County of Santa Clara Board of Supervisors February 10, 2026 9:30 a.m.

THIS IS A TEST, PLEASE STAND BY.

GOOD MORNING. TODAY IS TUESDAY, FEBRUARY 10th. ORDER. TO CALL ROLL.

GOOD MORNING.

YOU HAVE A QUORUM.

PLEASE READ THE INTERPRETATION ANNOUNCEMENT, PLEASE?

CERTAINLY. IF WE COULD PLEASE HAVE OUR INTERPRETERS TRANSLATE THE VIETNAMESE. IF YOU'RE IN CHAMBER AND REQUIRE SPANISH OR VIETNAMESE TRANSLATION, TRANSLATION DEVICES ARE AVAILABLE AT THE BACK OF CHAMBERS. THE CLERK CAN ASSIST YOU WITH SET UP. TRANSLATION IS AVAILABLE IN ZOOM USING THE INTERPRETATION BUTTON. ADDITIONALLY, AS A GENTLE REMINDER FOR PUBLIC COMMENTERS, STAFF AND THOSE OF US ON THE DIAS, PLEASE SPEAK CLEARLY DIRECTLY INTO THE MICROPHONE TO ENSURE ACCURATE TRANSLATION.

THANK YOU. MAY I PLEASE HAVE SUPERVISOR ELLENBERG TO LEAD US IN THE PLEDGE OF ALLEGIANCE, PLEASE. INTERPRETERS TO DO THE TRANSLATION.

HERE IS THE SPANISH INTERPRETER. [SPEAKING SPANISH]

TO OUR VIETNAMESE INTERPRETER. WE SEEM TO HAVE LOST YOU. [SPEAKING VIETNAMESE]

THANK YOU. NOW MAY I HAVE SUPERVISOR ELLENBERG PLEASE LEAD US IN THE PLEDGE OF ALLEGIANCE. READY. BEGIN. [PLEDGE OF ALLEGIANCE]

THANK YOU. BEFORE WE MOVE ON TO OUR ITEM OF INVOCATION. ANNOUNCEMENTS. COUNTY YEAR-LONG PREPARATION FOR I HAD THE CHANCE TO SEE OUR COUNTY EMERGENCY OPERATION CENTER ON SUNDAY WITH OVER 85 STAFF MEMBERS SUPPORTING THE ACTIVATION. COUNTY EMERGENCY OPERATION STAFF, SO MANY DEPARTMENT, FIRST DEGREE, FIREFIGHTER, NURSES AND VOLUNTEERS DOING 12-HOUR SHIFTS. WONDERFUL WORK TO ENSURE A SAFE AND SUCCESSFUL EVENT. APPLAUSE. [ APPLAUSE ] WE ALSO VERY RELIEVED THERE WAS NO I.C.E. PRESENCE AT THE EVENT. TO KEPT US INFORMED. MANY THANKS TO OUR RAPID RESPONSE PARTNERS HELPING DISPEL RUMORS AND RELIEVING FEAR OF OUR NEIGHBOR. EVERYONE COULD FULLY ENJOY THE GAME. HALF-TIME SHOW HEADLINED BY SUPER STAR BAD BUNNY. WHO CALL FOR UNITY, HOLDING A FOOTBALL WITH NCRYPTION TODAY WE ARE AMERICAN. PEOPLE BORN IN PUERTO RICO ARE AMERICAN CITIZEN. BAD BUNNY WHO REMINDED US NEVER STOP BELIEVING IN YOURSELF. THAT QUOTE ANYTHING MORE AND A IS LOVE. POWERFUL MESSAGE BROADCAST FROM 100 MILLION VIEWERS AROUND THE WORLD. THANK YOU. OTHER ANNOUNCEMENTS. COMING ON FRIDAY THE 13th, WE HAVE TWO THIS YEAR. ONE IS GOING TO BE THIS FRIDAY BUT THAT'S NOT THE ONE I'M TALKING ABOUT. WE WILL HOST THE 2026 STATE OF THE COUNTY ADDRESS RAKE HERE IN THE DOWN BOARD CAME PERCENT. -- CHAMBERS. THERE WILL BE GREAT MUSIC AND DELICIOUS FOOD. PLEASE RSVP IN ADVANCE. THROUGHOUT FEBRUARY, WE HONOR CO-SPONSOR HONORING THE CHILDREN OF PALESTINE. AND THE COUNTY CIVIC CENTER. FOLLOWING LAST NOVEMBER ANGEL OF UKRAINE EXHIBIT WHICH HONORED THOUSANDS OF CHILDREN WHO LOST THEIR LIVES. 64,000 CHILDREN WHO DIED IN GAZA AND THE WEST BANK OVER THE PAST 30 MONTHS. MEASURES AND REFLECTIONS AND WE THANK OUR COUNTY PARTNERS TO ARAB-AMERICAN CULTURE CENTER OF SILICON VALLEY FOR BRINGING THIS POWERFUL DISPLAY TO LIFE. NEXT WE HAVE OUR INVOCATION. I WILL PASS IT OVER TO SUPERVISOR ABE-KOGA. HAPPY LUNAR NEW YEAR TO EVERYONE HERE TODAY. LANGUAGES. SUPERVISOR YOUNG MR. BRING FORWARD FEBRUARY 17th AS FIRST DAY OF OBSERVANCE OF LUNAR NEW YEAR IN SANTA CLARA COUNTY. ESPECIALLY AS WE FACE A ADMINISTRATION THAT'S ACTIVELY INSTILLING FEAR. HORSE. BOLD ACTION. MOVE FORWARD WITH CONVICTION AND QUICKNESS. FACE CHALLENGING SITUATIONS THIS YEAR. CO-PRESIDENT OF THE ASIAN-AMERICAN PARENT ASSOCIATION. THE ASSOCIATION BRINGS PARENTS AND SCHOOL DISTRICT TOGETHER AND CREATES THE PROGRAM, LEADERSHIP OPPORTUNITIES AND SUPPORT STUDENTS NEED TO SUCCEED. ONE OF SIGNIFICANT CONTRIBUTIONS IS THE AAPI MULTICULTURAL FESTIVAL. WHICH WILL BE CELEBRATING THIS YEAR ON SATURDAY MAY 16th AT THE CUPERTINO IN FRONT OF THE LIBRARY. TOGETHER 500 RESIDENTS TO ENJOY CULTURAL BOOTHS, PERFORMANCES PACIFIC ISLANDS. IT STRENGTHENS CULTURAL UNDERSTANDING. CO-PRESIDENT, ROSA KIM WHO EARNED ACCOLADE SERVING THE AAPI DECADES INCLUDING WORKING AS TEACHING HISTORY AND BILINGUAL EDUCATION AT THE SILICONE VALLEY KOREAN SCHOOL. COMMUNITY CENTER, CO-AUTHORING KOREAN HISTORY TEXTBOOKS, ORGANIZING ANNUAL CULTURAL SEMINARS FOR LOCAL K-12 EDUCATORS AND CO-FOUNDING THE AAPI MULTICULTURAL FESTIVAL DURING THE PANDEMIC AS A WAY TO UPLIFT COMMUNITY SPIRIT AND COMBAT AAPI HATE. TO LEAD THE AAPI. I FORGOT TO MENTION. SHE'S TRUSTEE FOR THE FREMONT UNION HIGH SCHOOL DISTRICT. WELCOME ROSA AND THANK YOU FOR BEING WITH US TODAY.

THANK YOU SO MUCH SUPERVISOR ABE-KOGA. COMMUNITY MEMBER. OPPORTUNITY TO SHARE A FEW REFLECTIONS AS WE WELCOME THE LUNAR NEW YEAR. I WAS BORN AND RAISED IN SOUTH YOUNG IMMIGRANT PARENT WITH MY HUSBAND AND OUR 18 MONTHS DAUGHTER. SINCE THAT FIRST YEAR AND EVERY YEAR SINCE, OUR LUNAR NEW YEAR HAD STARTED WITH RICE CAKE SOUP. IN KOREAN CULTURE, EATING RICE CAKE SOUP ON NEW YEAR'S DAY SYMBOLIZES A FRESH START, GOOD FORTUNE AND THE GAINING OF ANOTHER YEAR OF WISDOM. LATER, WHEN I BEGAN KOREAN, I STARTED MAKING RICE CAKE SOUP FOR MY STUDENTS. I BELIEVE AND STILL BELIEVE THAT SHARING CULTURAL TRADITIONS HELPS CHILDREN UNDERSTAND WHO THEY ARE AND WHERE THEY COME FROM. WHEN YOUNG PEOPLE SEE THEIR CULTURE HONOR, IT BECOMES A SOURCE OF PRIDE, RATHER THAN SOMETHING TO HIDE. THE MORE CULTURE EXPERIENCES THEY HAVE, THE MORE THEY SEE THEIR IDENTITY AS AN ASSET. THE RECENT SUPER BOWL HALF-TIME SHOW REMINDED ME. THAT BELIEF IS ALSO WHAT LED THE ASIAN-AMERICAN PARENT AAPI MULTICULTURAL FESTIVAL. THE FESTIVAL PLANNING STARTED DURING THE PANDEMIC. A TIME WHEN MANY AAPI COMMUNITY DISCOURAGED BECAUSE OF RISING ANTI-ASIAN HATE. IDENTITY NO LONGER FELT LIKE A STRENGTH. AS A PARENT OF THE ORGANIZATION FOUNDED IN THE 1990s, AAPI HAS FOCUSED ON HELPING THE NEXT GENERATION GROW UP WITH CONFIDENCE AND PRIDE. SO, INSTEAD OF RETREATING, WE CHOSE TO SHOW UP. WE PARTNER WITH HIGH SCHOOL STUDENT VOLUNTEERS AND AAPI AND LAUNCH AN AAPI MULTICULTURAL FESTIVAL TO SHARE OUR CULTURES, OUR STORIES AND OUR CONTRIBUTION WITH THE BROADER COMMUNITY. THANKS TO THE FOUNDATION OF SUPPORT FROM SUPERVISOR ABE-KOGA AND THE BOARD PRESIDENT, LEE. WE COULD HOST OUR FIRST FESTIVAL IN MOUNTAIN VIEW IN 2022. THE FIRST FESTIVAL HAS CONTINUED EVERY YEAR IN CUPERTINO. WHAT'S BEEN MOST MEANINGFUL IS SEEING STUDENTS LEAD. SHARING THEIR HERITAGE THROUGH LEARNING ABOUT ONE ANOTHER. AGAIN, I HEAR STUDENTS SAY, DIVERSITY IS OUR STRENGTH. I SEE THE STRENGTH COMES ALIVE WHEN WE CREATE SPACES WHERE EVERYONE FEELS SEEN AND VALUED. THE LUNAR NEW YEAR MARKINGS THE YEAR OF THE FIRE HORSE. A SYMBOL OF ENERGY, COURAGE AND ACTION. BUILDING DOESN'T HAPPEN BY ACCIDENT. IT REQUIRES INTENTION, PARTICIPATION AND THE WILLINGNESS TO STAND TOGETHER. AS WE WELCOME THE NEW YEAR, I HOPE WE CARRY THE FIRE HORSE ENERGY. UNDERSTANDING ONE ANOTHER, HONORING OUR DIFFERENCES AND STRENGTHENING OUR SHARED COMMUNITY. ONCE AGAIN WITH ICE CAKE SOUP. REMEMBERING WHERE I CAME FROM AND FEEL HOPEFUL ABOUT WHAT WE CAN BUILD TOGETHER FOR OUR CHILDREN. MEANINGFUL, ENERGETIC YEAR OF THANK YOU SO MUCH.

THANK YOU VERY MUCH, ROSA. NOW, WE MOVING TO ITEM NUMBER 5. WHICH IS THE COMMENDATION AND PROCLAMATION. SUPERVISOR YOUNG AND MYSELF IN OBSERVANCE WAS LUNAR NEW YEAR. I LIKE TO INVITE OUR COMMUNITY PARTNERS TO JOIN US. PLEASE COME FORWARD. LOOK AT THE BEAUTIFUL DRESSES. LET'S GIVE THEM A ROUND OF APPLAUSE FOR THIS. LET'S SEE. [SPEAKING FOREIGN LANGUAGE] HAPPY NEW YEAR EVERYBODY. TODAY, THE COUNTY OF SANTA CLARA DECLARES FEBRUARY 17th AS THE FIRST DAY OF LUNAR NEW YEAR. ONE OF THE MOST SIGNIFICANT CULTURE CELEBRATIONS ACROSS ASIAN COMMUNITY. LUNAR NEW YEAR MARK TIME OF RENEWAL, REFLECTION AND HOPE. THIS YEAR WE WELCOME THE YEAR OF THE FIRE HORSE. THE 2026 CELEBRATION IS ON TO FEBRUARY 17th AND IT LAST FOR SEVEN DAYS. COMMUNITIES TOGETHER ACROSS ASIA SANTA CLARA COUNTY HOME TO ONE OF THE NATION'S MOST VIBRANT AND DEEPLY ROOTED ASIAN-AMERICAN POPULATIONS. CONTRIBUTIONS ENRICH EVERY PART OF OUR SOCIAL, ECONOMIC AND CIVIC LIFE. SPIRIT COME ALIVE WITH FEBRUARY 4th, THE ASIAN PACIFIC ISLAND COMMITTEE MOSTING A LUNAR NEW YEAR CELEBRATION FOR COUNTY EMPLOYEES. BROUGHT THE CELEBRATION TO BROADER COMMUNITY ON FEBRUARY 7th FILLED WITH TODAY'S PROCLAMATION CELEBRATING OUR CULTURINGS, UPLIFTING ASIAN-AMERICAN TRADITIONS. AT THIS TIME, I LIKE TO INVITE MY COLLEAGUE, SUPERVISOR DUONG TO SHARE HER THOUGHT.

GOOD MORNING, EVERYONE. HAPPY LUNAR NEW YEAR THAT STARTS TO JANUARY 17th. IT'S IMPORTANT THAT WE START NOT JUST TO RECOGNIZE THE SERVICES AND TALENTS AND GIFTS TO THE COUNTY BUT ALSO THE GIFTS OF THEIR CULTURE. OUR COUNTY EMPLOYEES OUR HEALTHCARE WORKERS, OUR STAFF BRING THE HEART AND SOUL TO THIS JOB. TO GIVE BLESSINGS TO THOSE NEAREST AND DEAREST TO YOU. THE YEAR OF THE HORSE SYMBOLIZES, STRENGTH, FREEDOM AND GENEROSITY. THOSE BORN DURING THE YEAR OF THE HORSE ARE OPTIMISTIC, DETERMINED AND ENERGETIC. THAN EVER DURING THIS AND COUNTY. SANTA CLARA COUNTY WELCOMED MY PARENTS AND THOUSANDS MORE JUST LIKE THEM IN THE 1970s AS REFUGEES WHEN THE WORLD DIDN'T WANT US. WE STILL ABIDE BY THOSE VALUES TODAY OF BEING AN IMMIGRANT, WELCOMING AND BELONGING COMMUNITY. THE MOST NEED OF OUR SERVICES NOT JUST SURVIVE BUT HAVE THE OPPORTUNITY TO THRIVE. CELEBRATION OF BOTH ASIAN CULTURE BUT ALSO DIVERSITY THAT MAKES OUR COUNTY SUCH AN AMAZING PLACE TO LIVE AND PLACE TO SERVE AND PLACE TO WORK. I'M SO PROUD OF OUR COUNTY'S WORKFORCE BY THE WAY THEY HAVE NOT JUST EMBRACED THE NEW YEAR BUT EVERY CELEBRATION WE HAVE ARE RECOGNIZED, OUR EMPLOYEES FEEL SEEN. AS A COUNTY, STEMMING WITHAL OF OUR COMMUNITIES. THE VIETNAMESE AMERICAN SERVICES SERVICES. SERVICES ADMINISTRATION TEAM FOR THEIR WORK YEAR ROUND BUT ALSO ALL THE EXTRA TIME SPENT TO THROW GRAND LUNAR NEW YEAR CELEBRATIONS AND INVITING EVERY COLLEAGUE IN THE COUNTY TO JOIN THEM. REPRESENTATIVES ARE HERE TODAY AWAY FROM WORK. THEN THEY HAVE TO GO BACK TO WORK AND WORK EXTRA TO MAKE SURE THEY COVER IT. WE WORK. PROBLEMS WE DIDN'T CREATE. THAT IS THE COUNTY WAY. LUNAR NEW YEAR HAVE MANY TRADITIONS. REMEMBER, JANUARY 17th, 18th AND 19th, WE SPEAK WITH KINDNESS AND GOOD INTENTION BECAUSE WHATEVER YOU GIVE, YOU RECEIVE TEN FOLD. GREATEST INTENTION. SOUL OR HUMAN SHALL EXPERIENCE LONELINESS. WELCOME AT MY TABLE. THESE TRADITIONS HAVE BEEN IN PRACTICE FOR 4000 YEARS. NO MATTER HOW FOREIGN THEY ARE TO SOME, I BELIEVE THEY ARE ROOTED IN PRINCIPLES RECOGNIZABLE TO ANYONE. NEW YEAR TRADITION, WE HAVE MIDNIGHT TONIGHT TO OBSERVE THE KITCHEN GOD. YEAR OF THE FIRE HORSE ON BEHALF OF MYSELF, MY FAMILY AND MY OFFICE, I WISH YOU GOOD HEALTH. GOOD PROSPERITY. GREAT WEALTH. ABUNDANCE, TIME WITH LOVE ONES. TO MY COLLEAGUES AND TO THE ADMINISTRATORS THAT SERVE US, I WISH YOU GOOD HEALTH, GREAT REST AND CLARITY IN YOUR JUDGMENT, COLLECTIVENESS IN OUR INTENTIONS AND FOR US TO WORK TOGETHER TO WEATHER THROUGH BAD STORM AND TOUGH TIMES. HAPPY LUNAR NEW YEAR. [ APPLAUSE ] AT THIS TIME I LIKE TO INTRODUCE OUR COLLEAGUE, SUPERVISOR MARGARET ABE-KOGA WHO HAS A LUNAR NEW YEAR WISHES OF HER OWN.

GOOD MORNING. I WANT TO THANK ROSA FOR OPENING TODAY'S MEETING WITH OUR LUNAR NEW YEAR INVOCATION AND CONTINUE THAT CELEBRATION WITH THE PRESENTATION OF THIS PROCLAMATION BY MY COLLEAGUES. LUNAR NEW YEAR IS A DEEPLY MEANINGFUL TIME FOR SO MANY OF OUR RESIDENTS. CHANCE TO ATTEND THE FESTIVAL OR COMMUNITY CELEBRATION HAPPENING ACROSS THE COUNTY FOR QUITE A FEW WEEKS. HOLIDAY. LIVING IN SANTA CLARA COUNTY IS THAT WE DON'T JUST OBSERVE DIVERSITY, WE LEARN FROM IT. WE ENHANCE IT. THAT MAKES PEOPLE WANT TO MOVE AND LIVE HERE. LUNAR NEW YEAR GIVE US A CHANCE TO UNDERSTAND HOW DIFFERENT CULTURES HONOR TIME, FAMILY AND RENEWAL. WE CANNOT AFFORD TO BE IGNORANT OF OUR NEIGHBOR TRADITIONS. IN SANTA CLARA COUNTY, NEW YEAR COMES A FEW TIMES A YEAR. FOR INSTANCE, MY JAPANESE CULTURE WE CELEBRATE IT ON JANUARY 1st WITH OUTLIER FRANKLY. OPPORTUNITIES TO CELEBRATE WITH CELEBRATIONS, WE STRENGTHEN THE AS COUNTY LEADERS, REALLY GRATEFUL TO BE PART OF THIS COUNTY WHERE WE ARE PROUD TO BRING PEOPLE TOGETHER AND PUT A SPOTLIGHT ON THE MANY CULTURES, HISTORIES AND EXPERIENCES THAT OUR COMMUNITY SO RICH. I WISH YOU ALL LUCK. PROSPERITY AND GOOD HEALTH AND A LET'S MAKE 2026 A YEAR WHERE OUR COMMUNITY GROWS EVEN STRONGER TOGETHER.

I LIKE TO ALSO INVITE HEIDI TO SAY A FEW WORDS.

GOOD MORNING, I'M THE DIRECTOR OF A COUNTY VIETNAMESE I LIKE TO HANK YOU FOR US OPARTICIPATE IN THE ROBLEM MISSION. THE COMMUNITY THAT THE VAST SERVE. OUR COMMUNITY TO HONOR THE TRADITIONS AS WELL AS TO ENGAGE IN THE COUNTY SERVICES OFFERED AT THE VAST. AS YOU HEARD FROM PRESIDENT LEE AND SUPERVISOR DUONG. THE THEME WAS ACROSS THREE REGIONS VIETNAM. PERFORMANCE FROM YOUTH GROUPS, LOCAL ELEMENTARY SCHOOLS AS WELL AS HIGH SCHOOLS. MEMBERS ATTENDING OUR EVENT AND 24 COUNTY DEPARTMENTS AND COMMUNITY ORGANIZATIONS TABLING AND HIGHLIGHT JUST A FEW OF THEM. OUR COUNTY DEPARTMENT OF EMPLOYMENT BENEFIT SERVICES TO SHARE WITH THE COMMUNITY, OUR COUNTY'S PUBLIC HEALTH DEPARTMENT TABLE TO SHARE INFORMATION ABOUT TUBERCULOSIS PREVENTION. SECOND HARVEST SILICONE VALLEY TABLED AS WELL TO HARE INFORMATION ABOUT THE FREE GROCERIES PROGRAM. BOARD OF SUPERVISORS, COUNTY DEPARTMENTS, COMMUNITY PARTNERS AT OUR LUNAR NEW YEAR EVENT. EVERYDAYED A WE WORK TOGETHER TO SERVE OUR COMMUNITY. THANK YOU VERY MUCH.

GOOD MORNING. I'M THE SECRETARY OF THE ASIAN-AMERICAN AND PACIFIC ISLANDER EMPLOYEE COMMITTEE. I LIKE TO THANK OUR SUPERVISORS FOR PROVIDING THIS PROCLAMATION. TO SAY ABOUT THE WORK THAT WE DO. WE ARE TOTALLY VOLUNTEER-BASE ALL OUR OFFICERS ARE ACTUALLY FROM DIFFERENT CULTURES. NONE OF US SPEAK THE SAME LANGUAGES AT HOME. ASIDE FROM BEING A MODEL U.N., WE ARE EXCHANGING CULTURE, EXCHANGING FOOD. WE GOT FOOD FROM EVERYWHERE AND WE DON'T SPEAK THE SAME LANGUAGE AT ALL. THOUGH, THAT SITUATION IS A MICROCOSM OF WHAT LIFE IS IN SANTA CLARA COUNTY. CULTURE, IDEAS, PEOPLE, ETHNICITIES. GLOBALIZED SOCIETY. EMPLOYEE LEVEL THROUGH OUR EMPLOYEE COMMITTEES. ONE OF THE MOST IMPORTANT THINGS THAT WE DO IS WE REACH OUT TO ONE ANOTHER IN TERMS OF EMPLOYEES, WE REACH OUT AND WE SHARE OUR CULTURE. WE EXTEND THE INVITATION. ON WEDNESDAY OF LAST WEEK, WE WERE LUCKY ENOUGH TO HOST A LUNAR NEW YEAR CELEBRATION FOR THE EMPLOYEES AT THE SOCIAL SERVICES AGENCY. SUPERVISOR DUONG SAID SOMETHING PROFOUND IN THAT SHE SAID, WHEN YOU GROW UP IN THE AY AREA, LUNAR NEW YEAR IS FOR EVERYONE. IT REALLY. IN THE LANGUAGE OR CULTURE. HEAR THE NOISE. YOU EAT THE FOOD. IT'S NOT YOUR CULTURE BUT IT IS. YOU'VE BEEN INVITED. IF YOU WANT TO KNOW THE OWER OF THAT INVITATION, TWO DAYS AGO, WE HAD ONE OF THE MOST IMPORTANT AMAZING CULTURAL INVITATIONS IN THE NFL HALF-TIME SHOW. I BE LYING IF I SAID I'M NOT SINGING BAD BUNNY IN MY CAR. IMPROVE MY SPANISH JUST LITTLE BIT. ANYWAY, THE POINT OF THIS IS THAT WHEN WE OLD THESE CELEBRATIONS AND WE EXTEND THESE INVITATIONS, WE STRIP AWAY DIFFERENCE. WE LIVE IN TO THE COMMUNITY YOU LIVE IN. FROM THE COMMUNITY IT GOES TO THE NEIGHBORS AND FROM THE NEIGHBORS IT GOES TO YOUR FRIENDS. AND YOUR FRIENDS EXPERIENCE ADVERSITY, YOU GOT SOMEONE TO STAND UP FOR YOU. THOSE THE MOST IMPORTANT WORK WE DO IN OUR EMPLOYEE COMMITTEES. AGAIN, THE CELEBRATION OF THE LOU MORE NEW YEAR -- LUNAR NEW YEAR IS MORE THAN A NEW YEAR. IT'S A CULTURAL INVITATION OR EVERYONE. OUT FOR ONE ANOTHER. IMPORTANT WORK WE CAN DO. IN CLOSING, I LIKE TO SHARE MY INTENTION FOR THE LUNAR NEW YEAR WITH ALL OF YOU. IT'S THE WAY I CLOSE MOST OF OUR EVENTS AT THE AAPI. DIMINISH MIRROR, IT'S MY WISH YOU FIND HOPE. HAPPY LUNAR NEW YEAR EVERYONE. THANK YOU.

GOOD MORNING, I'M TIFFANY. I'M EMPLOYEE AT SOCIAL SERVICES AGENCY, DEPARTMENT OF YEAR TO ALL OF YOU. IT'S NOT JUST THE ASIAN THAT WE CELEBRATE THE NEW YEAR, WE INVITE ALL COMMUNITIES TO CELEBRATE WITH US. FOR EXAMPLE, SHE'S NOT BORN VIETNAMESE. CELEBRATION, LUNAR NEW YEAR CELEBRATION, SHE'S THE MAIN PERSON THAT DRIVE US TO ORGANIZE HAVE.

THANK YOU.

THANK YOU SO MUCH. WE'LL RESENT THIS. HAPPY NEW YEAR. LET TAKE A PICTURE FOR THE PROCLAMATION.

TODAY WILL BE A GOOD MEETING RIGHT EVERYBODY? COMMENT. THIS ITEM IS RESERVED FOR MEMBERS OF PUBLIC TO ADDRESS THE BOARD ON ANY ITEMS NOT ON THIS AGENDA. REQUEST TO SPEAK AT THIS TIME. WE WILL CALL UP TO 30 NAMES NOW. THEN THE REMAINDER NAMES ANY MORE WILL BE CALLED AT THE END OF THE GENDA. IN-PERSON SPEAKERS WILL BE CALLED FIRST. FOLLOWED BY THE ZOOM SPEAKERS. NO FURTHER REQUEST TO SPEAK WILL BE ACCEPTED UNDER THE CONTINUED PUBLIC COMMENT IN THE AFTERNOON. SOON AS THE FIRST SPEAKER STARTS SPEAKING, NO MORE SPEAKERS WILL BE TAKEN. DO NOT ALLOW APPLAUSE OR BOOS. BUT TO SHOW YOUR SUPPORT, YOU CAN RAISE AND MAKE YOUR HANDS QUIETLY. MOVING ORDERLY. HOW MANY SPEAKERS WE HAVE THIS MORNING? IN CHAMBERS AND ONE SPEAKER ON ZOOM.

LET'S DO ONE MINUTE EACH.

ALL RIGHT. THE PUBLIC SPEAKING QUEUE. I'M GOING TO CALL FORWARD SEVERAL NAMES. YOU MAY SPEAK IN ANY ORDER. GUADALUPE, -- [CALLING OF NAMES] PLEASE COME FORWARD. [SPEAKING FOREIGN LANGUAGE] [SPEAKING ALTERNATE LANGUAGE]

TRANSLATOR PLEASE? I BELONG TO DISTRICT ONE. THIS MESSAGE IS FOR SYLVIA ARENAS. I LOVE THE IHSS. IT IS HAVING A LOT OF ATTENTION IN MY COMMUNITY. AS MEMBER OF THE COMMUNITY, I'M VERY CONCERNED WHAT'S HAPPENING IN THE COUNTRY, SPECIFICALLY IN WHAT'S HAPPENING IN SANTA CLARA. WE WERE IN THE COMMUNITY. I'M VERY CONCERNED ABOUT ABOUT THE LATIN AMERICAN COMMUNITY. WE WERE SUPPORTING THE -- WE WERE TOLD THIS WAS GOING TO BE A BIG ALLY. SPECIFICALLY FOR ITEM 8. WE GAVE FULL SUPPORT AND NOW IT'S OUR TURN THAT OUR VOICES ARE HEARD. THANK YOU.

[SPEAKING ALTERNATE LANGUAGE]

GOOD MORNING, I AM A MEMBER OF IAH, S ALSO. I LIVE IN SAN JOSE. I LOVE IHSS. BECAUSE IT IS REPRESENTING -- IT IS TAKING CARE OF OUR COMMUNITY. IT'S ALSO TAKING CARE OF OUR FAMILY AND ALSO TAKING CARE OF OUR IMMIGRANT COMMUNITY. MR. TRUMP DOESN'T CARE ABOUT THAT. DOESN'T CARE ABOUT THE LIFE OF IMMIGRANTS. TAKING CARE OF FAMILIES ALSO. HR1 WAS A DIRECT ATTACK. THEY TOOK MILLIONS OF DOLLARS OUT OF MEDICAL AND THEY PUT IT IN I.C.E. OUR COMMUNITY IS HERE FOR SUPPORT. THIS MESSAGE IS FOR YOU. [SPEAKING ALTERNATE LANGUAGE]

GOOD MORNING. I'M TALKING ABOUT THE UNION TO SUPPORT OUR COMMUNITY. THIS HAVE DONE A LOT OF WORK. I WOULD LIKE TO THANK THEM FOR THAT. FAMILY MEMBERS. THIS HELP ME TO -- [ INDISCERNIBLE ] THE WORK OF UNION IS GREAT. WE NEED TO WORK TOGETHER IN ORDER TO ACHIEVE OUR WORK AND TO BE SUCCESS. UNIFICATION IS THE OBJECTIVE. I LIKE TO THANK THEM AND WE WILL BE UNITED. WE WILL COME TOGETHER AND TO COMPLETE THIS FURTHER. THANK YOU.

I LIVE IN THE DISTRICT FIVE. OUR PROGRAM IS A SAFETY FOR THOSE WHO HAVE ALREADY MADE MAJOR IMPACT ON OUR LIVES AND SHOULD RECEIVE CARE AND THE COMFORT. MORE OTHER WILL NEED ASSISTANCE AS TIME GOES ON. THE COUNTY HAS MONEY -- WE ARE FALLING SHORT IN DUTY TO PROVIDE FOR THOSE WHO NEED THE SUPPORT. WE SHOULD NOT BE -- GO [ INDISCERNIBLE ] YOU CANNOT FINISH. YOU GIVE THE COMMENTS TO OUR CLERK AND WE WILL INCLUDE IN OUR RECORD. THANK YOU.

MY NAME IS NATASHA WALKER. I'M AN IHSS PROVIDER. THIS MESSAGE IS FOR THE COUNTY CEO, JAMES WILLIAMS. OUR COUNTY LEADERSHIP SHOULD BE RECEIVING REGULAR INFORMATION MAKE INFORMED DECISIONS. MY TEAM AT SEIU ARE CERTAIN THERE ARE BUDGET ISSUES WE ARE PRESENTING AT THE BARGAINING TABLE. REGULAR UPDATES OF NECESSARY INFORMATION THEY ASK FOR SO THEY CAN DO THEIR OWN EVALUATIONS. THE BOARD SHOULD BE MANAGING THE CEO. OUR UNION PROVIDERS WORKED HARD TO PASS MEASURE A. THEY DONATED THEIR TIME. WE ANSWERED THE CALL. WE DELIVERED RESULTS. WHY BECAUSE WE VALUE OUR HEALTHCARE SYSTEM. WE ARE GOOD FAITH ALLIES OF THIS COUNTY'S LEADERSHIP AND THE COUNTY AND WE ARE INVESTED IN THIS COUNTY'S HEALTHCARE SYSTEM FOR THE LONG-TERM. WE HAVE TO WORK TOGETHER TO ENSURE CAREGIVERS AN PAY THEIR BILLS. CREATIVE SOLUTIONS NOT FLAT WAGES. [SPEAKING ALTERNATE LANGUAGE

GOOD MORNING. I AM A IHSS PROVIDER. THIS MESSAGE IS FOR SUPERVISOR ELLENBERG. I LOVE THE IHSS PROGRAM BECAUSE IT IS TAKING CARE OF MY CHILDREN ALSO MY WIFE AND I ARE TAKING CARE OUR SON. WE ARE REALLY NEEDING THIS PROGRAM. DAY MAINLY BOTH PHYSICALLY AND EMOTIONALLY. HOWEVER, MY WIFE AND I WANT TO TAKE CARE OF OUR CHILDREN AND WE DON'T WANT TO GO AN EXPENSIVE CENTER. IHSS IS MAKING THIS POSSIBLE. WE ARE REALLY GRATEFUL FOR THAT. WE REALLY WANT TO STAY IN SANTA DISABLED. THANK YOU. SEVERAL SPEAKERS FORWARD. JACK McGOVERN, RAYMOND GOING, JESSE WHITES, JUSTIN RUFFNER, MARK TROUT, MONICA SIMON, ANDRE

GOOD MORNING. I'M TONYA YORK. SINCE THE RULE FOR PUBLIC DIFFICULT FOR OUR MEMBERS TO HAVE THEIR VOICES HEARD. OUR MEMBERS HAVE IMPORTANT STORIES THAT ARE HARD TO SHARE IN UNDER A MINUTE. WE HAVE IMMIGRANT MEMBERS WHO NEED TIME TO EXPRESS WHY THEY ARE CONCERNED ABOUT THEIR FAMILY'S FUTURE. WE HAVE FAMILY PROVIDERS WHO LEFT THEIR JOB TO TAKE CARE OF OUR LOVED ONES AND STRUGGLE RUNNING KEEP UP WITH BILLS. SACRIFICE THEIR TIME AND TRAVEL LONG DISTANCES JUST TO SPEAK TO THE BOARD FOR A FEW SECONDS ABOUT HOW BADLY THEY NEED A RAISE. IHSS PROVIDERS ARE A LIFELINER IMMIGRANTS FOR FAMILIES IN SANTA IS READY TO MEET THE NEED FOR OUR COMMUNITIES FOR YEARS TO COME. A AND WHEN CRUCIAL FUNDING FOR THE COUNTY. HEALTHCARE IN SANTA CLARA.

GOOD MORNING, BOARD. I'M JACK McGOVERN. STRONGLY SUPPORT MY SEIU 2015 BROTHERS AND SISTERS. THEY PROVIDE ESSENTIAL CARE THAT KEEP THOUSANDS OF SANTA CLARA MEASURE A. DIFFICULT THIS UPCOMING BUDGET SEASON IS. WE KNOW DIFFICULT DECISIONS NEED TO BE MADE. OUR 2015 WORKERS ARE TAKING CARE OF SOME OF THE HIGHEST NEED POPULATIONS IN OUR COUNTY. WE MUST DO WHAT IS RIGHT. WE ARE CALLING ON THE COUNTY ADMINISTRATION TO BARGAIN IN GOOD FAITH AND ENSURE THAT HOME CARE WORKERS RECEIVE LIVEABLE WAGES AND AFFORDABLE HEALTHCARE. PLEASE SUPPORT YOUR 2015 MEMBERS AND ENSURE THAT SANTA CLARA COUNTY LIVES UP TO ITS VALUES. THANK YOU.

GOOD MORNING. I'M HERE ON MY INDIVIDUAL CAPACITY. ATTENTION. ON JANUARY 21, SANTA CLARA POLICE DEPARTMENT EXECUTED THE MAN WAS FLEEING AWAY AND HE WAS SHOT. WASN'T A THREAT. WHEN HE WAS SHOT, APPROXIMATELY 26 TIMES, HE LAID DOWN THERE IN THE CITY STREETS, HE WASN'T A THREAT. WE RECALLED DONALD TRUMP ENFORCING IMMIGRATION TO GO ALEX PRETTI WAS KILLED AND RENEE GOOD WAS KILLED AND KEITH PORTER WAS KILLED UNDER CRIMINALITY. I ASK THE COUNTY TO STAND BY US AS WE FIGHT, AS OUR FIGHT FOR JUSTICE. MURDERED ON OUR COUNTY STREETS.

I'M SENIOR A HIGH SCHOOL. THIS YEAR, I'M GOING TO BE GOING TO SANTA CLARA COUNTY FAIR. MID-DECEMBER THE FAIRGROUND OFFICIALS RELEASED STATEMENT ABOUT EXPECTED DATE CHANGES. FOLLOWING FIRST WEEK OF AUGUST, THE DATES HAVE BEEN CHANGED. FAIRGROUND RELEASED DATE CHANGE AND RELEASED THE PRESS RELEASE THAT FAILING TO ACKNOWLEDGE THE STARTING THEIR FIRST WEEK OF COLLEGE. MOVING IN THE WEEKEND OF AUCTION OR BEGINNING CLASSES. THIS BROUGHT ME TO HARD DECISION TAKING A MAJOR LOSS OF MONEY OR SACRIFICING MY FIRST SEMESTER F COLLEGE. PAST FOUR YEARS TO GET TO HIS POINT. THE BOARD MISTAKES. TAKING ACCOUNTABILITY FOR THIS THEY SHOULD HAVE WIGGLE ROOM FOR US. THANK YOU FOR YOUR TIME.

I'M JUSTIN RUFFNER. I'M PART OF THE MORGAN HILL FAITH CHAPTER. HAS A VERY REAL PERSONAL BASKET -- PERSONAL IMPACT ON MY LIFE. THIS IS MY SENIOR YEAR. IT'S HONESTLY HEARTBREAKING TO THINK THAT IT MIGHT NOT HAPPEN. MY FAMILY IS SCHEDULED TO MOVE TO MIAMI, FLORIDA FOR MY DAD'S JOB. WE ALREADY ADJUSTED OUR PLANS ONCE SO I CAN STAY THROUGH THE SUMMER. NOW I MAYBE FORCED CHOOSE BETWEEN BEING WITH MY FAMILY DURING A MAJOR LIFE TRANSITION, OR STAYING BEHIND JUST TO FINISH THE PROJECT THAT I'VE ALREADY COMMITTED SO MUCH TIME, EFFORT AND MONEY TOWARD. STUDENT SHOULD HAVE TO MAKE. THERE ARE ALSO SERIOUS ANIMAL WELFARE CONCERNS -- BASED ON THE THE TIMELINE, PUSHING THE FAIR LATER MEANS I WILL HAVE TO HOLD HIS WEIGHT LONGER WHAT IS CONSIDERED HEALTHY. OVERWEIGHT ANIMALS AND FORCING UNHEALTHY FEEDING ADJUSTMENTS.

I THINK EVERYONE WHOSE GOING TO BE A NURSE AND GOES TO ANY COLLEGE TO BECOME A NURSE SHOULD BE REQUIRED TO READ THIS BOOK. "MOVING BEYOND THE COVID-19 LIES" THERE'S A DOCUMENTARY I'VE OFFERED MONEY TO PEOPLE TO WATCH. IT'S SO POWERFUL. IT'S CALLED INCONVENIENTSTUDY.COM. THE NIGHTINGALE PLEDGE. I PLEDGE MYSELF BEFORE GOD. IN THE PRESENCE OF THIS ASSEMBLY TO PASS MY LIFE IMPURITY AND TO PRACTICE MY PROFESSION FAITHFULLY. IS MISCHIEVOUS WILL NOT ADMINISTER HARMFUL DRUG. IN THIS DOCUMENTARY, --

HI. MONICA SIMON. GOOD MORNING SUPERVISORS AND THANK YOU FOR LISTENING TO OUR CONCERNS LAST MONTH REGARDING THE 2026 SANTA CLARA COUNTY FAIR. SITUATION SURROUNDING THE FAIR HAS ONLY GROWN MORE CONCERNING. THE SUDDEN DATE CHANGE ANNOUNCED LONG AFTER ANIMALS WERE PURCHASED OR BRED FOR THE ORIGINAL LATE JULY SCHEDULE HAS CREATED SERIOUS CHALLENGES FOR YOUTH EXHIBITORS. SELECTED IN SEPTEMBER BASED ON THE FAIR'S ORIGINAL TIMELINE. NOW WITH THE FAIR PUSH TO MID-AUGUST, EXHIBITORS ARE BEING TOLD THEIR ANIMALS MAYBE OVERWEIGHT OR THEY SHOULD HOLD THEM. WATER TO MAKE WEIGHT. IT PLACES YOUNG PEOPLE IN AN IMPOSSIBLE POSITION CREATED BY BOARD PLANNING. THE FAIR'S FUTURE IS UNCERTAIN. WITHOUT TRANSPARENT MANAGEMENT, WE RISK LOSING THE LONG-STANDING COMMUNITY GENERATIONS OF YOUTH.

HELLO, BOARD. I'M VICE PRESIDENT OF SEIU 521 IN THE SANTA CLARA COUNTY. I'M A HEALTHCARE WORKER. I'M HERE BECAUSE I'M CONCERNED ABOUT THE ALMOST 200 POSITIONS THAT THE COUNTY WANTS TO DELETE. SOME OF THOSE BEING FILLED. YESTERDAY, I READ THAT ONE OF THE CORE VALUES OF SANTA CLARA COUNTY IS COMMIT TO EFFICIENT, EFFECTIVE, QUALITY SERVICE. HOW THE SOON, THE POPULATION THAT WE SERVE EXPECT THAT WHEN WE ARE GUTTING THE HANDS OF THE PEOPLE WHO ARE PROVIDING SUCH SERVICES? HEALTHCARE WORKERS LIKE MYSELF. BECAUSE THIS DECISION CAN AND WILL BECOME A DARK MOMENT FOR THE FUTURE HEALTHCARE OF EVERY FAMILY IN OUR COMMUNITY. PLEASE DO NOT FORGET THE DUTY THAT WE HAVE AND WE OWE THEM. THANK YOU SO MUCH.

I LIKE TO CALL FORWARD THE REST OF OUR SPEAKERS. PLEASE GO AHEAD.

GOOD MORNING. WITH THE INTEGRATED CARE TEAM WITH THE HEALTH AND HOSPITAL SYSTEM. WE HAVE NOT BEEN TOLD WHERE WE ARE GOING. AS A PILOT TO ADDRESS SYSTEM GAPS AFFECTING THE MOST VULNERABLE PATIENTS. THESE INDIVIDUALS HAVE EXECUTIVE FUNCTIONING IMPAIRMENTS ILLNESS, SUBSTANCE USE DISORDERS AND COMPLEX MEDICAL NEEDS. THEY DO NOT FAIL SERVICES DUE TO LACK OF MOTIVATION. ARE BROKEN. ACROSS HOSPITALS, CUSTODY, COURT AND THE COMMUNITY ENSURING CARE PLANS ACTUALLY HAPPEN. THE PILOT REVEALED ERSISTENT GAPS AND CRISIS WHEN SUPPORT IS WITHDRAWN. DISENGAGEMENT. PRESERVE THE INTEGRATED CARE TEAM AND ITS POSITIONS WHILE FUNDING ALIGNMENT IS EXPLOREED.

I WANT TO SAY, THANK YOU FOR THE COMMENTS AND THE ONE THING IS THAT THIS PORTION FOR THE PROCEDURE PURPOSES, THIS IS REALLY ONLY TALKING ABOUT ITEMS NOT ONLY THE AGENDA TODAY. YOU TALK ABOUT THE BUDGET SECTION ITEM NUMBER 13. WHICH WE WILL BE HEARING LATER. SINCE YOU SPOKE IT NOW, YOU WON'T BE ABLE TO SPEAK LATER. WE HEARD YOU LOUD AND CLEAR. I WANT TO MAKE SURE EVERYBODY KNOWS THIS PORTION NOT TO TALK ABOUT THE BUDGET AND TALK ABOUT THING NOT ON THE AGENDA TODAY.

GOOD AFTERNOON. SPECIALIST WITH THE INTEGRATED CARE TEAM. EXPERIENCING HOMELESSNESS, JUSTICE INVOLVEMENT AND COMPLEX MEDICAL AND BEHAVIORAL HEALTH NEEDS. MENTAL HEALTH SERVICES YET CONTINUE TO STRUGGLE. NOT DUE TO LACK OF EFFORT BECAUSE OF THEIR NEED EXTEND BEYOND MENTAL HEALTH ALONE. EXISTING PROGRAMS. ADDED LAYER OF COORDINATION. BECAUSE WE ARE INTERNAL TO THE COUNTY HEALTH AND HOSPITAL SYSTEMS, WE CAN ACCESS MEDICAL RECORDS AND DISCHARGE PLANS THAT OTHERS CANNOT. TREATMENT WHILE WE STABILIZE THE FOUNDATION. STOPGAP. BACK IN THE EMERGENCY ROOMS OR CUSTODY. PRESERVE THIS TEAM SO WE CONTINUE TO SUPPORT CLIENTS AND EXISTING PROGRAMS. I WILL TURN IT OVER TO MY NURSE PRACTITIONER, TAMMY. I'M THE NURSE PRACTITIONER WITH THE ISCT TEAM. PATIENT ON OUR CASE LOAD ARE MEDICALLY FRAGILE, TERMINALLY ILL AND REQUIRE A LEVEL OF COORDINATION. PATIENTS SHOWED A SIGNIFICANT REDUCTION IN EMERGENCY VISITS, CUSTODY STAYS, EPS VISITS, REPRESENTING A SUBSTANTIAL COST AVOIDANCE. INCREASE COST TO THE COUNTY. INSTEAD, WE CAN BUILD AN EXPAND. THERE'S CURRENTLY NO TEAM PREPARED TO SAFELY ABSORB THESE PATIENTS IF THE PROGRAM IS ELIMINATED, PATIENTS NOT TO CRISIS AND SOME WILL DIE. PRESERVE THE INTEGRATED CARE TEAM INTACT AND RELOCATE TO A CLINIC WHERE WE CAN CONTINUE TO TAKE CARE PATIENTS ENTRUSTED TO US WHILE RESPONSIBLE SOLUTIONS ARE EXPLORED. A MEDICAL HOME WILL ALLOW US TO BUILD, GENERATE REVENUE.

I'M A HEALTHCARE WORKER AND THIS IS ONLY TIME I HAVE TO SPEAK. AND OPERATIONAL REALITY OF THIS DECISION. IF LBN POSITIONS ARE ELIMINATED THE WORK WILL NOT DISAPPEAR. R.N.s WILL BE REQUIRED TO MEET DEMAND. DEPARTMENT'S BUDGET BECAUSE R.N. COST SIGNIFICANTLY MORE THAN LBNs. DECISIONS THAT WERE NOT REDUCED BEFORE CUTTING LBNs. THE DEPARTMENT CONTINUED PAYING A MANAGER WHO'S REMOVED FOLLOWING AN INVESTIGATION AND HEALTH. BUDGET. REDUCED BEFORE ELIMINATING THE LOWEST COST LICENSE STAFF. THIS IS NOT BUDGET REDUCTION. IT'S BUDGET DISPLACEMENT. IT PUTS SAFETY ND COMPLIANCE AT RISK.

THANK YOU. AGAIN, I WANT TO MAKE SURE. WE ARE NOT YET TALKING ABOUT THE BUDGET ITEM. SHOULD SPEAK AT THE ITEM NUMBER 13. BUDGET ITEM NOW DURING THIS PERIOD, YOU WILL NOT BE ABLE SPEAK AGAIN LATER. UNDERSTAND THAT.

HI, EVERYONE. SPEAK. ELIMINATING ALL LBN POSITION IS BEING PRESENTED AS A BUDGET DECISION. PATIENT SAFETY. COUNTY HOSPITAL. AND VOLUNTEER, STAFF, IMMUNIZED TB TESTED AND MASK COMPLAINT AND COMMUNICABLE DISEASE EXPOSURE. CUTTING FRONT LINE STAFF CREATES RISKS AND TESTING AND RAISES RISK OF WORKPLACE TRANSMISSION. SERVICE HAVE BEEN REDUCEED. RESULTING IN SLOWER RESPONSE TIMES AND REDUCED ACCESS. FURTHER CUTS WILL WORSEN THESE DELAYS. POSITIONS TO BE REMOVED. WE RESPECT OUR R.N. COLLEAGUES. WE'RE QUESTIONING HOW LBN IS THE MOST COST EFFECTIVE LICENSE STAFF IMPROVES THE BUDGET WHEN THE WORKLOAD REMAINS. THANK YOU.

GOOD MORNING. CENTER. I'M HERE TO READ A STATEMENT ON BEHALF OF COURTNEY. BEFORE THE INTEGRATED CARE TEAM CAME INTO MY LIFE, I HAD BEEN LIVING ON THE STREETS FOR SEVERAL YEARS. I THOUGHT THAT THAT'S WHERE I BELONG. I LOST EVERYTHING IN 2021 INCLUDING MY APARTMENT. SINCE THEN, THE TEAM HAS BEEN IN MY LIFE EVERYTHING HAS CHANGED FOR ME. LIFE. LOST AND I WANT TO LIVE. I HAVE NEVER HAD A EAM LIKE THIS. MY DAD AND I ARE BEST FRIENDS. I WAS ABLE TO WALK THROUGH THE DEATH OF MY GRANDMA BEING SOBER AND WITH THE SUPPORT OF THIS TEAM. THE PROGRAM WORKS. PLEASE RECONSIDER, COURTNEY. THANK YOU.

GOOD MORNING. 521. THIS TRUST IN GOVERNMENT IS ALL-TIME HIGH. IMPACT ON WORKING FAMILIES. IT IS VITAL THAT YOU ENGAGE WITH US AND COMMUNICATE OPENLY ABOUT THE CHOICES TO BE MADE. TRANSPARENCY IS NOT AN OPTION, IT'S ESSENTIAL TO REBUILDING THAT TRUST. WE DESERVE TRANSPARENCY WHEN IT COMES TO HOW OUR MONEY IS BEING USED AND THE IMPACT OF YOUR DECISIONS ON OUR LIVES. AGAIN, WE ARE HERE TO MAKE SURE VOICES ARE HEARD AND THAT YOU PRIORITIZE ACCOUNTABILITY AS KEY PART OF YOUR LEADERSHIP. THANK YOU.

LAST CALL FOR JUSTIN FOX, GAVIN MARTINEZ AND SEAN. JUSTIN FOX, PLEASE COME OVER TO BOARD CHAMBERS TO GIVE YOUR PUBLIC TESTIMONY. IS THAT YOU?

FOR THE SPEAKERS, IF OFF STATEMENT YOU LIKE TO PRESENT YOU CAN GIVE IT TO OUR CLERK. WE'LL ADD IT TO OUR RECORD. THANK YOU SO MUCH.

HI.

WE ANNOUNCED NAME -- THANK YOU, GOOD MORNING. FOR ITSELF. PROGRAM. BECAUSE GETTING PEOPLE SOBER WHILE THEY ARE HOUSED, THERE'S NO POINT GETTING PEOPLE SOBER AND RETURN THEM TO THE STREETS. THAT'S JUST USELESS. ACTION DIRECT ACTION NOT SAY SOMETHING BUT ACTUALLY TAKE ACTION. ARE BEING SWEPT AND SWEPT. TAKING THESE PEOPLE TO JAIL OVER AND OVER, EXPOSING PEOPLE WHO MAY BE UNDOCUMENTED TO JAIL IS POINTLESS. CONVICTED CRIMINALS IS POINTLESS. PEOPLE IN JAIL FOR STUPID TICKET LIKE TRESPASS OR LOITERING. SAY NO. BY AN IDIOT MAYOR WHO WANTS TO BE GOVERNOR. PEOPLE IN JAIL FOR TRESPASS. IF YOU NEED A WHISTLE. I GOT THEM. PUBLIC SPEAKERS. PLEASE UNMUTE.

HELLO, GOOD MORNING. DOES NOT CARE ABOUT CHILD MOLESTATION CASES. CHARGES AGAINST GILROY WOMAN HE DROPPED CHARGES LAST YEAR AGAINST PALO ALTO MIDDLE SCHOOL HE BOTCHED A CASE LAST MONTH AGAINST SAN JOSE YOUTH PASTOR THE PERSON WHO MOLESTED HIM, HE'S BEEN ON THE CASE FOR FOUR YEARS. BECAUSE OF THE SMALL CHILD'S MY OWN CHILDREN ARE BEING MOLESTED. SEXUAL ABUSE OF MY KIDS. GOOGLE D.A. JEFF ROSEN SEX TRAFFICKING.

THANK YOU SO MUCH. WE CAN MOVE THROUGH THE CONSENT CALENDAR AND CHANGES TO THE BOARD SUPERVISOR AGENDA. TO THE CONSENT CALENDAR.

THANK YOU. LEE AND SUPERVISOR ABE-KOGA TO CONSIDER ITEMS NUMBER 13, 14 AND 15 CONCURRENTLY. ITEM NUMBER 13, CONSIDER RECOMMENDATIONS FOR RELATING TO THE FISCAL YEAR FY 2025-2026 MID-YEAR BUDGET REVIEW. 14 IS ADOPTION OF SALARY ORDINANCE NUMBER NS-20.25.04. DELETEST TREATING VARIOUS TAX COLLECTIONINGS, OFFICE THE ASSESSOR, VALLEY HEALTH PLAN, FACILITIES AND FLEET DEPARTMENT AND SANTA CLARA COUNTY NUMBER 11 RELATING TO COMPENSATION FOR THE UNCLASSIFIED ASSISTANT ASSESSOR CLASSIFICATION. ORDINANCE NUMBER NS-5.26.42. DELETING AND ADDING VARIOUS POSITIONS PART OF THE FISCAL YEAR 2025-2026 MID-YEAR BUDGET REVIEW. UNCERTAIN. SITE LETTER AGREEMENT WITH COUNTY EMPLOYEES MANAGEMENT ASSOCIATION, CEMA, AMENDING ARTICLE 2 SECTIONS 2.5 AND 2.6 OF THE MEMORANDUM OF AGREEMENT WITH CEMA DATED JUNE 24th, 2024 THROUGH DECEMBER 19, 2027. ADDING NURSE LONGEVITY PAY AND ALIGNING THE NMIC CLASSIFICATION SALARY AND STEP SYSTEM WITH OTHER NURSE MANAGER CLASSIFICATIONS REPRESENTED BY CEMA. ORDINANCE NUMBER N -- RETITLEING THE NURSE MANAGEMENT INFECTION CONTROL AND ALIGNING TO THE SAME SALARY AND STEP SYSTEM AS ALL OTHER NURSE MANAGER CLASSIFICATIONS. THERE'S A CORRECTIONS TO ITEM NUMBER 52J. ITEM NUMBER 52J, ADOPT COMMENDATION RECOGNIZING STEAM AT STIPE ELEMENTARY SCHOOL AND PROMOTING APPRECIATION ON THE OCCASION OF THE 2026 LUNAR NEW YEAR. ADMINISTRATION TO HOLD ITEM NUMBER 57 TO FEBRUARY 24, 2026. ITEM NUMBER 57 IS TO CONSIDER RECOMMENDATIONS RELATING TO A COST SHARING AGREEMENT WITH THE CITY OF SAN JOSE REGARDING THIS CONCLUDES OUR CONSENT CALENDAR UPDATE.

THANK YOU. SEE IF THERE'S ANY MORE FURTHER CHANGES TO THE CONSENT. ANY QUESTIONS ON THOSE? YES, SUPERVISOR ELLENBERG? I WANT TO MAKE A COMMENT ON ITEM 38. COLLABORATING WITH THE CITY OF CAMPBELL. AUTHORITY AND CHARITIES HOUSING. TO THE BRING ANOTHER AFFORDABLE DISTRICT. AS STAFF'S FILE MENTIONS, OUR CONTRIBUTION WILL HELP FACILITATE THE CREATION OF 91 NEW AFFORDABLE HOUSING UNITS. INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES. 30 UNITS FOR UNHOUSED VETERANS AND 51 UNITS FOR HOUSEHOLDS ACROSS THE AREA MEDIUM INCOME SPECTRUM. I'M SO PLEASED TO SEE THE EXPANSION OF OUR AFFORDABLE CONTINUE TO FOLLOW THIS PROJECT AS COMMUNITY ENGAGEMENT AND THE DEVELOPMENT OF THE PROPERTY GET UNDER WAY. THANK YOU.

THANK YOU.

I'M HAPPY TO SECOND THE MOTION THROUGH THE CONSENT I DO HAVE A COMMENT. BRIEF COMMENTS ON ITEM 33. I WANT TO APPRECIATE ADMINISTRATION FOR BRINGING THIS ITEM FORWARD, 33 AND 34. REGARDING BUDGET RESERVE POLICY, I WISH THE POLICY HAVE BEEN IN PLACE DECADES PASSED. IT WOULD BE LESS SEVERE. I'M PROUD THIS BOARD IS TAKING THE OPPORTUNITY TO ENSURE FUTURE BOARDS WON'T FACE ALL THE SAME CHALLENGES OR MUCH AS POSSIBLE MITIGATE THE SAME CHALLENGE. IT WILL TAKE US TIME TO GET TO WHERE WE NEED TO BE. EVEN WITH THE ACCELERATED RESERVE POLICY, I DID THE MATH. I'LL BE 75 YEARS OLD WHEN WE REACH OUR RESERVE TARGET GOAL. ONE STEP AT A TIME. BETTER LATE THAN NEVER. NOW MORE IMPORTANT THAN EVER. I KNOW THAT OUR ADMINISTRATION WILL ACTIVELY PURSUE OPPORTUNITIES WHENEVER IT AVAILSITE TO -- ITSELF TO THE AD MORE TO THE RESERVE. THEIR FUTURE INTO ACCOUNT, WE DID. INTERGENERATIONAL EQUITY IS AND GRANDCHILDREN. AGENDA ITEM. NOT REALLY BUDGETARY EXCITING THING, THIS IS THE TYPE OF PLOT TWIST WE NEED TO SECURE THE FUTURE. THANK YOU.

THIS IS COMMENT N ITEM 47. THIS IS AN ITEM THAT WAS -- THAT IS A GRANT ROM THE DISTRICT ATTORNEY. SORRY, LET ME CLARIFY. CAN I ASK THE CLERK. THIS IS ON CONSENT, CORRECT? OKAY, SORRY. I WAS JUST SECOND GUESSING MYSELF FOR A MINUTE THERE. THIS IS THE BURN STATE CRISIS INTERVENTION GRANT PROGRAM. I THINK IT'S VERY ADMIRABLE FOR OUR D.A. TO BEGIN TO USE GRANTS TO PAY FOR SOME OF THE POSITIONS THAT MAY BE AT PERIL. WE HAVE A REDUCTION. WE HAVE A DEFICIT. WE MUST REDUCE. I KNOW THAT THEY HAVE -- HIS GRANT IS MEANT TO HELP FOLKS IMPLEMENT STATE GUN CRISIS INTERVENTIONS IN COURT PROCEEDINGS RELATED PROGRAMS INITIATIVES. GOING TO USE THIS TO MAY BE PROCESS MORE PROP 36 CLIENTS. I WANTED TO MAKE THAT NOTICE MYSELF THAT THE CAMP -- THE PROGRAM THAT HE FOCUSED ON IS ABOUT KEEPING NONVIOLENT MENTALLY ILL AND HOMELESS OUT OF OUR JAIL SYSTEM AND GETTING THEM TO CARE. THAT HAS VERY LITTLE TO FIREARM RELINQUISHMENT. USE IN TERMS OF HAVING EXTERNAL GRANTS COME IN, THIS IS MEANT TO BE REDUCING GUN VIOLENCE. IT'S ALSO BEING UTILIZED, AT LEAST IT'S STATED TO BE UTILIZED TO PROCESS MORE PROP 36 CLIENTS. I DISAGREE WITH THAT PURPOSE. I WANTED TO JUST PUT IT IN PUBLIC COMMENT AND MAKE SURE THAT I HAVE THAT STATEMENT AS WELL AS ASKING OUR COUNTY EXECUTIVE TO CONTINUE TO USE, UTILIZE EXTERNAL GRANTS TO FILL SOME OF THE HOLES THAT WE'LL HAVE IN OUR SYSTEM IN THE SAME WAY THAT THE D.A. IS DOING IN ITEM 47. THANK YOU.

