>> the regular meeting of the health service board is being held virtually. if we can have the roll call, please. item 2. >> call to order at 1:01 p.m. roll call. president follansbee. >> present. >> vice president canning excused. commissioner breslin. >> here. >> supervisor chan is arriving momentarily. >> commissioner hao. >> present. >> commissioner scott. >> present. >> commissioner zvanski. >> present. >> we have a quorum. >> thank you. before the next item i want to

announce that the health service board appreciates all of the members and public for send g.e. mails to us. we receive them and read them carefully. several we have reviewed several e-mails for this meeting. several deal with an item that will be covered in the director's report which is agenda item 7. i don't want to discourage anybody from commenting in item 5. if it refers to a topic in the director's report i would request that the public and members limit their comments to that agenda item. i understand there are time constraints. we are not going to reject comments under item 5. if you can we appreciate it. with that, i would like to move to agenda item 3.

>> agenda item 3. resolution allowing teleconferenced meeting under california government code section 54953.3. >> we are operating under 30-day extension to allow virtual meetings under this current pandemic situation. we have approved similar resolution in the past. we need a resolution for the next 30-days. any questions? otherwise i will entertain a motion. >> i make a motion to accept as presented. >> second commissioner scott. >> moved by zvanski and seconded

by commissioner scott that we approve the resolution extending the meeting for 30-days. any further discussion? if not i open this up for public comment. >> i will display those instructions and read. public comment will be available for each item. each speaker is allowed three minutes unless the board president deems new time limits. all public comments are on the agenda item presented. there is no obligation to answer questions or even gauge in dialogue. when i welcome you on the call state your name clearly. you may remain anonymous. you will be placed on mute and the moderator will unmute the next caller. remote viewing is online using web ex. opportunities to speak are

available by dialing the number on the screen. 415-655-0001. when prompted use access code 24842306521. then press pound pound. you will enter as attendee on the public call line and dial star 3 to be added. when the message says your line is unmuted that is time to speak. if you are on hold wait until the system message indicates you are unmuted. sfgovtv has a standing 40 to 45 second delay for those watching live online. we will take a 45 second pause to allow the system to catch up and callers to dial in. the 45 seconds begins now.

>> the 45 second pause has ended. moderator will notify us of callers. >> we have five callers on the phone line. zero callers entered the public

comment queue at this time. you may enter as comments continue. reminder to callers on the line. you must dial star 3 to join public comment for this item. we will wait five seconds and close public comment for this agenda item. >> there are still no callers in the public comment queue at this time. >> no further callers, public comment is closed. >> it is moved seconded to approve the resolution allowing teleconferencing for the next 30-days. in favor signal by saying aye. opposed. hearing no opposition the motion passes unanimously.

thank you very much. agenda item 4. >> approval with possible modifications of the minutes of the meeting set forth below. this is an action item to be presented by president follansbee. >> in the packet are the minutes of the january meeting of the health service board. any discussion, modifications or corrections on this item from health service board members? >> mr. president. this is randy scott. i move that the minutes of the january meeting be approved as distributed. >> second. >> thank you very much. moved by commissioner scott and seconded by multiple

commissioners that we approve the minutes of the january regular meeting of the health service board of the city and county of san francisco. i will open up for public comment. >> there were grammatic cal errors. whoever did the minutes doublechecks they will show up. nothing major that changes anything. >> thank you very much. >> public comment is available. each speaker is allowed three minutes unless the board president deems more time limits. as a reminder you may ask questions of the policy body. state your name clearly.

you may remain anonymous. i will thank you for the comments and the moderator will unmute the next caller. remote viewing on sfgovtv and using web sex. opportunities to speak are available by dialing the number on the screen. 415-655-0001. when prompted use access code 24842306521. press pound and pound again. you will enter as attendee and dial star 3 to be added the queue. when your line is unmuted this is your time to speak. for those on hold continue to wait until the system indicates you are unmuted. sfgovtv has a standing 40 to 45 second delay for those watching online. we will take a 45 second pause

to allow the system to catch up and callers to dial in. 45 second pause begins now. our moderator will notify us of

callers in the queue. >> we have seven callers on the phone line. zero callers have entered at this time. reminder. you must dial star 3 now, if you want to join public comment for this agenda item. we will wait five seconds and close public comment for this item. >> there are no callers in the public comment queue at this time. >> public comment is now closed. >> thank you. it is moved seconded we approve the january 13, 2022 health service board regular meeting minutes with some minor grammatic cal changes.

all those in favor say aye. opposed? thank you very much. that passes unanimously. now we will call for item 5. >> general public comment. an opportunity for members of the public to comment on any matter within the board's jurisdiction including anything not on the agenda or requesting the board place a matter on a future agenda. this is a discussion item. >> thank you very much. before we open this up i want to remind any callers that my message earlier in the meeting that we received a number of e-mails from people who were wishing to speak to the issue of public safety and mental health and substance abuse treatment

disorders regarding an organization out of maryland, iaff. this will be covered in an agenda item 7. the director's report. for context if the public can withhold comments until that agenda item, we would appreciate it. we realize people have time constraints and may choose to comment now. we will entertain all comments on this agenda item 5 at the present time. board secretary open up for public comment. thank you. >> each speaker is allowed three minutes. all public comments are to be made concerning the agenda item presented. caller may ask questions.

there is no obligation to answer. you may remain anonymous. i will thank you for your comment and the moderator will unmute. remote viewing is on sfgovtv and online viewing using web ex. opportunities to speak during the public comment period are available by dialing 415-655-0001. use access code 24842306521. press pound pound. you will enter as attendee and dial star 3 to be added the queue. when the message says you are unmuted this is your time to speak. if you are on hold wait until you are unmuted. sfgovtv has a standing 40 to 45

second delay for those watching 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. our moderator will notify us of

any callers in the public comment quo. >> we have seven callers on the phone line. one caller has entered the public comment queue. other callers may enter. i will indicate when there are no more callers. first caller. >> welcome, caller. >> good afternoon, president follansbee. i am with the national union of healthcare workers. i want to bring to your attention your recollection last october in 2021, the board of

supervisors started a series of hearings on behavioral health access for h.h.s. and health plan providers. from that hearing kaiser permanente presented with the clinicians providing behavioral health access. what was significant about the hearing. the data they present to measure access to healthcare is self-reported and goes to the department of managed healthcare in the state of california. they say the data access to behavioral health treatment is appropriate and the timeframes they provide clinicians were able to show otherwise. for the tens of thousands of people who receive healthcare, behavioral healthcare from the health plan it is important we get this right. we get from the city what we

paid for in health benefits from our health plans. that hearing really demonstrated that you are going to need to know the board of supervisors and the health services if we are actually getting what we paid for. we encourage health services system to work with public sectors unions representing workers to see if they get access they need. conducting the survey will help and the findings will help in working out better plans with the health plan. we think health service system should be able with the findings discuss with the department of managed healthcare that measures access we get the right measures and tools to show whether we are getting what we paid for. these are important rules in the coming months as we renew health plans for the next year. i look forward to working with you on that.

thank you. >> next caller. >> we have eight callers on the line. no other callers have entered the queue at this time. reminder to callers dial star 3 now to comment for this agenda item. we will wait five seconds and close public comment for this item. >> there are no other callers in the public comment queue at this time. reminder to callers that spoke dial star 3 to lower your hand.

thank you. >> thank you. no further callers. public comment is now closed. >> thank you very much. we will move to item 6. >> thank you, president follansbee. >> the president's report. discussion item presented by you, president follansbee. >> i have no written or verbal report. we can go ahead and close this and move to agenda item 7. >> thank you, president follansbee. >> item 7. director's report. discussion item. this will be presented by executive director yant. >> good afternoon. so noted many commissioners were able to figure out the

technology to get the backgrounds that acknowledge this february month is black history month. it happens also to coincide with lunar new year. i appreciate the efforts that the commission did to acknowledge that background and recognize the work that is before us at hss to ensure equity for all races in healthcare. the covid-19 update as you just passed the resolution to continue to virtual board meetings. it is likely that this may change in the next month or so as impact of omicron is on the downswing. we are very happy about that as we consider how we will conduct business going forward. we will keep you informed and

our staff as well. the other related covid issue this month is the decision to make home test kits available through medicare programs. the devil in the detail as they say. that is quite convolutessed. it will take them some time to issue guidance and regulations. in the meantime our medicare advantage plans kaiser and uhc have acknowledged this and kaiser already has a site and forecast set up kp.org how on the kaiser advantage plan can get reimbursed. i believe it is up to eight tests per month. during this hiatus.

we expect medicare to be addressing this. we will let you know when we know. unite also has just figured out how to do this. we have been working really hard to figure it out. we will be putting instructions up with the help of unite and communications team for unite members next week. similar model 8 tests per month with $12 capper test. that is hopefully getting resolved. we have had a number of calls and concerns from some of our members how we were going to address this. it always seems simple and it is never simple. i do appreciate the efforts that our account management team have put to this. they are employees of very large complex organizations and to

process these decisions in short arder is no small task. i appreciate that. last month and on occasion there is a discussion at the board level about reimbursement of providers. i want to acknowledge that those issues are addressed by the plans. we don't negotiate directly with providers, but we do share your concerns with the plan. i want you to know we are listening. we are providing that information and feedback to the plans. on the topic of public safety and mental health and substance abuse disorder treatment which several people are going to testify regarding this today. we have talked at the last two meetings about this. there is a particular program that members of our fire

department wish to have covered by health insurance. we are working with our health plans to see if that can be accomplished. we are getting adding a service to a network is also a lengthy process. the services need to meet the standards of the organization. we have had discussions with blue shield and kaiser about the inclusion of this program. we will keep you informed. i do understand the desire of the firefighters. we are doing a lot through our program to support the mental health and well-being of firefighters. we have as you will hear later in the finance committee heard this week, we are recommending a budget enhancement to enhance

the 24/7 services that we provide through aip. we have an ongoing work group with public safety developing the r.f.p., selecting provider. last part is figuring out how to pay for it. i have contacted department heads to let them know this is coming. i had that discussion with the mayor's office so i feel positive about addressing the budget concerns. on the center of excellence the firefighters want we will continue to work with the plans to see what they are able to accomplish. i have heard this organization is planning to open a second site in southern california. that is going to help tremendously. also we want to make sure our members recovery services are part of organized health

delivery system. that is what we promote to get full-service for people in need of recovery services with other health issues which should be addressed within that system. moving to director's report. the standard blackout notice period reminder is we are in the rates and benefits. we have issued some of the renewal letters. all will be out this week. we are off and running. we continue to do racial equity action planning in december at the board you heard report out from latisha harris regarding the progress we made on the plan that had been submitted to the office of race equity.

since that time just about two weeks ago we got feedback from the ore. so did 51 other departments. it took 13 months to go through all plans. we are to provide an update to the plan to the office by march 1st. latisha was clairvoyant, i think in the know that we would be getting an ask like this. i thought it was very good that we had updated the board as recently as december. i think the technical work that needs to be done will be easier. we will inform you should we need the need to make substantive changes you should be aware of. on the personnel front posting

is underway including chief operating officer position. we hired a recruiter to assist with. the team is staying really busy. i can't tell you how many projects we have going on. i think that summarizes things pretty well for today. i would like to entertain any questions from the board. >> general question. i know behavioral health access regarding kaiser. i would hope that would be done for other health planners as well blue shield and unite. is that possible to look at the other health plans the way you did at kaiser?

