00:00:12 >> GOOD MORNING. THE MEETING WILL COME TO ORDER
00:00:16 . WELCOME TO THE APRIL 8TH, 2026
00:00:17 MEETING OF THE BUDGET AND FINANCE COMMITTEE.
00:00:20 I'M SUPERVISOR CONNIE CHANG. CHAIR OF THE COMMITTEE.
00:00:21 I'M JOINED BY VICE CHAIR SUPERVISOR MATT DORSEY
00:00:24 AND MEMBER SUPERVISOR DANNY SOUDER.
00:00:27 OUR CLERK IT'S BRANT HALIBUT. I WOULD LIKE TO THANK KALEENA
00:00:31 MENDOZA FROM CIRCLE T V FOR BROADCASTING THIS MEETING.
00:00:35 >> MR. CLERK, DO YOU HAVE ANY ANNOUNCEMENT?
00:00:36 THANK YOU, MADAM CHAIR. JUST A FRIENDLY REMINDER TO
00:00:39 THOSE IN ATTENDANCE TO PLEASE MAKE SURE TO SILENCE ALL CELL
00:00:41 PHONES AND ELECTRONIC DEVICES TO PREVENT INTERRUPTIONS TO OUR
00:00:44 PROCEEDINGS SHOULD YOU HAVE ANY DOCUMENTS TO BE INCLUDED AS
00:00:48 PART OF THE FILE THEY SHOULD BE FORWARDED TO MYSELF THE CLERK.
00:00:51 PUBLIC COMMENT WILL BE TAKEN ON EACH ITEM ON THIS AGENDA.
00:00:52 WHEN YOUR ITEM OF INTEREST COMES UP AND PUBLIC COMMENT IS
00:00:56 CALLED PLEASE LINE UP TO SPEAK ON THE BUS SIDE OF THE CHAMBER
00:00:59 TO YOUR RIGHT. MY LEFT ALONG THOSE CURTAINS
00:01:02 AND WHILE NOT REQUIRED TO PROVIDE PUBLIC COMMENT WE DO
00:01:03 INVITE YOU TO FILL OUT A COMMENT CARD AND LEAVE THEM ON
00:01:06 THE TRAY BY THE TELEVISION TO YOUR LEFT BY THE DOORS.
00:01:09 IF YOU WISH FOR YOUR NAME TO BE ACCURATELY RECORDED FOR THE
00:01:11 MINUTES ALTERNATIVELY YOU MAY SUBMIT PUBLIC COMMENT
00:01:13 IN WRITING IN EITHER OF THE FOLLOWING WAYS HE MAILED THEM
00:01:17 TO MYSELF. THE BUDGET AND FINANCE
00:01:18 COMMITTEE CLERK HAT. B R E.A. DOT J L I P8 HAD S F G
00:01:25 YOUR G. IF YOU SUBMIT PUBLIC COMMENT BY
00:01:29 EMAIL IT WILL BE FORWARDED TO THE SUPERVISORS AND ALSO
00:01:30 INCLUDED AS PART OF THE OFFICIAL FILE.
00:01:33 YOU MAY ALSO SEND YOUR WRITTEN COMMENTS BY A U.S. POSTAL
00:01:36 SERVICE TO OUR OFFICE IN CITY HALL AT ONE DR. CARLTON BECAUSE
00:01:40 THE PLACE ROOM 244 SAN FRANCISCO, CALIFORNIA NINE FOR
00:01:45 1 OR 2. AND FINALLY, MADAM CHAIR, ITEMS
00:01:46 ACTED UPON TODAY ARE EXPECTED TO APPEAR ON THE BOARD OF
00:01:49 SUPERVISORS AGENDA OF APRIL 14TH UNLESS OTHERWISE STATED.
00:01:52 >> MADAM CHAIR. >> THANK YOU, MR. CLERK.
00:01:55 AND BEFORE WE CALL ITEM NUMBER ONE I WOULD AGAIN REMIND THE
00:01:58 PUBLIC THAT WE HAVE BUDGET AND LEGISLATIVE ANALYST REPORTS
00:02:04 FOR ITEMS ONE THROUGH FOUR TODAY AND FOR THOSE ITEMS WE
00:02:06 WILL HAVE THE DEPARTMENT PRESENTATION FIRST BY AND THEN
00:02:09 FOLLOWED BY THE BUDGET AND LEGISLATIVE ANALYST
00:02:12 AND THEN WE WILL TAKE QUESTIONS AND PUBLIC COMMENTS.
00:02:13 MR. CLERK WITH THAT PLEASE CALL ITEM NUMBER ONE.
00:02:17 >> YES, ITEM NUMBER ONE IS A RESOLUTION APPROVING
00:02:22 MODIFICATION NUMBER ONE TO A PROFESSIONAL SERVICES AGREEMENT
00:02:23 FOR GENERAL AIRPORT SECURITY SERVICES BETWEEN COVENANT
00:02:27 AVIATION SECURITY LLC AND THE CITY AND COUNTY PACKING BY
00:02:31 AND THROUGH ITS AIRPORT COMMISSION TO INCREASE THE
00:02:34 CONTRACT AMOUNT BY 10.5 MILLION FOR A TOTAL NOT TO EXCEED
00:02:39 AMOUNT OF 20.3 MILLION AND TO EXTEND THE CONTRACT TERM FOR
00:02:42 TWO YEARS FROM JUNE 30TH 2026 FOR A NEW CONTRACT TERM OF JULY
00:02:48 1ST 2024 THROUGH JUNE 30TH 2028 WITH ONE REMAINING OPTION TO
00:02:52 EXTEND FOR TWO ADDITIONAL YEARS PURSUANT TO THE CHARTER.
00:02:54 >> MADAM CHAIR, THANK YOU. AND WE HAVE A VOTE HERE.
00:02:58 GOOD MORNING DEANNA ALEK FROM SFO.
00:03:01 >> THE ITEM BEFORE YOU SEEKS APPROVAL FOR MODIFICATION
00:03:03 NUMBER ONE TO AN EXISTING CONTRACT BETWEEN THE AIRPORT
00:03:05 AND COVENANT AVIATION SECURITY LLC FOR GENERAL AIRPORT
00:03:09 SECURITY SERVICES TO INCREASE THE NOT TO EXCEED AMOUNT BY
00:03:15 10.5 MILLION AND EXERCISE THE FIRST OPTION TO EXTEND THE TERM
00:03:19 THROUGH JUNE 30TH 20 28. >> THIS IS A GENERAL AVIATION
00:03:22 SECURITY SERVICE CONTRACT WITH COVENANT AVIATION FOR SCREENING
00:03:26 OF MERCHANDISE AND CONSUMABLES ENTERING AIRPORT STERILE AREAS
00:03:30 VIA VENDOR SCREENING CHECKPOINTS.
00:03:31 >> THIS CONTRACT ALSO PROVIDES SECURITY FOR AIRPORT EXIT LANES
00:03:35 WHEN CHECKPOINTS ARE NOT ARE CLOSED AND NOT STAFFED BY TSA
00:03:38 AND AT ALL TIMES AT EXIT LANES NOT ADJACENT TO TSA PASSENGER
00:03:43 SCREENING CHECKPOINTS. >> THIS CONTRACT IS ALSO
00:03:47 ESSENTIAL TO PROVIDE TRAINED PERSONNEL TO CONDUCT AVIATION
00:03:51 WORKER SCREENING AT DESIGNATED AIRPORT DIRECTOR ACT DIRECT
00:03:55 ACCESS POINTS AS REQUIRED BY TSA AIRPORT SECURITY PROGRAM OR
00:03:59 LSP. >> ALL COMMERCIAL AIRPORTS ARE
00:04:03 REQUIRED TO PROVIDE TRAINED PERSONNEL AND INSPECTION
00:04:06 SERVICES THROUGHOUT AIRPORT TERMINALS AND EXITS TO COMPLY
00:04:10 WITH THE REQUIREMENTS OF THE TSA APPROVED HSP AND TSA
00:04:14 SECURITY DIRECTIVES. THIS CONTRACT DOES NOT PERFORM
00:04:18 PASSENGER OR CHECKED BAGGAGE SCREENING AND IN INCLUDES
00:04:22 COMPLIANCE WITH ALL CITY LAWS THAT DO NOT CONFLICT WITH
00:04:26 FEDERAL REQUIREMENTS. >> COVENANT HAS PERFORMED
00:04:30 SATISFACTORILY AND ALL ITS CONTRACTUAL OBLIGATE
00:04:31 OBLIGATIONS AT SFO. >> THE BLA HAS RECOMMENDED
00:04:34 APPROVAL AND I'M HAPPY TO ANSWER ANY QUESTIONS ALONG WITH
00:04:38 MY COLLEAGUES FROM OPERATIONS AND SECURITY.
00:04:41 THANK YOU. >> GOOD MORNING.
00:04:45 NICK MINARD FROM THE BUDGET LEGISLATIVE ANALYST'S OFFICE.
00:04:49 ITEM ONE IS A RESOLUTION THAT APPROVES AN AMENDMENT TO THE
00:04:53 AIRPORT'S CONTRACT WITH COVENANT AVIATION SECURITY.
00:04:54 THE AMENDMENT INCREASES THE VALUE OF THE CONTRACT TO $20.3
00:04:59 MILLION AND EXTENDS THE AGREEMENT THROUGH JUNE 2028.
00:05:02 COVENANT PROVIDES NON PASSENGER AIRPORT SECURITY TO ENTRANCES
00:05:06 TO THE SECURE AREA AT THE AIRPORT.
00:05:10 THIS AMENDMENT ALSO INCREASES THE STAFFING FROM 51 STAFF TO
00:05:14 57 STAFF STARTING NEXT FISCAL YEAR.
00:05:18 THE CONTRACTORS PERFORMANCE IS PRIMARILY BASED ON COMPLYING
00:05:21 WITH THE NUMBER OF TSA REQUIRED RANDOMIZED SCREENINGS THAT THEY
00:05:26 DO AND THEY ARE COMPLYING WITH THAT WITH THOSE REQUIREMENTS
00:05:30 ACCORDING TO THE AIRPORT. AND THEN ON PAGE FIVE OF OUR
00:05:33 REPORT YOU CAN SEE THE KIND OF ANNUAL SPENDING ON THE CONTRACT
00:05:37 IS ABOUT $5.7 MILLION NEXT YEAR AND THOSE COSTS ARE FUNDED BY
00:05:40 AIRPORT OPERATING REVENUES. >> WE RECOMMEND APPROVAL OF
00:05:43 ITEM ONE. >> THANK YOU.
00:05:47 COULD YOU ELABORATE A LITTLE BIT ABOUT HOW THIS CONTRACT IS
00:05:54 ALSO IN COMPLIANCE OF BOTH WITH CITY LAW AND THE FEDERAL LAW?
00:05:58 >> SO IN ALL OF OUR CONTRACTS WE INCLUDE LANGUAGE THAT THE
00:06:02 CONTRACTOR HAS TO BE KEPT FULLY INFORMED OF ALL CODES,
00:06:06 ORDINANCES, CHARTER LAWS OF THE CITY AND MUST AT ALL TIMES
00:06:10 COMPLY. BUT AS YOU ALL KNOW WITH
00:06:13 FEDERAL SUPREMACY, IF THERE ARE FEDERAL REGULATIONS OR
00:06:14 REQUIREMENTS THAT CONFLICT WITH THAT, THEY WOULD HAVE TO FOLLOW
00:06:18 THOSE FEDERAL LAWS. >> IN THIS CASE THE CONTRACT
00:06:22 SPECIFICALLY SCREENS AIRPORT EMPLOYEES AND BADGED EMPLOYEES.
00:06:26 >> AND SO THAT IS THEIR SPECIFIC DUTY IN TERMS OF WHAT
00:06:30 THEY ARE REQUIRED TO COMPLY WITH.
00:06:37 AND UNDERSTOOD. >> OKAY.
00:06:38 THANK YOU. I DON'T HAVE ANY ADDITIONAL
00:06:41 QUESTIONS FOR THE MOMENT. AND WITH THAT LET'S GO TO
00:06:42 PUBLIC COMMENT ON THIS ITEM. >> YES, WE'RE NOW OPENING
00:06:46 PUBLIC COMMENT FOR THIS ITEM NUMBER ONE.
00:06:48 IF WE HAVE ANY MEMBERS OF THE AUDIENCE WHO WISH TO ADDRESS
00:06:52 THIS COMMITTEE. MADAM CHAIR, WE HAVE NO
00:06:55 SPEAKERS. >> SEEING NO PUBLIC COMMENTS,
00:06:59 PAPA CARMEN IS NOW CLOSE. >> COLLEAGUES, I WOULD LIKE TO
00:07:02 MOVE THIS ITEM TO FULL BOARD WITH RECOMMENDATION AND ROLL
00:07:04 CALL PLEASE. >> AND ON THAT MOTION TO REFER
00:07:08 THIS RESOLUTION TO THE FULL BOARD AS RECOMMENDED.
00:07:11 VICE CHAIR DORSEY AND DORSEY MEMBER REMEMBER SAUTER SAUTER I
00:07:15 CHURCH CAN I CAN I HAVE THREE EYES?
00:07:18 >> THE MOTION PASSES. THANK YOU VERY MUCH.
00:07:21 THANK YOU. AND MR. CLERK COULD YOU CALL
00:07:23 ITEM NUMBER TWO? >> YES.
00:07:26 ITEM NUMBER TWO IS A RESOLUTION APPROVING AN AUTHORIZED THE
00:07:30 GENERAL MANAGER OF THE SAN FRANCISCO PUBLIC UTILITIES
00:07:31 COMMISSION ON BEHALF OF CLEAN POWER S.F. TO PARTICIPATE
00:07:34 IN CALIFORNIA COMMUNITY POWER'S PROCUREMENT OF THE WILLOW ROCK
00:07:38 LONG DURATION STORAGE PROJECT. AND BY ENTERING INTO THE BUYER
00:07:42 LIABILITY PASS THROUGH AGREEMENT AND ENTERING INTO THE
00:07:47 WILLOW ROCK LONG DURATION STORAGE PROJECT PARTICIPATION
00:07:51 SHARE AGREEMENT FOR A TOTAL NOT TO EXCEED AMOUNT OF 75.9
00:07:54 MILLION WITH THE CONTRACT DURATION OF 20 YEARS ESTIMATED
00:07:57 TO BEGIN JULY 1ST 2030 THROUGH JUNE 30TH 2050.
00:08:00 PURSUANT TO THE CHARTER. >> MADAM CHAIR, THANK YOU.
00:08:07 >> AND TODAY WE HAVE PUBLIC UTILITIES COMMISSION HERE.
00:08:08 GOOD MORNING CHAIR. CHAIR CHEN AND SUPERVISORS
00:08:12 DORSEY AND SOUDER. MY NAME IS MICHAEL HOLMES.
00:08:15 I'M THE DEPUTY ASSISTANT GENERAL MANAGER AT THE SAN
00:08:16 FRANCISCO PUBLIC UTILITIES COMMISSION WHERE I'M
00:08:19 RESPONSIBLE FOR CLEAN POWER S F AND OUR POWER SUPPLY RESOURCES
00:08:25 . WE HAVE A PRESENTATION FOR YOU
00:08:26 TODAY. I WANTED TO JUST MAKE A QUICK
00:08:29 INTRO NOTING THAT LAST YEAR THE BOARD OF SUPERVISORS APPROVED
00:08:34 LEGISLATION DELEGATING TO THE AS A P C GENERAL MANAGER
00:08:38 APPROVAL OF CONTRACTS FOR THE SALE AND PURCHASE OF POWER
00:08:45 SUPPLY. THIS DELEGATION ALLOWS THE SPU
00:08:46 C TO MEET THE TIME REQUIREMENTS OF THE COMPETITIVE MARKETS WE
00:08:50 OPERATE IN SO THAT WE CAN SECURE COST EFFECTIVE RENEWABLE
00:08:56 ENERGY AND ENERGY STORAGE SUPPLIES FOR OUR RATEPAYERS.
00:08:57 WE REPORT CONTRACTS EXECUTED USING THIS AUTHORITY TO THE
00:09:01 BOARD OF SUPERVISORS EVERY QUARTER.
00:09:04 TODAY WE HAVE A CONTRACT WHERE WE DO NOT NEED TO RELY ON THAT
00:09:07 DELEGATED AUTHORITY FOR TIMELY EXECUTION.
00:09:11 >> IF I COULD HAVE THE NEXT SLIDE.
00:09:12 THANKS. SO TODAY WE'RE REQUESTING THAT
00:09:15 THIS COMMITTEE REFER TO THE FULL BOARD FOR APPROVAL A NEW
00:09:19 CONTRACT FOR CLEAN POWER STAFF TO PROCURE LONG DURATION ENERGY
00:09:21 STORAGE. THE AGREEMENT WILL HELP
00:09:24 FACILITATE CLEAN POWER SEPS COMPLIANCE WITH A JUNE 2021
00:09:28 CALIFORNIA PUBLIC UTILITIES COMMISSION ORDER.
00:09:32 THE CLEAN POWER ESF AND OTHER POWER PROVIDERS UNDER ITS
00:09:35 JURISDICTION PROCURE LONG DURATION ENERGY STORAGE
00:09:38 RESOURCES. LONG DURATION ENERGY STORAGE IS
00:09:40 DEFINED AS THOSE RESOURCES THAT ARE CAPABLE OF STORING
00:09:46 AND DISCHARGING ENERGY TO THE GRID AT THEIR MAXIMUM POWER
00:09:50 CAPACITY FOR EIGHT HOURS OR MORE.
00:09:51 CLEAN POWER S.F. WAS ORDERED TO PROCURE 15.5MW OF THIS RESOURCE
00:09:58 TYPE BY THE CPC IN 2022. THE BOARD OF SUPERVISORS WAS
00:10:05 APPROVED CLEAN POWER ASSETS PARTICIPATION IN THE TUMBLEWEED
00:10:09 AND GOAL LINE LONG DURATION ENERGY STORAGE PROJECTS WITH CC
00:10:12 POWER. THESE TWO PROJECTS WOULD HAVE
00:10:13 SATISFIED CLEAN POWERS OF REGULATORY OBLIGATION FOR LONG
00:10:17 DURATION STORAGE. WHILE THE TUMBLEWEED PROJECT IS
00:10:21 ON SCHEDULE TO REACH COMMERCIAL OPERATION THIS JUNE THE GOAL
00:10:24 LINE PROJECT WAS TERMINATED BY THE DEVELOPER LAST YEAR
00:10:28 IN ANTICIPATION OF ADDITIONAL MEMBER PROCUREMENT NEEDS.
00:10:32 CC POWER ISSUED A REQUEST FOR OFFERS IN 2024 FOR RENEWABLE
00:10:36 ENERGY AND ENERGY STORAGE SUPPLIES.
00:10:39 AS PART OF THAT SOLICITATION. THE AGENCY RECEIVED OFFERS FROM
00:10:44 30 LONG DURATION STORAGE PROJECTS.
00:10:48 CC POWER SELECTED THE WILLOW ROCK ENERGY STORAGE CENTER FOR
00:10:51 A CONTRACT DUE TO ITS HIGH PROJECT VIABILITY
00:10:54 AND TECHNOLOGY DIVERSIFICATION BENEFITS.
00:10:57 IF APPROVED THIS WILL BE CLEAN POWER ASSETS FIRST NON LITHIUM
00:10:59 ION ENERGY STORAGE PROJECT. THE CC POWER BOARD APPROVED THE
00:11:06 ENERGY STORAGE AGREEMENT WITH WILLOW ROCK ON JANUARY 28TH
00:11:09 AND THE AGREEMENT WAS EXECUTED ON FEBRUARY 4TH.
00:11:11 CC POWER MEMBERS NOW HAVE 120 DAYS AFTER THAT EXECUTION DATE
00:11:15 TO EXECUTE THEIR OWN PARTICIPATION AGREEMENTS
00:11:19 AND THAT DATES MAY 4TH. >> NEXT SLIDE.
00:11:25 >> CALIFORNIA COMMUNITY POWER CC POWER FOR SHORT IS A JOINT
00:11:29 POWERS AGENCY FORMED IN 2021 BY COMMUNITY CHOICE AGGREGATION
00:11:32 PROGRAMS IN NORTHERN AND CENTRAL CALIFORNIA.
00:11:35 THE BOARD OF SUPERVISORS APPROVED MEMBERSHIP IN CLEAN
00:11:39 POWER AS A FORMALLY BECAME A MEMBER IN APRIL OF 2021.
00:11:43 TODAY THERE ARE NINE MEMBERS OF CC POWER REPRESENTING ABOUT 2.7
00:11:47 MILLION CUSTOMERS ACROSS 112 MUNICIPALITIES FROM HUMBOLDT
00:11:50 COUNTY TO SANTA BARBARA COUNTY. >> BY JOINING FORCES CLEAN
00:11:56 POWER SEVEN OTHER KS CAN LEVERAGE A LARGER BUYING POWER
00:12:00 TO DEVELOP PROJECTS AND PURCHASE ENERGY FROM LARGER
00:12:04 PROJECTS AT A LOWER COST THAN IF WE WENT ALONE.
00:12:08 PROVIDING FINANCIAL BENEFITS TO OUR RATEPAYERS.
00:12:09 CC POWER IS SUBJECT TO THE BROWN ACT SO ALL OF ITS BOARD
00:12:13 MEETINGS ARE OPEN TO THE PUBLIC WITH BOTH VIRTUAL AND IN-PERSON
00:12:16 ATTENDANCE OPTIONS. >> NEXT SLIDE.
00:12:20 HERE'S A SUMMARY OF THE KEY ELEMENTS OF THE WILLOW ROCK
00:12:23 PROJECT AND THE AGREEMENT WITH CC POWER WILL IRAQ IS A
00:12:29 PROPOSED 500 MEGAWATT AND 4000 MEGAWATT HOUR ADVANCED
00:12:30 COMPRESSED AIR ENERGY STORAGE PROJECT TO BE BUILT
00:12:34 IN ROSAMOND, CALIFORNIA, A REGION THAT HAS AN ABUNDANCE OF
00:12:38 UTILITY SCALE SOLAR ENERGY RESOURCES.
00:12:41 A RENDERING OF THE PROJECT IS PROVIDED ON THIS SLIDE.
00:12:45 ON BEHALF OF ITS MEMBERS CC POWER IS CONTRACT IT FOR A 50
00:12:50 MEGAWATT PORTION OF THE FACILITY.
00:12:51 CLEAN POWERS OF SHARE OF THAT WOULD BE 11.5MW OR ABOUT 23% OF
00:12:59 POWER'S COMMITMENT UNDER THE PARTICIPATION AGREEMENT WITH CC
00:13:03 POWER. CLEAN POWER S.F. WOULD COMMIT
00:13:04 TO PURCHASING RESOURCE ADEQUACY CAPACITY AND ENERGY STORAGE
00:13:07 SERVICES FROM WILLOW ROCK FOR 20 YEARS FROM THE PROJECT'S
00:13:11 COMMERCIAL OPERATION DATE WHICH IS EXPECTED IN JULY OF 2030.
00:13:15 UNDER THE PARTICIPATION AGREEMENT CLEAN POWER SUPPLY
00:13:20 COSTS ARE NOT TO EXCEED $75,900,000 OR ABOUT $4 MILLION
00:13:25 PER YEAR. THIS AMOUNT INCLUDES A BUFFER
00:13:29 TO ACCOUNT FOR A STEP UP IN CLEAN POWER AS THOSE PROJECT
00:13:33 SHARE. SHOULD ANOTHER PARTICIPATING
00:13:34 MEMBER WITHDRAW FROM THE PROJECT?
00:13:37 THE DEVELOPER HYDRO STORE HAS COMMITTED TO USING A PROJECT
00:13:40 LABOR AGREEMENT TO CONSTRUCT THE FACILITY.
00:13:42 THEY'VE ALSO COMMITTED $2.1 MILLION PER YEAR OVER FIVE
00:13:46 YEARS FOR A TOTAL OF 10.5 MILLION IN COMMUNITY BENEFITS
00:13:49 TO VARIOUS ORGANIZATIONS IN ROSAMOND, TEHACHAPI AND THE
00:13:52 ANTELOPE VALLEY REGION WHERE THE PROJECT WILL BE LOCATED.
00:13:59 OKAY SO HOW DOES THIS WORK? >> THIS ILLUSTRATION SHOWS THE
00:14:04 MAJOR COMPONENTS OF THE PROJECT.
00:14:06 FIRST AN AIR COMPRESSOR WHICH IS LABELED ONE ON THIS IMAGE
00:14:09 USES ELECTRICITY DRAWN FROM THE GRID TO DELIVER PRESSURIZED AIR
00:14:14 INTO AN UNDERGROUND WATER FILLED CAVERN SPECIFICALLY
00:14:18 DESIGNED FOR THIS USE. AND THAT'S LABELED THREE ON THE
00:14:21 SLIDE. THE PROCESS OF COMPRESSING AIR
00:14:24 GENERATES HEAT WHICH IS EXTRACTED USING A HEAT
00:14:28 EXCHANGER AND CAPTURED IN A THERMAL MANAGEMENT SYSTEM.
00:14:32 >> AND THAT'S LABELED TWO AS COMPRESSED AIR IS PUMPED
00:14:36 UNDERGROUND. IT PLAYS THAT DISPLACES THE
00:14:37 WATER IN THE CAVERN WHICH IS THEN FORCED UP THROUGH A
00:14:41 DIFFERENT SHAFT INTO A RESERVOIR THAT'S ON THE SURFACE
00:14:45 AND THAT'S LABELED FOR WHEN ENERGY IS NEEDED ON THE GRID.
00:14:48 THE WATER IS ALLOWED TO FLOW BACK DOWN INTO THE CAVERN
00:14:52 PUSHING THAT COMPRESSED AIR BACK TO THE SURFACE.
00:14:56 THE COMPRESSED AIR IS THEN REHEATED USING STORED THERMAL
00:15:00 ENERGY IN NUMBER THREE WHICH HEATS AND EXPANDS THE AIR AS IT
00:15:06 PASSES THROUGH A TURBINE GENERATOR.
00:15:07 THE GENERATOR PRODUCES THE ELECTRICITY FROM THE HEAT
00:15:10 HEATED EXPANDED AIR AND THEN THAT ELECTRICITY IS DELIVERED
00:15:14 BACK TO THE GRID TO CHARGE THE SYSTEM WILL DRAW POWER FROM THE
00:15:19 GRID WHEN ELECTRICITY MARKET PRICES ARE LOW AND SOLAR ENERGY
00:15:22 SUPPLY IS HIGH. THE STORED ENERGY WILL THEN BE
00:15:25 DISCHARGED. AS I JUST DESCRIBED WHEN
00:15:29 ELECTRICITY MARKET PRICES AND THE GRID DEMAND ARE HIGH,
00:15:32 CAPTURING THE DIFFERENCE IN THOSE ENERGY MARKET VALUES.
00:15:36 THE PROJECT WILL USE PROVEN TECHNOLOGY LIKE AIR COMPRESSORS
00:15:40 AND HEAT EXCHANGERS AND WILL NOT RELY ON ANY COMBUSTION
00:15:41 COMBUSTION OF FOSSIL FUELS TO STORE AND DISCHARGE THE ENERGY
00:15:47 . >> NEXT SLIDE.
00:15:48 IN ORDER TO PARTICIPATE IN THE WILLOW ROCK PROJECT CLEAN POWER
00:15:52 S.F. WILL NEED TO EXECUTE TWO AGREEMENTS.
00:15:55 THE FIRST NOTED HERE WITH THE NUMBER ONE IS CALLED THE
00:15:58 PROJECT PARTICIPATION AND SHARE AGREEMENT.
00:16:01 THIS AGREEMENT GOVERNS THE RELATIONSHIP BETWEEN CC POWER
00:16:03 AND THE PARTICIPATING MEMBERS. IT SPECIFIES THE ENERGY PROJECT
00:16:06 PRODUCTS TO BE DELIVERED TO CLEAN POWER S.F. AND THE OTHER
00:16:10 MEMBERS AND OUTLINES THE PROCESSES AND PROCEDURES.
