. >> chair: the san francisco health service board will now come to order. this is thursday, march 10, 2022. madam secretary, please call the roll. >> clerk: thank you, commissioner. [ roll call ]. >> clerk: with that, we have quorum. >> chair: item number 3, please.

>> clerk: item number 3 is the resolution allowing teleconferenced meetings under california government code section 54953. this is an action item. commissioner breslin, with your permission, i would like to speak to this. for several months there have been special findings authorized by government section 54953. the city attorney is recommending that all city bodies continue to make findings once every 30 days. a draft resolution has been presented including the following findings. the state of california and the city remain in a state of emergency due to the covid-19 pandemic. at the meeting, the san francisco services system and board have considered the circumstances of the state of emergency because of the covid-19 pandemic conducting the

needs of this body and needs in person without allowing certain bodies to attend remotely would present risks to certain attendees due to covid-19 and the state of emergency continues to directly impact the ability of those members to meet in person, thus the resolution before the board. >> i move, ms. president, i move that the board adopt the resolution as read and distributed. >> second. >> chair: is there any public comment on this item? seeing or hearing none, do we have to do roll call for the vote? >> clerk: excuse me. we'll want to go through the public comment and i do have new instructions for us to read aloud that would allow for both

hybrid remote and in person. i'll be reading those instructions aloud for both our in-person and remote public comment. public comment will be taken both in person and remotely via webex. it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no requirement to engage with the

caller. when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee and dial *3 to be added to the queue. when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you

have been unmuted. i will look around the room for any person approaching for in-person public comment. there are no people in the public comment queue for in person at this moment. we will now turn to our moderator to see if anyone in the public comment queue via webex. >> operator: board secretary, we have six callers on the line, zero callers have entered the queue at this time. a reminder, you must dial *3 now if you want to join public comment for this specific agenda item. we will wait five seconds and close public comment for this agenda item. board secretary, there are still no callers in the public comment queue at this time.

>> clerk: thank you, moderator. hearing no callers, public comment is now closed. i'll hand this back over. >> chair: you have to do the roll call. >> clerk: for the action to take the vote, yes. would you like to repeat the motion? >> i can't hear you. >> clerk: would you like to repeat the motion before us on the action item? >> chair: repeat the motion? >> clerk: yes. >> chair: this is a resolution allowing teleconferenced meetings under code 54953 (3). >> clerk: i'll take a roll call for all those with us today. [ roll call ].

>> chair: it's unanimous. >> clerk: thank you. shall we move on to the next agenda item? >> chair: item 4, please. >> clerk: agenda item 4 is the approval with possible modifications of the minutes of the meeting set out below which were february 9, 2022, february 10, 2022, and february 16, 2022. >> chair: commissioners, we have three separate sets of minutes in front of you. i think we can take them all together. i will entertain a motion. >> i move that we adopt the three sets of minutes as outlined in the agenda and distributed. >> i second. >> clerk: i state for the record

that commissioner breslin is working remotely. i'll read our public comment instructions out loud. public comment will be available for each item on the agenda. each speaker will be allowed three minutes in length, lls new limits are deemed. as a reminder, a caller may ask questions of the policy body, but there is no requirement to engage with the caller. when i welcome you on the call, you are encouraged to state your name clearly, but you can remain anonymous. i will thank you for your call when your time is up. remote viewing is available online and webex. opportunity to speak are available by dialling the number on the screen, the dial-in number is 415-655-0001.

when prompted use access code 2484 074 0933, again 2484 074 0933, then press #, #. you need to dial *3 to be added to the public comment queue. when your line has been unmuted, this is your time to speak. for those on hold, continue to wait until the system indicates you have been unmuted. we will take in-person comment first and proceed with remote comment. for those in person, you can approach the proceededium. there is no one on the line. we will move to webex for public comment. our moderator will notify us of any callers in the queue. >> operator: we have eight callers on the phone line and zero callers have entered the public comment queue at this

time. a reminder to all callers, you must dial *3 now if you want 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 queue. >> clerk: hearing no callers, public comment is closed. >> chair: roll call, please. [ roll call ]. >> clerk: may i move on to

agenda item 5? agenda item 5 is general public comment, an opportunity for members of the public to comment on any matter within the board's jurisdiction that is not on the agenda, including requesting that the board place a matter on a future agenda. i'll read our public comment instructions allowed. i'll be reading those instructions aloud for both our in-person and remote public comment. public comment will be taken both in person and remotely via webex. it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item

presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage in dialog with the caller. when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and thank you for your call. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment

queue. please wait when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. there is no one in line for in-person public comment. we will move to webex for virtual comment. our moderator will notify us of anyone in the public comment queue. >> operator: board secretary, we have six callers on the phone line. zero callers have entered the public comment queue at this time. a reminder to all callers on the line, you must dial *3 now if you want to join public comment for this specific agenda item. we will wait five seconds and close public comment for this agenda item. board secretary, there are still no callers in the public comment queue at this time. >> clerk: thank you, moderator, seeing no callers, public comment is now closed. >> chair: agenda item 6.

>> clerk: agenda item 6 is president's report. there is no written report this month. >> chair: does president follansbee have something to say? >> clerk: no, there was no written report. >> chair: i have nothing so i don't think you need any public comment on that? >> clerk: correct. >> chair: good. item number 7. >> clerk: thank you, commissioner. agenda item 7 is the director's report and this will be presented by executive director abbie yant. >> good afternoon, commissioners, abbie yant. i would like to begin this meeting by acknowledging the russian attack on ukraine and people around the world are feeling the stress and fear and the ongoing uncertainty. we send feelings to those who

are affected. as we send the energy abroad, we realize the importance of self care. please note that you can access your counseling services 24/# 7. if you need support accessing this, please tap into the san francisco services well-being and your well-being program and our health plan providers and partners. please know that our thoughts are with you and your loved ones. do take care. moving forward on the director's report. the strategic planning for the planning process is underway and we're getting together a very full agenda with guest speakers that we hope to be able to announce early next week. how that session is planned, where the commissions are invited to attend on april 28