>> commissioner, i think the last time i mentioned it when you brought this up. absolutely. in fact, the way to continue the hearing was to indicate the fact we were not looking into kaiser but other health service providers providing that same service to city workers. that was the intention. the hearing happened towards the end of last year. we have yet to be able to schedule some of the hearings and we are waiting for the chair of government audit and over site, supervisor dean preston, chair, to allow the scheduling. i look forward to seeing the opportunity to survey our members and to see independent survey for the members. what are their feedback for men taking healthcare not just for

kaiser but all members receiving services from all service providers. as we saw from the presentation for a directory. the service providers, not just kaiser, seem to have a high percentage ever responding rates. not the self-reporting data. i look forward to you verifying data from meshes to get a more critical aspect of the data and a conversation that is a bit more productive. >> thank you. we need help for the firefighters. it is important to include the police officers. they have just as serious job and sometimes even worse.

i just put that in. this excellence seems to be for firefighters. that is good. i would prefer more than just firefighters. i would like to see our other responders included in a new access place. >> commissioner breslin, the police department has a list of preferred providers they use that are contracted. they are comfortable and their leadership is very helpful. to help firefighters to those recovery programs that are

closer. >> the last time i checked was police department. they didn't have very good access. not enough providers. >> we are talking about mental health providers? >> right. >> mental health and recovery services are related. >> now there is a nationwide shortage of mental health providers. all organizations are struggling in that regard. >> this is randy scott. i would like to raise a question with director yant. >> go ahead. >> back on the racial equity planning report. i have read the paragraph that you said i thought i was listening closely. can you tell me what it is

specifically that they have given us feedback on and what this report back to them by march 1st is to be? this is still phase 1, i presume. >> correct we submitted that plan originally we got to think about the years. december 2020, the year we had your endorsement and approval prior to that. then we have worked on that plan during that time and provided the you date in december of 21. two weeks ago we got evaluation of the plan we submitted to ore with some suggested language in it, issues to address. not issues but thoughtful reflection of our plan. it was a summary of our plan

p.they have asked us to consider that and whatever else we need to consider in updating our plan and resubmitting on march 1st. it is still internally focused. phase two is externally focused and be that is yet to be published. >> i keep hearing the phases. i would like to encourage you as department head on behalf of this board we are interested in because of the lines of our strategic plan as we for late it dealing with providers and external member services. it is a critical item for us to address the issues of social determinants of health in our

members. i would like that to reflect as we respond back to this march 1 deadline. yes, we will address these things that you are suggesting. incorporate but we also want the guidance or parameters of phase 2 to be addressed in an expeditious fashion. >> i appreciate that. we are operating in that mode as if we would have standards. the topic of social determinants of health comes up almost every day. we were reviewing data with a health plan yesterday and had a lengthy discussion at that point. we have also recently with derek's departure asked latisha to be on the equity committee at

the integrated healthcare association, which is a very influential organization. she will be on that committee. the interesting thing next week they are going to postpone this month's meeting because the dhmc has recognized that there is a lot of clatter about equity measures and somebody needs to step forward. they are going to do it. that was like, yeah, there is an awful lot of chatter and time and work being done by really good people, but there hasn't been alignment. dhmc is taking that leadership role will allow a lot of organizations to leap frog into this discussion. we have something to be discussing. >> thank you very much.

>> commissioner zvanski. >> abbey, when you talk about a shortage of mental health providers, and we live in a provider rich area in the bay area, but i do understand the shortage. can you comment on how the situation is impacting eat. i also make an assumption that many of those are also referring our members to get the services to our providers in the health plans. can you comment on how the eap is impacted by the situation? >> our eap is small. three positions and one is

vacant with a retirement. we are recruiting. we expect that to be a challenge. we did at the beginning of the pandemic in april of 2020 gain mayor's office support since we did expect and were experiencing an uptick in demand for services. we expanded external contracting 24/7 service in order to meet that demand. that has been -- gary provides the reports every month in the director's report that is the service i am speaking with commissioner breslin that we are expanding services to meet some of these expanded needs in the public safety department. it is sheriff, police and fire. i think it is the good news of the whole endemicna that the

increase in utilization of mental health has increased. we are continuing to support the willingness of people to seek care. as to the shortage of the work force. there is federal hearings on this in the last week or two. there is a state healthcare work force committee. there is a lot going on. healthcare has been very impacted for a variety of reasons during the pandemic. the work force shortages are very real. there is a lot of effort being spent on that. >> if i could comment on a couple issues. number one, i saw figures last week looking at the expected employment. every healthcare sector including mental health and

hospital, offices, outpatient, all of this. every sector was below anticipated employment, mental health is one of the furthest below. the shortage extends across all healthcare sectors. i think that we need to acknowledge that this is the issue in san francisco. the city and county of san francisco. the cost of living for healthcare workers has not gone down. many of them as we have discussed. we understand in all sectors have lower paying jobs. have to community long distances and employees as part of systems often are looking for options closer to their zip code of residence. this is not an issue that we in san francisco are immune from as

well. i appreciate all the discussion and efforts and mental health as well as other sectors. i want to ask a couple things. one the covid benefits have a lot of information. it looks great through, you know, 2021. it doesn't include issues right now. such as under treatment, copays through march 2021. maybe we could ask ann to update for the current status. i would also maybe try to include some information about access to current therapies. there is a lot of concern that many of the monoclonal antibodies and antivirals are restricted through protocols or not available or dispensed

widely. if they plan to respond to this issue. should we come down with covid we would be first in line to get appropriate therapy. i am not clear from the chatter out there in the it world that is the case. i guess the last question i would have is how are we doing in terms of our strategic planning process for 2023, 2025, are we on track with that as best you can tell? >> absolutely. i think we did a presentation last month on the planning. that continues. holly is putting out updates on your calendars for the session where we will be asked to participate directly. >> that is focus groups with membership. that is good. i wanted to make sure there

hasn't been any change in that timeline. >> no, not at all. >> thank you. >> any other questions or comments from health service board members? hearing none we will open up for public comment. >> public comment will be available for each item. each speerker is allowed three minutes unless new time limits are deemed during the meeting. all public comments should be on the agenda item committed. there is no obligation to answer or even gauge in dialogue. state your name clearly. you may remain anonymous. when your three minutes end i will thank you for your comment and you will be on mute and the

next caller will be unmuted. opportunities to speak during the public comment period are available by dialing the number on the screen. 415-655-0001. access code 24842306521. press pound pound. you will enter as attendee on the public call line and dial star 3 to be added the queue. when the message says you are unmuted this is your time to speak. if you are on hold wait until you are unmuted. sfgovtv has a 45 second delay for the live broadcast online. we will take a 45 second pause. it begins now.

>> the pause has ended. notify us of any callers in the public comment queue. >> we have nine callers on the phone line. four callers entered the public

comment queue at this time. other callers may enter as public comment continues. i will indicate when there are no more callers. there will be a brief silence between callers. welcome caller. >> good afternoon, commissioners. i am acting battalion chief. the health safety and wellness chief of san francisco fire department i am responsible for development and organization of health safety and wellness for all uniform members. this is taking many forms from the tangible job for ensuring the members are fit and trained. firehouses maintained, personal protective equipment is clean, well fitting available, to supporting the mentally

emotional and spiritual health. the behavior health of members is what i am speaking about. the -- emotional burden working as a fire fighter or paramedic can be overwhelming as we are ex-spoused to traumatic situations at work. over time for some the way can become overwhelming. alcohol and drugs and behavioral health conditions such as post dramatic stress disorder some struggle with both any or all. from more severe cases they consider suicide. first responders are twice as likely to experience ptsd and more firefighters take their life than are killed in the line of duty. we is have two coaches that

support the department members and families including confidential alcohol chemical counseling for members, assistant to recovery hams and outpatient support. we is have a critical response team, peer support team, two facility dogs to provide k-9 support and working to enhance the chaplain program to provide multi nomination group to provide support and spiritual support to personnel. san francisco firefighters are not alone. we do not have resources to help members with this support. providing the opportunity to find treatment allows for robust and comprehensive program to adequately serve all of our members of the san francisco fire department and their families. i am in support of this program

and believe it supplements what we currently offer. thank you for this opportunity to speak to you today. thank you. >> thank you, caller. before you take the next caller i want to make an announcement for callers on the line. three minutes will begin and i will interrupt when you have 30 seconds remaining on your publicment. unmute the next caller. >> good afternoon, commissioners. i am adam wood executive board member of local union 798. we support retired firefighter who spoke to you last month encouraging the additional resources to treat behavioral health. i would like to share the union experience trying to address the elevated risk for behavioral health issues in firefighters,

including post-traumatic stress disorder and the struggle to find providers. the san francisco fire department has a long standing peer support team to help with substance and abuse and behavioral health problems. we have a problem finding providers to assist with referrals. in 2018 m.o.u. negotiations on advice of our peer support team leader we negotiated a benefit modeled on the health benefit available to police officers through their contract. they agreed to provide mental health providers outside of the health insurance and workers' compensation. this section has been in the contract for almost five years. the department has been unable to find a network or group of providers to provide is service

we need. this is our problem. group of workers with elevated risk for behavioral health disorders, peer support and employer trying to help workers. the efforts are failing due to extreme shortage of mental health professionals trained to assist this employee population. i urge the health service board to consider any resource to help suffering firefighters includes iaff center of excellence and treatment centers. there are too few resources to reject any without careful consideration. i understand your responsibility is to the city work force as a whole. you have smaller cohorts with elevated risks that must be addressed. police officers and firefighters is recognized as a job hazard by the state of california.