00:16:13 IN THE EVENT ANY INDIVIDUAL PARTICIPANT WITHDRAWS FROM THE
00:16:17 AGREEMENT. THE SECOND AGREEMENT NUMBER TWO
00:16:20 ON THE SLIDE IS CALLED A BUYER LIABILITY PASS THROUGH
00:16:23 AGREEMENT. THIS AGREEMENT IS EXECUTED
00:16:26 BETWEEN CLEAN POWER S.F. CC POWER AND THE WILLOW ROCK
00:16:28 PROJECT. AND IT ACTS AS A GUARANTEE BY
00:16:31 CLEAN POWER S.F. OF ITS SHARE OF CC POWERS PAYMENT
00:16:35 OBLIGATIONS TO THE PROJECT. >> THIS AGREEMENT'S INTENDED TO
00:16:39 ADDRESS THE FACT THAT CC POWER ARE THE JPA IS AN ENTITY WITH
00:16:43 NO CUSTOMERS OR REVENUES OF ITS OWN.
00:16:46 SO THIS AGREEMENT MIMICS WHAT CLEAN POWER S.F. WOULD COMMIT
00:16:48 TO IF IT HAD ENTERED INTO THE AGREEMENT ON ITS OWN.
00:16:52 CLEAN POWER SALES GUARANTEE IS LIMITED ONLY TO ITS SHARE OF
00:16:55 THE PROJECT. THE THIRD AGREEMENT NUMBER
00:16:59 AND ON THIS SLIDE BUT IS LABELED ARE A PLUS TB4
00:17:02 AGREEMENT. THIS IS ALSO CALLED THE ENERGY
00:17:06 STORAGE AGREEMENT AND THIS IS THE PURCHASE AGREEMENT ENTERED
00:17:10 INTO BY CLEAN BY A CC POWER EXCUSE ME AND THE WILLOW ROCK
00:17:14 PROJECT. CLEAN POWER RESERVE IS NOT A
00:17:15 DIRECT PARTY TO THAT AGREEMENT. THE CONTRACT STRUCTURE THAT I
00:17:18 JUST OUTLINED IS THE SAME STRUCTURE USED BY THE OTHER CC
00:17:22 POWER. LONG DURATION ENERGY STORAGE
00:17:25 PROJECTS THAT WE HAVE PARTICIPATED IN INCLUDING THE
00:17:29 TUMBLEWEED PROJECT. SO TO RECAP CC POWER ENTERS
00:17:33 INTO A DIRECT CONTRACTUAL RELATIONSHIP WITH THE PROJECT
00:17:37 AND THEN THE MEMBERS ENTER INTO A SEPARATE AGREEMENT WITH CC
00:17:40 POWER TO PARTICIPATE IN THE PROJECT.
00:17:41 THE MEMBERS ALSO PROVIDE A FINANCIAL GUARANTEE OF THEIR
00:17:45 SHARE TO THE PROJECT. >> THAT CONCLUDES MY
00:17:48 PRESENTATION. I'M HAPPY TO TAKE ANY QUESTIONS
00:17:52 YOU MAY HAVE. ITEM TWO IS A RESOLUTION THAT
00:18:00 WOULD APPROVE THE PUC TO PARTICIPATE IN CALIFORNIA
00:18:04 COMMUNITY POWERS PROCUREMENT OF THE WILLOW ROCK LONG DURATION
00:18:08 ENERGY STORAGE PROJECT. THE RESOLUTION ALSO APPROVES
00:18:12 RELATED CONTRACTS. THIS WILL ALLOW THE PUC TO
00:18:16 PURCHASE A SHARE OF LONG DURATION ENERGY STORAGE FROM
00:18:20 THAT PROJECT OVER 20 YEARS TO MEET A CPC REQUIREMENT FOR
00:18:23 OBTAINING A CERTAIN AMOUNT OF CAPACITY WHICH WE DESCRIBE
00:18:27 IN THE REPORT. YOU CAN SEE THE COST OF THE
00:18:30 AGREEMENT ON PAGE 11. THIS IS $75.9 MILLION.
00:18:36 AGREEMENT OVER 20 YEARS OR ABOUT $3.8 MILLION PER YEAR FOR
00:18:41 THE FOR THE CLEAN POWER DIVISION.
00:18:44 THAT INCLUDES THE POTENTIAL TO PURCHASE ADDITIONAL ENERGY IF
00:18:49 ONE OF THE OTHER CC POWER MEMBERS IS NO LONGER
00:18:52 PARTICIPATING IN THE PROJECT AS WELL AS A CONTINGENCY FOR
00:18:56 INCREASED POWER COSTS. THOUGH IT MAY BE OFFSET BY
00:19:00 REVENUES THAT THE PROJECT WILL GENERATE OVER THAT TIME.
00:19:03 SO IT REALLY IS A MAXIMUM COST. THESE COSTS ARE FUNDED BY CLEAN
00:19:07 POWER CUSTOMER REVENUES AND WE RECOMMEND APPROVAL OF ITEM TWO
00:19:12 . >> THANK YOU CHAIR CHAN.
00:19:17 >> I'M HAPPY TO SUPPORT THIS AND ACTUALLY I AM GRATEFUL TO
00:19:20 SEE PROGRESS BEING MADE. HAVING WORKED IN THE CITY
00:19:24 ATTORNEY'S OFFICE WHEN COMMUNITY CHOICE AGGREGATION
00:19:28 WAS COMING ONLINE JUST AS MOSTLY JUST FOR MY EDIFICATION
00:19:30 SUPPOSE WE COME OUT OF THE CPU EVALUATION PROCEEDING AND IT'S
00:19:37 A NUMBER WE'RE COMFORTABLE WITH AND WE'RE PROCEEDING WITH
00:19:38 MUNICIPAL IZATION. WHAT HAPPENS WITH COMMUNITY
00:19:41 CHOICE AGGREGATION IS IS FOLDED INTO THE ENTERPRISE OR IT IS
00:19:44 A6X IS SEPARATELY. >> HOW DOES IT LOOK?
00:19:45 YEAH THANK YOU SUPERVISOR. GREAT QUESTION.
00:19:48 IF THAT WERE TO HAPPEN WE WOULD ESSENTIALLY MERGE THE TWO
00:19:54 EXISTING SERVICES THAT WE OPERATE HAD TO ACHIEVE OUR
00:19:55 EXISTING PUBLIC UTILITY AND CLEAN POWER OURSELF.
00:19:58 SO YOU COULD THINK OF ALL OF THE COMMITMENTS THAT THE CITY
00:20:01 MAKES THROUGH CLEAN POWER S.F. AS SORT OF A BASE OF ENERGY
00:20:05 SUPPLY FOR THAT FUTURE INTEGRATED MUNICIPAL UTILITY.
00:20:10 SO ALL THE WORK THAT WE'RE DOING TODAY WOULD SUPPORT THAT
00:20:14 EFFORT. >> OKAY, GREAT.
00:20:14 SUPERVISOR SOUDER THANK YOU. >> THANK YOU FOR THE
00:20:19 PRESENTATION. WHAT IS THE IMPACT OF THIS
00:20:22 PARTICULAR PROJECT TO AN EVERYDAY USER?
00:20:26 RIGHT. I MEAN IS THIS SOMETHING THAT
00:20:27 YOU THINK IS GOING TO LOWER COSTS?
00:20:30 >> IS THIS GOING TO INCREASE RELIABILITY?
00:20:34 >> WHAT DOES THIS MEAN TO AN AVERAGE SAN FRANCISCO RESIDENT?
00:20:35 YEAH. YEAH, GREAT QUESTION.
00:20:37 SO THIS IS AN EMERGING TECHNOLOGY WHICH IS PART OF THE
00:20:42 REASON WHY THE CALIFORNIA PUBLIC UTILITIES COMMISSION HAS
00:20:43 ORDERED CLEAN POWER SRF AND OTHER ENTITIES UNDER ITS
00:20:46 JURISDICTION TO MAKE THESE COMMITMENTS.
00:20:51 THE VISION IS THAT AS WE MOVE TO A MORE RENEWABLE AND CLEAN
00:20:56 SOURCE OF ENERGY TO POWER GRID, WE'RE GOING TO HAVE MORE
00:21:01 RESOURCES THAT ARE VARIABLE. THEY PRODUCE POWER WHEN THE SUN
00:21:05 SHINING, THE WIND'S BLOWING AND WE'RE GOING TO NEED TO
00:21:09 STORE THAT ENERGY FOR DISCHARGE AND WHEN DEMAND ON THE GRID
00:21:13 EMERGES. WHAT WE'RE STARTING TO SEE NOW
00:21:16 BECAUSE WE'VE MADE GREAT PROGRESS NOT JUST HERE FOR THE
00:21:18 CITY BUT ALSO THROUGHOUT THE STATE IN TRANSITIONING TO CLEAN
00:21:21 ENERGY. >> WE'RE SEEING AN ABUNDANCE OF
00:21:24 SOLAR IN THE MIDDLE OF THE DAY. IN FACT, AT TIMES MORE THAN THE
00:21:28 GRID CAN ABSORB MORE THAN DEMAND AND WE NEED TO PUT THAT
00:21:33 SOMEWHERE INCREASINGLY THE GRID OPERATOR HAS TO CURTAIL THE
00:21:38 SOLAR ENERGY PRODUCER SHUT DOWN THE AMOUNT OF SOLAR POWER
00:21:42 BECAUSE THERE'S NOWHERE TO PUT IT.
00:21:45 SO RESOURCES LIKE THIS ARE GOING TO ALLOW US TO ABSORB
00:21:49 THAT SOLAR ENERGY AND MOVE IT INTO THE EVENING WHEN DEMAND
00:21:52 PICKS UP THAT SOLAR DECLINES AND ALLOW US TO REDUCE OUR
00:21:56 RELIANCE ON NATURAL GAS WHICH THE STATE GRID IS STILL USING
00:22:01 TO BALANCE THINGS ESPECIALLY IN THE EVENING.
00:22:04 SO FOR RATEPAYERS WHAT WE'LL SEE WITH THIS KIND OF
00:22:08 TECHNOLOGY IS A FLATTENING OF THE WHOLESALE COST OF ENERGY
00:22:12 SUPPLY BETWEEN THE MIDDLE OF THE DAY AND THE EVENING.
00:22:16 RIGHT NOW THERE'S A PRETTY BIG DISPARITY BETWEEN THOSE TWO
00:22:20 TIMES AT CERTAIN TIMES OF THE YEAR.
00:22:21 SO IT'S GOING TO HELP SMOOTH OUT OUR COSTS AND REALLY
00:22:24 LEVERAGE THE GREAT SOLAR RESOURCE THAT WE HAVE.
00:22:28 >> THAT'S VERY HELPFUL. THANK YOU.
00:22:31 >> THANK YOU. I'M EAGER TO LEARN MORE ABOUT
00:22:35 JUST HOW EFFECTIVE THIS STORAGE TECHNOLOGY IS GOING TO BE
00:22:39 INTERESTED TO LEARN MORE ABOUT WHETHER IT'S REALLY GOING TO
00:22:43 FULFILL ITS CAPACITY OF THAT 11.5MW.
00:22:49 THANK YOU SO MUCH FOR BRINGING THIS BEFORE US.
00:22:50 AND SO WITH THAT LET'S GO TO PUBLIC COMMENT ON THIS ITEM.
00:22:54 >> THIS IF WE HAVE ANY MEMBERS OF THE AUDIENCE HAVE JOINED US
00:22:57 TODAY WHO WISH TO ADDRESS THIS COMMITTEE REGARDING THIS ITEM
00:22:59 NUMBER TWO. AND IT WAS YOUR OPPORTUNITY.
00:23:03 >> MADAM CHAIR, WE HAVE NO SPEAKERS SEEN NO PUBLIC
00:23:04 COMMENTS, PUBLIC COMMENTS NOW CLOSED.
00:23:07 COLLEAGUES, I WOULD LIKE TO MOVE THIS ITEM TO FULL BOARD
00:23:09 WITH RECOMMENDATION AND A ROLL CALL PLEASE.
00:23:12 >> NONE THAT MOTIONED OR FOR THIS RESOLUTION TO THE FULL
00:23:15 BOARD WITH THE RECOMMENDATION VICE CHAIR DORSEY DORSEY MEMBER
00:23:19 SADR SADR I CHAIR CAN I CAN I HAVE THREE EYES?
00:23:24 >> THE MOTION PASSES. THANK YOU.
00:23:27 CLERK PLEASE. THANK YOU, MR. CLERK PLEASE
00:23:28 CALL ITEM NUMBER THREE. >> YES.
00:23:30 ITEM NUMBER THREE IS A RESOLUTION AUTHORIZING THE
00:23:33 DEPARTMENT OF TECHNOLOGY TO ENTER INTO THE THIRD AMENDMENT
00:23:35 TO THE AGREEMENT BETWEEN THE CITY AND COUNTY AND ETHICS LLC
00:23:38 FOR THE PURCHASE OF ORACLE PRODUCTS AND CLOUD COMPUTING
00:23:41 SOLUTIONS TO INCREASE THE AGREEMENT BY APPROXIMATELY 34.6
00:23:47 MILLION FOR A TOTAL AMOUNT NOT TO EXCEED THE APPROXIMATELY
00:23:50 94.6 MILLION AND TO EXTEND THE TERM FOR 31 MONTHS FROM APRIL
00:23:57 30TH 2026 FOR A TOTAL AGREEMENT TERM OF MAY 1ST 2021 THROUGH
00:23:59 NOVEMBER 30TH 2028. MADAM CHAIR, THANK YOU.
00:24:03 AND TODAY WE HAVE DEPARTMENT TECHNOLOGY HERE I GOOD MORNING
00:24:08 SUPERVISORS AND COLLEAGUES. MY NAME IS HOW SENIOR
00:24:12 STRATEGIST SOURCING MANAGER AT THE PUMP TECHNOLOGY.
00:24:16 TODAY I AM SEEKING APPROVAL OF THE THIRD AMENDMENT TO THE
00:24:20 CITY'S CONTRACT THAT MUSIC LLC FOR THE PROCUREMENT OF OTHER
00:24:24 PRODUCTS. OLLOCLIP PROVIDES COMPUTER
00:24:28 SOFTWARE HARDWARE AND CLOUD SOLUTION THAT SUPPORT MANY OF
00:24:32 THE CITY'S CRITICAL OPERATIONS SUCH AS FINANCE H.R.
00:24:35 AND PUBLIC SAFETY. THE AGREEMENT IS CURRENTLY USED
00:24:42 BY 12 DEPARTMENTS AND WILL EXPIRE AT THE END OF THIS
00:24:45 MONTH. OVER THE PAST FIVE YEARS THE
00:24:46 CITY'S SPEND ABOUT 10.5 MILLION ANNUALLY.
00:24:50 THIS AMENDMENT WOULD SIMPLY EXTEND THE AGREEMENT BY TWO
00:24:56 YEARS AND SEVEN MONTHS AND INCREASE THE NOT TO EXCEED
00:24:57 THE AMOUNT FROM 60 MILLION TO 94.6 MILLION.
00:25:03 FINANCIALLY THIS AMENDMENT WILL PROTECT THE CITY AGAINST RISING
00:25:08 COSTS. WE'RE SEEING MARKET INCREASE OF
00:25:11 8 TO 10% ANNUALLY BUT STILL NEGOTIATING WITH CAP INCREASES
00:25:15 AT 4% FOR ON PREMISES, SUBWAY AND HIGHWAY AND 5% FOR CLOUD
00:25:19 PRODUCTS. SO THIS IS EQUIVALENT TO A COST
00:25:25 AVOIDANCE OF 2.9 MILLION OVER THE NEXT TWO AND A HALF YEARS.
00:25:28 >> IN ADDITION, IF THE CITY BUYS MORE PRODUCTS TO ENHANCE
00:25:32 ALL THE PLACE THE EXISTING SYSTEM THAT WE WILL CONTINUE TO
00:25:36 BENEFIT FROM THE STRONG DISCOUNT THAT WAS SUCCESSFUL
00:25:39 NEGOTIATED FIVE YEARS AGO. WHY APPROVE THIS LEGISLATION?
00:25:45 FIRST IT WILL ENSURE CONTINUITY OF THE CITY'S CRITICAL SYSTEM.
00:25:50 SECOND, IT AVOIDS RECOMMENDED AND HIGH COST PURCHASING BY THE
00:25:55 PANELS. THIRD, IT MAINTAINS CENTRALIZED
00:25:58 MANAGEMENT OF THE CONTRACT AND VENDOR PERFORMANCE.
00:26:02 AND FOURTH IS SAFEGUARDS CYBERSECURITY AND DATA
00:26:03 PROTECTION ACROSS THE CITY. >> BEFORE CONCLUDING, I WOULD
00:26:09 LIKE TO THANK MY COLLEAGUE MANUEL WANG AND PUMMELING FOR
00:26:12 COORDINATING THIS CITY FOR ANGELA MAY POLLACK FOR HIS
00:26:17 ANALYTICAL SUPPORT. AND WE'RE ALL HERE AND HAPPY TO
00:26:21 ANSWER QUESTIONS. THANK YOU.
00:26:22 THANK YOU. >> ITEM THREE IS A RESOLUTION
00:26:27 THAT APPROVES AN AMENDMENT TO ITS CONTRACT WITH MATRIX WHICH
00:26:30 IS AN ORACLE RESELLER. THE AMENDMENT INCREASES THE
00:26:34 VALUE OF THE CONTRACT FROM 60 TO $95 MILLION AND EXTENDS THE
00:26:38 AGREEMENT THROUGH NOVEMBER 2028.
00:26:41 ORACLE PROVIDES SOME OF THE KEY SOFTWARE SYSTEMS THAT THE CITY
00:26:45 USES INCLUDING PEOPLESOFT WHICH IS AN H.R.
00:26:49 SYSTEM PRIMAVERA WHICH IS A CAPITAL PROJECT CONTROL SYSTEM
00:26:53 AND ALSO FOR THE PUC TO BUILD CUSTOMER S.
00:26:56 THEY ALSO PROVIDE CLOUD STORAGE FOR CITY DATA.
00:27:00 WE SHOW THE CONTRACT BUDGET ON PAGE 16 OF OUR REPORT.
00:27:01 THIS CONTRACT VALUE IS BASED ON ANNUAL SPENDING OF ABOUT $13.3
00:27:07 MILLION THIS YEAR AND PROJECTED FORWARD.
00:27:11 HISTORICALLY 71% OF THE CONTRACT HAS BEEN FUNDED BY THE
00:27:14 GENERAL FUND. AND YOU CAN SEE THE SPENDING BY
00:27:15 DEPARTMENT ON PAGE 15 OF OUR REPORT.
00:27:19 AND WE RECOMMEND APPROVAL OF ITEM THREE.
00:27:21 >> THANK YOU. DID I UNDERSTAND THIS CORRECTLY
00:27:25 THAT YOU DO ACTUALLY HAVE A FIVE YEAR OPTION ON THIS?
00:27:32 >> YES. OKAY.
00:27:33 THE ORIGINAL CONTRACT HAS A FIVE YEAR OPTION BUT BECAUSE
00:27:36 WE'RE PIGGY BACK ON THE MENDO CULPA COUNTIES CONTRACT THE
00:27:40 ACCOUNTS EXPIRE IN TWO YEAR AND SEVEN MONTHS.
00:27:43 SO WE HAVE TO ALIGN WITH THAT AND WE CANNOT GO BEYOND.
00:27:46 >> I APPRECIATE THE THINKING. >> ALL RIGHT.
00:27:50 I JUST WANT TO LET YOU KNOW THAT I APPRECIATE WHILE YOU
00:27:52 HAVE THE OPTION OF FIVE YEARS YOU EXERCISE NOT THE FULL FOUR
00:27:56 FIVE YEARS INSTEAD AND YOU'RE BEING STRATEGIC AND THOUGHTFUL
00:28:00 ABOUT HOW YOU APPROACH ALIGNMENT OF YOUR CONTRACTING.
00:28:04 WE NEED MORE OF THAT. WE WANT TO SEE MORE OF THAT NOT
00:28:05 JUST FROM YOU BUT ACTUALLY THROUGHOUT THE CITY.
00:28:08 SO WE APPRECIATE THAT APPROACH .
00:28:12 AND SO WITH THAT SAID, LET'S GO TO PUBLIC COMMENT ON THIS ITEM.
00:28:13 THANK YOU. ISRAEL OPENING PUBLIC COMMENT
00:28:16 FOR THIS ITEM NUMBER THREE IF THEY HAVE ANY MEMBERS OF THE
00:28:19 AUDIENCE WHO WISH TO ADDRESS THIS COMMITTEE.
00:28:22 >> MADAM CHAIR, WE HAVE NO SPEAKERS SEEING ON PUBLIC
00:28:25 COMMENT. PUBLIC COMMENT IS NOW CLOSED.
00:28:26 COLLEAGUES I WOULD LIKE TO MAKE THE MOTION TO MOVE THIS ITEM TO
00:28:31 FULL BOARD WITH RECOMMENDATION AND A ROLL CALL PLACE ON THAT
00:28:34 MOTION TO REFER TO THE FULL BOARD TO THE RECOMMENDATION.
00:28:37 VICE CHAIR DORSEY DORSEY I PRASADA SOUDER I CHURCH AM I
00:28:44 AND I WE HAVE THREE EYES. >> THE MOTION PASSES.
00:28:45 THANK YOU. THANK YOU.
00:28:48 >> SHORT CLERK PLEASE CALL ITEM NUMBER FOUR.
00:28:49 ITEM NUMBER FOUR IS A RESOLUTION RETROACTIVELY
00:28:52 AUTHORIZING THE DEPARTMENT OF PUBLIC HEALTH TO ACCEPT AN
00:28:54 EXPENDED GRANT IN THE AMOUNT OF APPROXIMATELY 7.9 MILLION FROM
00:28:58 THE CALIFORNIA BOARD OF STATE AND COMMUNITY CORRECTIONS FOR
00:29:01 PARTICIPATION IN A PROGRAM ENTITLED PROPOSITION 47 COHORT
00:29:05 FIVE FOR THE PERIOD OF OCTOBER 1ST 2025 THROUGH JUNE 30TH
00:29:12 2029. AND APPROVING THE NOTICE OF
00:29:12 AWARD THE AGREEMENT PURSUANT TO THE CHARTER.
00:29:15 >> MADAM CHAIR, THANK YOU. AND TODAY WE HAVE DEPARTMENT OF
00:29:19 PUBLIC HEALTH HERE. >> GOOD MORNING SUPERVISORS.
00:29:23 MY NAME IS KELLY HOM. I AM THE DIRECTOR OF SUBSTANCE
00:29:24 USE SERVICES FOR THE DEPARTMENT OF PUBLIC HEALTH.
00:29:29 TODAY WE ARE HERE TO REQUEST RETROACTIVE AUTHORITY TO ACCEPT
00:29:33 THE PROPOSITION FOR EVEN COHORT FIVE GRANT AS A REMINDER, PROP
00:29:41 40 SEVEN CHANGED CERTAIN LOW LEVEL DRUG CRIMES FROM MIS FROM
00:29:46 FELONIES TO MISDEMEANORS. THE RESULTING SAVINGS WERE SET
00:29:50 ASIDE AND AWARDED AS PART OF A COMPETITIVE GRANT AIMED TO
00:29:53 REDUCE RECIDIVISM. >> APPLIED FOR AND WAS AWARDED
00:30:00 THE COHORT FIVE GRANT THAT WILL ALLOW US TO CONTINUE CRITICAL
00:30:05 COMMUNITY CARE BY PROVIDING WITHDRAW MANAGEMENT RESIDENTIAL
00:30:08 AND RESIDENTIAL STEPDOWN SERVICES FOR JUSTICE INVOLVED
00:30:12 INDIVIDUALS WITH CO-OCCURRING SUBSTANCE USE AND MENTAL HEALTH
00:30:16 NEEDS. THE GRANT IS ADMINISTERED BY
00:30:17 THE CALIFORNIA BOARD OF STATE AND COMMUNITY CORRECTIONS.
00:30:21 THE AMOUNT IS A LITTLE LESS THAN $8 MILLION.
00:30:25 THE DURATION IS FROM OCTOBER 1ST 2025 TO JUNE 30TH 2029.
00:30:34 NEXT SLIDE PLEASE. >> THE GRANT REQUIRED THAT A
00:30:39 CERTAIN PERCENTAGE OF THE FUNDS WERE ALLOCATED TO CBOS OR
00:30:43 COMMUNITY BASED ORGANIZATIONS AND OFFERED BONUS POINTS FOR
00:30:47 HIGHER PERCENTAGES WAS ABLE TO SUBMIT A VERY COMPETITIVE
00:30:51 PROPOSAL BY NAMING CBOS WITH LONGSTANDING HISTORIES OF
00:30:55 WORKING WITH JUSTICE INVOLVED INDIVIDUALS IN COHORT FIVE.
00:31:01 WE ARE CONTINUING THE EFFORTS OF COHORT THREE THAT PROVIDED
00:31:05 WITHDRAW MANAGEMENT AND RESIDENTIAL SERVICES FOR
00:31:09 JUSTICE INVOLVED INDIVIDUALS AND ADDITIONALLY WE ARE
00:31:13 INVESTING MORE IN THE WHOLE CONTINUUM OF CARE BY ADDING
00:31:17 RESIDENTIAL STEPDOWN SERVICES TO ENSURE SUSTAINED SUPPORT AS
00:31:21 INDIVIDUALS CONTINUE IN THEIR RECOVERY JOURNEY.
00:31:24 TO THIS END $4 MILLION WILL BE ALLOCATED TO SALVATION ARMY
00:31:28 HARBOR LIGHTS 410 WHICH MANAGEMENT BEDS AND 18 RESIDING
00:31:34 BEDS AND WE WILL BE ADDING $2 MILLION TO PURCHASE 15 RESIDENT
00:31:41 WILL STEP DOWN BIDS FROM HEALTH REIT 360.
00:31:44 NEXT SLIDE. AND FOR YOUR JUST SO THAT YOU
00:31:49 CAN SEE THIS IS THESE ARE PICTURES OF SALVATION ARMY
00:31:53 HARBOR LIGHTS CENTER WHERE THE WITHDRAW MANAGEMENT
00:31:56 AND RESIDENTIAL SERVICES WILL TAKE PLACE.
00:32:00 THIS IS FOLLOWED BY PICTURES OF OUR THREE 60S RESIDENTIAL
00:32:04 STEPDOWN PROGRAM ON TREASURE ISLAND WHICH WILL BE PROVIDING
00:32:08 THE 15 RESIDENTIAL STEPDOWN BEDS.
00:32:13 >> THIS IS A NOTATION REGARDING THE RETROACTIVE NATURE OF THIS
00:32:17 REQUEST. I RECEIVED FINAL GRANT
00:32:21 AGREEMENT AFTER THE PROJECTED START DATE OF THE PROJECT.
00:32:28 WE GOT INITIAL NOTIFICATION OF THE AWARD ON SEPTEMBER 11TH
00:32:32 2025 WITH THE PROJECT START DATE OF OCTOBER 1ST 2025.
00:32:38 WE RECEIVED FINAL GRANT AGREEMENT ON JANUARY 21ST, 2026
00:32:46 AND WE WOULD BE BRINGING THIS REQUEST TO YOU AFTER GOING
00:32:50 THROUGH THE FISCAL APPROVAL PROCESS.
00:32:53 THANK YOU FOR YOUR TIME. >> I'M AVAILABLE FOR QUESTIONS
00:33:00 AND FOR IS A RESOLUTION THAT WOULD APPROVE TO ACCEPT
00:33:05 AND EXPEND ABOUT $8 MILLION FROM THE BOARD OF STATE
00:33:08 AND COMMUNITY CORRECTIONS. IT ALSO APPROVES THE UNDERLYING
00:33:12 GRANT AGREEMENT ASSOCIATED WITH THAT MONEY.
00:33:14 THE GRANT WOULD FUND THE SUPPORTING TREATMENT
00:33:16 AND PRODUCING RECIDIVISM PROGRAM FROM OCTOBER 2025
00:33:21 THROUGH JUNE 2029. YOU CAN SEE ON PAGE 22 OF OUR
00:33:25 REPORT HOW THAT PROGRAM HAS EVOLVED OVER TIME WITH PRIOR
00:33:28 ROUNDS OF FUNDING FROM THE PCC. THIS GRANT WOULD CONTINUE TO
00:33:33 FUND TEN DETOX BEDS AND 18 RESIDENTIAL BEDS AT THE
00:33:36 SALVATION ARMY. AND THEN IT ADDS 15 STEPDOWN
00:33:40 BEDS AT HEALTH RIGHT THROUGH 60.
