County of Santa Clara Board of Supervisors April 28, 2026 9:30 a.m.

TEST. ORDER. MAY ITCH OUR CLERK TO PLEASE -- MAY I HAVE OUR CLERK TO PLEASE CALL THE ROLL. (ROLL CALL).

>> WE HAVE A QUORUM.

>> WOULD YOU MIND READING THE INTERPRETATION ANNOUNCEMENT?

>> TRANSLATE THE FOLLOWING INTO SPANISH AND VIETNAMESE, IF YOU ARE IN CHAMBERS, INTERPRETATION DEVICES ARE AVAILABLE AT THE BACK OF CHAMBERS. THE CLERK CAN ASSIST YOU WITH SETUP, TRANSLATION IS ALSO AVAILABLE IN ZOOM USING THE INTERPRETATION BUTTON. ADDITIONALLY, AS A REMINDER FOR PUBLIC COMMENTERS, STAFF AND THOSE OF US ON THE DESK, SPEAK CLEARLY AND DIRECTLY INTO THE MICROPHONE TO IMPROVE THE ACCURACY OF TRANSLATION.

>> THANK YOU. NOW WE'LL GO TO THE PLEDGE OF ALLEGIANCE. CAN I ASK SUPERVISOR. [PLEDGE]

>> THANK YOU. NEXT WE WILL HAVE OUR INVOCATION. THIS MORNING I'M GOING TO PASS THIS TO SUPERVISOR TO INTRODUCE OUR INVOCATER.

>> THIS MORNING I HAVE THE STEVE PINKSTON. LCOMEING EVEREND- HE RECEIVED HIS BACHELOR'S DEGREE FROM POMONA COLLEGE. HE HAS A MASTERS IN THEOLOGY. HE BEGAN HIS TEACHING CAREER AT A COLLEGE IN 1980. HE'S THE FIRST AFRICAN-AMERICAN TEACHER THERE, HE WAS ORDAINED IN 1984 AND HAS BEEN A VOLUNTEER MINISTER AT THE JUVENILE HALL AS WELL AS AT SAN QUENTIN FOR MORE THAN 30 YEARS. HE SUPPORTS THE PINKSTON FELLOWSHIP WHICH BRINGS STUDENTS TO SERVE AS TEACHERS, COACHES, COUNSELORS, MENTORS AND IN THE FAITH-BASED MINISTRY. THANK YOU FOR YOUR SERVICE TO OUR COMMUNITY.

>> THANK YOU SUPERVISOR DUONG. GOOD MORNING. LET US PRAY. LOVING GOD, HEBREW SCRIPTURE SHARES THAT A GENEROUS PERSON WILL PROSPER. THOSE WHO REFRESH OTHERS WILL BE REFRESHED IN RETURN. DR. MARTIN LUTHER KING EMPHASIZED THE IMPORTANCE OF LOVING AND SUPPORTING ONE'S NEIGHBOR WITH AGAPE OR UNCONDITIONAL LOVE. HE SAID A GOOD NEIGHBOR LOOKS BEYOND THE EXTERNAL ACCIDENTS AND DISCERNS THOSE INNER QUALITIES THAT MAKE ALL MEN AND WOMEN HUMAN. AND, THEREFORE, BROTHERS AND SISTERS. TRUE NEIGHBORLINESS INVOLVES EMPATHY AND ALTRUISM, TRANSCENDING ABILITIES, RACE, RELIGION, SEXUAL ORIENTATION AND NATIONALITY. KINGEL SAID THAT THE ULTIMATE MEASURE OF A PERSON IS NOT WHERE HE OR HE STANDS IN MOMENTS OF COMFORT OR CONVENIENCE, BUT AT THE TIMES OF CHALLENGE AND CONTROVERSY. A TRUE NEIGHBOR WILL RISK HIS OR HER POSITION, PRESTIGE AND EVEN HIS OR HER LIFE FOR THE WELFARE OF OTHERS. GOD, CHALLENGE US TO EMBRACE RIGHTEOUS ANGER, RIGHTEOUS ANGER WHICH INSPIRES US TO CONFRONT INJUSTICE, CHANGE WHAT IS CORRUPTED AND RESTORE WHAT IS SACRED. WE PRAY ALL OF THIS IN THE NAME OF THE CREATOR, THE SUSTAINER, THE REDEEMER. AMEN. THANK YOU.

>> THANK YOU VERY MUCH, REVEREND. THIS TAKES US TO "D" LET'S SEE. ITEM 4. TODAY WE ARE PRESENTING A PROCLAMATION DECLARING APRIL 26 AS THE BLACK MEMORIAL MONTH IN SANTA CLARA COUNTY. I WOULD ASK SUPERVISOR DUONG TO JOIN US UP THERE.

>> THANK YOU, PRESIDENT LEE, THANK YOU COLLEAGUES. GOOD MORNING, COLLEAGUES AND FRIENDS, COMMUNITY. AT THE BEGINNING OF APRIL WE PROCLAIMED APRIL 2026 AS FLAG APRIL MEMORIAL MONTH IN SANTA CLARA COUNTY IN HONOR AND COMMEMORATION OF THE FALL OF SAIGON AND MASS EXODUS OF REFUGEES. IN 2025 WE ESTABLISHED THE HALF STAFF CEREMONY OF THE HERITAGE FLAG ON APRIL 1 AS A NEW COUNTY TRADITION. THE FLAG IS FLOWN AT HALF STAFF THROUGHOUT THE WHOLE MONTH OF APRIL HERE AT THE GOVERNMENT CENTER. THIS ACT IS MORE THAN SYMBOLIC, IT'S A COMMITMENT, A COMMITMENT WE MADE IN THE LATE '70s, OVER 50 YEARS AGO, A COMMITMENT WE CARRY TO REMEMBER OUR SHARED HISTORY, EDUCATING FUTURE GENERATIONS AND ENDURING FREEDOM, DEMOCRACY, HUMAN RIGHTS AND TRUE WELCOMING AND BELONGING THAT OUR COMMUNITY CONTINUES TO UPHOLD. THIS MARKS THE 51th ANNIVERSARY OF BLACK APRIL, THE FALL OF SAIGON. THIS IS MORE THAN A COULD MEMORY OF HISTORY, IT'S DEEPLY EMOTIONAL. I WANT TO WELCOME YOU TO JOIN ME. SHE'S THE DIRECTOR OF THE AMERICAN VIETNAMESE SERVICE CENTER. THANK YOU FOR STANDING WITH ME AND THANK YOU FOR SERVING OUR COMMUNITY IN EVERY WAY POSSIBLE AND SHARING THIS HERITAGE. FOR SO MANY OF US IT'S A REFLECT OF THE STORIES CARRY IN OUR FAMILIES, STORIES OF LOSS, ESCAPE AND STARTING OVER WITH NOTHING BUT HOPE IN A NEW LAND. I'M THE DAUGHTER OF REFUGEES. SO ARE YOU. I GET TO SERVE AS THE FIRST VIETNAMESE AMERICAN ELECTED TO THE BOARD OF SUPERVISORS. I ONLY STAND HERE BECAUSE OF THE SACRIFICES, COURAGE ND DETERMINATION OF THOSE WHO CAME BEFORE ME. MORE THAN 50 YEARS HAVE PASSED SINCE APRIL 1975, AND WE ARE FACED WITH THE REALITY THAT WE ARE LOSING MORE OF OUR ELDERS, THOSE WHO REMEMBER SAIGON, THOSE WHO HAVE SO MUCH TO SHARE AND LESSONS TO BESTOW UPON US. THAT LIVES ON IN US. THANK YOU FOR YOUR SACRIFICE. THANK YOU FOR YOUR LOVE AND BELIEF IN OUR SHARED FUTURE. THIS RECOGNIZES THE STRENGTH OF THOSE WHO FLED THEIR HOMELAND AND ACKNOWLEDGES THE PROFOUND CONTRIBUTIONS THAT THE COMMUNITY HAS MADE OVER THE LAST FIVE DECADES TO SANTA CLARA COUNTY AND UNITED STATES. WITH THAT, I WOULD LIKE TO PRESENT THE PROCLAMATION BY PRESIDENT LEE TO ACCEPT ON BEHALF OF THE COMMUNITY.

>> THANK YOU. GOOD MORNING, EVERYONE. THANK YOU FOR BEING HERE AS WE GATHER TO COMMEMORATE THE BLACK APRIL. IN TWO DAYS WE'LL MARK THE 51st ANNIVERSARY, A DAY THAT CHANGED THE COURSE OF VIETNAMESE HISTORY. FOLLOWING THE FALL OF SAIGON, MANY WERE FORCED TO FLEE THEIR HOMELAND. THEIR JOURNEYS WERE MARKED BY HARDSHIP AND SACRIFICE. MANY RISKED EVERYTHING AT SEA FACING VIOLENCE, LOSS AND UNCERTAINTY AND PURSUIT OF A BETTER FUTURE FOR THEMSELVES AND THE FAMILIES. RIGHT HERE WE ARE HOME TO MORE THAN 140,000 VIETNAMESE AMERICANS. OVER THE PAST FIVE DECADES. THIS COMMUNITY HAS MADE EXTRAORDINARY CONTRIBUTIONS TO OUR COUNTY, STRENGTHENING OUR CULTURAL FABRIC AND ADVANCING OUR ECONOMY, SERVING IN THE MILITARY, ENRICHED ARTS AND EDUCATION. HALF CENTURY THE VIETNAMESE AMERICAN COMMUNITY HAS CONTINUED TO HONOR THIS HISTORY AND ADVOCATE FOR DEMOCRACY. YOUR RESILIENCE, YOUR VOICE AND YOUR COMMITMENT HAVE KEPT THIS IMPORTANT LEGACY ALIVE FOR MANY FUTURE GENERATIONS. TODAY WE STAND WITH YOU. WE TAND IN REMEMBRANCE, IN SOLIDARITY ND IN HOPE. TOGETHER WE CONTINUE TO CARRY FORWARD THE TORCH OF FREEDOM, DEMOCRACY AND HUMAN RIGHTS. THANK YOU.

>> GOOD MORNING. I HAVE THE HONOR AS SERVEING AT OUR SERVICE CENTER AND BEING HERE TODAY FOR OUR PROCLAMATION. AS THEY MENTIONED, BLACK APRIL, THE EVENTS OF APRIL 30, 1975, WAS A PIVOTAL MOMENT IN VIETNAMESE AMERICAN HISTORY. FOR MY FAMILY, MY PARENTS, AFTER 1975 LEFT VIETNAM AND FLED BY BOAT. THEY WERE ONE OF THE FORTUNATE ONES TO MADE IT TO A REFUGEE CAMP IN THE PHILIPPINES BEFORE RESETTLING HERE IN THE U.S. IT'S BECAUSE OF THEIR SACRIFICES OF GENERATIONS THAT CAME BEFORE YOUS -- US THAT MANY OF US ARE HERE TODAY. THE VIETNAMESE AMERICAN SERVICE CENTER HELD OUR 51st ANNUAL COMMEMORATIVE EVENT FOR BLACK APRIL FOR OUR COMMUNITY TO COME TOGETHER TO REFLECT ON THIS PIVOTAL DAY. WE HOSTED A PANEL OF COUNTY STAFF WHICH INCLUDED JENA TREND, OUR COUNTY'S BEHAVIOR HEALTH MEDICAL DIRECTOR. THESE AMAZING STAFF REFLECTED ON THEIR FAMILIES' TORY AND HOW IT'S SHAPED THEIR PATH TO PUBLIC SERVICE AND THE PROGRESS WE HAVE MADE ACROSS GENERATIONS. THANK YOU AGAIN, SUPERVISORS, FOR THIS IMPORTANT DAY.

>> I WOULD LIKE TO INVITE OUR COLLEAGUES ON THE BOARD AND ADMINISTRATION TO JOIN US FOR A PHOTO.

>> THANK YOU. NEXT WE MOVE TO ITEM 6, PUBLIC COMMENTS. TO ADDRESS THE BOARD ON ANY ITEMS NOT ON THIS AGENDA AND ANY PUBLIC WHO WISHES TO SPEAK ON ITEMS ON THE AGENDA, PLEASE FILL OUT THE SPEAKER CARD. WE'LL CALL UP TO 30 NAMES. IN PERSON SPEAKERS WILL BE CALLED FIRST FOLLOWED BY ZOOM. NO FURTHER REQUESTS TO SPEAK WILL BE ACCEPTED. AS SOON AS THE FIRST SPEAKER STARTS SPEAKING, THERE WILL BE NO MORE SPEAKERS ACCEPTED. WE DO NOT ACCEPT BOOS OR APPLAUSE. YOU CAN SHAKE YOUR HANDS. CLERK, HOW MANY SPEAKERS DO WE HAVE THIS MORNING?

>> I HAVE NINE CARDS IN CHAMBERS AND I'M SHOWING SIX HANDS ON ZOOM FOR A TOTAL OF SEVEN HANDS ON ZOOM FOR A TOTAL OF 16.

>> 16. ONE MINUTE EACH, PLEASE.

>> OKAY. I WILL BEGIN CALLING NAMES OF SPEAKER CARDS IN CHAMBERS. I HAVE MARGARITA THAT -- HERRERA. ARI PATEL, INGRID BOCK. YOU CAN APPROACH THE PODIUM AND STATE YOUR NAME FOR THE RECORD, PLEASE.

>> HI. MY NAME IS MARGARITA HERRERA. I'M HERE WITH COLLEAGUES AND CLIENTS FROM BEHAVIOR HEALTH. GOOD MORNING TO YOU ALL. THANK YOU FOR ALLOWING US THIS TIME. I'M A HEALTH SERVICE REPRESENTATIVE. I WANT TO SPEAK ABOUT WHO WE SERVE AND WHY IT'S NOT EASILY REPLACEABLE. SIGNIFICANT PORTION OF OUR CLIENTS ARE SPANISH SPEAKING WHICH IS REFLECTED IN OUR NAME AND OUR HISTORY IN THIS COMMUNITY. IN FACT, THE COUNTY ITSELF DESIGNATES NARVIAS AS A CULTURALLY PROFICIENT SITE SERVING LATINO AND VIETNAMESE WITH SEVERE MENTAL ILLNESS. IT'S ONE OF THE FEW PLACES WHERE THEY CAN RECEIVE CARE N THEIR LANGUAGE WITH STAFF WHO UNDERSTAND THEIR CULTURE AND EXPERIENCE. ACCESS TO CARE IS NOT JUST ABOUT AVAILABILITY. THANK YOU FOR YOUR TIME.

>> ANY REMAINING COMMENT, GIVE THE NOTES TO OUR CLERK AND THEY WILL BE INCLUDED IN OUR RECORD. THANK YOU.

>> GOOD MORNING. THANK YOU. I'M ARTI PATEL. WE ARE A STAFFED MULTIDISCIPLINARY SPECIALTY MENTAL HEALTH CLINIC SERVING OVER 500 ACTIVE CLIENTS WHICH WAS PREVIOUSLY CLOSER TO 700. OUR CARE IS HIGH QUALITY AND RELATIONSHIP BASED. WE SEE THE DEMAND DIRECTLY. ABOUT 370 CLIENTS COME INTO OUR CLINIC IN PERSON EVERY MONTH. NOT INCLUDING TELEHEALTH AND PHONE SERVICES. WE PROVIDE STABILITY AND PROVIDE COORDINATED CARE. THE PROPOSAL ASSUMES THAT CONTRACTED PROVIDERS CAN ABSORB OUR CLIENTS. MANY HAVE LIMITED CAPACITY AND STAFFING SHORTAGES. REFERRING OUR CLIENTS OUT DOES NOT CREATE ACCESS, IT CREATES SHUFFLING CLIENTS. WE ASK TO PRESERVE A ULLY STAFFED CLINIC. THANK YOU.

>> GOOD MORNING. MY NAME IS SONYA. I'M A REHAB COUNSELOR AT NAVIAS. IT'S A CRITICAL ACCESS POINT EMBEDDED IN THE COMMUNITY. WE ARE LOCATED NEAR THE BRC SHELTER, SACRED HEART COMMUNITY SERVICES, ALMA CENTER AND BUS LINES. OUR CLIENTS HAVE ACCESS TO FOOD, HOUSING AND COMMUNITY SUPPORT. MANY RELY ON OUR LOCATION AND ACCESS TO CARE. WHEN LIENTS ARE REDIRECTED, ATTENDANCE DROPS, ENGAGEMENT DECREASES AND STABILITY IS LOST. THIS PROPOSED DISRUPTION IN CARE CAN LEAD TO IMMEDIATE CONSEQUENCES FOR CLIENTS THAT INCLUDE MISSED APPOINTMENTS, RELAPSE AND HOMELESSNESS. CLOSING IT DOES NOT JUST REMOVE A CLINIC IT REMOVES AN ACCESS POINT IN THE COMMUNITY IT SERVES. THANK YOU FOR YOUR TIME.

>> DO I PRESS ANYTHING? HI. MY LETTER IS TOO LONG. I'M JUST GOING TO SUMMARIZE. THIS LOSING THIS CLINIC WILL MAKE THINGS HARDER FOR A LOT OF PATIENTS. THAT'S WHY I WOULD LIKE TO REITERATE HAVING MORE CLINICS. WHEN SOMEONE IS STRUGGLING, IT'S QUITE IMAGINE IMAGINABLE. IT MAKES EVERYTHING A THOUSAND TIMES HARDER. SO IT'S JUST IMPORTANT TO HAVE AS MANY LOCATIONS AS POSSIBLE BECAUSE LIKE JUST TAKING THE BUS, IT'S NOT NORMAL EXPERIENCE FOR ME, IT'S VERY LOUD. AND I CAN WALK TO THE CLINIC RIGHT NOW. SO SORRY. IT'S MORE ARCTIC LAST. I HAD A GREAT LETTER, BUT NOT ENOUGH TIME.

>> GIVE THAT TO OUR CLERK AND WE'LL ADD IT TO OUR RECORD.

>> MY NAME IS [INDISCERNIBLE] [SPEAKING SPANISH]

>> GOOD AFTERNOON. I HAVE BEEN A PATIENT OF CLINIC NAVIAS SINCE 2025. BECAUSE I AM SUFFERING FROM SCHIZOPHRENIA. WHEN I ARRIVED AT THE CLINIC, I WAS AGITATED AND HEARD VOICES, THEY WANTED TO HARM ME. I USED TO CALL 9-1-1. I OVERCOME HESE VOICES WITH THE MEDICATION THEY GAVE ME AT THE CLINIC. NOW I'M NOT HEARING THESE VOICES, I'M SAFE, I FEEL CALM. THIS IS BECAUSE OF THE CLINIC. IF YOU CLOSE IT, IT WILL BE DEVASTATING, I WILL GO BACK TO FEELING FEAR ND MY LIFE THREATENED. IT WILL BE DIFFICULT TO START AGAIN BECAUSE I DON'T TRUST IN OTHER PEOPLE AND I DON'T TRUST -- I WOULDN'T BE TRUSTING IN OTHER PEOPLE. SO PLEASE KEEP THE CLINIC NAVIAS OPEN. THANK YOU.

>> I WILL CALL THE LAST TWO NAMES IN CHAMBERS. I HAVE CHAU VU. YOU CAN APPROACH THE PODIUM. THANK YOU.

>> I HAVE BEEN PATIENT [INDISCERNIBLE] MONEY, HOUSING, I WOULD BE HOMELESS. KEEP NAVIAS OPEN. THAT'S IT.

>> THANK YOU.

>> GOOD MORNING. I HAVE BEEN A CLIENT AT NAVIAS CLINIC FOR OVER TEN YEARS AND HAVE RECEIVED ONGOING MENTAL HEMMING SERVICE INCLUDING PSYCHIATRY THROUGH THE SUPPORT OF THIS CLINIC AND ITS TREATMENT TEAM, I HAVE MADE SIGNIFICANT IMPROVEMENT IN MY LIFE. THAT CARE HAS HELPED ME TREMENDOUSLY AND PROVIDE STABILITY I NEED. WITHOUT THIS SERVICE I WOULD DECOMPENSATE. THE CLOSURE WOULD NOT ONLY IMPACT CLIENTS BUT ALSO FAMILY AND LOVED ONE WHO DEPEND ON SEEING THEM SUPPORTED. IT WILL CREATE A DOMINO OF HARDSHIP FOR A OMMUNITY THAT ALREADY ENDURED SO MUCH. THANK YOU.

>> THANK YOU.

>> HI, MY NAME IS KIM. I'M A CLIENT AT NAVIAS. I HAVE BEEN GOING THERE FOR FIVE YEARS, AT LEAST. HOW HAS THIS CLINIC AFFECTED ME? IT HAS SAVED MY LIFE. IT'S KEPT ME FROM HAVING SEVERE RELAPSES THAT REQUIRE PSYCHIATRIC EMERGENCY CARE. AN OUNCE OF PREVENTION IS A POUND OF CURE. FROM A CLINICAL AND FINANCIAL STANDPOINT, IT'S THE MOST COST OWE EFFECTIVE ROUTE. IT MANAGES CONDITIONS BEFORE IT REACHES A BOILING POINT, NEEDING EXPENSIVE EMERGENCY ROOMS AND AMBULANCES WHICH WAS MY LIFE BEFORE THIS CLINIC. IT'S EASIER TO GET TO THIS CLINIC. FINDING PARKING AND GETTING THERE. DOWNTOWN IS THE OPPOSITE. IT'S DIFFICULT. EVEN FRIENDS AND FAMILY AVOID GOING THERE BECAUSE OF FEAR OF CRIME DOWNTOWN. THANK YOU SO MUCH.

>> MY NAME IS NEVU. I HAVE BEEN A PATIENT FOR TWO, THREE YEARS. WHEN I WAS FIRST ADMITTED, I WAS SUICIDAL, I MADE NUMEROUS PLANS TO END MY LIFE. FORTUNATELY, I WAS RECOMMENDED THIS CLINIC AND EVERYONE THERE WAS SUPPORTIVE, CARING AND MADE ME ANT TO OPEN UP TO THEM. AND ONE OF THE REASONS WHY I WANTED TO COMMIT SUICIDE IN THE FIRST PLACE IS BECAUSE I HAD TRUST ISSUES AND IT WAS LIKE, I DON'T KNOW, IT WAS AN ENORMOUS TASK FOR THEM TO OVER COME THAT ISSUE WITH ME. THEY HAVE BEEN COOPERATIVE AND I FEEL LIKE IF THIS CLINIC WERE TO CLOSE, IT WOULD BE VERY DESTRUCTIVE TO THE COMMUNITY. THEY PROVIDE A VERY IMPORTANT SERVICE. AND I FEEL LIKE IF IT WAS GONE, A LOT OF PEOPLE WOULD FALL THROUGH THE CRACKS. THANK YOU.

>> I HAVE BEEN GOING OUT TO COLLEGES SINCE 1978 BEGINNING WITH STANFORD, UNIVERSITY BEFORE I WENT OFF TO BIBLE SCHOOL. I GO EVERYWHERE. I GO UP TO UC BERKELEY, SAN JOSE STATE UNIVERSITY, SAN FRANCISCO, EVERYWHERE AROUND, WHEREVER COLLEGES ARE. AND I RECENTLY WAS INVITED BY TWO DIFFERENT PROFESSORS TO GIVE A LECTURE ON THE COVID-19 LIES WE HAVE BEEN TOLD BY YOU AND OTHERS. DR. STANLEY PLOTKIN WHO IS THE BIG DOG OF VACCINES, BILL GATES SAID HE WROTE THE BIBLE ON VACCINES AND MADE A UNITED COMMENT, I HOPE IT'S MORE ACCURATE THAN THE BIBLE. HE WAS DEPOSITIONED BY DELL BIGTREE'S LAWYER. HE WAS FORCED TO TALK ABOUT THE HEPATITIS B VACCINE.

>> WE'LL MOVE TO OUR SPEAKERS ON ZOOM. OUR FIRST SPEAKER, JULIA RAPOZA. PLEASE ACCEPT THE UNMUTE.

>> HELLO. GOOD MORNING, SUPERVISORS. I'M LIVING IN MY VEHICLE. I'M HERE ABOUT THREE URGENT ISSUES. FIRST, I MADE A PUBLIC RECORDS REQUEST FOR MY OWN RECORDS AND BILLING. AGENCIES THAT TOOK MY SOCIAL SECURITY NUMBER. I WAS TOLD THESE RECORDS ARE EXEMPTION. THAT NEEDS TO CHANGE. WE HAVE A RIGHT TO KNOW HOW OUR INFORMATION IS USED. A SUNNY VEIL POLICE OFFICER CREATED PROBLEMS. TO SET UP CAMP AT THE CITY SIGN. SUNNY VEIL CREATED THIS PROBLEM. THE COUNTY SHOULD HOLD THEM ACCOUNTABLE. THIRD, THE NEW CAMPING ORDINANCE HAS NO DISABILITY PROTECTIONS. PEOPLE WILL BE HARMED. I ASK THE OARD TO ACT ON ALL THREE. THANK YOU.

>> NEXT SPEAKER IS PARENT. PLEASE ACCEPT THE UNMUTE.

>> YES. GOOD MORNING TO YOU ALL. I'M -- I READ LOTS OF THINGS ABOUT BABY JACKSON AND ABOUT HOW HE DIED AND HOW HE WAS PLACED IN A HARMFUL SITUATION WITH THE -- BY DFCS. AND LOTS OF PEOPLE ARE CALLING ON THEIR TO THE ACCOUNTABILITY FOR WENDY AND DANIEL LITTLE. BUT NOTHING IS BEING DONE. ALL THESE OTHER CHILDREN, BABY PHOENIX AND ALI AND JORDAN HAVE ALSO DIED IN THE SAME MANNER. AND THESE PEOPLE STILL HAVE THEIR JOB. SUPERVISOR ARENAS SAID THEY EXPENDED THEIR CREDIBILITY BY WITHHOLDING THEIR REPORT. I DON'T KNOW WHY THEY ARE STILL BEING PAID BY THE COUNTY. MY OWN KIDS ARE BEING SEXUALLY MOLESTED. THEY REFUSE TO PROVIDE A SCREEN. PLEASE REMOVE THEM FROM THEIR POSITIONS.

>> THE NEXT SPEAKER IN THE CUE, RICHARD WEXLER. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING, PRESIDENT LEE, MEMBERS OF THE BOARD. I'M RICHARD WEXLER I'M DIRECTOR FOR CHILD PROTECTION REFORM. DETAILS ARE IN A POST TO MY ORGANIZATION CHILD WELFARE BLOG, WWW.MCCRBLOG.ORG. WITHOUT EVER INTENDING IT, THIS BOARD HAS MADE THE CRISIS WORSE. IN JUST TWO YEARS YOUR APPROACH NEARLY TRIPLED THE NUMBER OF CHILDREN TORN FROM EVERYONE THEY KNOW AND LOVE IN THE COURSE OF A YEAR AND CON SIGNED TO THE CHAOS OF FOSTER CARE. AT THE SAME TIME IT'S OVERLOADED WORKERS IT'S HARD TO FIND CHILDREN IN REAL DANGER. THAT MAY HAVE CONTRIBUTED TO THE RECENT TRAGEDY. THIS BOARD'S FAILED TAKE THE CHILD AND RUN MAY HAVE BEEN A FACTOR CONTRIBUTING TO THE DEATH OF JACKSON. I ASK YOU TO REFLECT ON THAT.

>> THE NEXT SPEAKER IN THE CUE IS BOBBY. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING, MY NAME IS BOBBY. MY FAMILY HAS BEEN A RESOURCE FAMILY SINCE 2020. I HAVE SEN CHILDREN SLIP THROUGH CRACKS THAT SHOULDN'T EXIST. I HAVE SEEN CASES COME CLOSE TO DISASTER. I HAVE SEEN SUCCESS. WE CAN'T HAVE A WORKER CATCHING A DETAIL ON IN THE KNICK OF TIME. WHEN CHILDREN DIE, IT'S A FAILURE ON DFCS AND A FAILURE ON THE BOARD FOR NOT CORRECTING THE SHIP. IT'S EASY TO POINT FINGERS. AFTER TWO, RESPONSIBILITY BEGINS TO SPREAD. WHEN THESE TRAGEDIES CONTINUE, THE ACCOUNTABILITY DOESN'T DIFFUSE, IT CONCENTRATES TO THE BOARD. THE BOARD'S FAILURE TO MAKE CHANGES IS THE CAUSE OF THIS. WHAT MATTERS IS WORKING TOGETHER ACTION AND. THE ACTION YOU HAVE TAKEN ISN'T WORKING. FOR TOO LONG THE RESPONSE HAS BEEN DEFLECTION OR BLAMING DFCS. THE REAL QUESTION GOES UNANSWERED.

>> NEXT SPEAKER IN THE CUE IS DANA. PLEASE ACCEPT THE UNMUTE.

>> HELLO, GOOD MORNING. CAN YOU HEAR ME? MY NAME IS DANA. I'M ONE OF THE SCHOOLING SERVICES SUPERVISORS. I'M SPEAKING TO SHARE THE CONCERN ABOUT A PROPOSED REDUCTION TO FUNDING IN OUR DISTRICT. IT'S ABOUT 50% OF UR CURRENT FUNDING. THIS WOULD IMPACT SERVICES ACROSS OUR 15 SCHOOL SITES. THIS LEVEL OF REDUCTION PROPOSED WOULD RESULT IN THE LOSS OF TWO OF OUR FOUR SLS POSITIONS. THESE CUTS DOES NOT EQUATE TO A DECREASE IN NEEDS. WE LIVE IN THE BEST COUNTY WITH THE RICHEST ULTURE, BRIGHTEST STUDENTS AND DEDICATED FAMILIES. SLS HAS BEEN ESSENTIAL IN SUPPORTING FAMILIES AND NAVIGATING RESOURCES, HOUSING, FINANCIAL BEHAVIOR HEALTH THAT IS ESSENTIAL FOR CHILDREN'S ACADEMIC SUCCESS. PLEASE RECONSIDER THE SCALE OF YOUR REDUCTION. THANK YOU FOR YOUR TIME.

>> THANK YOU. AND THE LAST SPEAKER WITH HEIR HAND AISED AT THE CALL OF THE CUE IS CARLOS DAVIDSON. PLEASE ACCEPT THE UNMUTE.

>> HONORABLE MEMBERS OF THE BOARD OF SUPERVISORS, THANK YOU FOR HEARING PUBLIC COMMENTS. I'M WITH FOSSIL-FREE CALIFORNIA. I'M SPEAKING IN SUPPORT OF FOSSIL FUEL. YOU HAVE ALREADY DONE THE HARD WORK, WE STILL BELIEVE IT'S VITAL TODAY THAT YOU PASS A DIVESTMENT POLICY. THERE ARE TWO REASONS FOR THAT. WE SAW WITH THE UNIVERSITY OF CALIFORNIA THAT WITHOUT A POLICY, INSTITUTIONS CAN SLIDE BACKWARDS ON THEIR DIVESTMENT COMMITMENTS. MUCH MORE IMPORTANTLY, RESEARCH INDICATES THAT THE POLITICAL AND SOCIAL IMPACTS OF DIVESTMENT THAT COME WITH A PUBLIC STATEMENT OF POLICY ARE MUCH MORE POWERFUL THAN JUST THE FINANCIAL IMPACTS. THANK YOU FOR YOUR WORK.

>> THANK YOU. THAT CONCLUDES OUR SPEAKERS FOR ITEM 6.

>> I BELIEVE THE LAST SPEAKER MIGHT BE TALKING ABOUT ITEM 68 ON THE CONSENT. SO WHEN WE TALK -- WHICH WE ARE GOING TO NEXT, THAT WILL NOT BE ALLOWED TO SPEAK AGAIN ON THAT SPECIFIC ISSUE. OTHER THAN THAT -- OKAY. SO LET'S MOVE TO ITEM 7 WHICH IS APPROVAL OF THE CONSENT CALENDAR. CLERK, PLEASE READ THE CONSENT CALENDAR UPDATE, PLEASE.

>> WE HAVE A REQUEST FROM THE APPLICANT WITH CONCURRENT FROM ADMINISTRATION TO CONTINUE ITEM NUMBER 9 TO MAY 19, 2026. ITEM NUMBER 9 IS A PUBLIC HEARING, APPEAL OF THE DECEMBER 18, 2025 DECISION OF THE PLANNING COMMISSION TO UPHOLD THE ZONING ADMINISTRATOR'S DECISION TO DENY CONCURRENT LAND USE APPLICATION CONSISTING OF DESIGN REVIEW AND GREATING APPROVAL FOR A CONSTRUCTION OF A SINGLE FAMILY RESIDENCE LOCATEDDALITY ZERO PEACOCK COURT, ASSESSOR'S PARCEL NUMBER 351-42-004. WE HAVE A REQUEST FROM SUPERVISOR ELLENBERG TO CONSIDER ITEM NUMBER 17 AFTER ITEM NUMBER 8. 8 IS A EARING FOR MOSQUITO AND VECTOR CONTROL. ITEM NUMBER 17 IS TO RECEIVE A REPORT RELATING TO A PRELIMINARY FEASIBILITY STUDY TO IMPLEMENT FULL SCALE COMMUNITY HEALTH WORKER PROGRAMS IN EAST SAN JOSE IN SOUTH COUNTY. WE HAVE A REQUEST FROM SUPERVISOR ABE-KOGA TO REMOVE THEM 33. NUMBER 33 IS TO APPROVE DELEGATION OF AUTHORITY OF THE COUNTY EXECUTIVE OR DESIGNEE TO NEGOTIATE OR TERMINATE AGREEMENT WITH SANTA CLARA COUNTY TRANSPORTATION AUTHORITY RELATED TO PROVIDING SMART PASS ONLY FOR SUPPORTIVE PASSES INDEPENDENT PROVIDERS AND SUPERIOR COURT EMPLOYEES AND NOT FOR COUNTY EMPLOYEES. WE ALSO HAVE A CORRECTION TO ITEM NUMBER 69-T, THE ITEM SHOULD REFLECT IT IS JOINTLY SUBMITTED WITH SUPERVISOR DUONG. IT'S FOR OPENING DOORS SILICON VALLEY FOR HOSTING THE SAN JOSE SALSA FESTIVAL IN CELEBRATION OF CULTURE, UNITY AND COMMUNITY STRENGTH. THAT CONCLUDES THE CONSENT CALENDAR UPDATES.

>> THANK OU VERY MUCH. LET ME SEE IF ANY -- SUPERVISOR DUONG.

>> I DIDN'T HAVE ANY ADDITIONAL CHANGES, HAPPY TO MAKE A MOTION TO APPROVE THE CALENDAR AS IS. I WOULD LIKE TO SHARE COMMENTS FOR NUMBER 72. THE PAVEMENT PRESERVATION PROJECT, I WANT TO RECOGNIZE THE ROADS DEPARTMENT FOR THE WORK THEY WILL BE DOING. THIS INCLUDES ASPHALT, RUBBER CHIP SEAL, REVERSE CAPE SEAL, MICRO-SURFACE, DON'T KNOW WHAT IT MEANS BUT IT SOUNDS NECESSARY. AND WHEN THE WORK IS CLOSE TO STARTING, PLEASE LET OUR OFFICE KNOW SO WE CAN GET THE WORD OUT TO OUR NEIGHBORHOOD. THANK YOU.

>> ALL RIGHT. MOTION, DO I HAVE A SECOND? OKAY. SECOND BY SUPERVISOR ELLENBERG. YES, I HAVE A COUPLE OF BRIEF COMMENTS ON THESE AS WELL. ITEM 34, I JUST WANTED TO MENTION THAT I DO HAVE THE UNIVERSITY OF SILICON VALLEY MUG IN SUPPORT OF HIGHER EDUCATION. IT'S ABOUT PROTECTING PEACEFUL PROTEST ON COLLEGE CAMPUSES. ESPECIALLY THOSE FACING TARGETED CUTS. HERE IN SANTA CLARA COUNTY, UNIVERSITIES ARE CENTRAL TO OUR ECONOMY, WORKFORCE AND CIVIC LIFE. WHEN FUNDING IS USED AS LEVERAGE, IT CREATES A CHILLING EFFECT THAT DISCOURAGES TUDENTS FROM ORGANIZERRING. IT WEAKENS OPEN EXCHANGE OF IDEAS, TRUST IN COMMUNITY AND IS AN ATTACK ON OUR FREEDOM OF FIRST AMENDMENT. THIS RESOLUTION MAKES CLEAR. FREE EXPRESSION AND RIGHT TO PEACEFULLY PROTEST MUST BE PROTECTED AND NOT BE POLITICIZED. FOR ITEM 68, I WANT TO THANK YOU TO OUR FINANCE AGENCY STAFF FOR THEIR WORK ON THESE UPDATES. YOUR DILIGENCE AND EXPERTISE MADE THIS POSSIBLE. I WANT TO THANK THE COMMUNITY MEMBERS WHO SPOKE UP AND ADVOCATED FOR STRONG LANGUAGE ABOUT SUSTAINABLE LANGUAGE AND FOSSIL FUELS. A SHOUT OUT FOR BRINGING THE RECOMMENDATION FORWARD. YOUR LEADERSHIP AND COMMITMENT TO ADVANCING FORWARD LOOKING POLICY ARE APPRECIATED. I HAVE FULL CONFIDENCE THAT WE'LL CONTINUE TO MAKE PRUDENT INVESTMENT DECISIONS. CLIMATE CRISIS IS ACCELERATING AND IMPACTING OUR COMMUNITIES TODAY. AT THE SAME TIME WE ARE SEEING ACTION AT THE FEDERAL LEVEL THAT RISK DEEPENING THAT CRISIS AND UNDERMINE ENVIRONMENTAL AND PUBLIC HEALTH PROTECTIONS. THAT MAKES LOCAL LEADERSHIP ALL THE MORE CRITICAL. THE ACTION WE ARE TAKING TODAY MATTERS. PUBLIC DOLLARS SHOULD NOT BE USED TO DRIVE INDUSTRY. THIS ENSURES WE ARE DRAWING A CLEAR LINE FOR THE FUTURE, ONE THAT LINES OUR FUTURE PRACTICES. I LOOK FORWARD IN VOTING IN STRONG SUPPORT. DO WE HAVE ANY PUBLIC COMMENT ON CONSENT ITEMS?

>> YES, WE DO. I AM SHOWING FIVE CARDS IN CHAMBERS AND FOUR HANDS RAISED ON ZOOM.

>> LET'S DO ONE MINUTE EACH, PLEASE.

>> WE'LL BEGIN WITH THE IN CHAMBERS SPEAKERS. WE HAVE HARRY ADAMS, MATT, ZACH VOIT, WESLEY AND SHAHEED. IF YOU CAN STATE THE CONSENT NUMBER YOU ARE SPEAKING TO.

>> GOOD MORNING. I'M HARRY ADAMS. I'M SPEAKING ON ITEM 68. I AM A DISTRICT 2 RESIDENT AND ALSO A MEMBER OF THE VETERANS FOR PEACE NATIONAL STEERING COMMITTEE ON CLIMATE CRISIS AND MILITARISM. THE USE OF FOSSIL FUELS IS IN LARGE PART DRIVEN BY THE U.S. MILITARY. IT'S THE WORLD'S LARGEST INSTITUTIONAL EMITTER OF GREENHOUSE GASSES AND USER OF FOSSIL FUELS. NOT JUST IN WAR, BUT DAILY GLOBAL OPERATIONS, FACILITATED BY THE MACHINERY AND WEAPONS PROVIDED BY DEFENSE CONTRACTORS AT A HEAVY PRICE. I URGE YOU TO ADOPT A STRONG ETHICAL INVESTMENT POLICY THAT BANS ANY INVESTMENT IN FOSSIL FUELS BUT ALSO I THINK THERE IS A NEED TO BEGIN TO DIVEST FROM WEAPONS MANUFACTURERS AND DEFENSIVELY CONTRACTORS. SO PLEASE DO ALL YOU CAN TO INVEST ETHICALLY AND MORALLY. THANK YOU.

>> GOOD MORNING, SUPERVISORS. MY NAME IS MATT. I'M A RESIDENT IN DISTRICT 4, A HOMEOWNER IN SANTA CLARA FOR OVER A DECADE. SPEAKING ON ITEM NUMBER 68. THE GENOCIDE OF THE PEOPLE IN MIRAMAR BY THE MILITARY WAS FINANCIALLY SUPPORTED BY OIL COMPANIES INCLUDING CHEVRON. WHEN THE MIRAMAR SECURITY FORCES COMMITTED THE BRUTAL MASSACRE, RAPE AND FORCED DISPLACEMENT OF THE PEOPLE, CHEVRON WAS UNBOTHERRED. AS A COUNTY, WE HAD AN INVESTMENT IN CHEVRON OF OVER $15 MILLION AS OF LAST AUGUST. I ASK YOU TO VOTE IN FAVOR OF ITEM 68 TO ENSURE WE NEVER INVEST IN A COMPANY LIKE CHEVRON EVER AGAIN. THANK YOU.

>> GOOD AFTERNOON, COUNTY SUPERVISORS.

>> GOOD MORNING.

>> SORRY. I'M WESLEY. I'M SPEAKING IN SUPPORT OF 68. CHEVRON'S RECKLESS ACTIONS HAVE CAUSED IMMEASURABLE HARM TO US RESIDENTS. IN 2021 THEIR OIL REFINERY SPILLED 600 GALLONS INTO THE SAN FRANCISCO BAY, THIS MADE A TOXIC ENVIRONMENT AND FORCED PEOPLE INSIDE BECAUSE THE AIR WAS NOT SAFE TO BREATHE. CHEVRON HASSLES SPILLED 16 BILLION GALLONS OF TOXIC WASTEWATER INTO THE AMAZON. THEIR ACTIONS THREATEN NOT JUST HUMANS, BUT EVERY LIVING THING ON THIS PLANET. CONSIDERING HOW RECKLESS CHEVRON IS WITH OUR HEALTH AND ENVIRONMENT, I URGE YOU TO NEVER INVEST IN FOSSIL FUELS AGAIN AND TO SUPPORT THIS ITEM. THANK YOU.

>> GOOD MORNING. MY NAME IS SHAHEED. I BELIEVE OUR COUNTY SHOULD LOOK FURTHER INTO INVESTMENTS. RIGHT NOW OUR COUNTY IS NO LONGER INVEST IN FOSSIL FUELS. OUR COUNTY CONTINUES TO BE HAVED IN APPLE, CATERPILLAR, MICROSOFT AND INTEL WHICH ALL SUPPLY TOOLS AND TECHNOLOGY USED TO REINFORCE PALESTINIANS. THEY DEMOLISH HOMES ON THE WEST BANK. THEY HAVE BEEN USED TO CAUSE MASSIVE DAMAGE TO ROADS, BUILDINGS AND HOSPITALS. INVESTING IN COMPANIES PUTS A STAIN ON OUR COUNTY'S HE IMAGE AND MORALS AND ALSO INVESTIGATE LANGUAGE INVOLVED IN THESE COMPANIES. THANK YOU.

>> HELLO. I'M ZACH. I LIVE IN DISTRICT 5 OF SANTA CLARA COUNTY. I'M SPEAKING IN SUPPORT OF ITEM 68. WE COLLECTIVELY NEED TO SHIFT FROM BURNING FOSSIL FUELS TO USING RENEWABLE ENERGY. IN THE EAR 2026 IT'S UNACCEPTABLE TO BE INVESTED IN CHEVRON. I URGE YOU TO SUPPORT ETHICAL INVESTMENT. I URGE YOU ALL TO SUPPORT TEM 68. THANK YOU.

>> THANK YOU. WE WILL MOVE TO OUR ZOOM SPEAKERS. OUR FIRST SPEAKER IS MARK GROSSMAN. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING. ITEM68. ON BEHALF OF OUR SILICON VALLEY MEMBERS, I WANT TO THANK THE SUPERVISORS AND STAFF FOR PRIORITIZING THE FISCAL AND PHYSICAL HEALTH OF THE COMMUNITY DURING EARTH MONTH. THANKS TO YOU OUR TAXES WILL NO LONGER SUPPORT ONE OF THE DIRTIEST INDUSTRIES ON THE PLANET. CLEANER ENERGY SOLUTIONS AND INVESTMENTS ARE READILY AVAILABLE AS YOU HAVE ACKNOWLEDGED. THANK YOU VERY MUCH.

>> THANK OU. OUR NEXT SPEAKER IN THE CUE IS PARENT. PLEASE ACCEPT THE UNMUTE.

>> YES. I WOULD LIKE TO SPEAK O ITEM NUMBER 65. THIS IS IN REGARDS TO THE DISTRICT ATTORNEYS OFFICE INCREASING ITS BUDGET FOR VICTIM SERVICES. WHILE I DO SUPPORT THIS, WE SHOULD BE UPPORTING ALL OF OUR VICTIMS, OUR CRIME VICTIMS. I DON'T KNOW WHERE IS ALL THIS MONEY GOING TO. THE DISTRICT ATTORNEY JEFF ROSEN HIMSELF IS VICTIMIZING ME, VICTIMIZING MY CHILDREN. THIS WAS -- I TOLD HIM SPECIFICALLY THAT MY CHILDREN WERE BEING SEXUALLY MOLESTED AND THAT SOMEBODY WAS ASSAULTING ME, AND WHAT HE DID WAS HE FILED CHARGES AGAINST ME BECAUSE THIS PERSON HAS A POLITICAL SUPPORTER. THIS PERSON HAS CAUSED ME GREAT BODILY HARM, I CAN'T GET ANY SERVICES BECAUSE JEFF ROSEN SUPPORTS HIS POLITICAL SUPPORTER. IF YOU WANT TO SEE MORE INFORMATION, GOOGLE DA JEFF ROSEN AND YOU WILL SEE WHAT I'M TALKING ABOUT.

>> NEXT SPEAKER IS MAXI346789INA M. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING. I'M SPEAKING IN SUPPORT OF ITEM 68. I BELIEVE THE MOVE TO BAR INVESTMENT IN FOSSIL FUEL COMPANIES IS JUST. BUT I BELIEVE THESE ARE NOT THE ONLY UNEARTHED CAL OMPANY -- UNETHICAL COMPANIES. TAKE APPLE. THEY FIRE UNION ACTIVIST, RETALIATING AGAINST SUPPORTERS. IT'S ASTOUNDING HAT 1.1% OF THE COUNTRY'S INVESTMENT POWERFUL IS PLACE IN AMAZON BONDS. I URGE YOU TO DO THE RIGHT THING AND VOTE YES ON ITEM 68. AND ADDITIONALLY, TO ADOPT AN ETHICAL INVESTMENT POLICY. AND DIVEST FROM COMPANIES LIKE AMAZON. THAT'S ALL. THANK YOU.

>> THANK YOU. OUR LAST SPEAKER WHO HAD THEIR HAND RAISED AT THE CALL OF THE CUE, LAWRENCE HUANG. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING. I'M LAWRENCE. I WANTED O SPEAK IN SUPPORT OF ITEM 68. FIRST, I WOULD LIKE TO HANK THE BOARD FOR CUTTING TIES WITH BLOCK WHICH HAS BEEN USED TO CONDUCT MASS SURVEILLANCE ON THE PUBLIC. THERE IS NOTHING KEEPING THE COUNTY FROM INVESTING IN OTHER COMPANIES. I HOPE YOU VOTE IN FAVOR OF ITEM 68. SO THE COUNTRY CAN STUDY LANGUAGE TO REVENT INVESTMENT IN COMPANIES THAT HARM S. THANK YOU.

>> THAT CONCLUDES OUR PUBLIC COMMENTERS UNDER ITEM 7.

>> THANK YOU VERY UCH. ALL RIGHT. WITH NO FURTHER COMMENTS, I HAVE A MOTION -- SORRY. YES. ENVIRONMENT ARENAS.

>> IN LIGHT OF SOME OF THE COMMENTS THAT HAVE BEEN MADE BY MANY OF THE PUBLIC, I JUST WANT TO THANK THE TREASURY OVERSIGHT COMMITTEE AS WELL AS OUR COUNTY EXECUTIVE FOR BRINGING THIS FORWARD FOR REVIEWING THE INVESTMENT POLICY AND PROMOTING ENVIRONMENTAL STEWARDSHIP IN THE WAY THAT WE INVEST OUR FUNDS. SO I THINK THAT IS SOMETHING TO REALLY ELEVATE IN THE TIME WHERE FOLKS MAY NOT CONSIDER WHERE PROFITS ARE COMING FROM AS WE SEE NATIONWIDE. THANK YOU SO MUCH.

>> THANK YOU. WE HAVE A MOTION AND SECOND. LET'S TAKE THE ROLL.

>> MOTION BY SUPERVISOR DUONG, SECOND BY SUPERVISOR ELLENBERG. (ROLL CALL).

>> MOTION PASSES.

>> THANK YOU. MOVING ON TO THE EXT ITEM, 8, WHICH IS A PUBLIC HEARING OF THE SANTA CLARA COUNTY MOSQUITO ND VECTOR DISTRICT FOR FISCAL 2026-2027. DO WE HAVE A REPORT FROM STAFF, PLEASE.

>> GOOD MORNING.

>> GOOD MORNING.

>> GOOD MORNING, PRESIDENT LEE AND MEMBERS OF THE BOARD. I'M THE PROGRAM MANAGER AT MOSQUITO AND VECTOR CONTROL DISTRICT JOINED Y THE ASSISTANT MANAGER OF THE DISTRICT. TODAY WE ARE HERE WITH ITEM NUMBER 8 AND WE'LL BE HAPPY TO ANSWER ANY QUESTION THAT YOU MAY HAVE RELATED TO 1996 AND 2005 ASSESSMENT.

>> I WILL GO AHEAD AND OPEN THE PUBLIC HEARING OFFICIALLY. SO DO WE HAVE ANY PUBLIC CLERK THAT WOULD LIKE TO SPEAK ON THIS ITEM RIGHT NOW?