that cannot be mitigated with resources available to us. consider supporting the public safety workers. >> next caller. >> thank you, commissioner for putting this on. i am fred sanchez protect our benefits president and retired deputy chief for san francisco fire department. what walter and the union are talking about is the uniqueness of public safety. not only fire department. police department, nurses, but this goes beyond the pandemic.

this condition was here long before the pandemic. it will continue long after the pandemic. we are trying to get mental health professionals that know the uniqueness of the fire or police profession. it is so unique. you see things on a daily basis. myself i lost a child in a room at a fire. it got me so nuts i walked out of the building and threw my badge off and was going to quit. i will take a moment. it takes mental health professionals that really know the job, specifically the job. i remember when i was in the fire academy. they told us that one in every five of the firefighters would become an alcoholic.

it wasn't because we did things in the fire station that shouldn't be done. it is how we felt medicated after trauma. it is way beyond the average worker in city government. i ask you schedule a special meeting to talk about this in more depth. i know abbey is trying to facility this. i would like to have a special meeting to speak at length to try to how best facilitate this and move the process forward a little faster. thank you. >> you can elevate the next caller. >> welcome. >> good afternoon, commissioners. i am a retired firefighter for the san francisco fire

department. i spoke in the december and january health service board meetings during public comment requesting to be on your agenda. i hope this all coming to for the io firefighters to create an option in a behavioral crisis. the center of excellence is doal treatment that can serve as treatment for member in crisis. we have different roles and titles. commissioners, executive, firefighters. we have a gate goal for the citizens. adding another mental health resource and associated resource facility provides greater options to the firefighters and first responders. it was introduced a year ago this month february 2021.

they had gone through several treatment facilities and outpatient through health insurance plans. they no longer wanted treatment in their own backyard. they appealed for specialty treatment at center of excellence. after -- [indiscernable] we have a work force that lives up and down california and many other states. center of excellence will be in maryland but open west coast treatment facility in 2022 near san diego. let's wait until the west coast is open is not the best solution in the current behavioral crisis. last week i streamed the service of the three firefighters in baltimore. i listened to the eulogies.

firefighters take an oath to serve communities. think of ores before themselves. run towards danger instead of away from it. it is a passion. they are there to help not ask for help. let me ask for help for them. come together to help in the behavioral crisis. [please stand by]

>> caller: i think somehow that calling meagain . i just spoke. i appreciate the opportunity to just thank you for all you do forus . >> thank you,caller . moderator, you can let us know if there are any callers who need to be elevated for public comment. >> it wouldappear we have a few hands raised .

a reminder to pressá3 to lower your hands and aadditional reminder to other callers you must dialá3 to join public comment for this agenda item . we will wait five more seconds and close public comments for this agenda item . board secretary, there are no callers in thepublic comment q at this time. >> thank you moderators and hearing no further callers . >> president follansbee thank you to all the callers for their succinct and clear messages regarding the issues . the board appreciates your participation and this process. with that we willclose agenda item number seven and moved to agendaitem number eight .>> thank you president follansbee .

agenda item number eight is an roly demographic support of the plan year 2022, this is discussion item meant to be notedon the agenda it did read 2021 . but it is on plan year 2022 presented by grantcoleridge, director of enterprise . >> thank you holly, good afternoon commissioners andthe board . i'm with health analytics and if you could give me presenter privileges. >> those are coming through's thank you.

>> is my pleasure to bring to you the 2022 demographicsreport . in this report i go into the details and i must acknowledge the herculean effort of ryan costs are team members who put in a very extensive effort. there's a lot of data points in this report and it literally takes weeks to assemble so my gratitude to those individuals and in fact there's so much information in this report. i'm just going to call out to you highlights and items of interest for your discussion. everything in this report flows into our strategic planning and we also use initiates unpopular

results. [inaudible] moving to page 3 of the report to talk about plan your changes so 20/20 to the health services system offers a health net and take care hmo and this debuted 322 and the other changes we have is the change to plan administrator for the ppo from united healthcare and then met transition of 5.2 percent decrease in enrollment and in part that is related to our makeup to medicare families will also see in the report the uhc companions and cbo. since we don't have medicare with the blue shield this is only available to mixed medicare family who desire the ppo.they have less than 114 lines in there and 57 families.

overall our total the line decreasedby one percent and i'll talk more about that in a few slides . the non-medicare population increased by three percent and medicare population by four percent. there's a look at page 4 and i'd like to call out our flexible spending account because we still have the double-digit increases. health care fsa increased by 10 percent and dependent care fsa increased by 45 percent and this was aided certainly by a target outreach of the health service system performed in 2021 to our non- income earners so these were employees to educate them about pretax benefits and also the changes the irs had allowed during last year and it was an extremely successful campaign and just a

reminder that we only administer the fsa for employees of san francisco and for the superior court. moving on to page 9 in the report. here at the bottom table please look at our vision premiere. this is available to all of ou members , employees and retirees that are enrolled in the medical plan and the vision premiere is by a component that is fully paid by the employer and it continues to be popular and we saw another two percent increase in enrollment of the plan. our voluntary benefits, these are also only available to superior court of san francisco. our most popular benefit continues to be supplemental licensure. it's not always a benefit with the highest enrollment but it's also one where we saw the

greatest increase over the previous year. i talked about that total line going down by about one percent so here were taking a quick look at the five year trendsfor hires . retirements and termination and the hiring decreased in 2020 and in part that's because the testing centers closed that are a necessary part of the recruitment period that began to rebound in 2021 but the hires, the terminations are still outpacing those with new hires. i'm moving forward to page 9 and i want to talk about that hedge population and here we're taking a look at the small signal on the bottom right at the total lives we have and that didn't decrease by 24 billion but moving forward to page 14 we will take a look at the breakdown by our hsf

members and in the employee populations that decreased from 68 to 60 and the retirees in that area decreased by a count of two. let's talk about families here on page 17. this is where we give you a breakout of our employee and retiree members by adult child or with children or both adult and child. and then across the board we saw increases in both the employee andretiree population . and i am moving that forward to page 19. this is a look at just the employee members and dependence and in the top left here we got the graphic that looks at our employers by race and ethnicity

and i'd like to caveat this and make you aware we do not have race data for all our employees. this is reflective of33,903 individuals and do not have available the base data for 26,284 . of note and comparing to 2021 there's a decrease in the percent of employees down from 14.392 13.86. also or our black employees that decreased from 14.2 to 13.1 three percent. with our white employee population that's an increase from 33.22 33.6 percent. and asian population increased by 27.4 percent to 27.5 percent with all of the other rate at the city groups less than one percent staying the same as

they were in the previous year. and the bottom right of this page we're looking at a breakdown of average age by plan for our employees and dependents as well as the overall. the overall age did increase slightly in active employee population from 35.9 236 point 10. i'm going to take you forward to page 25 so we can take a look at what's going on with the average age of our chinese population.same thing the graphic here takes a look at it by plan and here we see the overall age. for our medicare population that decreased 5.02, 75.93. by non-medicare population decreased by over three years on that average age and so that decreased from 56.21 to 53.15. there are risk for predictors

which is most of certainly age correlates to patients so we're definitelytaking a look at that. moving forward , we just want to take another lookhere at what's going on with our retiree population . and so most of the retirees are in california. 92 percent of those enrolled are in california with another seven percent being in other states and those are the same things we've been seeing this year among our concentration of retirees list. at the far right-hand column of the slide are international retirees by country both enrolled and waived. this population is less than 12 percent. it's very small individuals and we do monitor this information to ensure that services are

available where our employees always live but this remains relatively unchanged and if i didn't mention it already this report exists on our website, sf hsa .org and there's a lot of detail here for our members to pull up and go through and with that i will end my presentation and take any questions . >> thank you for this detailed and incredibly important review of the demographics. i guess my first question i would have is you have any sense on what this might mean as part of our strategic planning?you see trends over several years, you refer to rates of hiring issue for enrollees or employees and i'm

assuming this will go up over the next few years based on budget projections etc. do you have any comments in terms of your own sense about the meaning of all this my own sense and i've said this for multiple years is we are a very consistent population so a lot of our data points remain very close year-over-year. we don't see dramatic change, definitely and i agree withyou . we continue to see a rebounding so some of these are certainly important and will be filed by the executive team. we will continue to take this data more now, it takes more time within the department as we also report ontheir initiatives .>> i'm

particularly sensitive to the issue around our active employees and file how far they have to commute. i'm assuming that the demographic data is their home addresses that people don't list their office address in that information. >> what we put in the demographic report is based on home address but we also know that potentially people are getting scared near where they work and so we do a lot of other analysis that doesn't make it into this report. i think we've brought some of it before the board but eric has done a lot of work looking at the usability indexes and aredoing that in terms of looking at computer skills and language and education levels by zip code . we do it by both. where you live, where you work. the problem with the work data is around data control ability and thatcities been getting better at it but we don't

always have the right ideas , or many parts are areas of the city, the same thing with bus drivers. some of those aremobile . some jobs and department may have billing addresses and there's one billing address. that data i'm happy to say has been gettingbetter over the years . so that helps improve our ability to do those analytics but we take it and use it with what it is butthat's the caveat .>>. >> president: questions or comments from other commissioners. commissioner scott,your unmute i think . >> i'd like to thank you and your team for another thorough and comprehensive review of our population and enrollment so i know thistakes a lot of work .

