All right, so good morning.

Let's call the meeting to order for the Health Board of Supervised Health Committee on July 27th, 2026.

Clerk will take the roll.

Supervisor Cam.

Present.

Supervisor Miley.

We have a call.

Okay, thank you.

All right.

First item is healthy schools and communities update.

There we go.

Now you can hear me.

Good morning, Supervisor Miley and Supervisor Tam.

Good to see you.

Thanks for having me this morning.

I'm just going to provide a brief update on what's been happening with healthy schools and communities over the last couple of years.

You have the slides up.

Thanks.

The first slide that you can see, that's actually a photo of all of our staff that we took at the Reach Ashland Youth Center this past year.

You can see our outfits are color coordinated.

I don't know how we manage that.

But I'll just I'll jump in.

Our our North Star, like what we're really trying to envision with healthy schools and communities is uh that youth embody self-determination and that they graduate from high school equipped with options and they're ready for college and career.

And our work is really around uh integrating education and health and making sure that we're looking at the whole child and all aspects of youth and in their communities.

Next slide, please.

And these are the strategies that we work on, kind of the three big buckets.

Uh the first one is around systems building.

Um we work a lot with our school districts and community-based organizations, um, increasing their capacity, uh, just making the health and wellness systems work better.

One example of this is our coordination of service teams.

We've been working on this for several years in Alameda County with community-based organizations and school districts.

Um, probably our biggest bucket of work is the school is the youth wellness and leadership.

And I'll go into more detail on all of our programs, but um examples are our Reach Ashland Youth Center.

We oper, we don't operate, we fund 28 um health centers uh throughout Alameda County.

We have our youth family opportunity initiative, our Caminos program, just to name a few of our strategies.

And we also do family engagement and support.

So we fund um school linked and school-based family resource centers.

We work with our family liaisons at school districts.

Um we also have some community health workers that work within school districts to help families navigate public systems and connect them to resources.

Next slide, please.

And the first uh strategy I'm gonna talk about, or actually, I think it goes to the map next.

The next slide, yeah, here we go.

Um, this just shows that we really are focused on all of our work is focused through an equity lens.

And we uh we make sure that all of our programs and services are in the neighborhoods, you know, furthest from opportunity, and where uh our children and families are experiencing the greatest health disparities.

And this you can see all the different programs that we have kind of mapped out throughout the county, some of our youth and family opportunity hubs, our school health centers, um, and then the Reach Ashland Youth Center, which is right there in the center of the county in Ashland Cherryland neighborhood.

Next slide, please.

And just a little bit about reach.

Um these are some updates and some of the priority areas that we're working on right now.

Uh we've been working a lot around coordination in the unincorporated area, um, focusing on staff and our partner agencies.

Uh, we have three, just as some examples.

We have three uh reach members right now who are um have voting seats on the Eden Area Community Collaborative.

We're also right now involved in the Eden Promise Neighborhood application.

So we're partnering with Cal State East Bay and the Eden area partners around that application.

So that's a really exciting opportunity.

We're also working on healing-centered engagement, and we've um some of our staff have been certified in this model.

It's a um Dr.

And it builds on the trauma informed approach that REACH has done throughout since it began.

And we also continue to work on youth and adult power sharing, and we're in our third year with this work.

And then lastly, we continue to work on our coordination of services, and we're expanding our clinical team to make sure that we're you know working really closely with the school district and all the CBOs in the neighborhood around our coordination of services.

I think this is a picture at our summer camp.

We always take the kids to one of the beaches in the area at our summer camp.

I believe this one was Angel Island, I want to say.

This was recent.

And then the next slide, it's a video of our arts and creativity program.

It's a promotional video clip we thought we'd show for you today.

And this is all produced in-house outreach.

Hopefully, you can get it to work.

You can try the there's the link, or you can just click on the video.

The arts consists of mainly two spaces in addition to some.

Thank you.

Thanks.

In the works, we paint.

And we also do a bit of sculpting and other arts.

You can also sign up for cooking classes in the bike.

All that, and we post it on social media, just like you're seeing that.

We also have special offerings like a class taught by a Pixar Animator and real world artists.

On top of that, all the youth facilitators teaching here are also real world artists.

So you can come to the arts Monday through Friday, and don't be afraid to ask.

Thanks.

Um, and then the next slide is around some of our service numbers at Reach.

Um, but I should just mention that our uh our numbers are back to pre-pandemic levels.

So we've been serving, we've continued to grow our membership and we're back to where we were before the pandemic, which is great news.

Um, we're also really like working more with our clinic, the Fuente Clinic, which is on site at REACH to make sure that those numbers can't remain.

Don't be afraid to ask about special signups and summertime and drop in every Friday for second lab.

Couldn't get the plane now, it's hard to go back to the deck.

Um, I'll just mention that our clinic, uh, the Fuente Clinic has been experiencing a little bit of a drop in in service numbers.

Um, they think due to you know everything that's been happening with HR1.

So we're trying to just really like work as much as we can with that clinic in partnership to you know increase their um their services and um service for our children and youth in the neighborhood.

Let's see, here you go.

And the the photo here is um our color of youth event, which we do annually, and this is a chance for them to showcase the youth to showcase their creative, all of their creative endeavors over the course of the year.

Uh and they also do like a breakdancing contest with Destiny Arts at this event.

And then there now you can see the numbers.

Um we're gradually going up since the pandemic.

And we're also, like I said, over to the right working on the cost.

We're trying to increase those numbers as well as one of our priorities.

All right, next slide.

And now moving on to school health centers.

Um, as I mentioned, we have 28 school health centers in the county.

Healthy schools and communities provides a base allocation uh for our partner agencies to operate these these centers, and they're throughout the county.

Um, this is you can kind of see a map throughout the county here uh in how many different school districts?

Oh, 10 lead agencies and um in five, let's see, five different school districts, I believe.

Next slide, please.

And these are just some of the highlights.

Uh we've been partnering with UCSF for many years to evaluate our school health centers, which has been great because they've also been able to access in recent years the electronic health record, which helps us understand, just better understand how our school health centers are doing and how they're serving our clients.

We've served approximately 15,000 clients with almost 60,000 visits.

And we have strong client retention with 60% that returned for follow-up visits.

And we have 206 youth that participated in our youth leadership programming.

And uh we also learned that school health center uh users are more likely than non-users to report receiving needed help with sexual health and counseling services.

And 98% of students agreed that the school health center helped them have somewhere to go when they needed um help or support.

And these are just some of our provider or some of our priorities that we're working on right now.

We're really working on sustaining our school health centers.

They've been experiencing some challenges over the last few years due to rising costs, also possibly because of HR1.

So we're um really leaning into sustainability work and partnering and talking about how to increase funding for our school health centers for the base allocation just to help them operate.

It's not a particularly profitable uh endeavor, and it's just gotten more difficult over the years to operate these clinics.

Uh, we also continue to uh host our learning community, which has been even more important because of those sustainability issues, where we share best practices and we develop our cross-agency support for the clinics.

And we continue to just build more partnerships with our stakeholders to address and approach all of our challenges and ensure that the school health centers remain safe spaces for young people, especially during this current climate.

Um, and one area that we've been leaning into even more is uh better partnerships, stronger partnerships with AC Health with our entire agency, especially around Medi-Cal outreach.

AC Health has been working really hard right now to make sure that we're doing a lot of Medi-Cal outreach given all of the changes with our uh federal policy changes.

So we've been really leaning in around that as well as around immunization and dental health.

Next slide, please.

And then this is just a little bit about our youth and family opportunity initiative.

Uh let's see here.

We fund um, we have uh programs across 10 cities and five different supervisorial districts, and we fund 10 CBOs and five school district partners.

And this has enabled us through these partners to serve approximately 15,000 individuals, almost um 4,000 families received health coverage uh application assistance, and most of our children and youth and families are you know very um pleased with our services.

They're uh connected to their uh have better access to healthy food and health care as a result, and the youth are feeling like you know, they have an adult who cares about them as a result of participating in our programs.

Next slide.

And over the uh this next year, we hope to again leverage our family resource centers to really help assist families with Medi-Cal and CalFresh changes at the federal level, making sure they understand the policy changes and helping families continue to enroll and keep their coverage.

Um, and we will want to continue to explore opportunities for more client voice in our programming, and we'll do this in partnership with with REACH.

We've learned a lot about our youth adult power sharing at REACH, and we want to spread that throughout the county, that knowledge and those best practices.

And this is uh a photo, I think, at REACH, and then this is it just says here about a Dublin student that launched a podcast to address mental health, and this was with one of our YFO partner organizations.

Next slide, please.

And then a little bit about our Caminos program.

Um, our communos program offers case management and capacity building for school districts and educators to support unaccompanied immigrant youth, children of migrant families and caregivers using a culturally relevant lens.

Um these were some of the things that we did over the um this past year.

We had a provider retreat, which was an end-of-the-year gathering to celebrate over 10 years of work in our communos program.

And this was a really important time to do this work to offer our providers self-care and resilience building in response to all the increased stress that's been happening due to the changing immigration policies.

We also served over almost 3,000 newcomer students throughout Alameda County.

And we offered quite a few consultation sessions with our schools and districts and offered trainings.

And we trained nearly 100 providers around family emergency preparedness with Inc.

East Base Sanctuary Covenant to help families prepare for potential separation due to the threats of detention.

And then lastly, we co-hosted the first Tri-Vally Immigration Resource Fair.

And we offered legal immigration resources as well as connections to community resources and know your rights workshops.

Next slide, please.

And these are just some of the things we're going to be working on this fiscal year.

We'll be playing, we'll be publishing our Caminando Juntos Resource Guide, which is a resource guide helping our community-based organizations and school districts better serve our newcomer populations.

And we're going to be continuing to partner with school districts to make sure that they're remaining welcoming and in safe spaces during this time.

And we're going to continue to sustain our communos learning community where we share all of our best practices.

And expand our partnerships to address all of the emerging needs, including the Medical outreach, legal services, and basic needs.

And we also do a lot of school-based behavioral health.

And our school-based behavioral health initiative expands universal access to behavioral health supports, and it builds the capacity of schools and districts to promote mental health wellness and social emotional development.

I think what's important to kind of emphasize here with our behavioral health work is that it serves kids that don't necessarily, they don't have to have Medicaid to get served.

It really focuses on serving all the kids with very limp, like very little barrier to be to being served.

And so we have some clinical case managers that are providing direct service within schools.

And we've served through those clinicians around 150 students.

And of those students, eight eight out of 10 of them reported they learn new ways to help them feel better, manage stress and anxiety, and they felt they had an adult at school who cared about them.

We also do a lot of coordination of services team work.

So we help support school districts with how to do these cost, this cost system.

And we also fund school districts to do this work.

And so we have these supports in 284 schools and approximately 20,300 students were referred through the coordination of service teams.

And we do a lot of behavioral health consultation to help our staff be prepared for serving their students.

And then lastly, we executed over 2.5 million dollars worth of contracts to 14 school districts and four CBOs to provide those direct behavioral health services.

And these are just some of the priorities that we will continue to work on over this fiscal year, coordination of services teams.

We're also doing a lot of behavioral health consultation around crisis protocols and serving priority populations like LGGPQI populations.

And we're also offering clinical consultation groups for our providers working in schools to really support their work around best practices and support.

And we're doing a lot of training.

So cost training, youth mental health first aid, and cannabis opioids 101.

And lastly, peer leadership has been something we've been working on for the last few years.

So peer mentor programs are something that we support and train around throughout the county.

Next slide.

I think this is our last program slide.

This is a little bit around the family engagement and support work that we do.

We support a lot of work.

Again, it's working with our school districts and CBOs to help their family engagement specialists.

We have a family liaison community network.

And we've launched a new, we've been working on parent cafes.

So this is kind of a new model that we've that we've been trying over the last couple of years.

And we're offering this parent cafe trainings in English and Spanish throughout the county.

And let's see, we've been working with training and coaching for family liaisons in the Eden Unincorporated area in partnership with Eden United Church of Christ.

And we do a consultation group with the San Lorenzo School Community Liaisons.

We also have three community health workers that focus on West Oakland, Tri-Valley, and South County, connecting those families to resources.

And we've served about 247 families connecting them to healthcare through that work.

And lastly, this is our systems change work, our systems building.

As I mentioned before, and as you can see throughout the presentation, what we've been talking about is that we support we work in partnership with school districts and our uh community organizations and public agencies to build health and wellness systems.

Um of this work is internal to Alameda County Health.

Uh we facilitate a youth, um, a children, youth and families work group.

So all of our programs across Alameda County Health that serve children, youth and families come together.

We talk about what we're doing, we coordinate efforts and we align our work.

Um we're also leading an internal Alameda County Health Measure C implementation work group.

Uh we just finished our theory of change.

Um and again, we're working on coordinating that work, uh, learning from each other and aligning the work.

And we also facilitate seven learning communities, which I just talked a bit about.

Um, our Camino's learning community is an example, our school health centers.

And we lead the school health steering committee in partnership with the Alamedi Coffee County Office of Education.

