. . . >> thank you very much. we will now close agenda item

number 7 and move on to agenda item number 8. >> agenda item 8 is hss report as of november 30, 2021. this is a discussion item. this will be presented by chief financial officer larry loo. >> thank you, commissioners. happy to present and some of the highlights of the financials for the san francisco health services system through november 30, the first five month of our fiscal year. and in the board commissioners packets and also available on the website to the public. we are five months into our fiscal year and important to note that the fiscal year starts in june and ends in july, but the plan year starts in january and ends in december. so we're at the cusp of getting

into the end of the first half of the year and rolling into the new plan year. having said that, and this is a reminder to the commission that the commissioners that we have several sources of funding. one major source is the trust and then also the general fund budget which serves as our really operational budget. and so in the trust and the balance of $123.4 million. as i mentioned in previous report, it is a little too early to tell exactly where we're at, but the first five months that is kind of where we are. but with regard to our funded plan, we are projecting to have

a variance of $77,000 to the fund balance that does include the projection of $8.7 million in the pharmacy rebate. year to date we received a little less than half of that already. and an additional source of revenue to the trust fund is from performance guarantee. typically we prefer to see it as low as possible. these are agreements that we have with our plan and administrators that if certain things such as the calls are not getting picked up in time to the extent we both agreed to, there are things to monitor. and we received $21,000 in the form of the securities. an additional source of funds includes the income from interest. that is typically posted by the treasurer's office on the schedule.

typically that happens closer to the year end and as the time of this report, there is no interest posted. with regard to the funds where we do build a budget and use debt for communicating our benefits, developing well being programs for all of our members and covered under sfhss and also creating initiatives to reduce the cost of health care, that fund is projecting a fiscal year end balance of $2.7 million. and then moving on to the general fund administrative, that is our administrative budget. we have that intended to be net neutral. currently we are showing a surplus of $492,000. we do manage that to have a no surplus, no shortfall position. and with everything all told,

currently projecting a fiscal year end change of a smidge above 0 or an addition of $3,000. >> thank you very much. and i open up the floor for questions or comments from whole service board members. >> i have a question and the point and what i see in these fluctuations are some of the figures going to and that works out.

and expected sooner in our fund. >> yes, that is the plan in effect. that is probably good opening salvo to the mrabing that is done for the rates and benefits. when the rates are set, there is a projection on where claims and expenses are projected to be on the funded plan. there are fund that are used from services in the past and the funds and decreases in the in the area. and building up reserves and a couple of points on that is pay attention to what utilization which drives cost and then it

will drive surpluses and expectations along those lines. and in the long term in the last several years, everything netted out to be on balance. in other words, no shortfalls or gain. on dental, however, there were surpluses on the self-funded side. and so there is a strategy to mitigate that. >> thank you very much. >> any other questions or comments for mr. loo? hearing none, we will open it up for public comment. >> thank you, follansbee. instructions for public comment will be displayed visually and i will read them aloud. public comment will be available for each item on this agenda and each speaker is allowed 3 minutes unless the board president deems new public comment time limits.

all public comments are made concerning the agenda item that is presented. a caller may ask questions of the policy of the body but there is no obligation to answer or engage with dialogue with the caller. you are encouraged to state your name clearly although you may remain anonymous. i will thank you for your comment at tend of 3 minutes, you will be placed on mute and the moderator will access the next caller. opportunities to speak during the public comment time period are available by dialling the number on the screen. the number is 415-655-0001, meeting code 2498 558 9335. again, 2498 558 9335 and press pound and pound again. you will enter the meeting as an attendee on the public comment call line and dial star 3 to be added to the public comment queue. when the message says your line

is unmuted, this is your time to speak. for those on hold, please continue to wait until the system indicates you have been unmuted. sfgov has a standard 40 to 45 second delay. we will take a 45 second pause to allow the systems to catch up and callers to dial in. the 45 second pause begins now.

the 45-second pause has ended. the moderator will notify of us of any callers in the public comment queue. >> we have three callers on the phone line. zero callers have specifically entered the public comment queue at this time. reminder to all callers to dial star 3 now if you want to join public comment for this specific agenda item. we will wait five more seconds and close public comment for this agenda item. board secretary, there are still no callers in the public comment queue at this time. >> thank you, moderator. hearing no further callers, public comment is now closed.

>> this closes item 8. let's move to ie agenda item number 9. >> thank you, president follansbee. mayor's budget instructions for the sfhss general fund administration budget for fiscal year 2022-2023 and fiscal year 2023-2024. this is a discussion item and will be presented by hss chief financial officer larry loo. >> thank you, commissioners. i am here to present the mayor's budget instructions for health services board as we are doing annually, we are building a budget, a general fund budget for the biennial period for fiscal 2022-2023 and 2023-2024.

it's an annual cycle that is driven by the mayor's office for all intents and purposes sfhss staff is treat as a department within the city's budgeting system, and this budget rolls up into the mayor's budget so that is why we have the instructions for this budget are important. the mayor's budget office released the instructions and on december 15. we'll pause to note that there was significant good news by the mayor's office. for the first two years there is a projected surplus of $108 million and followed unfortunately by some structural shortfalls, so this is incredibly good news and a significant turn around from the liability of last year when we were projecting significant deficits to the tune of about half a billion or more.

what's driving this is to point this out here and the newer sources and coming in greater than what was project bid the controller's office, and so that is driving one source of that. one of the drivers of costs include the liability for the retirement system and all the benefits that they must convey on retirees. and quite frankly, they had a record year in terms of returns on their investment. it was stated the return and their assumption was about .2% return on investment but their actual was about 33%. so what that does is reduce the future cost estimate for the city as a whole.

the other driver of better than expected income for the near term is the extension of the emergency relief dollars. and not necessarily a good thing because we are still in an emergency. however, there are dollars flowing into the system to offset some of the expenses. and the other driver to the positive view of the next two years is that the operating costs of the city's departments have been moderated. they were not clear ex-pend which you ares as quickly as anticipated. so with that in mind, it is very good news. and the cities and the mayor's office and the priorities going into this budget setting cycle to restore vibrancy of san francisco including public safety and street conditions, most notable there is a lot of activity to insure that the

streets are safe and clean. so that there is more commerce to be had in the city which, therefore, drives the revenue. the focus is also in recovering the local economy driven by returns of residents and tourists and even office workers like ourselves back into the office so that that drives the economy. n internally or at least more specific to city services, really wanted to reprioritize the funding to improve core services and what really is working and what is not really working. there is a push towards more accountability and equity in programs and services and the way that we account for that and the way that those are prioritized moving forward is also a priority for city. so with that there are some specific instructions that the department must abide by. first, there is no mandatory

reduction. so not only will it pause for positive comment there, but everyone who has worked on the budget at hss has experienced reduction targets every single year and this is the first year there is zero reductions. the flip side to that is no targeted enhancement, so we're not supposed to be putting enhancements into our budget. the focus should be going back to basics filling the funded vacancies in a lot of the departments. some of the savings that we have mentioned above include the fact that it's been tough filling some of the vacancies. and so there is a big push to insure that we complete the filling of vacancies that are budgeted and keeping this budgeted vacancy. and focus on programs that produce meaningful, ethical results. and quantifying that and our

other departments are focused on having those departments balance their budget within their own revenue projections for the non-general fund departments. what are the implications to sfhss? first, this kicks off the budget setting segment. we have worked with managers to identify what are the needs for the next two years. we will be developing the general fund administrative budget as well as the health sustainability fund budget on parallel tracks. we will have to have that go through the budget and finance committee and to the full health service board and are required to have two public hearings to ask for public input and to track that. and the most significant change this year is also that there is new budgeting software so that should make the process a lot more efficient in terms of turn

around times. however, with any new system, there are hiccups, so our staff and trained and provisioned to add software and we are ready to take on the challenge. with that, that concludes my report out on the mayor's budget instruction. i will take any questions. >> thank you very much. it seems encouraging and a challenge. i would like to focus on the priority of restoring vibrancy. i can speak from my position as the board that vibrancy is about people, and that includes our active employees in the employers that contract with us including the city as well as early retirees and retirees and their dependents. and so the challenge includes mental health, substance abuse, counseling and improving on that as well. i think we can meet this challenge not only to restore,

but maybe exceed vibrancy that we have been used to in the past. i think this is a great summary of what we're facing for the next two fiscal years. thank you very much. any other comments or questions from board members? i am glad there is an emphasis placed on accountability and equity and that is the past strategic plan and priorities as well as as well as the program that we have been putting in place for diversity, equity and inclusion. so i think that these priorities overall are not going -- we are

not going to be misaligned in the current and future thinking as a board around these issues. those are the strategist and goals we are about to put in place. >> a commissioner follansbee, i would like to support what commissioner scott indicated and also just to comment when i see no mandatory reductions on a budget year, i am so thrilled i can hardly speak. that was some of the best news and it looks like we will have good opportunities going forward for the next two years.

so that's great news. i think this will be able to maintain service and do what we plan to do for the next two years. thank you. >> thank you. other comments from board members? >> commissioner, larry, this is great news. i was a longtime san francisco public servant as well. so that you are able to fill all funded vacancies is like magic, and i guess that begs the question, how many unfunded positions do you have? >> we have about four unfunded positions actually. and one of the things with budget proposals and requests, and will be trimming that out to

look what we need going forward with all the programs we are trying to support. >> great. thank you very much. >> thank you. important point. thank you. any other comment from board members? i would also say the agenda item number 11 strategic planning process will have the chance to see the budget instructions incorporated into the planning process as well. hearing no other comments, would like to open this up for public comment. >> thank you, president. our instructions are being displayed visually and i will read them allow. public comment will be allowed and each speaker will be allowed three minutes to comment in length unless the board comment deems new public time limits.

you are encouraged to state your name clearly, although you may remain anonymous. you will be placed back on mute after the 3 minutes and the moderator will unmute the next caller. remote viewing is available and opportunities to speak are available by dialling the number on the screen. the dial number is 415-655-0001. again, 415-655-0001. when prompted use access code 2498 558 9355. again, 2498 558 9355. then press pound and pound again. you will enter the meeting as an attendee on the public comment call line and dial star 3 to be added to the public comment queue. when the system message says the line has been unmuted, this is the time to speak. for those on hold, wait until the system indicates you have been unmuted.

sfgov tv has a standard 40 to 45 second delay for viewers watching online. we will take a pause to allow the system to catch up and callers to dial in. our 45-second pause begins now. the 45-second pause is ending.

the moderator will notify us of any public callers in the comment queue. >> we have three callers on phone line. zero callers have specifically entered the queue at this time. 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 close public comment for this agenda item. board secretary, there are still no callers in the public comment queue at this time. >> thank you, moderator. hearing no public callers, this is closed. >> this closes agenda item 9. i would like to move to agenda item 10 which we postponed from our december meeting and then i will promise everyone we will take a break after the completion of agenda item 10. >> thank you, president

follansbee. agenda item 10 is a board education item, health insurance portability and accountability act, hippa and is a training and discussion item and will be presented by rin coleridge, enterprise system and analytics director. i will be passing over the presenter privileges to you momentarily. >> thank you very much. good afternoon, commissioners. i appreciate your time today. and as soon as i get those privileges, i will share my deck and we will get started. >> it is coming through clearly. >> great. thanks for acknowledging that for me, holly. so let's get started.

rin coleridge with the health service system. and we are a covered entity and as such we must rely on the accountability and health information technology for economic and clinical health act, also known as hi-tech. the recent change that occurred last year is sfhss is designated a component of a hybrid entity, which is the city, along with other departments that fall under hippa requirements. for example t department of public health, fire department, city attorney, department of technology, and treasurer, tax collector. and that is an administrative construct to help simplify when we have to go out and do various legal compliance items. compliance requirements do extend to health service board commissioners and in the

presentation we're going to provide introduction to the sfhss privacy officer and that will as well as your role as commissioners and a general overview of hippa and the penalties and the practices to which we must adhere. i know many of you are conversant with hippa and so the details is in the latter part of the presentation because i want to focus the little time we have today to let you know about how does your role intersect with hippa and what you need to be aware of. hippa does not override state law and we are mindful of the state regulations that we have to comply with and so especially that are as protected of hippa and today we are focussing on the federal regulation.

