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>> THIS IS THE CALL TO ORDER FOR THE FRIDAY, MARCH 20TH, 2026, SPECIAL MEETING OF THE FINANCE AND GOVERNMENT OPERATIONS COMMITTEE OF THE COUNTY OF SANTA CLARA. SO HAPPY TO SEE SO MANY OF OUR MEMBERS OF THE COMMUNITY AND NETWORK OF CARE HERE. WELCOME TO THE MEETING. I'M BETTY, THE CHAIRPERSON OF THE COMMITTEE, JOINED BY SUPERVISOR ELLENBURG AS MY VICE CHAIR. COLIN, I TURN TO YOU FOR A ROLL CALL TO ESTABLISH THE PRESENCE OF A QUORUM.

VICE CHAIRPERSON SUSAN ELLENBERG.

>> I'M HERE.

AND CHAIRPERSON BETTY DUONG.

>> HERE.

>> WE HAVE A QUORUM.

>> BEFORE HEARING FROM THE COUNTY LEADERS, I'D LIKE TO MAKE A BRIEF OPENING STATEMENT AND INVITE MY VICE CHAIRPERSON, SUSAN ELLENBERG, TO DO THE SAME. SIX MONTHS AGO, OCTOBER 2025, WE HELD A SPECIAL FGO DOC MEETING TO DIVE INTO THE BUDGETS AND WHAT IT WOULD HAVE HONOR PROVISIONS. THE PASSED BILL WAS THE MAIN FOCUS. WE HEARD FROM THE COUNTY LEGISLATION ABOUT FUNDING SHORTFALLS, MEDICARE ENROLLMENTS AND REIMBURSEMENTS, AND NEGATIVE IMPACTS TO PUBLIC HOSPITALS AND CARE FOR THE UNDOCUMENTED AND UNINSURED. IMPACTS ON FOOD ASSISTANCE, AND CALFRESH, HOW IT WOULD AFFECT FOOD SECURITY IN THE LOCAL COMMUNITY. A FEW SHORT WEEKS AFTER THE F.G.O.C. DISCUSSION, THE COMMITTEE STEPPED UP AND PASSED MEASURE A. MANY OF YOU PASSED MEASURE A. A SALES TAX TO RAISE ABOUT $330 MILLION. WITH THE NEW AND IMPORTANT REVENUE, WE ANTICIPATE THE NEED TO CUT HUNDREDS OF MILLIONS FROM THE COUNTY BUDGET TO ENSURE ITS BALANCE IN FUTURE FISCAL YEARS. GIVEN THE DIFFICULTY REALITY, AND WITH NO HOPE FOR A CHANGE OF HEART AT THE FEDERAL LEVEL ANY TIME SOON, A LOGICAL NEXT STEP IS TO REACH OUT TO PARTNERS AT THE STATE WHO ARE NEGATIVELY IMPACTED BY FEDERAL ACTIONS. WE ARE LUCKY TO BE REPRESENTED BY A DELEGATION AT THE STATE LEVEL UNDERSTANDING OPPORTUNITY TO WORK TOGETHER TO MITIGATE DIRE IMPACTS THAT HR1 WILL HAVE ON OUR RESIDENTS. WE'LL BE JOINED BY MEMBERS OF THE DELEGATION TO SHARE CONCERNS OF FUTURE OPERATIONS AND IDEAS FOR HOW THEY MAY ASSIST IN REDUCING THE IMPACTS. WE LOOK FORWARD TO HEARING FROM THEM ABOUT THEIR IDEAS WHERE THEY CAN EXERT LEADERSHIP FOR THE RESIDENTS SUFFERING UNDER HR1. BABIES ARE WELCOME. THEY CAN MAKE AS MUCH NOISE IN THE CHAMBERS WITH THE CO-CHAIR. IF THE BABY WANTS TO HOP UP, I'M MORE THAN OPEN TO DOING CHILD CARE DUTIES. I LOOK FORWARD TO HEARING FROM THE STATE DELEGATION ABOUT THEIR IDEAS AND HOW WE WILL EXERT LEADERSHIP AND HOW TO PROTECT THE VULNERABLE FROM HR1 AND HEAR THEIR INSIGHTS FROM THE STATE DELEGATION AS TO HOW THE COUNTY CAN ADVOCATE FOR THE NEED AT THE STATE LEVEL. WE HAVE TWO BROAD GOALS. ONE, TO ENSURE THE COUNTY AND DELEGATION ARE ROLLING THE SHARED LIFE BILL IN THE SAME DIRECTION. TWO, THIS CONVERSATION HAS TAKEN PLACE AS PART OF A PUBLIC MEETING TO ENSURE THE COMMUNITY AS PART OF THE CONVERSATION AND HAS THE OPPORTUNITY TO CONTRIBUTE AND SHAPE THE CONVERSATION AS IT MOVES FORWARD. SPECIFICALLY, WE HOPE TO LEAVE THE MEETING WITH A SHARED UNDERSTANDING OF OVERLAPPING AREAS OF INTEREST AND RESPONSIBILITY OF GREAT CONCERN, SOLUTIONS, AND HOW TO COLLABORATE TO BRING THE SHARED VISION TO REALITY. THAT IS WHY - AT THE HEART OF WHY WE FELT IT WAS IMPORTANT TO CONVENE THIS SPECIAL MEETING OF THE FINANCE & GOVERNMENT OPERATIONS COMMITTEE. WE NEED TO WORK IN UNISON AND IN FOCUS TO ENSURE THE VULNERABLE ARE NOT LEFT TO FEND FOR THEMSELVES IN THE AFTERMATH OF RECKLESS CHANGES TO FEDERAL POLICY. EACH ADVANCE WE MAKE MEANS LESS SUFFERING, FEWER GO TO BED HUNGRY OR DO WITHOUT ACCESS TO MEDICAL CARE. WE OWE IT TO OURSELVES TO HAVE THESE CONVERSATIONS. WE'LL HEAR FROM THE COUNTY EXECUTIVE. IT WILL NOT BE A SURPRISE THAT THE TOP THREE AREAS OF CONCERN INCLUDE PUBLIC HOSPITAL SUPPORT, MEDI-CAL, AND CALFRESH AND HEALTH COVERAGE FOR THE UNINSURED AND INDIGENT. THERE'S A RATHER LARGE AMOUNT OF ITEMS WHERE THE COUNTY WILL BE IMPACTED. I TRUST EVERYTHING HINGES ON THE PRIOR THREE TO SURVIVE IN FOR OUR COUNTY TO THRIVE. AFTER WE HEAR FROM THE ADMINISTRATION, COMMUNITY LEADERS REPRESENTING KEY STAKEHOLDERS IN THE CONVERSATION, WE'LL HEAR FROM FOUR ELECTED REPRESENTATIVES FROM THE STATE LEGISLATURE, SCHEDULED TO JOIN US AT 3:00 P.M. THE COMMITTEE WILL ENGAGE WITH A STATE DELEGATION AROUND A DISCUSSION OF SHARED GOALS AND OPPORTUNITIES TO MAXIMIZE OPPORTUNITY FOR SUCCESSFUL OUTCOMES. FOLLOWING, WE'LL HEAR PUBLIC COMMENT. AND I WANT TO ACKNOWLEDGE OUR STATE LEGISLATORS ARE GOING THROUGH THEIR MOMENTS NOW AND FOR THEM TO MAKE TIME TO SHARE THEIR PROCESS IS A DEMONSTRATION OF THE PARTNERSHIP WITH THE COUNTY, ADMINISTRATION AND COMMUNITY. AT THIS TIME, I'LL TURN TO MY COLLEAGUE, VICE CHAIRPERSON SUSAN ELLENBERG, TO HEAR HER OPENING COMMENTS.

>> THANK YOU SO MUCH, SUPERVISOR DUONG, FOR CONVENING THE SPECIAL MEETING. THIS COUNTY, AS WELL AS EVERY OTHER COUNTY ACROSS THE STATE, IS EXPERIENCING BUDGET CUTS OF A SCALE AND AT A SPEED THAT NO ONE ANTICIPATED. MEDICAID, MEDICARE, FUNDS, AND OTHER SAFETY NET SERVICES WERE CREATED IN THE 1960S TO ALLEVIATE DEEP POVERTY WITH THE KNOWLEDGE THAT WE ARE SAFER, HEALTHIER, AND MORE STABLE WHEN NONE OF US IS IN DESPERATE STRAITS. THE PROGRAMS HAVE NOT ONLY SURVIVED OR GROWN THROUGH DEMOCRAT AND REPUBLICAN-LED ADMINISTRATIONS, AND HAVE BECOME A PART OF THE FABRIC OF OUR SOCIETY. THEN THIS DECADE HAS BEEN FULL OF UNEXPECTED WORLD-SHIFTING OCCURRENCES. EVEN MONTHS BEFORE HR1, NO ONE ANTICIPATED THE DISMANTLING OF OUR SERVICES. THE GROUP SHIFTED ON JULY 2025. HERE WE SIT ON THE COUNTY BOARD OF SUPERVISORS. COUNTIES ARE THE ENTITIES THAT IMPLEMENT THE SAFETY NET. HEALTH CARE, HOUSING SUPPORT, ETCETERA. WE HAVE LIMITED CONTROL OVER THE FUNDING OF THESE PROGRAMS. THEY ARE ALL FUNDED BY STATE AND FEDERAL GOVERNMENT. OUR CURRENT SITUATION IS WE HAVE A COUNTY-WIDE CRISIS. IT'S NOT A PROBLEM COUNTIES SHOULD BE EXPECTED TO SOLVE ALONE. IMPORTANTLY, THIS IS NOT A ONE-YEAR CHALLENGE. THE CUTS DIRECTED BY HR1 CREATED STRUCTURAL, ONGOING IMPACTS, CHALLENGING THE FRAGILE SAFETY NET FOR YEARS TO COME. IF COUNTIES ARE FORCED TO REDIRECT DOLLARS TO BACKFILL, THE CONSEQUENCES WILL BE IMMEDIATE. PROGRAMS ON WHICH RESIDENTS RELY, INCLUDING PUBLIC SAFETY AND PREVENTION SERVICES, WILL BE REDUCED OR ELIMINATED. WE NEED THE STATE'S PARTNERSHIP TO PREVENT THAT OUTCOME. THERE ARE AT LEAST THREE AREAS WHERE COUNTIES ACROSS THE STATE ARE ALIGNED WITH SANTA CLARA'S LEADERSHIP AND WHERE WE NEED SUPPORT. FIRST, STABILIZING PUBLIC HOSPITAL SYSTEMS. IN THIS COUNTY ALONE, HR1 CREATES A $1 BILLION DEFICIT FOR THE PUBLIC HEALTHCARE SYSTEM AS THE LARGEST PROVIDER OF MEDI-CAL AND MEDICARE AND THE LARGEST PUBLIC SYSTEM IN NORTHERN CALIFORNIA. WE SUPPORT THE ASSOCIATION OF PUBLIC HOSPITALS' REQUEST FOR A $500 MILLION STATE INTERVENTION TO REPLACE THE FEE FOR SERVICE THAT PUBLIC HOSPITALS SHOULDER ALONE. I WANT TO MAKE CLEAR THAT IS A CONSERVATIVE ASK BECAUSE IT WILL BRING PUBLIC HOSPITALS TO PARITY WITH PRIVATE AND DOESN'T ACCOUNT FOR THE FACT THAT EVEN THOUGH THEY COMPRISE 6%, WE PROVIDE MORE THAN 50% OF TRAUMA CARE. WE SEEK RATE FOR TRAUMA AND BURN SERVICES AND ADDITIONAL ASKS IN SUBSEQUENT YEARS. INVESTING IN THE WORKFORCE REQUIRED TO IMPLEMENT THE FEDERAL CHANGES. ANNUAL WORKLOADS WILL BE DOUBLED AT A TIME WHEN COUNTIES ARE STRUGGLING TO HIRE AND RETAIN STAFF. HERE WE SUPPORT THE COUNTY DIRECTORS' ASSOCIATION REQUEST FOR $373 MILLION IN THE UPCOMING FISCAL YEAR TO ENSURE MEDI-CAL AND CALFRESH ADMINISTRATION ARE ADEQUATELY FUNDED. AN ADDITIONAL CHALLENGE THAT THE STATE SHOULD CONSIDER IS THE MODERNIZATION OF THE DATA SYSTEMS USED BY ALL COUNTY ELIGIBILITY WORKERS SO THEY HAVE THE CAPACITY TO AUTOMATE WHAT WILL OTHERWISE BE TIME-CONSUMING WORK TO COLLECT EMPLOYER VERIFICATION AND OTHER DOCUMENTS THAT ARE REQUIRED TO BE CLEAR WITH THE PRECISE INTENTION OF MAKING IT MORE DIFFICULT TO SECURE SUCCESSFUL REDETERMINATION. THIRD, PROVIDING COUNTIES WITH A MINIMUM OF $2 BILLION TO ADDRESS THE SURGE IN UNINSURED RESIDENTS. MILLIONS OF CALIFORNIANS WHO ARE ELIGIBLE FOR MEDICAID ARE PROJECTED TO LOSE COVERAGE DUE TO FEDERAL REQUIREMENTS AND THE EXPIRATION OF CALIFORNIAN SUBSIDIES. THE CALIFORNIA STATE ASSOCIATION OF COUNTIES ESTIMATES COSTS BETWEEN $2-5.5 BILLION EACH YEAR. COUNTIES ARE DOING EVERYTHING WITHIN OUR CONTROL TO MANAGE SIGNIFICANT LEVELS OF UNREIMBURSED CARE. WITHOUT MEANINGFUL STATE PARTNERSHIP, THE SAFETY NET ON WHICH CALIFORNIANS DEPEND WILL ERODE AND CRUMBLE. I WANT TO THANK IN ADVANCE ALL OF THE STATE LEGISLATORS WHO WILL BE JOINING US AND THOSE LISTENING ONLINE. THANK YOU. WE ARE COUNTING ON YOUR PARTNERSHIP TO TAKE CARE OF THE RESIDENTS WHO WE JOINTLY REPRESENT. THANK YOU FOR YOUR LEADERSHIP TODAY AND EVERY DAY, AND THANK YOU FOR YOUR ATTENTION.

>> THANK YOU, VICE CHAIR. NOW, WE ARE GOING TO - NEXT ITEM ON THE AGENDA. ITEM NUMBER 3 IS CONSIDER CHANGES TO THE COMMITTEE AGENDA AREA. VICE CHAIRPERSON SUSAN ELLENBERG, DO YOU HAVE CHANGES TO PROPOSE?

>> I DO NOT. I'M HAPPY TO MOVE APPROVAL OF CALENDAR AS PUBLISHED.

>> I SECOND THAT MOTION.

>> VICE CHAIRPERSON SUSAN ELLENBERG.

>> YES.

>> CHAIRPERSON BETTY DUONG.

>> YES.

>> MOTION CARRIES. WE ARE ON TO ITEM 4 ON THE AGENDA, WHICH IS A STUDY SESSION RELATING TO STATE BUDGET IMPACTS TO THE COUNTY AND STARTING WITH THE COUNTY OF SANTA CLARA PRESENTATION. COUNTY EXECUTIVE JAMES WILLIAMS. I UNDERSTAND YOU'LL LEAD OFF THE PRESENTATION WITH SUPPORT FROM SOME OF THE KEY STAFF AND HEAVILY AFFECTED DEPARTMENTS. THE COMMITTEE AND MEMBERS OF THE COMMITTEE IN CHAMBERS ARE LOOKING FORWARD TO YOUR PREPARATION. WHEN IT CONCLUDES, WE HOPE TO HAVE A CLEAR IDEA OF THE AREAS WHERE STATE BUDGET AND POLICY ACTION CREATE AN OPPORTUNITY FOR COLLABORATION BENEFITTING THE RESIDENTS.

>> THANK YOU, MADAM CHAIR, MEMBERS OF THE COMMITTEE. JAMES WILLIAMS, COUNTY EXECUTIVE. I'M PLEASED TO BE HERE WITH STAFF AND WISH TO EXPRESS APPRECIATION FOR STAKEHOLDERS IN PERSON AND ONLINE. OUR COMMUNITY CARES AND RECOGNIZES AND UNDERSTANDS WHAT IS AT STAKE. I COME IN A POSITION TO PRESENT SOBERING NEWS ABOUT WHAT IS AT STAKE FOR OUR SAFETY NET IN SANTA CLARA COUNTY, ACROSS THE STATE OF CALIFORNIA, THE PIVOTAL AND ESSENTIAL PARTNERSHIP WE NEED FROM THE STATE TO DO ITS PIECE TO HELP ENSURE ACCESS TO HEALTH CARE AND FOOD FOR ALL CALIFORNIANS. WE ARE FORTUNATE. WE ARE FORTUNATE TO HAVE A GREAT DELEGATION AT THE STATE LEVEL. I'LL REPEAT THAT LATER. THEY HAVE BEEN STANDING WITH US IN THIS EFFORT, AND WE WILL NEED THEM TO CARRY THE CRITICAL ESSENTIAL ASKS FORWARD AS PART OF THE UPCOMING LEGISLATIVE BUDGET PROCESS. I'LL TAKE A FEW MINUTES TO OUTLINE WHAT WE ARE TALKING ABOUT, WHAT IS AT STAKE, AND WHAT THE STATE CAN DO TO ENSURE THAT IT DOES NOT EXACERBATE THE HARMS FOISTED UPON US BY THE FEDERAL GOVERNMENT, BUT INSTEAD MITIGATES THOSE HARMS. SADLY, THE GOVERNOR'S GENERAL PUBLIC PROPOSAL AS IT CURRENTLY STANDS EXACERBATES THE HARMS. IT DOES NOT MOVE US IN THE RIGHT DIRECTION. SO WE ARE SEEKING SUPPORT FROM THE STATE ADMINISTRATION AND THE LEGISLATURE TO ENSURE THE CONTINUITY OF THESE CRITICAL, LITERALLY LIFE-SAVING SERVICES FOR CALIFORNIANS. I'LL SHARE MY SCREEN. I HAVE A BRIEF POWERPOINT TO WALK THROUGH.

>> SO WE ARE HERE BECAUSE OF HR1. THE SO-CALLED BIG BEAUTIFUL BILL THAT WAS PASSED AND SIGNED INTO LAW BY PRESIDENT DONALD TRUMP LAST JULY 4TH. HR1 IMPOSES THE LARGEST CUTS IN OUR NATION'S HISTORY TO MEDICAID, MEDICAL, AND FEDERAL FOOD ASSISTANCE KNOWN AS FOOD FRESH IN CALIFORNIA, PUTTING THE CRITICAL PROGRAMS AT SEVERE RISK. YOU SHOULD KNOW THE NUMBERS ARE STAGGERING ACROSS THE REST OF CALIFORNIA. ONE IN FOUR RESIDENTS RELIES ON MEDI-CAL FOR ACCESS TO HEALTH CARE, AND 133,000 RELY ON CALFRESH FOR ACCESS TO FOOD. IMPORTANTLY FOR THE CORE SERVICES DELIVERED AS THE COUNTY GOVERNMENT, OVER HALF OF OUR REVENUE AS A HEALTH SYSTEM DEPENDS ON MEDI-CAL. THE THREATS ARE MULTIFACETED IN HR1. THERE ARE SEVERAL CATEGORIES OF CUTS IN THAT BILL THAT CUMULATIVELY REPRESENT AN ONGOING CUT OF OVER $1 BILLION. TO MAKE THINGS WORSE, WHAT WE HAVE EXACERBATED THE IMPACTS. WE TALK ABOUT A COUPLE OF THOSE PIECES NOW. ONE OF THE MOST SIGNIFICANT IS THE STATE'S OWN CUTS TO THE STATE-ONLY MEDICAL PROGRAM. MORE THAN 70,000 RESIDENTS HERE IN SANTA CLARA COUNTY DEPEND ON THE PROGRAM FOR ACCESS TO HEALTH CARE. IT IS FROZEN TO NEW ENROLLEES. WE'LL HAVE MONTHLY PREMIUMS, AND WE'LL FACE A NUMBER OF OTHER SIGNIFICANTLY IMPACTS. THERE'S CHANGES TO FUNDING MECHANISMS THAT AFFECT OUR COMMUNITY CLINICS THAT ARE AN ESSENTIAL PART OF PRIMARY CARE THAT CAN SEE A 70 OR 80% DROP. WE ARE SUPPORTIVE OF THE SENATOR'S SP 1422, A BILL THAT SEEKS TO REVERSE SOME OF THE DAMAGE CAUSED BY STATE-ONLY MEDICAL CUTS. I WANTED TO CALL THAT OUT AS A SPECIFIC WAY IN WHICH THE STATE RIGHT NOW IS MAKING THINGS WORSE.

