fact that we don't have enough staff to do the work that we needed to do in 2022 and we can already predict what the future may hold with that regard. >> supervisor stefani: thank you. i want to touch on gun violence and shootings, because obviously i've done a lot of work on gun violence prevention and we know that gun violence and shootings are not considered as part of the crime rate to evaluate that, but we know that shootings are up. i think the public perceives gun violence as crime and something that makes them feel unsafe. reports certainly, of course, of gun violence require a police response one would think. and i am wondering what is happening in the field when it comes to gun violence and how that this shortage impacted that? because we know that like it's increased it rates i haven't seen since i lived here.

>> i think there are two areas. it's what are we doing in patrols and how proactive are we being in investigations bureau? i know we have the acting deputy chief here which is a whole other topic. staffing shortage is affecting the entire organization. it affects investigations, operations. but with regard to gun violence, there is two big strategies we've been moving forward on as of late. one, the investigations bureau can talk about all their great proactive work with their community violence response team. our work with the california partnerships, with our consultant on really narrowing down shooting reviews and really focusing on those that may be future shooters or victims and doing an intervention piece on that. that is a national best practice we've embarked on. but in terms of the patrol, on day-to-day operation, we've been

having officers work on an overtime basis because of staffing to be highly visible in some of the corridors and areas we believe shootings may occur, so we have a visible presence, so that we can prevent the next shooting. i feel -- i believe based on my experience and what i've seen, we've been successful, but again, it's a heavy-lift when you don't have enough officers to make sure they're out in the corridors and the portions of the city preventing the violence and shooting from taking place. it's a tremendous burden on the workforce and on the officers. they have been great. they have done it. they've done a great job. i feel we would have had much more if they had not done that, but there is a cost associated with that. >> also, supervisor haney did ask the question i had around opening our drug markets and how that is impacting the san francisco police department and staffing and arrests.

so, i don't think i need to go into that any further unless you want to add anything. i also want to talk about how reoffense rates -- because we hear over and over gain of drug dealers, it's a catch-and-release program, where if you make an arrest, how much does it even matter it seems to the public. i would like to talk about reoffense rates and length of detention and what are you experiencing with regard to the frequency offenders are rearrested and how is that affecting your work in the feel. >> i'll turn it over to deputy chief from investigations who works in the narcotics unit. >> thank you. >> good afternoon. thank you very much, supervisors, for this very important subject. i want to thank also the community that is watching this and their interest is really important to us.

for public safety. for narcotics, the way staffing has impacted narcotics is we're down to about one lieutenant, three sergeants in narcotics. we do borrow a team from operations and we do have an enforcement team of 12 officers that assist us in these street-level narcotics operations. we also really value the arrest that patrol makes when they have a chance for narcotics. and we sometimes adopt those cases and are able to work them up. they're very resource intensive. many of these cases require multiple search warrants, surveillance, could take weeks and weeks just for a crew of drug dealers. the drug dealers in the tenderloin as you know are in the hundreds. the ones that we do arrest, we do petition the court to try to

get stay away orders from. we see a lot of repeat offenders. and, you know, again, and that's just what the narcotics detail does and they do about two operations a week. we're kind of tapped at that level for various reasons, but that's pretty much what our commitment is. and we've been able to keep that commitment. >> supervisor stefani: thank you. and i know that the public has been waiting and i want to turn to public comment. i just want to also mention, too, that we have -- i've had three pedestrian deaths in district 2 and one was because a woman ran a red light and a teacher was killed at sherman elementary. i know the impact on the motorcycle unit is very significant. we do not have enough police officers to patrol as we would to meet our vision zero goals and i don't know if you want to say anything about that.

but when you see increase in stunt driving which we've seen in my district and supervisor safai's district, the stunt driving, you know, what i'm talking about -- it's just the level of duties that you need to perform to keep us safe is somewhat astronomical when you look at all aspects of it. and these staffing numbers are concerning. so if you could touch on that and then i do want to turn it to public comment. >> thank you, supervisor. i'll get right to the question. i know that for the folks that are watching online and other individuals who might not be familiar with it, i know that you and supervisor mandelman, supervisor peskin, are involved in the c.t.a. and concerned with all things traffic-related in the city. so the impact that staffing has, reduced staffing has on my bureau, the motorcycle officers

that handle traffic management, traffic investigation, and response to stunt driving commonly referred to as sideshows, is significant. it is just numbers-wise, i think currently we're at for the motorcycle company, we're at less than 30% of what our historical staffing has been. and the impact for us is that the city now has more road users. we have transportation network companies like uber and lyft which have brought additional traffic into the city. we're trying to meet our goals related to vision zero working with sfmta and walk s.f. and other partners and it does create a challenge, not only with the additional use of vehicles, but also with things like rental scooters and bicycles. there are a lot more folks using

the roadways and traffic company or motorcycle officers have traditionally been the department's go to in the community to address specific traffic concerns. there is certainly been an increase in the stunt driving incidents that we've had. there was -- and with those, unfortunately, there is a potential for violence. we've had firearms discharged. we've had a homicide connected to one in the ingleside. last night i watched the story on a local news network on a similar incident that happened in the livermore, again, there were shootings and shots fired at that incident. so the reduction in our staffing has a huge impact. and then specific to the tragedy that you referred to at union

and franklin, where the young man, the schoolteacher was killed in a vehicle collision, as a result of a vehicle collision. we feel that impact in traffic company as well because our unit also houses the officers responsible for traffic collision investigations. major incidents like that one. so, one of our ancillary responsibilities and it's important to people in the community, if you get your car towed because you have a suspended license, there is a program called stop. you have to respond to traffic company to get through the administrative process to get your vehicle back. well, the person that used to staff that has retired. so now we're using folks that are within traffic company to handle that responsibility. it's a responsibility that requires a supervisor. one of the supervisors is also a supervisor who is involved in our -- or was detailed to the

traffic collision investigation unit, so there is impact. now he's balancing. our concern with that is that it delays the investigative process for us. the impact of that is to that man's family, his friends and colleagues and people in the community who want, you know, some closure, some finality in what is going to happen in that process. and if i could add one other thing real quickly, our bureau also includes the officers who are assigned to security for muni. and, you know, due to the reduction in staffing that we have in patrol which is our primary most important function, the officers that were in uniform that were responsible for security on muni were all sent back to district stations. we see the incident two days ago in new york where the person got

on the train and without warning, you know, attacked and injured numerous people. so when that happened in the police department, we have to respond to that, we have to put officers out. we have to draw officers from other places where we would normally have officers assigned to muni to get out, because we didn't know at the time if that person was acting alone, if that was coordinated, where attacks were going to happen in other places and we have to be mindful of those public safety concerns, because one of our most important goals is prevention. i think people would rather we prevent crime than arrest those responsible for victimizing others. >> supervisor stefani: thank you all for that. i know that the public might be waiting to weigh in. we'll turn it over to them. thank you so much. >> >> supervisor mar: thank you. why don't we get to public comment.

>> yes, members of the public who wish to provide public comment on this matter and our joining us in-person should line up to speak along the side of the room by the windows. as for those joining us remotely, call 1-415-655-0001. enter the meeting i.d. of 2491 567 5344 # #. once connected, press star 3 to enter the speaker line. for those already in the queue, please wait in until the system indicates you've been unmuted. we have in-person speaker. >> thank you. neighbors emergence. supervisors stefani, could you please ask me a question, what are my answers to one of our questions to officer lazar.

>> you could just make your comment. >> okay. our organization works a little bit differently than the others because we like to get results. and first of all, thank you for giving me captain jackson. he's outstanding. but we found out in our neighborhood and it's very interesting that we have one, two, three, four, five entities of police officers. we have the presidio, we have fort mason, we have the park and rec, we have the library and we have the highway patrol. and three of the five of them had new captains and we pulled them in a room so we could work out who had what jurisdictions. and several of the other entities within this city have similar problems because of tourism. it has worked. they know each other.

they're interacting because all of them are short of staff, they're trying to help each other out when available if they can. we have another problem that happens that the poor police officers have to deal with. it's our communication system. one of the people that we had was called -- there were 17 calls on her last weekend. she came up in front of restaurants, threw her clothes off, spit on people, threw things and then as soon as the police showed up, then she would move to another location. we simply do not have enough police officers to handle these types -- [bell ringing]. >> speaker, time has elapsed. thank you.

>> good afternoon, supervisors. i'm jim hands. i'm on the board of the civic center community district. i'm a partner in the phoenix hotel on eddy street and i live at 100 van ness. i want to go back to the subject of the tenderloin and drug dealers. as you know, they gather together in large packs on certain streets. one of them is the 600 block of ed dy where the phoenix is. they just take over the whole street. and, you know, in the tenderloin, we have been complaining -- by the way, i would note that most of these drug dealers aren't local. they commute in from east bay on shifts. -- with their product and that's a whole different issue how to

deal with them and requires regional cooperation that does not seem to be much there. but the tenderloin has complained for years about not enough policing. we appreciate the additional officers who have come, but we've found on their days off, they don't know the neighborhood very well and they're there from 11 to 9. it's also true that the -- that the urban people are there until 9:00. you saw "the chronicle" article about what happens after 9:00. and one of the points i want to make on behalf of all of this, there doesn't seem to be a strategy. they're out on the street, but there isn't any program to use them in an organized way, which is something that bothers a lot of us in the tenderloin. and so, you know, not only is it a matter of staffing, but it's a matter of how they're utilized.

and we feel that the tenderloin is not getting -- >> thank you. seeing the end of in-person speakers, we're checking to see if we have remote attendees. if you're on the phone and haven't done so, please press star 3 and then wait until the system indicates you've been unmuted. that will be your cue to begin your comments. i would like to note that supervisor mandelman has been appointed to serve on this committee in place of supervisor haney. we have 36 callers with 28 in line to speak. can we have the first remote caller? >> good afternoon. my name is suzette. i'm the direct other of sales and marketing at freight hotel at union square.

i'm calling to support s.f.p.d. in securing the necessary resources to increase staffing levels and recruit new officers to increase safety or everyone. protecting their budget is important to my livelihood and the fiscal of my company. i am now spending my time with clients convincing them san francisco is still a safe and wonderful city to send their clients to. as a salesperson, i can easily move to selling another hotel in other city, state or country. work from home has opened up all possibilities. let's please work together to once again bring san francisco to its full and wonderful potential as a desirable destination where both residents and visitors can feel safe from crime. thank you for all of your service to san francisco and your support as the s.f.p.d.