we will let the privacy officer and a look at my credentials. i don't need to read them. the privacy officer is part of the hippa regulation and within that role i am a resource for you. so some of the requirements in that position are to deliver training so that is part of what we are doing here today. and also to develop our privacy policies and procedures to make sure those are implement and receiving and investigating and responding to any requests and logging disclosures and filing annually with health and human service. regularly monitoring our compliance around those hippa regulations. taking a look at the data we have and determining the classifications and that final bullet point, i want to stress that i function as a resource for any questions or concerns. and really if you ever are

unsure, ask a privacy officer prior to releasing information. and that is how we make sure we remain compliant and keep everyone protected. let's talk about your role as commissioners for the health service system. and on the health service board. i think one of your activities is that you receive, consider, and act upon member second level appeals. as part of this process a significant amount of protected health information is shared with the board. there are times that you are also receiving communication directly from our members outside of the apeels process and our membership does reach out as individually. and while a member can share any of their information, somebody is allowed to do whatever they want with their own information, but once you receive it, it is govred by hippa because we are

part of the covered entity and you are careful with that data and make sure you treat in it a compliant manner. it doesn't matter how you came to have that information. once you have it, you are bound by hippa. so one of the things like to share as a good takeaway for helping us stay compliant and protecting our members information is to always comply with the hippa minimum necessary requirement. essentially i am not sure a named person with rights to receive the information and we have ways to do that on our website in the privacy section. you will find all the hippa authorization forms that members can use to designate a third party be allowed to receive that information, but just being a commissioner does not grant you that permission to anything other than minimum necessary. an example might be follow-up information on what happened for the members who contacted you or

participated in the appeal process. and that is not necessarily a requirement for resolving the issue. so minimum necessary is really the minimum amount of information needed to either resolve the issue or complete a task or objective. that is what we mean by minimum necessary. we're always questioning ourselves with regards to me to answer the question do i need to share item a or are b and c also necessary. and fairly often you can really limit the amount of information you are sharing and still achieve the end state. and another activity as health service board commissioners is to be compliant with training requirements and i would like to extend mycin sere appreciation to all of you for completing your 2021 training by end of year so that kept us as a department completely compliant

with insuring we did that. and i do believe hss in terms of insuring the commissioners also have this information and practiced in cyber security. that is a little bit about what you are allowed to do. and that is local rules under hippa but the main are the privacy and the security rule. under the privacy rule, we are able to use and disclose phi for treatment, payment, and operations without having that explicit written consent that i referred to in the previous slide. but that did not mean, oh, hey, we all work for hss and are all on the board, so we can always have that information. no, it's really specific to, are you working on one particular issue? and so we see that frequently on member services and might have a role in resolving an issue that

doesn't involve a member of finance or communicationser to welding team. it is not an umbrella, hey, we are hss and deal with benefit administration and we all get to do this stuff. nope, it's very specific. you can always provide information to the individual who is the subject of that information. our members are allowed to have their own information. i did mention that for third parties the way they can be granted information is by obtaining written consent and we do have all those hippa forms on our website. and those are reviewed to the officer prior to releasing any information. there is some discretion they utilize in making a determination to release data under certain conditions and finally, one of the ways that we

release data is by de-identifying that data. fit's got on the a point where it is no longer personally identifiable, we are okay releasing it. there are two ways to do this with hippa. one is this scientific principles to make sure that we have reduced the data to a small risk to identify an individual. we do not use this data in how you define an expert and what are the scientific principals that you want to apply. we're going with something that is much easier for everybody not to deal with the data. you don't have to be an expert. this is accessible to everybody and that is the safe log-in method. we remove 18 type of identifyers and once we have made sure they are not in the data or information we are releasing, we know it's being de-identified

and that keeps us hippa compliant. we will look at the identifiers in a moment. here is some of the department practices for insurance and compliance. and that is the primary entity is always accountable for the protection of the information. so that is us. minimum necessary we talked about this but we limit the amount of personal information we collect, use, or share to only what -- to having a clear reason for why it's needed to take care of those activities. we do not discuss people and our members information outside of the treatment, payment, or operations. if we are discussing with within that realm, we do in it a secure manner. some secure mail. it is not in a public setting whether it is an elevator or health service board meeting or

break room and only to the individual who is have a need to know it so there again, you may find at different times as your roles as commissioners you interact with phi but your need to know it may vary at different times for the process. we do not put any phi or pii on our own computers. we keep that on secured servers that aren't something breaks into -- you have heard the stories and people leave the laptops in the car and sitting there with a coffee at a coffee shop and grab the laptop and runs. that is the world we live in. we do not put any phi or pii on those machines. pii is personal identifiable information. if we have hard copies of items that have to be shredded, we have those and i have a compliant manner when no longer

needed. phone communications is another area to be careful. we don't leave voicemail with specific information if we haven't actually reached that individual on the phone, we will wait for a callback because you don't know who is picking up the voicemail. essentially if we don't need the information, we don't store it. leaving that information around opens us up to risk. and there again, back to the privacy policies and forms that i have mentioned, there is the url for it which you don't have to remember. if you are on any page and you scroll to the bottom of that page in the footer you will see a link for our privacy policy. and of course, we must complete required training. we have done that already. and when we talk about no phi or pii on computers, we also have to be careful about hackers, right? they can access our systems.

and then get into maybe even the other systems that we've got more secure down. and that is why we are providing all of our health service board commissioners with laptops. and recently sent off by our executive director. abby. but this we find is a really critical piece as well because we want to make sure we can fully protect the systems with the end point solutions. cyber security integrates strongly with hippa because some of things that we can control like us learning about this so we know what we should and shouldn't do and there are the very capable threat actors and the items they can do to insure one less risk in terms of your own personal computers and who

you have using those personal computers. and what sites will using the secured provided hss labtops that you have for the protections on it and do remote support and making sure it's upgraded so you have to latest protections. those also are in the way. if you suspect any type of information about how to protect and go about securing it, please contact me. i am your resource. we want to make sure all the questions are being answered and empowering you before we do something we don't want to do. we went a little bit out of sequence, so let's quickly talk about hippa. what, why, how, boom. but it comes into use and transfer of false information.

iesz essentially is basis of this is to protect the continuity of care if they move from providers to specialists or to other hospital systems, so it's really both side of that coin is allowing the data to move but allowing and putting controls about how we do it so we know we are doing it in a way that helps protect personal privacy and what hippa applies to. medical, dental, prescription drug, long-term care, health and flexible spending care accounts. all of those are bolded because those are items the hss admin

registers. what it doesn't apply to, long-term disability, worker's comp, accident or life insurance. and so we have a little bit of those as well. and it does apply to covered entities which i have said we need that definition. and any of our business associates or subcontractors. so we work very closely with our contract team to have the proper legal documents in place before we share anything with our associates. and we all have a role in that privacy governance. so protecting members privacy and the security is just as important as assuring quality health benefits. i talked about phi so thanks for bearing with me if that was a new term for you.

so when you take a component and mary that up with health information, we have protected health information. it is considered any identifiable health information whether it's used, maintained, stored, or transmitted by a covered entity or our business associates in relation to the provision of health care payment or services. but it's not just past or present information or current that is aid. it is also future. it is also doesn't just have to be written or digital data. it can be verbal. it comes in any form. physical, electronic, etc. and so all of health information is considered phi when it includes any kind of individual identifiers. so back to a point i want to

stress with you because members reach out to you directly, it is phi and it falls under hippa and doesn't matter how it came to any of us. we have to protect and treat that data very carefully and who we're turning around and then sharing that information with really has to be only those that we have the protections in place that are for the treatment payment operation aspect but not just this is what i did at the office today. all right. let's talk about the 18 identifiers that i really like to use for making sure our data is accessible and you don't have to have any advanced statistical degree to be able to do this. you pull out all the items, names, geographic subdivision smaller than an estate, and any kind of dates. you can go with year and as soon as you have added a month to that information, that becomes identifiable. phone numbers, email addresses, medical record numbers.

any kind of account numbers. and you can see the list but url, internet, and so the ip address cans be traceable to individuals by a metric identifiers and finger, voice, and facial recognition as well. and number 18 is that catch-all. any other unique identifying number characteristic or code. so if we do need to share information outside of ppo, we render it as non-phi and to do that, we remove all of these items. frequently the zip code you can only do first three digits and no further down than that. as i mentioned earlier, there is a couple of components of the hippa and the privacy rule and the security rule. and so i briefly mentioned earlier that the privacy rule is really about establishing those

standards to protect individuals and medical records and other personal information. and the security rule is where we get into all sorts of layers of protection for that electronic phi and that gets subset further. we don't have time for that today, but into physical controls and that might be access to administrative controls and these are like pause words and log-ins and other technical solutions, such as when we equip information, for example, to keep that data confidential to make sure that the data is accurate so that is speaking to the integrity of that information and the people's information isn't changed in the way it should have been changed. it is available which means whether the members are requesting their own information or we need to be able to provide that information to the provider, we can get to it. we haven't done so much locking down and the annual security

service training is what helping you understand on a high level how to protect some of that information. and just a little note there are violations that you can encounter, so these violations are across four tiers. and they can go from tier one which you are looking at, like $100 per violation all the way up to a tier four which you are looking at $50,000 per violation and upwards of 1.5 million per year and i assure you we don't have that type of money to spend even though it sounded like a good budget report from the cfo. the difference between the tier one and tier four is really all about if you are completely unaware and maybe if you would recognize some due diligence, you might have known how we have a risk here all the way to

willful neglect meaning that you knew you had a risk and you had no effort whatsoever to correct that vulnerability, and so that is how these get assessed. but i want to let you know as well as the civil money penalties, there are criminal penalties that we can face, which include up to 10 years in prison. they could be lawsuits. it could be loss of a medical license. it could be employee termination and so these are significant. and at any time if there is more than 500 individuals in a certain geographic area affected by a breach, we have to notify outlets and the california attorney general's office and we want to make sure we are compliant with all of this information. and with that, i will bring my presentation to a close so that if there is any questions, i am

more than happy to take those. >> thank you very much, rin. it does complement the training that we have taken and the mandate to take yearly, so i appreciate that. with that, i will open this up for questions or comments from board members. >> this is the board secretary. rin, seeing that the presentation is still up if you were trying to take it down and screen share. >> is it still up? >> yes. >> i lost the nice bar that makes me stop doing that. >> mr. president, i would only add to your comment about this presentation supplementing what we have gotten in our training, and we speak to this in the terms and governance provisions

that we have talked about in terms of policies and regulations that apply to the hss board. and i particularly like the fact that, rin, you tailored some of the comments to our roles as commissioners. that was very useful. >> thank you, commissioner scott. and part of the reason for that as well is because in that hippa requirements we do have to do annual training and i know there was a couple minutes of hippa overview as part of the security training and this is requiring about our own policies and procedures. you use the third party tools, they are not talking about what we at hss expect. >> thank you. and if i could add to this, i think that two points. one is that the hippa rules are never supposed to interview with the actually delivery of care, but we are not delivering care

in our functions, hopefully that is not an issue. but as a member of the board f we get a specific issue from one of our enrollees who don't know where to direct the issue, it might be better as an intermediate step as to sort of send a jenin kwirry to the person we think might be responsible without forwarding the message saying i have an inquiry about benefits around the dental care or something like that. are you the one who should be dealing with this issue before we send off this message and it may go to the wrong person and department and technically that would fall into a violation if we said to someone who really should not have had that information and the wrong department and person and puts one more step in there if we are not sure where to forward a concern or complaint as a board member, we need to ask

generically and not specifically before we forward it. >> i would only add to that the first stop should be to abby and i would recommend as a board member and then certainly she can get it to rin or whomever. but i think that if we get those kinds of messages from members containing this information, the two of them should be kind of where we're sending that initial email. hey, i have received this. how do we want to process it? >> we have a pretty strong system set up for the board email and that was a risk and we shored that up so the emails come to holly, mitchell and i and we make a determination on who will address it. what we don't do is we don't tell the board what we did with it. because that is where the -- you have handed that you have to us.

