and providers. we will start off first with sherman. i can it over to you. >> thank you. the clicker here. good afternoon, everyone. these pictures show me at the book ends of my military career. 17-year-old private first class that became the 29-year-old commissioned officer you see on the slide. i did not know at that time much about being a veteran, nor did i care. i did not receive care from a va provider. any information would have been provided by secondhand information or outright ignorance. we have too many in the media and government who share the lack of insight and insist they know best. hopefully we can change that today. here is why. because this happens. car accidents, training, illnesses, combat. the hazards of military service. this was my car after i was extra grated from the vehicle desk extricated from the vehicle 14 years ago. i was unconscious. 11 days of intensive care until i stabilized. with theirst contact v.a. medical center where i started my rehabilitation journey. it was

it does provide on the provider side. there are things that we do wrong and that we can improve on, but i think coming together and figuring out a way to get through some of the prompt pay issues that we deal with, we believe, would bring especially some small providers into this network in this important program. program. [applause] >> okay. thank you. so we've now turned-- we're going to turn to the q & a portion of our program and i'd like to throw out the first question. we've talked a lot about care within the va system and the private sector. i would love for one or more of our panelists to take us back to square one for a moment and talk about the choice program that was-- that came about in 2014 and help us to understand. who is eligible for this program? how are veterans using it? and to what extent are they use it go? do we have just about everybody using it and what kinds of services are they getting? what is the experience like so far? >> sure, why don't i take that one? so the choice program came about approx

next is provider payments this is critically important, we view our providers as partners. in order to be good partners to our providers we have to pay timely and accurately. and this is something that va continues to work on because of the multiple ways we have of buying care today, it creates a lot of confusion. i'll give you one example. when the choice act was passed va by law was required to send out nine million cards to individuals. these cards looked like health insurance cards. and we've encountered many veterans that have taken that card to a community provider, the provider worked on the assumption was eligible and delivered care. but on the back end we were not able to pay the clinicians because they did not meet those criteria. we have to have very clear eligibility criteria that's simple. no red tape. make it very easy for folks to understand. so that the community and the veteran know exactly what is eligible and what isn't. and then also the va can do our part to make sure we pay timely and accurately. then wrapped throughout all that is a focus on customer

these services are also provided for our incarcerated db transwomen, stalk and trafficking victims. i will just end with this quote, one of my favorites from helen keller, that i love and it's just simple as to say," alone we can do so little, but together we can do so much." and when i look around with all of the agencies here, and the hard work in changing our systems together we can definitely make a change. thank you. [ applause ] >> thank you so much, dahlia. i just want to acknowledge a couple of staff people who are here, alden from assembly member ting's office and i want to acknowledge the family violence counsel chair katy albright who here as well. next up is the community education at las casa delas madras that opened as the first domestic violence shelter in the state of california and only the second in the nation. please welcome cara. [ applause ] >> i'm going to put this down, but i was holding the door to shelter. good evening, it's wonderful to be here with all of you standing in support of domestic violence survivors. over 40 years ago we began as a small shelter

these services are also provided for our incarcerated db transwomen, stalk and trafficking victims. i will just end with this quote, one of my favorites from helen keller, that i love and it's just simple as to say," alone we can do so little, but together we can do so much." and when i look around with all of the agencies here, and the hard work in changing our systems together we can definitely make a change. thank you. [ applause ] >> thank you so much, dahlia. i just want to acknowledge a couple of staff people who are here, alden from assembly member ting's office and i want to acknowledge the family violence counsel chair katy albright who here as well. next up is the community education at las casa delas madras that opened as the first domestic violence shelter in the state of california and only the second in the nation. please welcome cara. [ applause ] >> i'm going to put this down, but i was holding the door to shelter. good evening, it's wonderful to be here with all of you standing in support of domestic violence survivors. over 40 years ago we began as a small shelter