>> thank you. good afternoon. i'm representing the bay area council. i'm calling to voice my organization's support to provide the police department with the resources needing as the current number of officers are down by nearly 500. thank you for your time. >> thank you. >> caller: good afternoon, supervisors. my name is gary cox. i'm representing the axiom hotel and resident of district 6 living in soma for the past eight plus years. i'm calling to support the san francisco police department in securing the necessary resources to increase staffing levels and

recruit new officers in order to keep us all safe. protecting these resources for the san francisco police department is of vital important to my entire team and visitors of our city. i have been a victim of crime. i've lost several team members as a result of their fear of working in the city. this is unacceptable to me and needs to be addressed. the funding to increase the police presence in this city is absolutely necessary for us to feel safe and the city to return to business. please protect our residents and visitors by supporting the resources needed for san francisco police department to achieve full staffing levels. thank you for listening. >> thank you. >> caller: good afternoon, chair and supervisors. each day we see the challenges

realities of those suffering on our streets. issues including skyrocketing inequality, systemic racism and the lack of shelter access, affordable housing, mental health and substance use services are driving many of the crimes in our streets. focusing on criminalization -- [indiscernible] -- will never address the root causes. true solutions must be anchored in life affirming resources that will reduce the workload of police officers. the need to reinstitute help to the shelter system, that could result in fewer people suffering with nowhere to go on our street. this pre-existing policy has been blocked for more than two years. if the compassion alternative response team were implemented, police would no longer be one of the main responses to homelessness. the report referenced in the hearing identifies long response times to the priority c calls, but the cart program in place and it is already partially funded, police would not respond

to priority c calls. if the police stop engaging in public safety-related traffic stops known as pretextual stops, police department could respond to more severe situations. these are constitution -- problems are institutional and deep. fishing expeditions are -- communities of color who are disproportionately targeted by these stops. lastly, consumption services would be life-saving for people who use drugs. we should not rely on law enforcement to engage in issues for which is not the appropriate response. thank you. >> thank you. >> caller: good afternoon, supervisors, thank you, supervisor stefani, for calling

this hearing. i'm the president and c.e.o. of the hotel council in san francisco. i'm a life long resident of san francisco and i currently live in the sunnyside district 7. i'm calling as a resident but also on behalf of the hotel industry workers. and also to ensure the safety of our employees, residents and workers. you've all received a copy of a letter from the hotel council, leader national association of theater and stage employees and the san francisco building and trade council have all signed on to in support of safety for our employees. many of whom live in san francisco. this letter is to demonstrate our united support for san francisco police officers and resources that are needed to keep the staffing levels where they should be. our employees continue to

experience acts of violence while traveling to and from work and they're asking for more protection. the hotel council and its partner organizations conducted a survey about their views on crime and safety. voters are concerned about crime and safety and believe that elected officials are not doing enough to address that. two very specific findings are 79% of voters surveyed said the presence of police make them feel safer. 8% of voters increasing the number of officers in high crime areas. i call today to represent the thousands of industry workers and also to ask that you protect our workers, visitors, by supporting the resources needed. thank you for your time. >> thank you. >> caller: thank you, supervisors.

my name is randall scott. i'm the executive director of the fishermen's wharf community district. i'm calling in to strongly support our city investing in our officers and in whatever it takes to increase the staffing levels and quality of life for our officers. i think that's been touched on a number of times. i would love to see more community policing which will come from the multi-hundreds we need to attract to our city. thank you so much. and god bless, san francisco. >> thank you. >> caller: good afternoon, chair mar and supervisors. my name is cassandra and i'm calling on behalf of the san francisco travel association. i'm calling today to ensure that the city is doing everything in their power to make sure our city is as safe and welcoming as it can be. thank you to supervisor stefani

for calling this hearing today to shed light on the alarming staffing deficits that the sfpd is contending with. we're gravely below the number of police officers we need. we need recruitment tools to bring us up to adequate staffing levels and to complement the great work that the city has done around building our network of response tools such as the street crisis response team. when we look at the need for public safety and ratio of officers, we have look at the numbers coming too our city. in 2019, we had 25 million visitors. we're in this to partner, recover and restore our public safety response tools. we love this city just as much as all of you do and work really hard to make sure we can recover and rebuild.

we appreciate your time and attention to this serious matter. >> thank you. >> caller: hello, supervisors. my name is joanne desmond and i represent the theatrical stage employees, local 16. one of the signatories just mentioned by mr. carroll. our industry has experienced an almost 100% shutdown during covid. our members desperately need to return to work and we need to make sure our city is safe, clean and inviting to attract business. police presence is vital for workers and visitors alike, to ensure all of our safety and well-being. on behalf of our 1500-plus members, we strongly support full funding for public safety. thank you.

>> thank you. >> caller: hello, supervisors. my name is -- i'm a resident here in the tenderloin, san francisco. i'm calling in to support sfpd in securing the resources necessary to increase the staffing levels as well as the foot beat patrols in the area. i'm also a hospitality professional in the security field and i've been seeing increase in assaults. we want to make sure that our team members and our people that are visiting san francisco feel safe and i think with the necessary tools to increase the staffing levels would help sfpd out tremendously and increase the safety for visitors and help bring our city back. thank you, all, for taking the time out to listen. >> thank you.

>> caller: hello, supervisors. my name is amy and i'm representing the golden gate restaurant association. represent hundreds of restaurants and cafes in san francisco. the safety of our employees and customers is a real need and concern. we urge you to support this request. we believe it's important to have police officers out on the street addressing crime. [indiscernible] our employees do not feel safe in the city, our businesses will suffer. the recovery of the city and the industry as a whole is dependent on safety and a fully staffed sfpd will protect not only our citizens but also our economy. we're requesting city leaders on the resources needed to achieve the staffing levels outlined by the department. thank you for your time. >> thank you.

>> caller: hello, supervisors. my name is kelly powers. i'm the director of the hotel council of san francisco. we are in full support of any creative solutions to increase staffing and police resources and address the low morale as a serious hindrance to officers choosing to work in san francisco. crisis, depleted staffing numbers correlate with delayed response time, increased crimes to our employees and residents, unreported crimes and a situation that encourages criminals to come to san francisco because they realize there is limited police staffing and see it as an opportunity. in essence, leaving residents and employees vulnerable to becoming victims. our employees at the hotel council share stories of violence that is nothing short of harrowing. we need our city leaders to prioritize this serious issue. i'm gravely disappointed it's

been allowed to reach this critical level that we're here today to talk about. it should have been addressed much earlier. thank you, supervisor stefani, for addressing this issue and i appreciate your time today. thank you. >> thank you. >> caller: hi, supervisors my name is david harrison. i'm a resident of district 5 and the inner sunset. firstoff, thank you to all of you supervisors for your attention to this issue. i'm rovoicing support. unfortunately, as we try to repopulate downtown, concern of permanent safety remains a top issue. with so many additional challenges to this effort, it's critical we do everything we can to ensure that our residents, our office workers and retailers

feel safe. recognizing the current challenge and the potential to get worse, we're supportive of making the appropriate budget assessments to address this challenging issue. >> thank you. >> caller: good afternoon, supervisors. my name is peter hart. i'm representing the lower -- polk gulch neighborhood. it's my first time calling into the hearing and it's with my full support to the sfpd to keep our residents and visitors safe. i've lived in san francisco for 15 years and never felt as unsafe as i do today. my car has been broken into twice. my building garage was robbed recently.

and my neighbors didn't even call to make a report. they didn't, because previous incidents, no one seems to come. it takes hours. and there just isn't the deployment needed. i walk to union square regularly. frankly, the walk has become -- we're accosted by transients every day. our streets are not safe. thank you. >> caller: hello, supervisors, my name is terry lewis, i'm the complex general manager of the union square park 55 hotel. i live in district 3. above all things the safety of my employees and the residents of san francisco and our visitors is of utmost importance. accordingly, i'm asking this committee to support the resources needed for our sfpd to

achieve full staffing levels that have been outlined for the department. covid-19 has had an outsized impact on all of us over the past few years and i hope we finally turned a corner. as individual tourism and business travel begin returning to a semblance of our new normal, we can't forget the role that safety improvement will play in the city's ongoing recovery. again, i urge city leaders to fund the resources needed by sfpd to secure full staffing levels. it will vitally benefit our employees, our neighborhoods and guests. thank you very much. >> thank you. >> caller: supervisors, my name is francisca. yesterday, i addressed this issue with the police commission. the police commissioners were

astounded by what they heard. this presentation that was given today muddies the waters. we should all know that the strength of our police force should be over 2000 and is about 1,100. and so there is 1600 people, or 1500 people is a lie. now, we have to address this situation on a -- footing. i happen to know all of the officers who are sitting there in room 250. they know me very well. we need to address this situation on a -- footing. the supervisors have let us down of the mayor has let us down. the controller has let us down. who is -- the constituents?

