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tv   Government Access Programming  SFGTV  December 23, 2017 7:00am-8:01am PST

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you say the same exact thing and as the well-being score goes down the days off goes up, right , so that is what the research said would happen and that's what we're seeing in our population. slide 8, slide 8 is a little harder to read and so there were questions at the end of the well-being assessment that asked folks of the following factors which impacted your ability to be productive at work so it wasn't actually taken in to account in to the well-being score so you can look at their well-being score on the productivity measures so what you see is that people who are reporting that they are less productive because of these factors have a lower well-being and it differenters so a lot of people are saying that they have too much to do and that is
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impacting their ability to be productive. and that does have a detrimental effect on their well-being bringing it down to an average of 67 points, our over all average is 74 so it brings it down a bit. so there are other factors like depression, problems with your supervisor that when people report those their well-being decreases substantially more to 53 or 54 so lots of different factors impacting productivity but they impact over all well-being a different level so lots going on on that slide and it's very interesting. a lot of opportunities there for us. slide 9, just don't look at it for a second, just listen. it's a little bit of a mess but basically there's research that looked at is there a single cut point. so there's the score out of 100. is there like hey if you get over this one point all of a sudden there's a big increase
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and that research showed that that one point was 7 a or higher so what i looked at was in 2014 what percentage of our population was at 75 or higher and then how did that change in 2015 and we went from 50% at 75 or higher in 14 to 15 and that is a big jump because it has significant i am fact -- impacts to healthcare costs according to the research and so our average score only went up a couple of points so we had a big chunk of the population shift in to that safer zone of over 75. but what is driving your
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well-being score up and what fast -- factors are influencing the well-being. so there are a couple of trigger points there too. the well-being score jumps significantly when people are eating five serveings of fruit or vegetables on four or more days it's a difference between that like i do it three days and they have a big impact on the well-being scoring, same thing with physical activity, if can you get people from two days of 30 minutes of exercise to three days it's a big jump in the well-being score and if you can get people to the overweight or normal at category from obese is a big shift. physical activity healthy eating , weight, those were all things we talked about when we started but one thing we didn't talk about before we started was how important the employer is to
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our well-being and we talk a lot about healthcare and individuals but understanding the environment we exist in and the employer in which we exist has an influence on our well-being is a really important point because to some extent we have control of that right and so what you see on slide 11 is when folks feel they're on a high-end of that 0-10 scale and that for us to have influence and slide 12 just sam ar eyess and weight management and physical activity and healthy eating and emotional well-being and the organizational caring and those things are highly correlated if
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they're good well-being is good and well-being and associated and productivity measures of absenteeism and performance and costs things like higher preventative screening rates and hospital costs and workers com many in the research we do not have that data to look at that in our population at this point. that is what we started with looking at how we happened in our population and then it takes you in to our mission because one of the things that we didn't start with and we've really grown in to is who we are and in 2017 we defined well-being as living and feeling and being better every day and understanding that when we do that there are things that happen today, today we have more energy and we feel better and that's where you really see those enhancements on your
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productivity and tomorrow, hopefully those things accumulate and in to us preventing health conditions and berman age health conditions and in the long-term really allowing our quality of life to improve and so that's where our mission came from. on slide 14, you have those factors that are associated with well-being and a list of the some of the programs we offer to address them and you will get my usual overly long annual report in the new year that summarize those programs and how they've been doing and we report on them as they come up and lots of different data points for you so there's no one like look at that and we did that for well-being it's all of these different programs and it's all of these different concepts they're all driving that number so they all play a piece so i can't just give you one. i am working on being more brief
