(coughing) (gavel) good afternoon, everyone. >>

>> welcome to the city and county of san francisco health services board meeting this afternoon at 1:00 pm., thursday, september 12, 2024. would you all please stand and please join me in the pledge of allegiance. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. >> thank you. we'll take roll call now, please. >> a 2 starting with president hao present. >> vice president zvanski present and commissioner cremen present and commissioner dorsey present. >> commissioner howard present and commissioner sass and k34i8z we have quorum. >> thank you next agenda

planner, sfhss plan representatives from kaiser permanente, health net, and blue shield of california. remote viewing a loud and the health service board public preparation and an opportunity for the general public comment on as well as an opportunity to comment on each agenda >> public comment: in-person. for anyone waiting in the room, approach the podium now. you have up to 3 minutes to address the commission. >> all public comment will be made concerning the agenda and a caller may request questions but not requirement to give me in public comment and members of the public

the public attending the 415-655-0001 and then enter access code 2661 444 1531, then, enter webinar password: 1145 then press *3 to enter the public comment queue. please wait until the spark calls on message says, “your line has been unmuted,” - this is your time to speak you will be muted when your time to speak has expired. tax-exempt to speak has expired. tax-exempt to speak has expired. tax-exempt to speak has expired. tax-exempt to speak has expired. tax-exempt

to speak has expired. tax-exempt anonymous. you will hear an audible warning when you have 30 seconds remaining. when your 3 minutes have ended, you will be placed back on mute. thank you to sfgovtv for sharing the 3450e89 with the public begin with in-person and opt for the. >> the moderator will notify us of callers at this time. >> board secretary one caller has specifically entered the queue at that time and you'll hear a brief silence as we transition into callers and unmuting the first caller now. >> well caller welcome caller. >> good afternoon. i'm richard and i want to when i retired went to the board

meeting but nothing it going on at kaiser they're getting (unintelligible) a couple of transportation um, why you have to make a rise vacation 3 days in advance i needed to get blood initially a day or two you don't need a approximately accommodations or an uber or lyft you should be able to call a day or two they want to save money. and you need to talk to kaiser about that and the other thing is need to talk to kaiser whether getting the flu shots in the san francisco i'm not going there, there are places able to handle large crowds like they did behind target i live it thirty blocks and i'll go to

daily city you can drive there and i'm disturbed you're - i took family members there and would drive from san francisco to sean leandro that was a good place kaiser employees there. who take care of you not somebody like didn't have with the near san francisco physically removed in the middle of night if you fell out of bed if you negotiate with kaiser to find out why they are making the changes. i mean the doctors are. okay. they're keeping me alive but you need to find out why all stages are going on kaiser and those are, you know, we're a big

- um, we give a lot of money and service to kaiser i think you sunshine they should listen to us and you can have a report from kaiser why those changes are are not helping the patient make life a little bit easier for the retirees. >> thank you. >> thank you, caller i realized the sound is very faint the transcription will be able to provide specific language and i'll be calling the support sometime. >> >> the moderator will notify us of callers at this time. >> board secretary there are no other called in the queue at this time. >> thank you public comment is closed. >>. thank you. >> next agenda item mr. >> >> 4. approval (with

possible modifications) august 8, 2024, health service board regular meeting minutes. presented by president hao. >> colleagues, we had the minute in august if you had a change if any q's if not i'll entertain a motion to approve the minutes from the last meeting. >> second. >> i need a motion. >> yes. >> you make the motion. >> i make a motion to accept the minutes. >> been moved and seconded and take public comment. >> public comment is on and the instruction on the creep for sfgovtv and webex

“your line has been unmuted,” - this is your time to speak you will be muted when your time to speak has expired. we'll move to the remote public comment and. >> the moderator will notify us of callers at this time. >> board secretary we have one caller on the phone line that entered the queue at this time. >> thank you moderator for confirming one caller on the line by no hands have been raised with that public comment is closed. >> and competing against our lively hss. >> next item, please. >> 5. president's report. (discussion) present by president hao. >> excuse me - we didn't ask for a vote. >> please a vote on the

minutes. >> roll call with president hao. >> vice president zvanski, aye. >> commissioner cremen, aye. >> commissioner dorsey. >> commissioner howard, aye. >> commissioner sass, aye. >> commissioner wilson. >> thank you the minutes are approved unanimously now proceed for agenda 9. >> 5. president's report. (discussion) >> you have a couple of items first abby will speak about the news is out she'll be retiring on the executive director so not yet we have her for a couple of more months we're going to holiday on to that and in order for us to prepare for they are departures and we started with the human

services to place an rfq or request for a proposal for and new executive director search firm to conduct the selection of our new executive director. >> so the rfq has not been posted. um, by once it is post will be out for a couple of weeks and then hopefully viable applicant for this role and we'll be working closely with them to um, with the recruitment firm selected to develop the recruitment broesh and the qualifications for abby successor so more news will come with that and - but also along those lines i prepared a memo a copy is available and i'll read that out loud so it is a memo from me to the health and human

services and the subject is in-home supportive services executive director an awesome opportunity to select the next executive director 6 in-home supportive services over the next few weeks and with partners within h.r. and to guide us in celebrating the best executive director candidate please be prepared as fellow commissioners to be called on victimized for a input and informed judgment as commissioners of this board and thank you to work on the task and glad you'll be in the process together to get starred i have requests. one, that you commit yourselves to the transparent process we hold this and two, you understand your work would be subject to all public meetings and disclosure

requirements, and deputy city attorney will be our guide and counselor and interpreter what we must do and 3, the board secretary be the sole source of distribution of all materials working with our assigned consultant in dhr and four, once all communication with the search firm be communicated through me and the board secretary and the dhr consultant and though make sure the guidance is focused and finally number 5 you feel you're unable to abide by the requests tell me we can have resolution of concerns we have a big undertaking but glad and excited to be doing this i think the last time we found as abby executive director we hope there

are um, more like her out there for us to select from so - and the secondly, i failed to give an update they last meeting but have an opportunity to do training. and so at the end of july in boston it is on public plans administration so it was being in school for 4 days so kind of - hot and humid weather and lots of (unintelligible) a great time we talked about the administrations and strategies for that and also their the responsibility the gambit we regularly talk about and my fellow commissioners, if you've not had a chance i ask you look at this and have memberships based on the roll as

commissioners on the board so and it is what it is. >> one comment they have courses and really great guidelines i will courage and gone to a number of them over the years and i was strongly courage my fellow commissioners have an opportunity to take a course with them and definitely do it you'll learn a lot. and they make i stay for the whole class. >> they do? >> you, you can't sneak out you don't get credit until in any scion you're ticket at the end. >> (laughter) and so, thank you. >> i guess open up for public comment. >> open up for public comment

and instructions are displayed and in-person followed by remote and those callers on the line press star 3 for those webex begin with any public comment. >> no one has approached the podium. >> the moderator will notify us of callers at this time. noting we have adjusted the volume so is for concerns. board secretary we have two callers on the phone line and zero queue callers public comment is closed and (laughter). >> no news is good news oh, next item. >> 6. vote to whether to cancel the october 2024 health service board regular meeting: (action)

presented by president hao. >> that's okay. that's okay. >> so colleagues, we generally cancel the october board meeting because of open enrollment and to prepare for materials for our meetings. and so shall i make the motion. >> please. make the motion we cancel accountant 24 regular board meeting in reference to open enrollment to support the staff. >> i second that motion. >> all right. so properly moved and seconded and any public comment. >> public comment is not open and instructions are on the screens for sfgovtv and webb exhibition and in-person will be

first and callers on the line press star 3 and for those watching webex. >> in-person public comment. >> no one hesitate and. >> the moderator will notify us of callers at this time. >> zero public comment on the queue. >> public comment is closed. >> with the roll call vote. >> yes and starting with conveys, aye. >> vice president zvanski, aye. >> commissioner cremen, aye. >> and supervisor dorsey, aye. >> commissioner ward, aye. >> commissioner sass, aye. >> a commissioner wilson aye. >> thank you. >> so we will next month see our next scheduled meeting no

november all right. let's see the next item. >> 7. director's report: (discussion) will be presented by abbie yant, sfhss executive director. >> yeah. that's great. >> yes. good afternoon. commissioners my director's report. >> started with the news has been stated that i (bell ringing) plan to retire in the last working day will be november 14th a between or explain seven years an honor and privilege i worked at the heat department in 90 and came back. it is really been a delightful experience and talking to supervisor dorsey earlier how that i put my career will culminate in a position i was well prepared to the for the job