00:33:44 AND THEN ON PAGE 24 OF OUR REPORT YOU CAN SEE THAT THERE
00:33:48 IS A MATCHING FUND REQUIREMENT FROM THIS GRANT THE CITY IS
00:33:49 REQUIRED TO COMMIT $2 MILLION TO RECEIVE THE $8 MILLION OVER
00:33:54 THE NEXT THREE YEARS THAT WILL BE MET BY EXISTING STAFF.
00:33:57 SO THERE'S NO CHANGE TO THE SALARY ORDINANCE BEFORE YOU AS
00:34:02 PART OF THIS GRANT APPROVAL. WE RECOMMEND APPROVAL OF ITEM
00:34:05 FOUR. >> THANK YOU.
00:34:06 AND SUPERVISOR SOUDER, THANK YOU.
00:34:09 CHURCH IN QUESTION HERE. THESE BEDS THAT WOULD BE FUNDED
00:34:14 I KNOW THERE'S BEEN PAST FUNDING COMING THROUGH PROP 47
00:34:17 BUT THESE PARTICULAR BEDS ARE THESE ARE THESE NEW OR THESE
00:34:21 EXTENSIONS OF CURRENT SPACE? >> THANK YOU FOR YOUR QUESTION.
00:34:26 SO THE BEDS AT SALVATION ARMY THE TEN WITHDRAW MANAGEMENT
00:34:32 AND THE 18 RESIDENTIAL BEDS THOSE ARE CONTINUED FROM COHORT
00:34:36 THREE WHERE WE HAD USED PROPOSITION 47 FUNDS FOR THOSE
00:34:40 PARTICULAR BEDS THE RESIDENTIAL STEPDOWN BEDS AT HEALTH 360
00:34:44 WOULD BE NEW BEDS THAT WE'RE NOT PREVIOUSLY FUNDED BY THIS
00:34:48 GRANT AND THEN THE I SEE THAT THE LAST COHORT OF FUNDING
00:34:54 COHORT FOUR HAS BEEN SEEING DELAYS BUT THAT LOOKS LIKE IT
00:34:59 WAS FUNDED. ARE YOU ABLE TO SPEAK TO THAT
00:35:00 AT ALL? >> SO THE THE CODE YEAH COHORT
00:35:05 FOR THE LEAD AGENCIES H S H AND UNLESS THERE ARE A
00:35:11 REPRESENT IT IS FROM H S H I I'M NOT ABLE TO SPEAK TO THAT.
00:35:15 >> THANK YOU BY CHAIR DORSEY. >> THANK YOU CHAIR CHEN.
00:35:21 I'M HAPPY TO SUPPORT THIS. THIS IS THESE ARE BOTH
00:35:22 FACILITIES IN MY DISTRICT AND I'M PARTICULARLY
00:35:26 ENTHUSIASTIC ABOUT RESIDENTIAL STEPDOWN BECAUSE I THINK THAT'S
00:35:29 A NEED IN THE CONTINUUM OF CARE THAT WE REALLY HAVEN'T BEEN
00:35:33 FUNDING ENOUGH. SO I'M GRATEFUL TO BE SEEING
00:35:36 THAT. I KNOW THAT THERE ARE SOME
00:35:37 CHANGES IN HOW THE STATE IS GOING TO BE ALLOCATING
00:35:41 RESOURCES. I THINK BOTH AS A RESULT OF
00:35:43 CHANGES TO PROP 47 AND PROPOSITION ONE, THERE WERE
00:35:50 SOME ISSUES ABOUT LIKE THE PROCUREMENT THAT CAME UP IN THE
00:35:54 BUDGET AND LEGISLATIVE ANALYST REPORT.
00:35:58 IT'S MY UNDERSTANDING WORKING WITH THE MAYOR'S OFFICE ON
00:35:59 THESE ISSUES THAT THE THAT THEY ARE TRYING TO BE MINDFUL OF
00:36:05 IDENTIFYING BIDDERS BUT I JUST WANTED TO ASK IF THERE'S
00:36:09 ANYTHING YOU HAVE TO WANT TO ADD TO THAT ABOUT MAKING SURE
00:36:12 THAT WE HAVE MORE COMPETITIVE BIDDING ON THESE KINDS OF
00:36:16 SERVICES AS WE EXPAND THEM. >> YEAH.
00:36:19 THE NATURE OF THE APP GRANT APPLICATION AND DID NOT AFFORD
00:36:24 US AN OPPORTUNITY TO REQUEST FOR PROPOSALS IN ADVANCE OF THE
00:36:31 OF THE GRANT APPLICATION. SO IT WAS DETERMINED BEST TO GO
00:36:35 FORWARD WITH TRIED AND TRUE CBOS THAT WE HAVE WORKING
00:36:42 RELATIONSHIPS WITH AND WHO HAVE LONG STANDING COMMUNITY
00:36:46 RELATIONSHIPS AND HISTORIES OF SERVING THIS COMMUNITY.
00:36:50 >> >> THANK YOU. >> AND SO WITH THAT I DON'T
00:36:55 HAVE ANY QUESTIONS AT THE MOMENT AND SO LET'S GO TO
00:36:59 PUBLIC COMMENT ON THIS ITEM. >> YES, WE'RE NOW OPENING
00:37:02 PUBLIC COMMENT FOR THIS ITEM NUMBER FOUR IF WE HAVE ANY
00:37:05 MEMBERS OF THE PUBLIC WHO WISH TO ADDRESS THIS COMMITTEE.
00:37:07 >> MADAM CHAIR, WE HAVE NO SPEAKERS SEEN NO PUBLIC
00:37:11 COMMENT. >> PUBLIC COMMENT IS NOW CLOSE
00:37:15 . COLLEAGUES, I WOULD LIKE TO
00:37:16 MOVE THIS ITEM TO A FULL BOARD WITH RECOMMENDATION AND A ROLL
00:37:20 CALL PLEASE. >> AND ON THAT MOTION THAT WE
00:37:21 REFER THIS RESOLUTION TO THE FULL BOARD WITH THE
00:37:24 RECOMMENDATION VICE CHAIR DORSEY DORSEY I'M SAUTER SAUTER
00:37:28 I CHURCH CAN I CAN I WE HAVE THREE EYES.
00:37:31 >> THE MOTION PASSES. >> AND MR. CLERK PLEASE CALL
00:37:36 ITEM NUMBER FIVE AND ITEM NUMBER FIVE IS A RESOLUTION
00:37:39 RETROACTIVELY AUTHORIZING THE SAN FRANCISCO PUBLIC DEFENDER'S
00:37:43 OFFICE TO ACCEPT AN EXPANDED GRANT IN THE AMOUNT OF 850,000
00:37:47 FROM THE OFFICE OF THE STATE PUBLIC DEFENDER TO MAINTAIN THE
00:37:51 CAPACITY OF THE OFFICES POST CONVICTION UNIT OR THE FREEDOM
00:37:55 PROJECT TO MEET THE INCREASED DEMAND FOR D CARCER ATION
00:37:59 REENTRY AND RE SENTENCING REFORM SERVICES FOR THE PERIOD
00:38:03 OF FEBRUARY 1ST 2026 THROUGH JUNE 30TH 2028.
00:38:06 >> MADAM CHAIR, THANK YOU. >> AND WE HAVE OUR PUBLIC
00:38:10 DEFENDER'S OFFICE HERE. >> GOOD MORNING SUPERVISORS
00:38:14 LISTENING THE COURT CHIEF OF STAFF AT THE PUBLIC DEFENDER'S
00:38:16 OFFICE ALONG HERE WITH DANIELLE HARRIS, MANAGING MANAGER FOR
00:38:18 THE FREEDOM PROJECT POST-CONVICTION UNIT.
00:38:22 I WANT TO FIRST THANK SUPERVISOR WALTON'S OFFICE
00:38:25 AND TEAM SPECIFICALLY NATALIE G AND TRACY GUERRERO FOR HELPING
00:38:31 US IN SPONSORING THIS RESOLUTION.
00:38:35 SPECIFICALLY WE'RE ASKING FOR THE APPROVAL OF THIS RESOLUTION
00:38:39 TO RETROACTIVELY AUTHORIZING THE PUBLIC DEFENDER'S OFFICE TO
00:38:43 ACCEPT AND EXPAND A GRANT IN THE AMOUNT OF $850,000 FROM
00:38:47 THE OFFICE OF THE STATE PUBLIC DEFENDER TO MAINTAIN THE
00:38:50 CAPACITY OF THE OFFICES POST CONVICTION UNIT SPECIFICALLY TO
00:38:57 POSITIONS WHICH ARE OUR SENIOR SOCIAL WORKERS AND MS. HARRIS
00:39:01 IS HERE TO SPEAK MORE ABOUT THE FREEDOM PROJECT AND ITS IMPACT
00:39:05 AND THE NEED FOR THE POSITIONS .
00:39:08 THANK YOU. GOOD MORNING EVERYBODY.
00:39:09 I'M REALLY HAPPY TO BE HERE TO GIVE YOU A BRIEF INTER
00:39:12 INTRODUCTION TO THE FREEDOM PROJECT WHICH AS YOU HEARD IS
00:39:16 THE SAN FRANCISCO PUBLIC DEFENDER'S POST-CONVICTION UNIT
00:39:20 AND WHAT WE DO IS LOOK AT THE CASES THAT WE SAN FRANCISCO HAS
00:39:25 SENT TO STATE PRISON PEOPLE WHO ARE SERVING PRISON SENTENCES
00:39:29 SOMETIMES FROM TWO, THREE, FOUR DECADES AGO.
00:39:33 WE LOOK OFTEN I SHOULD SAY THAT OLD WE LOOK AT THESE CASES
00:39:37 AND SEE WHICH OF THEM DESERVES A SECOND LOOK AND PROCEED WHEN
00:39:44 IF WE FIND SUCH A CASE WITH RE SENTENCING AND OR PAROLE BOARD
00:39:48 REPRESENTATION. >> RIGHT.
00:39:52 WE JUST FROM 2020 WHEN WE WERE STAFFED UP WITH A DIFFERENT
00:39:59 STATE GRANT THAT IS EXPIRING IN JUST A COUPLE MONTHS WE
00:40:03 STAFFED UP TO THREE LAWYERS, TWO PARALEGALS AND TWO SOCIAL
00:40:06 WORKERS. IT'S THOSE TWO SOCIAL WORKERS
00:40:09 THAT WE'RE HOPING TO CONTINUE ON FOR THE TWO YEARS THROUGH
00:40:13 THE EXPANDED PUBLIC DEFENSE GRANT AND IN THIS TIME PERIOD
00:40:16 WE HAVE BROUGHT HOME ACTUALLY THIS IS JUST SLIGHTLY OUTDATED.
00:40:20 IT'S NOW 105 INDIVIDUALS WE HAVE REUNITED THIS 105 FAMILIES
00:40:27 AND 105 COMMUNITIES WITH ALL THE BENEFITS THAT THAT ENTAILS
00:40:30 BOTH FISCAL IN TERMS OF FISCAL AND HUMAN COSTS WE FOCUS ON A
00:40:38 FEW DIFFERENT TYPES OF CASES. NUMBER ONE, WE FOCUS ON ELDERS
00:40:42 AND SENIORS WHO ARE IN PRISON BECAUSE WE KNOW FROM MANY
00:40:46 ROBUST STUDIES THAT RECIDIVISM GOES DOWN AND THEN VIRTUALLY
00:40:53 DISAPPEARS ONCE A PERSON REACHES A CERTAIN AGE AND OUR
00:40:56 THE POPULATION OF FOLKS SERVING PRISON TIME FROM SAN FRANCISCO
00:41:01 IS AN OLDER POPULATION WITH 69% OVER 50, 44% OVER 60 AND 12%
00:41:11 OVER 70. WE ALSO KNOW THAT THIS THE
00:41:15 STATE AND THUS THE TAXPAYERS PAY A MUCH HIGHER COST TO HOUSE
00:41:23 FOLKS OVER AGE 55 THAN OTHER AGE GROUPS AND THAT'S BECAUSE
00:41:27 NEARLY ALL OF THEM HAVE CHRONIC HEALTH CONDITIONS FROM BEING
00:41:31 IN PRISON FOR A LONG TIME AND AGING UNDER THOSE
00:41:34 CIRCUMSTANCES AND OUR SOCIAL WORKERS MAKE SURE IF THEY DO
00:41:38 COME HOME THEY'RE CONNECTED TO ALL THE SERVICES THEY NEEDED
00:41:40 NEED IN PARTICULARLY HEALTH CARE.
00:41:45 >> THE SECOND GROUP OF CASES THAT WE LOOK AT SPECIFICALLY
00:41:49 ARE THOSE WHO WENT TO PRISON AS YOUNG OFFENDERS INCLUDING
00:41:53 MINORS. >> WE STILL HAVE FOLKS
00:41:57 IN PRISONS SERVING LIFE SENTENCES THAT THEY WERE GIVEN
00:41:58 AS TEENAGERS FROM THE 1980S. IN THE 1990S AND THOSE FOLKS
00:42:04 ARE QUITE DIFFERENT INDIVIDUALS NOW AND HAVE DONE MANY OF THEM
00:42:08 DONE A LOT OF WORK AND DESERVE A SECOND LOOK TO SEE IF IT'S
00:42:14 TIME FOR THEM TO COME HOME. >> AND THEN THE THIRD CATEGORY
00:42:18 WE LOOK AT OF COURSE IN OUR CRIMINAL LEGAL SYSTEM IS IS
00:42:22 RACIAL INJUSTICE IS CASES WE CAN TALK ABOUT ANY NUMBER OF
00:42:29 STATISTICS. >> THE ONE I'M HIGHLIGHTING
00:42:30 HERE IS THAT ACROSS CALIFORNIA APPROXIMATELY 90% OF CASES
00:42:34 INVOLVING YOUTH THAT ARE TRANSFERRED FROM JUVENILE COURT
00:42:39 TO ADULT COURT THAT WE'VE DECIDED IT MAKES SENSE TO TREAT
00:42:43 KIDS AS ADULTS LEGALLY ARE KIDS OF COLOR AND THE SAME IS TRUE
00:42:47 FOR FOR THOSE WHO ARE SERVING PRISON TIME OUT OF SAN
00:42:51 FRANCISCO. >> I'VE HIGHLIGHTED ONE CASE
00:42:54 HERE WHICH CUTS ACROSS ALL THREE OF THESE CATEGORIES A
00:42:58 CLIENT OF OURS WHO CAME HOME ABOUT FOUR YEARS AGO NOW HE WAS
00:43:02 59 BUT HE HAD GONE TO PRISON AT AGE 17 IN THE 1980S ON A LIFE
00:43:08 SENTENCE AND AT THAT TIME HE WAS ONE OF MANY, MANY, MANY
00:43:14 BLACK YOUTH WHO WERE TRANSFERRED TO ADULT COURT AT
00:43:15 IT AS TEENAGERS. HE'S NOW WORKING AS A CASE
00:43:19 MANAGER AT THE TRANSITIONAL HOME THAT HE CAME HOME TO
00:43:24 HELPING OTHERS WALK THE PATH THAT HE'S WALKED.
00:43:28 >> OF COURSE WE DON'T WANT TO JUST BRING PEOPLE HOME.
00:43:32 >> WE WANT TO MAKE SURE THEY HAVE WHAT THEY NEED TO STAY
00:43:36 HOME AND BE PRODUCTIVE COMMUNITY MEMBERS.
00:43:39 >> THAT MEANS WE BUILD SUPPORT SYSTEMS.
00:43:43 WE WORK WITH THEM FOR MONTHS IN ADVANCE TO PLAN WHAT WHAT
00:43:46 THEIR RELEASE IS GOING TO LOOK LIKE FROM PICK UP AT THE PRISON
00:43:50 GATE TO HOUSING TO HEALTH CARE TO EMPLOYMENT WE CELEBRATE
00:43:54 HOMECOMINGS, FREEDOM CELEBRATIONS EVERY YEAR AND A
00:43:58 MONTHLY FREEDOM PEER GROUP TO MAKE SURE THAT THEY HAVE
00:44:03 PRO-SOCIAL NETWORKS TO RELY ON .
00:44:06 AND OUR COMMITMENT IS AS LONG AS THE FREEDOM PROJECT IS HERE
00:44:10 ,WE ARE THERE TO MAKE CONNECTIONS.
00:44:11 SO WE'VE HAD FOLKS COMING BACK TO US THREE YEARS INTO REENTRY
00:44:15 SAYING I'M LOSING MY HOUSING, CAN YOU HELP?
00:44:18 I'M GETTING LAID OFF, CAN YOU HELP?
00:44:19 AND OUR ANSWER IS AS LONG AS WE'RE HERE YES.
00:44:23 AND WE HAVE SO MANY SUCCESS STORIES TO SHARE AND WE ARE
00:44:26 ALSO WORKING AT THE STATE LEVEL TO EXPAND PATHS TO TO RE
00:44:30 SENTENCING AND SECOND LOOKS. THANK YOU FOR LISTENING.
00:44:34 I'M HERE TO ANSWER ANY QUESTIONS YOU MAY HAVE AND VERY
00:44:38 GRATEFUL FOR YOUR TIME. THANK YOU AND JUST WANT TO
00:44:42 THANK YOU FOR YOUR WORK AND THANK YOU SO MUCH FOR
00:44:45 WORKING ON THIS NOT ONLY THE PROJECT BUT WITH OUR PUBLIC
00:44:49 DEFENDER AND BEING ABLE TO HAVE THIS GRANT THROUGH THE CITY
00:44:53 AND SO I DON'T SEE ANY NAME ON THE ROSTER.
00:44:57 I DON'T HAVE ADDITIONAL QUESTIONS AGAIN, THANK YOU.
00:44:59 WE'LL GO TO PUBLIC COMMENT ON THIS ITEM.
00:45:02 >> YES. IF ANY MEMBERS OF THE PUBLIC
00:45:03 WHO WISH TO ADDRESS THIS COMMITTEE REGARDING THIS ITEM
00:45:05 NUMBER FIVE THAT WAS YOUR OPPORTUNITY AND WE HAVE NO
00:45:10 SPEAKERS SEEING NO PUBLIC COMMENTS PUBLIC COMMENT NOW
00:45:12 CLOSE COLLEAGUES I WOULD LIKE TO MOVE THIS ITEM TO FULL BOARD
00:45:15 WITH RECOMMENDATION AND A ROLL CALL PLEASE AND I MOTION TO
00:45:19 REFER THIS RESOLUTION TO THE FULL BOARD WITH THE
00:45:22 RECOMMENDATION VICE CHAIR DORSEY DORSEY I REMEMBER CARTER
00:45:26 SOUDER I CHURCH CAN I CAN I WE HAVE THREE EYES.
00:45:30 >> THE MOTION PASSES. MR. CLERK PLEASE CALL ITEM
00:45:34 NUMBER SIX. >> ITEM NUMBER SIX IS A
00:45:35 RESOLUTION APPROVING AND AUTHORIZING THE MAYOR'S
00:45:38 OFFICE OF HOUSING AND COMMUNITY DEVELOPMENT TO JOINTLY APPLY
00:45:42 WITH 69 POST LLC AND SWORDS TO PLOWSHARES VETERANS RIGHTS
00:45:45 ORGANIZATION TO THE CALIFORNIA DEPARTMENT OF HOUSING
00:45:49 AND COMMUNITY DEVELOPMENT FOR THE HOMEKEY PLUS GRANT FOR THE
00:45:53 PROPERTY LOCATED AT SIX TWO NINE POST STREET IN A TOTAL
00:45:56 AMOUNT NOT TO EXCEED THE APPROXIMATELY 15.8 MILLION OR
00:46:00 THE MAXIMUM AWARD AMOUNT ALLOWABLE UNDER THE NOTICE OF
00:46:03 FUNDING AVAILABILITY WHICHEVER IS GREATER ON BEHALF OF THE
00:46:07 CITY AND COUNTY. >> MADAM CHAIR, THANK YOU.
00:46:08 AND TODAY WE HAVE MAYOR'S OFFICE OF HOUSING DEVELOPMENT
00:46:11 HERE. GOOD MORNING CHAIR CHAN
00:46:14 COMMITTEE MEMBERS DORSEY AND SAUDER MY NAME'S LA CASA
00:46:18 SCOTT. I'M A PROJECT MANAGER WITH THE
00:46:19 MAYOR'S OFFICE OF COMMUNITY DEVELOPMENT.
00:46:22 I'M HERE TODAY TO PRESENT ON ITEM SIX TO REQUEST APPROVAL OF
00:46:29 A RESOLUTION SUPPORTING THE REHABILITATION OF 629 POST
00:46:33 STREET INTO 63 UNITS OF PERMANENT SUPPORTIVE HOUSING
00:46:36 ALONG WITH ONE GROUND FLOOR COMMERCIAL SPACE TO SERVE
00:46:41 UNHOUSED AND FORMERLY UNHOUSED VETERANS EXITING HOMELESSNESS
00:46:48 STAFF REPRESENTING THIS THE PROJECT SPONSORS THOUGHTS TO
00:46:53 PLOWSHARE ARE HERE AS WELL AS OUR COLLEAGUES FROM THE MAYOR'S
00:46:56 OFFICE OF COMMUNITY DEVELOPMENT TO ANSWER ANY QUESTIONS YOU MAY
00:47:00 HAVE AT THE END. NEXT SLIDE THIS RESOLUTION
00:47:04 AUTHORIZES MOST CD TO JOINTLY APPLY WITH 629 POST LLC TO THE
00:47:12 CALIFORNIA DEPARTMENT OF HOUSING AND COMMUNITY
00:47:16 DEVELOPMENT FOR THE HOMEKEY PLUS GRANT OF THE
00:47:19 REHABILITATION OF 629 POST STREET IN A TOTAL AMOUNT NOT TO
00:47:28 EXCEED $15,869,669. >> NEXT SLIDE THE HOMEKEY
00:47:32 PROGRAM BEGAN AS A STATEWIDE INITIATIVE LAUNCHED DURING THE
00:47:36 COVID 19 PANDEMIC TO RAPIDLY EXPAND HOUSING OPTIONS FOR
00:47:40 INDIVIDUALS EXPERIENCING HOMELESSNESS OR AT RISK OF
00:47:45 HOMELESSNESS. THE HOMEKEY PROGRAM FOCUSED
00:47:48 FOCUSED ON THE ACQUISITION AND CONVERSION OF HOTELS,
00:47:52 MOTELS, MULTIFAMILY BUILDINGS INTO PERMANENT SUPPORTIVE
00:47:56 HOUSING ALLOWING JURISDICTIONS TO QUICKLY BRING NEW UNITS
00:48:00 ONLINE IN SAN FRANCISCO, HOMEKEY RESULTED IN THE
00:48:05 CREATION OF 1074 NEW PERMANENT SUPPORTIVE HOUSING UNITS ACROSS
00:48:10 SEVERAL PROPERTIES. THESE EFFORTS NOT ONLY PROVIDED
00:48:15 IMMEDIATE HOUSING SOLUTIONS DURING A PUBLIC HEALTH CRISIS
00:48:18 BUT ALSO ESTABLISH LONG TERM ASSETS THAT CONTINUE TO SUPPORT
00:48:22 THE CITY'S HOMELESS RESPONSE SYSTEM.
00:48:26 HOMEKEY PLUS IS THE STATE'S NEW PERMANENT SUPPORTIVE HOUSING
00:48:31 INITIATIVE FUNDED THROUGH PROPOSITION ONE.
00:48:34 THE PROGRAM ALLOCATES 1.9 1.972 BILLION STATEWIDE TO HOMEKEY
00:48:44 PLUS AND IS AND IS A MINISTER BY THE CALIFORNIA DEPARTMENT OF
00:48:47 HOUSING AND COMMUNITY DEVELOPMENT HOMEKEY PLUS BUILDS
00:48:51 UPON THE ORIGINAL HOMEKEY MODEL BY SHIFTING THE PROGRAMS
00:48:55 ENTIRELY TO PERMANENT SEPARATE SUPPORTIVE HOUSING WITH THE
00:48:59 STRONG EMPHASIS ON RAPID PROJECT DELIVERY TYPICALLY
00:49:03 WITHIN 12 MONTHS OF A WAR THE PROGRAM PRIORITIZED THIS
00:49:10 SERVING VETERANS EXPERIENCING HOMELESSNESS WHO ALSO HAVE
00:49:14 SIGNIFICANT BEHAVIORAL HEALTH CHALLENGE IS HOMEKEY PLUS
00:49:18 REQUIRES A LOCAL MATCH AND IS STRUCTURE TO ALIGN WITH COUNTY
00:49:22 BEHAVIORAL HEALTH COMMITMENTS TO ENSURE LONG TERM SERVICE
00:49:25 IN OPERATING SUPPORT. THE NOTICE OF FUNDING AVAILABLE
00:49:29 AVAILABILITY WAS RELEASED IN NOVEMBER 2024 CONSISTENT
00:49:36 WITH THE STATE'S IMPLICIT IMPLICIT TEMPTATION EXCUSE ME
00:49:41 TIMELINE FOR PROPOSITION ONE PROP ONE APPROVED BY CALIFORNIA
00:49:45 VOTERS IN MARCH OF 2024 PROVIDES A STATEWIDE FRAMEWORK
00:49:52 TO EXPAND BEHAVIOR HEALTH SERVICES AND SUPPORTIVE HOUSING
00:49:55 WHICH AUTHORIZE 6.4 BILLION FOR NEW TREATMENT OUTBREAKS,
00:50:02 SUPPORTIVE HOUSING, COMMUNITY FACILITIES AND DEDICATED
00:50:06 HOUSING FOR VETERANS WITH BEHAVIORAL HEALTH NEEDS.
00:50:10 THE PROJECT 629 PULSE STREET, ALSO KNOWN AS THE SHELDON HOTEL
00:50:16 IS A SIX STORY 63 UNIT 63 MIXED UNIT BUILDING LOCATED BETWEEN
00:50:23 TAYLOR AND SHANNON STREET IN LOWER HILL.
00:50:27 IN MARCH 2023 THE BOARD OF SUPERVISORS APPROVED THE CITY
00:50:31 SMALL SITE PROGRAM LOAN TO SUPPORT THE ACQUISITION
00:50:35 AND REHABILITATION OF THE BUILDING.
00:50:39 SWARTZ CURRENTLY OWNS THE BUILDING AND HAS BEEN WORKING
00:50:43 ON THE REHAB SCOPE. THE 15.8 MILLION HOMEKEY PLUS
00:50:46 INVESTMENT WILL FUND KEY REHAB VISITATION NEEDS AT 629 PULSE
00:50:51 INCLUDING STRUCTURE SEISMIC UPGRADES, MODERNIZATION,
00:50:55 MODERNIZING THE ELECTRICAL AGE BACK IN PLUMBING SYSTEM
00:51:02 AND REMODELING OF THE BASEMENT. THE PROJECT WILL CONVERT 20 SRO
00:51:06 UNITS INTO STUDIOS TO MEET HUD VASH REQUIREMENTS AND CREATE
00:51:12 SIX FULLY ADA ASSESSABLE UNITS BY RE RE BY RE BY REHABBING THE
00:51:20 ENTIRE STACK AND INSTALLING A NEW WHEELCHAIR LIFT.
00:51:25 IN ADDITION ONE GROUND FLOOR COMMERCIAL SPACE WILL BE
00:51:28 CONVERTED TO CREATE A ADA COMPLIANT BUILDING ENTRANCE ON
00:51:32 PEARL STREET. THE PROJECT IS SUPPORTED BY THE
00:51:36 CITY AND STATE FUNDING SOURCE OF THE 26.5 MILLION IN THE CITY
00:51:42 LOAN FUNDS COMMITTED TO THE PROJECT 14.02 MILLION WAS USED
00:51:50 FOR THE INITIAL ACQUISITION. IN ADDITION, THE PROJECT
00:51:56 INCLUDES 15.9 MILLION IN HOMEKEY PLUS FUNDS FROM 8CD
00:52:00 WHICH ARE BEFORE THE BOARD OF CONSIDERATION OF WHICH ARE
00:52:04 WHICH ARE BEFORE THE BOARD FOR CONSIDERATION TODAY THE HOMEKEY
00:52:08 PLUS MONEY WILL REDUCE THE OVERALL MOST CD SUPPORT FOR
00:52:12 THIS PROJECT BY 3.4 MILLION WITH THE BOARD'S SUPPORT SWARTZ
00:52:20 THE PLOWSHARE ANTICIPATES BEGINNING CONSTRUCTION
00:52:24 IN NOVEMBER 2026 CONTINGENT ON THE HOMEKEY PLUS AWARD WITH
00:52:28 PROJECT COMPLETION EXPECTED NOVEMBER 2027.
