If you wish to speak to an item listed on the agenda at a time when public comment is called for, we ask that you fill out a speaker slip.

If you're online, we would ask that you raise your hand at the appropriate time.

But the clerk will now give brief instructions on how to participate in our meeting remotely.

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Public comment will generally alternate between in-person and online speakers as determined by the president of the board and subject to overall time limits.

Thank you.

Thank you.

First of all, we have uh public comment listed in several different locations.

The first option, uh opportunity is for public comment on closed session items.

The next item would be in our open session items under public comment for items number one, items number two, sub bullet small I A and B, and item number two, sub bullet small I.

Three locations for public comment.

I will note that we are about to adjourn recess rather into closed session.

We will um attempt to come back um in a timely manner, but it will likely be um 11 o'clock, perhaps.

Um, not listing that time specific, but we will come back from closed session.

But I also have to say something that's unique about today.

We have a press conference that has been scheduled in the plaza across the street.

Our board will recess at 11 15 so that we can participate in that press conference.

We expect that we will come back sometime around 12 30 or 1.

We also have to have a quick lunch break in there.

So much of our agenda will happen at one o'clock, 12 30 or 1 o'clock.

I just want to make that known to the public.

So that said, our first item is public comment on closed session items before we recess into closed session.

I'll ask the clerk to call in-person speakers first and online speakers after that three and three alternating back and forth.

Um, may I ask the clerk how many speaker slips for closed session items or hands raised or closed session discussion items do we have?

Showing no hands, showing one hand in Zoom and no in-person speakers that have submitted a card for closed session.

Very good.

We'll hear for the online speaker before we recess into closed session.

Okay, my deaf therapy, Dr.

Hunt.

You may unmute yourself and begin your comments.

Hello, can you hear me?

Yes, we can.

Okay.

Um, first of all, I am hard of hearing, and I wanted to mention we have a couple of deaf uh members in the audience who are with me.

They um, so although we understand interpreting and requests generally require advanced notice.

We only learned of this meeting on Friday.

So we were unable to secure interpreting access to today's discussion, which shows illustrates how easily deaf community members can store encounter barriers to meaningful participation in important public processes.

Um, I wanted to say good morning.

My name is Dr.

Heather Hunt, and I'm a licensed clinical supervisor with Duff Community Counseling Services.

I want to emphasize that this is not simply a budget issue, it is also an access and compliance issue.

DCC has said, deaf hard of hearing, deaf blind, and late deafened individuals, including clients with severe mental illness, intellectual and developmental disabilities, and language deprivation.

Many of these individuals cannot safely or effectively receive behavior health treatment through standard interpreter mediated services alone.

Would you please therefore Alameda County remains responsible for I'd like to thank the speaker, but I just have to point out that's not an item listed on closed session.

Please return for an item that your comments pertain to.

Do we have any other speakers for closed session items?

No, we do.

See none, we're going to recess in the closed session, everyone.

And President Howard.

We have a quorum.

Thank you very much.

I'll ask County Council, is there any reportable action for more closed session?

Thank you, President Hubbard.

No reportable action was taken in closed session.

Thank you very much.

As mentioned earlier, we have a very important press conference to attend briefly.

Each of us will be participating.

We're going to recess now the meeting and attend that press conference.

We will hope to be finished with that and back here around twelve thirty.

It will not be before twelve thirty, and we may possibly be a little bit late, but for now we are in recess.

Successful press conference announcing results from our recent homelessness point in time count.

I'd like to thank our team for putting that together.

I'll ask the clerk to please call roll to reestablish our quorum.

Supervisor Marquez.

Present Supervisor Tam.

Excused.

Supervisor Miley.

Supervisor Fortunano Boss is excused and President Halbert.

Present.

We have a quorum.

Thank you very much.

I'm also pleased to announce that we have secured um ASL services, American Sign Language Services, and I'd like to thank staff for working so diligently to do that.

Will the clerk please explain for members of our community that need to access that service how they may do so?

Certainly, President Halbert, to the ASL interpreter.

If you can raise your hand if you are in Zoom so that I can promote you to panelists so that you aren't able to enable your video to provide ASL services.

Thank you.

Can I mute and enable your video, please?

Hello, hi.

Um yes, I mean I'm on video, I'm not sure how it's set up and how it looks on your end.

Um, what the best approach is.

We can see you, and I'm assuming those that need to see you can also see you.

Thanks to staff for making that happen.

What we're going to do now is to have our first.

Okay.

We're going to hear that and take public comment on that.

And then I'm told we will need to recess again into close session.

We will have a working lunch because we have an item that we must discuss in closed session at that time, and then we will come back and address item, both items of item two.

With that said, I'd like to turn the meeting to our county administrator to introduce this item.

Thank you, President Halbert, members of the board.

Um, we'll be providing a brief update on federal state and county budget status with particular attention to the May revision that was just issued at the state level, and also to update with regard to the status of the county's budget or funding gap and progress towards balancing.

Okay, thank you.

I'll do a brief overview of what we're going to cover in this presentation.

We'll start as we typically do in our budget updates with economic updates.

I'll then hand it over to Amy Schrago to cover state and federal updates.

Following will do an overview of the maintenance of effort budget for the developing fiscal 26-27 year and do a recap of the funding gap that the county administrator's office has identified for fiscal year 26-27.

Then I'll do uh a little bit on the our progress with respect to balancing the budget, do a review of pending factors, and then talk a little bit about next steps.

So thank you.

So here's a look at Alameda County's unemployment rates since July of 2019.

In February, the unemployment rate in Alameda County is 4.5% compared to the state's 5.4% and the nation's 4.4%.

As you can see on the chart here, we're hovering above a bit the historic lows that we were experiencing before the pandemic peak, obviously well below that peak that we experienced in April of 2020.

This next slide was presented at East Bay EDA's state of the East Bay event.

This is a snapshot into employment growth trends for the nation as compared to the state and the Bay Area.

And as you can see, comparatively, employment growth has been slowest in the East Bay at 3% over the last 10 years.

Again, here's a look at the changing landscape with respect to the tech industry, upon which the state and the local economy is so highly dependent.

The central bank has left interest rates unchanged last month for its third straight meeting, despite debate amongst members in recent meetings, with some favoring rate cuts to support employment, while others are more cautious due to persistent inflation.

Particularly as of late, given the uptick in energy prices due to the war in Iran.

We're continuing to see tech companies scale back after years of growth during the pandemic as investments shift towards AI and automation and away from personnel, leaving tens of thousands of workers searching for limited opportunities in an increasingly competitive job market.

So most recently in the news, Cisco had reported record revenue, and still announced another round of layoffs, a little less than 4,000 employees, roughly less than 5% of its workforce.

So this is just the latest, and tech company is shifting more of its investments towards AI.

Here's another slide that was shared at East Bay ED EDA East Bay EDA's event last week illustrating tech's K-shaped expansion.

So between the first quarter of 2023 and 2024, average annual wages and tech increased 25%, while the number of tech workers declined by 6% over the same period.

We always like to cover these trends, in part because our general fund is property tax rather is the most important source of discretionary revenue in our general fund.

So according to the state association of realtors, in March, the median price in the county is 1.36 million.

That's a 4% increase from the month prior and down slightly from a year ago.

March home sales are up about 30% month to month and down about 4% from last year.

On the next slide, you can see that counties face various pressures, sometimes competing with one another, often with limited resources.

So this illustration is just some of the financial and policy pressures that counties face.

Some of the current financial pressures include rising costs with increased service demands, unfunded mandates, policy pressures in particular include changing federal priorities and limited abilities to raise revenue, which is particularly challenging given how reliant the county is on state and federal revenue, particularly in its general fund.

So now I'll hand it off to Amy for the state and federal updates.

So just quickly on the federal budget side, the House and Senate are in session until they go out from Memorial Day recess.

They are working on a reconciliation package, which the president has given them a June 1st deadline.

So it is unclear whether they'll meet that deadline.

The reconciliation as a reminder is to fund customs border patrol and immigration and ICE and provide additional resources to the Secret Service.

This is above what was allocated to them through the HR1, one big beautiful bill last summer.

This is additional funding to take them through the end of President Trump's term.

And the House unveiled a transportation bipartisan transportation service transportation reauthorization bill that they're calling Build America 250, and it's scheduled for markup on Thursday, and they're hoping to get this through.

This is our five-year surface transportation reauthorization act.

On the state side, last Thursday, the governor released his May revise.

For the county, that looks like we did not get anything that we had asked for for counties, but there's some stability in the May revise, in that there is additional revenue higher than expected.

And we'll be adding uh nearly 30 billion dollars to the reserves.

Some of that is constitutionally mandated, and some of that is new new reserves, but there are no new major spending commitments in this proposed budget.

For us, it means there is a reduced risk of immediate cuts, but the continued funding from many of our services is not at the level we would we need to offset the impacts of HR1.

Just a quick overview.

The May revise includes statewide resources for medical administration and additional funding for eligibility workload increases.

So they're looking at 44,000 medical disenrollments in 26-27, going up to 1.3 disenrollment, 1.3 million disenrollments by 2930, which is significantly less than they had originally estimated.

And there are some changes to MedicaL as it relates to immigrants, specifically transferring some immigrant populations from managed care to fee for service Medical.

And then they'll this is proposing to delay implementation of restricted scope Medi-Cal until July 1st, 2027, and also reinstating the Medical asset test.

As it relates to behavioral health, um, we did not see any additional resources for behavioral health mitigation.

We had made the counties as a whole had um made requests of uh 224 million next year, and then 828 million in 27 28, and uh this budget includes zero through the chair to the ASL interpreter.

Could we assist you?

You may unmute yourself.

I think maybe we needed to switch interpreters.

Christy Fraley.

By any chance, are you our other interpreter?

Yes, Christina Freely, I'm here.

Uh I don't have a way to open.

Thank you.

You have been promoted as a panelist.

Is it working now?

Christina, if you are other interpreter, please unmute your um please enable your video so that we can see your interpretation.

Yes, I'm here.

I'm just trying to remove the virtual backdrop.

I apologize.

Um I will work on that if you want to use the other interpreter for one moment.

Okay, we'll continue.

As it relates to homelessness, uh the homeless housing assistance and prevention program does have continued funding, but it is at a reduced rate of $500 million for hop round seven and additional accountability requirements for our county.

One of those is providing local matching funds, which we already do.

Um, but there are some additional um uh reporting and accountability things that we'll we'll need to do that do present um uh administrative burden for our staff.

As it relates to CalFresh, there is some resources in the budget, but $30 million one time statewide to assist with increased um uh increased administration as it relates to CalWorks and federal work requirements.

Um there is $30 million one time for food bank statewide, and um there are resources in the budget for IHSS in home supportive services related to immigration eligibility and the Medi-Cal asset test.

On a positive note, the May revision does update our 1991 and 2011 realignment estimates and projects moderate growth.

Um we are seeing uh 89.1 million in statewide savings from Prop 47, and uh the budget does include SB 678 probation funding.

So overall, there are some positive impacts for counties in that we are not seeing uh increased uh reductions, but we are not seeing um increased support from the state.

So while there are is some resources for county administration of Medi-Cal, and they are continuing the HAP funding, it is at a reduced rate.

And then our major risks are that there are still HR1 impacts on Medi-Cal and CalFresh that we are going to be not supported by the state to address.

Um we're gonna see an increase in our uninsured population, no direct funding to public hospitals to mitigate their HR1 losses, no support for county indigent programs, um, and we're continuing to see an increased demand for services without sufficient support to counties.

Okay, I'm gonna for context, I'm gonna move quickly through the current year budget overview.

So the county's budget in all funds is 6.1 billion for uh programs and services.

General fund appropriations total 4.3 billion, which is an increase of $300 million over the previous fiscal year.

And the budget supports a workforce of nearly $10,500 full-time equivalents.

Uh, we closed a funding gap of $105.7 million for the current year with a combination of one-time and ongoing strategies.

I'll note that the one-time strategies totaling $61 million essentially becomes the start of our funding gap for the fiscal year 26-27 developing budget, with ongoing strategies totaling $45 million.

Every effort is made to prioritize ongoing strategies to the extent that they're available, so that we're really addressing the county's structural funding gap.

And then this next slide really underscores the reliance on state and federal aid and the general fund.

So if you take a look at this pie chart, you can see that state and federal aid in the general fund is nearly two-thirds of the county's total financing.

Moving on to the maintenance of effort budget, our board has established maintenance of effort budget guidelines.

These guidelines essentially guide the department submissions annually for the developing budget.

So the maintenance of effort is essentially the funding level that's needed to continue existing programs and staffing levels.

Moving on to the program area summary, you can see that appropriations have increased $78 million over the prior year, while revenues essentially remain flat, resulting in a net county cost of $76.4 million on the program side.

This next slide breaks down that side of the equation by our four major program areas: general government, public protection, public assistance, and health care.

And then the next slide covers the net cost change by program.

So you can see on a percentage basis, general government is up 4%, public protection is up 10%, which is driven in large part by a decline in the statewide public safety sales tax revenue, public assistance is up 8%, and health care is up 4%.

Here are some of the notable program changes that are driving the gap on the program side.

I will bring your attention down to the bottom bullet point on net salary and benefit adjustments.

I'll talk a little bit more about that in detail in a future slide.

Here's a summary of our internal service fund adjustments.

So you can see the uh slight change downwards for information technology services, an increase in communications and radio, which is significant on a percentage basis because of radio replacement to replace emergency communication radios.

Building maintenance is up 11.5%.

Motor vehicle is up 18%, in part driven by the cost of fuel, and risk management is up 8%, almost 9%.

Here's the detail on salary and benefit adjustments.

You can see the cost of living and wage adjustments totaling $71.5 million, health and dental up nearly $10 million, workers' comp up 30 million, overtime, the overtime adjustment recommended is $7.2 million, and other all other benefits in the aggregate 16.6 million.

So the gross salary and benefit increase is 134.4 million.

We benefit from net retirement savings of 93.4 million.

So the remaining net salary and benefit adjustments is 41 million.

Here's additional program net cost change, both on the appropriation and the financing side.

And then the next slide moves on to the other side of the equation, so to speak.

So this is a non-program summary.

Capital and major maintenance has a net cost of 50 million, contingency and reserves 125 million, debt service, a little less than 40 million, and then non-program expenses and revenues, credit at over 1.1 billion, resulting in a total non-program net cost of negative 954 million.

So here is the net cost change by those categories.

So as you can see, capital and major maintenance is up 50 million, contingency and reserves a half million, debt services down about 8 million, and non-program expenses and revenues down 27.2 million for a total net program net cost change of 15 million.

So this is the analog on the non-program side with additional detail broken down.

So as you can see, I'll draw your attention to us backing out what was built into the current year budget and investment into general liability reserves of 75 million and an increase in workers' comp of 33 million on the expenditure side.

And then on the financing side, you can see what I referred to earlier as the 60 million of one-time budget balancing solutions becoming the start to our funding gap.

All of that added together, resulting in the 15 million increase on the non-program side.

So if you put both of those sides of the equation together, you can see that results in the 91.4 million dollar funding gap that we have to close.

This next chart illustrates the funding gaps that the county has had to close since the implementation of ERAF and fiscal year 9293.

So if you look on the far right at that stack bar, you can see the section in red represents the funding gap that we have to close of 91.4 million.

Absent the net retirement savings that we're seeing in the budget, which resulted in a prepayment to a SERA to pay down our pension liabilities, the funding gap would have been 184 million.

So we've essentially closed half of the funding, that funding gap with the net retirement savings.

So we're now in the process of balancing the maintenance of effort budget so that we could present a balanced proposed budget to the board by next week.

The budget balancing approach that was recommended was that the county administrators' office work directly with agency and department heads to try and close the structural funding gap through the combination of strategies that are listed here on the slide, including a review of all program revenues to identify additional ongoing adjustments, another review of program budgets to see if we could identify further cost reductions, a review of vacant funded positions, all other available departmental funds, a review of non-program revenue and expenses based on additional data, and then considering other countywide strategies that we could deploy to reduce net cost.

Bottom line is we want to continue to reduce our reliance on one-time strategies, including prior year savings, so that we can really address structural funding gap.

So here's a look at our progress so far towards closing the 91.4 million.

So far, we've identified additional revenue of 40.2 million, ongoing cost reductions of 3.1 million, salary and benefit adjustments, which will likely include the elimination of vacant funded full-time equivalent positions, as well as other solutions totaling about 55 million.

What is newer on this list are the special election costs that are noted at the bottom of the slide.

Often we find ourselves in a situation where we have unanticipated costs related to special elections, and unfortunately, no reimbursement is available for some of the statewide or federally mandated elections that we have to hold.

So looking ahead, in terms of our long-term obligations, it's important that the county try to maintain the triple triple designation.

This is a distinction that only a handful of counties hold in California.

It's the highest possible credit rating from the three major rating agencies.

We also have the capital improvement plan, where we've identified over a billion of unfunded capital costs over the next five years.

The board has adopted a long-range capital financing plan, including the establishment of a special capital construction fund.

So in terms of next steps, we will continue to review and analyze the impact of the governor's may revise.

As I mentioned earlier, you know, continue to update our revenue projections and implement cost containment and reduction strategies, work you know, throughout the week to try to identify additional strategies to close the remainder of the funding gap, including continuing to review positions and vacancy factors, considering technology solutions and other efficiency initiatives to streamline our operations, and then continuing to work with stakeholders, including labor, our uh community partners and incorporated area residents to help identify strategies to maintain a balanced budget and uh continue to provide critical services to our diverse communities and finally continue to work with agency and department heads uh to address the structural funding gap through a combination of strategies.

Uh finally, here's a look at uh the remainder of our budget development timeline.