find someone with a background may not be possible because - >> sadly true but i'm certain there are people that have great leadership skills and continue. so thank you and we'll be talking more maybe a board meeting in october to initiative the recruitment and the process and you'll be hearing from holly to try to get everyone together. so that may occur. and the um, life and disability request for proposals you heard about last month as planned that is good news the healthcare fibrillator board and advisory committee i sit on i noticed them i was

retired and made it clear i didn't need to be employed to finish my term (laughter) been an amazing experience and my clerk and we are scheduled to cidar down and talk about the proposals complexity of what they're trying to do that enormous so it is to understand what is going on and is a cherry and will impact us over time. >> the department you'll hear from the department we have a new senior clerk it joined the finance team she's not in the room but maybe watching well connie and one employee left for better opportunity in the controller's office and he's

been served temporarily as board secretary so talented individual we'll miss him and we're working to replace them or him and a few recruitments underway you'll see list is shorter that would be great and h.r. consultant will have anymore time to debilitate to support the director and operations- in our packet and that concludes the director's report. >> any questions? >> i have a request under the law. thank you very much for your years of service it will be hard to replace you but also i request - change the title of one of our employees. um, categories right now brought up by one of the members dennis

corresponding early retirement employees i agree it is misleading people share years working with the city and consider retirement didn't makes sense and request that um, the membership name about changed to premedicare between 465 and retire before their 65-year-old. >> not all of employees qualify for medicare? >> so that's yes - >> okay. >> fire? >> yes. >> so - i have a little problem with the turn around i'm proud to say we're using the

material for medicare so that works for our system and it is little late to get it into the materials we have this year their in the printer but chris to have seen was supportive so. >> non-medicare fits. >> that's right. >> thank you director. >> yeah. >> any other questions or comments. >> a public comment open up for public comment instructions are displayed on the screen and in-person will be first fold by remote public comment for those callers on the line press star 3 to be added to the queue and

we'll begin with in-person comment and no one has approached move to the. >> the moderator will notify us of callers at this time. >> board secretary we have. >> board secretary we have to callers on the phone line and zero have entered the queue at this time. >> thank you moderator with that public comment is closed. a was there - >> commissioners nancy was encouraging the speakers (laughter). >> with that, public comment is closed. and like come on down. >> all right. >> thank you. we'll take the next item, please.

>> 8. sfhss financial report as of june 30, 2024: (discussion). >> welcome. >> good afternoon. >> all right. (unintelligible). >> before the light goes off (laughter) so we were actually the results for june preaudit we're still working with m go and it is going well. so members should hold this is the year but we were concerned about the experience last year um, we got hit hard on the plans on high claims and happy to report this year so eventually will in turn lead to the future years and we have a keen experience. we um, and the other good news we have $50 million more last year, we

had a higher spend. by still good to have the $28 million for the impact from the trends and interest income was a record high $4 million due to the phases we're going through and the opportunity fund increased and increased came into through from blue shield for activities in the general fund we are running lower that helps the city in their budget issues going forward and gaps. and for the audit i said earlier started and i'll be happy to answer any questions you may have. >> on that financials. >> a quick question on the

spend was higher as well as because it corresponding higher? or - >> so our trends yeah. our trends are by 12 percent. >> it was what. >> it is quite high. >> and other costs. >> i see okay. thank you. >> just um, on that taking off of interest. all the cash in the trust fund is invested for the city treasurer and a cool investment is that still; correct. >> exactly we didn't have an official balance to have the portfolio we have an equity basically the city manages the voechlts and have an investment in the treasurer pool. >> the investments are very

safe. >> (multiple voices). >> mostly csd and treasures so, of course, all those rates are higher this year are high interest rates, you know, so that's all understandable. i wanted to make sure that was still the case time in the past the board looked at where where whether we should be concerning the investment and vice chair. >> no crypto in our portfolio. >> i have a question. do we - is there any one person or position i should say (clapping.) that monitors our trusting other than yourself in the treasury department anyone in the office that monitor our fund specifically and so the city's

controller's office so when we use the fund for the process disbursements all within the guidelines that the city issues so we follow that. we um, we, um, have the external audit that is done every year with the controls and transactions we have a madam clerk look at that as well and for unusual items and we pull out the positions and the plans also to look at the expenses. >> so you're the one working with the treasures staff. >> (multiple voices.) >> but with for example, retirements and . >> i'm sorry the controller's office. >> (multiple voices). >> yeah. >> very um, in all the jobs i've had the rules here are as

strict as (unintelligible). >> on. >> (multiple voices.) >> we like to hear that i you know. >> i'm still yeah. i should right-hand turn the process and i i can't imagine i can't imagine what is controls we have with that anything like that ta can happen. >> thank you just checking. >> not checking you but just the process. >> (laughter.) >> our members are concerned always and what i found is that once i retired - retire they're more nufrg and (clearing throat) watching but everyone it trusting of the process we are retired out of the same bucket as 2 were. >> (multiple voices.) >> and yeah. >> absolutely. thank you. >> all right. thank you. >> take public comment. >> open up for public comment and instructions are displayed

on the screen for sfgovtv and web x in-person will be first followed by remote and the callers on the line press star 3 and watching on webex click on the queue in-person. >> board secretary two callers on the line and no hands on this time. >> thank you mandatory discretionary reviews public comment is closed. >>. thank you. >> and >> and next item. >> and next item. >> and next item.

>> and next item. by iftikhar hussain, sfhss chief financial officer; raymond tsai, md ms, vice president, advanced primary care, purchaser business group on health (pbgh). >> this is my pleasure to introduce raymond tsai, md ms, vice president, advanced primary care, purchaser business group on health (pbgh) and from - a really you'll find the presentation is good work and people associated with healthcare and from me, you want the best surgeon and so this is preliminary work by pg h and on the providers side partnered with us on initiatives with that, i'm going to turn it over to - >> thank you. >> thank you, very much. >> um, commissioners and supervisor we have the honor to present um, the update on our

work to advance primary care on behalf of hss for the planned goal my name is raymond tsai, md ms, vice president, advanced primary care, purchaser business group on health (pbgh) a physician and also group benefits society so i'll shout out again there (laughter). >> but the um, i - um, what was i going to say sorry i represent prejudice group on health and primary care we're a nonprofit alcoholic about 40 jump about purchases and we work together to advance access, affordability and equity in the healthcare system i can't imagine one of the main ways

we're doing that to increase the investment think primary care but we don't want to just do that and absent quality checks what we developed in conjunction with the members is the um, care excellence program was developed in conjunction with the members to look at what are the standards and what we want from the primary care system to be sure we are putting departments to where we know are high quality and get the outcomes we want and we have to do this work because the primary care system is in duress and afternoon a wait time for a primary care appointment this is a pinpoint that is by in-home supportive services members not just national so - and almost a little bit the of irresponsible spending those who don't have a primary care clinician from all

the ways this can occur of our members have taken approaches to think though how they can support primary care. and in-home supportive services and abby challenged us to think through how we can do it on behalf of 6 on hss members to transform a primary care system that is struggling requires a lot of unique work and required a unique partnerships as well we brought together um, pb g h along with the california along with the representatives for the providers side to think through an all levels the system what we need to do to really transform primary care and into something will ab proud to oh, your patients and friends and

families and community. and so we looking at not just for investment primary care but investment primary care that insures access that is timely in what way that a party will prefer and need care and where they need care we want to make sure the patient experience and the family that is involved is good we want to make sure we have a primary care system that is not just about the medical care but considers the entire being of a person that includes the emphasis on behavorial health and make sure that we also have comprehensive care that - has to do with with a person outcomes as the medical care. and we also want to be sure that the system is not just about primary care but

integrated with the health care system as whole lot. some patients need specialist care we want to make sure that is a high quality and assessable to the patient and finally, one of our key priorities has equity and thinking how to make sure the primary care given is equitable and access to probable cause acceptable i hope sharing the goals in the primary care system we're showing we're not just addressing the hss goal of advancing primary care but all the good neighbor policies and priorities. this is the current primary care system that we have now doesn't come over night it is has been slowly evolving or devolving from decades. and so to be able to do this type of

work for transformation advertised difficult and to - to be able to do if we have to find partners will help us all levels of system committed to primary care to work together to really rethink how the system works and reimagine this i want to share the stage with some of our partners that helped us starting with the doctor. >> can you also include i think so what we're doing in northern california but we have members all over the country so if it is possible to let us know what goes on in other states or areas we have large concentrations of members will be that would be great. >> i'll start off the work we

