Part of the health committee for February 9th.

She provides a PAM.

President Supervisor Miley.

We have a floor.

Is there any instructions you need to provide?

For in-person participation, the meeting site is open to the public.

For online participation, follow the teleconferencing guidelines posted at www.acgov.org.

For remote participation, use the raise your hand function.

All right, thank you.

Everyone make sure everybody knows the mics will pick up any conversation because they're in the ceiling.

So the inside conversation, whatever.

Mics will pick it up.

So if you're you know saying something bad about Lena and myself, the mics will pick it up.

So please uh don't uh talk.

We're not uh speaking, and then apologize for this being for I'll take responsibility, but I'm annoyed about the fact that we're in this room, not at the training center.

The board chambers are being retrofitted for uh mics and stuff.

Should have been in the training center because it is anticipate number of folks being here this morning.

So I'm just publicly seeing the way, so I can get that off of my chest, and I will follow up with folks who are responsible for putting us in this room.

Yeah.

Supervisor, we do have an overflow at the TEC.

Okay.

That's nice to know, but still, I'm annoyed.

Okay.

Um, first item is uh leisure C pediatric health count.

Informational item.

Who's presenting that?

We've got about um hi, folks.

That's correct.

Hi, supervisor.

I just see you again.

I'm Nicholas Holmes, I'm the president of Biddy.

Next slide, please.

UCS Binning Up Children's Hospital Oakland is nationally recognized for its excellence in providing comprehensive high quality care for children.

We're more than just the name suggests a hospital or a system of care.

We're we're have community-based clinics within our schools and Oakland, with our outpatient facilities and an incredible level one pediatric trauma center.

Pediatric trauma are rare events and require specialized teams of care to save lives.

We are recognized nationally for the great quality care we provide, as noted by the USA, we'll report rankings of one of the best children's hospitals with top 10 rankings in the neatology, gastroenterology, and gastroenterology surgeries.

We have just over 2,500 employees with about 50% of our team residing within our slide.

Who do we care for and where do they come from?

The vast majority of our patients live within Palameda County.

We've all types of patient encounters.

These patients are occur in the outpatient setting, but inpatient setting.

We see approximately about 1,400 uh trauma cases, uh encounters in the last fiscal years.

Next slide.

We are one of three level one pediatric trauma synopsis, but one of seven in the state of California.

We get referrals as far north as Oregon border as far east as Utah and all the way south to LA.

We will hear from the members of our trauma team leadership why we are considered experts in this highly complex market.

Next slide.

At the heart of what we do is to serve all children, all patients regardless of their economic status.

Is our core value starting from our founder's birthday right in Able weed when our divorce opened in 1924?

To be committed to care for children regardless of the ability to pay.

As a result, you see the overwhelming majority of our patient revenue, outpatient visits, and patient revenue and patient base or for children that this has led to cumulative operating deficits here.

Providing care.

Next slide.

Quantify the financial impact to the preceding slide.

We're providing over $88 million dollars in community benefit.

The gap of what we do, and the additional government support.

When you look at the value of charity care, about $2 million dollars, those are for those who are uninsured, or for the short, as well as all the rest.

There's about $300 million dollar shortfall for those on public governmental health programs.

We are grateful for the supplemental revenue, but this is even at risk with ongoing hospital provider fee and disproportionate shared fundings with federal told us.

Next slide.

Our UCSF affiliation provides significant benefits to the outcome's home.

Each year, UCSF provides intergovernmental transfer to finance the drawdown of additional federal Medicaid dollars, which are return to BCH Oakland as a supplemental payment.

When you look at the last four fiscal years, the gap or loss in hospital operations has continued to grow.

Without the continued investment, financial support of UCSF Health, we're going to have Children's Hospital would not be able to financially function.

Since affiliation in 2014, UCSF Health has made or will make almost two billion dollars in capital improvements in the has included our outpatient clinics, consolidation of our electronic health record EPIC as the same instance to ensure interoperability and seamless care for patients, a remodeling of inpatient units like the PICU, and it will culminate in the modernization of our acute care campus with a new hospital building coming online in 2031.

Next slide.

This picture is a rendering of our new hospital building, which will be completed in 2031.

Our emergency department and trauma center will be relocated on the first floor.

The entire building would be seven floors, almost 300,000 square feet.

It'll be mostly single and private patient rooms.

We relocate there, as well as two medical surgical portals.

Plus, we will have the first inpatient and child adolescent behavioral health.

Also includes a new parking garage and relocation of our heelopad, as you see it depicted on the image there.

The HELOPAD is absolutely critical to the patients that are seriously ill or have trauma and trauma events, excuse me, to get life-saving trauma care.

Because of the measure C funds that have been collected prior to the dispersal in the spring of 2025, we were able to be programmatically updating and enhancing the way we provide trauma care in this new trauma center.

With advanced radiologic imaging and continued movement in our center, the escalating cost of construction, tariffs placed on goods, materials, and significant financial pressures we face makes the supplemental funds absolutely.

Next slide.

Not only with this new hospital building, we'll enhance how we provide care to patients, it will actually help them redo the idolization and the configuration of the economic city of Oakland.

In June 2024, we signed a community workforce agreement with Alameda Building and Trade Council.

Work together to hire local union workers for our modernization construction process.

Our goals for 30% of the union workers to be from the two counties where we serve the most kids, Alameda and Company, plus the goal of 25% of the union workers to be those die within the city of Oakland.

We estimate that over 400 workers per year will have these opportunities.

We certainly can't do this without ourselves.

Do this by ourselves, so we've also partnered with West Oakland Job Resource Center and local veterans organizations to make this a reality.

Next slide.

We pride ourselves at bidding up children's hospitals to be a highly reliable organization.

Focus on continuous improvement to ensure safe, reliable, and excellent quality of care for our patients.

What does this mean in practicality that in order for us to operate in a way to be effective?

We have to have the means to garner feedback from our team members who are doing the work of caring for our patients.

Whether it's a doctor, nurse, pharmacist, therapist, tech aid, or others doing direct patient care.

It's important to see here all issues.

We talk to staff as it relates to input, heat tunnels, monthly staff meetings, town halls, which happens quarterly, and I have a monthly presence coffee where I meet with the staff to hear their concerns, issues, and what is needed to provide the best care.

With this model of a highly reliable organization, we've even received more awards based on our ability to provide patient care that's safe and high quality.

Most recently we received the 2025 Leap Frog Award for Patient Safety and Quality as a top children's hospital in the country, which only 15 of the total children's hospitals have been received.

I'll have the rest of my team talk more specifically about what we're doing with Measure C on those from the trauma care.

So we turn it over to Dr.

Zoltanski, who's our chief medical officer at Benny Hub Children's Hospitals.

We appreciate that.

We what I wanted to do in this next section is talk to you a little bit about the why and the how that we're using.

Next slide, please.

So what we're working to do is really to really embrace the letter of this, but also the spirit of Measure C.

So the Measure C is I'm sure many of you know, but just to remind provides additional support to keep open and we staffed a local level one pediatric trauma center and emergency department in Alameda County to ensure the availability of critical care to all children and young adults in the East Bay and surrounding areas.

And so as we received some of the funds last year, we didn't spend them immediately.

What we wanted to do was really work on a process to be really great stewards of those funds for our community.

And as we did that, I'll talk a little bit about what that process looked like, but we really wanted to highlight that we needed to have a focus on three things.

We wanted to bring in to uh BCH Oakland advanced equipment.

We wanted to bring in up that advanced updated equipment and also to uh work to highly train and to really invest in our specialized staff, and also to create evidence-based and support evidence-based programs so that as we use these funds, we can come back and talk about the impact and say this is what we're measuring.

This is how we know that it's not just a you know one off grade event, but that it has impact and also that that impact is sustainable.

Next slide, please.

So as we did that, um, we set up a Measure C committee.

Uh, the Measure C committee is tiered in a way that it has all of our operational areas, and we worked and asked for all of our leaders to work with their frontline staff.

So our employees, our represented staff to work with their direct supervisors, their direct managers to bring forward information and programs that they thought would be important.

And so the inputs you can see is so we listened to patients and families, we listened to our clinical staff, listen for recommendations, worked with our operational and financial people to look at the requirements around Measure C, and also our patient and family advisory councils for ideas and for projects to bring forth.

The evaluation criteria that we used again, really looking to meet that letter and to embrace the spirit was around.

We asked ourselves for these projects as we review them, what is the impact on trauma care, and how will that make the lives of our trauma patients and their families better?

We looked at the number of patients served by the programs that you'll talk about that we brought forward, but we also looked at the impact of clinical outcomes.

So some programs would reach a lot of patients, which is a great thing and advance the care for all patients.

But some programs would only impact a few patients.

But that impact could be life-changing.

That could be the difference of life and death for a patient.

Those also, so again, it may not be a broad number of patients, but even if it's a rare patient, that that changes, if it's life-changing, we felt that was important, also.

So we included that as a criteria, and also our ability to achieve an outcome.

Also, we wanted to again measure that.

We wanted to bring back measurements so that we can come back and say, this is what we set out to do.

Did we do it?

Didn't we?

These are the numbers that can show that.

Um next slide, please.

So these are examples of a few of the programs.

Again, because we received the money last year, these are in various stages of like you didn't go in and immediately spend it.

We stopped in with that committee, we started reviewing programs and looking at, you know, what are the needs for these programs.

Um, but these were really uh really brought in with um the feedback from our frontline providers from our patients, our families.

This is very important to us.

This is how they had to come up through the Measure C committee.

Um, and so a good example of it, and uh Dr.

Jensen will talk about other programs in here, but an example of that is the simulation-based training program that we put forward.

We talked about how pediatric traumas are rare.

Um, I guess they're relatively rare because they're happening every day in our hospital.

They're rare compared to adults, but certainly if you're in the children's hospital, you're sitting there, and every day you're hearing emergency responses, traumas that are coming in.

And what we were hearing from our staff was they wanted more training on those because it may not happen.

Specific types of trauma may not happen every single day, but they wanted to be prepared for those and they wanted the right training and the right equipment.

And we certainly need updated equipment for our simulation-based training.

Um, we need to the ability to have resources to do that more frequently.

And so that's a good example of that.

We're bringing in new equipment so that our simulate simulation-based training, state of the art, and that the people that that trains that are part of our trauma team are clinical nurse specialists, our OR techs, our imaging techs, our nurse practitioners, social workers, security guards, everybody that's involved in these trauma responses, can have that state of the art training to invest in our equipment, but also invest in our people so that we're prepared for that.

Um, there are more on there, which some of which we'll hear about in more detail as we go forward.

And I'll turn it over to our direct trauma team too.

That's the next slides to talk about that.

So, Dr.

Jensen and Jackie.

Can I it might be easier if I just advance my own slides?

Thank you.

He likes to have morning, everybody.

Um I'm Aaron Jensen.

Um I'm joined today with by two of our nurse leaders, uh, Jackie Hogan Schleins, who's our trauma program manager who's worked at the children's hospital, she tells me for 38 years.

Um, and you hide a colorado as our nurse administrative director.

I grew up in Alameda County.

I spent the first 21 years of my life living in San Lorenzo.

I went to high school and college in Hayward.

I went to medical school with the specific goal of coming back and practicing as a pediatric trauma surgeon in Oakland.

And it's really my dream to be doing the job that I'm doing today as a trauma surgeon and leading this program.

Um, and it's really an honor to be here to present today about the incredible work that we do at all.

And truly this this blessing that we have to do even better work and expand our services and optimize care.

So today my goals for the presentation are really to define why have a level one pediatric trauma center.

What do we do?

Why are we here?

Illustrate some opportunities to expand our specialized staff, specifically board certified specialists and many of our other represented staff, and also modernize our facilities so that we can really treat kids with the most critical injuries, life training.

And I'm gonna tie everything back to the patients that I take care of, boots on the ground in the trenches every day, with many of you I see that have joined us today.

I'm here to represent really the viewpoints of frontline.

I want to start with a case.

I think this is the best way for all of us to come to alignment around the topic that we're talking about today.

So I changed some of the details of the case for anonymity of the patient, but this is a real case.

It's a real kid that I took care of with real humans.

Alex is riding in a car on the freeway when the car lost control.

Alex wasn't median flipped over and burst into flames.

Alex was found in the front seat by bystanders.

It's unclear where Alex started, whether it was the front seat or the back seat, but Alex was in the front street front seat of a burning car.

Uh was unresponsive and was bleeding.

The bystanders called 911.

The ambulance on scene took the patient to a local level two trauma center.

Five, maybe 10 minutes away from the scene.

And you say, Well, why did they not just go straight to children's Alex was dying of injuries and they needed to get to the closest hospital for early stabilization prior to coming to the trauma center?

And at this level two trauma center, they put in a breathing tube, they started some IVs, and they started giving blood transfusions.

This care saved this child's life.

And the reason they did this is because we've trained them to do this.

See, we, as a pediatric trauma center, we work in context of an overall pediatric trauma system within Alameda County, and we have trained providers at these other institutions through our pediatric readiness program in order to stabilize these kids and keep them alive long enough to transfer them out to our center where they can get life-saving surgery and critical care.

This is our job at the center of the trauma system.