from 1:00 to 5:00, i believe holly has secured that time on your calendars. what we're also doing is putting together a packet of information. you will have homework, pre-work before the workshop, rather than spending our time together reviewing the data, i'm going to send it to you ahead of time with highlights, really to look at the current state of having us all on the same page. we do have reports familiar to you, but they will be updated like the annual report, the express dashboard, and other pertinent information. covid-19, as we all know by being here today is continuing to go in the right direction and we are working with the health plans to modify the reports that we have been giving you on a regular basis through the pandemic, as we're having a different understanding of how the disease is impacting people and what the costs are and what

we're projecting as time moves forward with some of the new pharmaceutical therapies and such that are not quite yet readily available, but in the pipelines. we're working with our health plans to develop a meaningful report that will help us monitor covid as a chronic condition that we will continue to see. i imagine if dr. follansbee were here, he would remind us of the waxing and waning, and this would be on the dashboard going forward. the testing availability and the home test kits are resolved. the test kits are readily available. the demand has bottomed out, the positivity rate is quite low and home tests are available. i don't know what to do with the ones i have in my house. we might have a garage sale and swap tests.

there's plenty out there. that's good. we're encouraging people to continue to use them. our office is in the process of resuming in-person activities in the office and we are reminding our staff that although the city does not require that you register your health status before coming to work, we're asking people to leave the old habit of marshaling through. those days are over. when people are colds and flu-like symptoms, we will send them home if they come to work. that's part of the new world that we're living in. we are continuing to look at our regional equity planning process. i think we told you at the last meeting that we've gotten some feedback from the office of race equity and the city. they had given us a rather

aggressive timeline to have the report due on march 1, which was about 10 days' notice. that deadline has been pushed back to may 1, because there are a number of city-wide issues that need to be worked on and time is limited there and we will be contributing to that update to hit the may 1 deadline. reminding the commission that the blackout period we are still in the middle of and the rates calendar that is attached to your calendar, we are adjusting each month as we need to, but as posted, it is currently up-to-date. i think everyone is well aware that we have time constraints on the room availability here in city hall. we're all doing what we can to

be as quick as we can so we get through these meetings and don't have a second meeting. the decision to have a second meeting will depend on the outcome of this meeting today. the healthcare workforce wage statistics, there are does go questions about these statistics and we've done some dive into them. what i discovered is that the national wage statistic report -- the next one is due in may. since this is such a fluid issue, i thought we should wait until that report comes out and see. i'm hoping that things may have improved or changed in some areas. the follow up to the public comments are in your packet. i think most notably is in the conversation we are having in the san francisco fire department, local 78.

some of the stakeholders in the community, active firefighters talking about this in their net work. the considerations are ongoing and really doing formal evaluations and we will keep you informed as we learn more. and our team is always hard at work, developing all kinds of communications. our budget, we're waiting to see what we get through the mayor's office as we present it to you. we asked for extra funds in employee assistance, programs for [indiscernible] -- that has been well received at the mayor's office and we will see what we receive going forward. i think respecting the time constraints, that's it from me unless there's any questions.

public comment. >> clerk: i'll be reading those instructions aloud for both our in-person and remote public comment. public comment will be taken both in person and remotely via webex. it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. that's unless the board chair or president deems new public comment limits in the meeting. all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage with the caller. when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i will give a verbal 30-second

warning. when your time is up, you will be placed on mute. remote viewing is available. that is online. viewing online on webex. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee and dial 3 to be added to the queue. when the system says you have been unmuted, please speak. for those already on hold, please continue to situate until the system indicates you have been unmuted. i will look around the room for any person approaching for in-person public comment. there are no people in the public comment queue for in person at this moment.

we will now turn to our moderator to see if anyone in the public comment queue via webex. >> operator: board secretary, we have 11 callers on the phone line. one caller has specifically entered the public comment queue at this time. other callers may enter the queue as public comment continues. i will indicate when there are no more callers in the queue and you will hear a brief silence as we transition between callers. board secretary, if you could enhance host privileges, i will advance the first caller. >> can you hear necessity? >> clerk: yes, caller, you're coming through. >> i wanted to say that [indiscernible] because yesterday i wasn't able to get through. you guys are doing an incredible

job with your first hybrid meeting. i wanted to check in. thank you. >> clerk: thank you, caller. moderator, you can elevate the next caller. >> operator: a reminder to all callers on the line, please dial *3 again to lower your hand in the queue. board secretary, there are no other callers in the queue at this time. >> clerk: hearing no other callers, public comment is now closed. >> chair: i have number 8, please. >> clerk: thank you, commissioner. agenda item 8 is sfhss financial report as of january 31, 2022, and it will be presented by iftikhar hussain, sfhss cfo. >> good afternoon. >> clerk: we'll be loading that presentation momentarily.

can you make sure the mic is coming through. yes, okay. thank you. >> so the package has the entire report -- >> chair: could you speak up a little. try now. >> what i would walk through is the highlights of the january results. as you can see, the trust fund has a healthy balance. we're projecting an

end-of-the-year balance of $120 million. it is expected to decline by $4 million this year. the reason for the decline is the rate to stabilization where we take the experience from prior years. if the experience is favorable, we reduce rates going forward, which involves a decrease in the fund balance. the other highlights are the pharmacy rebate. we expect to get $6.# 8 million. last year a similar amount, about $8.6 last year, $8.7 is what we're forecasting. we think the interest rate income is not there yet, but last year the interest income was about $1 million that would increase the fund balance. we would expect that when the money becomes available.

the healthcare fund would have a balance of $3.8 million. the general fund would be a net neutral by the end of the year. with those highlights, i'm happy to answer any questions. >> i noticed that you noted in the director's report that you are preparing paper work for the audit. is that correct? >> that is correct. that's the internal audit which is looking for our internal controls. >> that is starting now within this month? >> so we've submitted the responses to the questioner already and the next part is the select transactions and we provide them with supporting documents for those transactions. >> thank you.

