although so be handled through hsa. we continue to be mindful about the state budget impacts and the changes that could be coming down. a final note on the next steps, we are working to develop a director position job description. we will float its common to our interviews, and make recommendations to the mayor on candidates. with the final appointment in august with the intent of opening the office in september or october. the director and staff will move over to the new space. in terms of the space, we will be looking at space that is currently occupy by the city. all of the agencies have some space. we need to make some determination about how close the office needs to be to hsa for logistical purposes. we are looking in places where there will be no rent incurred. supervisor chu: thank you. supervisor avalos: i want to thank you for your work in helping to guide the department through this process. of course, i really want to thank -- i know people entered this discussion about how to create this office with a great

many of our major initiatives are jointly funded with dcyf and hsa. our total expenditures is $24.7 million. so our major initiatives, of course, are preschool for all, and you can see the majority of that money is going into subsidies. we're currently serving 3100 children and will increase to 3200 next year. we also invest with our partners in capacity building. that is a lot of technical assist. we do an assessment of the center to measure their quality, and then we are targeted a gene targeting quality improvement, technical assistance, and coaching. we also are contributing to the program with hsa and dcyf, and we also support a family supports and curriculum enhancements. we do some major initiative funding in child health, again in partnership with dcyf and hsa. our amount is about $1.8 million. we are in almost all of are subsidized child care centers. mental health consultants, and this money is work ordered over to dph. our new initiative is around inclusion. we really want to expand options for families that have children with special needs

hsa? ok, thank you. supervisor chu: ok, i had intended to go to the human services agency next, but before we jump into that, i wonder if we might be able to go to the county education office. i know they have been patiently waiting, and i think it is a relatively small one. >> the county education office, supervisors -- the calculation of dollars, the small amount we provide to the school district to pay for a portion of the superintendent's salary set by formula. supervisor chu: thank you, and there is no budget analyst recommendation on that item? >> that is correct. supervisor chu: thank you very much. now we will move to the community services agency. >> good afternoon, supervisors. director of the human services agency. prior to your request, i will give a very high level overview of hsa's budget and then speak to some specific new initiatives and then identify the cut areas we had to make. all right. first of all, again, a very high level of the budget, which, as you know, is the price is comprise

if we can draw down the title for money for training -- we are working with hsa to do that. we are working on this -- supervisor cohen: i have a quick question. can you give me some kind of an idea of what are the cost drivers that bring the expenditures up so high? i am looking at the preschool public and sustainability. -- preschool sustainability. excess expenditures covered our reserves. i wanted to know what some of these expenses are -- >> the bulk of those expenses are reimbursements. that is the majority of our expenses. last year, i think are reimbursed them was about $14 million. -- reimbursement was about $40 million. as we keep growing it, the reimbursement rates grow. ok? we do have funding, a joint funding for our early care and education initiatives that will be part of the office of ece. some of the direct program allocation is about $18.2 million. we think of it together, our contribution to that is about $3.5 million. the family child care quality network, the central eligibility list, the quality improvement system, things like that. we're working with our

i also notice that you have one new position dedicated for purchasing for hsa. a pretty high volume of purchase requests. i was wondering if this is new demand or something existing. what is generating this volume of requests? >> i will point that question to the city purchaser. >> the position for hsa is due to the fact that they have to respond sometimes very quickly to their clients' needs. whether it is providing shelter, in some cases, they may go to the assistance of a child and have to relocate them very quickly. and so they have asked for assistance in having someone on site with them. supervisor campos: thank you. -- supervisor kim: thank you. as much as possible, i am excited about potential new funding for support. i do find it challenging to work with multiple departments and i am glad that you're sitting down to coordinate this work but i didn't -- i do want to be thoughtful about where we place positions. i am sure that we're able to pick up that kind of work as we move forward. i am appreciative of the budget you put forward in the sense that ther

hsas as established under federal law, the data is not owned by the employer. and, in fact, in most cases, only one of the insurance carriers is structuring their products so that they actually can do an analysis that includes what is being spent out of the health savings account. and even with them, because the law allows the employee to move the hsa provider bank and then there's no reporting back, is the vast majority of research to date excludes from analysis what is being spent out of health savings accounts, and treats that spending as not occurring. so, the data on that whole area is exceedingly dirty. >> comments, anybody? okay, let's see. i think michael barr is next. >> thanks susan, i'm going to go in a slightly different direction if that's okay. it's been refreshing at least for me that we've been in a meeting about 2 1/2 hours on the role of technology and chronic conditions and nobody's mentioned the phrase "meaningful use, which is nice. but i'm about to change this. i have a question for the panel, and full disclosure i'm on the health i.t. pol