my question extends to how this and i asked this question over several years how this gets communicated back about the benefits negotiations with our actuary. using this datawith our health plans . can you draw that out just a littlebit ? >> i defer to our actuary about what he's doing with this data but i know for example i think there's a page on here where we break out individuals that are involved in the kaiser outside of california so that's where we looked at that demographic information and how we had gotten to sufficient lives in those areas that the report is pursuing and helping get offerings throughkaiser . that's one of the ways that data gets used. i note something like rich wants to talk about it being a

predictor correlating to utilization. certainly on actuarial level we know that more than just our totalpopulation we are looking at enrollment specifically . >> historically again there hasn't been a lot ofvariation . am icorrect in saying that ? >> that is correct. >> i just bring that up again just as a nuance as we're dealing with our partners. >> if i may commissioner scott mike clark, actuary with ai. we definitely use the data demographic report as well as the information that will we will subsequently produce later in the race benefit cycle. i especially am interested in looking at demographic changes as they may influence production of cost under the 2023 plan year when there is

notable change and average age in a given plan that has the potential to influence claims cost in the future and especially the risk because the demographic information ultimately is a component of the risk tours. i specifically look at that information to see how risk profile population keeps changing over time so thank you for the questionand thank you commissioner breslin for putting this together . >> i think the commentor asked to listen. >> thank you very much doctor follansbee. i want to commend you and your staff for a phenomenal report. when you do it annually it blows my mind. i think my clerk just on the fact that with every year at every birthday some of the statistics have to change but it's curious as to how stable the trend seems to continue and

we're sort of a predictable population but please you and your staff are just a phenomenal asset to the health service and providing us with information we need as we go forward. i would like to ask one question. i noticed when we look at our international population , some years ago before director again was on board we did kind of a campaign, a membership type of campaign with our members for living abroad and suggested to them that they might look to the nations and areas in which they live whether or not there were some national health plans options available to them and saw that that also help with some of our costs because as

they switched to some of those mobile plans and where they were living they came off of mostly our city plans options. you have any idea as to whether or not those who are unenrolled are in fact enrolled with any kind of health plans in their areas? i know it's a small population and i don't know that we reach out to them but do we have any sense that they have other options for health coverage ? and for any of these that are unenrolled do we know if there are other options that they are pursuing? >> i do not have that information commissioner. i will let you know for ultimate enrollment we do also communicate with our international numbers. >> so unless they tell us we don'tknow .

i also assume that for some people maybe they had prior employment or different employment or maybe through a partner they could havebetter options but thank you, i appreciate it very much . >> thank you very much. >> other questions orcomments . i can't see all the commissioners on myscreen. i'm going to have to change my layout . >> this is commissioner howe i have a quick comment . the few years that i've seen this presentation from you i become more and more impressed with your data powers. i think this information is really needed and it helps us think about the lives that we cover and how to best serve them. so thank you i know that your hard work contributes to great outcomes that we've seen so thank you to you and your team.

>> thank youvery much and that is definitely a tool to help . >> any other questions or comments from board members ? hearing on we will hold thisup for public comment . >> iq president follansbee. i'll be playing ourinstructions . just a moment while i've received those privileges to be able to be cochair again. the screen sharing may take a moment. i will begin to read those

instructions allowed. and hopefully wewill sync up . seems like it's coming through. yes. so public, it will be available on each item on this agenda. the speaker will be allowed three minutes unless the board president needs new public comment time. all comments are to be made concerning the agenda item i presented and as a reminder there's no obligation to answer or engage in dialogue with the caller. when i welcome you your encouraged to state your name fairly although you may remain anonymous. when your three minutes have ended you weekly be placed on mute and the moderator will

have the next color unmuted. opportunities to speak during the public comment period are available by dialing the number on the screen, 415-655-0001. again, 415-655-0001 . when prompted use access code 2492 235 0478 again, 24842306521 then press pound and pound again. dialáthree to be added to the public comments you. when the system has indicated your lifehas been on muted this is your timeto speak . for those all in team to wait until the system indicates you have been on muted . sfgov tv is standing a 45 second delay for viewers watching our broadcast and will take a 45 second pause toallow systems tocatch up and callers to dial-in . 45 second pause begins now .

the 45 second pause is ending. our moderator will knowto notify us of any colors in the queue . >> thank you board secretary, if you) we have 2 colors on the phone line. one has entered the public comment queue at this time. other colors may enter the queue.

this fund has been raised since the last round ofpublic comment and will be elevated toensure the caller does have an additional comment . you may hear a moment of silence as we transition . awaiting host privileges. elevating the first caller now. >> welcome caller. caller, your line has been on muted. >> it appears as though the handremains raised from a previous round of comments . there are no other colors in the queue atthis time . a reminder to other colors on the line you must dial á3 now

if you wantto join public comment for this item. we will wait five more seconds and close public comment for this agenda item . board secretary, there are no callers in the queue at this time . >> hearing no furthercallers, public comment is now closed . >> thank you for that extraordinaryreport and to your staff as well. we've been meeting for an hour and a half . what iwould like to do is unless there are objections is to declare a break at this point . we will reassemble in 10 minutes with a rollcall. which will be at 2:30 8 pm or 2:30 9 pm. we are temporarily taking a break, thank you. >> thank you mister president.

>>.

>>. [rollcall] >>. [rollcall] with that we have a

quorum. >> agenda item number nine. >> thank you president follansbee. i'll be presenting. agenda item 9, hhs financial report as of december 31 2021. this is a discussion item will be presentedby hs as cfo . >> good afternoon. so this is the summer report and you'll have moredetailed information in your package . the trust fund does have we expected on.

[inaudible] >> mister president. >> mister scott, i'm having difficultyhearing our cfo . it's like it's garbled. >> so am i. >> i'm going to give this to the speaker, is it better? >> that is much better. >> sorry aboutthat. i'll start over . these are results fordecember . the total trust fund, balance and the trust fund there projectingthat my 7 and a half million by the end of the year 218 million . thisis still a healthy balance in the trust fund . and the 7 and a half decline is coming from rate stabilization. that is a process whereby when we have a positive experience we pass on the benefits of that

positive experience which is basically meeting the claims and expenses coming in though we passed it back to as acredit . so most of this was planned. we are experiencing slightly higher claims. 2 and a half as the main suppression from covid where people are going back and getting services . the plans for most of this, it's a half-million is the substitute plans. so i'll keep going.we do have a pharmacy program where he received 4 million, extending a point seven by the end of the year. last year wereceived 8.6 .

the interest when we get these submissions wouldbe controlled by investments . our funds are invested into with the cityand county investments . the standard of living fund we are projecting ayear-end balance of 3.8 million . which is just incredible and we have an ongoing annual basis, january is about to end so the administrative fund we expect to close close to budget. we are currently running favorable but we take wethink the work orders will come through by the end of the year .

that's my report and i'm happy toanswer any questions . >> you for the clearreport mister zane.any questions from the commissioners ?any questions at all? i guess it was so clear there are nine. in that case will open this up with public discussion . >> thank you president follansbee. i'llbe displaying those instructions and reading them aloud.public comments will be available for each item on this agenda . all public comment will be made concerning the agenda item

presented and as areminder a caller may ask questions of the policy body but there's no obligation to answer or engage in dialogue . when i welcome you are encouraged to state your name clearly although you may remain anonymous . when you're three minutes have ended you will be placed back on mute and the moderator will unmuted the next caller. remote viewing is online via web ask. opportunity to speak are available by dialing the number on the screen, 415-655-0001 . again,415-655-0001. when prompted use access code 2484 230 6521 . again, 2484 230 6521 then press pound and pound again. you will enter the meeting as an attendee on the public comment call line and dialáthree. when the system indicates your line has been on muted this is your time to speak. for those on hold continue to wait until the system indicates you have been on muted. sfgov tv is has a standing 45 minute delay and we will take a 45 second pause to allow colors

todial in. our pause begins now . >> ... our 45 second pause has ended. moderator will notify us of any calls in the queue.>> we have 2 colors in the phone line.

if the city could and are the public comment queue at this time.a reminder, you must dialá3 now. we will wait fivemore seconds and then close public comment for this agenda item . board secretary,there are still no callers in the public comment queue at this time.>> hearing no further callers public comment is now closed . >>you for this report. i guess i'm reassured that last month we discussed or asked why there might be some lag in the billing . and representative samantha said thatwasn't the case. they suggested that suppression was from the clinical encounters . i will call for agenda item

number10 . >> thank you president follansbee. agenda item number 10. approval of the san francisco health services system fiscal year 22 to 23 and 23 to 2024 proposedgeneral fund administrativebudget . this is an action item and will be presented by commissioner howell, chair of the finance and budget committee . >> thank you president follansbee and fellow commissioners, mary howe here . yesterday finance and budget committee met and had the pleasure of hearing from our cfo about our health service systems proposed general fund

administrative budget that it will present to the mayor for the next 2 fiscal years. we as a committee comprised vice president canning and breslin we recommend to the full board we approve this item as presented. mister hussein presented us a budget that wasconsistent with the mayor's budget instructions. no growth and yet no decreases . no growth with the exception of any colas or other adjustments that are built in and so what he presented to us and i believe he will have a summary in short order is our ways that the health system proposes to submit some of x expenditures sothere is no net reduction or increase . again, ourcommittee recommends the full board that we approve this item .ithikar, i don't

know if you have items you want to present to our board. >>. [inaudible] >> ithikar, what's coming through is your full screen. yes, it's coming to your full screen. >> this document i'm sharing now has the budget for the next two years. every year we submit budgets for the upcoming 2 years. and then on this page the first column of numbers and second to the last column of numbers represent the budget for those years. it is as the commissioner mentioned to the mayor's guidelines we do have a request to the mayor for 2 items which are not representedhere but if

those are approved we will add those to the budget . those two items are $200,000 increase for the enhanced mental health support for public safety employees. and another $600 to transition some of our runs of prevention that we are currently funding out of the health services fund since those activities are effective we would like to transitionthose and fund those out of the general fund . >> director follansbee, i'm turning it back to you. >> i will entertain a motion then to accept the recommendation of the budget and finance committee to approve the budget as

presented. >> second commissioner breslin i'm going to elevate your motion. now i'dlike a second . >> it's been moved and seconded that we approve the sf hsa general fund administration budget. there is nofurther discussion . >> i do have a question. we indicate that we have through negotiation and expectation of somewhere between 24 million and i forget the other number. 39 million dollars in sort of overall reduction of expenses for this upcoming budget cycle. can you give me what we have

achieved through these negotiations from the prior budget? you may not be able to do that right off today but i think that would be of interest as a notation going forward. we have each time we submit these budgets we say we are expecting a forecast of x number due to negotiation and so forth but i think showing that that has happened in this prior budget would help to bolster the case of that forecast. >> i can answer that. and we do the health care sustainability budget, in the material for that we showed the rate and negotiations that we have been able to achieve and how those rates are compared to

benchmarks they are very favorable in the current year the net effect is negotiated at 1.28 percent benchmarks or about 4 to 6 percent suggests yes. so the negotiation efforts are paying off in terms of being able to deliver healthcare to our employees and their families. >> i see that, i'm just saying on this one slide and i don't know the page number. the page number is not there. it says it's one and a half, 1.28 for the benchmark of 4.2 to six percent and there's a forecast here for2021 . i think it would be useful if that figure is available to have that appear there as well.

we forecasted so much in fy 2021 that this is what we would actually happen. that would be helpful i think to sustain what you'resaying your forecast is going to be for 2022 . what we actually achieved in 2021. just requesting that number or adjustment. in this document. >> so it's been moved and seconded and we approve the proposed general fund administration budget for 2022 2023. and so as i hear no more discussion we will hold this up for public comment . board secretary yields this up forpublic comment .