>> chair: thank you. so there's a second item here, a memo and a presentation? >> that's a separate agenda item i think. >> chair: thank you very much. public comment. >> clerk: thank you, commissioner. i'll read the public comment instructions out loud. i'll be reading those instructions aloud for both our in-person and remote public comment. public comment will be taken both in person and remotely via webex. it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no requirement to engage with the caller. when i welcome you on the call,

i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and thank you for your call. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code

2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment queue. when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. i'll now look around the room to see if there are any people waiting for in-person public comment. there are no people in line for in-person public comment. we will move to webex for virtual comment. our moderator will notify us of any public comment. >> operator: we have 11 people on the listen line, and zero have entered the queue. you must dial *3 now if you want to join public comment for this specific agenda item. we will wait five seconds and close public comment for this agenda item.

order secretary, there are no callers in the queue. >> clerk: thank you, moderate. public comment is now closed. what we're experiencing is the audio might not be getting to you, commissioner breslin. i'm not sure why. i'll check in with our tech department. it may be there is some kind of delay, but silo try to stay close to you so you and i can -- and speak a little louder for you. >> chair: we're going into the rates and benefits section. item number 9. >> clerk: item number 9 is a presentation on the 2022 rates

and benefits calendar for plan year 2023. commissioner breslin, for you to note, executive director abbie yant, did mention this in her report, unless you have further comment. >> i do not. >> clerk: with that, we do not have to take public comment with no presentation. >> chair: okay. >> clerk: shall i move to the next agenda item? >> chair: is there a calendar? it was presented in here i guess, the calendar? >> clerk: correct. >> chair: nobody needs that. so you don't need any public comment on this item? >> clerk: to. >> chair: item 10. >> clerk: thank you, commissioner. agenda item number 10 is review and approve 10-county survey results. this will be presented by iftikhar hussain, sfhss cfo.

>> we look at the 10 most populace counties in california and look at setting the contribution limits for our eligible employees. in this employees who were affected by this were mainly retirees and i'll give you the

highlights. >> chair: can you speak up as well, speak up a little louder. i'm having trouble hearing you. >> all right. okay. >> chair: can you have the tech team to turn up the volume in this room. >> clerk: okay. >> i'll use my telephone voice. my karaoke voice. so we look at the -- i'm not sure if you heard. i'll just repeat. so we look at the contributions made by the 10-largest counties in california. and this information is then used to set the benefit rates for mostly our retirees. you can see from the summary slide that the net increase from last year's survey is about 3.1%

and the rates actually are fairly consistent across the counties. the two notable changes are in san diego. we went back and looked and that increase in san diego is across all products that they offer. they must have had a high experience across all plans, so that transferred into the higher rates. on the lower side, the riverside county has a decrease. they added a lot of plans and were able to get a net reduction as a result of those changes. so i'm happy to answer any questions about the survey, but this is the motion as displayed on the screen now. >> i have no questions. i'm ready to make a motion.

>> chair: please. >> i move that we adopt the annual 10-county survey results as presented and note that this is a charter requirement for this board to do so. >> chair: second. all right. public comment. >> thank you, commissioner. i'll be reading the instructions aloud. public comment will be taken both in person and remotely via webex. for each item, it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. for anyone waiting in person, please approach the podium. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item presented.

as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage in dialog with the caller. for those callers on the line, when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and you will be placed back on mute. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment

queue. please wait when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. i'll now take a look around the room to see if anyone is waiting for in-person public comment. there is no one waiting in line for in-person public comment. we will now move to webex for virtual comment and our moderator will notify us of any people in the queue. >> operator: we have 12 callers on the phone line. zero callers have specifically entered the public comment queue at this time. a reminder to all callers on the line, you must dial *3 now if you wish to join public comment for this agenda item. we will wait five seconds and close public comment for this agenda item. board secretary, there are still no callers in the public comment

queue at this time. >> clerk: thank you, moderator. hearing no callers, public comment is closed. [ roll call ]. >> clerk: agenda item no. 11, review blue shield of california flex-funded non-medicare hmo plans 2021 claims and utilization experience and approve the use of one-third of the stabilization reserve surplus as of december 31, 2021. this is an action item and will

be presented by mike clarke, aon. >> good afternoon, commissioners, mike clarke from aon here to review the blue shield of california flex-funded non-medicare hmo plans 2021 claims and recruit recruit /* -- reutilization experience and approve the use of one-third of the stabilization reserve surplus. i will take you through the key costs and utilization drivers for the populations, leading to the december 31, 2021, rate review. i will not be reviewing the -- [indiscernible].

>> clerk: i believe that is resolved. >> i hope it is. so on the next page you will see the recommendations i'll present as i finish the discussion. in congruence with the stabilization policy, approve the use of one-third of the december 31, 2021, reserve surplus or $6,592,000, which is one-third of $19,775,000, to be applied towards the rates for all tiers of the blue shield plans for 2023 and applied proportionately. this will make a balance of $13,183,000. first with financial experience overview, this presentation

captures experience on calendar year 2021. associated with the blue speedily of california plans, access plus and trio. access plus has been offered for several years with trio added for the current plan year. the total incurred plan expense increased by 9% on a per employee or retiree basis, versus the 2020 levels. not surprising higher than last year's comparison because of the claim suppression that existed in 2020. as a reminder, it is a 9% increase this year coming from 2019 to 2020. total premiums collected, 6%, that reflect the 2020 actions. actual enrolment for 2021 and in

2020 when the rates were developed. the overall loss ratio is positive for 2021 at 98.3%, keeping in mind loss ratio is basically the comparison of claim and expense for the plan divided by the premiums. so in other words, plan expenses were 1.7% less than the premiums collected. if we look at page 7, what you'll see is actually a three-year comparison of change of cost in the table because we wanted to capture what actually happened over this period, knowing that 2020 was the unusual claim year. as you see, from a medical standpoint, there was a reduction of 5.5% expense.