>> I HAVE NO CARDS IN CHAMBERS AND NO HANDS RAISED IN ZOOM.

>> OKAY.

>> FIVE, FOUR, THREE, TWO, ONE. STILL NONE? OKAY. ALL RIGHT. IN THAT CASE WE'LL O AHEAD AND CLOSE THE PUBLIC HEARING. AND I WOULD LIKE TO SEE IF THERE IS ANY UESTIONS AND COMMENTS OR MOTION FROM MY COLLEAGUE ON THE BOARD. I DON'T SEE ANY LIGHTS EITHER. OKAY. IF THAT'S THE CASE, MAY I GET A MOTION FROM ONE OF MY COLLEAGUES?

>> MOTION TO APPROVE.

>> SECOND.

>> MOTION AND SECONDED. ALL RIGHT. LET'S TAKE THE ROLL.

>> THAT'S A MOTION BY VICE PRESIDENT ARENAS, SECONDED BY SUPERVISOR DUONG. (ROLL CALL).

>> MOTION ASSES.

>> OKAY. AS EARLIER MENTIONED, WE ARE HEARING ITEM NUMBER 17 FIRST AT THIS POINT. WHICH IS THE ITEM UNDER ADVISEMENT FROM MAY 6, '25 TO RECEIVE A REPORT RELATING TO A PRELIMINARY FEASIBILITY STUDY TO IMPLEMENT FULL SCALE COMMUNITY HEALTH WORKER PROGRAMS IN EAST SAN JOSE AND SOUTH COUNTY. GOOD MORNING.

>> GOOD MORNING, PRESIDENT LEE, VICE PRESIDENT ARENAS, MEMBERS OF THE BOARD. DR. SARA REDMOND DIRECTOR OF THE HEALTH DEPARTMENT. I'M PLEASED TO BE JOINED BY THREE COLLEAGUES WHO WILL GIVE YOU A BRIEF PRESENTATION. TO MY RIGHT IS ANGELICA, DIRECTOR OF PUBLIC HEALTH DEPARTMENT. NEXT TO HER, DR. GOMEZ, DIRECTOR OF RESEARCH AND OUTCOME MEASURES FOR THE PUBLIC HEALTH DEPARTMENT. AND DR. VICKY, OUR ECONOMIST. ALONG WITH THEIR NCREDIBLE WORK. MULTIPLE MEMBERS OF THEIR TEAM, I WANT TO THANK THE MEMBERS OF THE COMMUNITY FOR NOT ONLY VIEWING HE WORK, BUT WHO CONTRIBUTED TO THE WORK WE ARE ABOUT TO SHARE. BEAR WITH ME TO GET OUR SLIDES PROJECTED. AND I WILL ASK THE -- EXCUSE ME A MOMENT. OKAY. THERE WE GO. I WILL ASK THE CLERK TO PLEASE CONFIRM WHETHER I'M SHARING APPROPRIATELY, CORRECTLY.

>> YES. IT IS UP ON THE E BOARD.

>> OKAY.

>> THANK OU. I WILL START US OFF BY REMINDING WHY WE ARE HERE. WHICH IS THAT NOW SEVERAL YEARS AGO UNDER THE CHAMPIONSHIP OF SUPERVISOR ARENAS, THE PUBLIC HEALTH DEPARTMENT AND COMMUNITY PARTNERS CONDUCTED THE 2025 LATINO HEALTH ASSESSMENT. OVER AND OVER AGAIN, THE FINDINGS OF THAT HEALTH ASSESSMENT AS PRESENTED BEFORE THIS BOARD AND REPEATEDLY SHARED THROUGHOUT THE COMMUNITY AND REFERENCED BY THIS BOARD FOUND STRIKING, HEART BREAKING ADDITION PARITIES THAT IMPACTED OUR COMMUNITY MEMBERS. IT LED TO RAYS OF HOPE IN ITS RECOMMENDATIONS OF HOW WE MOVE PAST THE DISPARITIES THAT THIS COMMUNITY HAS SEEN OVER AND OVER AGAIN. ONE OF THOSE RECOMMENDATIONS THAT CAME UP OVER AND OVER AGAIN IN THE ASSESSMENT IS THE IMPORTANCE OF COMMUNITY HEALTH WORKERS TO MAKE A DIFFERENCE IN THE HEALTH OF LATINO COMMUNITY MEMBERS. WE FOUND FROM THE EVIDENCE IN THE ASSESSMENT ITSELF, THE WORDS OF THE COMMUNITY MEMBERS AND EVIDENCE PUBLISHED ACROSS THE SPECTRUM OF SCIENCE TELLING US THAT WHEN YOU LEVERAGE THE WISDOM OF THE VERY COMMUNITY WHO NEEDS SERVICE, YOU SEE THE BEST POSSIBLE OUTCOMES. SO THAT'S, I IMAGINE, WAS PART OF THE WISDOM BEHIND THE BOARD AND UNDER SUPERVISOR ARENAS' RECOMMENDATIONS, WAS THIS ASSESSMENT, WHAT WOULD IT LOOK LIKE IF WE WERE O BUILD, TO GATHER HE BUILDING BLOCKS OF A TRULY COMPREHENSIVE PROGRAM THAT SERVES LATINOS, BUT PEOPLE OF ALL RACES AND ETHNICITIES THAT THEY FOUND WERE SO IMPACTED BY SOME OF THESE HEALTH OUTCOMES. WE HAVE CHOSEnd AND DEFINED THE COMMUNITY HEALTH WORKER. THEY ARE NAZI NON-MUST. IT'S NOT A QUESTION F TRANSLATION. BUT ONCE WE LISTENED TO THE VOICES OF OUR COMMUNITY, UNDERSTANDING THAT THE MORE MEDICAL TERM, COMMUNITY HEALTH WORKER, WHICH WAS USED TO DESCRIBE FOLKS WHO HELPED NAVIGATE THE HEALTH SYSTEM, TO GET PEOPLE THE CARE THEY NEED, WAS DISSTRING FROM A ROMOTOR, NOT ONLY TO NAVIGATE HEALTHCARE, BUT TO STRENGTHEN THE RESILIENCE AND BUILD FACTORS THAT WILL KEEP IT HEALTHY FOR GENERATIONS BEYOND THE NEED FOR HEALTHCARE. YOU WILL SEE US USE THAT ERM, COMMUNITY HEALTH WORKER, AND PROMOTOR,ED MEDICAL PATHWAY AS WELL AS THE COMMUNITY ADVOCACY COMPONENT THAT LEVERAGES THAT FULL CULTURALLY INCLUSIVE WISDOM. WITH THAT, I TURN OVER TO ANGELICA.

>> GOOD MORNING, MEMBERS. BOARD. I'M THE DIRECTOR OF THE HEALTHY COMMUNITIES BRANCH. I WILL COVER THREE AREAS OF THE STUDY. FIRST, TO PRESENT A COMPREHENSIVE STRATEGY TO YOU, WE DID CONDUCT A FEASIBILITY STUDY. THREE GOALS FRAME THIS WORK. FIRST IS A STRUCTURAL ONE ON THE WORKFORCE WHICH IS LOOKING AT HOW THEY OPERATE IN SANTA CLARA COUNTY. SECOND IS AN ECONOMIC ANALYSIS, THE COST EFFECTIVENESS AND RETURN ON INVESTMENT. AND THE THIRD IS THE DEPLOYMENT STRATEGIES AND GEE ONGRAPHYS IDENTIFIED. TOGETHER THIS CREATED ONE QUESTION FOR US WHICH WAS WHAT WOULD IT TAKE TO MAKE THIS WORKFORCE SUSTAINABLE, NOT EPISODIC. THIS MATTERS BECAUSE WE CAN'T IGNORE THE CRISIS IDENTIFY IN THE LATINO HEALTH ASSESSMENT. NEIGHBORHOODS ARE FACING PREVENTABLE LOSS OF LIFE. RESIDENTS ARE DIEING FROM DIABETES AND OPIOID OVERDOSE. TEEN BIRTH RATES ARE HIGHER, THEY ARE TWICE AS HIGH. WHEN LATINO ADULTS GET MEDICAL CARE, HALF SAY IT'S DUE TO COST. AND ONE IN SEVEN LOW INCOME IMMIGRANTS AVOID HEALTHCARE BECAUSE OF IMMIGRATION FEARS. THIS IS WHAT WE CAN ADDRESS. THE VIDENCE IS REALLY CLEAR HERE. WHEN A SYSTEM CANNOT REACH PEOPLE WHO NEED IT MOST, IT'S THE PROMOTORS AND HEALTH WORKERS THAT CAN. THEY REACH PEOPLE WHO ARE AFRAID TO WALK THROUGH OUR DOORS. THE STRONGEST EVIDENCE SHOWS THAT THE PROGRAMS CUT EMERGENCY VISITS, HOSPITALIZATIONS AND READMISSIONS BY 20 TO 50%. ONE TRIAL, IT SAVED MEDICAID 1.4 MILLION IN A SINGLE YEAR AND IT CAME FROM ADDRESSING HOUSING AND FOOD. THE RETURN ON INVESTMENT IS FROM SOLVING THE PROBLEMS THAT DRIVE ILLNESS IN THE FIRST PLACE. THESE ARE NOT SMALL IMPROVEMENTS, THIS IS COMMUNITY TRANSFORMATION. HEALTHCARE STARTS IN THE HOME, IN THE NEIGHBORHOODS, IN THE KITCHEN. THAT'S WHERE OUR COMMUNITY HEALTH WORKERS, PROMOTORS WORK. NEXT SLIDE. THIS SLIDE HERE SHOWS YOU WHO HELPED SHAPE THIS ORK. WE HAD SEVERAL COMMUNITY PARTNERS THAT MADE UP THE ADVISORY COMMITTEE. YOU SEE THREE GROUPS AND COALITIONS THAT ARE NOT ONE SINGLE GROUP BUT ARE SEVERAL COALITIONS. I WOULD LIKE TO RECOGNIZE SOME OF THEM ARE HERE TODAY, THESE ARE THE PARTNERS THAT HELPED US DESIGN THE TOOL, HELPED OPEN OUR DOORS. THEIR DOORS TO CONDUCT FOCUS GROUPS AS WELL AS HELP WITH THE RECRUITMENT. AND AT THIS TIME I WOULD PASS IT OVER TO DR. GOMEZ. THANK YOU.

>> GOOD MORNING. SOPHIA GOMEZ DIRECTOR OF RESEARCH AND OUTCOME MEASUREMENT. I WILL PRESENT THE VARIOUS SOURCES OF INFORMATION AND THE FINDINGS THAT GUIDED OUR RECOMMENDATIONS. TO INFORTUNATELY THE RECOMMENDATION, WE DREW FROM FIVE SOURCES OF INFORMATION, NOT JUST A SINGLE SOURCE. OVER THE PAST FIVE MONTHS, OUR ADVISORY COMMITTEE MET TO ENSURE THAT THE RESEARCH APPROACH AND FINDINGS WERE ANCHORED IN LIVED EXPERIENCE AND PRACTICE BASED EXPERTISE. THE COMMITTEE HELPED SHAPE THE SURVEY HOSTED MEETINGS IN THE COMMUNITY. THE FOCUS GROUP AS WELL AS HOSTING COMMUNITY ACROSS THE REGIONS THAT WERE HELPFUL IN REACHING PROMOTORS WORKERS. WE FIELDED A BI-LING GAL SURVEY REACHING OVER 200 PROMOTORS, COMMUNITY HEALTH WORKERS ACROSS 24 PARTNER ORGANIZATIONS, GIVING US INSIGHT INTO THEIR NEEDS. WE HELD A FOCUS GROUP WITH SUPERVISORS AND MANAGERS CAPTURE ING THEIR CHALLENGES AND NEEDS. WE CONDUCTED KEY INFORM YACHT INTERVIEWS FROM COMMUNITY BASED ORGANIZATIONS, COMMUNITY COLLEGES, SAFETY NET PROVIDERS AND COUNTY GOVERNMENT. FINALLY, WE CONDUCTED A LITERATURE REVIEW SPANNING FROM LOS ANGELES, FREEZE KNOW AND SACRAMENTO COUNTIES TO IDENTIFY HOW COMPARABLE JURISDICTIONS ARE APPROACHING THIS WORK. THESE FIVE SOURCES GAVE US A RELIABLE FOUNDATION FOR RECOMMENDATIONS YOU WILL HEAR TODAY. NEXT SLIDE. ACROSS THESE VARIOUS INFORMATIONAL SOURCES, FIVE THEMES EMERGED CONSISTENTLY ACROSS THEM. I WILL WALK THROUGH EACH FINDING. THE FIRST IS FOUNDATIONAL. THE PROMOTOR AND COMMUNITY HEALTH WORKER IS STRUCTURAL, NOT SEMANTIC. THESE OVERLAPPING THE WORKFORCE MODELS. AS ONE LEADER SHARED WITH US, CHWs ARE MORE CONFINED. WHILE PROMOTORS COVER A BROADER SPECTRUM. CARE COORDINATION, CHRONIC DISEASE MANAGEMENT REDUCES EMERGENCY DEPARTMENT USE, HOSPITALIZATION AND READMISSIONS. SOME OF THESE SERVICES ARE BILLABLE UNDER MEDI-CAL. COMMUNITY FACING WORK SUCH AS GROUP EDUCATION, OUTREACH, ORGANIZING ADDRESS THE CAUSE OF POOR HEALTH. AND BOTH ARE NECESSARY. FROM THE FINDINGS BRIDGING THESE TWO MODELS REQUIRES ADMINISTRATIVE INFRASTRUCTURE THAT CURRENTLY DOES NOT EXIST AT SCALE IN OUR COUNTY. THE SECOND IS REGARDING COMPENSATION. REPORTED AGES OFTEN FALL BELOW LOCAL LIVING WAGE AND DO NOT REFLECT THE FULL SCOPE OF THEIR WORK. DURING OUR COMMITTEE CONVERSATIONS WITH PROMOTORS COMMUNITY HEALTH WORKERS, THEY MENTIONED THEY ROUTINELY NGAGE WITH COMMUNITY IN THE EVENINGS, ON WEEKENDS AND DURING MOMENTS OF CRISIS, A TIME THAT GOES UNCOMPENSATED. THEY ALSO MENTIONED THAT THE WORK RELATED EXPENSES SUCH AS TRAINING COSTS, TRANSPORTATION AND MOBILE PHONE USE ARE FREQUENTLY UNREIMBURSED. THE THIRD THEME WE FOUND IS TRAINING GAPS ARE STRUCTURAL AND TOPICAL. BY THAT WE MEAN THERE IS CURRENTLY NO COORDINATED TRAINING PATHWAY THAT SPANS THE FULL RANGE OF ACTIVITIES THIS WORKFORCE CARRIES OUT. THIS GOES ACROSS CLINICAL NAVIGATION AND COMMUNITY RESILIENCE WORK. IN REGARDS TO TOPIC, SIGNIFICANT GAPS REMAIN IN DISABILITY COME COMPERATORE -- SUSTAINABILITY, NO SINGLE FUNDING SOURCE CAN SUPPORT THE FULL PROMOTOR MODEL HEALTH WORKER ON ITS OWN. IT COVERS SOME ACTIVITIES, NOT ALL OF THEM. SUSTAINING THIS WORKFORCE LONG TERM REQUIRES A BLENDED FUNDING APPROACH. BY THAT WE MEAN DRAWING FROM MANAGED CARE INVESTMENTS, LOCAL FUNDING LOCAL DOLLARS. IT REQUIRES COORDINATED COMMITMENT ACROSS SYSTEMS AND FUNDERS. WE'LL RETURN MORE ON THAT POINT IN OUR RECOMMENDATION SECTION. FINALLY, THE LAST THEME IS COMMUNITY VOICE AS NOT A PROGRAM FEATURE, BUT A CONDITION FOR PROGRAM LEGITIMACY. PROGRAMS HAVE BY-PASSED INPUT AND FELL SHORT OF INTENDED OUTCOMES. WHAT WE FOUND IS THAT AUTHENTIC ENGAGEMENT IS NOT OPTIONAL. IT'S WHAT ENSURES THESE PROGRAMS REACH AND SERVE THE PEOPLE THEY ARE ESIGNED FOR. SO THIS MAP ILLUSTRATES THE GEOGRAPHIC DISTRIBUTIONS OF PROMOTORS AND COMMUNITY HEALTH WORKERS. THE HIGHEST CONCENTRATION PPEAR WHERE COMMUNITY NEEDS AND POPULATION DENSITY EXISTS IN EAST SAN JOSE SOUTH COUNTY. WE SAW MEANING. CLUSTERS IN MOUNTAIN VIEW AND SUNNY VALE. THE MAPS ARE INFORMATIVE. THEY DO NOT INDICATE AN ABSENCE OF NEED, THEY INDICATE WHERE COMMUNITY BASED INFRASTRUCTURE IS THINNER, FEWER ORGANIZATIONS CURRENTLY HAVE CAPACITY. IT TELLS US WHERE THE WORK IS HAPPENING. NOW, I WILL TURN IT OVER TO MY COLLEAGUE TO DISCUSS THE IF FISCAL FINDINGS AND RECOMMENDATIONS.

>> GOOD MORNING. I'M VICTORIA, SENIOR HEALTH ECONOMIST. EACH COMMUNITY HEALTH WORKER AND PROMOTOR POSITION COSTS ABOUT $113,000 PER YEAR. THAT INCLUDES BENEFITS, SUPERVISION, ONGOING TRAINING, DEVELOPMENT AND SALARY. THE MODEL RETURNS ABOUT $278 IN AVOIDED HEALTHCARE COSTS. THAT'S A RATIO OF 2.5 TO 1. WHERE THAT MONEY GOES SHAPES EVERY RECOMMENDATION WE SHARE TODAY. THE $278,000 DOES NOT LAND IN THE COUNTY BUDGET DIRECTLY. IT ACCRUES TO MEDI-CAL PLANS, THE STATE, HOSPITALS, HOUSEHOLDS. NONE OF IT RETURNS TO WHICH EVER ENTITY IS FUNDING THE COMMUNITY HEALTH WORKER PROMOTOR POSITION. THE PROGRAM CANNOT FUND ITSELF OUT OF THE SAVINGS IT GENERATES. THAT'S MY EVERY RECOMMENDATION IN FRONT OF THE BOARD TODAY POINTS TOWARDS A BLENDED UNDING STRUCTURE RATHER THAN A SINGLE PAYER. I WANT TO BE CLEAR ABOUT WHAT THE RATIO DOES AND DOES NOT MEASURE. THE $278,000 COVERS THE MONETIZED COSTS OF CLINICAL OUTCOMES WE CAN SEE TODAY. THOSE ARE LIKE AVOIDED EMERGENCY DEPARTMENT VISITS, AVOIDED HOSPITALIZATIONS FOR PREVENTABLE POSITIONS. IMPROVED CHRONIC DISEASE MANAGEMENT. IT DOES NOT INCLUDE COMMUNITY RESILIENCE. THE ORIGINAL NICING, THE PLANNING, THE TRUST BUILDING THAT HOLDS THE REST OF THE SYSTEM TOGETHER. THAT'S BECAUSE THE METHODS OF MEASUREMENT IS DEVELOPING. THEREFORE, THE 2.5 TO 1 RATIO IS THE FLOOR, NOT THE CEILING HERE. THE MODEL UNDERSTATES THE FULL CONTRIBUTION OF THIS WORKFORCE. THE TAKE-AWAY IS STRUCTURAL. THE WORKFORCE AYS FOR ITSELF IN AGGREGATE, BUT NO SINGLE PAYER RECOVERS THE FULL BENEFIT. THAT'S THE PROBLEM THE NEXT SET OF RECOMMENDATIONS IS DESIGNED TO ADDRESS. THESE SEVEN RECOMMENDATIONS ARE PRESENTED IN PRIORITY RATHER THAN GROUPED BY ATEGORY. RECOMMENDATIONS 1 AND 2 ESTABLISH THE INFRASTRUCTURE THAT IS NEEDED. THE COMMUNITY RESILIENCE HUB AND PATHWAYS. RECOMMENDS THREE AND FOUR DIRECT TRAINING DOLLARS AND TOPICAL FOCUS. RECOMMENDATION 5 IS A CAUTION, WE SHOULD NOT BUILD PAIR LET ME COMMUNITY INFRASTRUCTURE OR CBOs ALREADY DELIVER SERVICES. AND RECOMMENDATION 6 ADDRESSES THE COMPENSATION FINDING DIRECTLY. PAY EQUITY AT COUNTY LABOR STANDARDS. RECOMMENDATION 7 RECOGNIZES THAT PEER SUPPORT IS PART OF THE WORKFORCE MODEL ITSELF. THE NETWORK COULD CONNECT PROMOTORS ACROSS SYSTEMS AND GEOGRAPHIES. SO LEARNING AND PROBLEM SOLVING TRAVEL BEYOND ANY ONE SINGLE CBL. NEXT SLIDE, PLEASE. THE HUB. THE HUB S NOT A BUILDING, IT IS AN ENTITY THAT SERVES AS A BACKBONE FOR THESE SIX FUNCTIONS, POSTING SHARED INFRASTRUCTURE, BROKERING AGREEMENTS AND CONVENING THE NETWORKS. CBOs DELIVER THE SERVICES. THE BACKBONE REMOVES THE BARRIERS THAT KEEP THEM FROM DELIVERING AT SCALE. ON BILLING, THE BACKBONE BROKERS , RELATIONSHIPS SO CBOs CAN FILE. COMMUNITY COLLEGES, MANAGED CARE PLANS, COMMUNITY BASED ORGANIZATIONS RATHER THAN DELIVERING THE CURRICULUM ITSELF. IT NEGOTIATES ACCESS TO TOOLS, TO BILLING TOOLS. AT A NO -- AT A VOLUME NO SINGLE CBO CAN ACHIEVE ITSELF. THE BACKBONE CONVENES AND COORDINATES IN TECHNICAL ASSISTANCE, AVOIDING DUPLICATION ACROSS PAYERS AND THE COUNTY. ONLY A BACKBONE ENTITY CAN DO AT SCALE. THIS IS THE REASON FOR THE RECOMMENDATION OF THE HUB'S CREATION. THE HOST, TO HOST SHARED INFRASTRUCTURE, TO BROKER VOLUME AGREEMENTS, TO CONVENE A NETWORK. THE CBOs DELIVER SERVICES. THAT'S THE ODEL PROPOSED. NEXT SLIDE PLEASE. THERE ARE FOUR ECONOMIC POINTS TIED TO EACH STRUCTURAL FEATURE OF THE MODEL. THE FIRST IS THAT INVESTMENT PAYS BACK OVER TIME. THE 2.5 TO 1 RATIO IS A STEADY STATE FIGURE, IT DOES NOT OCCUR IMMEDIATELY. THE UNIT COSTS FALL WITH SCALE. THE PROGRAM IS MATERIALLY CHEAPER THAN ONE THAT IS 15. BECAUSE SUPERVISION AND TRAINING OVERHEAD GOES ACROSS MORE WORKERS. THE THIRD, IS THAT AVERTED COSTS OCCUR ACROSS COUNTY ENTITIES. THE FOURTH IS THAT BLENDED FUNDING IS THE MECHANISM OF WHO PAYS WITH WHAT BENEFITS. NEXT SLIDE PLEASE. THERE ARE THREE DEPLOYMENT PRIORITIES. EACH WAS CHOSEN BECAUSE THE EVIDENCE-BASED IS STRONGEST THERE AND THE CBO INFRASTRUCTURE IS READY TO ABSORB THE INVESTMENT. THE LHA FLAGGED EACH ONE OF THESE. THE CHRONIC DISEASE, FOR EXAMPLE, IS WHERE MEDI-CAL BILLING IS MOST MOW TOUR AND WHERE THE CURRENT RETURN IS HIGHEST. YOUTH SERVICES AND VIOLENCE PREVENTION ARE COUPLED. THE NETWORKS ALREADY DELIVER BOTH. THERE WERE FOUR WORKFORCE GAPS IDENTIFIED ACROSS EVERY DATA STREAM. MANAGE SUPERVISION IS THE BIGGEST GAP. THEY CAN BE HIRED FASTER THAN SUPERVISORS CAN BE TRAINED. THE BOTTLENECK IS SUPERVISOR CAPACITY. DISABILITY SERVICES AND INTIMATE PARTNER VIOLENCE ARE TOPICAL TRAINING GAPS THAT THE FIELD IDENTIFIED EXPLICITLY. AND FINALLY, WORKER DEVELOPMENT AND COMPENSATION WHICH TIES BACK TO RECOMMENDATION 6, TO ENSURE PAY EQUITY. THANK YOU.

>> THANK YOU. WE'LL SEE THAT THE BOARD AND AGENDA PACKET HAS EEN PROVIDED WITH ADDITIONAL SLIDES. FROM HERE I WILL TURN THINGS BACK OVER TO MR. WILLIAMS FOR ANYTHING TO ADD BEFORE WE ARE HAPPY TO TAKE QUESTIONS FROM THE BOARD.

>> THANK YOU. I WANTED TO ADD A COUPLE OF COMMENTS. THANK YOU TO PUBLIC HEALTH STAFF AND ALL THOSE IN THE COMMUNITY THAT HAVE BEEN INVOLVED IN PUTTING THE EPORT TOGETHER. THERE IS MORE WORK THEY INTEND TO O. I WANTED TO SHARE A COUPLE THOUGHTS OF MY OWN AFTER HAVING READ THE REPORT AND LOOKED THROUGH THE MATERIALS ABOUT NEXT STEPS. I THINK THE MOST SALIENT QUESTION I EXPECT FOR MEMBERS OF THE BOARD AND COMMUNITY IS GIVEN THE FINDINGS AND THE VERY REAL TANGIBLE IMPACTS ON THE PATIENTS AND RESIDENTS IN OUR COMMUNITY AS WELL AS THE SOCIETIAL LEVEL COST BENEFITS ASSOCIATED WITH MAKING INVESTMENTS IN THESE PROGRAMS, HOW DO WE MOVE FORWARD. THAT'S ESPECIALLY CHALLENGING GIVEN TWO CRITICAL FACTS THAT I KNOW THE BOARD IS WELL AWARE OF. ONE OF THOSE FACTS IS THAT WE, OF COURSE, ARE FACING A DEVASTATING BUDGET UTLOOK HERE AT THE COUNTY. WE HEARD A LITTLE ABOUT THAT IN PUBLIC COMMENT, WE'LL HEAR MORE IN THE COMING WEEKS. SECOND, THAT, AND THIS IS SOMETHING THAT THE DEPARTMENT MENTIONED, AND IS INCLUDED IN THE REPORT, THE REALITY THAT THERE AREN'T TANGIBLE BUDGETARY SAVINGS ASSOCIATED WITH THESE KIND OF INVESTMENTS THAT CAN BE REDIRECTED TO FINANCE A COUNTY INVESTMENT IN THESE PROGRAMS. THAT'S NOT, HOWEVER, TRUE FOR EVERY ENTITY THAT MAY BE INVOLVED. IN PARTICULAR, FOR OUR MEDI-CAL MANAGED CARE PLANS, THERE ARE SAVINGS IN HEALTH COSTS AVOIDED THAT ACTUALLY ARE TANGIBLE SAVINGS FOR THOSE PLANS. AND SO ONE OF MY CONCRETE RECOMMENDATIONS TO THE BOARD, NOT A RECOMMENDATION FROM THE DEPARTMENT, BUT ONE OF MY RECOMMENDATIONS TO THE BOARD IS THAT WE URGE THE THREE MEDI-CAL MANAGED CARE PLANS IN OUR COUNTY, ANTHEM AND KAISER, TO HEAR PRESENTATION ON THIS SPECIFICALLY. AND O SPECIFICALLY CONSIDER N APPROPRIATE LEVEL OF INVESTMENT BECAUSE THOSE PLANS, WHILE NOT REALIZING THE FULL ECONOMIC BENEFITS OF THESE INVESTMENTS, WILL HAVE TANGIBLE SAVINGS IN HEALTH COSTS AVOIDED THAT WILL BE BANKABLE SAVINGS FOR THEM IN A WAY THAT IS NOT TRUE FOR THE COUNTY BUDGET. I SUGGEST THAT BECAUSE I BELIEVE THAT'S A VERY CONCRETE STEP THAT THIS BOARD COULD TAKE THAT CAN MOVE THINGS FORWARD, ACTUALLY IDENTIFY NEAR TERM FISCAL OPPORTUNITIES, TO MAKE THE INVESTMENTS THAT WE NEED AND DO SO IN A WAY

AND WITH ENTITIES THAT ACTUALLY HAVE A RETURN ON THAT INVESTMENT THAT'S REFLECTED IN THE RESEARCH THAT HAS BEEN BROUGHT FORWARD. I WANTED TO SHARE THOSE THOUGHTS BEFORE WE TURNED TO THE QUESTIONS. THAT'S MICRON CREATE RECOMMENDATION FOR -- MY RECOMMENDATIONS.

>> I SEE A COUPLE OF LIGHTS?

>> CAN WE ASK ONE CLARIFYING QUESTION REGARDING YOUR SESSION, JAMES. IT'S EXCELLENT AND I'M CURIOUS IF IT'S NEWS TO YOU, IF YOU HAVE ALREADY REACHED OUT TO TO THOSE ENTITIES?

>> I WILL SEE IF MY COLLEAGUES HAVE ANYTHING TO ADD. I CAN SAY THAT FAMILY HEALTH PLAN DID SEND MEMBERS TO THE GROUP THAT PARTICIPATE IN THE STUDY. SO THEY COULD BE CONTRIBUTING WHAT THEY KNEW ABOUT THE INFRASTRUCTURE THEY WERE ATTEMPTING TO BUILD AND LEARNING IN REALTIME AS WE WERE GATHERING THE INFORMATION. SO THERE IS EARLY ENGAGEMENT WITH THEM. I WILL ALSO SAY THAT PART OF THE CAL AIM RELATED CHANGES THAT HAVE COME TO LIGHT NOW REQUIRE MANAGED CARE PLANS TO MAKE CERTAIN REINVESTMENTS THAT MUST ALIGN WITH THE LOCAL COMMUNITY HEALTH ASSESSMENT WHICH IN OUR CASE IS THE LATINO HEALTH ASSESSMENT. THERE IS, IN ADDITION TO BOTH DIRECTION WE MADE HERE FROM THE BOARD OR ECOMMENDATIONS OF MR. WILLIAMS, A REGULATORY REQUIREMENT TO INVEST BACK IN THE COMMUNITY BY OUR MANAGED CARE PLANS AND TO DO SO IN ALIGNMENT WITH THE FINDINGS OF LATINO HEALTH ASSESSMENT.

>> THAT'S FASCINATING. I'M THINKING ABOUT THE MODEL WE CREATED WITH THE COMMUNITY ON THE BLACK INFANT HEALTH ON GETTING THE PROVIDERS TO TALK ABOUT THE ATA AND USING THOSE RELATIONSHIPS, WE CAN CONTINUE TO BUILD. I WILL SAVE THE REST FOR AFTER PUBLIC COMMENT. THANK YOU.

>> LET'S OPEN UP TO PUBLIC COMMENTS. HOW MANY CARDS O WE HAVE TO SPEAK?

>> WE HAVE NINE CARDS IN CHAMBERS. AND FOUR HANDS RAISED ON ZOOM. FIVE, SIX. WE HAVE THE HANDS GROWING. CURRENTLY HAVE SEVEN HANDS RAISED ON ZOOM.

>> LET'S DO ONE MINUTE EACH.

>> THAT'S 16.

>> CLOSE THE CUE.

>> WE WILL BEGIN WITH IN CHAMBER SPEAKER CARDS. I WILL BEGIN WITH THE FIRST FEW NAMES. I HAVE HINAY, MONICA, DOMINESE, TONY ROMERO, MEGAN GOOD GOODE HUGH. WE'LL PAUSE THERE.

>> [SPEAKING SPANISH]

>> WE NEED TO DO THE TRANSLATION.

>> GOOD MORNING. I'M AMY GONCALVES. I'M A PROMOTOR. PROMOTOR SHARE A CONFIDENT PROMOTOR IS OUR SHARING CULTURE AND EXPERIENCE AND LANGUAGE AMONG THE COMMUNITY. WE ARE IN CHARGE OF HAVING OF SHARING EQUITY AND ALSO WE ARE GIVING ACCESS TO HOUSING INPUT. DUE TO THE LACK OF SUPPORT IN THE NETWORK. THAT'S WHY I'M HERE TO ASK THE BOARD TO GIVE US SUPPORT FOR CARRYING OUT THIS FACILITY STUDY. THANK YOU.

>> [SPEAKING SPANISH]

>> GOOD MORNING. I'M MONICA. I BELONG [INDISCERNIBLE]. BESIDES GIVING ACCESS, OUR ROLE IS VITAL TO KEEP ACCESS TO THE COMMUNITY. PUBLIC SERVICES THAT GENERALLY SPEAKING ARE VERY COMPLEX. ALSO, WE ARE PROVIDING THE SERVICES TO VERY DEVASTATED COMMUNITIES. THAT'S WHY WE ARE HERE BEFORE THE BOARD TO ASK THE SUPPORT FOR THE FACILITY STUDY. THANK YOU.

>> [SPEAKING SPANISH]

>> TRANSLATOR: GOOD MORNING, I BELONG IN THE EAST OF SAN JOSE. BESIDES BEING A CULTURAL PILLAR, WE ARE PILLARS FOR ECONOMY AND ALSO RESILIENCE. WE ARE HELPING FAMILIES IN VERY DIFFICULT MOMENTS OF THE PANDEMIC AND ALSO RECESSION. AND MOMENTS LIKE THIS, OUR COMMUNITIES ARE BEING ATTACKED. WE ARE HERE TO ASK YOUR SUPPORT FOR HAVING THIS STUDY IN ORDER TO MAKE MORE INVESTMENTS IN PROMOTORS AND ALSO TO GUARANTEE THE PROGRESS OF THIS FIELD AND NOT ONLY HAVE CYCLES. THANK YOU VERY MUCH.

>> GOOD MORNING. MY NAME IS TONY. I'M THE CODIRECTOR WITH LUNA, LATINO TINAS UNITED FOR A NEW AMERICA. OUR WORK IS FOCUSED ON THE NEIGHBORHOOD. I AM HERE TO SHARE THE IMPORTANCE AND IMPACT PROMOTORS HAVE IN THE COMMUNITY OUTREACH WORK. WE HAVE WORK IN THE CITY, THE DEPARTMENT OF TRANSPORTATION AND OTHER AGENCIES THAT WANT US TO CONDUCT COMMUNITY OUTREACH. THE CAMPAIGN HAS BEEN SUCCESSFUL BECAUSE OF THE PROMOTORS BEENGAGING RESIDENTS, COLLECTING DATA THAT HELPS WITH THE PROJECT. THIS AGENCY RECOGNIZES THE IMPORTANT OF THE PROMOTORS AND THE WORK THEY DO. I THANK THEM FOR INCLUDING THEM IN THE STUDY. WE SUPPORT THE RECOMMENDATIONS. THANK YOU FOR YOUR TIME.

>> THANK YOU. I WILL CALL THE REMAINER SPEAKER CARDS. WE HAVE GABRIELLE. WE HAVE A DRARIA GREEN AND SAUL RAMOS.

>> I'M WITH PARENTS HELPING PARENT. I WANT TO THANK PUBLIC HEALTH FOR INCLUDING US. WE VALUE THE PARTNERSHIP AND LOOK FORWARD TO CONTINUED COLLABORATION. WE ARE ENCOURAGED TO SEE DISABILITY SERVICES INCLUDED IN THE RECOMMENDATIONS, ESPECIALLY TRAINING FOR COMMUNITY HEALTH WORKERS ON SUPPORTING CHILDREN WITH DISABILITIES. THERE IS A GAP, BUT THERE IS NO FUNDING FOR DISABILITY SERVICES. THIS WORK MAY NOT REACH THE SCALE NEEDED. WE URGE THE COUNTY TO ADDRESS THIS. THISTLES ABOUT PREVENTION. WHEN FAMILIES AREN'T CONNECTED EARLY TO SERVICES, CHILDREN WITH DISABILITIES FACE HIGHER RISKS OF SCHOOL DISENGAGEMENT AND INVOLVEMENT IN THE JUVENILE JUSTICE SYSTEM. IT THEY ARE TRUSTED MESSENGERS IN PLAYING A KEY ROLE IN CONNECT CONNECTING TO FAMILY SUPPORT. THANK YOU.

>> [SPEAKER AWAY FROM MIC] -- [SPEAKING SPANISH]

>> TRANSLATOR: GOOD MORNING. I'M THE PRESIDENT OF MY ASSOCIATION WHICH IS THE VERY LOW RESOURCE ASSOCIATION WHICH IS IN NEED OF PROMOTORS ALWAYS. WE ARE SUPPORTING AND WORKING AND I MYSELF HAVE BEEN PROMOTOR. IT'S VERY EVIDENT WE ARE IN NEED OF THIS. WE ARE GIVEN SUPPORT HE TO THE FAMILIES BECAUSE OF LANGUAGE AND THEY DON'T KNOW WHAT ARE THE SERVICES AVAILABLE. AND BECAUSE OF THE HIGH CRIMINALLALITY ISSUES WE HAVE. THAT'S WHY WE WANT YOU TO SUPPORT THESE TYPE OF PROGRAMS AND WE ARE COMMITTED AS AN ASSOCIATION AND COMMUNITY TO SUPPORT THE PROGRAM TOGETHER AS ONE COMMUNITY. WE WANT TO HAVE EQUITY, RESPECT AND COMMUNICATION AND WE WANT OUR VOICE TO BE HEARD. SO PLEASE SUPPORT THIS PROGRAM. THANK YOU VERY MUCH.

>> GOOD MORNING. I'M A COMMUNITY ORGANIZER. WE ARE PART OF THE COMMUNITY VIOLENCE PREVENTION ACTION WITH THE COUNTY PUBLIC HEALTH DEPARTMENT. WE WORK IN THE NEIGHBORHOOD. WE REVIEWED THE FEASIBILITY STUDY ON PROMOTORS AND COMMUNITY HEALTH WORKERS. I WANT TO HIGHLIGHT THE REAL IMPACT. THE COUNTY AND CITY OF SAN JOSE AND OTHER AGENCIES, WE HAVE SEEN THE OUTREACH BECAUSE PROMOTORS CREATE TRUST. IF WE WANT TO HAVE CONTINUED ENGAGEMENT, WE HAVE TO CONTINUE TO INVEST IN PROMOTORS. WE SUPPORT THE RECOMMENDATION, ESPECIALLY THREE, ESTABLISHING THE COMMUNITY HEALTH WORKER AND YOUTH SERVICES, CHRONIC DISEASE WORK AND ENSURING FOR PAY THAT REFLECTS LOCALLY IN THE REALITY. THANK YOU.

>> GOOD MORNING. DARCY GREEN. WE ARE EXCITED TO BE A PART OF THIS WORK GROUP. WE ARE ENCOURAGING THE RECOMMENDATIONS. WE BUILT A PIPELINE OF CLIENT TO PROMOTOR AND COMMUNITY HEALTH WORK. WE HAVE COME OUT OF THE 18 MONTH PROCESS OF BUILDING THE MEDI-CAL. WE ARE DOING THIS WORK EVERY DAY. BUT THE SYSTEM TO SUSTAIN T ARE STILL TOO DIFFICULT. WE ARE HELPING TO LEAD A OHORT OF NONPROFITS PROVIDING A SHARED HEALTHCARE RECORD TO MAKE IT MORE POSSIBLE AT SCALE AND TO ACCESS BILLING FOR CBOs AND CREATE COST SAVINGS EFFICIENCIES AND CREATE A INFRASTRUCTURE. WE WANT TO ECHO THE COMMENTS AROUND SETTING UP FINANCIALLY. BECAUSE THEY BENEFIT FROM THIS WORKFORCE. IN REGARD TO PAY EQUITY, WE BECAME UNIONIZED.

>> GOOD MORNING, SUPERVISORS. THANK YOU FOR HE DEPARTMENT FOR DOING THE WORK, THE COUNTY HAS DONE THE WORK AND PROMOTORRINGS DO THE WORK. WE ARE HERE IN SUPPORT OF THE STUDY, PROMOTOR FEASIBILITY STUDY. WE HAVE CLEAR EVIDENCE THAT PROMOTORS ARE ONE OF THE MOST EFFECTIVE WAYS TO REACH COMMUNITIES. THAT'S VERY CLEAR TO US. THE OPPORTUNITY THAT WE HAVE AHEAD OF US IS TO ADDRESS THE A FRAGMENTED SYSTEM INCONSISTENT REIMBURSEMENT.O HAVE MEDI-CAL- YOU HEARD WHAT IT DOES FOR FAMILIES. THE ALIGNMENT OF SERVICES, ADDRESSING BARRIERS, ADDRESSING CONCRETE NEEDS. AS WE LOOK AT SHORT TERM RESULTS, WE NEED TO OOK AT THE FUTURE. ANCHORING THIS WORK IN A POTENTIAL ALIGNMENT WITH A CHILDREN AND YOUTH MASTER PLAN. WE ARE LOOKING AT A SCALABLE PLAN THAT COULD IMPACT ANY AREAS OF YOUR WORK. WE ARE ASKING FOR YOUR SUPPORT AND LOOK AT CREATIVE WAYS FOR SANTA CLARA TO BE A LEAD IN THIS.

>> WE'LL MOVE TO OUR ZOOM SPEAKERS. ONE MOMENT. OUR FIRST ZOOM SPEAKER IS BARBARA. PLEASE ACCEPT THE UNMUTE.

>> OKAY. GOOD MORNING. I'M WITH THE HEALTH CLINIC OF SANTA CLARA COUNTY. I SPEAK IN SUPPORT OF THE COUNTY ESTABLISHING A PROMOTOR PROGRAM. I AM A PROMOTOR. [INDISCERNIBLE] SINCE 2021. ALSO TO PROVIDE THE MANAGEMENT CLASSES. SINCE THAT TIME I HAVE WITNESSED THE IMPROVEMENT OF HUNDREDS OF PATIENTS AS A RESULT OF THE EDUCATION. AS CHW, MY INTERACTION OF PATIENT, PLANNING HOW TO PREPARE FOR DOCTORS' APPOINTMENTS AND THE CLINIC AND APPROPRIATE FOR EACH ONE. THESE PATIENTS HAD TO SCHEDULE APPOINTMENTS WITH A SPECIALISTS. REMINDING PATIENTS ABOUT THE GAPS --

>> THANK YOU. OUR NEXT SPEAKER IN THE CUE IS VAUGHN. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING, PRESIDENT LEE AND MEMBERS OF THE BOARD. I'M HERE TO VOICE OUR STRONG SUPPORT FOR EXPANDING THE PROMOTORS IN THE COUNTY. IT'S A COMMUNE CAN I ROOTED WORKFORCE. THEIR ROLE DURING COVID-19 OUTREACH AND IN THE PUSH TO FOLKS INTO MEDI-CAL DEMONSTRATINGS THEIR URGENT NEEDS. OUR APCHIW NETWORK ALLOWS US TO REACH COMMUNITIES TO LINK THEM WITH RESOURCES, EDUCATION AND GET THEM CONNECTED WITH OUR SERVICES. BY SCALING UP THESE PROGRAMS, THIS APPROACH COULD ESTABLISH THE FOUNDATION FOR AN INTEGRATED COUNTY HEALTH WORKER ETWORK THAT MR. LEAD O IMPROVED HEALTH OUTCOMES AND MEASURABLE COST SAVINGS. THANK YOU.

>> THE NEXT SPEAKER IS DOLORES. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING. MY NAME IS DOLORES. I'M SPEAKING AS A MEMBER OF THE GOVERNING BOARD OF SANTA CLARA FAMILY HEALTH PLAN. I WANT TO START OUT WITH A COMMENT, I'M PRIVILEGED TO START MY CAREER AS A COMMUNITY HEALTH WORKER 50 YEARS AGO, THIS IS A WONDERFUL EVENT THIS MORNING. COMMUNITY HEALTH PARTNERSHIP IS IN FULL SUPPORT OF THIS INITIATIVE. I AM RESPECTFULLY RECOMMENDING THAT ONE OF THE NEXT STEPS SHOULD BE YET ANOTHER MEETING WITH THE THREE HEALTH PLANS, VALLEY, SANTA CLARA VALLEY HEALTH PLAN, ANTHEM/BLUE CROSS. THE FUNDING OF THE PROGRAM REALLY RELIES ON TRULY UNDERSTANDING WHAT THE COMPLEXITY IS OF MEDI-CAL AND HOW THEY SUPPORT COMMUNITY HEALTH WORKERS, WHICH ACTIVITIES. TOOK ME A YEAR TO LEARN THAT, BY THE WAY. I BELIEVE THAT THIS COULD RESULT IN A STRONG PARTNERSHIP.

>> THANK YOU FOR YOUR COMES. NEXT SPEAKER IN THE CUE IS JEREMY B. PLEASE ACCEPT THE UNMUTE.

>> GOOD MORNING, BOARD OF SUPERVISORS. I'M WITH THE CENTER FOR JUSTICE AND EMPOWERMENT. WE ARE IN FULL SUPPORT OF FEASIBILITY STUDY. WE ARE PROUD TO PARTNER WITH THE DEPARTMENT OF PUBLIC HEALTH TO PROVIDE INPUT DURING THE COMMUNITY ENGAGEMENT PERIOD. AND PROMOTORS ARE VITAL BECAUSE THEY SERVE AS TRUSTED CULTUREA LY IAISONS BETWEEN MARGINALIZED COMMUNITY AND HEALTH SERVICES. THEY PROVIDE EDUCATION, COORDINATING CARE, NAVIGATING SYSTEMS AND BRIDGING GAPS IN EQUITY. MORE IMPORTANTLY, THEY MEET THE COMMUNITY WHERE THEY ARE AT. DURING COVID WE SAW THE POWER OF PROMOTORS IN GETTING OUR IMMIGRANT COMMUNITY TESTED AND VACCINATED AND ENSURE A HEALTHIER SANTA CLARA COUNTY LET US INVEST IN THE PROMOTOR MODEL. THANK YOU.

>> THE NEXT SPEAKER IS CARMEN MARTINEZ. PLEASE ACCEPT THE UNMUTE.

>> MY NAME IS CARMEN. WE SEE THE UPPER AND LOWER PROMOTORS IN OUR COMMUNITY BY GIVING BACK. THEY ARE TRUSTED COMMUNITY MEMBERS WHO PROVIDE EDUCATIONAL WORKSHOPS. HERE T LCC THEY ARE ON CANCER WHICH ARE USED AS A PREVENTATIVE TOOL. THANK YOU FOR THE REPORT THAT IS GIVEN TODAY AS IT HIGHLIGHTS CRUCIAL RECOMMEND AGINGS THAT HELP US PAVE THE WAY WITH THE APPROACH WE ARE TAKING FOR OUR PROMOTORS MODELS. WE WANT AND WE MUST CONTINUE TO COLLABORATE TO BE ABLE TO REDUCE ANY BARRIERS TO EQUITABLE AND ACCESSIBLE HEALTHCARE SYSTEM. THE WORK OF OUR PROMOTORS IS COMPLEMENTARY AND HELPS BRIDGE THE GAP. IT IS ESSENTIAL THAT WE CONTINUE TO INVEST IN IN THE PROMOTORS MODELS, WE ARE INVESTING IN COMMUNITIES. THANK YOU TO THE PROMOTORS WHO HAVE TAKEN THIS CRUCIAL ROLE AND WE LEARN TO IMPROVE OUR SAFETY NET PROGRAMS HERE.

>> THE NEXT SPEAKER IN THE CUE, MAYRA. PLEASE ACCEPT HE UNMUTE. YOU MAY BEGIN.

>> THANK YOU. I'M HERE ON BEHALF OF COMMUNITY HEALTH PARTNERSHIPS. CHP HAD THE OPPORTUNITY TO WORK WITH THE PUBLIC HEALTH DEPARTMENT STAFF ON THIS PROJECT. ONE POINT WAS VERY CLEAR. COMMUNITY HELD WORKERS, CHWs ARE DOING CRITICAL WORK OFTEN WITHOUT THE LEVEL OF INVESTMENT NEEDED TO SUSTAIN IT. AS MENTION IN THE RECORD, MEDI-CAL REIMBURSEMENT DOES NOT COME CLOSE TO COVERING THE COST AND TRUE VALUE. NOT ALL ARE ELIGIBLE FOR THE REINVESTMENT. WE NEED TO BUILD A PROGRAM THAT IS STABLE, WELL RESOURCED AND ROOTED IN THE COMMUNITIES SERVED. WE URGE YOU TO COMMIT IN INVESTING IN THEM TO UPLIFT THE WORK OF THE COMMUNITY WORKFORCE. FOR OVER A DECADE CHW HAS WORKED ALONG SIDE ON CHRONIC DISEASE PREVENTION. WE HAVE SEEN THAT THIS WORK IS NOT SUPPLEMENTAL, BUT ESSENTIAL AND WE KNOW FOR A FACT THE CHW.

>> THANK YOU. OUR LAST SPEAKER WHO HAD THEIR RAND RAISED AT THE CALL OF THE CUE, SHARON LUNA.

>> GOOD MORNING. I'M FROM THE SAN MARTINE ASSOCIATION. I'M SPEAKING ON BEHALF OF THE PROMOTORS. IT'S ONE OF THE MOST IMPRESSIVE PROGRAMS I HAVE SEEN IN THE SOUTH COUNTY. THE INTERACTIVE COMMUNITY MEETINGS AND PUTTING A START TO HEARING WHAT FUTURE ENERATIONS WANT TO SEE. OUR YOUTHS NEED HELP. HEALTHY COOKING, ACTIVE SPORTS PARTICIPATION AND ACTUALLY LISTENING TO WHAT THEIR CONCERNS AND FOR US TO ACT ON IN A TIMELY, ACCURATE MANNER. THE PROMOTORS THAT WE HAVE ARE WONDERFUL. YOU CAN SEE THAT THEY HAVE THE DEDICATION FOR THEIR COMMUNITY. AND THEY TELL WHAT SERVICES ARE AVAILABLE. SAFER YOUTH ACTIVITIES AFTER SCHOOL, HELP WITH TUTORING AND ACADEMIC CHALLENGES. PLEASE SUPPORT THE PROMOTORS.

