good afternoon am everyone and happy new year welcome to the first health service board meeting of 2025 am all rise and join me in the pledge of allegiance, thank you.

[pledge of allegiance] >> thank you. board secretary call the roll. >> start being with president hao. >> present. >> vice president zvanski. >> here >> commissioner cremen. >> here. >> commissioner howard excuses. commissioner sass. >> here. >> commissioner wilson. >> here. >> we have quorum. >> thank you. next item. >> agenda item throw. general public comment. this is an opportunity for members to comment on any matter within the board's jurisdiction not on the agenda including requesting a burden place a member on an item. i will read our full

instructions. remote viewing is available online using web ex. welcomes public participation during public comment periods there will be an opportunity for general opinion comment and opportunity to comment on each item. in person comment fst and virtual. for anyone in person you can approach now. each speaker will be allowed 3 minutes unless new time limits. all made concerning the item has been presented. a caller may ask questions but no obligation to answer. the health service board will hear up to 30 minutes remote comment commendations will not count toward that limit. members attending the meeting via phone dial in calling.

and enter code 26636415839 and pound. when prompted press pound againful you will be asked to enter the password and then pound. star 3 to be added to the queue and will hear the promp you have raised your hand. wait until i welcome you and the message says your line has been unmuted. so those watching on web ex click on raised hand to speak. it will appear next to your name when you are muted or press unmute will appear select unmute to speevenlg once you hear, welcome caller, time will begin. when your time is expired you will be muted and click on the raisad hand to lower hand. members are encouraged to state their name although they miremain unanimous. i will thank you for your call and you will placeod mute and

unmute the next caller. thank you to sfgovtv for shareing with the public. we begin again this is our general public comment. with any in person comment. no one approached. our moderator will notice if callers in the queue -- we have someone approaching. gi think someone is approaching the podium. hi. i'm sarah cole i wanted speak on the new health plan blue shield i'm medicare retired firefighter. and we have been already denied a clinic that my husband and i attended the left 11 years east/west service an acupuncture clinic in china town they have offices in daly city and excelsior district. they when we were with blue

shield before, the we were covered and then united health care to being it on as well. now we are told because um -- blue shield contracts out with american special health for a contract they have for acupuncture. and chiropractics. but east/west service does not work with them. and they also don't accept medicare. so now -- we are being told we cannot use that clinic anymore. we had united health care, they still covered it just lieshg it was a part of the plan. and -- it is just extremely disappointing. we relied on this clinic over the years for different issues.

my husband has health sxrbs just gave him a free visit he had 10 years of visits with them. of going there they gave him a free visit. and he has good religions with people there. they helped him a lot. so, just you know >> i know we were told there would be no change this is a change and it is not i'm angry about it. and you have been. . anyway that's my comment. >> thank you. we'll move to remote public comment. this is general public comment and have an item where our staff on the blue shield ppo transition. where comments for that item can be addressed. so our moderator will notice us

of callers. knowing that we'll take general public comment. >> we have 12 callers on the phone, 4 entered the public queue at this time. other callers may enter as public comment continuous. i will indicate when there are no more callers and you will hear a silence as we transition. welcome, caller for general public comment. hello? welcome. you can begin your time. my name issela, can you hear me >> i like to speak about the kaiser plan. because many of my friends and irrelevant tifs enroll in kaiser plan and are senior advantage

plan. they automatic get the ot c over the counter benefits. since it start since january of 23. the benefitville monthly benefits for over the counter items you know -- not a lot many prescription drug become over the counter. i think this benefit is really beneficial for senior to have. and the regular kaiser plan senior advantage plan have the benefit automatic included. when i called them since i enrolled my husband a new retiree and enrolled in sf. health plan. with kaiser senior advantage plan i thought i should have that i dmaul and say, no, because it just because as of [inaudible] does not prescribe this benefit.

drugs and not in part of the prescription. i like to -- address this benefit for the board members consideration for the upcoming open enroll am health plan. thank you. caller. >> thank you. >> moderator will notice us of callers in the queue.

welcome other caller. hello? yes, you are coming through. go ahead. >>well, my husband is on medicare and his depentants, we have nonmedicare benefits through the city. >> thank you. but through blue cross we have not received our cards i have to call to make sure that our son and i were covered. and my husband has medicare and also has to pay his part bcd benefits. so, i wanted to say that it was difficult for us to understand the transition.

at this point. from united health care to blue shield. and i wish that had been made easier for us to understand. and we knew that on we transferred i think 2 years ago to united. which were a surprise. and i wish that this transition could be made easier for the beneficiary or the you know the -- people that are departments. thank you. moderator. notice us if there are other callers in the queue. there are upon 11 caller on the phone line, two callers remain

in the comment queue at this time. they promised a seamless transition and it hasn't been case. blue shield card it was at the former address. hopefully they have changed my

address. so i can consider notification. now this is working a hardship on other individuals they then need life saving therapies and chemo therapy. i believe they did not convey complete information. they were a [inaudible] team. this is really going to raise havoc with beneficiaries of the plan. you got to correct this, this is

your responsibility. we were really sold a phony bill of goods here and it is life threatening to some people. so, please, please correct this immediately. because some people's lives may be at stake. thank you. >> thank you, caller. before i move do you want to check in with our had the to continue with public comment. okay. let us know if there are other callers at this time. >> board secretary we have 11 callers on the line. reminder to callers dial star throw to lower your hand in the queue. thank you. i can seat hands still raised. i will unmute the last raised hand that has not spoke yet.

welcome, caller. >> caller muted. with that, there are no more hands and our general public comment is closed. >> there is someone. who is trying. thank you very much am i'm gail bloom and i am a blue shield member at this point with the medicare ppo. i wanted to bring to your attention something that i was very confused about. in all the benefit summaries, right. they list in that work and out of network costs. when you get to the wellness one, it says basic wellness. ma'am. could you speak in the

microphone. >> sure i thought my mouth was big enough everybody would hear me. wellness hope programs on page 9 of benefit package. shows a benefit of basic gym access. and then it says through silver sneakers. i inferd that to mean the in network and it has an out of network column this is not meaningful because there is no out of network benefits. i called health services they referred me to blue shield. blue shield referred neil to silver sneakers. and the best suggestion they have was i go recruit a vender in my county. marin county has no in network facilities.

i was suggested that i go to either san pablo or richmond. both of which bridge tell and traffic. thank you very much that's not meaningful. and so i wonder if you could take some notice of this and what i'm looking for is a single case agreement. i think that is the promote way to approach this. no one offered me the manner in which that would happen. thank you. >> and with that, public comment is closed. >> thank you. >> next item. >> agenda item 4 vote on whether to hold closed session this is an action item and presented by president hao. >> thank you. as you recall we heard a member appeal at last month's meeting. and it was continued to this

month. so -- i will entertain a motion and second to move us to closed session. >> so moved. >> it is is moved and there was a second. we will open up for public comment. public comment is open. anyone may approach for in person comment followed by remote commentful for those dial nothing call and enter the code followed by pound and pound again. star throw to raise your hand. watching on web ex click on raised hand to put in the queue to speak. in person public comment? no one approached. we will move to remote public comment and moderator will notify us of callers in the public comment queue. >> we have 10 callers on the phone line zero enter the queue at this time. >> thank you. hearing no callers public upon

comment is closed. >> thank you. >> absent other discussions from board members we'll take a vote. president hao. >> aye. >> vice president zvanski >> aye >> commissioner cremen >> aye >> commissioner sass. >> aye >> commissioner wilson. >> aye. >> we will recess to closed session. all party the gallery members who are not party to closed session we will ask you to leave. the room. you are welcome to return when closed session is over. and we are back in open session. thank you.

