>> welcome. i will call agenda 1 call to order. 1. . 07. >> good afternoon everyone. we welcome to you the september executive board meeting of the health service system. like to have you stand and join mow in the pledge. [pledge of allegiance]

>> item 2, >> agenda 2 is roll call. we have president scott. >> present. >> vice president hao is attending shortly >> commissioner breslin wrochl present. >> supervisor chan is excused. commissioner follansbee. >> present and commissioner zvanski. >> we have quorum. >> thank you. >> item 3. >> agenda item 3 is a resolution allowing teleconferenced meeting under california code section 52433e an action item and presented by president scott. >> good afternoon. you know we have for the past year, 2 years have been meeting

and having teleconferenced meeting of the board as well as the committees. what this does is continue that practice for the next 30 days. we had to upon given the guidance from the city attorney's office, meaded proride this notice to everyone each time that we paddle the resolution. i'm willing to entertain a motion for adoption. gi move we accept and approve the healing service resolution to allow teleconferenced meetings. is there a second? >> second. >> properly move exclude seconded that we allow teleconferenced meeting under california code 54953e. is there comment from the board? >> we'll have public comment at this time. >> thank you, president scott. in person comment will be first then virtual.

if you near person approach the podium now. each allows 3 minutes enemies the president deemed time limits. all comments made concerning the item that is presented. call are may ask questions of the body but no obligation to answer. for on the line when i welcome you you are encouraged to scientist your name clearly. i will give you a warning when 30 seconds close to ending when 3 minutes ended you will be placed on mute and the moderator will unmute the next caller. remote viewing with sfgovtv and web ex. opportunity to speak are available dialing the number on the screen the number is 415-554-0001. again 415-554-0001. when prompted use code, access code: 2484 203 8219 ##. again access code: 2484 203 8219 ##. you will enter the meeting on

the public comment call line and dial star 3 to be add to the queue when the system message says you are unmute third degree is your time to speak. for thoemz on hold wait until you are indicated you have been unmuted. now i will look for in person public comment. no one propped the podium we will move on to web ex for virtual public comment. i will check the callers now. we have one caller on the phone line zero entered the queue at this time. reminder to callers on the line dial star 3 if you would like to comment for this agenda item. we will wait 5 seconds and close public comment for this item. hearing no caller public comment is closed. >> thank you. secretary. with this we are ready to vote and will now have a roll call

vote. president scott. >> aye. >> vice president hao. >> aye. >> commissioner breslin. >> aye. >> commissioner follansbee. >> aye. >> commissioner zvanski. commissioner zvanski we see you you may have to peek in your mic for your roll call vote. >> he is muted. needs to unmute. upon commissioner zvanski you are unmuted now. aye. >> aye. >> i don't know [inaudible] [cannot understand]. you are coming in now. and we can take your roll call vote. >> [inaudible]. still a little hard to hear. try one more time [inaudible].

aye. >> >> [inaudible]. >> okay. >> with that, the voting is declared um on this motion. >> item 4, >> agenda 4 is general public comment. an opportunity for members to comment on a matter in the jurisdiction that is not on the agenda including requesting a board accomplice a matter on a future agenda. >> and public comment will be taken first in person then virtual. you are welcome to approach now. each will be allowed 3 minutes unless deemed time limits. all comments made concerning the item presented. a caller may ask question of the body there is no abgation to answer. for those on the line when i welcome you, scientist your name although you may remain unanimous. i will give you a warning when you have 30 seconds remaining then i will thank you and you will be placed on mute.

remote viewing online sfgovtv and web ex. opportunity to speak dialing the number on the screen the number is 415-554-0001 then access code: 2484 203 8219 ##. you will enter the meeting on the public comment call in and dial star 3 to be added the queue. we'll begin virtual comment. there is one caller on the phone line. zero enter the queue. remind to all dial star 3 if you

like to join this comment for this agenda item. wait another 5 seconds then close public comment for this agenda item. we feel go to item 5. >> agenda item 5 is approval with possible modifications of the minutes of the meeting below. this will be presented by president scott and the minutes for august 11, 2022 health service board regular meeting minutes. >> are there any idits. deletions or additions to the minutes as distributed for the board? >> i move we approve the august 112022 health service board regular meeting minutes. >> second. >> august 11 issue 2022 health

service board regular meeting minutes. >> and there are no further comments from the board members. >> president scott. commissioner false bee submitted mall typo that i corrected. there are some typo edits. >> thank you. and those are noted. >> are there other comments from board members present or online? >> hearing none we will go to public comment. >> in person first then virtual. you are welcome to prop now. each allowed 3 minutes.

>> remote ruing is available using sfgovtv and webeck. opportunity to speak are available by dialing the number on the screen. 415-554-0001 then access code: 2484 203 8219 ## press star 3 to enter the queue. when the system says you line is unmute today time to speak. for those on hold wait until you have been unmoued. we'll begin with in person comment. and no one approached we will begin our virtual comment. there is one caller on the line,

zero in the queue. all caller, dial star 3 now to join public comment for this item. we'll wait 5 more seconds then close public comment for this agenda item. >> hearing no further callers public comment is closed. >> thank you madam secretary. as the motion stands we are approving the minutes of august 11 regular board meeting all in favor will signify in their roll call vote. >> roll call president scott. >> aye. >> vice president hao. >> aye. >> commissioner breslin. >> aye. >> commissioner follansbee. >> aye yoochl and commissioner zvanski. >> aye. >> motion is unanimously carried. item 6. agenda item 6 is the president's

report this will be prohibited by president scott. >> thank you. i like to thank my colleague vice president hao for presiding expertly at the last board meeting in august. given my absence and like to thank those commissioners who accepted assignments as chairs and members for the finance committee and governance meeting. i also like to welcome officially our new counsel who replaced eric she is jennifer donlin she has 20 year 'experience as an attorney in employment law and benefits. i understand she is very widely

traveled visited 46 countries i'm not sure which continents but most, i'm sure. we absolutely welcome xu she has been with the city attorney's office since 2016. thank you for what we know will be distinguished service to the board as we do our work. >> thank you. >> do you care to say anything. why i'm glad to be here and thank you for this warm welcome and i'm looking forward to helping the board as i can. >> thank you. jennifer. lastly part of my report we have not met in october and i'm announcing today we will continue that tradition. this is normally the time of open enroll am. abbie yant reminded me during her first year as executive director, we did have a board meet nothing october. and never heard the end of it.

[laughter]. but -- this will allow our staff to attends to the various things that have to go on during the open enrollment season and so our next regular board meeting in november. >> and with this, that ends my president's report. >> i'm assuming we don't have to have a vote on not having the board meeting. >> no. item 7. >> public comment. why public comment i'm sorry. on the president's report. >> in person comment first then virtual comment. you are welcome to approach the podium now. each allows 3 minutes to comment. all public comment made concerning the item present. a caller may ask questions but well is no obligation to answer. for those on line, when i

welcome you state your name or you may remain unanimousism give you a warning when you have 30 seconds remaining then thank you and you will be placed on mute. remote viewing online using sfgovtv and web ex. opportunity to speak are available by dialing 415-554-0001 then access code: 2484 203 8219 ## then star 3 to enter the queue. when the system says your line is unmou third degree is your time to speak. for those on hold wait until the system indicated you have been unmoued we begin with in person comment. no one approached. we'll begin with virtual public

comment. there are 2 callers on the line zero enter the queue. you must dial star 3 to be added to join the comment for this agenda item of we will wait 5 seconds then close public comment for this item. >> hearing no callers public comment is closed. >> thank you. we will move to item 8 the director's report. >> number 7. the director's report this will be presented by abbie yant executive director. >> good afternoon, commissioners. i'm pleaseed report you know that there is a new covid-19 vaccine that is given this week. should you be have chosen or made an appointment to get that

we encourage all eligible members to receive had variant vaccine that will help us get through the winter. we hope. and don't forget flu shots you will had been more later from our team. there is a data attach to the report on the vaccine status, i know -- the data is not always satisfying because the carry yers may not know upon that you got a rackeen if you had it outside their system which many of us did. i think when we look at is trendses over time and the numbers increase and -- i think upon most people now are able to access these, these new boosters through systems that do capture the insurance information that will make a difference in the integrity of the data as well.