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he hsas lived a life in changing times, and understanding changes in climate. >> one reason was to show how i got to where i was. young people need to realize -- when they make good choices -- >> he shared the story of his life -- and the program can be seen thsi fall on pbs. >> wonderful man. speaking of the climate, we made it to 90 degrees. watch the temperatures. 103 -- get an idea of the moisture. in and around us. watch this wave in the atmosphere coming our way. that moisure isture is closing in. at 3:00 or 4:00, folks are catching it. that moisture is coming up and over us. there will be the morning showers. we will see afternoon showers and thundershowers. temperatures only to 70 degrees. the morning showers from port royal to the blue ridge and heavy rain possible with the rumble of thunder. this rain will linger on until rush hour. by wednesday temperatures will be in the low 80's. and a northewastern breeze. a lot of sunshine. a home page with live radar. showers in the morning. some of the heaviest rain into tomorrow afteroon. >>noon. >> you'll need the rain gear tomorrow.

hsa rescinded the rfp. they will reinstate it next year. it means i dismantle the program with the hopes of rebuilding it next year. i think it is very inefficient and a lot of people suffered. i am going to be left with $35,000. i can spend that in six weeks. as for all of next year to prevent homelessness. >> [speaking spanish] >> mar and isgarita alaman, i'm a direct member of the coalition of homelessness. -- my name is margarita alaman, of a direct member of the coalition of, as this. of homelessness. >> [speaking spanish] >> she said i am here today to ask you to replace the $5 million, $3 million for the shelters and supplies that are needed like diapers, toiletries, and other important things. $2 million to replace the losses from the stimulus from the obama

you heard hsa has already submitted a proposal to not cut some very valuable funding that we had for seniors. we are listening to our director tonight to make sure we pay attention to that. he is watching us like a hawk, make sure we do not say anything different, but at the same time, we will try to figure out other things that we need as a city. we need to invest in public safety. all of us have been around. i'm not getting any younger. neither is our police force. captain goldberg, thank you very much for being here today. his cohorts are younger. they will be here, but we need to move on, so we've got to make room for classes for our training. we also are paying attention to families. we are working very hard to create family-friendly policy that will lead to good investments in our city. by the way, i know you said may be giving away to some rich folks. i turned to my supervisor -- did we give some money to larry ellison i did not know about or to twitter? ok, but we are raising that money in the private sector. to cover our costs for america's cup. that is why we have recreatio

miss rosenfeld spoke to, it is difficult to find the subsidies, for child care a loan i think that hsa has worked with different providers to see what the impact would be. so, if the state budget came to be as it was when they did that analysis, we intend to recover that. that does not include in home potential service cuts, amongst other things. i think that we should think about that issue. child care is obviously part of it. i do not know that it is adequate, but i do not know that we have a better number, either. sueprvisor kim: can you go over what we were down this year from the state measured reserves? >> certainly. let me grab the report. so, of the $50 million allocated in the current year, just over $10 million has been allocated by the board for other services. including health programs, restored for the current year. it was a major source of funding for the department of public health appropriation issue with state cuts that were approved several weeks ago. those were last lead to draw from ryan white. all told, after those, there was a balance available that was soon close

the agency also contributed to serve supported housing projects that are part of the dph, hsa, and mayor's office of housing pipeline. they are no longer able to do that. on the neighborhood-based economic development side -- these are all included in the mayor's budget. on the neighborhood-based economic development side, we included approximately $1.6 million in the first year, $1.5 million in the second year relate to work in the mid market, $3.7 million in the second year related to bayview, one in the second year. that difference is due to early funding of the southeast community health facility. approximately $100,000 related to visitation valley. have also included funding for the jobs readiness program. you can see included in the mayor's budget, in the first year, $30 million of general fund support for these programs. second year, $10 million. that is a significant general fund cost. supervisor chu: just to recap, when you talk about the tax increment allocated to enforce obligations, the redevelopment agency could have asked for a higher version for the redevelopment agency but

side over the last five years has been moving to far more shifting to an individual, high deductible, hsa, hra, et cetera. this particular company did all of that. it produced a -- when one does the analysis and allows the analysis to have all of the new entrants flow in, which based on looking at the literature is the way most of the analysis by insurers and others has been doing it, then you see a -- not only an initial decrease in cost, but what appears to be a