the claims did go up before the cooling reimbursement. if you look at it over a two-year basis, the overall is increasing about 3.5% per year, versus 5.5% for expected market increase trend. there are positive if you look at it on a two-year basis, discounting what happened in 2020 with claims. prescription drugs, rebates are increasing at a little bit smaller rate for 2021 versus last year 8.8%, higher than market trend in part for this year due to some of the impact of covid direct care in the preparation drug plan. there was a modest utilization increase, only 2%. most of the price of inflation was attributable to medications,

especially for cancer. on page 8 there was a bend of 2% for administrative services and 18% for large claim cooling fee. you see the reserve changes which were decreases overall in the plan and then there was also a 3.6% reduction in a head count from 2020 to 2021. you'll see a lot of this detail in the upcoming slides. i'm not going to go through them specifically in a lot of detail. you can see the elements cost on a total basis on page 9 as well as pmp basis on page 10 played out. and on page 1, the difference between 2021 for active employees and early retirees.

just a little more detail starting on page 13 on key cost utilization drivers. we look at high-cost claimants. we look at individuals who exceeded high cost of claimants for 2021. there were 28 such members across member and drugs. they accounted for almost $26 million in expense. of this $4.3 million was reimbursed through the large claim cooling membering -- pooling mechanism. you see the childbirth, cancer, cardiovascular. on page 14 we list the it happen diagnoses, the leading factor is

factors influencing health status. this is where a lot of the covid care is captured. not surprising that was a high level of experience increase. the perinatal period was also among the top five reasons. cancer die jes active reasons lower spend as you see on the bottom of the page. the way to read this charge, cy is the most recent 12-month period. py is the prior year. ppy is basically two years ago. it shows you this progression over the course of time where ppy is clearly pre-pandemic.

py includes the start of the pandemic. and cy is the most recent 12 months, where there's been a noticeable reduction in breast cancer, prostate cancer. clearly the focus here is to try to see these rates of preventive care start to increase again. with that i'll transfer to the rate utilization stabilizations. we'll focus on 3, the stabilization. the other two were presented, as you see on the top of page 18, in the january 13 meeting. you'll see that the health service fund plan stabilization

policy requires an annual determination, the financial loss or gain over a calendar year, and the difference between expected and actual plan costs for the just-completed plan year is added to the balance and is advertised over a three-year rating period. on page 19, just noting that this plan became flex funded in 2013 and for many years operated at a deficit and it changed to a surplus in december of 2019. the favorable experience of 2020 added to that surplus. for instance, in 2022,th amortiation was higher. that led to $9.7 million which is applied in rating

calculations for this year. and so we do this calculation starting with the $9.7 million and looking for the change in plan experience over the course of the year. what you'll see as you look at page 21 is the positive experience built in 2021, built the surplus to a point where we're recommending the $6,992,000,000 buy down, which represents 1.8% of the early estimated 2020 plan year of blue shield rates. we will finalize the calculations for the rates in the may 12, 2022, meeting. so on page 22, that will be my final slide for presentation,

you will see the recommendation in congruence with the policy, approve the use of one-third of the december 31, 2021, stable reserve surplus for $6,592,000, which is one-third of $19,775,000, be applied to buy-downs of rates across all rating peers for the blue shield plans for plan year 2023 and apply proportionately between active retirees and employees. >> chair: any comments? >> this is just a high-level comment. i know that we had suppression services in the prior year, 2020. are you seeing any kind of early trend to tell us that we're getting back up to pre-pandemic

costs and services? >> yes. we're tracking that closely with the national team wording with the health plans. what we saw right at the end of 2021, beginning of 2022, we saw acceleration of costs related to the omicron variant and care related to that. we are seeing evidence of return to care, although what we're also hearing is many practices, especially practices like orthopedic. it is difficult to get an appointment for, let's say, an elective orthopedic surgery right now because of demands. we are seeing generally return of care levels, return of trends, to pre-pandemic expectations. we will certainly keep a close watch on what continues to

transpire with any deferred catchup of care. >> thank you. >> chair: thank you. >> i would like to move that we expect the two-thirds of the stabilization reserve surplus as of december 31, 2021, to be applied to the following the accident-funded non-medicare hmo plans. >> chair: public comment. >> clerk: thank you, commissioner. i'll be reading those instructions aloud for both our in-person and remote public comment. public comment will be taken both in person and remotely via webex.

for each item, public comment will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage in dialog with the caller. when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and thank you for your call. you will be placed back on mute and the moderator will unmute the next caller. remote viewing is available. opportunity to speak are available by dialling the number on the screen.

the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment queue. please wait when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. >> operator: there are no commenters in the public queue. >> clerk: hearing no public comment -- >> chair: roll call. [ roll call ].

>> can you hear me? i'm finally in the meeting. i would vote. i've been on the call since about 2:00, 1:59 p.m. i would vote aye as well. >> clerk: welcome, president. we're glad to hear your voice and your vote will be recorded. >> chair: item number 12, please. >> clerk: thank you, commissioner. agenda item number 12, review delta dental of california, self-funded active employee ppo plan 2021, claims & utilization experience and approve one-time suspension of the stabilization policy and approve use of one-half of the stabilization reserve surplus as of december 31, 2021. this is an action item and will be presented by mike clarke, aon. that presentation will be coming through momentarily.

>> mike clarke, aon, reviewing the active employee delta dental of california ppo experience and stabilization. on the agenda page, seeing that today's approval -- recommended approval actions are to suspend the policy on a one-time basis for the delta dental ppo plan and approve use of one half of the december 31, 2021, surplus or $503,508 to be applied towards buy-down across all rating -- for plan year 2023 which would remain a surplus for

plan near 2024 and beyond of $053,000. mindful that this is for active employees. the information will be presented to the health service board at the april 20, 2022 meeting. you have the background on the next page for the stabilization policy. again, just a reminder, that we're focusing on the active ppo plan today. the plan experience ended the year favourably relative to premiums. it is that result that creates the recommendation to the health service board of a higher level, that the buy down be applied to 2023 than the per-policy level

to reserve the stabilization balance for this plan. this will require the health services board to suspend this policy for the delta dental act and ppo plan for this cycle's approval. this is consistent with this year's actions taken on the reserve given recent favorable experience. again, you see the recommendation in red text to apply one half of the stabilization reserve $5,309,000. on the next page, claims in 2021 have returned to more typical levels after a substantial reduction in 2020 due to the pandemic. the actual experience was nearly identical to the claim experience figures in the year prior to 2020. you'll see in this chart where

the line represents the premiums and the bars represent the actual claims and fees, 102% loss ratio for 2021. thankfully in 2021 we did see an increase in preventive services utilization for the active employee ppo, but still not to where it was in 2019. in 2021, 36% of lives did not have a dental claiming. about three-quarters of services are diagnostic and preventive. the remainder were services, 4%, for major.