the taxpayers. they are suffering. every single day. assaulted. car break-in. home break-ins. this nonsense must stop. we need a plan. the emergency is for the whole city. thank you very much. >> thank you. >> caller: good afternoon, supervisors. and representatives from san francisco police department. i'm carolyn kennedy, a community leader in district 8 and leader of rescue s.f. it is sobering and scary how limited our field resources are. and it matches san franciscans' perceptions. neighbors in my community do not feel safe. neighbors have seen the market

rise in lawlessness and crime in our community. many have experienced crime themselves. i urge sfpd to increase its patrol force. i support of investments to recruit and retain officers, the labor market is much more competitive. offering a package that incoming officers really value is critical. and commander jones is right, this is a five-plus year effort. during the budget process please advocate for and fund the hiring of more officers in a more competitive recruitment and compensation package. thank you for holding this hearing and listening to my comments. >> thank you. >> caller: hi, my name is william jake, resident 8. please vote to fund increasing the staffing levels for the police department. break-ins, assaults, robberies, property theft, vandalism, hate

crimes, drugs, shootings, all commonplace these days. everybody knows that san francisco is not safe anymore. there is more trouble than ever and people disrupting our city know they probably aren't going to get caught. the majority of the citizens of san francisco support our outstanding police officers and we know that inadequate funding for the police department is one of the main reasons that crime is out of control here. this is your chance to use your leadership positions to change that. we need more police officers and we need you to support them. so, please help us and don't skimp on the police budget. thank you. >> thank you. >> caller: hi, my name is stefani. i'm calling to urge you to increase the staffing levels for san francisco police department.

as you know the police department needs to add more than 500 -- staffing. as a resident living here since 1996, i didn't need an independent study to tell me the streets are less safe. my car was stolen in front of my home. we've been parking that car in the street for 20 years without incident. in my opinion, it is going to take more than just you agreeing to raise staff levels to hire good candidates for the academy. our current police commission and incompetent d.a. and you on the board show a disdain for police officers and undermine support for them. i can't imagine how these brave officers wake up knowing that you folks are doing everything they can to undermine them. until this board of supervisors

value the hard work that police officers do and their contribution to public safety, what normal person would want to work here? there is abundance of support of police officers from evidence citizens and -- everyday citizens. hiring more police officers is only one of the things that is needed to restore public safety and that is also a fact. and you should understand that. -- turn around and -- [indiscernible] of the sfpd. thank you, supervisor stefani, for caring about public safety and calling this meeting. >> thank you. >> caller: yes, good afternoon, supervisors. my name is wes tyler, i'm the manager at the chancellor hotel in union square. i'm calling to support the police department and increasing staffing levels, recruit new officers. with the current number of

officers down by hundreds and resignations and retirements increasing, i'm requesting that the city leaders correct course from this terrible path we've been led down. recent crime stats in union square prove that increased police presence reduces crime and it shows that people feel safer. protect our workers, residents and visitors by supporting the resources needed for the police department to achieve full staffing levels. thank you. >> thank you. i'd like to do a quick check. if you're on the phone and have not already done so, please dial star 3 and wait until the system indicates you've been unmuted. that will be your cue to begin your comments. we have 10 more people in line for public comment. next caller. >> caller: hello, supervisors.

my name is kaetlyn fear and i'm resident of nob hill. this is my first time calling in. i'm calling to support sfpd in retaining and recruiting police officers. i would like to feel comfortable visiting any neighborhood to support local businesses where i do not out of fear of harassment or worse. i've been chased outside of my own place of employment by a woman not in her right state of mind. i have been spat on and urinated on. i've had meals thrown at me and my car broken into. all in broad daylight. i have been verbally accosted and witnessed open air drug use too many times to count. i firmly believe sfpd should not have to prioritize the crimes they respond to out of a lack of staffing and resource shortage. please protect the people of san francisco by supporting resources for sfpd. thank you for your time.

>> thank you. >> caller: good afternoon. my name is caydee and i've been a san francisco resident of district 6 since 1995. i -- [indiscernible] before and since community policing -- board as a treasure member. i have seen and heard firsthand what our officers -- and how they react. they're a great force. we need to grow that force. and we need to better support the staff that we have. feel safer with more officers to protect. please increase spending so that more officers can be hired. please make san francisco a safer city. thank you.

>> thank you. >> caller: hello, supervisors. my name is -- i'm the complex general manager with destinations and resident of soma in the heart of district 6. this is my first time calling in, i felt was important to do so. i'm calling to fully support the san francisco police department in securing resources. protecting the sfpd budget because i care about my team members, my family that all live here in the heart of san francisco. i have personally seen too many crimes happen, including break-ins into my own home building, car smash-and-grab robberies in the middle of the day, to my hotel guests and i know too many people that are fearful walking on the street. it is critical for the recovery of our city that both residents and visitors in the city feel safe. and a fully staffed police department is critical to make this happen.

please support the resources needed for the sfpd to achieve full staffing levels. thank you so much for your time. >> thank you. >> caller: hello, i'm a resident of the mission. i've closely followed the staffing situation since 2017. i've spoke with many officers about their futures. here are factors you should consider when it comes to staffing and the budget. number one. in 2016, the city's target leading response time for a priority call was four minutes. today, in 2022, the target is now eight minutes. we've doubled to eight minutes the time it takes to respond to the most urgent requests. if armed gunmen just kicked in your front door and were assaulting your family, sfpd

will not be able to get there under eight minutes. that prospect is terrifying. sfpd is losing through retirements -- one officer per day. i've heard over 300 officers -- retirement in july. combined with current officer shortages, the department could be over 800 officers below recommended staffing levels. the last two academy classes graduated 21 officers. historically, only 14 of those will make it through the first year. this is shortfall in staffing that will take decades to repair. only eight people showed up at the last physical fitness meeting for police department. point 3. few veteran officers are traveled into sfpd in the past five years. why. meanwhile, law enforcement agencies throughout the country are showing up in s.f. to make

job offers with five-figure signing bonuses to some of the finest trained police officers in the country. there are communities in the bay area where they treat their police department with respect. they're offering higher starting salaries. i urge you to show support to police officers -- >> your time has elapsed. thank you. >> caller: hi, good afternoon. my name is frank rock. i'm a -- san francisco california. i live out in the excelsior district. i work downtown in the tenderloin. i'm reaching out to you in support necessary resources to allow the san francisco police department to increase staffing levels in order to keep workers, residents and -- safe. i feel it is important to have more police officers on the

street engaging in policing addressing crime. the recovery of our city is dependent on safety and a full staff who played an important role in -- our economy. myself as a service working down here at a hotel, i was assaulted a couple of days ago. shows guest safety. from a military point of view, if you really want to hear it, i'm a military veteran. we are outnumbered, outforced by the homeless population. before the pandemic, we had major counsel. tourism has gone down. leaders need to stand up now and -- san francisco. -- down 500 police officers. we are urgently requesting city leaders like to you fund the resources needed to achieve the full staffing levels that have

been outlined by our department. i just want you to hear that from me. thank you for your support. >> thank you. >> caller: good afternoon, supervisors and staff. this is taylor, the president and c.e.o. of 39. i'm calling to support staffing for san francisco police department. we've seen a significant increase in petty crime in the wharf in the last two years. we need the city to be safe to recover from what we've been through in the last two years and i ask for your support of this important initiative. >> thank you. >> caller: hello. i am a resident of san

francisco. i've lived here for six months and i'm appalled by the state of the city. i think it's directly related to the lack of police funding. ignore the ideological nonsense and fund the police and work for your voters instead of people on twitter. thank you for your time. >> thank you. >> caller: hello, can you hear me? you need to turn down your background device to avoid the echo. you may proceed. are you still there? they did hang up. hopefully, they'll call back. next caller.

>> caller: thank you, supervisors and officers. my name is valley. i'm the -- valerie. the safety of our colleagues and guests are our number one priority. our hotels are open 24 hours day, 7 days a week, 365 days a year, so police support is critical. we experienced significant escalations in crime in and around our hotels. our colleagues and security teams do not want to feel like they're putting their lives at risk by coming to work. they employ over 500 employees in the city. they do their very best to ensure guests in san francisco has an incredible experience. the increases in crime is undermining the recovery of our business. this unfortunately contributes to fewer shifts, fewer new hotels and less jobs.

our city and industry need your help and support to fully fund the resources needed by the police department. thank you for making this a priority and listening to my comments. >> thank you. >> caller: good afternoon, supervisors. my name is -- and i'm a project director for the -- and mid market community district. and i'm calling today because both of our community benefit district are in support of staffing level of the police department. our management staff and our -- staff -- businesses that residents workers and visitors to -- [indiscernible] -- stakeholders at the officers on the -- sidewalks and plazas make a very positive difference and it does increase your

feeling of safety. i've been -- i would say i was struck by the numbers as i heard from the commander that there are only two -- three sgt.s work the units in san francisco. when we have hundreds of drug dealers every day, that's a -- out there. so, please, thank you so much, supervisor stefani for calling this hearing and i look forward following the future meetings. >> thank you. >> caller: good afternoon, supervisors. i'm gideon kramer. i am a 43 year resident of san francisco. and i'm calling and urging the

supervisors to increase staffing levels for the city -- for the san francisco police department. i would like to say that it baffles me that it is even required and that we have so many studies it's obvious that the city is in serious trouble and the fact that we're questioning whether to have sufficient police staffing should not even be a questions. -- question. -- in practice, this means that -- does not have the resources to keep our city safe. we see it in the departments inability to end -- in the tenderloin. we see it in union square and the property crimes in recent years. residents do not feel safe and that need to change. i urge the board of supervisors

to provide sufficient funding to allow the department to increase staffing and ensure public safety for all san franciscans. thank you very much. >> caller: good afternoon, supervisors. my name is -- i'm representing ian square alliance. we represent hundreds of members and thousands of stakeholders in the heart of san francisco. i'm also a san francisco native and a district 3 resident. i'm calling to support san francisco police department in securing the necessary resources they need for staffing levels for recruiting our new officers, for training new and existing officers to keep san francisco safe. protecting the budget is important because many of our members have been victims of crime resulting in negative impacts or all san franciscans.