Uh, we are scheduled to present a balanced proposed budget to the board on Thursday, May 28th at noon uh with the opening of formal budget hearings uh to begin on June 18th uh and to be continued to the week of June 22nd.

I'll pause there for any questions.

Any questions, any questions from board members?

Please proceed.

Are we finished otherwise?

We're gonna go to public comment on the federal, state, and county budget financial updates.

I'd like to thank staff before we do that and say um I know we've given this presentation several times, but to largely different audiences, it's an opportunity for everyone to see the macro and even some of the micro uh factors that we have to consider.

So thank you.

Public comment on the item one federal, state, and county budget finance updates.

Do we have speakers in the room and online?

If you could give me a count, I would appreciate it.

Yes, President Halbert, so far we have a total of five, two in person and three with their hand raised in Zoom.

Okay, before we go to public comment, I'll ask Supervisor Tam any questions or comments.

Um, thank you, President Halbert.

I just wanted to uh ask this one question in the hopes that either our social service agency or uh the food bank uh can address the question.

Um may revise.

There is uh 30 million dollars one time for food banks statewide, and that's this is an increase.

So I'd like to understand what it means for Alameda County food bank.

I'm ready for the basic director of postal services.

I think we have not been able to call it off the announcement, Alameda County in particular.

Um we are working on that to have it completed by this evening after food.

Is the food bank here?

Yeah, hi.

I just want to I'm I'm taking my community.

But it is statewide and it's under the Cal Food program.

Supervisor Marquez.

Uh thank you, Ken.

Thank you for the presentation and the work, especially um posts that may revise.

Um, do we have any strong indicators in terms of I know CSAC is advocating to make sure that the state helps us address HR one?

Do we have any updates with respect to those advocacy efforts?

CSAC did uh concerted advocacy um push the earlier this week, but uh until the Assembly and the Senate, you know, introduced their budget bills.

We aren't sure what will get included.

If anything.

Um, um they they have both laid out their priorities and they're not super strong necessarily on supporting the the counties asks, um, so we're you know, it is unclear what what will get included.

And you say you're that you're referring to the state legislators have not been in support of that.

Um both the assembly and Senate's package acknowledge that there are impacts of HR one, but they have not indicated as to which level which level they're going to try to mitigate those and how, whether that looks like what the counties are asking for, which is increased financial participation on the state's part or something else.

So I can say that um CSAC did convene an emergency meeting of the executive committee on Sunday at 6 p.m.

Um, as you know, Alameda County this year was readmitted to the executive committee, and so I participated in that.

The CSAC team is advocating for 1.9 billion dollars.

Thus far, that request has fallen on I won't say deaf ears, but there's no um they're not doing backflips to go make that happen.

Okay, so yeah, I would encourage everyone that's here to reach out to um our local delegation.

And if you uh Melanie, I know you've stated this statistic in the past, but are you can you recall um how much basically the state has called back in realignment?

I think it's in the billions.

Is that correct?

Uh supervisor, I think you're referring to local property tax.

Uh so um we we have shifted over 12 billion since ERAF has was implemented.

What's interesting to note is the amount that we're um estimating to shift in the fall.

Uh seven, it's a roughly 760 million.

That's actually more than what we're budgeted to keep locally in um secured, unsecured, and supplemental property tax.

So we shift more to the state to backfill the cut to schools than we keep here, correct?

So the state continues to take more, they're expecting us to do more.

We have these unfunded uh mandates, we have the impacts of the federal government, and at this point, there's not high confidence that they're willing to help us mitigate those cuts from the feds.

Correct, okay.

Cause I hope everyone heard that, and we can uh lobby our local delegation because we can't do this alone.

On top of that, they choose to spend their time to go after other things like SB 1193, working on the discretionary, the small amount of discretionary funding that we might have at our level to help alleviate this, looking at peanuts compared to the big picture billions of dollars that they are shorting counties.

Um, just to restate and address more cases.

Thank you.

Supervisor Fortunato Bass and then Miley.

Thank you, President Halbert.

Um, and thank you to our staff for preparing all of this information and the report.

Um, it is um underwhelming to see that we are not getting the support we had hoped for from the state.

And that said, I do think that there is a structural issue that we have to address, which is economic inequality.

Um, and the state could very well address that.

I have to say it's incredibly frustrating.

There has not been the political will in Sacramento to raise revenues and to correct uh the loophole in Prop 13.

Um, I think that's where we also need to focus in addition to the advocacy with CSAC.

I think we also have to focus on longer-term um structural uh fixes that will create a more equitable tax structure for everyone here in California, given that we are such a wealthy state and a wealthy economy in the entire world, and certainly uh the primary and the general election are very consequential in terms of the outlook for being able to uh change these structural issues in regards to state revenue.

Um I do have one question, which is on page 34.

Um, so in terms of the net cost to capital and major maintenance, I am interested in hearing um about the $50 million dollar change, seeing that last year it looks like there was no net costs.

Uh thank you for the question, Supervisor.

So this is a a little bit of a technical issue.

We did have uh $15 million budgeted for major maintenance on the program side on on the no on the non-program side of the equation, we are showing an increase of $50 million.

This is primarily recommended for major maintenance given the the long list of deferred maintenance that the county has.

So we are recommending a relatively significant increase to address those deferred maintenance needs.

Thank you and um is that funded through the allocation that we do at the end of every fiscal year or from the general fund.

No this this is recommended to be uh built into the maintenance of effort budget okay thank you.

Oh yes well thank the staff for the update very thorough um couple of quick questions though the um the state um governors may revise can we are we comfortable with um with the revenue projections because it just seems to me just seems optimistic it doesn't well I hate to say it seems like it's smoke and mirrors.

Um the LAO has largely validated those um those projections at this point but does uh caution that uh the the stock market uh as it stands right now could very easily uh you know change or the the projections or the revenue could increase even more if any number of the um AI companies that are located here decide to have an IPO this year um so it could go either way but the LAO did say they've they feel pretty confident about what the department of finance has put up which they don't generally agree to that level.

Okay but also to note um supervisors you know some of those excess revenues if you will are statutorily required to go into some of the reserve funds of the state.

Okay.

And then on the um the funding gaps to CRAF so uh this year we have um a 91 million dollar uh gap but it could have been one 184 almost 185 million um so the the the fact that it could have been that high is based on repeat that once again uh so the we've essentially closed half of what would have been a hundred and eighty five million dollar funding gap because of net retirement savings that we're able to capture um as part of this budget development cycle uh so the county has prepaid a portion of its unfunded pension liability to our retirement system a SERA and that has resulted in significant retirement savings and when do we start doing that Melanie roughly the the board adopted a policy probably five ten years ago five five at least five years ago um to establish a pension liability reduction fund knowing that we had a growing unfunded liability and was based on that board the board's policy that we assessed when it was appropriate to then invest additional funds in the retirement system um which brought down brings down our contribution I just want to I didn't want to have us kind of just skim over that because that was very very important because I remember when it happened and we're seeing the the impact of that because I think Supervisor Haggerty and um Carson brought that forward to the board at the time and I think had we not done it we'd be faced because we can never look into a crystal ball and predict what the future's gonna look like but we can take steps to be prudent in the um actions that we're doing annually to balance our budget and this action that took place years ago is reaping benefits presently, but had it not taken effect, we would be suffering the consequences of that.

So I wanted to really emphasize that with the current board as well as with the public, so folks understand that we're constantly looking not just at the immediate but um the actions that we take immediately and how that's going to have an effect next year, year after that, and may be down um uh in the in the future.

So I just think that was important to point out, um, and then you're gonna present the budget on May 28th, and we're gonna deliberate June 18th through with uh wait a minute.

We're gonna deliver June 18th.

So June 86.

So we're gonna submit the proposed budget to the board on May 28th.

We will officially open the hearings on June 18th, but we will actually continue um the start of the hearings and your board's deliberation until the following week.

So it'll pay Monday the 22nd.

Okay, so you're presented on the 18th, and then we'll deliberate the following week.

Okay.

Um then let's see, and I just want to also thank the staff, uh, both the county administrators' office and the uh department heads who represent um uh good portion of the unincorporated area, and I think other department heads for going to the MACs.

I believe you've gone to the uh the various MACs in the corporate area and presented the budget, and you're doing much a much more thorough job of letting the folks in the corporate area understand the county's budget processes and deliberation, it's uh impacts uh everything we're doing, both to be fiscally responsible holistically, but also uh to address uh the concerns in the other corporate area.

I've been getting positive feedback uh from going around and meeting with the MACs.

And I think those are the only comments I have at the moment, so thank you.

Any other questions on the board?

How many speakers do we have?

We have a total of five, President Hubbard.

Two minutes for each, thank you.

Okay, calling the in-person speakers that signed up for item number one.

Jane Kramer Kramer and Tom Panetta, you may approach the podium.

Ms.

Kramer, Jane, Ms.

Kramer, do you wish to speak for this item?

Why don't we have uh the next speaker?

Jane Kramer, I just want to continue finishing up my input from last time, which was the budget, human enhancement to an alternative health budget.

Um so the fifth item on um my short list was a few rehabilitated persons will re-enter society and they'll run for public office.

Why not?

Many more will become well employed within the community, they'll become architects, biologists, accountants, um, whatever.

So my conclusion is that alternative medicine persons and conventional medicine providers need to have an ongoing informative discussion with each other, in which each understands and respects the perspective of the other.

That benefits society, that benefits the public, and in effect allows persons to benefit from good health.

Thank you.

Thank you.

Next speaker.

And I'd like to close the application for speakers, freeze it at what we have today.

Is that for all items on the agenda, President, or just for this item?

This item.

Okay, thank you.

Next week.

Hello, my name is Tony Panetta, and I'm the chief impact officer for the Alameda Health Consortium.

Here to provide additional context on the May revise.

We agree with the top line that the May revise did not do anything positive for the county in terms of what we were looking for.

I wanted to follow up on comments that I had provided during our last opportunity at the last um work session when I had shared that we were advocating for a delay in current law that calls for the elimination or a cut in the rates that federally qualified health centers receive when they provide services to patients who are considered to have unsatisfactory immigration status.

We did not see that elimination or delay of that law, which means that effective July 1st, federally qualified health centers will be effectively receiving a rate cut when they provide medical care to patients who are considered to have unsatisfactory immigration status.

We have been in conversation uh with Director Chow J and with many of your offices to keep you apprised of the situation, but this does become effective July 1st, and our health centers do not proactively know which of their patients they will not be receiving full reimbursement for.

They will find out after the fact.

And the estimate from our state association is that they would be receiving about 20 cents on the dollar when they provide care to those individuals.

So we appreciate the thoughtfulness and the consideration that this board provides to sustaining the safety net in Alameda, and we appreciate your partnership and thinking through how we can mitigate the effects here.

So folks have access to care.

Thank you.

Thank you.

Thank you, online speakers.

Moving to our Zoom speakers, we have three.

We have a phone number ending in 7525, then Dr.

Free, then then Kari.

Phone number ending in 7525.

You may unmute yourself and begin your comments.

Moving to our next speaker, Dr.

Freed.

You may unmute yourself and begin your comments.

Great.

Thank you.

Um I'm Dr.

Freed.

I'm the department program manager for the Fairmont Alpatient Behavioral Health Services.

Uh speaking on behalf of both the programs at Highland and Fairmont.

Just want to make three quick points to keep this on the radar of the board of supervisors.

One, our programs are slated for closure by AHS after June 30th, that the county uh takes no action to avert this closure plan.

Number two, these programs provide critical and essential services for the most vulnerable.

Patients uh struggling with mental illness, uh, severe mental illness in our county.

Um we have been for more than 30 years uh maintaining this role in each in the county to um support all the county FSPs with our services.

So the way that works is uh the county FSPs have a large population of many medi patients, and when those patients are at risk to go in the hospital that need more care, they reach out to us.

Uh we do that through county case management BACs, all you know, all the FSPs have uh many, many patients, and we've been doing that.

Uh that that is our role for 30 30 years.

The FSPs do not provide day treatment.

We're the only ones that do that.

The third point is that there are no other programs in Alameda County that do what we do for our severely mentally ill patients in terms of day treatment.

Um, so our patients cannot be referred elsewhere.

If our programs close, this will be a disaster.

Not only for our patients who will be faced with homelessness, more frequent visits to psych emergency and inpatient psychiatry, as well as creating more of a financial burden.

You know, for the county, uh that uh we've been uh helping to save them millions of dollars over the years for.

Thank you for your comments.

Moving to Kari.

You may unmute yourself and begin your comment.

Just like to remind speakers that we're speaking on item number one, federal, state, and county budget updates.

We are not entertaining public comment on item two.

Hi, folks.

Um, yes, this is Kari from Restore Oakland.

I know that I spoke to um Supervisor Hubbard and Tem at the meeting yesterday, and just wanted to reiterate and and get some more clarification at in the next, hopefully in the next presentations, um, about different funding sources for the county's care first, jails last initiatives, and to remind the supervisors about the the commitment that has been made there.

Um, recognizing that in this time of dire budget cuts from the federal and state level, we need to be thinking about cost efficiency at all times.

I heard the supervisor speak to that yesterday, and I just want to reiterate again for the entire board that we know from the evidence and from the county's own um commission studies that the most cost efficient way to be supporting our most vulnerable folks is not through the jail and the sheriff's office and any emergency services, but rather through preemptive supportive services like the one that was just mentioned.

Um Fairmont is an incredible resource.

There are so many incredible resources in our county that are at risk of being cut or already have been, and we desperately need to be thinking about structural ways to shift funding from our extremely cost ineffective jail and sheriff's office into the much more cost-effective forms of support, including behavioral health housing, um, and supportive services for people with serious mental health issues and folks that are in engaging in the criminal legal system in the county.

Um, I also want to just say that it would be great if we could get better notice about these meetings.

Um, and understandably, I know it's all working very quickly, but please do public noticing and present the materials beforehand.

Thank you.

Thank you, President Halbert.

That was our last speaker for this item.

Very good.

As noted uh earlier, we now will recess into closed session.

When we come back, we'll take up items two high and two high high at that time.

Thank you.

Welcome back, everyone.

I'd like to reconvene our meeting.

Will the clerk please call the role to establish our quorum?

Certainly.

Supervisor Marquez present, supervisor Tam present, Supervisor Miley, Supervisor Partonado Boss, present.

And President Halbert.

Present.

We have a quorum.

Thank you very much.

Would County Council um anything to report out from our most recent closed session?

No, there's been no reportable action taken in closed session for the entirety of today.

Thank you.

With that, we'll move on to item two update on board initiatives, sub bullet I, board action on measure w, Essential County Services Expenditure Plans, and excess tax receipts.

I'll turn the meeting over to our county administrator to introduce this item.

Thank you, President President Halbert, uh members of the board.

Um, today we're going to provide an update uh per your board's direction on measure W, Essential County Services Expenditure Plan, and excess Tax Receipts.

This is a follow-up to your board's work session on um April 28th, and so want to provide some of the same background and information that we provided at your last meeting with regard to Measure W.

We will have a very quick overview of the Home Together component just to put into perspective the entirety of Measure W and then focus on the Essential County Services Fund.

So, just to start, we're just go back to a little bit of history that I think you're all aware of, but just to recap for the public, Measure W was placed on the ballot by your board in 2020 as a 10-year half cent sales tax measure.

It passed with 50.09% of the vote in November of 2020, and the ballot language emphasized the need to support essential county services, including homelessness, mental health, job training, safety net programs, and other general fund-supported services.

We began collecting the tax after it was approved by the voters in July of 2021, but funds were held in escrow due to litigation, and it was not until April of 2025 that the courts upheld the measure, allowing the county to begin appropriating the accumulated revenue.

I think the history is important because these funds represent voter-approved resources intended to strengthen essential services during a time of growing community need and now during a time of significant federal policy changes and funding reductions.

The next slide just summarizes the board's actions that you have taken since Measure W revenues became available.

And just quickly to recap, in December of 2024, you designated almost 395 million for housing and homelessness efforts contingent on the release of the Espero funds.

During the subsequent 25-26 budget process, your board approved early allocations focused primarily on food security and aging services.

In July of 2025, you adopted the overall allocation framework and guiding principles for Measure W implementation.

And you also reaffirmed housing stabilization investments and established a one-year expenditure plan focused on immediate and capital needs.

Additional allocations later in 2025 addressed immigrant and refugee services, food support, senior services, and supports for individuals with developmental disabilities.

And most recently in March of this year, your board directed staff to return with a two-year expenditure strategy, including capital and major maintenance investments.

We presented that initially to your board in April 2028, and based on your board's direction, are back today to review that with you again.

The board, as I mentioned, established guiding principles aligned with vision 2036 to ensure that Measure W investments are strategic and accountable.

The principles place equity at the center of funding decisions and prioritize communities most impacted by poverty, homelessness, and structural inequities.

The framework adopted by your board also emphasizes prevention focused strategies, cross-agency coordination, measurable outcomes, and leveraging outside funding whenever possible.

And importantly, the principles also stress responsible fiscal stewardship, including maintaining reserves and matching one-time revenues with one-time expenditures when appropriate.

Today's proposed strategy is designed to align closely with these principles while maintaining flexibility for future fiscal considerations.

The board also directed us to align the plan with Measure W Guiding Principles, which support Vision 2036.

Again, core principles of equity, strengthening safety net, addressing the root causes of homelessness and poverty.

And today's proposal builds on the framework and sets the stage for a longer investment strategy.

This slide provides a high-level summary of the Measure W allocations approved by your board through October of 2025 and consistent with your prior direction, 80% of revenues are allocated to the Home Together Fund and 20% to the Essential County Services Fund.