>> the other nows -- is the on going settlesment with the health system, the judge issued an order on in august for the distribution of funds. and clock of 35 days that is september 26. i know esther carr will watch for the mail that day. and we will let you know when we receive the check. >> very long store. healing equity updates. if is child obesity awareness month. we are also looking at suicide prevention activities and the difference in various population and how they are at risk for these very big concerns. so we will educate ourselves and members in the areas. you will learn more today in

great detail regarding the strategic plan we present in the draft form, we hope. and -- we will have a robust discussion about that shortly. we continue to work with the fire department. to and we are secured through our plans with blue shield and kaiser that the center of excellence in maryland that is supported by the firefighter's association will be available to them. and so we are working on the communication tricks to make sure the people that need to understand how this work understand how it works. that's where we are on that now we are excite body that. equal low as important or in perhaps more so we have a kickoff meeting this morning for a project in the works for of over 2 years to have this

collaborative contract of mental health network through a selection process that michael lead for 3 departments. so when was the left time you heard city departments working together we have 4 city departments that worked together to putting at this time the mental health services that are valuable for these public safety services and this vender has been with the police department for a time and they are an industry lead in understanding00 autoneeds. first responder agencies and they are different. police, fire and sheriff are sponders but they are not all the same. so -- the vender we are pleased have him with us and -- so it is -- a great meet thanksgiving morning and i think we will we'll be in a transition period the next couple months and have the right people working on this and the support of department

heads and their chief financial officers we did have to do a lot of wrestling through the budget process we did not get new funds but we were able to find existing fund in all of the departments. that in itself was also an important statement of the commitment of the departments to want to provide these service. so. weer pleased about that. um -- the you will hear more about the team's efforts whether or not they are appropriated and for the open enrollment around the corner. and -- so i will not steel their thunder. we are experiencing staff turn over we are not immune to that issue happening in every industry. people are choices and are making them.

our job is to be an employer that people want to come to when we have vacancies that is really a way we are approaching it. because we do have people take average promotional opportunity and not exist nothing our department. nice they have other places in the city and can retain their city benefits as they move along. so, i think that is all i got for today. unless there are questions. >> are there questions from the board? on the director's report? none from me. thank you. >> thank you very much comprehensive report y. thank you steven and hello. >> claire, i know you are out there do you have anything?

[condition understand speaker] commissioner zvanski we are have ditchy hearing your through the speaker you are breaking up. [inaudible] [inaudible] commissioner we will have a tech support team members call to you work on it. i did see you put up a hahn significant until i'm assuming that you are good to go. >> okay. >> yes. >> thank you. >> all right. thank you. with that we will turn to public

comment on the director's report. >> thank you president scott. in person comment will be first then virtual. anyone in person you are welcome to prop now. each speak allowed 3 minutes to comment. all public comments made concerning the item presented. a caller may ask questions but well is no abgation to answer. those on the line state your name or remain unanimous. i will give you a warning with 30 seconds remaining then placed back on mute. remote viewing can available using sfgovtv and web ex. opportunity to speak are available by dialing the number on the screen, 415-554-0001 then access code: 2484 203 8219 ## then press story 3 to enter the queue.

for those on hold continue wait until the system indicates you have been unmuted. we'll begin with in person comment. and no one approached the podium. we'll move to virtual public comment. i don't have 2 caller the online zero in the queue. to all the callers on the line, dial star 3 now if you would like to comment for this item. we will wait 5 seconds then close comment for this item. no further callers. public comment is closed.

>> thank you, secretary. >> that is a discussion item we will move to item 8. >> item 8 is sfhss hospital as of june 30 of 22. a discussion item and will be presented by sfhss chief financial officer. >> >> welcome chief financial officer hussein, how you are? >> well, >> good. >> [inaudible] [cannot hear speaker]. i don't know if everyone can hear you pull that closer? >> i will make a few points from the highlights slide. this is the cell phone. voice. okay the total trust fund decreased by 15 publicity 6 million we had planned for about

a 12 envelope million reduction as far as the rate stable wragz we use in the rate set being process. but the claims themselves were almost 6 million higher than when we assumed during the rate setting process. and off that 6 mission we are 2 off setting tlendzs the medical claims are running higher than expected. mainly result things we are seeing the demand for [inaudible] is climbing after the pandemic. compression. the dental claims are about 6 million lower than expected and the rate setting process. they are about 8% higher than last year. we are expecting interest to be about 900,000 for the year.

health sustain at fund the be flat. and on the general administrative fund we will have a surplus this year related due to deferral or cancellation of wellness events due to the pandemic. we have a carry forward of 150 to 200,000. funds get carried forward to the 2023 budget. i want to update you on 2 audits the started closing the year. so far the [inaudible] audit of the trust fund there are no findings we will keep you updated. internal audit by the controller's office focused on a couple line and processes is on going and when this is completed i will update you on the

results. so that's my report. happy to answer questions. >> thank you. are there questions from the board. >> no. hearing none we are red for public comment o this item. in person comment will be first then virtual. anyone in person prop now. each speaker allowed 3 minutes to speak. all public comments concerning the item presented. a caller may ask questions but no obligation to answer. for those on the line when i welcome you state your name but may remain unanimous. i will give you a 30 second warning. then thank you for your call and will be placed back on mute. remote viewing on sfgovtv and web ex opportunity are available by dialing the numbers on the screens 415-554-0001 then access code: 2484 203 8219 ## then

press star 3 to enter the queue. when the system says your line has been unmute third degree your time to speak. wait until the system indicates you have been unmuted. we'll begin with in person public comment. no one approached, so we will move to virtual public comment. we are 2 callers on the phone line zero entered the queue. you must dial star 3 now if you would like to comment on this item. we will wait 5 seconds then close the public comment for this item. hearing no call eshs public ment is closed

>> thank you. madam secretary and thank you chief financial officer hussein for that report. >> we're ready to move to item 9 . >> agenda 9 sfhss strategic plan 23/25 draft a discussion item and presented by executive director abemyant and harris [inaudible]. >> thank you commissioners we are back with the strategic plan. this is where i started. and -- so we have our draft plan for your rerue today and consider any comments and suggestions that you have for changes and finalizing the document to bring back for approval in november. it has been a great facilitator. had a robust input press from

staff and management. i think we all really own this. which is one of the most important things in the strategic plan. so i will let low tishia walk you through and take comments as we go or at the conclusion. thank you. >> good afternoon racial equity lead 4 years with sfhss. this slide provides an over view of the upon presentation agenda. i will begin with a time line of planning development mile stones. move to over view of environmental scan including internal and external factors considered as part of planning. a refresh to the mission vision and valueless. highlight 5 strategic goals each with objectives and key result and wrap up with less ovens learned. all with the aim of seek on going input from health service

board. >> the next 2 slides spotlight approaches and refresh activities linked to the 23-25 planning thai cycle. both come to pass as well as those planned for the future. note activities summarized in the tables will be reviewed as the presentation moves along. high level this journey included workshops and discussions. input from staff. strategic plan refresh exercises reflect on the current and future states of mission values and goals. a health service board special mote to identify important change in circumstances and knowledge this could be used to refresh strategy and keep it relevant in collaboration with partners. reflecting on the past few mongst sfhss invited subject matter experts present a part of

dprnlt board agendas. the educational opportunities support commissioners inquiring the knowledge nay need to carry out their duties. we are continuing to analyze data and existing retier and active from focus groups and surveys used to determine new data sources and touch points for the future and communications. we have an all [inaudible] plan for the end of this month members of all divisions explore. their work and themselves in relation tot plan. and after presentlying the final version as abbie mentioned in november, will track progress through internal quarter leave implementation meeting that connect our daily work with measures of success. as we lead in the next section on environmental scan i want top say why had is important.

environmental scan is used to identify internal and external factors about our organization that may impact our viability. ability to successful in the long run. during this step we are trying to develop an interview of influences that shape our work the slides in this section highlight internal and external strategic planning sect osors that affected this process. we started this scan asking, what story is the data telling snus the documents on the screen constitute the elements of the current state assessment focus. that includes annual reportful dash board and enregularly demographics report they shed light on who members are and health conditions that are in their covered care. they highlight the member support provided by our stof elevating prescriptional resource consideration for the

futures. everything about funt design benefits we think about and seek better understand the gaps between the current and future state of offerings. the report introduce the data we look at inform the next iteration of the strategic plan. . president sfhss project portfolio that maps the rate and benefits time lines to initiatives. linking portfolio strategic balance the use of resources to maximize the value delivered in programs. projects and operational activities. throughout environmental scan we realize we must look outside as an organization in the broader field as a part of the planning process. to do so sfhss offers rep centation on the d. managed care and quality committee and the integrated health care board of directors to gather best practices from other state and

initial health reporting know entities staying tuned to data developments sfhss atlas cost and quality data for 30 million people across california. sfhss following the development of a state wide all peer claims data base through care access and information. our organization tracks external practice legislation elevated by cover california that is intended provide lower costs andarc sesz to quality health insurance for can cabs and we are seek to arc line with leaders like specific business group on primary care data reporting. to consider factors beyond our organization sfhss brought together a board. employees retireys, department of human resource venders and experts for a day of information sharing the key objective was to

identify important change in our circumstances and to my knowledge refresh our strategy and keep it relevant on the screen are names of matter expert this is spoke to core areas including population mentalal healing. primary care and healing equity the agenda included a well being conversation. featuring voices and champions from across the city. bring together the thinkers and perspectives helped shape the current and future programs to meet the needs of the our population. our staff brought approximate perspectives and unique experience as a part of our membership. strategic plans refresh excesses on in10 and external factors. we use assess am tools to explore the state of benefit structure and identify core

strengths, weaknesses, opportunity and threats that lead to new ideas. on the screen now is one of the out puts from our staff workshops and discussions. a sum row of the strengths, weaknesses, opportunity and threats referred by [inaudible]. a swat analysis compiles all factors that have uncontrollable impacts to our decisions things like opportunity and threats. key themes used to [speaking too fast] affordable and sustainable. primary care. health, mental health and well being and optimized service. i will highlight a few from the swat analysis and move on to the rest of the deck. in the first role of affordable and sustainability strengths are stewardship including our trust

