very safe is challenging, but we are working on it and we are getting there. >> can i have the roll call please. >> call to order at 1:05 p.m. president randy scott is excused. vice president. >> present. >> commissioner bresland. is working with our tech support, will be joining virtually momentarily. commissioner caning. >> present. >> dismissinger fallensy. >> present. >> commissioner. >> present.

>> vice president, we have a quorum. >> next agenda. >> item number 3, allowing conference meeting this is an action item and will be present bid vice president hal. >> this is the 30-day renewal allowing tele conferencing regular meetings for the next 30 days. as we remain in the covid pandemic. are there any questions or concerns from commissioners? no? >> i move that we approve the resolution as incorporated within the agenda. >> second. >> it's been moved and seconded. we'll open it up for public comment. thank you, vice president. for anyone waiting in-person, you're welcome to approach the

podium now. all westbound comments can be made during the agenda item. there is no obligation to answer the dialogue for the caller. for those callers on the line, you're welcome to join the call, you may remain anonymous. you'll be placed back on mute and your moderator will unmute the next caller. online using web ex, opportunities by dialing the number on the screen. the dialing-in number, again 4115-615--2481, then press pound and pound again. you'll enter the meeting as an attendee and dial star 3 to be added into the queue.

for those already in hold please continue to wait until the system indicates that you have unmuted. looking around the room, there is no in-person comment, so we'll move to virtual comment. we'll paws momentarily to check virtual attendees. >> we have one caller on the foefn line. zero caller, other callers may enter the queue as public comment continues. we'll wait 5 seconds and then close public comment for the agenda item. secretary, there are still no callers in the comment view. >> thank you, moderator, seeing

no public callers, it's public comment has been closed. >> it's been moved and seconded, roll call please. >> vice president. >> yes. >> commissioner bresland. >> yes. >> commissioner caning. >> aye. >> commissioner falseby. >> yes. >> and commissioner ca venzki. >> yes. >> item 4, general public comment, [echoing] agenda item 4 is general public comment, an opportunity for members of the public to comment on any matter that is not on the agenda, including that the board place the matter on jaefnd items. i'll read our common procedures. for anyone waiting in-person,

you're welcome to approach the podium right now. caller may ask questions but there is no obligation to answer or engage in dialogue for the caller. you'll be, remote viewing is available. the dial-in number 415-655-0001. when prompted use access code, 21, again 2481641, and then press pound and pound again.

when the system says your time has been unmuted. we'll begin with any in-person public comment. no one has approached the podium. so we'll move on to virtual public comment. our moderator will -- ~>> board secretary i have a public comment that we're still in practice session. can you, moderator, i'm tending to that right now. >> and moderator if you can notify us of any callers in the private queue. >> thank you, we have two call line. zero callers have entered the queue at this time. you must dial star-3 now if you want public comment.

we'll wait five more seconds and then close public comment for this agenda item. board secretary there are several callers at the public comment queue at this time. >> hearing no other callers, public comment is now closed. >> thank you very much, agenda item number 5. >> approval with possible modifications of the meeting setforth, this will be presented by vice president and june 9th meeting. >> colleagues are there any questions or comments. >> move acceptions without objection. >> second. >> it's been moved and seconded let's open it up for public comment. >> thank you vice president, hao. >> virtual public comment, for anyone in-person, you're asked

to enter the public comment now. limits during the meeting. all public comments that has been presented, they may but there is no way to--for those callers on the line, you're encouraged to state your name--and when you're three minutes are ended, you'll be--remote is using web ex, opportunities to speak during the public comment period are available by dialing the dial-in screen. 655, 0001, when mrom pted use access code 2481 again 24816413533, you'll enter the meeting as an attendees and add star to be added. when the system message says

your time has been unmuted, wait until the system indicates you've been unmuted. we'll begin with in-person public comment. so we'll move to virtual public comment. our moderator will notify us of the queue. >> board secretary, we have three callers on the phone line, zero have entered the public comment queue at this time. a reminder to all callers on the line, you must star-3 now if you want to make public comment for this agenda item. we'll wait amor seconds and then close public comment for this agenda item. board secretary there are still no callers at this time. >> thank you, moderator, hearing no further callers public comment is now closed. >> thank you, so it's been moved and seconded, may i have a roll call. >> vice president hao.