The framework also includes a prudent reserve strategy to stabilize services during economic downturns or revenue fluctuations.

To date, substantial one-time investments have already been approved, particularly for housing, homelessness infrastructure, and county capital needs.

The structure also allows the county to balance a long-term system and systemic investments with flexibility and fiscal resilience.

And just to point out, in total, over the term of the measure, the estimate is $1.8 billion of tax receipts, of which your board has signaled an allocation of $1.4 billion to the Home Together Fund, $258 million to Essential County Services, and a prudent reserve of $170 million.

I'm now going to turn it over to Amy Schrago to talk about the proposed home together spending plan as well as the Essential County Services Fund.

So just to give you a refresher, since 80% of the measure is allocated to Home Together, the housing and homelessness investments are the largest of long-term Measure W priority.

This illustrates the estimated long-term spending plan for the Home Together Fund over the life of Measure W.

The largest share of investment is directed towards housing production and housing stability, and significant funding is also allocated to shelter systems, prevention strategies, coordinated access systems, and capital infrastructure.

This reflects your board's long-standing commitment to the Home Together Plan and regional homelessness response efforts.

These investments are designed to create durable system improvements rather than only short-term interventions.

Most of the early application allocations are focused on capital and shelter investments.

They're summarized here.

These are all, excuse me, these are the board approved home together fund allocations through 25-26.

Approximately 58% of approved allocations have supported capital investments, including affordable housing development and infrastructure improvements.

Additional investments support shelter expansion, housing programs, and coordinated service delivery systems.

These allocations focus on quickly addressing critical system gaps while longer-term program structures are developed.

FY2627 represents a major implementation year for the Home Together Fund.

The total expenditures are projected at approximately 288 million dollars.

Capital investments in housing operating subsidies account for the largest portion of spending during this fiscal year, and significant investments are also proposed for housing placement, shelter operations, coordinated entry and prevention efforts.

This shows the transition from planning and initial allocations into full operational implementation.

And in 27-28, the overall budget declines slightly as one-time capital investments taper off, and the focus shifts towards sustaining housing programs, shelter operations, prevention efforts, and ongoing service delivery.

This shows the expected transition from startup into implementation and a more stable operational phase and reinforces the importance of maintaining sustainable ongoing funding strategies moving forward.

Now just looking at our Essential County Services Fund.

You've seen this chart before.

It shows our six buckets.

It summarizes the allocations already approved by the board, totaling 73.5 million dollars.

Investments to date have focused heavily on boot security, safety net services, and immediate community stabilization needs.

And these investments addressed current needs while preserving flexibility for future years, especially as we're uncertain of the outcomes of HR1, the economy, and our state budget.

Here you can see a consolidated view of our current Essential County Services Fund allocations and remaining funding available.

About $88 million here is represented in one-time capital investments, one-time immediate known needs, and savings to carry over for future investments.

We have allocated $73.5 million as seen in the previous slide.

And looking ahead, approximately $170 million is available in ongoing funding capacity annually through the life of the measure.

So we're here today, presenting what we shared with you back on April 28th.

We are recommending a two-year strategy structured around four investment categories that encompass the six buckets that were identified previously.

The categories are stabilizing the safety net, meeting basic needs countywide, supporting housing stability and capacity building in unincorporated areas, and one-time capital and major maintenance projects.

Together, the proposed strategy includes $34 million annually over two years, plus $14 million in one-time capital investments.

This phased approach balances our immediate stabilization needs with flexibility for future years.

The primary objective here is stabilization during a period of substantial state and federal policy change.

Major investments include Proposition One transition mitigation funding, health pack network stabilization, and Medi-Cal retention efforts.

Funding is also proposed for immigration support services and LGBTQ community supports.

These investments are intended to prevent service disruption and preserve continuity for vulnerable populations.

And we've added another chart to this slide than previous that identifies which departments these allocations will go through, and the amount in each of the two fiscal years.

The proposed investments in our meet basic needs countywide support core safety net functions with immediate community impact.

Major allocations include ongoing support for the interpreter.

Oh, okay.

Ongoing support for the Alameda County Community Food Bank, nutrition programs, and staffing support for adult and aging services.

The proposal also includes targeted food security investments for low-income residents in unincorporated areas.

These are programs that directly affect day-to-day stability for many county residents.

In regards to the unincorporated area, this category emphasizes prevention first strategies intended to reduce displacement and housing instability.

Proposed investments include tenant landlord mediation, rental inspections, legal aid, rehabilitation assistance, and outreach programs.

The strategy also supports proactive code enforcement and rental registration efforts.

The underlying principle here, as you can see, is prevention is both more humane and more cost effective than responding after a crisis occurs.

And then this is continuation of our unincorporated investments focused on strengthening long-term capacity in unincorporated areas.

Our proposed investments support community-based organizations, economic development planning, commercial corridor improvements, financial literacy efforts, and staffing support.

These are intended to strengthen our local infrastructure and support sustainable community development.

In the one-time capital and major maintenance category, we're looking at durable infrastructure improvements and major maintenance needs.

Projects include the Castro Valley Library, food hub improvements, the Lorenzo Theater, sewer infrastructure, and safety net facility maintenance.

These are one-time investments intended to strengthen county facilities and community serving infrastructure, reducing future deferred maintenance risks.

And here is a summary of the full recommended two-year expenditure plan, totaling proposed totaling a proposed $82 million in investments across all categories.

The largest category is safety net stabilization, followed by basic needs, unincorporated area investments, and capital improvements.

And overall, we're looking for to balance immediate service needs and long-term infrastructure and fiscal sustainability.

And here is a summary of each of the four categories by fiscal year, and then each of the four categories by the department that will be responsible for the programming.

And then we're going to transition to our recommendations.

So the first recommendation is that your board consider approving the fiscal year 2627 and 27-28 essential county service fund expenditure plans that Amy just walked through again.

If you're with your board's endorsement and support, we would incorporate the 26-27 plan elements into the proposed budget that will be presented to your board later this month for your deliberation and adoption by the end of June so that we can start the fiscal year with an adopted plan.

With that, we wanted to talk about the proposed additional expenditures that your board discussed on April 28th and asked us to come back and report further on options to support those additional expenditures.

So here is the list of board priority programs based on testimony we heard and board direction at the April 28th work session.

In addition to the core recommendation, this slide summarizes those priorities.

These requests focus heavily on senior services, food security, immigrant and refugee supports, and behavioral health stabilization.

Together, these additional requests total approximately 20 million dollars annually, and they're presented separately because they will require an additional additional funding direction.

So we took the information provided in the senior services coalition letter.

We looked back at the contracts that we have with them currently, and uh that's how we came up with the amounts for allocations, because our other contracts um are uh trying to match what we what we're currently in contract with for these programs, and um so you can see a bulk of them are covered by what the senior services coalition proposed.

There is an allocation for food recovery and food bank and prepared meals, and then for immigrant and refugee supports.

Um the difference in the number for the immigrant and refugee supports is that 1.3 million is included in the 26-27 proposed um spending plan already.

So this would close the gap between that and uh what what was presented to the Act for All committee as an ongoing need for those contracts, and then the full amount for that is represented in the 2728 column.

Just a snapshot of the bridging MHSA to BHSA transition.

This was presented at the last health committee meeting and outlines the estimated funding gap associated with that transition.

While AC Health identified a range of mitigation strategies and reductions, they also identified that there was approximately 10.7 million dollars remaining that needed to be closed.

This issue represents one of the largest near-term fiscal pressures facing the county, and um AC Health is recommending temporary bridge funding to reduce disruption to community providers and vulnerable clients during this transition period, and uh we believe that this 10.7 million dollars with an ECAS support uh can be covered through resources that exist within AC Health already.

So at this time, we're not recommending that the 10.7 come from Measure W resources, and then here is the same slide with our six buckets that shows the total combined total of approved and proposed allocations for each of the six areas.

So in the unincorporated area, we're looking at investment of 24.3 million uh total of approved and proposed for food security, 24.8 million for affordable housing on county properties, 27 million for older adults and senior services, 6.7 million, or federal state policy and budget impacts 53 million, and for our critical county infrastructure, 15.1 million for a total of 150.9 million dollars.

So uh with regard to your board's allocation of Measure W Essential Services Funds for 26, 27 and 27, 28, a portion of those funds are recommended to help with the bridge funding for behavioral health care services.

I believe the total is 21.7 million across those two years.

So that's an important component of the bridge funding that's being recommended to support those CBOs who currently have funding recommendations uh based on the transition from MHSA to BH BHSA.

So we are also recommending that your board support and finalize the one-year bridge transition funding related to proposition one reduction to the behavioral health care community providers that would include the 21.7 million in Measure W and also as noted the 10.7 million dollar gap will be funded by ACH.

And then just to point out, in terms of your sales tax proceeds, um, you know, we've been tracking um for some time, and as you know, when we developed the plan, we estimated annual receipts at 170 million dollars.

You can see on the slide that revenues have remained relatively stable, generally ranging between 190 and 200 million annually.

And while encouraging, given the ongoing economic uncertainty, I think we need to be cautious.

As you can see, there is a slight decline over the last three years, and I think we should anticipate that that could continue.

Um, that being said, for the current fiscal year 25-26, um, our current projections indicate that we will probably receive at year by year end 190 million versus the 170 million that was budgeted.

So there could be excess um tax receipts.

So what we were what we are suggesting based on the direction that the board provided at our last work session is that you consider a policy amendment related to measure W revenues received above the annual base budget.

Those funds could be used to address federal and state funding cuts and challenges as well as your board's priorities.

So that would be the 20 million that we're projecting be received this current year, ending this June 30th, in excess of 170 estimate.

There could be up to 20 million dollars that will be confirmed by the auditor when the books close.

We're suggesting that those funds could be used to address the additional priorities that your board identified at your last work session, as well as use be used to mitigate federal and state funding cuts that we know are coming forward.

That concludes the presentation, yeah.

Um our health committee members, supervisor Miley.

Thank you, President.

Mr.

Albert.

So yeah, first of all, appreciate the PowerPoint presentation.

I know because this is a board work session.

PowerPoint presentations are not required to get to us until the time of the work session.

Is that right?

So the only requirement in the law for the material to be provided is um publicly is when it is provided to all or a majority all of your of all of your board members.

If it is only given to all or a majority at the time of the presentation, then that's when it has to be made publicly available.

Okay.

Because you know this is we've we're just seeing this now as as is the public just seeing it.

So I appreciate the thoroughness of the presentation.

So the PowerPoint presentation.

And I do uh want to remark that uh the health committee, we supervisor Tam and I were very um concerned about making sure that the board provided direction around how we were going to um uh um shore up funding for uh mental health um the mental health providers, the CBO providers.

Um so as I understand it, we've got 35 million, and the agency is going to identify another 10 million to give us about 45 million, and you believe that will be sufficient to cover the bridge funding that we need to cover uh the CBO uh providers uh who are gonna be delivering mental health services, preventive mental health services uh under Prop one, uh, so that we can work with them to look at how we're going to address this in the in the uh future fiscal years, but for now we've got the the bridge funding in place and the the additional money that we thought we would need to go up to 52 million.

You you feel we don't need that additional seven million or so.

Can you uh just um respond to that statement and then I've got a few others real quickly?

Sure.

Uh yes, supervisor.

So the the total um programming cuts that happened were about 52.7 million.

As you noted, we uh found funding uh across the agency, I think to the tune of 13 or 14 million, uh, plus the board had allocated uh uh or we had requested well the board had allocated four million in essential services fund back in November, and we had requested another 17.7 million in um uh April, and so all of those together come up to the 35.

There's another 7 million-ish that uh really was one-time funding or funding consultants, or there are uh opportunities where uh we have active RFPs right now.

So uh we think that those are uh things that given the broader context of all of the needs that are being presented to us, we feel comfortable not recommending those right now.

Um and so the remaining gap is 10 uh and we're working with the county administrator's office to figure out um the one-time sources within our agency to be able to pay for that.

Okay, and and I know the health committee wanted this to be an action item, so the board could, the entire board could hear it, and then if the board's comfortable with this, uh direct that this be uh on a board agenda June 2nd as a um action for the board to take up.

Yes, so your action today would allow us to um start communicating with providers uh ideally this week, and then by June 2nd we would have um a board letter that comes in with with the details.

Yeah, and that's important because in the health committee we've heard uh from a number of providers that some have already started to make reductions um uh cutbacks um uh that are affecting clients and staff, and without some assurance of those cutbacks would continue.

And so that's why we felt this was a sense of urgency to get this to the board in a work session today as an and as an action item to provide direction, and and I just want to state too that um, and I'm speaking for myself, I was a little frustrated that uh we're at this point because once again the providers have been talking to us about this for more than you know about two years, and we kept putting them off, putting them off, saying we'll handle it.

We kept putting them off, putting them off, and once again, I'm not putting any blame on anybody, but we are at a place where we've got to move forward with singling that we're gonna provide this bridge money at this point in time and officially vote on it on June 2nd.

Is that accurate?

Yes.

Okay.

Um the next thing is the slide that showed we were looking at 150 million point nine.

Uh, if we approve of the essential county services funding for fiscal year 20 uh 26, excuse me, yeah, 26, 27, 27, 28.

That would give us a total of 150.9 million from the central services bucket.

This is the combined total of what's been approved so far and what's being proposed today.

Okay, and that would leave us with a roughly 108 million in the essential services bucket for fiscal year 29, 28, 29, and 2930.

Oh over the term, if you use the 258 is what was allocated as the 20 percent, correct.

About 100 and 108.

Okay, and with that additional funds for the essential uh services bucket, it would take in once again, just to reiterate it, the request that we heard at our last work session from um a number of the providers, the AAA providers, uh, and others around other essential services needs to the tune of about 20 million per year for two years.

So that cumulative slide uh does not include the the addition of the 20 million dollars per year because your board has not um taken given us direction on um whether or not to bring this money in for these properties.

So you're saying the 150 million point nine does not include that those 20 million per year for correct, it only includes money that your board has previously indicated would be for the essential county services fund.

So if we want to include that additional 20 million per year for two years, that's 40 million, that would take us up to 190, almost 191 million.

Correct.

Because I didn't I didn't catch that, okay.

So that would be 191 million.

Okay, and then that would leave about um about 50, 60, maybe 60 million or more uh for the fun the balance of the other uh until the duration of measure measure w in essential bucket.

Uh our we're currently budgeting at 100 and uh well at 34 million dollars a year.

So it would, you know, be about 68 million dollars.

Okay, available.

If your board um amends the policy about bringing in money over the budget to the essential county services fund, then um you know we would estimate differently, but but because we don't close the books until until the end of the calendar year, we wouldn't know for sure what that dollar amount was, and we can start estimating as we get um, you know, in this instance as we get six seven months into the year, have a good sense of what of what would be coming in over over budget.

Um, so you know you could change your policy and then we could move forward like that.

You could not change your policy, and we could come back to you annually with what we think the overage might be over budget.

Um, so if we change our policy, um we're guesstimating that it's gonna be about 190 million this year, which is 20 million over, and we're not sure what it's gonna be in the future, but the point is whatever that overage is would go into the essential services bucket.

If your board amends the right, and I do understand why we set the policy up initially that the overage would go into the um home together bucket, right?

And I don't think the home together bucket need to, quite frankly, that's my uh I know Supervisor Bass and I struggled around that um before the board took it up.

And I'm I'm you know she doesn't mind me saying that, but we struggled, you know, whether how much to partition the measure W monies in terms of 80 uh 80 percent or 90 percent into uh the home together bucket.

Um, and I know I struggle with her around let's put some money into central services, and I know she wanted to put some more money in the home together bucket with the overage but quite frankly I'm hoping that based on HR1 Prop one all the other demands it's recognized that if we can put that overage into the central services bucket I think that would be the prudent thing to do as opposed to putting into the um home together bucket because I quite frankly think the home together bucket has enough money uh to address the needs and we've seen how over the course of time our strategies uh the home together uh strategy 2020 and then our strategy um home together for the the next five years and they're already looking at the the uh home together strategy for 2030 has begun to streak dividends in terms of reducing homelessness so I think we need to put that over it into the bucket um around essential services and if we do that that can also help prevent homelessness uh just by the mere fact that we're hoping to keep people housed with uh services and things of that nature um so I would just advocate that I I like the direction that is being proposed uh by the county administrator uh office and let me see if there's any other thing I wanted to comment on for the moment before I have the floor um I think I think that's that's it other than just being a broken record when it comes to the fact that we need to use these resources you know we've been blessed with these resources um it's like a um windfall for us a godsend because we were challenged the voters approved it we were challenged we didn't have the resources to begin with but we've had them and now we need to utilize them to the best of our ability to meet the various needs that are confronting us.

So I just think we need to put them to to good use and I can understand why the county administrator probably doesn't want to touch the prudent reserve just yet and so I can understand and support holding off on that and putting the and using the overage to go back into the essential services uh bucket um so I think I think those are my comments for now but thanks oh finally I would support addressing the the request the essential services request that we got at the board work session uh from the triple A providers um I guess the providers for immigrant and refugee services uh food bank etc uh I would support the additional 20 million per year um for 2627 and 2728 so those are my uh comments Ms.

President I know I said a lot but uh thank you for allowing me to speak.

Supervisor Tam you're also a member of the health committee um thank you Mr.

President I uh concur with uh supervisor Miley I um appreciate that the recommendations came back that incorporated many of the providers' uh comments that and requests that we had heard on April 28th and uh given what we just know about the May revise and what the feature might hold and the potential for a housing bond in November of this year um I think it's appropriate to move the projected tax receipts that are in excess of what we're projecting the 20 million into um backfilling some of the needs with HR one and what's happening with POP one uh the question I had is I just want to be clear about this at health committee we talked about the bridge funding, which we absolutely need um from MHSA to BHSA, and as it's proposed now, the 17.7 million dollars is coming out of the essential Services Fund from measure W.

