Track, you have to build your own system to distribute your own electricity to the city and county of San Francisco. Get rid of pg e altogether. How many more examples do you need to demonstrate that pg e is not dealing in good faith, and by the same response never had intentions of reaching a legal agreement on this matter. About this contract agreement that you referred to, in may, if that contract was signed by pg e and they made a deal with the city, that is a breach of contract. If they pulled out and did not keep up their end of the bargain, understand me. That is an additional lawsuit that should be filed against pg e. Pg e has been busted by investigator that showed that well over several years ago they were told about their defective equipment and the electrical wires, and the electrical poles could cause a fire hazard. They did not do a damn thing about it. That is further proof. A minimum of 89 people have lost their lives in that fire, that took place, on the other side of the bay. Its disgusting. About you, talking about you want to take over their system, and their defaulted equipment is a waste of money. You can start by going and gathering god damn new semi get that 21 billion that he put in, and stop rebuilding and build your own system to distribute electricity that you already didnt it demonstrated that you can generate on your own behalf. Also, sorry. Your time is up. Next speaker, please. Hello supervisors, i am a resident of district one. I am also an electrical engineer, retired, a graduate of davis and berkeley. I think i am probably the only engineer, graduate engineer in this room, of the presenters we saw today. I appreciate, mr. Peskin, you are a person with with attention to detail. That is what engineers do. Supervisor peskin i think the general manager of our puc is an engineer, but go ahead. Many people who talk about being an engineer, there are many with different flavors. My degree is in Electrical Engineering specifically. I wanted to speak to the risks, and challenges, little bit and say am probably in favor of the option that nobody wants. One of the things pg e has now is what they call a scale. The city will lose some of that. It costs that the city wont increase almost certain because of that. Im not going to go into details, but i think you understand what the scale is. Things like distribution facilities, maintenance facilities, all of the things that needed for infrastructure to support the operation are distributed along its territory and can be shared within the territory. We will lose out in San Francisco. Supervisor peskin we have some of that upcountry. May be some, not all. Not to the extent that pg e in terms of responding to largescale things like how many power lines down. Im not going to get enough time to speak. In terms of the cost, we just talked about the park escalator canopies, and the unexpected high cost, and that is typical. It is a very common thing. Im not going to go into that any further. Finally, about the employees, it has been reported the employees already saying if theyre only in San Francisco they will lose the ability to transfer out. They will be competing with tech employees for their salaries. Supervisor peskin thank you. No, sir. Are there any other members of the public who would like to testify on this informational hearing . Seeing none. Public comment is closed. Ms. Hale, general manager kelly, godspeed. Any additional comments from Committee Members . We will be hearing from you quarterly about the red, yellow and green lights of which i think around that long list you last furnished us which was pages long. Everything else was predominantly red, little bit yellow. If anybody out there, from pg e is watching and they have legions of lobbyists, Governmental Affairs people, would you at least be decent to the city on that issue. This is amounting to extortion. This has nothing to do with the rest of the conversation we are having. Why dont you stop that nonsense with that. We are adjourned. Clerk is there a motion on the item . We will continue the item. Working with kids, they keep you young. They keep you on your tones on your toes. Teaching them, at the same time, us learning from them, everything is fulfilling. Ready . Go. [ ] we really wanted to find a way to support Women Entrepreneurs in particular in San Francisco. It was very important for the mayor, as well as the Safety Support the dreams that people want to realize, and provide them with an opportunity to receive funding to support improvements for their business so they could grow and thrive in their neighborhoods and in their industry. Three, two, one because i am one of the consultants for two nonprofits here for entrepreneurship, i knew about the grand through the renaissance entrepreneur center, and through the Small Business development center. I thought they were going to be perfect candidate because of their strong values in the community. They really give back to the neighborhood. They are from this neighborhood, and they care about the kids in the community here. When molly molly first told us about the grant because she works with Small Businesses. She has been a tremendous help for us here. She brought us to the attention of the grand just because a lot of things here were outdated, and need to be uptodate and redone totally. Hands in front. Recite the creed. My oldest is jt, he is seven, and my youngest is ryan, he is almost six. It instills discipline and the boys, but they show a lot of care. We think it is great. The moves are fantastic. The women both are great teachers. What is the next one . My son goes to fd k. He has been attending for about two years now. They also have a summer program, and last summer was our first year participating in it. They took the kids everywhere around San Francisco. This year, owner talking about placing them in summer camps, all he wanted to do was spend the entire summer with