this means offering new access points to consumer by expanding our providers' office hours and providing off hour visits to better accommodate our patients busy lives. it means using new technology to our advantage, by offering online scheduling options and investing in a patient portal while patients can e-mail their providers, have video physician visits, review their lab tests, review their physician notes, schedule an appointment and refill their prescriptions. i'm sure many of you are participating in hospital and health care systems that offer these services. if they are not, perhaps the day you make come and join nochbt health. >> we conduct add study how they want to be treated value being treated with respect as much as quality care. that's a very important insight. people want to feel respected whether they are in a hospital or a clinic. we work hard to honor that wish by training doctors and nurses to empathize with compassion that delivers remarkable patient experience they deserve in a very authentic personalized way. second, we have invested heavily in health care technolog

we also provide counseling, case management, support groups, a teen program and legal services at our jobs center on mission street four of our advocates work as the only two women-specific supportive housing sites in san francisco, providing emotional and practical support to over 150 female residents. this partnership is entering its 18th year. la casa also had the opportunity to extend our support services in san francisco by providing targeted programming to specific populations alongside amazing community partners. i would like to highlight four of these programs today: first we're pard to be pard of zuckerberg san francisco gener hospital and la casa advocate is on-site to meet with patients that dispose instances of intimate partnership violence to their physician and providing danger and risk assessment, safety planning, grief counseling and resources and referrals. this individual will also provide training on intimate partner violence to health care professionals. second, funded by the department on the status of women, co-located at san francisco housing authority. as many

sea cdc will provide services to per to the families whereas swords will be responsible for providingservices to veterans. sea cdc will also be the property manager of the project. in february of this year the commission approved the clues of a glaciation agreement along with a $2.5 million predevelopment loan to begin design in other construction work. the predevelopment loan was capitalize using a portion of the sf thought city donation. the 11 53rd st. moment includes rental housing affordable homeless veterans and low income families. the veterans unit represent a little over half of the unit total will be restricted to no more than 30% of area median income or ami. which amounts to an income of $22,000 per year for a single adult veteran. the remaining half of the unit will be affordable to families earning no more than 50% of area median income were again, 64,006 over for a family of four. as stated earlier both sea cdc and sword will provide services at the development with swords focusing on the needs of veterans and sea cdc focusing on the families. 11 53rd st. will provide a

next, is provider payment. and this is critically important, especially it being a practicing physician, as we view our providers as partners. and in order to be good partners to our providers, we have to pay timely and accurately. and this is something that the va continues to work on because of the multiple ways that we have of buying care today, it creates a lot of confusion. and i'll give you one example. when the choice act was passed, va by law was required to send out about 9 million cards to individuals. these cards look like health insurance cards and we have encountered many veterans that have taken that card to a community provider. the provider worked on the assumption that this veteran was eligible and delivered care and on the back end, we got plans and not able to pay those clinicians because they did not meet those cry criteria. so we have to have eligible criteria that's simple, no red tape, make it easy for folks to understand so that the community and the veteran know exactly what is eligible

dha continues to provide care coordination and all of the providers in the network.e leadership system and governance. a particular emphasis on continent continuity and an oversight to a board of directors. third is the operational infrastructure, supply chain, hr and workforce and healthcare equity. finally eligibility eligibility. focusing on other than honorable discharge for healthcare benefits and design. we clearly do not like want this report to be on a shelf. we ask that you make our report come to life to enable legislation that was included that requires your action. we are mindful that some of our recommendations have cost implications and we work with health economists in modeling different options. we do not suggest that congress has not already made very substantial investments in the system. rather we call for strategic investments in a much more streamlined system that aligned va care with the community. i would be very pleased to be a resource for the committee as you continue to work on these issues and also look forward to your questions. >> it's a

i will work hard to provide funding for education. my opponent, however, has cut public school education funding both in the house not end in the congress. and how she got sick so 20 million from the public school budget, and in the congress she voted for an $800 million cut. she actually voted against an amendment that would provide stem grants for women, minorities and low income students. that's the kind of think we simply cannot do if we're going to move forward into the 21st century. >> moderator: thank you. congresswoman comstock, 90 seconds kind of action on the only one on this stage that has been very involved in virginia public schools the virginia public universities. i come from a family of educators. my husband is in the fairfax system. my mom is a teacher and librarian. i've already worked with state and local officials, many of my colleagues, pat, stu, tom who chaired subcommittees on education so i have those were to relationships on education. on tech jobs we've already passed the s.t.e.m. education bill that was part