And the department, Alameda County Health is going to make up the 10 point seven with one time changes.

Yes.

So the CAO's office uh has identified some potential strategies that we can use for one time.

So that's what our team is is looking at.

Okay.

Um I'm gonna offer a lot of sympathy for your department because I'm on the health committee along with uh supervisor Miley.

Thank you.

So we just heard uh at our budget meeting that we're about 60% or $55.5 million in reduction of the $91.4 million budget deficit, and every department is asked to try to fill in that gap.

Is this a burden on top of what you're gonna have to do?

Or is it inclusive?

Uh it's an addition.

But we we also do enjoy one of the largest budgets.

You're one of the few departments that actually generates revenue from programs.

So do you see offsets there?

What we just heard about the May revise and HR1.

Yeah, so I mean, I I think that um to realistically put all of the things on the table, you know, we're heading into a space where uh we are a revenue generating department, but that depends heavily on Medi-Cal, right?

And so as Medi-Cal enrollment decreases, um our revenues do take a hit for that.

Um, also one of the uh behavioral health is the largest revenue generating department, and you know, they're taking hits from multiple sides with a Prop One as well as with um uh HR one.

Um that said, I in terms of the again, one time strategies are easier for us to find than ongoing, and so for purposes of there being bridge funding for one time um we we think we can cover it.

I hear the reluctance, but I'll accept that.

Thank you, Supervisor Fortnite.

Thank you.

Um firstly, I am very appreciative of um all of our service providers uh in the behavioral health field, our health committee for the work that you have done, and our um our AC Health Director and your team for identifying this bridge funding for Prop one.

So just very that's incredibly good news for today.

So thank you for providing that good news and um identifying those funds.

Um I am also supportive of the two-year plan for the Measure W Essential County Services Fund.

That's a $34 million per year plan that we discussed at our last work session that we saw today.

Um, in terms of the new items that we're discussing today, I do have a few questions to clarify the information that's on page 29.

Um, so in terms of the senior services, I'm assuming there was a lot of great work done to make sure that uh what we heard from our senior community, what we're already funding and everything, that there's no sort of duplication of efforts, because I know that's something that Supervisor Miley had asked for.

And Supervisor Tan, yes.

Okay, so thank you for doing that homework.

Um, in terms of food security, uh, this is something that I think is very important.

Uh the need is great, and there could be a future food crisis just based on what's happening with um eligibility and work requirements.

Um I want to just clarify for the record that what's already in the proposed two-year Essential County Services Fund plan is uh 5.5 million per year, and so what we see on page 29 of what totals 9.8 million, that's additional.

Okay, so great.

So that's um that's I appreciate that increase.

I know that our folks in the food security community will probably appreciate that as well.

Um, does this include a 4% COLA for our food security service providers?

No, okay.

So how will COLAS be handled in contracts?

Are you talking about on the existing contracts?

Are you talking about the potential additional future resources?

Uh for future contracts.

It's based on direction from the county administrator's office, but typically cost of living increases are awarded to contractors who receive county general funds and not federal and state funds.

So that COLA would be to those community-based organizations.

Okay.

In the interest of time, we'll keep going.

Um let's see.

In terms of this particular list, there are a few other needs that I want to outline.

Um, so the two-year plan also includes 15.5 million in terms of a health pack allocation.

I am concerned that there could be a need sooner than the allocation, which I believe is for FY27-28, that the impacts could be felt next fiscal year versus the following fiscal year.

And so is it possible to potentially frontload that amount if needed.

So I think that might be a technical question for the CAO in terms of whether that funding can be available earlier.

I will note that the um health pack providers uh do have contracts with us currently, and we're we're keeping those contracts whole going into this next fiscal year.

So, you know, uh, and some of the impacts that are coming down the pike.

We don't anticipate them to be just a cliff on day one, but we should have some time to see things happening.

But I'll defer to the county administrator on the technical question.

You're proposing adding more into year one or is it shifting around?

So if needed, if the impacts are felt um by our FQHCs and other providers earlier, could we potentially the 15.5 million that's allocated for health back health pack and FY27-28.

If we feel those impacts sooner, next fiscal year 2627, is it possible to potentially use those funds earlier?

It would mean making some adjustments right in terms of the amount of funds that are you know available, or are there other one-time funds that are have been allocated for something that could be freed up to um use for a higher priority if that's what it turns out to be for FQHC.

I mean, you know, we're we're fixed in terms of the amount of annual receipts we get, but as you know, there's significant one-time sources that have been allocated largely to health to um homelessness to the extent that there's a need for some of those appropriations or funding to be used earlier on priority projects, you know, those are things that could be done through the with the board's approval.

Okay, I would like us to consider because uh the May revise the state budget does not include any relief for our FQHCs in terms of the PPS rates.

So if those impacts are felt earlier, I would want to see if there's some way that we can potentially use that allocation sooner and backfill it.

So I don't know if there's anything more that the staff would like to say about that, but I do want to flag that as a potential need.

I would ask that you know healthcare maybe come back with some proposed options in the event that happens.

Okay.

Um let's see, I have one more issue.

So Supervisor Miley and I are leading an ad hoc group with Alameda Health System.

We are hoping to make progress in terms of looking at efficiencies, revenue generation that will help provide some financial um relief in the future.

However, as some of you know, there's a PHP IOP program that behavioral health under AC Health and AHS are looking at evaluating, and right now those staff positions are set to be eliminated come July 1.

So I am very interested in keeping those programs going for the duration of next fiscal year while they're being evaluated.

And in addition to that, the health advocates and the complex care programs are also patient facing, and I'm concerned about those positions being cut July 1st when we're still going through a process of trying to find some uh relief for Alameda Health System.

I understand currently the cost of those programs is 5.3 million.

That might change, but I did want to put that on the record because those programs I think are pretty critical since they serve um serve patients.

And let's see, finally, I think there's just one more thing I wanted to uh touch upon.

Um, so as you know, I made the motion July of last year to allocate any overages excess revenue from Measure W into our Home Together fund for homelessness, given that there's such a huge need, and there still are some reductions in funding.

I mean, the May Revise saw that we're not getting the increase we had hoped for over the next two years in HAP funding.

So there's still a huge need.

That said, I am willing to consider having the overage from this particular fiscal year, the estimated 20 million, go towards the Essential County Services Fund.

I do want to note that what we're potentially proposing to fund on page 29, these are all ongoing programs, which means that there may be a need again in future years to reallocate that overage and those excess receipts.

Um, but for now, I would want to make sure that that third recommendation is specific to this current fiscal year, um, so that we can continue to assess things year by year and ensure that we're doing the maximum possible to continue the progress that we had a press conference about today, which is reducing homelessness.

Um, and then finally, I do have some questions about measure W home together.

Um it's very important for me in my office as I know it is for um for us to ensure that we are uh working with people who have lived experience, lived experiences of homelessness.

And so my specific question is: um, is there a way to fund programs that are designed by and implemented by people with lived experience of being homeless through the future RFPs that we are planning with the Home Together Fund.

And I'm asking this because it will help me in terms of supporting allocating the excess funds for measure Dolly 2 essential services.

Um yes, the short answer to that is uh yes, supervisors.

So as you know, we've been doing a lot of work with uh people with lived experience, especially as we look to improve our shelter standards.

Um, and so uh that aside, there are other future opportunities, say in the um RFPs that we'll have for workforce development or RFPs that we would have related to the acquisition and rehab of new uh of not new buildings but existing buildings.

So we do think that there's opportunities for that, and we would be happy to continue to work with your office on that.

Thank you.

And just to be clear, there are some very innovative opportunities to work with people with lived experience being unhoused around design of services, around providing leadership for providing those services, and even in the design of shelters and other projects.

So I want us to be able to have the opportunity to continue working with that community.

Thank you.

Supervisor Marquez.

Thank you, President Howard.

Thank you to our staff for doing an incredible job.

Really appreciate the information.

I do have a question.

Do we know when the slides will be added to the website?

Don't see them uploaded as of yet.

We can't add them to the meeting while the meeting's in progress.

So the clip can add them after the meeting.

Okay.

Do we have handouts for the public?

Yes, they all have handouts.

Okay, perfect.

Okay.

So appreciate the level of detail.

Want to also acknowledge the chair of the health committee, Supervisor Miley, know you've worked really hard in additional meetings to get us to this point.

I do concur that I wish we would have been able to advance this because I'm aware that layoffs have already happened with respect to proposition one.

So a couple clarifying questions.

The proposed recommendation for the bridge funding, and I will slow down and speak slower.

I know it's probably difficult for the ASL interpreters.

I'll try to slow down.

Is that for one year or two years?

So the bridge funding, and we've been clear with our providers throughout this, and as presented at the health committee, that intent is for one year.

Okay.

So our goal is to uh, you know, whatever board letter we bring forward to you on the second, um, all contracts would be uh uh effective uh July 1 so that we can minimize any disruptions in payment as well as any disruptions in care.

Um and the idea is that by July of uh at the end of June 2027 is when that funding would end.

Um, and we any organizations that are bridged, we would want to work with them throughout this next year, this next fiscal year.

Um, and we would want them to give us off-ramp plans is what we're calling them uh by uh December.

Um, and that's with the intent to uh because some of a lot of the programs have told us that they would need to either you know uh close down responsibly or transition care responsibly, or they may be able to bill or find other sustainable sources.

Um so we just want to ensure that that work is happening.

But the intent is for one year.

Okay, and do we know how many programs have already closed and or how many people have been laid off?

I have heard uh just anecdotally that that's happening, but I don't have numbers for that.

Okay.

Um, also just wanted to share with the community I want to acknowledge my team that has done an incredible job.

I'm holding a list, uh, an Excel spreadsheet of 16 asks.

So this is um by way of public comment as well as um emails that we've received.

And again, it's really important to me, and I know the public that we get this information as soon as possible, especially since the bulk of this presentation was already provided on April 28th.

Um, so I'm doing my best in real time to crosswalk what I heard, what I'm reading, um, comparing to the asks.

And for the most part, it is incredible what staff has done because the majority of the asks have been embedded, and I appreciate the contract um review to see like what the delta is.

So that's incredibly impressive.

Um a couple areas I want to flag because it's not clear to me.

I appreciate the funding to renew the contracts for our partners with respect to the work around immigration immigration and refugee support.

Understand that contracts are in place until September.

So just providing funding to extend those.

We've also already identified two positions.

When we had the work session on April 28th, that was in advance of the presentation and act committee on April 30th.

So we didn't have all the information at that time.

I do appreciate staff watching that.

So the only other area that I would like us to address, and the full board has not had the pleasure of hearing this presentation as of yet.

Just myself and supervisor Fortunately Bass, but what is going to be a priority is identifying the director position.

So I know that we could work with the CAO's office to identify a position that's maybe currently not filled.

With respect to spectrums ask, can you clarify whether or not that is embedded in the funding for senior services?

Are you referring to the LIHEAP allocation?

Yes.

Based on historical precedence is not slated to be cut.

The Congress doesn't uh doesn't go go for that.

So while it was in the president's proposed budget, there's no anticipation that that would be included in the final budget.

So they would not be receiving a cut.

Okay.

Thank you for that clarification.

And um also to clarify though, we would not continue to fund them with additional measure W recently.

That was a one-time correct.

And that was 3.1 million.

Three million dollars.

Three million dollars.

Okay.

Thank you for that clarification.

Um also wanted to speak to as the chair of public protection, we're going to have a joint public protection and health committee meeting in July to receive an update on CARES first jails last, but did want to flag for the community that have been advocating for advancing that work, which is something I support along with reimagined adult justice.

Um we have made a significant investment.

And if uh Director Shandra can uh correct me if I'm wrong, but is it at $34 million for EPIC?

Um at least at least $34 million.

Correct.

We also have advanced um pretrial services.

We identified additional uh funding.

We're we're working currently on the fair chance ordinance, so that is a question I have with respect to our regulatory agreements with affordable housing.

I know that ordinance um still needs to go to unincorporated services, but I want to see if we could uh advance that work under our contract specifically measure WA1.

I wanted to note that that's something I think we can get ahead of.

Um, and then also wanted to see we've also advanced the Wendy Wear contract and want to see if we could embed Measure W asks in terms of getting people uh with lived experience, something that supervisor for Tonal Bass also mentioned, see if we could um do more support around that within contracts.

So I'm doing my best to uh meet the needs of all of the asks we've been um hearing from the community in the last couple years.

Um also want to flag in this, I don't see um any information with respect to the reparations commission, and this body is going to receive a presentation on June 30th.

So just want to be mindful of that.

Um other areas that I want to make sure that we address um, sorry, my notes are kind of all over the place.

I also support the request with respect to our federally qualified health clinics and the impacts that they're gonna see.

Um we received a briefing yesterday with respect to the unsatisfactory immigration status.

There was public comments today about those impacts going into effect July 1st.

I see some money allocated, but as Supervisor Fortunately Bass also mentioned, what if the impacts are higher?

How are we going to address that?

So that is something that I also want to flag.

And I want to be clear on the recommendations for today.

Also, want to hear public comments.

So if it's okay with the chair, I will uh respond to the recommendations in terms of direct direction after hearing from the public.

Thank you.

Indeed, I think we do need to hear from the public.

I'll echo my um colleagues' comments that um and just say this is a point in time, a plan in place, doing the best we can projecting our needs.

Everything on here is worthy, from what I can tell.

There's nothing in here that we would not want to fund.

Questions that I have are: are we with this plan?

Are we truly prioritizing the people in our community that are the most in need, the least among us, the most vulnerable?

Because when cuts come and the federal government is making these cuts, and fortunately we have measure W to backfill that.

Are we backfilling everything that we need to backfill?

And are we prioritizing those that are most vulnerable with this plan?

So that's a social services and the health community question.

Thank you for the question, Supervisor Howard.

Alameda County Social Services Agency Director, and the answers yes.

I forgot the other category you use, but uh that you identified, but they're all considered in this funding.

Severely physically and mentally challenged.

Yes, which can which can also fall under um seniors.

Um that covers multiple categories, so yes.

Health, same thing.

Um I I think as a safety net entity, we would say that pretty much all services that we're providing are for uh people with the highest needs, and as there's more pressure, then you know we can adjust as we need to, but we would wait in in what we've proposed, uh, you know, in terms of sequencing the the Prop One ask uh and then the health pack ask, like the one-two year, that's largely because the Prop One impacts are a little bit more immediate.

Um, and you know, the health pack impacts are potentially going to be larger in magnitude and a little bit more sustained, but um they're not hitting right away, so it's just kind of trying to balance uh what we have available when.

Okay, um, we had a wonderful press conference today celebrating a reduction in homelessness across the county, however, we stopped short of pointing out areas where homelessness increased.

There are areas where homelessness increased.

So, with regard to flexibility, respecting regional needs, not doing things countywide because needs are different.

Does this plan allow for the implementation to be tailored, customized to regional differences?

Um I would say that that's not necessarily in this particular plan, but within the home together plan uh that does allow for that.

So, you know, with your your board's uh significant investment in the home Together Fund.

There's those pillars that we talked about in terms of you know increasing prevention, increasing shelter, increasing housing, increasing access to services.

Um all of those things are countywide goals.

However, we understand that there are uh differences where regions might need to be uh served differently, right?

And so um really appreciate you all for engaging the cities in your regions to uh work with us on a regional approach to things so that we can think about the best ways to leverage resources.

And I hear you, supervisor, you've asked us for flexibility uh previously, and we look forward to continuing to work with you on that.

With regard to um spending our money wisely and evaluating the costs and the benefits of the services that we provide, when it comes to housing, you mentioned the ability of we've talked about it before.

Converting hotels that are not a million dollars a door, but still do the job.

We've prioritized the first, I think, in the past, but we're going to shift into the latter going forward.

Is that right?

So in the home together fund, again, sort of focusing mostly that's focusing on homelessness.

Um, there was a first round of capital that went out where we uh tried to support projects that were going for state credits, et cetera.

Um, so that is in that realm of new.

Uh, there is additional capital funding that we would want to put out for uh rehab and acquisition.

So it's not to build new things, it's not to start things from scratch, but it's to uh quickly bring on units uh with what might be available and and potential for um you know revamping it or upgrading it.

So that's the intent there, and then our separate housing building goals.

I would defer to CDA on that.

And you've ever community development agency director.

In terms of housing goals, of course, our um we've been uh granted, of course, our uh the voters of uh Alameda County voted in measure A1, and so we use much of that, and that's been much of our new construction that's been going on, and we continue to put bring um affordable housing online.

So uh we've stretched that, and we're toward the end of our resources as it relates to measure A1.

Um, and so we would look to uh assist um H or AC Health in with their capital work, but our resources for uh new affordable housing is diminishing.

With regard to um when I think of the least among us and the most vulnerable shelters come to mind.

How much of this is going to help emergency shelter folks?

That again is included in the home together portion.

Uh so we've uh as you heard earlier today, we've brought uh 300 new beds on recently with a focus on uh people who are medically frail and need uh additional uh help.

We're also in the process of working with the social services agency to um uh make supplemental payments to the bed night rate shelters.

Uh those are existing shelter providers across the county, um, and then there uh maybe opportunity and then there will be another shelter RFP that goes out.

So the goal is to expand shelter as well as to um uh improve the standard of care in shelters.

Okay.

Thank you very much.

Um, those are my questions.

We'll now hear from the public.

If um the clerk could count the speaker slips in hand, and this again for those online to raise your hand is for item two.

