>> francisco health service board regular commission meeting this afternoon at 1:00 pm., thursday, january 12, 2023.)

>> good afternoon and happy new year to everyone. now i'd like to call the meeting to order. directors in session. for the thursday, january 12, 2023. we'll start by saying please

join me in the pledge of allegiance. will you please join me. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. >> we'll now have agenda item number 2, roll call starting with commissioner scott present. >> vice president hao plenty. >> commissioner breslin present. >> accumulation present. >> commissioner follansbee are we practice session or am i in the regular meeting now. >> we're in the regular meeting at this time. >> and commissioner follansbee present and commissioner jernigan commissioner scott we have quorum and and have item

item california government code section 54953(e): (action)presented by president scott. >> a continuing process we have to go through for each meeting to allow the commission our board and it's committees to meet in a teleconference way in the course of the como most and willing to i'd like to entertain a motion for the boards adoption and. >> finding to- and second probably moved and seconded. >> any discussion? hearing none, have public comment. >> thank you president scott. public comment in-person for virtual for anyone waiting in

the room approach the podium now up to three minutes and all public comment the caller my ask guidance and for those callers on the line your encouraged to please state your name for the record.. and i'll give you an audible warning and back on mute and the moderator will- is sfgov and opportunity to speak during the public comment are available by dialing. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. then press pound and pound again

“you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. and when our line is radios around you • address the commission as a whole, do not address individual commissioners. we'll begin with in-person public comment. and no one has approached the podium the moderator will notify us of callers at this time. >> madam secretary one caller on the line and a reminder to all callers on the line you must dial star three if you want to join the session and 5 more seconds and close public comment. (coughing) board secretary no callers in the public comment at this time. >> thank you moderator. >> i'm going to check one more

time for any viewers maybe in the public comment and moderator will you check as well? >> thank you board secretary refreshing call in any viewer raising your hand. >> welcome caller. >> thank you. >> for taking my call. i can hear you and public comment for the teleconference. >> i'm (unintelligible) and i'm calling into to make two suggestions. which. >> caller i'm going to pause you right there for this agenda item we're taking comments about the teleconference meeting with the california government code and after four is the best place to use the suggestions. and keep you on the line and answer your

call in the next agenda item . thank you. >> moderator shall we refresh one more time in the public callers. >> yes. board secretary two callers on the line and . >> thank you, moderator hearing no further callers public comment is closed. >> ready to vote take a roll call. >> roll call starting with president scott, aye. >> vice president hao, aye. >> commissioner breslin, aye. >> and commissioner canning, aye. >> commissioner follansbee, yes. >> and commissioner jernigan, aye. >> review committee. all items will be approved by a single roll call vote. anyone may ask matter within the board's jurisdiction that is not on the agenda, including requesting that the board place a matter on a future agenda. >> i'll read

those public comment reductions for anyone waiting in 2012 you can approach the populated now each speaker will have three minutes and all public comment will- and caller may ask questions but no going to answer or engage in the call and i ask radios around you • address the commission as a whole, do not address individual commissioners. an audible warning and with three minutes and the moderator will answer the next caller opportunity to speak during public comment are available by dialing. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again.

>> public comment call-in: 415-655-0001 / access code: 2481 453 5729 then press pound and pound again. and dial star three to be added to the queue and your line is unmuted your time to speak. >> begin with in-person public comment no one has approached the moderator will invite us of any commenter. >> board secretary two callers on the line. >> zero callers are entered the public comment at this time. >> a reminder to all callers you must hit star three if you want to make public comment this is the second agenda item and wait 5 more seconds and close public comment for this agenda item. >> board secretary in

refreshing caller number 5. thank you, moderator i'll unmute the first caller. >> welcome caller thank you for waiting. >> thank you. >> for allowing me to speak nobel peace prize a- and i'm (unintelligible). >> yes. brood to so a little bit low if you can speak louder will be helpful. >> a little bit better. thank you. >> okay. >> i like to suggest two things for the (inaudible) enhance customer service for all service members for reporters i would like to suggest that i opt in-person the health services to notify retirees i e-mailed not

just postal mail and then what happened i'm an retiree granted two months at that time and not i'm almost missed an e-mail notice from the insurance system i failed to have a response i have was not home and a problem in this town with healthcare. they (unintelligible) and enrolled me in the i pi program i didn't get this in a timely manner but one the option to receive notices by e-mail in addition to postal mail a good idea. the second suggestion i have is that one can contact the

health services system by e-mail not just by phone he called twice in the last two days and on hold 21 minute and is option to contact the health services by e-mail will be helpful as well. thank you. >> thank you. caller. moderator let us know if any other caller at this time. >> a reminder to callers have sponsoring spoken another the queue must lower your hand and now bred secretary no other callers in the queue at this time. >> thank you moderator public comment is closed. >> thank you, move to

>> >> 5. approval (with possible modifications) of the minutes of the meetings set for the below: (action) presented by president scott. and will be meeting minutes for november 2nd to november 8th regular health service board. >> in addition to the regular board meeting minutes are normally taken up at this time two governors committee meetings those minutes railroad attached and posted on the website. so are there any corrections first of all, go to the regular board meeting. in any corrections edits or comments by the board members? >> all right. >> now move to others minutes of november 2nd for the governance committee anyist,

comments, on those minutes. >> thank you. >> and we'll now move to the minutes of the governance committee on december 13, 2022. anyist, changes, from the board members regarding those minutes? >> hearing none, i'd like to entertain a motion accept all three meeting minutes. >> commissioner scott i move that the board accept the minutes of november, 2, 2022, health service board meeting, the december 8th 4ud health service board regular meeting and december 13th health service board committee meeting. >> second. >> there is been properly moved

any comments from the board? >> hearing none, take public comment at this time and in-person comment will be first and virtual for anyone waiting in-person each speaker is loud three minutes and during the meeting all public comment will be made concerning the agenda and no going to answer the dialogue with the caller but pause on the line and radios around you • address the commission as a whole, do not address individual commissioners. an albeit warning when 30 seconds are left and the moderator will go to the next caller. and the next opportunity will be available by dialing the number on the screen. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 when prompted use the