THANK YOU. LET OPEN UP THE PUBLIC COMMENT. ANY PUBLIC COMMENT REGARDING THE CONSENT ITEMS?

I CURRENTLY HAVE NO PUBLIC

LET CLOSE THE QUEUE ON THAT. WE GOT A MOTION. WE GOT A SECOND. TAKE THE ROLL. [ROLL CALL VOTE] MOTION CARRIES 5-0.

THANK YOU. WHICH IS THE QUARTERLY REPORT RELATING TO MENTAL HEALTH AND SUBSTANCE USE AS A PUBLIC HEALTH CRISIS.

GOOD MORNING, MEMBERS OF THE BOARD. HEALTH COMING FORWARD FOR THIS PRESENTATION. MAIN FOCUS OF THIS MONTH'S QUARTERLY REPORT IS A BUDGET STUDY SESSION RELATED TO BHSD AND FUNDING STREAMS. IT'S GOING WITH THE THEME OF TODAY, A VERY SOBERING REPORT THAT OUTLINES HOW WE ARE BEING HIT WITH A LITANY OF NEGATIVE FUNDING CHANGES ACROSS EVERY SINGLE ONE OF BEHAVIORAL HEALTH'S CRITICAL FUNDING STREAMS WITH VERY UNFORTUNATE TIMING OF STATE DIRECTED CHANGES, PILING ON TOP OF FEDERAL CHANGES. THE SLIDES TO COME. CONVERSATION WITH THAT. I WILL TURN IT OVER TO SHERRY TO KICK THINGS OFF.

GREAT, GOOD MORNING, BOARD OF DIRECTOR WITH OUR BEHAVIORAL HEALTH SERVICES DEPARTMENT. TODAY'S FOCUS WILL BE BUDGET OVERVIEW STUDY SESSION. INFORMATION TO ALL OF YOU. THIS IS A LIST OF OUR MOST RECENT REPORTS THAT WE PROVIDED SINCE OUR LAST QUARTERLY REPORT IN NOVEMBER. TODAY, WE WANTED TO PROVIDE BUDGET OVERVIEW ROAD MAP FOR EACH OF YOU. WE WILL BE PROVIDING INFORMATION ON THE ROLE OF COUNTIES AS THE BEHAVIORAL HEALTH PLAN FOR MEDI-CAL BENEFICIARIES AND OTHER INFORMATION THAT WILL HELP INFORM ALL OF US AROUND OUR CURRENT BUDGET AND OUR FISCAL PLANNING FOR FISCAL YEAR '27. AS AN INTRODUCTION TO OUR BUDGET PRESENTATION, WE THOUGHT WOULD BE HELPFUL TO HAVE A SHARED UNDERSTANDING OF THE ROLE OF COUNTIES AS THE BEHAVIORAL HEALTH PLAN FOR MEDI-CAL BENEFICIARIES. BHSD HAS BEEN CONTRACTING WITH AURRERA HEALTH GROUP. WE THANKFUL FOR THEIR GUIDANCE AND EXPERTISE. TURN IT OVER TO JILL.

HI. I'M JILL DONNELLY. MANAGING PRINCIPLE AT AURRERA HEALTH GROUP. BASED IN SAN FRANCISCO. WE DO A LOT OF WORK WITH THE DEPARTMENT OF HEALTHCARE THROUGHOUT THE STATE HELPING THEM INTERPRET FEDERAL AND STATE OBLIGATIONS AND HOW THOSE ARE OPERATIONALIZED ON THE GROUND. THE PURPOSE OF MY PRESENTATION TODAY IS TO RELEASE SET OF FOUNDATION BOTH FOR THE BOARD COUNTY BEHAVIORAL HEALTH OPERATES WITHIN CALIFORNIA EASE MEDICAID PROGRAM, MEDI-CAL. BEHAVIORAL HEALTH IS ONE OF THE HEALTHCARE SYSTEM. FOR HOW IT'S GOVERNED. SANTA CLARA'S BEHAVIORAL HEALTH PLAN EXIST TO SERVE PEOPLE WITH SERIOUS MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. NEEDS ARE THE MOST COMPLEX AND REQUIRE THE MOST SUSTAINED AND COORDINATED CARE. SANTA CLARA BEHAVIORAL HEALTH IS THE SAFETY NET FOR THESE FOLKS. WHEN MANAGED CARE PLANS WHEN COMMERCIAL INSURANCE, WHEN COMMUNITY, INFORMAL SUPPORTS AREN'T SUFFICIENT, THE COUNTY IS THERE TO CATCH THEM. WE CAN GO TO HE NEXT SLIDE. I WANT TO START JUST WITH A 10,000-FOOT VIEW OF WHAT WE'RE TALKING ABOUT. TWO PRIMARY COMPONENTS. YOU CAN SEE THEM AT THE BOTTOM OF THE SCREEN THERE. THE FIRST IS THE ENTAL HEALTH PLAN AND THIS IS THE HEALTH PLAN THAT COVERS FOLKS WITH THOSE SERIOUS SPECIALTY MENTAL HEALTH NEEDS. MEDI-CAL ORGANIZEED DELIVERY SYSTEM WHICH PROVIDES SUBSTANCE USE DISORDER SERVICES. THE WAY THIS WORKS IS THAT SANTA CLARA COUNTY CONTRACTS WITH THE CALIFORNIA DEPARTMENT OF STATE AND THIS IS PART OF THE STATE'S MEDI-CAL PROGRAM. ARE REQUIRED TO ARRANGE FOR AND ENSURE ACCESS TO SERVICES WHEN A MEDI-CAL MEMBER PRESENTS WITH A SERIOUS MENTAL ILLNESS OR SUBSTANCE USE DISORDER. MEMBER IS FOUNDATIONAL. IT MEANS THAT COUNTIES AREN'T JUST RESPONSIBLE FOR FUNDING THOSE SERVICES. FOR ENSURING THAT A FUNCTIONAL SYSTEM EVEN EXISTS. ARE THERE BEDS? ARE THERE PROVIDERS? IS THERE A CRISIS RESPONSE TEAM? IS CARE COORDINATION AVAILABLE? WHATEVER THAT MEMBER NEEDS TO SERVE THEM. ABOUT WHO'S ELIGIBLE FOR THESE SERVICES. IN CALIFORNIA, MEDI-CAL BEHAVIORAL HEALTH SERVICES ARE INTENTIONALLY DIVIDED BASED ON THE SEVERITY AND COMPLEXITY OF A MEMBER'S NEEDS. ARE REFERRED AS MILD TO MODERATE NEEDS. SERVICES WERE PROVIDED THROUGH CLARA, THAT SANTA CLARA FAMILY THESE ARE SERVICES LIKE GROUP THERAPY, LIKE PSYCHOLOGICAL TESTING. OTHER OUTPATIENT MENTAL HEALTH SERVICES. SIGNIFICANT SPECIALTY MENTAL HEALTH SERVICES OR SUBSTANCE USE DISORDER SERVICES, THE RESPONSIBILITY SHIFTS TO THE COUNTY. ENSURE THAT THE MOST COMPLEX AND HIGH ACUITY NEEDS ARE REALLY MET IN THE COMMUNITY WITH SPECIALIZED AND LOCAL EXPERTISE. AT THE SAME TIME, THIS MEANS THAT THE COUNTY CANNOT SIMPLY STEP IN TO FILL GAPS APS GAPS TG MANAGED CARE PLAN WITHOUT CREATING FINANCIAL AND COMPLIANCE RISK. LET TALK A LITTLE BIT MORE ABOUT WHAT THESE SERVICE LOOK LIKE. WHEN SOMEONE QUALIFIES THROUGH THE COUNTY MENTAL HEALTH PLAN, THEY CAN RECEIVE SERVICES SUCH AS RESIDENTIAL TREATMENT, INTENSATIVE CARE COORDINATION OR THERAPEUTIC FOSTER CARE AND DESIGNED FOR FOLKS WITH SIGNIFICANT FUNCTIONAL IMPAIRMENT. SYSTEMS. UNDER DMCODS. THAT'S THE DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM, INDIVIDUALS WITH SUBSTANCE USE DISORDERS, MIGHT RECEIVE CRISIS INTERVENTION, RESIDENTIAL WITHDRAWAL MANAGEMENT. ADDICTION TREATMENT. THIS IS JUST A SAMPLELY. THESE ARE AMONG THE MOST RESOURCE INTENSIVE SERVICES IN HEALTHCARE. ACCESS TO THEM FOR ELIGIBLE MEMBER. THIS MEANS MAINTAINING THE INFRASTRUCTURE NEEDED TO DO CAPACITY AND OVERSIGHT. THIS IS REGARDLESS OF DEMAND OR COST. TALKING LITTLE BIT MORE HOW THESE SERVICES ARE FUNDED. I COULD KEEP YOU HERE ALL DAY TALKING ABOUT THE COMPLEXITY OF HOW COUNTY BEHAVIORAL HEALTH IS FUNDED. FUNDING SOURCES THAT REALLY SHAPE THE COUNTY'S ROLE. THE FIRST IS THE 1991 AND 2011 REALIGNMENTS. THE COUNTIES. ALONG THAT CAME A WHOLE HAND FULL OF ONG-TERM FISCAL AND OPERATIONAL OBLIGATIONS. THOSE REALIGNMENTS FUNDAMENTALLY CHANGED THE RELATIONSHIP BETWEEN CALIFORNIA THE STATE AND THE COUNTY. OPERATORS OF SPECIALTY BEHAVIORAL HEALTH. BHSSA OR THE BEHAVIORAL HEALTH SERVICES ACT REPLACED MHSSA. IT SIGNIFICANTLY RESTRUCTURED THE COUNTY'S BEHAVIORAL HEALTH FUNDING. AMONG OTHER THINGS, HSSA REPURPOSED A PANEL PORTION OF -- SUBSTANTIAL PORTION. PRIORITIES BUT ALSO IT CHANGED THE BALANCE FLEXIBLE FUNDING AND MANDATED SERVICE DELIVERY FOR THE COUNTIES. BIG PICTURE HERE. FUNDING CHANGES ALL THE TIME IN VERY SIGNIFICANT WAYS BUT THOSE COUNTY OBLIGATIONS REMAIN THE SAME. THEY REMAIN THERE TO SERVE THOSE WITH MOST SERIOUS MENTAL HEALTH AND NEEDS. LET'S TALK A LITTLE BIT ABOUT WHERE THESE REQUIREMENTS ORIGINATE AND HOW THEY FLOW DOWN TO THE COUNTY. BEHAVIORAL HEALTH PLANS ARE SUBJECT TO REQUIREMENTS THAT ORIGINATE AT THE FEDERAL STATE OF CALIFORNIA AND FINALLY PASSED ON TO THE COUNTIES TO OPERATE ALSO -- OPERATIONALIZE THOSE REQUIREMENTS. FINANCIAL COMPLIANCE, QUALITY REQUIREMENT. AND NEGOTIATING THEIR WAIVERS WITH CMS. DETERMINING WHO'S ELIGIBLE ONCE THAT'S IN PLACE, THE STATE IS CONTRACTING WITH COUNTIES WHO HAVE VERY LITTLE SAY IN THOSE OBLIGATIONS AND REQUIREMENTS BUT WHO ARE OBLIGATED TO IMPLEMENT THEM AND TO OPERATIONALIZE THEM. THIS DISTINCTION MATTERS COUNTIES ARE HELD ACCOUNTABLE. COUNTIES CANNOT EASILY OPT OUT. WE CAN GO TO THE NEXT SLIDE. THESE ARE SOME EXAMPLES OF SOME OF THE REQUIREMENTS THAT COUNTIES HAVE TO OPERATE UNDER. THESE ARE VERY CONCRETE IN THE LAW AND IN POLICY. THEY HAVE TO MEET THINGS LIKE TIMELY ACCESS TO CARE, NETWORK ADEQUACY, PROVIDER MONITORING, QUALITY OVERSIGHT AND MEETING THESE STANDARDS REQUIRES SUSTAINED INVESTMENT IN THINGS LIKE STAFFING IN SYSTEMS AND OVERSIGHT PROSSES. WHEN THESE STANDARD AREN'T MET, CONSEQUENCES INCLUDE THINGS LIKE CORRECTIVE ACTION PLANS, FINANCIAL SANCTIONS AND PAYMENT WITHHOLDS. ENFORCEMENT HAS ONLY INCREASED IN RECENT YEARS AND SCRUTINY OF COMPLIANCE IS GROWING. THESE AREN'T THEORETICAL RISKS. THEY ARE HAPPENING NOW. ARE OPERATING AND REORGANIZING. I'M GOING TO TALK A LITTLE BIT MORE ABOUT THESE FISCAL AND COMPLIANCE RISKS. FIRST I WANT TO SAY ALL OF THIS IS HAPPENING IN A PERIOD OF POLITICAL AND FISCAL UNCERTAINTY. COUNTIES ARE NAVIGATING. STATE BUDGET PRESSURES AT THE PROGRAM IS INCREASING. THIS COMBINATION OF THAT STATE BUDGET PRESSURE AND FEDERAL PRESSURE MEANS THAT COUNTIES HAVE LESS MARGIN FOR ERROR THAN THEY HAVE IN THE PAST. I'M GOING TO HIGHLIGHT JUST A COUPLE OF EXAMPLES SOME OF THE FINANCIAL SANCTIONS IN RECENT HISTORY. DEPARTMENT OF HEALTHCARE CARE PLANS $1.6 MILLION IN 2022. THEY FINED L.A. CARE MELT PLAN $55 MILLION FOR FAILING TO MEET FEDERAL TIMELY ACCESS TO CARE REQUIREMENTS. YOU SAY THOSE ARE HEALTHCARE PLAN EXAMPLES. IN CALIFORNIA TODAY, COUNTY BEHAVIORAL HEALTH PLANS ARE BEING REQUIRED TO MOVING INTO FUNCTIONING AS FULLY OPERATIONAL HEALTH PLANS. FOR COUNTY BEHAVIORAL HEALTH PLANS. OF SCRUTINY AND THE USE OF FINANCIAL SANCTIONS WILL INCREASINGLY APPLY TO COUNTIES AS WELL. IN FACT, IN 2025, DHCS ISSUED CORRECTIVE ACTION PLANS. ENFORCEMENT WILL BEGIN IN UPCOMING YEARS. I WANT TO PULL TOGETHER ALL OF THAT CONTEXT. SANTA CLARA'S BEHAVIORAL HEALTH PLAN, AGAIN, THAT ENTITY THAT IS SERVING THOSE WITH SERIOUS MENTAL ILLNESS AND SUBSTANCE USE DISORDER IS THE EXECUTER OF VISION AND SET OF RULES THAT ARE DETERMINED AT THE FEDERAL AND STATE LEVEL. CONTRACTUAL AND THEY REQUIRE SIGNIFICANT ONGOING PROVIDER NETWORKS, CRISIS RESPONSE CAPACITY, QUALITY AND UTILIZATION MANAGEMENT, DATA SYSTEMS AND STAFFING WITH SPECIALIZED EXPERIENCE. WORK IS COMPLEX. IT IS LESS FLEXIBLE THAN EVER BEFORE. OBLIGATIONS DO NOT. ALL OF THIS IS HAPPENING AT A TIME OF SIGNIFICANT UNCERTAINTY COUNTIES ARE NAVIGATEING TO ESCAPE BUDGET PRESSURES. THIS COMBINATION MEANS COUNTIES HAVE LITTLE ROOM FOR ERROR. IN THIS ENVIRONMENT, STAYING TIGHTLY ALIGNED WITH CORE MANDATED SERVICES IS NOT A PROGRAMMATIC CHOICE. TO PRESERVE ESSENTIAL SERVICES AND THEIR ROLE AS THE SAFETY NET FOR RESIDENTS WITH THE MOST SERIOUS MENTAL HEALTH AND SUBSTANCE USE NEEDS WHO HAVE NOWHERE ELSE TO GO.

THANK YOU.

THANK YOU SO MUCH, JILL. WE APPRECIATE YOU PROVIDING THAT FOUNDATIONAL SETTING FOR US AS WE MOVE THROUGH OUR PRESENTATION. THE ENTIRE PRESENTATION AND THEN OPEN UP FOR QUESTIONS AT THE END.

THIS SLIDE REPRESENTS THE WIDE ARRAY OF PROGRAMMING THAT THE BEHAVIORAL HEALTH SERVICES DEPARTMENT PROVIDES. MANDATED AND NONMEN NON-MANDATED CATEGORIES. FAILURE WILL RESULT IN STATE FINE AND SANCTIONS. OFFERED IS VERY ROBUST WITH PROGRAMS INCLUDING, FOR EXAMPLE, OUR OUTPATIENT SERVICES, INTENSATIVE SERVICES, CRISIS STABILIZATION, RESIDENTIAL, OUR SUBSTANCE USE TREATMENT SERVICES INCLUDING WITHDRAWAL MANAGEMENT, RESIDENTIAL TREATMENT AND ACUTE INPATIENT HOSPITAL SERVICES. THE NON-MANDATED PROGRAMS LISTED ON THE RIGHT ALSO SUPPORT OUR SYSTEM. THERE ARE ALSO SOME PART OF THESE PROGRAMS WITHIN THE PROGRAM CATEGORY THAT ARE MANHATTAN MANDATED. OUR EFFORT,S, BHSD ADDED HEALTH BEDS. WITHDRAWAL MANAGEMENT AND THE ADDITION OF THEE 263 BEDDING SERVE AN ADDITIONAL 2850 CLIENTS A YEAR. BEHAVIORAL HEALTH SERVICES DEPARTMENT HAS EXCEEDED OUR '24 IN THE AREAS OF FOLLOW-UP AFTER HOSPITALIZATION FOR CHILDREN AND AFTER EMERGENCY DEPARTMENT VISITS. THIS IS AN IMPORTANT METRIC AS WE KNOW THAT IMMEDIATE FOLLOW-UP POST HOSPITAL DISCHARGE AS A STRONG RELATIONSHIP WITH REDUCTION IN HOSPITAL READMISSIONS. DIRECTORRED ABOUT BOARD OF 25 -D 33,000 CLIENTS WITH 76% RECEIVING TREATMENT FOR SUBSTANCE ABUSE DISORDER AND 67% FOR MENTAL HEALTH PLANS. APPROXIMATELY 56% OF OUR LIENTS ARE LATINO. LATINOS ARE EQUALLY LIKELY TO HAVE SUCCESSFUL TREATMENT OTHER RACIAL AND ETHNIC GROUPS RECEIVING TREATMENT. WITH THE SUPPORT OF THE BOARD OF SUPERVISORS, BHSD HAS EXPANDED ACCESS TO SPECIALTY MENTAL HEALTH AND SUBSTANCE USE TREATMENT SERVICES SINCE FISCAL YEAR '22. OVERALL NUMBER OF CLIENTS SERVED SINCE THE LAUNCH OF CAL AIM IN FISCAL YEAR '24. AS A BOARD, YOU HAVE CONTINUED TO SUPPORT INCREASING ACCESS TO SUB ACUTE BEDS Y 24% SINCE 2022. SINCE FISCAL YEAR '22, WE HAVE SEEN A SHARP INCREASE IN ACUTE ADMISSIONS IN LINE WITH INPATIENT BED EXPANSION. I THINK IT'S SAFE TO SAY THAT THERE'S NO OTHER SYSTEM OR

POSSIBLY ANY OTHER COUNTY DEPARTMENT THAT IS EXPERIENCED AS MUCH CHANGE AS BEHAVIORAL HEALTH. THE MANY BEHAVIORAL HEALTH STATE REFORMS IMPACTING COUNTY AND 2025. OUR DEPARTMENT HAS REALLY BEEN TASKED WITH A DIZZYING AMOUNT OF STATE, HEALTH REFORMS IMPACTING BEHAVIORAL HEALTH.

SLIDE TO BRING SOME AWARENESS AND OBSERVATION. IF THERE'S ONE MESSAGE TO SEND, THE STATE, AS WAS EXPLAINED EARLIER IN THE PRESENTATION, REALLY PLAYS A KEY ROLE IN SETTING THE POLICY AND FUNDING STREAMS ASSOCIATED WITH BEHAVIORAL HEALTH. THIS SLIDE TO ME REALLY, IN ONE PICTURE, DEMONSTRATES THE BROADER STATEWIDE CHALLENGE IN FUNDING STRUCTURES AND FUNDING STREAMS. LAYER ON PROGRAM AFTER PROGRAM, MAKE NUMEROUS ADDITIONAL CHANGES AND MECHANISMS AND STRUCTURES FOR TREATMENT ALL AT THE SAME TIME. THIS IS ALL SINCE 2022. WITHOUT OPPORTUNITIES FOR ASSESSMENT AND EVALUATION, A LOT OF THESE, WITHOUT ACTUAL FUNDING OR CERTAINLY ADEQUATE FUNDING FOR IMPLEMENTATION. EACH LAYERING THEM ON OVER AND OVER AGAIN ON TOP OF EACH OTHER. YOU CREATE EXTRAORDINARY CHALLENGES FOR THE ACTUAL DELIVERY OF SERVICE, AND EACH OF THESE, ONE WAY OR THE OTHER, REPRESENTS MANDATES AND OBLIGATIONS IMPOSED ON COUNTIES ACROSS THE STATE BY THE STATE GOVERNMENT. IT'S WORTH PAUSING FOR A SECOND. SOME OF THESE ARE VERY SUBSTANTIAL SHIFTS, THESE CHANGES, INCLUDING COMPLETE REFORM OF HOW PAYMENT IS STRUCTURED ACROSS THE BEHAVIORAL HEALTH DELIVERY NETWORK. PROVIDER OF THESE SERVICES.

NOW, AS YOU WILL GET TO LATER IN THIS PRESENTATION, TO SEE THE SHIFT IN MAJOR STATE FUNDING STREAMS LAYERED ON TOP OF THAT, POSES JUST EXTRAORDINARY CHALLENGES FOR COUNTIES ACROSS THE STATE AND CERTAINLY FOR OUR COUNTY WHICH, AS YOU'LL SEE, HAS HISTORICALLY MADE DIFFERENT LOCALLY THAN WHAT THE STATE IS NOW DIRECTING COUNTIES TO DO.

>> THANK YOU SO MUCH, JAMES. WE CAN MOVE AHEAD TO THE NEXT SLIDE, PLEASE. THIS NEXT SECTION IS GOING TO BE A TRANSITION INTO DISCUSSION REGARDING OUR BEHAVIORAL HEALTH BUDGET.

BEHAVIORAL HEALTH FISCAL YEAR '26 EXPENDITURES BY SERVICE AND PROGRAM CATEGORY. HIGHLY CONCENTRATED IN OUTPATIENT, ACUTE, AND CRISIS SERVICES, WHERE OUR LOCAL FUNDING IS CONCENTRATED. SOME CASES, YOU WILL SEE THE BRIGHT BLUE BAR COVERING THE MAJORITY OF A SERVICE LINE, FOR EXAMPLE, IN HOUSING OR SUB-ACUTE OR OUTREACH AND PREVENTION. IN OTHER AREAS, SUCH AS OUTPATIENT, WILL YOU SEE THERE ARE OPTIONS TO CREATE EFFICIENCIES THROUGH EXPANDING AND BUILDING MEDI-CAL.

BOTH MARKET CONDITIONS AND INCREASING NEEDS AND OUR CURRENT FISCAL CHALLENGES. INCREASING COST FOR BEHAVIORAL HEALTH SERVICES, INCREASING RELIANCE ON COUNTY BEHAVIORAL WITH PRIVATE INSURANCE. WITH GROWING DEMAND FOR BLAIR HEALTH SERVICE -- BEHAVIORAL HEALTH SERVICES. IN ADDITION, THERE ARE ALSO KEY PRESSURES CONTRIBUTING TO OUR FISCAL ENVIRONMENT. UNCERTAINTY AROUND FUNDING, FUTURE FUNDING LEVELS, AND INCREASING ADMINISTRATIVE WORKLOADS. CHANGES REQUIRE SPECIFIC ALLOCATION PERCENTAGES OF FUNDING ACROSS DISTINCT SERVICE CATEGORIES. MOBILE CRISIS BENEFIT AND THE GOVERNOR'S BUDGET WHICH SHIFT RESPONSIBILITY FROM THE NONFEDERAL SHARE OF THE BENEFIT. WE WANTED TO NOTE THE IMPORTANCE OF OUR MOBILE CRISIS PROGRAMS AND HOW CRITICAL THEY ARE TO OUR COMMUNITY. STRENGTHEN THE COORDINATION ACROSS OUR CONTINUUM OF CRISIS. OUR FOCUS ON MAKING THESE PROGRAMS SUSTAINABLE.

THIS PIE CHART REPRESENTS OUR TOTAL ANTICIPATED FUNDING AVAILABILITY FOR FISCAL YEAR '26. ANTICIPATED EXPENDITURES OF $959 MILLION, EXCEED AVAILABLE FUNDING OF $893 MILLION, INDICATING A FUNDING GAP OF APPROXIMATELY $66 MILLION. THAT THIS CHART ILLUSTRATES A HISTORICAL OVERVIEW OF OUR BEHAVIORAL HEALTH SERVICES DEPARTMENT BUDGET. INCREASING RAPIDLY SINCE THE DECLARATION OF THE PUBLIC HEALTH. OUR CURRENT FINANCIAL POSITION INCLUDES IMPLEMENTATION OF PAYMENT REFORM. SERVICE EXPANSION AND ANNUAL RATE STRUCTURE INCREASES HAVE SIGNIFICANTLY INCREASED PAYMENTS, CONTRIBUTING TO SUBSTANTIAL AND ONGOING GROWTH AND PROVIDER RELATED COSTS ACROSS THE SYSTEM. AS WE'VE NOTED, TEMPORARY INCREASES IN REVENUE FISCAL YEAR '24 AND '25 WERE DRIVEN BY THRILL BHSD WILL REQUIRE NEW FUNDING SOURCES TO HELP SUSTAIN OUR SYSTEM MOVING FORWARD.

THESE CHARTS ILLUSTRATE SPEND TRENDING FOR BEHAVIORAL HEALTH SERVICE DEPARTMENT TWO MAJOR FUNDING SERVICES. 2011 REALIGNMENT ALLOCATION HAS BEEN ROUGHLY FLAT BECAUSE SALES TAX AND FEES HAVE BEEN FLAT. IF THE CURRENT SPENDING AND ALLOCATION TREND CONTINUES, BHSD WILL RUN OUT OF FUND BALANCE IN. AS WE HAVE NOTED IN PAST PRESENTATION, THE MENTAL HEALTH SERVICES ACT FUNDING IS VALUABLE. WE ALSO RECEIVED THOSE TWO INCREASES IN REVENUE DUE TO COVID. SINCE PUBLISHING THIS PRESENTATION, WE HAVE BEEN PROVIDED ADDITIONAL GUIDANCE FROM A FINANCIAL CONSULTANT THAT THE STATE'S PROJECTIONS AROUND MHSA MAY PAINT A MORE ROSY PICTURE THAN MAY MATERIALIZE FOR FISCAL YEAR '27.

>> I WANT TO REMIND FOLKS WHEN WE'RE TALKING ABOUT MHSA. THIS IS EXTRAORDINARILY VOLATILE TAX THAT'S HEAVILY DEPENDENT ON CAPITAL GAINS. THERE'S BIG SWINGS THAT CAN OCCUR AND GREAT VARIATION YEAR-OVER-YEAR. STREAM IN THAT SENSE. THAT MAKES IT HARD WHEN YOU'RE TALKING ABOUT FUNDING ONGOING PROGRAMS AND OPERATIONS WITH WHAT IS A VERY VOLATILE FUNDING STREAM.

THIS SLIDE REPRESENTS OUR FISCAL YEAR '26-'27 DEFICIT PROJECTION. WE ANTICIPATE $100 MILLION PROJECTED DEFICIT IN FISCAL YEAR '27. COUPLE OF COMMENTS. ONE, THE REDUCED FUNDING DUE TO THE TRANSITION OF MHSA. SOME OF THE UNCERTAINTY AROUND HR1 IMPACTS. OUR CONTINUED INCREASE EXPENDITURES FOR NEW PROGRAMS UNDER MEDI-CAL. ABOUT SOME OF THE CHANGES ASSOCIATED WITH THE TRANSITION FROM THE MENTAL HEALTH SERVICES ACT TO THE BEHAVIORAL HEALTH SERVICES ACT. COUNTY ALLOCATION, 10% IS WITHHELD FOR THE STATE ACTIVITIES. BASED PREVENTION ACTIVITIES. THAT WILL BE ADMINISTERED BY THE CALIFORNIA DEPARTMENT OF PUBLIC SERVE INDIVIDUALS AGED 25 AND YOUNGER. THE CALIFORNIA DEPARTMENT OF PROGRAM GUIDES. LOCAL COUNTY PUBLIC HEALTH DEPARTMENT AS WE WORK TOGETHER TOWARDS SUPPORTING POPULATION-BASED PREVENTION BEHAVIORAL HEALTH WORKFORCE AND ADMINISTERED BY HCA.

THIS CHART REPRESENTS A SHIFTS AND FUNDING FROM CURRENT SPENDING IN MHSA CATEGORIES TRANSLATED TO NEW REQUIREMENTS. AS NOTED, THIS TRANSITION REQUIRES SPECIFIC PERCENTAGES OF FUNDING ALLOCATED BY CATEGORY. UNDER MHSA, INCREASE -- THIS REQUIREMENT IS INTENDED TO CREATE GREATER ACCESS TO OUR MOST MOST VULNERABLE POPULATIONS REQUIRING MORE INTENSIVE SERVICES.

>> STOP ON THIS SLIDE FOR A SECOND. THE BOARD WILL NOTICE THERE'S A COUPLE OF CATEGORIES WHERE THE SHIFT IS REALLY PROFOUND FOR OUR COUNTY ORGANIZATION. OF THE CURRENT ALLOCATION THAT'S IN THE BHSS. UNDER THE NEW STATE REQUIREMENTS HAS TO SHIFT DOWN TO 17%. THERE'S TWO DIFFERENT DYNAMICS WITH THIS CRITICAL FUNDING STREAM. FUNDING FROM THIS VOLATILE TAX. BUT ALSO AS SIGNIFICANT, IF NOT MORE SIGNIFICANT FOR OUR COUNTY IN PARTICULAR, IS THE SHIFT IN WHAT THE FUNDING CAN BE SPENT ON AND WHAT THAT MEANS FOR PROGRAMMING HERE LOCALLY WHERE HISTORICALLY, WE HAVE STEERED MORE FUNDING TOWARDS PREVENTION, INTERVENTION TYPE SERVICES AND TREATMENT INCREASES IF FUNDS. THAT'S WHAT'S REFLECTED IN THE GRAY AND BLUE ON THE LEFT HAND SIDE, SHIFTING OVER TO THE GRAY AND BLUE ON THE RIGHT HAND SIDE OF THAT CHART. WHICH REFLECT NEW STATE MANDATES ON SPENDING CATEGORIES.

>> THANK YOU, JAMES. NEXT SLIDE, PLEASE. IN ANTICIPATION OF FISCAL YEAR '27, BEGINNING IN THE PAST FALL, BHSD HAS BEEN INVOLVED IN COMMUNICATIONS WITH BOTH OUR COUNTY STAFF AND CONTRACT PROVIDERS TOGETHER THEIR INPUT ON ANTICIPATED BUDGET REDUCTION. THIS SLIDE LISTING SEVERAL ACTIVITIES AND MEETINGS AND EFFORTS THAT WE'VE BEEN ENGAGED IN SINCE THE FALL IN ANTICIPATION OF SOME OF OUR FISCAL CHALLENGES FACING US IN FISCAL YEAR '27. WITH THAT, I'M PLEASED TO TURN THE NEXT PART OF THE PRESENTATION OVER TO OUR PARTNERS. REPRESENTING THE BEHAVIORAL HEALTH COMMUNITY ASSOCIATION AND RACHEL MONTOYA FROM COMMUNITY SOLUTIONS.

>> THANK YOU. GOOD MORNING. I'M WITH THE BEHAVIORAL HEALTH COMMUNITY ASSOCIATION. PROVIDERS DELIVERING MENTAL HEALTH, SUBSTANCE USE, AND SUPPORTIVE HOUSING SERVICE. MANY OF THE LEADERS ARE HERE TODAY. TO PARTNER IN THIS PRESENTATION AND MORE IMPORTANTLY, FOR PARTNERING WITH US IN ADDRESSING THE SERIOUS CHALLENGES FACING OUR COUNTY BEHAVIORAL HEALTH SYSTEM. AND MANY NUMBER THIS MORNING. THE MAGNITUDE AND COMPLEXITY CAN BE DIFFICULT TO FULLY ABSORB. I KNOW THAT WHEN I FOCUS ON UNDERSTANDING NUMBERS, I SOMETIMES FIND MYSELF DISCONNECTED FROM WHAT THEY TRULY REPRESENT. BHCA MEMBERS SPEND EVERY DAY FOCUS ON THE RESIDENTS WHO RECEIVE VITAL SERVICES BECAUSE OF THE FUNDING WE ARE DISCUSSING TODAY. CONVERSATION, WE E-MAILED YOU EACH A CLIENT STORIES THAT REFLECTS THE DIVERSITY OF THE PEOPLE WE SERVE AND THE RANGE OF SERVICES MADE POSSIBLE BY THIS FUNDING THAT SUPPORTS INDIVIDUALIZED CLIENT-CENTERED CARE. MY COLLEAGUE RACHEL MONTOYA, PRESIDENT AND CEO OF COMMUNITY SOLUTIONS AND CHAIR OF THE BHCA FINANCE COMMITTEE I WILL SHIR A FEW EXCERPTS. WE CANNOT DO THEM JUSTICE IN A SHORT PRESENTATION. READ THE FULL DOCUMENT.

A 12-YEAR-OLD GIRL STRUGGLING WITH EPILEPSY, DEVELOPMENTAL DELAYS, AND UNSTABLE HOUSING RECEIVED BIWEEKLY THERAPY, CONNECTION TO PRIMARY CARE, AND HELP SECURING STABLE HOUSING THROUGH INTENSIVE OFS PROGRAM. HER MOTHER CALLED IT A LIFESAVER, LIFESAVER.

>> DIEGO, A 14-YEAR-OLD AS REFERRED TO COMMUNITY SOLUTIONS FOR SKIPPING CLASSES DUE TO ANXIETY, SLEEP ISSUES AND AVOIDANCE. INCREASED SELF-AWARENESS AND MOTIVATION.

>> AFTER DIVORCE, 60-YEAR-OLD STEVEN LIVING WITH BOTH MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES, FELT VIOLATED, VIO- ISOLATED AND UNSURE OF HIS FUTURE. WITH SUPPORT, HE REDISCOVERED HIS SENSE OF SELF AND FOUND PURPOSE VOLUNTEERING IN SPECIAL EDUCATION CLASSROOM.

>> AN ADULT REFUGEE FROM AFGHANISTAN AFTER SURVIVORRING LIFE-THREATENING EVENTS. SHE FOUND NEW ROOT AGAIN AFTER LOSING ALL HOPE.

>> ROBERT AGE 50 STRUGGLED WITH BEHAVIORAL ISSUE, MEDICATION CHALLENGES AND HOMELESSNESS. A COMMUNITY SOLUTIONS, HE SAID HE LEARNED TO ENJOY A MOMENT AND FEEL PEACE AND A CLEAR MIND.

>> JOSH, 43. GREW UP AROUND GANG ACTIVITY. FIRST LOCKED UP IN JUST FIFTH GRADE AND SPENT YEARS CYCLING IN AND OUT OF INCARCERATION. HE CREDITED THE STAFF FOR SUPPORTING HIS NEW PATH. CLEAN FOR OVER THREE YEARS, RECONNECTED WITH FAMILY, WORKING STEADILY AND TRAINING TO BECOME A TRUCK DRIVER.

>> CHRISTINA WHO LIVES IN NEW YORK, CALLED NOMI'S HEALTH LINE CONCERNED ABOUT HER BROTHER WHO HAS MENTAL AND PHYSICAL HEALTH CONDITION IN THE SANTA CLARA COUNTY JAIL. STAFF CONNECTED HER WITH MILLION STAFF AT THE JAIL TO DISCUSS THE ISSUES. BROTHER'S HEALTH HISTORY. FAMILY HOUSE OF AFFAIR.

>> THROUGH CARE, SHE BEGAN ATTENDING SCHOOL MORE CONSISTENTLY AND GREW MORE CONFIDENT AND ENGAGED.

>> AT AGE 16, UMA ATTENDED LGBTQ YOUTH SPACE. HIRED AS AN OUTREACH COORDINATOR, HELPING STUDENTS IN THE WAY HE ONCE NEEDED.

>> AFTER A SUICIDE ATTEMPT, BELL FELT HOPELESS. AT MOMENTUM RESIDENTIAL PROGRAM, SHE LEARNED COPING STRATEGIES AND SHARED SHE NEVER FELT CELEBRATED SHE DID THERE. BIPOLAR, ADHD AND INSOMNIA, RECEIVED CAREER SUPPORT. SHE EXPLORED NEW OPPORTUNITIES AND PROMOTED TO OPERATION SUPERVISOR.

>> ROXANNE FACED EATING DISORDER. SUBSTANCE USE AND SHARED SHE IS LEARNING TO GIVE HERSELF THE COMPASSION SHE OFFERS OTHERS.

>> JENNA, 17 STRUGGLED WITH TRUANCY, DEPRESSION, UNHEALTHY RELATIONSHIPS AND INVOLVED IN THE JUVENILE JUSTICE SYSTEM. THROUGH THE WRAPAROUND PROGRAM, INDIVIDUAL FAMILY AND GROUP THERAPY, SHE ENGAGED WITH SCHOOL AND STRENGTHENED HER WHEN SHE ENTERED MOMENTUM. SHE FOCUSED ON RORY AND HER HEALTH. SHE'S RAISING HER CHILD IN A SAFE AND STABLE ENVIRONMENT.

>> JH WAS BEING INVOLUNTARILY HELD AT EL CAMINO HOSPITAL. PATIENTS RIGHTS DVOCATES EAM ARGUED FOR HER DISCHARGE ALLOWING HER TO RETURN HOME.

>> A MEDICAL SOCIAL WORKER SHARED THAT SHE HAD BEEN SOBER FOR 15 YEARS. AS A CLIENT IN PATHWAYS MARIPOSA PROGRAM, SHE BUILT HER LIFE AND ESTABLISHED THE FOUNDATION FOR LONG-TERM RECOVERY.

>> A 6-YEAR-OLD ENROLLED IN GARDEN INNER HEALTH SERVICES HOME VISITATION PROGRAM DUE TO AGGRESSIVE BEHAVIOR TOWARDS HIS MOTHER. HOME AND IN SCHOOL.

>> JORDAN, A 19-YEAR-OLD, NON-BINARY YOUNG ADULT FELT DISCONNECTED. CLINICS THEY ARE NOW GROUNDED.

>> ASHLEY CONTACTED THE TRUST PROGRAM ABOUT HER SISTER WHO HAS BIPOLAR DISORDER AND HAD BECOME MANIC, EXHIBITING RISKY BEHAVIORS INCLUDING TRESPASSING ON A NEIGHBOR'S PROPERTY. HER GET TO URGENT CARE. SHE WAS ABLE TO UTILIZE THE HELP LINE MULTIPLE TIMES WHERE STAFF PROVIDED INFORMATION ON SHARING VITAL BACKGROUND INFORMATION, CONSERVATORSHIP. CALLED BACK TO SHARE THAT HER SISTER WAS DOING WELL. FUNDING THAT YOU'RE HEARING ABOUT TODAY. THEY ARE THEIR NEIGHBORS IN OUR COMMUNITY. PHONE CALLS ABOUT AND HEAR CONCERNS FROM THOSE IN THE COMMUNITY. ENSURE THAT OUR COUNTY BEHAVIORAL HEALTH SAFETY NET CONTINUES TO BE STRONG.

BHCA MEMBERS DEVELOPED RECOMMENDATIONS THAT WE SHARED WITH BHSD. I'M PLEASED WE'RE IN THE PROCESS IDENTIFYING WAYS TO COLLABORATE WITH THEM ON THEM. IN REGARD TO CLIENTS MOVING THROUGH THE MOST INTENSIVE SERVICES TO LOWER LEVELS OF COMMUNITY-BASED CARE, PROVIDERS WORK WITH COUNTY STAFF ON INDIVIDUAL CASES. WE RECOMMEND BUILDING ON THIS AND REESTABLISHING CROSS-SYSTEM STEPDOWN WORK GROUP IN FOCUS ON SYSTEMIC ISSUES IMPACTING TIMELY STEPDOWN, ENSURES WE ARE MAXIMIZING FEDERAL FINANCIAL PARTICIPATION. OPEN THE NEW PSYCH HOSPITAL. WE LIKE TO ESTABLISH A PRIVATE INSURANCE BILLING WORK GROUP TO DEVELOP A COORDINATED SYSTEMWIDE APPROACH TO BUILDING THE INFRASTRUCTURE, WORKFLOWS, AND COMPLIANCE MECHANISMS NECESSARY TO BUILD COMMERCIAL INSURANCE. I WANT TO HIGHLIGHT THAT PROVIDERS ARE PARTNERING WITH THE COUNTY AS THEY ROLL OUT THE STRUCTURE NECESSARY FOR INCREASING BILLABLE SERVICES AND BRING ONLINE NEW REIMBURSABLE ROLES SUCH AS COMMUNITY HEALTH WORKERS. NEXT, WE RECOGNIZE THAT UNSUPPORTED FUNDS ARE LIMITED AND SHOULD BE RECEIVED -- RESERVED FOR SITUATIONS WHERE NO OTHER PAYER EXIST. IMPROVED TRACKING AND CONTRACTS WILL HELP ENSURE DOLLARS ARE USED APPROPRIATELY AND CONSISTENTLY. CURRENTLY, ALL PROVIDERS WORK CLINICAL OPERATIONALLY FROM COST-BASED REIMBURSEMENT TO FEE FOR SERVICE WHICH WILL HELP IMPROVE FISCAL SUSTAINABILITY. HISTORICALLY, THE TIMING OF COMPLEX PAYMENT SYSTEMS MAKE ACCURATE TRACKING OF CLIENTS AND BILLING DATA CHALLENGING. ENSURE THAT CONTRACTS REFLECT THE ACTUAL SERVICE DELIVERY SO WE'RE NOT CARRYING ON UNEARNED DOLLARS DURING A TIME OF SIGNIFICANT BUDGET CONSTRAINT. THE FINAL THREE RECOMMENDATIONS ENSURE WE ARE SPECIAL FUNDING. FIRST, ELIMINATING TAFF REQUIREMENTS THAT ARE NOT REGULATORY. THIS CREATES FLEXIBILITY FOR PROVIDERS AND AVOIDS ADDING COST THAT DO NOT DIRECTLY IMPROVE ACCESS. TOO MUCH TIME ON DUPLICATE ADMINISTRATIVE TASKS. CHANGES THAT WILL STREAMLINE DATA ENTRY AND REPORTING. FINALLY, COUNTY DOCUMENTATION STANDARDS THAT EXCEED STATE REQUIREMENTS CREATE ADMINISTRATIVE BURDEN. SIMPLIFYING THESE REQUIREMENTS WILL INCREASE PROVIDER CAPACITY AND HELP PRESERVE SERVICES DURING THIS FISCAL CRISIS. I PASS IT TO RACHEL.

>> I'M RACHEL MONTOYA PRESIDENT AND CEO. [CAPTIONERS TRANSITIONING, PLEASE ATTEND -- STAND BY] DELIVERING THE VITAL SERVICES WE'RE TALKING ABOUT TODAY. COMMUNITY BASED ORGANIZATIONS PROVIDE 85% OF BEHAVIORAL HEALTH SERVICES IN THIS COUNTY. I WANT TO ACKNOWLEDGE THAT MOST OF US, INCLUDING MYSELF, MY COLLEAGUES IN CHAMBERS, MY COLLEAGUES AT THIS TABLE AND LIKELY MANY OF YOU DON'T SEE THIS WORK AS SO JOB, IT IS A CALLING AND I WANT TO EXPRESS MY APPRECIATION IN ALLOWING US TO BE PART OF THE CONVERSATION TODAY. I AM HERE TO HIGHLIGHT THE NEED FOR CONTINUED, CLEAR, AND COLLABORATIVE COMMUNICATION IN THE KEY ASSUMPTIONS AND DATA UNDERLYING THE PROJECTS WE JUST LOOKED AT, THOSE PROJECTIONS THAT RESULT IN THE HUNDRED MILLION DOLLARS STRUCTURAL DEFICIT SHOWN IN THE DEPARTMENT SLIDES. YOU MAY NOTICE THAT THE FUNDING STREAMS IN MY SLIDE HERE OVERLAP SIGNIFICANTLY WITH THE SLIDE THAT JILL PUT UP FROM AURORA AND I WANT TO ACKNOWLEDGE THAT JILL SAID, AS WELL. BEHAVIORAL FUNDING IS COMPLEX. PHSD HAS BEEN LEANING INTO TRANSPARENCY AND HAS BEEN WORKING COLLABORATIVELY WITH US AS PROVIDERS, ESPECIALLY AROUND THE REVENUE AND EXPENSE INFORMATION THAT WAS JUST PRESENTED. THE AREA WE ARE CURRENTLY WORKING ON AND NEED TO CONTINUE TO WORK ON IS UNDERSTANDING THE UNDERLYING ASSUMPTIONS USED TO CALCULATE THOSE PROJECTIONS. AS WE ARE LOOKING AT POTENTIAL CUTS IN VITAL LIFE SAVING SERVICES, IT IS CRUCIAL THAT WE ARE CLEAR ON THE BEST PICTURE OF WHAT THESE CUTS NEED TO BE. IT WOULD BE DEVASTATING TO DISMANTLE OR REDUCE SERVICES THAT MAY NOT HAVE HAD TO HAVE BEEN CUT WHEN WE LOOK AT THE REAR VIEW MIRROR. ONE EXAMPLE OF AN AREA THAT NEEDS FURTHER UNDERSTANDING IS THE ASSUMPTIONS THAT ARE BEING USED IN THE F. YES. 26-27 HR1 IMPACTS. WHILE WE KNOW THE IMPACT OF HR1 HAS THE POTENTIAL TO DEVASTATE MEDICAL RECIPIENTS AND COUNTY FUNDING IN MANY WAYS -- DEVASTATE MEDICAL RECIPIENTS AND COUNTY FUNDING. IN MANY WAYS IT HAS AN IMPACT TO OUR CLIENTS THAT WE SERVE. THIS IS SEEN MOST CLEARLY IN THE WORK REQUIREMENTS THAT ARE INCLUDED IN HR1. INDIVIDUALS WITH DISABILITIES BE LIKELY TO BE -- CAN ALLOW US TO WORK TOGETHER TO MAKE SURE WE ARE WORKING OFF THE SAME INFORMATION AND ACTIVELY WORK WITH CLIENTS TO MITIGATE LOSS OF COVERAGE, SUPPORT AND CERTIFICATION OF THEIR DISABILITY AND MAINTAIN THE MUCH NEEDED FUNDING FROM FEDERAL FUNDING PARTICIPATION. GO AHEAD AND MOVE TO THE NEXT SLIDE.

AS WE MOVE INTO THIS NEXT SLIDE AND I PASS IT BACK TO SHERRY WITH THE DEPARTMENT, YOU WILL SEE BHSD GUIDING PRINCIPLES ON THE LEFT-HAND SIDE. PROVIDERS SHARE THESE SAME PRINCIPLES AND THAT ALIGNMENT MATTERS BECAUSE PARTNERSHIP HAS CONSISTENTLY BEEN OUR GREATEST STRENGTH. WE SAW THIS CLEARLY DURING COVID. WE WEATHERED THE CRISIS AS A COMMUNITY WITH VERY FEW LAYOFFS AND PRESERVING A WORKFORCE THAT IS VITAL AND INCREDIBLY DIFFICULT TO RETAIN. WE SAW THIS DURING BEHAVIORAL HEALTH PAYMENT REFORM WHERE OUR SHARED EFFORTS RESULTED IN RECOGNITION BY THAT THE STATE OF THE SUCCESS OF SANTA CLARA COUNTY IN THE PIVOT, INCLUDING MAXIMIZING REVENUE. A PIVOT NOT ALL COUNTIES WERE ABLE TO DO WITH SUCH SUCCESS. WHILE WE ARE ENTERING THE TIME OF MAKING DIFFICULT DECISIONS, I AM CONFIDENT THAT WE ARE BETTER TOGETHER. THANK YOU.

>> THANK YOU SO MUCH ALICIA AND RACHEL. AS WE PREPARED FOR WHAT WE KNEW WOULD BE THE CHALLENGING BUDGET FOR FISCAL YEAR '27 CONSISTENT WITH THE BOARD OF SUPERVISORS BEHAVIORAL HEALTH, ENSURING ACCESS AND PRESERVATION OF SERVICES IS OUR KEY GUIDING PRINCIPLES MUST BE MADE THROUGH AN EQUITY LENS AND PROMOTE TRANSPARENCY. IN ORDER TO ACHIEVE A FINANCIALLY STABLE PATH AND ENSURE STABILITY OF OUR NETWORK, WE MUST MAXIMIZE MEDICAL LEVERAGING WHEREVER POSSIBLE AND SHARE OUR COMPLIANCE WITH OUR REGULATORY REQUIREMENTS, PROTECT ACCESS, MAINTAIN QUALITY, AND SERVE OUR MOST VULNERABLE BENEFICIARIES. OUR STRUCTURAL DEFICIT MITIGATION STRATEGIES INCLUDE REVENUE EXPANSION AND COST REDUCTION STRATEGIES. AS WE SHARED DURING OUR NOVEMBER PRESENTATION ON BH CONNECT, WE ARE ON THING INTO ALL BH CONNECT REVENUE OPPORTUNITIES, RAMPING UP OUR EFFORTS AROUND MEDICAL ADMINISTRATIVE ACTIVITIES CLAIMING REFERRED TO AS TMA, IMPLEMENTING ENHANCED CARE MANAGEMENT AT COUNTY OPERATED CLINICS AND WOR WORKING TO INCRE PRODUCTIVE ACROSS ALL NETWORK PATIENT PROVIDERS. WE ARE PROPOSING TO RESTRUCTURE ALL LEFT OF BHSD TO IMPROVE OPERATIONS, FOCUSING ON BILLING EFFICIENCIES WITHIN OUR COUNTY OPERATED CLINICS, INCLUDING IMPLEMENTATION OF A.I. SOFTWARE TO INCLUDE ACCURACY OF BILLING, REALIGNING CONTRACT PAYMENT RATES WITH FUNDING ABILITY ACROSS ALL CONTRACT TYPES AND ENSURING COMPLIANCE WITH REGULATORY COMPLIANCE. SO IN SUMMARY, BHSD HAS A LARGE STRUCTURAL DEFICIT AND TWO OF ITS LARGING FUNDING SOURCES 2011 ALIGNMENT AND MHSA, IT HAS BEEN IMPACTED BY MANY NEW STATEWIDE INITIATIVES THAT DID NOT COME WITH NEW OR ADEQUATE FUNDING. WE WILL NEED TO MAKE REDUCTIONS IN A WAY THAT PRESERVES THE GREATEST DEGREE OF ACCESS TO MANDATED SERVICES FOR MEDICAL BENEFICIARIES THAT WE ARE CONTRACTED TO SERVE. THE SHIFT FROM MHSA TO BHSA DOES NOT COME WITH NEW FUNDING AND WE WILL BE REQUIRED TO INCREASE SPENDING IN CERTAIN CATEGORIES. BHSD IS A NOTED LEADER AMONGST LARGE CALIFORNIA COUNTIES, AND WE WILL CONTINUE TO STRIVE TO MAINTAIN OUR LEVEL OF EXCELLENCE AND EXCEEDING OUR STATE PERFORMANCE TARGETS. SO WITH THAT, WE CONCLUDE OUR PRESENTATION AND WE ARE OPEN FOR QUESTIONS. THANK YOU.

>> THANK YOU, DOCTOR AND THANK YOU FOR THE TEAM. ANYTHING, JAMES TO ADD BEFORE WE OPEN UP THE PUBLIC?

>> I DON'T KNOW IF YOU WANT TO DO PUBLIC COMMENT FIRST AND THEN I MIGHT HAVE A BRIEF THING TO ADD.

>> I'LL ASK FOR PUBLIC COMMENT FIRST.

>> I CURRENTLY HAVE FIVE SPEAKERS IN CHAMBERS AND SIX ON ZOOM.

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

>> ALL RIGHT. THANK YOU. WE ARE NOW CLOSING THE PUBLIC COMMENT. WE'LL CALL FORWARD THE PEOPLE IN CHAMBERS, ANDREW ZIEGLER, ALLISON GEORGE, LORI CATCHER, SANDRA ASHER AND SEAN.

>> GOOD MORNING, MY NAME IS ANDREW ZIEGLER. I AM A MEMBER OF SEARCH SANTA CLARA COUNTY AND ALSO ON THE TRUST COMMUNITY ADVISORY BOARD. I SUFFER FROM A MENTAL HEALTH DISABILITY. CRAZY. SO, WE ON THE CAB GOT A PRESENTATION BACK IN JANUARY THAT SHOWED THAT TRUST WAS GOING TO BE DOWNGRADED TO A MOBILE OUTREACH TEAM, AND NOT A CRISIS RESPONSE. MARKETING MATERIALS DON'T SAY THAT IT IS A CRISIS RESPONSE, AND THE PROBLEM WITH THIS IS THAT IF IT'S DOWNGRADED FROM CRISIS RESPONSE TO OUT.

>> REACH TEAM IT WILL NO LONGER BE BILLABLE BY MEDICAL. WITH THE REPORT SAYING THAT TRUST IS GOING TO CONTINUE TO BE FUNDED BY MEDICAL REIMBURSEMENT, THAT'S NOT GOING TO BE POSSIBLE IF IT'S A MOBILE OUTREACH TEAM. I DON'T KNOW, I HAVE THINGS TO LOOK INTO. THANKS A LOT.

>> ACTUALLY, THE MIC IS ON THE PODIUM, JUST USE THE PODIUM. THERE YOU GO.

>> SANDRA ASHER, DISTRICT FIVE RESIDENT, MEMBER OF THE TRUST COMMUNITY ADVISORY BOARD, AND TODAY WAS INTENDED TO BE A STUDY SESSION AND NOT JUST A BUDGET OVERVIEW, SO THAT'S WHY WE ARE HERE TALKING ABOUT TRUST. THE CAB IS DEEPLY CONCERNED ABOUT THE CHANGES THAT WERE COMMUNICATED TO US IN OUR LAST MEETING, SHIFTING TRUST AWAY FROM A MEDICAL REIMBURSABLE MOBILE CRISIS TEAM AND TOWARDS A COMMUNITY OUTREACH PROGRAM, AND ALTHOUGH WE APPRECIATE SOME ASSURANCES WE RECEIVED FROM COUNTY STAFF, THERE'S A LACK OF SORRY FOR THE PUN, TRUST BETWEEN THE CAB AND THE COUNTY BASED ON THE COMMUNICATION THAT WE'VE BEEN RECEIVING, SO WE ASK THAT STAFF COMMUNICATE EARLY AND OFTEN AND WELL BEFORE ANY DECISIONS ARE MADE EITHER THIS BUDGET YEAR OR NEXT BUDGET YEAR AND REALLY RETURN TO THE SPIRIT AND INTENT OF A COLLABORATION BETWEEN THE COMMUNITY, THE PROVIDERS AND THE COUNTY, THANK YOU.

>> THANK YOU.

>> HI, GOOD MORNING, MY NAME IS LORI CATCHER, I'M A 23 YEAR RESIDENT AND VOTER IN DISTRICT TWO PROUDLY AND A MEMBER OF SURGE. I'M GRATEFUL FOR THE COLLABORATION OF IMPACTED FAMILIES WHO LOST LOVED ONES TO POLICE VIOLENCE WHO GAVE THEIR HEART AND SOUL TO WORK WITH THE COUNTY AND COMMUNITY PARTNERS IN COLLABORATION TO CREATE THE TRUST PROGRAM SEVERAL YEARS AGO. AS A MOM OF THREE YOUNG ADULTS AND AS A NEIGHBOR TO SOME OF OUR MOST MARGINALIZED RESIDENTS HERE IN SANTA CLARA COUNTY, TRUST PROVIDES DESPERATELY NEEDED NON POLICE CRISIS RESPONSE. OF ALL OUR MOBILE CRISIS TEAMS, TRUST RECEIVES THE HIGHEST VOLUME OF CALLS AND UNLIKE MCRT, TRUST IS OUR ONLY COMPLETELY NON POLICE CRISIS RESPONSE PROGRAM WHICH IS WHAT OUR COMMUNITY CALLED FOR AND CONTINUES TO STAND BEHIND. SO I JUST WANT TO CALL TO ACTIONS VETERANS OF THE CAB MEMBERS AND ASK OUR BOARD TO SLOW DOWN TO LISTEN TO PLEASE AND INTEGRATE CONCERNS FROM CAB MEMBERS. THANK YOU.

>> HI, MY NAME'S ALLISON GEORGE, AND I LIVE IN DISTRICT FIVE AND I'M A MEMBER OF SURGE. I THINK MAINTAINING TRUST AS A PEER BASED NO POLICE CRISIS RESPONSE IS CRITICAL. AS A PARENT OF AN ADULT WITH A HISTORY OF SIGNIFICANT SUBSTANCE ABUSE AND MENTAL HEALTH ISSUES, I AM PARTICULARLY CONCERNED ABOUT MAINTAINING TRUST. GRATEFULLY MY SON IS STABLE NOW BUT HAS HAD EXPERIENCES IN THE PAST OF PSYCHOSIS WITH SIGNIFICANT DELUSIONS AND HALLUCINATIONS AND THESE WERE PARTICULARLY RELATED TO FEAR OF THE POLICE AND EXPERIENCES THAT I THINK FOUNDED AGGRESSIVE BEHAVIOR DUE TO EXPERIENCE. I WOULD NOT CALL 911 IF MY SON WERE TO EXPERIENCE AN EXACERBATION AGAIN FOR FEAR OF ESCALATION AND POTENTIAL RISK TO HIS HEALTH AND LIFE. I URGE YOU NOT TO RECEIVE THE REPORT, THANK YOU.

>> THANK YOU. ANY MORE COMMENTS, PLEASE GIVE THE STATEMENT TO RHONDA AND SHE'LL PUT IT ON TO THE RECORD.

>> IF YOU COULD NOT FINISH YOUR STATEMENT, PLEASE GIVE TO IT RHONDA AND SHE CAN ADD IT TO OUR RECORD. THANK YOU SO MUCH.

>> I AGREE WITH WHAT EVERYONE SAID BEFORE ME. TRUST IS THE ONLY ONE THAT PEOPLE TRUST, THAT WHEN YOU -- WHEN SOMEBODY'S IN CRISIS AND YOU SAY HEY, IS IT OKAY, IF WE CALL TRUST? PEOPLE SAY YES. IF YOU SAY HEY, IS IT OKAY, IF WE CALL ANYTHING ELSE, 911? NO! NO! NOBODY WILL ACCEPT ANYTHING WHEN WE NEED HELP TO INVOLVE THE COPS AND THAT SAYS A LOT. SO WHEN YOU SAY IS IT OKAY, IF WE CALL TRUST, I DON'T KNOW, WHAT IS THAT AND YOU EXPLAIN IT, DOES IT HAVE COPS. YOU'RE LIKE NO, NO, OK. SO EVERY EXPERIENCE THAT I'VE EVER HAD WITH TRUST HAS BEEN GREAT. EVEN IF THE PERSON DOESN'T LEAVE WITH THEM, IT'S JUST WHEN WE'RE STANDING THERE TALKING TO TRUST AND THEY'RE TALKING TO TRUST, IT IS STILL A GREAT EXPERIENCE, AND, YOU KNOW, I NORMALLY NEVER HAVE ANYTHING GOOD TO SAY ABOUT ANYTHING, YOU KNOW, SO TRUST IS GREAT.

>> THANK YOU. WITH THAT, WE'LL MOVE TO OUR ZOOM SPEAKERS. OUR FIRST SPEAKER IS CATHERINE HEDGES. WE ASK YOU TO UNMUTE.