>> welcome to those of you just joining us and thank you. as we come out of closed session. so. call would you call the roll. >> a roll call starting with president hao. >> present. >> vice president zvanski. >> present. >> commissioner cremen. >> present. why commissioner sass. >> present. >> and commissioner wilson. >> present. we have quorum at 1:55 p.m. >> thank you. item 6. >> upon agenda 6 vote to elect whether to disclose all discussion in closed session with a san francisco

administrative code 6712a this is an action item and presented by president hao >> thank you. colleagues zee an opportunity to decide whether or not we will discuss any or all discussions we held. so,il entertain a motion. >> not disclose any of the information held in closed session. >> second. >> all right. there is a motion. not to disclose and a second. public comment. please. >> public comment is open. and strugzs are displayed for those on sfgovtv and web ex. no one approached we'll move to

remote public comment. board secretary we have 9 callers on the phone line one has entered the queue at this time. other callers enter as public comment continuous i will indicate when there are no call and you will hear a silence as we transition between callers. >> thank you. i'm going to remind everyone on the call this is agenda item number 6. first caller. welcome, caller. no response from the caller. >> welcome, caller. il put this caller on mute.

move to our next caller. this is for item 6 regarding closed session. we'll take a vote, please. >> roll call vote with president hao >> aye >> vice president zvanski >> aye >> commissioner cremen. >> aye. >> commissioner sass. >> aye >> commissioner wilson. >> aye. >> item 7. >> agenda item 7, possible report on action taken in closed session. under government code. in san francisco code section 6712 b an action item and presented by president hao. >> great. thank you. and so i will entertain a motion

about possible reports on action taken. we don't report on action taken in closed session. one call are entered the queue at this time. other may enter the queue. i will indicate when there are

no callers in the queue and hear a brief silence as we transition between callers. i will unmute the first caller. yu choose it have a public hearing but there is no discussion for the people that are listening on in the room to a better understanding of what was discussed. that's it. thank you. thank you. caller.

president hao yoochl aye >> vice president zvanski. >> aye >> commissioner cremen >> aye >> commissioner sass. >> aye >> commissioner wilson. >> we'll move on with regular matters starting with agenda item 8. >> agenda 8. approval with possible modifications. this is an action item and will be presented by president hao. colleagues we have the opportunity now to approve the two sets of minutes. >> emi don't know if you have a chance that need to occur. if there are edits go ahead and either state them now or forward them to holly.

are there questions or discussions? if not i will entertain a motion for this item. for the two sets of minutes. >> i move to approve the minutes. >> second. >> we have a motion and a second to approve both the december 6, 24 committee meeting minutes as well as the december 12 board regular meeting minutes. we will open up for public comment. public comment is open. for those watching on web ex click on raised hand icon to

speak. public comment is now closed. >> great. thank you. next item, >> we have to take a vote >> shoot. >> okay. let's vote >> a roll call vote president hao. >> aye. >> commissioner zvanski. >> aye >> commissioner cremen. >> aye >> commissioner sass. >> aye >> commissioner wilson. >> aye. >> thank you. i vo i brief report this month. first i want to note that it is job posting for the recruitment

of new executive director to succeed abbie is posted and live it is on the city's job's website as well as on the website of our executive recruitment firm that is berkeleys search consultant. berkeley as in the city. search consultant. it is through and we look forward to the applicants who will responded. second item i want to preview since abbie's retirement date is upon us in march. we doment to make sure -- leaders there is no vacuum in leadership in the department. >> we'll take public comment now.

those watching sfgovtv and web ex. in person comment will be first followed by remote comments. no one -- i didn't think i would speak come hao when you said the february meeting you were in closed session discuss a possible interim replacement for abbie. people of the public are going to want to know who possibly can be occurred and might have things to weigh in on that possible. why you guys just being isolated

you know -- you will never know of may be concerns. so much i'm just -- i know you don't comment on what we say but that's a concern that other people might want to know who the possibilities are.

>> hello. thank you, thank you. i want to echo what the last speaker said and in addition to that, why have a public hearing with that is behind closed doors where the public community hear may be if you could not be in an agenda item if it is not open to the public. thank you. >> thank you, caller. >> moderator will notify us if others are in the queue. we have 9 callers on the line one additional caller enter the queue at this time. >> on the next caller. i would like to know what the criteria is per people who are

beneficiaries of the health service system. thank you. place you on mute. and we will be notified if there are other callers in the queue. board secretary there are 9 on the phone line no callers entered the queue at this time. >> moderator hearing no further callers are now closed. >> agenda item 10, please. >> agenda item 10 director's report. a discussion item and presented by abbie yant executive director. >> good afternoon. happy new year. the first item i would like to ask to step to the podium to

introduce her new staff member. >> good afternoon. gives me pleasure to introduce the newest member of my team on my right. eli join in the 2017. working people soft development and -- production support of was with the d. emergency management. and most reasonable with the controller's office. he was doing the production support for the payroll we and not love. anyway. recruit eli to our team. welcome. >> welcome. >> welcome.

rfp is out and had a number of responses to adjust the rfp and the deadline is now accepting proposals between january 13th and february third this is moving right along. and as commissioner hao noted i do continue to plan to retired on march 15th. also what is important to note is the election for a member. seat is under way. i believe -- that seat vacates in may of 2025 and so the election process is official. as of today. and nomination forms are available. and this is this election as you

know is very highly regulated by the registrar of voters. it is i -- it is a solid process. the -- racial diversity and cultural heritage celebrations the martin king junior a noon concert at the old st. mary's cathedral and other activities occurring the asian art museum. culturally we are rich in celebrations in upcoming weeks and months. i did continue to participate in the health care affordability boarded as -- and advisory committee tackling really difficult challenges of trying to understand to set they have set targets for the increase the

total cost care and looking into many other related issues around this point talking about mental health measures. later in today's presentation. we are -- very dedicated to working through the transition. with our members that are moving from the united m ap d productivity blue shield product. and so, yea those are the highlights of my report for today. i know we have a packed agenda i will not take your time i will entertain questions you might have.

public upon ment is now open. >> call 415-655-0001, code and pound and pounds againful press star throw to raise your hand. for those watching on web ex online click on raised hand to be placed in the queue to speak. in person first followed by remote. no one approached. we'll move to remote comment and our moderator will notify us of callers in the queue. agenda common law the financial report. this is a discussion item and we

will be presented by sfhsf chief financial officer. and principle administrative analyst. [inaudible] >> thank you. joining virtual special available to answer any questions. >> great. >> this report is for 5 months of fiscal year and end of november and projections through june 2025.

[inaudible] the year -- 3 million. health care fund decrease by 2 million ending balance of 4.6 million. and general fund administrative fund, ahead of budget due to vacancies.

are they higher or lower then and there usual? >> [inaudible]. you want to take this? or? he is joining online we are having trouble hearing you. i it take this. they are for [inaudible] and self funded plans and we normally receive them quarter low basis. and it is a function on pharmacy

claims and single shated i think it is pretty consistent. colleagues other questions? public comment is now open. instructions are being displayed. for those call nothing call and enter the access code and pound and pound again. press star throw to raise your hand. on web ex online click on the raised hand i conto be placed in the queue. in person will be first followed by remote. we will begin with in person

comment. no one approached we will move to remote public comment. upon item 12 budget instructions for general fund budget for 24-25. and fiscal year 25-26. this is a discussion item and will be presented by chief financial officer. i will do a tech check to make sure he is coming in clearly. are you in the room >>. s proceed. i can't seat screen. we are up in the room everyone in the room can see it. you would not be able to see it.

