Comment is closed. Vice president follansbee okay. On the motion to move the budget to the Mayors Office, all in favor . Opposed . Lets go into item 16. Clerk item 16 is the infert willi infertility benefit status update for blue shield of california, presented by shawn lovering. I would be remiss if i did not think, on behalf of did not thank, on behalf of blue shield, natalie, for all of her work and support. We are going to miss you. Next slide. Next slide. So were here today to give you an update on our efforts around infertility. It was brought to our attention last year that there were some issues, and were going to bring to your attention that we can fix things. [inaudible] when they added the Custom Benefits that you see on the right. Next slide. So we did a ton of research when this was brought to our attention, and we identified the following areas where we had gaps. Benefit authorization and identification process. We understand that infertility is a prepersonalize very personalized and very difficult process to go through, so we had to adjust our authorization timelines to better fit the challenges proposed by receiving infertility treatments to extend those. [please stand by]. As i mentioned before, we pulled all the previous denials for inFertility Services, rereviewed them. We also created access for members to a dedicated internal subject Matter Expert for assistance in navigating the matter with our patients. We have put in an endtoend process and oversight for every infertility request that comes in. In addition, we have created a more friendly overview of the Fertility Services available to sfhss members and put that on the sfhss microsite. Next slide. Access to meds. This, as you know, was an area that was brought up to be very difficult to navigate. [please stand by] so that the members have additional options when it comes to getting their fertility meds that are allows them to use their insurance and is easy to access and timely for them. We anticipate that these new contracts should be in place by november and we certainly will come back and update you on that item at the november board meeting. Are there any questions around what we identified, what we have corrected . And Going Forward how this will work for members . Lets open up the discussion now to the members of the board. Any comments or questions . This is commissioner. And looking at this presentation i see only one picture that points out a nonheterosexual couple. I think in your materials it would be nice to have a few more depictions of alternate family groups so that its not quite as heterosexual oriented. I think that is especially important for a number of members of our Health Services system membership. Thank you. Thank you, thats a point well taken. And on the on the website the information that we uploaded there we have certainly were focused on making it extremely culturally compassionate for all members. So if you take a look at that i think that you will find that we did achieve that. Other questions or comments . I have a couple. One is that, you know, its pretty i think that you covered from the beginning of the of this benefit in the beginning of 2018, so we had more than a 30 denial rate which looks to me, except for the few individuals that were not covered benefits were reversed. Over the two years now, 2 1 2 years, you know, thats a long time for people who are trying to undergo fertility. And i dont know that its not germane for what youre doing for future, but theres a significant fallout for the individuals who were inappropriately denied coverage. Im just kind of curious to know if you can maybe in three months or so to provide some followup information to those 58 individuals who were denied the service inappropriately. The way that i understand your presentation. The other thing is that the pharmacy benefit item is still very real and the information that we have been provided by obstenostensibly from a member o resourced this considerably, is that like a lot of pharmacy benefit systems or companies, that theres a very complex interrelationship between these companies and the providers. The pharmacy is now been brought out by express scripts. Express scripts is now a subsidy of cigna insurance. And i think that theres some concern that maybe cvs or walgreens are trying to buy it, but theres now cigna. And so my understanding now is that the decisions and the relationships and the reimbursement and the price setting now is under the auspices, frankly, of another Insurance Company cigna. So i think that this is opening up a hornets nest in terms of pricing for all of these specialty drugs. I know that they specialize in drugs that have to be administered intravenously, and it can be administered by the members themselves. But there may be other drugs. So i point this out because this is an issue not resolved for this benefit and i think that it deserves our look at it more carefully for all of our contracts that involve this kind of a pharmacy benefit company, a forprofit company, where our members are paying outrageous amounts of money for drugs that are accessible to them in other ways. Yes, thank you. And i think that is exactly why, you know, we are seeking additional contracts with other providers at this time. You know, the way that the benefit is currently set up, the drugs are paid under the medical plan and not the pharmacy plan. Because the fact that there are injectable drugs. But for infertilities theyre paid under the medical plan. So we are working with our partner, cvs, to secure additional providers and access for members and looking at reaching out to different specialty pharmacies in San Francisco to secure contracts with them to have additional opportunities for members. I think that its important