>> THANK YOU. MY NAME IS CATHERINE HEDGES AND I'M A MEMBER OF SURGE AND A FORMER MEMBER OF THE TRUST CAB, AND I WANT TO AMPLIFY EVERYTHING PEOPLE SAID BEFORE ME. IT'S CRITICAL THAT WE KEEP TRUST AS A PEER-BASED CRISIS TEAM. THEY WERE THE ONLY ONES WHO COULD GET THROUGH TO MY NEIGHBORS WHEN THEY WERE IN CRISIS. THEY WERE RAMBLING, NOBODY WANTED POLICE AROUND. WE HAD A POLICE SHOOTING IN OUR BUILDING. PEOPLE DO NOT WANT POLICE WHEN THEY ARE IN CRISIS. THE POLICE ARE NOT GOING TO KNOW HOW TO COPE WITH SOMEBODY WHO IS PULLING THE WIRING OUT OF THEIR MOUTH BECAUSE THEY THINK IT'S A SPY SYSTEM. THAT'S NOT WHAT POLICE DO. WE NEED TRUST, IT WORKS. KEEP IT. DON'T ACCEPT THE REPORT, LISTEN TO THE TRUST CABS.

>> THANK YOU. OUR NEXT SPEAKER IS KAREN MITSUDA.

>> MY NAME'S KAREN, I LIVE IN DISTRICT TWO AND A MEMBER OF SURGE. I ECHO WHAT EVERYONE HAS ALREADY SAID. PLEASE LISTEN TO THE CAB MEMBERS, DON'T RECEIVE THIS REPORT AS IT'S BEEN GIVEN. I'M A SISTER OF MENTAL ILLNESS SO KNOW FIRSTHAND OF CRISIS ASSISTANCE RECEIVED CAN MEAN THE DIFFERENCE OF LIFE AND DEATH. MENTAL HEALTH PROFESS AND EMT'S WITH PEER LIVING TOGETHER WITH CARE AND SKILLS WITHOUT LAW ENFORCEMENT. THIS ISN'T MY FAMILY'S EXPERIENCE, IT'S BACKED BY DATA AND EXPLAINS WHY TRUST RECEIVES MORE CALLS THAN ANY OTHER CRISIS RESPONSE PROGRAM IN THE COUNTY. PEOPLE CALL TRUST BECAUSE THEY TRUST TRUST AND TRUST'S ABILITY TO SAVE LIVES DEPEND ON ITS DESIGNATION AS A NO POLICE CRISIS RESPONSE TEAM SO IT'S ELIGIBLE FOR MEDICAL REIMBURSEMENT. PLEASE LISTEN TO THE CAB AND LET'S HELP OUR NEIGHBORS. THANK YOU.

>> THANK YOU. OUR NEXT SPEAKER IS EMMA HARTON.

>> I'M SHOWING UP FOR RACIAL JUSTICE AND A CONSTITUENT OF DISTRICT FOUR. JUST ECHOING WHAT EVERYONE HAS SHARED, PEOPLE TRUST TRUST AND IT'S CRUCIAL TO MAINTAIN THAT TRUST AS A GENUINE NON POLICE CRISIS RESPONSE FOR EVERYONE'S SAFETY AND FOR COMMUNITY TRUST AND ALSO FOR BUDGETARY MEDICAL REIMBURSEMENT PURPOSES. I WISH TRUST WOULD HAVE EXISTED WHEN I MOST NEEDED IT WHEN I WAS A YOUNG ADULT. WE'VE JUST SEEN IN MY HOMETOWN OF NEW YORK CITY ANOTHER POLICE SHOOTING OF A YOUNG MAN CUFFED TO HIS HOSPITAL BED. JUST REALLY HOPING THAT WE CAN MAINTAIN THIS BEAUTIFUL PROGRAM THAT FAMILIES HAVE BUILT WITH THEIR LOVE AND SUPPORT AND INPUT. PLEASE DON'T RECEIVE THE REPORT AS WRITTEN AND WORK WITH THE COMMUNITY THAT WORKED WITH THIS PROGRAM. SHOUT-OUT TO THE WORKERS.

>> THANK YOU, OUR NEXT SPEAKER IS LORI VALDEZ.

>> HI, ANYWAY NAME IS LORI VALDEZ AND I'M ONE OF THE 13 FAMILIES WHO ENVISIONED TRUST, WHO WORKED WITH BEHAVIORAL HEALTH TO GET THIS PROGRAM TO BE IN OUR COMMUNITY, TO SAVE LIVES. IT'S IMPORTANT THAT ON MOST OF A CAB MEMBER AND WANT TO EXPRESS THAT ME AS AN IMPACTED FAMILY WHO ACTUALLY ENVISIONED HOW TRUST WOULD OPERATE IN OUR FAMILY HAS BEEN DISRESPECTED BY SOME OF THE COUNTY PEOPLE THAT WORK WITH TRUST. WHEN I EXPRESS MY OPINIONS, THEY ATTACK ME, AND I -- IT'S HARD TO SAY I WANT TO SAY BECAUSE THIS IS OUR VISION, I'M ONE OF THE 13 FAMILIES, THERE'S THREE OF US ON IT AND WE NEED TO KEEP TRUST AS A NON POLICE CRISIS TO GET FUNDING BUT ALSO BECAUSE ANTONIO GUZMAN LOPEZ E. LOPEZ, WITHIN 50 SECONDS, HE WAS KILLED BY A CIP TRAINED OFFICERS.

>> THANK YOU. OUR NEXT SPEAKER IS JENNA CREZ.

>> HI, I AM FROM DISTRICT SIX AND ALSO HERE IN SANTA CLARA COUNTY. I GREW UP IN A HOME WITH A LOVED ONE WITH SEVERE MENTAL HEALTH CHALLENGES THAT REQUIRED CRISIS RESPONSE ON MULTIPLE OCCASIONS AND I DEVELOPED MY OWN MENTAL HEALTH CHALLENGES. IT'S DEEPLY IMPORTANT TO ME THAT ME, MY LOVED ONES AND THE COMMUNITY I CARE SO MUCH ABOUT ARE ABLE TO CALL A PEER BASED NO LAW ENFORCEMENT CRISIS INVOLVES WHEN WE NEED IT THE MOST. LISTEN TO THE FEEDBACK FROM CAB MEMBERS BEFORE ANY MATERIAL CHANGES TO TRUST ARE MADE. TRUST WAS CREATED BY FAMILY MEMBERS LIKE LORI WHO LOST LOVED ONES TO POLICE VIOLENCE DURING MENTAL HEALTH CRISES, AS A PEER BASED NO LAW ENFORCEMENT CRISIS PROGRAM, IT NEEDS TO REMAIN THAT SO MORE IN OUR COMMUNITY AREN'T HARMED OR KILLED DURING THE MOMENT THAT THEY NEED THE MOST HELP.

>> THANK YOU. OUR NEXT SPEAKER IS KIM GU PTU.

>> YES, THIS MORNING, D4, MEMBER OF SURGE, SANTA CLARA COUNTY AND WE ARE SHOWING UP FOR RACIAL JUSTICE AND PUBLIC SAFETY IN SOLIDARITY WITH OUR SBD PARTNERS. I HAVE A NEPHEW WHO HAS SERIOUS MENTAL HEALTH CHALLENGES AND THE THOUGHT OF HIM BEING APPROACHED BY POLICE IN A CRISIS MAKES ME SHUDDER. THIS IS ABOUT LIVING UP TO OUR COMMUNITY VALUES OF RACIAL JUSTICE AND PUBLIC SAFETY. NEARLY THREE QUARTERS OF PEOPLE SERIOUSLY INJURED OR KILLED BY POLICE, SAN JOSE POLICE 2014-2021 WERE BELIEVED TO BE EXPERIENCING MENTAL HEALTH OR SUBSTANCE ABUSE CRISIS. DO NOT RECEIVE THE REPORT AS WRITTEN AND ASK FOR AN OFF AGENDA REPORT. WE WANT YOU TO LISTEN AND INTEGRATE THE FEEDBACK FROM THE CAB MEMBERS MANY OF WHOM JUST SPOKE AND BEFORE ANY MATERIAL CHANGES ARE MADE TO TRUST. IT NEEDS TO REMAIN PEER BASED NON LAW ENFORCEMENT CRISIS RESPONSE PROGRAM SO THAT MORE PEOPLE IN OUR COMMUNITY DON'T GET --

>> AND THIS CONCLUDES OUR PUBLIC SPEAKERS FOR THIS TIME.

>> JUST WANTED TO MAKE A BRIEF COMMENT AND INVITE THE DEPARTMENT TO MAKE A BRIEF COMMENT REGARDING THE ISSUE OF TRUST, WHICH AS THE BOARD IS AWARE WAS NOT AN ITEM WHERE THERE'S ANY PROPOSAL OR RECOMMENDATION INCLUDED IN THIS REPORT. AS THE BOARD'S ALSO AWARE AND I MENTIONED ON NUMBER OF OCCASIONS, THE TRUST PROGRAM IS FUNDED UNDER INNOVATION FUNDING, UNDER MENT MHSA. THAT INNOVATION FUNDING IS GOING AWAY UNDER THE BHSA AS PART OF THE BROADER STATE SHIFTS THAT HAVE BEEN DISCUSSED, AND THAT PROJECT ENDS IN NOVEMBER OF 2026. AND SO CONSISTENT WITH A LOT OF THE COMMENTS THE SPEAKERS HAVE SHARED REGARDING TRUST, WE DO WANT TO FIGURE OUT A WAY TO ENSURE THE PROGRAM CONTINUES, CONTINUES AS A NON LAW ENFORCEMENT RESPONSE AND CONTINUES IN A WAY THAT IT CAN QUALIFY AS A MEDICAL MOBILE CRISIS BENEFIT, GIVING THAT WE ARE LOSING INNOVATION FUNDING. I INVITE THE DEPARTMENT TO ADD ANYTHING TO THAT BUT WE SAID ON WRITTEN COMMENTS THAT WERE SUBMITTED THERE APPEARS TO BE A LITTLE CONFUSION AROUND THAT. THERE IS NO PROPOSAL HERE, THERE IS CONTINUED ONGOING CONVERSATIONS AND OF COURSE SOMETHING WOULD COME IN FRONT OF THE BOARD WELL IN ADVANCE OF ANYTHING BUT THE REALITY AS IT STANDS TODAY, ABSENT CHANGES BEFORE NOVEMBER OF 2026, THE CURRENT FUNDING FOR TRUST IS GOING AWAY AND AGAIN, THAT IS A STATE LOSS OF INNOVATION FUNDING AND JUST ONE EXAMPLE OF MANY OF WHAT HAPPENS WHEN THE STATE MAKES SOME OF THESE POLICY CHANGES. BUT WE VERY MUCH ARE COMMITTED TO FIGURING OUT WAYS FOR THE TRUST PROGRAM TO CONTINUE, SHERRY, I DON'T KNOW IF YOU WANT TO ADD ANYTHING.

>> I JUST WANT TO ACKNOWLEDGE AND THANK YOU FOR YOUR PUBLIC COMMENTS TODAY. THE COUNTY IS REALLY COMMITTED TO HEARING, YOU KNOW, YOUR CONCERNS AND BETTER UNDERSTAND SOME OF YOUR COMMENTS. MEGAN AND I WILL BE ATTENDING THE NEXT CAB MEETING, AND WE REALLY LOOK FORWARD TO, YOU KNOW, HAVING A REBOOT, RESTART, REALLY UNDERSTANDING WHAT SOME OF YOUR CONCERNS ARE AND BEING ENGAGED IN THAT DIALOGUE SO WE LOOK FORWARD TO SEEING YOU AT THE NEXT MEETING. THANK YOU SO MUCH.

>> THANK YOU, I SEE THE LIGHT'S ON FOR SUPERVISOR ELLENBERG.

>> THANK YOU VERY MUCH, REALLY APPRECIATE FIRST THE PUBLIC COMMENTERS WHO CAME OUT TO SPEAK ON THIS ITEM AND THE PRESENTERS FOR -- FOR THE FORMAL DECK, JILL, I WISH EVERY STATE LEGISLATOR WOULD BE REQUIRED TO HEAR YOUR PRESENTATION. SO MANY JUST DON'T UNDERSTAND THE CHASM THAT EXISTS BETWEEN THEIR MANDATES OFTEN UNFUNDED AND WHAT IS NEEDED TO ACTUALLY IMPLEMENT AND OPERATIONALIZE THOSE DIRECTIVES HERE, AND I JUST THOUGHT YOU DID A REMARKABLY CLEAR, CLEAR JOB THAT I THINK IS APPLICABLE ACROSS THE STATE. ALSO, REALLY WANT TO APPRECIATE THE PRESENTERS INCLUDED BOTH COUNTY STAFF AND COMMUNITY PARTNERS. TO ME, THIS IS ALSO A VERY ENCOURAGING SIGN. DOESN'T MEAN WE ARE EXACTLY WHERE WE NEED TO BE, BUT I'M HEARING FROM A LOT OF SUPPORTERS THAT WE ARE ON THE WAY. I HEAR THAT THIS YEAR'S BUDGET IS TRULY TRULY UNPRECEDENTED FOR THE BEHAVIORAL HEALTH SERVICES DEMOCRATIC. AS YOU SO ELOQUENTLY LAID OUT, WE ARE SIMULTANEOUSLY IMPLEMENTING A TRANSITION FROM MHSA TO BHSA WHICH COULD RESULT IN A LOSS OF $6,212,000,000 OF REVENUE NEXT YEAR WHILE WE'RE PREPARING FOR THE MEDICAID CUTS ADMINISTRATION AND MEDICAL CUTS BY THE STATE. NEW MANDATED PROGRAMS AND NON MANDATED PROGRAMS THAT WE HAVE ADDED TO MEET COMMUNITY NEEDS AND COMPLY WITH STATE AND FEDERAL REQUIREMENTS, SO GIVEN THESE COMBINED CHALLENGES AND THE FACT THAT THE DEPARTMENT IS FACING A NEARLY $100 MILLION BUDGET HOLE FOR THE UPCOMING FISCAL YEAR, IT IS GOING TO BE SO ESSENTIAL THAT WE ARE FULLY, TRULY JUST TRANSPARENT ABOUT HOW DECISIONS MADE, WHAT SERVICES ARE IMPACTED, AND WHO IS THE POPULATION, I THOUGHT. ALICIA AND RACIAL, YOU DID A WONDERFUL JOB CONNECTING THE NUMBERS TO THE INDIVIDUALS, WHEN WE SAY THE WORDS CUT PROGRAMS OR CUT SERVICES, WE ARE BEING ABLE -- WE ARE OFFERING LESS TO ALL OF THE INDIVIDUALS THAT YOU TALKED ABOUT AND SO MANY MORE. I DO UNDERSTAND THAT THE FIRST DRAFT OF THE PROGRAM, I RECOGNIZE THAT THE DEPARTMENT IS WAITING FOR STATE FEEDBACK BEFORE FINALIZING THOSE ALLOCATIONS, SO THAT IS FINE. SHERRY AND MEGAN, AS PART OF THIS YEAR'S BUDGET REPORTING COMPANY COMMITS IN APRIL. I WANT TO MAKE SURE WE HAVE A CLEAR UNDERSTANDING OF BHSD PROGRAMS INCLUDING THE CHANGING TRANSITION. I'LL MAKE A MOTION OUTLINING WHAT I'M LOOKING FOR AT THE END OF MY COMMENTS. ESSENTIALLY I WANT TO MAKE SURE OUR COUNTY AGAIN HAS FULL TRANSPARENCY ABOUT THE REASONS FOR MAKING SPECIFIC BUDGET RECOMMENDATIONS AND THAT OUR PROVIDERS AND COMMUNITY STAKEHOLDERS HAVE SUFFICIENT TIME TO PROVIDE MEANINGFUL INPUT ON THE BHSA PLAN AND BROADER BEHAVIORAL HEALTH BUDGET WAY BEFORE THE MAY BUDGET STUDY SESSIONS. THANK YOU VERY MUCH. I'LL MAKE THE MOTION A LITTLE BIT CLEARER AT THE END, BUT I APPRECIATE THE EARLY SUPPORT. THANK YOU. I WANT TO ACKNOWLEDGE THE CONCERNS THAT WE'VE HEARD BOTH FROM BEFORE TODAY AND THIS MORNING FROM COMMUNITY MEMBERS AROUND THE TRUST PROGRAM AND OUR BROADER CRISIS RESPONSE TEAM AND JUST TO SHINE A SPOTLIGHT ON OUR LEADERS IN THIS WORK, GRETA, KEY, MEGAN AND SHERRY. IT'S CRITICAL THAT OUR MENTAL HEALTH CRISIS RESPONSE DELIVERS HIGH QUALITY RELIABLE SERVICES, AND I KNOW THAT YOU DON'T DISAGREE WITH ME, BUT I ALSO THINK THAT WE NEED STRONGER COLLABORATION ACROSS THE ENTIRE CRISIS RESPONSE NETWORK AND WE CURRENTLY HAVE SPECIFICALLY BETWEEN THE TRUST COMMUNITY ADVISORY BOARD, COUNTY STAFF AND OUR MOBILE CRISIS RESPONSE SYSTEM PROVIDERS. THE ORIGINAL VISION FOR TRUST AS ARTICULATED BY COMMUNITY PARTNERS WAS A NON LAW ENFORCEMENT BASED IN THE FIELD MENTAL HEALTH CRISIS RESPONSE, NOT SIMPLY AN OUTREACH MODEL. AND THAT INCLUDES, SO THAT WOULD INCLUDE IN MY VIEW RESPONDING TO INDIVIDUALS EXPERIENCING SUICIDAL IDEATION, WHO ARE NOT NECESSARILY POSING AN IMMEDIATE SAFETY RISK. WHAT I'VE BEEN HEARING FROM COMMUNITY STAKEHOLDERS ABOUT TRUST IS THAT THEY WOULD LIKE THE CAB MEETINGS TO BE MORE COLLABORATIVE, SHERRY I'VE HEARD YOU SAY THAT YOU ARE ALREADY MOVING ON THIS PATH, SO I AM REITERATING WHAT I BELIEVE IS ALREADY IN MOTION, AND CAB CERTAINLY HAS LEGITIMATE QUESTIONS ABOUT THE TRUST PROGRAM SCOPE, DIRECTION, LONG TERM STABILITY. JAMES, THANK YOU VERY MUCH FOR YOUR COMMENTS INDICATING THAT WE REALLY ARE ALIGNED IN TURNING OVER EVERY POSSIBLE STONE TO FIND SUSTAINABLE FUNDING. AND AGAIN, ALL OF THIS IN LIGHT OF THE FACT THAT THE COUNTY HAS TO MAKE SIGNIFICANT BUDGET CUTS IN THIS UPCOMING IF I SAY TALL YORE, SO I WOULD DIRECT ADD TO GUESS ORK WITH CAB MEMBERS AND THE TRUST PROVIDERS TO DEVELOP A BETTER STRUCTURE FOR THE TRUST COMMUNITY ADVISORY BOARD, ONE THAT PROMOTES GENUINE COLLABORATION AND ENSURES THAT EVERYONE AT THE TABLE FEELS HEARD AND RESPECTED, AND WHERE REASONABLE INFORMATION REQUESTS FROM CAB ARE APPROPRIATELY TRACKED AND RESPONDED TO. AS AN INITIAL STEP, I WOULD RECOMMEND, I'M NOT DIRECTING, I'M RECOMMENDING THAT THE CAB MEMBERS SELECT A CHAIR WHO CAN PARTNER WITH COUNTY STAFF AND TRUST PROVIDERS TO HELP SET AGENDAS AND FACILITATE MEETINGS. I KNOW THAT EVERYONE INVOLVED IN THE TRUST COMMUNITY ADVISORY BOARD TRULY, DEEPLY CARES ABOUT BEHAVIORAL HEALTH ACCESS AND SUPPORTING OUR COMMUNITY, SO LET'S TAKE FULL ADVANTAGE OF THIS PRECIOUS, I'M NOT USING THAT WORD LIGHTLY, THIS TRULY PRECIOUS OPPORTUNITY AND CLIMATE WHERE SO MANY IMPORTANT VOICES CAN COME TOGETHER. FINALLY, I WANT TO THANK BHCA FOR INCLUDING SYSTEM IMPROVEMENT RECOMMENDATIONS ON PAGE 36 OF THE UPDATED SLIDE DECK, AND BEHAVIORAL HEALTH FOR THE DEFICIT MITIGATION STRATEGIES ON PAGE 39. I WOULD APPRECIATE AN UPDATE ON THESE RECOMMENDATIONS. THEIR FEASIBILITY OR A PROGRESS UPDATE, IT'S AN OFF AGENDA REPORT BY THE FIRST MEETING IN OCTOBER. WITH ALL OF THAT, I WILL MAKE WHAT I HOPE IS A CLEAR AND SOMEWHAT CONCISE MOTION. MY MOTION IS TO RECEIVE THE REPORT WITH DIRECTIONS TO, NUMBER ONE, INCLUDE INFORMATION ON THE TRANSITION FROM MHSA TO BHSA AND BEHAVIORAL HEALTHS BUDGET PROPOSAL TO HHC IN APRIL, INCLUDING WHAT I HAD ORIGINALLY REQUESTED FOR THIS REPORT, WHICH WAS INFORMATION ON THE PROGRAMS AND SO WHAT PROGRAMS AND SERVICES ARE CONTINUING, AND BEING RECATEGORIZED UNDER A NEW OR EXISTING BHSA FUNDING BUCKET, WHAT PROGRAMS ARE BEING ADDED FOR EXPANDED TO MEET NEW STATE REQUIREMENTS, AND WHAT PROGRAMS ARE SCALING BACK OR BEING COMPLETELY ELIMINATED DUE TO BUDGET LIMITATIONS. FOR REFERENCE, THIS WAS THE EARLIER REQUEST. I'M JUST RESTATING IT HERE. SECOND PIECE OF DIRECTION IS TO WORK WITH THE TRUST COMMUNITY ADVISORY BOARD MEMBERS, COUNTY STAFF AND TRUST PROVIDERS TO DEVELOP A MORE COLLABORATIVE STRUCTURE FOR THE TRUST COMMUNITY ADVISORY BOARD AND IN RECOGNITION OF A NUMBER OF THE THOUGHTFUL IDEAS THAT WERE SHARED THROUGH PUBLIC COMMENT AND COMMUNICATIONS WITH MY OFFICE, I WOULD REQUEST THAT BEHAVIORAL HEALTH COLLABORATE WITH MY OFFICE AND THE TRUST COMMUNITY ADVISORY BOARD TO EXPLORE POTENTIAL REFINEMENTS TO THE MOBILE CRISIS RESPONSE SYSTEMS REPORTING METRICS. THIRD, THE THIRD PIECE OF DIRECTION IS AN OFF AGENDA REPORT BY THE FIRST BOARD MEETING IN OCTOBER ON THE FEASIBILITY AND OR PROGRESS TOWARD STRUCTURAL DEFICIT MITIGATION STRATEGIES THAT WERE INCLUDED ON PAGE 39 AND THE RECOMMENDATIONS OUTLINED ON PAGE 36 OF THE UPDATED PRESENTATION. I'M HOPING YOU ARE STILL IN FOR A SECOND.

>> SECOND. I JUST HAVE A QUESTION ABOUT THE STRUCTURAL DEFICIT IMPROVEMENTS, YOU'RE ASKING FOR THOSE TO HAVE BEEN AFTER THE BUDGET IS IMPROVED? YOU SAID OCTOBER.

>> YES, BECAUSE THOSE ARE THE ONGOING PIECES, NOT NECESSARILY THE ABSOLUTE URGENT NEEDED FOR THIS FISCAL YEAR.

>> OK.

>> THANK YOU.

>> I THINK.

>> WELL, YOU SECOND IT. I JUST DON'T WANT TO SKIP ANYBODY, BUT THANK YOU. OK, SO I AM GOING TO PICK UP A LITTLE BIT WHERE YOU LEFT OFF, SUPERVISOR ELLENBERG, ONLY BECAUSE I THINK IT MAKES SENSE AND THEN I'LL GO BACK TO SOME OF THE POINTS THAT I WANTED TO MAKE. SO SOME OF THE IMPROVEMENTS BASED ON ONE OF YOUR SLIDES, YOU HAVE STRATEGIES THAT YOU'RE GOING TO TAKE IN ORDER TO INCREASE OR TO DECREASE THE STRUCTURAL DEFICIT STRATEGIES. ONE OF WHICH IS ON THE COST REDUCTION STRATEGIES IN THIS ONE, TWO, THREE, OUR, FIVE, THE 51ST DOWN IS THE CRISIS SYSTEM TO ALIGN WITH ANTICIPATED STATE BENEFIT CHANGES WHILE ENSURING SUSTAINABILITY. SO TRANSLATE THAT FOR ME. WHAT DOES THAT MEAN? WHAT DID YOU MEAN BY IT?

>> THAT IS A VERY FAIR QUESTION. SO SINCE THE INCEPTION OF TRUST AND ALSO PART WAS ANOTHER INNOVATION PROGRAM, ADOPTED BY MEDI CAL, WE HAVE BEEN ACTIVELY WORKING WITH OUR CONTRACTORS TO MAKE SURE THAT WE ARE FULLY MAXIMIZING THAT BENEFIT EVEN CONTEMPLATED CHANGES AT THE STATE LEVEL THAT WOULD REDUCE FUNDING, IT IS STILL AN ONGOING FUNDING STREAM THAT WE CAN TAP INTO TO MAINTAIN OUR ROBUST SYSTEM.

>> I DO WANT TO JUST TAKE THIS OPPORTUNITY TO POINT OUT ONE OF THE MANY THINGS WE ARE NOT PLEASED WITH IN THE GOVERNOR'S BUDGET PROPOSAL, WHICH IS SPECIFICALLY TO SHIFT THE POSSIBLY CRISIS RESPONSE BENEFIT FROM BEING MANDATED TO OPTIONAL, WHICH ON ONE HAND YOU MIGHT THINK THAT GIVES FLEXIBILITY. ACTUALLY WHAT IT DOES IS TAKES AWAY THE STATE FUNDING ASSOCIATED WITH THAT AND MAKES IT SO THAT IF A COUNTY CHOOSES TO DO IT, THE COUNTY HAS TO COVER 100% OF THE NON FEDERAL SHARE. SO WHAT IT ACTUALLY IS, IS A PROPOSAL BY THE STATE TO COST SHIFT TO COUNTIES LIKE OURS THAT THEY KNOW WILL BE COMMITTED TO TRYING TO CONTINUE THE BENEFIT. OF COURSE IN OTHER PARTS OF THE STATE, DIFFERENT THINGS MIGHT HAPPEN THAT ARE EVEN MORE PROBLEMATIC, SO THAT'S ONE VERY CONCRETE ITEM IN THE GOVERNOR'S BUDGET THAT WE STRONGLY OPPOSE ALONG WITH SEVERAL OTHERS AND IS A PIECE OF OUR STATE RELATED BUDGET ADVOCACY, SO THAT'S RELATED TO THE SAME ITEMS. I WANT TO JUST POINT THAT OCCUPANT SO IT'S ON PEOPLE'S RADAR.

>> I APPRECIATE THAT. I JUST WANT TO MAKE SURE THAT AND WANT TO THANK SUPERVISOR ELLENBERG FOR MAKING IT CLEAR THAT WE WOULD LIKE TO KNOW WHAT THOSE PROGRAMS AND SERVICES ARE THAT ARE BEING DISCONTINUED, SCALED BACK, THAT ARE BEING ADDED, ALL OF THAT, BECAUSE I THINK THAT ALLOWS FOR US TO CONTINUE TO SUPPORT THE DIRECTION THAT BHSD IS MAKING OR NOT MAKING AND NOT TO HAVE ANY SURPRISES ESPECIALLY THE LAST TIME THAT WE HAD A SURPRISE WAS WITH PERT. PERT WAS NEVER IN FULL DEVELOPMENT AND NEVER WAS REALLY INGOT AD ON THE PART OF THE COUNTY, SO WE NEVER EVEN GAVE IT A CHANCE AND THESE ARE FOLKS INTERACTING WITH THE LAW ENFORCEMENT AGENCIES, THE LOCAL LAW ENFORCEMENT AGENCIES THAT COULD RESULT IN DEATH OR SEVERE INJURY. SO I WANT TO MAKE SURE THAT THAT DOESN'T CONTINUE TO HAPPEN AND WHILE I'M ON THAT TOPIC, WHAT I MOTION TO FIGURE OUT WHAT FROM THOSE CRISIS RESPONSES THAT YOU HAD EITHER WITH THE TRUST OR THE MCRT, PROBABLY MCRT AT A DIFFERENT LEVEL, HOW MANY OF THOSE INVOLVED LAW ENFORCEMENT OR INCLUDED LAW ENFORCEMENT INCIDENTS? YOU SHOOK YOUR HEAD YES.

>> WE HAVE THAT DATA. I DON'T KNOW IT OFF THE TOP OF MY HEAD BUT IF YOU WANT TO MAKE A REQUEST FOR A TIME PERIOD, WE COULD CERTAINLY PROVIDE THAT.

>> I'LL ASK FOR IT IN THE SAME, ACTUALLY, SUPERVISOR ELLENBERG, YOUR REQUEST FOR ADDITIONAL INFORMATION FOR THE REDUCTION, ADDITION, ALL OF THAT, THAT'S BEFORE THE BUDGET, CORRECT? SO I'LL FOLLOW, I'LL GO AHEAD AND FOLLOW THE SAME TIMELINE THAT SUPERVISOR ELLENBERG RECOMMENDED IN HER I THINK OFF AGENDA REPORT.

>> I HAVE A NOTE THAT THE -- THAT INFORMATION IS IN THE REPORT.

>> SORRY, IT'S ON PAGE 53 OF THE REPORT. YOU CAN SEE -- INAUDIBLE LAW ENFORCEMENT. IT'S BROKEN DOWN.

>> SINCE YOU FOUND THE PAGE, ACCOUNTED YOU SHARE THAT, WITH IT SAYS ABOUT THE PERCENTAGES FOR VICE PRESIDENT ARENAS? THANK YOU.

>> SURE. JUST WANT TO MAKE SURE I'M INTERPRETING IT CORRECTLY. SO I'M LOOKING AT THE LINE FOR TRUST. WE HAVE LAW ENFORCEMENT AGENCY ARRESTS LESS THAN 1% OF THE CALLS. FOR MRSS, WE HAVE 0% OF THE CALLS. AND FOR CRT, LAW ENFORCEMENT ARRESTS IS 1% OF THE CALLS AND FOR WE HAVE LAW ENFORCEMENT ARRESTS AT 2% OF THE CALLS, SO OVERALL INAUDIBLE? IS THAT CONSISTENT FROM PREVIOUS YEARS. I'M JUST WONDERING DID THAT INCREASE, DECREASE, DID OUR RELATIONSHIP BUILDING WITH THE LAW ENFORCEMENT AGENCIES IN THIS COUNTY GROW AND SO THEN THEY CALL IS MORE OFTEN, OR IS THAT PRETTY STAGNANT? THE TIME FRAME IS FROM OCTOBER, 2025 TO DECEMBER 2025 SO IT'S NOT SO COMPARATIVE OVERTIME BUT WE CERTAINLY HAVE THE DATA TO DO THAT.

>> WONDERFUL. I'D LOVE TO LEARN MORE ABOUT THAT. ONE OF THE THINGS I WANT TO MAKE SURE THIS WE DON'T -- SOME OF THE PREVENTABLE DEATHS THAT UNFORTUNATELY HAPPEN WITH -- BECAUSE OUR LAW ENFORCEMENT AGENCIES USE DIFFERENT KINDS OF TOOLS THAN OBVIOUSLY YOU ALL DO, SO THOSE TOOLS MAY BE UTILIZED WITH FOLKS OR AND SOME OF OUR LAW ENFORCEMENT AGENCIES MAY FEEL THREATENED, RIGHT, AND SO I'M, YOU KNOW, I'M NOT EXCUSING ANYBODY, AND I'M CERTAINLY NOT GOING TO BE ON ONE SIDE OR THE OTHER BUT I UNDERSTAND THERE'S INTERACTION THERE IS THAT COULD BE PREVENTABLE AND WE ALSO HAD A DEATH IN OUR JAIL SYSTEM OF A GENTLEMAN WHO, YOU KNOW, SHOULDN'T HAVE INTERACTED WITH OUR POLICE DEPARTMENT IN THAT WAY AND SHOULDN'T HAVE BEEN IN JAIL, AND SHOULD HAVE BEEN IN A DIFFERENT UNIT, SHOULD HAVE, SHOULD HAVE, SHOULD HAVE, BUT HE'S NOT HERE WITH US ANYMORE. THAT'S AT THE BEGINNING OF LAST YEAR, RIGHT? SO THIS IS ALMOST AN ANNIVERSARY FOR THAT GENTLEMAN IN TERMS OF HIS DEATH, AND I KEEP THAT IN THE BACK OF MY MIND, BECAUSE THOSE ARE THE FOLKS WHO WILL CONTINUE TO INTERACT WITH OUR POLICE, OUR DIFFERENT LAW ENFORCEMENT AGENCIES. OK, SO I'M GOING TO MOVE ON TO THE REVENUE EXPANSION STRATEGIES. I'M GLAD YOU HAD THIS IN HERE, BUT THERE WERE SOME OTHER STRATEGIES THAT YOUR PARTNERS MENTIONED, ONE OF WHICH WAS REDUCING DUPLICATE INPUT OF INFORMATION, SIMPLIFYING REQUIREMENTS AS NEEDED, AND I THINK THERE WAS SOME ASSUMPTIONS THAT WERE MADE THAT WERE INTEGRATED. HOW ARE YOU TAKING THOSE, THAT FEEDBACK AND APPLYING IT, INTEGRATING IT, RESPONDING TO IT, SHERRY, WHAT IS IT THAT YOU ALL ARE DOING?

>> THANK YOU FOR THE QUESTION, SUPERVISOR, WE ARE CONTINUING TO WORK WITH OUR CONTRACT PROVIDERS. AS JILL MENTIONED IN HER PART OF THE PRESENTATION, THERE ARE MANY REGULATORY REQUIREMENTS AND DIRECTIVES AND OBLIGATIONS WE ARE REQUIRED TO DO WITH RESPECT TO DATA COLLECTION, REPRESENTING THE NETWORK, THE INFORMATION THAT WE ARE REQUIRED TO SHARE WITH THE STATE, AND, YOU KNOW, THOSE DO TRICKLE DOWN TO THE COUNTY AND THEN TO THE PROVIDERS, WE CONTINUE TO WORK TOGETHER TO ATTEMPT TO MITIGATE, YOU KNOW, ADMINISTRATIVE BURDENS TO THE EXTENT POSSIBLE, HOWEVER, YOU KNOW, THERE ARE GOING TO ALWAYS BE SPECIFIC REQUIREMENTS THAT WE ARE REQUIRING OUR PROVIDERS TO PROVIDE, JUST THAT ARE PART OF THE REGULATORY REQUIREMENTS, SO TO YOUR QUESTION, WE ARE CONTINUING TO ALWAYS LOOK AT OPTIONS FOR REDUCING ADMINISTRATIVE BURDEN, BUT THERE, YOU KNOW, CERTAINLY ARE CERTAIN CIRCUMSTANCES FOR WHICH WE ARE JUST REQUIRED TO GET INFORMATION THAT WE NEED TO HAVE.

>> THAT'S COMPLETELY UNDERSTANDABLE, BUT WHAT IS SUBSTANTIAL THAT TO TAKE AWAY FROM THE PROVISION OF A SERVICE IS SOMEBODY WHO IS A THERAPIST WHO IS JUST INPUTTING SOMETHING THAT THEY HAVE ALREADY INPUT INTO -- I DON'T HAVE THE ANSWER TO THIS, BUT I KNOW THAT BETWEEN YOU AND THE STAKEHOLDERS, THERE IS AN ANSWER, AND THERE'S ALWAYS IMPROVEMENT FOR IF YOU ARE NOT LOOKING TO INTERNALLY IMPROVE, THIS IS WHAT IS MISSING HERE FOR ME, YOU HAVE A STRUCTURAL MITIGATION STRATEGY IN ORDER TO EXPAND NEW REVENUE AND DECREASE YOUR REVENUE BUT MISSING A REAL ANALYSIS OF YOUR DEPARTMENT AND WHERE YOU'RE DOING REALLY WELL AND I KNOW THERE'S A LOT OF REALLY GREAT PLACES THAT YOU'RE DOING WELL AND I'LL MENTION THOSE IN A MINUTE BUT THERE ARE ALSO AREAS WHERE THERE'S GAPS. I THINK THIS IS AN OPPORTUNITY FOR US TO TAKE A LOOK AT THOSE GAPS AND IMPROVE THOSE, AND I DID NOT HEAR THAT IN THIS PRESENTATION, SO TELL ME, WHAT YOU ARE CONCRETELY GOING TO DO?

>> I SEE JAMES' LIGHT ON.

>> I WOULD JUST ADD, SUPERVISOR, THERE'S A TREMENDOUS AMOUNT OF WORK HAPPENING ON THE DEPARTMENT AS A WHOLE. IF YOU LOOK AT BULLET #1 UNDER COST REDUCTION STRATEGIES, RESTRUCTURING ALL LEVELS OF DEPARTMENT TO IMPROVE EFFICIENCY OF OPERATIONS, AND I THINK YOU SHOULD EXPECT TO SEE COMING FORWARD AND THIS DEMOCRATIC'S BUDGET PROPOSAL'S PRETTY SIGNIFICANT.

REDUCTIONS ASSOCIATED WITH THE DEPARTMENT. WE'VE ALSO RAISED, FOR SOMETIME NOW, THE ISSUE OF OUR OWN CLINICS. THEY'RE THE MINORITY OF THE BROADER NETWORK, BUT WE DO HAVE COUNTY-RUN BEHAVIORAL CLINICS, AND THE NEED FOR THOSE CLINICS TO ALSO BE ACHIEVING PRODUCTIVITY AND TRANSITIONAL FEE-FOR-SERVICE JUST LIKE PROVIDERS DO, AS WELL. THERE'S UNIQUE THINGS ABOUT THOSE CLINICS BECAUSE OF THE POPULATION SERVED OR LOCATIONS SERVED THAT MAKE THEM A LITTLE DIFFERENT THAN THE COMMUNITY PROVIDERS IN TERMS OF ACCESS OR POPULATIONS, BUT THAT IS ANOTHER BIG PIECE OF THINGS. AND THE BOARD WILL RECALL, ACTUALLY, IN THE LAST BUDGET, THAT THERE WERE A NUMBER OF RESTRUCTURING WITH THE SERVICE DEMOCRATIC'S OWN CLINICAL OPERATIONS, AS WELL. I ASSURE THE BOARD THAT THAT IS A SIGNIFICANT PIECE OF THINGS, AS WELL, THAT IS ONLY ABOUT 10% TO 15% OF THE NETWORK.

"I'M GOING TO ADD THAT TO THE MOTION. I WANT A REALLY THOROUGH BREAKDOWN OF WHAT THAT RESTRUCTURING IS GOING TO BE AND PER THE DEFICIENCIES OF THE OPERATION BECAUSE I THINK IT STARTS IN-HOUSE. IT STARTS WITH TAKING A LOOK AT WHAT OUR ANALYSIS -- THAT YOU GIVE US AN ANALYSIS OF THE DEPARTMENT SO THAT WE CAN CLEARLY SEE WHAT ARE SOME OF THE STRUCTURAL DEFICIENCIES, AND THEN WE CAN ALSO, AS POLICYMAKERS, BE ABLE TO SUPPORT YOU OR NOT, OR BE ABLE TO GUIDE WITH POLICY A DIFFERENT DIRECTION. BUT IF WE DON'T HAVE THE INFORMATION, WE'RE NOT GOING TO BE ABLE TO DO THAT.

THERE ARE SOME REALLY WONDERFUL PERFORMANCE AND EQUITY OUTCOMES THAT I DO WANT TO MENTION BEFORE I CONTINUE ON. AND THE REASON I -- WELL, LET ME JUST START BY SAYING THAT I KNOW THAT BEHAVIORAL HEALTH EXCEEDED THE STATE TARGETS AND MULTIPLE QUALITY MEASURES, AND THAT INCLUDES FOLLOW-UPS WITH HOSPITALIZATION, EMERGENCY DEPARTMENT VISITS, MEDICATION ADHERENCE, SCHIZOPHRENIA SPECIFICALLY. THERE IS ALSO, I THINK, TREATMENT OUTCOMES THAT ARE COMPARABLE TO OTHER RACIAL AND ETHNIC GROUPS. AS YOU KNOW FROM THE LATINO HEALTH ASSESSMENT AND LATINOS OVERREPRESENTING CLIENTS IN BEHAVIORAL HEALTH DEPARTMENT, IT'S IMPORTANT TO ME AND IT'S IMPORTANT FOR US TO CONTINUE TO LOOK AT THOSE WHO ARE UNDERSERVED. THEY REPRESENT, LATINOS REPRESENT 58% OF THE CLIENTS SERVED, SO I WANT TO MAKE SURE WHEN YOU MAKE THOSE CUTS OR YOU REDUCE ANYTHING, I WANT TO UNDERSTAND HOW THAT'S GOING TO IMPACT THE LATINO COMMUNITY, HOW THAT'S GOING TO IMPACT SOUTH COUNTY SPECIFICALLY.

BUT THEN I'M GOING TO ALSO BRING IT BACK TO REALITY, BECAUSE WHEN OUR CHILDREN AREN'T MET WITH THE KIND OF SUPPORT SERVICES THAT THEY NEED, THERE'S VERY SERIOUS CONSEQUENCES TO THAT. AND WE MIGHT TAKE A LOOK AT, WELL, WE NEED TO CREATE EFFICIENCIES INTERNALLY SO THAT WE CAN RUN A BETTER PROGRAM. AND IN THE END, WHAT WE'RE HOPING TO DO IS SUPPORT OUR YOUTH, AND OUR YOUTH HAVE LIVED THROUGH A PANDEMIC. I KNOW PERSONALLY, MY DAUGHTER WAS IN KINDER. IN KINDER, YOU SOCIALIZE IN ORDER TO LEARN. IT'S A PHASE THAT YOU'RE IN, AND THAT WAS ABSENT FOR HER, SO THERE'S CONSEQUENCES IN TERMS OF DEVELOPMENT FOR THAT. AND EVERY ABLE, AND EVERY WHETHER IT'S ELEMENTARY OR HIGH SCHOOL, WE'VE HAD THOSE CONSEQUENCES, RIGHT? AND AS A SYSTEM, I HAVEN'T SEEN IT CLEARLY RESPOND TO THE PANDEMIC, THE NECESSITIES OF OUR CHILDREN AND YOUTH IN A WAY THAT I THINK IS DIRECTLY CONNECTED. AND I'LL GIVE YOU AN EXAMPLE IN TERMS OF HOW I HAVEN'T SEEN THAT, BECAUSE IN THE SDRTPS AND THE SCATTERED HOMES THAT WE HAD, THERE WAS SOME REALLY DIFFICULT THINGS THAT WERE HAPPENING THERE, AND IT WAS -- IT MADE ONLY SENSE TO ME TO HAVE BEHAVIORAL HEALTH AND DFCS WORKING TOGETHER IN ORDER TO BETTER SUPPORT OUR CHILDREN AND YOUTH. THEN THERE WAS FOSTER CARE NOW DUTIES WHO STEPPED UP AND PARTICIPATED IN TERMS OF GIVING SOME FEEDBACK. THAT DIDN'T HAPPEN ORGANICALLY. THAT CAME FROM THE BOARD. THAT CAME FROM A REFERRAL FOR ME, AND SO THOSE KIND OF IMPROVEMENTS, THOSE ARE THE KINDS OF IMPROVEMENTS, THOSE ARE THE KINDS OF CROSS-DEPARTMENT MENTAL WORK THAT I WOULD LIKE TO CONTINUE TO SEE, ESPECIALLY AS DFCS IS DOING OVERHAUL IN TERMS OF THEIR -- THE WAY THAT THEY'RE PROVIDING SERVICES AND IMPROVING THEIR SERVICES.

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

"YES, THANK YOU FOR RAISING THOSE VERY ALARMING STATS, SUPERVISOR. YOU KNOW, THE BEHAVIORAL HEALTH DEPARTMENT, LIKE MANY OF OUR COUNTY DEPARTMENTS, COMMITTED TO THE WELL-BEING OF CHILDREN IN THIS COMMUNITY FOR MANY DECADES. THE BOARD HAS SUPPORTED MANY, MANY OF HIS AND BEHAVIORAL HEALTH SERVICES TO REINFORCE THE SUPPORT OF THE WELL-BEING OF CHILDREN TO BE ABLE TO THRIVE IN OUR COMMUNITY. WE HAVE COMMITTED OVER THE YEARS EFFORTS AROUND SUICIDE PREVENTION, PREVENTION, EARLY INTERVENTION AND EDUCATION ACROSS THE COMMUNITY, AND EVER DEVELOPED A REALLY ROBUST CONTINUUM OF SUPPORT AROUND BEHAVIORAL SUPPORT FOR CHILDREN, YOUTH AND FAMILIES. YOU THINK SOME OF THE THINGS THAT WE'RE EXCITED TO BE ABLE TO POINT TO ARE SOME OF THE STATE-WIDE EFFORTS AROUND THE CALIFORNIA YOUTH BEHAVIORAL HEALTH INITIATIVE, WHICH IS GOING TO BE ABLE TO BRING SERVICES TO YOUNG PEOPLE UP TO AGE 25 IN SCHOOLS AND IN COLLEGES. AND SO THAT WILL CLEARLY EXPAND THE OPPORTUNITY FOR INDIVIDUALS AT WHATEVER LEVEL OF BEHAVIORAL HEALTH NEED THEY HAVE TO RECEIVE SCREENING, ASSESSMENT AND TREATMENT OPPORTUNITIES. AND SO WE'RE REALLY LOOKING TO EXPAND AND PARTNER WITH THE STATE ALONG THESE INITIATIVES WHILE BRINGING YOU KNOW AND CONTINUING TO PROVIDE THOSE SUPPORTS AT THE LOCAL LEVEL. WHILE THAT MAY NOT ADDRESS YOUR QUESTION SPECIFICALLY, I WILL SAY THAT WE DO VERY MUCH TAKE THE NEEDS OF THE CHILDREN IN OUR COMMUNITY VERY SERIOUSLY. WE HAVE COMMITTED FOR MANY YEARS TO ATTEND TO THEIR BEHAVIORAL HEALTH NEEDS, AND WILL CONTINUE TO DO SO TO THE EXTENT THAT WE'RE ABLE TO."

LET ME JUST CORRECT MYSELF. I SWITCHED THOSE NUMBERS, SO THAT TWO OVERDOSES, TWO -- IN 2010-2018, AND IT WAS 25 FOR 2019-2023. IT JUST TELLS ME, AND THIS IS JUST ONE ASPECT OF IT, IT'S NOT THE WHOLE. I DIDN'T DO A COMPARATIVE OF ALL OF THE DEATHS, BUT IT WAS VERY CLEAR THAT NEGLECT HAD A LOT TO DO WITH SOME OF THE PREVENTABLE DEATHS. AND IT IS VERY DIFFICULT FOR US TO SEE NEGLECT, DFCS TO SEE NEGLECT, BUT THERE ARE ALSO A LOT OF THE DEATHS HAD TO DO SO WITH SUICIDES. THAT IS, THOSE ARE OUR CHILDREN WHO ARE ASKING FOR HELP. OUR TRANSGENDER YOUTH, WHO IS OBVIOUSLY, YOU KNOW, IN A PLACE WHERE THEY'RE IN A CRISIS, AND FOR THEM TO HAVE THIS OPTION TO ME, IT MEANS WE'RE FAILING THEM. SO YOU CAN TELL ME EVERYTHING ABOUT HOW THE FEDERAL GOVERNMENT AND THE STATE GOVERNMENT IS IMPOSING REGULATIONS, REDUCTIONS, BUT AS A MOM, WHAT I'M GOING TO SEE IS OUR CHILDREN ARE, THEY'RE DYING AT THEIR OWN HANDS, BECAUSE WE ARE NOT SUPPORTING THEM, AND WE'RE NOT BEING RESPONSIVE. AND SO I'M GOING TO ADD TO THE MOTION ON THE FLOOR TO HAVE A MORE DIRECT RESPONSE FROM THE RECOMMENDATIONS THAT WERE MADE BY THE COMMITTEE, BY THE NUMBER OF DEATHS THAT WERE COMMITTED EITHER THROUGH SUICIDE AND SOME PREVENTABLE DEATHS. I'D LIKE TO SEE A DIRECT RESPONSE FROM YOU, AND MAYBE LATER WHAT I'LL DO IS A REFERRAL DIRECTLY ON THAT SO WE CAN HAVE SOMETHING ONGOING AND STRUCTURAL THAT BEHAVIORAL HEALTH AND DFCS HAS A RESPONSE ON AN ANNUAL BASIS. BUT FOR THE MOMENT, I'D JUST LIKE TO USE THIS MOTION TO ASK FOR THAT.

"THAT'S FINE."

PERFECT. YOU KNOW, I'M GOING TO END THERE. I DO HAVE A LOT MORE POINTS I WANTED TO MAKE, BUT I'M GOING TO REST THERE, BECAUSE I THINK THAT THE CHILDREN THAT PASSED AWAY THAT ARE IN THIS REPORT, I THINK IS -- THEIR STATEMENT ABOUT HOW WE ARE DOING IS STRONGER THAN ANYTHING ELSE THAT I CAN ADD IN TERMS OF COMMENTS, SO I'LL END THERE.

SUPERVISOR ABE-KOGA.

THANK YOU, AND THANK YOU FOR THIS PRESENTATION. I THINK IT'S A GOOD START TO THIS CONVERSATION, BUT I AGREE WITH MY COLLEAGUES WHO HAVE ALREADY SPOKEN THAT I THINK THIS IS REALLY SORT OF THE TIP OF THE ICEBERG, AND WE DO NEED FURTHER IN SOME OF THESE ISSUES. I'LL START OFF SAYING THERE IS DEFINITELY A LOT OF POSITIVE WORK BEING DONE. I'M GLAD THAT THE COUNTY IS CONTINUING TO ADD HEALTH BENEFITS CREDIT DOING MEETING THE NEEDS OF OUR COMMUNITY. I GUESS I'LL PICK UP WHERE VICE PRESIDENT ARENAS LEFT OFF. MY FOCUS OR INTEREST WAS ON THE YOUTH MENTAL HEALTH SERVICES. AS SOME OF YOU MAY KNOW, WITHIN MY DISTRICT, WE FACED ANOTHER TRAGEDY LAST WEEK WITH ANOTHER STUDENT WHO DIED BY SUICIDE. AND THIS IS THE, I BELIEVE, THE FOURTH HALF IN THE ONE CITY IN THE CITY OF PALO ALTO, WHICH HAS EXPERIENCED THESE CLUSTERS OVER THE LAST 10 YEARS, AND IT LOOKS LIKE ANOTHER ONE HAS BEGUN. AND SO MY, YOU KNOW, QUESTION WAS ALONG THE LINES OF WHAT ARE WE DOING TO RESPOND TO THE NEEDS THAT ARE CLEAR IN OUR COMMUNITY, ESPECIALLY AROUND YOUTH. I KNOW THAT THERE'S BEEN, THERE'S COMMENT OR NOTE THAT WE AS A COUNTY HAVE THE HIGHEST RATE OF RESPONSE, BUT I'M LOOKING FOR REALLY MORE SPECIFICS ON HOW WE'RE DEALING WITH THE NEEDS OUT THERE. I DO APPRECIATE SUPERVISOR ELLENBERG'S MOTION. I REALLY WAS LOOKING FOR THE, YOU KNOW, WHAT ARE OUR PROGRAMS THAT WE'RE GOING TO BE NEEDING TO SCALE BACK, AND PERHAPS ELIMINATE. AND IN PARTICULAR, MY INTEREST IS THAT GIVEN IT LOOKS LIKE 85% OF THE SERVICES PROVIDED ARE FROM OUR COMMUNITY PARTNERS, THE REAL NEED TO ENGAGE WITH OUR COMMUNITY PARTNERS IN THIS CONVERSATION. AND I APPRECIATE DHCA'S RECOMMENDATIONS. THE SLIDE WASN'T IN OUR PRESENTATION, SO I HOPE WE CAN GET A COPY OF THAT, BUT I'M SPECIFICALLY INTERESTED IN LEARNING OR SEEING HOW WE RESPOND TO THOSE RECOMMENDATIONS, BECAUSE I VALUE THOSE, FROM THE, OUR PARTNERS WHO ARE OUT THERE ON THE FRONT LINES PROVIDING THESE SERVICES. I JUST WAS LOOKING AT AND LOOKING AT SOME OF THE IDEAS OR RECOMMENDATIONS, YOU KNOW, I KNOW WE FOCUSED A LOT ON MEDICAL PATIENTS, THAT'S ONE OF OUT OF FOUR IN OUR COUNTY. MAD CAL IS COMMUNITY-WIDE. I DON'T KNOW IF YOU CAN PUT UP THE BHC SLIDE, BUT THE IDEAS OF TRAINING FOR PRIVATE INSURANCE BILLING, THESE ARE THINGS I HEAR IN THE COMMUNITY. MEDICARE, WE HAVE A LOT OF MEDICARE FOLKS, SO LOOKING AT WHAT ARE THE ALTERNATIVES OUT THERE FOR FUNDING SOURCES AND BEING BETTER AT CAPTURING THE FUNDING SOURCES THAT ARE OF INTEREST TO ME. I THINK ABOUT THE PROGRAMS WE PROVIDE. GENUINE THINK WE NEED TO WORK WITH OUR COMMUNITY PARTNERS TO COME UP WITH, YOU KNOW, GOOD SOLUTIONS. I'LL BE, YOU KNOW, FRANKLY, I'LL JUST BE VERY FRANK. ALCOVE IS A YOUTH MENTAL HEALTH COUNSELING CENTER IN PALO ALTO, AND JUST LIKE PERK CAME UP IN ONE OF OUR MEETINGS FOR ELIMINATION WITHOUT ANY CONVERSATION HERE, AGAIN, AND YOU KNOW, IN LIGHT OF THE FACT THAT THIS COMMUNITY IS FACING THESE TRAGEDIES, IT'S JUST A VERY OPPORTUNE TIME TO BE CUTTING COMPLETELY ELIMINATING A PROGRAM. SO OUR OFFICE ORGANIZED A COMMUNITY MEETING WHERE WE HAD 150 PEOPLE SHOW UP, AND I APPRECIATE STAFF COMING, BUT WE HAVE BEEN WORKING WITH THE COMMUNITY PARTNERS WHO HAVE STEPPED UP AND SAID, YOU KNOW, WE'RE WILLING TO TRY TO EVEN HELP FUNDRAISE TO KEEP THIS PROGRAM GOING. AND SO MAYBE WE HAVE TO PARE DOWN. THAT'S WHAT I'M LOOKING FOR IF WE HAVE TO REDUCE BECAUSE OF OUR DEFICIT, WE HAVE TO BE, YOU KNOW, LOOK AT WHAT'S GOING ON IN THE COMMUNITY AND RESPOND ACCORDINGLY. AND TO CUT A PROGRAM FOR YOUTH WHEN WE HAVE THESE SUICIDES HAPPENING IS JUST NOT THE RIGHT THING TO BE DOING. AND SO IT'S JUST AN AWARENESS ISSUE, I THINK, AND THEN TO BE, TO WORK WITH THE COMMUNITY. AND YEAH, WHEN I SAID LOOK, WE NEED HELP, YOU KNOW, FOLKS ARE WILLING TO STEP UP. SO I REALLY THINK THAT, YOU KNOW, I APPRECIATE THE WORK THAT'S BEING DONE, BUT SOMETIMES I FEEL LIKE IT'S VERY INTERNAL, AND WE'RE NOT REALLY FOCUSING OR FACING OUTWARD ENOUGH, AND I THINK WE NEED TO BE DOING A BETTER JOB OF THAT. SO THAT'S WHAT I WOULD LIKE TO ASK, SO, YOU KNOW, THE PROGRAM BY PROGRAM SPECIFICS I THINK WILL HELP US IN THAT -- IN THAT EFFORT, AND LOOKING AT WAYS TO, YOU KNOW, PRESERVE AS MUCH AS WE CAN, NOT WITHOUT -- WITH, YOU KNOW, COMMUNITY INVOLVEMENT, I THINK IS REALLY THE WAY TO MOVE FORWARD IN THESE TOUGH BUDGETARY TIMES. SO THANK YOU FOR THE MOTION. I THINK IT CAPTURES PRETTY MUCH EVERYTHING. YOU KNOW, INCLUDING TRUST, I THINK THERE'S A LOT OF WORK WE CAN DO THERE, TOO. YOU KNOW, THERE'S FOUR PROGRAMS. I'M WONDERING FROM AN ADMINISTRATIVE LIKE BUREAUCRACY, ARE THERE WAYS TO ELIMINATE SOME OF THE BUREAUCRACY AND MAKE IT MORE EFFICIENT? AND I THINK THERE'S AN OPPORTUNITY TO DO THAT THROUGHOUT ALL OF THE PROGRAMS IN THE DEPARTMENT, SO I VERY MUCH SUPPORT THE MOTION. THANK YOU FOR THE ADDITIONS, AND APPRECIATE THE CONVERSATION.

IF I GO BACK TO VICE PRESIDENT.

I JUST WANTED TO ADD ONE THOUGHT ON A COMMENT THAT YOU JUST MADE, SUPERVISOR ABE-KOGA, WHICH IS CRITICAL. AS WE LOOK AT COMMUNITY MENTAL HEALTH NEEDS, ONE HUGE CHALLENGE THAT THE BEHAVIORAL HEALTH DEPARTMENT FACES IS THAT THEY BECOME THE PROVIDER OF LAST RESORT, EVEN FOR FOLKS WITH PRIVATE INSURANCE. THE REASON I'M LIFTING THAT UP IS I THINK THERE'S ALSO A NEED FOR US TO REALLY PRESS THE STATE TO HOLD THOSE PRIVATE INSURANCE PROVIDERS RESPONSIBLE, BECAUSE WHAT HAPPENS WHEN THEY DON'T STEP FORWARD AND ACTUALLY PROVIDE ACCESS, WORK WITH THOSE PARTNERS, YOU KNOW, THE PRIVATE INSURANCE PLANS ARE WHO SHOULD BE REACHING OUT TO OUR COMMUNITY PROVIDERS, MAKING IT EASIER FOR THEM TO BECOME PART OF THEIR NETWORKS OF CARE AND DELIVER SERVICES TO THEIR MEMBERS, THEN THE HEALTH SERVICE HAS TO TAKE ON BUT SHOULD SERVE THOSE ADDITIONAL CLIENTS WHO ABSOLUTELY NEED TO BE SERVED. SO I THINK AS I'M LISTENING TO THIS CONVERSATION, I'M REFLECTING ON HOW WE AS A COUNTY CAN REALLY LIFT UP THE BURDEN THAT WE'RE BEARING THAT TRULY IS THE RESPONSIBILITY OF PRIVATE INSURANCE COMPANIES WHO ARE MAKING HUGE PROFITS AS WE FACE MAJOR CUTS. ANOTHER THING I WOULD JUST SHARE ON I THINK YOUR POINT IS COMPLETELY WELL TAKEN AND IS GOING TO BE MORE WELL TAKEN AS WE ENTER DIFFICULT BUDGET CHALLENGES IN TERMS OF ENGAGING WITH OUR CORE PARTNERS. ONE REALITY THAT I WOULD JUST SHARE THAT I THINK IS GOING TO BE HARD IS THAT WE ARE UNDOUBTEDLY GOING TO BE PROPOSING SIGNIFICANT REDUCTIONS IN THE ADMINISTRATIVE TRANCHE, WHO ARE THE STAFF WHO ALSO DO COMMUNITY OUTREACH AND ENGAGEMENT AS THEY MANAGE THESE ENDEAVORS. WE ARE GOING TO TRY AND REDUCE THAT CAPACITY WHILE ALSO INCREASING OUR EFFICACY IN THOSE VEINS, AND I JUST WANTED TO KNOW HOW CHALLENGING THAT BECOMES AS WE FACE LIMITED RESOURCES BECAUSE WE REALLY DO NEED TO MAKE THOSE REDUCTIONS TO AVOID INSTEAD CUTS TO CLIENT-FACING SERVICES, BUT THAT DOES MAKE THE TASK OF MANAGING ALL THE WORK OF OPERATING THE DEPARTMENT IN DEEP COLLABORATION WITH OUR PARTNERS EVEN MORE TAXING ON THE STAFF THAT REMAIN.