>> okay. good afternoon. [inaudible]. want to convey to you the instructions and the [inaudible] said let me know when slides are up. >> they are up. >> i will support with that. the next is coming up for you. >> okay. >> if you go to slide number two. which is the budget [inaudible]. in the -- so the reason why our impact on the city is made of 3 piece. the highest impact is for what we do with the [inaudible] our total cost to the city.

and the employees is 1 million dollars. there are [inaudible] manage the self funded plans and [inaudible] as i during the city's budget process, we are focus on the general fund. [inaudible]. in the general fund, our expenses 13 million dollars. this year because of the [inaudible] that we are talking about [inaudible]. the health sustain ability funds 5.5 million dollars and [inaudible] from [inaudible] the annual [inaudible] includes

[inaudible] 33.3 million and hae a process for the plan to support on going [inaudible] fund. the priority this is year are similar to left year. and expense [inaudible]. and society focus is to focus is that direction is [inaudible]. on slide 4, you see the -- general fund impact. if you go to slide 4.

the good news is the city is fine the [inaudible] reaches higher than the growth [inaudible]. creating [inaudible]. 6 billion [inaudible] [echo and muffled] go to the next slide. so look at all the [inaudible] and look at efficiencies. and so propose [inaudible] next upon month. we will take into account the instructions laza what we need to do to provide an fortunate operation.

there is a finance committee meeting for the 13 in the morning. that will be the second opportunity for input. the final budget present to you at the board meeting on the 13th. and the board of supervisors will approve the budget or view it -- this year. this is my presentation, happy to answer questions on the instructions. thank you. question sns >> a question/comment. i think these instructions make sense they were mayor breed's instructions and i wanted say we have a new chief and mayor of upon 27 hours ago. i suspect well being be other

instructions if i listen to his -- there are. >> acceptance speech >> well is a press release today. >> there are not other things every department. the budget was a priority and went throughout standard expectation of department head and how they respond to the mayor's directions. and -- he has announced there is an immediate hiring freeze. and there is a ga zillion dwhaes come with that. don't ask the answers are not available. but he is looking to curb spending. and -- structure of the staff

and the mayor's office is designed to foster a collaboration amongst departments we know this tha is a challenge and having a structure in place may have really good impact in that regard. i think that will be fine but i think as we -- enter in this environment it is not it is going to be confusing. and will be stressful and difficult for any of us this

have been through the kinds of constraints environments and careers know how hard it is we manage to get through. that's where we are at the moment. thank you. any questions or comments. public comment is open. remote public comment and

moderator will notify us of callers in the queue. there are 10 caller on the line zero in the queue at this time. public comment is now closed. >> thank you. >> item 13, please. >> item 13 is the approval of the resolution ordering the board 25 election for one expiring term seat and authorizing staff to initiate and proceed with the election an action item and introduced by abbie yant. and presented by board secretary myself hole. >> yes. i think i spoke to my director's report the election is under way and holly, louder. closer to the mic. >> yes, i mentioned my director's report we have a

member seat election. that is ready to get started holly can describe the process. >> holly lopez board secretary. hello, commissioners. health service board election materials were presented today. i come before the board to review the materials terror edits or suggestions. as executive director may 25, one member's term will expire and under charter section 12. 200 and san francisco code section 16. 550-16.554 when a term of office expires an election must be held. the resolution buffer today out lines the intentions for that election including the dates. and that packet included public

notices. schedule. nominations for candidates and fact sheet. and include active and retired employees who are enroll in the the health plan. and qualified surviving spouse

or domestic partners of active or retired employee. and term length is 5 years. and the commissioner coming in would start june of 25 and term would end may 15th, 2030. nomination period begins tomorrow of and open until february 14th friday at 5 p.m. and materialless will be available on our election web page on the healing service board system website. then will be available in our offices for anyone who drops in. and the there -- when candidates valdatd under the components zeal an orientation session.

surviving spouses and domestic partners and voting dates will begin may 16th and go for two weeks on may 30 at 5 p.m. and the d. elections will need 1-2 days tod- count the results june second to june 4 and year's past that will go quicker the new member would need to take the first meeting in june and now under the rates and benefits calendar will look at another item the first reading may be june fifth for the first meeting. election information distributed on our web page i will meet with jessica our executive -- communication's director to develop a plan. and then i will be cord narrator for any and all questions if there are questions for the department of elections i will be able to be in contact with

them. expiring in may of 25. and sets the dates for election thirzs san francisco health service staff to narcotic it and authorizing staff to prosecute seed with dates and deadlines. >> all right.

so -- a motion and second. >> a motion. >> you can present it. >> so, i'd like to move that we sept staff recommendation to order the 2025 health service board election for one seat expiring may of 25 this we set the dates for the election authorized the health service to narcotic the election and authorize the staff to proceed with the election. >> second. >> a motion and second. >> open up for public comment. >> public comment is open. instructions are displayed for those watching on sfgov.

>> we have 9 callers on the phone line. zero enter the queue at this time. >> thank you. public comment is now closed. president hao yoochl aye >> vice president zvanski >> aye yoochl commissioner cremen. >> aye. >> commissioner sass. >> aye >> commissioner wilson. >> aye. >> we have a vote. we are at the end of the regular meeting matters before we go in rates and benefits section of our agenda it is now a great time to take a 10 minute on the nose break. >> thank you.

we'll reconvene starting off with a roll call. please. >> roll call starting with vice president or president hao >> present. >> vice president zvanski. >> present. >> commissioner cremen. >> present. why commissioner sass. >> present >> commissioner wilson. >> present. >> great. thank you. we will start our rates and benefit's portion item 14. >> agenda item 14. presentation of rate and benefits process and calendar for plan year 2025 this is a discussion item and presented by mike clark. introduction by abbie yant. >> thank you. >> you have on the screen the

rates and benefits calendar for plan year 26. as of today. as we know things get adjusted throughout the cycle this is the plan as of today. and -- so we are kickoff with a depth explanation of the cycle we have a couple new members. if you have questions raise them during the presentation. this silent r and benefits. what other upon responsibilities for entity and other elements that will cover during the rate and benefits cycle from today through the june meeting.

so, you see a full agenda but each correlates page in the presentation. starting on page two duties and responsibilities under the sanning front city charter section a8. that is 422 the health service board. that does play an important role in designing the benefit plans covered include adopting plans for the rendering of medical care and members and designing the benefit plans and changes. to members covering the health plans, medical and prescription, dental, vision, life insurance and disability. an important note, i channel the late prosecute scott the full board meets as a whole. y way back when. serving as lead healing service board.

rates and benefits are important that the entire boarded meets as a committee to review the rates and benefits. the benefits and rates and process guides our board to approval health plans for the following calendar year of page 3. really shows january-december. the cycle time line today. we start with the release of rates and benefits and later in the meeting i will present on the reported and reserves. and then february through june. the health service board approved the plan and rates. that then leads to july the rates and benefit package reviewed by the board of supervisors first the budget and finance and the entire board of supervisors once those are confirmed renewal letters are signed by the health plans. we work those during the board of supervisors cycle.

