Right.

Hello, everyone.

Good evening.

I am calling to order a special meeting of the Berkeley City Council.

Today is Tuesday, February 24th, 2026.

Clerk, could you please take the role?

Okay.

Councilmember Kessarwani is absent.

Councilmember Taplan is absent.

Councilmember Bartlett is absent.

Council Member Tregum present.

Okay.

I'm here.

Blackaby here.

Munapara.

Here.

Humbert.

Present.

And Mary Ishii.

Here.

Okay.

Quorum is present.

Okay, very good.

So today we have a very special work session.

Um, only one item on this agenda, it's the community health improvement plan.

So I'm going to pass it over to Director Scott Gilman for our presentation.

Thank you.

Thank you, Mayor.

Um, yes, uh, again to introduce myself.

I'm Scott Gilman.

I'm the director of health housing and community services, and I'd like to introduce Tanya Bustamati, who is our deputy director.

We also have several staff in the room that have helped um put this information together over the last year.

And if they could just raise their hand, please.

We've got our crew there.

We have members of the community health commission that are present.

And then at the end, we'd like to recognize the members of the steering committee that actually work specifically on this project.

So with that, we'll start a slideshow.

So the agenda that we have for you tonight is we're going to do an overview of the community health improvement plan, better known as the CHIP.

We have a short video that we'd like to show you.

We have an exciting new dashboard that we plan to demonstrate with some data, and then we'll talk about implementation, next steps, and questions and recognition.

Tanya.

Okay, so the purpose of our community health improvement plan is really to describe how the health department and the community will work together to improve the health of the citizens of Berkeley.

The community health improvement plan, or CHIP, identifies health priorities that came out of our community health assessment and strategies for how to address them.

In addition, the CHIP is required for national public health accreditation, which is something that our department, HHCS, is actively working towards.

It is also a requirement for local health jurisdictions to align their chip with behavioral health strategies that the health jurisdiction will be focusing on as part of our behavioral health services act plan.

Okay.

To guide this work, four guiding principles were used to draft the high-level goals and objectives in developing the CHIP.

The first one is to balance ambition with feasibility.

So setting goals that are achievable and realistic.

The second one is to cultivate cross-sector work.

As you know, at any given time, there are various planning processes, commission meetings, policy debates that are happening.

It's critical for us as city staff to be aware of and collaborate with other city departments and community members on the work that we're all doing so that we're not operating in silos.

The third principle is to emphasize prevention.

So to really address the root causes and not just the health outcomes.

And lastly, establishing a long-term cycle of assessment improvement planning and implementation.

In fact, local health departments and health plans are required to collaborate on assessment and planning processes every three years.

So this cycle is an opportunity to build trust and achieve long-term impact.

So I'd like to talk a little bit about how we got here.

We worked with a consulting firm, JSI, to gather information, activities, and resources through both qualitative and quantitative data synthesis.

JSI helped to conduct key informant interviews with local leaders and community members.

They conducted a handful of focus groups.

And we also partnered with them to develop a community survey that was distributed throughout Berkeley, of which we collected over 320 responses.

The qualitative data that we collected focused on the community environment, access to services, lived experiences, et cetera.

During this first phase, a community steering committee of 10 community members with diverse backgrounds and experiences was convened.

This committee was instrumental in analyzing the data that was collected.

The second step was to develop our community health assessment by taking a thorough look at health safety and equity in the city.

The health assessment identified priority issues and priority populations and enabled the community steering committee to distill the information into six key findings.

From the community health assessment, our steering committee, in collaboration with city staff, developed the health improvement plan, which lays out a realistic response to the priorities that were identified in the health assessment.

As part of the community health assessment process, the steering committee identified two broad goals for the CHIP for both their universality and potential impact.

Well, the first goal was to address disparities in life expectancy.

And the second goal is to increase community power and partnership.

While the health assessment identified several key findings and health topics, it elevated four priority areas under the umbrella of these two broad goals.

Those are housing, environmental health, behavioral health, and community safety.

Housing is defined as being able to live in a place that is safe, affordable, and stable.

Environmental health was defined as being safe from things like pollution and wildfires, and having clean resources and access to green spaces.

The behavioral health area highlighted that mental health problems are common in our community and our members need access to care.

Community safety highlighted how often people get hurt and experience violence in our community.

The steering committee worked closely with city staff to review the health assessment data, as well as existing Berkeley policies, resources, and initiatives to establish a high-level objective for each priority area, which you see here.

Additionally, these high-level priorities or these high-level objectives aligned with strategic priorities across other local, county and state agencies.

Our participants included representatives from managed care plans, our county partners, community-based organizations, city staff, as well as both steering committee and community members.

We put together a video that hopefully conveys the depth and significance of this work, as well as highlighting some of the experiences of our community steering committee members.

I'll play it for you now.

So you want this one ideally to be under 120.

So you're in the normal range, which is great.

I think we all want the same thing.

We all want our communities to be healthy.

We want to see our children grow.

We want to see our families happy and thriving.

To have a community health improvement plan that's based off of a community health assessment really allows us to be grounded in what is most important, not just to the city but also to the community.

We all took that on as a and define the intentions of where we want to go together in the next three to five years.

If we want some of these objectives to be met, kind of hinges on the strength of the partnerships.

JSI was brought in basically to be facilitators in this space.

I think a lot of what we do is hear from all these different perspectives, whether it's a community survey or a focus group or a community steering committee meeting, talking with the staff at City of Berkeley, and then synthesizing it and thinking about okay, how do we talk about what happens next?

It was a learning process for the steering committee.

Understanding the data that was available, what resources and programs were already in place.

What objective do we have within the workforce domain that is?

It's been amazing to see the really detailed underpinnings on what it is to build and to you know develop a city, but also how do you make change in a city?