are presenting today is given this work is so um, ground breaking the future state we want to have scale the work of the business on health and the care excellence podium to move this and hoping nationally whereby a expectation and not just a nice to have. >> good afternoon, commissioners. supervisors city so much for having us i'm a family physician and i'm the medical director. um, i also it is lovely to be here when i today. i became a doctor in san francisco i did my residence

with the san francisco general hospital and picturing abby you're working here i was in the rise and a lot of health issues the participation of san franciscans with their health and wellness as a family did remember um, so i'm here really because humbling as a pair we can we have to bring something meaningful to this conversation to transform our healthcare system to make it worth any and grateful to abby that pushed to conclude us in the work we had to show up and bring value and excited to work on this project bus blue shield we're with working for the channels to look how we can we know that primary

care is one of the areas to increase the rehabilitation and assess and decrease costs by implementing the experience we're going whole hog for blue shield and this is one of several very efforts we are using to advance primary care with the primary care so we get doctors off the treadmills and into producing things that matter to their patients. and we're working on a multilingual pair to collaborate with the come terraces we're thrilled for the collaboration and organizations of pg h that includes really excited to showcase and the fact there are

3 physicians are not consequences we are walking the walk so i'm excited to hand it over to my colleague to talk about the ground breaking work. >> great. thank you. >> and thank you all for allowing us the opportunity it share the great work going on i comb from a perspective of primary care. but i'm a pediatrician and so very excited about all the work that is happened here and our goals are aligned with pg h to advance the primary care accreditation some of you heard about patient medical home dedication with joint commissioners because this program the dedication has more rigor you have to performance

with measurements and true actionable change inside of the practice those practice and not just checking the boxes we have yes and have registries and that's what the other accreditation programs in particular this dedication are a bit different we're excited and combaishg on this journey so without further ado, i want to utility the great work that has happened in the model we created we spent the last year planning around and implementing as of january 2024 that is worthy of a patient experience with friends and families so when you look at the model includes a large team traditional primary care just

has prominently when i look around the best practices in the area it is a positions are a with a practice praurn and a nurse outside of that no teams for social workers and behavorial health managers and pharmacists and that's what we're displaying here we are pro-active day one we rolled out the program our goal to one board patients to our practice and by the way, our practice while i represent we own and operate primary care in the bay called (unintelligible). >> so there are 5 locations in the bay area we on board them to let them know are the services

available and here's your care team in the process. also how to assess us and communicate with us is important with the one on board process so that a lot of patients are not aware that um, we are available 24/7 and our access 80 is wide open the third next available if you call our practice today and try to get a visit with a primary care doctors you can get in the 5 days or a followup e follow-up or urgent care with after hours to help. so we we built to model and assured the access in addition with all the planning over the last year um, we rolled out this and started the

dedication process back in january with um, building the work flows and training of the physicians and the care staff to have to be culturally committee so they delivery the care a curriculum we track and to make sure that everyone in the practice understand the differences in the population, the individuals so that we delivery individualized care plans and services to sour patient that are in the practice. so this is a timeline i'll in the read throw by a lot of work and in addition to the concern about advances primary care and the services we expect to be delivered. is how do we decrease administrative burdens? in this product the - but also

the documents to measure and practicing the past performance and how well we're delivering care to the patient so to alleviate that we rolled out a product artificial diligence to support the physicians to see our patients in realtime but have a conversation and all that information. co-laid by the 20ish8 diligence to help them with their documents they're not stepping up to the plate time hours documenting that traditionally if you go to an eir this is a human that follows the doctor's orders and take the orders all, all that we have

virtual conversation and the doctors reads this out load i hear your heart and lung sounds they're not spending additional time a timesaver more than an hour a day may not sound a lot to many of us but meaningful they can eat lunch and during the hours spending quality the with their families afterwards that is part of journey we put in place to make sure thatur physicians and curb impervious are cve voted and not w0ishd documenting the time, this is the performance set of metrics part the designation process the dark line bars are sfhss members

that are receiving this level of service inside the practice and then the light a bar is all patients inside the practice. so that that we are delivering care one way not specifically for - but everyone in the practice received equal care as as you can see the red bar right there is the target the 66th percentile of national average perform performing well above the benchmark except for this is the where it gets challenging the data comes from so many spaces we don't process the pharmacy but no information

in realtime only realtime if the pharmacy we have and to the electronics it is important information therefore our performance is a bit low at that at that time we're calling the pharmacies and that's what the particular measure is how confined with patient with asthma that is. >> please state your name and whether you are a resident or nonresident. that is a work in progress i see a question. >> i'm looking at those serve california cancer and diabetes and places you under your regular calendar ma i know a number of callers with donaldina cameron house a lot of them with ar zone ma are you finding within the population those

particular diagnosis are especially prevalent more than in other groups. >> the previous in the bay area is is a sniejd higher but not far off the average we looked at this and it is not much different but nationally it is a problem across the u.s. that no in this area. >> are we doing anything - i guess the question would be i think within the purview store involved in looks to help to lower those percentages or impacts are environment and also specifically with the city and county of san francisco given the nature of the work of some

of our classifications. >> we are involved with other organizations that are focused on that i'm familiar with the zones i'm sure i are as well so it is not just had happened inside the practice with the care team is the environment and a simple as a enclosure or gas station i think that is more of a public movement all we'll be happy to participate in a more regional movement across the city because 5 blocks are always part of that rezones that's why

people are losing beyond one hundred not just to take care of themselves but the environment and socialization and the culture itself. and setting that that is a public movement. >> because i'm thinking that still the vast majority of our employees live within the bay area and retirees as well and significant numbers in san francisco. are least in the san francisco bay area a lot in san francisco. because of of you grew up here and still in the homes to the extent they're involved if i think that is - that's commendable and helpful for us because your specific membership is represented in this very tight um, geometrical

area and need to keep watch on that. >> absolutely. >> just maybe a stupid question has b t health so i understand. >> yeah. >> what and is the nature a acronym. >> we call it b t health. >> (multiple voices). >> i understand that that's fine the abbreviations i'm not a fan of a abbreviations and a lot of way too many i struggle with many of those i'm not familiar on earlier slides a reminder when you put together a slides like this it would be nice to be more specific and avoid abbreviations.

>> apologizes. >> ditto. >> i'll go if any abbreviations i'll try to address those. thank you. >> and then i have a couple of more slides just to emphasize some elements i don't how much time i have. >> okay. >> but increasing access to care and making it easy for patients to communicate practice is so important i touched on that but tremendous that 79 percent of patients have access to my chart to communicate with the physicians. and then so important i mentioned earlier um, in engaging the physicians and care team and the patients to were the and as you can see the key results here that we um, had over 1,000 preconversations with the patients and in other words, called them before the

visit and helped them prepare after the visit the physician followed up to make sure they understand their care plan but any questions? and help them to schedule but additionally, we have had a lot of screening activities happen before the visits as well. that patient engage in um, before they are seen in the practice but also at the point of care screening for anxiety goods undiagnosed

>> we look at. >> w ( in recess). >> roll call, please. >> a roll call starting with president hao. >> a vice president zvanski presents. >> commissioner cremen present. >> supervisor dorsey present.

