the presentation. >> any questions from board members? you're going to have to speak up, i can't see everyone's hand. >> this report is interesting to me because obviously the three drivers of increase over $500,000 claims, one of which is sepsis which i think would probably be hard to sit at home

missing. but the other two, cardiovascular and cancer, one worries it will be sort of a snobby effect. you lose already in thelonger length of stay . potentially higher cost i guess of the population, length of stay was a little bit shorter but there's still whenyou look at utilization in terms of emergency room visits , then was in this report, it does raise the specter of a problem for the future. we will have to see. and i guess the other question i had was about the covid services. you said one percent, was that one percent of people who were diagnosed because the services would include testing. and i'm assuming that a certain

percentage of those tests were negative. >> the vast majority would be negative and actually a majority of the dollars for the program while attributable to hospitalizations . the vast vast majority of those members showing what with the covid claim were testing claims. >> any comments or questions from the board members. before we moved the second part of this presentation. >> a quick question, thank you so much for the information. a quick question on your prescription drug costs and utilization area is there any information about the drugs or is it kind of and that it in one of these lines? >> it is inherent within that information what we find is especially medications make up less than one percent of total

prescriptions dispensed. but it is a large proportion, approximately 40 percent of the total plan costs . so we meet with lou shield regularly to review updated experience information and update strategies for new special medications that may be coming to the market and how to assure that members are supported. who are requiring those specialty medications but also in a way that can be cost-effectively delivered to the members as possible. >> but in terms of the data, you know, dollars and percentages, it's just included in the average pay for prescription. >> it's embedded in that, yes. >> thank you. >> this is commissioner scott. i recognize that a lot of these members here as you've indicated have a depression to

them. is there anything in your crystal ball that says when we see the impact of that?are we going to be into next year before we start to catch up with what would be kind of normaloutpatient , inpatient. i can't imagine between now and the time that we get ready we would all of asudden people are going to go out and get all these services . so is the thinking now that that's what you're going to be delayed until later this year or what have you? >> fascinating question, thank you for posting it really arguing our next amendments within our ai. with senior actuarial team members regularly. with the health plan lead actuary across the country. and ultimately we had a number of very large health system

plans. nationally so we're trying to stay on top of what may emerge in terms of utilization patterns. candidly, we could not be in the second half of 2020 with the type of return of deferred care when we were first starting to forecast impacts to the pandemic, road closures in april and may. many of my clients experienced somewhat lower claims in the second half of the year to perhaps would have been thought to be exactly prior to the pandemic. at this point in time, we do expect some winter cost. in the later of 2021 so for example, we continue to rollout and certainly members won't be charged for the vaccine product fills given its paid for by the

federal governmentbut there could be costs to administer, vaccines that may present . you may find that individuals could be sent to different care so for instance we saw distant surgeries during the pandemic period. we saw the reduction in the percentage of the population who was actively in care for these conditions so issues, back issues. there is thinking that we may see some character in thesecond half of the year . but at this point in time we don't see anything that would be pointing to a large surgeon that. and we would fully anticipate thankfully the vaccination rates to increase certainly in northern california and all over the country and we would

hope by the time we get to play 22 that care pattern may return to normal. in fact there could be some lower overall utilization simply because individuals may have sought alternative pathways to address their care needs. we're all going to wait and see but the new report on an ongoing basis on our observations for our national leaders. >> thank you very much. >> if there are no other questions or comments from the board members, i'd like to go ahead to the second partof your presentation . >> thank you president. so the ppo plan experience has

been a smaller calculation. it proceeds with the blue shield hmo plans but as you go through the experience it is also a population that has higher average cost and higher health needs so we'll be going through that information. as istart , i want to clarify that there are different types of individuals. enrolled in this plan both from anactive employee and early-retirementstandpoint . the city plan itself , the ppo plan is administered today in 2021. it wasadministered in 2020 . the plan administrator is changing from united healthcare to blue shield. expect them to change on 2022 butthe plan remains . so i just want to stress the

information we are looking at and the material would also translate over to blue shield administration of the ppo plan effective 2022. i will refer to some data here with this term nonprofit claims so from a question standpoint, for this presentation if individuals who exceed 60,000 in medical andpharmacy claims . for active employees there's approximately 100 in the plan or three percent of total enrollment active employees in any access plan.and you look at this particular population there really segmented into three different types of employees . first there are the employee only tear individuals within the hundred 96 mou which means regardless of any of the plants