we have to be super careful we don't get into specifics of specific cases. we will on occasion and you may not even know sometimes when we bring things forward that have been addressed and maybe affected more than one individual or something like that. and we have the responsibility to take affect and so we will come back and tell you about something new we are doing. and not necessarily tie it back to a single incident and that may indeed have been the instigator or something like that. we don't get into a discussion with a board member about how to manage a particular complainant. that gets into messy territory. >> again, just to alert board members sometimes members may have a personal email address for a board member through another route. and those are the times when our system can't really triage that

in a way and monitor that. so those are situations where either we send it directly to holly to deal with or send it directly to the director and not try to self-direct or whatever. i think that is a good -- the process is robust. and i think that it needs to be reinforced even if we get personal emails. we're trying to get away from that specifically. >> any other questions or comments? >> and this is commissioner and my original start date on the health service board was way back before hippa, so it's been interesting to see how things have changed over the years and rin, i want to thank you for this training and for the ongoing trainings in hippa because this, when it first came about, it was a very big issue

and a number of staff were sent to specific hippa training, but i think it's essential for those of us on the board as well in my personal experience and all the years that i have been involved with health service systems is a number of employees from all different classifications that will reach out. and either make a phone call or an email and when i have said, i don't need to hear all the details. these are projected, etc., etc., after hippa came in, what i find is that most employees because of their situation or condition or issue are incredibly willing to provide phenomenal amounts of personal information. they say, no, they're trusting you and willing for you to have

it. what i also find is that when i can call abby or mitchell and say here's an issue and can somebody call back or someone in customer service or whoever we want to deal with, when it is passed on, what i usually find is that employee will often call back and say this was resolved. it wasn't resolved. only this much could be and whatever and those employees are grateful for the assistance and very often easily relinquish what i would consider too much personal information. but they want the help and they are trusting of us. and so i think it is incredibly essential that we understand hippa and that we respect these rules and that we abide by them and we make sure that every

effort is taken to ensure their privacy. what i tell them is don't give me all the details in your email. i have don't want it. just let me know part of what the issue is and i can get someone who will call you back and deal with all those other essentials. but a lot of our members are just so desperate for the help and so trusting that they do share the information. so i think it's very, very important that we have this training and that we respect those guidelines and those boundaries, and that we work closely with our staff to make sure our members are protected. >> thank you very much. any other questions or comments from health service board members? >> i would like to comment that the line that keeps me on a narrow path and i would advise commissioners to do as well is minimum necessary.

so should you have a colleague or someone that you know who has an issue and handles hundreds of the calls very effectively, and please just take the minimum necessary information that will definitely protect you and is the right thing to do. so that we can promptly get to the concern of the member we need to talk to them directly. >> any other questions or comments? hearing none, we will open this up for public discussion. >> thank you, president follansbee. i will be pulling up the instructions.

i will be reading our instructions aloud. thank you for your comment. you will be placed back on mute and the moderator will unmute the next caller. remote viewing is available on sfgov tv channel 26 and online on web ex. opportunities to speak are available by dialling the call-in number on the screen. the number is 415-655-0001.

415-655-0001. when profrmented use access code -- when prompted use access code 2498 558 9355. then press pound and pound again. enter that meeting an attendee on the public comment call-in line and when the system message says is line is unmuted, this is your time to speak. for those already on hold, continue to wait until the system indicates you have been unmuted. sfgov tv is a standard 40 to 45 second delay for viewers watching the live broadcast online. we will take a 45 second pause to allow the system to catch up and callers to dial in. i realize my screen is not being displayed. is that correct? >> yes. >> the instruction screen is not visible. >> only says agenda item 10.

>> i want to post that for anyone who may need that and just give me a moment. >> thank you for your patience. >> i will set our clock for our system and our 45-second pause will begin now.

the 45-stekd pause has ended.

we will wait for the moderator. there is still no callers in the public comment queue at this time. commissioner, hearing no further callers, public comment is now closed. >> thank you very much. this concludes agenda item 10. and what i would like to do is take a break now. it is 3:03. we will resume at 3:15 with a roll call and agenda item number 11. so a little break until 3:15 which is 12 minutes away. thank you. >> president follansbee, i wanted to make a note that commissioner hao did need to drop off for about 30 minutes and will return. and then i believe vice president canning has joined. >> president: thank you very much. we still have a quorum at this

point, but we will resume with another roll call. thank you very much.

[roll call]

>> thank you. president follansbee, we have quorum. >> i can call for agenda item number 11. >> thank you, president follansbee. i will be pulling up the screen momentarily. and agenda item number 11 is strategic planning process update and this is a discussion item and will be led by the leticia harris senior planner and program lead. i will be giving the presenting privileges over momentarily. >> please pass presenter privileges to brian, that would be most helpful.

the advanced strategic planning through 2020 to 2022 next slide please. this slide provides a brief overview of our agenda and i will begin with the review of the perspectives with a profound and lasting process and discuss how the original strategic planning process framework has evolved over time. i will share a timeline of milestones with spotlights on tactical approaches and refresh

activities linked to 2023 to 2025 planning cycle to seek input from the health services board and commissioners. next slide please. when we think about formative strategic plan perspectives, we are acknowledging our past, present, and future. what were we facing and thinking about when we put together our existing plan? what are the pieces of our reality in the current state and has anything changed about the reality for which we need to adjust in the future. when we designed our strategy in 2018 health care perform was a driving factor fining a line on premium costs and affordable and carrier and provider consolidation and health and through the department and citywide and encouraging

information among disparate partners. in addition to reducing cost barriers and simple i willfying membership and initial focal areas with opioids and maternity and fertility. in the pregnant day the covid-19 pandemic is a driving factor of market dynamics and keeping an eye on the pandemic's effect on employee turnover, not only for ccsf and provider retirement nationwide. over the last 18 months we have seen a virtual shift to care. the key difference now is it is being provided by those who have historically performed only in-person care versus specialty tele medicine vendors and the stress of the pandemic and societal events increase and the number of members seeking mental health support and is responsive to this shift with the integration of well being and established citywide and emphasizing mental health and emotional well being. for the future we are aiming to link day-to-day work of

organizational excellence and working to collect and leverage data driven insights around population health and also equity. building on the department's lean training to focus on employee engagement and member needs and continuous quality improvement and using pricing transparency to guide rates and advocate for providers to comply with rules and krinting to the growing body of knowledge involving health care value, cost savings and quality through our evaluations. areas of focus include ageism and emphasizing mental health and care agent mth and tapping into the unique sphere of influence to the organization's goals. next slide please. as part of the strategic planning process we want to listen to the stakeholders and to manage, change, pivot and

respond to member needs with the continuous improvement con cements noted in the blue arrow spectrum. for the 2023 through 2025 cycle and analyze the initial plan to identify successes and growth opportunities including what is driven and prohibited the implementation framework when it comes to making decisions, changes, modifications or additions. to identify the progress over the life of the plan and conducting an environmental scan of the health care eco system to inform our go forward strategy. the strategy refresh exercise wills refine the quantity and scope of the business initiatives and measurable values to achieving mission and vision for 2023 through 2025.

next slide please. this slide shows a timeline of strategic planning development milestones from the beginning of the timeline and milestones in blue which represent activities that occurred pre-pandemic. and back in july 2018 we had the innovation day to bring stakeholders around facilitated discussions to guide the strategic health philosophy and guiding principals and in august we engaged all staff around discussions to develop the foundational principals with leadership and staff. by september our plan had been approve and endorsed by the board and in june and september we concluded a two-part health plan market assessment. the first part including analysis of health care systems models, friends, major players, contracting strategies and the second piece being an sfhss member focus group entitled your health plan options 2021 and beyond. we heard from many members in

that feedback session and 34 unique departments clibt kribting to the inclusive strategic planning process. in the same month we are tapping our staff through the employee engagement survey to understand how we aligned with team growth, fit, voice, values and in october we solicited our members again for a premier open enrollment survey, specifically gauging customer effort and satisfaction using national benchmarks and our response levels grew from the initial focus groups to gauge 1,000 responses from 49 unique departments. and as we move to the right-hand side of the screen, i want to indicate red post pandemic milestones to point out two previous strategic plan progress reports received by the board. one in november 2019 and again in march of 202. these reports speak specifically to the status of sfhss goals and

business performance and key performance ind kaytors. in other words, how much of the plan is accomplished. i want to convey to the board that these previous reports are publicly accessible online and distinct from today's report which speaks to the methodology that is used to inform our planning process shortly after that preliminary report on november 2019 we leveraged the board's input and learnings and partnered with the controller's office to redefine quantity, scope, and as we advance, we see in red the post pandemic milestones and think about the staff and the work force conversion they took part in extending the gratitude to them as we shifting to remote work environment and we want to acknowledge efforts of well being, finance, contract division that executed contracts in response to the mental health crises spoken to today.

launching the app and customized wellness for first responders, current employees and retirees and our esa and member services work tirelessly to make member services e-benefits accessible to all sfhss members. in the communications division to lead a development of a comprehensive suite of webinars and with interdivisional support and health partners to acknowledge the gratitude to the board for the participation of the milestones in green and the rfp for health plans 2022 plan year that concluded in february 2021 as well as our medicare rfi and that concluded in december 2021. this time reminds us of everything we have accomplish sod when we go forward, we will raise the bar and challenge the limits of our own capabilities. next slide please. enterprise systems and analytics is building an sfhss project

portfolio that maps the rates and benefits timelines to interdivisional initiatives and annual reports, audits, sum system upgrades and the creation and manager of the portfolio will aid in the 2023 through 2025 strategic planning process. and this is because a tactical approach to project portfolio management involves the continuous process of selecting and managing the optimum set of project oriented initiatives with the portfolio management to strategy and balances the resources to maximize the value delivered in executing programs, projects and operational activities. some of the benefits include greater visibility, to ground realities about resource utilization. realtime alignment of project timeline, increasing collaboration among the team members and reducing duplicative work and reimproving productivity and it helps to benefit governance and the

portfolio helps to build structure timelines around reporting and project initiatives. this streamlines the evaluation of the progress and identifying barriers, interdependencies because we can use predictive scenario modelling that is mapped out in the timelines that the portfolio contain. and lastly, control. this tactic affords greater command of the strategic direction with day-to-day operation and strategic business having been clearly defined, refined and aligned through project portfolio management. overall the portfolio management focuses the organization on achieving what is needed not merely on doing what is best but elevating performance and not just productivity. next slide please. we're always striving to convene multistakeholder experts to promote with and engage in unique sphere of influence as mentioned by the commissioners that involves a direct link between the budget and strategic

planning processes. having met with the finance department, i can reassure there is a great deal of intentionality around meeting for the fiscal year 2022 through 2023 as well as 2023 to 2024 budgeting in anticipation of the february budget deadline with allocations for strategic planning and engagements of members, staff, and equity considerations. we are proposing another kickoff day and reminiscent of innovation day back in 18. this is projected for april of 2022. we want to bring together our stakeholders and have another meeting of the minds bringing together a broad set of thinkers and perspectives that help shape our current and future programs and services to best meet our population's needs. this is centered in between a preand post refresh exercise with our leadership which will take place in march and may, again, wanting to engage all staff at every step of the process and build a consensus around the implementation framework for the future. we want to assure the board that

existing data around active and retiree member engagement from focus groups and surveys will be analyzed to determine whether new touch points and data points are needed to inform contracts, programs and communications. we aim to deliver preliminary drafts of the next strategic praft in june with the presentation of the final draft in august. our health care board secretary with the scheduling of exact dates and the distribution of calendar holds pending all covid safety protocols in relation to meeting digitally versus in person as the pandemic is continually monitored. i would to thank the board for the ongoing endorsement of the strategic planning work and the high level planning is a preview of the strategic plan refresh activities and deeper level workshoping to come and i hope this overview is helpful to you. thank you for your time. >> thank you. this is a great presentation to get us really starts thinking

about this in a real concrete way. i recall the kickoff meeting in 2018 and how robust that was and i am confident that that meeting that prow proposed will again address really the changing landscape and a lot of the barriers and successes and changes that have occurred in four years since we had that meeting. that is great. i look forward to that. with that, i will open up the discussion and questions from members of the board. >> i would like to follow on the comments of president follansbee. this process has evolved over the it racingses of my tenure on the board over the last five to seven plus years in terms of where we started and in terms of the first effort and for

strategic planning and got more sophisticated in the june 2018 every ra and now we have taken it to another level and the presentation today is a good road map to that, so i thank you for your work on this. i look forward to participating in april as we go forward to complete the plan. >> thank you. other questions or comments? from any board members? >> this is commissioner zvanski. this is a wonderful appreciation. i appreciate it and a better focus and understanding of where we're going and look forward to seeing how this all plays out. i think it is very thorough and well organized report. thank you very much. >> thank you.