>> thank you president follansbee. i'll be displaying those instructions visually and reading them aloud. >> excuse me, and i'm not reading my agenda correctly that this is adiscussion item? and that we are not approving or expecting a financial report ? did i misunderstand or is my agenda this late? >> mine is an action item. >> number nine was a discussion item but a budgetwe need to approve . >> i stand corrected, i appreciate it . >> now board secretary go ahead and open this up for public comment. >> thank you president follansbee. public comments will be available for each item on this agenda. each speaker will be three minutes and all comments should be made concerning the agenda item presented.

as a reminder a color may ask questions but there's no obligation to answer or engage in dialogue . you're encouraged to state your name although you may remain anonymous. when you're three minutes and ended you will be placed back on mute and moderator will unmute the next caller. remote viewing is available at sfgov.org and by using web apps. opportunities to speak are available by dialing thenumber on the screen . the number is period. again, 415-655-0001. when prompted use access code 2484230 6521 . again, 2484 230 6521. then press poundand pound again. you will enter the meeting as an attendee on the comment line . when the system indicates your line has been unmute it this is your time to speak. forthose on hold continue to wait until the system indicates you have been unmute it . sfgov tv has a 45 second delay

for viewers watching our broadcast andwe will take 45 second pause to allow the system to catch up . when a 45 second pause begins now. sfgov tv ... the 45 second pause has ended. ourmoderator will notify us of any colors in the queue .

>> we have two colors from the phone line, zero colors that entered the public comment queue at this time. a reminder, you mustdialá3 if you want to join a comment for this item . we will wait five moreminutes and close public comment for this agenda item . board secretary,that are still still no colors in the queue at this time . >> .no further colors public comment is closed .>> it's been moved and seconded that we approve the sf hsa general fund administrationbudget for fiscal years 2022 and 2023 and fiscal year 2023 2024 . all those in favor signify by saying aye. opposed.

it passes unanimously. thankyou very much. we will move on to agenda item number 11 . >> thank you president follansbee. agenda item number 11. approval of the san francisco health services systems fiscal year 2022, 2023 and 23 to 24 proposed health care sustainability fund budget. >> . [please stand by]

>> so much so that we are anticipating by the end of fiscal year 2024 the funds will be reduced to about $296,000 because our expenditures will out pace the income. nevertheless, based on our review of the budget and the purpose it serves we bring this item to the full board for adoption. we might have a high level overview for the board and the public as well. >> thank you, commissioner. >> you can see the numbers for the last two columns. 23 and 24 budget.

if our activities end up using prior year balances. our plan would leave positive balance of 296. it would limit what we could do in the future. the request to the mayor is to fund some of the activities currently. [indiscernable] to be funded by the general fund to allow us some room for these projects. those are my comments. >> thank you, mr. hussein. any members of the cord have questions or comments?

before i turn it back to president follansbee. i would be remiss if i did not congratulate mr. hussein on his first budget only moments after landing in the health service system. lang you for learning what -- thank you for preparing the budgets for the mayor's office. thank you for diving in head first. really doing a knockout job. >> thank you. >> president follansbee. back to you. >> thank you very much. go ahead, commissioner zvanski.

>> sorry. i want to congratulate mr. hussein. quick learning process. you did a great job. my question is going forward because i was very concerned to realize that our plans that this particular sustainability fund would virtually disappear at the end of 2024. i am wondering if the committee is going forward exploring other options or if this is going to be an issue that is going to be returned to all of us as the full board going forward? i am very concerned because i served on this board when we didn't have it in the past and we had great losses. this was the real problem we didn't really have any kind of trust fund in those days and life was a struggle. i am concerned if we have any plans for the future.

will this be done through your committee, commissioner, or will it be turned over to all of us as full board to deal with it in a different way? thank you very much. >> i can probably answer that in brief. we are presenting some options to the mayor's office to shift expenditures to the general fund to free up more fund balance in the healthcare sustainability fund. other strategies we have not discussed. those will be things we will explore as necessary. do you have anything to add to that? >> i would concur with your assessment, commissioner hao. what we have identified is the

potential problem. we have made recommended steps to the mayor's office to correct it. should we not be granted that, then we will have to do a full assessment and make recommendations to the board how to address that. >> any further comments? i would say we have good evidence that these activities that actually produce results. that evidence has been forwarded as well to the mayor's budget committee and office. that will help, i think, assure us that there will not be any interruption of services which is the heart of your question, commissioner. we are committed to that in one way or the other. thank you for that. >> i want to note that the

assistant to the mayor's office worked on our board when we didn't have a sustainability fund. i will be curious to see what the response will be from the mayor's office and with a significant amount of input. a lottery mains to be seen. thank you. >> i will entertain a motion to approve the recommendations of the budget and finance committee and to forward fiscal year 22-23 and 23-24 proposed healthcare sustainability fund budget. >> i move that we approve the proposed san francisco health services healthcare sustainability fund budget. >> it is moved and seconded. with that we open up. no further discussion. i open up for public comment.

thank you very much. >> thank you, president follansbee. just a moment to display the instructions and read out loud. public comment is available for each item. each speaker is allowed three minutes unless there are new time limits. all public comments concerning the agenda item presented. caller may ask questions of the policy body. when i welcome you state your name clearly. you may remain anonymous. i will thank you for your comment and you will be placed on mute and moderator will mute the next caller. opportunities to speak during the public comment are available

by dialing the number on the screen. 415-655-0001. when prompted use access code 24842306521. press pound and pound again. you will be an attendee on the call line and dial star 3 to be added the queue. when you have been unmuted this is your time to speak. for those on hold please continue to wait until the system indicates you are unmuted. sfgovtv has a standing 45 second delay for the live broadcast. we will take 45 seconds to catch up and callers to dial in. that pause begins now.

>> the 45 seconds have ended. >> we have two caller on the phone line. zero callers are in the public comment be queue. reminder to all callers dial star 3 if you want to comment on this agenda item. we will wait five seconds and close public comment for this agenda item.

>> there are no callers in the public comment queue at this time. >> public comment is now closed. >> thank you very much. it is moved, seconded that we approve the san francisco health service fiscal year 22-23 and 23-24 healthcare sustainability fund budget proposed. all in favor signify by aye. >> aye. >> it passes unanimously. we now move into the governance committee matters. agenda item 12. >> approval every visions to the governance terms of reference and policies. this is an action item to be

presented by commissioner scott, chair of the committee. >> thank you for recognizing this item. as we indicated last month we had to adjust the timeline to provide sufficient public notice at this meeting for the approval of the terms of reference and governance policy. this is kind of every three year review of this document to update it from the standpoint of any changes or other related questions that may impinge upon our work. in addition we take the time to in this particular version to update the charter section as well as the membership rules. we now will going forward be

able to add those changes on an annual basis in between a full review of the terms of governance. some of the changes are really edits in terms of language and some of the policies. not substantive changes. they are clarifying edits. in a few places we did indeed take a look at in some detail some of the actual policy provisions. the summary of those changes which included president foe lapse be and the commissioner and myself are outlined in the summary document. with that, mr. president, i turn it back to you to put this question before the board for approval. >> okay. thank you very much. are there questions or comments?

i would point out that the attorney's office is well represented in this process. several questions came up as part of deliberations. they are reviewed. as a committee member the document really is up-to-date. i appreciate chair scott's oversight of this process as well as board secretary's contributions to really complicated process to not only review but red line changes. a lot was asked of both of you. i appreciate that. comments or questions? >> page 20 are you able to get the screen up?

two-thirds vote was erased. that was in the charter there someplace. i didn't go back to take a look. i wondered why that was erased. >> it is to conform to the charter. >> it was there with the original. >> we went back and looked at issues to make sure the language conformed to the charter. >> i want to talk about the other stuff, too.

there are some things i didn't quite understand why they were done. i will call you. great. i hope we all get a hard copy of this. >> i was going to speak to that at this point. we agreed any of the commissioners that wanted hard copies of the document once we got it all approved and reviewed and finished the edits holly will notify us via e-mail so you will respond back saying, yes, i want a hard copy and she will send that out to us. >> that's great. >> that is if we pass it today she will send that e-mail and make our request known. >> i am hoping, commissioners, i

have my binder next to me. i would only want those pages where there are changes made and not the whole new copy of the entire document because it is rather substantial. i think there should be no need to get a whole copy, just the changed pages. >> it might be easier to send the whole thing than to selectively go through it. what we will do, it will follow the same tabs in the current hard copy. holly and i had a preliminary conversation about this. do we want to send out just changed pages? given the fact the terms of reference, the charter changes and some of these others, it would be simpler to send a new document. it will be three hole punched. you can take it out tab by tab

and replace the items in it. >> thank you. that will work. >> i would add to president follansbee's comment about the work our board secretary put in on this between committee meetings and review. eric taking a very detailed look at the charter provisions to be sure they were updated and corrected and so forth. there is a lot of effort in this activity. i appreciate that. >> no further discussion or questions at this point i will entertain a motion to approve revisions to the governor's terms of reference and policies of the health service board of the city and county of san francisco. >> this is commissioner zvanski. i submit the motion to approve

red line changed to the governor's terms of reference and policy. >> i will second that motion. >> moved and seconded. if there is no further discussion we will open up for public comment. >> thank you, president follansbee. public comment instructions will be displayed visually. i will read them out loud. public comment is available for each item on the agenda. each speaker is allowed three minutes unless the board president deems new limits. all comments are for the agenda item presented. there is no obligation to engage. you may remain anonymous. i will thank you for your comment. the moderator will unmute the

next caller. viewing on sfgovtv and online with web ex. opportunities to speak are available by dialing the number on the screen. 415-655-0001. when prompted use access code 24842306521. press pound, pound. you will enter as attendee and dial star 3 to be added to the public comment queue. this is your time to speak. for those on hold please continue to wait until the system indicates you have been unmuted. sfgovtv has a standing 45 second delay for the live broadcast. we will take a 45 second pause to catch up and callers to dial in. the pause begins now.