that the members have, you know, other options to for when they go to access their drugs. And so that is a point well taken. Thank you. Just, again, to reiterate some of the points that have been made in multiple discussions, about the competition may be a good thing in this regard. Yes. I think that youre right. So other comments from any of the other commissioners . If not, id like to go to the period of silence where we open up to comments from our members. Thank you very much. At this point everyone at home who is watching and or on the conference line, please be sure to press 1, 0 after you have dialed into the conference line to ensure that youre put into the queue. We will start the 30 seconds of pause right now. Moderator, please up the public line for the callers. You have zero questions remaining. Clerk that concludes Public Comment on this item. Thank you very much. I believe that this concludes the discussion on this item. The agenda is that everyone had access to to eliminate some of the items that we normally have during the open times with comments on the health plans and other items. So with that its been a long meeting and ill entertain a motion to adjourn. Mr. Scott i wanted to thank the doctor for taking over for me. This is commissioner scott. I would thank karen and you for the way that youve conducted this meeting today. And with that i move that we adjourn. Second. May i remind my members that a motion is not required for adjournment. The chair merely indicates that the motion that the meeting is adjourned and thats all. You dont need a second either. Thank you very much, but i wanted everyones concurrence with this. [laughter]. Thats the spirit that i offered it, commissioner. Thank you very much. Thank you for all of your presentations and the meeting is now adjourned. President caen is excused from the meeting. [roll call]. We have a quorum. Thank you, commissioner secretary would you mind make the announcements please. Due to the covid19 Health Emergency and the department of Public Health and governor and mayor lifted restrictions on teleconferencing and being televised. For those watching theres a time lag. On behalf of the commission id like to extend our thanks to sfgov. Tv for their assistance. If you wish to make a Public Comment on an item dial 8882733658 code 3107452 and pound followed by found again. When Public Comment is given youll hear when it is your turn to speak and your twominute speaking time will begin. I will alert you when your time is expired. The instructions will be repeat. If you have not already done so, ill ask Commission Staff to mute their microphone to minimize background noise. Before i read the first item id like to let everybody know item 12 [reading item] has been pulled from the agenda. The first item of business is item 3 approval of minutes of june 9, 2020. Commissioner you have before you the minutes from june 9. Are there any discussions on recognizing the minutes . Hearing none, Commission Secretary would you go to Public Comment. Members of the public who wish to make Public Comment on item 3 approval of the minutes from june 9, 2020, dial 8882733658 and access code 3107452 and pound followed by pound again and press 1 then 0 to be added to the comment line. Do we have callers . Theres one call in the queue. Thank you. Hello, good afternoon go ahead. Caller hello . Go ahead. Caller my name is jackie yan. Hello. I just wanted to make a general comment. Clerk im sorry, this is the Public Comment for the minutes. General Public Comment will be the next item. Caller says, sorry. There was a tone and said to speak. I will hold until next item. Clerk thank you. Caller, be advised you will have to rejoin the queue following the instructions from the secretary. Do we have other callers . No more in the queue. Clerk thank you. Public comment portion is closed. Commissioner is there further discussion from the commissioners on the item . Hearing none is there a motion . Move to approve the minutes. Second. Commissioner allin favor clerk Vice President , i need to do a roll call vote. Commissioner thank you. [roll call] clerk four ayes. Commissioner the motion carries. Next item, please. Clerk item 4, Public Comment and you can dial 8882733658 access code 3107452 and pound followed by pound again. Dial 1 then 0 to be added to the speaker line. Clerk do we have callers . Thats multiple callers in the queue. Caller commissioners, my name is christopher acosta. Im asking two things. Number one, we the people from the bay view are not getting a clear picture whats happening with [indiscernible] and were not getting a very clear picture of all the benefits that are linked to the shore system improvement project. We keep donating 150,000 without any notice to the public. Taxpayers money. Thats not right. We have discussed the point in detail and we need to release as much water as we can, not foolishly but with reason so we can save the salmon. We come again and again and again to speak to power but some of you all condone the staff thats working behind the scenes to defy us. And i know a number of speakers will be speaking on this topic. So thats all ive got to say this time. Thank you. Thank you. Ill queue the next caller. Caller hi, my name is Jessica Silva power sf [indiscernible] [audio digitizing] is not something a Clean Power Program should be doing. Im understanding the program may not be considering adding this Nuclear Energy. But is it still an issue with the energy pg e is trying to offload because theres no market for it. Have to purchase the energy but it will be sold at the same price as fossil fuel energy so pretty much youre only getting the attribute of a carbonfree Energy Product and thats the only incentive but its not actually marketable and a Clean