How do you uproot the things that no longer work and how do you plant the things that you hope will?

And that's a really really um meaningful process, and not one that I have been able to kind of participate in before.

One of our core values for the city, this department and for the public health division is that community voice is that community drives.

There you go.

Now, the things that we develop and the programs we develop to serve them.

We talk in public health about how health is connected to so many different things, but being a part of this process, we really saw what that connection looked like, where all of the health priorities that rose to the top were behavioral health, community safety, environmental health, and housing, and none of those are like directly physically health related, but are all interconnected to how people, what people feel like they need to be able to thrive here.

The focus areas this process identified isn't something that just the health department can work on in isolation.

It offers an opportunity to invite other departments and other community-based organizations to join us in this journey.

These relationships and these collaborations are gonna be even more important moving forward.

We're definitely going to need the support of council and city leadership, and we're definitely gonna need the support of our community members.

In working side by side with some of the folks across departments in the city of Berkeley, there is an extra level of passion and dedication that I honestly will say to be totally open, wasn't really expecting.

What I saw was people continually inspired by their work.

It's energizing to know that they're really receptive to the ideas that we were bringing forward.

I just feel like my voice is heard as we've been discussing, like, you know, how are we going to integrate this?

What do we have to consider?

Is this going to affect um a different demographic that we didn't think about?

I love that I can see the tangible results coming through.

I think especially the way the world is right now, you can feel really powerless.

And I would say, yes, and get involved locally.

These kinds of projects can help you build community and have impact.

We need to center community members in order to understand the story.

And then the second part is actually to understand what the right solutions are.

And that was really important for us in the centering was that community members be at the table to say, okay.

So if we think the problem is displacement, for instance, in Berkeley, what are potential solutions?

We want to come up with ideas that are actually gonna make a difference and move the needle on some of these issues.

But we want to do it in the realm of what's possible and not just say this is what should happen and demand that the city do something, but rather have this dialogue with people who are really embedded in these systems so that they're more feasible.

We really need to remain attuned to what the community's needs are because they're going to be evolving.

They're going to be dynamic, and we need to be able to be dynamic with that.

The only way to do that is to listen to them.

As health assessments and health improvement plans become more of a standard part of the planning cycle in California communities, creating that space for trusting problem solving together.

It's sort of the essential thing.

I just think that it's really important that if you want to make that change, you gotta be a part of it.

And that's why I love Berkeley so much where there is that huge sense of community and commitment to one another.

When a group of people fall down, they're the group who's trying to lift them up.

Thank you.

Thank you.

Um we'll go on to our next slide, please.

There we go.

If you've been in Berkeley for a while, you know we used to produce a health status report every few years.

The last one was back in 2018.

I'm happy to report that we'll have a new health status report coming in early 2027, and we'll be reporting back at that time.

At this point, we want to give you a sneak peek demo of a public facing dashboard that will go live this fall.

The reason that that we're demoing this as part of this demonstration is this will be where we'll be reporting our progress on the on the chip activities as well.

I'm going to show you some data that's uh again show you data that will be included in the dashboard just to give you an idea of what will be available.

Um I'll talk a little bit about about what we're presenting, but the purpose of tonight isn't really to go into depth and have um uh a detailed analysis for you on what this shows us really to give you an idea of of what's coming.

And so with that, we're going to um uh move to the community help.

We're we're logging in right now to the dashboard demo.

CHA.

I25.

Here we go.

There we go.

So once live, this is the the the first page that um residents will see um when they log into the dashboard.

You'll see there's a table of contents and introduction, and then the most significant part will be the key findings.

And again, this data is taken directly out of our uh community health assessment.

For example, if we take a look at key finding number one, um, we'll scroll down to the actual chart.

You'll see that Berkeley has a lot to be proud of.

Um, our physical environment, our diversity, and our local local partners are world class.

Generally, our health data um is impressive, but as you can see, um Berkeley consistently outpaces both Alameda County and the rest of the state and life expectancy.

Um I want to just take a second and just show you if you hover over um any part of of this, it'll it'll drill down a little bit, it'll tell you exactly where Berkeley is compared to um other um other communities, or you'll see in future charts here other information.

Just makes it easier because some of the charts get kind of confusing.

Um, if we can go on to finding number two.

So we'll scroll down here.

This one is about racial disparities, and and as you can see, while our general life expectancy is good in Berkeley, actually extremely good, the data makes it abundantly clear that there are disparities that we have to talk about as we design interventions.

It's true, we are a vanguard of social movements, yet our health data shows that historical and structural identity issues are still deeply baked into our outcomes.

So you can see here we have life expectancy by race.

If you live in Berkeley, I'm sorry, we'll go on to the let me just stop there for a second.

This particular one shows life expectancy by race.

If we go to the next one, we'll go on to finding number three, we'll also show life expectancy by geographic location.

And so if you live in Berkeley Hills, for example, you'll see that your life expectancy is 91 years.

If you also live in certain census tracts in South or West Berkeley, that number drops to 78, 78 years.

A 13-year-old difference based on zip code is not just a statistic, it's a call to action.

If we can't measure it, we can't track it, we can't change it.

Our biggest opportunity for progress lies exactly where the outcomes are the worst.

And we'll exit our demo.

So again, just wanted to give you a quick snapshot that that will be available, and we'll send you information as soon as it's live.

We can go on to our next slide.

I have another um slide that will be built into the dashboard.

Um, and this particular one's uh is slide nine.

Slide nine is uh is another example of data that will be um front and center on our new dashboard because it highlights the growing fact, a growing fact that we cannot ignore between fiscally between 2022 and 2024, drug overdoses and self-harm suicide rose to uh into the top ten leading causes of death for our neighbors.