>> I TALKED ABOUT THE LAYERING OF THESE CUTS OVER THE NEXT COUPLE OF YEARS. WE SHARED THIS BEFORE. IT SHOWS IN THE CURRENT FISCAL YEAR THAT WE ARE HALFWAY THROUGH, WE HAVE BEEN HIT WITH EXACT ATTACHED TO HR1. THAT NUMBER GROWS IN THE FISCAL YEAR, AND THE YEAR AFTER. THEY ARE ONGOING REDUCTIONS TO REVENUE, NOT ONE-TIME. THEY REQUIRE ONGOING SOLUTIONS. UNLIKE THE FEDERAL GOVERNMENT, WE HAVE NO CHOICE BUT TO MAINTAIN A BALANCED BUDGET. WE DON'T GET TO PRINT MONEY, AND WE ARE IN THE DIFFICULT POSITION OF HAVING TO DEAL WITH THESE IMMEDIATELY AS THEY AFFECT US. WE NEED TO BE AWARE OF OTHER STATE-RELATED CHANGES THAT FROM A TIMING PERSPECTIVE HIT US AT THE SAME TIME. AND THAT, AND A SERIES OF CHANGES AT THE STATE LEVEL TO BEHAVIORAL HEALTH FUNDING AND PROGRAMS THAT BOTH CHANGE HOW MUCH MONEY COUNTIES GET, WHAT PERCENTAGE SHARE COUNTIES GET, AND HOW COUNTIES ARE OBLIGATED TO SPEND THE FUNDING, WHICH WILL HAVE A DISPROPORTIONATE EFFECT ON OUR BEHAVIORAL HEALTH CARE DEPARTMENT AND PROVIDERS, AND FORCE SHIFTS IN SERVICE DELIVERY AWAY FROM CERTAIN CATEGORIES, LIKE PREVENTION, TOWARDS OTHER CATEGORIES. THESE ARE STATE-DIRECTED POLICY CHANGES IMPOSED ON US ON TOP OF FEDERAL CUTS. SO WHAT ARE WE DOING? THIS COMMUNITY DOES NOT TAKE THINGS LYING DOWN. WE HAVE COMMITTED AND PUSHED BACK WITH EVERY LEVER AND EVERY BUTTON THAT WE CAN. INTERNALLY AS A COUNTY ORGANIZATION, WE PUT IN PLACE AN AGGRESSIVE HIRING FREEZE. WE HAVE MOVED FORWARD WITH SIGNIFICANT AND PAINFUL BUDGET CUTS, INCLUDING $200 MILLION IN BUDGETED SOLUTIONS THAT THE BOARD ADOPTED MIDYEAR TO KEEP THE BUDGET IN BALANCE, LARGELY INVOLVING THE HEALTH SYSTEM. WE MOVED FORWARD WITH A LITANY OF INITIATIVES TO INCREASE REVENUE, TRYING TO MITIGATE IMPACTS ON THE MOST VULNERABLE. WE ARE NOT IN SACRAMENTO SOAKING A HANDOUT WHERE I TESTIFIED, BUT BECAUSE IT'S AN INTENTION AND FUNDAMENTAL PARTNERSHIP IN THE DELIVERY OF THESE SERVICES. WE ARE NOT STANDING STILL AS A COUNTY ORGANIZATION, BUT INSTEAD HAVE BEEN MOVING FORWARD EVERY INITIATIVE THAT WE CAN. OF COURSE, OUR COMMUNITY HAS STEPPED UP WITH THE LEADERSHIP OF THE BOARD OF SUPERVISORS, PLACING AN EMERGENCY MEASURE ON THE BALLOT. OUR VOTERS HERE OVERWHELMINGLY STEPPED FORWARD, ADOPTED A SALES TAX INCREASE AT THE HIGHEST AMOUNT WE ARE ABLE TO BRING FORWARD TO THEM UNDER STATE LAW. AND YET, AS INCREDIBLE AS MEASURE A IS, AND IT IS, AND AS MUCH AS IT WILL MITIGATE AND SOVEREIGN IMPACTS THAT WE OTHERWISE WILL FACE, $330 MILLION UNFORTUNATELY DOES NOT A BILLION MAKE. SO WE HAVE A DAUNTING GAP TO CONTINUE TO ADDRESS. BUT WE HAVE MOVED FORWARD WITH OUR PRONGS OF OUR APPROACH IN A STRATEGIC, AGGRESSIVE, AND THOUGHTFUL WAY, AND WILL CONTINUE TO DO OUR PIECE, BUT TODAY'S CONVERSATION IS ABOUT STATE PARTNERSHIP. BECAUSE WE NEED THE STATE TO DO ITS PIECE AS WELL. WHAT DOES THAT LOOK LIKE? WE HAVE PUT FORWARD A SERIES OF CONCRETE AND SPECIFIC STEPS FOR PRESERVING THE SERVICES IN SANTA CLARA COUNTY, AND ACROSS CALIFORNIA. THE FIRST IS SUPPORT FOR PUBLIC HOSPITAL SYSTEMS. THEY ARE NOT THAT MANY COUNTIES THAT HAVE PUBLIC HOSPITAL SYSTEMS, BUT THE COUNTIES THAT DO ARE WHERE ABOUT 80% OF THE POPULATION LIVES, AND THESE 6% OF CALIFORNIA HOSPITALS OPERATE HALF OF THE STATE'S TRAUMA AND BURN CENTERS AND TRAIN HALF OF THE STATE'S PHYSICIANS. THINK ABOUT THAT. 6% OF HOSPITALS. THE HEALTHCARE FOR ALL CALIFORNIANS IS BUILT ON THE BACKBONE IS BUILT ON THE BACKBONE OF THIS SYSTEM THAT THE STATE CANNOT AFFORD TO LOSE. AT BARE MINIMUM, IT'S ESSENTIAL FOR THE LEGISLATURE TO UNDO SOMETHING THAT HAPPENED IN 2005, WHICH WAS A STATE CHANGE THAT FORCED COUNTIES TO FUND THE STATE'S MATCH TO DRAW DOWN FEDERAL MEDICAID DOLLARS FOR INPATIENT HOSPITAL STAY. THIS IS AN AREA WHERE WE ARE TREATED WORSE THAN PRIVATE HOSPITALS, AND SEEKING PARITY WITH THE PRIVATE SYSTEMS SO WE CAN FREE UP THE FUNDING TO PRESERVE THE PUBLIC HOSPITAL SYSTEMS. IN ADDITION TO THAT, IT IS ESSENTIAL FOR THE STATE TO MAKE APPROPRIATE BASE RATE ADJUSTMENTS TO MAKE UP FOR THE LOSS IN SPECIFIC REVENUE STREAMS THAT PUBLIC HOSPITALS RELY ON FOR THE DELIVERY OF ESSENTIAL CARE. SECOND, WE HAVE TO KEEP AS MANY PEOPLE AS POSSIBLE ENROLLED IN MEDI-CAL. WHAT DOES THAT MEAN? WELL, IT DOES MEAN DOING EVERYTHING THE STATE CAN TO MAKE SURE THAT THERE IS AS MUCH AUTOMATIC VERIFICATION OF ELIGIBILITY AS POSSIBLE. AS SUPERVISOR ELLENBURG SHARED THOUGH, THE FEDERAL GOVERNMENT IS DELIBERATELY TRYING TO THROW PEOPLE OFF THE COVERAGE, AND THAT WILL BE A CHALLENGING TASK AS IT WOULD BE EVEN IN THE BEST CASE SCENARIO. SO WE ARE ALSO GOING TO MEET MORE HAND-HOLDING ON THE GROUND TO HELP PEOPLE JUMP THROUGH THE HOOPS DELIBERATELY CREATED FOR PEOPLE TO LOSE COVERAGE. WE URGE THE LEGISLATURE WITH THE CALIFORNIA DIRECTORS ASSOCIATION, WHICH IS A CONSORTIUM OF SOCIAL SERVICES DIRECTORS FROM ALL 58 COUNTIES IN CALIFORNIA, TO SUPPORT A MODEST INVESTMENT IN RESOURCES TO HELP ENSURE THAT WE ARE POSITIONED TO ASSESS AS MUCH AS POSSIBLE, HOLD PEOPLE'S HANDS THROUGH THAT PROCESS. FOR EVERY PERSON WE CAN KEEP ON COVERAGE, WE ARE TALKING ABOUT THE EXPANSION POPULATION. FOR EVERY PERSON WE CAN KEEP ON COVERAGE, THE FEDERAL GOVERNMENT COVERS 90% OF THE COST. SO ABSOLUTELY, IT BEHOOVES THE STATE TO DO EVERYTHING POSSIBLE TO SUPPORT ALL 58 COUNTIES IN THIS ENDEAVOR. THE THIRD PIECE IS TO DEAL WITH THE REALITY THAT MORE PEOPLE WILL BE UNINSURED. AFTER THE PASSAGE OF THE AFFORDABLE CARE ACT, THE STATE REVISITED ITS RELATIONSHIP WITH COUNTIES FOR COVERAGE OF INDIGENT CARE PROGRAMS. COUNTIES LOST STATE FUNDING. UNFORTUNATELY, WITH AN INCREASE IN UNINSURED, THE STATE MUST REVISIT THAT FISCAL ARRANGEMENT. THERE'S NO WAY TO RESTORE COVERAGE TO PROVIDE HEALTH CARE FOR THOSE THAT LOSE COVERAGE. FINALLY, FOR THE STATE NOT TO EXACERBATE THESE HARMS BY MAKING CUTS IN THE STATE-ONLY PROGRAM AND PRESERVE FULL ACCESS TO THE PROGRAM SO ALL CALIFORNIANS CAN RECEIVE ACCESS TO LIFE-SAVING HEALTH CARE. THERE ARE TWO OTHER PIECES I WANTED TO NOTE RELEVANT TO THE STATE BUDGET CONVERSATION. ONE IS THAT THERE'S A PROBLEMATIC PROPOSAL IN THE GOVERNOR'S BUDGET TO COST-SHIFT TO COUNTIES MORE COSTS RELATED TO THE IHSS PROGRAM, AND TO ELIMINATE STATE FUNDING FOR MOBILE CRISIS RESPONSE. THESE ARE INTENDED PROGRAMS FOR THE STATE NOT TO BACK AWAY. SHIFTING THE COSTS TO COUNTIES WILL ONLY PUT COUNTIES IN A WORSE POSITION FOR THESE SERVICES AND OTHERS, AND TO RESTORE FUNDING FOR THE HHAP PROGRAM AND ENSURE THAT IT DEALS WITH THE REAL AND PRESENT NEEDS IN THE COUNTIES. MUCH FEDERALLY, IT'S A SOBERING UPDATE. WE HAVE BROUGHT FORWARD A PACKAGE OF EXTENSIVE PROPOSED SOLUTIONS. WE RECOGNIZE THAT THE STATE IS IN A CHALLENGING FISCAL SITUATION AS WELL, NOT NEARLY AS CHALLENGING PROPORTIONATELY AS THAT FACED BY COUNTIES. BUT WHAT WE DO KNOW IS THAT CALIFORNIA CANNOT LOOK THE OTHER WAY AND CANNOT WAIT TO SEE WHAT HAPPENS. BECAUSE ONCE THESE TYPES OF SERVICES GO AWAY, YOU LOSE A MULTI-GENERATIONAL COMMITMENT AND INVESTMENT IN ACTION TO CARE THAT WE CANNOT AFFORD TO LET HAPPEN AS A STATE. WE LOOK FORWARD TO THE LEADERSHIP OF OUR DELEGATION IN THIS EFFORT. WE WILL CONTINUE TO LEAD AS A COUNTY ORGANIZATION WITH CREATIVITY, WITH STRENGTH, WITH A DEEP COMMITMENT TO VALUES, TO DOING EVERYTHING THAT WE CAN, BUT KNOWING THAT WE CANNOT DO IT ALONE. HAPPY TO TAKE ANY QUESTIONS THAT YOU MAY HAVE NOW OR LATER. THANK YOU.

>> THANK YOU, JAMES. THANK YOU FOR THAT SOBERING PRESENTATION AND AS ALWAYS, GETTING TO THE HEART OF THE MATTER. WE'LL CONTINUE WITH THE PREPARATIONS AND HAVE DISCUSSION TO THE END. I WANT TO WELCOME AND ANNOUNCE THAT WE HAVE SENATORS DAVE CORTEZ AND MARRERA WA HAB WITH US. THEIR IMAGES WILL BE PROJECTED AS THEY RECEIVE THE PRESENTATION. ITEM NUMBER 4 (B). COMMUNITY STATEMENTS. WE ARE JOINED BY ABILITY PATH, VALLEY PATH, SILICON VALLEY COUNCIL OF NONPROFITS, BEHAVIORAL HEALTH COMMUNITY, WORKING PARTNERSHIPS USA, AND BEHAVIORAL HEALTH CONTRACTORS ASSOCIATION. AND WE ARE GOING TO START - WE'LL MOVE FROM MY RIGHT TO LEFT, STARTING ABOUT COLORADO, FINISHING WITH JOOEN COHEN WITH THE SOUTH BAY LABOR COUNCIL. STATE YOUR NAME, NO NEED TO WAIT FOR THE NEXT SPEAKER. DELORES, I TURN TO YOU TO KICK US OFF.

>> THANK YOU VERY MUCH. THANK YOU. GOOD AFTERNOON, EVERYONE. GOOD AFTERNOON, SUPERVISOR ELLENBURG AND DUONG AND JAMES WILLIAMS, ETCETERA. THANK YOU FOR INVITING US TO BE HERE AND SHARE IN THIS SOBER MOMENT, I GUESS IS THE BEST WAY TO SAY THAT. I REALLY WANT TO TALK ABOUT HAVE A LITTLE CONVERSATION ABOUT WHAT THE SITUATION LOOKS TO THE COMMUNITY HEALTH CENTERS AND HOW HAPPY WE ARE TO BE HERE WITH YOU. THE COMMUNITY HEALTH CENTERS IN 2025 SERVED 21,000 FOLKS, BEFORE THE ICE SITUATION. OUT OF THOSE 21,000, TOOK ADVANTAGE OF THE SPECIALTY CARE SERVICES THAT VALLEY MEDICAL CENTER PROVIDES. AND THIS HAS BEEN GOING ON FOR MANY YEARS, BY THE WAY, THE 21,000. THAT IS THE REASON - FOR MANY REASONS, BUT PARTICULARLY BECAUSE OF OUR RELATIONSHIP TO VMC AND THE PARTNERSHIP WE HAVE WITH THEM IN THE SPECIALTY CARE ARENA. I AM HERE REPRESENTING THE COMMUNITY HEALTH CENTERS AND THE BOARD OF DIRECTORS, AND TWO OR THREE OF THE BOARD MEMBERS ARE HERE. I THINK IT'S TWO. WE ENDORSE SANTA CLARA'S REQUEST FOR PARTNERSHIP. WE NOT ONLY DO WE ENDORSE IT, WE WILL PARTICIPATE IN THIS. WE STARTED OUT BY LOOKING AT THE UNINSURED DATA THAT WE HAVE. AND THANKS TO JAMES AND TO BRIAN DERO AND VALLEY HEALTH PLAN FOR GETTING US THE DATA. WE GOT TO THIS MORNING, AND IT'S WORSE THAN WE THOUGHT, UNFORTUNATELY. THE IMPACTS TO HR1 ON INDIGENT, UNINSURED, AND UNDOCUMENTED PATIENTS IS CATASTROPHIC, AS WE KNOW. I SEE IT AS INHUMANE, AND HONESTLY, IT GOES AGAINST FEDERAL LEGISLATION THAT HRSA PUT TOGETHER UNDER TED KENNEDY, INCLUDING THE 330 GRANTS COMING TO US AND THE CLINICS, A BENEFIT OF BEING FEDERALLY QUALIFIED HEALTH CENTER. THAT MONEY WAS USED TO HELP THOSE WITHOUT COVERAGE THAT HAVE NO OTHER OPTION. I KNOW YOU BROUGHT IT UP, JAMES, IN YOUR PRESENTATION, THAT'S A VERY, VERY SERIOUS CONCERN. ALONG WITH THAT COMES A CONCERN. REIMBURSEMENT MODEL THAT THE COMMUNITY HEALTH CENTERS, FEDERALLY QUALIFIED HEALTH CENTERS, AGAIN, INCLUDING THE COUNTY, THEY ALSO HAVE FEDERALLY QUALIFIED HEALTH CENTERS, AND THAT METHODOLOGY, WHICH IS A COMBINATION OF THE STATE AND FEDERAL, MOSTLY STATE, IS SET TO SUNSET AT SOME POINT IN THE NEAR FUTURE. WHEN YOU ADD THE 330 GRANT REMOVAL, PLUS THE PPS, CALLED THE PATIENT PERSPECTIVE PAYMENT SYSTEM, I BELIEVE. I KNOW THAT THOSE IN THE AUDIENCE, I THINK SOME ARE PARTNERS, FRIEND AND FAMILY, I'D LIKE TO MAKE A STATEMENT ABOUT THE JACKET IN VMC, REGIONAL ST. LOUIS, ETCETERA, HAVE BEEN SERVING MANY, MANY PEOPLE WHO PERHAPS HAVE OTHER FORMS OF HEALTH COVERAGE OR NEEDS - ARE WELL OFF ECONOMICALLY. SO THE ISSUE OF COMMENTS THAT I HAVE HEARD - THIS IS FOR THE UNINSURED, FOR MEDI-CAL. THIS IS NOT TRUE. I CAN VERIFY WITH MY OWN FAMILY, BY THE WAY. WHAT WE ARE ASKING FOR, AND GOOD AFTERNOON, ASSEMBLYMAN, THANK YOU FOR BEING HERE. WE ARE ASKING FOR A COUPLE OF THINGS THAT ARE HUGE. ONE IS TO ENSURE THAT THE CAL SOURCE PROGRAM REMAINS. CAL SOURCE IS A DATA SYSTEM THAT HAS TRULY HELPED US ENROLL FOLKS TIMELY, REHUE THEIR APPLICATIONS, HELPING THEM TO KEEP TRACK. WITH THE FACT THAT THERE'LL BE A REDUCTION SYSTEM, IF CAL SOURCE GOES AWAY, WE GO BACK TO PEN AND PENCIL. THAT IS REALLY, REALLY IMPORTANT TO US. IT'S NOT AS WELL-KNOWN THIS THAT PIECE IS IN DANGER. LIKE THE COUNTY, OUR COMMUNITY HEALTH CENTERS MUST SERVE EVERYONE REGARDLESS OF HEALTH COVERAGE OR ABILITY TO PAY. WE ANTICIPATE THE DEMAND FOR CARE IN THE HEALTH CENTERS WILL INCREASE DUE TO THE REDUCTIONS THAT WE TALKED ABOUT AND THE PPS SYSTEM, THE LOSS OF THE PPS SYSTEM. I WANTED TO SHARE WITH YOU A COUPLE OF EXAMPLES OF THE ADDITIONAL SERVICES THAT THE COMMUNITY HEALTH CENTERS PROVIDE BESIDES PRIMARY CARE. CHILD DEVELOPMENT SERVICES, CHIROPRACTIC, COMMUNITY OUTREACH, DENTAL HEALTH ENROLLMENT, HEALTH CARE ENROLLMENT, HOUSING REFERRALS, SPECIALTY MENTAL HEALTH, WHICH WILL BE DISCUSSED LATER, WELLNESS AND PREVENTION, WHICH IS OFTEN NOT REIMBURSED SO WE OFTEN USE THE 330 GRANT TO DO THAT, AND NUTRITION COUNSELING, WHICH IS OFTEN NOT REIMBURSED BY ANYTHING. THAT ADDITION TO PRIMARY CARE IS REALLY IMPORTANT TO US. NOT ONLY DO WE LOSE THE PRIMARY CARE PIECE, WE LOSE THE OTHER SERVICES THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. WE ARE A COUNTY THAT ARE ALWAYS TALKING ABOUT SOCIAL DETERMINANTS OF HEALTH. THIS IS IMPORTANT TO US. THE LAST COMMENT I'D LIKE TO MAKE, BECAUSE WE DO HAVE CLINICS THAT WILL SPEAK. I HAVE SOME DATA THAT I'D LIKE TO SHARE WITH STATE ASSEMBLYMEN. YOU'LL NOT LIKE THE DATA. GIVE ME A SECOND. CALIFORNIA PRIMARY CARE ASSOCIATION HELPED US PULL THIS DATA TOGETHER. IN ASSEMBLY DISTRICT 25, CALIFORNIA PRIMARY CARE ASSOCIATION ESTIMATES ALMOST 42,000 UNDOCUMENTED POPULATION. HALF OF THEM SERVED BY COMMUNITY HEALTH CENTERS. DISTRICT 26, MR. PATRICK O'ARONS, THANK YOU FOR BEING HERE. ESTIMATES THAT THE DISTRICT HAS ABOUT 22,000. A LITTLE OVER 22,000 UNDOCUMENTED WITH OVER HALF OF THEM SERVED BY COMMUNITY HEALTH CENTERS, AND THAT EQUATES TO $7.5 MILLION. BEFORE I MOVE FORWARD. THE OTHER HALF. WE KNOW HALF OF THE DATA. THE OTHER HALF ARE PROBABLY PRIVATE COMMUNITY CLINICS, SO THOSE MAY OR MAY NOT BE PART OF THE CPCA. YOU CAN POSSIBLY DOUBLING THE AMOUNT IN MY OPINION. FOR SENATORIAL DISTRICT 15, SENATOR CORTESE, GOOD AFTERNOON. WE ESTIMATE THAT THE DISTRICT HAS A POPULATION OF A LITTLE OVER THAT EQUATES TO A LOSS OF $226 MILLION. THESE CONSERVATIVE NUMBERS REPRESENT EFFECTIVE LOSSES WHICH CPCA MEMBERS, INDIVIDUAL MEMBERS NOT MEMBERS OF CPCA IS NOT IN THE DATA. WE ENOUGH TO ASK YOU THE FOLLOWING, RESPECTFULLY, THAT YOU DO WHAT YOU CAN TO ANNEX STATE FUNDING MEASURES TO PROTECT ALL THE RESIDENTS, ESPECIALLY THE INDIGENT, UNINSURED, AND THE UNDOCUMENTED POPULATION. MY TEAM IS HERE, FAMILY IS HERE. THIS IS A FAMILY AFFAIR. AND I JUST WANT TO THANK YOU, AND FINISH BY STATING THAT COMMUNITY HEALTH CENTERS LEADERS ARE IN TOTAL ALIGNMENT WITH THE COUNTY'S PRIORITIES AND HOPEFULLY THE STATE PRIORITIES. THANK YOU.

>> HI. I'M BRIAN SNYDER, CEO OF ABILITY PATH. I WANT TO TELL YOU ABOUT A FAMILY. MARLA IS 34. SHE HAS A DEVELOPMENTAL DISABILITY. SHE LIVES WITH AGEING PARENTS IN SAN JOSE. HER FATHER WORKS IN CONSTRUCTION, HER MOTHER PROVIDES FOR MARLA'S CARE. MARLA RECEIVES MEDICAL COVERAGE FOR SUPPORTED LIVING SERVICES, SUPPORTED LIVING SO FAR AS BEHAVIORAL SUPPORT AND MONTHLY VISITS TO HEALTH CARE. SHE PARTICIPATES IN A DAY PROGRAM, HAS FRIENDS, DIGNITY, AND A LIFE. UNDER HR1, HER LIFE WILL BEGIN TO UNRAVEL. UNDER HR1, WORK REPORTING REQUIREMENTS DESIGNED FOR PEOPLE WITHOUT DISABILITIES, ADMINISTERED BY AN ALREADY OVERWHELMED SOCIAL SERVICES WORKFORCE, PUTS MARLA'S MEDICAL ELIGIBILITY AT RISK. ONE MISSED FORM, ONE MISSED SYSTEM ERROR, ONE ELIGIBILITY WORKER STRETCHED TOO THIN, AND MARLA LOSES HER HEALTH CARE. HER SERVICES STOP. HER PARENTS, IN THEIR 60S, BECOME HER ONLY SUPPORT SYSTEM OVERNIGHT. THIS IS NOT HYPOTHETICAL. NEARLY 3 MILLION CALIFORNIANS, INCLUDING INDIVIDUALS AND FAMILY MEMBERS, LIVE WITH DEVELOPMENTAL DISABILITIES, AMONG THE MOST MEDICAL-DEPENDENT, VULNERABLE, AND INVISIBLE POPULATION IN SACRAMENTO AND WASHINGTON D.C. I'M CEO OF ABILITY PATH. WE SERVE 1,500 INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES FOR OVER 100 YEARS. I STAND WITH SANTA CLARA COUNTY URGING THE STATE TO TAKE ACTION. THE COUNTY'S DOCUMENTS PRESENTED OUTLINES A DEFICIT TO THE PUBLIC HEALTH SYSTEM, THE LARGEST IN NORTHERN CALIFORNIA. FOR THE I.D.D. COMMUNITY, THIS IS NOT AN ABSTRACT FIGURE. SANTA CLARA HEALTH CARE IS WHERE MARLA GOES WHEN SHE HAS A SEIZURE AT 2:00 A.M. IT'S THE SAME SYSTEM EQUIPPED TO TREAT HER. WE URGE THE LEGISLATURE TO MAINTAIN MEDI-CAL ENROLLMENT, INVESTING IN THE ELIGIBILITY SYSTEMS SAFEGUARDING PEOPLE LIKE MARLA, PROVIDE DEDICATED FUNDING FOR THE PUBLIC HOSPITALS AND HEALTH CARE SYSTEMS THAT SERVE THE COMMUNITY, OFTEN DISPROPORTIONATELY, AND SUPPLY THE RESOURCES TO COUNTIES TO HANDLE THE SURGE OF UNEMPLOYED PEOPLE WHEN SUBSIDIES END. MARLA'S PARENTS LAY AWAY WONDERING WHO WILL CARE FOR OUR DAUGHTER WHEN SHE HAS GONE. THE STATE OF CALIFORNIA HAS THE POWER AND THE MORAL OBLIGATION, I WOULD ADD, TO ANSWER IT FOR OUR FRIENDS, NEIGHBORS, AND FAMILY MEMBERS, ONLY IF IT ACTS NOW. I WANT TO THANK THE SANTA CLARA COUNTY SUPERVISORS FOR PROVIDING THE OPPORTUNITY TO SHARE THE CONCERN AND THE IMPACT IT HAS WITH PEOPLE WE LIVE WITH, KNOW, AND CARE FOR ACROSS THE STATE. THANK YOU.

