All right.

I would like to call the meeting to order of our three thirty meeting.

It's a bit late, later than three thirty.

This is a special meeting on Tuesday, March the tenth.

And I will start the meeting by asking the clerk to call roll.

Thank you, Supervisor Marquez.

Supervisor Tam present.

Supervisor Miley.

With that said, our open session item is Supervisor Fortunato Bass and Miley asking us recommending that we would approve the following, and this is uh referenced in a board letter.

Um, a reaffirming the Board of Supervisors approved motion of 3326 requesting Alameda Health Systems to defer um well, it's all listed here in the agenda.

What I'd like to do is to start with Supervisor Miley making brief comments and a motion, Supervisor Fortunato Bass seconding that motion so that we have a motion made and seconded and then have discussion, which I think will be expedited if we do it that way.

Supervisor Miley, the floor is yours.

Yeah, thank you, President Howard.

So um, Supervisor Bass and I uh have presented a board letter.

Um you know, we are serving on the ad hoc committee that the board authorized uh so that we could look into the um financial uh challenges facing Alameda Health Systems, and it was brought to our attention that the um action that the board approved last week needed to be clarified.

So we appreciate Supervisor Bass.

Her office worked with my office, and we prepared this board letter that's before you today to clarify uh the intent of our motion.

And you know, we were very much interested in all of the uh reductions in uh staff at AHS being um delayed, uh deferred, postponed until uh June 30th, when we would have a chance to convene the ad hoc, and we've set dates for the ad hoc uh meeting as well in April, May, and June, so that along with uh the county HS and uh labor, we could work on uh the situation, the financial situation for facing HS, both uh presently and in the next uh fiscal year.

And that's pretty much what the board letter uh points out.

So I'd like to move that, move the recommendation, uh, and then um I know Supervisor Bass has some comments, and we can go from there.

Motion's been made.

Is it seconded?

I'll second it.

Supervisor Bass seconds it and makes comments.

I will just share briefly that uh after we made our motion, uh the Alameda Health Systems um surprisingly did move forward with uh deferring certain layoffs for only two weeks.

Uh and these were just for patient-facing positions, and so um I felt the need, as did Supervisor Miley, to clarify our motion in terms of deferring all of the uh layoffs as well as the program closures through the end of this fiscal year, June 30th, whether they're patient-facing or non-patient facing, and also continuing to support the county administrator in doing the work that was laid out in the discussion last time.

And I know that she and her team has been very diligently moving forward on that work.

And so to summarize these deferments, we'll give our work group that we created the time to do our due diligence to come up with recommendations to raise revenue as well as fine savings and really minimize reductions in services and impacts on staff, and perhaps even more important to do that in collaboration so that we're all on the same page with a similar level of information, fact-finding, etc.

Um, and really able to move forward in an even more collaborative way.

Thank you.

Are there any questions from the board?

I do have a question, which is to say um, just to clarify, we um have a relationship with AHS such that uh it's you know the the ultimate need to provide medical care delegated to them, but ultimately we're kind of a backstop for this.

We don't have the authority to direct them to do this.

We're requesting that they do this.

Is that correct?

That's what I'm here seeing head nods.

That's correct.

Uh that's correct, and we're hoping that with our motion and the board letter it's in writing.

Our intent is clear.

We are, you know, we're not trying to throw the board of trustees or HS under the bus or anything like that, but we are hoping this sends an unequivocal clear message to the board of trustees that they can take such action in confidence or with confidence that we will um move forward and try to uh address the financial challenges uh that they see themselves facing.

As we do, then we're committing to um in all good faith to vote your time, Supervisor Miley, and your time, Supervisor Fortnana Bass to follow through on those ad hoc meetings to continue to come to a collaborative decision.

Yes.

That'd be right.

Yes, Supervisor Bass and I met right after the board meeting last Tuesday.

We uh came up with the dates in the times.

Uh and the uh I don't even know if we came with the location, but they'll be in person locations too, and we directed uh our staff to prepare and work with um the stakeholders, HS, County, as well as uh labor on the agenda, and we have the meetings set for the first Wednesday of each month, April, May, and June.

We are set to go.

Right in the middle of budget season.

Okay, with that said, the to clarify the ultimate decision is theirs, and that it will be as I understand it, we've discussed this collaborative.

Um, that is uh good.

Um, I'll ask because I see um the executive director or CEO or what are you, James?

CEO.

Uh I just would like to ask uh, I'm sure there's public comment to come on this, but um have there been discussions with the CEO and um this is amenable uh in some way or will be well received and participative in because if we make the request, it it was not gonna fall on deaf ears, right?