Not only the pediatric trauma system, but the whole trauma system for injured kids to get them into the system and then to us so that we can save their lives.

We've been a trauma center since the 1980s, over 40 years now.

We've been designated by the county as a trauma receiving center, and we achieved ACS level one verification CD trauma center in 2014.

This is the highest level verification.

Continuous verification since 2014 and we anticipate getting reverified next year.

That's our initial verification team back in 2014.

The bottom photo is our current trauma quality team learning together at the ACS's trauma quality improvement conference.

Every day these people come to work and look at every single patient's chart and the care that they receive and ensure that they're getting the highest quality care and that evidence-based protocols and guidelines are being applied to all of the children that we take care of in our hospital.

But it's more than just what we do in the trauma bay and the OR, even our rehab unit to save lives from injury the best way to save lives is to prevent those injuries from happening to begin with so what if Alex would have been restrained in the back seat in a car seat at seven this child should still be in a booster seat these injuries probably would have been a lot less severe, right?

So we have a comprehensive injury prevention program that gets out into the communities we give out free car seats and we teach families how to use them.

We give out bike helmets we give out window guards.

We give out gun locks you come to our ER and say I want a gun lock you can have a gun lock no questions asked we don't ask your name we don't ask anything we will give you one or six however many injury prevention is the best way to save lives we are dedicated to this at our trauma center.

Unfortunately kids still to get hurt and we provide impeccable care in the hospital but what about when they leave the hospital how do we get them reintegrated into their communities?

How do we prevent them from getting injured again focusing on social drivers of health community connecting people with community based organizations violence prevention all of these things will be augmented by projects that we are moving forward with with these special C4.

I'll detail those a little bit later perfect timing fast forward.

You want to leave the building by the nearest exit or not supervisor TAM present supervisor Miley.

Presentorum all right so we're going to resume the meeting sorry for that um emergency not our control.

Right so I think we were presentation or on one of the slides copies of level one ETC services.

Backwards that's perfect.

Okay.

Welcome back to I've had a presentation that I've been so we were talking about Alex and a lot of people were asking me out on the curve well what happened to Alex we'll get there.

And we were talking about the comprehensive nature of our trauma system.

What I put on the slide here is all of the people it takes to run a comprehensive level one center and we won't go through all of this but on the right side are all the physician groups these are groups that are required by the American College of Surgeons to maintain our trauma.

What is not on this list but what is required and something that I had conversations with the app on the sidewalk cardiac surgery and hematology so comprehensive surgical care including cardiac surgery including hematology are part of the requirements for the American public.

So as a trauma medical director I need hematology for sick cell disease and other hematologic blood disorders and I need cardiac surgery at the trauma center and if we were to lose those surfaces our trauma center would not be verified and then where would kids go to gig so that is part of our trauma center and part of our trauma services but more than that is the quality program on the left that I've talked to you about the injury prevention the quality team aftercare at the top but the bottom left part of the slide is really the driver of our trauma program.

This is the nurses in the access center, it's the nurses on the transport teams, the technicians and the blood technologists that run the radiology machines and the CAT scanners and the MRIs, all the therapists in the rehab unit, our mental health support, our child life specialists I see here today.

These are all integral members of our multidisciplinary trauma team, which includes a huge number of represented staff.

I can't take care of these patients without all of the allies in that bottom left box.

Okay, so it's not just the doctors, it's not just the ER, it's the whole team to keep the trauma center moving forward and to keep the trauma center to have optimal outcomes.

So we'll talk a little bit about some of these support programs that are essential that we want to expand with some of these dollars.

The current state of our trauma center, Dr.

Holmes mentioned we took care of a hundred of 1400 trauma patients last year.

Um we are the designated trauma receiving center for children under 15 and home.

Ambulance picks up a kid, 14 and under, they will bring her to us.

Unless the child is like Alex, who will not survive the drive to our center and they will stop at the closest hospital first to get that reading tube put in and get blood started and then get transferred to us for those life savings.

But more than our local impacts, we have huge regional impacts.

66% of our patients come from another hospital, an interfacility transfer.

You saw that map that was put up earlier about the various traumas.

There's only seven level one ACS verified trauma centers in the whole state, and only three in Northern California.

So we have a huge catchment area of patients, 18 and under, we admit, from Fresno all the way up to Oregon, and we say all the way to Salt Lake City.

These are the most severely injured, critically injured patients, and they come to us because the referring centers know that our trauma center can take care of these injuries.

Dr.

Zoltanski mentioned earlier that it seems like we're busy because we take care of a lot of patients.

We take care of 1,400 patients a year, which is pretty busy for a pediatric trauma center.

But an adult trauma center, of which there are four others in Alameda County, their numbers are a lot higher.

They take care of a lot more patients and a lot more patients with very severe injuries.

Despite this, we have to maintain readiness 24 7 365.

We have to always be ready because we don't know when these injuries are going to occur, and we don't know when these patients are.

We can see how it could be a challenge to maintain readiness with a much fewer number of patients, not only to spread the costs across, but also to maintain provider skill sets, right?

Because there's less patients for us.

And if we look at the kids like Alex, the kids who need an operation within 30 minutes to save their lives, those are even more rare.

About 50 per year come through our ED.

But these are the kids who need us most, and these are the kids whose lives we can save.

But we're talking about once a week, our trauma team has to resuscitate somebody with truly life threatening, like they will die within 30 minutes.

And those are the kids that we really need to focus our efforts on because these are lives saved.

Okay.

And I'm also going to put in a little bit of evidence that we've generated some of the research that we've done at the Oakland Children's Hospital that supports the need for these measures.

I won't go into detail too much into that, but I will show you that many of these interventions are still.

The first I want to talk about is multidisciplinary simulation-based team.

One of the things that we recognize is a need for training of our staff.

Talk to many of you guys on the sidewalk about this outside.

And let's go back to the case of Alex.

Okay, so Alex is now being transferred from the level two trauma center to our pediatric trauma center, and Alex is in the ambulance, and they are giving blood in the ambulance because his blood pressure is still low.

We think he has a traumatic brain injury.

He'll be at our center in about 10 minutes, pretty quick.

Fortunately, we have a team assembled and ready in the emergency department.

Because we know Alex needs rapid stabilization, and he probably needs to get to the operating room really quickly to stop bleeding and address his traumatic brain injury.

So, how do we make sure that this team who maybe does one of these really high-stakes resuscitations once a week is ready every single time one of these patients come in?

And if we look at our team, we use a 12-member resuscitation team in our trauma center.

The top six are nurses and doctors and technicians who work in the ED every day together.

The bottom six are specialists that come from other areas of the house.

Surgeons, physiologists, pharmacists, and these 12 people have to come together and work in a cohesive led team in order to save a life.

We have a hundred and ninety potential people that can fill these 12 roles.

So you can see that there's infinite combinations of people that might make up this team.

But the team has to function as one team.

And again, I'll highlight that many of the people on this team are doctors.

These are our represented staff.

These are nurses, they're x-ray technologists, they're pharmacists, they're therapists.

It takes the whole team.

And how do we make sure that the whole team of highly skilled individual providers knows how to work together to save Alex's life?

When Alex comes into the ED or any patient for that matter, they come in, we may suspect bleeding or severe traumatic brain injury.

We have to get a breathing tube in.

In this case, it was already done at another hospital.

But just getting that breathing tube in requires an airway doctor, a respiratory therapist, a pharmacist, and a nurse to make sure that the medicines, the medicines go in and that the ventilator is ready.

And while the airway doctor is doing that, the surgeon is trying to figure out is there bleeding, is there not bleeding?

Let's get some blood, let's give some medicines to protect the brain.

All the while thinking about is this patient stable to get a CAT scan, or do we need to go directly to the operating room to stop them?

All of this has to happen rapidly, otherwise, patients don't survive.

And all of these we call these resuscitation processes.

They have to happen in a tightly organized fashion, quickly.

And this requires leadership, it requires teamwork, it requires communication and planning ahead for the next step.

So how do we maintain these team skills with one severe resuscitation a week?

Well, research out of our center has shown that trauma centers that use simulation based training have higher survival rates.

They also tell us that their staff has lower levels of anxiety when taking care of these patients in the trauma they have higher levels of confidence, and they perceive that the quality of care is better.

So we've shown that the use of multidisciplinary simulation-based training improves outcomes for kids and also improves the provider confidence.

This is our team.

We do simulation currently in our hospital.

They're interacting with the simulator.

This is our multidisciplinary team.

You can see a respiratory therapist, a couple nurses, a resident, one of our physician assistants, all working together in a simulated patient resuscitation so they can learn those team skills to learn to work better together so that with the next patient who comes in, like Alex, we have a seamless resuscitation.

Currently, with our simulators, we're able to do this once every month or two.

We need more equipment and more staff and more human resource in order to support moving this forward so that we can do frequent simulation-based training.

We really like to do this several times a month, and we are measuring our team performance as we use.

So a real significant investment in developing the skill sets of our specialized staff.

Next thing we'll get into is when Alex showed up in the emergency room that day.

Alex showed up, they recognized that he was bleeding, he rapidly got blood from the department.

He got medicines to protect the brain from that brain injury.

He got medicines to stop bleeding.

But the team recognized that he needed to be in the operating room and he needed to be there quickly because he had bleeding internally.

And you can see all of the specialists at the bottom of the screen, two trauma surgeons, two orthopedic surgeons, a neurosurgeon, two board-certified pediatric anesthesiologists, and an interventional radiologist.

This team of doctors and all of the nurses and therapists and x-ray tech in the room that they saved Alex's life.

And this is what it takes to save these children with the most critical of injuries.

And you'll notice that I put down their interventional radiology.

Dr.

Lamb is in the middle at the bottom of that slide.

And what interventional radiology is a way to stop bleeding without incisions.

We know that bleeding is the leading cause of preventable death.

If you can stop the bleeding, you save a life.

Interventional radiology is a technique where we access usually the artery and the groin, the femoral artery, with a needle and a it looks like a straw, that white straw, we call that a sheath.

And we can pass wires and catheters and things to stop bleeding up through the artery without making any incisions to stop bleeding from the inside of the vessel rather than doing big surgeries and stopping it from the outside of the vessel.

So this is a much more modern way to do hemorrhage control.

But it requires a full-time support team.

24-7, 365 call team of a nurse, an angiotech, a radiology tech available all the time.

So it's not just the doctor, and it's not just the technology, it's the team behind it.

So, this is an example of the whole program that we're investing in, the whole program that we're expanding services in.

We need to upgrade our equipment.

Our current equipment, we can only see one radiologists can do way more procedures if they have the ability to see in two projections at the same time.

That's called biplanar angiography.

So this particular project is designed to help our radiologists stop bleeding.

On the right on the right, you see that black stuff.

That's that's bleeding from the vessel on the bottom.

When they inject the dye, there's a little coil in the middle, the bleeding is stopped.

All through a puncture in the groin, not a big surgery.

Okay.

So this particular project is really aimed at providing a state of the art interventional radiology suite with biplanar imaging and also ensuring optimal coverage with specialists and support staff to run a comprehensive program to expand these services on our Oakland drum essentially.

Our key performance indicators are to decle decrease declinations.

So we do get patients who are referred to our center that we sometimes have to say no to because we don't have the ability to do some of these complex neurointerventional procedures.

We don't want to say no.

We want to take all these kids.

We want to maintain how quickly we're able to get kids to intervention, and this is measured by surgeons.

And as we start to do more and more new procedures, we will continue to attract these quality metrics to make sure that we meet.

So Alex survived the injuries, and we know that there are a number of social drivers of health that impact recovery.

And if we look specifically at Alex's case, who's now recovering in the hospital, I didn't tell you this earlier.

Alex has a parent with a restraining order in place.

The caregiver who was driving the car, there were some circumstances around that crash that led to that caregiver having custody removed as well.

So we now have a little kid in the hospital who underwent 11 surgeries, spent 37 days in the ICU and 35 days in our rehab unit without their home social support.

That's a problem, but it's not just Alex.

This is a lot of our trauma is a disease or an injury is disproportionately occurring in patients who don't have the same levels of support.

This is a typical trauma patient for us.

And we need to do better.

We need to have dedicated social workers that can meet the needs of these injured kids.

So we plan to move forward with use of these funds to implement a pediatric trauma-specific social services program, a program that will meet the needs of these particular families that will focus on these families.

We know that substance abuse is very high, particularly in the teenagers in this population.

But we know that acute stress disorder, if it's untreated, that can lead to PTSD.

So screening for acute stress disorder in the hospital and making early referral to community-based partners to get that cognitive behavioral therapy that kids need so that we can decrease the long formicity.

We're trying to make sure that we get 80% of our kids screened and 80% of our kids screened for acute stress disorder with provision of psychiatric first aid and referral to mental health resources after discharge.

These are real needs that my patients have.

We're meeting these needs with the expansion of social services for injured kids at the trauma center.

Wound nostalgia incontinence nurse.

So this is a nurse specialist, right?

Who can help us not only heal wounds but prevent wounds?

Again, I'll go back to Alex's case.

So Alex is recovering from injuries.

On the legs, you see those bars, they look like an erector set.

Those are called external fixation devices.