when that pleads we release the letters and have the health plans provide their sign off. and the system programming also begins in earnest. and commences or leads to open enroll am where they are mailed in september. and october the open enroll am occurs. in december confirms the elections to be effective the start of the following year. you heard >> michael leading the benefit contract and assessment and so the contract division does report on the status under jurisdiction every year. in august specific low. informs of planned request for proposal or requests for information for primary service providers. you seat process which is a

formal proposal required financial commitments, the renewal processes a plan add administrators. presents the recommendations to the health service board for review and approval. with this approval required prior to the submission and rates package of the board of supervisors or alternateively requests for information are brood forward look nothing scope. asking voluntary commitments no contracts award it may be conducted as a market assessment or narrow the scope in determining the timing of the future rfp. the serve approvals again start today i will talk through that report reserves and the reserves. and then later in the cycle the march time frame will present on rate stabilization process. >> the funding types for the plans are 3 core manageds and

every health rate presentation that we do in the june touches on these funding methods. it is a graphic you have seen before in prior rating discussions every year. and so thought it would be helpful to include them just to illustrate the difference in funding methods the plans. that engage each will self funded the claims. that are on service delivered are paid by the trust and administrative fees to manage the plans. flex funded plans the hmo and health net carried through hmo insurance prop for most claim dollars bazed on services paid through the trust. certain fixed costs for capitation and plan administrative fees and large claim reinsurance that applied the blue shield plans can apply,

for full insured health plans that is the 6 dollar premiums with our scrutiny and negotiation. so, the health service board rate policy does apply to the self funded scomplans flex funded not to fully very insure they are set by the plans. health plan ewe lagz experience reviews every year before we present. rates for approval. so again in the march/april time. we very well view the costs will and experience for plan with you. this experience serves to help guide what is expected for rating. for the flex fund fully insured and self funded plans. which could include for medical looking at the claims. top spend categories, in patient admission. out patient visit and health status and preventative care

rates. industry resource are important the 10 county survey is prescribed by the charter. and so you see the typical language. typically in march presented to you results of the survey of the cost across the plans for the 10 learningest counties in california. that served the basis for the employer contributions for the members. the work is performed by you heard from earlier today cents roll to this analysis. and we present it for approval in march. we all conduct a bench marking study typically in april, this looks at costs and benefits for the medical plans for active employees relative to the data base of 800 employers.

and supplemental information from time to time cfo will upon present on general information in the marketplace you will hear from us next meeting with an update on health care. the rate i will not go in detail i will have a detailed presentation in the next item. out lines information on how we perform the calculations for actives and retirees and get in this in more detail in the next item. page 10 we will bring the rates and help make changes to the board and the health service board approves next month will present on vision and will take us through june for the medicare plans. >> and then finally after the health service board approves the package that is submitted to

the board of supervisors for review by budget and finance at board and then what follows upon their recommendation to cascade to the full board their action in july. per charter the approval of the following rate and benefit's package requires approval from throw fourth members spread across 2 meetings a first and second reading. and once that occurs the mayor will present it. tell be helpful to go through more detail what is coming in front of you. >> today through june. and beyond. >> thank you. mike and happy new year to you and ann. thank you. >> any questions about this presentation and time line? it is thorough. >> thank you. >> when you put it reduce it down to one presentation i'm like we do a lot, you do, too.

thank you. no questions or comments we'll open for public comment. thank you. >> public comment is open instruction on the screen for those on sfgovtv and web ex. for those dialing in call. board secretary there are 8 callers on the phone line. one caller enter the public queue at this time. other callers may enter as comment continuous i will indicate when there are no

caller in the queue will hear silence as we transition. >> thank you, i will unmute the next caller. >> welcome. caller. >> talking to me. >> caller you are unmuted you can begin your time. >> hello. are you talking to francine austin. >> hello. >> yes, caller we hear you in the room this is public comment for the agenda item about the rates and benefits. for the health service board you have throw minutes to comment. >> i'm sorry. i wanted raise my hand for another topic. >> thank you. >> thank you. bye. >> moderator will let us know if there are callers in the queue.

no further callers public comment is closed >> thank you. >> we will go ahead and move to agenda item 15, please >> item 15, board education. nonmedicare rate setting methodology a discussion item and presented by mike clark lead with aon. >> mike clark. we first asembled this with the intent to deliver it in person but our service board in spring of 2020 we know what happened. we did at that time create a 4 part series educational series we post on the website. with yours truly. we thought with the evolution of the board and certain as we start the rate and benefit's cycle. here we are 5 years later it would be helpful to do a refresh of the information on how the rates are set for the healing

plans you all have presented to you. as well as the public on how the healing plan rates are set for the medicare retiree populations. include discussion of relationship of health plan rates accountability actives and nonmedicare retirees. single coverage for employee only or retire each two party coverage including retiree or employee and a department and family coverage with 2 or more within a plan and across the health plans offered. and the multiple employer contribution determination rules are also touched on in this presentation. will often just focus on the city and county of san francisco. methodologies when we presents.

rates to you in the presentations but this contains information for city college, and superior court employees. >> so, when we finished the process you get this table on page 3, which is included in our sumization documents. m may and june and everybody wants to know how we get there. that's what this education helps to supportful today's discussion in 4 topic areas how it is funded. and the healing plans report activities for next year rate recommendations. developing the total costs and from there segment to employer and member contractions for active and retirees. historical perspective back to

2013, on the health plan rate relationships across the plans. coverage tiers and how it evolved to the current state of the relationships and some modifications. thank you to holly. there is a health care glossary of terms i will try not to overwhelm in this i can tell thank you is a fantastic resource on understandsings all the different terms. this are utilized you know across the plans and the rating work we do. first, with the methodology the self funded plan rates we caththose rates for all the plans including medical and dental. you see the various plans. that roll up under self or flex funds arrangements and the plans not listed above there are fully

insured the premiums are developed by the plans kaiser is an example that the medicare advantage plan. most of the dentsal plans with the exception being the active employee ppo plan self funded and theed vision plans and then in addition it is not listed the life insurance plans are fully insured. the self funded plan rates you see this graphic is a high level a 5 step process. starts with the prior period claims apply trends factor. to account for you inflation of medical costs as you go over time. accounts for those design and head count changes if applicable. add fees and then the cost elements like the sustainability fund charge. and so those developed a prosecute jection period rates

by plan and tier. each the next couple pages with page 8 touch on the 5 steps the total rates on step one is starting with the prior period claim experience. and certainly a fully credible population for a large population and the plans. and we are starting with the claim experience from the sipically the most completed calendar year for prosecute jections if we see anomalies through the data, the first quarter before we present on the rates we could incorporate that.

on page 9 aplied health care cost inflation and again. cfo and i will present on current trend and this is something we keep a close eye on. when you see increases and plan equalization. talked about that in november with the prescription drugs with our pharmacy expert. want to incorporate the fact that health care costs increase over time. when is the appropriate factor for us to fwhld those protections? so, we applied those factors on mid point to mid point basis to make sure we adjust the timing properly with the experience period and projection period for the blue shield plan will develop a trend factor we review

carefully. with the blue shield team for the nonmedicare ppo delta dental ppo we developed the trend factor using statistical methods. as well as national trend factors. the claim and rating include the prosecute vision for prescription drug rebates that was a question earlier in today's meeting. we incorporate expected increases the rebates as prescription drugs happen and the changing landscape and prescription drug rebates as well as the capitation levels to the fixed costs for services that apply in the plan and and the large claim pooling for blue shield hmo plans. those factor on how we take prior experience and forecasted to -- the projection date.

we look in plan design and head count changes that could occur. factor this in. to the projections. and they could influence the claim costs. could incorporate changes in any health risk or drfks the great reporting kosh are provides if we see change in health risk or population composition in a plan we could incorporate that. we don't see that historically in the data. but we are prepared if we do see it. page 11 the fees. those are based on fee catharsis provided by health plans. as well as again for the blue shield hmo's the pooling fees we built those inform could be legislative fees. california's mco tax was approved for continuation by the california legislator. that is a component of cost that

is built in the flex punldz everfunded plans. the other specific cost elements we make provisions for change in president claim stabilization reserve. so that -- certainly is an important part of the rating we do that is us specific. those amounts determined every year in the march/april time frame and the health care sustain ability fun charge moved 4 dollars per month. per covered member. as well as the basic vsp vision insured rates that are part of the medical plans. you see those line items on those medical rate cards. >> so, that's how we take the prior data all the other cost elements we know project them to the new plan year. and then how do we allocate that across the 3 coverage tiers. you know for example, this is

a -- exhibit that it shoes what plan rates could be based on how costs are allocated across the retire rew. verse you employee and retire weee with two or more. we are taking a figure per plan and across to be 3 tiers. we'll talk later in the presentation about how that is applied. allocating costs you start with the premium and budget dollars. the left side of the page the 5 elements i walked through and am get segmented based on the population distribution across each 3 into the rates using the tier ratios. and another complication.