the thing to consider if you're looking around, get a high deductible, get hsa, health savings accountmoney in that. that will be helpful. if you decide to stick with what you have or not open a business, go to an association, get a large group plan. >> good luck. don't do anything illegal. we don't want your next skype from prison. that would be bad. >>> alley from toledo, ohio. she's on the phone. good morning, alley. >> caller: good morning. i work for amer core, don't have much savings. i hope to find a part-time job but won't work much because of school. i'm worried about taking out loans, not sure if i can find a job outside of college. my question is should i take out a loan. >> thanks so much for your great public service. i would tackle in two ways. pause and ask yourself, does it make sense to go back to grad school right away? i say this, because in my view grad school is to forward your career and make potentially more money. you said yourself you're not quite sure at the end of this program you're going to end up with a job. consider an alternative solution which is potent

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you say that if you have the opportunity, add an hsa because you save money tax-free?e hsa is, again, a type of policy and this may have been the best thing george bush did during his presidency. it's the i.r.a. of the health insurance world. it's a huge deductible. and so if you're very sick or you're very healthy, it's ideal and it covers 100% after you hit the deductible plus you can save money tax deductible to cover your out of pocket costs. so the h.s.a. is genius. it can solve the whole landscape issue here. >> at last you say to ask hospitals and doctors to make payment arrangements. what do you mean? >> well, if you'll go ahead and talk about paying cash and the fact that you're a cash customer, for instance, you're going in for an m.r.i. that insurance for some reason doesn't cover, instead of charging $500, i had a friend paid $69, he called up in advance and said i'm going to pay when i come. and you just negotiate in advance. same thing with pregnancy on labor and delivery. if you'll pay in full in the second trimester, you can negotiate and cause hospital

guest: i have supported hsa. host: peter welch has been our guest for nearly the past hour. democrat of vermont talking about slight jerk -- several different legislative issues on the floor of the house and in the supreme court. we appreciate your time. we're not going to take you to the supreme court. we will show you what is happening out in front. live pictures from the supreme court. >> [inaudible] host: live pictures and live video from the steps of the supreme court. 45 minutes from now the supreme court will begin its final decision making at rendering for this session of the supreme court. we will continue live coverage. the house will begin at 10:00. we will not be able to show it to you on c-span right away. on c-span3 we will be live, continuing coverage of the supreme court's decision on health care. we will continue to take your calls at that point, and it will also be live at c-span.org. you can watch it all live there just like here. many hearings recover on c-span. you will be able to watch the whole thing live on c-span.org. now, we have a little over 40 mi

you need to give people true choice, catastrophic insurance or hsa as this plan outlines.h like you buy life insurance. you want to stick with it. >> what are your thoughts on medicare and the defined contribution versus defined benefit model that paul ryan has been arguing we need to morph towards more of a defining contribution and what role does medicare pay? >> we have to more to a more premium support contribution model. it will probably take another election cycle to get that built into medicare and it's not going to affect current retirees or about to retire but it will restructure the program in the future. >> the microsofts of the world never started defined benefit plans. it didn't make sense. you had to assume you were growing at a linear rate for perpetuity, right, so that to me seems sort of inevitable. >> you said some democrats are on board with that? i haven't heard one yet, instead they run ads pushing granny off the cliff. >> ryan wyden. >> okay, one democrat says we have to shift to defined contributions in medicare. it's a start. >> there's certainly no

know, again, put free market systems -- or disciplines back into the system, you know, things like hsa's people to buy insurance across state lines. again, the free market is a marvelous thing in terms of controlling costs. it's been absent from health care for far too long. >> look forward to talking to you afterwards. the decision comes down at 10:15 eastern time and everything changes and everybody is affected. thanks so much. >> keep your fingers crossed. >> next on the rundown, benjamin franklin would be proud. how the united states army is using lightning in the war on terror. i played benjamin franklin. i'll talk about during the break. this clerk refused to let someone buy cigarettes with food stamps. why is he fired? we'll ask. dude u don't understand, this is my dad's car. look at the car! my dad's gonna kill me dude... [ male announcer ] the security of a 2012 iihs top safety pick. the volkswagen passat. that's the power of german engineering. right now lease the 2012 passat for $209 a month. great! tyler here will show you everything. check out our new mobile app. now you can