Update on board initiatives, board action on measure W, the Central County Services consideration of allocation of measure W tax receipts.

Let's see how many people are in person and how many hands are raised.

Yes, President Halbert, we have about 36 in person and 20 right now with their hand raised, 21 with their hands raised in Zoom.

So about 56.

We're gonna have a minute for each speaker, up to a minute.

We're gonna close off the sign-up process, hands raised at the moment.

Speaker slips in at the moment, we'll provide enough public comment, up to a minute, recognizing that it's very effective to say ditto, sometimes to the last speaker, or not take the full minute if you don't need it, so that more people can get public comment in.

We're gonna have public comment for an hour, a minute apiece.

Let's see if we can get it done.

First three in person and then online.

Thank you.

Thank you, President Halbert.

We're gonna start with online our ASL speaker, Dr.

Hunt, before we hear from our ASL speakers in person as you authorize.

We're gonna do the ASL first, if you can, but let's call five at a time in person and then online if we could.

Certainly.

We'll hear from after we hear from Dr.

Hunt Online, Moni, in person, Antoine Hunter, Mariah LeBlanc, a Hyde, Patamera, and Yuri Schoen.

Dr.

Hunt.

Yes, hello.

Thank you for your time and thank you for the interpreters.

I really appreciate it.

So, um, this is Dr.

Heather Hunt, and I'm a licensed clinical supervisor with deaf community counseling services.

I want to emphasize that this is not simply a budget issue, it is also an access and compliance issue.

DCC asked the deaf, hard of hearing, deaf, blind, and late deafened individuals, including clients with severe mental illness, intellectual and developmental disabilities, and language deprivation.

Many of these individuals cannot safely effectively receive behavior health treatment through standard interpreter mediated services alone under the Americans with Disabilities Act and Section 504.

Alameda County remains responsible for ensuring meaningful access to behavior health care for this population.

That obligation does not disappear if this contract ends on July 1st.

If DCCS closes, many clients will lose access to clinically appropriate care altogether because there are no comparable candidate contracted services equipped to serve them.

Bridge funding is not simply preserving a program, it's it is preserving the county's existing infrastructure for equitable deaf behavior health access where a sustainable long-term solution is developed.

Thank you, Dr.

Hunt, for your comments.

If the ASL speaker can provide the yes, I'm so sorry.

I'm trying to be able to see her.

So sorry, just one second.

Okay.

Okay.

Okay.

So my name is Natalie.

I'm the program manager for the deaf community Services here.

I just wanted to expand a little bit about our services.

So here we are the only program that is designed to support the deaf and hard of hearing community.

We offer access to funding and we do captioning for our clients.

We ask that we have the ability through the county to keep our program open.

And our community that we service, it's for mental health and uh programs, our programs here are just very important to to the people and clients that we service here in the county.

I'd like to ask a follow-up question.

Do you work with the school of the deaf in Fremont?

Yes.

Yes, both with adults and children.

Thank you.

And um through doctors appointments too.

Not just uh with a specific group.

Thank you.

Community depends on it.

My name is Ive.

I am the administrative manager for the DCCS program.

And I want to share a true client experience.

I am deaf.

I was hospitalized without being given an opportunity to explain my situation.

I was placed on a 5150 hold for two days.

No until no interpretation was provided.

I felt isolated and disconnected from my family and community.

After I got out, I never wanted mental health support again.

DCCS rebuilt that trust.

Please continue to support and protect DCCS and the deaf and hard of hearing individuals in Alameda County can receive accessible, life-changing mental health care.

Thank you for your time and come as well.

If you heard your name, please approach the podium.

Yes, um, I just wanted to provide some feedback.

I'm so sorry.

There's a spotlight setting on, and it's making it a little difficult to follow, but I'll try my best.

Okay.

Oh, thank you.

That's wonderful.

Okay, so hello board.

Um, my name is Anton.

And so I'm a community member.

I grew up in the area.

I'm deaf.

So for our deaf community here, we are the last to receive from this community in some instances.

Often, you know, we think of who's who's the least valued.

And sometimes really, if you can remember back in 2020, many of us were coming asking for help.

You know, as deaf people, we were trying to figure out how to survive, you know, as a disabled uh person.

There were just many barriers for us.

And we just wish to be part of your community.

And the counseling services has been a big empowerment with building a bridge for us so that we can be involved.

And with the budget cut, I'm wondering what that would look like for our resources.

You know, I mean, if you think about, you know, the the farming and things like that, they don't have the same amount of budget cuts there that we have to struggle with.

So it's just, it feels like we just need more time.

We need just we just need to survive, and that's what we're trying to do as as deaf people.

We're just trying to survive.

And if we don't have this program, it feels like we're just gonna be no more and it's gonna come quick.

So I wanted to ask for the deaf community and the counseling services if we could just have that that more have more time so that we can learn about how to survive in the community.

Because I, you know, I've been here for over 30 years, and having to do life without each other is it's really hard.

We need each other.

So thank you for for listening and for understanding.

I know as a deaf person, it's it's hard for us to communicate.

I do understand, but for just for you guys to hear us out, and it doesn't mean that you know you're truly listening.

We need to be listened to.

So we would just really appreciate if you could listen to the deaf community and give us that support.

Thank you for your comments.

Thank you.

Thank you.

Next speaker.

A hide Patamera, Yuri Shon.

Oh, you went okay, thank you.

Mirage LeB LeBlanc.

I will move to the Zoom users.

Was your name called?

Okay.

The button on the right.

So little person.

And feel free to there you go.

Thank you.

Good afternoon, Board of Supervisors.

Um, my name is Yeri Sean, and I represent Baru, also known as Korean Community Center of the East Bay.

We serve monolingual immigrant and refugee seniors for 46 years.

And first of all, I really sincerely want to thank you for your continued support for the seniors.

Um, senior services or lifelines.

Actually, a lot of potential.

For example, one of our clients came to us isolated and without any community after relocating from Virginia several years ago.

And through case management and other senior services, he found belonging and now he's volunteering with us as our meal program driver, giving back to the isolated seniors that he learned and he got connected to in need.

Our senior population here is growing and increasing needs and policy changes under H1 and attacks on immigration, leave our best our most isolated seniors with nowhere to turn.

And that is why I urge the board to adopt senior service coalition's recommendation to invest $9 million a year to meet the basic needs so every senior in this county can age with dignity, safety, and support.

Thank you very much.

Thank you for your comments.

Moving to our Zoom users.

I'm sorry for mess pronouncer name, and then Lavan Gibson.

Alyssa, you may unmute yourself and begin your comments.

Hello, my name's Alyssa Laman.

I'm the clinical case manager here at DCCS hearing case manager.

Many members of the deaf community face barriers that are often invisible to others.

For many Deaf individuals, American Sign Language is their first language and not English.

Language deprivation, a limited access to information, ASL can make it difficult to know where to seek help, understand available services, or advocate within systems that are not designed with deaf people in mind.

Without accessible, culturally and linguistically appropriate care, the individuals are at risk of being left without support until situations escalate into crisis.

Although interpreters may be available, they must also have the competence and skills to effectively interpret at the individual's language comprehension level, especially for deaf individuals impacted by language deprivation.

When it comes to mental health services, deaf community counseling services offer much more to interpretation alone.

DCCS.

Hello, my name is Yui Nishike.

I'm a practicing nurse practitioner and head of strategy and value at Lifelong Medical, Federal Aqualified Health Center in Alameda County and Contracosta County.

First, a sincere thank you for the proactive attention to Medi-Cal coverage disruptions.

We support all recommendations presented today, especially number three.

That said, we remain deeply concerned that the proposed three million for health pack expansion will not be sufficient for stabilizing the safety net system.

And what we're facing now is an unprecedented financial instability that I hope to illustrate here.

Since October, lifelong has already seen a 10% decline in visits, and we're using that conservative estimate in our budgeting process, and we're projecting a structural deficit of operating margin, negative 17%.

And this is after eliminating 17 positions across the organization, first of our 50-year history.

And to your previous points supervisors, we have not factored in all the uh May provision uh proposal.

Good afternoon, supervisors.

My name's Lavon Gibson, City of Fremont Family Services Administrator.

Uh I'd like to share a story of a shared client that we have with the Afghan Airly Association.

Miss Ann was a traumatized and suffered from mental health issues for many years, beginning in her youth in Afghanistan after migrating to Fremont, California.

She became increasingly isolated and began dissing herself from her family and friends.

Anne's brother enrolled her in the Afghan Elderly Association's health promoter program.

Unfortunately, the program could not engage with Ms.

Ann.

Following that, she was enrolled in the City of Fremont's Mobile Mental Health Services.

After several months, she developed coping skills that help to reduce her mental distress and become more receptive to the support offered by the health promoters and AEA's program.

I appreciate the effort that the counties made to uh present um additional funds for senior services, and I urge the board uh to adopt the senior service coalition recommendation and utilize the overridge that has been mentioned for essential county services.

Thank you.

Moving to our in-person speakers, Lara Calv Calvert, Warren Cushman, Pasa Anis, Heather Little.

A hi, hello Lemmer.

Okay, thank you.

And please state your name for the record before you begin.

Oh, yeah, absolutely.

It's right here for you.

There you go.

Hello, board.

This is Warren Cushman here.

Is this on?

Okay.

Well, you guys sure know how to time things.

My ride just arrived.

Anyway, I wanted to say your board is doing a great job of uh of prioritizing all of the needs in the community.

As an unincorporated resident, I'm really happy with what's going on in with regard to the prioritization in the unincorporated communities.

There are a lot of uh active folks that are really um excited about that.

Um putting on a senior senior services coalition hat.

We definitely want to support the ask that the senior services coalition letter has put forward.

These are obvious needs.

There are a lot of different organizations that provide food, uh food services and disability-related services like mine at Krill and other uh other kinds of uh needs, including housing needs and so forth.

So we do support that.

And finally, just to say that this has been a very long process, and uh generally speaking, I think you people you guys are hitting the mark.

You're doing right, you're hitting all of the right spaces.

So thank you for what you're doing, and I'll see you next time around.

No one of us helps each other, right?

Interpreters, people, people helping get get out the door, people helping um keeping us housed.

Um, the second highest um group in poverty here in Alameda County are older adults.

Um, and out of those, the renters particularly are um black and Pacific Islanders are severely written burdened.

They're looking for help from multiple places.

Please support the senior services coalition ask, um, through Measure W.

All of our programs are on the verge of having to turn people away because we can't keep up with the number of people coming to us.

We need to be able to expand our services and keep our services in place.

Please um adopt those recommendations.

Good afternoon, Board of Supervisor.

Thank you for championing the mental health prevention.

My name is P.

Sey Fenneth, program director at Maru, formerly KC CEB and representative of the Prevention Matter Collaborative.

Prop one is dismantling our county mental health safety nets, specifically the UELP prevention programs that have served immigrants, refugees, and indigenous communities.

These are not supplement services.

They provide culturally rooted trauma-informed care built on decades of trust that no lock facility can replace.

But many of our clients' institutionalization settings are severely and actively retraumatizing, evoking detention, forced institutional institutionalization and state violence.

These communities are already absorbing compounding shocks, federal immigration enforcement, Medicaid threat, housing instability.

Cutting prevention now will push people towards crisis and emergency rooms.

We urge you please fully restore and protect the $7.7 million UELP prevention programs.

Please do not let the most marginalized community bear the consequences.

Thank you.

Thank you.

Moving to our Zoom users, calling the next five names in Zoom.

We'll heal here from Shirley Gee, Janice Roberts, Maria Alderit, Jane Garcia, and Craig Metz, starting with Shirley Key.

You may unmute yourself and begin your one-minute comments.

Good afternoon.

This is Shirley G, CEO with the Regional Resource Center.

Yeah, it's operated by the Vietnamese American Community Center.

We primarily serve Oakland, San Leandro, Hayward, and the unincorporated areas.

We are in support of the recommendations coming forward via the position paper by the senior Services coalition led by Wendy Peterson.

Please incorporate these thoughtful recommendations into your allegation decisions under Measure W.

They represent the collaborative position of 80 plus organizations and their respective constituents, numbering in the thousands.

These recommendations are based on the collective needs and experiences of our agencies throughout the county.

Our ask, 18 million for the fiscal year 26 to 28 period.

This is a small investment for a huge return to keep our seniors safe and healthy during these turbulent times.

This would also protect our health service system, which are overextended and very resource challenged.

Thank you.

Thank you.

Moving to Janice Roberts.

You may unmute yourself and begin your comments.

Janice.

Thank you.

Good afternoon, supervisors.

Janice Roberts, Executive Director Mercy Brownbag.

I wanted to speak in support of the senior services coalition ask for 9 million Measure W annually.

In particular, I want to support the need for nutrition capacity funding from excess receipts if necessary.

Supervisor Howbert once asked how much food insecurity had grown for Alameda County seniors.

I can tell you Mercy Brownbag serves 6,000 very low-income seniors in the year 2000 regularly with fresh healthy groceries.

Five years later, in 2025, that number had almost doubled to 11,000.

This is a vulnerable population.

The average age is 78.

Average monthly income is just 1,068 a month.

Over 90% of those we serve are people of color.

Thank you for your comments.

Moving to Maria Alderit.

You may unmute yourself and begin your comments.

Maria.

Thank you.

Good afternoon.

My name is Maria Alderdi, and I'm the executive director of community kitchens.

I just wanted to give you a share the state of hunger in our community.

Community kitchens has experienced a significant increase in the number of clients we're feeding.

When the SNAP shutdown occurred in November, we immediately had double the number of clients at our line at our door.

And since that time, it's doubled again.

So we are serving triple the amount of clients since October.

I did want to comment on the page 29 recommendation for one million for one of the food security organizations for emergency meals.

I want to make sure the supervisors are aware that this is currently a regional contract, and this funding request does not include funding for Oakland or Berkeley.

Thank you so much for your time.

Jane Garcia.

Good afternoon, Board of Supervisors.

My name is Jane Garcia, and I'm the CEO of La Clinica.

We celebrated our 55th anniversary, and I've been with the organization and in the movement for 48 years.

And I'd have to say this is the worst situation I've ever seen.

And I see, especially with our immigrants under attack, that the safety net is under attack.

I we are in the middle of preparing our budget and we are looking at something close to 12 million dollars in reductions in services.

We were hoping that the governor's budget would restore our PPS rates as well as dental, but that was not to be seen.

And these are silly cuts because in the end, if the safety net can't do its work, then our patients are gonna end up in the emergency room, a way more costly uh intervention.

So I want to thank you for the considerations that you're entertaining and to share with you that that it's the right decision.

We save the money system, and we are a great value to our community.

Thank you very much.

Craig, Craig and Matt's Metz.

You are unmuted, you may begin.

Good afternoon.

My name is Craig Metz.

I'm clinical manager of the IOP PHP program at AHSS Fairmont Hospital.

I'm asking you to use Measure W discretionary funds to keep our program open.

AHS plans to close it on June 30th.

About one third of our clients have experienced homelessness and many more are at risk.

Our program prevents the acute psychosis episodes that cost people their housing.

And our clients see an 83% reduction in inpatient hospitalization days per year.

If we close, they have nowhere to go.

The county is closing all but one wellness center.

Other IOP PHP programs don't accept Medicare and are short term only.

Case management is not treatment.

Please consider a temporary bridge of Measure W funds to keep this program running.

Thank you very much.

Thank you.

Moving to our in-person speakers.

Heather Little.

Quinn Tai.

Cynthia Orrington and Sofal Yin.

Please approach the podium and please take your name for the record.

Good afternoon.

Thank you, Board of Supervisor.

My name is So Paul Yin.

I work at Center for Empowering Refugee and Immigrant called Siri, with survival of Khmeru genocide, and myself included.

I am here today to ask you to please keep funding from UELP program.

Many of our elders, but you can see today, I brought eight of them.

They came right away, and they've been sitting here since 10 a.m.

So some of our elders need individual therapy, but many are mainly suffering from loneliness and isolation.

What they need most is community, a place where they feel understood, where they can speak their language, share food and story, laugh, cry, go on outing together, build friendship and support to one another.

Through UELP funding, we have been able to create loving community for the survivor and have spent 20 years building trust within it.

Thank you for your comments.

Thank you.

Good afternoon, supervisors.

Thank you for your time.

My name is Dr.

Breath Gore Saberwall.

I'm a program director at the Hume Center.

For the past 13 years, I've done work with the Punjabi community as one of the few Punjabi therapists in the region.

With the transition to BHSA, the EI opt-in program requirement says that we're expected to serve 90% Medical eligible members.

At the same time, where our immigrant refugee community members, survivors of abuse, are losing Medi-Cal coverage.

This leaves only 10% of outreach and engagement capacity for communities that are already unserved, underserved, and inappropriately served, which is contrary to the county's priorities and the state's commitment to equity and access for vulnerable communities.

We appreciate Alameda County Behavioral Health for keeping us whole.

However, we're being asked to change the service delivery.

So we aren't preserving our UELP prevention program services.

We're only supporting treatment services.

I want to offer that clarity that UELP prevention services aren't being sustained.

They're being dismantled, and they're still need to be funded.

As a member of the Prevention Matters Collaborative, we urge you to prioritize mental health prevention.

Thank you for your comment.

Thank you.

Good afternoon, Board of Supervisors.

I'm Cynthia Arrington, Community Outreach Coordinator at Mills on Wheels.

When I retired from corporate America, being a senior myself, I felt my purpose was to help homebound seniors who are less fortunate than myself.

I went to work for Meals on Wheels nine years ago, and my experience has been our homebound seniors with food insecurities asking for more food.

Thanks to Measure W.