>> other comments or questions about the presentation or the sort of timeline for the future. it seems ambitious, but i am thinking that, again, the board has been doinged in leadership at hss and the board has been doing a lot of the work in prep pags for this as we have implemented the last strategic plan, so i think that all this seems quite doable and challenging and will be quite rewarding, i think. >> thank you to all the commissioners and president and the key objective to identify as you mention the important changes in the circumstances and our knowledge that we can use to keep our strategy relevant and refresh it. thank you all for the engagement. >> if there is no comments or questions from the board, i will open this up for public comment.

public comment will be available for each item on the agenda. each speaker will have three minutes. all public comments to be made concerning the agenda item as presented. a caller may ask questions of the policy body but no obligation to answer or engage in dialogue. i encourage you to state your name clearly although you can remain anonymous.

remote viewing is available on sfgov tv and webex. opportunities to speak during the public comment period are available by dialling the number on the screen. it is 415-655-0001. again, 415-655-0001. when prompted, use access code 2498 558 9355. again, 2498 558 9355. then press pound and pound again. you will enter the meeting as an attendee and dial star 3 to be added to the public comment queue. when the system messages says your line has been unmuted, this is your time to speak. for those on hold, wait until the system indicates ufb unmuted. with a standard 40 to 45 second delay for viewers watching the live broadcast online. we will take a 45-second pause to allow the systems to catch up and callers to dial in. the 45-second pause begins now.

the 45 second pause has ended. i will now check to see if there are any caller who is wish to make comment on this agenda item. we have three callers on the phone line. 0 callers have specifically entered the public comment queue

at this time. a reminder to all callers to dial star 3 to be added to the public comment queue to be added for this agenda item and wait five second and close public comment for this agenda item. there is still no callers on the public comment queue at this time. commissioner, hearing no further callers, public comment is now closed. >> thank you very much. this closes agenda item number 11. i would like to call for eeg item 12. >> thank you, president follansbee. i want to know for the record that commissioner hao has returned to the meeting. we have quorum for all further action item. >> thank you. >> agenda item 12, delta den that quarterly report. this is a discussion item. and will be presented by a representative from delta dental. i will be passing presenter privileges momentarily.

good afternoon. again, my name is sharen stanek-lowe with delta dental. thank you for having me today. today we'll be discussing the quarter three, so q1 through q32021 report to the health service board. during q3 of 2021, our focus was in the following three areas.

improve oral health, network, and member satisfaction. you may call in q2, we presented this dashboard that focused on sfhss utilization of the dental plan both sieve and retiree members and the focus primarily was on prevention and looking at and pulling data for cleanings, the smile way program, online accounts and then overall utilization by type of service. i would like to go through each of these boxes to update you on the q3 numbers. so first in the upper left-hand corner, number of submitted cleanings and the teeth on the left-hand side, one cleaning, two, and three, pretty self-explanatory. but when we are looking at

numbers if we look at the active column, those are the number of active members who have had at least one cleaning from january 1 through september 30 of 2021. for retirees that number is 11,702. and when we look at the total population of individuals that have had cleanings, 40.8% of the actives and 35.2% of the retirees had at least one cleaning as of q3, 2021. 60% of our actives and 61% of our retire rear population have had a cleaning as of september 30 of 2021.

this will become much more relevant as we move from 2021 into 2024 and a more non-pandemic view of the utility i willization. the positive information here is that as of right now we have q4 data to utilize the benefit and surpassed the book of business benchmark of 58%.

and next our smile way program we have the total enrollment of 1,672. with the call out to the right explains the members receiving one, two, or three cleanings as well as the members that have received a root planing. as that asterisk indicates, members can receive more than one benefit. there are six dental codes that encompass the smile way program and they could have a root planing as well as a scaling counting towards the number of utilized benefits. what is important here is that the smile way program is designed to allow and afford the members both active and retirees

who are enrolled that third cleaning as well as the root planing at 100% if they are seeking services from a ppo dentist. this san added benefit and demonstrating that members are utilizing this benefit once they are enrolled. next our number of online accounts, why this is important is because this -- these members and actives and retirees have given us authorization, delta dental, to be able to communicate and with them electronically. this will allow us in the future to continue to promote prevention type activities to drive more individuals to get cleanings and more individuals to enroll in the smile way wellness program. last but not least is our utilization by type of service. and there are three primary

categories, dmp, diagnosic and preventive. basic and major services. this is both for actives as well as retirees. what you can see from this data and we are utilizing 2019 as a benchmark compared to 2021-2019, prior pandemic, so that's a more solid number base or database or benchmark to utilize. when we look at the utilization for actives in dmpa slight increase as well as for the retiree population. and there is a slight decrease in both basic and major services for both actives and retirees. these are numbers we want to see. we want to see more individuals in the dmp category where we identify a situation, a dental

situation and hopefully provide that prevention so it doesn't move into the major category. you might be looking at these numbers and saying, well, wait, dmp, 75.3% of activities and 69.3% of retirees use this benefit and up above when i talked about the cleanings and 60 and 61%, why don't those numbers add upper to equal the same? dmp encompasses not only cleanings but it also covers exams, x-rays, and fluoride treatment with a little bit of a difference in the percentages when we look at dmp usage comparative to the cleanings up above. i will pause here for any questions. and then i will go on to the

network slide if that is agreeable to the commissioners or i can continue. >> maybe the question i have -- this is president follansbee. the question i have is going to be addressed and i have to go through the presentation beforehand and in terms of, for example, the cleanings, do you have a breakdown in terms of whether the cleaningses are being provided and how provided for h.m.o., ppo and out of network? because one of the concerns we have had along is around access to the hmo and ppo because of the out of network or members have a much higher share of cost in terms of the costs of the claims that may be billed directly back to the member. not reimbursed by delta. do you have a breakdown of that or is that coming up? >> it is not in this slide deck,

so that is something that we can circle back with the information going forward as well as provide that to abby so it can be incorporated if she so chooses in the director's report next month. >> i would urge that and this is an important part of our understanding and both the positive side of this report but also where we can focus our efforts as the health service system in trying to improve this as well. >> thank you very much for that feedback. >> i just have a clarification on this under the number of submitted cleanings and one cleaning is 30,000 something members. two cleanings is 13,000 members.

so do you add these all together to get your 58% you said? >> the percentages. that is correct. 60%. and then the same for retirees. >> there is still only 40% have one cleaning, right? >> no, 60% -- you are correct. but overall, your population and that one individual has had two or three cleanings, they have also had one cleaning already. we add those total numbers up. the 40, the 18, and the 9 to get the 60%. >> that is a little deceiving because the merge that has only had one cleaning is still 40.8%. and people that have had two cleanings is 18%. so they still need a little pressure for these people having

only one cleaning. that is why we have this dashboard together to monitor this behavior and take action and i appreciate your input. i am being sensitive to the time and we might want to continue on. >> great. thank you. >> our next is the network and this is just a sampling of california counties. and this has this particular information has really morphed and works with not only our actuary department and also with aeon and the executive team to really build a more thorough as well as informative slide and comparative to years past and why i say that is before what we would report on to the board is

the number of dentists in our network and the numbers of dentists being utilized, added, termed and now this report is actually taking sfhss's claims data and the dental claim data and looking at how those dentists are being utilized. so when we look at the third column in, unique in network providers utilized by sfhss, those unique in network providers and unique in network refers to our ppo and premier contracted providers. and then we're looking at specifically that top line alameda county. and there were 924 utilized dentists that are contracted with delta dental that were utilized by sfhss members. when we look at next column as of september 30, 908 of those

dentists remained within our network. that change is a negative 16. they are 16 dentists that sfhss members were utilizing and are no longer on our network. and those can be reasons for the great resignation where they have decided to either sell the practice, retire or leave entirely and become a concierge type dentist. and the percentage of the next one over is that percentage of change so what that 16 den cysts who have left the network, what that change is specifically to sfhss and the good or positive information is in total our network has grown in alameda county by 88 newly acquired in

network ppo and premier dentist. and here january through september we have added 88 den cysts in alameda county to demonstrate counties that we have reported on in the past. and it's going to be a really great, useful tool in the future as to monitoring any specific county where we might see a very high uptick of utilized dentists that have left the network and drilled down as to why and how it might have affected your population. so we're hopeful that with all of the work that so many partners have put into this that this is going to be a much. relevant and useful tool so

sfhss and the membership. and that concludes my presentation. i am happy to sake any questions. so open up the floor again to questions and comments from board members. i would like to thank you for the last slide because this one is a very data driven provider definition for us. and i think that where this conversation bebegan, i had at least the initial impression there was a large provider shift going on and going on. we can talk about which group they're in and all of that and this clearly demonstrates that the magnitude of this is not as expansive as the initial impressions might have been and without this type of data, and

monitoring going forward, we would still be in that place of kind of guessing at provider changes there are. so thank you for this level of specificity. >> further questions or comments from board members? >> thank you. >> thank you, dr. follansbee. i can't resist pointing out with relatively strong populations as part of the hetch hetchy system and employees and other remote areas. i think that speaks well so mu

my concern is only this week i received calls from local member who is actually represent organizations of other members and they were talking about their only personal dentists in santa clara counties but the comment was their dentists were complaining to them. and letting them know as long-time patients that they were no longer accept delta as the complete reimbursement and going to charge this regarding cleanings. and they were going to charge their patients the full billing rate and they would submit their

invoice to delta on behalf of the client, the patient. but the reimbursement that would come would go to the client so that the dentist maintain the full reimbursement and the dentists complain they have been in practice a long, long time and were finding it extremely difficult to continue with the reimbursement rates and delta had not increased the reimbursement for such essential services such as cleanings and close to five years. i was looking to see how many were leading and san mateo and santa clara and san francisco as well. and even contra costa because we have been getting a few -- or i have received calls from members in these areas and dentists have

indicating they are leading delta because of reimbursement rates have not increased in a number of years. and the addition of in-worth network providers and we don't know if those are group practices where there are a lot of new dentists so as long as the number goes up in the last column and gaining over losing 97 and i think you will need to look at that and be realistic

about what it is the impact and they will have to pay $130 for a cleaning because the reimbursement from delta is too low for the dentists to make it worth his or her while. thank you. >> thank you very much. >> thank you for your comments. commissioner breslin, is that you? sorry. other questions or comments? >> awe i am sure it is

