any non-routine procedures would have a medical exemption. so i'm going to talk about the evaluation results of the program and these are mainly from a study that we did with uc berkeley, jamie robinson and tim brown, which was published in health affairs in august of this year. that i think is in your packet. so this is looking at utilization, this is the volume of hip or knee replacements. and the first three lines in this chart have to do with cal pers anthem enrollees, what's unique about their study, they were able to get from anthem, the non-cal pers enrolee data as well. so we can look at where our members were going before and after the imp limitation of the program. the first line is the volume, the number of procedures and then the second line is looking at what percentage of your members went to the reference based pricing facilities. it was about 50% before the imp limitation of the program. and an increase to 63% after. non-cal pers members, 54% to their reference based pricing facilities. then dipped and came back. i have a addi

so the reference price is for routine procedure, so if the procedure becomes non-routine, it would not fall under the reference-based pricing program. and i think you see that when i was showing some of the variation in the chart. some of those dots are outside of the 0,000 or above -- 30,000 or above that, and those are falling into the non-routine procedures which are not excluded from the way the claims data is set up. >> before -- don't forget what you were going to say, but i did want to follow up because there's another question in the be pile that asks about how you work that medical exception. does it happen before or after? how big is the acquisition between the two -- the division between the two categories, that sort of thing? >> my understanding is that it works through, it's before, and it would also occur after, say the colonoscopy gets in, and they need to do some other procedure. >> right. it's a question of communication between our case manager and the calpers staff so that the aberrations or the exceptions are picked up and then can be dealt with. >> okay. andrea? >>

the participating hospitals were based on the procedure volume as you've heard. they met the standard regulatory standards, so they were they met the levels. and we also have an anthem quality program for hospitals. and treatment that the hospital provides and outcomes that provide publicly. all of these hospitals were participants in the program. so, the impact was the shift of members to hospitals and i think i would -- the big change was the shift away and the decrease of total costs and this was a critical point. how the market reacted to this. was the decrease in costs in the nondesignated hospital. some of which immediately prior to the advent of the program, lowered their pricinging the network. the other poinlt is that the upward cross trend from 2008 to 20 2010, was reversed in 2011 with the advent of the program, so this was a very striking example of bending the cost code down, which i believe is the washington phrase or the goal that has been set for the affordable care act. on the quality side, we use the hospital planes to look for general infection

such as wages for extra time off, child care, post procedure follow up visits. expenses for traveling companion. i think we may have heard a little bit about that. that's all on one -- care for follow up care for family after procedures preferred provider who's located far away from the patient's home. and finally, reimborsment for traveling expenses is good, but what about for conditions where travel is difficult and painful. where people who don't have a companion to travel with them. what are the conditions under which you're requiring people to pay for travel impacting the able thety and ability to get to the high quality care? would you like to expand on your descriptions. >> sure. and to use one of the facilities and they don't have one in their community. we have a group of professionals, that's what they do. they help to coordinate the flights, the hotels, the meals, the companion traveling with them. all of that is taken care of so it's not taken out of the pocket of the associate. so it's billed as a claim. so all of that is taken care of for them. if

thus, the procedural filibuster was born. and it was used around 20 times a year, throughout the carter and reagan administrations. but perhaps not surprisingly, its use spiked under bill clinton. >> they required us to get 60 votes. we didn't get it, we didn't get it twice, and so where i come from, that means we lost. >> reporter: by 2005, it was republicans who were threatening filibuster reform. >> we turn to the latest political battle braing on capitol hill. it's the fight over federal judges and the so-called nuclear option. >> reporter: back then, it was a senator mcconnell urging up or down votes. >> let's get back to the way the senate operated for over 200 years, up or down votes on the president's nominee, no matter who the president is, no matter who's in control of the senate. >> reporter: back then, the two sides were able to avoid pushing the button. since then, republicans have embarked on an unprecedented obstruction campaign against the president's agenda, particularly against his executive and judicial nom

let's think about what this procedure does. we all deserve to know what happens in these procedures, and that's why i say without a shadow of a doubt that abortion is not medical care. and we document on tape, they give them labor inducing drugs, and give them poison, and tear the children, limb from torso in excruciating pain, and they send the women to a hotel room to wait for the baby to be delivered. sit on the toilet and leave the door unlocked and don't look down. this is not women's health. >> let's talk about rape and incest. i think that any wom woman of rape and incest needs care, but the child is innocent. and the child does not deserve the death penalty because of the sins of the father. and when you tell a woman you've had a rape, you should have an abortion, and that's only going to add violence. you think that's going to help her recover from the rape? we're lying to ourselves to say that it helps women emotionally or psychologically or spiritually to say it, go have an abortion. >> we want to bring in the third