>> GOOD AFTERNOON. I'M OLISE COVENS, WITH THE BEHAVIORAL HEALTH COMMUNITY ASSOCIATION. HONORED TO PRESENT THE NONPROFIT AGENCIES THAT FORM THE BEHAVIORAL HEALTH SAFETY NET. OUR COUNTY HAS A LONGSTANDING TRADITION ESTABLISHED BY SENATOR DAVE CORTESE, AND PREVIOUS BOARD MEMBERS, AND CONTINUED BY SUPERVISOR DUONG AND SUPERVISOR ELLENBURG, RECOGNIZING THE CRITICAL IMPORTANCE OF SUPPORTING THOSE LIVING WITH MENTAL ILLNESS AND ADDICTION. WE HAVE GONE BEYOND MINIMUM REQUIREMENTS TO BUILD A SYSTEM SERVING THE MOST VULNERABLE. IT IS AT RISK DUE TO FEDERAL AND STATE BUDGET PRESSURES WITHOUT FIRST OF ALL, FILLMENT OF BUDGET REQUESTS. WE FACE THE REAL AND FRIGHTENING PROSPECT OF SCALING BACK SERVICES TO ONLY THE MOST EMERGENT NEEDS. ON BEHALF OF CHILDREN TRAUMATIZED, THOSE STRUGGLING WITH ADDICTION, ADULTS WHOSE DAYS ARE CHALLENGED BY THEIR SEVERE MENTAL ILLNESS, AND IMPACTED FAMILIES, AS WELL AS THOSE IN THE COMMUNITY WHO SERVE THEM, I WANT TO URGE OUR STATE DELEGATION NOT ONLY TO SUPPORT THESE REQUESTS BUT TO MAKE THEM A TOP PRIORITY, JUST AS OUR COUNTY AND COMMUNITY HAVE DONE IN THE PASSAGE OF MEASURE A. EVEN WITH THESE RESOURCES, DIFFICULT DECISIONS REMAIN. THE REQUESTS REPRESENT THE MINIMUM NEEDED TO SUSTAIN OUR SYSTEM. IN ADDITION TO THE DEVASTATING IMPACT OF THE LOSS OF MEDI-CAL COVERAGE THAT MANY WILL SPEAK TO, BEHAVIORAL HEALTH FACES THE LARGEST PROPORTIONAL DEFICIT DUE TO MULTIPLE CONVERGING FACTORS. PROP 1 EXPANDS INVESTMENT IN INTENSIVE SERVICES, REDUCING FLEXIBILITY, SHIFTING RESOURCES AWAY FROM FOUNDATIONAL SERVICES THAT PREVENT ESCALATION. THESE ARE THE SERVICES THAT KEEP INDIVIDUALS FROM REACHING CRISIS. IT ALSO SHIFTS RESPONSIBILITY FOR PREVENTION AMONG CHILDREN AND YOUTH, WITHOUT ASSURANCE THAT SCHOOLS ARE PREPARED TO MEET THAT NEED AND WITHOUT ASSURANCE THAT REDIRECTED STATE FUNDING WILL COME TO OUR COUNTY. I ALSO WANT TO HIGHLIGHT THE GOVERNOR'S PROPOSAL TO MAKE MOBILE CRISIS AN OPTIONAL BENEFIT, SHIFTING THE COSTS TO COUNTIES. THIS LOSS OF FUNDING MAY PUSH MENTAL HEALTH AND SUBSTANCE USE CRISIS RESPONSE BACK ONTO LAW ENFORCEMENT, LEADING TO POOR OUTCOMES, HIGHER COSTS, UNNECESSARY INCARCERATIONS AND HOSPITALIZATIONS. FINALLY, THE STATE MUST ACT QUICKLY TO CORRECT ERRORS IN SPECIALTY HEALTH FEE SCHEDULE RATES. IN OUR COUNTY, CRISIS RESIDENTIAL AND ADULT RESIDENTIAL RATES HAVE BEEN INCORRECTLY SWAPPED FOR THREE YEARS, RESULTING IN SUBSTANTIAL LOSSES. WE HAVE MORE CRISIS RESIDENTIAL BEDS, YET THEY ARE REIMBURSED AT A LOWER RATE THAN LESS INTENSIVE CARE. I THANK YOU ALL FOR THE OPPORTUNITY TO SPEAK TO YOU TODAY. MY COLLEAGUES, WHO DO THE HARD WORK OF SUPPORTING THE VULNERABLE RESIDENTS OF THE COMMUNITY, WILL SHARE MORE REAL-WORLD IMPACTS DURING PUBLIC COMMENT. THANK YOU.

>> GOOD AFTERNOON, EVERYONE. I'M MICHAEL ELLIOTT, EXECUTIVE DIRECTOR OF VALLEY HEALTH FOUNDATION. SUPERVISOR DUONG, AND SUPERVISOR ELLENBURG, THANK YOU FOR HAVING US HERE. ASSEMBLYMAN COLLER AREA, ERA MEANS, AND DAVE CORTESE, THANK YOU FOR TAKING TIME OUT OF YOUR BUSY SCHEDULE TO HEAR THE TESTIMONY. I WANT TO THANK THE PARTNERS AT THE STATE ASSEMBLY ABOUT YOUR LEADERSHIP. I KNOW MANY OF YOU CARE ABOUT THE ISSUE AND WILL FIGHT FOR US. I HOPE YOU TAKE THE MESSAGE TO YOUR COLLEAGUES WHO MAY NOT APPRECIATE THE GRAVITY OF WHAT WE ARE FACING. HR1 IS NOT A ROUTINE QUALITY CHANGE. IT'S THE EQUIVALENT OF AN EARTHQUAKE, AND ADDS GROWING NEEDS AND MOUNTING PRESSURE ON THE SYSTEMS WE RELY ON. IN THIS COUNTY ALONE, THE PUBLIC HEALTH CARE SYSTEM IS FACING A ONE BILLION ANNUAL IMPACT, AND THAT'S NOT A JACKET. IT MEANS FEWER SERVICES, LONGER WAIT TIMES ABOUT WHO GETS CARE AND WHEN. WE HAVE NOT STOOD STILL. OUR BOARD OF SUPERVISORS ACT APPROVING $200 MILLION IN REDUCTIONS WAS MORE TO COME. SANTA CLARA HEALTH CARE LOOKED FOR EFFICIENCIES AND NEW REVENUE WHERE POSSIBLE. AND OUR RESIDENTS STEPPED UP. LAST FALL, AS WE KNOW, VOTERS PASSED MEASURE A TO PURSUE PREVENTION SERVICES. IT REQUIRED TRUST, URGENCY, AND A WILLINGNESS FROM THE COMMUNITY TO TAX ITSELF TO PROTECT ITS MOST VULNERABLE. LET ME BE CLEAR, IN SANTA CLARA COUNTY, WE ARE NOT WAITING. WE ARE ORGANIZED, WE ARE ENGAGED, AND READY TO FIGHT TO MAKE SURE THAT ALL OF OUR RESIDENTS CAN HAVE ACCESS TO HEALTH CARE SERVICES THAT THEY NEED. THERE'S ONLY SO MUCH THAT WE CAN DO AT A LOCAL LEVEL. AND THAT IS WHY STATE PARTNERSHIP IS NOT JUST HELPFUL, IT IS ESSENTIAL. WE STRONGLY SUPPORT THE COUNTY'S RECOMMENDATIONS BEFORE YOU, AND ASK THE STATE TO ACT IN A FEW SPECIFIC WAYS. ONE, INVEST IN THE PUBLIC HOSPITAL SYSTEM. TWO, PROTECT AND FUND THE WORKFORCE ADMINISTERING MEDI-CAL AND CALFRESH. RECOGNIZE THE COMING WAVE OF THE UNINSURED, AND EVERY STRATEGY AND RESOURCE MUST BE DEPLOYED TO KEEP AS MANY COVERED. LAST BUT NOT LEAST, AVOID COST-SHIFTING PUTTING PRESSURE ON THAT WHICH WE CANNOT CONTROL. AS I ALLUDED TO, THIS IS LIKE A NATURAL DISASTER. IT IS A MAN-MADE DISASTER. A MAN-MADE DISASTER. THE DECISIONS THAT CREATED THIS WERE MADE IN WASHINGTON. THE CONSEQUENCES ARE FELT HERE IN THE CLINICS, EMERGENCY ROOMS, AND COMMUNITIES. SANTA CLARA COUNTY STEPPED UP. RESIDENTS STEPPED UP. WE STRETCHED EVERY LOCAL TOOL AND THEN SOME. WE HAVE REACHED THE EDGE OF WHAT LOCAL COMMUNITIES AND GOVERNMENT CAN CARRY. WITHOUT STATE LEADERSHIP, OUR SAFETY NET WILL FRAY, ACCESS SHRINK, AND PEOPLE FALLING THROUGH, NOT BECAUSE WE FAIL TO ACKNOWLEDGE. WE ARE LEFT WITHOUT THE MEANS TO KEEP GOING. WE NEED THE STATE TO ACT WITH URGENCY IN ITS KALE BEFORE THOSE CONSEQUENCES ARE IRREVERSIBLE. THANK YOU.

>> GOOD AFTERNOON, CHAIR DUONG, VICE CHAIR SUSAN ELLENBERG, AND PARTNERS AT THE COUNTY AND STATE. THANK YOU FOR THE OPPORTUNITY TO SPEAK. I'M KYLIE CLARK, HERE ON BEHALF OF THE SILICON VALLEY COUNCIL OF NONPROFITS. I REQUEST SUPPORT FOR THE COUNTY'S REQUEST TO THE STATE PROVIDING DEDICATED FUNDING FOR PUBLIC HOSPITAL SYSTEMS, PRESERVING ENROLLMENT IN MEDI-CAL AND CALFRESH THROUGH INVESTMENT AND ELIGIBILITY, ALLOCATING FUNDING FOR CARE, AND REVERSING HARMFUL CUTS TO THE STATE-ONLY MEDI-CAL PROGRAM ARE STEPS TO PROTECT THE HEALTH AND STABILITY OF OUR COMMUNITIES. THESE ARE THOUGHTFUL, TARGETED SOLUTIONS RECOGNIZING THE SCALE AND THE URGENCY OF THE CHALLENGE IN FRONT OF US. I ALSO WANT TO SHARE WHAT WE ARE HEARING DIRECTLY FROM THE NONPROFIT SECTOR. THIS WEEK, OUR NONPROFIT POLL REPORT WAS RELEASED, CAPTURING HOW FEDERAL INSTABILITY IS AFFECTING ORGANIZATIONS ON THE GROUND. THE FINDINGS ARE STARK. 78% OF NONPROFITS REPORT INCREASED DEMAND FOR SERVICES. MORE THAN 40% SAY THEIR FINANCIAL HEALTH HAS WORSENED. NEARLY 40% EXPERIENCED CHALLENGES RECEIVING PROMISED FUNDING, AND 73% REPORT SPENDING STAFF TIME RESPONDING TO FEDERAL POLICY ATTENTION. AT THE SAME TIME, MOST ORGANIZATIONS REPORT THAT MILAN THROUGH FUNDING IS NOT REPLACING FEDERAL DOLLARS. CHANGES REFLECT DOWNSTREAM IMPACTS, AND NONPROFIT PROVIDERS UNDERMINING THE STABILITY OF NONPROFIT ORGANIZATIONS AND THE SYSTEM. WHAT ALL OF THIS TELLS US IS THAT NONPROFITS ARE CONTINUING TO SHOW UP FOR OUR COMMUNITIES, BUT THEY ARE DOING SO UNDER STRAIN AND WITH FEWER RESOURCES. THE REPORT IDENTIFIES OPPORTUNITIES FOR ACTION. THEY NEED FASTER AND SIMPLER FUNDING SO THEY CAN FOCUS ON SERVICE DELIVERY INSTEAD OF ADMINISTRATIVE BURDEN. THEY ARE ASKING TO BE INCLUDED IN POLICY DECISIONS AFFECTING THEIR WORK IN COMMUNITIES THEY SERVE. THEY CALL FOR LONG-TERM SUPPORT FOR NONPROFIT INFRASTRUCTURE AND COMMUNITY POWER BUILDING. WE LOOK FORWARD TO WORKING WITH THE COUNTY LEADERSHIP TO EXPLORE HOW THE RECOMMENDATIONS CAN BE IMPLEMENTED AT THE LOCAL LEVEL AND REALIGN EFFORTS TO RESPOND TO THE CRISIS. I WANT TO EXPRESS GRATITUDE TO DISTRICT FOUR FOR THE FUNDING SUPPORTING SPCN IN PARTNERING WITH THE COUNTY TO HOST TWO TOWN HALLS, ONE FOR NONPROFITS AND ONE FOR THE BROADER COMMUNITY. THROUGH THESE, THE COUNTY GATHERED FEEDBACK FROM THE ORGANIZATIONS AND INDIVIDUALS WHO WILL BE MOST IMPACTED BY THE CUTS. WE LOOK FORWARD TO SHARING OUR FINDINGS AS WE WORK THROUGH THE CHALLENGE. I WANT TO CLOSE WITH THIS. WE ARE IN AN EMERGENCY. THE COUNTY OF SANTA CLARA CANNOT SOLVE IT. THE NONPROFITS CAN'T SOLVE IT ALONE. AND THE STATE CANNOT SOLVE IT ALONE. IT WILL BE SOLVED BY WORKING TOGETHER, REQUEST EXCITEMENT, DEDICATION, AND COLLABORATION, AND A SHARED BELIEF THAT WE HAVE TO STAND UP FOR OUR COMMUNITIES AND STAND TOGETHER. THANK YOU.

>> GOOD AFTERNOON, MARIA NOELLE FERNANDEZ. AND I'M THE DIRECTOR OF WORKING PARTNERSHIPS USA. AND LET ME EXPRESS GRATITUDE TO THE SUPERVISORS DUONG AND SUSAN ELLENBERG, ASSEMBLY AND SENATORS DAVE CORTESE AND WAHAB. AT WORKING PARTNERSHIPS USA, WE ARE HELPING COMMUNITY PATIENTS AND WORKERS RELYING ON THE SANTA CLARA COUNTY FOR CRITICAL CARE FOR THEMSELVES AND FAMILIES. TOO MANY IN OUR COMMUNITY HAVE ALMOST NOWHERE TO TURN. THEY RELY ON THE COUNTY SAFETY NET AND PUBLIC HOSPITAL SYSTEM FOR BASIC HEALTH CARE NEEDS AND LIFE-SAVING CARE. IN SANTA CLARA COUNTY, PART OF THE REASON I'M SO PROUD TO DO THIS WORK IS WE BELIEVE HEALTH CARE IS A RIGHT, NOT A PRIVILEGE, AND WE STEPPED UP AT EVERY TURN. WHEN HCA, A CORPSE CUT SERVICES FROM REGIONAL MEDICAL CENTER ON THE EAST SIDE, SO MANY PEOPLE IN THE ROOM COLLECTIVELY STEPPED IN AND SAVED THAT HOSPITAL. WHEN HR1 THREATENED TO CUT THE COUNTY BUDGET, WE CAME AND PASSED THE HRA. WE ARE SO PROUD OF WORK DONE TOGETHER. WITH HR1, THE FEDERAL ADMINISTRATION MADE A DIFFERENT CHOICE, AND WE HAVE TO BE CLEAR WITH EACH OTHER. THEY ARE CUTTING CARE TO FUND TAX BREAKS FOR BILLIONAIRES. THAT IS NOT WHO WE ARE IN SANTA CLARA COUNTY AND NOT WHO WE WERE IN CALIFORNIA. MEASURE A WAS A SIGNAL THAT WE WILL NOT ABANDON THE MOST VULNERABLE. WE ARE CALLING ON THE STATE TO STAND WITH US AND MAKE THE SAME CHOICE WE HAVE MADE IN THIS COUNTY. SANTA CLARA COUNTY RUNS THE SECOND LARGEST PUBLIC HEALTH SYSTEM IN CALIFORNIA, AND SANTA CLARA COUNTY HAS ABOUT 400,000 PEOPLE THAT DEPEND ON MEDI-CAL. WHAT MAKES THE COUNTY VULNERABLE IS THIS - A MAJORITY OF MEDICAL AND MEDICARE PATIENTS RELY ON THE HOSPITAL AND CLINIC SYSTEM FOR THEIR CARE. HR1 TARGETS THE PUBLIC HOSPITAL SYSTEMS AND PATIENTS IN WAYS THAT LEAVE COUNTIES LIKE OURS DISPROPORTIONATELY EXPOSED. THAT IS WHY WE ARE HERE TODAY. COMMUNITY, CLINIC, ADVOCATES, LABOR, PHILANTHROPY, ASKING SACRAMENTO TO RECOGNIZE THE DISADVANTAGES AND STEP UP AND STEP IN WITH US AND SHARE IN THE RESPONSIBILITY. ACROSS SANTA CLARA COUNTY, WE ARE UNITED IN SAYING THIS - THIS IS THE PRIORITY. IF PEOPLE COULDN'T ACCESS HEALTHCARE, EVERYTHING ELSE WE WORK TOGETHER ON, EVERYTHING WE WORK TOWARDS AROUND STABLE JOBS, AFFORDABLE HOUSING, AND THRIVING FAMILIES, BECOMES IMPOSSIBLE TO ACHIEVE. SO YOU HAVE HEARD OUR ASK, THE NEEDS THAT WE HAVE. TO OUR STATE REPRESENTATIVES, WE ARE COUNTING ON YOU TO CARRY OUR VOICES AND VALUES INTO THE CAPITAL AS YOU DO WELL ON A DAILY BASIS. WE ARE GRATEFUL FOR YOUR LEADERSHIP AND LOOK FORWARD TO CONTINUING TO WORK TOGETHER. THANK YOU.

>> GOOD AFTERNOON. GOOD AFTERNOON. MY NAME IS JEAN COHEN, I'M THE EXECUTIVE OFFICER OF THE SOUTH BAY LABOR COUNCIL. WE REPRESENT OVER 100,000 WORKING FAMILIES, UNION MEMBERS. MEN IN THE AUDIENCE TODAY TO ONE, THANK YOU FOR THE HARD WORK THAT YOU HAVE DONE, AND TWO, ENSURE THAT SANTA CLARA COUNTY REMAINS A SAFE PLACE AND URGING TO CONTINUE TO BE OUR PARTNERS IN THE IMPORTANT WORK ACHIEVED OF US. THE FEDERAL GOVERNMENT MADE A CHOICE TO PRIORITIZE BILLIONAIRES INSTEAD OF INVESTING IN THE PEOPLE. NOW IT'S PUSHED TO STATE, COUNTIES, AND COMMUNITY. WHAT WE SEE ON THE GROUND IS REAL. A $1 BILLION IMPACT TO THE PUBLIC HEALTHCARE SYSTEM, GROWING NUMBERS OF THE UNINSURED, POVERTY WAGES, INCREASED DEMAND FOR FOOD, HOUSING, AND BEHAVIORAL HEALTH SERVICES, AND A MOUNTING PRESSURE ON THE PUBLIC WORKFORCE, COUNTY EMPLOYEES THAT DELIVER THE SERVICES AND RELY ON THEM TO SUPPORT THEIR OWN FAMILIES. THE THREAT TO THE SAFETY NET ARE NOT ISOLATED. THEY ARE SYSTEMIC AND HITTING AT EVERY LEVEL ALL AT ONCE. THIS MOMENT REQUIRES MORE THAN CUTS, DELAYS, AND SHORT-TERM FIXES. IT REQUIRES REVENUE, POLICY LEADERSHIP, AND IDEAS TO MATCH THE SCALE OF THE CHALLENGE AND COMPOUNDING PRESSURE. THIS IS A MOMENT TO THINK DIFFERENTLY ABOUT HOW TO FINANCE CARE, HOW WE DELIVER SERVICES, AND PARTNER ACROSS THE STATE AND LOCAL GOVERNMENTS TO CLOSE GAPS BEFORE THEY BECOME CRISIS. THE REALITY IS THIS. WE NEED OUR LEADERS, AND OUR ALLIES IN SACRAMENTO TO FOLLOW OUR LOCAL DELEGATION, TO FLEX INFLUENCE, TO FIND SOLUTIONS, AND TO USE THEIR VALUES AS THE FOUNDATION FOR ALL OF THAT. IF THE FEDERAL GOVERNMENT IS STEPPING BACK, WE ARE GOING TO CONTINUE TO STEP UP. AND WE'LL DO THAT IN PARTNERSHIP WITH OUR WORKERS. RIGHT NOW, COUNTY DEPARTMENTS ARE BEING ASKED TO MANAGE INCREASED CASELOADS, FREE KEPT ELIGIBILITY, HIGHER SERVICE DEMAND WITHOUT CORRESPONDING RESOURCES. COUNTY EMPLOYEES ARE DELIVERING THE SERVICES AND IN MANY CASES RELY ON THEM. THIS DUAL IMPACT IS IMPORTANT. WHEN THE SAFETY NET IS WEAKENED, IT AFFECTS THE PEOPLE SERVED AND THE WORKFORCE RESPONSIBLE FOR DELIVERING THE SERVICES. GIVEN THIS CONTEXT, WE URGE SACRAMENTO TO FOCUS ON THE THREE THINGS. ONE, REVENUE STABILITY. THE STATE WILL NEED ONGOING SUSTAINABLE REVENUE SOLUTIONS TO MAINTAIN CORE SERVICES. SECOND, POLICY ALIGNMENT. WE URGE THE LEGISLATURE TO REJECT COST-SHIFTING PROPOSALS, INCLUDING THOSE RELATED TO IHSS. THESE SHIFTS DO NOT REDUCE COSTS. OUR FOCUS SHOULD BE ON INCLUDING AND PROVIDING HOMECARE WORKERS WITH WAGES AND BENEFITS THAT THEY DESERVE. THIRD, TARGETED INVESTMENT AND SYSTEM CAPACITY. ONGOING FUNDING FOR PUBLIC HOSPITALS. INVESTMENTS IN THE WORKFORCE DELIVERING THE SERVICES AND CONTINUED AND EXPANDED FUNDING FOR THE MOST VULNERABLE. WE ENCOURAGE THE STATE TO CONSIDER NEW APPROACHES TO FINANCING AND DELIVERING CARE, PARTICULARLY AS THE UNINSURED POPULATION IS EXPECTED TO GROW. THIS IS A STRUCTURAL SHIFT ON HOW WE DELIVER OUR SAFETY NET SERVICES, HOW THEY ARE FUNDED NATIONALLY AND BY THE STATE, AND WE NEED TO RESPOND URGENTLY AND CORE RESPONDINGLY. WE KNOW THAT THIS IS A SHARED RESPONSIBILITY. COUNTIES CANNOT ABSORB THESE EXACT ALONE. WORKERS CANNOT ABSORB THESE EXACT ALONE. ADDRESSING THE MOMENTS WILL REQUIRE COORDINATED ACTION BETWEEN THE STATE, COUNTIES, LABOR, AND COMMUNITY GROUPS, AND WE ARE COMMITTED TO BEING PART OF THAT WORK AND URGE THE LEGISLATURE TO FOLLOW OUR OWN LOCAL DELEGATION AND WORK IN PARTNERSHIP TO PROTECT CORE SERVICE ASKS THE WORKERS THAT SUSTAIN THEM. THANK YOU.