Uh some of that work we're doing, um, we have a behavioral health sustainability work group as part of that steering committee, where we're looking at trying to um come up with strategies to you know learn about our funding for behavioral health, expand the funding within our school districts.

And lastly, uh we're coordinating partnerships and services in the urban unincorporated area of Alameda County.

And an example of that is that um the promised neighborhood application that we're working on right now, and hopefully we get funding for.

I think that was the last slide.

Thanks.

All right, thanks.

Thank you for that presentation.

Um there seems to be a lot of underlying themes about the need for funding and sustainability.

Yes.

Uh so along those lines, um do you happen to know the status of the school-based health center at Alameda High that was run by Alameda Family Services.

Because I think back in April, there was a concern that because of staffing shortage, because of HR one and the lack of medical coverage, that uh Alameda Family Services could no longer provide support and La Familia and Roots wasn't able to provide some corresponding support.

We are still looking for a medical provider for that site because Native had to pull out.

Uh, so we're still in the process of trying to find a provider for that site.

So it's a challenge.

In terms of funding, um because I I know the Ashland Youth Center, uh, Supervisor Molly's office has been um basically trying to fill the gap for a long time.

And we're looking at trying to get Measure W funding and similarly, um, the Wilma Chan Family Resource Center at Hayward Acres, uh, which provides uh family support, including referrals and legal uh consultation for immigrant support as well.

Um how I mean we're we're looking at trying to provide some measured W funding to close the gap, but then we're seeing it, as you said, in Ashland, a decline in usage.

So how how are we reconciling like REACH?

I know is is definitely a county, but is there some way in which uh the schools can partner more closely in the school-based ones?

Yeah, for sure.

So we haven't seen a decline at REACH in the REACH services and membership.

It's just the clinic there.

Is that what yeah, the Fuente Clinic, they've experienced a little bit of a decline that we're really trying to like carefully monitor.

Um, and yes, we're trying to increase our partnerships to make sure that we have we do a lot of like newcomer support across all of our school districts.

So one example is we have a clinician that specializes in that, and she works with a lot of newcomer youth at some of the schools throughout Oakland.

And so one focus will be to have she's going to kind of help us bring those youth to Fuente and kind of have sort of like a warm handoff to that clinic.

So that's just one example of a strategy, but we're also continuing to partner really closely with the San Lorenzo School District.

We have really strong relationships there to basically help the clinic ensure that you know those students are getting served and are in their, you know, the the numbers stay high.

But yeah, I think same the same kind of work could happen in Hayward.

And we also have staff that work within the Hayward um unified school district.

So if I would love to talk with you offline too to kind of explore more ideas around that family resource center.

Yeah.

I think that uh it would be helpful if perhaps you can um offer a presentation at like the Alameda Youth and Families collaborative with Supervisor Chan started, you know, 30 years ago, right?

And because there's just changes that have happened.

And similarly, um, there was an effort to do something similar with Oakland Thrives, which involves multiple jurisdictions and trying to get an update and see how we can best leverage some of these uh multiple challenges and resources.

Yeah, we would be happy to do that.

Okay.

Sure.

Um supervisor, could I sorry, could I add something uh real quick?

Thrives.

Yeah, I was just gonna say in terms of the school-based health centers in general, you know, the way that the county supports those models is that we provide through the center some base funding, and historically that's been measure A funding.

It's a small amount of money, um, but it supports um those learning communities, like a consistent model, et cetera.

Um, and the clinics, the the medical providers who actually provide the services, bill for those services.

So what we're seeing is that, you know, with the Medi-Cal HR1 uh um changes that are coming down the pike, um, clinics are having to make some choices about where they want to put their resources, right?

Um, and there's just an overall decline in Medi-Cal.

Um, I think that's also one of the issues that we see in Alameda is that it's a lower percentage of students who are on Medi-Cal compared to some of our other areas.

Um, so we have had some conversations both with the Alameda County Office of Education and uh talked with the superintendent about like how do we bring this to Oakland Thrives, perhaps as a way to think about some different models.

Um, and then we've also talked with the uh um clinic consortium, uh, because most of the providers are FQHCs, um, to see can we do something different in a in a way that um make sure that we're providing those services in the in the schools.

Yeah, I I think that's important.

I um in terms of looking at alternatives, uh, I'm trying to get a better sense of whether or not the the family resource center can become a more um encompassing if some of these other school-based programs, because it's it's dealing with the whole unit rather than just the the children or the kids at schools, and um and I know the FQs have a role in um providing a lot of that support and and perhaps um the challenge that we're facing with is obviously also on the behavioral health front, right?

And how to provide some adequate support on the behavioral health front, especially right now.

I know that my office has been trying to get um a career teen center, the QTAC center up and running at Alameda, the unified school district.

Um so we're hoping maybe we can lean into some of that support from your organization.

Yeah, definitely.

Okay.

Yeah.

Thank you.

Thanks.

Well, thanks for the report.

Appreciate it.

I definitely um feel we need to have an annual update from the healthy schools and communities.

So how many staff do you have?

Oh, that's a good question off the top of my head.

Uh I want to say like 40.

40.

Yeah.

But I should tell I'll get back to you on the exact number.

Okay, just curious.

Um in the opening slide, it says we envision a county where all youth embody self-determination and graduate from high school, healthy and equipped with options for college and career.

Do we have any metrics that indicate from whence we were and started to where we are presently?

Good question.

I mean, that's kind of our north star, like population outcome.

Yeah, big.

Yeah, yeah.

So I'm just trying to get a sense.

Yeah.

Do we know we're making progress?

Or we sort of get a sense of that.

Not I'm just gonna be honest, like not really.

Um, I don't our program is small in the whole, you know.

have any metrics that indicate from whence we were and started to where we are presently good question i mean that's kind of our north star like population outcome yeah big like yeah i love it yeah yeah so i'm just trying to get a sense yeah do we know we're making progress or i mean starting a sense of that a feel for not i'm just gonna be honest like not really um i don't our program is small in the whole you know so what we try to do is we try to uh like pilot best practices and kind of that like sort of practice to policy work but I do think that that would be a good thing to try to measure because as we try to spread some of these you know services that we've basically designed and spread like cost would be an example it would be a good kind of like study to look at to see how we have impacted that North Star but it's it's a tough I think it would be a tough thing to measure given our like small um kind of footprint because across you know for the whole county but I feel like if we did some place based efforts we could probably do that like that's why I'm excited about the Eden Promise neighborhood because that will allow us to do to really lean in around all of our coordination and to kind of take everything that we know and try to pilot it in that one community and then maybe we could actually look at some of those outcomes.

Yeah yeah I don't want to jump ahead of myself because when I hit the different slides but it just kind of seems to me you know um I'm challenging you and your boss because it just seems to me that with the systems change piece bringing all the systems looking at all this you could try to create some type of metrics to kind of see if we're making any progress or we're just spinning our wheels or you know we're doing good stuff but are we going anywhere?

I mean I'm I'll just say what I like what I hope to happen is to have more of that coordination across Alameda County Health with children and youth so beyond healthy schools and communities and that's why we've started that work group I think measure C is a big opportunity so I think that's where we might be able to see some of really meeting that North Star is if we do it across all of our programs.

Yes okay so I would that would be that would be my I wouldn't put it just on uh the Office of Healthy Schools and neighborhoods with the Center for Healthy Schools Neighborhoods I think you need to bring in you know others yeah in the agency and you know external partners etc to try to create uh that that system and that vision yeah that was I believe kind of the vision of ICPC back in the day too wasn't it to kind of the interagency children's policy to kind of do that collective impact across the county and look at you know goals and outcomes and be able to measure I mean that would be I think in a perfect world how we would be able to measure and reach that North Star.

Yeah.

Let's see here so um doing a lot of good stuff for with reach it's great um with with reach with this with the the fact that the number of students youth uh atreach increasing do we know um the demographics of the youth not necessarily their their their race but their age what school district they're associated with etc.

Yeah I don't have it in front of me but we do have all that information that we could share with you.

Yeah I'd be curious to kind of get a sense of where that is uh today um mostly San Lens school district but I think some come from South Hayward as well and also some from Oakland.

Right right it was just yeah that's so we can give you the exact numbers that's been my understanding and just curious and um I was just thinking if if we're gonna have this report annually you could just bring it at a future a future update you don't have to um give it to me before then but if you if you choose to that'd be great too um then let's see then I and then my office has been keeping me abreast of the promised neighborhood uh proposal and application so that's really great hopefully we'll we'll be successful in in receiving that um that grant and I did want to make a notation with the um 28 healthy um school health centers are what's our relationship with all of the federally qualified clinics are we working with all of them are they part of that working group uh for systems change or what's going on there yeah we have um we work with Toburcio La Clinica native I might be forgetting one um I don't know that they're all the FQHs I don't think we have relationships with all of them but we do have relationships with a handful of them and they are involved in that learning community and as Anika said we're trying to kind of meet even more with our leadership to try to understand the um the cost you know some of the challenges that they're having with the with the rising costs and just kind of making these clinics work so we've been working and partnering with the FQHs even more so in in the recent couple of years.

So we've been working and partnering with the FQHCs even more so in in the recent couple of years.

Okay.

There was a slide you have you put up school health centers highlights.

Was that the nearly 15,000 clinics with uh almost 59,000 visits?

Was that since the inception or was that over one year?

What one year?

Okay.

Yeah.

And we have a lot of data around school health centers because we partner, as I mentioned, with UCSF.

Um, they actually use our data to like publish reports and all kinds of um like journals and yeah, so they it's a very extensive evaluation, and I could I'm happy to share more on the evaluation if you're interested in the case.

Yeah, because I'd be interested in a uh maybe the committee be interested in knowing um what the the demographic breakdown because all of the are you just working with high school students, are you working with junior high and elementary school?

Not so much elementary school.

When out there we go, it's back.

Um, not so much with elementary, but mostly high school and some middle school.

Yeah.

But people, you know, the way it works is that uh youth from all over the schools can go to those, you know, clinics from other schools.

So trying to kind of refer students from all over to those clinics.

And I think, supervisor, to your question about just sort of how we're connecting the different systems together.

Um, you know, there's a lot of great opportunity, for example, uh, through some of the measure C work, the the children's pediatric measure C work, we've explicitly um sought to improve connections across the Center for Healthy Schools and Communities with the public health department and the work that they're doing and kind of thinking about how to leverage those um school-based services.

And then depending on what happens with HR1 and how um it affects again that FQHC billing component, um, there might be new things that we can look at where you're kind of seeing those physical locations in these schools as a place for community members to come in, right?

So it's not necessarily just limited to um to the students there.

And so uh those are some of the things that we we want to explore.

Um because it is a it's it's been a long um steady investment that we've had.

There is some um some of the schools have done a lot of like capital improvements on those clinics, and so uh it's both real estate and an infrastructure that we have that we can be leveraging.

Sure.

Yeah, because I'm trying to recall, because this isn't a new territory, um, islands of Branny Park.

Um is it Madison?

Exactly.

And and is that clinic open to the whole community?

Because I thought if I'm gonna recall it quickly, it's just not youth, it's adults too.

They have a community entrance.

Um it's not all community entrances are created equally, I would say.

They still have to walk through the school.

So it's a little not super accessible.

Um, I think the true community entrance where you would get, you know, kind of more revenue and more uh clients would be if it was like maybe kind of not they wouldn't have to walk through the school campus.

We just met about native just about this the other day, and they were saying that it's it's kind of tough to get people to come in because it's so embedded within the school, even though it has that, even though it does serve the community.

But is that the kind of thing you're looking to maybe ponder because of the possible changes?

Yes.

So what we're trying to do right now is um keep you know, kind of keep things whole for the next couple of years or even year while we explore those those questions because those questions uh it takes a while, right?

Because it's like facility planning and working with school districts, and it's it's not an those aren't easy questions to kind of figure out, but that's exactly what we're trying to like dig into now.

Is that model?

I've got confidence in you, Lisa and Anika and the rest of her executive team and everybody who works with you, I've got confidence.

You're gonna figure this out.

My job, our job is to keep you on your toes, keep it, keep you thinking.

Let's not get you know, let's not get comfortable.

Yeah, so good.

That sounds good.

Um then back on the health centers at the schools and the federally qualified clinics.

You know, I serve on, and it's not part of um Almade Health.

It's part of community development agency, the lead abatement authority.

And we've been, and even in the unincorporated area, there's been a strong push for wanting to get all school age kids tested for lead.

And I'm actually gonna ask my staff working with Anika to schedule a presentation or information presentation on that, on that with all of our stakeholders, including Center for Health Schools Neighborhoods, Office of Education, et cetera.

Because I do think if we either can pilot something or establish something uh throughout Alameda County, and this isn't just for children in you know one school district or in one geographic area, it would be countywide.

They'd all get tested for lead upon entering, let's say the third grade, whatever it might be, whatever's um we would figure out would be the best thing.

Uh have you had any conversations with the joint powers authority staff on lead around this, as well as the Office of Education, because I know I talked to both about this.

Yeah, so we've met with the Office of Education around it.

Um Dr.

Moss, I believe, was in that meeting with Kimmy.

So we have met and we met with ACOE.