access code. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 then press pound and pound again. >> and dial star three to be added to the could you and when our line is unmuted this is the time to speak. we'll begin with the public comment and no one has approached the podium to the virtual public comment the moderator will notify us. >> board secretary we have zero callers on the phone line for public comment. >> thank you, moderator. >> without any need for rich no callers on the public comment public comment is closed. . >> thank you. >> we're now rode to vote,

please call the roll. >> roll call start with commissioner scott, aye. >> vice president hao, aye. >> commissioner breslin, aye. >> enlightens, aye. >> >> commissioner follansbee, yes. and commissioner zvanski, aye. >>. thank you. >> minutes are for those meeting with approved. >> we'll now to item number 6. >> 6. president's report: (discussion) presented by president scott. >> for my accidents report welcome, everyone to this new year has we begin by in agenda rates and benefits recycle and all for the next 6 months. i want to personally thank the board who completed the board evaluation as well as the executive director performance evaluation since the last

meeting. in addition, we have required training and some of it was maybe redundant to where but again, it is one of the things annually go through in terms of looking at the essential harassment we looked at the issue of it security and other requirement as we're board members for the health services and up ahead of us, you know, the person conflict of interest form couple of in april and training and and so forth the ongoing board secretary will remind us and i hope with the same enthusiasm you'll go for that and thank you for the-

with that, that is the end of my presidents report. >> item 7. >> public comment. >> public comment i'm sorry. >> 7. director's report: (discussion) presented by abbie yant, sfhss executive director. you're welcome to approach the podium each speaker will be allowed three minutes for the public comment. and all public comment will be made within the agenda and the caller may ask questions but no obligation to answer and you're- and 30 seconds remaining and the moderator will- it is available online and up to period are available by you dialing.

>> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 then press pound and pound again and enter the call line and dial star three when the message says your line is unmuted now is the time to speak and begin with in-person public comment and immunity has approached the podium to virtual the moderator will notify us of comments. >> no caller on the line and no callers in the public comment. >> thank you moderator hearing none, public comment is closed. >> thank you, move to item no.

7. >> 7. director's report: (discussion) presented by abbie yant, sfhss executive director. . >> good afternoon. commissioners and happy new year to each of you and rather brief i did want to remind us we're still in covid 19 and the pandemic and subject to all the rules and regulations and i called out to rather than trying to summarize when the public health advisors for the treatment and the vaccine has been in children age 6 months and older and takes a few seconds. (clearing throat) there is also information in the health on the website as mentioned here about the vaccination recommendation as well as what we have come to know as it will with respiratory

virus and many of us so be safe and we continue to work diligently with the unified school district on helping make sure that members who eligibility has been in question and we're having a number of procedures to address that issue and will be at the district site however long to fix the under lying problem a reminder a real endeavor that requires a good deaf deal of our staff time and i mentioned some of the meetings i've been attending the reason in the report as that relates to the strategic plague a lot of

the work we basically approve it in health care so city of lincoln with the other public providers for covered california and i have a committee within the specific business group identifying areas have in common and work to work together i find that significant and we can update the board as that work continues. >> i want to remind everyone of the blackout notice that was initiated at the last meeting which is ongoing for july fy23 so if anyone has any questions about that or has an experience that perhaps they need to report

please let us know we'll address the situation. we did an indicated last month the mental health form in december and support and consulting services on the area of market street mental health with- providers as well some key department leaders and our leadership staff from hss. we really walked through a rigorous full day to identify what we see as- we can develop plans to get there. um, we'll be intending on bringing this report to this board next month. and also, we completed um, as we discussed in the past

annual the audits for the calendar year 2022 and also on the staff worked diligently to get the inventory of the compliance to continue to track at completion of all that i know to o want to reinsure it was due diligence to make sure we don't have a problem so that has been completed theist that were done last year mentioned in the report elsewhere and they're were no significant finding. and planned for audits the kickoff with martin luther king celebration and also chinese new year comes early on january 22nd

so fess activities are underway and join in the celebration where we can and say the- did a fantastic job to get the approval on the strategic plan going forward. um, and completed the task of closing out the strategic plan was finished and there is details in the director's report and you are sure we didn't forgot anything and carry forward obvious they should be and in case i- the analysis how much synergy there is and that makes sense in the flow so we're on track. >> outside of that um, the staff it has a operations report

in the drovrt address to my entire team thank you, it is we are down significant number of staffing those working are working hardly than they would if we're fully staffed and getting the work done. and there is not a attitude it is we understand we are working with a system that is far from optimal and i think literally everyone in town is working on the efforts to modernize the recruitment for the system. not because it needs to be done but so things are getting easier and get ahead of a curve so a lot of things governing in that area and the director for the human

resources thank you for them taking on the significant changes that occur to allow us to have a um, more easier time dba because it takes too long. >> that's my report i think for today and any questions from the board? >> any questions from the board? comments from the board regarding the director's report. >> yeah. i have one. >> yes. commissioner follansbee. >> thank you very much. for that this detailed report i thank you, thank you very much for the staff and abby for the staff in closing out 2020 to 2022 the strategic plan you mentioned several of the- are ongoing a majority have been completed but monitoring and

determines how the ongoing were they completed or a operating have to include, you know, set with the 2022, 25 and integrated with the new strategic plan has a structure to it? >> yeah. we do have a committee within the hss working with the implementation of strategic plan that detail will be coming from that effort we look at how we measure things and called out that um, we'll makes sense to carry forward and identify. >> well also i think some of these ongoing that we know are going to not only be a part of upcoming strategic plan the one we adopted and extended beyond

that as abby we're talking about collaborating and doing something about adult care and that is a massive kind of task toxic and not accomplished in one strategic plan but ongoing effort maybe undertaking different initiatives under that topic but i think that is the topic itself will be with us and lowering the cost of prescription drugs and trying to provide quality and so forth and ever expanding toupgz we have to take them one one time with the coordination i join with xhoments commissioner jernigan about the fact we have a documented result where we end up in the last plan and have a new one in place. i want to also