we've brought -- service jobs because people are afraid to work here and to visit here. help us recover our city and support our police. i want to thank san francisco police department, deputy chief lazar, captain jones, captain pereira for their comments and hard work in supporting the department, as well as i want to acknowledge the potential burnout of our officers. there are not enough. they're working so hard to try to keep our city safe. those who are still here. they need our support. i want to continue to support them. in addition we need to support our city and the heart of our city as well. thank you so much. >> thank you. >> caller: supervisors, i want to applaud you for holding this hearing today. unfortunately, the reality is the colleagues of yours on the

board of supervisors have done nothing but demonize this profession. they do nothing to promote the honorable profession which is constantly under the microscope. those at this hearing today should encourage your fellow colleagues to stop the demonization. to encourage young constituents to get involved in keeping this city safe for all. please continue shining a light on these issues. the public deserves to know how dire the situation is. thank you. >> thank you. >> caller: resident of san francisco and i've lived in the -- district and -- [indiscernible] -- my neighbors and my friends have -- when they're just parking the car overnight on the

street or one of my friends come to visit from out of town and just park the car on the street for like 10 minutes and was a victim of a crime. and -- the things we see on the news, it's really happening, it's not a conspiracy or conservative attack on san francisco. i'm calling to support this funding of police. that's the only way we can feel safe. as a resident, every time we walk into the supermarket or drugstore or the apple store, it makes you excited to see the officers in the front protecting us. until we have the district attorney recalled, these -- [indiscernible] -- as a normal resident and law-abiding citizen, i don't feel safe on the street. please continue to support the funding of the police. >> thank you. >> caller: yes, hi, can you hear me?

>> please proceed. >> caller: yes, hi, my name is ann ferguson i'm a resident here in san francisco and member of -- clean streets. and i strongly urge you to please increase funding for the police department. no disrespect, but the visuals around union square at the time of the massive robberies was extremely enticing for those watching on the news, but the rest of us who are citizens who actually have to live here, those police officers were down there protecting the tourists and the expensive retail stores at expense of the rest of us who are actually taxpayers. i'm in an industry where an awful lot of people get recruited by companies and what we've started doing is torrential bonuses please -- retention bonuses. instead of losing our people,

we're giving people who stayed with us a retention bonus. i strongly urge you to do that with the law enforcement officers here now. i applaud them all. they're out there putting their life on the line for us every single day. they deserve our respect, but they also deserve to be compensated adequately. thank you for listening to me. >> i just want to do one last check in of people who are on the line. if you do wish to provide public comment, please press star 3 to line up to speak. the system will indicate you've been unmuted -- when it is time for you to speak, the system will indicate you've been unmuted and that is your cue to begin your comments. we have five callers left on the line. >> caller: members of the board

of supervisors, i'm ellen grant, district 8, resident for more than 20 years and i have two teenage sons who go to school here. i'm the cofound otherer of the mothers against drug deaths. affected by the drug epidemic in san francisco. we're urging the board of supervisors to increase staffing levels for the police department. we wrote a detailed letter. and i'm going to highlight a few key areas. so san francisco's open drug market which operate in broad daylight draw people in from other cities and states including the kids of many of our members. reports thousands of our citizens have come to san francisco for the inexpensive and easy access to lethal drugs including fentanyl. hundreds of people have contacted us, many sharing their

stories about how their loved ones have been affected by the drug crisis in san francisco and blaming the city's permissive attitude. here's excerpts. i'm going to read a couple. one is, my son frequents the tenderloin every day and sometimes for days at a time. he is addicted to fentanyl and meth. if something happens to my son, i'm going to hold them accountable. he told me he thought he'd be arrested, but the cops either turn their heads or rough him up and let him go. >> last year, i saw my son in i.c.u. attacked and drove to my house and i called 911 immediately. they put a metal plate in his jaw, it's still healing, swollen. he was released into the streets. this time he was arrested for fentanyl possession. i think he was living in a tent in the lincoln center.

>> your time has elapsed. huh. -- thank you. >> caller: good afternoon. my name is daniel. i'm calling on behalf of the san francisco chamber of commerce. we represent thousands of businesses of all sizes in san francisco and that includes over 250,000 employees who live and work here in the city. and the top concern we hear from them is public safety. they don't feel safe here working in our city and it's a major impact in trying to bring back our economic core. i want to thank supervisor stefani and you all for having this hearing today. recruitment and retention of the police officers is of vital importance making sure that san franciscans and our employees feel safe.

thank you. >> thank you. >> caller: good afternoon. thank you -- excuse me, sorry. good afternoon, thank you, supervisor stefani, for calling this meeting. i urge you to increase the staffing levels of the san francisco police department. as you know the police department needs to add more than 500 officers to meet the recommended level of staffing. as a life long san franciscan i don't need someone to tell me the streets are less safe. my home was broken in last year. my car has been broken into three times in the last two years. an elderly asian man was severely beaten walking down the street around the corner from my home last year. i'm sure you have seen the news today, stabbings and people are trying to cut fingers off to get their wedding rings.

public safety is separate issue from police reform. it's going to take more than just raising -- our current police commission, incompetent d.a. and others on the board show disdain for the police officers and undermine support for them. i cannot imagine how these brave officers wake up every day to deal with all they deal with knowing folks like you and our incompetent d.a. are doing everything they can to undermine them. and value the importance of their contribution to public safety, what normal person would want to live here or work here? for the record, there is abundance of support for our police from everyday citizens and it's high time the board recognized that. our city is no longer safe and that is a fact.

hiring more police officers is only one of the things needed to restore public safety. obviously, the d.a. should be recalled. it would be hypocritical for you to sit here and take -- >> thank you. next caller. in >> caller: hello, can you hear me? >> hello? . yes, this is mar lane morgan. good neighbors association. i want to support adequate staffing, upgraded staffing for the city of san francisco. our neighborhood had to go out and hire a private security patrol about five years ago because we were dealing with so much -- so many problems that the police officers could not respond to adequately. we have a very close working relationship with the northern police station. we just met with the captain. we've asked what we could do for

them. they've been very helpful. and one of the things we know we can do is ask for adequate police staffing and police compensation. i just want to add this is also a great opportunity while we're beefing up our police staffing, we know that the officers have addressed the -- the department has addressed a lot of the compliance issues around training. it's a great time for the city of san francisco to tell the department what we see the vicks is for their officers and the role the officers play, so they're not constantly confused by changes back and forth, what they can do, what they can't do. it's very difficult for them. we have great relationship with them and we want to have a better one. i am a member of -- part of our concern around staffing is handling homelessness. thank you. >> thank you.

>> caller: good afternoon. this is anastasia. the hearing is about police staffing. i heard about the current staffing levels. and i'm thinking that one way to improve this is -- i don't know if you are paying the applicants -- first of all, you've got to waive that application fee to get more people to come in. you've got to screen them before they go to training. and then the training has to be coordinated so that they get on to the job. so that it goes one, two, three. if they're screened and they're, you know, qualified, then bring them on right away. and as far as housing goes, our housing policy is terrible. you've got to get the prices of

the rents so that the police can afford to live here. thank you. >> thank you. that was our last caller on the public comment call-in line. >> thank you. public comment is now closed. i do want to thank everyone who called in for public comment and shared your perspectives on this extremely important and urgent issue. i think it reflects how much concern there is across the city among residents and businesses about public safety and the need for us to ensure that our police department is staffed adequately. and i think this hearing was extremely informative looking at what the problem is right now. and also what's needed to address it. and particularly, a real proactive and strategic retention and recruitment plan from the department.

so i look forward to working with supervisor stefani on supporting that as we move ahead. and thank you, supervisor stefani, for your leadership and calling for this hearing. >> supervisor stefani: thank you, chair mar. i do want to thank you as well for scheduling this hearing and to all the callers who called in, my colleagues for their great questions. i do believe that one of our primary responsibilities as elected officials is to keep san franciscans safe. i want to thank sfpd for showing up today and for your presentation. i look forward to our continued work on this issue. and i encourage all those who called in and watching to continue to follow this discussion as we go through budget negotiates, because we need to properly invest in our police department to meet the needs of so many that are calling and so we can do the preventative work that so many are demanding as well. at this point, i think we can move to file this hearing and

we'll bring this up, of course, throughout the budget negotiations and i will continue to focus on this issue until it's resolved. >> supervisor mar: thank you. mr. clerk, can you call the roll on the motion to file this hearing? >> on the motion to file the matter, supervisor mandelman is absent. vice chair stefani? >> aye. >> supervisor mar: aye. the motion passes without objection. >> supervisor mar: great. any further business? >> that completes the agenda for today. >> we are adjourned.

dp press pound twice. enter the meeting on the public

comment calling and dial star 3 to be added to the queue. when it saysure line is unmute third degree is your time to speak. for those on hold wait until the system indicatesure unmuted. keep will begin virtual public comment. we have 3 call are zero have entered the public comment queue. a remainder to all callers on the line dial star 3 if you want to join public comment for this agenda item. we will wait 5 more seconds and close public comment for this item.