>> aye. >> commissioner breslin. >> aye. >> commissioner fallansbee. >> aye. >> commissioner caning. >> aye. >> commissioner svanski. >> i don't have a report today we can move on. >> so agenda item number 7. >> yes. please. >> board assigns to governorance committee for fiscal year 2023, this is an action item and presented by vice president hao. and we'll have a slide to view that. >> while the slide is being brought up, i'm speaking on behalf of president scott who has confirmed these assignments with the assigned commissioners for the governorance, it

appears that the composition of each committee remains the same while the chairs of each committee has changed. so the governorance committee will be chaired by commissioner follansbee and it will include commissioner scott and zvanski. commissioners canning and hao will be members of the committee. board colleagues are there any questions or comments on this item? >> i move that we approve the assigned committee members for the next fiscal year as presented. >> second. >> it's been moved and seconded. let's open it up for public comment.

>> thank you, vice president hao. public comment will be held in-person first then virtual public comment. for anyone waiting in-person you're welcome to approach the podium now. each speaker will be allowed three minutes, all public comments can be made concerning the agenda item that is presented. they may ask questions of the body. for those callers on the line, i want to welcome you on the call, although you may remain anonymous. when your 3 minutes have ended, you'll be placed back on mute and the moderator will review the next caller. online using web ex, opportunities to speak during the comment time. the dial-in number, is 415-655-0001. when prompted use access code

24963659185 then press pound and pound again, you'll enter as an attendee. when the system message says your line has been unmuted, this is your time to speak. for those already online, please stay until--and no one has approached the podium. so we will begin the virtual comment. our moderator will unmute any callers who are in the public queue. >> board secretary we have three callers on the phone line, zero have entered the public comment queue at this time. a reminder to all callers on the line, you must dial star-3 now if you would like to join public co. we'll wait five more seconds and then close public comment for this agenda item. >> thank you, moderator,

hearing no further callers public comment is now closed. >> thank you, may i have a roll call please. >> roll call vice president hao. ?fm aye. >> commissioner breslin. >> aye. >> commissioner canning. >> aye. >> commissioner folansbee? >> aye. >> and commissioner zvanski. >> aye. >> next item. presenter. >> good afternoon, commissioners thank you for being here today and our director's report is fairly straightforward this month. we're talking again where we are in covid which is, i don't know, we're all wait to go see what is next. exercising due caution as the

omicron variant is still around. so that's really good newsing that everybody is well. the other emerging news out of the public health is out of the monkeypox outbreak that is occurring and the back of vaccine availability and i think everybody is struggling with the situation that we find ourselves in and again, exercising caution is the best medicine at this point to decrease the risk of exposure. so, living with infectious disease is what they predicted and we are here. that's not to say that influenza is just around the corner and the open enrollment team is working diligently with our partners to work the up take of the influenza in the fall.

the rates and benefits as you know, were approved by this board and sailed through the board of supervisors, supervisor chan was very gracious in her introduction and oversaw the passage of the legislation that went very smoothly. so we're grateful to her and to this commission for their support in the rates and benefit process and the package that we were able to deliver at really good rates, this past year. we're looking forward tone joying those rates into the next several years. we also wanted inform you that did receive a notice and accepted on behalf of our members a benefit change with this kaiser permanente senior advantage that changed from 50 a year to 1,000 a year this was a global change made across the organization. and it was not quite synched up

but we did a full analysis of the generous offer and did accept that on behalf of our members. as we know the supreme court made a decision on pregnancy determination, how best to address the needs of their members, locally, the blue shield of california, was very aggressive in forward thinking in looking to because they have the responsibility for ppo, we do have members that live throughout the united states in that plan. they did ain tern al analysis and identified our members that live in states that have very restrictive abortion rights in those states and have informed them of their ability to travel out of the states to make use

of the benefit that is provided to them. treatment where a number of firefighters have asked for us to have our plans include, the if association center of excellent currently located alcohol and substance abuse disorder order. i'm happy to report that both kaiser and blue shield have organizations in their instruct bottom line is that our members should they and want to travel that distance are able to do so

through the health plans. chief medical office, and some of their peer counselor how they can support the members should they wish to. that center also is on practical with opening a southern california base center in 2023. so we'll, address that as that center becomes available. and education centers that helped inform the strategic

plan. with the aim of getting an input as we bring this to a close. harris us has included the dei update. we've also reported out the on going progress of u.s. berkeley study of evaluation that continues to get a lot of attention within the academic circles and we're looking for a

publication in the near future. we're looking forward to getting with it without any bumps. any questions? >> are there any questions on the report? >> i just have one. can you comment, more what i noticed more that the call volume has increased significantly for the eap