We all that would be our desire okay and our firm um okay uh wish uh and guidance, and I know both our offices have been in contact with all stakeholders, all stakeholders.

Okay, then I'm supportive.

Um we can just ask for public comment and then have this continue just continue to discuss if we need to, but we have a motion made and seconded.

We'll now go to public comment.

Do we have any in first the speakers?

I think six, right?

Any online currently currently not showing any hands.

In persons call them back up, two minutes each, everyone.

Okay, and I did receive some more speaker cards in person, but maybe okay.

Thank you.

Tony Fuentes, Drew Scott, Nathan Hansford, Christian Pause, David Padilla, Iman, Ashley Mar, and Susan.

So I will remind everyone of uh adage sometimes that is said in discussions and negotiations and nice friendly talk.

Sometimes get to yes and then stop.

So you might read the room and find your yes, you don't want to talk us out of yes, so use your time wisely.

Good afternoon, chair members of boards.

Three minutes is all I ask you.

Okay.

My name is Tony Fuentes, and I serve as the director of Alameda, the acne director for Alameda Health System.

I'm here today because of the recent uh proposed program closures and reductions in force at Alameda Health System.

They raise serious concerns about patient access and the ability of the health care workforce serving Alameda County.

Alameda Health System is a safety is a county safety net health system, caring for more than 150,000 patients each year, the vast majority of whom are low-income, covered by medical, by medical or uninsured.

When services close or positions are eliminated, the impact is immediate and is felt most by the residents of this county who have the fewest alternatives for care.

Our March 3rd, 2026, this board unanimously unanimously approved a motion introduced by Supervisor Nate Riley requesting that Alameda Health System Board of Trustees defer any program closures and all reductions in force, including both patient-facing and non-patient facing positions through June 30th, 2026.

While the fiscal impacts are evaluated and options are brought back to the board.

In short, the board asks AHS to point the layoffs and program closures while while financial solutions are explored.

However, despite that clear direction, AHS has not rolled back the layoffs but simply delayed it till the 23rd of this month.

And as indicated, it is seeking clarification regarding the motion.

The board has since issued a letter reinforcing its intent that the layoffs and program closures closures be deferred.

Our healthcare professionals are deeply committed to their patients and the mission of the system.

But reduction in force and services place additional strain on the workforce that keeps this safety net functioning and can affect access to care for vulnerable residents across Alameda County.

As the governing body responsible for the health care of this county.

So I thank you very much.

I'll take 30 more seconds of your time.

Thank you.

As the governing body responsible for the health of this county, we urge the board to ensure that its direction is carried out and closely scrutinize, scrutinize these decisions and to require transparency about their impact on patient care.

We also urge meaningful, meaningful engagement with the workforce and their and their representatives before further reductions move forward.

Protecting the workforce at Alameda Health System is not just a labor issue.

It's a fundamental patient care issue for Alameda County residents.

Thank you very much for your time.

Good evening, board.

My name is Nathan Hansford.

I am the one of the area supervisors for SCIU.

I'm also the chair at the bargaining table with Alameda Health right now.

I was wondering if I can get eight minutes.

I'm just kidding.

I actually will make this very, very quick.

I think it is an integral part of the community.

This isn't just about the workforce.

We we do understand all the problems with HR1, but this is about protecting our community.

And so it is our hope that not just you know postponing layoffs, but bringing people back because we have a lot of people that have been on paid leave this entire time.

And so it is our hope that part of this is to bring them back so those services can be fully restored while we work out these issues, which I'm confident we can work out with with you.

That said, I also need to let you know that I am a formal child welfare worker.

So if you ever want to talk about that, I can help you with that too.

We might need you back.

Thank you.

Next speaker.

Welcome.

Thank you.

Uh hello, my name is Christian Puss.

Uh, we also want to thank you, all of you to take your time to hear us about this issue.

We know that HR1 is really horrible for all of us.

Um how work in the historical firmware cafeteria.

Uh, we'll like for every of you come to that building.

It's very old though.

So you will be surprised.

Uh this time we would like to uh say that we would like to have all the people back.

They isn't being a pay on Ms.

Relief, and hopefully this time uh we can work out better uh with AHS.

Um that's all I need to say.

Thank you very much.

Next speaker.

Good evening, board.

Great.

Uh my name is Drew Scott.

I'm a full-time therapist at the Fairmont Intensive Outpatient Program, and I'm here because now on March 23rd, AHS plans to close our program.

Uh which is a lifeline for clients with severe mental illness.

And many of the clients that you heard at the Beelinson hearing, or some of them rather, were from our program, and they gave very moving testimonies.

And all of our clients were anxiously awaiting to hear the outcome of the Beelinson hearing.