>> commissioner howard present. >> commissioner sass present and commissioner wilson present and with that, we have quorum. >> next >> next agenda item. >> >> >> >> engagement plans:(discussion) presented by rey guillen, sfhss chief operating officer, and carrie beshears, sfhss wellbeing manager. rey guillen, sfhss chief operations officer i along with carrie beshears, sfhss wellbeing manager walk you through through the open combrolt for 2025. >> in today's preservation we'll review what open enrollment is at the timeline and walk you through the member experience including the communications members will receive and the resources will be made available to them such

as benefit fairs and webinars and flu clinics and review the secretary metrics whether this is successful. >> as a reminder open enrollment one time a year the members make changes to their benefits from one plan to another or wave they're coverage or drop dependant and really into the flexibility account and any changes during the open enrollment is effective june 1st for 20 that 25 if a member is happy don't need to do anything they'll roll over into 2025 automatically. >> oh. >> equip for f s a the one exception members reenroll and

required under the internal receive coincide for employees to pay firing contributions on a pretax base and based on this is the employees for open enrollment arrived during the year will go through the first few days of enrollment and wait for the pictured for the 2026 plan year to make changes, however, xripgsz qualifying life events are the loss of non-hss coverage if this year an employee is married with their coverage if they lose that coverage they can enroll and other things are marriage or a

partnership the birth of adoption of a partnership have the ability to make that within thirty days. this is our high-level open enrollment timeline for this year open enrollment for the monday, september 30th through friday, october of 25 the letters will be delivered to members homes the welcome back of september 24th and then open enrollment launched at 8:00 a.m. on september 30th and this is when issuing online benefits system opens and the dictated web page is available. open enrollment budget committee will end at 6:00 p.m. on october of 25. and following that mail a confirm letter to members on december 12th listing their benefit electrifications for

2025 and members will be required to call if any errors and for any planned year are effective in january 2025 the first. >> that is what our envelopes looks for the mailing we try to use bold text to grab their attention that important information about their benefit is enclosed each member has a custom letter that informs them of their current elections are and the dependence are covered and the benefit premiums and if they want to enroll need to see in the open enrollment those customized letters will make that ice for the anybody's to know their options for the

upcoming planned year and making it simple for the results in the complications for the staff given the fact we have 34 employer group we're responsible for and also responsible for active and retired members and numerous union contractors with and special rules for active and retired members special rules for commissioners and have special rules for those on leave of absence, etc., etc. and in the end need to crate 91 templates and over 3000 rates to make that work. this next page is ma the confirmation postoperative enrollment and their elections that our system

has on file for 2025 and provided them how to notify us if any administrative errors and we've got those corrected for the members and included with the retiree mailings a booklet with a plan change in a step-by-step instruction and last open enrollment do an all electronic guide and materials. and speaking of guides here's what the guides look like for 2025 i want to shout out to our graphic designer ryan does a lot of work to make that nice every single year the guys for city and county employees the light blue for school district and green for city college and orange for the required members

those will be online resources for members but we print a few hundred. this is what you're online open enrollment resource page looks like for open enrollment this is where mretz find out all the resources and dates for open enrollment. from there members can find the calendar of events and also where they find details for the 18 webinars and 3 haight fairs and clinics. and in mailings we'll send all weekly ames and this year hosting benefit fairs at the 4 of the locations city hall and that will be the event

that open to all members and retirees. and then have adapts specific events one all the way at moccasin for the utilities employees that work at the city's hetch hetchy and event other airport and other locations. >> because getting to an in-person event is difficult we have (noise near microphone) events throughout the move of october and opportunity for members to an impact with the person's and ask quiz. to help make sure we don't miss no one not getting the mailings we will have a variety of materials to provide you a couple of sample

including table tents that did departments will post in their break rooms and poverties throughout they're location we're trying to make sure we capture everyone attention and we'll have a q r code from picking up the table tent or poster scan it with their phone with the information on the health fairs and online resources. we know the blue shield of california transition will increase the calls we have assistance and those resources include again, you know, as we mentioned the dictated blue shield medicare call center and brought back the ancillary call center bs a we provided with the

last year enrollment and in addition members will schedule individual telephone appoints are providers and blue shield will be providing in support for the medicare callers and blue shield will assign help if people have questions the blue shield of california represent will help the will provide non-medicare related - so we are confident with that collection of support. members will have excellent service during this year's open enrollment now out of harm's way carrie beshears, sfhss wellbeing manager walk you through the flu shot initiative for this year. >> good afternoon carrie beshears, sfhss wellbeing manager. we are upon a flu an

manual campaign with the flu clinics you'll kicking off by tell you but the communication each year we have generally sending out dedicated e-mails in partnership a lot of e-mails go out is between september and october have to dedicated e-mails citywide and one thing we're doing this were we go each year a champion sharing that makes up 200 employees who death many of their work time to help spread the work around well-being and we'll include a template e-mail for departments to send out for their department i'll mention we're doing additional training for open enrollment all the materials that we'll be giving out the

table tent for o e or the flyers. >> we have a number of different handouts and flyers have a retiree insert into their booklet has general information an important status and why to get the vaccine and has individual information go someone can get their vaccine and have to workplace flyer as well for the active employees. and then have two additional handout we give to our departments 3 really all we call the open and closed clinics. all right. so something we like to highlight know before you go before a going to a flu clinic you don't have to register we

are open and closed clinics you'll see in a couple of slides we which is considered an open and closed open are added clinics an employee has access to one of the employees may want have open clinics is a good place for individuals to get their vaccines and we put echol cole an informed consent but some that folks like to print them to walk in and get their vaccine and head out after that, you one of the things i like to mention we're pales in comparison with kaiser this year for our flu vaccines will be our go last year partisanship with kaiser looking at new options for next year i know i reached out to commissioner wilson to do

brainstorming for the upcoming next year this year looking at flu and hoping to add covid vaccinations in our flu messages as well. who is eligible to participate active applies of our 4 employers we serve additionally, our retirees of those 4 employers and spouses and domestic partners of our retirees only. so we like to emphasis that it is for some times run into issues with locations and again, for the open clinics we offer. so this year we're offering 19 clinics four less than last year but we try identify where we get bang for the buck and we also have required minimums that our

inventoried does to make sure we meet that is okay. this clinic meets the required minimums for so many years let's not offer that but we can add a clinic or really center lists our clinics had you see on the screen a portion of our clinics and wrap up the last of our clinics anywhere that is noted with a double red asterisks one of the clinics. next slide, please. and we set girls to increase our vaccines we've seen a lot of change through covid and in the numbers and so we are looking to increase the vaccines by 19 percent compared to previous years that concludes the flu and i'm going to turn it over to ray. >> again rey guillen, sfhss chief operations officer what will evaluate us and open enrollment looks like in that again, we want to make sure that

all our members are informed and if they need assistance we want to make sure they have a good experience so we set goals for ourselves on the communication side we want get on e-mails and members visit the without any doubt to engage for for one hundred seconds to stay that long to gather enough permanent information and want to increase the number of required members that use the website by 10 percent over last year and we want to at least 50 members to attend each within webinars i

think the kind thing the staff are sweshg questions and once that call is conducted they need to process whatever change the members have after that, the fact so we try to limit that for 5 minutes or less oftentimes those transmissions they need to reach out to the carriers can extend the call longer with the call center again, the call center with olgas position with a number of members we do on the whole time of under 3 minutes is a reasonable that is what our goal is and those are the calls for people that hang up before the call is answered to make sure that is less than 10 percent we want to handle the calls in less than event minutes

and make sure our staff is on the line to answer the questions with only a staff of 22 in your call times exceeds this our system shuts down we need to resolve those in less than 10 minutes but not a problem for staff if it going over that our average is 10 minutes or less and resolve the first call let's 75 of the time so earlier vice president zvanski ask are members needing to call back a number of times no harm but in most cases to resolve the member issues in the first call so they don't have to call back we track that. so we'll be happy to share

the results of those metrics in the november director's report. >> but still be processing open enrollment changes throughout the month of november a full postoperative enrollment update will be given not until the december meeting that's our plan and i'll be happy to answer any questions you may have. >> thank you, ray and kari for the report i think that every year you do our best so beat your best metrics and thank you for all the preparation. >> i should mention that is very much a group project have a great team our project manager bryan rodriguez has a multilingual page and different items keep us on track each weeks ago we meet to be on tranl

track with the enrollment before an and if we're failing behind we stay on track. this is really a yearlong activity so, you know, think of the rates and bins process we go through and starting with the plan year 2026 that is the start of our open enrollment before we're done with the current open enrollment we've starting planning for the next one over time we figured out where we make sure we set those goals and metrics so we have this and very much a group project and we're here by the entire is involved and thank you for that. >> some of us have watched and you've improved greatly and

appreciated before the anybody's very much so keep up the good work. >> i tell my staff we're in pursuant of providing the best serviced sophomore the members we want to provide the service to the members we expect for all our staff is our colleagues not we're over here in one area they're over there as staff we look at them differently we're all colleagues in the same boat. >> thanks. >> i will- >> (multiple voices). >> tell them we appreciate them and nobody thinks of that and all of a sudden wait a

minute and here we go. >> so. thank you. >> thank them. >> any other questions of comments? >> all right. thank you we are looking forward to the report in november but also december with a more robust report. >> thank you. >> open up for public comment. >> public comment is on and instructions for sfgovtv and in-person public comment is first and followed by remote and for those callers on the line press star 3 and web x and begin. >> no one has approached the podium. and. >> the moderator will notify us of callers at this time. we have two callers in the public comment queue and no callers are raised their hands with that,

public comment is closed. >> m.s. ches, senior health program planner, sfhss plan representatives from kaiser permanente, health net, and blue shield of california. >> welcome. >> thank you, commissioners. thank you, holly and, yes michael visconti, sfhss contracts administrator manager i'm joined by leticia harris, m.s.ches, senior health program planner. and we'll be speaking to how hss 34urz are commercial performances and how the performance impact fees and required reporting and decide how the monitoring is beyond the measures and utilization and how the outcomes in care management

for the finding of our health and well-being of the population and after laying the ground work how they come about and modify the metrics and i'll be joined by leticia harris, m.s.ches, senior health program planner and our planned partners at blue shield and kaiser permanente and health net for the guarantees into monitoring the reporting and how hss and our planned partners share the focus in expanding with a history of unquestionable or equitable um, and social determine of presence of their access to care.