>> we did promote heavily and continue to do so. to call to help with, so we do both group intervention and individual intervention. and that continues to be a great service. so in our minds, increase calls of success. it's not a concern, it's a success. we know that 20% of us experience anxiety and depression, we do want people to call.

provided by our personal officer and i spare you the details in the report. >> where we can support the initiatives whether it be pipeline or high schools or residencies or internships or, or, or, or, or, we need more therapist. >> that's true, thank you very much. >> thank you, commissioner zvanski? >> no comment. >> i do want to express my appreciation to kaiser and blue shield to provide services.

>> we can open it up with public comment. >> thank you vice president. >> public comment will be in-person public comment will be first for anyone waiting in-person, you're welcome to approach the podium now. unless the board president, all public comment can be made concerning the agenda item. caller may ask questions but there is no engagement to answer. i want to answer on the call. i'll give you an audible warning when your three minutes are ending.

the dial-in 415-655-0001. this is your time to speak. for those on hold, wait continue to hold. we'll begin were any inperson public comment. in viewing the room nobody has approached the podium. >> a reminder to all callers, you must dial star-3 now if you

want to make public comment. we'll wait 5 more seconds and then close public comment for this agenda item. >> thank you, moderator. public comment is now closed. >> thank you, agenda item number 9 please. >> thank you, vice president. agenda item number 9 is financial report as of may 31, 2022, discussion item and will be presented by chief financial officer. >> good afternoon, i'm happy to present the financial report i'll go with highlights and open up to questions. our trust fund is projected to

decrease by 17.7 million. we had planned this reduction so we have a stabilization where we take surplus and bring the funds down. claims are just mentioned. >> basically a change from last year.

that's my report and i'm happy to answer questions. >> thank you, and thank you for keeping an eagle eye on the pots of gold here. commissioners are there any questions or comments? >> no question, but compliment thank you for always providing detailed information it's great. my compliments to you and your team. >> thank you. >> all right, let's open it up for public comment seeing that there are no comments. >> in-person public comment will be first. you're encouraged to stay. i'll give you an audible

warning when you have three seconds remaining. i'll thank you for your call, and you'll be placed on mute. remote viewing is available on live tv and using web ex. when prompted use access code 3946. again 2496. you'll then press pound and pound again. you'll enter a meeting and dial star-3 to be added to the public queue. wait to wait. nobody has approached the podium so we'll begin our virtual public comment.

>> secretary, we have three callers on the phone line and zero callers on the queue to comment right now. you must press star-3 now if you want to comment on the agenda item. we'll wait 5 more seconds and then close public comment for this agenda item. board secretary there are still no callers. >> thank you, moderator. hearing no further callers, public comment is now closed. >> thank you, and thank you again for the excellent report. let's move on to agenda item number 10. >> thank you, vice president helm. just a brief pause, i forgot to introduce somebody with us today. lauren wood is our acting city attorney on behalf of jennifer donnelly, so i just wanted to make sure you recognize and welcome.

>> welcome. >> pharmacy, high cost drugs discussion item and will be presented by vice president of pharmacy service south side with aon. >> welcome. >> good afternoon. we'll be discussing what is happening in the market with genetic and other medication that's are impacting your cost as well as across the nation for all of us. >> can you please speak closer to the microphone. >> yes. >> thank you. >> is it better now? >> yes. >> i'm hearing myself a little louder than and you are i guess. my name is ammas and the agenda is to look at the manufacturing and the approval process that

we see in the market. we are not the one step and complex and we'll go over it in more detail. and the resent fda approval as astro nom cal in cost and thought, it would be a good agenda item to discuss and look over. is there any other solutions or what other impact out there.