Um, so we did have a partner meeting with ACOE public health department and us to talk about this question.

I think it was mainly focused around OUSD or on Oakland.

Um, but I think, yeah, I think what you're proposing would be a good to sit down and really have like a planning discussion around how that would work.

There's a lot, it's it's complex, as you know.

Um, but we haven't talked, I don't know if you've talked to the JPA around it.

I have uh no, I I've not had those conversations, and I think you know, to the extent that we've talked about them internally um with public health in the center, some of it it's it's sort of uh really wanting to think through like the next steps of so if we did offer testing, what does that mean?

And you know, does that um what can families do and wanting to pair it with appropriate education and resources?

Um so look forward to connecting with you more on that.

Yeah, because I do think uh that's something we should be um doing.

Um, I'm not gonna even bring up PFAS, but you know, I what I think about PFAS and the need to for testing there eventually, but at least lead, we know lead is out there and it's causing uh problems, and we have the JPA, and at some point we might be able to um expand the JPA and expand its funding stream, but I know that's not going to happen anytime uh uh soon.

Uh that's something I've been trying to achieve for uh at least a decade or so.

Um, but so I wanted to bring up that lead testing piece with the youth.

Make a little pitcher on the lead too.

That's something I work on.

I used to work at First Five way back when, and we actually worked on a lead program with CDA, I think it was many years ago with family child care providers, and just wanted to kind of plug that that I think that would be a good population to partner with first five around because the kids are in these, you know, like housing stock that's really old and they're kind of like crawling around on the floors, and it's anyway.

So I just wanted to say as an advocate for the little ones as well.

Yeah, and I don't want to prolong this, but I know through the JPA Joint Powers Authority for lead abatement, uh, they're looking at trying to do a pilot in a couple of schools, I think in Hayward and Oakland potentially.

So the point is I just think we need to uh move this agenda along to a pilot and then um see if we can bring it to scale so that all kids are being tested.

And I just think going through the schools, although I'm not you know, I'm not opposed to the um the child care um uh development centers and uh uh child care facilities, but I just think the the school would be probably the most um expeditious way of of monitoring it in gathering the data uh but but I'll wait, but I'm gonna uh get a report here in the future on that.

So let's see uh a couple other questions here one of the slides you mentioned, uh it's it including HSC.

What's HSC stand for?

Healthy schools and communities.

Oh and with youth uprising, or is the only thing you're doing with youth youth uprising is the clinic out there?

Yeah, we have the Castlemont Clinic, which is right there on campus, and we also have the contract with youth uprising, as you know.

And are we are we um because I know there was a lot talked about with REACH, but Youth Uprising is our other youth center that you know the county doesn't run it, but we you know we own the facility, we provide a significant amount of funding for youth uprising.

Uh it's a nonprofit that runs it.

So REACH, it's county operated youth uprising is nonprofit.

So what are we doing with youth?

Yeah, so that's a good question.

Uh when I started healthy schools and communities, we had a very like kind of hands-off approach to youth uprising, and we were managing the contract, but we weren't doing a lot of like real like partnership with them, but now that's changed.

So the over the last few years, um, we meet with them regularly.

We've been offering, like we've been including them in trainings with REACH around all kinds of topics like mental health first aid and evaluation and um part working with partners, like partners organized, you know, partnerships with CBOs, that kind of thing.

Uh, and right now we're actually working with Em around helping with their behavioral health work because um they had MHSA PEI funding, and that was cut.

So we're trying to kind of help them uh access Medi-Cal to see if they can you know build Medi-Cal, because I believe they did in the past.

So that's just an example of the kind of work that we're doing with youth uprising.

Um, and we also really work really closely with the school district, so also helping with that school partnership.

But youth uprising is amazing, Kiana's amazing.

Um, we're really lucky to have her as a CEO and great leadership there now.

Well, I just thought it was um because you we wouldn't know the off the center of health schools.

I'd probably put that in the presentation actually.

Obviously, I'm in the youth operating board, so I know kind of what's going on.

Uh and quite frankly, I've probably been the youth uprising more than I've been to reach in the last year or two.

But um I just don't want us to forget youth uprising, even though it's run by a nonprofit.

You know, we've in the past we've had to provide additional resources many years ago, million dollars to help bail out youth uprising, et cetera.

And in that model, I still think is very important.

And I think youth youth uprising is very important.

Yeah.

So I think if if it's not successful, uh and we're not working with him and collaborating with them as well as we could, um, I think it'll be a disservice to the youth in Oakland who primarily go to youth uprising.

We will go to youth uprising.

Yeah.

Great.

Yeah.

Uh and let's see here if there's anything up.

Okay.

I think I'm now over to over to systems building.

Yeah, I think I'm really interested in having this committee have a presentation on what's going on with Alamia County Officer of Education around the behavioral health piece, um, Medical Ps.

Um Peace, etc.

Yeah.

That's a good, yeah, that's that's a great idea.

Because I know you're talking with the superintendent.

Yeah, we've actually been working with AC.

So when I started HSC like in 2020, we um before 2020, we we didn't partner as much with ACOE.

And because of I I that was one actually positive thing that came out of the pandemic, we became very close partners.

And over the last six years, we've been working really closely together around that children and youth behavioral health initiative, um, supporting that work, sustaining that work.

Uh, and like I mentioned, we have the school health steering committee now that we run together in partnership, and yeah, we're just working side by side to try to align our work and be as efficient as we can with our resources to make sure that as many kids as possible are served with behavioral health services in the schools.

But yeah, I think it would be great to have them come and talk about that work.

Yeah, because I get bits and pieces sometimes from the director and some sometimes from the superintendent, but I think it'd be good for the committee to kind of get a real good informational update, because it just seems like things are kind of making progress, but um I'd be curious to see what progress we've made and where we need to go and what are the impediments to us getting there.

Yeah, we actually are meeting this afternoon, as I mentioned, that school health steering committee, and that's the question that you just posed is exactly what we're grappling with in that work group.

And so maybe as we progress through that work group, we can bring some of those findings um around what are the gaps and what do we need to do as a county to try to fill that behavioral health gap within schools.

Okay.

So yeah.

But the the thing that I would add, supervisor is so in addition to the work that um healthy schools and communities does directly with ACOE.

I believe the board recently received a communication from the superintendent sort of providing an update on the work around foster youth specifically.

So with the ICC, I always forget the acronyms, but the interagency children's council.

So there's some stuff that you know we're required to do per state law for that.

So there is a leadership steering committee that includes me, the social services agency director, director uh uh Dr.

Tribble, um, Chief Ford, as and recently we've had first five, uh, sorry, the regional center added to the mix, um, and the superintendent.

And so I think there's multiple layers of of the work that's happening.

And we just had a meeting last week where we were talking specifically about what are the things that we want to collectively measure together.

Um, so happy to reach out to the superintendent and we can bring something back for you in the fall, maybe.

Okay.

You have anything else before we have public speakers?

Um, do you have a sense of uh the proportion of kids in our schools that are um under Medicaid or Medica.

Good question.

Do you have that data, Anika?

We I think we have it out the top of my head, but we can look into that.

Yeah.

The reason I'm asking is because I I know uh this is back in the day was when I was working at the water district when we were uh trying to um provide means to test for lead um in the schools, school buildings.

And I know recently um the Center for Disease Control through the federal government that received some significant grant funding to test for lead in drinking water, but I know it was a requirement back then for kids that are like around two or three years old to get tested for lead.

So that was a requirement under Medicaid coverage um children.

Yeah, I think we have a good sense by district and school and neighborhood.

Um a decent sense of Medi-Cal rates.

Uh I don't have it off the top of my head, but there's actually also a kind of a map that we have through our school health center state alliance that looks at Medi-Cal rates too that I can show we can just share that with you.

That would be good because the testing is covered by Medicaid for that.

Great.

Yeah, and it it looks like about um a quarter of the our total Medi-Cal population in the county is uh youth under the age of 18.

Um, so that's well over or close to 100,000 kids.

Do we have any public speakers on this item?

I have no speakers for item one.

All right.

So thanks, and we look forward to uh ongoing updates.

And um thank you.

All right, so our next item is an action item uh that really pleases here before us, the proposed ordinance prohibiting the sale and NOx's oxides in Alameda County.

So this is gonna be good.

Okay, thank you.

Um good morning, supervisors.

Um, this is Paul Cummings, uh Director of Alameda County Public Health Department's tobacco control program.

And my name is Rachel Graz Lazarus, senior program specialist with Alameda County's Tobacco Control Program.

Uh, we'd like to walk you through the public health concerns surrounding nitrous oxide for recreational use.

Um, discuss the regulations intended to limit retail access to nitrous oxide, especially among teens and young adults, and provide an overview of the proposed ordinance prohibiting the sale of nitrous oxide and nitrous oxide devices with an unincorporated Alameda County.

Next slide, please.

So Alameda County Tobacco Control Program conducts observations in tobacco retailer establishments to assess the prevalence of tobacco products.

And our program has increasingly noticed the sale of nitrous oxide in these stores, particularly in smoke shops and vape shops throughout Alameda County.

We have observed nitrous oxide for sale or advertised on the websites and social media accounts of smoke shops in Alameda County in unincorporated areas, including the smoke shop pictured here.

Our program is committed to ensuring that tobacco retailers do not replace tobacco with other harmful and addictive products.

So nitrous oxide is an odorless, colorless gas that, when inhaled, gives a rapid and short-lived euphoric high.

It is often referred to as laughing gas, NOx, Whippets, or Galaxy gas.

Nitrous oxide does have a number of legitimate legal uses.

It is used in medical, dental, and pharmaceutical settings as a sedative and pain reliever.

It is used for culinary purposes as a food propellant, such as in whipped cream containers.

And it is used for automotive purposes to boost engine horsepower.

Inhaling for recreational purposes is not a legitimate legal use.

Nitrous oxide products are commonly sold in smoke shops and at gas stations, and given their low costs and availability, they can be dangerously misused for recreational purposes.

Nitrous oxide is a growing public health concern.

When abused as an intoxicating inhalant, nitrous oxide displaces oxygen in the lungs and can cause irreversible neurologic, cardiovascular and psychiatric damage, including asphyxiation, paralysis, and death.

Nitrous oxide products are marketed with sweet flavors and bright colorful packaging that entice youth and young adults.

Social media trends glamorize, normalize, and rebrand nitrous to appear as fun and harmless.

For example, news reports have highlighted a viral social media trend involving galaxy gas, where users, influencers, and teens post short clips on platforms like TikTok and Instagram inhaling the gas for a fast euphoric high.

Because nitrous oxide products are accessible in the retail environment, young users may underestimate their danger.

Emergency room visits due to nitrous oxide misuse are on the rise, as well as significant increases in nitrous oxide related mortalities.

According to the CDC, there were 23 cases of nitrous oxide related deaths in 2010, compared to 156 cases in 2023.

Data consistently shows that recreational abuse is highest among teens and young adults ages 16 through 30 years of age, with a notable overrepresentation among males and a disproportionate impact on socioeconomically disadvantaged populations.

Driving under the influence of nitrous oxide is also extremely dangerous.

And jurisdictions in California have been experiencing a rise in nitrous oxide DUIs.

For example, in San Francisco, a young woman was left paralyzed after riding in a car with her boyfriend who crashed at roughly 100 miles per hour after inhaling nitrous oxide.

And in Albany, recently, a driver was arrested for driving under the influence of drugs and unlawful possession of 85 large canisters of nitrous oxide.

The FDA advises consumers not to misuse or inhale nitrous oxide products from any size canisters, tanks, or chargers due to the potential for severe adverse health effects, including death.

In California, nitrous oxide can legally be sold for legitimate purposes, but it is illegal to sell or give nitrous oxide to a miner or to knowingly sell or possess nitrous oxide for the purpose of intoxication.

California law also requires retailers to maintain on-site documentation of nitrous oxide sales.

There are some proposed California bills which could potentially regulate nitrous oxide sales.

None of these bills are comprehensive, and it is unclear whether they will continue moving through the legislative process.

Local laws allow for jurisdictions to set standards around nitrous oxide sales to protect public health in communities.

And given these public health concerns, a growing number of California jurisdictions have already prohibited the sale and distribution of nitrous oxide for recreational use amid an uptick in youth misuse and public safety incidents.

The City of Alameda was the first jurisdiction in Alameda County to prohibit the sale of nitrous oxide for recreational use a few months back in April.

San Francisco and Los Angeles are currently considering regulations prohibiting nitrous oxide sales as well.

And I'm going to pass it on to Paul.

Okay, thank you.

So as Rachel meant described, the idea of this is to protect the public health by eliminating retail access to nitrous oxide for recreational use.

So this would prohibit the sale of nitrous oxide and devices within the unincorporated areas.

Uh it prohibits property owners from knowingly allowing the sale um on their premises and holds retailers accountable to comply with documentation.

Um next slide.

Um so the products themselves as well as the devices would be prohibited.

And um, you know, it just looking at those products, they don't look like the things that you're going to use um in automotive shops.

Uh next slide.

Um so there are exceptions uh for legal uses, and these include contained in a food product for use as a propellant.