With kids with severe unstable injuries, we often have to use this form of fixation.

And we often have to leave a collar on their neck until we're sure that they don't have any broken bones or weeds in the neck.

We've done some research that I've shown on the right that really shows that it's these devices that lead to hospital acquired predictor injuries or bed source in kids.

And we are really trying to make these never happen.

Unfortunately, these devices and immobilization are the biggest driver of this.

So how can we prevent these injuries from happening?

And that's what the wound ostomy incontinence nurse.

These are nurse specialists who have expertise in preventing pressure injuries, particularly those around devices.

But also they can help us promote faster healing of wounds that these kids have.

And finally, sometimes kids have to go home with a colostomy, usually temporary, but sometimes they do.

And these particular wound ostomy incontinence nurses can help train those families and prepare them for life with a colostomy even in time.

So again, focusing on the patient, focusing on needs of the patient with a nurse specialist that can help decrease health care.

Comprehensive surgical specialist coverage.

So I showed you all of the surgeons, the pediatric board-certified surgeons that took care of Alex that day.

But we are starting to see more and more teenagers are getting bigger.

Anybody disagree?

Teenagers are getting bigger.

And we're seeing adult pattern injuries.

Injuries that we used to only see in adults, not in kids, and we're seeing them more and more frequently in kids.

And we have to have specialists that know how to fix those injuries because they don't happen in kids very rarely or very often.

But Dr.

Zoltanski said earlier is some of these things are really rare, but really, really high stakes and delays can lead to complications.

And we want to make sure that we have comprehensive coverage for these injuries.

Not only else, this by a story, this is Marcos.

So Marcos was surfing in the Pacific Ocean.

Unclear what happened, but his buddy saw him wash up on the shore, not moving his arms and legs and not.

They started CPR, they called 911, and the aircraft transported him from the scene, flew over a bunch of other adult hospitals and landed on our helipad with this patient.

He was met in our trauma center by that multidisciplinary team who got the breathing tube in, who gave him medicines, got him rapidly to the CAT scanner to diagnose a broken neck, and then rapidly to the MRI that showed that there's actually injury to his spinal cord associated with that.

Dr.

Sun is one of our pediatric nurse surgeons.

He decompressed the pressure on the spinal cord and he fixed the neck so that it didn't move anymore.

Guys, that's a picture of Marcos kicking a soccer ball.

He came in not being able to move his legs, and he's now kicking a soccer ball.

It takes surgical specialists that know how to fix these really rare injuries to get remarkable outarms like this.

So we're looking to invest in adult pattern surgical specialists to fix injuries like Marcos, and so that we have 24-7, 365 coverage any day of the week we can take care of these.

Vascular and endovascular surgery, comprehensive spine surgery, and orthopedic traumatology are the first three that we're going to address.

We're looking again to decrease declinations.

We get referrals of some patients that have injuries that sometimes we don't have a specialist available to fix.

We don't want to say no.

We want to say yes to every single child.

And we want to improve the time it takes to get that surgical intervention because of availability of these surgical specialists.

And I'll wrap up with this.

So we talked about how perhaps Alex's injuries could have been prevented with a car seat or proper restraints.

There are many other injuries that could be prevented.

But if we look at the number one injury-related killer of kids in our country these days, is firearms.

And I don't have to tell you Alameda County has one of the highest rates of firearm violence in the state.

A lot of people focus on this graph.

This published in New England Journal, and they look at just at the orange line of firearm injuries going up.

But you're missing the more important part of the story.

And I want you to look at that blue line.

That blue line is death from car crashes.

Look at all the progress we've made over the last two decades in death from cars.

This is car seats, this is safer cars, this is safe driving practices.

This is a public health approach to injury prevention, and we need to do the same thing with firearm-related injury.

We have to get that orange curve going down, not continuing to go up.

And we know that the biggest predictor of firearm injury is previous firearm injury.

So these kids who come in that are injured by gun violence, if we don't break the cycle of violence, they're gonna go out and they're gonna get shot again, or somebody else is gonna get shot.

So, how do we fix this problem?

So in 2023, we got a grant from the state of California from the CalVIP, the violence intervention program, to hire a hospital-based violence intervention program closing, Billy Bs.

The first year that Billy was with us, he more than doubled our referrals to community-based partners for violence.

We know that firearm violence is heavily impacted by social drivers of health.

We know that getting them stable housing, we know that getting kids stable access to food back in schools, a lot of these social drivers can decrease firearm injury rates.

We had a problem connecting our inpatients with the outpatient community-based organizations.

Billy has filled this gap.

He meets the kids in the hospital, and he makes connections with many of our partners in the communities.

And all of these connections are leading to decreases in re-injury rates, secondary to firearms.

So we're happy to say that we know we had a two-year grant, and this measure C funding is allowing us to extend Billy's tenure and making this a permanent in our trauma program so that he can continue doing the amazing working cars, decreasing firearm injury, reinjury in kids.

The key performance indicator we're monitoring here is to maintain high levels of enrollment of these at-risk youth into the um community based support services I talked a lot about Alex and what our trauma center does for kids in our community and our region I've talked about we take care of a lot of injuries but we do have some areas that we can expand services.

And with expansion of these specialties it also comes with expansion of represented staff it comes with expansion of the care that our kids can has the halo effect throughout the rest of the hospital.

And finally we're focusing on keeping our kids safe keeping them from getting reinjured with our violence intervention program and ongoing I really again I'm I'm really honored to have Garage Center today.

And we're very appreciative to supervisors by 10 for this privilege.

Thank you.

Thank you.

Any other okay thank you for the presentation learned quite a bit that I didn't know before yeah I know a lot.

Well supervised Jim do you have any questions comments?

I just have a couple um thank you very much for that presentation we all are in complete agreement that children's hospital is a critical facility in our region and you've done great work.

I I did want to follow up on one of the slides that you added uh since we last met last week um so last year we talked about five percent of the funds in the pediatric health account would go toward staffing and training and um we were hearing from um many of the line staff especially with the expansion of mental health care needs and and treatment at Children's hospital that uh you mentioned that sometimes kids are bigger than we see them now and some of the line staff feel a safety issue in terms of um working and intervening uh as the first line of of contact with somebody that has a psychosis or mental health care problem before bringing in the psychiatrist to do the assessment and trying to get the proper training making sure that um while they get training there's adequate staffing has that issue been addressed in that um five percent staffing so I think in the number is five percent we're working on the programs now that all hasn't been allocated so we don't have a final accounting of that but I think to your point we're all worried about mental health that is a national trend that everyone myself included every physician every doctor nurse security behavioral health and one of the things that we do great at children's hospital of Oakland is our behavioral health and so when we work on that investment we're also in our new hospital building um building I think unlike most other hospitals building inpatient beds and so that training that support we have a behavioral health intervention team that colleagues from across the country reach out to to learn more and so we work on that that's not only something that we need but that's what we want is our pride point.

So certainly a point of investment for us now but I think also what we see is our future at children's hospital Oakland.

Okay.

Uh so this is still uh forthcoming yes so we don't have the final accounting but I think in in that we talked about um it is around the focus of it when we brought that committee together we said everything we do we want to have training we want investment in our people there's hiring that goes with it but also the people that are there we want to invest in the training around that um and bringing in latest state of the art equipment and then expanding the programming measurable that has measurable results like the violence intervention.

This was around the time I think that there was some talk about uh hiring freezes at uh UCSF Benefop and and how that was dovetailing with uh the training and the staffing.

Has that all been so if you look at the number of individuals that we've hired in the last two years, even despite the cross-board to write University of California did put in a hiring freeze, but it was very specific, right?

And so there are certain exceptions and so there's credit for patients.

We still continue to hire through that hiring freeze and set, still continue to get it.

I appreciate that.

Um, so you know that we also at the county are joined with the Alameda Health Systems that run the three major hospitals here, and we're in the middle of trying to plan for uh HR1 that you mentioned earlier, and the potential reductions in force.

Is that something that you anticipate uh going forward?

Uh, but there's some installation that you have because you have IGT funding because of uh the UC uh affiliations.

Do you expect to see um some issues with reductions in force because of HR one?

So we've done multiple different types of scenario planning.

Uh our goal is to make sure that we continue to have the programs available, and with programs you need people, so we're doing everything we can to not be in that situation again.

Um, we've made significant strides uh to make sure that we're getting maximum efficiency cost savings from other things, particularly supplies and other things that are non-people.

And uh we've actually done a really good job this past year in the anticipation of that.

So a greater threat for us in addition to HR one is a thing called the provider fee, and that's an additional supplemental fund that we receive.

And so there's a very specific call the children's hospital class for supplemental funds for the seven children's hospitals in the state, and um part of that is that it has to have parity with the uh provider fee programs, which and so it's children's hospital because disproportionately take care of uh much more of the Medicaid population.

Um we're gonna end up getting a reduction in that.

So it's still underway, whether CMS is going to enforce that.

They said it has to be by 2028, um, that there will be some significant reductions.

So our goal is to try to maintain as many programs as we possibly can.

And it's been we'll have to find other ways, and that's why measure C funds is is incredibly important because we didn't have that, we wouldn't be able to continue to do some of the things that we want.

We know that we have to do to keep our covenant with the community.

I appreciate that.

We're we're just I mean, the county's working through figuring out how to backfill some of the cuts that we're going to be seeing with HR one with some of these other measures.

Are you planning that with measure C as well?

That's obviously in a yeah, so we're yeah, we're focused on making sure that we maintain our designation because the kids don't have anywhere else to go.

So they're not going to be able to get that very specialized care that can be absolutely life-saving.

So we're focused on making sure that we have all those resources available.

Okay, thank you.

Right.

So we have how many speakers are how many speakers in the virtual eighteen speakers in the room, and then I have currently one speaker online.

So anybody wants to speak on the training facility or online virtually, if you would raise your hand.

So let's give the speakers a moment, let's give them two minutes to speak.

Two minutes.

Anyone want to say there?

No, I don't know.

You can speak from this.

So the new for me.

I have no idea I was gonna, but um, here I go.

Uh hi, Supervisor Miley and Supervisor Tam.

My name is Susan Remold.

I'm an eight-year retiree from children's hospital after a third-year career.

I managed many of the community benefit programs for many years, as well as under Dr.

Lubin's vision, was part of the creation of the Center for Community Health Mediation.

And I think there's a bit of confusion on the intent on the intent of this legislation.

When I was canvassing for Measure C, I understood its intent to be to improve accessibility, availability, and effectiveness of health care services for Alameda County's children.

No one's arguing that stellar trauma care is not crucial in the East Bay, but so is investing in the full health of children in East Bay.

That includes balancing high-end interventions with prevention and wraparound services that meet the needs of LED.

Across Alameda County, families are facing deep cuts to health care and critical wraparound services.

At the exact moment their needs are growing, rising costs, housing instability, and food insecurity are pushing families to the edge.

When preventative supports are cut, children end up sicker, emergency rooms become the default point of care, and preventable trauma becomes more widespread and more costly.

As UCSF continues to expand pediatric services in the East Bay, it's essential that this growth reflects the realities of Alameda County.

We cannot simply replicate the San Francisco model and assume it will meet the needs of this community.

Equity demands that we protect and sustain the hospital-based services and the wraparound programs that have long supported families here in the East Bay.

In the slides, it says that 22 million has been mentioned to support community health.

And I worked on the community benefit report for many years, and I think it would help all of us if we could get a breakdown of what that 22 million is.

So I would say we're respectfully on the UCF, UCSF widen their perspective on the use of these critical funds.

Thank you.

And then Martha, because we have a lot of speakers, if everybody could try to keep the helpful so we can hear everybody.

Erica Garner and then Martha.

Okay.

So yeah, Erica Garner.

Erica is not here.

Okay.

Martha.

Yes.

Hi.

Hi, everybody.

I'm Martha Cruel, and I'm a vice president of the Alameda Labor Council and a member of CNA.

And I've been in RN for over 45 years.

And 40 of those years, I worked at Children's Oakland, caring for sick and eating children, and then specialized in children with cancer and other chronic diseases of the bud, like sickle cell and thalassemia.

I have a short message this morning that is a warning to all here.

UCSF Health cannot be trusted.

So whatever is decided, and I don't dispute that we do great care, Mitchell, but whatever is decided, there must be a mechanism to hold UCSF Health accountable for the use of the funds.

I say this because UCS Health decided to break the workers' union contracts.

They unilaterally.

Then they imposed contracts with lesser rights.

And even then they failed to comply with what has been voted.

This has caused great harm to so many workers and our families.

The working conditions have deteriorated.

But more importantly, this working conditions are always the basis on which workers are able to provide quality patient care.

Without this, patients do not get the best possible career.

So whatever is decided, in imperative that there be a mechanism where UCSF is held accountable and supervised all the way.

And the way to do that, and what we have been asking for is that they are required to work with the workers chosen by the workers and the workers' chosen's representatives.

Thank you, Rita.

Okay.

I'm waiting.

Okay.

You don't have to get up.

Okay, can you guys hear me?

Because it's going to be hard for me to get up?

Anyway, my name is Melanie Davis.

I'm a community activist, he's west and North Oakland, North Open.

I'm just going to make much short as possible.