on behalf of this board thank the staff for their diligence and their continued hard working effort to recognize there are a number of vacancies in the staffing structure. and i know that the executive director eye have talked about this since the last four meetings and i know she has been working tirelessly work with the department of human resources and the executive director to take a look at the competitiveness and the salaries in terms of trying to hover staff and just continue to work at that but again to all of the staff members we thank you for your hard work at this time. >> are there any other comments with the executive director's

report. >> i have a question. >> yeah. combholts. >> thank you very much. to staff director and looking at the positions and the vacancies i'm wondering we're vice president marshall having- so many shortages and areas those day's work vacancies that- but our work is specialized are there specific difficulties in recruiting people that are qualified for those positions? or have difficulties um, with regards to that we're not- - >> (multiple voices). >> very well, maybe a contributing fork and one of the things that statewide is the classifications are out of control we're seeing 12 hundred

shared amongst h.r. requirements and other departments um, so with that our review of that make sure it is right and to look back see if there are barriers in positions and because and in addition to that we're talking about how we can enhance our training standards um, within the department um, that would not only reduce the liability and our staff but would also help us bring people in the organization that don't have access so right now under consideration but have to have the right support structure in order to do that with the training. >> but we think and grace is

the expert we think we can do a great job and do the modernization but the modernization services within the departments i mean the public comment that came in those items are are on the list to be able to do and the right kind of staff on board and get those operations working um, and we can- kind of a chicken and egg thing but would be sweet at the right point in time and i'm trying to think back waivers on this health services. >> (multiple voices.) >> you. >> the more stress is the

harder i believe at this time we're going to everything we can looking at in order to allow the work to be lighter people are right now looking for work but the training and training for people who don't have the background?. thank you very much. appreciate that. >> director comments if not go to public comment. >> thank you for in-person comment is first and then visible and approach the podium each caller will have three minutes. and all public comment need to stay within the agenda and callers may ask questions but no going to answer them and

state your name and address for the record. >> and i'll give an audible warning about thirty that seconds remaining and the moderator will unmute the next caller and available on sfgovtv and dial the number on the screen. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 then press popped up and pound again and identify the caller and dial star three to be added to the queue and when you're line is unmuted then is the time to speak. >> begin with in-person and no

one has approached and now visible and madam secretary one caller on the phone line. >> will specifically for public comment at this time. >> a reminder to all callers on the line you must dial star three now. >> we'll wait 5 more seconds and public comment for this agenda item. >> board secretary no callers in the public comment at this time. >> thank you moderator hearing none, public comment is closed. >>. thank you. >> we'll nova to agenda >> 8. sfhss financial report as of november 30, 2022: (discussion) presented by iftikhar hussain, sfhss chief financial officer. >> who will be joining us

virtually i can see iftikhar hussain, sfhss chief financial officer. >> the chief financial officer are you there how are you this average. >> very good we're delighted to see you with us. >> yeah. so and everything i ended up getting covid 19 thank you for allowing me to join us. >> so for the financials as of november we um, the good news were 4.8 higher than we started at the beginning of the year but concerns about the- and have assess plaza running how and we looked at the details we're seeing a lot of maternity and

plains mostly extend for the new they're adding up to millions of dollars we're working about what is causing that perhaps and the trends we're not seeing that in all their how by (sirens) high enough to get to the um, health measures they're doing and finding those trends and have a- for self-insured so as we get into the process we can understand those trends working to identify and (unintelligible)

for um, pharmacy they look good for the year and the general fund i talked about that favorable and we um, expect to have the process use some of the unfavorable vaz and avoid um, swiegsdz like this going forward but the highlights of the financials and i'll be happy to answer any questions you may have are there questions from the board regarding the financial statements or reports?

>> hearing none, have public comment. >> thank you commissioner scott in-person public comment will be first and then virtual and for anyone in-person you are welcome to approach the patio now you have three minutes for public comment. and all public comment will be made concerning the agenda and the caller may ask questions but no obligation to answer and i'll give you an audible warning when our three minutes are ending and the moderator will unmute the next caller and opportunities to speak during public comment are available by dialing the number on the screen. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 when promoted use. >> public comment call-in:

415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 and press pound and popped up again and enter the meeting as an attendee when the system message says your line is unmuted then that the time to speak. we'll begin with in-person public comment and no one has approached the podium to over to the virtual and the moderator will. >> board secretary one caller on the line and zero comments are entered at this time and reminder to all callers dial star three now for the agenda item and we'll wait 5 more seconds for the callers and then close public comment. >> board secretary no callers

in the virtual audience public comment is closed. >> thank you, you iftikhar hussain, sfhss chief financial officer. we wish you a speedy and rapid recovery thank you for your report. >> move to item >> move to item number general fund budget for fiscal year 2023-2024 and fiscal year 2024-2025: (discussion) presented by iftikhar hussain, sfhss chief financial officer. >> um, so um, i see the material. >> so you have had slide now can i go to the highlights. the agenda item covers not only um,

the special but an opportunity for public input and go to two public input on february 2nd just the financial committee the second opportunity for public input so- into. >> we'll be moving the minutes. >> so number two, slide just to give you an overview the input of cities and counties the three components versus the cost for the city is $145 million added the other (unintelligible) $1 million and we're responsible

for- which come to and then during (unintelligible) the general fund is is in the process anyone is about $18 million and, of course, the fourth year the budget and additional three percent in the following year and lastly, we presented the budget back with the funds in the fund on this $3 assessment of whether the muteists so i'll bring the budget to you that's fine and

for the mayors concerns. the next slide- (rustling of papers.) so in meeting the target they are not- looked at automobile the- and see whether some thought to be used as a way to meet those target. next slide, please. as you can see that the deficit are expected to grow so the second year is one hundred and $27 million so for the path to

avoid those deficits the reasons on the next slide for the deficits the recovery of support from- yeah. from the pandemic purchasing is running out (unintelligible) as the pandemic is approaching the year they're putting out expenses- expenses to go out with the revenue and the tax revenue base not recovered with the high vacancy rate. an off space and slow down businesses. um, so the last