It's sold in a wholesale capacity, it's designed, marketed, and safety labeled for industrial use, exclusively for automotive purposes.

Um providing medical or dental care sold by or sold by a pharmacist or pharmacy.

And then um, if there are other exceptions that come up later, um there is an exception created for those as well.

Um so the penalties for um sale of these products, uh first trialation is 250 and then 500 and then a thousand for each additional violation.

Um violations are um counted during any um 60 month or five year uh time span, and um each day that that a product is for sale um can count as an additional violation.

So um, and finally the products that are for sale can be seized.

Uh so community development agency would do um enforcement through their inspections at retail establishments, and retailers uh alleged to have violated the ordinance may request an appeals hearing before a hearing officer.

So um essentially this creates a very clear um enforcement penalties um structure for the sale um for prohibiting the sale of nitrous oxide for recreational use.

Thank you.

Okay, thank you.

Thank you, Chamarley.

Um I support the development of this ordinance.

Uh I just have a few questions because we as a board, especially in our planning meetings, we often get appeals um, especially from tobacco retail smoke shops that are in the unincorporated area that have violated a number of terms related to sale to miners of flavored tobacco products.

So I'm just trying to understand, like from an enforcement standpoint, you know, these violations at 250 to 503 or more a thousand, is that like on top of like their violations of tobacco products, and then the next item that we're going to be talking about is uh the Kratom products, and that's an added layer.

So I'm just trying to understand like if you're enforcing for I mean sale to miners is just not appropriate.

Um how come it wasn't like included in a blanket license for uh uh tobacco retail, for example.

Um I guess that the short answer, I don't know if it's short, but um would be that um because the tobacco retail licensing ordinance has appeals that goes to the Board of Zoning Adjustments.

Um it was determined that this um ordinance really didn't have um a particular zoning um interest, therefore it was deemed that this should sit as a separate ordinance.

Um, but I do hear that people could be fined for um sales of nitrous products as well as for sales of um say flavored tobacco products or um selling to underage use.

And um, you know, and ideally we're gonna do some education so that retailers aren't doing any of those things.

Um, and and that would be preferable to to finding them.

Okay, I I mean I think it's just uh encompassing it seems like we're we're chasing every new addictive product um as they come online, and so like if if a cannabis dispensary or tobacco retailer sells things that are not appropriate for minors, they should just be banned, right?

Um so the the only question I had on that front was um who determines the penalties?

I mean, is it the sheriff department or the code enforcement or how how do we make sure this gets enforced appropriately?

Um code enforcement is the one that that would do the inspections, yes.

Um, and so you know, if if someone violated the ordinance, they would cite them, and depending on how many citations they had, um the penalty would would be appropriate to that.

Okay, so you can be cited without closing your facility, right?

Okay.

Thank you.

Thanks for those questions, because those are some of my questions too.

Um it just seems like we're constantly chasing you know one product after another to uh ensure the public health and safety of young people, and there's no way of and we can't connect this with like having the BZA have authority over it.

Uh yeah, the Raymond Leon Deputy County Council.

Uh good morning.

Yeah, the determination by our office has been that the nitrous oxide is it's a separate product from tobacco tobacco products, and there isn't a nexus, there isn't a sufficient land user zoning nexus, whereas with the tobacco retailer licensing permit, there was a permit in place, and that's why that was permissible to go through the BCA.

Okay, because for this, you don't have to get a permit to sell this.

Uh that's correct.

Under the truth under this draft ordinance, that's correct.

Okay.

Um is this so the same type of gas that goes into like party balloons and stuff like that?

So would the ordinance prohibit the sale of this for that purpose?

I think I think for party balloons it would be helium, right?

Yeah, yeah.

So um I think that that would be wouldn't be regulated because um that's it's a different chemical.

I yeah, I got a little confused as to what what substance was what until we dug into this.

Right.

And then the product has this product always been around because it just seems like it's being marketed, you know, very colorfully and attractive in this and the other.

Has it always been around?

Have I just missed it or it's just puzzling, it's baffling to me.

I would say that you probably aren't the main target audience.

Um I think that that this is something that has um really ticked up in the last few years.

I mean, you know, just looking at the um number of deaths and how they've been increasing over the like the last 10 years.

I think that this is something that um use has been increasing and um the harms associated with it are increasing.

Uh I would also say that right now the numbers are still relatively low, and that this is potentially a good time to address it before um it gets to be like an epidemic.

So then this goes to a hearing officer, yes.

Who pays for the hearing officer?

Does the cost of the hearing officer come out of the violation?

You know, who covers that cost?

Uh I expect the county to cover that cost.

There I I think that that is a process that still needs to be discussed with the CDA and how they uh plan to obtain uh a hearing officer.

Okay.

And then because I know we use hearing officers in different um for different uh reasons, and three or more violations, it'd be a thousand dollars.

Uh so if a person has like a fourth violation to three violations, they could get a thousand dollars, then if they violate again, would they get another thousand dollar?

So it's cumulative.

That's right.

Sorry, that is correct.

Um, it's third or subsequent violation that triggers the $1,000.

So if there's a fourth or fifth, it'll be 1,000 apiece.

1,000.

Because we want to make sure that this is you know the violations are sufficient enough to prohibit that type of behavior if we find out that it isn't, then obviously we're gonna ask this come back.

I'm assuming the board's gonna adopt this ordinance when they come back if we find it uh in the future that this isn't enough to stop this type of activity that we increase the fines.

Yeah.

Uh, because I don't know how much these retailers make on selling this product, and maybe the cost of um violating the ordinance um is worth it based on the sale.

I don't know.

Do we have a sense of what kind of money they make on this?

Retail?

We don't know.

All right, okay.

I do think this is good that we're doing this uh in the unincorporated area, and hopefully other jurisdictions will pick up on it.

Alameda's done it in in this county, so hopefully other cities will consider doing it in this county as well.

We'll chase it out of the county and we'll chase it out of the region.

Because once again, we're not banning the product for lawful purposes.

It's just for recreational uses and to be sold to minors.

Yeah.

Okay.

Do we have any speakers on this item?

Okay, let's have the speakers.

Caller, you're on the line.

We're on item two.

Yeah, two minutes.

Liz.

Wonderful.

Thank you.

Good morning, supervisors.

I'm Liz Williams, and I'm speaking as a vice chair of the Alameda County Tobacco Control Coalition.

Um I want to express our coalition's support for this proposal to end the sale of nitrous oxide products for recreational use.

This is a reasonable restriction of a product that is too often sold in deceptive ways and too often used in a harmful manner.

Just like our communities have been taking great local action to create a healthier retail environment that reduces the availability of tobacco and nicotine products.

Our coalition likewise supports local action to address the harmful recreational use of nitrous oxide products.

Many of these nitrous products are sold in bright, enticing packaging with fun names and appealing flavors.

I've seen ones called vanilla cupcake and bomb pop and rainbow candy, just like the vapes and other tobacco products that we thankfully now regulate.

These nitrous manufacturers are thinking about how to sell more of their products, not about the negative health consequences of improper use.

And that's the role of our local governments.

And our coalition wants a healthier, safer retail environment where our young people are not targeted by misleading packaging or have easy access to harmful products in our local retailers.

So, as explained, the proposal would prohibit the sale of these products for recreational use, designed for the purpose of intoxication, but the exceptions would still allow their sale to adults for the various legitimate purposes.

We know it's used in food service and pharmaceutical settings and medical and dental services, but selling candy-flavored nitrous to young people, especially in spaces like tobacco and vape shops, it's creating a real health concern.

And as you heard, that's only increased over the last few years.

So we thank you for your ongoing leadership and public health and for your consideration of this proposal.

Caller, you're on the line.

We're on item two.

You have two minutes.

Douglas.

Hello.

Hello.

Yes.

Yeah.

Good evening, members of the Alameda County Health Commission.

My name is Elvis Perez.

I am a student at the Beau College and Alameda County resident.

I'm here to share serious concerns regarding the sale of nitric oxide at local tobacco retailers.

I want to bring attention to the substance increasingly known as gas station drug, which carries real health risks and is being sold with little oversighted smoke shops, convenience stores and tobacco retailers through Alameda County.

Nitrous Oxide is often sold in flavored, rightly packaged canisters marked marketed under names like galaxy gas that appeal directly to young people.

Despite being sold recreationally, it is not a harmless product.

Heavy or repeated use can cause serious nerve neurological damage and misuse has been linked to injuries and deaths often from asphyxiation.

As someone who lives and studies here in Alameda County, this hits close to home.

When these products are so easily available and packaged look fun and makes it way too easy for young people to get their hands on them.

And it honestly undermines a lot of the work the county has already put into public health.

I've talked to classmates and people in my neighborhood about this, and it's something a lot of us have noticed and cared about.

Overall, what I've observed suggests that nitrous oxide is far too accessible to youth, which raises real concerns about the potential health impact and what that means for community well-being.

I encourage the commission to consider setting a precedent by reducing access to nitrous oxide at tobacco retailers, starting a growing number of communities that have already moved to restricted sale.

I appreciate the work the commission is doing and encourage continued attention to protecting youth and community health moving forward.

Thank you again for your time and consideration.

We have no additional speakers on item two.

No more speakers.

Okay.

Do you have anything, Supervisor Jam?

Um, I can move the action item to move the draft ordinance prohibiting the sale of nitrous oxide and nitrous oxide devices to the full board.

I'll second that.

Um I want to just take the role.

Supervisor Tim.

Hi, Supervisor Miley.

Hi.

Yes.

Yeah.

You know, it's just I'm compelled to say this.

It's just um disturbing that we have folks who would try to take advantage of young people by selling products like this, and um putting them in attractive containers, this, that, and the other.

It's just very disturbing.

Um I'm really gonna be interested to see maybe after a year or two or more of the implementation of this ordinance, you know, what kind of um impact it's had, because it's just very, very disturbing.

I mean, the you know, the the staff report about the young uh person who was injured was a boyfriend was under the uh effects of this, and yeah, it's just horrible.

Because I I know um, you know, when I had my wisdom to teeth pulled, um big TAP gas, and you know I I kind of at a point you could you would just say you can do anything you want to do, but you know, you don't have any any conscious sense of right, wrong pain, anything.

So to sell this product for recreational purposes to young people is just I mean, it's just revolting, quite frankly.

It's just revolting.

I think it's the abuse that's the issue here.

And I know Supervisor Miley and I are past our youth, but um it it just seems like in terms of the nexus, if you're marketing flavored tobacco with colorful signs and hello kitty to kids, you're you're kind of doing the same thing with nitrous oxide devices.

So what what's the difference there?

Yeah, because to me it's like I don't mind legal products being sold legally to adults and for appropriate purposes, but when they're being misused and sold by proprietors, I just I mean, I just want to put them out of business.

You know, you don't even need to be in business, at least in my jurisdiction.

Go somewhere else.

You know, so I don't know if you have any response, but we're kind of just venting here.

Okay, so this will come to the full board.

Do we anticipate this coming to the full board next week on August 4th, or will it be after the recess?

My recommendation would be after the recess, given the CEO timelines.

Okay.

If you know, you know, that's September 15th after the recess.

Okay.

Hopefully, nothing happens between now and then.

And then it requires two readings.

Okay.

All right.

Okay.

Thanks.

Okay, let's go to item number three.

This is an action item as well, draft ordinance prohibiting the sale of Kraton.

Um, and seven hydro cement.

Well, whatever how you pronounce that.

We call it 70H.

Okay.

70H, good.

Okay.

Products.

All right.

Um, for this next presentation, we'd like to walk you through the public health concerns surrounding Kratum.

Um, discuss the regulations intended to limit access to Kratom, and provide an overview of the proposed ordinance prohibiting the sale of Kratum and 70H products within unincorporated Alameda County.

All right.

Alameda County Tobacco Control Program, as mentioned earlier, conducts observations in tobacco retail establishments to assess the prevalence of tobacco products.

And we have increasingly noticed the substance kratom for sale in these stores, particularly in smoke shops and vape shops throughout Alameda County.

We've observed Kratom for sale or advertised on the websites and social media accounts of smoke shops in unincorporated Alameda County, including the smoke shop pictured here.

All right.

So what is Kratom?

Kratom is a substance among a group of unregulated products referred to as gas station heroin, which are linked to significant health risks and the potential for dependency.

Kratom is an opioid product derived from the kratom tree, which is native to Southeast Asia.

And 7OH, formerly known as 7 hydrox hydroxymetragenine, is a powerful and psychoactive compound found in Kratom leaves.

7OH products are synthetically concentrated kratom derivatives which bind to the same receptors in the brain as opioid drugs.

The impact of kratom can depend on the amount consumed.

At lower doses, kratom acts as a stimulant or an energy booster.

While at higher doses, it acts like a sedative and produces dangerous opioid-like effects.

Because the FDA does not regulate kratom products, there are no manufacturing standards to ensure their safety, purity, or consistent strength.

So kratom products vary widely in potency, which increases the risk of unexpected effects and contamination.

These products are commonly sold at smoke shops and gas stations as gummies, tablets, shops, drinks, powders, and capsules.