00:52:32 THANK YOU FOR YOUR CONSIDERATION AND SUPPORT.
00:52:36 HERE WITH ME TODAY ARE REPRESENTATIVES FROM SWARTZ,
00:52:40 THE PLOWSHARE AND WELL AS WELL AS OUR COLLEAGUES FROM THE
00:52:44 MAYOR'S OFFICE OF HOUSING AND COMMUNITY DEVELOPMENT WE
00:52:47 ARE ABLE TO ANSWER ANY QUESTIONS THE COMMITTEE MEMBERS
00:52:51 MAY HAVE. >> THANK YOU FOR OUR
00:52:52 PRESENTATION TODAY. I APPRECIATE THE THE
00:52:56 PRESENTATION. I WOULD LIKE TO SEE IF WE I'M
00:53:00 IN SUPPORT OF THIS ITEM TODAY. I WOULD LIKE TO ACTUALLY WITH
00:53:03 MY COLLEAGUES SUPPORT TO HOPE TO VOTE AS OUT OF FULL BORE
00:53:07 WHICH IS THERE WILL BE A FULL BOARD NEXT TUESDAY APRIL 14TH
00:53:10 BETWEEN THIS TIME THOUGH IF I WOULD LIKE TO REQUEST IS
00:53:13 ADDITIONAL EXISTING CONDITION PHOTOS OF THE EXISTING
00:53:17 CONDITION OF THE BASEMENT BECAUSE THAT IS WHERE THE GRANT
00:53:19 IS GOING TO GO FOR REHAB AS WELL AS EXISTING SRO UNITS
00:53:25 AND THE UNITS THAT WILL BE CONVERTED INTO ADA.
00:53:28 YES, JUST HAVING A PHOTOS OF THAT ATTITUDE IS GREAT BECAUSE
00:53:32 YOU ALREADY SHOW THE ENTRANCE AND AS WELL AS A STAIRCASE THAT
00:53:36 HELP US UNDERSTAND THIS IS HOW YOU GOING TO CONVERT IT INTO
00:53:38 ADA BUT I WOULD JUST LIKE JUST ADDITIONAL LIKE WITH A BETTER
00:53:41 UNDERSTANDING OF WHAT THE CURRENT CONDITION LOOKS LIKE
00:53:45 AND WHAT ARE WE ANTICIPATING SO BY THE TIME THEY COMPLETE WE
00:53:49 HAVE SOME A LITTLE BIT OF BEFORE AND AFTER COMPARISON FOR
00:53:52 FOR THAT COMPLETION AND OF COURSE WE ALWAYS REALLY
00:53:56 APPRECIATE YOU KNOW SWORDS AND PLOWSHARES PARTNERSHIP
00:53:59 AND FOR THEIR WORK SO THANK YOU.
00:54:00 >> AND DO YOU THINK THAT'S POSSIBLE?
00:54:02 YES THANK YOU. WE LOOK FORWARD TO THOSE
00:54:04 ADDITIONAL BASEMENT AS EXISTING SRO UNITS AND THE UNITS THE
00:54:07 CURRENT CONDITION OF THE UNITS THAT WILL BE DONE CONVERT TO
00:54:10 THE SIX UNITS OF THE 88 UNITS. SO THANK YOU.
00:54:13 AND WITH THAT LET'S GO TO PUBLIC COMMENT ON THIS ITEM.
00:54:18 >> YES, WE'RE NOW OPENING PUBLIC COMMENT FOR THIS ITEM
00:54:21 NUMBER SIX IF WE HAVE ANY MEMBERS OF THE PUBLIC WHO WISH
00:54:24 TO ADDRESS THIS COMMITTEE. >> MADAM CHAIR, WE HAVE NO
00:54:29 SPEAKERS SAY NO MORE SEEING NO PUBLIC COMMENTS.
00:54:32 PUBLIC COMMENT IS NOW CLOSED. COLLEAGUES I WOULD LIKE TO MOVE
00:54:33 THIS ITEM TO FULL BOARD WITH RECOMMENDATION AND A ROLL CALL
00:54:36 PLEASE. >> AND ON THAT MOTION TO REFER
00:54:39 THIS RESOLUTION TO THE FULL BOARD WITH THE RECOMMENDATION
00:54:43 VICE CHAIR DORSEY AND DORSEY I MEMBER SADR SADR HIGH CHURCH
00:54:47 IN HIGH CHENNAI WE HAVE THREE EYES THE MOTION PASSES MR.
00:54:51 CLERK PLEASE CALL ITEM NUMBER SEVEN.
00:54:52 >> YES ITEM NUMBER SEVEN IS A RESOLUTION RETROACTIVELY
00:54:56 AUTHORIZING THE OFFICE OF THE CITY ATTORNEY TO ACCEPT
00:54:59 AND EXPEND THE GRANT IN THE AMOUNT OF 600,000 FROM THE
00:55:02 CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS LABOR
00:55:05 COMMISSIONER'S OFFICE FOR THE WORKERS RIGHTS ENFORCEMENT
00:55:09 GRANT PROGRAM TO FUND THE ENFORCEMENT OF STATE LABOR LAWS
00:55:13 FOR THE PERIOD OF AUGUST 1ST, 2025 THROUGH JULY 31ST, 2026.
00:55:17 >> MADAM CHAIR, THANK YOU. >> AND TODAY WE HAVE THE CITY
00:55:21 ATTORNEY'S OFFICE HERE WITH US. GOOD MORNING SUPERVISORS.
00:55:25 I'M MATT GOLDBERG. I'M THE CHIEF ATTORNEY OF THE
00:55:29 WORKER PROTECTION TEAM WITHIN THE SAN FRANCISCO CITY
00:55:30 ATTORNEY'S OFFICE. I'M HERE TO REQUEST RETROACTIVE
00:55:33 AUTHORIZED ACTION OF A $600,000 GRANT FROM THE STATE OF
00:55:38 CALIFORNIA TO OUR OFFICE TO ENGAGE IN WORKER PROTECTION
00:55:44 WORK AND COMBATING WAGE THEFT. >> I'LL BE HAPPY TO ANSWER ANY
00:55:49 QUESTIONS. I'LL GIVE YOU JUST A VERY SHORT
00:55:50 SUMMARY OF THIS. >> THIS IS A UNIQUE GRANT
00:55:54 PROGRAM. TYPICALLY THE STATE OF
00:55:57 CALIFORNIA IS NOT IN THE BUSINESS OF FUNDING LOCALITIES
00:56:00 TO DO WORKER PROTECTION WORK SO WE WERE PLEASED THAT THEY
00:56:05 COMMENCED THIS PROJECT. IT'S A TWO YEAR GRANT CYCLE.
00:56:09 WE IT WAS A COMPETITIVE PROCESS.
00:56:10 WE WERE THE RECIPIENT OF A FIRST YEAR GRANT FOR JUST OVER
00:56:16 $400,000. WE REPORTED A LOT OF SUCCESSFUL
00:56:17 WORK FOLLOWING YEAR ONE AND WE WERE PLEASED TO ONCE AGAIN BE
00:56:21 ACCEPTED FOR A SECOND YEAR GRANT THEY INCREASED OUR GRANT
00:56:27 BY ROUGHLY 50%. I THINK THAT WAS A REFLECTION
00:56:30 ON THE EXCELLENT WORK WE HAD DONE IN THE FIRST YEAR.
00:56:33 >> I'LL SAY THAT THE GRANT PERIOD WE'RE NOW SORT OF TOWARD
00:56:38 THE END OR IN THE MIDDLE OF THE OF THE GRANT PERIOD WE'VE
00:56:41 ALREADY HAD A NUMBER OF IMPORTANT SUCCESSES.
00:56:46 I THINK ROUGHLY WE HAVE SECURED OVER $5 MILLION IN RESTITUTION
00:56:49 FOR WORKERS VIA JUDGMENTS AND SETTLEMENTS DURING THIS
00:56:56 FIRST PART OF THE GRANT YEAR AN ADDITIONAL $500,000
00:56:58 IN PENALTIES COMING BACK TO THE CITY AND THE CITY ATTORNEY'S
00:57:03 OFFICE. >> I GUESS SIMILARLY WE'RE ON
00:57:07 TRACK BASICALLY THIS IS FUNDING EXCLUSIVELY FOR SALARIES
00:57:11 AND BENEFITS AND SO WE'RE TRACKING THE TIME THE
00:57:15 QUALIFYING TIME WE SPEND ON DOING WORK THAT QUALIFIES FOR
00:57:19 THE GRANT FUNDING AND WE'RE ON TRACK TO USE AND EXPEND DOWN
00:57:23 ALL OF THE FUNDING. >> I THINK THAT'S ESSENTIALLY
00:57:30 IT. >> SO I'M HAPPY TO ANSWER ANY
00:57:31 QUESTIONS YOU MAY HAVE. >> VICE CHAIR DORSEY THANK YOU
00:57:34 CHAIR AND I HAVE NO QUESTIONS BUT JUST WANTED TO SAY THAT I
00:57:38 AM ENTHUSIASTICALLY IN SUPPORT OF THIS.
00:57:42 I WILL SAY THAT DURING MY TIME IN THE CITY ATTORNEY'S OFFICE I
00:57:43 THINK THESE ARE THE KINDS OF CASES THAT WERE SOME OF THE
00:57:46 MOST IMPORTANT AND CONSEQUENTIAL.
00:57:47 IT'S NOT JUST FOR THE WORKERS AND THEIR FAMILIES WHO ARE
00:57:50 CHEATED OF THEIR WAGES AND BENEFITS BUT IT'S ALSO
00:57:54 REALLY ABOUT PROTECTING THE LAW ABIDING BUSINESSES AND MAKING
00:57:57 SURE THAT THEY'RE THAT THE LAW BREAKERS ARE NOT CORRUPTING THE
00:58:00 MARKETPLACE. SO I'M A HUGE BELIEVER IN THIS
00:58:04 WORK AND I WORKED FOR YEARS THERE WITH WITH VINCE CHHABRIA
00:58:08 ON IT AND I'M GRATEFUL TO SEE A LAWYER OF YOUR CALIBER, MATT SO
00:58:12 KEEP UP THE GREAT WORK. >> I'M HAPPY TO SUPPORT THIS.
00:58:16 THANK YOU. THANK YOU.
00:58:17 AND SO THEN WITH THAT LET'S GO TO PUBLIC COMMENT ON THIS ITEM.
00:58:20 YES, WE'RE OPENING PUBLIC COMMENT FOR THIS ITEM NUMBER
00:58:23 SEVEN IF WE HAVE ANY MEMBERS OF THE PUBLIC WHO WISH TO ADDRESS
00:58:26 THIS COMMITTEE. >> MADAM CHAIR, WE HAVE NO
00:58:30 SPEAKERS SEEN NO PUBLIC COMMENTS.
00:58:34 PUBLIC COMMENT IS NOW CLOSE AND THEN SO WITH THAT
00:58:38 COLLEAGUES I WOULD LIKE TO MOVE THIS ITEM TO FULL BOARD WITH
00:58:39 RECOMMENDATION AND A ROLL CALL PLEASE.
00:58:42 >> AND ON THAT MOTION TO REFER TO THE FULL BOARD THE
00:58:44 RECOMMENDATION VICE CHAIR DORSEY DORSEY I REMEMBER SORTER
00:58:48 SORTER I CHURCH HIM I CAN I WE HAVE THREE EYES THE MOTION
00:58:52 PASSES. >> THANK YOU.
00:58:55 AND SO WITH THAT MR. CLERK PLEASE CALL ITEM NUMBER EIGHT
00:58:59 ITEM NUMBER EIGHT IS OUR HEARING ON THE DENIAL OF HEALTH
00:59:03 CARE INCLUDING CANCER CARE FOR SAN FRANCISCO WORKERS, RETIREES
00:59:07 AND THEIR FAMILIES BY BLUE SHIELD AND REQUESTING THE SAN
00:59:10 FRANCISCO HEALTH SERVICES BOARD BLUE CROSS BLUE SHIELD OF
00:59:14 CALIFORNIA AND PROTECT OUR BENEFITS TO REPORT.
00:59:18 >> MADAM CHAIR, THANK YOU. >> COLLEAGUES, I IF I MAY JUST
00:59:27 STARTED WITH SOME REMARKS I DON'T KNOW IF VICE CHAIR
00:59:29 DORSEY. I ALSO HAVE SOME INITIAL
00:59:31 REMARKS ABOUT THIS HEARING WE OR I HAVE LEARNED AND IN
00:59:39 ADDITION TO VICE CHAIR DORSEY HAVE LEARNED THAT THERE WERE
00:59:43 THAT DENIAL OF CARE FOR PARTICULARLY REALLY OUR FIVE
00:59:50 FIGHTERS AND RETIRED FIREFIGHTERS AND BOTH OF US
00:59:54 HAVE SAT ON THE HEALTH SERVICES BOARD WITH THE UNDERSTANDING OF
00:59:58 THE TYPES OF TRANSITIONS THAT WE'VE BEEN THROUGH WITH OUR
01:00:01 HEALTH CARE SYSTEM AND SERVICE PROVIDER AND PARTICULARLY
01:00:05 IN THIS CASE FOR OUR RETIREES IS THE TRANSITIONS FROM UNITED
01:00:12 HEALTH CARE TO NOW BLUE CROSS BLUE SHIELD OF CALIFORNIA AS AN
01:00:16 INSURANCE AND PROVIDER SERVICE PROVIDER TO OUR RETIREES.
01:00:21 SO AS YOU CAN IMAGINE WHEN WE LEARN ABOUT THE DENIAL OF CARE,
01:00:25 IT'S ALARMING AND DISHEARTENING AND WE WANTED TO GET TO THE
01:00:32 BOTTOM OF THIS AND SO THAT WE CAN UNDERSTAND WHY AND HOW
01:00:35 AND MOST IMPORTANTLY, I THINK THAT OUR CORE MISSION HAS
01:00:40 ALWAYS BEEN PRIORITIZING CARE FOR FOR OUR CITY WORKERS
01:00:46 AND THOSE WHO ESPECIALLY THOSE INCLUDING THOSE WHO ARE NOW
01:00:50 HAVE CONTRIBUTED THEIR CAREER AND SERVICE TO OUR CITY.
01:00:54 >> AND SO I THINK TODAY'S HEARING IS NOT ONLY THAT WE
01:00:59 WANT TO LEARN FROM OUR HOW SERVICES SYSTEM WHO HAS BEEN
01:01:06 PROVIDING US THE ADVICE AND THE CONTRACTS FOR US TO EVALUATE
01:01:10 AND IMPROVE BUT ALSO FROM THOSE WHO ACTUALLY HAVE FIRSTHAND
01:01:18 EXPERIENCE RECEIVING CARE AND INCLUSIVE OF THEIR PROCESS
01:01:23 EVENTUALLY RESULTED IN THE DENIAL OF CARE AND THEN WE WE
01:01:30 DO WANT TO GIVE BLUE SHIELD AN OPPORTUNITY TO ALSO EXPLAIN TO
01:01:34 US PUBLICLY WHAT HAS A HOW THAT PROCESS HAD SPIN AND THEIR
01:01:41 REASON FOR DENIAL CARE. I AM COMING FROM A SPACE THAT
01:01:46 IT'S NOT JUST THAT I SEE IS POTENTIALLY A PROBLEM FOR US AS
01:01:52 A CITY IN TERMS OF PROVIDING EFFECTIVE AND COMPREHENSIVE
01:01:57 CARE FOR OUR WORKERS. >> IT IS ALSO I WANT TO
01:02:02 UNDERSTAND BETTER THE ENTIRE HEALTH CARE SYSTEM.
01:02:05 THERE'S NO DOUBT THAT THERE'S THE HEALTH CARE SYSTEM AS IT
01:02:09 CURRENTLY EXISTS NOT JUST FOR OUR CITY WORKERS BUT REALLY FOR
01:02:12 THE COUNTRY IS BROKEN. SO I ALSO LOOK TO OUR HEALTH
01:02:16 SERVICE SYSTEM AND HEALTH SERVICES FOR STAFF TO KIND OF
01:02:20 WALK US THROUGH FROM YOUR PERSPECTIVE WHAT AS A CITY WE
01:02:24 CAN DO TO FIX IT AND WHAT IS IT THAT IN THE CITY THAT NEED TO
01:02:31 DEMAND OUR PARTNERS, OUR CONTRACTORS AND IN THIS CASE
01:02:35 BLUE SHIELD TO MAKE SURE THAT THEY DO DELIVER THAT CARE BUT
01:02:39 ALSO WHAT ELSE DO WE HAVE WE MISSED IN THIS TRANSITION
01:02:47 AND AND WHAT CAN WE DO AS A CITY TO MOVING FORWARD
01:02:51 IN ADDITION TO WHAT WE WANT TO HEAR FROM BLUE SHIELD TODAY?
01:02:54 >> SO WITH THAT VICE-CHAIR DORSEY THANK YOU CHAIR CHAN
01:02:58 AND I WANT TO THANK YOU FOR CALLING THIS HEARING AND I WANT
01:03:02 TO JUST ELABORATE A LITTLE BIT ON SOME OF THE BACK THE
01:03:05 BACKGROUND WHEN OUR HEALTH SERVICE SYSTEM INITIATED AN RFP
01:03:09 PROCESS FOR SOME OF OUR RETIREE HEALTH CARE SERVICES RIGHT NOW
01:03:17 WE ARE IN A SITUATION AS CHAIR CHAN MENTIONED WHERE HEALTH
01:03:21 CARE PRICES ARE FAR OUTPACING THE COST THE RISING COSTS OF
01:03:26 EVERYTHING ELSE AND MAYBE THE ONLY TOOL THAT WE HAVE IS A
01:03:30 COMPETITIVE BIDDING PROCESS. AN HSA DID THAT WHAT THE WHAT
01:03:37 CAME BACK WAS THAT BLUE CROSS BLUE SHIELD WAS THE LOWER
01:03:41 BIDDER BY TENS OF MILLIONS OF DOLLARS AND I WAS I WAS AS A
01:03:45 MEMBER OF THAT HEALTH SERVICE BOARD FELT STRONGLY THAT HHS
01:03:52 AND OUR CONSULTANTS DID A THOROUGH, CAREFUL, METICULOUS
01:03:56 RFP PROCESS. I PUT FAITH IN THAT.
01:04:00 BUT IT WASN'T WITHOUT CONTROVERSY SEE THAT WE WERE
01:04:04 REPLACING AN INCUMBENT WITH BLUE SHIELD AND WE HEARD FROM A
01:04:08 LOT OF OUR RETIREES ON THAT. I MADE A COMMITMENT AS A MEMBER
01:04:13 OF THE BOARD OF SUPERVISORS THAT WE HAD NO INTENTION OF
01:04:17 BALANCING OUR CITY BUDGET ON THE BACKS OF OUR RETIREES
01:04:21 AND WE EXPECTED THAT PEOPLE WERE GOING TO KEEP THEIR WORD
01:04:24 ABOUT THE SERVICES THAT THEY WERE GOING TO BE PROVIDING.
01:04:28 AND I DID SAY AFTER THIS HAPPENED THAT, YOU KNOW, THE
01:04:32 FIRST THIRD OF MY CAREER I WAS A CONSULTANT AND I OFTEN
01:04:37 ENGAGED IN COMPETITIVE BIDDING PROCESSES AND SOMETIMES THERE'S
01:04:41 REALLY COMPETITIVE BIDS AND THE GOOD NEWS IS WHEN YOU WIN IT
01:04:46 YOU WANT IT. AND THE BAD NEWS IS YOU WANT IT
01:04:49 AND NOW THERE'S EVERYBODY'S EYES ARE GOING TO BE ON YOU
01:04:51 AND THERE'S GOING TO BE A REALLY HIGH STANDARD AND HIGH
01:04:54 EXPECTATIONS TO DELIVER. SO THAT WAS I THINK WHAT
01:05:00 ANIMATED THE CONCERNS THAT I HAD AND I THINK THAT WE SHARE
01:05:05 AS A BOARD OF SUPERVISORS TO MAKE SURE THAT OUR CONTRACTORS
01:05:12 ARE DELIVERING WHAT THEY SIGNED UP FOR AND IT WAS OBVIOUSLY
01:05:16 CONCERNING WHEN WE ARE GETTING REPORTS FROM SOME OF OUR
01:05:20 RETIREES IS THAT THEY'RE BEING DENIED CARE AND WE'RE SEEING AT
01:05:25 LEAST ANECDOTAL INFORMATION THAT THAT WAS NOT THE CASE WITH
01:05:28 SOME OF THE PREVIOUS PROVIDERS. SO I REALLY APPRECIATE THE WORK
01:05:32 THAT CHAIR CHEN'S OFFICE IS DOING ON THIS.
01:05:39 I APPRECIATE THE WORK THAT H. S HAS DONE ON THIS AND I KNOW
01:05:40 THAT WE SENT A LETTER OF INQUIRY TO YOU.
01:05:43 I DO WANT TO ACKNOWLEDGE THAT THERE'S NOT MUCH THAT H US I
01:05:47 KNEW WHEN WE SENT THAT LETTER OF INQUIRY THAT IT WAS UNLIKELY
01:05:50 THAT YOU WOULD HAVE ANY INFORMATION BUT TO DO OUR DUE
01:05:52 DILIGENCE WE HAD TO DO THAT. WE ALSO REACHED OUT TO MANY OF
01:05:55 THE UNIONS IN BARGAINING UNITS OF EMPLOYEES TO JUST ASK THEIR
01:05:59 MEMBERS IF THEY'RE EXPERIENCING ISSUES SIMILAR TO WHAT WE SAW
01:06:05 WITH SOME OF THE FIREFIGHTERS. SO I REALLY APPRECIATE THAT WE
01:06:09 ARE DOING EVERYTHING WE CAN TO DO RIGHT BY OUR RETIREES
01:06:13 AND OUR WORKERS. >> AND THANK YOU AGAIN CHURCH
01:06:17 AND FOR HOLDING THIS HEARING. >> THANK YOU.
01:06:18 SO LET'S START WITH OUR HEALTH SERVICES SYSTEM.
01:06:32 >> GOOD MORNING COMMITTEE MEMBERS.
01:06:33 I'M RICK IAN, EXECUTIVE DIRECTOR FOR THE HEALTH SERVICE
01:06:36 SYSTEM AND I'M HERE TODAY REPRESENTING BOTH THE
01:06:37 DEPARTMENT AND THE HEALTH SERVICES BOARD.
01:06:40 HEALTH SERVICE BOARD PRESIDENT MARY HOWE WAS UNAVAILABLE TO
01:06:43 ATTEND TODAY'S HEARING DUE TO A PREEXISTING WORK OBLIGATION.
01:06:47 HOWEVER COMMISSIONER JACK CHRISMAN IS IN THE AUDIENCE
01:06:49 TODAY AND AS YOU KNOW SUPERVISOR DORSEY IS A CURRENT
01:06:52 BOARD OF SUPERVISOR APPOINTEE ON THE HEALTH SERVICE BOARD.
01:06:58 >> LOOKS LIKE IN MY PRESENTATION THIS MORNING I
01:07:02 HOPE TO CLARIFY THE ROLES OF BOTH THE HEALTH SERVICES SYSTEM
01:07:05 AND THE HEALTH SERVICE BOARD AND ALSO EXPLAIN EACH ENTITY'S
01:07:07 LIMITATIONS. >> I WILL THEN HIGHLIGHT THE
01:07:09 ROLES OF OUR SELECTED HEALTH PLAN VENDORS AND THE REGULATORY
01:07:13 AGENCIES RESPONSIBLE FOR OVERSEEING THEM.
01:07:16 FINALLY I WILL GO THROUGH THE RESOURCES AVAILABLE TO OUR
01:07:18 MEMBERS SHOULD THEY FEEL THAT THEY ARE NOT RECEIVING THE CARE
01:07:21 THAT THEY NEED, IT LOOKS LIKE. AND ONE MORE PLEASE.
01:07:28 >> THE HEALTH SERVICE SYSTEM STAFF ADMINISTER THE PROGRAMS
01:07:29 RULES AND POLICIES APPROVED BY THE HEALTH SERVICE BOARD
01:07:32 IN REGARD TO THE MEDICAL PLANS THAT ARE OFFERED TO OUR ACTIVE
01:07:36 AND RETIRED MEMBERS AS WELL AS THEIR FAMILIES.
01:07:39 >> SFH SERVES AS THE PLAN SPONSOR AND OUR MAIN
01:07:42 RESPONSIBILITIES INCLUDE MANAGING MEMBER ELIGIBILITY
01:07:46 AND ENROLLMENT COLLECTING AND PAYING PREMIUMS, ENSURING
01:07:50 COMPLIANCE WITH REGULATIONS SUCH AS HIPA COBRA IN THE
01:07:51 AFFORDABLE CARE ACT AND COMPLETING CERTAIN LEGAL
01:07:55 REQUIREMENTS SUCH AS OFFERING REQUIRED PLAN DOCUMENTATION
01:07:58 LIKE THE SUMMARY PLAN DESCRIPTIONS TO OUR MEMBERS.
01:08:01 AND FINALLY WE ASSIST THE HEALTH SERVICE BOARD IN MEETING
01:08:05 ITS FIDUCIARY DUTIES. >> THE HEALTH SERVICE BOARD
01:08:09 SETS THE POLICY DIRECTION FOR THE HEALTH SERVICE SYSTEM
01:08:13 AND IS RESPONSIBLE FOR SELECTING THE VARIOUS HEALTH
01:08:15 PLAN VENDORS. IT HOLDS A FIDUCIARY
01:08:17 RESPONSIBILITY TO PRUDENTLY SELECT AND MONITOR THESE
01:08:21 INSURANCE CARRIERS. BUT THE CARRIERS HANDLE THE DAY
01:08:25 TO DAY ADMINISTRATION OF THE HEALTH PLANS.
01:08:26 THE CARRIERS HOLD THEIR PRIMARY RESPONSIBILITY FOR MANAGING
01:08:29 AND DENYING CLAIMS. THE HEALTH SERVICE BOARD'S
01:08:33 FIDUCIARY RESPONSIBILITY RELATED TO CLAIMS DENIALS IS TO
01:08:36 ENSURE THAT ITS SELECTED HEALTH PLAN CARRIERS PROVIDE MEMBERS
01:08:40 WITH A CLEAR APPEALS PROCESS AND THAT THEY ARE FOLLOWING
01:08:42 THAT PROCESS. >> NEITHER THE HEALTH SERVICE
01:08:46 SYSTEM NOR THE HEALTH SERVICE BOARD IS RESPONSIBLE FOR THE
01:08:50 SPECIFIC DENIAL DECISIONS MADE BY ITS HEALTH PLAN CARRIERS.
01:08:54 PROVIDED AGAIN THAT WE HAVE ACTED PRUDENTLY IN SELECTING
01:08:57 THE CARRIERS UNDER HIPA. PLAN SPONSORS LIKE SFH SS
01:09:01 GENERALLY CANNOT RECEIVE THE SPECIFIC IDENTIFIABLE MEDICAL
01:09:06 DETAILS OF EMPLOYEES CLAIM THAT WOULD BE NECESSARY TO EVALUATE
01:09:10 A CLAIM DENY WHETHER A CLAIM DENIAL WAS APPROPRIATE OR NOT.
01:09:14 IN MOST CASES PLAN SPONSORS ONLY RECEIVED DE-IDENTIFIED
01:09:17 AGGREGATED DATA ABOUT CLAIMS SHOWING TRENDS RATHER THAN WHO
01:09:21 WAS DENIED WHAT SERVICE. PLAN SPONSORS ARE LIMITED TO
01:09:25 MONITOR KEY PERFORMANCE INDICATORS FROM THEIR INSURANCE
01:09:28 CARRIERS SUCH AS DENIAL RATES FOR SPECIFIC TYPES OF CARE.