disease states that have not been treated to prior. or those treated prior but newer drugs that will treat the same but with the different type of mechanism fashion as we call it. then there is a indication when the drug is already in the market to treat one disease state. but then, it's decided to treat another state. in this case, as you will see with your inflammation drug spent influence, mira will be, approved initially for arthritis and then for treating crones disease.

what that does, is based on indication but as new approval happens you're getting more utilizer in the drug increases. the other third type of approves are when we see approval for medication that is existing but existing in one type for instance, if it was only injectable and then an oral version of it is approved. we know they're administered in clinic, some of them may be self administered and experience and there is also that issue of being more expensive in an oral form of it. so next slide please.

approved in 2011, so far about 16 drugs. and the list that you're seeing on the slide is complete list of all of those 16 drugs but what matters is 7 out of the 16 includes includes diseases. when you accumulate it to over 100 k per member and that makes it significant. what we're seeing tht complex and rare diseases. what is in the pipeline for 2022 through 2023. we're seeing about 45 agents

are under about review or have entered. and of those, about 18th are city classes meaning this busy states that they are treating. what matters is i'll point you to the side of the slide where 26% of those in the pipeline agents are to treat rare diseases. of those are orphan drugs, those are designated process to help the manufactures to approve drugs that are only going to treat a small sub set of population. because there is not enough market to be willing to approve such drugs, our government subsidizes some of the research and even in the regulation that are coming about, you'll see

that those are spared. what that also means it tends to be more expensive. so if we're looking at the process for upcoming approvals, we're talking about 10,000 proficient minimum year cost. therefore there are solution that's are in the market that we'll discuss to mitigate such costs. so i wanted to spend a little bit more time on genetic therapies. those are medications that could be eliminating a function of your genetic make up or incorporated to replace what is

dysfunctional we call them indigenous, they're outside of your body. some cancer sell treatments, that we've seen cancer type of therapists where you take a component of somebody's tissue and develop that drug and as you might have seen, those could be up to 500 k per treatment because they're really taylored to that individual. we juflt got approval for couple of drugs one is muscle atrophy and that's about 1.1 million dollars for one-time treatment.

and lexturna is another drug that was approved for blindness and that comes at a cost of 850k for one-time treatment. they're cure tiff for justification for wanting to approve them with one treatment you can potential cure an individual from the ailment that we're treating. however that does not make them less scary. and on the next slide, you can see how many people in the united states that these drugs are targeting to treat. it's not many, particularly, i want to point to you rectivia,

that is a drug that is third from the bottom, we have higher preference of it. you can say that all of my clients have had some form of feel yack drugs. just because we look at 19 how themz. --members. so what is likely to happen ever the market predict i have data tell us, for 2021, the market share was 4.4 billion, however by 2027, we're expecting that number to jump up to 36.2 billion. in the pipeline the expectation is that if it will be a proven 10 to 20 of these drugs in

upcoming years by 2025. so other specialty, i'll take you back to 2010 where our overall drug spent for the specialty drugs was about 26% of your total spent. however in 2022, we're seeing about 53% of the total drug spent devoted to specialty population. and it's a huge market with not too much help in the next three years. fda is expected to approve another 20 therapists in earlier expansion of indications is causing more and more spend and we don't see the light at the end of the tunnel

if you will with that. so what type of solutions could we use? what value base contracting is when the pairs contract with the manufacturers to say only would we pay for a drug when it is affective. meaning if a member takes a drug and you pay 2.2 million if they did not get the cure, then the manufacture will have to pay it back. so in this, previously with the smaller drug, it was not worth the sweat and we didn't really

see pm, but come with this genetic type of drugs that would be a solution that we would see servicing more. drug management tiers, this is where we see particularly with our drugs, we see some pairs kind of carve them up in a tier of their own and pay a portion of what they're able to afford without really breaking the bank. that is a structure that we have seen. it does come in handy when you look if there is assistance versus when it's not, then it becomes i little dilemma.