>> what does it look like. hss measures the planned performance to influence the health providers for a guarantees active management of our plans and benefits and close collaboration with the partners we lion with leading health thoefrts some will be speaking to us and employer groups and agencies with common metrics and goals and at that point into this alcoholic experience and leverage to the betterment of our health outcomes. under pitting this hss is our strategic plan our mission and focus on equitable be sustainable and health and well-being. >> now at that slide i'm giving you a 1,000 components and, yes performance impact fees

are a fundamental aspect you'll see that in the pink and light pick shaded colors this process from the origins within the health plan operational metrics you've heard today and with the first call resolution and extend to the behind the house accuracy of claim in 2018 with the support of our members call the ann thompson we aligned with our performance guarantees with the planned partners and bundled those metrics to give them anymore strength one of the performance guarantees in allowed us to expand our performance guarantees and focus on the critical metrics and health outcomes that was all done in concert with our 2020 strategic plan and is expansion to whole health and president's

report. governed by the which will be presented on later on by mother colleague leticia harris, m.s.ches, senior health program planner when moving towards the performance with our partners this is an cerebral part of what hss does behind the scenes and there are critical partners in the operational units with embroiders with our finance team and with this presentation i'll piece that together into equitable metrics and two metrics that we are aligned with our headquartered plan partners would say brought up vice president zvanski you spoke to diabetes and to cardiovascular

calorie care and hypertension let's begin with the commercial guarantees are how they come about and collect and access and monitoring of planned performance. a performance guarantee is a heat plan architecture mandates an insurer or provider delivers high quality services helps the provider by putting performance stalls below expectation so how does that come about all have good functional goals. we then look to see this medic is a standard and in the operational spectator but others are common diabetes and hypertension and common conditions that effect our population, however, sometimes a way to look at a medic perhaps a way that

clinical advance to better capture good health or in this case we'll discuss loornlt that we are focusing on a specific medic how it shouldn't require - should be clear she should be functional we do this in our contracts but easy to understand even if the underlying facts are highly critical in nature. and again, take those metrics we obvious, we work with our planned partners and collaborate we use indicators and determine whether or not they want to set a thirdly, those thresholds are not done in a vacuum we collaborate with the health authorities and lion what they recall and goals i'm proud to

say hss leads operational and clinical. >> now i would be remiss if i didn't call out my contract team behind the scenes they are assessing those performance guarantees collecting quarterly bilingual and annual reporting up to over 3 dozen medic clinics and a believe it or not of up to 10 operational metrics those from the leaders so they actively negotiate with our annual renewals this happens every year throughout the year. and we review and confirm this as a team and in alignment with the planned partners as well as the leaders and our exceptional team. >> with is this slide

breakdown the geese and reporting into 3 segments the first the operational metrics you're familiar with and presented developments comments across the industries but represented in, you know, call centers and behind the processing. those are critical to us because members directly experience will be a lack of exceptional a service in the areas i'll say i'm impressed with our planned partners over the last years mraefrl during the pandemic all dealing with health shortages and continued to hold those high standards and meet those metrics again and again, which is not an easy task for any of that impressed with the work and equally the team has done that in support internally for those are the ones of conditions you're well

familiar with and again, represent about 3 dozen across our plans those are aligned where the commercial planned members and fanl in addition to the performance impact fees we have delayed reporting by the way, but if it informs those discussions throughout the year with the partners and in support of the team at i a i. >> it is your summarizing of myriad meetings. hss and our partners at a on discuss the changes in the population health over time throughout the year whether monthly or biannually and support the active planned

management. >> with that, joined by our senior planner leticia harris, m.s.ches, senior health program planner with the final segment and the discussion of health care reporting. >> actually michael before you leave the podium we heard from the partners at d b h with their measures and performance. >> yes. >> are there any thoughts designed to maybe join forces with them in some ways for the mushlth abused we're ultimately after the best care we can get and your skills are on points i'm going to talk about that and prominently the advanced care initiative. thank you. >> good afternoon leticia

harris, m.s.ches, senior health program planner going on 6 years with hss and many of our board attendees and commissioners are familiar with many i really as a is liaison. equity t is to make sure that our members get the care notice need when this i need it with the intersections within the performance that michael has been describing hss has been at the table with the planned partners tracking the activities have the potential to impact the health um, and seeking to look at data in support of partnerships that e to have focus in operational framework to aid the health inequities and understanding base line and helps to lay the

ground work and as evidenced by the stakeholders weighing not alone in the work in our equity focus and in the city and county of san francisco a racial equity and focuses on the policies and what phase two focuses on the external services with the community engagement and indicators in support of vulnerable population on a national scale thirty states stacking part in the government's a network of on the municipal governments with respect to the best practices prior representation on both the managed healthcare and community and the intrathdz healthcare board of directors to evaluate

health and equity criteria and for other perfumes focused on investing in and evaluating the solutions we are focused on having important and meaningful conversations with partners we want to say that having a job and health benefit is not enough our members need help 90 in physical and emotional challenges for their well-being we advanced the staven plan we'll lion to make sure that equity it isn't fabric of our performance plan and to michael. >> thank you so again that alignment is cradle critically in the health authority we have one fortunate was - care needs

to be equitable and access and participation in the california primary care led by the chief financial officer allows us to focus on those comforted outcomes and aid those not just here in primary care but expanding that as hss lines the effort with the leading employers and healthcare organizations listed here and as you can see one i focus on the two metrics i spoke to diabetes and hypertension we're aligned on those metrics as well. >> michael when you say aligned are you saying that what, if anything, does that mean are you mur similar things. >> you're right measuring not similar but the same metrics

we're talking about those metrics to the guarantees that are set every year they may not change it every year i'll explain that briefly but monitoring the same thing but proud to see that hss has guarantees in addition to the ones aligned and we'll continue to have those. >> thank you. >> thank you, president hao. >> so i'd like to close with two key metrics but a longitude approach not a one year effort often takes upwards to 8 to 10 years and a concentrated efforts for those two metrics we're starting with here this began back in 2020, 2021 with the analytics unit we took those metrics to realize, as i mentioned, when a medic is common but need to focus on that

and in this case that reservoirs intense work and collaboration i must say support from the planned partners to make sure we have the system at the place to collect the information and report it out. i will say no data is perfect we work on those indicate sets every single year to conclude them and the indicators to help with the outcomes that process began in the pandemic and advanced in setting up the framework we're receiving for the data. during the time we take the data and create the benchmarking and not taking the pandemic years a snapshot given xoirm dposhgz that my influence the medics by the metrics over time and access them and in this case if we diagram a medic shows an

inequitable in health outcomes we work with the planned patterns and their providers to make sure we adequately address those in the future. >> with that, before i introduce our planned partners will speak to the initiative i'd like to focus on is alignment where multiple organizations who agreed to begin those cardiovascular hypertension we want to focus sorry going in reverse order apologizes so i'm opposed to start with diabetes that was determined focus on diabetes for a factor of our population maybe xrirng inequitable haight outcomes in the latino x or hispanic with the a-1c port control with the h

b c level is low and with the q c initiative and the d m h cal person cover california on the i'm sorry to conclude on the deck that hss has 4 guarantees with at risk around diabetes. the same for cardiovascular and hypertension again four metrics a 350 ppo that up until recently an accolade will be introduced with the ppo population for two 25 ar aligned with the hmo but focusing on the metrics for cardiovascular health and hypertension with the black and asian-american population going forward. >> do we know within the