>> THAT CONCLUDES OUR SPEAKERS FOR ITEM 17.

>> THANK YOU VERY MUCH. WE'LL CLOSE THE PUBLIC SPEAKING PORTION AND LET ME SEE IF MY COLLEAGUES HAVE ANY COMMENT. A COUPLE OF LIGHTS.

>> THANK YOU. FIRST OF ALL, I WANT TO THANK YOU FOR AKING THIS VERY COMPREHENSIVE STUDY AND PRESENTING IT IN A WAY THAT REALLY MAKES SENSE, NOT ONLY JUST TO US AS BOARD MEMBERS, BUT TO OUR SYSTEMS AND OUR COMMUNITY. OBVIOUSLY, WE HEARD LOUD AND CLEAR FROM OLKS HOW IMPORTANT PROMOTORS ARE. THEY NOT ONLY HAVE A CULTURALLY INCLUSIVE ADVOCACY ROLE BUT THEY HAVE A MEDICAL PARTNERING ROLE AND PREVENTION ROLE. WE HAVE SEEN IT TIME AND TIME AGAIN HOW CRUCIAL PROMOTORES HAVE BEEN. WHEN I WAS A COUNCILMEMBER FOR THE CITY OF SAN JOSE AND THERE WAS A CENSUS THAT WAS BEING DONE, WE KNEW THAT THERE WAS AN ATTEMPT BY ADMINISTRATION TO UNDERCOUNT PEOPLE. AND THE PROMOTORES ESPECIALLY ELEVATED THEMSELVES AND WERE CRUCIAL DURING THAT TIME BECAUSE IT WAS PANDEMIC AND IT WAS JUST A LOT OF THINGS, A LOT OF FACTORS THAT WOULD RESERVE PEOPLE'S INTERACTION WITH ONE ANOTHER, LET ALONE THE IMMIGRATION PIECE. AND WE CALLED ON THEM AND THEY CAME OUT AND REALLY HELPED US NOT LOSE, NOT ONLY JUST COUNT THE PEOPLE WHO REALLY ARE HERE AND ACKNOWLEDGE THEM, BUT THAT ALSO TRANSLATES INTO FUNDING OR OUR LOCAL AREA. AND THEN, OF COURSE, DURING THE PANDEMIC, AS A COUNCILMEMBER FOR THE VERY FIRST TIME OUR CITY COUNCIL INVEST IN PROMOTORES IN THIS FRAMEWORK BECAUSE WE UNDERSTOOD THAT THERE WAS -- WE NEEDED TO HAVE CULTURALLY RESPONSIVE MEMBERS OF THE COMMUNITY TO CONNECT WITH FOLKS IN A WAY THAT HAS ALREADY SOME BUILT-IN TRUST IN THE RELATIONSHIP, THAT CARRIES THEM VERY, VERY FAR IN TERMS OF THE MESSAGING FOR THEM AT HIS POINT DURING THE PANDEMIC IT WAS ABOUT IMMUNIZATIONS, IT WAS ABOUT HEALTH AND SAFETY, HOW TO CONTINUE TO BE SAFE AND WORK OUT IN THE COMMUNITY BECAUSE A LOT OF FOLKS WERE ACTUALLY IN PERSON AND NOT LIKE MANY OF US WHO WERE ABLE TO STAY AT HOME AND HAVE THE SAFETY OF OUR HOMES TO PROTECT US. THEY RISKED THEMSELVES TO BE ABLE TO ACCOMPLISH WHAT WE NEEDED AT THAT TIME. AND SO WE ARE TAPPING ON THEM ONCE AGAIN TO RESPOND TO THIS CRISIS. AND WE ALREADY ACKNOWLEDGED THAT THE LATINOS IN THIS COMMUNITY ARE EXPERIENCING A CRISIS. YOU REITERATED AND TALKED ABOUT THE OVERDOSE RATE THAT EXISTS IN OUR COMMUNITY, THE TEEN PREGNANCY. I'M GOING TO INCLUDE, YOU DIDN'T SAY THIS, BUT THE TWO YEARS LESSER LIFE SPAN THAN COUNTERPARTS. THE INCREASE OF SUICIDE RATE. THERE IS JUST SO MUCH THAT IS HAPPENING TO THE LATINO COMMUNITY. WE HAVE SEEN IT HAPPEN SINCE, I MEAN, IT JUST HAS BEEN CHRONIC. SO CHRONIC THAT I THINK THIS SYSTEM ASN'T REALLY BEEN ABLE TO ADDRESS IT IN AN EQUITABLE AND PRIORITY WAY. BECAUSE LATINOS OVERWHELM OUR SYSTEM. THE MAJORITY ARE IN OUR SYSTEMS THAT TAKE A LOT OF INVESTMENT LIKE OUR CHILD WELFARE, LIKE OUR PROBATION, LIKE OUR EDI-CAL, LIKE OUR HEALTH AND HOSPITALS. AND THAT IS TELLING US A MESSAGE. IT'S TELLING US NOT O WAIT UNTIL THINGS GET REALLY TOUGH. IT'S TELLING US TO CONTINUE O INVEST IN A WAY THAT MAKES SENSE WITH OUR COMMUNITY. AND THIS IS ONE OF THE WAYS IT DOES. IT IS RESPONSIVE NOT ONLY TO THE LATINO HEALTH ASSESSMENT AND ALL THE ISSUES YOU ALL ELEVATED IN THE STUDY, BUT IT ALSO ADDRESSES THE ISSUES THAT ANOTHER STUDY THAT WAS BY THE PUBLIC HEALTH DEPARTMENT, THIS IS THE COST OF GUN VIOLENCE. RIGHT? AND THE VIOLENCE PREVENTION INITIATIVE THAT SUPERVISOR ELLENBERG AND I SUPPORTED. THIS IS LAYERED. THIS APPROACH ADDRESSES A LAYER OF STUDIES AND ISSUES THAT WE WANT TO MAKE SURE THAT WE SHIFT AND REATE, THAT WE HAVE TRANSFORMATIVE CHANGE. BUT WE CAN'T JUST STOP MIDWAY. WE CAN'T JUST TAP THE SHOULDERS OF THOSE PROMOTORES AND ASK THEM TO RISK THEIR HEALTH AND WELLBEING BY NOCKING ON DOORS THEY DON'T KNOW, BY USING FACE MASKS, BUT BEING IN THE PANDEMIC, OR DURING THE CENSUS WHEN THAT ADMINISTRATION IS TRYING TO LOWER THE CENSUS COUNT SO WE HAVE LESS FUNDING IN OUR AREA. AND NOW IMMIGRATION. WHEN WE ARE BEING PERSECUTED. LATINOS ARE BEING PERSECUTED, THAT IS ONE CRISIS ON TOP OF ANOTHER ON TOP OF ANOTHER. WE CONTINUE TO TAP ON PROMOTORES. YET, WE SAY WE CAN'T JUST INTEGRATE THEM INTO OUR SYSTEM AS ART OF THE SOLUTION. SO WHEN IS THE RIGHT TIME TO ACTUALLY INTEGRATE A FRAMEWORK THAT CONTINUES TO WORK ON OUR COMMUNITY, THAT CONTINUES O BE THE ANSWER CULTURALLY, RESPONSIVELY, AND NOT ONLY THAT, BUT FISCALLY. WE HAVE SEEN THAT NOT ONLY ARE THERE CULTURAL OUTCOMES, BUT THERE IS CLINICAL OUTCOMES THAT COME WITH THIS, RIGHT? IT'S AN AVOIDED FUTURE ER VISITS THAT WE KNOW ARE VERY EXPENSIVE. OR HOSPITALIZATION BECAUSE THERE IS LACK OF DISEASE MANAGEMENT CARE. AND YET THESE FOLKS ARE BEING UNDERPAID AND NOW REALLY UNDERVALUED BECAUSE WE ARE NOT INTEGRATED THEM IN A WAY THAT MERITS THEIR CONTRIBUTION AND THEIR ROLE IN THIS CRISIS. I CONTINUE TO CALL IT CRISIS BECAUSE WE HAVE ALREADY ESTABLISHED IT AS A CRISIS. YET WE HAVE NOT ESPONDED TO THE LATINO HEALTH ASSESSMENT, THE OUTCOMES THAT WE HAVE ALREADY DECLARED ACKNOWLEDGED. WE HAVE NOT RESPONDED IN A WAY. THIS SYSTEM HAS NOT RESPONDED IN A CRISIS MODALITY. WHICH IS BEING QUICK TO LOOK AT SOME OF THE SYSTEMS THAT CAN BENEFIT US IN THE LONG TERM, TO FIGURE OUT WHAT IS IT THAT WE CAN ACTUALLY DO. WE HAVE BEEN DRAGGING OUR FEET. AND I HAVE GOT TO SAY THAT THIS IS ABSOLUTELY JUST FRUSTRATING AS A LATINO LOUISIANA -- LATINA. I HAVE FOLKS I HAVE GROWN UP WITH. THIS IS MY COMMUNITY, BUT ALSO YOUR COMMUNITY. THIS IS OUR COMMUNITY. IT DOESN'T MATTER WHETHER YOU ARE A LATINA OR NOT. EACH HEALTH ASSESSMENT THAT HAS BEEN DONE PREVIOUS TO THE LATINO HEALTH ASSESSMENT HAS RENDERED A CONCRETE SOLUTION FOR THOSE MEMBERS OF THAT ETHNIC GROUP. AND YET LATINOS CONTINUE TO WAIT. THIS IS THE FOURTH YEAR. MY FOURTH YEAR. AND I REALLY NEED TO SEE THAT WE ARE -- I WILL ASK MY COLLEAGUES WITH ME, AND I KNOW THEY HAVE BEEN ABSOLUTELY SUPPORTIVE IN THE PAST, I NEED US TO BE RESPONSIVE WITH THE WAY THAT WE CONTINUE TO INVEST IN THE LATINO COMMUNITY. THIS IS JUST ONE SEGMENT OF IT. WHEN WE ARE IN TROUBLE, WE TAP ON HAT SHOULDER OF THE PROMOTORES AND I DON'T WANT TO GET INTO ANOTHER CRISIS -- WE ARE ALREADY IN A CRISIS. WHAT OTHER CRISIS ARE WE GOING TO WAIT FOR SO THAT WE CAN FINALLY INTEGRATE A FRAMEWORK THAT WE KNOW HAS BEEN CLINICALLY PROVEN, FISCALLY E KNOW IT MAKES SENSE FOR SOME, NOT COMPLETELY FOR ALL OF THE FRAMEWORKS, YOU ARE GIVING US A SPECIFIC PATHWAY IN TERMS OF WHERE IT BENEFITS, BUT IT DOES HAVE A BENEFIT, A RETURN FOR OUR INVESTMENT. AND THOSE RETURNS OF INVESTMENT, WE CAN'T EVEN PUT INTO WORDS. YOU CAN'T PUT A PRICE ON LIFE, ON THE WELLBEING OF PEOPLE AND THE AVOIDANCE OF THEIR INVOLVEMENT IN OUR SAFETY NET SERVICES, WHICH IS ULTIMATELY WHAT WE WANT. I DON'T WANT TO SEE LOTTO KNOWS -- LATINOS IN OUR SAFETY NET SERVICES. I WANT THEM SUPPORTED TO WE CAN CONTINUE TO WORK WITH THEM WHERE THEY ARE AT. SO THOSE ARE MY COMMENTS. BUT WHAT I WAS HOPING THAT I COULD GET FROM YOU, JAMES, IS YOUR APPROACH IS TO HAVE A PRESENTATION, HOPEFULLY A BUY-IN FROM THE MEDICAL MANAGED PLANS SO THEY CAN HAVE THAT LEVEL OF INVESTMENT. WHAT IS THAT TIMELINE THAT YOU ARE THINKING ABOUT?

>> SURE. LET ME BE MORE CONCRETE. MY SUGGESTION IS THAT WE MOVE FORWARD WITH THE RECOMMENDATIONS EMBODIED IN THIS REPORT INCLUDING THAT INFRASTRUCTURE THAT WOULD PRESUMABLY BE HOSTED AT THE COUNTY THAT'S THE BACK END INFRASTRUCTURE TO SUPPORT EXACTLY THE KIND OF INVESTMENT THEY ARE TALKING ABOUT THAT WOULD BECOME A PERMANENT BACKBONE INFRASTRUCTURE. AND THAT WE SEEK FUNDING FROM THE THREE MEDI-CAL MANAGED CARE PLANS TO FINANCE THAT ALONG WITH DIRECTED FUNDING TO SUPPORT THE PROMOTORES THEMSELVES. AND HAVE THE MEDI-CAL PLANS FUND THAT. I WANT TO BE CLEAR ABOUT ONE THING. THERE IS CONVERSATION ABOUT THE BILLING COMPONENT. ONLY A PORTION OF THE SERVICES THAT WE ARE TALKING ABOUT ARE DIRECTLY BILLABLE. WHAT I'M REFERRING TO ABOUT THE PLANS ISN'T JUST THE BILLING COMPONENT. IT'S AN ACTUAL DIRECT GRANT SUPPORT AS DR. REDMOND SAID THROUGH THE INVESTMENT REQUIREMENTS THAT THE PLAN IS REQUIRED TO MAKE. IT'S NOT LIMITED TO THOSE SERVICES THAT ARE BILLABLE. BUT ACTUALLY THE FULL SUPPORT FOR THE PROGRAM IN TS ENTIRETY. I THINK THAT THE TIMELINE FOR THOSE INVESTMENTS COULD BE QUITE RAPID. IT SOUNDS LIKE FROM JUST THE PUBLIC COMMENTS ON THIS ITEM TODAY, AT LEAST TWO OF THE GOVERNING BOARD MEMBERS OF SANTA CLARA FAMILY HEALTH PLAN ARE SUPPORTIVE. I'M CONFIDENT THERE. BUT I DO BELIEVE IT'S IMPORTANT FOR THERE TO BE PROPOSSESSIONAL INVESTMENT FROM THE OTHER TWO PLANS AS WELL. I DON'T THINK KAISER AND NTHEM SHOULD BE OFF THE HOOK. THEY HAVE FEWER MEMBERS. PROPOSSESSION YACHT IS FINE -- PROPORTIONATE IS FINE. WE NEED TOE PUT FIRE UNDER THEM TO STEP UP TO THE PLATE AS WELL. THAT INVESTMENT CAN BE TIMELY. I DON'T HINK -- I DON'T MEAN LIKE PRESENTING TO THEM AND HAVING SOME LONG CHITCHAT. WE KNOW THE CONCRETE INVESTMENT THAT NEEDS TO BE MADE. I THINK OUR ASK IS SIMPLE TO ANTHEM AND KAISER IN PARTICULAR WHICH IS THAT THEY SHOULD MAKE A PROPORTIONATE INVESTMENT RELATIVE TO THE TOTAL NUMBER OF MEDI-CAL MEMBERS THEY HAVE TO WHAT SANTA CLARA FAMILY HEALTH PLAN WILL BE MAKING.

>> I APPRECIATE THAT. I'M GOING TO MAKE A MOTION TO ACCEPT THE REPORT. I WILL INCLUDE TO ASK ADMINISTRATION TO DIRECT ADMINISTRATION TO COORDINATE A PRESENTATION/MEETING WITH THE MEDICAL MANAGED PLANS AND PRESENT OPTIONS FOR INVESTMENT. I'M ALSO GOING TO ASK FOR ADMINISTRATION TO EXPLORE WORKING WITH AN AGENCY SUCH AS SOBRATO TO SERVE AS A FISCAL SUPPORT THAT INCLUDES BUT NOT LIMITED TO SPONSORSHIP FOR PROMOTORES. THIS IS THE IDEA OF HAVING A HUB THAT CAN BE USED AS A FISCAL PASS-THROUGH SO THAT WAY IT CREATES THE KINDS OF EFFICIENCIES, OVERHEAD. AND NOT ONLY JUST FISCAL, BUT ALSO IN PRACTICE. SOME OF THE RECOMMENDATIONS THAT YOU HAVE HERE ARE SOME OF THE TRAININGS THAT NEED TO BE INTEGRATED. FOR EXAMPLE, HE DISABILITIES AND WE HEARD THAT LOUD AND CLEAR FROM PARENTS HELPING PARENTS. I WOULD LIKE TO THANK THEM FOR THEIR CONTINUED FEEDBACK INTO OUR SYSTEMS AND CONTINUING TO ACKNOWLEDGE WHERE THE PIPELINE, THE PRISON, SCHOOL TO PRISON PIPELINE ACTUALLY BEGINS. THAT'S WHEN CHILDREN DO NOT GET THE RIGHT KIND OF SUPPORT WITH THEIR LEARNING DIFFERENCES RIGHT FROM THE START. SO THANK YOU, PARENTS HELPING PARENTS, FOR CONTINUING TO BE THAT VOICE FOR OUR CHILDREN. I THINK THAT IS IT FOR ME AT THE MOMENT IN TERMS OF QUESTIONS AND MOTION. I WILL INCLUDE, I WILL ACCEPT THE REPORT, THE PIECE ABOUT THE MEDICAL MANAGED PLAN AND THEN THIS LAST PIECE ON THE SOBRATO, SUCH AS SOBRATO. THEY ARE ALREADY DOING A PILOT. SO WE CAN EXPLORE HAVING THEM BE THAT FISCAL SUPPORT. THE ISCAL SPONSORSHIP AND THAT HUB THAT WAS DISCUSSED.

>> HAPPY TO SECOND THAT IF YOU ARE FINISHED.

>> THANK YOU.

>> MOVED AND SECONDED. SUPERVISOR ELLENBERG.

>> THANK YOU FOR THIS REALLY UPLIFTING REPORT. IT'S INCREDIBLY MEANINGFUL ALWAYS, THIS WORK IS IMPORTANT. BUT RIGHT NOW WHEN SO MANY FOLKS SEEM TO BE JUST TURNING THEIR BACKS ON COMMUNITIES THAT HAVE HIGHER LEVELS MUCH NEED, I AM REALLY IMPRESSED BY IT AND APPRECIATIVE OF THE WORK THAT YOU ALL ARE DOING. THANK YOU TO THE DEPARTMENT AS WELL AS TO THE TREMENDOUSLY LONG LIST OF CONTRIBUTING COMMUNITY BASED ORGANIZATIONS THAT BROUGHT THEIR VITAL XPERTISE. I WANT TO EXTEND A PARTICULAR THANK YOU AS WELL TO THE CADILLAC WINCHESTER RESIDENTS WHO CAME OUT TODAY AND WERE ON ZOOM SPEAKING ABOUT THEIR NEIGHBORHOOD. BECAUSE IT'S MY DISTRICT, I'M GOING TO FOCUS A COUPLE OF COMMENTS ON THIS COMMUNITY BEING IN D4, THEY ARE SOMEWHAT GEOGRAPHICALLY SEPARATE FROM THE MUCH LARGER LATINO COMMUNITIES IN SAN JOSE AND SOUTH COUNTY. THEIR NEEDS AREN'T GREATER, BUT THE LOCATION MEANS THEY HAVEN'T RECEIVED THE SAME ATTENTION AS AREAS IN OTHER PARTS OF THE COUNTY WHERE THE POPULATION CONCENTRATION IS GREATER. THANK YOU FOR THE CALL-OUTS THERE. THE COLLECTIVE NEED OF LATINO RESIDENTS IS STARK. 12% OF THIS COMMUNITY IS CURRENTLY UNINSURED. THIS IS AT A TIME, OF COURSE, WHEN AS A COUNTY WE ARE FACING UPCOMING ENORMOUS ADDITIONAL LOSSES FOR SAFETY NET SERVICES BASED ON HR1. I'M GOING TO URN BRIEFLY TO JAMES. WHEN THE PROGRAM RETURNS TO THE BOARD FOR DISCUSSION, I THINK IT'S SOMETIME IN THE FALL, I WANT TO UNDERSTAND HOW THE COUNTY PLANS TO COMMUNICATE AND DISSEMINATE INFORMATION ABOUT ENROLLMENT TO ALL OF THE RELEVANT COMMUNITIES INCLUDING CADILLAC WINCHESTER.

>> WE CAN DO THAT. THERE IS A LOT OF CONVERSATIONS THAT STILL NEED TO HAPPEN TO IMAGINE WHAT A REVISED PCAT PROGRAM LOOKS LIKE IN THE WAKE OF HR1. THAT WORK IS STILL IN THE EARLY STAGES AN NEEDS TO BE FLUSHED OUT BEFORE WE CAN BRING THOUGHTFUL RECOMMENDATIONS FORWARD.

>> DO YOU HAVE AN ESTIMATE OF WHEN YOU ARE THINKING OF BRINGING THAT BACK?

>> I DON'T HAVE PRECISE TIMELINE. WE ARE TRYING TO HAVE THAT CONVERSATION BEFORE FULL IMPLEMENTATION OF THE FULL WORK RULE REQUIREMENTS WHICH WILL BE JANUARY 7. SOMETIMES LATE IN THE FALL.

>> THANK YOU SO MUCH. TURNING BACK TO THE RECORD AND RECOMMENDATIONS, DR. REDMOND, I WANT TO UNDERSTAND ABOUT THE COMMUNITY RESILIENCE HUB. NOT IN LOVE WITH THE NAME BECAUSE IT'S NOT A PHYSICAL HUB. IT ALSO IS THE SAME NAME AS THE HUB AT PARKMORE AND MERIDIAN. AND HIS ISN'T PREDOMINANTLY PUBLIC FACING. THIS IS FOR CBOs, ORGANIZATIONS AND BILLING AND TRAINING.

>> THAT'S RIGHT. MORE.L LET MY TEAM SPEAK TO IT- I APPRECIATE NOT JUST YOUR FEEDBACK ON THE NAME BUT ADVICE ON HOW TO IMPROVE UPON IT. WE LEARNED THERE WAS SO MUCH ALREADY HAPPENING IN THE COUNTY THAT WAS NOT ACCESSIBLE TO THE GROUPS WHO NEEDED IT. THERE WERE CBOS ARE PROVIDING TRAINING THAT ANOTHER WANTED AND THEY DIDN'T KNOW. THERE WERE CBOS ARE WITH THE CONTRACT THEY NEEDED TO FACILITATE BILLING AND ANOTHER DIDN'T UNDERSTAND IT EXISTED. KNOWING A SINGLE POINT OF CONTACT, A VIRTUAL PLACE TO GO TO GATHER THAT NEW MEXICO WAS THE GOAL.

>> THE CON ACCEPT IS BRILLIANT. I'M NOT CONCERNED ABOUT THAT. IT'S A SEMANTIC THING. IT NEEDS A DIFFERENT NAME. AND IF YOU ARE TALKING ABOUT IT AS A CENTRALIZED RESOURCE, WHAT DASHBOARD, IS IT A SIGNAL GROUP, WHAT IS IT?

>> YEAH. COMMUNITY BASED ORGANIZATIONS AND COOPERATIVES OR PROMOTORES WILL BE ABLE TO ACCESS THIS TWO WAYS VIRTUALLY OR IN PERSON. WHEN IT'S IN PERSON, THEY ORGANIZE ACTIVITIES IN CLOSE PROXIMITY TO OUR PARTNERS. THE SERVICES DELIVERED WILL BE DELIVERED USING A COLLECTIVE MODEL WHERE WE ARE LEVERAGING OFF EXPERTS SUCH AS CBOs ALREADY DOING THIS WORK AND PROMOTORES THAT ARE ALREADY TRAINING OTHER PROMOTORES. IT'S HYBRID, IT'S FLEXIBLE AND WELL BUILT OVER TIME.

>> GREAT. MAYBE EL CENTRO, SOMETHING THAT'S NOT AS CUTE. WE DON'T DIVE TOO DEEPLY INTO THE NAMING. BUT YOU HAVE HEARD ME WEIGH IN THERE. I KNOW YOU ARE IN THE PROCESS OF LOOKING AT PHYSICAL SPACES FOR TRAINING. I WOULD URGE YOU TO CONSIDER COUNTY FACILITIES AND BEING CLOSE IN THE FACILITY OF THE AREA, THE NEW CLINIC MIGHT MAKE SENSE, LIBRARIES. LET'S LOOK TO LEVERAGE WHAT THE COUNTY ALREADY HAS AUTHORITY OVER. RECOMMENDATION 4, CAN YOU SPEAK TO THE NEXT PHASE OF THE PROJECT IN ADDITION TO THE HUB, WHAT OTHER STRATEGIES ARE YOU LOOKING AT THAT COULD HELP PRIORITIZE CHWs IN CADILLAC WINCHESTER?

>> I WILL TURN IT OVER TO MS. DIAZ. THERE HAS BEEN A GREAT DEAL OF WORK IN THE LAST YEAR BY ARE PRIMARILY A DIFFERENT BRANCH FOCUSING ON VIOLENCE PREVENTION AND THE INTERSECTION WITH YOUTH AND MENTAL HEALTH AS AN EXAMPLE OF CHRONIC DISEASE BUILDING UP IN CADILLAC WINCHESTER WHILE SUSTAINING THE WORK ALREADY IN SOUTH COUNTY AND SAN JOSE.

>> I WILL ADD THAT SOME OF THE NEXT STEPS WILL BE TO CLOSE THE LOOP WITH THOSE PARTICIPATED. WE'LL LEARN MORE FROM PARTNERS AS WE COMMUNICATE THOSE LESSONS LEARNED. WE HAVE ALREADY STARTED TO INVESTIGATE GRANT OPPORTUNITIES, SOME NAMED TODAY. AND THEN WE WILL ALSO BE FOLLOWING UP TO TAKE A DEEPER DIVE WITH SOME OF OUR PARTNERS WHO ARE PARTNERING ASPECTS OF THE HUB ALREADY AND LEARNING ABOUT THEIR FISCAL OR INFRASTRUCTURE FORMAT.

>> APPRECIATE THIS. WE WORK WITH SAN JOSE STATE ON A NUMBER OF PROGRAMS FOR THAT NEIGHBORHOOD AND YOU PROBABLY ARE AWARE OF ALL OF THE ENTITIES ALREADY CONNECTED THERE. THERE IS ALSO A REALLY WONDERFULLY STRONG NEIGHBORHOOD ASSOCIATION IN THAT AREA. SO PLEASE CONNECT WITH Y OFFICE, DIRECTLY WITH THEM, IN ANY WAYS I CAN BE HELPFUL. THANK YOU FOR THIS WORK. I'M EXCITED ABOUT IT. THANK YOU, SUPERVISOR ARENAS FOR YOUR INITIAL LEADERSHIP ON THE LATINO HEALTH ASSESSMENT. I'M GLAD TO SUPPORT TODAY'S MOTION.

>> SUPERVISOR DUONG.

>> THANK YOU FOR YOUR HARD WORK ON THIS STUDY AND SHARING THE KEY FINDINGS AND RECOMMENDATIONS IN THIS REPORT. I KNOW IT'S A LANDSCAPE OF CHALLENGE WE ARE FACING. THIS IS BRINGING THE TYPE OF OPTIMISM AND HOPE THAT THIS COUNTY REALLY LEANS INTO. JAMES, I APPRECIATE YOUR RECOMMENDATIONS. I KNOW -- I UNDERSTAND THE COUNTY'S STRENGTH. ONE OF OUR GREATEST STRONGS IS ADVOCATING WITH PRIVATE/PUBLIC RELATIONSHIPS. THAT'S A DEEP INVESTMENT THAT WORK REQUIRES AND DESERVES. WE HAVE KNOWN THAT THE IMPACT OF PROMOTORES, PEER SUPPORT WORKERS, COMMUNITY AMENDMENT WORKERS AND SUPPORT SERVICES FOR A LONG TIME. THANK YOU FOR VALIDATING WHAT WE HAVE ALWAYS INHERENTLY KNOWN TO BE TRUE, ESPECIALLY IN DISTRICT 2. DURING THE COVID-19 PANDEMIC, IT WAS THE WORKER OWNED COOPERATIVES THAT PROVIDED LIFE-SAVING OUTREACH CONNECTIONS. I WANT TO GIVE A SHOUT OUT TO DR. GARCIA, THAT'S WHERE WE MET AND WORKED AND PARTNERS FOR THE FIRST TIME IN DEVELOPING THE PROGRAM. PAUL MURPHY, YOU WROTE THE LEDGE FILES FOR IT. IT'S NOT A BAD NAME. WE CALL IT CHIBET AND.KIDS, WE HAD SOME YOUNG COMMUNITY HEALTH WORKERS THAT CALLED US CHIBAY. THEY ARE COMING TO THE DOOR. BRINGING HOPE TO A HARD SITUATION. I HAVE NO DOUBT THAT THAT ON THE GROUND TEAM GOING DOOR TO DOOR WELCOMED AND RECEIVED BY THEIR NEIGHBORS WITH TRUST, THAT SAVED LIVES. IT ABSOLUTELY DID. SO THANK YOU, DR. GARCIA, THANK YOU FOR THAT WORK. AND SO HEY WERE LAUNCHED ON A PROMOTORES PROGRAMS. PROMOTORES ARE OFTEN EXCLUDED WORKERS WHO EXPERIENCE MANY BARRIERS TO FULL PARTICIPATION IN THE WORKFORCE. I SEE THE COMMITTEE AND EXCLUDED WORKERS OUNCIL HERE. THANK YOU FOR COMING IN TO PROVIDE YOUR PERSPECTIVE AND LIVED EXPERIENCE, THIS IS POLICY, WE ARE MEETING THE HEALTH NEEDS IN A MEANINGFUL, RESPECTFUL WAY, BUT ALSO DEVELOPING A WORK THOSE THAT CONTINUES TO BE ACTIVELY EXCLUDED. I'M EXCITED THAT WE ARE GOING -- WE CONTINUE TO BE IN CONVERSATION TO ELEVATE THIS REPORT AND IMPORTANT ORK OF THIS. IMPLEMENTATION OF ANY RECOMMENDATIONS INCLUDE IN THIS REPORT, I KNOW WILL CENTER ON THE EXPERIENCES OF EXCLUDED WORKERS. BECAUSE BY DESIGN AND RIGHTING THE WRONGS OF HISTORY, IT HAS TO. THE PROMOTORES PEER SUPPORT WORKER AND HEALTH SUPPORT WORKFORCE COMPRISED OF EXCLUDED WORKERS, WOMEN, MOTHERS, IMMIGRANTS. RATHER THAN BUILD TWO PATHWAYS THAT ARE CONNECTED BY THE SAME WORKFORCE, AN OPPORTUNITY EXISTS TO STRENGTHEN THE PIPELINE TO GREATER ECONOMIC MOBILITY OR EVEN IN-HOME SUPPORT SERVICES WORKER. I WANT TO ACKNOWLEDGE THE PARTNERSHIP WITH COMMUNITY HEALTH BASED PROGRAMS THAT CONTRIBUTE TO A GROWING WORKFORCE. AS THE WORKFORCE CONTINUES TO GROW, WE HAVE A RESPONSIBILITY AS PARTNERS AND PROMOTORES, COMMUNITY HEALTH WORKERS AND HOME SUPPORT WORKERS TO ENSURE WE ARE BUILDING PIPELINE FOR LONG TERM ECONOMIC MOBILITY. I THINK SUPERVISOR ARENAS, AS YOU WERE TALKING ABOUT THE NECESSITY, MAKING ROBUST INVESTMENTS, I CAN'T AGREE WITH THAT MORE FOR THE ABILITY OF OUR COMMUNITY. WE BUILD ECONOMIC PIPELINES BY INVESTING IN INFRASTRUCTURE, TRAINING, PAID LEARNING THROUGH APPRENTICESHIP PROGRAMS AND EXPANDING RATHER THAN LIMITING THE END OF THE PIPELINE. MEDI-CAL REIMBURSEMENTS IS NOT SUFFICIENT. AND MEDI-CAL BILLING IS TOO BURDENSOME. I LEARNED THAT FROM COMMUNITY PARTNERS, FROM CONVERSATIONS FROM OUR OFFICES AND THE REPORT. THE COUNTY AND STAKEHOLDERS MUST LOOK AT INCREASING VOLUME. WE WANT TO SEE RETURN ON INVESTMENT. LOCAL PLACE BASED FUNDERS FOCUSED ON ECONOMIC ABILITY HAVE STRENGTHENED THE PIPELINE. EXISTING GRANT FUNDING CURRENTLY SUPPORTS BUILDING INFRASTRUCTURE AND REFERRAL SUCCESS THROUGH A PILOT PROGRAM THAT MANY OF THE SAME PARTNERS MENTIONED IN THIS REPORT ARE ALREADY LEADING, DEVELOPMENT OF A PHYSICAL COMMUNITY HEALTH WORKER HUB THROUGH A PARTNER IS ALREADY UNDER WAY. I KNOW IT'S A RECENT DEVELOPMENT, SO IT DIDN'T MAKE ITS WAY INTO THE REPORT. AND THAT WOULD BE ONE OF MY RECOMMEND AGES, ONE OF MY ASKS FOR FURTHER FOLLOW-UP. AND EXPLORING HOW TO MAXIMIZE MEDI-CAL REIMBURSEMENTS FOR THE EXPERIENCE PATHWAY FOR COMMUNITY HEALTH WORKER CERTIFICATION THAT REQUIRES 2,000 HOURS OF PAID OR VOLUNTEER HOURS, AND 500 HOURS, I HOPE I DIDN'T GET THE NUMBERS INVERTED, SOMETIMES I DO THAT. BUT THIS EXISTING GRANT AND EXISTING INVESTMENTS IN THE COMMUNITY ALSO SUPPORTS EXPLORATION OF INCREASING REIMBURSEMENT THROUGH CAL-AIM, THROUGH THE CATEGORY AND EFFORT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. FOR THESE REASONS, THANK YOU FOR BEARING WITH ME, I WOULD LOVE FOR HE MAKER AND SECONDER OF THE MOTION TO CONSIDER MY RECOMMENDATIONS THAT IN THE NEXT REPORT, IF WE COULD INCLUDE ANNAL ASSIST OF CURRENT LOCAL FUNDING LANDSCAPE FOR COMMUNITY HEALTH WORKER, PEER SUPPORT WORKER, PROMOTORES PROGRAMS TO MAKE SURE INCOME POLICE DEPARTMENTRY RATHER THAN -- IT'S COMPLEMENTARY RATHER THAN DUPLICATIVE. SECOND, INCORPORATE IN-HOME SUPPORT SERVICES AS AN ADDITIONAL PATHWAY IN THE WORKFORCE DEVELOPMENT PIPELINE THAT THE STAKEHOLDERS SEEK TO STRENGTHEN. WE LEARNED ABOUT A STATE TRAINING HE FOR WORKERS. IS THAT SOMETHING THAT CAN CONDITION LEVERAGED IN SUPPORT OF HEALTH WORKER MODELS AND PROMOTORES MODELS. OFTEN THEY OVERLAP WITH EACH OTHER. A THIRD REQUEST IS TO ASSESS STRATEGIC OPPORTUNITIES FOR THE COUNTY TO DEVELOP AN EFFECTIVE BILLING INFRASTRUCTURE FOR REIMBURSEMENTS FROM MEDI-CAL AND OTHER FUNDING RELATED TO WORKFORCE DEVELOPMENT. WE TALKED ABOUT HOW HARD BILLING IS. WE HAVE MULTIPLE FLOORS OF SMART PEOPLE CRUNCHING NUMBERS ALL DAY. IS THAT A BURDEN WE CAN TAKE FROM HIS WORK WEAR WE CAN DEVELOP THAT BILLING INFRASTRUCTURE. OF COURSE, I KNOW THAT FACING THIS CURRENT BUDGETARY TIMES, WE CAN'T CARRY EVERYTHING ALONE. THIS IS GOING TO TAKE FULL PARTNERSHIP. LET'S ASSESS AND EXPLORE WHAT THOSE STRATEGIC OPPORTUNITIES CAN BE. AND I WOULD LOVE FOR US TO CONTINUE PARTNERING WITH LA ESQUINA OF HOW TO STRENGTHEN THIS WORKFORCE DEVELOPMENT PINE LINE. I -- PIPELINE. I TALKED ABOUT A PHYSICAL HUB. WE ARE LOOKING AT SYSTEMS WIDE IMPACT. THERE IS A PHYSICAL HUB BEING DEVELOPED RIGHT NOW. AT ROOTS WITH THE ROOTS COMMUNITY CLINIC. SO CAN WE EXPLORE A PARTNERSHIP OR SOME TYPE OF INFORMATION SO THAT THE COUNTY CAN COMPLEMENT WORK. IF THEY ARE DOING IT BETTER THAN US, NO KNOCK ON US, THE COMMUNITY LED WORK IS THE STRONGEST. WHERE CAN WE COMPLEMENT, NOT DUPLICATE. AND WHERE CAN WE DIVE DEEP AND BUILD THIS INTO THE INFRASTRUCTURE OF THE COUNTY. THANK YOU. I CAN GIVE THAT TO YOU IN WRITING. YOU ARE FURIOUSLY WRITING THE NOTES DOWN THERE. THANK YOU.

>> THANK YOU.

>> I AVE SOME QUESTIONS.

>> I JUST WANTED TO MAKE SURE BEFORE WE PROCEED IN THE CONVERSATION, I BELIEVE THERE IS THREE OR FOUR ITEMS THAT YOU WERE ASKING O INTEGRATE INTO THE MOTION, IS THAT RIGHT?

>> ANALYSIS OF CURRENT -- DO YOU WANT ME TO REPEAT IT?

>> SURE.

>> INCLUDE ANNAL ASSIST OR EXPLORATION OF CURRENT LOCAL FUNDING LANDSCAPE FOR COMMUNITY HEALTH WORKER, SPEAR SUPPORT WORKER PROMOTORES PROGRAMS. SECOND IS EXPLORE WAYS TO INCORPORATE IN HOME SUPPORT SERVICES AS AN ADDITIONAL PATHWAY IN WORKFORCE DEVELOPMENT. THREE, ASSESS STRATEGIC OPPORTUNITY ITS FOR THE COUNTY TO DEVELOP AN EFFECTIVE BILLING INFRASTRUCTURE FOR REIMBURSEMENTS FROM MEDI-CAL AND OTHER STATE AND FEDERAL FUNDING SOURCES. FOUR, LET'S PARTNER WITH THE EAST SIDE COOP HUB AS THEY ARE DOING THIS ON THE WORKFORCE DEVELOPMENT SIDE. AND EXPLORE AND LEARN FROM THE ROOTS CLINIC WHO HAS FUNDED TO DEVELOP A PHYSICAL HEALTH WORKER HUB. WE ARE TRYING TO BUILD A SYSTEM THAT SUPPORTS THAT. I THINK THERE IS VALUABLE LESSONS LEARNED.

>> I WANTED TO SEE IF THE MAKER OF THE MOTION ARE IN AGREEMENT WITH EACH OF THOSE FOUR ITEMS.

>> I HAD QUESTIONS ABOUT SOME OF THE ITEMS. SO I WILL START WITH THE END WHICH IS LOOKING AT TWO DIFFERENT FRAMEWORKS WHICH IS THE COOP HUB AND THEN THE COMMUNITY WORKER HUB HICH MIGHT BUT I UNDERSTAND IT'S A MODEL THAT YOU THINK IS WORKING WITH THE ROOTS COMMUNITY CLINIC, RIGHT? EXPLORE THAT, LEARN FROM IT, SEE WHAT WE CAN TAKE FROM IT AND APPLY WHATEVER FITS WITHIN THIS.

>> YES.

>> THEN THE NEXT ONE IS, I THINK IN AN EFFORT TO FURTHER THE WORKFORCE DEVELOPMENT OF THE PROMOTORES AS IT MAY BE A NEXT STEP TO HAVE WORKFORCE DEVELOPMENT OPTIONS THAT ARE SPECIFIC TO IN-HOME SUPPORT SERVICINGS, RIGHT?

>> YOU KNOW --

>> WHAT DID YOU MEAN?

>> NOT THAT SPECIFIC. BUT I APPRECIATE IT. IN-HOME SUPPORT WORKERS DO A LOT OF THE SAME WORK. I'M NOT GOING TO SAY IT'S EXACTLY THE SAME. BUT A LOT OF COMMUNITY HEALTH WORKERS ARE ISSH WORKERS. THEY ARE WEARING MULTIPLE HATS. THIS IS WORK THAT THEY CONTINUE TO DO. THEY CONTINUE TO SHOW UP, AND THE COMMUNITY HEALTH WORKER MODEL. IS IN A WAY TO LEVERAGE THE TRAINING RESOURCES THAT IN-HOME SUPPORT DOES THAT'S ALREADY FUNDED BY THE STATE TO INVEST IN THE COMMUNITY HEALTH WORKER MODEL, THE PROMOTORES MODEL.

>> LET'S BORROW FROM THE TRAINING, TAP INTO THE TRAINING THAT'S PAID FOR AND SET UP FOR IHS WORKERS SO THAT PROMOTORES CAN BENEFIT FROM IT.

>> YES. AND LET'S LEVERAGE EXISTING INVESTMENTS INTO THESE TYPE OF TRAININGS TO INVEST IN THE PROMOTORES MODEL. MAKE IT MORE PERMANENT. I KNOW WE ARE GOING TO LOOK FOR FUNDING STREAMS AND OPPORTUNITIES TO SUPPORT THIS WORK. AND MY GOAL IN EXPLORING EXISTING INFRASTRUCTURE IS HOW TO CREATE LONG-TERM FUNDING SOURCES WITHOUT HAVING TO FUND ONE-OFFS. IT'S MY BEST CREATIVE THINKING TO SEE WHAT WE CAN EXPLORE.

>> LET ME ADD, SO WE CAN HAVE GUIDELINE, BASED ON THE RECOMMENDATION THAT THEY HAVE HERE FOR TRAININGS?

>> OH, YEAH. I WASN'T TRYING TO DEVIATE FROM THAT.

>> SO --

>> GOOD CATCH.

>> ALIGN IT WITH THE RECOMMENDATIONS THAT THEY HAVE FOR THE TRAININGS. I'M ALL GOOD WITH THAT. I THINK I MISUNDERSTOOD WHAT THAT WAS. IT WAS LIKE MAYBE THE NEXT STEP COULD BE AN IHHS, IN-HOME SUPPORT SERVICES WORKER FOR THEM AS A NEXT JOB. THAT WOULD BE --

>> THAT WOULD BE GOOD, TOO. THE OPPORTUNITY, I MEAN, THAT'S THE VALUE OF THIS WORK, RIGHT? WE BOTH INVEST IN THE WORKFORCE DEVELOPMENT AND DELIVERY OF SERVICES. THIS COULD OPEN UP JUST CAREER PATHINGS FOR PEOPLE IN THE FUTURE.

>> I REALLY LIKE THAT. BECAUSE WE WANT TO MAKE SURE THEY DO HAVE CAREER PATHS, THAT THEY ARE LEARNING, THEY CAN CONTINUE TO HAVE PROFESSIONAL DEVELOPMENT AND THAT BUILDING END OF THE TRAININGS AND TAPPING INTO WHAT ALREADY EXISTS, I LIKE THAT. THAT MAXIMIZES AND LEVERAGES WHAT WE ARE ALREADY DOING. I THINK THE LAST PIECE WAS YOU WANTED ANNALYSIS. I DIDN'T CATCH THE REST OF THAT PHRASE.

>> WHERE IS THIS WORK BEING FUNDED? DO AN ANALYSIS OF FUNDING. THE FEASIBILITY ASSESSMENT IS FOCUSED ON THE WORK ITSELF. AND THE EXISTING INFRASTRUCTURES AND LACK OF INFRASTRUCTURES. I WOULD SAY HE NEXT STEP IS LET'S FIND OUT WHERE THINGS ARE ALREADY BEING FUNDED.

>> I THINK THEY DID MENINGITIS WHERE THEY ARE BEING FUNDED. SOME WAS ALAMEDA COUNTY. I'M HAPPY, IF THERE IS ANY ADDITIONAL WORK THAT NEEDS TO BE DONE UNDER THIS. LET'S EXPLORE IT. I DON'T KNOW IF, R. REDMOND, DID YOU HAVE A RESPONSE?

>> A GREAT DEAL OF WHAT YOU ARE ASKING FOR WAS GATHERED IN THE REPORT. SINCE THAT FULL 75 PAGE DOCUMENT THAT CAME TO YOU TODAY IS STILL A DRAFT. I THINK WE MENTIONED THERE WOULD BE MORE DATA SPECIFIC TO MOUNTAIN VIEW AS WELL AS ADDITIONAL CLEAN-UPS, WE CAN BE MORE --

>> AND THERE'S RECENT INVESTMENTS. THINGS HAPPENING IN REALTIME. I THINK AN EYE TOWARDS CONTINUING TO ANALYZE OR UNDERSTAND WHAT THE FUNDING LANDSCAPE IS. LOOKING AT IT THROUGH A LENS OF WHERE CAN WE COMPLEMENT WORK.

>> I REALLY LIKE THAT. SO YES, I'M GOOD WITH ALL OF THAT. THANK YOU SO MUCH FOR YOUR FEEDBACK, FOR YOUR VERY THOUGHTFUL CONSIDERATION OF THIS PROPOSAL, OF THE STUDY. AND THEN THE NEXT STEPS WE'LL HAVE, THIS TO ME IS TELL MEG YOU ARE LOOKING FOR THE INVESTMENTS FROM OUR COUNTY, FROM OUR SYSTEMS, LEVERAGING. I REALLY APPRECIATE THAT.

>> I'M FINE WITH THEM AS WELL.

>> THANK YOU. I AM ALL IN ON THIS MODEL FROM THE TIME OF COVID-19 AND SEEING WHAT HAPPENED, WHAT WE DID THERE. AT THE EMERGENCY OPERATION CENTER, WE STARTED OFF THE DAY, YOU KNOW THIS, WITH THE OST DEPRESSING LIKE ROUTINE. WE STARTED OFF EACH DAY WITH THE DEATH COUNT, THE HOSPITALIZATION COUNT, THE NUMBER OF LAYERS WE HAD LEFT. THAT'S HOW WE STARTED EVERY DAY FOR TWO YEARS. AND WE SAW THOSE NUMBERS REALLY NOT JUST GRADUALLY, BUT THERE WAS A SHARP AND DRASTIC PIVOT WHEN OUR CHIBET PROGRAM LAUNCHED. AND WE WEREN'T JUST REPORTING NUMBERS ANYMORE. WE WERE HAVING CON SAYINGS WITH PEOPLE WHO WERE HARD TO REACH. AND I'M A TRUE BELIEVER, F ANYONE NEEDS ANY CONVINCING AT ALL, I STILL HAVE THE DASHBOARDS. I WAS IN CHARGE OF MAKING THE DASHBOARDS AT EVERY BOARD MEETINGS. I REMEMBER ALL YOUR QUESTIONS, SUPERVISOR, LEE.

>> ME? WE CALL WORKED SO HARD. THANK YOU.

>> SUPERVISOR ABE-KOGA.

>> THANK YOU FOR THIS REPORT. IT IS VERY ENCOURAGING. I, TOO, BELIEVE IN THE PROGRAM. I REMEMBER FROM THE COVID TIMES AS MY YEARS AS MAYOR AND WE DO THE WEEKLY SATURDAY MORNING MEETINGS WITH ALL OF THE MAYORS AND I REMEMBER YOU, BETTY, BEING THERE AND GETTING THOSE AWFUL COUNTS. WHEN THIS PROGRAM LAUNCHED, I KNOW MANY FOLKS IN MY COMMUNITY SIGNED UP TO BE A PROMOTORES. I REALLY DO BELIEVE IN THIS PROGRAM. I KNOW YOU HAVE SEEN THE BENEFITS OF THE CHW PROGRAM THROUGH THE AAPI HEALTH ASSESSMENT AND I SEE HE OVERLAP IN A LOT OF THE FINDINGS. IF ANYTHING, IT WOULD BE MY INTEREST, YOU MENTIONED MOUNTAIN VIEW AND SUNNY VALE. ALL OF OUR DISTRICTS HAVE COMMUNITIES. MY INTEREST IS TO SEE HOW WE CAN EXPAND IT TO ALL FIVE DISTRICTS. I WONDER, JAMES, YOUR CREATIVE IDEA OF GETTING SUPPORT FROM THE MANAGED CARE PROGRAMS, WE CAN LOOK AT THAT AND HAVE THAT ANALYSIS. SUPERVISOR DUONG, YOUR AMENDMENTS CAN HELP WITH THAT, IF LIKE NOT DUPLICATING BUT LEVERAGING WHAT'S ALREADY OUT THERE. BUT AGAIN, THAT WOULD BE MY INTEREST IS TO SEE HOW WE CAN EXPAND ALL FIVE DISTRICTS, MAKE SURE WE INCLUDE EXISTING PROGRAMS, UNFORTUNATE THE API PROGRAM LOST ITS COUNTY FUNDING. THEY WERE ABLE TO GET OUTSIDE FUNDING FOR ANOTHER YEAR. BUT I WOULD HOPE THAT WE ARE LOOKING AT THIS ALL INCLUSIVE PROGRAM THAT WILL ROLL IN ALL OF THE PROGRAMS THAT ARE ALREADY BEING DONE IN THE COMMUNITY. I SEE A LOT OF NODDING HEADS. I WILL TAKE THAT AS A YES AND APPRECIATE THAT. VERY SUPPORTIVE OF THIS.