in providing goods and services and local merchantin the area should bene participate in providing goods services and local merchants.participate in provid and services and local merchants.the area should benef participate in providing goods and services and local merchants. bayview has been the most virtualized area in the hill. [inaudible] additionally and finally the doctor was a member of the church and a strong supporter of the work that mr. kelly to improve the sewage plant water system. where conference, that we want to see the new campus erected and it would serve as a monument to her trim and a vision. thank you for your time. >> thank you rev. in addition i'm also reported. i look forward to this, hopefully we can actually work together. i think, with climate change and everything happening is can be very critical. i'm also a business owner. i own a consulting for. one of the other things that is the most goal is that we have developments in the shipyard happening and candlestick. i think it's important that we have a world-class facility at third and evans. so as we as a commi

in providing goods and services and local merchantin the area should bene participate in providing goods services and local merchants.participate in provid and services and local merchants.the area should benef participate in providing goods and services and local merchants. bayview has been the most virtualized area in the hill. [inaudible] additionally and finally the doctor was a member of the church and a strong supporter of the work that mr. kelly to improve the sewage plant water system. where conference, that we want to see the new campus erected and it would serve as a monument to her trim and a vision. thank you for your time. >> thank you rev. in addition i'm also reported. i look forward to this, hopefully we can actually work together. i think, with climate change and everything happening is can be very critical. i'm also a business owner. i own a consulting for. one of the other things that is the most goal is that we have developments in the shipyard happening and candlestick. i think it's important that we have a world-class facility at third and evans. so as we as a commi

i will work hard to provide funding for education. my opponent, however, has cut public school funding and those of the house of representatives and in the congress. in the house she cut 620 million from the budget. they provide stem grants and that is the kind of thing we simply cannot do if we are going to move forward into the 21st century. >> 90 seconds. >> i am the only one on this page that has been very involved in the virginia public schools and universities. i come from a family of educators. my husband is in the system, my mother is here today, teacher and librarian. i already worked with state and local officials, the school board member, the chair of the subcommittee on education, so i have those working relationships on education. on technical jobs, we've already passed the education bill that was part of our education reform. we had a major education reform bill when we were in richmond and i was a delegate and also, tom and i and others in richmond stopped the $120 million in cuts and one of the first things i dealt wit

providing veterans unfettered choice as to their provider jeopardizes this critical mass. the american legion also opposes allowing a complete option of primary care providers within the proposed vha care system because we believe the commission analysis is faulty. the commission supports this recommendation based on the estimate that was quickly using medicare rates. the commission however gave no consideration to how medicare rules would apply to the current quality of care provided through the primary care physician. vha physicians are not restricted as to the amount of time they're able to to dedicate to each patient or the number of presentations per patient. medicare and the other hand only provides payment based on ten to 15 minute consultations which would deny veterans for quality of care they are entitled to through their earned benefits. if scored the cost of this recommendation would be triple if not more and is financially and stable. a better proposal is found in bas plan to consolidate community care program. the american legion supports allowed virginia set

>> november is when we expect to provide service to them. they are technically enrolled today, right? they are not going to receive service until november. >> of that number, 151 are going to be, how many of that are we expecting super green? >> so far 151 have said they want to be super green. and at the end of this presentation, i'm going to show you what we are doing to try to bring that number up with some of our marketing materials. okay. >> great. >> so, procurement. we have two outstanding regulatory requirements from the state that affect our procurement efforts. one is we have to meet resource adequacy requirements and the other is we have to meet a long term contracting requirement. we have negotiated and are finalizing arrangements for the resource adequacy requirements. we actually finalized one of of four. we have more work to do there and on our second requirement our long-term contracting requirement. we are making progress but i don't have a report yet. i want to make sure that stays on your radar screen . >> what about those