>> the pause is ended. are there any callers in the public comment due? >> two callers on the phone line. zero callers are in the queue. you must dial star 3 to join

public comment for this agenda item. we will wait five seconds and close public comment for this agenda item. >> there are no public callers in the queue at this time. >> public comment is closed. >> it is moved seconded to approve the red line changes suggested by the governance committee to the governance terms of reference and policies for the health service board of the city and county of san francisco. in favor say aye. opposed. it passes unanimously. thank you very much. this closes the governance committee matters. now we move to rates and

benefits. agenda item 13. >> thank you. agenda item 13. presentation of the 2022 rates and benefits calendar for the plan year 2023 discussion. this is be presented by abbey yant, executive director. >> you have in your packet the rates and benefits calendar. it is updated as of february 4th. it is routinely posted on our website. there is no changes in the calendar as it currently reads. however, there is a hold on all calendars for february 24th for possible second meeting. i recommend to the chair we cancel that meeting. the other thing that i want to note we spoke earlier about the timeline for the strategic planning meeting.

we have tentatively and we will get an invitation scheduled the gathering with the commission members on the second meeting in april. april 28 at 1:00 p.m. we will be talking to you about that. i believe it is a safe bet we will not need that second meeting that month. should we meet it we will come up with plan b. please look for that information coming forward in the next few days. with that i would recommend this as an action item. >> this is a discussion item. >> any questions? >> let me make sure i am clear. i recommend we release the hold on february 24th possible hsp meeting. is that clear? >> correct. >> not release on march 24 and

april 28. we might not need it, not release it at that point. is that a summary what you recommended? >> at next month's meeting we will take that under consideration. you will get an invitation for strategic planning session on the 28th. >> of april? >> correct. >> i accept the recommendation to release the hold on the february 24th. any other questions or comments for director yant? >> i didn't see april 28th on this calendar. >> did i misunderstand you? >> it is there. >> top of the second column. april 28th. >> i see it at the top of the page. thank you.

>> possibility, if i understand correctly, the city may mandate we go back to in-person meetings. is this something to affect the april 28th meeting as well? >> optimistically it is better to do strategic planning in person. i am hopeful we will be there by then. i don't have any say so over that. >> no crystal ball? >> no, it stopped working in march 2020. >> talk to everyone including doctor fauci. any questions? >> with that i open up for public comment. >> thank you. those instructions will be displayed. public comment will be available for each item on the agenda.

each speaker is allowed to comment for three minutes. caller may ask questions of the body no opligation to answer. state your name clearly. you may remain anonymous. i will thank you for your comment and you will be on mute. remote views is available online with web -- web ex. dial 415-655-0001. when prompted use access code 24842306521. pound pound. you will be an attendee. dial star 3 to be added the queue. when your line is unmuted it is your time to speak.

please continue to wait until the system indicates you are unmuted. sfgovtv has a 45 second delay for viewers watching online. we will pause 45 seconds to dial in. it begins now.

>> the pause has ended. please notify us of any callers in the queue. >> we have two callers on the phone lines, zero callers in the queue at this time. you must dial star 3 now to join public comment for this agenda item. we will wait five seconds and then close public comment for this agenda item. >> there are no callers in the queue at this time. >> public comment is now closed. >> thank you very much. we note that we released the february 24th hold on possible meeting date for health service board. we move to item 14.

>> review and approve the hartford fully insured 2023 rates and contributions. life insurance accidental death and dismemberment and long-term disability plans. this is an action item. >> thank you. mike clark, aon. i will screen share momentarily. today i will be presenting the hartford fully insured 2023 rates and contributions for life

insurance ad and d and long-term disability. the first renewal of the rates and benefits. recommendation summary and introduction including prior background, talk through the recent plan experience and influence on the rates for the 2023 plan year in the document for each plan listed. provide overall summary of expected 2023 premiums based on current insurance volumes and present my recommendation for the health services board action. i will not review the appendition. there is a recent loss ratio for each coverage we talk about today. it is recommended the health service board accept renewal of all life insurance, accidental death and dismemberment that are included in this presentation for the 2023 plan year.

all rates reflect reduction in 2022 plan year rate levels. insurance rates for 2023 from hartford represent first year of new three year rate for 23, 24, 25. specifically today's health service board approval is for 23 plan year rates. the hartford is committed to offering the 2023 plan year rates today as part of three year renewal rate system force 24-25 plan years. populations covered by these life and disability cover ages today. including the city and county of san francisco and court and executive populations, life insurance paid by employers, ltd insurance and supplemental life

is paid by participating members. these are not offered to retirees. the policies renew every three year with most recent period for plan years 2020-2022 as approved by health service board during the june 13, 2019 meeting. basic life insurance increase in premium for 2020. subsequently based on improved experience in the 2021 renewal hartford was agreeable to reduce basic life insurance rate at that point. next three year guarantee period starting january 1, 2023 partnered to review the claim experience in the appendix for each benefit. as you will see on this page leads to significant premium rate reductions proposed by

hartford. we appreciate the partnership to reflect these premium adjustments. employers $2 million in projected savings for 2023 based on premium volumes. employees on the supplemental coverages over $200,000 of projected savings based on the current premium for 2023. we have agreed to 12 month situation of coverage in 2022 for employees on leave of absence or furlough. measured from initial date of the leave of absence or furlough for a given individual to maintain the life insurance and ad and d coverages at no additional premium. three different amounts offered depending on the type of

employee. that detailed information is found at the web link included on this page. most employees have the $50,000 coverage level. enrolled employees start of 2022. basic life insurance insured monthly rate for thousand dollars of coverage is 0.105 right now. it will change to 0.1089 on january 1, 23. 15% reduction in basic life insurance rate. long-term disabilities two benefit level available. differentiating type of employee with the detail in the web link on this page. there is a 25% reduction in the new 2023 insurance rates for each of the two ltd benefit level as you see on this page. you will see over $18,000 in the 60% plan and 6500 employees in

the 66 and two-thirds percent plan. supplemental coverages, the rates for 2022 currently and 2023 going forward for each of the programs are listed on this page. all are reducing by 20% from 2022 to 2023. to neat, for supplemental child life insurance eligibility is to age 26 for otherwise a child meeting disabled dependent definition. in summary, the financial expectation based on existing premium volume for both employer paid plans at the top and member paid plans at the bottom of the chart are substantial premium reductions overall going to the 2023 plan year. rates that you see today are

being asked for approval for 2023 would also hold for 24 and 25. it is recommended that the health service board accept renewal of fully insured life insurance and ad and d and ltd rates for the 2023 plan year. noting they all reflect reduction from 2022 plan level. insurance rates for the 2023 plan year from hartford are first year of three year rate commitment. the rates would be expected to be retained from 2023 to 2024 and 2025 with approvals being requested in the future rates and benefit cycles for those two sub subsequent years.

>> thank you very much. that is an encouraging report. i would like to think the claim history reflected a little of this activity. maybe it is over optimistic. it can't hurt. that is great. thank you very much. comments from board members? >> i move we accept the recommendation as outlined by the actuary for the respective cover ages offered by hartford. >> i second that. >> moved seconded that we accept the recommendations apfor renewal of the fully insured life insurance ad and d and long-term disability insurance programs for the 2023 plan year. further discussion? >> i would only like to suggest

that this ties back to possibly the earlier presentation regarding our demographics as well. i am trusting some of that data two have flowed into that analysis. is that true, mike? >> correct. the hartford underwriting for this. it is more of a long term perspective of experience. the loss ratio in the appendix cover five year period. there certainly is impact from any recent potential demographic shifts. also, noting the rating actions in the hartford. we appreciate the reductions for 2023 are a result of evaluating the experience.

>> thank you. >> any questions or comments? hearing none, i will open up the item to public comment. >> thank you, president follansbee. instructions will be displayed and i will read them out loud. >> public comment be is available for each item on the n agenda. all public comments to the item presented. there is no obligation to engage in dialogue with the caller. state your name clearly. you may remain anonymous. when your three minutes end you will be placed on mute and we will unmute the next caller. go sfgovtv to view.

you can dial 415-655-0001. access code 24842306521. press pound, pound. you will enter as attendee and dial star 3 to be added the queue. when your line is unmuted this is your time to speak. please continue to wait until the system indicated you are unmuted. we have a 45 second delay online. we will take a 45 second pause to catch up. it begins now.

>> the pause ended. moderator will notify of callers in the queue. >> two callers on the phone lines. zero callers on the queue at this time. to all callers you must dial star 3 now to join public comment for this item. we will wait five seconds and close public comment for this agenda item.