AND I VERY MUCH APPRECIATE THAT, YES. I THINK THERE'S A LOT OF WORK THAT WE NEED TO DO AT THE STATE LEVEL. FRANKLY, THERE'S SO MUCH RED TAPE THAT THEY KEEP ADDING ON, IT'S MAKING IT PRETTY HARD FOR US TO ACTUALLY DO THE DIRECT SERVICE. I WILL SAY THAT I THINK THAT, YOU KNOW, WHAT I AM TRYING TO GET AT, AND IT'S, YOU KNOW, GOING THROUGH THE ALCOVE PROCESS WAS ACTUALLY VERY HELPFUL FOR ME TO SEE A PROGRAM AND SEE, YOU KNOW, FOR THE FUNDING, THE STAFFING, ETCETERA. I WILL SAY, YOU KNOW, AS A COUNTY, YES, WE ARE THE LAST RESORT, BUT I THINK IN THIS AREA, THERE'S A LOT OF WORK THAT CAN BE DONE WELL IN A LOT OF AREAS FRANKLY, BUT UPSURGE THAT WE DON'T GET TO THE LAST RESORT. AND AS A COMMUNITY, AS, YOU KNOW, THE PUBLIC LOOKS AT THE COUNTY AS THE MENTAL HEALTH RESOURCE, OR THE LEADER. THERE'S NO OTHER ENTITY OUT THERE THAT'S GOING TO BE BRINGING EVERYBODY TOGETHER TO TALK ABOUT EVEN THE POLICY AROUND MENTAL HEALTH. THEY LOOK TO THE COUNTY. SO I THINK THAT IS A PART OF OUR ROLE. AND SO, YOU KNOW, WHETHER THAT COMES FROM GENERAL FUND, WHICH I KNOW THAT IT DOES, I THINK THAT'S REALLY ACTUALLY AN EXPECTATION OF THE PUBLIC FROM THE COUNTY. SO WE JUST HAVE TO OWN IT AND FIGURE OUT HOW WE'RE GOING TO DO THAT AND, YOU KNOW, BE THE LEADER, CONTINUE TO BE THE LEADER IN THIS AREA. I WILL SAY, YOU KNOW, BUT IN TERMS OF LIKE THE PROGRAMS, I THINK WE ALSO JUST HAVE TO LOOK AT WHAT WE'RE GOOD AT AND ADMIT THAT WE'RE NOT GOOD AT EVERYTHING. AND I'LL SAY IN THE ALCOVE MODEL, IT'S A TEEN CENTER COUNSELING SERVICE. I DON'T THINK WE'RE THE BEST AT RUNNING A TEEN CENTER, BUT THERE'S A LOT OF OTHER PROVIDERS WHO ARE. THAT'S WHAT I'M LOOKING AT AND SAYING. I'LL BE HONEST, I'D LIKE TO LOOK AT OUR STAFFING, AND IT'S PRETTY STAFF-HEAVY, AND I THINK THAT HAVING WORKED IN THE NONPROFIT WORLD AND PARKS AND REC AND WHAT NOT, THERE ARE OTHER PROVIDERS WHO CAN DO IT MORE EFFICIENTLY. SO LET'S PARTNER WITH THE RIGHT PARTNERS AND THEN PROVIDING THEM WITH WHAT THEY NEED TO BE ABLE TO ADMINISTER THE PROGRAMS, AND THEN, YOU KNOW, WE CAN ADD -- WE CAN DEFINITELY VALUE ADD, BUT WE DON'T NEED TO BE RUNNING EVERYTHING. AND THAT WAS THE POINT I WAS TRYING TO MAKE.

JAMES.

I WANT TO EMPHASIZE A POINT TO GRETA JUST SHARED AND SUPERVISOR, THAT YOU WERE TALKING ABOUT, BECAUSE I THINK THIS IS REALLY SIGNIFICANT. AT ITS CORE, THE BEHAVIORAL HEALTH SERVICES DEPARTMENT IS THE STATE MEDICAL PLAN. THAT IS HOW IT'S FUNDED, MANDATED, THAT IS THE CLIENT POPULATION THAT IT'S DESIGNATED TO SERVE. AND THE ONE TAKEAWAY THAT WE HOPE THAT THE BOARD WOULD GET FROM THE PRESENTATION WAS TO RECOGNIZE THE FUNDING STREAMS AND THE FACT THAT THE ONE FLEXIBLE SOURCE OF FUNDING, MHSA, HAS NOW ALSO BEEN SHIFTED TO FORCE FUNDING AWAY FROM THE EXACT KINDS OF PROGRAMS THAT THIS BOARD HAS LONG CARED ABOUT AND THAT THIS COUNTY HAS DEEPLY INVESTED IN, AND FORCES THAT FUNDING INTO A DIFFERENT SET OF PROGRAMS THAT ARE REALLY FOCUSED ON ACUTE SERVICES FOR THE ADULT POPULATION. AND I SAY THAT BECAUSE THE REALITY THEN IS THAT FOR US TO CONTINUE THE KINDS OF PROGRAMS AND SERVICES THAT THIS CONVERSATION HAS BEEN ABOUT WILL REQUIRE GENERAL FUND MONEY, WHICH MEANS PULLING THAT GENERAL FUND MONEY FROM ELSEWHERE IN THE ORGANIZATION. AND I THINK WE JUST HAVE TO BE VERY CLEAR-EYED ABOUT THAT. AND THE REASON WE OPEN THE PRESENTATION WITH THE DISCUSSION OF THE MEDICAL PLAN IS BECAUSE THAT IS THE CORE DEPARTMENT. WE COULD RENAME THE DEPARTMENT, AND MAYBE IT WOULD BE CLEARER TO THE COMMUNITY IF WE DID, RENAME THE DEPARTMENT THE BEHAVIORAL HEALTH MEDICAL PLAN DEPARTMENT, BUT THAT IS REALLY THE OVERWHELMING BULK OF WHAT THE DEPARTMENT IS, WHAT IT DOES, HOW IT'S FUNDED, AND WHAT THE MANDATES ARE. I SHARE THAT BECAUSE THERE'S NO DISAGREEMENT ON THE PART OF STAFF, AND IT HAS LONG BEEN THE PRIORITY OF THIS COUNTY, UNIQUE IN THE STATE, TO INVEST UPSTREAM IN PREVENTION, IN EARLY INTERVENTION, IN YOUTH, IN VERY SUCCESSFUL PROGRAMS, IN INNOVATIVE PROGRAMS. I THINK THERE'S SOME INCREDIBLE IRONY THAT THE STATE HAS ELIMINATED INNOVATION FUNDING AT A TIME WHEN INNOVATION IS ABSOLUTELY NEEDED IN THE BEHAVIORAL HEALTH SPACE ACROSS CALIFORNIA, BUT I JUST HAVE TO EMPHASIZE THAT POINT, BECAUSE IT IS THE COLD, HARD REALITY THAT PROGRAMS LIKE ALCOVE, AND OF COURSE ONGOING CONVERSATION ABOUT HOW TO CONTINUE AND MODIFY THAT PROGRAM, ARE NOT ACTUALLY A PART OF THE DEMOCRATIC'S MANDATE, NOT PART OF THE MANDATED FUNDING STREAMS, AND HAVE BEEN HISTORICALLY FUNDED THROUGH MHSA INNOVATION FUNDING THAT'S NOW GOING AWAY. AND I KNOW NONE OF US WANT THAT. STAFF DOESN'T WANT THAT, THE DEPARTMENT DOESN'T WANT THAT, ADMINISTRATION DOESN'T WANT THAT. WE KNOW THE MEMBERS OF THIS BOARD DON'T WANT THAT, BUT WE, WE ARE TRYING TO MAKE SURE THAT PEOPLE AT LEAST ARE AWARE OF WHAT'S BEEN FOISTED ON US BY THESE STATE-DIRECTED POLICY CHANGES, LED IN PARTICULAR IN THIS SPACE ON MHSA BY THE CURRENT GOVERNOR, WHO ADVOCATED FOR AND BROUGHT THAT MEASURE TO THE VOTERS TO RADICALLY SHIFT HOW COUNTIES WERE DIRECTED TO UTILIZE THE FUNDING. AND SO WE WILL BRING FORWARD OUR BEST RECOMMENDATIONS IN THIS SPACE. IT WILL OF COURSE BE ITERATIVE. WE WILL ABSOLUTELY BRING THE INFORMATION FORWARD IN APRIL AS REQUESTED IN THE MOTION, BUT I DON'T WANT ANYONE TO LEAVE THIS CONVERSATION THINKING THAT WE HAVE THE ABILITY ON OUR OWN TO JUST CONTINUE ALL OF THOSE PROGRAMS THAT WE LOVE IN THAT SPACE WHEN WE ARE BEING FORCED TO STEER THE FUNDING TOWARDS OTHER SETS OF PROGRAMS AND ACTIVITIES. WE ARE. AND WE'VE TRIED TO SHOW THAT IN A VERY VISUAL WAY IN SOME OF THESE CHARTS JUST HOW SIGNIFICANT THE MAGNITUDE IS. AND I WOULD JUST POINT THE BOARD BACK TO TWO THINGS, SLIDE 24 THAT SHOWS ALL THE MANDATES THAT ARE IMPOSED ON US, AND POINT THE BOARD TO SLIDE 33, AND YOU'LL SEE JUST HOW SIGNIFICANT A SHIFT FROM THAT BLUE CATEGORY OF MHSA FUNDING, RIGHT NOW 48% OF OUR CURRENT FUNDING IS IN THE CATEGORY OF BEHAVIORAL HEALTH SUPPORT SERVICES, AND THAT'S GOING TO BE CAPPED AT 17%. THAT'S HUGE. THAT'S HUGE. SO THE OF COURSE WE HAVE LOTS OF THINGS WE CAN DO BETTER. OF COURSE WE'RE GOING TO BE BRINGING FORWARD RECOMMENDATIONS TO REDUCE ADMINISTRATIVE STAFFING IN THE DEPARTMENT, BUT WE HAVE TO ALSO BE VERY CLEAR-EYED ABOUT WHAT THE ACTUAL ON-THE-GROUND IMPACT IS OF THIS STATE-DIRECTED FUNDING SHIFT ON US AND OTHER COUNTIES, BUT ESPECIALLY ON US BECAUSE THIS IS NOT HOW THE CHART LOOKS IN OTHER COUNTIES IN CALIFORNIA. WE HAVE REALLY DISPROPORTIONATELY PUT MONEY ON THESE KINDS OF PROGRAMS BECAUSE OF THE LEADERSHIP OF THE BOARD, BECAUSE OF THE VALUES OF THE COUNTY ORGANIZATION, AND THAT SHIFT IS BEING IMPOSED ON US, BUT I DON'T WANT US TO LEAVE THIS CONVERSATION WITHOUT ACKNOWLEDGING THAT. WE WILL CONTINUE TO MAKE IMPROVEMENTS, CONTINUE TO BRING FORWARD THE BEST THINKING AROUND THAT, BUT WE'VE GOT TO JUST BE UP FRONT AND TRANSPARENT ABOUT WHAT THIS MHSA TO BHSA SHIFT MEANS FOR THE TYPES OF SERVICES THAT ARE DELIVERED IN THIS SPACE IN THE COMMUNITY.

OK, THANK YOU, JAMES. YES, VICE PRESIDENT.

THANK YOU. ON THAT NOTE, LET ME JUST ASK YOU ON THE REVENUE EXPANSION STRATEGIES, YOU HAVE MEDICAL ADMINISTRATIVE ACTIVITIES AS SOMETHING THAT YOU'RE GOING TO USE TO EXPAND REVENUE. WHO IS DOING THAT AND ARE YOU STARTING TO DO THAT? WHO --

YEAH, SO MEDICAL ADMINISTRATIVE ACTIVITIES IS ANOTHER KIND OF STREAM WAY OF BILLING FOR THE ACTIVITIES THAT WE PERFORM IN THE DEPARTMENT. IT'S SOMETHING WE'VE BEEN BILLING FOR MANY, MANY YEARS, BUT WE WANT TO EXPAND OUR ABILITY TO DO THAT IN OUR FINANCE TEAM. I DON'T THINK THE FINANCE DIRECTOR CAME, IS BUILDING UP THE INFRASTRUCTURE WE NEED TO EXPAND THAT BOTH WITHIN OUR DEPARTMENT AND ALSO IN PARTNERSHIP WITH OUR COUNTY CONTRACTING PROVIDERS.

GOOD MORNING.

IT'S 1:00. YOU DON'T HAVE TO WORRY ABOUT THAT.

I THANK YOU FOR YOUR QUESTION. IN TERMS OF THE -- MEGAN HAS STATED THAT WE HAVE BEEN DOING THAT IN OUR DEPARTMENT, BUT WE HAVEN'T BEEN ABLE TO EXPAND MUCH, SO FIRST STEP FOR US TO EXPAND WITHIN THE COUNTY OPERATIONS FIRST, WHERE WE'RE TAPPING INTO BILLABLE ACTIVITIES WITH REIMBURSEMENTS FROM OUTREACH ACTIVITIES, OUR ADMINISTRATIVE TYPE OF FUNCTION THAT HAVE NEVER BEEN -- THAT WE COULD GET REIMBURSEMENT FOR. THEN ONCE WE HAVE THAT IN ORDER AND WE ARE WORKING WITH OUR -- SOME OF OUR CONTRACTORS TO KIND OF BUILD TO OUT AS WELL TO MAKE SURE EVERYTHING IS IN ALIGNMENT, WE WILL START ROLLING THAT OCCUPANT WITH THE COUNTY CONTRACTED PROVIDERS SO WE CAN BUILD THAT AND BE ABLE TO --

I'M VERY FAMILIAR WITH THAT MA BILLING. I DID THAT 20 YEARS AGO WHEN NANCY PENA WAS THE HEAD OF MENTAL HEALTH WHO FACILITATED THAT FOR FIRST FIVE AND ALL OF ITS SUBCONTRACTORS. SO I'M VERY SURPRISED THAT 20 YEARS LATER, WE HAVEN'T IMPLEMENTED MA BILLING WITH OUR SUBCONTRACTORS. SO FOR 20 YEARS, WE'VE MISSED MA BILLING WITH SUBCONTRACTORS IS WHAT YOU'RE TELLING ME.

I THINK IT IS UNIQUE ACROSS THE STATE TO EXTEND THAT TO CONTRACTORS. STATE-LEVEL TEAM WAS ABLE TO GO TO A CONFERENCE WHERE WE HEARD ABOUT A FEW OTHER COUNTIES THAT ARE DOING IT AND LEARNING FROM THAT EXPERIENCE.

NO, WHAT I'M SAYING IS WE DID THAT 20 YEARS AGO WITH FIRST FIVE, WITH NANCY PENA'S ASSISTANCE WHO IS HEAD OF MENTAL HEALTH AND DID IT WITH ALL OF THE FIRST FIVE'S GRANTEES, SO IT IS NOT A NEW MODEL. IT HAS HAPPENED BEFORE. I DID IT MYSELF. I DIDN'T PROVIDE ANY DIRECT SERVICE. I WORKED DIRECTLY FOR FIRST FIVE. IT WAS MA BILLING, SO I'M JUST SURPRISED THAT WE'RE JUST GETTING THAT GOING RIGHT NOW.

AND SHERRY, YOU WERE AT FIRST FIVE, SO I'M VERY SURPRISED THAT MA BILLING ISN'T INTEGRATED AS A REVENUE EXPANSION FACILITY. IT SHOULD BE BASIC BUILDING BLOCK OF REVENUE. I'M GOING TO MOVE ON TO SOMETHING ELSE, AND THAT IS THE PERCENTAGE OF DEATHS, OVERDOSES THAT HAPPEN IN OUR JAILS BASED ON THE LAST REPORT THAT WE HAD, AND I CAN'T REMEMBER, IT WAS IN THE LAST COUPLE OF MONTHS. AND I BELIEVE LAST YEAR IT WAS AROUND FIVE OVERDOSES, AND THE TOTAL NUMBER OF ADULTS IN CUSTODY THAT RIGHT NOW ARE DOCUMENTED THAT HAVE DOCUMENTED PSYCHIATRIC CRISIS IS 1,637. IT COMES FROM THE AGENCY ADVISORY FORM THAT HAS INDICATED THAT, PERSON HAS DEMONSTRATED SUICIDAL BEHAVIOR OR THROUGH THE ACUTE PSYCHIATRIC UNIT, SO THROUGH THE AGENCY ADVISORY FORM, THAT'S 298, THE ACUTE PSYCHIATRIC UNIT IS 833, AND THEN EPS EMERGENCY PSYCHIATRIC SERVICES IS 281 FOR A TOTAL THAT I JUST GAVE YOU. AND THESE ARE FOLKS WHO ARE COMING INTO OUR JAIL SYSTEM BECAUSE OF PSYCHIATRIC DIFFICULTIES. SO THEY'RE ENGAGING WITH OUR LAW ENFORCEMENT, AND MY ASK IS IF WE HAVE A CAPTIVE AUDIENCE IN OUR JAIL SYSTEM WHERE WE CAN PROVIDE AND RECEIVE REIMBURSEMENT FOR THE SERVICES BECAUSE I'M GOING TO GUESS THAT EVERYBODY, MOST EVERYONE IN THAT JAIL WHO IS SERVING LONGER PERIODS OF TIME IS PROBABLY MEDICAL ELIGIBLE, WHY AREN'T WE PROVIDING SERVICES FOR FOLKS THAT ARE IN CUSTODY THAT WE KNOW HAVE HAD PSYCHIATRIC ISSUES?

SUPERVISOR, THE BEHAVIORAL HEALTH ACUTE SERVICES IN CUSTODY ARE PROVIDED BY CUSTODY HEALTH.

NO, NO, NO. CUSTODY HEALTH IS NOT PROVIDING PSYCHIATRIC SUPPORT. I'M ASKING BEHAVIORAL HEALTHY THEY AREN'T INTEGRATED INTO OUR JAIL SYSTEM, NOT WHAT CUSTODY HEALTH IS DOING SEPARATELY.

CUSTODY HEALTH MANAGES A CONTRACTED PSYCHIATRIC SERVICES FOR THE INPATIENT POPULATION IN OUR JAIL.

THE CONTRACTED SERVICE PROVIDER IS NOT BEHAVIORAL HEALTH.

THAT'S CORRECT.

WHY AREN'T WE PROVIDING SERVICE INTERNALLY IN OUR OWN SYSTEM AND YET WE ARE CONTRACTING SOMEBODY ELSE? THAT TO ME IS AN INDICATION OF EITHER AN INEFFICIENCY, INTERNAL INEFFICIENCY SO WE CAN'T PROVIDE SERVICES IN A MORE DIRECT EFFICIENT AND EFFECTIVE MANNER THAN A CONTRACTOR. THAT'S WHAT IT'S TELLING ME.

WE HAVE HAD SOME CHALLENGES IN THAT REGARD. I THINK IT MAY BE BENEFICIAL TO SHARE SOME OF THAT IN AN OFF-AGENDA FORMAT WITH THE BOARD, BUT WE ARE ACTUALLY IN THE PROCESS OF TRYING TO EXPAND THAT CONTRACTED SERVICE IN CUSTODY, BUT THAT IS NOT A BEHAVIORAL HEALTH SERVICES DEPARTMENT FUNCTION, AND WHILE FOLKS ARE IN CUSTODY, THOSE SERVICES ARE NOT MEDICAL BILLABLE. WHICH IS WHY CUSTODY HEALTH IS A GENERAL FUND, MASSIVE GENERAL FUND OBLIGATION.

YOU TELL ME THERE IS NO CREATIVE WAY TO PROVIDE SERVICES FOR THOSE FOLKS WHO CAME INTO OUR JAIL SYSTEM WHO ARE GOING TO BE REPEAT OFFENDERS, SOME KIND OF SUPPORT WHERE WE CAN CREATIVELY USE OUR SERVICES SO THAT WE CAN DIMINISH THEIR PRESENCE IN OUR JAIL SYSTEM AND SO THAT WE DON'T HAVE A DEATH LIKE WE HAD LAST YEAR.

WE ABSOLUTELY DO PROVIDE THOSE SERVICES. I WAS JUST NOTING THAT THEY'RE NOT MEDICAL BILLABLE SERVICES.

ALL RIGHT. WELL, IT WOULD BE GREAT TO SEE WHAT YOU CAN DO IN TERMS OF CREATIVITY. I DON'T THINK THAT WE HAVE COMPLETELY EXPLORED THAT. THERE IS SUBSTANCE ABUSE, OVERDOSES, THAT SHOULDN'T BE OVERDOSES IN OUR JAIL SYSTEM, BUT YET THEY ARE. WE HAVE SUBSTANCE ABUSE THAT'S INTEGRATED INTO BEHAVIORAL HEALTH, AND YET OUR SYSTEM ISN'T RESPONDING. I'M GOING TO LEAVE IT THERE.

SUPERVISOR DUONG.

THANK YOU. APPRECIATE THE DISCUSSION TODAY AND VERY COMPREHENSIVE SO WE'LL BE VOTING IN SUPPORT OF IT. I JUST WANT TO ACKNOWLEDGE THAT HAVING SAT ON IT FOR OVER A YEAR, THESE ARE REPORTS THAT COME OFF OUR COMMITTEE. I SEE THE REQUEST FOR MORE INFORMATION, FURTHER DETAILS AND BREAKDOWNS OF SERVICES AND MORE INFORMATION. I WANT TO ACKNOWLEDGE THAT LEVEL OF WORK THAT'S GONE INTO THIS. I DO APPRECIATE THE SLIDE ON PAGE 53 DELINEATING BETWEEN MANDATED AND NON-MANDATED PROGRAMS. THAT MANDATE, WELL, WE KNOW WHAT IT MEANS, THIS IS THE JOB WE ARE TASKED TO DO, AND EVEN WITH THE MANDATED CATEGORY, WE DON'T RECEIVE THE APPROPRIATE LEVEL OF FUNDING TO DO THE JOB WE HAVE TO DO. IN THE CATEGORY OF NON-MANDATED, THAT'S REALLY A SOURCE OF PRIDE FOR ME, AN ADDITIONAL SORT OF PRIDE ON BEHALF OF COUNTY AND THE OUR DEPARTMENT THAT IS WE LEAN INTO LANES THAT WERE NOT MEANT FOR US. WE LEAN INTO LANES WHERE PEOPLE WHO ARE SUPPOSED TO PROVIDE THESE SERVICES HAVE ABANDONED MANY PATIENTS OR ABANDONED THIS PORTION BECAUSE IT WASN'T PROFITABLE ENOUGH. AS WE HEAD INTO THE FUTURE, WHAT JAMES, I HEARD FROM YOU TODAY IS CLARITY, BUT NOT ANY CLEAR DIRECTION THAT WE'RE GOING TO RECEIVE NON-MANDATED PROGRAMS, CORRECT? KEEP SIGH. I KNOW WE HAVE A BUDGETARY CRISIS, BUT THAT IS NOT THE RECOMMENDATION TODAY.

WE'RE NOT MAKING ANY RECOMMENDATIONS TODAY. WE'RE TRYING TO ENSURE THAT THERE IS APPROPRIATE BACKGROUND INFORMATION SO THAT WHEN RECOMMENDATIONS COME FORWARD, OBVIOUSLY FIRST THE COMMITTEE AND WHEN THEY COME FORWARD IN FRONT OF THE BOARD LATER, THERE'S BACKGROUND AWARENESS AND UNDERSTANDING OF WHAT WE'RE WORKING WITH, SO THAT THOSE RECOMMENDATIONS CAN BE RECEIVED AND PROCESSED WITH APPROPRIATE CONTEXT, BECAUSE THE CORE MANDATED PROGRAM CATEGORIES ARE ONES THAT ARE LARGELY DICTATED TO US, AND, YOU KNOW, WE WILL CONTINUE TO IDENTIFY EVERY CREATIVE EFFORT POSSIBLE TO PRESERVE NOT JUST MANDATE-RELATED PROGRAMS BUT CONTINUED CAPACITY, EXPANDED CAPACITY TO TRY TO MEET EXPANDED COMMUNITY NEED, BUT JUST LIKE WE HAD IN THE BUDGET STUDY SESSION REGARDING HOSPITAL SYSTEM AND DIFFERENT SOURCES AND USES OF FUNDING, MOST OF THE FUNDING IN THE BEHAVIORAL HEALTH SPACE IS DIRECTED AND VERY PARTICULAR CATEGORIES AND WAYS, AND OF COURSE THERE ARE ALWAYS DELIVERIES IN THOSE CATEGORIES OF SERVICES, BUT IT'S IMPORTANT TO RECOGNIZE WHAT THAT LOOKS LIKE ESPECIALLY GIVEN THE REALLY SIGNIFICANT SHIFTS THAT ARE HAPPENING AT THE SAME TIME. AND I JUST WANT TO SAY ONE THING ABOUT THE TIMING PIECE. IN FAIRNESS TO THE STATE, AS CRITICAL AS I AM OF ALL OF THE CHANGES THAT THEY ARE MAKING, WHEN THE STATE BROUGHT THE INITIATIVE IN FRONT OF VOTERS AND THE VOTERS ADOPTED IT IN NOVEMBER OF 2024, THERE WAS NOT AWARENESS THAT WE WERE ALSO GOING TO SEE MANY OTHER FEDERAL IMPACTS THAT WOULD HAPPEN TO THEN OCCUR AT THE EXACT SAME BUDGET CYCLE. SO, YOU KNOW, THERE IS AN UNFORTUNATE COMPOUNDING AND STACKING EFFECT ON TIMING. IT WOULD BE A GREAT TIME FOR ADDITIONAL FLEXIBILITY ON STATE FUNDING STREAMS GIVEN SOME OF THE OTHER CHANGES THAT ARE HAPPENING, BUT IN FACT, THE OPPOSITE IS OCCURRING. SO THERE'S NOT JUST A GENERAL CHALLENGE, BUT THE TIMING CHALLENGE OF THESE THINGS HAPPENING TO DOVETAIL TOGETHER ON THE EXACT SAME TIMELINE THAT MAKE IT EVEN HARDER.

THANK YOU FOR THAT, JAMES. I KNOW THAT WE ARE HELD ACCOUNTABLE TO A BY NEAR WORLD OF MANDATE, NON-MANDATED FUNDING SOURCES FROM THE STATE AND THE FEDERAL GOVERNMENT, BUT AS THIS DISCUSSION HAS EXEMPLIFIED AND WHAT OUR WORK HAS DEMONSTRATED THUS FAR AT THE COUNTY IS THAT WE DON'T VIEW THE WORLD IN THAT WAY. WE GO WHERE HELP IS NEEDED AND WE DO OUR BEST. AND I KNOW THAT GRETA, TO YOUR POINT EARLIER, THAT, YOU KNOW, ARE WE RESPONSIBLE FOR BEHAVIORAL HEALTH SERVICES AT LARGE AND TECHNICALLY, LEGALLY, NO, BUT WE KEEP LEANING THAT IN DIRECTION AND I WANT TO ACKNOWLEDGE THAT AND ALSO TO ACKNOWLEDGE THAT AS WE TO YOUR POINT JAMES IN TERMS OF PROVIDING CONTEXT FOR US IN BEING ABLE TO MAKE THE RIGHTEOUS DECISIONS ON BEHALF OF THE HOLISTIC WELLNESS OF OUR COMMUNITY AND NOT BEING INFORMED BY MANDATES AND NON-MANDATED SERVICES, BEING INFORMED BY SOURCES OF FUNDING, INFORMED BUT NOT DIRECTED BECAUSE THAT'S NOT HOW WE OPERATE. A SIMPLE ASK FROM MY PART, I HOPE IT'S SIMPLE, MAYBE IT'S NOT SIMPLE, BUT WHEN WE'RE DELETING FTE'S HEADING INTO THE BUCKET PROCESS, IT WOULD BE REALLY HELPFUL FOR ME IN ADDITION TO THE NUMBER OF FTE THAT IS PROVIDED, THE JOB CODE THAT IS PROVIDED, THE PROGRAM THAT IT'S LINKED TO. I THINK PART OF OUR SOURCING UP HERE, OUR DECISION-MAKING PROCESS IS GOING TO BE LIKE WHAT IMPACTS ARE WE ABLE, CAN WE AFFORD TO SUFFER ACROSS THE WHOLE ORGANIZATION AS WE HAVE TO FACE THESE VERY CHALLENGING BUDGETARY CUTS. THAT'S IT, THANK YOU.

GRETA, DO YOU HAVE ANYTHING ELSE?

I WAS GOING TO JUST MAKE A RELATED POINT THAT I'M SORRY I CAN'T REMEMBER WHICH SLIDE NUMBER IT IS OR HOW HE SAYS IT WOULD BE TO PULL IT BACK UP, BUT JUST WOULD REDIRECT FOLKS TO THE SLIDE THAT DOES HAVE THE MANDATED PROGRAMS ON THE LEFT AND NON-MANDATED ON THE RIGHT, AND I THINK TO EMPHASIZE THE TAKEAWAY THAT WE WERE TRYING TO STRESS WITH SOME OF THIS INFORMATION IS HOW PAINFUL WHEN YOU LOOK AT THE NAMES OF THE PROGRAMS ON THE RIGHT SIDE THAT ARE NO LONGER MANDATED, IT IS, BECAUSE THOSE ARE THE ONES THAT AS BEHAVIORAL HEALTH IS ASKED TO REDUCE ITS SERVICES, THAT THEY HAVE TO LOOK TO REDUCE FIRST BECAUSE THEY CANNOT REDUCE THE ONES ON THE LEFT IN ORDER TO CONTINUE FUNDING THE ONES ON THE RIGHT. SO AS JAMES MENTIONED, THE ONLY WAY TO CONTINUE THOSE PROGRAMS IS TO CUT DEEPER INTO OTHER COUNTY PROGRAMS AND SERVICES, AND I THINK YOU COULD PRESENT, WE'VE BEEN, AND WE WILL BE PRESENTING SIMILAR INFORMATION FOR A NUMBER OF OTHER DEPARTMENTS, AND THIS IS JUST REALLY THE SHARED PAIN THAT I THINK WE'RE ALL GOING TO EXPERIENCE, WHICH IS WE WILL TAKE EVERY STEP POSSIBLE TO PRESERVE THOSE SERVICES, AND THERE'S A, YOU KNOW, THERE'S ONLY IT REQUIRES US THEN SHIFTING MONEY FROM OTHER PROGRAMS AND SERVICES THAT WE ALSO CARE ABOUT OR NOT BEING ABLE TO, BECAUSE THOSE PROGRAMS AND SERVICES ARE MANDATED, TAKE THE PROBATION SERVICES DEPARTMENT, THEIR SLIDE WOULD LOOK SIMILAR WITH MANDATED SERVICES THAT I THINK ACTUALLY ALL OF US WOULD MUCH PREFER TO REDUCE OVER THE ONES THEY'RE FUNDING ON THAT NON-MANDATED SLIDE. SO JUST TO SAY AGAIN WHAT I THINK WE'RE TRYING TO COMMUNICATE IS LETTING THE COMMUNITY KNOW IN ADVANCE THAT THERE'S GOING TO BE REALLY DIFFICULT RECOMMENDATIONS COMING TO THE BOARD THAT THERE'S VERY LITTLE POOL TO PREVENT, GIVEN THAT WE WOULD HAVE TO REDUCE OTHER PROGRAMS AND SERVICES, AND THOSE WILL BE THE TRACES THAT WE'RE GOING TO HAVE TO COLLECTIVELY STEER DOWN, AND WE WILL I'M SURE MAKE SOME DECISIONS TO SHIFT SOME SERVICES TO BEHAVIORAL HEALTH FROM OTHER DEPARTMENTS IN ORDER TO PRESERVE SOME OF THESE SERVICES, BUT IT IS GOING TO BE THAT REALITY, AND WE JUST WANT TO MAKE SURE THAT -- THAT WE'RE LAYING A GOOD FOUNDATION OF JUST KNOWLEDGE AND UNDERSTANDING OF WHAT'S HAPPENING WHEN IT COMES FORWARD AND WHAT THE BUDGET PROCESS IS GOING TO LOOK LIKE JUST FOR THAT.

THAT REMINDS ME TO I REALLY WANT TO APPRECIATE THE BEHAVIORAL HEALTH CONTRACT ASSOCIATION FOR LEANING INTO THIS WORK WITH US. I ALSO SEE OUR NURSES IN THE ROOM HERE, TOO. I THINK NOW MORE THAN EVER, BEING ABLE TO LEAN INTO SHARED CONSENSUS, LEARNING FROM EACH OTHER FROM THE PERSPECTIVES FROM THE GROUND LEVEL, FROM THE SERVICE PROVIDERS, BEING ABLE TO HELP INFORM THE LEAST AMOUNT OF HARM THAT CAN BE DONE BY THESE CUTS THAT ARE INEVITABLE. THANK YOU TO OUR PARTNERS IN THE ROOM, AS WELL. THANK YOU.

OK, SEE NO MORE LIGHTS. LET ME FINALLY ASK MY QUESTIONS. FIRST OF ALL, I WANT TO HAVING BEEN ON THIS BOARD FOR OVER FIVE YEARS, I WOULD SAY SHERRY, AND YOUR TEAM, THIS IS BY FAR THE MOST CLEAREST, MOST INFORMATIVE PRESENTATION I'VE SEEN FROM YOU GUYS, SO MANY QUALITY DATA POINTS AND FACTUAL HEIGHTS. THANK YOU SO MUCH FOR PUTTING THIS TOGETHER. I'VE LEARNED A LOT, I'VE BEEN HERE FIVE YEARS BUT LEARNING MANY NEW THINGS. THANK YOU, FIRST. MANY, MANY ARE THE GAPS THAT WE STILL HAVE TO WORK HARD TO SOLVE IN THE FUTURE TO FIND THE EFFICIENCIES ESPECIALLY DURING THESE TOUGH BUDGET MOMENTS, BUT, YOU KNOW, WE WILL BE MOVING FORWARD. ONE THING I WANT TO ALSO MENTION, TRUST FUNDING FIRST JAMES, THANKS FOR CLARIFYING BEING COMING FROM A STATE INNOVATION FUND THAT'S BEEN DRIED UP. AS WE STAND TODAY, I WANT TO JUST CONFIRM THAT AT THIS TIME, THERE WILL BE NO IMPACT ON TRUST UNTIL THE FUNDING RUNS OUT AND THAT'S 10 MONTHS FROM NOW, CORRECT, JAMES?

THAT'S CORRECT.

OK, AFTER ALL, TWO YEARS AGO, OUR OFFICE PROPOSED TO ESTABLISH DIRECT LINE TO TRUST TO REDUCE THE VARIOUS ACCESSING TO NON-LAW ENFORCEMENT SERVICE. LOOK AT THE DATA, 1728 CALLS, MORE THAN ANY OTHER SERVICES AND CONDUCTED OVER 1,076 FIELD VISITS AND WITH WHAT, .0 AVERAGE CALL WAIT TIME. THAT'S AMAZING AND AVERAGE RESPONSE TIME 30 MINUTES. FEWER THAN 1% LED TO LAW ENFORCEMENT INVOLVEMENT OR 5150 HOLD, WHICH REALLY DEMONSTRATES STRONG OUTCOMES WITHOUT THE UNNECESSARY ESCALATION. TRUST CLEARLY IS WORKING, PEOPLE ARE USING IT, LIKE IT, AND THEY DON'T WANT TO LOSE IT. I ALSO WANT TO ASK QUESTIONS, IS THERE A PLAN FOR THE BOARD TO GET A MORE THOROUGH REPORT ON THIS TRUST FUNDING PLAN IN THE FUTURE AND STRATEGIES WE CAN DISCUSS IN THE FUTURE, JAMES?

YES, WE'RE TRYING TO WORK ON STRATEGIES AS WAS INDICATED THAT SUSTAIN THE PROGRAM, AND WE WILL BRING THOSE FORWARD, GIVEN THAT THE INNOVATION FUNDING IS EXPIRING IN NOVEMBER.

OK, SO CERTAINLY, THE SOONER THE BETTER IF YOU CAN. WOULD YOU GIVE A GUESSTIMATE HOW LONG IT WOULD TAKE TO GIVE US THE REPORT.

IT WILL BE INCLUDED AS PART OF THE INFORMATION THAT WAS REQUESTED TO COME AS PART -- AHEAD OF BUDGET PROCESS.

GREAT, THANK YOU, JAMES. I WANT TO SHARE SOME OF THE HIGHLIGHTS OF THESE REALLY AMAZING SUCCESSES ON FLAG 20. THESE ARE BEAUTIFUL SUMMARIES OF THE HARD WORK INVOLVED IN SERVICES, MANY CONTRACTED PROVIDERS AS DELIVERED. ON THE PART OF THIS BEHAVIORAL HEALTH SYSTEM THAT FUNDED 121 MENTAL HEALTH CLINICS, 17 SUBSTANCE ABUSE TREATMENT CLINICS AND 10 DUAL CLINICS ACROSS NETWORK PROVIDERS SERVING 33,000 CLIENTS WITH THREE OF OUR AND TWO OF THREE MENTAL HEALTH CLIENTS MEETING THE GOALS. SLIDE 22, THERE WERE GAPS I HAD TIED, BACK TO THE STUDY A COUPLE OF YEARS AGO. IT'S GREAT TO SEE THAT THIS DRAMATIC INCREASE IN THE ACCESS TO MENTAL HEALTH TREATMENT WHICH IS EXTREMELY DIFFICULT TO ESTABLISH BECAUSE OF ALL THE RULES FROM THE STATE, RIGHT? SHERRY? SHE IS NODDING, AMAZING HOW CAN WE CAN GET THIS FAR. FROM AMAZING REFERRAL BY SUPERVISOR ELLENBERG JOINTLY SPONSORED BY US, IT'S CLEAR THAT THE COUNTY STAFF HAS BEEN RESPONSIVE TO THESE DECLARATIONS OF MENTAL HEALTH AND SUBSTANCE ABUSE AS A MENTAL HEALTH CRISIS AND I THANK OUR PARTNERS FOR THE ENORMOUS EFFORTS GROWING THESE PROGRAMS. I DO HAVE A COUPLE OF QUESTIONS, I'LL TRY TO KEEP IT SHORT. ON SLIDE 36 ARE GUIDING PRINCIPLES PROVIDED BY THE ADMINISTRATION HIGHLIGHTING A NEED TO PROTECT OUR CORE SERVICES TO ENSURE ACCESS AND PROMOTE TRANSPARENCY. I UNDERSTAND THAT TIMELY ACCESS METRICS ARE IMPORTANT FOR THE DEPARTMENT TO FULFILL THESE GUIDING PRINCIPLES. MY QUESTION IS CAN THE BOARD GET SOME INSIGHT INTO TIMELY ACCESS METRICS OF FUTURE QUARTERLY REPORTS? I THINK THIS WOULD BE HELPFUL FOR US TO BETTER UNDERSTAND THE SERVICE REQUIREMENTS ON DATE THAT SELECTED SPECIFICALLY FOR MANDATED PROGRAMS THAT REQUIRE OUR ATTENTION.

YES, WE CAN PROVIDE THAT, SUPERVISOR.

THANK YOU SO MUCH. FINALLY, I ALSO WANTED TO MAKE SURE THE OFFICE CONTINUES TO WORK CLOSELY WITH OUR BHCA PARTNERS TO ADDRESS THE BUDGET CONCERNS MAKING ADJUSTMENTS TO PROGRAMS AND ENSURE PATIENTS ARE PROTECTED INDEPENDENT MIDST OF THE VERY DIFFICULT BUDGET CUTS IN THE UPCOMING MONTHS. I AM VERY ENCOURAGED TO SEE THAT MS. GINSBURG, ALONG WITH THE BHCA PRESENTING WITH THE ADMINISTRATION AND HOPE TO CONTINUE TO SEE THIS PARTNERSHIP AS WE NAVIGATE THROUGH THE TOUGH TIMES AHEAD. AND WITH NO FURTHER COMMENT AND QUESTION, LET'S TAKE THE LOCAL.

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

SUPERVISOR ABE-KOGA.

AYE.

SUPERVISOR DUONG.

AYE.

SUPERVISOR ELLENBERG.

YES.

VICE PRESIDENT ARENAS.

YES.

PRESIDENT LEE.

AYE. YOU.

MOTION CARRIES 5-0.

THANK YOU. QUICK TIME CHECK FOR FOLKS HERE. WE ONLY FINISH ONE ITEM SO FAR, IT'S ALREADY 1:08, I SEE. SHOULD WE TRY TO AT LEAST GET A COUPLE MORE ITEMS BEFORE WE GO TO LUNCH? LIKE ITEM EIGHT? I THINK SHOULD NOT TAKE TOO LONG, YES NO AM I CORRECT?

ITEM NINE SHOULD BE VERY QUICK, BUT THEN PROBABLY MAKE SENSE TO BREAK AFTER ITEM NINE.

JUST GET ONE MORE, ITEM NINE, WHICH IS PURCHASE REAL PROPERTY ON SOUTH FIRST STREETS AND SOUTH MARKET STREETS. OK? ALL RIGHT. OK, LET'S DO IT. GO AHEAD.

GOOD AFTERNOON, DIRECTOR FOR THE OFFICE OF SUPPORTIVE HOUSING. I'M JOINED BY DEVELOPMENT MANAGER. NATALIE IS GOING TO SHARE DETAILS. I JUST WANT TO NOTE THAT GATEWAY TOWER, THE PROJECT BEFORE YOU IS ONE OF 11 THAT RECEIVED TAX CREDITS IN THE PAST YEAR, AND I WANT TO GIVE KUDOS TO NATALIE AND HER TEAM WHO WORKED REALLY HARD WITH DEVELOPERS AND OUR OTHER PARTNERS TO SECURE TAX CREDITS SO THE PROJECT COULD MOVE FORWARD. YOU'RE GOING TO SEE A LOT OF GROUND BREAKINGS BECAUSE OF THAT WORK. THERE ARE TWO THIS WEEK OR OTHER PROJECTS SUPPORTED WITH MEASURE EIGHT FUNDS INCLUDING SANTA TERESA APARTMENTS IN SAN JOSE AND MAGNOLIAS IN MORGAN HILL. COLLECTIVELY THOSE PROJECTS INCLUDE 57 UNITS OF SUPPORTIVE HOUSING AND 28 AGO WORKER UNITS, AS WELL. WITH THAT, I WILL PASS IT TO NATALIE TO SHARE ABOUT THE NEXT STEP FOR GATEWAY TOWER WHICH HOPEFULLY WE'LL BE CELEBRATING A GROUNDBREAKING SOON, AS WELL.

NUMBER NINE IS RELATED TO GATEWAY TOWER, THE AFFORDABLE HOUSING DEVELOPMENT LOCATED AT 445 AND 460 TO 480 SOUTH MARKET STREET IN SAN JOSE. THIS 220 UNIT PROJECT IS BEING DEVELOPED BY THE CORE COMPANIES AND INCLUDES 55 UNITS OF RAPID REHOUSING. CORE HAS SECURED ALL FINANCING AND APPROXIMATELY 18.2 MILLION OF THE COUNTY'S $25.5 MILLION COMMITMENT WILL BE USED TO ACQUIRE THE SITE WHICH WILL BE GROUND LEASED BACK TO THE PROJECT SPONSOR. IF APPROVED TODAY WE WOULD CLOSE ON THE CONSTRUCTION FINANCING IN APRIL AND CONSTRUCTION WOULD START SHORTLY THEREAFTER. THIS IS ONE OF 64 APPROVED MULTI-FAMILY RENTAL AFFORDABLE HOUSING DEVELOPMENTS THAT THE COUNTY HAS FUNDED WITH THE 2015 MEASURE EIGHT AFFORDABLE HOUSING BOND WHICH WILL HAVE HOUSED OVER 20,000 PEOPLE WHEN ALL PROJECTS WERE COMPLETED. THAT CONCLUDES OUR REPORT.

GO AHEAD AND OPEN THE PUBLIC HEARING. HOW MANY PUBLIC WOULD LIKE TO SPEAK ON THIS ITEM?

I CURRENTLY HAVE ONE PUBLIC SPEAKER IN ZOOM.

OK. LET'S DO TWO MINUTES.

THANK YOU. CINDY, WE ASK TO YOU UNMUTE.

THANK YOU. I HAVE A VERY -- QUESTION AND I LOOK AT YOUR AGENDA PACK, PAGE -- LET'S SEE, THIS IS THE PAGE 97. AND YOU'RE TALKING ABOUT ON JANUARY 13, 2026, THE BOARD APPROVED A REVISED CAPITAL INVESTMENT OF UP TO 25.5 MILLION FOR THE UPDATE PROJECT DESIGN TO DEVELOP 218 AFFORDABLE AMOUNTS PLUS TWO MANAGER'S UNIT. AND SO I TRIED TO LOOK AT YOUR WEBSITE, COUNTY WEBSITE. THE INFORMATION I GOT OH, SORRY, ACTUALLY, LET ME TALK ABOUT THE FIRST ONE. THE FIRST ONE IS ALSO IN THE BACKGROUND, THE UPDATE DESIGN, UNIT MIX AND FINANCING PLAN ALLOW DOOR APPLY 125.7 MILLION STATE OF CALIFORNIA FINANCING AGENCY MIXED INCOME PROGRAM. ABOUT THIS NUMBER, 125.7 MILLION, AND I CHECKED YOUR WEBSITE, COUNTY WEBSITE, THE NUMBERS NOT MATCH. THE NUMBER I SAW IS 4 MILLION ONLY, SO I WOULD LIKE TO KNOW WHERE IS THIS NUMBER COMING FROM, THANK YOU.

OK. I'LL GO AHEAD AND CLOSE THE PUBLIC HEARING PORTION OF THIS. SUPERVISOR DUONG.

ALL RIGHT. PUBLIC HEARING HAS BEEN CLOSED?

YES.

I'D LIKE TO MAKE A MOTION TO ADOPT THE RESOLUTION AS LISTED IN OUR PACKS AND ALSO TO APPROVE THE DELEGATION OF AUTHORITY.

SECOND.

MOTION IS SECONDED, THANK YOU ANY FURTHER COMMENTS.

THANK YOU FOR SEEING THE FRUITION OF MEASURE EIGHT BEING PUT FORWARD AND WE'RE BUILDING. WE'RE BUILDING AND I KNOW THAT YOU MENTIONED THAT WE CAN WITH THE APPROVAL OF THIS ITEM TODAY, WE GET TO PUT SHOVELS INTO THE GROUND, WE GET TO BUY DIRT, PUT SHOVELS IN THE GROUND AND CELEBRATE A RIBBON CUTTING. DO YOU HAVE AN APPROXIMATION, WHAT SEASON, WHAT YEAR?

I DON'T THINK THERE'S A DATE SET YET FOR THE GROUNDBREAKING, BUT I WOULD EXPECT THIS SUMMER WE CAN CONFIRM.

FANTASTIC. WELL, MY APPRECIATION.

OK, NO FURTHER COMMENTS. LET'S TAKE THE ROLL. PRESIDENT LEE, I DID MISS WHO SECONDED THAT MOTION. A MOTION OF SUPERVISOR DUONG SECONDED BY SUPERVISOR ELLENBERG.

SUPERVISOR ABE-KOGA.

AYE.

SUPERVISOR DUONG.

YES.

SUPERVISOR ELLENBERG.

YES.

VICE PRESIDENT ARENAS.

YES.

PRESIDENT LEE.

AYE.

MOTION CARRIES 5-0.

THANK YOU, JUST ONE LAST THING, THE CALLER HAS A PROBLEM FINDING WHERE THE 125 MILLION IS COMING FROM, MAYBE YOU CAN IDENTIFY THAT IN

THE FUTURE FOR THE ALLER.

CAN YOU CLARIFY THAT QUESTION?

THERE WAS A NUMBER 125 THAT THE CALLER MENTIONED THAT SHE COULD NOT FIND IF YOU COULD IDENTIFY WHAT THAT IS.

OK, COULD ANSWER THAT NOW.

THE 120 MOMMY IS THE TOTAL OF BOTH THE 4% TAX CREDIT AWARD AND THE CAL FHAMIP PERFORM, IT IS $4 MILLION ONLY THE WAY IT WAS WRITTEN AND THE BOARD REPORT WAS THE SUM OF THE TWO NUMBERS.

GOT IT. THANK YOU VERY MUCH. ALL RIGHT, LET'S BREAK FOR LUNCH. LET'S RECON SEEN BACK AT 2:00 P.M. SHARP. THANK YOU. TEST TEST

I DID SAY 2:00 SHARP. WE'LL BE STARTING THIS MEETING IN A FEW SECONDS. GOOD AFTERNOON, I GOT 2:00 P.M. WE'LL GET STARTED RESUMING OUR MEETING. [ROLL CALL] WE HAVE A QUORUM.

ITEM NUMBER 10.

GOOD AFTERNOON. SUPERVISORS. I'M CURTIS BOONE CLERK OF THE BOARD SUPERVISORS. WITH ME ARE OUR ASSISTANT CLERK OF THE BOARD REBECCA ROSS PROGRAM MANAGER, DARRELL, ADMINISTRATIVE SERVICES MANAGER. I HAVE KATHY TAYLOR, MANAGEMENT ANALYST IN THE AUDIENCE. WE'RE HERE TO TALK ABOUT THE PROPOSED ASSESSMENT APPEAL ADMINISTRATIVE PROCESSING FEE. WE HAVE A BRIEF PRESENTATION FOR AN OVERVIEW.

BRIEF IS GOOD. THANK YOU.

THE OFFICE OF THE CLERK OF THE BOARD IS HE NEUTRAL ADMINISTRATOR OF THE ASSESSMENT APPEALS PROGRAM BETWEEN THE OPPOSING PARTIES OF THE ASSESSOR AND PROPERTY OWNER AND APPELLANT APPELLANT. JUST A BRIEF COMMENTARY ON THE TIMELINE. EACH YEAR IN JUNE, THE COUNTY ISSUES A NOTICE TO PROPERTY OWNERS OF THEIR PROPERTIES ASSESSED VALUE. WE ARE ONE OF 11 COUNTIES THAT OPT TO SEND THAT AHEAD OF THE TAX BILL. JULY 2nd THROUGH SEPTEMBER 15th, PROPERTY OWNERS MAY FILE AN APPEAL. THIS IS WHAT IS KNOWN AS THE REGULAR FILING PERIOD. OVER HALF OF ALL FILINGS WILL RECEIVED EACH YEAR ARE DURING THIS TIME FRAME. THE VAST MAJORITY OF THOSE WHO RECEIVE DURING THE FILE PERIOD TEND TO COME TOWARDS END OF THAT TIME FRAME. IN OCTOBER, PROPERTY TAXES ARE DUE. TAXES ARE FULLY DUE REGARDLESS OF WHETHER OR NOT APPEAL HAS SUCCESSFUL APPEALS RESULT IN THE COUNTY REFUNDING THE AMOUNT BASED UPON HE CHANGE IN VALUE. I WOULD LIKE TO NOTE THAT OUTSIDE OF THE REGULAR FILING PERIOD, THE COUNTY DOES ISSUE SUPPLEMENTAL ESCAPE ASSESSMENT. STRUCTURE. NOTICE AND THEY HAVE 60 DAYS TO FILE AN APPEAL. THERE ARE MULTIPLE PROACTIVE MEASURES THAT THE COUNTY TAKES. OTHER AVENUES RELIEF AVAILABLE TO PROPERTY OWNERS WHO HAVE CONCERNS ABOUT THE ASSESSED VALUE OF THEIR PROPERTY. MANY OF ARE FREE MEASURES THAT THE ASSESSOR TAKES TO ASSIST RESIDENTS. SOME THAT I ANTED TO HIGHLIGHT. COMPUTER ASSISTED MASS APPRAISAL IS A SOLUTION THAT THE OFFICE OF THE ASSESSOR UTILIZES TO IDENTIFY CHANGES IN VALUE THAT AFFECT LARGE AREAS THAT HAVE SIMILAR VALUATION STANDARDS. TRACKED HOMES THAT ARE ALL GOING TO LARGELY RISE AND FALL TOGETHER. IF THERE ARE IMPACTS THAT WOULD CAUSE A REDUCTION IN THOSE PROPERTIES, THEY ARE PROACTIVELY APPLYING THAT AS THOSE HAPPEN. COMPARABLE SALES INFORMATION THE OFFICE OF THE ASSESSOR MAKES IT EASY FOR RESIDENTIAL PROPERTY OWNERS TO ACCESS COMPARABLE SALES INFORMATION. AS A PROACTIVE MEASURE. THERE'S AN INFORMAL REVIEW PROCESS. PROPERTY OWNER CAN CONTACT THE COUNTY OF ASSESSOR. IT IS REALLY A WAY TO QUICKLY RESOLVE CONCERNS WITHOUT GOING THROUGH THE APPEAL PROCESS. ALSO I WANT TO NOTE ERROR CORRECTIONS. THE ASSESSOR IS MANDATED BY STATE LAW FROM ADDRESS MISTAKES IN AN ASSESSMENT WITHOUT REQUIRING AN APPEAL TO BE FILED. JUST AS A QUICK OVERVIEW OF THOSE ITEMS. OF THOSE WITH THE EXCEPTION OF THE APPEAL WHICH WE'RE TALKING ABOUT TODAY. THOSE ARE ALL FREE TO THE APPLICANT. LAW. SPEAKING TO OUR FEE -- FEE CALCULATION TO NALYZING PROCESS. THE FIRST CATEGORY CONSISTING SINGLE FAMILY PROPERTY, MULTIFAMILY. AGRICULTURAL LAND AND VACANT LAND. THE SECOND CATEGORY CONSIST OF COMMERCIAL INDUSTRIAL MULTIFAMILY APARTMENTS WITH MORE THAN FOUR UNITS AND BUSINESS PERSONAL PROPERTY. WE'RE CALLING THOSE COMMERCIAL AND BUSINESS APPEALS. IT'S IMPORTANT TO RECOGNIZE THAT EACH APPEAL DOES KIND OF FOLLOW A UNIQUE PROCESSING PATH DEPENDING UPON A LOT OF DIFFERENT FACTORS. SUCH AS FILING METHOD, TIMELINESS AND ACCURACY. THERE'S A DIFFERENT STEPS THAT MIGHT APPLY INCLUDING SCHEDULING, POSTPONEMENT, WITHDRAWALS AND REINSTATEMENTS. ALL OF THAT CORRECTS THE WORKLOAD OF THE PROGRAM. OUR COST STUDY SHOWED THAT STAFF SPEND SIGNIFICANTLY MORE TIME ON COMMERCIAL AND BUSINESS PPEALS UP. AND BUSINESS APPEALS MAKE UP THE 54% ANNUAL FILING BUT REPRESENT 73% OF THE PROGRESSING EFFORT. RESIDENTIAL AND LAND APPEALS ARE ABOUT 46% OF FILING BUT ONLY 27% OF EFFORT. COMMERCIAL AND BUSINESS APPEALS REQUIRING MUCH MORE FREQUENT POSTPONEMENTS THAT CAN HAPPEN UP TO 40 TIME. MANY SINGLE FAMILY APPEALS RESOLVED BEFORE HEARINGS EVEN ACTUALLY HAPPEN. AMONG COUNTIES AND NOT CHARGING ANY FEES. EFFECTIVELY WE'RE SUBSIDIZING PROPERTY OWNERS. COMMERCIAL AND BUSINESS APPEALS IN PARTICULAR WHEN YOU THINK ABOUT THE AMOUNT OF PROCESSING EFFORT THAT GOES INTO HANDLING THOSE APPEALS. I DO WANT TO MAKE A NOTE THAT JUST SO WE'RE ALL CLEAR, THE TIME STUDY WE CONDUCTED THE KNES DO NOT INCLUDE THE TIME AND RESOURCES BY THE OFFICE OF THE COUNTY COUNSEL AND HEARING OFFICERS NOR DOES IT INCLUDE ANY OF THE COST OFFICE OF THE ASSESSOR AND DEFENDING THEIR ASSESSED VALUES BEFORE THE ASSESSMENT APPEALS BOARD OR HEARING OFFICERS. I DID WANT TO TALK UNINTENDED INCENTIVIZATION OF ASSESSMENT APPEALS FILING BY HAVING FEE. WE HAVE SEEN AN INCREASING NUMBER OF APPEALS FILED BY AGENTS. OF A BUSINESS MODEL FOR INDIVIDUALS WHO ARE PROPERTY TAX AGENTS WHERE THEY WILL SOLICIT BUSINESS FROM PROPERTY OWNERS BASICALLY, FILING AN APPEAL ON THEIR BEHALF, ESSENTIALLY ON CONTINGENCY AND THEN IN EXCHANGE THE PROPERTY OWNER AGREES TO GIVE THEM A PERCENTAGE OF ANY SAVINGS THEY RECEIVE REGARDLESS OF PURPOSE. OF ONE THAT SAYS LOWER YOUR PROPERTY TAX BY $1150. IT'S GOT A QR CODE AND EVERYTHING. SINCE THERE IS NO FRICTION AT ALL. THERE'S NO FEE. IT'S VERY LOW COST FOR THE PROPERTY TAX AGENTS TO FILE THEM ON BEHALF OF RESIDENTS. WHAT WE'RE SEEING HERE IS A REALLY SIGNIFICANT INCREASE IN THE AMOUNT OF RESIDENTIAL APPEALS FILED BY AGENTS. IF YOU LOOK AT THE CHART ON THE RIGHT SIDE THE CURRENT SLIDE IN 2019, WE HAD ABOUT 16% OF RESIDENTIAL APPEALS FILED BY AGENTS. IN 2025, THAT WAS 50%. TO PUT THAT IN CONTEXT, IN 2019, WE HAD A TOTAL OF 1980 RESIDENTIAL APPEALS FILED WHICH 315 WERE FILED BY AGENTS. BY 2025, WE HAD 3623 RESIDENTIAL APPEALS OF WHICH 1820 WERE FILED BY AGENTS WHICH IS ONE NEARLY AS MANY TOTAL RESIDENTIAL PAMELAS FILE -- APPEAL FILED IN 2019. IT'S EQUAL TO THE INCREASED NUMBER OF RESIDENTIAL APPEALS FILED. INCREASE IN RESIDENTIAL APPEALS -- WE CAN ALMOST ATTRIBUTE THE ENTIRE AMOUNT OF THE INCREASE IN RESIDENTIAL APPEALS FILES TO APPEALS FILED BY AGENTS. THE OTHER ELEMENT THAT POTENTIALLY INCENTIVIZES ASSESSMENT APPEALS FILING IS TWO YEAR STATUTE OF LIMITATIONS. THE APPEALS MUST BE EXTENDED IN WRITING. IF THEY ARE LEFT UNRESOLVED WITHOUT THAT WAIVER OF STATUTE, THE APPLICANT STATED VALUE BECOMES A TAXABLE VALUE VEN IF THAT STATED VALUE IS ZERO DOLLARS. IN SOME CASES THAT CAN BE A VERY SIGNIFICANT SUM OF MONEY FOR THAT ONE YEAR. WE DID TAKE THIS THROUGH FGOC. FCOG ADOPT FEE RECOMMENDED. ASKED THE CLERK OF THE BOARD TO WORK ON DATA GATHERING TO REFINE BOTH RESIDENTIAL AND COMMERCIAL FEES IN THE FUTURE. I DO WANT TO NOTE THAT THERE WAS A ERROR IN THE LEGISLATIVE FILE IN THE COMMITTEE PORTION. AT HOW TO TRACK FURTHER AND WE WILL IMPLEMENT THAT TRACKING ON ALL TYPES OF APPEALS. FINALLY, AFTER THAT DISCUSSION AT FGOC, SHOULD THE BOARD ADOPT OUR RECOMMENDATIONS. WE WILL RETURN TO THE COMMITTEE AFTER WE HAVE A CHANCE TO ONE HAVE A YEARS WORTH OF DATA TO ASSESS AFTER WE'VE IMPLEMENTED THE FEE. THEN HAVE TIME TO ANALYZE THAT AND WE'LL PROVIDE OME MORE INFORMATION TO THE COMMITTEE AT THAT POINT. QUESTIONS. I WANTED TO MAKE A COUPLE OF ADDITIONAL COMMENTS. JUST THANK YOU TO THE CLERK OF THE BOARD'S OFFICE FOR STEWARDING AND BRINGING THIS ITEM FORWARD. OF THE MINORITY COUNTIES THAT DOES NOT HAVE AN ASSESSMENT APPEALS FEE. OF THE ITEM WE SAW IN THE SERIES OF WRITTEN COMMENTS RELATED TO THIS ITEM. WHICH WAS N EXPRESSION OF CONCERN THAT THIS WAS A COST SHIFT, SO TO SPEAK. THAT SPEAKS TO HOW THE ASSESSMENT SYSTEM IS DESIGNED IN CALIFORNIA. UNDER PROP 26. IN OTHER WORDS, THIS WOULD BE A FEE THAT WOULD ONLY SEEK TO RECOVER THE COST THAT THE COUNTY ACTUALLY SPENDS ON THE PROCESSING SPECIFICALLY OF THE APPEALS. OCCUR AS A PRACTICAL MATTER WHICH SOMEONE HAS ACQUIRED A NEW PROPERTY OR DONE NEW CONSTRUCTION RESULTING IN CHANGE IN ASSESSMENT WHERE THERE MIGHT BE A DISPUTE IN VALUATION. WHAT ACTUALLY IS THE CASE FOR THE ENTIRETY OF THE PROPERTY TAX SYSTEM, WHETHER THAT'S THE COST OF THE ASSESSORS OFFICE, IN THIS CASE CLERK OF THE BOARD FOR THE ASSESSMENT APPEALS PROCESS, THE COUNTY COUNSEL'S OFFICE, THE TAX COLLECTOR AND THE CONTROLLER TREASURER DEPARTMENT AND THE DISTRIBUTION OF PROCEEDS. THE COUNTY BEARS THROUGH ITS GENERAL FUND ALL PIECES OF THAT PROCESSES THE COST OF ADMINISTERING THE SYSTEM S A FIDUCIARY ON BEHALF OF ALL LOCAL GOVERNMENTS. BUT, THE OVERWHELMING MAJORITY OF THAT PROPERTY TAX DOLLAR COLLECTED ACTUALLY DOES NOT COME TO THE COUNTY. PEOPLE DON'T REALIZE THAT BECAUSE THEY MAKE THEIR CHECK OUT TO THE COUNTY. OF EVERY DOLLAR ACTUALLY GOES TO SCHOOL DISTRICTS AND COMMUNITY COLLEGES, A SLICE GOES TO CITIES. DISTRICTS. THE COST ASSOCIATED WITH THE ADMINISTRATION OF THE ENTIRE SYSTEM ARE ALMOST ENTIRELY BORN BY THE COUNTY GENERAL FUND. AS A RESULT, I ACTUALLY THINK THE MORE FAIR PERSPECTIVE, ALTHOUGH CERTAINLY PEOPLE CAN HAVE DIFFERENT PERSPECTIVES IS WE'RE ESSENTIALLY SHIFTING FUNDING AWAY FROM CORE SAFETY NET SERVICES, AWAY FROM COUNTY DIRECT OBLIGATIONS TO THEN COVER THESE KINDS OF CATEGORIES OF COSTS. THAT'S WHY ACTUALLY THE STATUTES EXPRESSLY CONTEMPLATE AND AUTHORIZE COUNTIES TO LEVY A COST RECOVERY FEE FOR THIS PARTICULAR SERVICE SO TO SPEAK FOR ASSESSMENT OF APPEALS. THERE WAS GOOD CONVERSATION ABOUT COLLECTING DATA. THIS WAS MENTIONED BY CURTIS TOWARDS END OF HIS PRESENTATION. TO TRY TO BETTER CREATE GRADATIONS ASSOCIATED WITH COMMERCIAL APPEALS AS WAS EXPLAINED THOSE DO REPRESENT DISPROPORTIONATELY MORE WORK. UNDER PROP 26, WE HAVE TO BASE THE CALCULATION OF THE FEE ON DATA. ADMINISTRATION COMMITTED TO CLERK OF THE BOARD OFFICE ON ROBUST DATA GATHERING. SO THAT CAN BE EXAMINED AND POTENTIALLY A MORE GRANULAR FEE SCHEDULE ADOPTED IN THE FUTURE. WE REALLY NEED TO GATHER THAT DATA FOR AT LEAST A YEAR TO BE ABLE TO DO THAT AND DO SO IN COMPLIANCE WITH THE VERY SIGNIFICANT RULES AROUND A PROP 26 COST RECOVERY FEE. WITH THAT, I KNOW CLERK OF THE BOARD IS HAPPY TO ANSWER QUESTIONS AND I AM AS WELL.