that should provide voters with confidence that there is a check to ensure that their votes have been accurately recorded. these factors and others have mentioned they make it highly unlikely that there could be a successful widespread attack to change the vote totals. having said this, i want to talk about the problem of aging equipment in the united states. i do believe that if this is not addressed, it can do damage to voter confidence and therefore the integrity of the elections. if this is particularly true now when there are discussions of the elections in the public discourse. in 2015 we oversaw a study that looked at this and found that 42 states are using voting machines that are over a decade old this november and that is close to the lifespans particularly those designed in the 1990s. i want to be clear that it is a blunt tool to measure it doesn't mean that it will suddenly start working. before i can get a hearing today i saw in 1965 ford mustang running and it looks like it was running perfectly and obviously the kind of maintenance and investment that is put into machin

as required under federal relocation law, mta provided 42 months' of rental subsidy to each household displace -- to each of the displaced households. the subsidy was used to pay the rent differential between 30% of the household's income, and the rent that was being charged. in addition to the federally-required relocation assistance mta wished to provide permanent replacement units as an option to the displaced residents. mta and mohcd identified the broadway sansome site to provide the unit and mta committed $8 million to the construction of broadway sansome a 75-unit affordable housing housing development locates at 255 broadway. 12 of the displaced households with incomes at or below 50% ami were offer a unit at broadway sansome. five of the households qualified for 50% ami units, and 7 qualified for 30% ami units. all households are required to pay 30% of their household's income for rent, with mta picking up the difference between the actual rent charged and the household's 30% payment. the subsidy will continue to the households for up to 30 years, provided at least one member

i would like to thank you for providing this. the future will be bright for our youth in our communities. thank you. >> thank you. jackie flynn please. >> good afternoon commissioners. i am jackie flynn. we were fortunate to be one of the many, provided outreach and engagement services. it took us the opportunity first, we targeted our public housing residents and also used. we did a series of meetings and focus groups and through another that i wear, i am also the director, we included the survey and also physically look at location. one of the hardest thing to accept about the current southeast building, which i do i do love, it's his limitations. over the last three decades. it is not the center for education that was once dreamed of. we all know it's possible, because it built the starbucks and hundreds of people are there every day. when he that kind of energy in our community center. today, we have a huge opportunity to establish a new center for education. this was promised over all these years. i hear about green industry

this means offering new access points to consumers by expanding our provider office hours and providing off-hour visits to better accommodate our patients's busy lives. and using new technology to our advantage by offering online scheduling. review their lab tests. review their physician notes. schedule an important and refill their prescriptions. many of you are participating near hospitals and health care systems that offer these services. if they're not, perhaps today you may come and join novant health. we recently conducted a study that showed how consumers wanted to be treated. they value being treated with respect just as much as they value receiving effective quality care. that's a very important insight. people want to feel respected whether they're in a hospital or a clinic. and we work hard to honor that wish by training our doctors and our nurses to empathize with compassion that delivers the remarkable patient experience that they deserve in a very authentic personalized way. second, we have invested heavily in the health care technology. and we are big tphraoefrs that heal

money or some money it can be provided by well-trained professionals or a professional but i'm clear of the benefits and of the what it takes for a human being to get out of bed each day when certain services are not provided i beg you at this point to please do one thing everyday and there are a thousand things to do but one would be nice everyday to forward this so that we who have survived this holocaust have a place where we can meet and discuss our unique problems we shouldn't be tloel thrown in with generally population people who are just discovering they have aids or want or looking at taking the cocktail we've done that we have a fierce ability to stay alive to put it mildly i was diagnosed in 1985 and i'm still here it is in the pretty anymore it is very difficult some days and other days it is a complete lark but we need your help and commitment and we need our compassion more than anything to motivate you to do the right thing for us we're being overlooked in every which way thank you. >> thank you. >> that is the only public comment request. >> okay. well proceeded to th

