This special joint meeting of the Alameda County Board of Supervisors' Social Service and Health Committee focused on the impacts of federal HR1 and state budget proposals on county health and social services. The meeting featured three informational presentations: a backbone agencies update, a state budget overview, and detailed analysis of policy changes affecting Medi-Cal for non-citizens. No formal votes were taken; the session was informational and planning-oriented.
Good afternoon and welcome to the Alameda County Board of Supervisors special meeting that is a joint meeting of the Social Service and Health Committee. May I have roll call for January the 12th 2026? Supervisor Fortunato Bass. Present. Supervisor Miley. Present. Supervisor Town. Present. We have a quorum. Thank you. Did you need to go through instructions on participation? For in-person participation, the meeting site is open to the public. If you'd like to speak on an item, you can fill out a speaker's card in the front of the room and hand it to the clerk for remote participation, follow the teleconferencing guidelines posted at www.acgov.org. And if you'd like to speak on an item remotely, use the raise your hand function. Thank you. So we have three informational items. This is a long-awaited joint meeting that will help us understand and prepare for the impacts of HR1 on the state and on the county. So we'll start with the first informational item from Alameda County Health and Social Service. Good afternoon, Supervisors. Anika Chowder, Interim Director for Alameda County Health, and I'm joined by Director Ford from the Social Services Agency. So we have three presentations for you today. The first one is a backbone agencies update, followed by a budget update, and then a much uh lengthier one where SSA has done some deeper dives into some of the data and upcoming policy changes. So to start with the backbone agencies, the context here, you know, as you just reiterated in your last meeting, is that HR1 is really pushing some very significant Medicaid policy changes that are phasing in over a number of years. And there's a big impact on the Alameda County communities. So there's narrowed, eliminated, narrowed or eliminated eligibility for many community members, and then of course uh increased and new requirements, such as the work required requirements for people who do remain eligible. Um and that's uh there's also a lot of complex implementation challenges, so essentially uh, you know, any reduction in Medicaid eligibility or enrollment will result in revenue loss for our providers. Um it also means increased administrative complexity, especially for the social services agency, uh, as they're doing eligibility and enrollment. Um, there's a lot of policy and funding implications for the indigent care program, which is Health Pack, which is in our agency, and then of course, you know, one of the tricky things about doing this work is that there's so much that's dependent on state and federal guidance that hasn't yet come out. Um, and so, and as you even heard with the budget, you know, we don't have all the information and and we're trying to plan ahead. Um, so back in October, I believe it was the board designated um SSA and AC Health to help provide some backbone support to ensure coordination across our partners, and then report back regularly on Medi-Cal related efforts to this joint committee. So on the right here is just a little bit of uh uh, there used to be a big Venn diagram of this uh previously, but essentially just to give you a sense of uh context for the backbone is social services, AC Health, and we're working closely with our board offices. Um there's a core group of key health partners, uh, just because they're so large in the safety net space, which is Alameda Alliance for Health, Alameda Health System, and the Clinic Consortium, and then we've got a broader group of community providers to include the community provider advisory group, which is uh a meeting that uh was initially started by AC Health to join uh you know behavior health providers, homelessness providers, and public health providers in our system. Um, and director Ford has uh been able to join those meetings as well because so much of the focus is uh now on HR1. Um and uh we've got additional safety net partners, you know, in the social services space, and we're open to doing any ad hoc convenings as those happen. Um, and then sort of at the broader county governance level is where uh this committee comes into play where we want to keep you apprised of the things that are happening. So just recently, um, between SSA and AC Health, as you heard me list all the meetings. We talk about a lot of meetings, and we meet to coordinate. Um, we're also working on the implementation of some measure W funding that was allocated specifically for Medicaid outreach. Um, and uh we're under we're developing a MOU between our two agencies, which will uh provide some enhanced um access to data for our health pack team because they have a team of people who help people enroll in different insurance options. And so it would help that team to better refer people back to SSA. And then as I mentioned earlier, working with our uh large healthcare safety net providers, and really the work there is to you know continue to do data analysis so that we're all working from the same numbers, and you know, working to develop different strategies for how we're going to implement things that are coming down the pike. There's shared messaging work that I'll share a little bit about and um just coordinated medical outreach and engagement because that's probably the um biggest thing that I want to uh underscore is that uh the more we can prioritize medical outreach and engagement and enrollment retention, the better it will be for our system as a whole. Um can we ask questions as we go along, or did you want questions at the end? Um I think because this is going to be an extensive, let's ask them as we go along. So feel free. Okay, thank you. So before you leave this slide, um, how often does this backbone body meet? Um, so the uh SSA director and I have a regular meeting and regular check-ins, we see each other often. The meetings with the key health partners, those are currently every couple of weeks. Um, and I do want to thank the alliance for providing some additional um facilitation support for those.