and fiscal responsibility. in the center column, the opportunity in the health equity domain is focus on addressing population specific healing deparities. the last column in which budget is listed as a weakness to optimizing service. it is important to acknowledge and address how they affect the strategic planning process. when we think about formative strategic plans we acknowledge the past, present and the future. the environmental scan factors in when we face and think burglar when we put together the original plan. learn beings and discovery that taken place since a part of this new planning process. and current piece of reality we need to adjust in the future. support from arcon we analyzed the 5 goal in the previous plan shown on the box on the left. we. teased out areas within each, shown in the center box. and recategorized based on

ability to influence change. the right side the out puts of the exercise. the draft strategic goals for 23-25. before move to the final details about each goal we want to search sfhss mission, vision and value as a building blocks of our organization. the next section of the presentation highlights validation exercise done with staff, validate our mission, vision and values to which make sure we feel the same to discuss how we feel and how that might have changed. mission and vision and values designed to be long-term. if they change frequently they lose meaning. if they don't change frequently enough or have no meaning they are as damaging as having no values. on the periphery of the circle tell us it was time to take another look. we had a rapid period

growth. significant change as an organization the past several years. changes external and internal low our team has grown to include manager and supervisors. 3 fourth's participating in this on whiches for the first timer. we also.ed eliminate gimmicky or buzz words to actualize how we live and breathe. we wanted them tob not expected behaviors like honesty which are honorable butmented to pin down what defines us and sets us arc part as an organization. the internal staff exercise validate our values come from interact a communication's company offers the prompt on the screen. what would you miss about working at your organization? and having the conversations we are able it break down the scyllos that e merge.

out puts of conversation shown as a word cloud oat screen. our team feels passionate but b small but mighty. the w this we do is not just health benefits, support and programming it is about helping people to find relief and the provide that stems from empowering them the resources and education. responsibility, comradery real, humor and joy are a few shared and the desire to be at the forefront of change with our partners. the express sentiments feed to the mission, vision and values they describe the impact we want to achieve, how we treat members in our organization and community and what we wish to accomplish. >> i have a question this is supervisor -- yea. commissioner follansbee. i had a question about this. number one, there is a -- the

size of the font indicate anything or was it intentional or to fit the diagram. it is intentional the size of the font is indicated the weight in which the words mentioned how many times and frequency. >> and [inaudible] market urined everunder all staff meeting system that farmer's market or am ieverunder all staff meeting system that farmer's market or am i that is farmer's market. some are in white and black is there a significance to the color? >> yes. the bolded and dark text learningest represent ones mentioned the most. >> okay. great. thank you. >> thank you. you see on the top row the

previous values compare to the nuityeration on the bottom row. our proposed mission and ensure equal, sustainable and quality benefits enhance well being of members and families throughout the life cycle. proposed vision engage am and care that centers the disease prevention and services for optimal member health and will values, inclusion, compassion, operational excellence, collaboration and alignment. our previous mission, vision and values reflected who we were and how we worked. we have grown and need to make soar they grow with us. the final section ghs to detail about each the strategic goals proposed for 23-25. each the 5 goals presented along side objectives and key results.

those are an effective goal setting tool for communicating what you want to accomplish and what mile stones you need to measure to get there. they are used bite leading organizations to set a strategy. on the screen now is a draft summary of the goals and objectives. goal one, provide affordable and sustainable health care and well being service value driven decisions and program designs. them is achieved through 2 objectives sustainable funds board edge. goal 2, advanced primary care and member engage am and the right care at the right time in place. this is achieved improving primary care services and enhancing equal in the deliver of primary care service. goal 3, fostering health through intentional culture, accessibility. inclusion and belonging applying a health lens to the customer

service and workforce environments. goal 4, support the mental health of membership reducing stigma and addressing barriers to care with key stake holders. yoot revision of accessible path ways and enhancements of support for retirees, goal 5, optimizing service to maintain exceptional member and stake holder engage am. enhancements to member inn gage am and support service staff training and development and quality arc suburbans reviews and the right of the sum row the new mission, vision and values so our commissioners and membership see the big picture view. >> the ~ifiabling final section draws an leadership of the draft summary you have seen including the strategic goal at the top. the objectives are carried forward on the left hand side of the screen.

with new key results shown to the right of each object itch. the key results communicate when weep want to accomplish and what mile stones we need to measure to get there. measurement is stratosphericed differently based on the nature of each failing to meet, inconsistently meeting or exceeding. goal one affordabling health care and well being services value driven decisions and programs. sfhss track health care spends and transparency dam data to meet the sustainable funds. remain committed to board education through consultant services so commissionerers knowledgeable of the role in assuring benefits offered. can we pause at that one. i'd like the board to focus on one, 2, 3 and 4. as the metrics for this

descriptor. i think that if we are somewhat aware at level 2 and moderately aware at level 3 that we really are not where we need to be as a boards i think given the experience of the board members. prior experience, and the knowledge that they bring expertise they bring this we should have a better higher measurement. so i'd like to propose that we move number 2 to moderately aware. and that number 3 is aware. and number 4 is highly aware. so we are stretching ourselves a bit beyond what is described here. i think we have to assume a certain level of confidence in

board members the last years of served with this board individual expertise that brought each us here. i'd like to propose those adjustments in the descriptors. >> we with note and make those. and it compliments the objective framework which centers on challenging and ambitious goal. we can make that change >> thank you. any different questions before we move to goal 2? thank you. >> goal 2, advance primary care and member engage am ensure the right care at the right time and place. sfhss will use metrics and set targets for effectiveness. bodying want population measurement plan presented to the board. tracking metrics and goals for primary care pend and costs of care in alignment with others will help to meet the objectives improved care and well being

service. sfhss focus on targeting under served population tracking seek to enhance equity and he delivery of primary care services. >> i have a comment. i think that this is going to be i will make more as we go along. i think. i want it thank you for your hard work putting together this puzzle of strategic plan is woman's work. and -- i appreciate all the input that you and the rest of the staff and director yant committed to hearing from the voice of customers. thank you for this and i look forward to hearing how your retreat went or will go. so i think the one thing about goal 2 in the advanced primary

care and member engage am to ensure the right care at the right time and place the word ensure is a high calling a verb not within our control fully. i want to -- caution that the over use of the word ensure in areas where sfhss does not have full control. we can note that and look at other verbs relation tot influence uponing to balance the context with more specificity. i think that is an excellent comment. with the word advance. meaning the role of striving to advance. might be a verb that might work in this because i think that is a well placed comment. >> thank you. goally.

fosters equity through cullure, inclusion and belonging from the mayor and the office racial equity. phase one of the framework released all city department in summer of 2020 and focuses on internal staff programs and policy. 2 of the framework will be distributed in 2023. and will focus on the deliver of external services and programs. so applying a health lens to our internal am workforce environment and external customer service prop arc lines with the 2 phases of the mandate. health equity in customer service related to the role in advancing health equity for members including staff. at the time the city framework released, half of the staff were aware relating to the city mandate and seek to grow that awareness. we are partnering with department of human resources to

have trainings. that are interest to staff. the mandate requires we form an add vise real to support decisionmaking as a part of ouring organizational culture and with dhr required to report data like those with the board this january. to ensure our workforce remains inclusive for all. could i comment on the last one at the bottom there conduct a biannual workforce analysis. you have in 4 not applicable and that always00 disturbs mow when i don't see a metric this goes above the standards. i don't know all of the intkaess what the city is requiring diameters to do versus what diameters may say on their own in addition to meeting the requirements we want to do x, y

and z. i will make this proposal and i'm asking director yant and you and the others on the staff in the area to consider it. that for 4, after you have done the workforce analysis and completed that biannualy which is your level 3. the level 4 there at least be a leadership departmental leadership discussion about the reports on an annual basis. so that whether -- goes into something that might called planning. i'm not going to suggest that because there may be contrains but the leadership team or management group needs to discuss what those reports have resulted in. and where are there gaps or try to focus as we cooperate and hiring and interviewing process that i know is not i part that

is mandated bite department of human resous we will approach this we will try to be aware of the issues. in our department based on the revowing the annual reports. some type of sum row discussion or focus around what the upon biannual reports provide will be useful upon i would put that as someone exceeding the requirement will door the report. so i would offer that to you as a suggestion. >> we can add that. under the exceeding category. and this year was the first year we had access to the workforce analysis dash board we submitted in may and waiting for feedback.

jury room i happened what is moneys to apply equity lens to customer service but how do you apply health equity lens to the workforce? >> when we trained with d. of human resource they have a set curriculum that includes communication of cross cult urs bias and a bunch workshops we filter the staff through to acquire a lens in the way we approach our work. they work with the trainers to specify the training around our needs and strategic goals and that's the implications of the internal. >> i think what you described sounds like an equity 11s and health is external to customers and internal i suggest that you drop the health care or health. >> we can amend that upon.