it would be like the credit card type of deal where you would pay it in installments or at a later time. does not take the whole money, the whole costa way but at least to mitigate having to come up with it up front. we're expecting more and more of the pbms and curater to part

implementing. there is some good news on the next slide. bi similars have been approved and we have seen so many litigations in patent related delays. but we're hopeful with one of your top spender drugs go into bi similar where this is different from generic versus this is our biologic and created by a bio logical by a, like you would see with generics versus brand. and that's what caused a lot of delays, a lot of concern and

fear about are they interchangeable. these are, at least the active ingredient is enter changeable but they may have a clearer fluid that is different. and that has created concerns. in a pharmacy setting, brands can be auto substituted for generic. but in this type of bio similars that has not always been the case. we're now seeing insulins that are coming in biochemical and we're allowing finally this year to be able to substitute. so that is about 49 billion opportunity and looking toward to that in the coming years. on the next slide, i wanted to give you a little picture of

what it means when we see the first time, remicade is an injectable medication that we were using up to the biosimilars surfaces. and when that happened in 2019, the original cost was 810 for the grand and then you keep on seeing the as the new biosimilars entered, the price goes down by 2022 to less than half of the cost. what that creates is competition but even the parent drug then start coming down in price. so it's really a double affect that we more than welcome. so for the next couple of slides, i'll go over the efforts that are happening from

the government identify to mitigate cost. so newsom, we're in the next slide. yeah, so what this is, is to contract with manufactures or to create a facility to develop insulin bio similar. what the cost 50 billion will be dough voted to the development of the drug but another 50 to developing a facility. manufacturing at least one form of insulin where it will be california branded insulin and the idea is to really help with the overall spend but also the $35 per member, per fee if membersed have to be burdened with this cost. it has not passed any senate or any of the regulatory parties, but that is the idea behind

that. the prescription drug provision, we just know that it it was passed jaent over the weekend, my slides were developed prior to that. so now, that it is passed and the whole contract our hope as you can see in my slide, it would also include private experiences but what is passed only includes medicare. and the whole implementation of this is to resolve 288 million of des sif offset or reduction at least in the next decade. this will require as you might have seen through the different consolidated appropriation act, we're compiling drug cost and

the focus is on the top 50 drugs that have been utilized by all pairs. where starting 2026, they will be negotiating medicare will be negotiating their own price of ten of them and each year it will go up by five until it gets to the top 20 of drugs that they will negotiate. that will not affect the private pairs but i'm sure you have read that it may create a shift to private pairs to kind of for manufactures to come for the loss in there. none of this has been reviewed by our legal team. therefore i'm only telling you what i read and see.

and there is also the extension or the delay of the rebate rule. . to 2032 as opposed to updating soon. so yeah, that is impactful. there are a lot of other provisions here that we will probably be sending out information as we there is another regulation pharmacy benefits management transparency act. and this one is really to bring light to the kind of less transparent process that we have right now. and it is to reduce prescription price overall for

everyone involved not just medicare in this one at least as it stands right now. and this is to where pbms pay the pharmacies a certain rate and charge the pairs a certain rate sp. if there is a difference in the price, that is kept by the pbms and that is pricing. that is to eliminate ability to obtain cost difference. fall backs, i don't know if you have heard dirs this is where the pbms go back to the pharmacies and retrieve the money that they paid for claims.

those are there and there are other stakeholders that i can see this being contested. so they'll be required to report to ftc and if they fail to adhere there is a penalty for million dollars for each occurrence in potential civil action. nothing has passed the senate. and that concludes my presentation. >> thank you so much, colleagues do you have any questions or comments for dr. doit? >> doctor i just want to say thank you, this is extremely complex and very sophisticated,

and why i'm still digesting. thank you for making it as easy as possible to understand. >> i want to second that, it's going to take a second to understand what is in this report and presentation, it sounds fairly complex, money is going back and forth but these are drugs that are not easily or readily described. so we have to see how that impacts our overall plans, but thank you, this is very comprehensive. >> commissioner follansbee? >> you did a great job, everything you talk about is really open for lots and lots of questions. i had just a couple of, i guess more generic questions. one is, at what point, canadian

healthcare system looks at approving drugs in assessment of dollars, approved for year of quality of life, and was something like the european looking at it, i understand na it was being toyed with, by the fda at one point maybe a decade or more ago. the idea being that healthcare is not a bottomless pit. at some of the of price that's don't appear. with the assumption that healthcare financing is infinite.

there is a guarantee that if it does not work, show up on tv and their plan will be reimbursed. the contractual around that, must be complicated because sometimes when you look at the benefit if it works or not, drugs are not a cure. interested in drugs that can kind of improve something for the rest of your life and you'll take it forever. i'm curious if you can comment on drug advertising and value for dollar spent on a drug in terms of how we might factor this into future, you know, cost control.