selected by the members they don't get premiums. they don't pay contribution for any plan's offer. both individuals in that circumstance about 250 and role in the plan versus any of the other plans offered by hsf. about 70 as lower contributions than the total plan employees. and based on their geography so the city plan choice not available contributions , predominantly those who are residing. [inaudible] and the remaining 780 employees the choice to pay a significantly higher employee contribution to the in this ppo plan versus one of the available blue shield hmo plans. and when you consider why the contribution ishigher , it's due to the mou being capped at

the employer contributions for the second-highestcost plan which is the access clause . so the majority of the employees are electing to plan among the various choices it's a significantlyhigher employee contribution . that generates a per member claim and help their scores in this plan. whenwe look into early retiree , about 800 or 14 percent of all early retirees select for this plan and a couple of different population perspectives here. about 450 of the 800 or just over half were the ppo is the only plan. whether they live in this area are other little areas in california or outside of california because for the most part hmos are not available

we did see an increase in prescription drugs, it was 9% for covered life so that led to a decrease of 6% per person but we do see, especially with the reduction and the early retiree high-cost claim content, the over all contempt does remain

very high relative to the book of business, they were tripled the rate of high cost, catastrophic claimants, and versus the uhc book of business. from a covid-19 stand point, we saw about 3% of total expense, 1.1 million and it was for direct testing and treatment expenses and 4% of all covered lives were suspected to have covid-19 at some point. based on the review of the data and about 1%, so in other words, about 1/4 of those suspected to have covid-19 about 1/4 of those were hospitalized at some point. we saw, reported by uhc, a reduction and the surgeries for in 2020 versus 2019 so very

similar to reductions in surgeries that we observed with blue shield plan. service reductions were evident across the board. strong, high reductions and hospital admission rates, emergency room rates, primary care physician visits were down 14% for active and 12% for retirees. only 25% of adults in the active employee group and 27% in early retirees had a preventative care visit and specifically this was a substantial reduction for the active employee group and we also observed key screening rate reductions and like mammogram, cervical cancer and colorectal cancer. the rates of preventative screening in 2020 versus 2019, again, influenced by pandemic factors but we did see virtual

visits. early for trim retirees and an increase in convenience care use even though that decreased for active. i talked about the 90% and drug cost increases were higher for active employees than early retirees so that was a similar observation to the blue shield data and it was entirely almost driven by the catastrophic claim increase and the active employee populations so do commissioner howell's question earlier, especially drug influences here and a slight increase in the merge of members you'ding medication and increase in the that was driven by especially 17% versus 12% in 2019 and then specialty is not only especially but it's in the medical office and you see an increase in cost

both for medical specialty and cost delivered by physicians as well as the pharmacy plans spend for especially medications. as we look ahead. couple of concerns. first, is the high level of average claim costs recovered life in this plan it's more than double. if they book a business for active and early retirees and we saw reductions in medical plan utilizations so how much will that come back in 2021 and especially concerned if there's delayed identification of new chronic disease diagnosis. the health risk provided by uhc did decrease from 2019 to 2020 but we suspect it's the reduced utilization and even with that decrease, the average over all health risk is about 40% higher for the hhsh and 15% of active

employee in 21% of early retiree covered lives are in the clinical program engagement among those who are targeted by uhc and identified based on claim information. and that drop in preventative care is a concern and the utilization rates were already below united healthcare book of business storms and we saw further reductions especially with the active population. those are the highlights. i'm not going to go through the rest of of this in the interest of time. but there's further information and that is available to you as you look through the remainder of this report and i will make perhaps pause here and if you look at leading diagnosis of catastrophic spent and sip simir to blue shield. cancer and circulatory are high. and you can see the other

elements for the active employee and early retiree group but we focus on these diagnosis because they drive to much of high cost cost and then i'll pause here for a quick review of data that we captured for the population. about 180 employees of the early retiree and dependents live in than the remainder of enroll's because again they don't have that plan choice and we see a lower risk score over all for the population sometimes there could be questions about and there are robust is network

choices. 98% utilization of the p.p.o. network for the planned numbers living in tuolumne county versus 97 for the plan. we see demand for services and not surprising given the risk scores lower for this population 10% fewer emergency department visits and then, we also present some information that shows health risk continuum and you can see the concern around the at risk, chronic and complex percentage of over all members as identified by united healthcare reporting so we show for active employees and early retirees and this is detailed to elaborate on my earlier comments

around preventative care services and look ago head to rating, it's the highest cost population. there's concerns that there could be lingering undiagnosed chronic disease in the population based on lower rates of preventative care, lower incidents of planned utilization over all. we will plan at the health service board meeting and then there's further information in the appendix. you can see covered details. i'll turn it back to you. >> president cohen: thank you, very much. this is a very robust for blue shield and the p.p.o. plan and i thank you for the detail. i'd like to open it up to

