hra's are restricted what types of medical services or premiums that the employer did reimburse. he also asked olse to specifically track hra reimbursement rates distinctive from all the other reimbursement accounts and to compare those accounts to reimbursement rates, he also decked olse to employ on which employers allow employees to draw down hra funds to cover health care. he asked our department specifically olse the office of small business and dph to conduct employee outreach around their rights and obligations under the health care security ordinance. and he called for a qualitative research effort to better understand employee barriers, real or perceived to accessing hra funds sparkly, that's something that we are working on doing that, i'm work -- working with many of the departments, privacy may be one that we would look at, but looking at it, i think ideally within those employers that are doing a real ri good job of drawing down and doing those reimbursements, what are the best practices and also looking at likely would be within the pool of employers that olse has i

finding 12, hra's may not be an allowable option in reading the requirements, partially disagree, just in that we simply don't know what the affordable care act will bring and we are watching very closely for when the rules and regulations are issued, and i think at that point as a city, we'll need to sit down and quickly address what this means fwr the health care security ordinance. finding 13, financial incentive to retain hra funds could be a motivating force for employers to access employee funds to those funds. that certainly could be the case. i think the motivation behaind what that financial incentive is, we don't always know, it could be to retain more money for the profit of their business, it could be to augment employee's salaries or to hire more workers so i think there's varied motivating factors for companies. finding 14, by submitting personal medical invoices directly to their employers, employers are forced to reveal their private history, employee protection regarding health status and the majority of hra's are administered by a third party, if there is data showing

sdpt of public health has no information with respect to the demographics of those individuals in hra's, we did however indicate as i just mentioned the range of provisions that we had in our mra's to facilitate high utilization, the second finding ak humbly is finding 112 which related to whether or not hra's were allowable or are allowable under the affordable care act. we were unable to respond to that finding, and finally we did disagree with the recommendation r5 which is essentially requested that there be an elimination of time limits for the medical reimbursement accounts under the city option. there are no time limits for the medical reimbursement accounts under the city option, therefore we disagreed. of the remaining findings and recommendations, we're not in urn the purview of public health so we appropriately referred and deferred rather our comments and/or perspectives to the appropriate departments, they were findings f1, f8, f11, f13 and f13 to the office of labor standards and enforcement and finally recommendation of 4 which related to whether or not hra's should be di

supposed to be set aside for workers and if you're using the hra's, if the private employers and a considerable amount of them employ their own accounts, this discourages employees from coming in and basically you're telling their employers what you need the medical expenses for, it's an invasion of privacy, i would rather, it's nothing we saw in the revised legislation that actually standardized guidelines, as far as we know, employers can still insist on whatever they can restrict their guidelines to whatever extent they want, and i think that this, in essence, limits the ability, limits the access of workers regardless of the amendment to the benefits that they're entitled to. >> frankly, supervisor wiener, if i might say, just to be more clear to your point, what you ask, i'm sorry, it could be more clear, we didn't see enough changes to warrant change our findings. >> just to be clear, i think it's perfectly appropriate to have a policy debate about the issue which we had and which is ongoing and that's fine, i'm not critiquing that in any way, when you draw conclusions based on data when

that we were called upon to respond to indicated that significant number of restaurants utilizing hra's in 2010 paid out no medical expenses for their employees. the office of labor standards enforcement does not collect industry specific data when collecting our annual reporting forms nor would i know exactly what a significant number meant. what i can tell you is that the 184 employers in 2010 indicated that they did not reimburse any of the money that they allocated into these reimbursement programs, that number was 126 employers in 2011. those are our responses to the findings. i thought i would take a few moments and summarize the findings from our report that we issued just last month. some of this area -- some of this material's been covered so i'll go through that quickly. i do want to highlight as a preliminary report, the amendments were passed last year, directed us to collect some specific data, in 2011, we collected sliekt lip different data than we collected in prior years, as indicated the report is based o on the responses of many employees, it is 80 to 90 percent of emp

hra's may be technically legal, but are they ethical? we really don't think so. thank you. we'll take any of your questions. >> thank you very much. could you respond to the question that i raised earlier about the fact that this is 2011 data, 2012 data will presumably come out whenever -- you know, next year, and to just respond to the concern that that data is from before the change of law took effect that places restrictions on the ability to give us the health surcharge when we're not spending the money on health care, etc.. >> i'm matthew cohen. i'm glad to be before the supervisors, for one thing, this is the information we had, and when we saw this information, we found that even though we knew more information was going to come out subsequent to that, this is really indicative of a process which we felt was not something that you can merely look away from even with the amendment that was passed, and for one thing, i am kind of concerned that even though money is supposed to be set aside for workers and if you're using the hra's, if the private employers and a consid