>> i think we're heading in that direction by at least looking into the consolidated approaching act to at least review what are we paying for, finally and hopefully that leads to how affective are these that we're spending our dollars on. as far as fda related to do so, i'll direct you to just what happened with the alzheimer drug where i'm not, very hopeful if you will, in that that we will get any resolution or or really looking at effectiveness, but yes, there is ethicacy studies as you already know, but as far as are we holding manufacturing accountable for how affective their drugs are.

we're not there and i have not seen any other efforts to follow the canadian or other nations who have looked into that. we have not made any progress unfortunately. but my hope is that value base contract team will bring that to light. as drugs expensive drugs are being approved we can bring to light by discovering in those areas how many times this drug failed to treat what they approved to treat.

>> can i ask, a lot of advertising, as dr. follansbee, there is that statement that says if you have any drugs paying for this drug, call your manufacture, what happens in those cases? is there some arrangement made with those manufactures to provide those drugs at an affordable cost or no cost to those individuals who might need those specialized drugs? >> yes, there are solutions for non medicare pairs. and the reason for that is because our government side has regulations and you cannot go and find help for patients in

that kind of coupon state. and therefore can assist and as you may have noticed, there are few drugs that were just approved in terms of weight loss drugs. they're a thousands plus cost a month, and with that, you'll ask your pharmacist to help you if you're a government payer, or you're not a medicare or medicaid type of patient, then, the reject and the pharmacist can connect you to a coupon and get that drug at a fraction of a cost. they're not permanent solutions because manufactures once they get enough to use the

medication, they tend to take those away too. >> and we're not seeing it in insulin. >> insulin has been pretty interesting. this drug have been out there and from 1991 to now, the costs have gone up. and we're not seeing the type of help for insulin if you will. however for insulin if you're for the most part is the copayment that you pay is not as long you stick with the preferred drugs, is not as high. however, there must be a lot of people who are not insurances or on medicare who have to come up with to meet the catastrophic levels which with

this new regulation will be helped as far as being able to lower catastrophic. yourselves included. >> thank you. the process approval and regroup and stay profitable for a little while.

was typically that can enter at the end of that. is this really a same drug, it's not a genic it's biosimilar. >> i guess i'm just curious, at the end of the day, how does that get chosen? do they stick with the brand name drug or biosimilar? >> because the biosimilars have not been as high.

we've seen carries who don't push for that. i think it's a cumulative effort for us all to push for incorporation of those. to incorporate however, like i was showing earlier, the manufacturing of the brand drugs. that is why you hear the cost. so it's, it will create competition, it will definitely

decrease the overall spent but, with all of them being in your form larry preferred drugs, i would not think so. >> okay, great, thank you. >> visions of my organic chemistry class is coming in my brain. >> i would like to comment, i want to point out that it was founded 100 years ago, insulin. this is the 100 year anniversary of insulin. and there are lots of generic products, there are, there are many products that are off patent.

good example, there are 34 companies that manufacture insulin in the world. you would think that with competition, the prices would be done, only three companies hold about 99% of the market worldwide. so this is really more complicated than we think. we want to be sure that the net cost is the lowest that you can potentially have. however, when there is no mandate to decrease that what

happens when i was saying 1991 through 2022, the increase is more than 100 percent. meaning if the inflation is 6%, manufactures can only increase by 6% year over year. so that is then again, how do we control how they price it from the get go. >> that was very dense, thank you. very super helpful. seeing no more comments or

questions, let's open it up for public comment. >> thank you, vice president hao. in-person public comment will be first and then virtual public comment. for anyone waiting in-person, you're welcome to approach the podium now. all public comment should be made concerning the agenda item presented. you'll be placed back on mute. remote viewing is available on sf gov. tv. opportunities to speak during the comment period are available by dialing the number on the screen.

for those already on hold, please continue to wait. we'll begin with in-person comment. and nobody has approached the podium in the room. our moderator will notify us of any callers at this time. we have four callers on the line. a reminder to all callers on the line, you must dial star-3 now. we'll wait 5 more seconds and then close public comment for this agenda item. there are still no callers on the queue at this time.