Kratom is a growing public health concern.

The FDA has warned consumers not to use Kratom because of the risk of serious adverse health effects, including liver toxicity, seizures, addiction, and overdose.

In some cases, deaths have been associated with kratom use.

When 70H products are used in combination with alcohol, medications, or illicit drugs, they can significantly increase the risk of severe life-threatening respiratory depression and slow or stop breathing.

Since April 2025, Los Angeles County Department of Public Health reported six fatal overdoses linked to 70H products among previously healthy residents ages 18 through 14.

Because Kratom and 70H are widely available and advertised in the retail environment, consumers and retailers may incorrectly assume that such products are legal to sell and manufacture for consumption and that they are safe to consume.

The FDA has not approved any Kratom or 70H products as safe or effective for medical use, food additives, or dietary supplements.

Both the FDA and state of California consider Kratom and 70H products to be adulterated for the purpose of consumption.

As such, the sale of these products for consumption is prohibited under California state law to individuals of any age, and California Department of Public Health Food and Drug Branch routinely embargoes seizes and impounds products containing Kratom and 70H during retailer and wholesaler inspections.

The agency has seized over 3,300 illegal Kratom and 70H products in recent crackdowns.

At the federal level, the FDA has issued warnings against companies selling 7OH and has recommended that 70H be classified and regulated as a controlled substance.

The FDA exercises its authority to protect consumers from companies selling unapproved kratom drug products, making false or misleading claims about unproven benefits of kratom and selling unlawfully marketed kratom dietary supplements and conventional foods.

While there is anecdotal evidence that some people have found natural kratom leaf to be beneficial in supporting pain relief and addiction recovery, neither FDA guidance nor California state law distinguishes between individual kratom products.

So natural kratom leaf for the purposes of consumption is considered an adulterated product, as are all kratom products for consumption, and is therefore prohibited for sale in California and subject to CDPH enforcement.

There are no FDA-approved Kratom drug products or over-the-counter drugs containing Kratom that are legally on the market in the US.

As noted, California state law regulates both Kratom and 70H as adulterated food products.

California Health and Safety Code provisions state that it is unlawful for any person to manufacture, sell, deliver, hold, or offer for sale any food that is unadulterated.

And given these public health concerns and the high risk of abuse of Kratom and 70H products, a growing number of California jurisdictions have restricted the sale of Kratom products.

Okay.

Thanks, Rachel.

So the ordinance is to protect public health, and it would within Alameda County law, it would prohibit the sale of Kratom and 70H products within the unincorporated areas.

So just as a reminder, it's already illegal to sell these products per state law.

And this would just clarify that within the county law.

And so it would do the same things as the other law to prohibit retailers, require property owners to not allow the products to be sold on their premises.

And if there is any um any allowable sales or documentation requirements, then retailers would need to comply with those.

Next slide, please.

So there are a lot of products out there.

So this is very similar to the other ordinance that first violation 250, then going up to 500, a thousand.

Each subsequent violation would be a thousand dollars.

And the products can be um embargoed, seized, and destroyed.

Um inspections would be done by the community development agency, and uh retailers alleged to have violated the ordinance may request an appeal hearing before a hearing officer.

So I I know our pro the Rachel and I got a bunch of emails um since um the agenda was announced, and and we encourage people to um make sure that they submitted their comments directly through the system.

Um a lot of people were making a distinction between Kratom Leaf and 70H.

And um without trying to dispute people's experiences, which which I believe, um, state law doesn't make a distinction between Kratom Leaf and 70H.

And so um, you know, though both of those products are illegal to sell per state law, and this is clarifying that those are illegal to sell um within the unincorporated areas, and it's creating a clear penalty uh process um for violations.

Thank you.

All right.

They're on their JOB, so damn.

Um CDA code enforcement is also going to be doing this enforcement mechanism at the local level, even though it's banned by state law.

Why can't they do that now since it's banned by state law?

Why do we need a separate ordinance to do that?

I I mean, I'm not disputing the importance of the ordinance.

I'm just trying to understand the enforcement mechanism.

And then the the other issue is you you mentioned it's a gas station, heroin.

So is it sold at health food store, gas stations, and just tobacco shops, or how's this going to be enforced?

Uh this is June 0, Deputy County Council.

Uh, I can speak with respect to uh the regulatory part.

Because under uh the current health and safety code uh with respect to the enforcement of adulterated product, that really occurs at the state level.

There's not an independent mechanism for local uh counties or municipalities to independently enforce uh uh products that may be adulterated.

It's all done according to through CDPH.

Um so that's why this ordinance will be a little different, provides a clearer regulatory pathway with respect to the unincorporated counties for uh local enforcement.

Um so that that provides a little more context about uh uh that aspect uh for the other questions I'll refer uh to pawn region.

So um community development agency would um the stores that they inspect, um, and I I mean I I know that that would be the tobacco retailers, the smoke shops, um, the gas stations that are selling a variety of products, all of those would be part of um whom they're inspecting.

I'm not sure if they're they inspect health food stores.

Um you know what we're mostly where we've mostly been seeing these products showing up have been in gas stations and smoke shops.

And um, and I think that's where the concern is arising.

So in um the counties that have it like Orange County and the cities, mostly in Southern California, uh how long have they had this ordinance in place?

Uh has it been just within the last year or is it it's been in within the last year to 18 months.

It's yes.

And um what's their experience with enforcement?

Has it seen an increase from their code enforcement or we haven't um gotten that information?

Uh we've sort of looked to see who had um similar ordinances, but we didn't have uh data on enforcement results.

Okay, so I I know when we had a briefing about this earlier last week, um uh you mentioned that a lot of the uh associations uh with the public health directors and Almy County Health um directors that this is something they recommend that we look at at the local level, even though there is a statewide ban to reinforce that enforcement mechanism.

And so that's kind of why I'm asking how other jurisdictions have been doing with the enforcement part.

Yeah, I I mean I think that um you know, just like what we've seen in Alameda County around like tobacco retail licensing, that enforcement can really vary between jurisdictions.

Um I know that within the unincorporated areas um that enforcement has been really good and that there's been really consistent inspections of retailers and um sort of doing clear education with the retailers about what products can and can't be sold, and um providing you know, penalizing them if they they violate, but um, so I can't speak to it to what's happening in the other uh jurisdictions, but uh just to echo what what June said that um despite it being illegal to sell per state law, we didn't have clear regulations at the local level to enforce against it.

I I don't want this to become a jurisdictional issue, for example.

Uh let's say right at the border between Hayward and the unincorporated area of Terryland.

Uh you know, this is a statewide ban on this issue.

It's illegal.

So if code enforcement happens to see it across the street, which in another jurisdiction, they don't have the authority to cite that person, or they just report it to the city and then have them cite uh the uh local jurisdiction would not have independent uh ability to do that.

The uh in terms of enforcement fines or even prosecution would need to be coordinated with the state's uh uh CDPH in particular uh about that.

So in that situation, um if it was in the unincorporated, they have the tiered fines similar to the ones we have for not just oxide, but if it was like let's say in the city of Hayward, which borders the unincorporated uh those fines would not be imposed upon that jurisdiction, right?

It would not the scope of the ordinance is uh with respect to the unincorporated uh county.

Okay, thank you.

Yeah, I think like with the other ordinance, we're hopefully we'll we'll be able to get other jurisdictions in the county to adopt similar ordinances, you know, our public health staff uh can share hopefully this, both what we're doing with Crayton and what we're doing with um the umxide uh um nitrogen oxide, uh form other jurisdictions about this and uh hopefully they'll adopt it uh as well.

Um we could talk to the the mayor's conference, um city managers conference uh about these two ordinances and maybe they would pursue it because I do think it's important that it be pursued and done as comprehensively throughout the county as possible.

I understand why uh uh through our public health officer, we just can't impose this like we did with um some of our regulations regarding um you know COVID.

Um I do understand uh the breadth of how that was possible, but this isn't, but I do hope we can inform other jurisdictions in the county so that they can mirror what we've done here because this is this is just once again repugnant uh that we've got retailers out there, gas station heroin.

That's that's just sickening.

That's just sickening.

And in the way in the slide you show the products, they're um they're so colorful and attractive.

Uh and it was good the response of Supervisor Tam that where we've seen the problem is in smoke shops and gas stations.

We haven't seen it in other places.

Okay.

If we see it in other places, then our ordinance would cover it as well.

And I also think if food is if this product is adulterating food, at some point environmental health should have a role to play when it comes to food in grocery stores or wherever food products are sold.

I would think, do we know if that would be the case?

Because we're putting all this on code enforcement, and I'm gonna ask my staff if they're listening, uh, to have us talk to um community development agency uh uh about the resources they need for code enforcement, because once again, we're putting more burden on code enforcement, which I don't mind, but we're already putting a lot on code enforcement and code enforcement might need more resources to do everything we're asking of co-enforcement in the unincorporated area of what Supervisor Tam and I pretty much have the responsibility for in the urban unincorporated area.

So we want to make sure we're just not passing a law that's not going to be able to be enforced because of lack of uh sufficient resources for personnel.

But I know I've said a lot.

So back to environmental health.

Yeah, I think with environmental health and the food regulations, um, there's a few different ways that that comes into play.

So um in a lot of corner stores, et cetera, there's cottage food regulations, which is pre-packaged food that's sold.

Um, that actually falls under CDPH guidelines.

Um, and so there's you know, there's some enforcement activity that they can do, but that that's limited.

Um, in terms of restaurant and food preparation where people are actually preparing and making the food.

Um, as you know, environmental health has extensive uh responsibility and and does quite a bit of enforcement there and permitting.

Um, but we would have to look further into this.

Um, and you know, just on the uh idea of uh resources and uh environmental health has that responsibility countywide.

Um, and we only have so many people in this particular area, we don't think that there's a role for them, and so that's why we wouldn't have brought them in.

Yeah, and you know um we have mentioned that we want to see environmental health get more resources so they can have hire more staff to do the work they need to do, but that's another issue that hopefully agencies looking into environmental health is all fee-based, but if they don't have enough fee to have the personnel that they need to do their job, then because if this type of product is adulterated and becomes more of a countywide issue, I would suspect uh particularly around food.

You know, I don't know if our health would then be you know engaged in it, but I guess we'll wait and see if I'm I think we that would depend on again how CDPH pulls it out and sort of where they're monitoring and tracking it.

I don't know if Rachel or Paul are aware of instances where it's used in food.

Um I'm not aware of it.

I think it's mostly sort of um you know prepared substances that that are um sold um you know, sort of in um shops of some sort, right?

So mostly what we've seen is the gas stations and and smoke shops.

Okay.

Okay.

But I do think your response to our exam is really important.

We really need to get the word out to other other local jurisdictions in the county, see if other cities would adopt similar ordinances around uh creating because yeah, this is um creighton and seven oh high gas station heroin.

I mean, that's that's just oh my gosh.

That's just horrible.

Um the other thing that I was concerned about is I'm a retailer.

I want to do the right thing.

How do I would I know I have these products like the umxis oxide, and oxis oxide and the creaton.

I mean, these are separate products.

But I'm consciously aware I have these products right.

Or do I need to have training and more education to know if I'm buying if I'm getting bad products to sell in the community?

I think that um be pretty clear that that you are selling it.

Okay.

Um, but um, you know, we our program in the past has worked with local jurisdictions when they have um modified their tobacco retail license.

Um, and if the you know, certain products are no longer legal to sell, um, we try to make sure that this clear education that goes out to all the retailers.

And so, you know, we we'd certainly work with CDA to make sure that that went out to all of the retailers in the unincorporated areas.

Okay, yeah, because that's it's just I would think it's yeah, I just don't want retailers to say, but we're not aware of uh the products that um that we're selling.

I just want to make sure that they're uh uh they take on responsibility and and we're um providing the necessary education and training or whatever it might be or awareness, so they know this product is not something appropriate, these products are not something appropriate, so don't even go there.

Yeah, okay.

Um, let's see, do we have any public comments on this?

Yeah.

Jeffrey Laredo and then Brandy Clark and Charles Bowden.

Good morning, members of the committee.

My name is Jeffrey Laredo.

I'm a retired federal science policy official, having spent 30 years working on addiction and mental health policy.

And most of those years are with the U.S.

National Institutes of Health.

I've lived in Santa Cruz for the past few years and I've continued that work as a policy consultant.

And full disclosure to you today, I am a consultant to the American Kratom Association, which advocates nationwide on behalf of Kratom consumers.

Almuda County has a really well-deserved reputation for relying on science and evidence to inform and help craft public policy on a variety of health issues.

And I'm urging you today to do the same in this instance and reject or amend this proposed ordinance.

I've submitted a much longer and detailed statement for the record.

I hope you have an opportunity to read that.

But today time is short.

So here's my bottom line.

Pure natural kratom leaf products and concentrated synthetically produced and manipulated 70H and all of its synthetic derivatives are not the same thing.

They're not the same thing.

I understand what CDPH has said.

They're not the same thing.

Even a rudimentary examination of the science related to these products, obviously and emphatically reveals this truth.

And if you choose to move forward with the ordinance, we hope that you'll remove pure natural kratom products from it.