. >> my first thought, the procedure that you outlined with regarding to response and submission of concerns about findings of fact, i find that to be accurate. i just want to ask miss blitz if what you describe was correct, if that's what i found and i got a document today outlined the procedures here so -- >> that's correct commissioner marshall. the commission has a document that's available online on commission website and it's section roman numeral 14, subsection c. there's a timeline and process for submitting proposed findingings from the department and from the officer as just summarized by department officer alden. >> my concern is that if it does go on and on and on, so with the procedure outline, i can't see going any further than tonight. >> well, i would ask that you give me the benefit of the doubt. i'm not an attorney. nobody from the police commission told me that you need to submit a response by a certain date. >> it's not our role to tell you how to defend your case and you had several council in this case. >> i've chosen now to not to be represented by council. >> you've c

. >> a tubal ligation procedure is a form of sterilization. >> i freaked out. i'm like, are we doing what? i'm like, no doctor please don't give me any outside procedure outside of this c-section. i haven't agreed on anything else. so he brought in a form for me to sign, declining the tuberlagation while i was strapped down on the table. you know not in my right mind. >> kim's story is not unique. according to a recent report by the center for investigative reporting, california women's prisons conducted at least 148 sterilizations between 2006 and 2010 without the state's

it is now the largest coronary procedure done, and there are about 500 to 600,000 procedures done per year now, which is significantly more than the number of bypass operations that are done in the united states. the physician threads a catheter through an artery in the arm or the groin until it reaches the coronary arteries-- the same procedure as an angiogram. but then, the physician threads a second balloon-tipped catheter through the first. the ballis inflated, breaking uthe plaque while compressing it against the arterial wall. faxon: the arteri a not like pipes. ey are like your skin, or anything. and thengioplasty balloon, when 's inflated, stretches the artery and creates a sort of an aneurysm. t there are disadvantages to aioplasty angioplasty has an unfortunate problem of restenosis, which is the recurrence of that narrowing. it can be highly successful, but within three months on average. but up to six months afterwards, the narrowing comes back again. so the procedure has to be done again. or if it can't be done again, the patient goes to a bypass operation. bypass surgery

. >> it is an occasion for the commission to decide upon a document that fairly states the s procedural history and the facts when the commission found the fact that specifications in your opinion one and five were found and sustained. also as commission council on discipline cases, for you i have prepared a draft that revises, suggests some revisions to what you've received from department council based upon my understanding of commission's reasoning and department council was of course not privy to your closed session deliberations when you decided the case. so what you see in the draft you have from me is one where i've taken the proposed findings and added to that my understanding of what the commission's /spwepbts intent was in your deliberations in deciding this case. we did not receive any proposed edits or alternate proposed findings from inspector lee, as far as i know. and i had double checked that again recently with lisa tom and inspector monroe and so we did not have anything further in writing to fold in here from him. as is also our usual practice this evening, we usually

. >> a tubal ligation procedure is a form of sterilization. >> i freaked out. i'm like, are we doing what? i'm like, no doctor please don't give me any outside procedure outside of this c-section. i haven't agreed on anything else. so he brought in a form for me to sign, declining the tuberlagation while i was strapped down on the table. you know not in my right mind. >> kim's story is not unique. according to a recent report by the center for investigative reporting, california women's prisons conducted at least 148 sterilizations between 2006 and 2010 without the state's approval. and possibly a 100 more dating back to the 1990s. >> it was just shocking to us, that this was being done by medical professionals across the state through these people. >> doctors cited in the report argued that sterilizing poor women would save the state welfare money in the future. they also said inmates were given a choice and not coerced. >> federal law is very clear that any entity that gets federal monies cannot sterilize people in prison for the purpose of birth control, per