>> thank you, moderator, hearing no other callers, public comment is closed at this time. >> thank you very much, very very helpful. thank you. let's move on to item number 11 please. >> thank you, vice president hao. item 11 is delta dental discussion item and will be presented by julie fernandez, with delta dental. thank you for the opportunity to provide an update to you. so we'll look at cleanings and sef,s, member engagement and then a quick snap shot of network.

: so when we take a look at first active populations through the second quarter. new aoultization, zero is anyone on the plan that utilized the benefit outside of a cleaning post or a deeper cleaning. if you're in the one bucket, that means you went in for the resent 12 months. if you had two cleanings that means you're in the one. we can see that 64% had at least one cleaning.

we do see that there is a aoutization. there is a point 4, less than 1% change. and one cleaning and more. and overall, 69.6 percent utilize benefit in the most resent 12 months. when we look at comparatively through the california sector, that 64.1 is higher than what we're seeing at 58.1%. we'll see that there is a .5 percent increase. again, less than a percent in

terms of percent. and then 3.1 percent increase in one cleaning and more. again, total members that had one or more cleaning was 69.9% and then that same california public sector when cleaning. so 72.8 percent of members utilized their residents. okay. so the next is going to be an active distribution of services. so current and past and prior is in blue. so the first, overall there is not a lot of change, from the resent 12 months. we do see that the bucket had the year.

and specifically in diagnostic. and we do see the procedure utilizer in the pie chart. procedure which is what you want to see. when we take a look at the next slide, same format, green is current and blue is prior. and we'll see dnp had the greatest change but specifically in the diagnostic, it was 9k that we saw in the 12 months.

so we see unique aout lasers, 96.5 percent utilized those preventative service which is good. and we go to the program. when we look at the active at the top and require', our goal is really to increase membership for those who are allegable and for those members to get that aoutization. we know healthy gums is going to translate to a healthy body. so we can see that wellness benefit members.

the second half is retiree specific aoutization. we can see there again there was an increase in the members that are allegable. and so we'll continue to work through messaging and get those individuals to know that educate them about this feature that is available to them. that was affect. and that be we were able to quickly come together with sfh and create and deploy a post card to all members on both the ppo and delta care plan. the messaging was targeted and the importance of dental

benefits preventive. we also highlighted the smilely wellness program for those members that may not know about it. and then we earned, awesome encouraging accounts. we know that we can get an individual it's going to benefit them in terms of our preventative campaign that we have in place. so this is just a snap shot that we were able to use and messaging available. so i hope you all received your post cards which then we go to the second page which is engagement. and we have that campaign that is in place for members that do not seek services.

and the last is a network snap shot. this is the most resent 12 months. specifically to the state of california and looking at high level of review of all counties. so for the time period listed above, 6100 were utilized as of 7-1, we had 5 remaining in network. of that, that did affect 354 members. we did during the same time period throughout all of california, and of those providers 218 of them are now being utilized by sfhfs.

so from the whole, of the picture, you know, sfh population, there is about 91% that reside in california. so although it's smaller, we realize that we continue to recruit and retain going forward. and dha was my presentation. >> thank you, julie. any comments or questions for julie. >> if i may, i'm grateful to see the member engagement slides. i'm interested to see what the year to year will look like. so my compliments to you and the delta dental team for doing that. >> i appreciate everyone coming

together and coming with us. >> are the post cards the only way that you're reaching out? or are there other methods for folks who may be site and compare and kpt read a post card. >> typically, the post card to something we did, we know we're coming off the pandemic and we're trying to get everybody to get their dental exams. i'll have to check though, because i know that our, our website and those communications to see if like for the, i'm going to use the word, accessibility i know that we're accessibility compliant, but i'm happy to take the feedback and absolutely see what we have on the future horizon. >> and while it's hard for you to guess at folks who first language may not be english, if there is some resource for

multi lingual access as well. >> absolutely. thank you. >> i didn't know, if there was a a relationship between that. but soon after, i got an email from my dentist. so there was a follow-up, but it was interesting that the two items came close together. it made me feel better going back to my dentist. >> i wish i can tell you we did that -- ~>> i have a very active deny at this time so i appreciate her. >> i have another question to your turnover -- ~>> i would like to thank thelma for sending out this post card. and are you planning to do this

every year. >> we're definitely looking into in terms of what we're going to do in the future, we are going to be tracking the success as best as we can too and be thoughtful about it, but this is definitely a first step in making sure that we get the communications out. >> i think this is important and an email would be important too. >> yes. >> commissioner reslin. please encourage your friends to send an email. >> especially when those emails change, the update, that's what you need as well. >> yeah, okay.