slide as you can see the calendar earlier on february 6th had a finance meeting and provided input. our final budget will be presented to you the end of next year. >> um, so those are the highlights i'll be happy to answer any questions you may have. >> about the mayor's budget instruction. >> are there questions from the board members regarding the mayors presentation on the budget to your budget? >> yeah. commissioner follansbee if i can ask a question. >> police commissioner. >> thank you very much. i assume those are the same that have load governor gavin newsom to announce california state budget will be in diversity next year of $220 billion i'm

wondering does the mayors budget take into account the decrease from the state as well or the state support i don't know how that might work but is that factored in or no relationship? >> and the causality a comment that your saying the governor may support that so- the instructions. >> thank you. >> so we're anticipating some more information coming from the city. >> so help me with this we have to submit our budget in february. we know that there will be revisions with the state budget and the controllers projections after we submit our budget so is there a process where they come back to us and say based on the revisions and the respectfully we're prepared

to look for this is a that worsen do we have to go back and resubmit our budget how does that that add up. >> and then so this is a request or you can request from the public- and usually the board of supervisors go through a process after the budget is done. but this because one item this year is, you know, not clear so i follow-up on that- in the mayor's office to answer your question as to how input or information is used in the mayor's office.

>> can you go to the calendared? yeah, the next board meeting we'll be approving the original submission absent those other quote worsening outlook factors. is that; right? we're approving the initial submission of the budget that is compliance and also have to weigh in on that as a board? >> that's correct. >> (multiple voices). >> to answer your question (unintelligible). >> all right. so thank you for that clarification. >> other questions. >> commissioner jernigan. >> i'd like to ask the board of supervisors has their budget committee working concurrently with that process. are we

working and not yet we engage with them once the mayor has the budget. >> nothing in advance. >> nothing in advance. >> yeah. >> okay.. thank you. >> all right. other questions or comments for the board regarding the process? >> if not take public comment. >> thank you commissioner scott. >> in-person public comment will be first and then virtual public comment. and while waiting in-person you can approach the podium now. and all public comment is made skernl the agenda and the caller may ask questions but no going to answer. for those caller on the line when i call you're encouraged to speak clearly and we'll do an audible warning of

30 seconds and place you back on mute and the melting is available in sfgov opportunity to speak period are available by dialing the number on the screen. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. when promoted use the access 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. then press pound and pound again and dial star 3. when the system message says your line is unmuted now it is the time to speak. we'll begin with in-person public comment. and no one has approached the podium move to the virtual public comment and the 3-d rapport will notify us of my commenter. >> board secretary we have one caller on the phone.

>> zero callers specifically for public comment a reminder to all callers on line dial star three now if you want to be placed in the queue and we'll wait 5 more seconds and then close public comment. >> board secretary still no callers in the public comment queue at this time. >> thank you moderator hearing none, public comment is closed. . all right. thank you and again, chief financial officer iftikhar hussain, sfhss chief financial officer. wish you a speedy recovery. >> now go to >> now go to item insurance portability and accountability act(hipaa) training: (discussion) presented by rin coleridge, enterprise system and analytics director. >> this was a carrier over item

in december so we're at a point of continuity and good afternoon and how are you? and welcome back. >> pleasure to be here. >> good afternoon, commissioners. director for the rin coleridge, enterprise system and analytics director. and security officer. >> and today, i'm presenting your annual hipaa training i know you be all well-versed in hipaa and any review definitions regulations or practices you'll find that in the appendix today

we're going to focus on increases in the civil penalty when is new since january 2022 when we did the rops training and for fy23. so we'll start in top 5 hipaa violations number one, is when you got our non-crypt devices with a black top that's why we provided those laptops when you're doing our ph i and lack of training but training for today. and there is also a properly sharing of information and finally rounding out the top 5 is the disposal of the information and see yourselves perhaps 4 out of 5 of those; right? that's why we doing this today and more importantly to slide two. we'll

take a look at quickly at the changes in the civil penalties and actually still the same disclosing amount originally set as part of the high tech app but adjusted for a filtration for one $279 million and the caps is just a reminder that the very tiers are escalating based on whether you have known or no way of knowing about a improper breach and add clarity that's the difference and a reminder commissioners criminal liabilities put you in jail and fined $2,000 or loss of licenses and others. moving ahead to slide three talk about what was new since the last time i was up

here of those are the maximum are just a inflation change and human services has reevaluated how that is applied 0 instead of it an individual torres only applied on the tier 4 level the moment cap is for the other three tiers is reduced to one $25,000 up to $300,250,000 and just in december of this prior month hss released guidance on online talking technologies. so what that means to you if you're vista a website or applications running in the background talking where did you come from and where do you- it helps the

website owner more effective how they make their site applications effective and engaging but instead of tracking making sure that is compliant with other practices. and jumping ahead to fy23 actually 10 years since updates to hipaa for the high tech hss released a to change and the final rule change is expected in- so just a note no plan changes on the hipaa security rule but expectation we have new privacy rules r50e78d in fy23 and, of course, in 24 with administrative requirement and also he moving provisions and

discourage the coordination and gets to finalize this with the director's report and so final is what i'm reviewing we'll take a look at when might be coming and more than a couple but time to provide access to ph i for 15 days to thirty and how to review the medical records and- allowing patients it request a transfer of ph i to their personal health applications and a lot of opts and devices tracking your house the against of healthcare operation will- will be broadened to cover the management and to help with the continuity of care and covered

in the 4 points of bottom just posting on the website for the fee schedule for ph i and someone makes that request of information they can provide that with individual estimate of fees that they may entertain. and with that, that's your presentation for today, i will take any questions or comments. >> on this individualized fee when do you think we'll have that information? >> so the fees- what did organizations do the individuals time to copy materials and copying costs not have any requests come to in any 10 years as a officials for hi example