Um I'm I'm always, I'm glad that you guys doing what you't want to do it.

We had a misunderstanding because I walked for measure C.

And now seeing something different about the hospital part.

I don't have a problem to hospital, but you guys need to help us understand what's really going on because I walked.

Now you see me on the K.

Okay, so I would never forget that.

But let me address two things real quick.

On this local hiring, I have a big problem.

That 25% local hire go for city of Oakland residents.

No, if you talk about having people working, it's keeping them off the streets, keeping them guns up their hands, the robberies that's going on because they don't have jobs.

I would like for you guys to uh put like 35% on that, and then when you say local hiring for Alameda and Contra Casa County, I mean people from everywhere go.

We gotta have at least six.

Sorry, y'all.

I said the West Resource Center is not being uh represented.

Anybody from Mr.

Cobb people in here?

So you don't even have a see this is what I was saying with the communication.

You don't even have none of these people here.

West Oakland Tower Resource Center, where they people have anybody in here for uh representing instruction trade workforce.

That isn't what I'm talking about, y'all.

See the the language here.

Come on now.

If you go put these people's name in here, where they at?

They're not here, okay.

So next watch, I want you to know that.

So you tell your friend, all copy.

Yes, today.

That's a lot of money.

Uh oh.

Am I supposed to be a good thing?

Good morning.

My name is Brianna Wallace.

I'm a district three resident, a parent leader with parent voice in Oakland, and a board member of the Measure C Community Advisory Council.

I'm also a parent whose child receives care at Oakland's children's hospital.

A chunk of the measure C dollars was specifically dedicated to ensure funding for Oakland's children's hospital, protecting local pediatric care, specifically services such as sickle cell and black maternal health.

The promise was pretty clear.

Keep these vital services in open, not shift them away.

Contradicting Measure C's intent.

This integration could weaken the hospital's independence and move essential care out of the community.

Measure C emphasized transparency, accountability, and community involvement to prevent exactly this kind of shift.

As a parent and community member, more specifically a member of the council.

It's vital to honor Measure C's promise and keep these services local.

In conclusion, let's ensure that Oakland Children's Hospital remains a strong independent pillar of our community.

And let's keep the services here and honor Measure C's language by truly listening to and involving our community in these decisions as the ordinance has stated.

Thank you.

Umberto Rosana Ryan Villardi.

My name is Umberto Rentana.

For the past 13 years, I want to take a psychotherapist.

I couldn't have cool.

Specifically, I work insured by Medica?

We treat a clinic called psychological services.

These are youth ages six to 20 years old.

Yes, the teenagers keep getting older and older and everybody bigger.

Uh be that as it may.

We specialize in moderate to severe acuity.

Many of the youth we treat, regardless of presenting concern, also burned by significant trauma.

It could be medical trauma, certainly, but not all traumas are medical.

Say the obvious.

In the main, the youth we treat come from uh African American Latino households, typically headed by heroic single mothers working tirelessly for the well-being of their children.

These families already carry disproportionate cultural and economic burdens, which tend to fall heaviest on the youth.

COVID and its aftermath have piled on burdens to which the current Trump regime has only had it.

I have chosen to serve these youth and respective families as I believe that justice demands that we care for those most in need first.

This has ethic also informed my guest vote on measure C and my canvassing for its adoption.

While serving justice gratifies the most fulfilling still is the opportunity to make direct contributions to the lives.

Sir, adding to the sense of fulfillment is research findings that mental health services make the biggest difference precisely with said population.

Now I want to raise some questions uh as to how venture sea money is being spent by UCSF.

I noted earlier that I work in a clinic called Psychological Services.

We are five frontline clinicians down from a high of 13.

The last open position was filled approximately two years ago.

And that's about nine months of encumbrances.

Meanwhile, the number of frontline personnel have steadily declined.

Furthermore, since the last hire, UCSF imposed a higher increase.

According to my colleagues who handle reports, according to my colleague who handled referrals for the clinic, short staffing has resulted in turning away many referrals.

This means that the great number of youth are not being served.

While some may improve as a function of time and circumstance, many likely worsen while waiting for service openings.

In the past six to nine months, my colleagues and I have noticed that youth building openings seem to worsen uh condition.

This translates into heavier clinical burden.

More direct terms frontline staff is feeling more depleted.

The quality of service offering naturally diminishes of extra cycle average.

Ryan and then I'm just kidding, if people call it 9, just taking time from others who might so try to keep it in two minutes.

So we can hear everybody.

Okay.

Hi, my name's Ryan Bellorty.

Uh, with clinical labor, uh, with the at Children's Hospital.

Um, dear members of the board, I have had the privilege of working in the laboratory at Children's Hospital over nearly 10 years.

The work we do provides critical diagnostic information for patients facing serious illnesses, including leukemia and lymphoma.

I have had uh since transitioning to GCSO, the laboratory has faced mountain risks to its capacity for essential local testing, despite staff communication.

To the ER with a life-threatening condition.

Thanks to our locally available testing and rapid turnaround, you're able to cause and initiate treatment promptly without the necessary equipment and resources.

Yes, patients were good.

Measure C funds belong to this community, not to a corporate campus campus in San Francisco.

To protect my colleagues and our patients, I'm asking for two things.

One, a quarterly oversight, quarterly oversight meetings where county supervisors or their staff sits in labor and management to audit exactly how every measure is spent.

Yeah.

Two, a detailed proposal from UC on the use of least funds to address staffing shortages and open and preserve current laboratory testing at Children's Hospital.

Thank you.

Hi, Chair and then Allegrian, and then Judy Cavasos.

Hi, I'm Taisha Allen.

I'm a parent.

I'm a mother of four.

Um, I'm with a parent boys in Oakland, I'm an advocate.

Um I was uh recently made a sea of essential in helping families and community members to stand and meaningfully engage.

And as a parent and advocate, I'm a mother of four.

My daughter, she went to children's hospital, and she received care at the trauma center.

She had the doctor uh Pamela Sims Mackey.

I really love children's hospital.

I attest the fact that uh we were able to walk there, it was convenient.

So I feel that you guys should keep it open.

I can't visit Measure C alongside my children.

So I'm encouraged, encouraging them to do what is right and to speak up for what is right.

So I just wanted to think thank you guys for hearing me out and understanding that we're here for the better grade of Oakland, and we want to see um more transparency as how we can get involved.

Thankfully.

Good morning, everybody.

I'm a ladyman from the National Union of Healthcare Workers.

Um, I want to start off by saying, first of all, the hiring phrase from UC.

There was a hiring freeze at Show prior to the to the integration at UC.

So I don't want uh supervisor to you to think that that just happened because of the integration.

There was a hiring freeze prior to that that was put in place by UC.

Um, Dr.

Holmes, it's very nice to meet you.

Our members have been looking forward to trying to meet you for quite some time and have not been able to do so, probably from the advice of your community advisory uh committee that has let you all probably advise me not to meet with labor, which is a shame because these people do the work on the ground.

Um, it is said in your presentation that traumas probably come to the hospital one day a week.

What happens the other six days?

These people fill in those other six days.

It is also said that the presentation about traumas, yes, there are tons of traumas that come to kill by these corporatized hospitals that have shut down in other communities and other counties bringing their hospitals to us because we are the last standing ones because of the people in this room.

We are standing 10 toes down for our hospital.

That being said, the pick new.

There are two nurses and two social workers that help families that are dealing with traumas that are downgraded.

There are two people now that started, I believe, somewhere at eight of eleven.

So, how are these kids that are downgraded from trauma supposed to then go home?

And there's nobody there to help them do so.

That being said, we are in the reality of what is going on on the ground.

Each of them should have met with labor.

It was part of the measure, and you refuse to do so.

And then once the the unlawful integration happened, you brought our members to a table to where you spoke at them, didn't you speak?

You did not speak with them.

They're members of this community, and they deserve more respect than that.

Um, I will say also too, um, all the good things that the doctor has presented.

What are the community sidebars?

They presented giving out helmets and giving out lights and things.

Who's supposed to do that?

Staff.

If you don't have staffing, who was supposed to take care of that?

Also being said, too, a case she missed it there, been numerous strikes at Cho based on low staffing.

What are you all gonna do with it?

You can't go from the top down.

You need to reinforce your foundation with whack that mechanism.

Marissa Schwever Corinne.

Good morning.

My name is Judy Cavasmas.

I'm psychologist with our PCRC.

I'm a neurocognitive writer for kids who have rare neurotarian diseases, as well as working with simple cell patients.

I'm reading this on behalf of a colleague because she's not able to be here.

Um, I'm her DM for clinician in the emergency department at Children's Hospital Oakland.

BERT stands for Behavior Emergency Response Team, which by the way, I was also there for eight years, and I reside in July.

The BERT team completes 5150 evaluations in the emergency department and responds to behavioral crises on the medical units.

I've been a BERT clinician for the past five years.

This span of time includes both pre and post-UCSF transition, which began in July of 2025.

I absolutely love the work that I do in patient family care.

I get a real sense of fulfillment through the difference.

I'm making as high-intensity crisis work.

Additionally, I love working with per diem, the flexibility and the autonomy that comes with it.

This contributes to my work life balance, which includes fostering self-care, essential for reducing burnout, given that I have a full-time job elsewhere at a school locally.

While recognizing that being a BRIC clinician is high intensity work, the intensity has only increased through the negative impact felt by our team leading up to and since the transition from children's to UCSL.

This hydrogen has also been detrimental to our patients.

Concerning transitions related changing to per DM staff, we no longer receive fair and equitable pay for picking backup shifts.

As a result, this has created a situation where backup shifts aren't being picked up.

No one wants to commit to working an eight to 10-hour shift with a huge decrease in pay.

This leaves a primary clinician who is now without a backup clinician to triage patients coming into the emergency services with behavioral concerns.

In turn, this results in patients not being seen in a timely manner and places the attendings, residents are in sitters, and security in higher risk or stressful situations.

Further, time spent with the patients' family is rushed.

The hiring freeze quite literally has created huge gaps of lack of coverage, which means shifts can go by before patients are evaluated and treated.

I've also observed an impact at the UC hiring freeze on clinicians in terms of not having enough to provide proper uh time and thoroughwritten handoffs to oncoming staff because of this organized paperwork resulting in the admission of important details.

Other negative impacts effects include calling out work, incomplete work, and the pressure that's about to sit, all of which has reduced team morale, including burnout, and finally had multiple recognition.

That's your time.

Thank you.

Thank you.

Hi, my name is Marissa Schwaber-Corrin.

I'm a proud Oakland resident, and I work as a social worker at Children's Hospital Oakland, where I've been employed for 4.5 years.

I'm I'm speaking in collaboration with my teammates on the Oakland Hematology, Oncology, and Bone Marrow Transplant Social Work Team.

Recently, many life-saving services that were previously offered to our patients have been slashed, forcing East Bay families to now travel to San Francisco in order to undergo testing and treatment from their child's cancer and boys.

Examples of services slashed from the Oakland side include nuclear medicine scans, which provide images of the body's organs and image-guided biopsies, which enable providers to safely insert beetles into heart resources to test if a tissue sample is cancerous or infectious.

Further, UCSF recently cut staffing to our neurooncology and bone marrow transplant departments due to shifting prioritization of police services to San Francisco.

In major restructuring, children's hospital Oakland no longer provides bone marrow transplants at all.

Patients undergoing bone marrow transplants now must be admitted to San Francisco.

BMTs are lengthy, complicated and high-risk medical procedures that require around the clock care for a minimum of 100 days.

It's critical that caregivers actively participate in their child's inpatient care during bone marrow transplants because these critical first 100 days, patients are typically discharged, and caretaking responsibilities shift from the inpatient to the family.

Families must be able to provide complicated care, assess medical risk, and follow strict neural memory.

This means that East Bay families have to travel to San Francisco to be with their child throughout their lengthy hospitalization.

It also means that a discharge, children removed from San Francisco to Oakland, and this is done while the child does not have a functioning immune system and is an extremely vulnerable medical state.

Study after study demonstrates that increasing caretaker and patient stress have direct negative impacts on patient outcomes.

BMT is a high-risk procedure for patients already struggling with life-threatening diseases.

UCSF has provided no reasonable justification for cutting the service.

It's a service that has saved countless children's lives and is working well.

We know our East Bay families deserve better, and we ask you to help in getting our families the care they need.

Hi, I'm Julina Evangelista.

I'm a pharmacist that I've that has worked at Children's Hospital for 20 years.

I'm going to read a statement on behalf of Diana Katu Arena, who is a PICU nurse case manager.

Good afternoon, my name is Diana.

I'm a nurse case manager in the PICU at Children's Hospital Oakland.

My history with this unit goes back years.

I spent eight years at the bedside as a picking nurse before transitioning into my current role as a case manager 13 months ago.

I do this work because our hospital is a level one pediatric trauma center and the gold standard for the East Bay.

The nurses and doctors in my unit perform miracles every day, but right now we are being forced to work in a system that is systematically dismantled.

Since the takeover last July and the hiring freeze that began in March 2025, we've been dealing with a massive service drain.

To ESF, moving services to Mission Bay is just a line item.

To us, it is a moral injury, and to our patients and their families, it is a direct threat to their safety and their dignity.