are the three tiers for split families the split family retirees that have the members and family tiers and also certain covered in the families the medicare plans and others in nonmedicare that factor in as well. segmenting the rates to the employer and member contributions i will talk through this for active employees. the employer form lapse funds negotiateded mou's and you will see the two common ones will call them 196/83 and 93, 9383 the percentage. cost across left side employee only. middle employee plus one department and right side employee plus 2 or more departments the percentage of

cost the city is covering for this given employee. and depending on the m u someone may have this cost sharing verses the 93, 93, 83. those contribution amounts for the medical and drug and vision for most expensive plan are the same for the second most expensive plan. now the ppo is done the most expensive plan and those contribution dollar amounts are tied to the second most expensive mrafr dh is blue shield access plus. it changed with the cost of plans change. but these are the relationships. and then the employee contributions for the healing plans the total cost rates. the routes and plan and tier. for dental the mo u prescribes employees pay 5 dollars for sing and he will 10 for two party and

15 for family per among for delta dental. no contribution for the hmo's and those electing the vsp plan they pay the difference in rate between the core or basic vision plan. part of the over all medical costs determination and the premiere plan it was addd and i believe 2018. it has been successful. we will talk next month how it increases in the premiere plan. for the usd population, the contributions vary. and anchor in the 10 county amount of the could be higher. for begin employee segment. and/or plan. now in 2025, for kiez and health net hmo the employee only contribution equals the premium.

the employee contributions for the plus one and [inaudible] do vary by employee type and planful based on the agreements but the krksz for the family plans increase with the total rate increase simple and the employee contributions bank account difference between the total rate less when the employer is paying. usd does not offer dentsal. so they have dental through other means and the same applies for the vsp premiere plan. city college similar in nature to usd. could be different agreements but generally, employee only is anchored to 10 county amount. with the employer contributions. varying by typor plan but the family tiers increase with the toll rate increases.

and the other elements are similar to usd. and for superior court most pay no contributions for medical, drug or vision. they pay no contributions for dent yam vsp applies. you will see page 20 the form lapse to round out the section. which involves flejs credits can be spent on benefits. including heck and employer krksz equal to the 10 county amountful employees in the dentsal delta ppo plan. . superior court employees pay no contributions for dental and buy out for premiere li

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reserve amounts presented in the material before us. second. >> we have a motion and second we will open up for public comment. please. public comment is open. instructionsor the screen.

public comment is closed. in we don't have more questions we will take a roll call vote >> a roll call starting with president hao combroochl aye >> vice president zvanski. >> aye. >> commissioner cremen. >> aye >> commissioner sass. >> aye >> commissioner wilson >> aye. >> thank you very much. >> thank you. >> we return to our regular board meeting matters. at the top of the lineup is item 17. >> agenda item 17 blue shield medicare advantage ppo transition update a discussion item and presented by operation's manager and charles lee blue shield of california senior manager of group retiree. >> good afternoon will of gal

operation's manager health service system. this month's blue shield medicare ppo u. we will go over going over the hss implementation dash board. success and sb4 call metrics we will have a review of the implementation dash board. call center metrics and followed by a review member engage am experience addressing occurrence blue shield medicare program and care and will we will wrap up with a look ahead. last month all tasks on our hs circumstance implementation dash board are complete and completed timely. work streams for payment and reductions file and it is cms and other report are on track for future 25 dates.

>> wield like to highlight the successes of transition. that were accomplished in december. 19, 100 members sent to blue shield for enroll am allowed id cards and welcome kits to begin to be mailed out on december 16th. as we mentioned in last month's open enroll am the process is does not end at open enrollment takes several months accomplish with annual manual processing and large numbers of data entry and corrections. our goal with blue shield to send them out early as possible to get the major of our members id cards by mid december. due to the need to expedite we saw sen % of the record sent it blue shield requiring manual processing this was completed by

december 20. with next steps taken for those members and ensuring their id cards and kits were sent out. a small portion of that 7% of the record experienced error due to manual processing the case are getting expedited as they come up ensure members experience limited to no experience with access to care. i like to take a brief moment to focus a feature i talked about in our previous presentations. we continue to solve a -- functionality in our hss call center system where by member who is call hss directly are able to self select or triage and be connected to the blue

shield concierge call center without transferred or call another number. to get connected to blue shield inform december. this had a highest usage since we implement in the october of 2024. over all, our call center metrics are consistent from month to month we seat resolution is over 90%. we are seeing consistency in the average hane time. and we see biwe see an increase in the average speed of answer we saw a significant spike in over all call to thes call center during the month of decemberful in december we had factors contribute to our long are call wait times. confirmation letters went out increasing call volume with the holiday closures saw significant increase of call in both weeks that had holidays which is did she then and there when we see with monday and tuesdays or high

volume days. and member services team has only 11 benefit analysts who are responsible for both phone and in person support processing new retiree and new hire applications along with qualifying life events venter reports and internal audit reports. we did have holiday time off schedules in december ruszing or team. i point out to the board that the member team has a block out period the left 2 weeks of sept through november vacation time cannot be taken to accomplish all of our administration for open enrollment. i expect our call volumes will remain the same in january. as we work to back fill positions that are open on the

member services team. i will lo like to fasz over to charles lee. >> thank you, olga. >> welcome charles. happy new year. charles lee blue she said. you see on the deck a similar to hss, the transification for blue shield has been positive. we completed a variety of tasks required for the implementation for one line and we are on track for various post implementation items such as medical transition ensure transition is successful and transition as well. so since january 1 we have not experienced major system or other issues of prior post, knock on wood there. but in the effort of

transparency we acknowledge we have experienced wind number of issues with the transition. i will speak to those later. but in more detail. but we want to reassure the board and retirees that we are working diligently with the staff and -- with additional advocacy groups to understand those issues address them, quickly and get them resolved. and lastly, 19, 100 members did receive. their welcome kit and id cards. i will pause and go to an upon call metrics. i want to highlight this is for our december and so it shares the experience this retirees had prior to 1/1. the number of id card inquiries

the hot topic for retirees. and so, we have certainly stheen a cost hike as a result of the questions and the same time you will see the average speed answer unfortunately it went up from the usual commercial that i talk about and like a superbowl commercial a 60 seconds there. i want top reassure the board again that we have increased staff. from our 22 concierge folks and i believe 34 to be able to bring this down and address additional call volumes that will report out in january. lastly of course the 64 second system an average we have heard of instances where the timing of the call wait time exceed the 64

seconds in minutes. and we attribute that to spike in calls. i had a sample id doored share that are did in the get to us in time of i am sharing a with the board a hard copy of the welcome kit we shared with members once they are enroll exclude they have received in december. once again, we had no major system issues id cards and welcome kits were delivered in decemberful thank you. so the next item we have is addressing member concerns.