sppth the well being. membership reducing stigma and barriers to care with key stake holders objectives elevate the need to path ways use disorder service progress propelled by a posted vendor sum sit and boost resource utilization and employee assistance program group to support decisionmaking in collaboration with city partners the second will poichl evidence based and best practice enhancing retiree well being of memberships and family throughout the life cycle. the final goal optimize the service to mooin maintain exceptional member engage am. this is cover in the 3 slides to

reflect sfhss largest division and member services with innerdivisional efforts. the first education and spchlt seeks to digitize employee benefit notices. increase member satisfaction and first call resolution and develop a member portal for benefits mchlgz and wellness engage am. the second optimize service are improve ams to staff training and professional development. results include documentation of standard operating procedures. development of training and measurable improvement in staff readiness for open enroll am related tasks. call service support in the development of the sales force knowledge base and participate in improve am opportunity that involve team participation to promote career development.

and the third is improve quality assurance processes. functions include responds to calls from the sfhss call center. processing benefits administration transactionings carrier and discrepancy reports and processing premiums. they will be gefrned by quality assurance standards and reviews part of the 23-25 cycle. i'd like to ends with lessons learned had a profound influence. as an organization we learn to embrace strategy we want to ensure we are lynching to stake holders and the external market place. the it helps you to manage change. pivot and responded to member needs with the organizational capacity and partnership capabilities. we are learn to distinguish the

work we do to keep the lights on [inaudible] using key results changing and ambitious goals. and as we staff retreat we'll reenforce how members see themselves and work on the plan. as a reminder the draft in power point will be transition currently under development in the final presentation in november. we look forward and thank the board for endorse am of this work. >> i like to join commissioner hao in commending you and your team for what you have done to date to and bring it you to we have had 3 different strategic planning cycles and another prior to that not fullee comprehensive. but this draft and document has

been thoroughly it is complete, comprehensive and leaves hope the expectation tomorrow thank you. i would turn to any other members of the board who wish to comment ownership make further additions or edits to the document. >> president scott. a note i want to make sure that commissioner zvanski -- to look toward your phone our tech support can support you if there is mic needs. have your phone ready. through go. commissioner zvanski or follansbee, do you have commentses? yes. i would this is my second participation in the 3 year strategic plan and i think that the even the planning has become

more sophisticated and this reflects a lot of input from all of the sfhss staff. i'm also impressed. i have a question about strategic goal number 5. stake holder engagement. i guess the comment is the definition of stake holders. i understand to be our contracted venders. are we do we is that -- does the strategic goal include trying to get feedback in terms of our processes and their willingness to participate? at all leflts of upon engagement. and the question with the sfhss staff i was impressed with the goals of improving you know the

functions. also i guess the -- job satisfaction or opportunity for growth from within. is there is that covered here? or is there an opportunity to also may be find tools to see how a staff or an appreciate the -- these goals and the participation in the [inaudible] and responsibilities. s you are spot on the work that teams do in member services is done with our healing plan partners. when we look to resolve issues a lot of the issues need feedback and support from those carrier partners. when we want to do is build out

processes and procedures that are not only known it us internally but our carrier partners we are able to support the membership. in terms of your second question regarding employee development, a lot of the work that the member searchses team does went unit itself. they deal a lot with the supervisors and they work with coworkers. but well is in the a lot of opportunity currently for cross divisional engage am. what we want to do is promote opportunity for staff when they will see an issue that they can w that issue through commreelgz and resolution often times that will work with our communication's team. our finance team. our system and analytic's team. we want to empower them to follow the path to coming up with a solution to better build

their skill set. if they are interested in different prosecute motional opportunity within our departments that those opportunities will be presented to them. the team feeled constrained in the current w they do and often times the opportunity for promotion are within other departments. such as human resources and retirement. we want to make sure we are giving them equal opportunity within our departments so we don't see all that talent walk out the door. those are the responses to questions. >> i appreciate that and thank you very much. are they in our am results and expectations? are those issues somehow incorporated into whether a 1,

2, 3 or 4? i don't think we have something on staff's development we consider how that might be integrated and bring this forward at the november meeting. >> thank you very much. president carr i will -- make one more mention commissioner zvanski our tech team will call your cell phone to make sure your support is coming through. take a look at that phone and make sure she can join it. >> we hear her or does she have questions? we can test that out. commissioner zvanski if you want to unmute yourself.

you are unmuted we want to practice your sound. >> [inaudible]. unmuted now [inaudible] >> okay. i concur with my colleague and comments and questions. i wanted to support the [inaudible] [inaudible]. >> thank you. are there other comments from the board on this item? it will be coming become to us for endorsement in november. and our november meeting and we will see it posted make a little earlier than the rest of the board materials i'm not trying to put pressure on anyone. but the more time we have to see it before it is in the final

form the better. even if you want to send out a draft and this looks like the final, final last look do you have anything to say about it. might be helpful. could you do it in track changes. if that's possible. >> so, that's to ease the approval process. tell be approved. you know that. we are to a trash narrative format. this is the power point tell depends on communication's team ability to get haproduced in a timely way and so we will do our best to get approximate advanced copy to you when we do post it something you have seen. >> okay. >> that i think will be helpful to informing our decisionmaking around it.

so. again, thank you for your leadership and the all of the team who is participated in this process. so, with that, we will open it up to public comment. in person comment first and virtual. anyone in person approach the podium now. each speaker allows 3 minutes to speak. all public comments concerning the item presented. may ask questions but no obligation to answer. theory those on the line when i welcome you state your name but you may remain unanimous when your 3 minutes ended i will say thank you you will be policed back on mute. remote viewing on line using sfgovtv and web ex opportunity to speak are available by dialing 415-554-0001 then access code: 2484 203 8219 ## then press star 3 to enter the queue.

when you have been unmou third degree is your time to speak. for those on hold wait until you vehicle unmuted. we will begin with in person comment. zer over callers entered the queue the this time. reminder to all on the line dial star 3 if you would like to join for this item we wait then close for this item.

public comment is you in closed. >> thank you that is a discussion item we will move to item 10. and after that we will take a break. briefly. >> agenda item 10 open enroll am health fair and food clinic plan for 2022 for iary 2023 is a discussion item and presented sfhss chief operating officer and well being manager. why chief operating half guillen welcome you to our circle. and cycle. this is your first time through the hoop. we'll be here to support you in every way possible. know that. >> thank you, president scott i appreciate that welcome and members of health services board, again, ray guillen chief

operating officer we are prepare to kickoff the enroll am period are this year tell run monday october third through monday october 31st. each year staff come and provides you with 2 presentations related to the open enrollment period. the pifrpts i'm here to provide come prior to the kickoff of open enrollment to provide you with staff's goals for this year's season. the strategies that we devised for meeting objectives and how we tabled our communication campaign to support the genome it is the second will be provided to the health services board following the conclusion of the period and inform you from staff's perspective how well we achieved the goals provide you with summary of the changes by sfhss members made and review changes or lessons

learned throughout the process. >> during today's presentation i will go over the major changes for the plan year. run down of the communication efforts. specific plan related not transition of our medicare split families from blue shield to united health care and the schedule for the sfhss member services tome for the month of october. i will turn over the remainder of the presentation to our well being manager. who will walk you through the health fair and flu shot clinics. at the conclusion we will be happy to respond to questions the board may have. the change in this year's communication included re turn of in person health faris suspended during the pandemic. include a focus on introducing

sfhss members to the canopy hmo plan last year's period. let's than 200 members transitioned this plan last year. however much of health net's advertising around the city went unnoticed by members. most were still wing from home due to the pandemic. this year health net reduced promotiums to make the second most affordable plan behind kaiser and extended network and service areas. our communications will out lining what makes health net care different. like the alliance referel program allowing members to referred to a specialist in different medical group with kaiser the out of pocket max for senior advantage membersrous friday 1500 to 1 thousand dollars per individual. for vsp and wal-mart and samers

in network and allows member who is don't need eye glasdzs to use it to prescription sun glasses or blue light glass. delta dental see preventive service no longer count toward the member benefit. . retirees coinsurance for preventsive service has been increased to 100%. several changes made to services offered by united health care for retirees includes addition of personal emergency response system. think. i fall and i can't get up and -- the coach programs offer weight

loss, diabetes and nicotine susation. >> for 2023 employees able to contribute up to 28 in health care flexible spending accounts through payroll deduction up from 2750 of this year. changes to the long tomorrow disability and life insurance programs for mea members came out of the negotiation process. how to communities with employee system a question our team ask thejz every year. this season presents fresh demands many employees adjust to a mix of on site and remote work. the priorities of many workers changed during this pandemic. the open enroll am communications are chance to hoe

case our organization's values and help stem turn over rates at public agencies. thissier's staff decided the best way to navigate decisions go with the multimedia approach combines virtual tools along with the traditional printed communications that our members are used to. staff feels an approach ensures all members are reachd and array of communication preferences are met. the task is large. this year we will mail out over 76,000 printed packets. in the break goun down of the group system listed below. these packets are taylored for each target population the city of san francisco. municipal employees. city college. u nighted school district and retirees get a separate booklet.