For the first time, I had an option for them with an additional five meals per week without removing nor without removing or losing any of those and refusing any.

Good afternoon, Bob Supervisor.

My name is Quinn Kai.

I'm with Paul Felton Institute at the MM Manager.

Today I come here to support one of our programs that community counseling because it got shut down by the end of this uh fiscal year.

And I also want to reach one of the message from one of our clients.

I'm a debt and have compact language and disabled need.

Whenever I meet meet with my case manager, they often do not provide interpreter.

As a result, I'm frequently left frustrated and not fully informed about my care service and important decision.

I understand information much better when my case manager from BCCS is involved to help communicate what I have been missed and to support me in making informed decision.

Thank you.

Heather Little.

Sorry, Heather Little in the room.

Okay, thank you.

Moving to our Zoom speakers.

We have an ASL speaker I have promoted so that our ASL interpreter can see their video and read their lips.

Malaj LeBlanc.

Okay.

Hello, my name is Malaj.

I'm one of the clinical case managers at DCCS.

And I wanted to make a comment about the clients and how often the mental health system fails the clients who are deaf because they provide unclear communication, conflict.

Sorry, often there is a conflict.

So we provide accommodations and access.

And that really prevents them from feeling the isolation, the mistrust, and the miscare.

We provide early intervention, cultural responses, and we're able to have that support for them long term.

Thank you for your comments.

Okay, going to our next batch of Zoom users.

We'll hear from Dongsa, Carla Guerrera, Margo Julia, Robert Phillips, and Elle Martinez.

Dong, you may begin.

Good afternoon.

This is Dongsa, Chief Deputy of Administration at Asian Health Services.

In solidarity with other community health centers whose patients are all in similar dire situations regarding state funding and dental cuts for patients with unsatisfactory immigration status and federal Medicare Medical Cuts.

We support the recommendations presented today, especially recommendation number three that stabilizes health care and other safety net needs.

Thank you.

Carla Guerrera.

You may begin.

Good afternoon, Board of Supervisors.

My name is Carla Guerra.

I'm here on behalf of the Unity Council in District 3, serving hundreds of low-income, monolingual, Spanish speaking, immigrant older adults who are one of the most vulnerable residents of Alameda County.

We urge the board to adopt the Senior Services Coalition.

Nine million recommendations to invest to meet the basic needs of older adults in our county.

This request includes 2.2 million a year to backfield cuts to AAA contracting services so that we don't lose service capacity.

Second, we, as the board to include much needed colas.

Third, we urge to include 1.8 million a year to continue the immediate need support for increased capacity in senior fluid and meals programs.

And just lastly, we support the request of behavioral health providers for bridge funding to reduce the impacts of cuts from Prop One.

We need to be able to expand services and keep the services we have already in place.

Please adopt this recommendations.

Margo, Julia, you may I'm beginning your comments, Margot.

Yes, thank you.

Um I am Margot Dashil.

I'm a family advocate, volunteer, a family member with deep lived experience.

Um secondhand from family members that I support.

Um hundreds of family members want supportive housing, permanent supportive housing for people living with mental illness.

And I'm here to ask if you will please lift up out of the shrouds, out of the from under the radar, the supportive housing creative land alliance.

We have a stellar land trust that focuses on licensed board and cares.

It has a beautiful property in West Oakland, nicely furnished, ready to take in those with serious mental.

Thank you for your comments.

Robert Phillips, you may begin.

Good afternoon.

Uh Robert Phillips, CEO of Baywell House.

Um, we support all of the recommendations here today, especially number three, along with our sister health.

Um, just a bit that we're already beginning to reduce uh school house services, reducing our workforce and already have noticed the union as well as renegotiating our contracts, um, and still with the state's July and January cuts.

We still haven't opened yet.

Um, so the recommendations were for you, particularly number three, exactly the bridge to safety and it needs.

So we urge you to adopt those recommendations in full.

Thank you.

And lastly, right now, El Martinez.

You may unmute and begin.

L.

Martinez.

Hi, hello.

My name is Maria Martinez.

I'm the parent of Jaden Alva Martinez.

He's uh he's currently a client in the DCCS program, and I just want to express my profound appreciation for the positive and transformative impact it has had on my son.

Prior to Jaden's enrollment with DCCS, he faced considerable challenges related to anxiety and exhibited certain behavioral patterns that significantly hinder his overall well-being both within the academic environment and in his daily life.

These difficulties were a source of concern for our family.

However, since joining the CCS program, we have witnessed a truly remarkable and enduring change in Jaden.

He has developed improved coping mechanism, demonstrating enhanced self-regulation and a noticeable reduction in his anxiety levels.

It is incredibly rewarding to observe and thriving, engaging more possibility and making substantial progress.

We are immensely grateful for the dedicated support, expert guidance, and nurturing environment provided by the DCS program.

Thank you.

Moving to our in-person speakers, Jeffrey Wong, Carl Walters, Tony Panetta, Ella Schwartz, Katherine Schwartz.

Please approach the podium.

Please state your name for the record, please.

Good afternoon.

Okay.

Good afternoon.

My name is Carl Walters.

I'm the Chief Operating Officer with Bay Area Community Health.

We are a large FQHC that serves as part of your our community safety providers safety net.

First and foremost, I want to thank you all for the outstanding work that you're doing here today.

It is very refreshing to come in here and to see the love and the compassion of trying to take care of our communities as a whole, but also to make sure that we're taking care of our communities' most vulnerable populations.

Like all health systems, we're having to evaluate cuts that we may have to make as well because of the changes in funding and things of that nature.

So the two messages I would really like to ask three things that I'd like you all to take home.

One, thank you for what you're doing.

We couldn't do what we're doing without your support, and we appreciate that.

Number two, it is always more cost-effective to care for the patient in an outpatient setting, preventative care.

Our dollars go further when we invest in preventative services.

It's more expensive to treat them when they're getting into the hospital.

Thank you for your comment.

I encourage you to please.

Thank you.

Good afternoon, Tony Panetta, Chief Impact Officer, Alameda Health Consortium.

We appreciate the thoughtful work on the Measure W recommendations by AC Health, AC Social Services, and the CAO's office.

We understand there's a strong commitment by your board and county leadership to ensure clinic sustainability as demand grows to maintain the current level of access as more and more of our patients lose medical coverage.

We support all three recommendations presented today, including a one-year bridge strategy for mental health services and recommendation three to amend existing policy to allocate revenues collected above budgeted amount to be allocated to the Essential Community Services Fund.

We believe this is critical to sustain access to Safety Net Healthcare.

We remain disappointed to see only three million allocated from the Essential Community Services Fund for County Fiscal Year 2627 to the Health Pack program, but we also appreciate the willingness of the county leadership to move forward in developing a strategy to be flexible and nimble to sustain the safety net during this immediate upcoming fiscal year.

Thank you for your comments.

Can I ask Tony a question?

Yes.

So Supervisor Bass mentioned Health Pack 2627.

So I need to understand.

We got a response from our staff.

Do you agree with that response?

We agree that there is going to be a wave of when the revenue cuts will hit.

As patients come in for services, clinics submit their claims for payment, and then the state will not pay the full amount that they are due for services.

So that will happen as patients show up in July.

And then in January, when patients lose their medical coverage due to work requirements, that will be the next time when there will be the loss of reimbursement for patients who lose Medica.

So it will be coming in fiscal 26-27.

We agree with agency leadership that it will get bigger as time goes on.

So we are looking for support in both fiscal years.

Yeah, so we're allocating board approval three million initially and then 15 million.

So it kind of seems like we're if we need to make adjustments, I think.

I think, I heard we'll do that, but right now, 3 million and 15 million.

That is what we understand is proposed, and we would like to see, we would like to work with agency leadership to see how there can be pivots in fiscal 26-27 to increase um contracts in response to the magnitude as we're experiencing it.

Good afternoon.

My name is Ali Schwartz.

I'm the Chief Impact and Partnerships Officer at Tavercio Vasquez Health Center.

I'm also here in support of the recommendation, especially number three regarding Measure W allocation.

We're doing everything we can to improve efficiency in our clinics.

We're offering group visits, telehealth, expanding our nurse practitioner workforce, and leveraging community health workers to support every non-clinical component of a patient visit.

But without the Measure W funds, we are still facing restriction of services as La Clinica and Lifelong and many of the other organizations have referenced.

Tabersio employs nearly 400 people in central Alameda County, many of whom grew up in the neighborhoods they now serve.

They chose this work knowing the pay wouldn't match what the larger health systems in the region could offer, but they rely on us for a modest annual wage increase every year and opportunities for upskilling and advancement.

In this moment of financial pressure, even those modest commitments are at risk.

And that puts our workforce and the patients who depend on them at risk as well.

Thank you.

If you heard your name, please approach the podium.

Catherine Schwartz.

Okay, thank you so much.

Noting that Jeffrey Wong is online, I did call that name.

Valerie Guillo.

Hello, my name is Valerie Gallo.

I am the executive director of the Behavioral Health Collaborative.

On behalf of our member organizations, we would like to thank the board for passing this bridge funding.

While we recognize it is not a permanent solution, it is a necessary and meaningful one.

It gives providers, the county and the communities the time they need to transition responsibly and do it in a way that is humane, thoughtful, and focused on the people who depend on the services the most.

We ask that the effective programs be contacted by the health department as soon as possible so they know that their contracts will be uh renewed and continue so they can begin making the staffing and organizational decisions that have been on hold.

Thank you.

Thank you.

Moving to our Zoom users, we'll start with Jeffrey Wong and proceed with Kultora and Beanistar, Alison M, Natalie Soon, and Krista Lucci.

Sorry for mispronounce any of your names.

Jeffrey, you may unmute and begin your comments.

Thank you so much.

Good afternoon, Board of Supervisors.

My name is Jeffrey Wong, and I'm with the City of Oakland Public Works.

And today I'm speaking alongside partners from the Alamuna County Food Recovery Network and Food Sovereignty Roundtable.

We are in support of the staff recommendation to increase food recovery funding by almost $9 million through Measure W.

But wanted to note that this is far short of the 14.8 million that was approved in fiscal year 25-26.

I also noted that most of this funding is going to the food bank, but we know in Alamina County that we have more than 103 food recovery organizations that are redistributing food across the county.

And many of them are operating with extreme limited resources and with fewer than you know five or six volunteers.

So I would like to ask you know the board and staff to consider perhaps giving more money to food recovery organizations, and really appreciate the board's leadership and support for this cause.

Thank you so much.

Hello.

This is Alison Monroe from FASME.

I'd like to see money for Measure W spent on board and cares through our existing land trusts, the supportive housing community Land Alliance.

My daughter who had mental illness stayed in three licensed boarding cares.

Board and cares serve the most vulnerable people with mental illness, people who are too sick to stay at home, people who are too even too sick to stay in shelters.

They provide long-term housing with medication management, cleaning and meals and rights to doctors.

They're accountable because they're licensed.

They're essential for the people in our society who are conserved.

Some of them are bare bones and some have great services therapy and activities.

They're falling between the cracks.

They often do.

They often get left out of discussions of permanent supportive housing.

Housing agencies don't generally deal with licensed permanent supportive housing like board and cares.

Behavioral Health Department has given millions to the supportive housing community land alliance.

Thank you for your comments, Alison.

Moving to Kultura and Beenister.

You may unmute and begin your comments.

Thank you.

Yes, thank you.

I just want to able.

Yeah, I'm signed as the name of the program that I supervise.

My name is Monica Suniga.

Thank you, the Borough of Supervisors for recognizing the urgency of this crisis and for considering Measure W as a breach funding for prevention and early intervention programs.

We respectfully urge to prioritize to give priority to ULP programs and the community-based organization most impacted by the proposition one implementation.

Our program is at risk, not because we have failed, but because Proposition One created an artificial separation between prevention and early intervention services, threatening to dismantle the comprehensive ULP collaborative model that Alameda County has built over many years.

We are asking for one more year breach funding to protect this proven model, serving immigrants, families, communities of colors, and residents facing linguistic and cultural barriers to care.

Without this support, vulnerable communities are at risk of losing cultural responsive care.

Thank you.

Thank you, Natalie.

You may unmute and begin your comments.

Natalie soon.

I serve as the Director of Community Engagement and Government Relations at Rams Inc., a nonprofit mental health organization who envisions mental wellness for all.

I also serve as the interim director of the Regional Pacific Islander Task Force, whose mission is to increase the visibility of Pacific Islander needs and assets.

Rams has uh one program in Alameda County, the Pacific Islander Wellness Initiative serving Pacific Islanders.

This program is not a single service program.

It is a prevention ecosystem that combines culturally grounded, lateral mental health promotion activities, early mental health intervention, family and faith-based engagement, community partnerships, and workforce development.

Prevention services of our essential public health investment, and I respectfully urge the board to fully commit to bridging MHSA to BHSA transition dollars from measured.

Thank you for your comments.

Krista or Christy, Krista.

Hi, thank you, Board of Supervisors for your care for the most vulnerable.

I'm Christa Lucese, the special project manager with Mercy Brown Bags Measure W food recovery.

Ditto to senior service coalition's recommendations, as people said.

Since it was approved in February, we've started sorted, distributed, picked up over 20,000 pounds of edible food.

But in order to address the 30% drop in USDA shippings we've experienced last year, we have a target of 30,000 pounds of recovered food every month.

So your help in this is essential to make sure that we can keep the uh seniors fed and help them to stay in their homes.

Thank you so much for all you're doing for the most vulnerable.

Thank you.

And we will move to our in-person speakers.

Bill Sheeman, Kim Olson, Caitlin Chan, Alberto Perez, Wendy Peterson.

Please approach the podium.

Please state your name for the record.

Good afternoon, supervisors.

My name is Bill Scheinman with Tubercio Vasquez Health Center.

Thank you for considering Measure W bridge funding for prevention and early intervention programs during this critical time.

These programs provide trusted support, connection, and mental health services for immigrant, refugee, and indigenous families facing fear and uncertainty during this time.

Our collaborative program, recognized statewide for its success, is at risk due to BHSA funding changes.

We respectfully ask for one year of bridge funding to preserve this proven model and protect an important community lifeline.

Thank you.

Kim Olson, SOS Meals on Wheels.

15% of the daily meals that we'll serve this year came from Measure W funding.

That's uh an augmentation to our contract that accounted for 71,000 meals serving roughly 44 homebound seniors, all the way from Oakland, South Down 880 to Fremont and the Tri-Cities.

Measure W prevented seniors from being moved to wait list and has meant that we are saying yes to every eligible senior who calls looking for help.

And even better, we can now provide additional meals through our AMP meal program.

One of these seniors is Mary Ann, she's a 79-year-old window who lives in Oakland.

She needs mechanically softened meals because she has trouble uh swallowing.

We are able to provide those for her.

And when she told us she needed more, we were able to say yes.

There are now 270 seniors like Mary Ann who are getting additional meals prepared specifically for them thanks to these funding.

Uh we were in a crisis, but bold moves prevented our seniors, uh at least in our services from uh being moved off.

It kept them staple, keep them fed.

Thank you.

Good afternoon.

I'm Wendy Peterson with the Senior Services Coalition of Alameda County.

Older adults are a priority area, and we're identified today as vulnerable population, yet the expenditure plan includes zero funding for senior services.

I urge you to fix that and adopt the senior services recommendations on slide 29.

Without the 2.2 million in triple A contracted services and the 1.7 million for triple A food services, we will lose service capacity and thousands of older people will lose services.

Providers are seeing more seniors in need and referrals from adult protective services and hospitals are increasing.

Increased service capacity is desperately needed to meet the need and help seniors remain stable and housed.

Thank you.

So can I ask?

Can I ask Wendy a question?

Okay, so Wendy, um, we just got this handout, and you mentioned the information on slide 29.

So if we adopt and incorporate the information on slide 29 for the triple A uh contracts, um that would be a solid piece of action.

All right.

Yes, that's all I need to know.

And Nikki Bassett, very good.

Caitlin Chan, Alberto Perez.

Pamela Glassoff.

Audriana.

Please state your name for the record.

Good afternoon, everyone.

My name is Pam Glassoff.

I'm the community director of community engagement for Eden Information and Referral 211 LMU services.

Oh, from all over the county.

We hear the needs, we hear the stories every day.

And I'm gonna tell you one specific letter that someone wrote to us, which was uh which might be very pertinent.

And besides, we urge the board to uh adopt the senior service coalition recommendations to invest to meet the needs of the basic needs of older adults in our county.

This is the letter.

At 63 years old, after owning two homes and earning a six-figure salary, I never imagined I would be facing homelessness.

The breakdown of my marriage and the emotional weight of recovery all at the same time.

Unforeseen circumstances led me to sleeping in my car on October 1st and later losing that car all together.

I assume that the experience of standing on ground that was crumbling beneath me.

I was carrying guilt, shame, heartbreak from my divorce and the daily humility of walking my recovery journey.

The fear of ending up and possibly dying on the streets or in a shelter is sometimes overwhelming.

Thank you for your comments.

Thank you.

My name is Adriana Furuzawa.

I'm with Felton Institute Division Director, and we support uh all three recommendations and special specialty, specially sorry.

Um recommendation number two.

Uh the CCS is our deaf community counseling services and is not just another behavior health program.

It's a lifeline for deaf and hard hearing residents across all ages, children, adolescents, adults, seniors, and this team is not easily rebuilt.

There is no comparable resource available for the adequate transitional care for existing clients and families.

And a breach funding would allow us time to for to explore long-term solutions.

Thank you very much.

Going to our Zoom users, we'll hear from Katie Greenwald, Angus Cochrane, Mitch at IRC Oakland, Ivan from FERC, and then Patricia Toscano.