we have to wait until the procedures with the trial and it may take two years or four or one year maybe i'm not sure about that but according to the procedure and according to the situation of the president morsi himself. >> reporter: he is refusing legal counsel, do you think that is a wise move? >> do you think what, sorry? >> reporter: a wise move for morsi to be refusing to have a legal defense team? >> i don't think it's a wise move. morsi and the muslim brotherhood should admit to the situation in egypt. there is a force the street that he is in the trial, he is in the cage today, a trial is beginning and he has to admit the whole process and defend himself. he is not the president of egypt. this is a reality. and he has to admit the assistance of his legal team. >> reporter: yes, i see your point but he is now in the situation and therefore he should make the best of it and it must be an incredibly difficult situation to accept as the first democratically elected president and one should be immune from such trials. >> yes. just like the president of egypt but he is not the presid

today, we've been joined by officials from four agencies responsible for the policies and procedures used to determine who was eligible to obtain security clearance, access to government facilities, and computers. they are the office of management and budget, the office of personnel management, the office of the directer of national intelligence, and the department of defense. we want these officials to talking with us this morning about the critical, security related policies and procedures and also about the coordinated reviews of the processes now underway throughout the government in the aftermath of navy yard tragedy and other recent incidents. we will hear from an expert at the government accountability office known as gao which produced a wide body of work on security clearance process. welcome. this hearing builds on the ongoing good work of the subcommittees which held a hearing on security clearances just this past june under the able leadership of senatorrers tester, portman, mccaskill, and johnson. that hearing exposed the urgent need for additional resources at the offic

the procedure was approved in two thousand and six but no one really knows under what pretext d.h.s.s. actually allowed to flick the internet kill switch and some pair could be abused during a protest against police brutality in san francisco in two thousand and eleven bay area rapid transit officials disrupted activists plans by turning off the internet and cell service for three hours at four different transit stations. following this the electronic privacy information center filed a freedom of information act request for department of homeland security to hand over its plans to activate the internet kill switch to determine whether or not the procedure violates free speech rights and public safety and d.h. has previously argued handing over such information could hinder law enforcement technique techniques and prosecutions but that argument was tossed out last by last week's federal court ruling though the core did leave the government some wiggle room for an appeal noting the court is not unaware of the potential adverse use to which this information could be put its ruling furthe

the procedure was approved in two thousand set. but no one really knows underwear pretax dhs is actually allowed to flank the internet kill switch. in some fear it could be yours. during a protest against quiz for talented stampers is going to cut eleven. bay area rapid transit officials disrupted activists plans by turning off the internet and cell service for three hours in four different transit stations. the following is the electronic privacy information center filed a freedom of information act request for dhs to hand over its plans to activate your neck else which determine whether the procedure violates free speech rights and safety. dhs previously argued that handing over such information could hinder long course the techniques and prosecutions. that argument was tossed out by last week's federal court ruling the court did leave the government some wiggle room for detail noting the court is that not unaware of the potential adverse use to which this information could be caught this ruling for the more is no judgment on whe

today we have been joined by officials from four agencies responsible for the policies and procedures used to determine who is eligible to obtain security clearance and access to government facilities and computers. they are the office of management and budget. the office of personnel management. the office of the director of national intelligence. and the department of defense. we want these officials to talk with us this morning about the critical security related policies and procedures and also the coordinated reviews of these processes now under way throughout the government in the aftermath of the navy yard tragedy and other resent incidents. -- recent incidents. we also will hear from an expert at the government accountability office, affectionately known as g.a.o., which has produced a wide body of work on the security clearance process, welcome. this hearing goes on the ongoing good work of our subcommittees which held a hearing on security clearances just this past june under the able leadership of senators tester, mccaskill, and johnson. that hearing exposed the urgent need