continuing. the cost of delivery is higher in the bay area and that they are in other regions. >> and bringing new people into the network far exceeds and i do think part of the return level in such an organization. and to me that is a low number

to have that little bit of turn. and where we're delta is help in helping us is these are the dentists that are serving our members. this is not a list of people we don't relate to. and getting into the relationship between delta and their dentist and the rate setting process is, i am not certain that is where we want to go. >> it is a complicated issue and we have to acknowledge how difficult it is for the members who have been dealing with the data for sometimes years or longer to have to then seek out and interview new dental practices knowing that their own dentists are still in practice because it is and especially with inflation, everyone's costs are going up. we have to acknowledge the pain

that this may engender for people. [reading of instructions]

when your 3 minutes have ended, the moderator will unmute the next caller. remote viewing is available on sfgov tv on channel 26 and webex. opportunities to speak are available on the number on the screen. and the number is 415-655-0001. access code 2498 558 9355. press pound and pound again. you will then enter the meeting as an attendee on the public comment call line and add star 3 to be added to the public comment queue. this is your time to speak. for those on hold, continue to wait and until the system indicates you have been unmuted. sfgov tv is a standing 40 to 45 second delay for viewers watching the live broadcast online. we will talk a pause to allow

the system to catch up and callers to dial in. our moderator will notify of us any public comment callers in

the queue. board secretary, we have three callers on the phone line and zero have specifically entered the public comment queue at the time. a reminder to dial star 3 now and you want to join public comment for this specific agenda item. we will wait five more seconds and close public comment for this agenda item. board secretary, there are still no callers in the public comment queue at this time. >> thank you, moderator. hearing no further callers, public comment is now closed. >> thank you very much and thank you very much for the presentation and the discussion and feedback. that closes agenda item number 12 and we would like to move to item 13. >> thank you, president follansbee.

this is a discussion item and will be presented by executive director abbie yant. >> you have in your packet the rates and benefit season. and we will update this and pre-present at each upcoming meeting. we put holds on these months for a second meeting. and this just is what gives us space if things get complicated. and i think we have only had to invoke one of these one time. so don't stress about it too much. and our february meeting i think is pretty straightforward where we'll be looking at the hartford insurance policy that's the extra item that will be at that meeting and so on and so forth. so should -- and do pay attention to sort of when this

is dated because as i said, it does change throughout the experience that you want to keep track and know you are on the right page and you will have to look at to put it at the top as of january 7. this is the plan. thank you. >> thank you very much. attempt to quell anxiety as well. and in these times. open this up for questions and comments from the board. hearing none, we will open this to public comment. >> pibb lebron jamesing comment will be available for each item on this agenda. each teaker will be allowed three minutes to comment unless the board president deems new public comments and all public comments to be made concerning the agenda item that has been presented.

a caller may ask questions of the policy body and no obligation to answer or engage in dialogue with the caller. you are encouraged to state your name clearly and you may remain anonymous. when the three minutes have ended, you will be placed and mute and the moderator will replace the next caller and available on sfgov tv channel 26 and webex. opportunities to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001. 415-655-0001. access code, when prompted use access code 2498 558 9355. and then press pound and pound again. you will enter the meeting as an attendee on the public comment call line and dial star 3 to be added to the public comment

queue to ind case this is a standard 40 to 45 second delay and the hah-second pause begins -- the 45-second pause begins now.

the 45-second pause is ended. the moderator will notify of of any public comment callers in the queue. board secretary, we have four callers on the line. zero callers have entered the public comment queue at this time. 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 second and close public comment for this agenda item. board secretary, there are no callers at this time. >> hearing no callers, public comment is now closed. >> thank you very much. this concludes agenda item number 13. we can move on to agenda item 14. >> thank you, president follansbee. agenda item 14, approve the june 30, 2021 incurred but not

reported ibnr reserve and contingency reserve amount for self-funded and flex funded health plans. this is an action item and will be presented by mike clarke with aon. i will be passing over presenter privileges. >> thank you. good afternoon, commissioners. i will shortly share my presentation. i will be reporting on the ibnr

reserve and from flex-funded plans and today's discussion focuses on the first two. and the ibnr occurred and not reported is our estimate and actual estimate of the unpaid liability that would be expected for runout claims for the services are incurred.

these are calculated as of the end of the plan year, december 31, and we will be discussing stabilization reserves in the march time frame. there are these three distinct reserve policies that i just covered for the following plans. flex funded nonmedicare and hmo plans and the self-funded dental ppo plan presented by delta dental of california. two important notes in the latter half of this page. first, we will not be talking about health net because the plan was not authored as of june

30, 2021 and in the future we will develop ibnr and flex reserves for 2022. and secondly there was the transition of the medical plan administrator and most participants and early retirees with uhs continued to administer for non-retiree and noting the two elements that are not part of today's presentation because the measurement data is june 30, 2021. this presentation request and health service board approval today for the incur but not reporting and contingency amounts that will be displaced on the next coup of page. for the ibnr, this table where the top of the table is for the blue shield access plus and trio

plans with the nonmedicare ppo plan administered by uhc and the self-funded dental ppo plan administered by delta dental. a slight decrease in suggested reserve for the blue shield hmo planned and substantial increases for the other two plans and as you see in my notes generated by the fact that on the prior measurement data june 30, 2020, there were substantial covid-19 claim suppression impacts during the second quarter of 202 especially in dental, most pronounced. and what we're seeing for june 30, 2021 a return to more expected an typical levels for the incurred but not reported reserves relative to more suppressed levels for the ppo plan and the dental ppo plan

that existed as of june 30, 202. in total, the overall ibnr reserves are projected to increase 1,800,274. and for contingency reserves we are seeing in total a near flattening of the suggested figure from june 30, 2020 to june 30, 2021 and though certainly with variability by individual plan. a slight reduction in the calculation of contingency reserve for the blue shield plans and as you see in my notes at the bottom of the page, the more substantial increase for the mon medicare ppo plan came with a suggested change in methodology that we use for the calculations of cycle going to more of a large claim predictive

modelling approach. we discuss this at length with chief financial officer lieu and the update to methodology was prudent since this ppo plan does not have stop los and the delta dental ppo plan to recommend a change in methodology that was discussed and agreed upon by chief financial officer lieu knowing for dental the plan exposure is essentially catched on how much per individual the plan will pay versus medical where the participant exposure is capped through maximum out of together levels.

the health service board policies are captured on the website within the governance policies in terms of reference documents and with the web link included here in this presentation. and with the numbers that you see at the bottom of the page. and finally just to note the changes in contingency reserves will be a component of the december 31, 2021 stabilization reserve calculations that we start to present to you in march. so with that, i will stop sharing. commissioner follansbee.

i have one question and that is where i can understand and the concept to deal with this regularly in terms of the pandemic effects, is there any suggestion that there's been some delay in the actual mechanism of billing? and members are being seen or

hospitalize and because of staffing problems and billing offices and whatever that we have not been getting more timely reports? in terms of reimbursement? or is it all just around the utilization that i can understand, but i am curious about the actual process of getting the charges to us. thank you for the question. what is interesting is the calculations around june 30, 2021 and we were not necessarily observing any patterns of difference in the first half of 2021 and interestingly for many of my clients as we have done year end reserves and december 31, many of my clients and the fiscal year on december 31, and we have seen some instance with some carriers of longer lag times to process and pay claims.

so it is something we will keep an eye on for us at sfhss to see if that may have impact on what to calculate as of june 30, 2022. and fantastic question. we just didn't necessarily see it as of june 30, 2021. >> thank you very much. so it's been moved and seconded that we approve the recommendations and any further discussion or questions before i open it up for public discussion? hearing none, i will open this up for public comment. >> thank you, president follansbee. i will be pulling up the instructions to display visually and reading them aloud. >> public comment will be available for each item on this agenda and each speaker will be

allowed to comment three minutes in length unless they deem new public comment items concerning the agenda item as presented. the caller may ask questions of the policy body and no obligation to engage in dialogue. when i welcome you on the the call, you may state your name clearly although you may remain anonymous. i will thank you for your comment and placed back on mute and unmute the next caller. remote viewing is available on sfgov tv and webex. opportunities to speak are available by dialling the number on the screen. the number is 415-655-0001.

access code is 2498 558 935 # an and wait until the system indicates you have been unmuted with a standing 40 to 45 second delay for viewer watching the live broadcast online. we will take a 45-second pause to allow the system to catch up and callers to dial in. the 45-second pause begins now.

the 45-second pause has ended. our moderator will notify of us any callers in the public comment queue. >> board secretary, we have four callers on the phone line. zero callers have entered the public comment queue at this time. reminder to all callers on the line to dial star 3 now if you want to insure public comment for this specific agenda item.

>> item 15 is reports and updates. this is a discussion item.

i am continuing with delta dental and still behind the scenes. but we have now been fully staffed both directors and v.p.s, national account manageers and so i officially will be handing off sfhss to the most capable jen and she will be spro deucing herself in the next moment to give you her history. not to worry. i am in full support of her and full support of sfhss. >> sharon and ri in constant

contact. lucky sharon. i am a manage we are delta dental and in the employee benefits industry for 17 years. all within the consulting world. i have started my career actually at aon. and i frequently say i grew up at aon and most recently i am coming from haze company. while i may be new to delta dental, i am not new to the industry and throughout my

career the data can tell us the story to make critical decisions and pinpoint behavior population and as well as identify critical opportunities to allow us the ability to better strategize and make recommendations as appropriate to the needs of your population. so with that i really look forward to working with the team and learning how we can continue to build on our partnership and city and county of san francisco in the future. thank you very much.

>> thank you. >> how long were you here? >> four years. >> any other comments? >> this is commissioner zvanski. all those days when i was off the board and we were sitting in the back couple of rows. the hearing room. and i will certainly miss the chatter and camaraderie back there. and you have been a wonderful representative for delta and thank you very much for your work. i am actually very happy to hear that you will remain with delta. i want to welcome jen. i think it's going to be -- i am glad the hair color seems to be consistent so i won't get the reps mixed up but i want to welcome you on board and it is interesting you came out of aon and this should be familiar ground. i think you will find this is a good group to work with. welcome aboard. >> thank you.

>> thank you again. any other comments? hearing none, any other reports from plan representatives? ? >> hearing none, i would like to open this up for public comment. holly? >> thank you, president follansbee. >> i would like to make a comment. >> yes? >> i would like to see what the mental health reimbursement is for the providers, for the mental health providers from each plan if that is possible. probably not. but i know that it came up in kaiser representation. part of the problem is the reimbursement level for mental health providers in our plans. i think that could be a big

issue because that is a difficult job. if that is possible, i would like to hear that in the future from our health plans. thank you very much. and any other comments before i open this up for public comment? hearing none, we will open this up for public comment. >> thank you, president follansbee. i will be displaying our public comment instructions visually and reading them aloud. a caller may ask questions of the policy body but there is no obligation to engage with the

caller. when the 3 minutes have ended, i will thank you for your comment and you will be placed on mute and the moderator will unmute the next caller. remote viewing is available on sfgov tv channel 26 and webex. opportunities to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001. access code 2498 558 9355. again, 2498 558 9355. and then press pound and pound again. you will then enter the meeting as an attendee on the public comment call line and dial star 3 to be added to the public comment queue. this is your time to speak. for those already on hold, continue to wait until the system indicates you have been unmuted. sfgov tv is a standing 40 to 45 second delay for viewers

watching the live broadcast online. we will take a pause to allow the systems to catch up and callers to dial in. the 45-second pause begins now. the 45-second pause is ended. our moderator will notify us of public comment callers in the

queue. >> we have three callers on the phone line and zero callers have enter the public queue. >> public comment is now closed. as we approach item 16 which is adjournment, i would like to restate the unanimous commendation of the health service board and the city and county of san francisco for the

work of larry loo during his tenure as cfo of health and human services. much appreciate and we all wish him the very best in his new position in san francisco. but not with us. again. thank you very much. with that, i would like to adjourn this meeting.