i think so for me with a loss of provider the fact that we're still able to add an additional 1338 and of that already utilizing them, i think that is a positive growth, we never stop recruiting in that is something that we watch very closely because our providers are they're very important to us just like our clients. >> thank you. >> there was people dropping out of delta because the reimbursement was high. >> thank you for your feedback.

>> can i make a comment. >> absolutely. >> sorry, i know that one of the issues that's come from the past. the district that were sleazing but not really available some of them had moved. and i think the address some of those issues in the past who remind us of the on going efforts to make sure that the services that are available to members who are looking that

those are up-to-date, if we can reiterate that. >> absolutely, and that was before i came into your account, so i apologize if i have to deliver in the response. we do update your provider directories. we had to make sure that those individuals whether there was confusion that it be clearer, we do on a yearly basis not obviously not every year because the dentist but it's a rotation of going in there and verifying information as well. we work with our provider partners with that. i certainly, our search future, i love it because you can search bye-bye evenings, it's pretty robust and you can take

it down into the specialty, of the specialty that you're seeking. i do like that we get that. >> good afternoon, michele director of account services at delta dental. thank you for having us this afternoon. the member that speaking of, commissioner had some questions in regards to contra costa county, and we were able to work with the team to outline adequate access. >> and that's something with the webinars, we're focusing on the website and how to search.

>> thank you, any other final questions before we open it up to public comment. seeing none, let's go to public comment. >> thank you, vice president. >> in-person public comment will be first and then virtual public comment. for anyone in-person, you're asked to approach the podium now. you may remain anonymous. i'll give you a warning when you have 20 seconds remaining. remote viewing is available.

the dial in number, 415-615-0001. to enter the meeting and dial star three to be added to the public queue. he will begin with in-person public comment. our moderator will notify us of any moderaters in the public queue. >> board secretary, we have four people on the line, zero have entered the queue for public comment. you must press star-3 now if you want to comment.

we'll wait 5 more seconds and close public comment for this agenda item. board secretary there are still no callers at this time. >> thank you, moderator, hearing no further callers, public comment is now closed. >> thank you julie and mitchell for your presentation. >> okay, let's move on to agenda item number 12. >> this is a discussion item and anybody can approach the podium. >> hi, heidi, kaiser permanente, this is my first time being back in-person since covid, it's a pleasure to see you all. we do have to announce which is a notice from our behavioral health specialist to begin 6:30

monday morning should there not be a resolution with them. we have been working with them for well over a year in this contract and hopefully they will come torres losing but they have notified us of a strike. i do want to assure everyone that facilities will stay open. we're contacting any individuals if we have to schedule reteen care, we have strong support and other providers that we can work and we'll work to cover anybody who needs care and make sure that people get the continued care that they deserve. >> thank you, >> thank you. >> any other up daitsz from those in attendance? >> anyone who wishes to provide an update? >> it does not look like anyone has raised their hand. if anyone wants to unfuture, feel free. does not look like.

>> all right, thank you for the update kate and we'll it up for public comment. >> for anyone waiting in-person, you're ak to come. all public comment can be made jerning the agenda item. a call but there is no obligation. for those callers online, want to welcome you on the call. you'll be placed back on future. remote viewing is available on gov. tv use or web ex.

the dial number is 415-655-0001 when prompted use access code 24963659185 then press pound and pound again. you'll press star-3 to be added into the queue. we'll begin with in-person, no one has approached the podium. so we'll go to virtual public comment. our moderator will vote notify us. >> we have four callers zero callers have entered the queue line. you must dial star-3 now if you want to join public comment for this agenda. we will wait and then close public comment.

we will wait few more seconds and then close public comment for this agenda item. >> hearing no public callers, closed. >> next agenda item? >> next agenda item is adjournedment. >> seeing no other comments, this meeting is adjourned. [gavel]

>> i don't want to be involved in the process after it happens. i want to be there at the front end to help people with