>> THANK YOU SO MUCH FOR THE POWERFUL STATEMENTS TODAY. I THINK SOBERING IS THE THEME OF THE DAY. WE HEARD YOU LOUD AND CLEAR AND WILL CONTINUE THE CONVERSATIONS. IT'S CLEAR THAT NO ONE IS ESCAPING THE IMPACT OF HR1 AND SCATHE. NO ONE WILL BE SHOULDERING IT ALONE. WE'LL DO IT TOGETHER. NOW WE'LL TURN TO ITEM 4 (C), THE STATE DELEGATION. I HAVE BEAUTIFUL INTRODUCTIONS FOR ASSEMBLY MEMBER KARA, AARONS, DAVE CORTESE, AND WA HAB. WE'LL SKIP THAT. KNOW THAT WE LOVE YOU AND YOU ARE AMONG FRIENDS IN THE INTEREST OF TIME. THANK YOU FOR BEING OUR CHAMPIONS AT THE STATE LEVEL FOR CONTINUING TO REPRESENT THE COUNTY, BAY AREA. IT'S A HUGE FIGHT UP THERE. YOU ARE NOT GOING TO EASE UP, NEITHER ARE WE. TODAY WE LEAN IN TO HOW WE PARTNER TOGETHER. FIRST, SENATOR FORMER SUPERVISOR AND CURRENT CERTAINLY DAVE CORTESE, FOLLOWED BY SENATOR WAHAB AND ASSEMBLY MEMBER AR TAHSA. AND...

>> WE ARE GOING TO ALPHABETICAL ORDER. AND ENGAGE IN DISCUSSION AND CREATE A PATH FORWARD. DOES THAT SOUND FORWARD? LET'S DO IT. SENATOR DAVE CORTESE, YOU ARE UP.

>> THANK YOU VERY MUCH, SUPERVISOR DUONG AND SUPERVISOR ELLENBURG. THANK YOU BOTH FOR YOUR LEADERSHIP. CAN YOU HEAR ME? ARE YOU ABLE TO HEAR ME?

[ PAUSE ]

>> I'M MUTED. CAN YOU HEAR ME? SUPERVISOR, ARE YOU ABLE TO HEAR ME?

>> THEY ARE WORKING ON IT AT THIS END. WE'LL LET YOU KNOW AS SOON AS YOU CAN HEAR ME.

>> DAVE CORTESE, WE'LL TURN TO ASSEMBLY MEMBER ASH KARA, WHILE WE WORK ON

THE SOUND. IS THAT OKAY WITH YOU? SIGNAL THUMBS UP. ALL RIGHT. ASSEMBLY MEMBER ASH KARA.

>> THANK YOU SO MUCH. GOOD AFTERNOON, EVERYONE. HE WANTED TO BE HERE WITH MY COLLEAGUES VIRTUALLY AND MY COLLEAGUE TO MY LEFT. SENATORS AARONS, I REPRESENT DISTRICT 25, COVERING DOWN COUNCIL AND A LARGE COPE PACES AND SOUTH-EAST COUNTY. I WANT TO THANK SUPERVISOR DUONG AND THE COUNTY SUPERVISOR ELLENBURG, AND THE COUNTY MANAGER FOR THIS CONVERSATION AND THE LEADERSHIP DURING A CHANGING TIME. AND I SAID THIS MANY TIMES, THIS COUNTY IS WELL RECORDED FOR THE CREATIVE WAYS IN WHICH IT SERVES THE COMMUNITY. THE INVESTMENT IT MAKES IN THE COUNTRY, IT'S NOT ONLY A REFLECTION OF OUR ELECTED LEADERSHIP AND COUNTY MANAGEMENT, BUT A REFLECTION OF MANY THAT YOU ARE HERE IN THE AUDIENCE, THE COMMUNITY DEMANDING SERVICE THAT IS THEY DESERVE.

TODAY IS NO EXCEPTION. WE DO NEED TO BE CLEAR ABOUT WHAT IS HAPPENING RIGHT NOW. THE FEDERAL GOVERNMENT'S BIG UGLY BILL IS DRIVING A MANUFACTURE CRISIS HERE AT THE LOCAL LEVEL. IF IT WEREN'T FOR FEDERAL IMPACTS, BOTH FROM THAT BILL AS WELL AS MILITARY ACTIONS THAT ARE DRAINING THE RESOURCES AND CREATING ECONOMIC UNCERTAINTY, WE WOULD QUITE LIKELY LOOK AT THE SURPLUS IN THE STATE BUDGET. BECAUSE OF THE IMPACTS THAT HAVE ALREADY OCCURRED FROM THE FEDERAL BUDGET AND COMING AROUND THE CORNER, ON TOP OF THE DIRE ECONOMIC UNCERTAINTY, NOT JUST IN TERMS OF FUEL COSTS, BUT THE ECONOMY AS A WHOLE, HAS PUT US IN A DIFFICULT POSITION - ALL OF US, FROM SACRAMENTO TO SANTA CLARA COUNTY. AND AS OTHERS HAVE POINTED OUT, THAT HR1 FROM THE FEDERAL GOVERNMENT TRANSLATES TO A $1 BILLION ANNUAL SHORTFALL THREATENING CORE SERVICES THAT COMMUNITIES RELY ON. THIS HAS A REAL TANGIBLE IMPACT ON PEOPLE'S LIVES, HEALTH CARE ACCESS, FOOD ASSISTANCE, BEHAVIORAL HEALTH AND SUPPORT FOR THOSE THAT NEED MOST. AS USUAL, THE BURDEN FALLS ON WORKING FAMILIES, SENIORS, PEOPLE WITH DISABILITIES AND INDIGENT COMMUNITY.

THE COUNTY HAS TAKEN STRONG STEPS MAKING DIFFICULT BUDGETARY DECISIONS. WE HEARD THE CUTS ALREADY MADE. AND ASKING VOTERS TO STEP UP THROUGH MEASURE A, WHICH I WAS PROUD TO SUPPORT AND PROUD OF THE COMMUNITY DURING CHALLENGING ECONOMIC TIMES UNDERSTANDING THE NEED FOR US TO PASS MEASURE A. EVEN WITH THE EARLIEST, LOCAL GOVERNMENT CANNOT ABSORB A CRISIS OF THIS SCALE ALONE. THAT IS WHY THE PARTNERSHIP WITH THE STATE IS CRITICAL. I WANT TO THANK SENATOR DAVE CORTESE, WHO OVER - WELL OVER A YEAR NOW HAS BEEN CONVENING MEMBERS IN SACRAMENTO, OFTEN TEAMS INVITING COUNTY MANAGEMENT AND SOME OF OUR PUBLIC POLICY FOLKS TO SPEAK DIRECTLY TO REGULATORS, TO HEAR ABOUT THE IMPACT, THE DEVASTATING EXACT THAT SOME. NOT JUST FEDERAL CUTS BUT POTENTIAL AND STATE CUTS THAT HAVE HAPPENED, DEVASTATING IMPACTS IT HAS AT THE LOCAL LEVEL. AND I WANT TO THANK SENATOR AARONS. I WAS PROUD TO JOIN HIM IN SUPPORTING THE BUDGET COUNTY REQUEST TO PROTECT AND STABILIZE SAFETY NETS, MEDI-CAL, CAL FRESH, PUBLIC HOSPITAL AND CRITICAL SERVICES LIKE I.H.S.S. AND MOBILE CRISIS RESPONSE TEAMS. ALSO, AS PART OF A COHORT OF OURS, THE LEGISLATIVE PROGRESSIVE CAUCUS, WE ARE PUSHING BACK ON EFFORTS TO FURTHER MAKE CUTS, AND, OF COURSE, ONE TO RESTORE CUTS MADE TO ENSURE THAT ALL OF OUR UNDOCUMENTED BROTHERS AND SISTERS RECEIVE THE SAME ACCESS TO HEALTH CARE AS THEIR NEIGHBORS. WE ALSO - WE MAY TOUCH ON THIS GOING FORWARD. THE SUPPORT OF REVENUE GENERATION OPPORTUNITIES, AND LOOK FORWARD TO DISCUSSING THAT AS WELL. I'M CONTINUING TO FIGHT FOR THE COMMUNITIES IN SACRAMENTO, NOT JUST TO DEFEND WHAT WE HAVE BUT CHANGE, INCLUDING REINTRODUCTION OF CAL CARE, WHICH WAS REINTRODUCED A FEW WEEKS AGO. AB 1900 TO GUARANTEE HEALTH CARE FOR ALL. AND CONTINUING OUR WORK TO PROTECT SENIORS AND STRENGTHENING LONG-TERM CARE SYSTEMS IN CALIFORNIA. THANK YOU FOR HAVING ME THIS AFTERNOON.

>> THANK YOU, ASSEMBLY MEMBER CAL RA. I'M GOING TO SEE IF DAVE CORTESE IS - CAN WE DO A SOUND CHECK.

>> YES.

>> THERE WE GO. ALL RIGHT. WELCOME, SENATOR DAVE CORTESE.

>> THANK YOU VERY MUCH. I AM NOT SURE WHAT THE ISSUE WAS BEFORE. IT GAVE ME CLEAR UNMUTE SIGN ON THE IPAD. IT DIDN'T WORK. I'M HAPPY TO BE WITH YOU. I WAS TRYING TO SAY A FEW MINUTES AGO, THANK YOU SO MUCH TO OUR TWO COUNTY SUPERVISORS, WHO WERE THE F.G.O.C. COMMITTEE MEMBERS HERE. HAVING SERVED ON THE COMMITTEE DURING THE TIME I WAS ON THE BOARD OF SUPERVISORS, I KNOW HOW CRITICAL YOUR WORK IS. IN TERMS OF VETTING ISSUES - NOT JUST TODAY, BUT CONSTANTLY THROUGHOUT THE YEAR AND HOW IMPORTANT THAT IS TO THE OVERALL BOARD OF SUPERVISORS AND COUNTY ADMINISTRATION. EVEN MORE SO, THANK YOU FOR INVITING US TO PARTICIPATE, SUPERVISOR DUONG, AND SUPERVISOR ELLENBURG. APPRECIATE THE OPPORTUNITY. I KNOW I JUST HAVE A FEW MINUTES TO MAKE OPENING COMMENTS. YOU HAVE GIVEN US A LOT. NONE OF WHICH WE ARE NOT AWARE OF. ALL OF WHICH WE ARE AWARE OF. I WANT TO THANK SENATOR CAL RA FOR ACKNOWLEDGING THE WORK WE HAVE BEEN DOING GOING ALL THE WAY BACK TO A YEAR AGO, PERHAPS A LITTLE LESS THAN A YEAR AGO, BRINGING PEOPLE TOGETHER IN INFORMAL GROUPS AND CAUCUSES, EXISTING AND INFORMAL CAUCUS, BRINGING IN FOLKS LIKE ACCOUNT EXECUTIVE JAMES WILLIAMS AND OTHERS TO MAKE SURE THE IMPACT OF HR1 WERE AND ARE UNDERSTOOD BY AS MANY PEOPLE AS POSSIBLE. I THINK THE AWARENESS IS SIGNIFICANT AT THIS POINT.

LET ME TRY TO RESPOND TO A FEW THINGS. FIRST OF ALL, I WANT TO SAY SOMETHING THAT IS A LITTLE BIT - A LITTLE TO DO WITH THE DIFFERENCE IN GOVERNMENTS, IN THE POSITION I'M IN NOW, VERSUS THE FOGS I WAS IN AS -- POSITION I WAS IN AS A COUNTY SUPERVISOR. WE DON'T HAVE A LOT OF PEOPLE COMING INTO THE STATE CAPITOL THROUGH THE POLICY COMMITTEE PROCESS AND BUDGET HEARING PROCESS LIKE YOU HAVE IN THE ROOM TODAY. THAT'S A PROBLEM. AS LONG AS OUR ISSUES ARE FRAMED AS STATE IS GOING TO HURT THE COUNTIES, THE COUNTY IS GOING TO GET HURT BY THE STATE. A LOT OF PEOPLE HEAR THAT, I BELIEVE, AS GOVERNMENTS COMPETING FOR DOLLARS IN ORDER TO TRY TO BALANCE THEIR OWN BUDGETS AND DO THEIR OWN GOVERNANCE AND WORK. IT IS - IT'S TRUE. BUT THE REAL FACT HERE IS THAT WE HAVE OVERLAPPING IDENTICAL COMMON CONSTITUENCIES. IF YOU ADD UP THE 40 SENATE DISTRICTS AND 80 ASSEMBLY DISTRICT, IT COMPRISES THE SAME POPULATION AS 58 COUNTRIES. THE FOLKS THAT YOU ARE REMINDING US WILL BE HURT BY ONE ACTION OR ANOTHER IS THE SAME FOLKS THAT VOTE FOR US OR NOT. THE SAME FOLKS THAT WE OWE THE SAME RESPONSIBILITIES TO. AND ANYTHING YOU CAN DO WITH YOUR REALLY GREATER ABILITY TO DRUM UP GRASSROOT REPORTS TO GET LETTERS INTO THE PORTALS, PEOPLE DON'T HAVE TO GO TO SACRAMENTO ANY MORE. THERE'S A TREMENDOUS AMOUNT OF ACTIVITY COMING INTO EVERY ANALYSIS, BUDGET BILLS THAT IS THE SAME TESTIMONY WE HAVE HEARD TODAY BUT SHOULD BE COMING IN DROVES, AS FAR AS I'M CONCERNED. EVERY LEGISLATOR TO YOU WILL BE LOOKING AT ANALYSIS AND SEE CONSTITUENTS FROM HIS OR HER OWN DISTRICT MAKING THE SAME ASKS THAT YOU ARE MAKING TODAY. BECAUSE EVERYBODY IN SACRAMENTO - I DON'T WANT TO BE CASZ UNDERS ARE UNDERSTANDING THEY ARE ELECTED OR NOT BASED ON WHAT THEIR CONSTITUENT THINKS OF THEM. NOT WHAT COUNTRY ADMINISTRATION THINKS OF THEM. IT'S A BASIC POLITICAL NATURE THING THAT I WANTED TO GET OUT AND REMIND EVERYONE OF. WE HEAR A LOT FROM THE LOBBYISTS, THEY ARE GOOD. I AM SURE THEY ARE LISTENING. EVERY COUNTY HAS THOSE, LOS ANGELES HAS MANY. IT'S IMPORTANT TO HEAR FROM ACTUAL RESIDENTS - WHETHER DOCUMENTED OR UNDOCUMENTED. WHATEVER THE SITUATION IS, ANYTHING YOU CAN DO TO HELP WITH THAT IS GREAT.

THE PROCESS IS THAT THE GOVERNOR PUTS OUT A BASE BUDGET IN WHICH FRANKLY OFTENTIMES IS A PIECE OF GAMESMANSHIP BARGAINING. FOR EXAMPLE, ASIDE FROM DIRECT COUNTY ISSUES, THERE'S AN ALMOST $6 BILLION PROPOSAL BY THE GOVERNOR TO REBENCH OR GRAB AND UTILIZE PROP 98 MONEYS, EDUCATION MONEY FOR THE GENERAL FUND. THAT'S NOT TYPICALLY SOMETHING THAT WILL FLY. BUT IT'S PUT IN THE BASE BUDGET IN JANUARY AS FORCING THE ASSEMBLY AND THE SENATE IN OUR INDIVIDUAL BUDGET PROPOSALS, AND YES, THE SENATE AND THE ASSEMBLY HAVE SEPARATE PROCESSES AND PROPOSALS TO BRING FORWARD OUR VERSIONS OF THE BUDGET. IT FORCES US TO ASK THAT THAT MONEY IS PUT BACK. ANY OF YOU THAT HAVE BEEN TO A BARGAINING TABLE UNDERSTANDS WHAT THAT MEANS. WE ARE ASKING FOR SOMETHING PUT BACK IN THE BUDGET THAT SHOULD HAVE NEVER BEEN CUT OR PROPOSED IN THE FIRST PLACE. IT'S NOT THIS IS GOVERNOR, THAT'S THE WAY THAT PROCESS WORKS. SO, YOU ARE RIGHT TO IDENTIFY THINGS LIKE MEDICAL CUTS. WE CALL IT THE STATE FUNDED PIECE OF MEDICAL THAT HAS TAKEN HITS AND, YOU KNOW, THAT WOULD BE PROPOSED TO TAKE MORE HITS IN THE CURRENT BUDGET. THAT SHOULDN'T HAPPEN. WE ARE THEN FORCED WHEN THE GOVERNOR DOES THAT, TO ASK FOR THAT MONEY BACK, WHICH OBVIOUSLY OPENS THE DOOR FOR HIM TO ASK FOR SOMETHING FROM US AS WELL. MAYBE SOMETHING HE LIKES A LITTLE MORE THAN WE DO. SO, THAT PROCESS HAS GOT - IS ONGOING RIGHT NOW. MAY 15TH, AS YOU KNOW, THE REVISED WILL GO OUT. IT WILL REFLECT, I BELIEVE, SOME PROGRESS IN THE ASSEMBLY AND SENATE. CAUSED BY THE ASSEMBLY AND SENATE IN TERMS OF GETTING SOME OF WHAT YOU ARE SEEING IN THE JANUARY BASE BUDGET STRAIGHTENED OUT. RECTIFIED, NOT OUT. THERE'S A SCRIPT FROM MAY 15TH TO JUNE 15TH TO NEGOTIATE SENATE, ASSEMBLY AND GOVERNOR ON WHATEVER ELSE WE CAN BRING LEVERAGE TO THIS THAT CONVERSATION. EVERYTHING THAT YOU HAVE ASKED FOR, THIS GROUP, AS YOU HAVE ALLUDED TO, THIS GROUP OF SENATORS AND ASSEMBLY MEMBERS HAVE PUSHED VERY, VERY HARD FOR EVER SINCE THAT BUDGET CAME OUT. SINCE THAT BASE BUDGET PROPOSAL CAME OUT. SO, THE EASTERN I THINK TO SEASON AND EVERY ONE OF YOUR REQUESTS IT TRULY IS THAT WE ARE ALREADY DOING IT. I CAN'T SPEAK TO THE INTERNAL PROCESS, AND I'M ONLY AT LIBERTY TO DESCRIBE THE SENATE PROCESS IN GENERAL TERMS. WE STARTED TO SURVEY EACH AND EVERY SENATOR IN OUR DEMOCRATIC CAUCUS, WHICH IS THE SUPER MAJORITY OF THE SENATE. WE STARTED SURVEYING OVER 90 DIFFERENT BUDGET ITEMS THROUGH A PROFESSIONAL SURVEY PROCESS, MUCH LIKE IF YOU WERE PULLING A GROUP YOURSELF. AND WE HAVE DONE THAT. REPEATEDLY, AND WE HAVE TAKEN AND DEBATED THE RESULTS OF THE SURVEYS. IN PERSON. AT TIMES ALL DAY LONG. AND I'LL TELL YOU, THAT THERE'S NOT ANY NATURAL APPETITE FOR ANY OF THE THINGS THAT FEEL LIKE PILING ON TO YOU, ESPECIALLY IN THE HEALTH AND HUMAN SERVICES AREA. LIKE THE COUNTY, WE CAN'T PRINT MONEY. WE STARTED OFF WITH WHAT WAS SUPPOSED TO BE A $14 BILLION DEFICIT, WITH A $30 BILLION STRUCTURAL DEFICIT ON TOP OF THAT AS A MINIMUM OVER THE NEXT THREE YEARS. WE HAVE DONE NOTHING TO ADDRESS THE STRUCTURAL DEFICIT. THE GOVERNOR AT THIS POINT, AS YOU KNOW, IS CALLING THE JANUARY BUDGET A BALANCED BUDGET DESPITE THE FACT THAT IT'S BUILT ON THESE DRACONIAN STATE FUNDED MEDI-CAL CUTS AS WELL AS THINGS LIKE I MENTIONED IN TERMS OF EDUCATION FUNDING. I CAN TELL YOU, I CAN'T TELL YOU THE RESULTS OF, YOU KNOW, SENATOR WAHAB EXACTLY, I KNOW HER SENTIMENTS. I CAN'T TELL YOU WHAT SENATOR OGO FROM LOS ANGELES IS SAYING ABOUT THESE CUTS OR PROPOSALS OR SENATOR GONZALEZ OR SENATOR BLAKESPEER OR ANY OF THE OTHER 40 MEMBERS OF THE SENATE. I CAN TELL YOU GENERALLY THERE IS NO APPETITE FOR THESE CUTS. AND THERE IS AN APPETITE FOR NEW REVENUE MEASURES. AND THE APPETITE FOR NEW REVENUE MEASURES, WHICH IS NO SECRET, REVOLVES AROUND CLOSING THE SO-CALLED WATERS EDGE LOOPHOLE, WITH WHICH WOULD RAISE A FEW BILLION, MAYBE THREE ANNUALLY. BUT IT SHOULD BE DONE IN MY OPINION. AND A MEDICAL BACKFILL TARGETED AT LARGE EMPLOYERS WHO HAVE BEEN ESSENTIALLY MEDI-CAL AND HEALTH CARE BENEFIT SCAPOLORS. BIG RETAILERS, YOU KNOW WHO THEY WERE, AND OTHERS WHO BASICALLY PROVIDE NO HEALTH CARE BENEFITS AND PUSH THEIR EMPLOYEES ON TO OUR MEDICAID ROLES, INSURED OR UNINSURED. THAT'S NOT OKAY. WITH A TWO-THIRDS VOTE AT BOTH HOUSES WE COULD CORRECT THAT NOW. WE DON'T HAVE TO WAIT. THERE'S A LOT OF APPETITE FOR THAT. IS THERE A TWO-THIRDS VOTE? I DON'T KNOW. WE'LL SEE. PROPOSALS HAVE BEEN MADE. WHEN YOU COMBINE THOSE TWO THINGS, YOU PICK UP AS MUCH AS $12 BILLION A YEAR. THE MEDICAID FUNDING, BECAUSE IT'S MEDICAID FUNDING, BYPASSES PROP 98. SO 100% OF THAT IS MONEY THAT WOULD BENEFIT NOT ONLY THE STATE MEDICAID SYSTEM BUT BY TRICKLING DOWN THE COUNTIES AS WELL. WE ARE DOING EVERYTHING WE CAN TO BE THE OPPOSITE OF PEOPLE PILING ON AND EXACERBATING PROBLEMS AND MAKING IT WORSE. I HAVE NOT SEEN A BUDGET PROCESS START THIS EARLY BEFORE WITH ELECTED OFFICIALS IN ALL OF MY YEARS, SCHOOL BOARD, CITY, COUNTY. I HAVE NEVER SEEN THE RIGOR THAT OUR COUNSELING CAUSE AND THE -- CAUCUS AND THE SENATE EMPLOYED AS EARLY AS IT HAS. THE FIRST WEEK OF FEBRUARY WE ARE ALREADY DEEPLY INTO THE ISSUES AS WE ARE IN THIS HEARING. I SAY THAT NOT TO DEFEND OUR ACTIONS SO YOU HAVE HOPE, SO YOU REALIZE THAT WE ARE ON IT. WE ARE WORKING ON IT. IT'S NOT JUST YOUR SANTA CLARA COUNTY DELEGATION. THERE ARE MANY PEOPLE WE CONSIDER TO BE ALLIES. LOOK AT ASSEMBLY MEMBER AHRENS' $500 MILLION ASK, HIS LETTER AND HOW HE WAS ABLE TO PICK UP MANY CO-SIGNATURES ON THAT. THAT'S INDICATIVE OF HOW MANY IN THE LEGISLATURE FEEL ABOUT WHERE WE NEED TO GO. WHERE WE END UP IS TO BE DETERMINED. WE NEED AS MUCH POLITICAL ENGAGEMENT AND ACTIVISM AS YOU CAN BRING. I UNDERSTAND THAT I COULD BE CHALLENGED FOR SAYING WHAT I'M GOING TO SAY NEXT. BUT I DON'T KNOW HOW ANY EXECUTIVE IN ANY STATE CRITICIZES HR1 FEDERAL GOVERNMENT FOR MAKING DRACONIAN CUTS WHILE AT THE TIME PUTTING A STATE BUDGET OUT THAT DOES THE SAME DAMN THING. IT'S NOT SOMETHING THAT MOST OF US ARE PROUD OF OR APPRECIATIVE OF. IT IS A NEGOTIATION THAT WE ARE IN. IT COMES DOWN TO THE PRO TEM, THE SPEAKER, TWO BUDGET DIRECTORS, ONE IN EACH HOUSE AND THE GOVERNOR'S TEAM. WE NEED YOUR HELP. THANK YOU VERY MUCH.