population of the retirees this statistics for diabetes and cardiovascular are we within a range compatible to others groups or are we exceptionally high in either of those categories? >> i'm actually proud to say or is i'm going to say we have a high information officer heated score and in fact, hss has at typically the 90th percentile in the categories including in those two categories and again, we're looking at statewide populations dealing with medicare and their target are reaching towards something but not for several years we've proud of that and proud of

planned partners and continued to move the needle on this year over year and (captioning is ending at this point due to the time limit provided for captioning)

piece of a larger storm drains to address inequities and healthcare and will get a taste to that >> talk about that with equity but essentially put equitability in as a leading objective goals and in the planning process and gone about addressing this no one will solve the problems with multiple decades but i appreciate the questions and um, we'll and lateisha can provide the context of all the work that is underway with us in the plan to address those issues but i mean, i couldn't agree more a critical element and the plastic bags are a lot of work in many

ear but as meeting indicated so with no change we'll need to keep our eyes on the prices and experience the trials of change that needs to occur even say providers side so i equation. >> thank you director. >> not seeing any more questions i i'd like to introduce start with tiffany our executive manager for blue shield and good afternoon tiffany with blue shield of california major account manager and very excited to be able to

talk about blue shield commitment and definitely true to my heart we have established these if we get there we have established those 5 guiding principles in creating and updating our products and system throughout the company our principle number one, is getting rooted enhance is health enlargement and behavior to ownership embedded across occupy best practices and principle twoization meaningful data and ann listings and monitor and to inequalities and correct bias and adhere to ethics we collaboratively eliminate the misrepresent levels of imagining

equities, aye. >> validate and co-design seclusions with impacted communities and principle number 4 again soliciting and find and insight to those closet and embodying the principle of equity and inclusion to share power i think that in directly talking to whether or not e what commissioner sass is helping to get at the root of fear; right? and how we connect with members of communities. and i'll talk about that as well and is 5 principle temp the story and compelled to do the right thing and for members and to share our stories. we have 3 focuses we're

looking at in terms of community your members and our providers. our goal to expand combhungsz marginalized community and we're also have a goal of reducing k sections and cancers by 50 percent and the diversity of our network we are making progress towards that goal f we have a table talk an online community of members and community community-based organizations and ready to share thoughts of through surveys and focus groups and interviews. we have a community review committee a group of california members and community-based organizations who meet quarterly with blue shield of california share thoughts and suggestions for our

blue shield programs in addressing health disparities and have vendors and walgreens and a pam called let's get which i could for colin cancer for outreach with gaps. and we started to conclude food a couple of online programs one is health for network providers. this health is tailored to do lgbtq and heat is wrap around service for the latino with primary care and mental health and other issues and lastly, i spoken on this where i know new members on the board we have a tested a market test pilot for a program called mommy is a

solution of services been extended to the hss members it is excited one of the 8 um, employer groups we have in the program as part of the pilot happening this year and started last year and ongoing. we have piloted the program and here are a few of the most updated statistics other than that, mommy program. we did actually get quite a bit of a moment in the first three months but at the end of july the updated engagement is the 45 of hss members that are enforceability and one hundred and 57 one example is lactation and had 76

virtual and 51 visits we have provided kind of a statistics with the race of the employees of hrsz that are currently in the program. >> we um, have gotten some excellent feedback from the program we've wouldn't have results when i do will be reporting but the program will end this year and then our team will be evaluating this we're evaluating this test we can see if it makes sense and helpful for members and also kind of help um, with the outcomes for these pregnant and women and others having babies. and there is been great feedback on that. the insurance you can read some

of the feedback people are being appreciative of the dual services. and then again like i said we'll bring back information and the hope that we'll be putting this into our um, some of our programs and products going forward. >> the services unusually are not included. >> correct not necessarily - that is hard because some nurse midwives can be covered but the dual services are not normally covered. >> thank you. >> uh-huh. >> any other questions? >> thank you very much. >> thank you, tiffany. >> my partner over at haight care i have a few speaking points are available pubically.

so the slide to highlight the slides a high-level reported their remarkable ethic and as you can see on the right-hand side works of the sdasht and the program it's serving. the next slide in health net for the in action great covid in the state of california and the investment of $50 million for the time will i accurate providers and health net became one of the first medicare to offer dual services to its members and right hand

the equity strategic goals for the health net canopy hmo and the diversity sflied from the health net highlights how to see partners how health net has sponsored inclusive cultures and some or from a business perspective health net supports the innovations and retentions strategies. >> and the last slide highlight the advances primary care to chief financial officer that loans the hss advancing primary care and to summarize health net is planning to launch. >> california primary care initiative in november of 2024

will continue through 2025. >> with that, i'd like to introduce joan our senior workforce lead with kaiser and congratulate her on the recent promotion. >> thank you welcome. >> good afternoon commissioners and president hao i'd like to thank you for the invitation to join you i very much appreciate that as michael said my name is joan the senior workforce consultant for kaiser my roll will be to highlight the core elements of capillary responsive care approach and specifically like to call out things with within the facility that differentiate kaiser within that space. so i heard the expression incubate is in the

dna or kaiser our identity for the past 80 years has been based on representation and respect for the various community that we serve and continue that theme today. through intervention and early equitable services regardless of race or ethnicity similar kaiser has prioritized the goal with leading a catalyst for the refinement of the 4 commitments on the slides and through those commitments we will spark the economic opportunity and foster health or continue to foster that through the health system and continue developing workforce so everyone

has the opportunity to achieve their full opportunity. and now to achieve equitable outcomes we make sure we are addressing the social health of the members and community. and that example we or culturally a hole health approach i mean wearing saluting social health to physical and mental health. >> a developed a systemic approach with a care structure. and the beauty of this framework it allows us to more effectively engage with the members identify social gaps, and develop an initiative that addresses the greatest need. so i'm going to

transition. >> from social health and talk about more kaisers approach to equity care a two prong approach by people and data let's start with data we collected complete ethnicity on 82 percent of members and when it reveals disparity we close oig through outreach campaigns and screening for minors and gender identity campaigns. next, we voted a people powered strategy 3 allows to lurch the secretary of our diverse workforce we know that patient share the characterizations are more likely to build a trusting relationship that leads to

better outcomes and that illustrates what was talked about we are proud of 58 percent of our physicians represent communities of color and train the clinicians to develop responsive care for all the diverse members. >> whoops i'm sorry, i went to far. >> (laughter) thank you. >> sure. >> thank you a um, and or as i of was saying we develop

strategy to leverage the diverse workforce we this that patients who share personal characteristics are more likely to have trusting relationships that leads to favorable outcomes and 58 percent of physicians deliver care and because of those delivering better outcomes for example, cancer screening for hispanic and black and asian members are on par with white members and also noting that cancer survival rates for the black members compare to national averages. >> and another example of kaiser work to end maternal

death to eliminate those through evidence based care and patient education and integrated remote monitoring. so are owe percentages showing the rates that kaiser has over and above the national average is that what i'm looking. >> you're looking at the national. >> you think and it is- >> (multiple voices). >> previous slide. >> there we go. >> it is the previous slide those are the results of um, kaiser national averages yes. >> thank you. >> sure. >> so another example is kaisers work to end the maternal deaths to eliminate those types of deaths throats culturally evidenced based on care and

education and remote monitoring. while we're using the definite workforce to improve the outcomes and implement clinical strategies for the social needs of our members social screening are conducted regardless of the provider and allows us to create personalize plans to help people meet their social needs. >> and finally, i, is this is paying off kaiser continues to be recognized by industry and same thing build a inclusive workforce

i'll be happy to answer any questions you may have. >> colleagues do we have any questions for any of speakers from the presentation? >> no? so. thank you for your time. >> any wrap up michael or - >> yes. i'd like to thank all my presentation partners and harris for championship the equitability plan supporting our plans and equitable outcomes and thank you all for very lengthy presentation and look forward to reporting each year to you on this matter. >> thank you hopefully with the same robust group of group of presenters. >> thank you. >> thank you, president hao. >> open up for public comment. >> public comment is now open instructions for those on the

screen and in-person will be first followed by remote public comment and for callers on the line press star 3 and watching the meeting on webex we'll begin with any in-person public comment and a. >> no one has approached the podium. and now remote public comment all there is one caller on the phone line and zero hands raise with that, public comment is closed. >> our second to the last item on the agenda please. >> 13. reports and updates from contracted health plan representatives: (discussion) . >> all right. come on up. >> hi tiffany with blue shield