The background information you have received from staff, I'm sorry to say, is in part inaccurate, incomplete, and misleading.

It doesn't give me any joy to say that in public.

The background are in the slide set consistently conflates pure natural leaf products with the variety of 70H products and their synthetic derivatives.

It ignores recent federal action that will early next month place 70H products and their derivatives temporarily into Schedule One of the Federal Controlled Substances Act, which will effectively ban those sales across the nation.

The information ignores federal statements specifically omitting pure natural cratum leaf products from concern.

It ignores since and it also ignores significant uh FDA and NIH sponsored research, pointing to the general safety of pure and natural leaf craton products.

Also, I would love to get the citation for the state law that is claimed here today that bans these products.

There is no state law.

There is CDPH recommendation.

It's old, it's based on obsolete information.

If I'm mistaken, I will be I would be glad to be corrected in public.

Please act on scientific evidence.

Focus your efforts on preventing the real harm that is caused by the 7OH products and all the um synthetic derivatives.

Thanks so much for the opportunity to speak with you today.

Brandy.

Hello, thank you.

Um, I wanted to uh address the fact that everything that he said I'm fully backing.

There is a distinct difference between natural leaf cratom and 70H.

And the throwing around the gas station heroin is actually not correct.

That is for a substance that's called um tantropine, which has not been around for a while.

I am in this category.

I am in these shops.

I've been doing this for four years, and I have seen the growth of 70H products and the Kratom exponentially.

Um I'm behind a natural leaf cratom.

This is something that um helps me personally with social anxiety, it helps me with nerve pain, it keeps me away from pharmaceuticals and helps me maintain, not cure, but maintain and be able to like conduct my normal daily life.

So with natural leaf kratom, I believe uh the FDA is already signaled, or not the FDA, the DEA is already signaled that they are going to look into this, and there's a difference between natural leaf and synthetics.

The synthetics are when you take the natural leaf, which is from the coffee plant family and use the leaf, and you oxidize it.

And some companies are using this to oxidize it with everything to like pull chemicals.

So without a doubt, the 70H synthetic is a dangerous drug.

I've seen it, I watch it, I've seen it in the stores.

It's colorful, it's named as something that's already named after a drug, but PERC.

And then there are products out there that are just for healthy people making healthy choices.

And just to make an example, there is a bottle that you're using, it's a feel-free bottle.

That one bottle, if you take one of those pills that's in there, just one pill, that would take 250 bottles of feel-free.

Two categories, that one pill that's on there.

So we're talking about something from here to over here.

Extremely different.

And in the smoke shops, uh, my job is training.

I teach people every day on Kratom.

I teach them on what it is, what happens, how it works, and how it's not okay.

And I teach I talk to them every single day.

And so with that, I'm hoping that you guys would make the difference between natural leaf kratom and synthetics, because the natural leaf is not the problem here.

It's your synthetics.

Thank you.

Charles, and then Canberra.

It's my bad.

Hey, I'm sorry, I'm not um much of a public speaker.

I just wanted to say that I have been taking Kratom for the last 10 years uh to help me manage my chronic pain.

Um I've never taken the 7OH ones, um, just Kratom leaf.

Um it would be extremely difficult to overdose on that.

Um, not to be graphic, I guess, just like mechanically to consume enough to overdose would be prohibitively difficult.

Um I take kratom basically to be able to go through my life.

Um, when I wake up in severe pain in the morning, uh, kratom is what helps me get out of bed and go take care of my kid and go about my day.

Um the vendor that I purchase from uh does do third-party testing where they can give you a breakdown of the active compounds in the substance, um, any potential, you know, there's salmonella in it or something like that.

Um, I'm not buying from like a gas station that has the packaging that I saw on the PowerPoint.

Um, I would be strongly in support of age limits on buying kratom of requiring third-party testing and accurate labeling um of banning the enhanced uh products that uh have you know wildly varying amounts of the active ingredient in them.

I just think there is a smarter and more um more fine point way of going about this uh because I I'm not the only person I know with with chronic pain and disabilities who relies upon kratom um long term um as part of their basically medication regime.

Um if this legislation passes, I will no longer be able to uh you know get it from the responsible vendor that I purchased from and um my life is gonna get bad really fast.

Um I know that it's a public health concern.

Um, and I do care about the safety of children.

Um, I just wanted to let you know that it is um more nuanced, maybe than how it's been talked about here.

Uh, thank you for your time.

Canberra.

Good morning.

My name is Cambert Garrison.

I'm a proud Castor Valley resident, a mother of three, a wife, and an OB nurse.

Every day I care for pregnant women and I help bring life into this world.

My goal sharing my story today is to stress the importance of understanding and recognizing that natural plain leaf crani and synthetic concentrated 70H products are not the same.

I respectfully ask you to please oppose a ban on natural plain leaf crani.

I live with an autoimmune disorder that causes severe debilitating chronic pain.

For 12 years, I was a pain management patient and relied on prescription opioids.

Over time, like most chronic pain patients, I developed tolerance and dependence.

I felt defeated knowing that I depended and needed opioids to function every day.

Four years ago, I made the decision to take my life back.

After extensive research, I found plain leaf cratom.

It helped me through the brutal opioid withdrawals that I faced and has allowed me to manage my chronic pain without returning to prescription opioids.

Today I have been opioid-free for four years because of natural plain leaf cratom.

I understand that many people who have never experienced these products may assume that natural plain leaf cratom and synthetic concentrated 70H products are the same.

They are not.

In my personal experience, plain leaf cratom does not make me feel high, intoxicated, or impaired.

It does not alter who I am.

It simply relieves enough of my discomfort that I can live my life to the fullest.

If I felt impaired in any way, it would affect my ability to be present for my family, provide care for my patients.

I wouldn't get behind the wheel of a car.

I wouldn't take it, and I wholeheartedly would not advocate for it.

I have never taken 70H products because my goal has never been anything other than pain management while remaining fully functional.

Please don't make a decision based on assumptions or misinformation.

Make it based on the voices of people who have firsthand experience.

Thank you for your time.

Melody, we're on item three.

You have two minutes.

Thank you so much for your time.

My name is Melody Wolf, and I'm a 12-year-daily consumer of Kratom.

Um the FDA HHS asked me to speak at the July 29th, 2025 press conference on Kratom and 70H with the FDA Commissioner and HHS Secretary Kennedy.

I had to get my comments approved with both agencies.

So they knew exactly what I was going to say.

In fact, they asked me to talk about the benefits and then to help distinguish it from 70H, which I 100% would like to see off of the shelves.

And I'm so glad that I was able to be a part of helping make that decision to get it off the shelves.

So I've been a pink patient for over 20 years.

And about 10 of them, I was bedridden, and my kids were in elementary school.

Things were pretty dim, dismal in our house.

The kids had to have fans down in their room at night, so they didn't hear me crying in pain.

They had too many responsibilities too soon for for kids so young.

They never got to be just kids, and I didn't get to be just their mom.

Um see pain took me away from my family, away from my community, but Kraton gave me back.

In 2022, my um daughter was going off maternity leave and two weeks before her child care closed down.

And we were still in COVID, so that was a big problem for them.

They asked me to um move in with them for the year and provide child care, which I just was 100% all on board with doing, and it's something I enjoy.

Um, the very same zoo where my kids used to push me in a wheelchair.

Um, the very same zoo where my kids used to push me in a wheelchair, I now chase my granddaughter.

Um a couple of things that I wanted to point out is that the federal government has no appetite for a ban of craton of any kind, not even the National Institute of Drug Abuse Doctor of Volco.

She thinks that's part of the solution, not the problem.

Um regarding the FDA, they do not regulate any supplements for medicinal purposes.

Um they just guarantee what's on the label is what's in the package, and in Orange County, they did not ban Kratom either.

So I just kind of want to point those to my those two things on my way out the of the screen.

Thanks so much for your time.

Connie, you're on the line.

We're on item three.

Hello, my name is Connie Sanford.

I am against banning natural kratom by necessity from extreme pain.

I have taken unadulterated natural leaf kratom under doctor's supervision for 12 years.

Other medications and therapies have not helped me, only natural kratom.

I was better, and now I have several hours a day of productive time.

Um did you know that the FDA is banning synthetic made 70H next month?

70 is marketed as Kratom.

You guys even did it in your presentation.

You kept calling natural kratom, I mean 70 kratom.

I've even heard them do it on the news.

So the FDA said specifically that they're not going to ban natural leaf kratom.

Just this year, the NIH did a um did a study for the FDA, and the results quote, no serious adverse events or deaths were reported.

And conclusion, quote, kratom powder was safe and well tolerated at the dose ranges tested with no evidence of meaningful abuse potential or withdrawal, unquote.

Please keep Kratom legal and accessible.

Thank you so much for letting me speak.

Stephen, we're on item three.

Yes.

Hello, my name is Stephen Macintosh.

I'm a chronic pain patient whose story is a lot like many of the people you've already spoken to.

I would echo what Melody said the Orange County ordinance does not ban Kratom.

It only limits it to adults 21 and older, uh, prohibits products attractive to children and sets uh reasonable limits on potency.

I'm a support member of the California Narcotics Officers Association who supports the access to adults for botanical Kratom, not 70H.

The DEA has signaled uh that early next month it will federally schedule 70H under Schedule One.

It will have the full power of the Controlled Substance Act uh behind uh getting it off your shelves.

And I will personally call the FDA for any store I see selling it.

So you have no concern there.

Um I would strongly encourage you to also look at the legal nexus between what uh CDPH is saying and the FDA, uh, including the study that was by FDA that was just spoken about by the last uh speaker.

Um CDPH has no particular law against Kratom.

It's only saying that based on the FDA's prior statements made years ago based on an out-of-date web page that it therefore does not comply with California law.

This does ignores recent study, it ignores the recent statements made by FDA on in July of 2025.

It ignores the pending federal scheduling of 70H that explicitly exempts botanical Kratom from its definition on purpose because botanical kratom is safe for adults to use reasonably.

I went from barely able to get out of bed this morning to be taking my kratom, able to mop my floor and speak intelligently to you right now on matters of law and chemistry.

So I strongly encourage you to amend this bill to exempt botanical kratom.

Ethan, you have two minutes.

Um I don't think I can say anything better than what has already been said, but I do want to point out that the health department used this term of gas station heroin early in their presentation to elicit the exact uh response that it got from you, Supervisor Miley.

It is a shocking idea that gas stations would be selling heroin like products.

And and again, the shock and kind of horror that that term elicits is exactly why they use it.

But the facts of these products differ from that suggestion.

Um again, I do support the banning of 70H, but the DEA is actively working on that.

Uh you know, for the county to to do that is at this point unnecessary.

And and again, in the DEA's press release related to uh this scheduling of 70H, they take the time, which they would not have had to have done, but they did take the time to say that this scheduling action does not, and I'm reading from their website, does not apply to botanical craton products that contain naturally occurring 70H below the specified threshold instead of target synthesized products and those containing elevated concentrations of 70H.

I think that is a very important point.

The DEA is distinguishing between these products and if the county deems that it's necessary to uh to pass some ordinance around this.

It would not make sense for the county to move in opposition to the DEA's own actions related to these products.

Um I could say more, I'm a retailer of Crotom, not from not as a gas station or smoke shop owner, but you know, this is something that I've been working with for 15 years and have seen thousands of people's benefit, thousands of individuals benefit from these products over these 15 years.

I personally has have benefited in numerous ways as well.

So I'll cede my time.

Liz.

Hello, supervisors.

I'm Liz Williams again, speaking as a vice chair of the Alameda County Tobacco Control Coalition.

The coalition supports the proposal to end the sale of Kratom and 70H products.

Um these synthetic 70H products are an unregulated addictive and pose a particularly dangerous risk when combined with alcohol and medications or other drugs.

And as you heard earlier, there are a growing number of overdoses and deaths reported.

We all know the dangers that opioid misuse poses in our communities, and we do not need an easy access source of increased opioid risk.

Despite these risks, Kratom and 70H products are easy to find at tobacco and vape shops, gas stations, and other retailers in our communities.

Our coalition is concerned that these products are readily available and advertised as an innocent pick-me-up.

You can buy flavored gummies, energy shots, mint-flavored tablets, and canned drinks like seltzers.

Yet there's a risk to public health that people mistakenly think these products are completely safe to use.

Our coalition encourages the county to consider the proposed ordinance to ensure that we are protecting our residents from the harmful impacts of these addictive and unregulated products.

Thank you for your consideration.

Brittany, can you have two minutes?

Hi, can you hear me?

Yes.

Okay.

So I am for banning 70H and keeping Kratum naturally Kratum legal.

Um I wanted to explain that 70H is very addictive and it will ruin people's lives, and it has ruined people's lives.

Um Kratom saves people's lives.

Uh I was battled the 12-year addiction with prescription opiates.

And then I went to three years medication as this is the treatment with methadone.

I ended up in jail and did 26 days detox, and on my way home, I stopped and got Kratom.

No, all the um so I just beg you to think maybe ready to change their lives.

And if you take this vital resource from them, you know, it might not happen when they're ready.