3% used orthodontic services which is similar to prior years. we have detailed services in the appendix with a head count by month. you'll see the plan design when the level is lowest. also, there are incentives to use premier dentists such as 100% coverage for claim exams as well as x-rays. again, as a reminder, delta dental has two levels of dentists, based on the levels of discounts they are willing to accept. lesser more those in the premier network. there are no discounts for dentists choosing not to participate. members do receive the highest

level of benefits. again, there are a higher level of services for premier network, relative to non-participating providers. you see on the next page a listing of web pages that can be accessed by the members to aid and searching for the ppo and searching den pistons. from a rate stabilization history, we saw an increase in time over the amounts. for the 2020 plan year, one half of the new stabilization reserve was applied in rating buy-down. so that started to reduce the level of stabilization reserve in this plan, however, the

surplus built back up in 2020 because of lower utilization of the dental benefits. that is why we recommended two-thirds and it was passed by the house services bard last year for the 2022 rating. we're returning to the one half of stabilization reserve to apply in rates. you'll see the experience calculation on the next page. we're $4,503,000 should be added to the prior carry-forward balance. that leads to our calculation of $5,309,000 figure that you see on the next page. so i'll conclude our presentation with restatement of today's recommended approval actions.

number one, is suspend the stabilization policy on a one-time basis for this plan and approve use of one-half of the december 31, 2021, stabilization surplus or $503,900 to apply to the buy-down for all rating tiers for the delta dental plan for 2023. >> chair: thank you. i'd like to make a request request for our next meeting with delta dental. i received another e-mail from a member saying his dentist told me delta had become such a nightmare to deal with, that they're no longer dealing with them. he has to pay the dentist and

claim from delta. i would like to ask delta to do an assignment of benefits which would save this member from going through this kind of process. that would be for the active and the retirees for their plans. the second item i want us to look at is the deductible for retirees. we went from $50 to $75. especially with $75 just for the premier and not the network. now there is no premier. that came up a few months back. so there really isn't a definite premier. it is now a combined thing. i would like to see this -- we

would have to take a vote on that. at the next meeting -- we do the retirees next time. whenever that would fit on the agenda. i will ask the director. >> commissioner, you mentioned this to me yesterday. i have informed aon -- we've talked with aon about how we might integrate the questions that you have into the presentation that we will do on the rate recommendation for the retired dental benefits. i'm not says that we will integrate it into the recommendation because i don't know yet what our recommendation is going to be. but the staff recommendation will take that into consideration. >> chair: we took a vote to increase it. i don't know what that was.

>> we will answer your questions if they are in coherence or if not, we'll have a discussion about why we're recommending what we're recommending. >> chair: any other comments? excuse me. >> i would like to move that we accept the staff recommendation to approve the one-time stabilization policy and approve the gun-half stabilization surplus as of december 31, 2021, for the delta dental active employee ppo plan. >> second. >> chair: public comment. >> clerk: thank you, commissioner. i will be reading those instructions aloud. i'll be reading those instructions aloud for both our in-person and remote public

comment. public comment will be taken both in person and remotely via webex. it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. public comment will be available for each item on this agenda. each person can comment for three minutes. all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage

in dialog with the caller. for those callers on the line, when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and you will be placed back on mute. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment queue. please wait when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. i'll now take a look around the room to see if anyone is waiting for in-person public comment. there is no one waiting in line for in-person public comment. we will now move to webex for virtual comment and our moderator will notify us of any people in the queue. >> operator: board secretary, we have 10 callers on the phone

line. zero callers have entered the public comment queue. a reminder, you must dial *3 now if you want to join public comment for this agenda item. we will wait five second and close public comment for this agenda item. there are still no callers in the queue. [ roll call ]. >> chair: it's unanimous in favor. >> thank you.

>> chair: commissions, would anybody like to take a break or go on further? we have governance coming up and then we have to have a closed session down the road. what is anybody's wish? do you want to go on for a little bit further? >> maybe take the break when we have our closed session. >> chair: good idea. we're now going to enter the governance committee matters. item number 13, please. >> clerk: thank you, commissioner. agenda numb new brunswick 13 approval of a 2021 board education report and education plan for 2022 draft. this is an action item and will be presented by committee chair scott. >> thank you, president. this particular item has been

extensively outlined in the governance committee meetings which were distributed to the board and the general public. i would like to have holly, if she would, please bring up the two slides contained in the packet. >> just a moment. >> i'm going to ask for some technical assistance. would it be easier for me to go to the podium than webex? easier from there. i'm going to go up to the

podium. >> go right ahead. >> clerk: okay. >> double duty. [ laughter ]. >> all right. holly, if you just stand there and just highlight the next two pages. >> i can do that, yes. >> that is coming through for everyone. >> yes, thank you. >> so this first slide explains the education experiences that were offered in 2021. you'll see that we covered six experiences all together and there was a request in prior

reports to have both internal and external presentations. what you'll see is that there was a pretty good balance between that. we had presentations early in the year with mike clarke from aon. we had an internal hhs member present in may. starting in the summer, we brought in chris seers quarterback from ice miller, to do the fiduciary training which was a request of the board. and in the fall, an external person. and then we rounded out the year with a presentation by uc berkeley in conjunction with sfh vment s aco study that brought

in tim brown and emily hague from msuc berkeley. there were hours that commissioners could do outside of the meeting. two of our commissioners also attended an internal training, managing implicit bias, both the training and the work and commissioner hao attended a kaise pemenerate study. the next slide overviews the education plan for 2022.