so, we wanted share with the board that we did have a hiccup in terms of a confirmation of enroll am letter. that's in and a letter we sends once we get information from hss and we submit it to cms to confirm transition to blue shield. unfortunately, that is a templeted letter inform a confirmation enroll and want unfortunately, there was language on there regarding out of network coverage and requirement for prior altogether. unfortunately, those letters were sent out like i said in error. and i want to be clear it was an issue on blue shield's side sent out by mistake without editteen

though temptleted letters we have the ability to update and should have dhn to make it clear not all out of network services require prior authorization. at the same time what we did was once we understood the issue and heard about it we worked with staff to quickly sends out a correction all right to correct that misinformation and hopefully that will lessen the concerns for retirees moving forward. the same time we have a corrective action in place to be able to review all member materials or letters that are going to be sent out in the future to make surety edits are incorporated and not general templets sent out. >> in addition to back to prior authorization issuance as well. we received some reports of

providers not accepting our prior authorization process. for them. that is partially an education issue with providers to help them understand the 90 day transition process we have in place for hss members. and the same time, what we did is we have created a developed a written authorize. in addition to verbally talking to provide and assuring them that the prior authorization is accepted. we didn't extra stow develop a written authorization as well as to reconfirm and reassure them that the prior authorization is in place and they see the members as needed. >> hopefully after this is settled down after the new year we look forward to working with

hss staff and being able to be proactively engaged with our members moving forward to make sure that they stay healthy. some of the item this is we look forward to working with is to be able to have a cohesive cobrand campaigns to be able to educate folks on availability of the programs we have. listed below. such programs health vs. mailed kits and got membership appreciation programs which incentivize participation with gift cared ranging from 10 dollars to 50 dollars. so -- all those programs is the goal main goal is to able to get data for our retirees. with that data, what we want to

do is able to have them be able to access additional programs in care to help them stay healthy as well. what we want to do is get that data and identify folks that could participate in -- targeted out reach and support and services such as areas behavioral health. pain management, depression. cancer and et cetera . what we want to do is take that data and be actual actionable about it and proactive and reach out to member and offer them additional assistance and programs and resources to be able to engage them and keep them healthy again. thank you very much shares the programs we would offer to folks to be able to focus acute care,

pain management. chronic conscience. nutrition, et cetera. we have the programs set up so we can guide folks through the process and through the resources available to be able to have them work through healing issues and occurrence. and i our goal here for the programs is -- the right care at the right time to make sure we engage them in a proactive manner. >> and the last slide we wanted mention to the board that we are excited and we look forward to you know engaging members with those programs we want to be out there and engage with the retirees educate them on what is available and able to work with them on health care moving forward. we will make sure that access is not an issue that will be addressed proactively.

we will continue to take a look and make sure that the very popular groups weep typically utilize hss members such as stanford. dignity. and john mere have no access issues. >> we'll be proactive about pharmacy reimagined. blue shield as you heard were trying to break the mold on the terrible pharmacy benefit manager system. and so we want to make sure our efforts bear fruit and that they had positive impacts to members. i want to mention that this is an exciting time for blue shield. we are excited and can't down play the level of effort that we coordinated with hss to beally to transition 19,000 members successfully to blue shield.

and so, we want top move from implementation to the expectation and deliver on the first class care and service that we all want to deliver for the members. at the same time acknowledge we are not perfect. and that however, we are here to be committed it is quickly addressing issues and able to resolve them and make sure that there are no on going issues. with service. i open up for questions >> can i jump in, procedurally. it was handed out need to make sure it is in the record so that the public can see it. later. given the board has looked it a will work with blue he would to get a copy to post.

>> i have a couple questions on the card i received says blue shield of california and i on the back has -- billing to gallon to blue shield of california i live in california if you lived in arizona will the back have the arizona addressos it for billing or still california? >> does that create a delay?

should not be for the member at all? correct. no member impact. >> we do have service level agreements with counterparts to make sure that claims and where there are no provider issues with that. there should be no delays. >> okay. >> we are not members are not hearing from providers they are not getting reimbursement with regard to this? >> you are say thering is no issue for the member. but if the provider is not

getting service that information will get become to the member one way or another? >> we don't anticipate any issues for the provider as well. once again our association folks with process timely send it to us to work with under service level agreement time lines and process appropriately. >> okay. >> thank you. >> i have another question. >> commissioner sass can you >> yea. >> transition, the the kwhart i looked at said that on track. but that the date is january of this year. so we are now half we into january of this year is it on track? >> yes the pharmacy transition has been complete. we have we are with our pharmacy reimagined partners and amazon is a partner for our home

delivery service. the question is we want to not have issues with the transition. >> transition would require members to know these things. i don't know i'm not aware of an amazon may be that was explained somewhere >> that is part of the welcome kit in there as well. and all members outside of hss other members with blue shield have recard so they have the pharmacy information updated information so they can get there pharmacy service and medication. >> i guess you say completed and some say on track. i was trying to understand the difference with. >> okay. i apologize and we'll make sure

we are more concise and clear moving forward. >> i don't know if you were here earlier we had a member came up and commented about transition she was going through with her family and the problems she had with the east/west service. are you familiar with them >> with the chiropractors? >> yes. i spoke with her and we are going to continue on look in the situation we understand we got additional details we will be in contact. >> great. thank you very much >> of course. >> are you the talking about silver speakers is that going to come back >> yes. that is an item we are the fwhafs we are look to enhance and a concern has been the number of facilities contracted we are working with silver sneakers to get feedback from

membership. sometimes vocal feedback and understand gaps in coverage and -- do our best with silver sneakers to highlight the prior use where we have gaps and need to do better >> you came out with i list yet? >> we don't. the issue is for 1/1 that is part of the process, usually. when we start those are facilities that are not any longer accepting members. and so those impact the facility and we that way we take that as a trigger to -- work to increase the backup facilities >> thank you very much. >> on that we heard a comment earlier about silver sneakers programs being available in marin county can you look into? >> sure. >> thank you.

>> okay. >> any other questions before we open for public comment? >> i want to add to the issue on silver sneakers, i don't think a week guess by i don't get 2-throw comments from members worried about silver sneakers. and will it continue and what happened to their provider that thing this is a very vital program. and especially of the people contacting me are primary low retirees and silver sneakers programs help keep them healing competence active and so understand this is a really significant benefit and program. >> absolutely. we recognize it is a critical program for the health and well being of our members. absolutely. >> thank you. >> thank you. >> we will open up for public comment. why thank you. public comment is open. instructions are displayed on

the screen. we want to see you up here >> i have a letter if a member she asked i forward it to the board, which i did. i hope you read it and i hope you got it. here it is. on january second, 2025 i had an appointment with a spine doctor. which was an hour and a half from where i live. i knew the insurance was changing. so i called blue shield ahead to make sure there would not be i problem the represent assured me

there would not be a problem i called the spine doctor's office, also. oft dave appointment i walked the doctor's office i received a call from the office saying that i would have to reskechld they had been on hold for blue shield and said yes could get procedure but would not get formal approval. i made calls called the number on my card and told wait 15 minutes. health service got a long record and the end gave a number to call special tryd that number and told it would be 15 minutes. wait time i decided to call someone i knew with the service [inaudible]. after having wasted this time of driving out there and the disappointment not getting this epidermal for the pain in my back i left and started the drive back home.