THANK YOU, JAMES. LET'S OPEN UP THE PUBLIC HEARING.

I'M SHOWING ONE SPEAKER CARD IN CHAMBERS AND CURRENTLY ONE HAND IN ZOOM. TOTAL OF TWO.

TWO MINUTES EACH.

WE'LL CLOSE THE QUEUE FOR PUBLIC SPEAKERS. THE CHAMBER NAME IS CAROL CALLAHAN.

GOOD AFTERNOON. HOMEOWNER. THAT THERE SHOULDN'T ANOTHER BILL ON TO TAXPAYERS. I HEAR A LOT OF STUFF TALKING ABOUT AGENTS CREATING THIS PROBLEM, CREATING EXTRA FEES. WHY DON'T YOU HAVE AN AGENT AUTHORIZATION FEE? THAT LEAVES HOMEOWNERS TO HAVE THEIR RIGHTS. I DON'T THINK IT'S RIGHT FOR COUNTY TO CHARGE THE HOMEOWNERS A FEE JUST TO CHECK IF THERE THEIR ASSESSMENT VALUES IS CORRECT. SOMETIMES THEY ARE CORRECT. I WOULD SAY YOU'RE RIGHT. LET ME TAKE THAT. I WILL REDO THE ASSESSMENT. PLEASE CONSIDER TO REJECT THIS PROPOSAL AND ASK THEM TO REWRITE IT IN A DIFFERENT WAY SO IT'S NOT ON THE HOMEOWNERS ANYMORE. THANK YOU.

THANK YOU. OUR ZOOM SPEAKER IS CINDY. PLEASE ACCEPT THE UNMUTE. YOU MAY BEGIN.

THANK YOU. NONE REFUNDABLE FEE. THIS STAND FROM CONCERN EQUITY, ACCESSIBILITY AND ACCOUNTABILITY. THE ASSESSMENT APPEAL PROCESS IS A CORE GOVERNMENT FUNCTION. ALREADY FUNDED BY THE GENERAL PROPERTY TAX. CHARGING EXTRA TO CHALLENGE A POTENTIALLY INACCURATE ASSESSMENT AMOUNT. HOMEOWNER AND SMALL BUSINESS OWNERS SHOULDN'T HAVE TO PAY JUST TO EXERCISE THEIR RIGHT TO FAIR TAXATION. THIS NOT NONE REFUNDABLE FEE CREATES A REAL BARRIER ESPECIALLY FOR VULNERABLE MIDDLE CLASS FAMILIES AND SENIORS. IT DEFEATS ACCOUNTABILITY FOR ACCURACY AND EFFICIENCY. POTENTIALLY, ALLOWING ERRORS TO STAND AND WORSEN OUR HOUSE CRISIS. PLEASE REJECT THIS PAY TO COMPLAIN POLICY. KEEP APPEAL THREE ACCESSIBLE. UNDER CALIFORNIA LAW, REVENUE AND TAXATION SECTION APPEALS. IT EMPHASIZE TAXPAYER'S RIGHTS TO DISPUTES. THIS ACT MIGHT VIOLATE EQUAL PROTECTION OR DUE PROCESS PRINCIPLES. WOULD LIKE TO TELL YOU THE HISTORY 2007-2015. WE DO CHARGE THE ASSESSMENT FEE. APPEAL FEE. IT'S $40. THANK YOU.

THANK YOU.

OKAY, I WILL CLOSE THE PUBLIC HEARING PORTION OF THIS. I SEE NO LIGHTS. MY COLLEAGUES?

MOTION TO APPROVE. BEFORE WE VOTE, I WANTED TO CONFIRM WHAT I THINK I HEARD SAID, JAMES, WE COULD HAVE AN APPEAL FEE THAT COULD BE SCAFFOLDED LIKE A SLIDING FEE SCALE, LIKE SAN FRANCISCO HAS?

YES, WHAT WE'RE HOPING TO BE ABLE TO GET SOME DATA ABOUT A YEAR AFTER IMPLEMENTATION AND COME BACK WITH IS A MORE GRADUATED FEE ON THE SPECIFICALLY ON THE COMMERCIAL SIDE. STRUCTURED BASED ON THE AMOUNT OF VALUE AND DISPUTE. WE HAVE TO DESIGN A FEE THAT IS BASED ON THE AMOUNT OF PROCESSING TIME BASICALLY INVOLVED IN ORDER TO BE A PROP 26 RELATED FEE. SAN FRANCISCO MAYBE A PROP 26. WE CAN'T CREATE ONE THAT LOOKS EXACTLY LIKE THAT. BUT THE GOAL WILL BE TO HAVE ONE THAT HAS A LITTLE BIT MORE GRADATION. WE CAN DESIGN IT IN THAT WAY.

PERFECT. OKAY. THANK YOU.

DO YOU HAVE ANY QUESTIONS?

QUESTION. I WANTED TO CONFIRM. I KNOW THE ISSUE OF COST HAS FROM MY UNDERSTANDING HERE ARE ALTERNATIVES LIKE THE MASS APPRAISAL ADJUSTMENTS, INFORMAL REVIEWS. HAVING TO ACTUALLY SUBMIT A FORMAL APPLICATION. WOULD BE ELIGIBLE FOR WAIVERS.

ALL THOSE STATEMENTS ARE CORRECT. ASSESSOR'S OFFICE WHO DOES OF AND COUNTIES AND STATES DOES IT'S VOLUNTARY. NOTICES OF ASSESSMENT AND PROVIDES THAT OPPORTUNITY ALONG WITH THE COMPS THAT THE ASSESSOR USED TO COME UP WITH THE VALUATION THAT ALLOWS FOR RESOLUTION WELL IN ADVANCE AND FORMAL ASSESSMENT APPEAL.

THANK YOU.

I DO HAVE COUPLE OF QUESTIONS. WHEN IT COMES TO MAKING ASSESSMENT, MAJORITY OF THEE APPEALS IS UNSUCCESSFUL IS THAT CORRECT? OVERWHELMINGLY MAJORITY.

IF THAT'S THE CASE, IS IT POSSIBLE IF THEY ARE UNSUCCESSFUL, THEY GET REFUNDED THE APPLICATION FEE. DONE? DISCUSSED AT COMMITTEE THAT'S THAT WE BROUGHT FORWARD FOR A NUMBER OF REASONS INCLUDING THAT IT WOULD NECESSITATE AN INCREASE IN THE OVERALL FEE AMOUNT. THAT WAS AN ITEM THAT WAS EXPRESSLY AND DISCUSSED AND CONSIDERED.

AS PART OF THAT DISCUSSION IN FGOC, ONE OF THE PRIMARY DRIVERS THAT EACKNOWLEDGED, WHETHER OR SUCCESSFUL. THE COST HAVE BEEN EXPENDED. IF IT TRULY A COST RECOVERY, THEN WE NEED TO ACCOUNT FOR THE INVESTIGATIVE TIME AND THE ANALYSIS THAT STAFF NEEDS TO DO IN EVERY CASE.

THANK YOU. LET'S TAKE HE ROLL.

[ROLL CALL VOTE] MOTION PASSES.

THANK YOU. WHICH IS REPORT FROM AMES. COUNTY EXECUTIVE. THE BOARD. EXECUTIVE'S REPORT TODAY. FIRST I WANT TO GIVE THE BOARD AN UPDATE ON OUR ONTINUED WORK AND YOU'LL HEAR THE NEXT MEETING WHEN WE HAVE OUR MONTHLY INTERGOVERNMENTAL RELATIONS REPORT. THURSDAY AS PART OF OUR EFFORTS RELATED TO OUR STATE RELATED STRATEGIES TO TRY TO MITIGATE HR1 IMPACTS ON OUR COUNTY ORGANIZATION. INCLUDING ON EFFORTS TO KEEP FOLKS ENROLLED IN MEDI-CAL AS HOSPITAL SYSTEMS. REALLY POSITIVE CONVERSATIONS. ONE OF THE THINGS I WOULD NOTE, WE ARE VIEWED AS HAVING A LOT OF CREDIBILITY IN THESE DISCUSSIONS FOR A COUPLE OF REASONS. ONE IS THE FACT THAT WE HAVE ALREADY GONE OUT THE GATE WITH THE 2025 MEASURE A. WHICH IS SOMETHING THAT EVERYONE IS VERY WELL AWARE OF. I'M TALKING ABOUT FOLKS WELL BEYOND OUR DELEGATION. SECOND, THAT WE ARE PROACTIVELY TAKING ON AN MANAGING THE REDUCTIONS AS AN ORGANIZATION. THAT WILL BRING US TO ITEM 13 IN A FEW MINUTES. BEING ABLE TO SHARE THAT THE HEALTH SYSTEM IS IN FACT MOVING FORWARD WITH RESTRUCTURING IS ALSO A POINT OF INCREDIBLE CREDIBILITY IN THE CONVERSATIONS WITH THE STATE. TAKING PROACTIVE AND STRATEGIC STEPS FOR THE THINGS THAT ARE IN OUR CONTROL BEFORE WE'RE JUST APPROACHING THE STATE FOR WHAT THEY PERCEIVE INCORRECTLY AND WHAT THEY PERCEIVE IT IS A REQUEST FROM FOLKS AS A BAILOUT SO TO SPEAK FOR THE CUTS FROM THE FEDERAL LEVEL. BECAUSE WE HAVE APPROACHED IT IN THIS WAY AND IN THIS ORDER, THOSE CONVERSATIONS ACTUALLY I THINK ARE GOING VERY WELL. IN PARTICULAR, FEEL REALLY GOOD ABOUT THE CONVERSATIONS THAT WE HAD WITH THE STATE DEPARTMENT O FINANCE. MAY REVISE. I DO THINK THAT IT'S GOING TO CONTINUE TO BE A CHALLENGING PICTURE. WE'RE LEADING COALITIONS IN BRINGING FORWARD SPECIFIC AND CONCRETE IDEAS THAT INCLUDES NOT JUST THE PUBLIC HOSPITALS BUT ALSO URBAN COUNTY, WORKING WITH OTHER PARTNERS AND ALLIES. WORKING WITH OUR LABOR UNIONS AND OTHERS TO REALLY HELP THE LEGISLATURE UNDERSTAND WHAT'S GOING ON. UNDERSTAND THE INTERNET DISPROPE IMPACT. PARTNER TO MITIGATE IMPACT. I'LL GIVE ONE SPECIFIC EXAMPLE. WHICH IS RELATED TO THE DATA SYSTEM STATE UTILIZES. WE'RE NOT TALKING ABOUT SIGNIFICANT DOLLARS THERE. WE ARE TALKING ABOUT THE ABILITY TO KEEP THOUSANDS AND THOUSANDS OF CALIFORNIANS ENROLLED. OUR ABILITY TO DO THAT TURNS ON THE STATE'S RESPONSIVENESS AND CAPACITY AND ABILITY TO IMPLEMENT THOSE DATA SOLUTIONS. WE'LL CONTINUE WITH THOSE MORE COMPREHENSIVE UPDATE AT THE NEXT MEETING. WE HAVE BEEN REACHING OUT TO YOUR OFFICES TO SCHEDULE A SPECIFIC CONVERSATIONS TO DEVELOP INDIVIDUALIZED STRATEGIES FOR ASSISTING AND PUSHING ALL OF THOSE ADVOCACY EFFORTS. SECOND, I WANTED TO ACKNOWLEDGE THAT OUR COUNTY IS GOING TO BE HONORED TOMORROW NIGHT WITH TWO CHALLENGE AWARDS FROM CSAC. FIRST IS PEER HEALTH EDUCATION PROGRAM JUST AS INVOLVED YOUTH WHICH IS PARTNERSHIP WITH JUVENILE SERVICES AND PROBATION DEPARTMENT. FIRST-OF-ITS-KIND IN THE NATION, SERVES TO EMPOWER YOUTH WHO FACE SIGNIFICANT HEALTH DISPARITIES WITH SCIENTIFICALLY PROVEN HEALTH INFORMATION. AND TO ADVANCE LEADERSHIP AND COMMUNICATION SKILLS AMONG VULNERABLE YOUTH. THE SECOND AWARD AS FAR AS SOCIAL SERVICE AGENCIES, PAID INTERNSHIPS THROUGH A WIDE VARIETY OF EMPLOYMENT PARTNERS TO HELP YOUNG PEOPLE DEVELOP REAL WORLD SKILLS AND EXPERIENCE AND TO HELP COMBAT GENERATIONAL POVERTY. AND THE DEPARTMENTS INVOLVED IN BOTH OF THESE PROGRAMS. MANY OTHER PERFECT PROGRAMS HAT WERE PUT FORWARD FOR THESE AWARDS. SERVANTS ACROSS OUR COUNTY ORGANIZATION MAKING A REAL DIFFERENCE. THESE ARE JUST TWO SMALL EXAMPLES BUT IMPORTANT ONES OF ALL OF THAT GREAT WORK. THE THIRD ITEM THAT -- I WILL PAUSE THERE.

I WANTED TO MAKE SURE EVERYONE UNDERSTANDS WHAT A BIG DEAL THESE CHALLENGE GRANTS ARE. THEY RECEIVE THE COMMITTEE RECEIVES HUNDREDS OF APPLICATIONS FROM EVERY COUNTY I THINK L.A. COUNTY ITSELF SUBMITTED MORE THAN 50 PROGRAMS. IT IS A VERY SELECTIVE AND SMALL NUMBER OF WINNERS. THE WAY THE WINNING COUNTIES AND PROGRAMS ARE CELEBRATED IS THROUGH REALLY LOVELY EVENT IN SACRAMENTO THAT ATTRACTS MANY LEGISLATORS AND FOLKS FROM THE GOVERNOR'S ADMINISTRATION, THE LEAD THE PROGRAMS ARE FEDDED IN A VERY FESTIVITY RED CARPET AND SPECIAL MANNER. THE HARD WORK THAT COUNTY STAFF DOES AND TO BE ABLE TO SHARE BEST PRACTICES ACROSS THE STATE BY HIGHLIGHTING WHAT VARIOUS COUNTIES DO WELL. COORDINATING APPLICATIONS.

FROM CSAC PRESIDENT. UPDATE ON THE CONTINUED TRACKING OF TROUBLING DEVELOPMENTS AT THE FEDERAL LEVEL. NEWS THAT THE FEDERAL GOVERNMENT ANNOUNCED WITHHOLDING OF $600 MILLION IN HEALTH RELATED FUNDING FROM HAND FULL OF DEMOCRATIC-LED STATES. YET ANOTHER EXAMPLE OF WHAT APPEARS TO BE VERY LATANT POLITICAL TARGETS IN CERTAIN STATES BASED ON PARTISAN AFFILIATION. DEPARTMENT DOES SUPERIOR COURT TERMINATED CONTACT WITH THE COUNTY FOR JUSTICE RELATED FINE, PENALTIES AND ETCETERA. THAT BODY OF WORK IS NO LONGER WORK FOR OUR DEPARTMENT TO DO THE SUPERIOR COURT HAS CHOSEN TO CONTRACT THAT WORK OUT TO PRIVATE THIRD PARTY. THERE'S A NUMBER OF POSITION IMPACTS IN THAT DEPARTMENT AS A RESULT AS WELL. LOOKING TO THE UPCOMING BUDGET, MID-YEAR IS A TIME WHEN WE REASSESS WHAT THE BASE BUDGET PROJECTIONS FOR THE UPCOMING FISCAL YEAR. WE'RE FAIRLY CONSISTENT WITH WHAT THINGS LOOK LIKE IN OUR REPORT TO THE BOARD LAST OCTOBER. OCTOBER, WE IDENTIFIED A GAP OF ABOUT $800 MILLION. AS WAS DESCRIBED IN THAT OCTOBER REPORT, WHICH WAS BEFORE THE SUCCESSFUL PASSENGER MEASURE A BUT CONTEMPLATED THINGS WITH OR WITHOUT MEASURE A. MEASURE A DOES ADDRESS A PIECE OF THAT BUT LEFT A BALANCE OF $470 MILLION TO DDRESS. WITH THE ACTIONS IN FRONT OF THE BOARD MID YEAR FROM THE HEALTH SYSTEM, THERE IS A APPROXIMATELY $270 MILLION GAP THAT WE NEED TO BE ADDRESSED IN THE RECOMMENDED BUDGET AND THROUGH THE BUDGET PROCESS. ANY NEW SURPRISES FROM THE FEDERAL GOVERNMENT. THERE COULD BE. IT ALSO DOESN'T ACCOUNT FOR ANY CHANGE IN BROADER ECONOMIC CIRCUMSTANCES. SO FAR, FOR EXAMPLE, THE STOCK MARKET, LOCAL HOUSING MARKET ETCETERA HAVE REMAINED RELATIVELY STABLE. CHANGES FROM THE STATE LEVEL. THE GOVERNOR'S BUDGET DOES HAVE A FEW PROPOSALS THAT WOULD NEGATIVELY IMPACT THE COUNTY. WE WILL SEE WHAT ENDS UP BEING PROPOSED IN THE MAY REVISE AND WHAT THAT LOOKS LIKE FOR COUNTIES. IT IS GOING TO BE A CHALLENGE MOVING FORWARD. FOR THE BAYVIEW HEALTH DEPARTMENT. CYCLE OF REDUCTIONS AND WITH THE SIGNIFICANT UNCERTAINTY THAT WE HAVE. THE FACT THAT BASELINE FOR UR GENERAL FUND OPERATING COST CONTINUE TO GROW FASTER THAN REVENUE. DISCUSSION OF SOME OF THOSE CATEGORIES OF BROADER IMPACTS BUT THEY SIGNIFICANTLY INCLUDE THE DOUBLE DIGIT GROWTH IN OTHER RELATED COSTS THAT ARE ATTRIBUTABLE TO FRANKLY WHAT WE SEE MORE BROADLY NATIONALLILY OF INFLATIONARY PRESSURES IN WE'VE HAD NOW CONSECUTIVE YEARS OF BUDGET REDUCTIONS GOING BACK TO LAST SEVERAL FISCAL YEARS. WE'VE MANAGED THOSE AS AN ORGANIZATION QUITE SUCCESSFULLY WITH A WHOLE VARIETY OF STRATEGIES, FOCUSED FIRST ON REVENUE RELATED OPTIONS, INCLUDING THINGS LIKE COST RECOVERY FEES, SUCH AS THE ONE THAT THE BOARD JUST ADOPTED MOMENTS AGO. OVER THE LAST SEVERAL YEARS. AS THESE VACANCIES ARE REDUCED AND AS THESE FEES ARE UPDATED AS THESE OTHER REVENUE STRATEGIES ARE PURSUED, THE BROADER FLEXIBILITY FOR THE COUNTY ORGANIZATION BECOMES NARROWER AND NARROWER. CONTINUED OPPORTUNITIES. IT IS JUST AN IMPORTANT FOR THE BOARD AND FOR OUR BROADER WORKFORCE AND STAKEHOLDERRERS AND COMMUNITY PARTNERS TO RECOGNIZE THESE LAYER ON TOP OF EACH OTHER. WITH EACH SUCCESSIVE YEAR, IT DOES BECOME HARDER TO IDENTIFY THOSE STRATEGIES. WE ARE CONTINUING TO FOLLOW THE SAME PRIORITIZATION FRAMEWORK. WE DISCUSSED IT WITH THE BOARD IN OCTOBER. WE DO LOOK FIRST TO MAXIMIZE REVENUES TO CONSOLIDATE AND REDEPLOY RESOURCES AND REORGANIZE. RESTRICTED FUNDS WHERE POSSIBLE. OBVIOUSLY THOSE FUNDS HAVE LEGAL RESTRICTIONS. WE CONTINUE TO IDENTIFY SOME OPPORTUNITIES. HAPPENED IN THE LAST FEW BUDGETS. PURSUE THOSE. WITH A LENS PRIORITIZING CORE SAFETY NET SERVICES, OUR MOST VULNERABLE POPULATIONS CONSISTENT WITH CLEAR DIRECTION FROM THE BOARD. I DO WANT TO SAY ONE WORD ABOUT THE SUBSEQUENT FISCAL YEAR. I KNOW IT'S HARD TO -- WE'RE TALKING ABOUT MULTIPLE THINGS ALL AT THE SAME TIME BUT IT'S A CONTINUUM. WE'VE GOT MID-YEAR RIGHT NOW. WE'VE GOT THE BUDGET COMING IN FRONT OF US WITH ANOTHER $270 MILLION AFTER WE ACCOUNT FOR MID-YEAR ACTIONS. JUST THE HR1 IN RELATED IMPACTS FOR FY 27-28. LAYER AN ADDITIONAL $500 MILLION IN PROJECTED REVENUE LOSS ON TOP OF WHAT WE'RE LOOKING AT NOW AT MID-YEAR AND AT BUDGET SEVERAL MONTHS FROM NOW. WE HAVE TO KEEP THAT IN THE BACK OF OUR MIND AS WE STRATEGICALLY APPROACH WHAT WE'RE TACKLING, COLLECTIVELY AS A COMMUNITY. THAT 27-28 NUMBER IS REALLY THE PRIMARY TARGET OF A LOT OF THE STATE RELATED STRATEGIES. THE REALITY IS THE IMPACTS ON THE COUNTY ORGANIZATION AND THE CRITICAL SERVICES THAT WE PROVIDE FROM THAT ADDITIONAL LAYERING WOULD BE TRULY IN MY VIEW, DEVASTATING AND MAKE IT ABSOLUTELY ESSENTIAL THAT WE HAVE SUPPORT FROM THE STATE TO HELP ITIGATE THOSE. WE HAVE TO KIND OF LOOK AT THIS ON THAT MULTIYEAR TIME HORIZON AND MULTIYEAR ADVOCACY HORIZON AS WE PUT TOGETHER THE MOST STRATEGIC APPROACHES POSSIBLE. FOR MID-YEAR, EARLIER, CONSISTENT WITH A NORMAL MID-YEAR. THE OVERWHELMING MAJORITY OF TECHNICAL IN NATURE, AND OTHER ADJUSTMENTS. WHERE THINGS ARE LITTLE DIFFERENT. FILLED POSITION IMPACTS. NAMELY, SCVH AND DTAC. WE WORKED HARD TO TRY TO MITIGATE FILL POSITION IMPACTS BY STRATEGICALLY MANAGING VACANCIES. CAN'T SAY THIS IS ALWAYS GOING TO BE THE CASE. FOR THE MID-YEAR, WE CAN CONTINUE TO SAY SOMETHING WHICH HAS BEEN VERY IMPORTANT FROM A VALUE STANDPOINT FOR OUR COUNTY ORGANIZATION. TRANSFER TO ANOTHER POSITION BUT EVEN MORE SIGNIFICANTLY, 90% OF THOSE ARE TRANSFERS WITHIN THE EXACT SAME JOB CLASSIFICATION. THAT'S NOT AN ACCIDENT. THAT IS BECAUSE THERE'S BEEN A LOT OF EFFORT ON A WEEKLY BASIS TO MANAGE VACANCIES ACROSS THE ORGANIZATION. HARDER. MID-YEAR CYCLE THAN LAST YEAR'S BUDGET. TO DO TO THE GREATEST EXTENT POSSIBLE. IMPACTS IN MID-YEAR ARE VACANCIES. SPECIFIC TRUE UPS ADJUSTMENTS SUCH AS EXPIRING GRANTS. CERTAINLY, THE MOST SIGNIFICANT EMPLOYEE RELATED IMPACTS ARE SCVH AND DTAC. WE RECOGNIZE THAT. IT'S WHAT SCVH LOOKING AT STRATEGICALLY AT THE LAST BOARD MEETING. DTAC ONE IS FAIRLY STRAIGHTFORWARD WHICH IS IT'S TERMINATION OF THAT CONTRACT BY THE SUPERIOR COURT. IN FRONT OF THE BOARD ON ITEMS 13, 14, 15, THEY ARE LINK LD PAPERWORK 14 AND 15 THE SALARY ORDINANCE ALIGNED WITH THE APPROPRIATION MODIFICATIONS. WE DO HAVE STAFF INCLUDING FROM THE HEALTH SYSTEM HERE AVAILABLE TO ANSWER QUESTIONS THAT THE BOARD MAY HAVE. PRESIDENT LEE.

DO WE HAVE MEMBERS FROM THE PUBLIC WHO LIKE TO SPEAK ON THIS ITEM? WE HAVE SEVERAL CARDS ACROSS TWO ITEMS 5 FOR NUMBER 13 AND THREE FOR 15. ZOOM.

THAT'S TWO MINUTES EACH.

I WILL BEGIN CALLING THE FIRST BATCH OF NAMES. I HAVE VANESSA HERNANDEZ, NETTA, STEVEN OTERO, SUON LI. DEBI CHANG. PLEASE APPROACH.

GOOD AFTERNOON. DEPUTY PUBLIC DEFENDER. I'M HERE TO ASK THE BOARD TO DELAY DELETION OF THE CODES AT THE PUBLIC DEFENDER OFFICE. THERE ARE FIVE ATTORNEY POSITION AN FIVE STAFF POSITIONS THAT ARE PLACED UP FOR DELETION. THE PUBLIC DEFENDER PUT FORWARD A PROPOSAL TO DELETE THOSE POSITIONS AND PROVIDE FULL CREDIT FOR THOSE POSITIONS IN THE SALARY SAVINGS TOWARDS THE FISCAL YEAR 26-27 YEAR. ALTERNATIVELY, DELAY THE DELETIONS WHILE THE CODES REMAINING VACANT SO THAT THERE CAN BE FULLER DISCUSSION OF THOSE CODES THE IMPACTS THEY HAVE DURING THE FULL BUDGET CYCLE. THE GOVERNMENT ATTORNEY THE INCREASING CASE LOADS FOR OUR ATTORNEYS. DELETIONS IF THEY ARE MADE CURRENTLY WITHOUT THE FULL SALARY SAVINGS BEING APPLIED TO THE NEXT YEAR. WOULD RESULT IN ADDITIONAL IN THE NEXT BUDGET CYCLE THAT'S COMING UP. THOSE ADDITIONAL DELETIONS WOULD ALREADY HAVE THAT ARE LIMITED. WE ARE ALREADY CONCERNED THAT WE ARE RAPIDLY APPROACHING A POSITION WHERE OUR ATTORNEYS ARE AT RISK NOT BEING ABLE TO PROVIDE THE CONSTITUTIONALLY MANDATED SERVICES THAT THE PROFESSIONALLY BLIGATED TO PROVIDE. I WOULD ASK THE COURT, -- THE BOARD, MY COLLEAGUE IS WHO SUPPOSED TO BE PROVIDING COMMENT TODAY. AFTERNOON. DELETION TO PROVIDE THE FULL SALARY SAVINGS THAT PUBLIC SHIFTED TOWARDS THE FISCAL YEAR 26-27 BUDGET REDUCTION TARGETS.

THANK YOU, COUNSELOR.

GOOD AFTERNOON. SANTA CLARA COUNTY DOMESTIC VIOLENCE ADVOCACY. COUNTY EXECUTIVE FOR YOUR LEADERSHIP AND PARTNERSHIP THE SILICON VALLEY COUNCIL NONPROFIT TO HOST BUDGET TOWNHALLS. MOMENT, WE'RE VERY GRATEFUL FOR THE THOUGHTFUL TOWNHALL AND EXECUTIVE OFFICE. DEPUTY COUNTY EXECUTIVE AND THE OFFICE OF GENDER-BASED VIOLENCE PREVENTION. TRANSPARENCY AND COLLABORATIVE. AT A TIME WHEN UNCERTAINTY CAN CREATE FEAR AND INSTABILITY FOR SURVIVORS OF GENDER-BASED THE COUNTY HAS DEMONSTRATED A COMMITMENT TO SLOWING DOWN, LISTENING AND ENGAGING MEANINGFULLY WITH THOSE CLOSEST WE'RE THANKFUL TO THE COUNTY PARTNERSHIP AS WE NAVIGATE THIS DIFFICULT DECISION. THANK YOU.

GOOD MORNING, EVERYONE. WE HAVE MORE DOCTORS AND NURSE PRACTITIONERS. OUR POPULATION VIETNAMESE SPEAKING PERSON. HALF OF THEM SPEAK ENGLISH. THEY DON'T UNDERSTAND MUCH. SOMETIMES I BELIEVE WE ARE VERY HELPFUL I'M BILINGUAL SPEAKING. I RESPECTFULLY THINK THAT PLEASE RECONSIDER THE CUTTING THE POSITION. I JUST GOT THE NEWS THAT MY POSITION WILL BE ELIMINATED. I HOPE YOU RECONSIDER. THANK YOU.

HELLO. I'M DR. LAMB DO FROM VAST WHICH STAND FOR VIETNAM AMERICAN OUR CLINIC PREDOMINANTLY TAKE CARE OF VIETNAMESE SPEAKING PATIENTS. SPANISH SPEAKING. I WOULD GUESS 40% MY PATIENT SPEAK SPANISH. WE HAVE JUST TWO R.N. IN OUR CLINIC. SUPPORTING FIVE FRONTLINE PROVIDERS. ONE FULL-TIME PHYSICIAN, ONE 0.8FTE. FULL-TIME NURSE PRACTITIONER WHO SPECIALIZES IN DIABETIC CARE. IT WOULD BE VERY DIFFICULT FOR ME TO DELIVER EXCELLENT AND CULTURALLY COMPETENT CARE WITH JUST ONE R.N. IN CLINIC. I BELIEVE THAT PATIENT AFETY ISSUE WILL BE AT STAKE. PLEASE RECONSIDER. LASTLY, THANK YOU FOR YOUR HARD WORK, DEDICATION AND DIFFICULT WORK THAT YOU DO. I'M SURE YOU DON'T GET ENOUGH SUPPORT FOR THAT. THANK YOU.

THANK YOU. THE LAST CARD. JOSE. ALL THE OTHER NAMES HAVE BEEN CALLED. VANESSA HERNANDEZ, NITA, AND DEBBY CHANG. WE HAVE ONE SPEAKER ON ZOOM. PLEASE ACCEPT THE UNMUTE.

GOOD AFTERNOON. I'M REALLY FLOOD GLAD THAT WE'RE LOOKING FOR OPPORTUNITIES TO SAVE MONEY. TO PAGE 31 OF YOUR REPORT. DISTRICT ATTORNEY'S OFFICE IS DELETING ONE SENIOR PARALEGAL POSITION. WE'RE GOING TO SAVE $42,000 WHEN DANIEL CHONG PAID $200,000 TO STAY AT HOME AND NOT WORK. WE COULD BE SAVING ONE DEPUTY DISTRICT ATTORNEY POSITION IN OFFICE. WE COULD HIRE FIVE SENIOR PARALEGALS AT THAT SAVINGS. I'LL TELL YOU PARTICULARLY WHY IT'S EGREGIOUS THING. JEFF ROSEN DOESN'T HAVE JUST CAUSE FOR HIM TO BE SITTING AT HOME AND NOT WORKING. DANIEL CHUNG, HE DIDN'T DO THAT HE WAS WRITING IT IN HIS PERSONAL CAPACITY. THAT'S LUDICROUS THAT WE'RE PAYING HIM TO STAY AT HOME. IN PARTICULAR, TOO, HE WANTED TO PROTECT MY CHILDREN FROM BEING SEXUALLY MOLESTED AND ME FROM BEING PHYSICALLY ASSAULTED FROM ONE OF D.A. ROSEN'S POLITICAL SUPPORTERS. IT'S EGREGIOUS WE'RE ALLOWING THIS TO HAPPEN. IF YOU WANT TO LOOK AT MORE INFORMATION ABOUT THIS SITUATION, PLEASE GOOGLE D.A. JEFF ROSEN PETITION SEX TRAFFICKING. WITHIN THE TOP FIVES YOU'LL SEE WHAT I'M TALKING ABOUT. THANK YOU SO MUCH FOR YOUR TIME.

THAT CONCLUDES PUBLIC SPEAKER FOR 13, 14 AND 15.

THANK YOU, SUPERVISOR ELLENBERG?

THANK YOU. I WANT TO TAKE A MOMENT FIRST TO ACKNOWLEDGE THE MAGNITUDE OF THE CHALLENGES WE FACE. I REFERENCED HAT A ITTLE BIT IN THE BEHAVIORAL HEALTH ITEM. JUST LOOKING MUCH BROADER AT THE COUNTY BUDGET. TWO YEARS AGO BALANCING THE BUDGET REQUIRED $270 MILLION IN REDUCTIONS. ANOTHER $80 MILLION. THIS PAST FALL VOTERS APPROVED MEASURE A, THANK YOU. WHICH HELPS US AVOID $300 MILLION IN REDUCTIONS BUT ANOTHER $200 MILLION IN REDUCTIONS ARE STILL NECESSARY AT THIS MID-YEAR. LOOKING AHEAD TO JUNE IMPACT OF HR1 ILL BE BUILD AND WE HAVE TO CONFRONT ANOTHER $270 MILLION REDUCTION TARGET. YEAR SHOW THAT WE WILL LIKELY FACE ANOTHER $500 MILLION IN REDUCTIONS. $1.6 BILLION IN BUDGET REDUCTIONS OR REVENUE SOLUTIONS. WHILE THESE NUMBERS LITERALLY KEEP ME UP AT NIGHT, I WANT TO ACKNOWLEDGE, JAMES, THE IMPRESSIONS YOU HAD STARTING THIS DIALBACK SEVERAL YEARS AGO. WE SAW THE ECONOMY TURNING. WE SAW THOSE YEARS OF ENORMOUS AND EXPONENTIAL GROWTH IN PROPERTY TAX REVENUE SLOWING DOWN. FRANKLY, AS DRASTIC AS DIRE AS I THINK WITHOUT THE CHOICES WE'VE MADE OVER THE LAST A COUPLE OF YEARS, IT WOULD BE EX EXPONENTIALLY WORSE. MOST FOLKS. AS WE MOVE THROUGH THIS PROCESS, WHICH WILL STILL BE DIFFICULT, IT'S GOING TO BE SO IMPORTANT THAT WE KEEP ALL STAKEHOLDERS. PATIENT, CLIENTS AND SERVICE PROGRAM RECIPIENTS, COMMUNITY PARTNERS, COUNTY EMPLOYEES AND THE PUBLIC CLEARLY AND CONSISTENTLY INFORMED ABOUT ANY CHANGES THAT COULD AFFECT THEM. I ACKNOWLEDGE THAT WE, I CERTAINLY I'M TALKING ABOUT MYSELF, WILL NEED TO BE DISCIPLINED AND RECOGNIZE OPPORTUNITIES FOR REDUCTIONS PRINCIPLES WITHOUT ALLOWING TRANSPARENCY TO FALL BY THE WAYSIDE. THIS, OF COURSE, ON THE ADMINISTRATION SIDE MEANS WE NEED YOU TO INDICATE TIMELY, FACTUALLY AND OPENLY NOT ONLY WITH THE BOARD BUT WITH ALL EMPLOYEES. WE SAY THAT THERE ARE TRUSTED PARTNERS DELIVERING IMPORTANT SERVICES TO RESIDENTS THROUGHOUT THE COUNTY. WE HAVE TO TREAT THEM EXACTLY THAT WAY. TRUST. I DO FIND MAYBE A SMALL SLIVER OF OPTIMISM, THE FEDERAL AND FINANCIAL LANDSCAPE WE ARE NAVIGATING TODAY WILL NOT REMAIN OUR REALITY FOREVER. WHILE SOME OF OUR PRIORITY AREAS WILL FACE STRAIN. WHICH SERVICES CAN BE TEMPORARILY CONSTRAINED TO RESTRUCTURED OR SLOWED WHILE PRESERVING THE STRONGEST POSSIBLE FOUNDATION AND A CLEAR PATHWAY FOR RESTORATION AND GROWTH WHEN CONDITIONS APPROVE. I THINK THE LAST BOARD MEET WE TALKED ABOUT THE HOME VISITING ITEM. BE CON CONSTRAINED NOW. MAKES IT EASIER TO RAMP UP MORE WHEN THERE ARE MORE FUNDING. DO HAVE A COUPLE OF SPECIFIC QUESTIONS REGARDING THE REPORT. JAMES I WILL DIRECT THEM TO YOU AND YOU CAN CALL ON OTHER FOLKS TO ANSWER THEM. MAJOR CHECKPOINTS IN THE BUDGET PROCESS BETWEEN FEBRUARY AND JUNE. THE BOARD COULD EXPECT TO SEE OBJECT TWO INFORMATION AS WAS DIRECTED BY THE BOARD THROUGH THE REFERRAL THAT SUPERVISOR ABE-KOGA AND I BROUGHT IN DECEMBER. WOULD BE DONE BY MAY 1st AT THE LATEST. IS THAT -- ARE WE STILL ON TRACK FOR THAT DATE?

I'M TRYING TO REMEMBER THE DISCUSSION EXACTLY. I WILL DOUBLE CHECK. [ LAUGHTER ]

THANK YOU. THAT THE INFORMATION IS REALLY CRITICAL IN INFORMING OUR BUDGET DECISIONS. I WILL EXPECT AND WE'LL LOOK FORWARD TO HEARING MY COLLEAGUES EXPECTATIONS. PRODUCED FOR THE BOARD TO BE DETAILED TO THE POINT THAT WE UNDERSTAND THE SPECIFIC PROGRAMS AND CONTRACTS THAT WILL BE IMPACTED BY REDUCTIONS. MOVING FORWARD, THE EXPECTATIONS SHOULD BE THE SAME FOR THE SAME LEVEL OF DETAIL TO BE INCLUDED IN ALL BUDGET CONVERSATIONS. MID-YEAR PREVIEW, DEPARTMENT BUDGET PROPOSALS AS WELL AS THE RECOMMENDED BUDGET. START DATE FOR BUDGET REQUEST FOR INFORMATION PROCESS. ITEM 17 STATES THAT IT BEGINS ON MAY 1st. WE CAN SUBMIT QUESTIONS EARLIER.

I BELIEVE THAT'S COVERED UNDER ITEM NUMBER 17 ON THE AGENDA.

ITEM 17, THAT SAYS MAY 1st. WE TALKED ABOUT HAVING T EARLIER. TODAY'S AGENDA THAT FORESHADOWS THE REDUCTION OF ALL ONE-TIME EXPENSES AND RESERVES IS CONCERNING NOW. MAY 1st. MAY 1st TO KNOW I WILL WANT N EXPLANATION WHICH PROGRAMS OR SERVICE WILL BE IMPACTED. WILL BE IMPACTED BY POSITION REDUCTIONS. DATE?

THE RECOMMENDED BUDGET WILL COME OUT MAY 1st. IT WOULD BE HARD TO HAVE REQUEST FROM INFORMATION PRIOR TO THE PUBLICATION OF THE RECOMMENDED REFERRING REGARDING THE ELIMINATION OF ALL RESERVES AND ONE-TIME FUNDS.

I'LL GET THAT NUMBER FOR THAT. I'LL COME BACK TO THAT. YOU'RE RIGHT FOR SPECIFIC REQUEST. EXAMPLE, THE MID-YEAR OR FROM OTHER THINGS THAT WE SEE LONG THE WAY THAT WE ARE ANTICIPATING WILL BE PART OF THE PROPOSED BUDGET. WHY WE COULDN'T ASK A QUESTION EARLIER. EARLIER TODAY MADE REQUEST FOR INFORMATION ON THINGS RELATED TO THOSE AT ANY TIME. PROPOSALS THAT WILL BE BROUGHT FORWARD IN BUDGET WON'T BE PUBLISHED UNTIL MAY 1st.

OKAY, THAT'S FINE. I WILL AS I'M TALKING, I'LL SETTLE -- FIND THAT REFERENCE TO ONE-TIME EXPENSES AND RESERVES. WITH REGARD TO HHS, IS PAUL HERE?

HI, PAUL. $42 MILLION OPERATING DEFICIT. IN THE ENTERPRISE FUND. THAT WILL BE COVERED IN PART BY $35 MILLION FROM THE SERVICES AND SUPPLIES BUDGET. THIS IS A REAL LIFE RIGHT NOW EXAMPLE OF WANTING TO UNDERSTAND WHAT IS THE NATURE OF THOSE SERVICES AND SUPPLIES. WHAT SERVICES ARE BEING REDUCED AND ELIMINATED HOW MIGHT PATIENTS BE IMPACTED. THANK YOU.

THANK YOU, SUPERVISOR ELLENBERG. SANTA CLARA VALLEY HEALTHCARE. BY WAY OF BACKGROUND, YOUR CORRECT. ARE PROJECTING A DEFICIT OF A DOLLAR AMOUNT THAT YOU MENTIONED, $47 MILLION. IN ORDER TO END THE YEAR ON BUDGET, WE ARE PROPOSING, JAMES OUTLINED, $200 MILLION IN BUDGET INITIATIVES THAT IS ONGOING SAVINGS WHICH WILL ALLOW US TO BALANCE THIS YEAR'S BUDGET BY YEAR END. THOSE DOLLARS IN EXCESS OF THE $47 MILLION, THE BALANCE IS ONGOING CHALLENGE RELATIVE TO HR1. THE HR1 IMPACT AND IT ALLOWS US END THE YEAR WITH A BALANCED BUDGET.

I APPRECIATE THAT. MY QUESTION IS REALLY ABOUT THE DISTINCTION BETWEEN SERVICES AND SUPPLYIES WHEN WE'RE CUTTING $35 MILLION AND THE DESCRIPTION I HAVE NO IDEA WHAT THE IMPACT IS. CAN'T MAKE UP AN EMERGENCY I V MACHINES.

WHAT I CAN SHARE WITH YOU, SUPERVISOR, TO YOUR QUESTION ABOUT WHERE SPECIFICALLY. IT IS A NUMBER F DIFFERENT LINE ITEMS WITHIN THE BUDGET. IT'S NOT ANY ONE SPECIFIC ITEM. WHAT I'M REFERRING TO IS THAT WHEN YOU HAVE SERVICES SUPPLY BUDGET YOU CAN HAVE CONTRACTED SERVICES OF VARIETY OF DIFFERENT AREAS WHICH WOULD INCLUDE PHYSICIAN CONTRACTS, IT COULD INCLUDE SERVICE CONTRACTS RELATED TO CONTRACT STAFF. IT CAN BE A VARIETY OF DIFFERENT ITEMS. WHICH ONES?

ALL OF THE ABOVE. WHAT WE ARE TRYING TO DO IS ACROSS-THE-BOARD IDENTIFY BUDGET. I'M NOT SURE HOW TO ASK IT DIFFERENTLY. SUPPLIES YOU CAN TELL ME WE'RE NOT BUYING ANY MORE PAPER GOWN US. KNOW WHICH SERVICES, WHO WILL BE IMPACTED AND WHAT DOES THIS LOOK LIKE AT THE DELIVERY LEVEL?

THIS IS ONE OF THE CHALLENGES WHEN YOU'RE TALKING ABOUT BUDGETS AS LARGE AS THOSE WITH THE HOSPITAL SYSTEM. WE HAVE A MULTIBILLION DOLLAR OBJECT TO THE BOARD APPROPRIATED THAT BUDGET OBJECT LEVEL. WE DON'T OVER THE COURSE OF THE YEAR, THERE IS ONGOING DAY-TO-DAY MANAGEMENT WITHIN SUPPLIES AND THE USE OF CONTRACTED SERVICES IN ALIGNMENT WITH THE DAILY CENSUS, FOR EXAMPLE AT THE HOSPITAL. REGIONAL MEDICAL CENTER HAS A HIGHER THAN EXPECTED CENSUS. REGIONAL MILLION CENTER IS INCURRING HIGHER THAN EXPECTED EXPENSES. FROM OTHER PARTS OF THE HEALTH SYSTEM. IN NORMAL OPERATION OF THAT MAGNITUDE AND SIZE, WE EXPECT THE MANAGERS WITHIN THE DEPARTMENT TO BE ACTIVELY MANAGING THOSE BUDGETS ON A DAILY BASIS. ON A PERCENTAGE BASIS, WHAT WE'RE TALKING ABOUT IN THE LARGE NUMBER WHEN COMPARE TO OTHER SMALL DEPARTMENTS. BUT THE PERCENTAGE AMOUNTS THAT WE'RE TALKING ABOUT HERE ARE ACTUALLY RELATIVELY MODEST WITHIN THAT OVERALL MANAGEMENT. I THINK THEY HAVE SOME ADDITIONAL INFORMATION THAT THEY LIKE TO SHARE ON THIS PIECE SPECIFICALLY.

SUPERVISOR. INCLUDE PHARMACY SUPPLIES. WE'RE TARGETING A ERTAIN PERCENTAGE. THE TOTAL BUDGET. WE SET THAT UP AS A TARGET BECAUSE WE BELIEVE IT'S REASONABLE TO ACHIEVE.

THAT'S EXCELLENT SPECK EXAMPLE OF SUPPLIES. WHAT MIGHT SPECIFIC EXAMPLE OF A SERVICE BE? RENEGOTIATING ALL OF OUR PHYSICIAN CONTRACTS WITHIN THE HEALTHCARE SYSTEM. REASONABLE SAVINGS HAT WE CAN ACHIEVE THROUGH RENEGOTIATIONS OF THOSE CONTRACTS. IN OUR ESTIMATE, FOR EXAMPLE, WE'RE PROBABLY LOOKING AT ABOUT $6.5 MILLION BY YEAR END. ONGOING SAVINGS OF POTENTIALLY MORE.

DOES THAT IMPACT PATIENT -- DOES THAT IMPACT HEALTHCARE

NO, NOT AT THIS POINT IN TIME. OPPORTUNITIES WHERE WE ARE NOT GOING TO IMPACT PATIENT CARE OR SERVICES. IT WILL BE A RESTRUCTURING OF SOME OF THOSE SERVICE LINES OR PHYSICIAN COVERAGE. BUDGET PROPOSAL, WE ARE ADDING PHYSICIANS P41 POSITIONS TO ACTUALLY EMPLOY SOME PHYSICIANS IN CERTAIN SERVICE LINE, SUCH AS ANESTHESIOLOGY, HOSPITAL COVERAGE AT REGIONAL MEDICAL CENTER AND THROUGH THE HIRING OF THE P41, WE CAN ACHIEVE SAVINGS AND CERTAIN CONTRACTS. THOSE ARE MULTIPRONG STRATEGY RELATIVE TO COST SAVINGS BUT IDENTIFYING OPPORTUNITIES FOR POTENTIAL REVENUE. IN THOSE SITUATIONS, WE CAN BUILD AND COLLECT PROFESSIONAL FEES ON TOP OF HAT.

I WAS JUST GOING TO SAY, WHY DON'T WE START THE TEN MINUTE THING.

I'M HAPPY TO DO. I DO HAVE COUPLE OF QUESTIONS. I WANTED TO FOLLOW-UP, JAMES. I FOUND WHAT I WAS REFERENCING ABOUT ONE-TIME AMOUNTS BUDGETED FOR EXPENDITURES AND RESERVE HAVE BEEN REMOVE FROM THE FY 26-27 BASE CALCULATIONS. THIS IS PAGE 11. I'M SEEING COUNTY WIDE ALL FY 25-26 ONE-TIME AMOUNTS BUDGETED FOR EXPENDITURE AND RESERVES HAVE BEEN REMOVED FROM THE FY 26-27 BASE CALCULATIONS.

THAT'S JUST A DEFINITION WHAT IT MEANS TO LOOK AT A BASE BUDGET. ONGOING EXPENSES AND ONGOING REVENUES. ONE-TIME ITEMS IN ORDER TO LOOK AT WHAT YOUR STRUCTURAL SURPLUS OR YOUR STRUCTURAL DEFICIT IN THE CASE OF THE MOST SEVERAL YEARS IS. VORT A DESCRIPTION OF THE STATUS OF THE BASE BUDGET. THAT'S THE HEADER IF YOU GO TO THE BOTTOM OF PAGE 8. THIS IS A DESCRIPTION THE FACTORS THAT LEAD US TO THE CALCULATION OF 270 NET STRUCTURAL DEFICIT TO ADDRESS IN THE UPCOMING BUDGET. YOU DON'T COUNT ONE-TIME EXPENDITURE OR ONE-TIME REVENUES.

BASICALLY, ALL NONLABOR EMPLOYEE COSTS RE ONE-TIME EXPENDITURES?

NO. I'LL GIVE YOU SOME EXAMPLES.

IF THIS IS TOO DETAILED AND EVERYBODY ELSE UNDERSTANDS IT --

THIS IS IMPORTANT. BUDGET. GRANT. THAT'S INPUTTED IN THE BUDGET SYSTEM AS ONE-TIME REVENUE. NOT ONGOING REVENUE. IN OTHER WORDS, IT'S NOT MONEY WE EXPECT TO GET YEAR-OVER-YEAR. IT'S MONEY WE EXPECT TO GET ONCE OR ONCE FOR A PERIOD OF A COUPLE OF YEARS. THERE'S SIMILARLY ONE-TIME EXPENSES INPUTTED IN THE SYSTEM AND RECOGNIZED AS ONE TIME. WHEN YOU'RE LOOKING AT YOUR BASE BUDGET TO SEE WHAT YOUR STRUCTURAL SITUATION IS, YOU'RE ONLY LOOKING AT YOUR ONGOING REVENUE. ONGOING REVENUES WILL BE PROPERTY TAX, SALES TAX, MEDICAID, ALL OF THOSE KINDS OF THINGS. OVERWHELMING MAJORITY OF OUR REVENUE. WOULD INCLUDE MOST OF OUR POSITIONS AND OBJECT TWO BUT NOT ALL. POSITIONS ARE FUNDED ONGOING. OCCASIONALLY THE BOARD WILL SEE IN SALARY ORDINANCES UNCLASSIFIED AND EXPIRING POSITIONS WITH EXPIRATION DATES. ABSENT FURTHER ACTIONS SUCH AS WE GET ANOTHER GRANT OR WE GET ANOTHER SOMETHING, THOSE COSTS WOULD THEN FALL OFF. WE DO HAVE THINGS THAT ARE BUDGETED ONE TIME. MOST SIGNIFICANT SET OF THINGS THAT ARE BUDGETED ONE TIME ARE OUR CAPITAL PROJECTS.

I UNDERSTAND THAT.

THIS DOESN'T INCLUDE THE CAPITAL BUDGET. THAT. WE'RE NOT -- THIS ISN'T A PROPOSAL IN MY WAY WITH RESPECT TO WHAT'S GOING TO HAPPEN WITH ONE-TIME FUNDING OR RESERVES.

I APPRECIATE THAT CLARIFICATION.

VICE PRESIDENT?

THANK YOU. DIFFICULT WHAT WE'RE DOING IS REDUCING UR EXPENSES BUT THAT ALSO TRANSLATES TO SERVICES, TO PROGRAMS AND MUCH NEEDED SUPPORT THAT MOST PEOPLE COUNT ON THIS TO BE. WHEN THERE ISN'T ANYBODY BEHIND US IS REALLY DIFFICULT TO HAVE THESE CONVERSATIONS. I APPRECIATE THE PATIENCE AND YOUR WILLINGNESS TO HAVE ALL OF THESE CONVERSATIONS. YOU. WHAT I LIKE TO HIGHLIGHT IS SOMETHING THAT YOU MENTIONED EARLIER, JAMES. THAT IS THAT THIS PROPOSAL COMES WITH RECOMMENDATIONS TO DELETE, FILLED POSITIONS. 90% OF THE 365.6 T Es THAT EMPLOYERS WERE IMPACTED. THEY'LL HAVE LANDING IN THE SAME CLASSIFICATION. THAT IS LIKE GYMNASTICS. TO BE ABLE TO FIND THE FOLKS THE SAME CLASSIFICATION AND IT MIGHT WHAT WE'RE -- THAT IS UNFORTUNATE PART OF THIS PROCESS. OFFERED IN ANOTHER POSITION AND A DIFFERENT CLASSIFICATION THAT OVERALL, THE GOOD NEWS HERE IS THAT PEOPLE WILL HAVE A LANDING SPOT. NOT ONLY BECAUSE WE WANT THEM AND WE NEED THEM. THAT WE DON'T DESTABILIZE OUR SYSTEM. I WANT TO ELEVATE THAT. I THINK I ALSO NEED TO MAKE SURE THAT WE HAVE STAKEHOLDERS THAT ARE VERY INVESTED IN WHAT WE ARE DOING. GAVE US THEIR THOUGHTS EARLIER IN PUBLIC COMMENT. THERE'S ALSO INFINITY GROUPS THAT HAVE A VERY VESTED INTEREST INCLUDING OUR UNIONS. I WOULD ENCOURAGE YOU TO CONTINUE TO HAVE THOSE CONVERSATIONS WITH THE UNIONS IN A WAY THAT INSPIRES COLLABORATION. GOOD WILL WITH A LOT OF OUR STAKEHOLDERS INCLUDING OUR UNIONS. COMMUNITY WHO VOTED YES ON MEASURE A THAT ALLOWED US TO STABILIZE THE SYSTEM. I DON'T WANT TO REDUCE ANY OF THAT GOOD WILL AND COLLABORATION SIMPLY BECAUSE WE ARE MAKING CUT. GOING TO. WE SAID THIS IS 330. WE HAVE A BILLION. YOU KNOW, UP TRYING TO BORROW FROM YOUR NEXT SPEAKING TIME. THAT IS KIND OF WHAT WE'RE DOING TOO. NEXT BUDGET PROCESS AND TRYING TO MAKE SURE THAT EVERYTHING GETS PAID AND THE LIGHTS STAY ON. THAT IS JUST WHAT I WANTED TO START OFF BY SAYING.