them. He has strong women in his life, so he really appreciates it. I think that carries through and i appreciate the fact that there are more strong women in the world like that. I met dandrea 25 years ago, and we met through our interest in karate. Our professor started on cortland years ago, so we grew up here at this location, we out he outgrew the space and he moved ten years later. He decided to reopen this location after he moved. Initially, i came back to say, hey, because it might have been 15 years since i even put on a uniform. My Business Partner was here basically by herself, and the person she was supposed to run the studio with said great, you are here, i started new Nursing School so you can take over. And she said wait, that is not what i am here for i was by myself before for a month before she came through. She was technically here as a secretary, but we insisted, just put on the uniform, and help her teach. I was struggling a little bit. And she has been here. One thing led to another and now we are coowners. You think a lot more about safety after having children and i wanted to not live in fear so much, and so i just took advantage of the opportunity, and i found it very powerful to hit something, to get some relief, but also having the knowledge one you might be in a situation of how to take care of yourself. The selfdefence class is a new thing that we are doing. We started with a group of women last year as a trial run to see how it felt. Theres a difference between selfdefence and doing a karate class. We didnt want them to do an actual karate class. We wanted to learn the fundamentals of how to defend yourself versus, you know, going through all the forms and techniques that we teaching a karate class and how to break that down. Then i was approached by my old high school. One once a semester, the kids get to pick an extra curricular activity to take outside of the school walls. My old biology teacher is now the principle. She approached us into doing a selfdefence class. The girls have been really proactive and really sweet. They step out of of the comfort zone, but they have been willing to step out and that hasnt been any pushback. It is really great. It is respect. You have to learn it. When we first came in, they knew us as those girls. They didnt know who we were. Finally, we came enough for them to realize, okay, they are in the business now. It took a while for us to gain that respect from our peers, our male peers. Since receiving the grant, it has ignited us even more, and put a fire underneath our butts even more. We were doing our summer camp and we are in a movie theatre, and we just finished watching a film and she stepped out to receive a phone call. She came in and she screamed, hey, we got the grant. And i said what . Martial arts is a passion for us. It is passion driven. There are days where we are dead tired and the kids come and they have the biggest smiles on their faces and it is contagious. We have been operating this program for a little over a year all Women Entrepreneurs. It is an extraordinary benefit for us. We have had the Mayors Office investing in our program so we can continue doing this work. It has been so impactful across a diversity of communities throughout the city. We hope that we are making some type of impact in these kids lives outside of just learning karate. Having selfconfidence, having discipline, learning to know when its okay to stand up for yourself versus you just being a bully in school. These are the values we want the kids to take away from this. Not just, i learned how to kick and i learned how to punch. We want the kids to have more values when they walk outside of these doors. [ ] i will turn it over to abby first had thanks. Good afternoon commissioners. Thank you so much for finding the time following your usual vacation month of july to have this meeting i want to set context for where we are both for the commission and those that are attending or watching. We are looking at the design of the Services Provided for our members by the Health Services system. What, i mean, by that, what it looks like to all of us that go through open enrollment and select our plans and our products to make those decisio decisions. That is what it looks like, right . At the end of the day. What carriers do we contract with . What services do they provide . In the contributions by the members as well as the employers. We have many questions about how the future of healthcare, which is very dynamic right now is influencing how we think about the delivery of the systems. In order, we went on the road this past year for a few month considering how we might can start the system so it continues to serve all of our members and the very robust way that it does. And improve the services that we have in this very volatile market. When we talk about that in healthcare jargon. We talk about doing an rs rfp. Request for proposal. A legal term about how we go for contracting with services that we engage. Its a provision of our services. I want to be clear with everybody, what this discussion at the end of the day will yie yield, it will inform the very detailed ask that we put in a proposal that we send out to the different carriers that are eligible to bid. And it informs their response to us in how they would propose they deliver those services. That is what an rfp is. That is the administrative talk for what the Health Service system will do and we intend on issuing the request for these proposals in the first of the next calendar year. That is where we are at. What we are kicking off today is a conversation. A conversation about how this is all working for us today. What are all of these changes that i am talking about. How does it impact members . What is important to us . We all have very different perspectives on what is important to us and values and reasons why. Our job is both educational and listening to with our