>> public comment is closed. we will have a vote on this item >> thank you follausbee. president follausbee. >> aye. >> vice president ken. >> aye >> supervisor chan. >> aye >> commissioner scott. >> aye and commissioner zvanski. >> aye. >> yes it passes there are no neigh's or abstentions that moved to the rates and benefits section of our agenda today. call for item 10. >> agenda 10 the presentation on the 2022 plan year 2023. a discussion item and will be presented by executive director abby. >> executive director of healing

service social security the rate and benefit's calendar is in your report there are no changes at this time. any questions or comments? >> motion to approve the action item. discussion. okay. >> just a discussion item. open near public comment. where i'm trying i'm lost in the -- all this information. >> so open for public comment >> thank you follausbee. i will read the instructions. public comment in person and virtual and web ex first in person then remote.

wit nothing person prop the podium and you will be called after instructions upon have been read. >> public comment is available for each item and allows 3 minutes. there is no obfwagz to answer. for callers on line i welcome xu encourage to you state your name you may remain unanimousism will give a 30 second warning when time is close to ending. i will thank you for your call and you will be on mute. remote vowing on sfgovtv and online using web ex. opportunity to speak in the comment period digitizer tablet number on the screen. then access code 24890732393.

style star 3 to be unmuted. continue to wait until the line the system indicated you have been unmuted. we will begin with in person public comment. >> no one propped the podium. moderator will notice of callers in the queue at this time. >> board sect we have 3 callers on the line. zer over have entered the kwou. you must dial star 2 now if you want to join public comment for this item. we wait 5 seconds and then close

comment for this item. public comment is you in closed. why thank you very much. we will move to agenda item 11. thank you, president follausbee. rerowel kaiser active employee and early retiree hmo plan. this is the discussion item and presented by mike clark. >> good afternoon here to present the kiez are experience. >> >> a brief introduction. will not go throughout appendix there are detailed month by mont

head count data. we viewing the kiez are plan experience. we did this last year that will be the second experience presentation for the 2021 plan year. you will see a basis are if the kaiser renewal informing i will present next month at the board meeting. >> all data is based on information kaiser provide to us. to give context on the total financial exposure. in 2021414 million. and premium for nonmedicare numbers. . and 57 admissible for the medicare numbers. most of the data i will show you today is for the active employee

and nonmedicare populations i have one slide on medicare this represents half of total health and welfare spent in fwent 21 >> from a covid-1919 stand point you will see suppression if the 2020 plan year the second quarter of 2020. upon the experience learningly remained similar to prepandemic levels. one year the prior because of the unusual nature of the experience i show a 3 year view on covered live and how per member per mont experience for medical drugs and combined. played out for active employee and early retirees for the medical much less for the member

per mont experience in 2020. to me the most important figure its look at on page 8 is the annualized change which is baseod comparing 2021 data to 2019 data on annual basis. >> increase for active employee decrease for early retirees. what you see on the active employee side is medical increasing sick penalty 6%. slight decrease for prescription drugings. over all a 5 penalty 8% increase for active employees and early retirees pretty constant when you combine medical and drugs prepandemic and the year 2021. the next few slides show

information on top in patient cost drivers and out patient and prescription drug first on page 9 you see that pregnancy is the top in patient cost driver. on the out patient side factors influencing health status. with covid-19. where you finds covid-19. and out patient again covid-19 influence factors health at this times.

anti00 autonext slide produces insight on i haved i have in patient claim experience during 2021. in total active employees and retiree system then and over all claims are 400 million. tw and a half % attributable. to covid-19. you see if you remember back 2020 early 2021. we had a surge. the january and february data -- and the early retirees high claim to the april experience and there was a spike for active employees in the late summer months.

>> from an in patient stand point. active eaches. out patient drivers. the data to 20 between i 40% increase for active employees in various categories of out patient visits. and early retirees as high as 38% on page 14. >> and then for telehealth we are not seeing the level of telehealthutilization. the light are bar shading and video business the dark are bar

shading were popular with member and supported by the kaiser model. >> and finally to look at health status in the immunization for benefit rates for the population a big concern that we saw reduced levels of preventive care during the pandemic. 2021 thshg shows some of the things we talked to kiez are b. um -- health risk indicators that were constability low track to improve the results. what is good you see better health risk data lower percentages. for the active and early retiree. populations versus the regional average. this is still room for improve am. immunization rates higher. than what you see in the kiez are business dastasm but rom for

improvement. and to close, the one slide i have with medicare retiree data is similar on health risk indicators and screening and immunization rates compared to a medicare on the right side of the page. we got the healing risk percentage indicators similar to lower to the medicare population. preventsive rates higher. but we are monitoring and drive to improve the rates. >> that concludes my opinionation. president follausbee. >> thank you very much. very interesting report to me all of us and just to comment the last issue. i'm glad to see our members are getting cervical cancer screening and influencea

immunizations. easy to forget. . i think that will show benefit in the future. that our members are taking care of their primary health care. >> any questions or comments from the -- commissioners. i would hope that the types ofutilization rates reflect in the the ultimate promotium quotes that come become to us. >> me, too. >> any other questions or comments. >> open for public comment. >> okay. thank you. public comment taken in external remote via web ex the board will take comment from in person and then remotely. anyone wait nothing person approach the podium you will be

called after instructions have been lead read. available for each item each speaker allowed 3 minutes unless the board president deems new time limits. public comments concerning the item presented as a remierndz a call are may ask questions but no obligation to answer. ofltd line when i wuk state your name or remain unanimous. and i will give a 30 second warning when your time is close to endses. i will thank you for your call you will be on mute. >> opportunity to speak during public comment available dialing the number on the screen. access code is 24890732393.

. and then press pound twice. enter the meading on the public comment call line and dial star 3 to be added to the queue. when the message says you are unmute third degree is your time to speak. for those on hold. wait until the system indicate said you have been unmuted. begin with in person public comments. we will begin virtual public comment. moderator will notify us of caller in the queue. we have 3 caller on the line 0o callers have enter the public comment queue. reminder it all callers on the line dial star 3 now if you want to join public comment now. we'll wait 5 seconds and then close public comment for this agenda item.

>> there are still no call are in the queue at this time. >> thank you. hearing no call others public comment is closed. >> thank you. a discussion item we move to agenda item 12. >> thank you and promised a break after this item. why thank you. agenda item 12 rethu nonmedicare plan 2021 plan and equalization experience and third office stablization observe deficit. this is an action item and presented by mike clark. >> mike clark. presenting the 2021 medicare ppo plan experience. as well as the requesting approval of use of a third of the stablization deficit as of december 21. just a preface on the planned experience. as well as observations.

and then transition to the rate stablization recommendation. there are appendix slides i will not go through but available for reference. study's recommendation that i will wuk you through to lead to this conclusion is the stablization fund policy on approve the use of a third of the 2021 stableation reserve deficit of 403,000 or 1 third of a million 210 thbld applied to the rates here. for nonmedicare ppo plan including choice not available in 23. applied per policy active employees and early retirees will loaf the remaining deficit for 2024. just a reupon minored, so the information in this is looking

at 2021 claims and costs. relative to premiumless for the medicare ppo plan given in full. united heck in 2021. in 2022 the add administrator for the nonmedicare plan did change for most members the blue shield of, california united is the plan add administrator in 2022 nonmedicare split family retiree members and active members were more family member enroll in the the medicare advantage ppo plan. >> and the experience covers in the presentation active employees early retirees and departments in section 2 recognizing that with covid-19 pandemic we also include as we would the previous kiez issue

presentliation the comparison top 2019. you see the claims it is individuals exceed 50,000 in medical or pharmacy claims this is the self funded planning. claims generated by member use are flowing through the trust for medical and prescription drug dispenses. >> and also, individuals come in the plan with different perspectivives for the page there is 1900 total active employees and early retirees in the table you know there are different categories of active employees those who chose it among all the different plans available. there are some who are in the 19683 contribution strategies pay nothing for any plan 250 of those individuals. where ppo is the only available

the population is 70 individuals there and about 780 make the choice among all the choices available blue will cheeld and kiez are complanspate higher contributions of the ppo. early retirees on geographics more then and there half the ppo is the only available plan if you live outside of california or for 350 this is a choice among the hmo's for living in california. and this will serve the base i of under writing on the plan. also account for all of the cost changes that occurred from the rfp press when we present next month on the rates for 2023. >> now i gallon to planned experience observations. it was a reason trend relative

to precovid 2019. we saw a big increase from 20202021. when you look at the table, and you seat over all planned progression. we did not see covid suppression with drugs medical you see a pattern of decrease followed by big increase when you look at that over the two-year period comparing prepandemic 2019 it 2021. only a 3 opinion 1% increase. and medical plans spent 6% drug 4% over all.