ivy and evaluate that when we get closer to that time. >> all right. you can't project that will you to be done in-person so a person comes in to the offices and requests any ph i on them made available to them as soon as they make an appointment coming in and making a request a look at what we have and take pictures of that or ask us to make copies for them. >> yeah. and they can take notes. >> yeah. >> all right. thank you. >> thank you. >> any other questions from the board. >> no notion when the new

regulations will come out at this time. >> not at all they're well over do you. >> quite awhile ago. >> okay. okay. >> any other questions from the board? >> we having a question. >> yes. commissioner jernigan. >> what did it validate the individual making a request actually that person? >> is there- >> (multiple voices). >> i mean yes this is not just because someone comes in and wants their own information but so- they're collecting information um, date of birth. >> do we do anything? i'm thinking there are plans we have- listed if someone comes

in and applies their information but gathering that they may end up with information from others on the plan um, is how does that work? with regards to that and the individuals that are a member of the system and- >> (multiple voices). >> that's a great question. so you're right you called it out. from hipaa everyone has their own hipaa rights so, you know, so that didn't mean the member could necessarily look at the foils and get information we encourage the members we have a one-time hipaa form for an the website so that is simplifying things and don the information that is requested we have to go through and do reductions and check to see in the member

wanted to approve and get help on that and if they show up together so we'll have to look at those but as we get closer to those things calling out right fully. >> that might include others that too have independent children. >> all of them yeah. >> any on the comments if not we'll take public comment on this item. >> thank you commissioner scott. >> in-person will be first and virtual and you're welcome to approach the podium and you have three minutes. all public comment will be made with each agenda item when reached and

those caller on the line you're encouraged to speak and i'll give you an audible warning and thank you for your call. >> put you back to mute. >> dial the number on the 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 and when promoted use. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 press * then 3. - you will hear: “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. for those already on hold please continue to wait. we'll begin with the in-person public

comment. and no one has approached the populated and to the virtual public comment our moderator will notify us. >> we have one caller on the phone line. >> a reminder to all caller on the line you have to hit star 3. and give you 5 more seconds. board secretary still no callers in the queue at this time. >> thank you moderator hearing none, public comment is closed. >>. thank you. >> before we proceed with a rest of agenda we're going to be moving back and forth between devastate topics by the agenda next go into governance

committee items and move to rates and benefits and then indicated a closed session. um, i'm going to exercise privilege of the chair and move item 14 up to um, come. >> commissioner scott i believe there- error on our agenda. >> yes. >> i believe you're talking about the benefits and rates and 14. >> (multiple voices.) >> we have two 14 that is item 17 reports and update from the health plan roots that item will be moved up before we go

identified as closed session after item 14 we will take item 17 for any representatives who are here today have any update for us entertain those and then proceed into closed session. >> all right? >> so with that, commissioner follansbee. >> here. >> are you ready to assume the chair? >> i am. >> good. >> right now do so (coughing). >> so we're opening agenda item 11 i believe and that's correct sir. >> thank you this is the item the health service system governance policies and terms of reference: (action) presented by committee chair follansbee. >> take a moment i'll be

pulling up the screen for you to speak. >> so i think we can go ahead this is a background the agendize two um, meetings of the governance committee and november 2nd and november 13th we approved the minutes of those meetings earlier in this meeting. um, and there are several attached documents that are being brought up the first is a request for approval of the health service board in terms of reference changes. um, and then three other documents include a red lined changes were recommended. so what i'd like to do so this is a summary of the change we're going to everything we can to vote on i'd like to i'd like to entertain a motion to approve these and second and open up for discussion item by

item if it's okay with the board members? >> mr. chair, i move that um, we approve the changes as we'll be present with the request excuse me - accordingly with the reference governance policy 210 and 13. >> second. >> there is a motion and a second. we approve the revisions to the health service board governance policy in terms of reference open up for discussion before do thank specifically um, the chief financial officer iftikhar hussain, sfhss chief financial officer. and abby and holly for helping navigate all those discussions and changes that was reviewed and then spun out as in terms of governance on december 30th allowing more than

that than 10 days time for review that i know the commissioners and general public with that like to i guess open up for discussion and questions from the various commissioners. >> so let me go through four points we addressed the first was there was a proposal we add some language to allow for exceptions to the terms of governance of the board. and that was discussed it was proposed and reviewed by the committee with the help of our counsel. and decided a rare cause not move heed with that

agenda item. that item is not conducted was one of our tasks to review and decided not to proceed with amending our terms of reference in that regard and the second item has to do with in terms of of reference of in terms of regarding audits and go to sort of make our governance in terms of respect and governance in light of what we're doing and the third item was 210 which was updated on the contingency reserve policy and methodology and again, i thank mike clark and for remind us with the presentation made in november 2022 including in terms of and this item was a matter of

sort of updating this to fact of the matter what is required and necessary to fiscal year responsibility for regarding the contingency reserve policy. and the two 13 a new policy as you recall the health services from the settlement promoted by the health system cost action sought and we had the policies how to handle those best settles so policy 213 to cover the legal settlements and by the health health service board in this record ra read that smieshdz all four categories with the revisions as red lined as provided so again, that's background any further discussion? >> i'm seeing none, in the on

the amongst the commissioners at this time. >> hearing none, go and open up for public comment. >> thank you commissioner scott excuse me - in-person protect first and in-person you're welcome to approach the populated press * then 3. - you will hear: “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. i'll give you an audible warning of 30 seconds and then the motor art will go on to the next caller. >> and available by dialing the number on the