>> there are no callers in the public comment queue at this time. >> thank you. no further callers, public comment is now closed. >> thank you very much. moved and seconded that we approve the hartford fully insured 2023 rates and contributions for life insurance, accident will death and dismemberment and long-term disability as presented by mike clark aon. >> in favor aye. opposed? it passes unanimously. thank you very much. thank you for the robust presentation and advocacy for

our members. we now go back to the regular board meeting matters. agenda item 15. >> reports and updates from contracted health plan representatives. this is a discussion item. >> good afternoon, commissioners, kaiser permanente. i would like to say that kaiser permanente is open to discuss specialty facility treatment for first responders. we are available to review how a facility may fit in our quality standards and integrated treatment protocols. specific to the treatment facilities and the balanced recovery system partnership, other regents have partnered with a varying degree of patient

satisfaction and outcome. i wanted to share in light of comments we heard earlier this afternoon. thank you. >> thank you very much. other comments from plan representatives? hearing none. i want to comment on an item that was addressed by director. there was a lot of confusion over the hss approval for reimbursement or provision for home testing kits for covid-19. some health plans seem to step up to the plate regarding medicare advantage plans.

they offer reimbursement. the process is still in development. others took longer before hss finally included medicare advantage. clearly it was confusion generated on part of the federal government. we look forward to the health plans having robust system in place for reimbursing members for purchasing home testing kits for covid-19. any questions or comments from board members? >> i have a question about that. you say reimburse them. that means they buy them first from somewhere? >> all i can speak to is as a kaiser member. encouraging home testing, two, encouraging members to enroll in

the federal plan directly which provides four kits per household, which i think many members have and number three reimburse for payment. i think some health plans serve eight per month. to my knowledge, none are directly supplying through their own pharmacies in the case of kaiser or contracted pharmacies with health plans. you go in and show your membership card and pick up the 8 kits for the month. to my knowledge that is not in the process. it may be eventually. i don't know. >> this is a work from progress. let's not confuse the two programs. one is federal that allows all of us to get four kits or whatever it is one-time only.

that is separate. nothing to do with us. the other program that is a gap program because of timing of the ability of cms to promulgate regulation to allow this to occur. our two plans are putting together reimbursement programs as a stopgap. in the meantime everybody is talking on the networks how this can be done through getting them through a third-party, pharmacy or whatever. one of the reasons it is taking so long. cms does not have a mechanism to approve over-the-counter purchases of anything. where we are at is having the ability to work with our two

plans with medicare, kaiser and medicare to understand what we can do now. she will work to get that information out to our members. trust me as soon as it is out there it will change. that is where we are at. i hope that answers your question. we will do member communication telling what is going on. it will be fluid for a number of months. is that spring? i don't know when that spring sets. we encourage them to do the home tests. >> where do you get the home tests? >> at the pharmacy. >> do they have them?

>> they do now. there was a period of time where they were difficult to find. as omicron has decreased in the bay area the tests are much more available. >> the pharmacy has a sign about test or something like that. >> it has really changed. >> those in the market know within one pharmacy chain the individual sites vary a lot. certain neighborhoods are more difficult than other neighborhoods to get tests. you are right it is complicated. most of the tests were approved in emergency for the fda, not final authorization. that number is final is increasing. it is chaos. i think director yant's comments

are very appropriate. they encourage the health plans to be communicating with members exactly what the procedures are. if they are forms for reimbursement to make sure those are availability and can be submitted. this came from the federal government which initially they excluded medicare advantage plans from that requirement. then they rescinded that a few days later. it is chaotic. >> i would put this in the category of living with covid. we are all trying the health system is impacted by this omicron increase. their workers were sick at not able to do as much testing as they wanted to do or needed to do. demand for the home tests went

higher. going forward, i think we will all figure out what tests you need to have available and where we go to get them and when you get your next booster and all of that will become clearer to that as things settle down with omicron. crossing our fingers that another variant doesn't pop-up somewhere. >> pbs as a program focus on pharmacists and pharmacy techs. how they moved to the front line of this and under tremendous stress and pressure and burnout. we don't always address the pharmacists when we talk about the healthcare personnel and they have become front line for

mens in terms of information tests. we need to acknowledge the pharmacists and pharmacy techs as well. commissioner zvanski. >> i just want to indicate for some of us testing is available at no charge in our communities. i know that here the ii brooklyn center is not only giving boosters but are doing testing. my colleagues and neighbors are going there. in the park they have testing a

couple times each month. they have people that put up signs on the street so that neighbors could know they could go there. i see it in sanbr uno that they are telling people in the area they can go to these area sites with or without appointment. testing is available at no cost in some communities. i am hoping some of our members see that and take advantage of those community opportunities to be tested at no charge. i have to check kaiser. there is a bunch of signs up. i haven't checked to see if they

are doing testing. usually they want appointments. they have tents in the parking lots to get the boosters and shots and get tested as well. in san francisco some of my colleagues mentioned they go to the geary street facility and can find those options available also. they just show the keysser card -- kaiser card and no charge. >> any other questions and comments? we will open up for public comment. >> i have to say one thing. at the last meeting i requested from the providers that they tell me how they reimburse health providers. primary care or specialty

doctor? there are categories. i am curious how they do this and what they all have as far as how many visits per year and that whole system set upis what i would be curious about. >> dr. follansbee your hair looks like it is on fire. >> open up for public comment. madam secretary. >> public comment instructions will be displayed and i will read them out loud. public comment is available for each item. each speaker is allowed three

minutes. they are to be made concerning the agenda. there is no obligation to engage in dialogue. state your name clearly. you may remain anonymous. vues is on sfgovtv and web ex. opportunities to speak by dialing the number on the jean. 415-655-0001. when prompted use access code 24842306521. press pound, pound. you will enter as attendee and dial star 3 to be added the queue. when the message as your line is unmuted that is your time to

speak. situate inspecting you have been unmuted. there is a 25 second delay online. we will allow the system to catch up. it begins now. -- 45 second clause begins now.

>> the 45 second pause ended. are there any callers in the public comment queue? >> we have two callers on the phone lines. zero callers in the public comment queue at this time. you must dial star 3 to comment on this agenda item. we will wait five seconds and close public comment on this agenda item. >> there are no callers in the public comment queue at this time. >> thank you. no further callers. public comment is closed. >> thank you very much. this concludes item 15. before i adjourn i want to particularly thank our moderator for helping to transition through the process of virtual meeting. she has been consistent and

appropriate. i want to call her out and thank her for her participation in this. with that i want to thank the callers for public comment. i see your hand, commissioner zvanski, and also to remind everyone the next regular meeting of the health service board is thursday, march 10, 2022. it will be held virtually is my understanding. i recognize supervisor zvanski. >> thank you. i want to note that i attended yesterday the retirement board meeting. it was suggested they consider changing their meeting dates to the second thursday of the month, which is our meeting date. i wanted to bring that to the attention of our board and our

staff. even if they meet at 10:00 a.m. that presents a hardship for a lot of retirees. for those that monitor both boards. to it is on either board it would be devastating and detrimental to have our meeting on the the same die close time proximity. that is not efficiency. it is a hardship. i want to lay that out. we need to have that discussion going forward with our colleagues at the retirement system sooner than later. thank you. >> if there are no other comments i will adjourn the february 10 meeting of the health service board of the city and county of san francisco. thank you everyone for your

participation. >> happy new year.

>> shop and dine in the 49 promotes local businesses and challenges residents to do their business in the 49 square files of san francisco. we help san francisco remain unique, successful and right vi. so where will you shop and dine in the 49? >> i'm one of three owners here in san francisco and we provide mostly live music entertainment and we have food, the type of food that we have a mexican food and it's not a big menu, but we did it with love. like ribeye tacos and quesadillas and fries.

for latinos, it brings families together and if we can bring that family to your business, you're gold. tonight we have russelling for e community. >> we have a ten-person limb elimination match. we have a full-size ring with barside food and drink. we ended up getting wrestling here with puoillo del mar. we're hope og get families to join us. we've done a drag queen bingo and we're trying to be a diverse kind of club, trying different things. this is a great part of town and there's a bunch of shops, a variety of stores and ethnic restaurants. there's a popular little shop

that all of the kids like to hang out at. we have a great breakfast spot call brick fast at tiffanies. some of the older businesses are refurbished and newer businesses are coming in and it's exciting. >> we even have our own brewery for fdr, ferment, drink repeat. it's in the san francisco garden district and four beautiful murals. >> it's important to shop local because it's kind of like a circle of life, if you will. we hire local people. local people spend their money at our businesses and those local people will spend their money as well. i hope people shop locally. [ ♪♪♪ ]

>> hi. i'm chris mathers with channel 19, and you're watching coping with covid-19. today, i'm going to be talking about exercising during the pandemic. first, i'm going to tell you what i've been doing, and then i'm going to be checking in with some friends and family. i've been riding my bike. all i take is a pair of gloves and a mask if i come into contact with anyone. i try to ride my bike during the time i'm sheltering in place. i try to ride for at least 30 minutes. surfing is my other regular outdoor activity. california state guidelines recommend you don't drive more than ten minutes for a spot to

exercise, and although i'm close to ocean beach, i'm a bit wary to go there, so i'm using the time to do some maintenance. filling in gouges and dings, and sanding it down. i'm also repairing holes in my suit. fellow sfgovtv producer chris took his first yoga lesson a couple of years ago and used to go to a class regularly before the lockdown. he and his wife set up a space in their garage for exercising. this routine is from an on-line class by power yoga.

deann and andy have been using the ping pong table that they bought off craigslist and set it up in their back yard. ellie has been using this home gym to stay fit. it has everything she needed. and lastly, if the weather is bad outside, you can exercise your mind by doing a puzzle, sudoku, or just by reading a good book. here's a quick recap. since i started this episode, the guidelines have changed. for instance, jack may be able to go golfing with some restrictions. go to sf.gov to get the most up-to-date

>> 7 and a half million renovation is part of the clean and safe neighbor's park fund which was on the ballot four years ago and look at how that public investment has transformed our neighborhood. >> the playground is unique in that it serves a number of age groups, unlike many of the other properties, it serves small children with the children's play grounds and clubhouses that has basketball courts, it has an outdoor soccer field and so there were a lot of people that came to the table that had their wish list and we did our best to make sure that we kind of divided up spaces and made sure that we kept the old features of the playground but we were able to enhance all of those features.