we are seeing lower levels of planutile wragz this chart expressed on per thousand member base i an increase in 2020 to 2021. well is worn we have seen

increased utilization there their is a better ability toarc sesz care. in patient and out patient increased for behavioral health in 2021. >> prescription drugs slightly lore trends versus had was experience in the 2020. there was growth in both. scripts for member and rates of generic and home delivery declined. medications condition to be a driver here almost half of 21 costs. so as weez look ahead this is still the highest average cost population. with high risk scores we see through reporting the nonmedicare healing plans available and again we focus on the rating here coming up

presently thanksgiving next mont. >> with this, transition into the stablization reserve use recommendation. reminder today will be the last of stablization. and just a reminder we presented become in january on the other will 2. for recent actions we seen some vaeshgzs with buy up and down deficit and surplus. there was i rate stablization deficit for 2020 and 2021 plan years applied in rating you see on the bottom of page 18. however because of favorable claim experiences we transition to the next page it fliped a surplus for rating 2022. and so now with the information

that i'm presenting today we are back to a deficit forecast. again 1 million 210,000 in toll. a third recommended to apply in the rating for 2023 early estimated 2023 plan year on ppr rates. again we will show the recommendation for rating next month. >> page 21 my favorite chart but this shoes the comparison of expected experience contributions and the revenue short fall based on that deficit recommendation for 2021 rating compared to had transpired for 2021. and this load in the table page 22. which shows the progression of

calculation of todayy recommendation. >> so. with that, bottom of page 2022. to the recommendations with the stablization funds policy to approve the use of a third of the 2021 stablization deficit amount. a third of 1 million, 210,000 applied to rates across all rates the nonmedicare ppo plan. plan year 2023 and, ployed to employees and early retirees. >> thank you very much. >> any questions or comments. >> yes >> getting ready to offer a motion. move we sept recommendation as presented. >> second.

second. >> commissioner breslin. >> other questions or comments before we open up for public comment. >> you so clear that is great. >> open up for public comment. why i will read the instructions aloud. >> public comment taken in person and remote via webeck. the board will take comment from people in person and then remotely. for anyone wait nothing person approach the podium xu will be called after instructions were read. public comment will be visible for each item,llowed 3 minutes. all comment to be made concerning the agenda item presented. a call are may ask questions but no obligation to answer. on the line when i welcome you state your name although you may remain unanimous and i will give

you a 30 second warning when your time is close to ending i will thank you and you will be on mute. remote options available on sfgovtv and web ex opportunity to speak are available boy dialing the number on the screen 415-655-0001. access code 24890732393. press pounds twice. ut enter on the call line and dial star 3 to be added to the queue. when the system say us are unmooul mute third degree is your time to speevenlth we'll begin k with in person comments. upon approximate our moderator

>> we have 3 caller on the line zero call are entered the public comment queue. reminder to all callers dial star 3 if you want to join public comment for this item. we will wait 5 second and close public comment for this item. there are no call are in the public comment kwou >> thank you. hearing no callers public comment is closed. >> okay it has been moved and seconded. approve the recommendation. the rate stablization. we will have a roll call vote. >> thank you. president follausbee. >> aye. >> vice president kiny. >> aye. >> commissioner breslin >> aye >> supervisor chin.

>> aye >> commissioner scott. >> aye >> commissioner zvanski >> aye >> it passed unanimously. thank you very much and we would like to take a 10 minute break and pick up with agenda item 13. thank you we will break at 2:48 p.m. force force clear clear

there are no call are in the

>> okay it has been moved and seconded. approve the recommendation. the rate stablization. we will have a roll call vote. >> thank you. president follausbee. >> aye. >> vice president kiny. >> aye. >> commissioner breslin >> aye >> supervisor chin. >> aye >> commissioner scott. >> aye >> commissioner zvanski >> aye >> it passed unanimously. thank you very much and we would like to take a 10 minute break and pick up with agenda item 13. thank you we will break at 2:48 p.m. f i'm finding the masks united

states of americaling the people's comments it is more work for every listener and some of us men missing the statements. and so we will see if we can w on policy through the stele hall for the speaker and tell take arc while. i ask you to please all speakers speak cloud and clear and slower so we capture every world. agenda item 13 rerowel and

approve the full insured race and contribution this is is an action item and presented by mike clark. >> speaking about the vision. renewal today. why just a quick prebunkham and get in the insured renewal for plans you see here. the recommendations today. this is a slide on the plan design i will in the rerowel it is there for reference you've a reminds there are 3 funding methods on the plans and the vision happens to be insured you see the characteristic on the right side of page 4u will see a build up of prior year planned experience and how that compares

to 2020 rate and incorporating previous long are term agreement with the plan and this applies as we will review her shortly. >> the 2 plans offered for many years part of the enroll am medical plans you remember from the active employee and nonmedicare retiree rate card its is a component and premiere was offer in the 2018 providing benefits for a member paid increment that is the difference with the premiere plan rates and basic plan rates. >> in addition there is a vision care benefit offered to 19,000 employees. as well. >> and so we will recommend today the rate renewels for the plans as you see. that include plan design enhance

ams that will improve eye health. which include antiglare and ultare violet 11s protection. >> this is part of a 5 year green light that was created by s p for last year we review in the health service board meetingsanualy. part of the over all construct 2323 is year 2 you see a 2% provision in the rating based on loss ratio the loss ratio is 109%. the 2% over all premium cap applies like in prayer years recommending that increase applied to the premiere buy up as that is the plan that is driving the higher loss ratios over all. >> we have some experience exhibits here i will not go through in detail i focus on is

the right side of the page of the exhibits. >> lost ratio, claim and fees. when you see the number above 100% it means experience exceeded the premium. and puts pressure on the plan financially. over all it was 109% in 2021 across all the plans. which is higher than 2020 because the suppression but notable low low are than 2018 and 19. from an you should writing standpoint the health of the plan was improving the basic planned experience the component built in to rate cards has been low in terms of loss ratio and in 2021 finished 89.4% the premiere plan puts pressure members are paying the full cost

to be in the premiere and ewe likewising the benefit. but again you see a lower loss in 2021 versus 2018 and 19. why some of this is also a lower fee percentage. that start in the 2020, 9% the prior one. >> this is one of the best slides we show every year and we talked about this. the continued increase in the distribution enrollee in premiere you have double % of prae more in 2022 versus 2018. members appreciate having that premiere benefit available. >> the next 2 slides i will talk about the benefit recommend eggs for 2023. starting with those on the basic and premiere plans.

a program that was introduced by vps for availability for clines that provides a benefit inllow of prescription eye ware available at all in network locations except wal-mart and sam it is. right side you seat description on what is light care and why. >> and it includes protection. the time we spends in front of deraces and laptops and computers. and blue light fitering glass to combat the eye strain. this is available for 5% premium for combafk plans from employer

costs to 232,000 we will talk about this in a bits the frequency for basic and -- once every calendar year for premiere. 19,000 individuals there is an ability to add antiglare and ultare violet coatings for the computer vision care program. you will see it would increase the rates from 837s to con.04 per mont this is all employ are paid benefit temperature is in the funded by employees it is paid by employers this translates on 48,000 annual at a cost for employers. >> for the insured rate renewal the plan rates increase by 5% to reflect the benefit enhancement and a reminder the employers

paying most of the cost throughout contribution that projects throughout rate cards. it is 89% employ are paid and 11% employee paid. on the increments you see on the page with the basic plan.

we go to page 19. recommendation for healing service board action today is to recommend that the service board arc frufed the vision plan insured premium rate and member contributions the 2023 rates include the proposed benefit enhanceeptsments sdpt basic plan and computer vision care. president follausbee. >> thank you very much. >> could you -- what is the computer vision care entail. i don't understand that. >> it is an added benefit that is available to about 19,000 active employees that provides in an increased level of

services. beyond just the typical basic and premiere plans. almost all members who have the computer vision benefit available, also do elect either basic or premiere. >> >> a pair of glasses. these are my computer glasses. >> i get t. when you sit in front of your computer that computer vision so much of retinal exams are computerized i wondered if i was confouzing apples and grapefruit. okay. >> and i noticed that you left out the fact the plan reimburse machines to go to costco less. i don't we have been through it i will not bring it up. again i foind it somewhat odd that members when seek quality

care at lower >> mayor price:s get penalized. >> i agree. >> but i stated say it every year. >> yea this is not right. >> anyway. >> president follausbee i have a question. for members that are enrolled in the kiez are plan, do they have do you have people who are in dps basic or are we paying for them as well. >> the vsp is a benefit for kaiser and as well as blue shield. >> okay. why kaiser has their own. vision? >> they are not vsp. >> it is part of your medical. why kiez are has itself own vision department. and all the rest and i wondered would there be any process

additionaling if the kaiser members used the kiez are vision and not had that aid with vps >> for intense is the kaiser member is more for a medical condition this is more about eye health through preventive exam and the lenses and frames. it is like a duplicate benefit we pay twice for those members. is there i pay in the future get to explore separating them out? there's a question. >> yes. >> so the kaiser vision

benefit they do allow preventative care under this benefit. that is in the included vsp is the eye glatsdz frame benefits. we don't that is in the in our plan with kaiser. and they are not a vsp network.. we don't that is in the in our plan with kaiser and they are not a vsp network.. we don't that is in the in our plan with kaiser l frame benefits. we don't that is in the in our plan with kaiser and they are not a vsp network.. we don't that is in the in our plan with kaiser and they are not a vsp network.. we don't that is in the in our plan with kaiser s frame benefits. we don't that is in the in our plan with kaiser and they are not a vsp network.. we don't that is in the in our plan with kaiser s frame benefits. we don't that is in the in our plan with kaiser and they are not a vsp network. >> paying for 2 no. >> we don't that's not part of our kaiser plan. >> kaiser excludes optometry benefits. there is in the duplication. >> that's my understanding.