they are accompanied with a personalized open enroll am letter that is even more customized in order to remind employees of the current collection everelections coverage and current and future premium costs. with the information needed for the medicare split family members the number of letters increaseed 21 versions this year. and in addition members are provided with reminder of the steps necessary to complete the elections online using our e benefits self service system. on the screen is our different versions of envelope sizes and designs.

a lot of us are check physical mail box. to address the need it is communication team providing virtual information and online tools. we have 6 weekly open enroll am e maims delivered starting the last week of september. >> we developed a dedicated website -- to serve as a hub for more detailed information. this year we are going virtual by taking all our open enroll am presentations online with the webinars on a variety of open enrollment topics and question and answer opportunity for

members. the big challenge by far was communicating to those members with split medicare families of the health services system decision to transition the nonmedicare family members from blue shield it united health care. that is communicated to the healing services board in june of this year the reason for this is it reduce the complexity of split enrollments for both sfhss and our medical plan carriers. the next is a graphic rep 7ation of the information we shared with the board in june. united health care created 2 new epo plans to match close low as possible the blue shield trio and access plus hmo plans for nonmedicare family members from a benefit and provider network

standpoint. in addition the premium costs for the 2 plans are set to exact low match the promotium costs for the trio and access plus plans for 2023 on the slide, the vast majority of blue shield trio members transitioned to the new doctor's plan. 7 trio members live in the service your that is not available in the doctor's plan and transitioned to the uhc select epo plan this is with we were upon referencing the network epo plan during our june presentation. as the result of the transition, they will be paying 37.79 more a month than they would are were to fall within the doctory plan service area. all blue shield access hmo

members will be transitioned to the uhc select network epo plan that network exactly matches the current blue shield access plus network. that is important to note and the focus of our communications to no. members is the doctor's epo network is -- small are than that of the current blue shield trio network. when we did an analysis of the doctors visited under the plan during the 12 among period the 48% ofs haved providers don't fall in the doctor's plan. in order to maintain their concern doctor choices blue shield trio hmo members may chos to move to the uhc-epo plan. again this will come at a

slightly increased cost. increase in cost of 37.79 per month for employees in employee plus one coverage. that was upon 3739 employee and the member in the split family mrans plans one no, ma'am member in a medicare [inaudible]. um -- the there is one family member enroll in the united health care medicare plan and at least one family member enroll in the nonmedicare plan. the vast major of those enrolled are in employee plus one tier it is one employee or one retiree

and their covered department, a spouse. and society difference in cost for most retirees their coverage is paid for by the employer subsidy well is a cost for the cost of that one department and for the one the difference in cost between the uhc doctor's plan and select network is 37.79 per month. >> this is a good draft. >> thank you. a lot of work. >> so we developed a comprehensive communication plan for the split family members postcard demonstrated on the screen is set to be mailed out on september the 16th. in addition e mail pointing these members to a microsite set up with detailed information is

set to go out after. beginning the week of september 19th united health care attempt to reach out call to each impacted family in attempt to answer questions they may have. close to the end of the year, blue shield will sends a claim information file for all impacted family members so they will assist with continuity of care issues. in addition, we are both providing detailed train to sfhss member services staff and. uhc provide teams with information to be visible to answer questions. for the open enroll am month of october our member services team will be available on

monday-friday in the office in case well are network issues with computer system. we be providing members through phone support and video during enroll am. hss offices closed for most in person service staff will be on site monday-friday to provide in person support for hss member who walks in. all hss members have access to self service through e benefits. if they choose members will be able to submit forms via paper through fax or dropping them off to offices or via u.s. mail. with that -- excuse me. can you tell me is there general i don't want to get to a detailed schedule broadly the hours the member services are

available? >> 8:30-5 or 4 or what have you. >> our call system is available 9 a.m. to 5 o'clock p.m. every day except thursdays which we open at 9. . 30 and for in person service offices available for walk ins beginning at 9 a.m. >> thank you. >> with that i will turn it over to kerry our well being manager present the remainder of the presentation. >> that was a great presentation cleared up what i was trying to figure out i know there am be a ton of phone callos this every time there is a change. blue cheeld will lose about 600 people or something to the other plans is that it is bottom line? nobody was in the city plan from -- from this group. >> so the uhc medicare plan is

available to our members that just have all medicare families enrolled instead plan or an individual on the ua c plan and nonmedicare on the blue she said trioreo or access plans and about 700 or so that will be transition said. none of the people were in th ppo plan? could be there department is the one with medicare. but the ppo mrrns in accomplice and so they would not be affected by this change. >> okay >> all right. >> and another question i had asked about was in the open enroll am material the left couple years there was no

mention of counseling. did not real lives they had that. it important to post it somewhere. the best under preventive care, so. that is something that we'll look into. >> great. thank you. >> all right. are there other questions from the board? at this on this phase of the open enroll am. if not we will go to only enrollment health fairs and food clinics. >> good afternoon. well being manager. it is hard to believe that flu is upon us again. this year has flown by. i will cover where we are at for flu this year again we have a strong partner ship with kaiser they will assist with our flu clinics this year. they will start end of this month september 27th is the

first clinic. and we run through november third. so last year we launched soon in september and able to continue that o. eligibility for our on site flu clinics the same aural active employees of 4 employers in addition to retirees and the spouses and domestic partners are eligible to get the vaccine at clinics. >> this year we expand to 24 clinic the peek was 20-28. we are slowly creepinglyum there. and those will knowledge facilitated 23 different work site locations. we have 8 open clinicless you may recall on open clinic where anyone has access to no restrictions you need a badge or work in that department. and the remaining clinics restricted or closed clinic. some of the major changes is we

are no longer having an appointment system. we seen an influx prior pandemic people dropping in we will have a controlled environment. people be safe and feel safe but not a booking schedule. and as rill e louded to wore excited bring back or healing and benefit fair. this year we have 10 faris had we will be providing with our flu clinics. so -- the first 3 slides that cover all. our flu location and benefit fares where you see you will finish in addition to the flu we have a benefit fair. general low what that means is we asked our vendors to be on site at the length of that time

to be available for member questions and just to support during open enroll am this will be opportunity for our e ap well being and member services to be on site to support members of the exception on this slide is the airport. we will be facilitating 2 fairs for them. they have their own site health clinics we don't facilitate flu shots for them. one additional thing i note this has been chinked in the last 2 days is one south vaness a huge performing location in the behalf pa and the mru shots we were informed they are not offering activities the next couple of years. we contacted our on site person over at 49 van ness the newer

building for planning. and the reallies division has honored the ability for us to transition that location from one south van ness to 49. we are in the process of u..ing all of our materials this is -- just a slight couple days late. but know we will make the changes where necessary. >> and that rounds out our flu and benefit fairs. how are you supporting asking on behalf of commissioner zvanski. >> i go out there every year i love going there a great place. and we have been able to supporting this location through the pandemic we work with kaiser. kaiser works and know our passion about hetch hetchy they have been able to bring out a

nurse each year and additionally with rey's support and mitchell in the past, we have been able to figure out what vender would be appropriate to attend that location. so that the members can get the questions than i needed answered. >> and are you at the flu clinics appropriated to do booster shots for covid? i'm asking because there is at least initially some understanding that you can get both at the same time. and so i'm raising that as a question. >> we are not planned at this time to do boosters addition to flu we have been in contact with dhr and some discussions they may have the clinic for boosters. are there other questions from the board. i want to follow up on this. thank you for bringingum the

covichld realize why they can't call it [inaudible] once the frozen viles are that youed they have to be used. approximate that day it would not work. this is an opportunity because well is good evidence from last year that the flu. shot dp booster can be begin simultaneously. but an opportunity to follow update, that i think in -- executive director yanty report this is that some of the healing plans seem to not have as complete information on their members. and for example there is a lot of interest in the boft they're can't be administers based on

current knowledge to people who have not completed the initialling immunization series. if they got 1 shot but not the second they are not a candidate for the booster with the 4-5. by --. they have to complete the first an opportunity to have a hand out or something to the those who appear to reminds them of covid and remind them for each healing plan how they can enter their own vaccine data if they have gone off side to another pharmacy or provider or whatever. but also reminds nel that this it is an issue and they need to follow up with this. may be some information on the healing plan how the members contact them or take their information and see the booster would be a good educational opportunity in the flu clinics i

understands they cannot be you have been -- off side giving a booster or the second or the -- series of vaccination. i would suggest that. we can work on having information. >> thank you. any other comments from board members regarding questions. we will open up to opinion comment. thank you for a comprehensive presentation. in person comment is first then virtual. in person prop now. each speaker allowed 3 minutes. all comments can be made concerning the item presented. a caller may ask questions but no obligation to answer. for those on the line, you are

encouraged to state your name clearly. i will give you i warning when you have 30 seconds remaining. then i will thank you and you will be placed on mute. remote viewing on goff got and web ex opportunity to speak by dialing 415-554-0001 then access code: 2484 203 8219 ## then press star 3 to enter the queue. whennure line has been unmuted, this is your time to speak for those on hold wait until you have been unmuted. we'll begin with in person comments. no one propped the podium. we move to virtual comment and moderator joined us and let us

know if there are any attendees in the public comment queue at this time. zero callers are in the queue. all callers on the line you must dial star 3 now if you want to comment on this agenda item. we will wait 5 seconds and close public comment for this item. there are still in caller in the queue at this time. thank you. hearing no callers public comment is closed >> thank you. this was a discussion item we are closed we will take a break it is now 2. . 47 we will reconvene at 3

o'clock promptly. thank you.