>> THANK YOU, SENATOR DAVE CORTESE. WE'LL TURN TO ASSEMBLY MEMBER AHRENS. BEFORE I HEAD OVER, I WANT TO THANK THE STATE DELEGATION FOR SIGNING ONTO THE ADVOCACY ALERT TO THEIR RESPECTIVE STATE BUDGET COMMITTEES CHAIRS OUTLINING THE COUNTY SPECIFIC HR1 PRIORITIES AND TO SENATOR AARONS FOR CIRCULATING THE ALERT AMONG HIS COLLEAGUES AND TURN TO YOU.

>> GOOD AFTERNOON, EVERYONE. I'M PATRICK AARONS, THE NEWEST MEMBER OF THE SILICON VALLEY DELEGATION. WE HAVE OUR WORK CUT OUT FOR US IN BUDGET CONSISTENT YEARS. I WANT TO THANK SUPERVISOR DUONG AND MY COUNTY SUPERVISOR SUSAN ELLENBERG FOR THEIR LEADERSHIP CONTINUALLY. I WAS AT A PRESS CONFERENCE EARLIER TODAY WHERE WE TALKED ABOUT THE IMPORTANCE OF PROTECTING CHILDREN AND FAMILIES AND THEY CALL ME THE MOST OUT OF EVERYONE, I THINK, TO ASK ME WHAT AM I DOING TO HELP OUR COUNTY. IT'S THROUGH THEIR LEADERSHIP THAT I HAVE PRIORITIZED THE COUNTY BUDGET ASK. I WANT TO THANK THE TWO COUNTY SUPERVISORS, OF COURSE, IT'S THE TWO WOMEN COUNTY SUPERVISORS LEADING ON THESE EFFORTS TO PROTECT OUR FAMILIES, AND I WANT TO THANK OUR COUNTY EXECUTIVE JAMES WILLIAMS FOR YOUR LEADERSHIP, AND DAVID COMPO, AND YOUR ENTIRE TEAM FOR BEING SO OMNIPRESENT IN SACRAMENTO, AND HELPING HELPING A FRESHMAN LEGISLATOR NAVIGATE. I THINK I'M THE ONLY MEMBER OF THE LEGISLATURE HERE ON THE BUDGET COMMITTEE, AND SO YOU CAN IMAGINE THE AMOUNT OF REQUESTS THAT I'M ASKED TO PUSH FOR AND CHAMPION AND PRESERVE THE COUNTY BUDGET LETTER REQUESTING SUPPORT FOR PRESERVING OUR ENROLLMENT IN MEDI-CAL IS MY NO.1 ASK TO THE BUDGET COMMITTEE. AND THANK THE COUNTY - I WANT TO THANK MICHAEL ELLIOTT AND THE MEASURE A TEAM. SO MANY OF OUR COLLEAGUES IN SACRAMENTO, WE ARE HEARING FROM THEM ABOUT GOING OUT FOR A BALLOT MEASURE TO REPLICATE WHAT THE COUNTY BOARD OF SUPERVISORS LED ON THIS PAST YEAR. IT IS YOUR EXAMPLE THAT THE ENTIRE STATE OF CALIFORNIA IS PUSHING FOR. IT'S BY NO MEANS OUR SAYING GRACE. WE NEED TO BE UNITED IN THE DELEGATION TO PUSH FOR THE ASKS, AND I WANTED TO THANK GENE COWAN, THE EXECUTIVE OFFICER, AND MOORE EENO, IT KYLIE CLARK FOR THEIR TESTIMONY AS WELL. I THINK THEY HAVE BEEN AMAZING PARTNERS IN MY OFFICE IN HELPING TO PROPERLY BRING ALL OF US TO THE BIAS, AND HAVE BEEN HELPFUL TO EXPLAIN THE MORAL PART ITTY THAT WE HAVE, HOW IT'S BEEN FROM AN ECONOMIC STANDPOINT. I'M THE FIRST LEGISLATOR TO BE BORN AT THE COUNTY HOSPITAL. AND I THINK THAT IT IS A RESPONSIBILITY THAT I TAKE VERY SERIOUSLY WHENEVER I WHEN I ARRIVE AS A MEMBER OF THE BUDGET COMMITTEE. WE ARE AT AN UNPRECEDENTED POINT IN THE STATE BUDGET. WE CAN CHOOSE TO THROW OUR HANDS UP AND SAY THE FEDERAL GOVERNMENT IS CUTTING THE DRACONIAN BUDGETS, AND THERE'S NOTHING WE CAN DO OR WE CAN FIGHT. IF WE DON'T FIGHT, NOTHING WILL HAPPEN. IF WE DO, WE CAN TRY. AND I THINK MORE PEOPLE IN OUR COUNTY ARE UNDERSTANDING THAT WE WOULD - WE WANT TO TRY. SO IT'S TIME TO START FLIPPING SOME TABLES, QUITE FRANKLY. AND ADDRESSING THE ISSUES. UNDERSTANDING THAT, YOU KNOW, THERE IS CLASS WARFARE GOING ON IN THE COUNTY, AND THE STATE AND IT IS PITTING US AGAINST EACH OTHER. BUT WITH ALL DUE RESPECT TO THOSE ECONOMIC ARGUMENTS, CLASS WARFARE STARTED LONG AGO IN ATTACKING THE POOR, AND THE MIDDLE CLASS, IN EXCHANGE FOR HEAVIER TAX BREAKS TO BILLIONAIRES. I THINK THAT I WAS SPEAKING WITH COUNTY SUPERVISOR SUSAN ELLENBERG. THE WAR IN IRAN COSTED US CLOSE TO $11 BILLION IN SIX DAYS, AND WE ARE PROJECTED TO HAVE AN $18 BILLION BUDGET DEFICIT IN THE STATE OF CALIFORNIA. WE CAN COMPLETELY ELIMINATE ANY CUTS AND RESTORE FULLY ALL OF OUR SOCIAL SAFETY NET SERVICES IN ABOUT A WEEK AND A HALF WORTH OF GOING TO WAR. WE NEED TO KEEP TALKING ABOUT THAT AS WELL. THESE ARE POLICY CHOICES. THAT ARE - THAT IS HAPPENING IN OUR COUNTRY. AND THAT IS HAPPENING IN THE STATE OF CALIFORNIA. AND THAT ALSO NEEDS TO BE FRONT OF OUR MINDS. I'M PROUD TO ANNOUNCE THAT I'M AUTHORING A BILL TO PROTECT CALFRESH BENEFITS FOR FOSTER YOUTH. I HAVE SIX FOSTER CARE BILLS THAT I'M ADVOCATING FOR, THE MOST AMOUNT OF FOSTER CARE BILLS ANNOUNCED BY ANY LEGISLATOR SINCE JOHN BURTON AND JIM BELL. I'LL CONTINUE TO ADVOCATE FOR MEDI-CAL IN OUR COUNTY HOSPITAL SYSTEM. I'M WORKING CLOSELY WITH MEMBERS OF THE HEALTH COMMITTEE. I HAVE BEEN APPOINTED TO THE HEALTH COMMITTEE. I'LL BE AT THE FOREFRONT OF THE ISSUES. I WANT TO THANK AND APPRECIATE THE LEADERSHIP OF CLOSE TO 10 YEARS NOW IN THE LEGISLATURE. SENATOR ASH CAL RA WHO MENTORED ME IN FIGHTING FOR THE ISSUES. AND SENATOR DAVE CORTESE, AND SENATOR WAHAB FOR THEIR LEADERSHIP IN THE SENATE. IT IS NOT LOST ON ME THE RESPONSIBILITY THAT WE HAVE AND THE IMPORTANCE THAT WE HAVE. AS I STATED EARLIER IN THE PRESS CONFERENCE LED BY SUPERVISOR ELLENBERG AND DUONG. THE CALVARY IS NOT COMING. IT'S NOT THE STATE NEEDS TO STEP UP AND SAVE US, IT'S THE MUTUAL PARTNERSHIP THAT WILL GET US THROUGH IT. THIS. AND THE COUNTY, LOCAL GOVERNMENT AND STATE DELEGATION, IT WILL BE US TOGETHER. WHEN WE USE RHETORIC AND ORGANIZING, IT'S NOT CAN THE STATE HELP US, IT IS HOW CAN WE ALL HELP. BECAUSE IF WE LEAD WITH THAT, WE WOULDN'T HAVE PASSED MEASURE A. WE WOULD HAVE SAID THE STATE NEEDS TO HELP AND FIGURE THAT OUT. DON'T USE THAT RHETORIC. WE NEED TO HOW IS EVERYONE HELPING TO SELF AND FIX THERE. THERE ARE STRUCTURAL CRISES AT HAND THAT WE NEED TO ADDRESS. I'M HAPPY TO DRAFT THE LETTERS OF SUPPORT AND I WANT TO THANK MY COLLEAGUES FOR QUICKLY ADDRESSING $85 MILLION OF CORPORATE TAX BREAKS THAT WE GIVE OUT EVERY YEAR. MANY OF THOSE WE NEVER REVIEW, EVER REVIEW AGAIN ONCE THEY ARE PASSED. MANY OF THEM ARE GOOD, MANY OF THEM KEEP JOBS IN THE STATE OF CALIFORNIA, MANY OF THEM PROTECT GOOD PAYING UNION JOBS AND PROTECT THEM IN THE STATE OF CALIFORNIA. BUT IF WE NEVER REVIEW THEM - IF THE CORPORATE TAX BREAKS ARE DOING SUCH A GOOD JOB AT PROTECTING FAMILIES AND GOOD PAYING JOBS, THEY SHOULD HAVE NO PROBLEM COMING BEFORE THE PUBLIC AND EXPLAINING WHAT A GOOD JOB THEY ARE DOING. AND SO I'M WORKING IN CONCERT WITH ASSEMBLY MEMBER COL RA, AND REVIEWING THE CORPORATE TAX STRUCTURE AND SEEING WHAT IS WORKING AND WHAT IS NOT. DECISION TO LOOKING AT ALL OPTIONS THAT CAN AND SHOULD BE ON THE TABLE IN TERMS OF LOOKING AT REVENUE. IT IS IMPORTANT THAT AGAIN, WE DO NOT TALK ABOUT REVENUE IN A SILO ANY MORE. WE DO NOT TALK ABOUT TAX INCREASES ANY MORE WITHOUT TALKING ABOUT THE CORPORATE TAX BREAKS THAT WE GIVE OUT. AND HOW WE CAN BE DOING THINGS MORE EFFICIENTLY AND BETTER TOGETHER. THAT IS WHY I'M HERE WITH COUNTY LEADERSHIP BECAUSE WE HAVE TO SOLVE THESE ISSUES TOGETHER TO HAVE BETTER DELIVERY SERVICES FOR OUR MOST VULNERABLE RESIDENTS, BECAUSE THESE ISSUES WILL BE WON AND LOST IN EVERY ELECTION CYCLE AND WE CANNOT CONTINUE TO ALLOW THE MUTUAL CONSTITUENCIES TO BE AT THE WHIM OF WHOEVER IS IN THE WHITE HOUSE OR WINS THE GOVERNOR'S HOUSE. IT NEEDS TO BE US PUTTING TOGETHER PROPOSALS AND WORKING TOGETHER TO STREAMLINE EFFICIENCIES AND COUNT ME AS SOMEONE WHO WANTS TO BE IN THAT FIGHT WITH YOU ALL AND BRING ALL OF YOU WITH ME. FINALLY, I'LL JUST SAY THE NEED FOR FULLY FUNDING I.H.S.S. AND CHILD CARE SLOTS PROMISED TO US. IT UNLOCKS OUR ECONOMY AND WILL SAVE US FROM FUTURE BUDGET DEFICITS. I HAVE BEEN PUSHING HARD ON FULLY FUNDING THE CHILD CARE SLOTS AS WELL. THE INDIAN HEALTH CENTER, HOCKEY VALLEY MED WHERE I WAS GOSH, O'CONNOR, SUNNYVALE COMMUNITY SERVICES ARE ORGANIZATIONS THAT HELPED IMMENSELY, AS OUR COUNTY SUPERVISORS SAID, NO WRONG DOOR POLICY IN OUR COUNTY OR ANYONE THAT CAN GO TO A COUNTY FACILITY CAN RECEIVE THE HELP THEY NEED. I'M GOING TO TEXT THE GOVERNOR A PICTURE OF ALL OF YOU AND I WANT YOU TO HOLD THE MEDICAL TORE ALL HIGH AND SHOW SACRAMENTO AND OUR LEADERS THAT WE ARE HERE TO SUPPORT AND DEFEND OUR COMMUNITY. THANK YOU. I'M GOING TO TAKE A VIDEO, ONE, TWO, THREE.

>> THANK YOU. YOU ARE GOING TO TAG ALL OF US, RIGHT?

>> I WAS GOING TO TEXT IT TO GAVIN, BUT I CAN POST IT TOO. ALL RIGHT. THANK YOU. TO STATE DELEGATION, YOU ARE OUR CHAMPIONS. IT'S NO SURPRISE AND MISTAKE THAT AS THE SONS OF SAN JOSE - AS FORMER COUNTY SUPERVISORS, SOMEONE BORN OUT OF OUR OWN HEALTH SYSTEM AND RAISED THROUGH THE CHILD WELFARE CENTER, THANK YOU FOR TAKING THE FIGHT. SENATOR WAHAB IS ONLINE. SHE HAS TECHNICAL DIFFICULTIES PRESENTING HER TO SPEAK. ALL OF THE OFFICERS WILL TRACK THE CONVERSATION. WE DEAL WITH ITEM 4 (D). WE HAVE A HANDFUL OF QUESTIONS AFTER WHICH WE GO INTO PUBLIC COMMENT. VICE CHAIRPERSON SUSAN ELLENBERG, IF YOU WOULD LIKE TO GO FIRST WITH YOUR ASK.

>> SURE. I'M GOING TO GIVE YOU A MULTIPLE CHOICE. I HAVE THREE QUESTIONS REJECTED. I'LL BLEND THEM TOGETHER AND YOU CAN TAKE WHATEVER PART OF THEM YOU LIKE. THE FIRST IS WHAT IS THE APPETITE IN THE LEGISLATURE TO PUSH BACK AGAINST A DEPARTING GOVERNOR SPECIFIC WITH RESPECT TO THE MEDICAL ONLY PROGRAM. SECOND, WHAT IS THE APPETITE IN THE LEGISLATURE TO NARROWLY PRIORITIZE PROTECTING HEALTH CARE, AND TO TREAT THIS AS THE STRUCTURAL ISSUE THAT HAS TO BE ADDRESSED BEFORE ANYTHING ELSE OTHER THAN PROP 98. AND THIRD, THIS IS THE EASY ONE, PLEASE DON'T ALL PICK THIS, WHAT MORE DO YOU NEED FROM THIS COMMUNITY AND HOW CAN WE HELP YOU EXERT INFLUENCE APART FROM THE SANTA CLARA COUNTY BEST DELEGATION.

>> I'M GOING TO TAKE THE THIRD NOT BECAUSE I'M CHICKENING OUT. I THINK THERE IS ACTUALLY IN REGARDS TO - FIRST OF ALL, I THINK SOME OF THE THINGS THAT WERE LAID OUT, INCLUDING OPPOSING GOVERNOR'S, ELIMINATING THE MEDICAL MOBILE CRISIS BENEFITS AND THINGS OF THAT NATURE. WE ARE GOING TO FIGHT ALONG THE LINES OF WHAT FOLKS HERE HAVE BEEN ASKING US, INCLUDING COUNTY LEADERSHIP. I WANT TO MENTION BECAUSE OF THE SCALE OF HR1 THAT WE NEED TO FIGHT FOR REVENUE IN A MEANINGFUL WAY. AND IT CAN'T JUST BE CUT, CUT, CUT. AND HOPE THAT NEXT YEAR'S BUDGET IS BETTER GIVEN WHAT IS HAPPENING AT THE FEDERAL LEVEL. THERE ARE MEANINGFUL THINGS WE CAN DO TO ADVOCATE. WE HAVE PUSHBACK IN SACRAMENTO FROM COLLEAGUES, FROM THIRD PARTY INTERESTS. THAT ARE SO HESITANT TO EVEN HEAR THE WORD TAX. HEAR THE WORD REVENUE GENERATION IN ANY FORM. WE HAVE GOOD IDEAS ON THE TABLE. ONE IS A WATER'S EDGE TAX BREAK THAT CORPORATIONS GET. BASICALLY IT HAS TO DO WITH WHETHER THEY ARE TAXED ON REVENUES THAT OCCUR ONSHORE OR OFFSHORE. THE BOTTOM LINE IS WE HAVE A REAL POSSIBILITY OF GETTING THAT THROUGH, IF WE HAVE A COMMUNITY RISING UP SAYING CORPORATIONS NEED TO HAVE THEIR FAIR SHARE. THIS IS THIS NOT SOMETHING THAT NEEDS TO BE PASSED DOWN TO US. IT WILL BRING $4 BILLION A YEAR. ANOTHER THAT I WANT TO MENTION WHICH I THINK IS A TRAVESTY, IS THE COMPANIES THAT - WE KNOW WHO THEY ARE, RELY ON MEDI-CAL FOR THEIR WORKERS, AND OTHER STATE BENEFITS AND PUBLIC BENEFITS - WE ARE BASICALLY SUBSIDIZING THEIR BUSINESS MODEL. WHEN YOU HAVE A FAST FOOD WORKER GETTING A 20 HOUR SHIFT THEY WORK THREE JOBS, THOSE COMPANIES DON'T WANT TO HAVE TO PAY THEIR HEALTH CARE. SO BY PUSHING BACK ON THAT, SENATOR IS LEADING THE CHARGE ON THAT, WE CAN GET AS MUCH AS $17 BILLION A YEAR FROM THE COMPANIES. IT MEANS WE ARE SUBSIDIZING THEM MORE THAN $17 BILLION. TO MORE CONSIDERABLY CHARGING A FEE FOR WHAT THEY ARE TAKING. I WANT TO MENTION IT. IT'S NOT OFTENTIMES BROUGHT UP. POLITICALLY IT'S HARD TO DO. WE ARE IN A MOMENT WHERE WE HAVE TO FIGHT FOR OUR FAIR SHARE FROM THESE CORPORATIONS THAT HAVE BEEN FLEECING US. I THINK THE TIMING CAN BE GOOD. THAT'S WHAT I ASK OF OUR COMMUNITY, ENGINES, YOU ARE DOING AN A-PLUS JOB ON ADVOCATING WHAT THIS COUNTY NEEDS, PUSHING BACK AGAINST THE CUTBACKS THAT WE ARE SUPPORTING YOU IN THAT. I THINK NEGOTIATION TO THAT, I THINK THERE'S A BIG OPPORTUNITY FOR US TO CREATE A MASS MOVEMENT TO PASS AT LEAST ONE, IF NOT MORE OF THESE TAX REVENUE GENERATION MATTERS. ITEMS, SO, THAT IS WHAT I WOULD SAY.

>> RESPECTFULLY ASSEMBLY MEMBER, I'M NOT OPPOSED TO INCREASING REVENUE, BUT WE NEED TO APPROVE OUR BUDGETS BEFORE THE END OF JUNE. THESE THINGS WILL NOT COME INTO PLACE UNTIL LONG AFTER. THERE'S NO GUARANTEE THAT THE ADDITIONAL FUNDS WILL GO TO ADDRESS THE SPECIFICS OF THE CURRENT HEALTH CARE CRISIS. I THINK IN TERMS OF A MEDIUM TO LONG TERM SOLUTION, THESE ARE EXCELLENT IDEAS. I DON'T THINK THEY ARE SUFFICIENT IN THE SHORT TERM TO SPECIFICALLY ADDRESS THE CRISIS CAUSED BY HR1. I WILL ABSOLUTELY SUPPORT YOU ON THE EARLIEST.

>> WHAT THE COUNTY IS DEMANDING, AND SENATORS AHRENS PUT FORWARD, ABSOLUTELY WILL BE AT THE FIGHT FOR THOSE. THEY ARE THE SHORT TERM NEEDS, 100%.

>> THANK YOU.

>> I'LL JUST ADD, YOU KNOW, TWO QUICK THINGS. NO. 1, I THINK THAT THERE ARE 22 FRESHMAN MEMBERS OF MY COHORT WHO ARE NOT GOING TO WAIT SEVEN YEARS FOR US TO GET SENIORITY TO DO DIFFERENT THINGS. WE NEED TO VOTE AGAINST THE STATUS QUO. IT'S NOT WORKING. IT'S NOT WORKING IN THE HEALTHCARE SYSTEM OR THE RESIDENTS IN SANTA CLARA COUNTY, WHO ARE FEELING THE EFFECTS OF THE AFFORDABILITY CRISIS MORE THAN ANYWHERE ELSE. YOU ALL HAVE TO MEET THE MOMENT AND THE URGENCY OF WHAT YOU ARE HAVING TO DECIDE, IN MONTHS, NOT IN A YEAR. AND THE STATE LEGISLATURE HAS ACTED IN THE PAST ON EARLY BUDGET ACTIONS. WE JUST LAST MONTH UNDER THE LEADERSHIP OF THE WOMEN'S CAUCUS, MY COLLEAGUE SENATOR DAVE CORTESE, SENATORS WAHAB AND THE ENTIRE SILICON VALLEY DELEGATION PASSED A $90 MILLION BUDGET FOR PLANNED PARENTHOOD AND CLINICS BECAUSE OF THE CUTS FROM HR1. THAT WAS BECAUSE OF PRESSURE AND ADVOCATES FROM ACROSS THE DISTRICTS, AND SO EARLY BUDGET ACTION ITEMS HAVE BEEN DONE, AND ARE ALSO ON THE TABLE AND TO LOOKING AT MORE OF THOSE ACTION ITEMS. KNOWING THAT WE CANNOT FULLY BACKFILL ALL THE CUTS BUT WE HEAR YOU IN TERMS OF FINDING THE URGENCY, WHICH IS WHERE I HAVE AUTHORED BUDGET LETTERS AND MY BILL TO BACKFILL CALFRESH AND FOSTER YOUTH, HR1 CUTS. WE ARE LOOKING AT OTHER PROPOSALS TO SEE IF WE CAN GET YOU FUNDS BY THE SUMMER DEADLINE. AND SENATOR COL RA AND MYSELF WHEN WE PASS OUR BUDGET FOR RETROACTIVE BUDGET PAYBACK, IF YOU HAVE TO PASS AND MAKE THE DIFFICULT CHOICES AT THE COUNTY LEVEL THAT THE STATE IS LOOKING AT WAYS TO BACKFILL ANY DOLLARS THAT WE CAN SUPPLEMENT IN CRITICAL AREAS, AS WELL AS LOOKING AT WATERS EDGE AS WELL AS SOME OF THE PROPOSALS MR KALRA MENTIONED THAT DOES NOT INCREASE ANYONE ELSE'S TAXES, SIMPLY CAN BE A BUDGET ACTION THAT WILL HELP TO ALLEVIATE THE CUTS AND HAVE VIRTUALLY NO IMPACT ON THE AVERAGE RESIDENT. THOSE ARE THE SOLE OCCUPATIONS I'M LOOKING FOR. WE HAVE COME AND CAME TO HELP IN THE COUNTY. YOUR LEADERSHIP SAVED US SO MUCH. IT'S TIME TO LOOK AT THE CORPORATE TAXES THAT WE GIVE OUT. AND THE SOLUTIONS AS WELL AS THE ONES THAT WE EXHAUSTED LOCALLY.