can y'all hear me? >> thank you. >> great. so with regards to kaiser the materials are the glasses, frames and contact lenses not a covered benefit. i believe under the kaiser medical plan the exam portion may be covered beaut the materials themselves would not be covered. >> okay. >> okay. that makes sense one get a prescription but not go to the optometry services to then get eye glasses or antiglare. >> you go out. to the vsp site >> i wanted clarify kaiser has a vision benefit where you could get hardware and you purchase

glasses and get prescriptions filled. but this is in the purchased currently. >> that would be a separate cost. >> all right. >> >> any other questions or comments? then? >> i'm wondering the blue light glasses you were talking about? >> the recommendation does include the recommendation for the blue light lens protection. why that is a special 11s that go in a vision correction or not? >> correct. >> and the idea of the blue light enhancement and i benefited from this. a difference with having reading glass at my laptop all day that was about the first year and recommended blue light glass and my headaches are gone at the end

of the day. a see clearly during the course of the day at the laptop and i can arc test to the benefit the blue light lens enhancement. >> you buy up for that. >> so today not part of the plan but that it is included in the rate so there is a small rate increase as part of this that would incorporate that coverage. i think we are not atlet livesation level this time to talk about a benefit enhance am like this. >> i agree. >> okay. >> computer glasses. >> i'm sorry. >> speak up so everyone can hear. >> is this only for computer

glasses or blue light for across the board. >> and and may i ask the vsp representative to speak to that. >> nancy with vsp. the light care program that we rolled out last july it is for those members who don't need prescription eye ware at the time of their exam if they go in for annual and don't need glasses they use their frame allowance for nonprescription sun glasses or blue light fit are glasses. this is i separate benefit upon the computer vision allows for prescriptions in the lenses and the potential addition of antiglare coating >> it irrelevant is something this we put together to

incentivize people to get this eye exam. i will entertain >> move we except the recommendation regarding the vsp rates. >> renewal. >> moved and seconded. >> no other comment that opens up for public comment. public comment call-in: 415-655-0001 / access code: 2489 073 2393 providing public comment: dial into 415-655-0001 and then enter access code 2489 073 2393 then # press # again to enter the meeting as an attendee you will hear a beep when you join the meeting as a participant. stop and listen wait for public comment to be announced. when public comment is called, dial * then 3 to be added to the speaker line. you will then hear “you have

raised your hand to ask a question, please wait to speak until the host calls on you.” callers will hear silence when waiting for their turn to speak. to withdraw your question, press * then 3. - you will hear: “you have lowered your hand.” when the system message says “your line has been unmuted” - this is your time to speak. when the president or commission secretary states “welcome caller,” you are encouraged to state your name clearly. as soon as you speak, you will have 3 minutes to provide your comments. once your 3 minutes have expired, you will be moved out of the speaker line and back as a participant in the meeting (unless you disconnect). you will hear “your line has been muted.” participants who wish to speak on other public comment periods can stay on the meeting line and listen for the next public comment opportunity.

no one has propped the podium. virtual public comment. moderator will notify us of commenters in the queue. >> we have 3 caller on the line zero have entered the queue. all callers on the line you must dial star 3 if you want to join public comment we will wait and then close public comment for this item. there are no call are. >> thank you. hearing no callers public comment is closed. roll call vote pot follausbee. >> aye >> vice president. >> aye >> commissioner breslin >> aye.

>> virus chan >> aye >> commissioner scott >> aye >> commissioner zvanski. >> aye. >> thank you very much it passed no neighs if you want it protect your ice get your sun glasses and wear a big floppy hat had is in the cover in the our program >> item 47 >> thank you. agenda item rerowel and approve retiree dent will rate and contributions for fully insured plans delta carousa hmo, u noticed health care. hmo plan this is an action item and will be presented by mike clark.

recommendation is the health service board, proved dent will rates in this do you mean. that include 2 recommendations for design enhance ams for the plan year on the retiree ppo as you see on the bottom chart on page 3 captures most of the members. retired wanting a denial plan. information will follow. the delta dental ppo. the plan enhance ams include lowering the deductible for noncontracted dentists and increasing plan paid premiere dentists coinsurance to 100%.

they will be presented on slides 11 through 19. delta care plan the rates decrease based on a premium refund credit. and no change in the united health care dental hmo rates. i will skip the process they are insured plans. you seat current plan rates a reminder that this plan does cover you will retirees of sudden fran healing service system it different. than the active employee plan. be mindful this does cover all retirees. >> and -- 2022 the first year of the the now 2 year rating agreement with delta 2022 and 23. so this is year 2.

there was an increase in rate in 2022 because there was rate suppression built for 2021 and the hmo decreased by 10% last year >> the going in renewel for the ppo the key things on planned experience the second year of a 2 year waiting agreement. we observe the experience in the plan, low are than prepandemic levels it concerning since it is a member pay out plan. >> we saw a higher percentage of covered members using a denial clone nothing 2021. 6% higher than 202059% but low are than 2019 which was 71%. members rely on the plan

majority for preventative service. also the basic and major service in the chart at the bottom of page 11. met workletilization steady from 2020 of the well bar to the middle borrow now about half of all utile wragz is in premiere dentist. 7% in nan contracted ppo has i higher level of discount and gwen this means that low are reimbursement for the dentives we heard earlier today. why utilization cleaning a currently prepandemic a high percentage of the retiree members not had i cleaning during the year. you see the dast at last 4

years. there was also a plan design change in 2020 intended to troy to increase utilization of ppo, the single tier deductible increased in 2020. in trid off for know increase in major service coinsurance like crowns and dentures and so forth. increased from 50 to 60% in 2020. i rate newt roll change we are not observed a lot of change since that occurred in the utilization by dentist type. stregsz the primary objective today increase appropriate plan utilization for premiere in network. there was merit through plan to utize higher dent.

today for members to seek denial care preventive care from premiere network dentives. knowing a modest promotium is needed to facilitate that goal. >> so the design change observe you that will tuck about it is to promote dent will coverage see dentives twice a year for preventive services. now00 autoclaim amounts for the

preventive service don't count toward the benefit mechanic mum for the retirement ppo plan had is a financial barrier that does not exist because of that provision and design and preventive services are visible no member cost for those enrolled in the program implemented in 2019 one aside chronic conditions. >> so the 2 design changes lower the plan deductible for premiere and noncontract dental use for outside preventive. if i pay for preventsive service did in the apply today but if i paid i mirj service it does. so it is currently 75 per individual. 150 per family.

in 2019 prior it was 50 and 150. and we are talking about lowering it become to the 50 dear per individual and for the full family lower it from where it was in 2019 and before it 100. >> the second recommendation bring the premiere network planned paid cosurance up to 1 huh human % the member using a dentist pays 20% of the cost of cleaning or exam. bring it to 100% would e eliminate barrier to a member to receive i cleaning exams and/or x-ray service from a premiere dentist you would be covered in full. you see the concern plan design as well as the yellow shadeingly field indicate the features that

were recommending for change. that annual deduct believe and the cloning exam and x-rays for premiere dentists. the rate impact for this plan design improve am. we worked with delta to gent rit rate changes that are reusable. and hopeful low viewed as the minimal relative to the benefit for a premiere member on the deductible change the rate impact of the change about 5 dollars increase per year. for a 25 dollar improve am for those who seek basic and major services from premiere or noncontracted dentists. 38 dlrdz for the single tier.

250 if low00 in total. 60 dollars saved for someone using a premiere dennist and an annual cloning exam and x-ray. you seat progression of the rate. the rates stay the same. it 20 twoochlt to that agreement that's the plan year 23 quote column. >> the deductible change results in the rate increaseen for full family 1.50 per mont the coinsurance change has more financial impact and so it would lead to with both design enhance ams the proposed rates on the

right side of the page >> recommendation on the ppo plan is for both design changes increase by 7.7%. note on the premiere coinsurance change a small portion and for those using premiere services the benefit on the back end through low are out of pocket cost at time of service and that does not consider with increase utilization a better affiliation with your dentist and less potential going forward for need possible low for basic and major service. >> quickly i will run through again with the delta care usa there was a promotium reimbursement 21 they are member paid benefits. we asked for that premium reimbursement from pandemic

impeculiars to be reflected in 23 rates. 8.4 is one month out of 12 reflecting this rate reduction. and on page 24 united health care simple discussion rates will remain the same as 2022 for next year after 2 years of rate decreases. that takes mow to page 26 a recommendation for board action. recommended that the service board approve the plan year retiree dental plan rate actions on the information i presented today. said the ppo rate the 2 designed enhancements the noncontracts deduct able to 50 read and premiere preventive coinsurance

to con00 percent, president follausbee. >> thank you very much. >>y upon mind everyone we are talking about the retiree dental plans had 2 callers under agenda 4 who are active eaches we are not talking about active i would like to say i appreciate both call and ares calling in the issue this struck mow is we are putting emphasis on ppo and premiere dentist. and the second caller who -- called i think all 35 -- dentists listed or whatever and found 3 out of 23 or whatever the number was. is quite disconcerting. and so we have been had hospitals from delta dental about their network it raises the question how current is the network this we are supporting

and number 2 how often does in the network check to make sure there were in the changes and phone numbers and addresses. not only for retirees and the actives and early retirees as well. >> with that -- what percent of the marketplace did they have here and northern california or california? i can't speak to a percentage i know upon research on public sector employers and across california the delta dental has i high market share when we did this research. is there a represent from delta

on the hoin >> room representative i will ask him to podium. >> good afternoon, commissioners michelle with delta dental. california specific low to answer your question our market share is over 60 percent. >> in california specific low our market share is over 60%. >> 60%. why all right. >> thank you. >> could you address the issue about how accurate your provide are lists for the various categories is and how often that is checked00 on updated so that members have -- don't have to call 23 dentists to get 3. 35, may be. sure. >> we everhappy to look into this 28 and got 3. >> we are happy to look into this specifically but to answer your question we do have a

network development team that researches our network and -- analyzes the data regularly depending when is helping with contracting could be weekly or mont low >> it means what how often wrchl depending within a market accomplice they could be week low or mont lie. >> i'm sorry it is not you it is the mask. >> can't hear her. why speak loud low in the mic. >> weekly? >> weekly and or month low depen when is happening with contracts. i find it a bit alarming that this second caller on this issue was active not today. had to make so many phone call and got responses with phone numbers that were not accurate i week before but in the now.