Yes.

Let me show you what that looks like.

Recently, we cared for a 16-year-old trauma patient in the PQ.

He was brain dead.

He needed to confirm it for his family, but we couldn't do the standard the bedside test because the trauma was so severe that the there was brain matter that was literally oozing from his ear.

He needed an interventional radiology study to provide finality.

But because UCSF has moved those IR services across the bridge, we no longer do them in Oakland.

The administration actually suggested transferring the boys' body to San Francisco just to get this confirmation.

While we scrambled for hours to get a doctor to come over from the city, that family sat in the agon in an in an agonizing, unnecessary limbo.

That is not elite care.

That is a failure of our mission.

We warned management that shipping services would lead to this.

They didn't listen.

MedriC funds belong to this community, not to corporate campus in San Francisco to protect my colleagues and our patients.

I'm asking for two things: the quarterly oversight meetings and the detailed proposal from UC.

Our families shouldn't have to cross a bridge for digging.

Please hold UCS atomica.

Meggie?

Peggy Busher.

Hi, my name is Peggy Busher, and I'm grateful for this opportunity to speak with you about the utilization of Measure C funds.

I was honored to work as a social worker in community programs at Children's Hospital Oakland for 27 years before retiring in 2025.

Like many of our hospitals' community programs, these services are provided in families' homes.

Research has shown that home visiting programs improve outcomes for children and strengthen family resilience.

In spite of consistent support from the pediatric medical community for our program, funding has always been at risk.

Never has it been more at risk than it is now with Alameda County, a budget cut slowly.

I canvassed for the passage of Measure C six years ago now, believing that it could provide a solution to the funding issues that are shrunking community programs of desperately needed.

I was inspired by the voters that day who consistently assured me that they always vote for the kids.

I understand that UCSF wants to use Measure C funds for the new trauma center, which will undoubtedly provide life-saving care.

However, our existing community programs also provide life-saving care, and to lose them at this moment when our low-income and immigrant communities of color are under attack would be unconscionable.

Since the UCSF takeover began in 2014, UCSF has failed to understand that our communities and Alameda County have different needs than those of San Francisco.

Our communities need support in order to access medical care.

For example, many immigrant families are currently afraid to access care for their children, but will do so when they meet an interventionist.

Our community programs are currently providing these mental health services in place homes and our community can't afford to use vital services.

She writes, Measure C will provide approximately 24 to 39.

We appreciate the focus on staffing support, health care safety, and facility improvements that have been outlined for these dollars.

We agree that building a small, strong, well-resourced trauma center is critical for the children of Alameda County.

However, as frontline workers who work directly with patients every day and who are engaged with the community at large, we know our trauma center cannot stand alone.

Without asking throughout the hospital, equipment on the Oakland campus that matches what's available in San Francisco.

And sustained investment in community-based services, trauma care alone cannot deliver the outcomes our patients deserve.

The presentation from the hospital notes a 22 million dollar annual net surgery, and we respectfully request a clear breakdown of those funds.

Many essential programs in Oakland have long survived on grants with little direct hospital support.

Voters were clear.

These dollars were meant to support comprehensive high quality care for families in Alameda County.

We urge you to ensure Mesre C funds strengthen not only trauma services but hospital-wide staff.

Including aging facilities like the federally qualified health care centers known as primary care and the wraparound community services that help children heal, grow, and thrive.

Thank you.

Then Kane Bradley and Beverly Griffith.

And Joe.

Hi, my name's Angelica.

I've been a certified Charlie's mass for site in CF.

UCSF Benny Off Children's Hospital for the past six and a half years.

I'm assigned to provide childlife services in the emergency department, which is a 44-bed unit that serves more than 3,500 pediatric patients every month, over 42,000 children annually.

As a level one trauma center located in the heart of Oakland, California, our emergency department consistently sees high patient volumes, averaging 120 to 140 children per day.

Many of these patients are transported to us by helicopter or plane from distances, distant communities specifically to receive the high quality care our hospital promotes.

As a result, our patients, patient rooms, and waiting rooms are continuously busy, regardless of the time of the day.

Given the constant flow of patients throughout this unit, it's easy to imagine the immense stress, fear, and anxiety that accompany an emergency visit.

Children arrive at our doors after experiencing car accidents, severe burns, broken bones, lacerations, respiratory distress, new diagnoses of cancers or other such sorts, abuse and unsafe social situations, and countless of other traumatic events.

As a child aid specialist, I describe my role as a child development expert with a specialization in family systems and as a teacher.

My goal is to support children and their families through some of the most difficult moments of their lives by assessing psychosocial needs and ensuring their voices are heard.

On a daily basis, I select individual patients from an extensive census and meet them at the bedside to determine appropriate interventions.

Much of my work involves preparing children for medical procedures such as trauma exam, using developmentally appropriate language, creating personalized coping, helping me mandatory procedures and examinations more manageable for these children.

Providing diagnosis education as well as emotional and social support is central to my role.

Additionally, I also support caregivers and siblings during the most devastating circumstances anyone can imagine, including the death of a child.

As a psychosocial provider, my work serves as a reminder that we are caregivers, while physicians, nurses, respiratory therapists.

Yes.

I am reading on the top of one of our BERT clinicians.

She's actually the only full-time BERT clinician at children's hospital Oakland.

I am a mental health clinician with the BERT team at Children's Hospital in Oakland, working with youth and families in crisis to address mental health concerns because we're on 45 homicide behavioral dysregulation and psychosis grave disability.

It's my role to assess for safety risk as well as respond to behavioral escalations within the hospital.

If the youth is found to meet criteria for danger to sell for others, they require further evaluation and psychiatric hospitalization, which we manage from start to finish.

If, however, the youth does not meet criteria, we as a team create a robust safety plan with various community partners and referrals.

In addition, we respond to behavioral escalations across the hospital and are part of the team leading the interventions in order to de-escalate the situation of VP as the highest priority.

Since the UCSF merger, we have been experiencing structural and policy changes that impact our staffing.

Our team has lost the ability to sign up for extra shifts.

For example, any full-time exempt employee within the UC system were once able to work extra shifts where there were gaps in coverage.

Before the merger, experienced clinicians were able to sign up for back to uh for backup shifts and provide extra support and consultation to clinicians on site.

This position has since been eliminated, leaving one clinician per ship to cover the entire hospital without support.

This also created large gaps in coverage, particularly on the weekends and holidays.

As a result of all of these changes, we've lost at least six experience for being a clinicians.

Lower staffing numbers on site is problematic on a number of different fronts.

At times there is no coverage, and the ET is left without a clinician to respond to mental health crisis.

This has led to less efficient patient care, placed staff at higher risk of injury, contribute contributes to staff burnout and increases likelihood of mistakes being made.

UCSF leadership is aware of the problem and does nothing.

I'm not time.

I'm back again.

For those of us, I was raised and raised in North Oakland, South Berkeley.

So for those of us that were raised in that area, we all know that 10-point plan.

Voting was number 10 on that 10-point plan.

First, we had to make sure we established that we made sure our babies ate.

So we had lunch plans that actually made it all the way across the country.

Part of that plan was also to make sure there was a cure for sickle cell, which means that that quarry building that was donated by the Black Panthers was supposed to be utilized specifically.

It was for our community in our community.

We should not have, and I'm sorry, Dr.

Holmes, I'm gonna put this on you.

A brother should not be the person dismantling that plan.

Stop.

You have to be able to have some form of dignity within yourself that knows this area deserves better.

And what starts at Oakland sprinkles across the whole county.

And we have to make sure that we stand up for ourselves and our people here.

And anyone telling me not to speak with labor is not somebody from the Bay Area that has the gumption to fight for this.

We are here to fight for this.

We are here to fight for our kids.

We are here to make sure that they get what is necessary.

The people in this room are those that are here to fight for that reason.

So please take heed to what we are saying.

You have received, I don't know if all of you know, they received 182 million dollars last year to go into Cho.

Where is that money?

Where's the accounting?

What is it for?

You are getting $2 million per month to go into the hospital.

Where is that money going and how is it staying within the city of Oakland?

I have myself volunteered myself to be on the public health commission to make sure I can keep an eye on what you guys are going to go.

Because the county, the community needs to know what is happening.

We all need to get involved, and we all need to be able to hold you accountable.

That is the whole point of being here.

That is a whole point of fighting back.

There's a whole point of taking care of our babies that we show them how to be accountable, and we show you all how to be accountable as well.

Good morning, advisors.

Um, I see the faces of our leadership here, and I'm not sure how to register the expressions.

I'm not sure if it's disappointment of the realities that are being shared with you all here, um, or denial.

I heard some words that I actually used on the strike line during your presentation.

So something is telling me you are hearing, but please are you listening?

Here is my story.

My name is Triceda.

I'm an infant development specialist and community programmed home visitor who has worked at children's hospital for over 14 years, maybe more than the whole leadership team here.

My work is about helping families with young children who have developmental concerns and difficulties.

It has been my great honor and privilege to be working in service to these families who live across this wonderful county.

Well, over 10 years ago, when the affiliation was formalized, early intervention services was forced to sunset over a million dollars worth of grants and contracts within the community.

This loss of services meant an abrupt end to relationships, programming, and staffing that supported the early screening and mental health and development of young children.

I have grown used to the losses we've experienced under UCSF's management.

But in 2020, I had hope.

I learned of measure C, and I believed in it so much, I also canvassed for it.

As a result, I truly believe that this measure could help bridge the gap between what the community had lost as a result of the affiliation and what they deserved to have returned to them with the possibility of even more.

What I have learned that my hopes for what measure C could do for Cho was naive.

And now I feel frustrated and deceived.

In July of this past year, I along with one other employee were finally granted an opportunity to meet, but we were denied um a commitment to get the address the issues that we need to address.

I'm seeing my time.

What I want to mention here before I end is that UCSF is not understanding our community.

Chronic stress, toxic stress, is trauma too.

Where is the fight for this here?

Hello, my name is Alia Phelps.

I am the director of organizing at Parent Voices Oakland.

I'm a mom of six, born and raised here in Oakland.

Alameda County's past Measure C.

Expecting expanding access to quality and workforce support.

Services must remain here or it'll dismantle our community.

We must safeguard black maternal and infant health clinics like Bloom Clinic that are essential to addressing disparities and any service changes must protect black maternal and infant health.

We need you to commit to serving Alameda County families across all needs.

The communities that aren't even aware of these moves that you're making until they have an emergency, and that is wrong.

People plan their lives around access to this hospital and cannot afford and do not deserve to be surprised at vulnerable times.

Our county passed this measure.

Why are you all hiding from us?

Why aren't you reaching out and meeting to learn about what we need and not just making decisions for us?

Other bodies have been having community conversations regularly around Measure C funds.

It's activating leadership and voters.

And it's uh allowing folks to hear how we want our tax dollars spent.

We have three more in the room and four online.

Okay, and that's it.

Okay, Ruby Butler, Stacey Cummins, Gibriel, Gavin, real, Celebrill.

Ruby, here, okay.

Um, hi, my name is Ruby Butler.

I'm here with Parent Voices of Oakland.

I was born and raised in Oakland.

I'm 36 years old.

Children's Hospital is the only hospital I've known where you can get specialty services at.

Um, I'd like to say that there will be a number of services that families will lose because we don't have access to these services anywhere else.

Um, relocating or closing children's would have a huge negative effect on families, um, especially folks experiencing long-term or ongoing health care issues.

Um, for example, folks with sickle cell.

If we're moving the bone marrow transfusions, then what treatment or other options do they have?

Um, what else?

Oh, uh, also puts families in a dangerous position because with all of the services that are moved or we have to travel to, now we have a delay in care.

So I feel like this is not a choice.

It's a must that we keep children's hospital open and located in Oakland.

Thank you.

Good afternoon.

My name is Stacey Kemmins.

I've um been with Parent Voices since 2013.

I've worked with family uh Jewish family resource navigators for children with mental health, behavioral family uh community trauma.

I've worked with disabled children and families accessing resources.

I've marched this pavement with a severed leg trying to get measure C.

This is the second round I've gone through with this, trying to get this found uh access for our children.

Alameda County is very big.

We're not trying to put you guys or say that you're not doing it.

We know that you're doing good work.

We know that your intentions are well, but we need to keep what Measure C was specific about is right here in Alameda County.

Alameda County is huge.

We've got uh Castor Valley Hospital that receives the overflow from children's hospital with youth that are having uh behavioral and mental trauma, but they don't have family support.

Those resources need to reach other areas in our county to serve our children and our youth of Alameda County.

We go from Fremont to Livermore to Dublin to Newark.

We're huge.

If San Francisco wants resources, let them pay the pound the pavement like we did.

We are asking for stuff for our county.

Our children.

Stop putting us up under the carpet and give us our resources that we need, and we fought for the voters have made their decision.

It is Alameda County's families or nothing at all.

Alameda County's families, period.

They've they voted for it, they wanted it.

People are suffering.

If we're not going to keep the sort resources here, I have a friends whose child did have bone marrow uh trick cancer, having to go to San Francisco every time and then come back home, and the mom's stretching her legs, her bones to get to where that is that was hard for her.