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>> are there questions from the board. >> i forget some of your methodology of the assessment on the numbers look great but i don't know how many people harmed so it would be helpful to add a little n equals 3 for the healthy and equal 700 for the unhealthy, whatever, just because it gives us a sense of the magnitude and maybe how we can look at the whole populations so that was just one suggestion. >> yeah, definitely. >> take a minute to review the methodology but maybe for the few. the other question i had was having just finished the two hour training on harassment, which took three and a half because of the system i understand weight and height are protected catagories so i i just am curious with all of these how
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we protect against harassing people who might not be eating healthy or consuming five you know, and serveings of vegetable and fruit there's an opportunity for peer harassment or manager harassment or whatever, if people we think gee, you should be in our healthy eating program and you are not and how come? harassing people and i'm just curious how the well-being program accomodates that. >> just high level 20% of our employees took the survey so that is the underlying and why have the catagories off the top of my head. to your second point, a couple of things. it's definitely the tone that we set and with my previous employer, the companies that we worked with very often took a
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approach of you have to do these things to get this premium, right, and that creates a culture of people judging and forcing, and a lot of negativity and a lot of stress and a lot of those factors you brought up and the approach that we have taken is everything is fun, everything is optional and we admit openly that not every program is for everyone that our program is about being better every day and whatever that means to you and we want to you live healthy, we want you to feel good and get care and we know that well-being is this huge concept and everybody is working on different things at different times so opening the program with the well-being assessment defines well-being like that instead of saying our well-being program means you need to have
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these numbers and you need to be a healthy weight or if you are not doing these things you are driving up our costs, right if we had taken that approach that's the culture that you create but we took a very different approach and it's slower, it's harder, it's harder to explain to you being having an impact when you take that type of approach but if you set the culture wrong on the onset, it is so hard to take that back. >> other questions. thank you for all of your efforts to you and your team and we look forward to your report in january. and soy understand that there's part 2 and that's the diabetess. >> yeah, so today we were excited that the timing of the data report actually coincided really nicely with us getting back the initial data for the
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diabetess prevention program which was a partnership with kaiser and the division of research to really target a higher risk group so a group that is at risk for diabetess they're not diabetic but they're at risk for diabetess and so two years ago, we set out on this journey to recruit participants to see if a work place-based program or an online program worked better and the program regardless was the established diabetess prevention program which is a proven program that came out of n.i.h. and c.d.c. research and is a crediting programs all over the country and c.m.s. is looking at the importance of including diabetes s prevention programs so it's not like we made up an intervention we took an intervention and testing is it better in-person at the work site or is it better when
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delivered online so that was slide 16. slide 17 shows we were able to recruit 158 people and we, i didn't, i had nothing to do with it, kaiser division of research randomized them in to two arms and 80 people and 78 people and of those folks, we asked them to give us their initial measure ment and they attend 12 weeks of classes and hold line or in-person every week for 12 weeks and then they go every other week for a few months and they go once a month for a year so we asked these 158 people to do something for a year which is why we're reporting this out to you two years after we started and it took a long time to get those folks and check them for a year. at the end of the year, we had
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43 of the online folks show up again to get measured and it doesn't mean they completed it and it doesn't mean they didn't complete it it just means they shove off measured again and we had 54 of the work site folks so all the data you see really comes from those folks who showed up at both points. it isn't uncommon to have this drop off and it probably is somewhat took tell tale there was unanne drop off and the other thing that you have here, are the list of locations and i included that not just as a thank you to those departments and those champions who actually found rooms for these things, can you imagine trying to book a conference room once a week for 12 weeks and every other week for a year in the city where
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we're so space constricted, it takes a lot of work but it also shows all the different types of workers so we were out at dp yard and we were at the library and we were at laguna honda so a lot of different work environments in this study. so slide 18, of those folks and we lose weight what percentage of weight did they lose and some say d.p.p.66% of them lost weight so those in the online d. p.p.63% of them lost weight and that's of the people who showed up at the end to get measured. on slide 19 the average weight loss so we measured them at six months and again at 12 months and it's really important to see if it was holding up you expect a bigger weight loss at the beginning of a program but sustain tag isn't as easy so