>> as a woman of color who grew up in san francisco i understand how institutions can have an impact on communities of color. i think having my voice was important. that is where my passion lies when the opportunity to lead an office in such a new space came up. i couldn't turn it down. i was with the district

attorney's office for a little over nine years, if you include the time as an intern as well as volunteer da, all most 13 years. during the time with the da's office i had an opportunity to serve the community not only as the assistant district attorney but as director of community relations. that afforded the opportunity to have impact on the community in an immediate way. it is one thing to work to serve the rights of those without rights, victims. it is really rewarding to work to to further the goals of our office and the commitment we have as city employees and advocates for people who don't have a voice. i don't know of anyone surprised to see me in this role. maybe people have an impression what the director of the office of cannabis should be like, what

their beliefs should be. i smash all of that. you grew up in the inner city of san francisco. my career path is not traditional. i don't think a person should limit themselves to reach full potential. i say that to young women and girls. that is important. you want to see leadership that looks diverse because your path is not predetermined. i didn't wake up thinking i was going to be a prosecutor in my life. the city administrator reached out and wanted to have a conversation and gave me interest in the new role. i thought you must not know what i do for a living. it was the opposite. she had foresight in realizing it would be helpful for somebody not only a former prosecutor but interested in shaping criminal justice reform for the city would be the right person for the space. i appreciate the foresight of the mayor to be open how we can be leaders in san francisco. i was able to transition to the

policy space. here i was able to work on legislation, community relations, communication and start to shape the ways our office was going to reform the criminal justice system. it is fulfilling for me. i could create programs and see those impact people's lives. i am the change. it took truants youth to meet with civil rights movement leaders who fought to have access to education. being a young person to understand that helped the young people realize this was an important thing to give up. what we find is that young people who are truanted have a really high homicide rate in our city, which is a sad statistic. we want to change that. >> coming from a community we are black and brown.

i don't reach out to other people. i don't think they feel the same way. >> i had the great opportunity to work on prison reform issues and criminal justice reform issues. we created a program at san quentin where we brought district opportunities to lifers and talk about how we are all impacted by the criminal justice system. we brought over 40 elected das to san quentin for the situation. now we are inviting the police department. our formerly incarcerated group born out of this programming asked for the opportunity to work on a project where we could bring the men in blue on the outside to come speak to the men on blue inside to start the healing dialogue around how the criminal justice system specifically in san francisco impacts the community. i was attracted to the role. there was a component of equity that was part of this process.

the equity community here in san francisco is a community that i had already worked with. before i took steps to visit cannabis businesses i thought it was important my team have a chance to go inside and speak to men who had been impacted. that conversation needed to happen so we know how we are making an impact with the work that we are doing. the da's office as we were leading up to the legalization of marijuana in the state we started having conversations on the policy team what that could look like. the district attorney was really focused on the right side of history for this. we realized it would be quite a heavy lift for individuals who have been negatively impacted by the war on drugs to expunge the record. it was important to figure out the framework to make it

seamless and easy. they put their minds to it after some time and many conversations the data analysts and other policy walk throughs on the team came up with the idea to engage the tech community in this process. code for america helped us developed the rhythm to be used for any jurisdiction across the state that was important to create a solution to be used to assist all jurisdictions dealing with this matter. the office of cannabis is the first office to have a completely digital application process. we worked with the digital team to develop the online application. there are going to be hiccups. we are first to do it. it is one of the most rewarding parts to offer a seamless -- to offer a seamless approach. that is how they can find solutions to solve many of the community challenges.

the best way to respond to prop 64 was to retroactively expunge 9,000 cannabis related records for san francisco. it feels like justice full circle for my personal experience. in the past i was furthering the war on drugs just as my directive. really coming from a place of public safety. that was the mandate and understanding. it is nice to see that pass a society we are able to look at some of our laws and say, you know what? we got it wrong. let's get this right. i had the privilege of being in the existing framework. my predecessor nicole elliott did an incredible job bringing together the individuals super-passionate about cannabis. >> the office was created in july of 2017. i came in early 2018.

i have been able to see the office's development over time which is nice. it is exciting to be in the space, stickily in thinking about her leadership. >> looking for the office it is always we might be before my time when i was working for the forboard of supervisors. i learn new things every day it is challenging and rewarding for me. >> we get the privilege to work in an office that is innovating. we get to spearhead the robust exprogram. >> i am excited she came on board to leverage experience as a prosecutor 10 years as we contemplate enforcements but approaching it without replicating the war on drugs. >> i was hired by cam laharris.

i haven't seen a district attorney that looked kind of like me. that could be a path in my life. i might not have considered it. it is important that women and certainly women of color and spaces of leadership really do their part to bring on and mentor as many young people as they can. it is superimportant to take advantage of as many opportunities as they can when they can intern because the doors are wide open. plans change and that is okay. the way this was shaped because i took a risk to try something new and explore something and show that i was capable. you are capable, right? it was about leaning in and being at the table to say my voice matters. you find your passion, the sky as latinos we are unified in

some ways and incredibly diverse in others and this exhibit really is an exploration of nuance in how we present those ideas. ♪♪ our debts are not for sale. >> a piece about sanctuary and how his whole family served in the army and it's a long family tradition and these people that look at us as foreigners, we have been here and we are part of america, you know, and we had to reinforce that. i have been cure rating here for about 18 year.

we started with a table top, candle, flowers, and a picture and people reacted to that like it was the monna lisa. >> the most important tradition as it relates to the show is idea of making offering. in traditional mexican alters, you see food, candy, drinks, cigarettes, the things that the person that the offerings where being made to can take with them into the next word, the next life. >> keeps us connects to the people who have passed and because family is so important to us, that community dynamic makes it stick and makes it visible and it humanizes it and makes it present again. ♪♪ >> when i first started doing it back in '71, i wanted to do

something with ritual, ceremony and history and you know i talked to my partner ross about the research and we opened and it hit a cord and people loved it. >> i think the line between engaging everyone with our culture and appropriating it. i think it goes back to asking people to bring their visions of what it means to honor the dead, and so for us it's not asking us to make mexican altars if they are not mexican, it's really to share and expand our vision of what it means to honor the dead. >> people are very respectful. i can show you this year alone of people who call tol ask is it okay if we come, we are hawaii

or asian or we are this. what should we wear? what do you recommend that we do? >> they say oh, you know, we want a four day of the dead and it's all hybrid in this country. what has happened are paper cuts, it's so hybrid. it has spread to mexico from the bay area. we have influence on a lot of people, and i'm proud of it. >> a lot of times they don't represent we represent a lot of cultures with a lot of different perspectives and beliefs. >> i can see the city changes and it's scary. >> when we first started a lot of people freaked out thinking we were a cult and things like

that, but we went out of our way to also make it educational through outreach and that is why we started doing the prosession in 1979. >> as someone who grew up attending the yearly processions and who has seen them change incrementally every year into kind of what they are now, i feel in many ways that the cat is out of the bag and there is no putting the genie back into the bottle in how the wider public accesses the day of the dead. >> i have been through three different generations of children who were brought to the procession when they were very young that are now bringing their children or grandchildren. >> in the '80s, the processions were just kind of electric. families with their homemade

visuals walking down the street in san francisco. service so much more intimate and personal and so much more rooted in kind of a family practice of a very strong cultural practice. it kind of is what it is now and it has gone off in many different directions but i will always love the early days in the '80s where it was so intimate and sofa millial. >> our goal is to rescue a part of the culture that was a part that we could invite others to join in there there by where we invite the person to come help us rescue it also. that's what makes it unique. >> you have to know how to

approach this changing situation, it's exhausting and i have seen how it has affected everybody. >> what's happening in mission and the relationship with the police, well it's relevant and it's relevant that people think about it that day of the dead is not just sugar skulls and paper flowers and candles, but it's become a nondenominational tradition that people celebrate. >> our culture is about color and family and if that is not present in your life, there is just no meaning to it you know? >> we have artists as black and brown people that are in direct danger of the direct policies of the trump administration and i think how each of the artists has responded so that call is interesting. interesting.

>> first of all, thank you for coming to celebrate this incredible milestone. i am really excited that she accepted. because i know what you often times may see is the fights between kim and i. what you don't know is about the friendship and the amount of love and respect i truly have for her and her work ethic from the moment i met her actively engaged in labor in a way that brought the conversation to a different level around women and minorities and their role in leadership and labor. it is good to see more women step up and in fact, it is 125

year history not one woman has ever led the san francisco labor council and kim is doing that, which is absolutely extraordinary. [applause] and you are the first executive director of the labor council to serve on this work force investment board because i didn't want to appoint the others. just kidding. but in fact, you know, this is so important. when i think about growing up in the western addition and the fights that we used to have to be included in the placements and job opportunities that exist in the city, i feel like we have come a long way but we still have a long way to go to make the real connections between people in many of the communities that many of you represent but himself the same people who want these

opportunities, the new jobs that come to san francisco. not just the work related to construction and engineering but as you know there are even shortage of nurses. the work you have done with nuhw was extraordinary onever the years. how that played a role to make sure there is a real connection between people and the opportunities, through organized labor to make sure they get their fair share, the appropriate pay and benefits and the ability to take care of themselves and their families. you have been doing this work for a really long time. i know that you are going to bring a really strong voice to this body. in the process you are going to make a lot of folks upset what it is you have to say, but i wouldn't have wanted it any other way because some things need to be upset. some things need challenged. in fact, i am not afraid of a challenge and not afraid of the

conversations that need to be had to get to a better place that is what we want. we want a better place so people have better lives. you have dedicated your lives to public service. organized labor but public service because of the people that you know you represent. the people that you know are counting on autophytes for them and make the right decisions that are going to have an impact onnary families and livelihood. regardless of disagreements at the end of the day the underlying message i know that is most important to much of you and i know is important to kill is the fact that we want to fight for better lives for the people we represent. that is why you are going to be serving on this board, and i appreciate and honor that you accepted this opportunity. i am looking forward to seeing

something change for the better for workers throughout san francisco. with that let's debt you sworn in. (applause). >> i will put on my mask. covid is running rampant and we are close to each other. place raise your right hand and repeat. i say your name do solemnly swear that i will support and defend the constitution of the united states and the constitution of the state of california against all enemies foreign and domestic that i bear true faith and allegiance to the same. that i take this obligation freely without any mental

reservation or purpose of evasion and that i will well and faithfully discharge the duties upon which i am about to enter and during such time as i serve as a member of the work force investment san francisco board for the city and county of san francisco. congratulations. [applause] >> here is a little city seal pen with my signature. i give this to all people i swear in to serve.

ladies and gentlemen, the latest person for the board tackling work force in san francisco and making real change. [applause] >> thank you, mayor breed, for taking time-out of your schedule to do this. thank you to the leaders of labor here today, especially my board members, susan, mike, charlie, debra, and my good friend karen. i want to thank you for taking time for the swearing in. it means a lot to me because i have always been really challenged by the fact there rvs and have notes in the work force, and i really want to fight overcoming making sure that everyone becomes a very. everyone has an opportunity to get a job and a wealthy job and

to join a union if they so choose. that is my mantra since i was little. it is my mantra to this day. i will fight to make sure. that is what the labor council is about making sure there are opportunities for people and career ladders. that has always been what i have been about. i want to make sure that happens. we have seen companies take advantage of people especially during strikes when they go into poor neighborhoods to try to recruit scabs. we knead to emphasize recruiting people to getting into them into construction and janitors and construction trades and up the ladder and nursing, healthcare. these are all opportunities they should all have. we want to make sure that the

san franciscans that we all know and love have that opportunity and that is my goal for this. i really intend to implement a labor caucus to make sure that we are doing what we need to do to give every san franciscan the opportunity be to participate from our economic recovery from covid and overall economic recovery as we get on with opening up the city and making sure that people come to san francisco. those the obstacles before us. i hope we overcome them altogether as we move along. thank you. [applause].