questions or comments on this presentation and the previous presentation there are additional questions or comments as well. so i can't see people's hands. i'm suring claire, you have a question or comment tonight. are you waving your happened yet. >> i'm looking for where my question yet? >> other board members at this point? i want to thank you for the presentation. i want to comment that you've anticipated a lot of the issues that have come up over the last year and and thank you for put together this information and

commissioner scott. >> this is the plan that is going to be replaced by the r.f.p.? is this one of the impact areas? >> correct. the administration of this plan will transition from united healthcare to blue shield in the start of 2022. >> i just wanted to be sure that that got on the record at this point as we look at this, do we believe that blue shield was going to have the same record capabilities so we see continuity between the datasets at this point. >> we fully anticipate that. i know exactly the director referred earlier to implementation getting underway and i will continue to work with both united healthcare and transition through the end of this year as well as blue shield as they commence their set up

for reporting on this plan once it goes live with blue shield 2022. >> thank you. >> i figured out a couple of questions and i appreciate that. for our tuolumne people, we acknowledge it's a generally lower cast population but in my history with them, they have continued to have a higher utilization and i wonder if we have insights as to why that is? i know there's a lot of families up there. one of my first questions is, in this transition to blue shield, one of the things i've encountered and i've talked to the providers when i've gone up there because they wanted to do that and demanded to do that with us over the years and a lot of them have admitted that the one thing that they've rejected

in the reason they're in those areas, are that they reject belonging to any of the insurance plans. they want to tell members to deal with their own insurance. so that is the whole h.m.o. thing. through the p.p.o., i'm concerned about the transition and if this means that -- what is our percentage going forward into 2022 with regard to the same physicians being available. i know in terms of specialities it's very limited access. what are we thinking it's going to happen with our tuolumne people and will they keep all of their own doctors? i know the number of facilities is limited and access to facilities is a big issue up

there. mike, do you have any comments on that? lastly, if we have any insights why their utilization is so high given the fact that they're a lower cost population. thank you. >> thank you for the question. we are underway with very, very micro detailed review of network analysis and comparison and our research has found that virtually all providers being used within the united healthcare version of the p.p.o. will be available in blue shield. with those that we may be concerned about, we're engaging with blue shield and conversations about those but again, i mean, virtually all we found will also be in the blue shield network. from a utilization standpoint, i

would say a lot depends on particular health needs of this particular population. i would say statistically, i'm 180 individuals is not a overly large population segment from a statistical validity of long-term views so what we want to make sure we're doing is working with united healthcare and blue shield and the transition to make sure that these individuals care needs are being met. there may be various reasons why it could be higher utilization. we want to make sure in the transition that sfhhs is doing everything possible to eastbound

ensure the healthcare needs are being met. >> any questions or comments from any other board members? >> >> president cohen: what i'd like to do then is. >> president follansbee, md: le. while you are doing that, if i can remind all of us in reviewing the rfp as i've been

doing over the last couple of weeks, part of our goal is to actually identify ways, not only to preserve health but improve health of all of our members and that was part of the r.f.p. and so i think that our hope is, that some of the issues that have been raised about utilization are -- our approach is not to decline utilization but to identify why the answers to some of the questions about why there may be more utilization and how we can improve the health of people to redirect them to a healthier state of well-being in this regard so i'm optimistic that our r.f.p. is going to help maybe address more fully some of the questions that we come up about our utilization and every category and with every population. not just tuolumne with all. i'd like to open it up. >> one of the things that i've

noticed and i -- the whole wellness, all of the wellness activities really originated in the city and are pretty much here as well as our wellness center in our own headquarters at 1145 market. for my tuolumne people, i think while they live in a wonderful area where they can go hikeing and biking and some of the wellness options are just not available because it's a small and discrete group in a very discrete location as well. i look to see that and i don't know it's mental health services and such but it there might be something not available to that smaller population that we have

here in the bay area. >> thank you. so, you open this up again now to public comment. >> clerk: thank you, president follansbee. all public comments are to be made concerning the agenda item presented. a caller may ask a question of the policy body but no obligation to answer engage in dialogue with the caller when i woke you are state your name clearly although you may remain anonymous. i will thank you for your comments and you will be placed back on mute and the moderator will unmute the next caller. they are streaming the number across the screen. opportunities to speak during the public comment period are available bee a phone by calling the number on the screen.

146 158 4753. you enter on the public comment call line. before we begin, we will take a pause to allow time for callers to dial in. after the pause, if you dialed in and wish to speak to this agenda item specifically, remember to dial star 3 now to be added to the public comment queue. when the system message says your line has been unmuted, this is your time to speak. for those already on hold continue to wait until the system indicates that you have been unmuted. our moderator will notify us of any callers in the queue. >> we have six callers in the phone line. zero callers have entered at this time. a reminder to all callers on the line, you must dial star 3 now if you want to join public comment for this specific agenda item. we will wait five more seconds and then close public comment for the agenda item.