karen was able to reach someone and put the wheel in action when i was close to home i received a call from gregory a supervisor with blue shield. apologized for the confusion and asked for the doctor's name and information and get back. unfortunately the doctors only there on tuesday and thursday. it is now set up for the next thursday january 9. i will live with pin for another week this is an example of how easy it is to reach hss and easy it is to reach blue shield. trary to what mr. lee said this has been a major problem beam getting anyone on the phone. you call the phone and you want hss. they insist you are a retiree you go to blue shield. how do you get a hold of hss if blue shield is not doing what you think they should be doing that's where you make your complaint you feel can't get a

hold of anybody. thank you. anyonel can approach will for in person comment. i apologize for being slow. maureen >> you can hold the mic down if you like. >> retired adult probation department of the until about a year and a half ago, i enjoyed good health i have not am not familiar with health insurance plans. i do think my concern that i will let you know about today. are very valid. beginning of december, i became very correspond because i had

received no medical card and no verification that i was transferred into blue shield. after trying to contact the healing service by phone, several times and only getting voice mails,ile was calling during business hours. i resorted to calling the mayor's office. and said she would contact the healing services system and i received two phone calls from the san francisco retirement system. finally, i received a message from a representative from the health service system telling me i would receive my card december 16th and giving me a number to will caw at blue shield. i think that i should have

received a card no later than december first. and probably november first and representatives from blue shield attributed it to the fact they did not receive the information from the. san francisco health service system in a timely fashion. my next concern was the difficulty in reaching the healing service system. i called many times and i spoke to a voice mail and never returned received a return phone call. now i'm speak as a taxpayer. healing service system is a city departmentful i would think that they would answer phones from 8

o'clock to 5 o'clock. i believe thatship answer from 9 o'clock to 5 o'clock which is acceptable. under 30 seconds remaining >> 30 seconds. >> so i am finished and thank you for your attention. >> in person comment is open if you would like to prop the podium. yea fred sanchez from protect our benefits. it is not what i was told in the plaza city hall don't worry about this. it is going to be the differences will have a different membership card. this did not pay out. but i am going to say that blue

shield especially like tiffany scombren what jessica's got from you jumping over houj boulders doing everything in capacity possible to solve these problems. that karen talked about she is having her appointment today. yes , it was an extra week of bad pain but you know, sometimes i have another one where a guy is on chemo therapy and i brought it to their attention and refused chemo therapy. they got authorization you fax in things up. in the office where on their side the woman is not in the office every day. as much as we are trying to

resolve problem its is not all on blue shields or hss staff have done workedful things but huge glitches.

i got my card yesterday. than i said, bad address. i gave my address to machine to input it. i never got a welcome packet. if you can show to bring up if you had this blue shield card. it is -- kind of goofy. this is for the future on the top says blue shield ppo. and with the bottom there is a suitcase ma medicare advantage ppo. this is in the future like u night the health care they if you on one part on the bottom said united health care medicare advantage ppo. may be the design of that card. these are things that you know will work out but the things on

delays where people like chemo. series things like that that is unfortunate. anyone can approach. hi. i'm david i'm a schizophrenic on 5150, three time in my life. i don't know why i'm here i wandered in and wanted to say it costs throw thousand dollar a night to stay in a mental hospital. 5 thousand dollars to take an ambulance ride and a lot of people with the psychiatric disabilities like me are extreme low disvajd and poor and don't have insurance like -- i'm paying to be under surveillance and it is a bit much.

i wanted say that and nut in your minds. thank you. no onel approachedit move to remote comment. >> i will check to see if there are callers in the queue. thank you for taking of my comment. there are i would echo what the previous people who come up to mention their occurrence. one major concern that needs to be addressed how hss communicates with blue shield. and then being somehow disconnect today happened more with hss then and there it has with blue shield. referrals back and forth contact

i never got the corrected letter on must go through a blue shield doctor. that has been addressed by the blue shield represents i did not get had letter. and i also have an okay puncturist who does not take blue shield. nor does she work with ash. thank you. is there further callers for public comment.

there areit callers wherevero raised their hand. public comment is closed. >> thank you very much. >> all right. if we don't have questions we will move on to the next item >> item 18. >> hss strategic plan 23-25 and progress report to the health board this is a discussion item and presented by several staff members. on the screen is a picture of the san francisco health service system strategic plan approve in the 2022. at this time the board endorse exclude approved the assessment

and evaluation of initiatives to vance strategic planning 23-25. this presentation reflects commitment to a report out on progress. n slide provides over view of the gone. the agenda is complimented by our strategic framework. including our mission, vision and values. i will begin today by sharing a time line of strategic plan development mile stones. how equity in the mission, vision and values. then myself and copresenters will share progress reporting for each goal area with a wrap up on strategic execution concepts for the road ahead. an important point we are reports on subset of active 2024 rural areas only. the last year of annual progress. we are not reporting on

initiatives that have just beghun january of 25 or those yet to begin in 25. we want to asurety board and members of public this no initiate 95s are missing or omitted they will be highlighted to come. in the packet a pdf report. and power point slide that had more detail. as always we are aim to seek input from the board. i have been informed we have a mere 15 minutes. 25 slides and 4 speakers passing the mic if it is possible for commissioners to field questions at the end.

>> 23-25 plan includes all levels of stake here engage am the voice of staff and informing our mission, vision and value to reflections of other county departments vender per ins and experts and members of the public at the strategic plan board meeting of 20 twoochl our commissioners played a role in reviewing the current state tool kit assessment. our report, dash board and disc report and other data we needed to review to create the iteration of our plan. you see that in 2022, 2023 and 24 our diverse educational opportunity provided commissioners including

expertise on matters that are per nan to role. made it a point to seek insights about how staff members see themselves and work and the strategic plan reflect in the our all staff retreat agenda and concepts in the 2024 member services open enroll am survey. the distribution of the 2024, your opinion matters survey, helped our department insights on the types of support received from member services in the last 12 months. help us to understand the gaps with the current and future states of offerings in relation to practices in the field. it helped shape programs and services to meet the nieced of the diverse populations we serve. i hope this time line was helpful in setting the stage how we arrived at the report out. the time line remindses us everything we accomplished when we go forward we raise the bar

and challenge our limes of cape abilities. as we approach the final year of strategic planning we want toup hold equity leading with it to support membership in accessing care regard will of characteristic of gender, location, statute and this includes the intersections of our goals. [reading fast] this leads me to present area one equity. a clarification that this is annual progress report centers around advancement for staff. future reports will center healing advancements for membership.

with other initial net works of regional and state governments. created as a new divifthz human right's commission in july of 2019. office racial equity was guaranteed authority to credit a citywide framework and completion of action plans for every department in the city. on a national scale the city of san francisco is also joined by a handled cities and 30 states in the government alliance. again this progress report centers advancement for staff as recommended by the san francisco office of racial equity and future reports enter advance ams for our membership. >> prior to 2024, the expectation of the office racial equity each city and county department recruit internal

staff to form work groups. reflection of the mile per hour's mandate. office shiftd that strategic with a fresh and more effective collaborative approach. the pier learning cohorts are organize in the 4 pipelineos department racial priorities shown on the screen. participating in what is the culture core. centers around sharing and reflecking practiceos creating belonging and safety. array of space. assessing roles and skill set in our department. the office of racial equity approved our request to participate in suite of staff training through the be the change consulting the sessions affordings supervisor and nonsupervisor leader the opportunity to deepen knowledge

and tools. thanks to the experienceship from office of racial ecquit added 47 hours of trin to ledgers to carry out smiments in alignment with our plan. developing a culture of belonging. employee development and approach to retention and vancement and designing and implementing performance reviews among other topics. when we combine hours in trainings like these, with internal d. human resource trainings reporting july of 24 through june of 25 or department is helpful way to molting the goal. i will speak to on the next slide. >> a new equity measure and goal part of the performance program to monitor in the mayor's budget book for quarter one of 25 the new measure includes mixed training hours to

expand collective knowledge about diversity. racial equity. this performance program reports data for every department this contributes to our performance scorecard. we are not alone in the work other different graph titting to the inclusion of metrics for scorecard to demonstrate a commitment to fostering equity through organizational culture. i would like to pass the mike to ceo to cover primary care practice and affordable goal areas. >> good afternoon. second goal is [inaudible]. and if you can go to the next line. the mile stones for 2024 and the happy to report we met the mile stones.