Not just the child, but for the parents.

They're watching the children suffer.

And you're taking our resources away.

That's not what the vote was for.

My name is Libray Gavin.

I'm organizer of Oakland.

And we're basically said, major changes with very little clarity.

We told there are plans, but no concrete safeguards.

We know the hospital is already understaffed.

We know there are currently no clear systems in place to hire from the surrounding community.

What we're hearing today is a lot of what ifs and a lot of promises, and nothing set in stone.

That is not reassurance, that is uncertainty and uncertainty put lives at risk.

At the same time, children's hospital specialty departments are being moved to San Francisco.

This decision directly threatens the health and safety of children in Alameda County.

Families who already face barriers to care, transportation, time off work, and costs will not be pushed even further away from life savings services.

Delays in care for children are not just inconvenient, they can be deadly.

Using measure C funds in this way does not reflect the needs or the voice of this community.

More and more this feels like an investment in public health and more like a cash grab when that benefits corporate agents while leaving Oakland families to bear the consequences.

Residents of Oakland will not continue to allow corporations to wreak havoc on our communities, you know.

Oakland is a city made up of large black and brown families.

We know that diseases like sick of cell anemia disport disproportionately affect these communities, and children's hospital Oakland has been a little critical place for that care.

Moving specialty departments that treat these conditions feel like a punch in the face to the very people measures she was meant to serve.

And I also want to say this plainly the lack of visible emotion and concerns you hear the real situation staff has faced, many of them caused by UCFS, speaks volumes.

When stories of burnout, unsafe conditions, and harm are met with resilience and and indifference, it makes it plainfully clear that this conversation is being driven by money and not by care for the community or the people doing the work.

Also, let me be clear.

This community deserves transparency, accountability, and a plan that truly strengthens care in Oakland, not one that puts our children, families, and healthcare workers at greater risk.

Thank you.

Jackie, you're on the line.

You have two minutes.

Annie, you're on the line.

You have two minutes.

Annie Banks.

Hello.

My name is Annie Banks.

I am an organizer with Parent Voices Oakland.

And I'm a parent of small children living in district six.

A lot of what I wanted to say has already been so well said by everyone in the room here.

And I found myself brought to tears by some of the testimony from the staff at Children.

So I just really want to say thank you.

You know, I think about my four-year-old daughter who has asthma.

And will I have to take her all the way to San Francisco to get treatment?

Why should I when we have these funds that we fought so hard for?

Um I heard a lot today about machines and technology, but what I didn't hear was anything to address the concerns that staff have been raising.

We were out on the strike lines with the staff this summer.

We heard firsthand from staff uh just how the impacts were feeling to them, and we heard from our parents the deep concerns of what happens when the the staff are being uh mistreated.

Uh the staff who have been like family, many of the parents that we spoke to said, you know, treating their children, um, supporting them through some of the hardest times of their life.

Um, a hospital without staff is just a building.

So if we're not treating the staff properly, and we're cutting their benefits and we're moving programs away that East Bay families so desperately need, what are we doing?

These programs need to stay in Oakland and in Alameda County for East Bay families and to support our uh the the staff, our community members and our neighbors who give their time and put so much care into making sure that our East Bay families and children are safe and healthy.

So if we're not doing right by the staff and we're not keeping these critical programs like for sickle cell and black maternal health and the pulmonary clinics, they need to stay here so that East Bay families can get treated in the East Bay.

Thank you.

Tracy, you're on the line, you have two minutes.

Tracy.

Ruth, you're on the line, you have two minutes.

Thank you.

Can you hear me?

Yes.

Thank you.

My name is Ruth Crow.

I'm a licensed clinical social worker.

I've been working at Children's Hospital Oakland for 24 years.

Most of that time, 22 of it in the NICU, the neonatal intensive care unit.

I'm also an Alameda County resident.

I grew up in this community.

And I'm a mother of a child, actually an adult child with a chronic lifelong illness.

I want to share with you today that I'm really discouraged by the presentation I heard.

Not by the amazing services that we talk about in the work that actually frontline staff do, but by the conversation or the proclamation that there has been input from parents and families from frontline staff about how to use these Measure C funds.

This must be the best kept secret on at Children's Hospital Oakland because we have not been provided with any option or ability to give feedback.

People from outside of children's hospital Oakland cannot even refer anymore.

In audiology, children are waiting nine to ten months for hearing exams.

And the hiring freeze that was downplayed in the presentation is real.

We hear about it in our staff meeting every week.

While some positions have been thawed or able to be hired, there are many that have not.

What we're asking for is a quarterly labor management meeting so that we can have oversight as frontline staff and collaborate in how this measure C money is spent.

Thank you.

Jackie, can you unmute your phone?

Tracy, you're on the line, you have two minutes.

Tracy, we can't hear you.

That's all the speakers.

Okay, we want to clean the speakers.

So let me see if um a lot of heart-wrenching testimony.

Any response and a reply.

Well, I certainly appreciate everyone's feedback.

Absolutely, absolutely heart wrenching.

Um, many of the things that you all said are are very true.

The challenges that we have in health care exist today and will exist as we go forward.

You know, it's our commitment to continue to work with our frontline staff, work with the rest of our leadership team to help address some of those issues that you all brought up today.

Okay.

Unless you have questions, I'd like to go to the action item.

Okay.

So we'll take up the action item now and the informational item.

So what I'd like to know is measure C.

We have the intent of measure C wording.

I don't know if County Council's on or staff wants to provide that information.

Was there any opening for that?

Well, the dead board letters, I have the whole ordinance.

Very long.

I have to test it.

This is the survey.

So this is uh of the ordinance, section three purpose and intent in enacting this ordinance.

It is the purpose and intent of the people of the county of Alameda to ensure that Alameda County children receive the high quality early care and education and health care they need to be successful adults by one providing additional support for and to extend access to high quality child care preschool and early education services for low middle income children and families across Alameda County.

Two improve wages and compensation for participating child care providers and early educators to provide services under this ordinance so that they can earn at least $15 per hour.

Three, promoting wellness, kindergarten readiness, and school success, four providing additional support to maintain and protect local children's health care safety net, including the maintenance and expansion of specialized staff and facilities to treat complex illnesses and other health issues for children and young adults without regard to insurance status or their ability to pay.

Five, to provide additional support to keep open and fully staffed the local level one pediatric trauma center department in Alameda County to ensure the availability of critical care to all children and young adults in the East Bay and surrounding areas and six impose a 20-year transaction and use tax for the purposes of maintaining the local children's health care safety net, including the level one pediatric trauma center and providing child care preschool and early education services.

You're reading from the ordinance, right?

This is the ordinance, okay.

So the board letter.

I'm trying to find it.

Yeah, may I interject real quick why I think you need to basically because then if I let you do that, let everybody.

Okay.

Squinkled and uh get me down.

She has it, I also added right here.

What's the date on the board letter?

This was the April 1st board letter for the pediatric account.

April 1st, 2025.

For the pediatric account.

So this board letter comes with a series of recommendations.

The subject is to adopt an updated expenditure plan and oversight policy for the pediatric health care account of the children's health and child care initiative for Alameda County Measure C.

The letter recommends a series of actions and it's to clarify and direct allocation and expenditures related to measure C pediatric healthcare account.

I recommend, and this was Supervisor Miley as president of the board, following updated recommendations to be adopted.

A allocate 75% of the pediatric healthcare account, including escrow and annual revenue to UCSF Benioff Children's Hospital, Oakland through direct payments to keep open maintain up.

And to approve availability access and effectiveness of pediatric health care services for Alameda County residents.

B, allocate 20% of the pediatric sub-account, including escrow and annual revenue to AC Health to maintain and protect the availability and accessibility of pediatric safety net services in Alameda County and to explore the implant and implement innovative programs that enable pediatric and young adult parties and their family to better access pediatric health care services and they enhance the effectiveness of such services.

Allocate 5% of the pediatric health care account with the escrow and annual revenue to UCSF Benioff Children's Hospital Oakland through direct grant to specifically address in consultation with specialty provider representatives the following purposes.

A, address critical staffing shortages in specialty and subspecialty care, B, enhance comprehensive medical training programs, and C, acquire essential diagnostics equipment.

What amount's been allocated to children's day?

I'll give you the exact stuff on the record.

The county's distributed a hundred and thirty-nine million nine hundred and sixty-two thousand eight hundred and fifty two dollars to Benioff Children's Hospital.

Monthly distributions average approximately 2.5 million dollars, but vary due to sales tax volatility.

Understanding, at least my intent was always that children's hospital would meet with uh labor and their representatives to come up with uh a plan on how best to utilize the measure C funding in Alameda County.

Um maybe the board letter wasn't clear on that, but that was my intent and understanding at the time.

Um I don't think anyone's disputing the worthiness of a children's hospital.

You know, I was on the Oakland City Council in the 1990s.

I've been a resident of Oakland for many years, well, maybe four decades, and strength and shortages.

When I hear people talking about the lack of uh equipment and programs, but then I hear, you know, how you feel the funding should be utilized.

My interest is trying to get consensus and not have people feeling a certain way.

And I think from my hearing of this, it's not a perception, it's a reality.

Um, and maybe how the resources are being utilized might, and I'm saying it might be appropriate, but maybe they aren't.

But even if they are, I think it's important that we have the folks in Alameda County who worked hard on this measure, and I know a number of them, and then we are part of it as well.

I know a number of them.

If we're not meeting their expectations, then I think you're being disingenuous.

I really do.

So before I go any further, let me see if Supervisor Tab has any comments or questions that he's going to at least propose what I think we should do.

Go ahead.

Um, thank you, Chair Miley.

Uh, can you help me understand the composition of the community advisory council or board uh and whether or not uh several of these projects that are on this list were uh brought up and vetted, and has there been labor representation on that community advisory council?

So the community advisory board is with a multitude of individuals in the community, some from some of the community clinics, some uh caregivers, uh physicians, uh, as well.

I believe there's individual from the Indian Health Service that's also uh part of that uh advisory board.

Um, also just some lay individuals that uh that just work in the community and do community work.

So uh community advisor boards, I think it's been in existence for five or six years, or a lot of it was because of specific feedback as relates to all the construction that was happening and anybody having any input to what's going on and what the leads are trying to do met.

Um, that has to do with the delay in uh construction of the new hospital because it was supposed to happen soon after the affiliation occurred in 2014.

So, so we certainly can, you know, if there's individuals here in this room.

Um, and I think also higher voices, actually, that is uh you know, it was prior to my arrival that this is created, but that's clearly a myth that we have in terms of not having you all involved uh in that as well, having a representative of that as well.

So, how was the Measure C uh projects uh addressed through this committee?

Yes, so we we presented the Measure C projects to the community advisory board um after the clinical people do the work, um, you know, created the plans, and so and they gave us feedback and input to anyone who probably supports or with the plan that we presented earlier today.

Okay, so I I concur with Supervisor Myrmy when we voted on his board letter in april of last year um it was our understanding that there would be a high level of consultation and um i don't think anyone's disagreeing uh we should be using the money for whether it's advanced uh equipment specialized staffing have a nice base programs uh but it doesn't sound like there's been some consensus or consultation and there seems to be information that's presented to us on where the funds are going whether it's going through the main campus at San Francisco or all the funds are going to Oakland there's no funds that are going to San Francisco for measure C for measure C all the funds are spent at children's hospital Oakland and what about the sickle cell um the sickle cell program is not is still continuing in in Oakland I'm not quite sure where people where that is coming from so very specifically sickle cell is different than bone trees so but the sickle cell therapy program I mean is a world class program that actually is a standard that other institutions actually use and also in addition we actually received a one million dollar appropriation that Congresswoman with assignments got for actually a research for a quarry institute to help promote hematology and blood disorder research in addition we're spending another 10 million dollars with it along with the Valley Foundation with the grant that we received with them to actually upgrade the quarry facility so we can continue to do research.

So clearly there's been some communication or maybe lack of communication or not enough communication on our part of all the things that we're doing to support vocal campus.

I appreciate that clarification and Supervisor Miley's going to tell you how we're gonna get this communication to improve right well I you know I want every everybody to be happy and seeing who I are quite frankly we have a lot of we have a lot of matter from trying to deal with quite frankly I'm a little annoyed that this has come to us this way because of a lack of communication you know you gotta talk to labor gotta talk to labor.

Gotta talk to the community folks um and if you're if you're avoiding them you're making a big mistake so I want to have this item come to the board of supervisors on March the 3rd that's our next meeting but between now and March 3rd this is in supervisor for your support for this is what I'd like to see happen.

I'd like to see children's hospital their techs their management their team meet with labor in the community to come up with um a consensus around how they're going to move forward with addressing this it's been suggested there be quarterly meetings of labor and representatives try to come up with a consensus plan.

And I'd like to know that that's if that's gonna be the approach that would be the approach but to now and March 3rd I want you to get together and figure this you know I don't want a curse so just think of this out.

Because if you don't figure it out then I'm gonna suggest to the board on March 3 with all funding I don't want to do that because there could be unintended consequences I think that's punitive.