as ed mentioned, reference pricing really is just setting a standard price for a drug, a procedure, a service, and then once you've set that price, that's the amounts, the allowed amount that the health planner insurer will pay and above that amount, the consumer is likely to have additional out of pocket financial liability. if you look at the graph there on the y axi axis, you'll see different ranges of prices, from a thousand dollars up to $20,000. on the bottom you see the frequency of the services. the blue line shows how often are the procedures taking place and at what price and where do they go up. this is the kind of analysis that has to take place. so you can set a reference price, it's complicated in doing that. a lot of analysis has to go into doing that. i'll give you an example, safe way is an example where they did analysis of how much they were paying for colon osk pis in the san francisco bay area. the prices ranged from $900 to $7200, with no correlation to quality. that's an extreme variation in price. once they did the analysis on the price and they saw the frequen

it's says the procedure is necessary in times of crisis to prevent detonation of a remote controlled explosive the procedure was approved in two thousand and six but no one really knows under what pretext v.h.s. is actually allowed to flick the internet kill switch and some fear it could be abused during a protest against police brutality in san francisco in two thousand and eleven bay area rapid transit officials disrupted activists plans by turning off the internet and cell service for three hours of four different transit stations now following this the electronic privacy information center bilder freedom of information act request for did chess to hand over its plans to activate the internet kill switch determine whether or not the procedure violates free speech rights and public safety d h s previously argued that handing over such information could hinder law enforcement techniques and prosecutions but that argument was tossed out by last week's federal court ruling the court did leave the government some wiggle room for an appeal noting the court is not unaware of the potentia

the procedure was approved in two thousand and six but no one really knows under what pretext d.h.s.s. is actually allowed to flick the internet kill switch and some fear it could be abused during a protest against police brutality in san francisco in two thousand and eleven bay area rapid transit officials disrupted activists plans by turning off the internet and cell service for three hours at four different transit stations now following this the electronic privacy information center filed a freedom of information act request for the department of homeland security to hand over its plans to activate the internet kill switch to determine whether or not the procedure violates free speech rights and public safety d.h. has previously argued handing over such information could hinder law. spent techniques and prosecutions but that argument was tossed out by last week's federal court ruling but the court did leave the government some wiggle room for an appeal noting the court is not unaware of the potential adverse use to which this information could be put its ruling furthermore is no j

thank you for the invitation to provide information on the government's procedures regarding security clearances. i will address the role of the director of national intelligence knows is dni. as the security agent has responsibresponsib ilities for oversight and clearance process across the government in areas in need of attention and initiatives underway to address those areas. before i follow i would like to make the comment that we also add our teeth as condolences to family members for their loss and our commitment to work towards continuing to approve -- improve security processes and access capabilities of the united states government. executive order 13467 the dni is a security executive agent is responsible for the development and oversight of effect that efficient uniform policies and procedures governing the timely conduct an investigation and adjudications for eligibility for access to classified information or eligibility to hold a sensitive position. the dni serves as a final authority to designate agencies to conduct background investigations and determine eligibility f

so the first line is the volume, the number of procedures. the second line is looking at what percentage of our members went to the reference-based icing facilities and we can see it was about 50% or so before the limitation of the program and then it wasn't increase up to about 63, 64% afterwards. you look at the non-calpers members, about 55% before the program, and it's slightly dipped and then came back. i have a visual representation of the next. the dark blue line being the calpers pricing usage. you can see it went up dramatically after the implementation of the program. and we can see for the non-calpers it was fairly the same overtime. so this is a chart or a table of the average prices charged or hip or knee replacement surgery. again, for calpers members and non-calpers members. so the first line here is for average of all facilities and we can see that basically for all of, across all the groups there was an increase from 2008-2010. and the average was about 35,000 in 2010 for the calpers members and then after a limitation of thi

and to the end of improving our processes and procedures, i thank you for the opportunity to testify regarding all of these issues. i will be happy to answer any questions that you might have. thank you. >> miss cap -- ms. kaplan thank you for that and those encouraging wrords. mr. prioletti proceeds. thanks for joining u >> good morning chairman carper, ranking member coburn, and distinguished members of the subcommittee. thank you for the invitation to provide information on the government's practices and procedures regarding security clearances and background investigations. the role of the director of national intelligence, known as the d.n.i., as a secured executive agent, his authorities and responsibilities for oversight of the security clearance process across the government and areas in need of attention in the current process and initiatives under way to address those areas. before i follow, i would like to make the comment that we also add our deepens condolences to the family members for their loss, and our commitment to work towards continuing to improve the security pro