415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. >> when promoted 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. >> then pound and pound again and dial star three to be added to the could you and the message says you're line is unmuted and many we'll begin with in-person public comment. no one has approached the podium and the 3-d rapport will notify the public comment on this time. >> madam secretary three callers on the line and specifically entered the public comment queue at this time. and a reminder to all called on the line must press star three now

if you want to address and wait 5 more seconds and close public comment on this item. >> board secretary still no callers in the queue at this time. >> thank you moderator herein public comment is closed. >>. thank you very much. and now roll call vote. >> starting with commissioner scott, aye. >> vice president hao, aye. >> commissioner breslin, aye. >> commissioner canning, aye. >> commissioner follansbee, aye. >> commissioner jernigan, aye. >>. thank you very much. and passes non-complying. >> thank you all the individuals that participated and conducted all the commissioners that provide input into the changes so we'll we'd

like to close agenda item 11. >> thank you before we do that as you know those will be incorporated into the terms of reference and newly adopted policies aforesaid into the large work and last fall approved cafeteria plan updates and member roles and so working with the board secretary over the next week's you'll see if you want it it hardcopy of those documents which is delivered at the next board meeting or a hardcopy for those board members that point one or you want an electronic version posted on the website so, so if you want the hardcopy please voices the secretary today. i do. she knows

that. >> noted yeah. >> commissioner jernigan and commissioner breslin she raised her hand you know you have that hard copies at the next meeting and the other will speak for themselves so. thank you, again. commissioner follansbee for you work in governance and move to 2023 rates and benefits now we're talking about 2023 rates and benefits is all that participated and with that start with with item number

>> 12. presentation on the 2023 rates and benefits calendar for the plan year2024 (discussion) presented by abbie yant, executive director. >> good afternoon materials the neighborhood calendar for this season. i will call out we put a hold on the fourth thursday of each month for the neighborhood and until the next meeting so i calling your attention to put that open your virtual calendar to have the opportunity to cancel those meetings. and few agree we cancelled the february 23rd meeting along with the clock work today and very comprehensive calendar and staff worked to have the items if you see anything missing let us know

the final approval day not gentlemen 0 confirmed with the board of supervisors we know we have a new president elected and know through the new chair the budget and finance committee and then should we need to develop a relationship work on that i think we have everyone on the board at this time and we'll wait by the way, will wait for the appointment to the health service board hoping the president has and his staff are able to appoint a member. with that, i'm available for any questions that you may have. >> questions with the 2023 rates and benefits calendar? >> by dates? hour we're going to work through the process of r5ir78 of the year?

>> if not we'll take entertain public comment at this time and sign up. >> thank you commissioner scott in-person public comment is first and virtual in-person welcome to approach the 3078d now three minutes during the press * then 3. - you will hear: “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. i'll give an audible warning and you'll be placed back on mute and is available on sfgovtv and dial in number. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. when promoted use. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again.

>> public comment call-in: 415-655-0001 / access code: 2481 453 5729. then press pound and pound again. and dial star three are and when the system says your line is unmuted this is your time to speak. >> we'll begin with in-person comment and no one has approached so move to the virtual and our moderator will invite notify /* notify us. >> a reminder to all callers on the line must dial star three now. >> wait 5 more seconds and then

close the public comment. >> still in callers in the public queue at this time. >> thank you moderator seeing none, public comment is closed. >> go to item >> go to item 13. >> thank you >> thank you (ibnr) reserve and contingency reserve amounts for self-funded and flex-funded health plans (action): presented by mike clarke, aon . this is action by presented by mike clark, aon. >> good afternoon, commissioners. >> welcome and to your colleague as well. >> (multiple voices). >> any time, sir (laughter.) >> (multiple voices.) >> one preservation. >> this is your first presentation of the year and welcome the further ones depends on how divisive this one is. >> today we'll review and ask

your approval for the june 2022 reserve and contingency amounts for the flex funded health plans on the first page a reminder today is discussion is on the two of that 0 overall reserve policies. and not reported the estimate of unpaid liable for anyone where the services incurred that is june 30th, 2022, and the process after. the contingency reserves as they determined amount against the funding estimate shortfalls over a variance exceeded the claims and again, calculated unanimously for june 30th and the thirsted which will not addressed today but the

stabilization which comes from the gains and loss and the flex plans that is calculated annually as of december that's it so we will review those recommendations with you in the march and april timeframe. >> with those three policies they applied to the following plans the flex medicare and hmo and the blue cross blue shield for active retirees and new element this year with healthnet canopy care in 2022 is the example b and r reserve for that plan the self-funded medicare plan that is primarily by blue cross blue shield for active

employees and reporters but healthcare for non-medicare or one family member is covered in the vague plan and the final ppo plan administered by adult for the active employees. the policies are are included in the web you see here though noted in item 11 will be an update posted soon to the consumer policy so the presentation today is asking for approval for the monument on the following pages. >> you see in the table each of the four major segments of plan administered by blue cross blue shield and healthnet and daily city for the active employees

you see amounts were improved for today um, for the june 30th, 2022, budget update overall an increase in the proposed um, result amount for i dnr as of june 2022 primarily due to not only an increase in the claims but chief financial officer be reported earlier in the meeting before you also observed for speeds of claim payments progressing by the health plans by the same employment issues we talked about today for the filling of vacancies and certainly the health plans struggle to maintain the levels of staffing to require the process for claims similar to what they had prepandemic another contributor longer time to process the claims

contributing to the there and we note in the page that was that on conversation with um, the auditor was discovery of h c for early retirees during the 2022 resulting in the transition of those lives for the h c to blue cross blue shield if we'd known about it with the charges only august 2022 are increased those for the plan for early retirees by (unintelligible) and then for the contingency reserves on page 6 as you can see the amounts about 6 percent increase overall that is consistent. so with

that, today is remove point health service board approve the contingency reserve amounts from june 2022 as for the material for the blue cross blue shield and the health plan and the health funded non-medicare plan administered by blue cross blue shield and usc and the dental plan and just the changes in the contingency rental units will be a component of the december 31st, 2022, stabilization calculation we have. >> commissioner scott. >> questions on this portion of the presentation? >> i have a question before the note. once this was discovered have made the amount of time and sfoithd some process in place

have a level of assurance that wouldn't be reoccurring in the future? so can you describe a what that is. >> absolutely cod changes like i said with the plans for 2022 so first of all, we identified this through the rating for that medicare and have the structure known in place so none of this would have been impacted for fy23 because none of this impacted 2021. and then, you know, perhaps a chief financial officer iftikhar hussain, sfhss chief financial officer. comment in the end they talked about it in the end and not found out it a significance in the value to request a restatement of