01:09:32 FOR INSTANCE BEHAVIORAL HEALTH VERSUS MEDICAL TO PERFORM THEIR
01:09:36 GENERAL OVERSIGHT. AND I'LL JUST STOP HERE
01:09:38 AND MENTION AS SUPERVISOR DORSEY MENTIONED EARLIER, YOU
01:09:42 KNOW, THE CITY IS CONCERNED WITH THE HIGH COSTS OF ALL THE
01:09:46 PLANS THAT IT HAS OFFERS THE PLANS THAT WE OFFERED ARE
01:09:49 MANAGED HEALTH CARE PLANS. >> AND AGAIN PART OF THE DUTIES
01:09:53 OF OUR HEALTH INSURANCE CARRIERS IS TO DETERMINE
01:09:56 WHETHER OR NOT SUBMITTED CLAIMS ARE WITHIN THE APPLICABLE
01:10:00 GUIDELINES FOR SUCH SERVICES. LOOKS LIKE HHS HAS SELECTED
01:10:11 HEALTH PLANS ARE RESPONSIBLE FOR MANAGING ALL CLAIMS
01:10:12 PROCESSING UTILIZATION REVIEWS AND PAYMENT OF BENEFITS
01:10:16 IN ACCORDANCE WITH THE EVIDENCE OF COVERAGE DOCUMENTS THAT
01:10:19 OUTLINE THE BENEFIT DESIGN APPROVED BY THE HEALTH SERVICE
01:10:21 BOARD. FOR EACH PLAN, THE INSURANCE
01:10:25 CARRIERS MUST PERFORM THESE TESTS IN ACCORDANCE WITH THE
01:10:28 LAWS AND REGULATIONS THAT APPLY TO THEIR PARTICULAR PLAN TYPE
01:10:32 EXCEPT IN ONE THE TWO MAIN REGULATORS APPLICABLE TO OUR
01:10:38 PLANS ARE THE DEPARTMENT OF MANAGED HEALTH CARE AND THE
01:10:39 CENTERS FOR MEDICARE AND MEDICAID SERVICES.
01:10:45 >> THE AFFORDABLE CARE ACT ENSURES THAT HEALTH PLAN
01:10:46 MEMBERS HAVE A RIGHT TO APPEAL HEALTH INSURANCE PLAN
01:10:49 DECISIONS. FIRST, HEALTH PLANS MUST OFFER
01:10:52 AN INTERNAL APPEALS PROCESS. THEN IF THE PLAN STILL DENIES
01:10:57 PAYMENT AFTER CONSIDERING A MEMBER'S APPEAL, THE LAW
01:11:00 PERMITS THE MEMBER TO HAVE AN INDEPENDENT REVIEW ORGANIZATION
01:11:01 DECIDE WHETHER OR NOT TO UPHOLD OR OVERTURN THE PLAN'S
01:11:05 DECISION. THIS CHECK IS OFTEN REFERRED TO
01:11:08 AS AN EXTERNAL REVIEW. HEALTH PLANS ARE REGULATED BY
01:11:12 VARIOUS FEDERAL AND STATE ENTITIES DEPENDING ON THE TYPE
01:11:15 OF PLAN IT IS HMO, PPO, MEDICARE ADVANTAGE AD ETC.
01:11:19 THESE AGENCIES ARE THE ONES RESPONSIBLE FOR ENFORCING
01:11:20 COMPLIANCE THROUGH INVESTIGATIONS, PUBLIC
01:11:24 REPORTING AND PENALTIES. >> IF A MEMBER CONTACTS OUR
01:11:28 MEMBER SERVICES TEAM WITH AN ISSUE ABOUT MEDICAL CARE
01:11:32 RECEIVED OR NOT RECEIVED, OUR STAFF PROVIDE GUIDANCE TO THE
01:11:35 MEMBER ON HOW TO NAVIGATE THE APPEALS PROCESS.
01:11:43 >> THIS FINAL SLIDE PROVIDES A SUMMARY OF THE VARIOUS ROLES
01:11:47 AND RESPONSIBILITIES THAT I WENT OVER TODAY.
01:11:50 THIS CONCLUDES MY PRESENTATION. THANK YOU.
01:11:53 >> THANK YOU. WE WILL HAVE QUESTIONS.
01:11:58 I THINK WHAT WE'RE GOING TO DO IS WE'RE GOING TO GO THROUGH
01:11:59 THE PRESENTATION AND WE'RE GOING TO FOLLOW UP WITH THE
01:12:03 QUESTIONS. AND SO NOW I AM GOING TO CALL
01:12:06 ON MR. FRED SANCHEZ. >> PROTECT OUR BENEFITS.
01:12:24 >> I'M FRED SANCHEZ. I'M A RETIRED DEPUTY CHIEF FOR
01:12:29 THE SAN FRANCISCO FIRE DEPARTMENT.
01:12:32 >> DID 32 YEARS THERE WAS GREAT EXCEPT THE LAST YEAR.
01:12:36 >> I'M PRESIDENT OF PROTECT OUR BENEFITS.
01:12:40 >> PROTECT OUR BENEFITS IS A WATCHDOG ORGANIZATION THAT
01:12:43 MONITORS THE RETIREMENT SYSTEM AS WELL AS THE HEALTH SERVICE
01:12:48 SYSTEM FOR THE 41,000 APPROXIMATELY RETIRED CITY
01:12:51 WORKERS. >> THEY'RE NOT ALL POLICE
01:12:55 AND FIRE. SOME OF THESE PEOPLE ARE
01:12:58 MISCELLANEOUS WORKERS WHO HAVE PENSIONS IN THE NEIGHBORHOOD OF
01:12:59 MAYBE 20,000 TO $25,000 A YEAR. SO WHEN THEY GET DENIED
01:13:06 SERVICES IT'S CRITICAL ANY OUT OF POCKET EXPENSE IS REALLY
01:13:10 EXTREMELY DIFFICULT. >> TODAY YOU'LL HAVE SEVERAL
01:13:14 SPEAKERS. THERE ARE SOME OF THEM THAT
01:13:17 CAN'T BE HERE LIKE AL CARCIERI WHO'S DOWN IN PHENIX WAITING
01:13:22 FOR A DOUBLE LUNG TRANSPLANT. >> HE WAS APPROVED BY BLUE
01:13:29 SHIELD TO HAVE THIS DOUBLE LUNG TRANSPLANT.
01:13:33 >> WHEN HE GOT DOWN THERE HE HAD TO GO TO A HEALTH
01:13:37 AND WELLNESS TRAINING THAT WAS PART OF THE PROCESS AS HE GOT
01:13:41 THERE ON A MONDAY. >> HE GOES TO GET THE TRAINING
01:13:45 AND HE'S TOLD THIS HAVE TO BE APPROVED BY BLUE SHIELD.
01:13:50 >> HE SAYS WHAT ARE YOU TALKING ABOUT BLUE SHIELD APPROVE THE
01:13:51 PROCESS. >> WELL, NOT THIS PARTICULAR
01:13:54 PART HE'S DENIED. I GET A CALL.
01:14:00 >> RAY IS GREAT. HE PICKS UP MY CALL.
01:14:04 I CALL BLUE SHIELD, CHARLES LEE AND ALL THIS STUFF.
01:14:06 HEY, WHAT CAN WE DO ABOUT THIS? I MEAN, IT'S HE NEEDS THIS
01:14:11 TRAINING TO PROCEED. >> IT TOOK TILL FRIDAY.
01:14:15 >> IT TOOK FOUR DAYS FOR THEM EVENTUALLY TO APPROVE WHAT THEY
01:14:20 ALREADY SHOULD HAVE BEEN PART OF THE PROCESS.
01:14:23 IT MADE NO SENSE. THE AGGRAVATION.
01:14:24 CAN YOU IMAGINE ON A GUY WHO'S ALMOST 80 YEARS OLD WHEN IT'S
01:14:28 LIKE A WHEN AM I GOING TO GET THIS LONG PROJECT HE'S TOLD IF
01:14:32 HE DOESN'T HAVE IT WITHIN SIX MONTHS HE'S NO LONGER GOING TO
01:14:36 BE WITH US. I MEAN IT'S CASES LIKE THAT WE
01:14:39 HAVE HERB WEINER WHO'S HERE. >> HE WAS AT THE JEWISH CENTER
01:14:46 REHAB BEING FROM A THORACIC VALVE REPLACEMENT IN HIS HEART
01:14:54 REPLACEMENT. >> HE GETS A CALL TELLING THEM
01:14:58 THAT THEY WANT TO MOVE HIM OUT BACK INTO HIS RESIDENTIAL CARE
01:15:02 AT THE FRANK RESIDENCE. HE CALLS ME I'M HIS ADVOCATE.
01:15:10 >> I CALL THE CASE WORKER HIS NURSE IS HERB READY TO GO BACK
01:15:14 HOME AND THEY SAID HE NEEDS ADDITIONAL CARE.
01:15:17 HIS BLOOD PRESSURE IS DROPPING BELOW 100.
01:15:21 HE'S HAD SOME INCONTINENCE ISSUES.
01:15:25 WE NEED MORE TIME, YOU KNOW. >> SO THE CASEWORKER TELLS ME
01:15:32 TO CALL THIS COMMENCE HEALTH WHICH IS AN INDEPENDENT REVIEW
01:15:37 LIKE PART OF THE PEER REVIEW PROCESS.
01:15:38 I CALL THEM I SPEAK TO THEM. I TELL THEM THAT WE NEED SOME
01:15:45 EXTENDED CARE AND HE'S NOT READY TO GO BACK.
01:15:48 >> I WAS CONFIDENT THAT YOU KNOW, HEY, TALK TO HIS DOCTOR,
01:15:52 TALK TO THAT NURSE. >> YOU'LL FIND OUT HE NEEDS
01:15:54 MORE TIME. I GET A LETTER OF DENIAL A FEW
01:15:57 DAYS LATER. NEXT THING I KNOW, HERB HAS
01:16:00 BEEN MOVED OUT THAT VERY DAY INTO HIS RESIDENCE.
01:16:04 >> HEY, THANK GOD HE'S NOT BACK IN THE HOSPITAL.
01:16:08 >> BUT I GET THE LETTER AND THE LETTER SAYS THAT THEY HE WAS
01:16:15 ADMITTED SKILLED NURSING FACILITY AFTER HOSPITALIZATION
01:16:19 FOR CARDIOGENIC SHOCK. >> THAT'S ALL IT SAYS.
01:16:26 IF HE WOULD THEY WOULD HAVE TALKED TO HIS DOCTORS AND HIS
01:16:31 NURSE. >> THEY WOULD HAVE FOUND OUT HE
01:16:32 HAD BLOOD PRESSURE ISSUES. >> HE HAD INCONTINENCE ISSUES.
01:16:36 HE'S STILL HEY, HE WASN'T READY TO GO BACK BUT THEY FORCED HIM
01:16:39 TO AND THAT'S WHAT THEY DO. SO I'M JUST TIRED OF BLUE
01:16:43 SHIELD ACTING LIKE THEY'RE THE MEDICAL PROFESSIONALS.
01:16:47 WHAT I EXPECT OUT OF THIS MEETING IS A COMMITMENT FROM
01:16:50 BLUE SHIELD TO LOOK AT THE PROCESSES OF DENIAL AND STOP
01:16:54 PLAYING DOCTOR. LISTEN TO THE DOCTORS.
01:16:58 CHANGE SOME OF THESE PROCESSES SO THAT THEY CAN BE STREAMLINED
01:17:02 BECAUSE LIKE THE TEN JOAN CASE IS UNBELIEVABLE.
01:17:05 >> I MEAN HE HAD TO GET CARE. >> I TALKED TO DR. GUBBINS.
01:17:12 HE SAYS THEY WERE WRONG IN THEIR ASSESSMENT.
01:17:13 HE HELPED SET UP THE GUIDELINES HIMSELF.
01:17:16 HE WAS ON THE BOARD AND HE KNEW THAT WHAT HE RECOMMENDED WAS
01:17:21 APPROPRIATE AND FOR BLUE SHIELD TO DENY IT AGAINST ONE OF THE
01:17:27 MOST PROMINENT DOCTORS ONCOLOGISTS IN THE WORLD.
01:17:31 >> THAT'S LUDICROUS. SO I NEED A COMMITMENT FROM
01:17:35 THIS BOARD THAT THESE MEETINGS WILL TAKE PLACE BECAUSE I KNOW
01:17:39 NOTHING TAKES PLACE IN THE CHAMBERS AT HHS OR HERE BUT I
01:17:43 NEED A COMMITMENT THAT WE WILL HAVE MEETINGS WITH BLUE SHIELD
01:17:49 TO STREAMLINE THIS PROCESS SO THAT THESE DENIALS CANNOT TAKE
01:17:53 PLACE. I HAVE A REPRESENTATIVE HERE
01:17:57 WHO'S GOING TO TALK ABOUT IRENE BRAUN, ONE OF THE FIRST WOMEN
01:17:59 POLICE OFFICERS. >> I MEAN SHE HAVE TO GET
01:18:05 TREATMENT EVERY SIX MONTHS. SHE'S BEEN DOING THIS FOR A
01:18:09 NUMBER OF YEARS. IT WAS STREAMLINED WITH UNITED
01:18:11 HEALTH CARE EVEN THOUGH UNITED HEALTH CARE IS NOT SO INNOCENT
01:18:14 AS PEOPLE MIGHT WANT TO THINK. BUT AFTER APPEALED AN APPEAL
01:18:21 SHE FINALLY GOT PAID SOME STUFF.
01:18:24 BUT I'LL LET YOU KNOW WANTING TO STOCKWELL SPEAK TO THAT
01:18:28 SPECIFIC ISSUE I'VE BEEN ASSURED FROM PEOPLE THAT ARE
01:18:31 CLOSE TO BLUE SHIELD THAT THEY ARE GOING TO PROCESS IRENE
01:18:35 BRAUN'S CASE BUT THERE'S TOO MANY I MEAN I GET A THING FROM
01:18:40 AL KASYANOV SAYING THAT HE JUST GOT CONTACTED FROM HHS THAT ARE
01:18:47 E MAILS THAT GO TO SS DOT RETAIL VERY CONCERNED.COM THAT
01:18:58 THEY'RE NOT GETTING ANY EMAILS TO THAT EMAIL AND THIS WAS FROM
01:19:03 PEOPLE AT HHS AND ONE WHAT ARE YOU TALKING ABOUT?
01:19:04 >> I'VE REFERRED NO LESS THAN 50 PEOPLE TO THAT WEB SITE.
01:19:10 >> THAT'S IMPOSSIBLE. SOMETHING IS BROKEN HERE REALLY
01:19:14 BAD AND I NEED A COMMITMENT FROM THIS BOARD AND BLUE SHIELD
01:19:18 THAT YES, WE WILL HAVE THESE MEETINGS AND THEY WON'T BE
01:19:22 IN TWO MONTHS. THEY'LL BE WITHIN THIS NEXT
01:19:25 MONTH AND WE'LL WORK FOUR HOURS TO MAKE SURE THAT THE PROCESS
01:19:30 IS FIXED NOT JUST A LITTLE BIT FIXED BUT GREATLY FIXED
01:19:34 AND SWITCH. I NEED COMMITMENTS FOR ME TO
01:19:38 COME HERE IS RIDICULOUS. >> IT'S LIKE A WASTE OF MY
01:19:41 TIME. I SPEND 2 TO 3 HOURS A DAY.
01:19:45 >> I'M A VOLUNTEER. I SUPPOSED TO BE ENJOYING MY
01:19:46 SON'S GRANDKIDS LITTLE LEAGUE GAMES AND I'M ON THE PHONE
01:19:49 AND I'M ABOUT READY FOR MY PARTNER IS READY TO KICK ME OUT
01:19:53 OF THE HOUSE BECAUSE YOU KNOW, GET A LIFE.
01:19:56 >> SO THANK YOU FOR YOUR TIME BUT PLEASE, I NEED ACTION.
01:20:01 >> I NEED REAL PROGRESS. THANK YOU.
01:20:04 >> THANK YOU. AND BEFORE I DO CALL ON BLUE
01:20:06 SHIELDS FOR THEIR PRESENTATION FOR THIS HEARING, THIS IS HOW
01:20:09 THE REST OF THE HEARING WILL GO.
01:20:12 >> WE WILL HAVE BLUE SHIELDS COME BEFORE US TO MAKE THEIR
01:20:15 PRESENTATION AND THEN WE WILL GO TO PUBLIC COMMENT
01:20:20 AND ALLOWING THOSE WHO CAN ALSO TALK ABOUT THEIR PERSONAL
01:20:24 STORIES OR THEIR FRIENDS AND FAMILIES THAT THEY LEARN
01:20:27 ABOUT CLAIM DENIALS, INFORMATION AND THEN WE WILL
01:20:32 THEN HAVE QUESTIONS AND ANSWERS WHICH I HAVE SOME AND BUT I
01:20:36 ALSO WANT TO MAKE SURE THAT WE DO ALLOW BLUE SHIELD TO BE ABLE
01:20:39 TO RESPOND TO ANY PUBLIC COMMENTS THAT WE HEAR TODAY.
01:20:44 AND AS FAR AS OUR HEALTH SERVICES ITEM SHOULD BE ABLE TO
01:20:48 RESPOND, SOME OF THESE PUBLIC COMMENTS.
01:20:51 >> SO WITH THAT I'M GOING TO CALL ON BLUE SHIELD TO MAKE
01:20:55 THEIR PRESENTATION AND THEN WE WILL GO TO PUBLIC COMMENT.
01:21:02 >> MADAM CHAIR AND THE COMMITTEE THANK YOU FOR THE
01:21:04 OPPORTUNITY TO BE HERE TODAY. WE WANT TO COVER THREE MAIN
01:21:07 THINGS TODAY WE WANT TO TALK ABOUT OUR PHONES AND THE
01:21:11 HANDLING OF THOSE WE WANT TO TALK ABOUT THE PRIOR
01:21:14 AUTHORIZATION PROCESS AND THEN VERY SPECIFICALLY ON ONCOLOGY
01:21:17 AND WHAT WE HAVE DONE ON A PROACTIVE WAY FOR PEER TO PEER
01:21:21 OUTREACH. SO MY NAME IS TIM LIEB.
01:21:22 I'M A SENIOR VICE PRESIDENT OF COMMERCIAL MARKETS FOR BLUE
01:21:26 SHIELD OF CALIFORNIA AND I'M JOINED BY DR. KAY JUDGE CHIEF
01:21:30 MEDICAL OFFICER AND A PHYSICIAN AT BLUE SHIELD OF CALIFORNIA
01:21:36 BLUE SHIELD OF CALIFORNIA. >> OUR MISSION IS TO CREATE A
01:21:38 HEALTH CARE SYSTEM WORTHY OF OUR FAMILY AND FRIENDS IS
01:21:41 SUSTAINABLY AFFORDABLE. WE HAVE ENJOYED OVER 20 YEAR
01:21:44 RELATIONSHIP WITH THE CITY AND COUNTY OF SAN FRANCISCO
01:21:47 AND WE HOPE THAT OVER THAT ENTIRE TIME WE HAVE
01:21:48 DEMONSTRATED OUR RESPONSIBILITY TO ADMINISTER YOUR PROGRAMS
01:21:52 AND TO REALLY TO SHOW WHAT IT MEANS TO ACTUALLY SERVE THOSE
01:21:59 WHO SERVE OUR COMMUNITY. WE'RE NOT ALWAYS PERFECT BUT
01:22:04 THROUGHOUT THOSE TIME AND THROUGHOUT THE PERIOD OF WE
01:22:08 WORKED WITH YOU, WE HAVE SHOWN THAT WE WILL STEP UP WHEN THERE
01:22:09 ARE ISSUES HOW DO WE ACTUALLY WORK TOGETHER TO ADDRESS THOSE
01:22:12 AND MAKE SURE THAT WE'RE DELIVERING A PROGRAM THAT WE
01:22:16 CAN ALL BE PROUD OF FOR YOUR MEMBERS BUT WE TAKE IT
01:22:20 SERIOUSLY WHEN WE FALL SHORT WHETHER THAT'S FROM A PHONE
01:22:23 SUPPORT OR AN ESCALATION PROCESS OR SIMPLY WHAT SERVICES
01:22:27 THAT PEOPLE NEED. WE ALWAYS AIM TO IDENTIFY WHAT
01:22:31 WAS THE ACTUAL BREAKDOWN AND MAKE SURE WE CAN ACT ON
01:22:35 THAT QUICKLY. WE'RE NOT GOING TO BE ABLE TO
01:22:39 SPEAK TO VERY TO ANYONE'S SPECIFIC ISSUES.
01:22:43 YOU KNOW, THAT'S JUST NOT SOMETHING WE CAN DO BUT WE CAN
01:22:46 ASSURE YOU THAT WE ARE TAKING ALL OF THIS SERIOUS.
01:22:48 WE RECOGNIZE WHAT WE NEED TO DO.
01:22:50 ONE OF THE KEY ITEMS THAT WE DID RIGHT AWAY WAS TOOK A
01:22:54 COMPREHENSIVE LOOK AT ALL OF OUR PROCESSES AND SPECIFICALLY
01:22:57 WE LOOKED AT THE CUSTOMER AND PROVIDER SUPPORT.
01:23:01 WE LOOKED AT OUR PEER TO PEER REVIEW PROCESS AND ESPECIALLY
01:23:06 SUPPORT FOR THOSE INDIVIDUALS THAT ARE RECEIVING CARE LIKE
01:23:07 CANCER ONE WE RECOGNIZE THERE WERE GAPS IN THE HANDLING OF
01:23:13 THE PHONES. WE PUT TRAININGS AND SYSTEMS
01:23:17 IN PLACE TO MAKE SURE THAT WE WERE ACTUALLY ADDRESSING AND WE
01:23:21 COULD MOVE THOSE INDIVIDUALS TO THE CARE THAT THEY NEEDED.
01:23:24 SIMPLY PUT, WE WANTED TO MAKE SURE THAT THERE WAS NO WRONG
01:23:26 DOOR COMING IN. THERE WOULD BE NO ONE SPENT ON
01:23:29 THE PHONES. THEY WOULD GET TO THE PEOPLE
01:23:30 THAT THEY NEEDED TO SPECIFIC TO PRIOR OFF AS IT WAS STATED
01:23:36 THAT'S PART OF MANAGED CARE PRIOR AUTHORIZATION IS A CHECK
01:23:43 AND BALANCE IT'S TO HOW TO ADDRESS PATIENT SAFETY UTILIZE
01:23:47 THE LATEST EVIDENCE BASED GUIDELINES AND NOW TO SPEAK
01:23:51 MORE ABOUT THAT AS DR. KAY JUDGE THANK YOU, TIM.
01:23:55 >> THANK YOU. CHAIR GOOD MORNING TO THE
01:23:58 MEMBERS OF THE COMMITTEE AND TO EVERYONE SITTING HERE LISTENING
01:24:02 AS MY NAME IS KATE JUDGE AS CHIEF MEDICAL OFFICER I'M
01:24:06 GUIDED BY ONE PRINCIPLE THROUGH MY CAREER AND THAT IS THE
01:24:11 HIPPOCRATIC OATH DO NO HARM. MY NORTHSTAR IS TO MAKE SURE
01:24:17 OUR MEMBERS GET THE CARE THEY NEED QUICKLY AND WITHOUT
01:24:18 UNNECESSARY BARRIERS. AT BLUE SHIELD OF CALIFORNIA
01:24:25 OUR APPROACH TO CARE IS BUILT AROUND CLINICAL QUALITY SAFETY
01:24:31 AND CONSISTENCY CARE DECISIONS HAVE TO BE CLINICALLY
01:24:35 APPROPRIATE. THEY HAVE TO BE CLEAR AND WE
01:24:39 FEEL THEY HAVE TO BE RELIABLE AND THOSE ARE JUST WORDS
01:24:46 AND THEY DON'T COUNT IT ONLY WORKS WHEN IF THAT TRANSLATES
01:24:50 INTO A REAL WORLD EXPERIENCE THAT WORKS FOR OUR MEMBERS.
01:24:54 AND FRED, WE'RE LISTENING. >> WE'RE LISTENING AND AND WE
01:25:01 ARE LISTENING AND EVOLVING. >> I WANT TO HIGHLIGHT TWO
01:25:06 THINGS THAT WE'VE DONE SINCE JANUARY AS MEDICINE IS AN
01:25:09 ITERATIVE PROCESS. MEDICINE IS COMPLEX, CARE OF
01:25:13 ELDERLY PERSONS IS COMPLEX AND AS SUPERVISOR CHEN SAID,
01:25:17 THIS IS BOTH A NATIONAL CHARGE AND ALSO FOR US IN THE CITY
01:25:24 AND STATE OF CALIFORNIA CITY OF SAN FRANCISCO WE DID TWO THINGS
01:25:29 WE RELOOKED AT OUR ONCOLOGY PROCESS.
01:25:32 WE WANTED TO BE APPROPRIATELY PROACTIVELY REACT LIVE AND WE
01:25:37 LOOKED AT OUR ONCOLOGY PROCESS AND WE SAID LET US ALIGN OUR
01:25:41 ONCOLOGISTS IN THE COMMUNITY WITH SAME SPECIALTY ONCOLOGISTS
01:25:45 FOR THE PURPOSES OF PRIOR AUTHORIZATION.
01:25:48 >> SO WE'VE SELECTED SAME SAME SPECIALTY REVIEW FOR ONCOLOGY
01:25:52 SO THAT ONCOLOGISTS ARE REVIEWING ONCOLOGY CASES.
01:25:55 THESE ARE BOARD CERTIFIED SPECIALISTS.
01:25:57 THEY HAVE DEEP FAMILIARITY IN MEDICAL ONCOLOGY, RADIATION
01:26:00 ONCOLOGY, CANCER TREATMENT AND THEY'RE THE ONES WHO ARE
01:26:04 MAKING THE DETERMINATIONS AND THEY ARE GUIDED BY
01:26:08 NATIONALLY RECOGNIZED GUIDELINES INCLUDING NCCN.
01:26:12 BLUE SHIELD DOES CONTINUE TO OVERSEE AND MANAGE THAT APPEAL
01:26:16 AND THIS WORK AND WE WANT TO MAKE SURE THAT THESE DECISIONS
01:26:19 ARE CONSISTENT AND THAT OUR MEMBERS RIGHTS ARE FULLY
01:26:20 PROTECTED. >> I ALSO WANT TO ACKNOWLEDGE
01:26:24 AS A PHYSICIAN THAT GUIDELINES ARE NOT ALWAYS BLACK AND WHITE
01:26:30 AND THESE ARE THE CASES WHERE RESEARCH IS AHEAD OF POLICY.
01:26:34 RESEARCH IS AHEAD OF GUIDELINES AS NEW AND INNOVATIVE
01:26:39 MEDICATIONS ARE OUT THERE AND WE HAVEN'T HAD A
01:26:43 STANDARDIZED NATIONAL PROTOCOL YET.
01:26:46 AND IN THOSE CASES WE DECIDED LET'S DO SOMETHING PROACTIVE
01:26:48 THIS IS INDUSTRY STANDARD. I DON'T KNOW OF ANY HEALTH PLAN
01:26:51 THAT'S DOING THAT RIGHT NOW BUT WHAT WE'RE DOING IS WHEN WE SEE
01:26:54 THAT WE MIGHT NOT BE ALIGNED BASED ON THE GUIDELINES WE'RE
01:26:58 LOOKING AT AND WHAT THE PHYSICIANS ARE LOOKING AT, WE
01:27:01 ARE INSTITUTING PRIOR TO A DENIAL, A PROACTIVE OUTREACH
01:27:05 WE'RE PICKING UP THE PHONE AND AN ONCOLOGIST IS CALLING
01:27:08 THEM COLLEGES AND SAYING HEY, THIS IS WHAT I'M SEEING WHAT
01:27:12 ARE YOU SEEING? WHERE'S THE DIFFERENCE AND HOW
01:27:13 CAN WE BOTH ALIGN ON SOMETHING THAT IS RIGHT FOR THE MEMBER?