>> in 201,755.7 million passengers traveled through san francisco international airport. we have on average 150,000 people traveling through the airport every day. flying can be stressful so we have introduced therapy dogs to make flying more enjoyable.

the wag brigade is a partnership between the airport and the san francisco therapy animal assistant program to bring therapy animals into the airport, into the terminals to make passenger travel more enjoyable. i amgen fer casarian and i work here at san francisco international airport. the idea for therapy dogs got started the day after 9/11. an employee brought his therapy dog to work after 9/11 and he was able to see how his dog was able to relieve passenger's jitter. when we first launched the program back in 2013, our main goal was to destress our passengers however what we quickly found is that our animals were helping us find a way to connect with our pang.

passengers. we find there are a lot of people traveling through the airport who are missing their pets and who are on their road a lot and can't have pets and we have come in contact with a lot of people recently who have lost pet. >> i love the wag brigade. >> one of my favorite parts is walking into the terminals and seeing everybody look up from their device, today everybody is interacting on their cell phone or laptop and we can walk into the terminal with a dog or a pig and people start to interact with each other again and it's on a different level. more of an emotional level. >> i just got off an 11.5 hour

flight and nice to have this distraction in the middle of it. >> we look for wag brigade handlers who are comfortable in stressful situations. >> i like coming to airport it's a lot of fun and the people you talk to are generally people who are missing their dogs. >> they are required to compete a certification process. and they are also required to complete a k9 good citizen test and we look for animals who have experienced working with other organizations such as hospitals and pediatric units and we want to be sure that the animals we are bringing into the airport are good with children and also good with some of our senior travelers. i think toby really likes meeting kids. that is his favorite thing. he likes to have them pet him and come up to him and he really

loves the kids. >> our wag brigade animals can be spotted wearing custom vets and they have custom patches. >> there is never a day that repeats itself and there is never and encounter that repeats itself. we get to do maximum good in a small stretch of time and i have met amazing people who have been thrilled to have the interaction. >> the dogs are here seven days a week, we have 20 dogs and they each come for a two hour shift. >> there is a lot of stress when people have traveling so to from these animals around to ease the stress and help people relax a little bit. i think it's great. >> one of our dogs has special

need and that is tristine. he wears a wheel around. >> he has special shoes and a harness and we get it together in the parking lot and then we get on the air train. he loves it. little kids love him because he is a little lower to the ground so easy to reach and he has this big furry head they get to pet and he loves that. >> he doesn't seem to mind at all. probably one of the happiest dogs in the world. >> many people are nervous when they travel but seeing the dogs is just a wonderful relief. >> what i absolutely love most about it is the look on people's faces, so whenever they are stressed and flying is stressful these days you get these wonderful smile. >> i am the mom of lilo the pig

and she is san francisco's first therapy pig. >> lilo joined the wag brigade as our first pig. >> wag brigade invited us to join the program here and we have done it about a year-and-a-half ago. our visits last 1.5 to 2 hours and it does take a little bit longer to get out of the terminal because we still get a lot of attention and a lot of people that want to interact with lilo. >> i feel honored to be part of the wag brigade. it's very special to meet so many people and make so many feel happy and people that work here. it's been a great experience for

me and a great experience for to toby. >> it's been an extremely successful program, so the next time you are here, stop by and say hi. >> restaurants will be open for take out only, but nonessential stores, like bars and gyms, will close effective midnight tonight. [♪♪♪]

>> my name is sharky laguana. i am a small business owner. i own a company called vandigo van rentals. it rents vans to the music industry. i am also a member of the small business commission as appointed by mayor breed in 2019. i am a musician and have worked as a professional musician and recording artist in the 90s. [♪♪♪] >> we came up in san francisco, so i've played at most of the live venues as a performer, and, of course, i've seen hundreds of shows over the years, and i care very, very deeply about live entertainment. in fact, when i joined the

commission, i said that i was going to make a particular effort to pay attention to the arts and entertainment and make sure that those small businesses receive the level of attention that i think they deserve. >> this is a constantly and rapidly changing situation, and we are working hard to be aggressive to flatten the curve to disrupt the spread of covid-19. >> when the pandemic hit, it was crystal clear to me that this was devastating to the music industry because live venues had to completely shutdown. there was no way for them to open for even a single day or in limited capacity. that hit me emotionally as an artist and hit me professionally, as well as a small business that caters to artists, so i was very deeply concerned about what the city could do to help the entertainment committee.

we knew we needed somebody to introduce some kind of legislation to get the ball rolling, and so we just started texting supervisor haney, just harassing him, saying we need to do something, we need to do something. he said i know we need to do something, but what do we do? we eventually settled on this idea that there would be an independent venue recovery fund. >> clerk: there are 11 ayes. >> president walton: thank you. without objection, this resolution is passed unanimously. >> and we were concerned for these small mom-and-pop businesses that contribute so much to our arts community. >> we are an extremely small venue that has the capacity to do extremely small shows.

most of our staff has been working for us for over ten years. there's very little turnover in the staff, so it felt like family. sharky with the small business commission was crucial in pestering supervisor haney and others to really keep our industry top of mind. we closed down on march 13 of 2020 when we heard that there was an order to do so by the mayor, and we had to call that show in the middle of the night. they were in the middle of their sound check, and i had to call the venue and say, we need to cancel the show tonight. >> the fund is for our live

music and entertainment venues, and in its first round, it will offer grants of at least $10,000 to qualifying venues. these are venues that offer a signature amount of live entertainment programming before the pandemic and are committed to reopening and offering live entertainment spaces after the pandemic. >> it's going to, you know, just stave off the bleeding for a moment. it's the city contributing to helping make sure these venues are around, to continue to be part of the economic recovery for our city. >> when you think about the venues for events in the city, we're talking about all of them. some have been able to come back adaptively over the last year and have been able to be shape shifters in this pandemic, and that's exciting to see, but i'm really looking forward to the day when events and venues can reopen and help

drive the recovery here in san francisco. >> they have done a study that says for every dollar of ticket sales done in this city, $12 goes to neighboring businesses. from all of our vendors to the restaurants that are next to our ven sues and just so many other things that you can think of, all of which have been so negatively affected by covid. for this industry to fail is unthinkable on so many levels. it's unheard of, like, san francisco without its music scene would be a terribly dismal place. >> i don't know that this needs to be arrest -- that there needs to be art welfare for artists. we just need to live and pay for our food, and things will take care of themselves. i think that that's not the

given situation. what san francisco could do that they don't seem to do very much is really do something to support these clubs and venues that have all of these different artists performing in them. actually, i think precovid, it was, you know, don't have a warehouse party and don't do a gig. don't go outside, and don't do this. there was a lot of don't, don't, don't, and after the pandemic, they realized we're a big industry, and we bring a lot of money into this city, so they need to encourage and hope these venues. and then, you know, as far as people like me, it would be nice if you didn't only get encouraged for only singing opera or playing violin. [♪♪♪] >> entertainment is a huge part of what is going to make this city bounce back, and we're going to need to have live music coming back, and comedy,

and drag shows and everything under the sun that is fun and creative in order to get smiles back on our faces and in order to get the city moving again. [♪♪♪] >> venues serve a really vital function in society. there aren't many places where people from any walk of life, race, religion, sexuality can come together in the same room and experience joy, right? experience love, experience anything that what makes us human, community, our connective tissues between different souls. if we were to lose this, lose this situation, you're going to lose this very vital piece of society, and just coming out of the pandemic, you know, it's

going to help us recover socially? well, yeah, because we need to be in the same room with a bunch of people, and then help people across the country recover financially. >> san francisco art recovery fund, amazing. it opened yesterday on april 21. applications are open through may 5. we're encouraging everyone in the coalition to apply. there's very clear information on what's eligible, but that's basically been what our coalition has been advocating for from the beginning. you know, everyone's been supportive, and they've all been hugely integral to this program getting off the ground. you know, we found our champion with supervisor matt haney from district six who introduced this legislation and pushed this into law. mayor breed dedicated $1.5 million this fund, and then supervisor haney matched

that, so there's $3 million in this fund. this is a huge moment for our coalition. it's what we've been fighting for all along. >> one of the challenges of our business is staying on top of all the opportunities as they come back. at the office of oewd, office of economic and workforce development, if you need to speak to somebody, you can find people who can help you navigate any of the available programs and resources. >> a lot of blind optimism has kept us afloat, you know, and there's been a lot of reason for despair, but this is what keeps me in the business, and this is what keeps me fighting, you know, and continuing to advocate, is that we need this and this is part of our life's blood as much as oxygen and food is. don't lose heart.

look at there for all the various grants that are available to you. some of them might be very slow to unrao, and it might seem like too -- unroll, and it might seem like it's too late, but people are going to fight to keep their beloved venues open, and as a band, you're going to be okay. [♪♪♪]

francisco. >> my name is fwlend hope i would say on at large-scale what all passionate about is peace in the world. >> it never outdoor 0 me that note everyone will think that is

a good i know to be a paefrt. >> one man said i'll upsetting the order of universe i want to do since a good idea not the order of universe but his offered of the universe but the ministry sgan in the room chairing sha harry and grew to be 5 we wanted to preach and teach and act god's love 40 years later i retired having been in the tenderloin most of that 7, 8, 9 some have god drew us into the someplace we became the network ministries for homeless women escaping prostitution if the months

period before i performed memorial services store produced women that were murdered on the streets of san francisco so i went back to the board and said we say to do something the number one be a safe place for them to live while he worked on changing 4 months later we were given the building in january of 1998 we opened it as a safe house for women escaping prostitution i've seen those counselors women find their strength and their beauty and their wisdom and come to be able to affirmative as the daughters of god and they accepted me and made me, be a part of the their lives. >> special things to the women that offered me a chance safe house will forever be a part of

the who i've become and you made that possible life didn't get any better than that. >> who've would know this look of this girl grown up in atlanta will be working with produced women in san francisco part of the system that has abused and expedited and obtain identified and degraded women for century around the world and still do at the embody the spirits of women that just know they deserve respect and intend to get it. >> i don't want to just so women younger women become a part of the the current system we need to change the system we don't need to go up the ladder we need to change the corporations we need more women like that and they're out there.