I don't want to be punitive I want to be conciliatory I want to build consensus I want to be you know co-by off so we're all happy and we're all moving forward and if there's a misunderstanding about sickle cell and the side beyond it then clear that mess up I mean talk clear it up I don't want to be at the table I don't want Aaron at the table.

I'm sure leave it as well figure it out and if you can't figure it out then trust me March third we will figure it out and I don't want to have to go down that road, but we will go down that road if necessary.

So that's what I would suggest.

We're gonna give folks March 3rd figure this out it'll be an item at the board meeting March 3rd.

And if um if we don't feel that there's compliance or a plan to move towards compliance around a consensus, then I think the board will have to take some severe action, of which I don't I really don't want to have to see us do.

And once again, it's only uh, you know, we would need three votes to do that, but that would be the course of action I would be recommending.

If you comfortable with that, I'm too severe.

I support the recommendation.

Um I might temper the threats to be uh depending on you.

I lose my patience as we do these days, and I used to when I was a younger man.

But I I agree that what we're hearing today definitely as you said, just needs to be a failure in communication, and we want to make sure that's clear um before we uh see the item in terms of the compliance with measure C.

So we would appreciate uh that level of collaboration before we hear it again.

So Dr.

Holmes, are you can you pull your team together and we'll come into meeting with these folks and getting this?

So we can all feel happy.

Because I mean the troubles of the world, and we don't need these troubles here.

Right, right.

Okay, that's what I'd like to say.

I think we're good.

Let's move on.

Right.

The next item is item number two.

Um, we'll give folks a few minutes to clear out until we're the way of this microscope.

You're right, yeah.

I think about it.

Hang on, yeah.

Alia, I'm sorry, I'll just go back to it.

I think it's not you then.

It is where's that?

I don't even understand.

Okay, we're probably not weird.

But that's where my microphone is sure.

No, no.

I think it's not.

Yeah, I think we shouldn't.

But it's good.

I think we're going on.

I think we're sure.

Yeah, sure.

I got you can actually have the job.

I think it's a thing.

Tell her, I have to have a cover.

Yeah, I think we can call it a outside.

We can clear the room so we can have our next item.

Folks, can you go on the call and talk?

And we should be able to make it more like in litigation.

We actually bring in a conjecture with that.

Okay.

Well, you're gonna have to talk to our council obviously about anything because it's a little litigation.

So, uh, I know I'm saying, yeah.

Yeah, we'll be running for you.

Yeah, just meet you things.

Okay.

So let's go to item number two, and thank you.

Thank you.

That's thank you, supervisor.

I don't try.

Supervisor Michelle's in here.

Michelle's gonna start.

Good afternoon, supervisors.

Thank you so much for letting us present this to you, this item to you today.

Um I'm gonna turn this over to John Lowe in just a moment, but I just want to remind you um a little bit about the background.

HCD in collaboration with H and H was provided uh direction by your board last summer and early fall, um, to spend some of the uh one-time measure W funding on uh homeless housing, uh both interim and permanent supportive housing.

And so we went out and we held an RFP, and as is our standard practice, once we receive that direction from you, we hold a competitive process, and then we bring it back to the health committee for review, and then we ask that you forward it to the full board for approval.

And so our staff report today outlines that process.

I'm gonna let John go ahead and do the presentation.

He and his team did a great job of very quickly getting these funds out into the community, and those funds are pretty critical to the affordable housing industry, and this was a RFP that was focused on multifamily affordable housing that would uh leverage state resources.

So thank you, John.

Thank you, Michelle.

Um good afternoon, supervisors.

My name is John Lowe, one of Michelle's deputies at uh HCD, that's the county department of housing and community development within the community development agency.

Um just uh Michelle laid out the um the board direction regarding this specific RFP, but on your screen, we'll do a quick uh reminder of how Measure W is structured.

Uh as you may recall, Measure W was split into three um funding buckets the central county services, prudence, and the bulk towards the home together plan.

Uh the intent of the home together plan is to serve those experiencing homelessness uh in the community.

Within the home together plan, there are some sub-buckets uh geared towards different things like prevention, shelter, access coordination, those types of things, and at the bottom you'll see the capital one-time funding intended for housing units and shelter units.

Now, this RFP that we're presenting for you today sits within that capital one-time uh bucket.

Slide please.

So, as Michelle mentioned uh in July and September, your board uh approved the Measure W framework, and then further direct the staff in September to uh to begin the implementation and distribution of funding, uh, specifically for the uh capital one-time funding.

So uh personal to that direction uh staff at both HCD and housing and homelessness services collaborated to put together an RFP focused on new construction projects, which uh will include homeless serving units and uh with a focus on speed, that these the projects which would receive funding would be ready for construction within 12 months of an award.

So uh the RFP initially for 40 million dollars of capital funding uh was released in late October, October 27th.

And as I said, uh HCD collaborated with H to focus on those high impact projects.

Uh next slide, please.

Uh these uh four sentences here were the goals that uh staff did our best to primarily of course focusing on serving those experiencing homelessness, uh speed as I mentioned, also geographic distribution within the supervisorial districts of the county, uh, and also uh feasibility and competitiveness for state resources.

Uh, one of the underlying uh purposes is to bring as much state and outstanding resources into the county as possible.

So to that end, we wanted the most feasible and the most competitive products, and uh also required Measure W funds to be filling real gaps and not supplanting any other sources.

Next slide, please.

So a little bit about the public process, public RFP process.

Uh HCD distributed notice of the RFP to over 5,000 uh recipients on uh the county mailing list.

We helped two uh public bidders conferences in late October and November.

Uh we presented at the uh twice monthly all city calls, which is a gathering of uh housing staffs across the county from the cities across the county.

Uh and uh in recognition that it was a short application window and that the initial due date was the first Monday after Thanksgiving, a revised RFP was issued and an additional week was given to respond.

Next project.

Next slide.

So the review process, we decided to divide and calculate staff.

So there was a scoring panel made up of staff from both departments, HH and HCD.

HCD led the financial and technical and feasibility review of the applications, including a staff member who was formerly homeless before he became employed with the county.

H uh as their area of specialty focused on services, the service providers, the service contracts, things like that.

Next slide, please.

So on December 8th, 2025, we received 20 proposals.

Those proposals were all initially reviewed.

Make sure that they were actually uh submitted everything that was required that they were asking for eligible eligible support.

And basically that they hit the completeness threshold.

Of those 20, eight were initially incomplete and did not progress to scoring.

After completeness, then was threshold and rating and ranking review.

In the midst of that, one project withdrew from the process.

So 11 projects ended up moving to scoring.

And on the next slide, you can see the list of the projects along with their ranks in the scoring.

This chart has uh the cities that the projects are located in, but if you look at exhibit A in your staff report, you'll see the supervisor districts as well.

So we ended up with as part of the recommendation today.

Staff are recommending increasing the funding from 40 million to uh 52.95 million.

Now it allow us to fund all 11 projects that move to scoring.

And you can see that we'll put a project, at least one project in Oakland and Berkeley, City of Alameda, Livermore, and Newark.

And uh sorry, I meant uh 10 of the 11 will receive funding through this RFP.

One project, uh number seven, 430 Broadway, uh, was determined to be uh to hitting uh funding county funding caps as a county-owned project already receiving other sources of funding.

So that would be funded separately from this RFP.

Uh next slide, please.

So in total, uh including all 11 projects would uh have over 900 new affordable units, over 300 units focused for households and people experiencing homelessness.

And out of over 80 projects countywide that are attempting to obtain state funding, this would uh progress over 10 projects towards that goal.

So again, we really wanted to bring as much state and outside resources into the county as possible.

Next slide, please.

This is a pie chart, basically sets out the regional distributions of awards through this RFP, and you can see the areas and Oakland was broken out separately for this slide.

Staff are requesting is for this committee to approve the results of this RFP and to forward uh RFP recommendations to the full board for the adoption of funding resolutions, which would reserve construction within 12 months.

And I'll add we have uh a few community partners in here.

Some of the applicants we have uh folks from the city of Oakland here as well.

Thank you very much for your support.

Okay, so thanks for the presentation.

Just ask a couple quick questions and let's see if Supervisor Jan has questions as well when we hear from the speakers.

So we're gonna fund 53 million dollars, measure W money to 10 projects.

10 projects, okay?

And the 11th project is 430 Broadway.

Yes, and we're gonna put another roughly 19 million there.

Uh separate from this RFP, right?

Yes, and is that 19 million measure w as well?

I'm about 14 of it is about 14 of its measure w, okay, and then 4430 Broadway, that's also in Oakland.

So when you talk about 59% of the point that's in Oakland, does it include 430 Broadway as well?

Yes, it does, supervisors.

Yes, yes, right.

And let me see here.

Of the 20 that submitted in let's see, you said eight were in complete.

One with the incomplete and the and the withdrawal.

Well, uh, if you look at exhibit eight, there's a full list of the eight that we're deemed.

Um, I couldn't get into the very specific project individual.

Perhaps their zoning and permitting were not a place where they could actually apply within the next year.

Uh perhaps the um perhaps they didn't actually make a request, which you might see as not specified on here.

Um some of them also did not include any home restricted homeless units in their proposals.

So that's a that's uh a bit of a slice of some issues.

They all had to with the this initial capital round, they had to be just like some already, restricted homeless units, leverage funding, etc.

Correct.

Um so the eight, let's see, one, two, three, three, five, six, seven, so the eight for different reasons.

We're not waiting.

I'm not saying at this point in time, but if we were to consider future uh funding allocations forwards uh measure wapital, because we have a hundred and eighty million dollars in capital, right?

Just a clarification on that.

I think that slide is from uh when we originally presented to your board in July of 2025.

Um so that was before we knew all of the uh HR1 impacts that were gonna happen and other policy impacts.

So for example, this was our best guess at that time.

Um I think since then things have or will need to shift.

So for example, you see that under access and coordination dollar per year federal backfill.

Um, depending on what happens with HUD, that could go up to 30 to 60.

So just this was a point in time.

So this needs to be adjusted.

Yes, it's not the most updated that.

Okay.

So do we anticipate any more money going towards capital?

Uh Jonathan, if you're online, you want to talk about that or Michelle?

The reason I'm asking is because looking at the incompleted projects, and there might even be others out there as well.

We're not saying that they're not worthy, we're just saying under this under this RFP, uh, they were not uh suitable for capital uh expenditure.

Yeah, can you all hear me?

Yes.

Okay, great.

Um yes, I I won't speak to the specific uh these specific projects.

I think it's you know the completeness of the allocation, yeah.

Oh, you can't hear me.

Yeah, can you speak up?

Not not okay.

I'm pretty loud on my end.

Sorry.

Uh how about now?

Any better?

Yeah we can okay okay um yes I think as Anika said there is still some uh to be determined on the the total amount of that one time allocation for capital for example a portion of that uh was initially and will still continue to be set aside to expand capital for clinics so about 30 million of that 180 was set aside to explain homeless serving healthcare clinics but I think there definitely will at least be another round that we've been jointly discussing with HCD uh I think potentially those projects as you mentioned supervisor could could go back in but we also also know there's a much wider range of of housing types that aren't necessarily new construction tax credit like deals um that we want to make available as well so opportunities for acquisition and conversion and a potential wider range of of development types so while the numbers specifically are still to be determined based on our continuing review of the federal impacts uh we believe that there will at least be one additional capital round that will be inclusive of a broader range of homeless serving units uh types of units permanent uh focus that we'll be releasing jointly uh in the in the next year with with HCD okay so Michelle what about A1 reserves so the A1 reserves came to your committee last at the last meeting and and one of the one of the programs was the rental development program of which that money your your board in a work session dedicated to the Broadway properties and your board has already approved 12 million of that directly to that one site and then there's another board letter coming for this second site with another with the balance.

And then there's two other programs that we're planning to launch one is the SHIFT program which is the small lot development.

We've come to your board a couple of times on that but we are we've finished the RFP and we're about to uh dedicate some funding uh to that program and then the the next one is the cares first jails last loan fund which was another big program that your board um has been pushing for us so those are those are the the plan for the measure a one interest earned um but definitely we see a need for additional resources um and where we get those resources is really uh where we want to bring our next presentation to you so we can discuss in more detail um how to raise additional funds I do want to also mention that you know there's a lot of advocacy around small lot development um especially faith-based organizations lots um and properties and uh we want to be able to lift that up as an important resource with all of the changes to state law that make it easier for us develop on smaller properties and the fact that we are a built out community except for maybe some areas in South County or the East County we don't have a lot of large lots left and so we do have to be looking at innovative ways to expand affordable housing.

Yeah last year we presented on several opportunities and this year what we're asking to do is come back with the results of the polling that has happened um and bring the pollster with us as well as you know lay out other possible funding um revenue generating sources that you might want to consider.

So when uh I I had suggested March or April.

Okay all right because I do think you know the projects that were incomplete uh uh let's get on that uh turn the the 10 but the eight and I know there's others out there as well um just trying to think of how we're gonna try to use all of our resources, all of our different possibilities, all of our ability to leverage and try to get more projects of all types out there, recognizing the limitations we have both because of HR one, Rob one, you know, the fact that the polling wasn't well on uh a bond measure, etc.

etc.

Uh I don't want us to not uh give up on our ability to try to push more capital projects forward, and not just for homelessness, but to prevent homelessness as well as to provide affordable housing for extremely low, uh low and um and better.