>> there are still no callers in the public comment queue at this time. >> clerk: public comment is now closed. >> president follansbee, md: thd i want to thank you, again, michael, for this really superb presentation and a lot of details that we need to continue to review and digest and apply as we move forward. i would like to move on to agenda item 12, which is an action item. >> clerk: review and approve stop loss insurance recommendations. an action item. >> i will share a brief presentation on our stop-loss recommendations.

our recommendation will be basically the same as last year and you have, as the health services, some required large claim cooling in place for the plumas shield hmos, access plus and trio and there are also the reserve policy and self-funded plan stabilization policy that provides protection to the trust. so, again, consistent with prior recommendations and our recommendation is not to have the san francisco health services system purchase stop-loss insurance for the health plans. again, you will see information on the plans that are self-funded and flex funded and it will include the health hmo scheduled to be added as a flex funded plan in 2022.

and as i mentioned before, the blue shield plans already have a one million dollar protection per individual. the premiums required for reinsurance coverage from external insurers tend to exceed those claim costs over the course of time it's an insurance product and so while it may create mitigation and any specific year over the course of time what we tend to find is the premiums paid for insurance will exceed the flames will reimbursed and the bottom of the page you will see that dental plans are not candidates for stop sloss insurance and the exposure is already limited and via an annual lifetime dollar maximum and for large pools the reserves provide the protection for the trust to absorb excess claim costs. where experience may significantly exceed original

expectations and the sfhhs has, through the health and reserve policy that articulates the use of contingency reserves and they're held in a 99% conference interval as established by the external actuary and audited by third party entity annually as well. and you will see the stabilization policy does provide protection for the plumas shield and p.p.o. plans. and again, 1 million protection for the blue shield plans. we asked for the recommendation that sfhhs not purchase external stop-loss for its self-funded plans in the 2022 with the reasons stated in the bullets

below. president follansbee. >> president follansbee, md: i'd like to open the discussion up to board members for questions or discuss. discussion.>> i'd like to make e do not purchase stop-loss plans into 2022. >> i second the motion. >> so moved and seconds and i haven't heard any additional discussion at this point so i'd like to open it up for public comment. >> clerk: just a moment. it does look like commissioner breslin has been able to join us. commissioner breslin, are you able to connect in? >> i'm here now, yes. thank you.

>> clerk: just one minute. >> president follansbee, md: so we're on agenda item number 12 and it's been moved and seconds and we accept the recommendations of aeon and the staff, do you have any additional comments or questions? >> no, thank you. >> thank you, very much. >> so public comment, public comment is available for each item on this agenda. they will fight three minutes to come in length and they deem new public time limits during the meeting and all public comments are to be made concerning the agenda item that has been presented and as a reminder a caller may ask questions of the policy body but there's no obligation or engage in dialogue with the caller and when i comeel you on the call, state your name although you may remain anonymous. i will thank you for your comments and you will be placed back on mute and they will unmute the next caller. channel 26 and sfgovtv.org are

screaming the number across the screen. opportunities to speak during the public comment period are available calling (415)655-0001 and (415)655-0001. and entering access code 146 157 4783 and 14 158 4783. you enter on the public comment call line. we'll take a pause to allow time for callers to use information that is on the screen. after the pause callers, if you-day-old in and you asked speak on this agenda item specifically, dial star 3 now to be added to the public comment queue. your line has been unmuted this is your time to speak. it's already on hold, wait until the system indicates that you have been unmuted. our moderator will now notify us of callers in the public comment

queue. >> a reminder to all commissioners on the line, please ensure that you are muted to avoid background interference noise coming through. we have seven callers on the phone line at this time. zero callers have specifically entered the public comment queue. a reminder to all callers on the line, you must dial star 3 now if you want to join public comment or the specific agenda item. we will wait five more seconds and close public comment for this agenda item. >> clerk: there are still no callers in the public comment queue at this time. >> thank you moderatorment public comment is now closed. >> thank you, very much. so, that call for a vote, all in

favor of accepting the recommendations as addressed, please signify by saying aye. aye. opposed. thank you, it passes unanimously. if we can move on to agenda item number 13, also action item. >> clerk: thank you, president. agenda item number 13, review and approve 10 county survey results. action item. >> thank you, commissioners, this is larry lou c.f.o. for san francisco health service system and i'm here to give my clerk a reprieve from the presentations. i'm here to present to you the recommendations for the annual 10 county survey results that is set the average contribution policy as is dictated in the city