calculations but um, perhaps iftikhar hussain, sfhss chief financial officer. defer to you for commentary on that. >> yeah. so for m go not an issue because this was small but aware now and make sure (unintelligible). >> one thing our team did we had in preparation for today, the updated claim lag actual data available from the end of october we went back and tested if you had that information at the time with the reserve calculation we obviously don't but pertinent information through october we have been calculating similar figures to what we have as the result of ppo plan the answer is yes, we will recalculate a reserve closer to the $1.16 million not

over that relative but tracking with the expectations given the adjustment to the um, you know, kind of all the coding that went into, you know, kind of looking at the particular ones. >> thank you are there other questions? >> i do understand all of that. >> i believe i did but. >> if you have questions care to- >> thank you um, so- >> if i understand what you have just explained this one point one that when you did the recalculation that put in the right could you and calculated to make changes so what we have this is not outstanding in any

way in the process? >> so, i mean you ultimately what is brought to the year total the $36 million looking at if we had captured those unmapped claims properly at the time we did the calculation i'd be standing with a recommendation around $33.7 million i think the dmaefl based on m go analysis is the amounts in place the three 2 the $6 million are sufficient overall and didn't ask for a financial statement recast with that incremental one point plus million dollar. >> with the material. >> according to m go i'm not qualified to speak to that.

>> you said material (unintelligible) when we do the recalculations the next caution through the policies and then- >> all right. thank you. >> thank you. >> other questions from the board? >> on this item? >> if not we'll have public comment. >> i'm sorry enlightens if i may if we approve the june 30th for self-funded. >> thank you very much for that motion. do i have a second? >> second. >> second. >> properly there is a motion and a second. we approve the recommendation as presently regarding the i b and r and reserve fund. >> if any, you further questions by the board members.

>> hearing none, have public comment. >> thank you commissioner scott. >> in-person public comment will be first and then visible if you're in-person welcome to approach the podium now. >> and all public comment to be made has been present the caller my ask questions but we're not obligated to answer. give an audible warning of 30 seconds and you'll be placed back on mute and sfgovtv and online opportunity to speak during the public comment are available by doyle the number on the screen 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. and would when proposed use the access code. >> public comment call-in:

415-655-0001 / access code: 2481 453 5729. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. and then press pound and pound again, you'll enter the meeting and dial star three when “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. we'll begin with in-person public comment. >> and no one has approached the podium and move to the virtual public comment our 3-d rapport will notify us. >> we have two callers on the phone lion and specifically entered the public comment could you. and a reminder to all callers dial star three now, if you want to join and we'll wait 5 more seconds and then close public comment for this agenda item.

>> board secretary still in callers in the public comment could you at this time. >> thank you moderator herein public comment is closed. . thank you. >> we're going to take a roll call vote on this item. >> roll call vote starting with excuse me - president scott, aye. >> vice president hao, aye. >> commissioner breslin, aye. >> commissioner canning, aye. >> commissioner follansbee, aye. >> commissioner zvanski, aye. >> >> that passes unanimously. >> unanimously and thank you for your support and effort. >> thank you. >> we will now take items 17. it won't take that long. >> >> reports and updates from

contracted health plan representatives: (discussion) i believe one representative in ready to present. >> good afternoon julie fernandez i'm here to give an update on the wellness been a future on the ppo plan for the retirees allows for enhanced benefits if a member has conditions and conditions are diabetes or heart disease or hiv or arthritis if you have those conditions covered 100 percent and dental plan is covered 100 percent and has identified 9 conditions that will now be available for this additional benefit and we're excited to provide that for the benefits

for members so 9 conditions are als and scar and kidney disease and opioid addiction and parnlz and a syndrome so wanted to bring to your attention and happy to provide a need for this for members might be suffering. >> just to be clear, you used to center a list or 4 or 5. >> uh-huh. >> conditions that qualified and now expanded to include another 9 conditions will be allowed for four cleansing a year. >> yeah. 14. >> thank you. >> any questions? >> any questions from the board?? >> thank you for your partnership. >>. thank you for your time. >> other plan representatives here who wish to provide us with updates? comments? criticisms,

public or private anything at all. >> this is your chance. >> and there are representatives on line but no one. >> thank you for coming and we'll take public comment on this item. >> thank you commissioner scott. in-person public comment will be first and then virtual and for waiting in-person your women to approach the 3078d now and all public comment will be made concerning the agenda item and the caller may ask questions but no obligation to engage request the caller and caller on the line you radios around you • address the commission as a whole, do not address individual commissioners. an audible warning of 30 seconds. remote viewing is available from sfgovtv and opportunity to speak

during the public comment are available by 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. and when promoted use. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 then press pound and popped up again and you'll enter the meeting and dial star “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. if you're on hold continue it wait and begin with in-person public comment? >> no one has approached the podium and virtual the moderator will notify us. >> board secretary two callers on the phone lines. >> zero called have asked for the- and for all callers on the

line dial star three if you want to address the board wait 5 more seconds and close public comment on this agenda item. >> board secretary still no callers it in the queue at that time. >> thank you public comment is closed. >>. thank you. >> we'll move to item 14 on the agenda. >> commissioner scott just a note that after um, if we wanted to take a break if he wanted to do that now or after the agenda item. >> we'll take a break for 5. >> i'll call agenda finally in the closed session we'll include a break in that. >> >> 14. vote on whether to

hold closed session for member appeal (action): presented by president scott. >> all right. there is a question and i'm willing to i'd like to entertain a motion whether we hold a closed session for a member appeal. >> commissioner scott i ask we have closed session to address the appeal. >> it is corporal moved and seconded we vote where to hold the closed session for a member for appeal. >> any comments from the board. take public comment at this time. >> thank you commissioner scott in-person public comment will be first and then virtual public comment during the meeting in-person welcome to approach the patio podium now the- you're encouraged to please state your name for the record. and an audible warning of 30

seconds and then you'll be placed back on mute and we are available- the dial in 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. when promoted 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. then press pound and pound again and enter the call line and press star three and “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. for those on hold please continue to wait and begin with the in-person public comment and do the visible public comment? our moderator will notify us of any caller. >> board secretary we have no

callers have specifically entered the queue at this time a reminder to a you will caller on the line you must dial star three now if you want to address the board we'll wait 5 more seconds and close public comment for this agenda item. >> board secretary still in caller in the queue at this time. >> thank you, moderator public comment is closed. >> >> all right. we're now going to do a roll call vote. >> starting with commissioner scott, aye. >> vice president hao, aye. >> commissioner breslin, aye. >> commissioner canning, aye. >> commissioner follansbee, aye. >> commissioner zvanski, aye. >> thank you. the vote is unanimous we will now hold a closed session for a member to appeal and at this time go into the closed session to begin that

process. >> thank you commissioner scott

(in closed session). >> good afternoon um.