Yeah, uh supervisors.

I I did want to point out that um half of the eight uh incomplete projects uh have been supported in some other ways through uh county or cd funding.

Oh good, okay.

Uh not it's just not through this RFP, right?

Okay.

Okay.

Right.

Well then I just want questions for now.

Uh supervisor to have you have any questions?

Um yes, so I appreciate um support spending the 52 million to get 946 units, which is pretty amazing in terms of the unit cost, so uh congratulations on trying to get that grading of funding going, because obviously our um contributions is only a small share.

The I did have a question on like the East 12th Street Circle, the the project 11 uh that was ranked number 11.

Um I thought for some reason that project had already been uh underway in construction with the city of Oakland, and and they got the Unity Council.

Uh well, we have we have Christian from the city here could probably speak some details to that.

Well, we can make that now, or I think that'll be Christian Katz Mully Housing Development Services Manager for City of Oakland HCD.

Um there are a number of 12th Street and East 12th Street properties in our portfolio.

Um the one I think you're thinking of is the Bald Sea um Lakeshore property that's on city owned land.

Right.

This is actually a different property.

Okay.

Because uh as you said, there's a number of uh East 12th Street projects, and uh the council member uh uh council member Wang from uh district two in Oakland had asked about uh potentially purchasing the it's called the American's best value in on 122 East 12th Street because it's being used for nefarious activities and the neighborhood and the community would like to see that uh become uh permanent supportive housing with wraparound services and to deal with some of the illicit activities namely associated with trafficking, and so if you if we look at um that project, like potentially purchasing a hotel and and maybe doing some retrofit, it probably wouldn't be as costly as building from the ground up.

What kind of rating of funding would be needed from Oakland?

That's a different kind of project.

I think that would fall under our R2H2 program, which is closely related to a home key program.

Sorry, my name is Fay Darmaui.

I'm the deputy director of housing, the city of Oakland.

So that's a different property and right the home key funding is what she mentioned specifically would be used, but the the problem was that there was a timing issue.

Uh they would need to get uh some certainty on available local funds in order to leverage home key funding.

We haven't actually gotten a formal proposal for that project, so I know that um they have been talking with CM, Councilmember Wang, but we haven't received the full workbook from a developer.

So it's not, it's not technically on our pipeline, but yes, it would need all kinds of different kinds of funding sources.

Okay, okay, but it wouldn't be uh uh limiting because there's a number of East 12th Street projects, right?

No.

East 12th Street's pretty low.

Okay.

Thank you.

Okay.

So let's.

How many speakers should we have TSA?

We have two online and we have four in the room.

All right.

Chris.

Let's give the speakers supervisor.

Start cleaning our own.

It's 12 50.

So please we could do it in two minutes because Supervisor Tam has a another committee meeting that she needs to go to, and then we have another committee meeting after that.

So she's got a long day.

I'd like to at least let her have a break.

So please, two minutes.

Faye Darmaui and then Christia Katz Malby.

Hi, I'm Faye Darmaui.

I'm the deputy director of housing at Oakland HCD, yet another ACD.

And we are here to support the staff recommendation for NEHW on behalf of Oakland HCD.

We want to thank staff from County H C D and Housing and Homeless Services by the release of this RBP and stretching the available funding to cover all applicants in the county who make the personal requirements.

But as you can see, Oakland is different than the brand of Alameda County.

We have the most impacted communities and the greatest need.

So from an equitable perspective, we uh need the greatest number of resources, and we are very prolific with these resources.

As noted in Oakland HCD's strategic action plan, our foremost priorities on reducing Oakland Thomas' population by providing houses housing with appropriate services, including printment supportive housing.

And to do this, we need to have a partnership with the county and the housing authority to pay operating subsidies with our capital funds.

With the the passing of Oakland's measure W as well as other dedicated affordable housing sources, the city has allocated 280 million dollars to the towards this cause over the last three years.

And at this time, we are thrilled that the city has over 750 unit, new affordable housing units under construction.

Nearly 500 of them are to for homeless exit homeless exits.

And the city's anticipating breaking ground on another 600 units over the next six months.

And yet we still have a big pipeline that is unfunded of partially funded projects.

Are funded with nearly 104 million dollars of city funds to match the 41 million dollars of county funds.

Now the city Oakland and the county will be focused on ensuring that these measure W and on RN Measure U funded projects are positioned to apply for bonds and tax credits and move forward to construction.

This was part of the impetus that allowed two deals and the third that withdrew um wound up being able to work a first-round tax credit application to the middle last week, partially because of the ability to move quickly on these funds.

At this time, we have a few projects that are intended to apply a little later in 2026 where there appear to still be some funding gaps, and we'd like to continue to work with the county and other partners to resolve these.

And in addition, we have in Oakland over 12 remaining developments in our current pipeline.

That's just from our current two-year NOFA pipeline that could deliver another 829 affordable units, including 265 for serving folks exiting homelessness.

In order to do this, we need to continue to partner closely with the county and the Oakland Housing Authority to maximize the resources that we've had, but also the types of um funding that we bring, each bring the capital operating and services funding necessary to build and sustain a project with permanent supportive housing units over time.

Thank you.

Basco, Yorgo, and then Obi.

Hi everybody, my name is Vasco Yorgo, and I'm a project developer with Eden Housing.

Just want to give a huge thanks to the board for making the recommendation to make this funding available and to County HCD staff for turning around this RFP in really record time.

Um I don't think I've seen anything go out as quickly as they did.

So they pay you to say that.

No, like genuine.

They did a great job.

We urge the committee to follow staff's recommendation of awards to all listed projects, especially downtown Livermore Apartments, Liberation Park, and Breider Bancroft, which uh Eden Housing is involved in, and all three.

Uh Measure W funding will enable the construction of 340 units of housing through those three projects alone, which are desperately needed to address our housing crisis.

Thank you.

Good morning, Supervisor Chair Miley and Supervisor TM and to the County ACD team.

My name is Obi Walker, and I'm a product developer housing nonprofit affordable housing developer working across uh Alameda County.

EDA currently has three affordable housing developments in our Alameda County pipeline, totaling 340 units.

Uh, this includes the downtown Livermore project that my colleagues spoke of, Liberation Park and Butter, Bancroft.

I'd like to briefly highlight Liberation Park because it clearly shows who measure W is serving and why this funding matters.

Liberation Park is a 119 unit affordable housing development in East Oakland with studios ones, two, and three bedroom units.

All of these homes serve households earning between 20 and 60 percent AMI, which uh is the county area media income.

To put that into real numbers, a studio serves individuals earning roughly 22,000 to 67,000 dollars a year.

A one-bedroom serves households earning about 25,000 to 76,000 a year, a two-bedroom serves a household earning about 28,000 to 86,000 a year, and a three-bedroom service family is earning about 32 to 96,000 per year.

These are people who keep our communities running.

Teachers, first responders, healthcare workers, child care providers, service workers, and other essential workers, many of whom are increasingly priced out of our neighborhoods they serve.

In addition, 24% of these units at Liberation Park are reserved for special needs populations.

This is the income range where housing instability and poor health outcomes overlap most sharply.

Stable, affordable housing at these levels, reduces emergency room use, supports family stability, and allows people to manage chronic health conditions.

Measure W helps close these financial gaps, meet hard funding deadlines, and ensures that health serving housing projects actually move into construction instead of stalling or losing other leveraged public funds.

I respectfully urge the committee to advance measure W, HTFRP, and to continue treating housing as a core public health investment.

Thank you for your leadership and consideration.

Carrie, you're on the line.

You have two minutes.

Thank you.

Hello, Chair Miley and Supervisor Dam.

Hello, my name is Carrie Lutkins.

I am director of real estate development at SAFA, a nonprofit based in the county that develops, owns, and operates and provides services to affordable housing communities throughout the county.

I wanted to speak in support of this item and staff's recommendations of funding for the home together planning awards and the new construction RFP.

I wanted to highlight three of the projects being recommended for funding that SAHA has had the privilege of planning for in close collaboration with three different cities throughout the county.

The first is 3135 San Pablo, which will be home to 73 seniors in West Oakland.

25 of these households will be referred by the county and assisted by the Home Together Fund.

We've partnered with the Incredible St.

Mary Center to provide case management services for these households.

Another 46 home together fund referrals would come to People's Park supportive housing in Berkeley, honoring years of grassroots advocacy and commitment to ensuring that there be space in people's park to meet the needs of the unhoused.

And finally, I'd like to highlight another 13 referrals that the Home Together Fund would make to an affordable housing community for individuals and families on Brenton Avenue in Newark.

Thank you so much to staff for investing in these specific communities, and its peers have demonstrated that permanent supportive housing is a crucial part of ending homelessness, resulting in high retention rates, improved health outcomes, and reducing public costs for emergency services.

We look forward to being part of the county's efforts and the overdue solutions for the unhoused community in our midst.

Thank you very much.

Regina Davis.

All right, thank you.

Uh Regina Davis, the um CEO, deputy CEO of Real Estate for the Black Cultural Zone.

We are in partnership with Eden Housing on two of the projects that are here.

And I wanted to just make you've you've heard about the development and who's included.

But I think it's important to also understand the role that these housing developments play in larger economic development within the city.

So for example, the the uh rise east, which uh is includes the black cultural zone, which raised 100 million dollars uh for the net over the next 10 years from local resources and for 50 million outside of the city through the Blue Meridian partnership.

What we've been able to do is something that we usually don't get to do, which is to directly purchase existing uh both housing and also commercial development.

Um so far we have six projects that will go under construction this year uh to provide not only affordable housing but the ability to afford housing, the ability to have jobs.

We've been able to hire over 50 local black-led contractors to work on our acquisition and conversion uh projects.

So I also am looking forward to the both the small lots as well as the acquisition and conversion funds uh to come out because I think it's important in this moment, this unprecedented moment uh of uh development of housing within Oakland as well as economic development in Oakland, that we work collaboratively and make a true impact on the communities, and this in particular is in the East Oakland community, which we want to just elevate that in the work that the Black Cultural Zone has been doing since 2019 to bring this level of funding, and so thank you for your cooperation.

And of course, we'd like to have you approve measure W Capital um RFP results.

Uh I also had a question about the projects that were uh applied but were staying incomplete.

Um there are a couple of them that are in East Oakland, the one that's across the from our liberation park that we're concerned that goes forward, particularly it's a teacher housing project.

So the ad chance project, I want to see that be elevated and with the cooperation of all of us, have an opportunity to really see Oakland rise.

So and I just thank you.

Thank you.

Bishop Logan, you have two minutes.

Thank you so very, very much.

I appreciate this time, and I just wanted to get online today just to thank you for your consideration and your recommendation for the Fijian legacy court uh project to be funded by Measure W.

Uh, as you know, it's going to provide tremendous difference in the lives of at least 80 persons or 80 families that will actually occupy those spaces.

Uh the desire is to be a blessing to seniors and to the homeless population in the uh Berkeley area.

Uh, thank you again for your consideration.

Um, we're in partnership with community housing and development corporation, uh, originally California.

And I really believe that you're helping us to be a difference and to make a difference in our community.

So, again, thank you so very much.

I don't need the entire two minutes, but I just wanted to tell you how much we have recently for considering this and recommending us.

Thank you.

That's all the speakers.

And I have some closing comments to make.

But can we just check with Super Minister Tam?

You have any comments or questions?

No, but I'm prepared to move the item.

We'll move it.

Yeah, I'll move uh the uh the results of the measure W capital project RFP to the full heart.

Yeah, I said, I'll second it.

Thanks for all.

Supervisor Tan.

Hi, Supervisor Miley.

Hi.

Motion passed.

Okay.

So yeah, my um closing remarks on this is I just wanna also coincide what Ratina was saying.

Um, and I'm gonna go a little further.

So I think everybody in this room is listening understands this.

We need to constantly work on how we can bring down the cost of housing.

We've got to get we've got to work on that.

Because even providing more resources, if we're providing more funding for housing and we're not bringing down the cost, we're just it's it's just gonna continue to snowball.

And I know we need resources, but we've got to figure out how to drive down the cost, but then also working to ensure that um folks are benefiting from this through economic opportunities, uh through you know, sustainable housing, through jobs, quality of life, uh in communities, etc.

It's all uh holistic and yes, I do want to see housing for the homeless, but I want to see housing to keep people from being homeless, and I also want to see housing for those who are not let's say extremely low or low income, but like teachers, you know, worker appropriate housing as well.

So when we can partner with the school district, we'll make a partner with the faith community, we're gonna partner and deal with tax default properties when we can partner with commercial properties that are underutilized or not being utilized for that matter, where we can want to deal with you know publicly owned land, all of that go it up against the wall, reduce the cost of housing, and let's get more housing and keep people housed and get people staying fully, you know, uh staying uh stainfully employed uh as well.

So just want to kind of just end with all of that because I don't think I think you can appreciate the point because I think we all recognize that.

Um we have any public speakers on non-agendized items today.

I have no speakers for public comment.

Right, very good.

So we are adjourned at one oh five given.

Supervisor Tam twenty five minutes before our next committee meeting.

I guess money