", which i think those provide some leverage or possible capacity on the part of olse, for example, hra couldn't bourses that were vastly and unduly restrictive would arguably run a foul of that provision when coupled with other factors would be not deemed calculated -- >> let me ask it to you this way x if the information for 2012 was for 2012 instead of 2011 and you have as you have here 53% of businesses putting these restrictions on the use by these workers of these accounts, so if 34% of these businesses said you cannot use it for health insurance, i mean, if the data was for 2012, would that be in violation of the amendment that was introduced? >> well, it's not facially a violation, and so i think you're trying to etch size the point that the amendment did not directly outlaw or prohibit restrictions, to the extent that they must be reasonably calculated to benefit the employee, we can give that consideration and look at the totality of the circumstances to see if the violation is there but it is right that the amendment did not facially address prohibition or use of restrictions

which again is now sort of a year behind, they indicated that 62 million dollars was allocated to hra's, 12 million was reimbursed, 50 million was retained by employers, up to 50 million, those statistics are right with a couple of caveats, that spoke to reimbursement programs, the annual reporting form didn't speak to what happened to that unused 15 million dollars, it's right that in 2010, the general practice was plans operated on a calendar year and money reverted back to employers, which has subsequently been changed, tla's finding number 8. finding number 10, the final finding that we were called upon to respond to indicated that significant number of restaurants utilizing hra's in 2010 paid out no medical expenses for their employees. the office of labor standards enforcement does not collect industry specific data when collecting our annual reporting forms nor would i know exactly what a significant number meant. what i can tell you is that the 184 employers in 2010 indicated that they did not reimburse any of the money that they allocated into these reimbursement programs, that

plans, or to provide plans or employee benefits at all, we believe if the city were to try to ban hra's, there are hundreds and hundreds and businesses and thousands of employees who have that benefit that would be forced to change that benefit and therefore would not be legal, and then in regards to we were asked to comment on i believe finding 5, it is something that we're not -- we don't have a position on, it's an mra, it's the city's plan, so we did not comment specifically on that, but otherwise, i'm very happy to address any other questions or if you have any issues. er >> thank you, mr. black, colleagues, any questions, okay, thank you, so those are all the presentations we have, i want to thank all the speakers from the departments for your comments and responses. we'll now proceed to public comment. i have -- supervisor compos? >> if i may, mr. khai, i know we have a worker, i was wondering if it would be okay to call upon him so he could testify, and that is graciano, yes. >> that's at the top of the pile, i have four speaker cards here, if i don't call your name and you woul

is we may have a possibility that as some people are defending the use of hra's here in san francisco, at the federal level because of the health care act, the hra's will no longer be allowed at the federal level, so you have a situation where the country is headed in the direction that san francisco was going not too long ago, in san francisco, it's going in the complete opposite direction. i think we're better than that and i hope we can find a solution here in city hall but i do think that if at the end of the day that solution is not found, i think that notwithstanding what happens in city hall, the people in the city of san francisco are fair and just and ultimately might require the voters step in and do what city hall is not aib do. i hope we don't have to get to that point but in the past, that has worked and has been needed so i think that all oxen are on the table today, but i look forward to continuing this discussion. thank you. >> thank you, supervisor compos, okay, so right now, having heard the various reports and taking public comment, the committee need to prepare res

report demonstrates that a large number of employers continue to place significant restrictions on hra's such as restrictions for dependent coverage, dental and vision care, we believe employers will continue to place these and other prescribers unless -- restrictions unless there are other restrictions, it's not that these funds come from nowhere, these fund should be there for these workers when they need it as previously stated by the worker that was here today. we recognize san francisco as a leader in many ways in health care reform and we encourage you all to continue your efforts, but most importantly to close this loophole once and for all, thank you. >> thank you very much. >> mr. palson? >> supervisors, thank you, tim palson, i'm the executive director of the son fra*ns labor counsel, we represent thousands of people in town who do have health care due to the fact that they're members of unions and they were able to bargain for that, we did not close the loophole the last time around, as part of the huge coalition of people that work diligently over a year to get what is by far

the report also shows that over half of employers using hra's actually placed some restrictions on the use of those accounts. when we first introduced the legislation, one of the things we heard from folks who were oppose today legislation was the problem is not so much, you know, the accounts themselves but simply the fact that people don't know that they exist, and we recognize that that was an issue, but we always said that that's not the only issue, that it wasn't just that workers didn't know but even workers who knew they had access to these accounts, even if they had the knowledge, they could not exercise their rights because restrictions were placed on how the money could be used, and these are some of the restrictions that were identified in this report, 30% of businesses actually do not allow employees to use hra's for health insurance. again, what the rational for not allowing workers to use that money for health insurance is, we're still trying to figure that out. we also found that 28% of employers did not allow, do not allow workers to use the amount -- use the money to e