And when you did your action on March 3rd, we were so excited to go back and tell our community that things were moving in the right direction.

And they were our clients were so relieved that this place they call home, that it was at least in the short term, it was going to be safe.

And then the following day at the Board of Trustees meeting, we learned that the Board of Trustees didn't adhere to your direction.

And we, with very heavy hearts, had to go back and tell our clients this news, and it caused so much undue stress and chaos.

And for staff and clients alike.

But in general, the way that this has been handled with our clients hasn't been done with client care in mind or their well-being in mind.

It's caused so much stress and dysregulation.

And I really want to thank you, all of you, for um reaffirming your action from March 3rd.

And we're just asking that you please vote yes on the proposed letter.

And thank you for your time tonight.

Thank you.

Next speaker.

Hi, supervisors.

Um, David Badea with SCAU 1021.

Um, just want to again thank you for your swift action and moving to reaffirm your decision on March 3rd.

I think we all had um a very opening and very open dialogue on at the Beelinson hearing.

You all heard the worker impacts, the patient impacts, and so it is with frustration that we heard that uh AHS and the Board of Trustees did not adhere to your direction.

Um, and quite contrary, openly defined that.

Um, and so we are here to thank you and your leadership.

We look forward to making sure that these layoffs are deferred until we can come together as an ad hoc committee with the best ideas put forward with our best foot forward in making sure that we're uh pulling all the the state funds and federal funds that we can find and making sure that we're addressing all of the um necessary patient care um that have been on the chopping block since uh AHS announced this.

And so again, I just wanted to thank you and make sure that we're I just wanted to reiterate we're in partnership with you all of you.

Um, and I think we're on the right track here.

And we're also expecting that AHS does the right thing tomorrow at their board of trustees and defer these layoffs and come to the table with with meaning and purpose.

Thank you.

Thank you.

Next speaker.

Hello, everyone.

My name is Susan Sandoval.

I'm a proud SCIU member.

I work at Sal Leandro Hospital.

On March 3rd, the Alamaria County Board of Supervisors voted anonymously five to zero on a plan to stop the layoffs at Alameda Health Systems and restore health care services and form an ad hoc committee to create solutions to the funding crisis created by HR1.

We are in full support of the Alameda County supervisors' letter to reaffirm their decision on March 3rd and defer the layoffs and reductions in services through June 30th.

The board letter affirms the decisions to rescind the layoffs through June 30th and bring back our members that were laid off.

The board letter helps to restore the health care services and protects our level one trauma services at Highland Hospital.

We ask AHS to come to the ad hoc committee with informed solutions to the HR1 cuts and not to cut patient care and accompanying services.

We ask AHS to come to restore the faith and the public health care system by ensuring that medical experts are consulted before any actions are taken.

Join us in demanding that state funds, public health care here at Alameda County.

We're already working on a state budget, ask of five million for public health care system services.

Stop shifting the burden of our care onto our jails and police departments.

Fund the intensive outpatient behavioral health units.

We ask the board of supervisors to vote yes on this letter and affirm their decision on March 3rd.

Defer the layoffs and service cuts and bring all the stakeholders together to our ad hoc committee meetings.

Together, we can oppose the federal cuts to health care and solutions to our patients.

Thank you.

Thank you so much.

Thank you.

Next speaker.

Ashley Marr.

Ashley Mark.

Is that the last speaker?

Okay.

Hello.

My name is Ashley Maher.

First of all, thank you.

Thank you to the Board of Supervisors for the request to the trustees to delay the layoffs and come to the table to collaborate.

Supervisor Tem asked for some data last time that I did not have at the time, but here's the answer.

In 2025, there were 10 contaminated blood cultures according to the CLSI definition, and that was 1.1% of all blood cultures.

In January 2026, there were 30, which is 3% or triple the previous rate, or 300 uh 200% increase.

This doesn't reflect the increase in contaminated cultures that don't meet the definition, but still use our resources.

All of these led to the provision of care that is not right for patients, take beds from others who need them and significantly increase workload for those who work with these specimens.

And keep in mind that tripling the positivity rate, though it is still acceptable, triples the amount of work that the micro tax have to do, leading to overtime and burnout.

So keeping in mind that I'll skip that part.

So I just wanted to show that I did my homework, and I think that if all of us did the same, we could find some real solutions.

So unprecedented times require thoughtful information gathering, creative thinking, and collaboration.

We're surrounded by passionate people with an awareness of issues in their departments and ideas on how to streamline our operations.

Use them as a resource rather than discarding them.

No one is arguing that something has to give in light of HR1 and the exploding cost of health care.

But instead of being a victim, we should evolve new strategies to improve efficiency and lower costs while maintaining quality and caring for our community.