provide our calendar whenever it's requested of me i've no problem with doing that. but i think it's wrong to write and-i think it is wrong to force me to provide the locations of where ever i am in that particular calendar so i have a big issue with that. >> thank you very much. mr. preston >> i think too much happens in secret at city hall and strong proponent of open government laws. supervisor breed now provides her calendar because the law passed requiring her to and was a 10-1 vote at the board of supervisors and she was the lone opponent and while she's entitled to have her concerns about that legislation, the other tenant supervisors thought that it was worthy of passing that law to require folks who are paying salaries of our supervisors and you are supervisors or representing us to know who they're meeting with and when. that's a basic right that this is a basic for anyone who believes in the sunshine and openness and city governments did i think that law was a no-brainer and as i said it past 10-1. so while the other supervisors agreed that it is eight ess

these services are also provided for our incarcerated db transwomen, stalk and trafficking victims. i will just end with this quote, one of my favorites from helen keller, that i love and it's just simple as to say," alone we can do so little, but together we can do so much." and when i look around with all of the agencies here, and the hard work in changing our systems together we can definitely make a change. thank you. [ applause ] >> thank you so much, dahlia. i just want to acknowledge a couple of staff people who are here, alden from assembly member ting's office and i want to acknowledge the family violence counsel chair katy albright who here as well. next up is the community education at las casa delas madras that opened as the first domestic violence shelter in the state of california and only the second in the nation. please welcome cara. [ applause ] >> i'm going to put this down, but i was holding the door to shelter. good evening, it's wonderful to be here with all of you standing in support of domestic violence survivors. over 40 years ago we began as a small shelter

here on 3rd street in the bay view, filling a vacancy on 3rd street, bringing good local jobs, and providing fresh produce to the neighborhood and the community. we have a number of speakers here who want to celebrate this milestone and important occasion and beginning with mayor lee, supervisor cohen, assembly member david chiu and howard ngo, the owner of duc loi and anthony page an employee at duc loi and the assessor-recorder carmen chou and without further ado, mayor lee. [phra*-urt/] [ applause ] come on up, the school district and school board is here as well. come on up. all right. congratulations everyone, you now have a local grocery store! [ applause ] >> you know, i want to say thank you to you and the staff for working so hard with the supervisor's office and all of the neighborhoodss and with howard. let me say this, good things just don't happen. . all right? for this community a lot of good things never have happened, but when they happen, it's because of good leadership, steady leadership, and i'm proud to have worked close, shoulder-to-shoulder with supervisor cohen, with h

on the provider side there's no silver bullet.engagement tools that we're using on the provider side to help them, "a," educate them about their care practices, the variation in terms of practice delivery that we have across many of our physician offices and across the hospitals. and so, electronic medical records, ehr, whether you're talking about e-clinical works or patient ping, which is one of the most recent we've implemented as of about 12 months ago. it's helped our providers identify patients, where they're accessing their care, how to practically engage them quickly, depending on where they're getting their care. that's been helpful, but has it reached what i call maximum efficiency? i don't think so. i don't think we've reached a silver bullet yet. on the patient side, in the commercial area, for our commercially insured products, we've been able to deploy a lot of those technologies, and under risk reimbursements, downside risk, we've been able to actually pay for those. for medicare, for medicaid, there's no revenue st

we represent clients of all ages but particularly children who have difficulty providing providers. in closing, i wish to offer a few recommendations to improve on laws and implementation. we strongly support hr 4276 congressman kennedy's behavioral health transparency act. no question we need greater disclosure. detailed information about how plans ensure mental health claims are treated equitably. it should be made public and written in language consumers can understand. there should be greater enforcement, including enhanced penalties to provide detailed information to members about the basis for coverage denials and comparative information on medical management and physical conditions. when hla requests this information, we rarely see it. an explicit right of action would allow consumers to enforce this themselves. they should have access to an easy to use process when coverage has been violated. this would help access the treatment they need and identify trends and compliance. it should be broadly promoted by government agencies to increase understanding amongst consumers. the