so if you look at the second page, the procedure that dan and i both went over, and with rose mary and the housing inspector. and we also had some neighborhood or some community groups, that were very interested in this, too. and this would, this would just apply for housing inspection. and then, this one says anonymous complaints are to be accepted for heat and hot water and apartment buildings and hotel, lead paint removal work practices. common areas of our two occupancy and two unit buildings including stairways and elevators, lack of or defective means of egress and imminent hazards. and then, the second part of the proposal would be anonymous complaints would not be accepted for interiors of units neighbor dispute and illegal occupancy and overcrowding. so, we will see this as a screening procedure, that could really greatly reduce a lot of the agony and the abuse that we see out in the field. commissioner mar? >> thank you for bringing these forward. i think that these are good examples just to compare. i will just, i had a question about what about the complaints where it is a

for an anal cavity search thankfully doctors in the town's emergency room refused to perform the procedure claiming it was unethical but the cops weren't willing to give up so easily so they took it to the next town silver city where they found physicians than willing to aid in their cavity search and according to k.o. before i went it's news who obtained the medical records this is what happened next eckert first received an abdominal x. ray were no drugs were found then received two anal exams or once again no drugs were found what happens next is. beyond comprehension because you think that by now the x. ray and manual anal exams of what have been enough to prove this man's innocence but the cops already gone this far so why not take it all the way am i right so doctors then performed an enema and forced acker to defra kate in front of police where they proceeded to search through his fecal matter not one enema not two enemas but three separate enemas administered against his will three times. oh no if you think the story couldn't get any crazier you're wrong because before being x. ray

they're imprying that the procedure is safe. they've also said that -- they've also conflicted with osha. they don't want to end it permanently so there's a conflict there. more on the hearing coming out. my colleague will have more on the evening news. live in san francisco, sal castaneda, ktvu channel 2 news. >> thank you. >>> muni officials in san francisco today launch add new public safety campaign. the new public awareness project called eyes up, phones down aims to remind passengers to be aware of their surroundings at muni stations, stops and on vehicles. the sfmta and san francisco police are also teaming up to deploy more rivers r officers on muni to increase overall security. >>> muni's quarterly performance report is out and confirms what many already know. muni buses still run well behind schedule. just 59% of muni buses were on time in june and july. there was a slight improvement in august with 60% of buses on schedule. that's lower than muni's goal of 85% on time rate. muni says the number of extended delays has

for an anal cavity search thankfully doctors in the town's emergency room refused to perform the procedure claiming that was an ethical but the cops were unwilling to give up so easily so they took it to the next town silver city where they found physicians than willing to aid in their cavity search and according to k.o. before i went it's news who obtained the medical records this is what happened next eckert first received an abdominal x. ray were no drugs were found then received two anal exams are once again. no drugs were found what happens next is actually beyond beyond comprehension because you think that by now the x. ray and manual anal exams of would have been enough to prove this man's innocence but if the cops already gone this far so why not take it all the way am i right so doctors then performed an enema and forced acker to defra kate in front of police where they proceeded to search through his fecal matter not one enema not two enemas but three separate enemas administered against his will three times. oh no if you think the story couldn't get any crazier you're wrong beca

seems like a similar procedural and without a direct. too think there are issues work out. it would depend on whatever you call this was -- this position. all of the issues become much more joint. i think there would be no be able that they would to appeal, for example, denial by the fisa court, or if you don't, they just have abstract proceedings. and then it would be the courts response ability and the courts ability to hold the government to account. to return toke former congresswoman harman and ms. pell. the challenge of the authorization that authorizes secret activity, it almost seems like a contradiction. how do you address laws that we don't want to talk about in public? democraticke a fully function and the government will fully comply, but how do you write about things that the government doesn't want to talk about? >> we can talk about the purpose of the program in the framework for the program. certainly, i recall very specifically in the debate on the fisa amendments in 2008, that is what we did. maybe members of congress for not paying much attention, but it