of california i didn't wanted to um, make the option we had alex our vp vice president and charles reports up through alex i would like to make sure you know who the vp. >> good afternoon, commissioners and supervisor nice to be here with you all thank you. i'm robert submitting the senior director of medicare what that means um, sort of the conductor of the our extra charles is any first chair in the orchestra charles is the one in the front line and the clinical staff you may see me

i've been in the business for thirty years working nationally and about the work we've done together with the team and hss here i couldn't be more thrilled our members are beginning to understand that we care about you and my mother was a nurse and i'm in the business because of her the work she did focused on seniors that was her work as a little boy i used to go to the nursing home and learned how to care for people and that's what i come with care and compassion and what blue shield doesn't best i'm glad to be and hope to see you in the future months. thank you. >> anyone else do we have a representative from usc here? we

would like to encourage you to speak to our colleagues about providing the data ultimately it serves our members so, thank you. >> all right. open up for public comment. >> public comment is now on a instructions are on the screen watching sfgovtv and public comment will be first and followed by remote. for those watching an webex click on the raised hand and again, that in-person. >> no one has approached the podium. and now remote public comment one caller in the public comment queue and zero callers with that, public comment is closed. >> and with that, i call i

adjourn this meeting of health service board of with a minute to spare before we have to exit. thank you. >> adjournment at 4:29 p.m. thank you. [meeting adjourned]

know san francisco invest nothing resource sos care for people with substance use crisis on the streets. includes new program and successful pilots. >> what is the location of the emergency. a san francisco 911 dispatcher. jot train that this dispatchers receive for street crisis team and our new program is to triage calls for mental health as a medical call. we don't tree it as a police matter more a medical matter enthusiasm clint iings, paramedics emt's and councilors

are dispatched through 911. we dispatch teams trined identify the crisis. they sends an emt and medic. if you are upon experiencing an emergencior worry body machine's safety on the street call 911 >> nonemergencies use 311. you can learn more about the street [music] hi. i'm san francisco mayor london breed i want to congratulate sfgovtv on 30 years of dedicated service as a broadcast channel for our vibrant city. you played a critical role during the pan dem and i can worked keep residents informed. adapted to changing situations that allowed our residents to

engage and participate in government. thank you for 3 decades of informing and inspiring and connect the people of san francisco as the voice that(mus >> i started the o was with a financing and had a business partner all ended up wanting to start the business and retire and i did was very important to me so i bought them oust and two weeks later the pandemic h-4 one of the moments i thought to myself we have to have the worse business in a lifetime or the best. >> we created the oasis out of

a need basically so other people bars and turning them into a space and when the last place we were performing wasn't used turned those buildings into condos so we decided to have a space. >> what the pandemic did for us is made us on of that we felt we had to do this immediately and created this. >> (unintelligible). >> where we would offer food delivery services with a curbside professionalism live music to bring spectacular to lives we are going through and as well as employ on the

caterers and the performers and drivers very for that i think also for everyone to do something. we had ordinary on the roof and life performances and with a restaurant to support the system where we are and even with that had terribly initiative and hundreds of thousands of dollars in debt had to pay our rent we decided to have an old-fashioned one we created club hours where you can watch to online and or be on the phone and raised over one quarter of a million dollar that of incredible and something that northbound thought we could do. >> we got ourselves back and

made me realize how for that people will show up if i was blown away but also had the courage but the commitment now i can't let anyone down i have to make the space serviceable so while this is a full process business it became much more about a space that was used by the community. and it became less about starting up a business and more about the heart of what we're doing. this building used to be a- and one of the first one we started working on had we came out what a mural to wrap the building and took a while but able to raise the money and pay 5 artists to

make a design around many this to represent what is happening on the side and also important this is who we are this is us putting it out there because satisfies other people we don't realize how much we affect the community around there when he i want to put that out there and show up and show ourselves outside of those walls more fabulous. and inspires other people to be more fabulous and everyone want to be more fabulous and less hatred and hostility and that is how we change the

>> recreation supervisor and bay sox coach and manual manny blackwell. we know him as royalty and sean white from the policy and public affairs office. and cindy lou our rec specialist for girls sports. thank you so much, rec and park. all right, so we're gathered here today to celebrate first the 13 players of our 12u bay

sox teams, give it up, give it up. these our mighty minis they're lead bit ever patient coach ana and handro never stop learning, never stop brianeding and finish the tournament with a nail biting traem with the blue crabs and coming up only run short in their final game. give it up for our 12u! and we're also here today to celebrate the 13 players of our 14u bay sox. [cheers and applause] who are lead by our power coaching team of our visionary coach rocky and our bay sox alumn and trailblazer coach justice. the 14u team was the only bay sox team to qualify for the

majors dwi, y'all, they went 4-0 in pool play. finished in fourth place out of 16 teams and scored an impressive 52 runs in only six games. give it up for our 14us. [cheers and applause] and of course, we are gathered here to celebrate the 11 players of our 16u bay sox. [cheers and applause] and their all-star coaches, our baseball brainiac and winning machine, coach burke and freshl off of her own baseball career and our home broen bay sox alumni coach julie, give it up. [cheers and applause] so this is the team who brought back to back national championships title home to san francisco. and more importantly this is

the team that proved that with hard work, dedication and with hard work and dedication that a public program with no try outs, no cuts, who only ever won one game at nationals can go to becoming two-time championship. so one more time for our 16u! [cheers and applause] impressive. all right so what we're witnessing tonight in san francisco is unprecedented record number of girls playing baseball. question for y'all, how many years have played or playing on your middle school or high school teams right now? hold them high. hold them high. give it up. it's hard. so middle school and high school is where we see the most drop out in baseball. but here in san francisco,

we're bucking the trend, we don't only talk the talk, because our rec and park and our mayor puts the resources where their heart is. there is a fund, safe and supportive place to do so. so, all of this incredible success, doesn't happen, you know, by luck. so some thank yous are in order. so thank you coach manny, coach glad, coach dan, coach julie, coach james, coach handro, getting worked autopsy y'all, for always treating our girls as ball players first and for your countless hours braving the fog, the cold, the heat so develop our players so the rest of the world has no choice but to treat them like ball players also. thank you coaches! [cheers and applause] thank you, families for trusting us with your amazing kids, for believing in your

daughter's wildest dreams and for all the stinky sox you wash, the snacks you pack, all the driving, the bracelet making and most importantly the community you build, we're so grateful for you families, thank you, thank you, thank you. [cheers and applause] and thank you mayor breed, and the san francisco recreation and parks department for deeply supporting this program because you truly understand that it is so much bigger than baseball and by investing in the bay sox, you're developing the next leaders and showing the girls that women and all women belong in all spaces. thank you. and lastly and most importantly, thank you players. thank you for all of your incredible head and heart and hustle. thank you for never backing down and for being stronger and

braver than you should have to be at your ages. buzz you are all role models for every girl in this city. i really hope that you take all the things that made you all good players into aspects of your life. please always continue to take up space, to be loud, to be aggressive and fearlessly pursue your joy always. you're all amazing and thank you. she is proof that when the city invest in a little girl that girl can become a baseball player and commissioner and

even mayor, help me welcome your mayor, london breed. [cheers and applause] >> mayor breed: annie, you were going to make me cry. let's give it up for annie jupiter jones! [cheers and applause] you know, annie, you were giving a lot of credit to a lot of people. but we want to give the credit to you for your amazing, consistent courageous leadership. [cheers and applause] because we know this program is not just a program you managed, it is a part of who you are and we appreciate the fact that you bring that with you every single day, which we know is what motivates these young players. to be their very best.