these were things that ranked with the commissioners. the first mental health, the second genomics and the third medication-assisted treatment. the fourth was primary care payment reform, and in the fifth was the social determinants of health, and fifth gerentology. these will be the items we aim to present throughout the year, internal and subject matter experts. there was a note that the education plan expired in december 2021. so a new plan for a two-year span will need to be created. it was noted that that will be best aligned with the strategic lang. so it will be coming out towards

the middle or the educational background end of this year for the following two years. at the end of the page is where our resources are posted online. >> i would as we go through our strategic planning process at the end of april and working with staff following up on that, even though we identified these topics for 2022, there may be others that emerge out of those deliberations or the background materials that the staff and other presenters will be presenting to us. we will be in transition for 2022 and lay out a more detailed plan for 2023 and beyond was we yet our strategy in place. this particular item is up for your adoption. i will entertain a motion. >> i would like to move that we

approve the 2021 board aggregation report and plan for 2022. >> it's been properly moved and seconded that we approve the report as seconded and adopt the tentative plan for 2022. we'll have a roll call vote. [ roll call ]. public comment, there any public comment? i'll be reading the instructions aloud. public comment will be taken both in person and remotely via webex. for each item, it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. for anyone waiting in person, please approach the podium. public comment will be available for each item on this agenda. each person can comment for three minutes.

all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage in dialog with the caller. for those callers on the line, when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and you will be placed back on mute. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933.

again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment queue. please wait when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. i'll now take a look around the room to see if anyone is waiting for in-person public comment. there is no one waiting in line for in-person public comment. we will now move to webex for virtual comment and our moderator will notify us of any people in the queue.

>> while holly is doing that, i would like to specifically commend her on managing and coordinating all of these evaluation processes and surveys for this year. historically, this has been a partnership between the health service board, the secretary, and the department of human resources, but as of last year, we had to shift this completely to her office and she's done a superb job, both last year and

this year. i would like to publicly thank her for her support. >> thank you. pleasure to do the work. with that, we can move into the first slide. chair, how quickly could you like me to work through? >> the highlights, and the areas of self-evaluation. we had 100% completion rate. i would like to thank the commissioners for engaging in the process. let's go to the executive summary highlights, if we could. >> this slide shows those executive summary highlights. it shows the improvement areas, the full report does. 17 questions increased their rating. seven questions remain the same. the chart blow shows the score

over time. in those four sections listed out listed on the screen. >> and the second slides show pretty much across the board and in detail, there has been a continued shift to the right, meaning we are more in agreement with the various questions and issues raised in the various segments that we find ourselves neutral or in disagreement. overall there has been progress year over year with this particular inventory. one of the action items is for us to review the statements for next year's survey to see if any need to be modified, deleted, or

if any new ones need to be added to help the working of the board in these dimensions. so with that, i would ask for a motion to adopt the results of the board self-evaluation. >> chair: commissioner scot, i would like to make the motion to approve the self-evaluation report for 2021. >> all right. is there a second to that motion? >> second. >> it's properly moved and seconded that we adopt the report as provided and distributed and presented today on the board self-evaluation plan. is there public comment?

>> clerk: i'll be reading the instructions aloud. public comment will be taken both in person and remotely via webex. for each item, it will be taken from people attending in person and remotely. i will facilitate the in-person comments and our moderator will facilitate the online comments. for anyone waiting in person, please approach the podium. public comment will be available for each item on this agenda. each person can comment for three minutes. scrirpt all public comments are to be made concerning the agenda item presented. as a reminder, the caller may ask questions of the policy body, but there is no obligation to answer or engage in dialog with the caller.

for those callers on the line, when i welcome you on the call, i will invite you to state your name, but you can remain anonymous. i'll give a 30-second audible warning when your three minutes have ended and you will be placed back on mute. when your time is up, you will be placed on mute. remote viewing is available. opportunity to speak are available by dialling the number on the screen. the dial-in number is 415-655-0001, again 415-655-0001. when prompted, use access code 2484 074 0933. again, 2484 074 0933 then press #, #. you will enter the meeting as an attendee on the public comment call line and dial *3 to be added to the public comment queue. when the system says you have been unmuted, please speak. please wait for those on hold until the system indicates you have been unmuted. i'll now take a look around the room to see if anyone is waiting for in-person public comment. there is no one waiting in line for in-person public comment. we will now move to webex for virtual comment and our moderator will notify us of any people in the queue.

>> operator: board secretary, we have nine callers on the phone line. zero callers have entered the queue. a reminder, you must dial *3 now if you want to join public comment for this specific agenda item. we will wait five seconds and close public comment for this agenda item. board secretary, there are still no callers in the public queue at this time. >> clerk: thank you, moderator, hearing no callers, public comment is closed. >> thank you. me have had a vote. [ roll call ].

>> we'll now move to item 15. >> clerk: that is an out of governance committee matters. would you like to -- >> this is chair scott supposed to be also for 15. >> clerk: my mistake. >> clerk: would now be the time that you want to take the break or continue? >> chair: i think we should all take a little break, 10 minutes. >> that would bring us in two minutes to 3:00. we would stand in recess. >> chair: don't we have to take the vote on whether or not to hold the closed session? >> we're holding the recess.

>> chair: i think we have to follow through on item 15 and take the vote to hold closed session. >> clerk: can i interrupt? >> yes, please. >> clerk: commissioner, you said you would like to take a recess before agenda item 15. so we'll take a 10-minute break. >> take a break and then come back and do the closed session. you don't want to do a closed session. >> going into closed session may allow a number of people to leave. if we want to let them have their time back. >> i think if we vote to go into closed session, we can handle that issue and when we reopen, we'll reopen in closed session. that will allow all the mechanics to be in closed

session. i would say we should proceed with 15 and take the vote to go into closed session and when we reopen we'll be in closed session. >> i'm not quite following that. i would propose that we take our break now and that we come back and formally vote to go into closed session and the executive director has asked those staff members who already made their presentations and so forth that they could be excused at this particular time while taking the break so they're not hanging around waiting for us to get into closed session and so on. so i would of the order of the day take the break as announced by the chair. thank you. we'll reconvene

>> we are now regular ready to continue with the agenda. >> item 15. >> thank you, committee chair scott. item 15, vote on whether to hold closed session to review and approve 2021 annual employee performance evaluation draft report. this is an action item. >> i am ready to accept a motion. for this item. >> chair scott, i'll make the motion. to hold the closed session to review and approve the 2021 annual employee performance evaluation draft report. >> second. >> properly moved and seconded we hold a closed session to review and approve the 2021 annual employee performance evaluation. is there any public comment?