>> TWO QUICK NOTES ON THAT. IT WOULD BE GREAT IF SOME OF THOSE TAX CUTS HAPPEN, THAT THEY COULD BE TIED TO HR1 IMPACT SO THAT THERE IS A NORTH STAR OF THINGS WE ARE TALKING ABOUT. AND IMMENSELY GRATEFUL FOR THE SUPPORT FOR PLANNED PARENTHOOD. REALLY CRITICAL WORK. ALSO JUST WANT TO MAKE CLEAR THAT THAT DOESN'T HELP GOVERNMENT BUDGETS. PLANNED PARENTHOODS ARE PRIVATE NONPROFIT ORGANIZATIONS THAT RECEIVE SOME GOVERNMENT FUNDING BUT ARE NOT GOVERNMENT ENTITIES. IF PHENOMENALLY VALUABLE EXPENDITURE, I DON'T WANT TO CONFUSE THAT WITH LOCAL GOVERNMENT NEEDS.

>> FAIR POINT.

>> SENATOR DAVE CORTESE. I WANT TO TURN TO YOU. I DON'T WANT TO SNEAK IN MY QUESTION. IT WILL IT WILL BE AN ASK OF OUR DELEGATION. CAN WE COUNT ON YOU TO ADVOCATE FOR THE A.R.1 ASK AND CHAMPION THEM IF THEY ARE NOT CHAMPIONED BY THE FOR YOURS. CAN I PUT THAT IN THERE, ON THE RECORD.

>> HELL, YES.

>> YES FROM SENATORS AHRENS, AND SENATOR DAVE CORTESE. I TURN TO YOU. THE MIC IS YOURS.

>> YES, OF COURSE. THE LETTER THAT ASSEMBLY PEOPLE MER AHRENS AND KALRA HAVE BEEN TALKING ABOUT, IT'S A LETTER TO THE BUDGET PROCESS ASKING FOR THE FUNDS AND OTHERS HAVE SIGNED IT TOO. IT'S IN THE MIX. WE'LL CONTINUE TO ELEVATE IT EVERY OPPORTUNITY WE GET. I GUESS I'LL TAKE THE QUESTION WHETHER I THINK THERE'S APPETITE TO PUSH BACK AGAINST THE GOVERNOR. FIRST LEVEL OF RESPONSE WOULD BE THERE ALWAYS IS, AT LEAST IN MY FIVE YEARS. IF WE DIDN'T PUSH BACK, FUNDAMENTALLY EACH AND EVERY YEAR OVER THE LAST FIVE YEARS, YOU HAVE SEEN MORE DRACONIAN BUDGETS. THE BASE BUDGET THAT HE PUTS OUT IS TYPICALLY A BARGAINING TOOL. WE SPEND FROM JANUARY ALL THE WAY TO JUNE 15TH, PUSHING BACK, FIGHTING, FIGHTING, FIGHTING AND WILL CONTINUE TO DO THAT. THERE IS A LITTLE BIT OF - SOMEONE WAS ASKING ALIGNMENT QUESTIONS EARLIER. THERE IS A LITTLE BIT OF MISALIGNMENT IN TERMS OF THE - HOW THE STATE IS VIEWING THE HR1 IMPACTS BECAUSE OF THE WAY IT'S SET UP IN TRANCHES. AND SOME OF THAT IS - AS FAR AS DIRECT STATE IMPACT IS NOT GOING TO HIT UNTIL 2027. I, FOR ONE - AT LEAST IN OUR HOUSE HAVE BEEN SPEAKING UP REGULARLY ABOUT THE FACT THAT OUR LOCAL TAXING ENTITIES, COUNTIES, PARTICULARLY DON'T HAVE THE OPTION OF WAITING - WAITING FOR THE MIDTERMS OR ANYTHING ELSE, BECAUSE YOU ARE GOING TO HAVE TO MAKE YOUR CUTS - YOU ALREADY HAVE TAKEN BOLD ACTION ON THE REVENUE SIDE. OBVIOUSLY IN SANTA CLARA COUNTY, WITH THE RECENT TAX MEASURE, YOU'LL HAVE TO MAKE YOUR DECISIONS NOW. AND THE REPERCUSSIONS INTEREST THOSE DECISIONS WILL IMPACT ALL OF OUR CONSTITUENTS NOW, NOT IN 2027, NOT AFTER THE MIDTERM ELECTIONS. THERE'S A BIT OF A DISCONNECT. SOME OF IT IS FISCAL. LIKE I SAID, THE STATE IS IN THE POSITION TO BE ABLE TO WAIT A LITTLE LONGER THAN THE COUNTIES TO, YOU KNOW, ESTABLISH A RESPONSE, A FINAL RESPONSE TO HR1. I DO BELIEVE. I THINK MY COLLEAGUES HAVE SAID IT THAT THE TAX MEASURES THAT WE TALK ABOUT, WATER'S EDGE AND THE MEDI-CAL BACKFILL WOULD - THERE'S NO DELAY THERE. WE ARE TRYING TO GET THOSE THINGS DONE NOW. THERE ARE BILLS RIGHT NOW, TODAY, YOU CAN ADVOCATE FOR ESSENTIALLY WOULD HAVE URGENCIES ON THEM. SO WE CAN GO TO THE GOVERNOR WHEN WE HAVE THE ABILITY TO GET THERE. WHAT HAPPENS IF HE REFUSES TO SIGN TO THEM? THAT'S A POLITICAL QUESTION ALL OF US CAN SPECULATE ON. IF WE DON'T, SHAME ON US. MEDI-CAL NOT TO GET OVERLY INTO THE WEEDS HERE. IF WE GO TO REPORTINGS AND CHARGE THEM FOR THE MEDICAL THAT WE ARE NOT REIMBURSING FOR, THINK OF A REAL TAILER, GIVING NO BENEFITS TO EMPLOYEES, AND NOW AT A TRILLION AN I DON'T REMEMBER IN REVENUE, THINK ABOUT THOSE GUYS, IF WE SAY YOU'LL HAVE TO PAY PER CAPITA FOR THE MEDICAL YOU ARE COSTING US, THAT CAN ONLY GO TO MEDICAL AT THE STATE LEVEL. YES, IT HELPS YOU. DOESN'T GO INTO A SLUSH FUND OR MIXED UP WITH THE GENERAL FUND. THAT'S THE REASON - IT WOULDN'T GO TO THE GENERAL FUND BUT TO MEDICAL REIMBURSEMENT. AND THAT IS WHAT WE ARE ADVOCATING FOR. MANY OF US INDICATE THAT IS WHAT SHOULD HAPPEN. SHIFT WANT TO CLARIFY THAT, THANK YOU.

>> THANK YOU, SENATORS DAVE CORTESE. NOW WE HEAD TO THE PUBLIC COMMENT PORTION OF THE SESSION. THANK YOU TO THE ADVOCATES, SERVICE PROVIDERS AND CAREGIVERS TODAY. YOU BEING IN THE CHAMBERS MOMENT YOU STEPPED AWAY FROM YOUR DAILY ROLE TO ADVOCATE ON THE CLIENT AND COMMUNITY. HOW MANY MEMBERS OF THE PUBLIC WE HAVE.

>> WE HAVE 55 REQUESTS TO SPEAK IN THE ROOM.

>> WE HAVE FIVE REQUESTS ONLINE.

>> SO IN ACCORDANCE WITH THE POLICIES, EACH PUBLIC COMMENT WILL BE LIMITED TO ONE MINUTE TO MAKE SURE EVERYBODY IS HEARD. AND IF YOU HAVE STATEMENT IN WRITING. COLIN, BEGIN TO CALL THE MEMBERS OF THE PUBLIC AS YOU COME UP WE GO TO THE LECTERN. IF YOU ARE ABLE TO STATE YOUR NAME BEFORE BEGINNING TO SPEAK THAT HELPS US TRACK. NOT BAD TRACKING. LAUREN, RACHEL NONE OF THAT TOYIA, DAWN TAYLOR, BOB BROWNSTEIN AND BOB WRA START ARRAYAS, APPROACH THE PODIUM.

LAUREN WITH GUARDSEN HEALTH SERVICES. WE ARE A COMMUNITY HEALTH CLINIC PROVIDING CARE TO TENS OF THOUSANDS OF UNIQUE LIVES THROUGHOUT THE SANTA CLARA COUNTY. I'M HERE TO TALK ABOUT OUR STAFF. ASSEMBLY MEMBER AHRENS, I APPRECIATE WHAT YOU SAID. PEER MEMBERS ARE RESPONSIBLE FOR WALKING THE CLIENTS INTO A ONE OF THOSE NO WRONG DOORS. RIGHT NOW THE CURRENT BUDGET CUTS ARE TO ELIMINATE PROGRAMS. WHAT WE SEE A REDUCTION AND LOSS OF TRUST WITH THE COMMUNITIES RESPONSIBLE FOR SERVING. OUR PROMOTERS AND STAFF ARE MEMBERS OF THE COMMUNITY DESIGNED TO GO INTO THE COMMUNITY AND BRING THEM INTO SERVICES COMMUNITIES WHERE THE TRUST IS NOT FULLY THERE, SO THEY ARE RESPONSIBLE FOR BRINGING THEM TO OUR CARE. IF WE LOSE THEM, WE SEE INCREASES IN DELAYED ACTION. I APPRECIATE EVERYONE'S TIME. THANK YOU FOR EVERYTHING.

>> RICH EING NONE OF THAT TIEST, EO OF COMMUNITY SOLUTIONS. WE ARE A COMMUNITY BASED ORGANIZATION SERVING INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, MANY JUSTICE INVOLVED. JUSTICE INVOLVED INDIVIDUALS CAN HAVE COMPLEX NEEDS. SOME ARE INCARCERATED WHEN BETTER SERVED IN TREATMENT. OTHERS NAVIGATING RE-ENTRY INTO THE COMMUNITY, ACCESS TO HEALTH CARE FOUNDATION OR TO STABILITY AND SUCCESSFUL RE-ENTRY. HR1 MAKES THIS MORE CHALLENGING. CLIENTS WITHOUT COVERAGE ARE AT RISK OF HOSPITALIZATION OR REINCARCERATION, OUTCOMES THAT ARE MORE COSTLY AND DEEPLY DESTABILIZING. ORGANIZATIONS LIKE OURS PLAY A VITAL ROLE IN PREVENTING THE OUTCOMES PROVIDING CARE AND STABILIZING SERVICES. WE CANNOT DO THIS WITHOUT STABLE AND EFFICIENT FUNDING. WE STAND WITH THE COUNTY URGING THE STATE TO PROTECT FUNDING FOR PROGRAMS SO WE CAN CONTINUE SERVING VULNERABLE COMMUNITY MEMBERS WITH DIGNITY AND COMPASSION.

>> DEEP THANKS TO YOU ALL OF YOU FOR BEING HERE. I'M DON TAYLOR, C.E.O. OF CATHOLIC CHARITIES OF SANTA CLARA COUNTY. WE WORK WITH COMMUNITY MEMBERS AND THOSE IN DEEP POVERTY, THOSE EXPERIENCING DEEP ECONOMIC CHALLENGE. OCCUPATIONAL IMPACTS INCLUDE SUPPORTING THOUSANDS OF UNHOUSED FOLKS THROUGH FOOD DISTRIBUTION, OFFERING AND ADDRESSING THROUGH OUR WINDOW SERVICES, ESSENTIAL FOR BENEFITS AND JOBS. OFFERING DEEP NEIGHBORHOOD CONNECTIONS FOR THE FAMILY RESOURCE AND COMMUNITY HUB, AND ALL OF THIS LEADS US TO OBSERVING COMMUNITY SERVICES AND DIRECTING THEM THROUGH PARTNERSHIPS. LIKE SAFETY NET PARTNERS. IN THE MIDST OF REDUCTION. IT IMPACTS THOSE WHO ARE IMPACTED MOST. SO WITH A FISCAL CHALLENGE UPON US. I THANK YOU ALL FOR YOUR CONSIDERATION AND YOUR POLICY DECISIONS WHICH ARE ESSENTIAL TO IMPACTING THE SERVICES THAT WE PROVIDE. AND WE DO IT TOGETHER. APPRECIATE IT.

>> IF YOU NEED HELP, BOB BRANSTEIN IN THE FIGHT WITH THE GOVERNOR OR OTHER LEGISLATORS, SOUND THE ALARM. WE'LL BE THERE WITH RIGHTEOUS FORTITUDE.

>> MY NAME IS [SPEAKING ALTERNATE LANGUAGE], I'M A CHW. I CAN ASK ALL OF YOU TO KEEP THE MEDICAL EXPANSION FOR ALL. I AM SURE YOU ARE AWARE THAT SANTA CLARA COUNTY HAS A SIGNIFICANT POPULATION WITH CONDITIONS. IT'S CRITICAL THAT THEY HAVE ACCESS TO HEALTH CARE SERVICES, REGULAR CHECK-UPS WITH THE PCP, AND HEALTH EDUCATION TO HELP THEM MANAGE THEIR A1C LEVELS. THESE SPECIALTY SERVICES ARE NOT JUST IMPORTANT. THEY ARE AN ESSENTIAL PART OF TREATMENT AND WELLBEING. ACCESS TO THESE SERVICES MUST BE MAINTAINED. WITH ACCESS TO ONGOING CARE, THIS INDIVIDUAL FACES SERIOUS CONSEQUENCES LIKE NEEDING DIALYSIS OR AMPUTATION OF LIMBS. AS A C.H.W., I HAVE SEEN A PATIENT WAITING A YEAR FOR SURGERY, AND NOW IT IS NO LONGER POSSIBLE. I LEAVE MY DOCUMENTATION.

>> I CALL LOPEZ, SANDRA HASHER, EMAND, VIROS. ESCALDA, AND ROSIE GOMEZ PLEASE. [SPEAKING ALTERNATE LANGUAGE].

>> ONE MOMENT FOR TRANSLATION SERVICES.

>> TRANSLATION.

>> HI.

>> HI, CAN YOU HEAR ME?

>> YES, GO AHEAD.

>> HI, MY NAME IS LOPEZ, I'M A COMMUNITY WORKER. FIRST OF ALL, I WOULD LIKE TO THANK YOU - I WOULD LIKE TO THANK YOU FOR SUPPORTING US. WE ARE STARTING TO SEE THE CHANGES IN MEDICAL. BUT WE ARE EXPERIENCING THE NEEDS IN THE COMMUNITY. WE HAVE BEEN HERE IN THE COMMUNITY HELD SERVICES, EMOTIONAL HEALTH, AND I HAVE A CASE OF A PERSON THAT THAT IS LOST COVERAGE GIVEN BY HER EMPLOYEE, AND LOST THE MEDICAL HEALTH COVERAGE, DUE TO THE FACT THAT SHE'S NOT HAVING IMMIGRATION STUDY SHOW IS NOT ELIGIBLE OR HAVE ACCESS TO THE SERVICES, LET'S SAY FOR MEDICAL. HEALTH IS A RIGHT. THANK YOU. THANK YOU, I'M A C.E.O. - THANK YOU FOR ALLOWING ME TO SPEAK. I'D LIKE TO THANK THE COUNTY AS WE GO THROUGH THIS PROCESS. NOT ONLY ON THE PRIMARY CARE BUT BEHAVIORAL HEALTH. COMPLETE SUPPORT. I REALLY DO APPRECIATE THE TRANSPARENCY AND COLLABORATION THAT WE SEE AS WE GO THROUGH THIS PROCESS. THE MOST PRESSING ISSUE I SEE, CONSISTENT, IS HOW DO WE ADDRESS IT IN A SATISFACTORY - THOSE ARE THE ONES AT RISK OF LOSING ACCESS TO PRIMARY CARE AND HELP BOTH ON THE FUNDING SERVICES PERSPECTIVE. IT'S A FISCAL CHALLENGE, I THINK IT CAME UP WITH OTHER FOLKS, AND THAT IS WHAT IT IS. I THINK FROM THE DATA PROVIDED BY THE COUNTY, ON THE PRIMARY CARE SIDE, IF WE LOSE ACCESS OUR P.P.S. RATES WILL GO FROM 37% OF PATIENTS OVER A...

>> PLEASE LEAVE YOUR STATEMENT WITH US. IT'S A SPECIAL MEETING.

>> MY NAME IS SANDRA ASHER, AND I'M HERE TO URGE THE STATE DO NOT NAME FUNDING FOR COUNTY MOBILE CRISIS OPTIONAL FOR FAMILIES LIKE MINE. THIS CARE IS ESSENTIAL. OVER VALENTINE'S DAY WEEKEND MY SON OUT OF THE STATE BECAME SUICIDAL, SAID GOODBYE AND DISAPPEARED INTO THE MOUNTAINS, WITH NO CIVILIAN CRISIS TEAM AVAILABLE. OUR ONLY OPTION WAS LAW ENFORCEMENT. HE WAS FOUND TERRIFIED, CURLED UP IN HIS CAR AND LEFT HIM THERE WITHOUT CARE. IT DIDN'T HAVE TO BE THIS WAY. WITH NO COMMUNITY BASED MOBILE CRISIS TEAMS MADE UP OF CRISIS COUNSELORS ARE MORE EFFECTIVE, LESS INSTRUMENTAL AND COST EFFICIENT THAN POLICE RESPONSE. THEY HAVE PEOPLE THAT CARE AND REDUCE LONG TERM SYSTEMS COSTS. MOST IMPORTANTLY THEY ARE SAFER. PEOPLE IN MENTAL HEALTH CRISIS FACE HIGHER RISK OF HARM DURING POLICE ENCOUNTERS. IT'S NOT A SYSTEM WE SHOULD RELY ON BY DEFAULT. PLEASE FIGHT TO KEEP THE FUNDING MANDATORY. THANK YOU.

>> THANK YOU, WE'LL PAUSE FOR A TRANSLATION. PLEASE STEP FORWARD. TRANSLATION.

>> CAN WE ASK...

>> I'M GETTING NO RESPONSE. IS THERE A TRANSLATION AVAILABLE.

>> SORRY, I WAS TALKING TO MYSELF. I AM SO SORRY. I'M GOING AGAIN. GOOD AFTERNOON MY NAME IS DAISY, SO I BELONG TO THE FAST FOOD WORKERS UNION. I'M GIVING MY FULL SUPPORT TO THE COUNTY AGAINST THE STATE. AND I WOULD LIKE TO HAVE THE PUBLIC HOSPITALS FULLY PROTECTED FOR US. THE COUNTY HAS HAD DEEP COSTS, DEEP CUTS LATELY, AND IT IS THE TIME FOR THE STATE TO PROTECT OUR PUBLIC HOSPITALS. I HAVE NOT HAD ANY MONEY IN THE PAST TO PAY, AND NO PUBLIC HOSPITAL REJECTED A SERVICE FROM ME. THAT'S THE REALITY OF MANY WORKERS IN THE COUNTY. WE DESERVE MEDICAL HELP AND ATTENTION. WE NEED TO PROTECT OUR HOSPITALS. AND I WOULD LIKE YOU TO KNOW THAT I'M AT RISK OF LOSING MY MENTAL HEALTH SERVICE, AND THEREFORE I'M PROBABLY LOSING MY MEDICAID. THANK YOU.

>> THANK YOU, PLEASE COME FORWARD AND BEGIN SPEAKING.

>> HELLO EVERYBODY, I'M COMING FROM THE FAST FOOD WORKER. [SPEAKING ALTERNATE LANGUAGE]

>> IF I CAN HAVE LILIA, VON, SERITA COLVEY, ANNA FERNANDEZ, AND CHRIS GONZALEZ APPROACH THE PODIUM.

>> AND TRANSLATION.

>> I'M HERE TO FULLY SUPPORT THE COUNTY AGAINST THE STATE AND I WOULD LIKE YOU TO KNOW IT'S URGENT TO PROTECT THE PUBLIC HOSPITALS. I'M ONE OF THOSE PERSONS THAT AM FULLY DEPENDENT ON PUBLIC HOSPITALS. NEXT WEEK I WILL HAVE A SURGERY IN MY LEFT EYE. IF IT WASN'T FOR THE PUBLIC HOSPITALS I WOULD NOT BE ABLE TO PAY. LAST YEAR I HAD A FIRST SURGERY IN MY RIGHT EYE. AND NEXT WEEK I WILL HAVE THE FOLLOWING SURGERY OF MY LEFT EYE. SO I'M REALLY GRATEFUL. I'M GRATEFUL. I WOULD LIKE TO FULLY SUPPORT YOU, AND PLEASE DON'T LET OUR PUBLIC HOSPITALS CLOSE. THEY ARE IMPORTANT FOR US WORKERS EVERYWHERE. THANK YOU.

>> LISTENING TO THIS CONVERSATION ABOUT CUTS TO CRITICAL HEALTH CARE I'M STRUCK BY HOW INTERCONNECTED THE ISSUES ARE WITH OUR SCHOOLS. FOR MANY FAMILIES, SCHOOLS ARE WHERE CHILDREN ACCESS MEALS, SUPPORT AND STABILITY. I WOULD LIKE TO TAKE IT TO I DON'T REMEMBER CRITICAL ISSUE THAT THE COMMUNITY IS FACING. THE PROPOSED CLOSURE OF FIVE ELEMENTARY SCHOOLS SERVING SOME OF OUR VULNERABLE CHILDREN. I WANT TO SPEAK TO THIS. MANY OF YOU ENDORSED OR DONATED TO CURRENT TRUST LEASE, AND YOUR VOICES CARRY WEIGHT. FAMILY AND COMMUNITY MEMBERS PARTICIPATED IN THE SCOPE OF TOMORROW AND HOW CLOSURE CAN AMPLIFY CUTS FOR FAMILIES THAT DEPEND ON THEM. BUT DO NOT FEEL LIKE THE DISTRICT BOARD OF EDUCATION IS LISTENING TO THEM. SAN JOSE UNIFIED IS NOT IN GUESS, AND THE CLOSURES WILL NOT SAVE MONEY. THE OPTION IS CLOSING FIVE COULD SERVING HIGH CONCENTRATIONS OF LATINO AND BLACK IN THE COMMUNITY. THIS DECISION ULTIMATELY SITS WITH THE BOARD, BUT...

>> GOOD AFTERNOON, I'M [SPEAKING ALTERNATE LANGUAGE], DIRECTOR OF ADVOCACY AT AGGIE. I'M HERE TO SUPPORT THEIR SUPPORT ARE TO PRESERVE AND SAVE THE SAFETY NET. CURRENT CUTS TO BEHAVIORAL HEALTH ARE FORCING PLACES LIKE AGGIE FROM DELAYING FILLING SERVICES, RESULTING IN SERVICES LEADING TO LONGER WAIT TIMES, REDUCED OUTPATIENT CAPACITY AND FEWER MANAGEMENT SUPPORT STAFF. WHEN PROGRAMS REMAIN, REDUCED STAFFING MEANS FEWER PATIENTS SERVED. LONGER DAYS AND INCREASED RISK FOR BURNOUT. THE CHALLENGES ARE EXACERBATED BY STATE REFORMS, LIKE THE TRANSITION TO B.H.S. A LEADING TO LESS FUNDING DISABILITY FOR MILD AND MODERATE MENTAL HEALTH CARE. WE ARE URGING THE COMMITTEE AND THE BOARD TO CONTINUE ITS DIFFICULT WORK TO PRESERVE FUNDING AND THINKING OF NEW AND CREATIVE WAYS TO ADDRESS THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. THANK YOU.