and 23 or then in one practice were not there the week before and not now it it is a bit disconcerting. in 2020 you nexted the deductibles to punish the members so they would go in the ppo plan and it did in the work. premium was not rused how do you justify the increased promotium now when we go back to the what it was before 2020. i don't see why we are increasing the benefiteen if it is i bit it is affects the families most. than i have a retirees with

families have the most problems across the board. so -- you know -- and who benefits from the 25 dollar increase and the 50 dollar increase? when benefited from that in 2020? >> in 2020 what changed was the single tier deductible per individual nkszing 50 to 75 dollars. the i did go back and research the family deductible mack was 150 dollars in 2019 and stayed the 150 dollars in 2020. what changed from 2019 to 2020 there was a page i had to stated. what changed was the -- deductible increase 75 on the single in return for an increase

in the ppo major coinsurance for services like crowns and dentures and increased from 50% to 60. part of this vkz and recommendation the ppo major coinsurance would remain 60% this part of the benefit this enhumans in the 2020 would not change. the proposed recommendation would now bring the deduct believe for single per individual become to 50 where it was before 2020 before would lower the over all family max deductible which is 150 dollars throughout >> it would bring it down to 100 dollars the full family and retiree 2 or more have a lower deductible exposure by 50 dollars in total. versus what is the 150 deductible all long.

i apologize there was a section of the document i stated the prior family max was 100 it was 150. upon further reflection after we completed the document. >> right. >> you said 150. now it is going to be 50 for individuals and 1 pun00 for a family >> 50 for an individual and 100 for a family max >> you say prior to 2019 it was 150. >> yes in 2019 and prior in 2020 the per individual deductible increased but family mack 150. >> i have to go look i can't remember. i don't is that why you have to have afternoon increase in the premium because of this? >> so there is a small increase in the premium to take down the

premiere and noncontracted coinsurance. for a single 5 dollars a year. is the single tier impact of the deductible change and the whole family is a $14anual impact to the premium and the potential to benefit the family as much as 50 dollars if all family members or 3 would use this deductible. >> what i like was in 20 between there was no adjustments to for the increase. nothing and i don't like the stick prop, either when we are talking about our members. so and the second thing i question is -- in john of 21 i asked delta dental about if the -- if a person can go in

premiere plan they said, yes they can but they have to join the ppo plan. if they are in the ppo and premiere plan why are we charging extra for the premiere plan for anything sing eversince than i are in the ppo plan, too. >> so that is my question. why do they charge them more. >> i can i ask i delta represent

to poke to difference with p p oshg dentives and premiere dentist. >> michelle bodey. could you repeat the question, please? >> in john of left year i asked the representative was can dentists still be on the premiere plan i heard they were not going to. they said, yes but have to be in the ppo plan. they can't just be in i premiere plan alone at one time they were. upon yoendz why you charge more or charge the members a different rate they are in the premiere sans the dentives has to be instead ppo plan. >> you are correct in that our contracting efforts do include the ppo and their premiere contract. correct. any new contract this we are doing with dentives than i have

to be in both the ppo and premiere. correct. >> why do is there a difference in copace for the premiere and ppo? >> plan design selection is based on what sfhsf. why yoendz it it is 80 percent coverage for the premiere. for cleaning and examine and 100 for ppo dentist if this dentist is in both why not cover 100%? >> in plan design options is up to sfhsf to decide how the plan coinsurance levels are dictated. this it is our decision? >> i don't know if you want to

>> thank you. why why charge them. >> i will say. my interpretation of the comment is new contract that is signed there are many, many dentives who are premiere only and for instance the slide lore that premiere only dent s moon retirees are higher than ppo. it soundses like that is a go forward contracting strategy. any dentist who has been premiere all along but in the ppo will remin as parts of constrakt. and -- for trans poirs with the premore only dentists on the retiree members than it is ppo does. that's why you charge more? >> correct. because there is a higher level discount available to those dentists when have been accepting ppo all along than

premiere that is why historically the claim design difference to try to enourj p p oshg dentives. today's recommendation recognizing that your premiere dentist remines eye and like to see more of your membersute lives the benefit. the only way you will get members to change is education. and serious education. i don't think i-ed anything in the mail from dealt to say have your cleaning thissier or this will help. these other results of team this don't have cloning. describes, high blood pressure. a list of things. i never get anything like that.

this is the education you need. change thanksgiving around will not change that. and -- that is -- where is the educational stuff. i don't get it. there is a lot of reason out there could make people say i don't want this or that i will take care of my teeth. i don't think anybody will move on this, otherwise. anything that's the reason and increase the family and the whole package -- 26 dollars annualy now paying 1, 755 a year for the dental care. and so i think the second -- coinsurance i don't agree with. i would not because it cost too much even though it sounds a fwit is adding on more it is hard enough already to pay for

this with a family. further comments or discussion? >> entertain a motion. move we accept the recommendation both recommendations for the enhancement that are presented. and the rate cards presented. >> second. >> chair >> okay. we no open for public discussion. i said i didn't don't agree with the second. >> we can't call the vote until we open for public comment. i would vote for the one but not the 2. moved and seconded, prove both enhancementless. guess i will open for comment.

thank you, president follausbee. i think if it does not psz and you want to move to accept one half that is fine. this is on the table now. public comment regarding the 3 plans for retirees, dental care, with both enhancements in dealt dental. okay. public comment taken in person and remote. comment opportunity. public comment call-in: 415-655-0001 / access code: 2489 073 2393 providing public comment: dial into 415-655-0001 and then enter access code 2489 073 2393 then # press # again to enter the meeting as an attendee you will hear a beep when you join the meeting as a participant. stop and listen wait for public comment to be announced. when public comment is called, dial * then 3 to be added to the

speaker line. you will then hear “you have raised your hand to ask a question, please wait to speak until the host calls on you.” callers will hear silence when waiting for their turn to speak. to withdraw your question, press * then 3. - you will hear: “you have lowered your hand.” when the system message says “your line has been unmuted” - this is your time to speak. when the president or commission secretary states “welcome caller,” you are encouraged to state your name clearly. as soon as you speak, you will have 3 minutes to provide your comments. once your 3 minutes have expired, you will be moved out of the speaker line and back as a participant in the meeting (unless you disconnect). you will hear “your line has been muted.” participants who wish to speak on other public comment periods

can stay on the meeting line and listen for the next public comment opportunity. our moderator will notify us of commenters in the queue at this time. there is one public commenter. pass on. other callers may enter as public comment continuous i will indicate when there are no more in the kwou you will everyou will hear i brief silence as we transition between caller. >> i will elevate the first call are now. >> welcome. >> hello this is fred sanchez from protect our benefits i appreciate the town to address you will the commissioners. one of the things i locked at. there are clez to between 35 and

40,000 retirees these are not currently they are medicare retirees. only 22,000 are using delta dendzal. and therefore it tellsut costs are so high they decided to pay out of pock competiforget using dealt dental. that trends is in the gotting more enis goingment other way it is telling you they are out of pocket expenses are too high. then i listened to commissioner breslin talk about education. i can't agree more how important this is. because when it talks about your ppo dentist and premiere and out of nets most will nod know when

a premiere dentist is and from i list they don't understand this if there is i benefit they don't know when that it is. that education pos is irrelevant important if something can be put out so this people will know the difference with ppo and premiere. i hope that and you know i love the fact that they want to lower the deductibles the bottom line is they will approve increases and it does not seem like people are getting that benefit. all for the lowering the deductible i don't know how they justify the increases. thank you. why thank you. >> there issue no other caller. thank you for lowering your

hands. argue everother caller you must dial story 3 now if you want to join comment for this item. we wait then close comment for this item. secretary. there are no other caller in the queue at this time. >> thank you. hearing no caller public comment is closed >> thank you very much. >> it has been moves and seconded this we approve the retiree 23 dental rates for fully insured plan and i will call for a vote. president follausbee >> aye. >> vice president. >> aye. >> commissioner breslin. >> no. >> supervisor chan. >> aye.

>> commissioner scott. >> aye. >> and commissioner zvanski. >> aye. the motion passes. agenda item number 15. >> thank you president follausbee agenda 15 reports and updates from contracted helling plan representatives i discussion item and i believe there are in person plan representatived red to approach the podium. upon shannon haa with united health care. i have been promoted to regional associate vice president of the west coast and with this

promotion monica will be stepping in to the senior strategic account executive role. i will continue it report to michelle, she has been promoted to senior vice president. and michelle and i will support monica. on your, count. and i want today say, thank you. i have enjoyed supporting san francisco health service fur past 7 years it hen i great learning experience and appreciate your support. i will let monica say a few words. >> i wanted introduce myself i'm monica and i'm a senior account executive with united health care retiree solutions. i have been admit industry working for healing plan the past 25 years and i wed for united heck as well as healing net. 2 plans