01:27:17 AND THIS IS SOMETHING THAT WE STARTED IN THE BEGINNING OF
01:27:20 JANUARY, JANUARY 2ND I BELIEVE WE'RE ALWAYS LISTENING WE
01:27:27 IDENTIFY THAT THE REPORTS OF A PRIOR PROCESS THAT WEREN'T
01:27:31 WORKING WELL ENOUGH FOR MEMBERS AND WE'RE LOOKING AT IT
01:27:35 HONESTLY AND WE'RE ATTEMPTING TO BUILD SOMETHING BETTER
01:27:37 AND THIS IS OUR COMMITMENT AND WE ALSO REALIZE THIS IS NOT
01:27:42 A ONE TIME COMMITMENT. MEDICINE IS ITERATIVE CHANGES
01:27:46 ITERATIVE AND SO IS IMPROVEMENT WHERE WE WANT TO BE CONTINUOUS,
01:27:50 WE WANT TO BE COLLABORATIVE AND WE WANT TO BE WORTHY OF THE
01:27:53 MEMBERS AND THE COMMUNITIES THAT WE SERVE.
01:27:54 THANK YOU ALL FOR YOUR OPPORTUNITY TO SPEAK TODAY
01:27:58 AND YOUR CONTINUED PARTNERSHIP ON BEHALF OF SAN FRANCISCO
01:28:01 MEMBERS TODAY I JUST WANT TO REINFORCE OUR COMMITMENT TO THE
01:28:05 CITY AND COUNTY WE FULLY RECOGNIZE HEALTH CARE IS
01:28:09 INCREDIBLY PERSONAL AND GETTING THE RIGHT CARE AND THE TIMING
01:28:13 OF THAT IS INCREDIBLY IMPORTANT.
01:28:14 WE HEAR YOU KNOW WHAT WHAT HAS OCCURRED WE TAKE MEMBERS
01:28:20 CONCERNS INCREDIBLY SERIOUS WHEN WE FALL SHORT IT'S ALWAYS
01:28:24 MOMENTS TO LEARN BUT WE RECOGNIZE OUR ROLE AND OUR ROLE
01:28:28 IS TO MAKE SURE WE'RE FOLLOWING POLICY.
01:28:29 WE'RE PUTTING IN PLACE THE THINGS THAT PROTECT PATIENT
01:28:33 SAFETY. AND SO WE WANT TO THANK YOU FOR
01:28:34 YOUR TIME TODAY. WE DO WELCOME QUESTIONS AND WE
01:28:37 RECOGNIZE THAT WILL COME AFTER PUBLIC COMMENT.
01:28:40 >> THANK YOU. THANK YOU.
01:28:43 AND SO WITH THAT MR. CLARK, LET'S GO TO PUBLIC COMMENT.
01:28:48 >> YES, WE'RE NOW OPENING PUBLIC COMMENT FOR THIS ITEM
01:28:51 NUMBER EIGHT IF WE HAVE ANY MEMBERS OF THE PUBLIC WHO WISH
01:28:53 TO ADDRESS THIS COMMITTEE, FEEL FREE TO LINE UP ALONG THOSE
01:28:56 CURTAINS AND AS SOON AS I HAVE MY FIRST SPEAKER ON A
01:29:00 MICROPHONE I COULD START YOUR TIME AT TWO MINUTES EACH
01:29:04 SPEAKER WILL HAVE TWO MINUTES TO ADDRESS THIS COMMITTEE.
01:29:06 >> FIRST SPEAKER PLEASE. >> MY NAME IS HELEN HORVATH.
01:29:21 I'M A RETIRED SAN FRANCISCO FIREFIGHTER PARAMEDIC I
01:29:24 RECEIVED MY HEALTH INSURANCE THROUGH THE SAN FRANCISCO
01:29:26 HEALTH SERVICE SYSTEM WITH BLUE SHIELD.
01:29:29 >> MY HUSBAND KEN JONES HERE IS ALSO A RETIRED FIREFIGHTER.
01:29:32 HE LEFT BLUE SHIELD AND SWITCHED TO STRAIGHT
01:29:35 MEDICARE IN FEBRUARY BECAUSE OF THE BARRIERS BLUE SHIELD PLACED
01:29:37 ON HIS CANCER CARE. KEN'S LIVING WITH WORK RELATED
01:29:42 STAGE FOUR METASTATIC LUNG CANCER IT'S AGGRESSIVE AND FAST
01:29:47 GROWING. WHAT STARTED AS A PIECE SIZED
01:29:48 TUMOR IN HIS NECK GREW TO THE SIZE OF AN EGG IN JUST SIX
01:29:53 WEEKS AND THERE ARE MANY MORE TUMORS INSIDE HIS BODY THAT WE
01:29:56 CAN'T SEE. DESPITE THIS URGENCY, BLUE
01:29:57 SHIELD DENIED THE TREATMENT RECOMMENDED BY HIS ONCOLOGIST
01:30:02 AT UCSF A WORLD RENOWNED LUNG CANCER EXPERT.
01:30:05 >> THIS IS A TREATMENT INTENDED TO SLOW THE PROGRESSION OF HIS
01:30:09 DISEASE. BLUE SHIELD OVERRODE THAT
01:30:12 EXPERT JUDGMENT CLAIMING IT WASN'T THE STANDARD REGIMEN.
01:30:16 >> THESE DENIALS DELAYED CARE DRAINED HIS MEDICAL TEAM
01:30:20 AND CAUSED US ENORMOUS DISTRESS .
01:30:23 EVERY DELAY MATTERS WHEN THAT CANCER IS GROWING FAST BECAUSE
01:30:28 BLUE SHIELD WOULD NOT COVER THE TREATMENT HIS ONCOLOGIST
01:30:32 PRESCRIBED WE PAID $50,000 OUT-OF-POCKET FOR JUST ONE
01:30:38 ROUND TO MOVE FORWARD WITH HIS CARE.
01:30:39 I APPRECIATE BLUE SHIELD'S CHANGES BUT WE AND REALLY THE
01:30:45 MANY PEOPLE AROUND THE COUNTRY THAT DONATED TO OUR GO FUND ME
01:30:47 CAMPAIGN ARE STILL OUT $50,000 THAT SHOULD BE BLUE SHIELD'S.
01:30:53 >> SINCE SWITCHING TO STRAIGHT MEDICARE, KEN HAS RECEIVED
01:30:54 EVERY TREATMENT HIS DOCTORS ORDERED WITHOUT DELAY.
01:30:57 EVEN GETTING PAIN MEDICATION BECAME EASIER UNDER BLUE SHIELD
01:31:01 DEALS. THOSE PRESCRIPTIONS WERE
01:31:02 REPEATEDLY HELD UP WHILE HIS PAIN WORSENED.
01:31:05 BLUE SHIELD CLAIMS THEY'RE FOLLOWING MEDICARE GUIDELINES.
01:31:08 THIS IS SIMPLY NOT TRUE. THEY'RE MAKING CHOICES THAT
01:31:10 PROTECT THEIR PROFITS AT THE EXPENSE OF PATIENTS.
01:31:13 I'M ASKING YOU TO HOLD BLUE SHIELD ACCOUNTABLE.
01:31:16 NO ONE FIGHTING FOR THEIR LIFE SHOULD HAVE TO FIGHT FOR FIGHT
01:31:18 THEIR INSURANCE COMPANY AT THE SAME TIME.
01:31:20 >> THANK YOU AND THANK YOU MUCH FOR ADDRESSING THIS COMMITTEE.
01:31:24 >> NEXT SPEAKER PLEASE. I'M HI MY NAME IS THERESA
01:31:31 PALMER. >> I'M A RETIRED CITY EMPLOYEE.
01:31:35 I WORKED AT LAGUNA HONDA. I'M A M.D. GERIATRICIAN AND MY
01:31:43 CASE OF DENIAL IS RELATIVELY MINOR.
01:31:46 I HAD A KNEE REPLACEMENT IN MID-MARCH AND BLUE SHIELD
01:31:51 REFUSED TO PAY FOR THE PAIN MEDICATIONS THAT I NEEDED
01:31:57 AND SO I WAS FACED WITH PAYING BETWEEN 1000 AND $2000 OUT OF
01:32:04 POCKET IN IN A SITUATION LIKE A KNEE REPLACEMENT IF YOUR PAIN
01:32:08 IS NOT WELL CONTROLLED YOU CANNOT REHAB JOB AND YOU END UP
01:32:12 WITH A KNEE THAT DOESN'T BEND AND YOU END UP GOING DOWN STEPS
01:32:20 ONE STEP AT A TIME FOR THE REST OF YOUR LIFE AND SO LUCKILY I
01:32:24 AM PRIVILEGED. I HAD $1,000 BUT I'M NOT SURE
01:32:28 THAT A RETIRED SCHOOLTEACHER OR A RETIRED JANITOR WOULD.
01:32:32 >> THE PROBLEM IS THESE ARE MEDICATIONS THAT MEDICARE
01:32:36 APPROVES. IT'S NOT EVEN THAT MUCH MONEY
01:32:40 FOR A BLUE SHIELD. IT'S A KNEE DENIAL.
01:32:43 THERE IS NO NEED TO DENY A LOT OF THE STUFF THAT BLUE SHIELD
01:32:50 DENIES AND IT OCCURS AT A TIME WHEN YOU NEED THE CARE RIGHT
01:32:54 AWAY AND NOT ONLY DOES IT DELAY THE CARE YOU NEED RIGHT AWAY
01:32:59 BUT IT PLACES A BURDEN ON A VERY SICK PATIENT AND A FAMILY
01:33:06 THAT IS UNDER DISTRESS CARING FOR THEM THIS IS REALLY
01:33:10 UNACCEPTABLE. IT'S UNNECESSARY AND BLUE
01:33:11 SHIELD NEEDS TO STOP PRACTICING MEDICINE WITHOUT A LICENSE
01:33:17 AND LET THE CLINICAL JUDGMENT GO TO THE PERSONAL PHYSICIAN
01:33:21 WHETHER IT'S A CASE OF SURVIVAL FROM CANCER OR BEING ABLE TO
01:33:25 WALK NORMALLY FOR THE REST OF YOUR LIFE.
01:33:28 THANK YOU AND THANK YOU MUCH THERESA PALMER.
01:33:31 NEXT SPEAKER PLEASE. >> A PORTION SERVES.
01:33:39 >> THANKS FOR LISTENING. MY NAME IS MIRIAM PINGEL.
01:33:41 I'M A RETIRED LIEUTENANT FROM THE SAN FRANCISCO POLICE
01:33:45 DEPARTMENT AND IN A NUTSHELL 20TH OF A MONTH AGO I HAD MY
01:33:51 KNEE REPLACED. >> TOTAL KNEE REPLACEMENT.
01:33:57 IT DIDN'T WORK. FROM DAY ONE IT DIDN'T WORK.
01:34:01 >> I WAS REFERRED TO A DOCTOR AT UCSF.
01:34:04 THAT DOCTOR WAS AN EXPERT IN WHAT I HAD GOING ON.
01:34:09 ESSENTIALLY I GOT DENIED. I APPEALED IT.
01:34:12 I GRIEVED IT. THEY DENIED IT AGAIN.
01:34:13 I GOT ANOTHER REFERRAL DENIED. I APPEALED IT.
01:34:17 I GRIEVED IT DENIED. >> I THEN WENT TO THEY SENT ME
01:34:25 12 DOCTORS TO GO AND SEE IN THOSE 12 DOCTORS I SAW THEY
01:34:28 SENT ME ELBOW DOCTORS. THEY SENT ME SHOULDER DOCTORS.
01:34:31 THEY SENT ME A MINIMALLY INVASIVE KNEE DOCTORS.
01:34:35 >> IT'S NOT MINIMALLY INVASIVE. I SAW THE ONE DOCTOR THAT THEY
01:34:38 THAT THEY SENT ME THAT SAID THEY COULD DO THIS REVISION.
01:34:42 >> I NEED A TOTAL NEW KNEE. THAT BEING SAID, HE SAID YOU
01:34:46 SHOULD GO SEE A DOCTOR WARD HE'S THE BEST IN THIS SYSTEM.
01:34:50 YOU HAVE TO SEE HIM. >> I WAS DENIED.
01:34:54 I KNOW MY BLUES SHIELD NUMBER. IT'S A NINE DIGIT NUMBER AND I
01:34:58 KNOW IT BY HEART. >> WHY?
01:35:02 BECAUSE I WAS ON THE PHONE. I WAS TALKING TO SUSIE
01:35:06 AND SALLY AND MARY WHO HAD NO IDEA ANYTHING ABOUT ANSWERING
01:35:10 PHONES AND WE DO OUR BEST AND OUR DUE DILIGENCE.
01:35:13 >> IT WAS RIDICULOUS. AT THE END OF THE DAY, BY A
01:35:17 MIRACLE I GOT IN TO SEE DR. WARD.
01:35:21 >> I HAD TWO WEEKS OF SPECIAL TESTING ON THE STUFF THAT CAME
01:35:24 OUT OF MY KNEE. WENT TO NEW JERSEY FOR TWO
01:35:25 WEEKS. I WAS SO FOLLOW UP WITH HIM THE
01:35:28 NEXT DAY BLUE SHIELD CALLED UCSF AND CANCELED MY
01:35:33 APPOINTMENT AND SAID TOO BAD IT'S NOT COVERED.
01:35:37 IT WAS A MISTAKE. WELL THAT'S A MISTAKE.
01:35:38 CAN YOU IMAGINE THE STRESS WHETHER KNOWING YOU HAVE AN
01:35:41 INFECTION OR REJECTION OF YOUR KNEE RESTRICTION INFECTION TIME
01:35:45 HAS EXPIRED. YOU KNOW WHAT?
01:35:49 I UNDERSTAND THAT. BUT YOU KNOW WHAT?
01:35:50 I WORKED FOREVER TO HAVE MY DRESSINGS COMMITTEE.
01:35:53 >> THANK. >> I DO APOLOGIZE FOR CUTTING
01:35:56 ANYBODY OFF BUT WE ARE TIMING EACH SPEAKER WITH TWO MINUTES
01:36:00 AND I HAVE TO ENFORCE THAT ACROSS THE BOARD.
01:36:01 NEXT SPEAKER, PLEASE. >> TIM O'BRIEN I'VE
01:36:10 SECRETARY-TREASURER FOR THE RETIRED FIREFIGHTERS
01:36:11 AND SPOUSES ASSOCIATION AND WITH THESE ARE SEVERE CASES
01:36:18 BUT THERE ARE ALSO OTHER CASES THAT ARE NOT SEVERE THEY GET
01:36:22 PUT ON. >> YESTERDAY I RECEIVED A CALL
01:36:25 FROM A FIREFIGHTER. HIS SPOUSE HAS HAD TREATMENTS
01:36:30 FOR MANY YEARS. SHE RECEIVED SHOTS TWICE A YEAR
01:36:36 FOR BRITTLE BONES CAUSED BY CANCER AND SO NOW SHE SWITCHED
01:36:40 OF COURSE TO BLUE SHIELD TO HAVE THIS SHOT AND NOW SHE
01:36:44 THINKS MAYBE NEXT WEEK IT MIGHT BE APPROVED.
01:36:48 >> SO SOMETHING IN THAT SYSTEM IS JUST SLOW.
01:36:56 >> FORTUNATELY IT'S NOT A LIFE OR DEATH SITUATION BUT IT'S
01:36:59 JUST PERHAPS A SYMPTOM OF WHAT'S GOING ON.
01:37:03 WHY DOES IT TAKE SO LONG FOR A PERSON WHO HAS BEEN UNDER
01:37:07 TREATMENT FOR MANY YEARS AND THEN FIND THAT WELL, MAYBE
01:37:11 SHE'LL GET A SHOT SHE DOESN'T KNOW YET BECAUSE SHE HASN'T HAD
01:37:15 A RESPONSE BUT SHE BELIEVES THAT MAYBE NEXT WEEK.
01:37:18 SO HOPEFULLY BLUE SHIELD WILL RESPOND AND TAKE CARE OF IT.
01:37:23 >> THANK YOU AND THANK YOU, TIM O'BRIEN FOR ADDRESSING THIS
01:37:27 COMMITTEE. NEXT SPEAKER HI, MY NAME IS
01:37:30 JOHN SKI DOSTOEVSKY. >> I AM THE PRESIDENT OF THE
01:37:35 RETIRED EMPLOYEES OF CITY COUNTY OF SAN FRANCISCO.
01:37:37 I'VE TALKED TO HUNDREDS OF OUR MEMBERS WHO GET DENIED WE'RE
01:37:41 SENIOR CITIZENS. >> WHAT HAPPENS WHEN WE'RE
01:37:44 DENIED? A SENIOR CITIZEN SAYS OH I'M
01:37:45 DENIED. I HAVE TO FIND ANOTHER OPTION.
01:37:49 SO THAT'S WHAT THEY DO. A LOT OF TIMES THEY DON'T EVEN
01:37:53 FIGHT IT. THEY DON'T HAVE FIGHT LEFT
01:37:56 IN THEM, A LOT OF THEM TECHNOLOGY.
01:37:57 WE'RE GIVEN A A SYSTEM A EMAIL TO CALL HEALTH SERVICE SYSTEM
01:38:04 ABOUT OUR COMPLAINTS ON OUR DENIALS.
01:38:08 WHAT IS IT? IT'S AN EMAIL.
01:38:08 THANK YOU VERY MUCH. >> I HAVE MEMBERS THAT DON'T
01:38:11 HAVE CELL PHONES NO COMPUTERS. THEY HAVE A LANDLINE AT HOME.
01:38:18 92 YEARS OLD BETTY IS CALLING ME ASKING ME WHAT DO I DO?
01:38:26 AND I SAY YOU'VE GOT TO DO WHAT THEY WANT YOU TO DO.
01:38:30 >> THAT'S NOT GOOD ENOUGH. THE DENIALS THAT ARE HAPPENING
01:38:34 ARE NOT OKAY. HEALTH SERVICE HAS PHONE CALLS
01:38:42 THAT THEY GET. WHAT DO WE GET?
01:38:43 AN ANSWERING MACHINE. AN EMAIL FOR PEOPLE DON'T HAVE
01:38:47 IT. COME ON.
01:38:50 THIS IS RIDICULOUS. I PUT OUT A NOTE A LETTER FROM
01:38:54 HEALTH SERVICE IN OUR NEWSLETTER AND I PUT A REBUTTAL
01:38:58 ON IT SAYING THEY'RE LEAVING OUR MOST VULNERABLE MEMBERS
01:39:01 BEHIND. >> AND IT HAPPENS ALL THE TIME
01:39:08 . >> THANK YOU MUCH JOHN SKI
01:39:09 TUSTIN US FOR ADDRESSING THIS COMMITTEE NEXT SPEAKER.
01:39:12 >> HI GOOD MORNING I'M MINDY TALMAGE I'M A RETIRED
01:39:15 FIREFIGHTER THAT PROUDLY SERVED OUR CITY FOR 24 YEARS.
01:39:18 I'M EMBARKING ON THE TRANSITION INTO MEDICARE RIGHT NOW.
01:39:23 >> I'M VERY BLESSED THAT I HAVE A BEST FRIEND WHO'S VERY
01:39:27 ETHICAL AND SHE SHE IS AN INSURANCE AGENT THAT WRITES
01:39:31 ONLY MEDICARE PLANS. SHE'S FULLY EDUCATED ME ON THIS
01:39:35 AND I'M HERE TO ENLIGHTEN YOU AND TO INFORM YOU OF THE
01:39:39 PROBLEM THAT IS IT'S MUCH MORE INSIDIOUS THAN BLUE SHIELD
01:39:43 DENIALS ALONE. >> THIS PROBLEM GOES ACROSS THE
01:39:46 BOARD WITH INSURANCE COMPANIES AND THEIR PLAN OFFERINGS TO
01:39:50 GOVERNMENT RETIREES. >> THE PROBLEM IS THEIR
01:39:54 MEDICARE ADVANTAGE PLANS WHICH HAVE CORPORATE PROFESSIONALS
01:39:59 MAKING DECISIONS ABOUT OUR HEALTH CARE.
01:40:02 THE ADVANTAGE PLANS ARE YET AGAIN ANOTHER TACTIC OF THE
01:40:06 INSURANCE COMPANY TO LINE THE POCKETS OF CORPORATE LEADERS
01:40:07 WITH MONEY SPECIFICALLY BY DENYING CARE THEY ARE CHEAP ALL
01:40:13 INCLUSIVE PACKAGES DRESSED UP WITH A LITTLE BOW.
01:40:17 >> THE HIDDEN CAVEATS ARE THAT PLAN PARTICIPANTS ARE LIMITED
01:40:21 TO A NETWORK OF DOCTORS AND THE DOCTORS MUST GET PRIOR
01:40:25 AUTHORIZATION FROM THE INSURANCE PLAN.
01:40:26 >> THE PLAN CAN DELAY THE CARE. THE PLAN CAN DENY THE CARE EVEN
01:40:30 IF THE CARE IS APPROVED, THE PROCESS CAN TAKE AN UNKNOWN
01:40:34 AMOUNT OF TIME. >> YES, THEIR DECISIONS CAN BE
01:40:37 APPEALED BUT THAT'S A LONG AND TEDIOUS.
01:40:40 MANY OLDER PATIENTS WOULD FIND THAT DIFFICULT AND OFTEN GIVE
01:40:44 UP AGAIN DELAYING CARE. >> THIS CAN MEAN LIFE OR DEATH
01:40:48 MAY CONTINUE. >> YOU HAVE 30S.
01:40:51 >> ON THE OTHER HAND, MEDICARE SUPPLEMENT PARTICIPANTS CAN SEE
01:40:55 ANY DOCTOR OR GO TO ANY TREATMENT CENTER THAT ACCEPTS
01:40:58 MEDICARE. >> 90 8% OF DOCTORS
01:41:00 AND TREATMENT CENTERS IN THE US ACCEPT MEDICARE WITHOUT PRIOR
01:41:03 AUTHORIZATION REQUIREMENTS OF MY DOCTOR ORDERS A TEST OR
01:41:08 TREATMENT I GET IT. I'M GOING TO SKIP TO THE END
01:41:12 HERE BUT I HAVE A LOT TO SAY. >> BUT IT BEGS THE QUESTION WHY
01:41:19 AREN'T WE OFFERED ORIGINAL MEDICARE THROUGH THE CITY
01:41:22 AND COUNTY OF SAN FRANCISCO? THANK YOU MUCH FOR ADDRESSING
01:41:23 THIS COMMITTEE. NEXT SPEAKER PLEASE.
01:41:28 >> GOOD MORNING SUPERVISORS. MY NAME'S ADAM WOOD.
01:41:32 I'M THE VICE PRESIDENT OF THE SAN FRANCISCO FIREFIGHTERS
01:41:34 CANCER PREVENTION FOUNDATION. CANCER IS CURRENTLY THE NUMBER
01:41:39 ONE CAUSE OF WORK RELATED DEATH FOR FIREFIGHTERS AND FOR OUR
01:41:44 RETIREES. THAT ELEVATED RISK IS
01:41:45 COMPOUNDED BY THE ELEVATED RISK THEY FACE WITH AGE.
01:41:48 SO I WANT TO DEEPLY THANK THE SUPERVISORS ESPECIALLY
01:41:52 SUPERVISOR CHAN AND DORSEY FOR HOLDING THIS HEARING AND FOR
01:41:56 THEIR ADVOCACY ON THIS ISSUE. >> I ALSO WANT TO THANK THE
01:41:59 HEALTH SERVICE SYSTEM FOR SOLICITING AND FACILITATE
01:42:03 TESTIMONY FROM BENEFICIARIES ABOUT EXPERIENCES WITH DENIAL
01:42:07 AND DELAYS OF TREATMENT. I'M HOPING AL'S EMAIL
01:42:08 EXPERIENCE WAS A ONE OFF GLITCH BECAUSE I KNOW THE ATTEMPT WAS
01:42:12 MADE BUT WHAT WE'RE HEARING IS AN ALARMING RATE OF DENIALS
01:42:16 AND AN EVEN HIGHER RATE OF DELAYS IN TREATMENT APPROVAL
01:42:19 AND FOR RETIREES WITH LATE STAGE CANCER A DELAY
01:42:26 IN TREATMENT CAN LEAD TO A DRASTIC REDUCTION IN QUALITY OF
01:42:27 LIFE AND LENGTH OF LIFE BECAUSE IT GIVES THE CANCER FREE REIN
01:42:31 TO WREAK HAVOC IN THE BODY WITHOUT ANY COUNTERMEASURES.
01:42:35 >> SO KEN JONES WHO BRAVELY STEPPED FORWARD AND ALERTED US
01:42:39 TO THIS PROBLEM AND WHO'S HERE WITH US TODAY RETIRED
01:42:42 FIREFIGHTER KEN JONES. I THINK HIS EXPERIENCE SHEDS A
01:42:46 LIGHT ON THE ROOT OF THIS PROBLEM.
01:42:47 AND HELEN SPOKE ABOUT IT WHEN KEN WAS ABLE TO SWITCH TO
01:42:50 STRAIGHT MEDICARE HIS ENTIRE TREATMENT PLAN THAT WAS
01:42:53 RECOMMENDED BY HIS TREATING PHYSICIAN DR. GOODMANS WAS
01:42:57 APPROVED. SO IT DOES NOT APPEAR THAT THE
01:43:01 BLOCK IS IN THE MEDICARE SYSTEM WRIT LARGE.
01:43:04 >> IT WAS WITHIN BARRIERS IN THE MEDICARE ADVANTAGE
01:43:05 SYSTEM THAT HE WAS PROVIDED WITH FROM BLUE SHIELD.
01:43:10 THAT'S WHERE THE SCRUTINY HAS TO GO IN THIS INVESTIGATION.
01:43:13 I THINK ALL OF OUR GOALS HERE TODAY IS TO MAKE SURE THAT
01:43:17 THESE CITY WORKERS, FIREFIGHTERS AND OTHERS WHO
01:43:20 DEDICATED THEIR LIVES IN SERVICE OF THEIR FELLOW
01:43:21 CITIZENS GET THE TREATMENT THEY NEED WHEN THEY NEED IT.
01:43:24 >> THANK YOU. AND THANK YOU, ADAM LLOYD.
01:43:28 >> NEXT SPEAKER, PLEASE. HI.
01:43:32 MY NAME IS ONE ADA STOCKWELL. I'M A RETIRED S.F. P.D. OFFICER
01:43:35 AND I WAS SUPPOSED TO TALK ABOUT IRENE BRUNS CASE WHERE
01:43:39 BLUE SHIELD APPROVES MEDICATION FOR HER KNEE SHOTS.
01:43:43 SHE GOES TO THE DOCTOR. IT'S BEEN DENIED.
01:43:47 SHE HAS TO PAY HERSELF TWICE LAST YEAR $2,900.
01:43:50 DO YOU THINK THAT'S GOING TO BREAK BLUE SHIELD?
01:43:54 SHE CAN'T WALK IF SHE DOESN'T HAVE THIS MEDICATION IN HER
01:43:58 KNEES. BUT MORE IMPORTANTLY, THEY'RE
01:44:01 JUST GOING TO KEEP SCREWING WITH HER BECAUSE THAT'S WHAT
01:44:03 THEY DO. >> I HAVE A QUESTION FOR YOU.
01:44:06 I SENT YOU AND YOU CHAN AND DORSEY AN EMAIL LAST THREE
01:44:13 MONTHS AGO ASKING YOU TO USE THE HSF SYSTEM AND SEND OUT
01:44:17 EMAILS AND FIND OUT HOW MANY PEOPLE ARE BEING DENIED.
01:44:21 YOU DON'T HAVE TO VIOLATE HIPA. YOU JUST ASK THEM A SIMPLE
01:44:25 QUESTION. >> HOW MANY PEOPLE ARE BEING
01:44:26 DENIED BY BLUE SHIELD? AND IF YOU DO IT I THINK YOU'RE
01:44:30 GOING TO BE SHOCKED. I GOT NO RESPONSE FROM EITHER
01:44:33 ONE OF YOU. >> I SENT IT TO THE MAYOR ALSO
01:44:35 . HE AT LEAST HAD HIS OFFICE
01:44:36 RESPOND TO ME BUT HE HASN'T DONE ANYTHING EITHER.
01:44:40 THIS IS BORDERING ON ELDER ABUSE.
01:44:44 IN CASE YOU DIDN'T KNOW IT AND I WOULD ENCOURAGE THESE
01:44:47 PEOPLE TO FILE POLICE REPORTS AND LISTS BLUE SHIELD AS THE
01:44:51 SUSPECT BECAUSE THEY'RE DOING IT ON PURPOSE.