membership to talk about the way the models are constructed today. What the possibilities are of doing things different in the future, and really listen to what is important. Keep the process very communicative i really have a robust dialogue. That is the intention and again it will inform the decision on how they will construct the request for proposal coming the first of the year. Todays agenda, we have a very packed presentation. We are trading off between thompson and clark with aon who have put this together with a lot of other input. We could go deep on any one of these topics and spend, you know, a lot of time. We will never be able to do that justice. We are talking about the industry activities, the Major Players and opportunities, the spectrum of the design and contracting strategies. Some of the factors affecting market assessments today. We have drafted Health System models that are current possible alternatives to scenarios for Health Service systems. We will then conclude with a recap of the discussions and the next steps. You can go ahead and pull up the slides, because im moving to slide three now. The goals of todays discussion, as i said are to focus on the plans available to early retiree employees. This process will not impact the existing medicare plans that we have in place. We are not tackling the whole enchilada. We are doing part of it. We also are talking about what that must haves are for current and future carrier partners. Our initial list of that is full acceptance and immersion of the strategic goals in all aspects of administrations from administrative to clinical. A deep understanding of the health, and varied health needs of the population. I think the fact that we have employees that spend their entire career, with the city, and then into retirement and are maintaining Health Benefits through the Health Services system pretty much for a lifetime, is rather unique and special in that we can focus on how we help people maintain their health as long as possible. The ability to ensure quality and highvalue care. How can we do that . What is the strength in numbers that we have . Weve talked a lot here at the board level about the modernization and inclusivity of solutions that continue to proliferate and how we manage those and whether that is the responsibility or best done with direct contact either hss or working with the plan or the Health Service systems to ensure the Digital Solutions that have been deemed available to our members. Our emphasis on the integration of data amongst partners. Ultimately accessible to each of us, as members. That Health Record belongs to me, to you, and so having those records consolidated in such a way that we can actually be a partner in managing our health is an ultimate goal we all working towards. Im going to turn the presentation over to Anne Thompson. We have put in a couple of clauses in the presentation pauses in the presentation, because i suspect the board will have some really good questions for us to hear, consider, and perhaps respond today or at another time. And then at the conclusion i know we have a number of members of the public who are very interested and have come today. We of course would be listening to their questions and concerns, as well. Without further ado, i will turn it over to Anne Thompson. Before you begin. There are a couple of questions that i have on some of these must haves that i would like like to at least articulate. The third bullet. Under this it says the ability to assure quality and highvalue care. I am wondering if that is a substitute for the work Cost Effective or is that another dimension to be included . We dont have endless buckets of money at the end of the day. To be able to do whatever we want. I think it is a shifting of the terminology. I think it is more common in todays world to talk about value based care rather than costeffective. They are similar. There certainly are a number of center of excellence concepts in different ways of going about ensuring the payment is on value and not necessarily on services and quantity. Alright. That that is helpful. The last one, the emphasis on interoperability. I wanted to know what that mea meant . I had to check my spelling on that. What it is, i think the big push of high tech money following the aca. There was a lot of money that came out to help systems to modernize electronic Health Records. There was a vision, i think that all of these records would communicate, and they do not. Today what is happening is that electronic Health Record, as well as you have all of these data points, if youre going through labs, if you have Health System data through a Health System. You have pharmacy data through another source. The concept of interoperability is one that virtually, everyone i just mentioned is working toward towards. To have the data operate in away that you would have a personal Health Record. All of those things could come into your record. The other way they are consolidating is around creating these big data sources so that Predictive Analytics and other discoveries can be made by large volumes of data. We can do presentations on interoperability. It is one of the biggest drivers and prove the delivery of healthcare today. That is helpful. I saw that term throughout this presentation, i dont have a clue. I understand integration and i understand interfaces between systems. But i did not understand what this meant. So thank you. Any other questions . No. Please do stop me as we go through this if there something you dont understand. I will try to take positive and explain. Just stop me if need be. On page four, continuation of the goals today. We are looking to gather your input on how to further define success metrics as well. Part of this is to set up this rfp, then how do we measure ourselves throughout the proce process . How do we measure success. That is something that is very important to us to make