>> I WOULD ADD, MY UNDERSTANDING IS THAT THE CORE OF THESE RECOMMENDATIONS ARE BROADLY APPLICABLE ACROSS OUR ENTIRE COMMUNITY. AND THAT FUNDING FROM THE MEDI-CAL MANAGED CARE PLANS SHOULD BE SONG THAT SHOULD BE ABLE TO BE ACCESSIBLE TO THESE ORGANIZATIONS ACROSS THE ENTIRE COUNTY. BECAUSE THERE IS A NEED ACROSS THE ENTIRE COUNTY. AND THE RECOMMENDATIONS AT THE CORE ARE UNIVERSAL.

>> THANK YOU. I JUST WANTED TO ADD A BRIEF COMMENT, THAT THE PROMOTORES MODEL HAS BEEN SO SUCCESSFULLY SHOWN DURING THIS COVID PERIOD WE HAVE HAD AND THAT'S EXACTLY THE REASON WHY WE REALLY NEED TO MAKE SURE THIS PROGRAM CONTINUES. I JUST WANTED TO SAY THANKS FOR THE ADMINISTRATION COMING IN WITH IDEAS THROUGH THESE POTENTIAL REIMBURSEMENTS AND WHATNOT WITH OTHER HEALTHCARE ENTITIES SO THAT FUNDING COULD BE MAINTAINED TO MAKE SURE THIS CONTINUES. YOU ALSO SEE THE MAZING COLLABORATION BY HIGH COLLEAGUES, DIFFERENT IDEAS CRAFTED RIGHT HERE WITH A MUCH MORROW BUST PROGRAM MOVING FORWARD. I'M SO PROUD TO E SERVING ON THIS BOARD WITH YOU ALL. ANY FURTHER COMMENTS?

>> I WANT TO SAY THANK YOU. I USUALLY START WITH GRATITUDE. THIS TIME I'M GOING TO END WITH IT. THANK YOU TO ALL OF YOU FOR, ONE, THE LATINO HEALTH ASSESSMENT, FOR COMPLETING THAT. FOR NOW GIVING LIFE TO THE LATINO HEALTH ASSESSMENT SO WE CAN SAVE LIVES. I JUST LOOK FORWARD TO SEEING ALL THE ELEMENTS COMING TOGETHER SO WE CAN CREATE THAT SAFETY NET FOR LATINOS THAT IT'S MEANT TO BE A LITTLE MORE INTENTIONAL. SO I REALLY APPRECIATE IT. THEN [SPEAKING SPANISH]

>> OKAY. LET'S GO TAKE THE VOTE.

>> THAT WAS A MOTION BY VICE PRESIDENT ARENAS, SECOND BY SUPERVISOR ELLENBERG. (ROLL CALL).

>> MOTION PASSES.

>> THANK YOU. OKAY. SO MOVING AFTER THIS ITEM SHOULD HAVE BEEN ITEM NUMBER 9. BUT, HOWEVER, NUMBER 9 HAS BEEN ALSO HELD. SO FOR ITEM NUMBER 10 WHICH IS A REFERRAL FROM OUR OFFICE REQUESTING THE COUNTY COUNSELS OFFICE. THIS IDEA WAS TO USE OF FARM LAND FOR GROWING MORE EGETABLE, MORE SHADE FOR FARM WORKERS AND IMPROVING SOIL NUTRIENTS. HOWEVER, I HAVE HEARD MANY MORE ADDITIONAL INPUT RECENTLY. AND I WOULD LIKE TO INTEGRATE INTO THIS REFERRAL AND BRING BACK TO THE BOARD AT A FUTURE DATE. I WOULD LIKE TO HEAR ANY PUBLIC COMMENT BEFORE MAKING A MOTION TO HOLD THIS ITEM SO I CONSIDER IT AS CONTINUE TO WORK ON THIS ITEM. CLERK, HOW MANY SPEAKERS DO WE HAVE?

>> I JUST WANTED TO ASK A PROCEDURAL QUESTION, IF YOU ARE DEFERRING THE ITEM, DO WE STILL HEAR PUBLIC COMMENT?

>> IT'S THE CHAIR'S DISCRETION.

>> THANK YOU.

>> YOU DID HAVE ONE SPEAKER CARD TURNED IN AND I NOW SEE ONE HAND RAISED ON ZOOM FOR A TOTAL OF TWO.

>> LET'S JUST DO TWO MINUTES EACH.

>> THE SPEAKER IN CHAMBERS, KELLY.

>> GOOD AFTERNOON. I'M HERE REPRESENTING DC -- VCI. WE ARE HERE TO STRONGLY SUPPORT IT. WE KNOW OU ARE CONTINUING IT. BUT I JUST WANTED TO MAKE A COUPLE OF COMMENTS THAT AGRICULTURE REMAINS A PRINCIPAL

ACTIVITY. THE LAND REMAINS ACTIVELY FARMED THROUGHOUT THE LIFE OF THE PROJECT. INCREASED SHADING, MORE EFFICIENT WATER USE THAT RESULTS IN HIGHER CROP YIELDS AND MORE LAND BEING FARMED. THE SECONDARY INCOME THAT THEY PROVIDE WILL HELP PRESERVE AGRICULTURE LAND THAT MIGHT NOT OTHERWISE BE USED OR FARMED. IT'S A PART OF THE EVOLUTION OF FARMING AND WILL ALSO BE SUBORDINATE PORTION TO THE PRIMARY USE OF FARMING. SUPPORTING THIS PROJECT WOULD POSITION SANTA CLARA COUNTY AS A LEADER IN ADVANCING INNOVATIVE AGRICULTURAL WITH COMPATIBLE ENERGY SOLUTIONS. THIS INCLUDES RESOURCE MANAGEMENT. THANK YOU FOR YOUR CONSIDERATION. AND THOUGHT I HAD A MINUTE. SO YOU GOT PLENTY OF TIME FOR SOMEBODY ELSE. THANK YOU.

>> THANK YOU. AND THE ONE HAND THAT WAS RAISED AT THE CALL OF THE SPEAKER CUE FOR THIS ITEM, DAVID BINI. PLEASE ACCEPT THE UNMUTE.

>> THANK YOU. GOOD AFTERNOON. I'M DAVID AND REPRESENTING THE OVER 35,000 MEN AND WOMEN OF THE SANTA CLARA AND SAN BERNARDINO BUILDING AND CONSTRUCTION TRADES COUNCIL. I'M SPEAKING IN SUPPORT OF THIS REFERRAL THAT WILL PRESERVE AGRICULTURAL USE WHILE EXPANDING THE USE OF RENEWABLE ENERGY. IT'S THE RIGHT TYPE OF DEVELOPMENT FOR OUR COUNTY. THANK YOU.

>> THAT CONCLUDED OUR SPEAKERS FOR THIS ITEM.

>> THANK YOU. SO FOR THAT, I WILL GO AHEAD AND MOVE TO HOLD THIS ITEM AT LEAST AT THIS POINT TO A DATE UNCERTAIN SO WE CAN INCORPORATE MORE DATA INTO THE REFERRAL. MY OFFICE HAS RECEIVED A LOT OF ENGAGEMENT INCLUDING THE FARMERS. I WOULD LIKE TO APPRECIATE THE TIME TO ENGAGE FURTHER. DO I NEED A SECOND ON THIS?

>> YES.

>> OKAY.

>> SECOND.

>> MOVED AND SECONDED. IF NO FURTHER COMMENTS, LET'S TAKE A VOTE. (ROLL CALL).

>> MOTION PASSES.

>> THANK YOU. ALL RIGHT. NEXT ITEM WE HAVE IS OUR ITEM 11 WHICH IS THE VTA LOCAL INVESTMENT PLAN REPORT.

>> GOOD AFTERNOON.

>> AM I ON?

>> YES.

>> THANK YOU. THANKS FOR HAVING US TODAY. I'M SCOTT HEYWOOD, I'M THE CHIEF OF STAFF FOR THE TRANSPORTATION AUTHORITY. WE HAVE A BRIEF PRESENTATION FOR YOU TODAY ON A POTENTIAL REGIONAL MEASURE, A TRANSPORTATION MEASURE THAT MIGHT BE ON THE NOVEMBER BALLOT. WE ARE HERE TO PRESENT THE INFORMATION FOR YOU ON WHAT WILL BE CONTAINED AND ALSO TO RECEIVE YOUR INPUT AS WELL TODAY. WITH THAT, I WILL TURN IT OVER TO SAM FOR THE PRESENTATION.

>> THANK YOU.

>> TRY AGAIN.

>> THANK YOU VERY MUCH. OKAY. I SERVE AS THE DIRECTOR OF STRATEGY AND TRANSFORMATION. DO WE HAVE THE SLIDES AVAILABLE?

>> WE TRY TO SEE IF YOU CAN MOVE THE MIC A LITTLE CLOSER.

>> YOU SUBMITTED THE SLIDES TO THE CLERK.

>> THAT WAS MY UNDERSTANDING FROM OUR STAFF.

>> ONE SECOND. LET'S SEE IF THEY HAVE THEM AND CAN CUE THEM UP FOR YOU GUYS. ONE SECOND.

>> FOR THE BOARD, I KNOW SLIDES ARE IN BACKUP. I SAW THEM THIS MORNING.

>> SUBMITTED TO THE LEGISLATIVE FILE?

>> YES.

>> OKAY. ONE MOMENT. THEY ARE CUEING IT UP RIGHT NOW. GIVE US ONE SECOND.

>> OKAY. WE HAVE IT UP. WE'LL GET IT TO THE SCREEN FOR PRESENTERS. THERE WE GO.

>> THANK YOU SO MUCH. NEXT SLIDE, PLEASE. SO THE REASON WHY WE ARE HERE TODAY WITH YOU, I KNOW WE ARE IN THE MIDDLE OF THE DAY, LUNCHTIME; WE'LL BE EFFICIENT. WE JUST WANTED TO PROVIDE AN UPDATE ON THE WORK THAT VTA STAFF ALONG WITH THE BOARD HAVE BEEN DOING TO DEVELOP A LOCAL SPENDING PLAN OR LOCAL INVESTMENT PLAN FOR OUR SANTA CLARA COUNTY PORTION OF THE POTENTIAL ON THE NOVEMBER BALLOT REGIONAL MEASURE. I LIKE TO START THINGS AT A 40,000-FOOT LEVEL. IT'S A GOOD REMINDER FOR THE PUBLIC MAINLY, THE BOARD UNDERSTANDS WHAT IT IS WE DO AT VTA. BUT WE DO MORE THAN TRANSIT. THE MOST VISIBLE PART OF WHAT WE DO MIGHT BE BUSES AND TRAINS AND PARATRANSIT FOR FOLKS WITH DISABILITIES, WE ARE THE CONGESTION MANAGEMENT AGENCY. WE HAVE MORE TOOLS THAN YOUR AVERAGE CALIFORNIA OR EVEN AMERICAN TRANSIT AUTHORITY. WE ARE ALSO FUNDING PARTNER FOR REGIONAL RAIL PROVIDER. WE MOVE 134 MILLION MILES AND CRITICAL TO MOBILITY AND QUALITY LIFE OF LIVE IN SANTA CLARA COUNTY. NEXT SLIDE. WE ALSO ARE A LARGE PART OF ECONOMIC DEVELOPMENT. FOR EVERY 1 DOLLAR INVESTED, THERE IS $5 IN ECONOMIC IMPACT. AN EXAMPLE IS BART SILICON VALLEY. WE CONNECT 2 MILLION PEOPLE TO THE 3.5 MILLION JOBS IN THE REGION. OUR TOD, 28 SITES IN THE COUNTY TO DELIVER 2500 NEW HOMES FOR FOLKS HERE IN SANTA CLARA COUNTY. MANY OF YOU HAVE BEEN LONG TIME SUPPORTERS AND SMALL BUSINESS OPPORTUNITIES. SMALL, MINORITY, WOMEN-OWNED BUSINESSES, PROVIDING CONTRACTING OPPORTUNITIES FOR OVER 350 OF THOSE BUSINESSES AND MAKING SURE WE PARTNER AS MANY LOCAL FIRMS AS POSSIBLE. $146 MILLION PAID TO THEM IN RECENT YEARS. THE CORE OF WHAT WE ARE HERE TODAY TO SPEAK WITH YOU ABOUT IS THE FIVE COUNTY REGIONAL PRESSURE. IT WAS THE LEGISLATION THAT PUT IT ON TO -- SET IT IN MOTION IN AN AUGUST 7 BOARD AGREED TO JOIN THAT MEASURE ALONG WITH SAN FRANCISCO, SAN MATEO. THIS IS A ONE-HALF CENT SALES TAX. 10.38% WILL GO TO CALTRAIN. THAT'S OUR OBLIGATION TO CALTRAIN. AND AS YOU KNOW, THEY ARE ALSO LOOKING AT SIGNIFICANT DEFICITS. BUT THEY ARE ALSO SEEING TREMENDOUS RIDERSHIP AS A RESULT OF ELECTRIFICATION. 5.25% WILL GO BACK TO THE ADMINISTRATION AND TRANSIT ACTION PLANS. THEN ULTIMATELY, $264 MILLION THIS IS IN FY2025 MUM, BACK TO SANTA CLARA COUNTY. THIS WILL BE 50% PLUS ONE, NOT TWO-THIRDS. NEXT SLIDE. A LITTLE BIT DIFFERENT ALSO TO LET'S SAY MEASURE B IS THAT UNDER THE ENABLING LEGISLATION, THIS MONEY COULD BE USED FOR PUBLIC TRANSIT EXPENSES AND ROADWAY REPAVEMENT PROJECTS ON ROADS SERVED BY FIXED ROUTE TRANSIT. A LITTLE LESS BROAD THAN MEASURE A OR B. WE ARE NOT TALKING ABOUT HIGHWAYS, EXPRESS LANES OR NOT TALKING ABOUT SPECIFIC BIPED PROJECTS. WE ARE TALKING ABOUT TRANSIT OPERATING AND CAPITAL FUNDS SO LONG AS THERE IS A LIGHT RAIL VEHICLE ON THAT CORRIDOR. NEXT SLIDE. AND OVER THE COURSE OF THIS YEAR AND ACTUALLY GOING INTO LAST YEAR, WE HAVE BEEN WORKING CLOSELY WITH A LOT OF STAKEHOLDERS, STARTING WITH OUR BOARD. WE HAD TWO GREAT WORKSHOPS ON FEBRUARY AND THIS MONTH TO FOCUS ON OUR LOCAL INVESTMENT PLAN. BUT GENERALLY, WHAT DOES VTA NEED TO BE FOCUSING ON TO MAKE SURE WE ARE MAKING THE GREATEST DIFFERENCE. SO WE ARE FOCUSED ON THREE OUTCOMES. GROWING RIDERSHIP; INCREASE PRODUCTIVITY, AND ENHANCE CUSTOMER EXPERIENCE. WE ARE TALKING IN PART AND PROBABLY IN LARGE PART ABOUT SAFETY, SECURITY AND CLEANLINESS. HOW DO WE MAKE EARTH THEY TICK IMPROVEMENTS AND INVEST IN TECHNOLOGY THAT MAKES US A BETTER CUSTOMER EXPERIENCE. WE HAVE ALSO GROUPED SOME OF THESE PROPOSED INVESTMENTS INTO THREE CATEGORIES. THIS IS HOW WE STRUCTURED OUR WORKSHOPS. A FOUNDATIONAL COMPONENT, HOW DO WE USE THE CURRENT DATA AND EXPERTISE TO MAKE THE MOST OF WHAT WE HAVE. A BACK TO BASIC INVESTMENTS, HOW DO WE MODERNIZE OUR BUSINESS MODEL AND IMPROVE OUR DELIVERY OF SERVICE BEING AS RELIABLE AND EFFICIENT WITH OUR MONEY AND RESOURCES AS HUMANLY POSSIBLE AND TRANSFORM, HOW DO WE USE TECHNOLOGY TO FUTURE-PROOF THE SYSTEM. WE ARE THE TRANSIT SYSTEM IN SILICON VALLEY. WE WANT TO MAKE SURE WE ARE EMBRACING TECHNOLOGIES AND WORKING WITH BOTH PUBLIC AND PRIVATE SECTOR PARTNERS. NEXT SLIDE. I WILL RUN THROUGH THESE QUICKLY. AS WE HAVE GONE OUT TO OUR CITIES. I THINK WE HAVE BEEN TO EIGHT OF OUR CITY COUNCILS SO FAR. WE HAVE BEEN ENGAGING WITH A COUPLE OF DOZEN OF COMMUNITY BASED ORGANIZATIONS. WE HAVE HAD THREE PUBLIC MEETINGS AND WE'LL HAVE ADDITIONAL PUBLIC MEETINGS MAY AS WELL AS OUR BOARD ENGAGEMENT. WE ARE SAYING WITHIN THE CONTEXT OF THAT DEFINITION, WHAT ARE TYPES OF THINGS WE CAN INVEST IN. FOUNDATION, THINK OF US CORRIDOR IMPROVEMENTS, IF THERE IS A BUS STOP THERE, WE WANT TO MAKE SURE THEY WORK WELL. STATION UPGRADES AND TRANSIT SERVICE AND CAPITAL IMPROVEMENTS. NEXT SLIDE. WE IMAGINE, WE ARE MOST FOCUSED. FOR THOSE WHO MAY NOT BE AS AWARE OF THE VISIONARY NETWORK, HOW DOES VTA GET FROM 30 MINUTE SERVICES DOWN TO 15 OR HOW DO WE GET BETTER THAN THAT. IF FREQUENCY IS FREEDOM FOR CUSTOMERS. IT MAKES IT A MUCH MORE ENTICING JOURNEY. THAT REQUIRES PARTNERING WITH CITIES, SPEED IMPROVEMENTS, FARE PROGRAMS FOR SENIORS AND STUDENTS. WE HAVE 22 PARTNERSHIPS WITH SCHOOL DISTRICTS AND INDIVIDUAL SCHOOLS, ESPECIALLY HIGH SCHOOLS, TO GET MORE PASSES INTO THE HAND OF OUR YOUNG PEOPLE. HOW CAN WE USE THESE MONEYS TO HELP STUDENTS AND SENIORS BOARD VTA SERVICES FOR LESS MONEY OR PERHAPS NO MONEY. AND SAFETY AND SECURITY ENHANCEMENTS. WE KNOW HOW IMPORTANT THAT IS TO OUR CURRENT RIDERS AND FUTURE RIDERS. THEN INNOVATION. NOT JUST TECHNOLOGY FOR TECHNOLOGY'S SAKE, BUT REAL CUSTOMER FOCUSED HUMAN CENTRIC PROJECTS, INCLUDING ZERO EMISSIONS VEHICLES AND REPLACING OUR LIGHT RAIL FLEET AND STATION REDEVELOPMENTS. NEXT SLIDE. SO WE HAVE AN UPDATED VERSION OF THIS SLIDE THAT WILL BE AVAILABLE IN BACKUP FOR NEXT THURSDAY'S VTA BOARD MEETING. AT THE END OF THE DAY WE ARE BRINGING TO THE BOARD IN MAY FOR DISCUSSION A LOCAL INVESTMENT PLAN FOR SANTA CLARA COUNTY. WHAT YOU WOULD SEE WOULD BE TYPES OF PROJECTS WITHIN THESE THREE CATEGORIES. YOU CAN THINK OF SOME OF THE THINGS I RAN THROUGH AS EXAMPLES. YOU WILL SEE A PERCENTAGE OF REVENUE ATTACHED TO THEM. THAT'S A LITTLE BIT SIMILAR TO MEASURE B. WHAT IS THE PRIMARY OUTCOME THAT TYPE OF PROJECT IS GOING TO DRIVE. IS IT RIDERSHIP, PRODUCTIVITY, CUSTOMER EXPERIENCE. YOU CAN'T EFFECTIVELY MANAGE WHAT YOU CAN'T MEASURE. WE WANT TO MAKE SURE WE HAVE VERY WELL INFORMED, WELL DEVELOPED KPIs OVER THE LIFE OF THIS MEASURE WE CAN MAKE ADJUSTMENTS. AND THEN WE ARE CONTINUING TO GO OUT TO THE PUBLIC AND REFINE THE PLAN FURTHER WITH THE INPUT WE HEAR. SOME PLACES ARE PROVIDING THAT INFORMATION. THE CITY OF SAN JOSE PROVIDED IT IN THE FORM OF A RESOLUTION. WE DON'T HAVE A SPECIFIC PREFERENCE AND WE ARE HOPING TO HEAR AS MUCH AS WE POSSIBLY CAN SO WE CAN HAVE THE MOST INFORMED ACTION ITEM FOR OUR BOARD ON JUNE 4. NEXT SLIDE. AND INVESTMENT.PLAN@VTA.ORG. THAT'S WHERE WE HAVE BEEN ENCOURAGING PEOPLE TO MAKE INPUT. THE QR CODE GOES TO ONE MEASURE LANDING PAGE WHICH IS ON THE VTA HOME PAGE. THERE IS A TEXT BOX WAY FOR PEOPLE TO PROVIDE INPUT THERE. AND WE WANT TO HEAR ANY AND ALL FEEDBACK. WE'LL HAVE MORE FOR OUR BOARD NEXT WEEK. AND THEN AT THE END OF THE DAY, I WILL SAY REAL QUICK, BECAUSE THIS IS A FIVE COUNTY REGIONAL MEASURE, YOU WILL NOT SEE THE INVESTMENT PLAN APPEAR ON THE BALLOT ITSELF. IT WILL BE COMMON ACROSS THE FIVE COUNTIES. THIS CAN WORK MORE LIKE A CAPITAL INVESTMENT PLAN. OVER THE LIFE OF THE MEASURE WE CAN MAKE ADJUSTMENTS. WE ARE NOT LOCKED INTO NECESSARILY WHAT THE BOARD VOTES ON ON JUNE 4. WE WANT TO STICK TO THE PRINCIPLES AND OUTCOMES. I APPRECIATE THE TIME AND WELCOME ANY QUESTIONS OR COMMENTS FROM THE BOARD.

>> HOW MANY SPEAKERS DO WE HAVE ON THIS ITEM?

>> WE HAVE NO SPEAKER CARDS, BUT WE ARE SHOWING THREE HANDS IN ZOOM.

>> LET'S DO TWO MINUTE EACH.

>> OUR FIRST SPEAKER, THIS IS THE CLOSE OF THE CUE, TO SPEAK FOR THIS ITEM, OUR FIRST SPEAKER HARRY NEIL. PLEASE ACCEPT THE UNMUTE.

>> HELLO. I AM A MEMBER OF THE CITIZENS ADVISORY COMMITTEE. I'M SPEAKING MANY MY PERSONAL CAPACITY. THANK YOU FOR YOUR PRESENTATION, SAM. THIS IS INCREDIBLY IMPORTANT FOR THE FUTURE OF OUR REGION. AND FOR THE FUTURE OF SANTA CLARA COUNTY IN PARTICULAR. WE MUST PRIORITIZE, THIS IS A ONCE IN A GENERATION OPPORTUNITY, WE MUST PRIORITIZE THE EXPANSION AND IMPROVEMENT OF SERVICE FOR OUR RIDERS IN SANTA CLARA COUNTY. THE CITY OF SAN JOSE PROVIDED A SPLIT WHERE ABOUT 50% OF THE MONEY WOULD BE USED FOR SERVICE. FRANKLY, THAT IS TOTALLY INADEQUATE. THE VISIONARY NETWORK THAT VTA LAID OUT WOULD COST ABOUT $210 MILLION PER YEAR. I HOPE WE CAN GET AS CLOSE TO THAT AS POSSIBLE. I DON'T EXPECT THIS TO 100% FUND THAT. BUT WE SHOULD GET AS CLOSE AS POSSIBLE TO THAT WHILE STILL LEAVING SOME MONEY FOR ESPECIALLY TRANSIT SUPPORTIVE CAPITAL IMPROVEMENTS LIKE GRADE SEPARATION, TRANSIT SIGNAL PRIORITY AND COMPLETE STREET DESIGNS THAT ADVANCE TRANSIT SERVICE. THERE SHOULD BE SOME MONEY, FRANKLY, I THINK WE WOULD BE DOING OURSELVES AND COMMUNITIES A DISSERVICE IF WE OVERINVEST IN ROAD MAINTENANCE. ROAD MAINTENANCE IS SOMETHING THERE WILL ALWAYS BE SOME MONEY FOR SOMEWHERE. TRANSIT SERVICE IS NOT ONE OF THOSE THINGS. TRANSIT SERVICE MONEY IS EXTREMELY LIMITED AND VERY, VERY DIFFICULT TO FIND OPPORTUNITIES TO ACQUIRE. THIS IS ONE. LIKE I SAID EARLIER, THIS IS A ONCE IN A GENERATION OPPORTUNITY. WE MUST PRIORITIZE SERVICE OVER ALL. THANK YOU.

>> THANK YOU. OUR NEXT SPEAKER IS RICHARD GALLO. PLEASE ACCEPT THE UNMUTE.

>> HELLO, EVERYONE. I DO AGREE WITH THE GENTLEMAN BEFORE ME, THAT WE MUST PRIORITIZE SERVICE. EXPANSION FOR RIDERSHIP, INCLUDING TRANSIT RIDERS LIKE MYSELF. I AM A PERSON WITH DISABILITY THAT UTILIZE TRANSIT IN THE BAY AREA COMING FROM SANTA CRUZ FOR MEETINGS, TRAIN TRAINING, ADVOCACY WORK AND SOMETIME WORK. WE ALSO NEED TO PRIORITIZE THE NEEDS OF THE DISABILITY AND SENIOR COMMUNITY WHEN IT COMES TO PARATRANSIT SERVICES. THEY NEED BETTER QUALITY SERVICES. THE NUMBER ONE COMPLAINTS I HEAR FROM THE SENIOR COMMUNITY AND DISABILITY COMMUNITY IS PARA-SERVICE, PICKING UP LATE AND PICKING UP LATE AFTER THE DROP-OFF. IT NEEDS TO BE BETTER OUTCOMES OVERALL WITH PARATRANSIT. THAT NEEDS TO BE PART OF CUSTOMER SERVICE EXPANSION BECAUSE THE SENIOR COMMUNITY IS GROWING IN THE NEXT YEARS. IT JUST IS. SO 10,000 RETIREES RETIRING DAILY. FIGURE THE NUMBERS WHAT IT'S GOING TO BE LIKE IN FIVE TO TEN YEARS. THAT NEEDS TO BE PRIORITIZED AS WELL. AND THAT'S IT. THANK YOU.

>> THANK YOU. AND THE LAST HAND THAT WAS RAISED AT THE CALL OF THE SPEAKER CUE, IS A ZOOM MEMBER BY THE NAME KH. KH, PLEASE ACCEPT THE UNMUTE. YOU MAY BEGIN YOUR COMMENTS. ZOOM SPEAKER KH, IF YOU WISH TO SPEAK, PLEASE UNMUTE YOUR MIKE.

>> HELLO?

>> YES, THERE WE GO.

>> THANK YOU. MY NAME IS CATHERINE HEDGES. I LIVE IN SANTA CRUZ, BUT I LIVE IN SAN JOSE, DOWNTOWN, IT WAS FANTASTIC. BUT THERE WERE A LOT OF PLACES THAT I WOULD LIKE TO GO IN THE COMMUNITY THAT THE BUS SERVICE WOULD STOP AT 6:00 P.M. AND NOT RUN AT ALL ON THE WEEKENDS, LIKE GOING TO CERTAIN PARTS OF SANTA CLARA. SO IT WOULD BE A MILE WALK FROM WHERE I WANTED TO GO INSTEAD OF CATCHING, I CAN'T REMEMBER THE NUMBER OF THE BUS, 73 OR 53 OR SOMETHING. AND MY FRIEND WHO LIVES THERE CAN'T USE THAT BUS TO COMMUTE BECAUSE IF HER WORK GET OUT LATE, THEN SHE WILL BE STRANDED AT WORK. AND IT'S ESSENTIAL TO EXTEND THE SERVICE, YOU HAVE MORE SERVICE IN THE NEIGHBORHOODS AND LATER SERVICE AND WEEKEND SERVICE. BECAUSE PEOPLE AREN'T GOING TO USE A BUS, THEY CAN GET THEM SOMEWHERE BUT NOT GET THEM HOME OR THEY CAN'T USE ON THE WEEKEND WHEN THEY HAVE MORE TIME TO RIDE THE BUS TO GO DO THEIR ERRANDS. ALSO, I LIKE TO TIE TOGETHER WHAT THE FIRST AND SECOND SPEAKER SAID BECAUSE A LOT OF PEOPLE DON'T REALIZE THAT THE PARATRANSIT COVERAGE AND HOURS ARE LINKED TO THE REGULAR TRANSIT HOURS. IF THE SERVICE AREA BASICALLY IS TRYING TO REPRODUCE WHAT THE BUS DOES. IF YOU LIVE WHERE THE REGULAR BUS WOULD STRAND YOU, THEN PARATRANSIT CAN'T BE TAKING YOU HOME AT 9:00 AT NIGHT EITHER. AND ONE OF THE THING I REALLY MISS ABOUT THE TRANSIT IN DOWNTOWN IS THE FREQUENCY OF SERVICE BECAUSE SANTA CRUZ --

>> THANK YOU. THAT CONCLUDES OUR SPEAKERS FOR ITEM NUMBER 11.

>> THANK YOU. SUPERVISOR ABE-KOGA?

>> THANK YOU SO MUCH FOR THE PRESENTATION. I THINK I HAVE HEARD IT A COUPLE OF TIMES NOW. BUT I JUST WANTED TO SHARE A FEW THOUGHTS. I THINK THAT THIS IS -- I HAVE TO EMPHASIZE THE SITUATION WE ARE IN. IT'S A SERIOUS SITUATION. WE HAVE, AS MENTIONED, SEVERAL TRANSIT AGENCIES THAT ARE ON THE BRINK OF A FISCAL CLIFF. SHOULD THIS MEASURE NOT PASS, WE REALLY CAN SEE TRANSIT GOING AWAY IN THIS AREA WHICH WOULD BE A TRAVESTY IN LIGHT OF HOW IMPORTANT IT IS TO MOVE PEOPLE AROUND, GET THEM TO THEIR PLACES AS OUR LATE PERSON SAID GETTING PEOPLE TO WHERE THEY NEED TO GO AND OPPORTUNITY. IT'S GIVING PEOPLE THAT CHANCE TO GET TO WHERE THEY NEED TO GO TO SUCCEED IN LIFE. TALKING ABOUT VTA, I'M GLAD THAT WE HAVE A LITTLE BIT OF A RUNWAY. BUT COME IN A COUPLE OF YEARS WE'LL BE LOOKING AT A $15 MILLION DEFICIT. CALTRAIN, THE OTHER AGENCY THAT SERVICES THIS AREA QUITE FREQUENTLY IS IN ONE OF THOSE MORE SERIOUS SITUATIONS AND THEY HAVE ANNOUNCED THAT STARTING IN 2028 THEY WILL EXPECT A $75 MILLION SHORTFALL EACH YEAR. AND IF NOTHING CHANGES, CALTRAIN WILL HAVE TO LOOK ON CUTTING TRAINS TO ONE HOUR, STOP RUNS AFTER 9:00 P.M., CLOSE MORE THAN A THIRD OF THEIR STATIONS AND CUT ROUTES COMPLETELY. BART IS ALSO SAYING DRASTIC MEASURES WOULD HAVE TO BE TAKEN. THIS IS CRITICAL BECAUSE THESE ARE THE SYSTEMS THAT INTERCONNECTED AND TAKE PEOPLE TO PLACES THEY NEED TO GO TO. AND SO I JUST WANTED TO SHARE THAT. ONE CHANGE THAT I WANT TO RECOMMEND TO VTA IS THAT WE CREATE SAFETY AND SECURITY AS A SEPARATE PROJECT LINE. THAT REALLY IS TOP PRIORITY. I HEAR IT ALL THE TIME. WE ALL HEAR IT ALL THE TIME. AND MAKE IT A SEPARATE LINE IN THE LOCAL INVESTMENT FRAMEWORK CHART ON SLIDE 11. IT'S UNDER FOUNDATION CATEGORY OF CATEGORY REIMAGINED AND SLIDE 9. IT WOULD FIT BETTER UNDER FOUNDATION. SO WITH THAT, THANK YOU AGAIN FOR THE UPDATE.

>> WANT TO MAKE A MOTION TO RECEIVE THE REPORT?

>> YES, HAPPY TO MAKE A MOTION TO RECEIVE THE REPORT.

>> I WILL SECOND THAT.

>> WONDERFUL. LISTEN, I AM GOING TO MAKE ANY QUICK. THIS IS AROUND THE TRANSIT SIGNAL PRIORITY POLICY MODEL. VTA CAN'T DO THIS UNILATERALLY AND IN A VACUUM. THEY HAVE TO RELY ON THE MUNICIPALITIES INVOLVED, THE CITIES AND COUNTIES. SO THEY NEED TO MAKE SURE, I THINK IT'S ESSENTIAL FOR VTA TO CONTINUE TO WORK WITH OUR LOCAL TRAFFIC ENGINEERS WITH OUR SYSTEMS TO IMPLEMENT SOMETHING SO AMBITIOUS AS THE TSP STRATEGIES. I WOULD LOVE TO -- I WANT TO HEAR IF YOU CAN BRING BACK A POLICY THAT WE CAN IMPLEMENT SOON THAT ALIGNS WITH TSP. PROVIDING TECHNICAL SUPPORT TO MEMBER AGENCY, TRAFFIC ENGINEERING STAFF ON TSP AND COORDINATING WITH MEMBER AGENCIES ON SPECIFIC PRIORITIZATION AND REPORT BACK ON THE MEASURED SPEED IMPROVEMENTS. I KNOW THIS IS AN ACTIVE CONVERSATION OVER AT VTA. IT'S ONE OF THE WAYS THAT WE CAN GET TO PLACES FASTER. IT'S NOT JUST EVERYONE IS INVESTING IN IT IN THE SAME WAY. SMALLER CITIES MIGHT NOT HAVE IT AS PRIORITIZED AS OTHERS. I KNOW THE CITY OF SAN JOSE IS SOMETHING THAT IT'S WELL ON THE WAY. BUT WE WERE TALKING ABOUT THAT FOR A REALLY LONG TIME BEFORE IT ACTUALLY HAD ANYTHING REALLY ON THE BONES. IS THERE ANY WAY OR HAVE YOU THOUGHT ABOUT HOW YOU CAN INCREASE THE COLLABORATION OR THE COMMUNICATION BETWEEN THE MUNICIPALITIES AND THE CITY PLANNERS? STATE OFFICIALS, ALL OF THOSE FOLKS?

>> SPECIFICALLY ON TRANSPORTATION. WE HAVE SAMPLE POLICIES WE HAVE DRAFTED FOR OUR CITIES TO CONSIDER. WE WORK CLOSELY WITH OUR TECHNICAL ADVISORY COMMITTEE MADE UP OF STAFFS FROM EACH OF OUR MEMBER AGENCIES AND THE COUNTY. THAT'S WHERE WE HAVE BEEN DOING THAT WORK. WE ARE HAPPY TO MEET WITH YOUR STAFF OR ANYONE.

>> LOVE IT.

>> TSP IS TWO THINGS, EQUIPMENT AND POLICY. WE CAN HELP WITH EQUIPMENT AND HELP WITH THE POLICY. ULTIMATELY IT'S OUR LOCAL JURISDICTIONS THAT CONTROL THE POLICY.

>> I WOULD LOVE FOR US TO LEND OUR EXPERTISE ANY WAY WE CAN, IF YOU ALREADY HAVE TEMPLATES LIKE THAT, THAT'S IMPORTANT. EVERY NOW AND THEN AT VTA WE TAKE ACTION BEFORE WE ADOPT A POLICY, WHICH IS VERY BACKWARDS TO ME. IN THE NAME OF EXPEDIENCY. OR BECAUSE I WANTED THE RIGHT MOMENT. AND I JUST THINK IT'S A BACKWARDS WAY OF UNFOLDING GOVERNMENT AND PUBLIC WORK. SO THANK YOU. I APPRECIATE THAT. AND CAN I FOLD THAT INTO THE MOTION?

>> YES.

>> PERFECT. THANK YOU.

>> SORRY. PROCEDURAL QUESTION AGAIN. I'M NOT COMFORTABLE VOTING TO HAVE -- TO DIRECT VTA TO PROVIDE SOMETHING BACK TO THIS BOARD.

>> IT'S NOT VOTING. WELL, YEAH.

>> IT'S THAT -- IS THAT APPROPRIATE?

>> A REQUEST CAN BE MADE. THE BOARD DOESN'T HAVE AUTHORITY TO DIRECT TO TAKE ACTION.

>> IT'S SOMETHING I WOULD PREFER NOT TO VOTE ON.

>> YOU CAN ABSTAIN.

>> I KNOW I CAN ABSTAIN. I JUST WANTED TO UNDERSTAND THE GENERAL APPROPRIATENESS OF THIS BOARD DIRECTING, ASSUMING OTHER PEOPLE DON'T ABSTAIN, DIRECTING A DIFFERENT ORGANIZATION TO REPORT BACK TO US.

>> TO GIVE US AN UPDATE?

>> SURE.

>> THEN THEY ARE COMING BACK TO REPORT TO OUR BOARD?

>> WE CAN HAVE A REPORT BACK TO THE BOARD.

>> THAT'S NOT WHAT I'M ASKING FOR. I'M CONCERNED THAT'S HAPPENING. THAT DOES NOT FEEL APPROPRIATE TO ME. THEY SHOULD BE REPORTING TO VTA OR WORKING INDIVIDUALLY WITH OUR OFFICES.

>> THEY ARE UPDATING REPORTING TO US NOW.

>> I THINK IF IT'S A QUESTION TO PROVIDE AN UPDATE TO THE BOARD, THAT WOULD BE FINE.

>> CHANGE IT TO A REQUEST.

>> PERFECT.

>> THANK YOU.

>> THANK YOU.

>> SUPERVISOR DUONG, COMMENTS?

>> ADDING TO YOUR REQUEST, NOT DIRECTION, [LAUGHTER] THE COUNTY HAS OVERSIGHT OF OUR EXPRESS WAYS. I FEEL LIKE THAT'S A NATURAL PLACE FOR THAT PARTNERSHIP AND CONVERSATIONS TO HAPPEN IN TERMS OF HOW TO ENHANCE CONNECTIVITY. THAT'S WHERE WE WOULD HAVE THE MOST LEEWAY WHEN IT COMES TO ROADS. SO A REQUEST WOULD BE SINCE YOU ARE ASKING FOR IDEAS AND SUGGESTIONS FROM THIS BOARD IS TO CONNECT WITH OUR ROADS AND AIRPORTS DEPARTMENT. RIDE, GIVING THE PARENTS A RIDE TO WORK AFTER THEY DROP OFF THE KIDS, OR LENDING MONEY, LIKE STARTING THE PTA'S NOW FUNDRAISING TO BUY BUS PASSES FOR THESE FAMILIES AND I THINK THAT THEY DON'T HAVE TO DO THAT. I THINK THERE'S AN OPPORTUNITY WHERE WE CAN DO BETTER HERE. SO I'M GOING TO RUN THAT BY YOU AND I'M GOING TO TRUST THAT YOU TAKE THAT. THAT'S MY REQUEST, PLEASE TAKE THAT TO THE POWERS THAT BE.

>> WE WILL BE HAPPY TO DO THAT.

>> THANKS SO MUCH.

>> LET'S TAKE A VOTE.

>> AND THAT'S A MOTION TO RECEIVE THE REPORT BY SUPERVISOR ABE-KOGA SECONDED BY SUPERVISOR ARENAS.

>> SUPERVISOR ABE-KOGA.

>> AYE.

>> SUPERVISOR DUONG.

>> YES.

>> SUPERVISOR ELLENBERG.

>> I'M ABSTAINING.

>> VICE PRESIDENT ARENAS.

>> YES.

>> PRESIDENT LEE.

>> AYE.

>> MOTION PASSES.

>> I FEEL SOME HANGRINESS FROM THIS BOARD. LET'S SAY 1:25, WILL THAT WORK? ALREADY, 1:25, THANK YOU, AND LUNCH IS HERE. [ LUNCH RECESS ]

>> GOOD AFTERNOON, WE DO HAVE 1:25, THANK YOU MY COLLEAGUES. WE DO HAVE A QUORUM, WHY DON'T WE GO TAKE THE ROLL.

>> SUPERVISOR ABE-KOGA.

>> SUPERVISOR DUONG. SUPERVISOR ABE-KOGA IS WALKING IN NOW. SUPERVISOR DUONG IS NOT IN CHAMBERS. SUPERVISOR ELLENBERG.

>> I AM HERE.

>> SUPERVISOR ARENAS.

>> HERE.

>> PRESIDENT LEE.

>> HERE. I'M GOING TO PROPOSE TO MOVE ITEM 33 UP, RIGHT AFTER COUNTY COUNSEL'S REPORT ON THE REQUEST OF MY COLLEAGUE, SUPERVISOR ABE-KOGA, SO LET'S DO, SO JAMES, ARE YOU READY?

>> YES.

>> THANK YOU.

>> SO GOOD AFTERNOON, MEMBERS OF THE BOARD, VERY BRIEF UPDATE TODAY. WE ARE ON TRACK FOR PUBLICATION OF THE RECOMMENDED BUDGET ON FRIDAY, MAY 1. FOR THE BENEFIT OF PUBLIC, THAT WILL BE FOLLOWED BY BUDGET WORKSHOPS THE WEEK OF MAY 11 WITH BUDGET HEARINGS IN JUNE FOR AN ADOPTED BUDGET THAT WILL TAKE EFFECT AT THE BEGINNING OF THE FISCAL YEAR ON JULY 1. AS THE BOARD KNOWS, IT'S A VERY, VERY CHALLENGING BUDGET, HEARD SOME COMMENTS THIS MORNING ABOUT THAT AND WE'LL WALK THROUGH ALL OF THAT THE FIRST DAY OF THE BUDGET WORKSHOPS. BUT DID WANT TO REMIND THE BOARD CONSISTENT WITH WHAT WE SHARED IN THE FALL, THERE WILL BE A MAILER GOING OUT TO COUNTY RESIDENTS UPDATING THEM ON THE BUDGET ITSELF, BUT ALSO WITH A LINK TO HOW FOLKS CAN ENGAGE WITH THE STATE PROS AS PART OF OUR EFFORTS RELATED TO STATE ADVOCACY, WE'RE GOING TO HEAR MORE ABOUT THAT LATER ON THE AGENDA TODAY SO I WON'T GO INTO THOSE POINTS NOW. I'LL SAVE THOSE COMMENTS FOR LATER BUT WE PUSH ACTIVELY ON THAT STRATEGY, AS WELL. WITH THAT, THAT CONCLUDES MY REPORT JUST NOW.

>> QUESTION FOR JAMES? OK. AND TONY.

>> THERE WERE NO REPORTABLE ACTIONS TAKEN AT THE APRIL 27, 2026 CLOSED SESSION OF THE BOARD OF SUPERVISORS. THAT CONCLUDES MY REPORT.

>> OK, THANK YOU. SO NEXT IS ITEM AS I SAID EARLIER, 33, WHICH IS RELATING TO THE SMART PASS PROPOSAL TO BE NOT BE RENEWED FOR OUR COUNTY EMPLOYEES WITH THE VTA. I BELIEVE THIS WAS PROPOSED BY SUPERVISOR ABE-KOGA, PLEASE.

>> THANK YOU, PRESIDENT LEE AND THANK YOU FOR MOVING THIS UP IN THE AGENDA. I PULLED THIS ITEM, BECAUSE, YOU KNOW, I VERY MUCH APPRECIATE STAFF'S EFFORTS TO REDUCE OUR COSTS AND I DON'T HAVE TO SAY THAT, YOU KNOW, IT'S A LARGE, BIG CHALLENGE THAT WE ARE DEALING WITH, BUT IN LIGHT OF THE PRESENTATION WE HAD EARLIER BY VTA, I, AND JUST MY REAL SUPPORT FOR PUBLIC TRANSIT AND THE IMPORTANCE OF TRANSIT, I WANTED TO SEE IF WE COULD PRESERVE THIS PROGRAM FOR OUR COUNTY EMPLOYEES IN ADDITION TO THE HHS EMPLOYEES AND THE COURT EMPLOYEES. I UNDERSTAND THERE'S CONCERNS ABOUT LOW UTILIZATION. I SEE THAT THE NUMBERS HAVE COME UP SLOWLY AFTER COVID, AND THERE'S OVER A THOUSAND MEMBERS OF OUR STAFF WHO USE VTA. I SAW THAT LAST YEAR, AS WELL, THAT THE RATE OF UTILIZATION AND I'VE BEEN THINKING LIKE WAYS THAT WE COULD WORK WITH VTA TO ENCOURAGE OUR EMPLOYEES TO USE TRANSIT MORE, AND INCREASE THAT NUMBER, SO I JUST WANTED TO REQUEST THAT WE MAINTAIN THIS PROGRAM, AND INCREASE OUR EFFORTS TO ENCOURAGE OUR STAFF TO UTILIZE THE PROGRAM FOR AT LEAST ANOTHER YEAR, SO THAT WOULD BE MY MOTION.

>> OK. I'LL GO AND SECOND THAT. LET'S SEE, DO WE HAVE ANY PUBLIC WHO WOULD LIKE TO SPEAK ON THIS ITEM?

>> I DO NOT HAVE ANY PUBLIC SPEAKERS ON THIS ITEM.

>> OK. SUPERVISOR DUONG, LOOKING AT ME, ANY COMMENTS ON ITEM 33 WHICH IS RELATING TO THE PROPOSAL TO NOT RENEW THE SMART PASS PROGRAM FOR OUR COUNTY EMPLOYEES, AND THE CURRENT MOTION FROM SUPERVISOR ABE-KOGA IS TO CONTINUE THIS PROGRAM FOR AT LEAST ONE MORE YEAR TO ALLOW FOR THE USAGE OF IT TO SEE IF MORE COUNTY EMPLOYEES WOULD BE USING THIS PUBLIC TRANSPORTATION SUBSIDY FOR THEIR COMMUTE.

>> THANK YOU FOR CATCHING ME UP. I APOLOGIZE, FRIENDS AND COLLEAGUES FOR BEING LATE.

>> NO WORRIES.

>> I WAS HANGING OUT WITH YOUR COLLEAGUE'S BABY.

>> THAT WAS A BIG DISTRACTION. I THOUGHT THAT WAS THE BEGINNING OF MY BIGGEST INTERN THIS AFTERNOON.

>> DANIEL PROMPTS TO BRING HIM DOWN FOR PUBLIC COMMENT.

>> SUPERVISOR ELLENBERG, PLEASE.

>> THANK YOU. I APPRECIATE THE EFFORT TO TRY TO PRESERVE A SERVICE WHEN IT IMPACTS ANY OF OUR EMPLOYEES, BUT THE USAGE IS REALLY NOT SIGNIFICANTLY MORE. WE HAD THIS CONVERSATION, I BELIEVE LAST YEAR AND SAID THE SAME THING, TO HOLD ON FOR ONE MORE YEAR, AND WHILE IT IS NOT A HUGE AMOUNT, WE'RE GOING TO HAVE TO BE DOING THIS ACROSS THE COUNTY AS WE LOOK FOR COST RECOVERIES, AS WE LOOK FOR PLACES TO SAVE MONEY, THEY WILL ADD UP. I SUPPORT THE -- I WOULD SUPPORT A SUBSTITUTE MOTION TO SUPPORT THE RECOMMENDATION FROM STAFF THAT WE DO CONTINUE THIS FOR OUR IHSS EMPLOYEES. I THINK IT WOULD BE EGREGIOUS TO PULL THAT AWAY, BUT TO REMOVE THAT BENEFIT IN -- FOR THE BROADER EMPLOYEE GROUP AND WOULD SEE IF THERE'S A SECOND TO THAT, ESSENTIALLY TO APPROVE THE --

>> SUPERVISOR, GO AHEAD.

>> I'M SORRY. THROUGH THE CHAIR, I CAN SUPPORT THAT IF I THINK IF WE INCLUDE, OK, SO RIGHT NOW WE ARE INCLUDING -- WE'RE KEEPING THE.

>> HOME SUPPORT SERVICES, RIGHT?

>> UH-HUH.

>> AND THE SUPERIOR COURT EMPLOYEES, AS WELL.

>> OH, YES, THANK YOU.

>> AND WHAT I WAS GOING TO ASK YOU IS WOULD YOU CONSIDER IF THERE WAS SOMETHING THAT WOULD COVER MAYBE WHAT WE ARE SEEING IS THE ACTUAL ACTIVE EMPLOYEES WHO UTILIZE IT, SO IF IT'S A THOUSAND EMPLOYEES THAT ARE ACTUALLY USING IT, OR I DON'T KNOW, 50 EMPLOYEES THAT ARE REALLY DEVOUTLY USING THE SMART PASS, I THINK THAT SPEAK TO SAY MAYBE ACCESS TO TRANSIT. THAT NECESSITY EASTERN LUXURY.

>> I WOULD BE INTERESTED TO KNOW WHETHER WE GET SIMILAR RATES, WHETHER IT'S ACTUALLY MORE EXPENSIVE SINCE WE HAVE SO FEW.