01:44:52 THEY'RE ASKING FOR EVERYONE'S MEDICAL RECORDS.
01:44:55 THEY'RE NOT ENTITLED TO IT. THEY DON'T TELL YOU WHY YOU'RE
01:44:59 BEING DENIED. THEY DON'T TELL YOU ANYTHING.
01:45:03 >> YOU'RE JUST DENIED. TOO BAD.
01:45:04 I LOVE THAT SOUND. >> SO MAYBE YOU GUYS CAN LOOK
01:45:08 AT YOUR EMAILS AND FIND OUT IF IN FACT YOU GOT THAT AND USE A
01:45:12 SYSTEM THAT YOU HAVE THAT IS AVAILABLE TO YOU AND YOU CAN
01:45:19 GET THOSE ANSWERS AND FIND OUT HOW MANY TIMES THESE PEOPLE ARE
01:45:20 DOING THIS. >> THANK YOU AND THANK YOU
01:45:23 RUNNING TO STOCKWELL. NEXT SPEAKER.
01:45:37 NO, IT'S FINE. THANK YOU.
01:45:38 HI. MY NAME IS KEN JONES.
01:45:42 >> I AM THAT KENT JONES. I WASN'T GOING TO I WASN'T
01:45:45 GOING TO SAY ANYTHING BUT ALL THESE BRAVE PEOPLE SPOKE TO THE
01:45:50 SITUATION THAT I FIND MYSELF IN NOW.
01:45:53 SO I FELT I SHOULD SPEAK FOR MYSELF.
01:45:59 THERE WAS A BIG DELAY IN THE TREATMENT THAT I RECEIVED.
01:46:03 AND AS SUCH IT'S GOING TO BE A DELAY OR A DELAY.
01:46:08 SORRY. I DON'T ALWAYS THINK THE RIGHT
01:46:11 WAY. I'VE GOT MET.
01:46:14 IT'S GOING TO NOT ALLOW ME TO EXTEND MY LIFE ANY MORE AND SO
01:46:18 IT JUST SEEMS TO ME THAT THERE ARE INSTITUTIONS THAT ARE MORE.
01:46:26 AND I MEAN I CAN'T BLAME FOR THIS MORE INTERESTED IN MAKING
01:46:30 MONEY THAN THEY ARE AND TAKING CARE OF PATIENTS.
01:46:34 >> AND SO I WISH THAT COULD BE ADDRESSED NOW.
01:46:38 >> I THINK IT'S TOO LATE FOR ME.
01:46:39 IT'S NOT TOO LATE FOR OTHER FIREFIGHTERS AND OTHER PEOPLE
01:46:42 THAT LIVE AND WORK IN THE CITY AND COUNTY OF SAN FRANCISCO.
01:46:45 SO MAYBE SOMETHING CAN BE DONE FOR THEM AND IF NOT FOR ME.
01:46:51 >> THANK YOU. AND THANK YOU MUCH FOR
01:46:55 ADDRESSING THIS COMMITTEE. AND IF WE HAVE NO FURTHER
01:46:58 SPEAKERS IF I CAN TESTIFY, JUST THANK YOU VERY MUCH.
01:47:12 >> UH, MY NAME IS HERBERT WEINER.
01:47:21 I'M A RETIRED 2912 SENIOR SOCIAL WORKER AND I WORKED FOR
01:47:28 THE CITY FROM 1964 THROUGH 2003.
01:47:33 NOW I WAS HOSPITALIZED ONCE FOR A PROCEDURE WHERE I HAD A STENT
01:47:45 REPLACEMENT. >> AFTER THAT REPLACEMENT I WAS
01:47:48 DISCHARGED TO REHAB. REHAB NOTICED VERY LOW BLOOD
01:47:57 PRESSURE AND I HAD TO BE RE HOSPITALIZED AGAIN.
01:48:03 I HAD A VALVE REPLACEMENT AND ALSO REHAB.
01:48:11 NOW WHAT HAPPENED WAS THAT I THERE WAS A I NOTICED THAT I
01:48:18 WAS TO BE DISCHARGED ON FRIDAY MARCH 19TH.
01:48:25 >> FRED CHAN SANCHEZ WHO IS VERY CONCERNED ABOUT A POSSIBLE
01:48:30 REAL LAPSE THAT COULD ACTUALLY BE FATAL IF IT WASN'T ADDRESSED
01:48:38 IN TIME WANTED TO FILE AN APPEAL?
01:48:45 WELL, THAT APPEAL WAS NEVER FULLY PROCESSED AND I WAS I WAS
01:49:00 WONDERING, YOU KNOW, ABOUT THE STATUS OF THE APPEAL
01:49:04 AND EVERYTHING. AS IT TURNED OUT I WAS
01:49:05 DISCHARGED BACK TO THE FRANK RESIDENCE WHERE I PRESENTLY
01:49:12 STAY AND I'M GETTING REHAB. I'M GETTING SERVICES NOW.
01:49:19 I'M WONDERING IF THIS ISN'T A BREACH OF CONTRACT BECAUSE THE
01:49:24 NURSE AND CASE MANAGER WERE NEVER CONTACTED BECAUSE TIME IS
01:49:30 COMERS COMMENCE HEALTH. YES WHICH PROVIDED AN
01:49:38 ASSESSMENT. >> AGAIN SPEAKER'S TIME
01:49:39 AND THIS IS A CLEAR VIOLATION OF THE BLUE SHIELD CONTRACT.
01:49:45 >> THANK YOU MR. WEINER FOR ADDRESSING THIS COMMITTEE IN MY
01:49:51 . THANK YOU.
01:49:55 >> I DID NOT AND YOU KNOW THE BOTTOM LINE, WOLF, THIS IS MY
01:50:05 THANK YOU. >> THEY WOULD SAY WHY WHY NOT?
01:50:09 THANKS FOR HAVING ME HERE. THIS MAY BE FAMILIAR BUT
01:50:17 SOMETIMES IT DOES. >> THANK YOU, MR. WEINER.
01:50:20 WE UNDERSTAND WE WANT TO GO TO BLUE SHIELD FOR ANSWER.
01:50:25 >> YES, I KNOW YOU GET IT. YES, WE DO.
01:50:28 AND AND WITH THAT TO GO AHEAD AND YES, IF WE HAVE NO FURTHER
01:50:32 SPEAKERS. >> MADAM CHAIR, IT COMPLETES
01:50:37 OUR CUE SEE A NORMAL POP OF COMMONS PUBLIC COMMENT IS NOW
01:50:40 CLOSED. I WANT TO THANK EVERYBODY FOR
01:50:41 YOUR PUBLIC COMMENTS TODAY. IF YOU FEEL LIKE YOU HAVE NOT
01:50:44 COMPLETE YOUR PUBLIC COMMENTS PLEASE FEEL FREE TO HAVE IT
01:50:48 IN WRITTEN FORM AND SUBMIT. WE ARE MORE THAN HAPPY TO HAVE
01:50:52 THEM ON THE RECORD BUT I THINK THAT WE ACTUALLY DO UNDERSTAND
01:50:55 FROM THE TESTIMONY FROM PUBLIC COMMENTS TODAY IS WHERE I WOULD
01:50:59 LIKE TO BRING BLUE SHIELD BACK TO BE ABLE TO ANSWER SOME OF
01:51:06 THESE. >> AS YOU HAVE HEARD FROM THE
01:51:13 PUBLIC COMMENTS THAT IT'S NOT JUST ONE CASE FROM KENT JONES.
01:51:17 >> THERE ARE KNEE SURGERY DENIAL, THERE ARE MEDICATION
01:51:21 DENIAL. THERE ARE CONFUSION OF
01:51:25 DIFFERENT CASES. AS YOU HAVE HEARD TODAY.
01:51:28 >> COULD YOU ACTUALLY PROVIDE US A RESPONSE AND INCLUDING
01:51:33 THIS WHAT I'M HEARING AND I WOULD LOVE FOR YOU TO ADDRESS
01:51:37 TODAY IS ALSO THE MEDICARE ADVANTAGE DECISIONS.
01:51:44 PLEASE ELABORATE. >> LET ME FIRST GO A LITTLE
01:51:51 BIT. I WANT TO FIRST SAY, YOU KNOW,
01:51:52 THERE'S BEEN A VARIETY OF ITEMS THAT WE HIGHLY SUPPORT BOTH
01:51:55 WITHIN CALIFORNIA AND AT A FEDERAL LEVEL AROUND HOW TO
01:51:58 EXPEDITIOUSLY MOVE PRIOR OFF NOT FROM AN ELIMINATION.
01:52:02 IT'S ELIMINATION OF WHERE PRIOR OFF IS NOT NECESSARY.
01:52:06 BUT THEN HOW IS IT WHEN WE HAVE THE DATA TO AUTOMATIC APPROVE?
01:52:09 SO THERE HAVE BEEN A NUMBER OF EFFORTS BUT IT DOES REQUIRE
01:52:14 THEN THE NECESSARY INFORMATION TO REALLY VALIDATE THAT IT'S
01:52:15 ALL ALIGNED TO POLICY. ANOTHER ITEM JUST TO NOTE IS WE
01:52:21 ALSO HAVE A CUSTOMER SERVICE THAT SHOULD BE MOVING
01:52:26 EVERYTHING THROUGH AND GETTING EVERYONE TO THE RIGHT LEVEL.
01:52:30 IT'S PART OF WHAT WE DID ON THE PHONE HANDLING BUT AGAIN IF
01:52:33 THERE ARE ISSUES WILL CONTINUE TO GO BACK AND LOOK AT THOSE
01:52:35 AND ENSURE THEY ARE ADDRESSED IN NO WAY, SHAPE OR FORM SHOULD
01:52:38 THAT BE A SERVICE THAT WE'RE DELIVERING.
01:52:42 SO BUT WHAT I'D LOVE IS DR. KAY JUDGE TO TALK A LITTLE BIT
01:52:45 ABOUT THE PROCESS AND COMPARING ORIGINAL MEDICARE TO MEDICARE
01:52:49 ADVANTAGE. >> HE HAS I THINK IT'S VERY
01:52:53 DIFFICULT. >> I'M GOING TO START OUT WITH
01:52:56 TWO PERSONAL ANECDOTES MY WHY I HAD A PARTNER WHO DIED OF
01:53:00 METASTATIC CANCER SO I CAN DON'T STORY REALLY SPOKE TO ME
01:53:04 WHEN I HEARD ABOUT IT. >> THE SECOND THING IS MY
01:53:08 FATHER'S IN PALLIATIVE CARE SO WHEN I MOVED TO CALIFORNIA FROM
01:53:11 MICHIGAN WORKING WITH ANOTHER PLAN I WANTED SOMETHING THAT
01:53:16 WAS MISSION ALIGNED AND I CHOSE BLUE SHIELD BECAUSE BLUE SHIELD
01:53:20 IS A NONPROFIT. WE CAP OUR WE CAPTURE PROFITS
01:53:23 AT 2%. THE REST IS INVEST INVESTED
01:53:26 BACK THE SECOND. >> THE THIRD THING I WANT TO
01:53:30 BRING UP IS I'VE I'VE WORKED IN MEDICARE FROM THE HEALTH
01:53:33 SYSTEM SIDE FROM THE HEALTH PLAN SIDE FOR NOW OVER TWO
01:53:37 DECADES AND OUR POPULATION IS AGING AND THE COSTS ARE
01:53:41 INCREASING. AND YOU'RE RIGHT WHEN ONE OF
01:53:45 OUR MEMBERS WAS TALKING ABOUT MEDICARE VERSUS MEDICARE
01:53:46 ADVANTAGE AND MEDICARE STRAIGHT MEDICARE IS A PPO PRODUCT.
01:53:53 MY FATHER IN PALLIATIVE CARE I'VE ENROLLED IN MEDICARE
01:53:57 ADVANTAGE SPECIFICALLY SO THAT'S WHAT I WOULD CHOOSE FOR
01:53:58 MY FAMILY AND THE REASONS ARE ARE MEDICARE ADVANTAGE IS IS
01:54:04 MANAGED BUT THE PATIENT IS MANAGED.
01:54:05 >> SO WHAT WE FIND ARE FOR MEDICARE ADVANTAGE QUALITY
01:54:09 MEASURES ARE USUALLY BETTER OUTCOMES ARE BETTER AND THERE
01:54:12 THERE ARE STUDIES THAT SHOW WITH DIABETES THAT AMPUTATION
01:54:20 COSTS ARE MARKEDLY REDUCED IN MEDICARE ADVANTAGE BECAUSE
01:54:21 YOU HAVE A PCP WHO'S DOING THE YEARLY ANNUAL VISIT, WHO'S
01:54:25 CHECKING THEM, RIGHT. >> SO WE WE MAY GET A LOT OF
01:54:28 CARE IN MEDICARE STRAIGHT BUT FOR MEDICARE ADVANTAGE WHAT
01:54:32 WE'RE FINDING IS THE QUALITY OF CARE IS BETTER AND I THIS IS I
01:54:35 THINK OF YOUR A PERSONAL DECISION BUT THAT'S JUST MY
01:54:37 PERSPECTIVE. >> I JUST MY APOLOGIES TO FOR
01:54:40 INTERRUPTION THAT DOES NOT ANSWER MY QUESTION AT ALL
01:54:43 AND NOR AND I THINK ANY OF THE PUBLIC COMMENTS THAT WAS
01:54:47 PROVIDED TODAY LET ME BE VERY BIT MORE SPECIFIC IF I MAY.
01:54:51 THANK YOU. BASED ON WHAT I'M HEARING
01:54:55 AND IF YOU CAN JUST ANSWER THAT IF IF THERE'S AN ANSWER TO IT
01:54:59 IS THAT WHAT IS IT THAT WHAT I'M HEARING TODAY SPECIFICALLY
01:55:03 THE THE PROCESS OF SEEMS TO ME THAT OUR RETIREE TREES ARE
01:55:10 RECEIVING A NOTICE BY THEIR DOCTORS AND SAY YOU NEED THIS
01:55:15 TREATMENT FOR YOUR SYMPTOMS OR WHATEVER IT IS THAT YOU'RE
01:55:19 TACKLING IN TERMS OF YOUR HEALTH CONDITION SO THAT THE
01:55:23 DOCTORS HAVE SAID THIS IS WHAT YOU NEED, BE IT KNEE SURGERY,
01:55:27 BE A CANCER TREATMENT AND SOMEHOW NOW WITH THE
01:55:31 UNDERSTANDING THAT IS PROVIDED BY BLUE SHIELD BUT AT THE
01:55:35 MOMENT WHEN THEY ARE ABOUT TO RECEIVE THE TREATMENT THAT THEN
01:55:39 THEY ARE NOW TOLD BY THE CENTER OR THE FACILITIES THAT IS
01:55:43 SUPPOSED TO PROVIDE THAT TREATMENT THAT THE COVERAGE
01:55:47 AND THE CLAIM IS DENIED WHEN THEY'RE ACTUALLY ABOUT TO
01:55:50 RECEIVE THE CARE. >> TELL ME WHAT HAPPENED
01:55:54 BETWEEN THAT TIME WHEN THAT THE DOCTOR HAVE NOW PRESCRIBE THE
01:55:58 TREATMENT TO WHEN THE PATIENT ARRIVE AT THE FACILITY TO
01:56:02 RECEIVE THE TREATMENT? WHAT HAPPENED IN THAT TIME
01:56:06 PERIOD WHEN SUDDENLY THEY'RE NOW BEING TOLD THAT BLUE SHIELD
01:56:09 HAS DENIED THAT CARE? >> I CAN'T SPEAK TO THE
01:56:14 SPECIFIC CASES THAT WE HEARD ABOUT WHAT WHAT DOES THAT WHAT
01:56:18 DOES A PATIENT DO WHEN WHEN THEY ARE AT THE FACILITY TO
01:56:21 TELL ME HOW HOW WOULD HOW WOULD YOU ADVISE ANY PATIENT WHEN
01:56:27 THEY ARRIVE AT THE FACILITY AND THEN NOW BARRY BEING TOLD
01:56:31 THAT THE TREATMENT IS DENIED, WHAT WOULD YOU ADVISE THEM TO
01:56:35 DO FROM BLUE SHIELD'S POINT OF VIEW?
01:56:36 IS THERE A NUMBER THEY CALL WHAT WHAT IS THE NEXT STEP AT
01:56:39 THAT MOMENT? >> SO THERE ARE MANY PROCEDURES
01:56:46 AND TREATMENTS THAT DON'T REQUIRE PRIOR AUTHORIZATION
01:56:50 AND FOR THOSE THEY'RE THEY'RE SCHEDULED AND THEY SEE THEIR
01:56:55 MEMBERS. THERE'S SOME THAT ARE REQUIRED.
01:56:56 THEY'RE ON OUR WEBSITE. IT'S PART OF OUR PROVIDER
01:57:00 CONTRACT AND THE PROVIDERS KNOW TO OBTAIN THE PRIOR
01:57:03 AUTHORIZATION. THERE'S SOME THAT THEY MAY
01:57:04 THINK THERE NEED TO BE A PRIOR AUTHORIZATION AND THERE DIDN'T.
01:57:08 >> SO IF I MEAN TO YOU THEN THEN THIS IS TWO CITIES ASK AT
01:57:12 THIS MOMENT FOR FOR THIS WE WANT A18 HUNDRED NUMBER
01:57:15 SPECIFICALLY FOR SITUATION LIKE THAT WE WANT A HOTLINE WHEN ANY
01:57:22 OF OUR RETIREES AND WE WANT BLUE SHIELD TO CONSIDER THIS
01:57:26 YOU KNOW CLEARLY I CAN'T MANDATE ANY OF THAT BUT I AM
01:57:30 REQUESTING THAT WE ARE RETIREES AND OUR WORKERS WHEN THEY
01:57:34 ACTUALLY HAVE A PRESCRIBED TREATMENT AND PREEMPT PROVED
01:57:41 AND WHEN THEY ARRIVE AT THE FACILITY TO RECEIVE THAT
01:57:46 TREATMENT AND CARE AND THAT NOW THEY'RE BEING TOLD THAT IT'S
01:57:49 DENIED WE WANT A18 HUNDRED NUMBER SPECIFICALLY FOR THAT
01:57:54 SCENARIO AND THAT IS NOT THEN THEY ARE GOING ROUND AND AROUND
01:57:58 AND SAY WELL WE NEED TO KNOW WHO YOUR DOCTOR AND WHO WAS
01:58:01 SIGNED IS AND WHAT IS THE SPECIALIST.
01:58:05 I CAN'T FIND YOUR CLAIM I CAN'T FIND APPROVAL OF CLAIM.
01:58:09 I THINK THAT AND I CAN TELL YOU THIS IS THAT I THINK THAT'S THE
01:58:13 SAD PART ABOUT THIS IS I'M SO SORRY TO SAY BUT THE SAD PART
01:58:17 ABOUT THIS WE ALL IN THIS ROOM HAS A STORY BE IT IS A PERSONAL
01:58:20 OR SOMEONE THAT WE KNOW. SO I'M JUST TRYING TO PROBLEM
01:58:22 SOLVE AT THIS MOMENT IS THAT LIKE CAN WE ACTUALLY HAVE A
01:58:25 COMMITMENT TO HAVE A HOTLINE THAT FOR FOR OUR CONTRACT THAT
01:58:33 WE WILL THEN RECEIVE THAT SPECIFIC PHONE NUMBER FOR FOLKS
01:58:37 TO BE ABLE TO CALL THAT WOULD BE ABLE TO ADDRESS THAT?
01:58:40 >> AND SO MADAM CHAIR, WE WE HAVE A PHONE NUMBER AND WHAT WE
01:58:45 CAN DO IS PUT IN PROCESSES TO HELP EXPEDITE THAT BECAUSE
01:58:47 THERE IS A NUMBER IT'S IT'S IT'S A CONCIERGE LEVEL SERVICE
01:58:52 THAT IS FOR THE MEDICARE RETIREES.
01:58:53 WE ALSO WILL THEN LOOK AT WHAT ARE THESE UNIQUE CASES AND WHAT
01:58:59 HAPPENED IN THE BREAKDOWN BECAUSE THAT IS PART OF A
01:59:01 NETWORK PROVIDER KNOWING WHAT INFORMATION THEY ARE TO PROVIDE
01:59:06 AND SO WE ALSO HAVE TO ADDRESS THAT AND WE'VE GOT TO DO THAT
01:59:10 ON BEHALF OF THE RETIREES. SO THOSE ARE TWO AREAS WE CAN
01:59:12 ABSOLUTELY COMMIT TO AND WE'LL LOOK AND WE CAN COME BACK
01:59:15 AND WE CAN COME BACK THROUGH SFH ACCESS AND SAY HOW CAN WE
01:59:19 PUT THIS IN PLACE? I JUST WANT TO SET EXPECTATIONS
01:59:25 . I'M NOT ALWAYS SURE LIKE WHEN
01:59:26 THEY'RE SITTING IN THE OFFICE SO WE CAN ALSO TAKE PHONE CALLS
01:59:30 WHEN SOMEONE IS EXPECTING CARE, RIGHT?
01:59:31 AND TO MAKE SURE EVERYTHING HAS BEEN DONE IN ADVANCE.
01:59:34 >> YEAH. >> I ALSO WANTED TO ADD THAT
01:59:38 OUR MOST COMPLEX MEMBERS GET CARE MANAGEMENT AND SOME OF OUR
01:59:41 MEMBERS HAVE NOT AVAILED OF THAT OR AND THEY'RE LOSING THAT
01:59:45 CONNECTIVITY BECAUSE WHEN YOU HAVE CARE MANAGEMENT YOU HAVE
01:59:49 YOUR NURSE'S NUMBER AND YOU CAN CONNECT WITH HER AND HEY, I'M
01:59:53 HAVING A PROBLEM HERE OR CAN YOU HELP ME WITH THIS AND I
01:59:57 THINK THAT THAT'S ANOTHER ESCALATION PATH AND I WOULD ASK
01:59:58 THAT ABOUT 50 TO 60% OF OUR MEMBERS WHEN WE OUTREACH FOR A
02:00:01 CARE MANAGEMENT THEY PROBABLY AREN'T AWARE OF THE BENEFITS
02:00:08 THAT CAN GET THEM TO AN INTERNAL ADVOCATE WHO CAN ROOT
02:00:11 FOR THEM AND KIND OF HELP GUIDE THEM THROUGH THAT PROCESS.
02:00:12 AND I THINK IT'S ESPECIALLY FOR SENIOR MEMBERS IS PROBABLY THE
02:00:16 SINGLE MOST IMPORTANT PART YOU CAN TAKE BECAUSE THEN YOU NEED
02:00:19 JUST ONE NUMBER AND YOU DON'T NEED TO NAVIGATE THE ENTIRE
02:00:20 SYSTEM AND TELL ME UNDERSTAND WHEN THE CLAIM IS BEING DENIED
02:00:26 AND WHEN WE'RE INFORMED THAT OUR CLAIM IS BEING DENIED, HOW
02:00:30 LONG WOULD IT TAKE FOR US TO RESOLVE THAT CLAIM DENIAL
02:00:34 MONTHS MAYBE NEVER. >> SO WE OKAY I KNOW BUT I GOT
02:00:42 TO LET BLUESHIELD TO ANSWER. I'M SORRY.
02:00:43 LET'S NOT OUTBURST LET SO BASICALLY WE IT'S A FORMAL
02:00:51 APPEAL PROCESS THAT'S GOVERNED BY LIKE MEDICARE SO THAT'S WHAT
02:00:52 WE FOLLOW BUT WHAT WE'VE ALSO PUT IN PLACE IS THERE IS THE
02:00:56 ABILITY TO HAVE A PEER TO PEER AT ANY POINT THAT PROVIDER CAN
02:00:59 GET A PEER TO PEER. WE ABSOLUTELY YOU KNOW, WE HAD
02:01:03 A BREAKDOWN AND THAT'S WHY IT WAS THREE HOURS ON THE PHONE OF
02:01:07 TRYING TO NAVIGATE. WE ARE RESOLVING THAT BUT IT IS
02:01:11 A PEER TO PEER REVIEW PROCESS AND THAT'S WHAT IT'S INTENDED
02:01:14 IS FOR THE PROVIDERS TO DISCUSS AND MAKE SURE IS THE RIGHT
02:01:18 INFORMATION THERE AND HOW DO I EXPEDITE WHAT IS THE TIMELINE
02:01:19 GOALS TO RESOLVE THE CLAIM RESPONSE AN OVERALL LIKE IF
02:01:25 IT'S IF IT'S A PRIOR AUTHORIZATION DENIAL AND THEN
02:01:26 THEY'RE LOOKING TO APPEAL. >> I DON'T HAVE OUR FORMAL 70
02:01:32 TWO HOURS TO FIVE DAYS DEPENDING ON DOLLARS TO FIVE
02:01:33 DAYS AND THAT'S MEDICARE ADHERENT GUIDELINES OF WHICH
02:01:37 WE'RE AUDITED. >> OKAY.
02:01:39 >> SO THE COMMITMENT IS IF WE RECEIVE A CLAIM DENIAL AND OUR
02:01:43 EXPECTATION IS THAT IT COULD BE ANYWHERE WITHIN 72 HOURS OR UP
02:01:48 TO FIVE DAYS DEPENDING ON THE CLAIM.
02:01:51 >> YEAH, DEPENDING YES, DEPENDING ON THE CLAIM.
02:01:55 MEDICARE THERE'S VERY MEDICARE SPECIFIC GUIDELINES THAT A
02:01:58 MANAGED CARE PLAN HAS TO ANSWER WITHIN X PERIOD OF TIME FOR X
02:02:02 DENIAL. >> AND WHAT HAPPENS IF THAT
02:02:03 DOES NOT HAPPENED? >> HOW DO WE ESCALATE THAT?
02:02:08 AND I THINK THAT THAT'S WHERE THAT IF IF IT'S A COMPLEX IF
02:02:13 IT'S A POLY CHRONIC COMPLEX MEMBER HOPEFULLY THEY HAVE
02:02:17 THEIR CARE MANAGER AND THEY PICK UP THE PHONE AND SAY WHAT
02:02:21 DO I DO HERE? HELP ME OUT HERE, WHERE CAN I
02:02:23 GO AND WE WE WILL THEN THEY ADVOCATE FOR THE MEMBER INSIDE
02:02:30 THE HEALTH SYSTEM, INSIDE THE MANAGED CARE PLAN AND WHAT ARE
02:02:33 THE OPTIONS THAT WE CAN HAVE THAT MIGHT ASSIST OUR MEMBER
02:02:35 THROUGH THIS PROCESS? >> BUT THEN WHAT HAPPENED
02:02:38 IN THE CASE OF FIREFIGHTER KEN JONES THAT YOU BASICALLY JUST
02:02:41 COMPLETELY DENIED THE CARE AND THE TREATMENT AND UNTIL THE
02:02:45 UNTIL THEY ACTUALLY HAVE TO COME TO HOW SERVICE SYSTEM
02:02:50 AND ESCALATED TO THIS POINT SO LIKE EXPLAIN TO ME WHAT
02:02:54 HAPPENED THERE AND I'M NOT SURE WE CAN COMMENT ON THAT
02:03:01 PARTICULAR CASE. YEAH SO SO WE I UNDERSTAND WHAT
02:03:08 THE AUDIENCE IS SAYING. WE JUST DO NOT COMMENT ON
02:03:09 SPECIFIC CASES BUT THAT'S WHERE AGAIN DOCTOR GEORGE TALKED
02:03:13 ABOUT THE ONCOLOGY PROCESS WHERE WE HAVE NOW COMPLETELY
02:03:16 REVAMPED IT AND IT'S AN PROACTIVE OUTREACH IF THERE'S
02:03:20 ANYTHING WITHIN THAT CONDITION THAT WOULD NOT BE APPROVED,
02:03:22 IT'S A PROACTIVE OUTREACH FOR A PEER TO PEER.
02:03:24 SO THAT WAS ONE OF THE THINGS AS DOCTOR JUDGE SAID, WE HAVE
02:03:28 PUT IN PLACE VERY SPECIFIC TO ONCOLOGY RECOGNIZING WHAT THAT
02:03:32 NEED IS SPECIFIC ONLY FOR THE CITY AND COUNTY.