>> we get have to get to help them. >> >> ♪♪ ♪♪ we are definitely pioneers in airport concession world a world of nationally if not entirely or internationally >> everybody is cop us right now. >> the people that were in charge of the retail this is where that began. >> i didn't think we would have a location at the airport. >> we've set the bar higher with the customer commerce. >> telling me about the operator and how you go about

finding them and they get from being in the city to being in the airport. >> so first, we actually find a table and once we know what we want a sit-down we go to the neighborhoods in san francisco and other people seminary of the retail let us know about the rain water and are excited to have the local operators in the airport. >> we have to go going through the conceive selective process and they award a lease to the restaurant. >> they are planning on extending. >> we that you could out the china and the length evens and the travel serve and fourth your

minds and it's all good. >> how long for a vendor to move through the process. >> i would say it could take 80 up to a year from the time we go out to bid until they actually open a restaurant. >> i don't know what we signed up for but the airport is happy to have us here. and, you know, even taking out the track simple things there's a learning curve >> with once we're here they are helpful. >> it's an award-winning program. >> we're prude of your awards we have won 11 awards the latest for the best overall food address beverage program and . >> like the oscars (laughter). >> the professional world. >> tell me about the future

food. >> all the sb national leases are xooirz and we're hoping to bring newer concepts out in san francisco and what your passengers want. >> well, i look forward to the future (laughter) air are we look fo >> by the time the last show came, i was like whoa, whoa, whoa. i came in kicking and screaming and left out dancing. [♪♪♪] >> hello, friends. i'm the deputy superintendent of instruction at san francisco unified school district, but

you can call me miss vickie. what you see over the next hour has been created and planned by our san francisco teachers for our students. >> our premise came about for san francisco families that didn't have access to technology, and that's primarily children preschool to second grade. >> when we started doing this distance learning, everything was geared for third grade and up, and we work with the little once, and it's like how were they still processing the information? how were they supposed to keep learning? >> i thought about reaching the student who didn't have internet, who didn't have computers, and i wanted them to be able to see me on the t.v.

and at least get some connection with my kids that way. >> thank you, friends. see you next time. >> hi, friend. >> today's tuesday, april 28, 2020. it's me, teacher sharon, and i'm back again. >> i got an e-mail saying that i had an opportunity to be on a show. i'm, like, what? >> i actually got an e-mail from the early education department, saying they were saying of doing a t.v. show, and i was selected to be one of the people on it, if i was interested. i was scared, nervous. i don't like public speaking and all the above. but it worked out. >> talk into a camera, waiting for a response, pretending that oh, yeah, i hear you, it's so

very weird. i'm used to having a classroom with 17 students sitting in front of me, where they're all moving around and having to have them, like, oh, sit down, oh, can you hear them? let's listen. >> hi guys. >> i kind of have stage flight when i'm on t.v. because i'm normally quiet? >> she's never quiet. >> no, i'm not quiet. >> my sister was, like, i saw you on t.v. my teacher was, i saw you on youtube. it was exciting, how the community started watching. >> it was a lot of fun. it also pushed me outside of my comfort zone, having to make my own visuals and lesson plans so

quickly that ended up being a lot of fun. >> i want to end today with a thank you. thank you for spending time with us. it was a great pleasure, and see you all in the fall. >> i'm so happy to see you today. today is the last day of the school year, yea! >> it really helped me in my teaching. i'm excited to go back teaching my kids, yeah. >> we received a lot of amazing feedback from kiddos, who have seen their own personal teacher on television. >> when we would watch as a family, my younger son, kai, especially during the filipino episodes, like, wow, like, i'm proud to be a filipino. >> being able to connect with someone they know on television

has been really, really powerful for them. and as a mom, i can tell you that's so important. the social confidence development of our early learners.

>> as a woman of color who grew up in san francisco i understand how institutions can have an impact on communities of color.

i think having my voice was important. that is where my passion lies when the opportunity to lead an office in such a new space came up. i couldn't turn it down. i was with the district attorney's office for a little over nine years, if you include the time as an intern as well as volunteer da, all most 13 years. during the time with the da's office i had an opportunity to serve the community not only as the assistant district attorney but as director of community relations. that afforded the opportunity to have impact on the community in an immediate way. it is one thing to work to serve the rights of those without

rights, victims. it is really rewarding to work to to further the goals of our office and the commitment we have as city employees and advocates for people who don't have a voice. i don't know of anyone surprised to see me in this role. maybe people have an impression what the director of the office of cannabis should be like, what their beliefs should be. i smash all of that. you grew up in the inner city of san francisco. my career path is not traditional. i don't think a person should limit themselves to reach full potential. i say that to young women and girls. that is important. you want to see leadership that looks diverse because your path is not predetermined. i didn't wake up thinking i was going to be a prosecutor in my life. the city administrator reached out and wanted to have a conversation and gave me interest in the new role.

i thought you must not know what i do for a living. it was the opposite. she had foresight in realizing it would be helpful for somebody not only a former prosecutor but interested in shaping criminal justice reform for the city would be the right person for the space. i appreciate the foresight of the mayor to be open how we can be leaders in san francisco. i was able to transition to the policy space. here i was able to work on legislation, community relations, communication and start to shape the ways our office was going to reform the criminal justice system. it is fulfilling for me. i could create programs and see those impact people's lives. i am the change. it took truants youth to meet with civil rights movement leaders who fought to have

access to education. being a young person to understand that helped the young people realize this was an important thing to give up. what we find is that young people who are truanted have a really high homicide rate in our city, which is a sad statistic. we want to change that. >> coming from a community we are black and brown. i don't reach out to other people. i don't think they feel the same way. >> i had the great opportunity to work on prison reform issues and criminal justice reform issues. we created a program at san quentin where we brought district opportunities to lifers and talk about how we are all impacted by the criminal justice system. we brought over 40 elected das to san quentin for the situation. now we are inviting the police

department. our formerly incarcerated group born out of this programming asked for the opportunity to work on a project where we could bring the men in blue on the outside to come speak to the men on blue inside to start the healing dialogue around how the criminal justice system specifically in san francisco impacts the community. i was attracted to the role. there was a component of equity that was part of this process. the equity community here in san francisco is a community that i had already worked with. before i took steps to visit cannabis businesses i thought it was important my team have a chance to go inside and speak to men who had been impacted. that conversation needed to happen so we know how we are making an impact with the work that we are doing. the da's office as we were leading up to the legalization of marijuana in the state we started having conversations on

the policy team what that could look like. the district attorney was really focused on the right side of history for this. we realized it would be quite a heavy lift for individuals who have been negatively impacted by the war on drugs to expunge the record. it was important to figure out the framework to make it seamless and easy. they put their minds to it after some time and many conversations the data analysts and other policy walk throughs on the team came up with the idea to engage the tech community in this process. code for america helped us developed the rhythm to be used for any jurisdiction across the state that was important to create a solution to be used to assist all jurisdictions dealing with this matter. the office of cannabis is the first office to have a

completely digital application process. we worked with the digital team to develop the online application. there are going to be hiccups. we are first to do it. it is one of the most rewarding parts to offer a seamless -- to offer a seamless approach. that is how they can find solutions to solve many of the community challenges. the best way to respond to prop 64 was to retroactively expunge 9,000 cannabis related records for san francisco. it feels like justice full circle for my personal experience. in the past i was furthering the war on drugs just as my directive. really coming from a place of public safety. that was the mandate and understanding. it is nice to see that pass a society we are able to look at

some of our laws and say, you know what? we got it wrong. let's get this right. i had the privilege of being in the existing framework. my predecessor nicole elliott did an incredible job bringing together the individuals super-passionate about cannabis. >> the office was created in july of 2017. i came in early 2018. i have been able to see the office's development over time which is nice. it is exciting to be in the space, stickily in thinking about her leadership. >> looking for the office it is always we might be before my time when i was working for the forboard of supervisors. i learn new things every day it is challenging and rewarding for me. >> we get the privilege to work

in an office that is innovating. we get to spearhead the robust exprogram. >> i am excited she came on board to leverage experience as a prosecutor 10 years as we contemplate enforcements but approaching it without replicating the war on drugs. >> i was hired by cam laharris. i haven't seen a district attorney that looked kind of like me. that could be a path in my life. i might not have considered it. it is important that women and certainly women of color and spaces of leadership really do their part to bring on and mentor as many young people as they can. it is superimportant to take advantage of as many opportunities as they can when they can intern because the doors are wide open. plans change and that is okay.

the way this was shaped because i took a risk to try something new and explore something and show that i was capable. you are capable, right? it was about leaning in and being at the table to say my voice matters. you find your passion, the sky >> hello, i am with the san francisco parks department serious we are featuring some wonderful locations in your and very own backyard. this is your chance to find your heart in san francisco with someone special.

we are here at the lovely and historic palace of fine arts, located in the bustling marina district. originally built for the 1950's exposition, the palace is situated along san francisco's waterfront. it is ada accessible and is reached by the 28, 30, and 91 bus lines. with its rotunda, columns, uncut the reflecting waters against the eucalyptus trees, it is one of the most romantic settings for special dates, and memorable proposals. it is also a perfect spot where you can relax with that special someone while listening to the water and fountain in the lagoon. beautiful to view from many locations, and inside is an ideal place to walk around with

your loved ones. the palace is the most popular wedding location in the city park system. reservations for weddings and other events are available at strecpark.org. shakespeares' guard and refers -- has plants referred to in shakespeare's plays and poems. located near the museum and the california academy of sciences, shakespeares garden was designed in 1928 by the california spring blossom association. flowers and plants played an important part in shakespeares literary masterpieces. here is an enchanting and tranquil garden tucked away along a path behind a charming gate.

this garden is the spot to woo your date. appreciate the beauty of its unique setting. the cherry tree, the brick walkways, the enchanting stones, the rustic sundial. chaired the bards'w ro -- share the bard's words. the garden is a gem to share with someone special. pack a picnic, find a bench, enjoy the sunshine and let the whimsical words of william shakespeare float you and your loved one away. this is one of the most popular wedding locations and is available for reservations. shakespeares garden is ada accessible. this park is located at the

bottom of a hill. it is a secret garden with an infinite and captivating appeal. carefully tucked away, one block from the bottom of lombard street, it makes the top of our list for the most intimate picnic settings. avoid all tourist cars and parking hassles by hopping on the cable car. or the 30, 45, 41, or 91 bus. this garden was designed by a the landscape architect thomas church in 19 to -- 1957. grow old with me, the best is yet to be is inscribed at this gem of a park. a lush oasis anchored by gazebosanchoreddekcs, -- gazebos, anchored by decks.

this is the place to tell your family the love you share. reservations are available for this hidden gem. i am jamie hopper. until next time, don't forget to get out and play. for more information about reserving one of these romantic locations, or any other location, call 831-5500. this number is best for special events, weddings, picnics, and the county fair building. for any athletic fields and neighborhood parks, 831-5510. you can also write us. 501 san francisco, calif. 94117. or just walk in and say hello.

and of course you can find more information and reach us at sfrecpark.org. >> hello everyone. welcome to the bayview bistro. >> it is just time to bring the community together by deliciousness. i am excited to be here today because nothing brings the community together like food. having amazing food options for and by the people of this community is critical to the success, the long-term success and stability of the

bayview-hunters point community. >> i am nima romney. this is a mobile cafe. we do soul food with a latin twist. i wanted to open a truck to son nor the soul food, my african heritage as well as mylas as my latindescent. >> i have been at this for 15 years. i have been cooking all my life pretty much, you know. i like cooking ribs, chicken, links. my favorite is oysters on the

grill. >> i am the owner. it all started with banana pudding, the mother of them all. now what i do is take on traditional desserts and pair them with pudding so that is my ultimate goal of the business. >> our goal with the bayview bristow is to bring in businesses so they can really use this as a launching off point to grow as a single business. we want to use this as the opportunity to support business owners of color and those who have contributed a lot to the community and are looking for opportunities to grow their business. >> these are the things that the san francisco public utilities commission is doing. they are doing it because they

feel they have a responsibility to san franciscans and to people in this community. >> i had a grandmother who lived in bayview. she never moved, never wavered. it was a house of security answer entity where we went for holidays. i was a part of bayview most of my life. i can't remember not being a part of bayview. >> i have been here for several years. this space used to be unoccupied. it was used as a dump. to repurpose it for something like this with the bistro to give an opportunity for the local vendors and food people to come out and showcase their work. that is a great way to give back to the community. >> this is a great example of a public-private community partnership. they have been supporting this

including the san francisco public utilities commission and mayor's office of workforce department. >> working with the joint venture partners we got resources for the space, that the businesses were able to thrive because of all of the opportunities on the way to this community. >> bayview has changed. it is growing. a lot of things is different from when i was a kid. you have the t train. you have a lot of new business. i am looking forward to being a business owner in my neighborhood. >> i love my city. you know, i went to city college and fourth and mission in san francisco under the chefs ria, marlene and betsy. they are proud of me. i don't want to leave them out of the journey. everyone works hard. they are very supportive and

passionate about what they do, and they all have one goal in mind for the bayview to survive. >> all right. it is time to eat, people. okay. >> are we live?t, people. okay. >> yes. >> good morning. the meeting will come to order. welcome to the thursday, january 13th, 2022,