And you'll see here it is number one, two, three, four, number, number six.

Um, that's going up from previous years where it had uh been in the bottom of the top 10, rose to number eight, and now it's up to number six.

We know why this is happening.

Along with the deep emotional trauma caused by the pandemic in our society, social isolation, economic stress, and everything going on in the world today have created the perfect storm for many of our residents.

That's exactly why the community identified behavioral health as a priority in the CHIP.

It's also why we must continue our efforts to integrate behavioral health and physical health at all levels.

We need a multi-prong approach, including wellness programs, easier access to care, and tighter bonds with our community partners.

In a time of declining revenue, it's more important than ever to be good stewards of public resources.

Partnering with and empowering our community is more important than ever.

Go to the next slide.

So implementation is really where the rubber meets the road.

Um, forming advisory groups for the four pillars, including housing, um, environmental health, behavioral health, community safety.

Um, they'll help us shape the actions that we're going to take.

You'll see right now, and this is outlined in the CHIP document, we're in the preparation stage, and as I said, that's where we've been selecting members of the communities, stakeholders.

As you see, some of those objective areas involve entirely different departments than the city, but we're all connected.

Um environmental health, for example, having green spaces, having safe areas for the community, all part of the public health strategy.

And finally, um, I want to make one important observation here.

Um, I've worked in uh a variety of communities over the last 35 years.

And and there's really something that's unique to Berkeley.

And you all might know this, but being here for about a year and a half now, um, it really jumps off the page at me.

I'm hearing in multiple venues.

Our residents want to be involved.

They want to help.

They even want to roll up their sleeves, and they demand to be part of the process.

They demand that.

And while it would be easy just for us to take this, very easy for us to take this roadmap that the committee put together for us, lock ourself in a room for a nice launch and strategic planning process and come back and deliver you a strategic plan.

That's not what the community demands of us.

What we're going to do at this point is we will be working with the focus groups during implementation, and we'll develop very specific, actionable, measurable outcomes that we can implement in our community with their help that have value to the community members, and that they um that they also perceive as having value.

So from uh actually from December and until July, we're in that preparation stage.

The reason that we put action in July is um what we are going to be working on this before July, believe me, but we also want to make sure that we get through the budget process before we really really um formalize structures and bring groups together, because we are expecting you know there to be difficult decisions, and we want to make sure that again that we're good stewards of money.

We realize that we're that some of this will, as I said, will involve community um rolling up their sleeves and and making things happen.

Um, and so with that, um, my last page.

So the journey towards a healthy, equitable, safer Berkeley requires more than just observation.

As we said, it requires partnerships.

We invite the council to walk this path with us, and we'll definitely keep you informed and invite you to participate every step of the way.

We will be fueled by the courage to change the status quo and uh um to quote James Baldwin: not everything that is faced can be changed, and nothing can be changed until it's faced.

Um so we'll go to slide 11, please.

So at this time, um, we really have two items left.

We'll take any questions, comments that you have at this point or discussion, and then we'd like to um conclude by recognizing uh members of the steering committee.

Thank you, Mayor.

Thank you so much, Director.

Um, and so I want to ask if my colleagues have any questions.

Not sure if our parliamentarian is working.

So I see that council member Drake was trying to select this, so give me a second.

Let me reset it, and you can start while I reset it.

Uh thank you so much.

Uh uh, thank you, Scott and Tanya, for your presentation.

Um I have a few questions.

I will to save time, ask them in rapid fire.

I think they go from more specific to kind of more meta.

Um, my first question is on page six uh under objectives.

I see that you called out.

Uh I I assume these are just examples, uh, and there are other um sub-objectives.

Uh say under community safety, I imagine there would be more than just improving walkability and walking safety that could be placed in that bucket.

Just not sure exactly what page you're referring to.

Uh sorry, page six of the presentation.

Sure.

Um, which I think is not in the slide deck, but it was in the report.

I wanted to see, you you may or may not be able to talk about this.

It may be too granular, but I also noticed an area in uh up or downtown um uh below south side of campus that was comparatively low to life ex in life expectancy as well.

I was wondering if you could talk about why.

I was curious how the focus group was selected and what equity screens um were incorporated in the selection process, as well as uh, well, you talked about how you would continue to engage with the focus group, but would it be the same focus group or a different one?

On page 19 of the report, I was wondering how CHIP can target interventions to communities that are most affected, and how will the root causes of these health disparities be addressed?

And lastly, I wanted to see if you spoke to how many of these uh the challenge or the interventions uh may not relate uh in may not be specific within the community health bucket, they may be informed by other disparities and barriers, whether it's within housing or other departments.

What is your vision and plan for a cross-cutting process, an interdepartmental process around this, and how will you be keeping the council apprised at various inflection points?

You can thank you, Councilman Verta.

Uh, those are a lot of questions.

Um, so hopefully we'll we'll we can address um all of them.

So, first I'd like to address the question that you had uh around the community safety objective.

Uh so this is a high-level objective that our community steering committee identified that really rose to the surface from the data that was gathered, and um the idea is to identify sub-objectives and strategies that will help address this, and also since we are going to undergo a process of revisiting um our planning and priorities every three years.

Um my assumption would be that the high-level objectives would under each of these areas would evolve over time, and um even the priority areas themselves may evolve over time, depending on how the community's um needs and priorities change.

So um at this point, um improving walkability and walking safety was something that really rose to the level of importance for them.

Um, but it could be that could change um when we revisit um this area, the future.

Do you want to take the question about life expectancy?

Yeah, um, so drilling down into those specific things are what the next steps will be.

Um I don't have the answer for how the focus groups were selected.

If you're referring to the to the community cafe, um that was open to the to everybody for that one.