>> nobody here. >> we have verbal instructions that we'll read out loud for anyone virtually attending. >> you don't have to go through this for closed session. >> it's an action item. >> even though nobody is here? >> through the computer. >> public virtual. >> available in the hybrid model. >> public comment will be taken both in-person and remotely vie a webex. the board will take public comment first from people attending in person and then remotely. moderator will facilitate the virtual public comment. waiting in person, no one right now, we will move through our virtual public comment instructions in case someone does come in. public comment will be available for each item on the agenda. each speaker allowed three minutes in length unless there

are time limits during the meeting. all public comments for the agenda item presented. the caller may ask questions of the policy body. when i welcome you on the call, state your name clearly, you may remain anonymous. 30 second audible warning, and you will be placed on mute. remote viewing is available on sfgovtv and webex. dial the number on the screen. 1-415-655-0001, again 1-415-655-0001. when prompted use access 24840740933, 24840740933. press pound and pound again. you will enter the meeting as attendee on the public comment calling and star 3 to be added

to the queue. for those on hold, wait until you have been unmuted. a look at the room to see if there is anyone in line for in person public comment. no one online for in person. and now webex for the virtual public comment. moderator will notify us of any callers in the public queue at this time. >> we have six callers on the phone line, and 0 have specifically entered the public comment queue. you must dial star 3 now for this agenda item. board secretary, there are still no callers in the public comment queue at this time. >> thank you, moderator. no further callers, public comment is now closed. >> thank you, and we will take a

vote, roll call. [roll call vote taken] >> it's unanimous. we will go into closed session on this par >> our cameras are back on, thank you everyone in closed session, i'm going to turn it over to committee chair scott to make announcements. >> given some technical difficulties, we were unable to conduct an compliance, in a compliant manner the closed session, so we are going to defer item 16, 17, and 18 on our agenda until our next regularly convened board meeting in april. i'll now turn the meeting back

over to our interim president. >> number 19, please. >> agenda item number 19, reports and updates from contracted health plan representatives, this is a discussion item. i'll look around the room to see if there are any in-person representatives waiting to speak. there is no in-person representatives here to speak today. i can check through our webex to see if any of our planned reps are ready to speak. >> do we need to do public comment? >> none of the plan representatives have unmuted to speak, no updates. we can skip public comment. >> ok, public comment, yep,

thank you. >> so with no public comment, we get to move to the next agenda item. >> 20, adjournment. >> we can move to -- >> to, just adjourn, yeah. you are doing public comment on 19? >> we don't need to do public comment, there was no presentation. >> all right. all right. so, if there is no objection, this meeting is adjourned. >> thank you. >> good meeting. >> thank you, thank you. >> adjourned at 3:35 p.m. we spoke with people regardless of what they are. that is when you see change.

that is a lead advantage. so law enforcement assistance diversion to work with individuals with nonviolent related offenses to offer an alternative to an arrest and the county jail. >> we are seeing reduction in drug-related crimes in the pilot area. >> they have done the program for quite a while. they are successful in reducing the going to the county jail. >> this was a state grant that we applied for. the department is the main administrator. it requires we work with

multiple agencies. we have a community that includes the da, rapid transit police and san francisco sheriff's department and law enforcement agencies, public defender's office and adult probation to work together to look at the population that ends up in criminal justice and how they will not end up in jail. >> having partners in the nonprofit world and the public defender are critical to the success. we are beginning to succeed because we have that cooperation. >> agencies with very little connection are brought together at the same table. >> collaboration is good for the department. it gets us all working in the same direction. these are complex issues we are

dealing with. >> when you have systems as complicated as police and health and proation and jails and nonprofits it requires people to come to work together so everybody has to put their egos at the door. we have done it very, very well. >> the model of care where police, district attorney, public defenders are community-based organizations are all involved to worked towards the common goal. nobody wants to see drug users in jail. they want them to get the correct treatment they need. >> we are piloting lead in san francisco. close to civic center along market street, union plaza, powell street and in the mission, 16th and mission. >> our goal in san francisco and

in seattle is to work with individuals who are cycling in and out of criminal justice and are falling through the cracks and using this as intervention to address that population and the racial disparity we see. we want to focus on the mission in tender loan district. >> it goes to the partners that hired case managers to deal directly with the clients. case managers with referrals from the police or city agencies connect with the person to determine what their needs are and how we can best meet those needs. >> i have nobody, no friends, no resources, i am flat-out on my own. i witnessed women getting beat, men getting beat.

transgenders getting beat up. i saw people shot, stabbed. >> these are people that have had many visits to the county jail in san francisco or other institutions. we are trying to connect them with the resources they need in the community to break out of that cycle. >> all of the referrals are coming from the law enforcement agency. >> officers observe an offense. say you are using. it is found out you are in possession of drugs, that constituted a lead eligible defense. >> the officer would talk to the individual about participating in the program instead of being booked into the county jail. >> are you ever heard of the leads program. >> yes. >> are you part of the leads program? do you have a case worker? >> yes, i have a case manager. >> when they have a contact with a possible lead referral, they give us a call.