>> GOOD AFTERNOON, I'M [SPEAKING ALTERNATE LANGUAGE], C.E.O. OF AGGIE. WE HAVE PRIMARY CARE AND BEHAVIORAL HEALTH CLINICS IN ALL OF YOUR DISTRICT. I'M HERE TO VOICE STRONG SUPPORT FOR THE BUDGET ASKS OF THE STATE. LIKE THE COUNTY, AGGIE IS BRACING FOR THE IMPACT OF CUTS TO MEDI-CAL, AND PARTICULARLY FOR THE US POPULATION, WHICH WILL MAKE IT CHALLENGING FOR US TO FULFILL A MANDATE TO SERVE EVERYONE REGARDLESS OF STATUS OR ABILITY TO PAY. THE PRIMARY CARE PATIENTS THAT WE SEE AT AGGIE TYPICALLY HAVE COMPLEX NEEDS DUE TO ACCESS CARE AND SOCIOECONOMIC CHALLENGES. WHILE WE MADE HUGE EFFORTS TO ENROLL COMMUNITY MEMBERS BEFORE DECEMBER 31ST LAST YEAR, WE ARE FACING TREMENDOUS CUTS TO THE P.P.S. STARTING IN JULY, WHICH WILL BE DEVASTATING. MOST COMMUNITY CLINICS HAVE 30% POPULATIONS FINANCIALLY DESTABILIZING. THANK YOU FOR DOING EVERYTHING YOU CAN TO SAVE THIS.

>> MY NAME IS ANNA FERNANDEZ, AND I'M THE EXECUTIVE DIRECTOR OF BEHAVIORAL HEALTH. WE ASSIST PEOPLE WITH DISABILITY AND MENTAL ILLNESS. FOR MOST OF THESE INDIVIDUALS, MEDI-CAL IS NOT AN INSURANCE, IT'S THEIR LIFELINE. THEY - MEDICAL PROVIDE ACCESS TO BEHAVIORAL HEALTH, PSYCHIATRIC SUPPORT, MEDICATION, CRISIS SERVICE AND DAILY LIVING SUPPORT ALLOWING THE POPULATION TO BE STABLE AND LIVE IN THE COMMUNITY. WHEN INDIVIDUALS LOSE THEIR STABILITY, FAMILY LOSE SUPPORT, AND THE SYSTEM SHIFTS FROM PREVENTION TO CRISIS. THEN WE SEE INCREASE IN EMERGENCY ROOM VISITS. MORE HOSPITALIZATION, INVOLVEMENT WITH LAW ENFORCEMENT. AND SPECIFIC POPULATIONS END UP IN A LOCKED FACILITY AT THE STATE HOSPITAL. COSTING MORE OF THE SERVICE THAT I MENTIONED BEFORE.

>> CHRIS GONZALEZ, GAIL WRIGHT, MIKKEL LOWE, PURLA FLORES AND OLGA MELD APPROACH THE PODIUM.

>> I'M CHRIS GONZALEZ, I'M A SUBSTANCE USE SOCIAL WORK FOR YOUTH. SILICON VALLEY DEPENDS ON A STRONG WORKFORCE TO BUILD THE FUTURE. RIGHT NEXT DOOR MANY IN FAMILIES STRUGGLE WITH ABUSE DISORDERS AND HOMELESSNESS. WITHOUT SUPPORT, THE CHALLENGES PUSH YOUTH INTO AN INCARCERATION SYSTEM. ASSISTANCE ABUSE HELPS THOSE BEING TRAPPED. IT GIVES YOUTH THE TOOLS TO IMAGINE AND BUILD BETTER FUTURES. I WANT TO SHARE A STORY OF A YOUNG PERSON. HE GREW UP IN POVERTY, ENTERED INTO PROBATION AT AGE 13. STRUGGLED WITH ADDICTION. HE'S 19 TODAY. WITH CONSISTENT SUPPORT AND HEALTHIER COPING SKILLS, HE MAINTAINS SOBRIETY AND COMPLETED PROBATION. COMMUNITY BASED CARE MADE THAT POSSIBLE.

>> WHEN WE CUT SUBSTANCE USE FUNDING, MANY OF THEM ARE MEDICAL. WE ARE PULLING THE LADDER FROM UP THE SQUAUTH. YOUTH...

>> THANK YOU, YOU CAN LEAVE YOUR STATEMENT, WE'LL ENTER IT FOR THE RECORD. SNOW.

>> GOOD AFTERNOON, I'M DR GAIL WRIGHT. A PEDIATRICIAN, AND PEDIATRIC CARDIOLOGIST AND CRITICAL CARE PHYSICIAN. I WORK IN THIS COUNTY PROVIDING THAT CARE FOR 22 YEARS OF MY 33 YEARS CARING FOR CHILDREN. I CAME TODAY TO THANK THE COUNTY FOR ALL YOU CONTINUE TO DO, TO THANK THE STATE LEGISLATORS AND ASK THAT WE PRIORITIZE CARE AND PARTICULARLY THE CARE OF

CHILDREN. I WANTED TO TELL A STORY OF A PERP. I CAN'T DO THAT IN 30 SECONDS.

OTHERS EMPATHISED HOW MUCH WE SAVED MONEY BY PROVIDING EARLY CARE. THE BEST EXAMPLES ARE IN FRONT OF US HERE WITH TWO BABIES BORN IN THE SAFETY NET HOSPITAL WHO WHEN THEY WERE GIVEN EDUCATIONS FOOD AND AN ADULT THAT CARED AND LATER EDUCATION ARE ABLE TO DE OUR LEADERS, AND OPPOSITE DESCRIBED BY THE PRIOR SPEAKER. I WANT TO SAY SANTA CLARA COUNTY, THAT YOUR DOCTORS STILL LOVE YOU. WE ARE DOING ALL WE CAN, LET'S DO THIS TOGETHER, PLEASE.

>> THANK YOU.

>> GP, OI OVERSEE GENDER BASED VIOLENCE SERVICES AND COMMUNITY SOLUTION, WE ARE GRATEFUL FOR THE COUNTY FOR LEADERSHIP IN ADVOCATING THAT THE STATE CONTAIN AVOKE AREA IN THE 2026/27 BUDGET AND FULL COST RECOVERY FOR LARGE VENTS. VOKA IS A FUNDING SOURCE FOR THE CONFIDENTIAL DOMESTIC VIOLENCE SEXUAL ASSAULT PROVIDERS, IN 25/26. THERE WAS $2 MILLION BACK FOUL FAR THE SEXUAL ASSAULT PROVIDERS, SANTA CLARA COUNTY HAS A LONG AND IMPORTANCE TRADITION IN INVESTING IN CRITICAL NET SAFETY SERVICES, INCLUDING GOING BACK TO SENATOR DAVE CORTESE, CHAMPIONING TRAFFIC FOR SURVIVORS, AND APPRECIATE THAT THAT LEADERSHIP CONTINUE, THANK YOU SUPERVISOR YOUNG AND SUSAN ELLENBERG, AND WE LOOK FORWARD TO PARTNERING WITH COUNTY AND STATE LEADERSHIP SO ADDRESS THIS ISSUE, THANK YOU.

>> GOOD AFTERNOON. MICHELLE LOWE, SENIOR VICE PRESIDENT WITH STAMFORD MEDICINE AND CHILDREN'S HEALTH. YOU MAY ASK WHAT STAMFORD ARE DOING HERE, OUR PEER MIX IS MORE THAN 40% MEHDI CAP. AS SENATORS AHRENS MENTIONED WE ARE HAUL IN IT TOOK. SANTA CLARA HEALTH CARE IS OUR PARTNER. WE LOVE YOU, THE LEADERSHIP OF PATRICK AR RENNESES, AND ARE HERE TO SUPPORT A STRONG COUNTY STATE PARTNERSHIP. THANK YOU.

>> IF I CAN GET OLGA, AVA CRUZ, JARIA, DID MANN ETA. ANDREW SIEGLER, RAYMOND GOING, AND MICHELLE NASH BURN, PLEASE.

>> [ SPEAKING ALTERNATE LANGUAGE ] .

>> STEREO TRANSLATION.

>> GOOD AFTERNOON, I'M VA CRUZ, AND I'M A MEMBER OF THE - I AM MEMBER OF THE OPPORTUNITY. I WOULD LIKE YOU TO KEEP MEDICAL - THE MEDICAL PIECE IN 2025. WE HAD A CHANCE TO IMPROVE STABILITY WE KNOW IN OUR COUPE HELD AND FAMILY ADD ARE AT THE CENTER. OUR COUPE IS CONCERNED BECAUSE MEDICAL MIGHT DISAPPEAR. THIS IS NOT ONLY HAVING PHYSICAL IMPACT BUT EMOTIONAL IMPACT. IT WILL BE, OF COURSE, A HARD IMPACT ECONOMY. WE WILL NOT BE ABLE TO HAVE A PUBLIC SERVICE, BUT WILL BE FORCED TO PAY A PRIVATE SERVICE THAT MAY - OR MAYBE WE WILL NOT BE ABILITY PAY. THESE HOLD THIS RIGHT. IT'S NOT AN OPTION. THANK YOU.

>> PLEASE COME FORWARD.

>> HELLO, I'M A MEMBER, OM-HERNANDEZ. AND I'M SPEAKING IN SUPPORT OF THE COUNTY BUDGET REQUEST TO THE STATE. OUR COUNTY HOSPITAL IS THE SAFETY NET FOR EVERYONE IN THE CHUNTY. THAT COUNTY HAS MADE CUTS AND NOW IT'S TIME FOR THE ESTATE TO STEP AND PROTECT THE HOSPITALS. I CARE ABOUT THE COUNTY'S PUBLIC HOSPITALS. THEY PROVIDE HEALTH CARE FOR EVERYONE, ESPECIALLY FOR THE MOST AT RISK POPULATION, THEY ARE THE ONLY - THEY ARE THE ONLY PLACE WHERE OUR NEIGHBORS, THE HOMELESS AND THE WORKING FAMILIES WHO ARE JUST BARELY GETTING BY TO WHEN THEY ARE SICK. WITHOUT THESE HOSPITALS, THESE PEOPLE WOULD HAVE NOWHERE TO GO. PLEASE SUPPORT THE COUNTIES BUDGET IN THE STATE BUDGET TO PROTECT OUR PUBLIC HOSPITALS. THANK YOU SO MUCH FOR YOUR SUPPORT AND COMMITMENT.

>> HELLO, EVERYONE, THANK YOU SO MUCH FOR YOUR LEADERSHIP AND HOSTING THIS WONDERFUL COMMITTEE HEARING. I'M JERIA WITH WORKING PARTNERSHIPS U.S.A. AND URGE THE STATE TO SUPPORT THE COUNTY BUDGETS ASK. I'M WORKING EVERY DAY TO EDUCATE THE PUBLIC ABOUT THE CHANGES TO MEDICAL. I MED A YOUNG MOTHER, WORKING TWO JOBS TO KEEP THE FAMILY AFLOAT AND CARING WITH TWO CHILDREN ON HER OWN. WITH THE RENEWALS AND DEPARTMENTAL CARE SHE'S WORRIED SHE'LL LOSE MEDI-CAL THAT SUPPORTS HER FAMILY, SUPPORT THE COUNTY BUDGET ASK AND PROTECT THE SAFETY NET AND PUBLIC HOSPITALS. THANK YOU.

>> GOOD AFTERNOON, THANK YOU FOR THE OPPORTUNITY O TALK. ASSEMBLY D 25, THE COMMUNITY ORGANIZERS, I'M ON DISABILITY TO THE MENTAL HEALTH DIAGNOSIS. PLEASE FIGHT FOR RECOMMENDATIONS AND DON'T NAME FUNDING FOR THE RESPONSE OPTIONAL. IN 2017 I WAS IN CRISIS, I GREAT TO GET HELP. THE DOCTOR SAID DO NOT SEND POLICE, HE'S COOPERATING. EIGHT OFFICERS SHOWED UP. TERRIFYING.

FAMILY THROUGH MENTAL HEALTH CRISIS FURTHER AND DESIGNED TRUST. LAW ENFORCEMENT SO PEOPLE LIKE ME COULD E MET WITH CARE, NOT GUNS. I VICE PRESIDENT BEEN HOSPITALIZED IN FIVE YEARS, BUT I'M A BAD DAY AWAY. I SUPPORT THE COUNTY'S RECOMMENDATIONS AND THE PLEASE DO NOT MAKE NOBLE CRISIS RESPONSE OPTIONAL OR SHIFT COSTS TO COUNTRIES FACING DEFICITS. THE DECISION WILL COST LIVES, INCLUDING MINE, THANK YOU. WE HAVE MICHELLE NASHBURN, MEGGEN GOOD HUE, SAVIA GONZALEZ. NATASHA WALKER AND BEATRICE WALTON. SNOOP MY NAME IS MICHELLE NASHBURN, I'M AN I HS S RECIPIENT. FOUND OFFER ALLINGS EQUITY. I'M AN ADVISORY BOARD MEMBER, I'M SPEAKING AS MYSELF DISABILITY PEOPLE IN THE COUNTY ARE NOT A UNIFORM GROUP BAITING FOR SERVICES, WE ARE EMPLOYED AND UNEMPLOYED, WE ARE PARENTING, RUNNING BUSINESSES, ORGANIZING AND CONTRIBUTING IN EVERY SECTOR OF CIVIC AND ECONOMIC LFE. AND ARE DISPROPORTIONATELY AMONG THOSE TARGETED IN THE CUTS. I.H.S.S. RECIPIENTS, PROVIDERS, WAIVER RECIPIENTS AND THOSE LOCKED OUT OF TRADITIONAL EMPLOYMENT NOT BECAUSE OF DISABILITIES, BUT STRUCTURALABLISM. THESE CUTS WILL LEAD TO INSTITUTIONALISATION, AND DEATH OF PEOPLE WITH DISABILITIES. IT NEEDS TO BE RECOGNIZED WITHIN THE COUNTY, I APPRECIATE THE COUNTY AND STATE DELEGATION'S COMMITMENT TO PROTECTING DURING THIS MOMENT. I URGE YOU TO CARRY VOICES OF DISABILITY PEOPLE FORWARD. THE.

>> GOOD AFTERNOON, I'M MEGAN GOOD HUE, THE PARAGRAPH OF ADVOCACY AND CHILDREN'S ENGAGEMENT AT PARENTS HELPING PERSONS, WE SERVE THOUSANDS OF FAMILIES WITH LOVED ONES WITH DISABILITIES, I'M HERE TO URGING TO PROTECT IN HOME SERVICES OR I.H.S.S. IT IS CRITICAL TO KEEP PEOPLE SAFELY IN THE HOMES OUT OF COSTLY CARE. PROPOSED CUTS LIKE ELIMINATING BACK UP PROGRAM AND RESTRICTING SERVICES WILL HAVE REAL DEFENCES LOCALLY. WITHOUT RELIABLE CARE PEOPLE WILL GO WITHOUT BAKE NEEDS AND END UP IN CRISIS, WHEN THAT HAPPENS THE BURDEN SHIFTS TO THE COUNTY.

IMPACTING HOSPITALS, EMERGENCY SERVICES AND SAFETY NET PROGRAMS, I URGE THE COUNTY TO BE PREPARED TO FILL THE GALS AND SURGE THE STATE LEADERS TO REJECT CUTS AND FUND I.H.S.S. PROTECTING I.H.S.S. MEANS PROTECTING THE HEALTH DIGNITY AND STABILITY OF THE COMMUNITY, THANK YOU.

>> GOOD AFTERNOON. I'M NATASHA WALKER, I'M WITH - RELATING I.H.S.S. U, S.C.I.U. AND ADVOCATING FOR FAMILIES WITH DISABILITIES, LIKE MY OWN. I HAVE A DAUGHTER AN AUTISM. I HAVE SOME SUGGESTIONS. SO I WANTED TO SAY FIRST OF ALL FOR THE STATE LEGISLATORS, IN YOUR CONVERSATIONS WITH THOSE OPPOSING YOU, USE THE OPPORTUNITY TO EDUCATE THEM ON HOW INVISIBLE THOSE WITH DISABILITY ARE. ALL THINGS DISABILITIESY, THAT WORD CAN HELP YOU WITH THAT. THAT WAS MICHELLE ASH BURN WHO WAS JUST HERE, SHE HAS A WEBSITE. THERE ARE FOUNDATIONS IN THE STATE THAT SIT ON THEIR FUNDS. THAT'S ANOTHER PLACE TO LOOK. AND LOOK AT THE COUNTY AND STATE AGENCY OPERATING EFFICIENCIES, EMPLOYERS CAN HELP YOU WITH THAT AND CONSUMERS. LEADERS OF ORGANISATIONS DO THE SAME. TRAIN YOURSELF. THERE TWO WOMEN IN THE ROOM RIGHT NOW THAT JUST BECAME HOMELESS.

>> [ SPEAKING ALTERNATE LANGUAGE ] TRYING TO GET HER TREATED AND PART OF SILICON VALLEY. I'M DEPEND LIVING. MEDICAL IS WHAT IS GOING TO COVER HER. WE HAVE TO FIND OUT IF SHE'S COVERED UNDER MEDICAL TO RECEIVE THE SERVICES. KEEP MADE CAM.

>> GOOD AFTERNOON, MY NAME IS OF.

>> CA, AND I'M THE ADVOCACY LEADER, WHERE WE PROVIDE SERVICES TO GENDER BASED VIOLENCE, AS WE CONTINUE TO STRATEGIZE ABOUT PROVOKE THE SAFETY MET. IT'S IMPORTANT TO REMEMBER SERVICES FOR SPECIAL POPULATION FOR SURVIVORS OF GENDER BASED VIOLENCE, IT'S NOT JUST A PUBLIC SAFETY ISSUE, IT'S A PUBLIC HEALTH ISSUE, WHEN SURVIVORS CANNOT ACCESS SERVICES, THEY SHOW UP IN EMERGENCY ROOMS, AND IN FAMILIES THOUGH DO NOT GET A CAPS TO HEAL. CUTS MAKE IT COSTLIER TO ADDRESS THE FUTURE. WE ARE THANKFUL TO THE COUNTY FOR SUPPORT OF GENDER-BASED VIOLENCE SERVICES WE CALL ON OFFICIALS TO TAKE ACTION.

>> WELCOME BACK FOR FUNDING. IT'S THSZ LIKE HOW ORGANISATIONS LIKE OURS PROVIDE SERVICES TO PROVIDERS. IT'S ABSENCE IT NOT AN OVER SIGHT WE CAN AFFED.

>> I'M CHRIS SCOTT. FIRST I WOULD LIKE TO THANK ASSEMBLY MEMBERS FOR THEIR CARR RA AND AR RENNESES, FOR WRITING TA LETTER TO THE STATE UPPED BS C.C. FUNDING FOR PREVENTION WAS AWARDED THROUGHOUT CALIFORNIA, AND ZERO FOUNDING WENT TO SANTA CLARA COUNTY BASED ORGANISATIONS OR LOCAL GOVERNMENTS. ZERO, MORE ADVOCACY IS NEEDED ESPECIALLY WHEN FUNDING IS AVAILABLE. WE SHOULD BE OUTRAGED. HOW WILL WE SHOW THE STATE THAT PREVENTION, RESOURCES IS AN IMPORTANT NEED WHEN OUR COUNTIES ARE QUICK TO SUT:

>>GOOD AFTERNOON. THE COMMUNITY SERVICE, SPEAKING IN STRONG SUPPORT OF THE BUDGET REQUEST TO THE STATE. OUR PUBLIC HOSPITALS, ESSENTIAL SAFETY NET TO THE COUNTRY, THE COUNTRY HAS MADE DEEP CUTS AND IT'S TIME FOR THE STATE TO STEP IN. IN OUR COMMUNITIES, WE SUPPORT SENIORS: EXPERIENCING HIGH LEVELS OF STRESS: THAT THEY DEPEND HON. SENIORS LIVE LONG TERM ILLNESS, RELY HONOR CLINICS AND HOSPITAL FOR ONGOING CARE. SUPPORT THE BUDGET REQUEST IN THE STATE BUDGET TO ENSURE PUBLIC HOSPITALS ARE AVAILABLE FOR THOSE THAT NEED THE MOST. THANK YOU. REASONABLE

>> GOOD AFTERNOON, I'M KIMBERLY WITH YOU WITH SIREN, WHEN THE FEDERAL GOVERNMENT STOLE 1 TRILLION TO REINVEST 170 BILLION INTO THE MALICIOUS FAMILY SEPARATION AGENDA, THE REQUEST TO THE STATE FIGHTING HOSPITALS IS HOW WE FIGHT BACK, ALONG WITH FUNDING THAT SIREN AND PARTNERS ARE ADVOCATING, HE'LL RELEASE A REPORT WITH THE HUMAN RIGHTS INSTITUTE. ACROSS THE BOARD OUR IMMIGRANT FAMILIES ARE WORRIED ABOUT AFFORDABLE HOUSING AND HEALTHCARE. OUR IMMIGRANT FAMILIES ARE FIGURING OUT WHERE THE HARD EARNT MONEY GOES TO, FOOD ON THE TABLE. HEALTH CARE, ATTORNEYS TO KEEP THE FAMILIES TOGETHER AND A LIST GOES ON. IT'S AN EXACT DECISION, ALL ARE INTERCONNECTED. SACRIFICING ANY MEANS A STEP CLOSER. WE URGE STATE OFFICIALS TO INVEST IN PUBLIC HEALTH CARE TO KEEP FAMILIES TOGETHER. THANK YOU.

>> WE HAVE CARR PEN MARTINEZ. SAMANTHA, ADRIANA GARCIA, SUSAN AREA PEGGY ELWELL. AND GREG MILLER PLEASE.

>> I'M ORGANIZING DIRECTOR SPEAKING ON BEHALF OF ANY DIRECTOR DARCY GREEN. WE ARE PATIENT NAVIGATORS, HEALTH EDUCATORS AND HEALTH JUSTICE ADVOCATES SERVING THOUSANDS DIRECTED BY H R1. WE SEE EVERY DAY WHAT IS AT STAKE. THIS IS AN URGENT MOMENT. OUR PATIENTS LIVES AND THE LIVES OF SANTA CLARA RESIDENTS ARE ON THE LNE. WE WORK WITH PEOPLE FACING CANCER AND SERIOUS ILLNESS, AND WE KNOW WHAT HAPPENS WHEN CARE IS DENIED ORB DISRUPTED. PATIENTS GET SICK ERG, OUTCOMES ARE WORSEN AND THE STRAIN ON THE SYSTEM GROWS. THE COUNTY SHOWS COURAGE AND COLLABORATION IN PROTECTING THE SAFETY NET. THEY CAN'T SHOULDER THE BURDEN ALONE. WE LOOK TO THE STATE DELEGATION AS ESSENTIAL PARTNERS, THE STATE HAS A TIME SENSITIVITY TIME TO REACT. WE ARE PREPARED TO ORGANIZE OUR COMMUNITY TO PRESERVE THE FUNDING NEEDED. THANK YOU.

>> GOOD AFTERNOON, I'M SAMANTHA, AND I'M A LEAD PATIENT ORGANIZER. I'M HERE BECAUSE WE ARE HEARING FROM PATIENTS IS ALARMING. PEOPLE ARE SCARED, THEY ARE SICK. LOSING FAITH BY ANYONE IN GOVERNMENT STEPPING IN TO PROTECT THEM. THE TEAM SPEAKS WITH CANCER PATIENT AND FAMILIES MANAGING SERIOUS ILLNESSES WE ARE SEEING MORE PEOPLE BECOMING UNINSURED. CANCELLING AND DELAYING APPOINTMENTS, MORE TELLING US THEY ARE AFRAID TO RETURN TO CARE BECAUSE THEY DON'T KNOW HOW TO PAY FOR IT. THEY COME TO US, WHEN THERE'S GOVERNMENT BREAKS, THEY TURN TO THE PEOPLE LISTENING, WHICH IS STILL US. COMMUNITY ORGS AND PARTNERS, THE CONSEQUENCE OF H.R. 1 FALLS HARDERS ON FAMILIES WE ARE WORKING WITH, FAMILIES THAT ARE FIGHTING FOR THEIR LIVES. THEY CANNOT WITH STAND ANOTHER BARRIER. THANK YOU.