Also, with the banning of 70H happening, a lot of people are going to be sick.

A lot of people in your community are already addicted.

Kratom can help those people without turning them back to pharmaceuticals or street drugs.

Um, so I would really encourage regulation and to do some uh extra research here.

Everything that these speakers have said is correct.

You know, Kratom has not been banned or 708 uh through the state.

Board of Health goes against those.

So yeah.

Thanks for having me on today.

Caller, you're on the line.

You have two minutes.

iPhone user.

Hello, can you hear me?

Yes.

All right.

Sorry, I have to step outside real quick because my son is watching this, Rachel.

Um thank you for giving us this opportunity to speak.

I think everybody is mostly kind of said what you've been hearing over and over again is that 70H is not the same thing as natural Kratom.

Uh there is not a state law that any legislator passed in California that says cratom is illegal.

In fact, there was a regulation law, AB 1088, to regulate Cradum, keeping it legal and banning 70H.

It passed the General Assembly unanimously.

Unanimously.

So the DEA and the General Assembly of the state of California are all on the same page.

70H needs to be banned.

And natural Cradom has a lot of benefits.

I've taken natural cratom for 15 years.

It's it's been very beneficial to me.

It's it's bizarre to hear anybody calling it gas station heroin because I don't even drink alcohol anymore because I don't like I don't like feeling intoxicated anymore.

That's why you know cradum works for me as I can continue about my day.

Um but anyway, I wanted to make that clear that you know they're saying it's it's banned statewide.

It's never been passed in the General Assembly.

The only reason it died in the Senate is because the 70H lobby is very powerful and they were fighting against it, and then they muddied the waters and it just kind of stalled out, right?

Um I'm sorry, I'm not that good of a public speaker, so I kind of lost track of where I was going to go next.

But I think everybody else has pretty much hit the nail on the head here.

Um it really is very beneficial to a lot of people, just the natural leaf.

It's been used for centuries in Southeast Asia without a single documented death, by the way.

In Southeast Asia, it's been used for up to um millennium, actually.

I've been using it for 15 years.

Um, I uh it's helped me be a productive person.

And I and as somebody else said, 70H is getting banned uh nationally, and there's a lot of people addicted to that, and and they're gonna be they're gonna be going into withdrawal, and they can either go to street drugs, maybe, maybe cradle's a week.

Kevin.

Hello.

Yes.

All right, yeah.

Um, I just wanted to add my own thoughts.

I didn't know I was going to be speaking today.

Um, Kratom has very much helped me with my joint pains and stuff.

And it's also helped me when I had gastritis and I went to the emergency room and they had no solutions for me and stuff like that.

And um, you know, it's it's such a better alternative than so many other things.

And when you think about a crushed leaf, all it is is an herb.

But the thing is, I remember that you know, when I walked into a gas station, I saw that bottle of feel good or whatever, and it's like, oh, this is this now this is gonna be vilified, this is gonna be turned into a party thing, and people are gonna abuse it like crazy.

And um, it's just not the case with just natural leaf kratom.

And um, I don't I don't like the idea that um, you know, that it's it's wagging is getting hitched to this super steroid version of this stuff that is yeah, very highly addictive and stuff like that, where this stuff takes gets people off of being addicted.

And I don't like to see um the idea that how can you vote against something that's being called gas station heroin?

Nobody would be able to do that.

Um, but this stuff is just a natural powder, and it doesn't um it helps people, it doesn't hurt them.

And you know, the the alcohol in the back of the the uh gas station kills more people than the six people that just died in what a year from you know, in the year of this time of being selling this stuff.

Um so yeah, it's it's a major difference between the two.

One is for good, and the other is going to ruin the reputation for uh natural leaf kratom that is just an herb that's been legal and around for 25 years, and it had no problems until these guys synthesized it.

Mac, you're on the line.

You have two minutes.

Uh thank you very much.

My name is Mac Caddo, Senior Fellow on Public Policy with the American Kratom Association, and thank you for this opportunity.

I speak for the 24 million consumers in America who safely and responsibly use Kratom, including the hundreds of thousands of California residents who do the same.

What you have heard today is accurate that the DEA and the FDA, in conjunction with what is known as an eight-factor analysis, have concluded that seven hydroxymetrogenine is and should be classified as a Schedule 1 substance, but they specifically say that that does not include natural Kratom leaf products.

And I think that should be the guiding principle that you on your board should consider, because access to these products for all of these consumers who commit to responsibly use it for manufacturers who produce products that are within the guidelines that allow for natural products to be consumed by Kratom consumers to do so in the way that we was intended.

I think that we would offer, and we have done so in hundreds of communities, uh, to brief your staff on the latest science that relates to Kratom.

You've heard about the FDA dose finding study that found that safe is Kratom is safe at all dose levels and is well tolerated.

And now you have the National Institutes of Health who have announced a study as of June 1st that will proceed to showing that purified metrogenine, the main Kratom alkaloid, will be used to help people and they will study whether it can be used as an alternative for an opioid use disorder treatment.

That has been proven in those people that are struggling with addictions today.

We urge you to separate the difference between 70H and natural leaf Kratom products and provide responsible consumers the opportunity to continue to use it.

Thank you so much for your time.

Cyrus, you're on the line.

You have two minutes.

Hello, Cyrus.

Hello.

Yes.

Yes.

Good morning.

My name is Cyrus Nicaragua, and I was born and raised in Hayward.

I'm a student at Deanza College, one of the top transfer colleges in California for students headed to four-year university.

My friends and peers from Berkeley down to Fremont, and they're the ones who carried me through the ups and downs of getting here, and the reason why I'm speaking today.

I'm speaking in support of the proposed ordinances restricting retail sale of nitrous oxide and specifically Kratom and 70H products in unincorporated Alameda County.

I don't have personal experience with either substance, but I've watched high school and college classmates lose ground to nicotine and alcohol.

These were capable people with real ambition, and I watched it shrink.

Grade slipped, and the goals they used to talk about stop coming up.

The common thread was never curiosity.

It was always proximity.

Nicotine and alcohol are regulated.

They carry age limits, potency standards, and licensed retailers.

They still did that damage.

Kratom has none of that.

It is an opioid product with no potency standard, no testing requirement, and no consistent labeling, most importantly.

Kratom has many has may have real value for people managing chronic pain or getting off prescription opioids.

That is real.

And I'm not here to take that from anyone.

But right now in this county, a miner can walk into a smoke shop and buy an opioid off the shelf.

I'm speaking as a youth for other youth.

I'd also to ask you to keep this ordinance whole.

There will be pressure to exempt loose leaf kratom, even though independent lab testing has repeatedly found products sold as plain kratom containing concentrated 7OH levels, the plant cannot produce on its own.

An exemption for leaf is only as good as the label.

And the label is the part that is proven unreliable.

On behalf of my peers, both those at risk and those suffering from substance use.

Hi, can you hear me?

Yes.

Okay, awesome.

Um hi, my name's Alison Smith.

I work with the Global Kratom Coalition to implement regulations on um traditional Kratom products while banning synthetic derivatives and other addictive substances.

Um, just a quick couple of notes.

Um, gas station heroin is slang for TNP.

Um, it has nothing to do with gas with uh traditional Kratom.

Um there are 23 million Americans who consume traditional American traditional Kratom products, three million in California alone.

Um, when you say that you're trying to ban all these products for safety, I need you to keep in mind that individuals use these products for a variety of reasons, ranging from energy infocused to minor pain relief.

And by blanket banning, you're punishing those who are lawful um contributing citizens.

They go to work, they go to school, they raise families and contribute to society.

Um the FDA does not approve dietary supplements because they are dietary supplements.

Instead, these products are regulated under the Federal Dietary Supplement Health and Education Act, otherwise known as Deche.

The federal government has made clear the distinction between natural kratom and on July 6th of this month.

Uh, they announced their intention to add concentrated 70H to Schedule One along with other synthetic derivatives, where it will be for about two years while they research it.

And in that announcement and the federal register, um, it made clear that this applies to concentrated 70H, and their focus is not on traditional products.

Um, this provides federal resources for implementing enforcement and federal punishments, uh such as prison time and fines for individuals who are caught selling these products.

But I'm again, make no mistake, traditional kratom is not the same.

Uh the state does not have a law banning Kratom that has been passed by the state legislature.

CDPH made a determination that Kratom is adulterated, but that does not mean these products are banned.

There is a question to the lawfulness of this uh determination.

And finally, this recommendation was based on legacy information from the FDA.

Um, but the FDA has changed their position in regards to traditional Kratom based on uh public statements regarding access to regulated traditional Kratom products with the DEA movement.

Um and then final point, I encourage you to follow the lead of Chino, Fountain Valley, Palm Desert, Los Alamitos, Marietta, Ontario, La Quinta, Moreno Valley, Fresno City, and County, Riverside County, Buena Park, Orange County, and many others to implement regulation and distinguish between these two products.

Thank you for your time.

So we have uh I think five more speakers.

If there are any more speakers on this, please raise your hand at this point because uh in the next uh minute or so we'll cut off any more speakers.

And we will at the moment uh Superfassor Tams left the diet, so we'll take a five-minute recess as well.

But we'll be back in five minutes.

All right, so we're back from recess.

Clerk want to take the roll.

Supervisor Cam, present, supervisor Miley.

Present.

So many more speakers.

Five.

Ryan, you're on the line.

You have two minutes.

Thank you.

My name is Ryan Sherman.

I am the legislative council and state lobbyist for the California Narcotic Officers Association.

Uh we've been actively working on getting the 70H banned throughout the state for the last two years.

And we've also been pushing for making ordinances at the same time that would also ban uh very scientific oxide products in the uh common sense regulations for natural leaf Kratom.

Our association doesn't have a uh full position on Kratom.

However, well, like I said, we've been actively working to ban 70H in communities throughout the state.

Uh as of today, we work with about three or four dozen uh cities and counties.

Um successfully got these ordinances um enacted.

Um we support uh 100% uh local effort to ban 70H, as you've heard um all the horror stories.

Uh we concur with those.

Um we also believe that some of them are the Kratom uh natural Kratom products do not pose the same concern or public safety uh risks that 70H does.

Um like I said, some common sense regulations as far as age gating, you know, 21 and over, no marketing kids, candy flavors, things like that.

Um very supportive of uh 70H is clearly been the problem whenever you see uh you know references to yes, Susan Heroin is one of the previous speakers alluded to.

They are generally talking about um the 70H synthetic concentrated products.

Um not the natural leaf Kratom.

Uh media's, I think, done a poor job in uh distinguishing between the two.

And so that's been uh where our focus has been at with uh 70H and not uh with naturally Kratom.

Happily answering questions.

Thank you very much.

Misty, you're on the line.

Well, now it's what?

Good afternoon.

Good afternoon, ladies and gentlemen.

My name is Misty Brown, and I'm a seven-year Kratom consumer advocate and activist.

I want to clarify and say that Kratom is not an opioid.

Kratom is not 70H, and Kratom is not gas station heroin.

I'm gonna read you my testimony.

From 2008 to 2019, I lived in the grip of FDA-approved pain pills, benzos, and muscle relaxers prescribed for my degenerative disc disease.

For 11 years, chronic pain management fueled my addictions.

What started as a dependency, so at least into a destructive cycle of misuse and despair.

In April of 2019, I was dismissed from my pain management after failing a required pill count.

I was 11 pills short, and my usual drug dealers didn't have any of the pink oxy tens I needed.

Cut off from prescriptions, I turned to the streets in desperation and eventually slipped into cocaine use while searching for another doctor.

Then in June of 2019, while suffering through cocaine withdrawal, I stumbled upon the documentary called A Leaf of Faith.

That single moment changed the course of my life.

The very next day I began my journey with whole leaf kratom, not synthetic 70H, by walking into a smoke shop.

I was carded, the Kratom was sitting behind a glass counter and it was locked up.

The Kratom quieted the relentless cravings, the constant voice whispering, one more pill, one more snort, one more escape.

For the first time in over a decade, I felt peace.

Kratom gave me the space and clarity to confront the deeper reasons why my addiction started.

I have not returned to pain management over seven years.

I only consume one teaspoon once a day, and I take one to four days off every week.

I control Kratom.

It does not control me.

I am currently not on Kratom right now.

So if Kratom was addictive for me, there's no way I would be able to take daily breaks every single week.

Addiction is what people are calling what a brain disease.

So it's the person, it is not the substance that they are consuming.

I also want to clarify and say that the six people that were the students saying that they died from uh 70H in their system, as much as I hate 70H, those deaths were poly drug use.

Thank you for allowing me this opportunity to speak.

Mike Hello, thank you for allowing me to speak.

My name is Michael Cassano.

I consume the holy Kratom tea powder.

Uh it's been very helpful for my chronic isamia as well as my joint pains.

I'm happy, I'm healthy, I'm a productive hard worker.

Um, going to on the regulation side, it said before the DEA already is differentiating between the semi-symptotics and leaf powder.

They are banning the 70H, the MGM 15s, all that.

They're taking the burden off the stage in a locality, so they don't have to have that kind of confusion anymore.