I REALLY APPRECIATE YOU HIGHLIGHTING THAT. THINGS RELATED TO THAT. ONE I DON'T USUALLY SHARE VERY MANY PERSONAL STORIES. OUR EMPLOYEES TO KNOW HOW SERIOUSLY I PERSONALLY TAKE IMPACTS ON STAFF. MY WIFE WORKS NOW FOR A SCHOOL DISTRICT BUT USED TO AS WELL. WHEN SHE WAS PREGNANT WITH OUR FIRST CHILD, SHE WAS LAID OFF. LAID OFF, OUT THE DOOR, LAID OFF. AT A TIME WHEN WE DIDN'T OTHERWISE HAVE ANY HEALTH INSURANCE COVERAGE, WHICH IS PRE-AFFORDABLE CARE ACT. PLAN. DEDUCTIBLE WAS GOING TO DOUBLE TO BE $10,000. THAT'S BACK WHEN I WAS STILL IN GRADUATE SCHOOL. I SHARED THAT BECAUSE WE VERY MUCH UNDERSTAND, PERSONALLY, WHAT IT MEANS FOR PEOPLE TO HAVE UNCERTAINTY FOR THEMSELVES AND THEIR FAMILIES. YOU'RE RIGHT THAT IT'S GYMNASTICS. THAT IS EXACTLY WHY WE HAVE A HIRING FREEZE. EVERY DEPARTMENT DOESN'T LIKE IT. POSSIBLY CAN TO MINIMIZE IMPACTS ON OUR STAFF. IT IS NO ACCIDENT THAT 90% OF FILLED POSITION IMPACTS HERE ARE MOVING TO SAME CLASSIFICATION THAT MEANS NO CHANGE IN TITLE. EVEN THE REMAINING HAND FULL CONTINUE TO HAVE A JOB WITH BENEFITS. THAT. WE CAN SAY WITH CERTAINTY WE WILL TRY OUR HARDEST TO BE ABLE TO ALWAYS SAY THAT. THAT'S A COMMITMENT THAT I PERSONALLY HAVE TO OUR STAFF. I KNOW IT'S SOMETHING SHARED BY EVERY MEMBER OF THE BOARD. IT'S SOMETHING WE WORK REALLY HARD TO DO. YOU'RE ALSO ABSOLUTELY RIGHT, SUPERVISOR. WE HAD INCREDIBLE COMMUNITY SUPPORT AND COLLABORATION AND PARTNERSHIP FROM OUR UNIONS FROM STAKEHOLDERS AND CBO PROVIDERS. IN PASSING MEASURE A. WE TRIED TO BE AS TRANSPARENT AS POSSIBLE. SAID WE ARE GOING TO HAVE CUTS EVEN WITH MEASURE A. MEASURE A IS ESSENTIAL BUT ISN'T THE PANACEA. THIS IS PART OF WHAT WE'RE SEEING. WE SAID MANY, MANY MONTHS AGO THAT WE WERE GOING TO NEED TO BRING $200 MILLION IN ONGOING HERE AT MID-YEAR. IT WAS FRONT PAGE ARTICLE. WE'VE BEEN TALKING ABOUT IT. TO DO EMPLOYEE FORMS. WE WILL CONTINUE TO PROVIDE THE BEST INFORMATION WE CAN. WE WILL CONTINUE EVERY EFFORT POSSIBLE TO TRY TO MITIGATE THOSE IMPACTS. ABSOLUTELY ABOUT VITAL SERVICES FOR THE COMMUNITY THAT WE SERVE. THAT'S EXACTLY WHY WE'RE PUSHING THE STATE TO DO RIGHT THING. IT'S EXACTLY WHY WE PUSHED DEPARTMENTS TO COME UP WITH THE MOST CREATIVE PROPOSALS THEY CAN TO MINIMIZE IMPACTS ON THOSE WE SERVE. ON THE PEOPLE WHO DELIVER THOSE SERVICES WHICH IS BOTH OUR STAFF BUT ALSO WE RECOGNIZE AS MANY OF OUR NONPROFIT PARTNERS TOO. WHO ARE HEAVILY DEPENDENT ON COUNTY FUNDING. I APPRECIATE YOU RECOGNIZING THAT BECAUSE IT IS VERY UNDERSTANDABLE THAT PEOPLE HAVE CONCERNS ABOUT ANY SPECIFIC PROPOSAL. IT'S UNDERSTANDABLE THAT STAFF DON'T RELISH CHANGING ROLES IN THE ORGANIZATION. WE HAVE TO BALANCE THE BUDGET. WE HAVE TO DO SO IN A STRATEGIC WAY AS WE CAN. WE WILL CONTINUE TO BRING OUR BEST THINKING AND RECOMMENDATIONS IN FRONT OF THE BOARD. MEETING WITH SCVH SPECIFICALLY, THEY HAVE REALLY BEEN PUSHING ON SOLUTIONS THAT DON'T INVOLVE POSITIONS. OVERWHELMING MAJORITY OF THAT $200 MILLION IS NOT BASED ON POSITION REDUCTIONS OR SERVICE REDUCTIONS. UNFORTUNATELY, IT IS A PIECE OF THINGS.

I'M NOT NAIVE TO THINK THAT THE TROUBLE THAT WE ARE IN IS NOT GOING TO REQUIRE SOME CUTS, SOME SEVERE CUTS. CUTS THAT I WILL NOT BE HAPPY ABOUT. WE'RE FIGHTING AGAINST OUR OWN SELVES. OUR POCKETS. AS MUCH AS WE SAY IN ADVANCE, IT'S GOING TO BE A REALLY HARD SUMMER. YEAR. IT'S JUST HOW HUMAN BEINGS ARE. CHANGE IS DIFFICULT AND CHANGE IS HARD TO ACCEPT. INCLUDING MYSELF. WE'RE ALL HERE TO MAKE SURE THAT WE ARE THAT SAFETY NET. WE CONTINUE TO BE THAT. I HAVE A COUPLE OF QUESTIONS I WILL ASK AND LET YOU ANSWER. BEFORE I DO, THERE ARE SOME QUESTIONS FOR PAUL. I'LL ASK THE QUESTIONS. THEN I WILL ASK THE QUESTIONS MORE GENERALLY FROM JAMES. I THINK OVERALL, WHAT I WOULD LIKE TO SEE IS -- I DON'T KNOW A LITTLE BIT TO DO WHAT SUPERVISOR ELLENBERG OF TALKING ABOUT. THAT IS I THINK A GENERAL, I LIKE TO KNOW THE REDUCTION -- HOW ARE YOU REDUCING YOUR OVERHEAD IN A WAY THAT IS BECOME THAT DEPARTMENT BECOMING MORE EFFICIENT? MATERIALS OR IT'S LESS CONSULTANTS. THAT I WOULD REALLY APPRECIATE. I THINK NOT ONLY -- I KNOW WE'VE HAD A BIT OF A STUDY SESSION BUT NOT INCLUDING THIS BUDGET CONVERSATION AS IN-DEPTH THAT IS WE'RE HAVING TODAY. UNDERSTAND EXACTLY THE LOCATIONS REASSIGNMENTS IN YOUR SYSTEM AND THAT THERE ISN'T A CONCENTRATION OVER THE AREA BECAUSE OUT OF NEED. WE'RE FAR AWAY DOES NOT MEAN WE'RE NOT THERE. THEY TYPICALLY WILL CALL. THOSE ARE THE QUESTIONS I HAVE FOR YOU. FROM JAMES AND THEN YOU ALL CAN CONTINUE ON WITH THE CONVERSATIONS. TO A THREE-PRONG APPROACH WHERE WE WERE GOING TO ASK OUR RESIDENTS TO TAX THEMSELVES FOR US TO LOOK FOR ADDITIONAL GRANTS. WITH THAT THREE-PRONG APPROACH I LIKE TO ALSO WHEN WE RECEIVING ITEMS THAT IS STRUCTURED IN THAT WAY, YOU TELLING ME SOME OF THE REDUCTIONS THAT YOU'RE MAKING, SOME OF THE IMPROVEMENTS THAT HAVE BEEN DONE INTERNALLY IN

THE DEPARTMENTS, HOW YOU'RE BECOMING MORE EFFICIENT. THEN, SOME OF THE SOURCES OF THE GRANTS. WE SAW THAT SOMEWHAT IN THE COMPLETELY. I THINK -- I LIKE FOR US TO CONTINUE WITH THIS THREE-PROPOSITION APPROACH -- THREE-PRONG APPROACH AND MOVING MIND.

>> ABSOLUTELY, SUPERVISOR. FOR THE LAST BOARD MEETING WHERE WE HAD THE SCVH STUDY SESSION, INCLUDED IN THAT PRESENTATION WAS A VERY SPECIFIC EXAMPLE OF WHAT IS YOU'RE TALKING ABOUT. LET ME JUST HIGHLIGHT A COUPLE. PAUL AND THE DEPARTMENT TALKED ABOUT SOME OF THE INITIATIVES TO INCREASE REVENUE AND BILLING, SUCH AS THE REVENUE GUARDIAN PROGRAM AND HOW THAT'S BEING UTILIZED TO INCREASE REVENUES RECEIVED IN THE HEALTH SYSTEM. THE UTILIZATION OF LOOKING AT SERVICE LINES AND OUR ENTERPRISE SYSTEM. TAKING ADVANTAGE. REASONS BEHIND THE ACQUISITION OF REGIONAL MEDICAL CENTER THAT GOES BEYOND NUMBER ONE, THE DIRECT SERVICE DELIVERY AT REGIONAL, BUT SOME OF THE STRATEGIC PIECES AROUND THINKING ABOUT WHAT WE CAN DO AS A HOLISTIC SYSTEM THAT PAUL HAD WALKED THROUGH. HERE ARE A NUMBER OF THOSE KINDS OF EFFORTS. MID-YEAR REPORT, PAUL MENTIONS BRIEFLY, ACTUALLY THE ADDITION OF SOME EMPLOYED PHYSICIANS AND THE ELIMINATION OF CONTRACTED PHYSICIAN GROUPS BECAUSE WE ACTUALLY NOW HAVE SOME BROADER SYSTEM TO BRING THAT COVERAGE IN-HOUSE. AND ALLOWS US TO DEPLOY RESOURCES MORE FLEXIBLY. PAUL MENTIONED THE ANESTHESIOLOGIST, AND THEY'RE A MID-YEAR. THE MAJORITY, DELETE -- THREE QUARTERS IS ACTUALLY THE WHOLE SERIES OF EFFICIENCIES, REVENUE OPPORTUNITIES AND RELATED ENDEAVORS.

[PLEASE STAND BY, CAPTIONERS TRANSITIONING]

REDUCTION, REDUCTION IN OVERTIME USAGE AND SO FORTH. THAT REPRESENTS 38% OF $200 MILLION. ANOTHER 32 MILLION, WHICH BRINGS IT UP TO IN TOTAL A HUNDRED MILLION DOLLARS, IS RELATED TO SERVICES AND SUPPLIES. THAT'S A HUNDRED MILLION DOLLARS, APPROXIMATELY.

>> WHAT'S THE PERCENTAGE?

>> THE BALANCE OF THAT IS ALL REVENUE OPPORTUNITIES THROUGH RESTRUCTURING AND EFFICIENCIES.

>> CAN I REPEAT THE SUPPLIES BY PERCENTAGE?

>> LET ME JUST GIVE DOLLAR AMOUNTS. APPROXIMATELY 68 TO $69 MILLION IS RELATED TO POSITIONS. IN OTHER WORDS, DELETION OF VACANT AS WELL AS A REDUCTION IN OVERTIME. SUPPLIES IS AROUND 32 TO $33 MILLION. IN TERMS OF REDUCTIONS WITH PHARMACEUTICAL SUPPLIES. OTHER SUPPLY CHAIN NEEDS OF THE ORGANIZATION WHERE WE IDENTIFIED A CERTAIN PERCENTAGE THAT'S ACHIEVABLE IN SAVINGS THROUGH RENEGOTIATION OF THOSE CONTRACTS OR THROUGH BETTER MANAGEMENT OF THAT SUPPLY CHAIN. THE BALANCE TO JAMES' POINT IS RELATED TO REVENUE IMPROVEMENT OPPORTUNITIES THROUGH REVENUE CYCLE IMPROVEMENTS, MAKING SURE WE ARE COLLECTING EVERY DOLLAR WE ARE DUE, ET CETERA. ANOTHER PART OF THAT IS THROUGH OPERATIONAL EFFICIENCIES, IN OTHER WORDS, SEEING MORE PATIENTS IN OUR PRIMARY CARE AND SPECIALTY CLINICS AS WELL AS IN OUR HOSPITALS. IF WE ARE ABLE TO BE MORE EFFICIENT, WE ARE ABLE TO GENERATE REVENUES TO HELP COVER OUR COSTS. ANOTHER PART OF IT, AS JAMES MENTIONED, IS A NUMBER OF INITIATIVES THAT WILL ACTUALLY ALLOW US TO BETTER MANAGE THE QUALITY OF CARE THAT WE OFFER AND IMPROVE ACTION SETTABILITY TO -- ACCESSIBILITY TO CARE. JAMES MENTIONED THAT THE PROPOSAL IN THE MIDYEAR INCLUDES A NUMBER OF P41 PHYSICIAN PROVIDER SUPPORT, PROVIDERS. AND THEY COME IN THE FORM OF REPLACING CONTRACTED SPECIALISTS IN THE HOSPITAL ANESTHESIA. I MENTIONED HOSPICE. ALSO A NUMBER OF DIFFERENT SPECIALTIES WHERE WE ARE HAVING DIFFICULTIES IN CONTRACTING FOR COVERAGE AT REGIONAL MEDICAL CENTER AT O'CONNOR HOSPITAL. IN ORDER TO HAVE CONSISTENT COVERAGE, OF COURSE, IT'S BETTER TO HIRE OUR OWN PHYSICIANS TO MAINTAIN CONSISTENT COVERAGE AND MAKE SURE WE ARE PROVIDING A LEVEL AND QUALITY OF CARE THAT I THINK ALL OF YOU EXPECT OF US AS A HEALTHCARE SYSTEM. THOSE ACTUALLY ALLOW US TO GENERATE NOT ONLY SAVINGS RELATED TO CONTRACTING IN THE MARKET, BUT ALSO ALLOWS US TO GENERATE PROFESSIONAL FEE REVENUES IN THE CARE THAT WE ARE PROVIDING BOTH IN THE HOSPITAL, BUT ALSO IN OUR SPECIALTY CLINICS. SO WE ARE ABLE TO GENERATE REVENUES AND PROVIDE MORE ACCESS TO CARE. ANOTHER EXAMPLE IS THAT STANFORD HAS NOTIFIED US THEY ARE NO LONGER GOING TO SUPPORT THE FAMILY RESIDENT PROGRAM. THESE ARE 27 RESIDENTS, NINE RESIDENTS PER YEAR, PLUS AN ADDITIONAL TWO SPORT MEDICINE RESIDENTS. WE KNOW IN OUR SYSTEM WE NEED PRIMARY CARE PHYSICIANS. AND WE HAVE TO GROW OUR OWN. AND FOR US, FAMILY MEDICINE PROGRAM IS CRITICALLY IMPORTANT TO OUR HEALTH SYSTEM AND THIS COMMUNITY. STANFORD HAS CHOSEN NOT TO SUPPORT THAT PROGRAM. THEY ARE NOT FOCUSED ON FAMILY MEDICINE OR PRIMARY CARE. THEY ARE MORE FOCUSED ON HOSPITAL-BASED SERVICES, INTERNAL MEDICINE, SO FORTH. WE HAVE AGREED TO TAKE ON THAT PROGRAM BECAUSE WE SEE WHO THINGS HAPPENING, NOT ONLY RELATIVE TO MAINTAINING AND GROWING OUR PHYSICIAN WORKFORCE IN PRIMARY CARE, BUT ALSO FROM A FINANCIAL PERSPECTIVE BECAUSE THE WAY IN WHICH WE ARE MODELED RELATIVE TO FEDERALLY QUALIFIED HEALTH CENTERS, WE ARE ABLE TO GENERATE REVENUES TO COVER THE COST OF THE PROGRAM AND POTENTIALLY SEE A MARGIN THERE TO HELP COVER OTHER SERVICES WE WANT TO PROVIDE IN THE COMMUNITY. SO THAT'S AN EXAMPLE WHERE WE ARE TRYING TO STRATEGICALLY GROW THE SYSTEM IN WAYS IN WHICH WE ARE BETTER ABLE TO SERVE THE COMMUNITY. AND LET ME JUST SAY THIS ABOUT THE FAMILY MEDICINE PROGRAM. THIS IS SOMETHING THAT SUPERVISOR ARENAS TALKED ABOUT, FINDING WAYS IN WHICH WE CAN GROW A WORKFORCE. OUR PHYSICIANS AND STAFF THAT ARE REFLECTIVE OF THE COMMUNITY WE SERVE. WE HAVE THE ABILITY TO MATCH RESIDENTS TO OUR MISSION IN THIS COMMUNITY AS A HEALTHCARE ORGANIZATION. THAT'S CRITICALLY IMPORTANT. THAT'S SOMETHING WE HAVE TO START NOW BECAUSE WE ARE TALKING ABOUT NOT JUST CHALLENGES THIS YEAR IN TERMS OF HIRING PHYSICIANS, BUT WE ARE TALKING ABOUT FIVE YEARS FROM NOW, TEN YEARS FROM NOW, HAVING A WORKFORCE THAT'S MORE REFLECTIVE OF THE COMMUNITY WE ARE TRYING TO SERVE. SO YOU CAN SEE WHERE WE ARE TRYING TO BALANCE STRATEGICALLY DURING THIS TIME, FINALLY HOW TO OFFSET THE CHALLENGES WE HAVE RELATED TO HR-1 BUT GROW THE SYSTEM IN A WAY IT CAN BE SUSTAINABLE -- SUSTAINABLE GOING FORWARD. SO THOSE ARE A FEW OF THE CHALLENGES.

>> OTTO: LET'S GO TO SUPERVISOR DUONG.

>> I WANT TO ECHO WHAT WAS SAID UP HERE BY SUPERVISORS ELLENBERG AND ARENAS ABOUT HOW HARD THIS IS. JAMES, I KNOW YOU DON'T OFTEN SHARE YOUR PERSONAL STORIES, AND I HAVE HEARD THAT STORY IN PRIVATE WITH YOU. I TRUST THAT EVERY PERSON HERE, TO CARVE OUT THIS BUDGET IS CARVING A PART OF YOURSELF OUT. WE ALL LOVE THIS COUNTY. I WANT TO ACKNOWLEDGE THAT THIS DISCUSSION IS GOING TO BE PUSH/PULL. AND IT'S TO ARRIVE AT THE BEST CONCLUSION POSSIBLE. SOMETHING OF CONCERN TO ME ABOUT THIS WHOLE PROCESS, WE DON'T DO THESE DELETIONS MIDYEAR. IT'S A LONG INVOLVED PROCESS, THROUGH WORKSHOPS AND HEARINGS WHERE WE ARE ABLE TO HAVE INFORMATION, SEEK INFORMATION. SOMETHING THAT I DO IS WHEN I SEE PROPOSED CODES, I CONTACT THE DEPARTMENT HEADS, I CONTACT MY LABOR PARTNERS, I CONTACT STAFF I USED TO WORK WITH MYSELF. THERE ARE OPPORTUNITIES FOR THAT ONCE IN AWHILE TO UNDERSTAND WHAT IS THE SERVICE IMPACT. WHAT IS GOING TO BE THE IMPACT TO OUR CLIENTS AT THE END OF THE DAY. AND I TAKE THIS PERSONALLY, TOO. I WAS RAISED BY THIS COUNTY. I RECEIVED YOUR MEDICAL BENEFITS. WHEN WE COULDN'T HAVE A TRANSLATOR, WE WERE SENT BACK HOME ON THE BUS TO COME BACK ANOTHER DAY. THAT DAY DIDN'T COME. MY MOM COULDN'T TAKE TIME OFF WORK. YOU ALL FEEL IT, I KNOW IT. I'M SHINING THIS TO THE AUDIENCE AND THOSE WATCHING, THIS IS A PAINFUL PROCESS. TO HAVE THIS DONE AT MIDYEAR DID NOT GIVE ME THE OPPORTUNITY TO UNDERSTAND THE FULL SERVICE IMPACTS. LET ME SAY THIS. OF THE PHONE CALLS AND THE CONSULTS I WAS ABLE TO MAKE, THE MAJORITY OF WHAT YOU ARE PROPOSING IS THE BEST POSSIBLE SCENARIO FOR US. I CAN'T SAY THAT FOR A SMALL MINORITY, A PORTION OF THE BUDGET, I DON'T HAVE THE ANSWERS. PAUL, ONE OF MY QUESTIONS IS THAT WE HEARD FROM THE VIETNAMESE SERVICE CENTER TODAY. WE STARTED IN 2021 WITH ONE CHARGE NURSE AND OVERTIME A SECOND CHARGE NURSE WAS ADDED. NOW THAT ONE CHARGE NURSE MOVED. THE CHARGE NURSE THAT'S SLATED FOR DELETION, ONCE THAT'S DELETED, DOES SHE HAVE A PLACE TO LAND? WILL SHE GO TO ANOTHER JOB, ANOTHER CLINICAL SETTING WHERE SHE CAN CONTINUE WORKING PROVIDING CARE. OPERATIONALLY, BECAUSE WE HAVE GONE FROM A ONE CHARGE NURSE MULTI-CLINIC MODEL AND A GREATER SERVICE MODEL WHICH IS UNIQUE, WE HAVE DENTAL, WE HAVE LAB, WE HAVE AMBULATORY CARE, PEDIATRICIANS, MULTISERVICE. CAN THEY SURVIVE AND THRIVE AND MEET THE CLIENT DEMANDS WITH ONE CHARGE NURSE WHO WON'T BE ABLE TO HAVE ANOTHER NURSE RELIEVE THEM? OR AM I WRONG? IS THERE A WAY FOR THEM TO BE RELIEVED.

>> TO YOUR FIRST QUESTION, YES, THE RN WILL HAVE A PLACE TO CONTINUE HER WORK FOR OUR PATIENTS. LET ME JUST GIVE SOME BACKGROUND BEFORE I ANSWER YOUR SECOND QUESTION. THIS IS WHERE WE AS A HEALTHCARE SYSTEM HAVE ASKED EVERY DEPARTMENT AND PROGRAM TO IDENTIFY WHERE THERE IS OPPORTUNITIES TO OPERATE MORE EFFICIENTLY, IDENTIFY COST SAVINGS IN ORDER TO GET TO THAT $200 MILLION MARK. THAT ASK IS THROUGHOUT THE SYSTEM. EVERY PROGRAM, EVERY CLINIC. AS WE RECEIVE THESE PROPOSALS, WE BALANCE THAT WITH THE NEEDS OF THE ENTIRE HEALTHCARE SYSTEM IN TERMS OF TRYING TO MAINTAIN ACCESS. SO TO YOUR SECOND QUESTION, IT'S VERY CLOSE TO TOTAL CLINIC. THE MANAGEMENT OF BOTH IS UNDER ONE INDIVIDUAL, THE HEALTH CENTER MANAGER. HE'S RESPONSIBLE TO ENSURE THAT THERE IS APPROPRIATE COVERAGE AT BOTH CLINICS. AND SO THERE WILL BE AN OPPORTUNITY FOR US TO PROVIDE RELIEF TO THAT CLINIC. NOT JUST RELATIVE TO THE RN, BUT ALSO RELATIVE TO DHSR OR THE LBN. BECAUSE WE HAVE TO MAINTAIN CONSISTENT COVERAGE THERE. WE ARE GOING TO HAVE TO WORK DIFFERENTLY IN ORDER TO ACHIEVE A SITUATION WHERE WE ARE LOWERING OUR COST OF CARE BUT STILL DELIVERING THE SAME LEVEL OF SERVICE. IT IS SOMETHING WE ARE GOING TO HAVE TO MONITOR. I WOULD TELL YOU IF THREE MONTHS FROM NOW VOLUME GOES UP BECAUSE WE FULLY EXPECT AND ONE OF THE IRONIC SITUATIONS WE ARE CONFRONTED WITH, WE FULLY EXPECT GOING FORWARD AS PEOPLE LOSE COVERAGE, THEY ARE GOING TO BECOME DEPENDENT ON YOUR HEALTHCARE SYSTEM. SO I THINK ACROSS THE BOARD WE ARE GOING TO START TO SEE VOLUMES CHANGE AND SHIFT TO YOUR HEALTHCARE SYSTEM. AND WE ARE GOING TO HAVE TO MAKE ADJUSTMENTS THERE. BUT IT'S GOING TO VARY BY CLINIC AND IT'S GOING TO VARY BY LOCATION. WE HAVE TO BE FLEXIBLE ENOUGH TO ADAPT AND SHIFT OUR RESOURCES. WE STARTED TO SEE THAT GOING ON. IT'S A PERFECT EXAMPLE. WE STARTED TO SEE THAT BETWEEN REGIONAL MEDICAL CENTER AND O'CONNOR HOSPITAL AND VALLEY. WE STARTED TO SEE THE CENSUS OF REGIONAL VALLEY CENTER SPIKE. SOME DAYS IT REACHED 218, 220 IN TERMS OF A CENSUS. THE O'CONNOR CENSUS LEVELED OFF AND SOME UNITS START TO DECLINE SUCH AS IN THE ICU. WE HAVE TO BE, AS A HEALTHCARE SYSTEM, FLEXIBLE TO SHIFT OUR RESOURCES TO WHERE THEY ARE MOST NEEDED IN ORDER TO MAINTAIN THE LEVEL OF SERVICE THAT WE EXPECT TO PROVIDE TO OUR COMMUNITY AND MAINTAIN ACCESSIBILITY TO THOSE SERVICES. SO YOU ARE GOING TO START TO SEE THAT THROUGHOUT THE HEALTHCARE SYSTEM. IN PRIMARY CARE, NOT ONLY WERE THERE POSITIONS THAT WERE FILLED DELETED, BUT VACANT POSITIONS DELETED WHERE WE BELIEVE WE COULD ACHIEVE SOME EFFICIENCIES ACROSS THE BOARD WITHIN PRIMARY CARE AND SPECIALTIES. WE ARE GOING TO MONITOR THE VOLUMES AND THE STAFFING NEEDS BY CLINIC AND ADJUST ACCORDINGLY.

>> I WANT TO MAKE SURE I REPEAT BACK TO YOU TO MAKE SURE I HEARD IT CORRECTLY. THE COVERAGE IS NOT GOING TO BE A CONCERN AT THIS TIME. BUT YOU WILL MONITOR THE VOLUME OF PATIENT CARE HERE. WHEN WE SAY MONITOR, DOES THAT MEAN ADJUST ACCORDINGLY TO MAKE SURE THERE IS APPROPRIATE COVERAGE FOR OUR PATIENTS?

>> YES.

>> AND THIS NURSE DOES HAVE ANOTHER POSITION, SOUND LIKE A LATERAL MOVE AT ANOTHER CLINIC?

>> YES.

>> I DO HAVE TWO MORE QUESTIONS, BUT I WILL USE THE REMAINDER OF MY TIME, IT'S NOT NORMAL FOR THIS TO BE DONE MIDYEAR. JAMES, I'M NOT SAYING YOU DID THIS ON PURPOSE. THIS IS A RAPID SITUATION WE ARE IN THROUGH LIKE A MANUFACTURED CRISIS THROUGH NO-FAULT OF OUR OWN. THAT'S WHY WE ARE HERE. I HOPE FOR FUTURE CYCLES OF MIDYEAR WE DON'T HAVE DELETIONS DISCUSSED HERE, BUT AT A MORE FORGIVING SETTING THAT ALLOWS US THE TIME TO DIVE IN AND HAVE THESE CONVERSATIONS.

>> WE LEARNED A LOT. IT'S BEEN MANY YEARS SINCE OUR ORGANIZATION -- IT'S NOT UNPRECEDENTED. I REMEMBER THE BOARD HAVING TO PULL $52 MILLION OUT OF THE CONTINGENCY RESERVE MIDYEAR IN 2011 RELATED TO FAILURE BY THE CITY OF SAN JOSE TO PAY AN AMOUNT OWED BY THE COUNTY. IT'S NOT UNPRECEDENTED. BUT IT'S BEEN A VERY LONG TIME. I DON'T THINK WE HAVE HAD SOMETHING LIKE THESE KIND OF MIDYEAR ADJUSTMENTS PROBABLY SINCE AROUND THAT TIME FRAME. WE HAVE LEARNED A LOT. THE BOARD HEARD PUBLIC COMMENT AT THE LAST MEETING ABOUT CONCERNS RELATED TO THE TIMELINE AND PROCESS OF NOTIFYING STAFF. WE LEARNED A LOT FROM THAT AS WELL. SUFFICE IT TO SAY, IT'S BEEN CHALLENGING FOR OUR DEPARTMENTS AND OBA AND ESA AS WELL. WE DID NEED TO AND THAT IS WHY WE FORECASTED MANY, MANY MONTHS AGO THAT THESE HEALTH SYSTEM IMPACTS WERE COMING. WE DID NEED TO DO SOMETHING RELATED TO WHAT WAS GOING ON NOW. AND SO WE HAVE HAD TO TAKE ACTION TO BRING THAT FORWARD HERE. WE ARE FORTUNATE THAT IT'S REALLY TWO DEPARTMENTS WE ARE TALKING ABOUT WITH FILLED POSITION IMPACTS. BUT WE AGREE THAT IT IS EASIER MANAGED FOR EVERYONE THROUGH THE BUDGET PROCESS. OF COURSE, WE DON'T KNOW WHAT MIGHT HAPPEN OVER THE COURSE OF THE NEXT FEW YEARS, IF THE FEDERAL GOVERNMENT DOES SOMETHING, WHATEVER ELSE. BUT WE AGREE WITH YOU ON THE BIGGER PICTURE PRINCIPLE.

>> WE KNOW IT'S GOING TO BE WORSE NEXT YEAR. THIS BUDGET PICTURE IS GOING TO BE WORSE NEXT YEAR.

>> ABSENT SOMETHING ELSE SURPRISING HAPPENING, THAT'S OUR BEST INFORMATION, UNFORTUNATELY.

>> THANK YOU. I WILL GO TO SUPERVISOR ABE KOGA.

>> THANK YOU FOR THIS PRESENTATION AND THE REPORT. I WILL SAY I APPRECIATE THE DETAILS. IT'S A LOT, FRANKLY, TO DIGEST AND I THINK THAT'S WHY, WELL, I KNOW THAT'S WHY SUPERVISOR ELLENBERG AND I HAVE CONTINUED TO ASK FOR MANAGERS IN ADVANCE AS MUCH AS POSSIBLE. YOU HAVE EXPLAINED TO US THIS IS COMPLICATED. I TOTALLY KNOW THAT. AND THAT'S WHY WE NEED THE TIME TO DIGEST THIS. I APPRECIATE THE DETAILS, THANK YOU, PAUL, FOR YOUR RESPONSES TO SUPERVISOR ELLENBERG'S QUESTIONS ABOUT OBJECT ONE VERSUS OBJECT TWO. AGAIN, I KNOW THIS IS BIG. BUT I TAKE MY FIDUCIARY RESPONSIBILITY SERIOUSLY. EVEN IF IT'S COMPLICATED, WE NEED THE INFORMATION. I HOPE OUR NEW BUDGET SYSTEM WILL PROVIDE THIS MORE EASILY. IT'S BEEN A CHALLENGE TO GET SOME OF THESE ANSWERS. MY STAFF AND I HAVE BEEN WORKING ON US AND ASKING QUESTIONS OF THE STAFF, WE DIDN'T GET ALL THE ANSWERS IN TIME. I THINK I WAS GOING TO ASK SOME OF THE BIG ONES, SOME RECONCILIATION ITEMS I WOULD LIKE TO ASK. BUT I WILL SAVE THE OTHERS AND RESUBMIT THEM AND ASK FOR STAFF TO RESPOND TO THOSE IN WRITING. BUT I WILL SAY OVERALL, THIS IS VERY DIFFICULT. I REALIZE IN THE CONVERSATION THE OTHER DAY, IT'S BEEN 17 YEARS SINCE THE GREAT RECESSION. AND THAT WAS THE LAST TIME THAT ANY OF US DEALT WITH SOMETHING MAJOR LIKE THIS. AND THEN INTERESTINGLY, FRANKLY, I WOULD SAY BECAUSE OF PEPRA, WE HAVE HAD A LOT OF TURNOVER. THERE ARE VERY FEW STAFF WHO ARE WITH US WHO WERE BACK IN THE 2008, '09 ERA. THIS IS NEW AND THE FIRST TIME TO SEE SUCH DRASTIC IMPACTS ON THE COUNTY. AND SO THIS IS REALLY NEW TERRITORY FOR MANY PEOPLE. BUT I WOULD SAY THAT I UNDERSTAND THAT MUCH OF THIS HAS COME FROM HR-1. THAT'S WHY WE HAVE HAD TO DO SOME MIDYEAR ADJUSTMENTS THAT WE NORMALLY WOULDN'T HAVE. I WOULD POINT OUT THAT SOMETHING I SEE IS THAT THERE IS ACTUALLY BEEN A STRUCTURAL DEFICIT FOR SEVERAL YEARS NOW. AND OVERALL, THE CONCERN I HAVE IS WHEN COSTS ARE INCREASING AT A FASTER PACE THAN REVENUE IS INCREASING. THAT'S THE ULTIMATE PROBLEM. SO THAT'S SOMETHING THAT IS JUST CONTINUOUS, YOU HAVE TO WORK ON. I APPRECIATE WE HAVE STRENGTHENED OUR RESERVE POLICY. BUT IT'S DAY TO DAY, EVERY DAY, EVERY YEAR DISCIPLINE WE HAVE TO BE WORKING ON. I KNOW IT'S HARD WHEN TIMES ARE GOOD AND THERE IS FUNDING AVAILABLE, THERE IS ALWAYS GOING TO BE NEEDS. SO THERE IS A DESIRE TO FILL THAT NEED. BUT FOR INTERNALLY TO KEEP OUR ORGANIZATION STRONG AND TO PREPARE FOR THESE TYPES OF CRISIS BECAUSE THEY DO HAPPEN, WE HAVE TO JUST BE VERY DISCIPLINED ON A YEARLY BASIS. I WAS GOING TO MENTION, I VERY MUCH APPRECIATE FROM WORKFORCE PERSPECTIVE THAT DESPITE THE REDUCTIONS IN POSITIONS, MOST OF THOSE PEOPLE, STAFF, WILL BE ABLE TO TRANSFER TO OTHER POSITIONS. BUT I DID SEE THAT WE FACTORED IN A SALARY SAVINGS FROM THOSE VACANCIES AT ABOUT 2.57%. AS WE FILL THOSE VACANT POSITIONS, THE ASSUMPTION IS THAT THAT IS GOING TO DIMINISH, IS THAT CORRECT?

>> THAT'S A SLIGHTLY LOWER -- I THINK YOU ARE REFERENCING THE PORTION OF THE REPORT SIMILAR TO SUPERVISOR ELLENBERG THAT DESCRIBES THE BASE OF THE FORECAST FOR THE UPCOMING YEAR. THAT'S A SLIGHT DOWNWARD ADJUSTMENT FROM OUR CURRENT YEAR AND PRIOR YEAR SALARY SAVINGS FACTOR. WE HAVE ALWAYS HAD A SAVINGS BUILT IN TO RECAPTURE ON AN ONGOING BASIS SOME OF THE SAVINGS WITH NATURAL TURNOVER AND VACANCIES. THAT'S AN ALLOCATION THAT EVERY DEPARTMENT CARRIES AS PART OF ITS APPROPRIATION. THAT NUMBER HAS BEEN ADJUSTED DOWNWARD SLIGHTLY PRECISELY FOR THE REASON YOU JUST MENTIONED, WE TRACK THAT AGAINST ACTUALS AND HAVE NOTICED THAT WITH THE DELETION OF SO MANY VACANT POSITIONS OVER THE LAST SEVERAL YEARS, IT'S BECOMING HARD FOR DEPARTMENTS TO STAY ON TRACK WITH THAT. AND SO THAT'S A SLIGHT DOWNWARD ADJUSTMENT FROM THE 3% THAT'S CURRENTLY ASSIGNED TO DEPARTMENTS.

>> SO THEN NEXT FISCAL YEAR WILL WE EXPECT TO SEE AN EVEN LOWER PERCENTAGE?

>> POSSIBLY. WE'LL CONTINUE TO LOOK AT IT BASED ON ACTUALS AND BASED ON WHAT THE FORECAST IS OF THE DEPARTMENTS. THERE WILL ALWAYS BE SOME AMOUNT BECAUSE THERE WILL ALWAYS BE SO -- SOME LEVEL OF TURNOVER. THERE ARE SOME DEPARTMENTS WHERE THEY ARE CARRYING HIGHER PERCENTAGES VACANCIES THAN OTHERS. IT'S AN ATTEMPT TO MAKE SURE WE ARE NOT -- WITHOUT PREVENTING DEPARTMENTS FROM APPROPRIATELY FILLING BUDGETED POSITIONS, IT'S AN ATTEMPT TO CAPTURE FOR BUDGETING PURPOSES SOME AMOUNT OF VACANCY RELATED SAVINGS SO THEY CAN BE USED TO PRESERVE OTHER THINGS OR BE SPENT IN A GOOD YEAR, BE SPENT ON OTHER PROGRAMS OR INITIATIVES, AND IN A BAD YEAR LIKE WE ARE IN NOW, BE USED TO PRESERVE AND REDUCE THE NUMBER OF CUTS WE HAVE TO MAKE.

>> THANK YOU. FOLLOWING UP ON SOME OF THE OTHER QUESTIONS OR COMMENTS REGARDING THESE REDUCTIONS IN POSITIONS, VALLEY HEALTH BEING ONE OF THEM, THE OTHER AREA THAT'S HIGHLIGHTED HERE IN THE MIDYEAR POSITION REDUCTIONS, THE 41.5 POSITIONS IN BEHAVIOR HEALTH. WE HAD THE STUDY SESSION EARLIER. AGAIN, THE REQUEST IS WHAT ARE THESE REDUCTIONS, HOW ARE THEY GOING TO IMPACT SERVICES. ANY CAN BE OFF-LINE AS FOLLOW-UP TO OTHER QUESTIONS THAT WE ASKED.

>> THEY ARE ALL VACANT POSITIONS. SO FOR EVERY DEPARTMENT ON THAT LIST, EXCEPT CVH, DTAC AND THAT ONE POSITION IN ESA, ALL THE REST OF THOSE POSITIONS ARE VACANT.

>> OKAY. THAT'S GOOD. PUBLIC DEFENDER'S OFFICE, IT'S A LITTLE CONFUSED READING THE BACKGROUND. IT LOOKS LIKE THERE ARE THESE POSITIONS IN PDO AND THE COUNTY COUNSEL'S OFFICE?

>> THIS FALLS MORE IN THE VEIN OF THE KIND OF ADJUSTMENTS WE NORMALLY SEE IN A NORMAL MIDYEAR. A COUPLE OF YEARS AGO THE COUNTY RECEIVED A SIGNIFICANT GRANT. THE GRANT WAS USED TO FUND POSITIONS IN THE PUBLIC DEFENDER'S OFFICE AS WELL AS IN THE COUNTY COUNSEL'S OFFICE FOR THE INDEPENDENT DEFENSE COUNSEL OFFICE PORTION OF COUNTY COUNSEL. THAT GRANT HAS EXPIRED. SO THE REASON THE ITEM IS HERE AT MIDYEAR IS TO REFLECT THE EXPIRATION OF THAT GRANT AND DELETION OF THOSE GRANT FUNDED POSITIONS. THE GRANT WAS ONLY PARTIALLY FUNDING SOME OF THOSE POSITIONS. THESE ARE ALL VACANT POSITION DELETIONS. THE GRANT WAS FUNDING A PORTION OF THE COST FOR THOSE POSITIONS. WE HAVE ASSURED THE PUBLIC DEFENDER THAT THE BALANCE OF THE AMOUNT WILL BE APPLIED, SO TO SPEAK, TOWARDS -- AND IS CONSIDERED PART OF THE DEPARTMENT'S TARGETS FOR THE UPCOMING BUDGET. THE REASON THE ITEM IS COMING FORWARD AT MIDYEAR IS THE EXPIRATION OF THAT GRANT WHICH WAS FUNDING THE PORTION OF THE COST FOR ALL OF THOSE POSITIONS.

>> CURRENTLY THE COSTS OR THE FUNDING IS SHOWING, WE SEE THE GRANT EXPIRING, BUT THERE IS A CATEGORY IN THE COUNTY COUNSEL'S DEPARTMENT, I BELIEVE.

>> COUNTY COUNSEL OPERATES THE THIRD TIER PUBLIC DEFENSE OPTION. WE HAVE THE PUBLIC DEFENSE OFFICE, ALTERNATE DEFENSE OFFICE, AND THEN IN THE EVENT THAT BOTH OF THOSE OFFICES HAVE CONFLICTS, THEN THE IDO, INDEPENDENT DEFENSE OFFICE CONTRACTED ATTORNEYS THAT PROVIDE PUBLIC DEFENSE SERVICES. THE GRANT WAS A GRANT RELATED TO INDIGENT DEFENSE MORE BROADLY. MOST OF THAT GRANT -- THIS WAS SEVERAL YEARS AGO. THE GRANT WAS APPROPRIATED FOR WHATEVER REASON, I COULDN'T SPEAK TO IT, IT WAS BEFORE I WAS COUNTY EXECUTIVE. THE GRANT WAS APPROPRIATED IN THE COUNTY EXECUTIVE'S BUDGET AND THEN HAD FUNDING TRANSFERRED OUT FROM THE COUNTY EXECUTIVE BUDGET UNIT TO THE PUBLIC DEFENDER'S OFFICE WHICH IS WHAT YOU NOW SEE REFLECTED IN THE POSITIONS THERE AS WELL AS A SMALLER PORTION TO THE COUNTY COUNSEL'S OFFICE BUDGET RELATED TO THE IDO FUNCTION AND THE POSITION DELETION THERE WHICH RELATES TO A PARALEGAL POSITION THAT WAS SUPPORTING THAT PANEL OF PRIVATE ATTORNEYS. IT'S THE SAME GRANT. THE ACTION IN BOTH OFFICES RELATES TO THE SAME ISSUE.

>> DID YOU HAVE, PUBLIC DEFENDER, ANY COMMENTS?

>> I THINK CO WILLIAMS EXPLAINED, I THINK THE BROAD STROKES OF THE GRANT. IN A NUTSHELL, I KNOW THE HOUR IS LATE, I WON'T BELABOR THIS. IN A NUTSHELL, WHAT THE GRANT WAS FUNDING WAS FOUR POSITIONS BETWEEN THE ALTERNATE DEFENDER OFFICE AND PUBLIC DEFENDER OFFICE, THAT WAS THREE ATTORNEY POSITIONS AND A PARALEGAL POSITION FUNDING FOR OUR POST CONVICTION SERVICES. WE HAVE HAD PRESENT AGES AT PSJC REGARDING THAT. THE GRANT EXPIRED THIS FISCAL YEAR AND FUNDS WERE DEPLETED EARLIER IN THE YEAR. THERE WAS AN UNFUNDED LIABILITY IN OUR OFFICE. THAT'S RESULTED IN THE ADDITIONAL SIX POSITIONS BEING UP FOR DELETION BEYOND WHAT WERE TRADITIONALLY FUNDED BY THE GRANT. THAT'S AN ADDITIONAL TWO ATTORNEYS AND FIVE OTHER SUPPORT STAFF IN OUR OFFICE DOING VARIOUS SERVICES. I'M HAPPY TO ANSWER THOSE QUESTIONS. BUT IN ESSENCE IT WOULD FALL WITH ELIMINATION OF AN IMMIGRATION ATTORNEY, ELIMINATION OF ONE OF OUR JUVENILE JUSTICE ATTORNEYS, SOME SUPPORT STAFF TRADITIONALLY DEDICATED TO THE JUVENILE JUSTICE SPACE AND ADDITIONAL SUPPORT STAFF. THAT'S REDISTRIBUTION OF THAT WORK TO CURRENT STAFF WHO, IN ESSENCE, DO HAVE THEIR CURRENT CASE LOADS. IT'S WHAT'S BEING WRESTLED WITH ACROSS THE COUNTRY. I DON'T KNOW IF THAT ANSWERED THE QUESTION.

>> MY TIME IS UP, I HAVE A COUPLE MORE QUESTIONS, BUT I WILL WAIT UNTIL THE NEXT ROUND.

>> SUPERVISOR ELLENBERG.

>> THANK YOU. THE BEHAVIORAL HEALTH NOTE ON PAGE 36 NOTES THAT THE CONTRACT MAXIMUMS IN THE PRIOR TWO FISCAL YEARS EXCEEDED THE BUDGETED OBJECT TWO AMOUNTS WHICH PROMPTED THE $71 MILLION FOR COSTS THAT WERE NEVER BUDGETED. IS THAT A CORRECT READING FIRST?

>> IT'S COMPLEX, BUT, YES. AND THIS RELATES TO THE TRANSITION TO THE FEE FOR SERVICE PAYMENT STRUCTURE WHICH HAS WREAKED SOME HAVOC ON THE SHIFT IN APPROPRIATIONS AND MANAGEMENT RELATED TO THE CONTRACT PROVIDERS' CONTRACTS. PARTICULARLY TO ME, JAMES, I CAN HEAR YOU IN MY HEAD THAT BUDGETING AND CONTRACTING ARE SEPARATE PROCESSES. IT SEEMS LIKE THE MISALIGNMENT WAS SIGNIFICANT HERE.

>> VERY.

>> THE TRANSITION TO FEE FOR SERVICE POTENTIALLY IS A ONE-OFF. BUT THERE ARE SO MANY OTHER SHOES, I THINK, THAT CAN KEEP DROPPING THAT MAY NOT BE ANTICIPATED YEARS OUT. HOW DO YOU THINK WE CAN BETTER ANTICIPATE AND PLAN FOR ADJUSTMENTS LIKE THIS.

>> THAT'S AN ONGOING CONVERSATION WE HAVE BEEN HAVING WITH BEHAVIOR HEALTH. ONE OF THE BIG CHALLENGES WE HAVE HERE AND WAS NOTED IN THE PRESENTATION EARLIER THIS MORNING, 85% OF THE NETWORK IS THROUGH CONTRACTED PROVIDERS. THEY ARE ALLOWED TO BILL UP TO 15 MONTHS POST DELIVERY OF THE SERVICE. AND SO THAT MEANS THAT COSTS CAN HIT ACROSS FISCAL YEARS, WHICH HAS POSED SIGNIFICANT CHALLENGES. ONE OF THE THINGS WE HAVE ASKED THE DEPARTMENT TO WORK ON WITH THE PROVIDERS IS TO TRY TO TIGHTEN UP A MECHANISM. THERE IS GUIDANCE ON BILLING TO OCCUR IN A MORE RAPID TIME FRAME. BUT THE DRAGGING ACROSS FISCAL YEARS HAS BEEN CHALLENGING. IDEALLY, THE WAY THIS WOULD HAVE BEEN HANDLED BETTER, WOULD HAVE BEEN THE ABILITY TO MORE REAL-TIME TRACK THOSE CLAIMS COMING IN AND THEN A ROLLOVER OF APPROPRIATION ACROSS FISCAL YEARS TO ADDRESS THE PRIOR YEAR'S AMOUNT. WHAT YOU ALSO SEE, TO LOOK AT THIS HOLISTICALLY, YOU WILL SEE ON AN EARLIER PAGE, THERE WAS A DEPARTMENT THAT HAD A LARGE FUND BALANCE AT THE END OF THE YEAR. THAT'S THE FLIP SIDE OF THE SAME COIN WHICH IS THAT WAS AN UNDERSPENDING OF AN AMOUNT IN THE PRIOR YEAR THAT ENDED UP HITTING THE BOOKS IN THE CURRENT FISCAL YEAR. IDEALLY WE WOULD HAVE ROLLED THAT OVER AND YOU WOULDN'T HAVE SEEN SUCH A BIG SWING. IF YOU ADD THEM ACROSS THE FISCAL YEARS, IT'S MUCH MORE MODEST A NUMBER.

>> INTERESTING. IS THAT SIMILAR TO THE INVESTMENT THAT WE MAKE IN THE HEALTH SYSTEM HERE? BECAUSE MEDICAID REIMBURSEMENT CAN TAKE A YEAR OR MORE.

>> IT'S DIFFERENT. THE SUPPLEMENTALS, IT'S SIMILAR ONLY IN THE SENSE THAT IT'S ALSO A TIMING RELATED ISSUE. THE MEDICAID SUPPLEMENTALS ARE THEIR OWN TOTALLY INDEPENDENT TIMING ISSUE WHICH IS THE STATE IS PAYING SOMETIMES UP TO 24 MONTHS IN ARREARS. ALTHOUGH RECENTLY THE STATE MADE A LITTLE PROGRESS ON BEING SLIGHTLY MORE TIMELY, MORE LIKE 18 MONTHS IN ARREARS. WITH THE STATE CALCULATION, THIS ISSUE ISN'T STATE PAYMENT TIMING. THE STATE IS RELATIVELY TIMELY. THIS ISSUE IS THE TIMING OF WHEN CLAIMS ARE FLOWING INTO THE SYSTEM FROM OUR CONTRACTED PROVIDERS. SO IT'S ALSO A TIMING ISSUE, BUT IT'S A 180 TIMING ISSUE. IT'S ESSENTIALLY WHEN THE CLAIMS ARE COMING IN AS OPPOSED TO WHEN THE PAYMENTS ARE COMING DOWN FROM THE STATE.

>> GOT IT. THANK YOU. I'M GOING TO CLOSE BY JUST REFERENCING ONCE MORE THE REFERRAL THAT SUPERVISOR ABE-KOGA AND I REFERENCED. THROUGH MEETINGS AND TODAY AND WITH OUR COLLEAGUES ON THE SAME PAGE, WE ARE MAKING IT QUITE CLEAR THAT THE BOARD NEEDS TO SEE DETAILED INFORMATION REGARDING PROGRAMS, POSITIONS AND CONTRACTS THAT WILL BE IMPACTED BY ANY REDUCTIONS. I STILL FEEL AS IT CURRENTLY STAND, THE BUDGET PROCESS HAS NOT MET THESE EXPECTATIONS. SO I WILL LOOK FOR OPPORTUNITIES TO CONTINUE TO OFFER DIRECTION TO PROVIDE SUFFICIENT DETAILS NECESSARY TO MAKE -- WE ARE ALL TALKING ABOUT MAKING DIFFICULT DECISIONS. WE HAVEN'T ACTUALLY PUT TO THE TEST, HONESTLY, YET IN A WAY THAT WE CAN SAY WE ARE GOING TO LIVE WITH CUTTING OR REDUCING SOMETHING WE KNOW IS OF GREAT VALUE BECAUSE WE NEED TO DO OTHER THINGS. BUT I THINK IN ORDER TO DO THAT, WE REALLY HAVE TO BE SO CLEAR ABOUT WHAT IMPACTS ARE. DID YOU WANT TO MAKE A MOTION FOR THIS, SUPERVISOR ABE-KOGA? I DIDN'T -- IT REALLY WAS AFTER ALL OF THAT JUST TO RECEIVE THE REPORT. I THINK WE HAVE GIVEN ALL OF THE DIRECTION ALREADY WE ARE LOOKING FOR.

>> THE RECOMMENDED ACTIONS INCLUDE APPROPRIATION MODIFICATION AND THE ADOPTION OF TWO SALARY ORDINANCES.

>> SO I WILL MOVE ADOPTION OF ALL THE RECOMMENDED ACTIONS.

>> WE'LL UNDERSTAND THAT TO INCLUDE THE INFORMATION REQUESTS THAT HAVE BEEN MADE.

>> THANK YOU.

>> I HAVE A FEW MORE QUESTIONS TO ASK BEFORE I CAN MAKE THAT -- DECIDE WHAT MY VOTE IS.

>> SURE.

>> SECOND THE MOTION AND THEN CONTINUE.

>> OKAY. THAT'S ONE, TWO. VICE PRESIDENT.

>> THANK YOU. ALL RIGHT. SO THE OTHER PIECE I WANTED TO ASK ABOUT, LISTEN, I KNOW YOU HAVE A LOT OF POSITIONS IN TERMS OF YOUR SYSTEM. AND WHILE I'M VERY RESPECTFUL THAT YOU ARE MAKING THE KIND OF DECISIONS THAT ARE GOING TO CONTINUE TO KEEP OUR HEALTH AND HOSPITAL SYSTEM FLOWING AND HEALTHY, THERE IS STILL A SIGNIFICANT AMOUNT OF GENERAL FUND MONEY GOING INTO THE HEALTH AND HOSPITAL SYSTEM. HOW DO YOU FIGURE WE ARE -- I THINK IT WAS LAST YEAR, TWO YEARS AGO, IS WHEN WE ACTUALLY TAPERED OFF OR STOPPED INCREASING THAT AMOUNT. AND THEN LAST YEAR I THINK IT ACTUALLY DECREASED. WHAT DO YOU PROJECT IN TERMS OF THE FUTURE IN GENERAL FUND? WHAT CAN WE EXPECT?

>> WHAT WE HAVE TOLD THE HEALTH SYSTEM, SO YOU ARE CORRECT, SUPERVISOR, WE HELD IT FLAT AND THEN ACTUALLY IT DID REDUCE. GIVEN ALL OF THE HR-1 AND OTHER RELATED IMPACTS TO THE HEALTH SYSTEM, OUR GOAL RIGHT NOW WITH ALL OF THOSE IMPACTS IS TO HOLD THE GENERAL FUND INVESTMENT STUDY. THAT'S GOING TO BE A DAUNTING TASK BECAUSE IT ACTUALLY THEN IS A REFLECTION OF THE SYSTEM ABSORBING DISPROPORTIONATELY THE FEDERAL RELATED CUTS. SO THAT'S WHAT WE ARE DOING SO FAR. I DON'T KNOW STATE-RELATED MITIGATIONS. THE IMPACTS TO THE SYSTEM AT THAT POINT FROM THE SERVICE DELIVERY STANDPOINT WOULD BE SIGNIFICANT THAT IT WOULD MERIT INCREASED GENERAL FUND INVESTMENT. THAT'S A DECISION A HUNDRED PERCENT FOR THE BOARD TO MAKE. IN TERMS OF MY THINKING OF RECOMMENDATIONS. BUT RIGHT NOW WE HAVE TOLD THE HEALTH SYSTEM TO OPERATE WITH A FLAT FUNDING -- I DON'T MEAN FLAT PERCENTAGE, FLAT DOLLAR AMOUNT. THAT DISTINCTION IS IMPORTANT. A FLAT DOLLAR AMOUNT IS EQUAL TO A CUT BECAUSE, AS THE BOARD KNOWS, WHEN WE ARE TALKING ABOUT BUDGETS AND BUDGET DEFICITS, THE COSTS, OPERATING COSTS GROW EVERY YEAR. THEY GROW SIGNIFICANTLY EVERY YEAR, WHETHER IT'S HEALTH INSURANCE, RETIREE HEALTH, WAGES, SERVICES, UTILITIES, YOU NAME IT. WHEN WE SAY FLAT DOLLAR AMOUNT, THAT ACTUALLY REPRESENTS A CUT. THE GENERAL FUND NEXT YEAR, EVEN THOUGH WE ARE FACING ALL OF THESE BUDGET CHALLENGES, WE ARE FORECASTING A GENERAL FUND THAT IS LARGER THAN THIS YEAR'S GENERAL FUND. JUST NOT LARGER BY ENOUGH OF A PERCENTAGE TO COVER THE GROWTH IN COST. SO FLAT DOLLAR AMOUNT ACTUALLY REPRESENTS A CUT. BUT WE DON'T BELIEVE WE ARE IN A POSITION TO PROPOSE A DOLLAR CUT RIGHT NOW WITH ALL OF THE FEDERAL CUTS IMPACTING THE SYSTEM.

>> OKAY. I'M GOING TO MOVE TO THE PUBLIC DEFENDER. I WAS CONCERNED ABOUT THE COMMENT THAT WAS MADE EARLIER ABOUT THE KIND OF CUTS THAT ARE HAPPENING AND ACTUALLY, IF YOU CAN STEP UP, YOU CAN SIT HERE IF YOU LIKE, ONE OF THE THINGS THAT I'M VERY CONCERNED ABOUT IS HOW THE PUBLIC DEFENDER IMPACTS THE WHOLE SYSTEM IN TERMS OF THE JUSTICE SYSTEM. AND I WANT TO MAKE SURE YOU HAVE WHAT YOU NEED IN ORDER FOR OUR LAWYERS TO BE ABLE TO CARRY OUT THE WORK IN TIME AND NOT HAVE FOLKS SITTING IN OUR JAILS, BECAUSE THAT'S AN EXPENSIVE PLACE FOR THEM TO SIT. ASIDE FROM THAT, I WANT THEM DEFENDED. WHAT IS YOUR REDUCTIONS? HOW DO YOU FORECAST MAKING UP FOR ANY OF THE REDUCTIONS? WHAT'S THE IMPACT?

>> I APPRECIATE THE QUESTION. AND I WILL TRY AND BE BRIEF BUT TRY AND ANSWER WHAT IS A COMPLEX QUESTION. I SPENT A LOT OF TIME WITH THE CEO, THE COO AND OTHER CRIMINAL JUSTICE STAKEHOLDERS DISCUSSING THE ECOSYSTEM OF THE PUBLIC SAFETY WORLD. THAT'S REALLY WHAT WE ARE OFTEN TIMES TALKING ABOUT WHICH IS WHAT'S THE RIGHT BALANCE SO THAT THAT ECOSYSTEM IS WORKING IN A HEALTHY WAY. LET ME BE SPECIFIC --

>> LET ME INTERRUPT YOU, BECAUSE THAT CONVERSATION NEEDS TO HAVE OUR BOARD INVOLVED. YOU ARE APPOINTED BY THE BOARD DECISIONS. IF YOU LEAVE US OUT OF THIS CONVERSATION, WE ARE JUST PLAYING CATCH-UP.

>> ABSOLUTELY. WHAT I WOULD DO TODAY IS HELP CONTRIBUTE TO THAT CONVERSATION AND TO YOU ALL COLLECTIVELY UNDERSTANDING AT LEAST, FROM MY PERSPECTIVE, WHERE WE SIT. LET ME JUST SPEAK BRIEFLY ABOUT MY PARTICULAR AGENCY IN THIS EQUATION. AS WE DISCUSSED A MINUTE AGO, TEN POSITIONS ARE ELIMINATED, FIVE ARE ATTORNEY POSITIONS. THREE ARE DEDICATED TO POST CONVICTION SERVICES, ONE OF THOSE POST CONVICTION SERVICES WAS THE SINGLE ATTORNEY DOING POST CONVICTION SERVICES AT OUR ALTERNATE DEFENDER OFFICE. THE ELIMINATION OF THAT POSITION MEANS IT WILL BE REDISTRIBUTED TO THE OTHER ATTORNEYS IN THE OFFICE AT THAT TIME, ADDITIONAL CASE LOAD. THE TWO OTHER ATTORNEYS FUNDED BY THE PDP GRANT, PUBLIC DEFEND PILOT GRANT WERE POST CONVICTIONS. ONE OF THOSE POSITIONS WAS ASSOCIATED WITH OUR RETROACTIVE JUSTICE ACT. THE REASON WE INVEST IN A POINT PERSON FOR THAT. IT'S A STATISTICAL ANALYSIS WHETHER PEOPLE WERE GETTING DISPROPORTIONATE CHARGES. IT WILL BE REDISTRIBUTED AMONG OUR CURRENT STAFF AND WE'LL LIKELY HAVE AN INCREASE IN COST IN THE RETENTION OF COMPUTATIONAL SCIENTIST EXPERTS TO ADVISE US. THOSE WERE THE FOUR -- THEN WE HAD A PARALEGAL HELPING US WITH THAT WORK. THOSE WERE THE FOUR POSITIONS ELIMINATED OR FUNDED SPECIFICALLY BY THAT GRANT. THE REMAINING SIX POSITIONS, TWO POSITIONS ARE ATTORNEYS, ONE IS OUR JUVENILE, ONE OF OUR JEWEL KNIFE JUSTICE ATTORNEYS. APPROXIMATELY, I HAVE TO CHECK THE DATE, SIX YEARS AGO WE HAD SIX JUVENILE JUSTICE ATTORNEYS. WE ARE CURRENTLY DOWN TO FOUR. THOSE CASE LOADS WILL INCREASE. WE HAVE COMPARED THE NUMBERS ACROSS THE ORGANIZATION INCLUDING IN THE FELONY CASE LOADS, WE BELIEVE THAT'S WHERE WE HAVE TO ABSORB THAT PARTICULAR WORK. THE OTHER POSITION IS AN IMMIGRATION ATTORNEY. WE HAVE TWO IMMIGRATION ATTORNEYS AND WE HAVE SPECIAL FUNDING WHERE WE HAVE TRIED TO SUPPORT OUR IMMIGRATION ATTORNEYS THROUGH THE EMERGENCY GRANT THAT WAS PROVIDED OR CREATED BY THE COUNTY LAST JANUARY. THAT MONEY HAS BEEN EXPENDED. WE HAVE COMMITTED TO KEEPING THAT INDIVIDUAL THERE UNTIL MAY. BUT, UNFORTUNATELY, THIS IS THE CIRCUMSTANCE THAT WE ARE IN, WHICH IS WE DID NOT HAVE AN INTENTION OF REMOVING ONE OF OUR IMMIGRATION ATTORNEYS. BUT ULTIMATELY ONE RESIGNED. WE ARE NOT IN A POSITION TO RECRUIT A SPECIALIST INTO THAT POSITION BECAUSE WE ARE EXPECTING ADDITIONAL LAYOFFS. IF I WERE TO RECRUIT AN IMMIGRATION SPECIALIST INTO MY OFFICE, I WOULD HAVE TO TELL THEM IS THEY MAY GET LAID OFF BY JUNE. SO IT MAKES NO SENSE FOR ME TO TRY AND DRAG SOMEONE AWAY FROM OTHER EMPLOYMENT OR SPECIALTY.