Katie, you may unmute yourself and begin your comments.

Hi, I'm Katie Greenwald with the Berkeley Food Network, a food bank in District 5 that serves community members and partner organizations across district lines.

Since the government shut down last fall, Berkeley Food Network has seen more county residents visiting our food pantries than ever before.

These have not been subsidized.

We are serving disproportionately people of color, children, multi-generational households, seniors, and individuals that are subject to immigration enforcement and discrimination.

Our home delivery program, which is designed to serve seniors and the most vulnerable community members, has reached capacity.

We have a wait list nearly six months long.

HR1 is wreaking havoc across the county.

In April, we saw 5,400 CalFresh recipients kicked off due to their immigration status.

Starting in June with the work restrictions, more community members will face food insecurity as cuts are made monthly.

$7 million is insufficient for food and security.

To nourish our community, we need full funding.

It would ensure community members can pay their rent and afford health care.

Thank you.

Thank you.

Angus Cochran.

Actually, before we move on, uh the interpreter is scheduled until 7 30 Eastern time.

So I will be signing off now.

Thank you for your services.

Thank you for your help.

Thank you.

Angus Cochran, you may begin.

Hi, good afternoon to the Board of Supervisors.

This is Angus Cochran from Washington Health.

We're a public district hospital serving Fremont, New York, Union City, and unincorporated Sinnol.

I just want to commend the board for addressing the crisis and funding for behavioral health today at Washington Health.

The crisis and behavioral health is felt most strongly in our emergency room as a CEO from the clinic appointed out earlier.

For the past two years, we've had a very successful pilot program in place in the ER with the Hume Center that was funded by ACBH.

We totally understood when that funding ended due to the changes in California state priorities.

But we'd like to carry on this program ourselves, as the program serves over 200 people a year who come to the ER multiple times a month or a week.

The program provides linkages to care for residents with mental health issues and substance use disorder.

So we just want to chime in and add our voice to the chorus, expressing our support for utilizing the Overridge for bridge funding for behavioral health prevention and early intervention services.

Thank you so much.

Mitch at IRC Oakland.

Mitch.

Hi, my name is Mitch Margolis.

I'm the director of the International Rescue Committee in Oakland.

As a UELP PEI provider, IRC Oakland delivers linguistically and culturally competent prevention services to refugee immigrant and limited English speaking communities throughout Alameda County.

Our staff speak the languages of the communities we serve and understand the cultural context that shape their experiences.

This is not a luxury, it is the foundation of effective care.

As a member of the Prevention Matters Collaborative, we urge you to protect the UELP prevention programs under Measure W Essential Services Funds for Immigrant, Refugee, and Indigenous Communities.

Thank you.

Patricia Toscano.

You may unmute and begin your comments.

Patricia.

Good afternoon, supervisors and members of the public.

My name is Patricia Toscano.

I'm a member of the Housing and Dignity Coalition, a group of grassroots organizations and service providers working to create solutions that make the journey from unhoused to housed, low barrier, positive, comfortable, dignified, and humane.

Our coalition has developed plans for providing services and programming at new or existing interim shelter sites.

We know both from experience and from published research that this human-centered approach is more effective at helping people get and maintain housing stability.

Despite the promise of new innovative approaches led by people with knowledge and experience necessary to transform our human homelessness system, there is no funding source for them.

Given the recommendation by staff to redirect Measure W overage funds from the homeless from homelessness to other services, we ask that the board dedicate money to funding new humans.

Thank you for your comments.

Good afternoon.

My name is Ingrid Yiwan Cheng, Clinical Manager with Asian Health Services.

I want to share the ask group experience that we have been facilitating for Cantonese speaking committee members in Oakland, Chinatown.

So when the group began about six months ago, participants focused on learning arts to reduce stress.

Staff quickly observed their frustration, anxiety, negative self-talk, lack of confidence and self-doubts when they were unable to handle techniques or achieve desired outcomes.

So we're quickly as group and ongoing affirmations and patients' validations in a non-clinical, non-threatening space.

They appeared calmer, more supportive of one another, and more connected as a community.

They were open, discussing the daily stressors, exchange resources, culturally and family-related challenges, and also uh offering mutual support and affirming each other's sense of value.

This is the result of the UELP prevention work.

We support using bridge funding for UELP prevention program.

Thank you very much.

Thank you for your comments.

Ivan A.

Yeah, thank you.

Um, I just want to acknowledge the staff members and everyone who continued showing up uh during uncertain times.

Uh, that commitment really matters and it doesn't go unnoticed.

Hearing that there's movement toward bridge funding and reopening gives a lot of people hope.

Uh, continuity in programs like this is incredibly important, not only for the community, but also for the long-term relationships and trust that have already been built.

So I simply want to express our appreciation to you, the board and gratitude for the work being done and for the consideration being given.

Uh, sustain and reactivate programs.

And again, my name is Ivan.

I'm coming from uh Family Education Research Center as an assistant director.

Thank you.

Thank you.

Ivan, going to our last Zoom user, Andrew Crispin.

You may unmute yourself and begin your comments.

Andrew.

Hi, everyone.

My name is Andrew Crispin.

I'm the executive director of Berkeley Food Network.

We are proudly situated in District 5, but serve communities and community members across all of Alameda County.

We have seen a continual increase in need for food assistance over the last six months.

And we know that the road ahead looks even more treacherous as HR1 cuts impact CalFresh as the economy puts more families vulnerable to food insecurity.

And we need full funding from the Measure W Fund to address food insecurity regionally.

Thank you.

Thank you.

Going to our in-person speakers, Lynn Vano, Tisa or Titsa.

Sorry for mispronounce your name.

Alison Pratt, Jenny Torres, Jet Lou.

Please state your name for the record.

Good afternoon, Board of Supervisors.

My name is Lynn Vino.

I'm the director of operations for Felton Institute.

I am here asking that you consider bridge funding to have DCCS stay open for at least one year for the deaf and hard of hearing community.

DCCS is a unique program where we hire deaf and hard of hearing staff and hearing staff trained in the ASL to provide culturally competent and equitable services to the dead, to this community.

DCCS bridges gap communications in with all crisis response agencies, such as mobile response team, the crisis response team, adult protective services, child family services, and the psych emergency response hospitals.

We also provide psychoeducation to the community providers on how to work with the deaf community.

We our staff also step in to provide ASL interpretation during crisis situations when there is no ASL interpreters, which is an ADA requirement.

We ask that you that this program not be closed.

Good afternoon, Alison Pratt, Alameda County Community Food Bank.

The food bank believes that food is a basic human right, and we commend this board for consistently upholding that standard in our community.

We appreciate and support the proposed additional funds for food security today.

These funds are desperately needed as HR1 cuts are being felt across the county.

Also, the 38 million dollars in Cal food, state Cal food funding that was mentioned earlier today would actually represent a 42 million dollar cut compared to funding last year.

The FY26 Measure W allocations are already having a hugely positive impact across Alameda County.

ACCFB partners with nearly 400 community organizations to distribute more than 60 million pounds of food each year.

Additional county funding has allowed us to double some of our core items, including protein.

ACCFB spent an additional one million dollars on food in November alone during the government shutdown.

We are also currently contracting for your comments.

Did you say you contract with 400 food providers?

That's our network partners, nearly 400 active food providers.

And they're all in Alameda County.

All in Alameda County.

Correct.

Because we've heard from some folks that we need to provide funding to other organizations besides the food bank.

Yeah, and talking with our agency director, who I don't see any more.

Um we've kind of tried to funnel our resources to the food bank to ensure that there's an ample disbursement of those resources in food, both recovery and meals and uh food packages and things of that nature.

Because, you know, I'm just gonna say this.

Um, you know, with the pandemic, you know, we had near nearly a billion dollars in requests, and we put about 50 million just into food.

So, you know, we need to try to be assured that the food bank can, you know, help disperse this as best as possible.

Because we don't have unlimited resources.

If I could speak to that really quickly, one of the ways that we're doing that of the um measure W dollars that were allocated to the food bank and FY26, approximately half of those are being passed through to community-based organizations, and those passed through contracts are not limited to feed bank member organizations.

So, for example, the 15 partners that are currently located in all five supervisorial districts that are um contracted to provide prepared meals to unhoused that includes food bank network partners, but it also includes organizations that are not part of that network.

So we are moving those funds out beyond our 400 partners.

Thank you.

Thank you.

It's very helpful.

Good afternoon, supervisors.

My name is I'm the program manager for the ULP program at Parsonship for Tama Recovery, serving the African immigrant communities.

I'm also seeking and also requesting on behalf of the prevention collaborative matter, requesting 7.7 million major W funding to sustain and restore um the essential prevention work.

For close to eight years, we have served almost 2,000 to 2,500 committee members annually through cultural responsive mental health and healing service.

We have built something both powerful and fragile, which is trust.

We have created safe culturally grounded space where immigrant families can speak support without fear, stigma, and shame.

Today that progress is at risk with the implementation of ProP1.

Service are increasingly tied to diagnosis-based eligibility, uh, medical and medical access.

As a result, many of the most vulnerable and underserved communities member will not qualify for support until they are already in crisis.

This further complicates by well, of course, over diagnosis and underdiagnosis in communities of color.

Um, meaning system-based deligability alone does not fully capture really real need.

Thank you for your comments.

Next speaker, please.

Thank you.

Hi, everyone.

I want to uh thank you for allowing me to come back to the podium and give you an app, giving me an opportunity to be with you again without the language barrier.

I cannot hear myself well, so if I take something fine, please bear with me.

I'm going to use my voice instead of my hand because I hope my message is very thick with everyone in this room.

I want to thank the interpreter for um interpreting.

She had been interpreting this meeting, but two hours by herself, and I'm sure her mind like her fingers are adjusted.

But I want to point out what just happened today between me and my colleague Malaj is one of the most common instances that happened with our crowns to receive services with Alameda County.

Language expectancy, a gap and communication, but consistently.

A message was not truly conveyed in a way that ensured understanding of the community that we started.

So I want the board of supervisors to imagine that.

Imagine not being clean or her fully, especially what you're asking for.

Imagine sharing what you're actually asking for, but that information does not get fully interpreted and understood, especially at the clinic.

What will become of our community that needs your support if our program is gone?

I hope that my message is truly received and that our program will be considered for continuation.

Thank you.

Good afternoon.

Thank you for your leadership and time.

My name is Liu, Debbie Tayotaro.

We're the Mentor House Association for Chinese communities.

I urge the border to pass the bridge funding today at Major CCE, the law of jobs prevention.

We provide a real-time crisis intervention for under zero Chinese and Asian immigrant families using language barriers and the stigma.

Recently, young man in Oklahoma Corona on one night during a mental health crisis, he had a broad bleach and a plan to harm himself.

Our stuff saved on the phone, calling the emergency response and connecting to treatment.

Today he has graduated to working and doing well.

But MHECC service at risk due to major funding costs with other programs like MHECC, many families may have nowhere to turn until crisis become hospitalization, homeless or tragedy.

We respectful of the county to support MHCC.

So this live CV and stores can continue.

Thank you so much.

Thank you for your comments.

President Halbert all names have been called.

Very good.

We'll bring it back for deliberation and uh advocacy.

I'll start with Supervisor Miley.

Sure, thanks, President Howard.

So I need to just check with the staff.

Um, and I believe in the healthcare services agent.

Oh my god, I'll be counting health.

Um we've heard from the deaf community.

Who provides resources to them?

And is uh what we're considering here?

Will that will their organization and services before?

I believe that they're referencing prep one cuts.

Okay, so we're good.

So if if uh that's incorrect, I'm happy to get additional information.

Okay, okay, all right.

Um, and then I and then with the food with the food assistance, we kind of heard for the food bank.

So Andrew Ford, if I recall correctly, like I said during the pandemic, we were doing about almost 50 million dollars, maybe more, uh annually, I think, in food, and we found that to be.

I mean, we couldn't sustain that.

So, what are we doing now for in terms of food, roughly a year?

Um, if you like county wide company, in the microphone, because it's not so, I mean, we do know people need food to sustain their health and this and the other.

Um, we need to make sure we we're covering our basis as best as possible.

And we heard food bank has got about 400 uh um entities in the net in their network, plus they're providing food to other uh entities that are not part of the network.

So, apologies I miss um the comments from the food bank.

I was out in the hallway.

So, Alison, can you share those again, please?

So, what so what are we providing with a look it up?

I think we've given what were your comments?

Sorry, just only my only point is um we are we have we don't we're blessed to have measure w.

Yes.

If we did have measure w, we'd be in more of a pickle.

Yes, we do have measure w, so we're trying to use those resources as to the best of our ability.

In in some cases, we do have to triage uh because we can't provide full resources for everything, and obviously food's important.

So what are we doing for food?

So when we when we came out of the pandemic, um we allocated base funding of four million dollars.

It was determined um by your board that that was insufficient.

So then you allocated um an additional four million of measure w funds, and then it was ten more million.

But the total for measure w it's been about sixty million.

How much?

Um three million.

12 point 12.3.

So how per procurement distribution has to pass through.

Distribution procurement and meal prep was the first allocation.

Um I'm just trying to get a sense.

Do we need to be looking because I know Supervisor Passes on this too?

Do we need to be looking at more money for food?

Or are we at the max?

Because obviously, you know, obviously, people need to be housed, they need to have food, and if we have to triage something else, then maybe we'll have to do that or look to put increase additional resources.

We're already looking to put if the board approves it over fiscal year 26, 27, 27, and 28.

Um if the board approves it, we'll be looking at 190 million dollars of measure W.

Okay.

So page 29 is allocating um 8.3 million in FY2627 and 2728.

That's the proposal.

Um and we have a current 8.3 million was the last amount that your board approved of measured up your funds.

And before that, I think it was 4 million.

And that was distributed between meal prep food distribution and food procurement.

And that's on top of what the agency already does.

The agency um has a 2.5 million dollar base funding to the food bank.

And then we have a little over $1 million um marketing contract with food bank.

Okay, and that's and that doesn't count the triple A providers.

Right.

Right, okay.

Okay, I think I think that's that's that's my question.

Okay.

Um just to frame a little bit of context.

We will never have any of our needs fully met.

The more we have, the more the need will grow.

This is indeed allocating scarce resources to needs and prioritizing.

We had $50 million during the pandemic, and if we said do we have $50 million in need today, the answer would be yes.

Somebody will need it.

The question is, are we allocating it to those most in need?

And how much are we willing to allocate across?

And are all of the people that are truly in need?

And so what I see in all of this is need, numbers, but what I don't know that we get much back, is where did it go?

For example, the $8.3 million dollars.

Can you tell me across the county where it went so that we know who's getting served and who isn't?

I we've never done that.

That's an issue that I have with how we allocate resources.

We are it's a one-way street.

We allocate out, but we don't ever get feedback.

Um that said, I'm supportive of this.

I think these are all as I said before, all things that need to be funded.

I just don't know that we'll ever.

I don't know if this was provided at health committee, but the bridge funding identified to um transition uh prop one.

Um, do we have a list of those providers?

Was that provided at health committee?

Uh no, we don't have that list uh publicly available yet.

Um, and that's partially because you know the original list was 52.7.

We've been wanting to be cognizant of not sending out partial information or you know, and so wanted to wait for final board uh um approval for the final bridge amount, and that will allow us to get there.

And so I think for the June 2nd board letter, it will certainly be there.

Okay, so um thank you for um frontloading one of my questions as well.

So understand this is a work session, understand the options, recommendation one, two, and I believe three captures one and two, is that correct?

If we're um in agreement with what's being proposed.

And when this comes back to us, it will be in a board letter on June 2nd.

So uh and the county administrator Amy can correct me if I'm wrong, but the the bridge uh recommendation is a part of the whole measure W uh recommendation that you're getting, but because of the expedited timeline for those were you will get a board letter specifically for that, and I believe the rest of it will be a part of the budget process.

Okay.

So there'll be a board letter, and is it possible to um include this presentation?

I don't see it changing between now and June 2nd, correct?

What we saw today just to allow more public input if there's any people that wanted to.

We'll be posting the presentation as soon as we can after the meeting concludes, so it will be online.

And if you want, we can attach it to whatever comes back to the board.

Okay.

And um since there is a moving target with the state budget, we're not 100% clear on when impacts of HR 1 are going to go into effect.

I'd really like to see us closely monitor this.

I know we have the state and federal updates at a regular discussion in our work session, but I think we just have to remain fluid.

Um I think on balance, this is impressive in terms of getting to nearly all of the ask.

It's not making um any particular group whole.

Um I'll just call on an analogy that Supervisor Carson used to always say is we're trying to make sure enough people get fed.

Not everyone's gonna get a full bowl, but we got to make sure we're sustaining the safety net.

So I do think that this is an effort to do that.

Um still want to process uh where we're hearing that there's still cuts.

I want to see an option to be a little bit more flexible.

I have said I think we're in a place where in a crisis where if we have to draw on some of the reserve funds, we should or reappropriate funds that aren't being used that are just sitting there.

I think we are um at a time of a crisis, so although I appreciate the work being done, I still think there's more to address.

Um also want to have the community have an opportunity, not everyone can sit here for eight to ten hours to wait to speak in public comment.

Um this information wasn't provided in advance when the agenda was published.

I do think we're hearing from a lot of community members and CBOs, but I'm sure there's more that went away in all this, so being very mindful of that as well.

Thank you.

Thank you, Supervisor Fortnite.

Thank you.

Um again, I want to appreciate um our leadership on the health committee as well as our AC Health Director for the Prop One proposal.

Um that's very positive news.

Um I did want to ask um, you know, there are a number of uh very vulnerable communities who will be supported with these recommendations.