>> I CAN JUST ANSWER THAT QUESTION, BECAUSE THIS IS SOMETHING WE'VE LOOKED AT IN YEARS PAST. THIS IS NOT THE FIRST TIME THIS CONVERSATION HAS COME UP, IT'S COME UP SEVERAL TIMES ON BEHALF OF THE LOW UTILIZATION ON BEHALF OF THE EMPLOYEES. I'VE HEARD THE ITEM DISCUSSED IN THESE CHAMBERS FOUR OR FIVE TIMES OVER THE LAST DECADE. IT'S A PROGRAM FROM VTA. THE COUNTY'S OBLIGATED TO PURCHASE TO ALL EMPLOYEES OR NONE WAS NOT CERTAIN EMPLOYEE GROUP, SO WE DON'T HAVE A CHOICE OF DOING SO FOR JUST THE ACTIVE USERS. THE COST PER, FOR EMPLOYEES, OF COURSE A MERE FRACTION OF WHAT IT WOULD COST TO BUY AN ANNUAL PASS, AND SO IF UTILIZATION WAS SIGNIFICANTLY HIGHER, THIS WOULD BE A VERY COST EFFECTIVE BENEFIT, BUT UTILIZATION HAS HISTORICALLY ALWAYS BEEN RELATIVELY LOW AMONG COUNTY EMPLOYEES. IT HAS PLUMMETED SIGNIFICANTLY POST PANDEMIC. IT HAS COME BACK A LITTLE BIT TO THE POINT THAT SUPERVISOR ABE-KOGA HAS MADE BUT HAS STILL REMAINED RELATIVELY MUCH LOWER THAN EVEN PREPANDEMIC BUT THIS IS A CONVERSATION THAT EVEN PREPANDEMIC WAS ONE THAT WAS AN ACTIVE ONE. YOU, JUST TO BE VERY CLEAR, YOU KNOW, ADMINISTRATION'S OBVIOUSLY VERY SUPPORTIVE OF BOTH THE AVAILABILITY AND ACCESSIBILITY OF PUBLIC TRANSIT BUT A LOT OF WAYS IN WHICH THIS PARTICULAR BENEFIT CANNOT CONSTRUCTED THE RIGHT WAYS FOR OUR WORKFORCE. IT IS ONLY FOR USE ON VTA. IT DOESN'T COVER CAL TRAIN OR OTHER PUBLIC TRANSIT AND WE'VE HEARD FEEDBACK FROM A NUMBER OF OUR OWN EMPLOYEES WHO UTILIZE MULTI-MODAL TRANSPORTATION OPTIONS THAT THIS IS NOT A BENEFIT THAT'S INCLUSIVE OF THAT, SO, YOU KNOW, UTILIZATION HAS REMAINED LOW. IT IS SOMETHING WE ADVERTISE ABOUT, SOMETHING WE INCLUDE ON RECRUITMENT AND HIRING MATERIALS, IT'S SOMETHING THAT EVERY EMPLOYEE WHAT THEY'RE ONBOARD GETS TOLD ABOUT, SO IT'S, WE CAN CERTAINLY MAKE ADDITIONAL EFFORTS, BUT I WOULD NOT EXPECT TO SEE THESE NUMBERS MOVE MATERIALLY EVEN WITH ENHANCED OUTREACH. IT IS ONE OF THE FEW EMPLOYEE BENEFITS THAT IS NOT CONTRACTUAL, WHICH MEANS IT IS ONE OF THE FEW CENTRALIZED PROPOSALS WE CAN BRING FORWARD THAT HAS AN ONGOING COST SAVINGS THAT WE CAN TAKE ACTION ON IN THIS KIND OF MANNER, SO THOSE ARE THE REASONS FOR THE RECOMMENDATION. OF COURSE, WE WILL 100% MOVE FORWARD WITH WHATEVER THE BOARD CHOOSES TO DO, BUT I DIDN'T WANT ANYONE TO THINK WE WERE IN ANY WAY NOT SUPPORTIVE OF TRANSIT ACCESS. WE DO HAVE A PRETAX PROGRAM THAT'S NEWER, IT WAS ESTABLISHED IN 2019, AND THIS IS REALLY A DATA BASED RECOMMENDATION BASED ON MANY YEARS OF LOW UTILIZATION AND IN THE CONTEXT OF OUR COUNTY'S OVERALL FISCAL PICTURE.

>> WHEN -- THANK YOU. SO WHAT IS THE AMOUNT.

>> WE SPEND $700,000 PER YEAR FOR THIS PROGRAM FOR COUNTY EMPLOYEES, SO THIS WOULD BE A $700,000 ONGOING COST.

>> WHAT IS THAT AMOUNT OF -- WHAT IS THE AMOUNT OF EMPLOYEES THAT NEED TO PARTICIPATE IN THE PROGRAM IN ORDER FOR IT TO BE COST EFFECTIVE.

>> I DON'T KNOW WE'VE CALCULATED THAT PRECISELY, BUT PROBABLY AROUND JUST BACK OF THE ENVELOPE, I WOULD SAY WE'D PROBABLY WANT TO SEE AT LEAST AROUND 9%.

>> BUT WE HAVE NEVER HAD 9%.

>> NOT THAT I'M AWARE OF, WE HAVE DATA GOING BACK TO 1999 BUT I DON'T BELIEVE WE EVER HAVE.

>> YEAH, SO MAYBE, I DON'T KNOW IF THAT'S AN UNREALISTIC.

>> THE COST MODEL FOR THIS BENEFIT CHANGED I FORGOT IN WHAT YEAR. I'M TRYING TO REMEMBER. I WANT TO SAY MAYBE AROUND 2016, 2015 TIME FRAME, SUPERVISOR ABE-KOGA MIGHT REMEMBER BUT THE COST MODEL SHIFTED. IT ACTUALLY USED TO BE IF MY MEMORY IS CORRECT AND I WASN'T IN THIS ROLE SO IT WASN'T SOMETHING I DIRECTLY WORKED ON IN ANY WAY, BUT MY MEMORY IS THAT THE COST FOR THE COUNTY USED TO BE MUCH LOWER FOR THIS PROGRAM AND THEN VTA SHIFTED THE COST MODEL, WHICH IS THAT THEY CREATED A SEPARATE, MY RECOLLECTION, JUST TO BE CLEAR, IF IT IS ME REMEMBERING A BOARD ITEM I DIDN'T WORK ON FROM YEARS PAST SO DON'T QUOTE ME ON IT. WE CREATED A SEPARATE CATEGORY FOR LARGER EMPLOYERS AND IT SHIFTED OUR COST STRUCTURE AND MY MEMORY IS THAT IT ROUGHLY DOUBLED OUR COSTS OR SOMETHING LIKE THAT FOR THE PROGRAM. THERE WAS A LOT OF CONVERSATION, OF COURSE THE COUNTY HAD FUNDING BACK THEN SO THE CHOICE WAS DESCRIBE EVEN THOUGH THE COST HAD DOUBLED, BUT IT WAS WHEN THE COUNTY FIRST JOINED THIS PROGRAM, THE COST FOR THE COUNTY WAS MUCH, MUCH LOWER.

>> HOW ARE THIS. IT SEEMS LIKE WE HAVE 1,031 FROM LAST YEAR OR FROM 25 TO 26, RIGHT, UTILIZING IT. IT SEEMS WHEN THE LAST ONE, TWO, THREE, IF YOU INCLUDE 25, 26, IT'S AROUND 900, AND I WONDER IF WE COULD SET ASIDE SOME FUNDS THAT CAN SUBSIDIZE A VTA MART PASS THAT EITHER COMPLETELY PARTIALLY JUST SO WE CAN TEST OUT, I JUST DON'T WANT TO LEAVE THOSE FOLKS WHO ARE USING VTA AS A NECESSITY, RIGHT? AND I'VE GOT TO SAY THAT THERE'S SOME FOLKS ON MY TEAM THAT HAVE THIS, WE ALL HAVE THIS BENEFIT, BUT THEY DON'T USE IT LEGALLY, BECAUSE THE ROUTES AREN'T AS IF, YOU KNOW, WHAT THEY USED TO BE. THEY JUST AREN'T. IT'S A CIRCLE, IT'S A CIRCLE, SO PEOPLE DON'T GET ONBOARD BECAUSE THEY'RE NOT GOING TO GET WHERE THEY NEED AND THEN THE RIDERSHIP KEEPS GETTING LOWER. WHAT I'M INTERESTED IN PROTECTING IS THOSE RIDERS THAT ACTUALLY NEED IT, SO IF I'M GETTING THE FEEDBACK AND I DON'T KNOW, THIS IS JUST AN HYPOTHETICAL ALTHOUGH WE KNOW THE ROUTES HAVE BEEN REDUCED OVER TIME. THAT IS A FACT. THE PEOPLE THAT ARE USING THESE PASSES IS BECAUSE THEY NEED THEM.

>> LET ME MAKE THIS SUGGESTION.

>> WHAT IS YOUR COMMENT.

>> I DON'T KNOW HOW MUCH NEGOTIATING ROOM THERE IS, BUT IF VTA WOULD AGREE TO A LOWER RATE OR HAVE AN ON-THE-IN SYSTEM.

>> OH, AN ON-THE-IN SYSTEM.

>> I HATE FOR PEOPLE TO LOSE THEIR TRANSIT BUT WE HAVE HAD THIS CONVERSATION MULTIPLE TIMES. IT DOESN'T MOVE AND IT'S NOT A COST EFFECTIVE.

>> I CERTAINLY DO NOT WANT TO CONTINUE IF IT'S NOT COST EFFECTIVE. I THINK THESE ARE THE FOLKS WHO ACTUALLY NEED THE TRANSIT AND DON'T WANT TO LEAVE THEM HANGING JUST BECAUSE EVERYONE ELSE HAS THE LUXURY OF A CAR AND OTHER OPTIONS.

>> JAMES, GO AHEAD.

>> I WOULD HAVE A COUPLE OF THOUGHTS THAT I WOULD MAKE AS SUGGESTION ABOUT THE BOARD IS INTERESTED. WHAT WE COULD DO IF THE BOARD CHOOSES TO MOVE FORWARD, WE CAN EXPLORE TWO THINGS IN A REPORT BACK. ONE IS WE CAN GO TO VTA AND ASK THEM TO REVISIT THE COST STRUCTURE OF THIS PROGRAM, LIKE I SAID AND I THINK SUPERVISOR ABE-KOGA NODDING. WE CAN TAKE IT BACK TO VTA AND SAY IF YOU CAN RETURN TO YOUR PRIOR COST STRUCTURE, IT WAS VERY, VERY EFFECTIVE. OUR COSTS ARE GOING UP AS OUR WORKFORCE HAS EXPANDED OVER THE YEARS. I THINK WE CAN GO BACK TO VTA AND SAY IF YOU RETURN TO YOUR PRIOR COST STRUCTURE, WE WOULD BE IN A POSITION TO REVISIT CONTINUING THE PROGRAM. AND WE CAN BRING THAT BACK TO THE BOARD. SECOND, WE CAN SIMULTANEOUSLY LOOK AT BASED ON OUR VERY SUCCESSFUL SUCCESS DECEASED PROGRAM TO PROVIDE FUNDINGS ON THE PRETAX BASIS FOR OUR EMPLOYEES -- WHO ARE BELOW A CERTAIN INCOME THRESHOLD FOR CHILD CARE. WE CAN LOOK AT WHAT MIGHT MAKE SENSE IN THAT CONTEXT FOR A PROGRAM HERE, BECAUSE WE HAVE THE PRETAX BENEFITS AND WE CAN LOOK AT BASICALLY MAKING MATCHING FUNDS OR PERHAPS SOMETHING LIKE THAT AVAILABLE. THE BENEFIT OF THAT IS IT WOULD BE AVAILABLE FOR EMPLOYEES WHO USE OTHER PUBLIC TRANSIT. THEY COULD USE IT TO SUBSIDIZE THEIR CAL TRAIN PASS OR THEIR BART, WHATEVER ELSE SO MIGHT BE A POTENTIAL BENEFIT. WE COULD DO AN ANALYSIS AND BRING SOMETHING BACK BASED ON THAT. IF WE CAN EXPLORE BOTH OF THESE IN BARREL AND VTA SAYS YES, WE'LL REVISIT THE COST STRUCTURE, WE CAN RENEW BUT IF NO, WE'LL LOOK AT WHAT IS THE CURRENT COST STRUCTURE, THEN WE CAN CONTINUE WITH A DIFFERENT COMMUTER BENEFIT.

>> I'M HAPPY TO INCORPORATE THAT INTO THE MOTION. I WAS MOST INTERESTED IN NOT CONTINUING WITH THE SAME PATTERN AND THE SAME FORMULA, SO WITH THOSE ADDITIONAL SUGGESTIONS, I WOULD MAINTAIN MY MOTION. AND THE SECONDER IS STILL OK?

>> PERFECT. WE'RE GOING TO CONTINUE TO LOOK AT THOSE TWO OPTIONS, LOOK AT THE COST STRUCTURE AND SUBSIDIZED FUNDING FOR THE PRETAX DOLLARS, WHETHER WE MATCH THEM OR WHATEVER THAT WORKS. IN THE MEANTIME, I ALSO AM INTERESTED IN LEARNING FOR THE IN HOME SUPPORT SERVICES AND THE SUPERIOR COURT EMPLOYEES. I KNOW THEY WERE THE EXCEPTION. I DON'T KNOW IF THEY WERE THE EXCEPTION BECAUSE THEY'RE THE ONES WHO ARE SIGNING THE VTA TRANSIT. IS THAT SOMETHING THAT WE KNOW.

>> THE SUPERIOR COURT IS JUST BECAUSE THE COURT FUNDS IT. IF THE COURT STILL WANTS TO PAY FOR IT.

>> YEAH, YEAH.

>> WE'RE THE CONDUIT ENTITY. THAT'S THE REASON THE COURT EMPLOYEES ARE SEPARATED. OF COURSE IF THE COURT CONTINUES TO DISCONTINUE, WE WOULD HONOR THAT, TOO, BUT WE'RE NOT TRYING TO PREVENT THE COURT FROM PARTICIPATING IF THEY SO CHOOSE WITH THEIR OWN MONEY. FOR IHSS, WE PROVIDED THESE, THIS TO THEM. WE -- I CAN'T RECALL. I DON'T KNOW IF YOU HAVE SPECIFIC UTILIZATION NUMBERS, BUT MY RECOLLECTION IS WE LOOKED AT THAT CATEGORY SEPARATELY AND GIVEN IT'S A DIFFERENT WORKFORCE, OBVIOUSLY MUCH LOWER PAY AND I THINK BASED ON WHAT WE SAW THERE, THAT'S WHY WE HAD MADE A DIFFERENT RECOMMENDATION THAN FOR OUR OWN COUNTY EMPLOYEES. I DON'T KNOW IF YOU HAVE ANYTHING TO ADD ON THAT.

>> DIRECTOR OF SERVICES AGENCY, YEAH, WE LOOKED AT THAT COHORT AND I THINK THAT AND LOOKING AT THAT WORKFORCE, IT WAS DECIDED THAT WE DIDN'T WANT TO MOVE IN THAT DIRECTION RIGHT NOW WITH THE RECOMMENDATION AND CONTINUING TO PROVIDE TO IHSS BASED ON ORIGINALLY WHAT WE WERE LOOKING AT.

>> THAT COST IS AT LEAST SHARED. ONE THING FOR THE BOARD TO BE AWARE OF WITH RESPECT TO IHSS, WHICH, YOU KNOW, IS A SOMEWHAT SIMILAR OVERALL COST JUST FOR THAT PORTION, BECAUSE IT'S 30 SOME ODD THOUSAND FOLKS. THAT AT LEAST HAS COST SHARE FROM THE STATE AND FEDERAL GOVERNMENT, SO THE COST TO THE COUNTY FOR THAT PIECE IS MUCH MORE MODEST, SO WE'RE ABLE TO STILL PROVIDE THAT BENEFIT TO A MUCH LOWER INCOME PORTION TO FOLKS WHO HAVE HIGHER UTILIZATION AT ONLY A SMALL SLIVER OF GENERAL FUND COST SO THAT'S WHAT INFORMED THAT GENERAL TREATMENT.

>> WE MIGHT HAVE A DIFFERENT YEAR THIS YEAR BECAUSE GAS PRICES ARE JUST THROUGH THE ROOF, RIGHT?

>> ABSOLUTELY.

>> AND WE KNOW THAT FAMILIES ARE REALLY HIT HARD MAKE CHOICES ON WHERE THEY GO BASED ON DISTANCE, RIGHT? ANYWAYS, I THINK YOU GET MY MESSAGE, I JUST DON'T WANT TO LEAVE THOSE FOLKS WITHOUT ANY OPTION, SO I APPRECIATE YOU ACCEPTING THAT ACCOMMODATION. THANK YOU.

>> CAN I JUST CLARIFY THE ST. LOUIS MOTION?

>> GO AHEAD, TONY.

>> I UNDERSTAND THREE COMPONENTS, ONE, THE RECOMMENDED ACTION, TWO, TO ESSENTIALLY DELEGATE AUTHORITY TO THE COUNTY EXECUTIVE TO EXPLORE AN ALTERNATIVE COST STRUCTURE THAT WOULD ALLOW FOR THE FULTON COUNTY EMPLOYEE BENEFIT AND REPORT BACK TO THE BOARD IF THERE'S A VIABLE OPTION.

>> BASICALLY TO ASK VTA.

>> RIGHT AND THIRD IS TO HANDLE OPTIONS FOR OTHER BENEFITS, INCLUDING THE PRETAX BENEFIT.

>> GOT IT.

>> SUPERVISOR DUONG.

>> YES, JAMES, WHEN YOU GO TO VTA TO REVISIT THIS PRICE COST STRUCTURE AND I KNOW THAT THIS IS A DIFFERENT POPULATION, I WANT TO MAKE MENTION AGAIN OF SOMETHING I COMMENTED ON THE PREVIOUS AGENDA ITEM, THAT WE DO HAVE ANOTHER POPULATION THAT DOES USE PUBLIC TRANSPORTATION, THAT WAIT IN LINE AT THE BEGINNING OF THE MONTH FOR A BUS PASS OR BUS TICKET, BECAUSE THEY ARE RIDERS OF NECESSITY, AND I KNOW IT'S NOT THE SAME GROUP, OR CLASSIFICATION YOU ARE NOT TALKING ABOUT HERE BUT IF YOU ARE GOING TO GO TO VTA SAYING THIS IS WHAT WE NEED, THIS IS WHAT WE'RE IN THE MARKET FOR, IT'S GOING TO BE ADVANTAGEOUS IF WE SAY THERE ARE MULTIPLE GROUPS TRYING TO PURCHASE TICKETS. SO WHERE POSSIBLE, PLEASE BROACH THE TOPIC OF HOW WE CAN PURCHASE AT A COST EFFECTIVE RATE TO PROVIDE BUS PASSES FOR OUR FOSTER KIDS AND FAMILIES WHO NEED SERVICES.

>> WE HAVE A BROAD BOOK OF BUSINESS SO TO SPEAK WITH VTA, LOTS OF DEPARTMENTS THAT ARE BUYING TICKETS FROM VTA FOR LOTS OF DIFFERENT PROGRAMS, AND IN LOTS OF DIFFERENT WAYS. VTA DOESN'T HAVE A MECHANISM LIKE THIS THAT'S AVAILABLE FOR OUR CLIENTS, BUT I THINK IF WE ASK, ARE ASKING VTA TO REVISIT THE COST STRUCTURE FOR THE EMPLOYEE BENEFIT, THAT THEY OFFER THROUGH SMART PASSES, IT WOULD BE BENEFICIAL TO TALK WITH VTA ABOUT WHAT CAN BE DONE FOR COUNTY CLIENTS, AS WELL. SO WE WILL BE HAPPY TO INCLUDE THAT. NO PROMISES ON WHAT OF COURSE HAPPENS IN THOSE CONVERSATIONS, BUT I DO THINK IT WOULD BE VERY BENEFICIAL TO HAVE A HOLISTIC CONVERSATION WITH VTA.

>> THAT MAKES SENSE, THANK YOU, JAMES. WORD ON THE STREET IS THAT YOU'RE THE TOUGHEST NEGOTIATOR AT THE COUNTY. I KNOW NO PROMISES ARE BEING MADE, BUT I BELIEVE.

>> ALL THE PEOPLE ON THE OTHER SIDE OF OUR CONTRACT NEGOTIATIONS LOVE ME?

>> JAMES, SHE CAN ALSO TALK TO SOME OF THE VTA BOARD MEMBERS, WHICH I THINK MIGHT BE HERE.

>> YEAH, AND I'D BE HAPPY TO HELP IN THE CONVERSATION, IF IT HELPS, BUT I REALLY APPRECIATE MY COLLEAGUES INTEREST IN LOOKING AT POSSIBILITIES. I WILL SAY YES, I THINK IT USED TO BE $15 AN EMPLOYEE WAY BACK WHEN. I JUST DID THE CALCULATION, IT'S 25, $26. IT HAS GONE UP AND HAD TO BE THE ENTIRE ORGANIZATION, SO THIS IS INTERESTING TO HEAR THAT IF WE INCLUDE OUR CLIENTS, MAYBE THERE'S DIFFERENT OPPORTUNITY. THERE'S ALSO OTHER OPTIONS NOW, CLIP OR START IS A 50% OFF REDUCED PILOT PROGRAM FOR LOW INCOME QUALIFIED APPLICANTS AND THE BAY PASS ACTUALLY DOES INCLUDE ALL SYSTEMS, SO THERE ARE OTHER OPTIONS THAT I THINK ARE WORTH LOOKING AT, SO I DO APPRECIATE MY COLLEAGUES WILLINGNESS TO ENTERTAIN AND EXPLORE FURTHER WHAT WE CAN DO, BUT CERTAINLY THE THOUSAND FOLKS WHO ARE USING IT ALREADY, I KNOW SOME OF MY STAFF ARE USING IT, I DO THINK THE PASS COULD BE MORE ACCESSIBLE. EXPRESS SERVICE IS NOT AVAILABLE, I'VE BEEN ASKING ABOUT THAT TOO. HOPEFULLY THERE'S OPPORTUNITIES TO EXPAND THE PROGRAM.

>> I THINK THOSE COULD BE VERY FRUITFUL CONVERSATIONS. YOU DID NOTE THE EXPRESS SERVICE THAT USED TO BE COVERED. THAT IS ONE OF THE THINGS VTA DROPPED. PART IS WHAT IS THE SCOPE OF WHAT WE'RE BUYING SO TO SPEAK SO THAT IT INCLUDES IN THE CASE OF THE EXPRESS SERVICE, SOME OF THE THINGS USED BY EMPLOYEES WHO MAYBE LIVE FURTHER AWAY WHO MIGHT BE TRANSIT DEPENDENT.

>> RHONDA, ANY PUBLIC SPEAKER ON THIS ISSUE?

>> WE DO NOT.

>> OK. WE'LL CLOSE THE PUBLIC SPEAKING PORTION. I WANT TO THANK SUPERVISOR ABE-KOGA FOR PULLING THIS ITEM TO ALLOW THIS VERY IMPORTANT DISCUSSION TO TAKE OPERATION, LAST 25 MINUTES, SOMETIMES THINGS ON CONSENT THINGS MIGHT SLEEP THROUGH. I THINK WE HAVE A MUCH BETTER WAY FORWARD ON THIS, SO THANK YOU SO MUCH. THAT BEING SAID, LET'S TAKE A VOTE.

>> THIS WILL BE THE VOTE ON THE SUBSTITUTE MOTION.

>> CORRECT, THE SUBSTITUTE MOTION.

>> MOVED BY SUPERVISOR ELLENBERG, SECONDED BY VICE PRESIDENT ARENAS.

>> SUPERVISOR ABE-KOGA.

>> AYE.

>> SUPERVISOR DUONG.

>> YES.

>> SUPERVISOR ELLENBERG.

>> YES.

>> VICE PRESIDENT ARENAS.

>> YES.

>> PRESIDENT LEE.

>> AYE.

>> MOTION CARRIES.

>> SUPERVISOR DUONG.

>> NEXT IS VALLEY HOMELESS HEALTH CARE PROGRAM.

>> GOOD AFTERNOON, PRESIDENT LEE. PRIMARY CARE OPERATIONS, I HAVE OUR ASSISTANT NURSE MANAGER AND YOUR BOARD PACKET, WE HAVE OUR OPERATIONAL UPDATES THAT INCLUDE SERVICE UTILIZATION. UPDATE ABOUT OUR CLINIC AND SHELTER MMU. WE'LL BE HAPPY TO ANSWER ANY QUESTIONS YOU HAVE.

>> SUPERVISOR ELLENBERG, DO YOU MIND IF I CHECK TO SEE PUBLIC? ANY PUBLIC WANT TO SPEAK ON THIS ITEM.

>> I CURRENTLY HAVE NO PUBLIC SPEAKERS.

>> OK, CLOSING THAT PORTION. SUPERVISOR ELLENBERG.

>> THANK YOU AND THANK YOU AS ALWAYS FOR THE REPORT. FEDERAL ADMINISTRATION INTENDS TO CUT $1.8 BILLION FROM THE HHS BUDGET BY MERGING VARIOUS HEALTH AND HUMAN SERVICE DEPARTMENTS, INCLUDING HRSA INTO ITS NEW WHAT'S IT CALLED AHA, ADMINISTRATION FOR HEALTHY AMERICA, ARE YOU ANTICIPATING ANY CHANGES TO OUR RENEWAL GRANT PROCESS OR TIMELINE?

>> THANK YOU FOR YOUR QUESTION. WE ARE ACTUALLY IN CLOSE COMMUNICATION WITH HRSA AROUND OUR SERVICE AREA COMPETITION GRANT RENEWAL.

>> OK.

>> THAT IS SUPPOSED TO SET TO RENEW ON JULY, ON JUNE 1 OF 2026, AND SO WE'RE WORKING WITH THEM CLOSELY TO ENSURE THAT WE'VE RESPONDED TO ALL THEIR INQUIRIES ABOUT THE GRANT AND IT WILL GET RENEWED PRIOR TO THE JUNE 1 DEADLINE.

>> THAT WOULD BE FANTASTIC. WILL YOU PLEASE UPDATE THE BOARD WHEN YOU KNOW?

>> YES.

>> THANK YOU. I'M HAPPY TO MOVE APPROVAL OF THE RECOMMENDED ACTION.

>> SECOND.

>> OK, MOVED AND SECONDED. VICE PRESIDENT.

>> THANK YOU. THAT I WANTED TO ASK YOU ABOUT THE NUMBERS, SO THE PATIENT, THE PATIENT ENCOUNTERS THAT ROSE 40% FROM 2024-2025, I'M SUPER GRATEFUL THAT YOU CONTINUE TO DO THIS SERVICE YEAR ROUND TO OUR AGRICULTURAL WORKERS WHO STAY IN SOUTH COUNTY EVEN AFTER THE OFF-SEASON, SO THEY'RE ALL YEAR ROUND, AND I SAW THAT THE THROUGH THE SERVICE OF THE CLINICS, IT ROSE 40%, SO I JUST WANTED TO KNOW IF YOU COULD SHARE WITH ME A LITTLE BIT ABOUT WHY YOU THINK THAT HAPPENED, LIKE ARE WE DOING SOMETHING DIFFERENT, IS IT THE NEED IS GREATER, OUR INCREASING ENGAGEMENT GREATER, MAYBE A COMBINATION OF BOTH, WHAT WAS THAT?

>> THANK YOU, SUPERVISOR, VICE PRESIDENT ARENAS. I THINK IT'S MULTIPLE THINGS. WE HAVE A COMMUNITY OUTREACH SPECIALIST WHO'S VERY ENGAGED WITH THE CLIENTS, WHO WORKS OUR SALUDOS CLINICS AND GILROY, DOES A LOT OF OUTREACH THERE. OUR PROVIDER IS ALSO VERY ENGAGED WITH THE CLIENTS. WE ALSO DO HAVE THE SAME, WE TALKED ABOUT THIS BEFORE, TOO, SAME STAFF WORKING MULTIPLE DAYS, WE'RE THERE THREE DAYS A WEEK AND TWO IT'S PRETTY MUCH THE EXACT SAME STAFF SO WE'VE BUILT TRUST OVER THE YEARS WITH THE CLIENTS THERE.

>> GOT IT. OK, WELL, IT'S THE WORK REALLY PAYING OFF OVER TIME WHICH IS WONDERFUL. IT'S WHAT WE'VE SEEN, IT'S ALL ABOUT RELATIONSHIPS, RIGHT, IN THIS KIND OF ENGAGEMENT. I SAW THE BEHAVIORAL HEALTH ENCOUNTERS WENT DOWN JUST A BIT. I'M WONDERING, ARE THE PATIENTS ABLE TO STAY ENGAGED AND CONTINUE CARE EVEN THOUGH THEY HAVE UNSTABLE CONDITIONS? HOW IS -- ARE YOU

SEEING FOLKS LESS INTERESTED, OR IS IT MORE DIFFICULT TO ENGAGE FOLKS? AND YOU THINK MAYBE THAT'S THE REDUCTION?

>> THANK YOU FOR THE QUESTION, PRESIDENT ARENAS. BASICALLY, WHAT'S HAPPENING IS WE'RE REFERRING THEM TO SPECIAL TEAM MENTAL HEALTH BECAUSE THEY HAVE MORE CAPACITY TO HANDLE SOME OF THE MENTAL HEALTH CHALLENGES THAT OUR CLIENTS FACE, MORE CAPACITY AND RESOURCES AT THE HHP. SO WE THINK THAT'S PART OF THE REASONS WHY THE NUMBERS ARE A LITTLE LOWER, AS THEY'RE BEING REFERRED TO SPECIALTY.

>> YOU'RE PROBABLY SEEING THOSE FOLKS WHO ARE AT THE HIGHER END OF THE SPECTRUM.

>> CORRECT.

>> GETTING THE CARE. IT WILL BE INTERESTING TO SEE IF THEY STAY ENGAGED AND IF THAT WORKS FOR THEM, RIGHT? OR IF THEY LIKE OR USED TO YOUR SYSTEM AND THEY COME BACK. IT WOULD JUST BE INTERESTING TO FIND OUT HOW THAT WORKS. OTHER THAN THAT, I'M JUST REALLY GRATEFUL OVERALL FOR THE WORK THAT YOU'RE DOING. AND IF YOU SEE ANY CHANGES, ANY TRENDS, AS YOU KNOW, A LOT OF OUR FOLKS WHO MIGHT HAVE IMMIGRATION-BASED ISSUES, HAVE A MORE DIFFICULT TIME ACCESSING, OR MORE FEAR OF ACCESSING, EVEN IF YOU ARE THERE. AND IT'S SIMPLY BECAUSE THEY HAVE A WAGE CASE PENDING THAT THEY DON'T WANT TO COMPROMISE. IT WILL BE INTERESTING TO SEE WHAT Y'ALL ARE SEEING ON THE GROUND AS IT IS IMPACTING FOLKS THAT HAVE IMMIGRATION RELEASE.

>> JUST KEEP YOUR EAR TO THE GROUND AND LET US KNOW. IT WILL BE INTERESTING TO FIND OUT.

>> YES, WE WILL.

>> THANK YOU SO MUCH, AND THANK YOU FOR THE WORK THAT YOU'RE DOING.

>> YES, SUPERVISOR DUONG.

>> THANK YOU SO MUCH FOR THE MONTHLY PRESENTATION AND GOOD REPORT ON ALL THE GOOD WORK THAT YOU'RE DOING. I HAVE CLARIFYING QUESTIONS. FOR THE PATIENT VISITS REFERENCED, ARE THOSE PATIENTS?

>> NO, THOSE ARE TOTAL VISITS.

>> DO YOU KNOW HOW MANY UNDUPLICATED PATIENTS THAT REFLECTS?

>> WE DON'T HAVE IT RIGHT NOW. WE CAN GET IT TO YOU.

>> DON'T WORRY ABOUT THAT. IN THE FUTURE, MY STAFF WILL TOP UP AS WE OFTEN DO THROUGHOUT THE COURSE OF TIME. NO IMMEDIATE TO PUT THAT ON YOUR TO-DO LIST, WE'LL REACH OUT. WHEN WE TALK ABOUT PATIENT VISITS, IT WILL BE HELPFUL TO CONTEXTUALIZE WHAT THESE VISITS MEAN, HOW MANY UNDUPLICATED PATIENTS, AND BETWEEN DUPLICATE OR UNDUPLICATED, IT HAS MEANING. PATIENTS REVISITING SERVICES AND PROGRAMS IS A HUGE WIN FOR A VERY HARD-TO-REACH POPULATION. THAT'S WHERE MY INTEREST IS COMING FROM IN TERMS OF TRYING TO UNDERSTAND WHERE WE HAVE EFFICACY AND ARE MAKING GAINS. HOW OFTEN DO YOU VISIT THE SHELTER SITES?

>> SUPERVISOR DUONG, WE VISIT THEM TWICE A MONTH, SO EACH SITE ONCE A MONTH.

>> YEAH. AND HOW IS THE TRAINING, THE CROSS-TRAINING THAT WE WERE SET TO DO WITH CITY SHELTER STAFF ON CONNECTION TO RESOURCES, HOW THAT IS GOING?

>> WE'VE BEEN WORKING TOGETHER WITH OSH AND BASICALLY HEALTH ON HOW WE CAN DO MORE OUTREACH TO THE SHELTER SITES. THAT'S GOING TO BE INCLUDED IN THE PLAN.

>> I'M EXCITED TO LEARN MORE ABOUT THIS PLAN. THE PARTNERSHIP WITH CITY IS ENCOURAGING. IT IS SOMETHING YOU'VE WANTED TO SEE FOR A WHILE. PLEASE BRING BACK UPDATES AS OFTEN AS YOU CAN TO SEE HOW THAT'S GOING. IN THE FUTURE, I'D BE INTERESTED IN KNOWING WHERE YOU SEE OPPORTUNITY, WHERE THIS PROS OR THIS SYSTEM, THE SYSTEM CAN BE EXPANDED. THAT'S WHAT I'M LOOKING FOR IN THE HORIZON, AND I THINK THAT'S IT FOR NOW. THANK YOU.

>> THANK YOU.

>> YEAH, THANK YOU. I JUST WANT TO THANK YOU FOR THE GOOD WORK AS SHOWN BY THE 40% INCREASE OF THE ENCOUNTERS OF THE PATIENTS, THROUGH YOUR EXTENSIVE OUTREACH EFFORTS BECAUSE AS WE ALL KNOW, THIS IS A TIME WHEN MANY OF OUR MIGRANT FARM WORKERS ARE HESITANT TO SEEK CARE. THE STRONG RELATIONSHIP THAT THE SALUDOS TEAM HAS BUILT IS ESSENTIAL, AND THIS GROWTH OF PATIENT COUNT SHOWS THAT THE TRUST AND THE TEAM'S COMMITMENT TO SERVING OUR COMMUNITY. I WANT TO THANK YOU FOR THAT GREAT WORK AND PLEASE BRING IT BACK TO THE TEAM HOW IMPORTANT THAT WORK IS, ESPECIALLY IN THESE VERY CRAZY DIFFICULT TIMES WE ARE LIVING IN RIGHT NOW. I DO WANT TO THANK YOU FOR LOOKING AT EXTENDING THE TIME FROM MARCH TO NOVEMBER BECAUSE THE FACT THERE IS STILL NEED, EVEN THOUGH THOSE ARE OFF-SEASON, AND TO ALLOW JUST ONE DAY A WEEK WOULD BE ESSENTIAL FOR THOSE BEYOND THE PERIOD. THANK YOU FOR COMING UP WITH THAT SOLUTION. AND ON THAT, I HAVE NO FURTHER COMMENTS, JUST THANK YOUS, AND LET'S TAKE THE VOTE.

ON MOTION OF SUPERVISOR ELLENBERG, SECONDED BY VICE PRESIDENT ARENAS.

>> SUPERVISOR ABE-KOGA.

>> AYE.

>> SUPERVISOR DUONG.

>> YES.

>> SUPERVISOR ELLENBERG.

>> YES.

>> VICE PRESIDENT ARENAS.

>> YES.

>> PRESIDENT LEE.

>> AYE. MOTION CARRIES 5-0.

>> THANK YOU VERY MUCH. NEXT, I HAVE ITEM 15, WHICH IS RECOMMENDATIONS RELATED TO STATE AND FEDERAL ADVOCACY BY THE OFFICE OF INTERGOVERNMENTAL RELATIONS, I.G.R.

>> GOOD AFTERNOON, PRESIDENT LEE, VICE PRESIDENT ARENAS, HONORABLE SUPERVISORS. DAVID CAMPOS, DEPUTY COUNTY EXECUTIVE, COMING TO YOU FROM SUNNY SACRAMENTO. MY APOLOGIES THAT I'M NOT THERE, BUT WE HAD A NUMBER OF MEETINGS THAT ARE HAPPENING AS THE WORK OF THE BUDGET CONTINUES AT THE STATE CAPITOL. WITH ME TODAY ARE MONICA TONG AND ELAINE TRAN FROM THE OFFICE OF INTERGOVERNMENTAL LEGISLATION, FROM THE INTERNAL ANNIVERSARY TEAM. THEY'LL BE MAKING THEIR PRESENTATION IN PERSON. IF WE CAN GO TO THE NEXT SLIDE. AS YOU KNOW, I.G.R., THE OFFICE OF INTERGOVERNMENTAL RELATIONS IS RESPONSIBLE FOR ENSURING THAT THE INTERESTS, THE LEGISLATIVE INTEREST OF THE COUNTY ARE REPRESENTED IN SACRAMENTO AND WASHINGTON D.C. YOU'RE GOING TO HEAR MORE DETAIL FROM STAFF ON SOME OF THE THINGS THAT ARE HAPPENING, BUT I THINK IT'S FAIR TO SAY THAT FOR THIS TIME, IT'S ALL HANDS ON DECK HERE IN SACRAMENTO. BECAUSE THE BIG THING THAT WE'RE ALL AWAITING IS THE ISSUANCE OF THE REVISED MAY BUDGET, THE MAY REVISE, WHICH WILL BE COMING OUT IN THE NEXT COUPLE OF WEEKS. AND SO THAT EVERYTHING WE'RE DOING IS WITH AN EYE TOWARD INFLUENCING WHAT HAPPENS WITH THE MAY REVISE AND DEPENDING WHAT IS INCLUDED OR NOT INCLUDED IN THE MAY REVISE, MAKE SURE WE HAVE A RESPONSE TO GET THE LEGISLATURE TO DO WHAT IS NEEDED TO PROTECT THE INTERESTS OF THE COUNTY. AND SO I WILL NOW TURN IT TO MONICA, WHO'S GOING TO GIVE YOU MORE DETAIL. AND ONE THING THAT I WILL NOTE IS THAT WHEN THIS LEGISLATIVE FILE WAS WRITTEN A COUPLE OF WEEKS AGO, THAT A LOT OF THINGS HAVE HAPPENED BETWEEN NOW AND THEN, AND SO WE HAVE UPDATES THAT GO BEYOND THE WRITTEN REPORT. MONICA, I'LL TURN IT OVER TO YOU.

>> GOOD AFTERNOON. THE STATE LEGISLATURE HAS BEEN BUSY WITH POLICY HEARINGS FOR THE 1800 PLUS BILLS INTRODUCED IN 2026. IN FACT, BOARD PRESIDENT LEE WAS IN SACRAMENTO FOR ONE OF THOSE BUSY HEARING DAYS AND REGISTERED THE COUNTY'S SUPPORT ON ONE OF THE BILLS. LAST FRIDAY WAS THE DEADLINE FOR POLICY COMMITTEES TO HEAR BILLS WITH A STATE IMPACT, AND FRIDAY, THE DEADLINE IS FOR POLICY COMMITTEES TO HEAR BILLS WITH SOME STATE FISCAL IMPACT. IT'S IMPORTANT TO NOTE THAT THE COMMITTEE IS LOOKING AT BILLS FROM A STATE FISCAL IMPACT ONLY. THEY DON'T CONSIDER COST TO LOCAL GOVERNMENT. I WANT TO MAKE THAT CLEAR TO EVERYONE IN THE PUBLIC. RELATED TO BUDGET, THE NEXT MAJOR MILESTONE, AS DAVID MENTIONED, IS THE MAY REVISION THAT WILL BE DUE ON MAY 14. WE'RE UNCLEAR WHEN THE GOVERNOR WILL ANNOUNCE THAT, BUT THAT IS THE DEADLINE. THE LAST TWO WEEKS OF MAY WILL BE VERY BUSY, NOT ONLY WITH THE RESPONSE TO THE MAY REVISION, BUT ALSO ON THE FLOOR OF THE SENATE AND ASSEMBLY, WHERE LEGISLATURE WILL BE WORKING HARD TO GET THEIR BILLS OFF THE FLOOR BEFORE THE HOUSE OF ORIGIN DEADLINE ON MAY 29. SINCE OUR LAST UPDATE, THE COUNTY HAS CONTINUED ADVOCACY AND STRATEGY AROUND DEDICATED FUNDING FOR PUBLIC HOSPITALS, PRESERVING ENROLLMENT IN SAFETY NET PROGRAMS, AND ALLOCATING NEW RESOURCES FOR INTELLIGENT CARE. WE THANK THE BOARD FOR ONGOING ENGAGEMENT REGARDING THE STATE BUDGET, AND WE'VE HAD SOME CRITICAL MEETINGS IN THE LAST COUPLE OF WEEKS, INCLUDING WITH OUR COUNTY EXECUTIVE. ON THURSDAY, APRIL 16, THE SENATE DEMOCRATS RELEASED THEIR FISCAL, THEIR 2627 BUDGET PRIORITIES AND CALLED IT THE FOUNDATION FOR THE FUTURE. THE GOOD NEWS IS IT DID ADDRESS A FEW ASPECTS RELATED TO HR1, WHICH WE ARE CAUTIOUSLY OPTIMISTIC ABOUT. IT DOES MAINTAIN FULL SCOPE MEDI-CAL, DELAYS PREMIUMS TO JANUARY 21, 2028, AND CREATES A FAIR SHARE CONTRIBUTION FUND THAT IS STILL BEING WORKED OUT THROUGH THE BUDGET PROCESS. BUT THE REPORT STATES THAT 42% OF WORKING-AGE MEDI-CAL EMPLOYEES HAVE FULL-TIME JOBS, MEANING MANY CORPORATIONS PAYING TOO LOW AND THEIR EMPLOYEES ARE ON MEDI-CAL. THIS WOULD FORCE LARGE CORPORATIONS INTO THE FUND USED TO OFFSET TAX COSTS FOR THIS MEDI-CAL. THIS IS STILL BEING WORKED OUT THROUGH THE BUDGET, AND WE'RE CAREFULLY MONITORING THAT, BUT THEY ANTICIPATE THE FUND TO BE BETWEEN $5 BILLION AND $8 BILLION. A FEW ADDITIONAL ITEMS INCLUDE THAT THE SENATE WISHES TO REJECT THE GOVERNOR'S PROPOSAL TO COST SHIFT TO COUNTIES RELATING TO IHSS. THEY ARE WORKING TO MAKE A $1 BILLION AVERAGE INVESTMENT. THE SENATE INCLUDED A ONE-TIME $100 MILLION FOR VOCA, AND THE SENATE IS ALSO WORKING TO MAKE THE NEXT STEP IN THE STATE'S COMMITMENT OF REACHING 200,000 ADDITIONAL CHILD CARE SLOTS BY ADDING 44,000 IN FISCAL YEAR 26/27. WE ARE AWAITING THE ASSEMBLY'S VERSION IF THEY SO CHOOSE TO RELEASE ONE AND ARE EAGERLY AWAITING THE MAY REVISION. A LOT OF WORK AND ADVOCACY ARE CLOSELY ON THE HORIZON. I'LL TURN IT OVER TO DAVID AND COUNTY EXECUTIVE.

>> BEFORE WE MOVE ON TO OUR BILLS, I DO WANT TO SAY THAT WE HAVE SPENT A LOT OF TIME IN SACRAMENTO AND A LOT OF TIME FOCUSING ON THE STATE SENATE, BECAUSE HISTORICALLY, AT LEAST IN THE LAST COUPLE OF YEARS, IT'S BEEN THE STATE SENATE THAT HAS ACTUALLY PUSHED BACK AGAINST GOVERNOR NEWSOM. WE ARE GRATEFUL TO OUR COUNTY EXECUTIVE WHO HAD A MEETING LAST WEEK WITH THE CHAIR OF THE SENATE BUDGET COMMITTEE. AND OUR NEXT FOCUS BETWEEN NOW AND THE MAY REVISE IS TO TARGET THE STATE ASSEMBLY. WE'RE SOMETIME WAITING TO SEE WHERE THEY ARE, AND WE WILL BE MEETING IN THE VERY NEAR FUTURE WITH THE CHAIR OF THAT BUDGET COMMITTEE AS WELL AS THE SPEAKER. BUT I THINK THAT, YOU KNOW, SO FAR BASED ON WHERE WE ARE, THERE'S AT LEAST SOME PROGRAMS. I DON'T KNOW IF THE COUNTY EXECUTIVE WANTS TO ADD TO THAT PIECE.

>> I DO, THANK YOU, DAVID. I WANT TO ADD A COUPLE OF IMPORTANT POINTS AS WE LOOK FORWARD TO THE MAY REVISE. THE HIGHEST PRIORITY ITEM HAS TO DO WITH FUNDING PUBLIC HOSPITAL SYSTEMS. WE KNOW THAT THERE IS A LOT OF CONVERSATION HAPPENING AROUND THE IMPACTS OF PR1 TO HOSPITALS AT LARGE, BUT WE ARE CONCERNED THAT THAT CONVERSATION IS TOO DILUTED, AND LOOKING AT HOSPITALS ACROSS THE STATE AND NOT CONCENTRATED AND FOCUSED ON THE OUTSIZED AND VITAL ROLE THAT THE PUBLIC HOSPITALS HAVE TO PLAY. THE STATE DOESN'T HAVE ENOUGH MONEY TO BACK ALL OF THE CUTS. IF THEY SPRINKLE A LITTLE BIT OF FUNDING, INCLUDING WITH THIS EXCELLENT PROPOSAL FROM THE IS NOT TO GET ADDITIONAL DEDICATED REVENUE FOR MEDI-CAL, BUT IF THEY SPRINKLE THAT TOO BROADLY, IT WILL NOT BE A SUFFICIENT AMOUNT OF FUNDING TO SAVE ANYTHING, BECAUSE IT'S NOT GOING TO BE A SUFFICIENT PERCENTAGE TO BACK IF I AM THE LOSSES AT THE FEDERAL LEVEL. SO THE STATE HAS DIFFICULT CHOICES. PRIORITIZATION IS ALWAYS HARD, BUT WE BELIEVE ON THE MERITS THAT THE SPECIFIC ROLE FOR PUBLIC HOSPITALS, THE VITAL AND ESSENTIAL ROLE THAT THEY PLAY FOR ALL CALIFORNIAN'S HEALTH CARE REQUIRES AND DEMANDS THAT THE STATE GIVE PUBLIC HOSPITALS UNIQUE ATTENTION. THAT'S THE PRIMARY FOCUS OF OUR EFFORTS BETWEEN NOW AND THE ADOPTING OF THE BUDGET, AND SOMETHING I THINK IS VERY CONCERNING. THE SECOND ITEM, THEY'RE SEPARATE FROM THE BUDGET CONVERSATION, CONCERNS WE ARE HEARING ABOUT PROPOSED CHANGES TO THE STATE-ONLY MEDI-CAL PROGRAM AND HOW IT'S STRUCTURED WITH MEDI-CAL MANAGED CARE IN WAYS THAT COULD BE EXTRAORDINARILY HARMFUL. WE DON'T KNOW IF THAT'S SOMETHING THAT WILL COME FORWARD IN THE STATE REVISE, SOMETHING THAT THE STATE MAY DO ADMINISTRATIVELY, WITHOUT LEGISLATIVE ACTION, OR OTHERWISE, BUT THE SPECIFIC CONCERN THERE IS A REDESIGN OF THE MECHANISM AROUND THE PROGRAM THAT WOULD HAVE VERY DETRIMENTAL IMPACTS TO OUR LOCAL REVENUES. WE'RE KEEPING AN EYE OUT ON THAT, AMONG OTHER THINGS. I WANTED TO NOTE TWO AREAS OF FOCUS BEFORE US, AND WE WILL BE OFF TO THE RACES IN THE COMING WEEKS, AS THE MAY REVISE COMES OUT, AND THEN THE SENATE AND ASSEMBLY RESPOND.

>> THANK YOU, JAMES. LET'S SEE, GET THE PUBLIC TO SPEAK FIRST?

>> THERE ARE NO PUBLIC SPEAKERS.

>> OK. LET'S MOVE ON, THEN, SUPERVISOR ELLENBERG.