>> good afternoon. >> and can you lone in your microphone. before you i recommendation from staff the healing service board proposed revisions to the health service system member rowels and the section 125 calftoryia plan document for 23 plan year. each year staff reports to the board with revisions for operational chinks, changes in the benefit's plan urth exclude changes to keep the plan in compliance with new laws. we have a sum row including language with the changes in the plans offered to medicare families.

removal of language related operational practices that are no long are applicable. and increase in the flexible spending account limits for 20 tweet and incorpation of changes in benefits for members the result of the union negotiation process. charges proposed reviewed boy deputy city attorney and i'm available to answer questions the board may have. >> all right. i'm ready to entertain questions. and receive a motion regarding this next i move to approve the member rowel in section 125 out lined in the packet. >> second. >> improperly moved and seconded this we vote on approval for the revisions to the healing service system member rowels in section 125 cafeteria plan.

comments or questions regarding the items cited in this item? >> hearing 91 we will go to public comment. in person comment will be first then virtual. in person, approach the podium now. each speak will be allowed 3 minutes to speak. all comments made on the item presents. for those on the line when i welcome you state your name clearly. i will give you a 30 second warning thing i will thank you for your call. remote vowing on sfgovtv and web ex. opportunity to speak are available by dialing 415-554-0001 then access code: 2484 203 8219 ## then press star 3 to enter the queue.

when it says you have been unmutes third degree is your time to speak. for those on hold wait until the system indicates you have been unmuted we will begin with in person comment. and no one approached. we will move to virtual comment. and moderator will notify us if callers in the queue. we are 3 caller on the line. zero in the queue. reminder to all online dial story 3 now if you want to join public comment for this item we will wait 5 seconds then close public comment for this item.

no caller at had time. >> public comment is closed. >> all right. thank you. public comment is closed we are ready to vote on this item. roll call president scott. >> aye. >> vice president hao. >> aye. >> commissioner breslin. >> aye. >> commissioner follansbee. >> aye. >> and commissioner zvanski. >> must be having difficulty. can you see her. >> we see her i will unmute. if all sails give a thumb's up or down. >> hang on a mobile home. dmrn zvanski you are unmuted.

verbal thumb's up was begin. >> agreement >> motion passes um unanimously. >> commissioners zvanski we will put you have you mute yourself -- so we can proceed. >> hang on a second. i can't unmute you have me muted i think. no. it hells me i'm muted by the host. we can hear you clearly. if you are. [laughter]. i will over ride that exactly. we will bring back in for the moment we will have that mute go on.

all right. thank you the motion carries unanimously we will move to item 12. >> agenda item 12 is the 2022 department eligibility verification audit. an update and discussion item and presented by rey guillen chief operating officer. >> again rey guillen. this is provide the board with a feign update to the 2022 department eligibility verification audit. this is the voluntary compliance a plan's rowels to departments enrolled in the plan the purpose of a diva is to identify departments that should not be covered control the cost. the last diva that entire

population in 2018. using an external vendor. the initial plan was to audit a third of the pop laling the actual population size was department on finding an outside vendor on configure the sales force management system. to allow for members to up load the documents nodeed verify department's eligibility. unfortunately rfp did not prowse firm that could sufficient low meet the techical >> reporter:s. straf determined to transition to a pilot audit 611 retiree who is are not previously audited in 2018. this diva was planed run may through august of this year. similar to the communication plan developed for open enrollment staff decide the best way to community to targeted

retirees to let the modia approach letters, step by step instructions, web page, phone support and a video. although we were not able to modify our sales 4s management system to allow members to up load the verification we were able to modify our e benefit system to allow retireeos up load verification documents online. although it was not an i deal solution due to system limations we wanted to see hapercentage would utilize a tool if begin the option along with faile mail and fax. the diva project plan included mailing up to 4 separate letters to member who is had not responded with the required verification prior to disconditioning their dependents for noncompliance. in this is a graphic rep 7ation

of hat letters locked like of letter number 2 did have different versions depending on whether or not person attempted to comply but was unsuccess ever or whether they did not respond at all. next slide. we used a pink envelope for this to hopeful low attract recipients attention. a lot of the members are less used to checking mail frequently. all of our communication pointed members to a web ping a hub for more information. and this just displays the print and digital compossiblies of the media approach of this project >> in addition we made recorded webinar available to members and instructing them how to isenroll

departments and how toup load the documentation via e benefits. and knowing everyone has their own communication preferences we have a vo to introduce the project to the members. show that to you today in a few minute in length. [music] can't get those on zoom. [inaudible]. it has been a long time. especially my marriage i was not

going it bring that up. i am still dealing with the divorce. well is so much paperwork and the san front health service system is auditing mow now. you mean diva? >> what? >> diva department eligibility verification audit. sfhss check to see if your powerhouse or partner is eligible. >> i guess that is what it is. don't worry they conduct audits at right-handom cross the entire member population. how do you know. i got a letter from sfhss a few years ago and after connie and i filed for our declaration of domestic partnership with the city and thank you they were picking on us so a called them. >> it turns out it benefits the

members. ineligible members not dropped our promotiums pay for their health care. that's not fair. after i submitted my eligibility documentation, it ensured that connie stayed covered. had i not responded, she would have been drop friday my healing coverage. >> they ask mow for a response. >> what do you mean? i got these 2 letters from them. you carry these around with you. >> paperwork is my life now. don't ignore this. the do you meanation they are asking for to verify the eligibility is simple it find. for unmarried couple or qualified domestic dependent it is the first 2 pages of their particular return and redact

their social security and financial information to protect privacy. so for connie and me i paid them our lease agreement. we could have used our shared mortgages statement. autoinsurance statement or a joint credit card statement. just one of these document sns >> just one and well is a deeper list of documents included in the first letter or download it from the sfhss website. the website has the information you need on how to respond to the audit. once you had your documentation you just go online and up load a copy of it or submit it by fax or mail. what if i ignore all of this. if i don't respond they will drop all my dependants. right. dropping now has no cost but if

you don't there could be consequence and you are following the health service system member rowels. gather your documentation and submit it. it is easy. >> okay. part of being an adult i suppose. >> well, you should be used to it the next stop is retirement. don't rush me. i want to eat my tart. [music]

>> to the results. the population of that audited increaseed sick there are with retirements. of those, 14 removed because of the family's status had changed. if they had a domestic part merand got mered they provided the marriage certificate and so they were remove friday the adit. at this upon point and catch up gentlemen in the future. 6 where are 1 success and 19 in termination. it was an a heff work load to go

through the process. we learned, lot in the work load 668 inbound calls related to the diva. and in addition staff made 331 out bound calls to members. and the list of different types of letters issued is listed on the slide here but again very labor intensive press. but we saw results 19 dependants were terminated and that is a result in annual savings. the savings from this audit would be about 86 thousand dollars. in terms of comparing to the first or most recent audit in 2018 of the entire population that result in the substantial savings of 2.8 million annual basis. in terms of when we learned, we

did learn that you know future divas of any size would require an automated system solution like the one we had previously pursued. we are planning to issue another rfp it get a vendor to work with our sales force system to accept the documents. and that really helps once the documents are up loaded than i are leverageed a member account. when document received via e mail or via mail or fax staff members have to research and link the documents machineualy with increases the work load. we did learn a lot about the audit process. we learned that there is a lot more versions of the different tax documents than we thought.

there are certain versions or visible to members that increase the front size and so the lesson learn thered we asked for the signature page which is page 2. if you increase the font size it push its it page 3. it increased the number of calls with each the lessons we learned will be in i better position the next diva to include that type of information in our communications. the other lesson we learned it is a labor intensive press we audited 6 34 members with 668 calls often times they have more then and there one question. for future diface, the initial

thought was we could get through the entire membership but edit knowledge a third each year. that would be about 8, 950 members each year. we would not be able to sustain that without additional staff. when we think of going forward and reasonable measure be to measure 1 fifth of population each year we cycle through every 5 years that would bring it down to 5300 members. i think with the given staff that is a number that we are able to sustain given the fact we have the lessons learned we incorp rit in the future audits. so, again, we will pursue vendors to make the chaefrnl and witness this is successful low done we will plan to kickoff the next audit process again for 1/fifth of the population.