we know that sports and working with teams, can help build amazing leaders in our city. and i think that girls can do anything boys can do. and sometimes we can do it better! [cheers and applause] but don't worry boys, we love you too. and today is really historic, because as mayor, we honor many teams in this rotunda and often times, they are teams that are mostly boys, mostly football teams and folks who win big trophies and when you talk about winning winning a state championship or national championship, it means something. because when you work hard, and you earn those slots in those national arenas, you are not

only representing your team and your family, you are representing san francisco. [cheers and applause] and you are paving the way for opportunities when young girls, young girls are looking at you and saying if she can do it, i can do it. just like coach alyssa natkin which is the first coach, coaches first women on the mlb teams coaching for the san francisco giants, because she can, you can. shout out to all the bay sox coaches here. and when you think about sports and women, i can't help but get excited about bay fc, this amazing women's soccer team

where their season tickets have sold out and people are so hungry to go watch them play. you are paving the way, and my own god daughter who is in high school, she is being recruited by colleges because she is an amazing baseball pitcher. that is what the new generation of young women who are playing the sport, and loving the sport, and really honing in on their skills, this is what you all represent. so let me give some love and shout out, where is our 12u team? stand up! [cheers and applause] keep working hard. keep doing everything you can to make it to that next level but never ever lose sight of what is most important, having fun. enjoying the sport, and making

sure team work is at the for front of everything you do. let's give it up for 12u sxwlaim. [cheers and applause] all right, you may be seated. where is our 14u team? stand up. 14u! [cheers and applause] you may be a small team, but you're a mighty team. the fact that you made it to a championship you should be proud. and you know what, get ready because i know without a doubt you're coming back next year for that number one spot. thank you and congratulations. you may be seated. [cheers and applause] and to our 16u team, stand up! [cheers and applause] you show the people of this country what san francisco is made of. what san francisco values mean.

it means never ever getting giving up. it means work hard and that hard work has paid off and you are now the national champion. this is extraordinary. we are grateful and congratulations. [cheers and applause] and i want to thank all of our coaches. can our coaches stand up please? [cheers and applause] thank you for committing to working in this industry. and to working with these young people. it means a lot to have your support and your service, and even sometimes when we're like, i don't want to do that, thank you for still saying well you've got to go do it if you want to win. and we appreciate, you never ever giving up on our young people. thank you.

[cheers and applause] and i know, annie, you thanked everybody including the parents with the snacks and you know, i hope the parents aren't out there, don't touch my kid and all the little screams and yells. but the parents are fierce cheerleaders too. so when the parents are out there on the fields and they see their kids or they see their teams, they are the loudest bunches of people that are out there screaming and hollering, giving these young folks the motivation they need to win. so thank you to the parents and family members of all the kids who are joining us. [cheers and applause] i can go on and on and on. but we all know, that we lit up city hall, i hope you had a chance to see it. and bay sox orange on september 7th. it was bright like giants orange except it was not giant

orange it was brighter so it was bay sox orange and it was beautiful. and i wanted to ask annie to come up for just one presentation. [cheers and applause] as i said earlier, opportunities like this, don't just happen because you invest resources. opportunities like this don't just happen because the city wants it to happen. it happens because you have people who love this work and who are committed to the next generation of san franciscans that are growing up in this city. this is an extraordinary opportunity. since 2015 when the baseball team for girls, the bay sox first started, some people might have thought that it may not make it to 2024. yet here you are, creating a

bench, creating a opportunity and growing more fierce and strong and winning national championships. so on behalf of city and county of san francisco, we are going to officially declare it, bay sox day in san francisco! [cheers and applause] all right, thank you everybody and congratulations! >> thank you, mayor. all right, those are incredible speeches. but we're not done yet, because we have to hear from the folks on the ground. so i have the pleasure of introducing our coach representative today and i cannot think of a better coach to represent this program than a player who played with this

program, one of the original first bay sox when rocky had this incredible idea to start this program. so i'm going to introduce coach justice, she is not only a bay sox player but played on her own high school in varsity. and she a part of our rec department and rec lead and came back after graduating college to give back. please help me welcome, coach justice. [cheers and applause] >> thank you, mama. look out and seeing a wave of like tiny orange hats chocked me with nothing but pride not only for this beautiful program but also as this beautiful city. what started as a quad of 14

girls has flourished into expanding program pumping out players, coaches and the next generation of san francisco baseball. i'm constantly amazed by how this program continues to raise the bar for itself. providing equity and an environment where girls are built up as leaders within their communities and trying new things without fear of ridicule or isolation. again, this is so much bigger than baseball. the bay sox community is like no other. taking place in a city like no other in a recreation and parks department like no other. since 2015, i have been lucky enough to grow alongside this program thanks to the talented coach, rocky, coach manny and the man, coach jandro. yes. all of whom have mentored

through my awkward stages as both a player and coach with the bay sox. thanks to the investment of time resource sxz energy of the bay sox players, families and coaches, coo, ceo and annie jones and our pr family, we made history in this city and cemented our place as the largest girl baseball in the united states and i will never stop bragging about it. in resent years we have seen a number of record of middle school and high school playing baseball and i don't know about you all but i feel it has to do with you. every time i take the field with you girls, i'm so proud of what we created together. if you would have told me that i would have a chance to coach my sisters in ten yae,z i probably would have freaked out. but i'm so proud that my sisters have grown-up with this

amazing program with other girls that share the love of the game. with a whole lot of smiles and a big shout out to my first team u team, every single one of you should be extremely proud of yourself. you have truly made a lasting impact on the city and the future of baseball. don't let any coach or teammate tell you what your relationship to baseball should look like. keep playing ball until you decide the journey is over. i now have a pleasure to introduce a member of the payyu, the mother of our two best players, frida 10 and leona 12. they have been with the bay sox programs since 2021. peggy grew up in the bay area. when not cheering on her daughters, she works with local farmers and ranchers to create

a better food system. please help me in welcoming peggy yu. >> good afternoon. as justice said, i'm a lucky parent of leona and frida. i am huge fan of this program. i love the bay sox and long after lea and frida age out, i'll be cheering for the bay sox, just on the sideline saying this is incredible. i'll be honest, i didn't think my girls would be playing baseball today despite how much we love the game. our oldest leo started playing when she was 5 but she had i didn't want to play more. boys started to say, you can't play and she felt she didn't

want and quit. and then we found the bay sox. and we were hooked. it was so inspiring to see a groove of girls here, playing the game with so much heart, commitment and hustle. it reignited a fire in leona and it was the best way that frida could start her own baseball journey. they have built an incredible community of friends here in the city and across the country who share the love of the game. the bay sox, equip them with the skills and knowledge so they can compete and they can compete well. they keep playing the game until they are ready to try something else. every girl should feel this support and know that they are capable of accomplishing everything. all of us here today to show up for these girls in this day.

thank you rocky for your vision to start the program. to annie and to for growing this program. to mayor breed and wreck and park. thank you. i'm also excited to bring up our next speaker who is vicky carrillo, she is our 14u coach captain. fresh manned at saint insus and been with the bay sox for three years. come on up vicky. [cheers and applause] >> my name is vicky and it's my

third with the program. i know i don't only speak for myself when i say that i'm grateful, it will last us a lifetime for our girls and for the opportunity to play the game that we love. i would like to thank my team for your unwaiving support and eagerness to learn and perseverance and for always picking me up when i was down. thank you for the mentors, this includes all the coaches, coach, jandr, coach manny, coach julie, coach justice and like canneddr likes to say, coach jupiter jones the women that does it all. before nationals, i was thinking of quitting baseball. the opportunity for us to play

and being reminded that it was something that i want today do. i could. this is us putting it out there for and you that's when i decided i really love baseball and i was going to play it for as long as i could. we have a motto, which knows how many outs there were and where to go and it reminds us why we love the game and work hard. and overall people. we did our best preparing for the tournament making the best out of every team and putting the work in our own. by being placed in a division. the 12u team also succeeded, still growing and the 16u team is a back to back champions. we hope that in the future we'll be able to continue to attend nationals and place on the podium while representing our home and our city. these are all things that i love about the program. my favorite thing is the people.

we're like a family, we inspire each other and we push each other to be the best we can. i'm personally inspired here by the girls playing baseball in high school that shows me that it's possible and i'm proud to say that those girls are my friends. i hope not only myself but every girl can continue to inspire each other and show that they can play baseball at the level of their choice. thank you every one, words can't describe our gratitude for helping us get this far with goals continue to go thrive with your support and the future. we look back to the task to see how we can improve we appreciate the opportunity and live in the opportunity present. we look for the opportunity to grow. go bay sox! [cheers and applause]

>> all right y'all, thank you for barring with us. we're going to take a picture with the mayor. so we'll all, the bay sox and coaches come up here and join us on the stairs. and we have the photographer from o filler photographer is going to take a picture and then we'll let the parents do it after, but let's let the official photographer do their thing.

>> i'm supervisor connie chan. over the last 4 years i worked to make district 1 stronger and safeer for all families. first generation chinese immigrant, i aserved the public over two deck ades to give back to it the city that gave my family new opportunities. it was haneer to be elected in 2020 and day one i worked to be a voice for district 1 residents. i believe every san franciscan deserve clean and safe streets. and pushed city hall to admore patrol to richmond, retired police ambassadors to neighborhood commercial