Um I will add that uh when the consulting firm conducted the focus groups that were part of the health assessment process, they did identify priority populations to conduct those focus groups.

Um, and again, I think they conducted a total of four.

Um, I think one of them was with transitional age youth.

I think one of them might have been uh with African American and Latino.

Um, and I can't recall the other two.

But we can get back to you on that.

Yeah, and uh to your question about how we will ensure um other departments, um, other stakeholders, that's the process that we'll be going through from now until July is looking at each of these areas.

And I wanted I want to also mention that um the steering committee gave us a bunch of ideas um for specific solutions or or interventions, but they didn't dictate it to us.

So our our challenge now will be is pulling together the different stakeholders, going through the data, um, and then figuring out actionable um actionable objectives, solutions as they referred to in the video, um, that we can implement within the financial restraints that we have.

Um, because this process is going to be so transparent, we're planning at a minimum of annual updates to council, the first one being um uh January february ish of 2027 the selfish me wants to make sure that whatever we commit to doing we're gonna get done and we're gonna deliver um for you um again this is different um for um most uh health departments around the state where they do plop down a plan on the table and that's the end of it so because we are going to be developing this community we're gonna be very transparent we're gonna be very measurable so that we can demonstrate our value um we we absolutely have to be very very focused on what we do make sure we can accomplish that I think that was the last question but make let us know if there's more yeah um just wanted to see um if you can drilling down um I certainly South and West Berkeley were called out as um communities of concern but I did notice a um also a reduced lifespan in upper downtown and I wanted to see if yeah at least within other parts of Berkeley um I wanted to see if you can speak to why that may be yeah I don't think I don't think we're to the why yet we're we're to the we're to the this is this is the data and what it is.

I I think the the there's a there's an infinite number of whys you know some of them for example we have uh data on um different uh health conditions asthma was a big one um that that we've looked at that that comes out um in the community health assessment and so as we look at asthma we can also look at asthma rates in different areas and then we can also start to match that up um with the outcomes that we want we're fortunate that we have epidemiologists on our staff you know that will work with us on that but um but that sort of deep analysis and and what does it really mean to the community we need to talk with the community about that you know and involve them in that process.

Thank you.

Moving on to council member Bartlett.

Well thank you and thank you for your work here um I I recall this is the chip was um conceived of a few years ago uh when we funded the health equity innovation zone I think the same manager was here then before he went to Amoryville I think I remember that so it's wonderful to see in action wonderful um amazing uh question looking at the leading cause of death um so I guess is diabetes is not on here right but is that is that not a cause of death or is it just a cause of cost uh diabetes number three is that what you're asking about I said I said heart disease oh I'm sorry um am I missing it not in the top channel it's not there well that's amazing that is well a healthy city you know the the um you know the work is incredible that we do here in Berkeley we are the healthiest city and of course as you mentioned um the disparities are super entrenched and we've taken taken many steps to address them and this is part of a long running effort by you know your your team in my office to get at um uh some new ways of approaching the the equity elements here um and so I was curious a couple things I wanted to ask you about um more just pegs for your memory I guess um will there be is it possible to have a dashboard assigned to the stuff really you know late to the budget I know Councilmember Blackaby has been working on something like this um some sort of dashboard that's readily available for people to see um our progress um and um does um another element was curious about was uh alignment with Medi-Cal Medicaid, right that despite the the cuts of those programs recently, right?

However, that works um and then um I guess with the the it seems that we we put a lot of um uh rightfully so we leverage our local talent, which is immense here in Berkeley for their ideas um in so the I guess the is there a strong decision making structure.

So they were making recommendations to your office, or you know, to have something in place to in terms of the decision making structure for how the specific um solutions will be identified.

That will be through the community.

Um there'll be a uh an oversight um and we've approached the community health commission um to be part of that process with us.

Um, and um at this point, there's also uh calling for uh another steering committee to be established as we get further down the road.

Um in terms of the medical um the medical implications or how this fits, um it absolutely fits because um when I said integration with primary care and and behavioral health, that's really the huge change that we're seeing right now in the Medi-Cal world, where they're actually requiring that.

So, this is the first year that there's been a requirement on both sides in both silos to work together with the you're probably familiar with the three year action plan that we have to submit and get approved from the mental health commission that has a ton of data, a ton of information before this cycle, that process never touched this process.

They were done in complete isolation.

The state's now requiring, as Tanya mentioned, they're requiring us to work together, and that's all around um our ability to bill and be reimbursed for Medi-Cal and do that.

Um, so yeah, we absolutely see this, and as we look at whole person care, you know, working together um around Medi-Cal.

Also, the health plans are very much involved in this process, and they're required to be.

Um, and uh, which is great because they're responsible for paying for you know for a lot of this.

Uh and so the state, I think was very um forward thinking when they put the requirements together for this, requiring the health plans to be at the table with us, requiring behavioral health to be part of the process, um, and then actually uh a small pot of money uh out of the behavioral fund will come to public health to help convene and coordinate all of this work.

That's wonderful.

That's great.

And uh let's just leave you with a couple points just to keep in mind.

The um, since Alzheimer's is uh dwarfs so much of the other the other cause of death here, um the I mean it'd be great to align with the senior centers and because there have been some ideas about ramping up the senior centers into more than just meeting places for Zumba, but for uh, you know, real health care delivery uh community health delivery vehicles to the community.

Uh and then the heart disease and hypertension, uh, which factors really greatly in my district, um, as well as um two other person that's bull on the bot on the body here.

Um, you know, this someone you're someone in your on your on your body should should be, I guess, aware of the of the city council's measures that exist, um, like healthy checkout, right?

And so that that that program is sub from lack of funds, but we know that um the stores in the in the communities where the heart disease is the highest has the highest concentration of um of heart disease making food right all over the place, right?