>> are there questions. >> one. members when fail to responded are they terminated then? >> yes. we did -- for members this did in the responded we did try to make out bound calls and sent them up to 4 letters. but if we did not hear from them their departments were terminated. >> okay. other questions? in the virtual world? i think the group for a weby. [inaudible]. [laughter]. i remember the last process and it created anxiety and an amount of hostile responses. i wander how your staff dealt with all of this? was the because, the left process was sort of pretty new

to many of our members. had not bn done this organization for arc while. hopeful low they had a preprepared your video was excellent. how did the staff feel about their own interactions with the membership and the morality issues whether it was all good? >> we did have a dedicated number of staff dee dealing with the audit process and not all member services focus attention on this project. we did provide training to those staff members. but it was a learning experience for all involved. again, we are only educating the members and the staff. it was a learning process for not only the member services but also our member services manager. and myself. and so -- i would say that you

know -- with the number of calls that we received and the number of calls we had to make the work load was overwhelming from time to time. but again we worked through it and you know staff is very resilient and once we provided the trinning and worked through the issues together. i think you know staff were feeling very accomplished the end of the project. it was designed to being a pilot and if not designed to find those bumps in the read we will have to work out for next time. you know i think, staff came out of process feeling appreciated for management listen to input and also for the learning experiences this we went through together. >> okay. i like to thank the staff for their w on this. testimony is a big deal and an

personal task. i wanted to thank you and everyone involved in this for your diligence and the learning that happened. >> okay. >> any other? >> [inaudible]. commissioner? [cannot understand speaker] >> commissioner zvanski the audit we went through was all retirees. for the target population for this pilot project we selected 600 retirees not audited through the 2018 diva. and so these were nower retirees that -- that previously did not go through the process. gwen all retirees this time. >> and -- as you look forward

to 20% of the population is this a mix of activists and retirees going forward. >> we have not made that decision it might be easy for staff if we focus on one population and did actives and worked through them then the retirees for ease of training and -- question this is we think is better to focus on one population. >> and to be sure i understood this you are saying given the scope of the current -- project you were not able to get anyone to bid on the project? is this right? >> released an rfp and received 1 response but that bidder did in the meet the specifications of when we were looking for.

we will do a better job in out lining the services we need and rerelease that rfp with hope of us having better results. >> idea this external service take on the full project or just phases of it? >> specific low when we are looking for is a programmer to dm in come work with our sales force customer relationship system. a system this holds our member information and trans lays our member informationo we note the calls we receive and what we want is that system to receive the up loaded information from the members and, tamps to each member file so we process it from there. and don't have to go through the task of scanning each document in reand to a member account. >> all right. >> it is a technical.

>> support. >> versus the 2018 we used external vender. >> our intention is it do this in house using technical capabilities that are provideed us with our current system. >> thank you. >> other board member questions. we will are public comment on this item. >> is there anything this guess out that kind of warns people. listen, you know -- don't do this or -- you know -- whatever. i mean people may think that than i are doing the right thing and i don't know, i was thinking. is it irrelevant spelled out what makes -- so far you will of the member -- again we have the member rowel and again in the plan documents that we produce

including the plan guides and open enroll am materials it listed who is eligible and will who is not. we feel we do a good job in know explaining who is and not eligible. you know with the depennants it easy to forget if they are going through a life event such as a divorce or enroll am in health services system is in the top prior at that time example with the projects we do state the purpose of the project and then gwen out lines who is eligible for enroll am in our system. >> okay. >> [inaudible]

>> commissioner zvanski. it is in the working you are bracking up again. and i have in the understood what your comment is. i don't know if we can assist you further. we i could not understands that, i don't know if anyone in the room could. so. we are sorry at this point we are to get the techical people back to you. all right. hearing no other comments from the board we will take public comment on this discussion item.

>> thank you president scott in person comment first then virtual. anyone in person approach the podium now. each speaker allows 3 minutes to speak. all comments concerning the item presented. a caller are miask questions but no obfwagz to answer. for those on the line you are encouraged to state your name clearly. i will give you a 30 second warning. then i will thank you for your call sdpu will be placed back on mute. remote viewing online sfgovtv and web ex. opportunity to speak during comment period are available by dialing 415-554-0001 then access code: 2484 203 8219 ## then press star 3 to enter the queue.

we'll begin with in person upon comments. now virtual comment are there callers in the queue at it time? we are 3 caller wherevero in the queue. dial star 3 now if you want to comment for this item. we will wait 5 seconds and close public comment for this item. there are in caller in the queue

at this time. >> thank you. hearing no further callers issue public ment is closed >> thank you that will be you will for this portion of the item. thank you again cho operating officer for all of your participation today. we will go to item 14. i believe, sorry 13. the contract fitsical 23 to 24. this is a discussion item and will be introduced by abbie yant and presented by michael visconti. thank you we'll here to actual the press we will use for selecting the actuary that will service sfhss beginning in july of next year the current

existing contract expires at that time. i will have michael and describe the process that we use, this is the contracts that is anymore in the your terms of references you must approve. we want to give you a head's up on the process so this you will expect us to be bring thanksgiving recommendation forward in the near future. >> thank you. >> thank you. >> and good afternoon president scott and vice president hao and commissioners breslin and zvanski and doctor follansbee. so, this introduction will be brooefr this press will go over 9 months will proper, history and become ground why we dot rfp's and the spoep of the service entail in the this itself. i will conclude with the

schedule and process. and we will open for questions and discussion boy the board. director yant said in the healing service board terms of reference the selection of venders section 26 the board rescue noises it neither effective or efficient for the board to be involved in the selection of all prosecute voiders the bhoord will be responsible arc proufring of foible contracts for following primary service providers. the first being act iaries. service providers you see include planned add administrators. investment advisors or technology service providers. it is important not with all of the other we have an expert panel that evaluate the proposals received. we take that a step further and present them to the board so you

review that analysis, review and our recommendation that is up for prove for the board. that will occur later in the process approximately 7 months from now. that will give us time to normality the contracts with that vender if approved. and that is beginning on july 1 of 23. this will be the third time in the last 11 years we had a competitive prosecute curement with these service the first in 2011. done in partnership with the controller office. there are's for services, our scope of work for health benefit consulting service this is lead us to the rfp in 2018. we did this independent low of controller's office focused on service provided to the healing

service board and system. with that process as we replicate here we selected a panel comprised of members of our team and executive members were senior managers from the controller's office and the retirement system. all with expertise in financial matters or health benefit consulting matters irrelevant voluntary to the scope. >> as with that process and we will do here we took the expert evaluation panel. presented results to the board. this board discussed, have made a determination that allowed us to prosecute seed with a condition tract for that service vender. in this case we selected arcon at that time. they continue to be and the scope of that rfp detailed in 5 year term. now, this is important concept to consider. the furthermore after rfp's

allow us to detail the nodes and the board and gauge how well each vender understands this scope. they help to ensure transparency from our department and show the public and members that sfhss and the board a counselable for selection and the services they perform. the scope of service is ebs tensive it important to cover some many help in front of the board and behind the scenes and support helling service system, this board and members daily. the key service include auditing and analysis. relying on expert eves our vendor. the critical rate and renewal

process is paramount to the scope and assess am of trends, delivery models, pharmacy and evaluating under writing that are critical to the conclusion of the rate's process. you know from this doing this yearly this requires a quick turn around team and team of experts from the team. we know well is a very short president of time upon had this board makes the determination and guess to the board of supervisorings in this packet is co component of the scope of service for the actuary. other work is supportive and evaluated in revowing the work by sfhss. the 10 county suri have done by finance under the leadership of our cfo and with the exceptional w boy work by [inaudible].

key aspect of the w is in the just the reporting we do every year. but often the ad hoc reporting necessary to support the needs law the daily intraekzch interactions with members or presents here before this board. and often you will know from our experience here you will see member questions. clinical trends and items we had no idea how to predict to covid-19 pandemic. we go on to rely on our experts out of aon to support us in a necessary review and evaluation of those requests. nought and he had press. it is i press we have been through before we are giving

more time. now in this discussion we present for the board the process the reasoning behind it and requirements as we discussed in the healing service board terms of reference inform november we again present to the board and begin when many. you are familiar with a communication blackout period ask for prove part of that. that will dovetail with the communication blackout period with the knowual renewal process. when we release it we will do that in january of next year. that will give us time for this rfp to be reviewed by venders responding to and have a bhd they will be able to ask us questions. again. this is all done public low. we post the clarifications and questions to our website and then witness we collect the proposals they go to the expert evaporation opinion. this upon is important part of the press we take serious low

that expert evaluation opinion must have expertise in the areas this scope covers. we make sure they sign nondisclosure agreements and agreements confirming than i have no intention of being in any way unbiassed. objectivity co in evaluating the proposals. they take the proposals, review them as a group over an among to 6 weeks giving time to review the number of proposals that come in. part of that process is this we are not reviewing the large entity in the case, we are reviewing the team members they are presenting to us that will be servicing san francisco health service system and the board. we will conduct as we did in 2018 oral interviews they will be required bring member and

other key merit experts. this allows you to make sure they are bring the a team. we present them with the circumstances similar to huf how they serve the board. upon present them with questions and meet as a team, discuss the questions in full view of panel and present the responses to us. which is an excellent way to test whether or not they are up to the task of servicing us and our large member pop ligz and their needs which are diverse. if approved bite board we will be able to prosecute seed to contract with them. something i should note is this this in no way will present or restrict the ability for the vender arcon to provide the

services they do provide for us. any communication blackout is limed services for the new contract. healing service benefit this is extend to plan year 2125 this will not inhibit the renewal process nor the processes with the board or board of supervisors. this press is done to be trans parent. and ensure done in unbiasd and onjective manner. that extends from the unauthorized communication period this begins in november of this year and will extend all the way through selection of this evaluation panel. requirements they sign agreements. and ensuring we keep the entity and identities confidential until the conconclusion of the press to make sure there are no