>> GOOD AFTERNOON,I AM WITH LATINOS CANCER. AND I'M THE HEALTH EDUCATOR. WHEN WHEN A WOMAN SURVIVES CANS OR OR EARLY ILLNESSES COMMUNITY MEMBERS THAT WANT TO RETURN TO EDUCATE PEOPLE. THEY WANT TO THEY KNOW WHAT THE CACHE LOOK LIKE, THEY KNOW THE FEAR EXPERIENCES REMIND US WHY THIS IS IMPORTANT AND URGENT. COUNTY NEED LOVE AND SUPPORT FROM THE STATE TO PROTECT OUR HEALTH AND HOSPITAL SYSTEMS, IT'S ESSENTIAL FOR THOSE OST IMPACTED BY ILLNESS, INEQUITY AND ECONOMIC HARDSHIP. WE ARE HERE TO MAKE AN ASK THAT THE STATE DELEGATION BECOME CRITICAL PARTNERS, THIS IS ABOUT THE WELLBEING, I HOPE YOU CONSIDER WHAT WE HAVE TO SAY HERE TODAY. THANK YOU.

>> IF I CAN GET ANDRE OLIVEIRA, GONZALEZ, SHAUN ALLAN, NATASHA WALKER AND CHRIS DEMERS, PLEASE.

>> I'M GREG WILLER, WITH THE SANTA CLARA COUNTY SINGLE PARENT HEALTH PAYER COLLISION, A RETIRED NURSE. I WANT TO FIRST OF ALL SUPPORT THE IDEA OF RAISING MONEY THROUGH TAXING CORPORATIONS FOR THEIR BAD TREATMENT OF WORKERS, AND MAKING PEOPLE GO ON TO MEDI-CAL. ALSO I WANT TO - EVERYONE TO LOOK AT THE LONGER TERM SITUATION, WE NEED TO GET - A SINGLE PARENT SYSTEM. WE NEED A SYSTEM WHERE THE GUARANTEES HEALTH CARE FOR ALL RESIDENTS. COMPREHENSIVE HEALTH CARE - THE CARE THAT WE ARE TALKING ABOUT, TRYING TO SAVE - IT'S - WE NEED A SINGLE PAYER SYSTEM, AND WE HAVE A BILL IN THE LEGISLATURE CALL CAL CARE, AB 1900, AND I REALLY ENCOURAGE THE LEGISLATORS, AND THE COUNTY FOLKS TO SUPPORT THIS BILL BECAUSE THIS WOULD REALLY SOLVE OUR PROBLEM. [ SPEAKING ALTERNATE LANGUAGE ] [ PAUSE ] TRYING TO SAVE - IT'S - WE NEED . [ PAUSE ] . [ PAUSE ] . . [ PAUSE ] [ PAUSE ] .

>> GOOD AFTERNOON, I BELONG TO LATINO COUNTRY CANCER, I HAVE BEEN WORKING WITH FAMILIES AND PATIENT IN THE SANTA CLARA COUNTY, WE HAVE EXHAUSTED EACH AND EVERY LOCAL RESOURCE, IT'S TIME FOR CALIFORNIA TO INVEST IN ORDER TO AVOID A COLLAPSE FOR FOOD AND HEALTH. THERE HAS BEEN A LOT OF ISSUES - PEOPLE ARE LOSING THEIR INSURANCES OR THE SOCIAL SECURITY, AND THIS MEANS THAT WE'LL BE IN A HUMAN CRISIS IN THE LONG TEMP. TERM. PLEASE HECH US TO PROTECT OUR HOSPITALS. FIRST, I WANT TO START BY THANKING LEGISLATORS FOR BEING HERE NOT ONLY TO HEAR CONCERNS, BUTTS SUPPORTS. I'M ANDRE AL-OLIVEIRA, A JANITOR AT THE O'CONNELL HOSPITAL AND CHAIR OF COPE AND CHAPTER VICE-PRESIDENT OF S C.O. U. I'M DEEPLY CONCERNED WITH THE ACCESS OF HEALTH CARE IN OUR COUNTY AT THIS MOMENT. MOMENT. I SAID IT BEFORE AND A GAIN, THIS WILL BE REMEMBERED AS A DARK MOMENT IN THE FUTURE HEALTH CARE OF THE COMMUNITY, A LOT OF US IN THIS ROOM HAVE DONE OUR PART TO HAVE MEASURE A PASSED. AT THE MOMENT THE COUNTY HAS TO DO MARSH ADDITIONS TO KEEP IT SUSTAINABLE. I URGE THE STATE TO DO THE RIGHT THING AND DO THEIR PART AND PROVIDE AS MUCH RESOURCES FOR US TO TAKE CARE OF OUR COMMUNITY, THANK YOU ALL.

>> GOOD EVENING, I AM THE ORGANIZING DIRECTOR WITH SICK READ HEART CHAUPTY SERVICE, I AM HERE IN SUPPORT OF THE BUDGET REQUEST TO THE STATE BECAUSE OUR PUBLIC HOSPITALS AND MEDICAL HEALTH CARE IS A SAFETY NET FOR EVERYONE, I CARE PEEP DEEPLY ABOUT THE ISSUE, I SEE THE STRESS TRYING TO ACCESS HEALTHCARE, ESPECIALLY THE YOUTH TURNING 18. I HAVE AN 18-YEAR-OLD DAUGHTER, WORKING PART TIME. AND SHE IS WORRIED WHETHER SHE'LL BE ABLE TO AFFORD HER MEDICAL CARE OR NOT.

MY SECOND TAUGHT SER ABOUT TO TURN 18. HER FATHER WILL REMOVE HER FROM INSURANCE, IT'S EXPENSIVE. SHE HAD A MAJOR MENTAL HEALTH BREAKDOWN DURING THIS TIME. THE DRESS CAUSED THIS BREAKDOWN, I IMAGINE WHAT OTHERS ARE GOING THROUGH NAUF GAITING A SYSTEM OUT OF REACH. HEALED CARE SHOULD NOT BE - IT SHOULD BE A RIGHT.

>> IF WE CAN C THE NEXT SPEAKERS.

>> I'M SHAUN ALLAN, I SERVE WITH THE PRESIDENT OF THE SILL KWON VALLEY A.C.P. I'M HERE BECAUSE THE PENDING FEDERAL BUDGET CUTS ARE NOT JUST NUMBERS ON A SPREADSHEET. THEY ARE A DIRECT THREAT TO THE HOLD OF OUR COMMUNITIES MUCH HOSPITALS ARELE PRIMARY SAFETY NOTE FROM THOSE I REPRESENT. DEEP PAINFUL CUTS TO KEEP THE DOORS OPEN. WE ARE CALLING ON THE SIT LEADERS TO BRIDGE THE GAP. IT'S ABOUT ACCESSIBLE RIGHTS TO HEALTH CARE. WE ARE HERE TO SUPPORT THE BUDGET ABBING. AND APPRECIATE YOU BRINGING UP IRAN (SPEAKS ALTERNATE LANGUAGE).

>> [ SPEAKING ALTERNATE LANGUAGE ] : . [ PAUSE ] [ PAUSE ] .

>> JEREMY BARR USE, MARY, ROBERTO GONZALEZ, JOSEPH COOPER, AND FLORA HERNANDEZ, PLEASE.

>> GOOD AFTERNOON, I'M A C.H.P. HEALTH PROMOTER. AND I'M HERE ASKING YOU TO KEEP MEDICAL FOR ALL, ESPECIALLY IN OUR COMMUNITIES, WITH NOT SATISFYING STATUS, BECAUSE OUR COMMUNITIES SUFFERING ILLNESSES LIKE DIABETES, AND THEY WOULD SUFFER IF PRESUMERY CARE IS NOT AVAILABLE ANY MORE. MANY OF THEM WILL HAVE A LOT OF DIFFICULTIES HAVING ACCESS TO HELP. PROTECTION. LAB TESTS ARE CRITICAL FOR SAVE LIVES. WE WANT YOU TO TR THIS POPULATION. WE THOSE YOU TO BE THE OICE OF THE UN HEAR. WE WANT YOU TO PROBING OUR PEOPLE. THANK YOU.

>> GOOD AFTERNOON HONORARY BOARD OF SUPERVISORS, AND INVITED GUEST. I'M DR JOSEPH DAVID COOPER, I'M AN INE FIXOUS DISEASES DOCTOR AT SANTA CLARA HEALTH CARE, I CHOSE TO WORK AT THE COUNTY AFTER FELLOWSHIP TRAINING, I WAS DROWN TO THE MISSION OF WHAT THE ORGANIZATION REPRESENTS. SIMPLY PUT PROVIDING HIGH QUALITY COMPASSIONATE AND ACCESSIBLE HEALTH CARE FOR ALL PERSONS IN SANTA CLARA, RECORD REGARDLESS OF SOCIOECONOMIC STATUS AND ABILITY TO PAY. I LOVE TO SEE PATIENTS AND TAKE CARE OF THE COMMUNITY, THAT'S WHAT I DO. I DON'T NEED TO BE THE FIRST TO TELL YOU WITH DO GREAT THINGS IN THE COUNTY AND HOSPITALS AND COMMUNITY, WITHOUT ACTION MANY OF THE CENTRAL SERVICES ARE AT RISK AND MAY BE ELIMINATED. I IMPLORE YOU PLEASE DO NOT LET THIS HAPPEN AND ALLOW MYSELF AND COLLEAGUES TO FOCUS ON WHAT WE LOVE TO DO AND DO BEST - TAKING CARE OF PATIENTS.

>> NON- JEREMY BRUCE, WITH THE CENTER FOR JUSTICE AND IMPAIRMENT. OVER THE YEARS COUNTY LEADERS WILL PUT VALUES TO ACTION MAKING STRATEGIC INVESTMENTS ENSURING VULNERABLE RESIDENTS HAVE BEEN HAVE ACCESS TO QUALITY HEALTH CARE, THESE ARE EXTRAORDINARY TIMES. WE HAVE SEEN IMMIGRANTS FAMILIES AND DIRE SITUATIONS, WE ARE NOT SEEING ICE ON THE STRETP FIDED WERE AN AS A RESULT OF IMMENSE STRESS FROM THE FEAR OF BEING SEPARATED AND UNCERTAINTY OF NOT PAYING THE RELATE.

>> ABRAHAM. DYE ARTICLO, GABRIEL HERNANDEZ AND EVA APPROACH THE PODIUM.

>> I'M MARY, I'M A RESIDENTS MUCH DISTRICT 4. SPEAKING AS A NONPROFIT MANAGEMENT EXECUTIVE, A COMMUNITY HEALTH EDUCATOR ENGAGING IN YOUTH WELLBEING AND EMPOWERING NATIVE HAWAII WOMEN AND A MEMBER OF A FAMILY UTILIZING THE COUNTY HOSPITAL MANY TIMES. I WANT TO UNDERSCORE THE CHIEF WHEN GOVERNMENT ENTITIES, STATEMENT, DOCUMENTSY CITIES, COLLAB WRIT WITH OPERATIONS FINANCIAL AND POLICY ACTIONS CONFRONT, H.R. 1. WE HAVE PROVEN OUR LEADERSHIP WHEN RESPONDING TO THE COVID PANDEMIC, AND IT IS POSSIBLE TO ADDRESS HA IN ADDRESSING EFFECTS TO MEDI-CAL FOR THE UNINSURED CUTS. FOR A COUNTY TO FILL THE CUTS TAKES AWAY RESOURCES UNDERMINING INITIAL ADDITION. MANY LED BY NONPROFIT OR NICITIONS. YOUTH DEVELOPMENT. STRENGTHENING EFFECTIVE...

>> I'M ROBERTO A COMMUNITY ORGANIZER, AND SPEAKING IN STRONG SUPPORT OF THE COUPE'S REQUEST TO THE STATE. THE COUNTY'S HOSPITAL ARE THE SAFETY NET FOR EVERYONE, THE B IS NOT ONLY A REFLECTION OF PRIORITIES, BUT VALUES, COUNTY AND RESIDENTS SHOW WHERE THE VALUES STAND AND ASK THAT THE STATE FOLLOW SUIT. THANK YOU.

>> GOOD AFTERNOON, I'M IBRAHIM HERE FROM A COLLECTIVE, A MEMBER. MY TRIBE THE FILANI PEOPLE FROM WEST AFRICA SAY (SPEAKS FOREIGN MEASURE) THAT HEALTH IS FIRST BORN OF WEALTH. IF YOU CONSIDER WEALTH OF FAMILY THE FIRST BORN, WE HAVE TO PROTECT THAT, IT'S THE NO.1 PRIORITY, IT'S NOT A FAVOR. IT'S A RIGHT. WHAT I MEAN ALSO IS IF THE FEDERAL LEVEL THEY ARE UNPREDICTABLE. SUGGESTING THEY HAVE OTHER PLAN, A, B AND C. IF YOU GO TO SACRAMENTO, DON'T LET THEM CONVINCE YOU THAT IT IS IMPOSSIBLE. (SPEAKS FRENCH), IMPOSSIBLE DOES NOT EXIST.

>> YOUR TIME IS UP THANK YOU.

>> YOUR TIME IS UP.

>> I READ ALL THE NAME IN CHAMBERS, THERE'S SIX SPEAKERS REQUESTING TO SPEAK BEFORE THE CUE WAS CLOSED IN JOOM.

>> GABRIEL, I REFUSE ORGANIZING FEAR, I THINK WHAT I WANT TO DO IS ASK THE STATE TO ACT YOUR SIZE. THIS IS A STRUCTURAL ISSUE, WHAT YOU SHOULD DO IS GO BACK, HAVE THEM TAX ME FOR MY STATE AND FEDERAL TAXES, YOU HOLD THE FEDERAL TAXES IN AWAYANS, IF THE FEDERAL GOVERNMENT WANTS MY MONEY, FIGURE OUT HOW TO SPEND IT. WHATEVER IS LEFT GIVE IT TO THE FEDERAL GOVERNMENT. ALL WHILE WE FIGHT BEEN THE CONFINES OF LAW. THIS GOVERNMENT IS NOT AFRAID TO BREAK THE LAW. HAVE THEM SUE THE STATE. USE OUR MONEY, PAY FOR WHAT WE NEED TO I SAW IT IN THE 1980s, THEY WIPED AWAY AND BLURRED NATION STATE RIGHTS. ACT YOUR SIZE. ACT YOUR SIZE: WE HAVE SIX SPEAKERS ON ZOOM. FIRST UP. PARENT. ONE MINUTE TO SPEAK.

>> YES, GOOD EVENING TO YOU ALL. ONE OF THE MACES THAT WE HAVE NOT -- PLACES THAT WE HAVE NOT REFUSED CUTS FROM THE FEDERAL GOVERNMENT IS TITLE 4 B, CHILLED PROTECTION SERVICES, I CAN'T GET THAT SERVICE FOR MY CHILDREN. THEY ARE MOLL ELFED. MY WIFE CONFIRMED THAT SHE LET A MAN RAPE HIM SINCE THE AGE. 13. THERE WAS BEEN UNNECESSARY BATHING. TWO CHILDREN HAVING SEXUAL KONT. IT LET TO CHANGES IN THE KIDS. I CAN'T GET A SCREENING FOR MY KIDS. THERE'S NEVER BEEN A SCREENING OR INVESTIGATION. I COMPLAINED TO THE BOARD OF SUPERVISORS, TO WENDY, AND NO ONE WILL HELP ME. CAN SOMEONE HELP ME GET A SCREENING, USE THE TITLE 4 B FUND TO GET A SCREENING FOR MY CHILDREN. SUPERVISORS OTTO LEE HAS MY INFORMATION.

>> NEXT SPEAKER IS JONATHAN LEADMAN.

>> GO RIGHT AHEAD. YOUR MICROPHONE IS OPEN. LOOKS LIKE WE HAVE A PROBLEM WITH JONATHAN. WE'LL BO TO ELIZABETH MOLINA. HI, GN, I'M ELIZABETH MELINA, I'M A COMMUNITY ORGANIZER. SPEAKING IN STRONG SUPPORT OF THE COUNTY REQUEST TO THE STATE. I WANT TO THANK THE STATE ELECTED OFFICIALS AND THE COMMENTS FOR THE INVESTMENT INTO REPRODUCTIVE HEALTH. I HOPING TO SEE THE SAME INVESTMENT IN COMMITMENT INTO OUR OWN COUNTY HERE. COMMUNITY PARTNERS HAVE BEEN STRETCHED BEYOND THEIR LIMB. WE MADE CUTS TO THE SYSTEMS, WE HAVE ALSO BEEN INNOVATIVE. TIME IS NOW FOR THE STATE TO STEP IN AND FULFIL ITS ROLE IN PROTECTING THE HEALTH OF THE COMMUNITY, WE ARE SEEING A DOMINO EFFECT TAKE PLACE, WHERE THE PUBLIC SYSTEM WILL OVERFLOOD. WHICH IS THE SAFETY NET FOR THOUSANDS OF RESIDENTS LIVING PAY CHECK TO PAY CHECK, UNINSURED OR IN DOCUMENTED COUNTRY. ACT AS A PARTNER, FULLY FUND THE WHY BY THE COUNTY...

>> NEXT SPEAKER IS JONATHAN LEHMAN, WE'LL GIVE IT ANOTHER SHOT.

>> YES, CAN YOU HEAR ME. THANK YOU, I'M JONATHAN LEADMAN, A POLITICAL ORGANIZER FOR S.C.G. HW. I WANT TO THANK ALL THE SOL PROPOSED. WE REPRESENT 120 HEALTHCARE WORKERS, AND THE LAST THING WE WANT IT TO SEE ANY OF THEM LAID OR OR LOSE THEIR CARE, THERE'S A BUDGET SOLUTION NOT COACH. . A TAX ON BILLIONAIRES, THERE'S A 5% TAX ON BILLIONAIRES, SIGNATURE ARE COLLECTED I URGE THE COMMUNITY TO SIGN THAT PETITION, BECOME A GATHERER. GO TO BILLIONAIRE TAX TO LEARN MORE. THIS WOULD RAISE ABOUT $100 BILLION. ENOUGH TO UNDO THE EFFECTS OF H.R. 1. TWO DIFFERENT ACCOUNT. 90% TO MEDICAL FUNDING, THE OTHER 10% THROUGH K THROUGH 14 AND S.N.A.P. BENEFIT. THIS IS THE SOLUTION, BILLIONAIRES HAVE TAKEN MORE THAN ENOUGH, IT'S TIME FOR THEM TO PAY THEIR FAIR SHARE.

>> NEXT SPEAKER IS MELISSA LOOP. YOU HAVE A MINUTE TO SPEAK.

>> GOOD AFTERNOON, I'M MELISSA LUKE. CHIEF PROGRAM OFFICER, HEALING AND JUSTICE AT WYB GOLDEN GAIT SILICON VALLEY AND REPRESENTING THE DOMESTIC VIOLENCE CONSORTIUM. THANK YOU TO THE BOARD OF SUPERVISOR, COUNTY STAFF AND DELEGATION FOUR OUR SUPPORT OF LIFE SAVING SERVICES FOR SURVIVORS OF GENDER BASED VIOLENCE. WE ARE APPRECIATE YOUR LEADERSHIP FOR THE DEVASTATING CUTS TO THE VICTIMS. VIOLENCE IS A PUBLIC HEALTH ISSUE AND SOCIAL DETERMINANCE AND VOKA DOLLARS ARE CRITICAL. EVERY YEAR NONPROFIT USES FUNDS FOR OVER 2,500 ADULTS AND SURVIVORS OF SEXUAL ABUSE AND PROVIDE OVER 1,800 IN PERSON SPOHNS, IN A WORLD WHERE WE ARE REMINDED THAT SEXUAL ABUSE IS COMMON AND HIDDEN, WE THANK YOU FOR SHOWING UP INDIVIDUALS AND FAMILIES.

>> THE NEXT SPEAKER. YOU HAVE A MOMENT TO SPEAK.

>> YES, I'M CALLING FROM SAN JOSE CALIFORNIA. DISTRICT 5. I'M CALLING TO URGE THE STATE O LEAVE MEDICARE OEN, AS A MOTHER AND A WORKER I'M WORKING IN CHILD CARE. WE RELY ON MEDICARE TO GET THE INSURANCE COVERED FOR ME AND MY FAMILY AND MY HUSBAND IS RETIRED: CUTTING FUNDS ON MEDICARE MEANS WE ARE VULNERABLE AS A FAMILY. THERE ARE SO MANY IN THE PRIVATE SECTOR THAT DOES NOT GET INSURANCE. MEDICARE IS THE ONLY POSITION. CUTTING MEDICARE IS CUTTING FUNDS TO A LOT OF PEOPLE IN OUR COMMUNITY, THANK YOU.

>> THE FINAL SPEAKER IS SHARON DANAULTA.

>> HI, I'M SHARON, THE DIRECTOR OF SOUTH BY COALITION TO END HUMAN TRAFFICKING, IN A FEW MONTHS WE'LL SEE THOUSANDS OF VISITORS TO THE COUNTY AND REGION HEADING FOR THE WORLD CUP, WE SEE MINIMAL INVESTMENTS FROM BUSINESSES AND ORGANISATIONS. AS SCMUPY AND BUSINESSES LOOK TO BENEFIT. WE NEED TO ENSURE SAFETY FOR RESIDENTS AND VISITORS, WE HAVE TO PRIVATIZE COMMUNITY SAFETY RESOURCES ESPECIALLY FOR DOMESTIC CRIME. THE PAST SUPER BOWL AFAMPED THE NEED FOR RESPONSE AND ACROSS THE REGION. WITH LAW ENFORCEMENT SHOWING 70 SURVIVORS OF TRAFFICKING, 10 WHO ARE CHILDREN OF SEXUAL EXPLOITATION SURVIVORS, AND WE NEED CONFIDENTIAL ADVOCATES IN THEY SAY SITUATIONS, THANK YOU FOR PRIORITIZE EGG SAFETY AND HEALTH.

>> THAT CONCLUDES THE PUBLIC COMMENT PERIOD FROM THE TIME UNTIL IT WAS CLOSED.

>> THANK YOU EVERYONE FOR BEING HERE WITH US TODAY. I WANT TO GIVE A SPECIAL APPRECIATION TO PATRICK AHRENS, SENATOR DAVE CORTESE, YOU BOTH TOLD ME YOU WERE ONLY AVAILABLE UNTIL H IT'S 5:35. -- 4 O'CLOCK, IT'S 5:35. TO THE STAFF IN THE BACK ROOM. YOU SAID YOU WERE AVAILABLE UNTIL 4:30, THANK YOU FOR STAYING. IMPORTANTLY TO THE COMMUNITY MEMBERS. TIME HERE IS TIME AWAY FROM YOUR WORK. THANK YOU FOR ADVOCATING, THERE'S A LOT FOR US TO THINK ABOUT, A LOT OF SUGGESTIONS FOR US TO MULL OVER. KNOW THAT WE DON'T HOLD THE SPECIAL HEARINGS WITHOUT BEING READY TO DO THE WORK TO FOLLOW UP. THANK YOU SO MUCH. WITH THAT I ADJOURN THE MEETING TO THE NEXT MEETING ON THURSDAY, APRIL 17TH, 2026, IN THESE SAME BOARD CHAMBERS, THANK YOU. [ MEETING ADJOURNED ]

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County of Santa Clara Finance and Government Operations Committee March 20, 2026 2:30 p.m.

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