Um, not to mention vapes and etc.

Um, so it'd be great to align some of these resources uh to help implement those health-making items that we already have that are just suffering from lack of funding, right?

Um and then uh that's all I can think of.

Thanks very much.

Thank you.

Thank you.

Moving on to Councilmember Blackby.

Thanks, Madam Mayor, and thank you, Director Gilman and uh Deput Director Bustamante for the great report, and thanks to all the team for putting this together.

Um, Councilman, apart and I were commenting about how great the video was, but everything is just really, I mean, we really appreciate the effort and the care that went into this.

Um, I just had a couple of questions and or comments and then questions.

Um, one is um, and Councilmember Bartlettman mentioned that I I really love the focus here on measurable outcomes in your comment again.

If you can't measure it, you can't manage it, you can't track it, and so that's so important.

And so having that on the dashboard and having that basis of information that we can then say, are we improving or not?

It's really important.

I appreciate that.

Also, also your uh focus on this is sort of the first step.

This is the the plan, but so much of this is about the implementation, and what are we gonna actually do in each of these buckets to sort of move the needle?

Uh I'm really excited to see what comes back as you move into that into that phase, so that really becomes an action plan, and there's really things and initiatives that you're tracking back and seeing what happens.

Um, and then last is other people have commented how sobering some of those deltas are on the neighborhood outcomes, especially life expectancy.

I think we all kind of knew that, but to see that so clearly and understand how big the the deltas are, that's obviously something we have to really focus on and improve.

Um, so first question is, um, you know, community health, big topic, very broad, some of which we can have an impact on here locally, some of which uh have factors that are far beyond our control.

I'm wondering as you put together sort of these goals and the objectives.

How did you think about that?

Were there sort of did you intentionally look at some things that were like, oh, that would really be great, but we actually just don't think we can do it?

Are there you know categories of disease or you you'd mentioned drug addiction things before?

So when you came up with those goals, I'm wondering if you if you also looked at other things and sort of said, well, you know, we're not gonna put this in the plan because this isn't something we can do at the community level.

Just curious about that process.

Yeah, I mean, as I mentioned before, I think the the four priority areas um really rose to the surface, and they were the areas that the steering committee um identified as um ones that we want to focus on, at least for the next three years.

Um, and you know, there were a myriad of other findings and um and data that was that was identified in the health assessment, but you know, we wanted to to keep things again reasonable and feasible.

Um, and so the steering committee, um, along with some guidance from city staff identified those areas as ones to tackle first.

And um I think as we move forward um in the action phase, um, that will be that will be it will be critical to really kind of hone down actions that that are feasible and realistic, and things that are within the span of control, and be able to relay that to the community, like this is what um the city has control over, and this is something that we can move forward on in collaboration with the county or with the state or with other community-based organizations, and also be transparent about what's outside of our control.

Yeah.

Just to follow up on that, you you're right.

There's pretty much anything anymore is called public health.

You know, some communities are declaring gun violence a public health crisis.

So it's huge, it's huge.

And what I what I love about what this process um accomplished is that the community told us what the top four are, you know.

And um they they had a quite a detailed process, and they said, This is this is where we want you to focus, you know, to get started.

Um, and so balls in our court.

Um you referenced um kind of a the sneak peek, I think uh page 18 in the actual blueprint where it's sort of the first look at uh, you know, one strategy in each category to advance, and then you know, so resources, workforce belonging across all four of those different subjects, and it again it's kind of exciting to see some of those first, you know, first looks at maybe what some of the actions might be.

When do you think you know in the timeline might be the point where we might see what the first kind of next version of that implementation plan is?

You know, the the next um because again to me that's that's where the rubber hits the road, it's the part that's really exciting.

It's like what are we actually doing?

Um, when do you think that we might just see that?

You know, our goal was to was to start much sooner on that part than July, yeah.

Um but because of budget discussions, that's why we're we're pausing just a little bit.

That said, we're still gonna keep working on this.

So I would hope that that by the time we come back in January of 2027 that we'll have some initial um initial uh I want to keep calling them solutions instead of specific measurable objectives.

Yeah, but solutions that we can share with you.

Okay.

And last question is um, given all that is um again, these are big bold, some of these are big bold goals.

Um, you know, how confident are you that you know we're gonna be able to move the needle on at least some of these, if not all these?

This is Berkeley.

Seriously.

I've never been in a community, and I've said this when the federal budget cuts were were raining down upon us, and I'm like, oh my gosh, how am I even gonna run a public health department?

I said, I know if public health puts a call out to our community for help that they will step up.

And so I'm confident if we do this right and we let the community roll up their sleeves and get involved and help figure out what it's gonna be that that we will move the needle.

Okay, well, thank you so much.

It's really great work.

Thank you.

Thank you.

Other questions from my council colleagues?

I have a few questions as well.

Um so thank you all very much.

I really appreciate just this report and everyone that did work.

I know that these these reports can take a very long time and involve a lot of work.

So thank you.

And I especially appreciate the community engagement that that you have uh intertwined throughout this process.

I think that's really essential.

And you're right, our community does demand that of us.

So um I so I have some questions.

I'm curious about what is the difference between the community health assessment in 2025 and the health status report, which I think you mentioned was the 2018.

I just there's a lot of different reports and plans and things, so um, so the last health status report that our department put out in 2018 um really focused on quantitative data and um data that's collected um both locally and from other um state and regional reporting sources, and some of them also nationwide.

And um the previous practice was that we put out a health status report, I think about every four or five years.

Um that again really focused on the quantitative um aspects of the community's health.

The health assessment is um more focused, well, it does take into account the quantitative data, but it also um engages the qualitative aspect.