[inaudible] and the next slide we seat mile stones that continuing to the [inaudible].

upon >> good afternoon will xhfrns customer healing service system. i will focus goal 4. which is supporting the mental health and well being of members reducing stigma and addressing barriers to care with stake holders. well are throw focus areas i

will cover. the first is reporting out on our mental health vendor summit in december of 23. we continue to do the work in around that summit. we are look to identify our next action items in regards to priorities in three areas around communication, training and assessment and we are continuing to work with our graphic artist and digitizing that journey map. enhancing retiree well being the last year of 24 was ensuring thereof an aline am in the services and support and monitoring the mental health and behavioral benefits for the transification from the uch flon

blue shield ppo transition. we vehicle receiving from our healing plan and continue to dive deep in that. third focus area is our annual health in may of every year i will focus highlights our goal is to next our engage am 5%. year over year. this last year from 200 throw to or 2023 to 2024. we saw a 59.9% increase in equalization. the web narc and group exercises class we offers. one big components to the

campaign we partnered with 13 department heads to creative don't wait we are hear for you. that was successful it 930 views and had more since then. and then we have a lot of clicks in the e mills people clicking and ewileizing the resource. we have 5 different areas we look at encombaj the one is through trainings and w shops and webinars and exercise classes in highlights. we look at how many individuals accessed our credible mind website and took an assessment and how many sessions to credible mind or how many going in the website and clicking and ewileizing the services and the number of e ap case those are when people call. seek service. how many that get when we call a case to seek services through a clint iing. and one thing i wanted note is

that you will see in three of the 5 areas we had a decrease but because we had a significant increase in training and we are seminars we offerd that helped to drive us to go beyond that 5% goal. and i will turn it over to olga. operation's manager. i will go over 4 areas under opt miization of everybodies system with gospel advancing stake holder engagement. in 24 we established a base line for members satisfaction with support they receive in the person and through the phone special our goal to increase the satisfaction 2%. we received 2,000 responses to the survey with rate of 58%.

among those who -- satisfaction or highly satisfaction in service. one element was the member survey was called the net promoter score ape mark research that measures how likely customers are to recommend a product or service to others. our score was 26 which is in line with industry standards for health care. in 20 twitch we will continue the survey, process and evaluate the strategies implemented throughout plan to evaluate how they are increasing the satisfaction of our members and increasing our met promoter score. the next several goals of our 23-25 plan look at improving staff experience and knowledge which is directly linked to

improved member satisfaction. part of the high level strategy do you meaning all member service divigsz operating procedures in 2024 we were able to document 11 procedures. able to update 5 of our member communications. conducted nime trainings followed by a staff survey of their reflections to which we had a 90% satisfaction rate. we'll take back the staff's

recommendation and incorporating them in our 2026 plan. and our last completed element of service plan to incorporate quality assurance members to the administration of benefits. the goal was deferred until all operating procedures were documented we were able to adopt a system used by other departmented for exalt quality assurance. i want to mention that is only one of the work streams of many the quality of informationa is shared. each supervisor on the member service team reviews two calls

per staff per month evaluating them against crip tear enthusiasm the information is used during staff one on one sessions and coaching and guidance for future calls. we utilized the dhr customer training during our all staff retreat last year. that created a foundation for our staff of 4 customer service expectations. this goal allows you to capture areas of improve am. and you can see from the appendix on page 2610 of the 22 areas scored a quality assurance of 90 or above. we will take the learnings from the reviews and search for staff training happy to pass the presentation to low litesia for final remarks.

in 4 direction of the plan completing the hear vard strategy execution course. i want to share themes that amfight lessons we learned. strategic plan implementation. knowing the various tensions leadership face. and building a frame w for managing them effectively. think burglar how to optimize the design of key jobs to aline them everyone understands their work and role. want to apply techniques among employees example to live by our values and inspire and guide them. aim to create measurement system that account for all dimensions conserving time and attention. identifying common business risks. faced and creating system for managing and mitigating the risk and lastly applying techniques

to adopt to change maintaining clear focus necessary controls 99 our influence. to end i like to share a quote from the course. all of us have to recognize today's strategies will not work tomorrow. to remain relevant you can't focus impelementing the strategies you plan in advance. we identify and important changes and knowledge. use to refresh and keep it relevantful our department strategy is e involving as a reflection of when we learned and we hope this is reflective of that. thank you for your time and i will invite the panel to be on deck for questions.

tell us more. >> we had two divisions participate in the trainings we commented a lot of our member service and teams on the phones. we are trying to stagger we all get a chance to participate in trainings. administrative division a well being assistance teams participated the future goals to rotate to carry out equity with the plan across all divisions with equal opportunity to participate. the suite of trainings is prerequisite. so currently we are filtering through bias trainings with dhr a prerequisite to communicating we are trying to complete the suite of trainings. when it come to office of racial

equity phase one goals centers original organizational culture and invest nothing valuable asat the time which is our staff we will want to work internal low from the inside out we continue it is a reflection how we treat one another and membership with the same 11 for members. so we are following the guidance of the office of racial equity and he awaiting faze phase two framework with vulnerable populations. that our equity related goals >> how will you measure you moved the needle. >> when is come to external equity trippings there are preset post evaluations. when we partner with office of get experienced provide with us sum rows and examples how appeal rated the trainings and translate to the every day work

environments. they provide us with over everying assessment of our department. with our all staff retreat the training we participated in we get our individual results and results by division and for each person. that provide them with context how to community better with colleagues and how to put xha what they learn in the realities in the work place so it does in the become a book on the shelf. >> for example, if you are taking the bias trin and want that to translate it how old staff works with members who call how will you measure that took root? those staff members how the bias training is work nothing their every day duties? >> i appreciate you asked this. this january having an assessment forum for how to

translate the learnings we do with the culture in translating that to the work we do with membership. so that is something we can report become on after attending that foir forum. >> great. thank you. >> and my last is for kerry. after the two videos, were released du see an increase from employees who saw it assist uponance throw or other behavioral healthervices

>> what is interesting about the data what you look at a couple different points for e ap for this campaign we report on cases. and we look at calls. and calls are could be someone calling and may be e ap is in the a fit they need financial supportful hard to know aside from those why people are calling unless it is a case. and soal we saw a decrease in

peep who received a referral we look at case to callerateo. how many calling and convert. we saw an increase from year to year in that standpointive don't report on this. what that means to us those who are calling they are calling and getting the services than i need versus i'm calling and i'm getting diverted to something else. in the a 21 one action what ruin someone calling. thank you. >> questions or comments. thk thank you very much for the

very thorough and rapidly presented presentation. thank you. thank you for being mindful of our time, too. joe will take public comment. >> public comment is open. instructions are on the screen. we will begin with in person comment. no one propped the podium. move to remote public comment. i will look at our excuse me. >> hello, again, i wanted say that the cure to depression is put down the phone, get out of the cubicle, and talk to a

ranom. >> thank you. >> >> no one else is approached the podium. i will move to remote public comment. >> we have 4 callers, wherevero placed their hand in the queue. i will take a 5 second pause. >> no one raised hand for remote comment. public comment is closed. >> great. next. number 19. >> reports and updates from healing plan representatives. this is a discussion item. >> any updates? i see kaiser shaking head. >> okay. >> and nothing from blue shield. anybody else. >> nobody. >> all right. >> then this moves us to adjournment and so -- i now call this meeting of the health service board adjourned. see you next among in february. adjournment at 4:43 p.m.

start on time and this is our special meeting for the homelessness oversight committee. this is tuesday, january the 28th and is our custom.

we will start off w