was health reform, san francisco recognized the importance of health insurance and health care access and adopted cutting edge policies x programs that extended health insurance to more san franciscans, these included the healthy kids program which provides health insurance to low-income children, the health care accountability ordinance which requires contractors and less sees of city property to provide health insurance to their employees and the health care accountability ordinance which you will hear about more today and healthy san francisco, our flagship program as supervisor campos mentioned. as employee of the public health system, i'm pleased to work in a place that puts high priority on health and access to health care and it's because of the citywide commitment that all san franciscans have a good health care home, we are doing this by connecting people to the insurance they're eligible for and to those that have no other options. we cannot afford to keep individuals on locally funded programs that are subsidized by the state or federal government. it will not be simple, it

. >> within the department of public health, we really have a two-fold focus on health reform implementation. first is about dph's own health care delivery system. we are looking to ready our system to be the provider of choice for our patients, our uninsured parents have not had a wide choice of health care providers but health insurance provides them with that choice, we want them to choose us. a recent survey indicated that 60% of low-income individuals who are uninsured would change their provider if they were given the choice to do so so we are responding to that challenge and integrating the service we offer throughout our delivery system so we do a better job to coordinate the care our patients need, we're working to improve quality and capacity to increase access to care, we're enhancing our patient's experience by shortening waiting times and increasing our efficiency in customer service and these are exactly the items that barbara is at the health department working on today. our second role is more citywide in nature and related to our mission to protect and promote the health of

care on their health care reform. it was encouraging to hear from legal council that there's a way in which the current health care ordinance will be able to support our low-income families to be able to afford health care reform. lastly, i will say you already heard that we got some funds for our enrollment and we want to express to educate our community around all the options, people have to remain in health care and we will do our part to ensure that those 35 thousand uninsured individuals have a place where they can call their medical home, so thank you. >> thank you very much, ms. story. next speaker, please. >> good afternoon, supervisors, my name is shanell williams and i'm a student trustee at city college of san francisco representing 90 thousand students, so also some history, in 2004, i served on the youth commission, at that time we wrote legislation to expand the healthy kids program to help to pave the way on what we have now in healthy san francisco, so the affordable health care act, we cannot allow it

that is not health care, that is avoiding health care. if we could fix it and make it different, what would we do. number one all of our coverage was personal. personal. we would also make sure that it was portable. and then we would try to make sure that what we are doing in health care has a premium base to it. let me explain that. personal means that your health insurance and audience think about this. shouldn't your health insurance owned by you and not your employer? >> changes are you change jobs and change insurance. and one of the role challenges and health insurance was a creation of post world war ii america and not done that way for health purposes. it was done that way for tax purposes and so that people could get benefits without the consequences. would it make sense to fix the tax consequence instead of revamping the entire system. maybe i will share that with them. make it permanent you own your health care and you move so does your health care. that's the way you go to your life insurance. 0, you are not the same person yo

the health care security ordinance would secure that more workers would get health care and health care is the human right and everyone should have the right to access health care regardless of their income. thank you. >> thank you. i'm going to call a few more names. (calling speaker names).

blue cross, blue shield, the chinese community health plan, health net and kaiser. technically, there is no mandate on employers to provide health insurance under the affordable care act, instead there are incentives and penalties for employers to offer coverage. they can offer for affordable coverage on the exchange, and for more full time employers, there is a financial penalty structure if employers offer no coverage or unaffordable coverage, no coverage is defineesed as an employer who offers coverage for fewer than 95% of its fte's and the employer is imposed if one employee receives a low-income subsidy on covered california, [inaudible] health insurance that covers less than 60% of health care expenses or costs an employee more than 9.5% more of their income, a penalty is imposed if one employee receives one subsidy. [inaudible] at a cost to an employee of no more than 9.5% of their family income would avoid any penalty. these provisions were scheduled to become effective in 2014 but the obama administration delayed their implementation until 2015. and finall

health care. that includes tens of thousands of san francisco resident, 10 thousand more that work in san francisco but do not live in san francisco, san francisco has been a huge success, all it takes to perceive for the future is to get the obama administration to recognize that it's a unique program and make some regulatory allowances unique for its design, this should not be controversial, healthy san francisco has a [inaudible] for healthy care reform and our national representative ares at the forefront of making the aca as strong as they could, but during this, we will ensure the health of san francisco remain a model for others to follow and doesn't allow us to enroll backwards. some people currently receive coverage through healthy san francisco will require for medi cal care and many will not, we estimate 3 to 4 million californians will remain uninsured even after the aca is fully implemented at the same time public hospitals will face cuts and dsh payment and the alignment fund, employ

the affordable health care act has eliminated the use of any health care programs that have lifetime or annual caps, and stand alone health reimbursement accounts by their definition have annual caps on the benefits and as such, it's been widely understood and interpreted following this most recent federal guidance that these will be impermissible commencing in 2014. >> i think for many of us, that's a good thing. now, if maybe for purposes of informing us, i know that when the debate around the loophole was happening, there was a different approach that was taken, as you know, i introduced legislation which mayor lee vetoed and there was sort of a revised legislation that was introduced and eventually passed and one of the things i want to ask you, and i remember that this was a key component of that legislation, and i will sort of read to you something that was includes, something that the mayor said at the time and the passage of the version of the legislation that was passed and was signed and he said, we must know what proportion of companies, however small, are placing these un