So the informant interviews um from community leaders, the focus groups, the community survey, all of that helped to really um build a more comprehensive story and picture of of our health.

Thank you.

Yeah, that's helpful to understand.

Um, and then I was also curious.

Um, in the past, the city prioritized addressing chronic diseases like high blood pressure and heart disease due to the serious racial and geographic uh disparities between communities of color and south and west Berkeley versus the hills.

Is there a reason that this data and the strategies are not included in this plan?

You are you when you say the are you referring to the four priority areas or um, no, I think that in the past they they would show like disparities by these different diseases by sort of the racial breakdown and also geographic breakdown.

I I think it's in here for cancer, maybe, but yeah, I'd have to go back and look.

Actually, where that would be located is in the community health assessment.

And so that will be populating, um, we'll be bringing that forward.

But in terms of the the priority areas, um, it doesn't mean we're not gonna work on that, but it just wasn't one of the main the main areas that they identified.

I see but having that if you're referring to having that data available, that data will be available.

It will be available on the on this on this dashboard that you're showing us.

Okay, great.

Okay, I have some more comments, but I'll save them for later.

Thank you.

Um, I what I want to do now is open it up for um public comment.

Is there any public comment on this item?

Thank you.

Hi, good evening, Mary Sheehan Council.

I'm Andy Katz, I'm chair of the community health commission, and uh speaking as an individual because our commission has uh not had a chance to uh meet since this uh went live.

Uh, but I would like to share that the um, you know, we we've we've received some interim presentations, and we've all seen that the the pillars of housing, community safety, behavioral health, uh, and uh environmental health, they they bring new insights, and we should all take note and reimagine what kinds of uh solutions in the spirit of community prevention and empowerment we can have uh as a result of this work.

But let's think about what CHIP is and what it isn't in this uh format.

Uh, health in all policies is really exciting um uh approach to to take, and I think that's what this is doing is looking at really uh big issues that affect all of us and how and highlighting how they affect our health.

Um, there's a big value to aligning with the future of public health program.

We can access funding through the plans.

There's a lot of benefits to the way the city is engaged uh with with this, uh, but the CHIP is so high level here.

Moreover, it falls short of addressing uh the strategic plan needs for the public health division.

Um so this leaves me with a deep concern that if CHIP would be intended to um address prevention of chronic disease, prevention of infectious disease.

Uh it's it's clearly not doing that, as many of you have have noted in your questions.

Uh it's critical for the city of Berkeley to improve and maintain programs that promote public health through peer-to-peer education, closing gaps in access to care, direct services like public health nursing, and an iterative assessment with a new kind of results-based accountability.

The city needs to move forward with that as well.

So, how will CHIP implementation be positioned to be successful across these pillars that are not traditionally implemented by HHGS?

I'll wrap up I'll wrap up with one more.

You can um you can actually, if you have additional comments, you're welcome to send them to us here.

Thank you.

Okay, thank you.

Good afternoon, Council.

Um, it's Baptiste, um, community health commissioner.

Um, I'd like to firstly second um what my commission colleague just um said, and also to say that um the city has been given a mandate on this this CHIP report.

Um, I think it it fairly concisely spells out um what my fellow community members have want around community health.

I mean, that these four pillars that we've been given um perfectly emblemize what our city is facing right now.

Um, so also um the city of Berkeley now has both the data and the mandate to act.

The Berkeley Wellness Blueprint makes clear that life expectancy in our city differs by as much as 13 years, depending on neighborhood, 91 years in the Berkeley Hills, and just 78 in South and West Berkeley.

That disparity is not accidental.

It is a predictable result of housing instability, environmental justice, behavioral health gaps, and unequal neighborhood investment identified in the CHA, the community health assessment, and elevated in this community health improvement plan.

At the same time, California's future public health framework warns that fragmented categorical and historically underfunded systems cannot meet modern health challenges without stable investment and workforce, data infrastructure, emergency preparedness, communications, and community partnership.

Berkeley cannot adopt the language of equity without committing to the structural investments that make equity real.

This community health improvement plan explicitly states that words and reports alone do not create change without accountability or dedicated funding.

Therefore, I urge the city council and city manager to formally align budget, interdepartmental work plans, and performance metrics with the CHIP's two central goals: closing the expectancy gap, the life expectancy gaps and increasing community power.

That means targeting resources to the neighborhoods with the worst outcomes, as we've seen in South and West Berkeley through the CHIP.

Investing in investing in thank you.

I'll send the rest of my comments.

Thank you.

I know there's lots of talk about here.

It's it's challenging.

Do we have any other public comment?

Okay.

Is there any public comment online for the community health improvement plan?

There's one hand raised that uh that's Matt.

Matt, you should be able to unmute.

Super, hi everybody.

Um, my name's Matt.

I uh was part of the community steering committee that um was uh on this trip.

Um, and I just wanted to point out just a couple of things that may be helpful for our council members, or those that are not as involved with public health to begin with.

I know that a lot of there was a lot of interest in talking about how to improve mortality from Alzheimer's disease, and there are a lot of things that are in this report um that I think push towards um having better primordial uh prevention.

Um, for example, diabetes is a high risk factor of stroke, diabetes is causal of ischemic heart disease, diabetes is causal of hypertensive heart disease, like all of these different things that are pushed at the very top of the city of Berkeley's um mortality.

Um, and you know, all of those things are associated or causal themselves of Alzheimer's disease, um, and other pieces of this are very, very interwoven within all of these things, and I can say as somebody that works for the Department of Medicine at San Francisco General Hospital, that um if somebody is unable to have housing, uh, their diabetes outcomes are going to be far, far worse.

And so I think a lot of these are addressing what are called like primordial prevention levels, so not only should the implementation of that look really really strong at that, but also at the public health programming that is kind of working on um uh you know mitigating those risks.