>> DAVID AND TEAM, THANK YOU VERY MUCH FOR THE REPORT AND FOR YOUR RELENTLESS WORK. JAMES, IN PARTICULAR, THANK YOU. YOUR INFLUENCE IS BEING FELT THROUGHOUT THE ASSEMBLY AND THE SENATE. I DON'T BELIEVE WE WILL GET EVERYTHING WE WANT AND NEED, BUT YOUR VOICE AND YOUR PERSPECTIVE ARE INFLUENTIAL, AND YOUR CONFIDENCE IS VERY APPRECIATED. I WANTED TO SHARE AN UPDATE ON SOME NATIONAL POLICY PIECES THAT I'VE BEEN INVOLVED IN RECENTLY, AND JUST WANT MY COLLEAGUES TO KNOW AS WELL AS THE PUBLIC. AS ONE OF THE -- THE CSAC OFFICERS, I SPENT FOUR DAYS AFTER LEAVING WASSERMAN D.C., MEETING WITH A NUMBER OF FOLKS FROM BOTH CONGRESS IN THE LEGISLATIVE AND ADMINISTRATION BRANCH. WE MET WITH BOTH SENATORS, WITH A NUMBER. I'M NOT GOING TO READ THE LIST OF ALL OF THE CONGRESS MEMBERS, BUT ABOUT 12 CONGRESS MEMBERS, THE WHITE HOUSE INTERGOVERNMENTAL AFFAIRS, FEMA AND BANKING COMMITTEE. WANTED TO SHARE A FEW HIGHLIGHTS. THE MOST FUN PIECE I HAVE TO SAY WAS GETTING TO PRESENT AT THE CALIFORNIA CONGRESSIONAL CAUCUS LUNCHEON, WHERE I HAD THE OPPORTUNITY TO BRIEF THIS GROUP ON THE COUNTY'S, OUR COUNTY'S EFFORTS AROUND FH1 AS WELL AS THE STATEWIDE ASK WITH OUR MULTI-YEAR BUDGET REQUEST, AND ASK OUR DELEGATION THERE TO PLEASE ENGAGE WITH THE GOVERNOR AND WITH THE STATE LEGISLATURE ON THE IMPORTANCE OF THIS OUR REQUEST, REALLY GALVANIZED TO THE EXTENT WE CAN OUR LEGISLATURE AND GOVERNOR TO FEEL THEIR FULL POWER, THAT IN CALIFORNIA WE DO HAVE THE OPPORTUNITY TO PUSH BACK AND MITIGATE MANY OF THE VERY INTENTIONAL HARMS THAT ARE BEING IMPOSED BY THE FEDERAL GOVERNMENT. SO SHARED ALL OF THAT WITH THEM. REGARDING HR1, WE MET WITH DAN WHERE I WILLMAN, THE DIRECTOR OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO DISCUSS A DELAY IN IMPLEMENTING THE FEDERAL REQUIREMENTS OF HR1 AS WELL AS CHALLENGES WITH FEDERAL RULES NOT EXPECTED UNTIL MID-SUMMER. WE REFERENCED OUR UNDERSTANDING ACCEPTANCE ESSENTIALLY THAT THE LAW IS CURRENTLY MOVING FORWARD, BUT COUNTIES, PARTICULARLY IN THE 10 COUNTY-ADMINISTERED STATES, ARE REQUESTING IMPLEMENTATION. AND CSAC IS COORDINATING WITH THE OTHER NINE STATES, SOME OF WHICH HAVE REPUBLICAN MAJORITY. AS AN ASIDE, IT WAS VERY INTERESTING TO ME AS A LEARNING PIECE THAT IN 10 OF THE 50 STATES, THE COUNTIES ADMINISTER THE SOCIAL SERVICES, YET FOR 50 STATES THOSE FUNDS GO DIRECTLY TO THE STATE, WHICH I THINK IT ACCOUNTS FOR SOME OF THE INHERENT TENSION WE OFTEN FEEL WITH OUR LEGISLATURE REGARDING ALLOCATIONS OF FUNDS THAT REALLY SHOULD BE GOING THROUGH COUNTIES, BUT BECAUSE WE'RE A MINORITY STRUCTURE, GO TO THE STATE. WE ALSO TALKED ABOUT TECHNOLOGY IN CONDUCTING ELIGIBILITY WORK, WHAT KIND OF TRAINING WOULD BE NEEDED. MR. BRILLMAN DID INDICATE THAT HE WOULD MAKE A TRIP TO CALIFORNIA IN THE FUTURE AND WORK TO COORDINATE STATE, OUR OWN HHS AGENCY, DHS AND COUNTY, STATE LIVES, AS WELL AS COUNTY REPRESENTATIVES, IDEALLY INCLUDING JAMES, IF IN FACT MR. BRILLMAN DOES MAKE THAT TRIP. WE MET WITH THE COMMITTEE MEMBERS OF THE AG COMMITTEE TO ADVOCATE FOR THE FARM BILL TO ADVANCE. THE MAJORITY MEMBERS EXPRESSED INTEREST IN MITIGATION. IT'S UNCLEAR WHERE THE DEMOCRATS WILL BE ABLE TO HOLD OFF PASSING OF THE FARM BILL THAT DOESN'T ADDRESS IT. CRITICAL REFORMS. I WAS AWAITING ACTION ON THE HOUSE FLOOR. THIS BILL, WHICH NIKO WAS HEAVILY INVOLVED IN WOOD DRAFTING, WOULD MODERNIZE FEMA. IT'S CURRENTLY AWAITING THE RESULTS OF THE PRESIDENT'S ADVISORY COUNCIL PRIOR TO MOVING FORWARD. WE DID HAVE A VERY PRODUCTIVE MEETING, AT LEAST A POSITIVE FEELING MEETING WITH OFFICE OF INTERNAL AFFAIRS ON THE REFORM ISSUES BEING DISCUSSED BY THE ADMINISTRATION AND CONGRESS. WE EMPHASIZED THE NEED FOR MORE TIMELY DISBURSEMENTS. I REALIZE THIS ISN'T AN ISSUE FOR OUR COUNTY, BUT IT IS, YOU KNOW, WE DO HAVE SOME RURAL COMMUNITIES IN THE SOUTH PART OF OUR COUNTY, AND THIS ISSUE COULD CERTAINLY ARISE, WHICH IS NEEDING AN ALTERNATIVE MEASURE SUCH AS THE PERCENTAGE LOSS OF HOUSING STOCK DUE TO DISASTER AS OPPOSED TO A FLAT NUMBER OF HOMES. FINALLY, WE ADVOCATE FOR IMPROVING TRANSPARENCY OF THE FEMA'S REIMBURSEMENT SYSTEM, EXPRESSED CONCERN WITH THE RECENT REDUCTIONS AND RATES WITH REGARD TO EQUIPMENT AND MUTUAL AID. THE REPRESENTATIVE SEEMED RECEPTIVE TO THE ISSUES RAISED, AND WE WILL BE DOING FOLLOW-UPS WITH FEMA, THE WHITE HOUSE FGA, AND WE HAD A PIECE OF ADVOCACY AROUND SURFACE HR7437, WHICH WOULD INCREASE FUNDING TO LOCAL GOVERNMENTS FOR THE SURFACE TRANSPORTATION BLOCK GRANT PROGRAM AND THE HIGHWAY SAFETY IMPROVEMENT PROGRAM. UNDER THE NEW BILL, BOTH PROGRAMS WOULD BE REQUIRED TO SUB-ALLOCATE 25%, A SUBSTANTIAL INCREASE COMING TO LOCAL GOVERNMENTS. WE JUST TALKED THE NEED FOR MONEY TO FLOW DIRECTLY TO COUNTIES RATHER THAN ONLY TO THE STATE. COUNTIES ARE RESPONSIBLE FOR MORE TRANSPORTATION INFRASTRUCTURE THAN THE STATE, I JUST LEARNED THAT AS WELL, SUPERVISOR ABE-KOGA, INCLUDING THOUSANDS OF ROADWAYS AND BRIDGES THAT INTERSECT THE FEDERAL HIGHWAY SYSTEM. FINALLY, IN ADDITION TO THE CORE PRIORITIES ABOVE, WE ALSO DISCUSSED THE IMPORTANCE OF MAINTAINING HOMELESSNESS CONTINUUM OF CARE FUNDING AND MARKET AND REGULATION CHALLENGES AROUND HOMEOWNERS INSURANCE. THE HOUSE COMPANION BILL HAS BEEN APPROVED WHICH THE HOUSE. IT WAS EXHAUSTING, BUT I HOPE AT LEAST MODERATELY FRUITFUL WEEK, AND THANK YOU AGAIN, COLLEAGUES, FOR THE OPPORTUNITY TO REALLY BE VERY ENGAGED IN STATE ADVOCACY WORK. I FEEL LIKE IT HELPS OUR COUNTY, AND CERTAINLY POSITIONS US TO HAVE SIGNIFICANT VOICES OF INFLUENCE. THANK YOU.

>> THANK YOU, SUPERVISOR DUONG.

>> THANK YOU, SUPERVISOR ELLENBERG, FOR THAT RUN-DOWN AND ALSO FOR ALL OF YOUR WORK OPERATING AT THE STATEWIDE AND NATIONAL LEVEL, ADVOCATING FOR NOT JUST OUR COUNTY BUT ALL COUNTIES. ABOUT THIS, THERE WAS REFERENCE TO FGOC MEETING WHERE OUR STATE DELEGATION WAS ABLE TO JOIN US TO HAVE A VERY FRUITFUL CONVERSATION ABOUT LEGISLATION AND BUDGET PRIORITIES. MY OFFICE HAS SHARED THAT REPORT OUT WITH ALL OF OUR COLLEAGUES THROUGH YOUR CHIEF OF STAFF. IT'S ALSO INCLUDED IN THIS AGENDA HERE, AND I REALLY ENCOURAGE YOU TO TAKE A LOOK AT IT. I THINK IT WAS A GOOD CONVERSATION THAT HELPED ME UNDERSTAND A LOT BETTER HOW WE CAN ADVOCATE AND MOVE FORWARD. I KNOW THAT IGR IS TRANSITIONING NOW IS LASER FOCUSED ON ADVOCATING FOR STATE SUPPORT OF A PUBLIC HOSPITAL SYSTEM. I DON'T WANT TO DETRACT FROM THAT WORK AT ALL. I WOULD LIKE TO KNOW THE COUNTY'S THOUGHTS ON AB3321 AND WHETHER OR NOT WE'D LIKE TO TAKE A POSITION OR OPINION ON IT. NO MOVEMENT YET. WE WOULD LIKE TO HAVE THE EXPERTS IN THE ROOM TAKE A LOOK AT IT AND SEE IF THIS COULD HELP OUR HOSPITAL SYSTEMS AND NETWORKS ALLOWING FOR TO STREAMLINE THE PROCESS FOR MORE HOSPITALS TO BE BUILT IN CERTAIN AREAS. AND SO I THINK, IS THERE A MOTION ON THE FLOOR? I DON'T THINK THERE'S A MOTION ON THE FLOOR. I'D LIKE TO MAKE A MOTION TO RECEIVE THE REPORT AND APPROVE AMENDMENTS TO THE 2026 DOCUMENT AND ADD 1761 AND 870. I'M PLEASED TO BE JOINING YOU IN OUR URBAN COUNTIES CAUCUS AND MA. WE'LL BE SPENDING THE NIGHT AND YOU'LL BE SENDING ME TO ALL THE MEETINGS. THANK YOU FOR YOUR FAITH THAT AND KEEP MY OFFICE AND ALL OUR OFFICES APPRISED OF THIS WORK THAT WE HAVE TO REALLY MAKE SURE WE LEAN INTO AT THE STATE LEVEL. APPRECIATE YOUR PRESENTATIONS AND YOUR REPORTS EVERY SINGLE TIME. I KNOW YOU HAVE SOME HEART UP THERE AND SHOUT OUT TO DAVID.

>> I'M STILL HERE.

>> HEY!

>> JUST THANK YOU. I THINK THERE'S AT LEAST TWICE A WEEK I'M HAVING SIDE CONVERSATIONS WHERE YOUR NAME IS MENTIONED AND HOW HARD YOU'RE HUSTLING AT THE STATE CAPITOL, SO KEEP GOING. THANK YOU.

>> THANK YOU.

>> VICE PRESIDENT.

>> THANK YOU. I'D ALSO LIKE TO EXTEND MY THANKS TO DAVID FOR ALL THE WORK THAT YOU'RE DOING, AS WELL AS OUR COUNTY EXECUTIVE FOR TAKING POSITIONS THAT WE NORMALLY HAVEN'T BEEN TAKING IN THE PAST IN ORDER TO PROTECT OUR RESPECTIVE COMMITMENTS TO OUR COMMUNITY. WE KIND OF START AND END WITH HOSPITALS. I LOVE OUR SYSTEMS, LOVE LOVE THEM. I WANT TO MAKE SURE WE CONTINUE TO ADVOCATE AND LOOK FOR BILLS THAT RELATE TO OUR CHILD WELFARE SYSTEM, AS WE ARE IN TROUBLE IN THAT RESPECT. WE KNOW THAT THERE IS A WHOLE GENERATION OF CHILDREN THAT WERE LEFT IN THEIR HOMES, AND THOSE CHILDREN TYPICALLY MAKE A BEELINE OVER TO PROBATION. THERE'S A WHOLE PIPELINE, RIGHT? SO WE NEED TO MAKE SURE THAT WE ARE LOOKING LEGISLATIVELY FOR SOLUTIONS. AND I KNOW THAT ASSEMBLY MEMBER AARONS HAS A PACKAGE OF SIX FOSTER CARE BILLS, ONE OF WHICH IS AB2767 JUVENILES FAMILY FINDING. THERE'S A -- HE RUNS THE GAMUT FROM FOSTER CARE, THE POST-SECONDARY EDUCATION, THE JUVENILES FAMILY FINDING, STUDENT FINANCIAL AID, AND ADOPTION ASSISTANCE PROGRAM. I'D LOVE FOR US TO VET THOSE BILLS AND SEE WHERE WE STAND AND REALLY ASK THE QUESTION, ARE WHAT IS IT THAT OUR SYSTEM IS GOING THROUGH AND WHAT DOES IT NEED IN ORDER TO LOOK FOR AND CREATE OPPORTUNITIES FOR US TO FIND SOLUTIONS TO SOME OF THE SYSTEMIC ISSUES THAT WE'RE DEALING WITH? THE CLOSEST THING THAT I COULD FIND IS THIS AB2767 THAT ASSEMBLY MEMBER AARONS HAS. IT IS ASKING FOR I THINK TWO THINGS AS I READ THROUGH IT: IS BEFORE THE CHILD IS FORMALLY REMOVED, THAT THERE IS AN OPPORTUNITY TO SHARE INFORMATION WITH RELATIVES AND CAREGIVERS ABOUT THEIR SITUATION, SO BEFORE THEY'RE ACTUALLY PLACED OR REMOVED BY THE COURTS, SO THAT IT EXEMPTS THEM IN TERMS OF OTHER CONFIDENTIALITY THAT IS USUALLY VERY WELL PRESERVED FOR CHILDREN IN THE CHILD WELFARE SYSTEM. AND THEN THE SECOND THING IS ASKING TO PARTICIPATE IN THE PLACEMENT OF THE CHILD. IT SEEMS LIKE IT'S INSISTING ON CHILDREN REMAINING WITH RELATIVE CAREGIVERS. SO WHEN IT EXEMPTS THEM FROM THE CONFIDENTIALITY AND THEN TWO, IT IS PROPAGATING THE IDEA TO FIND, IT'S A FAMILY FINDING AND ENGAGEMENT. SO AS WE HAVE SEEN, WE HAVE HAD PLACEMENTS THAT, AND WE HAVE HISTORICAL COMPLICATIONS WITH KEEPING CHILDREN IN HOMES IRREGARDLESS OF WHETHER THEY'RE SAFE OR NOT. AT LEAST OUR, WE'RE NOT AN EXEMPTION. THERE'S A LOT, I MEAN, THIS IS FAMILY PRESERVATION UP AND DOWN THE STATE. I'D LIKE FOR US TO VET THAT BILL AND SEE WHERE WE STAND ON IT AND IF THERE'S ANY FEEDBACK WE CAN PROVIDE THE ASSEMBLY MEMBER, THAT WOULD ALLOW FOR HIM TO EITHER, I DON'T KNOW IF THERE'S A NEED FOR A REVISION OR MORE MODERATE LANGUAGE, TO CONTINUE TO PREVENT IMMINENT HARM AND RISK TO THE CHILD, AND THAT IS PLACED AT THE CENTER OF THE BILL RATHER THAN JUST TYPICALLY FINDING A PLACE FOR THAT CHILD WITH THE FAMILY.

>> SUPERVISOR, IF I COULD JUST INTERRUPT YOU BRIEFLY BEFORE WE MOVE ON WITH THE DISCUSSION, JUST A PROCEDURAL MATTER, WE NEED TO UNDERSTAND WHETHER THERE'S A SECOND FOR THE MOTION SUPERVISION MADE.

>> I'LL SECOND THAT. OF COURSE. I DIDN'T EVEN KNOW WE SECONDED THAT. IN MY HEAD, OF COURSE WE'RE GOING TO MOVE FORWARD TO THIS. I SEE YOU SHAKING YOUR HEAD. I'LL ASK DAVID, BECAUSE I CAN'T SEE YOU, DAVID.

>> YES, SUPERVISOR, VICE PRESIDENT, CHAIR ARENAS, DAVID CAMPOS THROUGH THE CHAIR, WE WILL BE LOOKING CLOSELY AT THAT. WE HAVE IN FACT IDENTIFIED THAT BILL FOR OUR SOCIAL SERVICES AGENCY AND REQUESTED THEIR INPUT AND FEEDBACK ON THAT BILL. AND JUST TO BE VERY CLEAR WITH ASSEMBLY MEMBER AARONS, WE WORK VERY CLOSELY WITH HIS OFFICE AND HAVE MADE OURSELVES AVAILABLE AS HE DEEMS FIT, BUT WE WILL DEFINITELY PURSUE THAT AND WE'LL BE IN TOUCH IN THE VERY NEAR TERM TO LET YOU KNOW WHERE THINGS ARE.

>> YEAH, THERE'S STILL, FROM WHAT I UNDERSTAND, THERE'S STILL AN OPPORTUNITY TO HELP SHAPE SOME OF THESE BILLS, CORRECT.

>> WELL, I THINK IT'S A LITTLE MORE CHALLENGING HERE, BUT WE WILL DO WHAT WE CAN BETWEEN NOW AND THE END OF THE MONTH, AND HOPEFULLY SSA IS WATCHING THIS AS WELL SO THAT THEY CAN GET BACK TO US AS QUICKLY AS POSSIBLE, BUT WE WILL BE IN TOUCH AND WE'LL HAVE A REPORT IN THE NEXT FEW DAYS.

>> WONDERFUL. I'D LOVE FOR OUR LEGISLATIVE AGENDA TO, AND TYPICALLY, IT IS, IT'S VERY COMPREHENSIVE. I JUST WOULD LOVE FOR IT TO TOUCH ALL OF THE SYSTEMS THAT WE HAVE OR AT LEAST HAVE SOME CADENCE IN TERMS OF IF WE ARE FOCUSED ON HEALTH AND HOSPITALS IN ONE SEGMENT OR, YOU KNOW, IN ONE CYCLE, THAT WE MAKE AN EFFORT TO ALSO INCLUDE THE OTHER SYSTEMS IN THE NEXT CYCLE. AND LIKE I SAID, WE HAVE BEEN FOCUSED ON HEALTH AND HOSPITAL SYSTEMS QUITE A BIT, AND WHILE I AM GLAD TO AND HAPPY TO SUPPORT THAT, THERE'S MUCH MORE THAT WE DO AS A COUNTY THAN PROVIDE HEALTH AND HOSPITAL SYSTEMS SUPPORT.

>> AND IF I MAY ADD THROUGH THE CHAIR, AS YOU CAN SEE FROM THE ATTACHED MATRIX, WE ARE INVOLVED IN DOZENS OF BILLS THAT RUN THE GAMUT OF JUST ABOUT EVERY AREA OF OPERATIONS FOR THE COUNTY. AND SO IT'S JUST A QUESTION OF, YOU KNOW, AT THE BOARD'S PREFERENCE, HOW DO WE PRESENT IT SO YOU CAN SEE WE ARE DOING A LOT OF WORK WITH THAT WE EMPHASIZE THE BUDGET HERE, BUT THERE'S A LOT MORE THAT WE ARE WORKING ON AND HAPPY TO HIGHLIGHT THAT AS WE COME BACK TO THE BOARD.

>> LOVE IT. I'M SURE YOU'RE DOING A LOT, YOU'RE WEARING A LOT OF DIFFERENT HATS, AND I JUST APPRECIATE YOUR ATTENTION TO THIS, AND I KNOW THAT HEARING YOUR SUPPORTIVE, AND I APPRECIATE IT. THANK YOU.

>> THANK YOU, SUPERVISOR.

>> SUPERVISOR ELLENBERG, DO YOU HAVE ANYTHING TO ADD? OK. SO FIRST OF ALL, I JUST WANT TO THANK THE TEAM FOR TAKING THE TIME TO REVIEW AB761 THAT I REQUESTED EARLIER, THAT'S FROM ASSEMBLY MEMBER ROGERS. THIS IS A REALLY IMPORTANT BILL, INCREASE IN THE TRANSPARENCY OF HOW THE POWER CHARGED IN DIFFERENT ADJUSTMENT OR PCIA IS BEING CALCULATED. I'VE TRIED TO LEARN IT IN HOURS AND STILL NOT REALLY GETTING IT, ALL DIRECTLY IMPACTING THE RATES THAT OUR CONSTITUENTS PAY FOR ELECTRICITY EVERY DAY. I'M VERY GLAD THAT WE'LL BE SUPPORTING THIS APS70. MY PREDECESSOR, SUPERVISOR THEN, NOW SENATOR CORTESE. THANK YOU FOR THE WORK AND ALSO WANT TO HAVE YOU EXTEND OUR DEEP APPRECIATION TO OUR ASSEMBLY DELEGATION, ASSEMBLY MEMBER AARONS, CARR, LEE, ER MINUTE AND SPEAKER RIVAS, ALL OF THEM REPRESENTING OUR AND POWER, DON'T WANT TO FORGET THAT ONE, THAT FOR THE GROUP WORK WITH THE SENATORS, BECAUSE THIS IS REALLY A TOUGH TIME FOR THIS COUNTY AND THEIR SUPPORT OF OUR EFFORTS IS SO IMPORTANT. SO JUST WANT TO THANK YOU AGAIN AND AGAIN FOR YOUR AMAZING WORK. THANK YOU FOR STAYING UP IN THE HEAT, DAVID, AND GO OUT THERE AND KEEP KNOCKING ON DOORS AND SEE IF YOU CAN BRING UP SOME MORE FUNDS COMING BACK, OK?

>> YES.

>> THANK YOU, MR. PRESIDENT.

>> WITHOUT FURTHER ADO, LET'S TAKE THE VOTE. THANK YOU. ON MOTION OF SUPERVISOR DUONG, SECONDED BY VICE PRESIDENT ARENAS.

>> SUPERVISOR ABE-KOGA.

>> AYE.

>> SUPERVISOR DUONG.

>> YES.

>> SUPERVISOR ELLENBERG.

>> YES. I ACCIDENTALLY HIT MY CALL BUTTON, SO IF SOMEBODY IS COMING TO ME, I DON'T NEED IT.

>> VICE PRESIDENT ARENAS.

>> YES.

>> PRESIDENT LEE.

>> AYE, AS WELL, THANK YOU. GOOD AFTERNOON, DR. SHERRY TERRELL.

>> GOOD AFTERNOON, PRESIDENT LEE, VICE PRESIDENT ARENAS, BOARD OF SUPERVISORS AND COUNTY ADMINISTRATION. SHERRY TERRELL, DIRECTOR WITH OUR BEHAVIORAL HEALTH SERVICES DEPARTMENT, JOINED BY MY COLLEAGUES, MEGAN WE'LL HAND AND COURTNEY GRAY, AND WE'RE PLEASED TO PRESENT A BRIEF PRESENTATION. THIS IS OUR QUARTERLY PUBLIC HEALTH CRISIS REPORT RELATED TO OUR KEY PRIORITIES AND BEHAVIORAL HEALTH INITIATIVES. WE'LL GO TO THE NEXT SLIDE, PLEASE. THE FOCUS OF OUR REPORT TODAY IS ON TWO SPECIFIC AREAS: ONE, AROUND BEHAVIORAL HEALTH TIMELY ACCESS, AND SECONDLY, AN UPDATE ON OUR BEHAVIORAL HEALTH TREATMENT BEDS AND FACILITIES UPDATE. AND WE'VE ALSO INCLUDED IN APPENDICES SOME OF THE OTHER INFORMATION THAT WE PROVIDE ON A QUARTERLY BASIS WITH ADDITIONAL INFORMATION THIS MONTH. NEXT SLIDE. THIS IS A LISTING OF OUR RECENT REPORTS SINCE OUR LAST QUARTERLY REPORT, SO YOU'LL NOTICE THAT WE'VE PROVIDED 22 REPORTS SINCE OUR LAST REPORT. WITH THAT, I'M GOING TO TURN IT TO COURTNEY GRAY, OUR DIRECTOR OF MANAGED CARE OPERATIONS, WHO WILL WALK YOU THROUGH THE ACCESS PORTION OF OUR PRESENTATION.

>> GOOD AFTERNOON, SUPERVISORS. THANK YOU SO MUCH FOR HAVING US TODAY. SO I'M GOING TO WALK THROUGH KIND OF HIGH LEVEL WHAT IS TIMELY ACCESS RELATED TO YOU ALSO AS THE BEHAVIORAL HEALTH PLAN HERE IN SANTA CLARA COUNTY. SO WE PROVIDE THE MENTAL HEALTH SERVICES AS WELL AS SUBSTANCE ABUSE SERVICES FOR OUR MEDI-CAL BENEFICIARIES AS WELL AS THOSE UNINSURED. AS YOU CAN SEE, DHCS, OUR REGULATOR FOR THE SERVICES, DOES AN ANNUAL TIMELY ACCESS EVALUATION AND AUDIT OF US. AND ANNUALLY, WE SERVE 40,000 INDIVIDUALS, AND YOU CAN SEE BROKEN DOWN BY MEDI-CAL BENEFICIARIES AND NON-MEDI-CAL BENEFICIARIES FOR MENTAL HEALTH AND SERVICES. WE ARE WORKING TO GET TO THE THRESHOLD SET FORWARD. OVERALL, BHSD IS DOING A REALLY GREAT JOB HAVING ONLY THREE CONDITIONAL PASSES. THAT'S ON PAR WITH OUR SISTER COUNTIES, DOING BETTER THAN SOME AND NOT QUITE AS GOOD AS OTHERS, BUT OVERALL, WE'RE RIGHT THERE. AND THESE ARE THINGS WE'RE ACTIVELY WORKING ON THROUGH MULTIPLE AVENUES, DOING MONITORING OF WHEN OUR PROGRAMS HAVE TO CLOSE, REALIGNING HOW WE ARE FUNDING OUR PSYCHIATRY SERVICES, AND THEN SUPPORTING STEP-DOWN. WE ARE PROVIDING SPECIALTY MENTAL HEALTH SERVICES. THERE IS A NON-SPECIALTY LEVEL OF CARE, AND IT'S IMPORTANT WE SERVE FOLKS IN THE RIGHT LEVEL OF CARE SO WE CAN MEET THOSE STANDARDS. WE HAVE DONE WORK TO MAKE SURE WE ARE SERVING THE CORRECT PEOPLE WHO MEET THE MEDICAL NECESSITY AS OUTLINED BY THAT THE STATE. THIS IS THE SAME SET OF STANDARDS, SLIGHTLY DIFFERENT FOR OUR SAT SERVICES. WE HAVE FOUR ADDITIONAL PASSES FOR FULL PASS, VERY ON PAR WITH OUR SISTER COUNTIES. AND HERE AGAIN, AS YOU ALL KNOW, WE HAVE DONE EXTENSIVE WORK TO EXPAND ACCESS TO OUR SUBSTANCE SERVICES THROUGH A NUMBER OF AVENUES, INCLUDING OPENING MORE CLINICS, PARTNERSHIPS, AND WORKING TO ADDRESS ACCESS FOR ALL THESE, ALL OF OUR BENEFICIARIES. AGAIN, WE ARE WORKING TO ADDRESS THE DEFICIENCIES THAT WE DO HAVE, BUT VERY ON PAR WITH THE STATE. IT'S VERY COMMON TO HAVE CONDITIONAL PASSES. IT'S ALSO IMPORTANT TO NOTE THE STATE CHANGES THE EXPECTATIONS REGULARLY, SO WE'RE ALWAYS CHASING TRYING TO GET EVERYBODY IN AS QUICKLY AS POSSIBLE. NEXT SLIDE. SO THIS IS OUTLINING KEY THINGS THAT WE ARE DOING TO TRY TO ENSURE ACCESS FOR BENEFICIARIES FOR OUR SERVICES. IN FISCAL YEAR 27, WE WILL BE FOCUSED ON ACCESS AS WELL AS CLINICAL OUTCOMES. WE THINK THIS WILL HELP BOTH OUR CONTRACTED PROVIDERS AND THE NETWORK AS A WHOLE, REALLY NOT ONLY AVOID FINANCIAL SANCTIONS, BUT MAKE SURE WE ARE PROVIDING QUALITY CARE FOR ALL OF OUR CLIENTS. ADDITIONALLY, WORKING WITH BOTH BHSD UNDER BHSA AND THE BEHAVIORAL HEALTH TRANSFORMATION AND CONNECT ALL THESE THREE VERY SIMILARLY NAMED PROGRAMS THAT THE STATE IS ROLLING OUT. WE ARE DOING WELL AND EXCEEDING EXPECTATIONS AROUND THE MEASURE SET THAT WE ARE NOW HELD ACCOUNTABLE TO, INCLUDING FOLLOW-UP AFTER EMERGENCY ROOM VISITS FOR BOTH DRUG USE AND MENTAL HEALTH CONDITIONS. WE ARE ALSO WORKING WITH IHI IN A COLLABORATIVE SANTA CLARA FAMILY PLAN TO WORK TO ADDRESS THESE. AND BECAUSE OF THAT WORK, WE WERE -- WE DID NOT RECEIVE ANY PENALTIES FROM THE STATE, UNLIKE MANY OF OUR SISTER COUNTIES FOR THESE MEASURE SETS. SO THAT REALLY INNOVATIVE WORK THAT'S LOOKING AT BEST PRACTICES ACROSS THE STATE, WE ARE PARTNERING AND BRINGING THOSE THEY'RE ADDRESS AND MAKE SURE ALL OF OUR CLIENTS HAVE EASY ACCESS TO THOSE SERVICES. NEXT SLIDE.

>> SO, THAT'S WHAT WE HAVE BEEN DOING AND WHERE ARE WE GOING STILL? SO WE CONTINUE TO FOCUS ON COMPLIANCE MONITORING AND WORKING CLOSELY WITH NETWORKS WORKING IN PARTNERSHIP TO MAKE SURE THEY HAVE THE INFRASTRUCTURE AND SUPPORT THEY NEED TO GET FOLKS IN TIMELY. AS WE'VE DISCUSSED MULTIPLE TIMES, WE HAVE BEEN EXPANDING SUTS ACCESS THROUGH THE CLINIC AND OUTPATIENT IN GILROY, WHICH HAS BEEN VERY GOOD OVER THIS LAST YEAR. WE ARE PARTNERING WITH THE MANAGED CARE PLANS TO MAKE SURE THEY ARE PROVIDING THE NON-SPECIALTY SERVICE AND WE ARE FOCUSING ON THE SPECIALTY SERVICE. THIS ENSURES FOLKS ARE PROVIDED THE RIGHT LEVEL OF CARE AND WE'RE NOT HOLDING ON TO PEOPLE. WE'RE MAKING A CONCERTED EFFORT IN ALIGNMENT WITH THE DIRECTIVE FROM THE STATE TO HAVE MORE OVERLAP WITH MANAGED CARE PROGRAMS. THIS MAKES IT EASIER ON INDIVIDUALS, SO WHEN THEY ARE DOWN AT THE NON-SPECIALTY LEVEL, THEY CAN STAY AT THEIR CLINIC. IT'S JUST WHO GETS BILLED ON THE BACK END. IT'S MORE EASY FOR THE CLIENTS, NOT SENDING THEM CLINIC TO CLINIC. THAT IT IS A REALLY IMPORTANT AREA WE'VE BEEN WORKING ON. WE HAVE STARTED AN INTERNAL WORK GROUP. THE STATE IS ACTIVELY CHANGING HOW THEY MANAGE ACCESS, MOVING AWAY FROM MEDICAID BENEFICIARY ADDRESSES, MOVING TOWARD CENSUS POINTS, WHICH IS INTERESTING, BECAUSE IT HAS NOTHING TO DO WITH MEDICAID RECIPIENTS, JUST WITH GENERAL CENSUS. WE ARE TRYING TO UNDERSTAND THOSE IMPLICATIONS AND HOW WE WILL NEED TO ADJUST MOVING FORWARD, SO WE HAVE INTERNAL WORK GROUPS KICKING OFF AROUND THAT. ALSO, WE HAVE MULTIPLE RFQS BEING ISSUED TO HELP PLUG SOME OF THE HOLES IN THE SERVICES WE HAVE THAT THE STATE IS MANDATING THAT WE OFFER TO OUR BENEFICIARIES, INCLUDING DAY REHAB AND DAY INTENSIVE REHAB, SO DAY INTENSIVE TREATMENT, RATHER. THEY ARE JUST GETTING KICKING OFF AND WE ARE EXCITED TO ADD THOSE TO THE NETWORK AND EXPAND THOSE. WITH THAT, I'LL HAND IT OVER TO MEGAN TO SPEAK ABOUT BEDS.

>> GOOD AFTERNOON, MEGAN WE'LL HAND, DEPARTMENT DIRECTOR. SO YOU CAN SEE HERE, WE ARE ON TRACK TO MEET OUR BED AND FACILITY INCREASED GOALS IN THE ACUTE RESIDENTIAL AND WE'RE PRETTY CLOSE ON SUBACUTE, AND WE ACTUALLY ADDED SIX SUBACUTE BEDS SINCE WE LAST REPORTED TO YOU ALL IN FEBRUARY. ALTHOUGH WE'VE MADE SIGNIFICANT PROGRESS ON MENTAL HEALTH COMMUNITY TREATMENT, WE STILL HAVE AN ADDITIONAL 52 BEDS TO PLAN FOR. NEXT SLIDE.

>> THIS IS A VISUAL REPRESENTATION OF THE SAME. YOU CAN SEE WE DID ACTUALLY ARE ON TRACK TO EXCEED OUR GOALS FOR SUTS RESIDENTIAL WITH PROJECTS COMING ON LINE IN OUR COUNTY. WITH BOND FUNDS NOW EXHAUSTED AND NO FURTHER LARGE CAPITAL GRANTS ON THE HORIZON, WE ARE DEVELOPING ALTERNATIVE PLANS TO MEET THE GOALS THAT WE SET FOR PARTICULAR COMMUNITY RESIDENTIAL. LET'S GO TO THE NEXT SLIDE. BUT IMPORTANT TO ACKNOWLEDGE THAT ALL OF THESE ADDED BEDS ARE AND WILL CONTINUE TO SERVE AN ADDITIONAL 2800 CLIENTS YEAR OVER YEAR GOING FORWARD. SO DESPITE THE EXHAUSTION OF THOSE FUNDS AND KIND OF STALLING OUT OF THE STATE SUPPORT FOR ADVANCEMENTS AND FACILITY DEVELOPMENT, WE HAVE SOME SIGNIFICANT PROJECTS UNDERWAY RIGHT NOW. SO THE BEHAVIORAL HEALTH PAVILION, AS YOU KNOW, WILL BE OPENING IN AUGUST, ADDING VERY CRITICAL IN-PATIENT BEDS FOR CHILDREN AND YOUTH. MAR POSE SA LODGE IS EXPECTED TO REOPEN THIS SUMMER AND OPERATE AT A SIGNIFICANTLY HIGHER CAPACITY THAN THE PAST, AND PATHWAYS WITHDRAW MANAGEMENT FACILITY THAT WAS ALSO FUNDED IS PLANNED TO OPEN THIS SUMMER, AS WELL. THAT'S ALL THE INFORMATION I HAVE FOR YOU. I'D BE HAPPY TO ANSWER QUESTIONS.

>> THANK YOU. LET'S SEE, ANY OF THE PUBLIC LIKE TO SPEAK ON THIS ITEM?

>> I HAVE NO PUBLIC SPEAKERS.

>> OK. ALL RIGHT. LET'S CLOSE THAT PORTION. SUPERVISOR ELLENBERG.

>> THANK YOU. THANK YOU, VERY MUCH FOR THE REPORT AND PRESENTATION. I WANT TO BEGIN BY RECOGNIZING A REALLY SIGNIFICANT MILESTONE. SINCE THE PUBLIC HEALTH CRISIS WAS DECLARED IN JANUARY OF 2022, WE HAVE ADDED 269 IN-PATIENT BEHAVIORAL HEALTH TREATMENT BEDS, AND THAT MEANS THAT OUR TREATMENT CAPACITY HAS GROWN BY NEARLY 3,000 MORE RESIDENTS ANNUALLY WHO NOW HAVE A PLACE TO TURN AT THE MOMENT THAT THEY NEED CARE. THIS BRINGS US HALFWAY TO OUR 530 BED GOAL BY 2030, A GOAL THAT IS ROOTED BOTH IN THE TOYOTA PRESENTED BY THE RAND CORPORATION AND IN THE BELIEF THAT WE HAVE AN OBLIGATION TO ENSURE THAT EVERY RESIDENT ENSURES -- RECEIVES TIMELY, COMPASSIONATE BEHAVIORAL HEALTH SUPPORT. AND I WOULD SAY THAT IT REALLY IS NOTABLE THAT WE'VE REACHED THIS MILESTONE IN ONE OF THE MOST CHALLENGING YEARS IMAGINABLE WITH MAJOR FEDERAL HEALTH AND HUMAN SERVICES CUTS AND DIFFICULT BUDGET DECISIONS LOCALLY. I BELIEVE THAT THIS PROGRESS REFLECTS THE DEDICATION AND PERSISTENCE OF OUR STAFF AND OUR PROVIDERS. SO JUST FOR THAT, I WANT TO EXPRESS REALLY DEEP APPRECIATION. THANK YOU FOR CONTINUING TO MOVE THIS WORK FORWARD. I WANT TO SHIFT NOW TO THE TIMELY ACCESS METRICS. ANOTHER IMPORTANT MEASURE IS WHETHER PEOPLE CAN ACTUALLY ACCESS THE CARE WHEN THEY ARE SEEKING IT. I KNOW THAT WE'RE SEEING STRONG PERFORMANCE IN OUR URGENT SERVICES. IN OTHER AREAS, THE ROLLS ARE MIXED, AND I THINK WARRANT SOME DEEPER DISCUSSION. I BELIEVE, AND CERTAINLY CORRECT ME IF THIS ISN'T THE CASE, THAT THE STATE ONLY RECENTLY BEGAN COLLECTING TIMELY ACCESS DATA FOR SUBSTANCE USE TREATMENT SERVICES. IS THAT CORRECT?

>> SOMEWHAT. SO IT'S BEEN LONG STANDING TO COLLECT IT ON THE MENTAL HEALTH SIDE. DATA HAS BEEN FORMALIZED OVER THE YEARS. THEY STARTED TRYING TO MAKE IT EQUITABLE BETWEEN THE TWO, AND NOW BECAUSE IT'S ALL BEEN SELF-REPORT EXCEL FILES, THEY CAN CHANGE WHICH IS RIFE WITH ERRORS AND PROBLEMS. THE 274 FORMAT THEY ARE USING NOW TO JUDGE OUR ACCESS, WHICH IS -- DOES NOT ALLOW FOR THE SAME LEVEL OF MANIPULATION AND CLEANUP AS EXCEL FILES, SO THAT ALL THE COUNTIES WILL HAVE MUCH MORE CLEAN AND ACCURATE DATA MOVING FORWARD.

>> THAT'S ENCOURAGING, BECAUSE I SEE ACCORDING TO THE STATE DATA DASHBOARD CURRENTLY, SEVERAL COUNTIES OPEN FLAG WOULD FOR DATA ISSUES. SO HOPEFULLY, WE WILL BE ABLE TO INTERPRET MORE ACCURATELY IN THE NEAR FUTURE. AND I ALSO LOVE TO SEE THAT WE'RE CONTINUING TO STRENGTHEN OUR SUBSTANCE USE TREATMENT SERVICES THROUGH EFFORTS LIKE THE NEW COMPASS ADDICTION MEDICINE CLINIC THAT OPENED LAST FALL AND THE UPCOMING MOBILE TREATMENT VAN WHICH WILL OFFER ADDITIONAL ENTRY POINTS FOR PEOPLE WHO NEED MEDICATION ASSISTED TREATMENT. DO YOU EXPECT THOSE EFFORTS TO MAKE A SUBSTANTIAL DIFFERENCE IN THE AREAS WHERE THE COUNTY CURRENTLY HAS BEEN RAILED WITH A CONDITIONAL PASS?

>> THAT THAT WAS AN EXPECTATION EXPANDED. I DO THINK THAT THAT WILL DEFINITELY HELP, AS WELL AS INTEGRATING IT FULLY AND MAKING SURE THAT WE HAVE SERVICES OFFERED AT EVERY POINT OF ACCESS.

>> THANK YOU. I FEEL LIKE WITH A LOT OF YOUR EXPLANATIONS, I'M JUST FEELING THAT THE STATE HAS TAKEN VERY LONG TIME.

>> THEY HAVE.

>> TO REALLY BE AT A PLACE WHERE WE SHOULD BE IN 2026 REGARDING DATA COLLECTION, ANALYSIS, AND PRESENTATION.

>> YES.

>> WE'RE TALKING ABOUT THIS LIKE IT'S A NEW SKILL OR A NEW TECHNIQUE.

>> YES, AND IT IS NOT. AND 274 HAS BEEN A STANDARD ON THE MANAGED CARE PLAN SIDE FOR MANY YEARS, AND IT WAS A VERY BIG LIFT FOR MOST OF THE COUNTY BEHAVIORAL HEALTH PLANS. WE WERE VERY LUCKY WE WERE ONE OF THE PRIMARY COUNTIES WHO GOT IT UP AND RUNNING VERY QUICKLY IN GOOD COOPERATION WITH OUR PARTNERS AT NET SMART, SO WE HAVE A VERY STRONG DATA DEPARTMENT AS WELL. WE FEEL MUCH MORE CONFIDENT IN OUR DATA THAN SOME OF OUR SISTER COUNTIES.

>> I LOVE TO HEAR WHEN SANTA CLARA COUNTY IS AHEAD. I HAVE THREE QUESTIONS. ADD ANY CONTEXT OR THOUGHTS YOU HAVE. WHAT SHOULD WE TAKE FROM THIS INITIAL DATA SET, ESPECIALLY WITH REGARD TO SUBSTANCE USE TIMELY ACCESS? HOW DOES OUR PERFORMANCE, YOU ADDRESSED THAT A LITTLE BIT, BUT THERE'S MORE TO SAY, COMPARE TO OTHER THOSE COMPARISONS ARE YOU THINK APPROPRIATE? AND THIRD, WHAT DO YOU THINK THE BOARD AND THE PUBLIC SHOULD REASONABLY GLEAN FROM THESE EARLY NUMBERS, ALL OF THAT TO SAY HOW ARE WE DOING?

>> I CAN START, AND I'LL MAYBE TAKE YOUR SECOND QUESTION FIRST, IF THAT'S ALL RIGHT.

>> WHICHEVER WAY YOU WOULD LIKE.

>> TERMS OF ACCESS, I DID PULL A COUPLE OF THESE COMPARISONS. FOR US ON THE MENTAL HEALTH SIDE, WE HAVE THREE CONDITIONAL PASSES. SANTA CRUZ HAS THREE, ALAMEDA HAS TWO, AND SAN FRANCISCO SIX. THOSE ARE LOCALIZED COMPARABLE SISTER COUNTIES. WE'RE DOING A LITTLE WORSE THAN ALAMEDA, BUT BETTER THAN OTHERS. WE'RE ON PAR. I THINK THOSE ARE ALL KIND OF GOOD COMPARISON COUNTIES FOR US. ON THE SIDE, THE THREE COUNTIES, FOUR CONDITIONAL PASSES. ALAMEDA AGAIN, THEY ONLY HAVE ONE. SAN FRANCISCO HAS EIGHT, SO THEY HAVE CONDITIONAL ON ALL OF THEM, AND SANTA CRUZ HAS FOUR, SIMILAR TO US. WE'RE ON PAR GIVEN GEOGRAPHIC WHERE OUR SERVICES OFFERED AS WELL AS THE FOLKS WE ARE SERVING, SO I REALLY FEEL FIRST AND FOREMOST WE'RE VERY MUCH ON PAR. IT'S ESPECIALLY COMMON AS NOT ONLY DO REGULATIONS CHANGE, BUT ALSO MEASUREMENT CHANGES, SO WE'RE IN THIS HUGE SHIFT OF DATA KIND OF BEING AMORPHOUS GETTING MORE REGULATED.

>> WE SHOULD BE USING THIS BASELINE DATA TO COMPARE AGAINST OURSELVES A YEAR FROM NOW?

>> YES, AND WE JUST DID A RESUBMISSION ON APRIL 10 TO CLOSE OUT AND PROVIDE SOME ADDITIONAL DATA POINTS. SO PART OF THIS IS IF THERE'S HOLES IN THE DATA THAT WE GOT FROM OUR PROVIDERS OR CLINICS, WE TURNED TO GO BACK AND FILL IN THE HOLES. WE HAVE UNDERTAKEN A VERY LARGE EFFORT TO STANDARDIZE HOW WE COLLECT DATA FROM PROVIDERS AND FROM IT OUT SO THAT IT'S CLEAN FROM START TO FINISH. THERE IS NO EXCEL SPREADSHEETS, NO MANUAL TOUCHES, REALLY, SO THAT I BELIEVE WILL INCREASE OUR RATES EVEN MORE SO, AND WE'RE OVERALL IN VERY GOOD STANDING. YOUR LAST QUESTION, WHAT SHOULD YOU TAKE FROM IT.

>> I COULDN'T.

>> TWO THINGS: WE'RE NOT DOING BAD AT ALL AND DOING WELL COMPARED TO SISTER COUNTIES. THESE MEASURES ARE TIME OF OFFERED APPOINTMENT. THAT DOES NOT MEAN PEOPLE DON'T GET THE SERVICES, THEY MIGHT GET IT IN A 10-DAY WINDOW.

>> FOR NON-URGENT.

>> IT DOES NOT MEAN THAT YOU ARE NOT GETTING SERVICES, YOU MIGHT BE GETTING IT SLOWLY OUTSIDE THE WINDOW. AND FOR WHEN WE ARE ON THE CONDITIONAL PASSES, WE'RE PRETTY CLOSE MOST PLACES.

>> CAN I ASK YOU IF WE ARE NOT MEETING THE WINDOW, IS THE DATA JUST YES OR NO, OR DOES THE DATA SAY YOU ARE NOT MEETING IT BY THIS DAY BUT 90% MEETING IT WITHIN 20 DAYS, SOMETHING LIKE THAT?

>> CORRECT. YOU SUBMIT DATES ARE WHEN THE PERSON REQUESTED THE SERVICE AND WHEN THEY WERE OFFERED THEIR FIRST APPOINTMENT, WHICH CAN BE VERY SQUISHY, WHICH IS WHY THE STATE HAS BEEN TRYING TO MAKE IT MORE REGULATED. WE CAN SEE HOWEVER OFF PEOPLE ARE FROM AGAIN USING THAT OUTPATIENT, THAT 10-DAY WINDOW, WE ARE NORMALLY WITHIN 13 TO 14 DAYS AT MOST.

>> DANG. OVERALL, I KEEP PILING THE QUESTIONS, OVERALL, REQUIREMENTS ABOUT DATA ARE HELPING US, BECAUSE IT PROVIDES CLARITY, OR IS THERE ANY DEGREE THAT YOU FEEL THAT THEY ARE SLOWING DOWN THE ACTUAL PROVIDING OF TREATMENT, OR IS IT SEPARATE?

>> I DO NOT BELIEVE IT IS SLOWING DOWN TREATMENT. I THINK IT IS HELPING US TO UNDERSTAND WHERE WE DO HAVE OPPORTUNITIES TO EXPAND SERVICES, WHERE WE NEED TO ADD A LITTLE MORE. WE CHANGED HOW WE'RE COLLECTING THE DATA, BUT ALSO THE EXPERIENCE OF ENTERING INTO ESPECIALLY MEDICAL HEALTH SERVICES HAS CHANGED. THERE USED TO BE A TIGHTER TIME FRAME HAVING TO DO AN ASSESSMENT. NOW THAT THAT DOESN'T NEED TO BE DONE AT THE FIRST APPOINTMENT, IT HELPS, WHICH HAS BEEN A REALLY, REALLY GOOD THING.

>> I WISH THAT CAL LANE WAS ON FIRMER GROUNDS.

>> OUR INTENTION IN BRINGING THIS FORWARD PURSUANT TO PRESIDENT LEE'S REQUEST IS REALLY TO START GIVING THE PUBLIC, AFTER OUR WORKSHOP BACK IN FEBRUARY, JUST SOME MORE KIND OF UNDERSTANDING OF THE METRICS BY WHICH WE ARE BEING MEASURED IN THIS HIGHLY REGULATED ENVIRONMENT AND UNDERSTANDING THAT DHCS HAS SET A CLEAR INTENTION TO HOLD US EVEN MORE ACCOUNTABLE THAN IN THE PAST THROUGH EXECUTION ABILITY TO SANCTIONS, CAPS TO A GREATER DEGREE THAN IN THE PAST. THIS IS ONE METRIC AMONG MANY THAT WE ARE JUDGED BY ON AN ANNUAL BASIS AND THAT WE ALSO USE TO MAKE DECISIONS ABOUT OUR SERVICES. SO JUST KIND OF AN INTRODUCTION TO THAT.

>> THANKS, MEGAN. ACCOUNTABILITY IS CERTAINLY GOOD. I HOPE THAT THIS DOESN'T TURN INTO A -- AN ENVIRONMENT WHERE WE'RE LEADING WITH PUNITIVE MEASURES, AND THAT THERE REALLY IS AN UNDERSTANDING OF THE NEED TO CONTINUOUSLY IMPROVE RATHER THAN NECESSARILY BE PENALIZED OR FINED IF WE DON'T MAKE SPECIFIC MARKS, BUT WE ARE MOVING FORWARD. I HOPE, AND I THINK SOME OF THAT WILL DEPEND ON RELATIONSHIPS, AS WELL.

>> YES, I THINK AS SUPERVISOR TO YOUR QUESTION, AS BOTH COURTNEY AND MEGAN MENTIONED, WE ARE WORKING CLOSELY WITH OUR PROVIDER NETWORK AND DEVELOPING A PROCESS TO COLLECT THIS DATA TO HAVE THEM REPORT THAT TO US, SO WE CAN TRACK AND REALLY TIMELINESS LEADS TO ACCESS, AND ACCESS IS SOMETHING VERY IMPORTANT TO US TO BE ABLE TO MAKE SURE WE CAN OFFER THOSE SERVICES. AS COURTNEY MENTIONED, WE'RE REALLY EXCITED ABOUT LAUNCHING THE INAUGURAL PAY FOR PERFORMANCE IN FISCAL YEAR 27, WHICH OUR PROVIDERS HAVE BEEN VERY MUCH ENGAGED IN IN TERMS OF BEING ABLE TO REPORT THE DATA THAT COURTNEY REFERENCES AND HAVE EVEN MORE ROBUST FINDINGS AROUND SOME OF THESE TIMELINESS MEASURES.