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what we saw was at six months, they had about a four to five pound weight loss and the online group started to regain by the end and the work site group lost a little bit more so most importantly they sustained that after six months because you don't expect the biggest amount of weight loss in the first six months. slide 20. this is people who participated that were over weight versus obese because there are -- it's incredibly important looking at those high-risk obese folks trying to reduce them because they're probably closer to becoming pre diabetic or diabetic than the over weight but they're also, they tend to respond differently so what was great to see was the work site program both over weight and
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obese folks lost five to six pounds but you did not see the obese participants lose very much weight at all. slide 21 is, i bet you had to read this one twice. so this is about how many pounds they lost. so based on how many sessions they showed up for so in theory if they come to more sessions they're do better. the people in the work site program who didn't come to more than eight sessions actually gained seven and a half pounds which say negative seven and a half pound loss and the people who came to eight or more sessions averaged the weight loss of seven pounds and looking at slide 22 we asked participants what they liked and
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what they didn't like six and 12 months so some of the helpful features that showed up or having a lifestyle code so both programs had a lifestyle coach but one was in-person and one was e-mailing with you, right. and tracking food intake was a key factor and the content people actually learning the educational information behind all of these classes was really important to folks and some of the barriers to participation was the farm at and some thought it wasn't conducive to them and another barrier was they lost interest and another barrier was poor resources so you can see that there was the folks in the work site program reported the helpful features a lot more frequently and the people in the on online program reported barriers more frequently. >> on slide 23 you have a quote
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that i could have just not given you any of this presentation and just given you their quote sums up everything about the on site program that was successful. and slide 24, we asked them why they participated and -- when we asked them if being offered by the employer was important 83 to 86% that was a major motivator for them and having no cost was a major motivator for them so some of the implications of this incredible long is that i am person programs are an important component of an he can tive well-being program and it doesn't mean that online programs aren't going to be an important part but when it comes to something as important as a very integrated behavior change like weight, this study showed
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that the i am person program was substantially more helpful, folks appreciate no cost programs this program in the community cost $400 and just that up front cost can be a huge barrier for folks. sometimes i equate the work place to schools if you want to teach kids something you get to them at schools if you want to tell adults something get to them at work and people hearing things from their employer because they spend most of their time and so it's just important that the employer be promoting resources whether it's something at the work place or just what the health plans are offering and it's important that we continue to communicate and through the employer it's the flyers in their office and it's the champions telling them it's not just unfortunately it can't just be things we mail home to them it has to be things they're getting at work.
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and hopefully you took the time to watch the video and we have seven different videos up on our website now and as we look for a different reason we were looking for videos when people wanted to be the face of our better everyday brand and it just happened she was in the diabetes s prevention program and it had a big impact but her story talked a lot about how her work place makes it easier are for her to engage and it's been a big opportunity for her but she's one of our big success stories with the 23-pound weight loss during the program and so take a look at that and hear it from a real people and the real workers. >> i would like to have the representative from kaiser to come forward for just a few questions that i have and i thank you stephanie for the overview of the program. are you doing this type of program with any other of your
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employers, this type of not approach or pilot? >> sure a number of employers are interested in this and some are -- we have not done this sort of a formal research study with any other of our employer customers. >> to the degree that there's any other comparative data with other employers within your contractor to partner and what is your plan, what's your larger outcome here from your standpoint? >> we're enthusiastic about it and stephanie and what is in it for and you what do you plan to do with it and. >> we're looking at how we offer the program --
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>> the ymca who delivered the program here and they are nationally going to leader in this program so we right now are looking at 9 learnings using different models and they will help us formulate with our strategy. >> members any questions? >> i have a couple questions, one is i'm assuming that the class ideas on the employee's own time that they were not