residents that have worked with me for the last three years on trying to find a grocery store, a provider to come in. thank you for being patient. thank you for being thoughtful in your feedback. and for those of you overzealous neighbors thanks for reaching out to other grocery stores when you didn't think i was doing enough but i'm here to say also this is really the beginning. this is beautiful. this is a beautiful jewel our community deserves. no other community in san francisco should go without options to healthy food. aim wrong? am i wrong? could you imagine, this community has been living for years without a grocery store. let me tell you a story how i have come to know duc loi. three years ago when my staff and with my were brainstorm and drafting letters to send to different retailers across the united states, one of my staff members came up with the idea about going to visit duc loi. so one day after work, i just went simply into the store in the mission and walked around, up-and-down the aisles and i believe i bought in oxtails -- [laughter ]you remember that? salt and pepper

>> correct. >> and as to the activities they provide and the manhours they going to provide? >> we will review the proposals for their effectiveness. >> right now is the self help for the elderly is running it. >> i think they're providing some services, yeah. >> okay thank you. oh when it's finished are you going to give us another report, who got the contract? >> of course. it has to come before the commission for approval. >> i see. okay. thank you. >> i had a question regarding the senior employment program. >> yes. >> what type of employment were you thinking of in terms of senior employment? >> so this is going to be -- the way we're envisioning this program it's going to be modeled after a program that's been deployod the east coast called reserve and takes retired workers, looks at their skills and recruits employers and tries to match them, and the agency would serve to subsidize the contractor providing the employment service would serve to subsidize the senior worker making it more attractive for the employer to take that person on. >> oh okay. so it's not necessar

and provide clarity on the situation. where we may say we think that this process counters the parity law and the health plan will change its course. others will go to appeals. we'll raise the issues that way. good portion of the cases those appeals result in an overturning of the decisions that are made by the health plans. so, we have a pretty good record, a very good record actually when insurance denials occur. >> too bad that folks need an advocate at all because they're dealing with the personal issues every day and thank you for what you're doing. congressman kennedy raised the point of medicaid reimbursement rate, my colleague mr. green from texas would agree the fact that texas and florida haven't expanded medicaid at all is a real barrier to so many of our families receiving the care they need. do you have an opinion on that treatment across the country. >> the medicaid expansion has provided just incredible financial stability afor state programs. support the entire range ofselveses that members are entitled to

it provides what i call a bucket. when we start identifying funding in the future to support infant and toddler programs. and it also, number two, is asking the office of early care and education to start looking at -start looking at creating a program as we identify the funding that would be very similar hopefully, to a model that we would use which is the preschool for all program. the office of early care and education and first five are working to great a continuum of care for the children 0-5. but the biggest gap still remains for the infants and toddlers. the fund would allow families to return to work or continue their studies in order to provide better for their families. when children are learning in a healthy and quality environment and when families are able to provide our economic our economy grows. helping to support a cities infants and toddlers is an investment in a stronger san francisco. data is clear. the needs is far greater far to great them. our babies and toddlers can no longer wait to be an afte

it provides what i call a bucket.hen we start identifying funding in the future to support infant and toddler programs. and it also, number two, is asking the office of early care and education to start looking at -start looking at creating a program as we identify the funding that would be very similar hopefully, to a model that we would use which is the preschool for all program. the office of early care and education and first five are working to great a continuum of care for the children 0-5. but the biggest gap still remains for the infants and toddlers. the fund would allow families to return to work or continue their studies in order to provide better for their families. when children are learning in a healthy and quality environment and when families are able to provide our economic our economy grows. helping to support a cities infants and toddlers is an investment in a stronger san francisco. data is clear. the needs is far greater far to great them. our babies and toddlers can no longer wait to be an aftert

more importantly, you can actually see exactly what providers are doing online.you can see what cardiologists or oncologists or general practitioners are doing, who they respect, who they are listening to for advice, how your employees and providers are talking to each other. so when you actually look at the actual world of what's happening, you can start to say, hmm, how do we shape that? again, because too much of what we say is inside our company we'll share information rather than say, okay, who are the physicians in the network that we're in? what are they doing? how do we actually have a better relationship with them? that's pretty easy to do. doctors are online. they have an mpi number. you can see exactly what they do. and i think of like -- i'll give you one example. like probably can say this. a big clinic that -- very famous clinic you all know actually looked at what their providers do versus what they think they're doing, and it's not the same thing. so we have to also start with how do we actually impact the people who are prescribing medicine or im