>> LET ME INTERRUPT YOU. WE HAVE A MINUTE AND 21 SECONDS. MY CONCERN IS THAT -- THANK YOU FOR BREAKING THAT DOWN. IN THE SYSTEM, SYSTEMICALLY, WHAT THIS REPRESENTS IS BROWN AND BLACK PEOPLE IN OUR SYSTEM, STAYING THERE LONGER, MAYBE NOT HAVING THE KIND OF DEFENSE THAT THEY MERIT OR THAT THEY SHOULD HAVE. AND IT REALLY CONCERNS ME. I WONDER -- I DON'T KNOW WHO WAS GIVEN THE MOTION. YOU MADE THE MOTION. I DON'T KNOW WHAT MY COLLEAGUES THINK. BUT I'M HOPING THAT WE CAN HAVE A BIT OF A STUDY SESSION IN OUR PUBLIC DEFENDER, I DON'T KNOW IF IT COULD EXTEND TO PROBATION, OUR JUSTICE SYSTEM THAT WE HAVE, AS IT IMPACTS -- BECAUSE THE PUBLIC DEFENDER, IF YOU DON'T HAVE THE RESOURCES YOU NEED, YOU ARE GOING TO IMPACT THE INCARCERATION RATE, RIGHT? AND IF WE GET OUR INCARCERATION RATE GETS IMPACTED, THEN THAT ONE THAT IS MORE EXPENSIVE -- IT'S A WHOLE CYCLE. BEHAVIOR HEALTH IS SOMEWHERE IN THERE. I'M WONDERING, CAN WE GET A STUDY SESSION THAT INVOLVES SOME OF THE SYSTEMS THAT ARE PERIPHERAL TO THE PUBLIC DEFENDER? THAT WOULD BE MY ASK.

>> I KNOW YOU PROVIDED SERVICE LEVEL IMPACT TO THE FINANCE DEPARTMENT. THAT WASN'T REFLECTED IN THE MIDYEAR REPORT. IS THERE A PATHWAY OR SOMETHING IN PROCESS FOR DISCUSSION ON HOW THE EVER-INCREASING WORK LOADS AND RESULTING CHALLENGES?

>> WE CONTINUE TO BE IN CONVERSATION WITH THE COUNTY ADMINISTRATION.

>> TO INCLUDE US.

>> AND WE WOULD HAPPILY COME AND DISCUSS. WE CERTAINLY CAN SHARE IN PARTICULAR THE INFORMATION RELEVANT TO THE MIDYEAR DECISIONS. WE ARE PREPARING AND WILL WELCOME A CONVERSATION ABOUT HOW THIS PLAYS IN TANDEM WITH OUR FISCAL '26-'27 PROPOSALS. AND WE WOULD HAPPILY, IN WHATEVER WAY THE BOARD FEELS IS MOST APPROPRIATE, ENGAGE IN THAT DIALOGUE, WHETHER IT'S IN A WRITTEN FORM, A COMBINATION OF A WRITTEN FORM AND A PUBLIC SETTING, CERTAINLY WE WOULD WELCOME THAT CONVERSATION.

>> THANK YOU. AND YOUR PREFERENCE IS FULL BOARD AS OPPOSED TO PSJC?

>> ABSOLUTELY, FULL BOARD.

>> FINE WITH ME. IT'S THE PRESIDENT'S PREROGATIVE TO SET THE AGENDA. PRESIDENT LEE, I WOULD ASK IF YOU ARE OPEN TO FINDING AN EXISTING BOARD MEETING THAT THAT ITEM CAN BE AGENDAED.

>> PRIOR TO THE APRIL TIME FRAME?

>> THAT WORKS FOR ME.

>> THEY ASKED US TO HAVE A STUDY SESSION IN THE BUDGET IMPACTS?

>> YES.

>> DOES THAT MEAN WE HOLD OFF ON THE DELETION OF THE TEN CODES TODAY OR MOVE FORWARD WITH THAT?

>> I WANT TO CLARIFY THESE POSITIONS ARE CURRENTLY VACANT POSITIONS. SO FROM A SERVICE STANDPOINT, I JUST WANTED TO MAKE SURE THAT WAS CLEAR. I WANTED TO MAKE SURE THE BOARD ALSO WAS CLEAR THAT THERE IS NO CURRENT APPROPRIATION AVAILABLE TO FILL THE POSITIONS BECAUSE OF THE EXPIRATION OF THE GRANT. SO THEY WILL NOT -- THAT'S WHY I DESCRIBE THESE AS BASICALLY IN THE FORM OF KIND OF THINGS THAT THE BOARD WOULD SEE IN A NORMAL MIDYEAR. THIS IS REALLY A REFLECTION OF THE KIND OF ACTIONS THAT WE NORMALLY TAKE IN A MIDYEAR RELATED TO THINGS LIKE EXPIRING GRANTS.

>> I'M COMFORTABLE MAINTAINING THE MOTION GIVEN THE FACT THAT THEY ARE EMPTY AND GIVEN THE FACT THAT WE HAVE THE AUTHORITY ANY TIME AS A BOARD TO MAKE CHANGES.

>> CHANGES IN THE BUDGET.

>> I THINK THIS MAKES SENSE TODAY AND WHERE WE ARE AND WHAT WE ARE TRYING TO ACCOMPLISH.

>> I'M FINE WITH THE STUDY SESSION. I THINK THAT'S IMPORTANT. I AM VERY UNCOMFORTABLE WITH THE DELETION OF A JUVENILE JUSTICE ATTORNEY AND IMMIGRATION ATTORNEY. THE POSITIONS ARE VACANT AND WE DO HAVE TO COURSE CORRECT AND RIGHT-SIZE A BUDGET, I HEAR YOU, WE HAVE THE AUTHORITY TO ADD THOSE POSITIONS BACK SHOULD THAT BE THE PREROGATIVE OF THIS BOARD THROUGH A VOTE.

>> HERE'S THE CHALLENGE. IF WE ARE LOOKING AT THESE, I'M SURE YOU KNOW THOSE ARE VERY IMPORTANT AREAS OF WORK FOR ME AS WELL. WHAT I'M VERY WORRIED ABOUT DOING IS LOOKING AT THESE POSITIONS WITHOUT SEEING EVERYTHING. BECAUSE ALONG THE WAY THERE ARE SO MANY POSITIONS THAT I WANT TO SAY BUT NOT THIS AND LET SAVE THIS. AND WHAT I WOULD LIKE TO DO IS HAVE THE WHOLE MENU IN FRONT OF ME SO I CAN UNDERSTAND IF WE SAVE THESE, THAT MEANS WE HAVE TO GIVE UP SOMETHING HERE. IF WE GO PIECEMEAL IN THIS WAY AND SAVE THE THINGS THAT WE LIKE AND THIS IS HIGH ON MY LIST OF WORK I WANT TO CONTINUE, I'M AFRAID WE ARE GOING TO DIG OURSELVES INTO A HOLE THAT IS GOING TO BE THAT MUCH HARDER TO REBALANCE IN JUNE BECAUSE WE WILL HAVE ALREADY PREDETERMINED OF ALL THE IMPORTANT THINGS, THESE ARE REALLY, REALLY THE MOST IMPORTANT. AND I DON'T KNOW WHAT THE WHOLE MENU IS. I'M NOT COMFORTABLE AS A SINGLE SUPERVISOR, OBVIOUSLY, WE ONLY ACT AS A BOARD, BUT I'M NOT COMFORTABLE ADVOCATING FOR ANY PARTICULAR POSITION ESPECIALLY AN UNFILLED ONE WITHOUT HAVING EVERYTHING IN FRONT OF ME.

>> I THINK MY RESERVATIONS DON'T CONFLICT WITH THAT. THAT PUTTING OUT THAT WE DO HAVE THESE POSITIONS BEING DELETED. JUVENILE JUSTICE AND IMMIGRATION ATTORNEY IN LIGHT OF WHAT'S HAPPENING IN THE WORLD AND THE AMOUNT OF INVESTMENTS THAT HAVE ALREADY BEEN MADE ON THESE FRONTS. BUT I'M NOT GOING TO ADD A FRIENDLY AMENDMENT TO THE MOTION TO CARVE OUT THESE POSITIONS AT THIS TIME BECAUSE WE HAVE A STUDY SESSION COMING UP AND WE DO HAVE THE AUTHORITY AND THE PREROGATIVE TO ADD THESE BACK.

>> AND FOR THE SAKE OF CLARITY, WE HAVE BEEN WORKING FOR, IN ESSENCE, THE LAST 12 MONTHS AS PART OF OUR BROADER BUDGET STRATEGY ON HOW WE WOULD RIGHT-SIZE THE ORGANIZATION IN ANTICIPATION OF A REDUCTION. SO LIKE, FOR INSTANCE, TODAY WE STILL HAVE FIVE JUVENILE JUSTICE ATTORNEYS ASSIGNED TO THAT PARTICULAR UNIT. THE REALITY IS THAT PARTICULAR ATTORNEY IS OWED TO A DIFFERENT UNIT THAT HAS A MUCH HIGHER CASE LOAD, WE NEED TO ADDRESS THAT. SIMILARLY, THAT RESIGNATION FROM OUR IMMIGRATION ATTORNEY, SHE DOES NOT ACTUALLY NOT LEAVE THE OFFICE UNTIL THE END OF THE MONTH. THIS IS ALL IN SOME WAY AS FLUID PROCESS OF WHERE THOSE VACANCIES ARE SITTING AND BEING ABSORBED CURRENTLY IN THE ORGANIZATION. FOR INSTANCE -- FOR EXAMPLE, WE ARE USING A POST BAR FELLOWSHIP TO HELP SUPPORT OUR MISDEMEANOR TEAM TO FILL ONE OF THOSE OR BACKFILL ONE OF THOSE CURRENT HOLES. SO WE ARE ADJUSTING AND RIGHT-SIZING IN REALTIME AS THESE DECISIONS ARE BEING MADE.

>> THANK YOU. I APPRECIATE WHAT YOU SAID BY CAN'T JUSTIFY OFFERING A POSITION KNOWING THAT THERE IS UNCERTAINTY OF HOW LONG THE POSITION WILL STAY. I WANT TO ACKNOWLEDGE AND APPRECIATE FOR BEING A GOOD PARTNER. I'M SORRY. THIS WAS THE TEN MINUTES.

>> IT WAS. I'M LISTENING TO YOU HAVING THIS CONVERSATION AND I WILL BE HONEST WITH YOU, I THINK WE NEED TO RIGHT-SIZE THE EFFORTS FROM THE PUBLIC DEFENDER'S OFFICE BECAUSE THERE IS NO ONE ELSE. NO ONE ELSE. IF WE REDUCE, I'M SORRY, PAUL, COVER YOUR EARS, IF WE REDUCE STAFFING AT ONE HOSPITAL OR ONE SPECIALTY, ANOTHER HOSPITAL SYSTEM CAN TAKE IT UP. THERE IS NOBODY ELSE. THERE IS NOBODY ELSE. SO YOU HAVE A VERY UNIQUE SERVICE TO OUR COMMUNITY. ONE THAT IS ALSO BROWN AND BLACK, UNFORTUNATELY, PEOPLE ARE OVER-POLICED AND END UP IN THE SYSTEM THAT YOU ARE TRYING TO MANAGE. AND SO I WOULD LIKE TO JUST ENCOURAGE YOU TO CONTINUE TO HAVE CONVERSATIONS WITH THE BOARD. WHILE I UNDERSTAND THE COUNTY EXECUTIVE IS THE LEAD OF OUR COUNTY, WE APPOINT YOU AND WE NEED TO HAVE THE CONVERSATIONS DIRECTLY WITH US. THE COUNTY EXECUTIVE DOES NOT MAKE KNOWS DECISIONS, WE DO. AND SO FOR THE REST OF THE APPOINTEES, I WOULD SAY THE SAME THING. OTHERWISE WE'LL BE HAVING THESE CONVERSATIONS LATE IN THE GAME. THAT'S IT FOR ME.

>> SUPERVISOR, I WOULD LEAVE WITH ONE FINAL POINT, GOES TO YOUR ORIGINAL QUESTION. ONE ISSUE THAT CONTINUES TO BE FRONT OF MIND FOR US, I THINK, AS AN ORGANIZATION AND FOR ME AS THE DEPARTMENT HEAD IS THINKING ABOUT THAT BALANCE BETWEEN US AND THE DISTRICT ATTORNEY. YOU ARE NEVER GOING TO HEAR ME WALK IN AND SAY THE DISTRICT ATTORNEY'S OFFICE SHOULDN'T BE PROPERLY RESOURCED OR SOMEHOW PERSONNEL SHOULD BE REMOVED FROM THEIR OFFICE AND ADDED TO OURS. BUT THAT BALANCE A CONCERN AND DISPARITY OR PARITY BETWEEN THE OFFICES THAT APPEAR TO BE DIVERGING IS REALLY SOMETHING THAT I DO PLAN TO UPLIFT FOR THE OFFICE. WE KNOW, FOR INSTANCE, THAT THE DISTRICT ATTORNEY OFFICE HIRED TEN DISTRICT ATTORNEYS WITHIN THE LAST 30 DAYS. AND I SIMULTANEOUSLY AM ELIMINATING TEN POSITIONS. THAT'S THE TYPE OF CONVERSATIONS WE WOULD WELCOME ENGAGING IN.

>> JAMES, YOU WANT TO SAY SOMETHING? ALL RIGHT. NEXT TEN MINUTES?

>> PAUL, COULD YOU COME BACK UP? SO THIS MORNING WE HEARD PUBLIC COMMENT FROM STAFF FOR THE INTEGRATED CARE TEAM. AND I HAVE TO BE HONEST, THAT WAS A PROGRAM I WAS NOT ABLE TO REACH OUT IN TIME. THEY APPEAR IN THE MIDYEAR BUDGET UNDER A DIFFERENT TITLE. BUT WHAT I DID HAVE A CHANCE TO SPEAK TO SOME OF THE FOLKS OUTSIDE THE BOARD CHAMBERS BEFORE THE MEETING STARTED. SO QUESTION NUMBER ONE, DO THE NURSES OR THE STAFF BEING DELETED FROM THIS TEAM, WILL THEY HAVE -- ARE THEY GOING TO ANOTHER POSITION? WHAT'S THE STORY THERE, BECAUSE THEY THEMSELVES DIDN'T KNOW. AND I WILL ASK THAT QUESTION FIRST, THEN I WILL ASK MY SECOND QUESTION.

>> ALL OF THE INDIVIDUALS THAT ARE QUOTE, UNQUOTE, FILLED DELETES WILL HAVE A POSITION TO FALL INTO, YES.

>> DO WE KNOW IF THEY ARE LATERAL MOVES OR BUMPING? ALL THE TERMS, I'M USING THEM INTERCHANGEABLY.

>> FOR ALL THE REPRESENTED STAFF, THEY ARE ALL LATERAL.

>> FANTASTIC. THERE WAS A GROUP OF CLIENTS, AT FIRST I THOUGHT IT WAS THEIR COLLEAGUES, THEN I LEARNED IT WAS THEIR CLIENTS PAST AND PRESENT THAT ALL STOOD IN THIS SECTION OF THE ROOM HOLDING SIGNS AND STANDING UP WHILE THEIR CARE PROVIDER WAS SPEAKING. I HAD A CHANCE TO TALK TO SOME OF THEM. IT'S INCREDIBLE STORIES. THEY TALKED ABOUT THE NUMBER OF YEARS THEY HAVE BEEN SOBER, TALKED ABOUT WHERE THEY CAME FROM, THE NUMBER OF YEARS THEY SPENT ON THE STREETS BATTLING DEPENDENCY. SO THIS IS ONE OF THOSE RARE MOMENTS WHERE WE SEE THE SUCCESS STORIES FIRSTHAND. SO WITH THE DELETION OF THESE CODES, WHAT IS THE IMPACT TO SERVICE? WHERE WILL THIS BRIDGE NOW LIVE? SOMEWHERE ELSE IN THE ORGANIZATION OR NOT AT ALL?

>> THANK YOU FOR THAT QUESTION, SUPERVISOR. I WOULD FIRST START OUT BY SAYING TO YOU AND THE BOARD THAT THESE ARE THE DIFFICULT DECISIONS WE HAVE TO MAKE UNDER THE CIRCUMSTANCES. THE EXPECTATION GOING FORWARD FOR THOSE CLIENTS IS THAT WE WORK WITH THEM TO ENSURE THEY HAVE THE ONGOING SUPPORT AND TREATMENT WITHIN THE COMMUNITY. THE TRANSITIONS OF CARE FOR CUSTODY THAT IS RUN BY SANTA CLARA VALLEY HEALTHCARE IN CONJUNCTION WITH CUSTODY HEALTH IS AN OPPORTUNITY FOR US TO ENSURE THAT INDIVIDUALS THAT ARE INCARCERATED WHEN RELEASED HAVE THE BEST SUCCESS POSSIBLE IN MOVING INTO THE COMMUNITY. THAT MEANS MAKING SURE THEY RECEIVE THE APPROPRIATE SUPPORTS. THE PROGRAM IS NOT MEANT TO PROVIDE ONGOING TREATMENT AND SUPPORT INDEFINITELY. IT'S A TRANSITIONS PROGRAM. WHAT WE NEED TO DO IS WORK CLOSELY WITH THE CLIENTS AND STAFF TO ENSURE THAT THESE INDIVIDUALS REMAIN SUPPORTED IN THE COMMUNITY IN SOME FORM OR FASHION.

>> ARE THERE EFFORTS UNDER WAY ALREADY TO ENSURE TRANSITION PLAN FOR EACH OF THE CLIENTS?

>> YES. I DID HAVE A CONVERSATION WITH MICHELLE WHO OVERSEES THE PROGRAM. THAT IS EXACTLY HER INTENTION GOING FORWARD.

>> THAT WAS MY CONCERN. THE CLIENTS THEMSELVES DIDN'T KNOW WHAT WAS NEXT FOR THEM. AND THERE WAS A SENSE OF GREAT ANXIETY THERE. THEY ARE FULLY COMMITTED TO THEIR TREATMENT PLANS AND THEIR ROAD TO RECOVERY. I KNOW YOU UNDERSTAND THAT FULLY. YOU LIVE THIS EVERY DAY. SO THE SOONER WE CAN COMMUNICATE TO THEM THAT THIS IS THE PLAN FORWARD TO CRAFT TRANSITION PLANS FOR THEM BUILT AROUND THEIR SUCCESS AND ALSO FOR THE STAFF TO KNOW THEY DO HAVE MOVED BECAUSE THEY THEMSELVES SAID THIS MORNING, BOTH CLIENT AND SERVICE PROVIDER, WE DON'T KNOW WHAT'S NEXT. WE DON'T KNOW IF WE CAN GET CARE AND WE DON'T KNOW IF WE HAVE A JOB.

>> THANK YOU.

>> THE NEXT QUESTION IS WE RECEIVE CONSIDERABLE FEEDBACK FROM RNPA REGARDING NURSE POSITIONS IN CUSTODY HEALTH SERVICES. DO THEY HAVE A PLACE TO GO TO AND WHAT IS THE IMPACT TO SERVICE? DO WE HAVE A PLAN TO ENSURE THOSE SERVICES ARE COVERED? ESPECIALLY TAKING INTO ACCOUNT THE ROBUST CONVERSATION WE HAD ABOUT CUSTODY HEALTH SERVICES.

>> I WOULD INVITE LUNA TO COME FORWARD.

>> CUSTODY HEALTH IS MANAGED -- SORRY, PAUL.

>> I WANT TO CLARIFY. ALL THE POSITIONS IN CUSTODY HEALTH ARE VACANT. SO THERE IS NO QUESTION ABOUT LANDING SPOTS FOR INDIVIDUALS. AND IN BROAD STROKES, THE PROPOSAL RELATED TO CUSTODY HEALTH IS ABOUT CONSISTENT WITH DIRECTION THAT WE HAVE GOTTEN FROM STAFFING ANALYSIS AS PART OF THE CONSENT DECREE WORK. USING VACANT POSITIONS TO REALIGN THE ROLES THERE AND ESSENTIALLY RESERVING RN LEVEL WORK FOR THOSE WHO ARE REGISTERED NURSES AND ADDING POSITIONS LIKE LPN POSITIONS OR OTHER WORK. I WOULD

INVITE HER TO PROVIDE ADDITIONAL COMMENTS. THANK YOU. SORRY, PAUL, THIS IS A DIFFERENT OPERATION.

WE ARE CONTINUING TO OPTIMIZE OPERATIONS AND WILL BE CONTINUOUSLY MAKING CHANGES TO ENSURE WE ARE SUPPORTING OUR CORE STAFF SO WE ARE MAINTAINING OUR CORE RN STAFF AND ADDING A SIGNIFICANT AMOUNT, I WOULD SAY SIGNIFICANT AMOUNT OF PARAPROFESSIONALS TO SUPPORT THE WORK ALREADY UNDER WAY. SO WE ARE NETTING ADDITIONAL FT OVERTIME TO HELP OUR EXPANDING OPERATIONS. THE MOVES THAT YOU SEE AT MIDYEAR SUPPORT NURSES TO OPTIMIZE THE WORK. SO WE ARE REALLY JUST MOVING SOME TASKS ON TO LVNs AND MAs TO OFFLOAD SOME OF OUR NURSES. THAT'S GOING TO HELP THE NURSE'S WORK THAT MAXIMIZES THEIR LICENSURE AND WE ARE DOING THAT ACROSS THE BOARD.

SO ALL THE CLINICAL NURSE POSITIONS ARE CURRENTLY STRAIGHT CAN'T -- ARE CURRENTLY VACANT.

YES.

LVNs ARE BEING ADDED?

THAT'S CORRECT.

THE LEVEL OF SERVICE AND CARE WILL NOT BE SOME PROMISED. THANK YOU. -- COMPROMISED. THANK YOU. I'M LOOKING AT MY LIST. I'M DONE WITH MY TEN MINUTE ROUND WITH THREE MINUTES TO SPARE. THANK YOU SO MUCH.

THANK YOU.

I WILL TRY TO MAKE THIS QUICK. I JUST HAD A COUPLE MORE QUESTIONS. I NOTICED THAT THERE WERE SOME ENHANCEMENTS BEING PROPOSED. ONE IS THE IGR $1 MILLION. I WOULD LIKE TO JUST FIND OUT WHAT THAT $1 MILLION IS GOING TO GET US.

WELL, OUR GOAL IS 500 MILLION IN ONGOING REVENUE. THAT IS PART OF OUR EFFORT IN COALITION WITH OTHER PUBLIC HOSPITAL SYSTEMS TO HAVE AN EFFECTIVE ADVOCACY EFFORT AIMED AT THE STATE LEVEL RELATED TO OUR -- THAT CATEGORY OF WORK WHICH IS THE LOBBYING CAMPAIGN AND OUTREACH WORK. WE ARE LEANING FORWARD WITH THAT APPROPRIATION ALSO BECAUSE WE ARE HOPING TO HAVE OTHER ENTITIES MATCH THAT CONTRIBUTION. AND WE HAVE INITIATED THOSE CONVERSATIONS WITH OTHER PUBLIC HOSPITAL SYSTEMS AS WELL. SO THAT IS OUR GOAL. NOW I'M NOT -- I WANT TO BE CLEAR, I'M NOT MAKING PROMISES THAT'S GOING TO BE THE OUTCOME. THE GOAL IS TO FINANCE THAT EFFORT. AND MAKE SURE THAT IT'S AS EFFECTIVE AS IT POSSIBLY CAN BE.

CAN YOU GIVE ME MORE -- WHAT IS THE MILLION, IS IT FIVE STAFF? WHAT ARE WE TALKING ABOUT WITH THE MILLION DOLLARS?

WE ARE NOT ADDING ANY POSITIONS. THE FUNDING WOULD BE USED FOR A COMBINATION OF CONTRACT SERVICES FOR JOINT ADVOCACY IN SACRAMENTO, BUT ALSO FOR INFORMATIONAL MATERIALS AND OUTREACH PROBABLY DONE AS A COORDINATED CAMPAIGN IN CONJUNCTION WITH THE OTHER PUBLIC HOSPITAL COUNTIES. WE ARE HOPING THAT THE OTHER PUBLIC HOSPITAL COUNTIES WILL MATCH THAT CONTRIBUTION AND POOL IT TOGETHER IN THAT ADVOCACY EFFORT. ONE OF THE THINGS THAT IS IMPORTANT IN RECOGNITION OF WHERE WE ARE AT IN SACRAMENTO IS MAKING SURE THAT THERE IS BETTER AWARENESS OF THE ROLE OF PUBLIC HOSPITALS. THERE IS A SIGNIFICANT PRESENCE FROM THE CALIFORNIA HOSPITAL ASSOCIATION AND OTHER ENTITIES. BUT NOT AS STRONG AND VISIBLE A PRESENCE FROM THE PUBLIC SYSTEMS. THIS IS IN PART IN EFFORT TO ENSURE THAT THAT VOICE HAS A SIGNIFICANT PRESENCE IN SACRAMENTO.

I CAN APPRECIATE THAT. I GUESS IN LIGHT OF THE CUTS WE ARE LOOKING AT, IT'S HARD FOR ME TO SUPPORT ADDING MONEY INTO SOMETHING LIKE THIS. I GUESS BECAUSE MY QUESTION IS LIKE WHAT MORE, WE HAVE A STAFF, WE HAVE A DEPARTMENT THERE ALREADY. SO WHAT MORE CAN THEY DO, FRANKLY. AND THEN AS ELECTED OFFICIALS, I FOUND THE MOST EFFECTIVE ADVOCACY, FRANKLY, GOING TO SACRAMENTO IS USING US. I CERTAINLY -- I KNOW WE ARE ALL BUSY. WE HAVE OUR RELATIONSHIPS WITH OUR LEGISLATORS. I WOULD LIKE TO BE MORE UTILIZED IT'S A QUESTION OF RESOURCES VERSUS WHAT WE ALREADY HAVE. AND BETTER MAXIMIZE MYSELF -- MAXIMIZING WHAT WE HAVE ALREADY.

A COUPLE OF THINGS I WOULD ADD. WE HAVE REACHED OUT TO EACH OFFICE TO SCHEDULE A FOCUSED BRIEFING ON STRATEGY AND HOW BEST TO ENGAGE EACH OF YOU INDIVIDUALLY WITH THE BEST CONTACTS YOU HAVE IN SACRAMENTO. SECOND, IT IS A ONE-TIME ALLOCATION. IT IS NOT PROPOSING TO ADD STAFF. IT'S A ONE-TIME INVESTMENT IN THAT EFFORT THAT WE BELIEVE HAS THE POTENTIAL TO PAY SIGNIFICANT DIVIDENDS AND POTENTIAL TO DRAW DOWN SIGNIFICANT MATCHING CONTRIBUTIONS FROM OTHER SYSTEMS.

OKAY. I DIDN'T REALIZE THAT. I THINK PART OF THE CHALLENGE HAS BEEN THE DOCUMENTS ARE A LITTLE HARD TO UNDERSTAND WHAT'S ONGOING VERSUS ONE TIME. A CHART -- I KNOW YOU HAVE CHARTS IN THE BACK. I THINK MORE CHARTS WOULD BE HELPFUL TO JUST HAVE A LIST OF WHAT'S IN EACH CATEGORY. SO THAT THAT WOULD BE HELPFUL. THE OTHER ITEM IS THE CORRECTIONAL RECRUITMENT, THE 1.75 MILLION. AGAIN, WHAT IS THAT GOING TO ENTAIL?

I WILL SANTA FE COUNTY COUNSEL WANTS TO ADD ANYTHING TO THIS. AS THE BOARD IS AWARE, WE HAVE AN ONGOING COMPLIANCE RELATED ISSUE IN OUR CONSENT DECREE LITIGATION ASSOCIATED WITH HIRING OF CORRECTIONAL DEPUTIES. ONE PIECE OF THAT EFFORT IS THE USE OF RECRUITMENT FIRM. THIS WILL COVER THOSE COSTS. I DON'T KNOW IF COUNTY COUNSEL WANTS TO ADD ANYTHING NOW OR ADD SOMETHING CONFIDENTIALLY OFF AGENDA. THAT'S WHAT THAT ITEM RELATES TO.

HOPE TO PROVIDE MORE DETAIL OFF AGENDA. THIS IS CRITICAL TO DEAL WITH IMMINENT LITIGATION IN ENSURING WE ARE ABLE TO MAKE THE NECESSARY -- WE NEED TO MAKE QUICKLY IN TERMS OF STAFFING THAT PARTICULAR THING.

I KNOW WE HAVE A LOT OF VACANCIES IN THAT DEPARTMENT THAT WE NEED TO FILL. I GUESS I WOULD LIKE TO MAYBE GET MORE INFORMATION ON THE TIMELINE. I KNOW IT'S GOING TO TAKE TIME TO EVEN FIND A RECRUITER. SO THAT'S WHAT I'M LOOKING FOR IS MORE DETAILS ON WHAT THE SEQUENCING OF THAT PROCESS IS. AND IGR, TOO, I WOULD LIKE TO, MIDYEAR OR WHEN WE GET TO THE FISCAL YEAR, SEE HOW WE ARE DOING IN THIS EFFORT TO RE-EVALUATE WHETHER WE CONTINUE WITH IT OR NOT. THE LAST ONE IS THE IMPOUNDMENT OF THE $82 MILLION DUE TO THE MEASURE A FUNDS IN LITIGATION. I UNDERSTAND THAT. I WANT TO CLARIFY. THAT BASICALLY MEANS WE ARE NOT ABLE TO DRAW DOWN THE SALES TAX REVENUE THAT WILL START IN APRIL UNTIL THE LITIGATION IS FINALIZED.

THIS IS A SIGNIFICANT ISSUE. JUST TO BE VERY CLEAR AND TRANSPARENT, AT THIS TIME WE ARE PLANNING TO BUDGET THE MEASURE A REVENUE IN THE RECOMMENDED BUDGET AND FOURTH-COMING BUDGET PROCESS. BUT WE DO HAVE A PROBLEM RIGHT NOW BECAUSE OF THAT LITIGATION. THIS HAS BECOME A TACTIC THAT HAS BEEN UTILIZED IN CASE AFTER CASE. I WILL JUST POINT OUT THAT THESE CASES HAVE ALL BEEN UNSUCCESSFUL. BUT THEY HAVE RESULTED IN MANDATORY IMPOUNDMENTS OF TAX REVENUES FOR A NUMBER OF YEARS. I THINK THE WORST CASE WAS ALAMEDA COUNTY WHERE IT WAS ABOUT FOUR YEARS. SO WE OBVIOUSLY CANNOT AFFORD THAT. THAT'S THE WHOLE REASON WE WENT FORWARD WITH THE MEASURE ON THE URGENT BASIS THAT WE DID. I KNOW COUNTY COUNCIL IS DOING EVERYTHING IT CAN TO MAKE SURE THE COURT UNDERSTANDS THAT. AND WE WILL REMAIN OPTIMISTIC THAT THE COURT WILL EXPEDITIOUSLY RESOLVE WHAT, MY OPINION, IS BASICALLY A FRIVOLOUS CASE THAT SHOULD NOT BE STANDING IN THE WAY OF THE WILL OF THE PEOPLE IN OUR COMMUNITY TO GET US EMERGENCY RESOURCES NEEDED TO DEAL WITH THIS FEDERAL CHALLENGE. WE'LL CONTINUE TO DO EVERYTHING WE CAN.

THANK YOU. MY CONCERN IS THE TIME. I KNOW I DEALT WITH RM3 BRIDGE TOLL REVENUE MEASURE THAT TOOK AT LEAST THREE YEARS TO RESOLVE. SO IF WE DON'T GET THIS BY THE END OF ANY YEAR, THAT'S $82 MILLION WE HAVE TO FIND ELSEWHERE. SO THANK YOU.

I DON'T SEE ANY MORE LIGHTS. WE HAVE GONE THROUGH A COUPLE OF ROUNDS. DEBATED THIS ISSUE IN DEPTH. IT'S VERY REAL. I WANT TO SAY IT'S BEEN LAID OUT, ONE PRONG I WANT TO SAY INSTEAD OF CUT AND CUT THE REVENUE SIDE. I'M LOOKING FORWARD TO SEE IF THERE IS ANY POSSIBILITY AND ANY OTHER WAYS TO FIND MORE REVENUES. I WANT TO SAY THANK YOU FOR PROPOSING ADDITIONAL RESOURCES TO TRY TO FIND MORE OF THAT. I'M NOT SEEING A LOT FROM FEDERAL PARTNERS. BUT FROM STATE PARTNERS, WE HAVE A POSSIBILITY TO TRY TO SHAKE THE MONEY TREE, NOT THAT THERE'S THAT MUCH TO SHAKE. WAY TONIGHT PROPOSE IN THE FUTURE SOMETHING WE'LL TALK ABOUT. ANY TYPE OF POTENTIAL PUBLIC PRIVATE PARTNERSHIP WE MIGHT BE LOOKING TO COME UP WITH REVENUES FROM OTHER PRIVATE ENTITIES THAT COULD HELP US TO GET THROUGH THIS TOUGH TIME. JAMES, DO YOU HAVE ANY COMMENTS ON THAT?

WE ARE ALWAYS EXPLORING DIFFERENT KIND OF PARTNERSHIPS, DIFFERENT STRUCTURES. I WILL SAY ONE THING ON OUR STATE-RELATED STRATEGY. THERE ARE ABSOLUTELY THINGS THAT THE STATE CAN DO THAT WOULD HELP MITIGATE IMPACTS TO US THAT DON'T NECESSARILY COST THE STATE MONEY OR VERY MUCH MONEY. AND I WANT TO HIGHLIGHT THAT BECAUSE I THINK IT'S EASY TO SAY, OF COURSE, THE STATE IS NOT IN A POSITION TO BACK FILL BILLIONS OF DOLLARS STATEWIDE IN MEDI-CAL CUTS. WE AGREE. THERE IS AN IMPORTANT ROLE FOR THE STATE TO PLAY. ONE, HELPING KEEP PEOPLE ON MEDI-CAL. HELPING FACILITATE STRUCTURAL MANEUVERS WE HAVE TAKEN TO TRY TO MAXIMIZE FEDERAL REVENUES. BUT ALSO TO MAXIMIZE THE UTILIZATION OF FUNDING FOR SERVICE DELIVERY. AND THIRD, IMPORTANT CHOICES FOR THE STATE TO MAKE IN HOW MEDICAL FUNDING IS ALLOCATED THAT CAN PRESERVE VITAL PUBLIC HOSPITAL RESOURCES GIVEN THE OUTSIZED ROLE THAT PUBLIC HOSPITAL SYSTEMS PLAY IN THE HEALTHCARE OF ALL CALIFORNIANS. THAT'S WHERE THE STATE CAN MAKE A MEANINGFUL IMPACT WITHOUT BACKFILLING THE HR-1 LOSSES. AND I THINK THAT THERE IS A DERTH RIGHT NOW OF THOSE CONCRETE IDEAS COMING OUT IN THE STATE OTHER THAN THE LEADERSHIP OF THIS COUNTY AND COALITION PARTNERS. PART OF THESE EFFORTS ARE TO MAKE SURE WE CAN GET THAT MESSAGE IN THE RIGHT PLACES, MAKE SURE IT'S COORDINATED, WE CAN COORDINATE ACROSS THE TYPES OF ALLIES WE NEED TO SUCCESSFULLY MOVE THAT FORWARD. BUT THE STATE HAS SOME OPPORTUNITIES HERE TO SHOW REAL LEADERSHIP IN PUSHING BACK ON THE FEDERAL ADMINISTRATION. THE WAY THIS BOARD HAS SHOWN GREAT LEADERSHIP IN PUSHING BACK ON THE FEDERAL ADMINISTRATION AND NOT JUST TAKING THE HR-1 CUTS LYING DOWN. THAT WAS ONE OF THE DISAPPOINTING THINGS. THE PROPOSAL FROM THE GOVERNOR WAS IT WAS NOT RESPONSIVE TO HR-1. WE KNOW AND EXPECT CALIFORNIA TO DO MUCH BETTER THAN THAT.

THANK YOU. I ALSO WANT TO SAY THANK YOU TO YOUR TEAM AND THE BUDGET TEAM TO LOOK VERY DEEP. THESE ARE TOUGH CUTS FOR TWO THINGS. ONE IS MEASURE A, WE ARE THE ONLY COUNTY IN THE STATE OF CALIFORNIA, THE ENTIRE NATION THAT HAS GONE THROUGH THIS EVOLUTION TO COME UP WITH NEW REVENUES FROM THE VOTERS BACK IN NOVEMBER. THAT HAS MADE A HUGE DIFFERENCE IN TERMS OF HOW DEEP THIS CUT WOULD BE. IT WOULD BE MUCH DEEPER, FOR ONE. SECOND, THE FACT YOU HAVE GONE THROUGH TO LOOK FOR ALL THESE PLACES TO BE ABLE TO FIND PLACES FOR THOSE WHO HAVE BEEN AFFECTED. SO THAT NO ONE, I JUST WANT TO MAKE SURE, NO ONE IN THIS COUNTY IS BEING LAID OFF AND WITHOUT A JOB BASED ON THESE DECISIONS. THAT'S A HUGE FEAT THAT YOUR STAFF, AND I WANT TO GIVE YOU A SHOUT OUT FOR BEING ABLE TO COME UP WITH THAT. IT'S MORE DISCUSSION WE NEED TO HAVE. BUT THANK YOU FOR COMING UP WITH THAT PROPOSED SOLUTION. WITH THAT, WE HAVE GOT A MOTION AND SECOND. LET'S TAKE THE ROLE.

THROUGH THE CHAIR, CAN WE HAVE A STATEMENT IN FOR ALL THREE OF THE REQUESTS, CORRECT?

YES. ALL THREE ITEMS.

THAT IS A MOTION BY ABE-KOGA AND SECOND BY ELLENBERG.

OTHER WAY AROUND.

I'M SORRY. ELLENBERG. (ROLL CALL). MOTION PASSES.

THANK YOU. NOW WE MOVE TO ITEM 16. AM I CORRECT? WHICH IS THE REPORT FROM THE COUNTY EXECUTIVE RELATING TO UNBUDGETED COST FOR THE 2026 SPECIAL SPORTING EVENTS. GO AHEAD, JAMES.

WE RECEIVED A REQUEST FROM THE BOARD TO HIGHLIGHT AND CATALOG THE SIGNIFICANT COSTS FOR OUR COUNTY ORGANIZATION ASSOCIATED WITH THESE INCREDIBLE SPORTING EVENTS THAT OUR COMMUNITIES ARE FORTUNATE TO HOST, INCLUDING THE WORLD CUP AND SUPER BOWL WHICH HAPPENED TWO DAYS AGO. WE HAVE A BRIEF OVERVIEW REPORT. WHAT WE WANT TO HIGHLIGHT IS A COUPLE OF THINGS. ONE IS ALTHOUGH THE COUNTY HAS NO ROLE IN AGREEING TO HOST THESE EVENTS AND THE COUNTY DOES NOT RECEIVE REVENUES ASSOCIATED WITH THESE EVENTS, I WANT TO SAY THAT YET AGAIN, DOES NOT RECEIVE REVENUES ASSOCIATED WITH THESE EVENTS. WE DON'T GET REVENUES FROM TICKET SALES OR OTHER ACTIVITIES ASSOCIATED WITH THEM. THESE EVENTS DON'T AFFECT OUR PROPERTY TAXES WHICH IS OUR SIGNIFICANT LOCAL REVENUE STREAM. WE DO HAVE COSTS. THOSE COSTS INCLUDE EMERGENCY OPERATION CENTER, THE SHERIFF'S OFFICE, OTHER COUNTY DEPARTMENTS AND OUR HOSPITAL SYSTEM, ALL OF WHICH ARE INVOLVED IN THE PREPAREDNESS ACTIVITIES. FORTUNATELY, THE SUPER BOWL WENT OFF VERY SMOOTHLY. BUT THAT DOESN'T MEAN WE DON'T STILL HAVE COSTS ASSOCIATED WITH ALL OF THE ACTIVITY THAT HAPPENS TO ENSURE WE ARE PREPARED. THAT DOESN'T MEAN WE DON'T HAVE COSTS ASSOCIATED WITH THE STAFF INVOLVED IN ALL OF THAT PLANNING AND COORDINATION AND INCLUDING THE UP-STAFFING THAT WE HAVE TO HAVE ASSOCIATED WITH THESE EVENTS AND ACTIVITIES. WE WILL BE IN A POSITION TO REPORT MORE TANGIBLY ON WHAT THE COSTS LOOK LIKE AFTER THE FACT. WE DO COST TRACKING. BUT BECAUSE IT'S SOMEWHAT FLUID, WE DON'T HAVE THOSE COST NUMBERS IN ADVANCE. I CAN GIVE YOU ONE COST NUMBER, THE ACTIVITY FOR THE EMERGENCY OPERATION CENTER. WE DON'T HAVE THE FINAL NUMBERS YET, WE ONLY FINISHED DEACTIVATION YESTERDAY. IT WILL COME IN AROUND $200,000 MARK JUST FOR THAT SPECIFIC STAFFING FOR THE WEEK. SIGNIFICANT COSTS IN SHERIFF'S OFFICE WILL TAKE TIME TO GET ON THE BACK END. THE OTHER THING FOR THE BOARD TO KNOW RELATED TO THIS, VERY LITTLE OF THE FUNDING IS COMING TO US. WE HAVE ONE SMALL GRANT THAT HAS COME THROUGH THE CALIFORNIA GOVERNOR'S OFFICE OF EMERGENCY SERVICES THAT'S FLOWING THROUGH THE COUNTY. BUT 90% OF THAT IS BEING DISTRIBUTED TO, BY DIRECTION OF THE STATE, IS BEING DISTRIBUTED TO THE HOST COMMITTEE AND TO OTHER PARTNER AGENCIES, ONLY 10% IS RETAINED BY THE COUNTY ITSELF. A PORTION OF THAT 10% IS ASSOCIATED WITH THE ADMINISTRATION OF THOSE FUNDS, WE ARE A FISCAL AGENT RESPONSIBLE FOR THE TRACKING AND INVOICING RELATED TO THAT. AND A SMALL PORTION IS ROUGHLY 5% OF THAT 7.8 MILLION WILL HELP REIMBURSE SOME OF OUR COSTS. BUT AS OF TODAY THAT IS OUR ONLY OFFSETTING FUNDING SOURCE SEPARATE FROM THE CONTRACT THAT THE BOARD APPROVED ON CONSENT WITH VTA WHERE VTA IS REIMBURSING SHERIFF RELATED COSTS FOR VTA SPECIFIC SERVICES. THAT DOESN'T COVER OTHER SHERIFFS RELATED COSTS. BUT WHERE WE ARE GETTING REIMBURSED FOR SECURITY, CTA PLATFORMS AND IN THE VTA SYSTEM. SO HAPPY TO ANSWER ANY QUESTIONS.

THANK YOU. CAN I GO TO THE PUBLIC? ANYBODY PUBLIC WHO WOULD LIKE TO SPEAK ON THIS ITEM?

I DON'T HAVE ANY CARDS IN CHAMBERS, BUT I SEE ONE HAND IN ZOOM. THIS IS FOR ITEM 16. SHARON DHANOA.

I'M WITH THE SOUTH BAY COALITION AND HUMAN TRAFFICKING. I WANT TO ACKNOWLEDGE THE DIFFICULT DECISIONS BEING MADE BY THE COUNTY AND THANK THE BOARD FOR YOUR LEADERSHIP ON PRIORITIZING SAFETY ESPECIALLY WITH THESE LARGE SPORTING EVENTS. YOUR SUPPORT FOR SAFETY FOR THE BAY, OUR INITIATIVE FOR COMMUNITY RESOURCE NAVIGATOR IS HELPING US MAXIMIZE INFORMED ACCESS TO RESOURCES WE HAVE AROUND THE REGION. WE CANNOT RELY ON LAW ENFORCEMENT PARTNERS FOR SAFETY. OUR COMMUNITY IS INCREASINGLY IN FEAR. SO THE RESOURCE IS HELPING US PROVIDE THAT ACCESS, INFORMED ACCESS TO INDIVIDUALS IN OUR COMMUNITY TO PRIORITIZE SAFETY.

THAT WAS OUR ONLY SPEAKER.

I SEE SOME LIGHTS. WHO WAS FIRST. SUPERVISOR ABE-KOGA.

THANK YOU. I APPRECIATE THIS BEING ON OUR AGENDA. THIS HAS BEEN A THORN IN MY SIDE SINCE SUPERBOWL -- SUPER BOWL L. THE SAME ISSUE CAME UP, WHO IS GOING TO PAY US FOR THE EXTRA COSTS THAT WE ARE PUTTING OUT TO PROVIDE MORE TRANSIT SERVICE, FRANKLY. WE WERE TOLD SALES TAX REVENUE WILL BE SO GREAT THAT THAT WILL COVER IT. BUT WE ENDED UP WITH A $4 MILLION HOLE BACK THEN. WHEN THIS CAME UP AGAIN EARLY LAST YEAR, IT WAS RECOMMENDED THROUGH SVRA AND VTA AND A NUMBER OF AGENCIES TO GET AHEAD OF THE ISSUE. AND DISCUSS THIS WITH THE BAY AREA HOST COMMITTEE. I WENT TO MEET WITH THE HOST COMMITTEE MYSELF. AND UNFORTUNATELY, I THINK THE CHALLENGE WAS THERE WAS NO ONE LEAD AGENCY TO BRING EVERYBODY TOGETHER TO WORK TOGETHER TO FIGURE OUT HOW WE WERE GOING TO GET COST RECOVERY. AND I THINK THAT IS SOMETHING THAT WE SHOULD CONSIDER. I KNOW THAT THE FUNDING, WE WERE THE HOLDER OF THE MONEY THAT CAME IN, THE MONEY THAT CAME IN. BUT EVERYONE, I WAS ASKING AROUND, WHO IS IN CHARGE OF ASKING THE HOST COMMITTEE OR WHOEVER, NFL, FIFA. I LOOK FORWARD TO SEEING THE NUMBERS AND THE RUNDOWN AND SEEING IF SALES TAX REVENUE GENERATED THE AMOUNT WE NEEDED TO COVER ALL OF OUR COSTS. IT'S SECURITY, IT'S TRANSIT. ALL OF THE -- THERE IS SO MANY DIFFERENT COSTS TO IT. EVERYBODY LOVES THESE EVENTS AND THEY ARE GREAT, TOO. AND HOPEFULLY THEY WERE MONEY-MAKERS FOR OUR BUSINESSES. BUT FOR THE PUBLIC AGENCIES THAT HAVE TO PROVIDE THE SERVICES, IT'S A MONEY LOSER. I DON'T WANT THAT TO CONTINUE TO BE THAT WAY. SO I WOULD LIKE FOR US, ACTUALLY, TO JUST TAKE CHARGE. BECAUSE I HEAR THE 2028 SOCCER GAMES ARE COMING, I THINK WE ARE GOING TO CONTINUE TO SEE MORE OF THESE EVENTS HAPPENING. SO I THINK WE JUST NEED A COORDINATED ORGANIZED SYSTEM. I HAVE TALKED TO A PERSON AT L.A. METRO. THEY ARE GETTING READY FOR THE OLYMPICS. SHE MENTIONED THERE IS AN INTEREST OR EFFORT TO TAKE THIS UP. BUT ASK THE STATE TO PROVIDE LEGISLATION REQUIRING THAT THESE GROUPS, ENTITIES, DO PAY FOR THE FULL COSTS OF THE SERVICES. SO I HOPE WE CAN WORK ON THAT AND I'M HAPPY TO SUPPORT THAT EFFORT.

THANK YOU, SUPERVISOR. I HARDLY CONCUR WITH YOUR COMMENTS. IT WOULD BE EXCEEDINGLY HELPFUL TO HAVE SOME STATE LEGISLATIVE FRAMEWORK BECAUSE WHAT HAPPENS IS WE LEARN ABOUT THE EVENT AFTER IT'S BEEN AGREED TO. SO WE LEARNED ABOUT SUPER BOWL WHEN IT WAS ANNOUNCED. WE ARE NOT A PARTY, WE DON'T OWN THE FACILITY. WE ARE NOT A PARTY TO THOSE CONVERSATIONS WHERE THOSE AGREEMENTS ARE BEING MADE. AND WE DON'T THEN RECEIVE THE TICKET REVENUE, WE DON'T THEN RECEIVE THE SALES TAX REVENUE. THERE COULD BE A SURCHARGE ON THOSE VERY EXPENSIVE TICKETS THAT WOULD BE QUITE MODEST AND HAVE NO IMPACT ON SALES THAT COULD COVER SECURITY COSTS, FOR EXAMPLE. BUT WE ARE NOT A PARTY TO ANY OF THAT CONVERSATION. SO WE ARE IN THE POSITION AFTER THE FACT OF REACHING OUT TO THE STATE, REACHING OUT TO OTHERS, WE WERE LUCKY TO GET THIS TINY 10%. BUT MOST OF THE MONEY INCLUDING THE FEDERAL MONEY BYPASSED US ALL TOGETHER. AND JUST WENT STRAIGHT TO THE HOST COMMITTEE. SO SOME FRAMEWORK WOULD BE HELPFUL ESPECIALLY WHEN YOU THINK ABOUT THE SOUTH BAY FROM A JURISDICTIONAL STANDPOINT. BECAUSE IT'S AT LEAST A LITTLE BIT OF A DIFFERENT STORY IF YOU ARE TALKING ABOUT A CITY LIKE LOS ANGELES WHERE THE CITY ITSELF CAN SUBSTANTIALLY ADDRESS, NOT ALL, BUT AT LEAST A SIGNIFICANT PORTION OF THE RESOURCE NEEDS ITSELF. BUT WE ALL KNOW, THIS IS NOT A KNOCK ON THE CITY OF SANTA CLARA, THEY DID A TREMENDOUS JOB BY THE WAY THIS WEEKEND WITH THE SUPER BOWL. BUT GIVEN THE MODEST SIZE OF THE CITY OF SANTA CLARA RELATIVE TO THE EVENTS WE ARE TALKING ABOUT, THEY INHERENTLY WILL DEPEND ON MUTUAL AID, ON THE COUNTY, ON THE SHERIFF'S OFFICE AND A WHOLE LOT OF OTHER PARTNERS, TOO. AND SO WE DO ACTUALLY NEED THAT KIND OF ENGAGEMENT. AND WE DO NEED TO BE A PART OF THOSE DISCUSSIONS. THERE ISN'T EXACTLY AN INCENTIVE ON THE PART OF THE CITY OR NICKEL THE ENTITY THAT MANAGES THE STADIUM WHICH IS NOT THE CITY TO NECESSARILY INCLUDE US OR OTHERS IN THOSE CONVERSATIONS. SO I DO THINK IT TAKES SOME ROLE FROM THE STATE OR SOMEONE ELSE TO SAY YOU HAVE TO AT LEAST ENGAGE THOSE PARTNERS IF YOU KNOW YOU ARE GOING TO BE INHERENTLY RELYING ON THEM TO SHOW UP AND PROVIDE THE SERVICES. THAT'S ALWAYS GOING TO BE THE CASE HERE EVEN FOR MUCH SMALLER SCALE EVENTS IN A WAY IT MAY NOT BE IN OTHER PARTS OF CALIFORNIA.

SO I THINK -- SHOULD I MAKE A MOTION TO RECEIVE THE REPORT. BUT ALSO I DON'T KNOW HOW TO WORD IT, BUT TO EXPLORE TAKING ON THAT ROLE OF -- AND HAVING IGR WORK ON THIS ISSUE. AND I WOULD SAY, JUST REGARDING THE SURCHARGE, THAT WAS MY SUGGESTION. I WAS TOLD THAT THE HOST COMMITTEE HAD SIGNED AWAY THE RIGHTS TO DO THAT. SO I BELIEVE THE HOST COMMITTEE IS GOING TO BE AROUND TO CONTINUE TO BE IN CHARGE OF THESE EVENTS. SO THAT WOULD BE MY SUGGESTION IS THAT WE ASK TO MEET WITH THEM AND TO PRESENT OUR CASE.

GLAD TO SECOND THAT.

THANK YOU.

I WOULD LIKE TO ALSO ADD TO THAT MOTION THAT TO THE MAKER AND SECONDER THAT WE DO ASSIGN THIS AS A PRIORITY TO IGR FOR THEIR LEGISLATIVE ADVOCACY. AND WHENEVER APPROPRIATE FOR THEM TO COME BACK WITH A REPORT BACK AND FOR THIS REPORT TO COME BACK TO THE FULL BOARD WHEN WE HAVE EITHER AS AN OFF-AGENDA OR ITEM WHEN WE HAVE THE FULL SCOPE OF COSTS INCURRED BECAUSE OF THE SUPER BOWL. WE ARE ABOUT TO EXPERIENCE SIX MORE SUPER BOWLS. JAMES, YOU SAID THAT WE ARE NOT A PARTY, RIGHT? BUT WE HAVE TO BE. WE INHERENTLY ARE TO YOUR WORDS, THESE TYPE OF BIDS DON'T GET AWARDED TO TOWNS IN THE MIDDLE OF NOWHERE. THEY GET AWARDED TO SITES THAT HAVE ROBUST INFRASTRUCTURE, EMERGENCY RESPONSE AND OPERATIONS. CONGRATULATIONS TO THE HOST COMMITTEE. CONGRATULATIONS TO ALL OF OUR CITIES, CONGRATULATIONS TO OUR COMMUNITIES THAT DERIVED GREAT JOY FROM THIS SPORTING EVENT. CONGRATULATIONS TO BAD BUNNY AND TO ALL OF US. BUT THE THING IS THAT WHAT I WORRY ABOUT IS AT SOME POINT WHEN OUR BUDGET SITUATION BECOMES SO DIRE, DO WE THEN SIGNAL TO THE WORLD THAT WE DON'T HAVE THE BEDS FOR WORLD CUP, WE DON'T HAVE THE BEDS FOR THE SUPER BOWL OR WE DON'T HAVE THE BEDS FOR THE NEXT TAYLOR SWIFT TOUR, I DON'T KNOW. JUST THE NEXT MAJOR SPORTING EVENT THAT WILL BRING HUNDREDS OF THOUSANDS OF MILLIONS OF PEOPLE FROM ALL PARTS OF THE WORLD HERE. AT WHAT POINT DO WE SAY -- I'M LOOKING AT YOU, PAUL. AT WHAT POINT DO WE SAY OUR BUDGETARY CUTS, OUR COMPROMISED SERVICE LINES, RIGHT, IS NOT CAPABLE OF RESPONDING TO A CRISIS IN THIS MOMENT. I WOULD SAY THAT WE ARE NOT TECHNICALLY A PARTY TO THE PARTY PLANNING, BUT WE ARE CRITICAL FOR THE PARTY TO BE HAD. WE ARE THE RESPONSIBLE PARENTS. WE ARE THE RESPONSIBLE PARENTS. THE COUNTY HAS BEEN THE RESPONSIBLE BIG BROTHER, BIG SISTER, MOM, DAD, IN SO MANY WAYS. SO, YEAH, LET'S LEAN INTO ANY AND MAKE IT CLEAR, WE MAY HAVE TO RAISE -- SOUND THE ALARM WE DON'T HAVE THESE RESOURCES.

SUPERVISOR, YOU MAKE AN IMPORTANT POINT. WE HAVE TRIED TO MAKE IN A FEW OTHER CONTEXT, TOO. WE ARE SAN JOSE'S ONLY TRAUMA CENTERS. ONE OF THE LARGEST CITIES IN THE UNITED STATES. AND A HUNDRED PERCENT OF ITS TRAUMA SERVICES ARE DELIVERED BY THE COUNTY GOVERNMENT. AND IN ORDER TO HOST ANY OF THESE KINDS OF EVENTS IN ADDITION TO, OF COURSE, OUR EMERGENCY MANAGEMENT FUNCTIONS AND SHERIFF'S OFFICE, YOU HAVE TO HAVE ACCESS TO THESE SERVICES. THEY ARE ABSOLUTELY ESSENTIAL. NO ONE WILL HOST THESE EVENTS IN A COMMUNITY THAT DOESN'T HAVE ACCESS TO THOSE SERVICES. AND SO IT IS ONE OF THE REASONS THESE ARE ESSENTIAL SERVICES. IT IS A POINT THAT WE HAVE TO CONTINUE TO EMPHASIZE AND I DO THINK IT IS A GOOD INVESTMENT, CANDIDLY, ON THE PART OF THE HOST COMMITTEE AND ON THE PART OF OTHERS INVOLVED IN ORGANIZING AND BRINGING ANYTHING WONDERFUL EVENTS TO OUR COMMUNITY, TO BE ATTENTIVE TO THE COST RECOVERY NEEDS OF THE INFRASTRUCTURE THAT HELPS FACILITATE AND MAKE THEM POSSIBLE. I DON'T THINK DOING SO WOULD NEGATIVELY IMPACT THE ABILITY OF THOSE EVENTS TO BE REALISTIC AND SUCCESSFUL. BUT I DO THINK IT WOULD, IN FACT, HELP ENHANCE OUR REGION'S ABILITY TO CONTINUE TO HOST THESE KINDS OF EVENTS OF ALL SORTS OF TYPES MANY YEARS INTO THE FUTURE.

YEAH, SPORTS. BUT YEAH, SAFETY. JAMES, I'M SORRY, NOT JAMES, BUT TO THE STAFF AT LARGE. WAIT, WHEN THESE REPORTS COME BACK IN THE FUTURE, CAN WE MAKE SURE TO LINK IT TO PREVIOUS ITERATIONS OF THE BOARD OR INCLUDE AS AN ATTACHMENT TO THE REPORT THAT THIS INITIAL REPORT WHICH PROMPTED BEING FORWARDED TO THE FULL BOARD HAD A LOT OF BACKGROUND CONTEXT AND DETAIL RANGING FROM THE TYPE OF SERVICES OFFERED.

WE'LL MAKE SURE TO LINK TO THAT.

THANK YOU.

YES, SUPERVISOR ARENAS.

WONDERFUL. I AGREE WITH MY COLLEAGUES. ONE OF THE THINGS THAT WE COULD TAKE STOCK IN IS FIGURING OUT -- AND THANK YOU, SHARON, FOR ALL THE WORK YOU ARE DOING BEHIND THE SCENES TO MAKE SURE THAT WE PROTECT OUR COMMUNITY FROM HUMAN TRAFFICKING AND FROM JUST ALL THE OTHER THINGS THAT HAPPENED ALONG WITH THE SPORTS EVENTS. I WOULD LIKE TO SEE WHAT THE IMPACT IS IN TERMS OF INTERRUPTION OF HUMAN TRAFFICKING EITHER -- WHAT ARE THE TACTICS THEY USED IF WE WERE ABLE TO PUT AWAY SOME BAD GUYS AND BE ABLE TO SUPPORT SOME OF THE FOLKS WHO GET DRAWN INTO THESE WEBS. I WOULD ALSO LIKE TO FIGURE THAT PIECE OUT BECAUSE I THINK IT'S PART OF THE COST OF DOING BUSINESS IN TERMS OF THESE SPORT EVENTS THAT WE CAN USE AS LEVERAGE. BECAUSE THIS IS HOW THEY DAMAGE OUR COMMUNITY AND IT IS SOMETHING THAT NEEDS TO CREATE BALANCE, WE NEED REPARATION FOR SOME OF THE DAMAGE THAT THE SPORTING EVENTS, JUST LIKE YOU SAID EARLIER, IT'S A PARTY WITHOUT THE PARENTS THERE. SOMEBODY HAS GOT TO PAY FOR THE BROKEN LAMPS. BUT UNFORTUNATELY, THIS IS NOT -- I WISH IT WAS JUST BROKEN LAMPS. IT'S MUCH MORE THAN THAT. RIGHT? AND AS EXCITING -- I'M NOT INTO SPORTS, AS EXCITING AS I THOUGHT IT WAS, I THOUGHT IT WAS EXCITING TO HAVE IT COME TO THE BAY AREA, STILL DON'T THINK IT'S WORTH THE COST OF HUMAN LIFE IN THE WAY THAT WE ARE SEEING. I WOULD LOVE TO SEE A REPORT BACK ON THAT PIECE.

MY UNDERSTANDING IS I BELIEVE THE SHERIFF'S OFFICE AND DISTRICT ATTORNEY'S OFFICE IS GOING TO REPORT ON SOME OF THAT INFORMATION TO THE HUMAN TRAFFICKING COMMISSION. WE CAN MAKE SURE THAT REPORT IS SHARED WITH THE FULL BOARD.

THANK YOU. APPRECIATE THAT.