I'm glad to see the LGBTQ community included.

In terms of the 1.5 million that the board already allocated for this fiscal year, I just wanted to confirm that those uh contract approvals are coming to our board on June 2nd.

Is that still the case?

Correct.

Great, thank you.

Um Supervisor Marquez mentioned the um immigration work and the act meeting we had recently with the proposed Office of Immigrant and Refugee Affairs.

So I do support that uh that the set of recommendations that was presented, including staffing for uh a director for the office.

I just wanted to put that on the record.

That's not in these proposals, but I am supportive of that.

Um I am definitely supportive of what I see in here for food security.

Um, folks might know that my office is uh helping to convene a food round table, and we've got incredible participation from about a hundred organizations as well as county staff, which I really appreciate.

So the 14.3 million that's in this plan, I think is good in terms of helping to sustain what we've been investing in.

The need is great, and I am spending a pretty significant chunk of my discretionary funding to support food security.

I'm also helping to support private fundraising because I believe it's just a basic basic thing that people need.

So if there is opportunity to do more, that obviously is a huge need.

So as we provide direction, I do want to say that when this comes back to us, I would like to hear some ideas about how we can potentially have flexibility to use health pack funding in fiscal year 26-27 as we analyze and see how those impacts are rolling out.

I want us to be as prepared as possible.

So I would like to see that come back to us.

Uh recommendations that the board has approved.

Thank you, Supervisor Marquez, for giving us a little bit of an update on the progress that we've made.

There was reference to board and cares and specifically the um the Shikla project, which is in my district, and I wanted to let folks know that I am working with county staff on uh finding a way to advance forward with that project.

I am also interested in some of the recommendations I've heard around mental health diversion courts, rental subsidies, which I know there are some overlaps with Measure W and our Flex pool.

So those are things I hope that we can continue to work on as we deliberate on the budget and after there is an update to the health and public protection committee.

And then finally, with recommendation three, um I do want to be clear since this is a two-year proposal that I am supportive of directing our excess tax receipts for both fiscal year 25-26 this year and next year, so that we can use those funds for the Essential County Services Fund.

And want us to just do it for those two years and kind of see where we are because I do want the original motion to stand in terms of those overages going to home together, unless there is a dire need like there obviously is right now.

Thank you.

Supervisor Tim.

Um I'm supportive of the three recommendations and I really appreciate staff, as I said earlier, incorporating the senior coalition's request back from April of April 28th, even though their letter was April 26th.

I did want some uh clarification on the um the bridge funding.

I know that we're looking at support for a lot of programs, including the UELP programs, and is what we heard today and we heard at Health Committee, even though it's not singled out at this point, is it addressing what we are hearing from the community in terms of their requests?

Um I would say generally yes on the UALP, and I don't want to speak out of a turn here, but I will say that as you heard both at health committee and in some of the comments today, as Dr.

Treville shared in her presentation with you at the health committee, that um some of the prevention providers who could transition to early intervention, which means that they could now bill Medi-Cal.

That a large number of providers took them took behavioral health up on that.

And so they've shifted them over.

Behavioral Health has uh with carryover funding, they're planning to keep those providers whole for the for that next year so that understanding that you know getting two billing would be a difficult um maybe not everyone's gonna be able to bill to the max of their contract that first year, right?

So there's that component.

Um, I will need to consult with them on is the UL is does keeping that whole mean that it covers the UELP component, or is that an additive component?

Okay, so I would also uh like to see some flexibility in terms of uh trying to use uh some of the access to provide that support to make them whole.

Uh similarly, that flexibility that we we just talked about with the PPS rate.

I've had a briefing with um the Alameda Alliance for Health yesterday.

I know they're meeting um, there's a consortium, including James Jackson AHS and yourself, and uh the consortium that are meeting with assembly member Bonta to look at trying to address the UIS uh the payment, which is what Health PAC is intended to help address.

And I don't I know that based on the governor's May revise, they they're moving to a fee-based uh program, especially for UIS patients, and so it's not clear to me at the moment what that um need is.

So I think we have that flexibility built in, but if we need more, we can um look at that prospectively.

Um yes, we will um, as we've heard from several board members, sort of track how that's going uh and we'll continue to work with the providers to see how the impacts are are coming to bear.

Um part of the biggest issues with the fee for service component, in addition to it not um uh not being uh sufficient um because the the PPS rate is much higher.

Uh so in addition to the revenue loss, there's also a lot of concern that um the state doesn't really have a way to actually bill for that, right?

Um, and so because that infrastructure has largely moved to managed care, and so it's unclear to us um how that's actually going to work.

You're absolutely right.

I mean, I think it's it's like we're gonna have to deal with it either at the front end or the um the tail end because the AHS system is going to absorb what we can't address um through health pack and through the clinics, right?

Uh so our health pack network includes Alameda Health Systems so it's Alameda Health System and the FQHCs currently.

Um those uh about half of the health pack contracts actually go to AHS because they are the only hospital and network and they're the only uh specialty provider in the network.

Um, but essentially, you know, if people are not able to uh get appointments at their primary care clinics or are not actually or too afraid to go into primary care clinics, we would see them show up more in the emergency room.

Okay, I appreciate that.

Um, so I I I got a little confused when you were talking about well, this isn't shifting gears on food now, because I know in the past you showed how coming out of the pandemic, we still sustain like an average of like six to seven million dollars when it comes to food, but based on the uh page 29, uh, the programs that are related to food from the senior services coalition included the senior food and meals, which is the 1.7 million dollars, emergency prepared meals for KCCEB, which is another million, the food recovery programs, that's half a million, the food bank and prepared meals is 8.3 million, and this is on top of what we had already uh contracted with the COLA for the food bank in that contract, and on top of what we did with the first tranche with the four million dollars.

Yeah, so thank you, um Supervisor TAM for reintroducing the food item.

I just want to give a couple of sound bites based on Supervisor Halbert's request at the end of last year.

He wanted an assessment of countywide contracts, and we're food related.

So the information I shared with you all in January of this year is that 62.7 million dollars in total contracts are distributed countywide.

Um, 23.9 million are annual contracts countywide, one two million monthly contracts countywide, 44 countywide contract contracts.

Um the largest allocation is in district five.

Um countywide, 31.4 million.

Again, this was shared with you in January.

Um District 5 was getting 12.5 million of that.

District 4, 5.6 million, along with District 3, 5.6 million, district one, 5.2 million, and district 2 is getting 2.5 million of that.

So I did share these countywide numbers and amounts with you all a couple months ago.

District 1's getting more than district four.

No, no, no.

District 4, 5.6 million, district one, 5.2 million, and on top of the contracts, we issue 34 million dollars monthly in CalFresh benefits, and then 408 million annually, remind Supervisor Miley that the second largest city in Alameda County is Fremont, District 1, and district two.

Thank you for that information.

That's very helpful.

I will stay out of the competition among the districts.

Yeah, let's put the recommendations back up where it's sort of a recap summarize.

Um, I would like to add one more bit on food, and I am our representative to the stop waste organization.

Food recovery, and uh when this comes back on June 2nd, I'm gonna ask for more than a half a million dollars for food recovery.

I think more than that occurs in our county.

This is mandated by the state, but yet completely unfunded.

They think that little elves are just gonna go to grocery stores and pick up food and redistribute it to somebody in need, miraculously without any funding, says Sacramento, no funding, but um greenhouse gas emissions result when spoiled food goes to the landfill, methane gas emissions.

It's you know, climate change and world catastrophes coming because food is spoiled in our landfills.

It's really good that we can take it and redistribute it before it spoils, and so stop waste would like to be a resource for us because they're the integrated waste management program.

Every city's required to do this in unincorporated Alameda County.

We are required to do this, but there's no funding for it.

Yet there's mechanisms of community volunteers and other organizations that we fund sometimes only with our discretionary dollars, continually under attack by members of Sacramento.

Our discretionary dollars, so I'm going to be asking that we provide some systemic systematic ongoing funding for stop waste integrated waste management group to work with food recovery organizations and cities and grocery stores to collect as much food that is past the best buy date, but well before the expired date, and to work with redistributed redistribution and/or my meals on wheels people.

If there is a way to end my shelter people, if there's a way to turn that recovered food immediately into prepared meals, say at our shelters, because the sooner it can be turned into real food that people can eat, the better it will be for everybody.

So that's a commentary on food.

So thank you.

And just as a reminder, your board um allocated half a million dollars to flu recovery, and it was procured.

So yeah, and I just don't think it's enough.

I'm not saying it's enough or not enough, but it was procured, and you your naming um entities that you would like to get it.

Thank you.

Let's see.

This is the recommendations one, two, three, four.

Yeah, summary of the recommendations um that staff presented to you today, and just to go through them quickly.

First is to approve the two year essential county services fund expenditure plans for fiscal 2627 and 2728, and to direct the county administrator to include the 26-27 allocation in the proposed budget that will be presented to you next week.

Secondly, that you support the one year bridge year transition funding totaling 45.7 million related to Prop One reductions to the behavioral health care community providers as recommended by AC Health.

Third, that you designate the Measure W projected tax receipts in excess of fiscal year 2526 and 2627 revenue estimates when confirmed by the auditor at year end to provide one-time funding for board priority projects, and we listed um ones that you had identified at your last work session on slide 29, and also to be able to mitigate HR1 and final state budget impacts, and finally that you consider amending the policy to allocate the Measure W accrued sales tax revenue received in excess of estimated revenue to the essential county services fund versus home together, which was the policy that's currently in place.

So this will come before us in a board letter on June 2nd.

Is that right?

So the two year the 2627 plan should come forward to you as part of the proposed budget, and you will be taking action on it when you adopt the budget.

I think there are some actions that you'll need with regard to the bridge funding, including the identification of the one time funding that AC Health is identifying, and then um I think we need direction on the excess for this year, and that will be confirmed once the books close.

And I think we need to refine a little bit further the list of board priorities, and then finally, you know, the policy we want to get your board's feedback, and that could certainly come forward for board action.

So I'm in support of all of these with the caveat that amending the policy to allocate annual measure W accrued sales tax revenue received in excess of estimated revenue, I think, for this year to the essential county services fund, but I would like that to be an annual call.

There may be times when we don't want to do that, and we come back and review that annually, maybe around budget time, make that a budget question.

Supervisor Miley.

Can I speak to that?

Because if we can do it, it's just we would be able to change it here.

Supervisor Miley.

Yeah, I I think it would be because I know Supervisor Bass mentioned that too uh initially.

I think it would be um more prudent to if the board doesn't want to amend the policy as outlined in number four, yeah.

Amend the policy to allocate annual measure w cruise sales tax received in excess of the estimated revenue of if the board doesn't want to amend it completely.

I think amending it minimally for fiscal year 26 um 26 and 27, 27 and 28 would be the the um would sort of the the best public interest because our our plan for measure w uh is for two years.

The essential um services plan is for two years.

Uh what they've outlined is for two fiscal years.

So I think we should at least try to amend the policy to conform with those two years, and then as you're suggesting, and or um Supervisor Bass suggested earlier, but I was able to convince her to uh reconsider it.

Um I think aligning it with the two years for the um services uh approvals that we're moving forward, I think would be the better thing.

So I would really suggest to the board that we consider doing the 27-28, and then if we need to uh look at it after that, we we take it up again and look at it after that.

Yeah, fair enough.

I multi-year budgeting is uh helpful for the entire system.

So that's that's that's fair.

Is there anything else to Supervisor Fortunato Bass, any other clarifications of the recommendations?

Thanks for pointing that out, uh, President Halbert.

Um I concur with amending the policy for the next two years so that the two-year measure W Essential Services Plan that was introduced today can be funded, and the following the subsequent years, I would like us to go back to the original policy, and we're going to have um June 2nd.

Everything posted to the website for public consumption, board letter presentation, this presentation.

Anything else that would be presented to us so that the public can consume it, and so that we can consume it.

So my ask is to include this presentation on the board agenda.

I think um appreciative that the presentation is gonna post after this meeting, but I do find it very frustrating that we have to continue to kind of dig and go on this like treasure hunt to find stuff.

We should make it really easy for the public and for us.

Just add all the links to the agenda.

We can do that.

We can do that.

Very good.

I do have some comments.

Go ahead.

Um, so full disclosure, it's been a very long day, and um sugar level is dropping, so I'm not as clear-minded as I'd like to be, and I'm sure I'm not the only one experiencing that.

Um, so thank you, Supervisor Dano Bass, for mentioning many of the comments I made pre-public comment, but I want to just round out the discussion just to be um really um uh clear with the community in terms of my priorities.

I'm gonna list a lot of things and fully acknowledging that not everything is captured under what the discussion is today, but this is front loading our budget discussion.

So again, just want to reiterate to um CAO teams, AC Help, Social Services, CDA.

This was a heavy, heavy lift.

And again, I am really really impressed with everyone's um commitment to hear public comment, not just in these meetings, but at the committee level.

We heard ACT, we heard health committee, we've heard public protection.

So just thank you for taking in all that information.

Um again, I would just please reiterate if we could front load this information so we all have the same information.

I think it's really important also for the public to um know what they're responding to.

You know, we're getting this information on real time, so it makes it really challenging.

Um, so just a couple of things I want to flag.

Um, what's going to be important to me is increased funding for the public defender's office.

We're gonna have an update on that at public protection this Thursday.

I mentioned earlier, reparations commission is gonna come to the full board on June 30th.

I'll reiterate my comments about the office of immigrant and refugee affairs, our counties one in three residents are um immigrants, and district two has the highest proportion of foreign-born residents at 40 point 45.9%.

So it's incredibly important that we institutionalize this infrastructure in this county.

So I'm really appreciative of the funding to extend the current contracts, but also want to see uh we identify the director position.

We've already funded two positions.

That was the additional ask through the implementation study.

There are other asks, but I do think we need to be um reasonable in terms of the long list of asks.

The these aren't the only asks of the communities.

I'm trying to weigh out all the uh priorities.

Really pleased with the work being done to address food insecurity.

Great work on Prop One, the bridge funding.

Happy to see the support of senior services coalition.

They're very clear in their asks and they do their own work, and it is our fastest um growing population.

And um also just want to commend the work around the funding identified through CDA for unincorporated services, that is a community that has historically been underfunded.

So I'm really happy to see the work done there.

Um, would like to see more work around cares first and um care first, jails last, as well as a reimagined adult justice.

I flagged some of the um the initiatives that we've already been able to fund and identify.

But of course, there's more work to be done, and I'll just reiterate we are going to get an update on that uh efforts of care first in July at public protection and joint health committee meeting.

So those are the things that are top of mind for me, and it is really difficult because um this does feel like triage and it feels like we're in a crisis in Remergie.

So I appreciate the work being done, but clearly there's more work to do.

So as long as we continue to keep an open mind and collaborate, I am confident we could figure out a path forward and just really appreciate everyone's engagement on this topic.

Thank you.

And I'm I'm supportive of the recommendations.

Thank you.

Uh appreciate everyone's comments as well as my colleagues, um, President Halbert had to leave to go to Sacramento.

Um we are going to be continuing the item uh Roman two, the number two, the Department of Children and Family Services status update on the findings from the state auditors report to the joint committee on legislative audits to June the second.

Um because we are running out of time today.

So I appreciate everyone's comments and I know that Supervisor Miley wants the last word.

Oh no, I don't want the last word, um, but I just um I just need to put this in context.

I mean, we've heard from a lot of people that this is the most challenging uh financial situation we found ourselves in.

Um, you know, maybe either for a while or uh forever.

And if you recall, if the board hadn't taken a decision um a number of years ago to put money into the retirement, we'd even have a larger deficit.

There are a lot of needs, there are a lot of demands.

Um we need to hear from folks, but at some point we need to prioritize what's in the priority because we're not gonna be able to fund everything to the level that the funding is needed.

Uh we might not even be able to fund um some things, and as I keep pointing out, during the pandemic, for instance, we had over a billion dollars of requests.

We only had about 600 million dollars that we could utilize and we figure out how to do that.

Um, I appreciate the fact that in the unincorporated area uh they've put in for an unincorporated area manager.

Maybe we'll have to defer having an office of unincorporated services because that's not mandated, it's discretionary.

Maybe we need to look at other trade-offs that are not mandated but are discretionary because we have to ensure that we deliver safety net services to populations that need them.

Uh I think that's important.

Reparations, I appreciate the fact that we're bringing up reparations as an African American.

I'm concerned about reparations, uh, but I'm not necessarily gonna sacrifice some safety net services for reparations.

We'll get to this stuff iteratively and talk if supervisor pass raised it.

We're talking with Alameda Health Systems about the hospital and their needs, which is really important, and that just doesn't deal with, you know, one race or one gender, deals with everybody that needs those services.

I would put that above certain other things.

So we have to really be conscious about all this stuff and take it iteratively as we're going forward.

I think the staff has done a tremendous job with what's been given to them, and I want to just emphasize this.

If we didn't have measure W, we would be in worse a much worse situation with all the needs that people are talking about.

Much worse and we'd probably be calling on labor for concessions and other other things to try to deal with the challenges we have faced or faced with so I just want to really make sure we keep all this in perspective I think we're doing well at this point and we'll continue to do this but we're gonna have to decide what's priority and what isn't priority and if we can't for fund something to the degree we want to fund it we fund it maybe to a limited degree because we have to put resources into something else that's gonna serve the greater good.

Very well said we are in much better position than the other counties throughout the state because uh our community voted to put measure w so it's a good problem to have thank you you have all the direction you need any other announcements we thank you for your feedback and direction and we'll be back with the conditions and information that your board requested thank you and since this is a special meeting there are no public comments on non-agenda items.

So thank you this meeting is adjourned