02:03:38 I KNOW THAT LIKE THE REALITY IS THAT THE CITY IS LIMITED WITH
02:03:46 ITS REGULATION OF WHAT WE CAN MANDATE AND HOW WE CAN MANDATE
02:03:50 YOU IN TERMS OF YOUR RESPONSE TIME AND YOUR PROCESS FOR
02:03:54 DENYING CLAIM. I KNOW THAT WE HAVE OUR
02:03:58 LIMITATION AND BUT I DON'T THINK I'M GOING TO ACCEPT THAT
02:04:03 LIMITATION FOR TODAY AND THAT INSTEAD OF SAYING THIS TO BLUE
02:04:10 SHIELD I THINK IT'S NOT JUST BLUE SHIELD BUT TO RECOGNIZE
02:04:15 THAT THERE'S REALLY A PROBLEM OF THROUGHOUT OUR HEALTH CARE
02:04:18 SYSTEM AND THAT THIS IS SOMETHING THAT I WOULD LIKE FOR
02:04:22 OUR HEALTH SERVICE SYSTEM TO ADDRESS AND I HAVE SPECIFIC
02:04:25 ITEMS FOR THEM TO WORK ON AS WELL.
02:04:29 BUT I THINK TODAY AND I DON'T KNOW IF ANY OF MY COLLEAGUES
02:04:32 HAD ANY OTHER QUESTIONS BUT BEFORE I LET BLUE SHIELD GO,
02:04:37 HERE'S MY REQUESTS TO BLUE SHIELD TODAY IS THAT AS MR.
02:04:44 FRED SANCHEZ FROM PROTECT OUR BENEFITS HAS INDICATED THAT
02:04:49 THEY WOULD LIKE FOR A MEETING DIRECTLY WITH BLUE SHIELD
02:04:53 SPECIFICALLY ADDRESSING THESE CONCERNS AND SO AND NOT TWO
02:05:00 MONTHS FROM NOW BUT WHAT I'M EXPECTING IS THAT BEFORE THE
02:05:04 MONTH BEFORE THE END OF APRIL THAT YOU WILL HAVE A MEETING
02:05:08 THAT REALLY WITH AGAIN, MR. SANCHEZ SANCHEZ IS HERE THAT I
02:05:15 AM EXPECTING YOU HAVE THAT MEETING TO BE ABLE TO HAMMER
02:05:19 OUT SPECIFICALLY A PROCESS AS THAT WITHIN FOR THE RETIREES OF
02:05:26 OUR SYSTEM THAT WE CAN HAVE A CONCIERGE AS YOU HAVE
02:05:30 INDICATED, A CONCIERGE SERVICE AND PROCESS FOR BOTH THAT THEY
02:05:37 CAN CALL IN ABOUT THEIR CLAIMS DENIAL AND PROCESSING RESPONSE
02:05:41 AND ALL OF THAT THAT WE ARE WE'RE GOING TO LOOK FORWARD TO
02:05:46 SEEING IN WRITTEN FORM IF I MAY, TO REALLY SPELL OUT THAT
02:05:53 AGREEMENT AND PROCESS SO WE WILL BE FOLLOWING UP THROUGH A
02:05:57 LETTER TO YOU FORMALLY REQUESTING YOUR AGREEMENT WITH
02:06:03 PROTECT OUR BENEFIT. >> WE WELCOME THE OPPORTUNITY.
02:06:08 THANK YOU AND SO I'M GOING TO LEAVE FOR YOU I DON'T THINK ANY
02:06:15 OF MY COLLEAGUES HAVE ANY OTHER QUESTIONS I WILL LEAVE FOR YOU
02:06:16 TO MAKE MAYBE YOUR REMARK I MEAN WE WANT TO THANK YOU
02:06:23 AND AND ENTIRE COMMITTEE FOR TAKING THE TIME WE UNDERSTAND I
02:06:27 MEAN IT AGAIN IF WE FALL SHORT WE WANT TO MAKE SURE WE HAVE AN
02:06:31 OBLIGATION TO ADMINISTER YOUR PLAN AND THAT IS WHAT WE WANT
02:06:35 TO DO AND AS A KEY COMPONENT OF THAT, IT'S TO ENSURE THERE'S
02:06:41 THE RIGHT LEVEL OF SERVICE THAT IS THERE.
02:06:42 WE APPRECIATE THE TIME. >> ABSOLUTELY.
02:06:47 AND I'D SAY WE ARE COMMITTED TO STANDING IN THE SPACE WITH YOU
02:06:50 AND COMING TO A COLLABORATIVE DISCUSSION AND AND SOLUTIONS
02:06:54 THAT IN OPENNESS TRANSPARENCY. SO WE LOOK FORWARD TO THE NEXT
02:07:02 STEPS. THANK YOU FOR YOUR TIME.
02:07:03 THANK YOU. >> AND BECAUSE OF THAT THANK
02:07:06 YOU. >> AND I'M GOING TO CALL ON OUR
02:07:10 HOUSE SERVICE SYSTEM TO ANSWER SOME OF THE QUESTION.
02:07:13 AND I JUST WANT TO BE CLEAR TODAY THIS HEARING IS GOING TO
02:07:17 LA COLLEAGUES, I WANT TO LET YOU KNOW THAT I, I IT IS MY
02:07:20 INTENTION TO CONTINUE THIS HEARING TO THE CALL CHAIR SO
02:07:24 THAT WE CAN CALL THIS BACK IN MAY TO GO THROUGH THE
02:07:29 AGREEMENT THAT IS GOING TO BE HOPEFULLY FINALIZED BY THE END
02:07:36 OF APRIL BETWEEN BLUE SHIELDS AND OUR PROTECT OUR BENEFITS
02:07:41 GROUP SO THANK YOU FOR COMING BEFORE US TODAY.
02:07:48 >> I WANT TO EXPRESS WHY AM I GLAD IT'S YOU FOR YOUR WORK
02:07:51 JUST FOR THE ENTIRE SYSTEM I WANTED TO ALSO EXPRESS MY
02:07:55 DISAPPOINTMENT IN YOUR PRESENTATION TODAY AND HEAR ME
02:07:58 OUT WHY I THINK WHAT I AM AND DISAPPOINTED IN THE
02:08:02 PRESENTATION BECAUSE OF THIS THERE'S THIS ENTIRE SLIDE ON
02:08:10 SLIDE FIVE IS WHAT YOU CAN NOT DO AND IT IS DISAPPOINTING TO
02:08:14 GO THROUGH THAT BECAUSE WHAT I WOULD LIKE TODAY IS TO TURN
02:08:22 THAT SLIDE FIVE TO WHAT WE CAN DO WITH WHAT IS HAPPENING WITH
02:08:26 US AT THE MOMENT AND AND I GET IT WHAT YOU'RE SAYING IS THAT
02:08:32 JURISDICTION AND AUTHORITY WITHIN OF WHAT YOU CAN'T
02:08:36 MANDATE A HEALTH PLAN BECAUSE OF REGULATION OR FEDERAL
02:08:41 REGULATIONS AND REALLY I DO UNDERSTAND THOSE CHALLENGES
02:08:45 THAT WE CAN'T MANDATE THEM TO PROVIDE TREATMENT AND PROCESS
02:08:52 CLAIMS THEY CAN THEY CAN DELAY, THEY CAN DENY AND THEN THEY CAN
02:08:56 GO BACK. BUT WE CAN'T MANDATE LIKE
02:09:00 RESPONSE TIME. BUT WHAT I DO THINK WE CAN DO
02:09:04 AND WHAT I'M EXPECTING YOU TO DO WHEN YOU COME BACK FOR US TO
02:09:08 US IN THIS BUDGET PROCESS IS THE FOLLOWING AND THAT WHEN YOU
02:09:15 DO COME BACK IT'S NOT JUST FOR BLUE SHIELD I THINK TO NOT TO
02:09:19 JUST SINGLE OUT BLUE SHIELD BUT ACTUALLY FOR ALL OUR SERVICE
02:09:23 PROVIDER BECAUSE I AM THROUGH YOUR RESPONSE TO OUR LETTER
02:09:26 INQUIRY IS ASTOUNDING AND THAT I'M LEARNING THAT THERE IS A
02:09:33 IN WORK DENIAL RATE IS 21%. I DON'T KNOW IF THAT IS IT
02:09:37 SEEMS TO ME WHAT YOU'RE SAYING IS IS A STANDARD THAT 21% OF
02:09:44 THE CLAIM IS ACTUALLY BE IN DENIAL.
02:09:45 IT DOES NOT TELL ME WHAT THEY ARE.
02:09:48 IT SEEMS LIKE WE CANNOT WE DON'T TRACK THEM.
02:09:51 YOU ARE NOT TELLING ME WHAT THEY ARE AND HOW WE ACTUALLY
02:09:54 END UP RESOLVING THOSE CLAIM DENIALS AND HOW DO WE ACTUALLY
02:09:58 MOST IMPORTANTLY ULTIMATELY IS THAT OUR OUR WORKERS ARE
02:10:02 ACTUALLY RECEIVING THE CARE LIKE I CAN UNDERSTAND THAT
02:10:07 PERHAPS THAT THERE ARE CLAIM DENIALS HAPPEN FOR WHATEVER
02:10:10 REASON BUT THEN HOW DO WE AS A SYSTEM THEN RESOLVE THOSE CLAIM
02:10:15 DENIALS AND THEN WE WILL EVENTUALLY STILL RESULT IN CARE
02:10:18 AND TREATMENTS IS WHAT I'M NOT UNDERSTANDING.
02:10:22 >> SO I WILL LOVE THIS INFORMATION FROM THE HEALTH
02:10:26 SERVICE SYSTEM TODAY IS FIRST I WOULD LOVE TO TRACK CLAIM
02:10:30 RESPONSE TIME LIKE CLAIM LIKE BASICALLY RESPONSE TIME FOR
02:10:37 CLAIM DENIAL FROM ALL OUR SERVICE PROVIDER.
02:10:41 >> I WANT TO UNDERSTAND THE PERCENTAGE OF CLAIM DENIALS.
02:10:45 I WANT TO UNDERSTAND HOW LIKE THAT DURATION OF TIME FOR THEM
02:10:49 TO RESPOND TO THOSE CLAIMS AND RESOLVE THOSE CLAIMS YOU
02:10:52 CAN TRACK THAT YOU MAY NOT BE ABLE TO MANDATE THAT BUT YOU
02:10:54 CAN TRACK THAT ALSO ACROSS ALL THE SERVICE PROVIDER AND NEED
02:10:58 TO COME BY THE TIME YOU COME BEFORE US FOR BUDGET IN JUNE.
02:11:03 >> I WOULD ALSO UNDERSTAND THE PERCENTAGE OF CLAIM THAT
02:11:08 ACTUALLY ARE DENIED ALL ACROSS THE BOARD FROM ALL SERVICE
02:11:11 PROVIDERS NOT JUST BUSH-QUAYLE BECAUSE IT IS AGAIN I CAN SEE
02:11:15 WHAT YOUR TRACKING IS AND OF AVERAGE OF 21% BUT I WANT TO
02:11:19 UNDERSTAND AND WITHIN OUR OWN SYSTEM WHAT IS THAT PERCENTAGE
02:11:23 LOOK LIKE? ARE WE ACTUALLY ABOVE THAT
02:11:26 PERCENTAGE OR ARE WE BELOW THAT PERCENTAGE?
02:11:30 I ABSOLUTELY WANT TO TRACK THE RESULTS OF THOSE CLAIM DENIAL
02:11:38 AND I DON'T KNOW EXACTLY WHAT THAT WILL LOOK LIKE MEANING
02:11:43 WITHOUT VIOLATING HIPA ON YOUR AND BECAUSE I DO UNDERSTAND IS
02:11:49 A LOT OF IT IS PROBABLY COMPLAINT DRIVEN MEANING PEOPLE
02:11:51 ACTUALLY HAVE TO TELL YOU THAT MY CLAIM HAS BEEN DENIED
02:11:55 AND I'M NOT RECEIVING CARE AND IN YOU KNOW THEY MAY LIKE
02:11:58 ACCORDING TO ALL THE PUBLIC COMMENTS THAT THEY END UP GOING
02:12:03 TO DIFFERENT PLACES DENTAL TO SEEK CARE SOME OTHER WAY AND I
02:12:06 THINK THIS IS PROBABLY BY FAR THE HARDEST ONE AND THE MOST
02:12:09 HEARTBREAKING ONE IS THAT LIKE PEOPLE HAS PAID INTO OUR SYSTEM
02:12:13 AND THEN THE WHEN TO CARE IS DENIED AND AND CLAIM IS DENIED
02:12:17 AND THEY END UP FINDING OTHER RESORTS BECAUSE THEY DIDN'T
02:12:20 THINK THAT THEY CAN CONTINUE TO TRACK BACK TO THE SYSTEM SO I
02:12:24 AM ASKING THE SYSTEM IS SELF THAT TO COME OUT WITH A
02:12:31 SOLUTION WHEN WHEN OUR WORKERS ARE ACTUALLY DENYING CLAIMS
02:12:36 AND THEY CANNOT BE RESOLVE OF ESPECIALLY AND PARTICULARLY
02:12:40 SIMILAR TO THE CASE LIKE FIREFIGHTER KEN JONES HOW DO WE
02:12:44 TRACK THOSE POPULATION CHURCHMEN THANK YOU FOR YOUR
02:12:51 DIRECTION. >> WHAT I WOULD SAY IS THAT
02:12:55 SOME OF THIS WOULD BE MORE OF A POLICY MATTER THAT I WOULD NEED
02:12:58 TO TAKE BACK TO THE HEALTH SERVICE BOARD SOME OF WHAT YOU
02:13:00 REQUESTED. CERTAINLY SOME OF THAT DATA IS
02:13:04 AVAILABLE AND YOU KNOW, BEFORE I START WHAT I WANT TO MENTION
02:13:10 IS AS I MENTIONED EARLIER, THIS COUNTRY'S HEALTH CARE SYSTEM IS
02:13:14 EXTREMELY COMPLICATED AS WE LOOK AT MANAGED CARE PLANS SUCH
02:13:18 AS BLUE SHIELD AS WELL AS OUR OTHER CARRIERS KAISER HEALTH
02:13:22 NET. >> UNFORTUNATELY PRIOR
02:13:26 AUTHORIZATION IS PART OF THE PROCESS.
02:13:27 >> WE AS THE HEALTH SERVICE SYSTEM DO REVIEW PRIOR
02:13:34 AUTHORIZATION DENIAL RATES ACROSS THE HEALTH PLANS THAT WE
02:13:38 MANAGE AS WELL AS THEIR COMPARATOR PLANS IN THE
02:13:42 INDUSTRY. AND WHAT I WOULD SAY IS THAT WE
02:13:46 DID PROVIDE YOU A NUMBER BUT THAT NUMBER IS WITHIN INDUSTRY
02:13:50 NORM AND AS WE LOOK AT THE PRIOR AUTHORIZATION DENIAL
02:13:54 RATES OF BLUE SHIELD AS WELL AS OUR PREVIOUS CARRIER FOR
02:13:58 RETIREES UNITED HEALTH CARE THEY ARE IN LINE WITH ONE
02:14:02 ANOTHER AND IN FACT LOWER THAN MANY OF THEIR COMPETITORS OUR
02:14:06 COMPETITORS. A LOT OF WHAT YOU ASKED FOR
02:14:10 RELATED TO DATA AGAIN IS PUBLIC AVAILABLE ON A PLAN WIDE LEVEL
02:14:17 WE CERTAINLY CAN REQUEST FROM OUR CARRIERS TO PROVIDE THOSE
02:14:21 DENIAL RATES FOR OUR PLAN SPECIFIC POPULATION.
02:14:25 >> BUT BECAUSE THE INFORMATION THAT WE RECEIVE IS AGGREGATED
02:14:29 ACROSS ALL ITEMS OF SERVICES IT'S REALLY HARD TO BREAK DOWN.
02:14:32 >> YOU KNOW WHAT THOSE DENIAL RATES ACTUALLY MEAN A LOT OF
02:14:39 DENIALS THAT HAPPEN ARE PART OF ADMINISTRATIVE PROCESS.
02:14:43 FOR INSTANCE, WHEN BLUE SHIELD OR ANY OF OUR CARRIERS CONTRACT
02:14:46 FOR HEALTH CARE SERVICES WITH THEIR PROVIDERS, A LOT OF THOSE
02:14:48 SERVICES ARE BUNDLED IN ORDER TO GET THE BEST REIMBURSEMENT
02:14:54 RATES AND SOMETIMES A PROVIDER NOT KNOWING OR NOT REMEMBERING
02:14:59 THAT SERVICES ARE BUNDLED WILL SUBMIT THEM SEPARATELY.
02:15:02 ONE DENIAL THAT WILL BE RECEIVED IS THAT CLAIM WILL BE
02:15:06 SENT BACK AND SAY NO, THIS IS A BUNDLED PROGRAM.
02:15:07 YOU HAVE TO RESUBMIT THIS CLAIM FOR FURTHER PROCESSING AND THAT
02:15:10 WILL MARK, YOU KNOW, A DENIAL FOR THAT PRIOR AUTHORIZED
02:15:17 ACTION. AND SO WITHOUT, YOU KNOW,
02:15:18 RESOURCES TO EVALUATE WITHOUT THE INFORMATION ON PLAN OR
02:15:25 CLAIM SPECIFIC INFORMATION, IT'S REALLY HARD TO MAKE ANY
02:15:26 SENSE OF WHAT THOSE DENIAL RATES ARE ACTUALLY SHOWING.
02:15:30 >> MY APOLOGIES. I DISAGREE.
02:15:33 >> THAT'S ACTUALLY EXACTLY WHAT THE PROBLEM IS RIGHT NOW.
02:15:34 AND AS WE CAN HEAR THE PROBLEM ABOUT THE BURDENSOME OF
02:15:40 ADMINISTRATION ADMINISTRATION, THE COST OF HEALTH CARE, IT
02:15:44 SEEMS TO ME WHAT YOU JUST DESCRIBE AT PARTICULARLY AROUND
02:15:48 THE THE CHALLENGE AROUND CLAIM DENIALS SOUNDS LIKE AN
02:15:55 ADMINISTRATIVE ISSUE TO ME THEN AN ACTUAL CARE ISSUE AND THAT
02:16:00 IS EXACTLY WHAT I THINK WE'RE ALL GETTING AT.
02:16:03 >> CORRECT BECAUSE IT SOUNDS TO ME THEN THIS IS A BLUE SHIELD
02:16:07 OR SERVICE PROVIDER THAT THEY'RE NOT DOING GOOD ENOUGH
02:16:11 JOB OF PROCESSING CLAIMS AND ACTUALLY ADDING
02:16:14 ADMINISTRATIVE COSTS AND CHALLENGES AND BUREAUCRACY
02:16:18 INTO THAT PROCESS. AND SO THEREFORE THEY CANNOT
02:16:22 PROVIDING CARE IN A TIMELY FASHION AND EFFECTIVE FASHION.
02:16:26 >> I THINK THAT'S ACTUALLY WHAT YOU'RE SAYING.
02:16:27 WELL, WHAT I'M SAYING IS AGAIN, THE INFORMATION THAT WE WOULD
02:16:32 RECEIVE WOULD NEED TO BE DE-IDENTIFIED AND AGGREGATED DO
02:16:35 NOT VIOLATE PRIVACY RULES AND SO AGAIN WE WOULD NOT GET
02:16:39 THAT CLAIMS LEVEL INFORMATION THAT WE WOULD NEED TO USE TO
02:16:43 EVALUATE WHETHER OR NOT A DENIAL WAS VALID OR NOT.
02:16:49 AND SO AGAIN WE CANNOT DUE TO HIPA PRIVACY RULES GET THAT A
02:16:54 MEMBER SPECIFIC CLAIMS INFORMATION AND AGAIN THE HIP
02:16:58 RULE WAS DESIGNED TO PREVENT EMPLOYERS FROM RECEIVING CLAIMS
02:17:01 SPECIFIC INFORMATION BECAUSE UNFORTUNATELY THERE ARE VARIOUS
02:17:06 EMPLOYERS OUT THERE THAT WOULD LIKE JUST A HEALTHY WORKFORCE.
02:17:11 RIGHT. AND SO THE THE LAWS ARE
02:17:14 PREVENTING FROM EMPLOYERS SUCH AS THE CITY AND COUNTY OF SAN
02:17:15 FRANCISCO RECEIVING MEMBER SPECIFIC INFORMATION THAT WOULD
02:17:18 BE NECESSARY TO REVIEW TO SEE WHETHER OR NOT THE CLAIM DENIAL
02:17:23 WAS VALID OR NOT. >> LET ME ASK AND LET ME
02:17:27 REPHRASE FOR THAT QUESTION. I SHOULD SAY THEN YOU SHOULD
02:17:30 ASK THE SERVICE PROVIDERS IN THE PERCENTAGE OF CLAIM
02:17:34 DENIALS IN WHAT CATEGORY IS SPECIFICALLY FOR THAT.
02:17:38 FOR EXAMPLE, IF BLUE SHIELDS IS THE AVERAGE NORM OF 21% AND OUT
02:17:45 OF THAT 21% OF THE CLAIM DENIALS AT WHAT PERCENTAGE IS
02:17:49 DUE TO ADMINISTRATIVE ISSUES THAT THEY EXPERIENCE AND AT
02:17:53 WHAT PERCENTAGE IS REALLY DENIAL OF CARE BECAUSE FOR
02:17:57 IN THE CASE OF FIREFIGHTER KEN JONES THAT IT SEEMS LIKE THEY
02:18:00 INTERPRET THE FDA REGULATIONS FOR CARE IT'S DIFFERENTLY THAN
02:18:04 HIS OWN ONCOLOGIST THANK YOU FOR THAT CLARIFICATION AND THAT
02:18:12 PROVIDES ME SOME ADDITIONAL INFORMATION.
02:18:13 WE WILL TAKE THAT BACK AND RESPOND TO YOU.
02:18:16 >> WHAT I DO NEED TO BE ONE OF MY CONCERNS IS ONE OF
02:18:27 RESOURCES. UNFORTUNATELY WE ARE ONE OF THE
02:18:31 SMALLEST CITY DEPARTMENTS WITHIN THE CITY ORGANIZATION.
02:18:35 WE HAVE A LIMITED NUMBER OF STAFF.
02:18:36 AGAIN, OUR ROLE PRIMARILY IS ELIGIBILITY ENROLLMENT.
02:18:39 AGAIN, WE CARE VERY HIGHLY FOR EACH ONE OF OUR MEMBERS BUT WE
02:18:43 DO NOT MAINTAIN ANY MEDICAL EXPERTS ON OUR STAFF.
02:18:46 AGAIN, WE ARE REALLY ONE OF AN ADMINISTER OF DEPARTMENT HERE
02:18:50 TO ADMINISTER THE POLICY DIRECTION OF THE HEALTH SERVICE
02:18:54 BOARD AND SO SOME OF THE WHAT YOU'RE REQUESTING IN TERMS OF
02:18:57 DATA ANALYSIS AND REVIEW WE SIMPLY DON'T HAVE ANY RESOURCES
02:19:01 TO PROVIDE SUCH DATA ANALYSIS OR REVIEW.
02:19:05 SO IT WOULD BE A POLICY DIRECTION THAT WE WOULD NEED TO
02:19:07 GO BACK TO OUR BOARD TO REQUEST CLARIFICATION ON HOW TO FIND
02:19:10 THOSE RESOURCES. >> ABSOLUTELY THEY CAN.
02:19:13 I THINK WHAT YOU CAN DO IS THAT YOU CAN ASK FOR THAT
02:19:16 INFORMATION DIRECTLY TO THE SERVICE PROVIDER AND ASK THEM
02:19:17 TO PROVIDE ANY OF THOSE CATEGORY AND ALONG WITH A SIGN
02:19:20 AFFIDAVIT THAT THESE CLAIMS HAVE BEEN THAT I GET IT.
02:19:27 WHAT YOU'RE SAYING IS YOU DON'T HAVE A STAFFING TO
02:19:31 INDEPENDENTLY VERIFY THE ACCURACY OF THESE CLAIM
02:19:32 PERCENTAGE AND THE INFORMATION THAT THEY PROVIDE.
02:19:35 I'M NOT EXPECTING YOU TO BUT WHAT I DO EXPECT YOU TO DO IS
02:19:39 TO ASK FOR THOSE INFORMATION AND HAVE THEM PROVIDE THEM IN A
02:19:43 TIMELY FASHION BEFORE YOU COME BEFORE US.
02:19:47 AS FOR YOUR CONTRACT APPROVAL FOR THEIR CONTRACT APPROVAL
02:19:50 AND ALONG WITH AN AFFIDAVIT FOR THOSE FOR THOSE INFORMATION, I
02:19:53 UNDERSTAND YOUR REQUEST. THANK YOU.
02:19:54 THANK YOU. AND I DON'T SEE ANY OTHER NAME
02:19:58 AGAIN ON THE ROSTER TO ASK FOR THE QUESTION.
02:20:02 BUT I THINK WHAT I'M ASKING IS PRETTY CLEAR AND AGAIN I WILL
02:20:06 BE CONTINUING THIS HEARING WITH THE EXPECTATION THAT YOU WILL
02:20:12 BE STARTING GATHERING THIS INFORMATION BUT YOU'LL BE READY
02:20:16 BY THE TIME JUNE 1ST COME FOR THOSE ALONG WITH THE CONTRACTS
02:20:21 THAT YOU HAVE DETERMINED AND BEEN APPROVED BY YOUR
02:20:22 HEALTH SERVICE BOARD. I DO EXPECT THAT YOU WILL
02:20:25 RELATE THIS. I'M ALSO HAPPY AND I WILL BE
02:20:28 SEPARATELY WRITING A LETTER BACK TO HEALTH SERVICE BOARD
02:20:32 REQUESTING THOSE INFORMATION DIRECTLY FROM ME TO THEM
02:20:36 AND THROUGH YOU TO BE ABLE TO PROVIDE THAT AS YOUR DAY
02:20:40 APPROVE ANOTHER YEAR OF THE CONTRACT BACK TO THE BOARD
02:20:43 SUPERVISOR THAT I DO EXPECT THAT INFORMATION THAT WILL BE
02:20:48 ATTACHED TO YOUR TO TO YOUR CONTRACT STRUCTURE AND I THANK
02:20:53 YOU FOR THAT EXPLANATION I RECEIVED.
02:20:55 >> THANK YOU. I WANT TO MAKE SURE THAT I
02:20:57 DON'T I LEAVE ROOM FOR YOU TO PREPARE TO ACTUALLY HAVE ANY
02:21:00 CLOSING REMARKS. >> NO, I THINK WE'VE COVERED IT
02:21:03 ALL SO THANK YOU. THANK YOU.
02:21:06 AND SO COLLEAGUES, I THINK THAT TODAY I THANK YOU SO MUCH FOR
02:21:10 YOUR SUPPORT AND AND TIME ALLOWING US TO HAVE THIS
02:21:17 QUESTION AND ANSWER WITH THIS HEARING.
02:21:21 BUT I THINK CLEARLY WE HAVE A LOT OF WORK TO DO STILL AND I
02:21:25 WOULD LIKE TO IF I CAN MAKE THIS MOTION TO CONTINUE THIS
02:21:29 HEARING TO THE COURT CHAIR AND THAT WE CAN PERHAPS COME
02:21:33 BACK EITHER IN MAY AND THEN POTENTIALLY AGAIN IN JUNE IF
02:21:37 NECESSARY. >> I DO NOT HOPE SO.
02:21:42 BUT AND SO WITH THAT A MOTION TO CONTINUE TO THE CALL CHAIR A
02:21:45 ROLL CALL PLEASE. >> AND ON THAT MOTION THAT WE
02:21:49 CONTINUE THIS HEARING TO THE CALL OF THE CHAIR VICE CHAIR
02:21:52 DORSEY DORSEY I'M AMBASSADOR SAUTER I CHAIR CHAN I CHENNAI
02:21:57 WE HAVE THREE EYES THE MOTION PASSES AND WITH THAT MR. CLERK
02:22:03 DO YOU HAVE ANY OTHER BUSINESS BEFORE US TODAY MADAM CHAIR
02:22:04 THAT CONCLUDES OUR BUSINESS. >> THE MEETING IS ADJOURNED