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provided during working hours? because i mean the -- i want to know what the average age was because you know, if you can do it any time and go over with your coach at 6:00 in the morning for the young technology people what's the age and make sure i'm clear about the on sight timing of the classes. >> i'll have to full the average age we have all the demographics and we are looking to publish soon and i have some of these findings but, to answer your question when it was offered it was offered during the work hours at the dpw cesar chavez yard it was at the beginning of the day before they went out so it was slightly different and it was designed to be facilitated by bringing it to you by making it free but it was not designed
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to take away from work time. >> the other question i have, as a diabetess prevention study and we know that weight is an important part but insulin resistance is related to exercise, tolerance and lean bod owe weight so do you actually have the ability to get a hemoglobin a-1c and the active participants or some other objective measure that would actually relate directly to diabetess or pre diabetess as a opposed to just weight? >> so, the screening was weight plus the cdc weight screener and we chose not to do a blood draw because of the realities of recruitment are hard and it's very hard to get people to show up to an information session to commit to a 12-month program to
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come once a week for 12 weeks to be like and we're going to take your blood twice was more than we thought we could handle and the screener is approved way of doing it according to the diabetess prevention protocol so we opted for the screener instead but it was looking at other risk factors in addition to weight. but that is why we don't have the hemoglobin a-1credit data. >> you presented one aspect of the screener which was weight, i gathered. or weight change. as opposed to you know, b.m.i. or any of the other parameters on the screen so you have the other parameters to look at in this group not just their absolute weight gain or loss but also some, something else that might be associated with elevated blood sugar. >> the other outcomes that we
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have everything was also done in b.m.i. i felt it's easier for people to wrap their head around a five-point weight weight loss than a .1% reduction in b.m.i. was harder and they are correlated and we also had had waist circumference change so there's trouble there and what we don't have yet but we will have is the report physical activity which will be really valuable as well. there's a lot of the survey data that hasn't been processed yet and we only had the pre imposed physical assessment data in. >> commissioner sass. >> just wanted to get an understanding of how you collect some of the weights. if people are coming to a work place session are they being weighed in each session? is that done or is this monitor
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ed and tracked? >> yes, so the folks who participated in the work site program were encouraged to weigh in each time. >> what about the online people? is this an honor system? >> they self-report that. >> we can't really validate the two -- it's an honor system online and how do you really draw conclusions between two different kind of methods for determination. >> it's a job of correctioning. >> throughout the program weight was tracked in those two different ways but the six month and 12 month assessment everyone came back to be physically measured. >> other questions from commissioners. >> well thank you for your initial efforts in this area and we look forward to more. to the longer report andel
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correlations and comparatives with other employers and we appreciate your partnership with us on this project and these are public comments. thank you, again. >> all right. we are ready to move on to item 10. thank you. >> clerk: item 10 discussion item network and heath plan issues if any. >> network and health plan issues. and this is normally where we have our perspective plan representatives to come forward and we have one coming. please do. and you are -- >> would you -- >> i am lisa and the company that provides the online voluntary benefits enrollment services. >> i'm going to ask you again to just don't be afraid of the mic,
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bend the head so it's right at you like you are getting ready to eat it. >> ok. >> all right. >> so we provide the online voluntary online enrollment services as well as third party administration services to reconcile the payroll and pay the carrier invoices so the two issues we feel we need to bring fourth to make you aware and one is last thursday e.b.s. experienced a reduce in force and i want to assure the board and the city that the people who were let go were not part of the team that takes care of san francisco and their employee and we'll be able to continue with our services. and customer service call center or any of the people that are behind the scene taking care of the city's benefits. >> so you had a reduction force
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but not impacting in the service staff that are working with us. thank you for that notification. >> and the second issue is part of what we do on the third party administration site is pay the carriers and we have additional benefits that we provide to m.e. a. and one of the carriers that we work with the westbound -- benefits are grandfathered so they're not offered anymore and we changed our payment method and went from paper check to electronic and a. c.h. and this is recent and it's across board with all our clients having a hard time applying the payments so there's about 15m.e.a. members in this group of about 200 that we're working on to fix. >> all right. so with the system change and the payment system you've run in though issues and i'm sure that