>> THANK YOU ALL AGAIN. I THINK THIS IS SUCH IMPORTANT WORK AND I'M HAPPY TO MAKE A MOTION TO RECEIVE THE REPORT.

>> HAPPY TO SECOND THAT.

>> MOTION AND SECONDED. YES, SUPERVISOR ABE-KOGA.

>> THANK YOU. THANK YOU SO MUCH FOR THE PRESENTATION AND ALL THE GREAT WORK THAT'S BEING DONE. ESPECIALLY APPRECIATE THE ADDITION OF THE NEW BEDS FOR BEHAVIORAL HEALTH AND TO HELP US CONTINUE TO WORK TOWARDS MEETING THE GROWING NEED IN OUR COMMUNITY. THE ONE ISSUE THAT I WANTED TO BRING UP WAS YOUTH MENTAL HEALTH. I THINK YOU HEARD ME TALK ABOUT IT, AND ESPECIALLY RIGHT NOW IN LIGHT OF SOME OF OUR TRAGEDIES THAT WE HAVE BEEN EXPERIENCING IN MY DISTRICT, AND THEN OTHERS THAT MAY NOT BE NECESSARILY MAKING THE NEWS, BUT IT IS A REAL CONCERN, AND JUST HEARTBREAKING FOR ME WHEN I SEE YOUNG PEOPLE FEELING LIKE THEY HAVE NO OTHER PLACE TO GO. BUT I HAD ASKED BACK IN FEBRUARY THAT THIS REPORT WOULD INCLUDE SPECIFICALLY WHAT WE ARE WORKING ON IN THE YOUTH MENTAL HEALTH BEHAVIORAL HEALTH ARENA, AND I COULDN'T FIND IT, BUT I WAS HOPING THAT YOU COULD -- BECAUSE OF TIME, I WON'T ASK NOW, BUT FOR THE NEXT REPORT, IT CAN BE SURE TO INCLUDE THAT AS A SPECIFIC TOPIC TO COVER.

>> YES, WE CAN CERTAINLY INCLUDE THAT IN OUR AUGUST REPORT BACK AND JUST HAPPY TO BETTER UNDERSTAND EXACTLY WHAT MIGHT BE

HELPFUL IN THAT REPORT BACK RELATED TO YOUTH MENTAL HEALTH. WE HAVE A WIDE RANGE OF SERVICES AND POPULATIONS THAT WE PROVIDE SERVICES TO, SO HAPPY TO, YOU KNOW, KIND OF HONE IN ON WHAT WE THINK MIGHT BE MOST HELPFUL TO THAT REPORT BACK IN AUGUST. I'M HAPPY TO INCLUDE THAT INFORMATION.

YES, THAT WOULD BE GREAT. AND JUST AS YOU MENTIONED, WHAT ARE SPECIFIC PROGRAMS THAT WERE -- WE ARE OFFERING, AND THEN IN RELATION TO, I KNOW THE CHALLENGES WE HAVE FISCALLY, BUT HOW WE'RE GOING TO TRY TO MAINTAIN AS MUCH AS WE CAN. OBVIOUSLY, THE RELATIONSHIP WITH SUICIDE PREVENTION IS IMPORTANT TO ME, SO THOSE WOULD BE AREAS THAT I WOULD ASK FOR INFORMATION ON.

YES, WE CAN DEFINITELY INCLUDE THAT IN OUR NEXT REPORT BACK.

GREAT, THANK YOU.

WELL, YES, FIRST OF ALL, THANK YOU SO MUCH FOR THIS GREAT REPORT AND GETTING BACK TO OUR REQUEST FOR THE TIMELY ACCESS DATA, AS WELL. THANK YOU. ON THE TRUST PROGRAM, CLEARLY WORKING BASED ON THE NUMBERS AND AT THE LAST MEETING. JAMES HAS TALKED ABOUT HOW AT THE STATE LEVEL THIS IS GOING TO KEEP GOING. I ASKED THAT WE COULD TURN IT INTO SOME TYPE OF A HANDOUT, LIKE A TWO-PAGE, ONE-PAGER THING SO SHARE WITH OTHER JURISDICTIONS. AND MAYBE DO SOMETHING. I DON'T KNOW, GRETA, I WAS GOING TO ASK JAMES FOR IT, BUT HE JUST STEPPED OUT ON THIS ONE.

SUPERVISOR, I APOLOGIZE, I ACTUALLY MISSED YOUR QUESTION.

I'M SORRY. JAMES, I'M NOT SURE IF I CAUGHT YOU. I WAS TALKING ABOUT THE TRUST PROGRAM BEING SO SUCCESSFUL AND HOW WE WERE ABLE TO KEEP THIS GOING THROUGH SOME OF THE STATE FUNDING ADVOCACY WORK. AND I'M TRYING TO SEE IF IT'S POSSIBLE TO TURN THIS INTO LIKE A TWO-PAGE, ONE-PAGE TO SHARE WITH OTHER ORGANIZATIONS.

SURE, WE CERTAINLY CAN DO THAT. WE HAVE A COUPLE THINGS GOING ON ON THE LEGISLATIVE FRONT WITH BEHAVIORAL HEALTH. ONE IS THE PUSH BACK ON THE GOVERNOR'S BUDGET PROPOSAL TO LIMIT MOBILE CRISIS AS A MEDI-CAL COVERED BENEFIT. THE SECOND IS RELATED TO SUICIDE PREVENTION FUNDING GOING TO THE COMMENTS A FEW MOMENTS AGO FROM SUPERVISOR ABE-KOGA. BUT RELATED TO THE SHIFT OF THAT FUNDING SO THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH. WE HAVE ADVOCACY ON BOTH FRONTS IN PROGRESS. WE'LL MAKE SURE THAT THE BOARD HAS THOSE MATERIALS, AND WE'RE QUITE CONCERNED ON BOTH THOSE LEVELS AND REALLY HOPE THE LEGISLATURE.

HE INVESTIGATES THE GOVERNOR'S PROPOSAL ON MOBILE CRISIS, IN PARTICULAR.

THANK YOU, JAMES. I THINK THAT'S ALL THE QUESTIONS I HAVE. THANK YOU. OH, VICE PRESIDENT, DO YOU HAVE ANY LAST WORDS?

YES, THANK YOU SO MUCH. I APPRECIATE THIS. SO, I THINK FROM THE FEBRUARY PRESENTATION, THIS IS A REQUEST FROM PRESIDENT LEE, AND AT THAT TIME, YOU HAD PRESENTED ON AVENUES THAT YOU WERE GOING TO EXPLORE TO INCREASE REVENUE. AND I WANTED TO SEE IF YOU HAD ANY UPDATE ON THAT FRONT AT THAT THERE WAS IMPLEMENTATIONS THAT WERE INTERNAL THAT YOU WERE GOING TO MAKE.

YES, WE'VE BEEN, YOU KNOW, REALLY WORKING ON IDENTIFYING OPPORTUNITIES TO BRING IN ADDITIONAL REVENUE. WE'RE WORKING WITH OUR INTERNAL TEAM AROUND QA/QI, WHICH IS QUALITY ASSURANCE AND QI REVENUE AS WELL AS SOME OF THE INDIRECT FUNDING THAT CAN COME TO OUR DEPARTMENT TO INCREASE THAT. WE DID REFERENCE MEDICAID ADMINISTRATIVE ACTIVITIES DURING OUR FEBRUARY 10TH PRESENTATION OR MAA, AND WE'RE CONTINUING TO WORK WITH A CONSULTANT HELPING US TO THINK ABOUT HOW TO MORE BROADLY GENERATE MAA REVENUE FOR THE ENTIRE SYSTEM. YOU HAD A QUESTION WITH THAT WORK -- WE'RE WORKING TO SYSTEMATICALLY ADDRESS SOME OF THE OPPORTUNITIES AROUND MAA. WE ARE, YOU KNOW, CONTINUING TO LOOK FOR.

BEFORE YOU GO AWAY FROM MAA, WHAT IS THAT TIMELINE?

WE'RE CURRENTLY INVOLVED WITH A WORK PLAN. WE CAN BRING THAT BACK AT A FUTURE REPORT OR PROVIDE AN OFF-AGENDA, BUT WE DO HAVE CURRENTLY WORK HAPPENING WITH OUR CONSULTANT ON MAA EXPANSION, SO HAPPY TO BRING THAT BACK.

AND WHY DON'T WE LEVERAGE OUR OWN INTERNAL RESOURCES TO DO THAT? AREN'T WE CONTRACTING OUT WITH COUNTY OFFICE OF ED TO DO THE SAME THINGS FOR SCHOOLS TO GET REIMBURSEMENT? DO MEDI-CAL?

THE MEDICAID ADMINISTRATIVE ACTIVITIES RELATED TO OUR COUNTY RESPONSIBILITY ARE ACTUALLY HEALTH WITHIN OUR HEALTH AND HOSPITAL SYSTEM. SO THROUGH THAT APPROACH, THE BEHAVIORAL HEALTH SERVICES DEPARTMENT IS ALSO LOOKING AT WAYS TO INCREASE THOSE OPPORTUNITIES, AND SO CERTAINLY WE CAN LEARN FROM THE COUNTY OFFICE OF EDUCATION, BUT THE MAA ADMINISTRATIVE ACTIVITIES RELATED TO GENERATING ADDITIONAL BILLING HAS REALLY HELPED WITHIN OUR HEALTH SYSTEM.

GOT IT. WHAT'S THE TIMELINE ON THAT? WHEN DO YOU EXPECT TO SEE. SO YOU HIRED A CONSULTANT.

WE CAN CERTAINLY BRING THAT BACK. HAPPY TO PROVIDE AN OFF-AGENDA REPORT WITH ADDITIONAL INFORMATION.

I'D LIKE TO SEE WHAT THAT TIMELINE IS FOR EACH OPTION THAT YOU PROVIDED IN THAT PRESENTATION, INCLUDING THE MAA. THAT WOULD BE REALLY HELPFUL FOR US TO UNDERSTAND HOW YOU'RE STANDING UP EXTERNAL AND INTERNAL REVENUE OPPORTUNITIES FOR US. I HAVE AS PART OF I THINK AS APPENDIX A, THAT IT IS THE BEHAVIORAL HEALTH EFFORTS TO ADDRESS PUBLIC HEALTH DEPARTMENT LATINO HEALTH ASSESSMENT ACTION PLAN, AND I'D -- IT -- I'D LIKE TO WORK WITH YOU OFFLINE ON THIS ITEM, AS I THINK THAT WE KNOW ONE OF THE FIRST ITEMS IS TO WORK WITH SCHOOLING SERVICES AND BASICALLY ONE OF THE ITEMS IS BASICALLY JUST CONTRACTING WITH SCHOOLING SERVICE PROGRAMS THAT LIST ALL OF THE SCHOOL DISTRICTS THAT SCHOOLING SERVICE HAS, BUT ISN'T TARGETED IN ANY MANNER. THERE'S NO PRIORITIZATION, THERE'S -- IT IS -- IT IS VERY GENERIC IN TERMS OF, IF THIS IS FOR THE LATINO HEALTH ASSESSMENT, WHAT IS THE ORDER OF THOSE DISTRICTS? IS IT BECAUSE THE ONES LISTED FIRST HAVE THE MAJORITY OF LATINO YOUTH, THE ONES AT THE END HAVE THE LEAST?

I THINK IT'S LISTED VIA ALPHABETICAL ORDER, NOT BY NEED. HAPPY TO WORK WITH YOUR OFFICE AND FOR TO YOU PROVIDE ANY FEEDBACK YOU HAVE RELATED TO THIS ITEM.

YES, IT ALSO REALLY MISS THE MARK IN TERMS OF WHAT I HAD MENTIONED HAS NOT BEEN, I'VE BEEN VERY VOCAL ABOUT THIS, THE INCREASE HAS DR. RUDMAN AND HER STAFF, THERE'S BEEN AN INCREASE IN SUICIDE RATE, ONE OF THE HIGHEST AMONG YOUNG LATINO MEN AND MEN. YET THERE ISN'T AN ACTIONABLE ITEM TO ADDRESS THAT. I'D LIKE YOU TO REVISIT IT AGAIN AND CREATE ACTIONS THAT ACTUALLY ARE RESPONSIVE TO THE LATINO HEALTH ASSESSMENT, INCLUDING SUICIDE.

YES, WE CAN CERTAINLY DO THAT, SUPERVISOR.

AND ONE OF THE ITEMS THAT I'M INTERESTED IN IN LEARNING ABOUT IS WITH REALIGNMENT FROM THE STATE, I KNOW THAT THERE'S REDUCTIONS IN SOME OF THE -- SOME OF THE DEPARTMENTS THAT ARE VERY NOT ONLY IMPORTANT TO ME, BUT IMPORTANT IN OUR SAFETY. THIS IS OUR SAFETY NET PLAN AND THIS IS OUR SAFETY NET SERVICES, SO IF THERE'S REDUCTION IN THE PROBATION DEPARTMENT, HOW ARE WE MAKING UP FOR THAT? THESE ARE KIDS WHO ARE IN THE PRIME POSITION TO RECEIVE THERAPY, YET BECAUSE WE DON'T RENDER ENOUGH NUMBERS, IT ISN'T SUFFICIENT ENOUGH FOR US TO OFFER THOSE SERVICES THERE. WHAT IS THE PLAN FOR OUR JUVENILE JUSTICE SYSTEM AND THE PROVISION OF MENTAL HEALTH SERVICES THERE. IF WE'RE GOING TO REDUCE IT, HOW ARE WE MAKING UP FOR IT? WE'RE JUST NOT GOING TO SERVE THESE CHILDREN IN OUR JUVENILE JUSTICE SYSTEM?

I THINK YOU'RE REFERRING TO BUDGET PROPOSAL REGARDING RECOGNIZED LEVELS OF CLINICIANS ASSOCIATED WITH JUVENILE HALL. I THINK THE APPROPRIATE TIME TO WALK THROUGH THAT AND WHAT THAT MEANS FOR SERVICE PROVISION WOULD BE AT THE BUDGET WORKSHOP.

ISN'T THIS THE MENTAL HEALTH AND SERVICE USE CRISIS QUARTERLY REPORT?

IT IS.

WE ARE ANTICIPATING MOVEMENT IN LESS THAN A MONTH AND A HALF AND WE ARE ALMOST AT THE BEGINNING OF MAY. BY MID-JUNE, WE'VE APPROVED A BUDGET. I DON'T WANT TO -- WHAT I WANT TO RECEIVE IS INFORMATION THAT IS STILL PLIABLE AND THAT IS NOT BAKED IN, SO I WILL TALK ABOUT THIS, BECAUSE IT IS RELEVANT TO THIS MENTAL HEALTH AND SUBSTANCE USE CRISIS. HOW IS IT THAT WE ARE SUPPORTING OUR JUVENILE JUSTICE SYSTEM CLIENTS? IT IS RELEVANT TO THIS SITUATION. CORRECT ME IF I'M WRONG, TONY.

I THINK IT'S WITHIN THE SCOPE OF THE NOTICED ITEM TO HAVE THAT DISCUSSION, YES.

SURE. SO TO ANSWER YOUR QUESTION, SUPERVISOR, YOU KNOW, WE ARE CONTINUING TO PROVIDE BEHAVIORAL HEALTH SERVICES IN JUVENILE HALL. AS YOU'RE REFERENCING, AND AS WE'VE ALL BEEN COLLECTIVELY REFERENCING, THERE ARE SIGNIFICANT FISCAL AND BUDGET ISSUES FACING THE COUNTY. IN LIGHT OF THAT, THE PROBATION DEPARTMENT AND THE BEHAVIORAL HEALTH DEPARTMENT CAME TOGETHER TO REALLY LOOK AT THE NUMBER OF YOUTH IN JUVENILE HALL, LOOKING AT THE TRENDS OF THOSE NUMBERS, THE CENSUS NUMBERS, EVALUATING, YOU KNOW, HOW QUICKLY WE WERE ABLE TO PROVIDE ACCESS TO ASSESSMENTS AND TREATMENT, AND WE WERE, YOU KNOW, THROUGH OUR PROPOSAL PROPOSING AN ADJUSTMENT THAT WOULD STILL CONTINUE TO MEET THE NEEDS BASED ON THE CENSUS OF YOUTH IN JUVENILE HALL.

WHAT DOES THAT MEAN, BREAK IT DOWN FOR ME. SO IT STILL WOULD MEET THE NEEDS. WHAT DOES THAT MEAN?

WE HAVE LOOKED AT THE NUMBER OF STAFF THAT WE HAVE RELATED TO THE CENSUS OF YOUTH IN JUVENILE HALL, LOOKED AT TIMELY ACCESS RELATED TO ASSESSMENTS, HOW MUCH TIME IS SPENT ON ASSESSMENTS VERSUS TREATMENT, AND WE'VE EVALUATED THAT WITH THE CURRENT PROPOSAL WE WOULD STILL BE ABLE TO MEET THE NEEDS EFFECTIVELY OF THE YOUTH THAT ARE IN THIS CARCERAL SETTING. WE HAVE CONTINUED TO WORK TOGETHER FOR MANY YEARS. WE HAVE A VERY STRONG PARTNERSHIP WITH PROBATION. WE CONTINUE TO LOOK AT THE NEEDS OF THE YOUTH AND HAVE, YOU KNOW, PIVOTED WHEN NEEDED, HAVE BUILT IN ADDITIONAL SUPPORTS WHEN NEEDED, HAVE LOOKED AT ADEQUATE COVERAGE, GIVEN THE TIME THAT YOUTH ARE IN THE FACILITY. I MEAN, WE, YOU KNOW, WILL CONTINUE TO DO THAT PARTNERSHIP. AGAIN, THESE ARE VERY CHALLENGING TIMES, BUT WE HAVE SPENT THE TIME TOGETHER TO REALLY LOOK AT THE CHALLENGES THAT FACE US AND ENSURE THAT THE YOUTH THAT ARE THE MOST VULNERABLE IN OUR SYSTEM ARE RECEIVING THE SERVICES THAT THEY NEED.

I'M GOING TO REQUEST FOR YOU TO GIVE ME SOME OFFLINE INFORMATION, BECAUSE THAT IS JUST NOT -- IT ISN'T CLEAR WHAT YOU'RE SAYING. I DON'T UNDERSTAND IT ANY BETTER, SO I'LL TAKE THIS CONVERSATION OFFLINE BUT JUST KNOW THAT THIS IS SOMETHING I'M LOOKING AT. I HAVEN'T -- I'VE MADE IT VERY CLEAR WHAT IS IMPORTANT TO ME IN TERMS OF THE LATINO COMMUNITY, AND SO I'LL CONTINUE TO EXPECT THAT DEMOCRATS HOLD THE LATINO COMMUNITY CRISIS AS A CRISIS AND BE RESPONSIVE IN THAT MANNER. AND I DON'T KNOW HOW ELSE TO DOUBLE UP ON CRISIS, THE LATINO HEALTH CALLS US, LATINOS IN A CRISIS AND THOSE CHILDREN IN JUVENILE HALL BECAUSE THEY ARE CHILDREN ARE IN A CRISIS. WHO BETTER TO SERVE THAN A CAPTIVE AUDIENCE THAT IS THERE FOR US, AND IT PROBABLY IS AT THE HIGHEST LEVEL IN TERMS OF NEED. OK, I'M GOING TO MOVE ON. I KNOW IT'S LESS THAN 10% OF THE CALLS THAT ARE GOING TO THE MOBILE CRISIS UNITS. THE AVERAGE FIELD RESPONSE TIME STILL SEEMS PRETTY HIGH. WITH THE LOWEST BEING 33 MINUTES FOR BOTH TRUST AND MCRT. WITHOUT ANY INFORMATION ON REGIONAL GIVENS FOR FIELD RESPONSE TIMES, DO WE KNOW IF IT'S HIGHER IN SOUTH COUNTY? I WANTED TO FIGURE THAT PIECE OUT.

I DON'T HAVE THAT RIGHT IN FRONT OF ME BUT FOR BOTH, WE HAVE TEAMS STATIONED IN SOUTH COUNTY, SO IT SHOULD NOT BE THE CASE THAT A FIELD RESPONSE TIME IS SIGNIFICANTLY LONGER ACROSS THE BOARD.

COULD YOU GET THAT FOR ME, THOUGH? THAT WOULD BE VERY HELPFUL. I WANT TO KNOW WHAT THAT LOOKS LIKE VERSUS A SAN JOSE BASED RESPONSE AND SOUTH COUNTY RESPONSE. I DON'T KNOW IF MY COLLEAGUES CARE. THE NORTH SIDE OF THE COUNTY MIGHT ALSO HAVE MAYBE SOME ACCESS ISSUES THERE, AS WELL. I THINK IT WOULD JUST BE A GREAT COMPARISON OVERALL. AND LASTLY FOR THE INFORMATION THAT'S ON THE MOBILE HEALTH CRISIS CALLS THAT INVOLVED THE LAW ENFORCEMENT, CAN YOU SEPARATE THE LAST CATEGORY THAT'S REFERRED TO SO THOSE TWO CAN BE SEPARATED AND WE CAN SEE WHICH CALLS ENDED IN ARREST, PLEASE.

THE CHALLENGES THAT WE DON'T ALWAYS KNOW IF THE CALL ENDS IN ARREST. IT'S NOT, WE DON'T HAVE -- WE'RE NOT LINKED TO CRIMINAL JUSTICE DATA, SO THERE ARE LIMITATIONS IN OUR ABILITY TO KNOW FOR SURE IF IT IS REPORTED, IF THE CLINICIAN HAS AWARENESS IF THAT IS SOMETHING THAT CAN BE TRACKED BUT WE DON'T HAVE 100% DATA INTEGRITY AROUND THAT.

ALL RIGHT, SO WHEN PERT WENT AWAY, WE WERE GOING TO YOU ALL COMMITTED TO HAVING THESE LINES BE RESPONSIVE TO WHAT FOLKS USUALLY WOULD CALL IN FOR PERT, RIGHT, AND BUT IF YOU CAN'T TRACK IT, HOW DO WE KNOW THAT WE'RE ACTUALLY SERVING THAT PURPOSE? HOW DO WE KNOW THAT KIND OF IN WE HAVE A DEFAULT PERT.

YEAH, I CAN SEE IF WE WERE ABLE TO SEE WHETHER OR NOT SOMEONE WAS ULTIMATELY ARRESTED BASED ON A CONTACT THAT WOULD HELP US TO UNDERSTAND WHETHER OR NOT OUR INTERVENTIONS PREVENTED OR DIDN'T PREVENT THAT ARREST. I DO THINK WE HAVE GOOD DATA, THOUGH, ON WHETHER OR NOT THE CALL IS ULTIMATELY REFERRED TO A LAW ENFORCEMENT AGENCY AND THAT OPPORTUNITY FOR ARREST BECOMES PRESENT, AND YOU CAN SEE THAT THAT IS HAPPENING A VERY SMALL PERCENTAGE OF THE TIME, AND STILL IS AN AREA THAT WE CAN WORK TO BRING DOWN IF LAW ENFORCEMENT ULTIMATELY IS NOT WHO RESPONDS AT THE ANY POINT, WE ARE CERTAINLY AFTER OUR TEAMS, THEN THERE ISN'T THAT OPPORTUNITY FOR ARREST OR IF LAW ENFORCEMENT IS THE INITIAL RESPONDER, IF LAW ENFORCEMENT DIVERTS THAT CALL TO OUR TEAMS, THE OPPORTUNITY FOR ARREST IS GONE.

OK. THAT IS DISAPPOINTING. THE LAST PIECE IS HOW DO YOU BUILD IN TO YOUR REPORTS YOUR RESPONSES, YOUR STRATEGIES, YOUR DIRECTION THAT YOU'RE TAKING YOUR DEPARTMENT WHEN YOU SEE THE CHILD AND YOUTH DEATH REPORT, HOW IS IT THAT YOU ARE INTEGRATING THOSE STORIES, THOSE INCIDENTS, BECAUSE THERE'S PLENTY OF SUICIDES THERE, OR GENDER BASED VIOLENCE RESULTED DEATHS. HOW DO YOU CONNECT THOSE DEATHS WITH THE WORK THAT YOU'RE DOING?

I WOULD -- HERE'S HOW I WOULD FRAME IT, WE TAKE THE DATA VERY SERIOUSLY. YOU KNOW, ALL OF OUR EFFORTS COLLECTIVELY ACROSS THE COUNTY ARE REALLY INTENDED TO HELP INDIVIDUALS, WHETHER IT BE A CHILD, A YOUTH, A YOUNG ADULT, YOUNG ADULT OR OLDER ADULT TO BE SUCCESSFUL AND THRIVE IN OUR COMMUNITY. WE HAPPEN TO BE PART OF THAT SYSTEM AND IN BEHAVIORAL HEALTH, WE HAVE CLEARLY SOME RESPONSIBILITIES IN ENSURING THAT WE PROVIDE THE SERVICES THAT WE'RE MANDATED TO SERVE AND PROVIDE. WE'VE ALSO FOR MANY YEARS HAVE FOCUSED ON OUR EFFORTS AROUND SUICIDE PREVENTION, AND HAVE BEEN ABLE TO BRING A LOT OF LOCAL POLICY AND LOCAL EFFORTS TO HELP IMPROVE THAT SITUATION. WE HAVE PROVIDED ANNUAL REPORTS TO THE BOARD RELATED TO THAT, AS WELL AS HAS HAVE CONTINUED TO IMPLEMENT THE SUICIDE PREVENTION OVERSIGHT COMMITTEE, THE SPOC, WHICH WE WILL CONTINUE TO PROVIDE OVER THE NEXT YEAR AND AS WE CONTINUE TO WORK WITH PUBLIC HEALTH DEPARTMENT AROUND POPULATION BASED PREVENTION AND SUICIDE PREVENTION. WE INCORPORATE THE FINDINGS IN TERMS OF OUR POLICIES AND PRACTICES. WE UTILIZE THE DATA TO HELP INFORM OUR ACTIONS, WHETHER IT BE PROVIDING A DIFFERENT TYPE OF SERVICE OR FOCUSING OUR CAMPAIGNS OR INFORMAL AND NORMAL EDUCATION OPPORTUNITIES TO THE PUBLIC TO DEDICATE WHAT IT IS THAT WE'RE SEEING IN THE DATA SO THOSE ARE THE WAYS IN WHICH WE INCORPORATE THE FINDINGS OF THOSE TIMES OF REPORTS SO INTO OUR ACTIONS.

TO MY COLLEAGUES, WHO DID THE MOTION, WHO HAS A MOTION ON THE FLOOR? YOU DID. WOULD YOU BE OPEN TO INTEGRATING ON AN ONGOING BASE FOR THE QUARTERLY REPORT OR AT LEAST UNTIL YOU SEE A LINK BETWEEN A RESPONSE FROM THE CHILD AND YOUTH DEATH REPORT FINDINGS RECOMMENDATIONS AND THE RESPONSE, ACTUAL RESPONSES, PRACTICES THAT ARE TAKING PLACE IN THE AGENCY.

I'M NOT SURE WITHOUT HAVING HAD TIME TO REALLY THINK ABOUT THAT.

THAT'S OK, BECAUSE WE WILL HAVE THE CHILD AND YOUTH DEATH REPORT COMING IN MAY. IN THE MIDDLE OF MAY.

LET'S TALK ABOUT IT THEN. I'M NOT SURE THAT I SEE ENOUGH OF A NEXUS TO ADD THAT TO THE BEHAVIORAL HEALTH QUARTERLY REPORTS, WHICH ARE -- THE SERVICE, AND CERTAINLY WE CAN CONNECT ANYTHING, BUT I WOULD LIKE TO KEEP THIS PARTICULAR REPORT A LITTLE CLEANER AND FOCUSED ON THE EXPANSION EFFORTS.

WELL, RESPECTFULLY, I'M GOING TO PUSH BACK THERE, BECAUSE ULTIMATELY, WHEN WE LOOK AT WHAT, HOW WE ARE DOING, WE ARE LOOKING AT DIFFERENT METRICS, RIGHT.

RIGHT.

WHETHER PEOPLE HAVE ACCESS.

UH-HUH.

HOW IMMEDIATELY THAT ACCESS IS, AND ARE THEY CONTINUALLY ATTENDING OR NOT ATTENDING THEIR VISITS. MAYBE ARE THEY TAKING MEDICATION IF MEDICATION IS APPROPRIATE, BUT ULTIMATELY, SUICIDE IS ALSO A METRIC, CAN ALSO BE A METRIC OF THE TREND THAT IS HAPPENING WITHIN THE POPULATION, AND THERE'S A RESPONSE THAT IS NEEDED, NOT JUST FROM PUBLIC HEALTH, BUT FROM BEHAVIORAL HEALTH, BECAUSE IT'S A BEHAVIORAL HEALTH ISSUE.

AND AGAIN, I DON'T DISAGREE WITH WHAT YOU'RE SAYING, BUT I THINK THAT WE RISK CONFLATING ISSUES THAT MAY NOT BE CAUSAL. I AM NOT THAT AS DIRECTLY RELATED, THE CHILD DEATH REVIEW CORRELATES DEATHS FROM A MULTITUDE OF REASONS INCLUDING SUICIDE AND WE DO HAVE OTHER MECHANISMS I BELIEVE THROUGH PUBLIC HEALTH WHERE WE ALREADY DO TRACK SUICIDES. WE KNOW THE DEMOGRAPHICS.

SO THEN I WOULD HAVE HEARD FROM THEM HOW THEY ACTUALLY RESPOND BUT I DIDN'T HEAR THAT? I CAN'T SPEAK FOR THEM, BUT I WOULD RATHER WAIT UNTIL -- I DON'T WANT TO INCLUDE IT TODAY. I'M HAPPY FOR YOU TO DO THAT SEPARATELY.

I'LL HOLD OFF ON THAT BUT WHY WOULD WE LOOK AT EXPANSION AND NOT EFFECTIVENESS OF A SERVICE IF SUICIDE RATE IS AN INCREASE, IF WE'RE LEARNING FROM THE TRENDS THAT WE'RE SEEING IN THE REPORT, IF THERE'S LGBTQ BULLYING, THERE'S VERY SPECIFIC DEATH AND I'M TALKING ABOUT SUICIDE RATES.

YEAH.

NOT THE OTHER DEATH THAT IT IS MAYBE ARE GENDER BASED VIOLENCE, WHAT IS IT THAT THE DEPARTMENT IS DOING IN TERMS OF STRATEGY AND DIRECTION AND SO I THINK THAT IS APPROPRIATE AND I'LL BE ASKING YOU THAT QUESTION COME MAY 19 AT THAT CONVERSATION. I'M CONNECTING ALL THE DOTS. WE HAVE TO CONNECT ALL THE DOTS. WE CAN'T JUST STAY IN OUR LANE AND FIGURE OUT THAT THESE ARE THE THINGS THAT WE ARE JUST FOCUSED ON. IT'S OUR RESPONSIBILITY COLLECTIVELY TO LOOK AT ALL OF THE METRICS. THIS BOARD THAT NEVER HEARD THE CHILD AND YOUTH DEATH REPORT. EVER. SO HOW WOULD WE CONNECT THAT DOT, THAT METRIC TO EVALUATE OUR SERVICES? BECAUSE IT IS A FLAG THAT IS BEING RAISED BY OUR COMMUNITY WHETHER WE LIKE IT OR NOT. ARE WE RESPONSIBLE FOR THOSE DEATHS? THAT'S THE QUESTION. IS THERE SOMETHING THAT WE CAN DO TO PREVENT SOME OF THOSE DEATHS? YES, ABSOLUTELY. ALL RIGHT. THAT'S THE DIRECTION I'LL BE GOING. I HOPE IT'S NOT A SURPRISE FOR MAY 19. YOU HAVE ALREADY SEEN WHAT MY PRIORITIES HAVE BEEN, I'LL CONTINUE TO ASK THESE QUESTIONS. AND HOPEFULLY, I'LL SEE A BETTER AND DIRECT RESPONSE TO THE LATINO HEALTH ASSESSMENT NOT ONLY ON PAPER BUT IN PRACTICE, AS WELL. THANK YOU.

OK, WE HAVE A MOTION AND A SECOND, PLEASE TAKE THE ROLL.

A MOTION OF SUPERVISOR ELLENBERG SECONDED BY SUPERVISOR ABE-KOGA.

SUPERVISOR ABE-KOGA.

AYE.

SUPERVISOR DUONG.

YES.

SUPERVISOR ELLENBERG.

YES.

VICE PRESIDENT ARENAS.

YES.

PRESIDENT LEE.

AYE.

THE NEXT ITEM WOULD BE THE COMMUNITY VIOLENCE PREVENTION STRATEGIC PLAN REPORT.

GOOD AFTERNOON.

GOOD AFTERNOON PRESIDENT LEE AND HONORABLE MEMBERS OF THE BOARD. I'M A DEPUTY COUNTY EXECUTIVE AND I'M ACCOMPANIED BY.

DR. SARAH PUBLIC HEALTH OFFICER AND DIRECTOR. WE ARE HAPPY TO PROVIDE YOU WITH AN UPDATE ON THE COMMUNITY VIOLENCE PREVENTION STRATEGIC PLAN. YOU HAVE A REPORT IN FRONT OF YOU. WE DON'T HAVE A FORMAL PRESENTATION BUT WE ARE HAPPY TO ANSWER AND READY TO ANSWER YOUR THOROUGH QUESTIONS.

THANK YOU. DO WE HAVE ANY PUBLIC WHO WOULD LIKE TO SPEAK ON THIS ITEM?

I DO HAVE ONE PUBLIC SPEAKER.

ON ZOOM, RIGHT?

YES.

LET'S DO TWO MINUTES.

OUR PUBLIC SPEAKER ON ZOOM IS AARON. WE ASK YOU TO UNMUTE.

YES, WE DO HAVE A SERIOUS ISSUE OF VIOLENCE IN SANTA CLARA COUNTY. I MEAN, THERE'S A GOOD WAY TO ADDRESS THIS, AND I DIDN'T SEE THIS ANYWHERE, BUT THE DISTRICT ATTORNEY'S OFFICE, I MEAN, THESE ARE THE PEOPLE WHO ARE SUPPOSED TO BE PROSECUTING VIOLENT CRIMES, AND I TELL YOU WHAT, THEY JUST ARE NOT DOING THAT. I'M BEING ASSAULTED, AND THE DISTRICT ATTORNEY IS INCENTIVIZING THESE ASSAULTS AGAINST ME. AND HE'S DOING THIS THROUGH CRIMINAL PROSECUTION THAT HE FILED AGAINST ME AFTER I TOLD HIM THAT MY KIDS WERE BEING SEXUALLY MOLESTED AND THESE PROCEEDINGS ARE DESIGNED TO -- TO ABSOLVE THE PERSON WHO WAS SEX TRAFFICKING MY KIDS OF ALL THE CRIMES THAT SHE'S COMMITTED AND BECAUSE OF THIS, SHE'S ASSAULTING ME, MAKING DEMANDS, AND JEFF ROSEN, HE'S ALLOWING THIS TO CONTINUE DURING THE CRIMINAL PROSECUTION OF ME, AND HE'S NOT DOING ANYTHING TO STOP THIS PERSON FROM ASSAULTING ME. IT'S JUST TERRIBLE WHAT THIS ATTORNEY JEFF ROSEN IS DOING IN OUR COMMUNITY, AND THERE ARE THROUGH THE SAME THING, YOU KNOW, IF YOU REPORT A CRIME TO HIM, THEN HE FILES CHARGES AGAINST YOU INSTEAD OF, YOU KNOW, GOING AFTER HIS POLITICAL SUPPORTERS. I'VE POSTED A LOT OF THIS INFORMATION ONLINE. IF YOU WANT TO SEE THIS, I KNOW IT'S ABSURD THAT THIS ATTORNEY WOULD BEHAVE IN SUCH AN EGREGIOUS MANNER, GOOGLE JEFF ROSEN SEX TRAFFICKING, YOU'LL SEE EXACTLY WHAT I'M TALKING ABOUT. I POSTED IT ALL. THANK YOU SO MUCH FOR YOUR TIME.

THAT CONCLUDES OUR PUBLIC SPEAKERS.

CLOSE THE PUBLIC COMMENTS PERIOD WITH THAT YES, SUPERVISOR ELLENBERG, YOU FIRST, YES.

THANK YOU. THANK YOU. CASEY AND SARAH FOR THE LEDGE FILE AND THE REPORT THAT WAS SUBMITTED. GIVEN THE IMMENSE FISCAL PRESSURE OF H.R. ONE, I AM STILL ENCOURAGED BY THE COMMITMENT IN THIS REPORT TO PRESERVE VIOLENCE PREVENTION PROGRAMMING WITHIN THE PUBLIC HEALTH DEPARTMENT IN OUR UPCOMING FISCAL YEAR, BUT I DO WANT TO BE ABOUT MY EXPECTATIONS FOR THE NEXT REPORT BACK. SO LET ME JUST MAKE A MOTION TO INCORPORATE A NUMBER OF PIECES. MOTION OF COURSE WILL FIRST BE TO RECEIVE THIS REPORT AND DIRECT ADD TO GUESS RETURN TO THE BOARD IN SEPTEMBER WITH AN UPDATED THAT INCLUDES OUTREACH CONDUCTED WITH POSSIBLE FUNDERS, PARTNER CITIES, AND COMMUNITY ORGANIZATIONS TO IDENTIFY POTENTIAL EXTERNAL SOURCES OF FUND AND OPPORTUNITIES SO BLEND AND BRAID FUNDING IN SUPPORT OF THIS WORK. AS WAS PROMISED DURING LAST YEAR'S BEFORE YOU GOT FOR DIRECT CHANNELS OF COMMUNICATION ABOUT VIOLENCE PREVENTION CAUGHT INCREASING AND DIVERSIFYING PRIORITY POPULATIONS AND DEVELOPING SHARED LANGUAGE VALUES AND DEFINITIONS AS PART OF THE DEVELOPMENT OF THE OFFICE OF COMMUNITY -- OF COMMUNITY VIOLENCE PREVENTION. I WILL LOOK FOR A SECOND.

SECOND.

YOU THANK YOU. I DO BELIEVE A COUNTYWIDE APPROACH TO ANALYZING VIOLENCE PREVENTION THROUGH A COUNTY OFFICE OF COMMUNITY VIOLENCE PREVENTION WILL IMPROVE EFFICIENCIES AND INCREASE COLLABORATION AND ULTIMATELY IMPROVE OUTCOMES WHICH IS WHAT WE ALL CARE ABOUT. THE WORK RIGHT NOW IS AT A CRITICAL JUNCTURE AND EVEN WITH A VERY BLEAK REALITY OF OUR CURRENT BUDGET I CONTINUED TO SAY THIS INITIATIVE IS ESSENTIAL BECAUSE WE ARE IN PART PLANNING FOR A TIME WHEN WE WILL BE AND WE WILL BE POSITIONED TO SCALE PROGRAMS BACK UP AND I WANT US TO BE READY TO DO THAT AND I WANTED TO BE THROUGH A PUBLIC HEALTH LENS. SO THANK YOU FOR CONTINUING TO WORK, THANK YOU FOR NOT DROPPING IT. HAPPY TO WAIT UNTIL AFTER BUDGET TO TALK ABOUT IT SO WE CAN REALLY START TO FOCUS ON WHAT WE CAN DO FROM A POLICY CONSOLIDATION, EFFICIENCY, ORGANIZATION PERSPECTIVE TO MOVE THIS WORK AS FAR AS WE CAN WITHOUT NEEDING ADDITIONAL REVENUE WITH THE CAVEAT THAT YOU ARE COMMITTING TO LOOK FOR ADDITIONAL REVENUE. LET ME KNOW IN THE NEXT REPORT HOW THAT GOES.

WE SHARE YOUR GOALS, THANK YOU. APPRECIATE YOU SPEAKING YES TO THE SECOND PIC OF ANYTHING TO ADD?

YES, I DO. I WOULD LIKE TO ASK IF WE CAN FIGURE OUT HOW WE ARE GOING TO MOVE FORWARD WITH -- YOU ARE ASKING FOR US -- SUPERVISOR ELLENBERG, YOU ARE ASKING FOR US TO DELAY DISCUSSION UNTIL AFTER THE BUDGET ABOUT HOW TO -- THERE WON'T BE ANY BUT BUDGET ASKS.

DEFINITELY NOT TO DELAY, BECAUSE WE DO HAVE A COMMITMENT THAT THIS WILL BE INCLUDED. THE PROGRAM WITHIN THE '27 BUDGET SO I WASN'T THINKING THAT WE NEEDED A BUDGET DISCUSSION.

GOT IT.

AND ABSOLUTELY THE WORK IS CONTINUING TO MOVE.

I HEARD THAT PART BUT I WAS CONFUSED WHEN YOU SAID WE WILL HOLD OFF THE DISCUSSION UNTIL AFTER THE BUDGET AND SO I THOUGHT --

THE NEXT TIME WE TALK -- WE CAN TALK ABOUT IT DURING BUDGET.

LESS IS MORE AND.

ALSO I DON'T WANT TO MISLEAD THE PUBLIC, IF WE ARE HAVING A CONVERSATION ABOUT IT AND SIGNALING THERE MAY BE OPPORTUNITIES FOR INCREASES. FRANKLY, WE ARE GOING TO BE DISAPPOINTING SO MANY PEOPLE. I DON'T WANT TO LOOK FOR MORE OPPORTUNITIES TO DO THAT. WE KNOW WHERE WE ARE.

I HEAR YOU.

WE WILL COME BACK IN AUGUST.

I HEAR YOU, I HEAR YOU.

THANK YOU.

THE ONLY THING I ASK, SUPERVISOR ELLENBERG YOU AND I CAME TOGETHER FOR THIS VIOLENCE PREVENTION, BUT WE ALSO STACKED OR OVERLAID ON A COUPLE OF OTHER STUDIES TO MAKE SURE WE INTEGRATED AND WE'RE COMPREHENSIVE, RIGHT, THE COST OF GUN VIOLENCE, THE LATINO HEALTH ASSESSMENT. I THINK THERE WAS SOME GENDER-BASED VIOLENCE PREVENTION INFORMATION AND THERE. IF MY MEMORY SERVES ME RIGHT AND IF IT DOESN'T MAY BE THAT LAST PIECE IS NOT IT BUT I KNOW FOR CERTAIN THOSE OTHERS WERE. I THINK THERE IS DEFINITELY AN OPPORTUNITY FOR US TO CONTINUE TO LEVERAGE EFFORTS IN ALL OF THOSE STUDIES THAT HAVE ALREADY BEEN COMPLETED. OBVIOUSLY YOU WILL ALL BE TAKING THAT DIRECTION AND IF YOU COULD MAKE IT REALLY CLEAR FOR US HOW THAT OVERLAY IS HAPPENING AND THAT CONNECTION IS HAPPENING. I THINK YOU HEARD ME TALK ABOUT CONNECTING THE DOTS SO ULTIMATELY WHEN OUR CHILDREN, OUR YOUTH ARE CONNECTED TO -- OR -- BEHAVING OR INCLUDING VIOLENT BEHAVIOR, IT IS USUALLY IS USUALLY A REASON. THERE IS A CAUSE. WE'VE TALKED ABOUT EVEN EARLIER ON TODAY WE TALKED ABOUT THE IMPORTANCE OF HAVING ASSESSMENTS FOR CHILDREN REALLY EARLY ON. PUBLIC, I MEAN, PARENTS HELPING PARENTS TALK ABOUT DISABILITIES AND MAKING SURE WE CASTLES REALLY EARLY ON. THESE ARE ALL -- THESE ARE ALL FACTORS -- THESE ALL FACTOR IN TO HOW THIS PIPELINE GETS SHAPED. SO WHEN THERE IS AN EARLY CHILDHOOD QUALITY -- QUALITY EARLY CHILDHOOD EDUCATION EXPOSURE, THAT IS DETRIMENTAL WHEN THERE IS -- WHEN THERE'S DISABILITY NEEDS AND THAT THOSE ARE IDENTIFIED AND THEN SUPPORTED. AND WHEN THERE IS CORPORAL OR SEXUAL ABUSE HAPPENING IS ALSO ANOTHER REASON WHY FOR GIRLS IT'S TYPICALLY SEXUAL ABUSE. THE NUMBER ONE REASON WHY THEY COME INTO THE JUVENILE JUSTICE SYSTEM FOR BOYS. IT'S THE OTHER WAY AROUND, USUALLY CORPORAL PUNISHMENT. WE KNOW THERE IS A PATH THERE AND I WANT US TO MAKE SURE THAT WE CONNECT ALL OF THOSE -- ALL OF THOSE OPPORTUNITY POINTS IN OUR SAFETY NET SERVICES THAT WE HAVE TO BE ABLE TO DISRUPT THAT PIPELINE BECAUSE IN THE END WHAT WE ARE LOOKING FOR IN THE VIOLENCE PREVENTION INITIATIVE IS TO PREVENT VIOLENCE. AND WE DO THAT BY CUTTING IT AT THE HELM. REALLY EARLY ON AND I KNOW THAT WHAT WE ARE FOCUSED ON IS MANDATED SERVICES AT THIS POINT AND NOT PREVENTION BUT WE DO PROVIDE PREVENTION WHEN WE ASSESS OUR CHILDREN FOR DEVELOPMENTAL ISSUES. OUR SYSTEM IS STILL FUNCTIONING IN THAT RESPECT. WE ARE STILL FIGHTING FIRST FIVE AND THEY ARE STILL DOING AGES AND STAGES OR OTHER ASSESSMENT USING OTHER ASSESSMENT TOOLS TO GIVE US A HEADS UP AND IN OUR OWN SYSTEM WE ARE USING.

YEAH, I'M SURE MY COLLEAGUE WOULD LIKE TO ADD TO THIS BUT I WILL JUST SAY AS SOMEONE WHO HAS WORKED IN AND AROUND VIOLENCE FOR TWO DECADES NOW I'M A VISUAL THINKER BUT THE WAY I THINK ABOUT IT IS ON A CONTINUUM OF CARE. ONE REPORT COULD NEVER FULLY ENCAPSULATE ALL THE WORK THAT WE DO AROUND PREVENTION AT THE DIFFERENT STAGES AS A SAFETY NET SERVICE PROVIDER. ESSENTIAL TO NEARLY EVERYTHING WE DO BUT I THINK YOU'RE ACTUALLY RIGHT THAT CONNECTING THE DOTS BETWEEN LOOKING AT KIND OF THE SPOKE IN THE WHEEL, WHAT CAUSES DIFFERENT FORMS OF VIOLENCE? WHETHER IT IS GUN VIOLENCE, WHETHER IT IS SUICIDE WHICH IS A FORM OF SELF HARM. GENDER-BASED VIOLENCE, WEATHER AND SEXUAL WHETHER IT SEXUAL VIOLENCE, COMMUNITY VIOLENCE. WHAT WE HAVE FOUND AND I THINK DOCTOR REDMAN WOULD SHARE THIS OPINION BASED ON SOCIAL DETERMINANTS OF HEALTH IS AT THE UNDERPINNING OF WHAT CREATES SYSTEMS OF VIOLENCE IN OUR COMMUNITIES COMES BACK TO SIMILAR SOURCES AND SO REALLY WHAT WE ARE ATTEMPTING TO DO THROUGH BOTH A VIOLENCE PREVENTION PROGRAMMING THAT WE CURRENTLY HAVE OR THE PUBLIC HEALTH DEPARTMENT AND ALSO WHAT CAN BROADLY BE TERMED AS FILINGS FILINGS INTERRUPTION SERVICES THAT WE HAVE FURTHER DOWN THE LINE, SECONDARY AND TERTIARY FORMS, IS TO LOOK AT DIFFERENT PARTS OF THAT CONTINUUM AND HOW DO WE REDUCE THE LIKELIHOOD OF FUTURE VIOLENCE. YOU BROUGHT UP INTERGENERATIONAL TRAUMA AND HOW DO YOU KEEP SOMEBODY WHO IS A CHILD WHO IS BEEN AROUND VIOLENCE IN THE HOME FROM GROWING UP AND BECOMING EITHER A VICTIM OR PERPETRATOR OF THE SAME KIND OF VIOLENCE. THE INTERVENTION WITH THAT CHILD MAY LOOK DIFFERENT THAN WHAT WE'RE DOING FOR A COMMUNITY VIOLENCE WHICH MIGHT BE SAFE PASSAGES WHERE OR GREEN SPACES OR LOOKING AT HEAT ABATEMENT OR ENSURING ACCESS TO FOOD. THEY ARE ALL INTERRELATED SO DOCTOR REDMAN AND I AM THE TEAM BEHIND US INCLUDING OUR OFFICE OF GENDER-BASED VIOLENCE HAVE BEEN WORKING IN DEEP PARTNERSHIP AS WE WERE SEEKING TO UNDERSTAND HIS WORK AND PREPARE FOR WHAT WILL BE OUTLINED IN THE BUDGET ON MAY AND MOVING FORWARD HOPING FOR ADDITIONAL FUNDING STREAMS TO ENSURE THOSE THOUGHTS ARE CONNECTED, THOSE STREAMS OF WORK ARE BRAIDED TOGETHER IN A WAY THAT ADDRESSES THE UNDERPINNING FOR VARIOUS FORMS OF VIOLENCE AND I'M SURE DOCTOR RUBIN LIKE TO ADD COMMENTS AS WELL.