Trustees, thank you in advance for your cooperation.

Thank you for listening.

Thank you.

Next speaker.

Thank you, Iman.

Khalil, she is online or they are online.

You may begin your comments.

Iman.

Hi, how are you doing?

Thank you, everybody, um, for coming together, and uh we really appreciate you holding this special meeting for today.

Um, I really just wanted to reiterate that uh we really want to work uh with uh board of supervisors and the uh executive team and uh the board of trustees to come to a solution.

Um I really feel that this uh these layoffs will have a negative impact on our community.

They have before they usually lead to homelessness and um just uh food insecurity, job insecurity.

A lot of these people will not be able to find uh new jobs.

Um, so and um again, just really want to encourage everybody to come to the table and to please vote yes on the um reaffirmation of what was promised on um March 3rd.

Thank you so much.

Thank you for your comments.

That was our last speaker.

Very good.

A motion's been made and second, and um, I just do want to make a final comment, which is to re reiterate indeed.

Um, this is a decision that uh the Board of Trustees for AHS must make.

Um, I think our uh board letter, I thank uh Supervisor Miley and Fortunato Bass for bringing this because I think it's meant in the spirit of collaboration and goodwill.

Um I also do understand that um recommendations from uh these types of recommendations that are made in advance of actual cuts are such that cutting now reduces possible cuts into the future.

Delaying cuts now may risk deeper cuts into the future.

We have to find a way to resolve all of that, if at all possible that will see how things play out.

Who knows?

Maybe the cuts uh don't happen or they're reversed.

Maybe we come up with more funding as a county, but the risk is delaying cuts now may lead to deeper cuts uh into the future.

Um, I trust my colleagues to come up with a solution that avoids all of that.

So that said, um, Supervisor Miley, you made the motion, Supervisor Fortnotta Bass.

You've seconded the motion.

We've had public comment.

Any last-minute discussion, Supervisor Miley, please.

Oh yes, a few last minute comments.

Um I want to thank everybody, um, labor, HS, management HS, the trustees, county, um the board letter from Supervisor Bass and I, and particularly want to thank Supervisor Bass for partnering with me on this.

We are asking HS in the county to report back to the board on March 17th.

Also in the board letter, I just want to read it.

This letter also intends to make clear that this board is willing to allocate county resources if necessary to eliminate the uh deferments through June 30th.

We're gonna look at the next fiscal year as well.

Now the thing is this isn't going to be easy, it's gonna be hard.

We've heard earlier, we've got ARP one that's affecting mental health services.

We got the federally qualified clinics, we've got a lot of other demands.

So this isn't going to be easy, it's gonna be hard.

But Supervisor Bass and I are confident working with the stakeholders everybody's gonna come to the table and we're gonna deal with this and get it and get it managed.

Uh and we've got a lot of confidence that that can happen.

But I just want to emphasize that we're looking, if necessary, uh, when the county reports back on this, county administration points back on this on March 17th in HS if there's additional resources that need to be allocated that they be identified and allocated so the board can vote on that, and then we'll also be in a little better.

Also uh directs the supervisor pointed out that the county administrator continue to work on looking at other funding uh options into the future, uh working with AHS around that.

So we'll be looking at all of that over the next three months.

Okay.

I just wanted to once again punctuate that.

And finally, I as you pointed out, President Halbert, we are not directing, we're taking action as a board on what we'd like to see happen and what we're prepared to do.

But that once again points to the whole thing that I've been talking about since I got here 25 years ago, governance, governance, governance, because we as elected officials, I think we have a different sensitivity to these matters than maybe appointed people have.

Um, but enough said on that.

I'll yield to my esteemed colleague, but that enough said.

Anything else?

Um, I do want to acknowledge, like uh Supervisor Miley, I also had a chance to talk uh directly with a number of stakeholders throughout this process, um, including the AHS CEO James Jackson, who is here with us.

Um, I do believe that the ad hoc committee, uh, once we kick off those meetings, that they will provide a forum so that we can you know really roll up our sleeves and put our best foot forward uh to figure out this um crisis that we are in.

So I'm hopeful about that, also recognizing that it will be incredibly difficult because of the cards we've been dealt.

Um but Mr.

Jackson, I don't know if you wish to speak, but certainly you're welcome to um if you wish.

I see a motion's made and seconded.

Let's have a roll call vote, please.

Supervisor Marquez.

Hi, Supervisor Tam.

Hi, Supervisor Miley.

Hi.

Supervisor Fortunato Bass.

Hi.

President Halbert.

Aye.

Okay.

With that said, we have completed our 3 30 meeting in near record time.

We are now adjourned.