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director greyson and the staff have been working with you on these items? >> all right. >> can you remind the board how long they have been provided services forks h.s.s. in the city? >> and last year it was the first year we decided to provide volunteer in the city and they administered that for us. >> well thank you for giving us a heads-up to both of these issues. we appreciate it very much. that is a sign of a true partner >> the m.a.a. for this member? >> say that again? >> have you reached out? >> i am reaching out. i've got about, i've been through about half and i'm working on it. >> because m.a.a. might be able to provide you more help because
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they have more information about their members and they have a monthly meeting and they could sell it out to their members. >> thank you. >> all right. >> thank you. >> i'd like to speak from united healthcare. >> united healthcare is there anyone here from united healthcare? >> commissioner breslin has a few questions, comments or observations. and you are -- >> shannon hoff united heath care. >> so anyway, i got many phone calls, complaints from members saying they got these phone calls constantly about signing up for the home visits. to the point of they feel harassed speaking of harassment, yeah, and so i mean, you have to have someway of making one call knowing it was called because people don't pick up their phone anymore and they say it's just like these robocalls, they don't
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even, you know, and then i personally got five at least and i don't know how many more but five for sure and then i also got three for the flu shot so i said can't you make a note that you made the call, left a recording and that's it. i mean -- >> i can take that back. >> i don't understand the whole visit thing, who is it benefitting? someone is making something from this or planning something from this? >> so we did pull some calls and we had 5,000 house calls completed this year and we would like to come and do a presentation to the board on the house calls program and bring a house calls nurse to speak about the program. >> that's fine but don't keep calling members. >> i can take the calls back so based on the complaint that came out of the october board meeting , we did pull the calls and we did find that there were
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three to five calls made i think there was a back and fourth some were calls in to united healthcare and some were calls out but they were looking at that and they are looking at the out reachs and a member can always request to be put on a do -not-call list and they should cease. >> it's alarming because you have an important message for you about your healthcare so some people are like oh, wow, what's the matter here so you know it's that thing like it's an emergency. >> i can take that feedback back >> it's not good it's annoying. >> any other comments for united healthcare? ok, thank you very much for being here today. any other reported issues from any of our planned representatives? things we ought to know about or things that you are thinking about doing and have done and wish you had, would be doing in the future? none of that, all right, thank
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you. we'll go to discussion item -- is there any public comment? we do have public comment. ok. in the next item. discussion item number 11. >> clerk: item 11 discussion item opportunity to place items on future agendas. >> den he is cruger active retired firefighters spouses. happy holidays to everybody and seeing how this is the holiday season i have a wish list. >> well, all right. >> actually noted. >> real quick. for next year rates and benefits this is just a pre notice, i'd like to see him look in to improving the hearing aid situation. i think it's archaic that you get one hearing aid every two years and it is possible that as soon as you get a new one your
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old one dies. i'd like to see something like three years for two new ones and maybe a co pay back if you have to get another one in between that and half of it a quarter of it would be nice. >> hearing aid benefit. >> number two, cater aks which i am now experience and i think it's also a shame that with our insurance they start out, this is what you get for a cataract operation and now if you have $5,000 more for each eye you get the best. it's so sad that there's something in between our insurance that can't be halfway up to that $5,000 per eye. and then the third one, seeing now we're doing so well with delta dental, possibly a two-tier dental system i know it's a lot to work around, the same as we have a two-tier vision system and happen owe holidays to everybody. >> thank you very much for those suggestions and we'll take them under advise.
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as we look at benefits design in the future. discussion item 12. >> clerk: opportunity for the public to comment on any matters within the board's jurisdiction. >> is there any public on any comment the board has under its jurisdiction? hearing and seeing none, on behalf of the board we want to wish everyone a very happy holiday and this meeting stands adjourned.
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>> welcome to the regular meeting of the san francisco ethics commission for december. i'll call the roll. vice mayor -- well, it could happen. you could be elevated right now. [roll call] >> so everybody's present. we'll now have public comment on matters appearing or not appearing on the agenda. >> i'm bob planthold. i want to say that during the time off that you have over this holiday season and in the next few weeks, it is