hundreds of put -- they represent 15,000 units and they block service providers from providing service. the chronicle highlighted the stories in tenants who are trying to get the internet provider of their choice and given the run around or denied. for the -- but he wouldn't tell him why. for trent and the sunset he wanted to acquire -- the provider's choice was told no by his landlord. when the isp identified a less invasive way to provide the service, he was denied. these should not be happening in our city today. we have an interest as a local government to make sure we have the best internet service possible at the lowest prices for our residents and while the federal government outlawing owners, land lord and property managers from entering into exclusive agreements with service providers to provide access, other barriers continue to persist through our city. in today's world, in 2016, as we are the innovation capital of the world in the private sector, we still and is -- have over 1,000 san francisco residents and 14% of our public school families who lack internet service at hom

and provide clarity on the situation. where we may say we think that this process counters the parity law and the health plan

now i would not provide a litmus test. but i am somebody who believes that roe versus wade was rightly decided. i think that abortion is a very difficult issue and it is a moral issue and one that i think good people on both sides can disagree on. but what ultimately i believe is that women in consultation with their families, their doctors, their religious advisers, are in the best position to make this decision. and i think that the constitution has a right to privacy in it that shouldn't be subject to state referendum, any more than our first amendment rights are subject to state referendum, any more than many of the other rights that we have should be subject to popular vote. obama: so this is going to be an important issue. i will look for those judges who have an outstanding judicial record, who have the intellect, and who hopefully have a sense of what real-world folks are going through. i'll just give you one quick example. senator mccain and i disagreed recently when the supreme court made it more difficult for a

plan provides the connection to the members.nd so that they are able to access the dental care, because not a lot of providers want to do them in medical and the paperwork is just crazy. and one other thing, is that brings in the family and usually complain that going to the hospital or to the appointment is very difficult and they get like, and they are late for like ten minutes and then their appointments cancelled. but sometimes they are waiting for an hour. it is like they can wait for an hour but when they are late, their appointments cancelled and it is another three months before you can get an appointment and so we are bringing it up to the governing board and to our quality improvement people. my co-chairs, in that committee. and so we want to make sure that these are addressed. and then, also we for instance, with regard to the formula, like sometimes a doctor prescribes a medicine and it is not in the formula, and so the access to the prescription will be instant, and sometimes members of the health plan were just lik

phillippe lam, a primary care provider for healthcare partners. it's great having you. >> thank you for having me. here again. and this is an important time for seniors. why is it so important? >> well, i just would like our viewers to know that medical enrollment -- i mean open enrollment period is the only time of the year where seniors have an opportunity to make changes to their medicare benefits. and so they must take advantage and it starts on october 15th, and runs through december 7th of this year. >> it's a very important time of year because we want to make sure people are taking advantage of those benefits. what happens if people miss the december 7th deadline? >> well, if they don't make the changes that they want to their health medicare benefits, then they will have to wait and tire year to make the changes again. >> and that could end up costing them several hundreds if not thousands of dollars over the course of that year because of the care and the gap in coverage that they might have. >> correct. >> which is not a good thing, obv

more importantly, you can actually see exactly what providers are doing online. so you can see what cardiologists or oncologists or general practitioners are doing, who they respect, who they are listening to for advice, how your employees and providers are talking to each other. so when you actually look at the actual world of what's happening, you can start to say, hmm, how do we shape that? again, because too much of what we say is inside our company we'll share information rather than say, okay, who are the physicians in the network that we're in? what are they doing? how do we actually have a better relationship with them? that's pretty easy to do. doctors are online. they have an mpi number. you can see exactly what they do. and i think of like -- i'll give you one example. like probably can say this. a big clinic that -- very famous clinic you all know actually looked at what their providers do versus what they think they're doing, and it's not the same thing. so we have to also start with how do we actually impact the people who are prescribing medicine o

