San Francisco Health Service Board meeting — January 8, 2025: votes, elections and next steps

San Francisco Health Service Board members met in person and by phone on Jan. 8, 2025. The board approved minutes, ordered a member election, completed several procedural votes relating to a closed‑session member appeal and approved SFHSS financial reserve recommendations; staff presented updates on the Blue Shield Medicare Advantage PPO transition, the mayor’s budget instructions and the department’s strategic plan.

Votes at a glance

• Closed session to hear member appeal (agenda item 4): motion to recess into closed session carried by roll call. Vote — President Howe: Aye; Vice President Zavansky: Aye; Commissioner Kremen: Aye; Commissioner Sass: Aye; Commissioner Wilson: Aye. Outcome: recess into closed session (unanimous). (Provenance: agenda item announcement and motion at 00:17:20–00:18:00.)

• Disclosure decision under San Francisco Administrative Code §67.12 A (agenda item 6): motion that the board not disclose any closed‑session information; motion adopted by roll call (unanimous). Outcome: no disclosure. (Provenance: motion and vote recorded at 00:48:27–00:49:12.)

• Report on possible action taken in closed session (agenda item 7): motion not to report on action taken in closed session; adopted by roll call (unanimous). Outcome: no report. (Provenance: item discussion and vote at 00:51:14–00:51:50.)

• Approval of minutes (agenda item 8): motion to approve the Dec. 6 governance committee minutes and the Dec. 12 regular meeting minutes; approved by roll‑call (unanimous). Outcome: minutes approved. (Provenance: discussion and vote at 00:53:42–00:56:05.)

• Resolution ordering the 2025 Health Service Board election (agenda item 13): board approved the resolution to order the election for the seat expiring in May 2025 and authorized staff to proceed. Outcome: resolution approved (unanimous). The nomination period will open upon posting and the ballot period is scheduled May 16–30, 2025; Department of Elections will count results in early June. (Provenance: presentation and vote at 01:20:03–01:22:30. Authorities cited in presentation: charter section 12.2 and San Francisco Administrative Code section 16.55–16.554 as stated in staff presentation.)

• Approval of IBNR and contingency reserves (agenda item 16): board approved staff and Aon recommendations for IBNR and contingency reserve amounts as of 06/30/2024 at the confidence level presented. Outcome: approved (unanimous). (Provenance: actuarial presentation and vote at 02:22:00–02:30:10.)

Highlights and reports

• Blue Shield MAPD PPO transition: Staff reported 19,100 members were transferred and that most ID cards were mailed in mid‑December. Blue Shield acknowledged some templated CMS letters were sent with incorrect prior‑authorization language and issued correction letters; staff and Blue Shield said they are tracking residual manual corrections. Members and advocates told the board about delayed cards, pharmacy rejections and provider authorization problems; the board asked for continued reporting.

• Budget instructions and general fund planning: CFO Iftikhar Hussain reviewed the mayor’s budget guidance and said the general fund faces targeted reductions in light of a projected citywide deficit; the new mayor announced immediate hiring restrictions at a separate department‑head meeting, staff said. SFHSS will pursue vacancy reviews and efficiency options as part of the department budget process.

• Rates and benefits process: Aon lead actuary Mike Clark presented the annual calendar and an education briefing on rate‑setting methodology for self‑funded, flex‑funded and fully insured plans. The board heard the timeline for actuarial analysis, benchmarking (10‑county survey), RFP timing and Board of Supervisors review in July.

• Strategic plan 2023–25 annual progress: staff reported on equity‑related training, primary care practice work streams, mental‑health and well‑being campaigns and operational service‑quality measures, and said additional metrics will be reported in subsequent meetings.

Next steps

SFHSS staff said they will post material Blue Shield distributed at the meeting, continue to report call‑center and implementation metrics for the Blue Shield transition, present stabilization reserve calculations later this spring and proceed with the scheduled election process and rates‑and‑benefits work through the calendar approved in the presentation.