YES. ON THAT NOTE REGARDING THE ISSUE OF HUMAN TRAFFICKING, I WANT TO MENTION THAT BOTH MYSELF AND SUPERVISOR DUONG HAD A CHANCE TO VISIT OUR COUNTY'S TASK FORCE TO HUMAN TRAFFICKING AND THE GREAT WORK THEY ARE DOING. THEY ARE SHOWING THE NUMBERS, AS OF THAT DATE IT WAS A FEW DAYS BEFORE SUPER BOWL, THERE WAS NINE MINORS RESCUED. I'M SURE THERE WERE MORE THERE AFTER. ALSO, THE TRAFFICKERS BEING MONITORED AND BEING ARRESTED AND WHAT NOT. THE WORK IS EXTREMELY IMPORTANT THAT'S BEING DONE. I WANT TO THANK THE FOLKS THAT WORK ON THIS PROJECT ON BEHALF OF THE COUNTY AND WORKING WITH ALL THE FEDERAL, IN THIS CASE, WE COOPERATE WITH THE STATE AND FEDERAL AUTHORITIES. BUT THERE ARE OTHER GROUPS WE WORK WITH CERTAINLY TO HELP CATCH THESE BAD GUYS. THANK YOU FOR THE FOLKS WHO DID THAT, AMAZINGLY IMPORTANT WORK. THERE ARE MANY VOLUNTEERS AND THOSE WHO USED TO BE VICTIMS OF TRAFFICKING THAT WAS IN THAT ROOM THAT HELPED PROVIDE COUNSELING, PEER SERVICES AND WHATNOT. JAMES, THANK YOU FOR THE INFORMATION.

I WOULD BE REMISS IF I DID NOT ACKNOWLEDGE JUST THANK YOU TO YOUR ADMINISTRATION, JAMES, I ONLY SAW YOUR PHOTO IN THE YELLOW VEST OR COLORED VEST. IT BROUGHT ME BACK PTSD. JUST NOT EVERY COUNTY HAS THEIR COUNTY EXECUTIVE IN THE EMERGENCY OPERATION CENTER. I WANT TO ACKNOWLEDGE YOU FOR THAT. AND THANK YOU FOR GIVING UP YOUR SUNDAY TO SERVE ALONG SIDE OUR STAFF.

ACTUALLY, IT WAS 12 HOURS ON SATURDAY AND 12 HOURS ON SUNDAY. SOMETHING LIKE THAT.

DOUBLING THE THANKS.

JUST SAYING. I KNOW THAT YOU DO GET OVERTIME. YOU JUST DON'T GET PAID FOR IT, RIGHT, JAMES?

CLARIFY FOR THE RECORD THAT SUPERVISOR'S ADDITION REGARDING THE ADDITION TO THE PRIORITIES IS ACCEPTABLE, THE MOTION MAKER AND SECOND.

YES.

WE HAVE A MOTION, SECOND. NO MORE LIGHTS. SUPERVISOR ABE-KOGA, READY TO VOTE?

THAT WAS A MOTION BY SUPERVISOR ABE-KOGA, SECONDED BY ELLENBERG. (ROLL CALL).

MOSTLY SUNNY PASSES.

MOTION PASSES.

MOVING TO --

ITEM 17, THE LAST ITEM. LET'S DO A QUICK TIME CHECK. I HEARD THERE IS RUMOR DINNER IS HERE. ONE ITEM LEFT. SHOULD WE PUNCH IT THROUGH? YES? LET'S GO. I DON'T WANT HANGRY PEOPLE HERE. ITEM 17, RECOMMENDATION LINKED TO FISCAL YEAR BUDGET PROCESS. GO AHEAD.

THANK YOU. THIS IS THE ANNUAL BUDGET PROCESS MEMO. WE HAVE MADE A RECOMMENDATION REGARDING THE INVENTORY PROGRAM IN LIGHT OF ALL THE CONTEXT OF EVERYTHING WE HAVE BEEN TALKING ABOUT. I WON'T REPEAT ALL OF THAT. IT'S A DECISION FULLY WITHIN THE DISCRETION OF THE BOARD TO MAKE. I'M HAPPY TO ANSWER ANY QUESTIONS.

THANK YOU. BEFORE I OPEN UP THE PUBLIC SPEAKING, I WOULD LIKE TO SAY THAT THANK YOU FOR PREPARING ALL THIS. THE PROPOSAL, MY UNDERSTANDING, IS TO ZERO OUT THE ENTIRE INVENTORY GRANT PROGRAM FOR '26-'27 WOULD AFFECT FAR TOO MANY NONPROFIT GROUPS WE WORKED WITH THAT ARE DOING IMPORTANT WORK. I WOULD PLAN TO, I'M NOT GOING TO MENTION IT, I PLAN TO MAKE A MOTION TO MAKE AN ADJUSTMENT TO THAT AFTER THE PUBLIC SPEAKER IS DONE. OKAY? GO AHEAD. ANY PUBLIC SPEAKERS.

WE DO HAVE SEVERAL CARDS. I'M NOT SURE IF THEY ARE STILL HERE. I WILL START CALLING NAMES. WE HAVE --

HOW MANY PEOPLE DO WE HAVE TOTAL?

14 CARDS. AND SEVEN HANDS RAISED.

ONE MINUTE EACH.

WE'LL SEE WHO IS HERE. SANDRA ASHER IS FIRST. PLEASE, IN ANY ORDER, YOU CAN APPROACH THE PODIUM. JOSE LIMONUS. JULIE ANDERSON. REMUNDO. MIKALAH CHARACTER. ADRIAN CORTEZ. JULIANA SAINTS AND YENETH. IF YOU ARE HERE, PLEASE COME FORWARD.

GOOD EVENING. I'M SANDRA ASHER. I'M HERE TO ADDRESS STRONG SUPPORT FOR FUNDING FOR NONPROFITS. THIS SPENDING IS VITAL TO ORGANIZATIONS LIKE OURS ENABLING US TO SUPPORT FAMILIES RAISING CHILDREN WITH DISABILITIES. THESE FAMILIES FACE COMPLEX HEALTHCARE AND PUBLIC BENEFIT SYSTEMS. THANKS TO THIS FUNDING, WE HAVE BEEN ABLE TO OPEN OUR OFFICE AND EXPAND SERVICES TO SOUTH COUNTY FAMILIES, INCREASE OUTREACH, PROVIDE DIRECT CAREGIVER SUPPORT INCLUDING FREE WEEKLY MENTAL HEALTH WORKSHOPS OFFERED IN ENGLISH AND SPANISH. IT'S HELPED US BUILD CAPACITY FOR OUR STAFF AND ASSIST IMMIGRANT FAMILIES IN NAVIGATING SERVICES. THE SPENDING ALLOWS THE COUNTY TO PARTNER WITH TRUSTED PEOPLE AND IMPROVES ACCESS TO SERVICES AND STRENGTHENS CAREGIVER ABILITIES.

THANK YOU.

THANK YOU. I WILL CONTINUE WITH THE CARDS IN CHAMBERS. MARTY ESTRADA. CARMEN, SAMANTHA, KEY ANNA WARD AND KIERA. IN ANY ORDER. PLEASE.

FIGURE GET A LITTLE MORE TIME THAN ONE MINUTE. I HAVE BEEN HERE SINCE 10:00 A.M. TEN OF THOSE CARDS CAME FROM FOLKS IN SOUTH CONCERN. THEY ARE NOT HERE, THEY HAD TO GO BACK TO WORK. THEY HAD TO GO BACK TO SCHOOL.

LET ME PAUSE THE TIME. LET ME EXPLAIN THE SITUATION. I WILL GIVE YOU THE TIME BACK. WE GIVE EVERYBODY THE SAME AMOUNT OF TIME. BUT TO GIVE A STATEMENT LONGER THAN ONE MINUTE. GIVE IT TO OUR CLERK. WE'LL ADD IT TO THE RECORD.

WE STRONGLY SUPPORT THE CONTINUANCE OF THE INVENTORY BUDGET TO SUPPORT NONPROFITS. THIS IS A CRUCIAL SUPPORT. WE HELP THE COUNTY SAVE MILLIONS OF DOLLARS, HUNDREDS OF THOUSANDS OF DOLLARS WITH THAT FUNDING SOURCE TO OUR AGENCIES. COMMUNITY AGENCY FOR RESOURCES IN SOUTH CONCERN, WE PROVIDE SERVICES TO YOUTH, MARGINALIZED YOUTH, THIS MONEY GOES TOWARDS THAT ENDEAVOR. WE HAVE YOUTH HUB OF CLIMATE CHANGE HUB AND THAT MONEY GOES TO SUPPORT THOSE YOUTH THAT ARE NOT OUT IN THE COMMUNITY OR GETTING IN TROUBLE. WE ENCOURAGE THIS BODY TO SUPPORT THE INVENTORY BUDGET GOING FORWARD. I KNOW THERE IS A LOT OF COSTS. IF WE COULD HAVE DONE BACK WHEN WE PASSED PROP 8, IF WE WOULD HAVE PUT LESS THAN 2 CENTS INTO THAT, IT WOULD HAVE BROUGHT BACK $1 BILLION. I ENCOURAGE YOU, WE ARE HERE, WE ARE YOUR PEOPLE FROM GILROY. PLEASE ASK --

THANK YOU.

YOUR NAME FOR THE RECORD?

MARTY ESTRADA.

THANK YOU.

GOOD MORNING. I MEAN GOOD AFTERNOON.

ALMOST GOOD EVENING.

I HAVE BEEN HERE FOR AWHILE. PRESIDENT LEE AND TO THE BOARD MEMBERS, I'M KEY ANNA WARD. I RESIDE IN DISTRICT 2. AND I AM HERE JUST AS A CITIZEN, BUT ALSO AS A COCHAIR OF THE ADVOCACY COMMITTEE THAT IS WITHIN THE BLACK LEADERSHIP KITCHEN CABINET. ONE OF THE INDIVIDUALS WHO DO RECEIVE FUNDING FROM THE BOARD'S INVENTORY GRANT. I'M HERE ASKING YOU TO NOT ELIMINATE THE BOARD INVENTORY GRANT PROCESS FOR THE UPCOMING FISCAL YEAR. THIS GRANT HAS SUPPORTED A CENTRAL PROGRAM. WHAT I MEAN BY THAT, IS THAT WE ARE ABLE TO HELP FUND OTHER SMALL ORGANIZATIONS, NONPROFITS AND ORGANIZATIONS THAT ARE WORKING IN THE COMMUNITY TO BRING EDUCATION -- THAT WAS FAST. BUT, YES, I HOPE THAT YOU GUYS --

THANK YOU.

GOOD AFTERNOON. MY NAME IS CARMEN. THE ORGANIZER DIRECTOR. I WANT TO BEGIN BY ACKNOWLEDGING THE DIFFICULT MOMENT THE COUNTY IS. THE UNCERTAINTY AHEAD AND DECISIONS THAT YOU MAKE. WE ARE GRATEFUL FOR THE CARE AND SERIOUSNESS WITH WHICH YOU APPROACH THIS WORK. I WANT TO EXPRESS APPRECIATION FOR THE BUDGET INVENTORY IT HAS MADE. THESE MATTERED. STRENGTHEN OUR ABILITY TO CARE FOR VULNERABLE PATIENTS. TO THE COUNTY DURING THIS TIME OF GROWING HARDSHIP. I WANT TO HIGHLIGHT THAT THE INVENTORY ITEMS HAVE BEEN THE WAY THIS BOARD HAS ENSURED EQUITY. THESE INVESTMENTS HAVE HELPED SUSTAINED ORGANIZATIONS THAT ARE DEEPLY ROOTED IN AND ACCOUNTABLE TO THE COMMUNITIES BACKED UP BY THE HEALTH INEQUITIES. THANK YOU.

GOOD AFTERNOON. I'M SAMANTHA. I'M HERE REPRESENTING A PATIENT ORGANIZING COMMITTEE. I WANT TO ACKNOWLEDGE THE DIFFICULT FINANCIAL MOMENT THE COUNTY IS FACING AND HARD DECISIONS AHEAD. I SUPPORT THE CONTINUATION OF INVENTORY BUDGET. I WANT TO HIGHLIGHT OUR PATIENTS DEPEND ON US TO NAVIGATE THEIR INSURANCE. THIS IS SYSTEM IS EXTREMELY COMPLEX ESPECIALLY THOSE FACING LANGUAGE BARRIERS. YES, SIR. WITHOUT OUR NAVIGATION TEAM, PATIENTS WILL FALL INTO CONCERNING HEALTHCARE STATISTICS. LISTENING TO PATIENTS AND EXPERIENCES IS KEY. THEY HELP US IDENTIFY WHERE THE HEALTHCARE SYSTEM IS FAILING AND ALLOW US TO WORK WITH THE COUNTY TO PREVENT THE SAME HARM FROM HAPPENING AGAIN. THIS IS HOW WE CLOSE GAPS AND CREATE A RESPONSIVE SYSTEM. FOR THIS FUNDING IS PART OF A SHARED RESPONSIBILITY TO KEEP PEOPLE HEALTHY, STABLE AND CONNECTED TO CARE. THANK YOU.

GOOD EVENING. I'M THE CEO OF THE SILICON VALLEY NONPROFITS AND ALLIANCE. WE DO ALSO UNDERSTAND THAT THE COUNTY IS FACING AN EXTREMELY CONSTRAINED ENVIRONMENT. THERE IS DIFFICULT DECISIONS TO BE MADE AHEAD. HOWEVER, WE STRONGLY FEEL THAT ELIMINATING THE INVENTORY PROCESS ENTIRELY WOULD HAVE HARMFUL CONSEQUENCES. THE INVENTORY PROCESS IS ONE OF THE FEW FLEXIBLE TOOLS TO SUPPORT INNOVATION, RAPID RESPONSE TO EMERGING NEEDS AND ACCESS FOR SMALLER NONPROFITS THAT CANNOT COMPETE IN TRADITIONAL RFPS. WE RECEIVED A GRANT THIS FISCAL YEAR. THAT GRANT SUPPORTING TOWN HALLS IN PARTNERSHIP WITH THE COUNTY. WE RESPECTFULLY URGE THE BOARD TO APPLY A PROPER MORE INFORMATIONAL AND MEASURED APPROACH.

THANK YOU.

SPEAKER CARDS IN CHAMBERS. WE'LL MOVE TO ZOOM. OUR FIRST SPEAKER IS PARENT. PLEASE ACCEPT THE UNMUTE.

YES, I WOULD LIKE TO SUPPORT THE BUDGET PROCESS RECOMMENDATIONS. AND I WOULD LIKE TO ASK THE BOARD IF YOU COULD ASK -- DIRECT LARRY ROSE TO LOOK CLOSELY AT THE DISTRICT ATTORNEY'S OFFICE, THERE IS A LOT OF MISUSE OF FUNDS THERE. FOR INSTANCE, THERE WAS ALTERING OF TIME SHEETS. GIVEN FREE VACATION TIME TO PAPERED ATTORNEYS. AND WHEN JAMES LEE REFUSED TO TAKE THE MONEY AND BLEW THE WHISTLE, HE GOT RETALIATED AGAINST AND INVESTIGATED. SO WE DON'T KNOW IF THERE IS ANY OTHER WHISTLE BLOWERS, IT'S CRITICAL TO LOOK CLOSELY AT THIS BUDGET. PARTICULARLY BECAUSE HE'S SEX TRAFFICKING CHILDREN, USING CRIMINAL PROCEEDINGS COULD SEAL CHILD ABUSE. PLEASE LOOK AT JEFF ROSEN VERY CLOSELY BECAUSE HE'S NOT A VERY GOOD PERSON. THANK YOU FOR YOUR TIME.

THE NEXT SPEAKER IS MARYANNE ARIF.

I'M THE DIRECTOR OF COMMUNICATIONS AND DEVELOPMENT AND SERVICES IMMIGRANT RIGHTS AND EDUCATION. THE SUSPENSION OF THE COUNTY'S BUDGET INVENTORY PROGRAM FOR THIS FISCAL YEAR LIMITS OUR ACCESS TO FLEXIBLE ONE-TIME FUNDING THAT SUPPORTS RAPID RESPONSE AND TIME SENSITIVE COMMUNITY EDUCATION. WITHOUT IT OUR ABILITY TO MEET URGENT COMMUNITY NEEDS WILL BE CONSTRAINED. WEAKENING THE COUNTY'S CAPACITY TO PARTNER WITH TRUSTED ORGANIZATIONS THAT PROTECT FAMILIES. IN 2025, WE RESPONDED TO OVER 1620 REQUESTS FOR IMMIGRATION EDUCATION. THIS INCLUDED KNOW YOUR RIGHTS PRESENTATIONS AND OTHER EVENTS MANY OF WHICH WERE OFFERED BILINGUALLY. WE HAVE FAMILY PREPAREDNESS.

THANK YOU. NEXT SPEAKER IS IPHONE OR CAROL LILLIG. PLEASE ACCEPT THE UNMUTE.

GOOD EVENING. I'M FROM ST. VINCENT. THE GRANT FUND THAT WE RECEIVE FROM SUPERVISOR ARENAS ALLOWED US LAST YEAR TO MOVE INTO HOUSING 35 WORKING FAMILIES, SENIORS, THESE GRANT FUNDS AND OUR VOLUNTEER TIME PAID THE DEPOSIT AND FIRST MONTH'S RENT. THERE IS NO OTHER FUNDING TO HELP THESE PEOPLE TO OVERCOME THESE BARRIERS. THEY QUALIFY FOR VERY REASONABLE RENTS, SEVERAL HUNDRED DOLLARS A MONTH. BUT THE DEPOSIT AND FIRST MONTH'S RENT IS 2 TO 4,000 PER FAMILY. SO THESE FARM WORKER FAMILIES NEED OUR HELP TO OVERCOME THAT BARRIER. WE LOVE WHAT WE DO. WE JUST NEED THE FUNDING TO MAKE THESE MIRACLES HAPPEN. THANK YOU SO MUCH.

THANK YOU. NEXT SPEAKER IS ELADIO. PLEASE ACCEPT THE UNMUTE.

HELLO?

YOU MAY BEGIN.

I'M COORDINATOR FOR AN ADVOCACY PROGRAM. FEAR HAS BECOME A DAILY REALITY FOR FAMILIES. I WAS SHOCKED BY HOW MANY PEOPLE DID NOT KNOW ABOUT THE RAPID RESPONSE. THE LACK OF INFORMATION IS DANGEROUS. FAMILIES ARE LEFT ISOLATED, AFRAID. OUR COMMUNITY IS SCARED. MANY WOULD RATHER HIDE THAN SEEK HELP. WE PROVIDE FREE COUNSELING -- CONSULTATIONS. OVER 200 PEOPLE HAVE BEEN SERVED. THIS IS NOT THE TIME TO TURN YOUR BACK ON US. I SAY US, I'M PART OF THE COMMUNITY BEING TARGETED. CLAIRE MADE A PROMISE TO PROTECT IMMIGRANTS. SOUTH COUNTY STILL NEEDS RESOURCES. WE CANNOT DO THIS WORK ALONE. WE ARE ASKING TO STAND WITH US TO CONTINUE PROTECTING OUR NEIGHBORS, OUR COMMUNITY.

THANK YOU. THE NEXT SPEAKER IN THE CUE IS LIBIER.

GOOD EVENING. I'M AN ADVOCACY DIRECTOR. SERVING FIRST GENERATION COLLEGE STUDENTS AND FAMILIES IN EAST SAN JOSE. LAST YEAR WE RECEIVED FUNDING FOR EDUCATION ADVOCACY AND COMMUNITY COLLEGE STUDENT AND FAMILY SUPPORT. THIS FUNDING EXTENDED HELP FAMILIES UNDERSTAND FINANCIAL AID AND DIRECT SUPPORT FOR SCHOOL, WORK AND FAMILY. THE COUNTY'S MOST UNDER-RESOURCED COMMUNITIES WITH UNCERTAINTY AND LIMITED FUNDING, THIS GRANTS IS MORE IMPORTANT THAN EVER. WE UNDERSTAND THE COUNTY FACES DIFFICULT DECISIONS. WE URGE YOU NOT TO ELIMINATE THE PROCESS, TO NOT IMPACT GRASS ROOT ORGANIZATIONS LIKE WE HAVE.

THE NEXT SPEAKER IS CHRIS SCOTT. PLEASE ACCEPT THE UNMUTE.

GOOD EVENING. MY NAME IS KRIS SCOTT. I SERVE AS THE MANAGING DIRECTOR. I STRONGLY ENCOURAGE THE BOARD OF SUPERVISORS TO KEEP THE BUDGET INVENTORY FUND. THIS HAS BEEN INSTRUMENTAL IN ADVANCING THE WORK AND SUPPORTING OUR PARTNER COMMUNITY BASED ORGANIZATIONS. THIS HAS BEEN ABLE TO PROVIDE LEGAL EDUCATION WORKSHOPS, WORKSHOPS FOR YOUTH AND HOSTING COMMUNITY EVENTS AND STRENGTHENING CONNECTIONS. WE BELIEVE THAT THE BOARD HAS THE TRUST AND BACKING OF BOTH STAFF, COMMUNITY MEMBERS TO MAKE TIMELY RESPONSIVE DECISIONS THAT ENSURE FUNDS ARE USED WHEN THEY ARE MOST NEEDED. THE FLEXIBILITY OF THIS BUDGET IS ESSENTIAL TO ADDRESSING URGENT COMMUNITY NEEDS AND RESPONDING EFFECTIVELY. THANK YOU.

NEXT SPEAKER IS OFISA.

GOOD EVENING. I SERVE AS THE ADVOCACY HEAD FOR ASIAN AMERICANS. I'M URGING YOU TO CONTINUE THE INVENTORY GRANT PROCESS. WE HAVE RECEIVED FUNDING, WE HAVE SEEN FIRSTHAND HOW THIS PROCESS STRENGTHENS THE PARTNERSHIP BETWEEN THE COUNTY AND THE NONPROFIT ORGANIZATIONS WORKING TO SERVE COMMUNITIES MOST VULNERABLE RESIDENTS. THESE FUNDS HAVE BEEN INSTRUMENTAL IN EXPANDING OUR REACH INTO UNDERSERVED COMMUNITY. WE HAVE BEEN ABLE TO INCREASE OUR SERVICES IN THE COMMUNITY. PROGRAMS THAT BRING HEALTHCARE PROVIDERS DIRECTLY TO NEIGHBORHOODS OR ACCESS TO CARE IS LIMITED. BY MEETING PEOPLE WHERE THEY ARE, WE REMOVE BARRIERS AND MAKE IT EASIER TO RECEIVE CARE AND RESOURCES THEY NEED. WE RECOGNIZE THE BUDGET IS CONSTRAINED AND APPRECIATE THE DIFFICULT DECISIONS YOU FACE. HOWEVER, MANY COMMUNITY MEMBERS, ESPECIALLY THOSE WHO FALL THROUGH THE CRACKS OF TRADITIONAL SERVICES DEPEND ON THE SAFETINESS RESOURCES.

THANK YOU. AND THERE IS ONE MORE SPEAKER WHO TURNED IN A SPEAKER CARD IN CHAMBERS. PLEASE ACCEPT THE UNMUTE.

GOOD AFTERNOON. I'M AN IMMIGRATION ADVOCATE WITH SOUTH COUNTY. THIS WAS A PLACE WHERE MY VOICE WAS HEARD. THIS WAS ONLY ONE OF THE ORGANIZATIONS TO GIVE A VOICE ESPECIALLY TO YOUTH UNDOCUMENTED FAMILIES. MY TEAM CANVASSED 650 HOMES IN GILROY. WE OFFER FREE LOCAL SERVICES. WE GIVE YOUTH A PLACE TO FEEL HEARD, GUIDANCE AND THEY OFTEN COME TO US. WE HOST BI-WEEKLY MEETINGS. I'M PROUD OF MY TEAM'S IMPACT. I URGE THE BOARD OF SUPERVISORS TO CONTINUE HELPING US MAKE AN IMPACT. THANK YOU.

THANK YOU. AND A HALF THE LAST SPEAKER WHO HAD THEIR HAND RAISED AT THE TIME OF THE CALL OF THE CUE.

WE ARE GETTING CLOSE TO PUBLIC SPEAKING PORTION OF THIS DISCUSSION. AS I SAID EARLIER, I'M TRYING TO FIND A WAY TO BALANCE THE INTEREST OF OUR NEED TO CUT OUR BUDGET AND CERTAINLY CUTTING THE ENTIRE INVENTORY PROCESS IS FAR TOO DRASTIC. I'M GOING TO PROPOSE SOMETHING MAYBE LESS DRASTIC. LAST YEAR WE SPENT A LOT OF TIME DEBATING BASEMENT, SUPPLEMENTAL AMOUNT. WE HAVE AN ALLOCATED AMOUNT FROM LAST YEAR. TO MAKE THINGS SIMPLE, JUST MAKING THIS PROPOSAL. IS TO HAVE THAT SAME AMOUNT ALLOCATED EACH YEAR, TO HAVE THAT REDUCED BY HALF MILLION DOLLARS EACH DISTRICT. WHATEVER AMOUNT YOU HAD FROM LAST YEAR, REDUCE THAT BY HALF A MILLION. THAT WOULD SAVE THE COUNTY THROUGH THIS PROCESS COMPARED TO LAST YEAR BY $2.5 MILLION. LAST YEAR THE TOTAL ALLOCATION WAS CLOSE TO $7 MILLION. SO WHAT I'M PROPOSING IS TO REDUCE THAT BY $2.5 MILLION. THE IMPACT WOULD BE EXACTLY THE SAME WITH EACH DISTRICT, A HALF MILLION DOLLARS FROM WHAT YOU GOT LAST YEAR. I OPEN THAT FOR DISCUSSION AND A POTENTIAL MOTION. I SEE SUPERVISOR ABE-KOGA IS FIRST. GO AHEAD.

THANK YOU. FIRST, I JUST WANT TO THANK YOU FOR THE TIMELINE ON THE BUDGET PROCESS. I APPRECIATE THAT THE RESPONSE TO OUR REQUEST TO GET THE INFORMATION EARLIER AND TO HAVE OPPORTUNITY AT OUR COMMITTEE MEETINGS AND THE WORKSHOPS TO ASK QUESTIONS AND MAKE RECOMMENDATIONS. I APPRECIATE, PRESIDENT LEE, YOUR SUGGESTION. I WAS GOING TO SAY THE SAME, I THINK THAT THE INVENTORY PROGRAM IS BENEFICIAL. WE HAVE HEARD ALL OF THE REASONS AND ALL THE GREAT PROGRAMS THAT HAVE BEEN SUPPORTED BY IT. I THINK IN LIGHT OF WHAT WE TALKED ABOUT EARLIER TODAY, THINGS LIKE REGULATIONS AND RIMS AND THE CHALLENGES THAT FRANKLY NONPROFITS HAVE TO DEAL WITH TO GET FUNDED, THIS IS THE ONE AREA WHERE WE HAVE FLEXIBILITY. AND WE CAN SUPPORT THE SMALLER CBOs THAT MAY NOT HAVE THE RESOURCES TO GO THROUGH THE HOOPS. MY FIRST YEAR, OUR OFFICE'S FIRST YEAR, PLEASED AT THE INNOVATION THAT'S COME OUT OF THIS PROGRAM. I DO THINK WE SHOULD CONTINUE TO PRESERVE IT IN SOME FORM. I KNOW THAT WE HAD SOME TARGET REDUCTIONS FOR OUR OFFICES THAT HAVE BEEN REMOVED. BUT I HAVE BEEN WORKING WITH MY STAFF TO LOOK AT REDUCTIONS IN OUR OFFICE SO THAT WE CAN RETURN SOME FUNDING FROM OUR OFFICE BUDGET AND WE'LL BE OFFERING THAT LATER AS WELL. BUT MY SUGGESTION WAS THAT WE JUST MAKE IT SIMPLE AND JUST -- I WASN'T HERE BEFORE LAST YEAR, BUT JUST FOR EQUITY SAKE, TO DO $1 MILLION FOR EACH OF THE OFFICES. THAT WOULD BE MY MOTION.

1 MILLION FOR EVERYBODY.

THAT WOULD SAVE 2 MILLION.

YOUR PROPOSAL WOULD SAVE 2 MILLION.

SORRY. AS A POINT OF PROCEDURE, IF I UNDERSTAND CORRECTLY, YOU PUT A RECOMMENDATION TO THE TABLE. I BELIEVE SUPERVISOR BE-KOGA MADE A MOTION. SO TO PROCEED WITH DISCUSSION, WE NEED A SECOND.

I WILL SECOND IT IF I UNDERSTAND IT. TELL ME AGAIN WHAT IT IS?

SO JUST BE THE $1 MILLION PER OFFICE. AND THEN THE SUPPLEMENTAL WE WOULD REDUCE.

I WILL SECOND THAT.

IT'S MY TURN.

YOU PAUSED AND I LEAPED IN.

I WANT TO THANK ALL THE FOLKS WHO CAME IN. ESPECIALLY FROM SOUTH COUNTY. IT'S A TREK TO COME UP HERE. AND THAT'S PART OF THE ISSUE, PERPETUAL ISSUE FOR THE FOLKS IN SOUTH COUNTY, IS THAT WE MAY ONLY BE ABOUT A HALF HOUR, 40 MINUTES AWAY. BUT WHEN YOU ARE CONSTRAINED BY TWO JOBS, RAISING KIDS ON YOUR OWN, IT IS A HUGE THING TO COME TO SAN JOSE TO SPEAK OR TO ADVOCATE FOR SERVICES. AND SO YOU HAVE ALL HEARD ME TALK ABOUT SOUTH COUNTY AND MAKING IT RIGHT FOR THEM BECAUSE THEY, THROUGHOUT THE WHOLE -- MY PREDECESSOR, THROUGHOUT HIS WHOLE SERVICE DID NOT PARTICIPATE IN ANY OF THE GRANT PROGRAMS. SO MY SOUTH COUNTY FOLKS NEVER RECEIVED ANYTHING IN ADDITION TO THE FOLKS HAVE HAD GENERATIONAL TRAUMA, POVERTY, VIOLENCE, THEY ARE THE HIGHEST IN TERMS OF REFERRALS INTO YOUR PROBATION DEPARTMENT AND TO THE JUVENILE JUSTICE SYSTEM. IT'S NOT THINGS I'M PROUD OF. JUST IN TERMS OF VIOLENT, GUN VIOLENCE, ONE OF THE TOP ZIP CODES OUTSIDE OF EAST SAN JOSE. AND I LIKEN IT -- I SAID SAN JOSE. NOT EVERYBODY HERE HAS A DISTRICT THAT IS IN NEED OF SO BASIC THINGS. SAN MARTIN DOESN'T HAVE A CITY STRUCTURE. WE ARE THEIR DEFAULT CITY STRUCTURE. SO GILROY DOESN'T HAVE A YOUTH CENTER. THEY DON'T HAVE ANYPLACE FOR OUR YOUTH. AND WHEN THE KIDS HAVE AN OPPORTUNITY TO DO SOMETHING IN THE STREETS LIKE THEY ARE ON THEIR BIKES, ALL OF A SUDDEN PEOPLE HAVE PROBLEMS WITH KIDS BEING ON THEIR BIKES. AND THEN THEY GET CRIMINALIZED FOR THAT. SO ALL OF THIS TO SAY IS THAT MY DISTRICT HAS ALREADY GONE ON WITHOUT VERY MUCH. AND THE LITTLE THAT THEY GET THROUGH SOME OF THIS INVENTORY, I THINK IT'S MINIMAL, WE ARE AN AGENCY THAT HAS $11 BILLION COMING IN TO OUR SYSTEM. AND I KNOW THAT A LOT OF THAT MONEY IS ALREADY EARMARKED THROUGH STATE AND FEDERAL MANDATES THAT WE HAVE TO COMPLY WITH. BUT THE TRUTH IS THAT MY DISTRICT IS IN A LOT OF NEED. WHEN I GIVE THEM SOMETHING THROUGH MY GRANT PROGRAM, IT IS A HUGE, HUGE -- IT MAKES A HUGE DIFFERENCE. THEY ARE USED TO MAKING, YOU KNOW, A LOT WITH VERY LITTLE. AND SO WHEN THEY CONTINUE TO GET SOME OF THIS ADDITIONAL SUPPORT, IT MAKES A HUGE DIFFERENCE. ONE OF THE THINGS, I THINK YOU HEARD ONE OF THE SPEAKERS SAY WE HAVE THIS UNHOUSED FIRST AND LAST RENT DEPOSIT THAT OUR UNHOUSED, SUPPORTIVE HOUSING DEPARTMENT DOESN'T OFFER. AND THAT MAKES A DIFFERENCE. WE ARE HOLDING ON TO

PEOPLE'S HOMES A LITTLE BIT MORE IN SOUTH COUNTY. AS YOU VERY WELL KNOW, WE DON'T HAVE SHELTERS. ANYWAY, I CAN GO ON AND ON. BUT THIS IS THE REASON THAT I'M GOING TO SUPPORT THIS. I APPRECIATE THE MOTION ON THE FLOOR. MAYBE FOR SOME OF YOU THAT THIS MAY NOT MEAN VERY MUCH. BUT FOR SOUTH COUNTY FOR MY FOLKS, THIS IS THE ONLY WAY THEY CAN APPLY TO A GRANT BECAUSE THE BUREAUCRACY OF APPLYING TO OTHER GRANTS IS TOO MUCH FOR THEM. THIS IS THE ONLY WAY THEY CAN MAKE THINGS WORK. SO I APPRECIATE THE MOTION ON THE FLOOR, I WILL SUPPORT IT AND HOPEFULLY WE CAN GET THROUGH THIS. THANK YOU.

>> UPERVISOR ELLENBERG?

>> THANK YOU SO MUCH. I HAVE A FEW THOUGHTS THAT I WANT TO SHARE. FIRST, WE WORKED VERY HARD LAST YEAR TO ADD AN EQUITY MEASURE RECOGNIZING THAT THE NEEDS OF EACH DISTRICT ARE OT THE SAME. AND SUPERVISOR ABE-KOGA, I HEARD YOU SAY FOR EQUITY SAKE, WE SHOULD EACH GET THE SAME THING. THAT'S EQUALITY. BUT TO ME IT TAKES US BACKWARDS FROM WHERE WE MOVED LAST YEAR. RECOGNIZING THAT NEEDS ARE NOT ALL THE SAME. AND I WOULD RATHER WE BE CONSISTENT TO THAT PRINCIPLE BEFORE I HEARD THE CLEAR SUPPORT FOR THE 5 MILLION. I HAD ACTUALLY BEEN INTERESTED IN THE OTHER PIECE TO JUST TAKE THE 2 MILLION ACCORDING TO THE EQUITY FORMULA THAT WE USED LAST YEAR. AND IF I'M IN A MINORITY, CERTAINLY, I WILL USE THAT MONEY IN MY COMMUNITY AS WELL. BUT IN ADDITION TO THE CBO AUDIENCE AND PARTNERS, SOME OF WHOM ABSOLUTELY HAVE NO OTHER OPPORTUNITIES TO RECEIVE COUNTY FUNDINGS, A GOOD NUMBER OF THEM ALSO AVE LARGE COUNTY CONTRACTS. SO JUST RECOGNIZING THAT WE HAVE A VERY WIDE SWATH OF PEOPLE, OF ORGANIZATIONS WE FUND THROUGH INVENTORY. I'M ALSO THINKING ABOUT OUR DEPARTMENT HEADS AND OUR EMPLOYEES WHO HAVE SIGNIFICANT REDUCTION TARGETS WHO ARE FACING THE LOSS OF THEIR POSITIONS EVEN FEELING IMPACTED BY THE CONTRACTION OF UNFILLED POSITIONS. AND THEN HEAR US SAY WE ARE NOT WILLING TO MAKE A EALLY MEANINGFUL EFFORT TOWARD PROTECTING THE COUNTY GENERAL FUND. I DIDN'T MEAN TO PICK ON YOU. I LOVE THAT YOUR OFFICE MAY BE ABLE TO GIVE BACK SOME MONEY. IT'S A GREAT EXAMPLE, WHICH I'M NOT SURE CAN FOLLOW BECAUSE WE DO USE OUR OBJECT ONE AND TWO. BUT TO ME THIS IS AN IMPACTFUL PLACE WHERE WE REALLY COULD MAKE OUR CONTRIBUTION BACK TO THE GENERAL FUND MORE SIGNIFICANT THAN THE $2 MILLION. I WOULD ALSO NOTE THAT WE ALL RECEIVED AN AUDIT REPORT THIS MORNING ON THE INVENTORY PROCESS WHICH CONTINUES TO HAVE A NUMBER OF PROBLEMATIC ASPECTS TO IT. IN PART, THE ACTUAL ADMINISTRATION OF A HUGE, HUGE NUMBER OF GRANTS THAT HAS CAUSED OTHER CHALLENGES. I WANT TO PUT THAT ASIDE AND ASK, IS THE CHAIR OF THE FGOC COMMITTEE, IF YOU WOULD BE WILLING TO HAVE THAT REPORT COME TO -- I'M NOT SURE IF SHOULD BE PART OF THE MOTION, BECAUSE I'M NOT SURE I'M SUPPORTING THE MOTION YET, IF THERE IS SOME OTHER WAY TO FIGURE OUT, WOULD YOU BE ABLE TO DIRECT THAT REPORT COME TO FGOC SO WE CAN LOOK AT IT, AND IF NOT FOR THIS YEAR, BE SERIOUS ABOUT PUTTING FURTHER -- MAKING FURTHER ITERATIONS SO THIS PROCESS REALLY WORKS WELL PARTICULARLY FOR THE ORGANIZATIONS THAT TRULY NEED IT THE MOST AND HAVE FEW OTHER AVENUES FOR PUBLIC FUNDING.

>> ABSOLUTELY. YOU READ MY MIND. SO THE FGOC COMMITTEE REVIEWS MANAGEMENT AUDIT REPORTS. SO IT MAKES PERFECT SENSE FOR IT TO GO. THIS ALSO BRINGS UP ANOTHER POINT. I KNOW FOR YEARS NOW OUR PARTNERS THROUGH SVCM HAVE ADVOCATED FOR A PARTNERSHIP TO BE ABLE TO THINK ABOUT THE INVENTORY PROCESS AND WHAT PART STAYS INVENTORY WITH EMERGENCY RESPONSE AND PIVOTING NEEDS. GRASS ROOT EXPERTS THAT DON'T FALL INTO A TRADITIONAL FUNDING. AND ALSO WHAT LANES OF CAPACITY BUILDING LOOKS LIKE. SO THAT'S, I THINK, REVIEWING THE HARVEY ROSE MANAGEMENT ON THE INVENTORY ROCESS, ALSO ASK TO COORDINATE WITH YOU FOR THAT MEETING, JUST TO HEAR SOME OF THE CONVERSATIONS AND YOUR THOUGHTS BASED ON YOUR MEMBERSHIP OVER THE YEARS. SO YES TO THAT.

>> IS IT HARVEY ROSE WE GOT THIS MORNING?

>> LAST NIGHT. I GOT AN AUDIT REPORT ABOUT THE INVENTORY PROCESS LAST NIGHT FROM HARVEY ROSE.

>> I DID, TOO. BY THE BOARD OF SUPERVISORS.

>> STILL YOUR TIME FOR THE PRIMARY MOTION ON THE ABLE.

>> THE PRIMARY MOTION, I'M NOT PREPARED TO SUPPORT, ONE, BECAUSE I DON'T LIKE THAT WE ARE MOVING BACK AWAY FROM AN EQUITY DIVISION. TWO, I THINK THAT THE OVERALL NUMBER IS STILL TOO BIG. BUT I WOULD MAKE A SUBSTITUTE MOTION AND SEE IF THERE IS SUPPORT FOR THE 2 MILLION RATHER THAN THE 5 MILLION FROM LAST YEAR. AND DONE USING THAT EQUITY DIVISION SUCH THAT ESSENTIALLY DISTRICTS ONE AND TWO ARE RECEIVING MORE THAN THE OTHER DISTRICTS GIVEN ALSO WHAT YOU DESCRIBED ABOUT YOUR DISTRICT FEELS VERY MUCH IN LINE WITH WHERE WE SHOULD BE MOVING. NOT A SECOND?

>> IT'S A SUBSTITUTE MOTION. HOW DOES IT --

>> SUBSTITUTE MOTION TAKES PRECEDENCE. FIRST QUESTION IS WHETHER THERE IS A SECOND.

>> SECOND.

>> I THINK HE 2 MILLION WOULD AMOUNT TO 500,000, RIGHT? AM I MATHING IN PUBLIC INCORRECTLY? MY WORST NIGHTMARE.

>> APPROXIMATELY. BUT IT WOULD NOT BE DIVIDED EQUALLY FIVE AYS. WE WOULD USE THE LENS THAT WAS CREATED LAST YEAR. OR SECONDARILY TO MY WN SUBSTITUTE MOTION, IF FOLKS WERE DETERMINED TO HAVE THE HIGHER NUMBER, A SECOND SUBSTITUTE OF THIS ONE DOESN'T GO ANYWHERE WOULD BE TO MAINTAIN THE 5 MILLION OF THE ORIGINAL MOTION, BUT STILL USE THE EQUITY LENS.

>> THE VERY SIMPLE MATH I JUST DID, REMINDS ME OF 2020 WHEN THE PANDEMIC HIT AND THE BOARD DURING THAT TIME ALLOCATED -- I'M TRYING TO GO BY MEMORY HERE. 500 EACH AND THERE WAS AN EQUITY METRIC AS WELL.

>> LAST YEAR WAS THE FIRST YEAR.

>> LAST YEAR WAS THE FIRST YEAR FOR AN EQUITY METRIC.

>> JUNE 2020, I WASN'T HERE. IT WAS A 3-2 VOTE AGAINST FOR THE $500,000 PER DISTRICT REASONING BEING THAT THEY FELT THAT'S ONLY EQUALITY, BUT OT EQUITY. THAT'S HOW THAT WAS BEING INTERPRETED. THAT'S THE HISTORY I REMEMBER, IF ANYBODY CAN CORRECT ME ABOUT WHAT'S WRONG.

>> SO I DO FEEL STRONGLY ABOUT AN EQUITY METRIC AS WELL. AND SUPERVISOR ARENAS, AS YOU WERE TALKING, WHAT YOU SAID ABOUT EAST SIDE, 1 AND 2, BEING KIN DREAD SPIRIT. REMINDS ME ALL THE MORE THAT OUR DISTRICTS ARE GOING TO BE IT HARD HARD WITH THE FALLOUT OF THIS BUDGET. THIS FEDERAL ADMINISTRATION AND IN TERMS OF BASELINE, LIKE THE AMOUNT, I WAS PREPARED TO SUPPORT LIKE AN AMOUNT THAT WAS MORE THAN NOTHING, RIGHT? LIKE FOR ME COMING INTO TODAY, THE NONNEGOTIABLE WAS NOT TO HAVE AN INVENTORY PROCESS. WHERE IN YEAR ONE AFTER MULTIYEAR BUDGET CYCLE OF ARMAGEDDON AND BUDGET DOOM. IN THAT MY CONCERNS WAS, MAYBE IT'S ONLY MY CONCERN, IF WE WERE TO DO AWAY WITH THE INVENTORY PROCESS, WE WOULD NOT BE BRINGING IT BACK BECAUSE THE SAME REASON WILL STILL EXIST NEXT YEAR AND THE NEXT YEAR. I WOULD LIKE TO HEAR FROM MY COLLEAGUES. I FEEL LIKE THIS IS A DISCUSSION THAT REQUIRES JUST MORE.

>> WE NEED TO CLARIFY PROCEDURE BEFORE THERE CAN BE A DISCUSSION, WE NEED TO KNOW THERE IS A SECOND.

>> I WILL SECOND SO I CAN CLARIFY WHAT THE OTION IS. IS THAT OKAY?

>> THE MOTION WOULD BE 2 MILLION AMONGST THE FIVE OFFICES DIVIDED ACCORDING TO THE EQUITY PRINCIPLE WE APPLIED LAST YEAR.

>> 2 MILLION. YOU ARE SUGGESTS A REDUCTION FROM AST YEAR OF $5 MILLION, APPROXIMATELY, BECAUSE LAST YEAR WE GAVE OUT $7 MILLION. I WANT TO MAKE SURE, VARIOUS PROPOSALS ON THE TABLE. I FIRST SPOKE, LET'S DO A TOTAL OF 4.5 MILLION WITH A REDUCTION OF 2.5 MILLION FROM LAST YEAR. THE INITIAL ACTUAL MOTION MADE BY SUPERVISOR ABE-KOGA, JUST DO 5 MILLION FOR ALL FIVE, EXACTLY SAME AMOUNT. THAT RESULTS IN A EDUCTION OF $2 MILLION. AND THIS THIRD ONE WE ARE NOW TALKING ABOUT FROM SUPERVISOR ELLENBERG, LET'S REDUCE IT EVEN FURTHER TO REDUCE IT BY $5 MILLION AND THAT THE TOTAL ALLOCATION FOR INVENTORY IS ONLY $2 MILLION. AM I CORRECT IN TERMS OF THESE NUMBERS?

>> YOU ARE PUTTING IN ADJECTIVES I MAY NOT HAVE INCLUDED, BUT YES.

>> SO I AGREE WITH YOU REGARDING THE EQUITY PARTS OF IT. MY INITIAL IDEA WHEN I PUT IN MY 4.5 HAD THAT EQUITY PART BUILT IN. THAT'S ALREADY WHAT WE GAVE LAST YEAR. THAT'S WHY I SAY WHEN WE REDUCE OUR BUDGET BY HALF MILLION DOLLARS EACH, THE EQUITY PART IS ALREADY IN THERE. AM I LOSING YOU THERE? IT'S A COMPROMISE TO TRY TO REDUCE AS MUCH. THAT'S THE REASON WHY THAT PROPOSAL I PUT IN WOULD RESULT IN DIFFERENT AMOUNTS FOR EVERY DISTRICT AND THE DISTRICT THAT GOT THE MOST LAST YEAR WILL GET THE MOST.

>> WITH THAT CLARIFICATION, THAT FEELS BETTER TO ME.

>> THANK YOU.

>> WE ARE SECOND, THE SUBSTITUTE MOTION AS BEEN REMOVED. SO WHAT --

>> SORRY. SUBSTITUTE MOTION IS STILL ON THE TABLE. IT'S BEEN SECONDED. IT BELONGS TO THE BODY.

>> REMOVE MY SECOND.

>> WE NEED TO VOTE ON IT.

>> NOT SECONDED ANY MORE.

>> ONCE A MOTION IS MADE, AND THERE IS A SECOND, IT BELONGS TO THE BODY.

>> CAN WE HAVE A DISCUSSION SINCE HE SECONDED. I WANT TO EXPRESS -- I'M NOT GOING TO SUPPORT THE MOTION ON THE FLOOR. I'M GOING TO TELL YOU SOMETHING. WHY THIS IS AN ITEM ALL BY ITSELF IS SOMETHING THAT I DON'T AGREE WITH. I'M NOT SURE WHY WE ARE HAVING THIS CONVERSATION. BECAUSE IF ALL IS TO BE FAIR, I WOULD LIKE TO SEE WHAT THE CEO'S OFFICE IS DOING IN TERMS OF REDUCING THEIR OWN RESPECTIVE TRAININGS, CONFERENCES, THINGS THAT MY OFFICE DOESN'T HAVE THE PRIVILEGE OF DOING, EXPENSES THAT GET PAID. THIS IS NOT ROM ME. THIS IS NOT FROM ME TO LINE MY POCKETS WITH. THIS IS FOR ME TO ENHANCE WHAT MY COMMUNITY IS DOING. AND THIS FEELS SO PETTY. IT FEELS SO PETTY. I AGREE WE NEED TO HAVE THIS BE MORE EQUITABLE AND I LIKE THAT WE ARE GOING TO ISTRIBUTE IT DIFFERENTLY. SOME OF YOU CAN AFFORD NOT TO HAVE THIS AND BE OKAY WITH IT. I CAN'T. AND SO YOU ALL CAN DECIDE ON WHATEVER IT IS -- I'M NOT SUPPORTING YOUR ORIGINAL AND I'M NOT SUPPORTING THE MOTION ON THE FLOOR. I'M SUPPORTING SOMETHING THAT ACTUALLY SPEAKS TO OUR COMMUNITY AND RIGHT NOW I THINK IT S BEING PETTY AND IT IS BEING TRIVIAL WITH WHAT THE NEEDS OF MY COMMUNITY REALLY ARE. AND SO UNTIL WE GET TO A NUMBER THAT I JUST -- IF YOU DON'T WANT TO ACCEPT IT, LET ME HAVE IT. LET ME HAVE IT AND I WILL DO WONDERS WITH IT.

>> OKAY. LET'S TALK ABOUT PROCESS. WE HAVE A SUBSTITUTE PROCESS. I SECONDED IT. I CANNOT WITHDRAW MY SECOND. SO WE HAVE TO VOTE ON IT IRST. SO THE SUBSTITUTE MOTION IS --

>> I'M HAPPY TO WITHDRAW THE MOTION. IT'S CLEAR THERE AREN'T --

>> WE ARE MAINTAINING ORDER. THERE NEEDS TO BE A VOTE ON A SUBSTITUTE MOTION.

>> I CAN'T WITHDRAW IT?

>> NO.

>> OKAY.

>> I HAD MY LIGHT ON, I WAS HOPING O MAKE A COMMENT BEFORE WE VOTE.

>> SURE. ON THE SUBSTITUTE MOTION.

>> I WILL NOT BE SUPPORTING IT. I APPRECIATE THE COMMENTS THAT -- I MADE THE ORIGINAL MOTION BECAUSE LOOKING AT THE NUMBERS, IT'S A 30% REDUCTION IN THE INVENTORY PROGRAM. AND AS I SAID EARLIER TODAY, I'M LOOKING TO TRY TO PRESERVE PROGRAMS, REDUCE THE COSTS IF WE CAN. BUT I DON'T WANT TO -- I DON'T THINK WE SHOULD BE COMPLETELY ELIMINATING PROGRAMS. THE 2 MILLION IS QUITE A -- IT'S A BIG -- I APPRECIATE WHAT YOU ARE DOING.

>> SUPERVISORS, I'M COOL, THAT'S FINE.

>> I ASKED THIS EARLY ON OF JAMES. HOW ARE THE TARGET REDUCTIONS DERIVED. AND I DON'T KNOW IF THERE IS A CLEAR FORMULA. BUT I DON'T KNOW THAT ANY DEPARTMENT IS TAKING THIS -- EVEN A 30% REDUCTION. I THINK THAT IT SHOULD BE COMMENSURATE TO WHAT OTHER DEPARTMENTS ARE HAVING TO DO. SO THAT'S THAT. IN TERMS OF THE EQUITY VERSUS EQUALITY, I VERY MUCH APPRECIATE THE INTEREST. I WILL SAY, I KNOW THAT MY DISTRICT IS PERCEIVED AS PROBABLY, THE WEALTHIEST AND MAYBE HAS THE MOST RESOURCES. BUT THAT'S NOT TO SAY THAT THERE IS NOT NEED. AND FRANKLY, I GUESS MY INTEREST IS TO FURTHER STUDY OR EXPLORE WHAT EQUITY MEANS. BECAUSE YOU CAN SLICE IT MANY WAYS. I KNOW WE PICKED MEDI-CAL PATIENTS. WE COULD LOOK AT SENIORS WHO ARE FOOD ASSISTANCE DEPENDENT, WHO HAS THE MOST SINGLE MOMS ARE CHILDREN. THERE IS SO MANY DIFFERENT WAYS TO LOOK AT EQUITY. I DON'T THINK THAT WE HAVE DONE ALL OF THAT YET. AND SO, FRANKLY, COMING FROM THE DISTRICT THAT RECEIVES THE SMALLEST AMOUNT FROM THIS PROGRAM, I DON'T FEEL COMFORTABLE AT THIS TIME MAKING THAT DECISION WHEN WE HAVEN'T REALLY DECIDED AS A GROUP HERE AT MAYBE PREVIOUSLY YOU HAVE, HERE WE HAVE NOT HAD THAT CONVERSATION. I WOULD LIKE TO EXPLORE THAT FURTHER BEFORE WE MAKE ANY MORE FUNDING DECISIONS ON THAT. AND THEN I THINK THERE IS THER ISSUES, TOO, ABOUT THIS WHOLE PROGRAM. I WAS TOLD BY STAFF THAT IT COSTS QUITE A BIT OF FUNDING AND RESOURCES TO ADMINISTER IT. SO RATHER THAN DOING SMALL 300 GRANTS, SHOULD WE BE LOOKING AT LARGER ONES. MY CONCERN HAS EEN SOME OF THE NONPROFITS HAVE BEEN AROUND A LONG TIME HAVE FIGURED OUT HOW TO APPLY FROM ALL OF US AND FROM A LOT OF US, AND THEN BECAUSE WE ARE NOT ABLE TO TALK TO EACH OTHER. I THINK THAT'S A BROKEN SYSTEM WE NEED TO FIGURE OUT HOW TO FIX. SO THERE IS A LOT OF ISSUES AROUND THIS PROGRAM. BUT I DO THINK IT'S AN IMPORTANT PROGRAM THAT WE SHOULD PRESERVE EVEN IN THESE HARD TIMES. AND CONTINUE TO REFINE IT TO MAKE IT WORK FOR EACH OF OUR DISTRICTS TO THE BEST OF ITS ABILITY. SO I AM INTERESTED IN DOING THAT WORK. BUT FOR PURPOSES OF JUST THIS TIME, I JUST THOUGHT IT WOULD BE EASIEST FRANKLY TO DO THE 30% REDUCTION.

>> THANK YOU.

>> OKAY. SO WE HAVE A MOTION BY SUPERVISOR ELLENBERG, SECONDED BY MYSELF. AS MENTIONED, I WAS TRYING TO WITHDRAW, I WILL NOT BE GO AHEAD.G IT WHEN I VOTE.

>> THIS IS A VOTE ON THE SUBSTITUTE MOTION, MOVED BY SUPERVISOR ELLENBERG, SECONDED BY PRESIDENT LEE. (ROLL CALL). MOTION FAILS.

>> SO WE GO BACK TO THE ORIGINAL MOTION WHICH WAS BY SUPERVISOR ABE-KOGA. BEING SECONDED BY VICE PRESIDENT ARENAS. AND THAT'S THE MOTION WAS FOR ALLOCATION OF TOTAL OF $5 MILLION WITH EACH DISTRICT RECEIVING $1 MILLION EACH. AM I CORRECT?

>> YES.

>> IF YOU CAN AKE A FRIENDLY AMENDMENT, WE CAN STICK TO THE EQUITY BASED FORMULA THAT WE HAVE NOW. AND THEN WORK TOWARDS HAVING AN EQUITY BASED FORMULA THAT WE ALL AGREE ON. WE WORK SOMETHING OUT LOOKING AT THE MEDI-CAL RESIDENTS IN EACH RESPECTIVE AREA AS ONE OF THE FACTORS THAT CONTRIBUTED TO THE EQUITY BASED FORMULA. IT DOESN'T MEAN THAT HAS TO BE IT. WE CAN FIGURE OUT WHAT THAT FORMULA IS COLLECTIVELY ONCE AGAIN. ANYWAY, SO I THINK IF WE DO THE AMOUNT, IF WE DO A TOTAL AMOUNT AND WE BASE IT OFF OF THE EQUITY BASED FORMULA, EACH DISTRICT RECEIVES THEIR RESPECTIVE DIFFERENT AMOUNT. IS THAT SOMETHING YOU ARE OPEN TO?

>> CAN WE TABLE THAT? I GUESS I WOULD LIKE TO SEE WHAT THAT COMES OUT TO, FRANKLY, BEFORE WE --

>> I DON'T THINK IT'S THAT MUCH DIFFERENCE BETWEEN ALL OF US. I KNOW THERE IS NEED EVERYWHERE. AND YOU HAVE SIGNIFICANT NUMBER OF MEDI-CAL RECIPIENTS IN YOUR AREA. SUPERVISOR DUONG'S DISTRICT OUTDOES ALL OF US.

>> BARELY.

>> WE ARE RIGHT BEHIND YOU, JUST A LITTLE BIT. I HAVE BEEN IN THE SPOT WHERE I WAS REPRESENTING DISTRICT 8 ON THE CITY OF SAN JOSE. THIS IS EVERGREEN AREA. WE HAVE THREE COUNTRY CLUBS. SO I HAD A PORTION OF THE EAST SIDE. AND SO THERE WAS A LOT OF TIMES WHERE I HAD TO SET MYSELF ASIDE BECAUSE I KNEW DISTRICT 7, SEVEN TREES, ANY OF THAT, DISTRICT 5 ON THE EAST SIDE. THERE WERE JUST OTHER DISTRICTS AND DISTRICT 3 IN THE DOWNTOWN AREA THAT WERE NEEDIER THAN MINE. AND SO I JUST MADE, YOU KNOW, WE DON'T WIN IT ALL THE TIME. THAT'S WHAT EQUITY IS. BUT I UNDERSTAND THAT THERE IS?- NEED EVERYWHERE. I'M NOT NAIVE TO THINK THAT, AND I HAVE WORKED IN YOUR DISTRICT BEFORE. I KNOW THERE IS A LOT OF NEED AND A LOT OF IMMIGRANT FAMILIES WHO HAVE DIFFERENT KINDS OF NEEDS. OUR SENIORS WHO HAVEN'T MOVED OUT OF THE AREA. AND SO I'M KNOTTED TRYING TO DIMINISH THAT AT ALL. SO IF WE ARE OPEN TO IT, WE CAN FIGURE IT OUT. I DON'T KNOW IF THIS IS THE TIME TO DO IT. BUT I APPRECIATE THE CONVERSATION.

>> OKAY. WE HAVE A MOTION WITH A SECOND. ANY FURTHER DISCUSSION ON THIS MOTION? GO AHEAD.

>> CLARIFY WHAT THE MOTION IS?

>> CURRENTLY THE MOTION IS $5 MILLION ALLOCATION. AND THEN WHAT WE ALKED ABOUT REGARDING ALLOCATION ITSELF, FIRST THE MOTION TALKS ABOUT HAVING IT TO BE EXACTLY THE SAME FOR EVERY DISTRICT. AND THEN YOUR SECOND, VICE PRESIDENT ARENAS, WANTS TO HAVE A FUTURE DISCUSSION OF HOW THAT EQUITY INDEX MIGHT BE USED TO ALLOCATE THE $5 MILLION. AT THE END OF THE DAY, THAT 5 MILLION WILL NOT BE EQUAL. AM I CORRECT TO THE SECOND?

>> THAT'S IF THE MAKER OF THE MOTION IS OPEN TO IT. YEAH.

>> ALL RIGHT. MAKE A MOTION?

>> SO I THINK I KNOW WHERE THE VOTES ARE. SO I WILL ACCEPT THE AMENDMENT TO THE MOTION. SO E WILL DO THE $5 MILLION TOTAL, BUT ALLOCATE IT BASED ON THE CURRENT EQUITY FORMULA AND THEN REVISIT THAT FORMULA FOR FUTURE DISCUSSION.

>> SO FOR HIS UPCOMING BUDGET, IT WOULD BE $5 MILLION ALLOCATED USING THE MEDI-CAL ENROLLMENT AS A METRIC. AND THERE WOULD BE FUTURE DISCUSSIONS ABOUT THE METRICS.

>> BASED ON THE CURRENT METHOD WE HAVE, THE UNDERLYING CURRENT METHOD WE HAVE.

>> CORRECT. IT'S IN THE BOARD POLICY CURRENTLY. SO THE METRIC, IF YOU ARE JUST KEEPING THE CURRENT METRIC, DOESN'T NEED TO BE PART OF THE MOTION. IT'S THE $5 MILLION USING CURRENT METRIC.

>> IS THAT CLEAR?

>> OKAY. WE HAVE A MOTION, WEAVE SECOND. ANY FURTHER COMMENTS ON THIS MOTION? OKAY. IF THAT'S THE CASE, LET'S VOTE.

>> THAT IS A MOSTLY CLOUDY WRITE SUPERVISOR -- THAT IS A MOTION BY SUPERVISOR ABE-KOGA. SECONDED BY SUPERVISOR ARENAS. (ROLL CALL).

>> OTION PASSES WITH FIVE.

>> THANK YOU. ALL RIGHT. SO I BELIEVE THAT SHOULD BE THE LAST ITEM OF THE AGENDA. AND I JUST WANT TO SAY THAT WE HAVE NOW BE ABLE TO ADJOURN THE MEETING. IT'S 6:04. NEXT MEETING IS ON FEBRUARY 24, 9:30 RIGHT NOW. THANK YOU FOR STAFF AND ADMINISTRATION. MEETING ADJOURNED. THANK YOU.