Power Program should being focussing on offering clean energy to their customers. I really hope that we can have some very honest dialogue about this because i think this is actually a detriment to our clean choice program. Thank you. Caller my commissioners. My name is jesse hahn and asking to consider a route between sawyer road. Its dangerous and vehicles driving 45 Miles Per Hour plus without shoulders or bike lanes and theres puc roads that could be made accessible to connect the two areas. Theres close calls nearly every day in this area. Folks are heading 92 over the hill and getting off on the freeway and think more people world ride bikes if there were safer [indiscernible] and this is a part of the peninsula and i think having part of this biking and exercise trail gives back to the community. We need healthy and safe ways to exercise and this is just one of the gems in San Francisco area and an encourage you to unlock those gates and make it safe for cyclists. Thank you so much. Caller thank you Vice President vietor. Ill leave a decree for the record use she and her and great to back and im still learning more about electricity in San Francisco and an appreciate the work that youre doing on the generation side to provide less Expensive Energy and the work must continue. Again, i continue to advocate for the formation of a municipal utility district for San Francisco. I ask you be active in the conversations about issues such as conservation to help people to manage their use of electricity and electrification and about the way of that electrirates are done in electric rates are done in california and the idea of baseline usage and tiers which is not under your control is concerning to me. On one hand i want people to conserve electricity but i dont want natural gas and oils and other fossil fuels to be used. I would fail on the baseline allocation because im averaging about 40 kilowatt hours per day and have an all electric home. Lets continually trying to clarify electric rate issues for people so they can be enpowered by electricity in the best way and i look forward to your work in adding more renewables to the mix. Thank you. Caller can you hear me okay . We can hear you, caller. Caller i represent the Green Committee at the San FranciscoUniversalist Church and interested in preserving our estuary in the bay and the tributaries are all intricately connected and as we saw during the drought of 2011 through 2017, the demand on water from the delta left us in shock how little attention was being paid by Public Utilities commission to the health of the delta. Future developments have to live with the reality of Climate Change and the owe kol gy of our ecology of our eco system. The delta plan say good plan that keeps the balance of our delta system intact while spreading water available to those who need it. The resource and control board spent a lot of time and effort in the issue and the bay delta plan is the right answer. Thank you. Clerk id like to remind callers this is item 4. If you want to speak to a specific item on the agenda. Please call back when that item is called. Thank you. Caller, can you hear us . Caller hello. Thank you for allowing public input im mr. Richardson and lived in district 2 a native of for instance for a number of years. Ive heard sf puc staff talk about the plans. Like any old designer suit, the designer drought has to go and ill tell you why. Until the most recent drought at the end of the summer 2016, sf puc had five years of water then we had the historic water year of 2017 and puc had enough water to last 12 years. Enough water to last a decade. We had so much water we had to reless release more of 80 . It makes a designer drought a story and it has to go. Whats this mean for people of california with boots on the ground . Instead of letting out an appropriate amount of water during the drought for fish, for recreation, People Living on the river or near the river, for down stream users, the s. Fpuc essentially put a choke hold on the tuolumne area. I know president caen isnt there but Vice President vietor is there and i appreciate your time. I was up in modesto for the meeting on the dam and was astounded by the disingenuous misinformation Staff Members shared with the committee. It was an embarrassment. You need to know what the staff is sharing with the feds. Im sorry, your twominute time allotment has expired. Caller hi there im nate holtzman from the bay area. I want to thank staff for pulling item 12. I had a conversation with staff yesterday about the item and i appreciate the action. This is about an allocation of Nuclear Energy from that project and were trying to get power without violating the policy of procuring the power for the customers and i get that and a get its a raw deal and were trying to reclaim a little bit of revenue but theres times you leave money on the table to make a point. I dont have time to go into an algy. I want to an analogy. And no one in the community had heard about this at all. Buyers lined up and it gets slowed and the community is involved and thats great but i want to highlight if you had found a buyer all this would have happen without Community Stakeholders knowing or lined up before commissioners should be involved. Thats not the way it should happen. Lastly the agenda item is written inaccurately. The point is not to reaffirm your antinuclear policy for no reason, its to change something and thats not reflected in the agenda item so im not technically sure its noted properly for today. Thank you so much and i hope for substitutive reasons we can go into at another time puc will not move forward on accepting the Nuclear Energy from them. Caller im steve rosenblom a puc customer in palo alto. Conserve water with replacing poi toile