But they are not banning whole leaf powder.

Now, I would recommend doing a regulatory approach.

First off, get it get it out of the gas stations.

It should not be sold in a gas station, in my opinion.

Put it in a 21 and older um location.

Have a registry system where the only products sold are one from reputable vendors that can provide a third-party certificate of analysis to ensure purity and that there's no contaminants.

Um, you know, this gas station heroin stigma is just really really brutal.

There are people that you know been helpful for the PTSD and for the chronic pain.

And I believe this alternative, because they can't get access to med, or maybe we're shut off, is should not be taken away from that.

I think that there is an alternative approach for the leaf powder where we can regulate it instead of prohibition.

And thank you for allowing me the time to speak.

Kevin, you have two minutes.

Hi.

So time to time.

And I would say I've never tried 70H, but I do think it needs to be regulated.

The whole leaf is very safe.

Thank you very much.

Okay.

This has been very informative.

There's been questions raised about this proposed ordinance.

It seems like this ordinance goes a little further than Orange County.

And Kratum is both natural form, synthetic form, as well as the um 70H.

There have been people that have spoken to the fact that Kratom that the least engineer form really helps them cope with uh their pain as opposed to getting um addicted to opioids.

So I need to understand uh at this particular moment uh if staff has a responses to this if our I know Dr.

Moss is here, our health officer.

So legal, etc.

Because I think from what I'm hearing, I'm not sure where Supervisor TAM's coming from at the moment.

It doesn't seem like we're we're ready to move this forward to the board.

There are a lot of unanswered questions.

And all we have here is uh is um an ordinance and a PowerPoint.

I'd like to get answers to these questions.

Uh we can have counsel talk a little bit about the the legal issues, especially with regard to state regulation.

Um and then I might ask Dr.

Moss to talk a little bit about some of the overall uh health pieces.

Uh uh, thank you, supervisors.

Uh, with respect to at least the references to the county of orange, their cratum uh ordinance, it does apply equally to synthetic and unnatural leaf products, including uh dried or extracted parts of the cranium leaf.

Um what Orange County does, it it includes a threshold.

So uh products that whether it's naturally derived, extracted or entirely synthetic, if it if it contains more than I believe two percent of the uh of the uh alkali uh substance, uh it is banned.

Uh so that's how the Orange County ordinance works.

So they have a a level uh and whether it's natural or synthetic, if it's below that.

Um so in the vernacular here, whether it's natural leaf or uh 70H, it will be allowed for sale.

And if it's bug that it will be uh banned regardless of its natural extracted or purely synthetic.

Uh with respect to the references that there is not a specific uh state law uh banning um uh cratum.

Uh the the law that's in question of why CDPH is enforcing it and uh has a legal authority to uh uh stop the sale of crane for consumption uh under existing state law is because it's a a under the adultered food product uh section of the health and safety code.

Uh that section does not necessarily need to have separate identification of Kratom or any other uh adulterated food product, it just applies generally to any adulterated food product, which in this case includes Kratom.

Um and it with respect to uh uh proposed federal ordinances uh or proposed federal regulations, uh regulation uh regulating under uh uh uh as a schedule one drug.

Uh again, I haven't seen what the proposal uh or what it applies, but to the extent that uh 70H uh in a synthetic form is regulated, does not necessarily mean that uh the FDA would then consider uh Kratom in its natural leaf form as an unadulterated food product is still considered adulterated food product.

Um it would not would not be considered legal for uh sale for consumption, and I believe it will continue to be that way unless there is some other changes.

Uh so that's some of the general league overview of the legal issues here.

So if you had a chance to look at this, because does crave them help people uh uh address their pain?

And if it does as a product, um is there a way that they could continue to get this product uh or would they have to go back to opioids and uh other things, other drugs.

Um as far as I know, uh there's no um the kratom is not available to be used as a drug, as uh you know pharmaceutical in that way, right?

So it's it's only this, what we've heard about today, the sort of unclearly regulated space where this market and use has grown up.

Um, we we heard uh well, a few things we heard from the callers say a lot of consensus around the potential um dangers of these synthetic products.

So we'll we'll put that aside in terms of the natural leaf.

Um I people are sharing their experience on the phone.

I have no doubt that that that is their personal experience, but we don't have that I've been able to see really wide large scale clinical trials showing how this would be used.

I mean, if it's a drug, it should be regulated as a drug to make sure that it's safe, that we know the dose, that people are know what they're getting, that they know what kind of outcomes they might get from it.

We're we're just not in that space in my experience.

I I don't see that I don't see the data.

I don't see colleagues using it that way.

So we're we're we're in another space where people are using a product that they've um that they've found that may or may not work for them.

There's gonna be probably a range of uses out there for it, but I think that's very different from saying, oh, this is uh this is a tool we use in medicine to treat people's conditions, just in my experience not there with this product, and I don't think we have uh we can say that that's um that that um that that's just the default, right?

That all users are they're using it for a medicinal purpose that's important for them so they can live their lives.

That may be true for some, not for others, but we don't know that much about the product, and we don't know that much about who's going to be using it out in our communities.

So I just I think we're there's still a lot of uncertainty in that in that space that makes me one wanna be very cautious.

I don't think you introduced yourself.

Oh, I'm sorry, uh I'm uh Dr.

Nicholas Moss and the Alameda County Health Officer.

And could I just add I'm reminded also with with uh uh medicinal marijuana and and and medicinal cannabis, right?

And the debates and the issues that people raised up there, but also was the space that we were in with with very limited data in terms of the the therapeutic applications.

Yeah, and I'm glad you brought up brought that up because I was thinking about municipal marijuana, Prop 215.

Um, with one reason why I supported municipal marijuana because all the people who testified, how that helped them it is hard for me to want to uh impose a blanket ban on a product.

And I think once again, people, I don't think everybody's lying uh in terms of how the product is used to help them.

I wonder in our ordinance, what if we were to mirror um large county's ordinance of death thresholds?

We can uh if if the committee would like us to go back and reconsider options, we can do that.

Um, and I think in the you know, cannabis debate, I I think just one other thing that comes to mind for me at least is that um sort of what um Dr.

Moss is saying is that in terms of the actual regulation of the product itself, right?

Medical cannabis was made available, but the strict regulations around pesticide use or other uh ways that um the product was cultivated and developed, that didn't really happen until Prop 64, many years later, right?

And so um this might be another space where we're kind of working with limited things, and as Supervisor Tam mentioned earlier that we're trying to catch up to the next new thing, um, but really wanting to come at it from a space of limiting access to use more than anything.

So um uh, but if if the committee would like us to go back and look at different options, we're happy to do that.

Yeah, let me see what Supervisor Tam would like to do, because I kind of jumped out here.

Um maybe she and I might be on the same page, maybe we won't be, but Supervisor Tim.

So I I appreciate um the speakers and definitely Dr.

Moss, your expertise, but we're not the right jurisdiction to make the distinction between the synthetic 70H and the natural leaf Creighton.

And what we're trying to do right now is develop an enforcement mechanism in Alameda County for what is in state law, albeit it's tied to the health and safety code, because of findings that the state public health department has made in terms of um what they see nationwide in terms of fatal overdoses associated with Kratom, synthetic or not, and in Los Angeles County with the Department of Health.

So I'm just thinking in terms of a like our ordinance, our code enforcement, our our short staff, code enforcement staff is already having enough trouble going to a an establishment to figure out whether the item is creighton, much less whether it's synthetic or natural leaf, much less whether it's under two percent or less, and looking at the ingredient list.

So my sense is unless the state makes those changes and distinctions on the safety of the product, all we are doing is basically having an a mechanism in Alameda County to basically move forward with the enforcement.

So that's kind of where I'm coming from in terms of the practicality of enforcement.

I just wanted to make one other comment about this idea of the levels and uh you know uh just for educational purposes, the 70H is a uh metabolite of the one of the main chemicals in the natural kratom lead.

So when you take the natural kratom leaf preparation, your body is making 70H internally and it's circulating.

So I just wanted to make sure that people knew that we're talking about levels in the product, but things are also happening in the body when people ingest these things that you know that contribute to the effects of the of what it is they're taking.

And um, so we just whatever levels we use, if we go down that pathway, we want to make sure we really have a good understanding that um, and there is some research about about levels and and quantities, but when you're talking about a natural unregulated natural product, you still have it's not subject to the same kind of testing and scrutiny that a pharmaceutical agent is subject to when it gets to the store shelves.

So we're operating in a in a space where there's going to be limited information for the consumers about the levels and and um and I just would want us to be on very firm ground if we were to give what seemed to be an endorsement of of you know certain products of certain below a certain level, things like that.

Um just two points to to keep in mind, and um so one is that an exception uh there is an exemption written into the ordinance, um if there are um legal uses determined for the product, so that already exists in the ordinance as written.

Um the other is that currently um per state law and how it's enforced, um retailers within our Alameda County unincorporated areas, um if they're selling these products, whether it's Kratom Leaf or 70H, those products will be embargoed seized and destroyed.

And if Alameda County were to pass an ordinance that created a distinction that still when CDPH did inspections in our unincorporated areas, those products would still be um embargoed seized and destroyed.

And so um if if we make a distinction that's different than what the state distinction is, I I think that we put our retailers at risk.

Is that consistent?

Again, the ordinance would not have an effect on uh or legal binding to uh CDPH.

So even if at the county sets a percentage uh threshold, um CDP is just not obligated to uh abide or uh honor that uh so very damn uh what what would you like to do?

Because I'm still thinking so um I'd like to advance this to the full board, and then if there's a more robust discussion that needs to happen, the full board can have that discussion as well.

But I I'm just trying to think in terms of practicality and the jurisdiction and what we're trying to achieve with this ordinance, which is similar to the nitrous oxide ordinance, is similar to what we've done with flavor tobacco, is they're targeting young people who are most at risk, and there has been data that shows that Creighton has at least the overdose of Creighton has resulted in fatalities in the nation and definitely in the state and in Los Angeles County in particular, as recent as last year.

So I would like to advance this to the full board for a discussion.

So if this goes to the full board, once again, it's not going to get to the board until after the recess in September.

And then is this going to come to a board meeting or the board planning meeting, which would which forum will this come to?

Or do you know?

We would look for your direction on that.

Um if you're wanting to have just a conversation in a work session space, we're happy to accommodate that.

Yeah, because I'm not gonna uh I think we should have uh we can advance it, but I'm not I'm not I'm not uh uh giving my approval to the ordinance just yet.

I'm okay advancing it to the full board so the full board can have um the benefit of this.

We can advance it to the board's planning committee since this deals only with the unincorporated area and look at it from the lens of enforcement and the practicalities of enforcement, yeah, because uh like I said, I I don't have that knowledge, expertise, or jurisdictional authority to make the distinction between the levels of Kratom and whether they're natural or synthetic.

Yeah, because I do think probably bringing to a board just so the public understands the full board would meet at a board planning meeting, but if it's a board planning meeting, we don't our agendas aren't aren't normally as uh full as it would be for a full board meeting, and the board planning meeting usually takes place on a Thursday as opposed to a Tuesday.

So I'd like to bring this without a recommendation to the board planning meeting, have CDA if you can contact state officials so they maybe can provide some testimony, it'll give staff more time to interact with the the public around this as well.

And if there are any modifications since it's not being advanced, um as um uh something we're adopting or advancing to adopt, but advancing to the full board for consideration, uh gives you a chance if you want to come back with any modifications or changes or whatever, you'll still be able to do that when it comes to the full board.

If you want to come in with options, you can come in with options, but it does buy more time for um uh consideration around around this, because once again, it's just I don't want to do any harm to folks who are using a product that's helping them out, but nor do I want to condone the use of a of product, the sense the synthetic product, if it um once again is um uh a public health issue, but then staff is also saying under the state, it doesn't matter.

So I'd really like the state if to be available for our meeting, um you know, not have to be in person, but at least virtually to speak to this as well.

So the board has the and the public has the full benefit of all of this before we uh take it take an action one way or the other.

Yeah, so this has been very helpful because I'd never heard of Kratum before, nor 70H, but this has been a very um informative meeting this this morning slash afternoon.

So does that kind of make sense?

Yeah.

And like I said, if you feel in the conversations you want to come back with options or or if you're going to stick to this ordinance, fine, but I want to leave it up to staff to also make some modifications if you think it's warranted.

Okay.

All righty.

So I think we've covered everything on our agenda for today.

The board planning meeting would probably be, let's see.

Do we do expect this in September?

We can work with your your team to figure out which planning meeting it comes to.

Yeah.

Because I think the board planning meeting in September is the 17th, I think.

Um but if it um if it doesn't make that agenda, then the October meeting.

Okay.

Okay.

Alrighty.

And the and all and all of our meetings are um uh Brown Act and their notable in their notice in the sending up there so the public knows about this.

Okay.

All right.

So let's see.

Um do we have any speakers on non agendized items today?

Public speakers on non-agendized items.

All right, I have no speakers for public comment.

All right, okay.

So today I think is our last health committee meeting before the recess.

So very enlightening meeting.

Everyone have a good summer, and we'll see you uh in September.

Thank you.