next speaker. >> [inaudible], national union of health care workers, we strongly support the health care ordinance and strongly encourages everyone to leave alone the employer mandate to pay for health care, but that aside, i just want to issue some concerns that i had about -- that it was the business community talking about this universal health care committee and i want to strongly encourage, if that train has left the station, in her statement saying people should be paid -- naoubl as this committee is going forward, i just want to make sure if it does go forward, i want to make sure there are users involved as well as community organizations and labor involved with na because i don't want the [inaudible] in charge of the hen house at all. thank you. >> thank you very much. is there any other member of the public who would like to speak who has not spoken whether you signed up or not, if so, come forward. seeing none, public comment is closed. and i just want to take this opportunity to thank all of the members of the public who have taken time out of their busy schedules to be here

the health care security ordinance would secure that more workers would get health care and health care is the human right and everyone should have the right to access health care regardless of their income. thank you. >> thank you. i'm going to call a few more names. (calling speaker names). next speaker. >> hi, supervisors, my name is judy and i'm a resident of the easier neighborhood and i'm part of the chinese progressive association, i parent panted in klektsing surveys and presenting our recommendations to the health care services master plan task force. as was said earlier, a lot of companies are cutting their employees' hours because they don't want to pay for health care, that's not fair and i don't want that to happen in san francisco, our local law limits employers to do this because they have to put aside for their workers' health care based on each hour the employer has worked and my family can't afford private insurance, this is a lot of the case of other health care workers in san francisco who work in restaurants or retail, they need health care security ordinance so eve

health insurance provides, two key problems continue to exist, health insurance will not be affordable to many people and many people will not be eligible for any sort of health coverage under the nca, affordability, more low-income people will be eligible for expanded medi cal, health insurance covered will still not be affordable for many, especially in a high cost city like san francisco, people will not be able to afford this health !insurance premium, a 2012 survey of planned parenthood clients showed that 60% of our patients had no health insurance because they couldn't afford any monthly premium whatsoever, 28% more couldn't afford more than 50 hours a month, accessabilities, we heard it here, three of four million californians will fall through the crack, our undocumented and immigrant families will not be eligible and have been shut out of the family, these folks are important people to our community and it is important that we ensure they have health care access to them at all times. again, planned parenthood supports healthy san francisco and we're doing a tremendous amount

that is not health care, that is avoiding health care.f we could fix it and make it different, what would we do. number one all of our coverage was personal. personal. we would also make sure that it was portable. and then we would try to make sure that what we are doing in health care has a premium base to it. let me explain that. personal means that your health insurance and audience think about this. shouldn't your health insurance owned by you and not your employer? >> changes are you change jobs and change insurance. and one of the role challenges and health insurance was a creation of post world war ii america and not done that way for health purposes. it was done that way for tax purposes and so that people could get benefits without the consequences. would it make sense to fix the tax consequence instead of revamping the entire system. maybe i will share that with them. make it permanent you own your health care and you move so does your health care. that's the way you go to your life insurance. 0, you are not the same person you

we will start with the director of the american public health association, which represents public health professionals. he is a board specialist. with somebody familiar public health and its role in dealing with different types of disasters at many levels. we are happy to have you on our panel. you for having me today. i am going to start by pointing out our new reality. can you hear me now? i am going to start i talking reality, the fact we are clearly in a dangerous technology we have today is very different from what we had years ago. i want to point out the nature -- we often say nature is the first terrorist because of the enormous impact nature can have in creating infectious diseases as well as extreme weather. globalization is a blessing and a curse, the fact we can have rapid movement of diseases. oneften talk about being plane ride away from something very bad. we are one e-mail away from dangerous information that should be out of the hands of people that are very dangerous. very challenging world today. heard about the significant threats. we had a foodborne outbreak. outbrea

of public health, respondent 311 12th avenue. appealing the revocation on may 13, 2013, of massage establishment permit. director's case no. msg-13-23. for hearing today.>> item no. 5. item 5: appeal no. 13-061 nancy luo dba "clement service center", appellanttss vs. dept. of public health, respondent 311 12th avenue. appealing the revocation on may 13, 2013, of massage establishment permit. director's case no. msg-13-23. for hearing >> item no. 5. item 5: appeal no. 13-061 nancy luo dba "clement service center", appellanttss vs. dept. of public health, respondent 311 12th avenue. appealing the revocation on may 13, 2013, of massage establishment permit. director's case no. msg-13-23. for hearing today. >> we will start with the appellants. you have 7 minutes to present your case. >> can i state appearance for the record. i'm fred baker, attorney and this is shawn salehih behind me. miss nancy lou would like to address the board. >> dear members of the commissioner -- >> could you speak into the microphone so we can hear you bett