So just kind of wanted to put that out there for folks that um aren't as familiar with the way that a lot of public health diseases sort of implement.

Thank you.

Oh, okay, all right.

Well, I will move us on to comments then.

Um we have a comment from Councilmember Humbert.

Thank you, madam mayor.

And I want to begin by expressing my uh immense gratitude to you, Director Gilman, to your Deputy Director Bustamante and other members of the HHCS team, Jan Janice Chin or Janus Chin, Kelly Knox, um Patricia Zielsita, and Catherine Roseman.

You know, I apologize.

There are too many other people uh to name, but I also want to thank our partners at JSI and especially members of the community steering committee.

Um the Berkeley Wellness Blueprint is a very candid document, and that's a great strength.

The 13-year life expectancy gap between the Berkeley Hills, my part of the town, or part of at least part of the Berkeley Hills and South and West Berkeley is a stark and necessary finding that should anchor every health and equity conversation we have going forward, and I've heard other people say that in different words.

The four priority areas housing, environmental health, behavioral health, and community safety, those make all the sense in the world to me.

Housing being number one, reflect what residents actually told us and the goals of closing that gap and building genuine community partnership, I think are the right ones.

I'm particularly glad that the plan emphasizes prevention and cross-sector collaboration because health is made in neighborhoods, not just in cities.

Um, but we've got to be clear-eyed about the constraints ahead.

The budget environment is severe, um, that's an understatement.

Federal funding, um, that our most vulnerable residents depend on is under threat.

That's also an understatement.

And the community organizations this plan relies on or absorbing those same shocks uh will not be able to act on everything, or maybe even most things in this document in the near term.

And I think saying that we can potentially a disservice to the community members who invested their trust in this process.

What we can and I think we have to do is use this framework actively where we have key decision points, such as in budget decisions, that's probably number one, departmental work plans, grant applications, equally important.

Um perhaps more importantly, public safety and roadway safety.

And I'm glad that that showed up in the report.

Um, and I think it's more than just what pedestrian safety and bike safety, it's public public safety in general.

Um I'm a little uncertain how we're gonna build out the accountability framework in our in the context of our limited constrained resources, but to the extent we actualize this plan, I think that needs to be a top priority.

I'd ask Director Gilman and HHCS to come back to council or the city manager with a concrete accountability framework, even a minimal one that reflects our current resource reality.

To the CSC members here today, I hope you will stay engaged and hold us to the maximum extent.

Hold us to this to the maximum extent feasible.

So again, a huge thank you.

This is a really important document.

I look forward to this plan being another guiding light in our decision, decision making as we work to overcome these health challenges and disparities that just should be, you know, are absolutely a prime priority of mine.

The disparities are just continue to be shocking.

Every time I see them, I you know, it makes me very sad.

Thank you.

Thank you, Councilmember.

Councilmember Trackup.

Thank you, Madam Mayor.

Uh thank you again, Director Gilman and Deputy Director Bustamante for your presentation, and to all who made this report possible to many people to list.

So I'm not going to I'm so glad that you emphasized the importance of the report being actionable.

I look forward to along with my colleagues on the council to engaging with it more deeply in the coming months and collaborating with you and your team and my colleagues, particularly my role as chair of the Health and Life Enrichment and Equity Committee, to uh look at uh how existing policies do or do not bring the report's recommendations into meaningful effect and where they do not what is needed within our community um through meaningful uh policy um and legislative uh direction.

Uh I will note also was that it wasn't five minutes.

You're gifted some time from Council Member Tapping.

Oh, thank you.

That was that could not have possibly been five minutes.

But I am almost complete.

Um I will note, and uh I I want to echo uh council member Hambert's comments, uh, of course, uh one of the guiding principles is to balance ambition with feasibility, and we have a tough situation on our hands.

I will note, uh, for instance, just around environmental factors, which was uh or environmental solutions such as tree planting.

Um I know that we have lost some needed uh grant funding for that.

Um, how do we backfill or are we able to?

Uh and so within establishing a long-term cycle, uh, the uh the final guiding principle uh laid out.

Even though this is not intended to be an advocacy document, and I recognize it's not, to the extent that this is a requirement by the state, I think uh we would be remiss not to also tell the state this is what needs to be funded in order for us to effectuate uh these goals.

So I I know we have uh another another agenda item tonight around legislative priorities, um, and uh some of this may come up, but I I really uh given that uh every jurisdiction and ours is no different, is trust into this very challenging environment, especially right now where we have to do a lot more with a lot less.

I think we need to be able to use any and every lever of power and opportunity to tell um the state what we need in order to pursue the growth of this plan.

Thank you so much.

Thank you.

Other comments from my colleagues?

Yes, Councilmember or Vice Mayor Luna Parra.

Thank you.

I just wanted to thank staff and thank the community members who have been involved in this process.

This was a great presentation.

Thanks.

Thank you.

Anyone else?

Okay.

Oh, I have a couple other questions that came up for me.

As we were talking about Alzheimer's and dementia, something that I was wondering about is it perhaps a very high cause, partially because people are living longer, so they're more likely to have Alzheimer's and dementia because unless it's early onset than typically folks would be later on in their years.

Can you speak to that at all?

I'm sorry.

We can get back to you on that, but I would I would need to consult with our public health officer.

Yeah, no, that makes sense.

Thank you.

And I think similarly, I was as I was looking at the geographic information.

One of the things that I was thinking about is like, yes, of course, those disparities are quite stark, and I think that that is something that's really concerning to all of us.

Many of us have commented on it.

And I also think that typically, you know, houses that are up in the hills cost more.