then with regards to the fourth response to recommendations around disallowing the use of employee hra options, i would recommend that it states it will not be implemented, the hra are important to businesses and with respect to complying with the chro, they use appropriate tools to make benefits readily available to their employees and with regards to the response of recommendation number 5, i suggest we state that it not be implemented with regards to eliminating time limits. it defer tos the public health response, so thank you for listening to that, and i'm making a motion that we revise the motion that included these findings and revise them as i had just stated on the record. >> and to budget and legislative analyst, anything to add? >> no, we have all of the information and if the motion is approver, we will revise the resolution part. >> i'm in agreement with those changes so we'll take that without objection. >> and just in closing remarks, i know this is an issue that obviously has a lot of perspectives and responses from my perspective, i do know and we will be monitoring th

sang to the child in old lull hra byes. a boy has come and laughter has come. a son has come and beauty has come. then the child gurgled and replied even now i can hear the music in his voice. suddenly wind spirits swished in turning and made the baby happily, we'll dance through the tall grass as you and i forever free. he is taken, he is taken aboard the ship and the elements go out and look for him and they do find him in, win finds him in south carolina in charleston, earth went looking for him. after earth fire, she could not get passed the fire. water follow it had ship and wind was able to go across and follow and find him. it was after many years that wind was able to find him. i'll read that last part. [inaudible] all living in the americas, i saw the taken shackled to the land from sun up to sun down working tobacco, sugar cane and rice. i listen to them tell stories different but strangely familiar. now prayer rabbit. i stopped by kitchens and watched our women with cook yams, rice, oh kra and beans. our children had not forgotten. and i rejoice, led

sang to the child in old lull hra byes. a boy has come and laughter has come. a son has come and beauty has come. then the child gurgled and replied even now i can hear the music in his voice. suddenly wind spirits swished in turning

sang to the child in old lull hra byes. a boy has come and laughter has come. a son has come and beauty has come. then the child gurgled and replied even now i can hear the music in his voice. suddenly wind spirits swished in turning and made the baby happily, we'll dance through the tall grass as you and i forever free. he is taken, he is taken aboard the ship and the elements go out and look for him and they do find him in, win finds him in south carolina in charleston, earth went looking for him. after earth fire, she could not get passed the fire. water follow it had

some -- identified some newly identified impacted areas that had not been identified in the previous hra. but in digesting that information it's important to recognize that the radiologically impacted does not mean there is contamination present. so to understand... going back to the letter we received in cdph today we wanted to make it clear that the quote, a direct quote, no health and safety concerns were identified in our surveys in or around the five locations at treasure island. and i'll administer on those additional locations in a moment. going back to the impact versus non-impacted i think that's been a source of a lot of confusion. i wanted to start, the definition of a non-impacted area, which is simply an area where there is no reasonable possibility of residual contamination. so for a non-impacted area we set a very high bar for being able to -- once an area is deemed non-impacted you're done. you don't do additional investigations, no surveys, no nothing. in general some sites you don't necessarily identify non-impacted areas. often your non-impacted areas are off site used

i will missÑ)hrá tremendously.e. >> you spent some of that time in the majority and some in thei minority how have you seen the congress change in your years of service? >> the saddest thing when i got there 14 years ago we used to have dialogue and conversations with the republican side. there was reasonable compromise. we reached consensus on many things. they were in the majority during that time. and something broke down. after we took the majority, we attempted to include them in some of the proposals but at that point, it was over. and then with the election of president obama, they became totally entrenched and then in 2010 we had such an infusion of tea party-type ideology that it was not going to be moving as far as again the dialogue, the communication and any compromise. if you look at the united states senate, tove plus filibusters in the past five years, i think that speaks for itself. we have to move forward. >> not only is your career in the congress coming to an end but an era.ñr your father henry g

i will missÑ)hrá tremendously.e. >> you spent some of that time in the majority and some in thei minority how have you seen the congress change in your years of service? >> the saddest thing when i got there 14 years ago we used to have dialogue and conversations with the republican side. there was reasonable compromise. we reached consensus on many things. they were in the majority during that time. and something broke down. after we took the majority, we attempted to include them in some of the proposals but at that point, it was over. and then with the election of president obama, they became totally entrenched and then in 2010 we had such an infusion of tea party-type ideology that it was not going to be moving as far as again the dialogue, the communication and any compromise. if you look at the united states senate, toavve plus filibustersn the past five years, i think that speaks for itself. we have to move forward. >> not only is your career in the congress coming to an end but an era.ñr your father henry g