>> the playground and the soccer field and the tennis fields and it is such a key part of this neighborhood. >> we want kids to be here. we want families to be here and we want people to have athletic opportunities. >> we are given a real responsibility to insure that the public's money is used appropriately and that something really special comes of these projects. we generally have about an opportunity every 50 years to redo these spaces. and it is really, really rewarding to see children and families benefit, you know, from the change of culture, at

each one of these properties >> and as a result of, what you see behind us, more kids are playing on our soccer fields than ever before. we have more girls playing sports than we have ever had before. [ applause ] fp >> and we are sending a strong message that san francisco families are welcome and we want you to stay. >> this park is open. ♪♪

>> it did take a village. i was really lucky when i was 14 years old to get an internship. the difference that it made for me is i had a job, but there

were other people who didn't have a job, who, unfortunately, needed money. and they were shown to commit illegal acts to get money. that is what i want to prevent. [♪♪♪] today we are here to officially kick off the first class of opportunities for all. [applause]. >> opportunities for all is a program that mayor breed launched in october of 2018. it really was a vision of mayor breed to get to all of the young people in san francisco, but with an intention to focus on young people that have typically not being able to access opportunities such as internships or work-based learning opportunities. >> money should never be a barrier to your ability to succeed in life and that is what this program is about.

>> there's always these conversations about young people not being prepared and not having experience for work and if they don't get an opportunity to work, then they cannot gain the experience that they need. this is really about investing in the future talent pool and getting them the experience that they need. >> it is good for everyone because down the road we will need future mechanics, future pilots, future bankers, future whatever they may be in any industry. this is the pipe on we need to work with. we need to start developing talent, getting people excited about careers, opening up those pathways and frankly giving opportunities out there that would normally not be presented. [♪♪♪] >> the way that it is organized is there are different points of entry and different ways of engagement for the young person and potential employers. young people can work in cohorts or in groups and that's really for people that have maybe never had job experience or who are still trying to figure out what they want to do and they can explore.

and in the same way, it is open for employers to say, you know what, i don't think we are ready to host an intern year-round are all summer, but that they can open up their doors and do site visits or tours or panels or conversations. and then it runs all the way up to the opportunity for young people to have long-term employment, and work on a project and be part of the employee base. >> something new, to get new experience and meet people and then you are getting paid for it you are getting paid for doing that. it is really cool. >> i starting next week, i will be a freshman. [cheers and applause] two of the things i appreciate about this program was the amazing mentorship in the job experience that i had. i am grateful for this opportunity. thank you. >> something i learned at airbnb is how to network and how important it is to network because it is not only what you know, but also who you know to get far in life.

>> during this program, i learned basic coding languages, had a had to identify the main components and how to network on a corporate level. it is also helping me accumulate my skills all be going towards my college tuition where i will pursue a major in computer science. >> for myself, being that i am an actual residential realtor, it was great. if anybody wants to buy a house, let me know. whenever. [applause] it is good. i got you. it was really cool to see the commercial side and think about the process of developing property and different things that i can explore. opportunities for all was a great opportunity for all. >> we were aiming to have 1,000 young people register and we had over 2,000 people register and we were able to place about

between 50 and did. we are still getting the final numbers of that. >> over several weeks, we were able to have students participate in investment banking they were able to work with our team, or technology team, our engineering 20 we also gave them lessons around the industry, around financial literacy. >> there are 32,000 young people ages 16 and 24 living in san francisco. and imagine if we can create an opera skin it just opportunity for all program for every young person that lives in public housing, affordable housing, low income communities. it is all up to you to make that happen. >> we have had really great response from employers and they have been talking about it with other employers, so we have had a lot of interest for next year to have people sign on. we are starting to figure out how to stay connected to those young people and to get prepared to make sure we can get all 2400 or so that registered. we want to give them placement

and what it looks like if they get more. >> let's be honest, there is always a shortage of good talent in any industry, and so this is a real great career path. >> for potential sponsors who might be interested in supporting opportunities for all , there is an opportunity to make a difference in our city. this is a really thriving, booming economy, but not for everyone. this is a way to make sure that everyone gets to benefit from the great place that san francisco is and that we are building pathways for folks to be able to stay here and that they feel like they will belong. >> just do it. sign up for it. [♪♪♪] [♪♪♪].

>> shop and dine the 49 promotes loophole businesses and changes residents to do thirds shopping and diane within the 49 square miles of san francisco by supporting local services we help san francisco remain unique and successful where will you shop and dine shop and dine the 49. >> my name is neil the general manager for the book shop here on west portal avenue if san francisco this is a neighborhood bookstore and it is a wonderful neighborhood but it is an interesting community because the residents the neighborhood muni loves the neighborhood it is community and we as a book sincerely we

see the same people here the shop all the time and you know to a certain degree this is part of their this is created the neighborhood a place where people come and subcontract it is in recent years we see a drop off of a lot of bookstores both national chains and neighborhoods by the neighborhood stores where coming you don't want to - one of the great things of san francisco it is neighborhood neighborhood have dentist corrosive are coffeehouses but 2, 3, 4 coffeehouses in month neighborhoods that are on their

>> it was an outdoor stadium for track and field, motorcycle and auto and rugby and cricket located in golden gate park, home to professional football, lacross and soccer. adjacent to the indoor arena. built in the 1920s. the san francisco park commission accepted a $100,000 gift from the estate to build a memorial in honor of pioneers in the area. the city and county of san francisco contributed an additional $200,000 and the stadium was built in a year. in the 1930s it was home to several colleges such as usf, santa clara and st. mary's for competition and sporting. in 1946 it became home to the san francisco 49ers where they

played nearly 25 years. the stayed de yam sat 60,000 fans. many caught game the rooftops and houses. the niners played the last game against the dallas cowboys january 3, 1971 before moving to candlestick park. the stadium hosted other events before demolition in 1989. it suffered damages from the earthquake. it was reconstructed to seat 10,000 fans with an all weather track, soccer field and scoreboards. it hosts many northern california football championship games. local high schools sacred heart and mission high school used the field for home games. the rivalry football games are sometimes played here. today it is a huge free standing element, similar to the original

featuring tall pink columns at the entrance. the field is surrounded by the track and used by high school and college football and soccer. it is open for public use as well. >> what we're trying to approach is bringing more diversity to our food. it's not just the old european style food. we are seeing a lot of influences, and all of this is because of our students. all we ask is make it flavorful. [♪♪♪] >> we are the first two-year culinary hospitality school in the united states. the first year was 1936, and it

was started by two graduates from cornell. i'm a graduate of this program, and very proud of that. so students can expect to learn under the three degrees. culinary arts management degree, food service management degree, and hotel management degree. we're not a cooking school. even though we're not teaching you how to cook, we're teaching you how to manage, how to supervise employees, how to manage a hotel, and plus you're getting an associate of science degree. >> my name is vince, and i'm a faculty member of the hospitality arts and culinary school here in san francisco. this is my 11th year. the program is very, very rich

in what this industry demands. cooking, health, safety, and sanitation issues are included in it. it's quite a complete program to prepare them for what's happening out in the real world. >> the first time i heard about this program, i was working in a restaurant, and the sous chef had graduated from this program. he was very young to be a sous chef, and i want to be like him, basically, in the future. this program, it's awesome. >> it's another world when you're here. it's another world. you get to be who you are, a person get to be who they are. you get to explore different things, and then, you get to explore and they encourage you to bring your background to the kitchen, too. >> i've been in the program for

about a year. two-year program, and i'm about halfway through. before, i was studying behavioral genetics and dance. i had few injuries, and i couldn't pursue the things that i needed to to dance, so i pursued my other passion, cooking. when i stopped dance, i was deprived of my creative outlet, and cooking has been that for me, specifically pastry. >> the good thing is we have students everywhere from places like the ritz to -- >> we have kids from every area. >> facebook and google. >> kids from everywhere. >> they are all over the bay area, and they're thriving. >> my name is jeff, and i'm a coowner of nopa restaurant,

nopalito restaurant in san francisco. i attended city college of san francisco, the culinary arts program, where it was called hotel and restaurant back then in the early 90's. nopalito on broderick street, it's based on no specific region in mexico. all our masa is hand made. we cook our own corn in house. everything is pretty much hand made on a daily basis, so day and night, we're making hand made tortillas, carnitas, salsas. a lot of love put into this. [♪♪♪] >> used to be very easy to

define casual dining, fine dining, quick service. now, it's shades of gray, and we're trying to define that experience through that spectrum of service. fine dining calls into white table cloths. the cafeteria is large production kitchen, understanding vast production kitchens, the googles and the facebooks of the world that have those types of kitchens. and the ideas that change every year, again, it's the notion and the venue. >> one of the things i love about vince is one of our outlets is a concept restaurant, and he changes the concept every year to show students how to do a startup restaurant. it's been a pizzeria, a taco bar. it's been a mediterranean bar, it's been a noodle bar.

people choose ccsf over other hospitality programs because the industry recognizes that we instill the work ethic. we, again, serve breakfast, lunch, and dinner. other culinary hospitality programs may open two days a week for breakfast service. we're open for breakfast, lunch, and dinner five days a week. >> the menu's always interesting. they change it every semester, maybe more. there's always a good variety of foods. the preparation is always beautiful. the students are really sincere, and they work so hard here, and they're so proud of their work. >> i've had people coming in to town, and i, like, bring them here for a special treat, so it's more, like, not so much every day, but as often as i can for a special treat.

>> when i have my interns in their final semester of the program go out in the industry, 80 to 90% of the students get hired in the industry, well above the industry average in the culinary program. >> we do have internals continually coming into our restaurants from city college of san francisco, and most of the time that people doing internships with us realize this is what they want to do for a living. we hired many interns into employees from our restaurants. my partner is also a graduate of city college. >> so my goal is actually to travel and try to do some pastry in maybe italy or france, along those lines. i actually have developed a few connections through this program in italy, which i am

excited to support. >> i'm thinking about going to go work on a cruise ship for about two, three year so i can save some money and then hopefully venture out on my own. >> yeah, i want to go back to china. i want to bring something that i learned here, the french cooking, the western system, back to china. >> so we want them to have a full toolkit. we're trying to make them ready for the world out there.

>> on behalf of the san francisco office and historical society, our partners and sponsors, welcome to the 2022 black history month kickoff program. i am aloe williams, president of the society's board of directors. the society was founded in 1955. in 1958, it merged with a local chapter of the association for the study of african-american life and history, which is better known as the national group which started the celebration of what is now black history month. that is the society became the official sponsor of black history month in san francisco. from the beginning, the society has centred its black history