ideally we can meet them at the scene where the ticket is being issued. >> primarily what you are talking to are people under the influence of drugs but they will all be nonviolent. if they were violent they wouldn't qualify for lead. >> you think i am going to get arrested or maybe i will go to jail for something i just did because of the substance abuse issues i am dealing with. >> they would contact with the outreach worker. >> then glide shows up, you are not going to jail. we can take you. let's meet you where you are without telling you exactly what that is going to look like, let us help you and help you help yourself. >> bring them to the community assessment and services center run by adult probation to have assessment with the department

of public health staff to assess the treatment needs. it provides meals, groups, there are things happening that make it an open space they can access. they go through detailed assessment about their needs and how we can meet those needs. >> someone who would have entered the jail system or would have been arrested and book order the charge is diverted to social services. then from there instead of them going through that system, which hasn't shown itself to be an effective way to deal with people suffering from suable stance abuse issues they can be connected with case management. they can offer services based on their needs as individuals. >> one of the key things is our approach is client centered. hall reduction is based around

helping the client and meeting them where they are at in terms of what steps are you ready to take? >> we are not asking individuals to do anything specific at any point in time. it is a program based on whatever it takes and wherever it takes. we are going to them and working with them where they feel most comfortable in the community. >> it opens doors and they get access they wouldn't have had otherwise. >> supports them on their goals. we are not assigning goals working to come up with a plan what success looks like to them. >> because i have been in the field a lot i can offer different choices and let them decide which one they want to go down and help them on that path. >> it is all on you. we are here to guide you. we are not trying to force you to do what you want to do or change your mind. it is you telling us how you want us to help you. >> it means a lot to the clients

to know there is someone creative in the way we can assist them. >> they pick up the phone. it was a blessing to have them when i was on the streets. no matter what situation, what pay phone, cell phone, somebody else's phone by calling them they always answered. >> in office-based setting somebody at the reception desk and the clinician will not work for this population of drug users on the street. this has been helpful to see the outcome. >> we will pick you up, take you to the appointment, get you food on the way and make sure your needs are taken care of so you are not out in the cold. >> first to push me so i will not be afraid to ask for help with the lead team. >> can we get you to use less

and less so you can function and have a normal life, job, place to stay, be a functioning part of the community. it is all part of the home reduction model. you are using less and you are allowed to be a viable member of the society. this is an important question where lead will go from here. looking at the data so far and seeing the successes and we can build on that and as the department based on that where the investments need to go. >> if it is for five months. >> hopefully as final we will come up with a model that may help with all of the communities in the california. >> i want to go back to school to start my ged and go to community clean. >> it can be somebody scaled out. that is the hope anyway. >> is a huge need in the city.

depending on the need and the data we are getting we can definitely see an expansion. >> we all hope, obviously, the program is successful and we can implement it city wide. i think it will save the county millions of dollars in emergency services, police services, prosecuting services. more importantly, it will save lives.

>> (speaking foreign language.) >> shop and dine in the 49 promotes local biz and challenges the san franciscans to do their shop and dine in the 49 within the by supporting the services we help san francisco remain unique and successful and vibrant so where will you shop and dine in the 49 san francisco owes itch of the charm to the many neighborhoods people coma greet and meet it has an personality these neighborhoods are economic engine seeing the changes is a big deal to me especially being a san francisco native and it is important to support the local businesses but also a lot to over here it is nice not to have to go downtown i think that is very important 0

for us to circulate our dollars the community before we bring them outside of the community for the time we have one dollars in the community is the better off we are it is about economic empowerment by apron ingress the businesses that are here. >> shopping local cuts down the cyber foot you'll find cookies and being transported the world where everything is manufactured and put on the assembly line having something local is meaning more the more we support our local businesses the more i can walk down to where i need to

be. >> bridges contingency bye like west portal it is about city and san francisco may have a big name but a small city and a lot of small communities shop and dine in the 49 highlighted that and reminded people come outburst and i love that about this city i'll always be a >> i personally love the mega jobs. i think they're a lot of fun. i like being part of a build that is bigger than myself and outlast me and make a mark on a landscape or industry. ♪♪♪

we do a lot of the big sexy jobs, the stacked towers, transit center, a lot of the note worthy projects. i'm second generation construction. my dad was in it and for me it just felt right. i was about 16 when i first started drafting home plans for people and working my way through college. in college i became a project engineer on the job, replacing others who were there previously and took over for them. the transit center project is about a million square feet. the entire floor is for commuter buses to come in and drop off, there will be five and a half acre city park accessible to everyone. it has an amputheater and water marsh that will filter it

through to use it for landscaping. bay area council is big here in the area, and they have a gender equity group. i love going to the workshops. it's where i met jessica. >> we hit it off, we were both in the same field and the only two women in the same. >> through that friendship did we discover that our projects are interrelated. >> the projects provide the power from san jose to san francisco and end in the trans bay terminal where amanda was in charge of construction. >> without her project basically i have a fancy bus stop. she has headed up the women's network and i do, too. we have exchanged a lot of ideas on how to get groups to work together.

it's been a good partnership for us. >> women can play leadership role in this field. >> i tell him that the schedule is behind, his work is crappy. he starts dropping f-bombs and i say if you're going to talk to me like that, the meeting is over. so these are the challenges that we face over and over again. the reality, okay, but it is getting better i think. >> it has been great to bond with other women in the field. we lack diversity and so we have to support each other and change the culture a bit so more women see it as a great field that they can succeed in. >> what drew me in, i could use more of my mind than my body to get the work done. >> it's important for women to

network with each other, especially in construction. the percentage of women and men in construction is so different. it's hard to feel a part of something and you feel alone. >> it's fun to play a leadership role in an important project, this is important for the transportation of the entire peninsula. >> to have that person -- of women coming into construction, returning to construction from family leave and creating the network of women that can rely on each other. >> women are the main source of income in your household. show of hands. >> people are very charmed with the idea of the reverse role, that there's a dad at home instead of a mom. you won't have gender equity in the office until it's at home. >> whatever you do, be the best you can be. don't say i can't do it, you can excel and do whatever you want.

just put your mind into it.

okay. the meeting will come to order. welcome to the thursday, march 10th, meeting of the public safety and neighborhood services committee. i'm chair of this committee supervisor mar. thank you to this clerk alisa samara and i'd also like to thank sfgov tv and michael baltazarfo