>> we'll hang on one more second i have not heard confirmation from sfgov that we've come back in open session. >> and it is confirmed we are live. >> thank you. >> board secretary call the roll. >> yes. >> roll call starting with commissioner scott present. >> vice president hao present. >> commissioner breslin here and commissioner canning here and commissioner follansbee? >> did we lose him? >> commissioner follansbee? >> commissioner follansbee can

you hear us, we can see you. >> commissioner follansbee can you hear us. >> yes. i can. >> i'm glad you can hear us can we have start the vote. >> yes. please do. >> roll call with commissioner scott presents. >> vice president hao presents. >> commissioner breslin present. >> enlightens present. >> commissioner follansbee present. >> commissioner zvanski present. >> and with that, we're now ready to take up item 15 discussion held in closed session: (san francisco administrative code section 67.12(a)) (action): presented by president scott. >> i'm ready to i'd like to entertain a motion a motion on this item and as president i move we disclose nothing that

was discussed in closed session. >> second. >> properly moved and seconded we not disclose any or all of the discussion held in closed session under the san francisco administrative code. is there any further discussion? by the board? >> hearing none, we're now ready to vote. >> thank you commissioner scott. >> oh- with an action item do we do vote or public comment. >> public comment. >> excuse me - >> all right. >> in-person public comment will be first and virtual public comment in-person you're welcome to approach the podium and you'll have three minutes and all public comment will be made concerning the agenda items and

callers may have questions but no obligation to answer for those callers on the line state clearly your please state your name and address for the record. and accountable warning when 30 seconds is remaining. and remote is available sfgov and available by dialing in. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 when promoted use assess 415-655-0001 / access code: 2481 453 5729 >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 (coughing) and press pound and pound again and public comment calling dial star three to be in the queue “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. please continue it to wait and before getting public comment

in-person public comment i want to check to make sure everyone is on line or panel or public comment and please give me one moment. >> illegality all assets is restored and in-person public comment no one has approached the podium to move to the virtual public comment our moderator will 0 notify us of my public comment in the queue. >> board secretary have zero callers on the phone line and entered the public comment queue at this time. >> thank you moderator. hearing none, public comment is closed. >>. thank you. >> and we're now ready to

vote by roll call. >> roll call vote starting with commissioner scott. >> aye. >> vice president hao, aye. >> commissioner breslin, aye. >> commissioner canning aids. >> commissioner follansbee can you say that one more time. >> aye. >>. thank you. >> commissioner jernigan, aye. >> vote is unanimous and now action taken in closed session (government code section 54957.1 and san francisco administrative code section 67.12(b) (action): presented by president scott. >> i'm ready to i'd like to entertain a motion on this item. >> mr. president i move that the report be limited for closed session for that.

>> do i have a second? there is a motion and a second. we not reporter on the administrative code and counterfeited any comment by the board? >> if not public comment on this item (coughing) >> thank you commissioner scott in-person and virtual public comment will be after that and you're welcome to approach the podium and you'll have three minutes. and all public comment to be made the caller may ask questions but no obligation to answer i your in-person call and an audible warning for 30 seconds and then placed on mute and opportunity to speak during the public comment are available by the number on the

415-655-0001 / access code: 2481 453 5729 again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729 when promoted use. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. again. >> public comment call-in: 415-655-0001 / access code: 2481 453 5729. then press popped up and pound again and “you have lowered your hand.” 6. when the system message says “your line has been unmuted” - this is your time to speak. formal those on hold continue it wait. and begin with my in-person public comment? >> no one has approached the podium and move to visible and the 3-d rapport will we have zero callers on the line and thank you. >> hearing no callers public comment is closed. . >> thank you we're now ready to take a roll call vote on item

16. >> roll call commissioner scott, aye. >> vice president hao, aye. >> and commissioner breslin, aye. >> enlightens, aye. >> i commissioner follansbee, aye. >> commissioner jernigan, aye. >> thank you. the motion passes unanimously and now ready to take up item 18 adjournment i hereby adjourn this board meeting. thank you. >> (gavel) adjournment at 4:26 p.m.

[meeting adjourned]

>> good morning i'm so honored to be with champions of-in the fight for civil rights and getting the bill across the finish line. the respect marriage act is affirmation the united states will stand up and protect the freedom for all americans to marry the person they love. it is reflection of the fact that for overwhelming majority of americans across political parties back fp grounds and every corner of the country the debate for marriage equality is settled. it was at city hall nearly 19 years ago when our governor then mayper begin issue mayor license for same sex couples regardless of it consequence. the court battle lead to success sfl lawsuit by equality california represented by friends

from land legal (inaudible) aclu challenging the state maerj bans. we move victorious in the fight we were devastating months later voters approved prop a. while the courts invalidated it ban the defense chb marriage act and all marriage bans we know (inaudible) own words that this new far right supreme court can not be trusted to up hold precedent or protect our civil rights. in contrast to the court this week's victory comes at a time when nation wide support is all time high. 71 percent of all americans from all walks of life acrautss dem graphics geography and party lines agree loving committed couples deserve equal rights equal justice and (inaudible) equal dignity under the law. it is big victory to be celebrated but not the sunsitute for full lived equality for all lgbtq plus people and will