I THINK YOUR QUESTION IS -- I COULD ANSWER IN A VERY LONG WAY. BUT I WILL SAY IT IS SO MUCH THE GOAL OF THE PUBLIC HEALTH DEPARTMENT TO CONSTANTLY BE INTEGRATING WHAT WE'VE LEARNED OR WHAT THE COMMUNITY HAS BEEN TELLING US BUT WE MADE EXPLICITLY PUBLISHED IN THE LATINO HEALTH ASSESSMENT AND LIKEWISE IN THE COST TO DRAW THOSE CONNECTIONS FOR EVERY COMMUNITY ORGANIZATION, EVERY DEPARTMENT OF THE COUNTY, FOR EVERY GOVERNMENT PARTNER THROUGHOUT THE COUNTY THAT I THINK THAT'S WHY YOU SEE THAT SHOWED UP IN WAYS LIKE -- I THINK I REFERENCED TODAY'S REPORT ITEM 17 WHICH WAS A DIRECT OFFSHOOT OF LATINA HEALTH ASSESSMENT AROUND HOW THE COMMUNITY TOLD US IF YOU'RE GOING TO IMPLEMENT A PROGRAM THAT IS COMPREHENSIVELY SERVING THE NEEDS OF LATINOS YOU NEED TO PRIORITIZE YOUTH AND VIOLENCE PREVENTION AS CORE FUNCTIONS OF THAT AND THAT NEXUS HAPPENED BECAUSE THE COMMUNITY SPOKEN BOTH OF THOSE DOCUMENTS AND SO THEY MATCH EACH OTHER BUT ALSO BECAUSE WE HELP TO MAKE SURE THAT LATINO HEALTH ASSESSMENT CONSTANTLY BROUGHT TO THE FOREFRONT EVERY TIME A DEPARTMENT IS DECIDING WHAT WILL WE FIGHT TO PRESERVE AND THE CURRENT ENVIRONMENT, WHAT WILL BE PUT OUR STAFF'S STAFF'S TIME BEHIND? OTHER EXAMPLES ARE BRINGING THE PRESENTATIONS TO SOUTH COUNTY TASK FORCE SOUTH COUNTY TASK FORCE, SAN JOSE, INTEGRATING THE VIOLENCE PREVENTION WORK IN ADILLAC WINCHESTER AS WE DESCRIBED EARLIER OR THINGS LIKE I WAS WITH SOME OF YOU AT THE CHILDREN'S HEALTH SUMMIT I THINK A WEEK -- TWO WEEKS AGO I CAN SHARE AGAIN SHARING THE FINDINGS OF LATINO HEALTH ASSESSMENT SO THAT EVERY SINGLE ENTITY IN OUR COUNTY THINK IT ABOUT THE HEALTH AND WELLNESS OF CHILDREN IS DOING IT FROM THE LENS OF WHICH COMMUNITIES HAVE LEFT BEHIND WHAT WE NEED TO DO TO MAKE UP FOR THAT? SO THAT KIND OF INTEGRATIVE THINKING IS EXACTLY WHAT WE ARE BRINGING TO THEM NOT JUST LETTING IT SIT WITHIN THE COUNTY DEPARTMENT BUT SAYING WHO ELSE THROUGHOUT THE COUNTY AND ESPECIALLY IN THE COMMUNITY IS MOST IMPACTED NEEDS THIS INFORMATION TO BE ABLE TO FIGHT FOR THE RESOURCES TO KEEP DOING IT AND DO IT WITH ALL OF THE RESOURCES GARNERED TO THEM.

WONDERFUL SO I LOVE THAT PIC OF NOT ONLY JUST INTEGRATIVE THINKING BUT INTEGRATED SOLUTIONS AND APPROACH WHICH IS WHAT I'M LOOKING FOR. WHAT I'M LOOKING FOR IS THAT RESPONSE TO THE INFORMATION WE ARE FINDING. AND THANK YOU FOR ACKNOWLEDGING THAT. ONE OF THE THINGS THAT IS REALLY IMPORTANT TO ME IS MAKING SURE THAT OUR YOUTH, WE DISRUPT THAT PIPELINE. INADVERTENTLY WE SOMETIMES IN OUR SAFETY NET SERVICES WE CREATE THAT PIPELINE BECAUSE WE'VE LEFT CHILDREN IN HOMES THAT WE SHOULDN'T HAVE LEFT CHILDREN AND I SHOULDN'T HAVE LEFT THEM THERE. THAT CREATES AN OPPORTUNITY TO CONTINUE WITH CORPORAL PUNISHMENT AND ABUSE AND A WAY THAT PRODUCES MORE VIOLENCE. BEING IN THE END THAT'S THE TRUTH. YOU KNOW, IF THAT IS WHAT WE ARE A COUPLE OF WHEN WE NEED TO FIX THAT AND WE NEED TO ADDRESS IT. ONE OF THE THINGS THAT HAS BEEN -- THE STRATEGIES THAT IS EFFECTIVE AS THE RESTORATIVE JUSTICE DIVERSION PROGRAM. THAT ALLOWS FOR THAT YOUTH TO CONNECT WITH THE CRIMES THEY'VE COMMITTED IN A WAY THEY MIGHT HAVE NOT UNDERSTOOD BEFORE AND IT IS A REALLY GOOD INTERVENTION. I'M WONDERING IF YOU HAVE ANY UPDATES ON WHERE WE ARE AT IN TERMS OF RESTORING FUNDING OR -- WHAT'S GOING ON, MAN? FAT?

WHAT YOU'RE ASKING ABOUT IS SOME OF THE RESTORATIVE PRACTICES WE HAVE IN THE COUNTY. I THINK MORE INFORMATION AS YOU KNOW PROPOSALS HAVE COME FORWARD FROM THE DEPARTMENTS. IN THIS PARTICULAR AREA OF MANY OF THOSE PROPOSALS WILL BE SUPPLANTED BY INFORMATION OF THE BUDGET WHICH WILL COME OUT ON FRIDAY. WHAT I CAN TELL YOU, THOUGH, AS THERE IS A LOT OF WORK HAPPENING BETWEEN THE PARTNERS AT THE SOUTH COUNTY TASK FORCE AROUND HOW DO TO BE EVEN AND DO WE EVEN IN THE DIFFICULT BUDGET ENVIRONMENT AND THIS GOES BACK TO SUPERVISOR ELLENBERG'S COMMENTS TOO ABOUT COORDINATION OUTCOMES. THE ANSWER TO A LOT OF THESE QUESTIONS IS GETTING THE RIGHT PEOPLE AT THE TABLE, UNDERSTANDING THE CATALOGING OF RESOURCES THAT CATALOGING OF RESOURCES THAT WE HAVE, BEST DEPLOYING THOSE RESOURCES FOR THE CIRCUMSTANCES THAT ARE NECESSARY. IN YOUR EXAMPLE OF A JUVENILE WHO NEEDS TO BETTER UNDERSTAND, I RESTORATIVE HEALING CIRCLE PROCESS. WE HAVE THOSE WELL INTEGRATED IN OUR SOUTH COUNTY MODELS THROUGH A COUPLE DIFFERENT PROGRAMS. THROUGH PROBATION, WE HAVE BEEN THROUGH SOME OF OUR LOCAL COMMUNITY-BASED ORGANIZATIONS AND THAT WE ALSO HAVE SOME TRAINED STAFF IN THE COMMUNITY AND ALSO TRAINED IN HOW TO LEAD THOSE HEALING CIRCLES. THEY WORKED FOR THEY DEPENDED ON EACH POPULATION THAT NEEDS THEM SO AGAIN I THINK THAT COORDINATION IS REALLY IMPORTANT. AS FAR AS BUDGET UPDATES GO I WOULD DEFER TO COUNTY EXECUTIVE WILLIAMS ON THAT BUT I DO BELIEVE WE HAVE MORE INFORMATION ON FRIDAY THAT WILL HELP SHED LIGHT ON SOME OF THOSE PROGRAMS AND KIND OF HOW WE ARE LOOKING AT REIMAGINING THEM EVEN IN A TIME OF FISCAL CONSTRAINT SO THAT WE KEEP THAT FOOTPRINT ALIVE. WEEK IF THAT STRUCTURE THERE SO WHEN THE FUNDING COMES BACK WHICH WE'LL TRUST IT WILL WE WILL HAVE THE INFRASTRUCTURE TO BUILD ON AND BUILD ON RAPIDLY.

YES AND I'M HOPING -- THE PROBLEM DOESN'T WORSEN WHILE WE TAKE OUT SOME OF THOSE SAFETY NETS THAT WE WERE -- THAT WE'VE BUILT IN OVER TIME, THAT WE RELIED ON. AND I'M REALLY -- I REALLY JUST WANT TO HIGHLIGHT WHAT YOU SAID. THIS INTEGRATED THINKING ALSO NEEDS TO CONNECT WITH INTEGRATED RESPONSE AND THAT -- THOSE RESPONSES NEED TO, WHICH I WOULD SAY ARE BEST PRACTICES. THOSE RECOMMENDATIONS THAT ARE BEST PRACTICES OR EVIDENCE-BASED PRACTICES THAT WE KNOW THAT WORK. NOT BECAUSE WE LIKE THEM. NOT BECAUSE THEY ARE PREFERRED BUT BECAUSE THEY ACTUALLY WORK. IT IS NOT A PET PROJECT IS WHAT I'M TRYING TO CLEAR UP. THESE WORK FOR OUR CHILDREN, THESE WORK FOR YOUTH AND SO I WANT THEM TO BE INTEGRATED INTO ALL OF THE FACETS THAT WE PROVIDE IN TERMS OF SERVICES SO WHEN WE TALK ABOUT SCHOOLING SERVICES THEY WOULD ALSO HAVE THE SAME LANGUAGE THAT YOU ARE USING, THE SAME LEVEL OF UNDERSTANDING ESPECIALLY IF THEY ARE DEALING WITH A DISTRICT THAT HAS HIGHER LEVEL OF LATINOS THAT PROBABLY FEED INTO OUR SYSTEM IF THEY ARE IN THE ZIP CODES THAT WE NOW OVERLAP WITH GUN VIOLENCE STUDY, THAT OVERLAP WITH LATINO -- OVERLAP WITH WELFARE. IT WOULD BE -- IT WOULD BE A DISSERVICE TO THE COMMUNITY NOT TO INTEGRATE AND SO THAT IS THE OTHER THING THAT I'M LOOKING FOR. I THINK YOU'VE SEEN MY CONVERSATIONS, YOU HEARD MY CONVERSATIONS. I AM HOPING THAT WE CAN CONTINUE TO MOVE WHAT WE KNOW ABOUT THE LATINO COMMUNITY, THOSE NEEDS AND CONTINUE TO INTEGRATE THEM EVEN WHEN THERE IS A REDUCTIONS BECAUSE WE MAY HAVE REDUCTIONS BUT THAT IS NO EXCUSE, THAT ISN'T AN EXCUSE TO NOT HAVE A LOGIC MODEL THAT WORKS AS A RESPONSE IN TERMS OF FRAMEWORK FOR ALL THE DIFFERENT SAFETY NET DEPARTMENTS AND PROGRAMS AND SERVICES THAT WE SERVE. I WOULD LOVE TO SEE EVERYBODY USING, UTILIZING THE SAME LANGUAGE AS YOU ALL ARE. SO AHEAD ANOTHER QUESTION AND I WILL GO AHEAD AND DIFFER IT BECAUSE I WAS ALSO RELATED TO A LITTLE BIT TO THE INCOMING BUDGETS BUT I JUST -- I JUST WANT YOU TO -- WANT TO GIVE YOU A HEADS UP IN TERMS OF THE SOUTH COUNTY YOUTH TASK FORCE. YOU KNOW THAT'S IMPORTANT TO ME NOT ONLY BECAUSE I REPRESENT IT. I WOULD ALSO SPEAK ABOUT IT IN BOTH, SPEAK ABOUT EAST SIDE AS WELL AS THAT WE HAVE TO START WHERE THE NEED IS THE GREATEST, RIGHT? BUT WE ALSO HAVE TO TAKE A LOOK. THERE IS A MAP OF THE SERVICES AVAILABLE TO COMMUNITIES EARLIER IN THE DAY. SOUTH COUNTY CONTINUES TO BE UNDERSERVED. WE ALL KNOW -- PREACHING TO THE CHOIR YOU ALREADY KNOW THIS AND SO I WANT THAT TO ALSO BE PART OF THE RESPONSE WHEN WE TALK ABOUT HOW ARE WE MOVING THIS FORWARD? HOW ARE WE GOING TO CONTINUE TO HAVE SAFETY NET SERVICES INTEGRATED INTO WHAT WE ARE DOING, EVEN IF THEY ARE BASIC SERVICES? THAT WE HAVE THIS APPROACH. ALL RIGHT I'M GOING TO STOP. I THINK YOU ALL UNDERSTAND WHAT I'M HOPING FOR. THE LAST THING I'M GOING TO SAY IS IN MY DISTRICT THERE HAS BEEN TWO DEATHS RELATED TO GENDER-BASED VIOLENCE AND IT HAS WEIGHED REALLY HEAVY ON MY COMMUNITY. NEIGHBORHOOD ASSOCIATIONS I NORMALLY WOULD HEAR HER TALKING ABOUT GENDER-BASED VIOLENCE SAID AT VISTA PARK THEY SAID THAT WAS A NEIGHBOR. I WOULD SEE HER. SHE WAS ONE OF US. COUNTY EMPLOYEE, SHE WAS A NURSE. WE KNOW THAT WOMEN OF COLOR ARE EXPOSED TO A HIGHER LEVEL OF GENDER-BASED VIOLENCE AND SEXUAL VIOLENCE ESPECIALLY IF -- ON TOP IF THEY HAVE DISABILITIES. WE UNDERSTAND THAT. I JUST WANT TO MAKE SURE THEY WE CONTINUE TO INTEGRATE WHAT WE KNOW IS HAPPENING WITH OUR COMMUNITY AND OUR RESPONSES SO THAT WE ONCE AGAIN HAVE AN INTEGRATED APPROACH AND RESPONSE TO THE ISSUES THAT WE ARE DEALING WITH AND CERTAINLY VIOLENCE AGAINST WOMEN TO SOMETHING THAT WE NOW CONTINUES TO BE ON THE RISE. CAN I ASK BECAUSE THE LAST TIME I THINK YOU REPORTED HE HAD SAID THAT MAY BE THE CALLS WERE ON -- WERE COMING DOWN ON IMMIGRATION --

THAT WAS CORRECT.

I THOUGHT YOU SAID IT STARTED GOING UP AGAIN?

HAVE TO LOOK AT THE DATA TO SEE WHAT THE CALL VOLUME HAS BEEN BUT IN GENERAL WE'VE HAD SEVERAL UNFORTUNATE TRAGIC LOSS OF LIFE RELATED TO GENDER-BASED VIOLENCE AND SEXUAL VIOLENCE. SO I WOULD HAVE TO WORK WITH THE DISTRICT ATTORNEY'S OFFICE TO GET THAT DATA BUT MY UNDERSTANDING IS UNFORTUNATELY WE ARE STILL -- THE CALL VOLUME MAY BE GOING DOWN TO BECAUSE PEOPLE ARE FREE TO REACH OUT TO LAW ENFORCEMENT BECAUSE OF ENHANCED IMMIGRATION EFFORTS IT DOESN'T STOP THE VIOLENCE FROM OCCURRING SO WHAT WE SEE WHAT IT ENTERS THE SYSTEM IS MORE SEVERE VIOLENCE BECAUSE SOMEBODY ELSE CALLS THE POLICE MAY NOT HAVE THE SAME FEARS SO YOU MAY NOT HAVE THE VICTIM CALLING BY A NEIGHBOR FOR EXAMPLE.

AND WOULD LIKE TO JUST EXPRESS THAT BECAUSE WE HAVE SEEN THIS HAPPEN -- I APOLOGIZE. I DIDN'T INCLUDE SEXUAL VIOLENCE ARE ABSOLUTELY RIGHT. THOSE ARE THREE INCIDENTS, THREE DEATHS HAPPENING IN MY DISTRICT. AND I WANT YOU TO MAKE IT VERY CLEAR IN TERMS OF NOT ONLY WHAT THE DATA ALREADY TELLS US OF WHAT YOU ALREADY KNOW BUT AS YOU MOVE FORWARD IN YOUR RESPECTIVE OFFICES HOW ARE YOU BEING RESPONSIVE TO THOSE VERY SPECIFIC ISSUES THAT ARE HAPPENING? IT IS TO ME VERY AMAZING TO HAVE TWO GENDER-BASED VIOLENCE, ONE SEXUAL VIOLENCE DEATH JUST TO MY DISTRICT IN THE LAST I THINK MAYBE SIX TO NINE MONTHS IF I'M CORRECT. I WOULD LIKE TO SEE WITH OUR RESPONSES BECAUSE WE ALSO HAVE TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITY AND TO THE NEEDS -- THE NEEDS -- THE COMMUNITY IS IN AN UPROAR ABOUT WHAT IS HAPPENING AND I'M GLAD -- WELL I'M GLAD TO SEE THAT WE ALSO NEED TO BE RESPONSIVE. WE CAN'T CAN JUST SAY GLAD WE ARE CREATING THIS AWARENESS BUT THEN WHAT? WHAT WE DO? HOW DO WE TAKE ADVANTAGE OF THIS INTEREST AND CONCERN FOR YOUR NEIGHBOR? AND WHAT IS HAPPENING WITH YOUR NEIGHBOR. HOW DO WE BUILD A NEIGHBORHOOD ASSOCIATIONS INTO THE FULL -- HOW DO WE TAKE ADVANTAGE OF THE INTEREST -- I LOVE THAT THE COMMUNITY IS EXPRESSING.

THAT -- THOSE ARE MY COMMENTS I APPRECIATE IT.

SUPERVISOR DUONG.

THANK YOU TO MY COLLEAGUES AND OUR STAFF FOR A ROBUST CONVERSATION. I WANT TO START WITH I APPRECIATE HOW HARD THIS WORK IS WITH LIMITED RESOURCES AND MORE CUTS COMING DOWN THE WAY. INCREASING NEED. CONTINUED TO DISPLAY ITSELF AS CRITICAL RESOURCES AND SAFETY NETS CONTINUE TO BE CUT. BUT WE ALL FEAR HERE IS THERE IS GOING TO BE MORE PAIN COMING DOWN THE WAY WHEN THE MOST BASIC NEEDS AND NECESSITIES OF FAMILIES ARE NOT SERVED AND NOT MET. I HAVE SOME QUESTIONS HERE AND COMMENTS. I THINK THE FIRST COMMENT IS THAT IN THIS LANDSCAPE OF RECEDING RESOURCES AND INCREASING NEED AND ALSO WITH STAFFING LEVELS NOW UP IN THE AIR AND BUDGETARY UNCERTAINTIES ACROSS THE WHOLE BOARD, LOCAL STATE FEDERAL LEVEL. ANYWHERE WE CAN FIND A SHARED APPROACH IN TERMS OF SET OF OUTCOMES AND RELATED METRICS, JUST HELPS US TURN A DOLLAR THE DOLLAR INTO $5 AND BE ABLE TO WORK TOWARDS MORE OF AN INTEGRATED APPROACH AND I HOPE THAT IN SOME SPACES THAT'S A LOW HANGING FRUIT WE CAN ACHIEVE ESPECIALLY GIVEN THE OVERLAP OF NEIGHBORHOODS OF PRIORITY AND OUR CITY PARTNERS WHO -- LET ME SPEAK PLAINLY THEY ARE BROKE TOO SO THEY ARE GETTING TO PARTNER WITH US AS WELL TO THE EXTENT POSSIBLE TO DOVETAIL RESOURCES TOGETHER AND BE AN AMPLIFIED EFFECTIVENESS BUT GIVE IT GIVEN THE OVERLAP OF PRIORITY NEIGHBORHOODS I KNEW YOUR PUBLIC HEALTH IN PARTICULAR DOING THIS WORK ALREADY. COULD YOU SHARE WITH US HOW YOU PLAN TO CONTINUE OPERATIONALIZING PARTNERSHIPS WITH CITY CRIME OF VIOLENCE PREVENTION PROGRAMS? FOR EXAMPLE PROJECT HOPE PROJECT HOPE AT THE CITY OF SAN JOSE. THE CRIME PREVENTION UNIT. THIS IS FOR CASEY AND FOR YOU SARAH, DOCTOR REDMAN. THE YOUTH SERVICES MASTER PLAN AND SUPERVISOR ARENAS I WANT TO MAKE SURE ACKNOWLEDGE CREDIT WHERE IT'S DUE BECAUSE THIS IS THE LOT OF THE WORK YOU DO AT THE CITY LEVEL SO REALLY JUST KNOWING HOW WE ARE GOING TO CONTINUE OPERATIONALIZING OUR COLLABORATION ESPECIALLY IN THE OVERLAPPING NEIGHBORHOOD PARITY.

THANK YOU FOR THAT QUESTION. JUST HAVE YOU BEEN DESCRIBING THE COMMUNITY PARTNERSHIPS ARE THE HEART OF HOW PRIMARY PREVENTION CAN WORK BEST AND SO REALLY WHERE THE PUBLIC HEALTH DEPARTMENT IS ENGAGED IN VIOLENCE PREVENTION IT IS USUALLY AN PARTNERSHIP IN EXACTLY THE NEIGHBORHOODS WE KNOW ARE HARDEST HIT AND THE COMMUNITIES HARDEST HIT. SOME EXAMPLES OF THE LUNGS INTO PARTNERSHIP WITH THE SAN JOSE PEACE PARTNERSHIP. AND THE NEIGHBORHOOD EFFORTS IN CATLIKE WINCHESTER FOR EXAMPLE SO WORKING WITH THEM ON THEIR COMMUNITY-BASED ORGANIZATIONS AND COOPERATIVE SENTENCES MAKING SURE THEY HAVE RESOURCES THEY NEED TO CONTINUE THEIR WORK. WE'VE BEEN PARTICIPATING IN BOTH SAN JOSE WHY A Y AND YOUTH TASK FORCE ON BOTH THEIR WORKING GROUP AND POLICY GROUP SO THAT EVERY EFFORT THAT COMES OUT OF THAT TASK FORCE WHEN IT CALLS ON A PUBLIC HEALTH LENS FOR PRIMARY PREVENTION AND WHEN THERE IS THERE'S AN OPPORTUNITY TO LINK WITH COMMUNITY GROUPS, COMMUNITY-BASED ORGANIZATIONS WE ARE THERE TO MAKE THAT CONNECTION.

I WANT TO ADD GOING BACK TO YOUR POINT ABOUT THE DIFFICULTY OF THIS WORK. I THINK THAT WE AS COUNTY LEADERS, ALSO A LOT OF MEN BUT A LOT OF WOMEN WHO HAVE BEEN WORKING THIS BASE I THINK WE ARE BUOYED BY EACH OTHER AND THE REASON WHY I SAY THAT AS IT IS HARD TO DESCRIBE TO THIS BOARD HOW OFTEN WE SEE EACH OTHER, HOW OFTEN OUR PATHS CROSS, HOW MANY MEETINGS WE ARE ALL AT. HOW MANY ORGANIC OPPORTUNITIES WE HAVE FOR COLLABORATION AND CONNECTION AROUND ALL THE DOTS THAT NEED TO BE CONNECTED SO FOR EXAMPLE I WAS AT THE SOUTH COUNTY CHILDREN'S ADVOCACY CENTER PLANNING MEETING EARLIER THIS WEEK WHERE RAN INTO PEARL FLOREZ AND HAD A GREAT CONVERSATION ABOUT GENDER-BASED VIOLENCE AND IN AND CARLA AND I ARE MEETING WITH THEM NEXT MONDAY OR IF I'M AT THE CHILD DEATH REVIEW TEAM AND MARIBEL MARTINEZ WHO IS BEHIND ME IS PRESENT WE HAVE A CONVERSATION AS WELL ABOUT HOW WE CAN DO WORK WITH FAMILIES AND FAMILIES OF COLOR THAT ARE IMPACTED BY VIOLENCE SO WHILE WE HAVE THESE FORMAL MEANS OF CONNECTING POLICY GROUPS WE ARE ALSO HAVING A LOT OF INFORMAL DISCUSSIONS BECAUSE SO MANY OF US ARE CROSSING PATHS AND SO I THINK THE FORMAL CONNECTIONS ARE REALLY IMPORTANT BUT THE DEDICATION TO THIS WORK FROM ALL OF US HERE AND SOMEBODY THROUGHOUT THE COUNTY ORGANIZATIONS SO PROFOUND THAT WE DON'T LET THOSE OPPORTUNITIES PASS WHEN WE'RE ON THE SAME ROOM TO GRAB FIVE MINUTES BEFORE OR AFTER TO HAVE A POLICY DISCUSSION ABOUT BETTER COORDINATION AROUND A CURRENT EVENT THAT JUST HAPPENED. WHEN WE LOST OUR NURSE AND LOST PARIS TO A GENDER-BASED VIOLENCE CRIME THAT WAS NOTED BY SEVERAL COUNTY DEPARTMENTS, SEVERAL CONVERSATIONS WERE HAD ABOUT HOW TO BE SUPPORT THE FAMILY? HOW DO WE GET VICTIM SERVICES CONNECTED. HOW DO WE ENSURE ESA IS RESPONSIVE. HOW TO BEGET, HOW TO BEGET, HOW TO BEGET SOME OF THOSE FORMAL PARTNERSHIPS I THINK YOU'RE INCREDIBLY IMPORTANT TO NOTE BUT I JUST ALSO WANT TO LIFT UP HOW COMMITTED AND DEDICATED THE TEAM IS WORKING ON THIS PROJECT AND ALL THE

INFORMAL WAYS WE ARE CONNECTING DOTS WHENEVER WE CAN.

>> I CERTAINLY DON'T DOUBT THAT, AND YOU ARE RIGHT. AS YOU ARE REFERENCING HOW OFTEN EVERYBODY MEETS. AT ANY TIME I RUN INTO -- YOU ALL ARE TOGETHER SPEAKING. WE ARE A LITTLE VIOLENCE PREVENTION CREW, YES. INFORMAL. WE WILL GET T-SHIRTS MADE.

>> I WILL JOIN YOUR TABLE NEXT TIME I SEE YOU. A TERM I'VE HEARD USED BY YOUR COHORT, YOUR COLLEAGUES BEFORE. IT IS JOINT STRATEGY DEVELOPMENT AND RESOURCE ALIGNMENT AND FUTURE REPORT BACK -- REPORT BACKS. REALLY WOULD LOVE TO LEAN INTO WHAT THAT LOOKS LIKE AS A STRATEGY. THAT BECOMES EVEN MORE NECESSARY NOW WITH OUR CONSTRAINT ON RESOURCES AND STAFFING, BUT THE NOT MOVING -- NOT WILLING TO MOVE -- WE CAN'T MOVE THE NEEDLE ON THE LEVEL OF WORK WE PUT INTO THIS AND THE OUTCOMES THAT WE TRY TO ACHIEVE. AND AS I MENTIONED BEFORE, I THINK CROSS-REFERENCING CHAIR APPROACHES, RELATED METRICS THAT CAN ACTUALLY HELP WITH BUDGETARY LIMITATIONS WHEN WE END UP SHARING MORE RESOURCES IN THAT WAY, OR OUTCOMES AND DATA.

QUESTION, SO YOU KNOW THIS BETTER THAN I DO. A LOT OF TIMES, OFTEN TIMES OUR FAMILIES OFTENTIMES OUR FAMILIES OF NEED, POWER FAMILIES WHO ARE DEALING WITH HISTORIES OF VIOLENCE, GENERATIONAL TRAUMA, RIGHT. THERE'S ALSO GENERATIONAL POVERTY ATTACHED TO IT, AND ALSO GENERATIONAL NEGLECT OF THE COMMUNITIES THEY ARE ROOTED IN. AND THIS ECONOMIC MOBILITY PART OF THE VIOLENCE PREVENTION STRATEGY?

>> I WOULD SAY ABSOLUTELY, SUPERVISOR. ONE OF THE THINGS THAT THIS SORT OF ALMOST -- NOT MRS. BUT FAIL IN THE LEGISLATIVE FILE HERE IS IT'S VERY CLEARLY DESIGNED TO PREVENT VIOLENCE. IT MISSES THE FACT THERE'S A WHOLE LOT OF RELATED WORK AND EXACTLY THE SAME NEIGHBORHOODS WITH THE SAME COMMUNITY MEMBERS THAT HAS THAT EFFECT OF REDUCING VIOLENCE. SO FOR EXAMPLE, WE CAME BEFORE THIS BOARD SEVERAL WEEKS AGO REPORTING BACK ON LATINO HEALTH ASIDE AND ASSIGNMENT AND MENTIONING WORK TO ACCESS HOUSING AND HOUSING SECURITY. AND IN THE CONTEXT OF A REPORT THAT TALKED ABOUT HOUSING DENSITY INCREASES THE RISK OF VIOLENCE. SO IN THE EXACT SAME WAY, AND WHICH WE MAY NOT HAVE THOUGHT OF OUR OFFICE OF SUPPORTIVE HOUSING AS VIOLENCE PREVENTION, THAT WORK OF HELPING PEOPLE STAY IN HOUSING AND ENSURE THEY ARE IN SAFE HOUSING MEANS THEY HAVE A PLACE TO SLEEP AT NIGHT. A PLACE HAVE A PLACE TO GO IF THEY DON'T FEEL SAFE IN THE NEIGHBORHOOD. AND THOSE EXACT SAME FACTORS THAT WE KNOW MAKE AN EPISODE OF VIOLENCE LESS LIKELY. SOMEBODY IN THAT DAY? HAS SOMEONE HAD A SAFE PLACE TO GO? HAS SOMEONE HAD SOMEONE TO TALK TO WHO SPOKE THE LANGUAGE WHO UNDERSTOOD THEM. ALL OF THOSE FACTORS REDUCE THE RISK OF VIOLENCE AND THEREFORE REDUCE THE RISK OF SECONDARY CYCLES OF VIOLENCE. AND SO THERE'S WORK THAT EXTENDS FAR BEYOND WHAT IS DESCRIBED HERE THAT DOES EXACTLY THAT. AND THAT'S PART OF A PUBLIC HEALTH WHO LOVES TO DRAW THOSE CONNECTIONS I WAS DESCRIBING. BECAUSE WHEN WE WORK WITH PARTNERS IN THE SAME COMMUNITIES WHO TELL US, YOU KNOW, WE REALLY NEED TO REDUCE VIOLENCE? WE NEED A PARK. THAT MAY NOT HAVE STOOD OUT AS THE BEST WAY TO REDUCE VIOLENCE, BUT OFTEN IF THAT'S WHAT THE COMMUNITY TELLS US, THAT ONLY IS THERE EVIDENCE BASE BEHIND IT, BUT IT PROVES TO WORK.

>> AND SO MUCH OF THE TENSION THAT WE GLEANED FROM THESE REPORTS AND ALSO FROM CONSTITUENTS DIRECTLY COMES AROUND, THE ABILITY TO PAY RENT, STRESSING ABOUT WHO WILL MAKE A PAYCHECK OR GET PAID THIS WEEK OR NOT. I REALLY, THIS IS WORK WE ARE ALL CLEARLY INVESTED IN AND I REALLY HOPE WE ARE ABLE TO CONTINUE THIS WORK DESPITE THE CHALLENGES OF BUDGET SO THAT WE ARE PROACTIVE AND RESPONSIVE, NOT REACTIVE TO SPECIFIC EVENTS, BUT BEING ABLE TO CREATE THESE INFRASTRUCTURES, EXISTING SYSTEMS OF REPORT FOR SUPPORT AND SUPPORT AND ACADEMIC ABILITY WEIGHS ON MY MIND HEAVILY BECAUSE VULNERABLE FAMILIES ARE VICTIMS OF WORKPLACE VIOLATIONS. VIOLENCE OF THE WORKPLACE, ASSAULT IN THE WORKPLACE. AND ALSO OVERLAPS WITH THE POPULATION THAT IS HISTORICALLY AND CONTINUES TO BE EXCLUDED FROM THE WORKFORCE ADDED ONTO THESE LAYERS OF STRESS AND THE ATTENTION THAT PEOPLE FEEL. THAT BECOMES EMBEDDED IN THEIR DNA. AND HOW DO WE UNDO THAT? I LOOK TO YOU FOR THAT. HOW DO WE UNDO GENERATIONS OF HARM? SO, YOU KNOW, LINKING THIS TO A PREVIOUS CONVERSATION WE HAD EARLIER IN THE DAY, THE COMMUNITY HEALTH WORKER MODEL AND ITS POTENTIAL FOR BEING AN ECONOMIC DRIVER OF WORKFORCE DEVELOPMENT. AND RELATED TO THAT TOO IS ALSO THE DEVELOPMENT OF WORKER-OWNED COOPERATIVES, WHICH HAS CREATED ECONOMIC MOBILITY FOR UNDOCUMENTED IMMIGRANTS, FOR EXCLUDED WORKERS, FOLKS YOU DON'T HAVE ENTRY INTO OUR CONVENTIONAL OR TRADITIONAL WORKSPACES. THIS IS ALL PERCOLATING AND ORBITING AROUND IN YOUR NECK OF THE WOODS. YOUR AREA OF EXPERTISE. AND SO I WOULD HOPE THAT IN THE COMING MONTHS AND YEARS THAT WE DELVE DEEPLY INTO THIS. AND NOT TO OUT MY PARTNERS AND COMMUNITY. I'VE HAD MEETINGS WITH PHILANTHROPIC ENTITIES AND THERE IS A MOVEMENT INTO THE STATE OF CALIFORNIA AT THE BAY AREA TO INVEST IN WORKERS RIGHTS, TO INVEST IN WORKER-OWNED COOPERATIVE ELEMENTS AS A WAY OF PROTECTING PEOPLE, VULNERABLE WORKERS AND FAMILIES, BUT KIND OF REJECTING THE CONVENTIONS OF CAPITALISM WHICH IS HISTORICALLY ROOTED IN VIOLENCE TO CREATE A NEW ERA OF ECONOMIC MOBILITY. SO LEAVE THAT AS FOOD FOR THOUGHT. ALWAYS APPRECIATE THE CONVERSATION OF THE PRESENTATION AND THE WORK YOU ALL DO.

>> THANK YOU. AND TO GO ONE STEP FURTHER, I THINK TO THE CONVERSATION ABOUT GENDER-BASED VIOLENCE. ECONOMIC EMPOWERMENT FOR WOMEN AS VIOLENCE PREVENTION.

>> YEP.

>> I'M GOOD TO BE EVEN MORE DIRECTED MY COMMENTS. IF THERE IS OPPORTUNITY WITH WHAT'S HAPPENING AT THE WORLD RIGHT NOW IN OUR COMMUNITIES WITH WORKER-OWNED COOPERATIVE ELEMENT AS STRATEGY, THERE IS INTEREST OUT THERE TOO, FOND OF THIS TO FUND THIS TYPE OF WORK RIGHT NOW. THANK YOU.

>> THANK YOU VERY MUCH FOR THE GREAT REPORT. AND AS WE ALL KNOW, VERY STRESSORS. PEOPLE DON'T BECOME VIOLENT FOR NO REASON. THERE'S ALWAYS A CAUSE WHY PEOPLE GET ANGRY OR VIOLENT. AS WE HAVE JUST EXPERIENCED TODAY, WE SAW ANGRY. AND THAT'S WHY WE HAD TO CALL LUNCH AT A LUNCH AT A CERTAIN TIME.

>> NOTHING TO THROW UP HERE.

>> LET'S CALL A VOTE. THANK YOU.

>> MOTION OF SUPERVISOR ELLENBERG, SECONDED BY VICE PRESIDENT KAREN S. SUPERVISOR ABE-KOGA HAS STEPPED AWAY.

[VOTING]

MOTION CARRIES FOUR TO ZERO.

>> THANK IT. AND MOVING TO ITEM 19, WHICH IS REPORT RELATED TO ANNUAL REVIEW OF REFERRALS. JAMES.

>> AS THE BOARD IS AWARE, LAST YEAR FOR THE FIRST TIME WE BEGAN A NEW PROCESS AT THE BOARD'S DIRECTION WHEREBY BOARD MEMBERS WOULD HAVE THE OPPORTUNITY TO LOOK THROUGH CURRENT OUTSTANDING REFERRALS AND TO PROVIDE A PRIORITIZATION. THIS IS NOT THE SAME AS THAT COMPREHENSIVE OVERALL BEFORE IT PRIORITIZATION PROCESS, BUT REALLY AN OPPORTUNITY ONCE A YEAR TO, I WOULD DESCRIBE IT MORE AS CLEAN UP THE REFERRAL LIST TO FOCUS ON THOSE SUBSET OF REFERRALS THAT THE BOARD WANTS TO ENSURE CONTINUED TO BE ACTIVELY WORKED ON BEFORE THE BOARD. OF THE THE RESULTS OF THIS YEAR'S PROCESS WITH INPUT FROM EACH OF THE BOARD OFFICES THAT HAS NOW I FRONT OF THE BOARD FOR ACTION. I WOULD NOTE ONE THING THAT I THINK WAS JUST NOTABLE WHEN I SKIMMED THROUGH THIS MATRIX, MOST OF THE ITEMS THAT HAVE ENDED UP ON CATEGORY THREE, AND OTHER WAYS TO DISCONTINUE, ALMOST ALL OF THOSE ITEMS WERE LAST YEAR PLACED ON DORMANT LIST BY THE BOARD, WHICH SUGGESTS TO ME CONTINUITY AND PERSPECTIVE ON THOSE ITEMS AND MADE A LOT OF SENSE WHEN I FLIPPED THROUGH THAT GIVEN THAT THE BOARD HAD MOVED THOSE TO THE SECOND CATEGORY A YEAR AGO. WITH THAT, WE ARE HAPPIER TO ANSWER ANY QUESTIONS.

>> ANYBODY IN PUBLIC WOULD LIKE TO SPEAK ON THIS ITEM?

>> I CURRENTLY HAVE NO PUBLIC SPEAKERS.

>> GREAT. SUPERVISOR ELLENBERG.

>> THANK YOU, JAMES, AND YOUR TEAM. I APPRECIATE THE REPORT. GRATEFUL TO MY COLLEAGUES AS WELL FOR OUR COLLECTIVE WILLINGNESS TO WORK COOPERATIVELY TO MAXIMIZE ORGANIZATIONS OF RESOURCES. I WANT TO JUST MAKE A COUPLE OF PROCEDURAL REQUESTS AS WELL AS SOME COMMENTS ON A FEW OF MY ITEMS ON THE LIST THAT WE MAY BE ABLE TO DISPOSE OF. FIRST -- I WILL MAKE A MOTION TO RECEIVE THE REPORT WITH DIRECTION AND FUTURE REPORTS TO PLEASE INCLUDE AN HISTORICAL OVERVIEW CUT MAY BE SOMETHING LIKE A STACKED BAR GRAPH THAT I CAN SHOW US THE RIGHT OF NEW REFERRALS, COMPLETED REFERRALS OF THE TOTAL NUMBER CARRIED OVER FROM ONE REPORTING PERIOD TO THE NEXT. AS MANY OF YOU KNOW, I LIKE A GOOD GRAPH OR CHART. I THINK IT HELPS TO VISUALLY SEE THE AMOUNT OF WORK THAT WE HAVE GENERATED. AND ALSO IN GENERAL, WHEN AN ITEM ON THE AGENDA HAS ACCOMPANIED BY A LONG TABLE, I WOULD LIKE IT TO BE STANDARD PRACTICE FOR A COPY OF THE EXCEL FILES TO BE SENT TO BOARD OFFICES INSTEAD OF JUST THE PDF VERSION, ESPECIALLY FOR A TABLE LIKE THIS ONE, WHICH IS 27 PAGES WITH ONLY A FEW ROWS OF DATA ON EACH PAGE. AN EXCEL FILE WOULD PROVIDE A MUCH GREATER ABILITY FOR OUR STAFF TO PROVIDE ANALYSIS AND IDENTIFY POTENTIAL OPPORTUNITIES FOR IMPROVEMENT. THOSE REQUESTS IN FACT COME FROM MY STAFF WHO HAS TO SLOG THROUGH THE PAGES. THAT IS MY MOTION.

>> I WILL SECOND.

>> THANK YOU. AND THAT IN AN EFFORT TO STREAMLINE THIS LIST EVEN FURTHER, I WILL COMMENT VERY BRIEFLY ON A FEW OF MY ITEMS. THE FIRST IS ITEM 60, WHICH IS RELATED TO IT ON THE BUSINESS REVIEW OF BYLAWS FOR BOARDS AND COMMISSIONS. MATRIX INDICATES THIS IS EXPECTED JUNE 2026. IF THAT'S THE CASE, I THINK IT MAKES SENSE TO KEEP THIS ON THE ACTIVE LIST RATHER THAN TORMENT. HOWEVER, IF EFFORTS TO STREAMLINE THE ADMINISTRATIVE ASPECT IS ALREADY INCORPORATED INTO THE DEPARTMENT WORK PLAN AND BUDGET REDUCTION STRATEGIES WHICH WILL CONTINUE TO BE SHARED WITH THE BOARD, I DON'T THINK IT'S NECESSARY TO KEEP THIS AS A STANDALONE REQUEST. DOES THAT MAKE SENSE?

>> IT DOES. THAT'S ACTUALLY WORK THAT IS HEADED BY THE CLERK OF THE BOARD'S OFFICE, COUNTY COUNCIL SOUGHT I WOULD LOOK TO THEM TO --

>> I THINK WE'VE REVIEWED THIS. DOES THAT WORK, CURTIS?

>> HELLO, CLERK OF THE BOARD. WE ARE WORKING ON THAT ON AN ONGOING BASIS. WE ARE LOOKING AT COMMISSIONS COMPREHENSIVELY. IN THIS SORT OF BUDGET PROCESS, IT'S A LITTLE BIT MORE FOR NEXT CYCLE THAT NECESSARILY THIS CYCLE, BUT IT IS VERY MUCH ON OUR MIND, BE IN MY TEAM, AND A LOT OF THAT WORK IS STUFF THAT WILL BE LOOKING AT REGARDLESS OF WHETHER OR NOT IT IS TRACKED ON THE MATRIX.

>> GREAT. SO THAT IT'S REALLY NOT PARTICULARLY ADDITIVE TO ASK FOR A REPORT THIS JUNE.

>> I THINK WE ARE LIKELY LOOKING AT AUGUST, SEPTEMBER TIME FRAME TIMEFRAME FOR SOME OF THAT ANALYSIS.

>> YOU DO YOU, THEN. AND A HIKE WILL OFFER TO DROP ITEM 60, DON'T GO, THOUGH. ITEM 88 IS SIMILAR IN THAT IT RELATES TO OVERSIGHT OF BOARDS AND COMMISSIONS, SO THAT MAY BE ALSO UNNECESSARY TO INCLUDE ON THE LIST AS A STANDALONE REQUEST AGAIN IF IT'S A COMPONENT OF YOUR BROADER DEPARTMENTAL EFFORTS?

>> ALL OF THE ITEMS ON THE MATRIX RELATED TO BOARDS AND COMMISSIONS ARE THINGS THAT WE ARE LOOKING AT AND WILL EVALUATE IN THAT CONTEXT.

>> WE CAN ALSO REMOVE 88. DON'T GO ANYWHERE. THE LAST ONE IS ITEM 80, WHICH IS RELATED TO THE ASSESSMENT APPEALS PROCESS. FROM THE MOST RECENT REPORTS AT FGOC, MY UNDERSTANDING IS THAT WE HAVE MOVED PAST SOME OF THE EXPRESS CONCERNS ABOUT BACKLOGS OF APPLICATIONS TO PROCESS. IF YOUR OFFICE AND THE ASSESSOR'S OFFICE ARE IN AGREEMENT, I ON'T SEE ANY REASON TO CONTINUE ASKING FOR A SPECIFIC REPORT BACK TO THE BOARD OR FGOC.

>> I HAVE NOT SPOKEN WITH THE ASSESSOR ABOUT THIS PARTICULAR ITEM OF THE REFERRAL MATRIX. I DON'T BELIEVE THERE IS A NEED FOR A SPECIFIC REPORT BACK TO FGOC ON THE PART OF MY OFFICE, AND I DO THINK WE ARE IN A BETTER OVERALL COORDINATION WITH THE OFFICE AT THIS POINT.

>> I'M GOING TO RECOMMEND DROPPING NUMBER 82. AND IF WE ENCOUNTER A CHALLENGING SITUATION IN THE FUTURE, WE CAN ALWAYS RESURRECT. SO THOSE THREE CAN ALL BE DROPPED. DOES EVERYONE NEED TO GO TO THAT? SHOULD I MAKE THAT PART OF THE MOTION?

>> I WAS GOING TO ASK CLARIFICATION ON YOUR ORIGINAL MOTION, SUPERVISOR. WE'VE RECOMMENDED ACTION INCLUDES SIMILAR TO THE PROCESS LAST YEAR, MOVING FORWARD WITH THE MATRIX BASED ON THOSE THREE PRODUCT CATEGORIES. COUPLE ITEMS YOU JUST MENTIONED WOULD BE ENCOMPASSED WITHIN THAT AS ITEMS THAT WOULD OTHERWISE BE DROPPED IS MOVING FORWARD ANYWAY, SO THAT FOR EXAMPLE, WOULD BE -- I SEE WHAT YOU'RE SAYING, BECAUSE RIGHT NOW SUGGESTED TO BE THE MIDDLE CATEGORY. PROPOSING TO MOVE THEM INTO THE THIRD.

>> PRECISELY.

>> DOES THAT NEED TO BE MY MOTION? DOES THE WHOLE BOARD NEED TO VOTE.

>> YES.

>> OKAY.

>> SO YOU'D BE PROPOSING TO MOVE, AS I UNDERSTAND IT, ITEMS 60, 80 AND 80 INTO THE THIRD CATEGORY.

>> SIXTY, 80 -- SPEEDY AND 88.

>> I'M LOOKING FOR THE SECOND ONE.

>> EIGHTY-EIGHT.

>> EIGHTY-EIGHT AND 80.

>> JUST TO BE CLEAR, THAT SLIGHT 88, NOT ITEM 88.

>> YES, THANK YOU. 60, 88, 80, THOSE LINES. SO THAT IS MY AMENDED MOTION.

>> SECONDED.

>> COULD I JUST CLARIFY, SO THAT MOTION IS THE RECOMMENDED ACTION PLUS THOSE THREE ITEMS?

>> PLUS TWO.

>> PLUS THOSE THREE LINES, 60, 80 AND 88.

>> AND THE REQUEST AND THE EXCEL FILE.

>> GOT IT.

>> THANK YOU VERY MUCH. THOSE TWO PIECES. ALL RIGHT. AND SUPERVISOR LEE, THANK YOU FOR THE SECOND.

>> NO ADDITIONAL COMMENTS? ANY OTHER COMMENTS FROM MY COLLEAGUE? IF NOT, I'M GOING TO ASK FOR THE CLERK TO CALL THE ROLL CALL.

>> THANK YOU. ON MOTION OF SUPERVISOR ELLENBERG, SECONDED BY PRESIDENT LEE. SUPERVISOR ABE-KOGA IS ABSENT.

[VOTING]

MOTION CARRIES FOUR TO ZERO.

>> CLERK, IS THAT THE LAST ITEM TODAY BEFORE ADJOURNMENT?

>> THAT IS OUR LAST ITEM FOR TODAY.

>> BEFORE WE ADJOURN, I WOULD LIKE TO MAKE NOTE OF THE HORRIFIC GOVERNMENT THAT ATTACKED THIS PAST SATURDAY EVENING AT THE WASHINGTON HILTON DURING THE WHITE HOUSE CORRESPONDENTS' DINNER, ATTENDED BY MANY FEDERAL OFFICIALS AND OF THE PRESS. LOCATION WHICH I'M SURE MYSELF AND MANY OF MY COLLEAGUES HAVE BEEN TO MANY TIMES FOR OUR OTHER WORK IN WASHINGTON, D.C. WE WERE VERY FORTUNATE THAT NO ONE WAS SERIOUSLY HURT, BUT THE OUTCOME COULD OF BEEN VERY DIFFERENT. I MUST BE VERY CLEAR, THERE IS NO JUSTIFICATION, EXCUSE TO ANYWHERE IN THIS DEMOCRATIC NATION FOR POLITICAL VIOLENCE EVER. DISAGREEMENTS DOES NOT JUSTIFY USING VIOLENCE TO HARM OTHERS. OUR STRENGTH AS A COUNTRY HAS ALWAYS COME FROM DEBATE, NOT DESTRUCTION. BUT BY THE SAME TOKEN, THERE SHOULD ALSO NOT BE AN EXCUSE TO LAY BLAME ON ANY POLITICAL OPPONENT OR PARTY. THIS IS A TIME FOR EVERYONE, REPUBLICANS OR DEMOCRATS LIKE, SHOULD AND MUST COME TOGETHER TO DENOUNCE POLITICAL VIOLENCE, ESPECIALLY GUN VIOLENCE THAT HAS TAKEN SO MANY LIVES OF OUR ELECTED LEADERS EXERCISING FIRST AMENDMENT RIGHTS. STANDING AND GRATITUDE AND SOLIDARITY IN GRATITUDE AND SOLIDARITY WITH ALL THE LAW ENFORCEMENT OFFICERS, ESPECIALLY THE BRAVE OFFICER INJURED WHILE PROTECTING OTHERS, AND WE PRAY FOR HIS SWIFT RECOVERY. WITH THAT, WE WENT OUT ADJOURN TODAY'S MEETING. OUR NEXT MEETING WILL BE OUR FIRST BUDGET WORKSHOP ON MONDAY, MAY 1ST AT 1:30 P.M. SAME CHANNEL, SAME PLACE. THANK YOU TO CLICK, SECURITY STAFF AND ADMINISTRATION. A MEETING ADJOURNED. THANK YOU.