and you'll able to have the procedure. >> oh, my god. seriously? oh, my god. that is awesome!thank you. >> great. >> oh, my god. >> thank you. thank you so much. >> there are so many calls for help on social media that won't get answered but in this case, someone stepped up and said i will help you. that is going to make all the difference for william and the family. they're heading to los angeles soon for william's surgery. >> what do you think about that? >> so awesome. so good. so great. >> thank you. thank you. thank you. thank you. >> best holiday present ever. and we'll be there to see william get that much-needed surgery in los angeles and bring you that follow up to his story. >> brilliant, cheryl, way to go. >> neat, neat story. let's check on the forecast right now. >> spencer is here. >> getting foggy outside. we've got patches of fog along the coast now. could be a problem for the commute. we expect areas of dense fog. here is the accu-weather forecast. it will be sunny by afternoon. mild again, cooling down over the weekend breezy, also, friday and saturday. no ra

and you'll able to have the procedure. >> oh, my god. seriously? oh, my god. that is awesome! >> thank you. >> great. >> oh, my god. >> thank you. thank you so much. >> there are so many calls for help on social media that won't get answered but in this case, someone stepped up and said i will help you. that is going to make all the difference for william and the family. they're heading to los angeles soon for william's surgery. >> what do you think about that? >> so awesome. so good. so great. >> thank you. thank you. thank you. thank you. >> best holiday present ever. and we'll be there to see william get that much-needed surgery in los angeles and bring you that follow up to his story. >> brilliant, cheryl, way to go. >> neat, neat story. let's check on the forecast right now. >> spencer is here. >> getting foggy outside. we've got patches of fog along the coast now. could be a problem for the commute. we expect areas of dense fog. here is the accu-weather forecast. it will be sunny by afternoon. mild again, cooling down over the weekend breezy, also, friday and saturday. n

for an anal cavity search thankfully doctors in the town's emergency room refused to perform the procedure claiming it was an ethical but the cops were unwilling to give up so easily so they took it to the next town silver city where they found physicians than willing to aid in their cavity search and according to k.o. before i went it's news who obtained the medical records this is what happened next eckert first received an abdominal x. ray were no drugs were found then received two anal exams or once again no drugs were found what happens next is. beyond beyond comprehension because you think that by now the x. ray and manual and all exams of what have been enough to prove this man's innocence but the cops already gone this far so why not take it all the way am i right so doctors then performed an enema and forced acker to defra kate in front of police where they proceeded to search through his fecal matter not one enema not two enemas but three separate enemas administered against his will three times. oh no if you think the story couldn't get any crazier you're wrong because before be

but a new procedure for landing planes hopes to improve that. it's nicknamed casper. >> it stands for closely spaced parallel runways. it's a new faa procedure that applies to sfo and a few other airports around the country. >> reporter: airports like boston and seattle. here's how cspr works. on bright sunny days planes can land at sfo side by side touching down on two different runways no problem. but when bad weather would strike, this kind of landing wasn't allowed. planes could only land in a single file line leading to long delays for passengers. cspr changes that allowing planes in bad weather to land staggered like this. a small plane paired up with a bigger plane a shorter 1 1/2 miles apart. the hope is cspr will allow the airport to land about five to ten more planes a day in bad weather. >> anything we can do to shorten the amount of delays we experience would be beneficial. >> reporter: no hard and fast numbers yet on how cspr is doing but passengers we found aren't delayed possibly a sign it's off to a good start. >> but so far, we

audit in 2000 resulted in 31 recommendations and performance measurement and public , policies procedures and information tracking, reporting system, staffing and travenlth virtually every aspect of the department. as of september 12, '30 of the recommendations were closed recognized by the city auditor the last recommendation was related to a case standards management policy for supervision levels. what's happened in the last years with we've implemented a tracking system for clients and developed regular operational reports and an oversight committee was formed and we are in sync with what is in the status of the department. i know that sounds so small, but for our department it was big. in the history of the department over 100 years they never had a strategic plan and now we do. and produced the first annual report last years since 2008. these administrative things that are so important to tracking and managing the direction of the department, we also implemented a comprehensive revision of the department's policies and procedures which are 10-15 years old which are in partnership wit