it's not going to be the way you provide certainty to businesses. when i go around and visit these businesses, what i hear is thank you for providing a certainty that you've got to give us more and what the democrats are doing unfortunately this year not all of them because we have some that work on the bipartisan basis with us because they try to add more tax increases. >> ms. bennett, there's an thern estimated 874,000 virginians, 874,000 who are uninsured and healthealthcare premiums contino increase much faster. the question, why woul what wouo to address these issues? >> one of the biggest things that would help immediately escort virginia to pass medicaid expansion. it would immediately address the 400,000 uninsured and it would address this by taking back the money we are sending to washington. right now we have the worst of all worlds. the congress voted against the medicaid expansion. i think that is misguided and it shows the lack of understanding of the budgets and the economi economics. the other thing we now have the affordable care act

and to get to that love all of clarity it will be hard for providers to know that. to make adjustments to the allies the biggest area right get complaints about provider payments relates to the emergency room care. er care is a plan to consolidate is very fragmented. in some circumstances it is the primary pair of those conditions and in other circumstances it is hell last resort. by a lot and statute we pay 70 percent of the medicare rate fell with doctors with the er it is considered payment in full but they have to carry a chunk of that of their accounts receivable and then they cannot pay us until we get the law changed. that is around the unauthorized care we have to figure out that the services connected or not. so we could pay the bill to get this more in line with a progressive industry does. does require some investment and if we can get the good criteria in the king said of the system and then we can leverage the community partners. when you actually go to the medical records and then the emergency room you cannot do that by the computer. and with that kne

they say they will follow, provide the ground troops, provide boots on the ground to not only gain the territory but hold it. these sunnis going to these regions, it would completely change the dynamics on the ground. you might end upwith a negotiated settlement but unless america provides the air cover, provide the no-fly zone, sets up safe zones, we're not going to solve this problem . >> i understand you went up to new york to meetings but he's in the senate. eternal of the homeland security committee. why hasn't he done anything why hasn't he made proposals? senators can make proposals and they can propose a no-fly zone. they can propose arms for the rebels. the fact is, what senator johnson does is criticize the president, you criticize the president but you don't you do your ownjob which is the layout legislatively what you need to do , provide the president with the authority to do some of these things and maybe he will use it or what but senator johnson is talking about this, he hasn't acted. >> he blocked three defense appropriation bills before the senate where he's prioritiz

or glasses were provided.in return for my $150 a week someone dropped a towel and change of betting each friday and gray sheets had small holes. the front desk was a plastic shield with a round hole in it. one happen to be there, which was not likely. beside the soul was a bunch of rules. some such as the one reading no visitors after 9:00 p.m. were not taken seriously. people came and went all night, knox rang out on doors, cars idled in the parking lot under the shadow lighting, issuing out of their tailpipes into the cold air. all visitors must sign in at the office. i never saw anyone doing so. one posted rule taken seriously, anyone evicted will have their things thrown away. on a regular basis families were evicted from rooms for not paying rent, they were locked out and all their belongings were forfeited. children's toys and favorite things were gone forever. anyone who has ever watched a young child form an attachment to a beat up raggedy doll or scrap of material or the way children fall all over the

it provides what i call a bucket. when we start identifying funding in the future to support infant and toddler programs. and it also, number two, is asking the office of early care and education to start looking at -start looking at creating a program as we identify the funding that would be very similar hopefully, to a model that we would use which is the preschool for all program. the office of early care and education and first five are working to great a continuum of care for the children 0-5. but the biggest gap still remains for the infants and toddlers. the fund would allow families to return to work or continue their studies in order to provide better for their families. when children are learning in a healthy and quality environment and when families are able to provide our economic our economy grows. helping to support a cities infants and toddlers is an investment in a stronger san francisco. data is clear. the needs is far greater far to great them. our babies and toddlers can no longer wait to be an afte