You know, houses that you know are in the flats cost less, meaning most likely that people who have more funding would live up in the hills, they would therefore have access to you know better health care, you know, gym memberships, you know, but better just care generally for themselves, but healthier produce.

And so um, you know, of course, there are structural things that systemic things that we need to be looking at our city that might be impacting the geographic um health or age life expense expectancy disparities, and um, and some of those things are going to be sort of embedded in just based on who can afford to live in these different places.

So I just want us to think about that as we're thinking about those discrepancies.

Um, okay, and then and then also I know many of these challenges that we've had are challenges that we've had for many many years, and are you know, not unique, of course, to our city, but are all around the country and the world.

Um, and I'm wondering: are there strategies that we've deployed that have had an impact on these numbers on on improving them?

You know, are there things that have helped us kind of see a jump, or is this sort of like a steady progress situation?

I think the way that I would look at it is more it's just you know, some of these are lagging indicators that that you know you might not see for a few years, you know, as we look at those.

Um, I think that the the thing that's new that we've seen better results on is is breaking down the silos.

Um, and you know, um you know, one of the examples that I use is we may at times, and I've seen this in my department, where we'll have three different city departments interacting with a family, um, mental health side, environmental health side, um, and we're not we're not coordinating care.

So breaking down the silos as we try to move these interventions forward is a big part of what we need to do.

Um, it's also it's also being better fiscal stewards.

Um, so when what the magic happens is when you can get primary care, um, mental health, behavioral health, the social net system all working together.

Um, that's that's where you can start to see the real movement.

I love that.

I think that's really important because it's really about being more efficient with the resources and the systems and the people we have in place already.

And um, and I think that that's important across all levels of our government.

So I'm I'm really glad to hear about breaking down those silos and um and especially given as everyone has commented on already, but just our concerns about our budget deficit, um, 32 million dollars is really significant.

And um, you know, I don't want us to I think Paul has said this to me before, our city manager that you can't you shouldn't be doing uh more with less.

It's kind of really like we need to be adjusting and right sizing and making sure that we're being realistic so that we also don't have burnout because I am particularly concerned about the people who do the work in in our communities and serve these families and see like year after year, you know, I want them to feel like they're seeing results and um that we're actually able to serve people and and help them get better health outcomes.

So I think when I I see this information, you know, what I worry about is just not having enough resources and not being able to like kind of wrap our arms around these massive problems because they are really big problems.

Um, so I appreciate knowing also that there's kind of a process moving forward that you all have to continue to engage the community and figure out like what are these areas that we can be better collaborating, connecting with the community and breaking down those silos.

Um, and that was one of the other comments I was gonna make, highlighting the insight that more transparency and collaboration are needed to increase trust and effectiveness of health improvement efforts.

Transparency, building trust, community engagement are all really important to me.

And I think that again is something important throughout our city.

It's something we've been trying to do on council, even with each other, just you know, connecting with each other and building relationships.

And housing in particular stands out to me.

When I saw last year's community health assessment, that approximately 60% of African Americans and 60% of Latinx households in Berkeley pay more than 30% of their income for rent, it's really clear that addressing housing instability and affordability remains a high priority, and that is a huge priority for me, and I know my council, many of my council members as well.

Stable, safe housing that's free of environmental risks like mold pollution, have a direct impact on health outcomes.

I really also am concerned about people not understanding the their legal um rights around this in particular.

I think so many people that I speak with, especially young people, are afraid to call out when there are these concerns about living in an unsafe housing situation.

And so I do also want us to keep in mind making sure people understand their their rights and their ability to to get health inspections or you know, inspections on the on their apartments if they have things like mold.

I've even talked to my own staff about that, advocating for themselves in that way.

Um, and then I'm really glad to see the plan focus on prevention, especially when it comes to mental health.

Um, and I'm also really concerned about the shift in mental health and behavioral health funding away from prevention and early intervention.

Um, it's just it is concerning to me that some of these shifts that we're seeing, especially from the federal government.

I don't want that to impact how we're doing things here.

Um, and that's really essential.

So just some thoughts that I have on on your report, and just really again thank you all so much for taking the time to come and present this to us and also to keep us updated because I think that's really important.

I think this really helps ground us in, you know, really what's happening with people's everyday lives and how our different policies are potentially impacting their their wellness and stability.

So thank you all.

Um I believe that is our final item on here, and we um and we don't need to do anything to receive it, but I do want to make sure that we acknowledge um the steering committee, so I'll pass it back over to you all.

Thank you, mayor and council.

Um so at this um time we wanted to uh recognize and appreciate uh the 10 members of our community steering committee who were so critical to uh the CHAW and the CHIP development process, and I'm going to read off names.

Um, but essentially the certificate um is appreciating these members for their dedication in creating the community health assessment and the improvement plan and for their service and creating healthier Berkeley communities.

As Tanya reads off names of individual members, if you wouldn't mind stepping up to the front, um and then we'll be ready to um to take a picture.

So I'd like to call up Mikhai Freeman, if they're here, Michael Rodriguez, Caitlin Cole, Penelope Collins, Matt and I know he's not here because he spoke earlier via Zoom.

Thank you, Matt.

Claritza Rios Israel Nicoti Nicodemos.

Rocío Almaguer Andrade, Isabella Ledesma, and J.W.

Fry.

Thank you, everyone.

Oh my god.

My call behalf of the thing.

Come on, you all.

Yeah, so you want to invite our JSI here.

Yeah.

Okay, here.

Thank you.

That's great.

I think that's what I think.

Okay, thank you, everyone.

And with that, is there a motion to adjourn?

So moved.

Second.

Second.

There we go.

Second.

All right.

And as long as there's no opposition, I will have us all marked as eyes, and we will be adjourned.

All right, meeting adjourned.

Thanks, everyone.