communication with any members of the panel and anybody a vender or representative and gwen this is to ensure this process is done if the highest standards of the san francisco health service system policies will and the city of san francisco. all right. with this i will open up to discussion and questions from the board. >> are there questions by board members? >> i would just -- go ahead. i ask this one. become on the schedule. and i will not ask to you bring this up if you can quickly that is final. you indicated that there is a period where well is a time for clarification bypass venders of the rfp. you said this is open. how open is open do you mean open? >> open in the sense we require all communication to be in

writing all communication will be init wroog to us only to the contract's department and everyone of the questions is not only answered by our division but we will post everyone of the questions regard manslaughter of the person who asked the question and this goes on the website. in addition if there is an e mail to us, we e mill it to them with the posting on the website so no enity gets advanced notify answer and kept on an even play being fold for everyone. why is there a phone conference call for perspective vendors i know sometimes involved in rf p press this is happens y. in 2018 he had a conference call now we are well versed in web ex we will continue to have this process. it is an excellent way for us to at the beginning of the press a

week or 2 after we released the rfp to have them introduced to san francisco health service system and speak public low to what our intentions are the time lines and the open for questions. i should mention the that call questions may be submitted orally we river them to submit them in wroiting after this call to which comply with our requirement of all communication in writing. more over we records that meeting that is also posted our website in case someone was unable to attend. you advertise this call was going on so a member can could call in and be a part of it to listen in? >> absolutely. i think we had over 50 on our 2018. call. >> all right. >> thshg. thank you. . >> how much. weight does the what they charge -- when you chos choose a

vendor? >> when we do is we are transparent when it miss to our scoring rubric and what we will use on a high level. did this in 2018. there were yours we say specific yours of scopes worth 20 percent. processing worth a specific percent knowledge we don't like to guest too pacific we want it to be balanced scoring if i include the processing was worst 90% of the total scores you would have respondents that may spendsings time on the rest of the substance and put a low ball offer in there. we want the best service we have a balanced scoring roubric. we don't want to surprise anyone.

do they get raises annually? >> so this is a great question. in 2018 we asked for we want to haves we did the 2020 meg plan we want to know for budget when future costs will be. we asked part of the rfp's to give us guaranteed costs including i percentage increase for the first 3 years of the contract. following the first 3 years we have 2, one year options to extend. that's how we came to 5 years and mirror that are with this one. we negotiated with them based on the prior 3 years. >> thank you. >> are there other questions if board members. you [inaudible].

come from within the city of san francisco gentleman. and [inaudible] or outside or [inaudible]. >> great economy commissioner follansbee. our panel in 2018 and mirror a similar kruck. one >> reporter: this is a recommendation in chapter 14 of the code make sure no more than 50% are members of the awarding department. in san francisco service system we have our own policy and procedures and keep a stricter standard we require that. in 2018 we had 5 panel members. 3 of then from within the city. they were experts subject matter experts. tw from the controller one from the retirement system the other 2 members were from san francisco health services and one had not become a member of the know front hang service system at that point.

we were even more add herrant to no more than 50% rowel >> how many are on the panel and joo we have in the determined a toll number but if our historically we include usually 5 members on the panel. if you look at health plan rfp we have 6. we went with low and 3. and i would not -- that is a manageable number but not so narrow anyone member has too much influence overnight recommendation before the board. >> yes. will be difficult to keep the panel. clean. >> no we have done this many times. i know. take it seriously and want to make sure this panel accurately reviews the principles and has the subject matter expertise and presents this to you. >> better from audit san

francisco. >> we are planning on doing that. absolutely. >> what is our vetting process. our vetting process part of that is as we did with the prior rfp ensure that have the lest of expertise similar it requiring to submit their cv like aion application. we will following up with them if there are yours we are concerned about and make sure every area of the scope we understand we will not find an act iary and consultant cover every area of scope. our aon team requires a slew of individuals. we make sure our panel can cover everything within that scope. and we double check that if we have questions we don't include that person on the panel and include someone as a backup similar to a your that is

empaneled for a criminal or civil case y. how do you recrew for the panel? figure out how do you recrew for the panel? do you, do you how do you look? for us we have a wide network and our department is full of people who have connections with other department and third parties. you notice from the health plan rfp in 2020 brought in the formy chief medical officer of cover california the breadth of the expertise we have and networks allows us to pick if i large pool in determining the opinion. this process is in the context of administrative code in the city. which has been rigorous low reviewed from a legal and ethical stand point.

i would expect welbe with requirements and had in the be a question by a member of this board to whether or not the panel would be slanted. i'm serious that is what i put oat table and sure michael and abbie as the executive director will be adhering to that. >> absolutely. thank you. are there other questions from the board. if not we will go to public comment. on this item. >> thank you president scott. in person comment will be first then virtual. for anyone in person prop the podium now. each will be allowed 3 minutes

to speak. all comments made concerning the item presented. a caller miask questions but no obligation to answer. for those online when i welcome you state your name clearly, i will give you a 30 second wharng it has ended i will thank you and you will be placed back on mute. remote viewing on sfgovtv and web ex. opportunity to speak are available dialing 415-554-0001 then access code: 2484 203 8219 ## then press story 3 to enter the queue.

we'll move to rirtual public comment. are there callir in the queue at this time? we are 2 callers on the line. you must dial story 3 now if you want to join comment for this item. we will wait 5 more seconds then close public comment for this agenda item. tlur no caller in the queue at this time of the >> thank you. public comment is closed. >> thank you and thank you michael. for your leadership in this area. continued leadership.

thank you, president scott. >> so we will now move to item 14. >> thank you president scott item 47 report updates from condition transacted representative this is is a discussion item and any reps can prop the podium. >> are there planings representatives in the recommend? this raise your hand. >> no. why curious. >> i'm looking out and i don't know because of the masks who are and are not. there are plan representatives in the room there. no plan representatives approaching the podium this i see at this time. >> we have representatives online but no one raised their hand. why all right. that being the case is there any public comment on the noncomments from the [laughter]. from the planned representatives? >> we need. i don't think we have to go through a nonpublic comment

comment. correct. why we will move to item 15 which is adjournment and i declare this meeting of healing service board, adjourned. learn

it across the city. [♪♪] the tenderloin is home to families, immigrants, seniors, merchants, workers, and the housed and unhoused who all deserve a thriving neighborhood to call home. the tenderloin emergency initiative was launched to improve safety, reduce crime, connect people to services, and increase investments in the neighborhood. >> the department of homelessness and supportive housing is responsible for providing resources to people living on the streets. we can do assessments on the streets to see what people are eligible for as far as permanent housing. we also link people with shelter that's available. it could be congregate shelter, the navigation center, the

homeless outreach team links those people with those resources and the tenderloin needs that more than anywhere else in the city. >> they're staffing a variety of our street teams, our street crisis response team, our street overdose response team, and our newly launched wellness response team. we have received feedback from community members, from residents, community organizations that we need an extra level and an extra level of impact and more impactful care to serve this community's needs and that's what the fire department and the community's paramedics are bringing today to this issue. >> the staff at san francisco community health center has really taken up the initiative of providing a community-based outreach for the neighborhood. so we're out there at this point monday through saturday letting residents know this is a service they can access really just describing the service, you know, the shower, the laundry, the food, all the different resources and referrals that can be made and

really just providing the neighborhood with a face, this is something that we've seen work and something you can trust. >> together, city and community-based teams work daily to connect people to

>> shop and dine in the 49 promotes local businesses and challenges residents to do their business in the 49 square files

of san francisco. we help san francisco remain unique, successful and right vi. so where will you shop and dine in the 49? >> i'm one of three owners here in san francisco and we provide mostly live music entertainment and we have food, the type of food that we have a mexican food and it's not a big menu, but we did it with love. like ribeye tacos and quesadillas and fries. for latinos, it brings families together and if we can bring that family to your business, you're gold. tonight we have russelling for e community. >> we have a ten-person limb elimination match.

we have a full-size ring with barside food and drink. we ended up getting wrestling here with puoillo del mar. we're hope og get families to join us. we've done a drag queen bingo and we're trying to be a diverse kind of club, trying different things. this is a great part of town and there's a bunch of shops, a variety of stores and ethnic restaurants. there's a popular little shop that all of the kids like to hang out at. we have a great breakfast spot call brick fast at tiffanies. some of the older businesses are refurbished and newer businesses are coming in and it's exciting. >> we even have our own brewery for fdr, ferment, drink repeat.

it's in the san francisco garden district and four beautiful murals. >> it's important to shop local because it's kind of like a circle of life, if you will. we hire local people. local people spend their money at our businesses and those local people will spend their money as well. i hope people shop locally. [ ♪♪♪ ]

please stand by for san francisco, budget and finance committee. >> good afternoon, the meeting will come to order, this is the september 7, 2022 budget and finance meeting. i'm supervisor chair of the committee. i'm joined remotely by supervisor asha and unfortunately suspect will not be able to join us today. mr. clerk, do you have any announcements. >> clerk: yes, just a reminder